The mighty mighty benzo

Aside from the diagnosis issues to discuss with PsychDoc on Tuesday, we are also looking to start withdrawing me from the Serepax. A little scary, but I'm really keen to try. Ultimately, research has proven that Benzodiazepams are really not the best drugs to be on long term... and I have been on one or another benzo for the past 10 years. My first script was Temazepam, which did sweet f.a., to be honest. That was followed by a brief affair with Valium, but we parted ways after just two doses as it made me feel incredibly disconnected from myself and the world and nauseous and dizzy to boot. Xanax was my buddy for a good number of years, but that was cut short by the Psych after my admission to hospital last year, when they changed me over to Serepax, as it was longer acting. I only ever took the Xanax to stem off major panic attacks, so pretty much left to my own devices, I would often go weeks without taking any, and when I did, it would just be one or two. When they changed me to Serepax to help with anxiety and insomnia I was prescribed 3 doses a day.... so in the end, even though the Public Health System doesn't like Xanax, as being shorter acting, its more likely to be abused, I have actually ended up taking more benzos under their guidance than when left to my own discretion... oh well. In addition to this, I take Clonazepam twice a day in conjunction with my anti-epileptic meds. So yeah, me and benzos? Old Pals!

I can't stop taking the Clonazepam as it helps significantly with my seizure threshold. But I never intended to be on the Serepax for this long, particularly taking it three times a day. And I've been bringing up the idea of ceasing it for about 6 months now, but there always seemed to be some crisis or upcoming event that made it advisable to hold off on cessation. But things have evened out a lot more over the last two months or so, so it is time to try.

Dr F is quite supportive of this, and is open to discussing the ways in which we can best taper it down. There are a few inherent issues. Usually they switch out the serepax with valium, and then taper off the valium, but as mentioned, Valium is no friend of mine, so I've chosen to taper down with out any crossovers. We also have to be careful, as withdrawing off Benzos can lower the seizure threshold for a while, but I have some room to play with my Epilim Dosage, which should hopefully counteract this.

I'm on the lowest dose for each of the three doses... 7.5mg, which is half a tablet each time... so it doesn't leave much room to half the dosage. So, we figured that I will just start skipping the lunchtime dose to begin with. I've had a bit of a trial run last fortnight, and whilst I definately felt more agitated and anxious in the afternoon, it was certainly manageable. Because I'm on weekly meds, Dr F wants to make sure I have enough tablets each week so that I can take the lunchtime tablet if I need to. But she's also quite rightly concerned about me hoarding them. Frankly it would be a temptation... not because I'm suicidal right now, but because Ive been on weekly meds and thus without the safety blanket of stored meds for so long now. When she expressed her concern, I admitted I wasn't quite sure if I trusted myself. So, I'm going to propose she writes ONE script with the extra dose (adding up to 3 and a half extra tablets, nothing I can do with that), and I will give the extras to my sister to mind, unless I need them. And after that she writes the script for just two dose, unless we discuss otherwise. I know part of recovery is being responsible for my own well being, but part of being responsible, I believ, is knowing the areas you can't yet be trusted and asking for help.

So, she has talked to me about how important it is to withdraw slowly... but frankly I didn't think it was going to be too huge a deal. I mean I did ok for those couple of days last fortnight, and although I've been on this particular Benzo for nearly a year, its a reasonably low dose, and I still have the Clonazepam and my anti depressant in my system. But then I made the mistake of looking up Benzo Withdrawal....oh, internet, sometimes you are a Pandoras Box!... Some of the side effects of withdrawal allegedly include:

abdominal pains, aching, agoraphobia, anxiety, blurred vision, body vibrations, changes in perception, diarrhea, distended abdomen, feeling of unreality, flu-like symptoms, flatulence, food cravings, hair loss, heart palpitations, heavy limbs, increased allergies, increased sense of smell, insomnia, lethargy, loss of balance, metallic taste, muscle spasms, nightmares, panic attacks, paranoia, persistent & unpleasant memories, severe headaches, shaking, short term memory loss, sore mouth and tongue, sound & light sensitivity, speech difficulties, sweating, suicidal thoughts, tinnitus, unusually sensitive, fear

This was one of the shorter lists. On some sites, there are those who seem to hold it responsible for everything from cavaties to the hole in the ozone layer... I don't know, its hard to find accurate information. I mean flatulence? Seriously? I think even when the side effects are written up on legitimate sited, the information is still derived from patient reporting, and there is a population of patients who just make the weirdest connections in their minds between vague somatic complaints and medications. Its hard to know which ones are valid. And then of course there is the fact its all planted in my mind.... you start thinking maybe my ears are ringing just a little, oooh and my mouth is dry, definately dry and that light is getting a bit bright for my eyes. Short story, I would have been better off not looking it up. And I know this from past experience... so why do I continue to do it? Sigh. We will just wait and see what the next week brings...

And in the meantime... if I do cut the cheese... I can just blame it on my benzo withdrawl, instead of the long suffering, unfairly maligned cat :P

Itty Bitty Tanties

Ok, so maybe I threw a little, eensy, weensy, tiny tantrum in therapy today. Highlights included telling her to back off, stop patronising me, screwing up my fists and lasping into a sulky, scowling silence for the last 15 minutes or so of the session. And yes, it probably is still a good thing therapeutically, working through transference issues and having the chance to experience and express (however clumsily) anger in the safe containment of the therapy room. But ultimately I'm left feeling like quite a prat, and am feeling quite embarrassed at the prospect of going back. And I maintain, for today at least, THERAPY SUCKS BALLS.

Had my PsychDoc appointment, and it went pretty well. We're going to put off the benzo withdrawal for a fortnight or so. With the current little slump I'm experiencing, its just better to wait until things stabilise a little. But then hopefully, we'll start a slow withdrawal process, and sometime (in the hopefully near future) I will be completely off the Serepax.

Other than that I'm just trying to focus on keeping a positive attitude. Its just a little slump and it will pass. It doesn't mean that things are spinning out of control. I will sleep again. And I will feel happy again. This too will pass.

Spoke to Case Manager (M) and she said to give her a call if things continue to be a bit down, otherwise I will see her next week. I guess a part of me just doesn't want to admit to them how low I am feeling, because I want to be able to handle it myself, there isn't really any particular problem that they can help address, and probably a little bit of pride as well.... I was doing so well, I hate that I wasn't able to keep it up.

Anyway, Lil Sis and I got some boxed sets...so we'll be watching Outrageous Fortunes, True Blood, and the first season of Glee for the forseeable future.

Peace and love
xOphelia

Musings on dependency

I have spent a lot of the last 12 months in therapy terrified of becoming overly dependant on (D)'s support and the therapeutic process. The psychodynamic therapy we are undertaking is somehow a lot more confrontational in this aspect than my previous therapy ever was. Whether this is indicative of a different type of therapeutic alliance or the difference in therapeutic orientation, I'm not sure. Perhaps a little form column a and a little from column b?

Trust and attachment are intrinsically intwined with dependency in my mind. If I allow myself to be open enough with a person, to share parts of myself and allow myself to accept and derive comfort from the relationship between us, if I allow myself to believe, that maybe, just maybe... I can trust that this person is going to stick around and not turn from the 'darker' aspects of me and my life... if I can believe that any of this is possible, than certainly I would want it, need it even and I wouldn't want to let it go. Always that belief that I would overwhelm people with my needs if ever I was to allow them to show.

Dependency, of course has developed a bit of a bad rap. Even amongst some of the MH professionals who really should be able to look at the issue a little less simplistically. Dependency is for infants and children, as adults we should apparently be able to look out for ourselves. At least this is the message we are given. In the public health system, "service users" may find themselves fighting and (sometimes losing) to access the services that they feel they need. The MH system creates an atmosphere of fear, fear of dependency on hospitalisation, fear of too much dependency on individual professionals, fear of dependency on medication, fear of dependency on benefits... the list goes on and on. And some of them are valid fears in certain situations. But the blanket, knee jerk reaction to these, and the suggestion that any form of dependency is regressive and not mentally healthy is unhelpful.

Yes, for some people and it some situation hospital can foster an unhealthy dependence on an 'unreal' world.  I think that's a possibility for anyone who is hospitalised. The world outside can feel scary and unsafe and full of decisions, that to suspend those responsabilities and know that you are at least physically safe for a while is certainly tempting. And it can be hard to know when you are actually 'able' to handle these things in the real world on your own. And of course, we have all heard the blanket dictate that anyone with a personality disorder will not benefit from hospitalisations (never mind if they have co-morbid depressions, suicidal ideations, psychosis etc) It's such a simplistic approach.Each situation should be looked at individually, rather than unbendable policies being enforced because of the bad rap of dependency. I myself have never had any issue really with accessing hospital care, but I read all the time about blogger friends who do, because of their labels, and it just seems so stupid to me.

Whilst I have not had much trouble accessing hospital care, my fears around dependency spring up in other areas. Dependency on medication. Now this is a funny one. Because whilst the MH professionals seem to make such a huge deal (rightly so) about the addictiveness of the benzos, it doesn't prevent them from dosing me up with them, and everytime that I have started to try and reduce my dosages, it has been at my suggestion rather than theirs. So on the one hand they help to create this fear of dependency, but on the other hand they continue to hand me medication, at times (not so much lately) it feels like hand over fist.

Within Case Management in the Public Mental Health system, I did undergo a little bit of stress at the end of last year in regards to being discharged from the service. The accepted thinking of the service is that they want to a) develop the individual's ability to soothe, contain and problem solve themselves and b) create a system of support that is community based rather than based on the mental health system. Fantastic in theory. But what I have found is that even while focusing on my ability to soothe, contain and problem solve myself, there are times when I am able to do this and times when it is a bit harder. In relation to developing community support, its great in theory, but the reality is that the average 'everyday' person is just not equipped with the skills, experience or ability to distance themselves as MH professionals are. So, some dependency on the service is necessary, and unless my MH issues disappear, potentially this dependency will exist for quite a while. But it waxes and wanes. I don't feel the need to pick up the phone and ring my case manager for every little issue (or even some of the big issues), we have cut contact back to once a fortnight, unless something comes up and that will probably reduce even further as things continue to go well. So, I think I am dependent on their being their as a safety net, but I don't feel its an unhealthy dependency.

