Wednesday, May 28, 2008

The Marce Society

That nice lady I spoke to earlier from the APNI told me about The Marce Society, which is an international professional group that is focused on the assessment, treatment, research and everything to do with post natal illness. She said that she thought they may be interested in my experience of PNI. So, I cracked on and found the site and filled in the application form so I could log in............ be informed that to join this society you had to part with £70.


Too "mental" for the Association of Post Natal Illness and too broke for the Society who is trying to work out how to reduce the illness and its effects. there's a challenge I like the sound of.

Incidentally, I'm feeling a lot better today. I feel that by starting this blog I have found a way of focusing all the different things I do into some kind of order. I feel I have got my new project and feel so excited about the limitless possibilities it presents. Although my thoughts continue to race, they are more focused and less random than before. I honestly feel that this is going to be the beginning of something really positive. I'm smiling as I write this because I'm so glad I finally decided to write some of the stuff in my head down -it gives my thoughts a sense of reality and meaning whereas before the thoughts just crashed on without ever being developed and then are gone forever.

Hubby says it's just my new obsession. He thinks I'm incapable of just having an interest or a hobby, he argues that I become obsessive. I tell him that he's just not as focused as I can be. I've always been the same though -when something catches my imagination i run with it, fly with it, chase it and don't let go until I have exhausted it. I'm just very highly motivated and like to follow things through to the absolute best of mine or any one's ability.

If a jobs not worth doing properly then it's not worth doing at all.

Take for example Facebook. Fucking hours spent on it. I LOVED IT!!!! Loved finding more and more people and talking to them all, and even setting up a whole group site and posting pictures and organising a big school reunion that about 60 or so people are going to. And now I can't really be arsed that much. I'll check my email but don't really go on there at all now. However, look at the positive gains from my Facebook phase. I've got in touch with loads of old friends, had a really good laugh, and arranged a big get together. Why is that so bad?

I know Hubby is worried that I'm not doing to well, but today I do feel better. The only slight thing that is worrying me in the depths of my mind is that I keep hearing things and I'm not sure if I'm hearing them for real, or I'm imagining them. It's not voices or anything specific, just odd hushes, whispers or what sound like a muffled talking. But no words. just really annoying sounds that cause my ears to prick up, and make me feel as if I look like a deer in the woods hearing the crack of a hunters boot on a twig.

Hubby said something tonight and I wasn't sure if he had spoken or if i was just imagining it. It happened a work yesterday as well when I thought someone had asked me a question and they said they hadn't said anything at all. But I do think that does happen sometimes. I i shouldn't become over anxious about it because if I do that it really will come up and bite me on the arse!

Association for Post Natal Illness(APNI) response

Well, I thought I would follow up the email I sent to the APNI with a little phone call and got directed to their voice mail. However, someone called back, and they felt that the points I raised in my letter were valid -yay!!! So, she gave me the number of someone more senior who I immediately rang. She also thought the points I had raised were valid, and asked if she could present my letter at the next 'big wigs' meeting in July. Of course - I said yes. Then she asked me if I could slightly amend the letter so it kind of skimmed over the whole little issue of bipolar disorder as she felt the professionals and doctors on the board might think that my experience of post natal depression just wouldn't be that relevant my main problem being BPD, and I may be best directed to Depression Alliance or something. Clearly the big wigs prefer their volunteers to have only suffered with a nice clear cut case of PNI. Oh dear. However, she didn't say to not mention it, just to play it down a bit. She genuinely seemed to understand where I was coming from, but basically felt that due to fact that I had a diagnosis of BPD and I remained on medication the big wigs who decide what the policies are might think that I wouldn't make a very good volunteer for several reasons.

Reasons I Might Not Be A Good Volunteer

1. Firstly, a mother who needs reassuring that they will get completely better and that the whole PNI thing is in fact just a temporary blip, might not be significantly cheered up by the fact that their telephone supporter was diagnosed with a serious and enduring mental illness after her post natal episode. Okydoky.

2. Also, the fact that I had been diagnosed with a mental illness meant that I was more fragile than those without a diagnosis, therefore more likely to be tipped over the edge by talking to someone else with a similar experience which would NOT BE GOOD FOR ME.

