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Posts Tagged ‘recovery’

This New Year seems a little odd as I’m leaving for Nepal in just under two weeks (Jan 14th!), so am certainly starting the year in a different way to any that have gone before. I’m not usually one for lots of resolutions and reflections on the year, as for me, having been in full time education for nineteen years, the year starts in September, when I move forward academically and get to buy a new set of highlighters. In spite of that, given that I turned 24 a few days ago, this turn of the year does feel a little different.

2011 was certainly a year of challenge and brick walls, more than I could have anticipated. It was also however, in the end, a year of triumph. I beat the challenges. I scaled the walls. I did not give up, although at times, I was so perilously close to doing so. I started 2011 on such rocky ground, unstable on medication that was making me dangerously ill, terrified of starting counselling, and with the odds more than stacked against me academically. I started 2012 on a new medication that I think is working, (despite the first three weeks being pretty awful), with counselling behind me, and the promise of a first doctoring job that I will love come August. 2012 is starting with hope for the future, whereas its predecessor began with nothing more than apparent desolation and a need to dig deep to find a promise of hope.

When I was first starting out on my journey into Christianity, two things that held me back were both a disbelief that God can heal anyone’s wounds, and that He certainly wouldn’t bother touching mine, but also a staunch fear of being healed and changed, of laying down arms and seeking guidance and solace from the road I’d been on. I believed I was too broken to ever even attempt wholeness. I thought I’d be fractured and empty forever. I was certainly not living life to the full. I was half dead.

I’m not saying at all, that now I am completely healed, that I went into last year with seams and came out the other end seamless; but I’m a lot closer to feeling whole than I was. That gaping, aching hole, is starting to fill. God stuck with me through last year and stayed with me as I tossed and turned away from Him. I believe now, that God does heal, with time, as a slow process in many instances, so slow that you doubt it’s even happening. It does happen.

Happy 2012, guys!

I leave for Nepal a week today and am planning on setting up a travel blog that will be completely separate to this blog. Once it’s set up, I’ll post the link up in case anyone wants to follow what’s happening.

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I had my last counselling session with L today. It’s been almost a year since I first met her, almost a year of our weekly meetings, almost a year of my tears and frustrations and setbacks.

Given my track record for people letting me down when I tried to trust them as a youngster, or the bad attitudes I got from people who either knew about my dad’s drinking, or just expressed a general opinion towards alcohol misuse, and coming from a family so emotionally desolate it could be the Sahara, it’s no wonder that I was so afraid of trying to open up. It’s no wonder, I found counselling such a challenge.

Sticking with it, is possibly the biggest proof I will ever have of my tenacity and determination. I never missed a session, even when it was the last thing I wanted to go and do. I’ve had a year of being totally drained on a weekly basis, and then having to go and try to live normally in the spaces in between, until the next strike. It’s the hardest thing I’ve had to do – a year of finding bravery. I’ve managed to purge a few of my demons and get some light into the parts of me that were pretty disordered and dusty. I’ve learned to accept and give my issues with alcohol a name, and because of that, because I’ve come to terms with having different thresholds and boundaries for dealing with it compared to a lot of people, it’s that bit easier – I don’t need to drive myself half crazy with it, anymore.

I’ve said before that I have a feeling that had L and I met on other terms, we would have got on very well. I’m going to miss her, in a lot of ways. Having a constant person in my life over the last year, has been a lifeline, even if that was really mostly because she’s so nice I didn’t want to upset her by failing to turn up, or worse. I have her some homemade shortbread and a thankyou card today, and was shocked when she looked genuinely sad and said she’d thought about getting something for me, but wasn’t sure about protocol – I was pretty touched. I think she’s sometime more open and puts herself on more of an ‘equal par’ with me than a counsellor probably should – but I also like that she’s been that bit more interactive than a more experienced person might have been – I always quite like it when she got visibly angry about the med school lot being rubbish, or something going wrong.

I never thought that when I finished with L, I’d be back in the middle of depression. All of this, is pretty bad timing, with me going away in January. But even in spite of feeling flat and low and empty, even in spite of being jittery on meds and exhausted from not sleeping, and anxious about my workload and all the rest, having untangled myself that little bit this year, makes it so much easier – I’m on more solid ground, I’m not coming from this emotional poverty, this inner warfare, that plagued me for so long. I’m thinking straighter, more able to formulate and follow a management plan.

