I am feeling as though I have just spent the last nine days on an outward bound course which I had either forgotten I had signed up to - or that some well-meaning friend had coaxed me along to because it would take me out of myself. Much of these last days have been an absolute blur and today is the first day I have made it to the computer. A huge effort of will over desire. As I write my hands are shaking and my typing is slow and I am need to think twice about my spelling. (Mind you as a sixties child in primary school I was taught expressing myself was more important than learning basic grammar - I've always been linguistically creative! I spelt before as either befour or befir probably until I was twelve.)
I was referred to a psychiatrist at our local day mental health facility nine days ago. It's on the same site where I work as a chaplain - but because of the work I have done within a few of the in-patient facilities - I know, first hand, the extraordinary quality of much of the support patients received. Attending the day centre, even in my acute anxiety, was a huge relief. It was rather like going home. I felt safe there.
My anxiety was at it's most acute at that point of referral. Speaking out loud seemed meaningless and as though someone else was doing the talking. I felt most comfortable silent. I was physically very agitated too. I couldn't keep my legs still and when they stopped bouncing about my hands would start flicking or I needed to rock. I think they are all self-comforting and calming techinques as is tapping my temples which seems to relieve tension, but also indicating levels of duress and at times they are my only means of communicating - that and hand holding or a thumbs up or thumbs down signals. I have always had a slight sense of being mildly autistic and at times like this I feel it much more acutely. It's as though my actions become a self-fulfilling prophesy of isolation and worthlessness.
I felt eight days ago I would be making other people's lives a lot more uncomplicated and easy to manage if I wasn't around. I guess I had vague notions of going to some hotel and taking an overdose - but - and don't laugh too loudly it is quite funny - I was far too anxious to work out the details and certainly didn't have the energy to do anything about anything. Far too much effort to leave the comfort of the duvet. At that time and even now the goals I am being encouraged by the CPN to set for each day are by most standards more akin to the management of a pre-school.
My new psychiatrist I intuited was gentle and safe. I had braced myself for a rather perfunctory ten minutes consultation and a prescription - very much my experience when we lived in the south and I had a similar bout of severe depression. This guy had the gift for giving me space and time to calm down emotionally and attempt to balance myself - and he told me my story - effectively inviting me to correct any inaccuracies. There were very few as my CPN at my local medical practice is a wise bird and had represented my circumstances clearly and concisely. Yes, I left with a prescription for an increase dose of antidepressant and Diazapan to try and reduce my anxiety. But I was utterly overwelmed by the help available; I would see a CPN a few times a week; start OT and there was a chance I could join a writing group. I know this is probably a sick mental health joke that only fellow depressives would understand - but I did wonder if I had overdosed and this was heaven. I felt someone was interested in me and not just what I could do for them - or what they projected on to me.
The only anxiety I have about my new CPN who I will call D is that she is a person of faith and I am already a bit anxious about some of the assumptions she is making about where I might be in religious terms. I sense she feels I have been 'sent' to her in some way and I feel I would be better off consigned to the compost heap for recycling.
The Diazapan and the increase in the Citolopram were very reminiscent of snuggling-up in a warm, cocoon like environment and when the Diaz' was at it's most effective all the physical symptoms of agitation were reduced and I was able to sleep - deeply and refreshingly. When I wasn't asleep all I really wanted to do was lie on my bed with dogs and cats, and count the hours to the next dose. The agitation and anxiety kicked in badly about two to three hours before I could take the next one. As the Diaz' wore off my darker, tormenting thougts returned in no greater intensity than before but became ever present like an unbroken record - same old complaints and criticisms. At least I know what's coming now - at least most of the time. Over the last few days these have been accompanied with flashbacks to memories - mostly unpleasant and brutal incidents in the past. The Diaz' is less effective now.
