rejection and being triggered

I had a job interview recently and found out today that I didn’t get the job. I’ve got a few other irons in the fire but it still was a bit upsetting. I really, really, wanted this post. The eating disorder/self hate thoughts have been really bad since then. Even though I can spot what’s triggered the thoughts it’s not been making it any easier. And I’ve started a slightly vicious cycle of triggering myself further. I’ve spent all my free time today reading diet sites and watching diet programmes (Channel 4OD Cook Yourself Thin – seriously… how annoying is that presenter! But I can’t tear myself away). I even started myself an account on a diet site to track weight loss and calories for fucks sake.

I couldn’t really be bothered trying to fight the thoughts so haven’t eaten much. I did end up breaking and eat ten sweets and then spent five panicked minutes trying to find out how many calories were in a single Skittle (about 4.6 apparently). Again… for fucks sake.

Not a great day overall. But I’m spending the evening trying to distract myself, playing with the dogs etc.

American π Day

It's one of my favourite days of the year. 14th March, the 14/03 or, if you're American 3/14. Or even better 3.14 - mmmmmm pi.

There's not many irrational numbers that I like. They normally bother me tailing off into the distance without an end in sight.



But I like pi because it fits in with the date the 14th March. And also because I like ratios. There's just something about dates that I can break down into ratios that I find a lot less stressful. The only thing that's better is dates that can be re-written as binary. Sometimes the very numbers in the date can have a huge affect on whether I have a good day or a bad day. Though I can balance this out by booking appointments at specific times to create further patterns.

And finally a word from Weebl and Bob (couldn't seem to link to the proper site so have linked to Youtube - but you can see the original video here)

Scared

My weights down a little bit this weekend. But I think it's partly as I got very drunk on Friday and was physically sick all day Saturday - so weight change is pretty much just dehydration I think. Apparently I will never learn what my limit is for drinking and won't stop until I have borderline alcohol poisoning. Today was a lot better, at least, I've stopped throwing up. I feel quite shaky and achey. But the weather was nice so I went for a long walk around some lakes near where I live. The dogs came to and they had a lovely time (you could see the epic dog joy in their faces - is there anything happier than dog joy?) I've also managed a bit of life admin today - paperwork etc, not fun, but at least I've been slightly productive.

I've only purged once this weekend (Friday night). Although, what with being a shaking/vomiting mess on Saturday I couldn't even look at food and my stomach rapidly rejected even the small sips of water I tried to offer it. (In my head hangover vomitting is apparently acceptable - though probably just as grim - in comparison to self-induced vomitting). Today I've eaten what amounts to a lot for me and I've managed to fight the urges.

I'm seeing my psychiatrist later this week. Partner has managed to secure a couple of days working so he won't be there - he's going to write down a few of his concerns (forgetfulness/obsessive behaviour) so I can discuss them with my doc, though it would be easier if he was there with me. In good news however he definitely feels I've been less of a space cadet since reducing my antidepressent dose and I haven't noticed a change in my mood. Part of me is glad he won't be there because it means I'll be more likely to talk to my psychiatrist about the eating problems. In my head I was already using him being there as an excuse to not bring it up. I didn't manage to talk to GP about these issues because partner was there and I think I've accepted the fact that I do need to get some support with this. I've been actively trying to fight the eating disorder by myself now since the end of January. Yes, the weight loss has slowed down and yes, I'm purging less than I was, but I'd be decieving myself if I said that I now think I can stop this without something more. I've lost 12lbs since starting the blog and I'm purging probably 5 or 6 times a week. And the thoughts haven't really gotten any easier - and as someone pointed out the other day, they're just as much part of the disorder as the actual behaviours.

A huge part of me doesn't want to ask for help... I'm scared. I'm scared about telling people in real life and them judging me and thinking less of me. I'm scared about my friends/family finding out and it changing our relationships. I'm scared about it having an impact on my job. I'm scared about asking for help and not being taken seriously (because I'm not sick enough). I'm scared about letting other people in on what I'm doing because it feels like losing control of the situation. I'm scared that if people know I won't be able to use purging/restricting and how I'm going to handle all these feelings if I don't have that to fall back on - would I just end up self-harming again instead? I'm scared about what will happen if I ask for help and I still can't get better - at the end of the day even with support it will still be up to me to recover. What if I can't do this?

Something wicked this way will come...

... and by come, I mean, ejaculate on a book.

Best sci fi pop video ever.

