Tag Archives: Adult ADD

A Provocation for the Declaration Festival

Tonight (technically last night, since it’s about 1am) I gave a provocation at the Declaration Festival. It was for the closing event, responding to Article 24 of the Universal Declaration of Human Rights (the right to rest and leisure). I was delighted to be part of it, particularly to be in the company of Jenny Lindsay and Harry Giles and their excellent, deeply personal responses to the topic. 

My own response was likewise personal. Unsurprisingly, I came at it from the mental health angle. This is the text…

 

Hi. I’m Jen. You might already know that. I’m never sure how much you know.

 

Thanks for coming. Not that you had a choice, but still… thank you.

 

I hope you like the weather. I chose it specially. I thought it would be a good introduction to my mood, you know? A bit grey. Frosty. Kind of a foreshadowing thing.

 

It’s really nice to see everyone here today. What’s even nicer is that I’m pretty sure that most of you are real. You look real.

 

Except you. You, not so much. I’m not sure whether I’m hallucinating you or not, and it’s not really polite for me to ask complete strangers whether they’re real or not. Normally I wouldn’t call attention to you, just in case you are a hallucination and everyone thinks I’m crazy for interacting with someone who isn’t there. I’d wait until someone else has demonstrated that you’re real to them before I said or did anything involving you. It’s a bit convoluted, I know – the easiest way to establish your reality would be to touch you, but there are two problems with that. First, if you’re not real then this entire room full of people would see me waving my hand through empty air. Second, if you are real then – wait, actually, it’s three problems. Because the second problem would be that I’d just started pawing at a stranger for no apparent reason, and the third would be that while we were in physical contact you might be able to read my thoughts.

 

That’s why I’ll avoid shaking anybody’s hand if I can. You seem like very nice people, and I’ve no doubt your hands are clean and everything, but I’m sure you’ll understand that I don’t really like letting people read my mind until I get to know them a bit better. It makes job interviews and networking sessions a bit of a bitch. Especially when people don’t employ me or don’t reply to me, because then I wonder whether it’s because they saw something in my mind that they didn’t like. I wouldn’t blame them. There’s a lot in there that I don’t like. And here’s an interesting thing – I’ve never succeeded in getting work from someone whose initial greeting involved a kiss on the cheek. I hate cheek-kissing. If touching my hand gives you access to my thoughts, kissing my cheek is like plunging head-first into them. So I’ll keep my distance and run the risk that you’ll think I’m stand-offish. I get that a lot. Stand-offish, reserved, arrogant, bitchy… I just don’t want to let you into my head, that’s all. I’m sorry. It’s not meant as a slight.

 

And now I’m noticing that all of these people are staring at me and that means I’ve been concentrating on you for far too long, trying to figure out whether you’re real. That suggests that you’re not and that I’ve been looking at an empty chair for all this time. So they think I’m weird already. And it’s not that they’re wrong – I’m well aware that normal people don’t have these kind of hallucinations – but I would rather they got to know the professional side of me first. The functioning side. And now they haven’t. Again.

 

The worst thing is that it didn’t have to be this way. I’m in control of this situation, after all. This entire room is part of my story, it’s a construct made in my own mind, so in theory I could turn it into anything I like. Surely, if everything here is the product of my will, I could have manifested a scenario in which I walk into the room and you all automatically think I’m amazing? I could have dreamt up people who have been waiting their whole lives to hear public speaking skills like mine. Why would I imagine a situation where people look at me with long faces, or sneakily check their phones while I’m talking, or think I’m crazy just because I sometimes see things that aren’t there?

 

Oh. I’m sorry. I’m so sorry, you look like you’re having a terrible time. Is it just to do with this? Or is it something bigger? If I’ve imagined you, if I’ve made you exist, have I given you an existence that’s that bad? I’ve done that before, and I feel pretty guilty about it. So if I have… If I have then I’m really sorry, but I don’t know what to do about it. The easiest thing, the usual thing, is for me to steer clear of other people. If I can manage my environment, it’s easier to tell when things are real. It limits the possibilities, but not in a bad way. Just in a way that makes life more manageable. Less exhausting.

 

Because that’s what this is. Exhausting. Every time I’ve been in treatment, when I’ve explained the experience of this lovely combination of schizotypal ideas of reference, magical thinking and good old ADD, that’s what my various therapists and head-shrinkers have said. “That must be exhausting.” Every time. And they’re right.

 

They’re right.

 

This is my punishment, my penance, the price I pay for bringing you into existence and making you miserable. The price of inhibited dopamine uptake, deficient serotonin production, of a genetic quirk that triggered an intermittent madness in me. A mind that never stops tormenting me for the real and imagined things I’ve done. A brain I can’t trust, can’t ever turn my back on. A reality in which I can never, ever… rest.

