The Ludicrous side of Mental Health.. #001

My most embarrassing experience.. - Probably getting chucked out of Pizza Hut after decimating the five quid lunchtime buffet. If you're bulimic, the words "All you can eat buffet" can suddenly take on a whole new meaning!

After five or six trips to the bathroom, and then back to the buffet, the staff eventually noticed what I was up to and "politely" asked me to leave.

(Cringe...)

Anorexia.

It gets on my nerves when the glossy girlie magazines are often blamed as the cause of anorexia. It wasn't like that for me, and the anorexics that I have come in to contact with rarely mentioned the images in magazines as the cause of their illness. Instead the reasons ranged from trauma, neglect (emotional or physical), being afraid of sex or growing up, to have some control in a chaotic life, the many forms of abuse, lack of self-esteem, being in the shadow of a dominant sibling, a dominant mother, and many, many other reasons. Every anorexic is different, and the reason(s) that he or she became that way also differ.

A person suffering with anorexia is often seen as attention-seeking, fussy, stubborn, or the whole situation is a silly diet gone wrong, or a way to manipulate people, revenge, or the person is just being plain awkward and "for F*** sake, why can't you just EAT?"

This was something I heard frequently when I was ill. Unfortunately, not being able to eat is the tip of the iceberg. It's more complicated than just shovelling food into your mouth, chewing and then swallowing. How do you explain to someone (if they are even willing to listen), that being presented with a meal is like attempting to climb Mount Everest with a broken leg? Or that the innocent action of a friend inviting you out for coffee can evoke extreme terror and the probability of you saying "no" is about 99.99%? Or the only way you can go to sleep at night is with the knowledge that you haven't eaten today, that you've notched up 1000+ calories on your exercise bike, and as you slump in to bed exhausted you are so hungry that it's painful. But you feel safe. And clean. As you drift in to sleep, you dream about food. Every night. Huge banquets. You can taste it in your dream. It's wonderful. But then you wake up and realize that you will never be able to attend that banquet or eat that food for fear of the consequences-whatever they may be.

During your waking hours, you think about food constantly. You salivate and your tongue craves the feel of food on it. You gaze longingly into the windows of cake and chocolate shops, savouring every smell hoping it will satiate your desperate hunger. But it doesn't. You want to go in and buy the whole shop. But you can't. You mustn't. It would be weak. Your bathroom scales are your best friend and your worst enemy. They determine your mood for the day. You also develop an uneasy relationship with your toilet. The fear that any food has been ingested is so great that you will go to great lengths to get rid of it. Vomiting, laxatives, ipecac, enemas and colonic irrigation to name a few. After a while, the laxatives don't work any more. Your body has gotten used to them and you need more and more just for them to take effect. When they do, you are perched on the toilet for hours in the middle of the night with stomach contractions comparable with what I imagine childbirth to feel like. They also make you have cold sweats, palpitations and chest pains which make you think you are having a heart attack.

I was fairly uncommon in that my anorexia wasn't about my weight or body image. It was about what putting on weight represented. Growing up. Becoming a woman. Sex. A boyfriend. Motherhood. A job. And just being in a world that I felt too young for and which I hated. At my lowest weight of 69lbs and a BMI of 9, I could see how thin I was. I looked like a concentration camp victim. I looked disgusting. But I felt safe.

In hospital, being stuffed up with food, calorific nutrition drinks, drips and a nasogastric tube terrified me. It brought me closer to a life that I was frightened of and one that I didn't feel ready for.

I have photographs of myself from those days. I used to be proud of them-the achievement of getting that thin! But now when I look at them, I feel sick.

I didn't really know all my reasons for becoming ill until far on in my recovery process. I made a conscious decision to become anorexic. Initially it was to buy time until I worked out what the hell I was going to do with my life after the devastation of the breakdown. I'd devoted my life exclusively to music and that had gone. I was left with nothing. I needed something to focus on. Anorexia fitted the bill.

As a person, I am determined, goal orientated, a perfectionist, single-minded, stubborn and I like my own way. These qualities are fatal in an anorexic.

Looking back, I'm not surprised I ended up that way, and my reasons for becoming so were much more complicated than I'd originally thought.