Then we get to therapy, ah....therapy. The dependency that can be fostered in therapy is probably the scariest, because (D) has so much information I have trusted her with, so much insight into my thought processes and feelings, that she really has the potential to hurt me big time. She is a person who consistantly supports, holds (emotionally) and cares about me. Encourages me and helps me to learn. Sound familiar? Yup, as much as I hate to admit it, she has taken on a somewhat motherly role in my life.  And what happened with the last mother in my life? Let's see... I was a dependent infant, and she was emotionally and physically absent due to her PND. She entered into a realationship with a violent alcoholic and allowed him to physically and emotionally hurt her babies, once again failing those who were dependent on her for protection She then (as a way of coping) withdrew entirely from those dependents abandoning them into an environment where secrets and darker, traumatic abuses could take place. So.... yeah.... feeling dependent + a person who acts in a motherly fashion = big fears of reenactments of past traumas and let downs for me. I do a dance with (D) of throwing up my cast iron shell, and letting in tumble and letting her in. Is the dependency I'm experiencing with her a bad thing? From a psychotherapeutic aspect of course all the transference issues that are brought up allow for great opportunities to explore, reexperience positively and grow. But she is not my mother, and I am no child. What kind of dependence is reasonable and sustainable? I guess this is where the boundaries come in. And (D) is pretty good at making those clear and keeping to them I guess. Sessions are consistently within the same frame. Time, structure, she's never late, always dependable. Contact outside of session is thoughtful and purposeful, whilst still flexible enough around times of crisis. The other big hurdle was me. Accepting that I need this woman, that I rely on her and thats ok. But I still keep my eyes open, still put all information and suggestions through my own validity tests and don't rely on her for *all* of my emotional needs, because a) she is only human and b) as important a part of my life as she is at the moment, by very defination she will not/should not be around for ever, and will never be a solid presence in my real day to day life. And that ,I am beginning to realise, is a healthy dependency

Not such a great day

Yesterday was hard. And I guess a little bit of a shock to the system after a period of relative good moods. We so quickly become accustomed to it: the good moods, the lack of agitation, the good sleep, that when things take a bit of a slide, even if it is nowhere as bad as it has been before, you kind of feel it even worse because of the contrast. But I am trying very hard not to let it turn into a snowball effect.

I was up early for the ultrasound appointment, making sure I had enough water to drink and taking the higher dose of anti-anxiety meds to get through it. Having (S) come along proved to be a good thing, not just as a safety thing with the increased meds, but also just as a bit of distraction. She did offer to come into the consulting room with me, but I refused... taking our friendship just that step to far into the intimate, methinks. But it was nice of her to offer. I was pretty lucky with the tech that I got. I explained without going into much detail that this was a difficult test for me to have due to past trauma, and she was very good about explaining things step by step, taking it very slow and offering to stop if it got too much. She also tried to engage me by talking throughout the test, although this was not very effective as I found (as a coping mechanism, I think) that I was drifting in and out of the moment. Not full blown dissasociation, but certainly it was there to some degree. Probably exacerbated by the medication. It did trigger a lot of flashback type episodes which continued on after the appointment.

I got home and headed straight off to bed for a little bit, but found that I was pretty damned agitated and resting was pretty impossible. I felt quite disconnected, emotional and fuzzy. (Medication? Flashbacks? Probably a combination of both) I wasn't sure how I was going to handle catching public transport to get to my therapy session. After the brouh-ha a few months ago about missing sessions, I find it pretty hard to justify missing sessions, I never know if its a good enough reason. In the end I called (D) my therapist and she pushed the appointment back a little for me, (S) came to the rescue once again and drove me across town for the appointment. In my eyes it wasn't a very productive session. I spent the majority of it wrapped up in a blanket, and to be honest I don't really remember that much about what we talked about.

It's time to be proactive. The girls stayed last night which was a good way to get me back into the present and stay there. We had a girly night chatting and laughing and then woke up for bacon and eggs this morning. (M) my case manager and I had a phone meeting, which went pretty well. She's pretty pleased with my progress in general, as am I. She is going to make a referral to the employment officer in the service. We also touched briefly on creating a proactive plan for how I am going to deal with "D-Day anniversary" in September. I'm going to have a think about it ( but not dwell!!) Whether I want to just try making it through with a little extra support (phonecalls etc) or whether we should do a planned admission. A lot of it will come down to how I do in general over the next 6 weeks or so. If things remain as stable as they are, perhaps this year the anniversary wont be as much of a struggle.

(D) is going to do a check in call this afternoon, as I wasn't doing so great yesterday. (S) and I are going to catch a movie tomorrow and then I have a shift at RMH on sunday. I'm determined not to let htis hiccup ruin my good streak.

Peace and Love
Ophelia

Why I'll never use a face mask again!

Therapy has been interesting. (D) and I were talking about how I have been able to contain the unpleasant stuff that's being brought up in therapy to the therapy room. Part of the problem with therapy in the recent past is that when things were brought up in session I have carried them into my outside life, ruminating and growing more depressed and anxious because I become overwhelmed with it all. I had thought that this new ability to contain it could only be a good thing, as it allows me to work on what I need to work on in a safe place, but not carry it with me to a place where I don't have that safety and support. (D) however, queried whether I might be repressing or avoiding the issues outside of therapy. For some reason this caused me to become extremely agitated. I think maybe because I felt a) like "shit, I thought I was doing good... obviously I can't do anything right" and b) annoyed because why does she have to go and mess with a good thing? (D) expanded saying that she just wanted me to be aware that whether I was doing well or not so well, she would not turn away from the parts of me that remembered the distress and hurts, and she didn't want me to either. I'm not really explaining this very well, and to be honest, I found it all a bit confusing myself. The conclusion we came to in the end, is that for the moment I need her to hold that distress for me within the therapeutic frame, because I cannot hold it by myself outside of session and still retain any semblance of balance. So maybe its a little avoidance/repression, but it's working for now. The analogy that comes to my head is that its kind of like keeping a child safe. When they are very young to keep them safe you have to attend to them all the time, leaving you no time to do anything else. Which is why parents will employ safety pens. Still interacting and keeping them safe, but with the ability to turn away and attend to other things, and know that it will still be safe for them. Therapy is the safety pen, and that distressed part of me is not yet able to be left unattended. As I mature emotionally, like the child, the distressed part of me will be able to venture out of the pen and spend less and less time needing to be constantly attended to and monitored. Anyway. Interesting session. Then in todays session we broached the subject of my "being unseen" as a child. Particularly within the mother-daughter relationship. And the way that affects me today. In particular, my automatic assumption that I am doing something wrong. (see above) Basically, she posits that as a result of my mothers post natal depression, my father's abandonment of me as an infant, and my sister's complete ambivalence about my existance (she tried to get rid of me by hiding me behind a wood pile as a baby) that I have come into this world feeling "unseen" and trying to remedy it by being the 'perfect child' and when this failed to make me visible to my family assuming that I was doing something wrong to be unworthy of acknowledgement. The whole idea that family dynamics of my infancy could really have any impact on me today seems a little odd to me still, but as (D) pointed out the dynamics have become set and remain to this day. My sister would certainly try and hide me behind the wood pile today if she could get away with it and she's 29 years old! Lol. And, whilst I think my mother really did 'see' me for the first time when I was in the ICU post overdose (not a great way to be seen and not something I wish to repeat!), I think as time has passed, we've slipped back into those old comfortable dynamics, where I am invisible once again. Anyway, we left it there and will pick it up again on Thursday. Gosh! Therapy makes my brain hurt sometimes, but I feel like we've finally scraped passed the first few superficial layers, not to the core yet, but its progress.

I got a call today from the mother of the kids I've been babysitting, to let me know they've come up with chicken pox. Sigh. First, this means I'm out two days work, because I was supposed to look after them until the end of this week. Second, I have never had chicken pox, so gulp! I've been exposed to it a few times through my work with kids though, so I doubt I'll catch it this time, if I haven't caught it so far. But it has reminded me that I do need to go and get the vaccine. If I catch it, it could take up to 21 days to show up. So, I promptly texted (D) to ask if she had had it (weird conversation to have with your therapist) but sitting in close proximity to her 3 days a week, and not knowing about her life (if she has regular contact with infants, pregnant women or people with suppressed immune system) I figured it was best to ask. I'm pretty sure I won't get it, but I'm going to be a little careful about where I go for the next few weeks, as the most contagious period is apparently before you get the rash.

That being said, I do have a Neurologist appointment and an Ultrasound appointment this week that I can't miss. Neuro is tomorrow. I'm not expecting much out of it. Seizure control not the greatest over the last two months, but this is pretty much directly proportional to fatigue so not suprising. That being said, since I got back from prac seizure control is pretty good, so obviously the medication works, just not in the face of crazy insomnia. Anyway will get the results from the sleep deprived EEG. And PsychDoc wants me to check with Neuro about the possible ramifications of reducing my Serepax (anxiety  med) on seizure threshhold. I still have that niggle in the back of my mind after all these years that possibly some of my seizures are pseudoseizures. I have been definitively told by specialist that at least some of my seizures are genuine epileptic seizures. There are certain things I won't go into that help them make that diagnosis. But, as my seizures are at times still medication resistant and as I already know well, I'm a bit of a nutter, I wonder whether some of them may be psychosomatic or stress induced. I can never get a straight answer from Neuro Doc, maybe because they have no real way of telling other than 'catching' a non epileptic seizure whilst EEG monitoring. I don't know why it bothers me, other than the fact that if the breakthrough seizures were pseudoseizures...well then there is a chance I could get rid of them, as medication doesn't seem to be the answer. I don't know, grasping at straws I guess. I try not to let it get me down, but the seizures are disruptive, exhausting and really make me feel out of control, which is not a feeling I deal with well.

I've recruited (S) to drive to me to my ultrasound on Thursday, as I'm planning on taking a lot of medication to get get me through it without a freakout. So probably not a great idea to be on public transport. God, I am cringing just thinking about it. I do have a good friend there though, willing to get up early on her holidays to drive me across town to the hospital for this extremely embarrassing and anxiety provokign test. Thursday night our other friend (SC) is coming into town and the three of us are going to watch the season finale of Glee and have a sleep over (yes, I am 27 and not 14....but meh!) This means the girls will be here when my Case Manager comes around on friday morning (if she still comes, have to check her chicken pox status first) but they can hang out else where in the house for a bit.

