How I Felt when I was Diagnosed and Rapid Cycling- Part The Second

My day has consisted of sleeping and gumming half-dissolved biscuits and warm, thick tea yet my brain has still saw fit to throw in the mood swings. I spent my evening lying prone on the floor while Rob ferried cups of Lemsip to and fro. I nearly burst into tears many times- why, I could not tell you. All day I have been pierced by deep despair and a feeling of hopelessness and then a feeling of great hope and worthiness. It’s almost five o’ clock now and I have been watching “A Bit of Fry and Laurie”, series two, and wondering why they got rid of the wonderful theme sequence of series one. I am tired but finding it too hard to sleep so am gathered up in a leopardprint mess in the kitchen, sweating and feeling sickly and sticky. The cat keeps climbing onto my knee like an affectionate toddler but, like an affectionate toddler, I am irritated by her as she has been in my face all day.

Goodbye, goodbye

As Pete and Dud would say. I called my Livejournal-of-three-years to a close earlier. It is too uncomfortable to read now. Back in the day before I had accepted I was manic depressive, I would write prolifically and vividly, then, very obviously, fall into deep depressions.

With my glib acceptance of my illness has come a distinct creative dulling. Now I know what ails me, the joy of describing how one feels has been lost. The ravishing highs and dreadful lows I feel are no longer a mystery to be unravelled, no longer a symptom of some deeper emotional being in me. They are, by and large, a symptom of a condition I suffer from.

My Friends Were Not Surprised

My friends were not at all surprised by my diagnosis in October. This is because I had been telling everyone I was manic depressive for years.

I was actually diagnosed with “a mood disorder” when I was sixteen (or possibly fifteen, my memory is quite awful) which translated to “manic depression”, which is what I was being medicated for with Tegretol.

However, “manic depression” to me was just a vague term I applied to myself to occasionally explain away some of my more lurid behaviour. I didn’t consider myself unwell at all- I had been suffering from the highs and lows for such a long time that I considered myself normal and affected by circumstances around me.

Being hospitalised for being rather crazy and being told in no uncertain terms that my flavour of illness is a rather severe one has meant that I have had to swallow all the manic depressive paraphenilia with gusto if I am to have any hope of getting better or understanding it.

So, the only person who was surprised by my diagnosis was me.

I had always assumed that I would Get Better. I honestly, truly believed that the doctors would tell me I was fine. Go home, get some rest, take it easy, that kind of thing. I did not believe for a second that I was geniunely ill. I never really believed that I suffered from manic depression.

You Have Bipolar Disorder Type One

Said my doctor, who introduces himself to his patients with a hearty handshake and wears old patches on his geography teacher jackets.

I was no stranger to manic depression, being that a few of my heroes like Stephen Fry and Spike Milligan were sufferers. However, I was far more ignorant than I knew and found myself sitting in my hospital room asking, “What is Bipolar Disorder Type One?”

He explained to me that, because I had gone through fully manic episodes, replete with psychotic experiences, that I was bipolar type 1. He then explained that bipolar type 2 was a disorder with hypomanic episodes rather than manic episodes.

There was a social worker with him who floated in the corner like the moon. She was smiling, all the time.

I didn’t really have much time to digest anything as after he told me that I was bipolar, I had my meeting with him and the Crisis Team to see if I could be released from hospital.

Why not

“You’re quite high at the moment”, said the psychiatrist as I got comfortable in my chair, just having been introduced to two members of the Crisis Team.

I vehemently denied it, petrified that I would have to stay in hospital. “I have had a lot of coffee”, I offered, omitting to mention that I had spent the past 13 hours doing starjumps in the toilets to rid myself of energy and how I had turned away my friend, Anna, as I was desperately trying to sleep in time for my interview. I had also spent time lying awake running through the entire script of “The Silence of the Lambs”, then getting caught up in how words sounded like each other. I had then spent considerable time repeating my name over and over to myself to try and slow down my thinking.

In hindsight, yes, I was quite manic at the time, having been in a mixed episode for quite some time before that. Haloperidol and Lorazepam had not calmed me down.

The doctor was keen to release me, thinking I would benefit from Crisis care at home. Then he looked at me sternly and said, “You haven’t been entirely honest with me- you didn’t mention that you had a very recent manic episode”.

Forgive me, but someone just diagnosed with bipolar would not be able to identify a manic episode. For me, it was just being a bit crazy.

The Crisis Team did not want to let me out of hospital as they were concerned that I was putting myself in danger.

Let me explain

In the time before I was admitted to hospital, I had developed a habit of inviting complete strangers back to my flat. I would bump into them in the street and try to lure them back, regaling them with charming banter and very probably scaring them out of their wits.

A defence against assault is being so obviously mentally disturbed that you scare even the other mentally disturbed.

The Crisis Team believed I was at risk to myself and it took some cajoling from Rob before they were eased. Rob promised them that he would take some time off work to look after me- quite frankly, to supervise me- on my discharge from hospital.

So, I was let out of hospital.

And then, it was war.

