New Old Medications Thoughts

If I’m honest, I’m still not sure what I’m doing – how I feel about my writing – but there’s been a lot in my head this week so I thought I’d just try and get it all down. Maybe it’ll help.

I’m not sure if I’ve mentioned it already but after two and a half years of trying medications, I’m back on Phenelzine for my depression. I’m back on the drug I was trying to get away from. Back in 2017, it was starting to fail but I was also starting to fight it. The lifts to my mood felt artificial and suffocating. I felt depressed but there was this thick layer of calm suppressing it and it was causing me great, great distress. I felt like I was scratching at the walls of my mind with my fingernails, desperate to get out and just feel how I was feeling. Of course, feeling deeply depressed is a miserable, paralysing experience but at least it felt real. It was the truth and the truth is one of the most important things to me.

But despite all of that, I’m taking it again and I can’t help feeling like we’re starting to run out of options. We must be if we’re going back to a drug that I struggled with, that stopped working – although it’s true that it did work for a significant period of time. But we started looking elsewhere for a reason. Multiple reasons. I voiced that in the session with my psychiatrist and he said that there are still options but I can’t help worrying. Because if I’m running out of options at the age of twenty four, that’s a lot of life left without much to work with. Will we reach a point where I just have to live with it? Live with crushing depression and paralysing anxiety?

And let’s talk about anxiety. Last time I was taking the Phenelzine, I also took Quetiapine, primarily for the insomnia that the Phenelzine caused but it also helped with my anxiety. Because it’s a sleep aid, it has a sedating effect, which helped me to manage that constant anxiety. But I can’t go back to it. The sedative effect almost seemed to increase over time and it got harder and harder to wake up in the mornings. It was like I was so deep underwater that I couldn’t find the surface; I could hear people talking to me but I couldn’t open my eyes or move or speak. By the time we were abandoning the Phenelzine, it was so bad that I was losing half the day just trying to wake up. I can’t go through that again. It was awful.

So that limits the options, if I can’t take that or any of the similar drugs. The drug we’ve decided on is Diazepam. I’ve been taking it on and off over the last year and it works; it stabilises my emotions when they get out of my control. But it has addictive potential and I’m not supposed to take it every day. So, every day, I have to look at my anxiety and feel my anxiety and assess whether it’s bad enough to take the medication. And that’s exhausting. I never get an escape from it. To me, that’s not living. That’s managing.

But this is it for the moment. This is life. We’ll reassess in a month.

The New Plan

The last few months have been tough, medication wise. I had a wonderful, un-depressed Christmas (which I’m massively grateful for) but since then, I’ve been struggling. My mood just kept dropping and my anxiety just kept getting worse and we tried to alter the medication to compensate, to find that perfect balance, but it’s gotten to the point where we just need to try something new. So I’m taking stock of everything and trying to figure out how I feel about all of it.

The Clomipramine (a Tricyclic anti-depressant) worked for a while. As I said, I had a really good Christmas where I felt joyful and energetic and actually happy for the first time in a really, really long time. But then it seemed to lose its effectiveness and my mood dropped, whether that was because I was taking a magnesium supplement (I talk about that here) or because it just had a short shelf life. I don’t know. But it stopped working and my depression returned. Since then, my depression has been stifling and I’ve really struggled with suicidal thoughts, at an intensity I’ve never experienced before.

My anxiety also skyrocketed so, in addition to the Pregabalin (also known as Lyrica) I was already taking, I started taking Flupentixol to help manage it. At first I felt no different but after adjusting the dose, my anxiety decreased dramatically and I started to feel a bit more functional. But in the months since then, it seems there have been a number of difficult side effects: my energy levels dropped dramatically, to the point where even a shower is a real struggle. Standing for any length of time is impossible and I ended up being wheeled around multiple airports in a wheelchair during my Nashville trip. The worst part though was that my hands felt thick and clumsy, like my fine motor skills had just evaporated into thin air. Playing guitar was practically impossible.