On being surrounded by people on diets

The last couple of days haven’t been great in terms of eating/purging. (Though I haven’t purged so far today!) I think because I have been trying so hard to eat meals and not restrict/purge I’ve not been losing as much weight (the weight loss has slowed down a lot) and this is triggering the thoughts to get worse. I try to not get on the scales... but sometimes I just can’t help it. And without explaining to partner the “why” I should really throw out (or hide) the scales they are just going to sit on the bathroom floor and stare at me. And I guess my antics at the weekend haven’t helped with mood either... though I’m starting to feel a lot better now. So maybe this is just a blip and once my serotonin replenishes I’ll rally the forces and fight the thoughts.

On another note it’s driving me mad the number at people at work who are asking me about my diet, asking for tips and congratulating me on how much weight I’ve lost. Pretty much all the ladies in the office are on on/off diets. They’re not particularly great at them... in that they starve themselves all morning and then give up and eat snacks all afternoon. “I have no idea why I’ve not lost weight!”, “because you’re still eating over the recommended daily amount of calories”. In a screwed up kind of way part of me feels almost smug – that I’ve succeeded. That I’ve lost weight and they can’t/won’t/haven’t. Not sure if smug is the right word – just the feeling that I can finally do something right, even though I really know I’m not. The office environment is sending the thoughts I’m dealing with into overdrive. When people go and get their lunch and pick like birds over their tiny salads it just makes me feel bad for actually eating lunch even though I know I do need try and maintain my calorie intake. But I can’t avoid them. I trying to put on headphones and listen to music. But it’s a bit like when I was a smoker. If I was trying to quit and around other smokers, even though it made me dislike myself, I’d still not be able to keep away from the group trips out to smoke. I only finally managed to quit when I changed my environment. But without everyone at work knowing about what’s going on I don’t see how I can do that. I can’t not go to work. Firstly I need the money and secondly I’m a complete workaholic.

Individualised Medical Care

In my former life (the life before I couldn’t cope with stress) I used to work in pharmacy research. The way pharmaceutical research and development works is a multistage process.

The initial “preclinical stage” is where small pharmaceutical research teams (e.g. at universities) do research e.g. lab and animal studies to check safety/bioavailability etc. Articles will be published and conventions will be attended and hopefully, if they’ve discovered something interesting, it will manage to enter the next stage of the process. I think an estimate is that for every 1000 compound looked at only about one will enter the next stage of the process.

The next stage is the clinical trails phase. There are several stages/phases starting with healthy volunteers and then moving onto larger trails on actual patients. This process is very expensive (millions upon millions of pounds) and is only really carried out by the Big Pharma™ companies. And then there are usually final steps (an “approval stage”) to be jumped through for approval depending on the country/region. For every five to start through clinical trails/approval stage it is estimated that only one will make it to final approval and release as a drug.

So maybe one out of five thousand potential chemicals evaluated might make it to the point of being released as a drug. Generally what happens is that the preclinical research is done by small research companies/universities/spin out companies and then Big Pharma™ will buy the rights for any promising looking research (with or without the original researchers being taken on in the continuing process as advisors).

This (after pre-clinical, but before or during clinical trails) is often the stage that research gets buried. There may be many good reasons that a potential drug would get stopped at this stage. It might be that there are other, probably better, drugs in development. There may be other valid scientific concerns. However if the Big Pharma™ company are concerned that a new drug will put a current money-making drug out of use they may buy the research and sit on it. For example there is commonly believed to be several preliminary drugs that would cure Alzheimer’s Disease, but the profits in curing a disease using a short-course of medication it may not be out-weighed by the current profits in treating Alzheimer’s for many declining years of a persons life, so as yet there is no financial incentive to continue with the development of these drugs.

Another category of drug that gets ignored in terms of development is a drug that would only target a small subset of a clinical population. What Big Pharma™ like are drugs called Blockbuster Drugs. Blockbuster Drugs are the big money spinners. Generally a drug becomes a Blockbuster Drug if it’s widely clinically used (by doctors/prescribers) as a standard drug to use for prevalent conditions that often require long term treatement – a lot of Blockbusters Drugs are currently things that treat blood pressure/blood clotting/heart problems/cholesterol i.e. is generally works for a large segment of the population. An important addendum needs adding to this definition however – prevalent conditions, but mostly this only applies to conditions prevalent in the developed world. Obesity, heart problems, pulmonary conditions are on-going problems in richer (older/fatter) nations so drugs that treat these conditions well across a wide spectrum of the population become Blockbuster Drugs. This is the same reason you’ll see psychiatric drugs occasional slip into the Blockbuster Drug lists – mental health conditions are relatively prevalent in the developed world and people tend to take these drugs on the long term, as such Big Pharma™ are happy to oblige in the provision of a whole variety of drugs. (Cynically, especially if the drugs make you put on weight and end up on more drugs </snark>)

