Progress, or lack of such

To be honest, I thought I’d have seen more progress by now. Three years after CBT started (it lasted about 8 months) and just over two years since I began taking meds. These have changed and dosages upped several times to where they remain steady at the moment. Daily: 600mg quetiapine, 20mg fluoxetine, 500mg sodium valproate.

And yes, they’ve topped and tailed my more extreme moods. In that respect there’s been significant progress. I still get frequent – and fleeting – suicidal ideation, but I don’t have the strength and wherewithal to actually do anything about it. I tend to ere on the side of caution and add ‘yet’ to that statement. It wouldn’t do to think I’m cured. I know there’s going to be no such thing.

So two years.. I’m holding down my job and – I think – doing well at it. My team gives me some support by way of accepting and dealing with my many cognitive and memory issues that pop up daily more than once.

I have no-one to talk to about my illness; at least, not in detail. Twitter remains a source of support, albeit from people I’ve never met and never will meet. There are loads of us on there exposing our souls and craving help and attention. Whenever it’s good to talk, Twitter offers a (usually) one-directional ‘conversation’ outlet. I have no input from my GP or any other medical service. I saw a psychiatrist last before the summer but that was only because my GP referred me due to a down-turn in moods. I have no future appointment set.

It would be interesting to see if I could hold-down a relationship at this point in my treatment. Bipolar destroyed all the romantic relationships I’ve ever had, and I still feel so bad about that. Some of these were good for me, and I let them go through my – admittedly uncontrollable – moods. As it stands now, three years since talking therapy began and just over two years since meds started, I have no such relationship. Indeed, I’ve not had a girlfriend (or even a date!) in two and a half years. That’s the meds for you; I’ve been stripped of emotions, feelings, libido and effort. I create no writing work, and barely any art work – the things that I’ve always done and done well.

I don’t really live; I exist. And even then, there are occasions when I get hypomanic and don’t even believe that. I exist with moods and delusions, my physical health has taken a hard knock (illness and meds) and I generally ache all over 24/7. I still don’t sleep. My short term memory is f*$*&d, basically. I’ve put on a couple of stone in weight since starting the meds but from looking at other people’s experiences I could have put on an awful lot more. Who knows, maybe I will? I’ve had to get rid of a load of clothes and start acquiring from scratch. (Though that’s actually been quite therapeutic!)

The biggest shock to me lately has been a letter from the Pensions people; I still have 9 more years to work in this stressful job. Until I’m over 66. How the hell’s that going to happen? I’m living day to day. Small mercies.

 

https://upload.wikimedia.org/wikipedia/en/thumb/e/e5/Magritte_TheSonOfMan.jpg/225px-Magritte_TheSonOfMan.jpg

 

 

 

 

 

 

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Poem – ‘I am Full of Bees’

I am full of bees.

 

I am full of bees; every

cell of my being every

breath of my soul aches

 

and pains day and night

night and day ad infinitum.

Gravity is in league with

 

this illness; I’m pulled

down. Down towards the

centre, making my feet

 

heavy, dripping the atoms

that compose me, leaving

me heavy but with little

 

mass. And I’m tired; you

couldn’t even guess how

much I’m tired. I don’t

 

sleep. Never have. Mired

in that sinking sand I’ve

tried everything. Nothing

 

works. My opponent is

me; however the moods

make, take, me. I am

 

full of bees; each cell

buzzing with exhaustion,

creating a sea-swell of hell.

 

 

Meds update

I’m on a relatively recent cocktail of meds now and overall they’re doing their job. The side effects are substantial, significant. I continue to pile on the weight (quetiapine). I ache literally in every cell of my body, constantly. I’m sedated much if not all of the time. I still don’t sleep through the night.

20mg of fluoxetine caps the low moods. 600mg of quetiapine stops the psychosis and the high / mixed moods pretty successfully. (Though see my other post of today.) And the latest, 500mg of valproate stabilises my mood. These three meds seem to have made friends though they gang up to bully me now and then. They know I need them.

I still have ‘extremely intrusive suicidal ideation’. I still have ‘rapid and uncontrolable mood fluctuation’. But regarding the former, I can control it more (hopefully – time will tell). And the latter, the valproate seems to have gone in with fists flying there.

