Invisible Damage

9.30 pm at the medication station.

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

‘See if that looks right.’

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

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

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

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

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

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

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

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

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

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

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

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

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

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

That time starts at discharge.

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

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

You may also like to read:

When Covid-19 And Bipolar Recovery Collide With Unexpected Results

From Holiday To Hospital In Under A Month

Psychiatric Medication And Stigma

Rewards For Reports: Entitled or Deserved?

I had an interesting conversation with one of my children this morning.

They opened with this:

‘Why don’t you give me something to celebrate my report card?’

 They paused briefly before elaborating: ‘It’s just that my friends who also got good marks are all talking about the presents their parents gave them for it, and they ask me what I got and I have to tell them I just got a pat on the back and a “well done”.’

Where to begin? Maybe with a little context:

For their entire school careers (so far) I have placed no pressure on my children to achieve academically and almost no importance on the marks they get. Providing they are not falling so far behind that they need additional support, and they are doing their best – I am not invested in the outcome. The only two report parameters I care about are their effort and their behaviour.

So far neither of my children have needed additional learning support. This is something I am grateful for, don’t take for granted, and I definitely don’t take any credit for.

I do my best to make sure they get enough sleep and have a decent breakfast before school. I pay for their uniforms, books, excursions, and other school related expenses. I try to give them an emotionally healthy home to return to after each day at school. And while their academic achievements may be built on this foundation, they are very much their own.

The child who began this conversation with me this morning happens to consistently get very high marks across their report card. None of these marks, or the awards received because of them, have ever been incentivised by my husband or I.

Of course, we are proud of our children when they do well, and we tell them, but we are not about to start rewarding high marks with extravagant material possessions. Here are some of the questions I asked my child to help explain why:

‘Do you feel good about getting a fantastic report card, just for the sake of it?’

‘Do you think the most important thing about you is the marks you get?’

‘For the kids getting the fancy presents for getting good marks – do you think they might feel pressure from their parents to get those marks? ’

‘And what happens if one of those kids has a really ordinary year – for example they get sick, or they have a rough time with their friendships and feel sad, and their marks slip below excellent? How will it make those kids feel if they don’t get the good marks and the presents, because of things that are out of their control?’

‘When those kids grow up and do something really well at work and don’t get presents for it, – because that is not the way the grown up world works – will they feel let down?’

‘And say for example I did give you a fancy big present for getting great marks, would you go to school and tell everyone about it?

I got different answers for each question, but the answer to the last one was (thankfully) a resounding ‘No.’

Whether you choose to reward your kids materially for academic achievement is your decision.

I don’t, because it feels like a slippery slope. It adds pressure. I don’t believe getting top grades at school is a marker for future happiness or success in life. I place more importance on developing my children’s emotional intelligence and mental health than their academic achievements.

I want my children to know that their worth as a person has nothing to do with the marks they get at school.

Living vicariously through your children by either shoving them into the same life path as you followed or wanting them to do better than you did, or (even worse) validating your parenting through your children’s achievements, can all present as pushing them to achieve academically. The problem is these motivations revolve completely around the parents’ needs. They have nothing to do with the child.

But if you want to give your kid a Nintendo switch for their straight A report, please give it with a side of humility and sensitivity. Teach them that doing well at school – while yes it may be the result of their hard work – is not a given for all kids.

Some kids work harder than your kid ever will and will never get top marks. Other kids are not privileged enough to get the basics for good academic achievements (breakfast, a desk to study at). Still others live with a diagnosis whose symptoms make it impossible for them to win any awards.

And none of those kids need to hear yours bragging about their report rewards.

You may also like to check out:

Don’t Try This At Home: Schooling

Mental Health Parenting Truths 101

Talking About Mental Illness With Children

When Covid-19 And Bipolar Recovery Collide With Unexpected Results

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I have spent the last five weeks in a psychiatric hospital for management of a Bipolar 1 Disorder episode.

I am no longer sick. But still fragile. Like an egg without its shell. I always reach a point on the return to wellness where I can get no better in the controlled bubble world of the hospital. A point where staying longer is of no benefit and can even become detrimental.

I ventured back out into the world at the end of last week. A world that hasn’t grown any softer in my absence. It is the same hustling harsh, bruising, breaking place it always has been, but perhaps more so. No one was fighting over toilet paper five weeks ago.

