The February Post – Anxiety…

Anxiety. That’s the word of the month for me. Not just the usual anxiety that I struggle with, about clearly identifiable things like ‘Will there be a horrible brown envelope from the DWP in the post today?’ or ‘What if the new flatmate turns out to be really scary?’, but that awful non-specific thing we like to call generalised anxiety. It been coming over me out of nowhere several times a day, gripping me with its icy cold claws, digging into my skin, even my soul – and there is absolutely nothing I can do about it. My heart pounding so hard and fast it makes me think that there is a genuine chance it might explode in my chest. That sense of doom, of just knowing that no matter what I do, something very very bad is going to happen, and there is no escape. That horrible fizzy feelings behind my knees that makes me feel simultaneously completely paralysed and as if I can’t be still for even a second.

That. I’ve had an awful lot of that this month.

In therapy P. and I try to slow things down, try to work out what it is I am reacting to – but, unlike anxiety about something tangible and definable, this fuzzy whizzing fog of fear won’t be so easily captured and analysed. Of course we know that if there are a lot of things going on for me, I am much more likely to experience these episodes of panic and anxiety – but more often than not, it feels as if it’s been triggered by something so microscopically small that we can’t even distinguish it with our emotional super lens trained directly on it.

I can’t remember a time where I’ve suffered quite so much with anxiety (that wasn’t caused by something specific). And this constant fighting off an unseen enemy is exhausting. Recently I have even been considering whether or not I may need to look into getting prescription meds to help me manage it all.

Now, I know that many people have strong feelings about the use of medication to treat mental health disorders. Some feel they are an evil that should be avoided at all cost, while others say that they are absolute life savers. Personally, I am not for or against using meds. I have not been on any kind of medication for a very very long time – but the reason for that is that I have had some very severe adverse reactions to a number of drugs (both ones to treat physical and emotional ills), and for that reason my GP is very reluctant to start me on anything I’ve not been on before. Also, the one psycho-pharmaceutical I have ever been on without having one of those aforementioned severe adverse reactions happens to be one that is frighteningly high on the toxicity index, so – owing to a proven tendency to not stick to agreed safe dosages – I am rarely allowed to have even that. But, as I said, at the moment the anxiety is so bad that I am seriously considering trying to persuade my GP to let me have some sort of anxiety reducing chemical prescribed. (I’m not terribly hopeful that she will agree to do so; she once told me that she ‘doesn’t prescribe sleeping tablets for sleep’ in an attempt to not have to prescribe me an untested medication).

This kind of anxiety is kind of new to me. Or, at least having such frequent episodes is. I’ve had panic and anxiety attacks before, and I am a pro at getting exceptionally anxious about anything that could possibly go wrong – but I’ve never had multiple episodes every day. I am very used to suffering from PTSD flashbacks – I have those all day, every day – but this is something very different. As horrible as the flashbacks are (and they really are truly disturbing, each and every one of them), at least once I have managed to come out of them, I know what they were about; there is a distinct traumatic event attached to each one of them. But these anxiety attacks.. I really don’t know what to make of them.

Of course P. and I will continue to explore them, and hopefully they will get better. But for now.. it’s really tough.

Anyway, I think I’ll end this post here. It’s not quite the update I would have liked to write, – but I guess it is what it is.

To all of you out there,
be good to your Selfs

xx

Out Of Control – Me On Steroids

There I was, having been told that there was a good chance that my hearing loss was due to my own actions. Not an easy thing to deal with. Part of me absolutely felt angry with myself, was blaming myself; I have a natural tendency to be very hard on myself – especially when the consequences of my actions turn out to be severely negative. But, there was also another part that just felt confused, because whilst the second most recent overdose was certainly a serious one, the most recent one was one where I didn’t ingest more than about half a teaspoon of the chemical, and I couldn’t quite understand how it could have had such a drastic effect on my hearing. But, clearly it had.

The ENT specialist had prescribed a high dose of Prednisolone which I was to take for a week in the hope that it may reverse some of the recent hearing loss. The name of the medication did ring a bell at the time, but not loudly enough for me to clock why, so I went down to the hospital pharmacy and picked the medicine up. It wasn’t until I got home that I remembered that this was a medication which a previous GP had refused to prescribe when my asthma was really bad, because she felt it was too much of a risk, putting me on it. There were two reasons for this: firstly, that people with a history of serious mental health issues are particularly prone to react badly to this medicine, and, secondly, that I have in the past had extreme adverse reactions to three other medications [one of which I was reacting to when I took the second most recent overdose], so the doctors are always very cautious about prescribing any non-essential new meds to me.

