The Rhino, The Quicksand and The Badger - Part three.

It was the beginning of July 2010 that we started our next placement. I was assigned to be with a Health Visitor for 8 weeks. Nursing students do not get typical student holidays, our course is more like a job except you are being paid much less than everyone else. I phoned in before we were due to start as to find out who my mentor was and what hours I would be doing. I found out that my mentor was on holiday in the Dominican Republic for a couple of weeks. Well that was another great start to a placement, my first two mentors were part time so I barely saw them and now this mentor was on holiday. How well organised of her. I was feeling very anxious and fragile about starting this placement, it was in an area I didn't know very well and technically not the most pleasant of neighbourhoods. In fact, Raoul Moat was from around there. (I don't want to mention the name as Nursing Students can get in trouble for that sort of thing.) However, this wasn't my main concern, what really bothered me was getting there. The most anxious part of the day for me is getting ready to leave the house and actually getting to the placement. Fortunately, on this placement I was not doing Long Days but 9-5.

The other Health Visitors decided to change my mentor to someone else, she was very friendly and kind. Just after a couple of house visits and driving around with her, made me realise what an understanding and caring person she was. I felt like I had an adopted mother at work. She was amazingly calm and approachable so about two days into working with her, I told her I had depression. I felt I needed to tell her because I had only been put on Fluoxetine (prosac) recently and it usually takes at least about a month to start noticing a difference in your mood. Personally, I didn't react well to Fluoxetine. The side effects I got from taking them, I would say made me feel worse. Everyone reacts differently to different drugs but prosac just wasn't for me. Previously, I had had problems with excess sleeping and wanted to sleep all the time, now that I was on prosac I was waking up very early, I was restless and fidgety. As well as this, my appetite decreased significantly, I wasn't interested in food at all. I remember my mum putting a roast dinner in front of me, I felt like it was so much effort to even pick up the fork but I had one mouthful and couldn't be bothered. I felt repulsed by food which was incredibly out of the ordinary for me.

I had always had a problem with my self esteem but it plummeted while I was depressed. I found a part of me being pleased that my appetite had decreased as I wanted to lose weight. There were many times where I didn't want to look in the mirror because I found myself repulsive, I wouldn't look in the mirror while getting dressed and I began wearing my baggy hoody and jeans all the time. Ideally I should have washed that hoody more than I did but I didn't care at the time. I took no pride in my appearance if I knew I could avoid it. I would only make an effort if I knew photos would be taken as I cared so much more for what other people thought than what I thought of myself. I knew it wasn't healthy but I didn't really care, eating was too much effort and my anxiety was making me feel sick which made eating even more offputting so it didn't bother me if I lost weight. I would eat when I felt I could but would never force myself. I couldn't cook for myself anymore, I had difficulty making decisions so I wouldn't be able to choose what to cook even if I did have the energy. 

Anyway, on placement when I wasn't distracted by doing visits, I would sit in the office at lunch. My hands would be shaking and clammy, my heart would be racing and I felt like I was constantly trying to fight off a panic attack. There were quite a few days where my mentor would just let me go home as I clearly wasn't fit to be in the workplace. During visits, sitting and staring into space became very difficult not to do. I didn't want to look rude but I couldn't concentrate, so trying to care about other peoples problems and listen to them effectively, trying to give others support was hard. Luckily most of the time people would just need someone to listen to them this is where my non-verbal skills came in so useful, managing to nod my head, holding a hand, facial expressions served me very well during this time. I would have bad days and very bad days. I didn't really have good days at that point. I found it difficult to laugh at jokes, I would pretend out of politeness where I could.

This is an insert from my diary around that time. I have taken certain sentences out as I feel they are too personal to me to reveal but I hope this can give you an insight as to how I was feeling.

