depression

The Rehab Diaries Redux – Week 3

Mac the Disordered rehab diaries , , , , , ,

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

The Rehab Diaries Redux – Week 2

Mac the Disordered rehab diaries , , , , , , ,

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

Mac the Disordered rehab diaries , , , , , ,

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

A Doctor’s Appointment and Lots of Hairballs

Mac the Disordered Uncategorized , , , , , , , ,

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?

Mac the Disordered anxiety, depression , , , , , ,

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 4 – Holiday Time is Over

Mac the Disordered anxiety, bipolar disorder, depression, mania, rehab diaries , , , , , , , , , , , , , , , , ,

 

2015-02-19 16.47.53

 

Finally, I got to see the new doctor.  He was a pleasant character and after a few leading questions I found myself pretty much telling him my life story, including how I had applied for medical school this year, and missed the UMAT cut off for my school of choice my just a couple of points.

He was supportive, saying that he had several patients who had gone on to careers in medicine, and some much older than me.  He tried to decipher my doctor’s notes – apparently he has typical doctor’s handwriting – and it appears that he eventually intends to supervise me onto 100mg of Zeldox, which would indicate 2-3 more weeks of rehab.  He told me that he would be putting it up to 60mg this week.

When mum picked me up for leave that afternoon I passed on that information and her reaction was one of despair.  How could I be there for a month?  Don’t my doctors understand the havoc I am wreaking on my family yet again? Thanks mum, real helpful…  (Actually I’ve been there for five weeks before but I think this admission will top that.)

If last week was the week of agitation, this week is the week of anxiety.  I’m still experiencing racing thoughts, racing through everything I could possibly be anxious about.  Just leaving the hospital makes me feel so ill.  BF and I were going to the beach last week but that’s out of the question now.

For some reason thinking about moving home is triggering me badly.  It’s just the whole moving process being such a pain in the butt, I just want it over with.  We’ve been going to my place to get bits and pieces and that’s so hard.  For some reason being in my suburb is giving me anxiety over the fact that it’s a super rough area.  Which it is, but I’ve lived there for two years and never been broken into or had any such trouble from the residents.  The drama stayed out of our house and on the street but still I can’t help agonising.  It sucks.

I’ve been catastrophizing something dreadful.  My mind latches onto a dreadful idea, and I can’t relax until I’ve been able to confirm it.  For example, while I was on leave one morning I became convinced that someone had gone into my room and stolen my contraceptive pill.  Which is ridiculous, right?  That’s a horrible thing to do and I haven’t even talked to the other patients enough to infuriate someone to the point where they would do that.  But I couldn’t let it go.  I ended up calling the nurses’ station and making one of the nurses check that it was in my drawer.  Which it was.

I’ve had many ‘ideas’ like this.  When I have them I make sure to tell the staff so that my irrational thinking is going on record because this needs to stop.  Of course the fact that I’m aware that these thoughts are irrational bodes well for me but it’s still eating me alive.

And then to add a poisonous olive on the side of this paranoia laced anxiety cocktail, I woke up one morning and the double doors between ward one and two had been thrown open.

Holiday time is over.

“Oh yes, we’re back to normal functioning this week.  Prepare for fifty thousand admissions.”  My nurse confirmed cheerfully as she brought my morning tablets.

I later found out that this number is actually closer to seven.  Admissions generally happen two days of the week, so they were able to stagger the patients coming in.

The advantage of course is that all the staff are running at full capacity, including the therapists.  Group therapy is back.  I gave groups another chance, and the first one I went to left me feeling positive – the therapist allowed us to check in, so the self pitying ramblers were not allowed to talk over anyone or hog the air time.

I’m certainly not above talking too much, and it’s something I’m very self conscious about; I’ve noticed in group therapy that those who talk the most tend to apply the skills the least and I can’t possibly be the only one.  I always cringe and swear I’m going to pass ever time they start going around the circle to check in but let loose when it’s my turn.  Those damn therapists sure know how to ask leading questions.

I was also eagerly awaiting the return of my therapist this week to finally start unpacking all this anxiety but my excitement was premature.  I saw her once before she had to go on leave for a week for surgery.  LAIM.  Am I going to get any kind of decent interpersonal therapy before I get discharged?

We’ll find out next week I guess.

Mac

 

The Rehab Diaries Week 3 – Oh so quiet, just not in my head.

Mac the Disordered anxiety, bipolar disorder, depression, rehab diaries, rehab problems , , , , , , , , , , , , , ,

 

 

justmymind

 

My brain is resisting sleep.  Getting out of bed is hard but getting in is harder.  My anxiety is so restless even though I’m on more than ever before.

