Amazing students!

After a bit of a wobbly morning, and a nice long 3 or so mile walk at lunch, it was time for the afternoon session.
I have been trying to drip feed the info a bit more this time around, as the first time I was here, I felt I was giving it all away a little too easily
Morning sessions were all positive, great interaction with each of the students doing their differential. However this afternoon, I have just come out of the first session and am genuinely blown away by the approach  professionalism and thoroughness of the first student.
Her approach was spot on, as if she has done this 100 times already, however it turns out it is just her first  time doing mental health this week. Calm, interactive, patient led and compassionate. You can't teach that sort of persona.
This is not to detract from the other brilliant students I have interacted with already today. Each one of them is fantastic in their own right. Simply for being in the line of education they are in, they get my full respect. Not to mention how each one has been brilliant in diagnosis and patient interaction
But sometimes one person really stands out, and this was the one this time around.

*Edit*
Just come out of the second session, and again, amazing! Empathy in gallons, understanding, and all the right questions and replies. 


Going back to me for a bit. This morning was a little draining. Feeling situational anxiety I think would be the right way to put it. As expected, the slight drain on my energy levels of late has had an impact  However it has also taught me something about myself too.
Situational anxiety, is not the same as general clinical anxiety. They may present the same, but bounce back from situational is instant, where as being clinically anxious and going through a full on episode is completely different  thank heavens! I can understand more now when people say they feel anxious for a moment, and can better relate to what they mean by it. I have felt it many times before  but this is an eye opener for me, and I can now feel the difference.
Similar with depression really, although my feelings of genuine depression are a whole lot lower than when I feel, what I call "down". But I can understand when people call it being depressed about something all the same.
I do love a situation where everyone is coming away with new knowledge, and today is certainly one of those times. Last time I said I thought I felt anxious about talking about anxiety, and presenting with the symptoms again. I can confirm this is the case again. Reliving the visits to the doctors really does bring things to the front of your mind and can start to feel really real. However I won't stress as I know how it passed last time, and will again this time.

RCGP session two!

The clock is ticking down on my next session at the Royal College of General Practitioners on Friday, and I have to say the suspense and stress is building. It will be my second rush-hour trip to Central London in the week, which never bodes well with me even at the best of times.

The first session I did was a real eye opener, and while it was fun, it was quite draining too. That was starting from a nice high spot in my mental cycle. This time around I am somewhat lower than I was before, so it will be interesting to see what impact that has. Whatever the cost to me, the important thing is being able to help the students understand the presentation of anxiety and depression.

On the plus side, the whole day is a known thing now, it is not full of surprises and uncertainty, so that will help enormously I am sure. I will just get there nice and early again, missing the majority of the morning rush, and have a little wind down walk before getting started.

I will have to put some thought into the scenario for this time too. I am quite happy with the original, but it is good to mix things up a bit. As much for my sanity as theirs. Really is quite draining mentally, recalling events from your life, and playing them out in a scenario over and over for a day. By the end of the day you are mentally exhausted. I kind of envy the actors who also participate in these events. Surely it is much easier to pretend to suffer with something you don't already struggle with. Maybe I am wrong, who knows.

Either way, as I say, the main thing is the students come away from it all with a better understanding. I really do want to have more time to answer questions, and help in any way I can. With so much work being done to raise awareness of mental health issues, it is only right to make sure it can be identified and caught nice and early, so help can be given before the issue worsens for the patient.

Which reminds me actually, I have got to read back through my emails, and do a submission to the BMJ as suggested by Niki. It may come to nothing, it may be the beginnings of being able to do something more positive, time will tell. Not like I don't like writing now is it!

Right, better get my head in gear and thinking cap on, ready for the (next) big day.

Thanks for reading.

PS, students, you can now find all my MH writings on my new website www.snazy.co.uk (if you are not already reading this entry there)

Dear students... #WorldMentalHealthDay

First off, I just wanted to say, publicly, what a pleasure it was to meet you all today, and thank you for your time listening to me rambling on about my experiences with depression, anxiety, and lets not forget gout.
As I said at the time, I am truly passionate about helping people have a greater understanding of what it is like to suffer from depression. Feeling a bit down, or a bit grumpy is really not the same. I really do admire people like yourselves who take the path in life to try and help others, however sometimes feel that the theoretical education somehow lacks enough depth to truly grasp some conditions.

I hope today was helpful for you all, and that in amongst some of my tales and analogies, there was some clarity there too. I am grateful for the feedback you all gave at the end, and hope you took as much away from the session as I did. Thank you to Dr Paul for having the foresight to suggest the session in the first place.

There are of course many other matters we did not get to discuss, compacting a few years of depression, the rises and falls, is of course impossible for a 90 minute session. Hopefully in amongst the rest of this blog (Nov 2015- Mid 2016) there is more information on the subjects which may be of interest. There are also entries from way back too which reflect on the depression. My journey through CBT is also in there somewhere.

If you have any further questions about the issues we discussed today, please feel free to contact me via the blog, or emailing me with any questions on snazy123@gmail.com. Also, feel free to share this blog with anyone you choose to, there are no secrets, especially on the internet.

Getting back to the main part of the blog here. I just wanted to add that physical training, cycling, writing, and believe it or not, being tattooed, all play their part in the maintenance of my well-being, as well of course as having the love and support of my close friends, who keep me grounded.

Today for me was a stepping stone, a step in the right direction for me, with getting involved in something I am very passionate about. The understanding, from a first person perspective, of what depression is, how people cope, and what can be done to help them on their journey.

For many, depression and anxiety is not a life long issue, but a journey taken within our lives, more for some than others. Seeing people convinced that they must live by the pill is quite sad, and also worrying. Not to mention the lifestyle choice that people make when they are convinced this is them for life now.  Talking with people who understand and can genuinely empathise with what you are going through is a massive step, certainly for the people I have had the pleasure in helping in my past.
However not all cases are the same, and the idea of getting involved is in no way a pipe dream of a one size fits all fit.

