(Selections from October, 2009)
I cried in the hospital clinic yesterday.
It's not his fault he was so rushed, uncaring, and uninterested. He's being trained to focus on lab results rather than people, and if the lab results are fine, it's somebody else's business, eh?
But I have the luxury of caring. I don't have responsibility for targets, for integrated pathways, or for commissioning patient tests and services. Therefore, I have the time to actually think about what might be wrong with me. Me. One Person. One non-dying non-emergency person whose bloodwork just happened to be, for the most part, on the right side of normal. Normal. Who really decides what normal is? And why is 220 normal and 180 not?
"Your cortisol levels are fine" ... well actually, you haven't tested them in the afternoon, the evening nor when I am stressed, so what have you really told me about the symptoms I'm reporting? All I've learned is that you are NOT LISTENING to anything I tell you and that you are basing your diagnosis on an unfounded medical assumption that if my levels in a non-stressed morning are fine (and yes, they are low but fine), they must also be fine at 3 pm, when my headaches and fatigue return full force. Thanks for invalidating my actual experience in favour of a single blood test.
"Your testosterone levels are fine but your sex hormone binding globulin is ever so slightly low" ... strange how NOW my barely normal values actually matter to him. Oh wait, you've already decided what was wrong with me based on my phenotype and the occurrence rate of the syndrome, didn't you?
Now I'm really angry.
You see, it's a bit of a sore spot to me. Some doctor came up with an idea about polycystic ovarian syndrome and other doctors ran away with it. And now, thanks to one of the worst diagnostic criteria in the world and way, way too much press, women everywhere can be labelled PCOS just because they ovulate irregularly, are overweight, and (god forbid) aren't perfect little hairless treasures: based on a few inconclusive and conflicting blood tests, irrespective of their personal accounts, because, as we all know, if it can't be discovered by existing blood tests, it doesn't exist. It can't be true. And there are no other reasons for why.
Let me remind you, doctor, since I didn't have the energy or the inclination to do it then, that obesity is not a diagnostic criteria of PCOS. At best, it's a correlation. So, thank you in advance for not listening in your medical statistics class in school. And also thank you for not actually admitting that was the main reason you felt I had PCOS. Because your real reasons sound just so conclusive now in light of my actual results:
(1) My repeated glucose tests are NORMAL. Not even borderline. Not anywhere near that border. In fact, you might say they are my most conclusive test.
(2) My ultrasound showed completely a NORMAL and HEALTHY production of follicles ready for ovulation. Not a single indication of PCOS nor any cysts at all.
(3) My hormones for ovulation (FSH, LH) are NORMAL and my LH peaks as expected. I have every physical indication of ovulating, including changes in my basal temperature. But one mis-timed progesterone test suddenly tells you I didn't ovulate. And one test showing I didn't ovulate means I have PCOS.
I told you I had a very stressful episode which disrupted my menstrual cycle and caused my luteal temperatures to drop early. And you mumbled about how stress can put my ovarian reserves over the edge. Wait, are you trying to tell me that every athlete and high-powered female exec has PCOS? I'm sorry, I had no idea 7% of the population actually meant 70%. Because clearly living a chronically stressed life means absolutely nothing to you. And so, every women who has ever missed a period because of stress must have elevated androgen hormones just waiting gleefully for an excuse to cause polycystic ovaries.
To be honest, other than the wealth of information from these blood tests, which I could've gotten without the insulting interjections from medical professionals, this jaunt in endocrinology was nearly a complete waste of time. I was afraid it would be. I sat down in advance and said to myself "the worst case scenario is if the blood tests come back and all they can say is that I have PCOS".
Now, there's nothing actually wrong with me having PCOS, per se. It's just that: I don't have it. And I'm offended by the idea that a blanket diagnosis is the best they can do. I told him specifically that fertility is just one part of why I was there. And he promptly ignored me.
So, no wonder I started to cry.
My counsellor suggested that there might be something biological going on, as the depression and anxiety never seem to be in reaction to any of my life events. And, the anxiety is getting worse. My endocrinologists say my blood tests are fine and don't even ask about my symptoms or why I am there. No wonder people with mental health problems keep them so quiet. It's not very hard to do, when even medical professionals try to pretend they don't exist, muchless that they have anything to do with MEDICINE.
I can't really say I was surprised though. I already self-referred for CBT before I came to this appointment, because I expected the endocrinology clinic would be useless. So now my little hot potato is being passed back into my hands, and I get to decide whether I want, in the next 18+ weeks of waiting for CBT, to be referred to a reproductive endocrinologist.
I can see that conversation now:
"You are overweight. I cannot tell you what's wrong until you lose weight."
or "You aren't menstruating every 28 days? Here are some drugs."
So very productive. Thanks for that referral. You'd never know that just moments before, I had looked straight into his nervous eye and said "Listen, I could care less about my fertility right now. My priority is sorting out my depression, anxiety, headaches and fatigue first."
It was written all over his face: what does your mental health have to do with me?
Read on the NHS Choices blog.
Friday, 30 October 2009
Thursday, 15 October 2009
Catching you up (18)
(Selections from October, 2009)
The 'nature versus nurture' debate was publicised in the UK via a two part show on BBC -- The Secret Life of Twins -- based on US research. It touches on mental illness among other things.
The philosophical question of 'which came first' (aka the chicken or the egg debate) interests me greatly. I know there are aspects of myself, like my hypersensitivity, which reacted with my environment to provoke certain events, like the traumatic bullying. I also know these events had a lasting effect on aspects of myself, like my personality and how I cope with stress. I suppose cognitive behavioural therapy rests on this same idea: that in knowing the process, you can change yourself through manipulating that process. But where to begin? And is it even possible?