All in all still in a reasonable mood. Sleep not perfect but still far better than normal. Biggest disruption at them moment is (you can laugh at me, its pathetic) I did a face mask last friday and had an allergic reaction, which I've never had before. I got it off pretty fast, but I have this welt on my left cheek bone, requiring ample amounts of make up each day, and the top layer of my skin has kind of burnt off on my forehead, cheek bones, under my eyes etc. So, have been using lots of moisturisor and taking make up off as soon as I get home.... but its getting to that itchy stage of healing and driving me nuts at night! Sigh, the stupid things us girls do in the name of beauty! Luckily its not all that noticible under make up....embarrassing much?

Anyway... off to slather on moisturiser and attempt to get some sleep.

Peace and Love
Ophelia.

Bleurghy has mostly gone

Appointment with BabyPsychDoc went as I had hoped yesterday. They have taken me off Effexor and put me on to Celexa. Still a wee bit nauseaus and dizzy, but nowhere near the horrible vertigo I have experienced for the previous week. I'm to call her tomorrow to let her know how the Cymbalta is going as it is an SNRI  (?) too. Missed therapy yesterday morning as I just would not have been able to navigate my way across town. Was going to take bus to Mental Health Clinic in the afternoon (literally like 500m from my house, but up a big hill, and the bus stops right outside my door and practically outside their's.) but Case Manager (M) called me, and when she heard how I was doing offered to come and pick me up for the appointment, which was great. The reason for her call, not so great. I have known for a fortnight now, that she is going on two month's leave, and she rang to arrange a time at my house tomorrow so I can meet her replacement (A). I am assured by everyone that (A) is lovely. She is an OT not a psychologist, but I am not sure how much difference that makes from a case management point of view. But I am often not good at opening up with new people, and trust is a huge issue for me, so the change will be....somewhat unsettling. Added to this my therapist (D) is away next week too, and BabyPsychDoc (Dr F) is on nights, I am left feeling somewhat bereft of my normal supports for those little crisis moments. But chin up, (K) is still around, and (D) will be contactable by phone.....and (A) well, I'll withhold judgement till I meet her. In other good news, my Group sessions on Wednesday's is going really well, and I am starting to feel a real cohesiveness with the group. Me, catergorically, not being a "Group" person. But there is a real sense of acceptance for who you are, and whatever state you may be in at that time. It is a shame it is so short in duration really.

Day Two on Effexor

Day two of my second attempt at Effexor. Still getting pretty bad vertigo, mild nausea. But will just follow BabyPsychDoc's advice and push through until our appointment on Tuesday, to see whether it abates. Sometimes drugs just have some yucky side effects while your body adjusts, I guess. Unfortunately, vertigo is competing with my still slightly manic-y mood, and with dental pain mostly abated, I set about cleaning the house, if somewhat staggeredly (yup, I making up words, just like Shakespeare). So the house is in perfect order, which is always nice to come back to after you go away for a few days. I also cleaned lil sis's room, just tidied stuff away, vacuumed, made her bed and did her laundry. Obviously, I stayed out of her drawers etc because I wouldn't like someone invading my space like that... I hope she doesn't mind, and is just happy to have a tidy room to come home to too. I just can't help myself at the moment. Everything has to be done. And it has to be done NOW,

Anyways, leaving early in the morning for hometown, not sure how much internet access I will have over the next few days. Mum (who is a registered nurse) wants to take me up to the hospital she works at to get my blood pressure checked. Just to see if that is what really is causing the vertigo...you know mums! But should be able to get in and out pretty quick, small country hospital, very slow and of course a dash of nepotism chucked in. Not sure I'll be up to the races though. Probably just spend a bit of time hanging with my gran, she has been pretty down lately. Am also excited to be able to grab some cuttings for my newly established gardens.

As for all the stuff from yesterdays blog, well, have decided to just let it go, and worry about it only if it becomes a more frequent occurance.  Am looking forward to a break away, and have enjoyed the min break from therapy thus far....but also feels quite odd...like I am in therapy withdrawal or something!

Happy Easter to All

Just plain scary

I guess "normal" is a subjective thing in any context, but probably especially to mental health professionals. In the last few months I have definately had some experiences that fall outside the realm of normal for me. Things that make me feel like I may actually be losing my mind. In particular, hallucinations (though these do seem to be linked to periods of extreme deprivation and seem quite benign when one considers what a hallucination could be.... its more shadows in my peripheral visions, strange patterns dancing off the wall and carpets ect) and dissociative states. Up until today, I would have said that I have experienced dissociative states beyond that which an average person would...we all do it, some of us just do it better than others I guess. Particulalrly in periods of real stress, ie after a horrible session, i would have no real memory of how I got home or what I'd been doing...it was like a mist I would slowly emerge from. But if I thought really hard, i could pinpoint the pertinenet details. Maybe not conversations, but yes, I saw that person. Maybe not how long, but I was in the Park for a while stuff like that. Until today. Today I blacked out an entire hour and a half, and I honestly have no recollection of what went on. I have evidence. (A new tooth in my mouth and an appointment for next month) but I went from lying in the dentist chair, beginning to panic, to being at home sitting on my bed, with an aching jaw and no idea how I got there. Just Blank. I even checked my medication to check i hadn't taken something. And frankly it scared the living shite out of me. Because I must have appeared normal-ish to the dentist or they would have kept me there. Or called someone. So "me" can leave my mind for an hour and a half and have some other seperate part of me take over, and no one notices?

I spoke to (K) and finally to (D) and (D) reassured me that everyone dissociates and whilst this was an extreme example it didn't mean I was going nuts. In fact given my fear of dentisits (not the pain, just feeling trapped and having things shoved in my mouth....flashbacks...enough said), given that I was alreasy under a wee bit of stress because the new attempt with efexor was not going to plan (same reaction, vertigo, but we're going to push on and see if it abates) and given that in general it has been a stressful few weeks, and there are a lot of changes coming up... it is quite understandable that it would happen. Rationally, I see her point, just as I did about the hallucinations, just as I do about the 'voices'.

But there is another part of me that thinks voices+hallucinations+losing periods of time is pretty much just leading me toward a nice cosy padded cell. It may be normal, expected or understandable to them, but to me it is just plain scary

Effexor Sucks

I started my first and probably only dose of Effexor this morning. They reduced my Avanza last night, and had me take 37.5 of the Effexor this morning, which was what I was supposed to do for a week. But I could barely get out of bed this morning with vertigo after I took the dose. At first I thought it was a seizure coming on, because vertigo usually is a pretty good warning of that, but by about 1pm, I realised it wasn't a seizure. Little sis has the flu coming on, but I have no other symptoms than the dizziness. So I rang the PMH, and they advised that for the moment I cease the Effexor, and get back on the Avanza at full dose tonight, and they have moved my appointmeent with the PsychDoc forward. Medication FAIL. Oh, well. Feeling pretty cruddy, so i might sign off for a whiles...
peace and love
Ophelia

Marsha Marsha Marsha

So Therapy Thursday was a doozy today. Basically, my private therapist (D) has been informed by Public Mental Health peeps that they think that the psychodynamic therapy is not the right thing for me at the moment, and that I should be doing DBT. I guess the basic concern is the increased suicidality. She couldn't tell me much as the letter she recieved was confidential (WTF? It's about ME!), but she needed to check in with me to ensure that continuing therapy with her was a) what I wanted and b) in my best interests. DBT has been brought up to me before through public mental health, and I have always rejected it. Firstly, I have developed (much to my dismay and disgust at times) a rapport with (D) and would need to stop seeing her, in order to do it. Secondly, my treatment before has been very CBT-ish with hints of the ol DBT mindfulness, and whilst it can be helpful in symptom reduction, it doesn't solve the problem. I don't want to live a managed life. I want a life. With ups and downs like everyone else, yes, but without the intrusiveness of these PTSD gremlins ruling my thoughts. It just takes so much energy. I knew going into psychotherapy that it was going to get a lot worse, before it got better.

I don't know. My head is very muddled. Voices are screaming inside my head. But my gut is telling me, that (D) is that path I need to take.......

(D) reiterated that she would be there and support whatever choice I make, treatment wise. I worry about whether it will be the same with PMH? If I choose not to undertake DBT will that be seen as non-compliance? I guess I'll have to cross that bridge when I come to it.

Mostly there is just this anger that this is not being dealt with directly with me. As I mentioned DBT has been brought up and I declined. But if they feel strongly enough to write a letter to my private therapist, should they not bring the matter up with me again, and emphasise why they feel so strongly about it. Give me more of a voice. I guess its probably professional curtesy.. I don't know.

In an attempt to make a more educated decision I have been reading some more about DBT. I can't put my finger on it, but something about the whole thing just sets my teeth on edge. The whole process is supposed to be about validation.... but I walked away from the reading feeling invalidated and pretty damned patronised.

Experiences anyone? DBT, good, bad or ugly?

P.S. I start changing to Venaflaxine today....we shall see....

On the ward and out of my mind: You are nurses, right?

Back to On the Ward and out of my mind, you may also want to read this, this, this and this.

I was diagnosed with epilepsy quite a few years ago. Juvenile Myoclonic Epilepsy to be specific. As I have, moaned about incessantly alluded to on this blog, this has been a bit hard to manage at times because of my PTSD encouraged insomnia. I tend to have a lot of myoclonic episodes (aka petite mals or weird little jerks that make me look freaky) and less of the tonic-clonic seizures (aka grand mals or randomly dropping to the floor unconciously in a break-dance type fashion) At the moment with sleep being completely f*cked less than ideal, I am averaging about 1 or 2 tonic-clonics a month.

Anyhow... when I was admitted to Ward B, I had a plethora of medical health issues as well as the quite obvious fuck-uppery, what with me trying to kill myself and all. I was still recovering from aspiric (sp?) pneumonia, from being extubated, I had  a little damage to my cerbellum (a fairly important bit of grey matter when it comes to motor skills and some cognitive processes) and some pretty major damage to my vestibular system (fairly important for staying upright and balanced) and finally I had the pre-exisiting condition of epilepsy.

