My Drink and Drugs Heck- Being Off Medication, Out of Therapy and Back to Work.

I meant to write my therapy tales as a weekly series, but it ended quite abruptly. Not for any bad reasons, but because my therapist was off to Peru (!) and wanted to finish the sessions before he left- which would involve squeezing a few into a week, which was the week before I went back to work. I would rather have spent time with my son than with the therapist, so we had two more sessions and left it there.

Did I find it helpful? I’m not really sure. There were more talk of trauma but a lot of it was just going through the self-help resource website. And the trauma is a whole other thing, so it picked at those threads a bit and left them dangling. My panic attacks have reduced but they often do when I’m incredibly busy, and I still have my horrible intrusive thoughts, but what can you do? (Except more therapy!)

I’ve also finally gotten off Quetiapine, which means I’m now medication free for the first time in 14 years. Yep, I’ve been on various brain potions since the tender age of my brain still developing, and that thought slightly horrifies me. I literally have no idea who I would be without medication, and I will never have the chance to find out since my brain is most likely permanently altered by them. Hooray! I can pretty much chart my life with various medications- 16: carbamazepine, 17, olanzapine (and becoming huge), 19-22, Lithium and Depakote, with various antidepressants and antipsychotics added, 22-28, on and off Lamictal, 22-30 antidepressants in low periods, Quetiapine. My Drug Heck.

Quetiapine was the last medication standing and the one I’ve found hardest to come off due to being dependent on it for sleep. My psychiatrist has utterly denied it causes a) weight gain and b) sleep dependence. She almost dared me to come off it, saying it didn’t have any withdrawal effects (I’ve almost torn my skin off with itching when trying to get off it before, taken a fork to bed where I’d lay awake for a week), and I can’t resist a dare, so I did. I can’t take Quetiapine if I need to do baby night duty which I would do twice a week so Robert could sleep. One night I just didn’t take it the next one. Instead took some promethazine (an antihistamine) and put on my sound machine app to sleep, and it worked. Promethazine has mitigated the worst withdrawal effects but i’ll need to get off that, too. I had gotten down to 75mg of Quetiapine which is why I think it wasn’t so tough this time. In the past when I’ve withdrawn I’ve gone mental fairly quickly and ended up back on it. But it’s been almost a month now and I haven’t had to call the police because I thought there was someone in my house wanting to kill me, so I call that a success.

I don’t feel hugely different. I tend to get quite down this time of year, and I am a bit. My brain is a bit more buzzy and detuned but I can get out of bed in the morning which is such a difference. My gorgeous human alarm clock helps, but even without his glorious gummy face I think I’d be much better. I haven’t been late to work once since I started back, when I used to be late every day (I’m late to my own time so I can leave by 5pm, but that’s transport rather than me).

As for being back to work- there’s a whole other post in there, about how it feels being a working mother. Lots of emotions, guilt either way, when I am at work and when I’m not. I’m only in for 3 days at the moment because I have a lot of leave to use up, but I’m fairly apprehensive going back full time in the new year because I will pretty much never see him in the week. My awful commute means I often don’t make it home to put him to bed, and I miss him terribly. He’s such a beautiful wee thing, in a lovely stage where he’s a real, proper little person. He’s crawling everywhere, chasing the cats, laughing his head off all the time, babbling (lots of, “mamas”, but I know it’s just babble right now), loving being read to (he brings you a book and puts it in your lap to read)- just an utter, utter joy. ¬†It’s nice to be amongst adults at work, I have some excellent friends at work, and I’m lucky to have a job I love and an understanding workplace. I would probably go mental being a stay at home mum, since I’m an introvert anyway and work forces me out. My social skills totally disintegrated when I was off work for four years. The baby is incredibly sociable, he seeks people out, smiles at everyone, makes friends everywhere he goes, and I’m not great at getting out when that’s what he needs. ¬†And it’s not healthy for him to just be my life, nor I his. I want to set a good example, and I’m glad he’s growing up with his dad being at home, to teach him, well, so many things, but one thing being that women aren’t handmaidens. And I know there is drudgery and frustration (a lot of the latter, since he’s so frustrated himself with being a baby), and it is good to get a respite from that so I¬†don’t mind it so much.

It feels almost unfashionable to say this, to not don my power suit and sing Eye of The Tiger. But I really enjoy being with him, much more than I ever expected to. He’s with his dad, so that’s great (we can’t afford childcare, and Robert quitting work made sense) but I’m always worried about how Robert is coping and feeling, too. I feel a bit like I’m letting everyone down, and I’ve got a case of imposter syndrome going on with work, my confidence is in bits. I’m sure it’ll get better and I’ll settle in, navigate the space between, but I had a bit of a cry at the station earlier after missing my second train, so it had taken me two hours to get home.

To this face. I mean, c’mon. You’d cry too.

(PS, I don’t smoke anymore either. Pass the yoga mat)

Family.

Family.

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Yep, I’m fat, have scarred arms and an incredibly happy son.

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Meeting Sugar the rat!

Meeting Sugar the rat!

He saw an alpaca for the first time.

He saw an alpaca for the first time.

My body comes with a trigger warning – Self harm and stigma

Hello!  I wrote a blog for Mind on self harm,  stigma and conflicting messages.

“Stigma” has two meanings. One is religious- they’re the literal marks on the hands of Christ at the crucifixion, and then bestowed upon those whom were holiest- and by extension, those who suffered the most. The other is social- a mark of disgrace. Self harm is both. It is highly stigmatised in society and within the health system, and it is a mark of suffering.

Suffering only has cache if it’s quiet, or, “dignified”.¬†If you make people uncomfortable with your suffering, then there’s stigma.¬†And therein lies the rub.

How do you combat stigma on something that makes other people uncomfortable?

How do you say people who self harm should be treated with kindness when their bodies are seen as attacks on others, to say that self harm shouldn’t be a problem hidden in the dark, when we do exactly that by not allowing representations of self harm?

I just have scars now. They’re very noticeable but also very faded.

