Stockholm Syndrome

 

 

 

Some of you say, ‘Joy is greater than sorrow,’ and
others say, ‘Nay, sorrow is the greater.’
I say to you, they are unseperable.
Together they come, and when one sits alone with
you at your board, remember that the other is
asleep upon your bed. 
Kahlil Girbran

The world is full of peculiar paradoxes. Have you ever touched something so cold that it burned your skin? Or laughed so hard you cried? Have you ever felt so much pain it’s pleasurable?

I think I have a touch of Stockholm Syndrome. I’m in love with my captor. I hate mania, I hate it, I hate it, I hate. But oh how I love it too. Flat as a pancake I find myself yearning for the high’s. Knowing full well the consequences of doing so.

For me the high brings such revelation, I suddenly understand my life and the world around me, everything makes perfect sense. But now nothing makes sense. I don’t understand how I am supposed to feel. I don’t understand how I got here. I don’t understand why bad things seem to happen to good people.

I don’t feel, when I know I should.

I just want to feel that manic/hypomanic energy. I want to be productive. I want to feel the unabashed joy and love. I want to dance because the music means something to me. I want to understand the universe again.

But will that come with a price of irresponsibility, risk taking, and psychosis?

Probably.

When I was about 18 I went through a period that I can retrospectively diagnose as mania…or perhaps hypomania. For about six months I didn’t sleep, I wasn’t tired, I became loud and argumentative in classes, I completely changed in personality,  I drunk too much, I got myself involved in all sorts of risky situations. I cared about very little.

And that is the crux of it really. I want to care. I want to feel those high’s but I want to care for my family and for myself. I want to be the best mother I can for my son, and the best wife I can for my husband. I want to be the best I can be, and I can’t do that when I am high.

So I keep taking the medication. If I were young, if I were single I would probably experiment with skipping doses. See if I could find a happy medium. But as a mother I can’t possibly risk that.

So I stay here, flat and stable. I’m in love with something I shouldn’t be. I’m in love with something that isn’t real. I’m in love with something that could potentially destroy my life.

But more than that I’m in love with what I have, my beautiful boy and husband. And so I will never succumb to the infatuation. For the pleasure, and the pain, are inseparable.

 

Toxic

 

I’m fine, but I’m bipolar. I’m on seven medications, and I take medication three times a day. This constantly puts me in touch with the illness I have. I’m never quite allowed to be free of that for a day. It’s like being a diabetic.

– Carrie Fisher

Hats off to Carrie Fisher! I couldn’t have said it better. For me, medication is a daily chore. No different from brushing my teeth or making my bed. I’m on four different medications twice daily. I take up to ten pills a day.

 

I am bipolar in my attitude towards medication. On good days I will dutifully take my pills, thinking how much they have helped me. On bad days I will complain about them, how they make me feel flat, how they shackle my creativity, how they nauseate me.  Perhaps I’ll ‘forget’ to take a dose.  But it’s less of a choice and more a responsibility. A trade off between side effects and stability.  I have a little one to look after now.

After a night of violent vomiting a few weeks ago, I came to the conclusion that I must be suffering from lithium toxicity. It seemed the only logical explanation for my nausea, mood swings, and shakiness. My recent bout of illness and dehydration could have easily resulted in concentrated blood levels. It all made sense. Lithium toxicity can be serious, even fatal. My nurse was at my place to assess me within an hour of my phone call to the hospital.

I was told to stop the Lithium, and because I was worried (and because I was angry at the potential effect that medication had caused) I stopped all other medications as well. That was a mistake. I spent the weekend grumpy, depressed, and dissociating so badly that it was hard to walk.

When the blood results came back I wasn’t toxic at all. In fact, quite the reverse. My level’s were too low. So I restarted all the pills and quickly returned to my ‘normal’ (but really, what is normal? ;)) self.

How did my lithium levels become too low? Partly, I suppose, due to the IV fluids I was given during my recent hospital visit. But mostly, I suspect, due to my careless attitude towards the medication. Skipping a dose here, a dose there. I’m not crazy anymore. I don’t need that stuff.

I seem to hold a deep distrust in the opinion of the medical profession. Somehow I believe my limited knowledge on psychopathology and pharmacology is superior. Then I get upset when my  medication experiments backfire. Funny that 😉 Recently I have been seriously questioning my diagnosis. Am I really bipolar? Was I really that unwell? Perhaps it was all a strange dream. Now, while I am stable, I simply cannot believe I became that unwell.

