Perspective

[Written in 2014, finally finished today!]

One of the techniques that I’ve been working on is looking at life differently.

My psychologist first got me onto this with a technique called cognitive behavioural therapy (CBT) which tries to redirect thought processes.

For example, people with anxiety and depression often catastropise. I would have a thought like, I’m not working at the moment, which would then lead to, I’m not contributing to our finances, my husband is looking after everything and I’m doing nothing, and, what if I never work again and become a vegetable, and I’m totally useless and live forever with other people having to take care of me, and hating me!!

Obviously, to an outsider this is a drastic way of thinking and a rapidly snowballing thought process! Which is not even factual, as I’ve never had it suggested to me even once that I will be doing anything but returning to my previous active, contributing life. Neither is it at all likely! But depression just has to nut out the worst case scenarios and get you to think, ‘what if’?! And the thing is, at the time, you can’t see it for what it is. It feels totally real, and scary, and awful even though other people may dismiss it as illogical.

Depression, does not have logic.

But depressive thoughts can be changed. It isn’t easy, but if you work at it in the right way, you can slow or stop the snowballing and start to prevent the catastrophising.

Around the same time as I started to see my psychologist, I was already involved in the 100 Happy Days photo challenge that I’ve talked to you about before. Happy. Depression. The two don’t naturally go hand in hand. They’re kind of opposites. Making this a real challenge! This involved, every day, taking a photo of something that made you happy. I knew I was suffering generalised anxiety when I took it on, and during the course of the challenge got diagnosed with depression and bipolar.

Finding something in the day that makes you truly happy takes a real change in thinking. It takes noticing the detail in the day, the little things that are often overlooked, appreciating what is often taken for granted.

These were not the happiest days of my life! Needless to say. In fact, some of the worst days that I have ever experienced were smack bang in the middle of the challenge. But did you know that it never once crossed my mind to not go on with the challenge? I never once considered not doing the challenge, even when I was sitting in the emergency department beside myself with suicidal thoughts and in so much mental pain that I didn’t know how I would live. My happy day photo that day? I was wearing my favourite dress with the huge rosettes around the hem and I was eating my favourite Snickers bar!

There’s always something. That’s what the challenge taught me before I was even conscious of it.

Depression is called depression because it’s depressing.

It lowers you down, it lowers your mood, it lowers your mind. It’s the mind version of walking along in life looking at the gutter. All you can see is the dirty, the trashy, the boring, the bleak, the wasteful, the dead, the mundane.

I’ve always been a stare at the ground in front of me and watch for snakes kind of girl. You know, just in case. But now, instead of physically looking down and stomping along to the train to go to work, I started looking up, casting my eyes around me and began to see all kinds of things in that 10 minute walk alone. The wood ducks nibbling on grass beside the path; never even knew they were there! How beautiful the pond looked shimmering in the morning like. How green was the grass, how blue was the sky. How beautifully kept that lady’s roses are so close to busy Box Hill Central!

And it got me mentally looking up. Instead of snoozing my alarm until the last possible minute, and dragging myself begrudgingly out of bed, I started to wake up wondering what I would see today that would make me happy. There is no mistaking that my mental health was in a dire situation, but at least for a few moments of the day there would be something that I found that would give me a glimmer of a smile, a bit of satisfaction because I found it! That thing that could make me happy. And the memory of it could be taken with me throughout the day. It truly proved to me that if you put yourself to the effort of looking up, mentally or physically, you will surely be rewarded.

So in an effort to lift one’s mind’s eye to a more beautiful view we try this technique of purposefully, intentionally looking up. Some call it mindfulness, some call it practising gratitude, some people call it thankfulness; doesn’t matter what it’s called, it’s a thing. A method to get out of the grunge and into the pretty meadows, or paddocks since this is Australia.

Probably this is the most powerful method of changing perspective, although I’ve way under used it! I came to it as a compulsory part of my insurance, and having someone tell you that you have to do something that you think is stupid is never a good starting place!! But I had to change my thinking. I had an amazing logical sensible teacher who was on my wavelength, and the lessons I learned were incredible!

Mindfulness teaches you to slow down, to take more time to take in the things that we usually just rush by. By doing this, you get greater fulfillment out of life.

I’ve also always been a person to try to scrape the most out of every second, minute, hour, moment. I always got up at the last possible moment, showered for as long as possible til I absolutely had to get out, dressed as fast as possible and left the house only when leaving a minute later would make me nine minutes late instead of eight! Because I was always rushing I’d often leave my lunch, my wallet, my phone, my brain at home! I always squeezed the most time possible into my breaks, felt jibbed every time I had to go back, put off going back to bed so I could fit more into the day. Etc, etc!

But anxiety made me realise that this is not a feasible way for me to live anymore. The extreme anxiety I feel when I’m rushing, late, overcommitted is so awful with the nausea, the sweating, the palpitations. And mindfulness reinforced this again. What if you could walk slowly and calmly without a care in the walk on your way to work? How would that be? Wouldn’t that be nice? Mindfulness is kind of addictive in it’s own way, because it’s highly rewarding to your brain. Of course then there’s the real world, but for a little while, you are in total control and that is amazing!