4th June 2010

"It's a sunny day which I would usually relish. It's difficult to write this and hard to concentrate. It's beautiful but I don't care. I feel grey, blue, whatever you want to call it. I'm not myself. I should be doing something fun but I'm not. Relaxing in the sun is one of my favourite things to do but it's not enough to make me happy now. Everything seems hopeless, pointless. It comes and goes in severity but never completely leaves. Things I know I would usually love or cheer me up seem worthless and irrelevant. I know their not but I have no joy from them anymore...These past two days  I've been becoming quieter, it's becoming harder not to stare into space and harder to get words out. "

 

 There was a time when I couldn't remember who I was, I hadn't forgotten any memories I had or what my name was but I couldn't remember what it was like to be myself. My behaviour when depressed was so unlike my true happy self and I was genuinely worried I would never remember that. My friends and family told me everyday that it would get better eventually and all I could do was hope they were right because I really didn't believe them.

I returned to my GP to have a medication assessment, I told him what had been happening and he changed my medication to Citalopram. It has worked incredibly well for me, just like with prosac, it takes a while for you to notice a change in your mood. He wasn't the most understanding doctor and I'd say he is probably just a bit quirky. Not all doctors will understand how you are feeling but most will do what they can to help you. You shouldn't let one bad experience put you off seeking help even if you feel like you've been slapped in the face, I changed my GP during this time because of this and She has been incredibly supportive and caring about my well being. This wasn't the end of my experience with depression and I'm sure it will have to deal with it throughout my life but I started to finally feel better. There was a light at the end of the tunnel which I found impossible to see before then.

Please feel free to comment and/or ask questions. I have been touched by the responses I have had from people who have read The Rhino, The Quicksand and The Badger so far. Thank you for reading!

The Rhino, The Quicksand and The Badger - Continued.

So as I mentioned last time, I hadn't told anyone how I had been feeling. The day I told my mum, I hadn't planned on telling her. I went to my parents house and sat down in the kitchen. I was noticeably quiet and not myself usual smiley self. 

This is a picture of me trying to cover up my insecurities and pretending things are okay. I found it difficult to come out of my shell but my friends (especially Sophie at this particular party, was the most helpful person. Having experienced depression herself and known me since birth, she knows just how my mind works and just how to make me forget how I'm feeling. Even if it is just temporary, I can be in an imaginery happy world for a bit and almost feel normal.)

Me, typically happy and smiling. 

She asked me how I was and I just started crying. She hugged me and immediately went into caring mumsy mode and did what she knew she could do, use her skills as a GP to try to help. She asked me if I would be willing to answer some questions from a typical depression assessing tool called a PHQ-9 (Patient health Questionnaire). It was the first time I had ever done one and little did I know that I would be doing this questionnaire hundreds of times in the months to come. 

PHQ-9 : http://www.psycho-oncology.info/PHQ9_depression.pdf

It is scored out of 27 and it gives a guideline to what severity of depression you may be experiencing.
0 – 4
None
5 – 9
Mild
Watchful waiting; repeat PHQ-9 at follow-up
10 – 14
Moderate
Treatment plan, considering counselling, follow-up and/or pharmacotherapy
15 – 19
Moderately Severe
Immediate initiation of pharmacotherapy and/or psychotherapy
20 – 27
Severe
Immediate initiation of pharmacotherapy and, if severe impairment or poor response to therapy, expedited referral to a mental health specialist for psychotherapy and/or collaborative management.

I scored 24. I can't describe what my mum was feeling, all I know is what she has told me and that is that she felt guilty she hadn't noticed earlier. The thing was, I hid it. I tried to act as normally as possible in front of people because it was not only embarassing but I was afraid that people wouldn't take me seriously.  Despite the fact that I know all my family and friends are very caring, both my parents are GP's and I know they wouldn't brush it off. But at the time, I was thinking negatively about everything. I was self-conscious, paranoid and I thought everything was pointless.

I even managed to acquire a job at wetherspoons when I was feeling that bad. The morning of my interview I collapsed on my bedroom floor and cried. I knew it wasn't normal. I was so fed up with life and I knew I didn't want to die but part of me really did want to give up. I was so anxious that I was shaking. I get anxiety not just when it would be normal to have anxiety like when I was due to have an interview, but also randomly and unexpectedly. I have been advised since then to tell people when I am feeling anxious as keeping it to myself can only make it worse. When I do tell people, they always seem to ask the same question "Why?".

