A dull ache sits in my centre. My cat Lucy, immortalised next to my old red keyboard on my Thought Food home page, is gone.
2 days ago the vet in me woke to a 16 year old depressed, immobile, incontinent feline patient. I needed more information before communicating with the cat’s owner, who was also me. The owner could read the vet’s face though and it made her feel as though a cactus was growing in her chest.
The vet came back with information later in the day.
Hypothermia, likely anaemia hiding under haemoconcentration, severe azotemia in the face of likely hyposthenuria, severe hyperglycaemia, and elevated ALT
At that point the owner and the vet in me began to overlap, like a Venn diagram, and both parts of me knew enough to know this:
None of these big words gave us a definitive diagnosis. To get to the big word that was causing the multi organ system problems indicated by a physical exam and first round of blood tests, we’d need to enter a new level of the diagnostics game. And with each new diagnostic test we’d opt for we’d open up the possibility of needing still more tests to get to the bottom of it.
What justifies further diagnostics in veterinary medicine?
The chance that the definitive diagnosis is something treatable or manageable to the point of returning the patient to a good quality of life.
When I started work as a small animal vet in 1998 we had fewer diagnostic and treatment options available for pets. It is good to have more options now. There are absolutely cases where we can return animals to a great quality of life where they would have been euthanased when I first graduated.
But this advanced knowledge also complicates matters, particularly when it comes to caring for our geriatric pets.
People often assume that the hardest part of being a vet is euthanasing animals. Yes, it can be devastating. But I have always found it equally as hard, if not harder, to hand hold people through the process of coming to terms with the fact that it is time to euthanase, while their pet is put through diagnostics and treatments that may prolong life but do nothing for quality of life.
An internal medicine specialist may well have wanted to know exactly what the cause of my cat’s abnormal blood results were before giving me their blessing to euthanase.
And, with those blood test results, had my cat been 2 instead of 16, I still would have stopped to consider that euthanasia could be the end point. But I would have gone ahead with more diagnostics because the chances of them leading to an outcome with a good quality of life for my cat would have been higher.
But I also knew that had I insisted on a definitive diagnosis 2 days ago, Lucy could have spent her last days scared, in a fluorescently lit hospital having rectal temperatures, blood and urine samples taken at regular intervals with no knowledge of why it was happening. Had she been able to come home it would have been heavily medicated, and still not feeling 100%.
When I weighed this with the tiny chance that she was suffering something treatable with a chance of return to good health – the risk of putting her through fear and pain for nothing at the age of 16 was not one I was willing to take.
Instead we made the hard choice.
Instead all four of her people cuddled her. We whispered in her little round ears and wet her fur with our tears. And I stroked her velvet neck as she drifted off into anaesthesia and then away into death.
Later that night I laid down next to Lucy’s siter, Lily and burst into deep sobs. These cats entered my life before the mental illness that came with my human children. With Lucy I have lost another part of me that existed before everything changed irreversibly…and not all for the better. The waves of grief beach unexpected thoughts and feelings.
When I work, I am not brutally honest with a vulnerable client if they ask me ‘What would you do in this situation?’ I stick to the facts, lay out probabilities as best I can and make sure euthanasia is part of the conversation so that they can make their own informed decision, in as much as their own time as their pet’s welfare allows.
But if the vet in me had been advising the cat owner in me for Lucy, I would not have held back. I would have said:
‘We can do every diagnostic test under the sun and you will probably get an answer, but we are doing it for you, not for your pet.’
Just because we can do something, doesn’t always mean we should.
In loving memory of Lucy (14.2.2005 – 7.5.2021)
You can find some of my other veterinary content in these posts:
huge heap of dirty disgusting dishes in the sink waiting to be washed by unreliable flatmate
Has it really come to this?
To the women who document their displeasure about the unequal distribution of their mental load passive aggressively on social media:
The likes and laughing emojis you get from hundreds of strangers might give you a quick sugar hit of instant validation, but will they solve the issue of your unequally distributed mental load, or will it just corrode what sounds like the already leaking vessel of your marriage further?
