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Welcome to My New Sobriety Blog

Be yourself; Everyone else is already taken.

Oscar Wilde

I’m quite new to my relative sobriety, finding my way in a world where I’m used to being the helper not the helped. I’m thinking there might be other people out there like me, scared to come out because of their professions so if I reach you and you feel less alone then I’ve helped us both.

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A week of two parts

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I’ve wanted to write all week but haven’t been able to as I’ve not known which narrative to share or how to combine them. If I told one it would invite a certain response that I didn’t really want, though I knew it would be heartfelt and sincere. To tell the other, and not mention her bedfellow would just be too disrespectful. So, a two part telling of the week.

I did an online yoga class last Tuesday night. Jane the teacher reminded us that life is always precarious but usually we are not aware of it. The practice focused on breath and grounding. I struggled to stay focused for the full session but it felt good to do yoga with others again and to hear Jane’s familiar soothing voice. Life is slower but the days pass. I’m getting used to working remotely. In some ways me and C have been practising for social isolation as we spend a lot of evenings in just the two of us normally. We are at ease with each other and comfortable and I feel lucky I’m with someone I love right now. The idea of not being able to see my friends though is hard. We are slowly getting to grips with the virtual meeting world. I’m very much a people person so I’m grateful I’m more at ease in my own company than I used to be. I miss my daughters terribly. It was J’s birthday on Saturday – the first one in her 22 years I’ve not been with her. We did a family present opening on line and a birthday cake later which was lovely. Imagine a lockdown without internet? The explosion of humour and cute stuff coming through on the WhatsApp groups is a distraction and a reminder of the resilience of humans. Gets in the way of working though and I’m getting less done than I thought I would. It’s too easy to leave it til tomorrow when there’s so much time. I miss the horse so having the dogs and the cat to cuddle helps. Walking the dogs is the highlight of the day. I find myself looking closely at the trees and flowers and wondering at Nature; creator of all this precious life as well as the virus we are all hiding from. There’s a tenderness in everyone’s interactions that’s not normally there. Almost everyone smiles and says hi, and I’ve had long conversations with strangers – at a 2m distance of course. We humans are social animals and you can see the need to connect in everyone’s face. Lots of houses have rainbow pictures in the windows – a message of togetherness and hope. I’m getting better at losing at Scrabble! Not had a tantrum in a long while! On line jigsaws are my new obsession. I’ve only baked one cake, which became J’s birthday cake. I left a third of it on a friend’s doorstep as it was going down a bit too easily! We got out in the back yard Saturday and I planted the random plants from the supermarket and a neighbour gave me a rosemary plant. So far the dogs haven’t trashed them so that’s a result! I’ve stopped avidly consuming the news or reading about Covid-19. In many ways it’s easier to be present and in the moment when every day is similar and there’s less to look forward to or plan for. It’s easier to savour the little moments – the taste of the cake; the joy of a favourite song on the radio dancing round the kitchen; a phone call with a friend; a soothing hot bath with bubbles. I hope that’s something we can all keep after this is over.

I had a call Wednesday morning telling me a young girl I’d seen twice privately had killed herself. Shock and disbelief enveloped me and for the next day I had to keep reminding myself it had actually happened. I emailed her mum then took myself out for a walk. Her mum rang me whilst I was out. Did I see it coming? Had she said anything? No I didn’t and no she hadn’t were the short answers but I shared as much as I could and offered as much empathy and love as It’s possible to through a phone. In normal times I’d have gone to see them but I can’t. For the family to be going through this in isolation and lockdown seems doubly cruel. The initial meeting when all professionals share what they know happened the next day. The thought that I am a lone practitioner in this and the person who others will think could have or should have spotted the signs was foremost in my mind. I looked over my notes and although I’d done a good job I could find holes and found myself mentally cross examining myself like a combative barrister on the one hand; the other trying to tell myself everything will be ok. I’ve voiced frequently that one of the things I like about my private work is it’s less risky; a major reason for leaving my day job. Is the universe trying to tell me to quit altogether? If I don’t will it something even worse happen? I felt guilty that I couldn’t help thinking about myself and the possible consequences when a girl has died. Missing my daughter on her birthday I thought of her mum never seeing her again; it broke my heart. My sleep was restless and images haunted me of her sitting in front of me smiling, as well as of her dead. Could I have done something different that would have made a difference? The next day the internal dialogue lessened and I cried. I realised I have a harsh inner critic and don’t readily accept mistakes or failings and have high expectations of myself. I want to be the person who makes a difference and I am often quick to criticise other professionals for their perceived failings. Humility has been lacking. I certainly feel humble now. I talked to my supervisor who sensitively gave me a reality check. “It’s an awful tragedy but not all suicides are predictable or related to depression, detected or otherwise. It’s often rejection in the moment that is the trigger and whatever you had done it wouldn’t have made a difference in that moment”. After a more restful nights sleep I’ve started to feel more at ease with myself. There is nothing to be gained from worrying; it has happened and what will be will be now. I can try to support the family as best I can and help them make some kind of sense from the incomprehensible. The yoga class this Tuesday had a message of standing tall and strong in the face of adversity. As I breathed deeply through warrior I began to feel like I might just be able to.

