GP visit

I saw my GP today (first thing this morning and then had to rush to work afterwards – oh joy) and my partner did go with me. Because partner was there I didn’t directly manage to say I was struggling with eating disorder problems again. I explained that my mood had been fine, but I was having some issues with obsessive/intrusive thoughts and that my partner had some worries about my current medication and side effects he was noticing that I hadn’t really noticed myself. Partner then explained some of the things that worried him with aspergers traits that he recognised from a colleague who had been diagnosed with aspergers. And he explained from his point of view how some of these traits (especially irritability/rituals) had been so much worse since taking this new medication.

I actually felt really shocked when he was talking as I didn’t realise how bizarrely I act sometimes from an outside point of view. He gave examples of how controlled I am by ritualistic behaviour and how this affected him and he found it hard to live with. He said that in recent months he’d felt sometimes I was so erratic/confused/forgetful it was like living with someone who had some form of dementia! That was really hard to hear and at first I felt like saying he was exaggerating or that it wasn’t true. But I guess it does tie in with the things I’ve been screwing up at work and how much I’m struggling with my work load (didn’t tell GP or partner this as hadn’t told partner how hard I was finding work at the moment and didn’t really want to go into it then and there). In the end GP made a couple of small recommendations and medication changes but really wanted me to see my psychiatrist to discuss any other medication changes/stopping any particular medication completely. I’m seeing psychiatrist in about 2 or 3 weeks.

I talked about it with partner on the way to the bus-stop so I could go to work and we discussed how actually talking to psychiatrist and potentially getting and ASD type diagnosis would or wouldn’t change things. He basically said he’d find it less frustrating if he knew there was a reason I sometimes acted the way I did. And he really thought that a different medication is really important as he says the erratic behaviour is something that isn’t me and is just because of the medication. I’ve just got to watch my mood now to make sure changes in medication don’t precipitate mood switching and go back to my GP if there is an issue.

Anyway, so in summary, I didn’t talk to GP about eating issues, but I do think that I made some big steps in letting partner be involved in medical care and how understanding/helpful he was has made me feel more confident about the potential for talking to him about eating problems. And hopefully if the medication was ramping up my intrusive/obsessive thoughts a lessening of them might actually help the eating issues as well. (Plus the medication does seem to have a big appetite suppression effect on me, so taking less of it might make it harder to engage in restrictive type behaviours).

Eating, however, hasn’t been too bad recently. I’ve not posted for a few days because I went away for a short break and didn’t have much internet access. While I was away I ate more or less normally and didn’t purge. And I actually gained a little bit of weight! Yesterday was a bit of a relapse into back into disordered ways (purged twice) and I’ve lost that little bit of weight again this morning. I’m currently on the border between normal/underweight, so I’ll try and maintain current weight and try and not weigh myself as often (I think the relapse yesterday was because of seeing that I’d gained) and try really really hard to talk to partner about what’s going on and/or be able to tell psychiatrist when I next see him. Telling psychiatrist might be easier as he often asks about content of intrusive/obsessive thoughts and that might give me a way to broach the subject. If I can’t tell partner (or psychiatrist, with partner present) then I’ll make a GP appointment (without partner) if I don’t manage to maintain my current weight/get purging under control.

Ok... enough waffling for the day... I guess I had a lot on my mind with not posting for a few days.

(Wrong) Diagnosis

I’m a very literal person. If someone says “ok, please explain this in minute detail” I often won’t realise that they’re being sarcastic and will start to explain <insert example> to them. I also often misinterpret people’s intentions/emotions. I’ll upset people as I don’t realise a topic is annoying them or will do something that I’ve understood they wanted – when they really wanted something completely different/opposite. I also fluctuate between being able to completely get absorbed in a task and block out the world around me completely, to being incredibly over-stimulated by small noises/distractions that other people wouldn’t notice. It’s a bit of a “running joke” in the office that I’m slightly on the Autistic Spectrum – one of my colleagues even pipes up and does social niceties on my behalf now as half the time I don’t naturally realise when I’m meant to acknowledge people (I’ve learned from experience when you’re meant to say certain things, but will often forget) so they jokingly do it for me – and I know they do like me and mean it in a fairly affectionate/friendly office banter kind of way. But recently a few people have said things that make me wonder if there’s anything in it. Do I have an Autistic Spectrum Disorder (ASD)?

