Seriously what next?

[Ihaveaquestionn]

Background - I’ve had anxiety/depression since 2016 related to chronic pain which has never been properly resolved but was coping okay

Had a baby in 2021 - things were going okay until he was 8 months old when I woke up suddenly panicky. This escalated to intrusive thoughts, constant fear, suicidal feelings. All related to myself, my past failures (why have I never been able to resolve my chronic pain, did I marry the right man and other random things I’d done as a child or teenager that were embarrassing/immoral)

Admitted to mother and baby unit and had a horrendous experience. Was essentially discharged without a care plan and left to carry on. I improved over time, went back to work etc. Was on sertraline and Quetiapine.

This level of functioning continued for around a year. Looking back I was not okay I was simply pushing myself through the day and avoiding any time alone, unable to relax etc.

In November my husband convinced me to stop taking my medication as I was still complaining of some anxiety and chronic pain… I’m sure you all know what’s coming.

Life stressors, massive relapse. Back on meds but no change. Swapped to fluoxetine, no change. Had a horrendous reaction to venlafaxine and now on mirtazapine which is making me extremely tired and angry but doing nothing for depression/anxiety.

I have been under the crisis team three times since January and keep being discharged back into the community on a new drug that ends up not working.

I am extremely suicidal and get through the day by simply holding on to the tiny slither of will to live I have because of my child. I can’t be alone, can’t drive, go out alone.

being around my son is unbearable because I can’t cope with him at all.

The next medication being suggested is Duloxetine. I have no hope left in medication but will try it anyway.

I’ve got to the end of this and realise I don’t even know what I’m asking. I just can’t live like this anymore it’s been this bad since January.

Cant have therapy at the moment as literally cannot process anything people are saying. It’s like nothing makes sense. Can’t focus on a book or tv. Can just about do a crossword with my heart racing and constant intrusive thoughts.

Am I literally fucked or does anyone have any words of advice

I’m hoping it’s a sign he’s seen the error of his ways in telling the OP to stop taking her medicine, to ‘let go’ and go to the gym more to get rid of her mental health issues. 😑

Oh no he still told me yesterday that if I would just exercise that would cure everything. In his defence he just doesn’t know what to do/say

Just deal with one thing at a time. The team you've now got around you will help you get off that when the time is right.

This is very sad to read. His ignorance in the face of his wife’s illness, no matter how much money he’s throwing at it, is grim.

I exercise all the time but still have been under the crisis team

In his defence I’ve had chronic pain and moderate anxiety for 6 years and he’s been a shoulder to cry on (sometimes daily) for that entire time. And he always told me I needed a healthy routine including exercise and I just never managed to stick with anything as I’d get so despondent every time I tried and my pain was worse. Since my anxiety has become severe again (I had a 6 month crisis episode in 2021) he is just repeating the same advice as I’m not sure he knows what else to say at this point. He’s been a huge emotional and financial support over that time but has never suffered mentally so can’t quite comprehend what I’m going through. He’s a saint for still being here to be honest

That’s helpful to hear thank you

Can you check in to a private in patient clinic? Do you or he have private medical?

I was in your position 12 years ago when my DS was 2. My private medical covered psychiatric and funded 4 weeks inpatient.

You do need to be in somewhere - it’s a case of “stop the world, I want to get off”.

He has private medical but not sure if it would cover this. Could check.

my family could fund it. We’ve discussed it many times but I was told by the local crisis team that I wouldn’t get better on an adult ward as they are chaotic and would make my anxiety worse

Please do definitely check.

You need to be in patient. I don’t mean an NHS adult ward, I mean a private clinic (such as Priory just as an example). You don’t go via NHS crisis team. You need your psychiatrist to confirm you need inpatient (and ask them for clinic recommendations), then the private insurance would approve, they’d give you a list of private clinics, you then contact the clinic you want and get yourself admitted. Or skip the insurance and self fund via your family.

