Profession or Identity? #Write28Days

Today I finally remembered to check out the #Write28Days Facebook group and jump back onto the challenge bandwagon. The prompt for today is “Profession”.

I immediately thought of all the career paths I had envisioned for myself as a teen. When I was sixteen, I was planning on becoming an English major in college, choosing to specialize in American studies and was sure I’d leave for the United States in my third year. I actually half-joked that I’d obviously find employment there and never come back to the Netherlands.

Now of course I never even made it to being an English major. I never made it to my third year in college either and haven’t been to the United States as of yet. I’ve never been employed, in fact.

For some time, I listed my old blog as my place of employment on Facebook. Now because I’m not keen on my family reading my blog, I no longer list it on my personal profile. I don’t have work listed on my FB profile at all.

Today, I was discussing my personal strengths profile, which the mental health agency is supposed to have on file for each client, with my community psychiatric nurse. It scared the crap out of me. In the plan, you’re supposed to write about your former abilities (before becoming mentally ill or whatever), your wishes and ambitions and your current abilities. I immediately thought big, thinking that since I used to go to university before my autistic burnout and lived with my husband before coming to the care facility, I should probably want to go back to these. My nurse said I can think small too. I later thought of the fact that I used to be stable on a much lower dose of daily medications and would really like to go back to a lower dose of my antipsychotic at least. That’s a valid ambition too. I don’t really need to find a profession.

In fact, I am also reminded of last week’s Hour of Power show, in which the preacher talks about one’s title vs. one’s testimony. In the Dutch show, Carola Schouten talked about her title as the minister of agriculture and vice-prime minister. She contrasts this with her identity in Christ. I love this and felt an interesting connection to her, even though with respect to profession, she is infinitely more successful than I am. With respect to identity though, we’re both children of God.

New Normal

Earlier today, Stevie Turner wrote a great piece on adjusting to the new normal of serious illness. In her case, it’s cancer. I have so far been able to avoid serious physical illness, but I get the idea of adjusting to a “new normal”.

In 2007, as regular readers may know, I suffered a serious mental health crisis. It was probably autistic burnout, though it got various labels over the years. I was 21 at the time and attending university and living on my own.

In the early months of my psychiatric hospital stay that followed the crisis, I was convinced I could go back to college, university or work and living more or less independently if I just had a little more support. I rejected the first place offered to me because I wouldn’t be allowed to cook in my own apartment. This, looking back, is ridiculous! After all, now, thirteen years later, I live in a group home with 24-hour care. I cannot cook, clean or even do some personal care tasks without help.

Now to be honest, I at the time didn’t have a realistic picture of what living in my own apartment in supported housing would be like. The training home I went to before living independently, had a 1:4 staff/client ratio during most of the day. That’s pretty high and it allowed for staff to help with most household tasks. If I went into supported housing in my own apartment, I’d be expected to clean it all by myself. The fact that I wouldn’t be allowed to cook, was understandable, as there wouldn’t be the staff to supervise me.

Then again, I thought I could handle a low staff/client ratio. It was 1:7 on week days at the resocialization ward and 1:14 on week-ends. I did okay with this. Now, not so much. The staff/client ratio here is 1:6 at the least and I get one-on-one for several hours during the day.

I often look back at myself before my crisis. When I was eighteen, I attended mainstream high school despite being blind. The autism or other issues hadn’t even been diagnosed yet. I coped with classrooms of 30’ish students with just one teacher. Sure, I had meltdowns multiple times a week, sometimes multiple times a day, but I somehow survived. Now, I can barely handle having my coffee in the living room without my one-on-one present to calm me if I start melting down. Oh my, this feels sick. I feel shame admitting this. Yet it’s my new normal. Whether I’m just lazy and manipulative and unwilling to be independent or I’m genuinely unable, it’s the way it is.

I often feel sad when I am reminded of my old life. I often dream that I go back to university. I most likely never will.

That being said, I’m also grateful for what I do have. I am forever grateful that my staff and behavior specialist saw the need for one-on-one. I am grateful whenever I can do a small activity, like this morning I made clay punch-out figures. Back in the psych hospital, I often couldn’t blog even once a week. Now I blog almost everyday.

The most frustrating aspect of my “new normal” is not knowing why. I constantly second-guess myself, wondering if I’m truly such a terribly manipulative attention-seeker. That thought is scary. Worse yet is the fear that this might be some type of neurological thing, that I might actually be deteriorating. There is apparently no reason to think this, but it’s still on my mind. Then again, it is what it is and I’ve got to deal with it.

