Greetings, strangers, and welcome. Please beware that because I’ve been too crap to update this blog properly for ages that this post is frustratingly long.
This is sort of continued from here. I considered splitting this into two posts but since when I write entries called ‘Blah Yakka Meh – Part One’ a ‘Blah Yakka Meh – Part Two’ doesn’t often seem to transpire, I decided against it.
I am indeed still in the land of the living, not that anything about the pursuit of living my life is particularly interesting. Which is partly why I haven’t written anything substantive in forever – though most of it is down to anhedonia. Or laziness. Whatever. I don’t feel especially depressed as of this writing, but the weird thing about depression, as I’ve found it at least, is that you can be in an episode without realising it. In fact, I’m going to (sort of) empirically test that contention…
I like things to be measurable and easily analysed. So I periodically take online tests to get a grasp on how my mental health objectively appears. As I said, I don’t feel depressed – but low mood is only one symptom of a complex phenomenon. As such, the following results have failed to surprise me:
- PsychCentral Depression Quiz – 59 (54+ is a severe depression)
- Beck Depression Inventory – 32 (31 – 40 is severe depression; 41+ is extreme depression, so at least things aren’t that bad)
- Hamilton Depression Scale – 25 (moderate depression, apparently, which at least is a hell of a lot better than last time I took this)
- Burns Depression Checklist – 58 (51 – 75 is severe depression; 76+ is extreme)
- Modified Scale for Suicidal Ideation – 16 (9 – 20 is mild to moderate suicidal ideation; 21+ is considered severe.)
In short, things are better than the last time I took these – but my mood was very low then. A lot of my stronger responses to the questions on the above scales are based on motivation, sleep disturbance, ability to work and engage with people and suchlike, rather than mood as such. But I believe those disabilities to emanate from the same source.
Also, I may as well admit it since The Man has worked it out anyway – I engaged in a wee bit of (superficial) self-harm last week. The reason is simply that I was bored. Or, at least, that was my conscious reason at the time. Presumably your average mentally healthy person alleviates boredom via alternative means, but I’ve never claimed to be anything approaching sane.
Anyway, that was a tangent. This post was intended to update on things with my new CPN and the status of my current tenure in group therapy.
CPN
This woman is excellent. It is well worth going the extra 20 odd miles to my new ‘base’ up at the specialist psychiatric hospital to see her. The first week, she came to my mother’s house, but I asked if I could see her at the hospital; I don’t feel I can speak freely in my mother’s house, even though I very much doubt that my ma is standing in the hall with a glass to the door. Anne, the CPN, was very glad to accept my suggestion of seeing her at the funny farm, mainly because it would “at least get [me] out of the house.”
On that note, she has, over our hitherto three meetings, expressed concern about my not going out of the house. I pointed out to her that I’m an anthropophobe (and probable borderline agoraphobe) and cannot deal with being around people, at least when by myself. With The Man, I can go out okay as long as the place we’re visiting is relatively non-busy. With my mother, a little less than that. The only places I feel comfortable going to myself are established appointments, such as those with my GP, the shrink or (now) with Anne herself. I have avoided other important appointments (such as the follow-up to the colonoscopy, the barium meal thing) and run out of basics such as milk and bread due to my inability to leave the house.
Anyway, were I to ever get to the point, this concerns Anne. This concerns Anne to the point where, even at our first meeting, she suggested getting me a support worker to help me get out of the house. To my own surprise, I not only agreed to this but actively welcomed it. It turns out that after she spoke to my psychiatrist that they agreed that it wouldn’t be a support worker, but an occupational therapist instead – but either way, I’ll get that form of help. The OT apparently operates on a graded exposure basis, and whilst I maintain a cautious level of cynicism about how much this will aid me in my ultimate quest – to be sane enough to go back to work – I am certainly open to it, and will try it to the best of my ability. Anne anticipates it starting around the end of January.
