ANXIETY IS FUCKING BORING

I’m not the most exciting person. Most days, the most exciting thing I do is break our geriatric tap in the kitchen. Whoosh, there is goes again. The momentary crisis of grabbing cloths and jumping back and hot geysers, a tiny little flood. That’s about as exciting as life often gets for me. Occasionally, I might say something slightly witty at an advert. Or write a tweet that gets FOUR likes and retweet. Put on the good bra to go to the shops. Pulse quickening.

I get plenty pulse quickening with my anxiety. Constant, worsening anxiety that turns every single thing into the same thing. Heart palpitations, hard to breathe, floaty, distant, shaking anxiety.

It used to just be Some Things. The Big Things. I’ve written at length about my fear of death and the therapy that I uselessly underwent to help it. I still have that but my more constant anxiety has even turned that heart stopping, face clawing, screaming existential terror into a mundane nightly chore, like brushing my teeth (just kidding, I don’t brush my teeth nightly, I’m not the Queen).  I climb to bed (it feels like a climb because I know what’s coming, that huge boulder perched on the precipice ready to flatten me), put on my sleepy sounds (an app that has waves on it), try and read shit on my phone until I can’t stay awake, but then I invariably do because I’m reading shit on my phone, then a word, a thought, death, dead, older, you’re 32 in a month, I wonder what it’s like to be 82 and know with utter utter certainty you’ll die soon, some sort of black jellyfish thing floats into my brain and sting sting stings until I can’t breathe, and want to fling myself out of the window, just to not feel this way anymore. I’m in bed, I’m safe, nothing is happening to me.

Every night. I could set my watch by it, if I had a watch. I don’t, because ticking clocks make me think of death and I can’t be in the same room as one. WHAT A CARD I AM.

How BORING IT IS to not be able to be in the same room as a ticking clock.  I just go through my nightly panic attacks alone. Occasionally I’ll have flung myself across the room. Reader, in previous years, I’ve even wet myself from fear. Really quietly. Try not to wake up Robert. “Why don’t you wake me up?” Because it’s fucking BORING. BORING. BORING. How many times have I talked this out, with you, with him, with a therapist, with this blog and Facebook and all the other things I fling my feelings at when I’m sick of them clinging to my heart like tar. It is BORING. I have reduced the most primal feeling of all men, all, since the beginning of time, to something so FUCKING BORING.  So self obsessed, so insular. Panic or paralysis, that’s about it.

It makes me angry.

It makes me angry it’s just gotten worse and worse. When is it my time to be okay? Over the past year or so my anxiety has changed from something that happened to something that just is. Everywhere, always. It has infested every single aspect of my life and made every single thing in my life bloodless.  The only exception is my son, because he is life and also because he is so attention consuming in his tiny toddlerness and I have to stop him walking into traffic it’s hard to think or feel anything else but hypervigilance.

Twee cartoons, though helpful for many, don’t capture the boredom of anxiety. They convey chaos, a mind racing with possibilities and thoughts and fears.  And that is anxiety, but racing isn’t the right word. It’s tumbling, jumbling, crashing, smashing and smithereening. Over and over, so it’s just a hum.  Just one catastrophic thought after another. From the big. I am going to die. Smash, bang. I am going to die soon. Smash, bang, thump. Then you panic. Smithereen. Rinse, repeat. (I am not going to do this thing at work well.  Now I’ve wasted so much time panicking I have no time to do it well. I am scared if I don’t cross the road at the right time I will get hit by a car. Now I am dissociating at the traffic lights and can’t remember how to cross the road. I think I fucked this thing up. Everyone must know I fucked this thing up.  I am anxiously obsessing over this thing to my friends. Now my friends must be annoyed at me.  I am coming across as a weirdo because I am feeling anxious and spacing out. Blah blah blah).  I am not suicidal in the least but I think about killing myself with alarming regularity just to never have another day of anxiety.

I am just really bloody tired of it. It is really exhausting. I don’t know what to do about it anymore. I have to think everything over a thousand billion times. It doesn’t feel like an exaggeration to say that. I find it hilarious I was once described as “impulsive” when I’m now everything I do is at a glacial pace because I have to investigate every other known option and settle on none of them.  I know in a sense it’s habit. Useless CBT tried to break that habit, it didn’t work. I can’t do mindfulness because so much of my anxiety is wrapped up in mortal things; hearts beating, breathing and all that, so it actively makes me panic more.

I was off work for months due to anxiety.  I had counselling, and was kicked out for missing 2 sessions (one flu, one sister visit). The counsellor was also clearly a bit unsure of me, having expected some sort of 12 session wham bam you’re cured mam and getting someone trying to process trauma and manage a mental illness on top of the day to day stuff (and it is the day to day stuff now really, it takes up such a huge amount of my energy to stay relatively sane while holding down 2 jobs to live and trying to keep everyone in my house not homeless). So I went to a private therapist for an assessment, begged skintness (despite having 2 jobs, I am skint) and will do more therapy, and maybe it’ll help, and maybe it won’t. I can’t take SSRIs because they kick off mania which would be another whole boring pile of shit to contend with. I’ve taken propranolol and it does its business but doesn’t do anything about my head.

Here are some ridiculous things my anxiety has made FUCKING BORING lately.

  1. Booking a holiday. Being in the privileged position of being able to take our first family holiday thanks to my mum in law, I decided the most fitting way to celebrate was to faff and worry so much I didn’t book anything for weeks until it was really expensive and we picked somewhere almost at random. Then I worried about that and felt responsible for preemptively ruining everyone’s holiday and terrified of wasting a lot of money we don’t have on not going somewhere utterly perfect and anyway taking a 2.5 year old on holiday is fucking stupid so I’ll have to ask Facebook for opinions and talk about it constantly until I eventually have a panic attack in the street while I’m holding an emergency sausage roll. THANKS BRAIN.
  2. A meteor shower. The splendor of the heavens! Shooting stars! The inky canopy dotted with bright stars, so beautiful and visible at my mum’s up in the mountains of Northern Ireland.  OH HEY BY THE WAY YOU HAVE NO FUCKING IDEA WHY THEY’RE THERE AND YOU’RE GOING TO DIE BEFORE YOU FIND OUT. Time to go back inside.
  3. Watching a beautiful sunset from my bedroom window. Aaaah, isn’t this nice, and it’s light enough still you might not have a panic attack in the dark. Try to go to sleep now. Go on. Sleep like the dead. What are you doing with your tiny finite life YOU COULD BE DOING SO MUCH MORE FOR ALL IT MATTERS ANYWAY. ARRRGGGGH.