Upon admission to the ward, the nurses freaked the frack out. I wasn't supposed to overhear these conversations, but meh, if you are going to talk right outside more door what do you expect? Basically, they didn't feel equipped to handle my medical needs, didn't have time to do the extra time with me for the rehab exercises I needed to do twice a day, blah blah blah. Ultimately in the end, they didn't do to badly that first admission. They managed to find time for my exercises, the pneumonia resolved with antibiotics, and although I had a number of seizures they would generally just help me to bed, or if in bed change the sheets if necessary, only calling the doctor in on one occasion where the seizure was longer than average.

However on my second admission about three months later, things were not quite so straightforward. It took four days just to get the necessary equipment (shower chair and toilet chair) brought down, which resulted in some very unsafe practices. (I was using a zimmer frame at this point). And there was one old bitch nurse who decided unilaterally, and without consultation with doctors or any other nurse, that my seizures were in my head. Had she read my medical notes she would have quickly been dissuaded from this notion... or maybe not, she was pretty old school, and seemed to hold the opinion that all people with mental health issues were merely naughty children needing attention. On particular day, I went back to bed, feeling quite dizzy and unwell. This nurse (not even my designated nurse) took umbrance to me being in bed in the middle of the day. I tried to explain I was feeling poorly and possibly might have a seizure coming on. I hadn't had the aura yet, but generally in the hours leading up to a seizure I can feel a bit poorly, and either way a nap would either resolve it, or else I would be in a reasonably safe place if I had a seizure. She basically told me it was nonsense and frogmarched me back to the tv room. After 10 or 15 minutes I felt decidedly worse, and got up to tell her I needed to be in my room (I also didn't want to have a seizure with a whole room of strangers gawping) but one look at her face told me she wasn't going to listen, so as my aura kicked in I made my way to the bathroom, where I promptly fell face first onto the tiles, smashing in my front teeth and bloodying my nose, having...suprise suprise... a seizure. By the time I properly came out of the post-ictal state, she had gone home and was not back on shift for the rest of my stay. I had smashed in teeth and a swollen nose, to remember our time together though. They took me to the dental hospital and got caps for the broken teeth, which subsequently crumbled, as there was not enough tooth to adhere too. Lucky me also got to endure four root canals about 6 months later, due to the nerve damage done. My teeth are still a mess, and it will likely cost me a great deal of money out of my own pocket to fix them (there is a possibility I can get them fixed through a referral program with new mental health service district... appointment is in March) My mother hit the roof when she found out, but unfortunately we were a bit to busy trying to keep me sane-ish over the next little while, to follow through and make sure my complaint was dealt with adequately.

Other than that, my immune was rather inept at this point, due to lack of sleep and a significant weight drop, and particularly during my first stay I seemed to catch every flu and cold that patients and nurses alike carried in on the germ infested little bodies.

Nothing quite so problematic at Big City Hospital. I did have a few seizures during my stays there. One rather humiliating one in the shower, however in general they did a pretty good job responding. The only gripe I have, is that during one such seizure, I not only voided (not all that unusual), but also threw up (quite unusual). They did help me to change (embarassed much?...yup!) but they left me to sleep it off with some rather unpleasant regurgitated matter in my hair. Fair enough, they were probably allowing me to rest, but running a damp wash cloth over my face and hair... basic nursing 101. I also vaguely recall my designated nurse delegating her student nurse to clean the vomit from the floor, because she could not handle vomit. Possibly why she became a MH nurse?

In my opinion, a nurse is a nurse here in Australia. Yes, Mental Health Nurses are a skilled subset, but that doesn't mean that they should let the basics of patient care go.

End result for the most part, if you are going to be in a mental health ward, you are better off to have no pre-existing medical ailments.

NB: That being said, from a Community Mental Health perspective, both my Case Managers have been super-duper in supporting my other medical issues. CM from my time in Ward B, would drop me off to Outpatient Rehab and Physio, organised to have a safety belt custom made for me so that I could do additional rehab safely at my Gym, and also came to a number of individual assessments with me to to keep abreast of my progress, and see what ways she could help facilitate it. CM from BCH, has made sure I was getting my appointments with NeuroDoc, and has also been the one to get me the referral for aforementioned Dental Appointment in March.

On the ward and out of my mind- Therapeutic or Babysitting?

Continuing on from here, here and here

One cannot expect to go into a mental health ward (at least in the public system) and experience any real therapy. There are several reasons. The focus on providing treatment in the least restrictive environment (and lets face it, also the lack of financial resources to have enough bed space) mean that all but the most severe cases of psychosis or the forensic cases are discharged in quite a short amount of time. In my experience, most people are there between 2-14 days at most. The emphasis is quite heavily on containment whilst the worst of psychotic symptoms/ suicidal ideations pass and medication adjustments.

I was first admitted to Ward B in 2006. My first admission was quite a lengthy one, in part due to the additional medical issues I experienced as a result of my overdose. I was in hospital for about 2 and a half months. Over the next two years, I was admitted on four other occasions, for periods ranging from 5 days to two weeks. Whilst in hospital there were a number of people I could theoretically talk to, in order to process what I was going through and experiencing.

Consultant Psychiatrist
Generally, I saw this guy maybe once a week at most. Usually it would be him, a Student, my assigned nurse for the shift and I. Occasionally members from my medical team were invited to participate. Not quite like the horrible ward rounds that you guys in the UK have described. But still somewhat intimidating. The focus of these meetings was primarily to establish where I was at, mental health wise and to adjust medications. They usually only lasted five minutes or so, and there was generally no suggestion on how I might deal with some of the symptoms I was experiencing, other than to suggest I ask my nurse for a prn when needed. The consultant changed over the two years that I was in and out, but the one thing that did remain the same was that he was male, usually quite authoritarian and foriegn. I found myself getting quite upset when having to go through my history with these guys, as a) I wasn't really comfortable with men b) several things on Doctor said to me about my family made me feel quite judged (I think it was due to significant cultural differences in the ideas surrounding parents and respect) and finally, as English was not their first language, it was near impossible to talk in the idioms and metaphors, we would generally engage to soften the impact of telling a trauma. They simply did not understand. Language had to be clear cut and brutally to the point. Raw and stark. Being the passive personality I am, I usually just accepted it, but one occasion it got too much for me and I got up and stormed out of the treatment room. Unfortunately, anyone who has ever needed a walking stick before can tell you it is near on impossible to "storm off" and I ended up going arse up in front of the nurses station and all the patients. I then promptly burst into tears, which the nurses responded to quite quickly, as I am known to be a non-crier. Bundled off to my room, the nurse could do little more than pat my shoulder as I howled for the next 15 minutes. That's why I don't cry. Once I do, I can't stop. Anyways....
Nurses
As I mentioned, you got an assigned Nurse at the beginning of each shift, who was supposed to check in with you for that shift, and if you had any additional problems you were to find them. The one thing all the nurses had in common was that they were OVERWORKED. The bulk of their time by necessity had to be spent caring for the geriatric patients. They weren't normally sitting in the office ignoring us (it was a cramped, uncomfortable space anyway), they were working hard. That's where the similarities ended. Some nurses were so burnt out from the demands of "general nursing" on the ward that they had no energy left for mental health nursing. A brief "How are you today?" was sufficient to their requirements and if you did approach them with an issue, they would try to listen but you could see that harried look in their eye of someone who knows they have 1001 things to do before their shift ends. Some were burnt out by the demands, but made the effort anyway. Spent the time developing rapport with the patients. Back in the days before somking restrictions came into full force, they may sit in the courtyard and have a smoke with a group of patients, always observing, in a non-confrontational way that is so much better than "How are you today?". They may be too busy to deal with you straight away but they will tell you when they can see you, and they will keep their promise. They had the skills to turn subjects that we had in common into ways of exploring the patients issues. For instance one nurse, who was also a professional photographer, would always want to see what was new in my portfolio, and we would discuss how it was representative of the way I saw the world..... and finally there was the last kind of nurse....relatively rare, thankfully. The ones who hated mental health patients, thought we were all just lazy sods who were bunging it on for attention. Mind you, the community had its share of acopic personalities that made their way to Ward B, but no excuse for the nastiness these women exuded. If its not a field you want to work in, that interests you...then why the hell work there!  I met some wonderful nurses in Ward B. As a gimpy, little long term patient, who wasn't violent or particularly demanding, I was out of the ordinary for them. Most patients were gone too quickly for them to develop rapport and the ones that remained (in Ward B at least) were pretty far gone to dementia. So, I guess in a way I became their little mascot. But for those majority of nurses who did the best they could in an under-resourced area, there were 3 or 4 nurses, whose callous actions or words remain with me today
Case Manager
I didn't get introduced to my first Case Manager until I was about a week away from discharge. Their focus is generally Ccmmunity Care. My first Case Manager (Y) was fantastic. She found away to relate to her clients, she made sure to make the meeting spaces somewhere comfortable, whether it be a park or a coffeespot, and she firmly believed in talking and doing.. in other words, by all means talk about what was going on, but at the same time go for a walk as part of my PT or go and check out a second hand book store. Anyways she was my Case Manager for most of the time I was in that area... and whilst I was in hospital she did check-in on me, she would drive me to and from my private psychiatrist appointments, when I had permission to leave the hospital. She was less of presence than out in the 'real world', I guess because she knew while I was in there I was relatively safe and contained.
Patients
Anyone who has spent time in a mental health facility will know that it is the patients that you spend the most time talking to. And often the ones you turn to, for advice or comfort. There are some inherent difficulties in this. You have to be concious of the fact that a) some of them will not be entirely truthful with you, and b) some of them will have issues that may end up impacting on your own mental health. This is particularly important to keep in mind if you decide to keep in contact outside of the ward. But the benefits are they are usually extremely judgmental, and even though no person has exactly the same experiences as you they do have a greater understanding than the average person. The other thing they bring to the table is some comraderie and humor in a dark time in your life. There is a suprising amount of laughter in a Mental Health Ward. The downside to this, is many of the 'acopic' patients, went from this comraderie and support back to their isolated and lonely existences, felt the void, and so would make a suicidal gesture just to be re-admitted for a few days to a world where they felt accepted.
Other hospital staff
Being a longer term patient, the housekeeping staff got to know me quite well, and would often stop for a quick chat. It was all very light, but it was always nice for them to compliment me on how well my walking was coming along, or as one old duck said to me "Some meat on your skin and those dark circles away from your eyes, you're starting to look quite bonny" :) In addition, (S) my physiotherapist was a fantastic support. She worked really hard to keep me goal focussed on the future, to give me hope, but on the few occasions I did fall apart, she was lovely too. I guess she didn't have to adhere to boundaries as strongly as the MH professionals do, and in those times when I was wondering if I was ever going to walk, read and talk properly again, she would take my hand and let me cry. She also provided me ample opportunites to get out the pent up anger inside me and direct it into my rehab sessions, knowing when to push my buttons to get me to push myself just that little bit further out of anger. She was a big reason why I recovered physically as well as I did, but I also believe she was a big reason why I made the steps forward with my mental health too.
Private Psychiatrist
By this stage I had been seeing Dr B for a little over a year. As soon as I was allowed out on leave, I began to go to my appointments with her twice a week, first on escorted leave with either my mum or Case Manager, and then by myself. I found it quite surreal that I was signing out of a psychiatric hospital to get psychiatric help, but the reality was, in order to get the containment I needed to go outside of the Public System.

