Taking Time to Listen

Life has thrown up some challenges over the last few weeks, which have caused me to slide from an overall good patch into a ‘feeling-very-anxious-and-struggling-with-various-physical-symptoms’ phase.

The physical condition I have been diagnosed with is caused by stress and anxiety, and one medication which is used to treat it is the medication I was taking regularly in Switzerland. but which I had to stop taking shortly after I moved here. I started noticing the physical symptoms which eventually sent me to the doctor shortly after I came off my regular dose.

I’ve been struggling with how and when I can take my PRN of this anti-anxiety medication. Although I’ve had moments when I feel I really, really need it, I haven’t been taking it… because I’m scared that if I take it once, I won’t stop taking it.

So this morning found me at the doctors. Ostensibly, I was there to get the results of some blood tests. Inside, I was hoping and praying I could talk about some of the things which are bothering me.

Some of the doctors at my surgery are very much ‘you-have-a-ten-minute-appointment-to-deal-with-one-issue’… so much so that they will remind you of this at the start of your appointment. I was hoping the doctor I was seeing today would not fall into that category.

She was wonderful. She let me talk, and it all came out in a random mass of symptoms and fears and questions and concerns…

We couldn’t find many solutions. But it helped to talk. To talk through the things that are an issue, and why they are an issue, and why it’s not a situation I can easily leave.

She has also done what no-one else bothered to do, and taken the time to go through exactly why they took me off that medication… and to reassure me that I can still take my PRN, and that it is up to the medical staff to monitor my usage, not for me to second-guess it.

I had found information online that suggested that an antidepressant might help with my physical symptoms. She didn’t pooh-pooh this, didn’t tell me off for trying to do her job… but said yes, that could help, but it really needed to be okayed by my psychiatrist. Which is perfectly reasonable.

I’ve now taken a PRN, and although I don’t feel better in myself, I feel listened to, I feel reassured, and I feel hope that there is a way forward through this anxiety.

Doctors, take time to listen. It may well mean the world to your patient. And if, next time, I’m the patient sitting waiting long past my appointment time, I won’t mind… because another time it could be me.

A Welcome Return

For various reasons, I have been unable to go to my voluntary job for several weeks. My anxiety flared up, then my medication was changed and I had problems with feeling very drowsy… and then I was getting anxious at the thought of going back after so long away.

Yesterday, I tried to go in. I got as far as the town centre, but then the anxiety started rising up again and I had to come home.

Today I tried again. I e-mailed my manager to let her know there was a problem, and suggested some adjustments. When I got in, she explained that she couldn’t do exactly what I had suggested, but offered a compromise.

It worked. I took things slowly, started off by having a cup of tea and a doughnut, before starting to pick up the threads of my work.

I stayed for a shorter time than usual, but I got all the way through, and the longer I stayed, the happier I felt.

I am now back at home, so pleased that I made it in, and managed to stay in, and feeling positive about going back again next week.

Little adjustments can make a huge difference. It was a big step to go back, but the fact that I felt listened to and that a small change was made, enabled me to overcome the anxiety.

Thank goodness for supportive environments!

Sharing Recovery

I am participating in a group on building self esteem. The topics are interesting (some more than others), and the peer support leaders do a great job. But for me, the best part of the group are the other participants.

We are all struggling. We are all struggling in different ways, and at times it is hard to grasp why someone else is finding a particular aspect of the session so difficult. But at the end of the day, despite our different labels and difficulties, we have this one thing in common: we are all fish-out-of-water in a mentally healthy world.

We have all been let down – by mental health services, by our co-workers, friends, even our families.

We are all struggling to find our way in this world… to identify a way of being which meets our mental health needs but also fits in with what the rest of humanity require from us.

We are united in our desire to make progress… and in our uncertainty as to if we can do this.

This creates a sense of camaraderie, of fellowship. The three hours we spend together once a week is valuable, not so much for the content or the progress… but for the sharing.

