Wednesday, December 30, 2009

Sojourns into the past

So, 2010 is coming whether I like it or not. And of course, a new year brings with it reflection on the years that have passed. A mental inventory of successes and an even longer one of fails. One trys to look towards the new year coming as a 'fresh start' or a 'place of hope' usually fails miserabley. One of my particularly stupid new year habits is to read back over journals. I started this yesterday evening, and have continued to do it at the expense of my assignment which really needs to be completed. I read 2009 journals, I read back over all the posts in this blog, I read back over email correspondance with my therapist. It is helpful, in that it gives an interesting perspective on the ups and downs, and turmoltuous emotions of the year. It is unhelpful, in that it helps to solidify what an unholy mess I have actually made of the year.

Whilst on a roll, I read back through journals of previous years, back through to the break-up of an abusive relationship and a psycho stalker neighbour in 2008, through to hospitalisations and a complete lack of direction and purpose in 2007, right through to what I guess I was looking for all along, the overdose in 2006. Why? I'm not sure. Maybe because I'm looking for signs to see how close I am in reality, to being back at that point? Maybe as a self-reprimand... see what can happen if you allow yourself to go there, see the damage you could do? Maybe, just maybe, because when I woke up from that OD, days later in the ICU, I was PISSED that it hadn't worked... and ever since that day, I have been silently raging against a world that would keep me bound here through obligation and 'doing the right thing', against my will. Maybe because I always knew, that one day I would be back in this place, but this time, fate or bad timing would not 'save' me. Some snippets from that year... there was not much written until May, towards the end of my hospitalisation, because you to the damage I did to my brain, I had to relearn reading and writing.

May 2006
 The scariest thing is I don't know what I have said to people in my delerium induced state. How honest was I? I have the vaguest of memories of somebody (Psychiatrist? Doctor? Nurse?) doing some kind of assessment and asking if I would try to do it again. And me, answering "Yes, but next time I will go to a motel in some far off town where nonone will be able to stop me". Is this memory real? Did I say that? Will they ever let me out of their sight again?

*I found out later that this conversation did take place, in front of my mother no less. How's that for confidentiality, only applies when you are fully concious, I guess.

June 2006
I can't stand the way that everyone stares at my walking stick and walking frame when I leave the house. After months in the hospital, I have become so institutionalised and agoraphobic, I don't want to leave the house anyway. It seems surreal. I am supposed to be dead. I am not supposed to breathe this air, or feel this breeze. But if I am ever to get out from under the magnified gaze of my family, Y**** (My Case Manager at the time) and Dr B, I have to make myself go out and pretend as if I am getting better, that I am happy to have this second chance. And in reality, its my karmic punishment isn't it. I am a heinous, selfish individual who put my family and friends through this hell, and I deserve this walking stick... its my Scarlett letter, a big red C for Crazy or maybe an S for Selfish Ingrate.
September 2006
Back in hospital again. Being told that I have choices. Sure, I have choices. But from where I'm standing none of them look particularly good. What you are really saying is I don't have a right to make a choice. Isn't choices about weighing two options (death vs a life where all facts indicate nothing much is going to improve) and deciding between them. I see the other choice, life. I just don't much like it. I did your CBT, your EMDR and every other little letter you through at me. I took your drugs, and did your rehab and occy health and speech therapy. I've kept your stupid safety contracts, and followed your inane crisis plan. And guess what? In the dead of night, when it all comes over me again, it means sweet, f*ck all. So don't sit there on your pedastal and judge me for the urges I am trying hard to fight against, not because I wan't to but because my family and friends would bind me here with promises and emotional obliagation and guilt. Just give me the drugs, keep the blades away from me, and let me get through this the best I can.
Sounds a lot like me now in 2009, huh? Except I think I'm a little less angry and a little more resigned, or maybe they just forced me to swallow any anger I did feel eventually. So what has this little sojourn into the past taught me? A) I've been here before, and I can get through it... or B) Who was I kidding? Nothing has changed, not one god dammned thing! I don't know.

Throw it out and start afresh

I have been quite unmotivated when it comes to the daily mundaities of 'keeping house' lately. The ashtray on my peaceful little porch area has been full for about a week now, but rather than empty it, I have just put the butts in an empty diet coke can (caffiene free, of course!) that has also been left slovenly lying about out there. And it is gross, filling with more and more ash and disgusting used butts until it is bordering on overflowing. So just now, I picked up the can and walked around to the bins and threw it out. And I had a thought... how good would it be if I could do the same with all the gross and disgusting feelings that are piling up towards overflowing inside of me.... pick them up, walk around to the bins and start again fresh. Would, that life be so easy, huh?

Tuesday, December 29, 2009

The question of finances

Well, fellow bloggers, if you are looking for a glimpse into my emotional psyche, today is, yet again, not the day. That's not to say there isn't a lot going on in this crazy lil mind of mine, but a) I am on break from therapy and all the analytical navel gazing it entails, and b) I just can't see to get enough of a handle on what's going on to write a half-way understandable blog entry at the moment.

So, I'm going to write about something else that is on my mind as we approach the New Year. Money. I've written a post before about the financial cost of mentalness. Money has always been a murky area for me to delve into, as it is intrinsically tied with experiences of past abuse, power differentials in relationships and a sense of being a burden on others. I feel guilty that, even though I am technically entitled to it, even though I am studying, even though I do volunteer work and even though I am trying very hard to stabilise both my physical and mental health issues, so I can become a productive member of society, I am one of 'those' people, draining society and benefiting from other people's tax dollars. I am immensley grateful that I live in a country where it is possible for me to get this financial support while I work at getting back on my feet, but guilty, oh so guilty!  I feel guilty that my therapist has cut her fees down to next to nothing so I can afford to continue to see her twice a week, because I am "that messed up". Sure, I get 18 sessions a year on medicare, and 7 sessions through my private health insurance, but without this substantial discount there is no way in hell I could afford the other 75 odd sessions a year.

I try very hard to be extra strict with my budgeting, to make sure that my bills are paid, I don't need to turn to family and friends for help and that I don't spend money on frivilous extras. And for the most part I do pretty well, considering the Disability Pension is not much money at all (about AU$375 per week) and my medical expenses can be quite high. (Including therapy, meds, doctors and health insurance about AU$180 per week, if there are no specialist appointments or extra meds)

But as I have mentioned before, with the increasing depression, things begin to slip, and I am less careful. Wasting electricty because I cannot be motivated to hang out washing, paying inflated prices at the service station across the road, because I can't deal with going to the crowded shopping centre up the road, catching taxis instead of public transport because my organisational skills are flagging, spending more money than I would like to admit on cigarettes because I am smoking more. And worse still, paying late fees and bank fees on bills because I let them sit unopened on the counter, not because I can't pay them, simply because I can't face them. Some of it comes down to lack of motivation and excessive self-involvement and I guess some of it comes down to not caring, because I just can't think about the future.

This was a major issue post-od in 2006. After I got out of hospital, and that safe insulated world, I realised what a mess I had gotten myself into financially. In the months leading up to my breakdown, I just let everything slide, once again not because I didn't have the money, I was working at the time, but because I didn't see the point and it just didn't seem important at the time. I was lucky to have been renting off a friend, who allowed me time to heal before bringing up the issue of unpaid rent. Another landlord would have dumped my stuff on the street. Whilst in hospital I gave a family member authorisation to deal with my financials during the months I was in hospital, and although I believe she tried, she had her own issues and a lot of stuff slipped by her. Debts went unpaid, with no explanation to the debtors, who then quite rightly instigated debt collection and cause bad credit ratings. The stupid thing is THE MONEY WAS THERE. To this day, although all debts are paid off, and I now live a debt free existence, pre-pay everything and live without credit cards, that period in my life still affects me financially. If for some reason I needed a loan or even a mobile phone contract, the bed credit rating from this period would probably effect my chances. The point is, whilst in the moment these things don't see important, and the future seems nebulous at best, when you let these things slide and get out of control it comes back to bite you on the ass.

I never want to be in this situation again. As with the therapy and my uni coursework and maintaining my friends and relationship with my boyfriend, I know that these things seem pointless, and my chance of sticking around long enough for it to matter seems less likely... but I have to keep on top of all this. Just in case. Just in case I am around in six months time to reap the 'benefits' of letting things slide.

So that's my New Years resolution. Along with therapy, uni, friends, boyfriend etc, to keep on top of my finances, to find ways to start saving a bit of 'buffer' money. In line with this, I have committed to quitting smoking as of January 1st, 2010. I know this may seem somewhat insane, given my emotional state at the moment, but it has to be done (and really, the deprivation will probably make the self-flagellator in me quite happy) Of course, the universe is having a great laugh at me at the moment... as I purposed to get as much nicotine into me as humanly possible, in my last few days as a smoker, I have been faced with a very nasty chest infection, making it increasingly difficult to breathe, even without the added pressure of smokes. Of course, I may be seeing the glass half empty, maybe this is the Universe's way of helping me transition to a smoke free existence. :)

So, with little sense of future, and little desire to make goals and dream... I'm going to do it anyways...

Ophelia's 2010 Resolutions
(Quantifiable... I hate airy fairy goals... how do you ever know if you are succeeding?)
1. Quit smoking
2. Tell Therapist at least one thing I don't want to tell her a week- big or little- overcoming the barrier to talking is most important.
3. Ensure I do at least one social thing with my friends a week.
4. Maintain a GPA of 6 or higher in my uni degree.
5. Lose 10 kilos. (Stupid Anti-psychotic weight gain... I saw pictures from X'mas... how did I go from being underweight four months ago, to looking like I'm in my second trimester? Its a wonder BNO can even stand to look at me...yuck!)