Mindfulness also teaches you how not to judge yourself and others!! Could there be a more powerful tool than this? In mindfulness, you sit with yourself, which sounds funny to start with, but you just sit with your thoughts and all you have to do is acknowledge each thought as it comes, without it being “good” or “bad”. Do you know how often we are bagging ourselves out in our head and we don’t even consciously know it? It’s terrifying! That’s the worst 3 second wrap ever, but I do highly recommend it, and not only for people with mental health disorders; it can help with a lot in life.

Changing perspective.

Looking for the happy, the good, the joyful things in life.

Some people call it being positive, but I’m not a fan of that description. I feel like being positive is ignoring the reality and the badness, and trying to paste over it with being chipper and perky and upbeat!! Maybe that’s unfair but I feel my arm hairs raise and my spine tighten when positive comes up!!

I prefer to fully acknowledge exactly what is present, what the problems are, and try to work with that to change it for the long term good, not for the short term glossing over it. I’m sorry if that’s offensive; but I feel that if the problems aren’t realised, the treatments won’t be effective so it’s important to be honest.

Changing perspective is hard. It’s hard. It takes effort. It takes perseverance. It takes time. It takes motivation. It takes emotional energy, sometimes physical energy.

Most of these are the things that depression takes away from you. Before you even have a chance to notice, depression whisks away your energy, motivation, ability to exert effort. And leaving you a blob sitting in a chair, staring at a wall wondering what to do next, and how on earth you’re going to do it?

Looking up. Changing perspective. Mindfulness. Gratitude.

The outcomes are so worthwhile if you can put yourself to the trouble.

I highly recommend engaging a psychologist, a mindfulness coach, a doctor trained in CBT because it’s much easier to be guided than to have to do it all yourself. If the session is pre-booked and all you have to do is turn up and be coached, you are already on an easier path, from someone who knows.

Of course you have to participate, and at some point in time you will have to do it on your own, but let’s focus on getting started and you will absolutely benefit from whichever path you go down.

100 happy days is different. You can do this on your own, and unlike me doing it all through Facebook, you can do it by yourself in a notebook and nobody has to know. I can’t recommend blurting everything about your journey onto Facebook like I did; it worked for me, but not so sure about all the poor readers, and it might just not be something you are comfortable with. It’s your call, and there are lots of other options out there.

I wish you well on your perspective changing journey!

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Tales of a missed dose

[Written 16th June 2015]

This is a story of what happens when I miss a dose of medication.

What happens depends whether I miss a morning dose or an evening dose. As I write this I’m suffering from missing an evening dose so let’s go with that.

At night I take several tablets: quetiapine, lithium, valproate, rosuvastatin, pantoprazole. Mood stabiliser, mood stabiliser, mood stabiliser, anti-cholesterol, antacid. Yes, it takes that many stabilisers to keep me going!

In the morning I take thyroxine, venlafaxine, Levlen, valproate, lithium. Thyroid hormone replacement, antidepressant, contraceptive, mood stabiliser, mood stabiliser.

All done! Hopefully...I'll still count the tablets out every morning and night to double triple check

In terms of missing a dose, lithium and valproate aren’t the worst to miss as a patient because I’ll be taking some again soon. This is not an official pharmacist, GP or psychiatrist recommendation! Lithium and valproate should ALWAYS be taken twice a day, as close as possible to 12 hours apart for the best effect! And I repeat! This is because for lithium a healthy person’s kidneys clear it out of you in that time frame so to keep a steady level you should take it consistently. And for valproate it’s your liver. That’s why you should respect these two organs very highly! They are very important. But what I’m meaning is its not the worst in terms of the adverse effect of missing a dose. If I miss taking lithium at bedtime, I take it first thing the next morning which gets it back in my system before I physically notice that it even left. My overall level will be a bit lower for a few days which isn’t ideal, but it will work back up to speed soon enough. And I do have a level at least.

Whereas for medications that I take once a day, I’ll miss the effect for 24 hours. Which sucks. Plainly and simply!

boxes, bottles, tablets, capsules

Quetiapine is one of the once a day tablets. It is prescribed to me to prevent mood swings, reduce my anxiety and has the handy effect of giving me a good night’s sleep. It was doing this a bit too well for some months there and I was doped out all of the time, but my awesome psychiatrist recommended a change in the times I take it and we’re back up to speed. Yes!