 

And that’s why I’ll always struggle with Article 24, the Right to Rest and Leisure. For someone like me, with a mind like mine, the management never stops. No amount of recognition or legislation will ever be able to force me to let up on myself. The coping mechanisms have to be constant, otherwise they won’t exist at all.

 

But because of that, I appreciate everything that leaves me with only this battle to fight. The wider the recognition of the right to rest and leisure, the more I feel like I have breathing space. Time to myself, time to hide from the world and focus on quieting the noise in my head. Knowing this to be my right makes me feel better when I see the judgemental faces that my brain conjures up looking at me as if I’m lazy or workshy or seeking attention.

 

Are they judgmental, these faces? Your faces? Are the expressions I see on them real? Are the faces themselves real?

 

I don’t know, and I don’t think I’ll ever have enough energy to reach a conclusive answer.

 

All I know is this.

 

I’m tired.

 

And I need to rest.


When a belief is not a belief

There will be a lot of things in this post that I’ve touched on in the past, but I’ve never explained the full extent of what’s been going on in my head over the past year.

I’ve mentioned before that it was the 10th anniversary of my mum’s death in October and will be the 10th anniversary of my dad’s in July next year. I’ve written at length about my experiences with depression and a wee bit about ADD and PTSD. I know I have a tag for Schizotypal Personality Disorder so I must have spoken about it somewhere, but I’ve never really gone into it in depth because it’s less well-known and harder to explain. But it’s a factor in what’s going on at the moment (or at least it seems to be), so… here goes. I don’t claim to be an expert on this. I’m just someone who lives with it, and I’ll try to explain what it is, what it feels like and how it’s affecting me as clearly as I can.

Schizotypal Personality Disorder is a schizophrenia spectrum disorder. It involves obsessive rumination, anhedonia, eccentric behaviour, inappropriate emotional responses, magical thinking, social withdrawal and anxiety, strange means of expression and occasional hallucinations. I remember the psychiatrist who diagnosed me, back when I was 18, explaining that as someone with StPD I would never see the simple solution to a problem if there was a complicated one available. Apparently the big difference between StPD and schizophrenia is that with StPD, you can still tell when what you’re experiencing is not reality.

Over the years I have learned how to live with and control my symptoms. Getting the obsessive rumination under control was a huge personal triumph, achieved through CBT and visualisation and relentless discipline. My means of expression changed gradually, influenced by years of blogging. By writing for an audience and reading other people’s writing, I got the hang of how other people sound. I gradually let go of my unusual patterns and word choices (though a few little things remain – read enough of my writing or listen to me talk and you might spot my obsession with patterns of three). I learned how to tell delusions and hallucinations from reality – most of the time, at least.

The difficulty – and this is the really tricky thing to explain – is that sometimes I find myself in situations where I don’t believe my beliefs. Ten years ago, when my parents died, they were the only people I truly cared about. (Failing to form close relationships outwith your immediate family is a fairly typical StPD thing.) Those events planted the seed of a rather unhelpful idea – specifically, that the people I love that much will die. That my love can bring about the death of whoever receives it. The basis for this belief seems to be that if my life were a fictional narrative, that’s what I would expect to happen next.

Now, on the one hand, I am well aware that this cannot be the case. The world just doesn’t work that way. I do not live in a novel. What happened to my parents was statistically improbable, but that makes me the victim of a misfortune, not deus ex machina or a particular stage of my journey as protagonist. My love is not some kind of deadly force.

On the other, I know it is true. I’m talking about the kind of absolute certainty with which I know my name, or that the face I see in the mirror belongs to me. It is this knowledge that makes me feel so bloody guilty about loving my husband, because if I know that my love will cause his death. So I feel guilty and selfish for putting him in danger, and I live every day with the fear that my belief will prove accurate. Every time I come home I experience intense anxiety from the moment I arrive at  our building to the moment when I am actually in the flat and have seen for myself that he’s still here, still alive, not imaginary. This is not rational or reasonable. I should be able to leave the house without becoming convinced that something bad will happen to my husband. I should be able to unlock my front door without my heart pounding in my ears. I talk myself through the rational argument every time. Usually, delusions respond to repeated dissuasion and a certain amount of CBT. This one, however, is very strong and extremely resistant to everything I throw at it. It has not diminished over time. If anything, it has grown stronger.

That’s  a big part of the reason why I’ve been so antisocial this year. I’ve skipped so many get-togethers because I just can’t manage the usual social anxiety on top of this. I’ve always been a little bit freaked out by large groups, but usually I’ve enjoyed hanging out with people on a one to one basis. Not so much this year. This year I’ve been a lot more withdrawn because my head is too noisy, and also because as this belief gathers strength, it seems safest for everyone if I don’t let myself feel too close to people.

