Late night reading

So, I can't settle tonight. Have been using a range of distractive techniques and relaxation to try and calm myself down, but to little avail. So I have ramped it up a notch, I try and go and find something to read either online or from the bookshelf, that really makes my brain work hard, or I try and do the advanced Kakuro puzzles, or watch a documentary on the Discovery channel. Anything that will make my brain work so hard, that there isn't much space for the voices that are shouting inside my head. Sometimes it works, sometimes it doesn't, I just can't block it out enough to concentrate. Tonight I have been reading Science Blogs online. I find neurology a particularly fascinating subject because of a) my mentalness and b) my epilepsy. The universe inside our heads still has so much unexplored and unexplained terrain. We make leaps of logic and faith when it comes to treating neurological disorders with medication, because we quite simply often don't know exactly why the treatment may work, just that it may.

I can look at my mentalness from a psychosocial perspective (which I am through therapy) and realise that the manifestations of my PTSD are quite logical. If the world has proven to consistently be filled with people who violate your trust, you find it hard to trust and relate interpersonally. If your world has previously been chaotic, unpredictable and filled with painful events, you grow cautious and wary even when there is no immediate sign of danger. If sleep has been a time, where consistently you have been violated either physically or metaphorically through nightmares, your body and mind are going to fight sleep. Its logical, and makes sense.

But then if you look at it from a purely scientific point of view it gets a lot more complex.

Fear arousal, initiated by an environmental threat, leads to activation of the stress response, a state of alarm that promotes an array of autonomic and endocrine changes designed to aid self-preservation. The stress response includes the release of glucocorticoids from the adrenal cortex and catecholamines from the adrenal medulla and sympathetic nerves. These stress hormones, in turn, provide feedback to the brain and influence neural structures that control emotion and cognition

When the fear arousal activation is consistent and prolonged enough, all these hormones that have flooded the brain begin to make structural and procedural changes to the functioning of the brain itself.

It begins to affect the very neural mechanisms underlying the acquisition, expression, consolidation, reconsolidation, and extinction of emotional memories

And it is somewhat comforting to then read articles such as this

http://www.scienceblog.com/cms/new-uab-study-sheds-light-brains-response-distress-unexpected-events-27095.html

To know that we are continuing to move towards a world with technology that allows us to better understand exactly what happens in the brain of someone with CPTSD, that we may be better able to understand and develop effective treatments. Just as the invention of the EEG, allowed those of us with epilepsy to move from the shadows of 'demonic possession' and 'madness', to a clearly definable and treatable physical malfunction.

I probably don't explain or understand the science that well. But reading articles like these a) helps to engage my brain in a way that goes some way to blocking the horrible recurrent thoughts in my head for a while and b) even if I don't fully understand it, gives me hope, that despite being a dunce student when it comes to the interventions thus far, that there might actually be something on the horizon that can help me.

Anyways, I'm off to watch a documentary on the parrallels between Ancient Mayan and Egyption civilisations.... yet another realm of unexplained phenonenom...not holding much hope for sleep tonight.     

A break from my life

Not doing so good. So I am going to take a little road trip back to the town where I lived before I moved to current city of residence. There is a good solid base there of people who know me and care for me, and all my friends little kiddies, who I love to bits and never fail to at least get a smile from me. Its just an overnighter, but hopefully will allow me to come back and have a bit more of a solid base to work off.

Sleep has been shite.  Not sure if that is a self fullfilling prophecy or what. But I'm edgy and emotional, and not dealing well with the tension at home. I'm just at the had enough stage. But my only option is to give myself a metaphorical boot up the backside and get on with it.