I was bouncing off the walls.  A good proportion of my dad was spent pacing back and forth.  I was hiding in my room to avoid human contact.  Even though the ward was closed and there were hardly any patients in, as we know I still found everything and anything to be irrationally enraged at.

My trichillomania had been triggered as it often is in times like this but bizarrely instead of pulling out my own hair, it has been transferred onto my boyfriend.

“Can you talk to the doctor about this?”  He asked jokingly, pointing to his scabbed up face.  I cringed.  Once he put it out there it seemed to be no joke at all.  Popping his zits is something I do a lot – be honest ladies, you know you do this – but my attacks on his face had gotten harsher.  Patches of hair from his beard were missing too, as I kept saying I “just want to get rid of the weird hairs.” I had to keep checking for grey hairs, or split hairs, or hairs thicker or thinner than the others.  And if I found one, it had to go.

BF had been saying that he wanted to meet the doctor to get a better understanding of my illness.  I asked the doctor if him sitting in for a bit was ok, which he agreed to but once the door closed, stage fright struck.  We asked BF if he had any questions and he kept saying he didn’t know.  After a few minutes of this I grew impatient and threw him out.

The doctor was sympathetic to my claims of elevated mood from the previous week, even though it was maddeningly settled that day so he couldn’t observe it in consultation.  He admitted that the increased melatonin may have overshot the mark and scaled it back to 25, increasing my zeldox by another 20 at night because previously when I had been taking 20 morning and night I always needed a nap at midday.

My med woes were not over however, as later that night a nurse came running into my room absolutely beside herself.  “It’s no good, Mac.  We’ve messed up your cycle.  You need to start used protection because if you get pregnant because of me, I’ll never forgive myself!”

She explained that there had been a communication issue regarding the dispensing of my contraceptive pill.  A few days after I arrived another nurse gave my pill back to me and told me to manage it myself.  I thought that was fair enough.  But that night, I saw a little Yaz in with my normal pills.  Silly me just assumed without questioning that they’d changes their minds.

Apparently it hadn’t been recorded that I was managing it myself, so depending on which nurse was doing the medication rounds, some nights I was being given the pill, and some nights I wasn’t.  And stupid Mac was just swallowing whatever she was given without checking.

After apologising profusely she launched into a lengthy lecture about safe sex that left us both ruffled and red-faced.  Do I have access to condoms?  Will BF wear one?  Will I make him wear one?  Can we abstain?  Is it hard for him?  Hard for me?

I’m going red again just thinking about it.

Her concerns turned out to be unjustified as I got my period a few days later.  Maybe that explains my mood.  I’ve had to deal with all the delightful extras that come with that, including the cramps.  My cramps are nasty at the best of times, and the only thing that really helps is heat.  Unfortunately heat packs are not allowed due to the risk of self-harm so the staff loaded me up with panadeine and I had several hot showers a day.  The temperature of the showers is set to a maximum of pleasantly warm so we can’t burn ourselves.

On the increased zeldox my brain became settled enough to make one major decision – I have decided to move back in with my parents.  My health has been so bad for so long I’ve had to get real about what I actually need and at this point I feel like living in my parents’ house is the best option.

The configuration of the house will have to be changed to give me acceptable independence.  My parents have tasked me with working it out and it has shown to be a good way to keep my mind active.

New year’s eve fell on this week and it had me really worked up.  Maybe because it was so hot, maybe because my mum and I had an argument over the way I cleaned the bathroom on leave but I was ready to go without dinner – and let my boyfriend do the same – after I called around several take out places for dinner to find they were all closed and had a ‘fuck this I’m done’ moment.

After a pep talk from mum I called one more place – which was open.  My anxieties about traffic and crowds were completely unfounded, while the restaurant was located in the middle of town it was deserted when we got there at 5.30.  And the pizza was fantastic.

I’m not really one to get worked up over FOMO, so I wasn’t keen for grandiose new year’s plans and BF is the same.  But I was a little bummed about not being able to do the midnight kiss.  See, normally the clinic doors lock at ten so we have to be back by then when we’re on leave.  The staff were willing to make an exception for new years eve but legally we had to be back by midnight.

So we went to 9pm fireworks which were fantastic…so fantastic that I had a brief seizure!  I’m epileptic, even though my seizures are very rare I am changing meds at the moment so it’s not that big a deal.  I notified the staff when I got back to the hospital and that was their impression as well.

