Panic Attack: 21/02/2017

I've lived in Edinburgh for nearly a month and until now hadn't experienced a panic attack. The cunt found me today though, during a walk around Calton Hill:

Panic Attack: 21/01/2017

We moved to Edinburgh yesterday. As always, I took valium to fly but this was to little effect on the flight from Bornholm to Copenhagen.

Not realising there was a tram from the airport to Edinburgh city centre, we took a taxi. Bourgeous. The taxi driver did not tell us his name but he did tell us to "never give money to homeless people or beggars" because "nobody in Edinburgh is a true beggar". I'm not sure what that means but by this point I'd stacked so many sedatives I didn't care to find out.

Current Joys - The Unbearable Lightness of Being

LSD and the Search for God - Starting Over

The weather in Bornholm is shit of course.

Panic Attack Playlist

These are some of the songs I keep on my phone for times of duress. 

1. Radio Dept - You Stopped Making Sense

2. Current Joys - Kids

3. Black Marble - A Great Design

4. DIIV - Follow

5. The Horrors - I Only Think of You

Escaping Wordpress

I've moved back to blogspot after trialling wordpress for a while. Same premise etc etc.

Nexplanon and Cerelle, Contraception from Hell

This is a post about hormonal contraception, or what I have affectionately termed 'hell'. How I came to opt for this piece of shit begins with my first foray into hormonal contraceptives with the Cerelle mini-pill in October 2014 followed by the Nexplanon hormonal implant in August 2016. Bear in mind I have panic disorder, rapid cycling bipolar disorder and a low BMI. At the end of this entry I've summarised the side effects I experienced personally, if that's all you're here for. 

Instagram: kaateflood

Despite being sexually active for years beforehand, it wasn't until I was 24 that I entertained the idea of hormonal contraception. Filling my body with synthetic hormones in a bid to suppress natural, healthy bodily responses seemed bizarre to me. I understand the pill is useful, particularly for women with heavy or uncomfortable periods, temperamental skin, hormonal imbalances or a desire for convenience. None of this was relevant to my own circumstances. I'd had long-term relationships, one-night stands and weird pseudo-relationships between, and condoms were always fine. My reasoning was that if a guy cares more about your vagina than your mental health, he can literally go and fuck himself.

Despite that, in 2014 I threw caution to the wind, ignored me instinct, and decided to trial hormonal contraception. I wasn't with anyone at the time, though coincidentally, a few weeks later I began seeing my now boyfriend of 2 years.

The nurse I went to see was keen for me to try Cerelle. I can't take oestrogen and the non-hormonal coil would make my periods too heavy for any nurse to consider fitting me with one. Aside from the fact I really do not want to deal with an abortion, I wasn't really bothered about whether or not I used barrier or hormonal methods and so after some (limited) reading, I went with her suggestion.

My periods have been hideous since I was 13, so it was something of a blessing when they stopped pretty much instantly after beginning Cerelle in October 2014. Less of a blessing was  water retention, mild nausea, mild acne and insomnia. Given that I'd just moved into a new place with new housemates, entered my final year of university, begun a new relationship and was taking too much MDMA, I didn't really notice the beginning or end of these side effects. However, three months later in January, the panic attacks started. I'd had panic attacks in my life before this but they were concentrated into a short window of time. My first panic attack came during the onset of my first migraine with complex aura. I'm not sure which was more terrifying. The second panic attack occurred on my way to the opticians after taking the emergency contraceptive pill the day before. It was summer, I'd just got back from six months in Sweden, I was drinking a lot and panic attacks became a near-daily occurrence.

