The Deep Breath before the Diagnosis

This is going to be a post of two parts. Half of this I'm writing Before, the other half will be written After.

After what?

After I see a Doctor seeking a diagnosis for whatever has been fucking up my mental health for the past 3+ months. The likely bet is depression, possibly with a dollop of anxiety to make things even more fun. I probably should have made an appointment for this *weeks* ago but that miserable little voice which I've talked about before has been a real bitch for talking me out of making that phonecall because it says things like "why do I need to see a doctor? There are loads of people way more unwell than I am, it's probably nothing. I'm just being lazy etc."

Over this summer I've become aware of my mental state in a way I don't think I have been previously and there is no getting away from the fact that I am not all right. I can literally tick almost every box of Depression symptoms without fudging my memories to fit (Anyone who follows on me twitter knows about my inability to wake up at a reasonable time & to feed myself proper meals). It is not good for me to continue avoiding getting a proper diagnosis, I don't think that sheer willpower alone is going to drag my head back out of the black pit that it's been living in for last stretch of time.

I just need to actually be brave enough to ask for that help - one of the hardest steps has been taken. I've made the appointment to see a Doctor. That's an accomplishment I should hold onto. The next step is going into that room and telling a stranger that my brain has been dousing itself in misery and is drowning in it to the point that I need someone to throw me a line to pull myself clear.

Obviously I am nervous to HECK about having to explain everything. There's this nagging fear that the Doctor won't actually believe that I'm actually depressed and send me home with only the sickening thought that I just need to pull myself together and stop wasting their time. That's the worst case scenario for me. I *need* to know that I'm not imagining all of these awful feelings.

So I'm taking a deep breath. And hoping that I don't get the wind knocked out of me when I hit the water.

After
Well I went to the Doctor's, admittedly I only got out of bed 12 minutes before I needed to be there and I was teetering on the verge of falling back to sleep for at least an hour before I moved. But I went.

And whaddya know I *do* have depression! The Doctor used basically the same damn diagnosis quiz thing I used myself last night on the NHS website and I came out with a 14 on what I could very flippantly call the Depress-o-meter (My sense of humour tends towards the morbidly dark when dealing with the unpleasant issues). That apparently means I'm at the upper end of "moderately depressed".

Now what?

The Doctor I saw wasn't particularly gifted with sensitivity settings so it was suggested to me that I ought to be making changes in my life to deal with the root causes of my depression, (the fact that I'm unemployed is definitely not helping) I need a reason to actually get out of bed in the morning and currently my own willpower is not motivation enough. The phrase "need to stop moping about" may have been used. *sigh*

It was also suggested that getting a part-time job to fill some time & tide me over financially while I figure out what the fuck I'm doing long-term would be "easy" like jobs are just falling from trees around here. Just because there is an enormous Tesco a stone's throw from my house doesn't necessarily mean that they are in need of staff.

I am fully cognisant of the fact that I need a job both for financial reasons and mental health reasons. I am not one of those people who can manage and divide up their time to use it productively without it being required of me. If I had a boss who was expecting me to get up at 7am in order to get to work on time then I could do it, but when it's just me thinking "oh you should do x,y & z today"there's no real incentive to follow through because there's no consequences if I don't do those things.

Of course there is the shame & self-loathing of knowing I failed to do what many people can do with nothing more than willpower as their motivation. But currently my inability to get out of bed and get things done is somewhat out of my control - if my brain has foxed itself on how to produce the chemicals which make me want to wake up in a morning and not feel like someone has simply dug me up with little care that I'm soft and squishy - then is it entirely my fault that waking up before 9am has become such a foreign concept?

When I initially had my diagnosis (it's now a week later because this post didn't get finished last Wednesday like it was supposed to *quelle surprise*) I didn't get a prescription for anti-depressants because I thought that maybe I'd be able to sort myself out by just booking some counselling & getting a job or whatever. But after mulling it over for a week now I've started to realise that in order for me to make the lifestyle changes which will allow me to stabilise myself I do really need to be able to function for a good portion of every day.

At the moment I can't - I'm waking up late every day, not really getting out of bed before noon & then milling about aimlessly for several hours before Le Boyf gets home from work and then we're both sat around doing nothing for the rest of the evening because it's very likely that he's also depressed and can't be fucked with anything.