The writers appear to feel more solidarity with the anonymous commenters than with the person they are in a partnership with. Underneath the jokes sits violently simmering resentment.
Let me back pedal to the source of my lack of admiration for this approach for a moment.
The first was a recent article a woman wrote about the (extensive) difficulty she was having getting her dog to feed her husband. Sorry her husband to feed the dog – although with the tone she used to describe her husband’s ineptitude, she could easily have meant it the other way around.
The second – I think it was on Youtube – an account of a woman who ‘went on strike’ and stopped washing the dishes and then posted updates about the ‘apocalypse’ unfolding in her house as a result of this. Piles of dirty dishes. The husband in question using a baby spoon to stir his coffee rather than doing the dishes.
I am not trivialising or dismissing the message these women are attempting to send their partners, but their delivery is conflicting.
In one breath it’s attempting humour and in the next red-hot anger.
Clearly we are not dealing with one of those minor sources of marital discord that can be shrugged off as a normal part of any relationship here.
The unequal distribution of the mental/domestic load is real and needs to be taken seriously. But is turning it into a farce and publicly infantilising the people whose behaviour you want to change the way to go about it?
Returning to the article about feeding the dog for a moment. The writer explicitly stated that in the four years she had off work outside the home, before returning to her career, she took on 100% of the domestic load. Feeling (rightly) entitled to a break, she then seemed surprised when the hand over of one chore (feeding the dog) didn’t run as smoothly as she wanted it to.
She also displayed another classic trait of the mental load martyr: overcomplicating a simple task, by insisting on her husband’s dog being fed a thermomix cooked diet for the sole reason that she thought ‘It made the dog’s coat shiny’.
Having read her article, I posted the following response:
As a small animal vet: The best diet for your dog is a high quality dry biscuit, something like hills science diet, water, and (if your dog tolerates them well) fresh raw bones for their teeth. You are wasting everyone’s time, energy, and to be honest a lot of words in your article on preparing fresh food for your dog.
As for the distribution of mental load: You mention that in your four years off you shouldered 100% of the domestic load. Why? Did you both consider your husband less of a parent or part of the household in that time? If he worked long hours, he may not have been able to do as much of it as you, but does that mean he should have done nothing in that time? If he had been living in a hypothetical share house instead of your family during the time he worked long hours, would his housemates have been happy to do his laundry, dirty dishes, and feed his dog?
So maybe setting the bar so low during those years is making it harder now? The martyrdom of women shouldering and complaining about the mental load is real. Change your dog’s diet for everyone’s sake – including your dog’s. Tell your husband if he doesn’t feed his dog you will report him to the RSPCA. If you stop treating your husband like a an inept toddler, he might stop acting like one.
To be clear – I don’t think there is anything wrong with giving your partner a wake up call to shoulder their share of the domestic load, by letting things slide. But make a choice – it’s either something funny that you don’t really care about that you post on social media, or it is a serious issue in your relationship, in which case yes, let the dishes pile up until your partner gets the message, but don’t then simultaneously trivialise and weaponise it by posting it on social media. Doing so might get you the hit of anonymous likes, but it’s not going to solve the problem in your relationship.
I have previously written about the equitable division of mental and domestic load in my relationship. Your Mental Load = Your Responsibility We both have careers. We share two children, and a menagerie of pets, and all the mental load. I have been called ‘lucky’ because of this.
I am not lucky.
I made a choice to be with my husband. We work on communicating well and from the very beginning of our relationship I have never given him the illusion that I would carry 100% of the domestic load.
But if either of us ever resorted to shaming the other on social media, if we had a significant issue in our marriage (such as the unequal distribution of the domestic load) I suspect we would each seriously re-examine our choice to stay with each other.
