Is everything ok?

'In some cases an accurate diagnosis may suggest an intervention to limit the damage that bad judgments and choices often cause' - D.Kahneman

I saw this line in the first page of a book I bought now that thanks to the new glasses I can actually read again, and for some reason it struck a cord within me and I couldn't get it out of my head. I think there are two key phrases in the quote that relate to mental health. Firstly 'accurate diagnosis' according to my Psychiatrist I am pretty straight forward in terms of my Psychosis, it is what it is and that is it, so to speak. But if being prone to Psychosis is caused by something like a personality disorder it becomes less straight forward. So it depends if we are looking at the cause or just the diagnosis because personally I don't think you can come to the conclusion on one without talking the other into account. The cause leads to a diagnosis, and the diagnosis is formed on the basis of the cause. So in terms of mental health, finding the root cause seems to be just as important as getting the diagnosis, because without knowing the triggers the fact you know the diagnosis means squat, then it will just happen again and again. I have been lucky this time  because I know what my triggers and first symptoms are so I can try and stop it getting to the point it did last time where I ended up in hospital.
The other phrase is 'limit the damage that bad judgments and choices often cause'. I wonder how many people can sit and say that their mental health issue what ever it is, was not partly caused or made worse by bad choices or judgments. I know mine was, even looking back before the psychosis back to when I was at school there was damage done both to me and by me that still seriously influences the way I act and behave today, and the psychosis just magnifies my faults in my life choices and also the bad choices and actions of others. Looking closer to the present to my first attempt at my first year of uni bad choices after the Christmas holiday played a serious part in causing my Psychosis. I made some bad judgments throughout  both attempts at my first year. During my second attempt I made choices that effected whether or not I could make it through the year, those choices meant I couldn't. Having said that the choices made were based on many factors such as my fear of going out on my own, and not managing to participate in things to the extent I wanted to. They were not just off the cuff choices. I owed it to myself and my parents to go back for a second attempt and I don't count that as a bad judgment, but what I do count as a bad judgment was not attempting to go to more lectures or social events as hard as I found them.
As Kahneman says intervention is key, and on both occasions intervention by my parents and my friends saved me. But there are those who don't get the intervention because they still can't talk openly about their condition, be they bankers, students or teachers. I don't necessarily think that intervention has to be by a health care professional immediately, the first step is, if you are worried about someone, ask them if they are ok. Simple as that. The times people ask me that, and actually sound like they care makes everything seem ok. Maybe like I am sometimes, that person is dying to be asked if they are ok, just for the chance to talk about stuff.

The New

Today I got new glasses, not a big deal for most, but for someone that doesn't do change, to me it is a massive deal. It has got me thinking about how I deal with new things and change generally. To me this is one big hurdle I still struggle to climb but change happens all the time and to an extent you have to just role with it. I cannot really explain why change scares me and makes me nervous, it just does. However I have come to the conclusion that worrying about stuff you cannot chance is pointless. Of course I wish I didn't have Psychosis, but I do, so I have to get on with it and it is my desire to use it to use it in every way I can to help other people and myself at the same time. Mental illness is such that it changes frequently, it evolves from one day to the next. And I think people who don't have it need to understand this. We are not fighting a label. We are fighting an illness that may change in its nature as quickly as over night. So to an extent you have to live with the new, even if like me you cannot stand it. Some change can be good though but even that I struggle with. Change is everywhere and always happening and I think it is important to be mindful of it and to an extent you just have to go with the flow, because fighting it can make it even worse. As my illness evolves and changes I too find my self changing and evolving. For example the first time I became ill I really let myself go, and became all unkempt and the like. So this time I am fighting it by trying to keep on top of all that stuff, by making myself feel better by keeping an eye on how I dress and how I look. Not in a vain way but in some ways, feeling better outwardly can make you feel better both mentally and physically. So I think when change happens you just have to change with it and just keep an eye on yourself and be aware of the changes in you, and around you.

The most important thing I think to do in this situation is just acknowledging the fact that you can't change change. And although I wish I could you cannot control it all of the time. But I have found the trick is to become aware of yourself and of the changes that you will go through.
The changes can be difficult, especially if it is a change for the worse. This is difficult for you, but is also painful for your parents and friends to see, so keep them in the loop. Talk to them about it, because that is the only way the will be able to understand it, as it may be a change they cannot see. And if it is a change that affects them it is important, and it is their right to know about it. This can sometimes not be easy to talk about. So I sometimes try writing it down for them, especially when my brain is so muddled that I am in no position to explain it verbally to them. And I have found this silent communication works well, when talking can be too painful or hard.