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Surviving lockdown

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So a couple of weeks later than the rest of the world thought we should be, the UK is now in lockdown; though the list of essential workers is long and people are still confused as to what they can or can’t do. We know what is coming but we don’t know either; not really as in what it will actually be like. Most of us have never directly lived through a national emergency, war, pandemic, or indeed anything remotely scary or disruptive on this scale. The news can often have a far away ‘otherness’ about it which no doubt has contributed to people struggling to accept the danger is imminent and real. This kind of thing happens to other people in other parts of the world, surely not here our minds ask?

With the re-introduction of spliff me and C have stopped arguing and are starting to find a rhythm to it. We’ve been gradually isolating more and more these last 2 weeks. We pay money to go stay in cottages to be just us and the dogs; so when I’m not consumed with the news and anxious foreboding I’m trying to look on it as a gift of time together. Lots of connecting with others too via WhatsApp groups and Facetime with my girls and my mum. Hard to get any work done with all the jokes coming through – can’t stop laughing!

Having watched a U tube virology lesson about Covid-19 and been reminded that we can bolster our immune systems to increase our chances; (should there not be a ventilator available if needed); I’m chomping on Brazil nuts, having cider vinegar every morning (my Dad will be proud – he swears by it) and taking Vitamin C. As I edged nervously around other shoppers at the supermarket today, gloves on and scarf over mouth, I felt the urge to bake and bought random ingredients as delicious things appeared in my mind. Randomly bought some bedding plants too – don’t know what they are but we will have the time to watch them grow. It was lovely to see my mum even if at a distance when I dropped her supplies round afterwards. Walking the dogs felt like a treat in the warm sunshine. Nature seems to be celebrating as she always does in Spring but it’s bittersweet this year.

C suggested more love making as a way to pass the time – always near the top of his list anyway! Vaguely remembering that sex boosts your immune system I enthusiastically agreed – ‘at least 4 times a week please!’ It’s fun, it’s free and it’s good for you – what’s not to like!

Of course the other thing that zaps your immune system is stress, and there’s a lot of that to be had right now. I did an online yoga class tonight and though different it was comforting and grounding. Jane, the teacher reminded us that life is always precarious – we just aren’t aware of it most of the time. I thought about the refugees around the world; facing this in overcrowded camps with little medical care available; after having fled their homes leaving all they had behind. I felt grateful I still have a warm home and good food. We may not have lived through anything like it but plenty around the world have. This pandemic is a great leveller.

So I guess this is my personal Covid-19 lockdown survival tool kit: good food, sex, yoga, connection with others whatever ways I can and remembering there are people much worse off than ourselves right now – (and lots of homemade cake!) – what’s in yours?

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Oops I did it again…

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So I lasted smoke free until Friday night. Worked from home all day – didn’t get much done between meetings (distracted by anxious thoughts and multiple funny Gifs memes etc coming through – humour is universally used to try and stay sane!) and late in the day became aware of a medication error that was in part because I hadn’t written up the plan on the plan though I had communicated it but still my bad. No harm done but it got to me. I was in an over aroused state in spite of meditating and when I’m like that I’m snappy and C got mad at me – really angry which is a rare thing from him. It hit me hard – (I hadn’t realised I was being that annoying!) and that was it.

