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.

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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.

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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!

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