NOTHING HELPS. Talking about it doesn’t help because there’s no solutions. That sausage roll might have helped for a few minutes, just like this glass of wine I had might have helped too, but that’s it. No baths, no walks, no runs, no good food, no wanky “self care” helps. Because it, all of it, becomes part of the same stair climbing routine with a panic attack at the end.

I’ve mentioned it before but the insularness of it makes me angry. I wonder sometimes if my anxiety is some sort of pressure release system due to feeling constantly and rightly worried about losing my jobs (therefore I must be perfect at them but then I worry so much I am shit at them) and making my family homeless. It is so internally focused that I have tried to block out the world in case my brain just fucking collapses.  Since I last wrote here a thousand awful things have happened and are still happening so I focus all my anxiety on internal, BORING things, some of which are in my control, and if they aren’t, then I try to wrench them into it. Of course, you can’t control everything, and then you freak out.  And this is the biggest thing in my life I don’t feel I have any control over whatsoever which just frightens me more. And bores me, because I am constantly trying to keep it socially acceptable, and that’s boring.  To just be a stuck record that skips over and over. A voice from a speaker in the distance garbled through air, a static buzz.

I’m bloody fucking sick of it.

 

 

 

 

 

Therapy Tales No. Etc- Death and Trauma. Fun.

Therapy is ending soon.

Losses, fears, love- that’s basically it. Losses of things I loved- including animals (I know pets die, but mine in sudden, cruel ways I can’t go into here but which haunt me) and people. They all died lonely, premature, unfair, painful deaths. As soon as I really understood what death really was (which happened when I had another loss- my friend who killed herself when I was 15), I have been completely heartbroken ever since. Of what life is. Of feeling. Of finality. Of memory. I can’t bear it, any of it. That’s when the fear really started. I’d always been afraid of my parents’ death, i obsessed over it. But that was my first big loss, of someone I’d seen so recently, so young, so similar to me. We were all steeped in bullshit pop music mythology, playing with self harm. But she died. Alone. And I was unforgiven for something. I never got to explain or say sorry. And she died. Died. Death. Forever. My first cremation, too.

Memory is important to me. Memory is evasive to me. I have convoluted memories of my own childhood.  Different from my siblings’ because we’re different people. Everything is kind of mixed up, muddy. Then my own brain conspired against me, and I don’t remember a lot of my periods of illness, or the life that existed, inevitably, as life does, within them. And I had my own fractious relationship with the truth when I was young.  When I look back I realise it was because I found it so hard to be living the life I had, so created another, not even one that was easier, but one I felt could justify the pain I was in without ever being honest about what was really causing it (it still feels churlish and trivial, and now I am at the other extreme of exposing honesty).  Other people have memories I don’t, largely negative and embarrassing. My own bad behaviour haunts me not just because it hurt those it was directed to (or caught within), but because I know it has become part of the memory arsenal, that chorus always waiting to be summoned, or to butt in, uninvited, and to hurt. And I hate that. I don’t want to be someone’s bad memories. Maybe if I can be better now, I can replace it or erase it? And all I want is to give my son happy memories. Robert says I’m morbid, which is true. He keeps us in the present- he thinks, “experiences”, I think, “memories”. Already living in the past tense.

Memory is all we have, really. In the end, if we’re lucky, that’s all we have. Since my dad died I have dug deep and cling to the good memories I have of him. Further and further away. It’s hard to remember happiness. It’s not the visceral gut punch of despair, more the balloon in your hand that drifts away, bright and then small and smaller. Physical pain is hard to remember (I couldn’t describe now what my contractions felt like, even though I know they hurt), but emotional pain recalls itself constantly. So I often only remember the bad things clearly (and how bad they were), and it feels like they just happened. How jealous I am of people whose parents weren’t like mine and who they went out to lunch with and they didn’t die like my dad did. Even those who did die but in ways that people had some sympathy for (alcoholics dying, lowest of the low, fuck their children, the way we were treated by the medical staff, my baby brother and sister, fuck them forever and forever for it, for every person afterwards who turned their face away from me),  I have to unfollow people on Facebook posting happy pictures with their parents. Out at lunch! Having drinks! Doing normal things.

Memory is the twoheaded monster. My memories of my dad are awful, Sometimes they engulf me and I feel like tearing my skin off in agony that I can’t go back, can’t change something, can’t intercept this awful image and make it different. That was it. And his memories. I think that’s perhaps worst. HIs life which he didn’t deserve. That he was so desperately unhappy. That he died like he did, and that I knew he was afraid of it. And there are tears pouring down my face as I write this. To be afraid without comfort. Without hope. I wanted to be there when he died to be a hand or a face or a word, and I wasn’t.

Me being there wouldn’t have changed the outcome, he would have died anyway. But I wanted to do something, anything.

My friend Brendan died not long after my dad. He was an alcoholic too, was trying to recover. He died of an accidental overdose and my last communication with him was a voicemail he left on the Monday before he died asking me to meet up, saying he was nearby, just passing, are you in? get in touch, and I was so up my own fucking selfish arse I never did and then he died.

In therapy we talked about safety behaviours and my big one is having my phone on me and being always contactable. I have a three hour commute to and from work and most of it is underground. I went for a rare night out on Tuesday and had a panic attack on the train as I visualised (fear not feelings etc, but it felt like a promotion, it felt like destiny), Robert screaming over our baby, screaming and screaming and I wasn’t there. That if he died I wouldn’t be there. What would his last memory be? Be held, be there, be loved. Not alone.

(Howl)

This is hard to write. I’ll come back to it.