I am not good at being confined and I’m finding doing everything through a screen unnatural and strange. I’m also really worried both for myself and loved ones but also the NHS, my friends working there and the human race. I don’t know when I’ll next see my daughters. Spliff is calming me down in spite of my angst about the state of my lungs. I’m going to revise my aims as I’m not sure I can be totally smoke free in this extraordinary time; not without serious domestic collateral damage! No cigarettes (which I’ve kept to) and focus on doing more of the other things that help like yoga and meditation so it’s not first port of call and try to have as many smoke free days as I can. I have a yoga book that A got me years ago that says ‘don’t worry about your bad habits – just do more yoga and things will naturally sort themselves’ so I’m going with that. I know it’s a cop out and I know the beginning part is the hardest but it just feels too hard without all of normal life to distract and a shitload of anxiety in its place. Maybe I need to do this over and over like I did with booze until I get sick of it? I don’t want that either so for now I’m retreating from this particular frontline back into my comfort zone.

To end more positively tried a virtual meet up with friends last night which didn’t really work but it was lovely to see their faces. We wanted to sing a tribute to Kenny Rogers together! It might yet happen! I’m seeing a silver lining in the fact the government is having to do socialist things or everything will collapse and I think that will be hard to reverse once this is over as it will be too obvious to fool anyone anymore that neoliberal capitalism is a really bad idea for most of the population. Also the community level humanity and caring that is happening is heart warming and I hope we can keep it up as things get worse. Stay safe everyone and take care.

Day 2 smoke free

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Well I got through the day! Some sticky points but there were always going to be. I’m writing this to reflect on what helped and what didn’t so I can do better today. By better I mean avoid the meltdowns!

I was busy all day but wrote and meditated in the morning – definitely helped. Then I worked at home all morning then in seeing patients in afternoon then riding. I usually smoke in the car so that was tricky but I ate instead. Got home about 7 and that was the most difficult time. Used to be wine o’clock and also spliff o’clock. I got irritated with C, and decided we would have a spliff. I got the box and C reminded me what I had written yesterday (he reads my blogs!) so I went away to read your comments and then decided to eat dinner first instead.

Your comments were so helpful! Helped me remember what my actual desire is – to be fully sober; encouraged me that I can do it and also that I’m not alone in this. Lots of lovely people are doing this too all around the world and they understand what it’s like. Thank you thank you thank you 💞💞💞 (Nadine I air smoked a bit too and it helped!)

After dinner I decided not to smoke and I was surprised that I didn’t actually crave much the rest of the evening. What I did do though was pick a fight with C just before we went to sleep. I ended up crying in my daughters bed but went back up and made up before sleep. My mum always used to say ‘don’t let the sun go down on your anger’ and I try to live by that as leaving stupid arguments overnight blows them up into more than they deserve. When I was downstairs I thought about going and having a cigarette and realised just how stupid that is. As if a smoke makes up for falling out with the person you love? Not being able to see your children for a while? Worrying about Covid 19 and all the people on the frontline and how we will cope as a community, a country, a species? This was clearly my addiction voice (now known as smoke devil 👿)at work and not my true self. It takes hold of my anxiety, distorts it into an all encompassing negative then presents itself as the only possible solace; having dissed all other available comforts along the way. God I hate that bastard! I hate it even more as it’s part of me but I do have a choice about how much it controls me.

When I did Kate Bee’s course I remember she commented to me ‘you’ll have learnt so much from your 3 months”. That really helped me reframe this as not about willpower, a battle, being good or bad but as a learning curve and she was right. I’ve learnt a lot from not drinking for 11 months and that is going to be invaluable in learning to not smoke. I need a toolbox for the trigger moments; recognition of the 👿; other ways to manage my emotions and connection with others. So heartfelt thanks again and I’d best get up and go meditate 🧘🏻‍♀️🧘🏻‍♀️.