Monday, December 28, 2009

Mental hiatus

Still on 'holidays', but just back in my own home. Was a very bizarre feeling today, to not grab my stuff and head to the other side of the city for my regular therapy appointment, but there was also a certain relief... not having to dive into all of 'that', just right now. So, no therapy, no case manager, no work. I do have some uni stuff to do, but it doesn't have to be done immediately. I spent the day at home alone, just enjoying the sense of no expectations or pressures on me, in the moment. Watched some TV, did some painting, ate cold pizza for breakfast. It was nice. There is an inherent sense of 'temporariness', as I know of course, that this brief respite will not be able to last long. But still nice, nonetheless. Sis and co are heading back off for the New Year, so I shall have the house entirely to myself for a while, which will be really good. I'm even sleeping a little more.. although I would put this mostly down to still being pretty ill. When I start coughing, you can see people around me wince, and my ribs just ache and ache.

There are issues I could talk about after an X'mas with FOO, but for now I am enjoying being out of the analytical headspace. I am on a mental hiatus... but the cloud of bleurghiness that awaits me outside this, remains ever visible.

Saturday, December 26, 2009

Seasons Greetings and stuff

This is our Christmas tree... pretty, huh?

Not much to report and am too busy staying on guard to the whole family thing to attempt an extensive post right now. There has been no major bloodshed, instead we have just wrapped our selves in blankets of past hurts, tensions and disputes. But there has been moments where the smile wasn't entirely fake. A water pistol fight with my mum and stepdad started as great way to cool off this afternoon, and turned into a strategically complex, military campaign. :)

Got some cool swag. Lots of art stuff and an art desk which is very exciting. My mum cried when we gave her her present, so that was a resounding success.

On the negative side, I am as sick as a dog, and finding it increasingly difficult to breathe, which is super annoying as I only have 5 more smoking days before I quit,  I guess maybe I can look at it as an illness driven, slow descent instead of going cold turkey as I had planned.

Lots of yummy food etc, no diet today!

I am holding it together. I am holding it together rather well. That is all.

Wednesday, December 23, 2009

Merry Christmas to all. I am heading home to town of origin tomorrow to spend christmas with the family (yikes) and I am not sure whether I will have much time to get on the internet, so I may have a little break from blogging.

Sleep issues have undergone a temporary reprieve as I have come down with a bad dose of the flu. Stabbing pains in the chest, and the sound of a barking seal emanating from my mouth. On the upside, today I went down for a nap at 11, woke up briefly at 3, and then went back to sleep till 8pm. I've just had some food and medications, and I think I'm about ready to hit the hay again. I guess my body is winning this round of mind over matter.

Had an interesting seesion with therapist (D) yesterday which primarily focussed on my sex life. Awkward. As I told her, the quality of my sex life seems... inconsequential compared to some of the other issues I am facing. But she continued to posit that it ties in directly with my issues of intimacy, trust and self worth... more on this another day.  Either way was excrutiatingly embarrassing and uncomfortable conversation to be having with my therapist.

So, here I am, therapist and case manager free for the next two weeks... quite intimidating, but I guess I don't have much choice but to get through the holidays as intact as I can manage. Spoke to (M) Casemanager today, and she gave me the number for a mental health line closer to my town of origin (but still over two and a half hours away). My other options if the shit does hit the fan is to head into the Accident and Emergency room at local small hospital, which in reality is not much of an option, as my mother works as a nurse there. But it doesn't hurt to have the options available, I guess.

Hopefully, I can peel myself out of my sickbed tomorrow, to give the house a quick clean, before we head off for a few days. So crossing my fingers, that I manage to at least maintain the appearance of an even keel for the next few days......

All the best for Xmas everyone.

Monday, December 21, 2009

Laying it out there

Well, I did end up going to therapy. If nothing else can be said about me, it can be at least said that I keep up with my committment to attend, whether I feel up to it or not. And I did actually tell her what had gone on over the weekend, as much as I didn't really want to. This weekend past has really been quite a kick in the guts... I have had to wipe a whole lot of 'at least I don'ts' off my list, and it has made me feel like an epic failure, amongst everything else. I used to be able to say, things are f*cked up but at least I....haven't been back in hospital, am not in therapy, am not on a bucketload of pills, am not case-managed, am holding down a job, am not on disability payments, am hiding it well.....but in the last 6 months, I have no longer been able to say these things any more. But then I was still able to say, things might be f*cked up, but at least I....haven't self-harmed in nearly four years, haven't given into crazy impulses, haven't taken more medicine than prescribed...... but after this weekend I can no longer say these things either.

The self harm is a major blow. Nearly four years! I don't know about for others, but for me SI is like an addiction, and blades my drug of choice. Even after nearly four years of abstinence, I still regulalry had to fight the temptation. Kind of what they say about alchoholics, I guess. You will always be an alcoholic, you are just in recovery. I will always be a self harmer... that instinct to turn to the blade will always be there, so I need to be ever vigilant, and not feed the addiction. And dammit, I have done it, I have stoked the fire, I have crossed the line that I drew in the sand, and once I put a foot over that line, it doesn't see such a big deal to step over completely. But it is a big deal. This is not how I want my life to be. And I made the choice to do it, I can blame it on the fatigue and depression, but I made a concious decision, to crack that razor, to set up the towels and betadine and steri-strips, to put the blade to my skin... that was all me, and I could have stopped it at any time. There was a time when, even though I kept my self harm hidden from others, in private I would look at it with an almost peverse pride. I did that.. I am in control of that... I control the pain and the damage, nobody else... and look, I bleed, I ache, I am still here, still alive. Now I look at these pitiful cuts on the skin of a 27 year old, who should f*cking know better, and I am filled with nothing but immense self-loathing.

What I didn't say about my haircut on Friday was, it was necessitated by a very bodgy at home job that morning. I had a flashback, and then when I looked in the mirror, all I could see was me, and I didn't want to be that person, that person that I recognised and weak, pathetic, contemptible and stained. So I grabbed a fist full of my hair and just cut. I dyed my naturally red-brown hair, the darkest shade of black-brown I could find. Gave into my immediate impulse, and consequently ended up having to a) come up with a good story to explain to the hair dresser the state of my hair b)grimace through people commenting on hair, that I of course now absolutely hate (although, really what does it matter?)

I'm just so freaking mad at myself, and disgusted by my complete lack of control. Therapist (D) contends that I am not giving enough credence to the exacerbating stresses in my life right now, instead trying to down play them. She really thinks that the home environment is too toxic. And finally, she posits that I use her and therapy, (M) Case Manager, school and work to ground me, and as all these things will be absent for the next two weeks, that this could be the reason I am fraying around the edges. She repeated several times, that she WOULD be back, and that just because I wasn't seeing her, didn't mean I would be forgotten. I really don't know how much this upcoming absence is impacting all of this. I mean, I am concerned about it, as I have mentioned previously, I have become used the containment of it. As I said to her, 'I am less worried about whether she would come back, and more worried about whether I would'.

On an interesting note, she also told me that whilst she would be there to support me through these feelings of hopelessness, she would not engage in the feelings of hopelessness herself. To which my immediate thought was, I should hope not! Somebody needs to see a light at the end of the tunnel in this situation. But then when I started wondering later, why she had felt the need to say this, I began to wonder if she thought in some way that I needed other people to agree with me on how shitty things really were, in order to validate my own feelings. Or that I was wasteing energy trying to get people to see through the same dark vision that I was seeing the world, rather than putting that energy trying to see instead, how they saw the world, and fix my issues. Have I become so safely ensconsed in this negative world view, that I am avoiding anything that challenges it, and trying to drag people into my own pity party, rather than stepping out into the world and something different? I don't know... I hope not.

So anyway, still residing in a pretty dark place. Still fighting even stronger urges than before (once that taboo has been broken, SI and misuse of medication doesn't seem to be such a hard step to take....sigh) Still living in bombshell of a house, as I haven't the energy or motivation to clean. My friend (S) is supposed to be coming down from the coast tomorrow night and I really should do something about the house... but frankly, I just mostly wish she wasn't coming. I am a terrible friend. My assignment (due Wednesday) is nowhere near done...but once again, I don't really care. I will care, eventually, just not right now. And on top of everything else, I am getting the flu. My throat is so sore, and when I cough it feels like my chest is on fire, and I wheeze for the next 5 minutes. Funny, I went to work with a dislocated shoulder, and later with a fractured wrist, and it didn't bother me, I had to be told to leave work and go and get them checked out by a doctor. I can cut and burn myself and it doesn't bother me. I have a pretty damned high tolerance for pain. But I CANNOT stand flus. Something about having my head all stuffy and blocked up, and fighting to breathe through the grossness, makes me want to die... which I guess, is quite fitting now.

So there, just laying it out there.