It’s also about fear. I used to have nightmares about my dad dying from his drink. But he did anyway. It happened even worse than I screamed about. So why should I trust my fears aren’t real? That the worst won’t happen? It did. All the worst fears I have (dying myself is a worst fear that will inevitably be true, but I fear dying young, leaving my baby, Robert dying, my baby dying, my mum being unhappy and dying) came true so why not these? It’s hard not to take my anxieties as facts. They happened.  And with Robert and my baby in particular, who are my husband and my son, I love them so fiercely, I think, my love must insulate them from suffering, from death. But it doesn’t and it won’t. How can I ever accept that? I know it’s a childish and possibly a bit narcissistic but there it is. When Robert has the slightest bit of discomfort, my refrain is, “What can I do? How can I fix it?”

We talked about my intrusive thoughts which often take the form of, when I’m speaking to someone, imagining them dead. And realising they have the same expression, that I am just superimposing my dad over everyone’s faces, just reliving it constantly.

We didn’t even get on that well when he was alive. We had some beautiful moments, a lot of understanding, and he was a good person. But I often hated him for what he put us through. I used to fantasise about him falling downstairs and breaking his neck just so he’d shut up. Stop shouting. Stop drinking. Then we’d be free. (I hate this freedom. I hate myself).

So the therapist talked a bit about trauma and how events can be too big for the brain to process so they never become memories. They’re always happening instead. A sort of PTSD. And how if you break them down they can be processed and become memories and stop being so present. I’m skeptical. I have some extra sessions before we quit but feel like we’ve pulled a thread and I want the jumper back. And I don’t want to do the homework. I don’t want to write it all down. I want to keep pushing it all out. I don’t want to break it down. I don’t want to break down.

I cried a fair bit after that session and Robert gave me a lot of hugs when I came home. And then abruptly I just stopped talking about it, as I do, Silly, trivial, depressing.

Yeah.

(Stay with the feelings)

Therapy Tales Part 1- So You’re Terrified of Death?

(If you’re wondering where my previous post went, I have made it private as I’ve found this to be true. Thank you for all your comments and encouragement!)

So, I’m starting therapy for death anxiety (my medical diagnosis that led me to it are generalised anxiety disorder and panic disorder but I prefer to think of them as ARGH).  Expect this series of posts to be even more introspective and self obsessed than usual, and for this blog, that’s saying something.

Two years ago (christ), I wrote a post called, “When Fear Becomes Phobia”. It described my ARGH FUCK panic around death and deadness, and how my world was getting smaller and smaller because of it.  Last year, I went to the doctor and asked for help. She was so sympathetic that she made me cry. Saying what an awful thing to carry around with me for 12 years (14, now) and she referred me to therapy. I found out I was pregnant, had an assessment and things didn’t go any further because I was suffering such crippling morning sickness that the 40 minute bus journey to the appointment was 1 hour 30 minutes because I’d have to jump off twice to vomit. Later on in pregnancy, I dispensed with such courtesies and just huffed up all over my lap, or into a friendly plastic bag.  Pregnancy was also pretty distracting- all my anxieties were focused on that, and I didn’t have the mental reserves to panic about death anymore.

My panic has returned, as it does. It’s not constant and strikes at night when I’m trying to sleep (and flip, I need my sleep!) It doesn’t disturb anyone because I sleep in the spare room (Robert does night feeds due to my medication). It means it’s quiet, private, lonely. It comes and goes, ebbs and flows.  It’s probably unsurprising. I had a baby, then I lost my grandmother, and it was my dad’s anniversary.  Catholicism ritualises death in a way that’s both comforting and horrifying. It makes you look at it, it makes an object of it.  She was in a coffin in the sitting room that my dad’s coffin was in, for days, with the same yellow, unnaturally smooth, chillingly cold skin that you have to touch to say goodbye. Their coffins, and every childhood Christmas. These things bring death bubbling back to the surface of your mind. It’s hard to close it out when you’re trudging up a hill behind it. Robert’s grandmother died the month after, and her funeral was like a trip to Argos. Closed, quiet, scripted, burned. I prefer the visceralness of Catholicism, even if it haunts me. It does at least give death, and life, some gravitas.

So, I’ve been referred back to therapy for it. My psychiatrist initially wanted to increase my medication but I refused. This feels existential, albeit obsessive. I’ve often been able to distract myself and try to be less up my own arse, but distraction is tricky and I’m introspective generally. It doesn’t need to be medicated away- that just makes me feel worse.

The assessment happened pretty quickly. A chat over the phone, which gave me a sense of pride that I didn’t have to list a litany of other issues. I haven’t self harmed in six years, my bipolar disorder (if I ever had it) is pretty well controlled. I wasn’t depressed, wasn’t struggling otherwise. I’ve come quite a long way. I knew what they’d recommend- CBT (*spits*) but I’m willing to give it a chance.

The therapist is called Sean, which means the assessment didn’t entail the usual 45 minutes of tuition in how to pronounce my name. It’s high intensity IAPT (Improving Access to Psychological Therapies), so the sessions aren’t at the mental health team (thank bollocks, I used to work at my local one), but in an unassuming house with comfy sofas, pot plants and James Frey books that I had to stop myself openly guffawing at perched proudly on the Ikea shelves.

He asked me what I wanted help with so I explained. I forgot to bring the questionaire they sent me so went through some of it there. My depression score was low, as I knew it would be. People tend to assume I must be suffering from depression if I’m having panic attacks and anxiety.

Au contraire.

Depression is both a mortal enemy and an enemy of mortality. For me, it is ageless, timeless emptiness. It tries to kill me, and it kills the thing inside me that makes me afraid of it doing so. I want to die when I’m depressed.

So when I’m not depressed, I’m scared of that. It’s like being held under water and a peaceful acceptance of what it happening envelopes you, until the final second, and you kick, you convulse in order to be free, to be alive, to throw off the aggressor and then relive over and over at how close you came to drowning.