I talked to both my psychiatrist and psychologist this week about this issue. I remarked to them that I felt like I was making the whole experience up. I can’t imagine feeling that depressed, or that unstable. I felt angry that I couldn’t remember aspects of my experience. But the recollections I had and others provided just didn’t seem like *me*. Rather than telling me to move on, that the past is the past and the present is the present (what I have been telling myself!), they both explained that I had been through a kind of trauma. Not the hospitalization itself, as my experience there was a positive one. But the very fact that I became so unwell and so unstable. I had assumed my inability to remember key parts of my hospitalization was due to being…well…mad 😉 I had also assumed my somewhat flattened affect and reduced emotionality now was medication induced. But both are apparently symptomatic of those who have experienced some kind of emotional trauma.

Now don’t get me wrong, I don’t feel traumatised. Not in the least. But I suppose that is part of what is going on. I don’t really feel any emotional response to what I have been through. It’s just something that has happened, no different to going to the shops for groceries. Apparently this will change, and my experience will become integrated with my sense of self.

Writing, talking to people, and my weekly therapy all help me piece together this puzzle of myself. It’s fascinating. I have learned more about myself in the last three months than I think I ever knew. I say now, and I will say again, that the experiences I have had (however apparently traumatizing they may or may not be) are one of the best things that have ever happened to me. I feel a confidence in myself that I never had before, and I have learned what is important in life. I’m happy being me, something I wasn’t for a very long time.

I assumed I had lithium toxicity when really it was the lithium I needed to become well. I assumed that a diagnosis of bipolar disorder was negative, when it resulted in an area of personal growth I may never have attained otherwise. It’s funny how something so potent, something so seemingly toxic can actually be the remedy.

 

If it’s Hurting You, It’s Hurting Me

I realised today that I have written very little on my depression, the very thing that saw me hospitalised in the first place. From a creative perspective I find my depression very difficult to write about. Depression for me was bleak, cold nothingness. How can I begin to describe the pain of nothingness? I usually try to inject a little humour into my writing, in an attempt to make it more ‘readable’. But there is absolutely nothing humouress about this particular depressive episode. Nothing at all.

My depression was, and remains to be a uniquely personal experience. I rarely talk about it to anyone, including my nearest and dearest. I seldom like to think about it. Irrational as it is, I’m frightened that a thought could suck me down into the darkness again. Because this is the darkness that nearly killed me. This darkness was, without a doubt, the most horrific thing I have ever experienced.

I didn’t really cry much when I was depressed. I’m not sure that I even felt sad. I just didn’t feel anything. I was completely numb from my soul outwards. In a way this is what allowed me to carry on untreated for as long as I did. Robotically, I carried out everyday activities. I did the things I needed to do. I created a facade that I was fine.

Occasionally I would break down, the numbness would melt away and all I felt was pain. Anger. Grief. Sadness. I started having panic attacks regularly and dosed myself on Valium until I had built up such a tolerance that the drug didn’t work anymore.

One day I was in a near car accident that would have been entirely my fault.  I wasn’t concentrating and made a stupid decision. Fortunately all I received was a loud honk and an angry gesture. Afterwards I felt completely calm, I felt no adrenaline rush, no guilt or remorse. It was then I realised how truly ambivalent I was. When faced with what could have been a serious accident, I felt nothing. I didn’t care whether I lived or died.

Eventually I began to give up. I stopped eating, stopped sleeping. Hubster frequently had to leave work to care for Master D and I. I kept experiencing this bizarre sensation where I felt I simply could not keep going. I couldn’t take another breath. I couldn’t take another step. If I was out when it happened I felt I was going to physically collapse and someone would have to come and get me. They would have to come and get me and I would be stiff as a board, carried out on a stretcher, not even able to move my limbs. In a plea for help I started telling the people around me, over and over, “I can’t keep going. I just can’t keep going.” I think they interpreted this as “I don’t want to feel like this anymore.” When really what I was trying to say was “I don’t want to be alive anymore”.

I was consumed by guilt and a pure hatred towards myself. One morning I woke up, listening to the two people I loved more than anything in the world sleeping peacefully. I decided I needed to leave. I couldn’t do this to them anymore. They both deserved so much better than me.

So – out of pure impulse – I grabbed the first article of clothing I could find, a dress, and threw it on over my pajamas. I slipped some shoes on, quietly opened the front door and left.

Halfway down the drive I realised I was wearing odd shoes. So I slipped them off and continued to walk barefoot down to the road. When I got to the road I looked around. Now what? I had no money, no phone, no plan, no SHOES for Christ sake. What on earth did I think I was doing?

