The place from where my words usually come is wrapped in wet cotton wool. I am in hospital.
For years now my prodromal signs of loss of concentration and short term memory – which can be precursors to either a manic/psychotic episode or a depressive episode – have always landed on the manic/psychotic side.
This time the signs were the same. My psychiatrist and I gambled, counted on the past history of manic psychotic, adjusted medication accordingly.
Only it went the other way. I flattened, unhelpful phrases trudged like a battalion of soldiers through my soggy brain: …better off without you…. Everyone.
There is no need for alarmed raising of eyebrows. This is not my first go on this merry-go-round.
Those derogatory words and phrases are completely alien to me. I can see them for what they are. Just a clinical sign. Nothing more, nothing less. They don’t prompt me to hatch self destructive plans. They prompt me towards my psychiatrist, and towards hospital, because the world feels like sandpaper on my soft brain. The hospital won’t fix it quick, but it will bandage the raw areas while they heal.
At this level I find depressive symptoms are easier to manage, easier to live with than manic symptoms…unless of course I plummet to the complete paralysis of catatonic depression…and then it’s just as horrid, possibly worse.
I may expand on this comparison of symptoms in the future. For now there is no concentration, and motivation feels like riding a slug to catch up with a leopard made of quicksilver. There is literally no point.
I do own a new hospital mug. The design is fresh, green, paisley, floral… It is sprightly. It’s the small things that make it less bad.
For the last 14 years this emotion and I have had a complicated relationship. Before that, I experienced its giddy joy like anyone else.
It greeted me on the first days of longed-for holidays.
I experienced it on planes during take-off. In that moment of palpable lift, when the wheels left the ground and I shed gravity for a while.
It swooped through my body when I’d meet my childhood best friend, Sandra, at airports and train stations in different countries after years of separation.
Many moments of elation were tied to achievement. School grades, University degrees, getting jobs, have all elicited it. A psychologist would grimace at that, but there you have it.
But when I was nearly 33 something happened that warped elation for me.
I gave birth to my first baby.
The birth of a baby is usually viewed as the ultimate source of elation. Much is made of the overjoy of brand-new mothers.
But I was brewing something sinister when I went into my 33 hour labour on 2 hours sleep. That sleep deprivation, and the massive shift in hormones after the birth became the key that fitted the genetic lock for my dormant Bipolar 1 Disorder. It introduced itself violently, as an episode of postnatal psychosis when my baby was seven days old.
Three and a half years later I did get a day of pure elation after the carefully managed birth of my second baby. But I took none of it for granted, as though I had an inkling the psychosis would be back at the six week mark.
Psychosis in Bipolar Disorder is often preceded by mania. For some people mania is preceded by hypomania, which is like an artificial sweetener to the sugar of real elation. Same same, but different.
I do experience hypomania, but it is transient. Blink and you’ll miss it before it progresses to the high speed car chase of mania. I don’t spend weeks feeling fantastic about everything. But I’ve lived through enough hypomania to make me wary of true elation.
I force my elation through an airport security like checkpoint before I allow myself to feel it, because I know it could be the hypomanic second that precedes a manic episode.
So when elation wings its way into my heart, I put it through my metal detector of questions: How are you sleeping? Any racing thoughts? How’s your memory and concentration? Any sense of urgency, a pressure in the part of your brain right behind your eyes?
But right now I am truly elated.
Even my psychiatrist agreed I am entitled to it, after I handed him my third baby a couple of days ago.
My third baby is of the paper variety. Its newborn smell is that of fresh new books. Its gestation period has been longer than a human’s, longer than an elephant’s. 14 years from first words to published.
This baby’s name is ‘Abductions From My Beautiful Life’, nicknamed ‘Abductions’, and it is my memoir.
You will find my DNA all through it. My many selves. The child, teenager, university student, veterinarian, mother, psychiatric inpatient and outpatient, writer, mental health advocate, partner, and friend.
I wrote this book because there are not enough first-person accounts of severe mental illness, especially those featuring psychosis. I wanted to dissolve some of the misconceptions about people who live with severe mental illness, and the stigma that accompanies them.
The road to get this book published has been long, rough, expensive, paved with barely-existent patience, blood, sweat, many tears, diplomacy, and a lot of rejection.
It seems– books that deal frankly with mental illness (other than depression and anxiety) are too prickly for many publishers to touch – or to quote the feedback my agent and I got time and time again:
‘It is beautifully written, and an important story, but it is not commercial enough’ ie it will not make us any money, so we won’t go near it.