Sunday, December 20, 2009

Trying not to

Two posts in one day. A little bit of overkill I guess. But I am putting all my effort into trying not to do something silly right now, so maybe if I put it out here in black and white, it will force me to behave myself. So what I didn't write about in my earlier post is my little bit of stupidity last night. I reached the end of my tether. I was (am) so very very tired. I took my sleeping medication, and then I took a little extra, and when that didn't work I took some more. End result, I passed out for a little bit, woke up and stumbled, crawled my way to the bathroom, where I proceeded to throw my guts up in a most spectacular fashion. Then, world spinning, I made my way back to my bedroom, and passed out for a little longer... all up I probably slept about 5 or 6 hours. But it didn't really make me feel rested.... (because it would take more than 5 hours sleep to catch up? because it was drug induced unconciousness rather than real sleep? I don't know.) It really just made the fatigue harder to deal with today, because my brain felt like sticky molasses. BUT, even if I didn't get 'real sleep' I did get 5 or 6 hours of blessed unawareness. Don't get me wrong, I wasn't in any danger of really have to take bucketloads of benzos and probably wash it down with a good deal of alcohol to achieve that.... but it was more than anyone would safely prescribe, probably more than was entirely safe for my body, and admittedly quite risky. But the oblivian was nice, and it is tempting to do the same thing again tonight. I tried calling my therapist but could not get through, I didn't leave a message, as I just really can't face answering machines. I tried calling the Triage line, but hung up when they answered, i just couldn't face talking to a stranger. So where does this leave me? I don't want to talk to friends in the frame of mind I'm in, because I don't think I could hide the depths of what I am really feeling right now. I've been running through my crisis plan top to bottom, and then starting right back up at the top again. I've even been reading "How I stayed Alive when my brain was trying to Kill me", in the hopes of picking up something to sustain me from there. I don't want to go to therapy tomorrow. I definately don't want to tell her about some of my crazy behaviour this weekend. I want to just slip back into the murky nothingness for a while.... but I'm trying not to.

Who is that girl?

Who is this person who just a few short hours ago was smiling and cracking jokes with the residents and kiddies? Who was industriously handing out keys, and change and sorting out accounts? Who was reorganising the office and photocopying and returning enquiry calls? Who was calmly discussing the weather? Who is that girl and how is it possible that she can go from that, to me, right now... fighting off tears, feeling hopeless and totally without energy or motivation? How is it that I can switch so rapidly between the two, and why can I not sustain that calm and positive persona?  The ashtray is overflowing, my bedroom is a wreck, I've only eaten two chocolate truffels and a handful of dry crackers in the last 24 hours. I can't seem to do anything but lie here and vegetate. I don't know how I'm going to make it through christmas, I don't know how I am going to make it through full stop. I keep thinking 'if I don't get some sleep soon, I am going to..." but I can't figure out how that sentence ends. I can't go on the way I am going, but I don't know what the other options are really? "Lose my mind", "Take to my bed and just not get up" "Take the final train"... I just don't know... I just don't know.

Saturday, December 19, 2009

Still chasing the Sandman

Still totally and utterly exhausted. No change on that front. I had to make a decision today whether I was going to be able to go in for my volunteer shift tomorrow, because if I was going to bail, I needed to give them ample opportunity to find a replacement. I decided, ultimately, that although I feel absolutely terrible, it would probably still be a good thing to get out of the house and force myself to get on with the normal things that make up life. I hope I'm up for it. After my shift finishes (S) and I are going to go down to the pool for a swim (hopefully it won't be too crazy crowded) which will be good, as the heat is really adding to my overall discomfort, when I am trying to deal with being extremely fatigued. I have had a pretty bad headache for the last few days, and my shoulder seized up again over night... and I really think both of these things can be attributed to my body not getting the chance it needs to rest and regenerate. My mood is scraping the bottom. I just really wish somebody could give me instructions on what to do to get this under control. I think I could probably deal with everything else if it wasn't for having to walk around sleep deprived out of my mind.

I took the opportunity last night, while I had many sleepless hours at my disposal to read over this blog. It's the first time I've really gone through and read past entries, but I have been writing long enough now that I have been able to get a clear picture of the ups and downs on my emotions over the past few months. This was good, as it just helped to reinforce the mantra I have been repeating to myself to try and sustain myself through this. "This is a moment, and it will pass". (Aside from that, on reading back I was appalled at the amount of typos, spelling, gramatic and punctuation errors in my post... my only excuse is that I tend to write these posts in a free-flowing, mindless kind of way, and don't really pay much attention to detail... however I do aim to do away with such carelessness and work on proofing documents before I post them... it's sheer laziness really... and me, studying to be a teacher...shame, shame, shame!)

Well, I'm going to lie in the dark with a washcloth on my head for a while now. Even if I'm not sleeping, I'm going to try and give my body a chance to rest at least.

Friday, December 18, 2009

Pummelled. stabbed, stretched and electrocuted

I am pretty bloody tired. I did not sleep at all last night, and I'm just kind of hoping now that a big seizure will come along and knock me right out. Taking another's advice, I decided to give myself some treats today, so I went and got my hair cut, along with the lovely head massage they give with the hair conditioning treatment, went and got some acupuncture and a massage done, and then finally went and got a manicure with (F). To be honest I haven't really done anything to deserve such treatment, but it helped to reduce my anxiety a little.

The acupuncturist was different from my normal guy, and attached me to this machine that fed electric pulses through the needles, which was actually quite painful, but I must admit a little pain was kind of relieving. Nonetheless my muscles are feeling a little less tied in knots than they were before.

So, starting from the beginning, Case Manager (M) came around yesterday morning. We spoke mostly about the insomnia, and some of the unpleasant consequences of it. We spoke briefly about my sleep hygiene, but there was really not much there that I could change. She did query whether perhaps backing off on the therapy for a little while might help, but I guess I kind of think, eventually I have to go through it all, and its going to have the same negative aspects to it whether I do it now or later, so I don't really see the point in putting it off. We tried to work out if there were any particular unusual stresses or triggers that were exacerbating the problem, but to be honest, there isn't really anything that can account for it.  She did a quick suicidality assessment, and realised, I think, the depth of how low and helpless I am feeling underneath it all. This line of questioning is always difficult. There is not much point in being dishonest, that is not going to do me and good, but there is also I reluctance to share particular details as far as planning and dates, because it feels safe (in a f*cked up way) to have that little plan that you, and you alone are privy too. So its always a bit of an internal arguement when trying to decide how much to share. She did ask me about timeframes, and I did not answer at first. But then she quite firmly reminded me that it was important information for her to know in order to do her job properly, so I quite reluctantly shared the date with her. (Which I am not going to put on here, as I don't think that is very fair of me) Our plan of action for now, is to make it through Xmas etc, and reevaluate in the New Year. She did mention the idea of hospitalisation at a later date if it is needed, but I think she realises that I am not going to do anything over the Xmas period, as I couldn't do that to my family. I really quite bulk at the idea of hospitalisation and don't think its particularly helpful, other than to immediately save me from myself, but I don't think it has any real long term benefit, but I guess we'll cross that bridge when we come to it. The other option is to go with the Private clinic that therapist (D) has suggested previously. It apparently has a better program, actual inpatient therapy and a more individualised approach to inpatients. Hospitalisation in a private hospital would only cost me a $250 excess, but I would have to become a patient of one of the Gap Cover Private PsychDoc's who have admitting privileges. And that's where the expense comes in, if I leave the Public system, I will have to pay out of pocket for a Private Psych, probably once a month, and Health insurance doesn't cover that, and Medicare only covers a portion.  But then, in my experience the private PsychDocs tend to be a bit more flexible and creative when it comes to meds, and perhaps a private PsychDoc could come up with a solution to help support through the sleep issue, until the underlying issues exacerbating it are resolved through therapy (if it is possible for them to be....sigh) But, I'm putting the cart before the horse, hopefully it doesn't come to that.

After that I had my appointment across town with Therapist (D) We skirted around the issue of my 'visual disturbances' which I really did not want to talk about. We also, of course went over what happened in the session on Monday, when she notice me baulk when she started to talk about me being angry with her. She asked if I could share with her what the voices were saying inside my head at the time, which of course I couldn't. It was a long and pretty fruitless session (through no fault of hers, I was just finding it really difficult to speak)We did talk for quite a while at the end about trust and expectations. I explained that I found it really hard to believe that she truly was as universally supportive and understanding as she attempts to be, and that eventually, she was just going to get frustrated at my inability to meet the expectations. She espoused, that she didn't think I was failing to meet expectations. After some direct and slightly agressive questioning about what her expectations were, she finally answered that "I show up, and I try my best to share as much as I can". They are some pretty flimsy expectations. I'm not going to get very far if all I do is show up and know, unless it gets a bit difficult, and then its ok, to sit in silence and waste her time! I was taking quite a frustrated tone with her, but to be honest, I was more frustrated and angry with myself. I know that I am hanging on by a thread, and I know the only way to move away from this place I keep returning to is to push myself to enage more in the therapeutic process and sort this mess out once and for all. I don't have the space or time to twat about! And yet, I seem to be incapable of doing this, no matter how I berate or beat myself up over it. And I know the ONLY person who can change this is me.

So after therapy I had a date with Bachelor Number 1, which given my current frame of mind I would have gladly cancelled, only he had organised a suprise for me. He also asked whether I would stay the night at his place, so we could wake up together....arghhhhhhh! This is the last thing I wanted to be dealing with at this time. So, I called for some back up support, and the gentle kick up the arse that I needed from (K). There was no doubt about it I was just going to have to suck it up and go. And, I was going to have to really suck it up and have a conversation with him explaining about my sleep difficulties and some of the other issues that were making the idea of spending the night so terrifying. We went to a lovely Turkish restaurant and had a really nice dinner. And then he took me back to his apartment, where he had done the very cliched but sweet rose petals throughout the apartment, candles and chocolates and roses on the bed. (Double arggggggggh). Ok, breaks on. I took him outside and we had a discussion, but he convinced me to give the whole sleepover thing a chance. So he drifted off, and I spent the next hour lying next to him wide awake, worrying, amongst other things, that if I went to sleep I was going to have a nightmare and wake up screaming...way to freak I guy out. I needn't have worried, because I didn't have a nightmare... I didn't sleep full stop. He on the other hand slept like the dead. So after an hour or so, I extracted myself from the bed, and I went out on the balcony, where I spent the whole night, surfing away on the computer and watching the city lights dim and the sun come up over the river. I really should have taken a taxi home. I had told him I might have to. But I didn't want to dissapoint him. So instead I just stayed awake all night, and slipped back in beside him at about 6.30am. Sigh....I am pathetic.