A problem shared is a problem halved, they say, and in finding this little community I have found a space where I have felt able to share my problems… even issues I have never really imagined sharing with anyone before.

Next week is our last session. I am already wondering how I will fill the space.

Caring Support

Yesterday I posted about my struggles with my medication. Of course, this problem had got worse over the weekend. So this morning I was on the phone bright and early to my mental health clinic.

I wasn’t entierly sure I was phoning the right place. I am waiting to see a new psychiatrist, and I wondered if I was going to find myself falling through the cracks.

I got through on my second attempt, and asked to speak to my care coordinator. She rang me back (relatively promptly), and I explained the situation.

She was very sympathetic, and said she would speak to a psychiatrist and ring me back at some point in the afternoon, which she duly did. The psychiatrist had suggested splitting my evening dose of antidepressants in half, and taking half in the morning. This sounded like a good solution (in particular seeing as I haven’t met this psychiatrist yet)… but there was one problem. My stock of 100mg antidepressants are in capsule form, and can’t be cut in half.

So she went off to speak to the psychiatrist again, and rang back to say they would fax a prescription for 50mg tablets to my pharmacy. We discussed the need for me to have a prescription that would ‘last’ until my January appointment, and she promised to discuss that with the psychiatrist and ring me again when everything was sorted.

I feel reassured, by the time taken and the care shown. I may not get a new prescription until Wednesday now… but I feel better for the treatment I have received today.

Medication Woes

For several years, I have been going on fairly happily with the same combination of medications. Not that this has prevented relapses, or even breakdowns, but the mix has helped me to be more stable than I might otherwise have been.

However earlier on this year I moved to a different country. In my new location, one of my medications – ironically, the one which helps me the most – is not usually prescribed for long-term use.

I find this hard to comprehend. Either a medication is dangerous when used long-term, or it is not. How can it be that the best practice on this medication changes depending on your geographical location?

Nevertheless, this is the siutation I find myself in. I did my best to work with my care team to find a solution to this situation which was mutually acceptable.

As a compromise, I stopped taking this medication on a daily basis (to keep my paychiatrist happy), but kept some of this medication in reserve for use on an as-and-when basis (to reassure me).

This isn’t working. My anxiety has slowly increased since I have come off the daily dose. Worse, because I am aware that there are concerns about my regular use of this medication, I hesitate to use it… when I really could use it. So I struggle on when I have acces to something which I know would help me… but which I feel awkward about using.

This can’t continue. I need some clear guidance. Either I can take this medication, or I can’t. And if I can’t, I need an alternative. Because right now, my anxiety is having a draining effect on my ability to live my life.

Most of all, it seems to me, there needs to be clear guidance on medications which is followed by physicians in all countries. A medication change should not be forced by a move.

Annie the Anxiety Butterfly

Yesterday I woke up feeling really anxious. I had had disturbing dreams, running on an all-too-familiar theme. I had been ill, and my illness had prevented me from doing something (in this case studying and doing coursework), and as a result I was going to fail in some way (in this case, my exams). Never mind that my school days are long behind me, in my dream it was a very real and present danger, and I woke up feeling sick and tight with anxiety.

I was supposed to be going into my voluntary job. But after half an hour of lying in bed trying to talk myself into that, I realised it wasn’t going to happen. I’ve had an up-and-down week, and clearly there was more down to come.

So what was I going to do? My instinct was to reach for my anxiety medication, but something stopped me. I’m trying not to take that too often, and besides, there was the personification technique that had worked so well when I felt depressed the other day. If making Glooming (my depression) feel uncomfortable had helped me to move forward when I’d been feeling depressed, perhaps I could overcome this anxiety in the same way?

So what was my anxiety like? I decided that she was called Annie, and that she was a butterfly. But not any butterfly. A half-and-half, or gynandromorphic butterfly. These half male, half female insects are split down the middle, as can be clearly seen by their mismatched wings. I imagine they find it hard to fly.

