Medication only part of the solution not the answer

About 4 months ago my doctor finally agreed to put me on medication for my anxiety level as it was just unbearable and stopping my every day life.  I have a love/hate relationship with the medication and recently moaned a lot about it to friends and people on twitter so I thought I would explain more about my thoughts and feelings and how being on medication makes me feel and what I have learnt.  

Last year I had a very depressive episode and when I finally got some grief counselling it lifted and exposed underneath the anxiety that has been building up really over the last 4 or 5 years.  I think reflecting back on my childhood I have always been an anxious person but always hidden it well which causes more anxiety.  Once I had done the grief counselling and gone back to my doctor I finally persuaded her to let me try some medication for it.  She prescribed my citlopram and started on a 10mg per day routine.

Now I got quite a lot of negative reaction from some friends.  Many were like are you sure you need to be on medication?  Are you sure it is the right idea and what about the side effects?  I hide my anxiety on a day to day basis and even though these friends knew I had had a hard time they still don't see all those worries that go round in my head.  I explained that at that time I was very anxious and that it effects my sleep, my eating, my speech and was giving me IBS through stress and worry.  Most once I explained this could see why maybe medication was a positive thing.

I have always known that medication is not the long term answer.  I had counselling when my parents split up and again round my Dad's death and I know it is a positive step for me.  Also I very much like talking things through and have also done some cognitive behaviour therapy programmes online.  I know that I need to do some of this therapy work rather then just rely on medication.  However getting these talking therapies on the NHS is a battle and a struggle.

I was asked to self refer myself back to the service I had tried to access last year.  Now asking someone who has anxiety disorder to self refer is really not the way to go about it.  Therefore I still have not done because I hate hate hate talking on the phone.  Also when I did this self referal last year I had to do a telephone appointment and through a very stressful process had no outcome.  They basically said we don't provide grief counselling and so I worry that there is no point to putting myself through this process again.  However my doctor is trying to see if I can access the counselling service at the surgery and if I can do that in evenings or on a Saturday.  I teach special needs and missing a morning or afternoon of every week would create so much more stress then it solves because the nature of my students.

Now all medication comes with side effects and I accept this.  I am quite happy to take medication if it is going to help me.  I think the benefits of taking citlopram is worth it because it means I can carry on with my normal life whilst waiting for another solution to help.  However I do not like taking it as I never know if how I feel is a side effect or just life.

A prime example of this is dreaming.  Now I have always been a dreamer; I can remember dreams from my childhood and still see them vividly.  However recently I have had so many dreams which I remember and unsettle me in the morning.  They are not good or bad dreams as such but they usually reflect something true to life and me.  They just put me in a weird mood for the day especially if I remember them for a while.  This recent dreaming could just be me but it could also be the medication.  

Other side effects include itchy skin but compared to the horrendous bed bug bites I got travelling it is a mild annoyance.  I also have at times insomnia and fatigue both of which could be life or medication.  One that I am very unsure of is the way I can feel very paranoid usually about friends and do they care for me and other feelings around trust.  

I am back at the doctor next week to discuss medication because of this paranoia and a few other things I have been feeling.  She possibly may put my dose up for now and hopefully she has had an answer back about counselling during out of hours.  

I know medication is only part of the solution and I need to seek help to use talking therapies and self care to find the bigger answer.  

Sleep and my journey

Sleep.  It is that thing you do when you get in bed, close your eyes and wake up the next morning.  Surely it should be that simple?  You have been doing it all your life so we all should be pretty good at it having practised everyday.  However when depression or anxiety happen sleep is often the thing you need most but yet the hardest to achieve.  My post is about the effects of sleep or not sleeping upon my emotional health and tips for what has worked for me.  They may not work for everyone but they are a starting point for me.

My sleep started being effected really as my dad started to become more depressed in the summer of 2010. When my Dad died it obviously got worse but then I went travelling and sleep was always interesting at times.  Jet lag and long journeys often resulted in missing sleep but it did not really matter as I could just catch up whenever and was always something exciting.  To help I was using rescue remedy tablets which are herbal and I found really did help with jet lag to just calm me down to sleep.  

