Learning new things

The best part about proofreading PhD theses for a living is that I learn so many new things about cutting-edge science.

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A little soggy

14-04-07 Little soggy

A little soggy kitten

 

When it rains, Dawn comes in looking for me to dry her with a towel. This can happen several times in an evening, if it rains for long enough, and I have to dry her off and give her a cuddle every time. I suspect she does it on purpose.

Chasing perfection

I received my marks back for the final proofreading assignment, which completes the course. The result wasn’t as good as I’d hoped, but it earned me the best outcome I could have achieved given the previous results. The three out of five assignments, I did well and was on track to complete the course with a distinction of over 90%. Then everything went to hell after I wound up in hospital. By the time I got out again, I was badly off track. I had to re-study the units I’d already covered, and it felt like I’d lost the ability to spot tiny details. When the fourth assignment came back, I’d only earned 75%. From that point onward, keeping my average above 90% was no longer mathematically possible, meaning a distinction was impossible.

I did even worse on this final assignment, earning only 69% for it. But that was enough to keep my average in the 80% – 90% range, earning me a merit. It’s not what I’d hoped for, but it’s better than a bare pass. Most freelance proofreaders use this course as a qualification to boast about, and about half or so mention the scores they got. Of those, nearly all claim a merit. I’ve only seen two people claim distinctions. So having my own merit is enough to keep level with others, even if it isn’t the outstanding claim I’d hoped for.

I’m not used to failing academically. Even when the doctor and therapist was trying to have me withdraw from sixth form and attend hospital instead, I was maintaining high marks through sheer stubbornness. The only subject that was slipping was pure maths, which was the one subject I’d been pressured into taking – I hadn’t wanted to do it but had been told I was too smart for them to allow me not to take it. My marks in pure maths had slipped to a B.

I’ve always been a perfectionist, and failing is not something I’ve been able to accept gracefully. My parents always expected me to succeed at everything – anything short of perfection was unacceptable, and I had just enough raw intelligence and an excellent memory to be able to meet those expectations. I never got used to coping with what happens when you try your best at something, and that best isn’t good enough. Getting a B was a failure, because it wasn’t perfect.

A merit instead of a distinction is the same. Rationally, I know that it’s enough, because I have the evidence of seeing other proofreaders’ websites and profiles listing a merit in this same course, and knowing that they’re able to support themselves in this profession. Even those who list no marks and presumably scored a bare pass are considered worthy professionals. So my own merit will be enough to suffice. But still – it’s not perfection. Rational has nothing to do with it. It’s not good enough – and there’s nothing I can do to change that. I’ll have to learn to live with it.

Withdrawal

Withdrawal

Currently, I’m sweating and shivering, and I feel like have the world’s most sudden-onset case of the flu. It’s entirely my own fault; I forgot to take my pills last night. I stayed up late in a fit of enthusiasm for playing videogames, and I tumbled into bed in such a hurry that I forgot about the pill organiser patiently sat on my windowsill. I’ve taken them now alongside the set for this morning as a catch-up, but it will be several hours before the symptoms go away.

I take a variety of pills, but I know exactly which one is causing the shakes: quetiapine. I loathe quetiapine. I hate having to take it, because not only does it involve this insanely rapid withdrawal crap, but it also makes it impossible to wake up in the mornings, and it’s caused me to gain nearly 25kg in just six months. And I have no idea if I should be taking it at all, or if it’s doing any good.

I originally began taking quetiapine over a year ago, in a tiny dose as an antidepressant augmentation and a sleep aid. I didn’t really notice any side effects back then, although my depression was unmanageable and in a self-destructive tailspin, and I wasn’t in a fit state to notice very much of anything. This all came to a head when my case manager prised the truth out of me that I was acutely suicidal and intending to kill myself that same day, and I was encouraged to volunteer for hospital admission in that politely worded tone of voice that makes it perfectly clear that if I fail to “volunteer” then there will be sectioning and coercion following shortly after. I was in the hospital for two months, during which the psychiatrist I saw made two recommendations at once: ECT and a massively raised quetiapine dose. Over two weeks he raised it from the tiny antidepressant-augmentation dose up to the heavy doses they use to combat psychosis.

