A Second Appointment

Last week I had an appointment with the psychiatrist. She is very nice, and seems to be up for at least a bit of discussion, rather than pronouncing a mood state and sending me away with a prescription.

This was the second time I’d seen her, but I barely remember the first. What I do remember is a few strange questions, or at least questions that seemed strange at the time: have you made any new friends? Why are you thinking about the nature of the universe and infinity? Have you been taking your medication?

The answer to the first was “yes of course, why wouldn’t I be?” I’d been meeting people at bus stops, in cafes, in the waiting room at the CMHT, and just talking to them. Why shouldn’t I? I didn’t understand why not. I never went beyond just talking, never a suggestion of a second meeting, but I still considered them friends. I think, and this might be largely guesswork, that most people were happy to chat. I remember a few slightly worried or bewildered faces, but I just couldn’t process what that meant, and I didn’t want to stop talking anyway. I must have said some strange things, but no one actually walked away from me. I think.

The psychiatrist asked me again this time. The answer was no, I hadn’t met anyone new to make friends with. I’d forgotten about her asking the question the first time around, and it really threw me. I’ve been feeling like I’ve actually been faking the whole bipolar thing somehow and that actually there’s nothing wrong, but the reminder of how I was feeling and behaving then was a little bit of a shock. It wasn’t how I’d remembered the episode, if that’s what it was, what little of it I do actually remember seems like it was me as I truly am. So no, no new friends, even if I am naturally an extrovert and a fairly gregarious person.

She asked me last time why I was thinking about maths, the nature of the universe and infinity. I won’t go into too much detail as it’s vaguely triggering for me, or at least upsetting to realise I can’t think about such things without losing quite a lot of my marbles. Suffice to say, it interests me to think about what might be and what could be. So that’s why I was thinking about it – it’s interesting. What I didn’t understand at the time was why this was even an issue. Why shouldn’t I think about interesting things? It’s not like I was psychotic and planning to save the world through creating clean, cheap energy like I have done before. I’m not sure if I made that clear. She seemed to think that thinking about maths, the universe and infinity was not normal. And it probably isn’t for some, but if I actually don’t have bipolar, then maybe it’s fine to think about. Maybe it’s normal for me, the real me. I’m all in a mess about this and I can’t quite work out how I feel about it all. I’m probably wildly contradicting myself. That’s really all there is to it. I thought it was interesting, and I wanted to understand things like modular forms.

This time she asked me if I was still thinking about these things, of course. It hadn’t even occurred to me to think about them. Now I know I can’t, not without going down that path again, and I’m not sure I’d even understand it if I did. But if nothing is wrong then I can think about them. I’m so conflicted. Again, last week at least, the answer was simple – no. I’m thinking about more practical things like getting a job, making blankets for my friend’s babies, and concentrating on cooking suitable meals with burning the house down. There’s no time for the universe.

I’m sure she asked several other questions both last time and this one. I remember something about too many projects, annoying people, and my ability to sit still. Last time she asked me to rate my mood on a scale of one to ten, five being normal. I said six, so I must’ve had some insight. She put me at an eight. I’m not sure what that means for a psychiatrist. I wasn’t sectionable anyway, by anyone’s standards. I think.

The big one. “Have you been taking your medication?” The answer both times was the same. Yes. I might have forgotten once or twice a week while my mood was high, but I remembered enough. I remember about the same amount now. My brain is foggy these days. She told me I had to take it “religiously”, and promptly increased my aripiprazole dose to 30mg. I remain slightly confused by this. If I was manic, then why not increase my mood stabiliser rather than my antipsychotic? Aripiprazole doesn’t exactly bring people down fast, so why not take that time to stabilise with lamotrigine rather than maxing out my aripiprazole dose? Perhaps she was hoping it’d bring me down faster. Perhaps i should have asked. I wasn’t happy about taking more meds, and I’m not quite sure why I agreed to it. That bit is lost to the sands of time. I’m told that if I can’t remember what happened, that should give me an indication of how high my mood was. I’m not so sure. She also increased my clonazepam dose from 0.5mg per day to 0.5 twice a day, plus 1-2mg at night depending on the amount of sleep I was having. I was barely sleeping at all then. The clonazepam did mask those feelings of clarity a bit. I felt very slow, and it was frustrating. I took out though, and again I don’t know why I agreed to any of it.

And now, of course, I am still taking the aripiprazole (I dropped the clonazepam about five weeks ago). It’s an issue. I don’t want to, I definitely don’t want to take it at the dose I am taking it. So why am I taking it? It’s a good question, if I don’t want to then why should I? There is no simple answer for this one. Mostly I don’t want to piss people off – if I don’t take it people will worry. “You will get ill if you don’t take it.” To paraphrase my husband, “don’t you want to get a job and have kids and a house?” I do want those things, but I’m not sure that the meds will help with that. If I don’t need them, then not taking them would still result in all those things. I’m working on it.