After several years of rejections, I did finally find a way to have it published, via a contributory contract with a publishing house in London that I supplemented with my own freelance cover designer and freelance copyeditor, to ensure it was published to a professional standard.
To the countless Australian publishers who passed on this book because ‘although beautifully written, it was not commercial enough’ – I say:
This book was never intended to be the next Harry Potter, or 50 Shades of Grey. But having finally published it I am elated because I have given the people who might be interested, the opportunity to read this allegedly ‘well written important story’.
An opportunity they may never have had if I had given up on it. So if you are one of those interested readers, you now get to decide whether or not you like it, rather than having an anonymous wall of publishers tell you what you should or shouldn’t be reading.
All reviews, feedback, and comments are welcome. For now you can leave them in the Comments section of this post, or email me at firstname.lastname@example.org
And if you do enjoy Abductions or find it meaningful and you can think of someone else it might resonate with, recommend it to them or maybe even gift them a copy.
Publication, purchasing, and launching information:
Abductions From My Beautiful Life will be published on Friday 30.4.2021
You can preorder it now and continue to order it once it is published from:
To begin with I am planning several smaller private launches over the next few weeks and months rather than one big one. They will probably take place at my house to work as flexibly as possible with ever changing Covid restrictions. But the format will be similar to a traditional launch with drinks, discussion of the book, maybe a reading, and books for sale and for signing, or if you’ve pre-bought your book you can bring it along to be signed.
If you live in or are passing through Brisbane and would be interested in coming along to one of these smaller launches, please email (anitalink73@gmailcom) or Instagram DM me @anitalinkthoughtfood so that I am aware of your interest when I send out invitations.
I will post further information about launches as they evolve.
For more on how ‘Abductions’ came into being you might like to check out:
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
I recently encountered Covid restrictions and a lockdown as an inpatient in a psychiatric hospital. And while the specifics are relevant, my experience was more complex than donning a mask and staying inside. But let’s start with the specifics.
There is the loss of the hospital dining room and its well-stocked salad bar. This normally bright spacious room filled with chatter and choice has closed, gone into mourning. The ability to choose your own food and sit where you liked – a small token of independence – replaced by a tray delivered to your room at 7am, 12 pm, and 5pm with a sharp rap at the door. You get little choice and a small window to eat before the kitchen staff are back to collect your tray.
There is not being able to leave the hospital grounds until discharge. No opportunity to test where you are at with a short visit home. Another small freedom lost, and you become totally reliant on visitors to bring you anything you might need from the outside world. Until restrictions turn to lockdown and the visitors are banned from visiting.
All staff start wearing masks, and the buzz of their anxiety fills the hallways like a swarm of bees. Within a few days patients are told to wear masks anytime they are outside their rooms.
For anyone who has lived on this planet for the last year, none of these restrictions or lockdown conditions will sound unusual. Everyone has lived some version of them.
But my experience of them as a psychiatric hospital inpatient was different to my experience of them when I’ve been well and at home.
Even with access to an excellent private psychiatric hospital, being an inpatient strips me of autonomy and leaves me feeling as vulnerable as a slug on a busy highway.
The admission process alone – which includes providing a urine sample for drug testing and the thorough inspection of your bags (for any means of self-harm or suicide) by two gloved nurses – is a humiliating experience.
It screams: ‘You cannot be trusted’ and whispers sharply: ‘We are in charge of you now.’
It’s made worse if the nurses attempt light conversation about the contents of my bag.
‘‘That looks like a good book…’
I don’t have the energy for it, and it makes me feel like a toddler they are trying to distract from something unpleasant.
As a patient in a psychiatric hospital I frequently lose the right to my feelings. For example:
One of my admitting symptoms (usually prodromal to mania) can be intense pathological irritability. It is completely different to feeling irritable in a normal context. And it is not the same as the irritability I feel when I am forced to interact with one of the nurses whose attitude grates on me even when I’m well.
I try to be polite, but when my tone slides into curt, she cocks her head and says:
‘Your irritability levels are quite high today.’ before self-importantly noting this down as a symptom for the day. And I am powerless, because if I protest that would just be further proof of my mental illness to her.
And then there are the cringeworthy names I am called, mostly by nurses and kitchen staff:
‘Dear, Darling, Love.’
