Tag Archives: mood stabiliser

CMHT Fail

This was not the post I planned on sharing today but I needed to get this out.

Today I had a psychiatrist appointment. It was with a new psychiatrist and my latest care coordinator. Except it wasn’t. While in the waiting area I received a phone call telling me my care coordinator had left on Friday and trying to arrange an appointment with my interim care coordinator. When I told her I was waiting for my appointment that was already running ten minutes late they rushed down. Remember they don’t even know me.

In the appointment the psychiatrist had no access to my notes as he had been blocked from the system. Thanks to the interim care coordinator he was able to access the last letter but couldnt read in detail.

He asked me how I was and when I mentioned my mood was low a lot and unstable, he asked more questions about my concentration, appetite, memory and sleep. He asked me to rate my mood which I put at two at best. I mentioned I was having suicidal thoughts and that the voice I hear is worse. He said I didn’t have plans to end my life, he actually didn’t ask.

The psychiatrist then wanted to refer me to a service that has refused to take me on. When I explained this he said he understood and offered no alternative. He did not want to change my medication despite my obvious deterioration. I managed to persuade him to up my mood stabiliser but he did it by the smallest margin possible.

I tried to bring up some other concerns but by that point he was already wrapping up the consultation and urging me out the door with the words “I’ll see you in two months”.

Everything felt like it was too much effort for them. This is from a trust that is rated as outstanding. A trust that can’t seem to retain staff or offer support. It is currently a postcode lottery within this Trust as to what treatment you can access (I am aware that this is actually down to the CCG).

When did continuity of care in mental health services become unimportant? Especially with people with BPD where fear of abandonment is a major symptom. When did it become acceptable not to fully risk assess people?

Unfortunately this seems to be the way it goes for many service users of mental health services. It isn’t often I cry in an appointment and straight after in the street but today’s fiasco made me feel awful and worthless. (Thanks to the psychiatrist who actually sked if I felt worthless).

To keep up to date with my mental health experience, follow me on Twitter, Facebook or Instagram or use these and the comments to share your experiences.

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A day in the life…

This is a personal piece so please be aware content may be triggering.

I thought I would do a little post about a day in the life with someone who has severe mental illnesses, in particular BPD, depression and anxiety. So below is my day. It includes my thoughts and feelings.

7.20 am: Woken up by my mum. This is common as I don’t tend to wake up until late otherwise. This is generally because I take medication to help me sleep and I also don’t sleep well. My sleep last night was broken with me waking up continually. I could of done with longer in bed. I did not want to get up. My thoughts were that I wish I’d never woken up. I tend to start the day wishing I wasn’t alive.

7.40 am: Breakfast and medication time. I tend to have cereal for my breakfast. I’m a creature of habit so this works well for me as its easy to do even on the days when I’m feeling like I can’t be bothered. Today I was actually quite hungry. I then take my morning medication which is 100mg Lamotrigine, 300mg Venlafaxine and 6mg Clopixol. This is a fairly new regime as my medication has been recently upped. I take them with water as in the morning that’s all I feel like drinking.

8.00 am: Social media check. I go through my social media checking what’s happened overnight. I guess I’m a little addicted as I hate this time being interrupted. Today I also had to help with washing.

9.00 am: Go out. I don’t always go out at this time but my mum had a blood test and I needed to pick up a prescription from the Doctors and the chemist. Today I picked up my Mirtazapine and ordered my Clopixol from the chemist as they don’t keep it in stock.

9.40 am: Christmas shopping. Me and my mum went to a big out of town toy shop to buy some Christmas presents for the children in our lives. This made me a little anxious as it was somewhere new and I wasn’t sure exactly where it was and what the parking situation would be. I wasn’t even driving yet it worried me. The voice started it’s usual repertoire of telling me to die. This can be distressing when I’m out but I tend to hide it from other people. I manage to find a toy for my friends son quickly so I can escape the shop quickly.

10.15 am: Morning Walk. Some mornings we take the dog for a walk in a different place. Today we met my Dad with the dog and I went for a walk with my Dad and Bramble (the dog) and then met up again with my mum for a drink. I enjoyed this and felt happy for a while. Walking has only really become a part of my life in the last two months since we have been able to take our puppy out for walks. It helps me a lot having the dog with us as it makes me concentrate on something other than the anxiety of being out where there are lots of people. It also helps being with other my parents. Otherwise I tend to get scared.

