Oh Dear
29 Feb 2012 Leave a Comment
in Bipolar Tags: bipolar, depression, mental health, moodswings
I’m somewhat concerned.
I’ve gone from fine, just over two weeks ago, to feeling like this. More
Hello Stranger
18 Feb 2012 1 Comment
in Bipolar, University Tags: boyfriend, impulsivity, mood disorder, normal, normality, unpleasant
I think it’s been about 4 months since I last blogged. Sorry to anyone who enjoys reading my natter.
Med school is hard – especiallly when you’re not on top form.
I had a very busy Christmas, trying to get all of my assignments done. I did manage this, helped by the presence of my boyfriend. So, I passed the first module exams. Exciting, right. I have another deadline in a month, then I’m safe for another 2 months – then I’ll be exposed to the main exam season. I’m a little worried about that, since I got more and more stressy and down and anxious until I finished the last set of exams which were smaller and less important.
But when I had finished my exams, I very quickly got better. I got to the point which I would be happy to call euthymia. With a normal amount of energy and enthusiasm, I was working as hard as I thought I should have been. That also involved staying up a bit later than I had been doing. And I was okay – for almost 2 weeks. So I’m very confident with bone physiology and bone disease pathology. *thumbs up*
I figure I must have worked too hard, or stayed up too late. Last friday, I felt nothing – nothing felt real. My skin was numb. I can’t describe it very well, but it was weird. It persisted. I shaved a portion of hair off, on impulse. So, I’ve been a bit out of it for the week since.
I hope I feel normal again soon. If not, I hope I can catch up over easter.
Empty Shelves
19 Nov 2011 2 Comments
I’ve been having a lot of trouble pinning down how I’ve been feeling, mostly because I haven’t been feeling all that much. It’s just bad.
Anyway, I thought a bit about it this morning; I feel like an empty bookshelf.
(Only follow the -more- if you don't mind reading brain mush. It's a bit twattish.)
Turbulence
18 Nov 2011 4 Comments
in Bipolar, Day to Day, Self-Harm Tags: bipolar, boyfriend, depression, impulsivity, moodswings, self-harm, university
Okay, it was only a little bump.
My boyfriend broke up with me, so I was understandably upset. I was completely naked at the time, so I pulled on some knickers and 2 tops (don’t ask, because I don’t know), then ran over to where one of our friends lives. He wasn’t in. I determined this by knocking on the window, as you do. Anyway, I then went to the front door and got buzzed into his flat by someone I don’t know and went to all the other flats of people I knew. “Safe” people. Only one (out of 3) was in. So, he opens the door to his room to me, trouserless and about to cry.
I sobbed for a while and explained what had happened (I’ll explain to you lot in a moment). He told me I should come see him if I ever want to self-harm. I get this offer a lot, but for some reason I am completely unable to act on it when I feel like that. Maybe because by then, I’m too far gone, or I’m worried about hassling people too often – becoming a burden. You can’t do that to people, especially if you want them as your friend. I have real trouble with this common sense preventative measure; honestly, I wish I didn’t. It would be so much easier if I could just trust myself with that sort of thing, don’t you know? I wish I knew what stopped me.
Anyway, I got a bit sidetracked there. I chilled with him for a while, until his female flatmate (another friend) turned up. We chilled together for a while. They told me I should stay the night with them. They took me to my flat to pick up my stuff for overnighting; duvet, pyjamas, work and clothing for the next day. I was ready for bed in my female friend’s room, then I banged my head. I burst into tears. Not because it hurt. No; because I wished my boyfriend was there to look after me. Because I felt that he would never do so again. My friend got tissues and we chatted, a bit. Mostly me chatting shit. Hey ho.
I didn’t want to talk anymore (mostly because she was trying to give advice), so I lay on the floor ready to sleep. Then I burst into tears again. So I left the room and sat in the kitchen, crying. She followed me, then listened to me berate myself and hate myself. I wanted to knock for the original friend I went to see, so we did. He was in, so I told him what happened. Chilled with him for an hour, distracted me from feeling like I did, then I went back to floor-bed. Slept.
Next morning, we got up. Female friend had to go to the doctor, but the first guy was leaving early, so he wandered me to my flat. I got ready, and then we left for lessons. Boyfriend was texting me. He explained that he made a mistake. I said that it was okay. He called me later in the day, confirmed that it was all okay.
