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Chocolate Heartache

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About Chocolate Heartache

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    Reading, sleeping, eating, sleeping some more. I'm like a coiled spring... or possibly a tangled-up Slinky. Probably the Slinky.

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  1. Hey CR. I'm a bit late to the thread, but I wanted to let you know that I get where you're coming from, in your first post. It's hard when you've been relying on self-harm to get by, and that gets taken away from you. It's even harder when that's being policed by your family, not just by mental health professionals, because there's such a complicated relationship there to begin with. I also get where your mom is coming from, because it's so scary to watch someone you love taking risks and hurting their body. Every instinct is to protect that person, until they get to a place where they're able to protect themselves. And she's following on from the mental health services, because stopping people self-harm is what they do. There are a lot of reasons why quitting self-harm is a good option, and there's a whole board of resources here and hopefully your mental health team will have some too. It is your body and your choice, but I think we're all rooting for you to choose to work on getting healthy. We're here to listen when things get tough, my PM box is always open, and I hope things start to look up for you.
  2. If you've had people check out your ears and there's no infection or irritation, then I'd guess it was either: - a psych / stress related thing - a nerve thing, a bit like pins and needles - a side effect of meds - dry skin. There are over the counter ear drops that might help when the sensation is bad, for example Otex (not Otex advance, the normal one) contains something menthol-like that gives a pleasant tingling sensation that might help. I get itchy ears from wearing hearing aids, and Otex is great for that. Talk it over with a doctor too, mention it to your pdoc as well as your GP. It might be worth referring you to an audiologist or an ENT - an ear specialist - to see if they can think of anything a generalist wouldn't. You're highly unlikely to have actual worms in your ears in the UK, we're quite lucky on the parasite front here, so try not to worry about that one!
  3. It's an observational cohort study, where the participants are divided essentially into people who need sleepers, and healthy controls. Sleeping pills tend to be prescribed to the stressed, the depressed, the anxious, and just plain insomniacs, whereas the control group here are just an ordinary sample of the population. The 'gold standard' drug trial is a randomised, double-blind controlled trial - you take people who you would consider prescribing sleeping pills for, and they're allocated to receive either the drug or the placebo, without the patient or the doctor knowing what the patient's getting. Personally, I think I'm more likely to step under a bus or write an incorrect prescription or just go batshit mental if I haven't slept for a week, than if I'm on zopiclone. Definitely merits further investigations before doctors change their prescribing habits. As an aside, I don't think advising people on a mental illness forum to stop their meds without consulting their doctor is ever a great idea, although it sounds like you've taken that on board The media really irritate me when they publish the results of new research, without really seeming to understand how to read or critique a research paper properly, and scare the living shit out of the population. Grrrr.
  4. Manic people getting undressed is fairly common, I'm not sure why. During a somewhat-dysphoric manic episode I stripped off and went swimming in the sea (in February, in the UK) then got lost and sat on the clifftop naked and wet until I nearly got hypothermia. It's probably best that I stay away from the sea for a while. I think it's a disinhibition thing?
  5. I find the main problem for me has been all-nighters, the combination of sudden change to my sleep pattern and not being able to take my rather-sedating nighttime crazy meds. I don't do them voluntarily any more, but they're occasionally required for work - one of the curiosities of the psychiatric system is that whereas 'normal' doctors here tend to work a week of nights or a week of days, we do 9-5 jobs with regular 36 hour torture shifts to remind us that we should be less human than the patients we tell to get some fucking sleep. If I'm working 'normal' hours I make sure I get an early night and get 8-10 hours sleep. I can go a bit hypo if I'm getting less than 8 hours a night, 6 is really cutting it fine, more than two all-nighters in a week and you have a batshit mental junior rattling around the ward, reorganising the whole filing system, completing paperwork that was due 6 months before you joined the ward, and coming up with new ideas for audits. Which is great, until the depressive crash and actually having to finish those audits, or at least drag your ass down to the ward to find the data to give to someone else. FTR, I don't plan on getting back to work until I'm less crazy than this, and have a proper relapse indicator plan. I'm thinking that in psychiatry, the best way to do that would be to be up-front with my boss, and ask him to let me know if I'm acting weird...
  6. I have the same problem - old scars on my arms, and working on a hospital ward with a Bare Below the Elbow rule. The majority of my patients don't even notice - they're ill, they're in pain, they're not focussed on your arms. One or two have commented, but it's never been a problem. The most important thing is that you can accept them yourself, that will show when other people look at them. See if you can keep them uncovered when you're alone, just getting used to the idea of them being on show, maybe wear your sleeves up when you go supermarket shopping or something like that. I really hope it goes well for you.
