Tag: Gratitude

Invisible Damage

9.30 pm at the medication station.

I confirm my name and date of birth. A nurse hands me a tiny paper cup. It rattles slightly, this mix of yellow, white, and orange lolly shapes.

‘See if that looks right.’

I never go on looks alone. I recite the contents of the 13 tablets back to the nurse, as though I were the one prescribing and dispensing:

‘750mg Lithium, 50mg agomelatine, 100mg quetiapine XR, 150 mg regular quetiapine, 1mg clonazepam, and 10mg of temazepam (prn)’.

Just before I swallow them, my mouth feels full of loose teeth.

And then I drift down a dimly lit blue carpeted corridor that ends in an opaque glass window covered in giant blown dandelions, until I am back in my room.

I feel so removed from my life I may as well be orbiting it in a spaceship.

I feel the anxious tug deep in my belly, knowing the longer I orbit, the longer and harder my earthling reintegration will be.

Outside of these corridors, this mission to heal my brain, my family pushes and pulls itself into an unnatural, temporary shape. Each member forced to stretch and thin out to cover the hole of my absence.

My family hurts in ways I can barely imagine, while the hurt in my brain lands me in this other world.

It feels as though my family is the only family to contort itself for as long and as often as mine does every time I get sick. It doesn’t matter that they are all resilient and used to it. It doesn’t matter that we manage it as well as anyone possibly could.

I don’t want my illness infiltrating my children’s’ growing years. But it does. Each time a little more.

This frustration doesn’t negate my gratitude for having access to a hospital that allows me whatever time it takes to treat acute episodes of this illness. But at the same time my gratitude sometimes feels like petrol when I attempt to douse the flames of frustration with it.

I know people feel relieved when I announce I am coming home. I don’t share their relief because it is not an easy slotting back into place. It is tearing my way back into a family that has been forced to operate without me. It is blinding and muting myself to all the tiny little things …and the bigger ones that they have had to do differently to survive the lack of me.

And yet, I know that my absence from my family is less damaging to them than my symptomatic presence would be, when I am barely safe in my own company. My distress at having no memory or concentration, at being loaded like a gun with pathological irritability, losing touch with reality – these are not things I want to subject my husband or children to.  It would shred us into irreparable pieces. So, I choose the lesser of the damages.

Even as I hate to think about the scar tissue left behind, I know I can repair the stretching, thinning induced by my absence, given time.

That time starts at discharge.

I will be home to begin work to repair while I work to reintegrate…possibly within days.

PS: The list of medications included in this piece is a snapshot of one evenings’ medications for me in hospital. It should never be used as a comparison to anyone else’s medication. Psychiatric medication regimes are highly individualised and often change over time. A medication combination that works well for one person can be a disaster for someone else, even if they share a diagnosis. Always consult a psychiatrist before taking any psychiatric medications. If that’s not an option, then a GP

You may also like to read:

When Covid-19 And Bipolar Recovery Collide With Unexpected Results

From Holiday To Hospital In Under A Month

Psychiatric Medication And Stigma

Covid Year 2: Timing Your Perspective

Welcome to year 2.

The frantic newness of the pandemic has worn off, although the announcement of a lockdown still triggers an anxiety that (for some people) expresses itself in toilet paper hunger.

As we move into the second year of life with Covid I feel as though I am part of sick game of involuntary musical statues. During intervals of relative local stability we all dance to the music of few restrictions. But there is a sinister undertone – our movement can be stilled instantly when the Covid puppet master stops that music and we are all turned to stone for a while.

When Covid cancelled our family trip to Heron Island this time last year it was disappointing, but I countered it with perspective, a stiff upper lip. After all what was a lost holiday in the big scheme of things? So many people were worse off.

So, we rebooked the Heron Island trip for this year. We’d been due to leave on March 30. The anticipation of it had built joyously for the whole family. I was particularly looking forward to it. Our last family holiday in December was marred by the onset of a bipolar episode the day after we arrived that saw me unable to enjoy it and heralded more hospital time. 2020 Ends In Hospital

I am stable now.