For me, the idea of being able to play a part in other peoples recovery is huge. I don't expect every encounter to be perfect, and am aware that my personality may not be suitable for all. But nothing ventured, nothing gained and all that.
If actually being involved directly is not a reality, then the next best thing would be to continue to give my time to enable those who will one day be at the frontline of things. Using every day analogies to make sense of how the depressed mind works. I was pleased that my "it's like" approach finally made some sense today.

After speaking with Dr Paul following the session, I am going to try and get my head around how I can get more involved. Organisations such as MIND are a good starting point, my only concern is how to explain my intentions, with absolutely no academic background whatsoever. We shall see how that goes, I will be sure to update the blog with any progress I make, as well as Dr Paul.

Any thoughts on this venture are welcomed.

Today once and for all clarified for me that I am in the right place mentally now, to start reducing my medication, clear the mind fog which sometimes presents itself, and get on with doing something constructive with my time.
If a legacy were possible for someone like myself, it would be wonderful to think that my efforts and words could be carried forward, and make a difference for even a handful of people. Especially those who are not as fortunate as myself, and have no immediate outlet or support network.

I know I said some pretty damning things both on here, and today about the services offered to those suffering mental health issues. I hope I struck the balance of both grateful and understanding of what is deemed possible from an academic level, whilst highlighting the short falling, and no mans land between what is written and understood, and what actually works for people struggling. There is a balance to be found, and hopefully one day, maybe with input from me and others, it will be achieved.

The message to take is quite simply, the input from the NHS and other health services is instrumental in building the foundations for a recovery from such an experience in life. However theoretical empathy only goes so far. Understanding, and experience bridges the gap which is left. There is nothing quite like being on the level with someone who truly gets where you are coming from.
Building baselines for all to understand, and be able to empathise with is key here, so expect to hear "it's like" quite a lot from me.

Now I shall take some time to reflect on today, and formulate a way which I can try and create this baseline. The input from the students today has been key in building my understanding of what is in place, and what is missing from the current structure. Although I would love to build my knowledge on the academic side of things more for my own benefit and understanding.

Key words from today, baseline, empathy, analogy and understanding.

Just as a final note, I want to sincerely thank Dr Paul for her time for me since we first met. That first blog entry following the consultation was a pivotal moment for me, as has been the continued support from you. To have been given the opportunity to carry out todays exercise has been very special for me, especially on what turned out to be World Mental Health Day. Imagine that.

Here's to the future. For us all :)

Thanks for reading as ever.

What can I do to help?

It is so frustrating at times to site idle while others suffer. Knowing you have information which could help others, you have the ability and time to talk to people who need someone to speak to. Yet no way or means to get involved at the grass roots level.

Over the past few days I have been looking into jobs in mental health, what qualifications are needed, and how I can help with the basic skill set I have. Apparently there isn't a way. Which while understandable, is also frustrating. Sure you can teach people the basics of mental health, draw up a curriculum which covers all the bases, make sure people understand the fundamentals of depression and anxiety. But you can't teach experience.

Somewhere there should surely be a crossover point, where experience and education meet, and can be combined to provide the services which are needed most by those suffering. It is great seeing big names coming out and admitting they are affected by depression, and explain their struggles. Saying things others can relate to, and feel like someone understands them. But that is where it ends. When you come forward and look for help, the understanding ends, and the empathy of education presents itself for the first time.

Having someone tell you they understand, because they have read about it is NOT the same as having someone share stories, or finish your tale for you, showing they truly know what the moment can do to you. The lack of this actual understanding is crippling for some, I certainly lost all faith for quite some time. Luckily I had the guidance to keep pushing me to keep going to the meetings, and to try and see what I could inject into the meetings to try and make them a little more "real" for others so to speak.

The thing I found was, as soon as I started openly sharing how certain incidents and events had made me feel, the whole group seemed to engage, waiting to share their experience too. A few meetings later and it had become the norm for me to offer a story, a real life example of such a feeling, to get the ball rolling, and by the end of the session we were all much more open about yet another aspect of depression or anxiety.

The difference to the first few weeks, and the attempts by the course tutors you try and get people talking, asking complete strangers to interact was almost troubling rather than helpful. Only being able to teach and discuss what you have learned from a book or lectures, while on paper might sound great, really isn't. I reflect back to when my daughter was being born, and the midwife told her mum to relax and enjoy the beauty of birth. When asked how many children she had, she replied none. That didn't get a great response. How can you tell someone how to feel about an experience you have never had... Quite simple, you can't.
In very few walks of life would you take advice from someone who only has theoretical experience in something. So when it comes to something as personal and unique as depression, the textbooks just don't cut it.

I desperately want to be able to intervene. Play a role in getting people who are hidden away in their heads, suffering in silence, speaking out. Not to the world, but just to a human who can be compassionate and genuinely empathise with them. Someone who can give their thoughts the time of day, and allow them to vent all the negativity that is drowning them.
You see, for me, and in my experience, speaking out is the first and most important key to the whole experience. While I have always been open enough to speak to a lot of people about it, there is a time when you feel you have exhausted them with the same stories, and you need someone else to talk to, a blank canvas. Unbiased, non judgemental, and willing to listen.
For me on my last round of depression, that person was Dr Elizabeth Paul at Wells Park Surgery. As my original entry says, I walked in silent, sat and just gazed. There was no immediate prompt from her, just a simple smile which gave me the courage to start trying to explain myself.

