Tag: Psychiatry

Accepting The Unacceptable

It has taken well over a decade.

In the beginning ours was an abusive relationship. Bipolar 1 Disorder entered my world by clubbing me over the head and dragging me away from myself and my life. There was no informed consent. No polite knocking at my door and asking ‘Are you ok with this invasion? Are you ok with me setting up camp in your head for the rest of your life?’

That first time, it committed horrendous crimes. It stole my most prized possession. All my control. It obliterated my reality, snatched me away from my husband and baby, sped me up and then poured concrete over me. I was convinced it would kill me…

But it didn’t.

When I finally kicked and screamed my way free, I sat panting on the other side of it, scraping all remnants of it out of my brain and off my skin, I vowed never to let anything do that to me again. This was the first and last time. I knew better now.

I knew nothing.

When my doctor told me it was unlikely that this would be my last encounter with it, I nodded but didn’t believe him.

It came, not immediately but in roughly two-year intervals again and again and again. When the early signs of those first recurrences nudged and poked and then slapped me in the face, I turned my back and raged ‘No, no , no this can’t be happening again!’

My denial fed the power it had over me to super levels.

I tried to fight it with sheer will and my bare hands grabbing at the invisibility of it. It laughed and continued to snatch my sanity, drop kicking me into hospital sometimes for months at a time.

In the face of this illness my denial was a house built of dandelion seeds.

Eventually a sliver of acceptance crept in. But only while I was sick. The moment I regained myself after each episode, I ran back into the arms of my previous life. Working and doing and being who I was before all of this. Driven by a need to prove to the world: ‘See I live with this illness and can still do it all!’

I can…but there is a cost.

In 2015 it broke me. It locked me in a torture chamber and made it clear that it was going nowhere. I sped into a brick wall, lost my reality, lost my living brain, had to have it shocked back into a feeble beginning again and again.

I limped away finally understanding that we were shackled together for the rest of my life.

I told my psychiatrist: ‘I don’t know what to do, I can’t keep doing this!’

He paused, then said:

‘Perhaps you have to learn to take this illness as seriously when you are well as when you are unwell.’

He was right.

By then I had learnt to pay lip service to my management of this illness when I was well by diligently taking my medication, living relatively healthily, taking care of sleep etc, But I had not mentally accepted that I live with Bipolar 1 Disorder every day, whether I am well or not.  I had made the easy, obvious choices, the choices that have become second nature, like exercising and taking my medications.

But it has taken much longer and been harder to make the longer-term decisions that are just as much a part of looking after myself.  Decisions like how to work and what is worth pursuing and weighing up the price I might pay for stress. Things I had the luxury of never considering before.

Fighting acceptance hasn’t served me well. Denial can damage me easily as much as the illness itself.

I have learnt acceptance is not giving up. Acceptance also doesn’t mean that the next time I get sick I will feel nothing but saintly calm. The unfairness of being yanked away from my life with no notice will still sting and ache.

I no longer leave this disorder behind in the rear vision mirror after each episode. It stays in my peripheral vision. But, the less I fight it, the milder the rope burn from being tethered to it.

It doesn’t define who I am, but I no longer expend energy proving it is not part of me. Because it always will be.

You may also like to check out the following posts:

On Uncertainty

The Well Times

Making Sense Of It

Don’t Bright Side Me

I don’t have 800 articulate words tied up in a neat bright-side bow in me today. So this instagram post it is. For context I am now into into my third week in hospital. Some of the manic symptoms are settling. The caption accompanying this instagram post is:

The symptoms are horrible, but it is never just about the symptoms. The symptoms and connotations severe mental illness carry with it. leave me staring at the rubble of my identity during and in the aftermath of every episode. It is never just about the symptoms…

#bipolar1disorder #vulnerability #psychiatrichospital #mentalillness #stigma #identityloss #thoughtfood #abductionsfrommybeautifullife

Other reading:

Visiting Someone In A Psychiatric Hospital?

From Holiday To Hospital In Under A Month

A Sinister Manicure

The inky shine of my DIY manicure is pathognomonic of a manic episode.

As is my daily step count doubling – not intentionally, not because of some romanticised elation of mania, but because my short term memory is so poor I have been constantly retracing my steps, wandering from room to room driven by a purpose that evaporates as soon as I arrive where I think I’m meant to be. Constantly. Not just the odd moment of forgetfulness everyone encounters.

My inner life speeds up. Thoughts, speech.  When I glance at my watch it is always half an hour earlier than I anticipate it will be.

I scrunch up, frustrated at the snail’s pace of the rest of the world. 

In the early years of this illness I didn’t register that scrunching, and would inflict bruises and scratches  on myself in these frustrated moments. A day or two later, I’d stare at the violent discolouration and scabs on my skin, and be completely unable to recall how they got there.