So, I’ve mentioned this ultimatum before. Well, it didn’t work here. I self-harmed a few times. I hoped he wouldn’t notice. I definitely didn’t tell him, because that’s the sure fire way of getting dumped.
Duh.
So I hid it, pretended nothing had happened, made transparent excuses – all of which he saw straight through. Bollocks. He pretended nothing had happened. He hid his responses. Until yesterday, when he was down. Suicidal. Having thoughts of overdosing. He’s said so to me. He’s said so to a lot of people. How can he be so open? Why is he being so open?
I pushed and pushed to find out why he was down. It all spilled out. He broke it off with me. I went straight to some of his friends and told them to look after him – via Facebook message. Fortunately, they took me seriously.
I was so fucking worried last night. There was some grieving, but mostly, I was worried. I knew exactly why he had done what he had done. He felt unwell and I had self-harmed.
I hate myself so much. I feel disgusting. Did I make him suicidal? Was he right to take me back?
He seems a bit better tonight. I don’t feel much better. I think it’s an evening thing. I don’t know why.
First Aid Kit
14 Nov 2011 1 Comment
in Bipolar, Day to Day, Self-Harm, University Tags: bipolar, boyfriend, impulsivity, mental health, mood disorder, self-harm, tattoo, university
So, I showed the lizard image to my friends on tumblr and one of them adjusted it. So, if you look to the left…
Isn’t that glorious.
The outline might look a bit weird, as I removed the star on paint (since that’s my best quality image editing software), but I think it’s amazing. I hope you agree. If anyone of you steals it, I will personally find you and wrong you. Okay?
That image is now copyright to me, S, and F. That’s how it works, right?
Anyway, from this point on, I will be discussing self harm a bit.
*Trigger Warning: Somewhat Graphic Discussion of Self-Harm*
I found that this evening, as I walked back from lectures, I was looking at the ground. At the paving stones; the gaps between the paving stones and the texture of the concrete in the dark. It reminded me of the cuts I’ve made which have gaped and revealed subcutaneous tissue. Mostly over my calf muscle (fortunately, I’ve never reached muscle). It looks odd.
My body instantly goes into “oh shit” mode. I feel as though I’ve been kicked in the chest. That’s usually enough to stop that ‘session’ of self harm. Occasionally not.
It’s a bit weird being somewhere that you can’t talk about self-harm. I haven’t done so for a while, really. I don’t really know whether that’s better for me or not. Does it make a difference?
If it’s better for me, I’d rather avoid talking about it, you know? But for now, it’s just floating around my head all the time. I’ve been fixed on the idea of making a first aid kit for a while. I would need: sterilising wipes, plasters, sterile low adherent pads, bandages, steristrips (lots of), large adhesive dressings, sterile scissors, first aid disinfectanct, tape, sterile gloves, and tubigrips. If I don’t self-harm, it’ll probably be a huge waste of money. Generally people don’t get hurt in a way that requires that sort of stuff, right? If it’s there, will I be more tempted to self-harm, as I am therefore able to fix most things I’ll do? Therefore self-harm will be less damaging or have a lower self-evaluated risk? Or does not having it mean I’m at more risk if/when I do self-harm?
I read some of the first aid for self-harm; parts of which made me laugh. Who goes to A&E for a cut on the hands? Do you really need to go for stitches for a cut more than 1cm long? I can probably count the number of self-inflicted lacerations that were 1cm or shorter on my fingers. Maybe that’s just me, but I somehow doubt it. Maybe that advice is more suited for people who are likely to self-harm more severely than I do. The only time I’ve sought medical attention was after series of cuts hadn’t stopped bleeding for an hour, so – panicking – I told a friend, who took me to a walk in center when a nurse steri-stripped it. Although I think the advice I’ve been reading includes steri-strips as a form of suture. On the one hand, it might be good to encourage people to come into contact with services earlier, not all services are terribly pleasant. I remember that talking to the GPs at the walk-in had me in inconsolable tears, although one of them was scary and the other was a bit more helpful. Of course, that set the ball rolling and now I am surrounded by professional support. Maybe I wouldn’t have that if I didn’t talk to my friend? Maybe I wouldn’t be in med school? Maybe I wouldn’t be with my boyfriend anymore – I doubt I would be.
