Medication shock

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I tried a new medication last week risperidone, to replace the quetiapine I was taking to try and treat OCD. Something that isn’t always obvious is that the side-effects of the medication can be worse than what it is trying to treat. You should note that this is just my experience, and yours may differ, but this is the worst experience I’ve had with a medication.

In my case it caused me to wake up multiple times throughout the night, and by the second day of taking it I was highly anxious and agitated, both of which are common side-effects. This led me to me hating myself, a lot. The thoughts run through my head every so often, but function as intrusive thoughts that dissipate when I pay them no attention. Being agitated led to me paying a lot of attention to them

The effects took about 48 hours to wear off completely. Physical effects included my right eye not opening properly and being short of breath.

In a way it “helped” with my OCD, as it rendered doing any decontamination procedures so intensely distressing I took shortcuts and skipped steps to try and escape the procedures. I didn’t feel any better afterwards.

On the negative the agitation prevented me from watching TV and reading. I even burnt my mouth from eating too fast, as the agitation made me want to get eating out of the way as soon as possible. That is a disadvantage of rushing to escape agitation.

It permeated through the rest of my day, and the only time I felt sort of settled was when I was moving, on the bus. Walking was a problem as my breathing way short (a narrowed throat is a side effect of the medication, but anxiety can also tighten your chest shortening your breath). A normal way for me to cope with intense anxiety and distress is sprinting, but that wasn’t available when I couldn’t breathe normally.

After consulting my psychiatrist’s office I was advised to stop taking the medication, which I did. Unfortunately I still had to put up with the side effects until they wore off. To get to sleep I had to visit A&E, and got sedative to calm myself and averted any risk of me self-harming.

At the moment I’m just feeling the trauma of the event, but I’ve escaped the side effects now.

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Coping with sleep

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My number one coping strategy is getting enough sleep. Should I fail to get enough sleep for long enough I will end up too exhausted to use any other coping strategies.

I forgot to get my repeat prescription on time this week, and as I usually rely on the sedative effect of quetiapine to get me to sleep, I had a few bad nights – when waking up the trouble of trying to get back to sleep made it feel like I was struggling to breathe. I don’t think that was the case, but my mind gave the illusion of it, probably because it had trouble expressing the feeling of being unable to sleep.

Historically a week with sleep disruption results in me acting implusively, not always dangerously, but always in a way that I regret.

Luckily this time around it was “just” two days, so I’m OK, and feeling, safe now, even if the feeling of fear when I try to go to sleep hasn’t faded yet.

Somehow, although it defies explanation I have found myself with too many things to do (programming, new series on Prime Video, and fitting in video games). That’s good, as it leaves me safe.

Bye for now.

Trusting professionals

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Lately I’ve been experiencing a large number of thoughts around self-harm. This has started my thinking about who do I trust to tell about them. The answer is, very few people, and just two professionals.

Trusting professionals is the subject of this post.

When I’m in crisis I’m advised to call the local CRHT (crisis resolution and home treatment) team. I don’t, ever. I am too terrified that I’ll call and be accused of threatening to self-harm. I don’t trust the CRHT to help me, and I have too many friends who have been dismissed by the CRHT as not at risk.

Comments made about me by professionals express that I’m too high functioning to need continued access to support, with the same arguments for removing me from the ward now being used to justify discharge from the CMHT (community mental health team). The reasoning being, that they don’t appear to do anything for me.

Then there is the incredibly common expression by psychriatric staff “it’s your choice to [self-harm/kill yourself/…]”. It doesn’t help, at all, it just works as a way to absolve the staff member of any responsibility to help you. This isn’t personal, it is just how they always respond, with the idea being that this will provide you with the willpower to not hurt yourself. It does not consider the case where you actually want to hurt yourself as it doesn’t feel like there is another option – they don’t explicitly provide another option. This also gives the staff grounds to disregard whatever you do to yourself as “your choice”, “your responsibility” and ignore the emotions and distress that led to the action. When seeing a psychologist this doesn’t happen, they understand that this method is extremely unhelpful and acknowledge your distress. Unfortunately staff are trained that reacting to your distress or expressed thoughts is a bad idea on the grounds that it encourages you to express yourself that way for attention. I’ve found it really doesn’t matter how little attention they issue, it doesn’t put me off self-harming, as the goal is internal and for me only, how they react isn’t relevant.

From my point of view that means I might as well self-harm without telling them, then they can’t accuse me of being attention seeking or say anything at all; at that point all that’s left to do is patch up and prevent any serious damage and send me out into the real world again (as stated by my care plan).

The staff reaction isn’t all bad. When I encounter A&E staff who are trained in treating physical problems I have found them sympathetic, supportive and worried. In a way I’m lucky, my diagnosis is OCD. If it was BPD there is a significant chance it might be the other way around.

Onto my two professionals, a psychiatrist, with whom my time is coming to a close. I did get more than the maximum allocated 20 sessions, which I am glad of – just 20 wouldn’t have been enough. The other is a social worker who has helped me navigate the benefits system and access a psychiatrist when necessary.

However I am going to lose both of them shortly, as I haven’t had any serious incidents since September (barring attempting to burn myself earlier this week). As such I am no longer view as appropriate for the CMHT to follow me.

