Therapy Tales No. Etc- Death and Trauma. Fun.

Therapy is ending soon.

Losses, fears, love- that’s basically it. Losses of things I loved- including animals (I know pets die, but mine in sudden, cruel ways I can’t go into here but which haunt me) and people. They all died lonely, premature, unfair, painful deaths. As soon as I really understood what death really was (which happened when I had another loss- my friend who killed herself when I was 15), I have been completely heartbroken ever since. Of what life is. Of feeling. Of finality. Of memory. I can’t bear it, any of it. That’s when the fear really started. I’d always been afraid of my parents’ death, i obsessed over it. But that was my first big loss, of someone I’d seen so recently, so young, so similar to me. We were all steeped in bullshit pop music mythology, playing with self harm. But she died. Alone. And I was unforgiven for something. I never got to explain or say sorry. And she died. Died. Death. Forever. My first cremation, too.

Memory is important to me. Memory is evasive to me. I have convoluted memories of my own childhood.  Different from my siblings’ because we’re different people. Everything is kind of mixed up, muddy. Then my own brain conspired against me, and I don’t remember a lot of my periods of illness, or the life that existed, inevitably, as life does, within them. And I had my own fractious relationship with the truth when I was young.  When I look back I realise it was because I found it so hard to be living the life I had, so created another, not even one that was easier, but one I felt could justify the pain I was in without ever being honest about what was really causing it (it still feels churlish and trivial, and now I am at the other extreme of exposing honesty).  Other people have memories I don’t, largely negative and embarrassing. My own bad behaviour haunts me not just because it hurt those it was directed to (or caught within), but because I know it has become part of the memory arsenal, that chorus always waiting to be summoned, or to butt in, uninvited, and to hurt. And I hate that. I don’t want to be someone’s bad memories. Maybe if I can be better now, I can replace it or erase it? And all I want is to give my son happy memories. Robert says I’m morbid, which is true. He keeps us in the present- he thinks, “experiences”, I think, “memories”. Already living in the past tense.

Memory is all we have, really. In the end, if we’re lucky, that’s all we have. Since my dad died I have dug deep and cling to the good memories I have of him. Further and further away. It’s hard to remember happiness. It’s not the visceral gut punch of despair, more the balloon in your hand that drifts away, bright and then small and smaller. Physical pain is hard to remember (I couldn’t describe now what my contractions felt like, even though I know they hurt), but emotional pain recalls itself constantly. So I often only remember the bad things clearly (and how bad they were), and it feels like they just happened. How jealous I am of people whose parents weren’t like mine and who they went out to lunch with and they didn’t die like my dad did. Even those who did die but in ways that people had some sympathy for (alcoholics dying, lowest of the low, fuck their children, the way we were treated by the medical staff, my baby brother and sister, fuck them forever and forever for it, for every person afterwards who turned their face away from me),  I have to unfollow people on Facebook posting happy pictures with their parents. Out at lunch! Having drinks! Doing normal things.

Memory is the twoheaded monster. My memories of my dad are awful, Sometimes they engulf me and I feel like tearing my skin off in agony that I can’t go back, can’t change something, can’t intercept this awful image and make it different. That was it. And his memories. I think that’s perhaps worst. HIs life which he didn’t deserve. That he was so desperately unhappy. That he died like he did, and that I knew he was afraid of it. And there are tears pouring down my face as I write this. To be afraid without comfort. Without hope. I wanted to be there when he died to be a hand or a face or a word, and I wasn’t.

Me being there wouldn’t have changed the outcome, he would have died anyway. But I wanted to do something, anything.

My friend Brendan died not long after my dad. He was an alcoholic too, was trying to recover. He died of an accidental overdose and my last communication with him was a voicemail he left on the Monday before he died asking me to meet up, saying he was nearby, just passing, are you in? get in touch, and I was so up my own fucking selfish arse I never did and then he died.

In therapy we talked about safety behaviours and my big one is having my phone on me and being always contactable. I have a three hour commute to and from work and most of it is underground. I went for a rare night out on Tuesday and had a panic attack on the train as I visualised (fear not feelings etc, but it felt like a promotion, it felt like destiny), Robert screaming over our baby, screaming and screaming and I wasn’t there. That if he died I wouldn’t be there. What would his last memory be? Be held, be there, be loved. Not alone.

