Dorset Cream & Quetiapine

It's a little difficult to recall the events of yesterday's meeting with Dr A, a psychiatrist. As I write now I'm distracted by two things: an unabated hunger and the sedative effects of my new medication. Oh, and the lady on the television is cooking in a sweet little domestic Parisian kitchen, breaking eggs onto a blue rimmed enamelware bowl.

Alicia came into the meeting with me and we sat in a glass office high above the coastline on comfy, fat, green chairs. On another day, under different circumstances, I imagine we would all have stood silently at the glass, noses pressed into the windows, hypnotized by the tides muted motion.

It was difficult talking through the story again as though it was the first time. I could feel the pressing need to cover a lot of ground in our allotted hour. I found it frustrating spending any of that time answering detailed questions about my employment history, and the occupation of parents and siblings. Perhaps it is relevant in ways I don't yet appreciate. The time line was important too, and I am hopeless at recalling the years in which various events took place. Alicia, helped me greatly with these questions.

I came away with a supplementary medication to be taken alongside the fluoxetine I already take. Quetiapine, a medication used as a mood stabaliser in lower doses. I am to take it daily at 8pm on an empty stomach, which has left us wondering when we should sit for dinner. One could consider eating a late supper after downing the medication, but for the fact that it makes me drowsy soon after. Slumped over my soup is hardly an attractive look is it.

Sorry, you lost me a couple of times there. I keep falling asleep you see. I started writing this post around six hours ago. The birds are singing in the tree tops outside my window. The family have been transplanted to a farm house in Dorset for the week. We travelled along the coast yesterday afternoon and arrived at dusk. The cottage is peaceful. A good place to be unconscious. These days away are a very generous gift from Alicia's grandmother, who overcame cancer last year. Xavier is a human space hopper in these new surroundings.

So the question of diagnosis is, for the moment, unanaswered. But, for the first time somebody spent time asking me about what life is like between the depressive episodes. Making sense of the last three years, however, seems impossible. The experiences are overlaid with the shifting reactions to different medications, the challenges of enormous life changes and extensive periods of poor mental health. From this muddy memory it is not possible to extract a simple story of manic and depressive episodes. It is as though the ink bottle was upturned onto the page and now the underlying story is obscured. Now with this further change to my medication I find it difficult to understand how this won't complicate the picture further. This seems to be the inherent difficulty of diagnosing mental health conditions mid treatment.

Anyhow, I embark on another phase of acclimatization to a new medication. Each time the experiment is unique, the first time this drug has inhabited this body and affected this brain. The notion is that the dose on this medication will be steadily increased as I find my feet with it. Under its influence my mood should become more even, which is something which sits uneasily with me. I have become rather attatched to my own particular vivid experience of this world's beauty and wonder if that is one of the mental creases to be ironed out by Quetiapine. I shall have to wait and see.

Waiting Room Thoughts

In three hours I'll be sat with a psychiatrist for the first time. I'm filled with anxiety. I will have one hour. Perhaps in that one hour I'll be asked the right questions. Perhaps I'll be fit enough to respond meaningfully. Perhaps he will have the expertise and experience to fill in the gaps that one can't cover in an hour. Perhaps he will understand how important that one hour will be to me. Perhaps.

Depression takes several forms and correct diagnosis is key to medicating appropriately. Three years ago I swallowed my first antidepressant. I've been on four different antidepressants since then: Citalopram made me anxious and suicidal; mirtazapine tranquillized me, took away my mental agility and made me fat; cymbalta was a love affair but it's affects were short lived and eventually we grew apart; fluoxetine made me aggressive in high doses, in lower doses it helped me bounce along the bottom of the mental health sea.

My working life these past 3 years has been a train crash. The hold this illness has over me makes me unreliable, anxious, fearful, socially awkward and completely without resilience to everyday stresses. I've gone from a £45k salary to living on benefits. I'd like to be well enough that I can work a year without another major depression tripping me up.

A year of uninterupted work growing my business. A year without my weight ballooning or shrinking under the influence of medication. A year without suicidal daydreams. A year of being a father and husband. A year without conspicuously missing seasons ... without a major depression.

It's been a while since I allowed myself to dream ahead a whole year. That is what this hour with a psychiatrist means to me.

White Rabbit

My mother just returned from Hajj, a religious pilgrimage, a sort of Glastonbury for Muslims. Since returning she has told me that I need to stop this, by which I think she means stop being mentally unwell. She tells me I need to go back to work, because I need to be a good example to my son, Xavier. If I read between the lines I think the suggestion is that I’m not a good example to him right now.

She visited too. I couldn’t explain why, but whenever my parents visit they typically insist from the outset that they cannot stay. My father will often sit in the car, outside the house; perhaps he’ll smoke a cigarette. Or, on occasion, he will stand on the door step. With only the most persistent of encouragement, will they both come in, and even then they both always refuse to remove their coats. Actually the whole thing becomes quite exhausting, because every step from leaving the vehicle, to entering the house, to taking a seat, to accepting a cup of tea, requires such reserves of energy and encouragement on our part. It is a scene fit for the stage, couched in comedy. Every attempt to make them feel welcome and comfortable is met with some retort about how brief this visit will be. This is made all the more comic if one takes a moment to survey the sedentary lives my parents lead. They have lived in this region for nearly thirty years, but still know little about its scenic beauty. A walk for them is what one does travelling from the dairy isle of the supermarket to the bakery section. And between walks they watch extraordinary amounts of television.

Anyhow, her visit to us was brief as always. On this occasion my father didn’t come in. My mother sat down but kept her coat on. She didn’t make much by way of conversation. She did prod my stomach and tell me I am fat, something she said I needed to sort out. She gave Xavier a few inappropriate presents, the sort that uniquely combines plastic, noise and violence.

Both Alicia and I couldn’t help but notice how well my father seemed whilst my mother was away. He came across as carefree, energetic, spirited and joyful. Now there is a marriage I might never understand.

It’s been a positive week and I continue to recover, with the expected ups and downs. To myself I say, surround yourself with passionate people, everybody else can wait for now.



6 Years of Alicia