Over the weekend two of us dutifully took Covid tests for minor sniffles, both of which returned negative with plenty of time to spare before our scheduled departure.

When I woke up on Monday morning, the day before we were due to leave, I actually thought we would make it. And then news of the 3 day Brisbane lockdown broke, and my joy turned to misery. Our household was plunged into mourning. There were tears, cries of shock, and lead filled stomachs as we processed this loss for a second year in a row.

Is my wording a bit dramatic?

Are you itching to respond with the catch cry of this first world country, the mantra of our year?

 ‘It’s ok because others have it worse than you.’

Does that make it ok?

Should this fact completely invalidate our experience or feelings? Does our disappointment, grief and anger have anything to do with someone else’s (potentially worse) experience?

No. It is totally unrelated.

 And often swallowing our feelings through gritted teeth can be unhealthier than just vomiting them out and moving on.

I first encountered the results of suppressing my emotions because ‘others had it worse’ the night before my daughter’s first birthday, thirteen years ago.

The condensed version of the time surrounding her birth (if you haven’t already read about it in some of my other posts) is this: A 32 hour labour on 2 hours sleep, developing postnatal psychosis 7 days later, a month later catatonic depression, months in a psychiatric hospital, electroconvulsive therapy and much medication, and finally home by the time my baby was 4 months old.

As I recovered, I practiced a lot of gratitude for my healthy baby, which in itself is not a problem, but I had not allowed myself to process my feelings about that time before I plunged into gratitude.

The night before her first birthday I was out to dinner with friends. I could not stop thinking about what had been about to happen to me the year before. On the way home I pulled into the maternity hospital car park and lost it.

I wailed, tears and snot streaming down my face. It was ugly. But I finally owned my grief, and silenced the pernicious little voice in my head that had been telling me that I had no right to my feelings because I had a healthy baby and  ‘others had it so much worse’.

It was only once I’d allowed myself to feel my feelings that I could move on baggage free and feel genuine empathy for those who, in the big scheme of things, had experienced worse.

I am not naturally inclined to drama. I am all for perspective. At times I have been quick to paper over my children’s strong emotions with perspective, not because it is helpful to them in the moment, but because it lessens my discomfort at their distress.

Perspective serves an important purpose. If it is timed right. Once the initial urgent feelings have been dealt with and released, perspective can help us move on with our compassion for others intact. But forcing it too soon can trap us in resentment and on the exhausting hamster wheel of pretending we’re ok, when we’re not.

 Perspective (however well intentioned) would have been an unwelcome guest in our house just after the news of the holiday cancellation broke. However, 2 days later it had just started to soothe me with the knowledge that it could indeed have been much worse.

Proof that this could have been much worse came just now. The Brisbane lockdown ends at noon today. Covid has pressed play again. Brisbane people get to dance into their Easter holidays.

For me? Right now? Perspective has again momentarily retreated.

Excuse me while I go away and vomit up my feelings about the military precision with which our holiday was assassinated. We were turned to stone over the exact two days when we needed to be dancing.

I will welcome perspective back once I have emptied myself of this minor resentment and am keeping everything crossed, that maybe the music won’t be stopped on our third rebooking in September.

You may also like to check out:

Making Sense Of It (introduces the concept of a ‘tantrum allowance’)

Covid Lockdown In A Psychiatric Hospital

When Covid-19 And Bipolar Recovery Collide With Unexpected Results

Trauma And Bipolar Disorder: Chicken Or Egg?

Photo by haik ourfal on Unsplash

Content Note: This post mentions trauma. It does not include specific details.

It’s a little acknowledged truth that sometimes bipolar disorder does not spring from a history of trauma. On my first admission to hospital and every admission since, I have been asked whether trauma smoulders in my past, and keeps the fire of my bipolar disorder burning.

