Mental Health Parenting Truths 101

Written for Queensland Mental Health Week 2020

At some point you will get it wrong.

It will be well intentioned. It may come from a place of not wanting to replicate your own upbringing or the mistakes you think other parents are making. And it will probably be informed by your experiences and biases.

I’ve always known this…in theory.

But the other day my fourteen-year-old daughter courteously yet clearly served my imperfections in this area up to me. This was no teenage tantrum. It wasn’t even an argument. It was simply a conversation in which I was presented with unpalatable information about myself, and then had to choose what I did with it.

It started simply:

‘Mum, can I please get TikTok? Remember I asked you about it a month ago, and you said you’d think about it.?’

‘Mmhm.’

For context – she gained Snapchat and Instagram over the last few months, to my knowledge has not abused any of her privileges, and right now appears to be in good mental health.

So, we talk about how she’d manage seeing distressing content if it popped up. I probe her with her worst-case scenario.

‘What about animal cruelty?’ I say and follow it with a graphic example.

‘I’d talk to someone about it.’ She answers calmly.

‘Who would you talk to?’

She doesn’t hesitate: ‘Well definitely not you! Probably Dad.’

‘Why not me?’ I ask,

‘You and your mental health stuff – you’d blow it all out of proportion, take me to a psychiatrist, have me medicated and force me into years of therapy.’

I did ask.

And while she is wrong about the imagined consequences of telling me she saw some distressing social media content, she is right about something else.

I am hypersensitised, filled with knowledge of the very worst mental illness has to offer. And not just my own. Every time I go into hospital, I share that space with others who are going through their own worsts.

When I see young inpatients often only four or five years older than my eldest child with bandaged wrists or cutting scars, bolts of fear shoot through me. Fear that one day my children could hurt like that.

Every time after my Bipolar 1 Disorder has put me through hell I am frozen by the threat that I will have given this illness to my children. I know that (beyond not introducing significant trauma to their lives and warning them of the dangers of drugs that can trigger the genetic component of this illness) there is nothing I can do to outparent it. But I still try.

After I got sick I was determined my children would grow up in a family that was open about mental illness. There would be no shame and no stigma. They would know from a young age where I was going when I went into hospital and why.

The knowledge that sometimes mental illness sprouts in childhood and adolescence is heavy and made heavier by the fact that sometimes it is fertilised (even in the absence of major trauma) by parents unwittingly invalidating their children’s’ feelings or experiences.

I never wanted to be that parent. And I am not. But I may have made the opposite mistake.

 By unintentionally force feeding my children my concerns around mental health, could it cause them to turn away from the very tools that could help them should they run into a mental health crisis?

Mental health is stitched into the fabric of our family’s conversations partly due to my lived experience, but also because of what I do. My children have never known a time when I haven’t been a vocal mental health advocate. I write about it. I talk about it frequently – sometimes quite publicly.  

And if I dig deep into my motivation for wanting to change the way mental illness is perceived and treated, my children are at the core of it. That motivation is as simple as it is unrealistic:

I want to fix our mental health system so that it can help rather than harm my children should they ever experience mental illness.

I am loathe to admit it but yes sometimes all my motivation, knowledge and focus, can morph into hypervigilance, ready to pounce on the very whisper of something not being right with my children’s thought patterns.  And in my futile efforts to protect them from my worst nightmares, at times I probably veer dangerously close to pathologizing their emotions, which can be as damaging as not acknowledging them at all.  

I do this reflexively even as I know that parenting out of the fear of what could happen is even worse than living your own life ruled by fear.

And yet, deep down I know that if either of my children get sick it won’t be my fault or TikTok’s. If that happens, hopefully their father’s less informed love will be the perfect counterweight to remind me that while my knowledge might be useful in some situations, at other times applying the full weight of it can be like attempting to kill a fly with a sledgehammer. Ineffective and potentially damaging.

Post scripts:

It was a yes to TikTok.

While I am deeply grateful that right now neither of my children require psychiatric care, my advocacy work will continue, because it is grim out there. I caught up with a friend recently whose child does need a child psychiatrist urgently. The waiting time to get an appointment with a private child psychiatrist is currently twelve months.

Or there’s the public hospital Emergency Room if symptoms become life threatening while you wait…

Published with full permission from the fourteen year old who also helpfully pointed out I’d misspelt TikTok in the previous draft.