Building and Breaking

In my last blog I talked about how hard it can be to tell your family and friends about your condition. But not about how and when and why you will inevitably have to tell strangers about it and what there reactions are like. 

It is everywhere, I filled out a drivers licence application a couple of days ago, and it asks if you suffer with mental health issues. Why ask that in those words? And I can't think of a half sensible answer to that. If it asked more specific questions about hallucinations or the like I could understand why that is important to tell someone, in relation to driving. But why ask about mental health under one overarching stereotype. This I must say I have a slight issue with. As I had to tick the yes box, so any sort of assumption can and probably will be made by the assessor of the application form. My point is is that the term mental health covers so much and so many different illnesses that the question is just wrong, and to an extent redundant. That being said if I get a reply asking me what my mental illness is I would be more than happy because then they are not tarring everyone with a mental illness with the too unstable to drive brush.
In the car this morning I was trying to think of a half decent metaphor for what it is like when you tell a stranger about your illness, for what ever reason that is. The best one I can think of is taken from Harry Potter, in book number two during the dueling club Harry speaks Parseltongue to ward of a snake. Something which is associated with being bad and dangerous but was in fact being used for good. However the reaction of the crowd around was that Harry must be bad and dangerous because he can speak it. In exactly the same way that saying you have Psychosis to a stranger sets alarm bells ringing and triggers instinctual defense mechanisms within them. I don't blame them, I blame the lack of education people receive about mental health. If it was talked about more at a school level people would grow up with an understanding of it so much better.
I am lucky with my boss I have the sort of open friendship so I can tell her everything and she understands it all but I am pretty sure people like her are in the minority. Not just because bosses like her are rare but also people are too scared to go to their bosses and have the conversation for whatever reason, which is totally understandable.

I had a similar problem when I tried to go to the USA with dad on holiday last summer, during my first psychotic episode, on their visa applications it asks about mental illness and was I a danger to myself or others. No I wasn't but they still demanded at least two letters from health care professionals to back it up. Which I had and when I went through security there were no issues and it turns out I didn't need the letters they asked for. But I had to wear a long sleeved shirt to hide old scars on my arms in case they saw and got twitchy about it, and that made me ashamed of myself, and what I was suffering with. Which no one should have to feel, no matter what the circumstance. In this instance I understand for security reasons why they do what they do but it is not helpful and I think could be handled better. because if i had said i was a danger to myself I would had to travel to the American Embassy in London to be assessed to see if I am fit for travel.

I think that when you tell someone who doesn't know about or understand mental health issues they automatically build walls to protect themselves from a threat that is most likely not there. For a while I thought it was my responsibility to break down those walls other people surround themselves with. But I think I have come to believe they can only be truly broken down by the person that builds them. 

Finding the words

Here's the big question; How do you tell or talk to your parents and friends about your mental health issues? For most people this is one of the first and hardest of many hurdles to clear. So many things went through my head. How will they respond? Will it change everything? Will they treat me differently? How will it impact my family? And a million other thoughts. Mostly? I worried about their reactions and whether it would change the relationships I have with my family and friends. I must say I have been extraordinarily lucky on the whole, with the reaction of the people around me. My family have all come to terms with it in their own way and our relationships are stronger than ever. But this does not mean that worrying about it was irrational because sometimes it is hard to describe how you feel, or what is happening inside your head without scaring people or making yourself feel worse. In the sense that finally verbalising what is happening can make it seem very real all of a sudden. This can be very scary but is an important step to take but if you stick to the facts and just be honest about it will make you feel better than if you tell half truths or lies. I cannot really say what it is like for a parent whose child develops a mental illness, and I wouldn't even try to second guess what they have gone through with me. But it is clear it can be difficult and scary for them too, so do go easy on them, because the chances are it is just as new and intimidating for them as it is for you .
My friends have been equally great. It seemed to me that they just took it in their stride and when you share something so personal with your friends I have found it creates a very deep bond. Even though I am no longer at university I feel connected to them in a way I cannot explain, they were so good to me. What with my almost weekly trips (for a while) to the hospital and the strange people visiting me in our flat. I would have understood if they had not wanted me to still live with them or be around them, as they saw the damage I could do to myself first hand, which I would think is fairly frightening. But instead it felt like they just held me closer to themselves.  I won't name names but the hugs, the cups of tea and the general being there for me was invaluable and if you do read this you guys know who you are! :)


Starting the conversation can be very tricky and emotional, that is just fact. But how to end the conversation on the right tone can be equally hard. Both for you and the person on the other end of what you are saying. I have found the trick is simple: be honest, to the point, don't try and play it down and constantly watch how the person you are telling is responding; so then you know once it is over how to leave it. Some, in fact most I have had have ended with a hug and a quiet word in my ear. However some people may need time to take it all in, if they do then give it to them because it can be a lot to digest, especially if they have never encountered mental illness before. Some may react badly and there is no skirting around the issue that some people do, and that is their problem and their ignorance. I have found that the people who matter the most, love you however you are and whatever you have.