It’s taken months to get the GP surgery and local pharmacy to get my (psychiatrists’) prescription right. This has caused me a lot of stress and worry. It’s isn’t rocket science; it’s a straightforward repeat prescription that should take moments to set up. So far it’s been 3 or 4 months of getting it wrong. Three or four months of stress. I wrote my GP surgery a begging letter recently, imploring him/her to get the ‘script’ sorted. I can do without the hassle basically.

I speak to no-one about my illness. No professional has come forward to offer me counselling or has even offered an ear. It’s all bottled up, and I hold down a stressful job because I hate the thought of being defeated by the evil bipolar monster. I’ve spent the day shaking and confused (again, see my other post of today). Got home, had a couple of glasses of wine, took my meds. Is it bedtime yet?

 

More meds and some Med

The past three weeks have been dedicated to getting used to an increased dose of quetiapine (now up to 600mg daily) and the introduction of valproate (500mg as Epilim Chrono). The fluoxetine has stayed the same at 20mg; psychiatrist wanted to double that dose to 40mg but I tried that once before and it triggered hypomania.

So far the valproate doesn’t seem to have kicked-in. Psych says this can take 2-4 weeks and couple of 6-8 weeks before noticing any change in mood. The valproate / increased quetiapine together have had a very sedating effect and at the moment this would seem to be the only side effect so far.

It’s been a real pain trying to get the prescription sorted with GP and pharmacy; the former seems to find it impossible to write a simple repeat prescription and the latter seem inept at getting a stock of quetiapine. Though I’ve noticed the past month that several people on Twitter have also reported problems of pharmacies getting stocks of it.

The school year has now ended and in the end I managed to have only 4 days off sick. I was aiming at having 0 days this academic year, after the several months I had off last year. I see these 4 days as failure, though no-one appears to agree with me.

I’m going away on holiday to the Med; I’ve worked bloody hard for it.

 

tabs for blog2

Starting to rattle

I started going downhill again a month ago. GP tried to get me seen by assessment team the same day but it took a week. Then I had to describe it all again; for what seemed like the hundredth time.

And again, another long assessment. My psychiatrists said something about juggling my medication a little and trying to get me more (1:1) CBT therapy. Last time I had therapy for several months I’d yet to start on the meds and it did very little for me I think. If I get more therapy now it will be interesting to see how it goes alongside medication.

So a couple of days ago I had my follow-up meeting with the psychiatrists; another ‘20 minute’ one that turned into 50 minutes.

The bottom line of which is that my Quetiapine has been increased almost to maximum dose – up from 500mg to 600mg. Fluoxetine remains at 20mg. And Valproate has been added into the mix, at minimum dose: 500mg. Lithium was discussed but I was told the side effects wouldn’t agree with me – and anyway, Valproate is better for OCD (and its anxiety trigger).

I’m starting to rattle.

epilim

 

June update

I’m relatively stable at the moment, hence the reason I’ve not written anything here in a while. The sole reason for this stability is my meds. After all, I don’t have any other help or input – in this respect I’m where I was three years ago, before therapy and starting on quetiapine + fluoxetine. I am theoretically in the care of my GP though I never see my GP.

After having so much time off work last year (several months) my main objective this academic year was to have no time off at all. That’s how stubborn I am! But here we are, seven weeks from the end of the school year and I have 100% attendance.

It doesn’t mean I’m “better”. I’m not; there’s no cure for bipolar. No cure for anxiety. No cure for OCD. No cure for the dissociation (DID). There’s just medication; damage limitation.

I still, of course, get intrusive suicidal thoughts. I still don’t sleep well. Surely 550mg quetiapine + 20mg fluoxetine daily should be knocking me out all night? But no, I’ve not slept through the night in decades, if I ever did at all. My short term memory has taken a severe hit (I suspect some of this is memory lapses linked to the DID symptoms) though my long-term memory in many respects would put your average elephant to shame.

Quetiapine continues to function in making me fat. It’s a straight either / or choice with these meds: Fat or Mad. I’ve opted for the former, somewhat reluctantly.

There’s a blog piece to be written about the DID symptoms I’ve experienced through my life and I’ll write than when I’m able to collect those thoughts together.