But coming home was a different story and my sleep got much much worse.  I had problems with being able to switch off, to be able to get to sleep as once asleep I would be out.  Some nights I would just watch TV on my laptop until 2am in the morning and then get up for teaching the next day at 7am.  I would tell myself just 10 more minutes or just one more programme.  Then once that time had lapsed would say again to myself the same thing.  I would only turn off the light to sleep once I knew I would fall asleep. 

Some nights would be ok and others I would sleep at 2am so I was able to cope with this until around September time.  I was also on summer holidays from school so most of the summer I just slept when I wanted and the lack of routine was bad.  When I went back to work in the September last year it started getting harder to sleep and most nights I was on about 6 hours a night and was able to just about live on that.  I split up with the guy I had been seeing in a very bad situation and that set my sleep off even worse.

To make things even worse in November I got pneumonia and during this time my friendship deteriorating with my ex and also missing out on a job I really wanted sent my sleep even worse.  I was still living at home and the situation was so tense that I only felt at rest once my mum and her boyfriend had gone to bed.  I went back to work and again was surviving on 5 to 6 hours a night of sleep.  However being weak from the pneumonia I was really only on verge of surviving on that.  I know I needed sleep to get better yet would waste my time watching TV on my laptop even rubbish programmes knowing I could watch them anytime.

I knew watching TV and being on the computer was trying to avoid that quiet time and that time to think and worry as you fall asleep.  I would worry over small things about the next day or something somebody had said to me that day.  I would worry about things I knew would be ok but I could make a mountain out of a molehill.  Once I got to sleep it would be ok but the next morning I would not feel like it had been restful.  I would often have very bad physical ticks when falling asleep which would wake me up again and unnerve me.    

As things came to Christmas and a lot of stress surrounding that I went to the doctor to see if they would give me sleeping tablets really just so I could function in the last week of work and over the holiday.  The doctor did give me sleeping tablets and I remember the first night I took them waking up in the morning was like a relief.  I had actually felt like I had slept properly and not tossing and turning all night.  Christmas was a horrible time and the sleeping tablets helped but I knew it was not a long term situation.  I hated the feeling of the tablets as would feel like a zombie and mixing them with alcohol was a massive no.  Trust me I tried and it was horrid.

After Christmas break I was only working 2 or 3 days a week so my strength started to recover from being ill and so I was better even though I was not sleeping any better.  I finally got a full time job and moved out 2 weeks ago.  I had been wondering if my new anti depressants had been causing insomnia but I would not know until I had moved out.         

Moving out and the effect of that on my sleep has been amazing.  I knew one of my problems was that I spent all my time at home in my small single bedroom.  One big tip is to only use your bedroom for sleep but this was impossible to do at my mum's house.  Now in my own house my bedroom is a TV and laptop free zone.  The only thing I do in my room is sleep.  I also have to make that decision to physically get ready to go to bed and actually move into my room which helps.  It also means that I now read in bed rather then play about on my computer which is something I had really missed giving myself time for.

Occasionally now I still take herbal sleeping tablets if I am feeling anxious but generally I can fall asleep naturally at about 10:30 to 11pm every night.  I sleep properly and ready to wake up when my alarm goes off.  I feel re energised and more ready to tackle the day.  I feel ready to sleep and do not worry about things when I fall asleep now as I enjoy a good book first.

Sleep has a massive effect on your ability to function even as a normal person let alone when you have anxiety and depression.  It would effect my ability to concentrate, to speak in a clear, normal way and it would effect how I would cope with change.  I am still not great when plans change or people do not do what I ask but I am getting better.

