Skip to content

Tag: medication

1

Published on 1 Comment on Feeling positive

OK, let's not get carried away, but today feels like a good day. Started out by getting up earlier, with the plan being to contact the GP to get a follow up appointment and discuss my med does, with the view to possibly increasing it. The past couple of weeks have been a little testing to put it nicely, so it got me thinking that maybe I needed an increase. However after getting up this morning and waiting for the GP phone lines to open, I had a think, reasoned with myself and decided that with all the upheaval at the moment, maybe now is the wrong time to just up the meds. Maybe let things settle down a bit first and see how it goes. Returning to work (I will come back to that), the change in weather, the sudden decrease in cycling and time outside, all has an impact on my mental state, and is not a direct reflection of my actual state of anxiety.

I had another CBT session this morning, my 8th so far. Prior to the session, especially yesterday I was talking myself out of doing the session, telling myself I didn't feel I needed it anymore, that I was starting to feel better, and any other reason I could come up with. However speaking to Ann about it, I soon realised that I was actually doing this as an avoidance behaviour, and just kidding myself. Of course I need to keep doing the sessions, and should finish the course, who am I kidding! This morning I was dreading getting started with it, but once in the moment, I soon fell into my happy place, and away I went. I mentioned to the therapist that I had considered dropping out or cancelling the session, and she was pleased that I had told her, and that I recognised my reasoning for it. Look at me, I am learning more and more about myself.

One word that has come up again and again is "control". Along with "structure" they are the two words that define my most basic needs. Not to be controlling, but to have an element of control over what I am doing, where I am going, and who I am with. Knowing who I will be with and what is going on makes life a lot easier for me, especially in new situations and surroundings. I only have to look back at certain events to realise how important those two things are to me, and how things can quickly spiral if I am trying to just be a free spirit.  With this knowledge, and the new skills I am learning with CBT I find myself more willing and able to push the boundaries a little, and to try and change my perception of things, especially before even trying or experiencing them.

As an experiment last week, set by my therapist, I tried to find ways to practice pushing my limits a little, and doing things I felt would make me anxious. One of those was speaking to groups of people, or persons I don't know. I had intended on going for a ride, stopping at an unfamiliar cafe and sitting there to eat for lunch, however the weather had other ideas. Instead I decided on something a little more tame, but still something I have avoided repeatedly. On Sundays I take part in a ride on Zwift (online training platform) which is a social event, and has a Discord channel running at the same time, where participants talk, have a laugh, and generally socialise. The idea of being on such a channel, speaking with strangers etc has long scared the hell out of me, but with no other options to try my experiment I downloaded Discord, and when the ride came around, I jumped on. 

For the first 20-30 mins of the ride I just sat back and listened in to what people were talking about, how they interacted, and tried to decide if I could engage with them without feeling stupid, or causing anyone any upset. When the moment presented itself for me to speak, I took my phone off mute, and spoke. Terrified yet vindicated all in the same moment. Moments later someone else responded, and the conversation begun. Careful to mute myself after speaking each time, I felt like I had taken a huge leap, and was now a part of something. Jumping in from time to time to offer some humour, have an opinion or just be a part of the group. Following the session I felt really positive about it all, and know I would not have done it without the CBT sessions and tools I have gained from them so far.

This week, when the ride came around again, I opened the app at the very start, and made a conscious effort to be more involved. Feeling I was getting to know a few of the people on the call, I felt a little braver, and able to be a little more like my natural "cheeky" self. By the end of the session I was more than happy to speak numerous times. After the session I wrote a little message to the group to thank them for the welcome I had received, and explained that I had been doing an experiment for my therapy. I was surprised and delighted with the response I received from that. I wrote the message because I felt like I needed to explain my actions to others, but with a nudge from a friend, and a little retrospective thinking, I realise this was not necessary. However the response had felt good, so no harm done. 

As you might be able to tell from this entry, I am starting to find my flow again with writing and expressing myself, so am hoping to catch up with a few entries over the coming days, and make some notes for myself, while sharing a bit more about my journey so far. I have booked a few days off work soon to give me some time to level out a bit from the sudden rush of going back to work, and also to settle down with the new normal. 

So I shall leave it there for now, and close by saying that I feel pretty good about myself at the moment, and hope to keep up the momentum. 

Thanks for reading as ever. 

Published on Leave a comment on Heigh-ho, heigh-ho…

It's back to work I go...

It has been a while, in fact it feels like an eternity if I am honest, both since working, and writing anything. But lets focus on them one at a time. 

I have been off sick from work since mid-way through September, when the anxiety all got too much for me, and my mind went pop. Signed off by the GP immediately, and put onto meds, and into therapy, the past 6 or so weeks have been one heck of a journey. And it's not over yet, far from it. I was late starting the meds due to reluctance to getting back onto a long course of medication for what felt like a short term glitch. However with no sign of the glitch being sorted any time soon, I decided getting on the meds was the right way to go, and thus far it has been the right decision. CBT has helped too, and I am planning an entry about that too, I just have to get my mind to work right to try and make sense of it all. 

Getting back to work has always been at the front of my mind, as with previous episodes, work has always offered me a sense of routine, and helped my structure my days even at the worst of times. So it is quite a relief to reach this point. That said, it is not easy! 
Right now my brain simply refuses to play ball, mostly because of the medication. Describing its effects to my therapist yesterday I think I hit the nail on the head explaining the difference between my current medicated and non medicated states.

