Archive for insomnia

The Latest NHS Complaint

Posted in Mental Health Diagnoses, Moods, Triggers with tags , , , , , , , , , , , , , , , on Monday, 4 January, 2010 by Pandora

The week before Christmas, I had to see a GP that I don’t normally attend, owing to the fact that LGP is so popular that I couldn’t get an appointment with him. The appointment was mainly to confirm the diagnosis of IBS, given as I had a number of blood tests to rule out other conditions. The below, addressed to the surgery’s Practice Manager, details what took place in the appointment.

Dear Sir or Madam

Re:​ Complaint

It is with regret that I am writing to you in order to make a complaint about an appointment that I had with Dr Arsehole on Friday 18 December 2009 at 8.40am. In particular, I wish to make my views known about Dr Twatbag’s dismissive and patronising approach in relation to my health issues.

The appointment was primarily scheduled to discuss a physical health problem. I had been told previously by a colleague of Dr Shithead’s that medication was available to assist in the management of this condition, a fact that Dr Wanker confirmed. However, he then refused to prescribe me anything to alleviate the severity of my symptoms, citing my age without providing any substantive reasoning. I am baffled as to the relevance of an individual’s age to their need or otherwise for medication, and was not offered an explanation. Furthermore, Dr Knobjockey chose to fixate on my weight at this juncture. I do recognise that I am overweight, but as intimated to the doctor, have recently been dieting and exercising, resulting in the loss of over three stones. Despite my attempts to make this clear, the physician continued to speak condescendingly to me about the strain on resources that the “obesity epidemic” is causing.

However, it was a discussion around my mental health that caused the most offence and which, in my view, demonstrated not only a lack of sympathy for mental illness, but in fact ignorance surrounding this group of health conditions. When I asked for medication to help combat insomnia and anxiety, Dr Bollockfist refused, in an irritable and frankly almost hostile fashion. In the past I have been refused these medications, and would certainly not issue a complaint on those grounds alone. However, I do not think it is unreasonable for me to have expected this request to have been denied respectfully and sympathetically, with an explanation of the reasoning.

Regarding my chronic sleep deprivation, Dr Cuntfeatures unhelpfully told me that a lack of sleep, no matter how long-term, “won’t kill [me]”, failing utterly to offer any practical help or advice on the matter. Perhaps this is, literally speaking, true, but this denies the extremely serious effects a lack of sleep can have on normal daily functioning. I am also fairly sure that this does not constitute professional advice nor assistance. I should not have to point out that forced sleep deprivation is used as a form of torture.

Dr Bastardface discussed insomnia that he had experienced following a personal bereavement; whilst obviously I have the greatest sympathy for his loss, I fail to see the relevance of the example, and indeed believe that the implied suggestion was that because my insomnia is not necessarily circumstantial that it is therefore somehow less real or less deserving of attention than a lack of sleep caused by a distinct traumatic event. He then, to my astonishment, point blank denied a connection between psychotic symptoms and insomnia. Might I be so bold as to suggest that Dr Dickhead researches this more fully; insomnia is, in fact, well known to cause or increase psychosis and the symptoms of psychiatric illness (source).

In discussion of the illnesses that (at least in part) contribute to the aforesaid, I was dismayed by the allegation that I was simply trying to “medicalise” my conditions. I do not believe this to be fair at all – I am presently undergoing intense psychotherapy and merely wish to try and manage my symptoms until it has reached a satisfactory conclusion (incidentally, please see the enclosed letter to Mindwise regarding the disturbing possibility of a premature cessation of this necessary process. If I cannot receive psychotherapy to sort through my illnesses psychologically, I fail to see what choice I have but to seek medical intervention). I would add, also, that even if I were ‘medicalising’ my illnesses that they are, indeed, at least partly biological. Borderline Personality Disorder is thought to exist in individuals with a biological predisposition (sources) and bipolar disorder is considered primarily a medical illness (sources). Both are, of course, considered serious mental illnesses, having disproportionate rates of psychosis, suicide and self-harm (sources).

Incidentally, I noted with interest that my file does not reflect these diagnoses, still stating that I suffer from depression and anxiety. Whilst these co-morbidities do exist, my primary diagnosis is BPD (with psychotic features) with a differential diagnosis of bipolar disorder, type II.

Overall, it was not so much what was said that upset me (though I felt that to be lacking too) as the manner and tone in which it was said. Although I felt Dr Bellend’s response to my physical complaint was inadequate, it was at least presented fairly amicably by him. His attitude to my mental illness was, however, dismissive, unsympathetic and thoroughly unhelpful – I would say it bordered on disdainful, indeed.

Whilst I appreciate the subjectivity of this judgement, I would hope that the fact I have never made a complaint about [the practice] in my life until now would indicate that I am not wont to take things out of context. Unfortunately I got the distinct impression that the physician was dubious as to the sincerity of my illnesses and that it was felt that I did not have ‘real problems’ (though should he require a list of traumatic events that have helped to contribute to my psychiatric illnesses, I should be happy to provide same). It is sad that such stigma is not only present in society, but apparently in the medical professional also. Dr Cockhead, like anyone, has a perfect entitlement to hold such a view privately, but given his chosen career should not allow it to impinge on his professional practice.

I would like to make clear that, in general, I have felt very much supported by the professionals at the practice – in particular, I would like to thank [LGP], [the Nurse Practitioner] and all the nursing staff for the support, respect and professionalism that they have shown me. I have also had the pleasure of having positive interactions with Dr Ballbag in the past, and would therefore hope that this incident merely represents a ‘blip’ in the professionalism of his practice. However, given the distress it caused me and the apparent lack of awareness that it represents, I felt that it was imperative to bring it to your attention.

Thank you for your time.

Best regards.

Yours etc.

Enc (of the letter to the advocacy service).


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Hearing The Voice (and Other Psychoses)

Posted in Everyday Life, Medications, Mental Health Diagnoses, Moods, psychiatry with tags , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , on Thursday, 1 October, 2009 by Pandora

I’ve mentioned the voice quite a bit lately, but I haven’t really gone into any detail about it. Largely, that’s because there’s not really a great deal about him to discuss. Still, I thought I’d make my best effort, as quite clearly hearing voices represents psychosis (or at least something odd), which clearly does not resemble anything approaching sane.

Let me start by introducing the voice. He is called Tom. He didn’t tell that he is called Tom – he just is. As discussed in the last couple of comments here, I don’t know why. I just thought of him as ‘Tom’ from the beginning, without consciously doing so. I thought about other names thereafter but dismissed them; ‘Tom’ still seemed the most appropriate. It just fitted.

You see, he sounds like he’s in his 30s – roughly speaking, anyway. One of the alternative names that I considered was ‘Ernie’, but that makes him sound like a sweet old man, and he’s not.

So he’s not old, but is he ‘sweet’? I’m not sure that that’s an appropriate description – not entirely. Nevertheless, many normals seem to believe that voices heard by mental freaks are all persecutory, or compelling the voice-hearer to commit heinous acts, or trying to convince the hearer that things of considerable distaste are imminently going to happen to them. Clearly, this happens quite a bit in this particular type of hallucination.

But not in all cases. Tom, so far, is none of those things. He’s friendly, comforting and reassuring and no doubt if I raise this with C – and I don’t think that I will – he’ll say my compassionate, vulnerable self is looking for an outlet, and it has provided it in Tom.

Hmmph. I’m more inclined to believe that Tom is a side effect of Venlafaxine, but it doesn’t really matter. Well, OK, it does, as hearing Tom speaking to me has implications for my diagnosis/es and, potentially, medication (and, again, C would no doubt say psychotherapy). But it doesn’t matter in the sense that I don’t mind Tom being there, and in that sense the reasons for his ‘existence’ don’t matter much to me.