It’s been a strange year, so marked by a struggle to get through that other landmarks sometimes went uncelebrated. Academically, I beat a lot of odds – I passed and passed well, when no student in my situation had done so for several years. I got a high enough score that I can get a job I will hopefully love. I delivered my first baby, fed my first lonely newborn, saw my first death, compressed my first chest in hospital. I preached my first sermon and learned about the power of the church community to heal, as well as do harm. I stitched my first scalp and sited my first cannula. I went on my first roadtrip, with two good friends and one grandma. I came close to losing my faith, and yet all it did was grow stronger and knit itself even closer to me than it had been before. I learned to talk about my past and issues and to find a voice that had been lost for years. I learned how to begin to heal. I learned how to let God, heal me. L was there through all of that – and I thank God for her, every day. With counselling ending for the time being, and the letter/email last week, I kind of feel that although I’m in this new phase of depression, last year is over and a new phase has began. I think this phase will be better.

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I possibly did something a little foolhardy last week. I’d been thinking a great deal on the last interaction I had with the person from my church whom I (misguidedly) confided in, when I was at my illest last year year, who subsequently broke my confidence (apparently I was suicidal enough to justify that, whilst leaving me alone, knowing that she was going to do that was absolutely fine…..cue dangerous situation) and made it incredibly difficult to both access the help I needed, and also go back to my church at all. We haven’t spoken since – although I sent thank-you emails after a sermon she gave to the students, she didn’t reply. It’s been pretty awkward. I don’t feel bitter or angry about it (though some of my friends would still quite happily lynch her) – but it felt so unclosed that I needed to do something.

So – I wrote her a letter, basically apologising for putting her in a difficult situation, but also asking that if she finds herself confronted with someone in a similar situation again, that she acts differently, as if someone is serious enough that you need to get someone else involved – they shouldn’t be left alone, and also that if she’s going to volunteer for being a pastoral support to someone, that she honours that by answering emails and actually getting back to them when they need it. We’re all learning – I am learning, you, reader, are learning, and she is learning – but there are some places where acting incorrectly puts someone else in danger, and I think people need to know where they’ve gone wrong so they can do better the next time. Last year was a mess, and no one knows that more than myself. To move forward though, we have to repair what’s gone before as best we can, we have to put the protections in place to prevent history repeating itself. We are all learning. I also said that I still pray for her, and that I am sure God will use her and her faith.

I’m not sure at all what I expected back – maybe just a short note saying that next time, she would better know what to do when faced with someone in crisis, maybe even an apology if I’m perfectly honest. I got a one-line email informing she’d received the letter and no other comment. Harsh? Possibly. There’s not much grace, there.

In some ways, this demonstrates well that I am better off with her having absolutely no involvement in my life, faith, illness, or recovery. It also shows that as I knew, we are very different people, and that I am glad for that, because I wouldn’t want to be like she is. When I first met her, I thought she had such a good faith and was such a ‘good Christian’. Now, I am not so sure. I’m nowhere near perfect, but I am not short on compassion (possibly over-imbued with it, at times) and I am not ashamed to admit mistakes and learn from them. Her reaction says a lot about her, I think. I hope that she does learn something, from our encounter – and sometimes I think that maybe that was God’s plan from it, that something good could come from my deep despair, that someone could benefit from my deep depression.

In other news, I saw the GP again on Tuesday and after hearing (and seeing my panda eyes) that I’ve literally not slept since starting the sertraline, she gave me some zopiclone (non-addictive sleeping tablets) to try. I was pretty wary of them, but after trying one, slept so much better and felt so much more alert the next day, that I think it’s ok to use them to get me through the adjustment period on the new medication. I’m still feeling very nauseous and am generally very flat, but I’m hoping that if I sleep  better (ie at all), things will improve.

I also met with the organiser of the paeds module this week as mostly due to said lack of sleep, I’ve just not been performing that well and have struggled to get everything ticked off. He was so lovely it took me by surprise – everyone else from the medical school has made me feel like a slacker, or a problem, or a weakling, but he was so kind, and knowing that I don’t need to panic quite so much about everything makes a huge difference. Hearing someone say ‘it’s not your fault, well done for getting things in place, and let’s see what we can do to make this easier’ was something I needed to hear. I’m so thankful for him.

So – it’s been a mixed week of blessings (at last, a lovely GP who listens and acts), the paeds guy, and some of my friends, who have been wonderful – and this not-quite-closure of the letter and its response. I feel like I did right though, by writing, even if the response wasn’t quite what I expected.

thanks, guys.

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As everything feeling like it’s tumbling down around my ears at the moment, it feels like a good opportunity to write about something different, that I’ve thought a lot on in the last few weeks. Distraction, and all that jazz.

