The Rehab Diaries Redux – Week 3

I’m home now so this will be an account of my final week in hospital.

My regular doctor came back and was not impressed with the medication change imposed by the other one. She removed the diazepam and changed the fluoxetine to 15 mg instead of 20.  This means I need to split the tablet into quarters as it only comes in 20s, which I have been trying to do on my own with not much success.  I need to find one of those pill cutter things.

I feel like my mood resolved a bit but my activity hit a low. All I did from when I got up at 3am (yes that’s still happening) to dinner time is watch Dragonball Z.  Anyone familiar with Dragonball Z knows there’s enough of it to sustain my inactivity marathon for weeks.  I find myself getting frustrated with it though – it’s so drawn out.  I can watch the same fight go on for about ten episodes and still not have closure.

Maybe next admission I’ll get into Bleach, ha. You won’t see me for months.

The dietician I’ve been seeing outpatient also works for this hospital so I had an appointment with him this week to get a free one in. He tried to encourage me to exercise – I’ve still been playing sport but in hospital they have a gym which I could be using but I’m not.  Would rather be watching Dragonball Z.

We also talked about something that has been concerning me, maintaining a healthy diet when I move in with my boyfriend. Our eating habits go to shit when we’re together – we hardly ever cook, we snack together watching tv and tend to influence each other’s drinking habits.  The solution, we agreed was to start cooking more.  He promised to bring me some print outs of healthy recipes for our next session.

I only went to two group therapy sessions this week. One was a dietician’s group in which I encountered more judgement from other patients but this time I wasn’t keeping quiet.  It happened during this exchange, where this girl who was about my age asked the dietician if walking was good exercise to lose weight:

Dietician: Well, all physical activity is good, but to lose weight you need to do something that gets your heart rate up.

Girl: Well I can’t go to the gym, they’re too intimidating. And who plays team sports at my age?

Me: Excuse me, I do.

*cue crickets*

Dietician: Yeah and Mac plays a very interesting team sport, don’t you Mac?

I told her what it was (a contact sport) and still she had nothing to say. The other patients took over with the usual comments I get for disclosing that I play that sport “wow you must be so tough!” etc.  But I didn’t hear from that girl for the rest of the group.

The other group I went to was another addictions group. I was hoping that the people who were in it the week before would be there so I could tell them what a bunch of dickheads they were but didn’t go.  Instead it seemed to be a bunch of patients who were just there for something to do.  I got sick of them asking too many self serving, irrelevant questions and walked out.

Well I’ve been willing to give my therapist a chance even though we have bad chemistry but in our final session of the admission she convinced me that I never want to work with her again. The session lasted 15 minutes and she spent it telling me how difficult I have been to work with and that I should seriously reconsider trying to get a job in admin because I’m too socially inept for it.  I challenged her to give me an example of a job that didn’t have face to face contact and she couldn’t.  I don’t know what she expects me to do, just sit at home watching Dragonball Z all day for the rest of my life?

I understand that, as someone on the spectrum, my personal presentation can sometimes leave a bit to be desired. But I would have thought that a psychology professional would have the knowledge to be accommodating of that.  I’ve worked with many therapists over my several admissions at that hospital and we’ve made great progress despite my being ‘difficult.’  Unfortunately she pulled this one after my last session with my doctor so I won’t be able to complain about it for a long time.

My discharge went smoothly. They gave me my papers over breakfast and I had them signed and handed back immediately.  The hard part is waiting around for my medication and scripts, which can take hours, but only took half an hour that day.  Then my boyfriend took me home and I arrived ready to face life sober.

Until I get admitted again (so ages away hopefully)

 

Mac

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The Rehab Diaries Redux – Week 2

We’ve reached the end of week two. The original plan was for me to go home after two weeks but considering I’m still fantasising about nailing myself with vodka as soon as I go home I decided to stay on for another week at least.

I have still been feeling low and unmotivated. I am supposed to be looking for work but I haven’t been motivated to do that.  I have a recruitment company looking for work for me and they got me a job interview that I had to go on leave for.  Obviously if I got the job I would have to discharge myself, but I didn’t.  They couldn’t give me any feedback except to say that I interviewed well but they needed to cull some applicants.  The whole thing sapped my mood even more.