So, do I get a mood swing if I miss one dose? No. Really not. The chemistry isn’t that reactive. In the same way that it takes weeks of first taking the medication to get the benefit, it takes longer than one day to mess up the whole thing. But I do have a rough day afterward, and a rough night too! It’s a bit like I’m sitting in my car going along nicely and I know where I am and where I’m going and how I am and suddenly another car rear ends me, or bumps into the side of my car at a right angle. Slowly of course, not fast. So my mood just takes a hit, a bump and suddenly I’ve jumped along or across and I find myself somewhere other than where I just was, a bit disorientated about how I got there and sort of catching up with what just happened and where am I now and how I am and are we still okay? That following day I may be in quite a different mood from the one before, either peppy and edgy and anxious and manic, or slow, and silent, and flat and a bit away with the fairies. But that doesn’t qualify as a mood swing, just a sudden small change that affects my day.

After missing a dose here and there I have now gotten the side effects of missing my nightly dose of quetiapine down in a pretty clear timeline. Yes, there are side effects from NOT taking your tablets, as much as taking them. Something to consider.

So here’s the quetiapine absence timeline.

strips, tablets, capsules

10 to 11pm: I can’t get to sleep.

This is a terrible thing. I need my sleep. Always have, and always will I guess, but especially since I’ve been sick. So does everyone, I realise. If I don’t get a good night’s sleep the next day is a struggle, emotionally. So I toss, and I turn, and I turn, and I toss. After an hour of this, if I’m alert enough, I’ll think to myself, self, why can’t I get to sleep? I usually go straight to sleep! Then I’ll look in my pill box, see my tablets, mentally or physically hit myself in the head, take them and all is good in the world. Just like that. If I’m not thinking too clearly, I might think to take a Valium and at least get some sleep. If I’m dull-witted, which is at least half of the time, I’ll eventually wrestle myself to sleep. It sounds funny to say, but I’ve become very good at putting myself to sleep. I nap most days from necessity, and there is a skill involved in going from activity to sleep in a short space of time. I guess shift workers eventually excel at this sort of thing. So I’m quite adept at getting myself in a comfortable position, getting the temperature right (cannot sleep well unless it is right!), darkening the room, doing a conscious relaxation of as many muscles as I can, and stilling my mind into sleep.

Say I managed that. Next time check?

3am. Yep, wide awake, fresh as a daisy, ready to go at 3am. I toss, and turn, and can’t get comfortable, and I’m restless and my poor husband is rocking and rolling every time I turn and I’m messing with his sheets, and he has to go to work tomorrow even if I don’t, so I try to lay still and physically can’t! Why am I awake, I’m usually asleep, what is happening, oh….ahhhh! Tablets! I forgot them! Duhh! I hate that moment! I try to do my utmost to prevent it, but it still happens and it does feel like a failure every time I somehow mess it up! So, should I take them now? The dilemma! It’s 7 out of 12 or 24 hours through the medication time period. So I can’t take all of them. Maybe just some of them. Can’t take quetiapine, I’ve missed the boat on that one otherwise I’ll sleep all day. And I’ll be taking lithium and valproate soon anyway, and can’t double dose. What about the rest? Which are nothing really, in the scheme of me being wide awake at 3am! Cholesterol and stomach medication. Sure I can take them, they should be taken regularly but it’s too late for my sleep. The next dilemma then: try to force myself to sleep again, or just get up, take my laptop to the spare room and do something else? Who knows? Depends what I’ve got on the next day really. I can never decide!

medication list

8am: I’ve finally given up the ghost on sleep so I’m up and peppy and full of life and only just partially anxious and ever so slightly manic and energetic and going to run the world! If I haven’t already taken one to sleep, now is the time for a Valium to wind back the jets on being super woman and achieving all my life goals in one sweet day! And talking my husband’s ear off and planning one hundred chores like a complete going through of the entire kitchen plus 3 loads of washing on a rainy day and lunch with girlfriends and all kinds of magical things. ‘Woah, says my husband, that’s too many things for today. No do that another day, you’ve got enough things for today. How about you sit down for a minute, what about some mindfulness? I think you should do some mindfulness…how about you go and do that now?’ At around about this point I have now blown my nose for literally the THIRTIETH time since waking for the final time. THIRTY. You just can’t blow you nose till it feels empty; there’s always residual. And it’s pretty much like a tap. The medical term is rhinorrhea, like diarrhea but your nose is melting and there is a constant liquid dripping, dripping, dripping!! Quetiapine dries you out like anything so you get dry mouth (and want to drink Coke all the time!), dry nose which leads to sores and blood noses, some degree of constipation which no one wants to know about and some urine retention. The last one isn’t noticeable on any other day, until the missed dose day and then I realise that yes I really have been holding back! TMI I know, but you wanted the whole story right?

But the nose thing really gets me! If I notice nothing else in the middle of the night, I do notice my nose dripping incessantly! It’s an instant giveaway! It’s different to regular waking up in the morning and blowing your nose. It’s more like hay fever without the sneezing but the medication to stop it cannot be taken til nighttime!!! Cue fierce under breath bursts of ‘idiot’!

