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.
The Covid pandemic feels as though it has equalised our collective mental health. Or if not equalised, then it has certainly ‘flattened’ the mental health curve.
Most people who live with a mental illness have at some point experienced unpleasant times with no fixed end point, over which they have little control. And now the rest of the world is being forced to experience this too.
I imagine everyone’s mental experience of this pandemic differs based on their mental health history (among other factors). But it’s fair to say that right now most, if not all, of us are experiencing some form of mental discomfort.
On the surface, those who live with mental illness appear to be most vulnerable to this. But, this demographic may not be as at risk as we think.
As someone who lives with a severe mental illness but is currently relatively asymptomatic, I feel surprisingly resilient…for now.
Having previously lived through the rock-solid horror of psychosis, the inevitable Covid anxiety that flits through my brain now feels relatively easy to manage. I have an arsenal of finely honed tools to combat it. All that Cognitive Behavioural Therapy, the Acceptance and Commitment Therapy, and individual sessions with my psychologist are coming in handy.
I am also familiar with having my freedom restricted at times. When I am on fifteen-minute observations in hospital, I can’t go outside. At my sickest I have been too unwell for visitors. It doesn’t mean I like it, but I have at least previously encountered similar conditions to the ones I am living with now.
But what about everyone else?
Many people had been living with mild to moderate undiagnosed or poorly managed anxiety and/or depression for several months or years before Covid hit. I am particularly concerned for this group.
They don’t have solid medical and social support systems in place yet. The all-encompassing Covid generated stress is the perfect trigger for worsening symptoms. And accessing good mental health care quickly and efficiently may become even harder than it usually is.
Depression and anxiety symptoms can make the sufferer feel isolated even if they are closely surrounded by loved ones. Social distancing – so essential to manage virus transmission – will exacerbate symptoms of mental ill health in this group.
Then there are the people who have never lived with mental ill health.
They may never have experienced racing thoughts, heart palpitations, chest pain, irritability, distractibility, gastrointestinal signs such as nausea, vomiting and diarrhoea due to anxiety, a low mood, insomnia, incessant worry, or any other mental and physical symptoms that can arise due to stress and/or mental ill health.
These people may not know why they are experiencing symptoms or have the psychological skills to put them in perspective. So, they will suffer more than they need to.
But there is good news in the quagmire of black headlines we are sucked into daily.
We can use our own mental health histories to help ourselves and others in this crisis.
If you live with mental illness and are currently symptomatic, your sole focus must be to do what you can to get well. I know from my experience I am of no help to anyone if I am symptomatic. It’s a cliché but one that applies here:
‘Put your own oxygen mask on before you help anyone else with theirs’.
Firstly, contact the medical professionals you would usually consult when you are symptomatic – whether that’s your psychiatrist, psychologist, GP, community health workers, or psychiatric hospital.
Limit your exposure to the news to once a day – if that. If you have family or friends who can reliably update you on the essential news only, do that. Immersing yourself in the details, is of no practical value, and it can make you feel worse.
Use the same tools you would usually use to distract yourself when you are living through an episode of illness. Eat regularly and well. Don’t consume alcohol or recreational drugs. And move your body in some way, even if it’s small, every single day.
If you live with mental illness and are currently asymptomatic be vigilant but not obsessed. Just because this time is stressful, doesn’t mean developing an episode of illness is inevitable.
Your oxygen mask will consist of continuing to take medication (if you take it), keeping your regular appointments with your psychologist, psychiatrist or GP where possible, eating regularly and well, exercising most days, avoiding or minimising alcohol consumption, and practising whatever psychological skills (for example Cognitive Behavioural Therapy) that you have learnt over the course of your illness.
Be aware of any news developments that have practical ramifications for you, but don’t marinate in the news. Once you have done all this and whatever else you need to stay well – consider this:
You can offer support to those who are struggling mentally, those who have never experienced symptoms of mental ill health. Reassurance that their symptoms are survivable with the right care, could mean a lot to someone who is new to these issues.
That said – only do this if you have the mental energy to spare – otherwise just look after yourself.
To those who sense they may have been living with anxiety or depression for a while and it is worsening: All the suggestions with regards to eating well and exercise apply. Don’t self-medicate with alcohol or other recreational drugs. It will make things worse. Getting the right help is also crucial.
I am acutely aware that accessing good mental health care is a challenge in this country even when we are not mid crisis, but some excellent online resources to start with are: Lifeline, Beyond Blue, and SANE (Links at the bottom of this post)
To all the people who have never lived with mental illness: Distraction, exercise, eating well, and maintaining social connections via technology are a good start. Don’t self medicate with alcohol or recreational drugs. If you are still experiencing symptoms related to anxiety or depression (as listed above) then the online resources at the bottom of this post may be useful, or make an appointment with your GP as a starting point.
And one more thing…
Once you have done what you need to help yourself – take stock of how this situation is making you feel. And then imagine feeling like this for much longer periods of time than this pandemic will last.