3. The fact that I was on antidepressant and anti psychotic medication would not sit comfortably with the "judges" as I shall now call them. It would be a bit dodgy having some medicated, mentalist advising on getting through post natal depression by yapping on about that one time when she thought her baby was possessed by a 23 year old called Daniel, especially if they just had a bit of baby blues and main problem was not being able to get up in the morning.

4. Another concern was that as a telephone volunteer you are basically left to get on with providing the support, and filling in the APNI admin office on how the mother is doing via a report card every couple of weeks. Basically, I would be lone working with no supervision and if I went bonkers it WOULD NOT BE GOOD for me or the poor depressed mother I was meant to be supporting. Fair one.

So, I shall mull these points over, and then I will begin in putting together a letter that could be presented to the Judges which will reassure them that I might be quite a good volunteer. Watch this space........................

Tuesday, May 27, 2008

A bit paranoid today..................

At work at the moment and struggling. Feel a bit paranoid and on the verge of tears and trying to control my thoughts and think straight. Received a letter this morning regarding a medication error and I instantly thought that I was the only one who had got a letter and everyone would be talking about me and what a shit nurse I was. In actual fact every trained nurse got the same letter. No big deal then. Also I got a bit panicked when I heard another nurse wasn't happy with a decision I made regarding my dealing with a the behaviour of a patient. I worry that everyone is slagging me off and how I work. I think I'm just being a bit over sensitive about this which I keep telling myself is normal in a new job.

I just feel terribly caught between my own mental health problems being a pro or a con when it comes to my job. I wish I could be one of those campaigners who is accepting and ease with their diagnosis and don't feel ashamed of it. I claim that I'm non-judgemental but all I do is negatively judge myself. But also I hate the idea of letting this whole bipolar thing become central to my identity - me becoming my diagnosis. I just want to feel at peace with it and move on. I just feel that at the moment is really hard trying to appear to be the same as everyone else - it's exhausting.

Monday, May 26, 2008

Racing Thoughts

My mind is quiet honestly racing at the moment. Thinking about so much, and feel desperate to try and apply my thoughts to something productive but every time I try to I end up not being able to do it properly because I get distracted and Paul moans at me for being obsessive. I think I just need to focus on something. I registered to two Open University courses today to get my BA/BSc in Nursing. also, I have looked into going on a WRAP course with MIND in June hopefully for free. Also, there is a bipolar disorder support group meeting in town and I might just attend. But I might not. I'm just trying to focus as it honestly feels as if it is all getting out of control. My brain feels like a giant Tony Buzan mind map and there is so much going on that no amount of paper could be enough for everything that is in my mind. I sent the Association of Post Natal Illness (APNI) a letter regarding them turning me down as a volunteer. It really pissed me off so this is what I wrote.

Dear Sir/Madam,

I received a letter from APNI in January of this year following my application to work as a volunteer for the APNI. It was explained that currently it was your policy not to take on volunteers who are still receiving psychotropic medication therefore it would be appropriate that I contact you when I had been off medication for 6 months. I have given this a great deal of thought, and I have finally decided to write back to you in order to suggest that this policy could be reviewed as I believe it may serve to exclude those who despite remaining on medication, could still be of value to both you and your service users.

I had a post partum psychosis following my daughter’s birth in 2003. Following discharge from the maternity unit I had a period of mild to moderate elation, which escalated into total sleeplessness and florid psychosis. Once the psychotic symptoms were managed I was left with a dark depression I felt that would never leave me. My illness was managed by the use of antidepressant and anti psychotic medication, and support by a Community Mental Health Nurse and regular review by a Consultant Psychiatrist. I recovered and returned to work and grew to love being a mother to my daughter. Following the birth of my second daughter in 2005, strategies were put into place to prevent a re occurrence, and I was fortunate to remain reasonably, though not entirely well during the initial post partum period. However the following year when my youngest daughter was 1 year of age, I suffered from a period of psychotic depression, which was followed by a period of hypomania. It was at this stage I was diagnosed with bipolar disorder type II. Once this diagnosis was made, lots of things began to fall into place, and I could begin to make some sense of the events of the recent years, and those years prior to having children. I also became aware that had the diagnosis of bipolar disorder type II been made prior to my having children, the increased risk of a psychotic episode during the post partum period would have been identified, and appropriate preventative strategies may have been put in place.

