Jonathan Tullett

Insanity: Insanity, craziness or madness is a spectrum of behaviors characterized by certain abnormal mental or behavioral patterns.

Someone said to me recently that insanity is repeating the same things over and over, expecting a different outcome.

I keep straying from my diet; I keep reintroducing foods which I know I’m intolerant of (or which have an ingredient I’m known intolerant of) because I’m optimistic that suddenly my body’s become tolerant of it and my diet will become, once more, enjoyable to live with.

Every time I’m bitch-slapped into submission again. Every single time. But I keep trying.

Does that make me insane? Is optimism – because that’s what I believe drives it – therefore a sign of insanity?

After a failed attempt at going cold-turkey on my benzo and z-class drugs (previously) I reintroduced the zolpidem and continued with no benzos.

While on holiday with Zachary – a trip which is yet to be written up – I halved my dose of zolpidem, reducing from 10 to 5mg/night. The first few days I struggled to get to sleep, but as I was on holiday there was no rush or stress and I slowly became accustomed to it.

Then this Friday I removed the final 5mg zolpidem. Thursday I slept very well. Friday and Saturday’s sleep were terrible, due to having acute tonsillitis. Sunday and then again last night were very good, sleeping for 10 and 8.5 hours respectively; and only waking the once.

I’ve been going to bed later than I usually do – around midnight – as that’s when I’ve been tired. I expect my cycle to change to an early bed/early wake when I start work next week, but until then, I’m happy with late nights.

I can’t emphasise how good this is: Between July last year and five days ago, I either didn’t sleep much, or I had to be heavily medicated to sleep. I have now had two consecutive good night’s sleep, waking a similar number of times as people who sleep ‘normally’. I’m seeing Dr Broadhead tomorrow, I think he’ll be happy with this progress; he was concerned I’d gained a dependency on these meds.

So it just leaves me on 45mg mirtazapine, which I’m happy to stay on for the time being.

I don’t fall for the Correlation does not imply causation line of thinking often, but on Thursday I finally severed all ties with my previous employer. Suddenly I’m able to sleep. Coincidence?

Detox is going swimmingly. Slept more last night than I had the previous night, fewer waking times remembered – only five or six.

This morning I feel better, more stable, emotionally, but physically I’m shaking. Like, actual shakes. What the fuck?!

Today is day three. I caved on Sunday night and took zolpidem – I didn’t have much choice, faced with 3-4 hours of driving Monday morning, I needed to sleep – but I’ve so far avoided all benzo use (which, for the record, I’m prescribed.)

Yesterday, emotionally, was a write off. Had huge anxiety onset early afternoon and aside from a couple of times where it subsided for a short while, remained until I went to bed.

Last night I felt awake a lot but I only looked at the alarm clock the once – at 2am. Today I’m spacey and can feel an undercurrent of anxiety – though it’s not above manageable levels yet.

Today, so far, aside from one part, can go fuck itself in the arse. I’m tired, want to sleep, need to sleep, but physically can’t. I’m determined to persist with the detox, but it’s testing my resolve far more than I expected.

I’ve decided to cancel the Croatia trip. For many reasons.

Despite the whinging, there have been some really positive/happy things the last few days, but I can’t write about them, as much as I’d love to.

Last night I started my withdrawal from benzodiazapines and the z-class (zolpidem, zopiclone etc) drugs.

Words can not describe how shit I feel today. I had very fitful sleep, waking so many times I lost count, and I was only in bed for eight hours.

My head is foggy; I can not think quickly enough to even have the most basic of conversations with people. My body’s aching.

Strongly dislike. But it needs to be done.

Last night was therapy night, where I drive down to Hayes Priory and sit with Barry while he works his way to the root of my thought processes before starting work on reprogramming them.

I’ve not written much about what’s happened during the sessions because while I’m usually open about my life on this blog, the conclusions and what’s been worked on are far too close to my core being for me to be happy sharing. Sorry to disappoint.

