The slow beat of the steady drum

[TW: Self harm and suicide]

I hardly know what to say, how to articulate myself. The truth is I haven’t really been well since 1st September when I reduced my quetiapine from 600mg-500mg under Consultant supervision. It only took a couple of days to see that things were going wrong and although I put the dose up again quite soon after, the damage was done. Since then I’ve been close to crisis a couple of times and considered asking to see my psychiatrist more urgently than our planned appointment at the end of November, but on both occasions I managed to pull things back. Last Friday (9th October) I realised I couldn’t handle things myself any more and contacted my Consultant who extremely kindly fitted in a consultation with me the following Monday.

It was an odd appointment in that no matter what I said to him over the past years, none of it made him seem as concerned or as sad as what I told him on Monday. I explained that there was so much going on in my head but underneath it all was a pulsing idea, like the slow beat of a steady drum, that I don’t want to be here. People had started to ask me about Christmas but it feel remote, irrelevant, because I didn’t think I would be around. I admitted that I had been Googling possibly fatal doses of my medication (although I had already asked my partner Tom to take my meds and hide them somewhere, which he has done) and tormenting myself by looking at pictures of the Dignitas assisted-suicide clinic. I told Dr S that what I wanted was to be able to go somewhere quiet and supportive to end my life, that I did not see why because my life-long disability was mental I should have to do violence to myself to end my life, violence that would be needlessly distressing for my family and emergency services personnel. The look on his face when I said this haunts me, as does the knowledge that I had managed to make an experienced psychiatrist look so sad.

On top of this I was experiencing wild, impulsive, intrusive ideas. I am not a self-harmer yet I was plagued with impulses to cut or otherwise damage myself. I was also inexplicably drawn to doing things which felt like suicidal impulses yet would nowhere near do the job. Jumping off my balcony is a good example, I felt my body was twitching towards doing this, but what would I achieve? We’re only two floors up. Nothing would come of it other than a couple of broken legs, maybe, and a period in an orthopaedic ward. I was baffled by these urges, but did not feel safe, scared I might do something ridiculous but drastic and end up with horrible injuries and the inability to return to the work I have built up.

The inevitable questions of admission or Home Treatment Team arose. I explained that I had a problematic relationship with the HTT Consultant before because I do not feel he listens, but my own Consultant seemed more willing to intervene if that becomes a problem again. He also reminded me that the referral to the National Affective Disorders Service (made in April of this year, despite which none of us heard a word) had originated from the HTT and might be better chased within the HTT.  Admission was also mentioned in rather more concrete terms than usual, and this was not something I wanted to hear, so I agreed to return to the care of HTT.

My initial induction/assessment was with one of my favourite nurses, D, and took place the following day. On the way I picked up my meds for my physical health problems, and found myself wondering how many sedatives I could easily buy over the counter. Waiting for the bus to the hospital an ambulance screamed past me, headed for A&E and I experienced a strong impulse to leap into its path. This, I felt, was a new low for me, an act that could cause someone inside the vehicle to lose their life. Despite these ideas I felt surprised how concerned D seemed about me, because another part of me was starting to believe that I was making everything up and HTT would think I as a waste of space. Instead, I found myself having to fend off quite serious talk of admission by agreeing to daily HTT visits (last time I only had to go every other day).

HTT seems more helpful this time around in that I am so confused and desperate that the sheer fact of seeing kind people with familiar faces is helpful. The HTT Consultant’s away this week, so I saw the Registrar, who I’ve also met before. The “med review” that was undertaken was pretty unimpressive, however. I don’t know if he was unwilling to do much in the absence of his Consultant, or until the referral has been chased, but his only advice for today was to try exercising for ten minutes every day. I was supposed to have a lithium blood test too, but somehow there was no one to do it, so I have to tweak the time of my dosage for a second night and hope someone can take the blood tomorrow.

In between I am swimming in a soup of confusing, conflicting emotions and thoughts. Usually when I don’t know what mood state I am in (a situation which leaves me baffled and scared) I am in a mixed mood, so I’m going to go with that. I am still thinking about suicide. A lot. Today I should have been at the Royal College of Psychiatrist’s general adult psychiatry conference as a service user rep, but I had to give my free ticket back to Mind because I was too ill to use it. Seeing others live tweeting something I had so looked forward to attending brought home to me, immediately and painfully, how unpredictable my life is, how many disappointments and how much suffering it is charged with.

Had I had access to that box of meds I feel that this afternoon would have been extremely risky for me. I have reached a point where I don’t even know if want to get better, because what is the point? Looking at my life, it’s littered with things I tried or wanted or started to do/achieve/try. Why bother to work at getting better, when it’s inevitable that all I’ve worked towards will come crashing down again at some point? Even over the summer while my mood was stable and good, I could not let go of the feeling that it might still be better to end things, before I could relapse again.

And yet part of me still thinks I’m not really ill. I had to draw this diagram for myself just to remind me that actually there is a hell of a lot going on (I’ve never tried to make a Venn diagram of my symptoms but it actually worked really well). I don’t know how to get out of this soup. I’m taking my meds and attending my appointments like a good compliant patient. I’m using prescribed diazepam to manage things; it doesn’t stop the thoughts or the feelings, but it blunts them. Only all the time, underneath it all, I hear the steady beat of the drum.