So my top tips for better sleep:

1. Only sleep in your bedroom. No TV or laptop.  I still have my phone as I use it for alarm but do not use Internet on it.
2. Learn what you need to make you sleep better. Things like light, noise and temperature of the room can have an effect.
3. If you need sleeping tablets on a short term basis use them to get sleep back into some sort of routine so that you can then improve things.  Use them when you really need them.
4. Relax before you go to bed whether it be reading a book or listening to music.
5. Use body wash and lotion that has lavender in it which can help with sleep.
6. Create your own routine for each night to do before you go to bed so that it forces you to start with but then becomes habit.

I do not really believe about do not have a meal 2 hours before bed as this for me with my lifestyle just does not work.  All the tips that have helped me within my own lifestyle.

Getting better sleep has improved my mood and my anxiety leaps and bounds.  Now just to sort out my symptoms of IBS I have.

Out of the darkness and into the light it seems

After the positive post I wrote the other day I have a follow up to it as I have felt that in the last week I have made massive steps forward in so many ways.   

It feels the mist that descended when I came home nearly a year ago is finally lifting and I can see things much clearer.  Having things to look forward to like my new job, house and having amazing friends has lifted so much weight of my shoulders.  I have been having grief counselling as I know that was the first thing I needed to work on to be able to then tackle myself underneath.

Grief

It is a difficult thing to focus on.  To deal with, to live with.

I have cried more in the last few weeks then when my dad actually died.  I locked myself away when he died so that I could leave and go travelling like I had planned.  I needed physical and mental space to even start dealing with things that had happened over the last few years.

I have been having grief counselling and it has really helped as a place to talk about life now because of my Dad's death and remembering my Dad.  My Dad had such a sense of humour and fun and welcoming to everyone.  I miss so many things about him but do not wish him any day.  I get sad about the fact he will never be at my wedding to embarrass me to high heaven in his father of the brides speech.  However I do try to remember all the happy times and the opportunities he gave me.

It was always be there though that loss, that sadness.  

It is not selfish as my mum called him in an argument we had the other day.  The last thing I think is that he was selfish.  He was ill, very ill and I wish she had been more honest about the care he needed and when.  She says I just brush her away and I feel I can never talk to her about my Dad.  When I move into my new house I want to find some things or his and put some pictures up because I want to remember those happy times we had together.

Friends

I have some amazing friends.  Often it is not quantity of time known or spent together but quality of friendship.  I have been able to share with many more people about how I feel and to support me rather then just relying on one person like I was.  One person was there for me when my Dad died and I felt I could understand.  Eventually when I came home from travelling this was too much for one person to cope with my down days.  Now I have friends that I share my low feeling around with, I am more honest to not just them but myself as well.  That person who was there from the beginning of this is still there and I spent a lot of Sunday talking to him after quite a bad day on the Sunday.

Next steps

Through this process recently I feel that I can address myself with the next priority which really is not depression as much but my anxiety problems.  I have always been a worrier and started having panic attacks in 2006 but since becoming a teacher and a grown up it has become worse.  In the process of growing up I have then had hit after hit with life changes and then finally my Dad's death.  Over the last few weeks I have felt that anxiety more and more in terms of not sleeping, IBS like problems with my stomach and generally not wanting to do things.  Sometimes I will sit in the car for a few minutes when I get somewhere to psych myself up in a way.

Anxiety is part of me but I know there are better ways to cope with it.  Currently I use control and keeping busy with things to cope but these are both mentally and physically exhausting.  I am on medication as of this week and going through process to get more counselling or CBT to help me cope better with life.  I also want to pursue mindfulness and meditation on my own as well to help with my worry and negative thoughts at times.  I know I need this as though I am better at the minute I still feel fragile and worry if something else hits then I will be back where I was nearly a year ago.

The best thing:  I finally feel like me again for the time being.  The mist has been lifted and I can feel my life is in some order at the minute.

5 Steps to wellbeing: Mind and me

When I first started feeling unwell and needing help I turned to the vast network of information called the Internet.  This at times is as helpful as it is unhelpful.  However key Internet sites of mainly charities that work towards better understanding and support of mental health offer some of the best advice.  