I do sometimes feel depressed because of the panic. I feel frustrated and angry with myself that I have panic attacks. I feel frightened and distressed by some of the intrusive thoughts I have (like when I’m speaking to someone and suddenly an image of them dead flashes into my brain, with hallucinatory vividness) and sometimes they make me feel like I’m going mad. But depression and this panic don’t come together, and that’s a big massive pain in the hole. The panic tends to be the worst during the happier periods of my life. I’m happy, hurrah, and then my mind goes, “This will end it, all of it, everything, and because it will end, this is meaningless, you won’t be here one day, any day, none of them will” and that’s just BLOODY FUCKING GREAT isn’t it. I don’t want to die, ever, because I enjoy my life. I’m essentially a happy person who wants to see what’s going to happen.  I want to be standing at the end of the universe with Robert and Oisín watching supernovas and planets and the sun.

(Rest your head)
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(Close to my heart)

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(Never to part).

Maybe it is partly a coping mechanism, the fear. Like pinching yourself.

He asked me if I had other anxiety- I do, social anxiety, but I’m dealing with that in my own way so I didn’t want any help which he accepted (and I think it’s tied up in this anyway).

Two things were said during the assessment that made me willing to continue. One was something stunningly obvious but that I had genuinely never considered. The therapist said that my kind of anxiety is, “idiosyncratic”. It’s not a common reason people come to therapy. That floored me. “Doesn’t EVERYONE feel this way?” I said. No, apparently not. At least, not to the degree they end up in therapy. So, is it that this is such an ordinary fear we live with it and are in denial, or am I the odd one for being periodically consumed by it?

Another was asking me where I think it came from. Nobody has ever asked me that before, and it’s not something I’ve thought about. The worst of my panic began when I was 15. That’s when it started flinging me screaming across the room. “Is that when your friend committed suicide?” Yes, it was- but the panic attacks started before then. Robert (who I first went out with when I was 14), remembers my panic on the phone, but it was more contained, and I was easier to comfort and distract.

It started well before then, when I was about 7 (?). Both my parents had mental maladies. I felt like they were going to die and I was terrified of it. I became aware they wouldn’t be there one day and I feared all the time it was the day. I used to pad into their room at night to check they were still breathing, then pad back and lie awake in the moon (just like I do now with the baby!). I realised I was going to die too, and sometimes would wake up screaming.  Death felt close, ever present, non abstract. I could only perceive it in my childish way, but I never felt safe, and I never have since.

Of course, that’s just a bit of it- I might be wrong, but I had never connected the two things before. I had a massive resurgence after my dad died, too, which is natural. But it wasn’t so much his death as knowing that he feared it. That kills me, still. I hate that he was afraid. If I could do one thing in my life, one magical thing, it would be to take that fear from him before he died.

He asked me what I wanted to get out of therapy. I don’t know really. Not to have panic attacks anymore. To be able to watch/read/listen to anything again. Not to have to ring in late to work because I’ve disintegrated at a funeral procession. To fall asleep. To be able to think about Oisín’s future. At the moment, I’m too scared to talk about it, think beyond tomorrow, in case he’s not here for it, or that I’m not. I’m petrified of something happening to him, and feel superstitious about it. It’s a loss I know I would never, ever recover from, be able to go on living beyond.  Pregnancy should have taught me the futility of this- when it seemed like there was bad news at the 20 week scan, my anxiety didn’t protect me. It didn’t cushion it, it didn’t make anything easier.  I want to be able to talk to Robert about him riding a bike, or going to school, or falling in love. I want to be here and present in the moment without thinking how it’s going to end. That it is. I want to be able to sleep without hours of panic beforehand. I want to be able to not feel regret about not living if I do die tomorrow. When I’m going through anxious periods I always feel mildly dissociated, not here. I don’t want to feel that way anymore. I don’t want horrible flashes in my brain anymore. I don’t want my coping mechanism for the feelings of helplessness and inevitability to be nihilism, as it means I make unhealthy choices (like smoking, which will actively shorten my life, and thus leads to more panic attacks). I want to be present for myself, for my child. Life is so brief. And it is all.

He said that this will involve some unpleasant feelings, but that it usually helps. He says when it doesn’t, “work”, it’s often because people haven’t done the things long enough (bit of, “blame the patient” here, but I understand what he means as my last assessment person gave me a workbook I barely glanced at). I’m pretty frightened of what this is going to entail, and how hard it’s going to be. I’m aware it might mean it gets worse before it gets better, and I’m feeling pretty apprehensive about that. Shit scared, to be honest.

But I’m doing it. So let’s see where this goes. I’ll keep you updated!

The Sane Guide to Living with Mental Illness: Medications

I was watching cigarette advertising from the 1950s onwards on Youtube today. It’s all very aspirational, grand cars billowing Camels smoke from the driver’s window, doctor extolling the virtues of Chesterfields and such like. So I made my own non-aspirational cigarette advert.

Anyway…

Here is another one of my more sensible guides to mental illness, this time, medication, from someone who’s been on most of them and suddenly packed in nearly all of them. (Although I am on 50mg Lamictal with Seroquel now to see if it dents my mixed episode). I guess a lot of you who are already on medications won’t find this helpful, but some other people might.

So!

The Psychiatrist has decided that you’re mental. Well done! By now you’ve probably been told what flavour of mental you have. The flavour favoured by most is bipolar disorder but you may have been told you have schizophrenia, depression, anxiety, a personality disorder, obsessive compulsive disorder or an eating disorder. Or even more than one of those things! That’s good, it means you’re extra special.

What will happen now is that they’ll hold a little conference behind your back to determine whether you’re going to be prescribed medication, going to be referred for therapy or whether you’re going to be kicked out of their office.

Chances are, you’ll be prescribed medication. It’s likely that they’ll be an antidepressant, antipsychotic, anti anxiety drug or mood stabiliser. Or pick and mix from all of the above.

So, here is the guide to medication.

1. You’re taking them because…?

Psychiatrists sometimes have a habit of thinking that their patients won’t understand clinical terms like “psychosis” or, “you’re flipping the fuck out”. So they might use helpful little phrases to explain to you why you’re being prescribed a certain medication, and they try to avoid frightening you by implying that your behaviour is a little…let’s say, off?