That’s a tough one to explain to people. “Sorry, I can’t meet because I’m really busy just now” is a much easier excuse to understand than “sorry, I’m worried that being friends with me will cause you harm so I’m just not doing the interaction thing right now”. I try to explain verbally when I have the energy, but honestly, talking this through takes a lot out of me and it’s easier just to write about it and hope that the message gets through.

The reason it takes so much out of me is that I fear people’s judgement. I know there will be people who look at this and think “well, you know that belief is nonsense, why don’t you just stop giving in to it?”, missing the fact that I don’t give in to it. I fight it every single day, I win minor victories every time I succeed in doing what I want and need to do without letting this stop me – but I haven’t won the decisive battle that gets it out of my life forever yet, and that’s not for want of trying. I also know that there will be people who write me off as completely crazy because I have a schizophrenia spectrum disorder and they don’t know enough about what that means to realise that they’re not unsafe around me. And I know there will be a few who think this is just attention seeking. It’s not. Even I am not masochistic enough to want the kind of attention that anything involving the “schizo” prefix gets you.

I’m writing this partly as explanation for why my 2013 has been quieter and less sociable than previous years, and partly because I’ve shied away from talking about anything explicitly StPD-related here in the past. I write about my mental health because I feel that if someone like me can’t be “out” about it, what chance is there for people working in less accepting worlds than the arts? Avoiding the issue of StPD was beginning to feel like a betrayal of that purpose, and an act of cowardice.

So there you go. A bit of insight into my head and hopefully into StPD as an everyday thing. I don’t feel like I’ve given you an accurate picture of how powerful and terrifying these beliefs can be, but I don’t know whether I can. I’ve been searching for the words for a very long time, and finally it felt like I should just get this much down and see whether the more minute, intense stuff follows later.

Hopefully some of this makes sense to people who are not me.


Adventures in Mental Healthcare: Hope

Today marks the start of Scottish Mental Health Week. As usual, whenever we reach an awareness day that applies to me, I feel annoyed that it’s still necessary. It’s 2013, aren’t we supposed to be sufficiently advanced and well-educated that we don’t make stupid judgements based on sex, age, orientation, race, whether you’ve ever had a physical or mental illness, or any other damn thing that people don’t have a choice in? Wasn’t this all supposed to be sorted out by now?

Maybe it was supposed to be. But it’s not, so for the present I will continue trying to reconcile my understanding of why we need these awareness exercises with my anger at the fact that they remain necessary.

I got involved with this year’s Scottish Mental Health Week unintentionally. I write ten minute plays for Jo Caulfield’s Speakeasy, and it just so happens that tomorrow’s Speakeasy is embracing the Mental Health theme. My play, Hawthorn & Candlelight, is not about mental health issues. It’s a comedy about a book of spells, so I suppose that if you were determined enough you could read it as an exploration of magical thinking and trace its roots in my own adventures in Schizotypal Personality Disorder, but that wasn’t my intention in writing it. I wrote it as a bit of pre-Hallowe’en fun and that’s about it. If my contribution fits the theme it’s not because of the play itself but because of what I am – mentally ill and “out”.

The fact that it’s Mental Health Week also makes me think it’s a good time for an update about my own situation and how things are going. Last time I wrote about this I was struggling to get access to the help I needed – most importantly, someone who could advise me on medication. I finally gave in and played another round of Russian Roulette with the meds, allowing myself to be put on fluoxetine to keep my serotonin levels in check. So far I’ve been fine – there’s none of the nausea I got from paroxetine or the memory loss and anxiety spikes that characterised my experience of sertraline. However, I’m still on a low dose just now. The real test happens in winter. At some point I usually tip from chronic dysthymia into a Major Depressive episode, and that’s when I have to increase my dosage and find out if my body can handle it.

I was also trying to find a suitable form of therapy to complement the drugs. I’ve been doing CBT on my own for over a decade and it’s a particularly useful weapon to have in my arsenal, but it’s not a magic bullet, and I have hit a point where either I need a different kind of therapy or help with expanding my CBT skills. As it stands, CBT helps me to combat depression and it was fantastic for dealing with OCD and StPD. Having got these things to a point where I can manage the symptoms, I now find myself dealing with issues that are more PTSD-related. I really want to get to a point where I don’t have nightmares, hypersomnia and a wide range of triggers that stimulate fearful, avoidant reactions. I want to be rid of the paralysing terror that accompanies the belief that everything I love dies.

Getting this kind of help is, as I have chronicled here, not easy. CBT with community psych nurses didn’t help me, because the CBT they were teaching was all stuff I’ve been doing on my own for over a decade. Eventually I lucked into an appointment with a GP who seemed to understand, and I made a particular effort to let the mask slip. I’ve been dismissed too many times for not appearing to be crazy enough because I can still do things like bathe, brush my hair, dress in a manner that makes me look pulled-together. I can still do these things until I am pretty far gone, because I have lots of practise.