Without meds I have what I would describe as a large Las Vegas style neon sign in my head. This lights up with all sorts of worries, both important and unimportant at the most inopportune times. When I am trying to sleep, it will over power my thoughts and make sure it is the only thing I can think about. 
With meds the sign goes out, and we swap the Vegas strip for a casino, and the slot machines. Now, when I try and think about something it is like hitting START or pulling the arm on a fruit machine, the reels start spinning, the icons become and blur and a thousand images / thoughts run through my head every second. Trying to focus on one topic is like trying to pick out the cherrys symbol on all three reels at the same time, impossible!

I hope that makes some sense, as in my head it makes perfect sense.
Usually when in a normal state of mind, without medication, I am able to focus quite well at the job in hand, or stay part of a conversation. However currently I can barely stay focused for one sentence. During my CBT yesterday I kept drifting away during the discussions, and had to ask for things to be repeated as I just could not take in what was being said. 

Last weekend a few small packages arrived for my for my office. Three simple monitor stands, comprising of 4 pieces of wood, and a few fittings. To say I felt a massive sense of achievement from putting a couple of them together is an understatement. Staying in the moment for 5 mins, focused enough to look at the instructions, make sense of them and put it all together was fantastic and a real boost for my confidence. Which was perfect timing as a few days later I was returning to work, so at least I was not worried I could not concentrate at all.

I have managed two days now working, and I have to say it is draining. Not as bad as it would have been a week or more ago, but I am VERY aware of how much energy it is taking to keep my head in the game. Again, it feels like I have accomplished something far more than doing a days work. 

That brings me to the writing side of things. As a coping mechanism it is great for me, so at times when I am less creative and unable to put too much down in writing, it is a bit of a set back for me. Not being able to get rid of the thoughts that weigh heavily on me takes it toll. So sitting here writing this now feels fantastic, and like I am starting to get a little bit of my sparkle back. But I won't get too carried away just yet. There is a big difference between a little clarity, and feeling better over all. 

During the past few weeks, I have so many things I wanted to write, but just not had the thought process to put anything worthwhile together, and after 10 mins of not putting anything in writing, the thoughts are gone again, so a few missed opportunities which will hopefully come back to me at a later date. 

I am now staring blankly at the screen again, so think it is best to leave it there for now. 

Thanks for reading, thank you to everyone who has lent an ear, chatted on IM and even given me a hug. 🙂 

Published on Leave a comment on It’s all just a blur!

The past few days have been a bit full on to say the least. After a long week of cycling last week, Sunday came around and it was time to complete the 26.2 miles of the Virtual London Marathon. With my head in the clouds and my mood in the gutter it was always going to be challenging. But with the increased lack of activity in my brain (does that even make sense? Increased lack?) it was even harder to make sense of what was going on, let alone stay in the right frame of mind to put myself through the mill to complete the task. Long story short, I did, just about. 18 miles mainly run, the last 8 walked. Got there in the end. Finishing a little deflated with the time, but in the circumstances I am taking it as a win. Six and a half hours. Sub six is the goal if I ever bother again.

Then there is the increase in meds, dose doubled, from Monday, which is a good thing as my brain continues to play games and stress me over nothing. That said, the brain numbness is definitely setting in now. My attention span is non existent, and I have to apologise at the start of conversations in case I tune out mid sentence. The first couple of days with the meds increasing I could feel the wooziness, and the absolute lack of attention and focus I now have. To the point of choosing not to drive. I haven't cycled either, but that is not through lack of want, just lack of useable legs right now! I have however been sleeping a lot better, broken but longer durations. Although the past couple of nights I have struggled to settle at first.

Yesterday was pretty full on. Ann returned to work after being off with her breathing for the past couple of weeks, during and post Covid. However this was short lived as she was back home quickly, and after a chat with 111 the ambulance was on its way. Meanwhile I was preparing for my 3rd CBT session. I subsequently rescheduled that as the ambulance was sure to arrive in the middle of it. Which by the clock, it actually did, so well played me. Back to CBT next week.  Ann was whisked away to hospital for further checks, while I went out for a quick walk to clear my head, before heading to the hospital. 

On arriving at the hospital and finding Ann in A&E, I received an email from work. It was just a quick catch up, but the content of it was quite good. In short it says "HR agree you should remain WFH". Which is what I really needed to hear, so that is massive and positive. But remember how I said I could turn anything negative, well in a flash... My brain went to, "but for how long", "is this just a play on words", "will me being off sick affect their decision" and many more negative thoughts. 
I do however have a catch up meeting on Teams with my boss on Friday, so can address some of my concerns again then. I just need to remember to write them down as I think of them, or I will just forget them in the moment. I really can't remember anything at the moment. 

Right now the way my brain is, I can type this as long as I rely on touch typing, and don't try and look at the keyboard. If I do, all the letters and keys float around and I have to chase them to type. It all feels very unpleasant indeed.

Going back to how I am feeling, and how the meds are affecting me, I spoke with the GP again at the start of the week, and it has been agreed that my absence from work should be extended a little while longer, to allow things to settle down in the grey matter, and for me to level out a bit before trying to actually function on a useful level. If I tried to work now, I would probably just stare at the screen and be completely unable to decide what to do next. How can you write a blog in that case I hear some of you ask... Well, first off, badly!
Secondly, this is me focusing just on what is in my head, and using my instincts and muscle memory to hammer it out on a familiar keyboard. I am sure there are typos in here. Hard to explain, but to get these thoughts out of my head is actually beneficial to my well-being, as oppose to working myself up over things with work.
So the extra time off will hopefully allow me to get some fresh air, clear my head, find some balance, and maybe even get some more news from work about how things are progressing. 

