¡Hola de las Islas Canarias, amigos! And a warm welcome to this week’s TWIM. This one may be a little shorter than those of my usual standard – my holiday can largely be blamed for this – but frankly that’s no bad thing, is it?
Possible triggers in this edition of TWIM: child abuse, infertility, benefits/poverty, mental health services being sidelined, general discussion of depression. Plus a shock at the end that some may find…socially unjust, perhaps? I don’t know. ANYWAY…
Sorry to cite a story from the odious Fox News, but the piece discusses a mental health issue I’ve always found intriguing: that of Münchausen Syndrome.
“They did a complete psychiatric assessment of her, and she is not psychiatrically ill in the sense of a major diagnosis like schizophrenia,” Feldman said. “There are no psychiatric excuses for what she did. She has a personality disorder which means she has long-term, self-defeating ways to deal with stress.”
Feldman said that a common misconception about Munchausen syndrome is that it is the same as hypochondria – the obsessive worry that one is suffering from a serious medical condition. However, he said the two conditions are drastically different. “The difference is the sincerity of the belief of the illness,” Feldman said. “People with hypochondria truly think they’re sick, interpreting aches and pains as indicative of severe illness. They don’t intend to deceive others, they just deceive themselves. With Münchausen, they know they’re lying, and they have often had to engage in considerable planning to deceive. They aren’t delusional; they know they or their children aren’t really sick.”
I’m somewhat uncomfortable with Feldman’s turn of phrase in the above passage, especially given that the last book I read by him on the issue was generally sympathetic to sufferers of fictitious disorders. However, this case involved some extensive child abuse; Feldman distinguishes Münchausen by Proxy (wherein someone uses another – often their child(ren) – to gain medical attention) from self-directed fictitious disorder using the following analogy. Suicide is often the result of a mental health condition, regardless of whether or not that’s been identified. Homicide, however, rarely is (obviously the media loves its horror stories about ‘violent schizophrenics’ or whatever, but many readers here will know that that’s completely blown out of proportion). So, he concludes, standard Münchausen ultimately damages only the self (directly, anyhow); proxy cases involve blatant abuse.
Is that a fair assessment, readers? Have you (like me) been on the receiving end of someone else’s factitious disorder, or have you experienced the phenomenon yourself? Is this ‘true’ illness to you, or just excuses?
Mama, Interrupted has come to the end of her intrauterine insemination process – sadly without success
I have very mixed feelings about this. On the one hand, I’m pleased to be moving on to IVF. Depending on which statistics you look at, it at least doubles our chances of becoming parents, and OH and I both have hope that it could actually work. She lost faith in IUI a long time ago, and I’d have been ready to stop after attempt #5, if it weren’t for the fact that one more failed cycle would qualify us for free IVF on the NHS. Even the ‘infertile’ label has come as something of a relief to me, as although you could argue our local NHS has set the barrier too low (are six IUIs really equivalent to a straight couple trying for a year?) it seems to give meaning to the devastating year of miscarriages and BFNs and a cancelled cycle that we’ve just been through.
On the other hand, not being able to have a child semi-naturally feels like a big loss. I’m grieving no longer being that girl who got pregnant first time (well, I still did, but…) I’m grieving a year of unsuccessful procedures and heartache. I’m grieving the loss of an easy and straightforward relationship with God: I cry every time I go to church now, sometimes able to hide it, sometimes not. I cried on Sunday because the hymn we were singing happened to contain the words ‘conceived’ and ‘period’… yes, really. And most of all, I grieve for my babies. Every time I see my youngest niece – who looks like me – she reminds me of what my own son or daughter would have been like. Of what should have happened.
Whilst it’s great that M,I can move on to the next stage of her treatment, I am so sorry that things have not yet worked out for her and her partner. Everything crossed for you as you proceed onward to IVF treatment, folks.