But, there I was with the medication in my hand, not knowing whether or not it would really be a good idea to take it. Yes, this medication could potentially save me from needing cochlear implants down the line, but, at the same time, if I did have a really bad reaction I could end up putting myself at considerable risk. The ENT specialist wasn’t someone who knew me well [or at all, really], so when he prescribed it, he did it on the same premises he would for anyone else; ‘Worth trying, no harm done if it doesn’t work’, whereas I knew that this medication could spell real trouble for me.

There was a part of me that was genuinely scared of a bad reaction; I knew perfectly well the horrible feeling of being out of control because of a medication. I had been through it three times.. Yet, there was another part that so badly wanted to be able to do something to reverse the damage I had apparently caused.

I spent a week going back and forth, unable to decide what to do, talking it through with lots of people, knowing full well that, ultimately, it was still my decision to make. I did speak to my GP [well, technically, the receptionist spoke to her on my behalf], and she said that it would be ‘perfectly fine’ for me to take the steroids, and – after all – I had had no adverse reactions to the steroid injections I was given when treated for anaphylaxis.

In the end I decided that I would give it a go, because I knew that if I didn’t I would always be wondering ‘What if..? What if..?’.

Still, to be on the safe side, I decided to start the course early Monday morning, so that if I did have a bad reaction I would be seeing P. later that day. [With two of the three medications I had previously reacted badly to, it had happened literally within a few hours of taking the first dose]. I also had a doctor’s appointment on Tuesday, and scheduled a ‘just-in-case’ appointment with K., my synagogue social worker who I have been seeing semi-regularly, for Wednesday afternoon.

Monday came round and I took the first dose, which – as this was a high dose treatment – was a good handful of pills, making me feel as if I was actually overdosing on tablets. By the time I was due to see P. – about six hours later – I already knew something wasn’t right. I could feel things firing in my brain, rapid electric sparks in my head, and it was as if I couldn’t keep track of my own thoughts. It was a truly bizarre experience. – Anyone who has ever been seen by the mental health crisis team knows that one of the questions you will be asked during the assessment is ‘Are you having racing thoughts?’. Being prone to deep depression and suicidal ideation rather than mania I have always answered ‘No’ to that question, not really knowing what ‘racing thoughts’ actually were. I’m telling you, by noon that Monday I knew exactly what they were – and it was freaking me out, big time!

So, I had a crazy rambling session with P. that day, very unlike any other session I have ever had. I also spoke to H., my care coordinator, that same afternoon and she sorted out a referral to the crisis resolution team for Wednesday, as it was clear I was not in a good way and would likely need the extra support, particularly over the weekend.

On Tuesday morning I went to see the doctor – an absolutely lovely F2 who I hadn’t met before. By then I had taken the second dose of Prednisolone – more out of a sort of manic compulsion than anything else – and consequently the reaction was getting worse. I had also used a surgical scalpel and cut myself very badly in two places; enough to warrant stitches. The doctor’s reaction was ‘Come off these meds immediately – this is a really serious and abnormal reaction!’.

I explained to her the reason why I was on the treatment in the first place and why I was finding it hard to ‘just stop taking the meds’, and this young doctor was absolutely brilliant. She sat back and listened to me carefully and then took the time to make five or six phone calls – while I was still in the room – to get hold of an ENT registrar to find out what the implications of stopping the treatment would be for my hearing, so that we’d be able to make an informed decision. The ENT registrar told her that as treatment had been delayed by several months already [Urgent NHS referral, remember?] it was unlikely that my hearing would improve, that the specialist who prescribed the steroids probably felt it was worth a shot – even if it was a shot in the dark – because sometimes people do respond, even with delayed treatment. But, the registrar concluded, in light of the extreme reaction I was having it certainly wasn’t worth staying on the meds, as the odds of success were so small.

I felt really reassured in that moment that I wouldn’t be missing out if I ended treatment prematurely, because the odds of any improvement were so small. It made complete sense to stop taking the meds.

But, then I got home, and I was still hyper and there was so much in me saying that firstly I was already dealing with the adverse effects of this medication [the GP had explained that it would more than likely be a few days, maybe even a week, before the chemicals in my body would stop messing with my brain].. and it was only a few more days to go.. and what’s to say that I couldn’t have an equally abnormal positive reaction to these meds..? After all, my body is clearly highly sensitive to small chemical changes..

So, the next morning I took the third dose, against medical advice. This time it wasn’t manic compulsion that made me do it, but that part of me that just needed to hold on to hope, that simply couldn’t give up, even though everyone around me felt this was a very bad decision, indeed.

I spent time in my session with P. that day, exploring why it was so terribly hard for me to stop taking the tablets, even though the rational part of me knew that the chance of a positive outcome was incredibly slim – and that was really helpful, even with the chaos raging in my head.

