Archive for suicidal thoughts

A Time of Not Being Suicidal?

Posted in Context with tags , , , , , , , , , , , on Tuesday, 19 January, 2010 by Pandora

In the last post, the lovely Karita who blogs at If Narky, Feed Profusely commented that she had never felt suicidal.  This got me thinking.  Was there a time when I didn’t?

I have had a fixation with death and dying from as far back as I can remember.  My mother was disturbed when as a four year old, I told her I wanted to be a forensic pathologist when I grew up (seriously).  Although I didn’t fulfill that dream, I did academically pursue what I thought would be a related discipline, the most interesting aspects of it being those that discussed death – including, indeed, a quite in-depth exploration of suicide in a sociology class.

I cannot say whether or not I actually wanted to die myself when I was four, but I wouldn’t rule it out.

It was certainly the case in my later childhood.  I first tried to kill myself when I was about nine or 10.  I have a very vivid memory of it; I tried to strangle myself behind the closed door of my bedroom.  Clearly this was a ludicrous attempt, but an attempt it was nevertheless, and I remember the despair and frustration I felt when it became evident that my actions would fail to bring about their intended result.  I was distraught at the prospect of my life continuing.

Since then, I’ve tried walking in front of vehicles, taken two overdoses (which saw me hospitalised), tried to slit my wrists*, ankles and elbows, hanging myself and suffocation.  I think that’s it.  (* Including, of course, the incident from Friday).

I know what you’re thinking.  Anyone who’s serious about committing suicide wouldn’t have such a number of silly attempts under their belt; they plan their death, and that’s that.  Fair enough.  I can only defend myself by saying that in most of the cases, the most serious ones at least, the desire to not exist felt serious.  The most serious attempt was a massive overdose when I was about 16, which did nearly kill me.  A couple of these attempts were gestures or based on circumstantial factors, I admit – but mostly they weren’t.

When I wasn’t actually actively trying to top myself, I was probably thinking about it.  I can honestly say that I’ve almost certainly fantasised and/or ‘planned’ my suicide for every day of my adult and adolescent life, and a lot of my late childhood too.  This even includes periods of mania and contentment.

In short, this is how I perceive normality – to all intents and purposes, I have never known anything else.  I’ve been sitting here for a while trying to imagine what it’s like to not feel suididal, and it’s just beyond the bounds of my imagination.

Well, there’s more proof – as if it were needed – that I’m a headbin 😉

Tomorrow is my first appointment with NewVCB, about which I will blog as soon as I can.  I don’t know whether to be amused or incredulous by the fact that my first appointment with this woman will be in the wake of a suicide attempt.  And then I have to face C on Thursday, and that will not be fun in the least.  Alas.

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Until It Sleeps

Posted in Moods, Triggers with tags , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , on Thursday, 19 November, 2009 by Pandora

The iPod has been acting as a mindreader again.

I’m not in the habit of doing this as this blog is mine; my life, in my words. However, sometimes others just say it (whatever ‘it’ is) better than me, and this is very much one such occasion.

So, ladies and gents, I give you the nature of my present sorry existence – as presented by Metallica.

Until It Sleeps

Where do I take this pain of mine
I run but it stays right by my side

So tear me open and pour me out
There’s things inside that scream and shout
And the pain still hates me
So hold me until it sleeps

Just like the curse, just like the stray
You feed it once and now it stays
Now it stays

So tear me open but beware
There’s things inside without a care
And the dirt still stains me
So wash me until I’m clean

It grips you so hold me
It stains you so hold me
It hates you so hold me
It holds you so hold me
Until it sleeps

So tell me why you’ve chosen me
Don’t want your grip, don’t want your greed
Don’t want it

I’ll tear me open make you gone
No more can you hurt anyone
And the fear still shakes me
So hold me, until it sleeps

It grips you so hold me
It stains you so hold me
It hates you so hold me
It holds you, holds you, holds you
Until it sleeps

I don’t want it, I don’t want it…

So tear me open but beware
There’s things inside without a care
And the dirt still stains me
So wash me ’till I’m clean

I’ll tear me open make you gone
No longer will you hurt anyone
And the hate still shames me
So hold me
Until it sleeps

(c) James Hetfield and Lars Ulrich, Metallica (from the Load album, 1996).

