Treatment

Anxiety and Depression: Eat Your Way to Better Health – A Recipe Book Review

Disclaimer – Please read this disclosure about my use of affiliate links which are contained within this post.
Today’s review is quite different but I like branching out and trying new things so here goes. This is a review of a recipe book called Anxiety & Depression: Eat Your Way to Better Health (The Medicinal Chef) which I thought was very relevant for my target audience and something that I’m very interested in myself. This book is written by Dale Pinnock and published Quadrille Publishing who very kindly sent me a copy. Now, I’ll start by stating that I’ve not changed my diet or lived off just meals cooked from this book for the past 3 months so I won’t be making any claims that it’ll change your life, cure you, or in fact make any difference to your condition because I’m simply not in a position to be able to say either way. However, I can tell you more about the book, the recipes, the layout and whether it might appeal to you or not.

As most of you will know, I have medication-resistant depression and my anxiety disorders are proving nigh on impossible to shift with meds too so I’m all for looking into other ways of helping myself. I’m not especially interested in “alternative” remedies because I’ve tried a number of them with even less success than conventional medicine and I’m not a believer of just trying anything in the hope that it’ll work. Trying things involves investing a lot of time, energy and hope into making something work for you and I’ve had my hopes dashed too many times so I really have to be persuaded into believing something might work before I’ll even consider attempting it. With that in mind, this is why I’ve not changed my diet or followed the suggestions in this book to the letter and therefore why I cannot make any miracle claims. However, don’t stop reading.

This book has a lengthy introduction about how anxiety and depression work on the brain, some of the common beliefs about where these conditions come from and the causes of them and then goes on to explain how foods can help and hinder the conditions and their symptoms. I’ve learnt during my own anxiety disorder journey that sugar is my enemy. As is alcohol. And caffeine. It took me ages to admit this to myself and I still battle with it but all three of those things make me very unwell, increase my already racing and irregular heart rate (I’m on beta-blockers to reduce and regulate this) and put my anxiety levels through the roof. I really do have to avoid them as much as possible. The information in the book explains why I’ve found this to be the case and suggests foods that can be great for stabilising your mood and your blood sugar levels so that you’re not cycling through highs and lows of energy all day with your body and mind never knowing if you’re coming or going.

I realised a long time ago that if I eat crap, I feel like crap. Don’t get me wrong, I’m not on some health kick where I eat every vegetable I can think of and ban cake from my house (even thinking about that makes me feel sick and somewhat blasphemous) but it has made me focus on what I eat and how it makes me feel. Sadly, like many people with mental illnesses, I also have IBS that in my case, seems to be almost solely induced by stress with the exception of onions which I discovered two months ago are the cause of intensely painful bloating and after months of denial and thinking that they couldn’t possibly be causing my pain because I eat them every day and don’t bloat badly every day, two days of eating accidentally under-roasted onion and having a rock solid stomach that didn’t move even when I tried to suck it in, I had to admit defeat and face the fact that onions are my nemesis that when raw make my insides feel like they’re waging war. This has made me realise that diet is important in helping to regulate and manage all of my conditions.

So, back to the book, Dale makes no claims about effectiveness and merely states that diet changes, alongside traditional forms of treatment, can optimise the functioning of the brain and nervous system. He explains how the central nervous system works and defines key neurotransmitters and the effect they can have on mental health. He then goes on to discuss in detail key nutrients for mental health, what they do and in what foods they can be found. Following this, he explains what anxiety and depression are, what happens to the body and what can be done nutritionally to help. It is worth noting that the introduction is very detailed and thorough but does take up a whopping 62 pages including quote pages and pictures. Image number 3 below shows where the recipes start in the book.

So, onto the recipes – the main reason why you’re considering buying this book. The recipes are split into sections: 6 Breakfasts, 15 Lunches, 24 Dinners and 6 Snacks and Desserts. About a third of the recipes have full page photos opposite and they’re all written in nice, clear text with a description at the top explaining which useful nutrients they contain. It doesn’t detail cooking times or calorie counts but does tell you how many servings it produces. I’ve made a number of dishes from this book including the Spiced Lentil Soup and Gorgeous Green Soup (both pictured below) and they were really easy to follow and very tasty – even the green soup of which I detest 50% of the ingredients!