I would like to make this very clear, being anxious and being nervous are not the same thing. They feel very similar but they are called different things for a reason. Anxiety is fear of the unknown. Usually when you are nervous it is because there is something to be nervous about. When I feel anxious, it can come from anywhere, I could be sitting in my flat, completely comfortable and I will get this horrific feeling like there is a Rhino running towards you. Impending doom. Anyway, I managed to make myself look presentable and just went in thinking I had nothing to lose. 

My mum arranged an appointment for me to see my GP, at this point I was struggling to come to terms with how I was feeling. I felt confused and my brain just felt fuzzy. I couldn't concentrate on simple things like reading or even watching TV. I constantly had thoughts whirling around my head, I didn't want to accept that I had a mental illness. I thought I was being dramatic and over reacting. I was overly sensitive with regards to anything people would say, If they mentioned anything about me I would take it the wrong way. I didn't do it deliberately, I just thought people were judging me when really it was me thinking in a negative light. 

My GP started me on an antidepressant called Fluoxetine which is Prosac. Many people are against using antidepressants as they don't like the idea of messing with their brain chemistry and that they will become dependant on them. I, on the other hand really felt like I needed them. People say you should concentrate on what has caused the problem and find a solution to why you may be feeling that way. I do agree that medication is not the be all and end all, as I have had counselling too. However, at my worst I could barely talk, it took a huge amount of effort to even say one word answers. So using an antidepressant was important for me at the time to at least make my brain wake up a bit so that I could be more responsive. There's no point trying to have counselling or people asking you questions about how you feel when one of the problems is actually expressing yourself. 

Around the same time that this was happening, I was meant to be attending lectures at university with an exam approaching. My closest friend at university - Joanna, had started to notice that things weren't right but sadly her Nana was very ill around this time and was spending more time at home in the Midlands. I felt very guilty that I wasn't supporting her in a way that I usually would for a friend in a time of need but I was so consumed by my depression that I was barely able to look after myself let alone other people. When I was in lectures I would avoid speaking where I could and if people talked to me I would pretend nothing was wrong. It was very difficult to cover up and I was surprised no one actually mentioned anything sooner, not that I wanted them to. I wasn't that close to the people in my group at that point that I felt I could tell them my problems, I didn't even want to talk to any of my closest friends about it at first. I was missing time off university as I felt too tired to go in, my motivation was very low and even when I was in lectures I couldn't concentrate. I could spend a whole lecture just sitting wallowing in my feelings, unhelpful and negative feelings. 

Joanna told me that her Nana passed away and that she would be going to the funeral over the weekend before the exam. I realised that it was a very stressful and understandably sad time for her so I didn't want to load her with my sad feelings too. I thought it would be inappropriate to tell her how I was feeling when I felt that she had something to be genuinely sad about. When she came back up she visited me at my parents house, I think by this point she was aware something wasn't right as I had been spending more time there and well, I looked like shit. She came into the living room and my mum told her what had been happening, it was at this point that we really bonded as friends. We decided we would go through this tough time for both of us together. 

The day of the exam came and we went to the university office early to hand in a PECs (Personal extenuating circumstances) form each. It was important for us to do this as neither of us had efficiently revised for this exam and we weren't mentally fit for an accurate result. When handing in a PECs form, you must provide evidence of why your situation will effect your marks. I took in a photocopy of my medication and a doctors note and the university made joanna bring in a copy of the funeral program which they needed to photocopy. We looked like a pair of sad messes, Joanna being understandly upset and me looking like a zombie. When we went into the exam, we sat in our places and stared into space for a while. When it began I couldn't really concentrate and felt like everything I was writing was utter jibberish. After that we had a week or two off until we were back at university. I don't really remember what I did during those weeks so I can only try to look back in my diary to see. 