Defeated, I dutifully checked the post box and started walking back up the drive. On the way I passed a tree. One of those weepy trees with long concealing branches. Before I knew what I was doing I sat inside the tree, huddled in the dirt. Suddenly I felt safe. I could see people go past, joggers, people walking dogs, women with prams…but they couldn’t see me. I felt like a child once more.  On the off chance that someone may see me I concocted a story where I was doing some weeding. The fact that I was in a dress, with my pajamas visible, barefoot, with no gardening implements in sight didn’t really concern me.

Suddenly our front door burst open and I heard Hubster running down the drive. When I saw him he looked absolutely frantic.

“Hubster?” I called out. He stopped. Looked around, clearly confused, then spotted me under the tree. He paused for a moment and then parted the long branches.

“What are you doing under there?” He asked calmly.

“Just…sitting” I said nervously. At this point I knew I had screwed up. Big time. Wordlessly he held out his hand. I hesitated and then took it, climbing out from underneath the tree. We walked back up to the house and I tried to explain that I felt safe there, that I wasn’t going to do anything bad.

Hubster just turned to me and said “do you have any idea how worried I was?! Don’t ever do that to me again. Ever.” I cried, told him how sorry I was. He just nodded and walked away.

I felt truly terrible. I realised what it must have looked like to him. My phone still at home. My (odd) shoes left in the middle of the drive. I realised that this couldn’t go on.

When I went into the bedroom Hubster was laying face down on the bed. I apologised and we held each other. I saw that he had been crying, or at least close to it. “do you think I’m bad if I go in to hospital?” I asked him. He looked at me “Quite frankly, I think you would be selfish if you didn’t go in and continued on like this” he said.

Suddenly I realised the effect that this must be having on him. Working fulltime, constantly on edge that he was going to get a call from me saying that I need him. Coming home and cooking dinner every night, feeding and bathing and putting Master D to bed. He had come to appointments with me, taken me to hospital, taken days off work to look after Master D. He had never once lost his patience with me. This man is a saint. I realised that he looked tired. I had been so consumed with my own despair that I hadn’t even considered him.

I realised my problem, my illness, was hurting him just as much as it was hurting me. I vowed to put an end to this. I decided I needed help. I made the decision to go into hospital.

Three

 

Over the past few months many people have asked me whether I will have another baby. My answer? “Of course!”

There is a reasonable chance, I suppose, that I will succumb to another ‘episode’ post partum. I also have a higher than average chance of developing post natal psychosis. But as cliché as it sounds, it’s worth it. He is worth it all, and I would do it all again in a heartbeat. Many mothers who undergo even the most traumatic of births choose to do it all again. This is no different to that.

If you had asked me a few months ago, my answer would have been “Hell, no!” I remember my doctor talking about future pregnancies while I was in hospital. I shut her down and told her I didn’t want another. I simply couldn’t go through this again.

 

But now…. I honestly don’t think I would go through it all again. The difference between now and then is that we know what we are dealing with. I have a diagnosis, I know which medication works for me. I have also been informed that any future pregnancies will be classified as “high risk”, so I will be taken care of by a clinic at the state’s main maternity hospital who specialises in mothers with severe mental illness. I have also been told I may be transferred back to the MBU following childbirth for a week or two so doctors can keep a careful eye on me.

In other words, there is a huge amount of support out there. If I showed any signs of instability I would have access to help. The people closest to me are aware and supportive. I’m certainly not alone.

The other week I asked my doctor, out of interest, about future pregnancies and the medication I am on. She looked vaguely horrified and encouraged me not to rush into things, and to just concentrate on maintaining my stability for now.

But I’m not rushing into things. I’m not ready for another baby now. There are things I want to achieve before being a mum of two. I also want to savour this time with Master d. I missed out so much of his first year through being so unwell. I want to enjoy now and him and us for a little while.

One day we will be a family of four, I have no doubt in that. But right now I’m enjoying the three of us. Me, you, and toddler too.

 

 

The Dark Side of the Mood

 

Mania is like a whirlwind romance with someone who is no good for you. At first everything seems wonderful. You giggle, you make plans, you forget to eat because it just feels that good. It’s a sudden ego boost. Before you know what has happened you have eased into it, you have fallen in love with it, you have committed to the high. And once you reach that certain point, you can’t turn back, not without a fight anyway.