Just another number

So, in my self indulgent melancholy yesterday I didn't really chat much about my therapy session.  Therapist (D) is off for a week now, so it will be a week and a half before I see her again, which is a little daunting.  We spent a good part of the session talking about the Crisis Management Plan, that the Public Health system has written for me, to be CC'd to the hospital ect just in case I ever need admission. She seemed to think that the person they were talking about in the plan had very little resemblance to me. I basically think, its just a piece of paper, another piece of paperwork to pad up my file that noone will ever bother reading anyway. The only significance it had to me, was just a reminder that I am being pushed out of the nest, and as far as the extra support that was lacking back in August, its just going to be there again. Step forward one, step backward one. Case Manager said that she could try and get as much flexability as she could, but there was a lot of pressure to close files. I pondered whether this had anything to do with BabyDocs sudden decision to scale medication right back. Their final recommendation is that I find a private psychiatrist. As I am already paying for a private psychologist and private health insurance, I'm not quite sure where I am supposed to pull the money for this out.

(D) asked whether the situtation made me angry, and I replied, that I couldn't let it get to me. The girl with a background of trauma and self harm is already ear marked as a PD before she even walks in the door. Having an opinion, causing too much of a fuss is a sure way to ensure that diagnosis is stamped right across my forehead, whether my concerns are valid and rational or not.  Questioning BabyDocs medication decisions too much, will brand me as a drug seeker (which I am far from).When it comes to mental health it doesn't pay to buck the system, if you want to recieve any help at all. So you keep quiet. And hope that the path they are pulling you along doesn't lead to disaster. that's all you can do. (D) admitted that with her previous experience in the public sector, I had pretty much hit the nail on the head.

I never wanted to be back in the public health 'machine', but until my Private health insurance kicks in for psychiatric cover in May, its all that I can afford. And its necessary. As a solo practitioner there is only so much support (D) can be reasonabley expected to offer.and with the nature of the therapy I'm undergoing with her, there are going to be times when the therapeutic work coupled with life situations are going to pull the carpet from underneath me. So, as I said to her, for now, Public Health is a saftey net, one filled with gaping holes, but at least there is a chance with it, that if I fall, I may not plummet to the ground smashing to smithareens. The imminent loss of that saftey net terrifies me. And I have recieved some quite positive support from the public health system in the form of my Case Manager and the Consumer Advocate

And I don't even blame the people either. They too are part of the machine, pushed to reach certain targets ect. Its a result of the Australian medical system approaching the American system, where some bean counter arbitarily decides what amount of time they are prepared to allow for you to 'get better', and past that...no funding.

So where does that leave me, come the new year? Just another number.

Change

Hmmm... So on top of everything else, it would appear that we are about to lose two housemates. Its all very nasty and tense, and there is no exact date for departure, leaving me worried that we will be left with not enough notice to get in a new house mate, and thus be stuck with footing double the weekly rent, until we do, which is a daunting prospect when you are on a limited income.  On top of that, the whole idea of having some 'unknown' person move in to the house is quite an anxiety inducing prospect for me. Studying from home, I spend a lot of time here, and it is my little sanctuary from the world.  I don't cope very well with strangers and have been quite lucky thus far to never have had to live with somebody I didn't previously know quite well. (Apart from College, many a year back, but that was a dorm, rather than a house, so a completely different dynamic, and even then I certainly had some major issues throughout the four years I lived there. I have lived with housemates who were friends which worked ok. I have lived in flats and apartments by myself, which is what I actually prefer, but is financially unworkable now in bigger city, and I am currently living with sister, her bf (looks like soon to be ex) and his brother, which has had its moments but for the most part has been a reasonably comfortable set-up.

Anxiety is really quite high at the moment, with therapist off for the next week, Case manager off for half of next week, Bachelor No 1 overseas for the next fortnight, Xmas and all that that brings approaching quickly, Changes to medication, sleep going completely haywire ect ect ect.  Add to the that the uncertainty of the New Year, with Case Management ending, possible new housemate, developing relationship with Bachelor No 1, Increased demand from uni, with practicuum element of the course for first Semester next year.... Its just all a bit too much.

On top of that, mood has hit quite a low. Am not sure if its the season, or another bout in the boxing ring of depression is imminent.