The AWS assessments seem to have stopped. I was told at the beginning that I would be breathalysed after going on leave but that hasn’t happened yet.  I haven’t got any of the withdrawal symptoms mentioned in the assessment but I’m told feeling low can be one.

My regular doctor went away and I have been seeing the same one I saw when she went away during my last admission. Previously I’ve been frustrated with him because he has a conservative approach to treatment and is hesitant to make any changes but this time he put my antidepressant up when I told him I’d been feeling low and prescribe 2mg of diazepam to combat any agitation that might cause.

He also pointed out that this is a regular private mental health facility; there is no alcohol specific programs. We discussed whether my aim is to cut down or stop completely and I said I wanted to cut down if I could; I wasn’t ready to cut it out.  He said that most alcohol programs are abstinence focussed, and I need to look at controlled drinking programs.

I continue to fight with myself to eat properly. The food is heavy and often unappetising and so far I have gained 2kg in here despite sometimes only eating a bread roll for dinner.  The 5pm dinner time is still throwing me off.  I’m lucky that my boyfriend is here most nights to take me out for dinner.  Come to think of it, that could be responsible for the weight gain.

Sleeping has been surprisingly easy; I usually take two hours to fall asleep after taking my night meds but here I have been falling asleep after only one, despite having a room across from the dining room where most of the patients hang out at night and make the most noise. Only problem is, I have been waking up early.  Like, really early.  I wait until 6 to eat then take my meds with food, as advised, and fall asleep at 7.  When I do this at home I will wake up at 5 or 6am but here I have been waking up at 3am.  All I can do is get out my headphones and watch the tv shows my bf downloaded onto the computer for me.

I have been making myself go to group therapy to fill in time because left to my own devices I would just watch my shows all day.  Trouble is I have heard most of them before and end up sitting there bored out of my mind and getting annoyed with the other patients oversharing or interrupting with their ‘hilarious’ comments.

There was an addiction specific group and I thought I’d go along to that, but I left feeling more annoyed than ever. The other group members were very judgemental – one guy was a former smoker and said that all smokers are losers.  That’s right.  He came to an addiction group and called people with addictions losers.  Are.  You.  Fucking.  Kidding.  Me.  I wish I had said something but I was to appalled at the time.

Another girl who was there because she was worried she had an addictive personality but no actual addictions (I wanted to shake her and tell her to get a grip) said that she didn’t want to associate with her friends because they drink and do drugs and she thinks they will ruin her reputation. Well how am I, a problem drinker, supposed to feel comfortable sharing after that?

I went over the session with my inpatient therapist who happened to be the same therapist running the group. She helped me realised that the underlying emotion to that annoyance was shame, and the comments from the other patients triggered that and made me shut down.

I’m still not sure about my connection with this therapist who I have never seen before this admission but apparently she is good for tackling addictive behaviours. I have had three sessions with her so far and I feel that I am opening up more but I still don’t have the same chemistry with her that I have had with others.

I will be seeing my regular doctor again next week and if all goes to plan I will be writing week three’s edition from home.

 

Mac

The Rehab Diaries Redux – Week 1

So I’ve been here a week and not much has happened. As I posted earlier we got off to a shit start when the admitting CMO fucked up my medication chart and it took an emergency phone call to my doctor to get me my regular meds.  She had to come in to the hospital the following day to change my chart to what it was supposed to be.  Next time I get admitted I will bring a list detailing exactly what I take morning and night in what strengths.

The changes to my chart must have rattled the staff too because for the next three days I was getting the wrong meds and sending them back. The other thing the CMO did to piss me off was to chart a new pill without telling me – a thiamine supplement.  This is apparently given to alcoholics to reduce the chance of brain damage leading to things like Korsakoff’s psychosis.  Not that I’m not happy to take it, I just don’t think it’s unreasonable to want to be informed of changes to my medication routine.

The staff have been doing the alcohol withdrawal quizzes with me but so far I haven’t experienced any of those insidious withdrawal symptoms. I was drinking a lot – think blacking out regularly a lot – but I guess I haven’t been doing it for long enough.

