Thursday, April 28, 2011

Day 28 of the Citalopram challenge

I think. Certainly tablet 28 – I took the last one in the box today and will go and collect my next pack later. I’ve definitely found some stuff: a little motivation for better eating, more walking, losing the weight I’ve gained, home cooking, being a little more socially active. These are all improvements and I’m pleased with the progress gained from the medication. I’m happy to keep taking it as long as I feel under mental strain – a mental strain which has become much more apparent as I’ve regained a little clarity.

I had my assessment with Healthy Minds yesterday which was the usual mix of graded PHQ questions (moderate-severe depression, minor-moderate anxiety) and exploration of mood, risk, family, relationship history and work. As may be apparent from my last post and is definitely clear from a recent chat with Tess, I’ve been introspecting recently to understand the reasons behind my depression; I stated as such to my assessor. I’ve sabotaged me by piling old problems and behaviours onto an already-stressed mind – itself an old, outmoded behaviour. I’ve reverted to eating, drinking and the internet to help myself feel better which, in themselves, have caused more problems than they’ve solved and are contributing to a vicious circle of self-esteem damage and comforting.

I admitted outright that I used to have problems with alcohol, weed and internet abuse (now that I think about it, sometimes all three at once!) but I have the first two under control and have done for many years. This leads to an important revelation, one which I’ve touched on here, admitted to myself and Tess recently but it’s worth reinforcing: I am addicted to the internet, I’m using it as my main source of entertainment, a crutch and a distraction, and it must be brought under control. It’s contributing in large part to my sleep problems, concentration issues and motivation and I am trying to wean myself off it and onto more healthy pursuits. I want to regain my love of walking, my absolute adoration of home cooking, spend more quality time with daughter and see my friends more. I want to read more books at work, play chess, doodle, blog, write for the Coll3ctive, maybe learn more Photoshop skills and the like.

One of the unfortunate side-effects of this is that I’m going to have to spend less time talking to Tess. Currently, if she’s free, we spend up to five hours a day in reasonably –continuous conversation online. Since our respective time-zones changed, I think we’re talking considerably more than we were, or at least in one big chunk instead of at each end of the day. I’m sure this is a swings-and-roundabouts situation; I get a lot of benefit from talking to Tess, but spending hours on end talking to anyone feels like too much, especially for someone with a history of internet chat addiction. Cutting back has its upsides too; our conversation is sometimes stilted because we’ve run out of things to talk about and I often feel a little guilty about this so try to keep the conversation moving. Spending less time talking overall may improve the quality of our interaction and make it a touch more special, sacred. Trying to look at the benefits, it may also give Tess more freedom in the evenings, something I know she’d dismiss as unnecessary but, were we living together, we’d both appreciate the chance to do different things occasionally and maybe this will free her up a bit.

Anyway, I’ve wandered off the point a little there. During the assessment I surprised myself with the answer to a simple question: “You said you’ve had some therapy before – what has your involvement been with mental health services?” and I said “Lots. A number of community psychiatric nurses, some private Adlerian therapy, ten sessions of psychotherapy with Costas at The Dove Centre in Aylesbury, twenty sessions of psychodynamic therapy via The Tindal Centre in Aylesbury and about eight or so years of anti-depressant medication, at one point two different tablets a day… I think that’s it.” The surprise was just how long my list of interaction with mental health services has been, and this was reinforced when she summed up our discussion with “Given your current situation and history of involvement with mental health professionals, I’m going to put you on the waiting list for Cognitive Behavioural Therapy.”

She told me all about CBT and how it focuses on the now instead of the past, how it tries to make sense of behaviour and tries to discover ways to mould unhelpful behaviour into more positive action. I like the sound of that, and it feels like I already have a couple of things to focus on, behaviours I’d like to explore.

This is positive action. I’m proud I’ve taken this path instead of the alternative; I have always told myself I’m not going back there, to that pit. I told my assessor I probably only feel 10% as bad as I did when I was at my lowest, and I think that’d an accurate estimate. That I’ve spent the past two months feeling utterly crap, I can’t imagine how I used to live at my lowest. I guess the answer there is that I didn’t, really – I survived. Now, I feel like I’m thriving again; not better, but definitely improving and moving in the right direction.

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