My doctor was off for the rest of the week and I was supposed to see one of the others but I didn’t realise that he works on a different schedule to mine, who works Tuesdays and Fridays.  The fill-in works Mondays and Thursdays so I went out all New years day thinking I would be seeing him on Friday, but no deal.  Oops!

With only the one tablet being increased it’s not that big a deal; they can’t bring it up faster than once a week anyway.

I would have to wait until the next week to see him, when the ward opened again…how would I be handling that?  You’ll have to wait until the next instalment to find out.

Mac

 

 

The Rehab Diaries Week 2 – Christmas On the Closed Ward

Mac the Disordered anxiety, bipolar disorder, depression, mania, rehab diaries , , , , , , , , , , ,

itsbeginningtolookalotlikefuckthis

 

Exactly a week before Christmas a note slipped under my door warning me of changes to the ward over the Christmas break, which would start in a few days and last two weeks. I was aware the ward shut downs to half capacity over Christmas, but I had never been in hospital during that time before.

One of the hospital’s two wards would be closed off completely.  This happened to be the one I was admitted to but I didn’t have to move because the wards are separated by a set of doors, and my room is one of three that are on the other side despite being under care of staff of ward 2.

No more patients are supposed to be admitted during this time, although there were about three more admitted over the next few weeks whenever someone discharged themselves prematurely.  Which happens, it’s a voluntary clinic after all.  Many discharges were planned for that Friday before the closing, so in the end the staff were caring for about a third of the usual patients.

Many staff were forced on leave as well by the hospital, including all of the therapists.  That meant no group or private therapy for two weeks.  No one was thrilled about this, least of all me.  Part of the reason I came to hospital was to have some intensive psychotherapy to unpack why I spent the second half of last year in a constant state of mental breakdown.  The timing of this admission is unfortunate.

Also going on leave against his will was my doctor.  After feeling frustrated with his apparent unwillingness to make a decision last week I explained the kind of pressure that I was feeling.  He explained once again that usually the way to treat my anxiety symptoms would be to add an antidepressant but that my bipolar made that a risky move.  He suggested doubling my melatonin pill, which could help my depression and anxiety and fix my broken sleep in a less risky way than a classic antidepressant.  I agreed.

His going on leave was another cause for concern.  This would be yet another doctor to haul out my life story in front of, who would no doubt have a different therapeutic philosophy and I had no way of knowing what kind of changes he might make.  It’s kind of disturbing really how so many staff said they wanted to stay on – especially the therapists.

As it turned out however upping the melatonin was not as risk free as we may have thought.  My mood swung, and it swung high.  And hard.

My thoughts were racing.  I was shaky, ruminative, anxious.  Irritable.  I spent much of the day pacing about my room and feeling murderous toward my fellow patients.  It just so happened that at this time there were several patients who liked to play instruments.  And just hearing them play sent me into the most unreasonable state of irritation.

There was a lady with a flute, a guy with a guitar and a nurse with a ukulele who liked to join them.  They had timetabled daily sing-alongs but guitar boy could be heard strumming away contemplatively at all hours of the day and for some reason my brain equated that with being unreasonable.

I know, irony.

I got so irritated that on closing day I ended up in the nurse unit managers office having a cry about how annoyed I was.  I thought she would laugh me out of her office but she was sympathetic.

“Why do you think I timetabled these music groups?  They annoy me too!  I was hoping they’d get it out of their system in the allotted hour.”

She jokingly assured me that most of them were getting discharged that day.

The ward closed but it wasn’t a happy place.  Christmas is a triggering time for many people.  I’m lucky not to have to deal with the family dramas that a lot of the other patients were trying to cope with and they struggled.  There was many, many meltdowns.  The short staffed nurses did their best to cope but some therapists certainly would have come in handy.

As for me, my mood just kept on climbing.  On Christmas eve I my mum came and picked me up to help prepare the house for Christmas and when I jumped in the car I stunned her by immediately covering ten different topics in two minutes, occasionally stopping to cackle manically.

“Oh my God…take a breath.  You’re acting a bit manic.”

“My thoughts are racing.”  I admitted.

“oooooooooook.  We’re going to working keeping a nice calm environment today.”

I was worried about how I’d handle Christmas Eve mass and dinner – when the mood’s up, anxiety tends to be up as well – but in the company of my family I was able to relax and go with the flow of the evening.

On the day itself my anxiety was intense- event though I was woken up by a nurse leaving a box of chocolates on my bedside table.  I thought getting out of the hospital was going to be hard and I was right.  The nurses were stressed out trying to get meds for ten patients at once as we all had to go out at the same time.  Some of the patients were getting agitated and taking it out on the nurses and that was hard to take.   I made a mental note to bring a box of leftover candies back with me that night.