I am sure there were more things I wanted to say, but as I sit here swaying from side to side trying to recall them, I realise it's time to sign off for now. 


Til next time. 

Published on Leave a comment on Just so tired!

The past couple of weeks now I have felt more and more lethargic in the mornings. Mentally and physically exhausted, and happy to just stay in bed all day of the opportunity were to present. My saving grace here is trying to build a routine for myself. At the moment I am off work sick, so part of my daily routine is missing, however I have managed quite well to substitute that section with cycling. Managing a good ride each day. 

In the morning I now find myself forcing myself to get out of bed, then making breakfast and a coffee, plonking myself in front of the TV and waking up slowly, before checking the weather and heading out for a ride. I have purposely scheduled my meds for 9am to make sure I am up and awake by that time, so no long lay ins. 

Once out on the bike I take it easy, and plod around, taking in the sights, keeping the brain busy, and getting some fresh air. But that seems to be my limit right now. Actually doing anything purposeful seems impossible at the moment. Focus is gone, attention span nowhere to be found, so trying to achieve anything which requires any of that is pointless and frustrating to try. 

I have said before about losing your flow mid sentence, we all do it, but I do it constantly at the moment, and it's the same for my train of thought. A blessing and a curse all at once. 

I am due to increase my meds on Monday which will be interesting, and also give an indication of what is causing my lethargy. It could be the meds as numbing my mind has always been an effect of them, or it could be the break in routine that is throwing me into a spin. Either way, right now I will just go with the flow, as the anxiety levels are dropping, sleep is improving, and general state of mind is better. 

I can't help but continue to feel that the meds are almost unnecessary, with anxiety levels having reached the point they did due to the speed at which work have dealt with the whole WFH issue. It still bothers me now, wondering what is going to happen, but alas there is still no answer on thay front. A full 10 days after I last spoke to work, not a single email to advise of what is going on. So still the cause of the spiral continues. I just don't get it. Thinking about it makes me anxious, sad, confused and angry all at the same time. As I have said before even a "we need to pass this up the line, hold tight" would be something, but nope! 

With the meds increasing, the wait continuing and the anxiety hanging on in there, I think this is going to be a long journey. While I am happy to wait it out, I just hope it won't be too long, as once I reach the point of questioning my own sanity, it becomes a whole different story, and depression starts to creep in fast. It's a cycle for me, and one I would rather avoid. So hopefully I will hear back from work next week.... How many times have I said that now? 

I am pleased to say Covid has been and gone now, and I am starting a bounce back physically from that at least. So the cycling is playing a part in helping me at least feel I can recover quickly. An important message for me right now, assuring myself I can bounce back from this episode of anxiety quickly too. Last time around with Covid it lingered for a while, so it's good to have shaken at least one monkey off my back. To be unable to get out on the bike right now would be crippling. 

 

Side note, I am sitting in the front room soaking up some morning sun, while watching the F1 while I write this. To write the above I had the sound on mute, as soon as I turned it back on, my ability to carry on writing dissolved. Focus, I just can't! 

Anyway, it's the weekend. Thanks for reading, and here's to a better week for news next week. 

PS, I'm off my for my flu jab shortly, if that doesn't knock me for six I will be surprised. 

Published on Leave a comment on CBT – Round 2 – FIGHT (or flight)

Today saw the second session of CBT for me, and I have to be perfectly honest, my mind was not in the right place for it today. Since the last session I have had a homework assignment to do, as well as a long questionnaire to complete, but quite frankly my mind has really not been up to the task. In fact it has not been up to doing much of late. Putting off and just leaving some tasks all together, choosing instead to slouch in front of the TV and binge watch TV programs. Although it is not all negative, after all, sometimes it's good just to completely let go. Relax a little, break the routine and just do whatever the mind chooses to do. All that before of course, reinstating a strict regime to follow, to keep the mind busy, and a routine ticking over. 

So back to todays session. It started with getting up in time to get the homework and questionnaire complete in time to send back before the session. That in itself was a challenge, finding myself getting confused and wound up by some of the questions. Not to mention starting to feel anxious while answering some of them, as they required me to put myself in stressful situations to decide on the answers. By the time the session came around I was already tense and my head was spinning a bit. 

At the start of the session I mentioned to the therapist that I was off to a bad start for the day, and we went over the mornings events to try and ease the stress a little. I of course know that had I bothered to get the assignments done before this morning, it would have made for a much easier start to the day. But I have already made my excuses, and I am sticking by them. From there we moved on to the rest of the session, going through the homework, discussing what I had learned about certain aspects of the anxiety structure, and seeing what I could improve on. Then the world turned upside down. The question came, "how would you feel if I asked you to speak to someone you have never spoken to before. Strike up a conversation, and chat for five minutes?". By the time she got to the end of the sentence my heart was already pounding and my mouth had gone dry. 

In a flash, running scenarios of what would we talk about, what would they be like etc. Pausing for a second I said "terrified!" The idea of someone else suddenly becoming involved and being expected to make small talk was horrific. Here I am in my safe little bubble, just me and her chatting about things, and suddenly there would be someone else! She replied, "do you think you could manage it though". Instinct said NOOOOOO!!, my happy space is not getting into these situations in the first place, let alone struggling my way through it. But obviously, for the sake of making some progress on the CBT course I know I have to put myself in awkward and uncomfortable situations, so I said I could do it, but didn't feel good about it.