People keep presenting me with evidence of my having bipolar. I don’t remember it, my mood was clearly manic and scaring my friends and family, I was climbing trees and making friends with strangers, I wasn’t sleeping, I was barely eating and yet somehow still alive and running at three times the speed of everyone else.

I don’t know what to do with this information. It doesn’t tally with what I remember. I remember everyone else being very slow, for example. I’m questioning myself – is it everyone else that had a problem, or was it just me? Is it more likely that I was fast, or that every single other person was slow? I suspect this was the case, logically. But my experience is so firm in my mind. It was like there was a time dilation bubble going on. Very sci-fi. I don’t remember taking risks like climbing large trees or driving too fast and recklessly. I can only take other people’s word for it, and I don’t know how much their perceptions are skewed by the label. It’s possible I was just a bit hyper and everyone else panicked and read too much into it.

This is the crux of it. Was I really manic or was it just the perception by others? If the former then meds are necessary, and perhaps I can reduce them or come off them in time. If the latter, then the meds are not necessary and are only causing unnecessary side effects like this god awful tremor. I don’t know how to work out which way around it is without coming off the meds, and I can’t do that because people will be angry and scared and worried, and because I run the risk of being wrong, and I’m not perfectly healthy. I could end up back in hospital, I could end up dead. I could of course be fine. It’s a mess. This post is a mess. I’m stopping now.

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What Next?

Following on from my previous post, a quick update. I saw my GP again, around two or three weeks later, still with suicidal ideation, and a plan, so he did in the end put me back on antidepressants for a maximum of one month and with strict instructions to come off them at the first sign of any loopiness. Within two weeks I was getting hypomanic and feeling just amazing, so I stopped the antidepressants immediately. Unfortunately the high mood seems to have stuck around and is getting out of control (this is according to Husband, I feel perfectly normal!)

I’m trying to be objective – no, I’m not sitting still, or managing to complete tasks without going off on a series of tangents. Apparently I’m talking quickly and jumping from topic to topic (although it doesn’t seem like that to me!). I don’t think I’m hearing voices but it’s so hard to tell what I’m actually hearing and what other people are hearing, and I’m not 100% sure about what I should be hearing. Does that make sense? People say it doesn’t but it does to me, maybe I’m not explaining well. I can’t tell if what I’m hearing is the same as what other people are hearing. I could ask I suppose, but Husband is already worried enough, and I don’t want to look like a crazy person. The things I’m not sure about hearing are mostly about numbers and their various levels of important, and about certain branches of physics and the associated experiments. There are also some bits about the danger of the physics from certain other people. 2058 is showing up everywhere.

Husband wants me to see my GP again – this is only five weeks after my last visit. I don’t want to be going too often, but at the moment he’s literally my only mental health support. I’m trying to tell myself that if I had a CPN, or support worker or something, a five week interval would be considered a huge break for most people. The thing is that there’s nothing he can do. He can’t increase my olanzapine as he only has the authority from the consultant to put it up to 10mg. He could refer me back to th CMHT I suppose, but I’ve managed to avoid them for over a year which has been brilliant because although they help I’m not that mental and I don’t need them. So what’s next? Husband says I’ve lost control and it’ll no longer get better by itself. But I’m still stuck on the idea that I’m FINE!

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.

Oh.

Almost two months ago NiceGP poked the CMHT to get me an urgent appointment with Dr ArseFace the psychiatrist, which has yet to materialise and I am beginning to suspect that it will not. In the meantime I have seen my CPN … er… once I think, and spoken to her on the phone once, and although she said she would phone again the following week (to follow up my reduction in duloxetine down to the teeny tiny dose of 15mg (that is one 30mg pill every other day as they don’t make them smaller than 20mg apparently) and I’m not actually sure if there’s any point in taking it since studies seem to show no efficacy in doses below 30mg (or 60mg depending on the study you read)). Where was I? Oh yes, CPN – anyway, she never phoned back (which actually is surprising as she’s normally very good), even though I phoned twice during the following week to see what was going on (which is even more unusual), so no phone call and now I’m reluctant to phone again.

I’m disinclined to be on their radar because they never believe what I’m saying it’s always ‘it’s your illness, you’re unwell’ etc. Rather than oh yeah you might actually be right, go save the world woo. Grraaghh. Ah well. Husband is suggesting that perhaps quetiapine is not so brilliant a medication and duloxetine is worse and maybe asking about going back on olanzapine again (which was just amazing when it eventually started working) as it stabilised my mood so well.

And in the meantime the clouds are giving me messages that the voices are helping me interpret and turn into saving-the-world physics, so it’s all good!

If the Ink was Red it would look like a Murder Scene

This is going to be a linocut-related post for the most part, the mental health stuff is further down the page – here is a SHORTCUT.