And then it’s just getting through the day like usual, but bearing well in mind that you’re a bit high today, a bit edgy, a bit fiddly, a bit anxious, a bit overstrung so remembering to breath, relax, calm, easy, gently does it. And I should mention that the other things ease off too, just not in such an obvious diagnostic way. I have the right amount of saliva in my mouth (who knew that was a thing!) and going to the toilet is a breeze, like really easy, like maybe a bit too much and too many times! So happy thoughts!

medication box, tablets

Now the morning lot and venlafaxine. Anyone who is involved in the prescribing, dispensing, and before too long taking venlafaxine knows about the withdrawals. It’s described in the textbooks and it happens like the textbooks. Exactly like. I used to think this was pretty cool. I still do theoretically, but in practice I either love or hate that they’re so reliable and unavoidable. I love them if I notice it before I’ve left the house for a work day because I immediately fix the shortcoming. I hate them if I notice once I’m already on the way to the bus stop and I don’t have time to turn back, or I’m on the bus, on the train, on the tram, in the building. Then it sucks because I know what’s coming and I can’t do a thing about it! Unless I can get to my doctor for an emergency script but that means paying full price, and after all it’s nothing life threatening. Not bad enough to pay three times the normal price! And believe it or not borrowing stock from the shelves is not strongly encouraged by my employers nor is it in any way legal!

What the symptoms/adverse effects of missing venlafaxine are: electric shocks/tingling in your fingers, light headedness/feeling like my head is spinning/wondering if I’ll faint, nausea. Nothing fun. Nothing dangerous. They don’t make for a good day, and I have to wait til the next morning to fix it! More banging of palm to forehead and severe muttering to oneself!

So that the what. The why is a whole other adventure and I don’t have time today, but hang in there and soon we’ll have another chat and look at the other part of the problem. Chat soon!

Keeping busy

Life has been a little busy lately. I’ve been trying to be an adult, a functioning adult. You know, one that gets up in the morning, does stuff all day then goes to bed at night. Without an afternoon nap or sitting in bed for half of the day or getting nothing done.

So I’ve been adding structure to my day, much like I did last May when I thought I might get back to work soon! Well that didn’t work that time, but hopefully this time I’ll get there.

Last May I took on an eight week photography course, an eight week mindfulness course plus went to the Imax once a week to check out a 3D animal feature, plus a joined a pilates studio and etc etc. I haven’t stayed in touch with anyone but my teachers.

This time I’m in a very different place. I took on an eight week getting back to bike riding course where I made a lot of new friends and still catch up with them every week. I’ve been doing housework: trying to keep on top of the dishes, the meals, the washing, the bins, the groceries and trying to commit to keeping up with the ironing. I have a bird bath, a little flower patch.

I feel like this is the real thing. Like I am breaking through the barriers to get back to the life I had before LRH (my old job). I’m cooking dinners and enjoying it, I’m getting the washing done before we start taking clothes out and wearing them dirty, and so on. My husband is thrilled! He got to love cooking but he’s happy to be alternating nights instead of doing everything; or even just not having to do the meals one night a week! And I’m glad that I’ve moved on from sitting watching him cook feeling useless and pointless and not worth my keep! He’s still surprised when he goes to do a chore and it’s done. It’s almost comical. He asks, who did this? Did you do this? Well yes, yes I did. There’s no-one else here!

I’ve still been trying to get out and about, checking out exhibitions, looking for day trips with either my bike group or my bird watching group. having coffee or lunch or brunch with friends. On Saturday I rode from Woori Yallock to Warburton return, 34km, with my bike group, Wheel Women. It nearly killed me but the weather and scenery and people were all wonderful. Yesterday I had impromptu coffee with a good friend. Tomorrow I’m going on a bird watching outing with Birdlife.

I’m having good days 🙂 And it’s so good!

 

Wired

Today I spent four hours without looking at my phone.

It’s sad that this is a fact worthy of comment. I’m not proud.

This came about because I had the opportunity to visit with a lovely girl who I hope will become a good friend. I checked my phone before I walked in the door then put my bag containing my phone down, and never thought of it again til three hours later. Even then I left my phone in my bag untouched, and didn’t check it until I was about to walk out the door.

This is definitely some kind of record. Being home and somewhat unoccupied I have gotten into a bit of a phone checking habit…actually this was a good going habit from well before I stopped work.

I say stopped work in the absence of a better expression; I didn’t actively stop work, I just got so unwell that I couldn’t keep being and had to go get emergency help.

Throughout my experience with mental and physical unwell-ness in the last eighteen months my anxiety and distress have generated a number of habits, some helpful some detrimental some iffy. One of these is checking. Checking checking checking.

What do I check on my smartphone?

All my ‘things’: Ebay active selling, sold, unsold, messages and reminders; email inbox, social box and promotions box for my personal email; email inbox for my professional email; email inbox for my work email (uff! I’m exhausted already!); my calendar for events and things ‘to do’; Facebook in case someone or something has said or done or manufactured something of vague interest; the weather for today, tomorrow, the week just so I know; my mobile banking in case someone has unexpectedly paid me a million dollars in the last hour; my mobile service provider for my internet usage in case I’m close to the limit and they forgot the notification text; Words with Friends in case someone desperately wants to play me and again the notifications failed; Fitbit if I’m wearing and have charged my device to see how many steps I’m up to for the day; and of course I have to check my stats for this my lowly blog to see if anyone cares about my self centric postings!