Post script: This post is not in any way aimed at those living with or who have escaped domestic violence or who are living with mental illness or any other disadvantage. It was intended as a prompt to reflect for the women who do not live with domestic violence, but do live with straight, white, cis-gender, non-disabled, privilege and who have choices but prefer martyrdom.
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.
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.)
Long before Covid-19 arrived, vets and vet nurses were quiet, hard workers who didn’t complain about less than ideal working conditions. And, possibly unbeknownst to most of the pet owning public, for many veterinary staff, challenging working conditions were the norm.
Since this crisis hit, these essential workers are not getting much opportunity or airtime to communicate the difficulties they currently face at work.
The advent of the Covid-19 pandemic has put the challenges of veterinary work on steroids.
I know a bit about what it takes to work in this industry.
I fell in love with veterinary work at fifteen, when I started volunteering at a local vet clinic. I wiped down tables, cleaned cages, and held animals. Then I started work as a casual junior vet nurse on Saturday mornings.
I committed the second half of my teenage years to the tunnel visioned hard work it took to get into veterinary science at university.
I worked as a small animal vet for twenty years, in many different practices in Australia and the UK. Working conditions ranged from excellent to atrocious.
Thanks to my experiences, I know this:
Vets don’t talk about their work stresses outside their own tightly knit vet circles. Some of us don’t even confide our struggles to our colleagues. We talk about our cases in detail for hours, but many of us still cringe at opening up about the state of our mental health.
Our clients get our kindness, our compassion our sympathy our skills our knowledge, our communication skills. But they never see our vulnerability. They don’t understand how high our risk of burn out (borne of caring too much and being overworked and undervalued) is.
They don’t see that when we walk through the door of the clinic our rostered working hours become irrelevant because we give ourselves over completely to everyone else who walks through that door after us.
Our clients don’t feel our pain when we lose yet another amazing member of our profession to its sky-high suicide rates.
I am currently taking a break from veterinary work while I concentrate on writing and mental health advocacy work. But I have many vet friends who are out there working and hurting.
I have spent the last couple of weeks collecting descriptions of work life from some of my (currently working) veterinary friends and contacts, because I believe that for the veterinary profession to survive this pandemic with its collective mental health relatively intact, the pet owning public needs to know about the difficulties its workers face at this time.
Here are some of the (summarised, paraphrased, and quoted) insights these vets generously shared with me:
On Covid-19 Regulations:
Some aspects of veterinary work make social distancing between staff impossible. For example, it is not feasible for a nurse giving a wriggly, excited puppy a cuddle and a vet looking in its ears with an otoscope, to be 1.5 metres apart.
Some of the protocols necessary to minimise the risk of Covid-19 transmission, such as contactless consultations (where the owner waits outside the clinic in their car, the pet is transported inside by a nurse in PPE, the vet examines the pet and then phones the owner to discuss further diagnostics or treatment), severely hamper efficiency and slow everything down.
Vets are used to working as efficiently as possible:
‘Normally I would type the history while the owner is in the consult and do an exam in between taking notes. Now I can only do one of these things at a time.’
Contactless consultations also limit a vet’s ability to read their client’s body language during the consultation, which can interfere with effective communication between vet and client.
Pets can be more anxious when separated from their owners. This may mean it takes longer to perform a physical exam, or it may be impossible to do as thoroughly as the vet would like.
Covid-19 level cleaning recommended between consults is more labour intensive and takes longer than usual.
On Finances
Downsizing or closure of a practice due to further restrictions or a Covid-19 infection will have negative effects on the practice’s financial stability very quickly.
‘The nature of small to medium sized veterinary practices even in normal times is to run with incredible efficiency, but still on very low margins. They cannot sustain even mild to moderate downturns. They will not survive and jobs will be lost long before the drop of 30% revenue occurs required to be eligible for the Job Keeper Payment.’
Locum vets are particularly vulnerable to job loss now. As practices work to minimise the risk of a Covid-19 infection in their permanent staff, many locum vets are having their shifts cancelled, and are facing the financial difficulties and mental health challenges that come with job loss.