My Crazy Bipolar Life experienced some horrible physical symptoms this week. The cause? Anxiety, apparently. The cause, in turn, of said anxiety? Frustratingly, an anti-depressant. *eyeroll*
I went back into the waiting room for half an hour and then the nurse called me through. I think lovely GP had managed to calm me down a bit as when I was lying on the bed and the nurse was sticking all the little things around my chest, wrists and ankles and hooking me up to the monitor I said to the nurse that I was sorry for wasting her time, that I knew the reading would be normal and this would all turn out to be all in my head. Indeed the reading was normal in terms of beating regularly but the nurse said a resting pulse should be between 60 and 80 and mine was ranging between 120 and 130 so beating almost twice as fast as it should be. But again anxiety was given as the cause of this even though I had calmed down quite a lot. I went back in to see lovely GP and she gave me a prescription for Buccastem to try and get rid of the nausea so I could eat, a couple of Lorazepam to replace my emergency two I’d had to use up and made another appointment for me for next Friday so I can be checked over again then. As always she was very nice about it and very gentle with me and told me that she completely understood that even though anxiety was something that started psychologically she didn’t doubt for one moment that the physical symptoms of it could be really terrifying. She assured me I was definitely not the first and certainly wouldn’t be the last person to think there was something seriously wrong with me and told me that a lot of people will actually phone 999 for an ambulance when they experience a panic attack for the first time because the symptoms can mirror a heart attack so much. So I felt a little bit stupid that I hadn’t realised this was anxiety myself but she told me not too.
Then, just as I was finally leaving the doctors surgery I said to her “I did wonder if maybe my Mirtazapine dose being increased to the max dose of 45mg could be causing me side effects but I’ve been on the higher dose for a few weeks now and was fine for the first couple of weeks so it couldn’t just suddenly change could it?” And that was when she said we might just have found the cause of all of this. She said she could think of at least three people who had tolerated Mirtazapine absolutely fine at 15mg and 30mg and even found it helped their anxiety at those doses but when they increased to 45mg they started having problems. And the problems they started having were??? ANXIETY. And pretty severe anxiety at that. She said the delayed reaction of a couple of weeks was the same for those people as well and she was now becoming convinced that it was the Mirtazapine making me feel so bloody awful. She also said stomach problems were more common with the higher Mirtazapine dose. So the plan of action now is drop back to 30mg and see if the heart pounding and complete loss of appetite and nausea go away. I left the surgery feeling a little bit more reassured that I wasn’t about to drop dead from a heart attack and it did help having the ECG done and seeing with my own eyes that my heart was beating regularly albeit way too fast.
That sounds terrifying. And it’s enraging that, especially as depression and anxiety so frequently serve themselves up together, an anti-depressant can cause the latter (though it’s far from uncommon, sadly). Hang in there, MCBL. Ultimately, I suppose it’s good to know that you’re not seriously ill.
LittleFeet from Chaos and Control laments the state of NHS Psychiatric Services.
I have been reading the news with interest about AMHPs increasingly detaining people in order to secure hospital beds. I hear about national bed shortages. I hear about teams, systems and structures being re-structured yet ultimately from where I sit, this means services are dismantled.
If this stuff happened in children’s cancer care, there would be national outrage. Yet because it’s psychiatry, Joe Bloggs doesn’t seem to care.
And I ask myself, what can I, little old me do about this? I feel so impotent, so powerless because the system designed to help is not advocating for my friends. The system appears to be advocating for itself.
Returning to the title of this post, where is the left? Where is the alternative? Where are the funds for change? What can I do? How can I make people care? I rant and I rave to the people who kindly listen while I share my outrage. But my outrage needs to turn to action. Yet I don’t know how to act, lobby, and make my voice heard.
And neither do I. It is an unacceptable situation, but how can we as (ex-?) service users seek to change it? With funding dropping and media reporting generally not changing, is there anything people with mental illness do to make their voices heard, their shoddy situations widely understood? I don’t know the answer, but I do know it’s high time something changed.
When did you last talk to a poor person? Someone like me who has done it day in day out for 13 years and never had more than £20 a week for groceries in their adult life? Or someone totally unlike me who doesn’t know how to cook or where to start? Or the person who can’t afford heat, light, council tax, bedroom tax and hot food without juggling so hard they’re exhausted? I suggest you need to start talking to us again Jamie, and this time instead of allowing us to be pithy parables of modern British life in your TV shows, you need to start listening.
Then you might understand that those 7 out of 10 families very often don’t have real choices. They simply make the best decisions from an underwhelming selection of poor options and they don’t deserve to be judged by you while they’re doing it. The fact that the family who eat chips and cheese you find so offensive probably can’t afford the £26 your new economical cookbook costs in hardback makes me feel that your current interest in thrift is actually a money making scheme for you. We all have to make a living Jamie, but if you’re going to be a hypocrite, at least be a self aware one. You’ve stopped trying to help the situation, but are simply inflaming it.
I had to resist the urge to scream out, “HELL YEAH!” after reading this.