At first I didn’t realise that these things were connected to the Flupentixol but thanks to my Mum and her incredible attention to detail, we realised that the dates all seem to match up and since we reduced said medication, these problems have disappeared. I’m ridiculously grateful to have my hands back, even if my anxiety has flooded back in.

We’ve reached a point where I can remain where I am or start over. So I’m starting over. I don’t want to live like this. So, after a lot of thinking and talking to my psychiatrist, I’m coming off both the Clomipramine and the Flupentixol. I’m not a massive fan of the Pregablin either to be honest but even changing two things at once is ambitious. So that one can wait. I’ve already started reducing the meds and I’m bracing myself for a barrage of mood swings, depressive episodes, and more. It’s not going to be fun. But it will be worth it. Hopefully.

The current plan is to come off the two drugs, go the ‘wash out’ period (two weeks of no drugs – apart from the Pregablin – so that there aren’t any negative interactions between the medications), and then start Phenelzine again. Yes, Phenelzine – the drug I stopped taking two years ago because it had stopped working, because the joyfulness it gave me felt fake and suffocating. BUT it’s the only drug that’s allowed me to be functional – creatively and otherwise – so we’re giving it another try. It did work for a long time and if it doesn’t, we’ll try another MAOI (monoamine oxidase inhibitor) anti-depressant.

I’m not sure how I feel about it, to be honest. Part of me is frustrated and disappointed. I’ve spent two years trying to find something better only to end up where I started. But on the other hand, that’s two years of knowledge, experience, and confidence that I didn’t have before. I’m a different person and chances are, my reactions will be different: our bodies change and our chemical makeup is constantly shifting. These medications all but cause a hurricane inside us. So I’m trying to be optimistic. I’m trying to be hopeful.

IMG_3833

Nashville Looks Good On You

IMG_7759

This trip to Nashville wasn’t exactly what I’d expected. I’d had this vision of going out there and writing a load of songs and going to show after show after show and seeing all the friends I’ve made out there. I managed to do some of those things – and I’m really proud of what I achieved – but my mental health really dominated the trip, much more than I’d hoped it would.

We got off to a pretty rocky start when I forgot to take my medication the night before we flew out. We had to leave at two o’clock in the morning so I never really went to bed and therefore my nightly routine was disrupted. Plus I was excited and nervous and just generally all over the place. We got to the airport and I couldn’t even walk the distance to security, I was so completely out of energy. I thought it was the lack of sleep and stress of travelling but I physically couldn’t do it. We ended up asking the airport staff for assistance and they were absolutely amazing, at every airport we travelled through over the trip: they got me a wheelchair and took me wherever I needed to be, getting me early access to the planes, and so on. It was so helpful and honestly made the whole thing possible. I don’t know what I would’ve done without their help. It took a few days to recover and it was only then that we realised what had caused it.

The reason we go at this time of year is because the Nashville Songwriters Association International hold the Tin Pan South songwriters festival, where hundreds of songwriters perform songs that they’ve written. They have a great mix of famous and up and coming so you get a lot of different, beautifully written songs. All of the shows that I went to were good and some of them were fantastic. My favourites include Lori McKenna, Alyssa Micaela, Emily Shackelton, Hannah Ellis, Natalie Hemby, and Travis Meadows. They were truly incredible.

There were a couple of other musical highlights too. By some wonderful coincidence, Kelly Clarkson was playing the Bridgestone Arena while we were in Nashville. I’ve always wanted to see her and I’ve always wanted to go to a show at Bridgestone. And to make it even sweeter, Kelsea Ballerini – who I LOVE – was opening. So it was perfect. The show was amazing and I had a blast. Totally a bucket list moment.

Version 2

The other musical highlight was getting to see my friend, Caylan Hays, perform. We’ve written together several times and on my last trip, she came to see me play a gig and by another beautiful coincidence, she was playing on the last night of our stay. She was fantastic. She’s such a talented writer and I love her voice. Throw in some gorgeous electric guitar and I was in love. You can check out her music here.