When I was discharged, I was told that if after six months I’d had no relapses, then the quetiapine could be gradually reduced again. Trouble is, it’s been six months now, and I’ve had no medication reviews – nor have I got anyone to ask for a medication review. My GP has firmly said all along that she’s not qualified to handle polypharmacy psychiatric medication, and that it’s solely in the hands of the psychiatrists at the personality disorders service who have taken care of me for the past ten years or so. That’s all well and good, except that the only person I see with any regularity is my case manager, who is wonderful but who isn’t a psychiatrist. I could ask to see one of the psychiatrists attached to the service, except that I won’t be a patient with them for very much longer. Budget cuts mean that they’ve got to severely slim down the services they offer to the point that my case manager doesn’t feel that he’ll be able to take care of me effectively any longer, and he’s currently putting through a referral to the depression specialists – which could take months. So right now, I don’t have anyone monitoring my medication which means that there’s no-one to prescribe me quetiapine in anything other than these huge pills, which I can’t subdivide into smaller doses. Snapping them in half is hardly scientific, and anything smaller just reduces them to powder. The god-awful withdrawal is enough to deter me from attempting to just quit them cold-turkey (I stuck it out for three days once, and I felt like I was dying) so for the forseeable future I’m stuck at the high dosage along with the weight gain and the morning-zombiehood.

The most annoying part is that I don’t even know if the quetiapine is doing me any good at all. It’s true that I’ve been mostly stable (if miserable) for the past six months and that I’ve only gone on a poisons research spree once or twice in that time, but since my hospital admission involved both the introduction of the quetiapine and the ECT at the same time, how can I know whether this period of stability is attributable to the ECT, or to the quetiapine? It’s possible that the ECT worked a miracle “cure” the way it’s supposed to, and the quetiapine’s doing nothing. Or it’s possible that the ECT was a failure and the quetiapine is responsible for saving my life. Changing two things at once is an appalling way to conduct an experiment, and it’s not possible to disentangle the two effects. The scientific method demands controls and only changing one variable at a time for this exact reason.

If the pills are responsible for my still being alive, then I’ll grudgingly deal with the side effects. But if they’re doing nothing productive, then I resent having to take something that makes me feel like a stoned beached whale and regularly makes me sick if I forget them even once for just twelve hours. Once, I forgot to refill my prescription and ran out of pills on a Friday. By Saturday evening I was so ill that I ended up having to see one of the emergency doctors at the hospital in order to get a dose to last me until the Monday. When I’m in a depressive fog, organisation and preplanning are not things I am good at. It’s inevitable I will screw up sometimes, and every time I do the withdrawal is way too severe a punishment for the actual transgression.

Springtime

Spring is here. The fuchsia bush by our back door is budding, and it’s possible for the first time this year to leave the house without a jacket. The sunshine was bright this morning, although I spent most of it in bed trying to summon the will to get up. Warm weather is beautiful and so much more convenient for getting things done, especially when it’s dry and sunny the way it was this morning. It’s no wonder that spring is the time when seasonal affective disorder (and its far lesser shade, the winter blues) is meant to lift.

If only.

As with so many things, I have to be the exception to the rule. Warm sunshine feels almost transparent. It’s paper-thin, and feels almost as if you could shred it without even meaning to. Winter is a time when you can burrow into yourself and claim to be hibernating, but spring is when you’re expected to come out of your shell and be who everyone expects you to be. It feels fake, like the polite smile you wear when you feel hollow and dead inside.

I feel ungrateful, for not appreciating the spring the way I’m supposed to. Depression has always felt so much stronger for me during the summer. The two most recent hospitalisations were both during the summer. I feel pressure to act as if the warmth and light have made everything lighter and more carefree, to meet the expectations of those around me. I feel guilty for not being able to give them what they want.