I will write properly tomorrow, but in the meantime you can listen to and watch the video for the above here.


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Remonstrations with C – Week 29

Posted in C, Everyday Life, Moods, Psychotherapy with tags , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , on Wednesday, 11 November, 2009 by Pandora

I was absolutely dreading seeing C last week, after the disaster of the previous week.  Although the rawness of my hurt and anger had abated somewhat, I still felt fucked over and undermined, and obviously had no idea what he was thinking.  In fact, I’d arrived at a position of relative indifference towards him, something I’ve never really felt during the whole time we’ve known each other.

My initial thinking was that, from a psychodynamic perspective, this was a very bad thing.  You can’t just switch transference off, not well before the relationship has fulfilled its duties anyway (which as you can tell, ours as yet has not). I mean, one is surely supposed to feel strongly – or at least not ambivalently – about the therapist in the course of this type of psychotherapy.  But perhaps it wasn’t such a bad thing after all.

As I walked behind him from the waiting room to his office, I couldn’t help but observe how much his bald spot has grown since I first met him back in February.  He has lovely fluffy hair, like a man about 40 years his senior (old people always have lovely fluffy hair, don’t they?).  But now it is falling out.  By odd coincidence, I noticed my first grew hair on the evening of the disaster session that this meeting followed.  I must not allow myself to be deluded into thinking that I am encouraging or in some way perpetuating C’s hair loss.  That would be fucking stupid.

I sat down, and immediately cast my eyes downwards, so as to avoid his gaze when he sat down.  I don’t recall what he said at first – maybe he offered some salutation or asked where I wished to begin, but in any case he paused for a few minutes (during which I sat in a fiddly silence) and then told me that I “seem[ed] very agitated.”

Well, look at Dr fucking Insight. Your powers of perception astound me, C!  Well, actually, they do at times – but I think on this occasion the observations could have been made by a dead giraffe with its neck twisted in a strait jacket.

I elected to ignore him beyond a mere shrug.  ‘They’ were laughing spitefully at the back of my head and getting on my tits, though I don’t think they influenced my behaviour around C particularly. He hadn’t mentioned the previous week, and I hadn’t the balls to bring it up unsolicited, so what did I have to say to him?

Eventually, of course, he broke the silent deadlock with that perennially irritating question, “what’s going through your head as we sit here?”

As I recall, I told him that very little was going through my head.  Apart from the grammatically- and personality-challenged ‘They’, not much really was happening in my head.  It felt as if I existed in a thought vacuum.  I didn’t feel good by an stretch of the imagination, but I didn’t exactly have anything tangible to exemplify that at that particular point.

This impasse continued for a few minutes, as ‘They’ assessed C.  Perhaps unsurprisingly, their conclusion was not especially positive.

Eventually, after having ‘They’ berate C for a few minutes I took a deep breath and told him that I was seriously considering voluntary admission due to the danger posed by ‘They’.  I went ahead and explained about ‘They’ in detail.

“I don’t want to go, C, I don’t want to go,” I told him, anxiously.  “But I’m concerned that I’m in dangerous position and that I ergo have no choice.”  It’s funny; it’s the the first time I recall using his name when addressing him directly.  Not that it matters really – but it seems more personal or something.

He talked for a while about the procedure one has to follow to seek admission to an NHS psychiatric ward.  Unfortunately, it doesn’t seem that it is as simple as it used to be.  You have to meet your GP or psychiatrist, but rather than them referring you directly, they then send you to one of those fuckwit Crisis Teams who decide how mental you are.  Based on my experience, you’d need admitted after meeting them, not that they’d realise that, because apparently a cup of tea and some meditating will cure all mental illnesses and emotional difficulties.  Yep.  That’s why people in my position are considerably more likely to end up topping themselves than the general population, you pathetic cunts.