Yep, ummm…I don’t have too much more to say about that! Sometimes I shortlist that to Ebay, calendar, Facebook, Words, WordPress; and I will justify the extensive list to say that it’s quicker to check these things than it is to write about or read about them!

Why didn’t I need to check my phone for that long, when at home I would be checking it almost constantly?
I just didn’t think of it. I was distracted, with new surroundings, a new friend, delightful pets, with hobbies and chatting and food and life. My phone alert was set to vibrate only instead of sounds which deprived me of (or benefitted me without) any audible reminders. And I wasn’t lacking in occupation; I was talking, laughing, photographing…instead of checking checking checking.

Amazing! Now how can I replicate this phenomenon at home…?

What did I find when I finally checked it?
Two missed calls, 4 messages, 3 notifications from Metro about train delays, a couple of Facebook notifications, a update reminder for some apps and a calendar alert. And an Ebay message and some emails and a Words with Friends game prompt.

A lot of stuff!

Any of it vital?

Well it was too late to do anything about the missed calls and most of the messages, one message could be sorted out tomorrow, the public transport notifications were irrelevant (I was driving) and this continues my gripe with the Metro app; that you can’t choose notifications for selected services only.

The Facebook notifications weren’t at all relevant, I updated the apps, the calendar reminder was for tomorrow, the Ebay message was easily answered, the emails could all be archived and so I wiped it all from my mind and got stuck into Words with Friends 🙂
So really, nothing that would be terribly missed…nothing vastly important; certainly not enough to fret over or to warrant fidgeting if I was unable to check for them.

But this all continues a theme that has been going along in my mind for a while, about how wired in I tend to me the majority of the time. And surely I can’t be the only one?

I have been participating in a mindfulness class over the last few weeks and I was initially quite daunted and still continue to be fascinated with the struggle it can be to let go of my white knuckled grip on the here and now, to just sit. Or lie. Or be, in any pose. To let the body come to rest and be still. Just quiet, doing nothing, thinking nothing, being nothing in particular; just resting.

I find it hard. My body wants to twitch. I want to roll over or change position. I want to wiggle my fingers and toes. It’s hard to just be still! And that’s just the body! Then there is the mind! Sitting quietly and having no other occupation than using your senses and paying attention to the mind ticking over gives a lot more room to notice all of the jumbled thoughts that are swirling around in my brain. I’m still sitting on the fence about whether this is beneficial or unecessary.

I initially started being so wired in because I didn’t want my thoughts. Particularly in the days when I was battling with anxiety I wanted to get as far away from my thoughts as possible.

I didn’t want to think about what it would be like if the global financial crisis hit us and we became homeless, or if the war spread and we were horribly mutilated in a bomb blast or if the end of the world came today at afternoon tea time or if all the children endured hideous burns in a fiery bus crash or if the global warming crisis caused my house that was built on a filled-in swamp to be completely inundated and we were swept away in the floods and watched horrified as relatives and friends drowned before our eyes or etc etc!

When you have anxiety or depression it is common to catastrophise. I wish I knew this a long time ago! I first heard the term with my new GP in October/November; can’t remember exactly when. By then I’d been battling with anxiety at least for six months or more and I really wish I’d known that this whirling dervish inside my head was just a symptom, perfectly normal for someone with anxiety, completely manageable, nothing to worry about.

Because when you start worrying about the worrying, everything turns pear shaped and gets out of control very quickly! So to avoid thinking about the thoughts or in fact noticing them at all I’d turn up the radio, try to force my concentration onto some reading, turn up a video, trying to override my brain with other things. Checking my things distracted me for a short while which was good enough for me; any kind of break from myself.

As I’ve gotten more well I’ve realised that these habits have become problematic and are kind of disrupting my plans for a new life. So there’s work to be done to wind back some of the checking, some of the background noise, some of the distractions.

It’s a work in progress. There’s a ways to go but every time I have a little success it’s nice because it gives me a glimpse of what could be, of life unattached to noise or distractions and just lived in full awareness of what’s around going on around me and able to cope with that!

And that looks lovely to me. Here’s to it!

Recovery

 

“You will get there when you are meant to get there and not one moment sooner. So relax, breathe, and be patient.” -unknown

 

Last Wednesday was an interesting day for me.

Another new start, another new pursuit, another new hobby, another new lifestyle angle.

I began a new journey, a new pathway towards I don’t know what exactly. I participated in my very first formal mindfulness class.

When I was in my first year of university and had my first panic attack, I went to see the campus counsellor. She was a really sweet lady and helped me through some difficulties, frustrations, emotional strain and odds and ends in our one-on-one sessions. She also got me involved in a lunchtime class where we tried meditation and mindfulness as stress reduction methods.