We then went through some pre conversation questions, asking me to gauge how I felt 1-10 about various things like ability to hold a conversation, did I feel safety behaviours would come into play and so on. After this it was explained who the person would be, how we would structure the chat, and what would happen next. Then it was time, the therapist brought the person into the meeting, and made introductions. To my relief it was a lovely softly spoken young lady, so any fear of confrontation or being overwhelmed slipped away. After the introductions we spoke about the chosen subject of exercise and fitness. Throughout I fiddled with a pen on the desk out of shot, and found myself doing what I do best, talking and talking, offering compliments and positive reinforcements to them, while trying to keep the conversation in my control until the time was up. It was not a total monologue, but I was aware of how much I had spoken, and how little I had breathed, based on my heart rate by the end.

She went off, and me and the therapist did a recap, and re-ran the questions again. I had found myself much more confident towards the end of the conversation than I had first thought I would. I am starting to learn things about myself I didn't know. The inital avoidance of the conversation is far more powerful than the anxiety once engaged in the moment. The anxiety then switches to what I can only describe as a sand timer filled with energy inside of me, and I can feel the energy draining away as each moment passes. Almost controlling my fight or flight response, keeping myself in the uncomfortable moment but at great expense to my energy reserves. It is all related, not two separate issues, but it is interesting to see the point at which it switches over from complete avoidance (comfort zone for me) to fight or flight. In my case I choose fight, but thankfully only metaphorically, and fight in this case is to fight my own anxiety, and stay in the situation.

So that was the stranger moment over with.... Or was it. As we finished up the summary of what had just happened, I was asked how I would feel repeating the exercise, this time trying to avoid any physical coping mechanisms. Sit on my hand so to speak, and focus on the conversation and staying engaged. My immediate reaction was almost identical to the first time, became a fidget, and started looking all over the place. But within seconds, I felt myself calming down a bit as this was going to be the same person again, no new introductions, just a new topic, and trying to stay in normal conversation. This time I actually sat on my hands and tried to leave breathing room in the chat for her to speak to. By the end of five mins, despite feeling more comfortable about the conversation, I found myself almost in a tight ball, and hunched up. I had found a different want to use up the excess energy generated by the fight or flight reflex. 

Asked by the therapist if I felt that safety behaviours played a positive role in the conversation, I had a mixed response. From the brief exercise I had learned that when my body switches to fight or flight, like anyone else I get a surge of adrenaline which causes my body to feel full of energy. If I can find a way to expel that energy, while remaining in the situation, things start to become more manageable. For example, the first conversation, while more challenging, felt more relaxed due to playing with the pen. Much like my trusty twisty handkerchief I wrote about before. It has clearly played a much more profound role than I had given it credit for. 
With regards to other safety behaviours, such as complete avoidance of situations, while it certainly makes aspects of life far more comfortable, it is also sadly impractical to avoid people completely. Besides, contrary to belief, I do actually like some people.. Not many, but a few, and I enjoy their company, so being able to do that more would be lovely, hence here I am in therapy.

So my take away from todays session is that I am stronger than I give myself credit for, more capable than I believe I am, but go into hyperdrive when put in a situation which makes me feel uncomfortable. That part I think I knew all along. Maintain control, wrap it up quickly, and get the hell outta Dodge! Flight plays a part in my responses after all, it's just a little bit delayed for politeness. 

Going back to the start for a moment, to address the lateness in getting the assignment done. It all comes back around to the slowing down of my mind at the moment. I am pretty sure it's 90% meds 10% mood, but I just have very little get up and go at the moment. I have recently started having random thoughts just popping up in the middle of other things. For example last night I was thinking about a route I could walk or run, and suddenly roast potatoes and gravy.... What the hell! I mean I love them and all, but what did that have to do with it, But they quite literally dropped straight into the middle of my visualising a route. Just one of many random thoughts. That said, I would take random interruptions to my thought process over the inability to let a thought or worry go for hours on end. Just takes some getting used to. Needless to say, certain tasks which require concentration or focus are rather difficult right now. Next week my med dose increases a little, so it should be interesting to see how that affects things. In the past it has gotten worse before it has got better, so we shall see.

Right, I shall leave it there for now, but to summarise, session 2, shellshocked but feeling positive. 
Back for another blog entry soon, got so much more to write, just lacking the focus to be able to get it out.

Published on Leave a comment on Another step in the right direction.

Another day, another work meeting, this time with the boss. Following on from my email to work the other day, advising of me being signed off for a while, and asking for updates, we scheduled a meeting for this morning. 

In the back of my mind I planned to write out all the questions I had, and bullet points for anything I wanted to discuss, but due to a lack of enthusiasm to do much at the moment I never got around to doing it. 10 mins before the call I grabbed a pen and pad and sat and looked at it for nine minutes. Writing down one thing. Timescale. 

I have been lucky with managers of late, and my last two have been very supportive when it comes to the crunch, so speaking openly isn't an issue. The last time we spoke the connection was poor and we were cut off, so at the start of this call I checked we were good to go. 

It was nice to have a relaxed chat to start with, catching up about things, and discussing my current situation and state of health. How things are being handled by the doctors etc and what the plan moving forward is with that side of things. Before moving on to the nitty-gritty of the situation with WFH. 

The first subject was the general group / team WFH situation, and where it stands as far as the readdress of the decision. As a group the hope was to remain with WFH, but it appears when the assessments were done, the team was not really understood, and for some reason it was decided to return to the office. Since that announcement the manager and HR have been requesting it be reconsidered, and it appears that it is finally getting somewhere. The hope is apparently to have a decision on the group as a whole in about a months time. 

