Trying to find the positives

The serious lower back pain continues, and I think the only way for me to get through it is to try and find the positives. That’s how I managed to stay reasonably upbeat during the trapped-gallstone incident – I found three positives:

  1. According to the people around me, I was handling the pain really well. I had a reason to be proud of myself.
  2. My doc told me the gallstone pain was equivalent to the pain of child birth, which is something I had always been a bit scared of. Well, now I have an idea of what it will actually be like pain-wise, and as per positive #1, I have reason to believe I can handle it.
  3. For some people, that gallstone attack would have been awful beyond the pain – it would interfere with a full time job, or child-care responsibilities etc. For me it wasn’t a problem in any other way than just hurting. This sounds weird, and on a logical level I know it isn’t right, but part of me believes in a sense of balance, so me having that attack meant someone else didn’t. And I was probably better positioned to handle this than that person. 

Finding positives is proving a lot harder with the back pain. I think I’m handling the pain reasonably well, but it hurts a lot worse than the gallstone did, and I’ve cried a few times. I’ve done better. So pain-handling isn’t something to be proud of this time round, but there is one positive I can think of – this is motivating me to adopt a healthier lifestyle. The excess weight I’m carrying around didn’t cause this pain, but it can’t be helping. And more exercise would strengthen my muscles and reduce my risk of back pain like this in the future. So it’s time for change: appetite-increasing meds will no longer be acceptable excuses for overeating, and I’m going to get back on that exercise bike.

Attitude changes aside, the pain is genuinely a bit better. I had an emergency appointment with my GP yesterday, and after examining me he said the area of my back that hurts is one that’s really easy to injure (there were lots of fancy biology terms, and a model of a spine and pelvis, but this was a bit beyond me!). The upshot is diclofenac acid and codeine. I’m not sure either of those is doing very much, but I guess every little helps.

Unfortunately I couldn’t get started on the anti-inflammatories straight away as you can’t take them on an empty stomach, and I had to fast for six hours before my ultrasound (investigating my gallbladder). As predicted, that scan sucked. The bed I had to lie on was more like a dentist chair, and the technician had me turn onto my sides a couple of time which was a) PAINFUL and b) difficult anyway on a slim dentist chair when you’re trying not to dislodge the towels and gel. Plus she was pressing hard enough that it hurt, but that’s my fault for being overweight. 

Anyway, that’s done now, and I get the results sometime next week. I’m currently home with my parents which makes life easier as there’s only one set of stairs to navigate. Despite the pain I’m not in a terrible mood, and I’m beginning to wonder if I have the trazodone (Desyrel) to thank for that. We’ll see. Fingers crossed I get better soon. Please please please let me get better soon!!

Check in: Pushing through

I am on fire at the moment, and it feels good. And no, that’s not a self-harm reference – I’m talking about getting work done. Today’s the day I was supposed to go and see Dr T for an extra session (during his week off) if I hadn’t managed to get my head down and really get going with my dissertation. My absolute horror at that idea worked as a kind of unintended incentive to push myself, and three days later I have 4000 words. Whoo!

In other news, I’m not sure what I make of the trazodone (Desyrel). I’m on 200mg nightly at the moment in the hopes it will ease my insomnia, and while it was certainly working to help me sleep solidly instead of waking up all the time, it wasn’t actually helping me get to sleep, which is my most frustrating problem. And yet about 30 mins after taking my dose this evening, my eyelids are incredibly heavy. It’s very strange.

That’s it on the news front, but there’s one more thing any readers on psych meds might be intrigued to read: I spoke to a close friend of mine who’s Dad is a consultant psychiatrist, and despite suffering with depression and suicide ideation, her Dad won’t let her take any psychiatric medications. Apparently he would rather she ‘gets through this herself’, and he wants to protect her health records. Makes you think, doesn’t it?

Setting the scene for something risky

I saw my GP again this afternoon, and this appointment was pretty different to last time. Disappointingly so; I was in and out within a couple of minutes with a prescription for a week’s worth of trazodone (Desyrel) at 200mg.

