Friday 22 May 2015

Progress, hopefully? (Updated)

Progress. I use that word tentatively. Don't get me wrong, of course I'm pleased if I have made any progress! I'm just still not sure if I have, or if I'm just telling the therapist what she wants to hear/complying with therapy tasks. My head's a mess I swear. I've spent so long trying to figure myself out. Why I think the way I do, why I behave the way I do, who I am even. Searching for answers and overthinking every single damn thing.

I'd been trying to do the therapy homework, and use the tools I'd been given/coping techniques etc (thought record, worry tree, relaxation/breathing exercises etc). I felt as if I was failing at everything & it was all my own fault for not trying enough, not being good enough. I never feel as if I'm *anything* enough (if that makes sense?). I really wasn't looking forward to this week's therapy session. I wasn't sure what to tell my therapist, or even discuss with her; apart from the fact that I'd been feeling really really down, I'd self harmed in order to cope, and I felt completely useless; as if I wasn't even worth bothering with.

I was supposed to have a psychiatrist appointment recently, but when I got to the reception desk, I was told that all his appointments had been cancelled & I should've had a letter. I thanked them and left quickly (even though I wanted to ask why they hadn't phoned, like the last time) because the waiting area was busy & I was very nervous. My neighbour had given me a lift, & I'd declined her offer to walk me in, because I wanted to challenge my social anxiety. The letter came later on that day, and now I have to wait until July!

Therapy went a little better than expected. I felt as if all I was doing was moaning to the therapist about things that pissed me off. We discussed things & analysed things together. One particular topic was how I use social media (twitter, mainly). I immerse myself in lots of different topics, I try to keep in touch and updated with friends, I try to be there for as many people as possible & rarely give myself a break (actually, I probably NEVER give myself a proper break). I've been trying to have space from Twitter because I know it can overwhelm me easily. I find it so so hard to stay away from it though. My therapist has been trying to get me to "catch" myself, when I notice something triggering my moods (starting to panic/feel suicidal/dissociating etc) & then either distract myself with something, or do a thought record so that I can monitor my moods & balance my thoughts. I've found it very hard to do, because I seem to have such extreme mood swings & my moods change & worsen so quickly, it's hard to keep up & catch them before they get too bad! I've really been trying though.

She noticed that I've developed checking behaviour when it comes to things like Twitter though. I'll try to "catch" myself when I find being on there getting overwhelming, so I'll leave a message then shut the window down. I'll manage maybe 5 minutes, before I either open the window up again, or go to the app on my phone. I check my notifications, my tweets, messages, people's replies to me over and over again. I have to make sure that what I've said has made sense, I've worded it properly (not in the grammatical sense, but that I've not said the "wrong" thing so that it could be misinterpreted?), I've remembered to reply to people, I've not misinterpreted what they've said (if I get a blunt reply, I instantly think that person hates me). Even if I manage to stop myself from checking for a little longer, it's still constantly on my mind.

So we discussed this, as well as intrusive thoughts, absolute fear of being wrong, the perfectionism, compulsions, other checking behaviours I've had in the past etc and she told me that this definitely sounds like OCD to her. So I think this is her diagnosing me? The more I've thought and read about it, the more I can relate to it though. I know the psychiatrist had previously said that he thinks I just have traits of OCD, but to be honest, I barely said a word in that appointment, & there was a lot I hadn't even realised myself! I feel relieved and validated to get this diagnosis though. Of course I'd much rather not have all these horrible thoughts, and worries, and compulsions, but at least I can put a name to them now! Treatment will be no different of course.

The therapist also said that, in terms of the cognitive side of CBT, she thinks that I've progressed. I've done my best to monitor how I think and feel, & I seem to analyse my own thoughts well, so there's that. If anything, it feels as if this whole round of CBT has been a journey of figuring out that I do in fact have OCD, even if I've not been able to do anything to lessen my symptoms! I have maybe one or two sessions left? She doesn't think an extension is needed this time round, so next session we will be going over a proper finish (I'm not sure what this entails) and also we will be sorting out a relapse plan for me. I've not had one before, and I've felt so lost with what to do, so this relapse plan sounds promising.

She also wants me to have a few months break from therapy (EEP!) to try out the therapy techniques on my own & see how I go. She doesn't think I'm ready to go onto the behavioural part of CBT yet, but I'm to get re-referred to see her when I feel I am ready. She did say that I can contact crisis team if I need to. I feel so disillusioned with crisis team though. I think they take one look at me, and think I'm fine. If anything, going there makes me feel even less safe, because it's the constant realisation that they Will Not Help Me.