It was at this point I looked at my note and decided to ask about the time frame of my own situation, and if we were waiting for the group decision to be made before addressing my situation, or if we could push forward with it. 

Given the report is in, all parties concerned have confirmed they have seen it, read it and understand the information within, it felt like there was no need to wait for the group. With all the things that need to be considered for a group of about 16 people, I have a doctors report, requested by work, detailing what my situation should be going forward. The only consideration that really needs to be made is WHO is making the final decision, and WHEN they can take a moment to do that. 

It is fair to say that me and my manager appear to be very much on the same wavelength, and understand the importance of getting this decision made. As well as feeling this and many other decisions are taking far to long to make with no good reason. 

With all this in mind I decided I would try and set a deadline so to speak, and suggested that it would be good to hear something back before my sick certificate runs out. This would hopefully help me with my mental health situation, and bring me back to a level I feel I can function on, and return to work without any further delays or extensions to my sickness period. I feel that is a reasonable comment to make, especially as most of the anxiety is based on the lack of information that has been made available over the past six or so weeks. It is not a threat, more a statement of fact, that knowing what is happening with my work situation will have a profound positive effect on my anxiety, as it already has once, but for the worse. 

The plan now is for my manager to speak to HR again and chase them for their decision. It is likely that HR will need to speak to their manager too, in order to authorise a permanent change. In theory it is quite a simple thing to do, but I imagine there is a lot of paperwork to do, welfare, work place safety, equipment and other considerations. However I have been explicit in saying I don't need it signed sealed and delivered.... I just need an notice of intent for now. A "we will get this done", and then a rough idea of time and what will happen next. Rather than being left in eternal limbo, with no decision made either way, and the constant worry that there are plans being made against me. As stupid as that sounds, that is what my anxious mind says. 

I know HR are a busy bunch, and that even if my manager has emailed them this morning, a reply is most likely tomorrow now (Friday), so any movement on things is unlikely to be til next week at the soonest. Hopefully I will head something back towards the end of next week, any longer and I know already that the anxiety will reach fever pitch again, and we will start the cycle all over again. 

I am itching to get back into a routine again, work / life balance is fragile, and routine really helps with that. But for now I shall relax a bit again now the conversation has been had, and keep my fingers crossed that next week brings news. 

PS, writing later in the evening today seems to be the right way to go. Clearer mind at the moment. Been a tough day today finding the energy to get things done. Simple little tasks that have either gone ignored all day, or simply forgotten about. I tend to move things now to be in my way, so I remember to do them. Must fill the dogs water.... Put the bowl in the middle of the floor etc. 

Right, that's my mind fried from recalling all that. Heres to a relaxing weekend (mentally at least) 

2

Published on 2 Comments on Urrrgh!

Gonna be one of those days I think. Long but crappy nights sleep (thanks Kallik), starting to feel less run down which is nice, but still very unsettled. Body battery (Garmin thing) is quite low for me, and reflects how I feel, but otherwise things are OK. 

Had my first CBT session this morning, and I have to say, after a little pre meeting trepidation, it all went well, and like before, I feel like I have a grip on it and am starting to have a bit of an understanding. That said, I think I have always understood my anxiety, but just not yet learned how to cope with it. She did say in the session that I had made great progress, understood the structure well and was becoming my own coach, so that's good, right?  We did also discover that I am pretty complex and my favourite word is "control". 

As I expected, the scores from my testing this week show a swing back towards depression, and a relaxation of my social anxiety. That is why the therapies route has always been such a pain for me. While they are connected, and dealing with one assists with the other, it's a "pick one" approach, and a more generalised one at that. But for the speed this therapy has come about, I am NOT complaining, and appreciate the help I am getting. But it does support the pendulum effect I have always spoken about, that as one issue lessens, the other gets worse. The goal here is to stop the damn thing swinging and sit happily in the middle, or at the very least, take the energy out of the pendulum and stop it swinging further and further into the abyss. 

Tomorrow I have my meeting with work to discuss my situation moving forwards, so hopefully some progress can be made there. I am hoping we can separate the two situations, and deal with mine individually rather than with the herd. Worst case, herd is first, and I just have to be patient. If that is the case, I still feel in control, so am not too worried about the outcome, just more frustrated by the delays. 

For the rest of the day now I am at a loose end. I really want to do something, but not sure what. Riding seems a bit of an effort and faff for how I feel right now. But sitting on my arse for the whole day seems pretty frickin dull, so maybe a walk is the answer. I don't want to socialise in any way, partially because of how my head feels and partly because of Ann having Covid and me not wanting to spread it. So a walk in the open sounds like the best plan right now I think. Fresh air, pod cast in my ears and get the HR up a bit. 

Mentally today I feel a bit lethargic, disinterested in doing much. Haven't washed the bike after yesterdays ride, a few odd jobs need doing but I haven't been bothered, and beating myself up a bit about forgetting to put the bins out. I wasn't sure if it was a bank holiday weekend for bin collection or not. Meh! Oh well. (edit, I just checked and seems they are being collected tomorrow, phew!) But yeah, head not in a bad place today, just not too motivated. Thought process seems a little more active today. Noticed I was quite engaged during my CBT session, able to think on my feet, and also writing this I feel 8 have some flow. That may of course be because I have only just taken today's dose of meds, so could go downhill from here yet, but all part of the journey. 