You may also like to check out:

Talking About Mental Illness With Children

As Mothers Of Sons

As Mothers Of Daughters

Is YouTube Rotting Our Brains?

On Uncertainty

Written for QLD Mental Health Week 2020

How does uncertainty make you feel?

I ask because uncertainty is having a moment right now. It galloped in with the Covid-19 pandemic, and the further we get into it the more it seems to be digging itself into our awareness.

I used to be deeply uncomfortable with the pebble of uncertainty in the shoe of my life. I liked to know what was ahead. It gave me a (false) sense of control and the misguided belief that just because I couldn’t see uncertainty in my life, it didn’t exist. I deluded myself for decades that when there were no clouds on the horizon, the course of my life was somehow more certain than if I could see trouble ahead.

Then all the certainty in my life was put through a paper shredder within five days of my first baby’s birth.

I got my new baby experience with a side of florid postnatal psychosis severe enough to warrant admission to the locked Special Care Unit of a psychiatric hospital. My sense of certainty and control over my life went down the toilet.

After I’d recovered from this psychotic episode I felt entitled to some certainty. I wanted to know this nightmare was over. And I wanted a guarantee it would never happen again.

So when my psychiatrist mentioned ‘a possible underlying Bipolar Disorder’ and that it would ‘take three to five years to know for sure’, the inside of my head threw a combination of a tantrum and a pity party.

When I got sick again after three years, after seven years, and after nine years and my diagnosis of Bipolar 1 Disorder was confirmed, I still felt entitled. Entitled because: ‘hadn’t I suffered enough yet?’ Entitled to not have to tiptoe through my life with everything clenched, waiting for the next time this thing pounced.

I have only recently acquired some degree of acceptance of the uncertainty this illness introduced into my life. I didn’t enjoy the last two episodes in 2018 and early 2020, but I also didn’t waste energy resisting them. In the same way I no longer spend any of my resources anxiously wondering when it will happen next and how bad it will be, because without wanting to sound nauseatingly Zen, the truth is: It will be what it will be when it will be.

Uncertainty exists in everyone’s life every day. But instead of it floating along in the background, right now it is constantly being rammed down our throats. It’s like having a nasty little gremlin on your shoulder whispering over and over again:

‘You do realise bad things could happen to you at any minute’, when the true risk of something bad happening to you is probably not that different to pre-Covid times.

For our mental health to survive this pandemic we have to learn to live with uncertainty, because the end of it is nowhere in sight. And just like my psychiatrist couldn’t give me any certainty when I first got sick, the smartest scientists in the world aren’t able to accurately answer this question about Covid-19: Will it ever be over, and if so when?

Uncertainty is an uninvited, kicking, snoring bedfellow. So how do we get comfortable with it?

First we tease out what about this situation we can control and what we can’t. For example, we can’t control the flow of information that feeds our uncertainties rushing over us every day, but we can control how much of it we absorb.

And once we’ve done what is in our control to help ourselves, we have to try and unclench from the need to know what is going to happen next. We need to stop trying to know and plan for a future that is like a spiderweb in a storm. Here’s what I mean:

During one of my admissions to hospital I sat staring out of the window of my room feeling as though there was no point in doing the work to rebuild myself because my future was too uncertain, my illness could tear me apart again anytime.

Over a couple of days of intermittent staring I noticed a spider in its web just outside my window. Every night it stormed. Rain, wind, a couple of times hail tore chunks out of the web, at times almost destroying it.

That spider showed me the way out of my tangled thoughts, by not only rebuilding every time after its pristine web was wrecked, but doing so in the face of the risk of the same thing happening again, whether the next day or in a year.

The sword of an uncertain future has hung over every single one of us since the day we were born. Nothing has changed there. It is just up to us whether we choose to battle with uncertainty and lose, or whether we accept that being alive will always mean living with uncertainty, pandemic or no pandemic.

You may also like to check out:

Lessons For A Control Freak

The Other Curve Being Flattened

When Covid-19 And Bipolar Recovery Collide With Unexpected Results

Tokenism In Mental Health Awareness

Tokenism In Mental Health Awareness

Written for QLD Mental Health Week 2020

Saturday 10th October is World Mental Health Day and I feel a little conflicted about highlighting it. There are a lot of positives to having dedicated days or weeks to draw our attention to mental health. But I also believe we need to approach these awareness days with a little caution. It’s too easy to post or repost something related to the topic, tick the box of doing good and move on with our days.