When partner and I row I get upset because I don’t understand what I’ve done wrong or how I could have done things differently, or don’t think I can do things differently so know we'll row again. He thinks that ASD is a possibility – based on his past experiences with some colleagues who had an ASD diagnosis. But my argument to that has always been that he’s fitting my behaviours onto a structure that he’s used to/knows/is familiar with – and if he’d worked with people who had other issues (like OCD) he’d probably spot that in me instead!  Either way he asked me to look into it (online) and said he’d go with me to see my doctor to ask about it if I agree it fits. And even if I disagree he would happily go with me to see my doctor and explain how I am from his point of view in case the doctor has any suggestions that would help.

So I have looked into it and there are some things that do fit. Though to be honest I’m not really a fan of looking up information online to diagnose yourself as it’s so easy to see everything in yourself if you over-think it enough/look hard enough. And even though I do probably meet some of the diagnostic criteria for ASD there’s also so much overlap with other disorders.  When I Google symptoms like “rituals”, “intrusive thoughts”, “obsessions”, “difficulty making small talk”, “noise sensitivity”, “overanalysing situations”, “misinterpreting people”, “irritability”, “taking people literally”... etc. Yes it does flag up pages about Autistic Spectrum Disorder. But it also brings up pages about Depression, Obsessive Compulsive Disorder, various Personality Disorders, Eating Disorders, and Sensory Integration Disorder and so on and so on and so on. For example it could be that I have a lot of OCD traits and coupled with the Eating Disorder/malnutrition  act a bit odd/out of kilter emotionally and I’m a bit socially inept, but no ASD. Or I guess just as equally I could have ASD and the stress it’s put me under coping with it all these years has caused all my other mental health issues.

One thing I did find fairly interesting was a few sites that flagged up mental health problems experienced by adults that had been born prematurely. I was born 6 weeks early (weighing in at a tiny 4lbs) and had to spend a short time in hospital as a newborn while my organs "finished developing" and the jaundice went away. The only issues it caused growing up was I was ridiculously small and skinny as a child (often the shortest person in my school year) and I didn’t really catch up growth wise until my teens (I’m now 5’7’’ which I think is around, or just above average). I’d never really thought of my prematurity being anything that could have influenced on-going health. Not that it matters why I’m like this... I’m more interested in how to not be like it, and I’ve got other relatives who are just as loopy as me and not born prematurely, so it could just as easily be genetic. Though fuck it... maybe the eating disorder isn’t really an eating disorder at all. Maybe it’s just a mix of OCD and sensory integration because I never cope with textures/flavours as a kid. (Has colic as a baby and then wouldn’t eat as a toddler and when I would eat as a kid I WOULDN’T eat sweet things, so I've always had food issues).

The only thing I’ve ever been diagnosed with (as in been told by a doctor “you have this”) in terms of my mental health is Bipolar Affective Disorder. And to be honest I’m not sure I really agree with that as the times when I’ve been allegedly high I find it hard to accept they were abnormal and I only really went on medication as couldn’t be bothered arguing with people. (I’m a bit of a seesaw about this as sometimes I will agree with this diagnosis and sometimes I don’t). I’ve probably also got comments in my notes about Eating Disorders (NOS?) and Borderline Personality Disorder – the latter, especially from around the time of my separation from the soon-to-be-ex-husband, as I’d started self-harming again and taken a small OD and the psychiatric nurse I saw applied the following formula: relationship instability + self-harm + ”pseudo”-suicidal gestures MUST = BPD + a referral to the local personality disorder network/treatment team. But that’s another topic/rant all together.

Anyway – I’m off on a tangent here...

There are things that don’t fit with ASD. I don’t think I have any issues with eye contact and I think I can talk about/express my emotions fairly well. I also think I’m fairly empathetic/caring and I do like other people, and I don’t really avoid social activity even though I’m a bit hopeless at it sometimes. I think I will take partner up on the offer of accompanying me to next doctor’s appointment – if only because I think it would be useful for psychiatrist to actually meet partner and get information on me from someone other than me. And I do usually push partner away when it comes to mental health problems, when really he could be such a useful support. Though I won’t take him to my GP appointment next week – I might wait until next psychiatrist appointment in March. Partly because I think my GP will just tell me to bring it up with the psychiatrist anyway. And partly because I was hoping to mention eating problems/weight-loss to GP and don’t think I’m ready to admit to partner what I’ve been doing. (I think I’ll feel more able to broach it once I’ve spoken to someone else about it).