This book isn’t ideal for fussy eaters like me because it uses a lot of fish, seafood and dark green veg. But, for those of you who aren’t so fussy it could be a great buy and would be well worth trying because the recipes are low fat and low sugar so not only may it help improve your mood, it may also help you lose weight. I can testify this has had a hugely beneficial effect on my own mood now I’ve lost 37lbs and counting since January (not through using this book I must point out). This book is clear and well-written, it’s very informative and explains things scientifically and uses research to back up any claims made but it’s not difficult to understand as it’s not full of jargon. As for whether it’ll help your mood, I don’t know, but it’s an interesting read that may help you gain understanding of your conditions and if nothing else, you’ll be eating some tasty grub! I’d love to hear from anyone giving this diet change a go to see if it has any effect or not and if you’d like to buy a copy of the book then head to Amazon via this link Anxiety & Depression: Eat Your Way to Better Health (The Medicinal Chef)

Crisis – Drowning and Trying Not to Sink Any Lower

Trigger Warning: This is not a cheery post and talks about feelings of hopelessness and worthlessness. Please don’t read on if you feel that this may upset you or cause you any form of mental distress. This blog is here to raise awareness, improve understanding and communicate difficult themes of mental illness that I experience, it is not here to cause any distress so please read with caution and look after yourself!

Crises are things that many of us go through at some point in our lives. Whether it be a mid-life crisis, a confidence crisis, a devastating loss, a sudden change in circumstance, they can all be crises to us that threaten to overwhelm, take control and force us to submit to the idea that we cannot and will not cope with whatever it is that we’ve just been dealt. I am very much going through this right now.

Despite being virtually housebound for 16 long months, I have mostly been able to keep plodding on, to keep my head just above water and to keep hoping and believing that I can and will get through this and get better. Sadly, this is a very fragile state for me and involves a lot of hard work and effort to keep the negative thoughts at bay and to keep moving forwards as best I can. I have to work at it every single day otherwise the drowning feeling quickly seeps in and takes over and I have to fish myself out again, always a little more damaged by the darkness that’s snuck into my head. Each time it gets a little harder for me to find the light, to find hope again, to believe that this may be temporary and I may be lucky enough to get my life back again.

So what sparked this crisis off? I’ve been waiting for the last month to hear from the support worker I’m supposed to have been allocated after my last psychiatrist appointment where I was finally diagnosed. I have been incredibly anxious about this phonecall and every time my phone has rung my heart has skipped a beat and my breath has caught in my chest while I check the caller ID and see if it could be them. But I haven’t heard anything. I’ve been feeling increasingly apprehensive about whether I’ll like the person, whether we’ll get on, whether the treatment will be set at my pace or whether I’ll be forced to do things I feel unable to do and pushed too hard or not be believed if I say that I cannot do what they’re requesting. I’ve worried about whether it will make me worse by pushing me too far too fast, whether it will indeed help and if it doesn’t, what, if anything, might help instead. All of these thoughts have been racing through my head every day for the last month and it’s exhausting. My head feels full, like it’s wedged full with cotton wool which makes concentrating on even the most basic of tasks increasingly difficult. It’s why my reviews are so sporadic, because some days I’m completely unable to get ideas down on paper or even pick a colour or a page to colour. Other reviewers complete around 5 reviews a week, I’m lucky if I manage half that despite not working, not having children and being a total disaster of a housewife because I find the task monumental and every single step takes longer than it should or would if I were well. I try to ignore this and just keep plodding on at my own pace but it’s hard not to compare myself to others and wonder how I’ll ever cope with a real job again if I’m struggling so much with doing this. Don’t get me wrong, I love reviewing and I’m unbelievably grateful that I’m being given the opportunity to write them for publishers who kindly donate copies of their books, but I find it very hard to keep on top of it and to not get overwhelmed. But, I refuse to give up – I refuse to surrender another part of my life to my condition. I have to challenge myself, to keep pushing my boundaries and to keep standing up to the anxiety or it will take over every part of my life and my personality. So I keep going, I keep fighting the demons, I keep telling myself that I can do it, that I am achieving something, that I am, in a small way, helping others with my reviews and that I’m not totally useless like I regularly slip into thinking.