The pressure of mania feels like my own adaptation of the fairy tale ‘the red shoes’ by Hans Christian Andersen. Instead of being cursed to dance until I die or my feet are cut off, I feel cursed to keep moving and doing. The further it drags me into its clutches the harder it becomes to stop and rest. Ironically exhaustion fuels mania. At its worst I am lucky to get an hour or two with a generous handful of sedating antipsychotics, sleeping tablets, anxiolytics, and sedating antidepressants on board.

Restoring sleep helps chase mania away. To be clear (for me) insomnia borne of mania is not something that can be alleviated with chamomile tea, lavender oil, or good sleep hygiene. I need the handfuls of medication. I need an environment conducive not just to rest, but an environment so controlled it feels like a bandage around my brain when the rest of the world acts like sandpaper on it.

You may say: ‘Just stop doing stuff and rest at home.’

That would be like me saying to you the next time you come down with gastro: ‘Just stop vomiting.’

As for my handfuls of heavy duty psychiatric medications – I learnt a long time ago I experience minimal side effects from most of them. I learnt that, in the midst of a manic vortex, those medications don’t cure me, but they make the sand-papered-brain feeling bearable. I learnt that the old wives tale of psychiatric medications stealing your creativity is bullshit for me.

My creativity is devoured by my symptoms of Bipolar 1 Disorder. I expect this post won’t be as concise as I’d like. Maybe a bit clunky. There may be typos that escape me because I don’t have the capacity to run it through my usual editing loops. But one thing is certain: If I were currently unmedicated, this piece of writing either wouldn’t exist, or it would be almost incomprehensible.

And that is why I am in hospital, swallowing medication by the handful and painting my nails midnight blue.

You may also be interested in reading these posts:

Misunderstood Mania

Psychiatric Medication And Stigma

Guilty Of Postnatal Psychosis

(Content Note: suicide and infanticide are mentioned in this post)

Who am I?

I am a veterinarian.

I had my first baby at 32.

I developed postnatal psychosis after the birth of that baby.

I had no history of mental illness before that.

I have a perfectionist personality.

This is me.

But given this information, you could mistake me for Melissa Arbuckle.

If you’ve read even just the headlines this week, you will know Melissa’s baby Lily died in horrific circumstances, as a direct result of Melissa’s undiagnosed postnatal psychosis and depression.

Melissa’s story is an important one. But I have yet to read a story by a journalist who gets the narrative of postnatal psychosis (or any form of psychosis) right. Journalism around psychosis, even decent journalism, focusses on the sensational.

But despite the inevitable sensationalism, in this case the journalists got one thing right. They investigated the lead up to this horror story. And that shows us the number of times this horrific outcome could have been prevented.

Melissa’s baby was born in April 2021.

The Age reports ‘Maternal health notes showed that as early as May 19 the new mother revealed she was having difficulty coping and became teary, later telling a lactation consultant she felt ‘out of control’.

According to News.com ‘Victoria’s Supreme Court heard that in the weeks leading up to Lily’s death, Ms Arbuckle had been ‘really down’ and she believed she injured her baby after rocking her bassinet too vigorously.’

She hadn’t injured her baby at that point, but her thoughts (believing she had injured her baby) were delusional, for weeks before her daughter’s death.

The Age also reports ‘The night before the incident, Arbuckle told her husband she was having suicidal thoughts, but assured him she could never go through with it.’

Lily died and Melissa nearly died after being struck by a train on the following day, July 11 2021.

Melissa was diagnosed with postpartum depression and psychosis the day after her daughter died.

When I think of all the points on this timeline that Melissa’s and Lily’s odds could have been dramatically improved, anger steals my breath.

Regarding the Maternal health notes made in May 2021:

‘Maternal health notes’ imply a nurse or midwife assessed Melissa at some point and, aside from making some notes about her difficulty coping and being teary, did nothing.

Midwives and nurses need to be taught: The baby blues and mild anxiety are not always the cause of a teary mother who is having difficulty coping. They need to know when and how to refer a new mother for assessment with a psychologist, psychiatrist, a mother baby unit, or at least a GP. And they need to err on the side of caution!

I am not surprised a lactation consultant didn’t know what to do with a mother feeling out of control. Lactation consultants tend to be laser focussed on getting breast milk into babies at all costs. But again – educating lactation consultants to look far enough beyond ‘latching issues’ and ‘milk supply’ to consider referral to qualified mental health care professionals when red flags are raised, would be a good idea.

In the weeks before Lily’s death, when Melissa is described as ‘really down’ – these were the weeks that preceded the night before Lily’s death.