The whole entry is here... http://michaelsnasdell.blogspot.co.uk/2015/11/the-trip-to-doctors.html

My point here is really, that there is no one right person or way for everyone, we each need to find our own. The person or situation we feel comfortable with, to finally take the first meaningful step. When I have spoken to others about their depression, the common thing I find is the almost relief shown by the person, when you can actually, first hand, appreciate the magnitude of what you are saying.
An example being, going to meet with a friend while I was mid way through my fight with depression most recently. I chose a place to have lunch, somewhere I knew would be quiet, no crowds. My anxiety at that stage was very bad, so people were not my favourite things.
All was fine to start with, however when we started eating, more people started coming in, sitting closer and closer to us. Paradise lost! Matt had no idea what was going on inside my head, but mad panic is the only thing I can describe it as.
When we left and were talking afterwards, in the nicest possible way, it was impossible for him to understand the difference 4-6 more people coming in had made. However speaking to other friends who have been through the same, they got it straight away.

The big issue here is, a lot of people just don't have "that person" around them, and most of the help on hand seems to be from people who are well educated in the field, but really can't fully grasp what you mean. This is a big stumbling block for people. Having finally spoken out about how you are feeling, to suddenly be faced with a stranger who wants to help you, but doesn't understand you, is crippling.

From my experience, things didn't go well from the start. From my first face to face with someone, it felt like I was doomed. The full blog of my first impressions is here.... http://michaelsnasdell.blogspot.co.uk/2016/01/touching-base.html

You may be able to tell from the words that it didn't really go too well, and I was left with a rather bitter taste in my mouth. If you read entries further into January, you will see things didn't exactly get much better, not for a while.
Had this interaction been with someone who could understand and properly empathise and assess what I was going through, I think I would have felt much better about the matter. Seeing the speed at which some people dropped out of the subsequent CBT course, I guess for some it didn't get better soon enough. When CBT was explained to me, it was a very rough and vague explanation, reading up on it wasn't much help either. It was only being there, and manipulating it to my own needs, that finally started to make a difference.

After the initial discussion about what CBT was, these were my thoughts.

But the thought I can't get out of my head right now, is the was CBT has been presented to me. My interpretation being that I am in control of my thoughts, and therefore if my thoughts are my problem, and I am in control, it is all my fault. That's how my brain takes it right now. Being told you simply CAN'T do or think something is not a cure. Breaking the cycle, which I know is what CBT is really about is the key. But how do do you that when there are so many triggers and issues to over come?

Here was a person of sound mind, with questionable experience with depression, certainly first hand, telling me in short that I was the issue, and I needed to just forget about the past, and look forwards. Not a great deal of help.

I would dearly love to be able to help people get through this first major step in the program. But it appears academics comes first. To me that feels like teaching someone who can already run, to walk again, because they didn't learn properly. Sometimes, certificates, diplomas and grades count for absolutely nothing at all. Sure, along the process they are without a doubt very important, but for some aspects, you just need to understand, properly. Especially when trying to convince someone to walk out of their door into daylight for the first time in a month.

So here I am, frustrated that due to my lack of qualifications, I am near helpless to play a role in this. Sure some will say, volunteer for Samaritans or similar, but that is just not it. Could I turn my hand to such a thing, probably, would it be as fulfilling as the feeling I felt helping my fellow sufferers through their battle with depression, probably not.

At the end of my CBT course I did consider asking to be the plant in the room, the one who has been through the course, but is there to go through the course again, and try and get things moving. Sure the tutors are doing their best, but from speaking to them, the drop out rate is high, and our group had a "good" retention rate compared to some. That left me thinking that there must be more that can be done.
In the end the course certainly played its part in my recovery, as did a network of friends, and carefully considered distractions. But I honestly feel that I was very close to not bothering with the course, as my blogs show. Had I had some understanding and encouragement from someone who got it, earlier in te process, I might have started feeling a bit more positive sooner.

I applaud anyone who trains to work in mental health. It is a huge problem for our nation, and one which is only getting better. Lack of funding, not enough genuine cases being recognised, but for me, the biggest issue is the lack of understanding in what really helps people in such crisis.


So I am off to scour the internet fr ways I can be more helpful to others. I will also be speaking to my favourite GP about the matter when we meet on Tuesday. I know she won't have the answers, but it is a start, and keeps my mind heading in the right direction.
Any thoughts on how I can get involved are welcomed, so please drop me an email or similar.

Thanks for reading, and here's to getting a better understanding for those suffering.

Deep breath, count to ten... Take control!

As I sit at the kitchen table, starting to write this blog, for which I have taken 24 hours to think of a name for, I am starting to understand my mindset on the whole matter.

The past year has been very different for me. Meeting Ann, moving in together, making huge physical and mental progress, as well as having many hiccups along the way. Roughly two years ago I was just starting to get caught in the whirlpool of depression. Starting to feel myself losing control, realising I was getting down, and fighting to keep my head above water. After a year long fight, I was in a position where I could say I finally felt back in control of things.

However being in a new relationship, and facing a very different living dynamic than the one I was used to, I wanted to tread carefully, and not rush myself off medication, or into to many changes at once. Almost another year later and I am finally in a position where I feel comfortable in considering a reduction in medication, and taking full control back.

Having been on Citalopram for 2 years now, I am more than aware that being off them will feel rather different to what I have grown used to. Since the first time on them, I am aware of the slight lethargic feeling they cause, which you just grow to accept in your day to day life. My recollection from coming off them last time is clear, and I remember how much more energised I felt, for the first few weeks at least. After that, well that is up to the individual.

And this is where the blog starts really.
There is an inherent fear of losing control early on, when there is no medication to "save you" from what life throws at you. When something unforeseen happens, you have no safety net to catch you. Truth be known, there never was. There is a placebo effect that is common when on such medication, and you feel safe, cocooned if you may. Such faith in the meds, that you feel stronger, and more resistant to outside influences. In reality, your mind is more chemically balanced, the right signals are being sent, and you take strength from this feeling. Almost a sense of enhanced confidence.

