Tedium

Tedium: The quality or condition of being tedious; tediousness or boredom.
[Latin taedium, from taedre, to weary.]

Therapy was ok today. Unsuprisingly, some of the content focussed around the conversation we had about Borderline Personality last session, and the feelings this aroused. We spoke a little about the split between the purpose of the Public Mental Health team (my PsychDoc and Case Manager) and her, my private therapist. She purported that there should be no split, and anything that was impacting on me re: Public Health, was important to consider in therapy as well. More specifically, I had stated that I wasn't really all that interested in discussing the Borderline diagnosis with her, as I didn't feel that it impacted in anyway on the therapeutic process... PH was the place where diagnosis, medication and day to day coping skills were paramount, and therapy was more for understanding the motivations behind behaviours. I kind of felt like we were wasting time talking about it.

As the conversation continued, evidently I let out a rather large sigh. Cue thera-speak... "I wonder what is going on for you right now, behind that sigh?" (Sidenote: Why can't they just talk normally? How often do you say to the average person "I wonder why you chose this movie"? Just ask directly...I can take it, and its a little less irritating) Anyway, I told her that I was just feeling a bit fed-up. Not with her particularly, just with therapy in general. Walking into the room three times a week, and talking about things that more often than not recently, feel pretty unimportant. It felt tedious, and I didn't particularly, in that moment want to be there.

This resulted in an examination of what tedium was, was it felt like and when I had felt  it before... a conversation that in itself felt pretty tedious.

The thing is... I don't feel like it is that important to look at in any great depth. For any human there comes times whether it be in relationships or work, where the act of doing the same or similar thing over an over again created a tedious feeling. It's natural, but it passes. Something will happen, that will break the monotony and spark a new engagement. In therapy, sometimes it is just the tedious task of poking around and hitting all the boring, non-painful areas for a while, until you hit a raw spot... and then the tedium breaks and there is room for growth or new insights. The only time I think the feeling of tedium is particulalry worriesome is if it persists and nothing sparks that break, or if you react to the tedium in a maladaptive way ie. this therapy is boring and wearisome in this exact moment, so I'm going to quit and never come back.

Sure the feeling is certainly a signpost in the therapeutic space that we're a bit off track, but if we keep pushing on eventually we'll get back on track again. IMO. Not a big deal. But everything must be examined within an inch of its life, whether important or not... so we'll be continuing this conversation in therapy tomorrow, no doubt, as we ran out of time today.

Re-reading this post it has a slightly snarky quality... but you know, I'm just a bit fed up. It will pass.

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

Hurt and confused

So. It rears its head again. Borderline Personality Disorder. I was at an appointment with my GP on Tuesday, and we were looking for the latest letter from the PsychDoc. My GPs computer is set up so that the patient can actually see information as it is pulled up. I don't know why, and I'm kind of wishing now that it didn't. Anyway, she pulled a letter that turned out to be from last year when I was with BabyPsychDoc Douchebag, rather than the lovely Dr F that I see at the clinic now. And the top line stated (I'm not sure of it verbatim) basically that patient has diagnosis of PTSD and Borderline Personality Disorder (although patient has expressed discontent over the latter diagnosis). Sigh. Patient did not express 'discontent', patient was never actually formerly given the diagnosis, tested for the diagnosis or had it explained in any way. Patient only found out about the diagnosis attached to her name when she saw it in the hospital records whilst in a neurologist appointment. Patient tried to (rather calmly and rationally, I may add) ask for confirmation and justification of this new added diagnosis, only to be met with noone who would actually admit to being the one to put said diagnosis in her file!

That was last September. Although it pissed me off, I let it go, because a) it didn't seem to be impacting in anyway on my course of treatment (as stated before BabyPsychDoc at the time was a complete and utter douchbag for many reasons, a classic line of his was "you seem to be doing better, but its always hard to tell with 'you people' WTF? But I was changed to seeing the Consultant Psych, until the new registrar replaced him,  and she is really quite good) and b)to confront it to aggressively would be to affrim the stereotypes that surround the diagnosis...we wouldn't want a female patient who is actually proactive about her mental health treatment and advocates for herself now would we?

This time, I was pissed and I wanted to do something about it. First, this is now outside of hospital records and in my general medical records which follow me forever, having a chronic medical condition, I need to keep my medical records intact, and although current GP is lovely and it doesn't affect the way she treats me at all, there are others in the medical field who will stigmatise based on this diagnosis...thats just the sad truth of it. If I'm ever in a court case (God knows for what?) it can be supnoead (sp?) If I wanted to adopt etc etc...none of these are issues at the moment, but when you are thinking of something that follows you FOREVER. Second, it creates a distrust in the mental health system I'm supposed to derive support from. It is blatent dishonesty. What other diagnosis would it be acceptable to just sneak into somebody's records and NEVER discuss it with them. How am I supposed to trust what they say with such a fundamental omission in play. This is how it should be. Clinician sees signs and symptoms of a particular disorder, they test their hypothesis against the DSM and through testing. (I've never undergone any of the accepted tests for Borderline diagnosis ie Perry Borderline Personality Disorder Scale) and once they are supported in their diagnosis, they then (here's the important part) sit down with the patient, share their findings and opinions, explain the diagnosis and share the current treatment plan.