IMG_4178

And of course, I got to go to two Song Suffragettes rounds. I love this organisation with my whole heart and so it meant so much to me to see both shows while I was there. They – the people who run it and the girls who play – are so inspiring and I hope I can play with them again someday.

IMG_3596

I had several writing sessions while we were there and for the most part, they were a struggle. I love the people I was writing with dearly but my brain still isn’t right: a casualty of my depression and the medications I’m taking. We’re still trying to find the balance where I’m emotionally stable and not creativity stifled. Still, I’m trying and I so appreciate these writers for having patience with me while I work through this. I also got to spend some time with friends, old and new, and they really inspired me in this dark patch of my life.

But throughout the trip, I really, really struggled. My anxiety was so high that I actually had trouble breathing and my depression was so overwhelming that I found myself falling apart (even in public places, which I’m usually able to avoid doing) multiple times. There were lots of tears and lots of Diazepam; it was very hard. I struggled desperately with wanting to go home and I was battling suicidal thoughts (helpfully described by Claudia Boleyn as, “my brain trying to kill me”) for most of the trip. In truth, it was a bit of a nightmare but there were some really great moments that helped me manage it and of course, I had my wonderful people (my Mum and my writing partner, Richard Sanderson) there to support me. The trip wouldn’t have been possible without them.

Also, shout out to Pancake Pantry for teaching me what it’s like to get excited about food.

My Personal Warning Signs of Depression

In a recent therapy session, my therapist and I were talking about this latest depressive episode and what I’ve learned from it. Because I’ve learned A LOT. I’m not ‘un-depressed’ yet but coming out of it a bit has given me a new perspective on it, on my depression and how it affects me. Hopefully that perspective will be helpful to me in the future. Because depression can creep in very slowly, you don’t always notice the signs but in hindsight, there are a handful of things that should be red flags in my mind. Maybe being aware of these things can help me prevent the depression getting as bad as it did this time.

  • Unable to write songs – I don’t mean a bit stuck. I mean a continued inability to reach the level of functioning necessary to write songs. Songwriters, do you know what I mean? I know exactly the feeling I mean when I write this and although it does sometimes come out of nowhere, it is the biggest sign that depression is creeping in again. It’s very distressing to be unable to do the thing I love the most.
  • Losing my excitement – This was something I didn’t realise was gone until it returned. I’d get excited about things in theory but I assumed the dampened emotional response was just part of the depression numbness. But since I’ve started to feel better, my excitement has resurfaced about as dramatically as a volcano. It’s fun but a bit disconcerting. So, in future, if my excitement seems to have gone AWOL, I know that it’s a potential sign of depression.
  • Overwhelming anxiety about the future – I am always anxious about the future so this is a tricky one but when it becomes overwhelming and it feels like more than I can cope with, than I could ever cope with, and it goes on for an extended period of time, it’s a symptom of my depression.
  • Feeling hopeless – Similar to the previous one, feeling overwhelmed by hopelessness is a real sign of a depressive episode. It feels like everything inside me has stilled, like there’s a new, sharp clarity to everything. Everything becomes very simple and really pointless. We all feel hopeless now and then but when this feeling doesn’t pass, I know I’m in a depressive episode.
  • Increased suicidal thoughts – This one is the final straw, the most telling sign. I’ve always felt very strongly against suicide so when these thoughts start to filter into my everyday thinking, I know I’m in trouble.

There are symptoms common in everyone – like low mood, fatigue, low self-esteem, and so on – but these are my personal warning signs. Do you know what yours are? Are they similar or different?

img_2020

So I Wrote A Thing For World Mental Health Day

(Trigger warning for self harm.)

Today is World Mental Health Day.

If I’m honest, I’m not really sure what to say. I’m in the middle of the worst depression I’ve ever experienced and I’m very aware that my perspective, my opinions, my hopes are distorted by that. If this was a video, I might just sit and cry. But this day is important so I’m trying to pull myself together and put something out into the world that is (hopefully) positive (and maybe helpful).