I read recently that one of the tell tale signs of mania is a complete denial that anything is wrong (when it is obvious to others around you that there is). I was irate when the doctor told me that she thought I may be experiencing a manic episode. I think part of the problem is the name of it. I mean manic? Really? I was so against the term ‘mania’ when I was in hospital that the nursing staff used to refer to my highs as ‘productivity’ instead. When I was depressed I was incapacitated. When I was ‘productive’ I had ideas, felt creative, completed tasks, and generally just got things done.

And how, I tended to think, is that a bad thing? How is it unhealthy to be productive? How can something that feels good possibly be an illness?

Retrospectively I realise now that I have experienced manic episodes in the past. But of course then I had no idea what they were, and I welcomed them. Now, occasionally I feel a slight twinge of mania wash over me. I feel the euphoria, or the confidence. I become engrossed in a project to the point of obsession. Or I just plain become ‘productive’. In that moment when I realise the rise in my mood I need to make a decision. I can sink into it, encourage the euphoria, and ride the wave. Or  I can attempt to stop it. Remove myself from any risky situations. Calm myself down.

But you have to understand, refusing that mania is like refusing a drink when you are on the cusp of intoxication. Are you going to get drunk tonight? Or are you going to stay sober?

 

But like many drunken experiences the aftermath of a manic episode often involves embarrassment and regret. And like intoxication, once you reach a certain point it is very difficult to remain in control. Mania, despite its allure, has a dark side.

 

 

 

 

In hospital I was protected from any kind of physical injury during my manic episode. But even so, I did walk out in front of a car, and was found standing on top of window sills. I was also largely protected from any kind of later humiliation. The staff who dealt with me were accustomed to mania, and my euphoric and antagonistic behaviour was really just another days work for them. Steven was the one who bore the brunt of my mood, and I know that if I were to continue the way I had been our relationship would begin to suffer. There is only so much patience a man can have.

 

But in the past, where I wasn’t protected by the hospital, my mood placed me in potentially dangerous situations, and hurt the people around me. For me, the euphoria, the creativity, the ideas and the confidence is just not worth that risk. Don’t get me wrong, I’m still happy, I’m still content, and I still allow myself to be so. The manic euphoria is distinctly different from everyday happiness and pleasure, and I’m able to recognise the difference.

So a few weeks ago, when I finished my shopping only to realise I had been singing out loud as I pushed my trolley, instead of giving into the euphoria I went home to bed instead. Then I completed the most mundane everday tasks you can think of. Cleaning the house. Doing the washing. And that night, when Steven and I sat down to watch TV together without fighting over my mood, it was worth it.

I’m sure there will be times where I am unable (or unwilling) to harness my moods in the way I have been recently. The memories of hospitalisation are still fresh in my head, and perhaps in a year or ten years those memories will fade. But I hope I always remember the trade off, the dark side. The dark side of the mood.

 

 

 

Mania

 

I have put off writing about my manic episode for a while. For starters my mania, I find, is very hard to write about. How can I begin to describe an experience that was so fast and loud and bright? It’s hard to remember, let alone describe, in what order events occurred. And can I even rely on my recollection of events anyway? I’m not sure. Hubster and I joke a lot about this particular manic episode. But in no way do I mean to make light of manic episodes. I was in hospital, safe and protected from any kind of danger. In other words, I was lucky. Manic episodes can be extremely dangerous. Indeed I fear mania far more than I fear depression. This was not my first manic episode, but it was the most extreme episode I have experienced. It all started one morning when I woke up with a ZING! The first thought in my head was “I’m cured!”

 

I felt good. Better than good. Brilliant! For the first time in months I had energy. The blackness had gone! I had ideas and plans racing around in my head so quickly that I could barely keep up with them. I called Hubster at the uncivilized time of 5:50am to tell him that I wanted to go to a restaurant and bake a cake. Afterwards I bounced out of bed and raced in to tell the nurses that I had been cured. I then informed them that I wouldn’t be attending meditation that morning, because I didn’t want to sit still. I had decided to go for a walk instead. My nurse that morning wasn’t terribly impressed warning “don’t get me into trouble Rachael!” as I waltzed out the doors. 

I   got no further than the park next to the hospital. The trees, the leaves…everything was so beautiful. I couldn’t believe I hadn’t noticed it before! I lay down in the grass under a tree marvelling at the beauty that was surrounding me. The feel of the breeze on my face, the grass under my skin, the sun…the beauty was literally overwhelming. Finally I stood up and made my way back to the unit. I was so focused on the beauty around me that I very nearly got hit by a car.