During my first major depressive episode I learned that allowing myself to look depressed attracted attention. I didn’t want attention. I wanted people to stop noticing me, not ask me stupid questions about whether I was all right, to look the other way while I quietly got on with the task of destroying myself. So I wore make-up long after I stopped caring about my appearance. I wore my hair up to disguise the fact that it hadn’t  been washed in days. The way I dressed didn’t change, because at 18 I wore a uniform of black velour trousers, black t-shirts and sweaters. There was no tell-tale day when I started wearing jogging bottoms all the time, because there was nothing in my wardrobe that would allow me to live the cliche. For several months, as I gradually stopped eating and talking and dropped out of one class after another, I still looked like my normal self. Eventually I lost the ability to keep it together and began to look gaunt and dishevelled in spite of my repertoire of tricks, but I held out for a long time. By the time I started to look depressed, I was too far gone to seek help of my own accord.

So now, when I know I will be talking to a GP about my mental health, I make a conscious effort not to conceal the effects of my mind on my body. No make-up. No dry shampoo. I try not to think about the appointment until I get there so that I haven’t prepared what I’m going to say and how I’m going to keep my voice level while I’m doing it. When the familiar feelings of pain and fear arise, I try to let them show. After more than a decade of training myself not to show those feelings, that’s no small task. It’s not easy to bring that stuff to the surface because I never trust that I’ll be able to get on top of it again. But if you look like you’re coping, they assume you’re coping, so it has to be done. After many years of trying to tell doctors how badly I was doing without having to come right out and say it, I finally did. I explained about my convoluted suicide attempts and self-destructive behaviour, told them that even now, when I’m happy and loved and things are going well, I’m also depressed and fearful and every winter I dread that this might be the one where I just can’t take it any more.

The message got through. At last, I got an appointment with a psychiatrist. By this point I had started on fluoxetine, and the psychiatrist advised me that it was probably my best bet just now, which was comforting (if a little on the late side). He referred me on to the psychotherapy department at the Royal Edinburgh, so I finally had to bite the bullet and get over my fear of going there. Previous experience led me to expect a 45 minute triage appointment, during which I would have to try to give a potted account of myself and what I was looking for. Fortunately, this was nothing like my previous experience…

I had three triage appointments in total, all with the same doctor. There was time to give a full explanation of all the previous diagnoses and experiences and life events. The doctor talked me through my options and made some suggestions, and between the two of us we figured out the next step. I’m now on a waiting list for individual therapy to help me work through the PTSD. The down side is that the waiting list is long, so it may well be next February before I start – but simply knowing that the wheels are in motion helps immensely. In the meantime, I know what my options are if things get too difficult around the anniversary of Mum’s death or over the winter. I feel much better informed. And because this is being done on the NHS, I’m not freaking out about how to afford it.

After so many false starts, getting this far is a massive relief. When people talk to me about their own battles with the system, it’s really nice to be able to say “don’t give up, it is actually possible to get help” rather than simply sharing their despair at getting nowhere.

Keep trying. And keep talking. I might not always have the energy to respond to the comments and private messages I get after these posts, but I always, always read them and I always care.


Picking up from roughly where we left off…

Hello blog, it’s been a while. May is always a bit of a crazy month. I’m not sure whether this is to do with seasonal shift or whether it’s a pattern I learned at school when it was always exam season, but the anxiety and depression always seem to squeeze a little bit tighter in May. It was also the Month of Many Deadlines, so between one thing and another I didn’t get anywhere near WordPress. But here I am now. Hello again.

There are plenty of things I’ve been meaning to write about, but I’ve been in the grip of depressive thinking recently. I get to the stage where I can’t face writing about anything because I’ve got the Demon in my head telling me that no-one is remotely interested and there’s no point in writing. My energy diminishes, so the act of writing out my thoughts becomes considerably harder (I am eternally grateful that I had solid plans to work from for my freelance gigs). It’s a significant danger sign for me, because I am always in the mood to pick apart my own psyche unless I’m getting depressed, and I have to be quite far gone before I lose the will to write.

Which brings me, by means of a completely seamless and not at all clunky segue, to the subject of a quote I see doing the rounds on Facebook. It’s attributed to Dorothy Parker, but I have no idea whether this is accurate and I am being too lazy to check. It goes like this “I hate writing. I love having written.”

Apparently many of my writer/aspiring writer friends agree with this, at least to the point where they’ll re-post it. I see an extreme version of this sentiment in some of my ghostwriting clients, who want their name on a book without the hassle of actually writing it. For me, it’s the other way round. I love writing. I really enjoy the actual process of stringing words together and typing them into my laptop, watching the word count rack up. Writing longhand is even better. There is something so incredibly beautiful about putting ink on a page. I like the sensation of forming letters, I like watching the ink turn from wet to dry. I never write with cheap ballpoints if I can avoid it,  because it’s a waste of an experience. Gel pens, fountain pens, rollerballs – those are delicious to write with. When I learned that my husband had a favourite type of pen, my heart skipped a beat.

