I was wrong

I was wrong in my last post.

I knew about the triggers but I’d missed the early warning symptoms. Why am I still so bad at this? Sleeping too much, things smelling weird, low mood.

And now I’m struggling. I badly need a wash but actually getting off my arse and getting in the shower seems so hard. Why can’t I do basic things? I can’t even concentrate on this post, let alone things I actually need to do. How am I supposed to hold down a job, even if anyone would actually employ me.

I’m struggling a bit with ‘thoughts’ and external headnoise around drinking tap water (is it poisoned?) and taking meds (do I really need them, are they also poison?). It’s making life tough.

I’m trying to keep up that happy mask, but Husband has realised I’m down, although my parents haven’t – so that’s half a win. I think. I just want to sleep.

What do I do? I can’t see my GP again, I’m there too often, I went less than two months ago. There’s no one else to help, even if there was anything anyone can do. My GP wouldn’t be able to do anything other than re-prescribe duloxetine, which makes me manic, and brings the cycle back around.

I’m just sick of this and I can’t see a way out (no active plans to kill myself, although the thoughts and external headnoise are making it hard).

I can’t win.

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Limbo

I am not unwell at the moment, or at least as well as I’m ever likely to get. I’m encountering triggers and dealing with them well, for the most part. I did get a few early warning symptoms earlier this week – strange smells, strange noises from outside my head, slight sleep disruption – but again, I’ve managed them well and I’m not slipping too deep into an episode. It’s really bizarre! It’s like I’m walking on a knife edge, waiting to fall into mania or depression. It’s like I’m walking on eggshells, trying not to crack myself up. There’s a real feeling of being in limbo. Waiting.

I’m also in limbo in life outside mental illness. Husband is (hopefully, essay results allowing) about to start is third and final year of his mental health nursing degree, and is going to want to move out of my parents’ house as soon as possible, which means I need a job.

Jobs are difficut things because I am having to be really constrained about what I’m actually able to do without losing my marbles. I need a low stress job, so the field I originally trained in and have experience in is now off the cards. This is really disappointing – I want to be abe to do what I enjoy, but that isn’t an option anymore.

I know I’m lucky to be in a position where I can even consider employment.

I need a purpose in life, and I’m losing that with every successive episode. I’m scared my whole life is going to be a constant fight against triggers – and that’s exactly what it is going to be. Maybe this is true for everyone, but I don’t half feel alone in it.

I want a job, a house, kids. It’s getting increasingly unlikely I will get these things.

What happens if I get a job and can’t handle it? Would I qualify for ESA, housing benefit and the like? Would that even be enough money to live on? How is it affected by Husband’s job? All my care is provided by my GP – I don’t have a psychiatrist or CPN, so coud I still even apply for ESA given I’m not seeing a specialist? I suppose the answer is to go and ask CAB, but I’ve not given up on the idea of working yet.

Maybe I’m less well than I think I am. Now that I’m thinking about it. I’m going to bed at 8pm because I run out of ideas of what to do, asleep by 9, waking up 10 or 11 if there’s nothing else for me to be getting on with. It’s so hard to wake up in the mornings. It’s a bit hard to take my meds at the moment – the internal voice (the one everyone has, not a psychotic voice) is saying I don’t need them, there’s nothing wrong with me, I’d be fine without them. I’ve been quite open with Husband about this, and he’s helping out by reminding me that I do need them as I go far off the rails without them.

It just feels like one big mess at the moment. I dare not move for fear of pulling the tangle of threads tighter, knotting myself. I’m “being kind” to myself. Even though I don’t feel I deserve it.

Trigger – early warning – relapse – remission, trigger – early warning – relapse – remission, trigger – early warning – relapse – remission.

Mixed Episode

I think I am having a mixed episode, my mood graph seems to be mapping a steady high-low-combo,, and I’m all messed up, full of energy, no energy at the same time. The worst thing is this need to do something but an inability to focus, or even decide what I want to do, I’m just wasting time and unable to distract myself from all the THOUGHTS whirling round, good and bad. It’s slightly easier to deal with when I’m on my own – I can pace up and down, dance, fidget, these things I am able to do – but when Husband is home he expects me to focus my attention and achieve things, which sometimes is just not always possible.