Chocolate-Whiskey Cupcakes

Chocolate-whiskey cupcakes from http://www.thekitchenprepblog.com/2012/08/chocolate-whiskey-cupcakes.html

The best way to use whiskey when you don’t like whiskey

When I’m feeling particularly bad, I get the urge to bake things. Not necessarily to eat them, but just for the process of baking. The flow of weighing and measuring ingredients, of sifting, stirring, whisking, folding… these repetitive tasks become almost a meditation, during which I can lose myself in the rhythm and ritual. Then I get to watch as the oven transforms my offering into something sweetly fragrant which magically rises.

This weekend, I baked chocolate-whiskey cupcakes, using a recipe from thekitchenprepblog. I have a collection of recipe books, but most frequently I tend to run a google search for ingredients of interest, and to pick a recipe off a random blog or site. This time, I went looking for a way to use the half-bottle of whiskey my brother in law left us with when he emigrated to Australia six years ago. Neither I nor my husband like the stuff, so it’s just been sitting unloved in a cupboard. It’s probably a sin against alcohol to use 15 year old single malt whiskey for flavouring cupcakes, but I reckon it’d be an even worse sin to never it for anything.

I was short on icing sugar so I reduced the quantities of everything else in the icing to match – but I still had plenty left over after I’d iced all of them. I tend to use a lot less icing than recipes usually call for, because I find that if you put too much on, then the finished cupcakes will taste of sugar and nothing else. Using less icing is less pretty, but it means you can taste the cake instead of getting overwhelmed with icing. I also didn’t make the Chocolate-Marshmallow-Whiskey-Caramel-Bacon Brittle that’s supposed to go on top. Instead, I sprinkled them with chocolate drops.

These were just gorgeous – moist, dark and rich. They’ve got coffee in them as well as chocolate and whiskey, so I’d be more inclined to call them whiskey-mocha cupcakes instead. There were far more of them than P and I could ever eat by ourselves, so I took them along to choir rehearsal on Monday where they lasted all of ten minutes. When asked what the occasion was, I told everyone I made them because I was bored. They told me that I need to be bored more often.

Paralysis

Two heaps of papersThis week has been filled by an uneasy tension between too many things to do and not enough time, and paralysis from being unable to focus for long enough to get under way with anything. Due to having to repeat last year’s course through having been too ill to complete it the first time around, my course load at present is three classes toward the science degree, at the same time as finishing off the proofreading course. Trying to complete four courses at once is too heavy for me to cope with, but at the same time I can’t put any of it off until next term. The funding rules and course offerings are changing, and all the ones I need to take to complete the qualification are on their final presentations. There is literally no wriggle room. I need to complete them and pass everything, plus the same for the next two years, and if anything slips them that’s the whole effort wasted. It’s very different from how I would have preferred to do things. I think I would have been able to handle taking one, or even two courses during the year. Three is more than I can handle without getting panicky and stressed, and trying to cope with four at once (even if only for a month or two) is too much.

All three science courses have an assignment due during the first week of April. I’ve answered some of the questions in the assignments already – the ones on topics I already knew – but there’s a heap of reading to get through before I can answer the remainder of them.

Having so much on the go at once is paralysing for me, because I become overwhelmed with anxiety. Doing any of one thing means losing track of, and falling behind with, the other three. No matter what I do, I’m so busy worrying about everything else that I’m not doing, that I find it almost impossible to concentrate and get anything useful done. I’m managing to avoid procrastinating, but inaction through paralysis is just as unhelpful as inaction through procrastination. A schedule or a study plan might help, but even the best schedule in the world isn’t going to help if there’s just too much to fit into too little time.

I don’t know how I’m going to survive this. It’s going to last like this until June. After June it will become easier. I hope.

Manipulations

Some people are able to brush themselves off and move on from difficult times as if they had never happened. I’ve never been able to do that, because nothing is ever fully over. It’s similar to the old idea that someone never dies as long as they are remembered. Because events and feelings get seared into my memory, I cannot forget them, which means they never fade away. They hang around, ready to jump up and bite me at the worst possible time. Most of the time it’s unpleasant, but okay in the way that painful things become endurable if they persist for long enough. But at other times, memories of being hurt, manipulated or betrayed can sour and ruin the present, because I become so scared that the things which happened in the past will occur again that I stop being able to function in the present.