Testing times

It’s hard to get your head round what is happening globally isn’t it? Within less than a week I’ve gone from relatively normal movements to doing most work remotely and no social contact. My world has shrunk to C, work, walking the dogs and riding though that may get banned soon as too dangerous. I’ll see my mum but not too often due to the risk. They are in lockdown pretty much where she lives. I don’t know when I’ll next see my girls. I’ve decided that I need to stop smoking and attempted this yesterday. It didn’t go well not surprisingly. Giving up the main way you manage your anxiety at the most globally anxious time of your life was never going to be easy. I’m caught between the anxiety of Corona and the knowledge my years of smoking make me higher risk and being stuck in the house with little distraction. What I normally do in this situation is smoke, play games on my iPad, read, etc. I’m not very good at doing nothing when I’m not stoned. My depression meant I’ve done that more in recent months and now I want to connect! I’m out of synch with the world.

If I had any doubt this is an addiction searching for the bits of hash left in the box last night dispelled those thoughts. I’m not sure if it’s the hash the tobacco or both? When away from home I don’t smoke hash and it’s fine but I do have cigarettes. When I’ve not had cigarettes (a 6 month spell a long time ago) I found I didn’t want hash so it was definitely tobacco to start with. I need and want to stop both. When I smoke a cigarette I’m thinking ‘why am I doing this?’ but I keep doing it. I think back to giving up alcohol which was so much harder as the rest of the world thinks alcohol is great. I had been battling with myself a long time and was truly fed up with it. I don’t feel like that about smoking which I know is pretty stupid.

Yesterday the wine witches friend, smoky devil was out in force. She started gently ‘try to notice when and why you smoke today in preparation for stopping’, she said as I had breakfast even though this was stop day and I’ve done that many times before. ‘You’ve got a full pack – stop after those are gone’ etc etc. When I stopped drinking I had a house full of booze and didn’t even throw it all out so whether I have cigs in is irrelevant – there’s a shop over the road. I managed to externalise this internal battle by shouting at C over some minor issue causing him to shout back which he rarely does. I went in a shop and got really anxious as was close to people. By the evening I was feeling miserable and saying things like ‘if I’m going to die then I may as well get pissed and have some fun first’ – ‘hello wine witch not seen you in a while! Come out to party with your friend?’ The addiction playing out in my thoughts and dragging me down once again to the fuck it mode which usually is followed by shame and self loathing.

So this morning instead of reading the Corona news (and ramping up my anxiety) I’m writing this. I’m not going to beat myself up or shame myself for smoking yesterday as that will push me towards doing it again. Instead I’ll try to check in here as often as I can; I will do my meditation this morning so I am grounded for the day ahead rather than late in the day in a vain attempt to calm down and I will prepare by writing down the reasons I want to stop and look at it every time I think of smoking. Take care everyone – sending love to you all and hope for a better world when this is hopefully over.

Hello there!

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Hello fellow bloggers – sorry I’ve not been here for a while. It’s Sunday morning and I’m being lazy drinking tea and reading and writing in bed. The thought of doing this last night gave me a warm feeling! I’ve been thinking of you all but I’ve been busy getting back to work and catching up with friends in the real world now I’m not feeling depressed; as well as reading a great book that you want to keep getting back to (A Gentleman in Moscow) that I’ve really enjoyed. The irony of emerging from my own period of self isolation just in time to enter one for very different reasons is not lost on me, but I’m glad I’ve seen the people I have in the last few weeks. I feel like I’m living again and that has been great. A lovely weekend with my eldest daughter; lunch with my youngest brother and his wife and new baby; dinner with my yoga retreat friend and a few other dear people. A couple of films (Parasite is just brilliant!); yoga, meditation, riding and dog walks. Hard to fit it all in! Going back to work dipped my mood but only for a couple of days and this week I did a full week without that happening. Everyone has been so supportive and lovely, I look back on my anxious paranoid thinking and see it as just that – not a reality except in my mind; but our mind is where we construct our reality whatever our circumstances. Colette (wine to water) and Boozebrain’s posts reminded me of that this morning! (I don’t know how to put links in being technically challenged but they both post great stuff!).

If I’m being entirely honest though another reason I’ve not been posting is because what I would post here is the internal dialogue I’ve been having about cannabis and smoking and whether to stop and when. I’m wondering if I have to give up completely, can I moderate etc but I think I know (as a voice in my head tells me) what you would all say and I’ve not been quite ready to hear it! I’m addicted to it in that my use is compulsive and when I try to cut down/stop I can’t. That isn’t a judgement it’s an observation and a truth that I can no longer ignore.