Ironically these tokenistic efforts are becoming more common as awareness around mental ill health grows, especially when we don’t have to move beyond the comfort of our keyboards to feel as though we are achieving change. Of course it is good that there is more awareness, tolerance and marginally less stigma surrounding mental ill health than there was fifty or even twenty years ago. But we have to make sure we don’t replace the old insensitivities with their more modern counterparts.

I have written about my dislike of RUOK day before RUOK Day: Full Disclosure and this year I heard another perspective that reenforced my reasons for disliking this day. When I am well, my psychiatrist appointments usually consist of me requesting scripts for any medications I am running low on, a brief check in with how I’m going and then we chat about the state of the world, my advocacy work, his psychiatry work. This year one of my appointments happened to fall around RUOK day and we talked about the pros and cons of this day. I expressed my opinion and my psychiatrist referenced one of his patients coming in on RUOK day in distress because they were bombarded by people they knew asking them if they were ok. People they didn’t hear from for the rest of the year. People who were probably well intentioned, but using them as the token mentally ill person in their lives, to tick the box of having asked: RUOK?

Awareness around mental ill health should not be confined to one day or one week of the year. Episodes of mental illness flare unpredictably and feel as though they will never end. This feeling is fed by the fact that no one can tell you when it will end. There are good days and worse days. There are days when the risk of it turning into a terminal illness skyrockets. Someone may have a spectacularly good day on RUOK day, a calm and uneventful mental health week, but be suicidal sometime in April or on Christmas day, when it is all too easy to be under the impression that we showed our support for those among us living with mental illness back in mental health week, and Christmas day is busy and by April we are into Caesarean awareness month and IBS awareness month.

 So what can we do to be meaningfully aware of the impact mental ill health has on those of us who live with it, and what can we do to support them for more than a day or a week of the year?

Everyone who lives with mental illness is different and everyone’s experience is different even if they live with the same diagnosis. So, I don’t speak for everyone.

For me – I don’t need to be asked how I am. I have enough insight into my Bipolar 1 Disorder to know when I need to seek help. I am fortunate to have good support systems in place, so I don’t tend to feel lonely or isolated.

For me it is all about the language people use. Hearing or seeing stigmatising language either in the media, on social media, or spoken, punches me in the gut. When I am confronted with words like nuts, crazy, lunatic, psycho, mental institution, – the list is long – it belittles me. It strips away the facts of my life, my healthy functional relationships, my personality, my university degrees, my profession, my interests, my sense of humour and it reduces me to a hellish caricature of who the misinformed masses believe someone mentally ill is.

So, think about how you write and speak around me. If you hear or see someone else perpetuating stigmatising language around mental illness, call it out. Do so politely, but raise awareness of it. I do it as often as I can, but I also get tired of being told to shut up, get over it, or that I am overreacting.

Perhaps the most helpful thing you can do for someone in your life who lives with mental ill health is not to automatically ask them how they are, but to ask them what you can do to make them feel valued and supported all year round. They may answer: ‘Ask me how I am’ in which case you are doing it meaningfully and mindfully, not because it is a certain day of the year.

All that said, Happy World Mental Health Day everyone. In honour of it also being Queensland Mental Health Week from 10th-18th Oct I am aiming to drop a few additional posts in Thought Food this week.

Look after yourselves and each other!

You may also like to check out:

RUOK Day: Full Disclosure

Mind Your Language Katy Perry

Don’t Call Conspiracy Theorists Crazy

Don’t Call Conspiracy Theorists Crazy

If I were to call out language that stigmatises mental illness every time I came across it on social media, I’d be posting about it every couple of days. But no matter how called for I may feel it is, I don’t want to douse my readers in a bitter diatribe that often. I also enjoy a break from being told to shut up or get over it by people who don’t agree with my assessment of stigmatising language. So I’ve let it go for a while.

But I came across the following facebook post recently, which hit a nerve and left it throbbing for long enough to drive me to the keyboard:

Thoughts?

Now, I don’t like the word lunatic – but that is the least of the problems with this post. And as much as I’d like to agree with the sentiment, I have to ask:

What does this post imply about those of us who live with severe mental illness?

It equates us with people who believe and propagate fake news. The most pejorative label for people who don’t believe in climate change, the author of that snippet could come up with was to portray them as mentally ill.

Anti vaxxers, people who don’t believe in Covid 19, or who don’t believe in climate change don’t  have those beliefs because they are mentally ill. They believe them because they are poorly informed and possibly brainwashed.

