Decisions

"We can try to avoid making choices by doing nothing, but even that is a decision. "

I might be admitted to the hospital tomorrow for a short stay. I think maybe its time. I'm kind of drowning. Therapist (D) has offered to come into the A&E Department with me, which makes it minisculy less terrifying.

Is it the right decision? I don't know. Time will tell.

Stuff n stuff...

Spoke to former psych on the phone this morning re: medication issue. Seems the best thing would be to begin seeing a psychiatrist again in addition to therapist, to manage medication. She quite rightly pointed out that GP's are restricted in their knowledge of medications for PTSD, and they tend to be quite rigid as far as the guidelines. (ie The dose I'm on for Lexapro is currently double the recommended dose, and GP expressed concern about that, but according to her its actually quite a common dosage for PTSD and nothing to worry about, the GP and Pharmacist believe that Avanza and Lexapro cannot be taken concurrently, and thus I would have to be 'weaned off' the Lexapro, hence the hospitalisation, but she says they quite commonly prescribe them concurrently) She also agreed with me to a certain extent, that medication has not been a particularly fruitful path in the past. End result: am more confused than ever.

I wish I could just go back and start seeing her again. I am confident in her ability and she knows my history, but unfortunately, she is in another town. In addition to this is the concern of having to pay a psychiatrist on top of the therapist... am not sure that I can manage it financially. Which means (gulp!) thinking about hooking up with the public system. Argh!

Anyway, appointment with therapist (D) in an hour, so I guess we can discuss my options there. Really don't want to go, battling the public transport at the moment seems a mammoth task, and in addition have been picking up some weird vibes from her in the last week. Not quite able to put my finger on it, and really too tired to think about it at the moment, but there is a weird tension there.

Other than that, Older sibling has departed, after her 'unannounced' one night stay, turned into a three-nighter. Managed to get my assignment in for uni yesterday, but having put a whole 3 hours effort into it, am not sure it will actually past muster. Is so hard to motivate myself to do the work, seems kind of pointless right now... but I am aware that when (if) I come out of all of this, I will be up the proverbial creek holding a paddle, if I've let things fall apart... been there, done that.

Mostly, I'd just kill to get some sleep. My eyes are achey and puffy, I look like the living dead, and my head is just full of cottonwool... I can't think straight. Its been over a month since I got more than 2 or 3 hours sleep a night...and I understand why they use sleep deprivation as torture.

Well, that's life at the moment...just stuff n stuff...

I know best?

Yay! For autonomy. Yay! For the people the people who don't treat me like an imbecile, unable to make her own decision, because of my mental health status. Yay! For the people, who want me to feel like my wishes are being listened to....

"You know what's best for you"
"Only you'll know what the right thing to do is"
"It's your decision"
"Let us know if it goes to far, and you need additional help"

I know that these things are said by friends, family and professionals who want to empower me at this time, to make me feel like I have some semblance of control over my life.

But.....

Truth is, I'm not always sure I am the right person to make these decisions. I don't want to cede control of my life and health over to someone else, but the pressure of trying to make sure I make the right decision, sometimes feels overwhelming. And the fear of getting it wrong is terrifying. And the fear that there will come a time when I am simply unable to make the 'right' decision, and nobody will notice is even more terrifying.

Right now, I am desperately trying to stay out of hospital. I am not going to mess about with my medications on the off chance in might improve things, I do not want to be case-managed with in an inch of life.

But....

I am fighting off pretty strong suicidal urges, I am trying to hold back what feels like a deluge of depression flooding over me. I feel like Sisyphus, rolling that boulder up the hill, only for it roll back down to the bottom, ad infinitum, for eternity.

What if I'm making the wrong decisions? What if, in a blink of an eye, I move to a space where I am no longer capable of making the 'right' decision or reaching out for help. It's happened before, and it happened so damned quickly... I went from struggling, really struggling but managing to keep myself in check, to oblivian. Literally, I have no real memory of the week leading up to my OD back in 06, or really, what was going through my head, to finally push me over the edge. And of course, no memory of the week that followed it in the ICU and then CCU. And that scares the hell out of me! All I know is that it started like this....

