There are good days and then the bad days

Energy energy where did you go? I had you. We were reunited. My arteries hummed with effervescence. Stuff got planned. Smiles crept out. The smiling girl in my wedding photos was back.

Bam!

God I missed her. Pre-depression me. She was awesome. I almost forgot what she felt like. Lots of days now I can feel her coming back. Filling me out. Blooming inside me. My own Spring. Buds pushing through. Come on! Come quickly!

I feel impatient to get better. Now that I am out of the fug, the worst of it is over, I can look back on being depressed rather than be in it. This of course is most most awesome. Like realising something precious you thought you’d lost was actually just hidden in the back of your wardrobe.

I do of course still have bad days. Tired sinking feeling days. Yesterday was one such day. I was tired. Bone tired. Dog tired. It had been coming on for a few days. Being back at work full time is hard. I am determined to make it work but it is of course tough after being on sick leave for a whole month. I start my new job in a few weeks and and I desperate to be better by then. Is this unrealistic? Possible. Am I putting too much pressure on myself- yes maybe.

Are we going down that road again? We could be. It doesn’t have to be a problem though, does it? I have learned lessons and I can apply them:

1. Acknowledging that I get stressed and that is ok.

2. Accepting that I am prone to getting depressed when overwhelmed or underwhelmed and this leads to not looking after myself.

3. Preparing myself and protecting myself is important- eating properly, getting rest and breaks and trying to have some kind of work life balance.

And being compassionate in my views of myself. Says my therapist.

This is what I need to do to look after myself.

Let’s see how it goes…..

 

 

 

“Disclosing” mental illness

There’s something abut the word depression  that I dislike. Many things, if I’m honest. It’s not the kind of thing you want attached to you. You don’t aspire to it. It ain’t glamorous. 

Even when I was a goth in my teenage years I never went in for melancholy.

Depression, once it gets tagged onto you, applied to you as a label, a diagnosis, it sticks. I wish to see it as a temporary thing- like flu, or gastroenteritis. Unfortunate but you’ll get over it. But it’s not, is it? It’s sort of hanging on; going to hang on to you, like a bit of extra skin you grew. Scaly.

I fought hard against that label. My GP and later on psychiatrist, patted it gently on me. I scratched it off. Depressed?! Me? Ain’t nobody got time for that! It took me two months of therapy to accept that yes I am depressed, and no that doesn’t mean I am a failure, incapable of continuing on the achievement merrygoround of life.

Six months on and I can accept being depressed. I believe it. Its there, a part of me. I am taking my medication with my coffee in the morning and it’s just a routine now. To start with just taking the tablets down from the cupboard filled me with shame. I hid them away any time we had a visitor.

The tablets are still hidden, but in a nice tea caddy. They are my secret, private.

My depression remains my secret. I might allude to it, in very couched terms. I am not comfortable with anyone but my husband and my sister knowing. 

Telling others? Nope. Less complicated that way. Don’t want to talk about. Can’t be bothered getting into it, explaining it, justifying it.

Telling people at work. NO FRICKING WAY. In healthcare we call this “disclosing”. Your employer should not, can not discriminate against you for having mental illness. They shouldn’t as they won’t, by law, get away with it (assuming the mentally ill person has the wherewithal  energy or motivation to call them on it).

But they might discriminate against you indirectly, unconsciously. Their view of you may differ. Projects may not come your way “don’t want to put extra stress on you”. Even if they don’t see you differently you might not be able to shake the feeling that they do.

Give other people some credit I hear you say- don’t assume that people will discriminate against you or think less of you if you disclose your mental illness. They might not. You wouldn’t, would you, if one of your staff disclosed to you?

I don’t even really know the answer to that. 6 months ago I couldn’t accept a diagnosis of depression because I saw it as a sign of weakness, failure, pathetic. And I’m a highly ethical, moral and humanistic person. 

My view on depression has changed. I have accepted it within myself. Is the next step feeling confident to disclose it to others?

And how hard must it be for people with more serious mental illness? You need to be a real tough cookie to wear that badge with confidence and yet complex mental illness saps your confidence and self efficacy to levels lower than most of us can even imagine.

I feel strongly about this. I wish there was something I could do towards this. I think it’s amazing, and shows such promise for the future when high profile celebrities like Stephen Fry, and politicians speak out publicly about their mental illness. Bravo.