Obviously, the voice is male, and as stated sounds circa early to mid 30s in age. I have more difficulty describing his accent. I keep wanting to say ‘normal’ or ‘non-accented’, but of course everyone has an accent so that fails at the first hurdle. I suppose he must be Northern Irish, but he doesn’t have some of the strong accents often heard here. Neither does he sound like a toff. An average, middle-class bloke, I’d say.

As to the content of his speech, it is totally innocuous stuff. The first time he spoke, he just said my name. That was a bizarre, surreal experience. I was alone in the house and the neighbours were out, so I knew there was no one there. Still, I walked in and out of each room to check, just to be sure. One thing it wasn’t, though, was frightening. Just one of those “what the fuck?” moments.

Since then, Tom will talk about stuff like the weather, what I’m watching on TV, what I have planned for the next few days. Utterly mundane and unfathomably dull smalltalk. However, he sometimes (not always) gets involved when I’m going mental. For instance, when I was losing my mind over the stalker the other week, he started talking to me. He was trying to be helpful, but unfortunately he wasn’t particularly. There is an inherent irony and curiously black humour in the fact that a voice that isn’t fucking there is trying to tell me that a visual hallucination is also not a part of what is understood to be reality.

The SHO I saw a few weeks ago – in the majorly fucked-up psychiatric appointment – asked me something that surprised me, though it really shouldn’t have done. She said, “is the voice inside your head?”

The obvious answer, from an outsider’s perspective, is “of course it fucking is”. But, in actuality, that would be false. Tom doesn’t sound like he’s ‘inside’ my mind – Christ knows there’s enough battling sides of myself chattering away in there, arguing interminably with one another. No, Tom sounds like he’s sitting or standing maybe two or three feet from me. Usually he’s on my right-hand side (my right-hand man?!), but sometimes he’s behind me. It’s odd; obviously I know he’s a product of my mind, but it really doesn’t feel (sound) like he’s in it.

I often reply to Tom, but not necessarily audibly. I might direct a thought at him – which apparently he can hear – or whisper ever so softly. Because I know he’s not real, I feel terribly silly about speaking out loud to him, even if alone. Even if there’s no one else there, I can’t bear the idea that someone might witness me talking to the shitting air (in fact, this has just reminded me of a long-held delusion – so long-held I’ve had it since I was a child; that someone – Mum, the paramilitaries, the government – had rigged secret cameras everywhereI was, and that they were always watching me. How come it’s only now, as I become more deranged by the day, that I’ve realised that that’s just a teensy-weensy bit abnormal?!).

So, overall Tom is not a bad thing. Having said that, I have heard of cases wherein the voice starts off to be completely benevolent, gaining your trust – only for it later to use that trust to manipulate you. I don’t necessarily think that’s as common as the media would have you believe – but it can happen. I hope I can retain enough rationality to recognise it if Tom ‘turns’; I do think I mostly have that quality, at present at least.

Which brings me to another point; since I recognise that Tom isn’t real, is he even a hallucination at all? Psychoses, as I understand them anyhow, require a clouding of the lines between reality and non-reality in the perception of the psychotic individual. In my case, that is definitely true of my delusional and paranoid beliefs – well, when I’m actually experiencing them anyhow. Yet I always know Tom isn’t there, not really. As for the main other hallucination that I experience – the shapes – well, I’m not actually sure about them. I think I know they’re not real, but perhaps because unlike Tom they are hostile, I feel greater distress over them. Bizarre stuff.

I briefly alluded above to the implications all this has in diagnostic terms. Psychoses are, as far as I understand it, not part of either BPD nor bipolar II. They can be part of bipolar I, whilst in mixed or manic states, but I haven’t been given that ‘upgrade’.

In fact, VCB made no reference to my diagnoses on Tuesday (not in relation to this material, anyhow). It’s possible that she considers Tom, and some of the more extreme delusions, to simply be a Venlafaxine side-effect (it’s uncommon to experience psychoses owing to it, but it’s certainly not unknown either). That is a viable explanation, especially given the timeframe of these symptoms’ arrival – but it can only explain some of the psychoses that I experience. Clearly, a lot of the paranoia was there well before I took this medication, as were the shapes. Both were, in fact, there years before I took any medication on a regular basis.

I’ve just remembered yet another childhood delusion (though not one I experience any longer): every night, when I went to bed, I was utterly convinced that an IRA gunman was on the landing, and that I was imminently going to be shot. Every creek or noise was evidence of him (or her, I suppose) being there. I used to creep out of bed and tiptoe, terrified, to the door of my room. I’d stand there, paralysed with fear, for a minute or two, then take a deep breath, fling open the door and look round the corner. Of course, the landing was always empty. Of course, that did not reassure me the next night.

This one is more understandable in some ways, as I was a child when The Troubles were still (to some extent) ongoing. The fact that I ‘grew out of it’ would support the idea that it was entirely circumstantial and not remotely organic nor chemical. Having said that, no one to whom I’ve relayed this story – including people that grew up or lived through the very worst of The Troubles – experienced anything similar.

I’ve recalled that one at various points over the years, but I seem to compartmentalise a lot about my childhood, so I hadn’t thought about it in some time. Ha – this post is turning into quite an education for me.

So anyway, my point had been that the psychoses kind of (or at least potentially) screw with my diagnoses. I’m not saying that I don’t have what VCB diagnosed me with in June, merely that there is maybe additional stuff which runs co-morbidly with it. Possibilities would be bipolar I (which as stated previous can produce psychoses – if this was correct, obviously I wouldn’t have bipolar II), schizoaffective disorder, bipolar subtype (this is my current self-diagnosis, even though I hate the idea) or even psychotic depression (if you can get that with mixed/manic states?). Yay! Of course, an alternative point of view is that I don’t have anything other than that with which I have already been diagnosed. As VCB told me in June, it’s not always just as simple as fitting people into one diagnostic box; some people present with symptoms that don’t fit with any specific disorder. She claimed it was not uncommon.

In conclusion – is Tom a good thing? I think that remains to be seen, to be honest; I don’t encounter him frequently enough at the minute, nor has he been ‘there’ for long enough as of this moment, for me to have formulated a definitive view on that. Having said that though, as of now he is certainly not a bad thing. I like him. He’s nice to me. It’s a start. InterVoice International argue that many people that hear voices should actually embrace them (assuming they’re not harmful, obviously) and not view them as psychotic or part of some disorder. I don’t agree entirely, of course – it sounds like PC Mad-Pride-esque nonsense to me. On the other hand, I can see the rationale for such beliefs; if your voice is benign, why not accept it – befriend it, even? (Incidentally, InterVoice’s website is well worth a look if you or someone you know hears voices – it has oodles of resources, information and real-life experiences there for your delectation).

I most assuredly do not like the delusions nor the shapes, though. Therefore, if it gets to the stage where VCB thinks I should take an anti-psychotic, I will gladly do so. I recognise they’re not necessarily miracle cures for psychotic symptoms, and in fact I’ve read that they don’t always eliminate the psychoses entirely anyway – they just lessen your reaction to them. But I would expect and hope some positive outcome in dealing with the delusional beliefs.

If they have the effect they’re meant to have (if I ever even get any, of course), then they’ll probably kill Tom. I’m not entirely thrilled with that idea, I have to be honest, and I will feel guilty for doing it. But in order to live a functional life, some bad things are necessary evils, and while I really don’t want Tom to go, ultimately, with regret, he may have to.


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What’s Annoying Me Today, and Ruminations on Seeing the Psychiatrist

Posted in Everyday Life, Medications, Moods, psychiatry, Triggers with tags , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , on Tuesday, 29 September, 2009 by Pandora

Well, fuck me, but didn’t the VCB actually manage to bother her arse seeing me today.  Will wonders ever cease?!

I took my Mum with me to the horrible, dilapidated, thoroughly depressing place as I wanted VCB to see that I was nervous about seeing her.  And was I nervous, oh yes.

I had had about half an hour’s miserable sleep on the sofa so was completely mentally fucked in any case.  This made the drive to my mother’s somewhat interesting, but anyway, she drove onward from there.