Two years ago, I was finally coming out of a pretty hefty (and probably pretentious) existential crisis. Many of us have these stages at some point, and yet for me at least, my own one felt like something so deeply personal, so totally confusing, that no one else could possibly understand the conflict I was under. This is the human condition, my friend. I had started going to church in late spring, when I suddenly found myself leading a new student charity I’d set up, starting clinical medicine, mourning my first major breakup, and in desperate need of guidance. From the outside, I was soaring – I’d done very well in my neuroscience year, had just finished my term as elected president of one of the universities biggest music groups, and was totally embroiled in my patient volunteering scheme. In reality, I was sinking pretty fast, and using my drive and busy-ness to avoid thinking about things I didn’t want to face. Church seemed like a strange country with a language I didn’t understand – all of these common experiences I’d not had, all of these discrepancies and expectations and exuberance, when I was not exuberant at all.

Being analytical to the extreme, I tried to assuage my doubts by reading as many books about faith that I could get my hands on. By autumn, I’d read all of CS Lewis and moved on to Tozer, and yet still felt so very far from what a person called by God, should be. I fell in love with the familiar rhythms of the scriptures I had heard as a child, but found no chain to link them in to my own faltering courage. As a young person still reeling from difficult family years that were dealt with by pure denial, the idea of a God who saw right through me was just too painful. As a young person who had forged a path of survival by doing a lot of hiding and a lot of glossing over, I felt beyond grace and beyond Jesus. I did not know myself; how then, could God know me?

As I learned more of God in those winter weeks, I ran further and further away. The idea of a distant, obsequeous deity in the sky was one I could handle, someone to follow who did not not look too closely or notice when I wasn’t there. This promise I encountered of a trustworthy, constant care-driven God was more than I could manage. I had little experience of being looked after. I was used to going it alone, to independance and reliance on my own terms. The concept of God as a father pushed me further away; I’d already been there. I’d already been wounded. I didn’t want a God who could see through the layers I’d built around myself. I could not handle a God who knew me for what I really was.

At some stage, my church opened a prayer room and called everyone to go. Being generally quite ingenuous, I took this pretty literally, and, in all of my agnosticism and doubt, with all of my tangles and messes and fears, in I went, always in the smallest hours when my mind stood still and the silence threatened to drown me out. A quiet prayer room, in an empty church, on a November night, with the clock striking midnight, was where I learned to pray. Those prayers were not eloquent, lengthy or self-assured. They were not loud and proud, or certain in audience. They were small prayers, slight prayers, hesitant, stumbling, hoping, seeking.

Somewhere in those quiet, restless hours, I started talking. I starting talking about all those painful things I’d never told anyone – about my family problems and my dad’s alcohol problems and how so often my issues resulting from those made me feel so very cut off, so very isolated. I talked about how confused and afraid my heart was making me. I spoke of my reticence to believe what was laid down in the book open in my lap. It was not easy. And at some stage, I realised that it didn’t feel like talking to thin air, like talking to an empty room. It felt like someone was listening, at last. It felt like someone was caring. It was as though after years of being invisible, suddenly someone saw me. Someone, was there.

That was when I crossed the line between uncertainty and belief, when I changed from feeling lost to knowing that even when I don’t know what I’m doing or where I’m heading, God does. God has only ever been gentle with me. I cannot say the same for our world. I am someone in dire need of shepherding. I am someone in dire need, of rescuing.

These two years have not been easier than the ones before, or lighter, or less disorientating, but without my dependance on God and his Son, I don’t know how I would get through the challenges I meet. God binds my wounds when I am bleeding, he steadies my feet so that I can keep going. He calls me through the white noise of depression and sends his star to guide me home. As a medic, I see pain and suffering and loss every single day, and it never gets easier. But with my faith, I also see grace every single day and it never stops coming. That bond never breaks. I don’t have all the answers, or many of them at all – but knowing that someone does, is a comfort. Knowing that there is a plan, gets me through.

Even now, my faith is not a loud faith, a hands-in-the-air faith, or a faith I shout from the rooftops. My faith is the certainty that in my most silent, most dejected hours, there is something there alongside my heart that keeps it beating. It is the hand on my shoulder that stays with me as I mourn. It is the bursting joy that, on the rare occasions that it comes, tells me that anything is possible and that everything is a celebration of creation. My faith is my own.

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It’s becoming increasingly clear that  at the moment, I’m just not ‘quite right’. I’m feeling a lot more apathetic and tearful, and just can’t quite be bothered with a lot of things. I’m struggling to work productively and find myself crying a lot more than I have for some time. I find myself thinking about things I haven’t thought of since my last ‘fall’. I can’t sing at church either, which seems to be quite a good signpost for things not being right.