This year’s theme is the mental health of young people. When it comes to things like this, I’ve never felt comfortable talking about anyone’s experience but my own. So that’s what I’m going to do. I hope that’s okay with you guys.

My experience at secondary school was a very mixed one. I spent the first three years dealing with some complicated health problems but by the time I reached Years 10 and 11 (ages fifteen and sixteen for those of you who don’t know the education system in England), I felt really settled. I loved learning, particularly English, Maths, History, Psychology, and Philosophy (real shout out to my teachers in all of those subjects). I got real satisfaction from working hard and that was reflected in my grades. I came out of secondary school with not unimpressive grades, especially when you consider I missed most of the first three years. So I felt pretty good about going into Sixth Form (A Levels/ages seventeen and eighteen).

But that was when it all started to unravel. I really, really struggled. I’d gone from completing the work with ease to barely scraping by. I couldn’t understand it: I was trying so hard and it didn’t seem to make any difference. And I couldn’t see it at the time, but my anxiety was getting worse and worse and what I now know to be depression was creeping in. But I didn’t know it was happening so I just kept pushing forwards. I spoke to a couple of people about the high anxiety I was experiencing but each one told me that anxiety is normal and that was the end of the conversation.

It all came to a head when I failed an exam, something that had never happened before. I’d been told I was all set for an A* and I came out with a U. I was absolutely devastated. I know now that our worth as human beings has nothing to do with grades but I was eighteen years old: I had only ever been valued based on my grades. It’s no one person’s fault but that’s how the education system in this country works. It needs changing.

But back to this little story. I don’t remember much after I opened the envelope and saw that U but I ended up in one of the less used college toilets, self harming repeatedly with a broken paperclip. I don’t know how long I was there (long enough that the automatic lights went off and I was plunged into a very appropriate darkness) but at some point, my friends tracked me down and coaxed me out of the stall. I still remember seeing my reflection: my make up all down my face, my hands shaking, and the scratches barely hidden by my long sleeves. One friend took me to a nearby café, bought me a hot chocolate, and just talked to me. And eventually I told her what I’d done. Her kindness and gentleness was so healing, not for the whole problem but for that very difficult day. I will never forget it and I don’t think I’ll ever be able to repay it.

After that, I dropped out of that course and clawed my way out with two A Levels and an Extended Project, far less than I and everyone had expected of me. I went straight into a music course but had to drop out two days in because my anxiety was so bad that I just couldn’t cope. I spent a year grappling with the anxiety and depression, trying the first of many antidepressants (so many) and trying to retake some of the exams in the hope that I could improve my A Levels (I didn’t end up opening the results of those until after I finished my degree, three years later, but that’s another story). During that year, I tried desperately to get help from the NHS to no avail: my anxiety was so bad that talking to people I didn’t know was practically impossible and they refused to help me if I wouldn’t talk. Eventually we were forced to go private, something that I’m endlessly, endlessly grateful has been possible. And I only managed to get my diagnoses when my university said they weren’t able to help me if I didn’t have an official diagnosis.

It still upsets me to talk about. I asked and asked and asked for help but no one either seemed able or willing to help me. I would not be as twisted up now had that not been the case. The information and support was not available to me, it wasn’t available to my family, and it wasn’t available or deemed important enough (I’m not sure which is worse) to the medical professionals I saw. That has to change. It is not acceptable.

Now that I’ve told my story, I want to include some other important, relevant stuff.

The first thing is that I want to link you to Hannah Jane Parkinson’s recent article in The Guardian. She makes the very important distinction between mental health and mental illness. And this is where, I think, physical health and mental health are most comparable: your mental health is something you take care of (or don’t) everyday, by eating and sleeping well, exercising, talking through your emotions, and so on. Mental illnesses, similarly to physical illnesses, can be caused by not taking care of your mental health but there can also be genetic factors, environmental factors, and just hard stuff going on in your life.

