Friday, 14 December 2007

I think, if I'm perfectly honest, that the time has come to accept that I might need some help with this.

There are only so many "Sorry, I've got a really nasty bug" or "Sorry, another migraine" excuses I can trot out before I'm rumbled and they realise that the reason I haven't been to work for three days is because I could not get out of bed.

I don't know which bit of what is affecting me the most and what to ask for help with, but right now I'm staring down a very long, very double-barreled black depression and it's not a fun place to be.

I don't know if it's chemical or reactive. I just know that staring blankly at the inside of my curtains all day every day is not normal and I am beginning to despise this place.

Will drugs help that?


I hate drugs anyway.

I've never met an antidepressant that I've got on with, or rather, that my body has got on with; they are all far too agitating. Citalopram sent me flying into a manic episode and straight into hospital, resulting with six months on Valium to reverse the damage. Effexor had much the same effect, even at the lowest dose. The neurologist that attempted to treat my migraines wanted to try me on Amitriptyline, an older, non-SSRI AD. The list of side effects is horrendous, and I suspect it would have much the same effect as the others. Am I prepared to deal with that to try and climb out of this pit? I don't know. Is it the lesser of two evils? Again, I don't know.

I don't know what to do.

I feel as if don't have a friend in the world. Well, I do, but not here. Maybe it's true what they say about London, and maybe this is just a clear cut case of the loneliness of the city, eating me slowly from the inside out.

If I didn't have my cats to think about - oh god, I *am* crazy cat lady, aren't I? - I would, right now, tonight, pack a single bag, with enough clothes to get me where I'm going, my laptop and my phone, and just get on a train. Leave all my stuff here - I don't care about stuff anyway. Let the next person to live in this place have it. It'd make a nice home for someone - just not for me any more.

Worked for Stephen Fry... didn't it?

Saturday, 8 December 2007

Make Soup, Not War

I never know quite what to do with myself on a Saturday.

The rest of the week, I find, can be pigeonholed quite neatly. On Monday to Friday, I am inevitably doing one of three things: working, trying to force myself out the door to work, or laying around wrestling with my conscience for not being able to do either. This, in itself, takes up a considerable amount of brainpower and energy, and keeps me occupied for the better part of the day - perhaps ironically, moreso than actually working itself would.

On Sundays, I am usually thinking about whatever it is I'm supposed to be doing on Monday.

But Saturdays are a bit of an enigma, where the world as I know it stops turning for a little while, and that lovely feeling of relief on waking at not having to do any of that is quite quickly replaced with a vague sense of feeling utterly lost.

When planning my move back to London earlier in the year, and knowing that the majority of my time outside work would be spent alone, I envisaged my future Saturdays as being spent in the pursuit of all things arty and cultural. Perhaps browsing lazily around an antiquated bookshop in Charing Cross Road, stopping in a French-inspired coffee shop afterwards to flick absent-mindedly through the musty yellowed pages and watch the world go by outside through a small cloud of steam rising from the cup. Visiting galleries, even though I neither understand nor appreciate art, or attending one of the hundreds of musical events at the Barbican. Lounging around on the South Bank, people-watching, wondering where this person is going or where that person has been. Wandering aimlessly around Portabello Road market, procuring a bag full of nick-naks for my Victorian-themed flat, all of which would of course bring me pleasure, but would be ultimately quite useless.

Obviously, it hasn't quite worked out like that.

This morning, it being a Saturday, I peeked around the curtains for a brief look at the world outside, hoping perhaps that doing so would, for a change, plant a seed of inspiration in my mind as to how to spend the day. As my still sleep-filled eyes unblurred and adjusted to the light, I was delighted to notice that it was raining hard. I love hard rain. As well as reminding me of home as a child, circa 1982 - that wonderful sense of warmth and comfort and belonging after arriving home soaked from the walk from the school bus to be met with a big fluffy towel, a glass of squash and a Marmite sandwich - hard rain gives me an instant sense of relief; I can watch it hammer against the windows, run gracefully down the metallic exterior of parked cars, settle in puddles on the pavement and bounce from the umbrellas of passers-by, safe in the knowledge that it's giving me a legitimate excuse to hole myself up for the day - because who in their right mind wants to go outside in that?