My post-pill panic attacks were different. I was having several panic attacks a day and each one lasted for ages. These were those ultimate doom panic attacks, the kind that take hours to recover from. I couldn't speak, focus or walk; I had tingling in my lower face and 'the claw' in both of my hands.* Initially I put this down to getting wasted too often and of course, that didn't help. Yet even after being sober for months at a time, the panic attacks continued. My doctors told me it wasn't the pill: it's because I'm in my final year of uni, it's because I have no money, it's because I left a bad relationship a few months ago. Essentially, 'it's because of literally anything but the pill'. I called bullshit but persisted with it anyway. Maybe if I let my body balance out these new hormones it will go away. I knew that my preexisting mental health conditions might mean finding my equilibrium was a longer process than for most people. And anyway, I'd be damned if I'd gone through this only to revert back to condoms, when waiting few more weeks could mean never having to worry about condoms again.

All I can say is: I am a fucking idiot. I'd never ignored my body prior to this and I never will again.

By February 2015, I was having regular headaches and assumed my eye prescription had changed. I was right. I also assumed that getting new glasses and contact lenses would help. I was wrong. The panic attacks and headaches continued and my mood swings worsened. I put up with this for the next few months while I worked and finished my final year dissertations. I figured that any change now would only disrupt my studies even further: hormonal changes caused this level of mental unrest, how would further disruption be useful right now ? This is a decision I don't regret given that I did really well at university - somehow - and received a full scholarship for a Masters beginning that September. And, despite ongoing hideous side-effects, my mood was lifted by the prospect of good things to come: most of my favourite people were also staying at Sussex for another year, I was going on to postgraduate study and I was moving in with my boyfriend. 

I moved in with Julian and another friend in September 2015 and started the Masters. For the first few months, everything was fine - then, in early December, the panic attacks started again. Because my panic attacks had ceased temporarily but my pill taking hadn't, I began to assume the two were actually unrelated. I must be drinking too much. I must be stressed. I must not be sleeping enough. I must have a poor diet. I must have lost weight. I must have put weight on. Maybe this is a precursor to a depressive episode. Nah. Fucking none of it.

From that winter onwards, I continued having panic attacks everyday, several times a day, for months. I was made redundant in February 2016 and started a new job in a bar in March 2016, which became the newest focus of my ongoing blame game. My colleagues are fantastic but the hours and environment of bar work are not conducive to decent mental health: poor sleep, taking other people's shit, getting abused just for being on the wrong side of a bar, and drinking more than I'm used to. I was working 40 hours a week alongside volunteering and doing a full time Masters degree. Of course my mental health wasn't great - I told myself that it cannot be the pill. It is circumstance. And, predictably, by April the headaches had started again. The panic attacks continued. 

I had three migraines in the space of a couple of months which for me is abnormal. In June I went to see a doctor and ended up being tested for a brain tumour. I got the all clear, thank fuck, and perhaps the best advice any doctor has ever given me:

"I could tell you there is absolutely nothing wrong, and I could believe it, but I'd be lying. I can never guarantee anyone that they won't develop a serious illness, I can just tell you that right now you're fine"

They may not have been his exact words but that's how I remember them. It was great advice - and I'm not being sarcastic. It helped a lot. Unfortunately, I was running out of lifestyle changes I could make to ease the panic attacks: I wasn't drinking or taking drugs, I couldn't quit my course else I'd lose my scholarship,  I was eating well and sleeping as best I could. I needed a job to pay the rent, so I couldn't quit that. I have asthma which means that, despite never needing my inhaler, I cannot take beta blockers. And so I deferred my thesis and my scholarship for a year. Not the worst outcome, but I was pretty gutted. It felt like failure at the time (although I see now that this is a ridiculous attitude).

I also decided it was time for a proper contraceptive review. While I wasn't quite ready to abandon hormonal contraception entirely now that I'd grown accustomed to the convenience, from both friends and the Internet I'd heard the implant was pretty good and according to my doctor, only the equivalent of 2.5 pills a week. Even if the unpleasant side effects didn't go away completely, surely less hormone can only make me feel better ? Nah.