Recently, I had a baby. In the postnatal ward, a midwife wrote that I was sitting on the bed holding my baby, “scars on arms”. That’s six year old self harm scars, as relevant to my medical history as a broken leg, and yet so very present, because they were, on a hot stuffy ward, visible. That’s what I was reduced to- “scars on arms”, the loving arms holding my newborn son, the arms of a new mother, a person, exhausted, elated, and ordinary.

If you’d like to rest the read,¬† it lives here.

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)

CBT Tales- session 1 and 2

Hello! I promised to update you on my therapy tales. I had my first session 2 weeks ago and it was so uneventfully boring I didn’t really have much to say about it. It was just going over what we’d be doing. He said a few times, “you fit the model so perfectly”, which I gather was meant to be reassuring but irritated me somewhat. I don’t want to fit any models but of course, we all do in varying ways. Especially us mental health bloggers who literally define ourselves by the set of symptoms we fit that all adds up to a few words on a doctor’s monitor and our entire lives.

There was a lot of diagram drawing on how thoughts and feelings and actions all interact. Talk of safety behaviours, and my biggest is keeping busy all the time, mostly by fucking about online, never letting that thought creep in, having my phone glued to my face until the very second I fall asleep. And it doesn’t work, because in the second afterwards, panic creeps in. And I have an awful tendency to use my phone to look up the things that scare me- cancer, death, cot death, death, death, more death.

Session 2 was yesterday. I wrote this for A Day In the Life, a website which gathers the stories of a day in the life of someone with mental health difficulties. You can submit yours too over at A Day In the Life. The stories are anonymous but I don’t mind outing myself for the purposes of this post.

26 August 2015

Today is Therapy Day. I had about three hours sleep, which isn’t good on Therapy Day. In the days before my baby was born, my medication (Quetiapine) would make me sleep for twelve hours straight. Now, with an internal Mum Radar activated, I wake up when he does (multiple times a night), although I’m pretty uselessly doped up from drugs and it’s up to my husband to feed him. The one time I tried I dropped the bottle and spilled milk all over the floor, mumbling dream talk, his crying from the end of a long, dark tunnel. So it’s pointless lack of sleep, but lack of sleep nonetheless. The baby, now five months old, has decided that 6am is a brilliant time to wake up, so I’m up too.

Despite being up from 6am, I’m still late for therapy. The hours in between are lost in a haze. I eat, too much, to try and muster some energy. A jam bun and some toast. In my sleepiness, I’ve forgotten my homework and worry all the way on the bus that the therapist will be pissed off at me for it. It’s just CBT- I say, “just” because it’s not the kind of therapy that plumbs your heart like a dentists’ drill. It’s functional, rigid, and thus requires concentration I can’t summon on so little sleep.

This is only the second session. The focus is on my anxiety about death. Or, as we find during the session of comparing, “Theory A to Theory B”, the focus is on my anxiety about my anxiety about death. The problem, the therapist says, isn’t that we’re all going to die. That’s true and has always been true. It’s that my anxiety about it is controlling my life. So we go through what happens when I feel anxious. About intrusive thoughts and how we shouldn’t try to control them. The more we try to control them, the more we think them. The aim, he says, is to accept them. To let them intrude.

Towards the end of the session he says we’re going to do something which may make me have a panic attack. It’s to feel where my anxiety is, to hold an image in my head and to focus on it. I try, but all I can focus on is the ticking of the clock coming to the end of our truncated session. I try to hold an image of myself panicking but nothing really happens. He then talks about how the more we look at an image, the more our mind will demonster-fy it. It might become interesting, comical even. I’m not finding this to be true, but I’m left with the instruction that the next time I get an intrusive thought or feel anxious to stay with it, examine it, and not try to suppress it. Good luck, me.

I leave and wander around the shops, thinking of lunch. I’m trying to treat these sessions as little holidays from my life, and take an hour afterwards to drink coffee or eat before I return to the baby, leaving whatever was in therapy scattered along the cafe tables. I get the bus home and exhaustion floors me. I can barely hold my head up and resolve to go to bed when the baby does. We’re all tired today, we forego any attempt at dinner and eat burnt creme br√Ľl√©e that Robert impulsively bought from Tesco. ¬†I take my medication just after I put the baby to bed, and let it drag me into the blackness of sleep by 8pm. He wakes at 10.30 and I do too, stumbling with my pillow into the spare room while my husband feeds him. And then back to sleep. It’s just like the old days- I slept for 12 hours.

Therapy Tales Part 1- So You’re Terrified of Death?

(If you’re wondering where my previous post went, I have made it private as I’ve found this to be true. Thank you for all your comments and encouragement!)

So, I’m starting therapy for death anxiety (my medical diagnosis that led me to it are generalised anxiety disorder and panic disorder but I prefer to think of them as ARGH). ¬†Expect this series of posts to be even more introspective and self obsessed than usual, and for this blog, that’s saying something.

Two years ago (christ), I wrote a post called, “When Fear Becomes Phobia”.¬†It described my ARGH FUCK panic around death and deadness, and how my world was getting smaller and smaller because of it. ¬†Last year, I went to the doctor and asked for help. She was so sympathetic that she made me cry. Saying what an awful thing to carry around with me for 12 years (14, now) and she referred me to therapy. I found out I was pregnant, had an assessment and things didn’t go any further because I was suffering such crippling morning sickness that the 40 minute bus journey to the appointment was 1 hour 30 minutes because I’d have to jump off twice to vomit. Later on in pregnancy, I dispensed with such courtesies and just huffed up all over my lap, or into a friendly plastic bag. ¬†Pregnancy was also pretty distracting- all my anxieties were focused on that, and I didn’t have the mental reserves to panic about death anymore.