So really, Do I know best?

Blood is thicker than water?

Off topic. Family issues.... although I guess it is still kind of on topic, because the stress inherent with dealing with family doesn't really help the mental issue front, now does it?

A friend gave me a little sign I had hanging by my front door for a while. "Friends Welcome. Family by appointment only". I thought it was funny, my grandmother did not. I took it down. But cliched or not, the truth is friends you choose, family, well, you just cope with what's been handed to you. Some of 'em I love to death, others, well, they just seem to be a part of this giant cosmic joke that God is playing on me.

My parents divorced shortly after I was born. (I know, great for the esteem, huh? My arrival precipitated the demise of our family unit) But the truth is the cracks had been there for a long time. My biological father had a variety of mental (?) or personality (?) issues. Its hard to know which really. He was unreliable, a pathalogical liar and seemed to thrive on drama. Example: Instead of coming home and admitting to my mother he had lost his job, he kept up the pretense for months that he had a brain tumor, and that's why he had to resign...wtf? But anyways, by the time I came along, my mother had had enough, and it was adios to him. Apparently they tried visitation for a while, but he was unreliable, didn't show up for the visits half the time.. leaving my 3 year old sister waiting on the steps for daddy to come. His precense was so irratic that I didn't know him when he did show up, and as babies do, screamed when being handed over to this stranger.

By the time I was two or so, my grandparents (with our best interests at heart, I guess) made him the offer that if he discontinued visitation that nobody would chase him for child support. And so, he dissapeared.

After a while my mother remarried the stepfather, and thus commenced a pretty horrible 11 years of abuse. (But that's another story)

I didn't see him again until I was 12, when my older sister sought him out, wanting to know her 'real' father. We saw him a few times, and then he dissapeared overseas for a few years.

Fastfoward a few more years, and my older sister sought him out once again. I guess it had something to do with having her first child. He was back in Australia by this point. The two or three times that I saw him, I was unimpressed with his dishonesty, flakiness and inability to follow through on anything. At this stage I had enough to deal with in my life, and didnt see the need to add more complications.

Ive seen him a couple more times since then, and nothing much has changed. My sister continues to have a semblance of a relationship with him. I guess being older, she had more time to form a bond, before he upped sticks, and it seems more important to her. For me, he is nothing more than someone I share DNA with, he has never made the effort to be in my life in any meaningful way, and yes, I guess I do resent, that he 'failed' to be around and protect me from the stuff that I went through in my childhood, even though, to be fair, he didn't know. But then, he never really made much effort to find out.

Now, my sister tells me he is in hospital. He has had a small stroke. She wants us to visit him. And I'm stuck wondering whether I should. It won't do me any harm (apart from the fact that I could do without the stress at the moment) but really, is it right to look for a bond, with someone who has never been there for me, physically, emotionally or financially? Does DNA matter that much?

Not lining up for the rollercoaster....

After much thought... (an entirely predictable night of ruminating), I have come to the conclusion that the only reason that I went to the GP to get my medications assessed in the first place, is because of the deeply instilled belief society has in medication as a 'fix'. I got off the rollercoaster of medication changes in the first place, because I realised that it wasn't really making much difference, and contributing to my feelings of hopelessness. But, like a conditioned puppy, my pavlovian response to this new bout of bleurgh was to run to the doctor for the magic pill fix. The therapy is my new attempt to find a way to manage all of this... and I have decided to stick to that, and see if the process will help. I don't want to get back on that rollercoaster of medications and hospitalisations unless there is absolutely no other way. So there's my decision. Some might call it ill-informed, or even dangerous given my current state of mind, but it is the decision I feel most comfortable with, so I'm going to go with it for now.

I'll stick with current regime of lexapro, clonazepam and xanax, as my nod to the 'biological base' theories, who knows, maybe they are helping? But I'm going to invest my hope and energy into trying to tame my mind through analysis, understanding and personal responsability.