When I was a child living with my parents, I had depression. Everyone agreed that this was true, and it became a way of understanding myself and understanding the world that didn’t fix anything, but it did make it a little more comprehensible. Feeling isolated and stuck and paralysed by apathy and misery was a painful way to exist, but it was an acceptable way to exist because I was ill. The GP and the therapist both kept trying to convince my parents that I was more ill than they would believe, but at least my parents accepted the fact that I was ill. I wasn’t a failure or lazy or ungrateful – I was ill, and it was not-my-fault.

After I left home and moved in with my boyfriend (now my husband) things gradually changed. My new GP was no longer the kindly man who had arranged hearing tests for me as a toddler, or who prescribed me the banana-tasting antibiotics for recurring ear infections long after I ought to have grown out of it and learned how to swallow pills. My depression grew worse and instead of treating me herself, my new GP referred me to the psychiatrists at the hospital.

The hospital psychiatrists refused to talk to me about diagnosis, and instead wanted only to discuss medications and side effects and if I felt “better”. However, I had no reason to believe that there was anything different about her diagnosis, because she prescribed me antidepressants. That all changed a year or so later, when I was in the middle of an extremely bad relapse, and made several suicide attempts in quick succession. I was told by the junior psychiatrist that he felt that I needed to be in hospital, so I agreed to be admitted. In the admission assessment, the doctor asked me what I thought my diagnosis was, so I told him I had depression.

I was in hospital for two weeks, and whilst I was there the ward staff treated me like something they’d scraped off the bottom of someone’s shoe. I was told that I shouldn’t be there because I was just attention-seeking, and taking up space that ought to belong to someone who was “really ill.” No-one would explain the rules to me, and every time I thought I had them figured out, they’d change them all again, and blame me for not being able to read their minds. I was told that I was being manipulative and banished to my room, but when I tried to explain to another staff member that I had been told I wasn’t allowed to come out, I was told that they weren’t going to play my games. After the first week I withdrew completely, and stopped trying to conform. I stopped speaking, and a day after that I stopped eating. No-one said a word to me about it. I suspect that the ward staff were happy about it because it meant that they could pretend I didn’t exist.

The psychiatrist in control of my discharge assessment was the same one who had put me in the hospital. He told me that I shouldn’t have been in the hospital at all, but he had sent me there because he believed that I needed to take some sick leave from work, but he knew I wouldn’t agree to it. He admitted to me that he had lied to me and manipulated me and had forced me into a position where the ward staff felt free to bully me, and then had the nerve to tell me that I had no right to be upset about his lies because he had done it for my own good.

From that point onward, I lost trust in the psychiatrists I saw. I no longer believed that they knew what was best for me, and I began to call them out on their bullshit when they lied to me and tried to gaslight me. The final straw arrived when the time came for me to return to work, and my psychiatrist wrote a letter to my employer to request that I be permitted to return part-time for a month, instead of straight back to full-time. Instead of telling my employer that I had depression, she instead wrote that I had been diagnosed with “emotionally unstable personality disorder.” At first I was confused, but when I hit the internet to learn more about this new diagnosis, my confusion soon turned to hurt and betrayal. No longer was I ill and not-my-fault. Instead she had diagnosed me as an incurable, twisted, evil emotional vampire destined to a life of hurting other people. She had made the judgement that I was not ill – that my diagnosis was a judgement of who I was as a person, and the judgement was that I was at-fault and no-good.

I brought the subject up the next time I saw her, and she had the brazenness to tell me that I had no right to be upset about what she had written, because she had diagnosed me with that long ago and I must have known anyway. She tried to tell me that I was inventing my ignorance of my diagnosis, and refused to listen to the logical counter-argument that if I had known about this personality disorder diagnosis already, then I would not be surprised and upset about suddenly learning it in the most hurtful way possible. I demanded to see my case notes, both outpatient and from my stay in hospital and was unsurprised to find that they were a complete fabrication and bore no resemblance at all to anything that had been said or done. By that time, it no longer surprised me to find that she was still lying to me.