I did everything to try and wriggle out of my diagnosis. I tried to disprove it, desperately tried to illustrate why I wasn’t manic depressive, why they were wrong.

I told the Crisis Team that I did not think I was manic depressive. I pleaded with them to understand that just because I was a little odd sometimes and got depressed sometimes it did not mean I was sick.

The Crisis Team ummed and aahed and humoured me and nodded and gently tried to show me that it was incredibly flipping obvious that I was manic depressive.

Rapid Cycling

When I was asked how many episodes I had a year (hundreds, but huge episodes, about 12), I was convinced that they were somehow trying to disprove my diagnosis themselves. I didn’t realise that they were just trying to evaluate my illness.

I told one of the team who visited with my Lithium that I would like a second opinion. She smiled quite half-heartedly and told me that I was in fact manic depressive but very well.

Another psychiatrist visited me at home, armed with my medical history and spoke to an extremely hypomanic me and concluded that I was suffering from bipolar disorder type one rapid cycling.

Rats

So, that was actually my Fourth Opinion. However, I was still so very keen to Not Have Manic Depression.

I tried everything to duck out of it. Long, impassioned speeches to Rob in the sitting room, pleading with the Crisis Team, taking my medications to show just how they would have no effect on someone like me who wasn’t ill.

It didn’t work. What was so obvious to everyone else would eventually catch up with me.

The Five Stages of Grief

I grew to accept that I was suffering from manic depression quite slowly. Oh, I knew I was when I realised that I physically “switched” moods and this knowledge forced me to observe how my moods changed.

Accepting that I am manic depressive hasn’t been easy.

After all, being diagnosed with a mental illness is a life-changing thing. You are afraid of the stigma. Afraid of the treatment. Afraid of being seen as “weak” (which has always been a particular bugbear of mine, Woman of Steel that I am).

After my diagnosis, I did go through, “The Five Stages of Grief”:

1.

Denial. Manic depression? Look, that shit is serious. There’s nothing seriously wrong with me. I’m just a bit, y’know *whistle*. Don’t be stupid.

2.

Anger. I was raging! After all I had been through in my life, why did I have to be manic depressive as well? This isn’t fair! Can’t something good happen to me? Why can’t I be normal? I’m so young! How could I let this happen? How could I let this happen to myself? I’m so weak. I’m so pathetic. Why wasn’t I stronger? What is wrong with me?

3.

Bargaining. Right, look. Okay. Yeah. I might have a problem. But it’s not manic depression! It’s, like, something else. Isn’t it? What if I, I don’t know, be quiet for a bit, does that make it go away, yeah? So, right, if we stop this whole jape and I stop taking these pills and I’m okay, doesn’t that prove that I’m okay? That I’m not ill? Can’t we try that?

4.

Depression. I can’t believe it. I have manic depression. I am so young and as well as having a dead alcoholic dad, no prospects and no talent, I’m fucking mentally ill on top of it. I really believed that I’d be Okay one day. That everything would work out and I’d get a bit of counselling and life would be okay for me. That I’d write a lovely book and on the back of it, I’d look really happy and be called “a survivor” or something. I can’t believe I have this mental illness for the rest of my life.

5.

Acceptance. So. I’m manic depressive. Well, I guess that explains all those mood swings. And the hallucinating. And delusions. And why I act so weirdly. And why I have a shit memory. Could be worse, I guess. Could have cancer or something. And there’s medications, isn’t there. Right. Let’s do this.

And there you go.

It’s been made clear to me a few times now that I am manic depressive. My medication doesn’t do much to help, but it does to some extent control some residual stuff, like irritation (because it is so sedating). As soon as I stop taking my medications, I become Mrs. Angry.

The psychotic nature of my moods is also a bit of a flashing light to being not that well. I mean, it’s not normal to think people are following you but I thought it was. Welcome to my world!

How to survive rapid cycling

So, I was bloody manic depressive. I had realised but the real knowledge would come to me after a very lovely few days of my bouncing around, not sleeping, making wonderful plans and talking to many. And then, for no reason, like so many times before, suicidal, paralysing depression kicked in.

And I understood what it was that I had. Because, for most of my life, this has been happening to me and I thought it was normal.

It is incredibly difficult to describe the changes in my mood episodes.

When I was younger, looking back, they were extremely marked. I spent months and months absolutely manic, with everyone around me thinking I was on drugs or going mad, but having no idea of this myself. I suffered from vivid delusions- for example, I had written a story about a young man and I came to believe that he was real, completely real. I hallucinated frequently, I spent a whole night chasing Satan around my bedroom.

To the outsider, this is odd behaviour. But believe me, I had no idea. No insight.

And then I would fall into terrible depressions. Dark, long periods of not washing, not wanting to wash or speak to people, punctuated with agitation and self-loathing.

A quick note on psychosis

Even now, knowing I am manic depressive, I still struggle with psychosis. Hallucinations are not, “Did I see that?” They are, “I saw that”, “I heard that”, real as anything. Same goes for paranoia, which is a big problem for me. Not, “I think they are following me” but proper, petrified, “I am being followed/watched”.