So, thats my world in a nutshell....

Wednesday, December 16, 2009

To wander in the mind

So the hallucinations, or whatever they are, are beginning to freak me out a bit. I am reminding myself constantly that it is just a byproduct of fatigue, and nothing to get overly concerned with, but still, its a bit disconcerting, right? I rang case manager (M) today just to check in with somebody else and confirm it was not a major problem, as excrutiatingly difficult as it was to admit it to somebody else. She agreed with me, stating that basically whilst it was something to be concerned about and we needed to have a closer look at what we could do about sleep, it was not uncommon, and not something to freak out about. She acknowledged that I was pretty good at managing my sleep hygiene... that is all the little tricks of the trade one has to do nightly to ensure that your body is in an environment and conditions most optimal to sleep, so there is not really much to change there, I am already doing all the things I am supposed to.  She suggested that maybe I needed to back off on the harder stuff in therapy for a while. She also suggested that I need to acknowledge the affect of some of the stressors in my life rather than minimalise them, which is somewhat confusing because the whole gist of behavioural psychology seems to be to accept these stressors and continue to get on with things regardless, which is what I've been trying to do. I don't want to give myself any excuse to dive any lower than I already am emotionally. Predictabley she suggested I try to take a nap, which makes sense in theory, but was just not going to happen, as a) I was too wound up and b) It is too bloody hot here in the middle of the day. But I did spend another day (not doing uni work...sigh) trying to at least rest my body if I could not sleep, watching tv, taking a cool bath. I did however get up this arvo and do a bit of a cleanup around the house, as the mess was beginning to distress me. I'm going to head in and clean the bathroom in a minute now that it has started to cool down.

So I was somewhat reassured by her, but as usual for a little bit of extra reassurance I went and looked up sleep deprivation induced hallucinations. It was quite reassuring to read that hallucinations themselves are actually reasonabley common. The relationship between sleep and hallucinations was quite interesting too.

Research subjects who have undergone sleep deprivation experiments typically begin to hallucinate after 72–96 hours without sleep. It is thought that these hallucinations result from the malfunctioning of nerve cells within the prefrontal cortex of the brain. This area of the brain is associated with judgment, impulse control, attention, and visual association, and is refreshed during the early stages of sleep. When a person is sleep-deprived, the nerve cells in the prefrontal cortex must work harder than usual without an opportunity to recover. The hallucinations that develop on the third day of wakefulness are thought to be hypnagogic hallucinations that occur during "microsleeps," or short periods of light sleep lasting about one to ten seconds.-
Interesting tidbit... the word hallucinate comes from the Latin verb hallucinari, which means "to wander in the mind." Even our language for quite scary or offputting things is quite beautiful when you break it dowm. I guess I was/am concerned because my only other experiences with hallucinations before have been quite scary. I had some when stupid neurodoc put me on too high a dose of anti-epileptics many years ago and sent me toxic, and more scarily I had quite a lot of them after I overdosed in 2006, weeks of them in fact, and they were quite horrible ones, thinking the nurses were trying to kill me, seeing snakes, spiders and maggots slithering all over me. (There were others that were less scary, and slightly more amusing in retrospect, like believing someone was baking in the ICU, and the cookies were on fire, and jumping (falling) out of bed to extinguish it, ripping out all my ivs in the process, believing that I had a baby by surrogacy for my best friend, and getting quite upset that she wouldn't let me see it, seeing clocks dripping down the walls etc etc) but at the time it was a pretty horrific experience for me, and for those around me. But this is quite different, as I have stated previously, I still have at least one foot planted firmly in reality.

So, I have a meeting with Case Manager (M) tomorrow morning, when we will look at the sleep issues and see if there is anything else I can try. Part of me thinks maybe I should have kept the appointment with BabyDoc today, but I also know I just really wouldn't have handled it well at the moment. So I asked (M) not to worry about saying anything to the doctors until we see whether it gets worse or not. In the afternoon I have therapy with (D). I have emailed her with the gist of what is going on, and admitted to the little hallucination in her office, just so she is working with all the information, but I told her I really don't want to talk about it, so hopefully she will respect that. I think we should really just focus on how I am going to get through Xmas. And maybe talk about whether she thinks the therapy is getting a little too intense, or whether it is necessary to keep it at this level to make progress. That being said, I really don't feel like enagaging in either of these two appointments at the moment, am just not really feeling up to it, although paradoxically I am stressing about the absence of these appointments over the Xmas break, so I really can't win either way. But I am going to keep them, because everything else regardless, I always try to keep up my commitment to therapy, despite how I might be feeling on any given day. That way at the very least I can be assured that I am taking responsibility for ensuring I recieve the treatment/support I need. The appointment today with BabyDoc is actually the first mental health appointment I have ever missed, apart from those while I was hospitalised or sick, or a couple of individual sessions when I've been on holidays (which I always try to give (D) plenty of notice for.

I also am supposed to have a date with Bachelor Number One tomorrow night, which I really, really do not feel up to.... but I kind of blew him off last week, and then haven't really seen him this week, so I kind of feel like I can't pull out, especially since I'll be heading home for Xmas without him next week. (That aside we do have to have a little talk about expectations and boundaries... he is getting a little too demanding for my liking...)

Well, off to clean the bathroom (hey, I find it therapeutic! I was talking to someone the other week who mentioned sometimes she doesn't do the dishes for a whole week... I nearly died! :) That would send me into complete conniptions... I have to be at absolute rock bottom, cannot get out of bed in misery before I let that happen, that being said I have been letting the house slide a bit... I've just been too tired to do anything other than the bare necessities.) After that, I guess I'll try for another night to try and get some damned sleep. It is at the point where I actually am kind of welcoming the seizures when they happen (and they have increased in frequency) because at least they knock me out for a bit... its not 'proper' sleep, but its better than nothing. I really wish I could just have someone come and put me in a coma for a couple of days, or failing that, knock me out with a shovel or something!

The courage to jump

Its Christmas next week... how the hell did that happen so quickly? I'm not going to let myself go into a rant worrying about the multitude of dramas that are possible when my family gets together for extended periods of time. I'm not going to waste my time catastrophising, predicting and worrying myself to death over something that hasn't happened yet. I'm just going to wait and see. The other factor that comes hand in hand with this pesky holiday sneaking so surreptitously up on me is the break from therapy. (D) has arranged for me to have my normal Thursday appointment on Tuesday next week as she wont be working Christmas Eve, understandbly. So, I will see her on Monday and Tuesday and take the chance to bulk up on my coping skills, before I head back up North to see the family. After that I will not see her for about a fortnight, as she won't start back at work until the 4th. The same goes for (M), my Case Manager. It is really quite scary how in a period of less than six months I have become so used to (and attached to) the containment of seeing her twice a week. The longest that I have gone without seeing her (apart from when I was in hospital and even then she called me every day or so) was a week (or two sessions) that she has off a few weeks ago. And I must admit I struggled.  I didn't call her, but I had the back up of (M) being available, and support withstanding, my mood and anxiety levels took quite a major dive.

On the otherhand, as aprehensive as I am about it, there is another part of me that is actually looking forward to a bit of a holiday from therapy. A break from the questions and ruminating that therapy throws up, the over analysing and forays into the darker places in my mind, a chance for the voices to feel not as 'challenged' and perhaps quieten down for a bit. I think, if I am to be completely honest with myself, that a good part of my recent discomfort in therapy comes down to a fear of change. Not that I don't want change, but more that I am scared of what it will look like, or that it will turn out badly and throw up more issues. As much as I don't want things to stay the way they are, at least there is a certain safe feeling in knowing what its like. Its kind of like being told to jump out the window of a burning building. I know I can't stay where I am, and I know that she is setting up a safety net below me for me to fall into, but what if she is not in the right position, or the net is not strong enough to catch me? What if I take the chance and end up smashing into a million pieces at the bottom? But nonetheless, the smouldering fire is gradually pushing me further and further out the window. Its a leap of faith. And I do have faith in her, more than I do with most people, but I also know she is fallible and human, and regardless its just not in my nature to trust implicitly.

Things are beginning to really unravel at the moment, and aside from the other additional stressors of Christmas and the poisonous atmosphere I find myself living in, I put it mostly down to the insomnia.  I think it is getting to the point where it is really starting to push me over the edge. I am nervous and anxious and my hands are constantly shaking. My brain is so foggy and unclear, I'm finding it hard to make it through some of the most basic daily living skills. I get in the shower, and I can't remember whether I've washed my hair, so I do it twice, or I forget to rinse the conditioner out. I go to put clothes on, but I can't make the decision what to wear, so I sit in my towel staring at the cupboard for an hour. I sit in front of the tv for hours staring at it, without ever actually watching anything. I realised tonight that I hadn't eaten anything since Sunday night, not deliberately, I just forgot I guess. So I've existed for the past 48 hours on juice, diet coke, meds and cigarettes. The hallucinations (?) delusions (?), seem to be ramping up, I'm seeing colours and patterns bouncing off the wall. I'm still able to ground myself and tell myself that this is just my brain throwing out weird signals and that it is not real, but the fact that they are there and I have to have this conversation with myself is worrying. The last couple of days in particular has been a real downhill slide.