He wants me to stop. I know, because of the ultimatum. I’m trying. It’s difficult, but I’m trying. I know self-harm is linked to an increased risk of suicide attempts (and therefore successful suicides). His justifications are fairly legit; it’ll trigger him and it makes me more unwell. But does it actually make me more unwell? Or is it simply a marker that I am getting unwell? The severity of self-harm isn’t necessarily linked to the level of distress. It just kinda tends to get worse.
That doesn’t help my case really. “It’s okay for me to self-harm, because it allows me to cope with whatever’s going on in my head, even though I know it’s going to get worse and leave nastier and nastier scars until this episode ends, although I might accidently do something dangerous”.
I don’t think I won that one.
See, that’s why I need to actually discuss these things! Otherwise I only get my point of veiw floating around my head. I suppose that’s why you can’t be scared of candid conversations. Start them, if you’re worried about someone. They might be waiting for it. Preaching to the choir, I’m sure. I know people are scared of “putting ideas” in peoples heads; but unless you’re giving hints and tips, chances are you’re alright. If you take the time to talk it through, you may even save a life. (I was trying to find a page to like here, but I found nothing appropriate.)
I have no idea how I am at the moment. I have little motivation and low appetite. My room’s a tip and I think I may actually smell. I’ve been feeling a bit self-destructive and impulsive. But I don’t necessarily feel down. I don’t have the ability to concentrate at all on lectures, but I’ve just written this. Which is odd. It has taken about an hour, I think. I don’t quite know where I’m at, so I don’t know what to do to help myself. Eat and sleep, I guess.
I still exist. Promise.
12 Nov 2011 2 Comments
in Bipolar, Day to Day, Psychiatrist, Self-Harm, University Tags: agitation, anxiety, bipolar, depression, lithium, mental health, mood stabilisers, moodswings, psychiatrist, self-harm, tattoo, university
I have been so busy, but I probably still require the catharsis that writing provides.
*Plonk some Trigger Warnings in here: self harm.*
Okay, below, is a badly lit image of my tattoo.
It says forelsket. This means that I need a nice shiney camera, rather than relying on webcam.
Just kidding.
forelsket (for – ehl – skert) adj in love
Easy peasy.
Above, you should see the variation on the rod of asclepius that my tattooist friend drew up for me. I will get that soon. I just have to work out what I want the background to be, because it can’t be that star – which is the symbol for emergency medicine (EMPs, paramedics, etc). If you know otherwise, let me know.
So I wouldn’t be adverse to suggestions for the background. My imagination is pretty dead at the moment, sadly. I also have a few ideas for other tattoos I would like. A fox with a strawberry/map and one with the words “it’s something unpredictable, but in the end it’s right” on it.
Anyway. That’s that bit over and done with (although, tattoos are awesome, amirite?). So; a lot has happened since last time I’ve blogged. Mostly good, I think. Let’s begin with just after I left off. I felt like shit so I called the psych and asked for a prescription for ADs (not just randomly, but she had offered fluoxetine before). She prescribed sertraline 50mg, which we could up if necessary. It was completely not necessary. My mood lifted within 2 days of taking them. Now, when things like that happen, you do have to wonder whether it was just placebo or whether I was just about to go up anyway. Nonetheless, I was to continue taking them. Fine. I fear that it may have made me a bit wobbly, moodwise, and very restless. I don’t want to say that it’s caused akathisia, because I’m not quite sure exactly what constitutes the diagnostic requirements for that, but I have been very pacey and I want to amputate my legs to stop the fuckers from twitching. Yesterday I was pacing/running for 80 minutes, up and down that hallway, partially due to restlessness and partially so I don’t anything stupid based on the brain screaming. In response to this, I am cutting out the sertraline (which I’ve only been on for about 2 months) to see if that makes a difference. I’m hoping I do it slowly enough to avoid any withdrawal symptoms (I remember that citalopram was unpleasant). My concerns are that it is not linked or that I will become much more depressive/anxious.