When I Was Fifteen

One of Mama Kat’s writer’s workshop prompts for this week is to explain how a parent or sibling would’ve described you at the age of fifteen. What an interesting thing that Mama Kat should mention age fifteen!

I turned fifteen in June of 2001. By August, looking back, I was close to insane mentally. This was the summer when I first realized I had alters inside of me, although I didn’t know what they were at the time. I just heard some type of voices that were and at the same time weren’t mine.

Neither my parents nor my younger sister knew this at the time. Still, they did realize something was up, if for no other reason, then because I didn’t care about school. I had always been a pretty studious kind of child, but this changed by November or December of 2001.

In addition, I was a rather angry, moody child. I had suffered from depression on and off since age seven or so, but it was particularly bad at age fifteen. I even made suicide plans several times during that year. My parents, being the type to dismiss mental health issues, felt I was just attention-seeking, of course.

My life turned around in a sort of positive way a few weeks before my sixteenth birthday, although no-one saw either the change or how positive it was at that point. On June 16, 2002, my father called me autistic as an insult. This led me to search the Internet for autism and to discover I may be on the spectrum myself. Although it’d take nearly five more years before I was diagnosed, in part because my parents and teachers didn’t believe me, I see this as a pivotal point in my life.

The day after this, June 17, I finally disclosed to my teacher what had been bothering me over the past year. I sugarcoated it a little, not mentioning the voices or suicidality or autism for that matter. I did tell him I was struggling with being blind in a mainstream school and that I realized I had been less than good of a student lately.

My father, at the time, worked at my school. My teacher told him that I had disclosed something to him, but he refused to tell my father what it was. This led to a really traumatic experience, because my parents demanded to know too and they weren’t kind about it at all. I am pretty sure they just tried to gain fuel for their idea that I was one giant attention-seeker.

Many years later, my parents used many of my struggles at age fifteen to “prove” this very point. I can see their perspective, sort of. Thankfully though, my current professionals don’t go along with it.

Mama’s Losin’ It

An Intense Monday

I’m not really sure what I want to write today. I started writing this blog post several times, only to delete it again halfway through. I intended on doing a food diary, then realized I wasn’t intending on sharing it here. (I did write a food log in Day One, my diary app, for today.) I then tried to do a more general health and wellness log, only to realize these don’t make sense if I don’t do them regularly. Then I started writing a post about today.

Today was, indeed, rather intense. Not really because of the food journal. I did okay on that one and it helped me make some healthy choices without becoming obsessive about it.

In the morning, a staff made a phone call to the assistive tech company. Yeah, my Braille display is once again broken, for the fifth or so time in eighteen months. I can still work around all the stuck dots, but I really want it repaired.

Then in the afternoon, I had an appt with my nurse practitioner. I can’t remember exactly what we talked about. I mean, yes, he shared about the bus metaphor. This is a metaphor in which a person is like a bus driver and all their thoughts etc. are passengers on the bus. I had already commented last time that my bus has multiple drivers, in that, if I hear a voice commanding me to do something, that voice (ie. alter) can take over the wheel too. Now I am hesitant to use words like “alter”, because I know my nurse practitioner doesn’t believe I have a dissociative disorder. This is my blog though so I can do with it what I want.

Today we somehow got talking about this metaphor in relation to emotions. Sometimes, you see, I get an emotion or urge or whatever and have no clue why. Honestly I can’t remember how this relates to the bus metaphor, but oh well. Oh yes, I told my nurse practitioner that Astrid is the bus with all its passengers and drivers. The body, then, is the bus.

Later, in the evening, we had an emotional reaction to a minor situation. After I calmed down, I talked it over with the staff who’d seen me have the reaction and it turned out I had no memory of it. I can now sort of see how I probably had that reaction, but I still can’t remember it as my own reaction.

This makes me feel kind of freaked out. I know that amnesia is part of dissociation, but didn’t we agree that I don’t have a dissociative disorder? Besides, whenever I do claim to have an undiagnosed dissociative disorder, it’s OSDD1B, which means having alters without significant amnesia.

I knew from previous experiences that I do experience what’s called emotional amnesia, where I can remember something but not the feels that go with it. The incident of amnesia that got my former psychologist, back in 2010, to suspect DID, was, in fact, emotional amnesia only. I know this because I claimed that I’d not remembered what went on in our session, but I clearly must’ve remembered something as otherwise I wouldn’t have known to tell her.