And this is how I thought of Annie. As a butterfly-like creature, desperately fluttering around but unable to really take off and escape. This is how I feel when I am anxious.

I then attempted to follow the thought process I had applied when Glooming came to stay, and ask myself what Annie would hate for me to do. But I couldn’t. Whereas I had wanted to make Glooming feel uncomfortable, so that he would want to leave, I felt sorry for Annie. She hadn’t come of her own accord, she was trapped in the room with me and was unable to leave.

That was when I hit on it. What can I do to help Annie to calm down, so she can fly away and leave?

I felt much more comfortable with this approach to Annie. I decided that a cup of tea would be a good first step. And e-mailing my voluntary job so they knew not to expect me.

I spent the next hour sitting in bed, sipping tea, browsing Facebook, and generally taking my time over getting up. Annie’s flutterings grew less and less frantic.

Then I put my normal morning routine into place, but I took care to go slowly. Annie was now fluttering gently around.

By the time I was up, dressed and breakfasted, Annie’s flutterings had diminished enough that I was able to think of activities I would like to do that day. Annie hadn’t flown away yet, but I was confident that if I continued to take things slowly, and treat her gently, she would.

… And eventually, she was able to fly away.

Dealing with Glooming

The other day, I posted about trying to personalise my depression by giving it a name and imagining what it was like. I decided that my depression was a heavy fog-creature called Glooming.

It amazes me how much this simple act helped. Instead of saying to myself, “I am depressed”, or even, “I feel depressed today”, I said, “Glooming has come to visit.” This helped me detach the depression from myself. It gave me the message that this was a temporary state of affairs, something that would not last forever. A visit is a stay of finite duration, whereas depression often feels like a permanent state – or there is the fear that it will last forever.

My next approach was to try and persuade Glooming to make his visit as short as possible. I thought of him as an unwelcome guest, and I asked myself, “What would Glooming hate for me to do right now?”

At this point, it was 11:45 am, and I was still in bed. So my first thought was, “Glooming would hate for me to sit up, read my Bible and pray.” This is part of my morning routine, but when I am depressed I struggle to open up the book. But I didn’t want Glooming to feel at home, so I went ahead and read.

I’m not going to say it was the most wonderful time of Bible reading and prayer I’ve ever had. In fact, it was a real struggle. But I did it.

“Ok, what would Glooming hate for me to do next?”

“Glooming would hate for me to take a shower…”

And so I went on. I showered, got dressed, and then went downstairs to sit with my family and eventually eat a small lunch.

By this point, Glooming had retreated a fair way. He had wanted me to lie in bed all day, wrapped up in misery, not washing, eating or doing anything to take care of myself.

It wasn’t that I wanted to do those things. I wanted to stay in bed too. It would have been the easier option, and in the past it is one I have often taken.

But that morning was different. I wasn’t making myself do these things because I should do, or even because they would make me feel better.

No, I was doing them to make Glooming feel uncomfortable so he would go away.

In the afternoon, I decided that Glooming would hate it if I gave myself a treat and watched a cookery programme. I decided he wouldn’t want me to be doing something that might give me pleasure… or at least distract me from his presence. And I was right. He retreated further.

Then in the evening, I decided to draw Glooming. He was much, much further away than he had been in the morning… and I wanted to keep things that way. And they say you need to know your enemy… so I drew Glooming, to remind me what he is like.

And to remind me what to do the next time he tries to come and stay.

Glooming and Me

Recently, I have been attending a course on building self-esteem. One of the techniques they have introduced us to is personification – to characterise and personalise our issues.

This morning, I woke up weighed down with the fog of depression. I spent the morning curled up in bed, hiding from the world.

Then I remembered this technique, and I decided to try and personify my depression.

What is his name? (I don’t know my, but my depression is definitely a ‘he’.)