Imagine feeling like this but the pandemic didn’t exist and people around you made you feel as though your symptoms weren’t real.
Then translate your feelings into compassion. And when you feel like yourself again (and you will), extend some sympathy and support to those whose mental illness lasts a lifetime.
And to everyone: We can use our individual experiences of mental health and ill health to support each other through this strange new world and into a kinder future.
So look at who you are sharing your living space with at the moment and consider starting a conversation about where on the spectrum of mental health and illness you and your housemates or family sit. Then think about how you could help each other psychologically.
My own household is one of extremes (regarding the adults). I live with severe mental illness, currently asymptomatic. My husband has never experienced mental illness.
So, when he expressed frustration a couple of days ago about his attention span feeling like that of a gold fish, I said:
‘Yes, I know it sucks feeling like that. But it will be ok.’
And I gave him a hug – something which I believe (at the time of writing) is still acceptable and safe to do in a household in which no one is symptomatic or has returned a positive Covid test.
This post is based only on my own experience and anecdotal evidence.
For professional mental health advice please contact your psychiatrist, GP, or for more mental health and ill health information check out the following links, all three of which are currently set up to deal with questions about Covid related mental health issues:
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.
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.
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.
If you are a man or know any men – please read on.
I recently accepted a SANE Peer Ambassador Speaking engagement for a small all-male audience in a male dominated industry (ages 30-50). To be clear, when this opportunity first arose a couple of months ago I applauded the company for their focus on male mental health and then sat back, certain they would find their ideal candidate in a male Peer Ambassador with a background in the trades to take this on.
Fast forward to a couple of weeks ago: No one had applied. It was re-advertised. This time with a note that the presenter did not need to be male. They just wanted someone willing to take this project on.
I gave it a lot of thought. On the surface, the only thing I have in common with this audience is my age. But I am also fast developing an interest in men’s mental health. Over the last couple of years I have supported several men from different areas in my life during episodes of mental illness.
Another strong motivator to learn more about this area, is being the mother of a son. I appreciate his future mental health is not all under my control, but I want to do what I can to secure him the most mentally healthy future I can.
So, I signed up for this engagement because I believe having me speak to this group has got to be better than having no one speak. Having no one, sends the message that men don’t experience mental illness. So wrong. Or it sends the message that if they do, then we shouldn’t be talking about it. Also, so wrong.
I am pretty confident I can do it, with the base knowledge I’ve got now, but I believe it could be so much better if I had the voices of some men to include in this presentation.
So if you are a man or can direct a man to this post who has some lived experience of mental illness and is well enough to offer some insights (or even if you are a man who hasn’t lived with mental illness but has some thoughts), either message me (on facebook or instagram) or email me email@example.com
I’d love to have a casual chat or exchange some emails if preferred. Any information I am given will be used anonymously unless you specifically tell me you would like to be named and/or identified.
I have mentioned in other posts, I am a huge fan of stretching myself outside my comfort zone. I am definitely doing that with this engagement. I gently encourage you to stretch yourself too and get in touch with me. You could make a real difference to other men’s lives by donating your voice.
Everyone knows depression is bad. But does this mean mania is good because it supposedly sits at the opposite end of the bipolar spectrum?
Mania is often painted as the cartoonish counterpoint to depression. Perpetually bright, happy, and fun. But it is not fun. It is the character in a horror movie who starts out friendly but then morphs into someone with sinister, glowing eyes.
Have you ever had a moment when your answer to a question determined whether your life imploded?
It came five days into parenthood. I was lying on the floor in my maternity hospital room crying because I was trying to outrun a jaguar chasing me towards a cliff. Things were starting to go very wrong in my brain.
In the following months, when my mind warped and writhed in the grip of psychosis and later catatonic depression, and when what started out as postnatal psychosis turned out to be a first episode of bipolar 1 disorder, I could not imagine things being worse.
When I ask my psychiatrist that question, he always answers honestly:
‘I don’t know how long, but you will get you better.’
That ‘I don’t know’ even when it’s followed by a promise of eventual wellness, is brutal.
Many years ago, my husband and I took part in a cycling trip over the Pyrenees from the south of France into Spain. The route followed the same path as the Tour de France sometimes does. The first day took us up the Col du Tourmalet, one of the longest and steepest climbs. We rode around twenty kilometres to the base of the mountain and then climbed for close to another twenty, each one steeper than the last, the air getting thinner and thinner.
The last two kilometres were gruelling. Mist closed in. We could barely see the drop off the edge of the mountain. We rode on our lowest gears. Our bones turned into burning jelly and our lungs felt as though they were trying to extract oxygen from water. We were forced to stop to catch our breath every twenty or thirty metres.
But there were markers to show us we were getting closer to the top. Mental footholds in the misty, painful, breathless soup. We had answers to ‘How much longer?’. And with them came hope and the tenacity to keep going. Although it was unbelievably challenging, we had an end point to work towards.
‘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.