I am ‘Darling’ to only my mother. ‘Love’ never fails to sound derogatory to me. As for ‘Dear’ – one of my worst and earliest hospital experiences involved being called ‘Dear’:
Fourteen and a half years ago when I was less than a week into my first episode of mental illness, I experienced a severe psychotic episode. I was led into the Special Care Unit (the highest security locked ward) of the psychiatric hospital by two nurses, one gripping each elbow. On the way there, one of these nurses said:
‘Don’t worry Dear. You won’t remember any of this in the morning.’
The next morning I was so sedated by the (necessary) medication I‘d been given, I may not have looked as though I had any memory of the horrors of psychosis. But I remembered all of it. The proof is in the account of that night in my memoir being published this year.
If I knew where to find the nurse who called me ‘Dear’ (on that occasion), I would give her a copy to show her just how much a patient experiencing florid psychosis can remember.
There are many other factors that contribute to my sense of infantilisation in hospital. But elaborating on them would take me well over my word limit. So I’ll leave it here, for now.
Thankfully this recent admission was short (two and a half weeks) but the combination of the inherent lack of autonomy in being a psychiatric inpatient and the above mentioned Covid factors hugely amplified my vulnerability.
And I am aching to get there, straining towards the moment I close the door to my hospital room on a world I am the wrong shape for right now.
How did I get here this time?
Fourteen days ago I had a regular appointment with my psychiatrist. Just a Bipolar 1 Disorder monthly maintenance appointment. I was completely asymptomatic.
Thirteen days ago I left for our beach holiday and forgot to pack my swim wear. Subtle. I mean that could happen to anyone. Right? But by the following morning I was symptomatic alright. My short term memory and concentration were dissolving like sugar cubes in boiling water.
A buzzing pressure behind my eyes radiated up my forehead. I knew from bitter experience, if I did nothing, soon that buzzing could make me second guess what was real or not.
That was symptomatic enough to page my psychiatrist on a Saturday morning. It’s only the second time I’ve paged him out of hours in 14 years. He called back in under three minutes.
Over the last nearly two weeks, the first of which I stayed at the beach, he telephone consulted with me every second day, adjusting medications, a little more of this, a little more often of that. I slipped from my bed gratefully into the ocean, timing the most sedating medications for times when I’d be in bed not the ocean. I seemed a little better, maybe? But then not.
Back home we continued every second day phone consults, adjustments. This is by far not the sickest I have ever been (although psychosis and catatonic depression requiring ECT to reverse, do set a very low bar)
So why would I want to go into hospital, rather than continue treatment at home?
The surface of my brain feels as though it is covered in papercuts and being surrounded by people and noise is like having lemon juice dribbled over the cuts.
Trying to hold in the irritability of being around people and noise (including my close family) is like being intensely nauseous with someone threatening to punish you if you vomit.
One of the parameters I use to assess how close I am to needing to go into hospital is ‘the sandwich test’. Think about the amount of concentration and short term memory it takes to make a sandwich – nothing fancy, just two slices of bread, some butter and one topping. For most healthy, able bodied, able brained adults, this is not a challenging task.
Right now – I can still make a sandwich, but it’s a challenge. I am making a decision, based on past experiences, not to wait with hospitalisation until challenge becomes an impossibility.
As for the seasonal timing – Christmas and New Years celebrations? I am veteran enough in the management of this illness to know it has no knowledge of nor respect for holidays and anniversaries. I could list my tenth and fifteenth wedding anniversaries as times spent in hospital, a longed for trip to Paris cancelled because of recent hospitalisation, and that would be the beginning of a list so long I’ve forgotten most of it. These times are just human constructs. If it swallows them I don’t dwell on them.
Instead I celebrate the unscathed special occasions extra hard, to make up for the times there is nothing.
The final reason for going into hospital now, is because I can access this level of care. I am fortunate to have the option of going into a private psychiatric hospital when I am sick. The standard of hospital care I will receive will be excellent. It will far exceed anything the public psychiatric hospital system has to offer.
I loathe getting sick enough to need hospital support. But perhaps even more than this I loathe the hypocrisy of someone with my privilege not utilising that support because of some misguided stigmatising ideas about what it means to be a patient in a psychiatric hospital.
I am profoundly grateful I can afford care in a good private psychiatric hospital. And part of my own recovery, once I’ve stabilised medically, is to remember there are many people living with this illness, and other severe mental illnesses, who are learning to live with them with far less support and privilege than I have. When my recovery feels hard I focus on this:
If I access the supports I am fortunate to have, I am more likely to be around for long enough to help raise awareness of the inequality between our private and public mental health hospital systems, and work towards our public mental health hospital system actually supporting some of our most vulnerable when they need it most.