Somehow, I didn’t want to give my depression a human name…

Then a line from Romeo and Juliet came to mind:

“A glooming peace this morning with it brings;
The sun, for sorrow, will not show his head:
Go hence, to have more talk of these sad things;
Some shall be pardon’d, and some punished:
For never was a story of more woe
Than this of Juliet and her Romeo.”

That phrase, “a glooming peace”, defines depression for me. It conveys a heaviness, a peace that is not restful or pleasant, but deadening and oppressive.

So I decided to call my depression “Glooming”.

What, I asked myself, is Glooming like?

Glooming is not human. Glooming is not an animal. Glooming is not really a recognisable being.

Glooming is a fog-creature. A thick, heavy fog-creature, with the insubstantial and creeping nature of fog, combined with the heaviness of a very wet, cold blanket. A creature that can at one and the same time penetrate every nook and cranny of your being, and weigh you down and submerge you. A creature with no legs, that hovers as it moves, but with many, many arms, reaching out for me, to pull me back down into his dark embrace.

That is Glooming. That is my depression. And strangely, having named him, I felt as if I had a slight measure of control over him.

But knowing and naming my depression is only part of the battle.

I will try and tell you more tomorrow.

Pacing Myself

The last few days, I have been taking things slowly. Frustratingly slowly.

I find that I am generally in one of two states. Either I am feeling really low, and unable to do anything… or I feel positive, and energised, and that I can do many things.

I have been told I need to find a balance. To try and do something when I am feeling low, and to avoid doing too much when I am feeling well.

On the whole, since my last post I have been feeling a little better, and with this improvement has come the desire to be doing.

But I am trying to listen to the advice I have been given, and to go slow.

I find it hard. I find it hard to keep a rein on myself.

I also find it hard to judge how much is ‘too much’.

But I am learning. Learning to do little at a time. Learning to stop, to think, to listen.

Learning to pace myself.

A Disconcerting Improvement

Today started with a heavy emptiness that definitely did not want filling with food. I sat at the kitchen table, sipping slowly at a small glass of pineapple juice, and felt slow and weighed down and low in my spirits.

I retreated into my cocoon – bed, under the duvet, with daytime television on in the background.

I worried about lunch, but when I was called I found I was able to consume a small amount. I was even able to explain that at times like this I find it hard to eat meat, or anything that tastes too strong.

My pastor came to visit, and by the time I had finished my cup of tea and slice of cake, I was feeling on a more even keel. After he left, I was able to go out for a walk on my own (but having a phone conversation in case the bad thoughts came back and caught me unawares).

None of this is particularly surprising. Much as I hate friends and family saying, “It will pass…” or, “You’ve got through this before; you’ll get through it again…” The fact of the matter is, they are right. I do slip from a crisis to a relatively good place quickly. Too quickly.

I know I should be pleased, but actually I find these rapid shifts in mood disconcerting. I am not stable. That may manifest itself in a sudden descent into a crisis, but it may also be seen in a speedy upswing through “feeling better” into “I can do anything”. And neither state is helpful.

People tend to only see the quick improvement. They tend to assume that because I will “snap out of it” in a day or two, that the crisis is not painful, upsetting, or dangerous. The also talk as if it is my fault when I take on too much in a good phase – they talk about me “not listening” and “stubbornly going ahead” with new projects. They fail to see that the over-active and hyper-energetic state is just as much part of my problem as the low, depressive, helpless state. I can no more prevent the first than I can avoid the second.

I try, I try very hard, to find a balance. To keep busy but not too busy. To avoid both lethargy and stress. To achieve that all-important even keel. But it is difficult. Because what I can do one day, I can’t do the next. Which makes any kind of long-term planning or strategy practically impossible.

My bad days are not the sum of my sickness. They are just one side of a see-saw that is perpetually in motion. And I am struggling to kind my balance in the middle.

Which any child will tell you is practically impossible.