This confidence is something a lot of people lack, and it is what starts the downward spiral in the first place for some. Simple matters defeat you, worries begin to control you, and soon you are just along for the ride. The ability to remain in control is what gives this heightened sense of confidence.

Realising this is key for me, especially right now, as I approach the first drop in my Citalopram dose for about 18 months now. Knowing that the sense of control I feel I have now is all me, and not the medication is a sobering thought. It shows me that this person is me, I am not the product of the medication. I am however aware of the balance that the medication has restored in me, and am in no rush to immediately come completely off it. There may be a balance to be found between me and the meds, then again, I may be free of it entirely in the coming months.

The title of the blog is a mantra I need to keep in mind at all times. From home life to work life. Flat out training, to resting in the evening. There are always moments where we need to pause for thought, compose ourselves, and react rationally.  I found myself practising it yesterday in fact, which is what spawned this blog, realising I was actually in control.

A spanner thrown into the works of the day, churning up my thoughts, whilst in mid flow of writing another blog. My initial reaction, rage, anger, and fire straight back. Closing the laptop and walking away for 10 mins was a good start. Deep breath.

Distracting myself with something else, watching a YouTube video, gave me time to consider the matter, and contemplate my response. Was one even needed. Count to ten, think about it.

With a few minutes taken to consider the outcomes of all scenarios (classic trait of an over thinker, but that is another story) I relaxed. Realising that any response would simply perpetuate the situation, and each cycle would simply trouble me more, and not resolve anything. Sometimes the cause is just not worth the battle.

That however is just one example. Somehow my mind finds itself in these situations too often, and that is my next battle. There is only so much one can do when it comes to change and influence. Speak your mind if there is hope of a constructive outcome. If the outcome is pretty clear from the offset, why even bother involving and upsetting yourself? A mantra I can recite, but not one I am familiar with following, yet!

To support this change in medication, and what will no doubt be a bit of a strange time for me, to say the least, I have also decided to take control of matters in other ways too.

Having been sat at home bored senseless for weeks on end this year, with foot issue after foot issue, the time has come to stand up to it, pun intended. Having now been through the medical mill, tested, scanned, xrayed, medicated, reviewed, and currently going through physio, the one message I have taken from it is, it's not going to get better any time soon. However, gently pushing on should cause minimal harm.

Now a long way away from my 3,000 mile cycling goal this year, this is one of the things which stresses me out, after all cycling is my great escape. And my very own body has denied my mind this escape. Failure is NOT an option, I must succeed.

Whilst in with the doctor yesterday, which I will return to shortly, I discovered my weight has skyrocketed while I have been laid up, and I am now a HUGE 117kg or 257lbs (18.3 stone). A month ago I was 245lbs! This is not good, neither mentally nor physically. Extra strain on my body is unwanted, and is just going to cause me more issues, especially as it is my feet which have to bear the brunt of it all.

So, medication change is tied first place with weight loss. They go hand in hand, and support one another. Health = movement, movement = freedom, freedom = happiness, happiness = good mental health. I am not unfamiliar with losing weight or increasing fitness, in fact I love the challenge of it, but the timing has to be right.
Knowing I have almost 1,000 more miles to cycle this year is a kick in the backside for sure. With my experience of low calorie diets, HIIT (high intensity interval training) and getting stuck into long rides, I reckon the bar should be set high for my improvements for myself this year. Targets yet to be set, but rest assured they wont be easy ones.

So the plan, as with the medication is to get started with it all next week. One big start line for the whole lot. This coincides with my return to work also, so that alone will help with the routine side of things. It also gives me the remainder of this week to work on the advice from the physio, to regain more movement in my right ankle before working it. There are 87 days left in this year or just over 12 weeks, so plenty of time to get back where I want to be.  Watch this space.

In the meantime, I will carry my mantra, Breath, count, control, and apply it to any challenge which presents itself. It is simple really, the hardest part for me will be preventing the initial knee jerk reaction, to let the rest of the cycle play out. But I know I can do it, if I put my mind to it.

What's worth less than worthless?

Me apparently!.......................

Or at least that is how I feel right now.
Talking to a friend earlier today I was sure I was on top of things. I felt that as the afternoon turned into evening and night I would settle down. How wrong I was!

Coming from a massive high this morning, running my first 10km non stop outdoors, it was a hard high to beat. With the weather moving in fast this morning and afternoon, getting back out even just to walk the dogs was going to be a feat in itself. Needless to say it was late evening (now) before I could.

I guess it is only fair to say that I have kinda felt this drop coming for a couple of days now, with a series of events really giving my self esteem a proper battering. I won't go into detail as the intention of this entry is not to give anyone a hard time. Life has just gone on, but it is how my brain has interpreted certain aspects of the past days which has resulted in this low.

Walking a tightrope of emotions is a hard thing to do at the best of times, but in the social winds, there is always a gust waiting to take you off your feet, and throw you off balance. As it would seem has happened to me... AGAIN!

Trying to re-gain some self worth and dignity has been a hard slog recently, but I know it is what will eventually get me back on my feet. The running and cycling, as well as being a great distraction, has also given me some worth, and occasional senses of achievement. These go a long way to making me feel good about myself. Not to be mistaken for vanity of course. Those feel good photos shared to the world of social media as a bit of an ego boost, and very little more.

Realising people have been ashamed to be associated with you, hidden their connection with you, and pretended it's not like that is a real kick in the bollox, and can turn the road to recovery into a muddy trail which is impassable in a matter of minutes. Impossible to comprehend unless you are actually there, it is soul destroying and tears through your past like a tornado. What was ever real?

Breaking ties with a support network in the name of trying to go it alone is a strange and dangerous thing to do, but after an event like the one above, trust is really hard to give to anyone, and feeling secure only when isolated and hidden away comes naturally. Is it the wrong thing to do, probably yes.
So why do it? Because in isolation I am the only one who can affect my mood, my day and ultimately my recovery. Eliminating the possibility of misinterpretation leading to a mood swing which I then have someone to blame for. Reducing the chances of me ruining friendships which I value so much. Taking away the expectation on others to somehow magically make everything better, and then blaming them when it doesn't happen.

