Tag Archives: Crazy

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.


The Tyranny of the Telephone

The internet can be a daunting, even terrifying place, but there are times when I’m incredibly glad to have access to it. In particular, I find it very comforting to be brought into contact with other people who share the same apparently unusual behaviours as me. For a long time I wondered whether I was the only person who was genuinely terrified of the phone. By being open about my hatred of phones online, I discovered that it was a surprisingly common fear – amongst my friends, at least.

Have I always been this way? Yes, for as long as I can remember. It was easier back in the days when I was very small and being taught to answer the phone when it rang. The deal was that I could answer provided I said “Hello, how may I help you?”, answered any direct questions and then handed the phone over to Mum or Dad. At that stage I didn’ t have to worry about actually making the calls. As I got older and was expected to have actual conversations with the people who called, or – worse – to call people myself, the anxiety began to set in.

What am I scared of? Being judged and getting things wrong, mostly. Like the writer of this article – http://freethoughtblogs.com/blaghag/2013/08/why-are-you-calling-my-texting-device/ – I don’t always find it easy to hear exactly what people are saying on the phone. I’m very sensitive to background noise, and anything with more bass than a human voice will drown out whoever I’m talking to. I also find that hearing someone’s voice when I can’t see their body language and facial expression is like reading a letter with every third word blanked out. It’s a confusing experience and I find it difficult to trust disembodied voices on the ends of phones. Unless I’m talking to someone I know, really, really well (and sometimes even then), my stupid depressive conviction that everyone hates me tries to get out of control.

However, when I was younger it was easier just to shut my anxieties up and get on with things. I could talk myself through the fear, doing a kind of rudimentary CBT. I still hated it when I called my friends and their family members answered because that interfered with the script in my head, but I could do it without having a meltdown. I was never exactly comfortable with phones, but I could deal with them and even have long conversations with people I knew well. Then, as with so many other fears of mine, the trouble really began when my parents died.

To be absolutely precise, the trouble began when Dad was dying. My mum went quickly from diagnosis to death, and for the couple of weeks that she was in hospital we barely left her. Dad and I would dash home to wash, change clothes, top up our supply of cornflakes and peppermint tea for her and then go back. When Dad got diagnosed he was at a much earlier stage, so the plan was for life to go on as normal until the need for palliative care grew more pressing. A few days after he came home from hospital, he had a stroke and ended up right back there.

When Dad and I arrived at A&E I was warned that he probably wouldn’t make it through the night. He did. Then I was warned he probably wouldn’t make it through the next 48 hours. He did. I snatched a few hours’ of sleep in some unoccupied doctors’ quarters but didn’t dare go further away than that. After day three, the doctors encouraged me to go home, get some sleep, spend a bit of time outside the hospital. After I’d been home for some sleep and a shower, I went shopping. Specifically, I went looking for the kind of yoghurts my dad liked. As I pulled into the driveway, my aunt came and told me that the hospital had phoned and it was that “come at once” call. I went tearing across the city, terrified that I might be too late.

I wasn’t. Dad would survive for another four months, but throughout that time he would not only be dying of cancer, he would be at risk of a secondary stroke which would probably kill him. Since he was partly paralysed and I couldn’t handle caring for him on my own at home, he was transferred to the hospice. I practically lived at the hospice until he died, but I still had to go home for showers, changes of clothes and occasional time off and nights in a bed rather than a chair. My home phone and mobile numbers were written in large letters on a pinboard in my dad’s room and I have never been more diligent about keeping my phone charged. Every time I left the hospice I was just waiting for my phone to ring, dreading that it would be the call telling me to come back because we were at the end – or worse, the call telling me that I could take my time because it was too late.

As it happened, my dad never had another stroke. In fact, he made an incredibly impressive recovery from the first stroke. It was truly galling to watch him battling to regain his vocabulary, his diction, use of his right hand, while at the same time watching him wasting away as the cancer took hold. (He even got as far as being able to recall most people’s names accurately, though he always confused mine and Mum’s. That was painful.) He died slowly, his body shutting down bit by bit, and I was with him throughout it. But even though I never got that call telling me he’d had a second stroke, the fear of it never left me. I learned to associate ringing phones with bad news, and that’s why my mobile lives on silent.