So I'm going to look into getting meds, because if they help me to function well enough to get up properly, do the things I need to do & sort out fixing the root causes of my depression then it can't be a bad thing to try them. Just got to make another appointment at the doctor's and *not* with the original guy because I don't need my worst perceptions of myself reinforced again ta very much.

This has been a bit of a rollercoaster post and has taken me far longer than I would have liked to finish. That's another thing which depression has fucked up for me - writing. It's been like trying to transfigure shit into diamonds with a toothpick. Agonising and damn-near impossible. I'm hoping like hell that meds will help whatever it is that has kicked the bottom out of my creativity or the next 9 months are going to be hellishly difficult.

So deep breath, let's try to deal with this. One day at a time.

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The Big D

After talking last time about my anxieties, this week I wanted to talk you through my recent journey through Depression.

First of all, I wanted to say that Depression is sneaky. It's one of the worst things about the illness because you may not realise you are depressed, or be more depressed than you first understood.

This is essentially what happened to me, twice.

As a bit of context, I've suffered with Depression on and off since I was a teenager. I don't really know when it started, I just know it was there. And it could stay for months before finally leaving me and letting me get on with my life again.

So I thought I was

1. Able to know when it was about to strike
2. Capable of dealing with it when it did.

Turns out, I was not.

Depression snuck up on me in a way I wasn't even aware it was possible it could do.

But I thought I was aware. And that is the biggest problem. It started with an inability to read, and then a lack of motivation to blog. So I took a step back, did what I had to, to let my brain work through it. The way I always did. A bit of self-care. A bit of looking after myself and making myself finally feel better.

And so I got my reading and motivation back and I was certain that I was fine again. Back to my normal.

I was wrong.

This was my Depression lying and hiding from me.

On New Years, I suddenly worked out that I had not cried for months. Many things had happened in those months when I should have cried. When my emotions should have come tearing out of me but I realised that instead I had just brushed everything off. I thought I was being strong about everything. I wasn't. I then realised that as well as not being upset about things, my happiness never stayed for very long either. After I felt happy, I felt numb. The joy of happiness wasn't sticking behind to make my life feel better.

So I realised I was Depressed. And I decided that I would work on getting better. And I did. And I felt better. I felt happy and sad at times. I was on the road to recovery, I was sure of it.

And then I started Citalopram.

And now I know that I was still Depressed. It was still lying and hiding from me. I was feeling emotions but I wasn't feeling emotions. They weren't coming from deep inside of me, they were just there to hide what was actually going on in my brain.

I've now been on the antidepressants for over two months, I am finally aware that I am now getting better. I am now officially on the road to recovery.

I know this because;

1. People have told me I look and am acting better
2. I am getting on top of my workload and to-do lists
3. I feel happy, sad, angry, annoyed, irritated, excited, passionate, etc. And understanding that I haven't felt this range of emotions for a very long time.
4. I am just aware that I feel different; that everything is different.

Depression is not nice. It sucks you in an makes you feel nothing. You feel numb and empty. And people who have never experienced it may never understand what that feels like. It is also more dangerous than people realise because it can hide even from the person who has it. And if it hides long enough, it becomes harder to deal with. 

So I just wanted to post my journey to show you that Depression isn't just feeling sad. That people with Depression can be happy, but it's just a different kind of happy, a happiness that you may not really be able to tell is different until the Depression goes away.

For me, the light has returned to my eyes. I am a stronger person again. I am a happier person again. And I am so very glad for this.

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My Mental Health Treatment Journey Part 2: Therapy

This is the second part of my mental health treatment journey all about therapy. Make sure you check out part one about medication here.

Like taking medication, I was very reluctant to go to therapy. I think I was around fifteen when I went for my first therapy consultation and I was very self-conscious. I was worried that someone I knew would see me go into the mental health section of the hospital and tell everyone I was mad. Back when I was a teenager mental illness was still a very taboo subject that had a lot of misinformation surrounding it. There was no Depression, Anxiety, PTSD and OCD known to my friends, there was just sane and crazy and nobody wanted to be associated with the mad girl.

That first therapy appointment was a bit of a disaster. Back then I didn’t have a diagnosis and just assumed that I was depressed. My GP had referred me to the children’s mental health services at my local hospital and I remember being very nervous. This was the first time that I’d ever told a stranger my story. At the end of that appointment the lady I’d poured my heart out to for the past hour basically told me that she wasn’t really qualified to treat me. You see, what triggered my mental health problems was being in a mentally and physically abusive relationship with a boyfriend. I was essentially a child with a grown up problem that that particular therapist had no experience in handling. After weeks of getting my hopes up and psyching myself up to tell someone, I was sent away and told that I would need to see an adult psychologist. Sorry.

