The Anxiety of Absence

Time off makes me anxious. Luke and I have booked a week off for some much needed R&R so from tomorrow I’ll be a lady of leisure for a whole seven days. But the list of worries passing through my mind is stressing me out.

First of all, there’s the concern that I’ve been cocking up my work for the last 6 months. You might think the reassurance of the half-year of few complaints would be enough, but it really isn’t. When I’m here I rarely doubt my ability to do the job and succeed at it. I think I’m just that much of a control-needer. ‘What if something comes to light and I’m not here to explain the mistake?’ and so on.

The issue that underlies all this anxiety is the events of three years ago when I first took time off ill because of a psychotic episode. I had continued to work right up to the point that my psychiatrist threatened to have me sectioned if I didn’t take two weeks off. I know some of you will have experience of what it’s like to try to continue living normally when your mind is rebelling against you. Little wonder then, that I made some mistakes. Amazingly they were not big bucks mistakes; simple things like forgetting to send an order confirmation or return a phone call. Shouldn’t really have been much of an issue, except my manager at the time didn’t see it like that. Whilst I was away on sick leave she got access to my computer from IT and went through to find anything that I had made a mistake on. When I returned to work, these were presented to me as a significant failing. It was horrible, I felt terrible; despite my illness I had worked hard – so hard – at that job despite being over-worked and under-staffed.

So that’s why I get nervous about time off. I know for a fact that I have been doing a good job here. The figures and feedback reflect that; I’m on target and have built fabulous relationships with my accounts. I just can’t shake the feeling that there’s going to be something I don’t even have the first inkling of rearing its ugly head to ruin my life.

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The Anxiety of Absence

I Don’t Know What I Want

The frustration is the worst thing about days like today. In all honesty, I am pushing myself further than I should and trying to achieve a goal that ultimately doesn’t really mean anything. Pushing myself to the limit because I don’t want to leave my colleague to cover my Friday afternoon jobs (report, report, repeat). A bit of reflection over the past three days highlighted a possible link between slow days at work (read: under-used, under-valued and generally b o r e d) and heightened mixed moods. Today goes against the grain; I’ve been a busy, busy woman playing the high-powered executive that my mask demands yet I am finding myself drifting into the muddy waters of mixed-mood.

Back to that frustration then. It’s hard to write eloquently about it because it is so confusing. It is the conflict between doing what I ‘should’ do and wanting more. I work so hard at just being a regular person who can do a regular job with regular hours. It is this kind of mood that leaves me yearning for an adventure, needing to rebel against the 9-5 existence and break free. I am sick of fighting with myself. You can’t let anyone down argues with screw the lot of them. And I honestly don’t know what to do about it. I know that it would be a lot easier to just allow myself a little slack in the reins; I keep them pulled tight out of a sense of obligation to society to fit in.

On my referral to the Personality Disorders team I had to answer a few questions about the things I wanted to achieve from talking therapies. I can’t remember my exact words but I wrote a lot about wanting to learn how to be satisfied with what I’ve got, about feeling trapped by my wonderful life. Writing this out now feels like a betrayal of my husband who I know will read this; once again I feel like admitting things is hurting him. There’s nothing in the world that makes me happier than being with him. So why this need to bust open the back door and invite the world for a party?

I Don’t Know What I Want

Criticisms

No one likes criticism, but most people deal with it. I’m very proud to report that I am well practiced at not rising to it; I’m less happy with the fall-out after. Today has been a day of bollockings and I’m not at all happy about it. Less happy about a colleague commenting ‘well I can understand why he was shouting at you,’ after I got off a ten minute ear-bashing over the phone.

My job is a balancing act. I have targets and deadlines to meet, and I work hard to meet them. And not only do I meet them, I beat them every month. My problem is that me meeting deadlines and targets is achieved by causing financial implications to other businesses that can’t very well afford the impact. This makes me feel like a bad person.

I’m fed up of selling my soul to the daily grind. I want to do something that matters; I want to impact this world in a positive way. I’m a small, temping fish in a very big corporate pond. Worst of all is the fact this impacts my mental wellbeing in a big way.

Back to that criticism thing. I am so proud of how I handled the phone call; remained calm and level-headed throughout. ‘Yes I understand,’ and ‘Of course I can see your point.’ On the inside, though, my blood was boiling. And it still is; you’d just never guess it to look at me or talk to me. Sure, I thought about walking out. I’ve thought about doing that a lot; pleased to say common sense has always prevailed and I’ve stuck it out.