My panic has returned, as it does. It’s not constant and strikes at night when I’m trying to sleep (and flip, I need my sleep!) It doesn’t disturb anyone because I sleep in the spare room (Robert does night feeds due to my medication). It means it’s quiet, private, lonely. It comes and goes, ebbs and flows. ¬†It’s probably unsurprising. I had a baby, then I lost my grandmother, and it was my dad’s anniversary. ¬†Catholicism ritualises death in a way that’s both comforting and horrifying. It makes you look at it, it makes an object of it. ¬†She was in a coffin in the sitting room that my dad’s coffin was in, for days, with the same yellow, unnaturally smooth, chillingly cold skin that you have to touch to say goodbye. Their coffins, and every childhood Christmas. These things bring death bubbling back to the surface of your mind. It’s hard to close it out when you’re trudging up a hill behind it. Robert’s grandmother died the month after, and her funeral was like a trip to Argos. Closed, quiet, scripted, burned. I prefer the visceralness of Catholicism, even if it haunts me. It does at least give death, and life, some gravitas.

So, I’ve been referred back to therapy for it. My psychiatrist initially wanted to increase my medication but I refused. This feels existential, albeit obsessive. I’ve often been able to distract myself and try to be less up my own arse, but distraction is tricky and I’m introspective generally. It doesn’t need to be medicated away- that just makes me feel worse.

The assessment happened pretty quickly. A chat over the phone, which gave me a sense of pride that I didn’t have to list a litany of other issues. I haven’t self harmed in six years, my bipolar disorder (if I ever had it) is pretty well controlled. I wasn’t depressed, wasn’t struggling otherwise. I’ve come quite a long way. I knew what they’d recommend- CBT (*spits*) but I’m willing to give it a chance.

The therapist is called Sean, which means the assessment didn’t entail the usual 45 minutes of tuition in how to pronounce my name. It’s high intensity IAPT (Improving Access to Psychological Therapies), so the sessions aren’t at the mental health team (thank bollocks, I used to work at my local one), but in an unassuming house with comfy sofas, pot plants and James Frey books that I had to stop myself openly guffawing at perched proudly on the Ikea shelves.

He asked me what I wanted help with so I explained. I forgot to bring the questionaire they sent me so went through some of it there. My depression score was low, as I knew it would be. People tend to assume I must be suffering from depression if I’m having panic attacks and anxiety.

Au contraire.

Depression is both a mortal enemy and an enemy of mortality. For me, it is ageless, timeless emptiness. It tries to kill me, and it kills the thing inside me that makes me afraid of it doing so. I want to die when I’m depressed.

So when I’m not depressed, I’m scared of that.¬†It’s like being held under water and a peaceful acceptance of what it happening envelopes you, until the final second, and you kick, you convulse in order to be free, to be alive, to throw off the aggressor and then relive over and over at how close you came to drowning.

I do sometimes feel depressed because of the panic. I feel frustrated and angry with myself that I have panic attacks. I feel frightened and distressed by some of the intrusive thoughts I have (like when I’m speaking to someone and suddenly an image of them dead flashes into my brain, with hallucinatory vividness) and sometimes they make me feel like I’m going mad. But depression and this panic don’t come together, and that’s a big massive pain in the hole.¬†The panic tends to be the worst during the happier periods of my life. I’m happy, hurrah, and then my mind goes, “This will end it, all of it, everything, and because it will end, this is meaningless, you won’t be here one day, any day, none of them will” and that’s just BLOODY FUCKING GREAT isn’t it. I don’t want to die, ever, because I enjoy my life. I’m essentially a happy person who wants to see what’s going to happen. ¬†I want to be standing at the end of the universe with Robert and Ois√≠n watching supernovas and planets and the sun.

(Rest your head)
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(Close to my heart)

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(Never to part).

Maybe it is partly a coping mechanism, the fear. Like pinching yourself.

He asked me if I had other anxiety- I do, social anxiety, but I’m dealing with that in my own way so I didn’t want any help which he accepted (and I think it’s tied up in this anyway).

Two things were said during the assessment that made me willing to continue. One was something stunningly obvious but that I had genuinely never considered. The therapist said that my kind of anxiety is, “idiosyncratic”. It’s not a common reason people come to therapy. That floored me. “Doesn’t EVERYONE feel this way?” I said. No, apparently not. At least, not to the degree they end up in therapy. So, is it that this is such an ordinary fear we live with it and are in denial, or am I the odd one for being periodically consumed by it?

Another was asking me where I think it came from. Nobody has ever asked me that before, and it’s not something I’ve thought about. The worst of my panic began when I was 15. That’s when it started flinging me screaming across the room. “Is that when your friend committed suicide?” Yes, it was- but the panic attacks started before then. Robert (who I first went out with when I was 14), remembers my panic on the phone, but it was more contained, and I was easier to comfort and distract.

It started well before then, when I was about 7 (?). Both my parents had mental maladies.¬†I felt like they were going to die and I was terrified of it. I became aware they wouldn’t be there one day and I feared all the time it was the day. I used to pad into their room at night to check they were still breathing, then pad back and lie awake in the moon (just like I do now with the baby!). I realised I was going to die too, and sometimes would wake up screaming. ¬†Death felt close, ever present, non abstract. I could only perceive it in my childish way, but I never felt safe, and I never have since.

Of course, that’s just a bit of it- I might be wrong, but I had never connected the two things before. I had a massive resurgence after my dad died, too, which is natural. But it wasn’t so much his death as knowing that he feared it. That kills me, still. I hate that he was afraid. If I could do one thing in my life, one magical thing, it would be to take that fear from him before he died.

He asked me what I wanted to get out of therapy. I don’t know really. Not to have panic attacks anymore. To be able to watch/read/listen to anything again. Not to have to ring in late to work because I’ve disintegrated at a funeral procession. To fall asleep. To be able to think about Ois√≠n’s future. At the moment, I’m too scared to talk about it, think beyond tomorrow, in case he’s not here for it, or that I’m not. I’m petrified of something happening to him, and feel superstitious about it. It’s a loss I know I would never, ever recover from, be able to go on living beyond. ¬†Pregnancy should have taught me the futility of this- when it seemed like there was bad news at the 20 week scan, my anxiety didn’t protect me. It didn’t cushion it, it didn’t make anything easier. ¬†I want to be able to talk to Robert about him riding a bike, or going to school, or falling in love. I want to be here and present in the moment without thinking how it’s going to end. That it is. I want to be able to sleep without hours of panic beforehand. I want to be able to not feel regret about not living if I do die tomorrow. When I’m going through anxious periods I always feel mildly dissociated, not here. I don’t want to feel that way anymore. I don’t want horrible flashes in my brain anymore. I don’t want my coping mechanism for the feelings of helplessness and inevitability to be nihilism, as it means I make unhealthy choices (like smoking, which will actively shorten my life, and thus leads to more panic attacks). I want to be present for myself, for my child. Life is so brief. And it is all.