Anyhow, I was actually reasonably impressed with C’s non-judgmental take on on both ‘They’ and my hospitalisation proposal.  It is often his wont to tell me that I can be in control of stuff like this, which to my mind is (mostly) horseshit.  Although we later discussed the possibility of exploring non-medical ways of dealing with ‘They’, certainly at this juncture, his tone was accepting, as was the content of what he said.  That was encouraging.

After the discussion around hospitalisation, I admitted to him that ‘They’ didn’t like him.

This enraged ‘They’.  “That is not what we said,” ‘They ‘ shrieked at me.  “We said he was a cunt.  Tell him.  Tell him…TELL HIM!”

For the first time, in utter frustration, I actually spoke aloud to them – or rather, I shouted at them.

“Alright, for fuck’s sake, I know!” I yelled.  I had actually been in the middle of a sentence directed at C at the time, and he must surely have been taken aback by this random outburst – but he managed not to bat an eyelid.

I don’t remember how the discussion of my anger at the previous week’s annoyances arose, but eventually arise it did.  I do remember that he said that I hadn’t commented on that, and my responding that he hadn’t asked.

Rather than express my raw hurt, I simply said, “let’s put it this way; I wasn’t in the best of moods last Thursday.”

His response surprised me slightly, though I think I hid it well.  He said, self-referentially, “what a bastard, right?”

“Um…well.  Am I allowed to say ‘yes’ to that?”

“You’re allowed to say whatever you like.”

“Then yes, exactly.”

He nodded, apparently unoffended (not that he should be given his job), then we discussed the issue in a fairly forthright and adult manner.  There’s little point in going over it, as most of my annoyances were discussed in the letter – though I didn’t give it to him as I said I would in the comments of that post.  I did tell him about it, though, and admitted to having a printed copy in my bag.

C actively encouraged me to read it to him, but I refused.  I don’t know why; I’m annoyed with myself for chickening out, but it just didn’t feel ‘right’ at the time.  I told him I would think about it, and indeed I have the letter ready to take again tomorrow.

I had made the point that I had taken an awful lot of time to prepare the stuff I’d taken to him the week before, and told him that I’d found it horribly invalidating when that work was “thrown back in my face because [he] couldn’t be arsed to read it.”

He didn’t bother to defend himself in anyway.  Instead, he went to what seemed to me to be great pains to tell me that he really did understand my upset.

“And maybe you felt rejected?” he later queried.

Rather than duck out of this, as I would normally have done, I went ahead and confirmed his suspicion.

I wasn’t overly emotional throughout this discussion (though had been a bit during the discussion of ‘They’), but I had been out the day before wearing eye make-up (and hadn’t been arsed to wash it off – I know, I know, how disgusting), and my reluctance to express myself in this fashion in front of C had more to do with the possibility of having big black mascara-streaks down my face rather than my usual ‘must-fight-against-it-it-is-evil-and-weak’ stance.  For the first time I began to get a sense that I could and should talk openly to C about things I’d deliberately avoided, and that I could maybe start to demonstrate exactly how I might feel – and if that includes crying, or ranting or kicking things, then so be it.

There was nothing clear in the discussion that led to this, but for whatever reason, I felt the dynamic had subtly changed for the better – not that it’s generally been a bad one, of course, but perhaps it took an argument for me to fully trust him not to abandon me; ie. that if he was still there, still very much part of my life – and if anything more supportive – after a major disagreement, that just maybe he could be trusted with a range of unpleasantries.  Not that I ever consciously doubted that, but I don’t know – the subconscious is a funny thing I suppose, and I’ve always been firmly of the view that one should trust no one until they have definitively proven themselves trustworthy.  And even then, the trust should be cautiously administered.

Whatever subtleties took place last week, I hope they can sustain the future of the therapy.  Far from wanting to seek an alternative therapist, as I did the day I wrote the letter, I am quietly encouraged by things with C as they stand.