I don’t have a very clear memory of that time; I had a lot going on I guess. But I do remember one mindfulness exercise that we did with a mandarin and I’ve gone back to that a few times over the years since then.

This year and last year while I’ve been seeing a psychologist pretty frequently the idea of mindfulness has come up briefly a few times and the last time I was able to borrow a mindfulness CD from my counsellor by well known Dr Craig Hassad, lecturer at Monash University. That was a good reminder of what mindfulness is and how it can be used.

So now I’m doing this class for two and a half hours every Wednesday for eight weeks. So far, I’m very happy. The lovely group leader is a practical, kind lady who has made me feel very at home and the other members of the group all seem like they are very nice as well. I was a bit worried that it might be really alternative and other worldy, like rituals and incence and weird stuff; but thankfully its all very normal and logical and helpful.

We arrived on a freezing cold morning to a delightful old church done over for other uses. Not only was the heating on high but we were able to help ourselves to lovely fleece blankets that had been warming in front on one heater to keep ourselves soft and cozy! Plus cushions and pillows; how lovely! Off to a good start!

What I’ve been thinking about most is not the course so much, but how I introduced myself to the other ladies; no men in this particular course. My introduction of myself was that over the last year or so I’ve been progressively diagnosed with anxiety disorder, depression and now bipolar disorder. I told the other ladies that I’m now in the recovery phase of resting, starting medications, having doses changed and getting used to medicines.

Recovery phase.

Interesting.

When I got home that day I thought about that a bit more. And realised something. I tell other people that I’m in the recovery phase; resting, medications etc but I don’t let my brain get that memo. I’m telling myself a whole other message, which is hurry up and get your stuff together because your life is waiting for you and it won’t wait much longer!

See? A whole other message!! And quite a lot more stressful! So time to help myself out.

Danika, you are in the recovery phase.You can rest, you can allow time the healer of all things to have its place to work. You can allow medications to take their effect, you can attend your appointments with your doctor, psychiatrist and psychologist. You can go to your photography course, your mindfulness course, to free meditation class, on bird watching walks, on interesting day trips and excursions. You can take naps when you need them, rest when you are tired, socialise if you have the energy.

Can you take five minutes to realise how amazing this is? You have free rein to do whatever you feel like to help yourself and heal yourself!

Don’t think about how you can’t do everything that you want to, don’t worry about your limitations, don’t get put off by tiredness or weakness or feebleness. You can do whatever you feel like and are up to with whatever resources you have. That is amazing!

And make a new attempt at perspective, please. You have been on six different antidepressants on less than a year, each one taking a month to six weeks to show its full effect then needing to be washed out and a new one started. You have been on varying doses of a mood stabiliser since March and each dose or formulation change had its own issues. Remember that you started lithium not even eight weeks ago, and that the last dose change was just three weeks ago!

Three weeks. That’s not forever ago, you aren’t taking forever to get better, please remember that you are still taking step after step and every change takes some kind of toll, so you need time to roll through each new wave of turbulence.

 

 Don’t even think about work.

 

Those are the words from the psychologist provided with my insurance.

 

Don’t even think about it. Just relax, take it easy, take your time, get yourself better.

 

At my last psychiatrist visit we checked in again about my colossal weight gain and high cholesterol. He’s still thinking about putting me on a cholesterol lowering drug.

 

Its pointless trying to diet and exercise right now with all the changes in medication. You aren’t going to be able to do much about it until we get you stable.

 

Stable. We aren’t there yet. You are still in the figuring out what’s what and getting everything straightened out stage. You’re still adjusting to having this condition, and having to take medication twice every day and having to take life at a different pace.

But as always, instead of taking the psychiatrist’s words face value, I debated with myself and am still debating whether using that information is a cop out, and maybe I can do more about it than I think, and maybe I’m just being lazy and not trying etc. Typical!

But no, rest, relax, take advantage of this amazing time that you have. You’re young, you have time to fix your cholesterol, time to fix your weight, it doesn’t have to happen three weeks after changing doses of lithium! Sure, if you have the emotional and physical energy you can small changes now, but let’s resolve to postpone the big changes until 2015!

You’re in the recovery phase. You’re only job right now, is to recover. So off you go, recover. Rest, relax, enjoy, feast on this unexpected piece of time that’s been given to you, make the most of having very few responsibilities and hardly any “have to” claims on your time. Recovery.

The Brain

[Author’s note: written last Thursday]

Today I…

…Hmmm.

I just realised that a lot of my writing and thinking starts like this.

That’s one thing about being home by yourself for months; you get to thinking about yourself a lot! And not so much about others.

Plus, you know, the whole life-changing nervous breakdown thing that triggers a lot of soul searching, heart searching, mind searching etc.

Plus being in therapy which encourages looking into yourself and understanding yourself and changing yourself. Plus seeing doctors regularly who ask you about yourself and want an answer about yourself.

Don’t know whether it is bad or good but it is what it is. I’m just noting it for my own reference really. Without judgement, just like my psychologist, mindfulness teacher and gratitude life class coach would say!