Sorry this is so long; I guess I just needed to get all these thoughts off my chest. If you’ve read all this you deserve a medal!!!

Negative/Positive

My partner said I should try and focus on the positives more as apparently I can be a very negative person. I initially started writing this post as very short statements of negative ARGHness. So I’ve gone through it again and tried to add positive comments after each negative statement.

Another row with partner – I wish I could tell him why I’m so irritable and why I can’t seem to focus on anything.

But apart from the last couple of days we really do have a very strong relationship.

And I’ve been very busy at work again only this time it feels like I’m drowning rather than using the work as a distraction.

I’ve been so busy today because I have had so many meetings – I’ve been in these meetings because people invite me as they value my opinion. Tomorrow I only have one meeting and will have time to focus on other tasks. And tomorrow is Friday and the start of the weekend!

I purged again last night. I feel like I’m failing at recovery!

But the thoughts have been fairly quiet since then and I’ve had a “normal” day. I’ve managed a “normal” lunch – avoiding all the little rituals and obsessions usually accompanying it. And I even had a snack in the afternoon. And there’s been no real change in relation to weight. Not really down, and not up.

Back at work and relationship woe

I’m feeling a lot better, plague-wise, today and have dragged myself back to work. Although a tornado of chaos seems to have taken advantage of my brief absence. Or maybe the fact that my workload was already teetering on the brink of disaster meant that one day away was the straw which broke the camels back. Panic does concentrate the mind wonderfully – so I’ve had an ok day in terms of negative thoughts and got a lot done in da office!

I’m hoping the rest of the evening carries on in the same vein. (I know I’ve got a fair few things to do at home as well… busy busy busy).

Only negative point was a bit of a row with The Partner. I’ve been very irritable lately (which I think is a combination of lack of food/general moodiness or depression) and it resulted in shouting/meanness/things-best-unsaid-being-said. *Oops*. Anyway he wanted to know “what on earth was so wrong at the moment”. I tried to tell him. I really did. I find it so hard to talk to him about mental health issues. He knew about the relapse with depression (although he thinks taking antidepressants is a stupid idea). He doesn’t know that burning my arm just before Christmas was deliberate. And he doesn’t know that I’ve been purging/restricting since last November (he thinks that it’s a “normal diet”). It was on the tip of my tongue. But I was so scared it would make the argument worse. I just know that he won’t know how to feel if I tell him and he’ll probably deal with the confusion by shouting/feeling angry – I don’t think the anger will be necessarily directed at me… but shouting/anger is something I can’t deal with. We’ve both calmed down now and forgiven/mostly forgotten. I will try to tell him at some point – though, the middle of an argument isn’t the right time. Maybe telling my GP will make it easier to talk to other people about this.

Challenging the Status Quo

My cold has escalated to plague from hell and I’ve taken the day off work to recuperate (read: rock backwards and forwards in bed). I’ve been reading a book by John Langdon called Wordplay – The Philosophy, Art and Science of Ambigrams. The idea of an ambigram is to write a word and mutate the letters, so while still readable, the have some degree of symmetry (rotational/mirror) and so that the final ambigram is also a visual representation of the word. You can see some of the examples from his book on his website – I really like Art&Science/Philosophy and Waterfall.

The book has also spoken a lot to me about balance/control/power – it talks a lot about YingYang and the ideas behind Taoism. One of the parts I read today that deeply affected me was the section entitled “Choice/Decide”. Every day people say “I have to go to work”, “I’m obliged to pay my gas bill”, “I need to walk the dog” or “I must write a blog entry”. Fundamentally you feel like you have to do these things, and there may be negative outcomes if you don’t, but realistically you don’t HAVE to do them – you decide that you are going to do them, but you could equally decide “fuck it, I’m not going to, I’ll deal with consequences as they arise”. The author advocates trying to alter your speech/thoughts to represent the true power/control you possess over everyday situations, to realise that all these “have to” moments are actually unconscious choices and to rephrase them: “I choose to go to work”, “I decide to pay my gas bill”, “I wish to walk the dog” and “I want to write a blog entry”.

Sometimes I feel I don’t have any control over my actions. For example I haven’t been able to eat much today, but I still purged once. I felt like I had to – like I didn’t have a choice. But I did. I do have a choice on whether I act on these urges. And I think it’s really important that I never forget that.

This is a scan from the above mentioned book - interlocking mirror image ambigrams of the words Choice and Decide (I find the lattice pattern very soothing):

PS - thank you for recent comments, because I'm ill at home I don't have stamina to go round many blogs today, but normal operating will resume soon (I hope).