So, let’s not conflate pathological delusions experienced as a symptom of mental illness with people who are just misinformed and who refuse to delve into some scientific research.

I live with Bipolar 1 Disorder, and have experienced delusional thinking as a symptom of this illness. I not only believe in climate change, I am very concerned about it. I believe the overwhelming benefits of vaccination outweigh the few risks. Covid 19? Of course it exists. Donald Trump? Ten of my posts wouldn’t be long enough to list the reasons he has to go.

And yet when I jump onto social media I am bombarded with posts that tell me that the best way to insult  the people who believe the opposite of the truth is to call them mentally ill, and thereby imply that if you live with mental illness you are in the same category as people who can be brainwashed.

Delusions caused by mental illness are completely different to the overconsumption of, and belief in, fake news. By labelling all of the people who don’t believe in scientific proof as mentally ill you insult and dismiss the many people who live with mental illness and who are critical thinkers who do believe in scientific evidence.

I can only speak from my experience of delusional thinking, but here’s what I know:

Delusional thinking isn’t a contagious false belief system you are indoctrinated with. True delusional thinking as a symptom of mental illness is completely involuntary. You don’t choose to experience it. It sweeps in on the coat tails of an illness that fundamentally changes how you interpret the truth.

For me, delusions are accompanied by mania which at its worst tilts into psychosis. The inside of my head feels as though I am riding a rollercoaster that’s on fire. I don’t sleep. The first time it happened, I tried to convince everyone of the truth to my malignant belief system. And in my experience true delusions due to mental illness resolve with antipsychotic medications.

The chances are your average antivaxxer or climate change conspiracy theorist will not change their beliefs if you dose them with antipsychotic medications.

So, If you read the post above and shrugged your shoulders or like several of my facebook friends gave it a like, let me rewrite it for you and see if you change your mind. Here goes:

‘If you believe all of (sic) world’s scientists got together to fake 7000 climate studies as part of (sic) elaborate hoax, you are not conservative you are a cancer patient. We have to stop treating people brainwashed by right-wing propaganda as political actors and start treating them on an oncology ward.’

Uncomfortable yet? You should be because the implication that people who live with cancer are idiots, is as ridiculous as it is insulting.

So why is it ok to equate my serious mental illness and the fact that I have at times spent months in a psychiatric hospital to me being an ignorant conspiracy theorist?

You may also be interested in checking out:

Mind Your Language Katy Perry

You Don’t Die Of ‘Mental Health’: Why Wording Matters

Radio Interview On Electroconvulsive Therapy (ECT)

Ect interview photo

A few weeks ago I took part in an ABC radio national interview about my experience with ECT (Electroconvulsive Therapy). A psychiatrist and two other people who had had ECT were also interviewed. I am very happy I got to contribute to such a balanced, informative, digestible piece about a psychiatric treatment that is shrouded in stigma and false information. Highly recommend a listen when you get a moment.

Click the link below to get to it:

https://www.abc.net.au/radionational/programs/allinthemind/electricity-and-the-brain/12453120

You may also be interested in:

ECT: Blowing up some myths – Part 1

ECT: Blowing up some myths – Part 2

Vulnerability And The Exploitation Of Kanye West

vulnerability image

Kanye West is unwell again. Hurtling through a manic Bipolar episode while the world laughs. And as someone who lives with Bipolar 1 Disorder, I feel for him.

In the early years after my diagnosis, during one manic episode (while hospitalised) I started discussing my sex life with strangers. My friend who was visiting me steered me gently away.

Kanye doesn’t seem to have anyone to steer him away, gently or otherwise.

Kanye is a wealthy, influential man, who probably has access to the best mental health care available. But I don’t believe his problem is accessing top quality care.

His problem is that he lacks insight and no one around him is game to have the difficult conversations with him. The conversations that point out that while he may be a brilliant artist when he is relatively stable, when he develops manic symptoms his brain needs a break from the world, and the world is not entitled to its contents.

Instead, when Kanye becomes unwell his mania is left to run free.

He has been open about his choice not to take medication to help manage his Bipolar Disorder. That is his right. Medication doesn’t work for or agree with everyone.

But he seems to be unaware that to successfully manage this illness without medication, you need to employ other strategies. You need to hone your insight. And if your insight when you are unwell is shaky, you need a mental health directive.