What Big Pharma™ doesn’t like are conditions that aren’t common in rich nations, or uncommon conditions, or small genetic subsets of prevalent medical conditions that don’t respond to the standard drugs. Take cancer for example, if you have a common genetic subtype, of a common cancer, that responds well to drugs then you may have a good chance of recovery. Something like testicular cancer has a 90% plus survival rate, if it’s got the “right” genetics, even if it’s caught at a late stage. But if you have an uncommon cancer – say for example Neuroblastoma, a horrendous cancer that affects predominately very young children, where there may only be few hundred suffers worldwide - then Big Pharma™ just aren’t really that interested in helping (and survival rates are as low as 20% 5 years after diagnosis). Unless you have a fashionable illness you're kind of screwed.

Fundamentally, like a lot of things in life, it comes down to money. Big Pharma™ want to make money and they do this by focusing research and development on drugs that they think will do that – and by blocking the development of drugs that may risk the money making potential of their current catalogue. This is great for them but not great for health care as a whole. Arguably all medical conditions will have a genetic component at some level. And every person is an individual – created from their own personal genetics/environment. Drug companies want to find one drug to treat an entire clinical population, whereas the reality of what disease is/humans are, humanity would be better suited to finding a way to one drug tailored to fit that person/disease interaction.

I’ve talked about this from the point of view of drug development seeing as that’s what I know (well, knew). But maybe this logic can be extended to other aspects of health care. Surely the future of medicine should lie in determining the interaction of medical condition with a particular person and applying an individualistic approach to medical treatment. A person would have individualised/tailored drugs/therapy designed specifically for them as an individual and their particular version of their medical condition.

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NB: Emotionally I'm not in a great place right now so I’m not even sure I managed to say what I wanted to say and may continue this theme another day. Numbers I’ve quoted in this post are from memory so don’t jump at me if they’re not exactly right by current research. I left pharmaceutical research in 2007. This was a bit of a flow on consciousness after reading this post by RuftyRoo II.

There's a hole in my soul

I’m feeling absolutely horribly awful today. But it is, I’m sorry to say, one hundred perfect totally self inflicted. We spontaneously got a late train on Friday to stay with some friends. As we arrived late, Friday was fairly restrained and Saturday was a late lie in. I knew there would be a lot of drinking this weekend so I hardly ate anything on Saturday daytime (a boiled egg and a piece of toast). On Saturday we went out walking and around their city, so I avoided eating by saying I’d grabbed a sandwich earlier. We stopped in a pub for the afternoon and I started drinking then. My alcohol tolerance is through the floor – a combination of medication and losing weight. Two pints later I felt hammered and it triggered me off on a bit of an alcohol binge. Though I did drunkenly eat half a piece of pizza because of that – so at least I ate something else on Saturday.

I carried on drinking all Saturday afternoon and then we started getting ready to go out clubbing for Saturday night. We had some speed which was left over from a party at Christmas and had decided to take that while we were out. I love clubbing, I just love getting lost in the music and dancing like a crazy person. But I’m fairly socially inept and it does make feel awkward trying to make small talk with people. So I figured the speed would help and also keep me going for the night. And once I start I couldn’t really stop myself and ended up taking some random legal highs (I’m guessing) at an after club party. Finally stopped drinking and sobered up about midday on the Sunday and then had to train it home to collapse in bed. Felt hideous after drinking so much, so again didn’t really eat. And I didn’t take my medication on Saturday (was too drunk) or Sunday (forgot), so I’m blaming the “wanting-to-climb-out-of-the-window” misery and “are-you-staring-at-me” paranoia on the rebound affect of messing with psychotropics. And I’ve got incredibly fun intermittent palpitations and hot/cold sweats thrown in. Oops. Drugs, are apparently bad, kids!

