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.

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The temptation game

I’m awful when it comes to temptation. As soon as I think of something I want, or something I want to do, the temptation tends to stick like an obsession until I give in. Today’s temptation was buying another box of Nytol.

I ran out a couple of days ago after overdosing in increasing amounts on consecutive nights, and originally decided not to do anything about that since I was supposed to be starting trazodone (Desyrel) yesterday/today, which has sedative properties. Well today I established my GP has apparently forgotten about that, and I won’t be starting it for another week. Another week stuck with 200mg sertraline (Zoloft), and another week of the joys of insomnia. 

And then ‘you could buy another box of Nytol‘ slipped into my head. I had discussed this with a friend yesterday; I firmly told him I wouldn’t buy more because I know I lack self control and would inevitably continue overdosing if I had it to hand. That resolution wasn’t as strong as I thought, because the truth is that when you keep having nights with little and broken sleep, you become desperate. My psychiatrist reviewed my sleep hygiene a long time ago and I was already doing the things I was supposed to, I’ve tried herbal sleep aids, I’ve tried various sleep routines, audiobooks etc. None of it works, so you run back to the one thing that does. Even though you know it’s bad. Wrong. Irresponsible. Sometimes dangerous.

I’m not proud of it, but it isn’t like I haven’t tried to find help. Recently I’ve very clearly stated to my GP, therapist and psychiatrist that I have a serious problem with abusing Nytol. Enter: trazodone (thank you psychiatrist), except as I said the GP has slowed that down. And he won’t trust me with even the smallest quantity of zopiclone (understandable, but unfair, as explained in earlier posts).

What else am I supposed to do?!

 

Flash and burn

I don’t know quite what’s going on with me at the moment; I seem to have these flashes of impulsively wanting to hurt myself, and then long stretches where I burn with anger and a general sense of dissatisfaction. Every night I take a larger overdose of Nytol. If I continue with that, tonight will host 4x the recommended dose. I fantasize about being beheaded, or burned with the end of a cigarette, or smashed round the head with a hardback book. 

When I last saw my therapist (Wednesday), I agreed to move back to once-weekly sessions (as opposed to twice weekly), but Dr T said I should email him if I ended up needing to see him sooner. Given the above, I decided I should get in touch. Unfortunately he replied saying he can’t see me before Wednesday next week, and advised me to write my thoughts/feelings down. I found that kind of patronizing, and deleted the email instantly. 

On Friday I was up at the psychiatric hospital for the next medication review, and didn’t come away with anything conclusive. The doctor I saw said she wanted to talk to her consultant, and my GP, before either adding something to the sertraline I’m currently on, putting me back on fluoxetine (Prozac) as that’s a medication I found useful before, or introducing a new med altogether. I’m hoping they reach a decision some time next week.

The only good thing that’s happened is that the trapped gallstone episode seems to be over, and I’m not in pain anymore. Hurray. Despite the urgent referral for an ultrasound my GP made on Wednesday I’m disappointed to say I haven’t been given a date/time, but then again I suppose this isn’t life threatening, and there will be people in the queue with suspected cancer. 

I don’t want to be awake. I don’t want to do anything, except inflict pain on myself. 

So yeah, flash and burn

 

Check in: Sertraline to the max

For the last few weeks I’ve been on a daily dose of 150mg sertraline (Zoloft), and it hasn’t done anything for me at all. I have a hospital appointment next Friday, and I would put serious money on the psychiatrist telling me to up it to 200mg, so when I saw my GP this afternoon we decided to boost it now. Admittedly a week at a higher dose isn’t much time to test if it’s working, but I’d rather we did that than wait for the psychiatrist to tell me to increase the dose, and then be stuck with sertraline for another 6 to 8 weeks for re-assessment.

I highly doubt an extra 50mg is going to cross a magic threshold into usefulness. If the previous doses had had any effect whatsoever, I might hold some optimism. But 1.33 x nothing = still nothing.

I don’t want to take sertraline anymore. In fact, I don’t want to take any of these meds anymore. I can’t tell you why for sure, but I suspect this gut feeling comes from the long, long list of meds that I’ve tried and had to discard/wean myself off. Last time I saw the psychiatrist, they told me that if sertraline doesn’t work we will effectively give up. Well, give up already.

 

Not downhill, more like underground

My depression is really taking over, and I haven’t felt this bad since just under a year ago when things escalated beyond suicide ideation. I also feel quite ill physically – my head hurts a lot, I feel kind of sick so I can’t eat, and occasionally I feel weak…but I wonder if that’s psychosomatics at work rather than genuine illness. I don’t know.

What I do know is that all I want to do is curl up. No activity – just lie there, and be numb. I’m back to the days of struggling to get out of bed because I don’t give a s**t what the day holds. I don’t remember very much about what I’ve done this week – there are so many hours I can’t account for. The ones I do remember mainly involve sourcing ‘exit’ materials. I make myself leave the house each day, and try not to cry. I go to bed as early as possible, but can’t sleep.

I don’t feel like I can adequately explain the source of my depression, and last night I read about ‘endogenous depression’  (for want of a better way of putting this, that means the source is within my head) which is essentially psychotic. I’m wondering if that’s me. And what the consequences are if that is me. It’s adding to my already strong suspicions that I’m going to be mentally ill (either constantly or on-and-off) for the rest of my life. Which is why I need to shorten that time span.

I had an appointment with my GP yesterday, and he upped my daily dose of sertraline (/Zoloft) to 150mg. I nervously asked him if I could go back on zopiclone, and to my huge relief he said yes as long as I promised not to take all the pills at once (an easy promise as that wouldn’t kill me anyway). My GP almost made me cry; he talked about prodding the psych hospital into action and I said there was no point because at my last appointment the psychiatrist told me if sertraline didn’t work we’d have to give up – to which my GP immediately said he wouldn’t let them give up, and that he wouldn’t give up on me either. I still doubt what anyone can do at this point, but it was lovely to hear that.

I just want this over. 

 

Sertraline (Zoloft): Here’s hoping I’m not bipolar…

I had an appointment with my psychiatrist this morning, and told him about quitting the venlafaxine/mirtazapine. After refusing to go back on either of those, we decided I should try sertraline, and that if that doesn’t work it might be time to part ways with psychiatry. I left with a prescription for 14 days worth of 50mg tablets.

If anyone reading this has any experience of sertraline/Zoloft, I’d love to hear about it. I’m quite optimistic that this medication might do something useful for me as it’s in the same group as fluoxetine/Prozac, which I found to be helpful. What worries me though is that crazy meds says sertraline is the worst SSRI to take if there’s a chance you’re bipolar. As I wrote in an earlier post, my mood chart is showing mania scores recently, and my doctors have thrown the bipolar label around in the past (inconclusively). Oh well, if this med does trigger mania at least we’ll know for sure.