I woke up this morning and felt like my body didn’t belong to me. I was having to deliberate about each footstep and mentally tell myself what to do next. Even for really simple things like washing my hair. I just tried to call my friend, and she’s one of those people whose number I’ve been calling for years; it’s one of those numbers that my fingers know off by heart and I got it wrong. I had to stop, take a breath and then say the number in my head and concentrate hard on where to put each finger. Hanging out the washing and bringing in the dry laundry has been a severe challenge to my co-ordination.

It goes without saying, really, that this is testing my patience somewhat. In fact, even sitting here typing this is testing my patience severely. I’m – what?- a hundred words or so in and already I’ve had to use the spellchecker umpteen times. Usually my fingers fly over the keyboard and I can beat out paragraphs nearly as fast as I’m thinking them. Today, the effort involved is incredible.

It’s making me think, though, about how ineffectual print is to convey the act of writing. It’s hard to express the effort and thought and agony, sometimes, behind each word. My brain is mushed. Seriously. I just typed ‘between’ then, when I was trying to write ‘behind’. When I started writing the previous sentence, I couldn’t spell ‘brain’, either. Part of me wants to leave all the mistakes in, to demonstrate just how rubbish my physical ability to transcribe my mind’s wanderings is, but I am too vain and too much of a perfectionist to do this. I may feel like a retard today but i have no intention of giving anyone else the opportunity to think that.

I can only imagine that these are side-effects from the Lamotrigine. When my GP first said she wanted me on a mood stabiliser, she gave me a week to think about it and told me to go and do some research. Off I went, and looked at all kinds of things – the manufacturer’s statements, which of course are just glorified sales pitches written in reassuring medicalese; I looked at countless users’ and ’survivors’ websites, I looked at the NHS NICE Guidelines for Bipolar Disorder In fact, I looked at so much, and read so many books that my head went a bit potty with the weight of it all. But yes, the overwhelming concensus appeared to be that Lamotrigine was going to be nicer (I use that word with a hefty dollop of irony) than a lot of the other medication available.

You know, I still haven’t received a formal diagnosis. I am also not one to advocate the risky process of Self-Diagnosis With Internet Help. But really, I’m a mental health professional. I’ve worked with people in every state of illness imaginable for over ten years. Technically, my GP can’t make a diagnosis: I have to see a specialist to get one. Have I seen the specialist? Have I chuff. My GP mentioned cyclothymia, but as I understand it – and indeed as all the clinical guidelines instruct the doctors – depression in cyclothymics is ’subclinical’ rather than severe. I know, and my GP knows, that my depression is not ’subclinical’ in any way. Last year I was seriously bloody ill and posed a major risk to myself. God forbid anyone would read this and think that what I’m saying is [adopts Cartman voice here] ‘Nehhh. My depression is bigger than your depression,’ because I’m not. But what I am saying is that my depression is bigger than cyclothymic depression and therefore I need to see the specialist.

Gah. I am sitting here getting het-up and frustrated, and not just because it took me three tries to spell ’sitting’ just then. I am going to ring the GP’s surgery now and ask what’s happening about me seeing the psychiatrist, because the NICE guidelines say that I should. And I’m being prescribed medication which I have only ever professionally observed to be used to treat epilepsy or bipolar disorder. In fact, in the US, it’s specifically licensed as a treatment for both these conditions. The UK licensing issue is sketchier, because neither the BNF nor the patient information leaflet make any mention of any mood disorders whatsoever. Glaxo SmithKline’s clinical trials register is interesting, though. There is a part of me (mostly the vain woman part) that is extremely concerned that they felt the need to be researching the emergence of PCOS -type symptoms in female Lamotrigine users.

But I digress.

I am Not Well. Today I am also Not Well due to the medication I am taking because I am Not Well.

* * *

I just had a phonecall from a guy who’s an occupational therapist with the local Primary Care Mental Health Team. This is a new team that works with GP services. My GP had referred me to them to explore options for counselling and support. The guy – we’ll call him Dave – said that he was loathe to work with me directly because I’m a member of staff and because there might inevitably be occasions where our paths would cross in the future. He then directed me to my employer’s Staff Psychological Wellbeing Service, who have an appointment for me tomorrow to see a counsellor there.

It’s a two and a half hour bus journey away. Plus a taxi to the place. Then two and a half hours home on the bus. All because I’m a member of staff and local services are ‘loathe’ to see me. the knock-on effect of this is that I have to cancel my GP appointment in the morning, and oh! joy of joys! the next available appointment is on Friday 14th, by which time I will have run out of all my medication. I have the option of calling every morning at 08.30h to see if there’s an ‘emergency’ appointment, but they can’t guarantee which doctor I’ll get to see. To say I am well and truly cheesed off with all this is an understatement.

The secretary at the Wellbeing Service asked me the reason for my referral. She said, ‘Is it stress?’