The mere fact that she suggested a further form of input was astonishing to me. NHS Psychiatry and Psychology have not been kind to me over the years, and to have someone actually suggest extra support on an unsolicited basis is a completely new thing. The surprises didn’t end there, though. When I told her I’d been in and out of the system since the age of 14, when I told her how much school I’d missed and how I had to leave my Masters degree with a PgDip due to losing the plot, when I told her how Psychiatry had initially told me to get lost and Psychology prematurely discharged me, she was disgusted. Normally, whilst some of them acknowledge that the system isn’t perfect (masters of understatement), they try to defend their employers. Anne didn’t. She said that I should have been with CAMHS straight away when I first presented to my GP with mental health trouble. She was especially horrified when I told her that I didn’t even know what CAMHS was, or that it existed at all, until about 2010 or ’11, thanks to the online mental health community.
In relation to NHS debacles more recently, she was equally annoyed. In relation to Psychology, she stated that she felt that long-term therapy was something the NHS should invest in, in much the same way that it invests in long-term (sometimes for-life) medication. As she said – and as I have told my local Trust ad nauseum – it’s ultimately better for the health service itself; if I receive long-term therapy and deal with pertinent issues properly, then I am less likely to need long-term/life-long treatment. Having to dip in and out of services is not cost-efficient in the least.
She felt that perhaps I’ve not been taken as seriously as I should have been because, in her words, I’m “intelligent and articulate” (that alone makes me like her!)
She said:
It’s just as bad for you having mental health problems as it is for someone who is less intelligent. In fact, in many ways it’s worse for bright people, one reason being because they are less likely to simply accept their position – they think over it, analyse it and so on, and end up feeling even worse than they already did.
She went through a few other reasons as to why she thinks it’s even more difficult for smart people to navigate life with mental illness, though to be honest I can’t remember what she said exactly. Nevertheless, I agree. I also agree that it makes you less likely to be taken seriously, because being able to articulate yourself well does not ‘fit’ with traditional tropes of those with severe mental health difficulties. Sadly, in part thanks to personal experience, I’m firmly of the view that a lot of professionals still fall into the trap of viewing individuals through the lens of a stereotyping kaleidoscope of pre-conceptions.
So that was all good. At the second appointment, I approached a few issues with her that have been bugging me about my psychiatric ‘team’ for a while – since I started reading and writing mental health blogs, anyway. I have never received a care or crisis plan, or risk assessment. Again, before I met people online, I had no idea such things even existed. This was another thing to annoy and surprise Anne. It turns out that a care plan does exist, but that no one had bothered to show it to me (despite the fact I was meant to have signed the thing.) It was completed almost two years ago, which would be funny if it wasn’t so unreasonable.
There isn’t a crisis plan as such, but for the first time since I entered the psychiatric system, Anne explained to me exactly what I should do in a crisis. Obviously you have to see the heinous Crisis Team, but I had no idea how to access them before. Each Trust seems to be different. Anyway, I finally know now.
Finally in relation to Anne, she is just generally nice. My psychiatrist, Debbie, had once described her as being very much like my first CPN, of whom I was very fond, and so far I’d agree with this. She appears to genuinely listen, to genuinely care, and to genuinely express warmth with her parting words: “take care, m’dear.”
Group Therapy
I can’t go into an awful lot of detail about this, for two reasons. Firstly, and most importantly, I obviously have to respect the confidentiality of the others in the group. Secondly, whilst it’s very much psychodynamic-based therapy and although it helps treat them, it’s not for mental health problems per se. The organisation at which it’s based deals with people who’ve been through very specific experiences and I have no intention of going into the minutiae of those here. Most of you are already familiar with the circumstances, I’m sure. Those that aren’t are welcome to enquire privately if it matters to them.
There are four of us: one man, and three women (no cats, though I’m sure Therapy Cat is there is spirit. Thank you for this picture, Susan!) Originally there were meant to be eight of us, but for various personal reasons, the other four either didn’t start coming at all, or have dropped out. One poor sod did so in part because it turned out he knew one of the other attendees, which is a nightmare scenario in my view. She has stayed on, though.