He said that this will involve some unpleasant feelings, but that it usually helps. He says when it doesn’t, “work”, it’s often because people haven’t done the things long enough (bit of, “blame the patient” here, but I understand what he means as my last assessment person gave me a workbook I barely glanced at). I’m pretty frightened of what this is going to entail, and how hard it’s going to be. I’m aware it might mean it gets worse before it gets better, and I’m feeling pretty apprehensive about that. Shit scared, to be honest.

But I’m doing it. So let’s see where this goes. I’ll keep you updated!

Musings on Mumhood- Feminism, Love and Grief

Edit: for some reason this post is showing as May 18th. I wrote it on June 11, so go figure!

I’m currently writing this at 11.30pm, in the garden, where a fairly stiff breeze is blowing. This is the only place I know I won’t run to the baby if he cries (Robert is in the house with him, in case you think I’ve just left him). I’ve wanted to get some thoughts down about motherhood for months, but it’s been rather hard to write. Not just due to the new occupant of my lap. But because my feelings are hurricaning through me and evolving every day.

When I was pregnant, I finally kicked a nasty, expensive habit that garnered me more than my fair share of tuts and frowns.

Bad for your health. And your vocabulary.

Bad for your health. And your vocabulary.

Part of the reason I read these exploitative trashmags¬†is that I love peoples’ stories. I don’t think anything is banal. When I was pregnant, I would walk down the street with a person in my body (!!!), thinking, “And this will be you”. The fact that he would be walking down a street lost in his own thought was absolutely mindboggling to me. I find it endlessly fascinating that there’s a story behind every face, that every person dwells within their own private universe. ¬†In a way, there’s nothing more ordinary, and nothing more amazing.

In January,¬†Eva Wiseman wrote an article in the Guardian- “The seismic changes of having a baby”.¬†I read it when it was linked by various Facebook friends. The consensus being, “Big deal. Woman has baby shocker”. Commentary on how self obsessed her article was.¬†Big deal indeed.

Something isn’t less special, less beautiful, because it’s commonplace. Every day is filled with unfathomable, unpredictable¬†ordinariness. Dreams, seasons, love. And grief isn’t less black and deep and consuming because it’s something that happens to everyone, every day, everywhere. Nobody (well, I hope not) tuts and rolls their eyes and says, “Big deal. People die everyday”. So why do we do it when people are born? Why,¬†outside the climatic yet somehow bland scenes of a romcom, is it less amazing?

It’s a peculiarly misogynistic view to hold, this woman’s world of babies and childbirth. How dull, how droll. How very trivial. From woman to mummy, from one judgement to another. (I saw a tweet from a supposed feminist about another feminist, scorning an article they’d written sarcastically saying, “Did she mention she’s a mother?” I blocked her). Women across the world are judged on their status as a mother, or potential mother. Being a, “real” woman is partly¬†judged by your attitude towards or your ability to reproduce. ¬†Our reproductive capacity is perhaps the most dangerous aspect of being¬†female. ¬†It’s when domestic violence often starts or intensifies. It’s a visible, very visceral sign of your sexual activity. You can die because of it- through pregnancy, through childbirth, or through not being able to have a baby. Women are murdered because of it,¬†women kill themselves over it. And the first year postpartum is one of the riskiest periods in a woman’s life- where suicide is the biggest killer. Yeah, this shit matters. This is not trivial. ¬† The people I’ve spoken to most about parenthood have been men. It’s applauded for the dads to say how amazing it is to have a child, but for mothers, there’s ridicule. So what.

I can understand a distaste of the oddly consumerist and competitive side of parenthood. Who’s having the “easiest” pregnancy, to the easy baby, to the best pram, the milestones. That’s trivial. But sharing these things is part of the culture of parenthood. Part of life itself. ¬†Sharing the darker aspects- feeding problems, illness, relationship problems, postnatal mental health, postnatal physical health, sexuality, the huge shake up of your identity, your body, your mind (hormones are real fuckers), wifework and the distribution of labour and for some, regret- is only just beginning to find the light. And so it should. As I said, this shit matters. Motherhood is a feminist issue.

The whole experience has stripped me down and shaken up my values. I love my job, I care about my job, and I never thought for a second I’d not want to go back to work. I used to joke that I’d leave the maternity ward and go to the pub. ¬†But I would happily stay off to look after the baby. ¬†And the Daily Mail would write that shit as, “How Women Are Turning On their Careers for Babies”. Which is bullshit. I’m going back to work, and I’m not a different person. This is a new part of me, a new spoke on the wheel. ¬†It’s frustrating sometimes, exhausting often, but I never knew how easily it would come to love someone, to do those frustrating, exhausting things. How fulfulling it would feel to change a pooey nappy because it means I could kiss his toes and make him laugh, and how much joy I’d get in those tired hours. I had prepared myself for “not feeling it”. People warned me about it. After all, it makes sense. Here’s a person you’ve never met, you don’t really know, who, for a while, can’t give much back. It might take time to love them. And it did- about 10 hours. And since then my love has grown and grown to strain my heart against my chest, to spill into the world, to everyone in it.

And it frightens me. It terrifies me. Throughout pregnancy, I consciously tried not to connect. I felt at every stage I could lose it, and he could die. I tried to protect myself by keeping myself at a distance. Which is very hard when the distance goes as far as inside yourself. ¬†In the quieter moments with Robert on his nightshift I’d play him songs (him! It was him all along in there) and talk to him and feel his kicks in response. And it got harder and harder not to connect when I’d have my panicked morning frappucino (cold and caffeine, the perfect way to get your baby to move) and he’d give me a few pissed off kicks. But it was terror, almost constant terror.