So today I went to a free organ concert.

This is something that I’ve wanted to do for a while now and haven’t gotten around to. It’s actually something that I’ve wanted to do ever since school camp to Sydney way back, not sure which year; probably about a decade ago though!! We saw the majestic organ at the Opera House but never got to hear it played. So the idea of hearing an organ concert is something that has been lurking in the back of my brain ever since.

And now it popped up for free! Can’t beat that!

So I went along today and took in the concert.

Annoying thing is, I’m not sure if I enjoyed it. Annoying, frustrating, irritating, worrying, concerning,interesting; pick one, any one.

My logical brain appreciated the size and the grandeur of the organ and the work that went in to building such a large musical instrument. It registered the admirable fact that the organ has been in place for a long time and still rings true thanks to dedication of many people. It realised the lovely surroundings from where I sat including the bright colours of stained glass windows, lovely wooden furniture, carpets and heating that made the environment comfy cosy on a freezing cold rainy day. It took in the detail of paintings and carvings and settings that were meticulous and intricate.

My rational brain heard the satisfying chords of the music played and admired the skill of the organist, and the patience of the girl sitting by to turn pages. It was interested by the variety of other people with a like desire to hear organ music in this day and age, and the ongoing support of obvious regular attendees. It was intrigued by the range of notes and variety of styles in which the organ could be played; impressed really to hear fast furious pieces together with traditional classical music and lyrical hymns. It felt obliged to be satisfied overall because really, wasn’t I ticking off one of my longings?

My physical brain was engaged in making sure that I was comfortable. I overheat very rapidly these days because of my medicines so all my coats and scarves were off. But just to be sure my physical brain checked and checked again and found that I was in fact sweating. Seriously, it was 8 degrees outside and I had just walked into a mildly heated draughty room and I’m wiping sweat off my face! Argh. Moving on, my brain was okay with the seating, the position, the view. It was surprised to find the seats in fact very comfy for an old building, and the view to be very nice.

So my brain goes on, looking, checking, assessing, approving and appreciating.

But is it enjoying? Today I’m just not sure. Usually I can feel it; happiness, joy, enjoyment. But today is one of those days where everything is in place, but I just can’t quite get to where I think I want to be.

Is it the medication, is it the condition, is it just an off day? Was it my lunch not sitting well, the seat slightly skewed, the conversation I just had? Was it my planning for tomorrow, my list of others things I’d like to do, my thoughts on dinner?

I think it will take more time and experience before I know the difference and can say for sure which is which.

I’m glad I did what I’ve wanted to do for so long. I’m sorry I didn’t quite get out of it what I thought. Maybe my expectations were not aligned with reality or maybe today’s just not my day. At least I have the blessing of being able to try it again sometime since the concert is a recurring one. A lot of times we don’t get opportunity a second time so that’s definitely in the plus column!

Saturday Shoutout

I have hedged around this and hinted at in and mentioned it obliquely but it’s time for some straight speaking about an important part of my life.

My peeps.

Specifically, my psychologist, my psychiatrist and my GP.

My support crew.

Without them, I don’t know where I would be. Literally and figuratively. Would I be in a psychiatry ward in a hospital? Would I be in rehab? Would I be doing a lot worse than am I now? Would I be a vegetable in bed? They have stood by me, held me up, dealt with me, kick-started me, bucked me up and saved my life.

I don’t say this lightly.

They saved my life! They’re that important.

Everything I say here has what to me is an obvious unwritten addendum: as well as my husband. He is the most important person in my life and has been my most supportive friend through every hill and valley, through every new discovery and every boring pushing-on day, through every heartache and excitement. He is so critical in my life but there are times in life when you need to call in the experts!

And these times have been the last year!

My aim today is to give a shout out to my current team because I truly do owe my life to these people. There are other people who have also been hugely helpful to me and I acknowledge them mentally; they might get a write up another day.

Starting with my local doctor, my general practitioner or GP, Dr Richard Young.

I came to see him accidentally after a false start with the GP that I used to see back when I was at uni. She charged a fortune and didn’t give me any confidence that she knew what she was doing. In fact she said to me, I’ll ask my colleagues and check some textbooks; can you come back next week? Well no I couldn’t wait a week, I needed help now! I complained to a colleague at work that I didn’t know where to start looking for a good GP and that I wanted to find one close to work.and who didn’t cost me so much and she handed me a business card for this doctor. I rate this as the best recommendation I have ever had and am always so thankful to her for this!

I didn’t tell this colleague why I needed to see a doctor and yet she gave me a recommendation for a doctor with a special interest in mental health, and who sees many patients with depression and anxiety. That was lucky number one. Lucky number two was the location of the clinic, within a 5 minute walk from work! Could anything be more perfect? I could easily slip away from work in my lunch break, between discharges, after ward rounds etc for my 15 minute appointment. And lucky amazing number three is bulk billing for mental health patients! That is, no fee to pay for each visit! Thank you infinity for this amazing policy that has benefited me and my husband so much!

