Quote from Kat (eniwekwe)

June 30, 2007

From Kat’s (eniwekwe) youtube video Anorexia: YOU ARE GOING TO DIE:

“Your responsibility is to nourish your body and love yourself so that you can properly love other people. So that you can give.”


Quote: assessing mood

June 29, 2007

Dr Liz Miller in Pendulum, Spring 2007, page 13:

“The easiest way to know what mood you are in is to think of mood as having two separate parts: energy high and low, and happiness – how good or bad you feel. This can be seen and monitored visually by drawing two lines on a piece of paper and labeling the vertical line energy level and the horizontal axis bad on the left and good on the right.”mood

Quote: meaning of cure with analogy

June 29, 2007

Professor Nick Craddock in Pendulum, Spring 2007, page 6:

“It all hinges on what the word ‘cure’ means. The reason why I avoid the word ‘cure’ is because as a doctor my understanding of the word cure is that you take away the susceptibility to being ill. For example if you catch pneumonia, a cure is that you have an antibiotic and that completely eradicates the bacteria and you are free of it unless you catch the bacteria again. But in the case of asthma, it is not sensible to talk about a cure because the person almost always continues to have the susceptibility under certain circumstances. What we can do is to alleviate the symptoms and prevent episodes. If the person stops taking any medication or preventative measures, they would be quite likely to develop the symptomos again. There is an exact parallel with bipolar disorder.”

I made my illness worse but I didn’t cause it

June 29, 2007

I’ve just taken the Cardiff University Bipolar Lifetime Mania Scale. My score was 64 which is consistent with my diagnosis of bipolar I disorder. I was very cautious in my answers and tried not to over-play my symptoms. But I still came out in the range of bipolar I disorder. I find it hard to accept I’ve had a manic episode because it didn’t feel that bad though if I really was ill then I wouldn’t necessarily have known it. I went through the DSM-IV criteria for a manic episode and I think I had criteria A, B3, B4, B5 and B6 in April plus the depression criteria which means I had a mixed episode. The severe agitation lasted about three weeks. That episode ‘counts’.

I have to accept that I have this illness. It is damaging to me not to accept it. I made my symptoms worse by doing stupid things like taking drugs but I did not make it actually appear. Even if I did, it’s here now and that is what I have to deal with.

I need to stop paying lip service to the idea that I have bipolar disorder and actually fucking believe it! What is so bad about it anyway? Yes, it ‘makes’ me do stupid things but it doesn’t make me stupid. I embarrass myself but who doesn’t? Why is my self-esteem so damaged by the idea of having bipolar disorder? It doesn’t make me weak. I have a responsibility to look after myself like everyone else does. If I don’t do it the results might be more obvious but it’s still the same principle. I’m not that different from other people. I can be an okay person and have bipolar disorder.


June 27, 2007

I still have the depersonalization but it’s improved a bit yesterday and today. I asked my psychiatrist about it and she was worried that it was part of, or a remnant, from the psychoses. I did believe there was no me inside, that I had disappeared. If it was psychoses then it arose from depersonalization in the first place or at least that’s where it got it’s cues from. So as it leaves it seems reasonable that I feel decreasingly depersonalized then back to normal.

That assumes my ‘normal’ doesn’t have depersonalization. I have had chronic depersonalization and derealization symptoms for years.

I find these feelings extremely hard to describe and I think that has a lot to do with why I haven’t done much about them. First of all I should do some research.

Definition of depersonalization from Dictionary.com:
– a state in which the normal sense of personal identity and reality is lost
– loss of contact with your own personal reality accompanied by feelings of unreality and strangeness
– a psychopathological syndrome characterized by loss of identity and feelings of unreality or strangeness about one’s own behavior

Definition of derealization from Dictionary.com:
– an alteration in perception leading to the feeling that the reality of the world has been changed or lost
– an alteration in one’s perception of the environment such that things that are ordinarily familiar seem strange, unreal, or two-dimensional

From Wikipedia:
“Sufferers of depersonalization feel divorced from both the world and from their own identity and physicality. Often a person who has experienced depersonalization claims that life “feels like a movie or things seem unreal, or hazy.” Also a recognition of self breaks down (hence the name). The person experiencing the disorder may feel as though life is a dream or an illusion. Often, this results in very high anxiety levels, which further increase the feelings of “fakeness.” It is in a sense, a “feedback loop” that amplifies itself.

This feeling is said to be like being a ghost. No matter how hard sufferers of depersonalization try, they do not feel they are genuinely interacting with the world. Simply put, depersonalization is an alteration in the perception or experience of oneself, so that the self is felt to be unreal; sufferers feel detached from reality and/or their own body or mental processes. They may have difficulty fully comprehending what they hear and see.”

