What Do  You Do When You Are Tugged Down The Rabbit Hole (again)? #mentalhealth #depression #weekendblogshare

Most of the time I manage to maintain a sort of equilibrium, but occasionally I slip into a darkness akin to what it would feel like if the dementors in Harry Potter were real. In fact, the depression I am currently suffering from is real. It takes a lot of insight and self-awareness to realise a low mood, flat effect and compulsive pessimistic thoughts are not quite a facile lifestyle choice.

I am lucky to have an excellent sounding board in a therapy group I deeply care for, but when in session I focus on others and pragmatic problem-solving rather than expressing what I feel. Circling emotions is easier than expressing them. It’s a fear of being ashamed of showing my true emotions that hold me back. I know I would tell anyone else that they have nothing to be ashamed of when expressing how they feel in a depressive episode, but convincing myself is harder.

It’s been a long time since I found myself feeling this low and I frightened myself this morning when I woke to utter the words, “I want to die.” I have no reason to feel this way. I am well supported, feel pleasure from doing many things as hobbies, I have the freedom to choose to do anything I wish, but alas that voice in my head tells me I’m not a doo-er. My reading has slowed since my mental health began to deteriorate early this year. For the first time I find myself behind three books in my Goodreads Reading Challenge. It’s taken me weeks to write a suitable blog post about the truth of my mood.

When in therapy there’s a special type of shame that comes with failing to remain optimistic. It’s seriously like I’m failing a course, but I cannot deny how I feel and I no longer have the energy to push it to one side. I’m circulating a crisis, but I’m not being furtive about it. If I was having an acute asthma attack it wouldn’t carry the shame I’m burdened with for having an acute depressive episode, and why not? Administering drugs to ease someone’s airways is heroic as opposed to acknowledging the darkness in their thoughts, which at best is indulging narcissism at worst aiding laziness, if you ignorantly believe anyone would want to feel this way.

I’ve been open and communicated my concerns about myself, now I have to rely on that old adage of time and the new mindfulness based cognitive behavioural techniques I have read and championed. Not so easy when I feel I’m being smothered in a lead curtain of impending doom.I’m tired of being me and no amount of reminding myself how lucky I am, the miracle that is life is so rare and precious, can convince me I have a purpose. 

This too shall pass, they tell me. Eventually. 

#Mindfulness February #mentalhealth

Every now and then I suffer from mental fatigue. The bouts of mental fatigue are more regular at the moment, largely due to averaging a few hours of sleep daily for the past few months. 

Some days I don’t like dealing with words so I colour to ground myself and clear my mind. The following is the result of one of such day. 

Physically I am enduring frequent hot flushes and headaches, although these do not affect my daily activities as much as they affect my sleep. 

Maybe I need more mindfulness days? 


#MentalHealth Review #OCD 

Despite being seen three times a year by a psychiatrist to review the nuts and bolts of my OCD, depression and anxiety and the effect prescribed fluoxetine and anxiolytics are having on my general health, I now have another sort of review in my psychodynamic group therapy. Every six months we take stock of our goals, risks and achievements. I volunteered to go first in this new uncharted territory of therapy as it gave me less time to dwell on it and arouse the many critical thoughts that may have disabled me from benefiting from this event.

Reviewing myself or letting myself be reviewed, as a group activity, was odd, firstly because it is the only time, unless you want to have the spotlight in group, you are thrust into the group’s crosshairs. I was grateful for only having a week to ruminate over what initially felt like a bureaucratic hoop, but in all fairness I think I forgot about it by the weekend and only brought it back to mind the morning of my next session. 

Refusing to be cowed and rendered defeated by my thoughts I considered the individual points of the review in my allotted fifteen minutes at the start of the session and found that, without being completely aware I was doing so, I do actually keep a mental ledger of where I was at the start of my therapy and where I am now. With so much food for thought from each session over the weeks months and now years my mind has mulled over the problems presented to me, not just about my own psyche, but those reflected to me by others around me. I consider it one of my greatest achievements to take into account the way others might see me differently to my perceived view of myself and find I am able, albeit in an analytical fashion, to accept these observations to reflect and think about without drowning in a sea of my self-made negativity. 