There were some differences and some similarities at Big City Hospital.
Consultant Psychiatrist
Usually there was just you, him and  the junior doc. Not quite as confronting as at Ward B, but also it meant that there was no nurse to explain things to you when you left. I often found it hard to absorb what was being said. The consultations were the same length, about 5 minutes, but seemed to be more regular than on Ward B. Every 2-3 days. He is also the guy who heads the team the Junior Doctor and Case Manager assigned to me in community care are apart of. This means he is kept more regulalry apprised of what is going on with me, and is generally consulted in CM thinks I might need an admission. So there is a lot less repeating myself. And quite often they will do a direct admit rather than make you endure a horrible A&E admit.
Nurses
Now this is one that I do get quite cranky about. I understand that we live in a world of paperwork, back-up paper work and back up, backup paperwork, but the amount of time the nurses spent even out of the office, let alone actually engaged with patients was abysmal. They did not have the same geriatric workload as Ward B nurses. WHAT ARE THEY DOING?? I believe a small part of it can be attributed to the system of medication hand outs. In Ward B, three times a day you lined up outside a window for your medication, this took two nurses about an hour to do. Of course, they had to track down the odd non-compliant patient, but it worked pretty well. Assigned nurses gave out any prns or the odd medication that fell outside these times. In BCH, each assigned nurse, prepares the meds for each of their patients and then runs around the ward like a headless chook with a dixie cup of pills and another of water, trying to find their patient. As there is a bunch of nurse all trying to do this at the same time, the tiny meds room gets quite jammed up, which slows the process further. I've watched an individual nurse take two hours to get through all her meds. It seems to be a waste of time that could be better spent with patients. In BCH, I quite often went an entire shift without talking to my assigned nurse, or even knowing who is was until they came to give me meds. A common phrase was "Ive been measning to come and see you. Just let me finish these meds". And then you never see them again... I am not a squeaky wheel in hospital, so I am easy to overlook. Additionally, I have had a nurse tell my private psychologist who rang, that I was doing very well, and that she has spoken with me that morning....and she had not even seen me! Most of them are good nurses I think, but there is a culture of inefficiency and a tendency to migrate to the nurses station where its comfy. The nurses station in addition, is nowhere near the middle of the ward, so they had no idea what was actually going on (i.e patients smoking dope in the corner (I witnessed this!), there was gossip about patients getting it on in the laundry (not sure if that's true) If you did need to see your nurse, it would take a lot of banging on the door just to get anybody to respond. Massive Fails in my opinion.
Case Manager
Unlike in Ward B, my Case Manager in BCH was housed in a separate location from the hospital. I think she only came to the hospital once, when I was first admitted to introduce herself. However she does always make sure to let them know if I am coming etc and checks on me when I am discharged.
Other staff
Consumer Advocate (K) came and saw me twice during my last incarceration   admit. She also arranged for her counterpart to check in on me on my birthday, which was sweet.
Patients
Similar to Ward B, but have had a few bad experiences this time round. One of the girls I befriended in there ended up taking me on a bit of a roller coaster ride outside of the hospital. But I will always be grateful for the few months of friendship we did have. And I truly hope she manages to work through her issues. Unfortunately, I had to distance myself to preserve my own mental health.
Private Psychologist
I began seeing (D) about two months before I landed in BCH the first time, over the next 6 months I had two subsequent admissions. I cannot emphasize how much of a support she has been when i have been hospitalised, and I really need to remember that at times like now, when I am pissed off at her. I was really reluctant to go in my first admission. I had stayed out of hospital for nearly two years, I didn't want to go back to that. I didn't want to admit to how far things had gotten out of control. She did not push hospital, in fact she is in many ways anti-hospital, but eventually we both had to admit we were out of options. The first admit, she sat in the ER with me for hours, waiting for admittance. She also did a lot of the talking (background history stuff) that I was unable to do. I don't think I would have stayed and waited if she hadn't have been there. She also rang me pretty much everyday to check how I was going. At the end of the admission, the Consultant Psych told me, that if I was admitted again, (which I think he suspected I would be, with D-day anniversary coming up) that I was to go to my bi-weekly session with her, for continuity. So on the subsequent stays, I was faced with the surreal prospect of leaving a mental health ward on leave, to go and get mental health help. Seems ludicrous! But it helped.

Ultimately, I can see that Public Mental Health Facilities are not meant to be therapeutic communities, I can see the arguements for least restrictive environments etc BUT if the patients are going to be in the hospital anyway, you would think that there should be some attempts to provide an environment more conducive to processing whatever emotions etc they are feeling. I don't know exactly what the answer is, but I suspect a big part of it, particularly in BCH is getting the nurses off their arses, out of the nursing station and into the messy melee that is a psych ward. That's what they signed up for after all.

The second thing I have become aware of in retrospect, is how lucky I have been to have other people, (private practitioners, physiotherapist, auxilary staff ect) step into to fill the void left by the lack of involvement of behalf of the nurses.

On the ward and out of my mind

OK. It's nearly 2am and I need some distraction. Twice today I have heard/read about somebody elses experience with Mental Health wards. One, was through a phone call I had with friend (C) in another state, who just spent a few days in what sounds like the MH ward from hell. And then I read MadSadGirl's latest installment in her "Tackling the Mental Health Minefield" series. So I thought I would write a little about some of my experiences.

As my regular readers would know, I hail from the other side of the equator. Here in Australia, we run off what I guess would be called a two-tiered health system. Pretty comprehensive universal hospital cover in the public system (but with pretty long waiting periods for non-emergent stuff, and overworked, underfunded hospitals). And for those who opt into Private Health Insurance or are prepared to pay out of pocket, a number of private hospitals. I acquired private health insurance, when I was diagnosed with epilespy, because if I had to go to hospital for any length of time, then I wanted it to be somewhere my Private Neurologist had treating rights. I haven't needed to use it for that. Its also a good idea to get Private Health Cover here before you turn 30, otherwise you lose out on the tax-rebate. So pretty much, I just used it for covering basic dental, optometry etc. 

The first time I was admitted to a MH ward, was back in 06, post OD. It was a public hospital in large regional hospital. I spent some time in the ICU while I was at my worst. After a few days (its hazy... a week at most) they attempted to move me down to a MH ward. But I was still actively hallucinating as a result of the medication I had taken, my heart rate and blood pressure went through the roof, and after about 12 hours (and my mum pleading with them to get me onto a medical floor) they decided I was to medically unstable and transferred me back up stairs. As, they had begun to notice some of the effect of the brain injury I had acquired, I went up to the Rehab ward, so once I was stabilised my Physiotherapy, Speech therapy and Occupational therapy could commence. Once up there, they also realised I had developed Aspiric Pneumonia from being extubated, so they got started on treating that as well. I was place on 1:1, which basically meant as they didn't have me in the 'safe' confines of the ward, and I had (apparently) at some point verbalised that I had every intention of finishing what I started as soon as they all left me the hell alone, I had to have a Mental Nurse, who had me in sight all the time, as well as the regular floor nurse who looked after me medically. For the first two days, this was probably somewhat unnecessary, as I drifted in and out of consciousness, and was not able to walk or even get out of bed by myself anyway, due to the brain injury. But after that, as necessary as I see the 1:1 was now, it was a pain in the ass. I could not talk to friends or family without a stranger listening in, I could not take the time to process what had happened, as I had someone taking nots on my every move. And, although for the first week or so, I could not mobilise to the shower or toilet by myself, once in there, I was afforded no privacy, as they could not leave the room. Necessary, yes. Consquence of my own actions, yes. Pain in the ass, yes yes yes! For the most part of the, oh, two weeks, that I was on the Rehab floor, my 1:1 nurse had a pretty easy shift. Once I was not actively hallucinating, I was pretty quiet. And I was resigned to the fact that I wouldn't be able to do anything in hospital anyway. Plus my mum was there everyday, helping to feed and shower me (grimace) And all the medical stuff, obs, meds etc was done by the floor nurse. So pretty much they just sat there reading Women's Day. A few, given that 1:1 time with a patient, a luxury they did not normally get, did try to talk to me about what was going on with me, what had led up to the OD, where my mind was at now. But I wasn't really in a place where I was willing to talk yet. One tried to convert me to accept Jesus Christ as my Saviour. The whole Let Go, Let God shite... which was very unprofessional. But for the most part they were ok. I began my rehab with my wonderful physio (S) and her lovely assistent (lilS). Got taught how to transition from bed to chair, and then later down the track from chair to walking stick or zimmer-frame. By the time I left to go down to the ward two weeks later, I was mostly using frame or stick, with the wheel chair only when I left hospital on day leave with my mum or when the nurses had to escort me back up to rehab floor for my sessions (otherwise would have taken me half an hour to get there) So once my medical issues had somewhat resolved, they made the decsion to move me back down to the MH floor. Was probably still a bit too soon, medically, but is very expensive to have to dedicate nurse to one person, or else they just take them off the ward floor, and it becomes understaffed.

