Speaker 1: 0:10

G'day everybody. My name is Elliot Waters and you're listening to the Dysregulated Podcast, as always. Thank you for tuning in, alright, so the latest. What's the latest news? Yes, I've been to the psychiatrist at James Fletcher Hospital. I've had my appointment Now, remembering my goal was to get off, or at least start the process to get off medications and get that moving and maybe look at an admission somewhere like IJMU or Bloomfield out in Orange, the extended stay ward and I can confirm that none of those things have happened.

Speaker 1: 0:46

I'm not even joking, none of those things have happened. I'm not even joking. None of those things have literally happened. So instead I'm on a new medication which is replacing an old medication, so my net number of medications is still seven. But, yeah, no, no admission. At this stage. It seems to me that the reason that there's no admission so much is they seem that these wards must do their own sort of intake sort of thing, and me seeing the psychiatrist for this appointment is in a different sort of I don't know, it's part of the Newcastle mental health community team. It's part of the Newcastle mental health community team, whereas I think Ishmu does their own thing and Bloomfield out of Orange, they do their own thing, and it doesn't seem as though they do much talking between each other, which is, I don't know, fascinating, for lack of a better word, fascinating. I don't understand why it's so difficult for these different arms to sort of talk to each other, work together to get the best outcomes for the individual possible, but anyway, that's not what seemed to have happened. So, yeah, so I'm on a new medication.

Speaker 1: 1:55

You're probably wondering, geez Elliot, what is it? You've been on every medication, surely, and I just about have One that I haven't been on before, though, which is funnily well, it's pretty common. It's pretty common is metazapine. Now, metazapine is another of those old school antidepressants. I'm not going to go through the full pharmacological info on it just yet because I need to do a little bit more reading about it, but what I do know is that it's a tetracyclic antidepressant. It has a strong affinity for histamine receptors at lower dosages, so that means sleep. So if you're really on the ball, you might be sort of guessing now what medication it's replacing, and it also works on serotonin and norepinephrine pathways. So what it's replaced is Seroquel, quetiapine, bumperone. No more antipsychotic for Elliot. It's been years since I've been off an antipsychotic, and now I am, which is great. The Seroquel really, though, was only being used to treat sleep, to help me fall asleep and with sleep latency. That's something metazapine does quite well as well, but the benefit, the added benefit that I see and I think the psychiatrist agrees, or at least this was what he was postulating to me which was that it'll help me with my sleep, but it'll also do stuff with my neurotransmitters as well, so it should hopefully have that antidepressant, anti-anxiety effect as well as the sleep component, whereas the Seroquel, the quetiapine, at the dosages I was having it at, at 100 milligrams a night, was just really working on sleep. So there you go. So no admission.

Speaker 1: 3:45

I did make the point pretty clear that things have been pretty tough, but that didn't seem to Well, this is what happened, so I said I'm going to go more into this when I can. I've been very my social capacity has been on empty, as always, but very much so the last week or two. That's why there hasn't been a podcast episode updated for a little bit, because I just haven't had the energy or the oomph to get it out there. So this episode is always going to be a little bit shorter, but to get the sort of main point across. I'm going to go into this a little bit more detail, but here we go. Here's that ADHD moment again. What was I thinking? What was I saying? Quick, somebody tell me what was I saying. Yeah, I was making the point clear that things have been pretty difficult and I'd be willing to go anywhere. And I said Morissette as well.

Speaker 1: 4:39

And he sort of ummed and ahed about Morissette. He said, oh yeah, that could be an option, you know, but you know they would have to look into that. And there was a lot of this talk, you know. You know, ishmu, they would have to look into your referral Bloomfield, they would have to. So it's a lot of they and not us. In other words, like I said, I think these cogs are moving quite distinct of each other.

Speaker 1: 5:01

But with the Morissette thing, he did say, oh no, but it's usually for people, you know, with schizophrenia, you know, who are suffering psychosis, or you know, with manic bipolar disorder and all this stuff. And I was like, yeah, yeah, yeah. I said, yeah, let me guess, let me guess, I'm too functional, I'm too bloody functional, so you don't want anything to do with me. That's essentially what I've been told. Yet again.

Speaker 1: 5:25

Now I hate to make this point clearer, but it appears it's been made pretty clear to me now that you've got to be right at the edge of life itself for these extended wards to sort of take any notice. So for me to get to Morissette, or even back to Ishmael, it seems, or somewhere like Bloomfield, which was top priority, which was number one on my list, you know, you've got to be making some noise, you know what I mean. You've got to be the squeaky wheel, you've got to be making threats, whether it's to yourself or, you know, other people. We don't want to be doing this. Of course there's no.