I'm not saying that I flat out refuse to accept such a diagnosis. I have issues with the diagnosis itself on conceptual grounds. 5 out of 9 criterion to meet the Disorder. Two people can share 1 symptom and be diagnosed with the same disorder. Statistically there are over 2000 variations of criterion combination that could justify a diagnosis. It just seems to be a very broad brushstroke to me. And any diagnosis that has a 75% female, 25% male split certainly has to be examined in the light of sociological context. That is, behaviour accepted as normal for men, being pathologised in females. Takes us right back to Ancient Greek times when women were thought to suffer from "wandering wombs". It is not at all a far reach to say the broadness of this diagnosis has led to it being used as a wastebin for "difficult" female patient who have the audacity not to respond to the righteous treatment of hubristic practioners, because of course it could not be that their treatment is actually inadequate. And the stigma that comes from such a diagnosis just serves to marginalise and suppress a population that quite often has already had a lengthy history of marginalisation and mistreatment, and should be treated with empathy and understanding. Does Borderline Personality Disorder exist? Most certainly. And it can debilitating for those who do classically fit the criteria. I read some fantastic blogs from people who have accepted this diagnosis, and find it to be helpful in explaining why they see and engage in the world the way they do. Does it automatically apply to anyone with an XX chromosome that self harms? According to the DSM it shouldn't..... but in reality it does.

So, jumping off my soapbox now. Because this is about me. Does it apply to me? My gut says no. After extensive reading, my mind says no. But I am reasonable and open to hearing the professionals opinions. If I can get them to talk to me. I spoke to my Case Manager (another lovely lady) this morning during our appointment and told her what I had seen, and let her know that I was going to bring it up at my appointment with Dr F on Tuesday, that I just wanted to get all of it out in the open, rather than it being dealt with in an underhanded way. I have no idea if it is the enduring opinion of the professionals or just the work of Dr Douchebag. I was just letting her know in case she wanted to be at the appointment, as she has been my Case Manager since the time of Dr Douchebag when this letter was written. She was quite supportive about it, without ever actually saying whether or not she agreed with the diagnosis. She is a psychologist and they can't actually diagnose here in Australia, and really I guess its probably not her place to speak for the team. I think she understood my frustration about the manner in which it was handled, although she did express how incredibly difficult it is to get something like that removed from one's record. I think she still felt it was important for me to find out once and for all, and to feel like there was a transparency in my treatment and not a me versus them thing going on. She also said that if it were her, given the implicit stigmas that can be attached to this particualr diagnosis she would want to ensure that it was thoroughly assessed and valid before it was attached to her file. So all in all, a positive response, and I am sure it will be the same with Dr F. Not necessarily that they will agree with me, but that they will at least be open and honest with me about it... and that's all I ask.

But then.

I went to therapy. (D) is a private psychologist, with no link to the public system. She asked what had been going on over the last few days, and I let her know, about my talk with (M) and the upcoming appointment with Dr F. Now, keep in mind, I didn't actually ask her whether she thought I had this disorder. Why? Well, first because she has stated before that she feels that there is overly too much emphasis on labels and that it takes away from the ability to truly 'see' the person. And second, because I didn't want to know. Seems a bit hypocritical, no? I want full disclosure from the Public Health professionals, but I don't want to know what my therapist thinks? And maybe it is. But her opinion is NOT written down in my records, she cannot officially diagnose me, so her opinion can't hurt me in that sense. But it can sure as hell hurt me in a more practical sense. Unfortunately, I guess by bringing up the conversation she assumed I wanted to know her opinion, and I did nothing to dissuade her from that assumption. Totally my fault. Well, 99% my fault. So she proceeded to give me her take. First, labels tend to be more of a distraction from seeing and understanding the person (see I do know her!), second that she has issues with Borderline Personality as a disorder, for similar reasons to what I mentioned above. But that she does believe that people can suffer from (and I'm paraphrasing) a disorder of their sense of self... I do love how she believes that semiotics make much of a difference at all. And apparantly, a good part of her studies, she focussed on Borderline Personality (a disorder she has issues with, so I'm a little confused) And she does think that some of the criterion I don't think I fulfill, I actually kind of do. For instance, abandoment issues. I certainly don't display the traditionally thought of "Borderline" behaviours around it... ie lack of Object Constancy etc... but that you can't have the experiences I did in infancy and childhood, and not have abandonment issues. She admitted she couldn't quote the DSM verbatim, and would have to have a look at it, and would be happy to bring it in and go through it with me. At this point, I had gotten pretty quiet.... and yes, a little hurt and upset. I told her that I didn't want her to bring it in, and in fact, I hadn't asked her opinion. At which point she stated "I'm a little confused", to which I replied "Me too".