Feeling the force

Well today dad and I got a new puppy. He was born on May the fourth and as such he has now been named Yoda.  It is great to have a dog back in my life and the force is definitely strong in him :P

Since the car journey home he has done nothing but sleep and chew stuff up.
Talking about sleep, weird things are a happening. I have been going to bed at a reasonable time, sleeping fairly OK and waking up before 8 each day for the past week or so. It is funny how the little things can make a big difference. My day feels so much longer, and as such I have more time to do stuff I really like. I am genuinely amazed how beneficial a sensible sleep routine can be. It may sound silly but it has made a big difference this past few days.

As I said in my last blog, I have been having quite a big problem with panic and anxiety. To combat this I have set myself a few small challenges. Firstly I am trying to organize my thoughts into specific notebooks etc. At a time when I feel my brain isn't firing on all cylinders it is much better for me to write down my thoughts, and plan what I want to say, if it important, before I do it. And it does seem to be working to an extent. The second challenge I have undertaken over the past few days was to go to Cribbs Causeway, which is a big inside shopping centre, which can get quite busy. So it was a test to see if I can cope in crowds and be away from what I would call a 'safe place' for a whole day. Although I found lunch a little tense as the restaurant was pretty busy the day was an overwhelming success which made me feel very good. I think when dealing with mental illness it is important to take baby steps. Slow and steady wins the race. Trying  too much to soon, which is what I have done in the past only makes things worse. Everyone is different but everyone knows what to them are big or little steps. 

Taking these little steps can be vital in regaining control of yourself and not letting the illness control you. Which is the worse thing that can happen but often does for a while. However being mindful of it is half the battle fought. After taking what others may see as baby steps you do get an overwhelming sense of achievement, and it feels GREAT, a buzz most people who aren't ill wouldn't understand but it is amazing.
I saw my GP yesterday, whom I get on very well with and he really got me thinking, we were talking about psychiatric wards and their pro's and con's. but what was interesting was the word he used and the explanation he gave. He said they should go back to being called an asylum, even though this word was abandoned many years ago. He said it because you are seeking help in exactly the same way people claim political asylum. He said it is not unrealistic to at times feel like you need to seek 'mental asylum'. I found that thought quite comforting and reassuring in a strange sort of way. Like it isn't something shameful to consider, but it is in fact, sometimes the best and most rational decision to make. However now is not the right time for me to claim it. But he just made me feel that if I ever do need to, that you shouldn't be ashamed of it. And  people shouldn't you wouldn't be ashamed of having your appendix out so why should you about this?

Fighting on many fronts

Since I have relapsed I have been put on new set of various prescription drugs and at the last count I take up to 16 pills a day, depending on how the day is going and how I am feeling. But there are some I take regardless of how I feel. The 'bread and butter' drugs. These are Aripiprazole, which is an anti-psychotic drug and an anti-depressant called Amitriptyline. I also take pain killers and Diazepam which helps to control my moods and feelings. There is no doubt that all of them are working for me, on a good day or at a good point during a day at least. However during a 'crisis' or and episode of serious panic, I find myself doubting their effectiveness however these episodes are pretty rare. Which is what I will be discussing with my doctor on friday. I am not nor would I ever say taking them is pointless, they do do a lot of good but it is possible to reach a point (even whilst taking medication) where it has little or no effect. At present I do not know what the answer to this problem is, and is causing me a fair bit of worry. The difficult thing is that it takes time to find the right drugs and then the right quantities of that drug. This can be, and is for me, very frustrating. Which then fuels the circle of panic and fear. Of late these 'crises' have a number of effects on me, I get the shakes, my memory goes and I cannot remember basic things. I get dizzy and my spacial awareness fails me. This then makes my head worse and it goes on. The trick is to break the circle, every Dr, Nurse and other Professional has said this. I know it is true, but that is so much easier said than done, it takes time and effort and some days the effort just isn't there to fight it but most days it is. I am not saying I want it to keep happening but some days it just feels like there is no fight left. On the other hand some days I wake up raring to fight it and to an extent this blog is my way of doing so. For each person that reads this in my eyes it is one way of fighting it. 
It is not an understatement to say that medical intervention in terms of medication has pretty much saved me. But I am still not at a place where they work completely and it may well be that this is as good as it gets, as I am well aware it is not possible to cure everything with a pill or potion. They are one side of the coin. The other side is learning my causes and triggers of Psychosis. However this is not easy, both of the times I have had a psychotic episode the situations were totally different, some things are sort of the same but the way in which they manifest themselves are totally different. Which can be difficult to handle because it is like trying to fight a 3 headed beast, focus on one head and the others may strike. Hopefully in time it will be easier to fight on many fronts at the same time, at the moment it is not easy and to be honest I don't think I know how but I will try. What I do know is is that I wouldn't have a fighting chance without my family at my side, as they have been all the way through this.