After Dad died I was subjected to harassing phone calls on the house phone for some considerable time. That didn’t really help with the phone fears. Upwards of five times a day, any time from morning until the small hours, a particular member of my family would call and leave long, rambling, often threatening messages on my answering machine. (In retrospect I should have reported it to the police, but it’s amazing what you don’t do when you’re newly orphaned and made promises to your parents. Or I should have changed my number, but I was hoping against hope that I wouldn’t be in that house for much longer and I would change my number when I moved. To change my number would have been an admission that I wasn’t getting out my dead parents’ house any time soon.)

So, none of these things really helped me to deal with the existing fear of phones. I have mad CBT skills, but it’s an inadequate weapon against this particular demon. When my phone rings I am convinced of the following things:

1) Someone I love is dead/dying.

2) Failing that, someone I love now hates me.

3) Failing that, I am in some kind of massive trouble with someone over something.

4) Failing all of those, the person who used to leave those message has found me again. (This one is why I NEVER answer calls from numbers I don’t know or withheld numbers. EVER. My job makes it necessary for me to have my contact details available, which means that occasional calls from unknown numbers are inevitable, but that’s why I have voicemail. If a client leaves me a voicemail I expect that they’ll leave their name and ask me to call them back. If a friend leaves me a voicemail I expect it to be an emergency, because they all know everything I’ve written in this post and that I don’t appreciate being put through the phone fear unless something is wrong. Friends who want to chat to me know to text me first so I’m expecting their call. People who call from an unknown number and don’t leave a voicemail… I HATE THEM ALL. When that happens, I get those joyful feelings of “they’ve found me, it’s all going to start again, how much do they know, have they found where I live, am I going to have to change my number/move/call the police”. And this goes on for ages, just because some people won’t leave a fucking message. Thanks! Thank you so much! I love reliving traumatic experiences just because it’s too much work to say “This is X, I’m calling about Y, please call me back.” If it’s important enough to warrant a phone call, it’s important enough to leave a message. If it’s not important enough to leave a message, why are you calling me in the first place?)

This is why I love email. And Facebook. And Twitter. And video calling on Skype. And blogging. And texting. And pretty much anything else that means I can communicate with people without phone calls. Nothing beats a face to face conversation, of course, but if that’s not an option I’d rather use pretty much any means of communication rather than the phone.

There’s more to explore here, so I will revisit this subject at some point – as always, I’ve written until I couldn’t write any more and need to step away from this topic for a bit. The external influences on my fear are pretty clear, but it would be easy to get stuck on them and not look at the root causes. There are issues here concerning control, feeling unable to communicate with people, feeling that people are incredibly difficult to understand but that I have to keep trying and trying to do so. All the things that pushed me towards theatre, essentially. Though, sadly, I don’t think that “don’t phone me, just write me a play and I’ll write you one back” will ever catch on.


Decade

As the sporadic nature of my blog posts probably indicates, I’m not finding it easy to write about what’s going on in my head this summer. Writing fiction? Not a problem. The things that are going on in fictional people’s heads are just fine. But my own is another matter.

The trouble is the anniversaries. On October 23rd it’ll  be ten years since my Mum died, with the 10th anniversary of my Dad’s death the following July (we’re just coming up on the 9th just now). I don’t know why the tenth anniversary should seem more significant than the 9th, but it does. Probably because it’s a decade and having a word for the amount of time that has passed makes it feel larger and more of a milestone.

Ten years ago I was 20 years old and living with my Mum and Dad. I’d moved back in after my first major depressive episode and was just gearing up to move out again. I had learned a hell of a lot from going through depression. I had been self-employed for the first time. I had arranged my first solo trip abroad. I had booked my first professional singing gig. My relationship with my parents had survived a pretty hellish time and we’d found our way back to solid ground. For the first time, I felt like we were three adults rather than two adults and a child. I felt like I was finally getting the hang of this life malarkey.

