medication

What’s next?

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Last week of 2022 now.

Progress check

Positives

  • Want to be alive (except in a few instances, but haven’t done anything to progress dangerous thoughts)
  • Interacted with more people
    • DnD group
    • New care worker who works with my CPN
    • Social group for individuals who have self-harmed (at any point in their lives)
  • Completed an assessment for a unit to treat my OCD and been accepted, pending 1.5 years on a waiting list
  • Taking medication (the odd dose forgotten though)
  • Run a DnD group as the dungeon master online and play in person at a local group.

Still not happy with

  • Still get really anxious
  • OCD and associated distress and limitations to what I feel able to do.
  • Self-harm thoughts still play through my mind (most of the time they’re gone)
  • Negative scenarios playing out in my mind for interacting with psychiatric crisis ward staff – despite not having been near a ward all year.

Analysis

I feel there should be more on the positives listing. I know my CPN is happy with my progress.

I’m disappointed with the continued existence of the self-harm thoughts, and I would have hoped that the fear of a disastrous interaction with staff would have gone.

Looking forward. What do I want?

  • More friends
  • Seeing my sister
  • Able to enter a situation without my focus being avoiding contamination

Coping, just about

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In the last few days I’ve set some personal records for time spent running (not for time spent walking though) – feeling anxious is a strong motivator to run/walk a lot more than usual.

For me running is a way to forget how I feel. The sense of euphoria after running makes it feel worth it, as how awful I felt beforehand is just gone.

I don’t always get the sense of euphoria though. Often running/walking is just a way to burn time without negative consequences – although while writing this post I’ve come to the conclusion that I need new running trainers – 360 miles of use (mostly walking, as I don’t keep multiple pairs of shoes…) and my legs aching today and yesterday seems to indicate they’re at their limit.

Today running wasn’t enough to escape how I felt. At the end of the day (19:00) I was agitated. I did identify that I was at the limit (distractions were not working) of what safe (not self-harm) coping strategies were working. I used a (prescribed medication, PRN), sedative that calmed me down enough to use distractions to cope. Using medication is something to try when multiple coping strategies have failed, not as a first option.

For me not coping is any of:

  • Wanting to self-harm
  • Melting down in tears
  • Persistent agitation/not settling down on any task

Melting down in tears I usually let happen as I tend to feel better afterwards.

When struggling to cope distraction is the first strategy. Speaking to someone (about something irrelevant) is (for me) the next best option. Using medication works in the rare instances it’s used, but as it doesn’t tend to address whatever is stressing me out it isn’t a silver bullet – it works best when I calm down enough to resolve what is actually bothering me.

For me “only just coping” means I’ve had to use medication to cope, which is what happened today.

Going to sleep now, so looking forward to a better tomorrow 🙂

I’m still anxious

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I’m still worried about going to another unit, which has no real leave. My current position: nope, not going unless their leave policy improves

Eating on the ward is a bit hit and miss, both shifts forgot to place mine up separately. I think my complaint to staff got misinterpreted as “the staff paid no attention to me”

I’m changing medication again, moving one dose up, and removing a medication (the new setup is 15mg aripiprazole and 250mg clomipramine). I wanted the changes but I am not liking the temporary increase in anxiety.

I did cry, and eventually relaxed somewhat after having 2mg lorazepam and talking to one of the therapists on the ward.

Missing: Intense emotions

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Description

Make coping in difficult situations even more difficult, and turn an “OK” situation into a nightmare.

Last seen

Unknown, I’m not sure when they dissipated, just that I have suddenly realised they are gone, and that what might be low might just be the absence of any intense emotions. Anxiety isn’t gone though (not an emotion).

Suspects

A medication known as aripiprazole. This effect only happened after I started taking it (along with increased anxiety, which seems to have faded)

Further steps

Speaking to medical professionals.

Additional notes

I miss the emotions.

Postscript

Doing different formats for blog posts is fun.

