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.