If you have any way at all to access private inpatient treatment, you need to grab it with both hands and make it happen. It will save your life. Get calling, ASAP.

I just wonder how long I’d have to be there as apparently my case is “complex” due to long standing anxiety and health issues. I’m not resisting treatment but I’m so desperate and impatient at this point I worry I would feel very isolated. Did you just have straightforward PND? Not to dismiss how awful that us

A month there would help you step out of everyday life and reset yourself, eat, sleep, rest, reflect, get the correct medication, be looked after, have intensive 1:1 and daily group therapies, art therapy, music therapy, fresh air, no demands, no chores, no responsibilities for other people, few decisions, etc etc. Total stop and reset.

You will be surrounded by other people in various similar situations to you, and you’ll build connections with them (I am still in touch with some 12 years later, and will never forget any of them). It’s not lonely or isolating, it’s very therapeutic and comfortable.

I had severe PND, anxiety, insomnia and PTSD.

You need to do it.

Were you unwell for a long time beforehand? I feel like I have so many bad habits and all this is so deep rooted

Yes anxiety since age 6 and depression since age 16. My DS had just turned 2 and I’d been begging for help since the day after he was born. I first had suicidal ideation age 16.

You are not too complex for this. The month or however many weeks as an inpatient is the start of you getting a life back, not the start, middle and end!

No more obstacles or excuses.

Hi OP your thread really resonated with me, I have had problems on and off since 2015 and my MH collapsed about 10 months after DC1 was born (in NI, a country with no proper psychiatric care for new mothers). I got that feeling of detachment like the whole world wasn't real, or like it was all a fog and I couldn't break through it to reconnect (I can't explain it very well).

I was on the medi-go-round for ages with trying and failing various medications. September last year, 10 months after DC2 was born, having moved to England, I hit crisis. After my first attempt to end it all, the paramedics called the crisis team. I wish they'd just taken me into hospital. The crisis team were useless and sent me back to perinatal who refused to help because "they're not a crisis team". In November, perinatal discharged me with no handover or care plan just like you. Finally, I got in with adult mental health in Jan (after 7 more attempts to end it all), who found I'd been diagnosed with bipolar years ago and no one told me. We've worked out that SSRIs (like sertraline etc) make me feel better for the first couple of weeks after they start to work, then they massively destabilize me and leave me stuck in constant mixed episodes.

These mixed episodes are when I'm most vulnerable to intrusive thoughts. These mixed episodes look very similar to "quiet" borderline personality disorder, but in my case, they're actually bipolar episodes that are episodic and need treatment with medication. I now believe I was stuck in one of these episodes for years because I was treated with SSRIs instead of antipsychotics.

So I got put on olanzapine. It worked to sort out my moods but it left me feeling very sleepy. It shut down those intrusive thoughts quite a lot (mine tend to be intrusive suicidal thoughts out of nowhere) so I stayed on it and it's been much better than quetiapine for me. There is a massive long list of antipsychotics and mood stabilisers before you get anywhere near needing lithium.

What I've also found has helped, and I don't know if it will help you, is something called "sitting with your discomfort". Basically, instead of fighting the intrusive thoughts or giving them airtime or thinking "what if they're right" or responding to them in any way you just sit with them.

After doing this for a month or two the intrusive thoughts have stopped for the first time since 2015. Here's an outline of how to do it (I know it's talking about painful emotions but I do it for intrusive suicidal thoughts instead): https://laconciergepsychologist.com/blog/sitting-with-your-painful-emotions/

You may need to read several different versions of how to do it to find the one that works best for you, and practice for a while, before seeing any results (and it might not help you at all) but it has totally killed those intrusive thoughts I used to have. I just observe the thought and tell myself to sit with it.

Since the intrusive thoughts have gone, the depression has finally started to clear. I think medication helps you get a handle on the problem but in my case I needed to follow it up with proper concrete therapeutic action.