Let's let those questions sit for a while.
In the meantime, I'm reading excerpts from:
If Only I Had Known: Lessons from Gifted Adults
Volume 3 / Issue 3 / Spring 2003
Mary-Elaine Jacobsen, PsyD
---
Well, it's official. I 'opted in' to my referral to the community mental health services. I should be getting a letter in the mail regarding my assessment. They are deciding at their next team meeting who gets the pleasure of judging me. I've already done a full 12 sessions with the counsellor, so now it is on to the next step: in my case, cognitive behavioural therapy.
The problem I have with talking therapies is that I've spent most of my life practicing how to talk and act "right", no matter how I feel. That isn't an easy thing to unpeel. And it really, really needs unpeeling.
I'm quite well insulated from most of my triggers now, being thousands of miles away from my past. But I'm also becoming dangerously antisocial, even sociophobic. When does a strong preference become unhealthy fear? Is it abnormal if I can apply sound logic to it?
I suppose the point is that I know I can be more. And I need help to get there. I need to acknowledge and understand how my life experiences have shaped me. I have many good habits for dealing with depression, but many more worse ones. Habits take time to break.
And I'm just plain scared. My mind may be stable, motivated, and in control, but my body is often riding a completely different train. I feel physically depressed. Restless. Empty. Anxious. I want to die. And then one bad headache, and it all disappears. In comparison, the lack of those bad feelings is so pronounced, it feels almost orgasmic. Relief. Harmony. Optimism. Energy.
Normal. Peaceful. Me.
Read on the NHS Choices blog.
The 'nature versus nurture' debate was publicised in the UK via a two part show on BBC -- The Secret Life of Twins -- based on US research. It touches on mental illness among other things.
The philosophical question of 'which came first' (aka the chicken or the egg debate) interests me greatly. I know there are aspects of myself, like my hypersensitivity, which reacted with my environment to provoke certain events, like the traumatic bullying. I also know these events had a lasting effect on aspects of myself, like my personality and how I cope with stress. I suppose cognitive behavioural therapy rests on this same idea: that in knowing the process, you can change yourself through manipulating that process. But where to begin? And is it even possible?
Let's let those questions sit for a while.
In the meantime, I'm reading excerpts from:
If Only I Had Known: Lessons from Gifted Adults
Volume 3 / Issue 3 / Spring 2003
Mary-Elaine Jacobsen, PsyD
---
Well, it's official. I 'opted in' to my referral to the community mental health services. I should be getting a letter in the mail regarding my assessment. They are deciding at their next team meeting who gets the pleasure of judging me. I've already done a full 12 sessions with the counsellor, so now it is on to the next step: in my case, cognitive behavioural therapy.
The problem I have with talking therapies is that I've spent most of my life practicing how to talk and act "right", no matter how I feel. That isn't an easy thing to unpeel. And it really, really needs unpeeling.
I'm quite well insulated from most of my triggers now, being thousands of miles away from my past. But I'm also becoming dangerously antisocial, even sociophobic. When does a strong preference become unhealthy fear? Is it abnormal if I can apply sound logic to it?
I suppose the point is that I know I can be more. And I need help to get there. I need to acknowledge and understand how my life experiences have shaped me. I have many good habits for dealing with depression, but many more worse ones. Habits take time to break.
And I'm just plain scared. My mind may be stable, motivated, and in control, but my body is often riding a completely different train. I feel physically depressed. Restless. Empty. Anxious. I want to die. And then one bad headache, and it all disappears. In comparison, the lack of those bad feelings is so pronounced, it feels almost orgasmic. Relief. Harmony. Optimism. Energy.
Normal. Peaceful. Me.
Read on the NHS Choices blog.
Thursday, 1 October 2009
Catching you up (17)
(Selections from October, 2009)
Hello. I only found out late last night that side effects of the drugs they had me take for my blood test this morning include depression, anxiety, and suicidal thoughts. This, in combination with the 'other' stressful situation and my normal sensitivity to stress, has made me very depressed and anxious. I would never act on suicidal thoughts, but that doesn't make having them any less difficult.
I wanted to let you all know that I am okay. I, who never share anything of emotional importance to anyone, called my mother-in-law and asked her to come over. I have no idea what I'm going to say when she gets here. This sharing thing is all very new to me. But my instincts just needed someone here, for once.
--- (one day later) ---
Well, that wasn't fun. But I'm pretty sure being alone and letting myself stew in it would've been far worse. I definitely believe that the body needs time to recover and the best you can do for your body is to be in a place with people who can help in that recovery. Whether that's at home, with your family, or in hospital, with professionals, or some combination of medicine and therapy... really depends on you, I guess.
I don't feel tops yet, per se. But I feel supported and in control.
Last night when my mother-in-law (MIL) came over, we just talked. She talked more than me. I didn't really talk about how I felt. It was okay to listen (although very difficult to) and we took a short walk. Then my husband came home, we all had a lovely lamb stew, and she left. I waited patiently for him to finish repairing the fish tank light and then I explained to him fully how I was feeling.
It is incredibly difficult for me to admit that I have mental health problems. As I said to my MIL: "If it was simply that I experienced a horrible and traumatic event, developed PTSD as a result, have lingering depression and anxiety, and cannot cope with social stresses -- I could easily explain and seek treatment." But there was no single event. The resulting mental health problems cannot be defined by a single pro forma. And so, I cannot explain it at all.