Last night there wasn’t so much to talk about. I’ve been putting into action the cognitive reprogramming of the previous few weeks and I quite literally had nothing of relevance to talk about.

Instead we recapped the previous weeks’ information, and how I’ve been handling situations. While I said I’ve not been in the position where I’ve been challenged in ways which would normally invoke a calculated response/script, he questioned whether I’ve been handling situations better and thus not allowing them to get to the point they would normally become an issue.

Barry’s an insightful man.

We’re now working on me stopping therapy. My next few appointments will be at least two weeks apart, and we’ll take it from there, but Barry’s happy with how the cognitive reprogramming has been going.

One suggestion from Barry was that I would benefit from starting something at the Open University. Not computer / psychology related, but along the lines of creative writing. That would give me an outlet to continue to develop ways of viewing the world and situations.

What’s interesting, to me at least, is that while I’m now in possession of the toolkit necessary to handle situations where my anxiety levels can peak during the day, my sleep isn’t improving. In fact, it’s getting worse and I’ve found myself succumbing to the lure of zolpidem and, on occasions, alprazolam to get me to sleep.

I’ve been keeping my dose of lorazepam and mirtazapine stable (1mg and 45mg respectively), but I feel it’s becoming less effective. Now whether this is due to the tolerance onset of benzodiazpines, I don’t know – I’ve been on lorazepam for a number of months now, so it’s a possibility.

What’s the solution to this? ‘Fixing’ my internal day-time anxiety inducing mechanism doesn’t seem to be doing the trick. Am I heading down the path of permanent night time sleep aids? It’s not something which a thirty year old should need, but is it so bad to do so? Barry seems to think it is. Personally, I’m happy with taking the ‘z-class’ meds for life, whether Dr Broadhead agrees is another matter, and one which will be discussed this coming Monday.

I had my second session with Barry at The Priory tonight.

It’s making me think and consider things I’ve never thought or considered before, and it’s attacking – in a good way – the foundations of my thinking and outlook on life. This is one of the most challenging adventures of my personal life and it has a real potential to change some things for the better.

It’s been a few weeks since I started on the Low FODMAP™ diet (previously).

During that time, I threw out all products which I can’t eat and replaced them with things I can. I’m not being as good as I could be, as I’m yet to be able to cut down on the volume of sweet I eat. However, the sweets I am consuming have no wheat products in them or are made from any of the banned substances – they’re just high in glucose.

So far the results are promising. I’m experiencing few of the symptoms I had been, and I’m looking forward to a continued reduction as the weeks go on.

As I have interest from a number of people on the diet and what sort of things can and can’t be eaten/drunk, I finally got around to scanning in the documents which were provided by Miranda, and here they are:

edit: It has been requested by Terry from Guy’s and St. Thomas’ NHS Foundation Trust that I remove these documents because, and I quote

…these resources were intended to be used between patient and healthcare practitioner and we would not wish them to be used without adequate training on this particular dietary therapy or to be used by those who may have underlying conditions or comorbidities which might need to be considered before switching to such diets

Never wanting to put people at risk, I have honoured this request. When they release the information pack they’re promising, I’ll provide a link here.

I had an appointment – my first in three weeks – with Dr Broadhead tonight.

During the intervening time I’ve returned to work full time, have weaned myself off the during-the-day lorazepam doses and pushed my social interactions to the point of integrating with large groups of people.

I’ve also successfully identified certain trigger situations for my anxiety: passive-aggressive behaviour, direct confrontation (expected – most people have this) and one other I don’t want to go into details on at this point in time.

The outcome: we’re going to work towards weaning me off the nighttime dose of lorazepam; I’ll work with the psychotherapist on coping strategies for anxiety attacks and on identifying the root cause of it becoming an issue last year; and lastly work with him on my fear of not being able to get to sleep (which, of course, is self-fulfilling).

So, a lot to be getting on with, and some good goals to work towards. My next appointment is in a month’s time. I’m feeling accomplished.