I feel the same terror, mingled with bliss, never a hope of separating one from the other. I’ve sat, so many nights, with his downy head under my chin and cried over it. My fear of death has come back tenfold, because the absolute best case scenario is that I won’t see how my son’s life pans out. (Did my dad feel this way about us before he died anyway?) From both me and Robert, and through both me and Robert, there will come that inevitable terminal separation. Forever and forever from the one who I grew with my body. And that we will break his heart one day, and mine breaks over and over again.

Now my life seems to be measured in his days and weeks and months and years, and not my own. And it feels so very small. The grief is raw, and I try to centre myself. I grieve each clothes size, each little thing that was there that’s already gone- gone! forever! The way he’d sigh after finishing a bottle. Moro! Squealing with delight at Saturday in the Very Hungry Caterpillar. Not being able to reach Monkeys in his bouncy chair. Being so tiny, and now not so tiny. ¬†I used to think babies were hams. That’s the word I used- they’re angry and pink and wibbling. But every day! he does something new. He’s babbling now, giving us long lectures in his language we’re only beginning to understand. He rolled over this week and was so shocked he burst into tears. First, a second of silence, then he caught my eye and his lip began to wobble. I picked him up and called to Robert upstairs. This week, he also stroked a cat. He’s just noticing them, particularly fascinated by their hovering question mark tails. I held his hand- his tiny hand- and pressed it onto her fur. He unfurled his fist and began to laugh- a belly laugh (I understand that phrase now, as I held him he bellowed, and I understand that one, too). And it was utterly beautiful. This little moment of discovery in the world, and as near to death I feel I am sometimes, I am born, again.

That probably sounds evangelical, and I am, in a way. I can see why people worship their children.It’s okay to, as people. The problem is when we see them as extensions of ourselves, which they aren’t. From the second they’re born, they’re their own person. Which is frightening in itself, with all that being a person entails. I don’t know how I’m going to cope the first time someone’s horrible to him. When he’s hurt or disappointed. For the first few weeks I was afraid to take him to places I wasn’t sure were child friendly as I knew I’d disintegrate if I saw a tut, or someone mumbling about bloody kids. They’re part of our lives, part of our society. There are some places they don’t belong (we tried to take him to someone’s birthday dinner, thinking it’d be sedate, but I was on the train home 30 minutes later) but that’s okay.

Another reason why I cry is his childness makes me ache for mine. In as much as he makes me wonder and look at the world anew, my small self is huddled inside, nerves as exposed as my heart feels. When he cries- from hunger, or fear, or loneliness- I feel the fear and loneliness of my own childhood. I rush to make it right, to put arms around the lonely one, to wipe away the tears and soothe the fear. And now I feel every child’s fear and it means I can’t watch or read as much as I used to. It causes me physical pain. I find myself crying at the big things- news reports- and the small, FUCKING ADVERTS. (Fucking meerkat bastards). I feel like a layer of my skin has been sloughed off, and sometimes, I want the hardness back. Give me back my cynicism (it’s still there, somewhere). It’s agonising sometimes. Sometimes too much.

I’m not always walking around in a blissful daze. He can do my head in, too. The sheer relentlessness of it is a shock. This person (person!) is utterly dependent on you and it’s so daunting. And grinding. I miss the days of not worrying whether cot death has taken him (my head plays these awful scenarios, screaming), or worrying that something else will (please don’t take him, take me instead). Today, he was driving me up the wall. He’s going through a Baby Phase, you know, baby stuff. More of the mindblasting world to make sense of. I set my alarm so I could be there when he woke up (as Robert sleeps with him, not me, due to medication). He gave me this gorgeous smile and started kicking his legs excitedly and laughing. Which was a good start. And proceeded to go through the day refusing to nap, going on baby lectures, hating to be held, wanting to be held then hating it, lots of bottles, and a three hour battle to get him to sleep.¬†Then he does that thing- that melty heart thing which is why you eventually don’t care, have a second wind and want the whiny exhaustion to last forever. A three hour bedtime and finally get him to lie down, pick up a book and he coos in anticipation, holds his hand out for me to hold, giggles and makes cute noises with rapt attention the whole way through. Then a few songs which he smiles at so much I gave up with his dummy. Lie next to him and he sleepily gazes into my eyes and rests his little hand on my cheek. What a babe. ¬†This was the book.

book

It’s given me more love for everyone, and unlikely allies have emerged. People I didn’t know really cared have been on the end of Twitter, Facebook, a phone, with blankets, toys, little hats, clothes. He’s bedecked in the love and the kindnesses of others, and it’s beautiful. He’s an adored and doted on nephew and grandchild. It’s given me a new love for my husband, too. He was amazing throughout my pregnancy, throughout the labour, and he’s a wonderful father. Utter, utter gentleness and love, and pride. Watching them together is a delight. Just him talking- about any old thing- makes¬†Ois√≠n giggle and whoop with delight. He smiles so broadly when he sees him, they adore each other. Robert’s better than me at taking him out, he shows him the world, shares with him so many things. He’s going to be the stay at home dad, and it’ll be hard. The whole stay at home thing isn’t set up for fathers. But what a role model he will be. He’s just a baby, just a child, but the world will try to teach him he’s a boy, and what a boy is supposed to be. And Robert will be there to teach him that a boy can be gentle, and kind, and loving, silly and emotional, as so many boys are, but told they shouldn’t be. He will grow up with the very best boy to teach him. And I hope I can do teach him well, too.

So, my little baby, when you can read, and if you ever read this, I love the hell out of you. Sorry for the sort of swear word but I’m sure you’ll have heard a lot of those by now. It’s because you’re half Irish, and this is our punctuation. And I’ll love you, whoever you are (and I’m getting an idea, my curious, giggly, reachy little Bean) and whatever you do. Nothing you do will ever make me not love you. You’re pretty ace. Now go back to sleep. xxx

PS: I don’t read trashmags anymore. They make me cry.

