Thursday, 27 December 2007

Rebuilding walls

I love dry stone walls. The fact that they are built without any kind of mortar, relying instead on careful choice and placement of individual stones, really appeals to me. There's a craft to them, real skill. Look at the beauty of the one pictured above - I love this!

Unfortunately, they do sometimes collapse. Much like me really. So what to do when faced with a collapsed wall?

Well, I suppose you could try randomly throwing the stones back on to the wall. Trouble is, they tend to fall down faster than you can pile them up. Not a good solution.

You could gather together a whole bunch of people and get them all to hold up different parts of the wall. That support has been provided to me, and I have appreciated it massively. I still need these supporters - but I need to find a way of making the wall stand up by itself, in the long term.

Sellotape? Doesn't work either. Feels like that has been tried with me, with the many and varied recommendations for medications, often at maximum BNF doses. What with Escitalopram, Trazodone, Valium, Zopiclone, Quetiapine and suggestions of Risperdal and Flupentixol thrown in for good measure ... I'm sure they are all very good sticking plasters, but they're not seeming to help me mend my wall. So I'm giving up on them. All of them. Now.

To rebuild a dry stone wall, a skilled craftsperson has to take each stone and look at it carefully. A decision has to be made as to whether it is a good fit for a given gap. If not, it is put on one side - not discarded, merely left for a "better fit". Each stone is learnt by the waller, understood, and then found a place.

Feels like that's what I need to do. A possible moment of clarity. For my current crisis does not seem to be mainly a product of an underlying biochemical imbalance. Rather it is a reaction to events. The same two causes could be identified with dry stonewalls, I suspect; occasionally stones crack due to frost and that could cause a collapse. Alternatively, the wall could be bashed by something large, clumsy and inconsiderate.

I need to rebuild my wall. Not with sellotape. Not in haste. Slowly, carefully, with thought. I suspect that may involve me looking closely at a number of stones which I will not like the appearance of. Some of them may be heavy for me to lift. I might need help with some of them. I'll need to use all the skills I have, and call on the skills of others. But I'm not going to rely on drugs any more. Stopped one last night (the hated "fat pills"); tonight I will begin reducing my trazodone and, with determination, I can be medication free (apart from my asthma meds) before I go back to school next week.

It feels like a moment of clarity for me. Feels like I can see things clearly again, after a long time. What do you think?


marcella said...

what do I think?

That it's a beautiful and well illustrated post and a clear statement of intent.

Just a word of caution, SOME of those who are supportive now (thinking perhaps your GP?) may be unwilling because of their own background and experience (which will be expert but limited and with large holes) to do so while you pull the sellotape off.

Giving you a gentle and supportive hug.

Disillusioned said...

Thanks marcella.

Maybe I will have to be careful how much I tell some of those others... My GP is great though. I doubt he will be entirely happy with my decision to stop meds, but hopefully he will support me while I give it a go. He has said in the past that I manage my medication well. This is just a different way of managing it.
Off to see him now.
Thanks for the hug.

Disillusioned said...

err... my GP wasn't happy. I wasn't happy to make him not happy. I said the right words. Whether I will do what he wants remains to be seen.

marcella said...

Hmm - please consider his point of view as he obviously has your interests at heart and knows what he's doing to a greater extent than many. On the other hand make sure he's considering your point of view - the idea of rebuilding the wall without sellotape sounds a good one, although perhaps removing it a lot more slowly and piece by piece rather than all in one go might work better.
My daughter came off all hers "cold turkey" and was very disturbed for a while, and it would have been preferable had she been able to do so with medical advice - not that the medics were advising her to come off that it. Now that she IS off most of them and taking one of them properly along with vitamins, she's actually doing a bit better, so I think her decision to reduce them, and to stop taking what K's lovely son called paraquat (seroquel) was a good one, but slowly and surely is probably a better way to do it.

Rainbow dreams said...

I like the analogy of dry stone walls...
I have no experience of your medications, am sorry your gp wasn't happy but hope you can work together to the same end somehow...
lots of thoughts and a hug from here, xx

The Shrink said...

Nothing's written in tablets of stone (ha!) so your thoughts seem sensible.

You're thinking of stopping stopping medication.

Your GP has nothing to lose by you stopping medication (heck, his practice drug budget will be healthier if you do!) so you GP's unhappiness is a reflection of concern and clinical consequences (which in fact you're already mindful of).

To stop medication for a while or forever can of course be a good thing. If I were in your shoes, I'd be stopping the medication. But, equally, I'd be wanting someone to watch my back and go through it with me (someone I trust, whether that's a GP or psychiatrist or CPN) so if it's not peachy then someone able to offer informed opinions who's got my interests at heart can give me a heads up before it turns pear shaped.

Also, rather than an all/nothing thing, the other person could think through with you staying off antipsychotic "fat pills" you've tried but soldier on short term for a couple weeks with, say, an anxiolytic to tide you through stormy waters 'til things get better.

And of course they're there to see with you that some things can be much better off medication, giving you and them a healthy perspective on that.

Disillusioned said...

Thanks all for your very helpful reflections and support. Interestingly I seem to have made decisions which fit in well with what you suggest. Though, of course, 1am may not be the healthiest of times to make such decisions!

In any case, I did think about what my GP said, and Shrink you are right that he does definitely have my best interests at heart.

He's happy for me to stop the Seroquel (aka fat pills). The nurse from the Crisis team concurred with that being a good decision.
I decided last night to reduce the Trazodone by 50mg and see how that went. That's against advice, but I'll take it slowly and watch out for what happens.
I also did try my GP's suggestion of Flupentixol 1mg to help with overagitated thought patterns, but to be honest I felt it made things worse so I won't be bothering with that again!
As far as the escitalopram goes, I suspect that I will have to stay with. The Zopiclone is (hopefully) a means to an end - ie getting the sleep I need to cope. (Sleep is my early warning signal, but also the last thing to get "sotred" after a crisis.) I do have some Valium which I will use if the anxiety threatens to take over. However, having identified that this is (in old fashioned and simplistic terms) reactive not endogenous depression, it looks like it's time to start dealing with the current issues, or at least coming to terms with them. One stone at a time!

Kathryn said...

Sorry to be so late coming in to respond here...My first reaction was very much
"Hooray for moments of clarity and walls to be rebuilt...but trembling rather at the prospect of your coming off your meds against the advice of those offering you informed support"
Now it sounds as if others share that anxiety and as if you've factored in the concern of your GP ... Just take care because you are precious, and don't need to accidentally damage yourself amid the rebuilding process.
Sending hugs and prayers

Disillusioned said...

Have tried 3 times to reply to your comment, Kathryn...

Am I feeling precious? Particularly not so today.

Do I feel deserving of avoiding harming myself by reducing drugs?
Not really.