(Howl)

This is hard to write. I’ll come back to it.

It’s also about fear. I used to have nightmares about my dad dying from his drink. But he did anyway. It happened even worse than I screamed about. So why should I trust my fears aren’t real? That the worst won’t happen? It did. All the worst fears I have (dying myself is a worst fear that will inevitably be true, but I fear dying young, leaving my baby, Robert dying, my baby dying, my mum being unhappy and dying) came true so why not these? It’s hard not to take my anxieties as facts. They happened.  And with Robert and my baby in particular, who are my husband and my son, I love them so fiercely, I think, my love must insulate them from suffering, from death. But it doesn’t and it won’t. How can I ever accept that? I know it’s a childish and possibly a bit narcissistic but there it is. When Robert has the slightest bit of discomfort, my refrain is, “What can I do? How can I fix it?”

We talked about my intrusive thoughts which often take the form of, when I’m speaking to someone, imagining them dead. And realising they have the same expression, that I am just superimposing my dad over everyone’s faces, just reliving it constantly.

We didn’t even get on that well when he was alive. We had some beautiful moments, a lot of understanding, and he was a good person. But I often hated him for what he put us through. I used to fantasise about him falling downstairs and breaking his neck just so he’d shut up. Stop shouting. Stop drinking. Then we’d be free. (I hate this freedom. I hate myself).

So the therapist talked a bit about trauma and how events can be too big for the brain to process so they never become memories. They’re always happening instead. A sort of PTSD. And how if you break them down they can be processed and become memories and stop being so present. I’m skeptical. I have some extra sessions before we quit but feel like we’ve pulled a thread and I want the jumper back. And I don’t want to do the homework. I don’t want to write it all down. I want to keep pushing it all out. I don’t want to break it down. I don’t want to break down.

I cried a fair bit after that session and Robert gave me a lot of hugs when I came home. And then abruptly I just stopped talking about it, as I do, Silly, trivial, depressing.

Yeah.

(Stay with the feelings)

The Insane Guide to Living With Mental Illness: The Mixed Episode

Ah, here we are. It’s now time for me to introduce the special circle of hell reserved for the manic depressive: the Mixed Episode. These were meant to be funny, sarcastic guides (like the Depression one was) but somewhere, it’s become all serious!

A mixed episode (also known as dysphoric mania or, for depression with hypomania, agitated depression) bears a little explanation. It is literally a mix of manic and depressive symptoms at the same time. It’s generally considered as the most dangerous of mood states, being that if you want to kill yourself, you have all the energy and frantic invention necessary at your disposal with which realise that particular dream.

However, if you believe the DSM-IV, relatively few people with bipolar disorder experience these episodes. The reason? It is strictly defined as mania and depression for a week; leaving out hypomania, thus nobody with bipolar II or cyclothymia has ever had a mixed episode. From my forays into BipolarLand, reading and research, please take it from me (and the dissenting voices in the psychiatric community) that the DSM-IV needs updating. But lucky me, eh, bipolar I, so, by the DSM-IV rules, anything goes.

It lies close to my heart. Dysphoric mania is, by far, the most common episode that I experience. Those much romanticized euphoric manias has almost disappeared as I have grown older, and my manias are now increasingly black and almost always psychotic. It’s why I’ve escaped being diagnosed with depression. I’ve been suicidal and depressed many times in my life, but the manic edge which accompanies my depressions has exempted me from being considered clinically depressed. It is one of the reasons, I suspect, that even when I’ve been in front of a psychiatrist absolutely suicidal, the relentless diagnosis of bipolar I has always been returned.

It is difficult to describe how it feels; imagine the white noise of racing thoughts pitched at total destruction and despair, horrible images, frightening visions, flights of ideas punctured by the bleak feelings of failure, endless energy overriding utter, utter exhaustion, nameless guilt, manic lack of inhibition, rambling and ranting, restlessness, the damaging impulsivity and grandiosity of mania, terrible agitation, rage, anxiety, panic, psychosis, paranoia and fear. It can be constant, or can fling you from mania to depression and back again extremely quickly.

A mixed episode landed me in hospital, and mixed episodes are almost totally at odds with normal functioning; it is simply impossible to go about your normal life when in a mixed episode. Everything is frightening or an insummountable challenge.