One nurse, explained the MH wards to me, one night shift. She explained I was going to Ward B, which was a lower security ward, than Ward A, where they put the floridly psychotic and forensic patients. I was still on an Involuntary Treatment Order, which meant I could not leave ward without supervision, but the ward was only locked at night. So, I could try to leave if I wanted, but security and police would be called to bring me back, and then I would be transferred to Ward A. She also told me I could smoke in the courtyard in Ward B... that was enough for me after three weeks without a cigarette. I was brought down and shown to my room. The ward was laid out in a T shape. The Dining room/ Kitchenette/Common Room were in the middle, with small nurses station running along side it. From there, there was three corridors, to the left and right were "adult" beds, and down the centre a partition opened up what used to be the adolescent ward, to allow for more bed space still. At the very end of the corridor on the left (males), was another small tv room, with the requisite MH ward piano. I was taken down the right (females) corridor to a private room. There were 8 private rooms down one side of the corridor, with every two rooms sharing a bathroom. And four dorm rooms down the other side, with four patients sharing a room. I was happy to be given a private room, which I was later told was because I still had complex medical needs. They left me to settle in the room a minute, while they went to grab my paperwork. I took the opportunity to hobble my way to the bathroom to enjoy a bit of privacy for the first time in two weeks. Bliss. Once I got the hang of the weird bathrrom locks, that had to lock both the door from mine and the adjacent bedrooms access into the bathroom.

I was still sitting there 10 minutes later, when, let's call her Nicole, came back in to check on me. She knew I was dying for a cigarette, so she took me out to the courtyard, handed me my cigarettes, introduced me to a few of the younger patients, and told me she would be back in a few minutes to go through my paper work with me. I smiled hesitantly at the other patients, and then sidled away (as much as one can sidle with a walking stick) to sit on a bench and chain smoke seriously. I hate to admit it, (I think this is the case of a lot of people on their first admit) my immediate thought was.... I can't talk to them, they're crazy! Never mind out of all of them I was the one who just came off 1:1 and was still on an ITO. It was then it began to dawn on me what I had done, or more to the point, where I had landed myself.

Nicole came back out and took me around to a table on the other side of the courtyard, out of ear shot. She asked if I wanted to do this in my room, but I wanted to continue smoking, so I said outside was fine. Still she took care to speak softly, to protect my privacy. "This" turned out to be a patient intake form and a the first of what would be one of the many risk assessments forms I had done over the next four years and various inpatient stays. Mood leading up to the OD?... very low. Sleep?...had been bad for months but am told I didn't sleep at all for four days before OD. Have no memory of this week at all, although I was later told I did go to work for the first two days (Mon, Tues....OD on Sun), but I didn't have this info yet. Just one big missing chunk of time. Self Harm? No point denying, they had seen my scars and cuts. Eating? I was 38kg at 161cm at the time, so obviously not great. Current level of suicidality? Hmm...hesitant to answer that. Did I think I could come talk to a nurse if suicidal or self harm urges got to much? What am I going to do about it if they do...I'm in a MH Ward, I'm guessing they don't leave blades lying around. Did I have a plan? Like I'm going to tell you. Then she spoke about my life before OD. Professional Care? Yes, Psychiatrist for two years. Diagnosis? PTSD. History of sexual, physical, verbal abuse? Yes, yes and yes. Drug and Alchohol abuse? No. Psychosis? Apart from the OD induced hallucinations, no. Family support? Well.......... Housing? Not sure. Currently rent by myself, but mother insisting I come and live with her.

Nicole stopped and gathered up the paper work. And then suprised me, by pulling a packet of cigarettes from her pocket and lighting one up. She looked at me and said "I bet you are just feeling pretty shit about the way things have gone, huh?". I nod, dumbly. She went on to say "This place really isn't so bad... just think of it as a chance to take a break and focus on yourself" I say nothing. She smiles sympathetically (or is it empathetically) She goes onto explain the rules. Meals in the dining room at 7.30am, 12.30pm and 5.30pm. Meal selection is done at Morning meeting, which everyone is expected to attend in Common room at 8.30am. Courtyard open at 6am, closed at 9pm. No smoking inside. Permission (and for me supervision) required to leave the ward. Checks every hour (15 minutes for me, for the time being)

She walks me back inside pointing out things as she goes. Kitchenette is for staff to serve only. Coffee/Tea and snacks available for Morning Tea and Supper at 10.30am and 7pm, respectively. She points out the patient board. My first name has been written up there, next to my room number, and my dedicated nurse, which for this shift is Nicole. I am to find her if I need anything. We head back to my room. We both shiver as we walk in. I am to find out, my room is inexplicably colder than the rest of the ward, even the nurses say so. I will have to use four blankets at nights. My room contains a single bed, a laundry hamper and a built-in unit with a cupboard, shelves and a desk. There is barely enough room to get my zimmer frame in, so I will have to become more proficient with my stick. My bags have arrived. Friend (Miss G) has packed what she thought I would need, as mother is not ready to face apartment yet. She has included my Journals, thinking that I wouldn't want then left at home where prying eyes could see. I don't want them here either, content could keep me locked up for a lot longer than I was planning on staying. (I later give them to Miss G to keep at her house until I get out) Nicole goes through my bags, looking for contraband.... she finds it, disguised in ways that even I don't see the potential danger until she points them out and starts giving me ideas. Perfume (glass bottle, alcohol) Razor (obviously) Phone Cord (OK...hang on what???) Belt (I guess...) Shoe laces (Just take the shoes, I'll wear my thongs) ad infinitum. Lighter (Apparently I can probably get this back later) She eyes the journals curiously, but just gives them a cursory shake. She wraps a patient ID sticker around the back of my phone to cover the camera lens...for privacy reasons.

Any Questions? When do I get to go home??? Sigh. "That's for the doctors to decide, but it will probably be a little while, you're not well, physically or emotionally". She goes on to explain that they normally don't get patients with complex needs like mine. Most people either take a non-lethal OD, and are well enough to come down from A&E or CCU within a day or two. Or else they take the lethal dose, and well, they don't end up here. She said that (S) would be coming down for a meeting with the rest of my "team" and I, later on that day, to discuss my rehabilitation and the Psych Doc would come up with a plan for putting me back on meds... I hadn't had any since the OD, apart from my epilepsy meds, because they wanted to give my system time to recover.

She pats my shoulder and gets up to leave. At the doorway she turns and smiles. "You just have a bit of relax" Lunch is in 10 minutes, I will come and get you. If you need anything come and find me. If you start to feel dizzy, hit the call button" I notice the red button nestled next to the bed head. She turns and leaves shutting the door softly behind her. I lean back, clasping my childhood comfort object to my chest, and look around. And I think "What the hell have I gotten myself into?"

To be continued at some point.....

I got what I wanted and I don't want it anymore

I got what I wanted. Finally, after all the drama and crowding and  visitors staying, for the first time since I got out of hospital, I got the house to myself. Lil Sis is away down the coast until Monday. Big Sis is away for the night and should be going home on Sunday anyway. I spent all day, counting down the hours until they left, fantasising about the peace and quiet, tuning into the classical stations, maybe lounging around watching tv or doing some painting, blissfully and wonderfully alone.

But... they left, and I got some company to replace them. The 'Voice" kicked into overdrive. Freedom and an empty house was apparently too much of a temptation. I can cut without having to worry about anyone walking in on me, I can drink without worrying about detecting, all in the vain hopes of ignoring the central message from the "Voice". "Now is your chance, nobody home for the next day at least, nobody to accidentally find you, to call an ambulance. Do it now" Strong suicidal ideation, flirting with visions of a fistfuls of medication, swigs of vodka and full bathtub.

I don't know why. I mean, no, these thoughts and feelings didn't magically dissappear after "Horrible Thursday". But I guess, I had so much else that needed to be dealt with, that there wasn't so much time to stew. I honestly, was just looking forward to a nice quiet evening alone, and then bam! it all hits me, seemingly from nowhere. I suppose a big part of it on a subconcious level at least, is that I literally haven't been alone in over two weeks now, so limits the opportunities. So, I am viewing this a knee jerk reaction and trying to ride the waves as best I can. There has been some minimal SI and a little drinking. I tried to call therapist earlier, but could not get through. I left a message explaining the issue, but have not heard back. We have a planned check in phone call tomorrow, so I guess I'll just hold out for that. Problem is, I left a message, which means she'll be apprised of the issue, and ask me how I managed to work through it without support. And I don't really want to tell her I resorted to some unhealthy coping strategies. I feel like if I tell her that, it kind of sounds like, "I couldn't reach you, so I decided to slash myself" Which I guess is partially the truth, but makes it sound like "Why weren't you available when I needed you?" when in reality, I have always been fully aware that as a solo practioner, unless we have prearranged a contact time, and it is generally within business hours, she may not be available all the time by phone. I understand that. That's why we got Public Mental Health involved. But Case Manager (M) is of course only available 9-5, Mon - Fri. And although there is a Triage Line, it is staffed by people I don't know, who don't know me..and I find it incredibly difficult to talk in this situation. Naturally, the times when I am most likely to crack up, are evenings and nights, when the MH support I am comfortable with, is for the most part unavailable.

Anyway. It does kind of validate one thing that she said, about containment, and phone calls providing me with less of a feeling of having to struggle through on my own. I may not have got a hold of her tonight, but I know she will be calling tomorrow, so I just have to hold out until then. By that point I'll either feel a bit better, or I can talk to her about it. 12-14 hours isn't that far off. But if I had to wait until Monday at 3.30pm, it would be a lot harder to keep myself together.

My biggest fear, is that this is my knee jerk reaction, not just to being alone, but to being alone for a long enough period, that I can act on impulses without any risk of discovery. Up until this point lil sis was usually in the house most evenings and nights, or else her ex and his brother were, which was somewhat of a discouraging factor. Now it looks like little sis will probably head to the coast most weekends, which leaves me with a lot of opportunity, at least until we get a housemate. Sigh. So, hanging in there. I got what I wanted...not so sure I want it anymore.

Three times a week!!!