I currently work as a Registered Mental Nurse for a NHS Trust, and since this year I am working in the Recovery service. Prior to this I was working in on an NHS Acute Inpatient Unit, employed as a senior staff nurse for five years. In my job I nurse people with serious and enduring mental illness, and as a senior staff nurse I am responsible for taking charge of the ward and managing any situations that arise during the course of my shift. My manager, some colleagues and occupational health are aware of my diagnosis, and the fact that I am currently on both anti psychotic and antidepressant medication. They are aware that I am under the care of a Consultant Psychiatrist and CPN who were also both fully supportive of returning to work in my full capacity as a Registered Mental Nurse. They understand and support the fact that it is likely that I will need to take medication for a long time, perhaps for life, and it is the fact that I take this medication that helps to keep me stable and functioning at an optimum level of mental health. I feel lucky to be employed in a Trust is truly working towards the de-stigmatisation of those with mental illness, and shows it values, respects and trust the judgement of people like me employing me in a professional role, and trusting me to do my job. My employers understand that like a diabetic needs to take insulin to stay well, some individuals need to remain on psychotropic medication long term in order to stay well, and this is not to be seen as a weakness or a indicator of being unwell.

So, the point I am attempting to make is that although I understand that for some suffers of PNI, the sign that they are truly well is when they are medication free, this is not true for all. Some women who suffer from PMI also suffer from recurrent depression, and it is possible that they will need to take medication for many years. Those with bipolar disorder type I or II are also much more likely to be required to take medication for the long term in order function at an optimum level and prevent relapse. These two groups of women are more likely to suffer from severe PNI and psychosis than those with no previous history of mental illness. And these two groups of women, who may be on medication for the long term, could still make fantastic volunteers for the APNI, myself included. It is well reported that if you have a previous history of a mood disorder, the risk of PNI is significantly increased therefore it is likely that many women who have suffered from PNI will remain on medication for the long term. It seems to me to be a real error of judgement to turn the experiences and understanding of the women away purely because they remain medicated. I understand that you need to be sure that a woman is fully recovered to volunteer, but I don’t think that being medication free is the best indicator of wellness.

I hope this letter goes some way to explain why I think your current policy needs review. I feel that I, and many other women who remain on medication could be a great asset to the APNI and its service users, and I believe women like me serve to reduce the stigmatisation of mental illness and medication, and reinforce that despite mental illness you can have a valued and productive life.

I look forward to hearing your thoughts, and I sincerely hope to join you as a volunteer in the very near future.

Yours sincerely

So, I shall wait and see.............................................................

Anyhow - the house is a mess, the kids rooms and all the toys need sorting out, and I need to speak to my manager about what is going on. It's not that I'm particularly worried about these things -more that my mind keeps moving from one to the next without sorting anything out. I seem to spend long periods of time on things, but really don't sort anything out or get anything dome before I've moved onto something else.

I'm doing my own head in.

In a way I sometimes wish that Hubby wasn't here so I could just get on with it. If he wasn't here I could just scrap the night meds and get this feeling out of my system by getting it all done.

I feel that I could be onto something really big that might really help me and other people like me, but I don;t know how to stay focused enough to express it properly. All the distractions get on my nerves -Hubby, the kids, work, friends, the phone, cooking, the house -EVERYTHING. I just want to hide away and get on with it. I really do think that I may be able to do something fantastic and life changing. But instead I will take my pills and try to get some sleep so I can go to work in the morning.

I fucking HATE the Quetiapine yet sometimes love it too. I love the fact that it lets me actually sleep, it feels like a warm alcohol glow washing over me as it takes effect - and I'm only on a tiny dose. I hate the fact it makes me feel shit in the morning unless I take it so fucking early I loose half my evening as I have to think about bed from about 9.30pm. All I want to do is be able to stay up until 11 or 12 o'clock and get up at 7 without being bolloxed., It does my head in. I feel that it's such a waste of valuable time going to bed when I could be doing other interesting things. I'm not high though. If anything I feel a bit low right now. Some difficult thoughts starting up again. Hubby playing with little one and she didn't have any nappy on and I got a strong visual image of him raping her and her screaming and crying and wondering what was going on but there was nothing I could do.