I have some insight now so there are times I question things- like, when I saw the huge spider, it was absolutely real but afterwards I did say, “Could it have been a hallucination?” A lot of my psychotic stuff I keep to myself. I am alone a lot of the time and no-one is around to tell me what I saw or heard isn’t real.

With delusions, it’s obviously much easier for people to say it’s not real. Doesn’t mean I will believe them, though.

When I had no insight at all, back in my teens when I was seriously, seriously ill, my world was quite a terrifying one. I’ve mentioned before how I saw the world rot to maggots and my hands disintegrate in a taxi on the way home from school. It was real to me and scared me to death. I used to see black spiders crawling on my skin and would try to ignore them.

It’s one of the *ding ding ding* mentalist kind of things that I don’t really mention that often to anyone. Depression’s okay, so is being a bit manic, but when you talk about your hallucinations, delusions or paranoia, then you sound mad. I am scared of being the Token Mad Person to people. I am Seaneen.

Accelerate

I didn’t realise that my mood swings were accelerating. Not realising I was ill either, I didn’t pay much attention to the fact that my extremes of mood were becoming more frequent.

In the past few years, I have still suffered long periods of depression, long periods of mania, but in between, there has been shorter mood swings, in varying degrees of extremity.

Now I can, for example, be too afraid to go into my bedroom one day before I believe there is an enormous spider on a huge web across the wall in there, and find myself writing nearly all day. The next day, I am bought to tears by the simplest thing. My feelings towards Rob and life flucuate greatly- life is a beautiful gift we must embrace, how gorgeous is language and love and light and all the little things and then as suddenly we are all going to die and who cares. Mounting hysteria as I imagine the end of the world. And I find myself locked in my own brain of car crashing thoughts.

Rob is the person who deals with it most, now used to living with a person who is not the same from morning and evening. In the morning, I can be charming, delighted, playful and a few hours later, full of self loathing, unable to look at myself, convinced I should be murdered and disposed of.

Or I could be incredibly depressed for a while then dizzy with love, or incredibly depressed but full of agitation. I find it hard to concentrate on much for long, distracted from conversations by my own fractured thoughts, feeling very sociable then full of irritation for those around me. I can be florid and articulate then confused and bizarre, elegant and sexual then shaking and paranoid.

I think the worst for him is when I am cold, detached, unresponsive, catatonic and just not there. I see him struggling to get through to me but I can’t respond. He shows me that he loves me and is there for me but I just cannot respond, to anything at all.

The experience of rapid mood swings is different for everyone. I cannot put my moods into “depressed” “manic” “normal”. I do know that I do not really experience normal moods. I do also know that the famed “mixed episode” is a very prominent feature in my illness.

I Call Bullshit

A reader of this journal wrote a post saying he objected to the term “mentally ill”.

My opinion on this is, object away. It is a matter of perspective. Sometimes I will object to the term as I feel my mind is a gift, that I am more insightful, more humourous, more interesting for being manic depressive.

Then I will not object to the term “mentally ill” because my manic depression has also led me to suicide attempts, to part time jobs I can barely cope with and to mood instability so great that I can not even plan a trip to the pub as my mood will change so rapidly.

Manic depression has coloured my world for better and for worst. But I think it is biological condition, therefore, I consider it an illness.

I think it is important to think of it as a biological thing otherwise the general consensus that it’s something we bring upon ourselves will prevail.

There are people who think it isn’t biological which is fine. My opinion on it might change to but for now, that’s what I believe. Some people believe it can be cured. I personally don’t believe that- I believe it can be managed very, very well- but again, that’s only my opinion.

I will never deny the positive aspects of it- some manias are mad fun, but only some, people do tend to forget to mention dysphoria- but let us not forget the negative ones too. Manic depression has an incredibly high suicide rate.

Suicide

I believe in the right to take your own life but I will never think that it is a fantastic, sparkly thing or something wonderfully empowering.

I know that suicide is the result of a life that cannot bear anymore pain but I have experienced two suicides now of people very close to me- yes, I consider my dad a suicide- and now my life can’t bear anymore pain.

People say suicide is selfish but I think the selfish aspect is of those who are left behind. Of course we do not want to lose the person we love to suicide. It is devastating to feel so helpless but there is still that selfish aspect of “Don’t leave me, please”.

A friend of mine was suicidal a few months ago. I adore them and they are quite rational so I tried desperately to appeal to their reason but inside I was howling, “Please, don’t leave me, I can’t bear to lose you”.

A life means an awful lot. I think that sometimes when someone commits suicide they believe they’ll be around to read their own obituary. Certainly in my friend Vicky’s case, (she would have been 22 this month) I don’t think she understood that dead means that you’re dead. There is no going back.

Her death and the death of my dad are the two most painful experiences I have ever gone through and I am quite selfish. I never want to receive another phonecall telling me that someone has hanged themselves. It will break me.

Oh

This has become rather maudlin so I’ll sign off here, as it’s five thirty now and I should go back to being a stereotypical flu victim. I should probably put this cigarette out. Goodnight.