After my extreme high the day before I was tired for most of Christmas day and spent most of it on the couch pretending to mind my cousin’s children as they wreaked havoc in front of me.  For the most part everyone left me alone and I got a few good presents out of the day, so I can’t complain really.

If you read last week’s entry you may be wondering…did I speak to the nurse my boyfriend unloaded on last week?  Yes I did – eventually.  She wasn’t in for a week after the incident but on her first shift back I asked for her version of events.

The way BF told it, he’d appealed to her for help after I refused to engage him but she remembered differently.  According to her this guy – the boyfriend of a patient, remember – came up to her and gave her a brief history of BF.  It’s not a happy history.  She asked him if he was seeing a psychologist – which he is – and rightfully delegated that conversation onto him.  Then I suppose he asked her what to do about his wilful girlfriend problem.

How bizarre.

He didn’t deny any of this when I told him what she said, and did end up seeing his therapist soon after, saying that he felt better equipped for it.  I wish I understood what it was about my depressive episode that made his whole life flash before his eyes though.

Until next time,

 

Mac

The Rehab Diaries Part 3 – Week 1

Mac the Disordered anxiety, bipolar disorder, depression, mania, rehab diaries, rehab problems , , , , , , , , , , , ,

Finally, we touched ground at the clinic.

The first thing they do, after you fill out the paperwork and pay the gap, is take your vitals and take a picture to put in your file so the staff coming in on the next shift can match names to faces.  I’ve had several pictures taken over the years to account for aging – and my hair being a different colour in each one.

In all my previous pictures I look either depressed or agitated but in this one I was concerned that I look inappropriately cheerful.  There’s a good reason for that though – after I’d had my medical and was awaiting the nurse with my admission package, BF ducked into my bathroom.  The nurse came in while he was doing his business.

She apparently didn’t hear him flush the toilet and wash his hands while she was setting up the camera.  When he threw open the door just as she was pressing the button, she startled so badly that she jumped and we had to take the photo again.  The second one came out but it was obvious that I was trying to supress my amusement.

After BF left, I was to have my admission appointment with a doctor who I hadn’t worked with for five years, as my regular hospital psychiatrist was away.  I was a little nervous about this meeting; I had been a difficult patient to deal with at the time but was having a lot of trouble expressing what was wrong with me, and took a lot of frustration out on my care team.  As a result I was told again and again that they had no idea how to help me.  I harboured a deep distrust of mental health professionals for a few years after.

My communication skills have improved since then and bearing in mind that I didn’t get along with my current psychiatrist when we first met, I was willing to give him a chance.  I figured it was a better option than starting with yet another doctor who I don’t know at all.  I was relieved to find that he was willing to give me another chance too, and after the official admission business he asked me what I hoped to achieve with this admission.

I explained the deal with my current medication.  The mood stabilisers seem to be struggling on their own.  The efficacy of Topamax is unclear.  My anxiety is out of control.  I probably need to be on antipsychotic drugs as well as mood stabilisers – as many bipolar patients do – but we’ve had trouble sticking with one so far because of side effects.

He listened, and conceded that this would be worth a try…and if I left it with him, he would come up with something.  Wait, what?

Turns out I didn’t have a good appreciation for how gung-ho my regular psychiatrist’s approach is.

In our next appointment three days later I found my frustrations from five years ago resurfacing somewhat.  The doctor seemed unwilling to make a solid decision and kept throwing the conversation back to me, asking me if I had other ideas.  Um, why go through three years of psych residency if it were that simple?

I pressed him and he listed off some antidepressants to treat my low mood which was met with an (admittedly ungracious) groan from me.

“Pristiq?  PRISTIQ??? Don’t you remember what I was like when you put me on pristiq before?”

“remind me?”  He quipped innocently

“kinda nasty.”

He suggested Cymbalta, saying that some of his bipolar patients had seen improvements on the drug but I was hesitant, maybe unfairly due to the number of people of mental health forums I’ve been haunting despairing over side effects.  I said I would ask my dad, also a doctor, for a second opinion.

Finally he printed out some information on the natural supplement SAMe, explaining that it could be a cheaper way to regulate my sleep and depression.  Oh great, now we’ve exhausted all our pharmaceutical options I thought glumly as I left.  Clearly he thought he was giving me greater autonomy over my treatment plan but at the time I felt like I had all these decisions on my shoulders that I’m unqualified to make.