Sean from All the Avenues Look Ugly is struggling with day-to-day existence.
then early night
i am doing crossword puzzles on the coffee table and have the same song on repeat over and over again and i don’t feel like i will ever grow tired of it but know i will by next week – and i might have a movie on in the background just because i absolutely don’t trust any sort of silence and the song and film are playing well with each other and there are no gaps in the noise – with my phone turned off i have no way to communicate with anybody else. wonderful. i am okay here. my heart starts breathing normal or similar to that. i’m still sad, but whatever.
then late night
maybe a smile or two while i take my medications and wait for them to do absolutely fucking nothing.
and then i fall asleep and then i dream again and i wish the haunting would stop.
i am totally not okay with this.
No words of comfort – and even fewer of advice – come to mind. I do, however, feel great empathy, Sean. I know this existence, and I know how hollow and hopeless it feels. Just know that thoughts and every good wish are sent your way.
And finally, something completely different from the wildcard. It is from, and about, me. There’s narcissism for you.
This is my final TWIM as Editor of The World of Mentalists. Before I explain, let me thank each and every one of you for reading, commenting and taking part in any other way over the last two and a bit years; it has been a genuine pleasure and honour sharing this place with you. TWOM, its predecessors The Madosphere and of course the iconic Mental Nurse – plus the hundreds of amazing individual mental health blogs out there – demonstrate, I think, that conversations and commentary on mental health topics are important. We need to keep on talking and stigma-bashing. I have no doubt Phil (Z), and any co-Editor that replaces me, will move such discussions forward admirably, especially with the continuing input of a wonderful audience.
A few of you had emailed me about writing here. Apologies for not yet actioning these matters. If I don’t before I completely bow out, either Phil or my successor will be able to deal with them. Stick with us
So, why am I retiring from TWOM? Those of you that know me by my real life identity probably already know. You were shocked (though not as much as me!) and I suspect people finding out today won’t feel much different, if they ever read any if my personal drivel when I was writing Serial Insomniac…
I am 26 weeks pregnant. My partner A and I will be parents to a baby boy in December.
Dafuq?! I’m meant to be childfree, right? Right. And I didn’t want to pass my dubious genes on to another generation, right? Right.
Well, I can hardly tell you this was planned. In fact, I didn’t know – I genuinely hadn’t a clue – until I was taken into hospital just over a fortnight ago. At least I was hospitalised because, had I not been, I may well have found out about the baby as I was giving birth to him. No symptoms, nothing, gave it away. I only recognise things like foetal movement now that I know what it is. And before anyone asks, yes; I can assure that I was careful with birth control. Bloody pill…
I still consider having the option of either continuing a pregnancy or having a termination a fundamental and necessary right for women, but by the time we learnt of my pregnancy, we were beyond legally having that choice. And after getting over the initial shock of the situation, I would have found it unpalatable (for me personally; that’s not some sort of edict to others) to end such an advanced pregnancy anyway. So, he’s coming one way or another.
Yet I’ll be honest here; both of us were horrified at first. As stated, we really didn’t want children, and took care with contraception. But every rule has its exceptions, and it failed. So we had to quickly get used to a surreal, unexpected situation…and despite it all, somehow we’ve (mostly) managed that already.
I am scared for the baby, I must admit. I don’t want him to have to suffer through episodes of his mum’s mental illness, or to have to endure the tragedy of one of his own – this was, of course, one of the main reasons I’d decided not to have children. But my obstetrics and psychiatric teams have sprung into action, and I have faith in them to help if either (a) I end up suffering from PND/PNP or another breakdown and/or (b) the wee man, when old enough, starts showing any signs of a mental health condition. And A and I will protect him and care for him and love him as best we can, which I hope will count for something.
A child wouldn’t necessarily prevent my duties here continuing, but let’s face it – they’re demanding creatures. Obviously Mini Pandora is my priority now, and presumably will be forever more. I also have my voluntary work to juggle with him, which despite my love for this place and the Madosphere more widely, has to take precedence over internet meanderings. Baby first, A second, friends and family next, voluntary job lining up thereafter = very limited time for TWOM.
Thus, it is only fair for me to depart to focus on my new life – for our son, for us, for those around us – and for here, and the users of here.
So thank you again. Without my four to five years in the Madosphere, I’m not even sure I’d be sitting here typing this. Medication and therapy have of course been invaluable, but without the support from so many people online – many of whom I am honoured to now count as friends – they would never have been enough. You people are amazing.
I wish all of you nothing but the best for the future. For those that are struggling, may you find a way through your pain to a brighter future. For those who are stable or class themselves as (mostly?) recovered, may that path continue for you. And for the mental health professionals in the Madosphere, thank you for all your efforts both online – and on the front line, where we need you.
Aaaaand back to my last holiday as a non-parent.