I know I moaned about the appointment on Tuesday freaking me out with how concerned my GP was, and by how strongly he was insisting I drop out of uni. But with a little time for reflection, I’ve realized that actually, as much as it made me uncomfortable, it’s nice that someone (beyond my lovely readers here) recognized the seriousness of my situation well enough to be that concerned. Perhaps some of the people reading this might disagree, but I think things have been a bit dicey for me recently; dicey enough that it’s been scary at times. Someone recognizing that, and responding appropriately, was terrifying, but also grounding. At a subconscious level the voice goes: it’s okay 0sername, I know it feels like you’re losing control, but you’re not fighting this on your own. Your GP knows, and he won’t let your depression carry you past the point of no return.

So imagine my disappointment this afternoon when I didn’t feel there was anywhere near the same level of support. To be fair, it wasn’t literally a case of go in-get prescription-leave. I was asked if I’d thought anymore about alternatives to continuing at uni, and was urged not to self harm anymore. But that was it, and I was unpleasantly surprised when my GP handed me a prescription for a whole week’s worth of trazodone at the higher dose without any discussion on that – on Tuesday he understood my self-risk enough to prescribe me only a couple of day’s worth, and now I have a lot. And no mention of promising not to abuse these meds. I know I shouldn’t have to be bound by a promise to not OD, but that made all the difference last week as some readers may remember. I should have said something, but the disappointment was creeping in at this point, and all I wanted to do was leave.

I’m kind of worried. My depression is a little worse today; it’s back to feeling like a physical illness, or an actual weight you carry around with you. I know only too well where that can lead, and in a sense the scene has been set for some risky behaviour. I don’t mean to tempt fate with that sentence, or build a self-fulfilling prophecy, but I need to be honest. Part of me wants to go to the dustbin right now and bin everything before I can misbehave. But a stronger part of me refuses, and it’s not only because my GP wouldn’t want me to stop taking the correct dose. The darker reason is there too. And that’s what scares me.

When receiving care is like entering into a special form of debt

I had therapy this afternoon, and it’s thrown me. I told Dr T about what’s been happening recently, and his reaction was to firmly tell me to stop taking meds. Stop seeing my GP, the psychiatrists etc. 

His reasoning is that back when I had a psychotic depression (beginning of last year) there was a role for medications, but now my depression is caused by emotional problems, and ‘this medical drama gets in the way; it’s secondary, and takes you away from addressing the real issues here’. He correctly pointed out that all but one of the many meds I’ve been on have been useless or stress-inducing.

I reached this conclusion a while ago myself, and told my GP that maybe it was time for me to go med-free. He said no, on the basis that he’s concerned I’ll deteriorate back into that psychotic depression. Apparently it really scared him. And I didn’t argue any further.

So I don’t really know what to do or say on this. Given how worried and firm my GP was yesterday, I can’t imagine he’d allow me to go off meds right now. I know there’s almost always patient rights about making your own choices, but since we had to discuss potentially having me admitted to a psych ward I can see those choices being taken away. And I don’t actually want to stop taking meds at this point in time – for one I NEED the help to sleep (and finally, finally, a higher dose of trazodone is actually helping on that front, so that gives me a break on the Nytol ODing), but also…I want to do what my GP says. I think I wrote in my post yesterday that I have been overwhelmed by how much he seems to care even beyond dishing out pills, and as much as it scares me, I’m grateful to him. Very grateful. And doing what he says (when I don’t have any real objections myself) feels like a way to start repaying him.

On the theme of repaying kindness, and feeling bad when being the subject of someone’s care, Dr T gave me a dilemma of his own today. He isn’t working next week, so I’m not due to see him for another fortnight, but he said he’s very conscious of the time pressures I’m facing with my dissertation and wants to support me with that. He then said that if I still can’t get my head into my work after today’s session, I should come and see him on Monday morning and he’ll help me through it.

No. No no no no no. There is no way I can take him up on that offer. It’s his week off. I can’t intrude on that. His offer is SO, so generous of him, but it’s generous to the point that I can’t bear it. It’s too kind so I can’t accept it. I don’t know how to repay that kindness. So whatever state my dissertation is in by Monday, I won’t head to his office. 