But it could all change tomorrow…


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The Malice of the Voices of ‘They’

Posted in Everyday Life, Medications, Moods, psychiatry with tags , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , on Tuesday, 10 November, 2009 by Pandora

Owing to the pain of this –

Ouchies

– I’ve been somewhat in absentia from the blogosphere recently.  Was this gash – which is actually worse than the above suggests, being as it was nearly a removed-tip-of-finger – deliberate?  Was it fuck!  I even commented on the annoying irony of this on Twitter.  On Saturday the lid to a toothpaste tube had become lodged in the sink plughole, and the only way to get it out, aside from amateur plumbing, was to edge it out at the side with a knife.  A certain angle, a lot of force, and it wasn’t just the offending lid that ended up deeply cut to pieces.

I was urged to go to A&E to get this stitched, and I should have; it’s deep, and it’s very, very open.  But I didn’t.  Inertia?  Yes.  Social phobia?  Yes.  But the fact that an XBox 360 Elite has arrived in the house didn’t help either, not that I could use this finger to use the controls.  Neither could I drive initially, nor type, so forgive my lack of posting.

I admit to some malaise re: blogging though – I can’t blame everything on my half-axed physical extremity, given as the blog has gone unwritten for just under a fortnight.  A post that I’d originally started on Wednesday afternoon was to be called ‘The Rollercoaster’, such was my mental state between the last post and then.  Most of it is faff and I could never be arsed finishing it, so I thought I’d condense (ha!) the salient points of it into this new post.

Of course, I am aware that I haven’t written about my last session with C; I shall try and rectify this tomorrow.  In short summary, we are, for now, friends again.  We discussed the previous week’s annoyances, and although I didn’t give him the letter as intended, I did tell him about it.  He actually wanted me to read it to him, but I’ll detail that later.  I was honest with him for a change, but because I’d been too lazy to wash my face from the previous day, when I had worn mascara, I refused as ever to cry in front of him.  I think I might have done, though, had I not been horrified by the thought of having black streaks down my face, so I suppose that’s progress.  A silly reason?  Well, if I was a therapist, I’d laugh at an individual in such a position, so I can’t expect C not to.  On the other hand, I’m probably just a sick fuck.

Anyway.

The main thing of interest since my last post is the development of ‘They’.

‘They’

Poor A has been doing a lot of home-based overtime recently, and the morning of Saturday 31st October saw no exception to this.  That morning, he was in the study working, whilst I was lying in bed trying to fight off the usual Saturday migraine (this used to happen when I was at work each week, but when I became a dolescum, it mostly disappeared.  In the six to eight weeks prior to this date, however, the weekly migraine has returned.  Reassuringly, A asked me to ask Lovely GP if this combined with recent hallucinatory behaviour could be symptomatic of a brain tumour.  Yippee).

For contextual reference, overnight on 26/27th October, I had been plagued by horribly frightening auditory hallucinations all night (see this tweet), indicating to me that the hallucinations had moved beyond ‘just’ Tom and the shapes.  The music was the most terrifying, for reasons I cannot really articulate.  It was only about four or five notes on what sounded like a xylophone, but it carried the same unspoken message of hostility that the shapes do.  Not that the knocking and the whimpering didn’t.

So, anyway, here I was trying to soothe this migraine by lying in the darkened bedroom, when someone who wasn’t A nor Tom told me to get up and brush my teeth.  For some reason, I acquiesced and did as I was told.

Upon completion of this, the ‘someone’ became a ‘they’ – instantaneously, yet simultaneously gradually.  I know that makes no sense.  The best way to put it, I suppose, is that it was like an operatic or orchestral crescendo.  The nebulous ‘they’ then instructed me to go to the top of the stairs.  Tom turned up and told them to leave me alone, but they laughed at them.  I (internally) enquired as to what I should do.  Tom said to go back to bed.  ‘They’ repeated their aforementioned direction.

‘They’ and Tom kept bickering about what I should do but, much as I don’t mind Tom, the collective voice of ‘They’ was so much stronger, and carried a weight I can’t explain.  It was a compulsion.  I went to the stairs.