From Depersonalization Support Community:
“Depersonalization : A frightening and/or disturbing experience of not being within one’s own body or of being in immediate danger of vanishing/separating from reality – often described as the sensation of living inside a dream. Although cognitive functioning remains intact, the sufferers feel disconnected from their sense of self and often interpret it “as if I am losing my mind.”
Derealization : A state of consciousness that creates a sense of detachment from all environments, fogginess, as if a plate of glass is in between the mind and the physical world. Any concentration requires tremendous effort, and the harder the sufferer tries to focus, the more disconnected they become. Often including feelings of déjà vu or jamais vu. Familiar places look alien, bizarre, and surreal – as if they are part of a Salvador Dali painting. In fact, the more familiar the surrounding, the more foreign it seems to be.
Depersonalization and Derealization involve similar consciousness states, although psychiatric literature discusses them as two different symptoms. The major distinction is that the first is a distorted awareness of self, while the second is a distorted perception of the physical environment. Often patients experience both, simultaneously or alternately. These states of mind are accompanied by an obsessive need to self-monitor, to observe the self moment by moment. The sufferers describe an inability to experience their own lives while stuck in chronic self-observation (also feeling that identity is disappearing, or has already vanished).
Usually, but not exclusively, these altered states include debilitating anxiety and overwhelming preoccupation that a total loss of reality is only moments away. There may be pervasive beliefs of literally “willing oneself” to remain sane, along with a morbid fear of (and resisted wish for) total surrender to what seems to be an impending psychosis. Over time, the patients believe they are losing more of the self, and while actual reality-testing remains intact, the feeling of reality diminishes. There are increasing doubts about the actual existence of an external reality and the sufferers often harbor secret thoughts that they have only conjured up the world and their own being. Bizarre ideas may include a notion of being the only person in the world, or of existing merely as a thought without a body. Thoughts can develop about being the singular author/director/producer of one’s perceived existence (as is true in a night dream). Such ideas often lead to overwhelming ruminations on the nature of being human. The result is increased withdrawal into one’s own mind, which encourages social isolation and enhances the feeling of alienation.
But to the depersonalization/derealization sufferer, it seems there was no provocation for this bizarre state of mind. In actuality, the brain is often reacting in response to thoughts that exist outside conscious awareness – thoughts that were perceived as potentially threatening to the self’s status quo. In such cases, the mind dissociates as a form of protection – without any discernible trauma or shocking event as motivation. The “danger” was internal, and the potential assault was against self-identity, not the physical body.
Over time (and reinforced by obsessing over the original experience) the mind seems to develop a habit of re-invoking the symptom/neurological reaction. The patients usually become convinced that the way out of their nightmare lies in focusing more and more inward, relentlessly self-observing for any sign of returning reality. But like a child’s straw finger puzzle, the harder one tries to pull free, the tighter grows the trap.
Patients must strive for experiences that allow them to re-engage as actors in the drama of their own lives rather than clutching fearfully to the role of observer. Cognitive-behavioral therapy can help sufferers to modify their conscious thinking patterns and reinstate spontaneity of feeling and thought”


June 24, 2007

Something, either the latest medication risperidone and duloxetine or lack of quetiapine or coincidence, has really changed this last week. I have got up and dressed every day. It wasn’t even that big a deal and things didn’t feel like a fight. It was just straightforward: get up, get dressed. I’ve met up with friends and I’ve talked to people. In short, I think I’m coming out of this depression.

The relief I feel at the lack of symptoms is unbelievable. I can really feel the space that they took up. It’s fading now but I want to remember hence writing it down. It was like when the agitation from the mixed episode left and when the psychotic and depersonalization symptoms left. There is me inside my head. Well me and some negative thoughts but they don’t seem to be able to get the grip like they did before. I feel like I can push them away and like I have a choice.

I have depersonalization again. It turned up on Wednesday which fits in with idea that quetiapine helped that symptom. It feels like a separate thing at the moment not like it’s integral to me as it has in the past. That’s another thing I want to remember. I must ask my psychiatrist about depersonlization tomorrow and find out more about it. I may only have a short time to act before it gets a grip again.

I have started making plans for the future again. I didn’t see past the next day or week at a push before. I’m thinking about education and doing voluntary work. My god, me! I think it’s possible that I can do something useful with my life, maybe even something I’d be proud of. It’s upsetting as well thinking about these things. It always provokes “why haven’t I done anything yet?” and “I don’t have anything to show for my life”. The negative thoughts still have a hold on me. But I do have some things to show for me life: people I’ve helped and pets I’ve nursed and had fun with. I want more though. I want a job. I want to be able to introduce myself to people and not feel ashamed.

That’s not just about getting a job though. I will have to accept that all this mental illness has happened to me and that it isn’t ALL my fault. I have made some definitely bad choices and I’ve made some easy choices that really didn’t help. I have a mood disorder of some sort and I did not create my genetic predisposition to it. I had no control over that. I had no control over what I experienced as a child. So, not all my fault.

I feel like I have to ask, am I going hypomanic? I’m sleeping much less but I’m fucking exhausted when I haven’t slept much. Being sleep deprived doesn’t elevate my mood like it did before. I did felt restless and agitated last night but 5mg of diazepam made me really sedated and I slept well for six hours plus the two hour nap yesterday. So no, I don’t think I’m hypomanic.

Well that went well

June 19, 2007

Obviously The Plan did not happen. In fact I didn’t even get as far as having a fucking shower. Will I ever get it together enough? Why am I finding this so difficult?

1. Get up, shower, get dressed.
2. Leave house.
3. Buy tablets.
4. Go to hotel.
5. Take tablets.

This is the pared down version. My house is tidy and clean. There are clean clothes and groceries ready for my boyfriend. There’s always more that can be done but I have to draw a line somewhere. It is not that difficult.

I will not have another psychotic depression.