Relapse

And I got so close to coming off the medication.

If you’re not familiar with the ups and downs of my mental health experiences, please read Going beyond a pill first.

Coming off long term medication for anything is seldom easy, which is why I’ve been reducing my dosage at a painfully slow pace under supervision from my GP. Having been on the same medication for the best part of five years, my view is that now is the time to come off it – especially now that I am free from the pressures of the Whitehall jungle. I managed to get down to a quarter of my normal dose with no major side effects other than sleeping more in the days after each reduction.

So why the relapse? This happened in the bit where I moved from a tiny dose every day to one-on, one-off. There are a number of possible factors in my mind. These include:

  • Alcohol: I’m partial to a glass or three of wine. Too much of it is a vice, and on one or two occasions it’s become all too easy to be occupied watching TV or out, about with friends or at a social gathering and before you know it, a bottle of wine’s worth of booze has gone through the system
  • Caffeine: I always seem to drink coffee when out and about during the day. Limoncello’s and CafeAMT make the best lattes that suit my taste, but the caffeine is not good. Combining these with soft drinks full of caffeine that I drink to wake me up isn’t good either – too many stimulants
  • Sugar: A combination of too much chocolate and too many simple sugars combined with caffeine can’t be good. In a nutshell, I need to improve my diet & stay consistent with it.
  • Discipline with body clock: It’s all too easy to slip into the habit of late nights and late mornings when there’s little to compel me to get up during the day. This is different to me choosing to get up and do something – which is on most days due to my insistence on swimming and ensuring that I get out of the house for my own sanity. Full-time education and/or employment helps greatly with the self-discipline of getting out of bed when the sun rises – due in part to the incentive of earning a living and the routine of getting up at the same time day-after-day.
  • Intensive exercise: I swim about 1km per swim around three times a week – alongside the walk or the cycle-ride to and from the pool. But I never feel completely worked out at the end of it. Time to turn up the intensity?
  • Cognitive Behavioural Therapy: – this therapy isn’t cheap and as such is extremely restricted on the NHS. Going through the process of ‘retraining your brain’ and breaking negative thinking habits is an incredibly draining process to go through. An essential part of any ‘talking therapy’ process I think is finding a therapist who you can really open up to. I’ve had several over the years and can only think of one or two who really got anywhere with me. But when you’re paying £40-£80 per hour/session…exactly. (Is there a role for the NHS to subsidise the costs so as to get more people who need it to make use of it?)
  • Overuse of social media: It may seem to some of you that I don’t switch off. That I think has been part of the problem this year in particular. Puffles’ 50,000+ tweets didn’t get there by themselves. Nor does blogging almost daily. Hence why I tried (and nearly succeeded) in keeping my phone hidden away in my bag during both my teacher training session and during my art evening class. So part of my plan is to reduce my social media usage & replace it with activities that I hope can increase my concentration span that is somewhere between that of a gnat and a flea. (Recall my post Social Media – when does it switch off?)
  • Lack of sleep this week: There were a number of things I did this week that required early starts that I combined with late nights. Actually, it was more a side effect of a messed up body clock. To get it back into shape, early morning starts are needed. But that means potentially increasing the anxiety symptoms that I’ve noticed tend to emerge when I’ve been lacking sleep combined with activity.
  • Worry about the future: This is both my own immediate-to-medium term future – especially in terms of future income (I can’t be on job-seekers allowance for ever) as well as the daily feed of bad news that we’re all fed daily. Does anyone have any good news they want to share, only the stuff coming out of Westminster and the City have been rubbish for quite some time.

In terms of exercise, part of me wanted someone to tell me what I had to do. Procrastination is evil I tell you! Cambridge does have an exercise referral scheme but I wonder how many people who live in the city know about it?. I was also pointed in the direction of MoodGym in terms of a free online resource. There are other ones out there that some primary care trusts fund, but mine isn’t one of them. Postcode Lottery anyone? This is the first time that I’ve found myself excluded from NHS-funded treatment because I live in the wrong postcode. I could go into a stream of expletives & tell the political establishment to shove localism where the sun doesn’t shine, but I won’t. It won’t achieve anything.

Social media will be a difficult one – not least because nearly all of the people who follow this blog and Puffles only got to know me through one or both. It will also be a challenge because social media is an area that I want to explore in terms of its application in the public and not-for-profit/voluntary sectors. That said, I think one of the challenges for social media users and advocates is being able to advocate switching off. Sometime in the late spring next year I’m going to experiment going away to the middle of nowhere for a week or two minus any appliance or gadget that connect me to the internet. What impact will it have?

In the meantime, less booze, less coffee, less sugar, take up circuits and start some self-starting CBT.  

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One Response to Relapse

  1. Nick says:

    Just to say that I admire your openness and that I directly relate to many of your experiences and observations.

    I’ve been on ssri, on and off, for over 10 years, the current flavour for about 6 and have, to be frank, little intention of trying to come off!

    I’ve also undergone cbt, but for me the most effective (other than a chronic reliance on serotonin re-uptake) has been exercise, tee-totalism and heavy metal (distorted guitars I mean rather than lithium!)

    Relatively stable now, I’m able to live a somewhat less obsessive existence, moderate rather than tee-total, active rather than kinetic and with a (slightly) broader taste in music!

    Perhaps I should consider coming off the drugs but aside from not relishing another visit from the Black Dog I worry that it would impact too heavily on my family and work life…so for the cost of a weekly prescription I think I’ll stick with them for now.

    Good luck if you decide to try to come off again. Or if you don’t.

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