This means sitting down with your doctors and people closest to you when you are well and discussing how you would like to manage your symptoms when you are unwell. And if you experience manic episodes, one of the most basic requests may be to not have access to the media – social or otherwise – while symptomatic. Why?

Because mania can gobble up your inhibitions, make you see the world through a paranoid lens, and sprout delusions of grandeur.

Kanye recently gave an interview to Forbes magazine during which he rambled for four hours, to this effect:

‘…They want to put chips inside of us, they want to do all kinds of things, to make it where we can’t cross the gates of heaven. I’m sorry when I say they, the humans that have the Devil inside them. And the sad thing is that, the saddest thing is that we all won’t make it to heaven, that there’ll be some of us that do not make it.”

“Clean up the chemicals. In our deodorant, in our toothpaste, there are chemicals that affect our ability to be of service to God.”

If Kanye were a homeless man on a street corner sharing these ideas with the world, the interviewer from Forbes magazine would probably have walked past quickly, maybe shuddering at such overt insanity.

Instead that interviewer sat and listened to him for four hours. Noted down delusional quote after quote and then published an article in which they even describe Kanye’s lack of awareness:

‘If it all sounds like a parody, or a particularly surreal episode of Keeping Up With The Kardashians, West doesn’t seem to be in on it.’

Of course West isn’t in on it! He is walled off from reality by illness.

Did that interviewer ever pause to consider why much of what Kanye was saying made no sense? I suspect (with disgust) that they were fully aware their high profile subject was mentally unwell, but chose to exploit him while he was most vulnerable.

I have written thousands of words I thought were brilliant, while in the grip of mania. But once my symptoms recede, I am relieved no one else has read these largely nonsensical word vomits. Because if they had, that would invalidate the quality of my writing when I am healthy.

But Kanye’s word vomits are out there for all the world to snidely pick at, to brand him a rambling idiot and someone to be sniggered at.

At the time of publishing this post, headlines announcing Kanye’s withdrawal from the presidential race are emerging.

I understand stress and sleep deprivation are a president’s companions for most of their time in office, that pushing through is a corner stone of juggling the demands of the job.

Stress and sleep deprivation are the perfect fertiliser for Bipolar episodes to flourish. Bipolar episodes, once active, can’t simply be pushed through. They have no respect for deadlines or work demands – let alone international or national emergencies.

Whether Kanye recognised the risks of pursuing the presidency himself or whether someone in his circle came forward to have the hard conversations and steered him gently away, I am relieved for him.

 

You may also be interested in:

Misunderstood Mania

Psychiatric Medication And Stigma

If I Were Kanye Westwritten two years ago with a different angle to this post

 

 

 

World Maternal Mental Health Day: It’s Not All Postnatal Depression

Alex pregnancy and Elsa
End of 2009

My mental illness was born with my first baby.

I never considered my mental health as part of the decision to have a baby, because when I first fell pregnant within a month of trying, I had never experienced mental illness.

The pregnancy was uneventful.

Then I went into a thirty-three hour labour on two hours sleep. This severe sleep deprivation and the swirling hormone levels woke a slumbering monster, a genetic predisposition, which ensured that by the time my baby was one week old, psychosis had wrenched me away from reality. I found myself in the Special Care Unit of a private psychiatric hospital trying to explain my way out of my delusions, while my husband and mother cared for my daughter at home.

Welcome to motherhood.

Continue reading “World Maternal Mental Health Day: It’s Not All Postnatal Depression”

Don’t Try This At Home: Schooling

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I am not home schooling my children at the moment.

That implies a level of competence that far exceeds my attempts to provide a bit of supervision while they do what could pass for some form of schoolwork.

In fact, what I am doing could no more be called ‘home schooling’ than calling what my children’s teacher does when they are at school, ‘veterinary surgery’.

The new educational arrangements have made me ask myself this over the last week:

Are there any professions (apart from teachers) who are being asked to convey how to do their whole job to the general public in a very short time, using only online resources? I can’t think of any.

Yet suddenly teachers are expected to translate their university degree and years of practical experience into a format that parents with no training or experience in education can apply to their unwitting children at home.

And there will be some parents who will anticipate the same results as when their kids are being taught at school by the teacher.

I accepted a long time ago that I have no interest in the intricacies of how my children’s education is delivered. And I am not expecting to suddenly become enthusiastic about it, just because external circumstances have changed.

I do care about my children’s education. But my role and the teacher’s role in providing that education are clearly defined and there is little overlap.