I mentioned in a previous post that I'd wanted to be a nun for years. Now I can see that my motives for that were not fully religious, but an escape from the world, living in an ordered environment with somebody telling me what to do 24/7 for the rest of my life.

I'd felt a decade too young for my age. At university when my contemporaries were talking about jobs, in the back of my mind was a small voice telling me that I felt about 12 and too young for all of that. My childhood home-life was complicated; single parent, dominant younger sibling, and my own personality as a child, blah blah, which stunted my emotional development. I also believed I needed to punish myself for my failures. I felt I didn't deserve to live a normal life or to have love, so I deliberately destroyed the potential for both. There are other layers to the onion which I won't go in to, but it was definitely not a glossy magazine that gave me the idea to embrace an eating disorder!

It's hard to say if I regret those years. I do and I don't. I wasted a decade of my life which I can never get back. I am now left with osteoporosis, dodgy teeth, digestive troubles and food intolerances. I had no periods for 8 years and it's unknown whether I will have trouble conceiving when the time comes to have children.

Sometimes I feel very old for my 34 years.
Despite all this, I learned a lot. About me. About people. About life.

I feel a much richer person having come out the other end. I hit rock bottom and survived, and I found that life is not as scary as I once thought it was. Yes, I get anxious about all the crappy little things, but my attitudes towards the bigger picture have relaxed significantly. It irritates me when I see parents pushing their children to be something they clearly don't want to be which can cause emotional damage in the long run. As long as that child is healthy and happy, who cares if he wants to be a barista rather than a barrister?

I learned that life is precious and fragile and should never be taken for granted. I also learned that life can be very cruel.

I'll talk about my path to recovery in a later post, but I am extremely glad that I have no lasting food issues from those years. I put this down to my reasons for becoming anorexic in the first place-buying time and hiding from life rather than a distorted perception of my own body.

It's a sad fact that people have fewer expectations of you in the midst of anorexia, and now that I am recovered this is the thing I find hardest to deal with. I could never go back to that way of life, but sometimes when I'm having a crap day and stressed with the demands on me, I occasionally yearn for that simpler life where the only things I worried about were my weight and when my next binge would be. (I had bulimia alongside my anorexia, but I'll talk about that in time). Then I remember the fear that surrounded those years, how lonely it made me and how I nearly lost my life on several occasions. It makes me realize how lucky I am to be alive and how far I have come since I decided to face my fears and make the decision to recover.


Kerry.

Self-Harm. Baring all and dealing with comments.

I used to dread the summer. It's a time that most people look forward to - warm weather, a bikini at the beach, nice summer clothes. Things you take for granted.

During my illness I self-harmed extensively on my arms. I'm deeply ashamed of those scars and come every summer I'd literally feel paralyzed by not having the courage to bare my arms. I ached to be able to wear a T-shirt or a strappy dress but couldn't for the fear of the stares and comments I'd receive. Instead, I'd be wearing long sleeved tops, absolutely baking in the heat and getting frustrated and angry at other people who didn't know how lucky they were to be able to enjoy the sun without being judged.

I was turned down for laser treatment because the scars were deep and the skin uneven - the probability of the treatment causing further scarring was high. I was devastated and got very down about the fact I would probably be wearing long sleeves for the rest of my life.

When I first met my partner I was terrified to tell him about my arms and kept them hidden from him for a long time. He knew about my mental health past and I think he eventually worked it out. I don't think my scars bother him - they are just a part of me.

A couple of summers ago my life changed forever. A close friend commented that I was well covered up on a particularly hot day. I told him my reasons for this, and he made it his mission to 'get me in to short sleeves'.

He asked to see my arms which made me very uncomfortable, but I showed him anyway. He told me they weren't that bad - yes the skin was uneven, but as the wounds had been inflicted over 5 years ago, they weren't as noticeable as I thought they were.

"But what if somebody takes offense?" I asked him. "That's their problem isn't it?" he replied.

With a lot of support and encouragement from him, I managed to break free and by the end of the summer I was wearing short sleeves and strappy dresses! I felt liberated - it was such an amazing feeling!

It wasn't easy and I started off small. Initially I sat out in my garden. Even though there was nobody else there I still felt very self-conscious. But it was so nice to feel the sun on my arms after such a long time..