When I write, my brain calms down a bit. My head no longer feels like a browser window with dozens of tabs open. My focus narrows. I never get as far as a single tab, whether literally or metaphorically, unless I’m in hyperfocus, but I get closer than when I’m not writing. I create a playlist for each project or I put on a film or a series with the right voices to help me get absorbed in the task. I don’t answer the phone (any excuse). I feel more settled.

Then I finish whatever I’m writing. That’s when we ditch the calm and move onto the storm. Goodbye enjoyable act of crafting words, hello maelstrom of self-doubt and anxiety. That’s when I have to actually read whatever I’ve written and see all the flaws and clunky bits staring back at me. It’s horrible. It’s so much easier when you just don’t finish things, which is why I have a “Bits and Pieces” folder. All my favourite stuff is in there. The half-formed ideas that live in that folder are the best ideas, because I haven’t got round to destroying them yet.

I get over it, of course. When I’m writing for other people I don’t have the luxury of all this anxiety. When it comes to my own work, I freak out a bit more. Especially when I write plays, because then I have to hear what I’ve written at some point. Then I sit in the audience and second-guess the reactions of everyone around me. I do all the things I tell everyone else not to do, like measuring the reactions my piece gets against anything else I’ve seen recently and trying to work out whether I think audiences are the best people to assess my work or whether I think they’ll enjoy anything that’s dressed up the right way. It’s fun. My demons get some healthy (for them) exercise. I get to question the extent to which the demons really live in my head and to what extent they’re part of the tortured artist persona that I love and loathe in shifting measure. (Some days it feels like actual mental health torment, some days it just feels like I’m a bit of a wanker. Both statements are true. Sometimes concurrently. Like I said, fun.)

If I were able to skip straight to “having written” without the actual writing bit, I couldn’t do it. All the anguish and none of the good stuff where I spend days in front of the keyboard, wandering the internet to find the music and snippets that keep my brain ticking over, doing stuff with words? Hell no. The angst! I can only imagine.

The next post will be more upbeat. I wrote a play for the Fringe – my first commissioned play, I get paid for it and everything – and now that it’s had a couple of drafts and there are actors involved I’m starting to like it again.  There are things I’d like to say about it, and I should get in practise before August rolls around and I have to start telling people to go and see it.


A long and frustrated mental health post

Creative Scotland has taken over my blog for far too long. I’m still talking about the latest twists and turns in the saga over on Twitter, but the most recent piece of [headdesk]-worthy action took place while I was caught up with the double bill. Besides, Hannah McGill has been well and truly on the case and I don’t really have anything to say that she hasn’t already covered. I doubt I’ve written my last Creative Scotland post, but there are other things I need to write about just now.

So back to one of my other major topics: The Crazy and how to live with it. It’s that time of year. The dawn simulator has been back on my bedside table for a while. Mornings are just that wee bit harder than in summer (yes, even Scottish summer). And after my last self-sabotaging battle with myself, there’s an alarm set on my phone to remind me to take my antidepressants.

I wish it were as simple as just taking the bloody things, but instead it’s a minor skirmish every time that alarm goes off.

You  see, I hate taking antidepressants. I understand why I have to. My body is physically incapable of producing, transporting and absorbing sufficient serotonin by itself. So I get it. If my body won’t do this by itself and it’s a chemical I can’t do without, medication is necessary. But I hate it.  Logically, I understand that this mental illness is a manifestation of a physical problem and that I can’t overcome it through willpower alone. But to hell with logic – the point is that I hate that this is something I can’t control without relying on drugs.

Having established that, let me make it clear that any comments suggesting that I don’t really need antidepressants and could probably just take St John’s Wort or do more exercise or find god instead will not be met with grace and gratitude. I’ve spent the past 12 years learning the hard way that I have to take these drugs. Believe me, there’s only one possible outcome to my not taking them – my mental state deteriorates to the point where I stop eating or talking and start causing myself physical harm.

Earlier this year I had to increase my dosage. The dose I was on was no longer working for me. I could feel the symptoms of depression kicking in again, so I did the sensible thing and asked my GP for a higher dose. She put me on the next dose up. I’ve been round the block often enough to know that side-effects are to be expected and that the best thing to do is just hold tight for a while and see whether they subside. When the side-effects emerged, that’s what I did.