So that's the sum of it. I think I would have been better not knowing her opinion. And now I'm kind of stuck between not wanting to know anymore and needing her to actually explain her position because I don't know if she thinks I have it or not, and now its the elephant in the room. And yeah, my feelings got hurt. But I also have to buck up and be prepared to face the truth, whatever that is, and part of that is being prepared to listen to others opinions. So i think I need to hear her out in full, and of course (M) and Dr F as well, and then test those opinions against my own. Afterall, logically, living with a mental illness, whatever it may be, can distort ones own perceptions and insight. It doesn't mean I have to just unreservedly accept others opionions, but, if they've shown themselves to be trustworthy, and they have taken the time to know me, and try to understand me, which all three of these women have, then I should at least listen.

So, for now, I'm left hurt and confused

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

I've been thinking....

I have quite a few blogs that I read through Google reader. Some are other "mentals", some are more information based sites, humor sites etc etc. I love flipping open my laptop to see what awaits me in my Google reader each day, and there are a few blogs I get quite excited about when I see a new post in my tool bar. The blogs I read give me a number of different things... laughs, a feeling of "i'm not alone" and "oh, you too?", some inspire, some fill me with awe.... and recently, one in particular has been invoking a sense of "what the?"

Of course, its kind of a given in the Blogosphere that people write their own reality and sometimes that doesn't match up with ... let's say, reality reality. And people may tweak parts of their persona they are not happy with or are ashamed of. But what I really don't get are the people who out and out lie.

Especially about mental illness. Like its a badge of honor. A contest to see who can appear to be the most screwed up. Who has the absolute worst life. Newsflash. Mentalism is nothing to be ashamed of... but its certainly not a bowl of cherries, either. And why put so much effort into fabricating such an elaborate lie. Especially since, like most lies, it becomes more and more transparant as time grows on.

Certainly I tend to suspend my disbelief for the most part. Its a messed up world, and people certainly have unique histories and experiences, that I can barely fathom... but that doesn't make them any less real. This is the first time that my BS-meter has just sounded such loud alarms that I can no longer ignore the discomfort I feel reading this blog. I approach each knew post with a sense of trepidation and "what now?". I leave feeling insulted and patronised that this individual expects me to swallow the bollocks they are posting.

I guess its not restricted to the internetz. I have found myself simarly discombobulated when meeting people on the psych ward. ON THE PSYCH WARD! Why the hell would you take the charade of mental illness to the extent that you get yourself admitted, indeed actively seek admission, to a psych ward? It boggles my mind. But there have certainly been situations when I know, the other patients know, hell, the staff even knows these 'patients' are full of crap. Other patients certainly seem to be better than the staff at assessing who the 'fakers' are. But a person says the magic words "I'm suicidal" or "I hear voices", and they have to admit them. The first time at least. And for sure, often we can put on the most fabulous of fronts despite how crappy we feel. Certainly often the safety of the ward and the acceptance of the patient milleau is therapeutic and leads to positive lifts in the mood and symptoms of an individual. But don't tell me that you are barely sleeping at all because of your mania, when I walk past your room every night to hear your snores reverbrating down the corridor. When you miss every single breakfast because you are sleeping in. When you spend two hours talking perfectly normally and fluently to me, only to put on rapid speech and attempt to model disordered thoughts when a nurse sits and talks to you. You aren't that good an actress.

Why does it bother me? I mean really it doesn't affect me in the slightest. Well, it is somebody who is draining already limited resources and directing them away from people that need them, I guess. But I also guess that even if these people don't have the mental illnesses they claim to have, there is certainly something going on there to require such (and God, I hate this phrase, but I can't think of another) attention-seeking behaviour!  And, for sure, I would rather a bunch of people who don't need the help recieve it, than one person who really does need it get pigeon holed with the attention seeking label and not get the help they need. But that's part of the problem. These people with their foolishness, create such an atmosphere of skeptacism and mistrust between mentals and the MH professionals, that people in need do fall through the crack. So many of you in the blogosphere are examples of this. The cynacism and unhelpfulness of those whose jobs it is to help. But I can imagine being taken for a ride over and over again, it must eventually wear down even the most caring of professionals!

Sigh. I don't know. Really, I just need to learn to let it slide off and not bug me so much. As much as it feels incredibly insulting.. its not directed at me. And in the end, I don't have to read it, I don't have to listen. So I won't. I've deleted this particular blog and their caricaturised, overdramatic, histrionic postings from my reader. Maybe I'm wrong about them... but me not reading won't hurt them any, and it will make me feel better.