Richard is a young enough doctor to have passion for his job in spades, old enough to have experience and knowledge and confidence, and has bedside manner and compassion like you dream of in a doctor!

His knowledge of the health system is unsurpassed. I have attended many different GPs in my old clinic last year as well as here, and have never experienced such thorough care! I have cervical migraines; I get Medicare subsidised visits to a physiotherapist. I’m gaining weight on medication; I get some of those visits changed to see a dietician. I have deficiencies; I get treated. I have risk factors; I see the practice nurse to develop a care plan for how I will reduce my risk factors. I have depression/anxiety and need help managing my symptoms; I get ten Medicare subsidised visits to a psychologist, and when I use them all up, I get more! We need help managing the medications; I get Medicare subsidised visits to the psychiatrist. And most importantly, when I’m suicidal he doesn’t let me go home; he sends me straight to the hospital where I can be cared for and a new plan can be made for my treatment.

You get the picture: this doctor is amazing! There is nothing I have that he can’t fix me up with the appropriate health professional or service!

After 8 months of seeing Richard once a week every week I have no complaints! I have had to wait on occasion, I have had to be rushed through on occasion but I have proved abundantly that when I have acute and severe needs, I will be given as much time and attention as I need and be cared for exactly how I need. How I want not always; but always how I need. I think you do need to give credit where it is due and understand the limitations of the medical system and within those limits I have been wonderfully and carefully looked after!

I would absolutely recommend Richard to anyone!

It is due to Richard’s amazing insight and care that I was first given a referral to see a psychologist. Unfortunately the first lady I saw did not connect with me at all, and in fact I left worse than I arrived!! Crying going down the steps is not the right way to go. So Richard promptly organised for me to be assigned another psychologist and I have loved her since the first meeting!

Patty Sabbagh from the Nexus Psychology group is her name and place.

She has seen me through all kinds of scenarios. Happy, sad, suicidal, excited about life, demotivated, purposeful and everything in between are the ways that I have turned up at her door and she has adapted and given me real help and hope and a new way on from every problem! She has helped me to deal with all kinds of issues, she is so resourceful and like a good friend. Sometimes I have gone and its just been a good chat with an understanding fellow human that I needed, and she has been a listening ear, a shoulder to cry on and a clever therapist able to give me a better way to fight on. A mother, a friend, a support; all labels I could give her and more!

She listens and considers and recommends the best approach. Sometimes talking about it really does solve the problem, sometimes a new way of looking or thinking about an issue is needed, sometimes there is need for meditation, or mindfulness, or cognitive behavioural therapy. Whatever is needed, this talented psychologist and counselor has the remedy!

Anyone in trouble needing someone to help would be well advised to seek the help of Patty from Nexus Psychology or one of her colleagues.

Lastly my newest support crew member, and one who has changed my life. Another big statement but well deserved! My psychiatrist, Dr Ian Katz.

He entered later in the picture because I initially saw a psychiatrist as part of my outpatient follow up from being in the emergency department of the local hospital. He was the one who suggested cautiously that bipolar was indeed a possibility and who first started me on a mood stabiliser. However his role is to see patients in the short term then send them back to their GP to be managed. Which is what happened.

My GP and I went along with the plan for Seroquel and for a while we seemed to be winning. Then that started to fall apart and my GP gave me the referral for Dr Katz. He picked up the pieces, made a sensible picture out of it all and gave me a ‘wait and watch’ directive and asked me to come back in a few weeks. I returned with a history of the most manic-like state that had happened to me so far coupled with a long period of depression and the diagnosis of bipolar was complete. He prescribed lithium, one of the best things that has happened to me in a long time, and things have been improving ever since! He calls it “the game changer”; I call it a life changer!!

I have been so impressed with Dr Katz because of his huge capacity to listen, and hear all the information then process it in a logical and helpful manner. He will then set out a considered, clinically sound plan and make everything clear and easy for me, the patient. That takes a huge lot of knowledge, skill, patience, kindness and clinical experience to attain and I think there are very few other clinicians like him. In addition, his commitment to his work amazes me. I have had appointments at 6.45pm, 8pm and 9pm!! Thank you for that!

I have a very high respect for his opinion and his directions and am just so grateful to him for being the one to really turn my life around!

So there you have it. The three most important people in my life just now, besides my husband. Three people who have left a permanent impression on my mind, and my heart really. Conditions like bipolar absolutely need to have this three pronged approach, which in the past was not such a priority but I would not give up either one of these three for anything! Each has a separate but vital role, and each one contributes in a different way to my overall mental and physical health.

I don’t think I could step into any of their shoes, even assuming I had the appropriate training. They each have some strength of character to do what they do that is beyond my understanding but its so important to me that they continue to do what they do.

I don’t know when they take holidays, I don’t know how their families cope with their dedication to their jobs but I know that without them I wouldn’t know where to go or who to turn to and I am forever grateful to them, and everyone like them who works for us, the patients.