I dread going to it every week, as I actually admitted to them last night. Therapy is inevitably hard work, and the prospect of expunging oneself in front of several others feels like climbing up an even steeper hill. However, when I’m actually there it’s surprisingly okay and – dare I say it – rather cathartic. The four of us, the ‘core group’ as I’ve taken to calling us, seem comfortable around each other by this stage. The man and one of the other women tend to do most of the talking, and end up apologising for it – but I think I and the other girl are happy enough, as if the first two start the conversation, we can bat off that; take a lead on general themes, and speak of how they relate to us too.
Questions of each other are welcome, though of course you don’t have to answer. People generally do, though; I think we trust each other enough now to know that the answers will be treated sympathetically and confidentially. The facilitators – my former one-to-one therapist and a woman – tend to take a back seat, but when they do speak up, you can see the different approaches they’re taking. My therapist will analyse the object relations between us, the underlying psychology and the senses of transference and projection – though that said, any transference there has been thus far (and my observations have been that there hasn’t really been that much, surprisingly) has been completely non-hostile and non-invasive. The woman will look at things more from a ‘feelings’ angle, if you understand the distinction.
I think the key thing, and this always was the point I suppose, is the level of empathy. Each of us ‘gets’, to a point anyhow, where the other is coming from. If one person is having difficulties in an interpersonal relationship now, for instance, we can see how similar themes have come up in our own lives – and, crucially, consider as a collective the ‘whys’ of those issues.
Personally speaking, two things really pleased me. In a way that sounds perverse, because it’s like being pleased about other people’s suffering, but it’s a sense of relief, I suppose, that other people are or have been in the same boat. One of these things is that one of the others is also an educated type, and although she was able to go on and complete her post-graduate degree, unlike me, I did feel some vindication when she said that she’d had a major meltdown whilst undertaking it. It doesn’t change my feelings that I totally failed in that endeavour, but it does feel like I’m not completely alone.
The other thing is that the other woman really ‘gets’ dissociation. She was sitting there discussing how she was talking to someone one day, when that person innocently made an allusion to something – and bam! Her mind was flooded with memories she didn’t know she had. Without going into detail, that’s exactly what happened to me in relation to some stuff.
The thing is, I read a lot of DID-related blogs, so have certainly never thought this was a phenomenon exclusive to me, but she’s the first person I’ve met offline who’s experienced this influx of dissociated thoughts. (I have met several other bloggers who have dissociative tendencies, but that’s after following their writings or talking to them on Twitter first.) What was particularly ‘nice’ about this interaction was when I explained to her that my experience was very similar, she felt less alone. Apparently she’d never realised this was quite a common psychological issue, and I’m the first person she’s known that has also gone through it.
The same woman has, like myself, experienced long-term mental health problems, and hasn’t worked for 16 years. The other two do work, and have no diagnosable conditions, but are completely non-judgemental about us being unemployed, unlike a lot who seem to believe the ongoing and fallacious societal rhetoric about ‘scroungers’. I am (by far) the youngest of the four of us, so my fellow member’s long-term unemployment makes me feel slightly less shit about my own.
So I suppose one might say that it’s strange, spewing out your darkest history to five other people – but considerably less strange, and much less intimidating, than I had anticipated. I don’t think it’s going to completely eradicate the effects of what happened (I remain unsure that that’s even possible), but I do feel that it will have some positive outcome. My main aim in going to the group was simply to go to a group; as stated both here and in other posts, I am positively terrified of people, and my obsession with not being in work dictates that I am also obsessed with ceasing to be terrified of people. I don’t think group therapy will get rid of that entirely either, as the circumstances are obviously highly divergent – but it might help ease the tension a little (perhaps especially now that I am to try this graded exposure thing.) If nothing else, I feel a slight sense of hope I won’t always feel so isolated.