Yes. They’re no fun. So, here’s the Insane Guide to the Mixed Episode. I found it difficult to be sarcastic about mania, it’s almost impossible to be lighthearted about the dysphoric kind. So this guide is kind of crap.  Apologies.  Read the previous ones instead by clicking on the category, The Insane Guide…

The Mixed Episode

Manic, depressed, who the hell cares, you can have it all! Welcome to the mixed episode. You may never leave. I really mean that.

1. Eating and self-care

2. Social etiquette

3. Hobbies

4. Sleep

5. How to deal with those around you, who may not be so excited about your insanity as you are! Includes lovers, friends and the medical profession.

6. The future

1. Eating and self-care

Have you eaten? You can’t remember the last time you ate. You probably should eat, but you can’t focus long enough on anything, let alone the thought that you need food. Everything feels like it’s been put there to test you, and you find yourself by the kettle in tears of frustration. You can’t even do that, a task that wouldn’t tax a five year old. You can’t do anything.

You brush your hair and teeth, on automatic, and neglect to put on underwear, simply forgetting. It doesn’t feel very important. You can’t really concentrate, your clothes are a jagged mish mash of colours and shapes, old blood stains seeping through the cheap fabric. You look in the mirror but you can barely focus on the image. There’s pictures in your head, horrible pictures, that seem to permeate everything you try to look at.
2. Social etiquette

You did go out for a drink but found yourself crying at a table alone. You’ve been trying to talk to your friends but you just can’t, you can’t communicate at all. The words, rapid and free flowing, are not making sense. People can’t keep up with you. They listen, for a second, but you’re going too fast, and they drift off, nod, and turn their attention from you. You don’t look right, your eyes are fire in pitch from lack of sleep.

Self pity kicks in, and you’re convinced that everybody hates you, more than hates you, wants you dead. You are ferociously, wildly, suicidal and you begin to feel angry at those around you- why can’t they see that, why can’t they help you? The strong desire for someone to reach out is not as strong as your desire to be alone, so you leave, and walk quickly into a cold night, frightened at every single sound that you hear.

3. Hobbies

Nothing from the outside makes a difference; you can’t concentrate on a film, the things that used to calm you down don’t and your panic is rising. How can you slow the thoughts in your mind? So you have new hobbies- running on the spot, talking to yourself, anything to calm down. You’re exhausted, your whole body is screaming out to stop, but you can’t. Relentless, frantic energy grips you and there’s nothing you can do to get rid of it. Absolute rage and frustration courses through you, and the room is wrecked. You get up and write disjointed prose, the words jumbling up, making no sense at all.
4. Sleep

You tried to sleep, you lay down, but your head felt like someone was chainsawing inside, so you got up again. You want to sleep, but you can’t, you’re restless and anxious and the dark shadowy shapes in the room seem to be moving.

5. How to deal with those around you, who may not be so excited about your insanity as you are! Includes lovers, friends and the medical profession.

You’re depressed, you know you’re depressed, despair, sorrow and complete hopelessness is flooring you, but the doctor doesn’t know what’s wrong- you’re not eating too much or sleeping too much, you’ve had more energy than you’d had for some time and although you sit and talk for half an hour, nothing makes a difference.

Your friends are long gone- something you did or said, you can’t remember. Loved ones keep their distance, unable to cope anymore with your shouting and seemingly untriggered crying fits. It just compounds your guilt- you’re a bad person, and you know it.

6. The Future

You can’t think straight- tomorrow seems like it’s a thousand years away. You have no idea what you’re doing or what you’re going to do. You’ve been awake for days and are starting to become very paranoid. You don’t know how to feel safe or how to stop, you just want the agitation to calm down, for one second.

Crap guide there. I find it hard to write about. It’s just a horrible way of being and all I want to write is, “I’M SORRY” to anyone who might be going through one. To be honest, I’ve been getting so panicked and bizarre lately that I think I’m not doing too well myself. Today has been a White Noise Day, that is, very rapid, quite scary sequences of thoughts and voices going over and over in my head that frightens me and makes it impossible to concentrate.

Sometimes, I’m tempted to write down everything my brain voices say so that I can understand it. But I can’t, because they move so damn fast that it seems like malevolent gibberish.