How do you guys deal with people (on the internet or real life) who set your BS alarm into overdrive with their "mentalism?" Not the people who just misuse the terms 'depression' and 'anxiety' but those who seem to actively construct lies and grossly exaggerate and fabricate?

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

Attacked by a Ninja Nap

I got attacked by a Ninja nap this afternoon. Has a bit of a rough night sleeping-wise last night and then I had to be up quite early for Neuro this morning, so when I got home I had a bit of a rest that ended up being a four hour sleep. Ooops! Napping during the day is not something I can usually do, so it was lovely.

Neuro appointment was quite uneventful really. Tests came back proving her hunch that the type of epilepsy I have is Juvenile Myoclonic Epilepsy. Sigh. Juvenile! I am 27 years old! lol. Basically all this means is that I have a combination of myoclonic and tonic clonic seizures, best treated with Epilim (Depakote for those across the pond) which is what I'm already on. She gave me leeway to increase my dose by 500-1000mg a day during times when I am not sleeping etc, which gives me a bit more flexability to manage my own medications. She siad unless I have a significant amount of seizures I don't need to go back for 6 months. But that I am likely to have the odd one. And I will have it, and be on medication for it for the rest of my life.

I stopped by the Pathology offices on the way home, and got the blood work I needed done, and booked in my next appointment with my GP, so a throroughly medical day...blah!

When I got home, I rang up Case Manager (M) to check as to whether she has had chicken pox or not. Alas! She has not, so we changed our face to face meeting on friday to a phone meeting, until time shows whether I am going to come out in spots. Sigh. I also got her to check with PsychDoc (cos I'm responsible like that! :P) whether I could take an increased amount of Serepax tomorrow morning before I go for the ultrasound, to help deal with the inevitable anxiety. Dr F was not in the office, so she asked Dr S the consultant. The male consultant. Embarrassment much? Anyhow. He has approved up to 22.4mg rather than the 7.5mg I would normally take, so hopefully that should help take the edge off. My friend (S) is going to pick me up at 7.50am and take me there, so I'm not wandering around the greater pulic transport system in a drug induced haze. Hopefully I will be able to get a few hours kip between that and my therapy appointment in the afternoon. And then its gleeathon sleepover with the girls. Yea! (M) and Dr S are both pretty pleased with how well I'm going. (M) of course bubbling over with delight in her usual Pollyanna-ish way! I've had to call her twice this week, but both times for housekeeping rather than crisis, much to her delight.

Ok. I'm off to think about tidying the house before the girls rock up tomorrow
Peace and love
xOphelia

Unchartered Territory

I'm still....happy.... Go figure? And I am enjoying it, whether it heralds the beginning of a new frame of mind, or is merely a hiatus from my normal messed up self.

I'm enjoying relaxing without the threat of impending doom that usually follows me around like a little dark cloud. I am definately enjoying sleeping. 8 hours a night? How decadant! How luxurious a sleep life do you normal people have! It's awesome. I'm enjoying the energy and motivation I am finding I have now that it is not all directed into more nefarious activities like ruminating, worrying and plotting my untimely demise.

I'm not sure that my therapist quite knows what to do with a happy Ophelia. :)

It certainly does pose somewhat of a conundrum for us.

Why? Well, may you ask! Happy would seem to be something that she would encourage. And indeed she does. She has stated categorically that she wants to celebrate and enjoy this newly acquired harmony with me. But..........now that I am not floundering around like a fish on a deck gasping for air, it would also seem to be a good time to attack some of the harder 'therapy stuff', no? Now that I have a bit of balance and stable ground beneath me it would seem to be a good time, I can handle it better. But...... we also don't want to ruin this good place I'm in by miring me in that bog of horribleness. So its a hard line to toe.

My first reaction was one of "Lady! Why do you wanna go blow my mojo like that?". I'm feeling good. Why would you wanna mess with that. But, in all fairness, my argument before has definately been that I was in too bad a place to explore this stuff. So, I can't have it both ways, can I?

Well, we'll take it slowly and see how it all pans out I guess.

In other news, handover with Case Managers went well. (M) said she was going to keep (A) in the loop so I have back up at the clinic should she go away again, which is good. All in all, I think she was quite pleased with how I'm doing at the moment, so I'll catch up with her again in a fortnight. I also got lots of kudos for finishing my prac despite the difficulties, which of course made me squirm, as a) I don't really do well with praise and b) although I got good evaluations, I really don't feel in myself that I did that well. Ah, well, bygones!

And finally, I have a little cash in hand work coming up over the next fortnight, babysitting for a family over the school holidays. They're great kids and very easy to sit for. So far I've planned a few outings to activities the council is putting on, I have dug out a receipe for Ginger bread men, and I've grabbed a few craft things I had stored away... some jewellery making, oragami and clay. So, I think we're going to have a lot of fun! (Last holidays we made a volcano and I taught them how to make balloon animals, so some high expectations to fill! lol) And with the money I earn, I should be able to pay for the dentist to pull out the tooth that I broke....owies. So that's life at the moment. Weekend will consist of sleep, vegging out and consuming copious amounts of food that's bad for me, followed by my first shift back at RMH, which I am looking forward to!