Therapy today. Sigh. I began the day by catching up with (K) for coffee. Entertaining and thought provoking as usual. No BS, which is nice. I always seem to walk away from my catch ups with her with a few different ideas rumbling their way through my mind. Is always good to have a different perspective from somebody who has been in a similar place before.Among the many things our little chat through up (what is the opposite of hope? I say resignation.. she respectfully disagrees) she said something about how you can't tell everything about a person, just because they have a sunshiney demeanour... they may have become that way as a reaction to a not so sunshiney past. It made me think about one of the major discomforts I have with MH professionals. They always seem to have it so together. And you imagine from the way they are able to pull apart and analyse your problems and come up with healthy solutions etc that they must have it all together. But the reality is, I'm a client, they can't really bring their baggage into the room like in a normal relationship. So you get a skewed view. Maybe somedays their life is just as shite as mine. Maybe they are able to empathise and give good advice, because they are talking from their own experience. And I need to keep that possibility in mind, before I dismiss what they have to say. Is very easy with MH issues to become very ego-centric...nobody could possibly understand, wah wah wah, I need to keep in mind they are human too, not perfectly turned out robots.

After that we chatted for a bit about photography, and (K) asked me to bring some of my photos to see next time. I really must follow through on my plan to go to the botanic gardens and potter about with my camera. Its something I have enjoyed in the past, though I am not that great at it... and as (D) has pointed out I need to be "doing things"

Anyway, after (K) I jumped on a bus and then train to get to therapy. (D) commented that I seemed outwardly to be a lot calmer. (Which I attribute mainly to meds and ex moving out of the house...finally!) But was somewhat concerned that I had become a bit disconnected. I don't seem to be able to find a happy medium, either utter out of controll-edness or complete disconnect. She started talking about increased contact again, and pointed out that while I might feel that since I am disconnected rather than a shaking, gibbering mess, I don't need it, she actually feels that I probably still do, maybe even more so.

We spoke for a little while about anger again (flogging a dead horse). She pointed out that even if I can't do anything to change the way my family reacts to it, I can still work on finding ways to be more assertive and say no, in other relationships. To learn how to protect myself from others who would seek to exploit me. And if I feel confidant in doing that, I might not just cut people off out of fear of what they might do....

Which of course led to.... Bachelor Number One. No I have not broken up with him yet. I've tried, but I jsut can't seem to make myself. Argh. I sent him an email explaining everything thats been going on, half hoping that he would just go "Ooh, that bi-atch is crazy!" and back off. But he didn't. He sent one back asking to see me. I haven't responded yet. I know in my heart now is not the right time for a relationship. And I do not want to explain the state of my hacked up legs to him... but I can't seem to make myself cut ties either. He is a great guy. Sigh. And of course, if and when he does reject me as a nutter, deep down I'll be devastated..

Finally, we moved back to the "increased contact" discussion. Still haven't made any headway. I'm going to think about adding a third session and how that might make me feel. The other choice is the phone checkins. I think she realised how worked up I'm getting about it all, because she is only going to call me once over the weekend (on saturday) and then I'll see her at my normal time on monday. She pointed out that she thought, part of the reason the "Horrible Thursday" went down the way it did, was becuse she pushed me a bit too hard and then I left the session with all of this crap still going nuts in my head, but was not going to see her again for four days. And I'm not the greatest at reaching out for help on my own at times. I don't know if that's true, but I guess it kind of makes sense.

Anyway, I left therapy with all sorts of (you guessed it) crap floating around my head, and just really needed to go home. So I skipped my blood test at Big City Hospital, which means I'm going to have to travel half and hour each way to go and get it drawn tomorrow afternoon. Sigh. I also NEED to call the uni.

Not an incredibly exciting session, but still, gave me a bit to think about.

My kind of day

Today, I have not been doing anything that I am 'supposed' to do. I have stayed in my pajamas. I did not shower. After the big cleaning marathon on the weekend, there was little that needed to be done other than a few dishes. I had a pizza pocket for lunch. I drank real coke, rather than the decaffenieted stuff I try to drink. I watched all the shows that I had recorded on the IQ. I surfed the net. I dealt with the phone/cable situations, which took about 10 minutes, but pushed all the other things I have to sort...uni, carpets etc off the agenda for the day. And now I am cooking myself a very easy frozen curried lentil and rice microwave meal, before cuddling up on the couch for some more tv. And even though I haven't done any of the things I'm supposed to do to keep the depression at bay...exercise, socialise, eat properly etc.... it was just what I needed. The sheer bliss of a day of just kicking back, chilling out and doing exactly what I wanted to. It's not something I can keep up... but for today, it was good.

Therapist (D) texted me to let me know that she was back from overseas, and she hoped that I was doing ok, but she wasn't in a place where she could call me. Which was fine, to be honest I didn't expect a call from her tonight, when she has just gotten back, but it was lovely that she thought to send the text. I really need to remind myself next time therapy is going as I might want it to that I am quite lucky to have (D) who is consistent and trustworthy, is available as needed outside of the "50 minutes", without letting it turn into a situation where there is too much dependence. When times are tricky she really steps up to the plate with the everyday support, without making me feel bad or like a burden (although I can do that all by myself) I can say now, in a moment of relative peace, that it has been really interesting, though sometimes unsettling, to look back on how the therapeutic relationship has developed in just over 6 months. I trust her. I really do. Which is so strange for me. And the way she was able to take my anger, from that horrible 'Thursday' and let me know, that it was ok, it was a good thing, and the relationship could survive it, was pretty amazing. I'm still processing the concept. And then to be able to switch gears, and know that stuff needed to be put on the backburner while the whirlwind of the last week was endured, was fantastic. We have a fill-in session tomorrow morning, and I know its going to be time to start facing up to some hard sh*te, but tonight, I feel ok about this, because I have a pretty amazing therapist help me, as well as a wonderful (if annoyingly, perpetually happy) Case Manager, who has also consistently stuck by, and been available to me, despite the limitations of the Public Health system. And who has been able to advocate for me, within said system, when I am unable to do it for myself. And of course (K), who seems to find a way to both suprise me and get me thinking whenever we catch up. From a professional point of view, I am pretty damned lucky support-wise, even BossPsychDoc is ok, although I think I will probably be relegated back to his new BabyDoc. I met her when I was last in hospital, only once, but she seems ok, better than the douchebag who held the position before her at least. At some point I may need to consider getting a private psych. Particularly if sleep doesn't start to improve. Private psychs tend to be a bit more creative in their approach and of course, have more time to spend one on one and get to the bottem of things. But for now, its all pretty good. Now, I just need to work on maybe (maaaaaaybe) opening up to some friends and family a bit more, so my social support network is stronger.

Found my anger..didn't know what to do with it, so lost it again..

Lost my temper and very nearly lost the plot this afternoon. Lil sis just pushed me to far with her inconsideration and unhelpfulness in getting the house ready for prospective tenants. Plus I was on edge from lack of meds...Finally got the call that my script was ready and so removed myself from the house. By the time I reached the Mental Health Building, I was shaking with agitation. Was so bad that when (M) handed me a cup of water I could barely hold the cup. Chatted with her for a few minutes, which centred me a bit. Although she was of the opinion like therapist (D) that it is good for me to get in touch with my anger. Which I understand in theory, but practically, me losing my temper is not going to help the situation. Walked back down the hill to the mall to get script filled, still shaking so bad that the pharmacy attendant was giving me strange looks as I tried to sign my name. Thought I would want to get in and out of mall as quickly as possible, but strangely did not find it as claustrophobic as I would normally. Plus it was airconditioned and 10 000 degrees outside. So stuck around for an hour or so and did some frivilous shopping. Didn't spend much and I had some birthday cash left, so it was a nice splurge. Bought some cushions and a shoe rack and a new mat for the doorway. Also bought a big bag of pick and mix lollies as a treat. Ignored phone calls from sisters. When I finally got home I think lil sis was trying to apologise, as big sis had basically told her, if you don't cut it out then Ophelia is going to crack completely. But didnt realise that's what she was trying to do, and was too pissed off to bother listening. She still didnt really help me clean the rest of the house. So I finished tidying and vacuuming. Aunt arrived with two little cousins and my big sis went to pick up her son, so we have a full house ready for our trip to the water park tomorrow. At first found the infringement on my space a bit tricky, but had a 'good' chat with aunt and sister re: past history, and why therapy is good for me. They see me going month after month and don't think its helping, which I understand, but they don't understand the complexities of it. Besides they don't have a better plan, so.....Is now 2 am and I have to be up in a few hours to leave, so I should try and get some sleep. Sigh. Ex is pretty much all moved out, and has tomorrow while we are out of the house to get the rest. Anyways....longer post tomorrow.

Life in a nutshell

Found out a little more about the 'situation' from last night, this morning. Apparently while lil sis's ex was in the spare room (and I assumed sleeping), he was actually lying there in the dark incessantly calling her, and sending nasty and obscene text messages and pictures. Lil sis got a new I-phone the other day, and thoughtlessly left her old home lying about at home. I say thoughtlessly, given ex's current state of mind, but really... who goes through other peoples old text messages. Anyway, apparently he found some texts that enraged him, and thus the text message harrassment. A part of me feels bad for him, but he really just needs to pull his head in. Anyway, sis was supposed to head into the courthouse this morning to lodge a Domestic Violence Order against him. But once again, at the last minute she changed her mind. Ultimately, it is her choice, and all we can do is support and offer encouragement. She did however tell ex that she had picked up the paperwork and if he didn't leave, she would file it tomorrow. I understand where she is coming from, somewhat. Nobody wants a 6 year relationship to end that way, and prior to them breaking up, there was none of this crazy-ass behaviour from him. I really do think he is starting to lose the plot, and I thinked, faced with the prospect of the DVO, he started to realise that too. So he came home this afternoon, filled out the necessary paperwork to change things over with the lease, bond and car registration, packed up some things and left.