I was getting cravings though, and for very specific things. Like one morning at 6 am I was craving a long island iced tea of all things.  I’m not sure if I would have succumbed to that craving at home given the time of day, but that’s a dangerous thing to want.  I’m embarrassed to say that on my benders I would make myself two of those and go from there.

The other thing I want is vodka. I was getting that craving watching cartoons in the evening, when I would normally be drinking.  It was so strong I could half taste it.  I told my doctor about these cravings and she put me on naltrexone.  It’s a drug that won’t make me sick it I actually drink so it’s good for cutting down rather than cutting out.  She was worried it would make me sick but so far I’ve had no side effects, and no more cravings.

Even though the cravings are gone I still miss drinking. I told my doctor that I still have the attitude of “if I wasn’t here I could be drinking” and she told me that probably means I need to stay here for a few more weeks.  I’m not sure I can last here that long but we’ll see how we go.

I’m struggling a bit because of boredom. At home I was bored too because I’m unemployed at the moment but I have more limits on me here.  At home when boredom was getting to me I could get in my car and go to the shops or the beach.  Here I’m stuck unless someone takes me out.  My BF has tried to help by bringing a hard drive full of my favourite tv shows but you can only watch so much tv in a day.

I think the main reason I’m struggling is that I’m not really unwell. My mood is a little low, maybe from coming off alcohol, maybe from boredom but I’m not feeling distressed all the time like I have been on my previous admissions.  On all of them I have been starting new medication regimes and most of my time was spent sleeping off the side effects.  Now the only two new drugs I have don’t seem to have any side effects and I’m wide awake all day.

As per usual there are several group therapy programs a day going on here and I have been going to a few to fill in time but they’re a bit different to last time I was here; they are more discussion based and less skill based. I find them socially exhausting and I get uncomfortable when other patients overshare.

I’m trying to get used to the meal times here, particularly dinner which is at 5pm when I’ve barely digested my lunch. The food is very heavy so I try to go on leave for meals where I can.  My meds need to be taken soon after food; normally they give the night meds out at 8pm but I’ve been asking for mine at 6pm.  That means I go to bed at 8pm, which I don’t mind, but I’ve been waking up at 3 am when I would normally wake up at 6am at home when taking meds at the same time.

Not sure if it was my anxiety or my mania but I was a cantankerous bitch last time and literally everyone in the hospital annoyed me. Now that I’m not really unwell – except for the drinking thing – I find I’m more tolerant of the other patients.  There are a few that grate on me – like the one who’s singing loudly underneath my window right now – but not enough to waste my time thinking about.

My doctor has gone on leave starting yesterday so have to see a different one for the next ten days – although truthfully I don’t think I’ll last that long – the same one as I saw on my last admission when she went away. I’m apprehensive about what he will make of this new issue of mine as I found his approach a bit conservative last time.

And so I’ve made it one week without climbing the walls. I’ll be back next week detailing my experiences with this new doctor and group therapy.

 

Mac

Some Travel Anxiety

I am leaving to go away for a week tomorrow and I’m really nervous.

This trip has been planned for months; it’s a sports trip. I’m going over with a team to play a team from a sister club in New Zealand.  I signed up for this trip because on paper it sounds like an amazing experience that I knew I would be grateful for afterwards.  But leading up to it I’ve been worrying more and more.

It’s a week spent in close quarters with twenty other people, some of whom I don’t really care for, playing a gruelling game during the day against super fit and talented people, and partying until the early hours of the morning, while I know my boyfriend wants to be up early for sightseeing – hello sleep disturbance!

I’m worrying about how I’ll handle myself with so much socially exhausting activity going on. I’m worrying how I’m going to sleep – sleep, as we know, isn’t my friend.  I’m worrying I’ll get injured.  I suppose I shouldn’t worry too much about that last one because I do have travel insurance that covers me for sports.

My boyfriend has been away with the club before and assures me that on his first trip he was nervous too, but found it a great way to get to know everyone. Friendship is forged on common experiences and all that.

