(Un)fit to Practice

It’s coming to the end of Freshers Week at University. So far, it hasn’t been as bad as I was dreading. I’ve attended every scheduled session, maintained consciousness throughout and even made notes where relevant. The downside is I’ve been in bed by 10 at the latest every night and still overslept in the morning. I dread to think how it’s going to be next week when lectures proper start and I need to be in at 9am every day. There are too many pharmacy students, I feel crowded and overwhelmed by them. They’re so young and naive. A lot of them have never cooked a meal before or even been away from home for more than a week. Was I really that innocent 7 years ago when I first started a degree? Did you know that people who are 18 now were born in the nineties? That seems so wrong, it makes me feel incredibly old.

This morning we had a lecture on fitness to practice. Every time he needed an example of a condition that may impare fitness to practice, he picked on long-term mental health problems. There was a list of things that may cause issues in continuing on the course. These included a severe criminal record, substance abuse, lack of commitment to study and other things you’d expect. However, the last thing on the list was:

health concerns and lack of insight or management of these concerns: failure to seek medical treatment or other support; refusal to follow medical advice or care plans including monitoring and reviews, in relation to maintaining fitness to practise; failure to recognise limits and abilities or lack of insight into health concerns; a treatment resistant condition which might impair fitness to practise.

This concerns me greatly. Although I do tend to turn up to my hospital appointments and roughly follow the advice given, there are times I have rebelled against it or not sought help when perhaps I should have. As for insight, well I think I have that but then and again I thought I had it when everyone was staring at me. Although, I am a lot better than I was there are aspects of my condition that do seem to be treatment resistant. I still self harm, I still have suicidal thoughts particularly along the line of taking another overdose. There are days when I am genuinely too unwell to leave the house. Besides, BPD’s allegedly incurable isn’t it? I can’t guarantee to continue to be stable. There’s nothing that promises I won’t have another breakdown particularly when under extreme pressure such as exams. The real issue as far as I’m concerned is that if things were to get really bad, I don’t think I would be above acquiring bonus drugs from a place of work in order to escape it all.

I could bury my head in the sand and refuse to mention any of this but unfortunately it will all come out eventually. There’ll be a point when we need occupational health clearance to go on placement and there’s no guarantee that would be granted. Besides which, I don’t want to work really hard for a year only to be told I can’t continue. We are meeting our personal tutors this afternoon and I suppose I will have to raise all this with her. There’s a question of how honest to be, but I’m a rubbish liar and would only get found out.

It’s ironic given how little I wanted to start this course, how much I want to continue now I know there’s a chance I won’t be able to. I suppose we always want what we can’t have.

 

 

 

 

Embarrassing

A few months ago I started getting a rather embarrassing personal problem, I started lactating (*blushes*). I took a pregnancy test, it was negative so I took another one just to be on the safe side. Suffice to say, if I am pregnant it would have to be an immaculate bloody conception with no symptoms other than this. It took me several months to build up the confidence to raise this with the doctor and thankfully he didn’t ask for proof, just sent me off for a blood test to take my prolactin levels.

Last night I got the results. My prolactin levels are exceptionally high which at least explains the lactation. There are two possible reasons; either the Sulpiride is fucking with my system (even though the symptoms started several months after I started on it) or there’s a more serious problem with my pituitary gland which would be a real bugger. The solution is to change my anti psychotics and hope the levels decrease, otherwise I have to go and see a hormone specialist at the hospital, whatever one of those happens to be.

Then this morning, I met the SHO at my local CMHT for an assessment. I think I scared her slightly, I tend to be extremely blunt with professionals which doesn’t always go down very well. I also meant the consultant psychiatrist who I didn’t much like but probably won’t have to see again. The result is, they want to change me on to quetiapine. This is something I’ve been trying to avoid as other people say it makes them really drowsy, but allegedly that’s a rare side effect. We shall see. They’re also going to refer me for therapy which apparently has a sensible length waiting list. Again, we shall see.

Sorry, this is a really dull post. I will try and put more pretty jewellery photos on soon

Medication

I take a lot of pills but I’m starting to doubt their purpose. I am a rational person, I know the arguments. If I had a physical disease, I’d be prepared to take medication to treat it and therefore mental illness is no different. It doesn’t feel that way though. There’s a line in one of my favourite songs,

I’m unsure where what I am ends and what they’re making me begins.

That’s where I feel I am, I no longer know who or what the real me is. If I don’t take my meds, I have a meltdown. Admittedly, the majority of that is withdrawal effects, venlafaxine has an insanely short half life, miss a dose and you’ll know it. Still, being that dependent on something can’t be good for you. The utter reliance on chemical stimulants to get you through the day cannot be healthy. I hate having to swallow those pills every single evening, potentially for the rest of my life. It just seems wrong.