WAYS TO HELP YOUR MENTAL HEALTH:

  • Talk – Talk through your feelings with someone you trust.
  • Keep a journal – This way you can air your thoughts and feelings in private.
  • Keep in contact with friends – It’s really easy to get busy and fall out of touch but spending time with people you love and feeling connected to other people is so important.
  • Exercise – This doesn’t mean every or any kind of exercise will help. On a personal level some types of exercise can potentially hurt your mental health. You just need to find the one that does help and then it will really help. I always recommend swimming because it’s non-weightbearing and therefore causes less strain on your body when you’re potentially already struggling with physical symptoms, like fatigue.
  • Eat well/drink sensibly – Everything we put into our bodies affects our minds.
  • Be mindful of your commitments – Yes, social interaction can be really helpful but if you’re taking on too much, it will take more from you than it gives you. And then you won’t be able to cope as well with whatever else is thrown at you.
  • Ask for help if you start to feel mentally and emotionally overwhelmed – Fortunately it’s starting to become easier to access support and counselling but even if it’s a struggle, it is a struggle worth going through.
  • Spend time with animals – It’s scientifically proven that being with animals is good for your health!

WAYS TO HELP YOUR MENTAL ILLNESS:

  • Work with a medical professional/therapist that respects and understands what you’re struggling with – Finding one can be the mission of a lifetime but having that presence in your life whose sole purpose is to help you through your struggles is incredible.
  • Medication – If you’re prescribed medication, take it diligently.
  • Try to keep track of your triggers – Knowing what they are doesn’t always prevent them from sending you into a complete spiral but even one spiral avoided is progress.
  • Create a support system – This isn’t something you can necessarily do without help but, over time and with the help of people who care about you, building a circle of trusted people who will support you through whatever it is you’re going through is so special and helpful.
  • Take time off if you need it – This is one I think we all struggle with. It’s a learning curve for a lot of us but it is important and can prevent small problems from becoming big problems.
  • Find a stress reliever – Whether it’s reading, or watching every episode of your favourite TV show, or doing something artsy like watercolouring, taking a break from all the stuff in your head is well worth doing.
  • Create a safe space for yourself – Living with a mental illness is exhausting and so having somewhere where you can just exist without thinking or masking is so important.

And of course, there is overlap between these two lists.

Where we go from here, I’m not sure. The information about mental health and mental illness is spreading and spreading and more and more people are speaking up. Now we need the right systems to support it: doctors, treatment, government officials who advocate for positive change. For now, that’s all I know. For now, I’m just trying to manage one day at a time.

(And a gentle reminder, my debut single, ‘Invisible,’ which I wrote about my experiences with my mental health is available on iTunes and Spotify and all those places and all proceeds go to Young Minds, a charity that supports young people in their mental health.)

When Things Get Really Bad

Since I last posted on here, literally all I’ve done is survive.

After putting up last week’s post, I went to therapy, which just about wrecked me. It was really hard going. I don’t want to get too into what we talked about and what I’m currently struggling with because I’m really struggling with it and I’m still figuring out how to put all of it into words. But I think the gist of it is important to include: I’m struggling with ‘feeling’ autistic, like I’m never going to be able to function the same way as everyone else. I don’t know how to cope with a thought like that. And that has really triggered my depression, in a massive way. I feel like I say this every time, but it feels like the worst place I’ve ever been; but maybe I say it every time because each time takes more out of me.

It looks so small and simple when I write it out like that. But in reality it’s powerful enough to overwhelm everything.

I left therapy feeling absolutely drained. I didn’t know how I was going to get through the day, get through the week to the next session. But somehow I did, one minute at a time. This week has been about survival because sometimes that’s all you can manage – I feel like I’m standing on the very edge of the black hole that is my depression and it’s taking all of my focus to not get pulled in. So while I feel like I’ve achieved nothing, I’ve actually achieved everything. At least that’s what I’m trying to tell myself.