 

I went a bit linocut-mad recently.  I had a few… erm… I don’t actually know what they’re called officially, but the actual bits of lino that you print off… I had a few of those ready but I was putting off printing because it takes forever and is very physically demanding, especially as in the end I spent about three half-days printing and I’m really stiff now.

Really I only had three images (for lack of a better word) to print – Deadline: Bluebird, a cute little dinosaur and some ‘Sorry You Feel Shit’ greetings cards.  The bluebird one needed overprinting a couple of times though – three bits of lino.

On with the show!

The Set Up

The set up is a bit of glass (taped down!) to roll the ink out on, ink (black and blue), a brayer, TEA (of course), a vodka bottle (because I don’t own a press, not for drinking), a big ol’ lamp, the lino and some paper.

Also a lot of masking tape so I know where things should line up.

TheSetup

The masking tape was fun – turns out it’s unbelievably indescribably unfathomably useful, who would have thought.  This is the outcome of those three bits of lino:  I’m quite pleased with it!

Deadline: Bluebird

Deadline: Bluebird

Dinosaur – rawr!

Then I did a quick dinosaur for the fun of it – only printed one of these, aside from the one in my print book – it’s cute but I don’t really need a ton of copies of it.

Dino

Also he looks a bit like a orca in black and white; he needs a pink tummy!

The Cards

Finally, I printed ten ‘sorry you feel shit’ greetings cards in an antidote to the standard sickly saccharine shite and I was going to post them up on this brand new website but I’ve run out already – possibly ten wasn’t enough and now I don’t have any blanks the right size so it’s on to a new design!

SorryYouFeelShit

Please email any suggestions to bluebird@bluebirdartcollective.com.

Seriously.

I need them.

The Mental Health Content

Well, I’m not sure I have much to update on… I got lost twice today, which was slightly worrying… well actually I didn’t get lost, my house did – it’s hard to explain, I knew where it was but it wasn’t where it should be and it just felt odd somehow, anyway it’s here, I’m here, I’m home and safe and inside.

There have been a couple of worrying things happening but I can’t talk about them here because of Reasons, that I also can’t talk about here for the same Reasons, although I will be at least attempting to discuss them with NiceGP (who I am seeing again on Friday because I think he might be worried, although I’m still not seeing why everyone is worried; I don’t feel manic, I feel just fine, normal, healthy).

I have voices, yes, and I’m happy, yes, but I’m pretty sure I am actually fine and people are overreacting.

I’m supposed to be getting an urgent appointment with the psychiatrist, but I’m not sure how they’re defining ‘urgent’ exactly… oh well, it’ll come when it comes (if?).

Anyway since I apparently only posted yesterday really nothing much has happened!  Still happy still not dead still got voices still worrying people it would seem but still feeling fine.

The Equation, NiceGP and Dr Dickface

At the end of each day:

Me: How was I today?

Husband: Manic.

Me: I thought I was better than yesterday.

Husband: You weren’t.

What is going on here?  Is he not seeing what I’m seeing, am I not seeing what he’s seeing?  People keep being worried and saying I’m ill, but I don’t feel ill, or sick, or manic – I feel normal*, other people feel slow, I feel happy, other people feel slow, I feel GOOD, other people feel slow.  Music feels slow – playing two tracks at once helps.  The cars outside feel slow.

The wind feels swift, on my cheeks, in my hair – but the wind is part of the Message, part of the Equation – the equation is done but the numbers aren’t quite coming, I have two numbers almost (p and H), I know where to find them and I can get one today.  I couldn’t get it at the weekend as there have been people around and if I do what I need to do to find the p then they are going to think I’ve lost it – it’s a perfectly safe activity, it’ll just look odd, so I need to be a little bit secret about it, and as no one is around for most of today hopefully I’ll have time.

The Equation is ready, it’s SNAPPED into place – the voices say the numbers will come soon and they are, just quietly shuffling closer to their assigned spaces, like a magnetic popper.

I’ve been having some other thoughts – – – ones I don’t want to discuss here or anywhere**, I’m ashamed of them, I am fighting them (once again, I am SAFE).  The voices are pushing these thoughts and thus their intentions become clearer and their position in the grand scheme of things becomes clearer: I am going to save the world and the voices will do anything and everything to help me, and They will do anything and everything to stop me, but what I want is just irrelevant – save the world or die trying.