So, today, instead of tackling demons, I tackled vegetables.

I made soup.

I chopped and boiled and seasoned and tasted and smacked my lips in delight and marvelled at the delicious smells coming from my woefully under-used kitchen as this random, spur-of-the-moment creation bubbled away on the stove for two hours. I nearly set fire to my flat in a slight accident involving the naked flame of the gas hob and an errant sticky label which was, apparently, still attached to my shiny new crock-pot... but we'll gloss over that. I blended and poured and divided the fruits of my labour up into individual little containers, surprised at the sense of satisfaction and achievement garnered from such a simple activity.

Had I been wearing an apron at the time, I would have been the epitome of domestic goodness, and with the soundtrack of old standards and big-band jazz happily playing in the background, I felt like the archetypal 1950s housewife.

I may even have sung at one point.

After the blending part of the process, I realised that in my enthusiasm, I'd made enough soup to feed a small army and yet had nothing to store it in. I pulled on my trainers and, without thinking about what I was doing, made the two-minute trip to the local homewares store for the cheaper, multi-buy equivalent of Tupperware.

Arriving home, as I turned the key in the door - I can't put my finger on the reasons why - it felt for the first time in months as if I was walking into home - somewhere that things happen rather than a place where people hide and acheive nothing.

All this from soup.

How strange.

Friday, 7 December 2007

Tell me, Chicken - have you met Egg?

According to an article in the Guardian this week, patients in mental crisis are not getting the NHS help and treatment that the Government has promised.

Here's why I think this falls under the category of "No shit, Sherlock!"

During the summer, I was referred to the local mental health team for CBT. I managed the initial appointment, and blogged about it here, and in fact, the original purpose of this blog was to chronicle the course of my treatment. This, as you may have noticed, quickly fell by the wayside. Why? Well, further appointments had to be cancelled, because I was so sick I simply could not get there.

While in the grip of an agoraphobic period - for these things, as I've explained before, tend to wax and wane - no amount of cajoling, encouragement or even a stick of dynamite up the arse is going to get me out of my flat. This is not laziness, or pettiness, or stubbornness, or a reluctance to help oneself (which is how medical professionals tend to see it as they take out their big rubber stamp to label you as 'resisting treatment'), rather a deep rooted conviction that the outside world is a dangerous place, that setting foot outside one's front door, or in my case, my bedroom, will result in certain death. I can not tell you why it seems so dangerous, because by the time I get to the point where I can not leave my room, the deep rot of clinical depression has set in into the degree that I can not form a sentence. But it seems to be that some kind of survival instinct kicks in and keeps me confined to my safe area, hidden behind some kind of invisible force field, within which it is impossible to sometimes do the smallest of things - take a shower, stand in the kitchen for any period of time to prepare food, visit the corner shop less than 100 steps away to buy that food to prepare - let alone to take a trip across London to explain to someone that I can't do these things.

All things considered, I should be one of the lucky ones. I live in London and my local mental health centre is two miles away, at the other end of two bus rides. Yet still, with that degree of illness, I couldn't manage this; someone living in, for example, rural Devon, where the nearest mental health centre may be 25 miles away in the next town or city, has no chance.

I wonder how many people are in this position. Why should agoraphobia be the poor relation of the mental health family?

Is it, perhaps, because people with agoraphobia are still unwittingly stigmatised as the Miss Haversham figure with filthy net curtains and an almost impossible amount of cobwebs in their houses - the strange, reclusive figure to be mocked, ridiculed, filed under 'eccentric' rather than 'genuinely ill', and left alone to die?

But back to the article, and the problem at hand, which, I feel, lies in the definition of 'home treatment', where home treatment does not actually mean home treatment, rather a government buzz-word to refer to any treatment in the community that does not fall under the category of 'admissions to hospital'.

What the NHS has then, when considering the treatment of agoraphobia, is a chicken and egg, Catch 22 situation. The patient can't get the help she needs because she's too sick to get the help she needs.

How can that be right?

Has anyone in the NHS even thought of this? Why isn't there some kind of home therapy service? People in crisis are being forgotten, their healthcare needs are not being met, and therefore, it is desperately needed. I've never heard of this kind of thing. Have you? Should we be lobbying our MPs and suggesting it?