Anyway, on top of all of these daily thoughts and worries about the support worker which are already added to my general every day worries and anxieties, I received a letter on Friday which was what triggered this crisis. I’ve been asked to attend yet another assessment, with another member of staff I’ve never met (this time a nurse) at a day centre I’ve not attended since I was 18. I don’t know what this assessment is for, or why I’ve been asked to attend. I’ve been sent a standardised letter which totally panicked me because the wording states that they’re assessing me “to determine the best course of treatment for you at this time” and that it will last an hour to “enable you to discuss your current difficulties and whether we can help you at this time”. I’ve already been given a treatment plan and was under the impression that the next step was a support worker being allocated to me and contacting me to arrange a home visit. None of this has happened and I have no idea what this assessment is for. I’ve phoned this week to ask my psychiatrist what’s going on and what it’s for but I’m yet to receive a response so I’ve now spent 6 days (and counting) feeling incredibly anxious to the point where my insomnia has worsened and I’m now unable to sleep before 4am instead of my usual 2am and yesterday I didn’t sleep until almost 5.30am. This then means that I’m even less able to deal with the anxiety and I’ve already had at least 4 panic attacks this week because of it.

Not only has my anxiety worsened significantly, I’m now able to do even less than I usually can because my baseline anxiety level is so high that it takes very little to push me into levels where I can’t control it or cope and have a panic attack so I’m now leaving the flat even less than usual and I’m now even more trapped in my own home and my own head. This has really scared me because normally a letter would shake me up for that day, maybe the next as well but I’m now at nearly a week later and I’m still not calming down. It’s got me questioning major parts of my life (hence the crisis) and I’m now wondering if I’ll ever get better, what might help, will anything help, what do I do if I stay at this level of functioning for a number of years without improvement? I have goals and dreams and plans for my life. None of these are especially big or outlandish. I don’t want to travel the world, if I can never go on an aeroplane again then so be it. I don’t want to bungee jump, skydive or put on a concert for 1000s of people. All I want is to be able to leave the house when I want to. I want to be able to work. To socialise. To get married. Most of all? I want to stop feeling scared. I’m fearful of so many things, it has taken over my whole life and I now overthink everything. I want to be able to get dressed and not worry about what people will think of what I’m wearing. I want to be able to work without the fear that I will fail or let people down. I want to be able to say no to people without the fear that I will be rejected and end up alone. I want to feel confident in my own skin, to feel safe, and to know that the choices I make are ok and accepted and that I don’t need to worry all the time. I want to stop feeling afraid.

This week has caused me to feel totally lost. I feel like I’ve barely made any progress since getting ill 16 months ago. I try my hardest every day and I challenge myself regularly. I’ll achieve something one day and then not be able to do that thing again for another month or even 6. At this rate of progress I still won’t be able to work in a decade and that’s hard to stomach when you’re only 24 and you have your whole life ahead of you. I want to be able to fulfil my modest dreams, to achieve the things I hope for. I want to know that somehow, someday, I will get better. That I will get my life back and grab it with both hands so that I can change the lives of others with conditions like mine. I’m desperate to make a difference, a bigger difference than I can possibly make sat behind a computer screen and trapped inside my flat. I have no idea how to get better, or what will work. I was so convinced that medication would work and I’d be back at work within 2 weeks. I thought I’d be able to drag myself away from the irrational fears and force myself into no longer being scared but that has not been the case. I’m rapidly losing hope and I feel like I’m pretty much out of options. I’m not religious, I don’t have faith, I don’t have the comfort of believing in a higher being that has a plan for me that I just have to wait out until it improves. I don’t have anything to rely on or to comfort me in these dark hours to prove that I will get better and that it’s just a matter of time. So I have to keep working, all day, every day, on trying to keep my head above water and when I can’t do that, like I can’t currently, I have to just try to prevent myself from drowning and falling further down under the water. My hope is that this anxiety will calm down again over the next few days and I’ll be able to build myself back up with the help of those closest to me who I know still believe in my ability to improve and get myself better. One thing I have in spades is determination so if anyone can do it, then I can, but right now that feels so untrue and so impossible because I can no longer think of a solution or method to improve and without that it feels like all hope is gone because I have nothing left to hope with. I have heaps to hope for but that just feels like torture, like showing a hungry child photo upon photo of plates of delicious food without giving them any way of having it. The hunger is easier to deal with and ignore if you don’t think about the thing that you want most – food. So I’m trying to ignore all of the things I’m missing out on, the things I’m desperate to do, the simple things that everyone around me takes for granted but that would make my day if I could just do them without fear anymore. I’ll keep on colouring and reviewing and keeping myself busy in the hope that it will keep my mind occupied at least some of the time and keep me distracted from the constant stream of “what if?” and “how the hell?” questions running through my head. Hopefully this crisis will pass as quickly as it’s hit me but for the moment I’m drowning and trying desperately not to sink any lower.