One thing which is becoming abundantly clear to me right now is that I am not right. After all this time trying to find a path through all this mental mayhem, so many false hopes have led not only to disappointment, but also to a more damaging depth of depression.

Right at this point I have to call this my absolute low of this bout of depression. And one which has really gotten the better of me. Getting out of this hole is going to be a battle for sure, but one I hope I can win.
Already I have realised that my self destructive behaviour, obsessive exercise when my body is saying no, has returned. After the run today, sensible me knows that I should rest and go easy on myself. So a 5 mile walk followed by walking the dogs for another 3.5 miles is probably not the best way of resting.
I already have plans for tomorrow to keep me busy and exhausted, but am sure if I am home early enough I will make an effort to do even more.

A couple of weeks ago I had grand designs for my up and coming 43rd birthday, having decided it was my first in over a decade as a single man, and convinced by others I should make a bit of an effort, my brain was ready to do just that. Hell, I was even making plans for Valentine's (which is also my birthday), but quite frankly, fuck it! I can do without over-thinking another thing, especially as pointless as those above, so the day will pass with no interest from me whatsoever, again!

I need to see my doctor again, to discuss what is next, how to get out of this spiral which is growing ever tighter and faster. The CBT approach is really not for me, and even with a firm understanding of how it is supposed to work, I can see no way it will make a dent in my emotions. With my past biting me in the arse firmly again, I fail to see how putting it behind me with no further consideration is even considered possible.

Something is wrong, seriously wrong, and there is a limit to how many distractions I can hope or expect friends to provide for me, to take my mind away from it all long enough to feel better in the medium term. Times with friends are amazing, and I am eternally grateful for those showing me compassion, and taking time out of their own lives to give me a much needed lift. But I need to be able to do this for myself at some point, and not feel anger or bad in any way towards my support network when I am low and there is nothing anyone can do for me at that given time.

I feel pathetic even writing that, needy and full of unfair expectation, and that just compounds the issues I am struggling with, and makes me feel even more worthless.

I foresee a tough and lonely road ahead of me, and one I am not keen to even take my first step on, but if I want to overcome this, and rise once again, I really need to.

Another day, another blog.

After another rather stressy day yesterday I turned in early for the night. Not that I got to sleep straight away, and neither did I sleep very well. It would seem the initial improvement is now a thing of the past. Relaxing thoughts, and well rehearsed techniques to get to sleep no longer work, and the spiral of association has come back. Taking a simple innocent thought, within a minute it spirals into something I dread or a subject that winds me up. Change the thought, and the process starts again. Thinking of a video game for example, within three twists of association, can become a past memory of something I have done, which in turn makes me sad or anxious. It's incredible, as my concious mind could never make those twisted associations. It is almost like my brain WANTS me to think about these other things, and manages to contort the subject accordingly.

Right now though I have no rational way of addressing the matters, and no means of outlet to vent them to, so they will just have to wait for now.

Speaking of waiting, that is the theme of today, waiting for a contractor (who has now arrived), and waiting for a call from the GP. Thankfully, one thing I am not waiting for any longer is the report from my company doctor. After seeing him last week all seemed to go well, but you know how it is. Like job interviews, it went well but the letter isn't what you expected. However on this occasion I am happy to say that the report is favourable, and supportive, which is a great relief to me for sure. Painting a similar picture to that which my GP has already done, recommending the increase in medication as per the consultation, and outlining a realistic timescale for improvement and return to work.
Now I just need to speak to the GP when she calls, to discuss the report and see if she goes with the increase in meds dose.

Also having now received the next appointment with the therapy people from the NHS, I can now add that to her information, so she can make decisions accordingly. With the first face to face appointment with the therapy people not being til January, and only being an assessment once again, treatment itself is yet to get a confirmed start date. That obviously puts the brakes on things a little bit, but the company GP has allowed for this in his recommendations.

So there are lots of positives there for sure.
In other parts of life there is little improvement in my day to day goings on. Still borderline hurting myself to try and stay clear headed and sane, and of course to end the day exhausted enough to sleep. Which doesn't seem to be working very well anymore, but the getting out alone is helping keep my head clear.
Support from friends, and company being offered is a great relief, now all I need to do is make some of that actually happen.

On Xmas day I will be making my usual trip to Wales to have a clean up of the family grave, lay some flowers, and have some down time breathing fresh coastal air. Come rain or shine, I look forwards to returning to a place which holds only the most innocent of memories for me, and offers no complications, painful reminders, or associations for my mind to play with. Memories of youth are the clearest and purest I have. So I think it is that which keeps me going back again and again. As well of course as wishing to maintain the headstone, and pay my respects.
Fingers crossed I can have a wide awake day, and stay focused enough to do the round trip in the day. I am sure I can, but as ever it is a solo trip, so keeping my mind distracted might be a bit of a test for me.

So that is my download for the morning. Here's to a positive outcome to the call from the GP, and a chance to get outside and recharge my solar batteries in my head.

Thanks for reading.

Thank God that's over with.

So since being off sick with anxiety and depression,  and realising it was becoming a long term thing,  I kinda knew I would end up seeing the company doctor at some point. I have had a good relationship with him over the years with tennis elbow,  gout,  depression etc,  so know he is a good man with no ill intent.

None the less,  the thought of being judged by another in this state, and having to dig deep to explain myself all over again is a rather overwhelming experience to say the least.

So today was the day,  and sitting in the waiting room alone was a huge stress. Thankfully the train journey to London Bridge was nice and quiet,  and with headphones in I was in my own little world. When the time came to be called in,  the ever softly spoken Dr Mason came out and called me in. Formalities over with,  the conversation started. I gave him all the supporting paperwork etc,  and  he listened carefully as I tried to explain myself.