I know I don’t need a diagnosis right now. I can function okay’ish most of the time. Or can I? After all, when I’m functioning, I can’t remember that sometimes I am not and when I’m in severe distress, I can’t remember what it’s like to function normally. Or maybe I can, on some level. This is all so confusing.

My Hopes for 2021

Hi everyone and a happy new year! Last year was, well, quite eventful for most of us. I really hope this year brings some peace and quiet to all of you. Most of all though, I hope you all stay as healthy as can be.

Like I’ve done for a couple of years now, I’m going to share what I hope to achieve in the new year. I hate the word “resolution” and don’t really want to call them goals either, because that’d be pressuring myself too much. I’ve actually noticed that if I call them hopes, I somehow achieve more of the things I want to achieve. Here are my hopes for 2021.

1. Eat a somewhat healthier diet. I don’t really want to be eating just lettuce and carrots so to speak, but I do really want to make healthier food choices. Like, I want to eat 2-3 servings of fruit each day, like I did in the fall of 2020 too. I also want to choose healthir snacks and maybe I can really get into the habit of eating bread rather than cereal some days. Lastly, I really need to make sure I get in at least two liters of fluid each day. Ideally, these actions combined will lead to some weight loss. I’d like to lose about 5kg, but any weight loss is good.

2. Find other ways of exercising besides walking. COVID permitting, I’d still like to join a gym or go swimming again. I don’t need to get moving more, as I already get in my recommended 10K steps at least half of the time and I don’t think it’s realistic to want to reach the goal more often.

3. Keep up my blogging routine. I did really well over 2020 in writing regularly and really want to keep it this way for 2021.

4. Get stable mentally. In 2020, I experienced crises a lot due to a coombination of factors related to my mental health and adjusting to living in a facility. Like I said on Wednesday, the extra care hours got approved for a year. Hopefully by the end of this year, we’ll be able to conclude that they’ve helped me become significantly more stable.

5. Find more enjoyable hobbies and activities. I don’t need to be able to do them independently. Like, I’d really like to explore crafting and beauty product making more, but I know I’ll need help with those. I guess my hope is that I’ll find joy in more activities even if I can’t do them all by myself.

6. Deepen my faith. I didn’t even mention having become a Christian in 2020 when I reviewed the year on Wednesday. I however really hope to strengthen my relationship with Jesus and my faith in God.

What do you hope to achieve this year?

2020: The Year in Review

So 2020 is almost over with, thank goodness! Not that it was a totally bad year for me personally, but I really hope 2021 is better for the world at large.

I started the year hoping to settle in at the care facility. I did, but it did take some more accommodating from the staff than I’d expected they would be willing to. In July, for this reason, I was granted the highest care profile for blind people (I had the second-highest until then). I felt very mixed emotions about it. I mean, even though I had originally asked my support coordinator to look at that care profile when applying for my long-term care funding, I do remember her saying I would definitely not qualify. It turned out that I did.

Then in November, after I’d been in some major crises, the staff suggested I sign an official request for extra care hours. I just heard this morning that it got approved. Next week, the staff and manager are going to discuss how to use the extra care and whether new staff will need to be hired.

I hoped to settle in at the day center. That didn’t work out, as the center closed down due to COVID in mid-March. It has since reopened to some of the homes, where clients can utilize a specific room for their home. However, many clients in my home fare better now that we get day activities from the home.

COVID also had its consequences for my marriage. I had just been trying to learn to use public transportation, like I’d hoped I could, when COVID hit the Netherlands and care facilities were closed to visitors. Even though we’re in a second lockdown now, my facility does allow visitors this time around. However, my husband and I agreed it wouldn’t be sensible for me to use public transportation as of now.

As a result of the first lockdown, I didn’t see my husband at all for March, April and most of May. Thankfully, our marriage survived.

Looking back at my hopes for 2020, I see I did pretty well considering the circumstances. I mean, I didn’t settle in at the day center or learn to use public transportation, but like I said above, that’s to blame on COVID.

Health-wise, I didn’t lose weight, but I am much more active now than I was in 2019 and I do eat okay too. I could certainly do better, like I tried for some weeks in late October and early November. I’ll need to activate my water reminder app again too.