In the meantime, I'll try to ride out the waves of depression, anxiety and that nasty voice that's screaming suicidal thoughts into my brain....

Stuck between a rock and a mental ward...

GP appointment today re: antidepressants. Thought it would be good to check whether they might need a bit of a tweak. GP let me know that I am already on above the recommended dose on the Lexapro, so if we were going to do anything we would change it completely to a new med. The hitch is of course, that you have to let the Lexapro leave your system before they can introduce a new AD. Which leaves a very vunerable period. And because I'm already pretty much a snivelling mess on the floor, the GP doesn't want to do it unless I'm in hospital.... I told him I'd think about it...

Spoke to therapist (D) briefly on the phone about it, and she too seems to have some reservations about hospitalisation. It really is to be avoided unless absolutely necessary. Can be a demoralising and infantilising experience.... but can also save your life.. Ho Hum.... She's going to consult with a Psych colleague of hers to give us a little more information to make the decision with.. And when I say us... I mean me. Nobody is forcing me into hospital, they are telling me I know what is the right thing for me. Honestly? I don't. I don't want to have to make the decision. I don't want to risk making the wrong choice. Spoke to my mum, and then to an old friend.... trying to get one of them to tell me what I should do... but nope.. apparently, only I know what's right for me.

So, I made a list of pros and cons. Pros- new meds may help stabilise me somewhat, the AD he wants me to change with has more of a sedating effect then current drug, so may help with insomnia, hospital stays also tend to help sleeping patterns (I feel safer sleeping behind a locked door I guess?) , for at least a few days I wouldn't be responsible for keeping myself safe.. which would be a nice refuge. Cons- new meds might mean new and exciting side effect of the days, I am likely to feel really cruddy for a period (even more so than now), hospital stay (nuff said...bleaurgh) and finally hospitalisation would more than likely result in case management, ehich in my mind would 'officially' make me mentally unwell again................. sigh.

The damndest thing is it is a friday night.... so wont be able to anything until Monday at the earliest, probably more likely Tuesday when my next appointment with therapist is, which means three whole days of ruminating and stressing over this. And you know what, I already feel like shite... shite night last night with off the wall anxiety and suicidal ideation, exhausting day today, socialising with friends at lunch and trying to appear like am not about to completely lose the plot (Don't get me wrong, love my friends, but given the way I was feeling today, probably would have cancelled on them, if not for the fact that it was a make-up lunch for the one I cancelled on Wednesday because I felt too shite to come)

Sigh.

I hate making decisions and I hate being told that only I know whats best for me.. :(

Fairy Claps for me....

Do you remember in primary school, when you did something really well the teacher would tell you to 'give yourself a pat on the back' or even better, you would give yourself a round of applause with fairy claps (two fingers clapping.... to keep the noise down I guess?) Well, I have found myself, metaphorically giving myself a pat on the back a few times in the last few days. Yay... you managed to eat some food! Yay... you managed to call a friend today! Yay... you managed to have a shower!

Other people have also been giving me praise for above said nutrition, social contact and personal hygeine. BUT, of course the little voice in my brain is scoffing. How utterly pathetic that my biggest current achievement is to feed and bathe myself sporadically. I've looked after two year olds who can manage that!

In my therapy session today, I found myself in equal parts frustrated and validated by D (therapist). Because she was one of the ones complimenting me for above AMAZING feats. And whilst it made me happy that she understood how absolutely exhaustingly mind-blowingly hard it was for me to do above feats, I felt pathetic at her low expectations of me. Part of me just wanted her to take me by the shoulders, shake me and yell 'pull yourself together'. That's what I felt I deserved.

Sigh.

We spoke briefly about my outstanding talent in the department of beating myself up. And I admit I had a little chuckle to myself....well....because at least I can do something well, huh?