I was on the NHS waiting list for a good six months before a letter came through with an appointment to see a therapist at the big doctor’s surgery in my hometown. The only problem was my mental health problems had gotten so bad at that point that I could no longer leave the house never mind go to a place near where trauma had happened to me. After months of waiting I’d hit another dead end. I remember overhearing my mum on the phone to our doctor in tears begging him for help “She can’t go, I don’t know what to do” she whispered into the phone. He said that if I “refused” to go to the appointment there was nothing more he could do. Even my doctor didn’t understand that I desperately wanted therapy but I physically could not leave my house.

Deciding to take matters into our own hands, my mum found a local domestic violence support group who we got in touch with. They said they could send a support helper to our house for weekly appointments. I was so relieved to find someone who could help me. At the time a lot of mental health professionals had stopped doing home visits because of safety reasons (so I was told time and time again) so I couldn’t believe I’d found someone who not only had dealings with people who’d experienced domestic violence but who could also come to my home so I didn’t have to go out.

A couple of weeks after contacting the group a lady was sent to my home to learn more about my situation. I explained about how I was in an abusive relationship and how that had triggered some sort of depression. I was so hopeful that day but again was left disappointed. The lady didn’t seem to know what to do with me. All of her information sheets she gave me to read were about women who were married or have children and not for a teenager like me. At the end of the session she suggested making an appointment for both me and my ex to talk about the abuse because she wanted to hear his side of the story. The last thing I wanted was to see my ex again after finally breaking away from him. I had a huge panic attack and when she left I spent the rest of the afternoon in my bedroom in tears. I can’t explain how disheartening and lonely it feels to get knocked back time and time again when it comes to something so very personal.

With another road blocked off to me I went to see a new doctor who wanted me to get a proper diagnosis. A couple of weeks later I went to the mental health building at another nearby hospital to get assessed by a psychiatrist who diagnosed me with PTSD, Anxiety, OCD and Depression. It felt so good to finally know what was wrong with me. I went back to my new doctor with my diagnosis and explained to him about what I now knew was my Anxiety and PTSD making it impossible for me to go to places locally that triggered panic attacks and flash backs from past abuse. He was really understanding and referred me to a quiet little practice an hour’s drive from where I live.

Once again I was put back on the waiting list and this time it took eight months for me to get an appointment. By this point with no treatment for over a year I had untreated PTSD, crippling Anxiety, OCD and Depression. I was basically a recluse whose days consisted of debilitating routines and safety checks that could go on for hours. On that first appointment I had to share my entire back story again and was so scared that I would be turned away and told there was nothing they could do for me. At that point I was desperate for help. When she started talking about the type of therapy she wanted to do with me and asked me to make another appointment with her I burst into tears. I was just so relieved that I’d finally found someone who could help me.

The NHS gave me 24 appointments with my psychologist and she decided to treat me with CBT (cognitive behavioural therapy) a type of therapy used to stop a cycle of negative thoughts and create positive associations with things that scare you. Having CBT is one of the hardest things I’ve ever had to do. I constantly had to face my fears and challenge myself. I described the fear I felt to my family as feeling the same way they’d feel if they were put in a cage full of lions. We focused most of my sessions on treating my OCD which was probably the most out of control at that point. It was incredibly difficult and I didn’t enjoy it one bit but I slowly noticed myself getting better and started to find things easier. I’m pleased to say that as I type this my OCD is now pretty much completely under control.

I was so disappointed when my 24 sessions were up because in that time I’d managed to tackle all of my little fears and was now ready to move on to the big stuff and we hadn’t even begun to treat my PTSD. I was advised to take a break from therapy for a while and put the new strategies I’d learned from CBT into place on my own. Both my psychologist and doctor thought that I’d really benefit from some counselling which at the time I wasn’t ready for. I knew that counselling was going to involve talking about the past and I’d just got to a point where I was starting to feel better and build a new life for myself. The last thing I wanted to do was to look back to where I started. I wanted to move forward and was determined that I could do so and I did. I spent a few years out of therapy putting the things I learned from CBT into practise in real life situations and continued to move forward on my own with the help of medication.