I have fallen, and thrown myself, down the stairs at my mother’s house many a time, but the stairs there are relatively ‘safe’; they aren’t especially steep, are thickly carpeted and, until recently, had a…shall we say…deceleration zone.  This is not the case at A’s; the carpet is thin, the stairs are incredibly steep and there is maybe a foot of hallway at the bottom before you go crashing into the front door.  That’s if you don’t hit the radiator on the right.  In short, falling down A’s stairs could seriously injure me.  I doubt it would actually kill me, but it could definitely injure me.

Here I was at the top of these steep stairs.  It was almost as if they had morphed into a sheer cliff face – I mean, I didn’t see such a thing, but…I don’t know, it’s hard to describe; it just felt like that.  At this point ‘They’ started telling me that I was to throw myself down the stairs.  Tom tried to intervene, as did the voice of Me.  But ‘They’ were too strong.

When I didn’t immediately throw myself down, they became enraged and started chanting/screaming: “YOU MUST DIE!  YOU MUST DIE!  YOU MUST DIE!” followed shortly by, “THROW YOURSELF, THROW YOURSELF HARD!”.  Simultaneously, parts of ‘They’ were laughing in the manner that the dark monster’s under a child’s bed are supposed to.  Sinister.

I remember little of what was going on outside this mental cacophony, but I do recall that it was a physical effort to not throw myself down the stairs.  I have a very vivid memory of watching my bare toes teetering precariously on the edge of the step, trying – amidst this madness – to will them not to go over.

It’s funny really.  Given the almost perpetual suicidal ideation in which I engage, why not just go with the flow of ‘They’?  But I wanted to fight them.

Still ‘They’ went on, “die die die, throw yourself, throw yourself hard,” in their ritualistic chant.  Still Tom and Me tried, with considerable futility, to dissuade them that this was a desirable course of action.  But ‘They’ either just spat bile at or ignored us.  They called me (both me-me and the Voice of Me) a range of names such as “slut,” “cunt,” “bitch,” etc, but they just audibly sneered, if that’s possible, at Tom.

Somehow I sat down.  By this point, I presume in order to distract me, the amorphous ‘They’, were knocking at the side of my head, exacerbating the headache (as if their bloody noise hadn’t done enough of that).  I put my hands over my ears and started rocking back and forth, but of course that didn’t stop them.  That was a pointless gesture – they’re in my head so, how can covering my fucking ears shut them up?  But it was instinctive, I suppose.

Despite Tom’s best efforts to diffuse the situation, it wasn’t getting any better.  ‘Me’ wondered if taking my gaze away from the stairs would do anything to help things, so I lay my head down on the next step and hid under my arms.  They didn’t stop, but part of me ceased to be entirely sure of where I was, so the sheer compulsion to obey ‘They’ abated – but only slightly.

It was shortly after this that A emerged from the study and asked if I was OK.  He had been talking to himself whilst in the study and his voice had kind of morphed with that of ‘They’, so I didn’t even know if he was real.  Nevertheless, aside from Me and Tom, he was the only voice there with which I was familiar, so I told him what was happening.

A helped me down each individual step.  ‘They’ mocked him, sneered at him and wanted me to hurt him, but somehow, I managed to resist them.  When A finally managed to get me into the relative safety of the living room, he called ‘They’ “pathetic non-existent cunts” and told ‘They’ that he was going to “destroy” them.  Tom laughed agreeably and told ‘They’ to fuck themselves; ‘They’ were both insulted and incredulous.  ‘They’ called A a number of names that I no longer remember, continued to tell me to die, and although they didn’t ‘verbally’ say it, there was an intense sense in my head that ‘They’ found the notion that A could defeat ‘beings’ of such epic power an irritation and a source of amusement.

To cut what is already a very long story a wee bit shorter, eventually ‘They’ and Tom left.  A was disturbed; I was exhausted.  We were both worried about how this would turn out.