Anyway, Corona virus has given me a push and I’ve asked C not to get any more in as I want to have a break. We are worried as C is over 70; we have a lot of contact with my 81 year old heart diseased mum, and I’m a 55 year old smoker so also at risk if I get it and medical care is in short supply. If there ever was a time to stop smoking this is it. The reasons are up close and personal. Having had suicidal thoughts intermittently in recent months I can now say unequivocally I don’t want to die just yet if I can avoid it; and there is something I can do to help with that. I’m also coming up to a year AF and I’d like to be fully sober on that day so I don’t feel like a fake in this world.

I’m going to try to emulate the Sober School course applying the lessons and thinking to weed and tobacco whilst only committing to 6 weeks initially. Interestingly in search of literature to support me in this (reading a lot changed my mind set with alcohol but there’s a lot less out there for cannabis) I’ve found a book that advocates ‘changing your relationship’ rather than total abstinence with cannabis. But addiction’s addiction right? If I stop for 6 weeks I can test this all out and decide for myself at the end of that time. An experiment, no more no less.

I hope you’re all safe and well and thank god we have the Internet and these virtual communities to help us through what will undoubtedly be difficult times for us all. Take care and stay strong 💞💞

The Power of Yoga

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I have dabbled with yoga for many years but it’s only since I started my AF journey at the end of 2017 that it’s been in my life more consistently. When I came back from the retreat recently, recognising that I had neglected yoga for a few months I set myself a 40 day challenge to do yoga or meditate every day in an attempt to embed the habit. Ive missed 2 days so far out of 30. Some days it has been really difficult to get myself onto the mat and I’ve literally only been there for 5 minutes. More recently I’ve found myself prioritising it and looking forward to that time.

In his wonderful book, The body holds the score, Bessel van de Kolk talks about how trauma is held in our bodies and nervous systems, and people need more than talking therapy to help with that. It’s like the body’s smoke alarm is set to be triggered at any hint of danger, leading to over reactions, stress and catastrophising all over the place. Their research has confirmed what the yogis already knew; yoga calms it all down; encouraging balance between the parasympathetic nervous system (rest and digest) rather than the sympathetic nervous system (fight or flight). It is also said in yoga circles that we hold emotional pain in our hips in particular; a result of those muscles contracting whenever our stress response is triggered. Sitting at desks and in cars for long periods doesn’t help either.

I’ve had tight hips as long as I’ve been aware of such things; particularly on the left. Years of running and riding and not stretching – the folly of youth! Yoga has helped ease it but I often have pain in that area, particularly as I fall asleep. I’ve been doing a lot of hip stretches in my yoga routine these last few weeks. When I wrote my last post about getting in touch with the origins of my depression; I didn’t say that whilst the memories flooded me as I was going to sleep my hip was throbbing intensely – not super painful but intense. I wrote the blog and the next night I dreamt that my mum died. It was now, not the past, and all I did in the dream was cry buckets of tears. Since that night I have not felt depressed in the same heavy, unmotivated way; and my hip is looser and the pain has gone pretty much. I’ve felt extremely grateful to my unconscious that it took care of the weeping so I didn’t have to in the day!

Whilst there are other things that can take some credit for my improved mood; time off work and antidepressants have helped for sure; as does writing this blog; I don’t think they can account for the physical and emotional healing happening in tandem. As I move through the poses I feel stronger, more balanced and more connected to my body. I also feel a mental lightness and a sense of well being. My thoughts can still go to anxious places but not the black despairing holes they were finding before. I can rationalise my thoughts and put them in perspective more easily. Best of all I’ve got energy and I’m enjoying the small things again. Doing the weekly food shop no longer seems a gigantic task and I’m getting through things I need to do without getting stressed about them. It will be a challenge to keep it up when I get back to work later this week but I think my well being will depend on it!

The little things….