That lasted for one summer. Just one. I got back from Austria on the 18th of September. By the 3rd of October my Mum was in hospital. She had been having pains all year which had been dismissed as the menopause. The diagnosis suddenly shifted and became cancer. On the 14th we found out it was pancreatic. On the 23rd she died. I couldn’t believe how much things could change in the space of a month. Honestly, I still can’t.

Of course, the changes didn’t end there. My Dad’s death, the car crash, a good friend’s death, the two and a half years of being unable to move out of my dead parents’ house, all of that followed. It all took its toll and helped to shape my expectations for the future. Without realising it, I internalised the idea that if I love people they die, and if I value things they get taken from me in a painful way.

Being stuck in my parents’ house for so long was incredibly painful and I struggle to explain why, because I don’t know what frame of reference to appeal to when I’m talking to other people. It felt like being checkmated. The situation was completely out of my hands and there were no moves I could make. I couldn’t afford to buy, I had no rental history or guarantors, no-one I could move in with, and no idea how long the situation was going to drag on for. I couldn’t even redecorate and make the place mine, because that would have meant destroying something that was very special to my parents (that house and the way it was decorated were part of the long-term aspiration that got them out of their council estates and into the life they wanted). But more importantly, it would have meant conceding that I was going to be there for a while, and that was not an option. I might have had to tolerate the situation, but I did not have to give in to it.

However, there was another problem with being stuck there. It was completely the opposite of what I had wanted from life. I moved out at 17 because I couldn’t wait to get out and start my own life. Moving back when I was ill was galling, but I was determined that I would get myself back on my feet and start again. What I envisaged was a life of moving around a lot, working in different places, being ready to take off to somewhere new at short notice, underpinned by the security of knowing that I always had a home to go back to if I needed it. It’s the kind of life that I see most of my friends in their early to mid 20s living now. Instead, I found myself with a property to look after and legal issues to deal with. I was faced with the realisation that if I decided to freewheel my way around the world now, I would be doing it without anywhere or anyone to come back to. Perhaps there are people who can handle that kind of isolation, but I’m not one of them. I need a little bit of stability underpinning my chaos, so I had to rethink the kind of life I was going to build.

I began a complicated game of hide and seek with myself. I would let myself care about things, about ideas, about career options, about people – but never too much. I always had to be able to look at the thing in question and say “I would be sad if I lost this, perhaps it would stop me in my tracks for a while – but I would survive it, it wouldn’t break me”. That way I could reassure myself that I was still functioning, that I hadn’t cut myself off or shut my emotions down as a result of the loss I had suffered, but at the same time I wasn’t risking too much. Every new connection with another person took me out of my comfort zone a little bit, but I never set foot beyond my safety zone.

That continued until 2011, when I realised I couldn’t go on like that any longer and completely revamped my attitudes towards pretty much everything. The way I work underwent massive change and I finally found my feet as an artist. I moved back from London. I fell in love. We got together, moved in together, got a cat, got engaged and got married in a very short space of time. I had forgotten that I had it in me to be that impulsive and uncalculating. At this point, I am starting to feel like I’ve got the hang of life again – and that is fucking terrifying, because I remember what happened last time.

So I am spending this summer trying to silence the thoughts that tell me that I’m not allowed to feel happy or secure, and that it’s only a matter of time before the other shoe drops. It’s completely irrational to believe that I can bring harm to people just by loving them. I know that. But the little voice in my head that says “Yes, but look what happened last time” isn’t big on listening to reason, and it’s a pretty large dose of fear to live with. This is why I’m going back to therapy. I cannot let my life be governed by an irrational belief. I will not remain paralysed by fear of 2003 – 2005 happening again. I do not appreciate the last vestiges of schizotypal behaviour trying to re-establish their foothold and getting in my way.

It’s not 2003 any more. That’s the important thing. And that’s what I need to get into my head somehow.


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.


Unnamed Road

Well, happy New Year and all that kind of thing – was it a good one? I’m starting 2013 knackered. I can happily stay up until 2 or 3am on a regular basis, but apparently 5am still causes me to suffer through the following day. I might not drink, but you wouldn’t know if you saw me in the grip of a sleep hangover.

Anyway, now that January has started and the festive season is winding up, it’s time to start dragging myself back into some kind of routine. So here I am at 1.43am, avoiding editing by writing blog posts with Back to the Future on in the background.