You Wait 15 months for One Diagnosis and then Three and a Half Come Along at Once.

Yesterday, my boyfriend and I went to see my new psychiatrist after not being seen by one since September because mine left and I never got put onto anyone else’s books. We were told we were attending to finally discuss diagnosis and I went hoping that would happen and I’d finally get a straight answer about treatment. Luckily, this psychiatrist is very thorough and seems to actually care. I met him once when I was 18 and liked him then as he was honest enough to tell me that because I’ve tried the main effective medications for my conditions with very negative effects to my health, I have medication-resistant depression and there was little to no point in trying those types of meds again in the future (sadly this information didn’t get back to my GP so when I originally became anxious I had to try taking these types of meds again before she’d try me on any new groups). The appointment was incredibly challenging. As usual, we were seen late and it turned out that slot had been triple-booked (I despair at the organisational skills of these places sometimes). I spent the entire assessment on the edge of a panic attack and cried twice because it was so overwhelming despite having taken diazepam in order to even get out of my flat to attend. I managed to get my points across though and have a tentative set of diagnoses that will be confirmed by letter within a fortnight. As a psychology graduate, I already had a fair idea that I’d be diagnosed with Generalised Anxiety Disorder as I fit all of the diagnostic criteria and have just about every symptom listed in the DSM (Diagnostic and Statistical Manual – used for diagnosing psychiatric conditions). What I wasn’t expecting was to be diagnosed with Social Anxiety and Panic as well. I always thought Social Anxiety was extreme shyness and an inability to be around people or to socialise. It turns out, it’s not that simple and that actually I fit very neatly into that box thanks to my fear of judgement from others and excessive worry about failing to meet others’ expectations or letting them down in some way (more posts in the future about this I’m sure).

I also got a big shock when personality disorders were mentioned. I have, at times, wondered if I had a personality disorder because many people with as many stress-related conditions as I’m racking up do have one. I’ve looked at the diagnostic criteria and got friends from my degree course to look as well and none of us think I fit the criteria so I really started to panic when the psychiatrist started to mention it because sadly, a diagnosis of a personality disorder leads to a great deal of stigmatisation, particularly within the medical community. Having worked with 10’s if not 100’s of patients with them, I’ve heard countless stories from them saying their doctors simply don’t believe them when they state that their conditions have worsened, they put all symptoms down to the personality disorder instead of looking at whether they have a second, third, or fourth diagnosis that needs to be made and they’re often labelled as manipulative hypochondriacs. Luckily, my psychiatrist agreed that these diagnoses of personality disorders are often very unhelpful and that in my case this would be true and I don’t fit into the criteria to be diagnosed with one because essentially I’m not severe enough. I was very relieved about this. He said, instead, that I can be described as having Adult Sequelae (seemingly not a diagnosis but a description hence the half in the title of this post). I’ve never heard of this at work or at Uni and when googling it, there is very little information, particularly for lay-people, just journal articles investigating links into drug addiction and alcohol abuse. However, how the psychiatrist explained it and what I’ve gleaned from the few studies that described it, is that issues from a difficult childhood or a pre-existing condition cause a second (or more) condition to develop as a result of the first. Because I had issues growing up, my ability to deal with stress has not developed and has left me very vulnerable to any future stress or adversity. I then develop physical or psychological conditions because of this lack of ability to cope and when I then learn to manage each condition but still not the underlying stress, I then develop a new symptom or condition each time I’m under severe stress or pressure again. It’s essentially like turning on a garden hose that has a hole in it. The water is the stress and the hole is a symptom/condition. I keep patching up the holes but then the hose bursts somewhere else (a new symptom/condition). I never manage to learn to turn off the water or re-route it somewhere else so I spend my life patching up the holes and learning to manage new symptoms and conditions without ever learning how to deal with stress or the issues from my childhood. This isn’t as severe as a personality disorder because seemingly, all of the other aspects of my personality are fully developed but my ability to deal with the negative events of my childhood and negative events that happen in my life today is still not formed. The psychiatrist has explained that I need to deal with the current issues of the anxiety disorders so I can get back to functioning and then work on learning how to deal with stress generally and combat the problems I’ve had since childhood. This means I’m going to be having a lot more therapy over the next few years and he did point out that while there is no reason to suggest I won’t improve, recovery is a much harder battle and one I’ve not yet won with any of my conditions as all those I’ve been diagnosed with still affect me to varying degrees despite my management of them.