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My posts have all been a bit deep and introspective lately so I thought I’d write something a bit more cheery about (drum roll) – – teeth! A lot of us notice the positive effects of no alcohol on our sleep, our bowel habits, our weight and other physical concerns – for me a big one is teeth. I’ve been blessed with quite nice teeth but when I was drinking a lot I didn’t look after them as well as I should and it was starting to show. A daily reminder that my body wasn’t taking the punishment I was giving it unscathed. It’s hard to clean your teeth well though when standing up is a challenge! Rushing in the morning when you’ve overslept doesn’t lend itself to good dental care either. Trips to the dental hygienist would fill me with dread. Each time as I lay back in the chair with my mouth prised open she would exclaim about the sorry state of my teeth; take photos to show me just how awful they really were and quiz me on my habits and brushing technique. An early return would be recommended with a double appointment as one just wasn’t long enough for teeth this dirty and I would shuffle out armed with new things to use feeling like a naughty kid.

Since I stopped drinking (306 days ago) I have cleaned my teeth religiously every night. Interdental brushes in every space and a proper brush every time. My gums no longer bleed either. It’s a daily reminder that I’m taking better care of myself without alcohol, whatever else is going on and that’s a nice motivator. I was disappointed the hygienist didn’t seem to realise how much better they were on my last visit. ‘It’s been 6 months since I last came – can’t you see the difference’ I wanted to say but couldn’t speak with the cleaning in full flow. It all took a lot less time and hurt a lot less though, and I noticed that even if she didn’t! My teeth are not perfect but they are clean and cared for now and that’ll do for me. 😀

The Guest House

Since I’ve ‘come out’ as depressed I’ve felt as if I’ve allowed it in, to wash over me and occupy the space. ‘Like that poem’ my good friend A said as I tried to explain what I meant. I looked it up and Rumi says it far better than I ever could. Most of my life I’ve been fighting any negative feelings, trying to banish them one way or another. Allowing my depression is a necessary step to becoming comfortable with who I really am but I still want to fight it, berate it, and banish it a lot of the time. I feel as if I’m shedding identities and I’m not sure what’s left or if I like it very much. I’ve shed the party good time girl persona and my competent professional self (though hopefully this one is temporary). I’m still doing horse stuff and being a mum but not a lot else.

I did go to the Celtic Connections music festival in Glasgow a couple of weekends ago with 2 of my oldest dearest friends S and B. It was hard being so sociable but it was wonderful. The music and the joy of the musicians as well as the easy company lifted my heart and soul. I stayed out until the small hours – something I didn’t think I’d be able to do without alcohol and guess what – it was better! No glazed eyes, loss of memory, stumbling around etc etc. No anxiety about pacing oneself. Just unfettered enjoyment of the music. Live music is definitely high on my list of sober fun and my love of it is definitely part of the real me.

Returning home I was tired then got ill. The depression and lethargy came back and I found myself resistive again. Feeling frustrated that I’m not doing enough, berating myself for it. Yesterday I woke up really low and C responded to me in a way that made me connect with his frustrations and hate myself even more. I’m questioning a lot of my decisions from my life at the moment and I started to question us which felt really threatening. I’ve never doubted us – I’ve always known we are meant to be together. We reconnected in the evening and I tried to explain how I was feeling. ‘I know I’ve no actual reasons to be depressed which is the most depressing thing of all’ I said. ‘Maybe not in your life now, but I think there’s plenty of reasons in your past’ C replied.

I feel a lot like my 14 year old self right now so I got to thinking about that time in my life. That’s when I first got depressed. I remember being in my room and my stepmum saying in exasperation ‘what’s wrong with you?’ I didn’t know anymore than she did. I do remember that’s when I started smoking again. I’d first smoked as an 11 year old – the end of primary school. I was trying on rebellion for size but it scared me and a part of me was very critical of it so when I got to High School I ditched my rebellious friend and went back to being the clever good girl for a while. When I started smoking again at 14 I was much better equipped to manage the rebellious persona and now there were boys and sex in the mix as well! Alcohol followed but I didn’t really take to that until I was older. I first smoked cannabis aged 15 and I remember thinking it was the best thing I’d ever experienced. Drugs and alcohol have rarely directly given me a bad time or experience which has made it hard to see them as the problem until now. Of course they are not the problem per se; they have been my solution to the problem of my intolerable feelings and dislike of myself. The conflict between the good girl me and the ‘fuck it’ me (the one that smokes and drinks) has been a constant most of my adult life. I would flip from one to the other without really thinking about what they meant, what their function was, and when in one state of being I would be critical of the other, admonishing without compassion or understanding.