Within a few days of starting the new dose I noticed nausea, increased anxiety and problems with my short-term memory. I persevered for six weeks to see whether these side-effects were just teething problems, but nothing changed. I can deal with the nausea – it’s not pleasant, but as long as I eat little and often and/or suck sweets or sip water, I can manage it. The memory problems were much more of an issue. I’m used to having a rather good memory, but now I find that I reach for information and what I get is fog, or that tasks and appointments are completely forgotten unless I write them down (and I don’t always have time to write them down before they’re forgotten.) That scares me. It’s really unhelpful, especially as I’m self-employed, and it’s really worrying considering that I will probably have to increase my dosage again in future and don’t know whether that will make things worse.

Knowing that short-term memory is affected by concentration and that my concentration has always been affected by increased anxiety, I went to the GP to ask if there was anything I could do to control the physical manifestations of the anxiety. I was given beta blockers, which made me so dizzy I couldn’t stand and then made me fall asleep.

As you can probably imagine, that wasn’t ideal for getting through daily life. I stopped taking the beta blockers and asked to be referred to a psychiatrist to help me find antidepressants that will keep me from being depressed and suicidal but will still leave me in a fit state to live  and work. In the meantime, I was already struggling with self-destructive behaviour patterns. I got married at the beginning of the summer and found myself caught up in a massive internal battle between my newfound happiness with my husband and the depressive part of my brain that tells me I’m not allowed to be happy and that everyone I love dies. (Yes, that is what my brain is like even when I am taking antidepressants.) In my infinite depressed wisdom I decided the drugs weren’t working so I wouldn’t bother taking them.

Well, that worked out predictably badly. My mental state deteriorated, I found myself relying more and more on the façade and increasingly scared of being around lots of people. I did a bit of self-sabotage. Then finally the sensible bit of my brain remembered that I’ve done all this before and that it might be wise to take my tablets. Just for a few days. So I went back on them and voila, the greyness started to retreat… taking my short-term memory with it and leaving anxiety and nausea in its place.

After that I began trying to work out a viable pattern. Halving the dose doesn’t give me enough to keep the depression fully at bay, but more than half lets the side-effects run riot. Taking one tablet every two days is the same as halving the dose. My next move is to re-time the alarms on my phone and try one tablet every 36 hours rather than every 24.

I also went back to the GP for something unrelated, but while I was there I asked how my referral to the psychiatric department was coming along. The GP looked in my notes. Nope, nothing there about a referral to see a psychiatrist – just some stuff about my time with the community psych nurses. Why, did I want to go back for more CBT with them?

No, I damn well didn’t. If I want to do CBT worksheets (which I don’t, because the way I learned to do CBT was much more free-flowing and didn’t rely on worksheets as if I were still in primary school) I can do that by myself. I can certainly do it with a hell of a lot less judgment than I encountered from the two community psych nurses I saw before deciding that this really wasn’t for me – all they seemed to want to do was contradict my existing diagnoses and do those bloody worksheets. (Forgive me if I don’t give much credence to their contradictions, but I’m more likely to trust an actual psychiatrist who gives a diagnosis based on considerable observation and proper assessment techniques than a psych nurse who bases it on a five minute conversation and the infallible logic and clinical analysis that says “you couldn’t possibly have had a personality disorder at 18, that’s far too young”.)

So no, there will be no more psych nurse visits for me. Perhaps there are excellent psych nurses out there, but I got burned twice in quick succession. Also, CBT is not the answer here. CBT helps me with day to day management of my mental health, but it does precisely nothing to cause my body to produce, transport and correctly absorb serotonin. It’s the drugs that do that, and it’s the drugs that are causing me problems so I need to talk to someone who, you know, knows about drugs. GPs are barely trained in psychiatric medicine, hence my request for the referral in the first place.

I explained all this to the GP who told me that she was new to the area and didn’t know what was available, but she’d find out and let me know. To her credit, she did – but her letter was deeply disheartening. Apparently my options are 1) go back to the psych nurses for more CBT worksheets, because somehow that’s going to achieve something and not just waste resources that might actually benefit someone else or 2) go to a private clinic for which details were enclosed.

I checked out the private clinic. All it offers is psychotherapy. I have found psychotherapy useful on many occasions, but this time I do not need a therapist to talk to. I need someone who can advise me about medication. A psychotherapist cannot do that. A psychologist cannot do that. Who can do that? A psychiatrist. I’m not asking to see a psychiatrist because I think they’re higher status than psych nurses or psychotherapists or because I want preferential treatment, I’m asking because they are the people qualified to do the thing I need them to do.

So realistically, my options are 1) continue with the medication and see how long it takes for me to get myself into trouble for forgetting something important or simply being paralysed with anxiety and unable to do things, 2) find a private psychiatrist and hope against hope that I find a good one first time because at their hourly rates there’s not much room for trial and error, or 3) come off the meds and see how long it takes for me to deteriorate to the point where I am hospitalized, because at least there’ll be psychiatrists in the Royal Edinburgh. That last one really scares me. So far I’ve always managed to avoid being put in hospital. Even first time round, when I absolutely couldn’t take care of myself, my parents looked after me at home. Even last time round, when I was breaking my own bones, I only ended up in general medical. It’s unknown and I’m scared of it, and it would be the ultimate confirmation that my mental health is not under my control. And the path to get there is really horrible and involves the risk that I’ll succeed in doing myself permanent or terminal damage before I succeed in finding help.

