Group therapy, caring and fatigue: an update

It’s been about three weeks since I last posted about what’s been going on in my life, and a lot has happened in this time. This could turn out to be quite a lengthy update… but I will try to keep it as concise as possible. ;)

In a comment on my previous post, Chananth suggested that perhaps I wasn’t letting my therapy group support me much. She was right, of course, and I recognised this was something I would need to change. I went to therapy that evening hoping to bring up the issue – but quite early on in our 90 minutes, another member of the group began talking about something that took up the entire session. I didn’t like to interrupt as it was obviously something she found very difficult to talk about (which was partly why it took so long – there was a lot of rambling and diversions!) but I left feeling frustrated that she got all the support, while I was in crisis and no one knew. It had me questioning more than ever whether group therapy is a good approach for me.

By the following week, I was coping by spending all my spare time working on Sirius, a strategy which allows me to cut myself off from my feelings (and yes, I know this is not a healthy strategy!) I went to group very dissociated / depersonalised, and spent most of the session staring at my feet, feeling numb and thinking how pointless it all was and how the group never helps anyone. I was very surprised when, towards the end, another group member asked whether I was OK since I hadn’t been contributing. I explained that I felt numb and as though I had nothing to say; I also acknowledged that this is a way I cope when it’s all too much. I was then asked what was going on in my life. I began to talk about the situation with my partner and her job and how difficult I was finding things, and once I’d started I couldn’t stop! It all came spilling out and by the end of the session I was very much in touch with my feelings again.

It was really useful to get some feedback and suggestions from the other group members. I often feel there is no one impartial I can talk to about my partner, as most of our friends are mutual friends, and the group provided that for me. But just as importantly, I am amazed that people noticed I was struggling and reached out to me. It feels incredibly rare that that has happened in my life. I could be wrong, and maybe it’s more that I ignore / dismiss it when people do stretch out a helping hand, but it feels overwhelmingly that I have always had to take the responsibility of asking for help and support myself. While I recognise that I do need to be responsible for getting my own needs met, I find it so difficult that I often end up struggling on alone. To know that people care and will sometimes reach out anyway – that seems incredibly valuable to me.

As a result of the discussion, I realised I was going to have to talk to my partner about my own needs. I’ve been so focused on caring for hers that mine have gone unheard and neglected. It was not an easy conversation to have as she was very upset and I was very frustrated and said some things I shouldn’t have. However, in the end I was able to communicate my needs, and as a result of this my partner has taken some really positive steps. She got in touch with the union to try to move things forward with Evil Employer (more details will follow in a password-protected post), and she’s seeking more help with her depression – her meds have finally been increased and she has an appointment with a local mental health charity on Thursday to find out more about their services. She’s not currently in a position to work or apply for jobs, and I fully understand that, but it does feel now as though a plan is in place to help her get back to that point.

It seems to be the season for confrontations because I also fell out with a close friend this week. To protect her privacy I won’t post any details here, but basically I hadn’t been communicating my needs to her – I got frustrated because she was trying to support me in a way that wasn’t helpful – my frustration spilled out and I really upset her. We have been talking things out by email and it seems to be going well so I feel hopeful that we can move on from this and develop a friendship that’s more beneficial to both of us. I really regret the way I handled things and I know she still feels very hurt but at the same time I feel encouraged that I can communicate my needs without it destroying the friendship (it just would have been better if I’d expressed them in a healthier and more respectful way! I was so desperate to avoid confrontation that I ended up causing one).

Finally, an update on my fatigue. I’ve been reading up on CFS/ME and have come to agree with my GP that I don’t have it, for two reasons: firstly I don’t have enough physical symptoms to meet the generally accepted criteria, and secondly my fatigue doesn’t have a clear onset. Most people with CFS/ME, I’ve read, can pinpoint exactly when they became ill whereas with me what were once classic episodes of depression have gradually become more about fatigue and less about low mood. It seems fairly clear that I’m living with the same recurrent condition I always have, and it’s just evolved a bit. Perhaps I will add fatigue to my sparkly turquoise magic diagnosis. ;)

I do want to make it clear, though, that the level of fatigue I’m experiencing is comparable to someone with mild CFS/ME. It’s more than just tiredness. Last month, I was able to work but had to spend most of my weekends in bed recovering. This month, work has been extremely quiet, with the result that I’m only working part time, and I don’t feel I’d be able to go back to full-time hours as things stand. From what I’ve read, people with mild CFS/ME may be similarly able to work but have to spend most of their free time resting, and may need to take occasional sick leave. I’m embarrassed to admit this, but I often find myself struggling with things I used to take for granted, like going upstairs (especially if I have to do it twice in quick succession) or chopping vegetables standing up. I’m used to being able to walk for miles without getting too tired so this is hard for me to accept.

The blood tests my GP did mostly came back normal. I’m not anaemic, my thyroid function is fine and I don’t have diabetes, liver problems or coeliac disease. However, they did show my vitamin D is a little on the low side. My GP didn’t think it was low enough to be causing symptoms, but since I do have both the symptoms of a mild vitamin D deficiency – fatigue and generalised aches and pains – I’m now taking a supplement and you never know, it may make a difference. I have also just started reading a book about pacing and grading for chronic fatigue.

One last piece of news: my mood has continued to improve since my mirtazapine was increased, though I am still having the occasional meltdown. At this point in time I don’t think I want to switch to another med. I would rather try psychological approaches (like the pacing and my therapy) first.