When my mum left when I was 13 I remember feeling relief. I was riding before school and I shed a single tear and that was it. The ‘it was better afterwards’ narrative has been the only one I’ve allowed. I’ve not acknowledged how hard it was being a 13 year old girl living in an all male household; how lonely I was a lot of the time; how angry I felt. Nor that whatever the circumstances if your mum walks out and leaves you then that is an abandonment and it’s only natural to interpret that as you somehow not being good enough or loved enough. I’d had a lengthy separation from my mum as a toddler so perhaps the depression goes back to that; a time when we can’t put it into words so we have to embody it. This is the first time I’ve connected my parents divorce to my depression. I can’t help but also link my younger daughter’s struggles since me and her dad divorced to my own unresolved issues. A colleague of mine once said if you can’t understand what’s going on with a child that you’re seeing, ask what was going on for the mum when she was that age. We pass things across the generations in more ways than genetically.

As I was going to sleep last night I was flooded with memories of those years and I forgave myself my failings and comforted myself. I reminded myself I was just a kid. I woke up this morning feeling lighter and brighter and more my adult self – whoever that is these days! My daughter arrived home and she is lighter and brighter too and that cheered me more than I can say. I’m back in a space where I can appreciate this life and for that I’m grateful and in this moment happy.

Does a diagnosis make a difference?

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My last post – The Retreat led to an interesting discussion about depression and anti-depressants in the comments section amongst fellow bloggers. I had been to my GP as I’m off work so needed a sick note. I asked my doctor to write depression on the note which was in itself a significant step for me. I got a prescription but I hadn’t started taking them as I was going on The Retreat, and when I got back I felt so good I didn’t think I needed them. I planned to go back to work next week and ‘get on with it’. It hasn’t quite worked out that way. I continued to feel good until Wed and was functioning better – eating better and fitting in the yoga. Wed I had a riding lesson back where it all started 12 years ago; the 2nd time around horse part of my life. I was flooded with memories and I missed my old horse. I enjoyed it but I came home feeling really sad. I didn’t want to do yoga but I managed a little. By yesterday morning my thinking was dark again, I was crying and couldn’t be bothered doing anything. When I tried my brain was sluggish and I got easily frustrated. I decided to take the tablets.

What has been different is I’ve been more aware of this shift and I’ve not transformed it into something else; an irritation with C, a complaint or just a hissy fit about not much at all. I’ve also stopped myself going too far down the self critical ‘it’s all your fault you always mess up’ path too. That I credit to the retreat and yoga. It helps me keep a little bit of me in an observing role to myself so I can check what I’m doing more easily. I was resistant to it yesterday but managed a 5 minute meditation. However I’m not functioning well and I have now decided to label that ‘depression’. I am depressed or I have depression? Does it make a difference which way I say it? Does it make a difference to label it?

I don’t like diagnoses which is odd considering it’s my job to hand them out. When I first started psychiatry 30 years ago we were taught that basically people were either mad, sad or bad (I kid you not!). Psychosis, mood disorders and personality disorders. I quickly noticed that the people I met had stories to tell and usually their stories told of loss and bad things happening to them. Some people couldn’t tell you their story but their body told it for them – the young girl in a wheelchair with fixed contractures of her legs meaning it unlikely she would walk again though there was no physical reason. She had been sexually abused but she smiled and told you all was fine. She didn’t know what she was doing in a psychiatric unit. I found that the so called bad people were the most likely to go mad or be sad but because someone had labelled them ‘Personality Disorder’ no one was very sympathetic when they did. I still find this 30 years later; even though all the evidence backs up what I noticed back then. In Child Mental Health there has been a shift towards more diagnoses so that a huge proportion of referrals now are for assessments for diagnoses such as ADHD and Autism. I found that giving the child’s symptoms a label and then trying to medicate them away didn’t really work that well; especially if nothing else changed around the child; and especially if other things were not as they should be. I remember as a very green consultant seeing a child who I thought had severe ADHD. I gave the meds and at follow up asked his mum how it was going. ‘Oh I didn’t give him those she said – I stopped giving him Powerade’. A powerful lesson for me that symptoms can reflect many possible causes. I didn’t stop diagnosing completely but I tried to use it as a systemic intervention; a way of shifting parents thinking and their interactions with the child, as well as a way to get support in school. I also couldn’t help noticing that sometimes when you treated one set of symptoms a different sort popped up like an unsolvable puzzle that keeps changing shape. Quite a lot of my patients could have any number of diagnoses and none of them really helped with changing anything. I found that when people were able to put words to their secrets, their unspeakable experiences, their shame often their symptoms diminished somewhat. I was learning that symptoms have a function as well as a cause.