Why is it that everything changes at once? Why is it that just when you feel like you might have the shoreline in sight, another massive rip comes to drag you back out to see?

Confused

I am completely confused.

I had appointment with BabyDoc today, up at the Public Mental Health offices for my region (which lucky for me happens to be on the same road I live). To start off, he was running over half an hour behind, which meant 40 minutes of staring at the bleak surroundings of the waiting room. I'm sure the staff try their best with posters ect and it is very new, neat and clean. And I'm sure that some very important designer came up with the crisp, minimalist interior.... but seriously! Grey floors, grey paints, dark chairs, all encompassed in a purpley-grey building, that looks alike an amoebic representation of a depressive cloud settling on the hill. But anyway, I waited, because I understand that emergencies ect happen.

Then I walk into the tiny windowless airless office with BabyDoc. These offices alone are enough to get my heart racing. We spoke. I told him that I had good days and bad days, and that I was trying to concentrate on sticking to a good routine and reaching out for help within my crisis network when I needed it. I talked to him about the weight gain, and my attempts to lose the weight through diet and exercise. He pretty much told me that I had nothing to worry about, and that BMIs don't really mean that much in the end, and also made the 'incisive' observation that when patients begin to worry about the side effects of their medication, it meant they were starting to get better... which from my personal experience is just bollocks.

I mentioned that anxiety and panic attacks were still an issue, but I didnt really see the point in raising the serepax, because I think you need to find a balance between throwing meds at a problem and coming up with coping strategies. I told him my sleep was pretty damned bad at the moment. He asked if I thought the Largactil was helping. I said I didn't know. He suggested it would be possible to up the dose a little. He went off to get his prescription pad, leaving me stuck in this tiny room, all by myself. As I have mentioned in previous post, there is something about those rooms that just triggers me off. Its windowless, rectangular...much like being in the back of a closed in truck container. He was gone a few minutes, and I was focussing on trying to calm my breathing, and stop my body shaking, so I didn't go into a full panic attack.

This is where it gets confusing, he comes back in, makes a joke about the airconditioning being to high (I'm not cold, douchebag, I'm trying to convince my body not to totally flip out on me) And then all of a sudden, he says, that he is going to write a letter to my GP letting him know I'm on the Serepax, but to start the process of weaning me off, oh, and just as an experiment, lets cease the largactil all together and see whether it has any affect on my sleeping. I was still concentrating so hard on not flipping out from the panic, that I just kind of half nodded at everything he said.

I walked out of the Centre, and realised what essentially had just happened. I tell him I am still having issues with panic attacks, and that sleeping is pretty bad (about 3 hrs average a night) and he a)starts weaning me off my anti-anxiety meds and b)ceases my sleeping medications.

WTF? I hate that place, I hate the system, I hate being just a number and I am really not a big fan of Baby Doc at the moment. Plus I am Scared as hell, of what these meds changes might mean, especially heading into a time as hard as xmas.

BabyDoc visit

Appointment with Public Health Psych tomorrow, or as I like to call him BabyDoc. Fresh into the field and all Bambi-eyed trying to deal with all the crazies around him. Its not that I dislike him, he is.... benign. And in the scheme of the public system I don't really fit into the "high triage" catergory. I'm not psychotic or delusional ect. So, he sees me every month or so at the moment, and throws whatever drugs work with 'people like me'. Cos we're all the same you know. Tick box, tick box, take this drug a, and if that doesn't work well you're just not working hard enough! Maybe I'm being a little harsh. He does take the time to try and talk to you I guess, even if it does come off uber-patronising. I guess its just a different experience to having a private psychiatrist for five years. Tomorrow probably wont bring about any major change, and to be honest, I do kind of believe, whilst I need the meds as a crutch while I'm working this stuff out in therapy, meds are not the holy grail for me.

And, it is also partly my fault. I am not comfortable enough to be completely honest with him... so I am evasive. So I will probably leave the office without him knowing that:

1. The urge to self harm is particularly strong right now (although I am thus far, resisting that urge)

2. I am sleeping about 3 hours a night

3. The noise in my head is getting so bad it actually wakes me up, and sometimes when people are talking to me I can't actually hear what they're saying.