I began to regret requesting my mother’s company within minutes of sitting in the waiting room.  In my attempt to not appear mental and hyperventilating, I was a bit mental and hyperventilating.  I was rocking back and forth in the chair and covering my face with my hands.  The other nutters that were there had the courtesy to pretend they didn’t notice – initially, anyway.  When my bloody mother started going on that I didn’t “look OK” (10 out of 10 for observation, Mum), then they all turned round, as if her opening her mouth gave them a Licence to Gawk.  One of them looked like a bit of a freak.  The other one looked surprisingly normal.  I didn’t.  My hair was a mess, I was wearing the same trousers that I’ve worn on and off since about Wednesday and I was deathly pale, with big black circles under my eyes.  Not to mention the odd psychomotor movements.  Yeah.  A loon.

VCB kept me waiting, as well I suspected she might do.  Every time I heard the door open, I took a deep breath and got ready to face her, yet it wasn’t her.  Needless to say, this didn’t help my levels of anxiety.

Some rough-sounding bitch came in with what was, I presume, her father.  She had evidently already been seen by someone and was waiting for them to come back, but she was bloody raging.  She called the staff “dickheads” and said that her situation was “not fucking funny at all” and that her social worker was a bitch and that she was not taking any more of her crap.

Generally, I hope I don’t behave like this in public places, though I know I do here.  Nevertheless, I couldn’t help but feel the woman’s pain; these people are arseholes, and consistently seem to let patients down.  I also envied the girl’s ballsiness, if only temporarily.  I just knew I’d end up submitting to the VCB and I so desperately didn’t want to.  I wanted to stand my ground, demand answers and get help.

Another thing – the rough bint, as stated, referred to her social worker.  You may have read my rants on Twitter on Friday (here, here and here) that there are actually two Community Mental Health Teams (CMHTs) at the hospital in which the VCB and C are both based.  C and VCB will, in some way, be part of those teams, but as I understand it, CMHTs also include social workers, occupational therapists, CPNs, the stupid crisis teams and ‘duty’ teams who are there when your psychologist or psychiatrist isn’t.  The social workers, CPNs etc are, as far as I understand it, there for use alongside the professionals you normally see.

I’m not going to sit here and tell you that my mental health problems are the most serious in the whole vicinity.  They aren’t.  Mind you, I’m fairly sure that I’m not a million steps from sectionable behaviour, so they aren’t entirely innocuous either, are they?  So I’m wondering why it’s left to C to do all non-medical work with me.  As discussed in the comments of this post, it seems kind of odd that C is practicing psychodynamic therapy along with stupid DBT.  He is always banging on that whilst we need to tackle the underlying issues of madness, I also need practical measures to help me when I actually go mental.  I agree with him.  I just find it confusing to go from one to the other potentially several times during one 50-minute session.  bourach said to me that I should request a CPN to do all of the practical crap with me, leaving the actual ‘deep’ therapy to the psychologist.

In all honesty, I reckon a CPN or an OT or whatever would probably be shite; nevertheless, I think DBT itself is shite, so if it’s going to be insisted upon in my treatment, surely it is best served by someone specifically dealing with practical issues.

So, in short, I was very annoyed that LCP, C and VCB had failed to advise me of these CMHTs.  I did fantasise about ranting to VCB about it, but I reckoned that she’d only say it was nothing to do with her, which to be fair it isn’t especially as she is dealing with the medical side of things and fucking DBT and suchlike isn’t that by any means.  I do think I’ll have it out with C, though.  Was it his place to tell me?  I don’t know, but I do know that at least I can ask questions like this of him, whereas I’m way too scared of VCB to confront her, even if it were her domain.

OK, so that was a digression.  Sorry.  Eventually, VCB stuck her head around the door and summoned me.

Basically, the appointment was alright, but very little has changed.  Despite telling her about Tom, the voice, the delusions and paranoia, the increased mania and the stupid things I do whilst therein, and a full account of what happened on Friday, she is still not prepared to give me mood stabilisers and/or anti-psychotics (though thank Merciful Christ, she is not willing to section me either.  I think she realises that’s just about the worst thing that could happen right now).

In fairness, she has a fair rationale for not prescribing such drugs just right now.  Somewhere in this post, I outlined some of the mad things that have been happening to me since I started taking Venlafaxine – but I also drew attention to the fact that I thought it had made a very subtle improvement to my ‘base’ mood.

Encouraged by this, and at my own suggestion in fact, VCB wanted to double the dose to 150mg daily.  I begged her not to take it off me, as whilst it has a string of hideous side effects, at least it looks moderately encouraging as regards the depression side of things.

So, there are two things to consider in light of this.  The first was that she said that if I thought Venlafaxine had side-effects, then I should wait until I experienced mood stabilisers.  In fairness, she appreciated that I was probably quite aware of this, as she seems quite aware of how well informed I am about many psychiatric issues, including medication (C must have discussed this with her).  Secondly, and more pertinently from my point of view, she said that she would “never” make two medication changes at once (and by increasing the dosage of the anti-depressant, she is already making one).  She would – quite obviously, when you think about it – be unable to see what particular tablet was causing side effects or any changes in my mood if she made more than one change at the same time.

That’s fair enough, but the difficulty of this for me is that – given my original reactions to Venlafaxine – doubling the dose will probably send me utterly batshit again.  Even if it doesn’t cause me to react in such an extreme fashion, increasing the dose of this notorious drug is desperately unlikely to, in itself, stabilise my up-down moods and episodes of psychoses, is it?!  If she sees me again in six weeks, that’s probably bearable…but will she?

I actually specifically asked her this, and she said she would.  It fucking better be the case.

I also asked her, for the avoidance of doubt, if she would consider both anti-psychotics and mood stabilisers if things don’t change (which they won’t).  She said ‘yes’ to both.  I clarified that I actually quite like Tom, but that I recognised that hearing him was not normal (Obviously.  I mean…obviously!).  She agreed, but I think her greater concern (like mine) was regarding the other hallucinations, the delusions and paranoia.  Tom is benign (so far); they are not.  (Quotes to A – “why the fuck are you taking notes on me?  Are you in collusion with GCHQ?” //  “why is that sign trying to tell me something?”  //  “he [my stalker] is there, he’s fucking everywhere [he wasn’t there]”).

She did give me some fairly useful advice on dealing with the stalker. It’s nothing I didn’t really think of myself, but nevertheless it sometimes helps to have it verbalised by someone else.  I don’t think I have the balls to confront the bloke in the way she mentioned, unless I’m once more manic, and she did acknowledge that it’s easy for her to say.  Still, I have to do something about the fuckhead.  VCB said, “I’m not encouraging you to drink per se, but I do think it’s important that you retain the normal routine and do things you enjoy, such as going to your local.”  So I have to face up to him in some way.

Sensing disappointment regarding her unwillingness to prescribe additional medication, she said, “medication is not a cure, you know [no, I had no fucking idea given that I’ve been on it for 12 years.  If it was a cure I’d be cured by now, you old horse!].  The best route to recovery is via psychotherapy.  I know there’s nothing immediate happening in yours, but I spoke to C and he thinks there’s good work being done there.”

I laughed in her face.  I don’t know why; I’ve stated time and time again that I do think there’s hope with C, and my hopeless attachment to him is almost a textbook reaction to a functional therapeutic relationship.  I think I’m angry with C for fucking off for a fornight…again.  Additionally, I remember that when I told him about my planned discussion with VCB that he’d suggested an improved mood was down to him, not medication.  This is funny.  I don’t know why, but it is.

I told VCB about it.  “I’m terribly fond of him,” I admitted, “but really – any positive change like this is strongly attributable to the medication, I think.”

She didn’t seem sure about that, not entirely anyhow, but she didn’t argue either.  Her contention though was that, even though we are pretty agreed I have bipolar disorder as well as BPD, that that illness also requires psychotherapy.