Have a great weekend everyone!

Peace and Love
xOphelia

Ch..ch..ch.. changes!

Well, I'm not in the trees anymore. Feet are planted firmly on the ground and the gremlins firmly back in my head. Today's and yesterday's session with therapist (D) have been horrible. I spent most of today's session in silence, unable to speak. Most of yesterdays as well. I was angry and anxious and scared all rolled up into a silent seething ball, with voices inside my head screaming, and (D)'s voice quietly across the room trying to break through it all. I'm not sure what exactly is going on. The topic of intimacy and trust came up yesterday, which was certainly a trigger. And there is a lot of changes going on at the moment (well, a lot for someone like me who hanles change pretty damn poorly) (D) is moving her offices to a different suburb next week (hence her week off) Today I said goodbye to Case Manager (M) who is on leave for two months (which was a lot harder than I thought it would be) New Temporary Case Manager (A) will drop by for our first meeting alone on Thursday morning. I have to find a school to do my uni prac requirement next month in, which requires a lot of cold calling and talking to strangers. I'm just feeling a little overwhelmed. Sleep is shite. House looks like a bomb hit it after the visitors on the weekend, and I haven't the energy to do anything about it yet. Money has me grinding my teeth is fear and frustration as I try to figure out how I'm going to pay all this months bills, and beat myself over the head for not being able to go and work a full time job like a normal person. Feeling useless and helpless and pathetic. Things just feel a bit out of control at the moment. And of course, feeling out of control for me, starts pushing the self harm and suicidal ideation buttons. I haven't acted on them, have been utilising my WRAP plan, (besides I am still  on weekly only dispensation of medications because I obviously can't be trusted. No sarcasms there... I can't.) As the kids book says "I can't go under it, can't go over it...I'll have to go through it!"
                                                                                  

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.

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

Frocks and Fascinators

Therapy on Tuesday continued much in the same vein as Monday. The anger, the rage. We went back and tried to pinpoint exactly when the feeling started to overwhelm me, and concluded that in some ways it did come down to me feeling judged, and inadequate. But also, because I know inherently, it is not D's natural inclination to judge, the fear that arises from the vunerability and exposure of being with somebody who will regard me with unconditional positivity makes the "voice" very angry. D asked whether she could be privy to the conversation going on in my head between the "voice" and I, and I replied no. No from the voice, and no from me. She asked if I was trying to protect her or me? Both really. The "Voice" is a manifestation of a part of me I'm not too proud of, and it thinks some very nasty things about her (from my perspective). And the "Voice's" job is to keep my guard up and protect me from anyone who might hurt me, so he doesn't want her to be privvy to ANY information (from his perspective). It creates quite a quandry. She said quite firmly that if she could not be privvy to the conversation, then the "Voice" was going to have to quieten down so she and I could have one. (Is very strange to have somebody else see the "Voice" the same way as I do... intrinsically a part of me, yet distinctally individual of me) Well, of course that got the "Voice" quite het up... and sent me into a bit of a dissociative state, or at least deeply internalised and unable to deal with outside factors ie her. I actually don't really remember getting home.... about 4 hours I can't really account for which is incredibly scary, but has happened before, in extreme stressed out states.  Unfortunately due to Easter Long weekend, and a missed session tomorrow (only time I could get into Dentisit) I won't be seeing her for a week, which is the longest in between session break we have had, outside of time spent in hospital. She will be phone contactable and encouraged me to ring, but I am heading back to small rural town to spend time with family for the long weekend and phone reception is quite dodgy.


Had group this morning, which is going pretty well. Haven't said much about it on this blog because really, it is a collective experience and thus confidentiality does come into it, but aside from the first session (when I was quite mentally unwell to begin with) I have actually quite enjoyed it and gotten some positive effects out of it. Even if it is just a collection of "Ah, I thought it was just me that.....etc etc". And just the effect of having to get out of the house one more day per week has been positive. Will be quite sad when it is over to be honest.

As I said, Home for the long weekend. Off to the country races, so I found a fascinator to go with my frock today, now I just have to find shoes... I really hate high heels, but its a frock so....hmmmm

Down to the lowest dose of Avanza now, change to effexor tomorrow. Haven't noticed it soo much with the mood, but physically, have a pretty bad case of the shakes etc. Hope this attempt turns out better than the last try

Looking forward to Sunday, when all the chocolate comes!

Big Girls Don't Cry

My cat just knocked over a whole bunch of photo frames and then had the nerve to look at me with disdain, because the noise made her jump....