This blog will continue at a later date. Please feel free to write comments and/or ask questions.

The Rhino, The Quicksand and The Badger.

AHHAAA fuck you Librarians, you aren't getting £350 out of me! I forgot to return my 7 library books for like 6 months and I suddenly got a final notice demanding 350 squids off me. I certainly don't have enough money to pay that shit. Anyway I returned the books today and it has been reduced to £70, still not good but Imma gon' get a doctors note as I have a deficient brain which can't produce enough of my happy hormone called seratonin.

I decided to write about my experiences as a nursing student and my history of depression and as it's something which is still such a taboo subject to talk about and it really shouldn't be. Ever heard of the expression - 'Dying of embarassment'? Well obviously you will have done. In this case, people are killing themselves out of embarrassment of their behaviour and emotions. Depression is one of the most common illnesses in society today and yet the general public seem to know barely anything about it. I learnt about Depression in Psychology at A-Level but I never gave it a second thought once I left the classroom. I was just aware that if you had certain amount of pressures and 'stressors' in your life, which was too much for you individually then there was a risk you could feel depressed. I didn't realise the extent to which it could affect your life and others around you. As a Nursing Student I was going to learn more about it on my course but unfortunately I also learnt the hard way too.

 I was diagnosed with Generalised Anxiety Disorder and Recurrent Depression in May 2010. As far as I am aware, I have experienced symptoms of depression since I was 16 but always put it down to being a hormonal teenager up until about December 2009 when it increased in severity. Before I was diagnosed I was very sceptical about those with Depression, I knew nothing about it really. I thought they were people being overly dramatic about their problems and I never felt very sympathetic towards them beforehand. NHS statistics show that about six million people in the UK suffer from an anxiety disorder and/or depression. There was nothing significantly wrong with my life which is what confused me the most when I realised what was going on. I didn't understand why I was feeling like I was when I had nothing to be sad about. I now know that depression is a very complex illness and it is never straight forward. It can be caused by numerous amounts of things whether it be a chemical imbalance in your brain or a build up of stress or even by a severe illness such as food poisoning.

My memory is pretty hazy about when my depression increased in severity. I was in my first year of university living in student accommodation with two girls at the same university as me. We hadn't known each other before we had moved in together and to an extent I wish I had been closer to them. I've always liked my own space at home, a place to get away and do what I want. Even when I lived with my parents I would stay in my room for hours on end just entertaining myself in front of the computer, playing games or surfing the Internet. There would be times where I could spend over 12 hours without moving (unless to go to the toilet, that would be gross.) but that was just normal for me, though it does seem preeetty unhealthy. My dad nicknamed me 'The Badger' as I would only leave my sett to retrieve food etc. So basically as I had moved out of my parents house, it became much easier to 'badger' and do what I wanted, eat what I wanted and generally be a lazy get.

 It was in December 2009 when I was so lucky to get Herpes Stomatitis aka Cold sores of the mouth. I'd never had them before and reacted horrifically. I had them all over my lips, inside my mouth, under my tongue and down my throat. As my friends so kindly put, I looked like a walking STD. I couldn't eat for a week as it was so painful and I retreated back to my parents' house for some TLC. Looking on the bright side, I lost weight just before Christmas. SCORE! Then the following February in half term, I got Campylobacter - food poisoning. Another fantastic couple of weeks of my life. I managed about 4 days on my own before I phoned my mum crying because I was too weak to open a bottle of lemonade which would have been my only source of calories. I kept fainting every time I was walking back up the stairs from the toilet and decided to just crawl up them in future. So that was really fun, and I lost half a stone in just under two weeks. Though that was probably me being dehydrated and considering the amount I usually eat, suddenly eating nothing for a week was rather uncomfortable. In fact, I probably got the food poisoning from a Chinese take away I had ordered. Anyway, so those two illnesses in close proximity were enough to make me feel rather shit.