I’m on my third notebook now, I’m slowly saving the world but I need to build things now, which is also something I can’t do when Husband is here because he doesn’t believe I’m saving the world. Messages are coming clearer through through the TV.

The Voices are saying to hurry up, “you’re running out of time”, save the world or reset – be reborn. Reset back to when it was safe, when I was safe, before They knew about me and knew I was chosen. How far back is that? I can’t say for sure, could it be before the Voices came, it could be, but there is no evidence to say when it will be, I don’t know when I was chosen, but I think, I feel, it might be early 2012.

I can’t go on like this.

Husband wants me to go and see the GP but I’m not sure what the point is – Husband wants my olanzapine increased, but I don’t see the point in that either. I’m sure the GP will be happy to increase the medication, maybe he’ll let me go back on antidepressants too, because then I won’t sleep even my current couple of hours, so I would get even more done (although given my concentration).

How to deal with mania RIGHT NOW

When I’ve looked around, at books and on the internet, I haven’t found anything particularly useful for dealing with mania and hypomania RIGHT NOW (except this). There is a lot on spotting early warning signs, lots about making sure you sleep well, keep a routine, and eat properly, but nothing about what you yourself can do if you’re already past that point. The articles point you in the direction of doctors, therapists, and whatnot, but what if you’re on a bus somewhere and you need to calm down, stop talking to everyone around you, and sit still (or at least still-ish).

There’s nothing you can do to stop the mania in an instant, but I thought there might be techniques around that at least allow you to get home without getting sectioned. Or techniques you can use that get you through until you can talk to mental health professional.

Paced Breathing

Now Matters Now have a series of short videos on dealing with suicidal thoughts and anxiety, one of which is paced breathing. I’ve found this technique really useful to slow myself down physically, although it can take quite a lot of concentration to do more than a few breaths.

But a few breaths is enough! It acts as a sort of reset button, so whilst your physical agitation is likely to start up again any second now, it gives you just a short break. It takes so practice, but it’s well worth it.

I found paced breathing much easier when using the app they recommended in one of the videos (Tactical Breather for Android). The addition of a graphic really helped me to visualise the breathing.

Make Lists

I have a list of short, achievable tasks stuck to my wall for when I have no concentration but I need to do something. Think about what you could reasonably achieve right now. Some suggestions:

  • tidy a small area of one room
  • do a small bit of weeding in your garden
  • paint a 10×10 cm square of paper
  • colour in one page of a colouring book
  • put together a playlist

Exercise

Subtly.

Office exercises can be really quiet and strangers wouldn’t necessarily see anything you’re doing as more than a stretch. If you have the option to stand up there are some different exercises you could do. Just make sure not to overdo it – this is just a way to fulfil the need to move without other people noticing. Keep drinking water.

Use ADHD Techniques

Sometimes techniques for managing ADHD can be useful for dealing with some of the symptoms of mania.

In one technique, you direct your verbosity towards questioning your own actions. For example if you are pacing restlessly around your house, you would ask yourself “why am I pacing around? It’s because I’m agitated, I can’t sit still. So what should I do to stop pacing around? Maybe I could do some exercise.” This questioning of your actions forces you to slow down physically which can in turn slow down your thinking. Similarly, deliberately slowing down your speech can help to slow your thinking.

People with ADHD find making a plan for the day (or the next hour or two) helpful, and this goal-orientated approach can mean that some important tasks are actually achieved, for example at 12:30 pm I am going to make a sandwich and eat all of it. This is especially good if you have trouble remembering to eat and drink.

Break things down into short, achievable tasks. When it comes to complex things like cooking dinner, I find it impossible to work out the order of events, ingredients, and the like. Things get burnt a lot. If I can write down all the ingredients, and get the exact method down on paper then things get burnt less. Obviously making the least is a feat in itself.

Write

There is often, for me at least, a need to write and write. There are lots of ways I can deal with this and actually it’s quite a good technique because it keeps me relatively still and unobtrusive. I usually start out trying to write what I’m feeling and end up just writing out rhyming couplets over and over. You can also just write out the text from any book or website, just to feel the ink go on the paper. Some people do the same but with typing.

Dealing with Psychotic Symptoms

You can also write to help deal with psychotic symptoms – if you hear voices, writing down what they say can be a really useful way of acknowledging them without alerting other people.