4. I must put on a damned good show of being together, cos everyone tells me how great I'm doing. Meanwhile I've still got a plan, and a date. And with every month that passes it gets closer, without any real progress appearing to give me hope.

In fact, my Case Manager and Psychologist don't know most of this either. Who am I kidding? I'm paving my own road to hell, and there is noone to blame but myself.

So, thats why I don't really expect much from BabyDoc

There is noone else to blame

I am sitiing staring at my pill bottles. I'm not going to do anything.  But the temptation is strong... I am weary, and right now there doesn't seem to be a whole lot of point. But I am staring at the note on my wall reminding me that this moment will pass too. This song came on my MP3 player, and I just began to cry. Tonight is a lousy night

Blowing in the wind

The wind was blowing a gale this afternoon as I walked home from my therapy appointment. The promises of a storm that never actually eventuated. And as I walked along bracing myself against the wind, I was noticing the trees all about me, swaying with each gust.  And I started thinking (probably over thinking once again) about that saying about a tree needing to bend with the breeze or else it will break. I'm not very good at that. I find myself constantly braced (emotionally and a lot of the time physically) at some percieved threat or imminent storm approaching. My therapist (and others) have noticed how my body will physically close up and go as solid as a rock when I'm feeling vulnerable or threatened (which is a lot of the time). And so when it does hit, I have no 'give', I will brace until I am so tired from the exertion that I break. So that's what I was thinking on the way home from therapy today, I need to learn to bend, so that all these little smaller storms just gust by me, leaving me relatively unscathed and with enough energy to weather the real storms.

You'd better watch out!

The ornaments are out, carols are playing ad nauseum and Santa waits patiently, in the middle of every suburban shopping centre, as irate children are placed on his lap bawling and pulling his beard. (Does anyone else find it unsuprising so many kids are terrified of santa. Here, kid, sit on the lap of this complete stranger, who is wearing a fake beard and kind of smells like whiskey. Oh, and by the way, he'll breaking into our house on Christmas eve but don't worry cos its Santa! Yes, I was an over thinker as a child too. If Santa can get in through the keyhole (we didn't have a chimney....than who knows who else can?) Christmas is definately coming, they scream at us, even though its only early November

Is it weird that I am already starting to worry about taking a break from therapy over christmas? I blame the damned shopping malls! I've already had a little trial run by missing my Thursday session last week, which had its benefits (I am studiously avoiding talking about a particular issue with (D) at the moment, and so I kind of ran away to the beach for a week) But it was an unsettling experience to have such a gap between seeing her, and that's only a gap of a week. I seem to find a certain containment in not going any longer than 3 or 4 days tops without seeing her. Even when I was in hospital she rang me every couple of days. And the thing is, I am assuming my case manager will be off over the xmas period, and probably Consumer Advocate (K) too.... which leaves me with the PA triage line. And my family... at Xmas... when everybody gets hot, then cranky, then drunk, then resentful.....then sometimes ( most times) down right nasty. Is it strange that I am aready starting to stress about it... am I pre-empting it to turn out a certain way with my negative attitude? I don't know. What I do know is that I am stressed about the break from therapy, which then in turn makes me so angry at myself, because it is so pathetic and dependent. I need to build the resilience to weather these times on my own.

Christmas? Bah Humbug!