12.00 pm: Lunch time. The voice is back and I’m back feeling incredibly low. I don’t want to be alive and am thinking of ways I could die. I manage to eat a sandwich but not my piece of fruit that I usually have. I’m exhausted.

1.00 pm: Nap time. I don’t always have a nap as I don’t always have time. But today I do and I’m grateful for the escape from my mind for a little while. People don’t understand how tiring it is to fight your own brain everyday. Plus the medication makes me feel tired.

1.30 pm: Ironing. One of my least favourite jobs. Boring but necessary. Though I fold a lot of things without ironing them as it seems such an effort. The voice starts telling me to use the iron to burn myself. Resisting it is hard so I use some of the distress tolerance skills I’ve learnt in my DBT skills group. I use the paced breathing and the paired muscle relaxation skills. This allows me to get through the ironing.

2.00 pm: I play with Bramble for a while and check social media. This isn’t my second check of the day but my more detailed check where I manage to reply to people and share things on Instagram. I feel OK. The voice is quiet.

3.15 pm: Walkies for Bramble. This time it’s just a short walk around the block with him but this time I’m on my own. This brings up anxiety about going outside alone. It’s easier having Bramble than being completely alone. This I can manage but completely alone I cannot. Completely alone makes me physically sick with anxiety. Getting a dog has been a great thing for me as I get out a lot more and do more exercise. It’s not a miracle cure but it does help, especially as my love of photography has been reignited.

3.45 pm: TV. Only for 15 minutes but I watch the end of the quiz show 15 to one. I like it and enjoy answering the questions. When I get one right it makes me feel like I’m clever. Something that is a very alien feeling to me now. I have a degree and am a qualified teacher but still I feel thick most of the time.

4.00 pm: I spend some time writing. I enjoy writing but depression has made it hard work. I lost all motivation to do any. My ideas dried up. I’m still not completely back to normal and can only write for a short while.

5.15 pm: Dinner time. Not much else to say. My relationship with food has become more healthy with age.

6.30 pm: Shower time. I enjoy my showers. It is a time for me to relax. I do however have to be careful that I don’t overthink. I can find myself taken back to times which were basically horrid. Tonight was an OK night though.

7.00 pm: Chill out time. I use this time to watch TV and go on social media. This is also the time the voice takes over. Tonight was pretty awful. The voice was constantly telling me to die and what method to use. It was a struggle.

9.40 pm: Bedtime. I also take my nighttime medication now. This is 100mg Lamotrigine, 45mg Mirtazapine and 4mg Clopixol. I then self harmed. I was struggling with all the thoughts from the day and needed to feel some control. After harming I lay down to try and sleep. This normally takes me an hour or so. Tonight was fairly good.

So that’s a day in my life. It varies a lot though and this was a pretty reasonable day. I may write again on a bad day or a therapy day. If you’re interested in my life you can follow me on Twitter, Facebook or Instagram.

Picture from Pinterest.

Medication and Mental Health

Disclaimer: I am not a medical professional. All that I am writing is my own experience with medication. Every person is different and will react differently to each medication. If you are having issues with your medication please speak to a doctor.

I first started on medication for my mental health when I was 19 and it has been a huge journey full of trial and error. I’m still not even sure I have found the correct combination nine years on. This doesn’t mean it will be the same for you. Some people find the first medication they try works for them.

My current medications for my mental health are Sulpiride (an antipsychotic), Sodium Valproate (a mood stabiliser), Venlafaxine and Mirtazapine (both antidepressants). I have also tried Citalopram, Fluoxetine, Sertraline, Risperidone, Aripiprazole, Lorazepam and Diazepam. Here I plan to discuss my experience and journey with medication.

When I first went to the doctors, seeking help for my mental health, I was reluctant to try medication as I had heard negative things about it. So my doctor decided to get me to try counselling first but I continued to struggle and it was eventually decided to put me on an antidepressant. The drug of choice was Citalopram. I was started off on a low dose and had it gradually increased over time but, for me, it was not very helpful and didn’t make a dent in my depression. I was also lucky in that I didn’t get any side effects from it. I was on it for quite a while.