After a quick chat I filled out another anxiety / depression questionnaire and he totted up the score. Discussion turned to my meds and dose,  he suggested speaking to the GP again and getting an increase as he feels what I am on is a bit of a "girls dose" he said with a smile on his face.

Next he asked about work, then moved on to how he wanted to progress with me. Suggesting he would like to speak to me again once I have had some counselling,  and see how I am with that and the increase in dose of Citalopram.

Finishing up he asked how I was feeling,  I expressed how anxious I have been about the appointment since getting the letter,  and how it had made me feel. He reassured me there was nothing bad going to happen,  and that he wished me a good recovery,  and looked forward to speaking to me again and hearing some improvement.

Leaving the building my heart was pounding like crazy,  and feeling the fresh air of freedom outside was a relief. So glad it's over with now. Really has had me on edge for a few days now.

So I shall make a new GP appointment once I receive his report as suggested by him,  and see if the dose needs to be increased and if we are making progress yet. And also of course point out to them how long I have to wait for counselling,  as it doesn't look  like I will be working until that is underway.

Depression comes a knockin.

Before I say another word, I just want to get these few things out there.

Thank you to those who know me best, and understand the strange way my head works at times. And an even bigger thank you to those who go through the same processes and choose to share their thoughts with me. Your company on this journey makes it easier for sure.

Sorry to those who I impose my craziness on at times, who either don't understand what is going on, or would rightfully rather not be a part of it. I try and choose the right people to surround myself with when things start to go tits, up. Sometimes I get it wrong.

And finally sorry to those who don't get it at all. As most people who struggle with their own minds would agree, some things are best left unknown. This is certainly one of them.

Right, enough with the formalities, let's get down and dirty, but more down.... After all, that's what this entry is about.

Over the past week, a week which I have spent off work, some strange things have happened in my head. Totally understandable really, all things considered, but let's take a look all the same.

This week has been the first week I have spent "alone" for about 12-13 years. Not having spent such a long time in almost complete isolation can do strange things to you. Now before anyone jumps down my throat, yes I have kept company with some wonderful people in the past week too, but for the majority of the time, it's been alone. 

Before this week though, towards the end of last week in fact, I had a mini meltdown. Following a conversation with a friend, and some subsequent soul searching, I started to realise things were a little bit wrong upstairs, but skipped over it in the hope that it was just a glitch. However this week, slowly but surely the changes have started and the signs have started to appear that all is not well in paradise.  The last few days being the most telling, getting up later, losing focus on things, lack of motivation to name but a few. The worst of course being the slow demise of quality sleep due to over thinking. Once that part starts, I pretty much know I'm screwed, in the short term at least.

Some self destructive behaviour is the icing on the cake really, and in this case it is starting to consume foods which are usually avoided, and lack of interest in physical effects of them. Just the consumption of a few trigger foods for my gout alone is the sign that things ain't right. Fingers crossed now that I am realising why I'm doing it, I can do what's needed without a flare up of gout. Gout and depression together REALLY suck !

After being all melodramatic on Facebook earlier, I finally managed to speak to someone who gets me, enough to confirm what I was thinking, and get my head on the straight and narrow. We both agreed, I need to see a doctor, and ASAP!

Now before the eyes start rolling, and the tssk's being sounded, let me just say this. If you have not had depression or anxiety before, and I mean clinically recognised rather than just been a bit on edge, and have no idea what it does to your mind and your life, please politely shut the fuck up. 

But he is writing a blog, but he is going out with people, but he made a joke on Twitter.... YES ! Depressed people still live pretty normal lives most of the time, especially when things are just starting to take a downward turn.

Depressed people are humans, and do lots of things that normal people do on a day to day basis. But somewhere under the skin, a part or parts of their life is being shredded by their own mind. There is more than likely nothing wrong with what they are obsessing about, so even from the inside, say for example a work colleague, would not see for a second that something simple and petty is in fact destroying their life right now. 

For me, face to face, with people I know and care about, I am me. Same normal (slightly strange) Michael. Do I want to open up to them and get it all off my chest, of course I do! Will I, of course I won't. My respect for the relationship I have with that person prohibits me from burdening them with all my inner worries, which as I have said already, actually amount to nothing. Have you ever had a conversation with someone who is stressing about something, and it's ended with you both laughing and saying "don't worry about it"? Well, that is pretty much how most conversations would go with someone with anxiety or depression. On this level anyway. There are of course much worse forms, for which I am grateful I do not suffer with.

I know I blog quite a bit about feeling down, and in fairness it is one of the reasons I started blogging anyway, so if you hadn't worked that much out already, no prize for you. Is it attention seeking, another form of the vague status update on Facebook that we have all grown to hate. Hell there are even Meme's about vague status updates floating about, whining on about "attention seekers" etc. Well how about looking at it this way.

A vague status update is indeed attention seeking. But the question is, why?

You see most people who live with depression won't talk about it. And will have either never have spoken to a professional about it, or will just deny it is an issue, even though it has been identified. 

So that vague status update that you are posting Meme's about, or sniping about with other friends on private messages, could well be the subliminal cry for help from someone desperate for someone to speak to, but too afraid or embarrassed to ask. 

Have you ever been told no, or ignored about something trivial? I bet it pissed you off, or at least upset you a bit. Now imagine you are ready to lay it all down, share your innermost worries or fears. You think you know the person you can talk to about it, you build yourself up, and..... nothing! They either give you the "you will be ok" line, ignore you, or ask if you can talk about it another time.
Trust me when I say this, you really only get one shot at opening up about something as deep as this, and a single knockback can send you spiralling into what feels like an eternal pit of doom. 

