Getting a support worker : April 2016

I've been fortunate enough to have been assigned a number of outreach workers for over a decade.  These professionals come from a variety of backgrounds (usually mental heath or social work).  They've differed in strengths and weaknesses; the best ones are usually intuitive and have good memories for what you tell them about yourself.  They come to your home either weekly or fortnightly, initially just to chat and get to know you and build up rapport.  They then go about helping you set and achieve goals, like self-care and managing your affairs.  The downside is because they are all government funded their services are available usually only for 12 months or so.  That's why I've had close to a dozen workers in around 15 years.

You are given a single worker at any given time, and the demand for them is fierce, so there's often a waiting list of several months.  I waited 5 months for my current worker, a twenty-something young woman called Maddi.  We've met three times thus far.  I don't feel rapport with her at all.

I know I should be grateful to get any sort of help (especially because it's free), but honestly I am finding her very formulaic and impersonal.  Two days ago she came to my house for a visit and I was not in a good way; very low mood and hazy.  She kept rattling off questions about my goals and I refused to play ball, giving monotone answers like "s'pose", "yeh", "nuh", "dunno".  I was waiting for her to address my mood but she ignored it, and left after 15 minutes.

Now you might say I was being a bitch, but I genuinely was struggling for words that day and wasn't up for her line of questioning.  The fact that she just took off didn't impress me either.  I had hoped she might just ask me how I had been, or how I was feeling that day.  Instead it was straight to the pre-arranged agenda, which pissed me off.  So I blocked her.

It appears that this is one of Maddi's first jobs (she told me she used to work for Centrelink).  Maddi has a psychology degree, so she's no dolly.  I've had many more workers who were more gifted and experienced than Maddi, so I could be judging her harshly.  It's just a pain in the arse to have to break in a green worker; to guide them as much as they guide you.

It's still early days, I've only met her 3 times.  But my gut says don't put up with shit and don't put up with someone who is out of their depth.  I can always request another worker, but over the Xmas period there'd be a wait.  Probably a few more months.

I know I began this post as if it's a privilege to get a worker; and it is to an extent, it's not a right.  It's just that when they are inadequate it is very frustrating.

Meds, moods and foul weather

Update:  Well I was wrong about Latuda; it's an anti-psychotic, not a mood stabiliser.  So when I went into hospital in June to do the swap, it was Saphris that was removed, not Epilim.  Since then I've done another meds swap; this time at home for an anti-depressant called Edronax, which supposed to put you off smoking.  The Lexapro was substituted this time.

I had one superb week on my new anti depressant; then a nosedive.  So the latest telephone instruction from my PDoc is to double the second anti-d (Brintellix) and if no improvement then an extra half tablet of the Edronax.  No major side-effects from the Edronax other than a bit of disrupted sleep and lowered appetite.  I've lost 2 kilos!

Have to be wary of mania as always.  Nothing like a good dose of anti-d to send me rocketing.

The weather hasn't helped my mood; Spring in Melbourne was more like a mild winter, save for a couple of hot days.  The average temperature has been 17 degrees Celsius, often feeling colder due to wind chill.  We also had a colder than average Autumn, so it feels like we haven't had warm weather since March.  Too long ago!!!!  Surely December and the advent of summer will see some sunny days?

Smoking reduction making me depressed: can't lift anti-depressant or I'll go MANIC and psychotic

Sigh.  What a difference 3 weeks can make: yes, I have been successful in continuing to reduce smoking down to about 16 a day, but my mood has slumped majorly.  My psychiatrist has maintained that cigarettes act as a mild anti-depressant all along and now I see his point.

I saw my psychiatrist last week and he is interested in trying a new mood stabiliser on me: Latuda to replace Epilim.  He said Latuda is weight-neutral and also has an anti-depressant component to it which might be a safe way to raise my anti-depressant levels.

For those who haven't read previously, ever since I swapped from Zyprexa (I put on 30 kilos) as an anti-psychotic to Saphris (weight neutral) in January 2013, I have struggled with low mood.  When my psychiatrist did the hospital-based swapover I had a major manic and psychotic episode and have tried minimal levels of Pristiq, Lexapro and Brintellix since.  The levels have to be minimal because the Saphris isn't as sedating as Zyprexa and I react to "normal" anti-depressant" levels while on Saphris by going manic and psychotic.

The net result is that due to low levels of anti-d I have experienced no lift in mood for any sustained period.  Maybe feeling ok, even happy for a week maybe then BOOM back down again.

Like this weekend:  I put a small wager on a couple of football teams to win, and they did.  I doubled my money.  I withdrew the bulk of it to safely be back in my bank account and didn't feel elation or happiness.  I felt relief.  Now I can afford to get my dog clipped.  Just deadened emotions.

For anyone else out there who goes through depression regularly, I feel for you.  I wouldn't wish it upon anyone.  It's like the rest of the world is participating and you're encouraged to, told to, quizzed as to why you are on the sidelines.....people want to help you but they just don't get it.  Hopefully I can stick fat with reducing the smokes and maybe there'll be a hospital stay soon to jump onto Latuda.

Sleeping better despite an Indian Summer In Melbourne for March 2016

Life has improved in the last month; I am starting to get in the habit of being asleep by midnight or 11pm.  This has made a big difference.  More energy and improved mood.

I've also improved my diet; no more meal replacement shakes, only real food. This has helped my energy levels as well.

As a result I am starting to tackle the housework bit by bit, which also lifts my mood; both a sense of achievement and pride.  I've got a long way to go but at least I've started.  My psychologist suggested I attempt it a room at a time, even if it's only a few minutes when I can muster it.  So, for instance, I wiped 3 cupboards in the kitchen the other day.  There's about 12 to go, and it might seem slack not doing it all at once, but that's all my energy can manage some days.

The other significant thing is that I'm quitting smoking again, only this time I'm doing it with the guidance of a health psychologist using Nicotine Replacement Therapy.  I've been wearing a patch for almost 4 weeks now, and have reduced from about 30-35 cigs a day to about 20 and now down to 15 since last Friday.  I have the Nicorette mouth spray as backup for cravings but haven't used it yet.

Some people believe it is unsafe to wear a patch and smoke at the same time; that's not true; you can't overdose from nicotine.  You're more likely to have a heart attack from chain smoking than using a patch and smoking simultaneously.

I've noticed my mood dip a bit since Thursday; my psychiatrist has warned me that cigarettes act as a mild type of antidepressant and that people with mood disorders can be susceptible to feeling down as they reduce or quit.  He's given me some samples of Brintellix 10's in case I need to use them but of course I have to ring him first to get the green light to take them.  There's always the chance of me going manic if I take the Brintellix 10's along with Brintellix 20's and Lexapro 10's.

So overall things are better than last time I wrote but a few hurdles have to be leapt before I'm in the home straight.

I've set myself mid-May as my quit smoking date; I smoke roll-your-own tobacco as it is cheaper (the average packet of 25 cigarettes in Australia costs $25; the government tax the shit out of it to try to get people to quit; it's been pretty effective; I would no longer dream of smoking at an outdoor cafe due to the grief you get from other diners).  Anyhoo, I am reducing each fortnight by one pouch of tobacco (50 cigarettes).  So I've gone down from 25 to 21 and will go down to 17 then 14 then 10 then 7 then 4 then quit.  I'm managing under 20 ok the past few days so hopefully it's all good.