With respect to my mental health, I certainly took good care of that. I had had it as a secret wish to lower my Abilify dose, but I never did. However, that’s okay considering I wasn’t doing as great mentally as I expected to be. I hope I did finally find a PRN medication that helps me though.

I also blogged much more regularly in 2020 than in 2019. I didn’t do any other writing projects, mostly because I feel too inadequate.

Lastly, that self-care excuse of a goal I definitely did attain. I love love love essential oils.

How was your 2020?

A Really Validating Psychiatrist’s Appt

Today, we had our first appointment with the psychiatrist from the local mental health team. To my surprise, our nurse practitioner came to get us out of the waiting room. He attended the appt too though and looking back, it was really good.

I started to explain that our PRN lorazepam hardly worked at all. The psychiatrist seemed to think that’s a bit odd. We ultimately came to the conclusion that it does do something but the anxiolytic effect causes more emotions to surface.

The psychiatrist then started to talk about the “pieces”, as we call ourselves when talking to mental health professionals. She asked whether I’d ever been in touch with people with similar experiences. This utterly surprised me, as our nurse practitioner had said comparing our experience with others’ is useless. I felt able to share that I’d Googled my symptoms and come across dissociation and had met other people with similar symptoms that way. I did say I don’t really want a diagnosis.

The psychiatrist asked whether each of us experiences the effects of medication differently. Thankfully not, but some are more willing to take medication and to let it work than others. She explained that the mind is stronger than a pill, so if we don’t want to calm down, no medication can make us.

She ended up prescribing us a low dose of quetiapine (Seroquel). This is an antipsychotic when used at higher doses (like in the 100s of mg) but has a greater calming effect when prescribed at lower doses. She told me she had learned how this works – why its calming effect is greater at lower doses -, but had forgotten. I said I’d find out about it someday and let her know.

At one point, I started zoning out. The psychiatrist as well as the care staff who attended, noticed. I honestly had no idea other people, let alone virtual strangers like the psychiatrist, could tell if I didn’t say I was feeling out of it. The psychiatrist told me it’s a coping mechanism and fighting it will only make it last longer. I will work with my nurse practitioner on ways of coping with it when alone.

I also mentioned compulsively looking up things that trigger us online. Like, I now remember yesterday someone was reading a newspaper story about Russian opposition leader Navalny’s poisoning. Then one of the littles got triggered into thinking someone had put poison in her underwear too. The same happens on a more severe scale with us compulsively looking at other places to live. Our nurse practitioner said he’s definitely going to remember this for our upcoming appts.

Looking back, I’m so glad we had this appointment and also so glad our nurse practitioner attended too. He had seemed a bit dismissive when we had an appointment on Thursday, but we were able to express that via E-mail too.

Clarissa

Another Appointment With My CPN

Today, I had an appt with my CPN again. I can’t remember all the details, but I did tell her that I had had a breakdown on Sunday. I was completely honest, sharing that I had seen and heard things that aren’t there. It was as if something was truly telling me I’m a monster and everyone will leave me. Then I saw some form of Heavenly light. I can’t describe it really and it wasn’t very vivid even then, but it was more than mere wishful thinking.

My CPN encouraged me to discuss this with the psychiatrist when I see her on the 22nd. I really hope she can help me. My husband later asked me whether it was truly psychosis or a panic attack. I don’t think I was full-on psychotic but my perceptions and thoughts were definitely headed that way. My CPN agreed.

I can’t remember whether I told my CPN, but I had these thoughts and perceptions once before. Well, a few weeks ago I had them too, back when this depressive stuff all started, but then it wasn’t that bad. Back in December of 2009, I think it was even on Christmas, it was. I had run off from the psych ward in the snow. I picked up snowballs and somehow was convinced they contained drug needles. I wasn’t depressed at the time, just batshit crazy. It lasted only for a few hours though, but came back several times within the next few months, only disappearing when I was put on Abilify.

Now I’m pretty pessimistic. After all, I’m already on the highest dose of both Abilify and the antidepressant Celexa. (I mention this because I’m pretty sure I’m depressed, whether clinically or not.) I’m hoping though that the psychiatrist can put me on some PRN medication other than lorazepam, which I can use if I fully break down again. I know I have had experience with Phenergan (promethazine, a low-potency neuroleptic) and that worked great when I was on no other medication but not at all once I was on my current regimen. Maybe the psychiatrist can prescribe me something similar but different.