Now she’s a psychiatrist and I’m not, but I always understood that any psychotherapy in bipolar was about trying to recognise triggers, managing mania and mixed states, etc.  I didn’t think there was any exploratory psychodynamnic-esque stuff within it (unless it is co-morbid, as in my case), mainly as it’s largely an organic illness, rather than one supposedly created in large part by traumatic events like BPD.

When I relayed this part of the conversation to A, he said it sounded like she hadn’t a clue what she is doing.  Hmm.  I don’t know.  I suppose research into causation of mental illness, including bipolar disorder, is still ongoing.

So, anyway, it wasn’t the most productive meeting ever, but assuming I actually do get to see her in six weeks as promised, it could have been worse.  If I don’t, well – the shit hits the fan for her crappy department.

Despite the relative non-shitness of it though, I am feeling remarkably low and unmotivated and sad today.  I didn’t get much sleep as already discussed, and even though I appreciate VCB’s reasons for not prescribing me some cocktail, I must confess to some level of disappointment in it.

I was also irrationally angry last night when A told me of a discussion he had with his friend, in which A told him I was diagnosed with clinical depression.  That’s so last decade lol!  A told him that because he (very much a layperson) wouldn’t understand the terms BPD or bipolar, but I’d have thought he’d have understood the old term ‘manic depression’ at least.  This annoyed me as any time any of that lot see me, I’m in pretty good form; thus if he believes I have ‘clinical’ depression, it looks like I’m faking this whole damn thing (plus I’ve developed a crackpot identity beyond just depression since I first realised last year that it was more than that).  This potential belief was exemplified the other day when the bloke in question asked me how work was.  I told him I’d been off and said I was dealing with some “mental health issues.”

He said, “in other words, you don’t like work.”

Jesus fucking Christ, such willful bloody ignorance.  If it were about hating work then I’d have gone and got myself another fucking job.

My annoyance was compounded by the fact that the bloke’s father has suffered from depression but hasn’t responded to treatment.  Yer man therefore opines that it could well be that his “dad is just a dick”.  This, as I saw it, is a refutation that there is anything wrong with me or anyone else that has difficulty responding to treatment.  It is also suggestive that he believes depressed people are ‘dicks’.  Maybe it isn’t, maybe that’s just paranoia, but one thing it definitely is is ignorant.  It’s not entirely his fault; it is, of course, a greater problem in society than just one man.  But this in itself makes me despair.

If this is what someone that knows and seems to like me thinks, what does the world at large believe?

So: (stress of VCB) + (complete exhaustion) + (societal denial that my illness is as real as anything physical) + (other things that I don’t want to write about that really upset me) + (worry about OH on Thursday) = NOT FUCKING HAPPY.

Still, VCB didn’t section me.  I really convinced myself during the night that she would, given some recent events, but she doesn’t think it’s at that point, so I suppose I ought to be grateful.
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On Being on Holiday – Is this Normality?

Posted in Everyday Life, Moods, Random Mental Health Related Philosophising with tags , , , , , , , , , , , , , , , , , , , , , , , , , , , , on Monday, 28 September, 2009 by Pandora

Of course, almost by definition, being on holiday is not normality.  It is a break from it, a break from the humdrum everyday mundanity that is the rat-race in which most of us here in the West have to engage (or not if you’re a dolescum like me, but anyhow), not an experience we can hope to replicate as part of our ‘normal’ existence.

But I don’t actually mean the overall experience of having a break from it all, I mean the general emotions, behaviour and state of being whilst one is on said break.  I think, during my ten nights in the Turkish Republic, that I found something as close to “normality” in terms of these matters as I can ever remember.

I’d written here and here that I was manic the day we left, and the evening before that.  I’ve already offered my reasons as to how that differs from ‘excitement’, and it was certainly profoundly different from most of what I experienced whilst we were actually away.

I don’t particularly believe in ‘happiness’, not as a distinct emotional entity from mania, or at least genuinely-felt cheer, anyway.  This is not just cynicism; I really believe that the best any of us – mentals, normals, in-betweeners – can hope for is contentment in our lives.  If nothing else, the state of contentment conveys much greater connotations of relaxation to me.  ‘Happiness’ denotes a mood of elevation and excitement, which surely requires energy, and I believe that that can only be sustained for brief periods – ‘contentment’ suggests relaxed acceptance of life, the ability to contend with and combat any negativity in it, and that, I believe, can be (broadly) sustained over time – circumstances permitting.

So, I won’t say I was ‘happy’ whilst on holiday, with the exception of one manic episode (as A saw it anyhow), where I was randomly talking to the bar staff in a friendly pub we liked, and having my pictures taken with them.  This isn’t behaviour consistent with my everyday character, only my manic one, which is why A found it odd, but he let me continue experiencing it, as “normal people do it” and I was “having fun”.

By the same token, neither was I in a negative mood for the most part.  There was only one brief episode wherein I went mental – I broke a glass in our apartment which sent me into an insane rage at myself – but it was relatively minor and short-lived.  On the last day, I found myself quite emotional (I still hate that fucking evil word) and in tears quite a bit, as I didn’t want to leave.

The rest of the time, I felt nothing other than contentment.  I found myself constantly wondering, “is this what it’s like for ‘normal’ people, in the general course of their lives?” (of course whilst recognising we all have ups and downs, but you know what I mean).  Contentment and relaxation.  Both are so far removed from my version of normality that, despite the positivity of them, I found it all quite alien and perplexing.  But in a good way, I assure you.

Is this normal?  I’ve already questioned what the sodding hell ‘normality’ is anyway, and why I reject it, at least in part.  But if that’s it, then actually, I’d quite like some more, thank you very much.  Controlled madness, with this as my default mood, would be quite nice.  But maybe this is ludicrous idealism; perhaps my default cynic is right – ‘normality’, even for normals, is simply existence.  Achieving contentment, something akin to proper living, maybe – probably – takes a lot more work.  Maybe I’m wrong above and contentment isn’t a broadly sustainable state of being – perhaps a better way of describing a life that isn’t mental or shit in the long-term is to, paradoxically, say that one is “content with not-particularly-content”.  Content with mere existence.

Well, it may not be quite as enjoyable as what my perception of contentment in Turkey was, but it’s better than what I usually know.  Things have been shit (normal) since I came back, and it’s not just a case of the post-holiday blues.  Those of you that read the password-protected post will know the reasons, but in brief summary to the rest of you, the psychoses (auditory and visual hallucinations, severe paranoia and delusions) have been worse, I’ve got a fucking stalker through no one’s fault but my own and my mood cycles between depressed and mixed states.  I’m also experiencing the hallmark BPD traits of severe derealisation and depersonalisation at times.  I never like hypomania, because I know it ends (sometimes abruptly), at which which point you can crash and burn – but I’d rather have it than this.  Even more than that, I’d like to have my contentment back.

This week is not going to make things any better, I fear; it all starts when I have to see the VCB in the morning.  She has it in her power to change my mood right round, but she has let me down so many times that I simply do not trust her nor expect that.  I would not be surprised in the least if she actually exacerbates things – but if that’s the case, she better be prepared for some extra attention from the media, the voluntary sector advocacy services and high-ups in the NHS – I’ll write to the Minister and Permanent Secretary of DHSSPS (essentially, the NI Department of Health) if I have to.  But it’s all too stressful to think about now.  I hate thinking about it.  I hate thinking about her.  I hate thinking about that building, her office, the other mentals, the car park – and the fact that there’s a bin and a day-bin right beside it.  Bleugh.

Then I have to go to occupational health on Thursday, which is especially shit as even though it seems to be with the nice OH doctor, things simply haven’t changed since I last saw him.  That’s largely because VCB has neglected to see me, so I don’t have anything/anyone other than C (and frankly, not at the moment him either) to help me to control my all-over-the-place moods, other than stupid practices of ‘mindfulness’.  So yeah, I have to go there and say, “well, aside from the wonderful further development of psychoses [most notably Tom, the voice], things are exactly the same, so this meeting is fucking pointless and you should just tell them to fucking sack me and stop this silly little dance of procedural ass-covering.”  Meh.