At the beginning of August, I had the Nexplanon contraceptive implant put in my arm. Insertion was super easy and the plastic rod under my skin was kind of fascinating to me. The nurses were, as always, the coolest. Rather than taking my pill for the first week (Nexplanon is not effective for the first 7 days), I opted to stop taking the pill and went celibate for a week. During this week my panic attacks worsened and I felt like I had flu the whole time. I felt nauseated, dizzy and spaced. I was having hot flushes and shivering spells and assumed this was due to a sudden shift in my hormone levels and nothing to worry about. My body needed to adjust. However, after the first week, I felt worse than I had at any time while on the mini-pill. Nobody - online, at the clinic, through anecdotes - was able to give me an indication of whether this was 'normal', how long it might last, and whether it was related to Cerelle withdrawal, Nexplanon adaptation, or both.

Extreme water retention meant my weight rocketed - I wasn't gaining fat and looking at photos of myself from the time, I was still very skinny. But, I was getting heavier and my self-esteem fell to absolute zero: I had acne everywhere that I hadn't also developed terrible, repulsive eczema. I was exhausted everyday and wide awake at night. My sex drive dwindled into nothing and my moods were awful. I'd wake up in the morning completely furious: everything and everyone annoyed me to absurd proportions. I had no energy but was always restless. After three weeks of this, I was desperately unhappy, a nightmare to be around, but stuck with the stellar advice to 'let everything settle down' before having the implant removed. Not this time mate.

Even though I'd decided to have the implant removed - the clinic tried to talk me out of it by the way -I decided to do some more research online. After discovering it can take up to a year to feel 'normal' again (whatever that is) and with no guarantee you'll feel as you did prior to beginning hormonal contraception anyway, I knew I had made the right choice. After four and a half weeks, I had a series of panic attacks in my sleep (yes, that's possible). The worst night was before a double shift, when I woke up 11 times. Each time I was covered in sweat, each time my hear was racing, each time I was more freaked out than the last. I made an appointment at the university clinic the next day. After five weeks on it, I had the implant removed because fuck. that.

A few days after the removal I felt a little spacey and weird but within two weeks I felt fine. My weight went back to normal more or less instantly, my sex drive recovered and my skin and moods are stabilising. Unfortunately, even though its now been 3.5 weeks my period still hasn't returned.  My doctor told me that I'm still within the normal timeframe for my menstruation returning and that my low BMI may be playing a part too - its common to take a few months for menstruation to return to normal.

(**UPDATE**: my period came exactly one month after having the implant removed)

I never thought I would actually look forward to getting my period again, particularly not when I've had the joy of not having to deal with it at all for two years - but aside from my menstrual cycle currently being M.I.A. I feel better than I have done since the beginning of 2014. The mini-pill wasn't enjoyable but it was bearable, albeit an experience I wouldn't choose to repeat. For people without pre-existing or underlying mental health conditions, it would probably be fine, but given my experience I would not recommend it to anyone. Your mental health is just as important as your physical health, and the mind is much harder to heal.

I stuck with hormonal contraception for two years and was supported by a super cool boyfriend who never called me out for being a bitch. It should be the norm that guys don't make you feel guilty for not wanting to put a load of shit in your system just so they don't have to wrap up, but it isn't. J was great about the whole thing and so its perhaps easy for me to say this, but whatever: if your boyfriend thinks your reproductive choices are his territory to lurch into, he's a dickhead. Though the fact that the lesser hormone made me feel worse seems nonsensical, I can only assume that's to do with the difference in how the body absorbs the hormone. The implant constantly releases a low dose of hormones into your bloodstream while the mini-pill is absorbed through the stomach and gives you 24 hrs worth in one hit each day.

Maybe I should have trusted my instincts from the beginning, but at least now I know. Some of my friends have Nexplanon and love it - no negative side effects at all. Other friends have had terrible experiences and tried to warn me beforehand. My experience has left me wondering - why is there not more attention being paid to the psychological effects of hormonal contraception ?