Last October I had a play on at the Granary as part of Black Dingo’s launch season. Back then I mentioned that I would get round to telling the story behind Lost Love at some point, and since it’s going to be on again in a few weeks this seems like as  good a time as any. (Obligatory plug details: Lost Love is part of the line-up for this month’s Speakeasy, a spoken word event hosted by Jo Caulfield at the Scottish Storytelling Centre on 22 January. Info about Speakeasy here. Booking for this particular event here. Booking is essential, people were getting turned away from the last event.)

Lost Love was the product of one of my mini-frenzies. I was supposed to be writing something else, of course – a deadline was looming large enough to make it necessary that I write, but not yet large enough to ensure that I wrote the thing I was actually supposed to be writing. The voice of the obsessed SatNav started chattering in my head and all of a sudden I had a ten minute play on my desktop.

When you write a play about a sentient electronic device and tell people it’s partly autobiographical they give you funny looks (and rightly so, I suspect) .But it’s true. As far as I know I  have not yet had a SatNav fall in love with me, nor have I been a SatNav. The SatNav-related bit comes from an epic drive through Central London. I was working on a show at the Rosemary Branch in Islington and one of the props required was a barrel. I tracked one down at the National Theatre prop store, which is near the Oval, and set off to collect it.

Driving in Central London for the first time is an experience. I had no idea how the congestion charge worked and didn’t really want to pay it, so I decided to avoid the charge zone. Unfortunately my SatNav was determined that we were going in a straight line, right through the charge zone, and I couldn’t find a way of programming it to go round the outskirts. Instead, whenever I reached a Congestion Charge sign I would just go in whichever direction felt right, causing my SatNav to tell me off in what I felt was an increasingly judgemental tone of voice. I spent about an hour of the journey yelling “you can’t make me” interspersed with various obscenities at the SatNav. I have since learned how to switch off the voice, meaning I can cheerfully ignore it without getting any backchat.

However, the autobiographical bit is actually to do with driving in winter. The SatNav in the play leads its owner into the middle of nowhere on a freezing cold day. When I say that it’s a black comedy, that’s not just a description of the humour but also of the ice. I don’t drive in winter if I can help it because I’m truly terrified of black ice. I’m nervous enough when I’m walking if it’s slippery out, having broken some bones in a fall a few years ago, but driving… No.

My first assistant directing job was in Forres, rehearsing in December. I was staying in a cottage just outside the town. On the second morning of rehearsals I woke up to find that it was snowing. I got in the car and set off for rehearsal. Less than ten minutes later my car was upside down in a ditch and I was lucky to be alive. I managed to get one of the windows open and climbed out, uninjured apart from whiplash. I counted my blessings and got back to driving as soon as the insurance cheque came through.

It wasn’t until the following year that the shock caught up with me. I had moved to London but was back in Edinburgh for Christmas when I got called in for an interview for a job I really wanted. I needed to be back in London by the next day. This happened at about 9pm, right around the time it began to snow… I slithered along the M8 and M77. The gritspitters weren’t out yet (because for some reason the authorities are always taken by surprise when it snows in winter) and the traffic was packing the fallen snow down.

That’s when I realised what a near miss I’d had up in Forres. Claustrophobia set in as I remembered being trapped in my wrecked car, my windscreen pulverised by rock that had narrowly missed my head. My phone had fallen out of my handbag and I couldn’t see it anywhere. As much as I wanted to find it and call for help, my priority was to find a way out. I didn’t let myself consider the possibility that I might not be able to get out. I didn’t consider that at all until that nightmare drive back to London. Then it all came rushing in, all those thoughts about how I could have been trapped on that quiet road, how wrecked cars can catch fire, how cold it was and how long I could have lasted in that cold, how no-one would have known exactly where to look for me when I didn’t show up, how easy it would have been to have got myself killed. Being cold, alone and having no control… I can’t even complete that sentence. When I try all I get is that squirming surge of anxiety, panic takes over and fills my brain with NO and I can’t say anything more coherent. And that’s after therapy.