I am trying to keep it all in check by continuing on as best I can with volunteer work and school work. By making it to my therapy appointments even though leaving the house is the last thing I want to do, by keeping my dates with Bachelor Number 1 on Thursday night, and friend (F) on friday. I called and cancelled my appointment with BabyDoc tomorrow, as I figure that a) I'm going to being seeing BossDoc on the 7th anyway b) BabyDoc seems fairly committed to cutting the medications back, so I don't really see the point in going c) I'm not sure I really want to tell anybody, especially him what's going on as far as the little trips my brain is throwing out. I discussed it briefly with (D) when I thought it was a one of thing, but now that its happening more, I'm a little scared in case it is more than just severe sleep deprivation, and I just want to bury my head in the sand and not deal with it. I am too ashamed to talk about it, even if there is a chance he might be able to do something to change it. And finally d) I was just not up to going up to the purple building of despair, to be locked in an airless, claustrophobic room, and risk another panic attack like last time. I just don't have the energy for it.

Still, I am trying really hard to use the coping skills I have been taught, the deep breathing and the mindfulness to deal with the anxiety. Ensuring I still have a reasonable schedule to provide me distraction and going whether I feel like it or not. I got out the razorblades for the first time in a long time yesterday night, but managed to talk myself down from doing anything, before I risked losing the ability to say I have been self-injury free since 2006. It was bloody hard though, the temptaion was (is) strong, and to be entirely honest it came more down to the fact that I didn't want my bf to see new cuts and I know if I was to go home for Christmas and stay out of the water it would raise too many questions. Honestly, if I would have been able to do it without the risk of anyone finding out, as I was able to do previously, I probably would have. It may just be a distorted recollection, but I can just remember the sense of immense calm and control that would come over me when I used to do it, and its ability to (in that moment) pull me down and ground me.

There are the predicatble late night forays onto google, researching (again) the different fatal toxcicity levels of my medications ect (Information I really already know, but find comfort in reassuring myself time and time again is accurate) I find myself stopping on the freeway overpass near my house and thinking what if. But Suicidal Ideation and thoughts of self harm, are just that, thoughts... I am doing my very best to keep my actions under control, even if I can't control the thoughts in my head.

When I made the decision to reengage with therapy this year, it was because I noticed I was beginning to decompensate and I was trying to be proactive about it before things really got dire. Since I've been back in therapy, I have noticed things have continued to slide back quite rapidly. And I don't know how much of this would have happened anyway, as I was already on a downhill slope, and how much of it is produced by having to rake up the past. I believe wholeheartedly it is necessary that I do this, as I know even in my period of apparent stability, I was constantly on edge, trying to keep myself in check, and trying to keep the unresolved issues of the past from taking over. I was managing the symptoms at best, but had yet to really deal with the underlying issues. I knew that I didn't want to go through my life on a constant vigil, with all of this darkness looming reay to slide out and king hit me the minute I dropped my guard. I was existing sure enough, but not really living. And going into therapy I was aware I was reopening Pandora's Box, and thus opening myself up to a lot of emotional turmoil, but I was hopeful that by enduring through this that there would be a better outcome at the end. I still cling to that hope, but it is getting harder to hold on, to believe there is something good at the end, some kind of peace or closure, to believe that is possible. But I know that my brain is clouded by all the negative stuff it is being exposed to, and that I have to do this on faith alone.

But, I am tired. So very exhausted and lacking in the energy to really care. And afraid, afraid of not being able to cope with what I am trying to confront. Afraid that I am slipping further and further into a place I won't be able to climb out of. Afraid that I will never be able to achieve the desired outcome.

But what else is there to do? I can't turn back, I've opened to many dark closets to try and stuff all the skeletons back in now. Besides, I don't want to live life like that anymore, I would rather take the express train out of here if that is my only other option. So, I must plug on, and keep trying to do whatever I can to force myself to keep my head above water. Even if the coping skills seem pointless or don't really seem to work.

Maybe I should be more honest with (D) and (M) and even BabyDoc about where my head is at, at this point, but faking it seems to be the best way I have to keep my head above water at the moment. So, here I stay, clinging to the window sill of a burning building, trying to find the courage to jump.

Monday, December 14, 2009

Everybody wants control of my brain

Therapy this afternoon. We spoke briefly about the work that I'm doing at RMH, and how I can gauge whether I'm dealing with the emotion of bearing witness to some pretty sad events in an appropiate way or whether it is becoming a case of taking the sadness in too much, to the point that it begins to impact my own mental health in a negative way. I think at this point I am handling it pretty well, and it is not a major issue. But I am aware of the fact that I have to keep an eye on this. Speaking to my mother last night, she expressed similar concerns, and whilst she acknowledged it doesn't seem to be an issue at the moment, she urged me to be careful, explaining that in her experience as a nurse (and a number of year working in a nursing home.. which by nature is steeped in death) that the effects of bearing witness to death, can be culmative, and sneak up on you. She stopped working in nursing homes, because she began to burn out emotionally, after years of developing relationships with patients only to have them pass. And she pointed out that at least in that situation, one could derive comfort from the fact that it was an inevitable part of the circle of life, and the majority of the deceased had led long lives. At the RMH, it is children who are dying, and that will never be natural or acceptable. I think it will just be a case of having to carefully moniter myself to ensure that I am balancing the need to 'be there in the moment' with the residents, against the need to protect myself from the trauma of repeatedly being exposed to the sadness and unfairness of children passing. And I am only volunteering a couple of times a week, it makes me wonder how paediatric and neo-natal nurses manage to be immersed in it, and not burn out, or lose faith in the Ol Guy upstairs who allows such things to happen time and time again.

We then went back to the issues with lil sis, and more specifically to my inability to express anger or even to comfortabley allow myself to feel it. At this point 'The Voice' and some of his auditory comrades began to grow louder in my head, and when she suggested that perhaps I was angry with her, and that was ok, they began to make so much noise, I was finding it hard not to be pushed completely out of my own head. She went on to assure me, that it was ok to feel angry towards her, and that relationships can survive anger. In fact it was impossible to have a true relationship without it. She tried to explore my explanations that I felt anger was pointless and not productive... but must have noticed that I was having trouble trying to stay present in my head, with the entities that were trying to fight me, and each other for control. She stopped, and took a minute to try and assess where I was at, and who was talking inside my head. She asked me to share what they were saying, which I was promptly told (by them) not to do. To be honest, even if I was allowed to share, it would have been hard to, as it all becomes tangled up, and there is just so much competing din, that I find it hard to really here what each individual voice is saying.

The gist of it was a) "She is only saying that because she has to", "This is supposed to be about fixing up your fucked up behaviour, not getting angry at other people, you are the one to blame", "People only just manage to keep on caring for you, because you demand so little from them... most of them are just looking for an excuse to cut all ties... so go ahead, get angry, see how quickly you end up all alone" "Nobody wants to hear your pitiful  complaints, you are nothing... less than nothing, you are not worth the effort etc etc.." (The Voice) b) "She is trying trick you, just shutup and let me take over" "Do not speak. DO NOT SAY A WORD" (Game face) c)"Get up and walk away" "Go on then, if she wants to see Angry, show her how mad you can get" (The Others) There was in fact, a lot more than that screaming around the corridors of my mind, arguing back and forth, but it gets to a point where it is so loud and so simultaneous, that I only hear brief snatches of it, the rest just blends together as a general din. And on top of that, I experience being 'pushed' out of the way and to the side within my own head, so everything begins to take a kind of disconnected, fog like feeling. A new one, (which now I write about is sounds really crazy) is the Paranoid voice, which has long been a member of the chorus within my head, but this was the first time he really showed up in therapy (with D anyway). He quite often will tell me that people are trying to catch me out. They can read my minds, they have cameras set up, they are accessing my computer etc etc. I can usually just dismiss this as paranoia, all though there is a persistant uneasiness that follows it, and I must admit it is a fairly pervasive thought... particularly about reading my mind. I suppose to honest, that has come up a little bit in therapy, especially since (D) tends to be fairly perceptive, and can often guess quite accurately at whats going on in my head, or at least is able to tell when something changes, like the voices ramp up. But Paranoid Voice, as a seperate entity to myself, has not really shown up in therapy till today. Today he was claiming that D was secretly filming me, and wanted me to crack up and get angry.. I don't know to what purpose she would be doing that, it obviously made no sense on so many levels. But there it was anyway. As I have mentioned before, these voices are obviously just seperate parts of myself that I cannot reconcile or 'own' as my own feelings, so they have been separated into discrete entities, masculinised or feminised. I really wish that I could experience these as what they are, MY thoughts and feelings, it would be a lot easier to reason with something that doesn't seem to be running its own agenda or battling me for control.

Anyways, I guess (D) must have decided to back off a little bit and give my head a chance to quieten down... I'm not really sure what we talked about next, it all gets a bit blurry. The next thing I became aware of, does not bode greatly for my sanity. I experienced a brief hallucination. I saw a snake slide its way from under her desk, and dissapear under the table beside me. Now, normally this would have probably caused me to gasp, or show concern like any normal person, but the fact is that this is the third such hallucination that I have had in the last week or so. I attribute it to being most likely a result of extreme fatigue from the prolonged bout of insomnia that I am experiencing write now (its been well over a month since I slept more than 3 hours a night) So, having experienced this little visual blip, I managed to keep what I thought was a fairly neutral demeanour. But once again, (perception? esp?) D managed to tune into the fact that something had just happened and asked me about it. I brushed her off saying it was nothing. To which she replied, "Its not nothing. You look so worried". Desperate for escape and not really wanting to talk about it, I looked over at the clock and realised ou time was up, so I told her I had to go or I would miss my train.