Tired and Inspired

So yesterday I went to my sisters wedding and it was amazing! She looked beautiful and Ian (my now brother-in-law) is a fantastic chap. I don't really go in for all this soppyness but the whole day left me totally inspired. Firstly I was really inspired by the whole notion of love and marriage, to share that sort of bond with someone leaves me hopeful that there is someone out there for everyone. Secondly the venue for the wedding was stunning and sort of made me appreciate just how beautiful, tranquil and peaceful the world can be. Which is especially important to me at a time when I struggle to find peace and tranquility in my own life and in my own head. As I said the whole occasion gave me hope, hope for the here and now but also hope for what is to come. Even if I do not know what that is at the moment. I think hope is just as powerful a emotion as any other. And for me, at this point in my life it is one of the ones I cling on most to. Since I am on somewhat of an emotional ramble today I would like to thank all the people that have been in contact with me or family members since I started this blog. Your continuing support is greatly appreciated.

However I cannot say that the wedding was plain sailing for me. I am beginning to struggle being out in public quite a lot again at the moment, I get very nervous especially with people I do not know, so the post ceremony reception was challenging to say the least. Having said that many of the guests were friends of my extended family who I have not seen for many years which did make it slightly easier. Especially when a few of them told me they were following me on here. We did have to leave the reception early because I started to struggle more as the night drew in and I started to feel totally exhausted. But the amazing thing was that everyone was so understanding, partly this is because they are all such lovely people but also because they understand my 'condition'. That is why I think getting people to understand more about psychosis is so important. Few of the people knew I have it, they understand it and it is easier for everyone. That is why I think talking about it, however hard it can be is sometimes worth it.

It is hard thing to talk about, there is no getting around it. Finding the words can be hard enough, fear of being misunderstood as I blogged before is even worse. However it is also hard for the person you are telling too, because the chances are the subject will be just as alien to them as it is for you to begin with. With time you start to understand it better and then by sharing how you feel, the people around you can start to understand it better too. In the beginning it is understandable not to want to talk about it. I didn't, so I started a diary because for me acknowledging to myself how I feel is important before I can even begin to tell someone else. Even now I sometimes find it easier to talk to cyberspace than any one person. So for me part of the point of this blog, is to talk to people; the people I know and love, just as much as it is for the people I don't know but want to share my experiences with.

Cutthroat and Confusion

Today I set myself a challenge, to go into a proper barbers and have my very first cut throat shave. To most men this is no challenge at all, but it was for me. I have a real thing about people touching my neck, it makes me really nervous and at present my paranoia levels are at a point that I find it very difficult to trust and be comfortable with new people around me. So for a random stranger to be shaving my neck with a cutthroat blade was a big step.
But I did it and walked out of the shop with a real sense of victory Sam 1- Psychosis 0

One thing has struck me recently, and indeed it was backed up by my CPN when I last saw her. When I was diagnosed I was given a whole host of leaflets and information packs on what the symptoms of psychosis are and then the phases which one goes through during the 'episode.' However none of these even begin to prepare you for the emotional struggle which you go through. For example they say you have a heightened sense of anxiousness. Fine. I can live with that and this is the main issue I have at the moment. But what the leaflets do not say is how being extra anxious makes you feel; scared, wary and paranoid about everything. To the extend every time I leave the house my mind goes into overdrive about whether or not I have everything; have I locked the door etc. Even though I know I have. It is different from the 'oh have I got my keys' worry that everyone goes through. It sounds more like 'urkgfvh have orifgdhvrewo I rwiogfj got rrohgj my erougfvhoef keys rgfovhe'. Everything is mixed up my mind gets all fuzzy and confused under pressure at the moment. Which is becoming increasingly annoying as I am messing up even the most basic of tasks. My mind is in a 'what if' mode. All I can think of is what if this happens cause that to happen or if that happens what will happen next. I am finding it hard to live in the here and now at the moment. But that is all I can do because at present the future is so unpredictable and I just don't know what will happen today, tomorrow, next week or next month and I really HATE that.

