I'm going to the psychologist again today in about an hour and a half.
I've been awake for about 7 hours now, knowing I have to go, after a very stressful day yesterday, and I'm still in my dressing gown, unshaven, knowing that I should be getting dressed.
Instead, I'm sitting here on the sofa, doing almost anything except getting ready, again chain smoking cigarettes and thinking about why it is that I can't get my arse into gear.
This guy is good, sympathetic and very patient with me, but I have real problems in telling both he and my psychotherapist just how bad this is at the moment.
Weirdly, I feel I am letting both of these guys down if I tell them everything.
I know I ought to.
I thought there had been an improvement in my state of mind over the last few weeks, but I seem to have slipped right back to the state I was a in a couple of years ago.
I thought I was responding well to the medication, which is the most recent in a long list of drugs prescribed to help me help myself to get better - or at least under control.
One of the issues is that I dress well as a defence when I absolutely have to go out - I've always been 'well presented' in public - I'd no more go out in t- tshirt and shorts than fly in the air - and sometimes I wonder whether this interferes with the opinion the doctors make of my state of mind.
What they don't realise is the amount of effort it takes to get in the shower, clean my teeth, drag a razor over my face and dress in clean clothes - the reality is that I often don't dress for two or three days at a time, but sit around in my dressing gown, gradually starting to stink.
I have been doing some physical exercise in the last few weeks and I had noticed that I was following a pattern of waking up, exercising and lifting a few weights, then showering and dressing - and I felt better for doing those things, but in the last few days I have stopped doing them.
I don't know if the medication is actually working, and if I were not to be taking it, the mood would be even worse than it is.
It is very difficult to remain objective.
Also, I remain relatively articulate when I am speaking to these guys - I think so at least, although I have a tendency to sometimes repeat parts of a sentence over and over again, , for some reason being unable to get past a certain phrase or group of words, repeating them in different orders, until the jumble sorts itself out and I can make myself understood.
Sometimes, I get a word completely wrong for the context - for example I will say something along the lines of 'Ice cream man' when I mean 'doctor', or similar gibberish - I know I do this, because some people are kind enough to point it out to me.
The sheer effort of doing anything is completely exhausting me at the moment, I had a brief burst of energy two days ago, and wound up scrubbing the kitchen and hoovering the carpets, doing the mountain of washing up, changing the bed linen - at three am.
I had to go out yesterday - to the hospital - not for myself, but to support someone I care for while they went to have a breast lump checked out.
I think I held it together and did what was needed, but the impact on me today is one of complete exhaustion.
I'm feeling pretty much at the end of my tether.