Friday, 5 September 2014

Should vs Could

This week I had appointments with both my GP and mental health nurse.

My GP told me she'd spoken to the psychiatrist last week. She wanted to give the psych a good picture of my situation, so they went back through all the letters on my file, back to my first psychiatrist at the age of 12, the bullying throughout my school years, the abuse, trauma, old inpatient psych admissions, a massive overdose at 13; she listed them off one after another, and each one hit like a bullet in the chest.

But the psychiatrist is happy with my current meds, and doesn't want to change my antidepressants because mirtazapine's "the best I'll get". I told her I didn't understand what's changed between them recommending I try the last two antidepressants and now. It's not like I've tried that many either - maybe five total because I refused to take them from age 13-18. I think it made sense to her though, because she said she'd ask the psychiatrist next month if anything can be added to the mirtazapine, because no one seems to want to take me off that. I'm not trying to be a pain. I just want something to make everything slightly less unbearable, so that each day isn't so hard to get through.

On the upside, the psychiatrist agreed DBT would be helpful for me one day, but not at the moment, and definitely not in a group setting, so that's that settled for now.

The GP stressed that we're going to go about things very slowly, because she knows from reading through my history that previous doctors etc., especially ED psychs, have all come bowling in way too hard and fast, which obviously doesn't work for me, so that's not the plan here. I'm just relieved to finally have a team who are willing to work with me instead of against me, and recognize my previous teams may've been wrong in their approach.

At some point she wants me to see a psych, which is fair enough, but still scares the shit out of me. She gave me the name of a psychologist, but said it'd be good if I could work towards seeing the psychiatrist one day. She said she hopes I can get there at some point early next year, and I'd never be pushed to talk about anything or things from the past until I felt ready to. It all seems way too fast but we'll see what the next six months bring.

Then I saw the mental health nurse, and it actually went pretty well.

She asked if I'd been doing any sewing or tapestry or anything, but I haven't really. I told her I feel so overwhelmed all the time, it's paralyzing, and there are so many things I should be doing but I can't do any of them but I can't stop stressing about them either.

She stopped me there. She said 'should' is one of the worst words, a double negative. People with depression and anxiety tend to use it a lot, but it only makes you feel worse. She said there's nothing I 'should' be doing, and I need to learn to say 'could' instead - and I'm not allowed to beat myself up while doing it.
"I could be doing X, and when I feel up to it, I will."
Not "I could/should be doing X, but I'm not because I'm a lazy fat piece of shit."

She asked if I thought I was fat, which seems like a bit of a no-brainer to me. She went on to lecture about body dysmorphia, but I really don't think I'm dysmorphic at the moment. I was at one point, but I think I see myself as I am now, and that is far too much.

She asked if I thought I needed help from the ED services team, and I just said hell no, that they're worse than useless. I told her that when I was diagnosed with AN by their head psychiatrist, it was my first time asking for help with it. In one appointment, he diagnosed me, told me I could "keel over and die at any moment" (no blood tests or obs anything, so I'm pretty sure he was overreacting), and sectioned me. Then when I was finally discharged, I had to keep seeing them until I reached BMI 18, never receiving any actual psych help along the way because they say your brain can't absorb it. When I stopped seeing them as soon as I reached the goal weight, I was told there would be 'conditions' if I ever wanted help from them again, which put me off ever going back. I'd only been sick for about six months at the time, and tl;dr, the whole experience was horrific and I don't plan on seeing them again.

And I had another silly problem with the mindfulness stuff. I'd downloaded the Mindfulness Skills CD, but still hadn't listened to it yet because I didn't know when to listen to it or how to 'use' it. I must sound like a total idiot when it comes to all this mindfulness stuff. So she wants me to listen to all five tracks a few times, pick the one I like the best, and try to listen to it at least once a day... why didn't I think of that?

Those who read all of that, you're a champ and deserve a calorie-free cookie.



  1. Don't have a lot of words today Bells
    Just wanted to stop by
    And say that you are awesome

    Love you x

  2. is that a new picture you've got as your icon? well, it's lovely. it's brilliant to see you in your gaudy choice of clothing. :')
    well, reading about it definitely hurts a bit. i feel a bit of a sickness in my stomach whenever something bad has happened to you. i care quite a lot about you, sweetie.
    and you're not being a pain. wanting things to be a little more bearable sounds like a perfectly reasonable response towards your situation.
    i'm glad the DBT's been settled right now and i'm glad not in a group setting either (!). i pride myself in being less anxious than most people with issues related to anxiety, and a group setting is enough to make my heart race so that is a very very bad decision if she had gone through with it.
    "there are so many things I should be doing but I can't do any of them but I can't stop stressing about them either." this. this i understand and it definitely is a paralysing feeling. it's very exhausting (that's my biggest word for it. every moment of it is exhausting) and it's so unfortunate that you are feeling this way, beautiful.
    with my studies, it was a consistent feeling in the beginning. the only way i had ever dealed with it is knowing that i have always done it, and finished it off and i've not had any problems with my studies so far (though then there's that feeling of "oh, bugger, what if today's the day where everything goes to shit and i fail and never amount to anything ever" and whatnot.)
    funnily enough, i used to use "should" and "could" when dealing with Ollie and whatnot. and she used the same thing on me. it's funnily helpful but at the same time bloody not. it's confusing in its own way. depression is confusing. what annoyed and destroyed you one day gives you no response the other day, and what was alright one day is unbearable the next (one of mine is sound. i used to get pissed off when i heard certain sounds and want to end up crying. if i dropped a chocolate bar, i'd end up crying for hours because i'm a failure at holding chocolate bars. other days, i can drip over the Roman Colosseum and not give a damn).
    that is a very disturbing experience. i hate that you've went through it. i definitely am a believer of the fact that just because you gain a bit of weight doesn't mean that you've recovered from your ED at all. some girls i know are so thin but eat quite a bit (after restoring their weight, usually at small BMIs like 18 or 19) but others get to BMIs or 23-24 and have similar thoughts they did at their lowest (not weight, lowest point of disorder). in all essence, weight means nothing and everything.