If you really need to talk to your voices and you’re in public, put your phone on silent and pretend someone has rung you. That way you can say what you want and people won’t think anything more of it than they would if anyone else was on the phone.

If you’re agitated, use the paced breathing technique as above.

 

 

Obviously none of these things will ever cure mania, but they might just help you get through the next minute or hour until you can see a mental health professional, or talk to someone. Follow your crisis plan (if you have one).

As always, if you feel like you want to hurt yourself of others, go straight to A&E. Disclaimer over.

Rapid Cycling

When I was at university, yeaaaars ago now, I would cycling up and down pretty much daily, which was horrible and I hated it, but as I got older my mood episodes swung towards longer and more pronounced… things, which whilst also horrible, at least I could plan around them, and it also meant that I got long periods of stability in between. So now I’ve just switched from quitealotofquetiapine to alittleolanzapine and it’s not doing its job – I’m up to my ears in voices (pun intended, or whatever it is), my mood has switched three times in the last three weeks and a do.not.like it. I saw my GP today as an aside since my blood test results came back and I’m anaemic (10, but the worst it’s ever been is 8 – I work on “can I get up the stairs without getting out of breath?” if yes, I’m not that anaemic, and as I can I thought I was probably okay, but apparently this is an ineffective scoring method probably because I’ve got so used to it. Maybe running will be easier now, I always struggled with my respiratory system giving out before my muscles) and whilst he was concerned about mood (and some other things I may have talked about but I don’t want to if I haven’t already, here anyway – just don’t want it where They (you know who I mean) can get hold of it) he just didn’t have the time to go into it properly. He’s an amazing GP, but I can see the NHS stifling him.

The olanzapine isn’t doing its job, and there’s no one to call to help – I think I’ve talked before about the lack of accessible services in my area, I’m on meds, I should be well, so I don’t get any help. I do wonder if they’d change their minds if they actually talked to me though. I’m appalled by the lack of care I’ve received – some stats: I haven’t seen a psychiatrist (outside of the hospital admission in November 2013) since February 2013; I haven’t seen a mental health professional at all since August 2014 (ish, I can’t be arsed with looking things up), and god knows I’ve NEEDED to! I’ve seriously considered making a complaint, perhaps via PALS, but to be perfectly honest I’m not sure it would achieve anything other than get me blacklisted by the CMHT, and they’re really nice people besides, they just have limited resources.

I’m looking at other options for getting help – private is too expensive, although my parents have said they could pay for 3 or so sessions to get my medication sorted, but that won’t help with things like applying for benefits/jobs and other services the CMHT have (or at least used to have). The wonderful Sean has pointed me in the direction of Together UK, which looks like it could be useful. It’s hard though, I really don’t have the brain functionality to sort this out right now and Husband and my family all have too much on their plates, I can’t ask more of them and Husband (although he feels like a dick doing it) really doesn’t like me when I’m manic (and of course I don’t blame him, I’m horrendous) I don’t want this! The Voices aren’t helping with the whole thing, I’m trying to pretend I don’t hear them but I don’t know how well it’s working. Maybe people have noticed.

The Things We Gloss Over

I’m coming down from this high, once again I’m wading through treacle, as my GP so wonderfully puts it. Only this time it seems the treacle is sucking me down into its dark syrupy depths. I’m hoping that it’ll let me go and I can wash off the goo and get back to life-proper.

My GP changed wrote to the CMHT and asked for them to advise on medication. He didn’t ask for a referral, which is a shame as there are some things (mostly work-related) that I could have used some help on, but never mind. The psychiatrist (previously referred to, I think, as Dr Arseface) advised that olanzapine would be “appropriate”, so I have that now. This is a Good Thing – I was at my most stable (mood-wise, more on voices, etc. later) when I was on olanzapine, and only came off it as Dr Arseface sent the old GP a letter (I was copied in, gosh I’m so honoured to be included in correspondence about me!) simultaneously discharging me from CMHT care to primary care, and telling the GP that I should come off olanzapine over the course of a few months.

Of course I went batshit insane.

The beginning of this blog chronicles those adventures, that were pretty much repeated last summer but even worse, and seemed to be ramping up for this summer too, but hopefully olanzapine will keep things a bit more level.