When we last spoke this morning he signed off by saying “Remember, money, passport and meds – everything else is optional.” Because oh god the packing.  I haven’t even started yet.  I made myself a list which took about twenty minutes just to make sure I haven’t taken my 3DS and not brought a charger or something.

The medication issue is pertinent. I’m on six different scripts so try organising a week’s worth of meds out of that.  Very entertaining.  And I’ve got to include spares for if I lose a dose.  I’m worried because I forgot to get a psychiatrist’s note for my meds and I don’ t know if I’ll need one at immigration.  The last time I travelled overseas with meds was to the states in 2014.  I was on a lot less meds then though.  I did have a note from my doctor but they didn’t check it.  I’m considering getting my GP dad to write one on the off chance that I do get pulled up because of it.

So I’m anxious, ruminating and…probably going to have a great time. I’ll report back in a week, unless I fall down a hobbit hole or something.

 

Mac

A Doctor’s Appointment and Lots of Hairballs

My hair is falling out.  In freaking sheets.

I can’t quite remember when it started – maybe at the end of last year sometime – but I’m shedding like cat coming out of winter.  I fill up my hair brush in just one brushing session.  There’s always masses of it on the back of my shirts.  When I wash my hair clumps of it can be seen on the floor of the shower.  I swept out my bathroom and created a massive blonde tumbleweed.

It ends up absolutely everywhere – all over my clothes, through my car, my boyfriend’s beard – everywhere.

I’ve been a bit concerned even though I don’t appear to have thin spots on my scalp, but I do have way more hair than the average person.  I’m not sure what’s causing it, my meds, my anxiety or bleaching my hair.  I’m pretty sure it’s not the latter because it appears to be falling out at the root, not breaking off.

My anxiety has been up and down this year depending on what’s going on in my life – I had a particularly stressful end to the college term, but the hair loss has been steady and constant.  As for my meds, I don’t know what could be causing the shedding.  I’ve been on meds before that did it – on epilim I nearly went bald – I had never heard of any of the current set causing hair loss.

After a frustrating afternoon of pulling my furballs out of his shower drain, my boyfriend insisted that I raise the issue with my doctor.  I had an appointment coming up so I promised to do just that.

I haven’t seen my doctor since the Zeldox discussions.  She’s only seeing me six weekly now, as opposed to three.  I’ve been handling things well I think.

On the day of the appointment though, it was obvious that I was having an off day.  I usually take my night time meds early in the evening so I can have a good long sleep and wake up early.  Even though I take the maximum dose of Zeldox I don’t usually experience a hangover effect, but this morning was different.

My boyfriend pretty much had to drag me out of bed when his normal alarm tactic – rolling a chilled can of diet coke across my face – didn’t work.  I slept in the car and when I got out I was immediately overcome with a wave of nausea.  Unfortunately I didn’t have my ginger pills on me.

It was obvious to my psychiatrist was soon as I came in that I was doped up, and she questioned whether I was on too much medication.  I assured her that this episode was unusual.  I must admit I panicked a little – I think every appointment I have with her I’m going to be worried that she’s going to take me off Zeldox.  It’s not just that it works, I’m keen to stay on it because it keeps me thin.

Shallow, I know.

I didn’t talk much because I was so tired but somehow I convinced her that I’m going ok.  We raised the hair loss issue with her and she told me what I already knew – that none of my meds were known to cause this.  She also said that while it might seem like a lot of hair falling out, if I can’t see any thin spots then I probably shouldn’t worry too much.

I was probably in and out in under twenty minutes, and that was me done for another six weeks.  It looks like I’ll still be scraping furballs off my shower floor for the foreseeable future but hey, at least I get to stay blonde.

Mac

What is CBT, and how will it help me?

So in my absence, I’ve been attending a weekly CBT group therapy session.  The decision to refer me to this group was made when I was discharged from hospital back in January to tackle my anxiety.  I went onto a waiting list then a spot opened for me in April.

So what is CBT?

Cognitive behavioural therapy is a problem based, action focussed form of psychotherapy – it identifies problematic behaviours and thoughts, challenges them and encourages you to form new ones.  It has been proven to be effective in treating many different mental illnesses but in this group was focussed on depression and anxiety.  It can be done individually, or in a group setting.