Oh, now I remember, I think we talked briefly about my appt with BabyDoc on wednesday and more specifically about my appt with BossDoc (the consultant psych who actually makes the decisions regarding treatment, and when to discharge a 'client' from the service) This will be at the beginning of January, and I mentioned to her I am feeling quite nervous about the whole thing. I'm not quite sure why other than the obvious not wanting to talk to yet another person I don't know and the anxiety I have relating to being trapped inside the rooms in the giant purple amoeba of a mental health building. I think some of it comes down to not knowing if I can adequately describe my concerns, worrying that he will brush over some of the more difficult symptoms I am experiencing. Like the insomnia. I am not by any means a drug seeker... I would love to cut all psych meds out of my daily regime altogether. But when a person is getting 3 hours sleep a night for a protracted period of time, it needs to be treated. Obviously, the most appropriate treatment is therapy, as there is no medical reason why I can't sleep... it is pure anxiety. But that is a longer term project, and I need help immediately, with the increase in seizures and now these little pseudo-hallucinations (I say pseudo, because in my mind, a complete hallucination would be a detachment from reality, I see the hallucination, but am cognitively aware in the moment that it can't be real, and that it is just my brain throwing something that is not real out there) Anyway, am not quite sure I want to tell Boss Doc about this, as I dont want to appear nuttier than I already am. My concerns from a medication standpoint, is that my general baseline of depression is not too bad with the Avanza, its there, and I deal with it, but its not that breathtakingly low black place at the moment, I am better with my ADLs generally, although there are days when I find it hard to get motivated and self-care. But in general not a major issue, right now. My anxiety is fairly constant and at nighttime or times of particular stress ie lil sis and bf screaming shoots through the roof, and the occurence of flashbacks and panic attacks, is on par with the way it was before I was hospitalised. And with that, and the sleep deprivation my concentration is shot to hell, and my school work is suffering. On top of that, my anxiety causes me to worry that everything I do write is rubbish, so I rewrite it and rewrite it, until eventually it makes no sense at all, but the deadline has come and I have to hand it in anyway. And the final thing i've noticed is that since I was taken off the Largactil, the voices are more constant and louder, which kind of worries me, as that would indicate if an anti-psychotic quietens them, that is might be a psychotic feature, which doesn't make a lot of sense to me, as I have insight enough to understand that they are not real, and if they were a result of psychosis, I wouldn't be in touch with reality, right? This is something I really do not want to tell the psychiatrist about, and I kind of wish there was a way that I could make him see that I need th seroquel or largactil without having to say anything about the voices.

Anyway, (D) suggested that we need to talk about the upcoming appointment, so we could find a way that I could comfortabley share the pertinent information (but not ALL of it). She thinks it is a priority to ensure that I am not discharged from the service just now, and as i have mentioned in previous posts, I kind of agree with her. I hve this sense at the moment that things are beginning to teeter on the edge. The culmative effects of the insomnia and anxiety are beginning to make it harder and harder for me to hold things together, and I am expending so much energy into fighting to maintain my responsabilities for school (and failing) and holding myself together for work, and for lil sis and just because I know its my responsibility to do so. I have a range of professionals supports who are willing (at present) to be there for the moments when I cant keep it together, that I feel obligated to make sure I am doing whatever I can to control, modify, self soothe what I can and to use the techniques and tools I've been supplied with. But when you are sleep deprived the energy you need to do all of, work, self-maintinence begins to wane. That's the tightrope I'm trying desperately to walk at the moment.

Anyway. So I pitched my excuse about trains and hightailed it out of me.... dragging the voices along with me, and although they have quieten some, they are still there and arguing with every thought that I have. It is a horrible feeling when you are trying to write a blog entry having one voice decry that 'that's not what I said' another voice laughing hysterically and saying nasty things about what I'm writing and what a loser I am, and another voice telling me that we are alone and we need to call somebody to talk to us, even though its midnight and I'm trying to reason with 'the Baby" that we can't call somebody at this time of night.

Well, I'm going to leave it there... the entire post probably makes no sense, as my mind is a bit all over the place. Sorry bout that! 

Sunday, December 13, 2009

I don't like mondays

Am feeling a little emotional this evening. Was a tough day at work today as I was talking to one particular resident for most of the afternoon, who has been told her teen daughter only has a few days, at most left. Was particularly emotional, because it was so unexpected for her. The daughter was 100% fine a week ago, and within the space of a week, has been admitted to hospital, gone into a coma, and now her body is entirely shutting down. Its hard to know what to say, but I guess the point is they don't need me to say anything, they just need me  to listen. So she spent an hour or so, telling me about her daughter, showing me pictures......... and I must admit, although I held it together in front of her, I did cry on the busride home after work. I worry that maybe I wont be able to emotionally distance myself well enough to do the job. But then another part of me thinks, these people dont need emotional distance, they need a real human being to bear witness to their pain. And maybe my emotionality and empathy is not necessarily a sign of weakness and over involvement.,.. I don't know.

Other than that, I am anxious about going to therapy tomorrow after thursday session. Hopefully it will be a little less intense. And hopefull I can find away to reasonabley work through the anger that I am inexplicabley holding towards therapist (D). I then have an appointment with BabyDoc on wednesday, which also has my stomach tied in knots... another trip to the giant purple amoeba they call a Mental Health Service.

Finally, Bachelor Number one, is in a bit of trouble with me right now, and we will probably be having our first official disagreement on Thursday night (date night). But I think it will be fine, just some expectations and boundaries that need to be cleared up. He is such a man!

So yeah, not really looking forward to this week... but we'll see how it goes

Saturday, December 12, 2009

Everybody needs good neighbors

The universe just seems to be conspiring against me getting any peace in my own home. Sis and (ex)bf aren't screaming at each other for once. I think he is out actually. But the neighbors are having a rip roarer of an arguement filled with all sorts of nice expletives. Unfortunately my bedroom is on the same side as their house, and it is way too hot to close the window, so I can only hope they wind it up soon. I hope this isn't going to be a regular occurance. They have just moved in, and the guy has been quite friendly and invited us over a few tims, which is very weird in big city I live in. You just don't really talk to your neighbors, but a nice gesture on his behalf anyway. I am in a fairly antisocial frame of my mind, so I haven't taken them up on it.

Suprisingly, I am finding when I go to work, I am able to shed the more antisocial and anxiety ridden elements of my personality, and just let the job that needs to be done distract me. Today was a very busy day, with a lot of book ins and departures, and general enquiries from the residents keeping me on my toes for the whole shift. And tomorrow looks to be as busy... I am doing a double shift tomorrow, but am not too worried because, as I've said it is a good distraction and plus, the house is air conditioned which is a huge bonus given the current weather.

There were also, once again some sad elements to the day. Talking with the couple that lost one of their twin bubs, as they continue to process the situation, and booking in a family whose bub has sustained pretty serious head injuries from a car crash. I am trying to make sure I only talk about these things in the most abstract of terms to ensure the confidentiality of the residents, although I don't feel its much of an issue given this blog is anonymous and you all don't even know what city or state I live in. Still is a line that I have to be aware of..

I tried talking to my sister last night about the bub who passed. It wasn't like I was unnaturally upset over or anything, but it was sad and I just wanted to talk about it a little to kind of process it for myself. But I hit the wall of her emotional withdrawal pretty heavily. And she basically just asked me why I was doing the job if it was going to upset me. I got pretty frustrated, and snapped at her and ended up storming out of the room. I didn't want anything from her, other than just a few minutes of listening. I wasn't over the top upset or anything, I just wanted to talk about it a little bit, because of course it touches you when you sit there and listen to a parents grief over such a thing, you would have to be pretty unfeeling for it not too. But I don't think that it was making me wig out in such a way, that would merit her insinuating that it was just not something that someone like me could cope with and I should just not do it. If anything, the volunteer work has been, on a whole, quite good for me.. its a good distraction, less time for navel gazing, its a gentle reminder that there is a lot of people going through a lot worse than I am and it makes me feel like I am finally doing something productive and worthwhile again, which is good for my self esteem. The residents at the house know nothing of my issues, instead I am able to be a strong shoulder, an open ear and a caregiver... all good things for them, and me.

I guess in some ways, quite unfairly, I am really annoyed with therapist (D) for the feelings that she unearthed on Thursday. I generally don't snap at lil sis, but I am feeling quite an illogical anger towards her since Thursday. I don't see that its particularly productive and I don't really know what to do with it. I understand intellectually that it is not (D) who has created this feeling, rather she just tapped into something that was obviously lying somewhat dormant in me, but I guess its a bee hive I'd rather she hadn't beaten with a stick, and I hope that we can just leave it be now, so that the feelings die down again. As I've said, I don't see that it is particularly productive, and the presence of these feelings is just making me uncomfortable and unnecessarily upset. IMO. But what do I know, huh? Maybe this is just the invalidating part of me, trying to supress and rightful emotion? I think that's what she would say anyway. Sigh.

Anyway, am pulling a double shift tomorrow, so best see whether I can get a few hours shut eye.