If you are new to Thought Food and would like to know a little bit about who I am when I am well, you may like to check out:
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.?’
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.
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 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.
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.
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:
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?
Last week was breastfeeding awareness week, and the irritation I feel when I see strong pro-breastfeeding messaging flared. I usually bite my tongue and suppress my politically incorrect opinions about this emotive subject. I don’t care about how anyone chooses to feed their baby. But I do care that the ‘breast is best’ myth is still being drip fed to (especially first time) mothers like a sugary subtle poison.
Fourteen years ago I had my first baby. I lapped up all the breastfeeding propaganda from the hospital antenatal classes and my antenatal yoga classes. Because I trusted these sources.
And they didn’t exactly feed me falsehoods. But they did imply a mother who switched to formula before she had exhausted every possible option to keep breast feeding was not doing the best for her baby. Posters in the maternity hospital told me that exhaustion, blood streaming from cracked nipples and tears streaming down your face were all worthwhile prices to pay to feed your baby this liquid gold.
After going into thirty three hours of labour on two hours sleep, my daughter was delivered by caesarean. I fell asleep as I was being stitched up. The midwives wasted no time. I woke with a start, in recovery to find my baby attached to my left breast. It was so important to these midwives that my baby attached ‘immediatley’ that they didn’t even do me the courtesy of allowing me to wake up before making this most intimate of introductions.
The focus on the holy grail of establishing breastfeeding in the maternity hospital was so strong that I sat up for three hours at a time thinking I was feeding my baby, when she was comfort sucking for most of that time. It left me exhausted and my back a wall of pain from sitting in the ‘feeding chair’.
Now, if that were the worst of it, I would have probably gullibly pushed through all further discomfort to establish and continue breastfeeding. Had I succeeded, I would have probably felt proud of myself. And after being told time and time again children who are breastfeed are healthier, smarter, more empathetic, and more likely to poop rainbows, I may even have been arrogant enough to attribute all of my daughter’s future, health, smarts, and empathy to my valiant efforts to persist with breastfeeding. (She has yet to poop out a rainbow – but I can live with that.)
But within a week of her birth, whether or not I breastfed was injected with some desperately needed perspective. She was at home with her father, contentedly guzzling formula while I was tipping my breastmilk, tainted with antipsychotics, down the sink in the Special Care Unit of a private psychiatric hospital. I had come down with postnatal psychosis and I was clinging to my life with my fingernails.
To my credit, I quickly forgave myself for ceasing my ‘breastfeeding journey’ 7 days into motherhood. And I didn’t look back. I had been too sick to ever be riddled with the guilt I saw in other mothers who had been less unwell but had also made the smart choice (for them) to stop.
But we shouldn’t need extreme circumstances to justify feeding our baby formula to anyone. Breastfeeding is a personal choice. Nothing more. Nothing less. But our society has turned it into a religion. And it’s opt out not opt in. We are all automatically given anti formula education classes antenatally and then baptised in breastfeeding once the baby is born.
The high priests of this religion are lactation consultants and midwives who set ironclad commandments and rule with fear. The fear of harming our babies with our actions.
The pressure to breastfeed is a known contributor to and risk factor for developing perinatal mental illness. Mental illness that can leave a baby motherless if it is severe. Unlike the maternity hospital midwives, the nurses in the mother baby unit in the private psychiatric hospital I was an inpatient in don’t pressure new mothers about how to feed their babies.
But they do spend a lot of time undoing the damage done by overzealous midwives and lactation consultants who have bullied new mothers into believing they will hurt their baby if they consider formula anytime earlier than as a last resort.
For my second baby I had one breastfeeding aim: Get some colostrum into him. He went onto formula at day 7, just like my daughter. And just like my daughter, now you wouldn’t be able to pick what he was fed as a baby.
Breastfeeding is cheaper than formula feeding. It is more environmentally friendly. It is the safest and most convenient way of feeding a baby in a third world country and/or if you don’t have regular access to clean water or formula. If your baby is premature and/or has underlying health conditions for which a paediatrician has recommended breastfeeding or expressed breast milk, then – for that baby – breast is best.
But if your baby is full term, healthy, you have access to clean water and can afford to buy formula, then (beyond the first few days’ worth of colostrum) whether you choose to formula feed or breastfeed is as irrelevant to your baby’s wellbeing as the colour of your underwear while you’re doing it.