My favourite is from Minds Ecominds project.  There are 5 steps to well being to help anyone have better mental health.

As they say "We know that eating five portions of fruit and veg a day can help us to keep us healthy.  But researchers have found that people who introduce the following five steps into their lifestyle can improve their mental wellbeing too.'  

In this blog I am going to discuss each one briefly and how I try to say how I include them in my life.  They are not perfect but they do really help to keep my wellbeing going on a even keel.  It is not to say it will work for everyone but they are little steps that may help.

1. Connect

Advice: Build those connection with the people around you: your family, friends, colleagues and neighbours.  Think of these people as the cornerstones of your life and invest time in developing these relationships.  Building stronger connections will support and enrich your life. 

Me:  This can be a hard one as if your feeling low you may not want to see people or think people want to see you.  I try and do the following. 

1. Make time to see or chat on the phone to friends that are close to me locally and do dinner or just a chat and a cup of tea.

2. For those of my friends that live further try and arrange a weekend at some point to meet up and do something.

3. I try to be honest with how I am feeling with colleagues even though they do not know my history or depressive streaks.  So if I am feeling tired or down I say that to people and now I am starting a new job I will be honest with those around me.   

4. I try and do new activities where I will start to meet new people and build new connections through similar interests.

2. Be Active

Advice: Step outside.  Go for a walk or run. Cycle, play a game, dance.  Exercising makes you feel good.  More importantly, discover a physical activity you enjoy and suits your level of mobility and fitness. 

Me: For this to work you have to choose activities that you like.  If anyone suggests going to the gym that makes me feel depressed before I even get there.  By choosing something you like your more motivated to go and do it.  Also choose something you can see your own progress in.  I comfort eat and so I see the positives of exercise is loosing that weight.  I do the following:

1. Pilates - helps both physically and mentally.  It builds a strong core, builds connections in your body and  you are able to do it on every level.  I started because I had back problems which have just about gone now.

2. Dancing - something I will blog more about but its something I have always done.  I currently do pole dance and I love it because it is a challenge to me and that motivates me to go and get better. 

This does not mean I don't find it hard getting my arse out of the house to go and be active.  I just know if I go I will feel better and it gives me such a buzz when I come home.

3. Take notice

Advice: Be curious.  Catch sight of something beautiful today.  Notice the changing seasons.  Savour the moment, whether you are walking, eating lunch or talking to friends.  Awareness of the world around you, what you are feeling and your experiences will help you appreciate what matters to you.

Me: This is one I probably do not have solid examples of.  I have tried to take more notice of what I eat, what my friends are doing, what music I like.  I try and be thankful for small things that happen during the day.  How the mornings are starting to get lighter and spring seems to be on its way.   

4. Keep Learning

Advice: Try something new or rediscover an old interest.  Sign up for that course.  Take on a different responsibility at work.  Learn to play an instrument or how to cook your favourite food.  Learning new things is fun and will make you more confident.  

Me: A lot of this comes under being active for some things.  I have decided to take a new direction in my teaching career so I am always learning new things about special needs, disability and autism.  I am enjoying learning how to cook new things from scratch without adding jars of sauce or packet mixes.   

5. Give

Advice:  Do something nice for a friend, or even a stranger.  Take time to thank someone. Smile.  Volunteer your time.  Join a community group.  Look out as well as in.  Seeing yourself and your happiness, linked to the wider community can be incredibly rewarding and creates connections with people around you.  

Me: Sometimes it is just little things like I agree to help a friend with something or have a look on internet for something they need.  At work I help those that may not have the ICT skills or share things I have created for my class.  I have also volunteered with GirlguidingUK for the last few years and love being a leader and giving a chance for other girls to develop skills outside of traditional education.

I know that at times even doing one of these things can feel too much when you are really low but they can help in small ways.  Being active might be as simple of a walk round the block or a game on the wii but it may give you that little encouragement to try more.  Connecting might be texting a friend or having a coffee after work with someone.

Do you think any of these would help you to feel better?  