Put the two together, my experience of using a SatNav and my unfortunately extensive knowledge of car crashes and icy roads, and you get Lost Love. Black humour and lots of Jen anxiety distilled into ten minutes.  At some point I’ll probably write something more serious about the car crashes, but collectively they’re amongst my greatest traumas. Lost Love let me scratch the surface. First I learn to laugh at it, then later I learn to be serious.

And that leads neatly on to the next future post promise. Sooner or later I’ll look at humour as a defence mechanism. But not tonight, because there has to be sleep at some point.


Noting a Broken Pattern

Today (or yesterday, I suppose) I had a really useful meeting with Sandy Thomson, Artistic Director of Bell Rock (formerly Poorboy), in her role as a Cultural Enterprise advisor.

I had gone seeking advice regarding Tightlaced’s structure and legal status, as well as hoping to pick up some tips from an artist who successfully runs a theatre ensemble herself. She gave me lots of information and food for thought regarding company structure and how a co-operative model might work, and she referred me on to other Cultural Enterprise resources for anything she couldn’t help me with herself. (If you’re an artist who doesn’t already know about the Cultural Enterprise Office, READ THIS NOW. Then come back here and finish reading this.)

But just as important as her advice was her support. I don’t get many chances to talk to other artistic directors of methodology-led ensembles. Sandy and I spoke about the possibilities and pitfalls presented by ensemble work and she reminded me that considering my own needs and wants is not only allowed but actually essential.

We talked about the boom and bust patterns that seem so difficult to avoid in the leaders of groups who work this way, which led me to acknowledge a very important milestone that I had allowed to pass unnoticed – even by me.

I have not experienced physical burnout since April.

I know that probably sounds like nothing, but for me it’s major. For years I’ve run on 12-weekly cycles, working flat out for three months at a time and then collapsing with a monster cold/flu-type thing which seems to be the physical manifestation of my exhaustion. I’d take a day or two off if I could (by which I mean I’d keep working but I’d do it from home) then I’d drag myself back up to full speed as quickly as possible.

It was a ridiculously unhealthy attitude, don’t think I don’t know that. I once fractured my coccyx and destabilised a couple of joints and went straight from the ambulance to rehearsal with no time at all to rest. That’s one of the more extreme examples, but at the time I saw it as the obvious thing to do. I started behaving this way because I felt I had to, because there was never enough time to do everything I felt I should be doing, then I kept doing it because I was trapped in the pattern.

This time last year I figured out exactly how destructive my pattern was and made a promise that I would get better. I had just finished Romeo and Juliet and I was ill, yet again. I had been deteriorating for over a month, starting with the usual cold and culminating in a kidney infection. I’d like to say that was my last physical burnout, but despite my promises to myself there was one more to come. I completely overworked myself in March and had one last cold from hell to see me through April.

Since then, though, I’ve been doing well. Even though this has not been an easy year in terms of mental health, where physical health is concerned I’ve been a lot better at maintaining my equilibrium. Even if I’m knocked flat on my back by a cold tomorrow, the fact remains that I have come this far. I paced myself so that I didn’t succumb to Fringe Lurgy. I struggled mentally around the anniversary of my Mum’s death but stayed physically well. I was anticipating burnout after the double bill, but in spite of all the long days, late nights and endless energy being poured into the work, I was still standing afterwards.

As I said, this probably sounds like nothing, but do you know how long it’s been since I went more than twelve weeks without exhausting myself to the point of illness? The last time I can remember was 1995. Seventeen years ago. Something I hadn’t actually stopped and worked out until today. So it’s important to me – the footprint of the first tiny steps in the direction of a healthier approach to work and life.

Sandy talked to me about the importance of reward and recognition, and the fact that recognition is often of equal or greater importance than reward. It felt that was. Something in my mind feels lighter for realising this. Perhaps it’s just the feeling of letting up on myself after many years of berating myself for (ironically enough) being too hard on myself. (I’m sure that sentence could be better constructed and not contain the same word three times, but… welcome to nearly 2am.)

There’s more that came out of the session and I’ll write about that as I work through it. Some will be here, some on the Tightlaced blog. But for tonight, that was the big thing. Thank you Sandy. If nothing else had come out of the session, it would have been worth it for that alone.


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.