My Birth Story, The Bipolar Birth Plan Was Bullshit and The Stigma Of Mentalist Mums

So, this is a two part blog, covering two different topics. For they are different! This blog will be about how that whole well thought out, “bipolar birth plan” worked out. And the second will be about new parenthood in general and the feeling of your skin being stripped off your body. It’s too much to cover in one blog.

First, thank you again! Always thanking you, you considerate bastards. Thank you for your emails, comments and congratulations. I haven’t responded because I only have one hand these days. My lap is marked Occupied, which makes it very difficult to blog. I do tweet a lot- you can find me over at¬†ms_molly_vog. Twitter, like food, is a one handed affair. Add me!

How did that, “bipolar birth plan” work out? In short, it didn’t.¬† Absolutely nothing went to plan,¬†including the thing I took utterly for granted- my son exited via the sunroof and not my vagina. Lesson 1: Don’t have a plan!

The, “birth story” bit is largely for my benefit and it’s quite long! You can navigate thusly…

Part 2: Why bipolar birth plans are bullshit, breastfeeding woes, and encountering prejudice and stigma from a midwife on the postnatal ward

Part 3: How things are now, 11 weeks on.

Exit via the sunroof

I’d been booked for an induction on Thursday, but was so very unwilling. By that point, I was feeling unexpectedly traumatised from two sweeps. A sweep is when a midwife sticks her hand inside you and sweeps membranes away from your cervix to initiate, or speed up, labour. I had been pretty nervous about giving birth but was so fed up of being pregnant (I went to 41+6 in the end!) that I was sanguine about it. From the first sweep onwards, I found myself sobbing every day. I was so very desperate to go into labour naturally, with a longing that shocked me. I pushed the induction back to the Saturday.

On Thursday I started getting strong braxton hicks, though I didn’t know it then. I thought it was the real deal, and scoffed at the whole, “contractions are like your body being wrenched in half”. This was a piece of piss, but not piss-enough for me to sleep. I didn’t take my medication as I had images of me falling down the stairs in the dead of night and slurring in the back of a taxi, unable to properly understand what was happening.¬† I wanted to be completely present.

On Friday, the real deal happened. Contractions, which, it turns out, are indeed pretty fucking painful. All day, on and off, then suddenly they ramped up in the night (I like to say triggered by my friend’s funny tweet. I told him it had made me go into labour and he didn’t believe me). Excitement, and relief! It was happening naturally! Soon I’d be in the labour ward huffing and puffing and purple and beautific and then waaah a scream and there we go, job’s a good ‘un. Of course it didn’t happen like that.

Last bump picture. Bye bump!

Last bump picture. Bye bump!

As I mentioned before, I was with a team who care for women who are having home births, and also women with mental health conditions. Gold star service, and I can’t thank them enough. You get a pager number to call when you’re in labour. All I was having at the time were contractions- no dramatic, The Shining-esque gush, a pitiful bloody show (more a fecking matinee). But they were pretty bad, and we were timing them. Lots of dashing around, packing, tea-making, laughing (me), swearing (both). When they were 2 minutes apart, we tried the pager number. And tried. And tried. And it wouldn’t connect. (This is thanks to giffgaff, not hospital). ¬†Rang the labour ward and they caught one of the Brierley midwives on shift, and she made her way over, an excruciating hour wait. She arrived, examined me (1 of ELEVEN exams to come)- 1cm dilated! Did some breathing exercises with me, which helped. Lots of arse-in-air, head-on-hands. Had a shower (ace).. I couldn’t go to the labour ward until I was 4cm, so¬†off she went apologetically¬†and I stayed at home. Had a glass of wine, attempted to watch Wayne’s World on Netflix. Had a bath (useless) with Robert rubbing my back, tried (ahaha) to sleep, while Robert slept soundly next to me, my rage at him mounting with the pain. SLEEPING BASTARD.

Day 2 of no sleep.

Saturday morning, the day of my scheduled induction, and I’d been having frequent contractions for about 18 hours. I couldn’t take any more. I rang the labour ward and told them I was coming. I knew I wasn’t dilated enough. I couldn’t phone a taxi, I felt horrifically vulnerable. I was mooing, sweaty, smelly. The thought of trying to hold myself together in the back of a strange man’s car made me weep.¬†In desperation I asked Robert to call my friend Ellie who had a car and to beg her to take me to hospital, Thankfully, she was free, and she did. At 10am, a shock of pain over every bump, staring out the window, past Norwood, Tulse Hill, finally Herne Hill, the crawl towards the hospital. Two hefty suitcases- one for the baby, and one for me, since we were booked in for a long stay. Trying to find somewhere to park, a good luck wave and we were in. Robert in his good luck Word Up t-shirt. (Incidentally, Word Up by Cameo is a song we listened to a lot when Ois√≠n¬†was in the womb. Consequently, it’s one of the only things that is guaranteed to make him stop crying. Proof:


)

Thankfully, Kate was on the morning shift (after being on call the night before and coming out at 2am! Trooper) and congratulated me on holding out for so long and asked if I wanted an epidural. FUCK YES. Always say this to this. I think I would have been more hardy had I not slept for now more than 2 days and she was fully aware of that. I also didn’t take any medication in this time, worrying I’d be out of it for labour (and they said later they don’t think I could have given informed consent to a c-section- something to think about, mental friends). Until then, though, I had gas and air. Gas and air is a beautiful thing. I huffed more than I really needed, giggling my arse off while the room was set up. Music on (we had a birth playlist- that didn’t work out, either), snacks out, and Kate went to change into her scrubs.

Once the epidural was in, I put make up. I seriously thought I'd give birth with this face. Ahaha. No.

Once the epidural was in, I put make up. I seriously thought I’d give birth with this face. Ahaha. No.

The epidural was pretty frightening. I was giggling (part gas and air, part euphoria as I’d waited an hour and half for it). Siting the needle was quite scary. I was too afraid to move but still making quips, until the anaesthesia went in. It’s a feeling I can’t describe, as though half your body is being chalked out of existence.¬† A wave of panic swept over me, a feeling that I was losing control. I held onto Robert’s arm, pleading eyes and I knew that was pretty difficult for him. Once it was in, though, it was great.