In other news... spoke to my Grandmother tonight on the phone, and she well and truly clicked into the vibe that ALL IS NOT WELL with her granddaughter. Its a tricky line to balance. After my OD a few years ago, both she and mum were very specific in their desire that I should let them know what's going on with me in the future, rather than keeping it to myself and imploding so spectacularly. And I do, try to be as honest as I can, but on the other hand there isn't much point worrying them, when they live 3 hours away, and there isnt much they can do. But, sly minx that the old dear is, she figured it out for herself, so I gave her a semi-sanitised version of whats going on. Yes, I'm a bit depressed. No, I'm not sleeping or eating well. But I am seeing my therapist regularly, using all the techniques I'm supposed to and trying to use the support network and crisis plan I have in place.... nothing to worry about. She doesn't need to know about the intense suicidality, or the fact that it is more than a bit of depression...what good would that do? But, ultimately, I guess I'm glad we talked about it now, because I'm headed up there for my Grandfather's birthday in a fortnight and I have lost a lot of weight... which is going to raise eyebrows... so better to get it semi-out in the open. Am nowhere near as bad as pre-OD when my weight plummeted down to 38kg, but hovering just under 50kg, I'm not looking the healthiest... so I need to fatten up some....out comes the sustagen!

Other than that, am planning on catching up with friends for lunch tomorrow (fairy claps for me) unless I pike out again which I have been doing a lot lately. And I have an appointment to see Dr S (GP) to see whether we need to reassess the medication situation. So will see how that pans out... not keen to go on the rollercoaster rides of medication adjustments again....

The Anti-Pollyanna

Did you ever read the book 'Pollyanna' as a kid or see the movie? It was about this precocious, (read: obnoxious) 'lovable', little orphan girl, who inspite of all the woes in her life manages to find the silver lining in every situation. She calls it the 'glad game'. A friend and I were talking today, and we have given me the new moniker of the 'Anti-Pollyanna'. Because I have a remarkable talent, particularly in my current frame of mind, of finding the dark lining in every situation. Yes, I know... I should be using those trusty old CBT techniques to challenge these cognitive distortions....blah...blah...blah... but at the moment, I'm just too bloody tired.

The conversation came about when I called to let this friend know the outcome of my JCA with Centrelink today. It went as well as can be expected, frankly I was a bit of a zombie... just not really with it. But the assessor was a pyschologist, and quite lovely. After chatting with me and reviewing all the Treating Doctor Reports... (mine was a two prong claim, basically the PTSD which leads to really ridiculous insomnia impacting on the Epilepsy which is not all that well controlled to begin with) she said that she would be recommending I stay on the Disability Support Pension (no activity requirement, no quarterly reviews and more money) , rather than being shafted over to the Sickness Allowance (push towards employment, more reporting, more paperwork and less money).

SO that was a relief, because being the catastrophising numpty that I am, I have been stressing my little heart out about it all weekend. So, good news right? Nope.... can never be that easy with me... my brain starts whirring around the idea that, with the new regulations it is damn near impossible to get the DSP, I mean.. they're denying it to people with cancer... so how depressing is it, that under the new stringent guidelines, I am still considered f*cked up enough to need it? Cue violins, as I start feeling incredibly sorry for myself, oh woe is me.. I have all these health problems, yada yada. And then of course next comes the guilt.... I don't deserve this, its a waste of money on me, I am just a dud, and everyone should just accept this and let me go into oblivian...... Stupid huh? But that particular record has been playing non-stop pretty much since the appointment.

Of course, I was in fine form for my therapy appointment this afternoon. Zoning in and out. At one point, D (the therapist) asked where I had gone in my head, what I was thinking.... and I had to admit that I'd spent the last five minutes staring at the painting on her wall, wondering why I'd never noticed that it looked like someone had painted a giant q-tip in the middle of the field.... But tried to reign the brain in, and refocus, and we talked about some useful things re: crisis plan, and emailing. I told her I thought things were starting to seem a little bit more in control and I was starting to take some responsibility for myself. She questioned my use of the words 'control' and 'responsibility'. She implied that she thought it sounded very negative and that I was viewing my 'emotional meltdown' over the last few weeks as a failure.... well, duh! Girl can't motivate herself enough to eat, shower or sleep....pretty epic fail! Well... really boring stuff, I guess... but then, my life is pretty boxed in at the moment.

