Sunday, 28 October 2012

Clock changes, CPN's and irritable mood

Yep, new technology is great but I was still unsure as to whether my phone would automatically update, plus mum's boyfriend changed all the other clocks in the house this morning which I wasn't expecting and so ended up being totally confused.
Last Tuesday, as promised by my GP, my referral to mental health services was met by a meeting with my CPN.  We went through my history (as much as we can in an hour) and she filled in all the paperwork blah blah blah.  She said that I would be discussed at their case meeting which was held on Thursday and she promised to telephone me when they had decided what would happen next.
In short, she told me that I was not a priority and that I would be "discharged" from their care.  I had explained that in my meeting that without ongoing support and not just being invited to attempt to get through on their "crisis" hotline, that I would very quickly become a priority but apparently preventative care is not somehting in their remit.
Prior to hearing back from her, I received a report from my Swiss Psychiatrist which arrived after the meeting with the CPN and prior to seeing my GP on Friday.  Although I could only summarise my diagnoseseseseses [sic] in my CPN meeting it perhaps would have been helpful for her to read this report prior to them making a decision about me.  The support I will now get will now consist of telephone helplines and self help groups (surprisingly there are a lack of these in York and from what I have heard, a waiting list.
So, back to my diagnosis. It should be explained that in Europe they tend to refer to the ICD-10 rather than the DSM-IV. From my (Swiss) Psychiatrist's report:

"My diagnostic impression was that of both a type II bipolar disorder and a personality disorder with both dependant and emotionally unstable features. The illness was complicated by both an alcohol binge drinking disorder and thyroid disease."

Hmmm....so far, pretty much what I knew, although the "personality disorder" is a new one on me.  Let's read further.....

"Diagnosis
Axis I Type II bipolar disorder (ICD-10 F31.8)
Alcohol abuse (binge drinking) (ICD-10 F10.1)
Axis II mixed personality disorder (dependant/emotionally unstable) (ICD-10 F61.0)
Axis III Hashimoto Thyroiditis
Axis IV Finances, relationships, familiy of origin
Axis V GAF:35-55"

OMFG.  It feels so strange to have this summarised so clearly.  During my treatment with Dr.I in Switzerland I had muddled in my mind the various clinical opinions offered to me and to where I "fitted" in.  But to finally have it summarised and obviously my mixed personality disorder has been in denial about some of the Axes, but subsequently I have been mulling over the fact whether this is useful or not.  Will the label control me, or do I control the label?  Do I need a label anyway? I find it interesting that with a physical illness we are usually fine with a diagnosis and the labelling of such so why am I questionning the same for a mental illness?
How about the GAF? (For those who have not heard of this, it is the "Global Assessment of Functioning, a numeric scale of 0-100).  An assessment of 35 - 55 falls into the following area :
51 - 60 Moderate symptoms (e.g., flat affect and circumstantial speech, occasional panic attacks) OR moderate difficulty in social, occupational, or school functioning (e.g., few friends, conflicts with peers or co-workers).
41 - 50 Serious symptoms (e.g., suicidal ideation, severe obsessional rituals, frequent shoplifting) OR any serious impairment in social, occupational, or school functioning (e.g., no friends, unable to keep a job).
31 - 40 Some impairment in reality testing or communication (e.g., speech is at times illogical, obscure, or irrelevant) OR major impairment in several areas, such as work or school, family relations, judgment, thinking, or mood (e.g., depressed adult avoids friends, neglects family, and is unable to work; child frequently beats up younger children, is defiant at home, and is failing at school).
Now this I can identify with. Interestingly, swiss psych says keep in touch and I can always talk to him/ask questions if I need some additional help.

As for the rest of my week:
Saw my GP Friday, gave him a copy of the report.  See him again in 3 weeks.
Helping my sister in the shop she manages as they are opening a new sales floor. Long days.
Increasing irritability at living at mum's.  It is not her fault and I am finding myself taking a deep breath before I say anything so that I don't come across at annoyed at everything she says, but I am finding it very difficult.
Feeling low and upset; particular incidents which have affected me include hearing that it is snowing where I used to live in Switzerland and buying the wrong curtains for my sister's shop as I misunderstood her.  Wise mind says it's just miscommunication/snow, it's no big deal but MY mind is not rational so I have been feeling that I have done something wrong and that everyone back in Switzerland are having a great time and will be skiing within the week (not true, the snow will melt before it comes back).  I cannot get these repetitive thoughts out of my head.  Also, I have been feeling some detachment - my hands have seemed to not be of my own and I keep imagining I see someone out of the corner of my eye.  Plus I was pricing up some Crystals today and it felt like they were trying to convey something to me.  Mind you, I did take my medication really late today so I am putting it down to this. I am also extremely tired from all the hours I have been working for my sister and am worried that I will never handle working full time in my new job (which starts on 5th November).
So, in summary I am exhausted, emotional, unreal and anxious.  Not a bad week really.

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