I also had a good chat with K. that afternoon. She was characteristically open, direct and honest with me both about her anger and her disappointment that I had carried on taking the medication in spite of what the doctor had told me, and in spite of the fact that I had felt completely reassured at that point that I wasn’t missing out. I told her that I would think very carefully about handing the meds in to P. the next day, but I was also clear that I wasn’t prepared to make any definite promises, because I simply didn’t feel that I could. So much of me felt out of control and I just couldn’t say that I’d be able to do that, come morning.

Oddly, the thing that made me realise just how out of control I really was wasn’t the fact that I had cut myself so badly, but the fact that I found myself at a McDonald’s having a Big Mac.. I’ve been a vegetarian for something like twenty years, and I keep sort-of-kosher, so for me to sit down and eat something like that goes against so much of what I believe in. It is something I simply wouldn’t ever do, if I were in control of my actions..

I did end up giving P. the tablets the following day, but not before having taken a fourth dose that morning, this time – again – in a very compulsive manner. There was no reasoning whatsoever, just acting: I simply couldn’t not take them. This made me realise that I really needed to view the tablets in the same way I did my scalpels and cords [all of which I had handed in to P. two days earlier, feeling too out of control to be safe with them]; while I was still having this strange reaction I just couldn’t manage the tablets responsibly.

It took a good while after that final dose before I felt completely back to my normal in-control self, and I carried on working with the crisis resolution team through the weekend and most of the following week, just to be safe.

I am really glad that I had as much support available to me as I did during this time, because it was incredibly frightening to be so out of control. The experience was very different to other times when I have felt out of control. Whilst what came out in the midst of this whole ordeal – feelings, thoughts etc – were things that were almost certainly already brewing inside, it was – at least the way I look at it – triggered by outside factors. And that’s quite a scary thing.

All the very best,

xx

Being Unwell And Feeling Cared For

Cure For The Ill

Cure For The Ill

I’ve been unwell. Still am, actually. Pneumonia. It’s a bit of a long-winded story, but in short it involves leaving a psychotherapy session early for the first time ever, thinking I was better when I wasn’t, and ultimately on Friday having to go see the doc urgently.

I had just left a session, and on the train home I suddenly had this terrible pain in my chest. And it was a pain I had felt before; two years ago I had a pneumonia, and this was what it felt like.

Anyway, once I got to the doctor’s, she had a good listen to my chest, took my medical history and told me she felt confident that what I had the previous week was more than likely a flu virus, but that I had milder symptoms than most, since I’d had the flu jab, and that despite this my immune system was compromised enough for me to develop a pneumonia. [Ironically, the reason I have the jab every year in the first place is so as to make sure I don’t come down with secondary complications, such as this..] Since I have a history of pneumonia, starting in exactly the same way [top right lobe a week after having had another illness] and because my asthma was kicking off like crazy, she decided that she’d rather start me on antibiotics straight away, than wait for test results to come through.

So, home I went, antibiotics in hand. Crashed into bed, and this is where I’ve been stuck up until just now. I have to say, antibiotics are a wonderful thing once they kick in. You really do feel so much better, very quickly. Of course there was always a chance that the pneumonia I had was viral rather than bacterial, in which case the antibiotics would have done nothing for me, but ‘thankfully’ it turns out that it must have been bacterial.

While in bed I have been thinking about being unwell. It’s something I have a fair amount of experience with. You see, I have a really poor immune system, and so whenever something’s going ‘round, I tend to catch it. I mean, I had swine flu long before it became fashionable. But, also – as I have mentioned in previous posts – I am prone to what I call psychosomatic fevers. Other people get upset tummies when they are stressed out; I get a temperature. And this is what’s been on my mind, these last few days; the relationship between having a genuinely poor immune system and getting psychosomatic illnesses.

You see, I don’t think it is entirely chance that I get ill very easily, weak immune system aside. When I was little I was always seen as someone who could look after myself, someone who was responsible and dependable and able, far beyond my years. My parents tended to assume I’d be OK on my own, and mostly I was. I’m sure it was sometimes hard for my parents, this fierce independence I had; not so easy parenting a child like that. But, at the same time, they were very busy people; three other kids, one of whom really rinsed them clean of any energy they may have had. So, as confusing as it may have been for them, I’m guessing it was also something of a relief that I didn’t seem to need much looking after, that in fact, I was perfectly able to look after myself as well as anyone else.

But, when I was unwell, it was almost as if my parents’ parenting instincts suddenly kicked in, as if this was the kind of parenting they could understand, could relate to. After all, they are both trained in healthcare professions. This was something they knew what to do with. And so, as a consequence, when I was unwell, those were times when I truly felt like a child, like they were my parents and I was in their care.