The night when Melissa told her husband she was having suicidal thoughts.

From my standpoint and lived experience, I struggle to give Melissa’s husband much benefit of the doubt here. I understand (based on the article in The Age) that her husband lost his own father to suicide as a teenager. So, there is possibly a barrier of unresolved grief and trauma that prevented him from reacting appropriately to his wife’s symptoms.

But presumably he noticed Melissa being ‘really down’ for those weeks. Did he attempt to get help for her? And if not then, what was stopping him when she expressed suicidal thoughts to him on that night? The fact that she claimed she wouldn’t act on those thoughts? Did he not consider the amount of mental pain one needs to be in just to have suicidal thoughts?

For everyone reading this: If anyone ever expresses suicidal thoughts to you, PLEASE ACT! Even if there is no option but an ambulance to the nearest hospital. And if the person experiencing suicidal thoughts tells you they won’t act on them, not only are they too unwell to make that assessment, they are also suffering intensely and need help!

Yes, our public mental health system needs a lot of improvement, and there are nowhere near enough public mother baby units available. But even if the ideal of a private psychiatric hospital with a mother baby unit, was not available or an option for Melissa and Lily, a public hospital might have given them a fighting chance.

Back for a moment to the journalists reporting on psychosis. They tend to give all the characters surrounding the person living the horror of psychosis a voice, even if some of those voices are irrelevant and add to the stigma psychosis is already steeped in.

In Melissa’s case that person is her baby’s great aunt. In The Age article, this great aunt doesn’t want to be named, but she does suck up more than her share of oxygen. She has publicly expressed that she thinks Melissa’s actions were ‘catastrophic’ and ‘cruel’.  Catastrophic – absolutely. But ‘cruel’ implies the malicious intent of someone whose mental health is totally uncompromised. She used the words ‘Melissa’s actions’ but what she communicates is ‘Melissa is a cruel woman, and that is why she killed her baby.’

To that great aunt, I would say this:

If people like you didn’t perpetuate the stigma surrounding illnesses which feature psychosis by giving uninformed stigmatising quotes to journalists, then Lily’s father may have had some clue about what to do when presented with the symptoms of severe mental illness that were obvious in his poor wife for months before they led to such unbearable pain for everyone. If you want to blame something, blame this horrible illness, in the same way you might blame cancer for taking loved ones too soon.

News.com reports ‘The case has revealed just how quickly the 32-year-old’s life spiralled out of control after she developed severe major post-partum depression and psychosis following the birth of her daughter in April 2021.’

Melissa’s life didn’t spiral out of control quickly. She developed a life-threatening illness, the symptoms of which were either ignored or not acted on for months, until it was too late. Reporting it was quick, implies it was too quick to do anything about.

My postnatal psychosis set in by day 6 of first-time motherhood. By days 7 and 8 I was completely detached from reality, denying knowledge of my baby and my husband.

And when I was accurately diagnosed with postnatal psychosis in the safety of a mother baby unit in a private psychiatric hospital, my husband asked what he should have done if this had happened at home. This is what he was told:

‘Call an ambulance. Postnatal psychosis is a psychiatric emergency, but it is treatable.’

My greatest sympathy and compassion go out to Melissa. She was failed at so many points.

My memoir Abductions From My Beautiful Life was published last year and (among many other events) includes details of my experiences with Postnatal Psychosis. You can find an excerpt here: Book and it is available to buy online, including at Booktopia, Fishpond, and Amazon. If you are Brisbane based, you can also buy it at Avid Reader and Riverbend bookshops and Ruby Red Jewellery at 107 Romea St. The Gap.

If buying a new book is not in your budget, Abductions is also available to borrow from the Brisbane City Council Library Catalogue.

Other Thought Food posts that may interest you are:

My Sliding Doors Encounter With Our Public Mental Health System

Welcome To Motherhood

Lifeline 13 11 14

Bipolar Day 2022 – Great Inequality

Well

I remember my response the first time my psychiatrist suggested I could have an underlying bipolar disorder. That it had been the fountain of chaos that erupted in the form of postnatal psychosis the first time it came to call.

Denial. I believed he was telling me as a duty of care, because that was the case for some people. But not me.

I remember my response and where I was when he confirmed my diagnosis of bipolar 1 disorder several years later.

He was standing at the door to my hospital room that looked like a stack of post it notes had thrown up all over the walls. They were covered in technicolour squares that I had scribbled random ideas on and reminders of where I had put my fountain pen or my toothbrush.

Unwell

I had no short-term memory. My thoughts raced delusionally down corridors in my brain that had been emptied of the rational. At night, I wrote and wrote thousands of mostly nonsensical words. Sleep wouldn’t come, even with high doses of medications. I didn’t want sleep to come anyway. It ate into my thinking and writing time.