Vets are also more aware than ever of the financial constraints facing many of their clients.
‘It is super sad when you see a client who wants to do everything for their pet, but they have lost their job and can’t afford it. It breaks my heart. I am doing a surgery at a 25% discount tomorrow. The client didn’t ask for it, but I feel so sad for them.’
‘I feel even more conscious of the usual dilemma we have in vet practice of having to mix financial discussions with emotive ones as most people are understandably a lot more stretched financially right now. But veterinary practices are also under a lot more financial stress and if our invoices are not paid, there won’t be a vet for clients to take their animal to.’
And now more than ever vets are at risk of being on the receiving end of their clients’ financial frustrations.
‘I’ve already been abused in the car park once this week and I am preparing myself for a lot more of that to come as the stress is almost palpable in the air.’
On Mental Health
Vets often hold themselves to a very high standard. Under sub optimal working conditions that pressure will increase stress levels further.
‘Veterinary practice is already an emotionally draining vocation with highs and lows every day. Our staff feel responsible for their patients and care for our clients. And it goes against the grain to just drop our standards of care because of what’s going on. So, we are not going to start cutting corners.’
Many clinics have split their staff into two or more teams to reduce the chance of the whole clinic having to close if one staff member contracts Covid-19. This means vets and nurses may be working under short staffed conditions and even longer hours than usual:
‘The phones are ringing constantly. We hang up and pick up the next one. I am answering dozens of phone calls daily as a vet, as well as being my own anaesthetist, recovery nurse, and doing the usual vet things. And right now none of us have regular access to our stress relieving hobbies.’
Splitting staff into teams at work usually also means no contact between teams outside of work.
‘There were genuinely tears after the last ‘normal’ shift as people realised they may not see some of their friends for weeks, months even.’
Before Covid-19 brought added work stressors with it, vets were already at a high risk for mental ill health. This knowledge weighs heavily on many of us:
‘I’m concerned that abuse of controlled substances will increase and don’t even want to think about the suicide issue the veterinary industry already faces.’
To Clients
Vets appreciate the many clients who are doing the things that make their work less stressful, such as practicing social distancing, being patient when things take longer than normal, and assessing what might constitute an essential phone call.
For example, now is not the time to phone your vet clinic for a lengthy discussion about which breed of cat you should get.
‘If the public can show extra understanding towards vets and vet nurses that will only be a good thing. We are not the only profession under strain but the pressures we are under are very real. Everything is taking longer so people need to be patient.’
‘We place a lot of blind faith in the honesty of strangers at the moment…I feel angry when I hear of my colleagues having got to the end of a consult only to have a client mention that they just came back from a cruise a week ago.’
‘Thankfully 99% of our clients are understanding and adhering to protocols without complaint, but I don’t think they quite understand how hard everything is for us right now.’
Shortages
‘The shortage of equipment is tricky – no hand sanitiser, limited paper towels and gloves. It makes it hard to follow the guidelines to use hand sanitiser between every patient. Some human medications we use are in short supply, which will be hard to explain to clients when their pet’s medication needs to be stopped suddenly.’
‘We have also been asked to supply a list of things we can donate if needed – such as ventilators, propofol, midazolam, and surgical gowns and gloves.’
What is getting us through?
Now more than ever, humour, teamwork and appreciative clients balance out the challenges of veterinary work.
‘On the positive side of things, I work with a group of amazing humans and the way we all have each other’s backs has definitely shone even more so in recent times.’
‘On the upside we have always been good at the ‘make do and mend’ mentality. Also, we were born for this – we just need to pretend every person is a parvo puppy!’
(Parvovirus is a highly infectious, potentially fatal viral infection, most common in puppies, and requires full isolation nursing.)
‘Our team are amazing and have chosen to pull together with a plan to fight and minimise risks to client and staff safety, mitigate risk to the business and work toward sustainability.’