Scared of the dark

As this second phase has started to develop the primary symptom, and time during which I struggle the most, is as it starts to get dark, it terrifies me. The blackness, the shadows that aren't really there. Also first thing in the morning, before I get up and out of bed I have the same problem. I have started to have what my Community Psychiatric Nurse (CPN) describes as night terrors. It is the most strange feeling I have ever experienced, it is like dreaming when you are awake; flashbacks that are fictional but depict my worst fears and nightmares. Which more often than not leave me questioning what is real and what is just in my mind when I come round the next morning.

The strange this is that in the day time I am able to function almost totally normally. With the exception of a heightened sense of paranoia and anxiousness. This is how it started last time, however I am not resigned to the fact that history will repeat itself because situation I am in now is so very different to how it was then. Most of the factors that contributed to my condition last time are not the same as this time. Today I saw my CPN and she has mentioned the possibility that in fact my psychosis could potentially be a symptom of an undiagnosed 'personality disorder.' Apparently there are many types of these 'disorders' and even more causes for them. But we will have to wait and see what happens. However what ever the cause or reason for this relapse is, doesn't matter at the moment because it is happening for what ever reason, and will happen whether I know the cause of it or not. 

Herein lies the biggest problem I face- knowing it is happening to me. Last time I was in a place where I was not particularly aware of what was happening to me, it just sort of snuck up on me. This time I can see it coming, like some sort of cloud hanging over me and this, in my opinion, makes it scarier than last time, even though it hasn't got to the stage it did last time. 

A second problem I have encountered is that because I have been through it before people assume that the second time will be easier but this it not the case, far from it. In fact it is scarier and far more frightening because I know what is potentially coming. Only someone who has experienced this knows just how scary this prospect is. And when people ask I struggle to put it into words because I don't want to scare people or make them jump to conclusions.

Tomorrow I leave for Kent for my sisters wedding and I cannot wait. Going to something so normal in the midst of everything that is so abnormal and unpredictable really is unbelievably calming. As fate would have it, it could not have come at a better time and I wish Bridget and Ian all the happiness in the world. I will try and keep this up to date when I can while I am away but please excuse me if it remains quiet for a few days.

Well here goes....

Before I discovered this whole world of blogging I thought I was pretty good with technology but all this stuff is totally new to me and proof I am indeed not good with it, so please bare with me.

As I said on my page, at the beginning of last year I was diagnosed as having a psychotic episode which, to some people, can conjure up images of knife wielding murderers and the like. It certainly did for me at least, for a while, before I understood what it really meant and then I soon came to realize that this could not be a more incorrect judgment to make.
Of course I can only talk about my experiences throughout this illness from my own personal experience and what my friends and family have said I was like during my first episode
In reality the fact it is just like loosing who you are for a while, it is like loosing your nature, your essence as a human being and although I can only talk about what happened to me, I felt dead inside and so the notion I could get angry enough to wield a knife or whatever is totally paradoxical as I didn't have enough emotion to feel anything so how could I get angry enough to do that in the first place? And the times when I did feel something it just made me sad, not angry. But I will never shake the thought that my mum especially was, for a while, scared of me. This upset me and then made me scared of me. I knew I never would or could hurt anyone psychically but the fact that the voices in my head were telling me to meant that the people I stayed with, my mum and dad, needed to know what the voices were saying and so they got scared.

The primary emotion I felt last time was fear, pure and simple fear. I have always been the kind of person who likes to be in control and the psychosis meant I wasn't in control of myself and this is terrifying. And it is something that no shrink or nurse can prepare you for because as good as they are or can be, the power of the emotion involved cannot be explained in a book or by a person who has themselves not been through it. It can only be experienced. That is the purpose of this blog to share my fears and thoughts as and when they happen.

However it is bad to dwell on the past and so I will only really use it to help predict what may come next. I will not be explicitly replaying what happened last time on here and I don't like doing it in person either as I find it a scary place to look back to.
What I want to try and to do is put down in text how I feel and how this second episode manifests itself over the coming weeks and months. Last time this happened to me I felt so alone because I didn't have anyone to talk to who had been to the same point I had. Talking bout it helps but knowing you are not alone can help a lot more. Knowing your not the only one having odd or bad thoughts, in my opinion makes it feel less wrong or shameful.