But back to that moment when I looked up at my psychiatrist in my neon rainbow dump of a room and asked: ‘Postnatal psychosis or bipolar?’

He didn’t torture me with hesitation. Just delivered the sentence: ‘Definitely bipolar!’

Those words spread through my insides like a cold, nasty liquid. For nearly four years I had teetered on the edge of believing that my mood disorder would be confined to the perinatal period like so many other women. That there would be an end to it.

‘Definitely bipolar’ felt like a life sentence. Devastated doesn’t begin to describe my sick feeling. Then that sickeningness was replaced by questions I cringe at now:

‘How can I subject my children to a mother with this illness? How can I ever achieve anything again?

I was very achievement oriented back then, and self-stigma told me vicious lies.

It will be 16 years in August since bipolar disorder flew fiery through my life the first time. I am glad I didn’t know what was ahead of me then because fear would have told me I wasn’t strong enough to get to the other side of hell so often.

If I could go back now, I would tell myself that although my life would be different, it would still be my life. I would tell myself that my entire relationship with fear would change because of this illness. For the better.

That I repeatedly reach points of wellness where I stretch out my hands and grab fear by the shoulders. I stare deep into its eyes and compare it to what I feel during psychosis. And I find most everyday fears evaporate in the memories of what I’ve survived.

I wish I had known that my children would benefit from having a mother with insight, not only into her illness, but life. A life I’d describe as good.

I am not naïve enough to believe I’ve had these empowering experiences through force of will, intelligence, doing the work, taking the medication, fairy dust…

I will say this repeatedly in different mediums and articles, because it is important to acknowledge, again and again and again: I live with immense privilege. I am a straight, white, cis-gendered tertiary educated woman with no concurrent disabilities, who can afford private health insurance.

It is helpful that I have worked to gain insight into my symptom pattern. Exercising and taking medication that works for me, is also crucial. I am not shackled by addictions to substances that could derail my stability. But every one of those things would be much harder to enact and maintain, without my privilege.

My privilege does not mean I haven’t suffered. It doesn’t invalidate my experience, but it must be acknowledged for context every time I tell my story, otherwise that story is shallow, loses meaning, and does a great disservice to the many people who live with this illness, but without privilege to boost them to the head of the line when it comes to accessing the best care, and being the most supported they possibly can be, during the challenge that is living with this chronic, intermittent, potentially fatal illness.

You may also be interested in:

The Well Times

My 2018 World Mental Health Day

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

From Holiday To Hospital In Under A Month

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.

2020 Ends In Hospital

Insight: The Essential Ingredient

Visiting Someone In A Psychiatric Hospital?

Covid Lockdown In A Psychiatric Hospital

Welcome To The World ‘Abductions’

Elation

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 anitalink73@gmail.com

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:

Amazon Australia – click the link BELOW the image

https://www.amazon.com.au/Abductions-Beautiful-Life-Anita-Link/dp/152898319X/ref=sr_1_1?dchild=1&keywords=anita+link&qid=1619352950&sr=8-1

Fishpond Australia

https://www.fishpond.com.au/Books/Abductions-From-My-Beautiful-Life-Anita-Link/9781528983198

Booktopia Australia

Booktopia https://www.booktopia.com.au/abductions-from-my-beautiful-life-anita-link/book/9781528983198.html

If ordering from the UK:

Fishpond UK

https://www.fishpond.co.uk/Books/Abductions-From-My-Beautiful-Life-Anita-Link/9781528983198

Austin Macauley

https://www.austinmacauley.com/book/abductions-my-beautiful-life

Waterstones

https://www.waterstones.com/book/abductions-from-my-beautiful-life/anita-link/9781528983198

If ordering from the US

Amazon US – click the link BELOW the image

https://www.amazon.com/Abductions-Beautiful-Life-Anita-Link-ebook/dp/B091N7BSZP/ref=sr_1_1?dchild=1&keywords=abductions+from+my+beautiful+life&qid=1619353373&sr=8-1

Barnes and Noble

https://www.barnesandnoble.com/w/abductions-from-my-beautiful-life-anita-link/1139205441?ean=9781528983198

Launches:

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:

Accepted: Crumbs To Canary Wharf

And you can find a brief excerpt here: Book

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

Covid Lockdown In A Psychiatric Hospital

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.

Here’s why:

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 have never felt so powerless.

You may also like to check out:

2020 Ends In Hospital

Visiting Someone In A Psychiatric Hospital?

On Uncertainty

2020 Ends In Hospital

I am going into hospital later today.

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?

Here’s why:

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:

Who Am I ?

Radio And Podcast Interviews