‘We have had wonderful support from our clients and community who have commended us for our initiatives during this pandemic to ensure both human and animal welfare,’
To conclude I will reach for words one of my close vet friends passed on to me. Even though upper management of veterinary practices, can be notoriously out of touch with the needs of its veterinary workers, this directive from the upper management of my friend’s practice encapsulates perfectly what I would want all vets working through this pandemic to hold close to each day, and what I would want all veterinary clients to be aware of and respect:
‘Throughout our career, veterinarians have always put our patients first, then our clients, then ourselves. In this pandemic, we must put our safety and the safety of our nurses and support staff first.’
As a result of this post creating some interest in the US, I was invited as a guest on a couple of US veterinary podcasts, the first of which you can access below. The second, with Dr Kimberley Khodakhah, can be accessed in the Media section of the site.
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.
I am in hospital, compromised by my standard symptoms that precede a manic or depressive episode. Looking more manic at this point though. The three symptoms are: lack of concentration, loss of short term memory, and pathological irritability.
If you have never been ravaged by them, then listing these symptoms can make it sound as though I am just a bit ditzy and cranky.
So wrong.
It’s going to take it out of me but let me see if I can paint a more accurate portrait of this beast. I am not yet so sick that it has silenced me.
The memory loss and lack of concentration leave my brain moth eaten. Holding onto thoughts long enough to articulate them takes a lot of effort. It is like using tweezers to try and catch tiny fish darting around in a big aquarium.
And the irritability? Surely as a rational, compassionate human being I should not feel so permanently unreasonable. I always insert the word ‘pathological’ in front of this symptom to try and describe just how out of control the stream of swear words is that run through my head when I am surrounded by people within ten metres of my personal space.
I say ‘pathological’ to describe the feeling of having hundreds of mosquito bites, my hands tied, and someone running a feather over the bites while they make fun of me. Sometimes it feels more like I’ve been sandpapered and then doused in lemon juice.
It is excruciating.
I will eventually get better. I always do. I know in time I will have the reserves to write properly again, and I will eventually go home and continue to rehabilitate. But for now, any spare energy is going towards doing what I need to do to get well, and if anything is left over it is going towards giving some moral support to my husband and children. So there may be some time between posts.
I always hope it won’t be too long but have been here often enough to know that it will take the time it takes and focusing on it won’t speed my recovery.
2010 My daughter visiting her little brother and I in the mother/baby unit of the psychiatric hospital
‘My daughter never visits me in hospital. She doesn’t like this place.’
An elderly woman told me this in a private psychiatric hospital several years ago. Sadness dripped from her words.
The thought of visiting someone in a psychiatric hospital (especially for the first time) can leave people feeling: Awkward. Uncomfortable. Fearful. Repulsed. Guilty. Ashamed. Misinformed. Unsure. To name a few.
I just read an article that described one of singer Guy Sebastian’s friends as having:
‘lost his life to his battle with mental health’
Tragic. Another young man has become a statistic that should be at least partially preventable. Sadly, we can’t bring him back.
But there is something we can do to inch our way towards better describing why this happens. We can use accurate language when we write and talk about these tragedies. Language that doesn’t mislead. On the surface it may not look like there’s much wrong with the above quote.
It started on the paper bag that the breakfast toast came in. First, I shook out the crumbs to give me an even writing surface. I had no other paper. I was inside the SCU (Special Care Unit), in a psychiatric hospital in August 2006, emerging from my first psychotic episode. And as the medication slowed my boiling brain, a miniscule part of me, took in my environment and thought:
‘I am one step away from a padded cell. Unbelievable. But while I am here, I will record as much as I can, because not many people experience this.’
So, I made my words tiny to fit as much detail as I could onto the toast bag.
Over a year later I wrote an account of my psychotic episode based on that bag and some diary entries. My supervisor for my Master of Arts in Writing Editing and Publishing read it.
‘This is really good writing. You should consider expanding it into a memoir.’
Thought Food 