 Back at the unit I started to tell a student nurse about my experience. Well. ‘Tell’ is a nice way of putting it. The clinical term for it is ‘pressured speech’. I myself prefer ‘verbal diarrhea’. I talked and talked and talked, not pausing for a breath. I told her about the trees, and the leaves, and how I wanted to write a book, and where I wanted to travel..and…and..and…and! I’m sure she was cursing the moment she had initiated a conversation with me. But she was far too polite to tell me to shut up.

 

It was then time to see the doctor. I sat down on the sofa and waited until I had the attention of both doctors and my nurse before dramatically proclaiming “I’m cured!”.  Then I talked and I talked. I remember at the time watching all three of the staff looking at each other, raising their eyebrows. But I didn’t care. I was having a fabulous time holding court.  And man, I had some interesting stuff to say!

 

 When my doctor was finally able to interject, she told me that I seemed to be  ‘high’. I agreed and told her it was fantastic, before launching on a rather random tirade about how I should have never been put on ‘special’ supervision. I think after a while the staff  realised that it was absolutely pointless to try and have a sane conversation with me. It was at that point that my doctor snapped my file shut and turned to the second doctor. “I’m canceling leave”. She said firmly. I was devastated, I had been supposed to go home that weekend  for leave. I burst into tears, I pleaded and begged, but no amount of tears were going to change my doctors mind.

After the appointment I decided to call Hubster to tell him the tragic news. What I wasn’t expecting was:
“GOOD! I’m glad they cancelled leave. I’m not saying you have Bipolar, Rachael, but there is something not right about you at the moment.”

Yeah, that pissed me off. From that moment on I started waging a war. A war of ‘us’ against ‘them’. And in my opinion Hubster had very firmly planted himself with ‘them’.

 

 

At this point I must say that the nursing staff in that unit must have the absolute patience of a saint. From this point on I became, for lack of a better term, a thundering pain in the neck. Someone who can’t sit still, can’t concentrate on any activities, doesn’t sleep and won’t shut up is annoying enough. But someone who does all of this in addition to making it her mission to antagonise as many people as possible must have been a complete nightmare to deal with.

I went to group and attempted to derail the topic of conversation with inane questions and comments. I interrupted private conversations between staff and patients to have my say. I concluded that some flowers that were delivered to the hospital were evil, and asserted this to everyone who commented on how nice they were. And Hubster, poor Hubster, I took my frustration out on him the most. I’m not surprised that he was glad that I was not coming home that weekend!

 

As the days went on I just seemed to get higher. I didn’t seem to need to sleep, I didn’t feel hungry. I felt sexy, and confident,  powerful and in control. Given my lack of need for sleep I  started to suspect that I was, in fact, superhuman.

 I was allowed home for an hour or so and I selected a short little dress to wear (I hadn’t thought to bring cocktail attire to the hospital). While at home I put on some music, took off all my clothes and danced around the house. Unsatisfied with this I decided I should go out to the street and dance naked in the rain.  Surprisingly, I felt, Hubster was less than impressed with this idea and decided it was time for me to go back to the unit. I then refused to put my clothes on until Hubster started dialing my doctors phone number. Beaten, I put my little dress back on again.

But what goes up must come down, and come crashing down it did. Back at the unit I held my crying baby, trying my best to comfort him. Tears ran down my cheeks as I watched him cry, all I wanted to do was help him. Steven saw that I was getting upset and offered to take Master D from me. Something flipped inside me and I became angry, telling him that “I was his mother, I should know what to do”.

Sensing that things were escalating Hubster left then returned with two nurses. I shouted at them to stay away, they tried to take Master D away, but I held onto him. Finally the nurses grabbed my arms, physically restrained me and took my little boy away. I know that I was aggressive and out of control, I know that the nurses did the right thing, but I will never ever forget the feeling of my baby boy being ripped from my arms. My heart shattered into pieces.

I was then, quite literally, frogmarched into my room to be shouted at. Finally I was left alone and I cried and cried and curled up in a ball on my bed. After a while the nurse came back and invited me to come out of my room, I declined. She came back again and again, trying to tempt me with hot drinks, movie’s on the telly and coming to see what my baby was doing. But I was terrified of leaving my room. I was so embarrassed, so humiliated of all the silly things I had said and done. I didn’t feel powerful anymore, I felt tiny.

But eventually I tiptoed to my door and looked down the hall. Hubster was standing there holding Master D, he grinned at me and beckoned for me to come and join him. Taking a deep breath I left my room and slowly walked towards him.