At all other times I always felt equal to my parents. I always felt like I was an adult, just like them. And to a large degree, I think that’s how they and other adults around me saw me, too. But when I was sick, well, I could allow myself to be the child I really was.

So, is it so strange that I am prone to getting ill? Even now, as an adult, when I am ill, both of my parents will call me, will want to know how I am, will maybe even worry a little. This in contrast to other times, when I am nearly always the one to call them, nearly always the one to ask what’s going on for them.

Of course, something like pneumonia is a very real illness, it’s not psychosomatic, not imagined, not exaggerated, but in the midst of feeling so terribly poorly, I also do feel cared for, in that very special way.
Just like I did back then.

Psychology..
It’s interesting stuff.

xx

How I’ve kept myself busy. The Square-1 cube puzzle. It’s a fair challenge, getting it back into a cube shape, and then getting all the colours right.

Square-1

Square-1

Standing tall at a hundred-and-fifty centimetres

I’m not into drugs. Never have been.
Then again, since I’ve never actually tried any drugs, maybe that’s a bit like saying that I don’t like base-jumping or storm-chasing; I’ve never felt the rush it’s meant to give you, and maybe if I had I would think differently? What do I know?

As a child I was on a lot of prescribed but experimental drugs, however.
I was very short and begun showing signs of entering puberty when I was only about six or seven, so my parents decided that they’d try to find out if there was anything to do about this. I’m not entirely sure how, but eventually they were put in touch with a Germany born specialist; Dr Westphal, and I was started on the first of many treatments in order to help me carry on growing.

This was in the early 80’s and very much cutting edge. At first I was given testosterone tablets, which I assume were meant to stop me entering puberty. One pill taken three times daily. A few years down the line, when I was around eleven, this was switched for a nasal spray called Buserelin, also on a thrice-daily cycle. Buserelin is a man-made form of the hormone gonadorelin, which initially sets off an increase in both testosterone and oestrogen, but will in the long run solely cause testosterone production and stops oestrogen production altogether. I was kept on this medication until I turned fifteen and in the last two years it was combined with daily injections of a synthetic growth hormone; Genotropine.

What does this have to do with depression and dysfunctional families you might ask. Well, “I don’t know”, is the honest answer. And, I fear, this is the answer I would get myself, were I to ask anyone else.

To the best of my knowledge Buserelin is (these days) mainly used to treat certain forms of infertility and advance stage prostate cancer, and you are advised to talk to your doctor before starting this treatment if you are suffering from depression. I haven’t been able to find an answer what the reason for this is. Is it that it may interact with anti-depressive medication? Does it tend to heighten the risk to enter depression? I don’t know.

But, it worries me somewhat that I have been on various medications for such a long period of time, and at such a critical developmental stage, not knowing what the long-term effects may be. I was one of the very first in the world, to be given this medication – especially at such a young age – and I can’t help but to wonder what this may have done to me. Has it made a difference to the way I behave? The way I think? The way my body works? I just don’t know.

Surely being put on a medicine which will increase testosterone production and cease oestrogen production must cause some sort of chemical imbalance in a person? Especially if you are a very young girl. And how do I know that I’m not still suffering from the effects? I’ve never been a girly girl, I’m attracted to both men and women and I am generally hopeless at traditionally female chores. Is the medication to blame for this? That is not to say that any of the above traits are at all things I dislike, I am only asking from an intellectual point of view. Has the medicine made me more prone to depression? Has it veered me towards more radical suicide methods which are more commonly used by men? Or is this all a psychological side-effect of the sexual abuse I experienced as a child? Maybe the answer is that both have had a profound effect on me, maybe it is neither. It’s impossible to say. But wouldn’t it be interesting to know? To have a black and white nature vs nurture chart, where you could see exactly what has made you who you are.

The medication issue also poses another important question. How do you as a parent decide that you’ll take a gamble on your child’s present and future health? A shot in the dark that you will hit the target?

I’d say that I’m about 98% happy that my parents made the decision to put me on these drugs. It has been estimated that I would have been around thirty centimetres shorter had I not undergone the treatment, and while thirty centimetres may not sound like much, the difference between being only 120cm tall and being 150cm is enormous. It’s the difference between being viewed as very short and being seen as a midget. Those thirty centimetres have made it possible to live a normal life. Yes, I have to ask Dev to reach for me, but there’s no need for custom made lowered worktops and although I sometimes struggle it is possible to walk into a shop and buy a pair of trousers that fit without being taken up. So, they have definitely made my life easier in many ways.

Still, there are those 2% of me which can’t help but to wonder – was it the right choice? Would I have made the same one, had it been mine and not my parents’ choice? Would I give up those thirty magic centimetres if I knew they were definitely the cause for my recurring depressions?

Again, the answer has to be that I don’t know.

But it’s food for thought.

xx