Sorry again for whinging.  I seem to have been doing quite a bit of that this last week.  On a brighter (?) note, I said that I might share a picture with you from the holiday.  I have decided to do so, though obviously you won’t be able to identify me from it (or if you can, please let me know as that would be unacceptable!).  Below is SI…but what is that she reads?!  She lies on the beach of a remote, idyllic, tiny and largely empty cove, on the shore of the clearest water she has ever seen, basking in the beautiful warm sunshine…

How SI Spends Her Leisure Time

…and she is passing her time reading Social Factors in the Personality Disorders: A Biopsychosocial Approach to Etiology and Treatment.

This picture was not a set-up.  I really did spend most of my time at the beach reading it.

Well, as if you needed it, there is proof that I’m a freak.  It’s a really interesting book though, so thanks to beautifulstones, one of my blog readers, for suggesting it.  It came on a great journey with me 😀


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Things are Bad

Posted in Everyday Life, Moods, Triggers with tags , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , on Saturday, 26 September, 2009 by Pandora

Things are, indeed, bad.  I seem to have got myself a stalker.  Did I write here that a few weeks ago whilst manic I went up to some bloke in the pub and started talking to him?  Well, if I didn’t chronicle it, then there you go.

A was with me, and it was all totally innocent – the man in question is a grey-haired biker git, 20 years my senior.  Not that age matters a fuck to me, but really – there was nothing sexual or romantic about this liaison in any way.  He seemed fairly genuine too, and the three of us got on well, with shared interest in music and whatnot.

Unfortunately, I shortly realised my mistake and tried to get away; I’d nothing against having a pint with this man, but I didn’t want to spend all night with him.  But it wasn’t that simple, and to my horror I found myself agreeing to exchange phone numbers with him.

He harassed me on and off a few times but whilst it was bothersome, as I despise the fucking phone, it was little more than a nuisance.  However, just before we went on holiday, he rang me and was on the bloody phone for about an hour.  Towards the end of the conversation, he made a number of sexual comments that I don’t want to even think about.  I listened in horror, unable to hang up, though I eventually managed to ‘politely’ get away.

In consequence of this conversation, I have ignored the little contact he has recently directed at me.  He seemed to have got the message.

So, A and I went to the local after dinner last night.  We scouted it out for Blokey Bloke, and he wasn’t there, so we sat down and began to engage in conversation.  After about 20 minutes, though, to my horror, I saw Fuckhead cross the path of my peripheral vision.  I pretended not to notice him at first, but he’d clearly seen us and basically pushed me out of the way to sit down with us.

I wouldn’t say that A and I encouraged the conversation particularly, but what we didn’t do was tell the miserable son of a bitch to fuck the fuck off.  No, we both chickened out.  Pathetic, miserable wusses.  Me especially, as it was my fucking irresponsibility that had got me into the damn mess in the first place.

We pretended that we had only intended to come in for one drink and promptly left, and went to the other pub in the vicinity.  But by then I was so freaked out I kept seeing yer man.  He was there, in the bar – yet he wasn’t.  Then the bloody voice started wittering on.  Then I really lost it and was crying and panicking and begging A to protect me from everything and my skull was splitting and frankly, had A been a psychiatrist I think I’d have been sent to the bin right then and there.

Perhaps needless to say, A took me home.  I think I was able to feign having calmed down to some extent, but when he fell asleep I tried to sever the arteries in my ankles.  I momentarily tried my wrists too, but decided against that as the blood would be much more visible to me, what with one’s hands being much closer to one’s eyes.  I do like watching the blood from cutting, but I understand that severed wrists when done properly are actually pretty gruesome; you can see much more than just blood.  So I abandoned that.

As you can see, this pathetic suicide attempt failed.  The agony of trying to slit my ankles was indescribable, and the cuts that are there are little more superficial than any non-suicidal self-harm cuts.

I bandaged my feet and went to bed and did sleep briefly, but only for a couple of hours.  I woke at maybe 2am and have essentially been awake since.  The cat threw up on the landing and I used the bandages of my by-that-point dry wounds to clear up the vomit – how strange and surreal.

Today I can feel a migraine coming on, and I feel guilty about the cuts because I know it’s not fair to put A through this crap, and I’ve got to see the in-laws tonight (not that that’s a bad thing, however).  I’m also aware that I can hardly ever go for a quiet drink again without whatshisface harassing me, as he frequents both our locals.  I suck so utterly profoundly.  How irresponsible and stupid!  So, life could be better.

A wants me to tell VCB about last night but I think she needs to hear the redacted version.  I really don’t think being binned would help my fragile mental health; psychiatric wards sound like places of great evil to me (group therapy?  Fuck off.  Other mentals wanting to talk to you?  Fuck off.  NHS neglect, food and general wastage?  Fuck off).  I am seeing VCB on Tuesday and am terrified, then on Thursday I’ve got to go to occupational shitting health.  So another great week awaits.

Sorry for whinging.

Three Days of Professional Madness, Genital Vinegar and C: Week 24

Posted in C, Moods, psychiatry, Psychotherapy, Triggers with tags , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , on Thursday, 24 September, 2009 by Pandora

As you know, I’ve been on holiday, and as you also know, I promised I would go into more detail about the three mental health appointments I had in the days that preceded my departure. I had started this post well before going to Turkey, but despite my claim that I’d finish it on the plane, of course I didn’t; even flight-safe phones such as the iPhone were not allowed to be used onboard. Obviously in Turkey I was trying to enjoy myself, though as you will see in a later post that did indeed involve some forays into psychiatry. Anyway, I’ve finally got round to the post in question, so here it is.

Tuesday: The Psychiatrist

I said I’d go into more detail about how I responded to the psychiatric SHO on Tuesday 8th. Basically, I said I couldn’t deal things any more (I’m sick of my up-down moods and am worried about the effect some of my psychoses are having not just on me but the others around me). I said I’d been pushed from pillar to post by Dr C’s department – due to the ridiculous saga to be seen by them in the first place, then their cancelling an important appointment in July – and that I thought it was unacceptable.

The thing was, I was in a complete state and it sounded more than I was pleading with her than that I was angry with her. I was begging, effectively. My first reaction to her refusal to do anything was one of panicked desperation, and I half broke down, but she merely apologised and said she was too inexperienced to deal with a case like mine. She blamed the department’s failure to have me sitting there with Dr C on a “secretarial error”.

She said, “if you need help in the meantime, you can always get the Crisis Team to…”

Regular readers will know what I think of the CRT. See about three-quarters of the way down here, for example. So you can imagine my response.

“No,” I shrieked. “No, I can’t – they’re useless, they’re crap!”

“Well, they’re always there for you,” she started, but she seemed to realise the futility of continuing in this vein, so she changed tactics and continued by saying, “or your GP.”

She said, “Dr C will talk to your psychologist right away and see you as soon as possible – unfortunately she’s just doesn’t have a window today.”

Seems to be her curtains are always fucking pulled, but anyway – I told Dr A I would be on holiday until 21st September inclusive, so she agreed to organise a new appointment for sometime after the 22nd. I got up then, mumbled some sort of goodbye, and almost literally stumbled out of the building. Some other (male) mental sitting near the door tried to grope me on my way out (the “appointment” was in the psychiatric day hospital, rather than the usual outpatients clinic, so obviously he was ((erroneously?)) recently released from the actual bin).

As I was telling C the following Thursday, another thing of note was the physical environment of the “appointment”. As stated it was in the day hospital, which has much smaller one-to-one consultation rooms than outpatients. This was a problem as there was a window in the door, and I could see the other mentals looking in from time to time. Even worse than this was the fact that the room was near the entrance, meaning that all the others waiting for their cunty day therapy and other patronising OT-esque wank were directly outside the room smoking. Not a problem in itself – except that Dr A neglected to close the window, meaning that everyone else could hear the conversation.

