A change of course

Yesterday I had an appointment at the hospital to get the results that I was due from when I was an inpatient a few weeks ago. I was not due to see the Neurologist untill sept 24th but I got a phone call on tuesday morning to change the day to yesterday and it just so happened that the call came just as I was walking in to see the Consultant Psychiatrist for a review. So me and most people who knew about the changed appointment assumed that because they had brought it forward, there was something neurologically wrong with me. How wrong were we! After 4 days of pannic and lack of sleep I walked in to the consulting room for him to sit me down and tell me that my scans were all clear and that what is causing me psychical pain is actually my mind, not something 'organic' as he put it.
Of course I was over the moon that nothing neurologically is wrong with me, but it was short lived because I started to think about what he had said- my mind is causing me psychical pain. Now I have not intentionally harmed myself since I came home from university. But in my eyes I have just discovered that my mind is harming me, and has been doing it to me without me controlling it for some time now. This worries me on a number of levels because I am seemingly in less control of myself and my mind than I believed I was and had been for a while. If you have read any of my pevious blogs you may well have seen that control for me is very important, control of myself, control of what I do, and control of situations I put myself in.
Forgetting the Neurology stuff for a minute I have become increasingly feeling out of control of stuff (but until now, not of myself), I worry about anything and everything and am anxious of every situation I am in when I am not at home. I am paraniod about pretty much everyone and everything around me as I said in the last blog I wrote. Yet up until yesterday I haven't felt out of control of myself, now it seems subconsciously I am, a thought I really do hate having because apart from this, I do feel in control of myself. Now I ask myself what the hell do I do now then? And the answer is at the moment I have no idea. The two Community Psychiatric Nurses that are in charge of my care and I have been discussing a number of options to explore; firstly I am to undergo a sixteen week course of Cognitive Analytical Therapy, apparently this entails a really close self examination of myself and what makes me tick, this to me sounds like a very positive but quite difficult step as I personally do not like to be so mentally exposed to anyone, like I will have to be for this to work. Secondly we are going to further discuss the idea that I have some sort of personality disorder, although I hate labelling myself or seeing others to it to me or other people, I am of the opinion that if this is caused by different things that stress me out combining together and making me feel this way. I need to know that that is definitely how my mind works (or fails to work properly). I say this because if in the future I see a big change coming in my life, and I know in advance my mind may not deal with it well, I am forewarned about it and can plan accordingly.
I would not wish anything wrong on anyone or myself but there is a part of me that really wishes the Neurologist had said there is something wrong, but that it can be cured with a pill or potion, that way it would have come and gone and life would stay the same. But because it is not and this cannot be treated or cured overnight or in a short period of time, wheels have been set in motion that I didn't expect would happen. One of my CPN's did say that this maybe the case, but I really hoped it wouldn't be that, purely because it means that I have to do so much more than that just take a pill to go back to 'normal'.

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.

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.