Or rather, I can, but who on earth would be prepared to listen and help figure it all out?
I need to stop asking that question. Because really, we won't know the answer to that unless we try. So I decided to recontact my counsellor on Monday and ask for a referral to psychotherapy. Now that I drive, I can more easily access those appointments, and we both agreed on our final meeting to make a decision after taking some time off to think about it.
It's been nearly a year now (can you believe that??) and I understand a bit more how challenging and absorbing maintaining your own mental health is when you are unwell. I admire those who (with or without drugs) work so hard on a daily basis to monitor and care for themselves. Being a carer can be a full-time job for some: caring for yourself isn't any different.
I've spent most of my life self-managing traumatic stress, deep depression, and increasing anxiety. It's amazing, when you think how Able I am. How, even when feeling so empty and alone and wanting death more than anything, I still manage to care for myself. It's no less amazing you achieve it, too.
I feared that people would say I don't really have depression. Because I can smile, walk, talk, participate. I don't complain, least of all about myself. I'm not pessimistic. I'm not angry. But I am angry. I am deeply sad. I just know enough about surviving depression to not let myself think what I feel. This is precisely why talking therapy wasn't very helpful. The problem is believing that I'm fine just because I can say I am fine.
I'm not fine.
I have not properly dealt with all that emotion. I still feel crippled by my sensitivity to it and to others. I do not have adequate adrenal reserves to deal with stressful situations. I am easily triggered by people and interjected memories from my past. And looking forward to death is not a humane way to live.
So it's time for more radical lifestyle changes. We're packing up most of our house and putting it away. I feel regularly overwhelmed with the responsibility for all of my Things. So, I'm taking my Things away until I feel I can manage. Less to tidy, less to clean, less pressure on me. More space to create.
I'm spending more time with family. I'm not avoiding other people per se, but I'm erring on the side of caution when getting involved with new and other people. No more collaborative projects. No more selling my work online. I cannot afford to manage those relationships. I am happy and comfortable with the distance between me and my local friends. I will not pressure myself into developing more out of it.
I will live more locally. Participate and volunteer in community events. Give my work to charity, which always gives me great joy. Work with my hands, in my house. Do more DIY. Walk outside.
I will start taking my vitamins again now that the tests are done. Clearly, I have a vitamin deficiency and taking supplements is warranted (Vitamin D, Calcium). I want to increase my Omega 3 as well. When eating for eatings sake, I will try fruit and vegetables first before going for a biscuit. Did you know you should really be eating 9 a day, not 5, but the government thought 9 too depressingly difficult for most people to achieve?
I will be more honest with myself about my career plans. Do I want to learn X because I want to help myself or because I want to help others? I will be honest about the situations and roles in which I cannot cope. In a hierarchy, for example. In research. Being accountable to many people. Doing the same thing over and over again. It's not so much about the topic or content of the role but in the process and day-to-day. I like my current job especially because it's a fixed contract. I like being able to change and leave when I want to. I like new challenges and new people.
Most importantly, I will make every effort to prioritise these changes. I will acknowledge my mistakes and make every effort to fulfil my responsibilities to other people, but I will also recognise these as responsibilities to myself. And I guess we'll see if managing each day becomes easier.
Read on the NHS Choices blog.
Hello. I only found out late last night that side effects of the drugs they had me take for my blood test this morning include depression, anxiety, and suicidal thoughts. This, in combination with the 'other' stressful situation and my normal sensitivity to stress, has made me very depressed and anxious. I would never act on suicidal thoughts, but that doesn't make having them any less difficult.
I wanted to let you all know that I am okay. I, who never share anything of emotional importance to anyone, called my mother-in-law and asked her to come over. I have no idea what I'm going to say when she gets here. This sharing thing is all very new to me. But my instincts just needed someone here, for once.
--- (one day later) ---
Well, that wasn't fun. But I'm pretty sure being alone and letting myself stew in it would've been far worse. I definitely believe that the body needs time to recover and the best you can do for your body is to be in a place with people who can help in that recovery. Whether that's at home, with your family, or in hospital, with professionals, or some combination of medicine and therapy... really depends on you, I guess.
I don't feel tops yet, per se. But I feel supported and in control.
Last night when my mother-in-law (MIL) came over, we just talked. She talked more than me. I didn't really talk about how I felt. It was okay to listen (although very difficult to) and we took a short walk. Then my husband came home, we all had a lovely lamb stew, and she left. I waited patiently for him to finish repairing the fish tank light and then I explained to him fully how I was feeling.
It is incredibly difficult for me to admit that I have mental health problems. As I said to my MIL: "If it was simply that I experienced a horrible and traumatic event, developed PTSD as a result, have lingering depression and anxiety, and cannot cope with social stresses -- I could easily explain and seek treatment." But there was no single event. The resulting mental health problems cannot be defined by a single pro forma. And so, I cannot explain it at all.
Or rather, I can, but who on earth would be prepared to listen and help figure it all out?
I need to stop asking that question. Because really, we won't know the answer to that unless we try. So I decided to recontact my counsellor on Monday and ask for a referral to psychotherapy. Now that I drive, I can more easily access those appointments, and we both agreed on our final meeting to make a decision after taking some time off to think about it.
It's been nearly a year now (can you believe that??) and I understand a bit more how challenging and absorbing maintaining your own mental health is when you are unwell. I admire those who (with or without drugs) work so hard on a daily basis to monitor and care for themselves. Being a carer can be a full-time job for some: caring for yourself isn't any different.