So I thought I’d write down what I do when I’m in this place, where the only thing I can do is survive:

Each day, I get up at seven and go to the gym to swim for thirty minutes. I always want to do more but through trial and error (usually error), I’ve found that this is the amount I can do and still kind of function. If I push on, I end up falling asleep during the day and screwing up my sleeping pattern or I end up in a place where everything makes me cry. So I’m trying to be sensible and build it up slowly.

I get home and head for the living room. I curl up on the sofa, turn on the TV and continue the rewatch of whatever TV show I’m watching (currently The Mentalist). I’m not really watching; it’s more about having familiar, comforting background noise so that the scary thoughts can’t get in. Then I find something that will distract me from all the overwhelmingly difficult things. The activities that work best for me are playing piano and printing, cutting, and sticking pictures from Tumblr into notebooks. And sometimes reading a book works, if I have the concentration to actually read.

And I use those things to get me through the day. I spend time with the animals in my house. I’m lucky enough to have a Mum who works from home so that I can have someone with me when I need to have someone with me. I try to eat well.

And then I go to bed not too late and start all over again.

It’s a hard thing to get my head around and I’m aware that I’m very hard on myself. Because even though I genuinely believe that sometimes all you can do is survive, I find myself getting desperately upset that I’m ‘not doing anything.’ I feel like I’m not trying hard enough – in my mental health, in my music, in my life – and that I should ‘push through it.’ And it’s so hard to think that when I feel so overwhelmed by my depression.

And, outside all of that stuff, someone I care about is in hospital and no one really knows what the outcome is going to be. So I’m trying to manage all the anxiety around that too but it’s like trying to stand on ground that’s constantly shifting.

I think that, if I keep writing, I’m going to end up going in circles: ‘it’s okay to focus on surviving’ to ‘I should be trying harder’ and back to ‘it’s okay to focus on surviving’ and round and round and round. So I’m going to stop here. But regardless of all my anxieties and negative thoughts, I know that it’s okay to focus on surviving. And I hope you know that too.

Mental Health and Medication Update

I’m struggling. And I’m struggling to write this post.

Medication wise, I’m taking Amitriptyline for my depression and Pregaballin for my anxiety. The Amitriptyline has definitely helped with the physical symptoms of my depression: my concentration is better, I can think more clearly, and my appetite has returned. But as the depression pulled back, my anxiety returned in full force. It was so bad that I had to have something playing – music, audiobook, TV show – and playing loud so that I couldn’t think and therefore the anxiety couldn’t take hold, if that makes sense. I started to hate the evenings and going to bed because as the busy-ness that filled the day faded, my anxiety got stronger and stronger. Hence the Pregaballin. I’ve tolerated these medications pretty well. The thing I’ve noticed most is that I constantly have a dry mouth so I’m drinking ridiculous amounts of water every day. But that was something I needed to improve anyway and I’ve had far worse side effects.

For a while, everything was pretty good. I had some really good days, the kind I haven’t had for a really long time. That was really special. But the anxiety and depression – the depression especially – have crept back in and it’s a struggle to even get out of bed. I was starting to think that Amitriptyline might be the right medication but now I’m not sure. I can summon enough energy for the odd social interaction or professional opportunity but I’m really, really struggling with my energy. It doesn’t help that all day, every day something inside of me is screaming at me to crawl under my duvet and sleep for the rest of my life. I feel invisible and useless and miserable. Just living feels overwhelming.

My perception of time has completely flipped. Up until recently, time felt like it was moving really quickly, like I’d sit down to write a blog post and the whole day would be gone even though I’d barely written more than a few sentences. Everything seemed to take so much time. But now a day seems to last a week. When I’m having a good day, that’s great; I can achieve so much. But on a bad day – and I’m having quite a few of those – it’s overwhelming: I have to actively survive that long. So much happens, so many emotional ups and downs. It’s exhausting.

I don’t know what to do. But I’m in regular contact with my psychiatrist and my therapist; I’m trying to stick to my routine (swimming first thing in the morning, scheduled time for music practice, and so on); I’m talking it all through with my Mum. I guess I’m just muddling through.

IMG_4538