Other Faff
The #flegs nonsense is still ongoing, which is completely driving me mad. It’s not keeping me in the house like it is for some poor people, but I’m fed up hearing pathetic defences for inexcusable acts of aggression. Seriously, if these dickheads don’t stop their idiocy soon, I am sincerely concerned that history will repeat itself. In inoffensively expressing my disappointment on Fuckbook that parts of my beloved home city are seemingly war zones again, I inadvertently started a war between one fella who supports this bollocks and about 14,000 reasonable human beings. My fear of confrontation drove me away, but I’m pretty sure that overall sense prevailed. Although yer man was tenacious, his arguments – at least, as far as I could tell from a spy on Twitter – were (unsurprisingly) weak. It’s worth noting that the man in question is actually a really decent bloke in general, but he has some qualities that are unattractive and this blind so-called loyalism is definitely one of those. Loyal to what? British democracy, when people are throwing petrol bombs at the police? Whatever. All these twats are loyal to are dissident republicans, who are bound to be lapping every second of this up.
I still haven’t been on @mymorevividlife for a very long time – well before Christmas, I’m pretty sure. I’m presently pretty active on my personal Twitter account, perhaps because I’m ‘happy’ to simply be ‘me’ at the minute. I go through phases when I tire desperately of anonymity – or, in the case of this blog, semi-anonymity, and such is the case at present. Usually I then tire of being me (!), but I can’t necessarily guarantee that in this case. So if you would like to follow me, feel free to email me and I’ll give you the other Twitter handle.
Speaking of email, I owe loads of people responses via that medium. Some from five or six months ago. I’ve always been an appalling correspondent, but this is ridiculous. I’m genuinely sorry, and genuinely intend to respond properly – but when? I wish I could say. What I can say is that I’m a twat, and that I’ll try to get over this anhedonia as soon as I can and get back to you all. On a similar note, I haven’t been commenting on blogs, nor have I responded to comments left on this blog, for ages. I am actually still reading, but I can’t seem to think of anything remotely coherent, supportive or useful to say. It’s not that I don’t care; I really do. I’m just crap. And, again, I’m sorry.
And that’s about it. Well done to those of you that got this far! I hope you all had a pleasant Christmas (or at least a relatively non-shit one), and that this year will be a good one for you. Much love across the bandwidth to everyone. xxx
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Forgive me; I haven’t proofread this at all, so apologies for any spelling/grammar/syntax/other errors.
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Picture credits: the second picture is my own work. All the others come from the sites they link to.
Oh a-god-damn-hezus-humping-men! Smart people seem to be well and truly up the stink brown stream without a form of propulsion. My ex believed it was my ability to reason etc meant that professionals weren’t sure how to deal with me.
As for everything else, I’m jealous of your ability to do group therapy. I can’t get treatment unless I do group therapy (exception being if I lose the plot… watch this space). Gotta admit, the thought of group fills me with a grumpy cat style helping of ‘No’ so guess I’m screwed.
Hey ho, it’s all good fun really (it’s not but screw it), glad to see you back
I never, ever, ever thought I could ‘do’ group therapy. As well you know, Null, I’m hideously cynical – and I hate ’emotional’ stuff and crying. I expected all that, and dreaded it.
But it’s been so very different from what I expected. I’m surprised to say I’m very glad I’ve done it.
Totally agree with your ex, by the way – intelligence and insight are great disabilities when trying to access mental health services π¦
I haven’t read all this post because I’m struggling to concentrate at the moment but can relate so much to the experience of having to dip in and out of mental health services, and not being taken seriously because I try my best to articulate my feelings/experiences. When I attend appointments (or not, at the moment, since I’m discharged from services) I don’t *look* depressed; I am showered, with make-up on, etc) – Sometimes I think these things have really hindered me getting ‘proper’ treatment.
I almost never wear make-up anyway and don’t dress especially well, but nonetheless I ‘get’ what you’re saying; I probably don’t generally appear depressed. Debbie, my psychiatrist, has come to learn when I am and when I’m not, but it wouldn’t generally be the case. My previous psychiatrist and a lot of GPs haven’t taken me seriously because everything appears normal. Bastards.