Olanzapine has never completely got rid of the voices and it’s-not-paranoia-if-they’re-really-out-to-get-you (hereafter referred to as INPITROTGY). Other meds have been better – haloperidol was the best. No one wants me taking two antipsychotics so it’s a case of choosing what I can deal with least well and medicating that. Chances are that once the olanzapine gets going the voices and INPITROTGY will ease off to at least a manageable background level as before. I’m definitely not taking haloperidol ever again, since it made so horrendously, deeply sad.

And that is why I’m hoping the treacle lets me go – I cannot take antidepressants as they make me loopier than a roller coaster made of colourful American cereal. Mood stabilisers also don’t seem to be an option – my one and only OD was partly formed of depakote and so I can never ever take it again, just the thought makes me sick. Lithium scares me, seems to involve too much in the way of organisational powers (blood tests, don’t eat this, drink that…). Lamotrigine hasn’t been mentioned but I think I remember something about my local trust not prescribing it once upon a time, so that might be why.

I’m trying to pull myself out the treacle too, of course. I’m not passively accepting my treacle-doom (I may have taken this metaphor too far…). I’m keeping to my routines (as far as I can – so sleepy now), doing all the Things That Should Be Done. I’ve been over these before.

The hard thing is keeping that mask in place, glossing over all the “abnormal moods”, trying to keep my face mobile (apparently flat affect is an issue no matter the mood). The thing is that even when I am functionally well, my mood isn’t (alwaysusuallyoften?) affected by events that happen around me or too me. We had to have my cat put down; my gorgeous beautiful grey ball of fluff, and whilst I cried, a lot of those tears were crocodile. It wasn’t that I didn’t feel pain at his death, it wasn’t that I didn’t sympathise with my family’s sorrow. It’s hard to explain. I think half of the hardness is that I don’t want to admit it. I couldn’t not feel happy any more than a “normal person” could not feel sad. I felt all sorts of things in one go. I would love to have situationally appropriate moods, but my moods do what they want when triggered by … (see previous lists…). This is what we gloss over – I’m never “well”, I will never be “well”. “Well” to me means more to me than just functioning – going to work, looking after other people, cooking, cleaning. “Well” means feeling the right things at the right time: being able to grieve; celebrating getting engaged; being able to help friends out with problems, or being happy with them, without having to carefully arrange my face and words. I don’t mean that these moods are necessarily abnormally high or low, just in the wrong place at the wrong time.

Of course sometimes moods and events do line up, but that feels more like chance than design.

 

Okay, enough complaining. Here is a grumpy owl to make up.

The Grumpiest Owl

Propanolol

I had a really positive GP appointment today, after all my fear and anxiety!  I’ve got a bunch of propanolol which so far is amazing – I’m chilled out enough now that I can work on my world-saving project without being paralysed by the fear that MI5 are going to be crashing through the door any second.  I mean, they might!  But I will deal with that when it comes to it. The Signs I’m seeing around at the moment indicate that I have some time at least, I’ve got some important designing and building to do but it’s all got to happen quietly and in secret because I think my family might interfere; they tell me I’m unwell and I can’t do these things – I’m hyped up, hypomanic maybe, but I’m not that ill!

My GP is also going to see if he can talk to the CMHT and get my quetiapine changed to the glorious olanzapine (which had better work after me singing its praises for the last couple of years!), or get me referred to them if he can, but god knows if that will happen – they don’t seem to accept referrals for reasons that aren’t entirely clear, I’m wondering if it’s a case of you’ve had therapy, you’ve got a decent dose of meds, you should be better and you’re never allowed to relapse ever. We’ll see, GP is going to fight my corner as best he can but there’s only so much he can do, especially as he has however many hundreds of other patients to deal with (including but not limited to “little old ladies who get angry when [he] can’t get rid of their arthritis”). He made me laugh when he (jokingly!) suggested using the mercury in his blood pressure machine to blow up the Tories.

In other news, I’ve been having a bash at drypoint etching. I drew out a cat (which took longer than I care to admit), I spent ages faffing around trying to get his feet right, and eventually realised that in each of the earlier iterations they were far too neat – a cat is at its most catlike when it has feet all over the place. The actual etching part of the process was incredibly easy, but getting the pressure right and getting it inked up was a little tougher.

image

So here’s the cat, or at least one of the first prints, and I’m hoping to get some mooooore done Tuesday! Okay, on to the Important Project!!