I’ve done group therapy before but that was DBT, a therapy more oriented at reducing problematic behaviours in people with personality disorders.  I had to do the group something like four times before the therapists decided that they were done with me.  What can I say, old habits die hard.

With that in mind I was apprehensive towards CBT.  I was hoping it wouldn’t attract the kind of drama that comes with a DBT group, where you don’t tend to end up unless your life is well out of control.  My own life was pretty chaotic at the time, and I’m sure there were plenty of people in the group who got sick of hearing about me getting into the same dramas over and over.

My brother in law also tried individual CBT to treat his depression and didn’t like it.  Which is fine, not all therapy styles are appropriate for every individual but he really felt it was too impersonal.  He likened it to treating his brain like a computer that needs rebooting.  Which is interesting because I find that to be an appropriate metaphor for how my anxiety works.  It’s like my brain is programmed to dread unspeakable horrors at all times for no goddamn reason and if reprogramming is what CBT can do for me, then I’m all for it.

So I went along to this group.  It runs for three and a half hours, separated into three sections, sharing, mindfulness and doing worksheets.  When we first arrive we take turns sharing situations where we struggled with our anxiety and/or depression, and where we have done our homework from the last week which generally consists of identifying some problematic thought patterns and connecting them to our behaviours

After sharing – which usually takes twenty minutes or so per person – we have a twenty minute break, then go back to do a mindfulness exercise lead by the therapist.  This is the part I struggled with; I can’t keep my head clear to save my life.  Intrusive thoughts are a big deal for me.  I can do some mindful deep breathing but I’ll guarantee I’m also thinking about my favourite Archer quotes or something.

We then spend the last hour and a half working through the info and exercises on our handouts for the week.  If you follow me on Instagram you’ll notice I’ve been posting them as I get them; they are separated into two seven week modules, one on anxiety and one on depression.  Each week we explore some aspect of thoughts and behaviours that might be shaped by both.

Even though I was put in this group for anxiety, I found the thought challenging exercises in the depression module to be more relevant to me.  I love to catastrophise and obsess over possibilities – and I have a double whammy of autistic spectrum disorder and paranoid delusions from mania facilitating that – and I found the exercises grounding.

So about the people in the group…obviously I can’t share details about them, but was I right in assuming that they would be less dramatic than our mates in DBT?  The answer is yes…mostly.  People with anxiety as opposed to personality disorders tend to be higher functioning I’ve found, but there’s always some individuals who can’t not escalate any drama they get into and don’t want to help themselves by using the therapy tools to challenge their behaviour.  But one of our group rules is accepting that everyone is at a different stage of their recovery journey, so I just have to take it for what it is I guess.

After all, One of the benefits of group therapy that they’re too polite to tell you about is that there’s always something to be learned from other people’s mistakes.

Mac

The Rehab Diaries Week 5 – Hitting the Wall

I’ve hit the wall, and hit it hard.  To think it only took me four weeks.

My anxiety is spotty.  It’s kind of on and off but when it’s on it’s intense.  I’ve had days where I spent hours just pacing and ruminating.  Leaving the hospital is still making me feel sick.  Le boyf is making me go out, and is getting concerned over how I’m somehow not getting less shaky every time we do go out.

It seems to be spiking at night.  At night, anxiety is just on.  I guess it’s because it’s the time of day when the zeldox levels in my system are at a low but I just run in circles around my room, so dizzy and shaky, trying to wear myself out.

I have an agitating factor at night time; there’s a very real issue that can prevent me from sleeping.  My neighbour’s.  Fucking.  Snoring.  It has to be heard to be believed.  And it can be heard through the wall with the door shut.  They gave me ear plugs which do work, but they’re uncomfortable and I don’t like wearing them.

The rational part of my brain tells me that I shouldn’t be expecting to not be a competent, non agoraphobe in just a few short weeks.  The depressed all of my brain asks when I will ever not be an incompetent agoraphobe.  Suicidal ideation is back.  I just can’t do this for another fifty-odd years.