 Then in March, I started a placement in a hospital for my course on Adult Respiratory. The ward was full of people dying of various chest infections, cystic fibrosis and COPD (Chronic Obstructive Pulmonary Disease) most commonly caused by smoking, though not always. It was a shock to me. On my first placement I was pretty much just observing and following different nurses around everyday. Whereas this one was my first time to really get involved and nearly every patient was on oxygen therapy.

 It was tiring, physically and emotionally for me. I was doing Long Days (12 and a half hour shifts, 3 days of the week) but on top of that I was waking up at 5.30 as I had to walk 30minutes every morning and evening to get there and back. It was the most awkward place to get to from where I lived, no buses or metros directly there and as a student I thought getting a taxi was too expensive. 

This ward was the first time I ever saw a dead person, people I had been looking after and the first time I had ever done 'Last Offices' - this is where you have to prepare the body for the mortuary. At 18 years old, it all seemed a lot to take in. It's no wonder a quarter of all nursing students drop out. 

That placement tired me out, on the days I was working I didn't have any time to myself other than those horrible cold, dark walks to and back from the hospital. When I got home I just needed to sleep, except thoughts of the ward would be running through my head all night. I would dread going to bed because I knew that I'd be having to get up at 5.30 and I did find it incredibly difficult. Any of my days off were spent sleeping in and trying to relax, my desk chair wasn't really comfortable so I would lie in bed all day with my laptop 'badgering'. I found it harder and harder to control my diet, I felt the need to indulge myself all the time and found myself comfort eating all the time. Eating whole packets of chicken nuggets in one go, ordering pizzas and take aways all the time. Rarely cooking for myself and I was neglecting my appearance too. I wasn't leaving my room so I never felt the need to get dressed or put on some make up. I found it difficult to motivate myself to even have a shower. It was shortly after this placement when this behaviour continued and I was staying in bed from evening to evening that I realised I needed to do something about it.

This is when I decided to tell my mum how I had been feeling. I hadn't told anyone before then.

This will be continued at a later date. Please feel free to post comments and questions.

My Tropical Fish

So I missed my hairdressing consultation. I decided to press snooze too many times and then take too long to do my make up and had to ring to change the appointment for tomorrow otherwise I wasn't going to make it. WOOPS. 

Cardinal Tetras

For a couple of weeks now, I've been wanting to get some new tropical fish to fill up my tank a bit more. I started off with some hardy little guys called Cardinal tetras and some Bloodfin tetras. 

Bloodfin Tetras

One of my Bloodfins only has one eye so I have named him Cyclops, I would name the rest of them but I can't really tell them apart. I got 5 of each type of fish but unfortunately one of the Cardinals was eaten by the rest of them while I was in bed. So yesterday I went on a whirlwind adventure to Petsathome to get some more fishieees. So I now have a Golden Gourami, a Opaline Gourami, x3 Rosy Barbs and a Bristlenose Plecostomus. I am going to start trying to think of some names for them. 

This is what they are meant to look like -

Golden Gourami

Opaline Gourami

Bristlenose Pleco.

Rosy Barb.

All of this new fish I have bought can grow to 6" apart from the Rosy Barbs which only grow to about 2.5". At the moment my Gourami's are about 3 inches long, my Plec is probably only 1.5" and my Rosy Barbs all look pretty much fully grown. Love my new additions, I think they are all beautiful, I should probably get some more plants as they will probably feel more comfortable then which makes their colours more vibrant. Here's some pictures of my new fishies. 

This is my Golden Gourami with one of the rosy barbs in the background and some bloodfins. I think I will call her Marilyn after Marilyn Monroe. 

Unfortunately, I'm shit at taking photos of fish as they never stay still so I'll have to try again today to get some more photos. I'd quite like some purple and more blue fish. The hunt will now begin! I'm always on a search for new things which will make me happier. Keeping tropical fish is very relaxing to watch and I don't really find it that much hard work, just changing about 10-15% of the water every week and my Pleco should help control the algae. Love my fishies.