Then I was changed to Sertraline, another antidepressant. Again it was started at a low dose and increased. This time I felt a small benefit from it but I also felt disconnected from the world and like my creativity had gone. So I stopped it without discussing it with a doctor. This is something I would never advise and it ended badly for me with me becoming more unwell until it was restarted.

Eventually it was decided that Sertraline wasn’t right for me and I was switched to Fluoxetine. This is where I began to run into problems quite quickly. Fluoxetine, for me, was the worst medication. I quickly descended into a crisis and became extremely suicidal. My depression was at it’s worst with me being unable to get out of bed.

Me medication was quickly changed and I was put on Venlafaxine and Mirtazapine. These two drugs really helped me. Mirtazapine sorted out my sleep and I remain on it. I think this is the one drug I’d be reluctant to stop as sleep is important to keeping me well.

As for Venlafaxine it was also helpful but was decided I would stop it as the withdrawal from missing a dose was awful and I was always anxious I’d be ill and unable to take it. It took 6 months to come off and I was off it for several years before it , recently, was decided it should be added back in at a low dose. It is helping me slightly again.

These are all the antidepressants I have tried. I am also on a mood stabiliser and an antipsychotic. The mood stabiliser I am on is Sodium Valproate and its the only one I’ve tried though the dose has been played around with. It is currently working for me and stops, to an extent, the rapid mood swings of BPD. It has weight gain and acne as side effects and these are things I’ve struggled with. But the benefits outweigh these at the moment.

The first antipsychotic I tried was Risperidone and it worked for me. The voice I hear was reduced. I, however, couldn’t stay on it as a blood test showed it was effecting my kidney function and hormone levels. It was stopped and for a while I was without an antipsychotic.

After a while my symptoms were not improving so it was decided to try a new antipsychotic; this time Aripiprazole. Aripiprazole didn’t help me. It didn’t touch the voice and caused my anxiety to sky rocket. I also felt more like a zombie on it and even my parents noticed I wasn’t with it.

In the end I decided I needed to come off Aripiprazole and so with a doctors help I did and was put onto Sulpiride instead. This I am currently still on and I am not sure how much it helps me. It has had an effect on my hormone levels but it seems the benefits outweigh this. We shall see how it goes.

I have also tried Lorazepam and Diazepam to help with anxiety and have found them useful in the short term. I have not used them enough to go into detail though.

So this is my experience of medication. It has been a rocky journey but my current view is that medication can be a useful tool to manage symptoms. It may take a while to find the right one or it may not be right for you but it is a valid option. Noone should feel ashamed of taking medication for their mental health.

Please feel free to share your experiences of medication in the comments. Everyone is unique so I am sure many of you have different experiences.

Picture from Pinterest.

Intense thoughts and feelings

This is a personal piece. Please be trigger aware. This was written a few days ago and is a typed up version of what was going on. They are unedited.

This was originally going to be called raving thoughts as this is all this is. The mad, raving thoughts that are running through my head when really I should be trying to sleep.

The thoughts started this afternoon and are going at what feels like 100mph. I can’t make sense of them as they seem to be bouncing off each other and the inside of my head. My pen is struggling to keep up with my brain and I am conscious that my writing is difficult to read and make sense of.

I’ve always had times when my brain seems to work much faster than my hand. When I was at school I would get into trouble for missing out words or letting my punctuation and grammar go by the wayside in order to keep up with the speed my brain was working at. Now my thoughts go through phases where they become an unsettled mess and I just need to get them out.

When my thoughts are working fast I can become elated or I can crash into a pile of thoughts that I just can’t sort through. Things don’t always make sense. Instead it can become a rambling tale that has no direction.

So why am I documenting it? I think it is time I found an outlet and tried to make sense of why I sometimes end up in this state. I can spot patterns and it quite often happens when my mood becomes changeable. My thoughts can go from 100mph to nothing. This can happen quite quickly. Like now in the middle of this rushed scribbling my mind has suddenly blanked.

Controlling these sudden changes is difficult for me. I’m not sure if it is part of my BPD or not. The changeable mood definitely could be and although I am on a mood stabiliser its not totally controlled. Another way I try and control it is self harm. It is not a good coping strategy and only works temporarily. It is not something I recommend.
Right I am going to stop here. My thoughts are slowing. If any of you experience racing thoughts I would love to hear how you cope with them.