It's nice that people are reading these entries and being kind enough to respond to me via messages and other means. Feels good to know it's a shared journey and a path others have trodden before, so thank you to everyone who has been in touch in anyway, your support means a lot to me. And I hope in turn than by writing and sharing this, others somehow get some help and understanding from my journey. It has always been the goal of this blog to share both ways. 

Right, I better get my day in order before I give up on it all together. 

Til tomorrow... 

Published on Leave a comment on Side effects have arrived!

Almost at the end of the first week of taking the news meds, and the side effects are starting to show their face. Nothing alarming, or that I have not experienced before, but they change the game a little all the same. Sertraline is the drug in question this time around, a change to my usual Citalopram, but early days feel the same. 

Due to feelings really run down at the moment, I am already struggling to have the energy to do much, but combined with the early effects of the meds, it has kinda knocked me for six. Currently feeling physically fatigued, my interest in doing anything is badly affected, so I am spending a lot of time sitting around and not doing much. I noticed yesterday when going for a little ride that my energy levels were pretty low. By last night the mouth ulcers including one on my tongue had reached a point of not just discomfort, but annoyance too. Over salivating, so continually swallowing makes it really hard to get to sleep, making you feel like you are drowning in your own saliva. One of the ways to kerb this is to clench my mouth shut, but that leads to headaches. Lose-lose!

Anyway, this is meant to be about side effects of the meds, not ailements of being run down. So let's get back to those. Now the actual intended effects of the meds generally take 4-6 weeks to have a noticable effect on the condition they are treating. However that does not mean they don't start to have an effect straight away. The idea is to build up a level in the body to impact the anxiety, but with a regular dose, it soon starts to have an impact even before levels build up.

Previously, and indeed currently the main effect is a dulling of the thought process. There is a trade off to be had, and I will give a good example of it shortly, but for now, let me try and explain how I feel right now. I feel mentally lethargic, with a lack of focus on anything. Concentration is very, very low, so even something as simple as following the plot of a program I am watching can be difficult. When speaking I can lose my flow mid sentence, or completely tune out of a conversation I am having without warning. Even if I have listened carefully, recalling what was just said can be difficult. Even recalling what I just said can be tough. We all have this sort of thing for a moment, but for me right now, its all day long.

Trying to put a blog entry together is hard work, and in a rare moment of clarity, here I am trying to document what is going on before I lose my way again, and lose the chance to create this valuable reference point for myself. The upside of this feeling of course is the almost inability to dwell on anything. My anxiety can find me caught up in a self destructive loop at times, catastrophising the most simple of thoughts. To go back to the example I promised, last night while suffocating in saliva, I wondered why I was suddenly creating so much. My mind trying to be as irrational as possible took me back a few weekends where I saw a runner at the half marathon running in aid of "saliva gland cancer research"... Of course my mind went to cancer. 

Now, if this was just me, not on medication I can guarentee that I would have got up, googled the symptoms, and somehow worked on making them fit to what was going on, for a moment at least. Instead, my mind went there, the thought entered my mind, exited and was not heard of again for the rest of the night. It is almost like a temporary amnesia which makes it impossible for the conscious mind to hold on to a thought long enough to spiral down with it. Handy in those instances, difficult day to day. Needless to say, concentration comes at a price right now, and that cost is irritability. If I am trying to focus on one thing, and anything distracts me, I become very frustrated, very quickly.  Another cost is energy. To focus on a TV program for an hour, leaves me tired and needing to take a break, which is what I am doing right now.

Other effects include feeling a bit light headed from time to time, lack of interest in doing a lot of things which require any focus or physical energy, and general all round tiredness. Yesterday I liked the idea of going for a couple of rides this weekend, by the time I woke this morning, after a crap nights sleep, I had no interest in doing so whatsoever. Thinking about it, I honestly think I would be a liability on a bike today, as I just can't shake the wandering mind and eyes. We did pop to the shops earlier, and while I felt save taking an easy drive there, my ability to shop  was just not there. No idea what I wanted, so just grabbed a few obvious things, and called it a day. For the rest of the day I shall just rest body and mind.

Fingers crossed the mouth starts to feel a bit better soon, as the over production of saliva and constantly swallowing it leaves me feeling quite nauseous, and I could do without any more ailements right now thanks.
I am gonna leave this one here now as I am struggling a bit to write rather than ramble. Apologies for the waffle and any typos, I just don't have the capacity to do much better. From previous experiences with these meds, these effects should ease a little in the coming weeks. Replaced by some other weird and wonderful side effects, which will also hopefully be short lived.  Just to add, by the end of the week I had received no contact from work at all, no acknowledgement of me calling in sick, or my absence. And no updates on the outcome of my appointment with OH, so that is officially a month without so much as a single word being spoken about it. Nice one! Next week, if I can string a sentence together, I will chase this up.

Thanks as ever for reading.

Footnote..
Apologies to anyone I engage with over the coming few weeks. If I stop talking or replying, or just seem distant, it is just the meds making it hard to concentrate. If you are boring me, I will be sure to just say! 

Published on Leave a comment on Different doc, different feeling.

It is fair to say that the last time I spoke to a GP a couple of weeks ago was a relief. The pre appointment anxiety was dealt with swiftly by a doctor asking me to tell her what was going on, and listening as I spoke. Then encouraging me to share more information, before discussing with me what my options were. Well today was the follow up to that appointment, a checkpoint to see how things were going and what could and would happen next. Now feeling a little more confident about speaking to the GP about it again, I was ready with what I wanted to say. However, I was in for a rude awakening.