  7. Been up to the hospital and been seen by a relatively clueless junior doctor with no more experience than I have - perfectly lovely bloke, but not a psychiatrist yet. So I'm on the ward, still being given the Venlafaxine because he didn't want to overrule my pdoc, and on massive doses of AP to cancel it out (the logic defies me really) and waiting to see a grownup doctor tomorrow. I still have twisty creepy things and I still haven't slept. Ick.
  8. I didn't know whether to put this in the med section or the Bipolar section, because it's about how the two react, so I used the one with the most traffic. If this is wrong, can a smart person move it for me please? I'm wondering whether anyone here has experience with Venlafaxine in Bipolar disorder? I've always had a fairly antidepressant-heavy cocktail, but two days ago I switched from escitalopram 20mg to venlafaxine (alongside carbamazapine, quetiapine, and a whole bunch of physical meds) and I feel... wrong. Like I'm full of twisty creepy things, and I'm sort of alternating between wanting to curl up still in the dark with my eyes closed and wanting to run around like a hamster on a wheel. Lots of panic attacks, bigger and scarier than my 'normal' PTSD-related panic attacks, which are themselves fairly weighty. I've tried lots of totally illogical things that don't help, like hiding in the bottom of the wardrobe, and (TW): I'm having rather unhelpful thoughts about cutting myself open to let the twisty things out. I can sort of stand back a bit and see that that's insane, but there's another part of me that thinks it'd help, and I don't think it's the same bit of me as usually self-harms. On the plus side, I've also done more housework in the last 24 hours than I had in the last four months. I had a gradually-increasing-but-functional hypomania through October and November, a really horrible peak with mixed features in December, then a depressive crash in January which has trailed on long enough for my pdoc to want to switch meds again. The patient information leaflet and the BNF were relatively unhelpful, and some other resources suggested that venlafaxine shouldn't be used in Bipolar. That said, psychiatrists fairly frequently prescribe things they're not supposed to, because that's how psychiatry works, and I don't know whether it's a relative contraindication or a total contraindication, because the resources weren't that helpful (my best psych texts are all piled up in my office at that job I haven't been going to.) Has anyone here tried venlafaxine, and how did you get on with it? I'm trying to work out whether these are normal side effects that'll subside, or the beginning of an unpleasant episode that's going to get worse. I've put a call in to the Crisis team, and they're going to pop in to see me tomorrow, but I'd rather not go into hospital if I don't have to, although I was in recently and I'll go if they think it's really necessary.
  9. In my work, you have to disclose when you begin, and if you have any health conditions at all, you'll be called in for an hour-long chat with an Occupational Health doctor where he'll take a full history and want to know what meds you're taking and how long you've been on them. If he has any concerns he'll alter your training, might demand to see your test results or a letter from your psychiatrist, and will keep you under review. It's a hard-going process and damn near impossible to navigate when you're not well, but it's there to stop people practising as doctors when they're really too ill to work. I disclosed when I started my job, but played it down (it was under control at the time, but it was naive of me to think it would stay that way) and Occ Health don't share the information with your supervisors unless they feel it's necessary. That said, when you work with and for doctors, any time off sick they'll ask what was wrong, when they see you take your meds they know what they're for, and they do notice the warning signs when you're getting unwell, so hiding it from them can be quite a challenge, and if you've straight-up denied your illness to your boss, you can be in a whole world of trouble when you get found out. Sometimes it's just easier to say "I have Bipolar and PTSD, but I'm on meds and I'm OK." So far, touch wood, hasn't caused much trouble - mostly I just get the irritating curiosity about my meds cocktail, or unwanted nosiness about the events that led to the PTSD, but no doubting my abilities or anything like that. I'm also a really, really bad liar, and I live in a small town, in a block of flats with other doctors upstairs. Secrecy isn't really my forte.
  10. I think depression feels like an eel - slimy, heavy, squirmy, hideous. That's even kind of the feeling in my chest I get when I'm depressed. Hypomania, for me, is a happy puppy, bouncing around enjoying life and enjoying being gorgeous, totally unaware / uncaring that you're pissing all over someone's rug and chewing up their sofa. Being a puppy can't last forever. Mania moves almost too fast to be seen, desperate energy that can't be unleashed; a bird caught inside the glasshouse, desperately throwing himself against the windows, not understanding why he can see through to outside but can't get out, breaking everything and getting nowhere. Beautiful and tragic to watch, terrifying to actually go into the glasshouse with it to let it out. Mixed states to me are too complicated, too awful to give them an animal. Even the most hideous creatures of science fiction don't compare.