Screen Shot 2014-10-16 at 15.13.05


About purplepersuasion

40 something service user, activist, writer and mother living with bipolar disorder. Proud winner of the Mark Hanson Prize for Digital Media at the Mind Media Awards #VMGMindAwards 2013. Winner of the World in Mentalists Mood Disorder blog 2012. Regular guest blogger for the International Bipolar Foundation Expert by Experience working with Mind training department. Working on The Incoming Tide, a bipolar memoir. Find me on Twitter @BipolarBlogger or at my Facebook page
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17 Responses to The slow beat of the steady drum

  1. Henry Dunn says:

    Charlotte, what can I say, except how deeply I care about you. I’ve never heard you sound quite this desperate before. A ten minute run? Is that the best he can say? Sounds like some of the nurses are nice though. I often find that the lower the pay, the better the care and the levels of empathy, though there are notable exceptions. I wish I could whizz up and see you, and maybe I’ll find a way of doing it. I wasn’t able to visit another friend many years ago – he hadn’t intimated he was suicidal – a couple of days after I spoke to him he had killed himself. If I can’t be with you physically, I am with you in thought and spirit. You are precious to so many people, but saying that probably doesn’t help, just makes you feel guilty for your thoughts. I just hope and pray that things improve. With my love, Hxx

  2. You put into words far more eloquently and detailed, exactly (it seems) how we are both feeling. I feel that I am mixed too and refused to give away my meds or my alcohol. I’m so sorry that someone else feels like this because I really wouldn’t wish this on my worst enemy let alone someone who, although a stranger, is someone I admire greatly. I really hope with all my heart that you survive this as I feel like you have so much to offer the world, even if you probably don’t see that yourself right now. You’re in my thoughts.

  3. mrsshortie says:

    It’s so very sad to hear you talk like this, but at the same time once again you have put into words much of how I am feeling. Although at the moment the thing stopping me taking the final step is my kids. I will keep you in my thoughts and hope you find the right support to get through this terrible time. X

  4. Helen J. Gauperaa says:

    Kudos to you for writing so honestly about how you feel and what you are currently experiencing. I’ve had the same balcony thoughts, even quite recently, but I have exactly the same predicament: I’m on the second floor.
    I’m not qualified, nor do I want, to give you advice. It can sound so trite from others. I just hope to be able to carry on reading more posts from you, because, as brokenglassshimmers says, you are so eloquent and really do give so much to others, that you just don’t know (unless we pop up and respond to your posts 🙂 ). I’ll be thinking of you.

  5. pink0banana says:

    Sending you a virtual blanket to snug with and hot chocolate for comfort and big hugs xxx

  6. OnTheWay... says:

    Thank you for putting your experience into words, so many of the things you’ve written about are familiar to me, that steady drum beats loudly here too.
    I really hope that you can find some respite soon.

  7. Sam Candour says:

    Oh my love. I wish I could say something that would help you feel better, but if that was possible you wouldn’t be in this torturous situation. Instead I shall offer the usual virtual comforts of a blanket and Charlotte-sized bar of chocolate. Sending love.

  8. Amanda says:

    Thinking of you. I follow so much of your discomfort and distress of twitter but my account is linked to work so I am limited in what I can say there. I am so glad you can be so honest online, and I truly wish to send you strength to keep going.

  9. SB says:

    Very brave & achingly honest account of how you are feeling Charlotte, I’ve noticed your increasing distress on twitter over the last number of weeks. Please, please, take care and please continue to stay safe.

  10. fiona mackenzie says:

    I am sorry to hear you are so unwell. I really value the work you do in your blogs which I am sure a helps others to understand manage their illness. I hope you find the courage to go on and can hold out some hope of the National Affective disorders clinic having something to offer. Best of luck with the home treatment team.

  11. Mireille says:

    Charlotte, I am so sorry this wretched illness has you so fast in its claws. We all walk in the shadow of the place you are right now. If good thoughts and good wishes from the other side of the planet can be of any use at all, you have mine right now, wrapped and bundled and warm. Kia kaha.

  12. I feel every very brave word. I have, until recently (and still when I need suddenly med tweaks), fought against self-harm and suicide from the moment I woke up. Almost every day for 29 years. You are in my thoughts. Please hold on. When you’re able, find a treatment team worthy of your strength and open-ness. You are loved, by a stranger in Brooklyn. xx bipolar fab aka Marta

  13. roper says:

    I’m sure it is the time of year. At least for me it is always the worst, most difficult to get a grip on it. Also, the easiest time to forget I can manage BiPolar. I have been knocked down and winded by it again, even though I knew it was probably coming, like a cold north wind. Thankfully I had the support, at home and professionally, so I am OK now, just a little scared in the shadows and a bit shaken.
    I hope you too find the support you need and deserve. Please take care, it is not a race, so take your time and be kind to yourself, like you have been kind to so many others.

    • Nothing to do with the time of year for me, some of my most horrendous depressions have been in the summer and there is no pattern. For me this time it’s purely because I tinkered with my medication dose (under medical supervision) something I regret so very bitterly now.

  14. Pingback: An impossible ask | purplepersuasion

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