So as corny as it sounds, next time someone, who doesn't post something vague and cryptic every day, posts a bit of a strange status, if you have the time, and actually care at all, please just drop them a one liner asking if they are ok, or wanted to vent to someone. For someone like me, venting goes a long way. Hell you don't even have to read half the stuff I'm saying, just check for question marks, so questions don't go unanswered. If of course their punctuation is abysmal, tough shit I say, no time for poorly educated depressed people! .... That's a joke by the way, even depressed people can make jokes, especially at the cost of other depressed people! 

Anyway, for me, I have spent the whole evening going back and forth in my mind, do I need to see a doctor, am I just being stupid, is there another reason etc. But the simple fact is, if I am thinking it, I already know the answer. It is just my over thinking, over complex mind trying to, yup you guessed it, over think  the reasons why I would need to. Unfortunately, once that thought process starts, everything gets a little blurry. Bringing in other unrelated issues, trying to see if they play a part in the situation, and before you know it the world is a shitty place, and EVERYTHING is screwed up. 

I know I am just feeling like this, because I am! Not because of breaking up, not because work is a pretty shitty place sometimes recently. And not because of anniversaries, Xmas, lack of diving, missing my mum, wanting more money or any of the other crazy considerations that have entered my mind over recent hours and days. 

To be honest, as usual, just writing most of this stuff down, and knowing I am about to press publish, and throw all my inner most thoughts out there into cyber space for anyone and everyone to read, is helping. But of course it is far from the end of the matter. Medication is something I do NOT desire right not, avoiding as much as I can these days, inc pain killers, so I really don't want to be starting a new daily regiment of pills. Besides, they are only a quick fix, the real fix happens up in my strange little head, and only when I have a clear enough mind to make things right. 

The long and the short of it is, I have been dropping down for over a week now, I have another week off work to come, and somewhere in that time, I am going to be seeing a GP. Sooner rather than later if I can help it.
In the meantime I will be trying to maintain my routine of dog walks, training and other things to keep my mind occupied, and giving me reasons to get out of bed early, leave the house, and take in daylight and fresh air. All key things for me to ensure I do, just to make sure the downward trend at least levels out for now. Fingers crossed as ever, this is me catching myself from falling, and not going to end with me picking myself up from the bottom. It's been about five years since I had any serious issues with depression, and I am hoping that by writing this, I am facing my demons head on, and refusing to bow to their demands. 

Depression sucks, but fighting back at it makes me a stronger person each and every time. Here's to beating it once again, and getting back to being the same annoying idiot people have grown to know and despise.

Thanks for reading.

PS, if you suffer from depression, know this. You are not alone, but each of our journeys are different. I cannot swear to understand your thoughts, nor expect you to understand mine. But we share a common ground of confusion, despair, and lack of hope. On his level we are united, and can support one another. Providing someone to hear our cries, give us strength, and show one another that we can overcome these feelings.

Stand tall, do not be ashamed of saying you can't cope or need help. 

There will always be those who do not, and cannot understand how mentally crippling depression and anxiety can really be. Their ignorance or lack of knowledge should not be seen as lack of compassion or caring, but instead just an inability to truly empathise with you at this time in your life. 

If you have made it this far, but still have no idea what you just read. Thank you, for bothering to carry on reading. I hope that one day, should the need arise, and you experience either the symptoms, or identify someone who is, that this makes sense at last, and helps in some way. 

PPS... To those people who have been around me and made things normal over the past few days, thank you once more. I appreciate it more than I can ever express.  

A new week, a new start..

But lets take a look back at last week shall we, highlights and outcomes.

First up, the most popular topic searched on my blog last week was..... The great RIM outage of 2011. Affecting millions, infuriating most of them, and getting LOTS of media publicity over the course of the 3 day outage, and a hell of a lot of bad press. It sure was a testing time, and showed a lot of users how dependent they are on their Blackberry devices. With the loss of BBM some felt like a limb had been removed, others felt relieved and thankful for the peace and quiet. I was somewhere in the middle there I think. I wont deny im glad to have it back, but I was shocked at how annoying the notifications of BBM, email, Facebook etc can get when you are doing something else. In reply to the outrage of the outage, RIM have today announced a $100 gift to each subscriber to purchase apps from Blackberry App World, including a lot of their premium apps. Not only this, they are including apps that are for the Blackberry Playbook too, which means my games collection is about to increase somewhat.
So at the end of the day, thank you RIM, thats good compensation, and great customer relations.

Then of course we cant forget the launch of the iPhone 4S. Not the long awaited iPhone 5, but a step towards it. Following the passing of Steve Jobs recently, I think there were great expectations on the company, but most were unlikely to admit disappointment, but rather keep their opinions guarded out of respect. iOS5 was also launched at almost the same time, and that too had its fair share of disappointments. Firstly with users struggling to get it to download, due to the huge demand on the servers, followed by a few having issues with the install itself. Either failing or losing their data during the restore process. Everything is bound to have a glitch along the line, and like Blackberry their time was now. So a bad week for technology no doubt.

At the tail end of the week some of the major cities saw mass protests, like the one I blogged on Sunday, with Occupy London taking over the steps of St Pauls Cathederal, quite clearly inplicated in the financial crisis of course!? From being there it was interesting to monitor Twitter at the same time, and observe the number of bullshit posts from the unwashed claiming they were being kettled, crushed, denied access to food and water or toilet facilities. All of which was un-true. Certainly for the 5 hours I observed it for. Always nice to see both sides of the fence. From my perspective the police were very tolorant of the protesters, treated them fairly and spoke to them with respect. Any advances into the containment were clearly communicated, and done fairly... But then you are never going to get the truth from the 'victims' now are you! it was a great photographic opportunity though.

So what else was there.....