Getting help: me vs NHS

I recently managed to start grief counselling but it has been a long time coming and a lot of the frustrations I feel about how I feel and dealing with my Dad's death is about how I have not been given help and the fight to get help.

When my Dad died I was 24 years old.  An adult supposedly.  How we were treated by the Police at times was disgusting and horrible.  Were we offered support? No.  I know through a previous experience when I was teaching that if I was under 18 there would have instantly been a team of support around me.  Educational Psychologist recommending the best ways to support someone with teachers, counselling given on a short term basis to the child and all matter of other things.  So at 24 years old getting no help I was just expected to cope.  

Did I cope? No.  Do I cope now? Just about sometimes.  

I only had 3 months until I went travelling so I knew there was no point getting help to start with and being away at times was the best for me then.  However coming back I knew that I needed to get support and help as those friends who had been there for me, still were but I knew I needed more professional help.

June 2012 despite trying to keep my head above water I just sunk into a black sea of depression and despair.  I ended up going to see my GP which was one of the hardest things I have ever had to do.  It takes so much energy just to compose yourself and talk about it that afterwards you feel drained and exhausted.  She said to ring the service in Derbyshire called Rightsteps which you can self refer yourself for help.  At this point I was unsure what I really needed as it was a mixture between help with the grief and the depressive feelings.  

I called Rightsteps, a massive step as I hate using the phone, and I could not get a face to face appointment in the evening so instead settled for a telephone appointment.  I knew this was not really right for me but I just put up with it and waited the 3 weeks until it was my time.  When it came I spent at least an hour answering a lot of questions to in the end be given the choice of self help stuff or self refer myself to a charity for grief counselling as its not a service they provide.  This was the end of June 2011.

I put off referring myself to the charities that help with grief counselling for 2 months and finally summoned the courage to email one of them in August.  Did not hear anything back so just carried on coping until things came to head after splitting with a guy I was seeing and feeling like falling down the big black hole again.  She was very empathetic and really wished she could do more on the NHS.  She decided to write a letter to the same charity I had been trying to self refer to.  

I got a phone call within a week of the letter being sent and an appointment to be assessed for a couple of weeks time.  Unfortunately I was to ill to go to this due to getting pneumonia so I had to wait another 2 weeks to have this assessment.  At this assessment my frustrations about lack of support were evident and the counsellor was really supportive in saying that now I was on their books I would not be forgotten about.  I have managed to get a volunteer counsellor just after a month of that assessment.  Finally some help February 2013.  

I know others that have got help much quicker but they have been more severe having both self harm and suicidal thoughts neither of which I really have.  But if I did not get help in some way I could see myself continuing down that path.  Why not help me now when I am asking for help?  If I had a physical illness would I have had to wait so long to get treatment?  Would I have had to rely on a charity to give me that treatment?  I do not know if my depression is based sorely on grief or if it depression.  I have no idea and probably will never have that.  The doctors at the minute are trying not to see it as depression as when I asked for more help they gave me sleeping tablets I asked for but were reluctant to give me anything else before this counselling started.  

I know counselling is going to help with some of my feelings.  Writing this blog has already helped because a lot of my feelings are around frustrations and anger I feel in particular in getting help.  I know I am not the only one out there that feels like this.  The NHS is there for all and I know it is stretched but at the same time is our mental health not as important as our physical health?           

One thing I found on the Internet which helped me back in June and I still dip and out of is the mood gym programme.  It has simple exercises similar to CBT looking at how you are feeling and why.  It can be done at any speed and it saves the work as you go along.  It is definitely worth a try looking as it is not trying to give you answers but help you find answers.  It is easy to create an account and use and like I said you can do as much or as little as you want at any time.  It has sections on feelings, thoughts, unwrapping, destressing and relationships.  It has tests on anxiety and depressive feelings so for me it gave me validation that I was feeling highly anxious and depressive not just making them up.

Have you got help quickly or still waiting?  Did you manage to get it through NHS or relying on charities to fill the gap?