In 2006 I came across Pat Crittenden and the Dynamic Maturational Model (DMM) of attachment theory. (www.iasa-dmm.org). This made more sense to me than any other way of conceptualising mental health across the whole spectrum from well to really unwell had ever done so far. How you function is rooted in your early experiences and is your best adaptation to that unique context is the premise of it in a nutshell. Of course it’s a lot more complicated and I will write more about it in other posts as it has literally changed my life professionally and personally. The more I studied and trained in this the less I diagnosed, and the more I focused on trauma and adaptation.

The DMM conceptualises depression as when your strategies no longer work for you to get your needs for comfort and safety met, and you know it’s not working. Psychodynamic thinking about depression speaks of anger turned on the self; cognitive behavioural of negative thought patterns that bring you down. Women are so much more vulnerable at times of hormonal shifts – puberty, childbirth, menopause which supports a more biological understanding. I’ve used different thinking in different combinations to help patients understand what might be going on for them; a one size fits all approach isn’t that helpful. I still prescribed for patients, recognising that depression stops them from helping themselves, alienates one from loved ones and support. A barbed wire fence that keeps the pain out but the support as well. I know that meds alone can’t fix things but they can get you to a place where you can more easily help yourself. Ive not applied this to myself though. Is it arrogance that makes me think I’m different? Shame? Stigma?

Overcoming addiction is multi-faceted. We have to change our habits, find new coping strategies, new ways to manage our emotions, to have fun, to relax etc etc. We also have to deal with all the unprocessed losses and traumas that alcohol blocked out. I’ve been conceptualising my lack of energy and motivation as this – I’m processing lots of unresolved stuff as well as grieving the person I was and taking responsibility for the mistakes I’ve made. I’ve had therapy in the past so I’ve been surprised there’s still a lot of pain buried in my psyche. Also I’ve thought of it as a reorganisation process (that’s the attachment model term for significant change in how we adapt). I’m slowed up because doing things differently takes time; it’s learning a new way that isn’t yet second nature to me. I’ve also attributed it to cannabis. I’m lazy and demotivated because I’m still smoking dope. I’ve smoked dope a long time though and it’s not stopped me wanting to get out of bed in the morning before or had me crying at the thought of going to work. I’ve been reluctant to think of it as depression, an illness – until now. I’ve had enough symptoms for more than enough time to meet criteria for a diagnosis but I’ve resisted. So what difference does it make?

Firstly I think it’s given me permission to take time off work and look after myself. It is socially acceptable to stop functioning when you are unwell. Whilst I am trying to maintain as much functioning as I can, I’m not being so hard on myself for not managing all I set out to in a day. If I manage anything at all that’s ok. This is helping me keep some self compassion and stopping me from beating myself up mentally. It allows me to focus on what I can manage; walking the dogs, doing some yoga, trying to cook and eat well instead of going to work, not performing well and coming home too tired to do those things. Not doing them drags me down further. I can start from where I am at and build it back more slowly. It also allows me to separate it out from myself – one of the most helpful things a diagnosis can do. I’m struggling at work because I am depressed; rather than I’m struggling at work because I’m no good at my job. My GP said I’m self medicating with the cannabis. That’s a part of it for sure and I’m hoping that as I am able to do more I will want to smoke less. That the anti-depressants will take over some of the functions of the cannabis.

I still think the depression is related to the massive change of removing alcohol, processing unresolved issues and learning new ways of being. However I have to function as well as do this. I feel as if I’ve spent several months navel gazing and whilst necessary on one level too much of it takes you away from others and doing things that are good for you. It’s all about balance. Self awareness versus self absorption. I’m hoping the meds will help me reset that balance – reach out instead of hide away as I continue to find out who I really am without the shadow of alcohol. Help me embed the new habits that will help me stay well and connected to others and give me the energy and motivation to make the other changes I need to make; on the outside as well as on the inside.