I was set up with a session with CPN D based at the day centre. I didn't like to ask if I would see the one I'd grown attached to at the surgery again. I was thrilled he'd phoned and had an update. Apparently I will be able to see him again at some point, but for now I guess the idea is to stabilise me and make me feel comfortable at the day centre where they can keep a close eye on my progress. D was upbeat but gentle. She listened hard to both my partner and I as we tried to fill her in and make sense of our story.
D is hoping to work through a booklet with me which is an introduction to a series of workbooks on Depression using CBT (Cognitive Behaviour Therapy). We haven't got as far as Part 1: The Overcoming Depression Workbook yet - but I can feel my stomach churning at the prospect - mostly because it demands changes in the way I think, feel and conduct my life. It involves facing myself and continuing the process of be-friending my inner shadow which so often bullies me and frightens me. It involves trust too - absolute trust of others and of myself.
The changes are implemented and will be maintained by me - and that feels a tall order just now when getting to the sitting room and stting there for a while feels exhausting. Still, the flesh may be weak, but my heart, soul and mind is up for it. However tempting it is to listen to the voice that goads I know that the other, multifarious sub-personalities cannot be welcomed back into their rightful places unless I am proactive in releasing the issues that cause my anxiety and seek ways of managing my depression. It is my nasty, small-minded, mean, pinched voice that has been allowed to dominate. My mean-voice is usually a very unimportant part of my sub-personalities and maybe the reason mean-voice has taken such a vice-like grip now is because mean-voice hasn't felt heard fully for a long time.
D gave me a copy of the workbook we would use together and the Deacon's Flower Exercise which is brilliant but I would like to adapt - both to make it more inclusive and disability friendly. It was developed by a mental health practitioner and also a person who lives with mental illness, who also wanted to explore holistic approaches to patient care. In one diagram provided, the centre of a large daisy is identified as 'Mental Illness'. Rather like the game 'Loves me, loves me not' all the 'petals' are scattered around the page, but none are attached to the central part of the daisy. Each petal covers an aspect of life:
Values and beliefs,
Hopes and Dreams,
Spirituality,
Class,
Politics,
Work,
Sexuality,
Friends,
Family,
Culture
and a blank petal.
I didn't make a copy of my response but I can remember roughly what I wrote for each 'petal'. As I am now attending the centre three times a week I will try and remember to ask for a photocopy but my memory isn't my strong point at the moment - the cocktail of Citaloprame, Diazapan, Antihistamine (mosquitos love me - but my blood must stun them into a quick death just now), Voltarol (for the after effects of that accident a few months back - joints are like walking on molten lava) and Zopiclone at night means it's amazing I'm upright! (Still, in a previous life when I was a theatre director I could drink quite a few colleagues into oblivion. Interesting that since marrying a tea-totaller I haven't missed drinking and go puce after the first mouthful! Not always the company or conversation.)
Values and Beliefs
I focused on the idea that we are all uniquely and wonderfully made. We all have a unique vocation to fulfill. Belonging is more important than believeing. Justice is what changes the world.
Hopes and Dreams
To get well.
To be fitter and more confident now my mobility is shot to bits.
To get the book published and write the next one.
To live as I am as fully me as I can be.
Spirituality
Work in progress.
Angry with pacificity of the Church.
Inclusive.
Justice centred.
Heart.
Class
Parents middle class living in a very poor working class area. Both high achievers in their fields.
Educated and still actively learning and changing.
Politics
Left wing, pascifist, CND, Friends of the Earth, Amnesty International, Disability Rights.
Work
I wish. Some from writing. Some from lecturing. Some from running a retreat space. Some from consultancy. Happy - balance wrong - components right.
Not enough responsibility and therefore very, very frustrated. Feel de-valued and useless.
Sexuality
Heterosexual but no real sex drive at the moment - although even through much drug induced haze I can see I have a gorgeous husband and equal first would be Raymond Blanc.
Friends
Very few locally. Isolated and the local ones are busy professionals. Most friends it's phone, writing, or e-mail. Lonely.