Two steps forward…one step back

I don’t even want to write but I am going to try to, instead of going upstairs to wake my husband up and tell him how crap I feel.

It’s morning here in London. My neighbours have already left for work- my train goes soon. 

I don’t want to go, have to go, can’t drag enough energy to go.

Last night I purged. In the shower. Why? No I hadn’t binged. I just felt full. Uncomfortably full because maybe I’m not used to eating a normal amount. 

In the shower? Desperately washing away bits of food. Bulimia is dirty. It’s a stain. I’m ashamed. There was an episode a few days ago too. Slipping back in, to that bastard state. 

I have a job to go too. I start a new job in a few weeks. I don’t have room for bulimia and food restriction and size 2 jeans and infertility. 

Relapse. Exhausting and annoyingly predictable.

 

Yes, OK, I’ll give that a try….and other lies I told my Dietitian.

 

I had my initial appointment with the dietitian today.

I am sure this woman is well- used to her clients lying to her, telling her what she wants to hear and denying what she tells them. I am sure that she has been looked at in horror, laughed at, cried upon and maybe even been verbally abused. No, definitely.

I went willingly to my appointment. I requested it. I may be depressed and eating disordered but my need to be a good girl will always win out. So I am trying to be a good anorexic depressed person.

Here are the thoughts going through my head as I walk down the psych hospital corridor to outpatients:

1. Trying to strike the balance between walking without a care in the world and avoiding eye contact in case I bump into anyone from work (yes I work in the neighbouring hospital).

2. This won’t be too bad- all of the staff here so far have been great and she will be on my side.

3. Why is there a baby changing room there- babies should never be brought into a place like this! Oh. Unless their Mum is suffering from post-natal depression. Or a relapse of their ED triggered by post-natal depression. Or BY PREGNANCY! (more on this later)

4. How hard can this be?

So we met and we sat down and we got straight too it. I was honest. I explained the history- usually have on and off trouble with bulimia but over last 6 months have suffered depression and lost my appetite and motivation to eat which has spiralled into a mood and anorexia shit storm and I have lost weight,

Dietitian: how do you feel about your weight

Me: I don’t think I’m dangerously or even concerningly underweight and I am no longer losing weight (lie # 1 but I don’t know this as she hasn’t weighed me yet). I am just trying to keep things stable- I am happy with my weight because it is under control and therefore I don’t have to spend time thinking about how I should lose weight- which as most women know is a massive drag.

2: D: what do you want from this appointment? 

Me: for you to tell me if this weight is unsafe and if I am doing myself any harm because right now it is working for me.

Dietitian weighs and measure my height. Have lost teensy tiny 0.2 kilos but the downward trend however miniscule persists. BMI indicates underweight. There is a chart with swathes of colour indicating what level of healthiness your BMI corresponds with- orange is good. Red is overweight. I am yellow. I am on the edge of yellow and blue. 

She wants me to be in the orange. The weight she advises for me is a no-go never-ever. 

She tells me I am without doubt infertile right now. This is reversible.

She tells me that I am at risk of osteoporosis. This is not reversible. I need 4 servings of dairy a day- to be fair dairy is one thing I am ace at so one extra serving will be easy.

The meal plan she gives me is not outrageous but it seems unlikely to me. There is so much further I need to be along the recovery route mentally before I can take thus on. I say as much (truth). I say I will try (truth). I say it seems reasonable (lie) but there is not really anything reasonable about an ED. On this we agreed.

Vegan

Poor vegans. Poor old Natalie Portman and Woody Harrelson.

Fat Ballerina

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Vegan…vegetarian…anorexic (not to mention the horse-beef scandal)

Illustrated cleverly at Fat Ballerina’s blog   Vegan.

Hilarious (or a bit sad maybe) timing for me as I just received my Go- Veg starter pack from PETA.

Nobody can be mad at me or question the sanity of my being against animal cruelty.

Nobody can have a go at me if I decline to eat something because I’m a vegetarian.

Nobody can question my limited appetite and apparent disinterest in food.

It’s dangerous ground for the eating-disordered. Free reign to cut out whole swathes of food (practically bloody everything if you’re vegan).

Socially difficult, but so is eating  all &^%£ all.