I've spent most of my life self-managing traumatic stress, deep depression, and increasing anxiety. It's amazing, when you think how Able I am. How, even when feeling so empty and alone and wanting death more than anything, I still manage to care for myself. It's no less amazing you achieve it, too.
I feared that people would say I don't really have depression. Because I can smile, walk, talk, participate. I don't complain, least of all about myself. I'm not pessimistic. I'm not angry. But I am angry. I am deeply sad. I just know enough about surviving depression to not let myself think what I feel. This is precisely why talking therapy wasn't very helpful. The problem is believing that I'm fine just because I can say I am fine.
I'm not fine.
I have not properly dealt with all that emotion. I still feel crippled by my sensitivity to it and to others. I do not have adequate adrenal reserves to deal with stressful situations. I am easily triggered by people and interjected memories from my past. And looking forward to death is not a humane way to live.
So it's time for more radical lifestyle changes. We're packing up most of our house and putting it away. I feel regularly overwhelmed with the responsibility for all of my Things. So, I'm taking my Things away until I feel I can manage. Less to tidy, less to clean, less pressure on me. More space to create.
I'm spending more time with family. I'm not avoiding other people per se, but I'm erring on the side of caution when getting involved with new and other people. No more collaborative projects. No more selling my work online. I cannot afford to manage those relationships. I am happy and comfortable with the distance between me and my local friends. I will not pressure myself into developing more out of it.
I will live more locally. Participate and volunteer in community events. Give my work to charity, which always gives me great joy. Work with my hands, in my house. Do more DIY. Walk outside.
I will start taking my vitamins again now that the tests are done. Clearly, I have a vitamin deficiency and taking supplements is warranted (Vitamin D, Calcium). I want to increase my Omega 3 as well. When eating for eatings sake, I will try fruit and vegetables first before going for a biscuit. Did you know you should really be eating 9 a day, not 5, but the government thought 9 too depressingly difficult for most people to achieve?
I will be more honest with myself about my career plans. Do I want to learn X because I want to help myself or because I want to help others? I will be honest about the situations and roles in which I cannot cope. In a hierarchy, for example. In research. Being accountable to many people. Doing the same thing over and over again. It's not so much about the topic or content of the role but in the process and day-to-day. I like my current job especially because it's a fixed contract. I like being able to change and leave when I want to. I like new challenges and new people.
Most importantly, I will make every effort to prioritise these changes. I will acknowledge my mistakes and make every effort to fulfil my responsibilities to other people, but I will also recognise these as responsibilities to myself. And I guess we'll see if managing each day becomes easier.
Read on the NHS Choices blog.
Tuesday, 1 September 2009
Catching you up (16)
(Selections from September, 2009)
I am less afraid of having adrenal failure than of having nothing wrong. Because if there is 'nothing wrong' that almost means I'm supposed to feel this way. Feeling this way is normal. And I won't believe that. I can't start believing that now.
This endocrinologist took a detailed notes and began talking about PCOS. 'We need to rule out other things first' but essentially the treatment for PCOS-like symptoms is the same. There is no real treatment, except against insulin resistance and anovulation. Except I'm ovulating. And, I'm not insulin resistant.
I have 6 weeks to mentally prepare myself for an intellectual fight with a bunch of medical specialists. 'Partially secondary adrenal insufficiency' is my best guess now. It's the only thing to explain these clockwork of reactions my body has to stress. It's conceivable to me, that there is some lasting impact of being chronically stressed from pre-puberty to now, and this would be it. The HPA axis can be shaped, can crumble slowly away, and I am more confident mine is.
The trigger initiates a stress reaction with the hypothalamus (Tertiary). This disrupts signals to the Pituitary (Secondary) which over time, drains the Adrenal reserves (Primary). It takes a time to recover to 'normal' levels and it's getting harder and harder every year.
Am I going to be a pioneer? Am I even a pioneer? This endocrinology team is supposedly the best in the nation, and I wait quietly in my house wondering if they will have the creativity to think beyond their ICD-10 codes (primary diagnosis categories). Call me strict, but I don't believe anything is strictly psychological. And I'm only anxious, detached, and (dare I say?) suicidal in the long recovery period after stress. I know nearly every trick in the book to recover more quickly, but that still begs the fact that I've something to recover from… that, though I can walk, talk, and earn a payslip, I am still dangerously fragile and only as strong as the people and places I've surrounded myself with.
Did you know suicide victims are found to have hyperactive pituitaries? Their bodies aren't right. Yet, their symptoms were not loud enough to elicit appropriate help.
Did you know even the small pain from headaches is enough to help lift cortisol and therefore enable your body to operate more normally?
It's all just a bit too coincidental to not matter.
---
I don't seem to have the same sense of time as other people. Hence, I get two upset emails late in the evening, answer one, go to bed, and wake up to find another angry email about not replying to the other one in less than 12 hours. And I'm baffled!
I actively buffer myself with non-threatening and non-confrontational people, doing my utmost to avoid emotionally charged or stressful situations. It isn't always successful. I avoid friendships because I tend to easily and overwhelmingly feel whatever other people are feeling. While I concede that a little empathy is needed in this world, I can say with confidence that a lot of empathy certainly isn't.
It is not healthy for anyone to feel someone's uncontrolled anger.
But I can't expect everyone to handle their emotions in a controlled and productive way, can I? I need to prepare myself. I need to learn how to be strong and controlled and assertive even when the levy breaks. Even and especially when everyone else is laying all of their anger and fear and pride on me.