“I’m so sorry” I said, both to him and to Master D. He could have embarrassed me, or told me off, said he was ashamed of me, he would have the perfect right to have done any of this, considering the way I had treated him. But instead he just said the three words that I desperately needed to hear.

I love you.

 

 

 

Bipolar Bear

 

The first time my doctor told me that she thought I had bipolar disorder I almost choked on my Tim Tam (sneakily purchased from the local supermarket…I can assure you the public health system does not provide such wonderful chocolate snacks). “You’ve got to be kidding me!” I spluttered. “I have been horribly depressed for months…I FINALLY feel good, and I’ve got a disorder?!

Of course I was in the midst of a manic episode at that moment…but we’ll get to that some other time 😉

The point is, I had a fairly strong and ignorant idea as to what bipolar disorder was, and was of the utmost confidence that I certainly didn’t fit that category, thank you very much. bipolar disorder, to me, conjured images of really crazy people. Take the word ‘manic’ add a letter and you get ‘maniac’. Coincidence? I think not. Postnatal depression, I thought, well that’s one thing.  But bipolar? Woah man…let’s  not get carried away!

What is interesting is that I am by no means  uneducated in terms of clinical psychological knowledge. I have an undergraduate degree in psychology, have volunteered as a telephone counsellor, and have spent time with many individuals who live with what society describes as a ‘mental illness’. Logically, I knew that all psychological distress has a place on a continuum and there are shades of grey. Yet when I was faced with a potential diagnosis all I saw was black or white: crazy or sane. And I didn’t want to be the crazy one.

When my mania started to ease I finally started to think seriously about my potential diagnosis. My doctor took care to take time to describe the symptoms, explain why she suspected I had the disorder, and encouraged me to ask as many questions as I pleased. One day I decided to conduct my own research on the matter. I read website after website, page after page of symptoms and clinical descriptions, determined to find something that didn’t fit. Something I could gleefully take back to my doctor to prove her wrong. But at the end of it all I just sighed and sat back in my chair.

“Oh crap.” I said out loud to myself. “I think I’ve got bipolar”.

One evening at the hospital I voiced my concerns to Hubster. “Do you still love me….even if I’ve got bipolar.”

Hubster barely looked up. “Course I do” he said, as sure as if I had asked him if he likes Star Wars.

“But I’m….” I struggled to find a word, “INSANE!” I spluttered.

“You’re not insane” Hubster said, stroking my hair. “You’re going through a hard time. And I’m here…for better or worse, in sickness or in health, remember?”. I breathed a sigh of relief. “There is one thing though…” Hubster said “I can’t call you my Chi Bear anymore.”

I looked at him, startled. Chi Bear was his nickname for me.

“Why not?!” I asked.

“Because I will have to call you my Bipolar Bear now!” We both collapsed into giggles. It was the first time we had joked about my illness. Now, of course, we’ve graduated to fully fledged piss taking where any mention of maniacs or arctic dwelling bears is sure to set us off.

 

It was then that I realised that I was still me, I hadn’t changed. Bipolar had been with me all along but it just didn’t have a name. A diagnosis is simply a word. A term to describe a collection of symptoms that I happened to have. A tool for categorizing individuals such to predict their likely response to various treatment protocols.  “We diagnose” my doctor had told me, “not to label, but because it’s easier to treat someone if we know what we are dealing with, and what usually works for people with similar symptoms”.

Now I feel that bipolar disorder is merely an aspect of my life. I no longer feel shame in what I have experienced, and feel comfortable to talk about my story to those who ask. I feel relief that there is an explanation for the experiences I have had, and that I have access to a treatment which is currently working. I feel grateful for the lessons I have learned throughout this experience, and for the strength I now feel I posses. But I won’t ever let it define me. I’m not bipolar. I’m Rachael, and I have bipolar disorder.

 

Early Warning Signs

What has scared me most about this whole experience is the potential for ‘it’ to come back again. I’ve discussed this at length with many of the medical staff managing my care. At the moment I have so many people checking up on me that I’m confident someone would hear the alarm bells even if couldn’t. But what about in a year? What about in 10 years?

It was then that I realised that I need to be the one who monitors my own wellbeing. I need to be the one who hears the alarm bells. I can’t rely on other people to babysit me. I need to take responsibility for my own mental health.

But this is easier said than done. Depression, I feel, is easy enough to recognise. The lethargy, the low mood, the apathy. I know when I’m depressed. But the apathy that fuels my depression may prevent me from doing anything about it. Mania. Another problem. Mania, particularly in the early stages feels fantastic. I’m not going to go and seek help when I am manic. I may not even believe I am manic. Then what?