Leading on from all of that, I’ve also finally had my treatment plan outlined! I’m to be allocated a support worker who will visit me at home and work on practical things to get me going out more. If/when that improves I will then be enrolled onto a group CBT programme at the local day hospital which I will attend with the support worker. After that, I may well be enrolled to attend the local recovery college where I will be taught about the conditions I have, how they work and what can be done to manage them. I’m not sure how much use that part will be given that I already have a psychology degree where I extensively studied these conditions and have not only worked for a total of 11 months with patients with these conditions but have also heavily researched them since becoming unwell myself but if I get well enough to attend then I’m certainly willing to give it a go to see what it’s all about and whether there’s anything new and useful I can pick up. After all of that, my level of functioning is meant to be a lot higher and I will then be assessed by a psychotherapist who will advise me about what long-term therapy I need to have and I’ll hopefully be referred to a highly skilled therapist from there for treatment which is likely to need to last 12-18 months.

So, I now have three and a half shiny new diagnoses and I’m still in shock about it all. I was so worried that I was going to be fobbed off again without knowing what’s wrong with me and what’s caused my life to turn upside down for the last 15 months. I’m pleased I now know officially what’s wrong with me, that I’m being offered treatment and now have a plan of what’s going to be offered and what we’re trying to tackle first, but naturally, now the worry is setting in about the pressure I’m likely to be under to improve, to constantly be getting better without being able to get used to any slight increases in functioning (there will be a lot of these in between being virtually housebound now and having a normal life where I can work and socialise). I’m worried about how I’m going to cope with a support worker when that’s the job role I was in when I became too ill to work, whether I’m going to get on with them, whether my treatment will be done at my pace or a pace set for me that I don’t get to have input into and a whole heap of other worries. The nature of Generalised Anxiety Disorder is that you worry about everything, particularly the unknown, so this is all very scary. I now have some labels that roughly describe what’s wrong with me and what I’m going through but I currently have no idea how long it may take to improve my functioning or even if the treatment plan will help. It sounds like the psychiatrist expects it to help but then he kept saying “if” so I don’t actually know what the likelihood is or what time-scale we’re looking at. I’m trying to just stay calm and take each step as it comes but such is the nature of the beast that I’m fighting that this is nigh on impossible for me to do and I’m already worrying about what if all of that doesn’t work and I’m left housebound still with another treatment option crossed off the list as not having worked. I’ll certainly be giving it my best shot and anyone that knows me offline will know how motivated and determined I am when I set my mind to something but the worries are still ever present. At least I know what conditions it is I’m fighting and have an action plan to try. Beyond that I’m just having to hope, and wait and see! Updates will follow as and when there are any. I’m still shocked and stunned that I’ve waited 15 months for one diagnosis and then three and a half came all at once.

Physical Illness vs. Mental Illness – Why You Should be Outraged

Today I’m feeling anxious, I have been feeling increasingly so for the last couple of weeks because tomorrow I have an assessment with a psychologist. I was originally meant to have the assessment in December but wasn’t well enough to attend and moved it to the end of January hoping that I’d have improved by then. Sadly, it got cancelled with 3 days’ notice by the psychologist because she was striking that day. It got postponed again until after I’d finished withdrawing from my medication and hopefully improved. It’s now tomorrow. In some ways I have improved – I cope better when I have to travel in cars, I can go to the shops a little more often and stay out a little bit longer before the panic sets in, occasionally I even go out and don’t feel panicky at all. However, I feel incredibly anxious about tomorrow.