Well, okay, one person isn't everyone, but I still think I handled this situation extremely well. I was already emotionally tender. Been having empty, dark, and unhealthy thoughts for over a week, unrelated to this latest issue. In the past, I would have avoided this person and let their own willful silence protect me. But instead, I took the morally high ground, explained why I have been feeling uncomfortable and confused, and invited him to share what he is frustrated with.
I can't believe it! He actually does! This might actually improve!
But, like most people, once the anger is released, it tends to get out of control. His email is dripping with attacks, so very different from his previous polite silence. Although time brings more attacks and insecurities from him, I am the parent in this situation. None of this emotion will last. He needs me to reiterate all the positive things I said and continue to be there, even after he's used up all of his anger. If his attacks were personal, I would've stopped them immediately, but they are nothing more than bending of words, imbuing negativity where there is none, projecting anger on me, simple insecurities. Complex pride. Like a child.
We are all children. The mistake is thinking we grow into something different or better. But there are layers to all of us, biologically, that we access when 'needs must'. Everyone becomes, at some point, unreasonable and overemotional. Only time can make us whole again.
So I thank him for sharing, I reassure him, and I wait.
Moreover, despite how sad and stressed I feel, I also feel proud of myself. I could not have handled the situation any better. I faced and felt the emotions, acknowledged his feelings and my mistakes, and I communicated them productively, even when he was out of control. I protected myself against the attacks without insulating myself from the grief at making a mistake and letting someone down. Whether with time he calms down and forgives is not something I can control. I've done all I can to make peace both with him and within me.
That still leaves those empty, dark, and unhealthy thoughts, though.
Read on the NHS Choices blog.
I am less afraid of having adrenal failure than of having nothing wrong. Because if there is 'nothing wrong' that almost means I'm supposed to feel this way. Feeling this way is normal. And I won't believe that. I can't start believing that now.
This endocrinologist took a detailed notes and began talking about PCOS. 'We need to rule out other things first' but essentially the treatment for PCOS-like symptoms is the same. There is no real treatment, except against insulin resistance and anovulation. Except I'm ovulating. And, I'm not insulin resistant.
I have 6 weeks to mentally prepare myself for an intellectual fight with a bunch of medical specialists. 'Partially secondary adrenal insufficiency' is my best guess now. It's the only thing to explain these clockwork of reactions my body has to stress. It's conceivable to me, that there is some lasting impact of being chronically stressed from pre-puberty to now, and this would be it. The HPA axis can be shaped, can crumble slowly away, and I am more confident mine is.
The trigger initiates a stress reaction with the hypothalamus (Tertiary). This disrupts signals to the Pituitary (Secondary) which over time, drains the Adrenal reserves (Primary). It takes a time to recover to 'normal' levels and it's getting harder and harder every year.
Am I going to be a pioneer? Am I even a pioneer? This endocrinology team is supposedly the best in the nation, and I wait quietly in my house wondering if they will have the creativity to think beyond their ICD-10 codes (primary diagnosis categories). Call me strict, but I don't believe anything is strictly psychological. And I'm only anxious, detached, and (dare I say?) suicidal in the long recovery period after stress. I know nearly every trick in the book to recover more quickly, but that still begs the fact that I've something to recover from… that, though I can walk, talk, and earn a payslip, I am still dangerously fragile and only as strong as the people and places I've surrounded myself with.
Did you know suicide victims are found to have hyperactive pituitaries? Their bodies aren't right. Yet, their symptoms were not loud enough to elicit appropriate help.
Did you know even the small pain from headaches is enough to help lift cortisol and therefore enable your body to operate more normally?
It's all just a bit too coincidental to not matter.
---
I don't seem to have the same sense of time as other people. Hence, I get two upset emails late in the evening, answer one, go to bed, and wake up to find another angry email about not replying to the other one in less than 12 hours. And I'm baffled!
I actively buffer myself with non-threatening and non-confrontational people, doing my utmost to avoid emotionally charged or stressful situations. It isn't always successful. I avoid friendships because I tend to easily and overwhelmingly feel whatever other people are feeling. While I concede that a little empathy is needed in this world, I can say with confidence that a lot of empathy certainly isn't.
It is not healthy for anyone to feel someone's uncontrolled anger.
But I can't expect everyone to handle their emotions in a controlled and productive way, can I? I need to prepare myself. I need to learn how to be strong and controlled and assertive even when the levy breaks. Even and especially when everyone else is laying all of their anger and fear and pride on me.
Well, okay, one person isn't everyone, but I still think I handled this situation extremely well. I was already emotionally tender. Been having empty, dark, and unhealthy thoughts for over a week, unrelated to this latest issue. In the past, I would have avoided this person and let their own willful silence protect me. But instead, I took the morally high ground, explained why I have been feeling uncomfortable and confused, and invited him to share what he is frustrated with.
I can't believe it! He actually does! This might actually improve!
But, like most people, once the anger is released, it tends to get out of control. His email is dripping with attacks, so very different from his previous polite silence. Although time brings more attacks and insecurities from him, I am the parent in this situation. None of this emotion will last. He needs me to reiterate all the positive things I said and continue to be there, even after he's used up all of his anger. If his attacks were personal, I would've stopped them immediately, but they are nothing more than bending of words, imbuing negativity where there is none, projecting anger on me, simple insecurities. Complex pride. Like a child.
We are all children. The mistake is thinking we grow into something different or better. But there are layers to all of us, biologically, that we access when 'needs must'. Everyone becomes, at some point, unreasonable and overemotional. Only time can make us whole again.
So I thank him for sharing, I reassure him, and I wait.