I’m still on Lithium. I took a week off the stuff (I had one of those “these drugs are making me worse, not better, there’s not actually anything wrong with me, these drugs are just making me miserable and fucking up my social life” moments) and I very rapidly went high and fucked off a few people. Took the lithium again, started tippy-toeing around a few people; all just about alright…
As I mentioned, my mood has been a bit wobbly; I’ve been restless and brainscreamy as well as don’t-want-to-do-anything-down. Nevertheless, this is still probably more stable than I have been in the past and I haven’t reached the point of suicidality in the last 9 weeks. I’m thinking that one of the things contributing to the moodswings (as well as my perception of them) is that I’m actually stressed for, like, the first time. Sadly, the amount of work I have going on at once (although most of it is formative – doesn’t count towards my grades) means I have no idea where to start or what I should prioritise. I also can’t do too much at once without breaks, or I’ll crash, I’m sure of it. I’ve been tired since, well, the first night out, then I had a bit of a downer, now I’m just about alright, but I haven’t been able to catch up on any sleep.
You’ll all be glad to hear that I have accessed student support here, I’m talking to someone once a week and I’ve been referred to the EIT in this city too. The student support is quite good, and I’ve been told that in some circumstances it will be my responsibility to disclose that I’ve been diagnosed with bipolar disorder (as I have to my GP tutor). I haven’t told any of the students that I work directly with, mostly because I don’t think they really understand what is meant by bipolar disorder (one girl I’ve been talking to has made it clear that she believes that individuals with bipolar are always either manic or suicidally depressed – I’ve tried to right her on that, but I don’t know). I’ve told a few students that I don’t work directly with – my flatmates and 4 other med students. They’re fairly alright with it, I think. I’ll tell people if I think I need to tell them, but I think I’d have to be pretty unwell to do that. Otherwise, I can ask the disability services at the uni to do some disclosure on my behalf.
The early intervention team here are different. So far, I like the case manager guy and I’m not too fond of the psychiatrist lady. Then again, she is actually going to provide psychotherapies as well as drugs, so it’s okay. I didn’t like the way she spoke (although I wasn’t feeling terribly agreeable when I saw her anyway, so that might be the cause). It was really funny, the little I know about medicine – I could see the consulting skills and techniques she was using (calgary-cambridge model, anyone?). I asked her about stopping sertraline, but she kinda brushed it off (probably because this is the first time she’s met me). So I didn’t actually get to discuss my concerns about it destabilising me or causing restlessness (ICE, woman, assess my ICE!). So, I’m going to stop it by myself. I’ll tell the case manager if it goes alright. Otherwise, I’ll just start retaking them – in an emergency/crisis caused by me fucking around, I still have a variety of contacts. The only issue with the psychotherapies is that she’s implied I can only tackle one thing at a time. I hope she takes me fucking seriously when I say I think my biggest problem is the self-harming bullshit at the moment. I’m relatively stable. If I can get through a reasonable period without wanting to slice myself to bits for no real reason – or if I have the techniques that means that those fucked up emotions don’t screw up my day and all the stuff I have planned (who the hell can write about physiology/ethics/sociology when 95% of your brain is telling you to hack at yourself?).
Although, it might just be that I’m a lazy fuck. Procrastination queen.
Also, I’ve managed to get down to a sum total of £30… So I’ve got an interest free loan from the uni, which I’ve given to a trustworthy flatmate to look after for me. No idea how. It just happened.
You also have to mention what sort of trigger warnings I should have. I know some people think trigger warnings are stupid, but it’s less of an issue if those people get a bit sniffy about the trigger warning being present than if I accidently distress someone by omitting the trigger warning. I know I’ve been a bit shocked if I come across an image of self-inflicted cuts without any sort of trigger warning. It would just mean I had a choice. I’m sure that there are people more sensitive than me. I don’t know if anyone like that reads this blog, but just in case…
Pericyazine is Pants
03 Sep 2011 4 Comments
in Bipolar, Psychiatrist, University Tags: antidepressants, anxiety, depression, lithium, mental health, mood disorder, mood stabilisers, psychiatrist, tattoo, university
It did the same sort of thing that Seroquel did, and I didn’t like it. Admittedly, at 5mg it did relieve the anxiety before it inserted its own brand of unpleasantness in, which consists of tiredness and irritability. Irritability which led to me frightening one of my brothers and generally terrorising anyone that made me snap.
“Super-bitch.”
I’ve taken 5mg once and 2.5mg once. It probably gets better as I take more, but I don’t really want to. I don’t know whether to call my psych, actually, I think I’m going to have to. I really really do not want to be down any longer. Let her prescribe the ADs, or at least explain how I’m supposed to take these ones. As you can see, I’ve just taken a dose when I’ve felt anxious/wanted to self harm.