“This will calm you down”- “You are vibrating like a badly drawn cartoon”.

“This will help….even you out”- “You have burst into tears six times and then burst out laughing another ten for the thirty minutes you’ve been said here”.

“These should help lift your mood”- “You tried to kill yourself with my stapler”.

“These will help alleviate your compulsive behaviour”- “I’ve noticed that you’ve been counting the vowels I use in my sentences” (That was twenty three).

“These will help with your strange beliefs”- “You’ve referred to yourself as The Queen for the duration of this discussion”.

2. Know your enemy

Occasionally, a doctor will withhold a diagnosis from you or whoever bought you to the psychiatrist in the first place. Generally, you can guess what’s up with you via your medication. Antipsychotics, like Risperidone, Quetiapine, Amisulpride, Haloperidol and Olanzapine are generally used for psychotic disorders like schizophrenia, schizoaffective disorder, delusional disorder, manic depression, some types of personality disorders, some sleep, anxiety and compulsive disorders and occasionally, depression. Antidepressants like Prozac, Citalopram and Effexor are used for depression, some personality disorders, panic and anxiety. Anti anxiety drugs (the ones that are benzos, not antidepressants like Paxil) like Valium are for anxiety and panic and mood stabilisers, usually anticonvulsants, like Lithium (which is an antimanic), Depakote, Carbamazepine and Lamictal are used for some types of depression, personality disorders and manic depression.

If you have the interweb, and you do, since you’re reading this, research your medication. But be prepared to find out some things you didn’t want to know about…

3. Side Effects

Psychiatric medications are notoriously awful to take for some people and chances are you’ll have side effects. In short:

Get used to drooling. Antipsychotics and anti anxiety drugs can be really sedating and make your body go a little bit floppy, though it probably feels as though your limbs are made of lead. They can also cause you to slur your words, so, a little bit of spit might make a dash for freedom.

You will feel weird for a few weeks. Lots of medications take a while to work on the illness they’ve been prescribed for. In the wilderness of waiting, you might feel weird. You might feel blunted, spaced out, anxious, irritable or you might be having some odd thoughts. Tell your doctor.

You will sleep forever. If you’re taking antipsychotics, anyway.

Avoid the scales. It’s a shitter but psychiatric medication can make you gain weight. Antipsychotics are worst, anticonvulsants like Lithium and Depakote are pretty much wank too, antidepressants can be tricky and anti anxiety drugs, well, the benzo type, aren’t meant to be used for more than a week or two, so you shouldn’t gain weight from them.

Shake, shake, shake. The anticonvulsants will give you the shakes, listed on the PI sheet as “tremors”. It can be a bit embarrassing as people might assume, like they did me, that you’re an alcoholic. Try not to take sugar in your tea as it just causes confetti.

You might not think as clearly as you used to. Most drugs affect how your mind works. Even caffeine does, so psychiatric medications will. Well, they’re designed to. For the first while taking them, your head might be a bit foggy and…

I had a point here, but I don’t remember what it was… because I’m taking antipsychotics.

4. Don’t expect miracles.

Some drugs work on some aspects of illness very quickly. Antipsychotics are good for getting people out of psychotic and manic episodes pretty fast. Antidepressants can lift your mood within a fortnight.

You have to take drugs in order for them to work. If you’re not taking the medication as prescribed, the medication isn’t “not working”. You’re just not taking them.

There is more to mental illness than direct symptoms and medication isn’t a cure for them. The chances of you being suddenly completely better are slim, and because of this, medications will be changed, doses will be adjusted and other treatments will be drafted in alongside them.

You don’t actually have to take medication if you don’t want to. There will be times when you will have to- i.e if you’re under section, but aside from that, you can choose. Of course, if you’re under the care of a psychiatrist or mental health team, you will be strongly advised to take what they’ve prescribed you.

But, you can weigh up the pros and cons of medications. If the side effects are too much, say so, because another medication can be tried. If you hate the way they make you feel, say so, same applies. The decision is ultimately yours, though.

In reality, it’s best if the decision is ultimately yours and someone elses’ because getting ill again- relapsing into mania or psychosis, for example- means that you won’t be in the place to decide if you should be taking them because you might feel that nothing is wrong. It’s always good to have someone else tell you that you’re mental when you don’t believe it yourself.

5. The medication Hissy Fit.

Yeah, chances are you hate your medication, even if it is helping. You’ll want to flush them down the toilet, chuck them into the Thames, strap them to a rocket, etc etc etc. Have your hissy publically with the doctor before you decide to do the above, as they will be only too happy to tell you what a pain in the arse you were when you weren’t taking medication.

6. If you’re going to continue medication, DON’T:

Drink. Alcohol and psychiatric medications are a ridiculous mix. They make you a lightweight and you’ll be drunk a lot quicker, but be less inhibited so you’ll drink more. That way lies making a total dick of yourself in front of your friends, passing out in the street and pissing yourself or ending up in hospital.

It can be dangerous to drink alcohol while on certain medications like Lithium and Depakote.

And alcohol is a CNS depressant and it will generally make any mood unstable. There’s no point in taking an antidepressant to make you feel better, only to get wasted and feel like shit.

Take drugs. Because you’re already pumping powerful chemicals into your body and you don’t need more.

Drive. Don’t even attempt to drive if you’ve just taken an antipsychotic as it will result in a DUI and probably the end of your car. Don’t cycle either, because, like me, you might find that you’ve forgotten how to steer and career into the pavement of the Seven Sisters Road.

and DO:

Get a pill organiser. One of those cheap plasticky things you can get from chemists for the princely sum of £4.99. They sort your pills out by day so you can’t forget or take too many.

Keep tabs on them. By recording how you feel every day. Or ask someone else to do it for you if you don’t trust your own insight.

Drink lots of water. Because they can piss about in your blood stream, liver and kidneys.

7. And if you’re not going to continue taking medication:

Do it slowly. Don’t come off medications suddenly. They are drugs, and like any drug, they might have withdrawal. Do it slowly.

Look into other treatments. Like therapy, for example. For some people therapy works as well as or better than medication.