Moreover, despite how sad and stressed I feel, I also feel proud of myself. I could not have handled the situation any better. I faced and felt the emotions, acknowledged his feelings and my mistakes, and I communicated them productively, even when he was out of control. I protected myself against the attacks without insulating myself from the grief at making a mistake and letting someone down. Whether with time he calms down and forgives is not something I can control. I've done all I can to make peace both with him and within me.
That still leaves those empty, dark, and unhealthy thoughts, though.
Read on the NHS Choices blog.
Saturday, 1 August 2009
Catching you up (15)
(Selections from August, 2009)
I think Stress has a problem with me. I've been keeping meticulous track of my health, nutrition, etc. for several months now. I am like happy clockwork, but now the work-related stress has increased. I lose my very explicit health journal somewhere, please anywhere but the friends' house we stayed in last weekend. I take two days off for a pre-booked holiday. I run out of omega vitamins. And my temperature drops. Sudden continuous cramps. Skin gets worse. Anxiety levels start to broach dissociative levels. Migraines. I know what hormones are causing this, but they shouldn't be causing it a week before ovulation.
Can I be the supermodel of mindfulness?
Because certainly without this very active monitoring, I would be far, far worse. Even when I feel the sour taste of dissociation, that lingering soup of emptiness "what if" floats in, I:
Look out a window
Hold his hand
Take a photograph
Read a chapter
Watch a show
Play a game
Eat
The latter being the least healthy of the above.
I'm losing faith that I will ever be able to cope in a job that involves some intensely stressful times. Would this be worse if I wasn't regularly exercising (which I love, when I actually go)? Should I count my blessings that it's only affecting me this much?
I try to remain ambivalent, but I recognise the patterns too well now. I am deteriorating.
---
I'm going to see a specialist. An endocrinologist, in fact. Despite working in healthcare myself, I feel a bit uneasy about it. What if I'm wrong? What if it's all in my head? I don't have a medical degree, so I feel automatically unqualified to make any decisions about my care. So, here's the evidence:
I was shorter and more boyish than my female counterparts, until puberty hit. Magically, in a year, I grew to my full height and suddenly I had breasts of porn star quality. I take it that doesn't happen for everyone? It's supposed to last longer than that. Puberty. Periods were extremely light, and I often never had them at all. Didn't miss them.
I had no desire. Not really. If I did, I wouldn't have turned away all those guys over those years in physical disgust, sometimes literally. Even the ones I loved. I was completely asexual. Not homosexual and not heterosexual: Asexual.
I steadily gained weight, entirely in my torso, and it continues today. Entirely in my torso. I look pregnant. This doesn't seem normal, to me. If I lose weight, I look even more pregnant, as my legs and arms become more and more toned. But still, the belly persists. The breasts are balloons. I look like an asexual pregnant porn star. Or a classical Venus of Fertility. Except, I am neither a porn star nor fertile.
Which came first, the stress or the addiction to it? No doubt I had an extraordinarily stressful childhood. I suffered severe, chronic stress and depression for many, many years. Not months, years. It seems like pocket change now, 10 years. A dime. 315,360,000 seconds of cortisol and sugar and tears.
And then I got sick.
And kept getting sick. Getting sick, sick, sick, until I left home. And then the sickness went to my head. I was so fragile. So sensitive. So raw. I couldn't cope with any criticism, any negativity. I held everything together for 1 year. 2 years. Crack. And then I was sick.
I don't know when the anxiety appeared. It was subtle. It still is. I coped by leaving. Leaving home, leaving school, leaving work, leaving him, leaving the country. It always worked. For at least 31,536,000 seconds. And then I get sick.
In all honesty, much of that time has been spent trying to understand why. I'm not working in healthcare solely because of a great desire to heal the world. It feeds my addiction. Second by second. Coping, lasting, getting to tomorrow. Another 1440. Anything to know more, to solve the mystery of me.
People honestly don't live like this? I'm not sure I can comprehend that. My number one goal in counselling was to stop leaving, but I ended my last session still having no idea how I got to the point of leaving, to begin with. And then I left my job and...
I got sick.
Scientifically, I know practically the entire process. Psychologically, I cannot accept it. Am I responding to bad situations that need to change or am I responding poorly to average situations and I need to change? Surely 630,720,000 seconds is more than bad habits and coincidence?
I know myself. I know my life. I've been keeping busy and doing anything I can to get by. I'm damned lucky. And I'm damned good at surviving. That's saying something, because I am definitely not well. I have never been well.
This insidious imbalance in me will not win.
---
Thinking on my scattered and many talents, it suddenly occurred to me that perhaps I didn't know what to be when I grew up because I didn't actually want to be anything at all...
Except me, just as I was.
And will always be.
Read on the NHS Choices blog.
I think Stress has a problem with me. I've been keeping meticulous track of my health, nutrition, etc. for several months now. I am like happy clockwork, but now the work-related stress has increased. I lose my very explicit health journal somewhere, please anywhere but the friends' house we stayed in last weekend. I take two days off for a pre-booked holiday. I run out of omega vitamins. And my temperature drops. Sudden continuous cramps. Skin gets worse. Anxiety levels start to broach dissociative levels. Migraines. I know what hormones are causing this, but they shouldn't be causing it a week before ovulation.
Can I be the supermodel of mindfulness?
Because certainly without this very active monitoring, I would be far, far worse. Even when I feel the sour taste of dissociation, that lingering soup of emptiness "what if" floats in, I:
Look out a window
Hold his hand
Take a photograph
Read a chapter
Watch a show
Play a game
Eat
The latter being the least healthy of the above.