I got the “service user copy” of the letter to the GP:
We talked about additional medication such as Olanzapine but that will make her feel quite sedated. In the past antidepressants destabilised her mood. She was happy to continue on lithium. We later decided to add Pericyazine prn for agitation. She appeared more irritable than usual.
I didn’t know that was the reason I was prescribed Pericyazine.
She tried to prescribe Fluoxetine last time, so she’d probably go for that. It’ll be okay with the Lithium, right? It won’t make me feel worse, right? It won’t do what the Citalopram did, because I didn’t have a mood stabiliser with the Citalopram, right?
It’s not fair, I take the Lithium every day. Maybe I’m not seeing enough side-effects to expect it to work, but it should. I know I’ve not been on it for that long, and I’ve been on this dose for a shorter period than I’ve been down this time, so I shouldn’t expect it to work properly.
I’m moving in 13 days. Nothing else matters. I want to see that I’m definitely getting better by then. Because depression at University sounds hard. Maybe the simple act of moving in will make me feel a bit better. But for now, if I am getting better, it is very slow progress. I recognise I’m not as bad as I have been; which, I think, is because I am working towards moving in to Uni, rather than some sort of ambiguous non-future.
(Also, I got a tattoo.)
Pericyazine
24 Aug 2011 Leave a Comment
in Bipolar, Psychiatrist Tags: lamotrigine, pericyazine, psychiatrist
I went to the psychiatrist yesterday, 2 months since the last appointment. I brought my boyfriend, so we could tell her as much as possible. Otherwise I would skip stuff, or be even more vague.
Anyway, telling her about the last 2 1/2 months incited the typical reaction of: “Here, have some more drugs.” Initially, I tried to fight the corner of lamotrigine, but she wasn’t having it. She then offered me olanzapine, which I rejected due to my disdain for seroquel. It’s probably an unfair reaction, but I do not want something that will make me sleepy and fuzzy – especially when I’m already cocking up at work. A short time later, she recommended fluoxetine, which I instantly turned down – then I went into a little rant about what citalopram did to me and that SSRIs take so fucking long to work and there’s no point giving me a drugs that’ll take so fucking long, especially as I’m starting to get better now! If she had offered these things to me last month, I may have jumped at them, but not yesterday. Maybe I should have accepted them. Who knows.
Anyway, my boyfriend and I left the consulting room, to sit down in the waiting room and fill in a questionnaire (I hate closed-answer questionnaires, they’re so vague), then the case worker social worker lady trots out and asks us to return to the psychiatrist. This time she suggests an “anxiolytic”. Maybe we misheard her, because after we agree that a PRN anti-anxiety would perhaps be helpful – I could take it as and when it was necessary, but no more – she talks about an anti-psychotic. Pericyazine “just take 5mg if you need it, or you can even break them in half”.
Go to the chemist: get a box of 42 2.5mg pericyazine tablets. Instructions: take 2, 3 times a day, when required. What?
I’m assuming it’s like paracetamol – take one or two no more than every 4 hours, but consume no more than 8 – or some such thing. The internet is not helpful.
There is a group of young people outside my house, speaking very very loudly. It is frightening.
Worries about Medicine.
21 Aug 2011 Leave a Comment
in Bipolar, Day to Day, University Tags: bipolar, depression, mental health, mood disorder, university
As in the 5 year university course which just about qualifies me to make diagnoses and write prescriptions.
Firstly, the course itself:
- What if I don’t like it? That would suck. But if I dropped out, I would have nowhere to go.
- What happens if I get ill? Ill like I have been, with the extra support that is available, should be alright. Any more ill… That would suck.
- I’m awful with people. What if I don’t get better at that, then I’m a bad doctor, and patients won’t want to open up to me, then they don’t get treated as they should.
- What if I get ill as a doctor? Will I get fired? Will other people resent me for being a deadweight? What if I affect the prognosis of patients by simply being unwell?
- Will my own experiences affect my ability to doctor in a negative way? Will I judge people incorrectly, based on my own experiences? What if I become too lenient with the patients’ specific requests about medication? What if I meet people like people I know? Will I be prejudiced?
Nonetheless, even if they were at the level she wanted (0.6, which they probably were) being depressed for 2 1/2 months would mean something would have to change anyway, I’m sure.
Things others have graciously added to my blog: