Melatonin / infertility / cake

So the melatonin is still working. If I’m up late I’ll set my alarm to wake up at a reasonable time, but I find that mostly I wake up before it goes off. I’ve been having vivid dreams this last week, which have turned into mild nightmares these last couple of days – not exactly terrifying, but I don’t think I’ve had any nightmares since I was a kid, so it’s been kind of surprising. I’d tolerate much worse dreams in exchange for proper sleep patterns. They’ll probably go away anyway.

In other news, I’ll be having a sperm test in the near future, which should sort out whether or not I’m infertile. The three blood tests pretty much confirm that I have an isolated FSH deficiency, and since the rest of my pituitary function is absolutely fine, it means that I almost certainly have one of the rare genetic mutations that can cause this. All in all, I think I’d have preferred claws that spring right out of the back of my hands (“snikt”). The ability not to impregnate women you sleep with is just about the lamest super-power ever.

I’m going back to work in just over a week, which is pretty exciting. I made the calls to inform the benefits agency and the council of my change in circumstances, which felt like a big step. I’m looking forward to it. It feels like a fresh start and a second chance.

(Also this is genius. Made mine with cinnamon rather than chocolate and wholemeal flour rather than cake flour, so it was almost, but not quite, entirely unlike cake. But it was pretty damn tasty, especially since I don’t have an oven in which to cook proper cake. )

The Sleep Disorder Vanishes

This is just ridiculous. It’s 11pm and I’m getting tired. I’ll be going to bed after I finish writing this. Nine days ago, it was 11pm and I was getting tired. In between I’ve skipped my melatonin twice – once because I went out drinking for a friend’s birthday and yesterday because I wanted to watch the US election results as they happened. It’s been a crazy busy week. Last Wednesday I did my usual volunteer thing. On Thursday I was at the city archives learning how to do archive searches for people in the cemetery. Saturday was the birthday thing, followed by lunch and the journey home. Monday was more archive stuff. Tuesday I ended up going to the dental hospital because I was able to move my appointment forward (the actual surgey will be taking place in a month). Today I did my usual volunteering. Tomorrow I have a GP appointment and yet more archive stuff. Friday seems to be free.

And despite all of this, my sleep patterns remain stable. I’ve been able to manage the occasional mis-step (I made myself get up at a reasonable time today, despite not getting to bed until after Obama’s victory speech, which was about 5am GMT). Three things to wake up for in a row would have made me feel awful. There’s been a whole week of these things and I’m feeling fine. It’s just ridiculous.

2mg melatonin every night at 8pm and my sleep problems completely disappear. I’m sleeping like a normal person. The only side-effect I’ve noticed is a mild headache if I stay up late after taking my pill. And maybe that’s just how tiredness should feel.

Glass Sleeper

Day two of the melatonin. Took it at 8 as scheduled. It’s 11 and I should be going to bed soon. I feel sleepy but not exhausted. The Seroquel, the temazepam, they made me feel drugged up. This doesn’t feel like a drug at all. It’s way too early to tell if this is going to work, but ladies and gentlemen, we may have found a winner.

I haven’t felt like this in years. Tired without being tired out. It has to be more than a decade. It’s the kind of thing you don’t realise you’re missing. Then again I don’t catch onto these things quickly – it was a year before I realised that three-and-a-half hours a night wasn’t normal and the realisation was a big part of my spiral down into depression.

I don’t know if I like feeling this way. In some ways I enjoyed my sleep problems. Swapping the crystal clarity of sleeplessness for this fuzzed-out warmth? I’ve been scared for the last couple of years that maybe I was the cause of my sleep problems, that I wasn’t going to sleep because I liked the way it felt and didn’t want to sleep normally. But I think it was both – I kind of liked it, but couldn’t really do it any other way. The drugs I tried didn’t work, but I didn’t really want them to.

I guess the word I’m looking for is ambivalent. I relied on sleep-deprivation as self-medication for the longest time. I keep telling people that sleep-deprivation is like speed and then explaining that I’ve never actually taken speed. Sleep-deprivation never made me feel tired. I’d be exhuasted and I’d ache all over, but once I’d properly woken up I couldn’t get back to sleep for another 18 hours or so. It’s addictive. And it treated my depression. Maybe it only had this effect because I’m bipolar and it induced just enough hypomania to even things out a bit.

So why wouldn’t I use it as a coping mechanism? And therapy taught me that we don’t just discard our coping mechanisms when they’re not useful any more. Why wouldn’t I want to sleep like a normal person? But then normal people don’t cut themselves to feel better and I did that, so maybe I shouldn’t look for rational explanations for it.

I’m going to have to learn how to sleep again. I really think the melatonin is going to work and even though I’m happy about that and it should make my life a whole lot easier, there’s a hint of sadness there too. I’m not my sleep patterns, but it’s sure felt like it at times. And now I have to be just like everyone else?

It’s like when I started taking the lamotrigine and realised that it was making me better. It’s a lot of responsibility to take. It’s not just that I’m responsible for making sensible sleep choices now that I can actually do that, it’s also that I’m responsible for making the most of the way those choices affect my life. I’ve always claimed that the lack of sleep patterns was holding me back – if I don’t use the new sleep pattern to improve my life then I was wrong; it wasn’t the sleep patterns, it was me.

But I should probably think about these things when I’m not so tired.

I hope the melatonin really does work.

w00t

Another Damn Referral

So, as mentioned in a post yesterday, I was going to see my GP urgently. I was waiting for half an hour in the waiting room. At one point I was seriously considering asking the receptionist if there was somewhere quiet where I could wait by myself. I was feeling very disorganised and agitated. I felt like I was shivering. It was like the world had been turned up to maximum volume. Everything looked very visually active and the normal sounds of the waiting room seemed terribly loud and oppressive. It was like a low-grade panic attack, but longer. It’s worn off slightly now and I feel like I can organise my thoughts better, but it’s still there. I’m having difficulty keeping still.

My conversation with the doctor was strange. There’s always a part of me that remains the calm, rational observer, checking off boxes and noting down behaviours. That part of me thought I was acting crazy. I was finding it difficult to speak coherently and I felt like screaming at myself to say things right. My GP wanted to see the cuts that I did earlier. I’m not sure if I’m just paranoid, and it’s not as if I really care, but I definitely got that freak-under-the-microscope feeling. I told her that I’d been getting worse these past couple of weeks, that I’d been off work and my sleep cycles were completely screwed up.

“I don’t know what I can do for you,” she said. This did not inspire confidence. She wanted me to see her husband, another GP who works at the same surgery. She would discuss it with him and they would see what could be done. Then she called the receptionist in. I still had my cuts on display when she walked in. Some warning would have been nice. It’s not like I show these things to everyone if I can help it.

The appointment’s tomorrow morning. This will be medical person number 4 who I’ve seen since this all began. None of these people have been mental health professionals. Is it just me, or is that completely fucking insane? I know damn well that the mental health trust has provision for at least a community psychiatric nurse (CPN) to do proper assessments. As a self-injurer, I should, according to the government’s own guidelines, have been assessed immediately. Waiting a month for a counseller to come back off holiday so I can get an initial assessment of my needs is ridiculous. Being passed from doctor to doctor is not what I need. Seeking help is hard enough without these people making it even more difficult.

Here’s what I want to happen: I want the GP to refer me directly to a psychiatrist. I’ve tried counselling before and it wasn’t very helpful then. I have no reason to suppose that it would be now. If the psychiatrist believes it would help, based on his expert medical opinion, then I’ll be happy to try it. And I want to be prescribed something that will help with the anxiety in the meantime. Hotsandybeaches suggested Seroquel, and I want the doctor’s opinion on whether that will help.

So, I’m making a list of questions to ask tomorrow.

1. Can you refer me directly to a psychiatrist?
2. Can you refer me directly to a sleep specialist?
3. If not, why not? Who can? What are the chances of me actually seeing someone with the skills and training to properly help my long-term, potentially fatal condition?
4. Is there anything that you could prescribe to help me while I’m waiting?
5. I’ve heard that low doses of Seroquel can help in these situations, would that be helpful for me?
6. I’m worried about the impact this will have for me at work. I want to be back at work as soon as possible, but don’t feel capable of doing anything at the moment. Can you sign me off until I have this under better control?

If anyone has any suggestions on other things I should be asking, please comment in the next seven hours or so. Thanks.

Girls, girls, girls

With school finished, I became a vegetarian and within a few months had shed most of my excess weight. I started chatting online to a girl from Ohio. She was 22 and even more of an emotional wreck than I was. She had been sexually abused when she was a child, raped when she was in high school, suffered from anorexia and had a deeply screwed up relationship with her parents. She was in engaged to a lawyer who didn’t know about any of this.

I fell in love. She was smart and interesting and I desperately wanted to save her. In reality, I couldn’t even deal with my own problems, let alone anyone else’s.

I started to cut myself. You do it like so. You get a disposable razor and a pair of scisors and cut away the plastic pieces around the edge. You stick a fingernail between the blade and the plastic pieces that sandwich it and carefully lever away until the plastic pops off. You now have a razor blade. Proper double-edged razor blades, designed to be fitted into single blade razors are much easier to use, but I didn’t discover that until later.

If you’re in a rush (and when you’re being ripped apart by emotions you don’t know how to control, you’ll be in a rush), you’ll slice open your fingertips doing this. It stings a little, but much less than a paper cut.

The first time you do it, you hold the blade to your skin and barely manage to give yourself a scratch. You try again. The way they show cuts on TV is bullshit. You don’t end up with a line of blood seeping out as you cut. The blood needs time to pool, then overflow. It doesn’t do this as a sheet of blood flowing down the arm, but as a thin trail, oozing along. With small cuts, you hardly bleed at all.

I kept cutting myself. In November, I met a girl called Nicole in a Yahoo! chat room. We exchanged hundreds of emails. The girl from Ohio took a step back and left me to my own devices. In her way she was happy for me. Nicole was from Texas and I fell in love again. In the March after my 17th birthday, I got on a plane and went to stay with her for a couple of weeks.

I lost my virginity on the sofa of Nicole’s friends’ apartment the first night I was in Texas. I had a great time. Afterwards we plotted ways of getting together permanently. Then Nicole moved on. She found another guy – one much closer than me. This would have hurt enough, but she didn’t tell me about him. She cut contact with me. I would call and end up speaking to friends of hers I didn’t know. I even spoke to him once or twice. I finally found out weeks later when one of her friends I knew online told me about him.

It’s difficult to describe the way I felt for the next few months. A whirling vortex of pain doesn’t begin to describe it. My thoughts constantly spiralled around her. My cutting had been relatively minor before. I’d made a large number of small cuts, only going through to the dermis. Now I would cut slowly and deeply, down into the subcutaneous tissue. At one point I put together a cutting pack, comprised of razor blades, gauze and antiseptic spray. The resulting scars were large. Even now, eight years on, these scars are slightly raised, though they have faded to something close to skin colour.

I was working in a convenience store for a ridiculously small amount of money. A dead end job, with no prospects at all. Life at home was as unbearable as ever. I thought about suicide constantly.

Towards the end of the year, I met Emma, the third and last of my online girls. I was looking for something, anything that could save me and she was willing. We got together. I went to my GP and was put on Prozac and was referred for counselling. I felt a little better. Emma and I saw each other once every six months or so. She lived in Georgia, USA.

A year and a half went by and I decided to go to university. It was the only way out. Emma and I had run out of things to say to each other. We broke up a couple of weeks after I arrived on campus.

The End of the Beginning?

Living through more than a decade of depression will eventually get you down. Time was I could be clever and witty about my problems. Now I’m just dull and stupid. The lure of being the constant outsider fades into the reality of alienating yourself from everyone and everything. Hiding your problems for so long means that most people you know hardly know you at all.

I’ve been a cutter since I was sixteen. On a regular basis I take a razor-blade and score my flesh. Whatever angstful pleasure I got from it as a teenager has dissipated into an ongoing annoyance at my scarred arms. I’ve given it up many times, but once a cutter always a cutter. No matter how long you’ve stopped for, you’ll always have gone over that line. It’s always going to be an option.

When I was seventeen I went to my GP to get some help and confess the suicidal thoughts running constantly through my head. I didn’t tell her about the cutting because hey, who wants to be thought of as a freak? My GP put me on Prozac for a year and this seemed to help. But the reason I had enough energy to go to the doctor was because I was feeling better anyway. The effects of the Prozac seem more coincidental than causative.

But I hate not being able to cope and going to the GP with depression is pretty much the final admission that I can’t. I’m exhausted by the constant struggle. I have nothing left to put into the fight. At this point it’s medical attention or suicide and I figure I might as well try the medical attention while I wait at the bus stop.

A few weeks ago I overcame my resistance and called my local GP surgery to make an appointment. They told me I had to register first.

So I registered. I took the morning off work and went to the dumb little medical check-up, where the nurse took my blood pressure (a little high, but nothing to worry about) and tested my urine for sugar and infections (neither was present). The next Monday, I made my appointment.

I’d been reading about Delayed Sleep Phase Syndrome and the symptoms seemed very close to some of my own. I’ve been averaging about three and a half hours of sleep a night recently, so I wondered if sorting this out might make things better.

As my local GP surgery is horrendously oversubscribed, it was impossible to get an appointment that tied in with my schedules at work in less than eight days time. So I made my appointment and counted off the days.