I also talked to my CPN about the incessant crying. She told me this may be useful. After all, I learned from a young age on to hide all negative emotions except for frustration (because I couldn’t hide that). In fact, I was told that I was “too quick to anger”, but this was used as an excuse to force me to repress every emotion other than a smile. I hadn’t been able to cry unless I was angry first until only a few months ago. As such, my CPN reasoned that I might have a lot of catching up to do.

An Okay Day

I once again want to write, but am not too inspired to write anything more than a diary entry. That’s okay though. After all, when I first created this blog, I intended it to be my personal space to share my feelings and thoughts.

Today was a relatively good day. It was better than yesterday at least. Yesterday evening, I landed in a bit of a crisis. The extra staff who had been having dinner with me in my room, said that, while I’d do stuff on the computer, she’d be back “in a while”. That confused me and my first response was to elope. Thankfully, the staff foudn me pretty soon, as it was freezing cold outside.

I talked some to her about my needs and wants re extra support and what they’d do with me. She suggested I get a daily or weekly calendar that has activities on it for me to do with the staff. She also understood that her being unclear about when she’d be back, was confusing for me.

Thankfully, today, I feel okay. I went for a walk in the morning. Then at 2PM, my mother-in-law came by. We had a cup of coffee in my room and then went for a walk. I got in over 13K steps total today, even though in the evening, it was raining so I couldn’t go for another walk.

My mother-in-law offered to buy me an interactive stuffed cat. It’s not really a toy, as it can’t be handled harshly, so isn’t suited for young children. It was specifically developed for adults with dementia. The cat makes soothing sounds, purrs and moves a little when stroked, meows, etc. It obviously has an on/off switch. I am not sure how crazy this would be, as it’s obviously not a real pet. However, I think I’d really like it. I seem to remember at day activities there was an interactive dog, but I’m not sure that one was the same sort of thing as the cat my mother-in-law is thinking of buying.

The evening was okay. I played some card games of mau-mau with the extra staff. I also helped her make coffee or tea for my fellow clients. That is, I told her which cups everyone uses and whether they drink coffee or tea. I actually enjoyed myself a little being in the communal room.

I started reading Hatch, the second book in Kenneth Oppel’s alien invasion trilogy, which came out last Tuesday. So far, I am totally rooting for the main characters. I mean, I hardly even care whether the aliens wipe out all of humankind if they leave our heroes alone. That may be a bit weird, but I at least know it isn’t real.

A Profound Appt with My CPN

Yesterday I had another appt with my community psychiatric nurse (CPN). At first, we went into how I’m doing at the moment. Then my CPN scheduled some appts for me with my nurse practitioner. Last Monday, after all, he and the behavior specialist from my care facility had finally come to the conclusion that I need to do some work on stabilizing myselves and developing inner cooperation before I can do EMDR or another form of trauma therapy. At first, the secretary said the first appt she had available was late December. It turned out to be December 17, so that’s pretty early considering how long I’ve been waiting already.

Then we got to discuss some issues relating to my diagnosis or the lack thereof. These were mostly theoretical, since I have no idea what my current diagnosis is and I really don’t care. I mean, the most recent treatment guidelines here in the Netherlands for complex dissociative disorders, aren’t suited to me (or most plurals, honestly), so I have no reason to want such a diagnosis. All I want is help in getting the inner turmoil under control.

Then I somehow got to mention my former psychiatrist’s comment when first considering assessing me for DID/OSDD in the summer of 2018. She held both of my hands and said: “You have just one body.” Then she went on to explain that, while she was holding our hands, none of us could put our fingers in our ears and pretend not to listen.

We then repeated this exercise. A staff always attends our appts with mental health with us. She now held both our hands and said that we can stay at the care facility. Someone asked cautiously: “Even if I need more help than I get now?” She then reassured us that yes, even if we need more help, we can stay here.

Then the staff asked our CPN what she’s supposed to do when we openly switch, as we had the day before. My CPN seemed not to know, so I suggested she do not elicit it, but do not fight it when it happens either. After all, when she insists that “Astrid” come back, this may create some trouble since “Astrid” is either everyone or no-one at all.

I really hope our nurse practitioner isn’t going to insist people only talk to “Astrid”, as the current guidelines on DID/OSDD seem to suggest as far as I know. I mean, we are okay all listening to the body’s name and won’t sign our names on E-mails or the like when it’s not appropriate, but one of our main issues is that there is no host who somehow “owns” the others. As such, the daily living parts or apparently normal parts or whatever don’t have access to every bit of information needed to cooperate.