It’s quite a while since my last post – which is a good sign, I think. It’s a symbol that I’ve been living my life rather than stressing over my relationship with the psychiatric system and my battle to be free of medication. By the same token, it doesn’t take a genius to draw the conclusion that – once again – all is not well in paradise.

I’m still meds-free, still working and still living the live I choose to live (YAY!). The downside is that I’m still discovering how to manage my stress levels minus the protective blanket of neuroleptics. Given that I work extremely hard and have recently taken on an MSc on top of my day job, my life is currently far from stress-free.

My voices are much more active and I’m prone to stress-induced paranoia – but my coping strategies are standing up to the tests that I’m throwing at them. Despite the odd wobble, though, I feel proud that I’ve managed to keep my head above water and avoid the major ‘relapse’ that the docs predicted was a forgone conclusion.

So, what’s got me blogging again?

My psychiatrist – having been off on maternity leave for the last 9 months – is back. Prior to yesterdays appointment, I’m lucky in that I’ve been seeing two very respectful and understanding locum consultants in her absence. All in all, my relationship with the system has been pretty neutral. We’ve agreed to disagree. They think I should be on meds. I think I shouldn’t.

They key for me  is that they’ve acknowledged that I’m an adult making an informed choice about my own wellbeing, and that I’m being responsible in the way I’m handling it.

OK, so we’ve still had very incompatible views of the source of my mental distress (biological vs trauma) – but we’ve managed to put this to the background and carry on regardless. I mean, say you met someone who believed the world was flat. Your belief that it was round wouldn’t stop you going for a pint of beer and chatting about work, would it?

I’ve felt better about my relationship with the system in recent months. I’ve mentally disengaged from it, in that I don’t expect any useful support at all (and so I don’t ask for it). This means that my appointments have turned into a public relations exercise, where I’m careful to present an insightful and compliant front for the greater good.

By changing my expectations from the mental health system, I’ve felt more in control and more able to go through the motions with them. Luckily I have enough support in other parts of my life (family, friends and a private therapist) that I’m able to go elsewhere when times are tough.

In truth, if I believed I could physically disengage from mental health services I would. The problem I face, however, is that with such a risky long-standing history of being a ‘non-compliant’ patient – I have to play the game. In a year, I plan to start trying for a child. I need to show them that I’m stable, engaging and complying with treatment for them not to panic when I do get pregnant.

My fear is that they will look at my history and question my ability to be a good mother. I’m guessing pregnancy and motherhood is stressful enough without battling to prove yourself to a system that already thinks you’re enduringly ‘mentally ill’.

Playing the game was much easier when the system played fair. Yesterday, with the return of my old psych, I’m pretty sure things changed. The respectful neutrality I’d established with the previous two consultants was thrown out of the window as she made it clear that, in her eyes, I was a naughty school child who is being willfully difficult and selfish. She told me that I’m putting her in a very difficult position by not taking medication, that I’m leaving myself vulnerable to every little stress and that her team is the one that has to pick up the pieces.

Apparently there is no place for me within the service, I’m a drain on resources and she would discharge me back to my GP except that she feels this would be unfair on them and they’d struggle to ‘manage’ me. On top of this, she rarely made eye contact and was visibly hostile and seemed fed up with me.

In my defence, I tried to be understanding of the pressures she faces and acknowledged that my situation was an unusual one within the service and that this could potentially put her in a difficult position. I did stand my ground, though. I explained that I was still engaging with the services and although I’ve chosen not to take medication, I’m open to other forms of support.

This didn’t really make a difference, unfortunately. In her eyes medication is the only treatment for my ‘disorder’, and me not taking this is highly irresponsible. I think she’d feel better about it if she could see not taking medication as part of my ‘illness’ rather than a conscious choice.

My relationship with the system is a bit like a bad relationship that neither of us seems willing to call an end to. On my part, I’m very concerned that any hint of me being resistant or non-compliant with the services will bite me on the bum when I do have a child. On their part, I think they truly believe that I will have a massive breakdown and they’ll be needed to pick up the pieces in one way or another (either through an investigation if things go terribly wrong, or by reinstating meds if I come to my senses).

I know it’s up to me to call it a day, and I will as soon as I’m able to. Until then, we’ll see each other as little as possible for talks that make us both feel uncomfortable. Other than that we’ll live our lives as if we are single and that we’re not tied to each other at all.

Today I feel stuck. Hopefully tomorrow I’ll get on with that living thing.

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