Then became the second of FUCKING ELEVEN vaginal examinations, each more hideous than the last. You can refuse them, by the way, but there was no reason for me to. I sensed I wasn’t really progressing, and my waters hadn’t broken yet. But the baby was fine. I was on continuous monitoring so I could see that.

To speed things up, they decided to break my waters. They use a little hook, and the first attempt didn’t work. The second did, and from there things became simultaneously frightening and really boring.

They broke, not in a gush but a trickle onto the giant maternity pad I was lying on. Clear, so that was good. Things weren’t so good with us, though. The baby’s (baby? There was really a baby in there, all along?!) heart rate became to drop on and off.¬† My temperature and pulse were soaring- my pulse was so high they were having trouble telling if it was his heartrate or mine. I start to feel pretty unwell and my catheter is tested, there’s protein in my wee. I had various blood tests- my veins are terrible, so this was more painful than the contraction I was no longer feeling. Many, many, each making me more hysterical than the last. I was losing my good humour as they stuck a needle into my thigh in the end. Off the test goes for pre-eclampsia. It was negative- I had an infection and so now did my baby.¬† It might have¬†sneaked in when my waters were broken. It’s called chorioamnionitis- an infection of the amniotic fluid, but infuriatingly they never told me what it was infected with.

Another IV- this time, antibiotics. They put me on a Picotin drip to speed up the contractions to get the Bean out. Hours and hours pass. More and more examinations. I am progressing though- in the end, I actually made it up to 10cm, but there was a cervical lip in the way, and Oisin was twisting and turning inside, going from his perfect LOA position to who the fuck knows.¬† But he’s getting distressed. His heart rate plummets and I find myself flat on my back, surrounded by doctors, crash button hit, preparing to be taken for general anaesthetic for a category 1 section. Robert is in scrubs, and I am sobbing. But it recovers. Calm comes back.

C-section chic.

C-section chic.

I’m not allowed to eat or drink in case I need an emergency section.¬† Robert puts a mattress down in the bathroom and goes to sleep. I can’t sleep- my utter, ridiculous dependency on my medication fucks me again- so I try to watch a film on my laptop and chat to the midwife- the second one- Alex. More doctors come and look up my vagina. At this point I’d kick them in the balls if I could just move my deadweight legs. But I’m not in pain, except for the odd breakthrough where I use gas and air (and I was huffing it anyway to amuse myself- Robert took a sneaky few puffs when the midwife left the room).

Good shit.

Good shit.

Midwife number three comes on shift. My exhaustion is beginning to flatten me, on day 3 of no sleep- she prepares cold towels for me and rubs my arm and chats to me in the low light of the labour suite. I switch positions often- my left side being best for labour but worse for me due to the drips and epidural, which I am terrified of coming out. I can feel the tightening of contractions, know there is a black world of pain beyond the epidural. I play with the bed controls to try and sit up and feel pressure down below- hoping, hopes dashed- that I’d need to push soon. I hadn’t eaten or drank in 15 hours and felt shaky from hunger. Fluids were being pumped into me and I could sip water but lack of sugar coupled with intense tiredness was killing me. ¬†I’d started to vomit at about 8cm so that added to the fun.

They got the baby on an ultrasound and he was back to back (was nice to see him one last time on the ultrasound- I can’t believe it was him in there, all along). The last little bit wasn’t going to come away, and his heart rate was dipping, up, and down, from stress and sickness. The consultant came in and told me we had to do an emergency cesarean. I cried, and snapped at him when he started talking about, “normal birth”. One third of women have these, it’s normal. I felt weighed down by failure and utter terror. Robert was petrified too, kissing me, apologising for all the wrong things he’s done, for not being perfect, thinking, and me too, that I’d die, and our baby would die. I signed some paper work outlining all the risks, each one I felt certain would happen to me. And then I was wheeled to theatre.

It was a bit of shock, the white white lights away from the timeless darkness of the labour suite, the busyness of the place compared to the intimacy of before. I saw it all flat on my back. They put my arms in a crucifix position and topped up the epidural. They tested it by seeing if I could feel the coldness on my abdomen. They described what was going to happen, but I was gibbering from terror. I’d had few of the warned side effects from the epidural up until this point- a mild headache, that was it- but the top up made me shiver uncontrollably. I think I was in shock, too, thinking that this can’t be happening. Robert was next to me, holding my hand, telling me he loved me.

They asked me if it was okay to have the radio on- it was, I can’t remember what was playing, something cheerful. The screen was raised so I couldn’t see (I kind of wish I could have! I watched a video of another c-section on Youtube to see what had happened) and away they went.

This was Sunday morning. I tried talking to Robert but, well, it’s hard not to be distracted by someone opening up your insides. Tugging, pressure, but no pain. Then he was out- I didn’t see him, which I regret. No cry, not for a minute or so. He was whisked away and then he cried. Relief! He was born on 1st March at 11.24am, 25 hours after I’d gone into the hospital. ¬†7lbs 12oz of loveliness.

IMAG0919 IMAG0922 IMAG0925

I couldn’t move, obviously, so Robert up to see him. He said he kind of looked at him, like he knew who he was. After a minute or two they bought him over to me. And I wish I remember what I felt the first time I saw him, but I don’t. I don’t remember these photos being taken. I look happy- I’m sure I was. I was just so exhausted by this point.

They stitched me up and then we were taking our separate ways. No immediate skin to skin or breastfeeding, which even now makes me want to cry.  But he had to go to SCBU- we were still suffering from an infection and he needed antiobiotics. Robert went with him, and, so soon, already, we were separated. Off to the recovery ward I went, feeling overwhelmed and a bit confused. I had a baby.

Postnatal- why bipolar birth plans are bullshit, and encountering prejudice on the postnatal ward

So, I’m in the recovery ward feeling like I’ve been hit by a bus. They told me to rest (3 nights, 4 days without sleep now), which I didn’t. After about an hour, they bought¬†Ois√≠n¬†back. With some help from midwife Sue, we breastfeed and had a bit of a cuddle, and it was lovely.