I am excited for the referral that my CPN is making to a team that can offer CBT and DBT. I can’t wait to learn skills that will help me deal with emotionally charged situations in a healthy way. For now, I’ll bite my tongue.

Criticisms

Back to work and a bit on personality disorders

I’m pleased to be able to report that as of 12:30 today I’m back in the saddle; catching up on nearly a week’s absence has kept me busy enough that I’ve not really had time to think about Tweeting or Pressing until now. My CPN was very encouraging that I should come back and get some routine in my schedule. Part of the issue of the last few days has been being caught between not-coping-with-work and not-coping-alone-at-home.

This morning’s appointment threw a curve-ball at me. We chatted a bit about what’s been going on and ways to mitigate dangerous situations and then she said the team thinks I have a personality disorder going on in the soup I like to call my mind. They are referring me to a specialist team, who will do an assessment, and then from there I am likely to be offered talk-therapy; this is fab news really, but the idea of having another label kind of freaks me out too. I know it shouldn’t, but whoever decided to call them personality disorders needs a good spanking – your personality is a key part of your identity and saying there’s something wrong with it is a bit like being nut-punched in the mind.

Of course, being me, I’ve now been reading up on the various types of personality disorder (there are ten of them). I have known people with Borderline Personality Disorder and know how difficult a condition it is to live with for them, but I have never really identified with this disorder.

Here’s a super-brief rundown of the ten types:

Cluster A:

  • Paranoid PD: irrational suspicion and mistrust of people
  • Schizoid PD: social detachment, apathy
  • Schizotypal PD: social interactions are uncomfortable, unusual or eccentric beliefs.

Cluster B:

  • Antisocial PD: lack of empathy, grandiosity and manipulative behaviour
  • Borderline PD: unstable relationships and self-harm is common
  • Histrionic PD: attention-seeking behaviour, excessive emotions
  • Narcissistic PD: grandiosity, need for admiration, lack of empathy.

Cluster C:

  • Avoidant PD: social inhibition and sensitivity to criticism
  • Dependent PD: psychological need to be cared for
  • Obsessive-compulsive PD: sticks to rules, perfectionism and control.

I am feeling a lot of anxiety towards Histrionic Personality Disorder; I know this is because I’ve been accused of attention-seeking in the past and I think I would feel like a fraud in every aspect of my life. It almost feels like that diagnosis would invalidate the last three years of ups and downs, and that makes me nervous.

All I can do is wait for the referral and see what comes of it. I am keen to access talk-therapy again as this was helpful the last time I did a course with a psychologist.

Back to work and a bit on personality disorders

A Level Of Functioning

I saw a tweet yesterday that said something about ‘getting to the point of functioning’ and I thought, yes, that’s me!

During the good times, I thrive. I can face life head on and enjoy things like work. The obstacles seem easy to hop over (or knock down). When the blips happen, however, things change. Simple activities like taking a bus home become hurdles that feel six feet tall. My perspective on life is different, and it’s hard to deal with. The key point becomes surviving – functioning.

In the run up to my crisis in December I was nowhere near thriving. Unfortunately, because I was functioning (going to work, getting home safely), my concerns were not heard properly. My CPN was fabulous and referred me on to the Home Treatment Team, but from that point on I felt I was not being listened to when I said I couldn’t face another day.

Every call I made to HTT for help went something like this:

ME: “I’m at work and I’m struggling to cope with it.”

HTT: “We’re sorry to hear that, but you’re still working?”

ME: “Yes, but I can’t concentrate and really don’t think I can last the afternoon.”

HTT: “OK well try to stay calm for the rest of the day and focus on getting home.”

I think I usually gave up at that point. They just couldn’t seem to get their head round the idea of someone working through such a tumultuous time. The problem is that I hate to take time off ill; I feel as though I’m letting work down, even when I know I really shouldn’t be at my desk. The idea of work piling up in my absence gives me massive anxiety.

In fact, it took an intervention from my CPN and psychiatrist to persuade me to take time off in December to go into crisis care. It was like I needed their permission to admit temporary defeat. I couldn’t do it on my own authority; even though I knew it would be best for me.

And now I find myself in a position of functioning again. Work is a little too stressful, but I’m still ploughing through; I’m definitely not thriving though. Once again, I’m doing what I have to to survive.

A Level Of Functioning

The People Who Help

I wanted to write a little bit about the people in my life who have supported me over the last three years. Without them I believe I wouldn’t be here to tell my story.