A rambling entry about my weekend, weightloss and work

Well the busy weekend was good and I didn’t purge on Friday, Saturday or Sunday. And On Saturday and Sunday I ate more or less normally. This morning I had lost about a pound - which was shocking given food/alcohol intake over the weekend. I guess I must have either eaten less than I thought or done more than I’d thought – or maybe it just takes more than a couple of days normal eating to reverse the calorie restriction of recent months. But even so this weekend is fairly positive in terms of fighting back against the eating disorder.

Today has been mostly rubbish in that I’ve come down with a horrible cold. I was trying really hard to keep up the good work of the weekend and use the theory that you should “feed a cold” so I ate a lot for lunch. But that did tip me over the edge and I ended up purging.

Immediately after I came back from the bathroom (after purging) I had a customer/client turn up unexpectedly to see me. A lot of my role is managing customers/client’s records, but a significant part of my role is pastoral. I often end up being the initial point of contact when something is affecting a customer/client’s ability to work with the organisation, and I have to listen to the problems, put practical work related assistance in place where appropriate and direct customers/client’s to appropriate services/support within our organisation and related organisations. This particular person is really struggling with depression and I’ve been strongly suggesting to them that they should make an appointment with their GP (along with some other stuff that my organisation can help with).* I felt so hypocritical sitting there, feeling dizzy, with my throat throbbing and positive that my breath probably reeked of sick, trying to reassure them that it would be a sensible thing to do when I’m pretty much terrified of seeing my GP about the issues I’m having. It’s a pity that I won’t listen to my own advice!

*This is difficult to express with explaining exactly what my job is/where I work, and client/customer isn’t really the best terminology, but since this is an anonymous blog it’ll just have to be vague! Please be assured that by the nature of my vagueness you’re not getting all the details and all appropriate advice has been given/action been taken. And also I’ve changed a couple of key details, without changing the gist of the story, to protect my/client/customer anonymity and also on the extremely unlikely off-chance that my client/customer would read this blog and think “hey I went to see X today unexpectedly to talk about my problems and they had just come back from the loo and they did look a bit ill during the meeting, maybe this is their blog”, then no, sorry, I’ve changed details so that if you think you recognise yourself then it’s definitely not you! This and all examples I use from the workplace will always be amalgamations of real events that illustrate the point while still leaving me/others unidentifiable. Phew! Hope that incoherent babble made sense!!!

The one where she's a bit mental in the workplace...

I’m struggling at work a bit at the moment. I've almost fainted a couple of times during long presentations/getting up from my desk. And now I've missed a really important meeting yesterday. I spent the entire afternoon obsessing about weight/food/etc. and then suddenly looked at the clock at it was 5.45. My meeting was at 3!!! I didn’t even realise. Luckily I’m usually a model employee so apologies were accepted and the meeting rearranged. I even managed to light heartedly joke about how I’d spent half the day convinced it was Tuesday and that’s why I’d forgotten. Sympathetic replies “no worries, everyone does stuff like that occasionally!” – thank God for working in the public sector! But I’m so angry with myself. I’m treading water at work at the moment trying to stay on top of everything that’s coming in and covering for a couple of staff absences. While trying very hard not to let my clients/customers and colleagues see the cracks because I'm only getting half the stuff done because the thoughts are so intrusive and distracting.

I know from previous experience I can usually get away with coasting for a little while. Last summer when I was hypomanic, after a brief period of ultra-efficiency where I felt great/got loads done, it escalated to the point of zero concentration, extreme anxiety/irritability and embarrassing impulsive behaviour (*blushes* even to think about that to be honest). That lasted for about 3 weeks before I was finally convinced (by the one colleague that knows about these issues) that I should maybe go to my GP. Which was when I started back on medication. And once I was more in control I quickly caught up with the backlog – thankfully in time for October which is a key point in my organisations year. But I hope I get my head above the water soon before I end up irretrievably behind. My next key point in the year will be starting in April and running through to August. Plus I’ve got potential exciting job opportunity that I need to apply for and I will hate myself if my mental health problems get in the way of yet another thing. (Even though I shouldn’t blame myself, I really really do!)

I did purge again last night as well. Well two days this week is still better than none. And I met a friend for lunch today and ate something I would never normally eat and didn’t even contemplate purging. And I’ve got a really busy weekend planned so hopefully plenty of distraction from the thoughts!