The call itself was a little later than planned, but that is fine, schedules slip and all that. Although I had not received the usual text reminder yesterday about this, so did at one point worry a little that I had got the date or time wrong, or something else of my own doing. None the less, the call came in.

After introducing herself, she told me that she was calling to follow up on her colleagues appointment with me a couple of weeks ago. All good so far.  I thanked her for calling, and we got into the consultation. It went a little like this.

GP: You were prescribed 25mg of meds, is that correct?
Me: Yes that's right
GP: How has that been?
Me: Errm OK really, no real difference.
GP: No 25mg is a very low dose, we use this to see how it sits with you. I will increase the dose to 50mg, is that OK?
Me: Yes, ok if that's whats needed
GP:OK I will send the prescription to the pharmacy now. In the meantime take 2 of the 25mg a day until you collect the new prescription.
Me: OK will do. 
GP: I also need your BP, so do you have a machine at home?
Me: Yes I do
GP: OK I will text you now, reply to that with the reading when you can.
Me: OK I will do that shortly
GP: OK if thats it, we will arrange an appointment in 4 weeks to follow up with you, reception will call you. 
Me: Oh, OK then, thanks.

By the end of the whistle-stop conversation it felt apparent that this was not a GP I was going to feel comfortable having dialogue with, so just kept it short and sweet to prevent myself getting frustrated or upset by it. Lower my expectations to match the perceived level of interest. Something I have learned to do over the years. There will be another appointment, so I will bide my time and save the more intimate stuff for someone I feel is interested and listening to me. I think this is one of the issues with phone consultations, not being able to see the person, so having to gauge their levels of interest and interaction by voice and tone alone. Not always easy, and definitely not always right either. 

So now there are 4 weeks until I speak to my GP again, and the decision on taking, upping or abstaining from meds sits heavy with me. In the meantime my general state of mind has improved somewhat since getting the ball rolling on speaking with HR at work, them arranging the OH appointment, and my other decision surrounding the idea of returning to an office. Having a back-up plan has really helped, and just knowing that I am OK with finding a different job if it comes to that has made me feel far better about myself. 

Right now I would say I am in a stable place. Although today's perceived lack of interest and engagement has wobbled me for a bit. Not feeling comfortable to ask the questions I had, and explore other avenues at this point is frustrating, but not life changing, so deep breath, and looking at things in perspective, and it will be OK. The time for that will come, and I am in control of the situation. Screening etc can be done without the GP involvement, but at a financial cost... But so be it. 

In the meantime, I have my other appointments coming up with others such as OH and IAPT, so still more to do before worrying about what comes next. The WFH decision is a slow one, but in the pipeline, so that also just needs a little time, to get the final outcome, from which I can then decide which direction next. Options are aplenty. 

In general, day to day well-being has taken a bit of a hit in the past week or so. Physically my back is still giving me a bit of grief, but a lot better this week thanks to Andrew Fung the Osteopath, who I am seeing again later this week. This has led to a drop off in cycling and a complete lack of returning to running for now. Frustrating to say the least, but also has a knock on effect to my mental health too. 
In that respect, my brain is telling me all sorts of weird and wonderful horror stories of what might happen if I go riding. I want to get out on the single speed, but brain says "what if, what if, what if".... So I don't!

Running wise, I have a half marathon at the end of the month, which is looking less and less likely to happen, or at least certainly won't all be running, as it has simply been so long since I ran any distance whatsoever. So trying to jump back in with a half marathon might be asking for trouble. Although... Maybe if I keep the pace down....  !! We shall see. I want to try and get a run in before the end of this week. 
So til then, here's to next week and my appointments with OH and IAPT. As for WFH, no news is good news, as it means the 30 day countdown to return to the office has not yet started. But watch me eat my words in the next day or so. That said, just because the notice is given, it doesn't actually set a date for me to return at that point. 

Here ends todays update.  Thanks as ever for reading. 

Published on Leave a comment on To medicate, or not to medicate….

Not my first rodeo with anti anxiety, anti depressant meds, so that is not an issue as such for me. When the time is right, needs must, and I have no issue with taking such medications to help. But is that time now?

I am getting ahead of myself here, the last thing I said was I was going to speak to the doctors. Well, that appointment has come and gone. Much to my delight the conversation was relaxed and open, and I felt I was able to express myself clearly. More importantly I felt I was listened to throughout, and the doctor understood where I was coming from. Ironically 2 hours before the appointment I received a call from the surgery informing me that the appointment would now be on the phone as the doctor was working from home! Alright for some eh. 

I discussed how I have been anxiety "free" for a long while now, and how Covid times have shown me there is a way to do my job, and be in a good place mentally too. And that even starting to process returning to an office environment has thrown me into a tailspin, and it is affecting me. I said I have always been bad in public spaces, or crowded environments, and do much better alone or in controllable spaces. From there we moved onto the more general aspect of the issue, and the social anxiety.

Her feelings on the matter were two fold. Firstly recognising that this new episode is triggered by the fear of being back in a space I can't control, and that this has until now been avoidable with no impact to my ability to do my job, or work for a living in general. And that secondly she would like to try and improve my general wellbeing in all walks of life, by getting me help for my "anxiety disorder". Her suggestions being using medication to control the anxiety, and counselling to address the social aspect of it, and help me find ways of improving my state of mind in such settings.