Here's hoping tomorrow is a better day...

I just noticed a mountain goat in the tip I call my loungeroom

Perhaps a sign of the tide starting to turn? I have just looked around and realised what a complete and utter doss house I am currently living in. Usually, I am slightly OCD about keeping the house in order... I guess it makes me feel like I have some sembelance of control in my life. But in the midst of my current 'spin-out', the house and all that it entails has fallen to the wayside. And in my complete and utter apathy regarding everything at the moment, I haven't even really noticed the mess, the dishes piling up (heck, I'm not eating...what do I care?), the washing piling up (I'm wearing my pajamas for the forseeable future...what do I care?) or the fact that I have simply been shifting the detrius to the other side of the bed so I can get into it (I'm only sleeping an hour or two a night...once again...what do I care?) And of course, woe and betide that my housemates would notice and do something about any of the above. I guess they just feel we're embracing a new lifestyle..lol. As, I say, up until today it just hasn't even registered through the fog I've been walking in. But today I took a good, hard, look around and I noticed it... and it even bothered me a bit. I haven't yet got the energy to do anything about it... but the fact that I noticed it has to be a good sign......right?

When it rains it pours... a rant..

This is primarily just a frustrated rant. Centrelink has suspended my Disability Allowance, until I have completed a Job Capacity Assessment. Apparently they had been trying to contact me for a week before they suspended my payment, but I don't answer calls from blocked numbers, and they don't leave voice messages, for privacy reasons, so I ended up getting a letter suspending my payment. This in itself, whilst frustrating is fine. I understand why it needs to be done. What really gets me is I was approved for the payment 3 months ago, after I had to resign from my job because of instability with my seizure control. By this point I was quite often on unpaid sick leave, because I had used up my sick leave, or I was going into work, and having seizures (that's embarrassing, try walking back into a work place where your colleagues have seen you convulse and lose bladder control!) because I couldn't afford to miss work. The paperwork was filled out, Treating Doctors Reports submitted, I enrolled in University part-time externally, so the time not working was still productive, and have spent the time trying to get my health back to a point where I can return to full-time work.

But then, the depression hit me again. After quite a lengthy 'remission' if you will, its back in full force, and all of my energy is focused on trying to keep that under control (hence the re-introduction of therapy) and trying to get the seizures under control (now increasing dramatically because of the insomnia...what a vicious circle!) and trying to maintain the work needed for my Uni stuff. And just when I'm at a point where I'm barely keeping myself together... now, they want me to come in for a JCA. Not three months ago, when I would have been able to handle it....but now, when even the concept of leaving the house other than for therapy seems insurmountable, they want me to walk into an office and talk to somebody I don't know, about my problems, and try and keep my muddled brain together long enough, to make sense and get what needs to be done, done. It's such a little thing in reality, but my brain is catastrophising it, to the point where it just seems impossible. Added to the stress of the payment being 'suspended' until I have jumped through the hoops, so having to rely on my meagre savings to do what needs to be done.

I understand why it needs to be done, that there are checks and balances in place for a reason. And I am grateful to live in a country where I can get this financial support until I can pull my physical and emotional health back together... but there is another part of me whingeing......"Why now??????????????". Well, all I can do is wait and see what happens on Tuesday, I guess.

The end of rant. :P

Lying on the couch

I'd like think of myself as a pretty honest person. Except, when I get down to the bare bones of it, I'm often not. I don't engage in acts of malicious deceitfulness. But...... I will tell my friend that she looks great in that new pair of pants (even if she looks like a trussed up ham). I will tell my facebook friends that their latest addition to the family is 'absolutely adorable' (even when in reality the child has inherited his dads monobrow and resembles somewhat, a frog thats just been given an electric shock). I consider these social lies, and though they trouble me from time to time, its in my nature to try and avoid hurting the feelings of those I care about.