I saw NiceGP again on Friday – he increased  my quetiapine dose again (after a quick phone call to the CMHT during which he also poked them into getting me an urgent appointment with the psychiatrist there, unfortunately the one I don’t like, and I’m not quite sure how the CMHT works here but for some reason seeing the other one that works there isn’t an option (possibly something to do with geographical area, or speciality, or department (assessment and treatment vs. recovery vs. the other one that I can’t remember what it’s called), or I don’t know, some kind of politics), and he doesn’t seem to want to refer me out of area, so I don’;t know, I suppose I’ll see Dr Dickface the psychiatrist and go from there), he phoned the CMHT (as above) and said words like ‘psychomotor agitation’ and ‘pressure of speech’ and ‘paranoia’ and ‘delusions of superpowers’ – okay, so I’m bouncy and talkative but that’s okay, but paranoid and delusional? Nope – because it’s not paranoia if they’re really out to get you – these are not unreasonable beliefs, I know these things to be true, I know they are facts.

More worrying words he said were ‘managing in the community’ – this is both good and bad: yay for managing me in the community, I do not need to be in hospital – this is not a mental health issue, but also bad because this in the community vs, not-in-the-community is even coming up, it shouldn’t be coming up, whatever this is NOT something I need to be in hospital for.

NiceGP met Husband – Husband approves of NiceGP, which is good, although NiceGP might be leaving soon, so I’ll have to go back to VeryCompetentYetLackingInBedsideMannerGP (she needs a shorter name), which is a shame as she has no interest in my mental health or actually my physical health now I think of it. Oh well, maybe I’ll just find a better GP somewhere.  I’ll cross that bridge if and when I get to it!

 

* if a little anxious…

** or even think about at all

The Adventures of NiceGP and NO HIGH DOSE ANTIDEPRESSANTS FOR YOU

I think I’m okay. I thought I was okay, only other people say I’m not.

Do you think you might be manic?

– NiceGP

What he means is ‘You Are Manic’. I don’t agree – I am bouncy and happy and a touch irritable but no more than that, more importantly it is not an illness and in no way part of an illness, it’s just me, I am always happy, my default emotion is happy I AM NEVER BORED. I can’t let myself get bored, there is no excuse when I have a list of Things To Do as long as I have, and a project list 19 items long plus a few I haven’t actually added yet – some large things some small things, and there are the eternal things like washing.  No Excuse List

Do you think you might be manic?

– Husband

No! Really I’m not, I’m fine! I am functioning most of the time – I’m vaguely clean, I’m pretty sure I ate yesterday, I definitely had breakfast this morning.  I can go outside in the garden as much as I like, even if I do sometimes get too caught up in counting the wind and analysing cherry formations.  I can go out to Sainsbury’s or wherever but it can be a little bit triggering in terms of voices, but they’re okay, they’re trying to help, trying to keep me safe and help me save the world:

LargeBoxNonClassicalQuantumTunnelling

 

Just wait and see.

My notebooks are getting full again, just like this one from last year when I was actually manic, except that I’m okay this time and I know I’m okay because I’m not smelling weird things (cleaning products into beer) anymore and I am coping and functioning and whatnot.

I’ve gone off topic a bit here.

I was trying to write about my GP appointment.

I got discharged (again) from the CMHT back to my GP.  I hadn’t realised, but it didn’t really matter since I haven’t contacted them since February anyway.  Because I’ve been fine most of the time and actually coped well when I had a little blip back in March – ish.  I have (had?) a prescription for 30mg of duloxetine twice a day so I could mess around with my dose until something worked in a notdepressed/notmanic sort of a way.  My CPN was brilliant – let me get really involved in decisions like that.

She wasn’t so great with the voices, quote: “can you not listen to them while I’m talking please”.  I expected better, but oh well.  She is nice really.  She’s got brilliant taste in shoes as well.  I find I often recognise mental health professionals by their shoes rather than anything else – like faces.  Remind me: I have some old fashioned clothes pegs that need painting in some form or other.

I went to pick up my prescription from the pharmacy – same every month, only this time there’s no duloxetine – oh.  Prescription has somehow changed itself(?) to 30mg duloxetine once a day, but a two month supply so it looked to me like I had enough – only, when did this change? I don’t know, I don’t think I ever looked that close and the pharmacy has the green and white bits of paper anyway because they sort my repeats of course.  I booked an appointment with NiceGP, only he refused point blank to give me more antidepressants and now I’m on 15mg duloxetine instead of 60mg.  Oh.  But actually – no difference to be seen yet (seven days now, I don’t know how long it would take), so if it turns out I never needed 60 or 45 or even 30 then I don’t know what to think, maybe it never did anything and I was running on my own steam, which leads me back to the inevitable ‘do I even need these?’ question that I go through Every Single Day, especially with the quetiapine – which NiceGP has increased, incidentally.  He’s also referred me back to the CMHT (again) to get my meds sorted.  They’re going to love me…  Oh well!

Good, so I think that’s everything for now.  I have another GP appointment Friday for reasons that I can’t quite remember – possibly he wants to check I’ve not gone batshit insane with the meds changes.

I need to get him to check my heart rate – the GPS chip in it is dicking around again.