I could have (reluctantly) lived with all of this imbecility if they had done something, but obviously they didn’t.

So anyhow, I went and sat in my car. Recognising that I was unfit to drive, I decided to ring A for cathartic discussion. I cried down the phone to him for about 20 minutes. He was absolutely livid with Dr C and her people. He authoritatively told me not to drive until I’d calmed down considerably, but said when I got back to my mother’s house that I should get her to phone them and kick up a fuss and demand answers – not to mention an actual definite date to see Dr C.

After a while I thought I’d calmed down and left, but I remember bawling my eyes out at times on the way home and practically fell through the door to my mother’s. Initially I was incapable of even rudimentary speech, but eventually I managed to convey a basic version of Dr C’s neglect to my mother.

My mother tried to calm me and I suppose she partially succeeded, because she managed to eventually tear herself away from me for long enough to phone Dr C’s admin department (a suggestion unsolicited by me), who emphatically denied a “secretarial error” but did say they would try and find out what had happened. Apparently the girl Mum spoke to was very nice and she said she would phone back with information later.

Then Mum contacted the GP; the one on call was the (only) one I hate in the ‘surgery’ (I’m indifferent to the others, mostly), because on more than one occasion she has blamed my mental health issues on being overweight. Sure, luv; wouldn’t be anything to do with personal pathology, rape, abandonment, bullying, lies or bereavement. Obviously not. As it happens, I think a lot of my excess weight is caused by depression rather than the other way about; partly because of comfort eating, partly as an annoying side effect of antidepressants. But that’s another issue.

Anyway, let’s call this woman Horrible GP, in contrast to her colleague, Lovely GP, with whom I was due to have a review appointment the next day. My ma outlined the issues involved and Horrible GP asked to speak to me. I refused, but she pushed my mother to get me to talk and thus I started to go mental, screaming that there was no way in hell that I was going to pick up the phone.

Mum said to HGP, “she’s panicking now.”

Query: is “going mental” the same as having a panic attack? I’ve certainly had the latter; for me, a panic attack is much more of a physical problem. Not that that doesn’t affect one mentally, of course, but going mental is almost a reverse course of action. It’s the shit in my mind, racing around in a whirlpool splitting my skull, that causes physical distress, rather than the other way about.

Whatever the case, the long and the short of it was that HGP agreed to provide emergency Valium, as I had left my main stash from my last meeting with LGP at A’s house, on the other side of town.

This agreed, Mum sat down with me again and ranted about Dr C and her negligent behaviour and about how she was thinking of going to the media. About this time, A sent me a text message saying that he was “so angry with these abject cunts” and also suggesting contacting a popular local consumer affairs programme.

Handbags at dawn, dearest readers!

Mum eventually went to get the Diazepam from the pharmacy, at which point I inflicted the self-harm that I posted a photo of, perhaps irresponsibly, here. It’s no big deal, self-mutilation is not uncommon for me as many of you know. It helps. I did it as I perceived the situation as Dr C hating me. Therefore, I was a hateful person. Therefore, that had to be acknowledged somewhere. That’s a logical(-ish) train of thought that wasn’t exactly present at the time, but it was at least the sense of my reasoning.

I bled and bled and bled and then worried that I wouldn’t be able to try and hide the injury from Mum, who has been mostly unaware of my cutting. I managed to bandage myself up, though, and the bleeding was adequately hidden just in time for her return.

I took the Diazepam, and the rest of the day was mostly uneventful. A was good enough to go back to our house, feed the cats and get my tablets, then come and stay with me at Mum’s (I wasn’t allowed to drive due to the Valium). He and Mum spent some time scathing about the morning’s occurrence, and the words “criminal negligence” were used. My mother queried what would actually happen if someone were seriously suicidal, little knowing of course that a few weeks ago, I tried to hang myself. Mind you, I hadn’t told Dr A that either. To be perfectly honest, I didn’t tell her because I had forgotten that I’d tried to hang myself. Who forgets trying to hang themselves?! It’s a good thing I did, though, as there’s always the possibility they’d have sectioned me. I am, after all, a danger to myself at times.

Wednesday: The General Practitioner

The next day I had a very long discussion with LGP (his colleague having related the previous day’s fun and games to him). Appointments are meant to be 10 minutes long, so if you’re the poor sod that was waiting at least 15 minutes after your appointment time, then I apologise. At least it shows LGP cares about his patients, unlike others I can fucking think of.

LGP asked to see the self-harm of the previous day, so I showed him, and in fact gave him the guided tour of the words and slashes that litter the flabby rolls of my abdomen. He appeared to be genuinely affected by this; not freaking out like normals do over this sort of thing, nor angry, but sorry that I was in the position where cutting seemed my best course of action (which I maintain it often is, to be honest). He wasn’t judgemental nor overly worried – he’s obviously aware this is quite normal in mental illness, certainly in BPD and very definitely for me on and off over the years – but just fucking caring. Just nice, supportive and caring.

He showed me the letter Dr C had sent him re: my diagnoses and medication change. I was interested to observe that whilst she wanked on and on about BPD, she had then said that “a differential diagnosis” was bipolar II. I thought a “differential diagnosis” was a diagnosis based on the elimination of most other illnesses based on symptoms presented? If correct, that would suggest to me that bipolar is considered my primary diagnosis, but contextually the letter presented it – as Dr C had done to me in June – as if BPD was my primary pathology. Her whinging about NICE’s mood stabilisers and anti-psychotics in BPD to both LGP and me would seem to confirm that. Can anyone, therefore, clarify the meaning of “differential diagnosis”?

One thing it did say that was moderately encouraging was that she was not totally against the use of mood stabilisers in future. She didn’t make further mention of anti-psychotics, but with regret I am beginning to wonder if I really should have them. (Incidentally, MMcF’s husband was put on an anti-psychotic a few years ago to combat his very severe paranoia. It changed his life for the better almost instantly. You can take a guess as to what I think about that).

LGP wasn’t happy with Dr C as well he might not be. He believes that additional medication (though he didn’t say which) seems appropriate, and furthermore that the dose of Venlafaxine is very low, despite its dodgy side effects. However, he said that he was in an awkward position. He certainly has knowledge of psychiatric illnesses, but he’s no expert, whereas Dr C (supposedly) is. He virtually said that in an ideal world after her lax approach he’d refer me to an alternative specialist, but after all the trouble we had had getting me to one in the first place, he didn’t really see that as a viable option.

That’s fair enough I suppose, although it didn’t help me much. Regardless, LGP has been the only one out of the three main health professionals with which I deal that has been a constant source of support, rather than frustration, so I’ll forgive his reluctance to interfere with the psychiatrist’s domain. We discussed sleeping pills and he suggested I return to Zopiclone over the holiday at least, as it worked for me before and I wouldn’t have to drive on the holiday (prolonged use of it has affected my vision in the past, though not on every occasion on which I’ve taken it). I remembered that he’d given me an inhaler when I was about 14 to help with panic attacks and asked if, in conjunction with the Valium, this would help me when I start to go mental. LGP agreed to provide this inhaler and as I left, after wishing me an enjoyable holiday, he said that if I hadn’t heard from Dr Cunt within the next few weeks, to phone him and he’d get slabbering.

Thursday: The Clinical Psychologist

So the next day’s measure of insanity was with twatting C. We had agreed to spend most of that day’s session discussing coping methods of mentalism on the holiday, and he reiterated that point at the start of the session.

However, he firstly wanted to discuss a few housekeeping issues. The selfish prick chose to take leave the week I came back from Turkey (ie. what would have been today’s session), rather than taking it the same bloody week that I was away.

Is this annoyance on my part unreasonable? Probably, but sometimes I really wonder if mental health professionals, including C, realise the positions of responsibility, authority and trust in which they are placed by their patients. Anyway, at least he’d given me notice of this unfortunate absence before; I sat seething in silent rage as he then explained that the week after that, he’d be on a training course. This means three missed sessions, as opposed to the original expected one.