So, I'm sitting here with my warm cup of milo, starting my bedtime wind down. I have some Sia playing softly in the background, which I will soon switch over to the special "sleep" CD that (D) gave me. The house has been tidied away. Bed time routine has been completed. The world is quiet. except for my head. But its never really quiet in there. And I have been reflecting on the day.

I got up quite early and got a fair amount of work done in the garden, another bed weeded, the rockery cleared away and some lavender planted. I really hope it takes, I love the smell of lavender and it is quite close to where I usually sit outside. (M) arrived for our Case Management meeting at 9am, and was, I think, pleasantly suprised to see me out and about in the garden. She did that uber, over the top type praise, that reeks of behaviour modification. Positive attention for positive behaviours and all that. But in essence, it is right. It is good for me to be out in the fresh air, and getting busy, particularly if it is physical. (Although all that digging doesn't seem to have helped with the sleep at all...sigh) We spoke about what my options were if I decided not to go ahead with Uni this semester (that's a whole different post!) And then she dropped her bombshell. In less than three weeks she will be going on leave for two months. Which means a new Case Manager for me in the interim. While I tried to focus on not over reacting and losing my shit (the girl does deserve a holiday afterall!) she talked about how I still had (D) and (K) Consumer Advocate, and that the New BabyPsychDoc and I seem to be developing somewhat of a rapport. But, ugh, a new person. I just don't handle that sort of stuff very well. It will be a challenge. And whilst the maladapted part of me is feeling just a wee bit abandoned, it is a good opportunity really for me to start using some of the interpersonal skills I'm supposed to be developing.

Of course then my mind (and the gremlins) went a lil crazy and started to worry (D) was going to up and leave. (Coincidentally, she is scheduled a few days of leave the same week that (M) starts her leave, which is unfortunate timing, but will be phone contactable). So by the time I got to appointment with (D) in the afternoon, I was quietly despondant.We talked of course about attachement, dependency and mature dependency, We talked about how little I had actually shared about my past with any of the MH professionals. I mean, they know I was abused as a child. That's about the sum of it. They really have no real idea of what I went through. And according to (D) anyways it rates up there on the severe end... I was overcome with an overwhelming sadness. Tears silently making there way down my face as I drifted away from (D). When she called me back to her, and I realised I'd been crying, I was mortified. I don't "do" crying in front of people. Maybe was a good thing, in the end? I don't know.

Just feeling a bit sad, confused and abandoned tonight.

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....

Subsidies and rebates. Oh My! Oh My!

For too long accessible mental health care has been the under resourced, little brother of the medical world. Depressing clincs hidden in spaces, deemed no longer suitable for other purposes. That 'look' you get from the taxi driver when you give them the address, that you are "one of those people". Walking through a building that is on the verge of giving up, just as many of the souls who enter as patients (I hate the term clients) are.

The care afforded through the Public System, is by necessity, crisis driven. Case workers are overworked, wards are understaffed, bed shortages run amuck. Early intervention into the beginning signs of mental illness is left to poorly equipped GPs. Crisis Care is like a conveyor belt of tick the boxes and process the "crazy" through and out ot the system as quickly as humanly possible. The post crisis interventions as a whole can smack of the "bandaid" approach.

Overloaded caseworkers are unable to give due attention to the long-term needs of their clients. Shortages mean that mental health practitioners refuse to carry out early intervention until the person is ‘acutely’ unwell, leading to forceful intervention. Thus, patients are not kept well, risks are not minimised and disorders are not averted when they ostensibly could be...

Even in times of crisis, anecdotal evidence suggests that patients are not admitted or are discharged early due to an inability to access an available inpatient bed. Reduced access to care has been linked to higher rates of post-discharge suicide

http://www.hrdc.net/sahrdc/hrfeatures/HRF132.htm

Of course this is not just mental health. Public Healthcare all over Australia is suffering economic and staffing shortages. But Mental Health is an area where it is really easy to cut corners, because the ones who access it are less likely to be able to advocate for themselves.

A few years ago, the Government finally caught onto the idea that the average citizen is as entitled to subsidised mental health care visits, as they have been to visits to GPs, Optometrists ect. Well, kinda... I will use myself as an example: If I was to develop a chest infection and need antibiotics, I would book into my GP. Pay their fee (AUD$65 for short consult) and then claim my Medicare rebate (about AUD$38). So, I pay the $17 gap for the visit.  Now I can do this as often as I need. With me, it is at least once a month to get my scripts filled and blood levels on my epilepsy meds checked. Under the new mental health scheme, I could go to my GP with a mental health issue (in my case PTSD) and she would write up a mental health plan and refer me to a Psychologist for Medicare subsidised treatments. (Pay AUD$130, Rebate AUD$115) The catch is, it can only be for 12 sessions (18 in extremis), which averages at about one a month. now in a soild block, that might be helpful for say a CBT approach, or even short term psychodynamic therapy. but for people like me? Not so much.  Annoyingly, If I was seeing a psychiatrist, who would just want to shove pills down my throat, that would be covered for infinite amounts of sessions under Medicare.