I had to make the decision of whether to return to my regular inpatient psychiatrist who was returning to work this week.  This was more complicated than it sounds.  On one hand, I’ve seen the regular doctor for five years, we work well together and it’s important to keep her in the loop.  On the other hand, I’ve come to realise that these two have very different philosophies.  While I was frustrated at my current doctor to begin with, I came to realise that his comparatively conservative approach isn’t always a bad thing – bringing up my drugs slowly allowed me to tolerate them much better, and adding them to my chart as PRN rather than standard gave me greater control over when I increased the dose.

The deciding factor was whether I would have to change therapists.  Each doctor has a different psychologist working under them, and I was concerned that if I went back to my old doctor I’d have to change my therapist as well.  I just wasn’t prepared to change both at this late stage.  When I asked him though he promised that he’d fix it so I could see my regular doctor and his therapist.  So it was settled.  I’d leave his care and move to hers.

I was worried about this appointment, not because I’m scared of her – as the staff kept teasing me – but having explain my entire case summary to a new person is exhausting.  Plus with her less conservative approach to medication I was afraid that she’d effectively blow up this current regime and put me straight on a different cocktail which would make me violently ill, and keep me in hospital for several more weeks.

Despite my fears she did no such thing, but explained to me that she would normally be treating anxiety with a certain type of anti depressant.  Which as we know, for bipolar patients, is problematic.

She contemplated prescribing lovan, which is apparently a safer class of the drug but I know I’ve been on that before, I just can’t remember when or for how long.  If it was for a long time, that would indicate it was working.  She promised to dig through my files to see if it was in the last five years, I promised to check with my parents because I suspect it was long before that.

She also made the morning zeldox a permanent addition to my medication chart, so I don’t have to explain to the nurses every single morning why I need PRN just after I’ve woken up.  Taking it in the morning is definitely getting easier but I’m still struggling some days where I end up doing sweet FA all day really.  I have what my dad would call ‘bed days’ when he talks about his nursing home patients, where I just lie around and watch tv.   Of course dad would say that bed days are reasonable in elderly folk on their last legs who have slowed right down, not a young person like me.

Another addition to my anxiety is the demographic shift in the hospital’s residents that has happened suddenly this week.  I’ve noticed over my admissions that the hospital does go through stages of being either mostly young or mostly older folks over periods of several weeks. And there never seems to be a whole lot of inbetweeners like myself.  Maybe because they tend to assign themselves to one of the groups and manage to blend in but I’m not interested in either.  Although there are a few who, like me, do keep to themselves.

Anyway up until now, including over the holiday lockdown period, it’s been a decidedly old timers scene.  But this week has seen an influx of youngsters and whenever this happens the hospital turns into a giant sleepover party.  Shrill laughing, gossip, cliques, running in and out of each other’s rooms.

That last part I find particularly anxirty inducing.  I know that seems irrational but truth be told I would never go into another patient’s space.  And I would not tolerate them coming into mine.  In fact it’s against the rules to have another patient in your room.  Even if it wasn’t I would be enforcing that as a personal boundary.

The nurses don’t appear all that concerned; certain rules aren’t strongly enforced when nothing is being hurt except maybe the sensibility of personal boundaries.  One good thing about the youngsters is that they all want to hang out the smokers area so at certain times of the day the hospital completely clears out when they want their nicotine fix.  I do appreciate the quiet.

Something that has made a huge impression on me in my personal therapy journey is the importance of appropriate personal boundaries.  Generally – there are some exceptions of course – the older crew are totally on board with this idea, as many have been in therapy for years but watching the current lot is good for meditating on that concept.

I’m not saying that all young people suck at boundaries but, as I said seeing certain ones running into wach others rooms and jumping on their beds makes me wonder.  I could do I could do a whole other blog post on the topic but the gyst of it is, we are told that while socialising in here is fine, we are discouraged from maintaining friendships once we get discharged.  And after being admitted with certain people a number of times you often come to understand that despite presenting well freinship with them can be exhausting.  I include myself in that description, I suck at maintaining friendships.

Some food for thought might not be a bad thing, hey?  Anything to distract me from the anxiety.

Mac