Looking at it from another perspective- if eating vegan or veg helps you to get control of bingeing, or helps you to find an acceptable way to manage your intake without wrecking yourself then hey, knock yourself out. As a “functioning” anorexic I condone that. Anything you need to do to stay healthy, happy and in control.

Also anything that encourages you to eat more veg is great.

Tofu though. I have tried, really tried to like this stuff but Jesus. Come on. It’s rank. Spongy. It tastes like damp. If anyone can convince me otherwise with a great recipe I;ll give it a go.

Also think of the animals. The little critters and the big ones. Factory farming ad slaughter techniques are ugly. Free range feels better. Tesco value burgers is going to be plain wrong. Don’t be surprised there is horse in there. Be surprised there is beef in there, or any meat at all. People are OUTRAGED at eating horse- being DUPED into eating BLACK BEAUTY!

This debate also has a grey area. Easy to get on your high horse (heh) and preach about organic, free range, stroked to sleep with velvet pillows every night meat but not everyone can afford that, and if it’s a choice between ethical eating and not eating at all you’re going plump for the value burgers.

Basically you could argue your way around these ones all day.

FYI- horse meat is much leaner than beef.

 

My alter-ego

My alter-ago

As easy as ABC…or is it?

                                    It’s as easy as ABC..D.

Apparently so. It’s a CBT thing (cognitive behavioural therapy)- a method to change your thinking style, your approach, your default setting way of looking and thinking about things. And thoughts lead to feelings, so probably worth a looking at.

A- Activating event

B- Beliefs

C- Consequences

D- Disputation

Taking an example: I used the ABC…D method as advised by my therapist- just to try it out.

A: Last Sunday night it was the night before my first day back at work after being off for a month of sick leave.

B: Beliefs- these are the thoughts I had about it: What would I say to people to explain where I had been? Would anyone ask me? How would I feel about that? What about the pressure of being back at work and in that environment? What about my staff (I lead a team) and how they have been coping on their own without me?

I hadn’t heard anything from any of my colleagues while I had been away so had no idea how the land would lie.

It would be tough seeing my boss and discussing my phased return to work.

C: how did these beliefs make me feel?

Anxious

Unsure

Worried

Low in confidence

Scared of relapse

Pissed off!

D: disputation. So I explored these thoughts and challenged them- was anyone really going to ask me where I had been or push me for details? No. Unlikely. Most people I work with are lovely sensitive people and would get that I wouldn’t want to talk about it. Ok.

What was the worst my boss could do? (well now she has been known to take tissues to meetings because she knows in advance that she will make people cry so it could be bad).

I made myself try a different way of looking at it:

The first few minutes will be awkward but everyone else will get that too and do their best to make it smoother.

Yes I was off work unexpectedly for a month but I was unwell and it was the right thing to do. If one of my staff or colleagues was in teh same situation I would not criticise them for taking sick leave. There is no shame in having mental health problems and taking time off work does not mean that I have failed, or am a weakling or an unreliable person. I have worked my ass off in this job for the last two years and never taken more than a day off. People will be glad to see me back and pleased that I am getting better, and nobody will push me to disclose what is wrong with me.

So as I lay in bed on Sunday night I tossed and turned and fretted about the As, Bs, Cs and the Ds. I really wanted the Ds to come true.

Had a pretty shitty sleep (more bout the night sweats later!).

Monday went ok. Everyone was fine. It was cool.

I avoided my boss until Friday and she gave me a bollicking for not seeing her Monday but in grand scheme of things could have been worse.

So ABCD worked out. Must try again and use as default way to think.

Important point though- ABCD works ok if your frame of mind or mood is in a good phase. If I had tried this a couple weeks ago the D would not have broken through the depression fugg or the cycle of negative thinking. So what will really be a test of this new technique would be one of those times. Sure it’s possibly just around the corner. Bring it on!

Work….

Returning to work….eeeek

Returning to work on a “phased return to work” tomorrow.

Trying to stay neutral about this. Yes it will make me feel anxious and yes some moments will be tough but it will be ok. People will perhaps ask where I have been but mainly people will probably just say hi. But it could be awkward.

The first hour will be tough but then it will be fine. I am looking forward to going back to a routine- like getting up at 645 and heading out to work like a normal person.

I have been off for a month so it will feel rusty.

Will I eat?

Who knows- it depends how it goes I suppose….