After I got used to doing that I went for a walk around the block, my cardigan in my bag as a literal security blanket. I was so worried that each person who passed me would stare at my arms in disgust. But they didn't. They didn't even look at my arms. As time went on it got easier. I graduated on to busier places..the swimming pool, the bus, the local shops, the gym, the city center and finally in intimate gatherings where people were more likely to notice my arms. This was harder. This was around people I knew or sort of knew who weren't aware of my mental health past. Whenever I felt myself losing courage I'd keep in mind what my friend had told me "It's their problem.." and repeated it to myself 'til I felt better.

Of course, I did receive comments from time to time. I dreaded them. Usually an innocent, "What happened to your arms?" was met with a very awkward "Um, ah..erm..", before turning into a very aggressive "WHY?! What makes you think you've got the right to ask?!", before storming off in a rage, vowing never to bare my arms again.

I approached a self-harm specialist and asked how I could avoid getting wound up and aggressive when people commented, and what on earth could I give as an excuse for my scars?

Her answer was simple: Have three or four sets of standard answers that best suit the appropriate situation. I was very sceptical but at the same time amazed that I hadn't come up with it myself. It seemed so obvious!

I try not to wear short sleeves if I know I am going to be around children. I feel awkward about exposing a child to the horrors of self-harm. Sometimes I'm caught unprepared though. (If I know their parents very well, I'll ask if they have a problem with me wearing short sleeves, and how I should approach it if their children comment).

For very young children I say that I had a fight with a big cat at the zoo and the cat won. This usually works and I can distract attention by describing the cat etc. Older children don't buy this as much! I find the age group 8-12 the most difficult. They're not silly. They notice everything and are very inquisitive! Usually I'll just say that it is a big secret and that I'm not allowed to tell. This usually goes on to be a guessing game as to how I got the scars. The best answer being that I was "Just like Harry Potter" which made me laugh! One time a child had been particularly persistent and out of exasperation (and with the consent of his mother) I told him that it happened a long time ago when I was ill. He thought it was some kind of operation that I'd had, so all ended well.

If someone is genuine in their concern and reasonably well informed I'll just tell them the truth. The response to that so far has been good. For the deliberate troublemakers I'll say "If I told you that, I'd have to kill you..." smiling sweetly as I tell them. After that I'm often asked if I "Work for MI5 or something?" Further silence on my part convinces them even more..

Standard replies make things a lot simpler. Getting them out for the first time is very difficult but once you've said it once, it gets easier each time.

If you feel constrained by scars, but want to break free, it CAN be done. Just start small and gradually build things up. It isn't easy - the first time is the worst but it does become more natural as time goes on. I never thought that I'd ever have the courage to wear short sleeves, but I did it! Before the start of every summer I get a little apprehensive because I'm out of practice, but it doesn't take long for me to get back in to the swing of things again - I just do a little refresher of starting small and building up.

If you feel you just can't do it, there is a camouflage clinic formerly run by the Red Cross, but is now run by "Changing Faces". You can go through your GP. It wasn't suitable for me as my arms are very dry and the make-up wouldn't sit right on my skin. I prefer to not wear it anyway as it can be a bit time-consuming.

There is a certain vulnerability in exposing something that happened in a very dark period in my life but my scars are just part of who I am. I don't remember what my arms were like without them. They are just "there".

Wearing short sleeves doesn't bother me now. I don't even think twice about it.

I'm really thankful for the people who supported and encouraged me to be able to achieve this. If it wasn't for them, I'd still be dreading each summer as it comes along.

Kerry.

Mirtazapine withdrawal.

I had been on Mirtazapine, (also known as Remeron or Zispin) for well over 5 years. I never felt it did very much and the side effects of the drug were hellish.

Much to my despair I was told I'd be on the stuff for the rest of my life because my depression had been so treatment resistant. I hated being on it - the side effects were worse than the depression! My mouth was so dry I could literally go for hours without the need to swallow which put an end to my singing activities. I had vivid and disturbing dreams. I felt drowsy most of the time and couldn't get through the day without napping. I had the famous hangover effect in the morning. I kept involuntarily biting my tongue when my jaw went in to spasm. I had terrible food cravings for all the stuff that was bad for me, but I think the hardest to cope with was the continual thirst which accompanied the dry mouth. I got through at least 4-5 liters of water a day just to get by, and even then it wasn't enough. As a result I was peeing all the time, up through the night 5-6 times to go to the toilet and I never got a good refreshing sleep. I also wanted to have children in the future and I wanted to be off the drug before this situation even came up.