So, the system is kind of better for me then it was, but still not ultra helpful. My private health insurance  would assure you that they take mental health very seriously in their plan. They cover a whole.....6 sessions. Grrrrrrrrrrreat! So, thats 24 sessions covered in all, not even one a fortnight. And when you take someone like me, who has to go 2-3 times per week, well that's a heall of a shortfall I have to cover. Luckily, I have a therapist who works on a sliding scale. But let me tell you, it's still bleeding me dry.

I don't expect that EVERYTHING should be covered, and people should have no responsability for their own healthcare costs. But there has to be a balance. And  something as important as mental health, should be judged just as importantly as cardiac care. IT KILLS TOO.

Which is why it makes me really mad to read about them considering whether the Medicare Subsidy for Psychology should stay. The fact that it is costing more than projected should be telling the powers that be, that there is a serious shortfall in 'other' mental health services. It should be, in my opinion, expanded, not scrapped. Of course, there has to be limits. That's why the GP's have to do a thorough psych evaluation and you have to meet certain criteria to qualify.

http://www.theaustralian.com.au/news/nation/psychologists-quit-in-row-over-standards/story-e6frg6nf-1225839771023?referrer=email&source=AusBus_Morn_email_nl&emcmp=AusBusMorn&emchn=Newsletter&emlist=Member

*Ahem* Stepping off my soap box for the day

On the ward and out of my mind- My Keepers

For previous "On the ward posts" refer to here, here, here, here, here and here.

Well, it would appear Ophelia, that you are a naughty, naughty girl danger to yourself, and we, in our infinite wisdom have decided to provide one-on one nursing for you to spy on you, and take notes about every meaningless comment and insignificant action keep you company and ensure your safety.

Really, I am being quite unfair. I have only been put on constants once before in my 'mental career' and that was because I had to be on a medical ward, and they were worried about me being around all the shiney, sharp tools. This time, they quite fairly were concerned that while their back was turned I would do myself in, or at least leg it, and then do myself in. So I was put on Special Obs. To be kept within a couple of feet of my nurse for that hour at all times. Or as the nurses put it, in their ever so tactful way, to be babysat.

I'm in two minds over whether this was a great trial for the nurses to endure. It did mean one less nurse on the floor every hour. But each nurse was allocated an hour per shift with me, perhaps two at a stretch. I am told for the first few days I was pretty uncommunicative, so not a heck of a lot of fun. But with the invention of I-Phones the nurses found ways to pass the time. After a while my witty reparte returned, and I am sure I was a wonderful "constant patient". Well, I didn't abuse them, try to attack them, hurl obscenities or anything like that, so they should just be grateful! :P

There were four main reasons being on constants probably sucked for them:
1. They couldn't hide in the staff room "charting"
2. They had to accompany me to the bathrrom
3. They had to sit in an uncomfortable hospital issue chair, while I snoozed away in luxury.
4. I was up and down like a yo yo for ciggies, and as my shadows, so were they! he he.

The four reasons being on constants probably rocked for them:
1. Alarm bell: Sorry can't help I'm on constant
2. Needy patient wanting something. Sorry can't help i'm on constant
3. Code Brown: Sorry can't help I'm on constant
4. Paperwork not complete? Sorry was on a constant.

The four reasons constants sucked for me
1. No privacy. With phone calls, with visitors.
2. Nothing more annoying than someone sticking to you like a barnacle when you just want to be left the f*ck alone
3. The bathroom thing. OMG.
4.Constantly being asked, so "Do you know why you've been sectioned? Placed on constants? How do you feel right now? Blah blah blah.

The four things that rocked about constants for me.
1. Never having to wait for half an hour outside the nurses station for your nurse to actually get off her butt.
2. Always having someone to check the answers to the crossword with
3. Prevents family from having D and M conversations when you are totally not up to it.
4. Honestly, had some shit nurses, ok ones and a few really good ones. The good ones helped me to really process what was going on in my mind as it was happening. provide reassurance in a frightening time. Provide hope in a time of chaos and feeling out of control.

In a perfect world. Nurse caseloads would be a lot less. Paper work would be limited. And then maybe some patients could get the quality of care I recieved in that time. (Minus the "special time" in the bathroom together)

Locked up

Voluntary. It means a totally different thing to mental health professionals than it does to the laymen. You believe that if you sign yourself in to a psych ward voluntarily, you have the ability to leave. What it actually can mean is, you are voluntary until such time as you don't want to be here, and then we will section you under the mental health act, and make you an involuntary patient.