In fact, the possibility of voluntary admission was discussed.  My fear was not so much for myself – I don’t really matter to me, after all.  But ‘They’ hate A.  It turned out later that ‘They’ hate C too..  They’re more tolerant of Mum, but they still don’t like her.  ‘They’ haven’t met my friends yet, but I’m sure they’ll hate them too.  So, whilst if I want to do myself in I want it to be my decision and not theirs, and that side of things presents as an issue, my greater concern is that the complete control of ‘They’ over me would lead to harm of someone about whom I care.

I had an appointment with VCB today (more on that in a moment), and A and I both hoped that I could hold out to then before the drastic step of admission, but I did discuss that possibility with several individuals and, with a few qualifications, it was agreed amongst all that if ‘They’ returned with such hostility, that it was probably a good idea.

‘They’ did return a few days later.  ‘They’ were not demanding my death this time, nor the injury of anyone else, but they were chattering insults and laughing scornfully at a low level at the back of my head.  “Whore,” “cunt,” “slut,” “bitch” etc.  They were whispering spitefully and when A started into them again, the insults were then divided between him and me both.  But although distressing and unpleasant, there was no danger from this episode, so luckily I didn’t embark on a course to the bin.

‘They’ were there on Thursday morning when I went to see C.  This was the first time when I verbally spoke to them.  ‘They’ told me they thought he was a cunt, and I said to him, “they don’t like you.”

‘They’ got really mad at this; apparently, I was meant to tell C that he had been called a ‘cunt’ specifically.

“Tell him, tell him, tell him,” they ordered.

“Alright, for fuck’s sake, I know!” I yelled at them.  I’m not sure how C kept a straight face.

But they’ve not been there in a dangerous capacity since 31st October, thankfully, so I haven’t incarcerated myself.  As stated, I had an appointment with VCB today, which I had been anxiously waiting for thanks to ‘They’, but of which I was also simultaneously terrified, given as I am scared of VCB.

I was actually slightly surprised that she herself had the decency to see me today and not palm me off onto some minion.  Perhaps C told her about my threats of advocacy, media and contacting her boss from last time.  Anyhow, as usual I had developed my written list of symptoms from which she – unlike her stupid SHO – allowed me to work, recognising that it’s not always easy to remember everything.  She did quiz me on specifics – “what did ‘They’ say specifically?  Pretend you’re them talking,” or “what does Tom talk to you about?” – but mostly, she allowed me to speak freely about the last few weeks.

Essentially, the result of the meeting was that she wants me to decrease the Venlafaxine back to 75mg – not because of the hallucinations per se, as she actually does not seem to believe they are a side effect of it, but because being on 150mg hasn’t made any difference to the feelings of depression.  I’m not sure I like this.  I basically think Venlafaxine is crap (not to mention evil and insidious), but I’m scared of being on a low dose thereof again, and in particular I am petrified of a pseudo-discontinuation syndrome caused by a dosage reduction, despite VCB’s claims that there should not be any noticeable difference.  I am seeing LGP in the morning so will discuss this with him.

Secondly, and more helpfully, VCB says that the more recent hallucinations and delusions do represent outright psychoses.  Well, not that that in itself is nice – obviously it’s not, but it had a hopefully positive outcome.  She had been expecting to prescribe me a mood stabiliser today, but in light of the information I gave him, obviously decided that “a trial” of an anti-psychotic would be more appropriate.  I know how hideous side effects of such medications are, but frankly I’m glad because things as described above can’t go on.

She has decided upon 2.5mg of Olanzapine; she chose this drug because she thinks it’s better in terms of its secondary indication of mood stabilising than many of the other atypical anti-psychotics, despite most of the manufacturers’ claims that they all mood stabilise fabulously.  2.5mg is the lowest dose of this drug, but that’s fair enough I suppose.  VCB says it can be increased as necessary, but it is of course best to start on as low a dose as possible.  Unusually, she wants to see me in a month rather than six weeks.  Although she (obviously) didn’t bin me, this did suggest some concern on her part in my view.