Taking a step back, isn’t it weird how kindness towards you can be really uncomfortable, because it seems undeserved? And isn’t it weird that acts of genuine kindness feel like taking on a special kind of debt? A debt you can’t easily or obviously repay. 

I KNEW I should have cancelled my GP appointment

Note to self: next time just cancel it. Don’t question whether or not it’s sensible, or mood-related, just cancel it.

So I saw my GP this afternoon, and came out almost in tears (pretty rare for me, ‘soldier on‘ and all that). Why? Well, I’m pleased to say it wasn’t because my GP was angry, or told me off. My GP never does that; he might screw up his face or sigh when I’m reporting something bad, but there’s never anger.

Initially I didn’t think I could tell him anything – I just sat there and looked at the floor guiltily. To be honest that told him most of what he needed to know, but eventually I admitted to cutting. And I admitted to my pill-related activities, and how much I hated myself for promising him that I wouldn’t abuse last week’s prescription meds.

The first thing my GP talked about was meds, saying that slowly titrating off sertraline (Zoloft) and slowly building up the trazodone (Desyrel) doesn’t seem to be the right approach. Instead we made a plan for the next two days: come off the sertraline completely, and move up to 200mg of trazodone. Except he didn’t give me enough of the latter for me to do that, but by Thursday I’ll be taking 150mg which is three times what I’m on now.

With the meds sorted, he moved onto ‘keeping me safe’:

Should I be ringing the hospital, asking them if you can be admitted to stabilize…?

‘NO, THAT IS NOT HAPPENING. NO WAY.’

…okay, remember I’m asking, not telling…’

Is there a friend or someone who could stay with you for the next few days? No. Generally people don’t know, and I refuse to inconvenience the ones that do. They have their own problems. Okay…well look, given you’re not managing to work, and that this pain you’re in is only going to get worse as your deadlines and exams come closer over the next two months, perhaps you should drop out and save yourself the agony? No. I can’t. My parents don’t know about any of this. Okay…so you tell me, what could we do to make you safe? Nothing. I can’t think of anything that I couldn’t undo.

And then as I privately muse over how I should tell him there isn’t a solution and leave, he makes things worse. He tells me he’s going to make me an appointment to see the nurse tomorrow so she can check the damage I’ve done to my arms. I said that really wasn’t necessary, that I’d stitched them up myself with strips, but he wasn’t convinced (not that he looked, and I had them covered up anyway), and said he’d also like me to see the nurse so she can check I’m okay tomorrow. Oh fantastic. And he wants me to check in with him again on Friday.

AND THEN my GP very firmly told me that there is absolutely no point continuing with my studies right now, and that I should consider dropping out of university altogether. Bring my parents in to meet him and explain everything. Find a job, move on from academia, and get better. But I’ve heard this before; when I argued against taking time out this time last year, I was told I needed to give studying a break and would get better as a result. And we know how well that has worked.

My ‘homework’ is to think about a dream job, so we can work backwards in planning how to achieve it. The appointments are made (I’m now seeing the nurse on Thursday). I left. And tried not to cry.

I wish I didn’t have a brain; it hurts. First off, I feel awful about this appointment, because my GP was trying SO HARD to help me, and I didn’t help him in the slightest. That wasn’t deliberate and I wasn’t trying to be difficult; I had my own firm reasons behind every ‘no’ I gave. But I’m also stubborn, and very reluctant to believe that other people might know what’s best for me. My GP cares A LOT, and I try to shut him out. So yeah, I feel very guilty at how frustrating and difficult I made things.

Second…this dropping out thing…it can’t happen. It isn’t an option. I sometimes feel kind of pathetic when I admit that the thought of my parents suddenly finding out that a) I’m seriously mentally unwell right now and b) I’m dropping out for a second time scares the hell out of me despite me being in my twenties, but actually it’s fair. I’m financially dependent on them, so me suspending again means loaning me more money (a job would maybe cover rent, but this city is expensive and I’d also need to pay tuition fees etc). There’s also the problem that they don’t really understand depression etc, and would be firmly in the ‘laziness’ camp. And of course there’s the fact that I’ve effectively lied about my health improving continuously for the last few months (their current impression is that I have mild depression).