I’ve always been fairly honest with my doctor(s) about the issues I have with drugs (well, actually, I’ve been honest about what I take and when I’ve taken it, but I don’t have an issue with it, more that my doctor does and I’m unwilling to change). From what I’ve heard/read about substance abuse it’s not that uncommon with mood disorders. I’m not really sure which came first. I got into drugs around the same time I started suffering from depression (I was about 14). For me I’m definitely worse with drugs when I’m in the middle of a mood episode. Usually I will take the odd bit here and there like this weekend and although I’ll feel rough afterwards it’s not really an emotional crutch and no different from drinking. Regular drug use is usually an indicator to me that things aren’t all that great and often one of the first signs of a mood change. Highs tend to be worse as I tend to lose sight of the fact it’s probably a bad idea and this can spiral if the drugs trigger worsening of mood (speed is fairly bad for this one for me). When I first started seeing my psychiatrist last summer, when I was hypomanic, he asked if he could have some assurance that I would at least try to take the medication as prescribed and I told him that I would – but that I couldn’t start taking them until Sunday (it was then Friday) as I was going from my appointment to a party and was intending to take drugs and didn’t want the antipsychotics to limit the effect of the high. (At least I’m generally honest, if not particularly insightful about why this wasn’t a great idea). When I’m down I tend to take drugs to drown out the feelings, as an ill-advised form of self-medication – last time I was depressed in November/December I was taking ketamine on a daily basis as it gave me a brief period of not being me (and pretty floaty hallucinations).

I’m not really sure why I’m writing this - distracting myself from my total incoherence to function at work right now. This weekend was the first time in ages (since New Years Eve) that I’ve taken anything. So it’s not as if it’s a massive problem. I think just maybe next time I get offered stuff at least I might cast my mind back to this post and remind myself how awful the come-downs are and maybe, just maybe, not take anything. Given the abuses of the weekend, however, I haven’t really lost any weight, so I’m obviously made of sterner stuff than I thought – even if I currently feel like a lump of pain drenched in wibbly paranoia-jelly.

A to Z

A = Age : 28
B = Bedsize : double - but I have to share with partner and usually two dogs as well.
C = Chores you dislike : gardening (and specifically having to clean up the pups mess)
D = Dogs : 2 small terrier crosses
E = Essential start to your day : cup of tea and the BBC news website
F = Favourite colour : black red or green
G = Gold or silver : silver
H = Height : 5'7''
I = Instrument you play : flute grade 8, piano grade 3, bit of recorder and domra (Russian instrument)
J = Job Title : office work
K = Kids : yes please - two ideally, but waiting for a couple more years before trying. It won't be the end of the world if we can't though
L = Live : UK
M = Mother's name : not saying
N = Nicknames : not saying
O = Overnight hospital stay : Several. As a kid I was born prematurely, the got run over as a teenager. Couple of adult stays for suicide attempts/mood disorder.
P = Pet peeves : thing not being arranged symmetrically, lights being left on, background noise
Q = Quote from a film : Papillion
The rule here is total silence. We make no pretense of rehabilitation here. We're not priests, we're processors. A meatpacker processes live animals into edible ones. We process dangerous men into harmless ones. This we accomplish by breaking you. Breaking you physically, spiritually, and here. Strange things happen to the head here. Put all hope out of your mind... ...and masturbate as little as possible. lt drains the strength.
R = Righty or Lefty : Righty
S = Siblings : Two - brother and sister, both younger
T = Time I get up : 7am on work days. Varies on weekends.
U = Underwear : black boring knickers
V = Vegetables I don't like : not many, parsnips I guess taste a bit rank. Generally love veg.
W = What makes me run late: sleeping in and being disorganised
X = X-rays : a couple
Y = Yummy things I can cook : veggie sushi, veggie lasagne, lots of other veggie dishes. Not very good with sweet stuff or Chinese food.
Z = Zoo animal : bats

Do You Realise?

For various reasons it has been a very bittersweet Friday. There are life events that mark your passage through the world, and retirement is definitely one of those. Retirement on this occasion was a happy event - at the end of a full working life and the years ahead look like a time that will be spent with loved ones and on some much anticipated favourite activities. But I will miss my colleague so much. It feels like a loss. This song by The Flaming Lips, called “Do You Realise?” came to mind.

Do you realise
That you have the most beautiful face?
Do you realise
We're floating in space?
Do you realise
That happiness makes you cry?
Do you realise
That everyone you know someday will die?

And instead of saying all of your goodbyes
Let them know you realise that life goes fast
It's hard to make the good things last
You realise the sun doesn't go down
It's just an illusion caused by the world spinning round 

Eating hasn’t been great today. I went out for lunch with colleagues to celebrate the event and there was set courses so I couldn’t avoid eating. I ate far more than I felt comfortable with and ended up purging. And I developed a headache which doesn’t seem to want to go away. Though at least it is Friday and I'm going to try really hard to stick to eating planned food for tonight and not purging.