I asked VCB if the revelations had any impact on my diagnoses, as I was aware that psychoses weren’t generally a feature of bipolar II, and whilst they are seen in BPD, it is usually (as far as I understand it) during episodes of considerable stress, which I hadn’t been experiencing especially during the development of ‘They’.  She said that she still felt the diagnosis was correct, as the episodes of psychosis have been transient, as is seen in borderline, rather than prolonged and sustained.  However, she did imply that she would be willing to reevaluate things in future, should the need arise.

She warned that the main side effect of Olanzapine is weight gain, which is not apparently caused just because the drug itself makes you fat, but because it increases your appetite.  She said that I have to try and develop methods of ignoring any new or unexpected bouts of hunger, which I suppose I can discuss with C.  She also recommended exercise (obviously I suppose), so when I get my windfall from work, I may rejoin the gym.  As a dolescum, I do get to use the local leisure centre for cheap, but it’s usually full of pricks all day long, whereas I know for a fact that the gym and its pool are both almost empty during the day.  In any case, I’ve lost a lot of weight recently, so whilst I don’t exactly want to regain any of it, I suppose I can deal with a little bit more whilst I try to address countering any new-found appetite.

A final side effect is strong sedation, but perhaps it won’t surprise you to learn that this would be a positive thing for me.  Unfortunately, apparently that tends to wear off as one gets used to the drugs, but hopefully I’ll have the lovely Zopiclone in waiting then.

I haven’t got the pills yet; I have to take VCB’s script to the GP’s for them to load it onto the system and then prescribe and sent to the pharmacy.  Had I done so today, I would not have got them until tomorrow anyway, and since I’m seeing LGP in the morning anyway, I can just get him to prescribe them directly.

So all in all the VCB was quite useful today – I just wish she’d make that state of affairs consistent.  Perhaps the best thing about this – and I know this is really sad and childish – is that she’s defied the NICE guidelines on BPD.  I suppose she had little choice given the circumstances, but she always wanted to adhere to them insofar as was possible.  But I think NICE are useless knobs, a waste of public money who sit about saying a lot about very little, so this pleases me.

Other Events

New Friend

On Wednesday 4th, I had the pleasure of meeting K (can we call her K?  There’s no other Ks on this blog, are there?), another BPD ‘diagnosee’ that I met via Twitter.  K is also from Northern Ireland, though now lives in England (she was here on a quick visit).

We spent a couple of great hours chatting over tea – the conversation was lively and wide-ranging, but in terms of mentalism specifically, it was a relief to discuss things with someone who has direct experience of many of the same problems I have.  I’ve relied on the internet for this to date, still do and probably always will – K and I agreed the temptation to catch the bus without the support of online friends would be considerably higher than it already is – but nevertheless it’s great to actually speak to someone in person that understands.

I would normally be very nervous about meeting someone new, as you can probably imagine from earlier ramblings.  However, I actually wasn’t with K, and even had I been, her easy-going charm would have relaxed me very quickly.  So thank you, K 🙂

GA

Fucking cunt of evil bastardry aunt GA was in situ for the second time within a few months last week.  Why come across the Atlantic twice in such a short timeframe?  Last week was for my cousin’s wedding, that was only organised recently.  Needless to say, I didn’t go.  I can’t presently think of circumstances that would in any way make me tolerate seeing that woman and her shit descendants.

What pisses me off when GA is here (and even when she isn’t) is that my mother wanks on about what a poisonous twat GA is – GA knows everything, GA always thinks it’s worse for her than for others, GA must interrupt people and be the focus of the conversation, etc – yet as soon as I open my mouth to make any vaguely critical remark about the old battleaxe, Mum rages at me for being so cruel about her.

Fuck that, and fuck GA.

Meh

There was another ‘other event’ that I wanted to add but alas its exact nature has evaded me.  Another time – in any case, I think I have drivelled on for long enough as usual.

Did I say something near the start of this post about ‘condensing’ my words?!
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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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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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