A man came to my door and gave me a booklet. He said that there were paedophiles everywhere. It really upset me as I keep trying to tell myself that it's just me who think they are everywhere.

I'm just trying to distract myself from all that stuff at the moment as it feels like a slippery slope.

It's strange because my mind is racing, but not in a nice way with nice plans. More in a desperate panicky way. My stomach is in knots as I sit writing this - I have an almost overwhelming sense of urgency that I need to do something, but I don't know what it is. I'm caught between worrying that by doing what I really want to do could draw attention and ruin everything.

Perhaps I should just promise myself that I will try and write down my thoughts and feeling , no matter how stupid or random -just as it pops into my head, and hopefully by writing it down it will turn into something that makes sense. I do sometimes feel that my personal experience combined with my mental nursing could be combined to make something really good. I know it's there in my brain - I just don't know how to get it out in a way that will make sense to anyone, least of all myself. A diary might be a good idea as long as I just keep it to one diary, as I usually end up with lots of different scribblings on bits of paper or separate projects, or separate parts of the same project but creating a system to manage and organise my projects is too trivial and a distraction from the great ideas I'm having and if I sit and try to organise it into a folder with different sections I may forget all the different sections and the potential sections there may be. I feel terrified of giving into some linear type of organisational format because it will cause me to stop me from fully exploring all the possibilities of my mind.

But the downside of this is that I don't usually manage to get anything written down. At all. Which makes me feel like I'm a bubble of amazing knowledge of ideas and theories, but to everyone else I'm just a boring woman doing the school run or the shopping who doesn't think of anything. This feels crippling, like a bird with no wings, and then I feel like a big fraud because I don't want to be doing these mundane things but I do them because I have to. I feel torn between wanting to live as the person I want to be, but knowing that the person I feel like I want to be is ultimately not good for me, and I would get in a mess and have regret and shame. It must be like alcohol, drugs or gambling only with this its choosing to go with your personal sense of direction or putting self imposed fuck off red traffic lights, stop signs and speed cameras up so I stay in a state of wanting instead of doing.

Right -meds kicking in now and feel a bit fucked and can't hold my pen or read my writing. bye x


So then, I have decided to give this blogging malarkey a go purely because I want to try and get my head round being both a mental health service user and provider. I often feel uncertain whether my diagnosis of bipolar disorder makes me a better mental health nurse or just a liability. It usually depends on what my mood is doing at the time.

I have a terrible habit of becoming distracted and becoming overwhelmed with the sheer quantity of what I want to try and get down on paper which is another reason to start a blog -it stops me from loosing all the paper, and keeps all my ramblings in one place!

The main aims of this blog are in no particular order to

1. Reflect on my own mental state.
2. Monitor my own mental state.
3. Gain a greater understanding of bipolar disorder.
4. Gain a greater understanding of post natal illness and post partum psychosis.
5. Try and get my own story written down, so I can try to make sense of the person I am today.
6. Reflect on my nursing pratice, and what I actually do at work.
7. Look at bipolar disorder with fresh eyes, and try and work out what treatment programme will keep me well.
8. Try to identify a possible route of treatment tht will help others with the same problems.
9. Try and find something postive in the fact that I have been diagnosed with a severe and enduring mental illness.
10. Look at STEP-BD
11. Look at Recovery.
12. Look at WRAP.
13. Life charting.
14. The Social Rhythm Metric.
15. Interpersonal Inventory.
16. My Life History.
17. Get all those little stories from over the years down on paper.
18. Get feedback from anyone who can be bothered to read my thoughts and ideas.
19. Reflect on Manic Depression Support group meetings I plan to attend.
20. Really try to create a plan of care with the chap I am a named nurse for that is truly individualised and will help him in his recovery.
21. Care planning - look at good care planning for BPD.
22. Reflect on books, journals and articles I read related to BPD or PNI.