The primary supporter in my life is my husband Luke. We’ve been together since we were in our late teens and got married in Dec 2011. When we first began getting serious (i.e. after about a month!) I explained my struggles with depression from my early teenage years and the anxiety that had gone along with it. He made a promise to always be there for me when I need him, and he’s gone above and beyond that time and time again in the years that followed.

It was Luke who first noticed my mental health deteriorating in early 2012. As you’ll hear a lot from people who have been psychotic especially, it’s those around them who notice it even before the sufferer. I was living in an alternate reality in which it was perfectly normal to be hearing voices, not sleeping and suffering paranoia over the people living next door. Amazingly, and thankfully, the paranoia did not extend to my husband. Although I’d visited the GP on my own to get help for the anxiety, the warning signs of mania and psychosis had not been picked up.

Luke has since stood by me through thick and thin. He has sat with me in the hospital following overdoses. He has accompanied me to appointments and talked to the mental health team on my behalf when I couldn’t speak for myself. He is my carer; I still struggle with being out in public without him if it’s not part of my routine, and he makes sure I take my medication morning and night. When I’ve been unwell he’s kept the house clean and us fed. The stress I have put him under is unbelievable and he is still his jolly, jokey self.

What do I owe him? Everything – and nothing. What he does for me comes from a place of true love. I couldn’t be more appreciative, and I have no idea how I can repay it all. But he tells me regularly that he did it because he loves me and couldn’t imagine being without me – that he’d do it all again in a heartbeat.

My family have also been there for me in an entirely supportive capacity. My mum has driven me to the hospital a few times, and never judged me for it. She is a lovely, warm and caring woman and I am so lucky that she’s supportive and understanding. Never one to shy away from anyone in need, she makes sure I know she’s there for me any time I need her; as she says, her kids come first.

I didn’t speak to my father for three years following an argument in the run up to my wedding. When we got back in touch early last year I debated with myself for a long time over whether to tell him everything or not. I decided that honesty was my best course of action and wrote him a letter that described what had been happening with my mental health. I was terrified that he would see me differently once he knew everything, but there was nothing to worry about. He told me he supported me.

Unfortunately there is so much stigma surrounding mental health issues that there’s no guarantee that people will be supportive of those who suffer. I used to feel ashamed of my diagnosis, that the important people in my life would somehow blame me for what I was going through. The fear of them taking it personally was huge; I was worried that my parents would wonder what they’d done to cause it, or that my husband would think my suicidal ideation was proof I wanted to leave him behind.

I am so thankful to those who have supported me over the last few tumultuous years. I have learned that I have nothing to feel guilty for; no guiltier than someone who’s suffered a heart attack feels. It is my hope that this blog is not just for those with mental illnesses, but that the people supporting them will read and understand that the best thing they can do is be there for their loved one.

The People Who Help

The Anxiety of Suicidal Ideation

First up – a definition. Suicidal ideation concerns thoughts about or an unusual preoccupation with suicide. The range of suicidal ideation varies greatly from fleeting thoughts, to extensive thoughts, to detailed planning, role playing (e.g., standing on a chair with a noose), and unsuccessful attempts [Wiki].

When my ideation was at its worst, I visited my GP (this being pre-involvement of secondary mental health services). I was agitated and restless, and I spilled the beans. I had been planning and fantasising about hanging myself. I’d also been having vivid mental images of doing it, kind of like acting it out in my mind. It was overwhelming and upsetting.

It was almost like a craving to act on the urges. It felt similar to the times when I wanted a cigarette but had only empty packets. The totality of my attention was fixed on obsessing and planning the act in great detail, and it made me incredibly anxious.

The anxiety was two-fold. In one aspect it was the frantic feeling of a need not being met. I felt trapped between my desire to carry out the fantasies and my fear of actually ending my life. It was hugely unsettling.

The other side to it was more of a guilty anxiety. I was beating myself up mentally; “How could you think these things? What about all the people who love you and care about you? Your family will be devastated. Your husband will never get over it.” and so on. I knew the rational case against suicide, but knowing things intellectually doesn’t often stop the mind from wandering off on its own path.

Since then, I’ve learned better coping skills to help take my mind off the thoughts. Meditation and mindfulness have taught me to observe my thoughts and then let them go. If I’m really struggling to deal with ideation I talk to my husband or an understanding friend. Most of all, I’ve learnt that I can forgive myself for having the thoughts and that’s taken away a lot of the panic from the experience.

The Anxiety of Suicidal Ideation