Family
Resembles the story-lining for a new soap opera called Dysfunctional Enders.
Culture
Passionate about creative activity. Love music, art, sculpture and theatre.
Blank Petal
Disability
Visual impairment
Thalidomide
Mental illness
I am really looking forward to the sessions with the CPN and with OT when they get going but it is the most agonising journey to get myself ready and up, and contemplating coming out and being present and receptive somewhere other than our bedroom. After a couple of hours at the centre - and sometimes much less - I am exhausted and often sleep for three hours flat out.
This morning is a good example. One of my first pieces of homework has been to try and re-discover things that I enjoy doing just for me because I have lost sight of my own wants and can't really identify the subtler nuances of the me-ness of me. I drew a complete blank during the first days after this was suggested and got no where. Then it was reframed for me in a slightly different way. I was to set a goal. Think of one pro and one con regarding the goal and then divide into much smaller goals how the end goal could be achieved. So for example I had a second bad night last night - the sleeping pill doesn't seem to work at the time of night I most need it which is the early hours when my anxiety level boils over and goes into melt down. I have been asked to set a positive goal for each day. Today it took until about 3pm to get going on achieving the aim.
Yesterday was alot better. I managed to get up and shower by about 12noon and go into the sitting room and sit and watch West Wing Series II. I didn't watch all the episodes - but I felt as though I had achieved something I wanted to do and I enjoyed it - that's a word I haven't used for a while.
Like a toddler at a party I may have overdone it a bit yesterday because today was so much harder to get going. The night held dreams of being attacked and frightened. When I was awake I was plagued by fears of what others must think of me - by the morning all I was up for was breakfast, pills, blue woolly hat with ear flaps down and front part pulled over my eyes and more sleep. My goal for today was to blog again and to get back into this really very therapeutic habit.
In a sense going to the day centre had taken the place of the blog for a bit and once I had managed to get words out into the air of the consulting room, I didn't have the energy to be more reflective in blog mode once I came home. However D, my CPN and I think this is probably going to be an invaluable record to help me understand my illness when I am well again - and even as I am going along.
So today the goal was to get up and blog. First anxiety attack was the thought of getting out of bed. Decided to wait until my next round of medication and then do it after that. Very agitated but sat on the side of the bed. Next stage choose clothes to wear. I can't handle choices at the moment - "What would you like for supper?" "Do you want to..." so I used The Dog Whisperer trick and thought I am animal first, then species, then Jane. I visualised the animal and realised it didn't matter much what I wore - polka dot bikini isn't a flattering option - but the point is that it doesn't matter what I choose. So I was able to go to the drawers and take the first things I found. The multicoloured tie dye t-shirt and socks with stripes and individual toes in different colours may not be to everyone's taste but... Does it matter if it matches? Maybe if I was doing a book signing or meeting the Primate of the Scottish Episcopal Church for lunch, but not otherwise. Anxiety then bounced in about having to get up at all so I settled once more on our bed until the physical agitation subsided. Stage Three; loo and teeth clean. Difficult because the Diaz' is kicking in and making me feel like a snooze is a much more viable and inviting option. Complete task. Sit on bed, agitation less. Get up and run shower. Shower enjoyable once I'm in there. Water soothing and warm - why can I never remember this at an earlier point and use it as a motivator? Drying done. Forgot deoderant. Forgot to brush hair - but as I am not looking in the mirror just now and have only just remembered these details as I write, I still think I'm ahead on points.
Then, without stopping - straight into study and start blogging. It's a bit of a weird life just now - but it is LIFE.
Prayer for today
Dear Befriender,
I've never been a fan of footsteps in the sand and the idea that when the road gets tough you do the hard work and carry us, I guess because I can't quite see how over-parenting enables us to realise our potential. Can we agree you keep an eye on how things are going? I've got to concentrate on finding a new way of walking just now and your support in this way would be appreciated. Yours faithfully, JEWG
Comments