Fuck. Fuck. FUUUUUCCCKKK!!! Fuck you, C!!! [As it happens, so far I have hardly missed him at all, but (a) there’s still two weeks until the next session so Christ knows what’ll happen between now and then, (b) I’m trying to replicate my frustrations from then rather than my feelings now and (c) whether or not I miss him is not the point. The fact that I am essentially entirely devoid of mental health support for nearly an entire month is the fucking point].

So anyway, C asked was there anything I wanted to bring to the table before we discussed preventing and coping with madness whilst on holiday. I decided to refrain from coming right out and asking him directly if he had spoken to Dr C, and instead enigmatically replied, “has anyone spoken to you about me?”

He furrowed his brow a little and said, “not since I spoke to your psychiatrist, Dr…Dr..,” he searched for her name.

I reminded him, and asked when the conversation to which he was referring took place. It was clear he couldn’t remember exactly, and he eventually replied with something vague like, “a few months ago.”

Great work, Dr C. You and your SHO claim you want to speak to C and see me as soon as possible thereafter. Clearly it was right the fuck up there in your list of priorities.

I nodded at C, feigning casual indifference, eventually cracking under the pressure of his piercing stare of curiosity a few minutes later.

“You won’t be aware of the events of Tuesday, then?”

“It was Tuesday you saw her, wasn’t it?” he asked in all sincerity.

I laughed bitterly and made some vicious snipe about how useful “seeing” her was.

I went on to detail the circumstances in full. Those have all already been reported here so I can omit that part of the discussion from this summary of the meeting. Basically, two issues arose.

Firstly and of foremost interest was that C seemed utterly perplexed by the fact that I had cut myself in the wake of his colleague’s fuck up. Well, aside from the fact that’s a fucking hallmark trait of my illness, you twat, I was going totally up the walls and self-harm – as I have told about 496,960 times – is a quick, simple and effective tool to suppress such spiralling insanity.

OK, SI. Why the need for something so elaborate, then. Perception at time: Dr C hates me. I am hateful. That needs to be acknowledged.

Entirely predictably, C droned on for about 40 years on methods of “distraction” and “grounding myself in the moment”, all this bollocks we visit in a circular motion time and time again. I don’t remember my response to him. I just remember my metaphorical eye-rolling and desire that he’d move the fuck on from this DBT nonsense, because in its simplest form anyway, it doesn’t fucking work.

Anyhow, the second issue arising from the Dr C conversation was what he thought of the treatment meted out to me by Psychiatry. He seemed surprised by the strength of the reactions of A, Mum and (obviously) me, and his expressions and body language suggested, to me, something akin to nonchalance about the situation. Well – maybe ‘nonchalance’ is an unfair word. But I certainly did not get a vibe of overt concern like I had from LGP.

So, I set him a challenge. “If I ask you a straight question,” I began, “will you please give me a straight answer?”

This, of course, garnered a slight non-verbal reaction, because it was a strong inference that he often doesn’t answer straight questions. Well, he doesn’t. If he doesn’t like my directness about that on this occasion, that’s just too bloody bad.

“If I can,” he responded.

Ha! What you mean, C, is if you’re willing. Do you think I’m stupid? Can’t you even plan the answer in a straight fashion?!

I asked him if he thought I was being unreasonable in expecting better from the Health Service. I reminded him that I had been fucked about by Psychiatry from January to May, then fucked about again in July after a serious medication change to a seemingly effective but nonetheless insidious, potentially mind-altering, drug, then fucked about again in September. Was that fair? Was it fair, also, that such carelessness was exhibited vis a vis my privacy in my meeting with Dr A? Whilst acknowledging that to some extent the NHS is ‘free’ to use, was it fair that I had worked since I was 16 (insofar as my illnesses permitted) and will hopefully return to and continue to work until my 60s, thus facilitating the salaries of Dr C and her team via national insurance – only to be treated in this fashion? Was any of that actually fair? Was I being unreasonable?

When he didn’t immediately respond, I pointed out that my enquiry was serious. I genuinely wanted to know if something about my fury, and that of Mum and A, was somehow unjustified.

He eventually started wittering on about it being fair to expect certain standards from a service, regardless of what that service is, and certain frustrations were bound to be evident were those standards – or, more accurately, the expectations of standards (my distinction, based however on what I inferred from what he said) – were not met.

Exasperated, I said, “yes or no – do you think my anger is unreasonable?”

He sort of sighed, then said, “you talked about your main GP as being a good doctor, but the on-call one on Tuesday as being someone you strongly dislike. Dr C is, presently, in your mind, a second ‘bad’ doctor. If I answer ‘no’, I am just another ‘good’ doctor, affirming your present mindset. If I say ‘yes’, then I become a ‘bad’ doctor.”

He was obviously accusing me of black and white thinking, which is generally not a particularly unreasonable view for him to take, but nonetheless I resented every syllable of this fuck. Is what he said not profoundly black and white? Can’t he understand that if he can coherently and reasonably defend his position on the matter that I might have some insight, that if he disagrees with me that I might be able to derive some perspective from that? Oh no. Even in someone with an IQ of 148, it’s apparently as simple as a childlike concept of good v bad, with no room for relativism at all. I might have BPD, but I’m not completely colour-blind to shades of grey.

Rather than lose it with him, I tried to rationally explain my reasoning for my views on the GPs, the subject of his comments that had especially irritated me. My views on both have been developed over years. I first met LGP over 12 years ago. I first met HGP maybe six or seven years ago. I just didn’t meet either of them once or twice and form a view of them. My views on them, and on all other GPs and health professionals I’ve met, are based over time. They can change dramatically or quickly, I’ll admit, but not without very good reason.

In general, that is.

He conceded that perhaps there was more to it than good-doctor-bad-doctor, but pressed, “why self-harm though?”

This was irritating, as I’d already outlined my reasons. I sighed and said something like I wasn’t sure we’d ever see eye to eye on this.

He said, “I wouldn’t be sitting here with you if I didn’t believe you had other coping methods.”

Seeing my eyebrows raise, he added, “…or at least if I didn’t believe that you could develop them. What would be the point in that?”

I don’t recall my thinking now, but I looked him straight in the eye with what I think was some sort of oddly demanding expression and asked in a dark monotone, “are you going to leave me then? You’re going to abandon me?”

Poor C. The man was genuinely stunned. Reflecting on it now, so am I. Talk about adding two and two and getting half a million. There was absolutely no tangible link between expressing that he had hope for me and a suggestion he was going to desist from seeing me. None.

“Where did that come from?!” he exclaimed, mystified.

I honestly don’t remember my answer; I am writing this a fortnight later. I must have said one of two things; either I tried to justify my ridiculous belief that C had suggested he was going to ‘dump’ me, or I immediately apologised and submitted to him. Either way, we ended up in the submissive position, with me predictably following my Attack-Defend-Submit pattern. I said that my comments were clearly bullshit, that I was being daft and he should forget it.

“But it’s obviously something you’re bringing to this room,” C pointed out. “Why is that?”

As can be my won’t at times, I began playing psychologist. Interesting that I refuted any suggestion above that I was childlike, because I remember telling C that that’s exactly what I was. When he asked me why I thought this, I sardonically replied that I wasn’t allowed to intellectualise matters so I couldn’t answer his question.

He laughed and said, with a kind of amused defeatism, “go on then.”

Of course, I couldn’t. This was a PhD qualified clinical psychologist I was talking to. I’m a Wikipedia qualified psychologist. (Actually, I’m underselling myself, as I do have some knowledge of the subject, but it is from some time ago and was not even half as in-depth as a full undergraduate degree, nevermind a doctoral one). For the record, I was thinking of attachment and object relations theories and their roles in transference.

Anyway, my paranoid whining led to a monologue from C about ending therapy. Obviously I’m aware it’s not indefinite, it’s not a permanent fixture in neither his nor my life, aren’t I? But he’d like to assure me – again – that it will never just abruptly end. He envisions a minimum of four sessions of preparation before discharge, probably more, blah de blah.

