It is strange how often the way things begin is very often the way they continue - even if you try your hardest to make it otherwise. This week is very much a case in point. Monday was just a mess. Emotionally, physically, mentally... and the rest of the week has tumbled its way out a chaotic travesty I would not in any way be able to fully explain.
Work is busy, chaotic busy and I have flip flopped from one task to the next and back to the first in a whirlwind. Swept along in a gallivanting wave of emotions and frets and thoughts that I have barely the time to pin down and process.
I am aware that outwardly I am probably coping a lot better than I am inside. My mind has been thrown through a loop. Unsettled and up heaved and shunted in such a way that every glistening web of a lie I have told myself about coping is coming unstuck and falling to the ground in tears.
I am stopping the Mirtazapine, I haven't yet started stopping it, but it was agreed at my Psych appointment on Monday that as it has had no positive (or negative) effect on me, it is not worth taking the extra chemical. It was a low dose, so I can pick a time to stop it and stop.
I wish most things in life were that simple: it is not productive, so lets stop it. Boom. Stopped. Sadly, everything else, my mind, my body and my soul are far from simple and far from easily untangled.
My Psych now wants me to spend the time between Monday's appointment and the next (whenever that turns out to be, probably in December/January now) deciding two things:
1) If I want to try to reduce the dose of the Venlafaxine and in doing so, potentially risk unsettling my emotional/mental well-being (her words, not mine).
2) If I want to try an anti-psychotic.
I think the second of those two may well be the thing that threw me through a loop. Not at all discounting the fact that every Psych appointment I ever go on throws me through a loop anyway. Monday's session ended with my normal dissociation, finding myself randomly in town with no recollection of going there and wandering in a half daze for a while. There are bits and pieces and fragments but I really think I go into some kind of mind-hibernation whenever I have an MHU appointment. Bleh. Is probably the main reason I don't ever push for them to be more frequent.
Then, we get around to the Psychosis part. I mostly find this unsettling. I guess everyone finds psychosis unsettling, whether they have it, or hear or read about it (and if you hear about it as a part of the psychosis itself then you really have a double edged sword). For the most part, I can brush it under the rug where it belongs, pretend it is not happening and get myself to almost believe the facade of calm I attempt to put on on the outside. These are the times when it is mild and merely disconcerting:
The sound of sirens regardless of where I am (I have been on a train in the middle of a field before now.... )
The smell of burning and of rotting
The tactile sensation like ants crawling over my skin
The flicker of ghosts and monsters or the lingering doubt around people and crowds
Then there are the times when things begin to creep past my ability to ignore:
The ghosts becoming more frequent
The disturbed thoughts and the increase in my belief in them
Then the distinction moments when I no longer know which stage is the better one to have and the utter panic and disillusion that comes with wondering if it is you who is wrong, or everyone else.
Put down on paper like this, I can see why the psych is suggesting I consider an anti-psychotic. The problem is, I am not sure I have ever considered myself ill enough to take them. It scares me to think that the level of ability to cope I have feigned myself into believing I have may well be paper thin and merely an illusion. It scares me to think that any of these things are the psychosis and that it is not just a stage.
I have been told in the past that my psychosis symptoms are linked to my depression being bad. That the worst my depression is, the more likely it is that they will be triggered and I have the wonder of how much the psychosis plays of my social anxiety and how much of my social anxiety has been born as a response to the psychosis.
Everything in its duplicity plays off everything else and I find it hard to sit and work out what causes what and when and why and if I consider it enough to potentially try yet another line of treatment.
I have four months to mull it over.... I think I just needed to put some of my initial thoughts here to pin down some of the disquiet of the last few days. Somewhere.