I almost laughed.

If I wasn’t stressed before, I certainly am now.

I started this blog with the brave intention of chronicling everything that was going on, charting my moods, sharing my wisdom and all the rest of it, and it didn’t happen. There are a number of reasons, all valid in their own ways, but mostly it was just due to me being totally knackered by having to deal with being unwell and all the accompanying rubbish that’s come with it.

I’m in a weird situation. I don’t know if I mentioned this already, but I’m a nurse, and I work in Wales for the NHS as a ward sister on a busy hospital admissions ward. A busy psychiatric admissions ward, in fact. I’ve always been reasonably open about my history of severe depressive episodes, and the general consensus has mostly been that my experiences have furnished me with additional skills and empathy which can only enhance my job.

Earlier on this year my family experienced quite tragic circumstances which rocked our world immensely for a while. I suspect it was dealing with this that led to the stress that started to tip the balance for me. In addition, I had my 15 year old son home for the holidays; he has Asperger’s Syndrome and is a weekly boarder at a residential school about 70 miles away. His behaviour can be, and often is, challenging to say the least. But he is great, too. So yes, we had a lot going on, and I suspect that was probably what had triggered my elated episode. I was cleaning constantly, had extreme pressure of speech and flight of ideas and was prone to doing some strange and funny things. I’m going to save those for humorous entries, I think, so they can be savoured in their entirety.

But no, I wasn’t well at all- and indeed I’m still not well, really- and I did the right thing and signed myself off sick and took myself straight to the GP, who insisted I came off my anti-depressant – Duloxetine/Cymbalta- straight away in case they’d triggered the hypermania. I’d been well on Duloxetine for nearly nine months, following a very severe depressive episode last year, which itself had followed an equally hypermanic episode which I’d blithely self-medicated with excessive quantities of alcohol until I realised I was making a colossal ass of myself.

Anyway, my GP suggested she refer me to the local community psychiatrist, who is someone I’ve never worked closely with and with whom I felt comfortable. The PDoc – we’ll call her Dr Pleasant – said that she’d see me at home, to save me ‘running the gauntlet’ of the clinic where she’s based, and where I know most of the staff. So that was fine, and I had a week to think about the referral. In the meantime, Dr Pleasant suggested that my GP started me on Lamotrigine (Lamictal), a mood stabiliser from the anti-convulsant stable. Sometime during the next week, my line manager from the hospital called me to see how I was. When I’d filled her in, she was quite stern with me, and told me that I shouldn’t see Dr pleasant, that it would ‘damage our professional relationship’ and that it would be impossible for me ‘to be totally honest with her.’

OK… if you say so, boss. She also raised concerns about the fact that my records would be stored on our trust-wide electronic note-keeping system, which is accessible to all nursing staff, hospital and community based, in a trust that covers a large chunk of mid and west Wales.

Nothing like adding to my existing paranoia, eh?

I got really cross about this. I rang my Human Resources dept, to ask them if there existed a policy on how trust staff should access services that they already worked for. The lady there admitted she had no idea and referred me on to Occupational health. She also added that I had a Sickness Review coming up, where I’d automatically be referred to Occupational health anyway. So I rang Occupational Health. I have to explain here that this service is provided as a ‘favour’ by the general hospital where our psychiatric wards are based (we’re run by a separate trust based 50 miles away). The administrator there advised me that the next available appointment would be in October. This was on August 21st. She also had no idea how else to help me.

I was cross by this point that I rang my union for some advice. They were horrified, and suggested that it looked like I was, by virtue of my profession, effectively being denied access to services. Which is pretty much where I remain. At my most recent weekly GP appointment, the doctor rang the clinic and asked how my referral was progressing; they offered me an appointment with a different doctor (who is male, and gruff and not who I’d be told I could see) but I declined. The secretary then said she’d ‘have a word’ with Dr Pleasant and get back to me. To date she hasn’t.

I just tried to explain to my mum how frustrated I was about the whole thing. She mostly just said, ‘Hmm,’ which is kind of typical for my mum. But we’ll save dysfunctional family relationships for another day. (See, I think I’ve got nothing to write about, when really, there is oodles.)

But yes, right now I am mostly angry. And that’s angry about real things. Other real things I’m cross about include the shitty (literally) side-effects of the Lamotrigine, the loss of my fine motor co-ordination, the fuzzy-headedness which is contributing to my increasing frustration, because my head is still going so very very fast; the ideas and the concepts for stories and poems are flying through so quickly and yet I don’t always have the energy or the inclination to write them down. And my temper continues to be horrific at times. I am well aware that I am testing my girlfriend’s patience beyond most normal limits. This is unfortunate because she, and our housemate, are my rocks right now, and deserve better from me than snappishness and bouts of irrational anger.

Thankfully they do not just listen blankly and then eventually say, ‘Hmm.’