Summer 2012. I was told I would be getting a new consultant. The thought of somebody new was scary but I grabbed my chance. I explained all the trouble I was having with it. I had my arguments prepared and was ready to go to battle over it, but she astounded me 2 minutes into my plea saying that the drug obviously wasn't tolerable and that if I wanted to come off it, I could. I couldn't believe my ears! I'd been trying to persuade doctors to allow me to come off it for years. (I think if she had refused, I would have resorted to doing it on the quiet. I was so desperate). Amazing what a fresh pair of eyes can do! She did say that she wanted to see me regularly and for me to keep a diary and to withdraw slowly.

I've heard that Mirtazapine withdrawal is awful. Before I started cutting down, I looked at online forums so I would know what to expect but I didn't really find what I was looking for. Most people had been on it for much shorter periods than I had and more often than not the majority of people had given up with the withdrawal because it was just so awful. I knew what the possible withdrawal effects would be but nobody said how long this would last. Weeks? Months? Years even?

Despite knowing this particular drug is difficult to come off, I wasn't prepared for the hell it turned out to be.

I was on the maximum dose of 45mg. I got down to 15mg over four months without any trouble but as soon as I went down to 7.5mg it completely floored me. I ended up in bed for 2 weeks - I just had this huge urge to sleep all the time and I couldn't physically do anything. The consultant told me just to stop the drug completely and skip the last phase. She said that sometimes this happened with this dose although it's not known why.

Things got much better after that. The first night without any medication for nearly 15 years was terrifying. It was about a month sooner than I'd anticipated. What if I got ill again? Was I doing the right thing? I remembered all the side effects I was having and my desire to live a medication free life. My determination kicked in and I took the plunge.

I thought I'd escaped the withdrawal syndrome during weeks one and two. I felt great and much more energetic and alert! It was amazing, but it made me realize how much a zombie the medication had made me.

By the end of week two, I noticed my appetite going. Then a few days later - BAM! The full force of withdrawal winded me. For the first month after I couldn't eat. I couldn't sleep. I had vertigo when I stood up, restless legs when I was in bed and I felt sick all the time. This was accompanied by flu-like symptoms and cold sweats.

My doctor wasn't all that interested, but it was my local pharmacy who helped me the most. They gave me medication to stop the nausea, build up drinks as I was losing a lot of weight and they advised me to keep a continual supply of high protein snacks and water by my bed.

I had to cancel all my engagements for the next 6 weeks. Thankfully things were winding down for Christmas and not much was happening anyway.

I'll be straight with you - it was utter hell. There were several occasions where I felt I couldn't go through with it and nearly gave up. I kept remembering the reasons why I wanted to come off the drug and that the withdrawal was only temporary and this gave me the courage to go on.

Gradually things got better but I'd no idea that the process would take 4+ months. Some days were better than others and I felt I'd made an improvement, then I seemed to go back to square one again which was disheartening.

Often I lost sight of my end goal but I'm glad I persevered with it.

Five months on and I have no regrets about coming off the drug. I feel so much better and my psychiatrist has agreed that I made the right decision to come off it. I have since been discharged from mental health services.

Any lasting effects? Yes. It took a long time for my sleep and eating patterns to return to something resembling normality. It's only in the last few weeks that these have got better and I've had to adapt to a whole different schedule.

I used to need 10+ hours' sleep a night plus daytime naps and I never felt refreshed when I woke in the morning. Now I'm tending to get 6 or 7 hours' sleep a night. Sometimes I feel really refreshed, sometimes I don't. I'm hoping this will eventually increase to 8 hours' sleep a night but it is much better than the zero sleep I got once the full withdrawal kicked in. I had a lot of excitement when I started dreaming naturally again. It took a while and for me it was a sure sign that my brain was adapting without the drug and beginning to heal.