I view these as my roles:

To love my children unconditionally and make sure they know it. To set clear boundaries for them. I am privileged to be able to afford to feed them, clothe them, and buy their educational resources. To do my best to allow them a good night’s sleep in a room free of devices, during the school term. To offer them a decent breakfast and a packed lunch, or at least the ingredients to make them. To offer them support in completing homework or schoolwork set by their teacher.

And to make myself available for communication with their teachers at any time.

I regard teachers with awe for the job they do. I know from friends who are teachers the high levels of empathy, patience, resilience, and emotional intelligence, among many other skills, they draw on to do their work well.

I also respect my children’s teachers enough not to encroach on the territory of their expertise.

When I attend parent teacher interviews, I only tend to ask four questions:

‘Does my child seem mostly happy and engaged? Is their behaviour appropriate? Are there any areas they are falling behind in? And, Is there anything else you would like me to know?’

Do you know what I never ask about?

The curriculum. Because I trust the teacher to know it inside out.

I feel for the parents who ask in depth questions related to the curriculum during parent/teacher information sessions, because right now they may struggle with the concept that they can’t single handedly provide their child’s school education at home, no matter how much they research the curriculum.

From an epidemiology point of view, at the time of writing, I believe the best place for my children is at home. But at the same time, my care factor for the quality of my children’s academic education ranks way below how much I care for not only my mental health, but the collective mental health of my family.

I acknowledge that while the two cares might not be mutually exclusive for many households, in mine – they don’t always sit well together. I may be biased by my own life experience, but that experience tells me this:

If my children fall behind in the curriculum, I am confident they will eventually catch back up to where they each normally sit. And they won’t be alone in that experience.

Yet if I tried to deliver the full curriculum to my children at home, I would transfuse the stress of my unsuccessful attempts into them. Over time, their mental health would suffer. Mine might suffer to the point of me having to be hospitalised again.

It would make as much sense as my children’s teachers attempting to perform surgery on their dog with only my online instructions to guide them through.

So, the alternative of my children having to work harder to catch up when this is over feels fairly benign. And this doesn’t mean they are doing nothing now. It just means I don’t hold myself to the unattainable standard of replicating my children’s in school educational experience at home.

And I could be way off here, but I imagine whenever I eventually return my children to their formal school based education – their teachers may prefer those children with their mental health relatively intact and their academic knowledge lagging, rather than the other way around.

(Additional note: The veterinary surgery analogies were drawn from my experience of working as a small animal vet.)

You may also be interested in:

The Other Curve Being Flattened

The Comparison Trap

My Mental Illness Makes Me A Better Parent

When Covid-19 And Bipolar Recovery Collide With Unexpected Results

20200301_123742

I have spent the last five weeks in a psychiatric hospital for management of a Bipolar 1 Disorder episode.

I am no longer sick. But still fragile. Like an egg without its shell. I always reach a point on the return to wellness where I can get no better in the controlled bubble world of the hospital. A point where staying longer is of no benefit and can even become detrimental.

I ventured back out into the world at the end of last week. A world that hasn’t grown any softer in my absence. It is the same hustling harsh, bruising, breaking place it always has been, but perhaps more so. No one was fighting over toilet paper five weeks ago.

That said, after any admission for a Bipolar episode, jumping back into my life can feel like steel wool on newborn skin in the early days.

No one can tell by looking at me when I leave the hospital that I need rehab and resilience building before I am ok again. For me, on average that takes the same amount of time I was hospitalised for. So, in this case – another five weeks.

People tend to be congratulatory about me being well enough to come home. I don’t want to be a downer. I am grateful to be home. But just because I’m out of hospital it doesn’t necessarily mean it’s over. It can look like it is slinking away not to be seen again for a couple of years. But appearances can be deceiving.

Once, this illness spent a whole year of my life bouncing me in and out of hospital so often, I got dizzy. By the end of that year, in which most months had held a hospital admission for me, it had nearly killed me. So, that’s why I don’t think about exhaling as soon as I am home.

Today is my fourth day at home. I am still acclimatising. But I also recognise something unexpectedly positive borne of the last five weeks.

Being in hospital with Bipolar symptoms has prepared me for the Covid-19 headlines very nicely.

I get a sense from these headlines and the empty toilet paper and pasta aisles in the supermarket that many people are panicking, or at least are very worried by the uncertainty they are being force fed right now.