    -Sam Lupin
    PS. i've tried TimTams (i thought of you) in Thailand. they are...sickening. but perhaps it's because i've eaten the whole bloody pack?

  3. Funnily enough, I came online today to write a whole post of things that, in short, all revolve around 'should'. Which I hadn't realised until reading this. It's really made me stop and think.

    I like the idea of listening to a bit of the CD a day; hopefully that will help. There's several books on mindfulness on Amazon too; one I found has high ratings across the board from people with depression- maybe a book might help you? In all honesty, I was very close to buying a copy and sending it to you because I so thought of you when I was looking at it. I'm going to get a copy as it's on Kindle too- Mindfulness by Prof. Mark Williams.

    Your previous experiences sound horrific. To me, that's no way to treat anyone with an ED; especially the 'conditions'. I just want to hug you (on tiptoes of course).

    Love <3 xxx

  4. I hope everything goes well and no one pushes you dear :) this GP sounds good, and very understanding.
    I don't think I use "should" too much, but maybe it's just me. The most I say it is "I should be doing homework" and that is very true because I have an obligation to. Although this has opened my eyes and I'll try not to say it too much.
    The ED services team sounds horrible! I think it's too direct and inconsiderate to speak like that to someone who's asking for your help. Very inconsiderate of them.
    I still don't really understand the concept of sounds a bit like meditation to me. I can't do that - I can't focus on things.
    Calorie free cookies? Those exist?!
    Stay awesome and I hope your days get better sweetie :D


  5. I'm so glad you've found a medical team that like you said is working "with" you. That's so important to have doctors, nurses, etc you feel comfortable with. I think it will really move you towards the direction you want to be in with understanding and helpful people in your life.

    BTW: I had my first health promotion nursing lab today, and one of our projects is a Health Modality presentation, (i.e.: yoga, nutrition, and we give examples how it helps your body and make the class participate) well, my friend Michelle in the program with me chose Mindfullness, and it instantly made me think of you, because I don't quite understand it either, but you're always talking about it with your MH nurse.
    The professor even said, that's a tough one to understand and explain,so don't feel bad, we have a room full of nurses and we don't even understand it fully. HAH.

    Anyways, I read your entire post, so wheres my cookie?!
    ; )


  6. In my counseling program mindfulness is definitely a huge deal. It seems bigger than it is really. When you put it all together you see how everything interacts but it's not too hard. What you can do is start by taking into account the things you choose to wear and why you put them on. You can watch your mom and how she holds a fork or what her eyes look like when she smiles. Then, you start to think about how your body feels when you're hungry or tired or anxious. You progress to thinking about what preceeded that feeling or thought. I think it's good for you because I think you disassociate and it makes you connect with your world. Also, I don't think you're seeing things clearly as you're not large. You're tall, but you're the size of my thigh and your arm is probably the size of my wrist. Perspective dear. I'm pushing for the visits with the psychologist and just to explore the "could" of dealing with all the nasty stuff. From personal experience I can tell you it's freeing. I love you. Keep working.

  7. I'm glad that it looks like you're getting a good team behind you (or should it be beside you?). Except for the mirtazapine. Sorry, but I hate that medication. I find it rather strange that they won't try something else (believe me, there are a lot more than five different medications out there).

    I started yoga this week again, thinking I should go to all evening classes; that is four times a week. After two classes I was mentally exhausted. No, *should* is a harsh word. I will go to as many as I can handle, even if that means none one week. We do not do *should*, okay?

  8. Have you tried Ambilify? They added that to my meds and it seemed to help a bit. Thinking and praying for you always dear.

  9. re: my goal is to get to at least 8mm (0g) but preferably 10mm (00g) because 10mm seem to have more jewellery to chose from :)

    (and as Katie I also wonder about Ambilify/Abilify, which has helped me quite a lot during the ten days I've been taking them. In the beginning I took one before bed and slept like a baby, now I take two in the morning and my boyfriend says that I seem so much more energetic and happy than in in a long time)

  10. I really hope the new team can help you :) Take care of you hon.

  11. Hey, you have a really nice Blog with interesting Stuff on it! :)
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    Greetings & Kisses from Germany

  12. I'd like to claim my calorie free cookie please, they would be helpful for binge monsters!!! I'm glad things are slowly looking up and that the team are working with you. I also really like that could sentence thing - seems like this mental health nurse actually knows what she's talking about. York here want to do things slowly too, when I mentioned thed admission date they said they were reluctant to put a date but they just needed to give the funding commisioners a date to keep them happy but that it was flexible. phew. love youuuuuuuu i'll reply about skirt/post stuff on facebook later today LOVE xxx