Friday, December 11, 2009

Shite days

So, today has been a pretty shite day. Well, its been a pretty shite couple of days. Lil sis and her (ex)partner, (who I live with) had a horrible screaming match on Tuesday night, and I was of course dragged into it... he told her that she was making him crazy, and that it was no wonder her sister (me) walked around wanting to kill herself all the time. Which was a bit of a shock a) because it was a nasty thing to try and insinuate that she is responsible for my MH issues, and b) because I thought I was doing a damned good job keeping my suicidal ideations and other struggles from her, only to figure out, I've been expending all of that energy for nothing, because I've been fooling noone. But it did confirm that she doesn't want to hear about it or deal with it, or she doesn't know how to deal with it, because she has not once asked me about it, or even acknowledged in any manner that she knows I am struggling. Aside from all that, as mentioned in previous posts, the screaming just transported me right back to childhood, and I spent the night pretty upset and shaken up by the whole thing. And of course I didn't get any of my assignment done.

So, after next to no sleep.. (on top of everything when he left the house he let my cat out, so when I did finally fall sleep in the wee hours of the moment, I was woken up to the sound of her fighting outside, and she wouldn't come in, so I couldn't settle back down to sleep) I got up early wed morning to head off to the Ronald McDonald House where I volunteer. It was xmas party for the kiddies, so I passed the day doing crafts with the little munchkins (a good distraction), but by the time I got home at 2pm, I had to work flatout to get my assignment finished in time to hand in at 5pm. My brain was fried by the time I submitted it at 4.45pm.

So, after another night of fitful sleep (although better than the night before) I headed off to a specialist appointment this morning, where I was told surgery could be put off for at least another couple of years most likely (good news), but the whole appointment was just very horrible and triggering.

Off after that across town to see (D) therapist. This was a weird, and not incredibley pleasant subject. (D) was a lot more forceful, and almost...confrontational than I have ever experienced her in the past. I could understand (intellectually and logically) where she was coming from but.... The gist of the session was pretty much that by staying in the house, where I am obviously exacerbating my stress, depression, anxiety etc, I was not 'protecting myself'' but instead focussing on 'protecting my family' as I had already done. And that my inability to stand up and say 'hey guys, this is really affecting me badly, could you leave me out of your fights, and try and have them a little more privately' was once again, me sacrificing my needs to keep the peace and not rock the boat. Basically she said, that I am scared to let my needs be known, as to do so would make me visible, and I expend so much energy making myself invisible. I just am to braindead right now to go into the long history that makes me unable to even contemplate doing this. And whilst on one level I logically accept her points, and I DO recognise, that as an adult I am making a choice, by remaining in the situation, emotionally I am not willing to live with the consequences of moving out or trying to make lil sis understand what it is doing to me mentally. If I was to acknowledge what is obviously (I see now) the great purple elephant in the room, my mh issues, lil sis would be forced to acknowedge too, and she DOES not cope well with the idea of my mentalness. In fact the last time I had a major crisis period (in 06) she did not talk to me for 6 months, and it really took till 08 when she moved in with me to really begin to regain the relationship that was lost. It is the same to different degrees with all of my family. Whilst many of them (lil sis not included, she just blanked me from her life) expressed to me in 06 after the OD that they wanted me to 'be honest and tell them what was going on before it got out of hand', when it came to the pinch they just couldn't actually deal with the uncensored truth, and in fact, got very passively or aggressively angry with me. What they actually meant is, we want you tell us your OK, we want you to BE ok, because we don't know how to deal with the emotions that you 'not being ok' or not living up to the expectations of your role within the family is. And so after several months of attempts to follow their overt message, I finally got the message and listened to that implicit message instead. Because I would rather deal with my MH issues on my own (with the help of professionals) than lose the relationships I do have with my family. I can't change how they are, and I either have to give up and walk away (not an option in my book) or figure out a way to just deal with the inherent stress they all bring into my life. So, its not just a case of fear of confrontation or standing up for myself ( although they are intrinsic issues, it is a matter of having looked at the options available, and chosen the one that I am least unhappy with. Which was frustrating, apart from her unwillingness to let it go and move onto another subject, her confrontational attitude, which was a bit of a shock.... there was also the realisation that as unhappy and stressed as this situation is making me.... I did and continue to still, choose it.

Anyways, I only had about half an hour after that to pull myself out of the bleurgh that the day had plunged me into before I had to head off to my volunteer job. But I manage to muster up the required smile and calmness required and completed mmy first solo shift tonight... which was quite daunting, being in charge of the whole house. It was, once again a good distraction, a great deal of the shift was spent just listening to the parents, giving them a friendly ear and a shoulder to lean on. There was lots of good news... this baby putting on weight and off the CPAP, that child finally scheduled for a much needed op... and therefore a forseeable end date in sight. I did have my first really emotionally confronting conversation with a pair of very young parents who just lost one of their very premmie bubs. I wanted to cry, and had tears welling in my eyes for them, but the situation required someone calm, who would just listen as they talked through their experience, the funeral arrangements and their grief. And that is really the most important part of the job, and although sad, also fulfilling, because you know that just the little task of listening, helped them in some minute way, in this horrible experience. Luckily, there are also so many wonderful and miraculous stories, it balances out somewhat. I find it amazing, that babies born at 25, 26 weeks manage to fight their way through and survive.  And I find the parents resiliency and fierce love awe-inspiring. I met a little toddler yesterday who weighed less than a coke can when born, and now is this beautiful little girl, with next to no long term damage done.

So I finished there at about 11 and caught the bus home. I'll just make a note hear that after 6 months as a disabilty bludging student, I haven't had to wear closed in shoes since I quite my previous job in June. I am quite the minimalist when it comes to shoes, and much prefer a pear of thongs or sandels to closed in shoes. Thus the shoes I wore to work yesterday gave me the most remarkable blisters on my heels, and although I elastoplasted them up and wore a different pair of shoes today, the heat made the elastoplast slide off, and by the time I got off the buss to walk home, the back of my heels were covered in blood, and quite painful. So I took my shoes off and walked home barefoot, which resulted on me standing on a small piece of glass that I have now had to dig out of my foot. Minor injury, but a bad end to the day. So I am home... but it is hot, and the last few days have just left me feeling quited deflated. But I think the best plan is to just keep staying as busy as I can, pasting on a smile, and faking it till I make it.

NB: I got a letter in the mail from Public Mental Health, saying that I have an appointment with head honcho- consultant psychiatrist in January, so Case Manager (M) has come through with that. It still remains to be seen what he will personally make of my current state of being, or really to even know what state I might be in come January, but it is a hopeful sign, that maybe they will hold off on completely discharging me from the service, if it is indeed still needed in January... which therapist (D) feels it will, and on this point I tend to concede she is in all probability right.

Tuesday, December 8, 2009

Try water aerobics!!

Have just come back from the pool energised and much cooler, thank goodness! Our instructor is a really vivacious lady, who does the impossible and actually makes exercise fun for me, rather than something I must endure to get rid of this horrible belly, and the ladies who attend are a good variety of young and old, thick and thin, rather than the barbies in tank tops I have to watch on the treadmill ahead of me at the gym. Plus she plays awesome 80's music! I have a lot of fun and really must try not to let lack of motivation stop me from going, because when I do go, it keeps me smiling for at least the next few hours. So, if youre like me, and hate exercise, but need it for endorphins and to fight the medication bulge, my advice is to look up your  community pool and try water aerobics!

I just don't want to.... its too hot!

I should be writing my assignment, due in TOMORROW, and not this blog entry, but I am fed up. It is like 1000 degrees here at the moment, and even though I have all the windows open and fans on, and am dressed in a singlet and shorts, I am melting in the heat. I hate, hate, hate Australian summers! And my brain, through a combination of the heat and extreme fatigue is just mush. So, I am sitting on the front patio, the only place where there is just a hint of a breeze, smoking a cigarette and writing this entry. It's less than a month till my proposed quit date, and I am savouring each bit of nicotine until then.