Last year I got to a point where I felt like I’d got as far as I could go on my own and now I needed some more help. I’d started to build a solid new life for myself and felt strong enough to look back. My doctor said that what I’d been doing was putting a plaster over the wound which fixed it for the moment and stopped it from getting worse but it was now time to take the plaster off, go in and clean it up and stitch it together properly so that it could finally heal.

Going to counselling was one of the bravest things I’ve ever done. I managed to find an excellent private counsellor. I didn’t want to have to be put on the NHS waiting list again, this time I wanted to do treatment my way and be able to have as many sessions as it takes. She knew my financial situation wasn’t great and so she very kindly charges me half her usual rate. Her house is in the middle of the countryside it’s so peaceful and I love going there. Together we’ve looked at my past and how that affects my present and how my PTSD being left untreated for such a long time made it dangerously worse. I trust my counsellor completely and have started taking my biggest steps in treatment under her gentle guidance.

For me, timing with counselling was everything. I think you can have the best counsellor to talk with who gives the best advice but unless you’re in the mind set where you’re ready to put the work in and be uncomfortably honest, you won’t get the most from it. It’s hard work and it’s so easy to miss an appointment or to hash over the truth. I know that if I was to start counselling back when I’d finished my CBT I wouldn’t have opened up in the way that I have now and said the things I needed to say. I was like the person who desperately wanted to be thin but didn’t want to do the diet or exercise to get there, it just seemed too hard for me back then, I wanted immediate results and none of the hard work. With therapy, unlike medication, the hard work is ultimately down to you. It’s difficult and leaves you feeling like your heart has been scrubbed raw some days but my god is it worth it.

If medication is my shield then therapy is my battle plan. It’s knowing what areas are going to be difficult so I can prepare, it’s knowing my strengths and putting strategies in place to get through the hard times. Now I’m at a place where I have my shield in hand and my battle plan in the forefront of my mind. The war inside my head is not over but I’m in the midst of it now and I’m not alone. I have trusty allies by my side and confidence in knowing that when the battle is over and the dust has settled I have a future waiting for me on the horizon and it’s one worth fighting for.

If you enjoyed this post, you can find more on: 

 Bloglovin' | Twitter | Jess Hearts Books

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My Mental Health Treatment Journey Part 1: Medication

The other day I was talking to a friend about my experiences with medication for treating my mental illnesses. She was starting the same medicine that I’m on and wanted some guidelines on what to expect. After talking to her I realised that talking about what medication you’ve tried and what sort of therapy has helped you isn’t a common topic of conversation. 

When starting a new course of treatment it’s normal to have questions but other than talking to your doctor there’s nowhere to really turn to for these discussions. So I’ve decided to share with you my experiences with medication and therapy in the hopes of encouraging people to start having these conversations and also to hopefully shed some light on the different kinds of treatment out there. 

It wasn’t until I started writing this post that I realised that my story is a long one and so I’ve decided to split this into two parts, this first one is about medication and the second part which will be up later this month is on therapy. 

As a disclaimer it’s important to know that different medicines and therapy are used to treat different mental health problems and one set way doesn’t work for everyone. This is just my personal journey.

My first step in treating my mental health problems was with medication. My family noticed something wasn’t right with my mental health before I did, so when I was fourteen after a lot of coaxing (and the promise of a McDonalds after) my mum took me to see our family GP. I remember him speaking to her rather than me and them talking about my moods and how important it was for me to get through my GCSE’s. He prescribed me a low dose of Prozac and wrote off my moods as stress from school. The Prozac seemed to do the trick; it got me through the next few years although I did notice that I often felt happy or sad with nothing in between. When going for my medication reviews this was wrote off as typical teenage mood swings.

When I was sixteen my mental health got vastly worse and so I went back to my GP who put me on a higher dosage of Prozac. That’s when things went very bad. My moods were either very high or very low. I’d either spend my days constantly on the go or struggling to get out of bed and go to school. One morning I got out of bed and honestly felt the worst that I’ve ever felt in all of my years living with mental illness. In tears, I made it downstairs and collapsed on the living room floor hysterically crying. I was inconsolable and had no idea what I was crying about but I couldn’t stop. I felt deeply depressed and just wanted the dark cloud that seemed to be following me around, weighing heavy on my shoulders, to go away. I felt like I'd literally hit rock bottom lying on that floor. My mum couldn’t get me off the floor, never mind to the doctors, so she made an emergency phone call to him. He said I’d had a bad reaction to the Prozac and that I was to come off it immediately. Slowly, as the Prozac came out of my system, I started to feel better. My mental illness was still there but I didn’t feel as bad as I did on Prozac.