Tell someone. If you’re in the right frame of mind to. Quitting medication can cause a relapse that you might not notice but other people will. Subtle things, like stripping to your knickers and running into traffic.

Anyway, that’s my Sane Guide to Medication. Anything you want to add?

The Insane Guide to Living with Mental Illness: Depression

Contrary to part 1 of my “Sane Guide to Living With Mental Illness“, here is part 1 of my “Insane Guide to Living with Mental Illness: Depression”.


Introduction

So you’re mental! Congratulations! Your journey here may have taken you many years or you could simply have fallen off the doorstep of sanity one day and into the garden of madness. Either way, welcome!

Insanity isn’t an exclusive club; we welcome people of all ages, genders, shapes, races and cultural backgrounds.

Now, let’s get started. Being mad, you’ll want to know just how to wear your madness well, what the etiquette is in our club and how to make the most of your insanity. Each category will have five subcategories:

1. Eating and self-care

2. Social etiquette

3. Hobbies

4. Sleep

5. How to deal with those around you, who may not be so excited about your insanity as you are! Includes lovers, friends and the medical profession.

6. The future

So let’s get started with depression.

Depression

You’re depressed! Well done. It might have started one day: you were walking home from work and you felt the bottom of your world fall out. There was a hole in the earth that you could fall through, forever. And you did. I’ll keep this short; after all, you can’t waste valuable staring-at-the-ceiling time reading this. If you can read it at all. It’s difficult to concentrate when you’re depressed. Reading the back of the pill bottle can be a daunting task- those damn letters just won’t stay still! You might find that your vision is a bit blurry- don’t worry, this is caused by the constant trough of tears that have been welling up in your eyes.

Do you remember what you were like before you were depressed? You probably thought you were a pretty good person. Well, you’re not! Say that to yourself every day: “I am a bad and disgusting person”. All you’ve ever done is make mistakes in your life. There you go!

1. Eating and self-care

When you’re depressed, there’s a limited source of food available. After all, you won’t have the energy to cook something, and if you try, you’ll probably forget and burn it. So stick with these staples: cereal, chocolate, wilted old fruit. If you can get to the shops, that is. If not, just order takeout food. It’ll make you happy!

In fact, you may not be feeling hungry at all. This is normal. Don’t worry about eating. It’s too much of an effort anyway. You could drink tea to keep going or, even better, alcohol! Alcohol is well-known to make you feel better. If you feel depressed, hit the bottle and you’ll be right as rain in no time.

If you do feel hungry, overeat! Overeating makes you feel better. It means you won’t have to eat as much next time. This saves valuable energy. Try to get some fish oil in your diet (omega 3), it’s been clinically proven to be more effective at treating depression than anything else in the world!

You might get a lot fatter but that’s unimportant; no-one cares what you look like, anyway! There is no cure for ugliness! You’re fat and useless even if you’re 110lbs!

As for your appearance, you have two choices: either remove all mirrors from your room (who’d want to look at you anyway? ) or stand staring into one for hours on end measuring your every flaw, and let’s face it, you have many!
Since you won’t be leaving the house much, there’s no point in brushing your hair and teeth and absolutely no point in changing or washing your clothes. As you’re depressed, you’re not going anywhere so who cares what you look like! If anybody- lovers, friends, social workers- express concern, lie and say you changed your pants earlier! They’ll soon back off.

2. Social Etiquette

Who needs friends? Not you! Let your friends know that you don’t need them by pulling the phone out of the wall or ignoring your mobile as it rings for the fifth time that day. Try not to panic if that tinny ringtone irritates you; everything is going to irritate you, or, you just might not care at all! It’s great to be free of these social conventions.

Your friends will stop ringing eventually. But if you want to make a half-hearted attempt at sociability, make sure you meet your friends in a pub. That way you can drink! It may be very difficult for you to go outside, after all, the world is a hideous place. Show your friends you care by crying on them, shouting at them or treating them to miserable, stony silence. It’s okay; they don’t really like you anyway.

3. Hobbies

Before you became depressed, there may have been things in your life that you enjoyed doing. You may find that now you have no absolutely no interest in these things; in fact, the thought of doing them fills you with dread or total indifference. This is normal. None of it matters. Nothing matters.

4. Sleep

Sleep is important so you should get as much of it as possible! It’s much better to sleep in the day time because that’s when all those boring things you don’t care about; your job, your family commitments, your friends; are at their most demanding.

Of course, feel free to sleep at night time, too. When you are awake, remember that nothing is as fulfilling as lying there looking at the ceiling- what a fun way to collect your thoughts!

You may be finding it difficult to sleep. Panic and anxiety could be tearing through you, making you feel as though your own skin is infected. You may feel like you’re dying. Never fear, abusing prescription medication (which can be obtained from the doctors, more in part 5) or alcohol can help.

5. How to deal with those around you, who may not be so excited about your insanity as you are! Includes lovers, friends and the medical profession!

So, you’re depressed! Those around you may not be so excited about this as you are. But who cares about them? They don’t care about you.

Your friends and family may plead with you to talk to them. Don’t! They are trying to bring you to their side. Who wants to be there? You’re certainly not good enough for that. They may say they love you and care for you; they don’t! Don’t succumb to guilt. It’s all a ruse!

They may convince you to go a doctor; resist this for as long as possible! Nothing’s wrong with you- you’re wasting their time! Being depressed is all your fault. There’s nothing they can do to help. It’s all up to you! You don’t have depression. You’re depressed. Big difference! Depression is serious. Do you really think you’re that important?

The doctor may prescribe antidepressants. He’s trying to control you! He wants you to be a happy pill popping patient! Can’t he understand that there’s nothing wrong with you? Being happy is overrated- you’ll never be happy again.

However, if you’re finding sleep difficult, just tell the doctor that you’re depressed due to lack of sleep. Bingo! Happy little sleeping pills for you so you can spend all day every day in bed! Score!

Your employers or tutors may be worried about you. You’ve missed a lot of school or work, haven’t you? Tell them that you’re fine. They’ll believe you! If you lose your job or school place because you don’t have the energy, all the better! It wouldn’t have done you any good anyway.