I have never formally looked at what therapy is doing for me in such depth verbally or mentally, so viewing myself, my thoughts, emotions, goals and progress in this way clarified what my goals are from here on out. It was encouraging to see the positive work my ever chattering mind can do, even when I don’t feel in focus of the sessions I have weekly. It appears, as I have always suspected you don’t need a therapist to be with you daily but a mental voice that represents a therapist does exist in my cognitive choir. This maybe why I don’t feel defensive about the way I feel or come across and am altogether willing to consider the effect my behaviour has on others and on myself. 

To date I am grateful for the increased self-awareness I have developed in therapy. I am glad I appear to cope with the depression and anxiety I have more constructively whilst being more aware of their origins. Each session seems to increase my arsenal of tools to augment or mute my analytic thinking and self-reflection leading to a neuroplastic change that benefits me a little at a time. I am burdened with fleeting dark thoughts on a daily basis but I am finding more balance with the lighter thoughts I seem to be able to generate. 

I may have a few chronic illnesses, but my OCD and whatever else keeps it company, has to date affected me the most in my life and I have tools I am getting better at handling to cope with the condition. I know what my next step is in my self-development, and here’s hoping I generate the impetous to take it before the next review. 

#Non-Fiction #BookReview Sane New World: Taming of the Mind by Ruby Wax #Fridayreads #self-help 

​I found this book immensely helpful in understanding my depression and anxiety and piecing together the physiology and psychology of living with mental illness. Ruby Wax goes from the evolutionary viewpoint of why we are anxious to exercises helping us to retrain our minds to focus on the here and now. 

If you aren’t a Ruby Wax fan you may not get on with the style in which the book is written but as a sufferer of mental illness and cynic I found Sane New World filled in blanks for me and gave me a level of understanding of my illness that I had previously struggled with. By no means is this book a replacement for medical therapy and as lightheartedly it is presented it is actually on my shelf of go-to manuals, which I refer back to for exercises and reference when the need arises.

I was heartened to find myself already doing some of the things Ruby mentions in the book when it comes to dealing with negative thoughts and am delighted to have pages of exercises to try to master to help with my anxiety, depression and OCD. 

I found this to be a good book to begin building my personal mindfulness arsenal and am sold on the technique as Ruby cites a number of studies and references to back up her endorsement of Mindfulness Based Cognitive Therapy. A definite must-read for those suffering mental health issues, provided you like the humour Ruby Wax. 

Links To Book:

Amazon UK

Amazon US

Goodreads

When Change is a Good Thing

I have always considered myself not someone who adapts well to change, to the point I consider any change the enemy, but recently I have been compelled to consider that change is very much what I needed in order to progress on a personal level. 

Although the thought of change inspires much insecurity as I contemplate all the things that could possibly go wrong or the worst case scenario, I am also denying myself the opportunity for many positive events when I resist change. 

The same I feel applies when I dismiss others opinions and ideas out of hand without considering them seriously and if I didn’t take a chance and trust people by letting them into my life. Not everyone is going to leave a positive effect on me, but by closing myself off I’m definitely locking out all he potentially positive experiences that may be heading my way. 

I firmly believe a lack of any sense of responsibility for the choices we make, in other words, blaming others for my problems is not in anyway helping me to attain peace of mind, improvement of my mental health or happiness. Likewise complaining about everything and having no gratitude for anything is a sure way to let yourself down. I’m glad and grateful to experience change to rectify these negative habits which had been festering over the last couple of years. 

Currently, although I’m not completely comfortable with change, I do not dread it and am open to new experiences and models of thinking, which may work better for me. I am looking forward to making my own changes on my own terms.

Back to Slimming World

I took a break from Slimming World for a couple of years and gained back all the weight I lost in my two years of membership. During my weight gain I felt ill as a number of health issues exacerbated, but I made myself so restricted I was not enjoying food and really needed to address my deeper issues with food. 

This year I restarted the Slimming World plan and lost 5lb in my first week. Keeping an accurate food diary has been instrumental and is actually a good use of my attention to detail, but the biggest hurdle I have overcome is accepting I do not need to eat the foods I craved in the past. In reality, we need few calories to function but eating well means having a good knowledge of ourselves as much as being informed about the food available to us.

It’s different this time round as I don’t feel restricted and I feel much more comfortable about saying I’m not hungry and not limiting my life by not eating out or occasionally choosing food I enjoy. As is usually the case if I abandon Slimming World so does my husband, and going back on plan is something we both did this January. 