Rubix Cube

The Rubix Cube was invented in 1974 by a Hungarian sculptor and professor of architecture called Ernő Rubik. The cube is a 3D mechanical puzzle, with six sides made up of nine square – the outer eight squares can be moved by rotating the layers of the cube. The aim is have each side made up of nine panels of the same colour.

When I was a kid I had a Rubix Cube and never managed to solve it. Out of frustration and a desire for order and neatness I broke off the outer squares (I think I did this by peeling off the coloured stickers) and reattached them in the “correct” order. I “fixed” it. Well it looked fixed. *shifty eyes*.

I grew up and put away my childhood toys (well, most of them). But then I received a Rubix Cube as a gift in the New Year. I was going to keep it in perfect and pristine. But alas it was not to be, as a ‘friend’, knowing my obsessive preference for ordered patterns, mixed up the colours while I wasn’t looking. I’ve spent the past few months staring at the cube – planning my moves and imagining techniques for getting the squares back in place. I’m very reluctant to pick it up and rotate the panels without a fair chance of success. I’ve picked it up once or twice and tentatively made a few twists and turns. Brief forays into the mechanics of the cube. A few pieces have been manipulated back to perfection. I’m scared of making the wrong move and jeopardising the fragile beginnings. I am fairly prone to this pattern of behaviour. I’m cautious and reticent to change. Partner would refer to this as stubborn and “being difficult”. From an outside perspective it can come across as laziness or procrastination. If someone suggests a change (e.g. a new method of doing something, a new way of rearranging the living room) I do need to mull it over (sometimes for months/years) in my head before either becoming comfortable with the change and acquiescing or deciding that it’s an acceptable pathway to take.

Since starting this blog I have overall decreased the amount I am purging (albeit only slightly i.e. I’m no longer doing it everyday) and I’ve definitely become a little bit less rigid in what/when/how I will eat. The weight loss has slowed down. I’m still losing weight, however, still purging most days and I’m still very much dealing with the obsessive/intrusive thoughts and feelings surrounding food and this area in general.

I don’t know if the improvements are superficial – akin to pulling off the Rubix stickers and reattaching them. Am I faking something that it ostensibly looks like the start of recovery in a mission to con(vince) myself into thinking that I’m getting better and fighting this! Am I tricking myself so I’ll ignore the fact that in some ways I’m still actively eating disordered? So the eating disorder can cling on as long as possible but “under the radar” and with out my seeking external help or intervention. Or maybe the slight improvements are a sign of a little seedling of genuine recovery. Am I just sticking true to my nature and being cautious, taking things slowly? The latter isn’t impossible as pretty much every time I’ve struggled with eating and weight loss in the past I’ve managed to figure my own way out of it. The only psychiatric treatment I’ve ever really received has been for mood disorders – and generally the times I’ve struggled with eating, I’ve also been struggling with my mood, and the eating problems have become easier as my mood has stabilised. Maybe it will just take me some time to feel comfortable with changing and slowly, but gradually, I will get there.

Either way I hate how difficult it all it and sometimes I feel like giving in and smashing the Rubix Cube to pieces - both literally and metaphorically.

Image Credit: all images from this post were found on Wikipedia and have some copyright reserved. See Wikipedia for the terms.

Ranting and probably too much information

A short update for today as I've been too busy to think. Work sucked. It seems that even when I am functioning below par (as in the last few months where I've been spending a good portion of my time too obsessed/controlled by ED-type thoughts to actually do my job) I'm still functioning at a level above 90% of the people in the office who don't seem capable of doing their actual rolls. I don't get paid enough to be (or get any kudos/thanks for) taking the lead on team projects or patching up other people mistakes or looking ahead to analyse working practices so we can "contingency plan" and "future proof" and "apply best practice" and "increase capacity". And... ARGH! Business officey bollocky bollocks!!!

Anyway... breathe in, breathe out. Right. Rant over.

Yesterday sucked in terms of eating. I ate fruit for breakfast and purged everything else I ate. Today has been better, I've eaten more or less normally, though I have still purged once. And I feel hideous and moody. And I'm not happy about my bloody grey hair. And it's probably too much info but I feel horribly horribly constipated (but refuse to take laxatives and if I start doing that I'll be "giving myself permission" to use them and knowing me will end up mis-using them) and feel very bloated. And even though I'm trying to be pleased that my weight has more of less stabilised where it is for the last 10 days (because I'm trying really hard to fight these thoughts), to be honest I'm really not. 

But I finished my current pack of the pill yesterday so it's a particular "time of the month". So heres hoping that "normal" service will resume shortly. Well... in a week maybe.

Grumpy mo-fo signing out. G'night.