Medication shock

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.

Advertisements

Jumpy

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

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

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.

Motivation for self-harm, and alternatives

Trigger Warning: This post discusses self-harm, and references feeling suicidal.

This post’s focus is the often invisible self-harm that happens without people noticing it, normally. I explore the causes of myself having self-harmed in the past.

See here for help on minimising the harm you do to yourself. Some techniques I’ve found useful are snapping an elastic band against yourself, punching a pillow or sofa or running. Distracting yourself is a good option as it lets the emotions dissipate so you don’t end up harming yourself (see this post). I often count from 1-8 again and again when feeling anxious.

Should you ever want to kill yourself call someone you trust, a service like Samaritans 116 123, your local CRHT (if you have the number), or just 999. If you don’t live in the UK the numbers you have access to will be different.

Punishment

Self-punishment is a way of trying to cope with some “crime” you feel has been committed by you. It only emphasises the “crime”, and the goal is to make you feel worse as the punishment.

The crime could be an unwanted intrusive thought, or something like fogetting a chore. The action can be tiny, with no-one else aware of it, but to you it feels significant. A rational response would be to acknowledge that it happened, and move on, which is what you have to do in the end.

As the least extreme example (and not in the self-harm category) you could say not watch a series you like on Netflix, or make yourself go to bed early. This just emphasises that you were unhappy with the action, but, as I’ve found, isn’t any good at preventing it in future, as I just obsess over the mistake more.

At the other end of the spectrum you could feel you deserve to die for the action, and take some steps to do that.

Inbetween the two extremes are superficial cuts (where the cut draws blood, but doesn’t need treatment), serious cuts (which need treatment or leave very nasty scars), and burning. Any self-harm can leave a mark.

The main effect of the self-harm is it’s shock value as I find I am now well and truly distracted as I’ve done something worse that the original problem!

This gets out of control for me. As a tolerance develops to the mild self harm, so more extreme self harm is used to get the same shock again. This escalates quickly and is dangerous. I (back when it was a major issue) ended up taking it too far, and ending up in A&E, which persuaded me to stop it for a while, although not forever, the cycle repeated a few times.

It’s not an issue for me at the moment though. After seeing a psychologist I’ve found it easier to accept that I’m OK and that I mess up, but it isn’t such a big deal.

Venting emotion

When suffering a mental illness the distress felt can feel like it is inexpressible. So damaging yourself is viewed as an option.

The type of self-harm used and how extreme it is varies between people. I’ve found I tend to ramp up how severe it it is quickly, as I use it as a last resort to vent, and then next last resort is always worse than the previous one. I do know people self-harm regularly, every day a consistent amount without it getting worse over time.

Hitting something soft or smashing ice cubes is a safe way to vent aggressive emotions as it doesn’t cause any damage.

If you’re unbearably sad cozying up in a blanket is a good way to make yourself feel better.

Obsessing over self-harm

Sometimes I find my mind obsessing over self-harm, and I think about a specific way to hurt myself, again, and again, and again; which gets exhasting to just not hurt myself despite my mind thinking about it. For me, at least, this is part of suffering from OCD; what you obsess over can vary massively between different people with OCD, so some people may not even consider it.

Exhasting to just not hurt myself

Me

After several days of my mind obsessing over it it can feel easiest to just harm myself to get rid of the thoughts. That’s pretty much what happened today when I cut myself, the worst incident in a while.

Conclusion

The thoughts behind the self harm vary a lot, but the results appear the same, and none of it is ideal. Professionals refer to it as a maladaptive behaviour, as opposed to an adaptive, healthy response.

It can feel like you’re cheating by distracting yourself, or minimising the distress by not self-harming. You’re really not, you’re just coping differently in a way that will last and be usable forever.

Am I abandoned by you?

Yes? No? Are you sure?

Didn’t I feel like this last week? It wasn’t true then…

Sometimes the smallest items can trigger feeling abandoned by an individual. A late reply to a message. They forget to message you.

Sure, some of the time it’s real, but most of the time it isn’t a slight to me personally. So far I’ve always found there’s a good reason. Eventually messaging resumes, with no issues remaining.

The impulse is to disconnect from the individual so this never happens again. I abandon them first, so they can’t leave me. From experience this isn’t ever the right technique, and when the reason clears up, they message me, without prompting.

Coping with these events is normal. Other people have stuff going on. However sometimes it can escalate, when both sides feel abandoned due to experiencing mental health issues.