My doctor wanted to try me on a different medication but after my bad experience I was very reluctant to give anything else a go. Slowly my mental illness (which I didn’t have a name for back then) was steadily getting worse. My typical day consisted of waking up and feeling too anxious to leave my house so I’d stay in. Trying to make myself useful, I’d fight off the depression that was demanding that I stay in bed and force myself to shower, prepare meals and tidy up all of which required me to check certain objects or touch switches and door knobs repeatedly until the feelings of anxiety subsided - a ritual that could go on for hours. Then, mentally exhausted, I’d collapse into bed and sleep the rest of the day away. Something had to change but I was so scared of going back to my GP in case he wanted me to try medication again, which at this point I was really against. After much persuasion from my nearest and dearest I went to see a different doctor. Before doing anything he wanted me to get a proper diagnosis, something that other mental health professionals have since told me should have been done all along.

Two weeks later I had a one off appointment at the mental health branch of a local hospital and was asked some questions for about an hour by a psychiatrist. After the appointment finished she asked me “What do you think is wrong with you?” and I answered “Depression” it was the only mental illness that I’d heard of at that time that somewhat fit my symptoms. She diagnosed me with PTSD, Anxiety, OCD and Depression. I was confused, I said to her “I thought PTSD is what soldiers who’ve been to war have? And isn’t OCD when you need things to be clean and worry about germs?” She was brilliant and explained to me that the abusive relationship that I was in at that moment in time had created trauma in my brain and that OCD is more about the obsession behind the acts rather than what you actually do to stop the anxiety.

Having that diagnosis changed everything for me. My doctor now knew what was wrong with me, I could research the illnesses online and find people like me. It made me better understand my moods and  knowing what was wrong made it treatable. If you think you have a mental illness I’d strongly recommend asking your doctor for a referral to get properly diagnosed by a mental health professional so that you can get the right treatment. There are a wealth of mental illnesses and conditions out there that you may not have even heard of or considered. Knowing what you have and treating it correctly can make all the difference. It's like if you went to your doctor and were treated for eczema when you’ve actually got impetigo. Getting the right treatment for your condition is crucial.

When I went back to see my GP with my new diagnosis he then prescribed me Citalopram. I was very cautious about this but my doctor was really great asking me to keep in touch with him if it made me feel bad and saying that I could come off it or we could try something else. He told me that just because one medication didn’t work, doesn’t mean that none of them will. Those words were the real turning point for me and are something to keep in mind when going through treatment. Confident in my diagnosis and trusting my new GP I bit the bullet and tried Citalopram, because of the severity of my mental condition at that point I was put on a high dose of 60mg. At first it didn’t feel like the medication was doing much but a few weeks in and I started to feel very numb and a bit like a zombie. I hated feeling that way so in my medication review I was honest with my doctor who decreased it to 20mg which turned out to be the perfect amount for me.

Taking Citalopram certainly didn’t cure my mental illnesses but it did soften the sharp edges of my mind making the PTSD, Anxiety, OCD and Depression easier to live with. It also didn’t come without a trade; I put on weight, lost my sex drive and often felt lacking in energy. But to some extent I got my life back so guess who won that trade off? I’ve been on a 20mg dosage of Citalopram for the past ten years; it suits me and has improved my life so much.

I’m so glad that despite my bad experience with medication I tried again. There is so much negative stigma surrounding taking medication for mental illness and I was someone who, for a time, believed that stigma and refused treatment that could have made me better sooner. For the record, taking medication hasn’t changed my personality - if anything it's made room in my brain for my personality to shine through now that it’s not so cluttered with obsessive thoughts and all that darkness. It hasn't dulled my creativity (hello blogging!) and I still experience other feelings vividly and intensely. For the longest time I truly believed that medication was my enemy. That taking it was weak and wrong and would change who I was. Medication is not my enemy. It’s the shield I use to stop the mental illness from hitting me so hard. Deciding on whether you want to take medication or not is a personal choice, but know before you decide that there is no right or wrong option and that there is no shame in picking up that shield.

If you enjoyed this post, you can find more on: 

Bloglovin' | Twitter | Jess Hearts Books

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