He will be coming back on saturday to get the rest of his things, but only during stipulated hours while we are out at a local waterpark celebrating older sis's bday. Sigh. Waterpark...sheesh... that's going to be fun. Am a bit concerned about going due to the mess I have made to legs (SI-ing), but the cuts are limited to the upper part of my thighs, and after talking to (K) this afternoon, I decided I should go, so I bought some knee-length board-shorts and hopefully that will suffice. My sisters do know, I think, about the previous self-harm, years ago, because it came out in hospital, post OD in 2006. But we have never discussed it and nobody outside the mental health professionals knows I'm back at it again. I have always been pretty good at hiding it... taking care of it myself, and only cutting on areas that nobody else would see. Of course, with various boyfriends over recent years, the issue of my scars has come up, but I have always been able to reassure them that it was something I did many years ago, as a messed up kid. But here I am, 27, and back at it again. Pathetic! But, I've kicked it once, and I'll do it again. I am damned if I am going to go back to carrying around one more secret and trying to hide it from everybody. To carrying blades and bandages in my purse, just in case...I will NOT go back to that. I just have to be firm with myself. Yes, it serves a purpose, but its a purpose that could be served a few other, more healthy ways.

Other than that therapist (D) headed off overseas this morning. She called from the boarding lounge to check how I was doing, I could hear boarding calls in the background. Which was nice. And yes, its a bit scary she is out of contact for a bit, but it is only 5 days, and she is probably off learning more things about how to deal with nutters like me, so, its time to be a GROWNUP, suck it up, and deal with it myself. Which should be a bit easier since ex is now out of the house.

She would be very proud of me today, actually. I practiced being assertive and told little sis, that I needed help cleaning the house, as it was out of control and we are interviewing roommates this weekend. She agreed and then quickly dissapeared for an hour. Sigh. So I got started and scrubbed the kitchen, till it sparkled (although I still do have to clean the over...ugh) When she did reappear, she stood around for a few minutes not knowing what to do, so I directed her to the mop, and got her to the kitchen floor. Cleaning is not part of regular repetoire. When I told her it took me 3 and a half hours to clean the bathroom, she looked at me like I was crazy. The thing is, I was in hospital for a fortnight, nobody lifted so much as a chux to the bathroom, I was pretty depressed leading up to that fortnight... so in essence the bathroom hadn't had a proper clean in over a month. Revolting! I had to scrub the mould out of grouting in the shower, scrub the floor by hand plus some other spring cleaning stuff that needed to be done. Cleaning walls and skirting boards ect. I bought a whole bunch of wicker baskets for the cabinets, in the hopes that if she has to just chuck things in the appropriate basket she might keep things tidier. I also bought a new bath mat and handtowel, and just threw out the old ones...yuck. But it sure looks pretty now! After the floor, she moved on to her bedroom, while I gave the lounge a thorough clean out. Big Sis tackled the laundry for us, which was kind as she doesn't actually live here and thus really didn't have to. So all that leaves for tomorrow is to clean out the family room, and the spare room we will be renting out. Sort out the office. Fold some laundry which is currently sitting at the end of my bed and put it away. After ex is done moving his crap out, I am going to give the carpets a shampoo, and probably fleabomb the house, and give the cat a bath and a new collar. With summer, and her being outside, its hard to keep the flea situation under control, but I do my best.

Other than that, coffee with (K) this afternoon, which was a good chance to get some perspective. Good phonecall with friend (SC), where she told me that she had used a lesson idea that I came up with for her, with her history class, and the kids really enjoyed it and got the concept. One of the boys apparently said "Ms C, you're going somewhere with this activity..." and then joked to the class "Be careful, we might learn something accidentally!" Lol. Its a good ego boost to know that my ideas still work and I might make a good teacher if I ever finish this damned degree!. Got letter from the doc today so I can submit the application to drop my two subjects from this semester without financial or more importantly academic penalty. So I just have to pull myself together for the new semester in March. Also got an Appointment to see Neuro-Doc next week. Not sure how much use it will be, as I am pretty sure is not the epilepsy meds that are at fault but the lack of sleeping. Until that is under control, my seizure control is not going to get much better. I am much better these days at pulling myself together afterwards. I had one during the night last night, but slept it off for a few hours and then woke up this morning feeling ok-ish. Sore and a bit like I'd been hit by a truck...but manageable. And...at least I got a few hours of 'sleep'. *Post seizure sleep never really feels like sleep...its all post-ictal and more like semi-conciousness*

Still waiting for script for meds. Was a muck up today so will get them tomorrow, fingers crossed. Am climbing the walls! Very shakey, fidgety, jittery and agitated.

Anyhow. thats life in a nutshell (no pun intended).

And back in therapy land.....

Very little sleep again last night. Nothing new there. I headed out the door to meet with Case Manager (M) an hour or so early, so I could stop at some furniture stores on the way. Little sis and I own most of the stuff in the house, but her ex will be taking a few items with him which need to be replaced, including the dresser in my room. So, I killed some time looking for replacements. Headed across to the horrible, depressing metal health building. Usually (M) will come and see me at my house, which is lovely of her, but today she was pretty busy and just could not go away. God, that place makes my hypervigilance kick into overdrive... but these things happen, so off I went. I'm pretty jittery at the moment due to a lack of meds, as well as just my fairly consistent state of anxiety due to living situation, so there was much jiggling, twitching, hand pulling and shallow breathing... ho hum. Was a pretty fruitful appointment. I managed to speak through some of the craziness going on in my life at the moment, which was quite a relief, really... just to get it off my chest. BossPsych Doc, agreed to increase my Serepax for a short while, after talking with (M) about the current stressors in my life, which should hopefully calm some of the jitteriness. Just need to wait on the script change to be lodged at the pharmacy. (I'm only allowed a week's worth at a time at the moment...ho hum) She also had managed to make an appointment with the dentist for me in March (they have some sort of program running between Mental Health and the Dentistry Program, and after smashing my front teeth in by introducing my face to a tiled floor a few years back, I have some pretty major dental work that needs doing, that I just can't afford to get done through a private practice. She also gave me some information about a Respite House for people with Mental Health Issues in the area, as a place I could consider going as an alternative to Hospital in the future. They allow 4 days stay at a time, in a house that has a 24 hour carer. Guest only pay $15 a day to cover food. I'm not sure its for me, but I'll think about it if that time comes again. Other than the practicalities, it was just a nice, long chat about the general state of things. She had some interesting things to say, in her ever so Pollyanna way (although I'm sure I almost got a "sh*t" out of her at the beginning, that she quickly turned into an "awful". Giggle.) We did speak about how if I get into a similar state to last Thursday again, I really needed to call her, as it was her job to step in, in such situations. I replied that at times like that, I really didn't want her to step in (in the moment). She replied something to the effect of "But you have to, because its my job to step in, and if you don't let me, I'll feel like an awful Case Manager if something happens, you don't want that, do you?". It sounds awfyl written down, but really was quite funny in the moment as was quite transparent and she was smiling. I retorted "Nice. Guilt trip the client who already has a guilt complex!!" and we had a bit of a laugh.

Therapy was a 3.30pm over the other side of town. I had another session today, (in addition to yesterday's) as (D) is going to be on a conference from Thursday through to Monday. Worst still, its overseas! She told me yesterday, that she had found out that her phone does not have International Roaming, and that it was a bit complicated to get it, and that she also may not have email access. I was quite suprised a)that she was concerned about it, I really wouldn't expect to be contactable or to contact me whilst overseas and b) given how angry I was with her last Thursday, how much I was actually concerned that she was leaving. Its only for a few days, for God's sake! Pull yourself together, self! I think we were both just aware of the fact that the rest of this week is likely to continue to be rocky, at least until sis's ex leaves. But, she is going to call me tomorrow morning, (M) is aware that (D) will be away and I can always call her during the day, and other than that I'll just have to deal. Anyway, by this afternoon jitteriness had reached phenomenal heights and I was really quite agitated and very disconnected from myself. I still am, things just seem surreal. The problem with that is, when I get disconnected my censor seems to turn off and I end up blurting out things I may otherwise have held back. (D) contends this is a good thing.... I'm not so sure! We back off speaking about "Last Thursday" or really anything too deep, as my brain was just not equipped to handle that right now... its more necessary to focus on keeping a reasonably steady keel in the current crisis. To be honest, I can't remember what we talked about for the most part. A little about how triggering the current dynamics of the house are for me. Some about how offices that don't have personal effects make me nervous, as I tend to use people's "stuff" as another way to assess how safe they were. Apparently in one of the first sessions I had with her, I said something about how she didn't have a plant in the the office, and how it made me think, if she couldn't keep a plant alive, how would she keep me alive. Leap of logic I know, but that's just how my weird little mind works. She caught me looking at the tissue box as well, which this time had a tranquil ocean scene on it. I had mentioned in a previous session how the tissue box (with Dali-type clocks melting down the side, of course designed by some stupid drug company, sleeping meds I think) was somewhat disconcerting. I'm stupid like that. I'll often straighten the tissue box in the middle of a conversation, as its lack of symmetry disturbs me. There is often other things I would like to straighten or correct, but this is the only little concession I allow myself. I think its me exerting as sense of control into the room. I used to do the same thing with DrB's (prev Psych Doc's) window cushions. I couldn't begin a session till they were straightened. Anyway, session went ok, although my agitation was climbing. My sister commented upon picking me up (usually I bus and train home, which gives me time to pull myself together) that I seem to come out of therapy worse than when I go in... which is true, but I think quite normal? I usually fly out of the sessions as fast as I can!! I did mention to her that I was concerned how I would go in her absence, which is a big thing for me, I really hate the idea of depedence...ugh, makes my stomach churn even thinking about it now. But as I left the room, I wished her a nice trip. Unfortunately it came out, sounding to me rather saracstic and petulant, which was not how I meant it.... I was being genuine. I wonder whether she heard the same tone I did. Cringe. Anyhow. Relatively quiet on the home front, some minor flareups but nothing unbearable. I spent the evening manically rearranging and tidying my room. I now haver my art desk, supplies and my photography equipment all togther and straightened up. My electronic stuff as well. My goal for this week is to get out and do some photography, which is something I haven't done in a while. I was thinking of heading into the Botanic Gardens to do it, when I have to pick my pills up from the city on Thursday. If I take anything worth posting, I might put it up. So, in summary, doing ok though very jittery and manic-y. As a final note, I will share some song lyrics that keep going through my head at the moment which are actually probably a little appropriate?

You would not believe your eyes

If ten million fireflies
Lit up the world as I fell asleep
Cause they'd fill the open air
And leave tear drops everywhere
You'd think me rude but I would just stand and Stare


I'd like to make myself believe
That planet Earth turns, slowly
It's hard to say that I'd rather stay awake when I'm asleep
Cause everything is never as it seems