So, I had a meeting with Case manager (M) this morning, she wasn't able to get a car, so I walked up the hill to the grey amorpheous blob, they call a Mental Health centre, and nearly keeled over from the effort in the heat even though it was only just past 9 in the morning. As I have mentioned in previous blogs, I hate this centre with its tiny, airless, anxiety inducing rooms. But to be honest, it was kind of nice to be anywhere air conditioned at the moment, plus I really couldn't be arsed tidying the house and I really hate people seeing it in this state. It went ok. She noticed a difference in me from the last time we met, and I think to be honest, the busy-ness I am surrounding myself with, is going some ways to setting me back on a bit more of an even keel, even though it is exhausting to keep up with. We talked about various things such as the tension at home and my anxiety levels over Xmas with the family. We also talked about the proposed date for my 'discharge' from the service in the New Year. She mentioned that she had spoken to my private therapist (D) who had big concerns about me being discharged at the moment and asked whether I shared her concerns. I said that I did, that as imperfect as a saftey net the public health system was, I was worried about how I would cope with the things that my therapy throws up without it. I hate talking to people that I don't know, in fact I find it near on impossible, and if I was to go into crisis again, I'm not sure I would cope if I was reassigned to a different case manager and had to start all over again. Besides which, I really do not feel like I am properly stabilised as it is, medications are still not right, and my mood is all over the place, along with the constant suicidal ideation. Anyway, she basically said, that we would review things in the new year, but that the system here was based on the decision from the consultant psych, and not my primary treatment coordinator (her) or even BabyDoc, who I've at least actually seen a handful of times. Its an imperfect system, but you've got to work within the parameters of what's available, I guess. She is trying to get an appointment for me to at least see the Consultant, before a decision is made. (I actually don't remember the guy at all, but as I only saw him a handful of times in hospital, I guess that's not suprising) For all my groans about the service, I do have a Case Manager who listens to me, and trys to work the best she can within the system that she's given. She's a bit of a pollyanna, but this doesn't seem to bother me as much as when I first started seeing her, when I took it as invalidating and superficial. I've come to realise she actually does see the world in a happy sunshiney way, and it is authentic, which makes it easier for me not just to dismiss everything she says outright. She talked to me about how the drive behind community mental health now was about stabilising a client rather than fragilising them, and working with them to create support structures within their own personal communities, rather than just to provide that support for them, and then when it is withdrawn or the client is discharged, they fall apart because they lack support. I could see that this was a valid thought process. The problem is a) Subjectively I don't feel stabilised, but I wonder if the image that I give to others objectively is that I am? And b) whilst I do have support structures in place, good friends who I can turn to when I have a problem, or when I need a bit of extra love and care, I don't feel that it is fair of me, nor that they would be able to deal with the heavier issues that I deal with. Even though I have spoken with them and told them in times of deep depression or anxiety I don't need them to come up with answers, or to rush over and try to protect me from myself, that they just need to listen, they still feel overwhelmed and helpless in the face of it. (Straight from the horses mouth) And I don't want my friends to carry that burden, they don't have the experience or the professional knowledge to equip them to deal with me when I am on the edge. And knowing that I am burdening them as such makes me spiral into deeper self-loathing and just solidifies that gremliny little voice that tells me they would all be better off without me. My family, as much as I love them, proved to me after my overdose in 06 that when they were telling me that I needed to 'Talk to them and be honest about where I was at', what they were really saying was "Tell us you're ok, we need to hear that you're ok". So once again, I can look to them for support in somethings but cannot ever be truly honest with them, they just don't cope. (M) took me to a local drop-in centre for people with MH issues a few months back, but I am just not really into that whole scene. I know from previous experience in other big, regional city back in 06, that these centres tend to attract a lot of people who feel the need to compete for who is the most messed up, or commiserate on how horrible life is, and I don't find this to be particularly life-affirming or helpful. Peer support definately has its advantages and to a certain extent I get that with (F) who I met in hospital and now catch up with on a weekly basis, but such interactions (for me at least) are restricted byt the fact that I know she is still dealing with her own quite regular suicidal thoughts, anxiety and depression, and I don't want too add any pressure on her, or get into a relationship where our individual downspirals egg the others on, which can happen. What would be really great is like a form of AA where you are given a sponsor who understands where you are on the journey, but is a little bit further up the path and a little more stable. Which I guess in someways is kind of the support that I have from (K) the Consumer Consultant for Public MH. I guess, I need to be a bit more open to recieving people into my life who can provide support should the universe direct them my way.....Either way, I don't particularly want to become overly dependant on the professional support, and I wouldn't even mind so much if the support was not a weekly thing, just more the knowledge that if I needed it, I had my Case Manager, who I know and have developed somewhat of a rapport and understanding with who I could contact. Rather than just a crisis line of people I don't know. I'm just not comfortable giving that up just yet, as I still feel the need arises, with reasonable regularity and it is support I can access, that I don't have to feel the guilt or self-loathing about. Anyways, we shall see what happens.

After that, I made a quick trip to the store (in and out, I hate christmas crowds) to get the last few things I needed to run the craft at RM House Christmas party. And by the time I got home, it was nearly midday, so my resolve to get uni work done this morning went out the window, and I did not get the opportunity to 'treat myself' for getting it done as planned. At this stage, friend (S) is coming over in an hour or so, to pick me up so we can go do a water aerobics class, so I'm thinking I will just leave off the assignment, and come back and finish it off tonight when its a bit cooler....heck, its not like I'll be sleeping anyway.

Full on couple of days ahead with me volunteering tomorrow, thursday night, saturday and sunday, as well as therapy and specialist appointment on thursday, catch up with friend (B) on friday, and lots of uni work to fit in between if I am going to able to head home for the holidays without any assignments hanging over my head. But busy is good, busy dulls down the little gremlins voices, and lets me put on Gameface and get on with it.

Monday, December 7, 2009

Back on the couch

Its been a while since I talked about what was going on in therapy, which was of course what this blog was intended for in the first place. So, today I arrived at therapy two hours early (a combination of the heat and insomnia fuelled fatigue mushed my brain to the point where I got my times mixed up) so I spent two hours sitting in the air conditioned pub next door, drinking diet coke and reading a book that was loaned to me by Consumer Advocate (K). How I kept myself alive when my brain was trying to kill me (definately a post on that one when I've had a chance to read a bit more. I'm pretty damned exhausted, and I guess wasn't feeling up to a big, messy session, so we had a bit of a therapist/resistant client duel going on. Sidestep a question here, answer another question with a question there, and the proverbial favourite answer of all avoidant clients 'I don't know'. We talked a little bit about 'Game face' and how I used it to get through the weekend, and my date on thursday night with Bachelor number one. And then she asked if I had Game face on right then in therapy, to which I answered honestly, yes. Trickily, she asked if I was to leave Game Face at the door, what would that look like, to which I answered (aha! Don't think you can get me that easily!!!) "Now what would be the point of me using all my energy putting Game face on today, if I was to answer that question?" (Off the cuff defense!!) She laughed, and realised she wasn't going to get to far with anything heavy today, so changed tacts. We talked a little about a hallucination that I had a few days ago... I thought that maybe it was something to be worried about, but she told me not to be overly concerned with it. That given my current level of fatigue, it is not unexpected, and that these things can commonly happen as people are about to drift off to sleep, which I think I was, until I 'saw' a snake slither across my bed and scared the beejeezus out of myself! So that was comforting to know, that I'm not slipping into some new level of madness. We talked some about an idea that sprouted in a converstion with (K) this morning, where I mused if there was a scale of fucked-upedness, would where I placed myself along the spectrum, differ from where other people would put me. I came to the conclusion that yes, objectively people would see me as 'coping' a lot better than I subjectively see myself. She asked (one of those magic 'if' questions) if I could choose where I sat along the spectrum where would I put myself. I answered that although I know the expected answer would be somewhere towards the top, but not right at the very top. The whole, your negative experiences can help to shape you in ways that someone who does not experience many obstacles is not, you need to experience the dark to appreciate the light and all that. But that if I was to be honest, I would prefer to be right at the top living a completely calm, neutral, content life with no gremlins in the closet to bother me. I went on further to elaborate how much it can irk you sometimes when people talk about all the things your experiences had taught you, and how they have shaped me into a more insightful, empathic person. Said at the wrong time, it can ring of platitude.... and in reality, I would far rather have come by insight and empathy a different way, thank-you very much! We spoke briefly about how the relationship was going with Bachelor Number one, and she tried to get me to tell her what happened all those weeks ago when I had my complete flipout in front of him, but I promptly erected my red light, no go there zone. All in all, was a session with interesting conversation on an intellectual level, but not much on a purely emotional level, which was actually pretty good for me today, as I have been a bit of a depressed amoeba for the past few sessions, and not even up for discussion on an intellectual level, let alone an emotional level. So at least I actually did a reasonable portion of the talking this week. The resistance is an issue, because eventually I am going to have to allow myself to be a bit more exposed and vunerable if I am to effect any change. But as today it was, a deliberate self preservation resistance, rather than the usual "I'm trying really hard to move past this block, but I just can't make myself let it go, and its very frustrating', I wasn't too bothered. Sometimes I think, its just not the day for 'therapy' as such, but the act of going and keeping up with the consistency of it, and even just touching base to confirm there is someone there to listen and who cares, is all that you need for that given moment. I will try harder on Thursday.

I have done a few volunteer shifts, and they rang me to do a further five in the next few weeks, so that has been some good distraction and much needed time away from the navel gazing. Uni work is slipping behind and I must catch up on assignment that is due on wednesday tonight and tomorrow. But as I was challenged by (K) today to try and practice beeing kinder to myself and not such a hard task master, I am going to temper the drudgery of assignment writing, with some kind of treat for myself if I can get a reasonable amount done in the morning. Haven't decided what yet though! :) Case Manager (M) will also be dropping round for a catch up. Haven't seen her since the panic attack last fortnight, and am kind of stomache churningly embarrassed at the though of seeing her again. But she is a professional and will have seen a hundred people freakout worse than I did, so I just need to get over myself a little.

Am a little worried that there may be some tension between her and therapist (D), as (D) is not very happy about their plan to discharge me from the service in January, and I think, said as much to (M) over the phone. But really, there is very little I can do about it, the decision has already been made, and I need to just get as much as I can out of the last few weeks of support, and worry about finding a new private PsycDoc, and establishing new safety net contacts in the New Year when it all goes ahead. Its not really my place to get in the middle of professional disagreements, even if they are about me. And as I said to (D) it doesn't pay to rock the boat too much in the Public sector, as you will quickly find yourself being labelled a difficult client, and then getting any kind of help is made a hundred times harder.

Sleep is still a major issue, and clouds so much of what goes on in my life... I'm riding somewhat of an exhaustion high at the moment, after the craziness of the weekend, but am aware that it is all somewhat of a facade, and the likelihood of a crash back to amoeba status is reasonabley high.... just going to keep up the 'fake it till you make it' routine as long as I humanly can before I crash. The voice, and the gremliny thoughts are still there chugging away pretty strongly in the background, but (fortunately, in some ways) I've just got too many commitments at the moment to allow them to take over completely.

Well, that's life in a nutshell. (no pun intended)