The part that puzzles me is the remark that “my crisis plan will remain in place, with some follow up by CRHT”. It feels like it won’t matter how bad I get, I will not ever be brought back onto CMHT support. I do not like that. It feels that if I’m going to be at risk of hurting myself, I should still be on the CMHT, not the treat any phsyical problems, then discharge ASAP from A&E plan.

I have to admit this post isn’t the most cheerful, and is very busy expressing how I feel. That last paragraph is only expressed here, hasn’t been said anywhere else, and I wish it was, hopefully I’ll find a moment with a trusted professional to express that…

I don’t find it easy to trust staff, as there are way too many of them and they all react differently, trust only comes with extended positive interactions, which are rare.

Sorry I haven’t edited the post, it was too anxiety provoking to go back through it.

Jumpy

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Someone’s shopping trolley starts moving (just the sound), jump.

A siren, jump.

The washing machine starts/stops (noise), jump.

A door closes, jump.

A bleep, jump.

You get the idea. That was me, today. For whatever reason I am way more anxious than I usually am. Maybe it was the headaches a few days ago, or possibly the sedative effect of my medication is wearing off.

Living like that isn’t fun, so I try to make everything that happens as predictable as possible so I don’t jump. That isn’t possible out and about, but in my flat, most of the time, it is 100% possible.

This provides a significant motivation to stay in, however, if I do my mind will be free to run wild and make me feel even worse, so despite the penalty I will always go out. If there’s a day I don’t go out, then it’s a bad day, and usually only because I’ve got sleep to catch up on.

Coping with this sensation isn’t pleasant, I just have to go about my day, and avoid visibly overreacting. It almost seems worse than yesterday when I burn myself. Unfortunately my mind has a lot of ways to torture me.

On the plus side, I haven’t attempted to kill myself or self-harmed today.

Bye for now.

Winning, sort of

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For me this is

  • Getting up and showered, within 2 hours (that’s the best for now)
  • Getting a decontamination procedure done that’s stressing me out big time
  • Going to sleep without being afraid of what my mind might consider
  • Leaving my flat each and every single day
  • Keeping my (excessive) cleaning product consumption from increasing
  • Playing a new game or reading a new book
  • Writing a blog post

I haven’t posted in the last couple of days, and have been focussing on just getting the basics completed. I’ve managed to “win” so to speak.

Coping Mechanisms

Video games

Just shooting or destroying items on screen is cathartic. I play Overwatch (https://playoverwatch.com), and this week have withstood the anxiety of starting a new game and started one called Hades (http://playhades.com).

This game is about the son of the Greek god of death trying to escape the underworld. Which is a dark, miserable place where any occupants are trapped (including everyone who has died). Unlike most of the occupants the son of the god of death is alive, and reincarnates upon death again, and again, with no escape from his dismal reality. His only way out is to battle through all the levels of the underworld.

This makes a good analogy to recovery and restarting live after multiple suicide attempts. Life goes on, and the only rational way out, is to fight on, through a living hell.

This wasn’t what I had in my mind when I got the game, but I like the comparison. At the time I just liked the combat.

Walking

Walking just consumes time, with the end goal being that my mind will have sorted out whatever it is thinking about by the time the walk finishes.

This doesn’t always work, sometimes I break into running to vent stress – which helps. Going out in cold air is the most effective way to get my mind to “reset” (which is just clearing it of any impulses) and keep me safe.

Blogging/Diary (I have both)

Expressing how I feel is helpful. When something is written down it is much less scary as it is clearly acknowledged, as opposed to only inside my head.

Music

Listening to music provides a something for my mind to focus on. I like to call this providing the second track for my mind. The first track is whatever I’m doing at the moment. This avoids any ruminating, which I don’t want.

Onwards

I’ll keep fighting to win tomorrow. And the day after. To the future…

A year since my first A&E visit

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This day last year I was in A&E as a result of overdosing. That time I hadn’t taken enough tablets to be lethal, but I was still brought to the attention of the local psychiatry staff as a result.

I’ve gone a long way since then, with worse overdoses happening later in the year, and more than one admission to a psychiatric ward. I’m in a much better place than I was. Although my worries have evolved.

Since then I’ve gained weight, not that noticable visually, but definitely visible on the scales. That is what is irritating me today, and my mind briefly suggested another overdose to escape the problem.

My anxieties were heightened today, with a contamination becoming an almost unbearable load; I just left my flat and went to my parents to escape it. Later in the day (about 5 hours later) when I got back to my flat I was able to complete most of the decontamination to relieve the distress.

Today wasn’t fun, and had examples of almost every type of thought that could produce distress, except for nightmare scenarios in A&E or a ward. Fortunately I was able to dismiss them as insignificant. I am exhausted now however.

Contamination is my primary issue at the moment, with large amounts of cleaning materials being consumed. It would be great to obliterate it, but fighting it just makes it more traumatic, and causes my mood to crash. Calling myself “useless” or similar for it doesn’t help; it also provides an unwanted motive to self-harm.

As I’m writing this blog post it feels like I’m getting more and more disconnected from reality. Despite my fingers hitting the keys it doesn’t feel like I’m typing any more.

I suffer from tinnitus (persistent tone in my ears), and the noise has become really noticable right now; normally it’s background noise I filter out, but anxiety makes it get louder.

I’m safe, not about to hurt myself, and I’m going to finish the blog post with that.