I am still in the mindset it took to get through my last five weeks. I lived that time (and do every time I go into hospital) in two-day increments. Why? because it is pointless to look or plan any further ahead. Neither I nor my psychiatrist could fortune tell what would happen. Five weeks of observing, tweaking medication or not, and then waiting another two days before assessing again.

To be clear, there is a difference between not taking something seriously, and choosing to engage only in what is in front of you. I take my Bipolar Disorder seriously, especially when it flares. But does that mean it would be helpful to spend my entire admission panicking that this is the time I become a permanent inpatient (they exist)?

Or should I break it into chunks the size of a couple of days and hit repeat, until at some unknown time in the future I am out the other side?

I’ve spent early admissions, years ago, engaging in the first option but have learnt that the way through with the least energy wasted is the second one.

In the same way, I take the Covid-19 pandemic seriously. But you won’t find me panic buying or worrying about whether or when it will end. Breaking this issue down into two-day increments feels helpful to me right now. Every two days (or sooner if the headlines change dramatically) I reassess the basics: Do I and my immediate family have enough food, water, medication and accommodation for the next two days? I am fortunate. So, far the answer has been yes.

Is there any point in trying to predict what might happen next month or even next week, and worrying about it?

None!

Because no one knows where we will be then. You can only act on the information you have at the time.  And if right now your basic needs are met and you are well, don’t buy more and more and more food or toilet paper (unless you are doing it for the vulnerable members of our population).

Breaking the overwhelm of a difficult situation with no known endpoint into smaller portions lessens the strain on our mental health and preserves our energy for more productive tasks.

And if we do it often enough that’s what will get us to the other side of this situation too.

 

You may also be interested in:

What a mental illness can teach you about your mental health

Where’s Your Comfort Zone?

Interruption To Regular Programming

Update 27.2.2020

 

Update 27.2.2020

focus photography of sea waves
Photo by Emiliano Arano on Pexels.com

And so, we enter week four in hospital.

I emerged from the manic symptoms about a week ago. Pummelled into exhaustion by the high doses of Lithium and antipsychotic medication, and by the manic episode itself. Even in a hospital setting, taking all the right medication, and having good insight into the symptoms, manic episodes accrue a negative energy balance. It means when you eventually recover you are depleted, bone tired.

And this is where it gets tricky:

That exhaustion can mimic rebound depressive symptoms. One improves with rest and dialling back the antipsychotic medication. The other progresses beyond exhaustion to include other insidious signs that envelop you in a black, poisonous mist. Appetite drops off. The words ‘zero fucks left to give’ cast in a concrete block take up residence in your skull. Motivation evaporates and has to be faked until it decides to return in its own sweet time.

For a week now my psychiatrist and I have been watching and waiting. At first, we were both hopeful. We even (stupidly) dared to imagine I could be well enough to discharge by the end of this week. There is a reason we have a policy of never looking more than two to three days ahead when I’m in hospital. It’s because this illness has taught us – there is no point.

My psychiatrist entered my room mid morning today, looked at me back in bed and said

‘This isn’t good. You’re usually out walking.’

I turned towards him.

I don’t like it when his face arranges itself into concern within ten seconds of seeing me. It confirms what I already know. It also reassures me, because it is evidence of how well he knows me.

I have tilted towards depression, in the opposite direction to where I was headed when I was admitted.

This means we change our treatment plan in the opposite direction. We will cut back the Lithium and we will increase one of the two antidepressants I take. We will give it two or three days.

UNLESS…

My mood begins to shift back up before then, in which case I will inform the nurses and they will page my psychiatrist for further instructions. We don’t want to risk another ascent into mania. I’m not reaching for a YoYo or rollercoaster metaphor here, because they both imply the possibility of fun, which this decidedly is not!

The other switch over is the behavioural management of active Bipolar symptoms. For me it means telling myself to do the opposite to what my body wants me to do. So during a manic episode I should seek out quiet environments, be on my own, try not to overexercise. During a depressive episode it means kicking myself out of bed, engaging with others, and above all else exercise, exercise, and then exercise some more.

What a mind fuck.

While I continue to wait out my life in two to three day increments, I don’t feel inclined toward gratitude. But that’s largely depressive symptoms talking. So, I will do the opposite and stubbornly find something to be grateful for. Here we go:

I am grateful that at their current level my depressive symptoms are much easier to manage and tolerate than my manic symptoms were. The intense manic irritability has disappeared, and my concentration and short-term memory have mostly returned…for now.

 

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