In short, I think I’ve officially lost the race against depression again.

This isn’t really that surprising – after all, I’ve had a good five months of recovery after the last and worst dip, but doing these things cold with no medication, is not the best way. And no matter how much I argue that it was ‘best for me’ and ‘the only way I could manage’, it probably wasn’t. I should have pushed to be put on something that didn’t make me so suicidal.  I should have had more courage. I should have realised that like everything on this earth, depression isn’t something you can beat using your own willpower alone. Apathy is my greatest enemy, at times.

The defining moment was realising that my thoughts are getting progressively more negative and dangerous, and although I suppose it’s a good thing that I recognise that they’re coming from an illness which has a solution, and not myself, I’m pretty devastated. I feel like I’ve failed. I feel like I’ve lost the war, at last.

The thing is, I’m afraid to try medication again. I’m going to Nepal for my elective in January, to work in hospitals there, for two months, so there’s not much time to play with drugs and doses. Last time, no one, let alone myself, quite made the connection between how ill I was, and fluoxetine. This was one time when being the eternal perseverer, did not have a good outcome for me. I can’t feel like that again. I’m terrified of feeling like that again – but I’m not sure I have any options left. I feel like a total hypocrite after spending so much time convincing my flatmate to try them, but it feels inevitable. I’m also not really looking forward to going back to the doctors after spectacularly failing to refer myself to the psychiatrist/renew prescriptions/do what patients are supposed to do. It feels like this is all my fault, and that if I’d been just a little less brick-headed, just a little less obstinate, or, dare I say, it, just a little less depressed and incapable, this fall back might not have happened.

I’ve not got much time to play with as I’ve got two essays that need writing in the next fortnight, and there’s a lot to learn in paediatrics too – so I know that I need to act quickly. I know I need to stand up to this and stop thinking I can do it on my own. I know I need to accede the point and then start again from the beginning. It’s like a dreadful homecoming, an unwanted baseline. It makes me wonder if this pattern is going to be all I know, now, of a few months rising and then, repeatedly, falling back and losing everything I managed to salvage. This is a house I don’t want to be in, a party I don’t want to crash, and yet, here I am. I’m stuck  inside the walls again. I’m looking for God in this, and not really finding him.

So – let’s see what happens. I hope all my readers are having a better week than I am.

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I realise I’ve not written too much about my counselling with L of late – mostly just because other things seem to have subsumed them, or my posts haven’t gone up soon after a session.

It still seems odd as the longer I know (as much as you can ‘know’ your counsellor, anyway), the more it seems that if we’d met in other circumstances, we’d probably have got on very well. It’s like that Thomas Hardy poem, ‘the man he killed’ – except unlike in the Boer war, bloodshed is very much frowned upon in therapeutic circles…. The concept is the same though – in other times, in other places, on different terms, our relationship might have been more equal, more balanced. I’ve thought a bit this week about how I’m now past the mid-point in counselling as once I leave for two months in a Nepalese hospital in January, L and I will probably never meet again. I also had an email this week from an old teacher at school, which has also made me think a great deal, as she was the first person I ever told about my dad’s drinking, after I came into school one morning after sitting overnight in A and E, and just completely broke down. She was the first person who listened to me – and when I refused point blank to try any form of counselling, she didn’t push me, and supported me through my final years of school by giving me books (she was a very stoic English teacher and very much subscribed to ‘reading through the pain’ – as do I) and generally being lovely. She also never breathed a word to my parents, which must have been a hard decision to make, but one I am eternally grateful for.

I was sixteen, then. It took another seven years for me to get myself into a counsellors office and capable of staying there. Growing up in a substance misusing household changes your perception of risk, gain, and potential for harm. For me, the risks of opening up were just to great, for too long. I’d lived under the shadow of a tabboo topic and couldn’t break it. There was too much at stake, and too many ways that it threatened to push me over the edge. By the time I had no choice but to go, I was already as far over that edge, that I could go. And it’s taken more courage, each week, every week, than I can often describe.

Yesterday, I hadn’t been thinking too much about what to talk about, but then had an extra half hour to waste as I headed over as I got away early from the childrens hospital, and as I was walking, realised that I’ve felt pretty flat recently. And yes, I’ve been busy and harrassed, and busy again – but I’ve also been a little numb, a little flat, in a way that being busy and somewhat misguidedly listening to the latest deathcab for cutie album,  just doesn’t quite explain (everyone has a band they should have outgrown, but never will – deathcab are mine). I was already crying, by the time I got there. I was already crying, and wasn’t even that sure why. It’s that feeling of mourning something, that I can’t quite shake off, that feeling of being without something, of being tired out and work out and desperate for some relief from the heavy days and all of their requests. I can cry in front of L, now. It does get easier.