Up until relatively recently parents were still automatically blamed for their children’s mental illnesses, particularly schizophrenia and bipolar disorder. And while abusive parenting can be a contributing factor to these illnesses, and parents can pass on a genetic predisposition to a highly heritable mental illness such as bipolar disorder, beyond that, a parent isn’t responsible. As for my upbringing – my parents were not perfect. But they were loving and supportive. They were not a source of trauma.

I searched for years for some of the more common culprits of a trauma history (such as physical, sexual, or emotional abuse) hiding in the shadows. I ran a fine-toothed comb through my entire living memory for evidence. For something to explain the existence and severity of my bipolar 1 disorder.

After the second time I got sick, I began to wonder if I was missing something. If I had blocked out something horrible? I spent close to a year working with both my psychologist and psychiatrist to try and unearth a tangible cause for the god awfulness that had descended on me. And I came across a lot of things in this archaeological dig through my psyche.

Among many happy memories. I found sadness, exclusion, some bullying. I found burnout and disappointment. I found ambition and perfectionism. I found drive. I found questionable decisions. I found some experiences that my psychiatrist raised his eyebrows at, but when my psychologist worked through them with me, we found no symptoms of PTSD, no persistent feelings of powerlessness. I found experiences that were difficult and unpleasant and challenging.

But I did not find trauma.

Ironically, the only trauma I have ever experienced came with this illness in the form of psychosis, especially the first episode. Nothing I have experienced before or since that first time comes close to the hell of psychosis.

For me, the sudden onset of this severe psychiatric symptom contributed to its traumatic footprint. One week I was due to give birth to my first baby, with no history of mental illness. The following week I inhabited a terrifying alternate reality that no one else could see, in a psychiatric hospital Special Care Unit, tipping highly medicated breastmilk down the sink, while my husband looked after our new baby at home. For me, the experience of psychosis is the definition of terror and powerlessness.

The trauma of psychosis left its mark. After my second episode I started having panic attacks. I had never had them before. They were linked to the fear of psychosis recurring.

It took a long time to process what happened to me and to learn to live with the ongoing implications of this illness. But I am fortunate it was an acute trauma, not chronic or complex, and not of childhood onset. It didn’t happen at a time when my brain was still developing and more vulnerable to this kind of assault.

I have worked towards having excellent insight, which means I now recognise the precursor symptoms of mania, which can lead to psychosis. The early detection of symptoms and acting on them immediately have meant it’s been six years now since I’ve experienced true symptoms of psychosis. The deep sense of powerlessness has eased. In my case the trauma was a side effect of my bipolar disorder, not a causal factor.

But I sense I am in the minority. Of the people I know who also live with bipolar disorder many carry a history of trauma and/ or complex PTSD with them which, occurred before the emergence of their bipolar disorder.

I do not have the complication of a contributing trauma to re-trigger episodes of illness and to work through. These days, I don’t have a knotted web of psychological issues to untangle before my medication can get to work. I also think letting go of my resentful feelings at being landed with this illness has been somewhat easier because I can’t lay blame or direct my anger at anyone or anything  specific for causing this sickness.

And I am grateful for all of that.

If this post has brought up difficult feelings or symptoms for you and you are struggling, please contact your mental health professional. If you are in crisis (and in Australia) please phone LIFELINE on 13 11 14

Further reading:

Insight: The Essential Ingredient

My First Time

Misunderstood Mania

Honoured, Grateful, And Guilty: A Tangled Family History

image tangled family history

The strands in my children’s heritage are tightly intertwined, multicultural, and impossible to untwist from each other. History labels their predecessors perpetrators and victims, depending on which of their ancestral branches you examine.

A photograph of my maternal great grandmother hangs in my hallway. She looks serious. In mid 1920s Warsaw. Dark haired and dark eyed. My grandmother, aged three or four, stands next to her in a light dress, their arms linked.

My maternal great grandmother was too attached to her country. Fatally so. To me, she is a cautionary tale of the danger of fastening yourself too tightly to one part of the world.