Speaker 1: 6:09

You know, avoiding that at all costs is important, but unfortunately, I'd say my guess is because the system is so stretched, especially here in New South Wales and I've done an episode on that previously about the mental health system. You can look that up, it's a beauty and it explains all but I'd say because of the lack of, you know, beds available, doctors available, etc. Etc. Of the lack of beds available, doctors available, et cetera, et cetera. They've got to triage these things in a way that is sustainable for the system and, unfortunately, unless you're right at the edge, you're not going to probably get a look in, which is hard, because I made this point clear too.

Speaker 1: 6:41

I said, yeah, I'm high-functioning autism, but high-functioning doesn't mean I'm any further away from disaster than any other level of autism, for example. I'm going to look this up. I haven't looked at the research on this as much as I need to to make this claim, but, from what I gather, quite often people who are level one or deemed high-functioning with autism seem to be the more prone to suicidal attempts than, say, a level three who could be, for example, nonverbal or lower-functioning theoretically. But those with high-functioning autism, as a doctor once said to me and I'm sure I've said on the show before the thing with high-functioning versus low-functioning is often people with low-functioning autism aren't quite aware that they have the deficits, that they do. But those who are high-functioning autistics, we are very, very aware of our social shortcomings and the other effects of this disability, and that causes lots of stress, lots of anxiety and lots of depression. Because I see it, we see it every day. We walk around, we have conversations with people. Every day. It is reaffirmed to me, it's reinforced, that the way I see the world, the way that I perceive things and my ability to engage with, say, other people, is a little bit different than the supposed normal.

Speaker 1: 8:15

So this is what the point I was trying to make to the psychiatrist was that, although, while I'm sitting here right now, you know I'm not suicidal as such. That doesn't mean, though, that just because I'm presenting here and able to have insight and potential, they're the two words I've got to get rid of. I'm sick to death of them, because, oh really, if you're going to say that's good insight, yeah, I've got great insight. So great is my insight that I'm acutely aware of my shortcomings. Having insight in this scenario is not a good thing, and for some reason, a lot of mental health professionals don't seem to understand that when I tell them that that me being insightful and being able to conceptualize and analyze and explain my inner turmoil, that doesn't mean that I'm healthy and that things are okay. It doesn't, and in a lot of ways it makes things worse, because I know exactly what's wrong and I know exactly why. I can't seem to fix it. I don't know the exact answer, but I know the rest of the story, and that in itself is very depressing and causes some pretty pretty bad thoughts. So you know, that's the point I was trying to stress and unfortunately I didn't get it. Well, no, I got my point across, but you know it wasn't taken on board like I was hoping.

Speaker 1: 9:39

I was hoping to go in there and I'd have an admission somewhere. That was my plan, or at least, at least at minimum a plan to taper off medications, say in the community, here at home, and have some sort of option, some sort of way to be able to get to the martyr, for example, if I need to. Oh, what's this computer doing? No, go away. Sorry, everybody, my computer's just flipping out on me, so I'm not sure if there'll be a little break in the recording there, but if so, ignore it, let's continue on Now. Thanks, computer. Now I've forgotten what I was saying. What was I saying? Anyway? I don't know, but all I know is yeah. So I went in there trying to get X, y, z and I didn't really achieve any of it.

Speaker 1: 10:29

But I am on a new medication, metazepine, which, look, I'll be honest, there's people in my family, or one person in my family who's on metazepine. It works for them quite well. So maybe there's a genetic sort of link here and it'll help. That would be good. It is a medication I haven't trialed before. It is a medication that is indicated for depression and anxiety, so that's good. It does increase appetite, which ordinarily isn't good for people, but because I'm on the stimulant medication, vivance dexamphetamine, that's actually a good thing. So I'll be eating, which is good, because when I don't eat I get irritable and anxious and the spiral happens. So if I'm eating consistently because this medication, that in itself is a good thing.

Speaker 1: 11:18

What I have read, briefly, like I said, I'm going to do more reading on this sort of stuff and present the evidence as I find it to you guys as soon as I can. But as far as I understand, one thing metazepine does a lot better than Seroquel is it doesn't interrupt a person's sleep architecture. So you know the amount of time in REM sleep and you know all the different stages of sleep and stuff. Supposedly and some sources that I read actually said metazapine can improve sleep architecture, which would be good because I always wake up dead tired. So I'm hoping that maybe that will be some sort of improvement as well. But yeah, that's the story.

Speaker 1: 12:02

So I went to hospital. I went in there, I was ready to go. I'll tell you what it's funny going into a like it's a hospital, but you know there's no emergency ward anymore, there's no like real wards or anything, mostly at James Fletcher it's more the admin side of the mental health team is there, but they do have psychiatrists there for people to have appointments and it's just so amazing how the you know, the waiting rooms are so much colder in these places in the public system. Everything's just so much colder and I don't know if it's the color scheme or what it is, but it is and it just has that feeling to it. It's just too sanitized. I don't know, I don't like it, I don't like it, but anyway. So that's the story, that's the latest.