Oh, the F1. Seeing Lewis Hamilton finally coming back to form after so much time below par during the past few races. Coming good during quali, and snatching pole position from the Redbulls sure put a smile on peoples faces. The race... well it didnt go as well as it could have I guess, but second is still respectable against the destructive force that has dominated F1 this season. Meanwhile Lewis remains on an all time low, not being able to put his finger on the cause. All we can do is wish him well, and hope that he returns to form for 2012. Wishing you all the best Lewis. And not forgetting of course the surprising Jenson Button. Underdog for so long, but springing to his full potential with Brawn, Jenson continues to go from strength to strength. With a win last race, and some consistancy, he is also going to be exciting to watch in the McLaren in 2012.

Speaking of motor racing, last night saw a horrific crash at the Indycar in Vegas, with a 15 car collision, resulting in the death of Dan Wheldon, a well respected racer from the lower series in here in the UK, and very popular Indycar racer. Winning the Indy500 twice, he was by all accounts a stunning driver. Leaving behind and wife and children, and a lot of fan. Like the death of others, this was televised life, so a nation watched on as the events unfolded until it was determined he was deceased. Having done this when Senna died, I can say its a gutwrenching experience to know you have just watched a fatal accident.
That said, the the amount of flames and smashed cars, and the speeds of the collisions, it is amazing that so few were injured. The safety standards of Indy are nothing compared to F1, with concrete and mesh as guard rails, and different construction in the cars, the scope for serious injury is high. R.I.P Dan Wheldon

Oh, I guess I had better put something about me here as well, its meant to be about me isnt it!
So last week and this week. Well money matters are pissing me off a little, I really need to get on top of things before they spiral out of control again. Due to coming off benefits, all the 'you owe us' letters are arriving thick and fast now, so they need addressing. Then I also need to ensure I am on top of the other bills hitting the mat. on the other hand my 'mental state' seems pretty stable, and the reduction in Citlopram is working nicely, down from 40mg to 20mg and all is well. Cant wait for the next drop then the ending of the meds.
On the other side of things, I had my ultrasound today, finally after a month of waiting. It was quite a long winded process, far more in depth than I thought it would be. Nothing was said, but lots of screen captures were made and prepared to be sent to my GP, so I await hearing from him to see what the outcome is. I am still getting stabbing and cramping pains there after all this time, but not during yawning now, so I dont know what to think.

I have managed to get myself a cold too this weekend, so an coughing and spluttering everywhere at the moment, trying to focus on my work, and taking all the medication I can to try and keep it from going to my chest. If it gets there then I am pooped for the next month as it lingers for so long if it does. I just need a nice sunny holiday right now I think, that would hit the spot. However if any holiday is on the horizon it is a snow holiday. Speaking of snow I am buying winter clothes and jackets like their is no tomorrow. Maybe my spidey senses can feel an arctic winter coming!
Whilst on the subject of cold weather.... Wales. I am off there at the weekend hopefully to introduce my neice and nephew to my Aunty Joan. Its been way too long since I was last up there, and Joan has never really met either of them, not at speaking age anyway. I just think it is important for them to meet eachother. So there is some knowledge there. Joan can be proud of then next generation of her family, and the kids will get to meet their nanny's sister, and learn more about her up bringing. I want to spend at least a whole day up there so I can show them around a bit, and share some of my favourite places around the area, as well as showing them where mum grew up. At the same time I have borrowed a DSLR from Noel, so I can help Katie explore her interest in photography, and see if she is really interested in following up with it.

Personally I love photography, and it feels great to have a DSLR back in my hands, so its exciting on two levels for me. So we shall see if Katie can be bothered with the set up and experimentation of a DSLR, or prefers the ease of a point and shoot. It should be an exciting weekend for all, I hope at least. Chances are I will stop off in Derby on the way home, saving money on a hotel, seeing Cadell and Archie, and then possibly bringing them to London the next day. We shall see how it turns out. I have to speak to my Aunt's carer to see if Joan will be up for the visit, and everyone will actually be there. At this late stage I hope this is the case.

Right thats enough now I think, I will do another entry when the rest of the things come back to me. Thanks for reading, and feel free to follow me on Twitter @michaelsnasdell

Hmmm, a downturn or a bump?

Well I'm hoping its just a bump along the way, but not too sure. But mum is now back to not wanting to eat or drink much. Becoming tired and weaker by the day, and relying much more on the wheelchair to get about.

The steroids are being reduced, and since dipping from 2mg twice a day she has slowed down. Even on 2mg once a day she was still eating and quite active. But now on 0.5mg a day she is actually using the walker around the house rather than carrying it, prefers to be IN the wheelchair when out and about, and is really off her food and drink. Its a chore to eat. My worry, dehydration.

Yesterday we went to St Thomas's hospital to get mums "surgical appliance" also known as a wig, which she seemed very happy with. However today while getting ready for St Christophers she said she would not be wearing it as it was a bad fit and looked silly, and quite frankly could not be bothered to put it on.
She added on the that she was "very very sick".

A little while later we toddled off to the hospice for a meeting with Karen the nurse. Enquiring into mums health was like asking a 2 year old where the put the car keys. Not really willing to discuss it much. Changing the subject whenever possible. All the symptoms were to be blamed on any medication that she could remember she was taking, and promises were made that she really has no interesting on following through with. Using a nasal spray, trying to drink more, and seeing the GP later. However she WILL be seeing the GP, I will make sure of that.

A number of things could be contributing to this "bump" in the road but without tests and trying meds we will never find out.

We are returning to the same familiar "no I'm not doing that" attitude, which usually results in an ambulance and a week in hospital. Sadly it seems we have again passed the point of reasoning, and she just thinks doing nothing about it, and sleeping more will solve the problem. So fingers crossed the GP can put her on the right track, although at this rate a referral to the hospital.

So, back from the hospice now, lunch made for mum, just waiting on the carer. This afternoon, dog walks then off to the GP @ 3.30 to get mum seen.

Here we go again?
Regards
Michael

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