And all that’s before you mention the side effects:

• Weight gain. Having a similar mass to a fully grown elephant is never a good thing. I’ve recently started running again albeit slowly and very painfully. It just doesn’t seem worth it though as all I seem capable of doing the rest of the time is eat. I’ve recently had a blood test to reveal this has given me high cholesterol. So the ‘miracle’ pills have just given me something else wrong with me.
• Thirst. I dehydrate so easily. I get through 6-10 pints of water a day, not including juice in the morning and milk at night. This is a faff, and really difficult to maintain while out in public.
• Sleeeeeeeeeeeeeeeeeeeeeeeeeeppppppppppppp! It’s all I ever do, if I’m not asleep I’m napping and if I’m not napping, I’m preparing for my next nap. The few days I can’t sleep though, those are the worse. The days my mind is so dead set at my own destruction that it won’t even allow me that peace. Those I really can’t cope with.
• Memory fuzz. I’ve talked about this before, but my memory is not as it used to be. I used to recall facts and my memory would be sharp and active, now there’s just static. There isn’t just one area affected, everything is behind a slight grey screen.

Admittedly, the depression has receded somewhat which is wonderful and joyous. However, I’m still suicidal and stuck in a place I don’t want to be. Wonder pills clearly aren’t all they’re cracked up to be.

Oh, and in case you were interested, this is the song I mentioned:

Help.

I want to die. For a while I’d forgotten what that felt like, I’ve been ok for a while now, getting on towards a year so I must be better right? And yet, I’m not depressed. I score somewhere in mild depression based on various depression questionnaires and most of those points come from suicidal ideation. Back in January, the last time I was down the score was somewhere from moderate to severe and in my blackest times some 18 months to two years ago I scored off the blinking scale. Besides, I know what depression feels like and this isn’t it. Depression is a deep dark fog, it’s moving through treacle, seeing life through different eyes, a constant, burning pressure in the brain. Depression is and this ain’t it. If I’m not depressed, I must therefore be happy. So, why oh why do I feel so much like ending it all?

Life stretches out and it’s long and it’s pointless. What purpose is there to existence? I’m in love, I have a place to read an exciting, stimulating course at university, I have friends and family. But love’s not what I think it should be, I’d do anything to escape the university and the friends never call (not that I’d answer) and the family don’t understand. It’s not that I don’t enjoy things when I can summon up the motivation and when I’m not asleep, which seems to be an increasingly rare occurrence, it’s the thought of time stretching out for so many years and of this being it. Better to stop things now before it all goes too far.

If I hadn’t had a single drink tonight, I’d do something now. However, the first time I tried to kill myself I was mildly intoxicated. I was glued back together and sent out without even a psych consult and certainly no understanding or follow up. It was a genuine attempt and yet it was derided due to the presence of wine (and possibly my very drunk tutor wearing a silly hat in A+E but that’s a story for another day…). I have a wedding to go to on Friday. It’s my cousin getting married and I have nothing whatsoever in common with her and no particular desire to go but I owe it to my family to do the decent thing and pull myself together and pretend it’s all ok which it should be because remember I’m not depressed.

Also, I have my first psych appt in new home place next Wednesday. Woo. I suppose I should give the professionals a chance, not that they’ve prove much so far but maybe this time could be different? *laughs derisively* For now, lets make that my aim. In the shorter term, goodnight. I’m off to zopiclone myself (at prescribed dose only of course ) to peace.

Ranty

Dear ex-voluntary organisation of choice,

I thought I was big enough to get over the way you treated me and others but apparently, if my dreams of the last few nights are anything to go by, I’m not.  You see, you were my passion. I spent over 100 hours a year helping you out and that doesn’t include the time spent at meetings and socialising in your name. However, for a supposedly medical organisation, your attitude to mental health is abysmal. I appreciate the importance of health declarations in your field. I have always been honest in mine and will continue to be so but your policies do not encourage such sharings of confidence.

The first time I had problems, I was applying to do an advanced course. I answered every question, and gave you the opportunity to phone me and request further details. You didn’t. Instead you outright refused me advanced clearance. The reason? It would involve me working with only one other person and it seems I’m not to be trusted so unsupervised, despite my medical team being happy with my fitness to practice. However, you were more than happy to let me manage events of just two people where I had more power and responsibility than you were denying me in another role. Contradictory and offensive.

The next time I had to submit a declaration you refused to even reply despite the fact I sent several over a period of a number of weeks. That’s just rude. And even if you had the decency to reply, the person responsible for making these life affecting decisions (and yes, denying someone something that occupies a large amount of their free time is life affecting), was a gynaecologist. The last time they considered mental health was probably med school. How can they possibly be qualified to make a decision over whether or not someone is mentally fit?

I’m hugely disappointed to have been denied the opportunity to continue with my hobby due to your incompetence. I wish things had been different, I could have been good for you.

Yours rantingly,
Me.