Speaker 1: 12:50

I didn't get really anything that I wanted, but I did get on a new medication. Thankfully it has replaced an old one, which is good, but at this stage there's no real plans to get off these meds. That's sort of been. You know that idea is not quite dead and buried, but pretty close to it. So you know, and he didn't seem, my doctor didn't seem too concerned with the number of medications that I'm on, didn't seem too concerned with the types of medications that I'm on and the dependency that I would surely have to plenty of them right now, there wasn't, you know, too much of a concern.

Speaker 1: 13:27

I think part of it too is because you look at all of my disorders and everything that's going on and the complexities and everything, he's probably thinking holy dooly, this guy's got a lot going on under the lid and obviously he's seen a lot of doctors, and a lot of doctors have come to the conclusion that this guy needs lots of meds to sort of stay on the straight and narrow, because, remember, this is the first time I've met this doctor that doesn't know me other than reading my case notes leading into it, and he'd be reading those notes going holy dooly, what's this guy going to be like? And of course, I come in and you know, mr Insightful, with all this potential and yeah, so I'd say he's thinking I don't want to rock the boat too much and start taking him off everything, because I don't know this patient very well. For starters, I don't have a bit of an idea of what the reaction to that could be. So let's just keep things sort of going as they are. But obviously there's room for improvement. So let's tweak a medication here or there. Improvements so let's tweak a medication here or there. So this means, though what this essentially means is that my dream, or my dreams of returning to the transport industry they're not over, because obviously I can work in the office and be an ops manager or supervisor or whatever if I was to get a position doing that.

Speaker 1: 14:42

But to go back into the transport industry, I wanted to really build up my credentials before I led a team again, and that included driving a truck again and with the medications that I'm on although Seroquel was the one right at the top of the list that would have stopped me most likely from getting a job being able to be a heavy vehicle operator again because of how sedative it is metazepine is you know, it's sort of the same deal, it's the same thing. It's going to show up. Clomipepine is you know, it's sort of the same deal, it's the same thing that's going to show up. Climipramine is another one, pregabalin as well. The stimulants aren't so bad because you can get doctor's certificates for them, but it's the ones that cause potential sedation. They're the issue, you know the ones that on the box of my medications there's a sticker that says unless you know how this medication affects you, do not operate machinery. You know it's those medications and unfortunately I'm still on them and that's part of the reason why, of course, I wanted to get off. Them was to potentially go back into the transport industry and make my name there.

Speaker 1: 15:41

But I've been toing and froing between these thoughts about transport industry versus the mental health community engagement side of things. I think now this has made the decision a lot clearer. I think I'm going to go full tilt into the mental health stuff now. Maybe one day I can revisit transport, which would be nice. Maybe one day I'll have the ability to do some research in the transport industry and combine that with mental health, my mental health advocacy as well, which I always wanted to do and will want to do. So who knows, maybe down the track I'll still be able to combine the best of both worlds. But at this stage it appears that the smart idea would be now to look at the mental health side of things full tilt, because I think transport for at least the short to medium term, at least the way I wanted to do it, is off the table, unfortunately. So there you go.

Speaker 1: 16:36

So that's the story no hospital admission, no tapering plan of medications, yes, an introduction of a new medication, metazepine, and the withdrawal of quetiapine. So something has, because I needed a change. At least Something had to happen. Like, come on, you know, and I'll be honest with you going on, metazapine makes sense and I've always been a little bit not confused. But I've always wondered why, you know, for all the medications I've had, why that isn't one that I've tried previously. But now I can say that I have.

Speaker 1: 17:13

So starting titrating it slowly. You know, with a lot of these antidepressants it takes a couple of weeks to start working completely. So I can't report yet on the efficacy of the medication, but I'm giving it a go. There's a bit of hope again, because I am hopeful that this medication all I want to do is dial back the anxiety just enough and those obsessive, constant thoughts just enough that my psychology work, that's me being a client, that is, my psychology interventions on the self can then take hold. Because it's still the same story. Psychology for me is the way forward, that's the one that's going to get me the life worth living. But I need to pare back these other mental health complaints, which the cognitive obsessive thinking and all that sort of stuff. You know. I need to pull that back a bit so the psychology can do its thing, and that's the plan, and I'm hopeful that maybe metazopaine is going to do the job. All right, thank you everybody. Thank you for listening and I'll see you here next time on the DISS Regulator Podcast. Regulated podcast.