So when my lovely nurse from the Mother and Baby unit came for her weekly visit yesterday she was armed with papers and materials. She explained to me that the trick is to identify a mood change before it becomes a full blown depressive or manic episode. The first tool she gave me was a mood diary. She showed me how I could mark my mood every day and keep a track of my high’s and low’s. This way, if my mood started to dramatically change I would be able to see it and take action. I like graphs and charts so a mood chart appealed to me.

Next she asked me if I could identify my early warning signs. I thought for a moment then told her that I couldn’t. The memories I have of the past year are so convoluted and confused, I can’t really describe what came first. This is, in fact, the reason why I am writing this blog episodically rather than chronologically.

My nurse then pulled out a pack of flash cards and lay them out on the table. Each card had a symptom on it:“not eating”, “feeling sad or low”, “not being able to sit still”. When I saw the symptoms I was surprised at how easily I could remember if they were relevant to me or not. For about an hour we categorized the cards, moved them around, and talked about what the symptoms meant to me. Asides from being a cathartic exercise I ended up with personal symptom lists for depression, psychosis and mania. Furthermore, we were able to identify my personal early warning signs for each. My nurse left, promising to create a personalised early warning sign booklet for me over the next week.

I lost control before I was admitted to hospital, and the little control I had left was taken away from me when I was inside. But now, on the road to recovery, I choose when to eat, what to do and where to go. I take responsibility for myself. I look after myself. And now, with a few tricks up my sleeve, I feel empowered. Instead of feeling at the mercy of dangerous mood swings, I feel like I have control. But most of all… I feel like me again.

My Ray of Sunshine

 

The most important character in this story is my little boy, Master D.

I have always maintained that my depression, my illness, was never anything to do with Master D. The blackness hit me like a ton of bricks only a few days after his birth, but deep inside I knew my despondency wasn’t to do with him. Master D was the catalyst but not the cause.

People gave me all sorts of advice. They told me I should go back to uni, get a job, find a hobby, go on vacation, take time out for myself, or (my personal favourite) give myself a footbath. I know these people meant well, and they were only trying to help, but I felt like screaming. I knew that even if I were to put Master D into full time childcare, get a fantastic job, go on a holiday, and give myself a footbath every evening the blackness would still be there waiting for me. It wasn’t circumstantial.

It’s very hard for anyone to understand a non circumstantial depression. People understand the depression of someone who has lost a family member or a job, or their health. But how can someone be depressed when they appear to have everything going for them? I certainly didn’t understand my depression. I felt I had no right to be depressed. A psychiatrist at the emergency department of a hospital put it into words once. She asked me “You have a healthy baby, a loving husband, a roof over your head? Why would you feel depressed?”. Why indeed.

I was so ashamed of how I felt that I began to try and hide it. I got up every morning and showered, cleaned my house, returned phone calls, all the while giving Master D the utmost care and attention. Depressed people didn’t get up, didn’t clean their house, and certainly didn’t return phone calls – I had been there before. Therefore I couldn’t possibly be depressed. Yet at night I soaked my pillow with tears, and every morning I woke up wondering how I would make it through the day.

But there comes a point when you can’t fake it anymore. I stopped cooking, cleaning, doing anything other than the absolute necessary. I took care of Master D’s basic needs, he was well fed and always clean, but afterwards I would stare at him, wondering what I should do, wondering if – in fact – he was still my baby. At the end, just before my admission, as the psychosis began, I became convinced that the police were looking for me for being a bad mother.

But Master D, my darling boy, remained a ray of sunshine in a dark situation. He warmed my heart with each smile and cuddle he gave me. He taught me how precious life is, and gave me something to be strong for. Master D, ultimately, is the reason why I never attempted to hurt myself.

When I was diagnosed with bipolar disorder things started to click into place. I was told that women with the disorder are at high risk of experiencing manic or depressive episodes in the postnatal period due to the immense hormonal and biological changes. Usually these women are treated promptly, but since I was unaware I had the disorder and was therefore treated for postnatal depression (which requires an entirely different treatment protocol) things got to the stage they did.

Sometimes I feel guilty that Master D endured what he did. Even though he is too young to understand. I feel sad that he spent two months of his little life in a psychiatric institution, and I have virtually no photos of him between 7 and 9 months old. But then I look at the positives. Master D and I have an incredibly strong bond now, and I treasure the time we spend together. I have a WHOLE lot of photos of Master D from 10 months onward! He is used to being handled by strangers and is happy to be passed to new people. But most importantly Master D has a very happy mum.