Part of it is that I’m over-reacting a bit about a meeting I’m chairing next week for the medical school mentoring scheme that I set up (it’s going very well, which is nice) – and asked for a member of the medical school’s pastoral care counsel to come along to speak to us. The person they allocated is a psychiatrist that the student support person (aka ‘the dragon’, for longterm readers) told about my depression, without my consent, when I took myself off medication and went more than a bit haywire. And although I should be able to say that he’s a psychiatrist and this is what he does for a living, and that he probably won’t remember me by name alone anyway, I’m also terrified that he will and will say something, and I’ll start crying. I’m fed up of feeling as though every single time I feel like I’m getting past all of this stuff, something jerks me back. I’m fed up of feeling like I’m tattooed for life. I’m fed up of feeling as though I will always be judged first on my history of depression, before anything else comes into play.

L was pretty good about all of this, and I do find that I trust her opinion, which after six months, is a good thing. Counselling still leaves me exhausted though – it’s not as simple as being a release, or an outlet. It wears me out. Sometimes everything just feels so dramatic and difficult. Simplicity is a wonderful, enviable thing.

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Elegy to autumn

Now, I’m pretty used to be analytical, and most of medicine is about comparison, either with ‘the norm’, or the other side of the body. To find a pleural effusion, you’re looking at how one lung base sounds compared to the same spot on the other side. To work out if a knee is swollen, you look at the uninjured one. To assess a child’s development, you compare them against what a child of their age and experience ought to be doing.

Perhaps this is why I find myself referring to last year constantly at the moment. This run up to Christmas was the hardest time, in many ways, of all of my time with depression. There were a lot of painful moments, this time last year. I was pretty deadened. The changing leaves didn’t make me look closer for their beauty, but for their relationship to dying, as that was all I was thinking about. Everything was empty. Now, after a week of 9-5 lectures, I appreciate being able to concentrate in a way I couldn’t do for months, last year. I appreciate waking up and feeling exhausted, but not wishing I’d not woken at all. In the last month or so, I’ve got my ‘medical mojo’ back – I can approach patients and speak with them, and examine, without feeling like I’m having a panic attack or that I’m distinctly substandard. When my depression was both in its early, middle and late stages, I had real problems with that – as though patients could see my diagnosis and would assume I was useless, or that I was useless, and would never ever be a good doctor. You have to have a certain level of confidence to go and talk to someone with terminal cancer, or a sick child, or ask to do a pelvic examination. Medicine is no place for wallflowers, and my confidence is taking a long time to come back.

This time of year always makes me nostalgic, probably because it has so much packed in that a lot of my childhood memories are of walking home from school in the twilight, or waving sparklers, or carving pumpkins, or picking apples from the garden to make crumbles. The cold, clear autumn days are my favourites of all the year. They remind me that change isn’t always bad, or forever, and that all phases and stages, both good and painful, end at some time. We move on. We grow.

It was early autumn 2003 when my dad went to rehab for the first time, and deep winter when he came out. When we picked him up, we had to bring his winter jacket as he’d gone in with just a jumper. It was autumn 2005 when I applied to medical school, had my first set of interviews, and felt like my chance of escape was growing closer. It was autumn 2006 when I started medical school, which really was my lifeline, and what had got me through the previous three years at home. In 2007, I lost my last grandparent as the leaves were falling, spoke at a funeral for the first time, and mourned the loss of a generation. This week two years ago in 2009 marks my change, at last, after months of questionning and wondering and fear, from plaintive agnostic, to quiet, startled Christian (this is a post in itself). This week, last year, marks the anniversary of the day one conversation with a person I misguidedly trusted, led me closer to death than I hope to be again until I am old and worn and ready.

The autumn for me is a time of heartsome remembrance, an elegy to what has changed, and what starkly refuses to alter. This year, I am two years into faith and those two years have hardly been easy or straightforward. I remember the wounds of last year, and carry them with me. Those autumn days where my mood was hibernating, marked me. However, my years of faith have marked me more. My faith has survived, my prayers are still stumbling, my heart is still learning. Eight seasons on, I am still singing. Eight seasons on, I still see God when I look at the changing leaves and see the death of the year beginning, in all its glory. Eight seasons on, I can see how much ground I’ve covered, and am able to look forward and wonder where I will be in another eight seasons. This is my favourite time of year.

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