I can’t think anymore. I don’t even want to go to therapy tomorrow because this is such a contrast to how I was feeling last week. I don’t want to describe what’s happened since then.

I want to curl up and disappear.

P.S – want to know a secret? My GP doesn’t even know the worst of it. On Saturday I realized that although my highly impulsive, reckless state of mind was strange, I’d actually experienced it once before…about a month ago, minutes before I tried to kill myself.

I’m not sure I can be trusted with meds

Last night wasn’t brilliant, but it could have been worse. It turns out Nytol and trazodone (Desyrel) don’t make for a great combo; some internet research warned me that the two would interact, but it wasn’t the way I expected. I was hoping to be knocked out, but actually that didn’t happen at all. It took hours to get to sleep, which is unusual when I OD on Nytol.

Now I don’t know what to do. I want the Nytol to work, and for that to happen I would have to skip the trazodone. But at the same time I know I’m really meant to be giving the trazodone a proper try, so my doctor would say to skip the Nytol instead. My head is going ‘no. no, no...’ because the less sleep I get, the stronger the destructive urges get. And I guess also because I’m sick of insomnia, and when Nytol works it’s a nice change. If I’m being honest there’s a part of my brain telling me to take all the trazodone in one go and see what that does, but since that’s a promise-breaker I’m doing a good job of ignoring it.

You know what makes me feel pretty sad at the moment? I don’t think I can be trusted with meds. I was so pleased to be allowed weekly prescriptions again this week, but perhaps my GP was right to hesitate. I haven’t abused the trazodone so far, but it’s come pretty close. And now I think that even if we dropped back to twice-weekly prescriptions, the urges would be there all the same.

I don’t know what the answer to any of this is, but part of me wonders if I shouldn’t be given meds at all. That wouldn’t improve the Nytol-related problems, but it would make me safer in one sense at least.

I don’t know

 

The destructive part of my head wins

**Trigger Warning** – this post contains a detailed discussion of self harm

Last night took me to the extremes of my self control regarding self harming. It’s been quite a while since I’ve felt those destructive impulses so strongly. The first form they took was overdosing; I took my nightly dose of trazodone (50mg) and it didn’t help me sleep, so after an hour or two I found myself wanting to down the rest of my week’s supply.

To be fair, that wouldn’t have been dangerous at all given that I’m currently on a fraction of the standard dose, so I came quite close to ODing, when I remembered something. I’d promised my GP that I wouldn’t abuse these meds when I asked to be allowed weekly prescriptions again (instead of twice-weekly). And that was HUGELY irritating. Stopped by a promise I shouldn’t have made. But at the end of the day I absolutely won’t break my promises. My word has to mean something when I give it. 

The next option was Nytol, but something in my head was reminding me that I didn’t know whether or not it interacts with trazodone. So I hesitated for a while, and the only way I could move on from that idea was to think about cutting. The question was what to do it with; usually my tools of choice are pointed tweezers or a knife, but I’d read a news article online about how razor blades were best. I didn’t have any, and was nervous about buying them in a shop, so I ordered some online.

Ordering them, and knowing they’d arrive soon was enough to dampen the restless impulses to hurt myself there and then. I think I got to sleep around 3am. 

Today I can feel that destructive momentum building again. After trazodone’s fail on the sleep front yesterday I know I’m going to take at least a couple of Nytol again. I want my body to feel heavy, I want the world to spin and lurch when I stand, and I want to lie in bed knowing I can only stay awake if I fight for it. But now that’s not enough. It’s hard to describe exactly what cutting does for me, but there’s something peaceful about the focus it requires. There’s something satisfying about the pain, and the blood. I want blades, and a little more research told me how I can get them today without any questions.

The destructive part of my head wins. The rest is silent.