We also discussed moving forward with matters at work, and how I can go about addressing my anxiousness about being in an office again. Going back over how things were before Covid, and how I have over the years learned ways to "cope" with the anxiety it caused me, rather than overcome it and feel normal at the end of a working day. Touching on how mentally exhausted I get when in uncomfortable situations. Using all my mental energy to appear and function as "normal", and when the curtain falls, just crashing and being left exhausted, and totally drained. Not to mention feeling edgy and in a foul mood. Repeat that on a daily basis, and the cycle is, wake up OK, interact with partner and friends, go to work, be drained of all your will to live, come home and be an utter arsehole until you go to sleep....Repeat...

Some would say I am not that bad, or too cranky etc, but even that alone takes all my reserves to maintain. Being aware that you are behaving like a bit of an arse is really upsetting. So you are then left with two options. Hide away, or draw on your final reserve of mental strength to at least be likable. It is a really hard one to explain, everything feels so fake. Oh look, its people, slap that smile on, crack a joke or two and reply to "how are you" with a very plastic "yeah yeah good thanks". Rather than, "well to be honest dying inside right now, this is exhausting the shit out of me".

Having spent so many years with multiple personas (not split personality), switching at will to suit the audience, I have become very self aware, and know the second I am starting to be "fake" . And let me tell you, being fake has an energy burn 10x higher than just ticking along being me. To put it in physical terms, as some people only understand those, think of the difference you feel between walking at a nice sedate pace, and running flat out as fast as you can. Heart rate rises, body temp sky rockets, muscles tense, and energy rapidly drains from your body. Now imagine feeling like that, while still just walking along. It would be alarming right? Welcome to my anxiety mind!

So, here we are, post appointment. Diagnosis "Anxiety disorder", treatment, counselling and medication, prognosis hopeful but too soon to tell. I have sent off my referral to the Mental Health service providers locally, and await to hear back with any sort of waiting time, and suggestion of treatment. I have informed my work of the outcome, and await hearing if there is any intervention at this stage, and I have collected my medication from the pharmacy.

The last two are the important factors here. Work, I am sure there is no need for any intervention at this point for a number of reasons. Firstly there is no official 30 day notice period given to return to the office yet. Just the pre-notice notice, if that makes sense. In the meantime we all await to hear if there is a chance of overturning the decision to end WFH. And secondly, at this point the anxiety has not affected my work. While working from home I am still able to function OK, but can honestly say that my focus and concentration has taken a huge hit, as I have touched on before.  If and when work are to do anything, it will be a referral to the Occupational Health service, to assess my ability to carry out my job, and see if they agree with the GP. The GP has said they are more than happy to work with the OH to make sure the best and most suitable arrangements are made, to allow me to work, while managing my well-being. 

The second factor being the medication, and the point of this blog entry. So the deciding factors here are a bit of a mess, hence blogging to try and make sense of it. Bear with me here. 

My need to go down this whole road, to me at least, has been the anxiety triggered by the knowledge of the request to return to the office coming. Until that point I have felt better than I have ever been before. Sure there have been moments of avoidance and struggling with socialising away from work. That is something I have always lived with, and chosen my battles carefully. Risk vs reward so to speak. Is the end goal worth the use of all my mental energy, feeling exhausted and edgy for the next day or two? As you can imagine there are not too many scenarios which warrant that result. The GP wants to tackle this aspect too, so the medication and counselling is to help with all walks of anxious life. OK, great.

Or is it? In general, I don't like being around a lot of people, fake people, talking shit, all in the name of looking good. No thanks, I will stick with the genuine people I actually like, people who know ME and not one of my personas, and that I can actually communicate with, without becoming exhausted. There is no denying that there is social anxiety for me in both settings, but one is far more manageable than the other. Do I feel the anxiety in the calmer setting needs addressing? Maybe! It would be nice to spend more time with people I like in a wider range of settings and environments, but do I want to medicate to do that? THAT is the question here.

The other half of the question, am I happy to medicate, and have to attend counselling to learn coping mechanisms to return to an office, to do a job I have done without fault for the past two and a half years from home? Well............... errm, no, not really! I appreciate I did it from an office before, but that was before WFH was even accepted as possible for my team, and before it necessitated us being at home to do our jobs, to enable the company to keep functioning through Covid. A change I was willing to make for my employer, at very short notice. A change which proved itself to be beneficial to the company on a number of fronts, and one which showed me that my mental health was SO much better away from an office environment. All very accidental. But when you discover a better method by accident, or through circumstances, do you change back because the old normal is the only right way?

If you commute to work by car and the main road you use is closed, and a diversion is set up. If the diversion it turns out it's a quicker route. When the main road opens again, do you go back to your old route? See where I am going with this? There is a new, proven route / work method, why deviate from it for the same of going back to the "good old ways"?

So now, while I wait to hear about the official line on WFH, if any appeal has been successful, or if indeed we will get our 30 days notice to return. Do I start the medication now, to primarily treat the anxiety caused by the news. Tolerate the side effects as the levels build up in my body, and possibly trigger worse anxiety in the short term, and maybe the need to take time off work anyway. Or do I wait for the outcome, and if it us unfavourable, and the notice is given, THEN start the process of taking the medication, at which point I feel it would be more than needed, as my anxiety will blow up? Feel free to share your thoughts.

I know the idea of the meds is to help with my social anxiety too, but right now, I don't want to take meds, and feel like I have been forced into this by matters at work. Which are the primary reason I am in this situation, and had this conversation with my GP in the first place.

Phew, that was a lot to get out of my little head. Thanks for reading.