  11. When I'm hypo, I think I'm great at my job, writing extra audits and presentations, working extra shifts and extra overtime, really sociable, artistic, musical, poetic... generally, a great doctor and talented too. When my ex-colleague heard I'd had a 'breakdown,' he thought it was drug induced, because when I was hypo he assumed I was taking stimulants*. It's a long, long time since I had a hypo/manic episode that didn't either turn mixed or crash into depression that prove difficult to get out of, not to mention the amount of money I spend and stupid situations I get myself into, so I know they're not worth it, but I do miss feeling so good about myself - even if I know now that it's fantasy. I don't have fantastic insight when I'm on the up. *Thinking about it, it concerns me that he thought I was on drugs while working on a psychiatric ward but didn't think that was an issue worth pursuing...
  12. You'd have to grind it to make it instant release, and that's a bit of a pain to do - you'd need a mortar and pestle, the back of a spoon won't do it. Cutting it in half will stop it being as controlled a release as it ought to be, but it won't become fully instant-release either. IIRC Seroquel XR is made like Russian nesting dolls, layered with a thick filmy stuff separating the layers, and it stays in your GI tract slowly dissolving for hours. *disclaimer* Obviously it's not my recommendation to grind tablets to take them otherwise than your doctor prescribed, and my advise is based only on my experience of messing around with my own medication. If it goes wrong, please don't sue me! */disclaimer* I really hope you feel better and that you can get the right formulation soon.
  13. Buying those plastic food tubs - the kind takeaways come in - to vomit into. Because going to the bathroom is clearly way too much effort, and puking in a bin or a bowl you eventually have to clean it out. Those you can just seal the lid on and cast them into the pile of rubbish that you're going to tidy up soon, honest. When living in a shared student house, being so afraid of my housemates seeing me looking so messed up walking to the bathroom that I used to pee in a pint glass and empty it out of the window into the guttering. Keeping my curtains closed for months, just in case my landlord sees into the flat and evicts me. Going supermarket shopping at 3am for the means to kill myself, and ending up buying potted flowers, drinking glasses and a book as well because I'd convinced myself that the shop assistant would see that I was just buying pills, bootlaces and a Stanley knife, and somehow have me sectioned. Gave myself a fair-sized 4th degree chemical burn and tried for a week to treat it myself so I wouldn't have to show a health professional. And the standard depression stuff - I don't know how long I've been wearing these pyjamas but I do know they smell; the last time I ate a balanced meal (or tried to) was when I was in hospital; and the STR worker helping me to straighten out my flat has taken over 40 bags of rubbish away, that was just scattered all over the floor. I'd even given up trying to maintain the clear path from my bed to the bathroom, I was just walking on a layer of trash and dirty laundry. There's a version of Kermit the Frog singing that on Youtube, which my friend sent me a link to about a week after I tried to kill myself the first time around. I thought he was laughing at me - I locked myself in my room, cried for days and self-harmed a lot. Turns out he was trying to express empathy.
  14. I quit a couple of years ago - the NHS have a bare-below-the-elbow rule now, where the staff have to wear short sleeves, and when that came in I was still self-harming on my arms. I switched to thighs, I thought I'd get away with that, but an Occupational Health doctor insisted I strip to my underwear*, on the basis that if I was harming at all then I wasn't stable enough to finish med school. So I quit cutting then, although I started struggling quite immediately without that coping mechanism or any suggestion of how to replace it, and ended up on Quetiapine. Actually, I think Quetiapine is the best thing since sliced bread, so maybe it wasn't such a bad thing. *If any doctors are reading this, you may wish to think more carefully than that doctor did about the reasons the patient is presenting. My self-harm links to the PTSD I have from repeatedly being raped; locking me in an examination room and stripping me to my underwear was probably not going to help the therapeutic relationship much! Chaperone, chaperone, chaperone. After a gap of a couple of years I've restarted cutting on my thighs, because I can't cope without SI at the moment, and I don't think the OH doctor I'm under at the moment would care about my cutting. He's aware of the burn before Christmas (that was supposed to be a mild just-to-take-the-pressure-off burn and ended up being 4th degree and needing a LOT of attention,) and he's just told me to go steady and look after myself - at the moment work is inconceivable so we'll see what happens when we get to that point, I'm quite deeply entrenched in an episode of self-harm at the moment, but the main reason I stop for any period of time is if I'm with other people or in someone else's home, who would be upset know I'd done that. For example, I often stay with friends for a few days at a time, and the hostess would be heartbroken if I cut myself in her home. She knows I'm bottling it up and I'll 'catch up' when I get home and cut as much as I would have under her roof, but she can live with that more easily. The other thing that stops me is being in hospital, because I can't get clean blades, and I try really hard to keep my cuts infection-free because of my SLE.
  15. I have a pretty solid sense of self, but it's largely built around my career - I used to be a much more well-rounded person, with hobbies and interests, but I've had to give up things like my playing a musical instrument, in order to get where I want to be career-wise. . My recent (hopefully temporarily) inability to fulfil that role is leaving me feeling fairly useless and confused, I'm trying to explore the other parts of my personality to get me through this chasm of not being well enough to work, but I'm coming up short!
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