Also, have you ever had DBT (dialectical behavioural therapy)? They're seeing evidence that it can be helpful for a range of mental illnesses and it's difficult to access on the NHS but you can also get it privately.

Well shit I just googled mixed episodes and that sounds EXACTLY like me right now… the agitation and racing thoughts and guilt. Especially the detached feeling I know exactly what you’re trying to describe. I don’t feel I can read the article you sent as I’m so much distress at the moment but am going to raise with psych asap. How are you functioning now?

SSRI's were very unhelpful for me. When I eventually got diagnosed with bipolar disorder it was explained SSRI's trigger mania. The best thing for me was coming off the, there is very good treatment out there that can calm you and create headspace. The therapy you had sounds like something from the 1970s. Get a registered psychotherapist to work on intrusive thoughts. Anyone can claim to be a 'therapist'.

I would say it’s more constant racing thoughts related to why I am like this and the sense of unreality/disconnected I am suffering with most. And obviously feelings of hellish agitation and anxiety. Not sure if that all fits. It’s all such a mess!!

It may sound far fetched but Google hypomania in 'rapid cycling bipolar'. I'm not saying you might have this but look up the racing thoughts in hypomania. It's a horrible, uncomfortable nagging feeling of agitation mixed with obsessing on failure and guilt for me. I know this fits for others with different or no diagnosis. But the treatments might help or just researching therapy ideas for this. Simple things are often the best, swimming, walking, stress balls or something therapeutic to divert energy and get tired.

Yes it does fit and the constant thoughts are distracting me from life creating the detached feeling. I just don’t feel like I have a proper sense of my “self” during these episodes I can’t explain it

Keep pursuing healthcare and tell them you've looked into some conditions. If it resonates ask for a full assessment. When I am "in" an episode I have zero insight into anything. I feel disconnected, frustrated and nothing calms me. Before I got the correct meds It would escalate, need for sleep decreasing, agitated at night, restless legs etc. I am on fantastic meds now but it took time. The only thing that helped was me being v pushy about being assessed by a psychiatrist. I use valium diazepam every now and again when I feel agitation starting and for me it if I get it early enough it stops it dead and calms me down. Don't give up keep pursuing your Dr for help.

I've heard the racing thoughts described like a flock of birds flying through your brain while you're trying to think. Usually, bipolar is diagnosed based on having had at least one separate manic or hypomanic episode. For me, this was diagnosed based on my history, particularly at uni where on one notable occasion, I went 3 days without sleeping, and my spending habits.

I am doing a lot better now. Bipolar is never truly gone, but I'm between episodes at the moment for the first time in years. I have to be careful about certain things like managing my own money and not trying to buy things for everyone I ever met. I have ADHD as well just to complicate everything, and I have found being on olanzapine and an ADHD stimulant together has solved all of my mental health problems. I have a job for the first time in 8 years, which would have been unthinkable last year, and better still, it's a meaningful job that uses my skills/qualifications. I am managing to look after the children. And I am making plans for the future and feeling cautiously optimistic (again, this would have been unthinkable last year).

In a crisis, there is a very fine line between bipolar mixed episodes, ultra-ultra rapid cycling bipolar disorder, and borderline personality disorder, which made it very hard to get the correct diagnosis on the NHS because their lack of funding means they almost exclusively only saw me in crisis.

Well I’m now under one of the best psychiatrist in the UK so hopefully he should be able to diagnose, as “anxiety” just doesn’t make sense to me anymore.

weird question but did you ever just have the feeling of not being yourself at all. Hard to describe but like you can’t quite find your “self” to keep you grounded

Just want to say about your headaches. I get migraine in phases but the lay one was going on for months of having it every other day or two. I started a diet and stopped eating gluten every day and I think it might actually be affecting it. I’ve not had one for 4 or 5 days now

https://www.nhs.uk/mental-health/conditions/dissociative-disorders/

I’m sure you’ve already read all of this but just in case. I googled depersonalisation disorder.