My appetite is nowhere near what it used to be and I've never regained the weight I lost during that time. I'm now the same lanky shape I was as a teenager which is my natural body type. When I was on the medication I would put on weight even if I sniffed a delicious cake or bun, but now I find it very hard to put on weight.

Mentally I am much more alert and my friends say that I am actually 'present' now whereas before I tended to have a vacant glaze in my eyes. My memory is slightly better but this can go again when I'm stressed.

The main lasting downside is that I am more anxious than I used to be. It's annoying at times and if it gets very bad, I go to the gym and burn it off on the treadmill which is very effective.

I've not had the complete mental collapse I was expecting. Depression-wise I'm not any better or worse than I was when on the drug which confirmed my belief that the drug had no effect whatsoever.

If you are considering coming off Mirtazapine, be warned. It is not easy. Talk to your doctor about the options. It was better for me to come off the drug, but this might not be a suitable option for another person. Often, other antidepressants can be found which can be as effective without the same side effects. If you are wanting to come off antidepressants altogether sometimes switching to a drug with fewer withdrawal symptoms will make things much easier.

If you are really determined to come off the drug, hang in there and keep going - it WILL get better, I promise! You just have to keep your end goal in sight and remember why you are doing this. Give yourself plenty of time for the whole withdrawal and expect that some days will be a lot worse than others. Be very kind to yourself. Try to eat well if you can. I couldn't eat for the first month, but I had a stream of friends bringing in nutritious snacky supplies which kept me going.

If you are considering withdrawal, it's wise to let people know that you might be out of action for a while. Before I came off Mirtazapine, I was very stressed and busy. I used the initial month to have a complete break from everything which was nice as this window of time doesn't often come up, and I went back to "life" refreshed and rested.

Good luck!
*NOTE: This link was recommended in the comments section by a fellow poster. It covers many aspects of withdrawing from antidepressant medication and looks very helpful. I'll put it HERE to save scrolling! 


(See also Mirtazapine withdrawal - 6 months on.., Mirtazapine withdrawal - 9 months on.., and Mirtazapine withdrawal - 1 year on.. 

What happens after Suicide?

I was quite religious in my youth. Too religious in many ways. Instead of being a source of comfort, hope and peace, it was years of guilt, doubt and pain. Between the ages of ten and twenty I wanted to be a nun, but no matter how hard I tried, I couldn't be the perfect religious model that I aspired to. Every little thing I did wrong I beat myself up over it. In retrospect I believe this was one of the contributing factors to my breakdown at the age of 21.

I attempted suicide many times when I was ill. And it always caused me a great deal of anguish. This was a bit more serious than whacking my brother when he got cheeky or telling the odd fib to get out of doing my homework.

Obviously I never completed suicide, but I was still haunted by what might have happened had I actually been successful. 

A while ago I bumped in to a chaplain at a hospital, and over lunch I confessed my troubling fear. I wish I hadn't. When I asked what would have happened, he replied that I would have gone straight to hell. Fair enough. This is what he believes.

With a sinking heart I then asked him, "What on earth do you do if you are in such constant emotional pain, lasting months, that nothing will help to relieve, and you can't bear to be alive any more?"

He said that one had to weigh up the options, consider the consequences and just not do it. Hmm (thought I)..It's a lot more complicated than that!

With an increasing sense of guilt and panic I gave up, and had to exert a lot of self-control not to lose my temper with him. Don't get me wrong - I wasn't angry at him for having his beliefs and I admire him for sticking to them. He just handled the situation without sensitivity. He will encounter this dilemma frequently and with people who are on the edge and very vulnerable. I'll let him off the hook though - It's possible that he was not experienced in dealing with this sort of thing and I am well known for overreacting in highly charged situations!

Since deciding to leave religion things are a lot better and I feel more at peace with myself. I try to live my life in a mindful way, and to be kind and loving. I don't believe in organised religion any more, but I do believe that there is a "higher power" out there looking after us.

I don't think about the 'hell' thing these days. I prefer not to. I can't live the rest of my life in fear because of my past decisions. The way I reconcile myself to it now is that I was very ill at the time. The emotional pain was too excruciating to bear and I couldn't take the torment any more. I felt justified in the actions I took at the time. I didn't intend any evil or malice. It was simply an end to a life of torture.

Kerry.