Sisters

My little sister (A) broke down in tears tonight. And as the tears welled up in her eyes she began telling me her story. It was a familiar story. The story of our mother, our aunt, our grandmother. She met her partner when she was quite young. 17, in fact. They've been together 6 years. She tried to break up with him last year by moving to my town to live with me. But after not so long, he moved down too and she took him back. She stayed with him because it was all she knew, she stayed with him because she didn't want to hurt him, she stayed with him because she was scared she wouldn't find someone else to love her, she stayed with him because she didn't want to be alone. But she told me tonight, as the tears began flowing, she has never felt as alone as she does now, with him. It's a generational thing in our family, the willingness to settle for unhappiness in a relationship rather than alone. That's what kept my mother with my abusive stepfather for so long. I have, in many respects, been rather the black sheep of the family in this respect. I would rather be alone, than be in a relationship I wasn't happy in. My willingness to stay single (although the roots of this willlingness are far too complex to delve into in this post) have always been somewhat of an bewildering concept for my family members. But, back to (A). Her partner isn't abusive, he can be somewhat emotionally manipulative but then she can be quite cold and incisive. She just feels as though it isnt working. As she told me that she was at the point where she was beginning to no longer see the purpose of life anymore, get up, go to work, home to a broken relationship, sleep and then do the same thing over and over again, ad infinitum, I began to hear another familiar story. My story. That point at the beginning swell of a wave of depression, where life just seems to lose its sense of importance and purpose. And it shook me. Its an over reaction. She is not suicdal, nor probably even clinically depressed. She is experiencing a situational depression, probably somewhat exacerbated by her inability to communicate her feelings very well ( her legacy from the house of horrors we called our childhood) But nonetheless it shook me. Because she is my baby sister, I would and have given my life and soul to protect her. I don't want this black demon on her back too. It has made me so proud to watch her grow from the turmoil of our past to turn herself into a driven, level headed and successful individual. I have often joked that I want to be like her when I grow up. But, now was the time she needed for me to be her big sister. I had to put my own irrational fears aside. I had to tell myself that she was ok, that this was an understandable period of unhappiness and then I had to do what she needed me to do. Listen. Simply listen. Not wrap her up in my arms and protect her, not solve the problem. Just listen. So I did. I asked how long she had felt like this, I asked what I could do. She has decided (to my suprise given her character) to see a counsellor, just to try and sort out what her feelings are, gain some perspective, and maybe (hopefully) deal with some of the issue she has from her childhood. She wants me to get a referral from my therapist to somebody she thinks would be good. And I can do this. I can in someways protect her again. And I'm glad. But still, worried, always worried, after all she is my baby sister and thats what big sisters are for.

Alone and angry

The problem with developing therapeutic relationships with your various peeps in the mental health teams, is that you come to rely on it a little too much. In many ways, its a wonderful thing to be able to rely on somebody to help you sort out those nasty gremlins or simply talk you down when you are spinning out. Somebody who is experienced, somebody who can help carry the burden for a little while, when you feel to weary to go on, somebody who you begin to feel (unlike your family friends) can handle it, without it being too much of an emotional infringement on them.

And why, is it not an enfringement? Simply... boundaries. The boundaries of time and space, the boundaries of a professional relationship. My crisis plan allows for me to reach out if needed to a variety of different people both on the public team and my private psych (D). And this works well if my little spin outs happen between 9-5, Monday-Friday. I can talk to Case Manager (M), try and get a hold of (D) between appointments or even try to get a hold of consumer consultant (K). Its still very hard some times for me to reach out to these people at times, I feel like I am being a burden. I feel like I should be able to buffer my own emotions and draw on my own resiliency in times of stress. But I have begun to, and benefited from access to these people in times of crisis.

The big issue for me is the times after 5pm or on the weekend. The plan wold have me call upn a crisis line that is staffed by mental health professionals. But these are not the people that I have slowly and delicately begun to build trust in. These are not the people who already know some of my stories. I try it, but it just doesn't work. Of course, I can always try (D) after hours but the few times I have done this, she has either been unavailable or else if available, I just feel so incredibley guilty for interrupting 'her time.'

So, relevance? Well its happening right now. Its late on a friday night, and I am panicing, I am having serious thoughts of self harm... I am so angry with myself, and I don't know what to do with it. So I want to cut, badly, even though I've managed to not do it in years, the urge is there, and the urge is strong. But I just can't seem to contemplate ringing the crisis line, and I don't want to ring (D) and interrupt her weekend.