And then, there are the lies of omission. Like the fact that I am spiralling down into a pretty dark place at the moment, but I try to greet my friends and family with a smile and a 'I'm doing fine'. They say they want me to be honest if I'm struggling, but what they really want is for me to tell them I'm ok. (A post on that later).

Finally, the lies I'm struggling with at the moment. The lies on the couch. I'm finding that I am not being incredibly truthful at times with my therapist. Some are lies of omission, some are partial truths and some are out and out lies. And I'm not comfortable with it. The deception makes me feel horrible and guilty. So I've been trying to figure out why I do it. A couple of reasons might be...

1. Two months in, and I am still trying to build the trust. And its so hard, I guess because I feel like there is something inherently distrustfu about a relationship where I will never truly know the other persons true feelings or opinions 100%. Unconditional Positive Regard can be quite an ego boost... but it is also kind of creepy.

2. Time limits. This is where quite often the lies of omission are coming in. At the moment I am in therapy twice a week for 50 minutes. And I seem to have a heck of a lot of stuff I need to cover to hold me over to the next session. Quite a change from the beginning, when I spoke about 3 words a session. And so, I think, if I tell her about this particular incident or feeling, we'll be stuck talking about that for ages, and we won't have time to address this issue or feeling which I think is more important at the moment. But then after I feel guilty, and worry if the first issue becomes a bigger issue is she going to ask me 'Why didn't you tell me about that before?"

3. Quite simply... I don't want her to think I'm really crazy....or weird ie. (D) What do you do to soothe yourself when you wake up from a nightmare? (Me) *thinks, well first thing I do is grab my childhood doll, but I'm 26 years old, and I'm not telling you that!*

4. I don't want her to feel bad. Or like she is helping... so even if I'm feeling worse, I don't like to say.

5. Confronting questions. She asks about things I normally would never have to talk about to other people. About secrets that my heart is just not ready to let go of. But I fear if I tell her that I don't want to answer the question, she will either pursue it harder or will be angry at my resistance.

6. Confusion. My head gets so crazy and messed up and emotional, that sometimes I don't answer right, and then I'm afraid to go back and correct myself, because she might see me as inconsistent or dishonest...

7. Fear. If answer her questions about suicidal ideation, will she want to hospitalise me?

Well, those are just a few thoughts on why... but I guess, at some point or another I am going to have to find it in me to be completely honest or I will sabotage the whole process right?

Is it necessary to be 100% honest in therapy?

On the road to sanity?

So, I have just re-entered therapy, after a few years break. The CBT intensive therapy I underwent for FOUR YEARS (!), has helped me to almost fool myself into believing I'm ok. But, I'm sick of having to constantly manage my anxieties and symptoms just to survive. I'm exhausted, and I guess I feel like the CBT (for me) was nothing more than a bandaid solution. It stopped me bleeding out, which was I guess their first priority a few years ago when I completely dropped my basket, but I'm still hurting, still damaged, still not quite alive...

Enter D, my new therapist. Psychotherapy.... what a weird relationship! Previously, I have had psychiatrist and a case manager for about two years after they let me out of hospital, but I have never had a psychologist before. All sorts of anxieties arising... what does she mean when she says its ok that I feel depressed? That I am having suicidal ideation? What's with the positive spin she puts on every character flaw I present to her? When is she going to start talking about choices and taking responsibility for my thoughts? What does the word 'mindful' even mean anyway? What are the rules? What does she mean that we should 'sit with this?'. My mind boggles at this different approach to mental healthcare.

BUT, its about two months into therapy now, and after a lot of vascillating between this woman is a nutter and this woman might actually be able to help me... I have finally committed in my mind to the whole process. Sure, the whole thing is making me as crazy as a box of hair at the moment... but here is somebody who listens to me, who validates me and who doesn't turn away from the darker parts of me... finally I might not be totally alone in picking up the pieces of my past... and its a comforting thought.

That being said, even the short amount of time I have been seeing her, my emotions have been on the most crazy rollercoaster ride you can imagine. So I thought I'd write this blog, to help me keep it in perspective... and maybe...if anybody is interested in my mundane ramblings... get some advice from others.