I’m not particularly keen on any of these options, but most of all I’m frustrated – not just by the lack of care available, but more than anything else by the fact that the GP doesn’t appear to know the difference between psychotherapy and psychiatry. This is one of the biggest and most exhausting obstacles that you face in dealing with the Crazy. The GP is your first port of call, and even if you can get them to believe you (easier with depression than with just about anything else, but still tricky) it’s a real struggle to get access to any help. You might be lucky and win the antidepressant Russian Roulette where the GP prescribes you whatever’s cheapest and it either works for you or it doesn’t, but if you lose, my current situation is about the best you can hope for. I don’t know where this will end and all I can do is hope I don’t lose too much along the way.

The option I choose, unsurprisingly, is to start looking for a private psychiatrist and hope I can find one who isn’t charging £300/session. I have to keep reminding myself that while the illness is forever, psych sessions are not (because, guess what, I don’t like them either – not a fan of anything that suggests I can’t deal with this entirely on my own). All I need is long enough to get advice and a new prescription. I’m very good at monitoring on my own and following up with GPs. All of this is about making that very first step. I wish it didn’t have to be the most difficult and disheartening step of all.


Buzz buzz

My mum had a fantastic way of describing me – “her head’s full of bees and they’re all buzzing”.

It’s true. The inside of my head is a noisy place. Now it has a name and I know a bit more about Attention Deficit, distractability and hyperfocus, but having lived with it so long and never having experienced anything else… it’s just my brain. That’s just what it’s like.

On the one hand, as I’ve mentioned here before, the hyperfocus element can be remarkably useful. It has led to some fantastic writing binges. It can also lead to some horrible bouts of writer’s block. I’m not sure how other people experience writer’s block, never having been in anyone else’s head, but for me it’s not a lack of ideas. If there’s one thing I have never been, it’s lacking in ideas.

No, for me writer’s block is the sensation of being trapped beneath an avalanche of ideas, trying to claw my way out. I feel like I’m trapped in that moment of inception, it just happens again and again and again. I end up with snippets scribbled on bits of paper, random pages of notebooks, Word documents – I’ve got a whole folder where most of the documents don’t contain more than a sentence or two, because I can’t get past that stage.

When that happens I have a couple of options. If I don’t have a deadline to meet and there’s no strong contender forcing me to work on it, I can give in to the randomness for a while. I read, go on long Wiki walks, watch films, listen to music, watch my cat, hang around in busy places. I keep my notebook to hand (or at least in my handbag) and scribble things down in the hope that at some point one of them will demand my attention. The important thing is to keep going, because when I stop, when I try to ignore the ideas and not work on anything I get stressed and upset. My idea of hell is a long train journey with no pen, netbook or phone to make notes on. When I’m really in the depths I feel better if I have my fingers on a keyboard for as much of the day as possible. It’s just comforting to know it’s there. It used to be a notebook and pen that gave me that comfort, but times change…

The other option is to try and force a writing frenzy. I can pick one of the existing ideas from the Folder of Single Sentences and try to find the right place in my head for it. I need its soundtrack or a particular physical location that I can work in, or I need the right voices in the background.

(Voices in the background are why I watch TV while I write. My television has never been tuned in and probably never will be because the voices can’t just be random, I need particular ones and I need them until I’m done. When I was younger I would achieve this effect by watching the same film over and over again. When I got a bit older I discovered American television with its massive long seasons, so now I’ll happily put a box set and settle down to 20+ episodes of the right voices. The voices keep the bits of my brain that aren’t working on writing occupied, which means they don’t whine and tug at the sleeve of the bits that are. I have no idea if this makes sense to other people, but trust me – I struggle to work in silence, as my every school report can attest.)

If I can find the right sounds and feelings, I can trigger a writing binge that will either last long enough to flesh out an idea, taking it to a place where I can continue to work on it bit by bit, or I’ll finish the first draft in one go. The latter makes my life much easier, since it means I have a sense of actually having finished something. If I don’t finish the draft all at once, it means there’s a strong chance of my becoming distracted by the sound of the other bees and moving on without ever getting it finished.

The partial first drafts annoy me much more than the single sentence ideas. This is because every time I try to trigger a writing frenzy on the same subject, it becomes a bit harder. I struggle to recapture that initial fervour. Those bees don’t buzz as loudly as the new, shiny, unlistened-to bees.