I’ve been fighting for this assessment since September and was originally deemed “unsuitable” but was never told why. I fought and explained why I should be assessed for therapy and stated that as medication clearly doesn’t work, psychological therapy was my only hope other than spontaneous recovery which we can hardly rely on happening. Eventually my psychiatrist gave in, seemingly because he could no longer justify saying no and I was sent an appointment.

They keep refusing to do my assessments by phone even though I’ve already missed one face-to-face appointment because I got so anxious that I couldn’t move and they keep telling me to “just try” and “keep pushing yourself”. I push myself every day. I have almost no support from the health services now and was really unwell for months due to withdrawal from my medication which wasn’t monitored because I still don’t have a new psychiatrist. I’ve now not been seen by a doctor since the 3rd of September and am still yet to be allocated one – it’s been 7 months.

When you’re suspected of being diabetic doctors don’t just make you eat sugar in front of them and then pump you full of insulin when it’s clear that your body isn’t processing it and is rapidly killing itself. Why then must I keep “pushing myself” to go to appointments so that they can see “just how anxious I am”. Why am I essentially being tested? Most of what I say and do currently seems to be skewed by doctors and psychologists who just use it in whatever way they like to back up their own point. I’ve attended 3 appointments so I was well enough to get to those, why not the latest appointment? I explain that I’m so anxious about these appointments that I stop being able to sleep for a week beforehand and my IBS flares up. These appointments are making me more ill but I’m expected to attend them in order to get treatment. I have to go to assessment after assessment with healthcare professionals with different job roles and titles and so far all I’ve been offered is Group CBT sessions. I regularly go weeks at a time without being able to set foot outside my front door so how is it feasible to expect me to do this? Asking me to “just go outside” is like asking someone with a broken leg to walk on it with no plaster cast. They can want it as much as they like but as soon as they try to put weight on it the pain will be unimaginable and their leg will buckle potentially causing more damage. Wanting your bones to fuse together doesn’t mean that it happens and it’s exactly the same with my anxiety. I hope, wish and even pray every day that I will be able to go out and do all of the normal things that I took for granted but that doesn’t make me any more able to do them than walking on a broken leg.

Patients having a lump investigated are told what the possible outcomes and diagnoses may be and in time are told what treatments may be available to them. They are given a diagnosis as quickly as possible and then told about treatments, prognosis and available support. They are not kept in the dark about these things and are allowed to make decisions about what they feel would help them best and how they want to proceed. I’m afforded none of these luxuries as a mental health patient. Over a year in I’m still yet to be diagnosed, I’m still having to go to assessments and have still not received any psychological treatment. I’ve taken myself off the medication that was making me worse because I have no doctor to discuss it with or to advise my withdrawal so I did it alone. I have been in and out of the mental health system since I was 16, I have a psychology degree and until a year ago I worked in a psychiatric inpatient unit. I know my stuff when it comes to what therapies are available and whether or not they’re likely to help me. I’ve had so much CBT that I could almost certainly deliver low-level therapy with no need for further qualifications and while it’s a great therapy, it hasn’t worked for me and there’s no reason to think that would be any different for this anxiety disorder.

In 2011 I received Cognitive Analytic Therapy which really helped me at the time and is the therapy that I believe in most to be able to treat my current difficulties. I have been asking my psychiatrist since September to refer me for CAT and have been categorically told that it IS offered by my local NHS Trust and within my area so I fought for it for 5 months. I’ve asked more than one health professional on numerous occasions whether it’s offered here and whether the therapy assessments I’m going to are assessing me for CAT or just CBT and have always been told that they are. That was until January when I phoned the day hospital and the person I spoke to immediately said that the Trust DO NOT offer CAT. I was shocked at this and nearly burst into tears. I told her that both my psychiatrist and psychologist had assured me that it was and that I was being assessed for it so she said she’d check. The psychologist then called and finally admitted that CAT is offered by the Trust but that there are no NHS funded therapists in our area and due to my condition preventing me from travelling, I would not be being assessed for it.