But I only know fragments of her story:

My grandmother (in the light dress) was about nine or ten when she emigrated from the Jewish ghetto in Warsaw to Australia with her parents.

Shortly after their arrival, my great grandmother looked around at the vast, bright country she found herself in and decided it was too foreign for her. She pressed some coins into my grandmother’s hand and sailed back.

To Warsaw.

In doing so she inflicted a lifetime of trauma on my grandmother and signed her own death warrant. Her life was erased by the Holocaust that ripped through the country she chose over her daughter. A daughter who would be orphaned in the vast, bright country at twelve, when her father died just a couple of years later.

My parents’ wedding photograph also hangs in my hallway. Taken in Duesseldorf, 1971. My mother’s dark hair. Dark eyes. My father’s white blond hair. Blue eyes.

I was born in Germany, lived in Saudi Arabia from ages one to five and returned to Germany just before my sixth birthday, in time to start school.

Many German born children of my generation were infused with guilt. We read When Hitler Stole Pink Rabbit by Judith Kerr in primary school. The older grades took school excursions to former Nazi concentration camp sites. This shameful chapter in Germany’s history was rightly not denied or underplayed.

And the whole world pointed its finger at us. At least it felt that way when I moved to Brisbane with my family aged thirteen.

Almost as soon as I started school, a chunky, pimply, blond boy in my year began greeting me with a Nazi salute and yelling ‘Heil Hitler!’ every time he saw me. The other kids stared as though I were personally responsible for Hitler’s actions. Each time it happened I was swallowed by a boiling pit of mortification and anger.

I already owned my German guilt. Guilt with a twist. The country I’d been born in, whose language I spoke flawlessly, that was home to all of my friends, whose seasons, landscapes, and culture I loved, had in recent history been responsible for the genocide of my mother’s family’s people.

My guilt and that knowledge had already curdled uncomfortably inside me, before that boy began hurling the only, and highly offensive, reference point he had for German people, at me.

My maternal grandfather’s Jewish roots can be traced back to 16th Century Portugal. It is one half of where my children’s dark eyes come from. Their high foreheads and cheekbones travelled from Latvia and Germany via my father. The shape of their chins can be traced back to English ancestors from my husband’s family.

My children are both first and seventh generation white Australians.

It is messy alright.

My ancestors didn’t happen to be in Australia when white people invaded and began inflicting trauma that is still ongoing on the First Nations People. But my husband’s predecessors landed here as missionaries ten years after the first fleet.

Does any good ever come from entering a foreign country aiming to convert its peoples to a belief system not their own?

I don’t believe so. No matter what the intent.

And no matter how much I love the descendants of those missionaries, my guilt echoes around that family history. It feels similar to the guilt I felt as a German child of the early eighties.

Yet, guilt on its own achieves nothing unless it pushes us towards acknowledgement and action.

Over the last weeks I have researched and asked advice from people with Aboriginal or Torres Strait Islander heritage on wording an acknowledgement of Country and its First Nation Peoples to include in my book. I am so grateful for their time and knowledge.

I am still working on the exact wording. But I plan to include this (slightly reworded) content from an acknowledgement by the Climate Justice Union:

‘I appreciate I have much to learn about the oldest continuous living culture. I am listening, seeing, and learning.’

We are all capable of listening, seeing, and learning – in some form.

And when my children look at their own hallway photographs one day, I hope they will be proud of their incredible hybrid vigour, know where they came from, but also that they are honoured and should be thankful to travel safely over Aboriginal and Torres Strait Islander lands.

You can find an excerpt of my book, which is due to be published this year (Covid permitting) here:  Book  and the story of  the book’s journey here: Accepted: Crumbs To Canary Wharf

 

 

 

 

 

 

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.

 

You may also like to check out:

Interruption To Regular Programming

Misunderstood Mania

Mental Illness Doesn’t Respect Deadlines

Visiting Someone In A Psychiatric Hospital?

What a mental illness can teach you about your mental health

 

 

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