I'm not complaining. I was treated well. It was probably the right thing for me therapeutically at the time, however much it pissed me off. But... its kind of laughable right? Voluntary

The end of last week is all a bit hazy. Here is what I do know. I took a whole lot of benzos. Drank a whole lot of vodka. Apparently, I wrote, a couple of goodbye sweet world notes. I rang my therapist (D) to cancel our appointment. She was concerned enough that she insisted I either call an ambulance or my Case manager to take me to hospital. I did. At some point I then decided, I didn't want to go to hospital, and began filling the bath tub before they could come. I guess they arrived before I put that drug addled plan into play.

When I woke in hospital, they told me I was being taken to the psych ward, and could change make into my civillian clothes. Unfortunately, they had been cut through. Turns out instead of transporting me by car as originally planned, an ambulance had to be called as my heart rate went (paradoxically) through the roof, instead of through the floor as it should have with the benzos. They're still not sure why.

Upon installment in psych ward, I decided to finish off what I started and tried to asphixiate myself with a plastic bag and cord. At this point I was 'specialled'...which basically means one to one nursing at all times, (Yup! Including bathrooms) And sectioned as a 'risk to myself' and an involuntary patient under the mental  health act.

The world was topsy turvy. On one hand, I truly wanted it all to end, and I continue to fail to see how things can improve, and on the other nature wins out and wants to protect our survival. I am beaten and bruised emotionally and not really up for a big post, but will try again tomorrow.

My family has finally come to realise that they need to drop their expectations. For the moment. I cannot be the golden child. I am fighting just to keep my head above water, I cannot carry their hopes too.

This week, if nothing else, was a wake up call. Things have to change. I cannot survive if they continue the way they are.

Thank you for all your kind wishes and support. Hopefully Ophelia will be 'back in the building' soon/ Love and peace.

Containment

Today was my first additional session. I'll now be seeing (D) on Tuesdays as well as Mondays and Thursdays. I'm still not 100% sure on the third session schizzle, but it has already begun to show some positives, I think. (D) explained to me, that she often doesn't know how hard to push me, because the minute that the conversation turns to uncomfortable topics, I will say I don't want to talk about it right now. But I'll also say that about things that I truly am not ready to talk about at all, and that may very well cause a meltdown. Quite snarkily, I asked her what conclusion she reached, and she replied that she thinks its probably best to push me. As much as I hate it, she is probably right. I think that is partially why progress has stalled, because she lets me get out of talking about a lot of stuff I should be talking about. So yesterday and today, she would not let me deflect or change the topic. And yes, it was horribly uncomfortable and somewhat upsetting at times, but, because I knew it would only be a day or two at most before I would see her again, I was able to leave those feelings somewhat in therapy, rather than take them with me. So, yeah, "Containment 2010", is working...sigh

Tomorrow, I am catching up with Consumer Advocate (K) for coffee, and then back to therapy on Thursday, so the week is pretty structured. My friend (S) has been coming around a fair bit too, just to watch TV or eat dinner after work, because she knows that I need a little bit of company at the moment to stop me from withdrawing back inside.

Next week the Uni Semester starts up again, and I'm once again enrolled in two subjects. One is a prac subject (5 weeks of teaching). At this point I am unsure whether I will be able to make it through 5 weeks of full time work (more actually if you count the huge amounts of prep work) The Disability Officer at the Uni is trying to negotiate so that I can have one day off in the middle of each week, and just do an additional week at the end. But the faculty is resisting. Will just have to see how it goes. Still pulling together the necessary paperwork to get the uncompleted subjects from last semester dropped without academic or financial penalty. Is quite the process!

In that mode, have been trying to get a hold of Case Manager (M) since the end of last week, to get some paperwork from the psychiatrist for my claim at the uni. Finally got a call this afternoon, and as I understand it she had been out of the centre for most of the afternoon, and it was quite close to leaving time, but felt somewhat brushed off. I'm probably being unreasonable, and I know in part, I am overly sensitive to picking up "signs" that people are obviously sick of having to deal with me, pissed off with me etc. I tend to find problems where there aren't any. And realistically, she knows I am seeing (D) three times a week, and thus fairly well taken care of. It doesn't even matter really that it has taken her a while to get back to me, on a few occasion over the last few weeks because essentially my questions have either been "household stuff" like letters or scripts, or else, I have figured out ways to deal with whatever little emotional blow-out I am having myself. And I never specify my messages as urgent, because I don't really think there are. It just makes me feel a bit uneasy that if it was urgent, I still might have trouble getting a hold of her. Which is once again, probably unfair, because she has always gotten back to me quickly on urgent matters, and it would be my responsability to make sure it was clear if it was an urgent call. Anyway. Just makes me a little nervous, but I'm being silly.

Got two new appointments in the mail today, one for the Psych in about a fortnight and one for the Neuro at the end of the month.

I'm doing ok-ish at the moment. Starting to make tiny moves into going back into the world, I hope it lasts a bit longer this time!