I'm losing faith that I will ever be able to cope in a job that involves some intensely stressful times. Would this be worse if I wasn't regularly exercising (which I love, when I actually go)? Should I count my blessings that it's only affecting me this much?
I try to remain ambivalent, but I recognise the patterns too well now. I am deteriorating.
---
I'm going to see a specialist. An endocrinologist, in fact. Despite working in healthcare myself, I feel a bit uneasy about it. What if I'm wrong? What if it's all in my head? I don't have a medical degree, so I feel automatically unqualified to make any decisions about my care. So, here's the evidence:
I was shorter and more boyish than my female counterparts, until puberty hit. Magically, in a year, I grew to my full height and suddenly I had breasts of porn star quality. I take it that doesn't happen for everyone? It's supposed to last longer than that. Puberty. Periods were extremely light, and I often never had them at all. Didn't miss them.
I had no desire. Not really. If I did, I wouldn't have turned away all those guys over those years in physical disgust, sometimes literally. Even the ones I loved. I was completely asexual. Not homosexual and not heterosexual: Asexual.
I steadily gained weight, entirely in my torso, and it continues today. Entirely in my torso. I look pregnant. This doesn't seem normal, to me. If I lose weight, I look even more pregnant, as my legs and arms become more and more toned. But still, the belly persists. The breasts are balloons. I look like an asexual pregnant porn star. Or a classical Venus of Fertility. Except, I am neither a porn star nor fertile.
Which came first, the stress or the addiction to it? No doubt I had an extraordinarily stressful childhood. I suffered severe, chronic stress and depression for many, many years. Not months, years. It seems like pocket change now, 10 years. A dime. 315,360,000 seconds of cortisol and sugar and tears.
And then I got sick.
And kept getting sick. Getting sick, sick, sick, until I left home. And then the sickness went to my head. I was so fragile. So sensitive. So raw. I couldn't cope with any criticism, any negativity. I held everything together for 1 year. 2 years. Crack. And then I was sick.
I don't know when the anxiety appeared. It was subtle. It still is. I coped by leaving. Leaving home, leaving school, leaving work, leaving him, leaving the country. It always worked. For at least 31,536,000 seconds. And then I get sick.
In all honesty, much of that time has been spent trying to understand why. I'm not working in healthcare solely because of a great desire to heal the world. It feeds my addiction. Second by second. Coping, lasting, getting to tomorrow. Another 1440. Anything to know more, to solve the mystery of me.
People honestly don't live like this? I'm not sure I can comprehend that. My number one goal in counselling was to stop leaving, but I ended my last session still having no idea how I got to the point of leaving, to begin with. And then I left my job and...
I got sick.
Scientifically, I know practically the entire process. Psychologically, I cannot accept it. Am I responding to bad situations that need to change or am I responding poorly to average situations and I need to change? Surely 630,720,000 seconds is more than bad habits and coincidence?
I know myself. I know my life. I've been keeping busy and doing anything I can to get by. I'm damned lucky. And I'm damned good at surviving. That's saying something, because I am definitely not well. I have never been well.
This insidious imbalance in me will not win.
---
Thinking on my scattered and many talents, it suddenly occurred to me that perhaps I didn't know what to be when I grew up because I didn't actually want to be anything at all...
Except me, just as I was.
And will always be.
Read on the NHS Choices blog.
Wednesday, 1 July 2009
Catching you up (14)
(Selections from July, 2009)
My interjected memories are the most benign memories I have. I don't know how or why they became affiliated with such a rush of adrenaline and anxiety.
I don't remember the good moments.
---
I am not 'mentally ill', because I don't believe in that sort of label for myself. Everyone is, to some degree, mentally different. Some differences are more healthy, more consistently healthy anyways, than others. For much of my childhood, I suffered extreme, prolonged stress and depression. This will have certainly had a lasting, physical effect on me: my body, my brain, my personality, my everything.
I possibly disagree with the theories that disorders like PTSD can be cured. It's shown that the body can recover and so certainly the brain can as well, but most illnesses are incredibly complex things: more than just the sum of their symptoms. A diagnosis is rarely more than a best guess to guide best practice. Medicine, as a science, has a very long way to go, especially when it comes to neurochemistry.
I am no longer me without those interjected memories, those 20 unforgettable years. So it really becomes inconsequential whether I am, right now, mentally ill. The path forward doesn't need that diagnosis. Whereas, having an abscess really does require some sort of clear description. I still have the abscess, but I am no longer physically ill. Now it is a part of me, and I cannot pretend I should be any different.
I have a small lump that wanes and waxes with the day. I have breathless, vivid reminders of people and places of my past, dancing with today in my brain. I am perfectly fertile but have no children. I struggle to remember satisfaction. Feelings, good and bad, don't have a great shelf life in Chez Eliza.
And these are imprecise pieces of me.
---
The solicitor who triggered my PTSD and anxiety several years ago with the multitude of ways he and his staff royally messed up our conveyancing and then verbally attacked me for writing a letter of complaint.... is still, several years later, writing us letters revealing yet another way they've messed up our conveyancing.
It's taken me, well, four years to get over that particular trauma, and I still can't handle explaining to people what happened as it makes me so stressed. I'll be damned if I get pulled into another abusive situation over a bill they forgot to pay. YEARS, not months. And they didn't even post some proof of invoice with the letter, just a letter begging for money. Right. Like I trust them over the random African businessman begging for money in my SPAM folder. Never.