I just sat there and looked at the floor, struggling to not burst into tears like a bloody newborn, struggling not to get down on my knees and beg him not to leave me to try and make some sense of insanity, my past, my future – my entire damn life – alone. I know I sit here and spout bile about the man and slag him off and call him names – but I do like him despite it all, and I need him and see hope with him and I can’t do it without him – not yet anyhow.

I was utterly overwhelmed by how much I don’t want him to abandon me and how inadequate and feeble I felt because of that. How sad and ridiculous that an intelligent woman of 26 wants a man she doesn’t even know to take the place of her missing father, grandfather and, frankly, friends, given that she only has a few close ones. How pathetic that she is vulnerable like a girl 20+ years her junior, and that she wants this unknown figure to scoop her up and take care of her. It’s so wretched that it’s almost kind of darkly amusing.

He interrupted this self-indulgent and piteous stream of consciousness by asking, “how are you feeling now, in this moment?”

I can return to ranting now. I swear to fucking God that I am sick to death of that phrase. He must surely use it as his meditation mantra. Is there some cadence in it that I’ve missed that makes it an attractive thing to say all the time?

I cleared my throat and said I was fine. He looked at my cynically, but decided against pressing the issue, presumably as there was very little time remaining in the session.

“When Dr C contacts me,” he began, “I can tell her nothing if you want. What we discuss here is confidential. Some people might not be at all comfortable with the idea of a discussion about them behind their back. Others may find it helpful. What’s your take on that? What do you want me to tell her?”

“It is weird to think of the two of you discussing me whilst I’m in absentia,” I admitted. “However, I don’t think that makes it unhelpful.”

I shrugged. “Use your discretion, I suppose. Answer her questions, give her any information you feel is relevant.”

He nodded, and I saw him look at the clock, which to my annoyance he’s moved to behind ‘my’ chair so (I presume) that it’s less obvious to the patient when he checks the time. Which it’s not as you can see his eyes shift above your head. And in any case it was pointless to hide it on this occasion, as he said, “we’ve left very little time to talk about your holiday.”

Oh really, I had no idea, I thought we had six hours. To be honest, I was glad. The preceding minutes had been pretty intense for me and I was tired.

We did conduct a quick and fairly basic discussion on coping if I were to go mental in Turkey, but beyond talking about getting A involved in the techniques, there was nothing new in what was discussed. I did talk about the inhaler from LGP and the Valium, but C kept whinging that these were external sources (oh really? I thought I had them sewn into my oesophagus) and that I needed to develop internal responses. To be honest, I just sat there and nodded, not really agreeing, not really even thinking about what he said, because I just wanted to leave. Not a good thing probably, but there you have it.

As I left, he said, “I hope the holiday goes OK.”

I ranted to A about this later. OK? You hope it is OK?! No “have a nice break” or “I hope you have a great time”?

To my surprise, A defended C. A contends that C had to be careful; had he said he hoped it was “great” or whatever, I would have been too cynical to really believe that he meant it, or that I expected it was possible that the trip could be great. I actually don’t agree that that would have been my view, but in fairness I can see why C might have thought that. So I can forgive his lack of enthusiasm to some extent. I suppose.

Friday: The Flight

OK, the title says ‘three’ days and this is a fourth day, but it doesn’t involve professionals attending to my madness, and in any case I’m not going into too much detail. You can probably tell from the style of writing here and here that I was (hypo)manic on Thursday night. This carried on right into Friday.

I suppose there is an argument that I could simply have been excited about going on holiday, but I don’t think that is the case. Forms of mania are, to me (and as far as I know to diagnostic manuals), different from contentment or excitement, in subtle ways at least. I understand that bipolar II in particular often goes undiagnosed because the hypomania therein often presents simply as an especially good mood. Maybe I seemed in an especially good mood on the Friday of that week, and I probably was, but I was also behaving oddly and saying really stupid shit.

I don’t have the best recollection of it, I’ll admit. I do remember sitting at the departure gate at the airport, delayed, babbling incoherently and in a racing fashion to A. I remember dropping my bag and having some sort of hysterical fit of laughter and more racing speech about this ludicrously uninteresting event. People around me were looking at me as if I was mad (which clearly I was). A found it amusing, and I can understand why it might have been to some – but it is also not ‘normal’; certainly, it was not appropriate behaviour for a public place.

And it very certainly, profoundly and completely wasn’t appropriate for a plane, and luckily I had enough cognisance to realise this. So, for the first and to my credit (?) only time from then to now, I took Valium to space me out and slow me down. It worked, to A’s self-proclaimed disappointment, but obviously it is not a long-term solution to episodes of mania.

Thus began our holiday. I will write in more detail about that shortly; it’s a separate issue from most of this post’s material. However, don’t worry; I’m not going to bore you to death by telling you what we did, what we ate etc etc etc – even if you actually know who I am, such things become dull very quickly. Of course, I keep this diary primarily for my own reasons – but more in relation to my mental health, not ‘normal’ stuff, if there even is any of that presently in my life. No, I want to think about how I felt on the holiday, how I behaved – whether there was an overt exhibition of madness thereon, or whether I actually managed to acquit myself well. I hope to write this tomorrow, but if not hopefully early next week.

Meh

When A and I were waiting for the plane, I received a message from my mother stating that a letter had arrived from Psychiatry offering an appointment on Tuesday 15th. LOLOLOLOL. Can’t they get anything right? I clearly told Dr A I would be away until the 21st. Mum rang them for me and whinged some more, pointing out they had not explained the situation as promised to her on the phone on Tuesday. They promptly and without question rearranged the meeting for Tuesday 29th. I am now terrified of it. It’s not great timing either as I have another bloody OH appointment on Thursday 1st October as well, but there’s not much I can do.

So, finally, you’re probably wondering what the reference to ‘genital vinegar’ in the title of this post relates to. It relates to Dr C. In ranting on Twitter, someone responded to me that Dr C was a “vinegar cunted bitch” – or so I thought. It turned out he was actually referring to some bint spreading more “Obama is a Nazi” bollocks in the US, but never mind – the title as one for my psychiatrist stuck.

Obviously there are a lot of ‘C’s in my life anyway. The actual C, CVM, Dr C…I’m sure there are more. Therefore, to avoid confusion and to reflect my current position on Dr C, I shall henceforth refer to her as the Vinegar Cunted Bitch, or VCB. I know I have a terrible penchant for acronyms, and when combined with usage of terms such as ‘BPD’ etc it is bound to get confusing – but I’m not going to start calling C ‘John’ or VCB ‘Dr Alfonso-Smythe-Hetherington VI’ just to anonymise them, so you’ll just have to bear with me. I have to bear with myself, after all.

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How to be a Serial Insomniac: Lesson One

Posted in Everyday Life, Moods, Random with tags , , , , , , , , , , , , , , , , , , , , , on Saturday, 12 September, 2009 by Pandora

Come to Turkey, and drink some of this:


I was totally manic yesterday, and no doubt this Turkish coffee will induce more of the same, but it’s just so good. A asked me at the airport yesterday if I was on drugs, such was my mania. Then he laughed at me. People around us were looking at me as if I was a freak. Which to be fair I was (am).

A said I should blog about it, but I was way too restless to do that. I’m in a good mood today (!) but not manic, so it’s hard to describe. Anyway, I’m sitting in a Turkish coffee shop writing this on my phone, so it’s not the ideal medium to communicate it anyway. I will try to do so at another juncture, though.

I didn’t get publishing the draft post about Lovely GP and C and the aftermath of the psychiatric disaster of Tuesday, because even plane safe phones weren’t allowed to be switched on during the flight (what the fuck?). But I’ll get there.

For now, though, I’m going to concentrate on trying to enjoy my holiday. A and I are both in relaxed and good moods, which is a ridiculously unusual occurrence (we estimate the last time this happened was when we were in Lanzarote in May 2008). So we had better take advantage of it.


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