I spend a lot of that week in bed.  I was low, in mood and in energy.  BF normally cares for his mother but she had been in respite for a few weeks so he was with me constantly.  Whether I liked it or not.  All BF all the time.  I just didn’t have the energy to entertain him and I was getting more annoyed by his presence because I felt like he was just doing it to ease his own guilt, rather than because he thought he was helping me.

On one such day he said he was coming over.  I told him no, I wasn’t up for company but he turned up anyway.  In the mood I was in I told him that if he must be here fine, but I said I didn’t want to talk so I wouldn’t.  And rolled over and went to sleep.

I napped most of the afternoon while BF lay on the floor playing candy crush, every now and then being woken up by an overdramatic look-at-me sigh from him.  About two hours in when sighing his feelings out got him nowhere he got up and stormed out.  I’m not sure how long he was gone for as I was asleep in between but he came back with my nurse who looked a little perplexed.

“You should get up.” She turned to him “She hasn’t eaten today.”

I pulled the covers over my head. “Too bad.”

He yanked the quilt off my bed. “Nope!  We’re going for a walk.  Even if I have to wheel the bed out the front door.”

After some protests from me – and a threat to roll me off the bed that probably would have been carried out – we did go for a walk to the nearby lake, and ate Thai food in the sun.  My mood improved for about five minutes.

I was hoping to debrief with the nurse over whatever my boyfriend said to her, but she wasn’t in for the rest of the week.  If he wants to be around and harass me fine, but I don’t want him annoying the staff.

That was a conversation I wasn’t able to have until week two.

So you’ll be hearing about that in the next instalment of the rehab diaries.

Mac

 

The Rehab Diaries Part 2 – The Waiting Game.

Mac the Disordered anxiety, bipolar disorder, depression, mania, rehab diaries, rehab problems , , , , , , , , , , ,

Waiting, waiting, waiting.

After stressing out about getting the referral, turns out that was much ado about nothing compared to the limbo that followed.

Usually what happens is the referral gets triaged and paced in line based on need.  The line moves based on discharges, or you may be moved forward if they think your need increases which I’ll provide an example of later.

So when you’re next in line and there’s a discharge planned for the next day, you get a call informing you of there being a room free and could you be there the next day at a certain time?  However, patients do discharge themselves before their program is complete – being a private clinic, we are all supposed to be there of our own free will, after all – and I’ve be called in on the day with two hours’ notice one time.  By then the staff knew me well enough to know that I lived close enough to make it there in that time, and I have people who would take me.

You need lifts because patients are not allowed to drive to and from the hospital.  I would organise that as soon as the referral is sent because you never know when the call is going to come – previously I’ve gotten it the day after, or a week after.  This took two and a half weeks, which is the longest I’ve ever waited.

Turns out, everyone wants to go to rehab over Christmas.  Funny that.  I believe that the clinic was also trying to slow down their intake leading up to the closing of the ward three days before Christmas to reduce the strain on the staff who operate at half strength this time of year.

This doesn’t stop a lot of people looking for a convenient cover to get away from their families – and after some interactions with the residents I can’t help but wonder if some of the families were overly supportive of the idea.  This isn’t speculation, we’ve had whole group therapy sessions on the topic and I couldn’t get a word in edgeways for all the venting.

I’m not looking to get away from family, we certainly don’t have the type of dysfunction that the other patients are dealing with.  I need help.  That’s the long and short of it.

So I waited a week.  A week and a half.  I called the triage nurse (I really didn’t want to do that because we can’t stand each other, but luckily I only ever spoke to her minions) to check the referral had gone through.  It had.  Alrighty then, I’ll wait some more.

I called again two days later, because I was suddenly anxious about the wards closing.  I knew it happened, I just couldn’t remember when and I was convinced it was going to be in like three days before the line got to me.  The nurse assured me that no, it was more like three weeks.  Crisis averted.

Then the next day, the nurse unit manager called me.  And yes, he’d been notified of my calls and was concerned that my need had increased. He had a spare bed for me if I wanted to come in…only problem was, it was a shared room.  I’d had some bad experiences with shared rooms so I knew I had to decline.  He said he thought so but just thought he’d check.  More waiting.

While this was going on I was staying at mum and dads, my hospital bag, doona and pillows perched in a neat pile in the hall way, ready to go.  Mum started asking with concern if they could have forgotten me.  I told her about my calls and assured her that was not the case.  All I could do was wait some more.

And then, two and a half weeks later, it finally came.

There was a room, ready for me.  The time had come.

My boyfriend wanted to be the one that drove me, so we said goodbye to my parents and headed out.

And so began my stay…which you will be hearing more about in the next instalment of the rehab diaries.

Mac