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Posts Tagged ‘insomnia’

When I heard their outcry and these words, I was very angry

Nehemiah 5:6

Last week I had an appointment with my psychiatrist, but it’s only now that I’ve calmed down enough to write about it. I’ve always had issues communicating with my psych – she has the power to clear my mind of everything I had prepared to say – leaving me with just ummms, errrs, and a desire to leave the room as soon as possible. I’m not sure why I find her so intimidating, but I do know that she makes very little attempt to alleviate this, and that responsibility for making conversation falls entirely on my shoulders.

The last time I saw her, this culminated in being discharged, just after I had been accepted by the CMHT. Apparently this “is very unusual” – all I knew at the time was that noone seemed to believe I had really been discharged, and I was even asked for the punchline – it took some effort to persuade other professionals that I really wasn’t joking, and she really had discharged me.

Perhaps some background would help here – during 2009/2010, my psychiatrist was failing to acknowledge letters being sent to her (with my consent) by my YP-place worker, detailing her concerns, and my psych appointments were proving to be slightly less common than hens’ teeth. My worker was concerned enough to discuss my case with her manager, who wrote (another) letter to my psychiatrist threatening to make a formal complaint.

This appeared to have been the magic phrase, as a couple of days later my psychiatrist made a phone call to my YP-worker.  All I know about this call is what I’ve been told by my worker, but I’ve been told that she sounded very “defensive”, and said that as I didn’t have a “severe and enduring mental illness”, there was nothing she could do. Luckily for me, YP-place stuck to their guns, and she eventually agreed to refer me to an occupational therapist, insisting that there was no point as “they won’t see her”.

Needless to say, the OT disagreed, and agreed to see me for 3 months, which stretched into 6 months, after which he had to discharge me as I’d only been referred for “short-term intervention”, but he encouraged us to push for a re-referral to the CMHT in the near future if we felt I needed it, and re-referred me to my psychiatrist to discuss issues of “risk and function” that had come up in the time he’d been working with me. My worker thought this was a positive step forward, and offered to come with me to help me explain how things were.

Suffice to say that, we need not have bothered preparing for this appointment.  My worker and I discussed “risk” in some depth beforehand,  and I was very honest with her, as I believed that this was my only chance to be honest with my psych.

Instead, my words yet again deserted me, so my psych started telling me that she “thought I was better”, and my venlafaxine was going to have to go up – oh and I should take my sleepers at 6pm to avoid the pill hangover in the morning.

My worker tried to bring up the subject of risk, but my psych didn’t really take the bait. Instead, she told me that “we’ve tried our best“, and that I’m “not a child any more“. Apparently, I need to “behave more like an adult“, and “take some responsibility for my choices“.  If I “motivate myself more” then my problems will be solved, and I need to sort myself out because “with the new government” it will be really hard for “physically able people like myself” to prove that they’re incapable of work.

If my worker hadn’t been there, I think I would have taken that advice much more to heart. After all, when I go to see a doctor, they’re in a position of authority, see many patients like me, and (generally) tend to know their stuff – it’s hard not to listen to what they say.  In one fell swoop, she would have set me back about a year with respect to the progress I’ve made on asking for help when I need it, and not trying to take responsibility for everything that happens to me.

You see, what my psychiatrist doesn’t know, is that if I were still a child, I would not be in contact with mental health services, I would not be on antidepressants, I would not be trying to turn my life around. I would be sat on my own, in a bedroom with no working light, trying to end it. There was noone who would sort things out for me and see that I was ok – instead I was routinely ignored and just left to be weird, as if I were the proverbial elephant in the room.  I only managed to tackle my teenager issues once I became old enough to drag myself up by sheer force of will, and encountered some perceptive sixth form teachers who gave me the space I needed to put myself back together, and the approval that I needed to build my self-confidence.

My psychiatrist also doesn’t know (and hasn’t asked) that I’ve spent the last 6 months putting a lot of energy into doing the “adult” thing, and fighting the DWP, that I was preparing myself to represent myself at a tribunal, and thus trying to do the responsible thing and stand up for my rights as a British citizen.

I am painfully reminded of my adulthood every time the council bill me for my council tax.  I pay my bills (mostly) on time, I make sure I have a roof over my head, I give my seat to elderly ladies on the bus (if I’m not feeling too ill myself), I gave half my DLA Christmas bonus to the guy who sells the Big Issue.

So, what gives my psychiatrist the right to remind me that I can’t be childish anymore, that my lost childhood is, well, lost? And to then twist it around and make it my fault?

I am not a child any more, I am an adult, who understands adult things, that the people in authority aren’t necessarily right. An adult, who has room for feelings like “righteous anger”.

She gave me another appointment, for June.  I’m fully expecting to be discharged again at the appointment. I’m staying on the same venlafaxine dose, and I’ve stopped taking anything at night. Ironically, I’m feeling much better in the morning now, and I suspect that I was suffering more from the side effects than I had been benefiting from it.

Bonus points to anyone who can explain the title of this post.

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So, the mood has deflated somewhat, leaving me feeling…

… disappointed,
… betrayed,
… slightly dirty,
… bewildered.

I’m sure I should simply rejoice in the fact that I can enjoy moods like that, but the rollercoaster is getting tiring. I want real gold, not fake gold that flakes and tarnishes as soon as it is exposed to the light of reality. I’m embarrassed by some of the (minor) things I said and views I expressed, and worried by the fact that I stopped taking my dulox at one point.

Luckilly the euphoria started disappearing before I (finally!) saw the psychiatrist, as a week previously I’d been fully intending to give him the benefit of my theories and ask to be discharged… as it was, the session went ok. It was a fairly standard assessment, with all the usual questions asked, and the conclusion was that I should continue on the dulox as I seemed to be “stable” on it, and come back in three months (with the normal get-out-clause of “see your GP or make an earlier appointment if you feel you need to”). I was vibrating like a struck string all the way through the appointment, but I think he must have mistaken my agitation for anxiety/desperately needing the loo, and even commented that it “wasn’t long to go now” so I didn’t feel I wanted to enlighten him.

My sleep is still a problem, but he had no words of wisdom on that front, only noting that “insommnia can be a side effect of duloxetine” but that he “wasn’t sure about ‘nightmares'”. Great…

I did, however, manage to convince the receptionist at my GP’s to give me an appointment (whole ‘nother story there), so maybe I might get some advice tomorrow. It’s slowly driving me insane, as I’m still waking up in the night, having weird dreams, and am tired ALL THE FLIPPING TIME. It even drove me to embarrassed pleading with one of my collegues to take some of my work off my shoulders… not ideal, as he’s in the middle of failing a bunch of exams, and pretty stressed out himself.

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