I’m now in a very difficult position where I’ve been lied to by the very people that I’m meant to trust. I have to open up to these people about my deepest darkest fears and tell them about all aspects of my personal life. I’m meant to trust in them to tell me the truth and to work for my best interests and to advocate for me when discussing my treatment in meetings. But they’ve lied. They’ve lied over and over again, when I’ve asked them direct questions about whether or not I’m being assessed for this therapy. It feels like I’m being conned. How am I meant to persuade myself to go to an assessment that I’m terrified of attending when it looks increasingly likely that I’m just going to be offered Group CBT or sent back to my GP. I keep asking what provisions there are for people who are housebound and I’m still yet to get an answer. I have explicitly stated that I do not want to be discharged back to my GP, the same GP who put me on medication that I should never have been given in the first place due to previous bad reactions to it and who told me to “just stick with it” and more worryingly to “try harder” and “think more positively” while I deteriorated thanks to the horrendous side effects. If I can’t attend tomorrow though I may well be discharged back to their “care” meaning I won’t get any treatment.

I know that I’m one of the unlucky ones for whom medication is not the answer, or even part of the answer. I know that I’m a nightmare patient because my conditions are treatment-resistant and complex but I wish they’d been straight with me and not lied. If CAT isn’t offered in my area and I’m not well enough to travel out of area for it then that’s fine. I don’t like it but it’s not unreasonable and I understand that particularly in this economic climate there are limitations on healthcare provision. I’ve directly asked over and over again and been assured that I was being assessed for it. I’m left wondering what would have happened if I’d been well enough to attend the original assessment? Would I have been told I was “unsuitable” for CAT despite being suitable for it when I was assessed in 2011 by a different NHS Trust? Would they have just tried to palm me off with Group CBT and then said that I was “refusing treatment” when I declined due to not being well enough to attend? Would they have ‘fessed up and said that actually they’d got me there under false pretences and that CAT isn’t offered? I’ll never know.

I am not alone in being treated in a sneaky, underhanded way. Countless patients with mental health problems are treated like this every day. It simply wouldn’t be allowed if I had a physical condition. I wouldn’t get put on medication without a diagnosis. I wouldn’t have to prove myself, my tests results would speak for themselves. You may be thinking that you can’t test for mental illness and biologically that’s currently true. I can’t have a blood test and be diagnosed with an anxiety disorder but there are countless psychometric tests that measure anxiety levels, depression scores and every other psychological condition under the sun and my score on the anxiety tests is through the roof. There is no mistaking or denying that I’m severely affected and that my quality of life is hugely diminished by this condition and the test results show that. And yet, I’m still expected to prove it by attending the appointments and for some reason, unknown to me, not being able to attend an appointment because I’m so anxious that I’m not able to move, doesn’t prove that I’m even more ill than they thought and therefore in need of urgent treatment. No, my inability to attend appointments just seems to elicit threats of being discharged back to my GP and receiving comments about not trying hard enough or putting in enough effort. This would be a disgrace if I were physically ill but it’s widely accepted when mentally ill – You Should be Outraged!

N.B I’ll post soon about whether I manage to attend tomorrow and what the outcome is.

One Year On – One Year of Fear

This time 371 days ago I was interviewing for a job that I’d been trying to get for 9 months. It was a permanent role on the ward that I loved working on and meant that I would finally have job security, guaranteed hours, proper support and training.

370 days ago I was on top of the world after being offered the job. I was in work that day and the patients and staff were all thrilled for me and very excited that I was officially joining the team. I was filled with pride and excitement that I’d finally got to where I wanted to be and was one step closer to my dream career of Clinical Psychologist.

369 days ago and things weren’t as rosy. I felt strange all day. I was worrying a lot and felt a lot less confident in my ability to do my job and keep my patients safe. I started to doubt myself a lot and felt very insecure. In the evening I went out for a meal with my boyfriend to celebrate my new job and I deteriorated over the course of the meal. I couldn’t stop worrying and felt really on edge. I didn’t want to walk anywhere, even to the loo, because I felt like I was going to collapse and like everyone was watching me. On our journey home I was clinging to him and when a drunk sat opposite us on the train I could barely hold it together. I just couldn’t deal with it all. I burst into tears the minute we got through our front door and struggled to sleep that night because of all the worries going through my head.

The next day, 368 days ago, I got up for work and just felt paralysed by fear. I tried to work through it and make myself go in knowing that I’m obviously good at my job if I’d just been offered a permanent role but the fear took over and I had the first panic attack of what would soon be many and had to phone in sick.