Why do I go on?

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I don’t know.

I used to though? The plan was to go to a unit in London for treatment.

Now I’m scared the unit will refuse to treat me because distress still causes thoughts of self harm.

A unit near where I live that is rehabilitation accommodation refused me partly because of the self harm thoughts, and partly because I was “complex”.

I feel lost.

I may be experiencing short term side effects of my latest medication.

I’m not sure it matters if the feelings are the medication, they feel real to me.

Back to the original question, why do I go on?

I still don’t know, and that scares me.

I’m restless, but have nowhere to go

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In normal times, if I was restless I’d go for a long walk, go to the library or take a bus to see my parents.

These aren’t normal times, and I can’t do any of those things. I miss my old coping strategies. I still have one hour a day out, holding onto what I have is really important for me to cope.

For me restlessness is feeling unsettled and unable to focus for long enough to get anything done. When I relax enough and forget the world around me I can focus, but any disruption breaks me away from what I’m doing.

It’s not pleasant, and at least partly due to a new medication, which has agitation, anxiety and restless are common side effects for the first few weeks.

My OCD has become so overwhelming, that enduring those side effects feels worth it. Its a turn about from feeling tha medication would never work. I now feel like medication can help, the clomipramine seemed to break me out of feeling hopeless.

With any luck this new medication will break me out of being trapped by obsessive thoughts. The odds aren’t great, and getting medication that works feels comparable to finding gold at the end of a rainbow. I keep going by focussing on how awesome it would be to escape my mind.

I’ve been hopeless for so long that it feels strange to have a hope of beating my once OCD again.

P.S. Still on a ward, not transitioning to rehab accommodation my “risk is too high” and I’m “too unwell” to go there; I’m relieved though, as I won’t have to fight for my leave, as the rehab accommodation wanted to restrict it to groceries, once a week, probably enforced by threatening discharge if I didn’t comply.

I don’t want to leave…

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…the psychiatric ward. And I didn’t even want to go onto the ward in the first place. What happened?

The plan was to transition to rehab accommodation, but I’ve been told it would mean only being allowed off the premises once a week (Covid-19 precautions), and even then to only visit a supermarket, not to have a a walk. Being able to get out of my living “zone” helps me cope when the anxiety in one place becomes too much, just change place (zone) until I feel a bit better. Relying on sedatives isn’t something I want.

I don’t want to go back to my existence before I came onto the ward, being dysfunctional is no fun whatsoever.

I don’t want to stay with my parents, I moved out because they had trouble dealing with my OCD, and its worse than it was back then, so it will become an unpleasant issue that isn’t addressed or quite ignored.

I don’t ever want to try swapping medications in a community setting again – back in May it felt like I’d been forgotten and left to deal with any side-effects unsupported; there’s no way I’d cope with my current switch alone or without adequate support (my anxiety is up, a lot, made worse by the fact that is was lower than usual before starting the medication.

My coping strategies at the moment revolve around the ward and the staff, if I move I’ll create new coping strategies, but going to someone I don’t want to go as a “voluntary” patient isn’t something I can consent to.

I can’t stay on a ward indefinitely, I need an exit plan that works for me, but I don’t what that is now. The rehab accommodation was that exit plan, but Covid-19 has made that unpalatable. It’s possible something will change (I hope), but my mental view of the future is some kind of darkness, with nothing good visible, just spectres out to get me.

Informal, or not?

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My section 2, compelling me to remain on a psychiatric ward for 28 days (or until discharge, whichever is sooner) is going to expire next week.

I’ve been told that I can’t go back to my flat, yet, but if I agree to stay on the ward (and not go missing…) they’ll make me an informal patient, otherwise I’m going to get section 3 applied to make sure I stay, probably for another week or so, not the full 6 months!

I know that being informal would give me a lot more freedom, no more limits on leave, I just have to sleep in hospital and take medication at the right time.