I don't want to wait until July to review my dose of the Sertraline (I really don't think I can risk waiting) so I'm going to try to get an appointment with my GP tomorrow (Friday) to see if she will let me increase my dosage. I've also put in a repeat prescription request for Diazepam (prn). If this helps, then I can tell the psychiatrist in July, if not, then at least he knows I've tried & I'll have the opportunity at that appointment to either increase further/go on something else/add something else. We'll just have to wait and see. I just really really hope this next appointment goes well. I'm going to have to make sure that I can get my words out & be completely honest with him, no matter how ridiculous/embarrassed/messed up I might feel.

--------------------------------------------------------------------

On a completely different note, my left knee has been popping out again & I've decided to approach the GP about this tomorrow. I'm hoping that she'll refer me, although I'm not sure to which specialist. It needs investigating anyway.

--------------------------------------------------------------------

UPDATE

I spoke to my GP earlier today, about the Sertraline dose and knee problem specifically. I'm now on 100mg Setraline (as opposed to 50mg) and I've been referred to a specialist Physiotherapist to see what's going on with my knee/what I can do to manage it/if I need to be referred on to an Orthopaedic doctor/surgeon. The GP believes that it's my patella that is dislocating & seems to be getting worse (it has got worse to be honest!) although to me it feels as if the actual joint itself is dislocating. We'll have to see what the physio says though!

Tuesday 12 May 2015

Doubting

I did intend to write a post about my thoughts regarding the election result, but I am so so angry & scared about it (& what else the tories have in store for disabled people, unemployed people etc) that I can barely even form a sentence that would do it justice. All I keep thinking is that people have to stick together, be there for each other, support each other, know their rights (while we still have them!). I dread to think what'll happen next, but I refuse to be silent!

Anyway, back to the topic of this post. I want to talk about my mental health again, & how I think therapy's going.

I had therapy earlier today, & honestly I felt completely useless throughout it. It's been a few weeks since my previous appointment & with various things happening, my moods being all over the place again etc, maybe that's to blame but I was having my doubts about CBT again. I can't exactly put my finger on what's not working, but it just feels as if I'm hardly making any progress, & if I do make any progress, I tend to relapse not long after.

According to the therapist, I know a hell of a lot about CBT (I tried an online course of it, I've read up about it, watched videos, talked to people about it, studied it etc) & I tend to be quite familiar with the tools (the worry tree, thought records, behavioural activation). In theory, the tools sound useful & maybe they do help people. Maybe I'm not trying hard enough, or I'm not being open-minded enough, or maybe I'm expecting too much, but they don't seem to be helping me. I get to a certain point with them, where I'm (for example) challenging a negative thought, considering evidence for & against it & trying to come to some sort of balanced conclusion. I don't seem to believe it though. I won't let myself accept that the negative thought is just a thought. I won't let myself change focus in order to let the thought go. It's like I'm clinging onto these worries, automatic thoughts, paranoid thoughts etc because I've always been like this & I don't know how to think in any other way/I don't trust the other way of thinking to be the "right" one.

I told my therapist today that when it comes to my thoughts, it feels as if there's so many that they form this huge messy knot in my head. It's hard to select each one, break it down, critically analyse it or even just acknowledge and accept it.

I'm always trying to figure out what the therapist/GP/psychiatrist thinks when I talk to them. In terms of diagnoses, I'm still confused & the only ones *officially* in my notes are Generalised Anxiety Disorder & Depression. It seems as if none of them want to think about diagnoses though, & would rather focus more on how I feel, think, behave, how it affects my life & so on. I know diagnoses aren't the be all and end all of things, but I've always found them very validating & in a way, it's helped me feel as if I can connect with others with the same diagnoses, know that they understand, and that they know that I understand. Without that diagnosis, it's just a list of symptoms that could be A, could be B, or might not quite fit the criteria for A or B. I know this is ridiculous, & I don't think anyone has actually tried to make me feel this way, but it's like I feel as if I don't have the right to talk about those particular symptoms I have, that I think fit that particular diagnosis because I've not been given that particular diagnosis!