The best feeling comes from the organic, unforced frenzy, when I simply get caught up and can’t stop. But those are comparatively rare, and we all know that the work can’t be dependent on perfect conditions or nothing ever gets done.

For the past couple of months I’ve been struggling with the buzzing. Perfect conditions certainly aren’t happening, and forcing the frenzy hasn’t really been an option as it’s my busiest time of year and I can’t just drop everything because the characters are chattering. So mostly I’ve been writing reviews. Reviews have deadlines, structure, discipline. These are not usually things that I like.

Yet something is working. Despite August being busier than any other month, despite assuming that my creative writing would have to take a back seat to reviewing and performing, I find I’ve done more work on existing ideas in August than I did in the previous three months combined. I have some material for the as-yet-unnamed children’s novel. I have a much clearer idea of where the current play is going and a new completed 15 minute piece. Randomly, I have a plot and the beginnings of a script for a webcomic.

Constraints bring clarity. I should know this, it’s one of the things I say all the time in Affectable. Sometimes having that discipline in one area of your life frees you up to be creative in another. I wouldn’t say I’ve found exactly the right balance yet, and considering that there’s a lot of emotional stuff going on at the moment (dead parents, as ever) I don’t expect that I will in the immediate future. But I feel closer to it than I have done previously, and I’m enjoying the constraints of having to marshal my thoughts and present them in a way that makes sense to other people. That goes beyond just reviewing, that goes for blogging too. As we approach October I’ll be interested to monitor what effect the ninth anniversary of my Mum’s death has on my creativity and my ability to blog here. I might set myself a couple of challenges in this regard.

We’ll see. I’m certainly not committing myself to anything publicly at nearly 2am and under the influence of the Fringe. I have a tendency to convince myself that I’m invincible at this time of year. There’s been sunlight and theatre and nothing can possibly ever go wrong. Best to wait until my feet touch the ground again before I say more.


Openness

A friend who reads this blog recently asked me whether I’m concerned about the possible repercussions of writing as candidly as I do. (That might make my friend sound a bit judgemental – that’s not the case, I believe she was asking out of curiosity, not judgement, and she knows me well enough to know I’d take it that way.) The answer is ‘not really’.

Perhaps I should be, since this is a public blog on my personal site and I don’t make the slightest effort to conceal my identity. But to be honest, you won’t read anything here that I wouldn’t tell you in person, and if you asked about it I’d tell you on pretty short acquaintance. If I’m open about it in person, why not online?

There was a time when I worried about what people would think of me if they knew I had mental health problems. I would never actively conceal it, but I wasn’t as relaxed about it as I am now. For a while I stumbled through conversations making vague references to ‘illness’ and ‘being unwell’, trusting that people wouldn’t enquire further. They didn’t, but I found I wasn’t comfortable with keeping the waters muddy on purpose.

It’s difficult not to talk about it when you have these problems. I don’t mean that I spill the whole story to every passing stranger, but I’ve been dealing with it for over a decade and I’ve lost large chunks of time to the Crazy. There are gaps in my CV, my educational history and my life story due to non-functioning headspace, and if I’m getting to know someone it means that sooner or later they’ll start to notice that the chronology of my life doesn’t make much sense without context. My options are 1) redirect the conversation if it goes anywhere near the subject, 2) gloss over it by making the aforementioned vague references, or 3) tell the truth, with or without all the gory details.

I prefer the truth. I spent long enough being uncomfortable with all of this and fearing other people’s judgement. Keeping things vague only keeps people at arm’s length, and feeling that no-one knows or understands me feeds into the low moods during depressive episodes. Yes, it’s a leap of faith every time. No, I’m not always happy with the results. But on balance, it’s worth it. I can deal with the occasional bit of judgement in exchange for having other people open up in response to me.

As for whether this blog will ever hinder me professionally, I don’t know. Once again I find that I don’t really worry about it. I’m a self-employed artist and I choose to work with people who are likely to have experienced these things themselves or seen them at close quarters. The levels of judgement are reasonably low. Perhaps that wouldn’t be the case elsewhere in the industry, on the commercial side where the focus is more on business than art, but the choices I’ve made mean that I’m unlikely to find out first-hand.

More importantly, some of us have to take the chance. Talking openly about something that’s stigmatised will always put you at risk of being subject to that stigma. It’s not for everyone, but these days I’m feeling secure and supported enough to do it. I know how lucky I am to have that – there have been times in my life when I haven’t had that support and I know how much harder it makes things to be dealing with it alone. Every judgement, every bad day seems a hundred times worse. I haven’t forgotten that, and that’s why I feel the need to reach out from where I am now in the hope that it does some good. It helps me more to focus on that than to let myself go down the route of giving too much thought to what people I’ve never met or barely know think of me. If writing this costs me a job, I doubt it’s a job that would have lasted.