However I don’t feel able to agree to stay, or agree to not go missing, as I 100% do not want to be here. The main reason for not going missing at the moment is that I’ll just lose my leave (up to 2 hours, unescorted, a day now).

With a section at least it remains perfectly clear how I feel about being in hospital, and no-one can expect me to react as if I want to be in a ward.

Mind you, the staff did get pretty surprised on the second day I was in my current ward, and they had been “too busy” to take me escorted off the ward so I tried forcing my way through the main door. Something about “that’s not the kind of behaviour we expect from you” – referencing the fact that on the previous (voluntary) admission a while ago I hadn’t done anything disruptive.

That’s it for tonight. Guess I’ll find out what I do next week.

Although I guess if my (very active) conscience would just switch off I’d just “agree” to a voluntary admission and use the freedom to go missing. It does interfere with lying to get something I want done a lot!

P.S. Sectioned or informal doesn’t feel very much like a choice…

Life on a ward, with severe OCD

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I do not want to be on a ward. Who does? I guess me less than some as I’m sectioned. Although somehow I went onto a ward voluntarily in the past!

I’m here because my OCD has become so distressing and disruptive that I managed to concern my local CMHT a lot.

My daily routine, so far is:

  • Wake up in the morning, then not get up as I don’t want to feel any contamination anxiety.
  • Say I don’t want breakfast (08:15) when a member of staff asks (I do, just can’t face down the anxiety of getting stuff off a shared food trolley, contamination).
  • Get up when a nurse comes along with meds, and take them (10:00-ish).
  • Wash my hands, and partway up my arms.
  • Clean my teeth.
  • Ask a staff member for my phone – it’s been on charge in the locked office overnight, for those who don’t know, possession of cables is prohibited as they are high risk items.
  • Do stuff on my phone until about 11:45, or 15 minutes before lunch time.
  • Hang around the dining area to try and get my cutlery before anyone else, and get to the front of the lunch queue. Fail? Not having a hot lunch, maybe sandwiches instead, the staff seem to notice and supply them so I have something…
  • Water? Do I have an uncontaminated cup and can face down using a shared sink. Spoiler: nope.
  • More phone stuff.
  • Now I’m fed up with my phone, at approx. 15:00 and ask (and get) escorted leave to the hospital shop (getting a sandwich, bottled water and a chocolate bar) and a short walk.
  • Water? Yep, got a nice clean bottle 😁
  • Next mealtime, same as before, waiting from 16:45. If I can’t get desert before my anxiety (contamination and noise) overwhelms me, I’ll just skip it. So “wait 5 minutes until everyone else is served” is the equivalent to telling me no!
  • More playing on my phone, and possibly taking a nap as there isn’t anything better to do.
  • More meds (I do have meds in the middle of the day, but can’t remember when).
  • Sleep, I finally knock off sometime between 09:50 and 11:30.
  • Flashlight through the window of the door in my room, staff checks, which never, ever, wake me up 😛

Don’t have a change of clothes on me. Was not planning to get sectioned when the home treatment team (part of the mental health crisis team) assessed me on Wednesday (it’s Sunday as I’m writing). Fingers crossed I’ll get unescorted leave, or at least longer escorted leave, to visit my flat tomorrow and get some. I’m not a fan of having other people go into my flat to get stuff. Don’t know why…

Oh, and I haven’t told my parents I’m here – it feels too embarrassing to be in hospital for anxiety. Trying to kill yourself is easier to explain.

I’m on medication again technically voluntarily, but more because I don’t want to see if they’ll inject me if I refuse. I am aware that I’m struggling with my OCD, a lot. Having memories of agitation and feeling suicidal from a past med that I took for all of 36 hours is making me want to avoid medication, can’t any longer though.

Bye for now. Sleep incoming… Unless there’s something pointless I can do on my phone instead, got 2% left. Sleep it is, probably, I’ve still got 2% 📱

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.