 The therapist is most vocal about focusing more on my thoughts, feelings & behaviours (well, obviously!) & from what I remember, this is what she says about me:


  • I'm a perfectionist
  • I think in extremes (all or nothing)
  • I feel responsible for everything
  • I feel the need to control everything/one
  • I never put myself first/I don't feel I deserve to
  • I don't trust my own judgment
  • I look to others for reassurance & validation
  • I put a ridiculous amount of pressure on myself
  • I have a lot of compulsions, "checking" behaviour, looking for certainty, terrified of being wrong etc. (e.g. you would not believe how many times I check twitter, my tweets, other people's responses, my blog posts etc)
  • I'm very very self critical
  • I don't always notice when I'm worrying, until the worrying gets really bad
There's probably more that I can't think of right now, but those are a few key things she's said. She says she finds the things I say very interesting as well? She writes down so many notes each session, I'd love to know what she's written down! Last time I saw the GP though, I asked her what kinds of things mental health services have said to her in correspondence. It turns out there's barely anything! It's probably my paranoid brain again, but I really thought that mental health services (i.e. therapist, crisis team nurses, psychiatrist) were hiding a lot of things from me. It seems pointless even bothering to open up about things (especially the self harm) if it's just going to be disregarded.

I know I'm lucky that I'm getting therapy at all, & I'm lucky that I got the chance to see a psychiatrist at all. Sometimes it feels like the Sertraline the psychiatrist prescribed is helping a bit, even if just to keep me safe(ish), but I really don't feel as if I'm moving forward. I just feel as if I'm going round in circles. 


I'm not sure if I should ask to get re-referred for CBT once these sessions have ended. What else is there though? Who can I turn to when I don't feel safe? Will I be even more reluctant to ask for help when in crisis? It seems as if it's all up to me to figure out what I need, what will help etc but honestly? I don't know!



Thursday 7 May 2015

Amzie's Coping Toolkit

(CN: Suicide details in "deaths" link)

So today's the day! I'm actually scared about this election. After seeing the devastation caused by the tories (sky-rocketing benefit sanctions, bedroom tax, the huge rise in need for food banks, cuts, cuts & more cuts, deaths related to sanctions, abolition of ILF, the list goes on...) it terrifies me what could happen next if they stay in power.

I couldn't decide whether to write a post purely dedicated to the election. The information is everywhere (obvious statement is obvious) & people are anxious enough. I'm not sure if this post will be useful, but I decided to just write down the kind of things I might be doing to cope over the next few days. I've only managed to write this post thanks to Diazepam keeping me relatively functional/less like a big ball of anxiety and agitation.

Anyway, here goes:

Keep busy with enjoyable things, for example:
  1. Cross stitch 
  2. Colouring in
  3. Computer games (Doodle God, Sims etc. For online games, I recommend Shockwave and Newgrounds

Something to boost self esteem a bit:
  1. Do my hair/try out a new style
  2. Try a new makeup style/put on my favourite makeup
  3. Paint nails with my favourite nail polish

Something calming:
  1. Meditation (if you need a guided one, then Youtube has lots)
  2. Comforting drinks (hot chocolate, chai tea, horlicks, whatever!) 
  3. Calm music (I tend to go for meditation music/classical music/Enya)

Something cute/funny:
  1. Look for cute animal videos on Youtube (Kittens, puppies, bunnies, foxes etc)

Remember to eat:
  1. Have something easy to prepare
  2. Maybe order a takeaway (I'll be getting KFC on the way back from voting)

Remember to breathe:

Sometimes this helps me, sometimes I can't focus enough to, but I try to do breathing exercises when I feel the panic getting really hard to manage. If I remember correctly it's inhale for a count of 4, then exhale for a count of 4?


Get outside for a few minutes:

This is something I seem to want to do a lot at the moment, although I can't manage to do even little walks very often. I tend to take the recycling/bin out if it's light enough, then I can have a few minutes outside. The evening tends to be easier for this. I can try my breathing exercises again, and also try to focus on the things around me (the stars, the sound of birds, the smell of a bonfire etc). If I can get outside in the daytime, then I'll bring my phone with me and take pictures of flowers, trees, birds etc, I find focusing on nature helps a bit, even if very temporarily.


Keep in touch:

This is one I find hard to do quite often, as when I feel at my worst, I isolate myself a lot. Brains can be horrible though, and spending too much time just with my brain makes me feel very lonely, I get very self loathing and paranoid as well. Keeping in touch with friends helps remind me that people do care, I can talk to them, and I'm not really alone.


Don't overdo it!

I've immersed myself in blog posts, articles, email updates, political programmes, political tweets etc & tried so hard to squash my anxiety down and speak up when possible. It's so important to take breaks from it when you feel yourself getting overwhelmed. So having a plan for something to do/read/play/watch that has absolutely nothing to do with politics (or even the real world!) could be a good idea.


I'm sure I'll think of a load of other things after I publish this post, but these are just a few examples. It's something I'll be referring to later on today, even just to remind myself to be kind to myself. 

Anyway, take care & lots of love and hugs for everyone who needs them right now xxxxx