Your lover may lie next to you night after night wondering why you don’t want to touch them.  Or they may have stopped calling.  It doesn’t matter.   They don’t really care.

6. The future

Ha, this is a joke category. What future? You don’t have a future. I mean, look at you, you can barely get out of bed and cook yourself a meal. You spend your whole day abandoned to the horrible thoughts in your mind, you could be shot and you wouldn’t feel it. Everybody hates you and you’re a failure at everything you do. The world isn’t meant for people like you- you should just kill yourself. Why not kill yourself? Then you wouldn’t feel like this anymore. You will never feel like anything else ever again. It’s either death or this is the rest of your life. Can you imagine this being the rest of your life? Then kill yourself. No one will miss you. Nobody cares.

I hope you enjoyed part 1 of the Insane Guide to Mental Illness! Tomorrow: Mania- Nature’s way of telling you that you’re the best.

The Sane Guide to Living with Mental Illness

Wow, this blog has gone right off topic recently. Flippin‘ friends dying, they’re so inconvenient.

I am still nowhere near caught up on e-mails so please excuse me if you haven’t received a reply from me.

I am fairly sane at the moment.

This is somewhat of a revelation; I can’t remember a time in my life when I have been fairly sane. Oh, glimmers of sanity have squeaked through the black tarpaulin of madness but by and large, even my most coherent writings have come from a chaotic planet.

I am not incredibly depressed, nor am I manic. I’m not fantasizing about suicide- it’s been a few months since I’ve white-knuckled safety railings at the riverside.

Anxiety and paranoia, yes, excessive worrying- well, that’s just me- and my ongoing battle with weight and eating continues. A lot of sadness and sorrow and anger at recent events. But mood-wise? Steady, in a mildly depressed kind of way.

How do I judge my own sanity? By not comparing myself to other people. I’m never going to be Completely Sane. The lovely thing about the world is that you’d have to look a long way to find someone who is.

I’m never going to not have manic depression. Even now, with a somewhat clear head, there are “residual symptoms”.

Anxiety and paranoia. An ongoing battle with weight and eating habits (and not-eating habits). Still having trouble sleeping. The reckless nervous energy that is 50% me and 50% manic depression. A mild, niggling, irritating depression that blunts my experiences and emotions. Intrusive thoughts and panic. Narcissistically worrying about being narcissistic.

But this is good.

It was only a few months ago that I was ravingly psychotic, swallowing a huge dose of Lithium and on the verge of utter annihilation. Every little victory- the return from self-destruction- I cherish. To judge my sanity, I compare myself, to myself.

Every time I cast mind back to six months, a year, a year and six months, I’ve been ill. For most of my life, I’ve been ill. I’ve clung on to the merry-go-round of madness and am barely alive because of it.

So, while I’m feeling relatively together, here’s my sane guide to living with mental illness. Bear in mind it’s from the perspective of “been there” rather than “been told”. Feel free to ignore everything, though!

1. In times when you feel better, don’t expect the unexpected.

If you’re like me, this is much easier said than done. I’m a born worrier. I worry about everything. When I click “Publish”, I’ll worry about that, too. Talking about myself all the time? How self-obsessed. And in my self obsessed way? I’ll worry about that. I worry about everything I say, everything I don’t say, and everything I don’t do, and everything I do.

So I find it hard not to worry about the next episode of illness.

I know it’s probably coming, so I find it difficult to enjoy not being mad for a change. Experience has taught me that these lulls in time are the calm before the storm. I’m a rapid-cycler, and pockets of sanity are brief for me.

But, this time, I’m trying to think, “Maybe this will last longer than a few weeks”. You never know. So don’t try to will your next psychotic breakdown or manic episode. Relax, if you can. Take your medication, try to be okay.

2. Keep taking your medication, even if you feel better.

Ah, this old chestnut.

I’ve only been treated for manic depression for the past year and a bit. But every time I’ve felt “alright” and decided to ditch my medication and miss appointments, I’ve become ill again, very, very quickly. It has nearly always resulted in a messy hypomanic or manic episode and has meant that my antipsychotic gets upped to deal with the “crisis”. Or, there are times I’ve quietly skipped my medications and lied about it and become suicidal.

Something I believe, and have emphasized a lot here, is that mental illness is partly biological.

Sure, nature can embellish it, but I strongly agree with the idea that there is a biological basis for most mental illnesses- almost certainly some forms of depression, manic depression, anxiety, schizoaffective disorder, addiction, schizophrenia (their symptomatic similarities to biological illnesses such as epilepsy only strengthens my conviction) and possibly personality disorders, eating disorders and DID.

I don’t subscribe to the belief that mental illnesses are “labels”. Cancer, diabetes, asthma, etc, aren’t labels, they’re illnesses. And so it mental illness. Once I got past that, I found it easier to write with conviction, without worrying about “labelling” myself. I have got manic depression. Whoop.

I’m not on the gravy train of the “medication is evil”. It doesn’t mean I like to take them, though. I hate taking my medications, I always will. I hate the ritual, I hate the weight gain, I hate the exhaustion. I can see the argument- especially in countries where you pay for healthcare, such as the USA, and where medications are advertised like sweets. But if you take something and it makes you feel better, well, I think that’s okay.

And I don’t think people appreciate how difficult it is to continue taking medication for mental illness. On one hand, the side effects can be close to unbearable. I do entirely understand the stance that medication can numb you. But if I hadn’t been treated for manic depression- and medications are a huge part of that- I would most likely be dead.

So on the other hand, we come full circle to…

It’s not a cure. It’s to help you cope and live with your illness, to alleviate some of the more frightening and terrible symptoms that you are living with.

So when you feel better, don’t stop taking medication and don’t miss appointments, however tempting it might be. You might be feeling better due to sheer force of will, help from people, or maybe your illness just shifted somewhat, but, if you’ve been taking medications for a while, there is almost certainly something in them that is helping, too.

3. If it’s not working, say so.

Lithium made me physically sick and didn’t help at all with my illness. But because it was the “gold standard” for bipolar 1 disorder, I didn’t speak up, and quietly waited to feel better.

I never did and after the third or so bout of vomiting, shaking and passing out, I told the psychiatrist that I didn’t want to take it anymore.

Likewise, Seroquel helps me sleep, quells psychosis for the most part but it’s “antidepressant properties” are non-existent in my case and it turns me into a zombie. So I am being slowly switched to risperidone instead.

Of course, there may be times you can’t tell your medication or treatment in general isn’t working. So this one’s for those around you who know you- if you can, let someone know. I was manic for a while on Lithium and it was Rob who noticed I was, not me. Insight is an occasional companion sometimes.

4. Get support.

It can be isolating to live with mental illness. And not everything is as culture tells us it should be; lots of people don’t have close friends or family to rely on. And that isolates us further. Sometimes, family and friends don’t understand. Sometimes, you just don’t want to talk to them anyway.

There are support groups around the country that you can speak to and make friends at. The Manic Depressive Fellowship (now the much more PC Bipolar Organisation) holds regular local support groups, and The Support Line has some links and phone numbers for people with depression. Rethink also offer support groups for illnesses such as manic depression, depression, anxiety, schizophrenia and personality disorders, amongst others.Other “service user” groups include The Perceptions Forum, run by mad people for mad people, centering around the psychosis experienced by people with psychotic illnesses.

There are also tons of online forums that exist to support people with mental illness. A great one is The Mood Garden, which has forums for depression, self harm, anxiety and panic and substance abuse.

There are other good forums and support groups for problems such as anxiety and eating disorders.

5. It’s good to talk. Therapy is important too, but if you’re not going private, bring a book.

I was diagnosed with manic depression over a year ago and I’m still not in therapy. Medications can be good, but I think therapy is just as important. Having someone to talk to, learning ways to cope with an illness that you might have forever and taking the strain from ear-bashed loved ones is valuable.

I am finally speaking to a therapist soon- about friggin’ time an’ all. As biological as mental illness might be, sometimes, treatment is complicated. For example, I can’t take antidepressants. It’s been done a few times, and each time has been the same- hello mania. Treatment, then, is needed to help me cope with depression. I also have, as you know, Body Dysmorphic Disorder and problems with eating disorders, that pills don’t really help.

And even if you have a tidy mentally interesting diagnosis, life still happens, and it’s hard. Quite aside from regularly lapsing into depression because of my illness, there are life-things I struggle to cope with.

And again, it’s a little-thought line that dealing with the diagnosis itself it very difficult indeed. I still have trouble accepting my illness, however lucid and sage I seem here. Like any life-long illness, coming to terms can be hard.

The fall-out from episodes of illness can often be extremely hard to cope with. The strain it can put on your relationships, jobs, physical well-being, finances and other areas can sometimes be the beginning of a downward spiral. (After bad episodes of illness, I hate myself and feel so guilty and worthless I want to top myself. But there are always people I can’t look in the eye, and I find it very difficult to speak to friends and to manage the practical aspects). Psychotic episodes, in my experience, can be the worst as it’s a side of you people may have never seen before, and may find very hard to understand. It is really good to talk these things through.

So, if you’re being treated, push for therapy. You might have to wait a while, though. If you have specific issues (or your loved ones do), such as bereavement, substance abuse and “youth” related problems, there are many free counselling services around that you won’t have to wait so long for, such as Cruse and the Mind Guide to Counselling.

Also, never forget that if you feel you have no-one to turn to, there are confidential counsellors available by phone and e-mail such as the Samaritans. It’s their job to listen, and they can really help in a crisis.MIND also offer free counselling.

6. Mentalist- know thy services.

It’s not inevitable that you’ll need to go into hospital in an acute episode of illness. Whereas sometimes it may be the only option (such as needing to be sectioned for your own safety, and the safety of others), hospitals can be extremely traumatic. They are boring, above all else, and the surroundings can leave a lot to be desired.

If you, your “team” and those around you think you may need somewhere safe to be for a while, there may be other options. For example, there are crisis centres. I am lucky to have (and to be visiting next week with the CPN) a women’s only crisis centre.But look up mental health services in your council directory and ask questions. There may be a crisis centre near you.

You can also enlist the help of a crisis team if you want to avoid admission to hospital. Most councils have a community mental health crisis team who can give you ongoing support and evaluation at home.

7. If you can’t work, get benefits advice and help claiming them. And get someone to keep an eye on your finances.

I have been too disorganised and unwell to even begin to sort out my benefits. My CPN played a huge part in helping me, as did Islington People’s Rights. Now I’m finally on Income Support, Housing Benefit and DLA.

If you’re able, find out what to claim and how, and try to get independant help and advice from local people’s rights services or from the Citizen’s Advice Bureau. If you have family or friends, enlist their help in getting forms for you and helping you fill them out. There are also online services and resources such as the Advice Guide and Rethink.

When you have a mental illness such as manic depression, borderline personality disorder or schizophrenia, you might be, like I have been, impulsive and reckless with cash. When I’ve been working I’ve gone on many a manic spending spree and completely cocked up my finances. The “oh no” bank statement is not your friend, so, embarrassing as it might be, it can be a good idea to ask a friend or someone close to keep an eye on your spending for you.

8. If you’re reading this, you’re alive. Nice one.

Mental illness can equal terminal illness. It’s true that many people with mental illness will go on to commit suicide. Even with the best of care and support, it is not altogether unavoidable.

But being alive, day after day, is a victory. It’s not a failure, it’s not “being weak”. Whatever help you receive, it’s ultimately you who is responsible for yourself. So if you’re managing to continue living, no matter how horrible things get, even if in the past you’ve tried to commit suicide, you are alive and you should try to have some pride in your self.

Again, this is an “easier said than done” rule but I think it’s worth pointing out.That’s all from me for tonight- jesus, it’s a Saturday night. I’m going whip out the media player and turn on the lights so I can pretend I’m at a club or something.

I’ll be writing more trying-to-be-helpful things about living with mental illness in the future. Please feel free to suggest stuff.

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