A not so great way to test whether you’ve been forgotten is to not message the person on the grounds that they will message you. This isn’t a good idea, don’t do this at home, I’ve been advised by a mental health professional that it is destructive to relationships. It usually works just fine, the other person messages me; all my friends have “passed” the test way more than once.

This testing falls to pieces when both sides try the same tactic. There aren’t any messages. This tends to happen when both sides are experiencing low mood.

There’s only one solution, not running this “test”. Easier said that done, as the moment my mood crashes I lose the motivation to resist running the test. It’s really hard. When my mood is stable, I rarely consider it, but when my mood is low, it is done all the time.

Not sure that I can ask someone else to avoid doing it though, as I know that even knowing it’s a bad idea I still do it anyway. So how can I ask someone else to do better than me?

There isn’t a neat solution. Just trying not to jump to the worst conclusion, and then do the same again, again, and again.

The real value of distraction

Trigger Warning: Post discusses self-harm and avoidance strategies.

Distraction

When interacting with mental health professionals they often advise you to distract yourself to avoid doing something dangerous.

It can feel like they’re being dismissive “just distract yourself”.

Sometimes distraction really doesn’t work, but most of the time it just buys time. Buying time is valuable though, often the impulse to do something dangerous isn’t strong enough to last a significant amount of time. By distracting myself Igive time for the impulse to fade, and when it does, I’ve “won” – I haven’t hurt myself.

For example, today, I wanted to burn myself. I don’t keep a kettle on hand, which means heating up water to burn myself in a saucepan is going to take a significant amount of time. Today, by the time I’d put water in a saucepan, and started heating it, the impulse faded giving rise to the thought “what on earth am I doing”, at which point I poured the water down the sink and went out.

Usually 20-40 minutes is the estimated time for a normal impulse to last. The problem is when I disassociate, as that can last for hours, or even days. Disassociation is a when I feel disconnected from reality, and it’s as if my mind is still operating, but I’ve lost control. The best analogy I have found is it’s like being in a car, with the brakes broken, accelerator locked down and doors jammed, hurtling towards the edge of a cliff. You can steer to adjust how you fall, but you can’t avoid falling off the cliff.

It’s like being in a car, with the brakes broken, accelerator locked down and doors jammed, hurtling towards the edge of a cliff. You can steer to adjust how you fall, but you can’t avoid falling off the cliff.

Me

There’s very little that can be done to prevent me from hurting myself in that scenario, unless another person realises what is happening and gets in the way. As I’ve discovered that is incredibly unlikely, see below about seeking help.

Similar strategies can work. In this scenario I find myself tricking myself into doing a quite long sequence of steps is needed to be completed before I can do that final action of self-harm.

The steps can include procuring the items I need, decontamination related to my OCD, or tidying up my room/flat under the reasoning that whatever happens I’m left with nothing to clean up, or whoever has to deal with what I’ve left behind isn’t left with much to do if I’m suicidal.

Seeking help, personally

Trying to indicate to someone that I need help when distracting myself is something I find incredibly difficult. When in crisis I can’t justify threating to do something dangerous or preventing myself from doing whatever it is. Hence the most I can justify is giving a minimal indication that something isn’t right. Generally people will have no idea that it indicates a crisis, but if they know me well enough they might or might not realise what it means. So technically I’ve left it up to an unlikely chance whether someone stops me, which as far as I’m concerned at the time isn’t the same as getting someone to stop me.

Part of the difficulty in seeking help is wanting to avoid being viewed as threatening to do a dangerous act. Not really seeking help is, as far as I am concerned at the time, very much not threatening to do something. From my point of view as I’m not actually saying anything about doing something dangerous.

Included in that is that I don’t want to bother anyone if I’m not actually going to hurt myself. Unfortunately by the time I know whether or not I’m going to it’s too late to seek help, as I’ve already done or not done it.

There’s also the fear that I’m not worth the help and support. As far as I can tell that is entirely irrational. At the time though, it’s hard to believe that.

A lot of the time when professionals realise something is very badly wrong, it’s way too late and I’m already need A&E for treatment.

I have requested help before a crisis, but it’s usually a long time before when there isn’t any immediate threat.

That can make helping me difficult, as I’m aware, and make me seem unpredictable. I’m not sure how to break the thought patterns so that seeking help is viewed as a valid option.

If you can seek help, do!