A few months later, she said there was nothing she could do for me, and she referred me to a service who specialise in personality disorders. That referral was probably the only good thing she did for me. I know that she was doing her best and that she meant well, and she was going along with what best practice mental health treatment believed at the time, but knowing all of that does nothing to detract from the fact that she lied to me and manipulated me, and then accused me of being the twisted one. It’s wrong to think ill of people, and I don’t believe that she did any of what she did out of malice or spite. But her reasons and her justifications don’t make any difference to the fact that what she did hurt me, repeatedly. Her being well-meaning didn’t make any of it hurt less.

All this took place ten years ago. It ought to be long finished and done with, and buried so that it can’t hurt me any more. It still hurts. Every time I think about it, it still hurts.

The tyranny of group work

Group activities have always been a fear of mine. A group activity is one in which by definition my grades will depend on other people’s work and other people’s commitment. It’s not only nonsensical, but every time I get forced into it, I wind up oscillating between trying to control everything to make it feel safer, and getting so overwhelmed that I withdraw entirely. This is my second time around with this activity, and it’s harder than the last time. This is the second time I’ve attempted this specific course. I first took it last year, but was forced to drop out and start again from the beginning because the stress and anxiety and meltdowns from the group activity were a significant part of a complete breakdown which landed me in hospital for two months.

The activity is to mutually agree a set of questions that a theoretical government panel would use to assess research proposals for the creation of transgenic animals which would be used to pharm drugs. Easy enough in principle, but everything’s getting shredded by various group members who insist on going off on irrelevant tangents, generally arguing, or complaining to the tutor that other group members made it impossible to discuss anything because they started discussions too early. (I have no idea how you square that particular circle. That doesn’t even make sense as a complaint.)

It’s so frustrating wanting/needing to make a contribution to the activity, but not being able to say anything because if I do someone’s going to yell at me for dominating the group or for saying the wrong things. There’s so many things that no-one else seems to have thought of, but I can’t say any of them because someone’s already complained that “certain people” are saying too much and not letting others get a word in. But the cure for that is for them to post more! There’s stuff they need to know, that they need to consider, but I can’t tell anyone about it because they don’t want to hear it. And because they don’t want to hear it, the group is going to get shitty marks. I’m going to end up getting shitty marks because other people refuse to listen to me.

This is how everything went wrong last year, and it feels like it’s happening again. I can’t fall apart again.

Rumination

I’ve forgotten what it feels like to not be tired. A bone-deep exhaustion settled in so long ago that I’ve forgotten what it felt like to be able to climb out of bed with energy enough to dress and start being productive immediately. I don’t remember the last time I managed that. I’m in bed by midnight every night, and often long before. But it takes hours to fall asleep – hours spent generally staring at the insides of my own eyelids trying to stop the damn gyroscope inside my head from spinning. Rumination is the fancy name for it, and its meant to be a warning sign that things are getting bad. It probably was, an unknown time ago. Now it’s a permanent companion. From time to time my GP gives me the good stuff for sleeping, and then I can wake up ‘merely’ zombie-like instead of unable to move. But it’s not safe to take the good stuff for any length of time, because it’s addictive and it stops working. Instead, she offered melatonin. It doesn’t work very well (at all) but it’s a natural body hormone, so it can be taken indefinitely without worrying about harm.
Being so exhausted in the mornings makes it almost impossible to get out of bed at the right time. I try to get up when my husband leaves for work, but it’s usually an hour if not more before I manage to put my feet on the floor. It means wasted time that I should have been doing something productive to justify my existence, and sets everything further back. He thinks I’m lazy. I must be, because normal people can get out of bed when their alarm goes off, but I can’t. Yet one more failure.
The one good bit about lying awake for hours is that it makes for long snuggles with my kitties. I have three, and the two black sisters fight over which of them gets to snuggle with me. The little tabby prefers daylight cuddles, so she gets to be picked up and carried about all day instead. I spend more time with my kitties than with people. They don’t judge and they don’t expect any more than cuddles and food and a predictable nap schedule. It would be so much easier to be a cat. No need to worry about being good enough, or trying to decipher what other people are thinking. No need to throw on a shiny facade to pretend to the world that everything is fine. No need to worry about passing for normal. God, I wish I could sleep.