There’s always a ray of sunshine. My son. My sun.

 

A Mixed State

 

 

I just couldn’t stop moving. I tossed, I turned, I paced, I jittered. I got up in the night to pace. I wrung my hands and jogged my legs and drove everyone around me up the wall.

“Stop! Tell me what’s bothering you.” Hubster would say. “I don’t know!” I would reply.

“Stop! Take some deep breaths and try to keep still” My doctor would say. “I can’t!” I would say, before pacing around the room again.

It had begun about a week before I was admitted to hospital, and it was unlike anything I had ever experienced before. In my experience, depression is accompanied by lethargy. A complete inertia and apathy towards life itself. You don’t want to *do* anything when you are depressed. Merely getting up in the morning is a mammoth task.

But this wasn’t like that. I was acutely depressed. Suicidal. Hopeless. Yet, for the life of me, and despite the plethora of psychoactive medications I was offered, I just couldn’t stop moving.

I was moved to the most secure room on the ward. The bathroom door had a peep hole. This disturbed me. Though looking back the peep hole should have been the least of my concerns. Under ‘special’ supervision a nurse was required to be present every time I used the bathroom anyway. Although I was admitted to hospital as a voluntary patient, I was informed in no uncertain terms that if I were to attempt to leave the premises I would be sectioned under the Mental Health Act.

One morning I woke up to find three nurses conducting what appeared to be a sweep of my room. “We’re just giving your room a bit of a clean” they told me. “Umm, okay then” I said. I didn’t really think much about it until I had my shower and wanted to dry my hair. My hairdryer was gone, and when I questioned the nurse about it she told me it was for my own protection. On closer inspection I noticed that all my power cords were missing as well as my shaver, scissors and nail clippers (ok fair enough), dressing gown cord (lethal weapon there…) and my shoes (seriously?!). Hubster later told me that women’s bra’s are often removed in institutions. How he knows this I’m not entirely sure. Thankfully my underwear was left safely in my drawer. Small mercies!

Although I understood that the hospital was taking my safety into their own hands, I wasn’t entirely sure why. I mean, I knew I was suicidal. I knew I was severely depressed. But most of the other women in the ward were depressed. Yet they didn’t need a special room, or 24 hour supervision. They were allowed to go for walks alone, and wear dressing gowns with a cord. On a few occasions I felt angry about this perceived inequality, sometimes I felt upset. But mostly I was so depressed that I just didn’t care. I didn’t care that my rights, dignity and privacy had been taken from me. It just gave me one less thing to think about.

All of this happened well over a month before the manic episode that confirmed my diagnosis of bipolar disorder. But at this point in time the doctors were already suspicious that I had bipolar. You see, somewhere in between mania and depression there is a strange phenomenon clinically termed a ‘mixed state’. You have symptoms of depression and of mania at the same time. The agitation of mania without the euphoria. The chronic low mood of depression without the apathy. A mixed state is one of the most dangerous psychological states to be in, and many suicides associated with bipolar disorder occur during a mixed state. Somewhat ironically, the lethargy that accompanies depression acts as a  kind of safety net. A depressed individual may simply not have the energy to execute a suicide attempt. During a mixed state individuals are seriously depressed, but fuelled with energy – a deadly combination.

What I know now is that I was experiencing a mixed state, and this went on for many painful weeks. No amount of anti-psychotic or anti-anxiety medication dampened my agitation. No amount of anti-depressants lessened my depression. I barely slept, despite the copious sleeping pills I was offered.  My son was almost exclusively cared for by the nurses and my husband. To this day I have very few memories of this point in time and rely on my doctor’s and husbands recollections of how I was.

A mixed state is such an appropriate term. Because I really was mixed up, and I really was in a state. I was experiencing symptoms of depression, mania and psychosis all at the same time. I couldn’t explain my past and I couldn’t think about the future. I wanted to live, but I wanted to die. I wasn’t sane but I wasn’t crazy.

While I was in hospital I marvelled at my baby boy’s development. I watched him pull himself along on the floor, start to crawl, and finally pull himself up to stand. And as is the way of things, the mixed state passed, and transformed into something else completely. I was taken off ‘special’ supervision and onto 15 minute checks, and then half hour checks, then hourly. Soon I even got to go for walks, and was moved to a different room (without a peephole!).  Then finally, like my son, and with the encouragement of Hubster and the medical staff, I reached up and stood on my own two feet.