Hi, happy new year to you! Wow! There is so much going on in your life. Sounds quite overwhelming to be honest. Nice to see a blog post from you though, all the best and hope you can be kind to yourself
Thanks, MADD π Things have gone a bit quiet again (almost a month later comes my reply!), excepting the group. But I’m a bit pissed off about that to be honest – I’m waiting to hear from the CPN after having to cancel an appointment, and the OT and I have constantly missed each other’s phone calls (and no one wants to take a bloody message.) But I’ll not allow them to forget about me!
Anyway, thanks again. Happy new year to you too π
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My concentration is so poor it was difficult to read all of this but I did because you write very eloquently, particularly as you confess, it has not been proofread!
Congratulations on doing the group therapy thing!
It is quite a bit worse being intelligent and nuts I think because of the insight that becomes knowledge: ‘this is shit, really shit, it has been for years’ etc but I still wouldn’t want to give up higher faculties! I shudder at such a thought! It’s also, for me, what makes my mental health problem, to some degree, managable.
Thank you so much for commenting and for your kindness π I think a lot of people with mental health problems are intelligent types, but I suspect there’s a lot more intelligent types out there struggling, who can’t (or won’t) access services because they are or fear dismissal.
And you’re right, the insight can make things so much worse. Knowing that I must be hallucinating, for example, makes it more frustrating and probably frightening than ‘genuine’ psychosis. At least in the case of the latter, you feel that it’s the outside world that’s messed up, not your mind.
Anyway, I agree – I’d rather be intelligent and mental than stupid and sane. I value my brain highly, even if it does mess me about a lot π
Thanks again!
My best
Karen
I like the sound of your cpn – at last you’re going to have some proper support. This is a good thing. Group therapy would scare the living shite out of me, I’m so impressed with your doing it. The group also sounds quite reasonable which must mean a lot.
Take care of yourself and I loves you loads and loads xxxxxxxxxxx
They’re a decent bunch. As I said to Null above, I’m genuinely surprised by how well I’ve taken to it. In a million years, I really thought I could never do it. You know how misanthropic I am!
Love you loads too babes. xxxxxxxxxx
Great that finally you have a CPN who is actually willing to give out support like they are there for. HAving an OT to help you out the house sounds wonderful. I hope that all goes well! xox
Thanks lovely! The OT has tried to be in contact, but she’s phoned (bad enough in itself) in the mornings (when I’m hungover from the Seroquel) and when I’ve tried to get back to her, no one takes a message and she’s not there. So now I’m a bit scared that I’ve missed the opportunity. I’m waiting to hear from Anne but will raise it with her when I next talk to her.
Take care xxx
I’m not sure how much you’ll like me for saying this Karen but you sound just like your old self- which is _definitely_ good with me!! But you’re still just being _you_ I think which is great too. It does sound like things have been hectic for you lately but it’s so good to see you sounding positive about Anne, the OT and group. As ever, all fingers crossed that they all help and its a big step to recovery.
Take care
Best wishes
Kate
Thanks Kate π See above comments on how the OT thing isn’t working out quite as planned so far…but I hope that eventually I’ll get something sorted. The group is still going well, a little blip as detailed in my latest post excepted!
Take care xxx
I’m so glad you wrote! It’s very good to hear about this shift in your life and I’m so happy for you that you have a caring team and people actually making help available to you.
I am very, very like you in the not leaving the house thing even down to being more comfortable if my husband goes with me.
And your group therapy sounds like it’s something beneficial for you and for the others. I think that sometimes meeting people in our “real life” who have similar experiences and symptoms as us can be very comforting. Not that we want people to suffer of course but that there’s something different about finding these ones outside of the blogosphere or Twitterverse.
Good for you hun! I’m really happy for you. ((hugs))
Thanks sweets π We both seem to be getting a bit more support at the minute – I know you’d been having a bit of difficulty with your therapist until lately.
But for blogging and Twitter – meeting all the wonderful people that have commented here and voiced support in so many places – I still reckon I’d be dead. But yes, it’s also good to have ‘real life’ people in the picture too. I’m not sure if we could ever be friends as such – what an odd place to start a relationship, after all – but who knows? As things stand, we certainly all get on well, so it’s possible.
Anyway, take care and thank you again! xxxxx
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