I am amazed by how quickly I seem to be losing the weight this time round and at two weeks on plan I am looking at losing my first 7 lbs, that’s my half stone milestone, tomorrow. The key this time is to not get bored and allow my food choices to feel restrictive, as well as allowing myself to enjoy life as I lose weight. 

I look forward to bringing my regular weight loss progress to my blog. 

Losing a Loved One #PetLoss

On Tuesday we lost Tinky. This time last week she was fine. She went off her food at the weekend and lost her energy on Monday evening. Tuesday morning it became clear to us that we had no other treatment or management options and although to us she still seemed determined and herself that veterinary science had little to help her in its arsenal. 

Tinky has had renal failure since 2013 and we were told that the condition can be monitored and changes in her diet made to prolong her wellbeing but there’s no cure. Considering the effect the condition had on her she was remarkably well.

For us Tinky was the first kitten we ever reserved. She was mislabelled a he when we first met her and was pretty much the ringleader in her litter. She was always the loudest with the most to say and somehow led other cats to do her bidding. 

She was a tiny baby when she came to live with us but she had a huge personality and a will of steel. Headstrong, stubborn and extremely vocal we soon learned to do things her way. She was undoubtedly the smartest cat we ever had as well as the most bossy and authoritative when we bred kittens.

Tinky was scrupulously clean and she wouldn’t tolerate any cat or kitten eliminating where they shouldn’t. She kept us on our toes when it came to making sure all our littertrays were acceptably clean.

We learned early on that she would do almost anything for prawns and her special renal diet meant she had to give up a lot of her favourite foods, but she was so smart she knew eating anything other than her kidney food would make her unwell, so used to just watch the others tucking into things she loved. 

If she needed anything she would let us know, not too subtly, but most of all what surprised me most was just how empathic she could be. She used to come and sit next to me leaning against me if I was upset or feeling depressed. When I was ill before my pulmonary hypertension diagnosis she used to sit on me for hours and just purr. 

In 2012 when I was admitted at my local hospital for two weeks I was allowed home at weekend’s on day release and she used to tell me off for being away then sit on me refusing to budge as she knew I would have to go back to the hospital. 

She had a special meow just for me and without her constant companionship since she came to us in 2006, my life would have been considerably poorer. My first morning without her was unbearably quiet and despite the five cats outside my bedroom door there’s an empty space we all feel that cannot be filled. 

When you say you’ve lost a cat, people who don’t love cats can’t begin to understand that loss, so to put it in terms that can more accurately convey how I feel I will say I’ve lost a constant bestfriend and probably the closest being I will have to a child of my own. 

I knew she wouldn’t be here forever but losing her is hard on an already broken heart. 

(Not Successfully) Avoiding Joyless January

After the warm festivities of Christmas and New Year, I often find myself experiencing a bleak void in January. The weather is grey and dismal. It’s cold and wet and extremely easy to follow thoughts that make you feel ultimately bereft.

Procrastinating over stuff that happened more twenty years ago is pointless, but something I actively need to guard against. Unfortunately, due to bad timing I’m also reading a hard hitting novel, which is giving me nightmares. 

Every problem seems momentous and I feel easily tired and have a banging headache. The tiredness in my case could be attributed to a dozen things affecting my health., but this would just be pedantic. I have had to spend a lot of time alone and I’m sure this has had an adverse effect on my mood. 

My sleep is erratic and sporadic and I have uncharacteristically stopped using my CPAP. I just don’t have the energy to do the maintenance etc.

Imminent is my appointment with the heart/lung transplant assessment clinic. In fact when this post is published I will be a few hours away from sitting in the outpatient area for transplant assessment. 

I’m not sure how I feel about needing a referral to such a department. No one expects to need another organ and is it such a big deal in this day and age? 

My questions could be rendered null and void tomorrow after numerous tests I really don’t want and an answer I have no idea how to anticipate. I feel the appointment will be a weighing up of my worth, in general, as a human being. 

It’s odd to feel depressed and dejected knowing exactly why and seeing a pattern in your moods but being detached and watching yourself endure it as an indifferent observer. 