Over the weekend I deteriorated further. I needed to do a food shop and simply couldn’t face doing it on the Saturday. I don’t remember the exact thought processes but I just felt unable to cope and unable to deal with that many people and pressures and how busy the supermarket would be. On Sunday I felt that if I didn’t go that day then I’d end up stuck indoors and frightened to leave. I don’t know why I thought that but it was a very strong feeling and I knew I had to try. It was awful, the train ride there despite only being 6 minutes felt like a lifetime and the shop was really busy. I got the bare minimum that we needed and more than once I almost abandoned my basket because I felt so anxious. The only thing that stopped me was the worry of what people would think if I just left it. I cried the whole way home and got stared at a lot by other passengers on the train who couldn’t understand why I was sobbing surrounded by shopping bags.

365 days ago I went to the doctors. It’s a 2 minute walk around the corner from where I live and I had to force myself to go because being outside was now terrifying. The noise, the brightness, the people. Everything was just overwhelming. I cried as soon as I started talking and was immediately prescribed medication and signed off sick for 2 weeks while I waited for the worst of the side effects to wear off and for the drugs to kick in. I haven’t returned to work since. The drugs didn’t work, the side effects never wore off. Neither did the following two medications.

I’ve been medication-free for just over a month and am still no closer to returning to work and my level of functioning has barely changed. I’m less physically ill now I’m finally drug-free but the anxiety is not shifting. I now realise that a huge amount of why I was feeling so bad was because of the side effects of the medications I was on rather than the condition itself. This has been very difficult to come to terms with – to know that for 11 of the last 12 months I’ve been made worse by the very thing that was supposed to be making me better. I still don’t have a diagnosis, I haven’t had a new psychiatrist allocated since mine left in October and I’m still not receiving any psychological therapy on the NHS. I’ve just been left to deal with this condition that has no name on my own.

Now my reality is that everyday mundane tasks are completely terrifying. I think back over things I’ve done in the past, things that were huge achievements like my degree, getting the job, moving into university miles away from home and it feels like a completely different person did those things. I think back to all of the small things I used to think nothing of doing like popping to the shops, going on the train to Brighton for the day, visiting my mum on the Isle of Wight, taking the bins out. Now, just thinking about those things makes me feel sick and tense. I can’t fathom how I was able to do them when I’m so frightened of everything now.

My existence is almost solely contained within the walls of my flat and my world has shrunk to be unimaginably small. The person I once was is (I hope) hiding, but it feels like she’s gone. All of the things I’ve done in the past, the small things right up to the huge things don’t seem to count towards my confidence because I can no longer associate with them because they no longer feel like something I did. I’m now the girl who’s scared of her own thoughts, who’s surrounded by wool and spends her days watching tv, crocheting and cleaning. I don’t even recognise the girl with the psychology degree who was going to change the world.

So here I am, one year on. One year and a week ago the world was my oyster and I felt excited about the future, my career, the lives I would try to help change. Now my world mostly consists of fear and distraction from fear. I’m not excited about the future, I’m fearful of it, I don’t know what my future will hold and it’s currently unknown whether I’ll get better, stay like this, or get worse. The biggest thing I have going for me though is that I’m determined, more determined than most and I fight, despite feeling weaker than I thought it possible to feel. I don’t give up and I carry on hoping. I try not to set time-limited goals because I fear failing and feeling even worse, so instead, I hope and I aim for things without setting a time limit. My hope is that my future will be normal, quite uneventful and that I’ll be able to recover, not relapse, and be able to help others because I truly believe that’s what I was put on this planet for. My aim is to get better and to stay well, to decrease stigma, to increase awareness and understanding of mental illness and most of all, to no longer be afraid to go outside and do normal things. Here’s hoping that one year on from now this will all just feel like a bad dream and I’ll be well, working and helping people, if that’s not doable then I just hope that I’ll be better than I am now and I’ll be able to look back and see the improvement. One whole year of fear has been exhausting and this has been one of the longest years of my life. I’m not sure I can face another year like this but at least I’m facing it medication-free and with a few really supportive people around me who cheer me on no matter how small the victory and cheer me up when the condition gets the better of me. Maybe this coming year can be One Year of a Little Less Fear!