So it time to pull myself together, draw on my own strength, and suck it up....

Run and Hide

Ok...so when I said no internet access for a week, I forgot about the beloved Golden Arches. I am in McDonalds Cafe stealing their internets!

Reality check. There were a multitude of reasons I came to the coast, but the one that matters the most at the moment is that I was running away... running away from life, running away from therapy, running away from Bachelor Number one, running away from that nasty mess of gremlins, so I wouldn't have to think or do anything about them. Unfortunately, those damned gremlins packed themselves in my bag when I wasn't watching, and instead of gazing mindlessly at the ocean as I sunbathed on a towel, I was just doing the same thing I always do, wrestling my demons, just with more exotic scenery than usual.

So... Bachelor number one. Funny, sweet, respectful, interesting, and for some reason he seems to really like me. Even after I completely wigged out on him last thursday, by not being able to say this is too fast for me, by not putting my boundaries up firmly, by dissasociating, and freaking him out quite substantially. But he was a good guy. He stopped what we were doing, he gave me space, he waited for me to come back into myself and calmed down. He walked me to the bus, sweetly kissed me on the lips and asked when he could see me next. That's all he asked. Not hey, what the hell just happened, or what the heck is wrong with you, you freak, just 'when can I see you again?".

And still, I can't just allow myself to believe he might be a good guy. So, I am yelling at myself "What the heck is wrong with you, you freak?!"

And then therapy on Monday. Of course she wanted to know how it went. I stated firmly that things had not gone as planned but I didn't want to talk about it. She did her usual little attempts at trying to get to the issue through the back door, but I successfully fought her off (Checkmate!) Why? Because I am humiliated and embarrassed and angry at myself, and I just didn't want her to know. And I didn't want to see her again on thursday, nor did I want to catch up with Bachelor number one any time soon... not because of them but me... So when this opportunity came up, I grabbed it and ran with it. But, its nearing the end of the week, I have bitten the bullets and organised to meet (B1) on saturday, and of course I have therapy on monday. Time to come out of hiding and suck it up Ophelia!

It did cause me to think however on the multitude of things we hide from our therapists out of just sheer embarrassment, even if we know them to be pertinent to the therapeutic journey.

Sex, is just not something I talk about easily with anyone, including my best friends, let alone a therapist. But sex plays an integral part in how I came to be so royally f*cked up, why I continue to act in f*cked up ways, so I kinda need to talk about it.

Any suggestions on how to get this issue out in the open between (D) and I would be very much appreciated.

P.S. The beach was gorgeous...so lucky to live in Australia with beaches like that so close by... So I did get a bit of relaxation, and sleep was slightly better (I think its the sea air that does it)

Taking a mental health week

Lots of things going on at the moment, therapy, relationships issues, family issues, sleeping issues, all swirling around trying to suck me back down into the vortex of despair. So I am doing what I am best at.... denial... I am off to the beach for a week to (metaphorically, of course) bury my head in the sand. No Internet access from tomorrow through till Friday. Catch you on the flipside!

My new friend

Completely unmentally health related, other than the fact he makes me smile.... meet my new friend Koda the Triceretops.

Vain whinge

I am hungry.... really really hungry.

I have ranted and raved previously about the ridiculous amount of weight the new medication has made me gain. I have tried just making sure I was eating healthily, and getting a reasonable amount of exercise. But the kilos just kept on creeping up. And by Monday of this week I was just in tears over it.

So... I have done what I never thought I'd do and gone on a shake diet. I never really thought much of them, but I have a friend who lost a substantial amount of weight on this particular program. You are supposed to have the shakes for breakfast and lunch, and then three small low carb snacks and a small low carb dinner. And lots of water. The water and the shakes combined are supposed to make you feel full. But I am starving hungry pretty much all the time! I don't know how long its going to last. I am probably even crankier and more depressed than I was to begin with.

How do other people deal with anti-psychotic weight gain?