That said, after any admission for a Bipolar episode, jumping back into my life can feel like steel wool on newborn skin in the early days.

No one can tell by looking at me when I leave the hospital that I need rehab and resilience building before I am ok again. For me, on average that takes the same amount of time I was hospitalised for. So, in this case – another five weeks.

People tend to be congratulatory about me being well enough to come home. I don’t want to be a downer. I am grateful to be home. But just because I’m out of hospital it doesn’t necessarily mean it’s over. It can look like it is slinking away not to be seen again for a couple of years. But appearances can be deceiving.

Once, this illness spent a whole year of my life bouncing me in and out of hospital so often, I got dizzy. By the end of that year, in which most months had held a hospital admission for me, it had nearly killed me. So, that’s why I don’t think about exhaling as soon as I am home.

Today is my fourth day at home. I am still acclimatising. But I also recognise something unexpectedly positive borne of the last five weeks.

Being in hospital with Bipolar symptoms has prepared me for the Covid-19 headlines very nicely.

I get a sense from these headlines and the empty toilet paper and pasta aisles in the supermarket that many people are panicking, or at least are very worried by the uncertainty they are being force fed right now.

I am still in the mindset it took to get through my last five weeks. I lived that time (and do every time I go into hospital) in two-day increments. Why? because it is pointless to look or plan any further ahead. Neither I nor my psychiatrist could fortune tell what would happen. Five weeks of observing, tweaking medication or not, and then waiting another two days before assessing again.

To be clear, there is a difference between not taking something seriously, and choosing to engage only in what is in front of you. I take my Bipolar Disorder seriously, especially when it flares. But does that mean it would be helpful to spend my entire admission panicking that this is the time I become a permanent inpatient (they exist)?

Or should I break it into chunks the size of a couple of days and hit repeat, until at some unknown time in the future I am out the other side?

I’ve spent early admissions, years ago, engaging in the first option but have learnt that the way through with the least energy wasted is the second one.

In the same way, I take the Covid-19 pandemic seriously. But you won’t find me panic buying or worrying about whether or when it will end. Breaking this issue down into two-day increments feels helpful to me right now. Every two days (or sooner if the headlines change dramatically) I reassess the basics: Do I and my immediate family have enough food, water, medication and accommodation for the next two days? I am fortunate. So, far the answer has been yes.

Is there any point in trying to predict what might happen next month or even next week, and worrying about it?

None!

Because no one knows where we will be then. You can only act on the information you have at the time.  And if right now your basic needs are met and you are well, don’t buy more and more and more food or toilet paper (unless you are doing it for the vulnerable members of our population).

Breaking the overwhelm of a difficult situation with no known endpoint into smaller portions lessens the strain on our mental health and preserves our energy for more productive tasks.

And if we do it often enough that’s what will get us to the other side of this situation too.

 

You may also be interested in:

What a mental illness can teach you about your mental health

Where’s Your Comfort Zone?

Interruption To Regular Programming

Update 27.2.2020

 

What a mental illness can teach you about your mental health

jony-ariadi-197568-unsplash Photo by Jony Ariadi on Unsplash
Photo by Jony Ariadi on Unsplash

Here’s a paradox: My mental health improved after I developed a mental illness. When I am not symptomatic (which is a lot of the time) my mental health is fantastic. It is possibly better than that of many people who don’t live with a mental illness. Here’s why:

Mental illness can teach you a lot about mental health, because it confronts you with the choice to change the way you approach your life.

Continue reading “What a mental illness can teach you about your mental health”

Accepted: Crumbs To Canary Wharf

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It started on the paper bag that the breakfast toast came in. First, I shook out the crumbs to give me an even writing surface. I had no other paper. I was inside the SCU (Special Care Unit), in a psychiatric hospital in August 2006, emerging from my first psychotic episode. And as the medication slowed my boiling brain, a miniscule part of me, took in my environment and thought:

‘I am one step away from a padded cell. Unbelievable. But while I am here, I will record as much as I can, because not many people experience this.’

So, I made my words tiny to fit as much detail as I could onto the toast bag.

Over a year later I wrote an account of my psychotic episode based on that bag and some diary entries. My supervisor for my Master of Arts in Writing Editing and Publishing read it.

‘This is really good writing. You should consider expanding it into a memoir.’

Continue reading “Accepted: Crumbs To Canary Wharf”

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