---
I've been keeping detailed journals of my nutrition and my health for nearly two months now, and even knowing as much biology as I do (which is a lot) I am shocked how much of my moods and well-being is affected by hormones. I can see now, how some of the natural cycles of the body feed into cycles of mental health.
For example, increasing progesterone post ovulation raises the core body temperature and results in hot flashes. Between the two of them, I start having broken, inadequate sleep, resulting in headaches and increased stress. I concentrate less and get less housework done, which further increases my stress. The temperature rises to a point where the broken sleep causes dissociation and feelings of 'death/detachment' in addition to delirium. I suffer anxiety about feeling so sick/low, which to be honest is right on time as the increase in estrogen causes marked anxiety and strong cravings for fullness, ironic because my cells are so bloated. Menstruation almost seems like a relief, when you really look at it.
I merely point out to my male audience that they don't even have the luxury of that break, so there's no opportunity for gloating.
Read on the NHS Choices blog.
My interjected memories are the most benign memories I have. I don't know how or why they became affiliated with such a rush of adrenaline and anxiety.
I don't remember the good moments.
---
I am not 'mentally ill', because I don't believe in that sort of label for myself. Everyone is, to some degree, mentally different. Some differences are more healthy, more consistently healthy anyways, than others. For much of my childhood, I suffered extreme, prolonged stress and depression. This will have certainly had a lasting, physical effect on me: my body, my brain, my personality, my everything.
I possibly disagree with the theories that disorders like PTSD can be cured. It's shown that the body can recover and so certainly the brain can as well, but most illnesses are incredibly complex things: more than just the sum of their symptoms. A diagnosis is rarely more than a best guess to guide best practice. Medicine, as a science, has a very long way to go, especially when it comes to neurochemistry.
I am no longer me without those interjected memories, those 20 unforgettable years. So it really becomes inconsequential whether I am, right now, mentally ill. The path forward doesn't need that diagnosis. Whereas, having an abscess really does require some sort of clear description. I still have the abscess, but I am no longer physically ill. Now it is a part of me, and I cannot pretend I should be any different.
I have a small lump that wanes and waxes with the day. I have breathless, vivid reminders of people and places of my past, dancing with today in my brain. I am perfectly fertile but have no children. I struggle to remember satisfaction. Feelings, good and bad, don't have a great shelf life in Chez Eliza.
And these are imprecise pieces of me.
---
The solicitor who triggered my PTSD and anxiety several years ago with the multitude of ways he and his staff royally messed up our conveyancing and then verbally attacked me for writing a letter of complaint.... is still, several years later, writing us letters revealing yet another way they've messed up our conveyancing.
It's taken me, well, four years to get over that particular trauma, and I still can't handle explaining to people what happened as it makes me so stressed. I'll be damned if I get pulled into another abusive situation over a bill they forgot to pay. YEARS, not months. And they didn't even post some proof of invoice with the letter, just a letter begging for money. Right. Like I trust them over the random African businessman begging for money in my SPAM folder. Never.
---
I've been keeping detailed journals of my nutrition and my health for nearly two months now, and even knowing as much biology as I do (which is a lot) I am shocked how much of my moods and well-being is affected by hormones. I can see now, how some of the natural cycles of the body feed into cycles of mental health.
For example, increasing progesterone post ovulation raises the core body temperature and results in hot flashes. Between the two of them, I start having broken, inadequate sleep, resulting in headaches and increased stress. I concentrate less and get less housework done, which further increases my stress. The temperature rises to a point where the broken sleep causes dissociation and feelings of 'death/detachment' in addition to delirium. I suffer anxiety about feeling so sick/low, which to be honest is right on time as the increase in estrogen causes marked anxiety and strong cravings for fullness, ironic because my cells are so bloated. Menstruation almost seems like a relief, when you really look at it.
I merely point out to my male audience that they don't even have the luxury of that break, so there's no opportunity for gloating.
Read on the NHS Choices blog.
Monday, 1 June 2009
Catching you up (13)
(Selections from June, 2009)
There's new writing on my blackboard. "Do not self-censor."
I don't mean say and do everything that comes to mind. But everything deserves due consideration. When I am used to living so privately, so carefully, so avoidantly... I need to stretch. I need to ask myself: "What is really stopping me?"
"What am I trying to hide?"
---
The memories, those little wisps, they are starting to interject themselves into my days again. Breathless, disjointed pauses. Just one unified moment of taste touch smell sound... sight. One hour, researching NHS guidelines. One millisecond, Lost friendship. Remember. And it lingers, that one millisecond of nothing, while the rest of the hour fades away.
They are coming, more and more frequent. The answer is two months. Two months of stirring up dust. Two months new. And then the brain starts flipping channels.
Tonight I walked in place.
I will forget. I will.
Read on the NHS Choices blog.
There's new writing on my blackboard. "Do not self-censor."
I don't mean say and do everything that comes to mind. But everything deserves due consideration. When I am used to living so privately, so carefully, so avoidantly... I need to stretch. I need to ask myself: "What is really stopping me?"
"What am I trying to hide?"
---
The memories, those little wisps, they are starting to interject themselves into my days again. Breathless, disjointed pauses. Just one unified moment of taste touch smell sound... sight. One hour, researching NHS guidelines. One millisecond, Lost friendship. Remember. And it lingers, that one millisecond of nothing, while the rest of the hour fades away.
They are coming, more and more frequent. The answer is two months. Two months of stirring up dust. Two months new. And then the brain starts flipping channels.
Tonight I walked in place.
I will forget. I will.
Read on the NHS Choices blog.
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