Dismantling Alienation

There have been two instances this month where I felt I didn’t fit or matter. The first one was early this month where I had bought two tickets to hear someone famous speak and when the talk commenced I felt totally alienated and out of place. It started with the speaker pointing out the talk was for those that looked like her. I definitely do not fall into that category because of my race. I tried to put my misgivings aside and listen and even raised my hand seven times to ask a question, but I was overlooked on every occasion.What I thought would be a thought-provoking evening was a cheap, commercial and a superficial gimmick to move product. I will never look at the speaker the same way again.

Rightly or wrongly I felt I didn’t matter and could not rethink the evening as being vaguely enjoyable. It was constructive in one way only: I got a smashing present to send someone as their nominated Secret Santa. They say you should never meet your heroes and they, whoever they may be, have a fair point. After that evening I will not be actively seeking out works from that particular speaker again and I feel I really must develop a better sense of detecting sincerity from people generally, as my sincerity meter is evidently way off. 

I didn’t let my feelings fester into making me feel worthless, which is where they would have headed usually. In the past I took things as my fault due to my misconception of the topic, but in this case I realise my expectations were too high for this mercenary individual to live up to. Noble cause, unworthy messenger.

The second time I felt I just didn’t fit, I was doing it to myself. There was no one facing me telling me I was wrong, it was just a gut feeling. Rather than react to it in any contentious or inflammatory manner, allowing it to escalate to the point it obliterated what is positive, I stopped it. I thought it may resurface, because I’m never sure how effectively my distraction technique works, but I haven’t had a chance to dwell on it much as my social diary filled up and I kept hearing all the sound advice I’ve been given to let moments of insecurity pass. With time it did feel like water under a long forgotten bridge. Next month the incident and individual probably won’t even come to mind.

Now I know I’ve made positive steps to adapt and have grown emotionally as I can let the negativity pass. On reflection I think it’s time to find voluntary work I can physically and mentally manage.

Point of View Differential

When it was first mentioned to me in Autumn this year that I was going to be referred to an organ transplant team, I didn’t think I would see anyone until 2017. Maybe Spring 2017. I’m not complaining or dissatisfied in any way with my pulmonary hypertension care. This isn’t my first rodeo. I know referrals take an age. I still have had no news from the endoscopy unit regarding the OGD I am being considered for and that referral went in September. I was surprised to be sent an appointment to go to the Pulmonary Vascular Diseases Unit in December having already seen them in October. 

Not sure why I was being recalled, I assumed maybe they wanted to do a right heart catheter. However, I left feeling maybe I wasn’t totally clear on how precarious my health is at the moment. Two things in particular made me anxious; the offer to start nebulizer iloprost, which I declined as I felt too well to jump to the next phase in treating my PH and the follow up request to the transplant team. As always I was reminded I could call the unit at any time if things deteriorate.

As is sometimes the case, the day I was in clinic, from my point of view, I felt better than I had last time I came to the clinic. I did still have to stop three times on the way to the PVDU from the hospital car park, but I had no nagging cardiac chest pain. Despite the sleepless night before, I felt well. I was happier with my shuttle walking test and felt I had improved, maybe not significantly as far as numbers go to anyone else, but enough to not make any clinical decision regarding any change in my treatment imminent. Enough to make it feasible to park somewhere not too far from disabled spots and walk to my destination. After all, I managed 260 yards. That’s 60 yards more than a relatively well blue badge holder.

However, reading this month’s clinic letter I’m marvelling at just how different my perception as a patient is to the experience of my symptoms compared to the clinician I see. My 30 yard improvement in the shuttle walking test, which I saw as a personal triumph, was described as “similar” to my previous score of 230 yards. There was an overall tone of precaution in the letter that sent my over-analytical mind into hyperdrive.

I still think it’s absolutely implausible, if not impossible, to get into seeing anyone as a new patient in clinic in 2016, as we are so close to Christmas. However, I suppose it should be business as usual despite holidays officially. But it’s not like I need a transplant this year or next year, is it?  Why the hurry? 

As a patient,whose symptoms of pulmonary hypertension aren’t as good as last year my instinct is to hibernate until Winter is over, but luckily my fatigue isn’t shared by the clinical team, who behind the scenes are planning their next moves in terms of my treatment. With a great deal of effort I have convinced myself there’s nothing to get anxious about. After all being prepared is good. However, the nagging chest pain has been back in the last 24 hours and I’m beginning to wonder what those minor ST changes in my ECG anterior chest leads were. It’s not that minor, when it’s your ECG.