The bipolar birth plan had specified some key things, remember. Thing 1: private room. Thing 2: Robert to stay with me. Thing 3: I get some rest. Thing 4: Minimum 3 day stay.

There’s a fundamental flaw in the whole plan- you’re never alone, and you’re not allowed to either leave the ward nor take the baby off it.

Thing 1 we got. It was a tiny side room at the end of the (huge) postnatal ward. But there was nowhere for Robert to sleep, not even a blanket for him. I don’t expect hospitals to be hotels, but this was in our plan, we were being forced into this. So Robert called his brother for help (and this is why I mention it- what if we’d had no family, no friends to help?), and he came with an inflatable bed and a blanket for him. I sat paralysed, bleeding and cathaterted up, and not in the mood for visitors (who I banned totally from the hospital). Ois√≠n was in a plastic cot in wheels, like a chicken in an incubator. Twice a day, he’d be wheeled up to SCBU for his IV dose of antibiotics. We’d be staying until he was clear of infection, which could be up to 10 days.

The first night as parents was hell. People kept commenting on Facebook how amazing the first night must be, when we were both in tears and feeling as though we were going mad. We were interrupted CONSTANTLY by staff, for various reasons. Checks, OBs, intrusions. The whole, “stay here to get rest” part of the plan was dreadfully ill thought out. Because a) we were always having someone knock at the door and I was woken up often and b) two people in the room are still in a room with a crying baby, and it’ll wake both of us up. ¬†None of us got any rest. I ended up, even with my medication, getting only four hours of sleep after now 5 days without any. Robert was exhausted, too. ¬†Nobody ever knocked, including the cleaning staff and food people, while I lay on bed, tearful, with my breasts hanging out struggling to breastfeed. I was confused every time the baby cried, a totally alien sound to me. I kept forgetting I had a baby, and I was paralysed from the epidural and couldn’t get up to help him. It took me a few days to comfortably lift him from the cot.

Perinatal psychiatry discharged me after the second night on the ward, with no concerns. They were bollocked by me and Robert, who told them we couldn’t understand how they thought that trapping someone on a ward, in a room, with constant intrusions, was in any way going to let them rest. There was a bit of back and forth, but basically, the psychiatrist admitted it wasn’t the best plan. Once I left, my nurse would come to see me weekly (now fortnightly).

I couldn’t leave anyway- we had to stay until Oisin was free of infection. I was on fairly heavy duty myself- a regime of antibiotics, nightly clexane injections and diamorphine for the pain. ¬†The pain was fine, as long as I kept on top of it. On the second day, I bounced around like Willy Wonka and sorely (so very sorely) paid for it by being immobilised the next day.

I had reasoned with myself that the plus side of being on the postnatal ward so long was that I could get lots of breastfeeding support. Hooray! But the support was crap. Hooroo.

The first time we breastfed was, as I mentioned, in the recovery ward, after being separated for more than an hour. A midwife in the breastfeeding cafe later said this might be a reason we had problems, which made me cry. But that time wasn’t too difficult, and it felt lovely. It made me feel spacey and relaxed. I chased that ease and feeling for the next three weeks, before giving up.

My supply was fine, great, in fact. The problems we were having were that it was hard to get him to latch, and I was in a lot of pain from the surgery and struggled to find a comfortable position. What I should have done, and what nobody ever told me I could do or helped me to do, was to basically stay in bed naked and do skin and skin a lot, to let him find his way, and to express and feed him that. Instead it was a few hellish, uncomfortable days of increasingly feeling like a complete failure and giving him formula in begged bottles.

I asked for a lot of help on the postnatal ward, which mostly consisted of people shoving my breasts into his screaming mouth. ¬†The last time I asked for help was on our last night there. I’ve found out in my notes (which I got in my “traumatic birth” debrief) what happened behind the scenes.

The night shift midwife came on and I asked if we could have a bit of support breastfeeding. I wanted one last good go at it before we were leaving. She said to set an alarm for the baby’s next feed, which was in 45 minutes, ¬†so I did. 45 minutes passed, the alarm went off and I wandered out to let them know. Over the next hour or so I tried again and again, while the baby got increasingly hysterical from hunger. They kept telling me someone would be with me, and an hour later, they came in. ¬†They told me they’d been on holiday so didn’t know these “new” positions (I’d asked about rugby hold, which was the comfiest position we’d tried) and only knew “cradle hold”. Which we tried, but it was futile because he was screaming his head off, and then started kicking me in the scar. I was fairly pissed off and exhausted and said to leave us alone. ¬†One of the worst feelings in the world is trying to feed your baby, and not being able to. ¬†I was a bit rude, but no more than any new, exhausted mum.

The next day, without warning, while I was quietly sitting on the bed with the baby, reading magazines, my perinatal nurse walked in. ¬†She said the midwife (who hadn’t once approached me herself) had rang them to tell her to come straight away because I was, “hyperactive, chaotic and abrupt”. It should be said that previous night I’d slept better than any other- I was asleep by 1am, after I’d made a cup of tea.¬†I guess, though, because I have bipolar disorder, that was, “hyperactive and chaotic”. As for abrupt- I’d barely slept for 10 days. Robert was pretty abrupt, too, but because he’s a man without a diagnosis, I guess he was just “forthright” instead.

I have my maternity notes, as I’d had a traumatic birth debrief. I’d thought the reason the midwife had called the perinatal team was because of my “abrupt” manner towards the (useless, rude) maternity assistant. Possibly, as they’d written down that I was very angry and “not being patient” (waiting for an hour more than your baby needs while he screams will make one impatient)- but what was more significant is that she’d noted- twice- that I had self harm scars. SIX YEAR OLD self harm scars- CLEARLY not new, and most clearly not new since the last fecking time she’d noted them. One of her notes was that I wasg with the baby with self harm scars. A new mother, holding her baby! I wore a cardigan anytime I left my room, but was wearing a vest top in my room, as it was roasting.

It’s clear what’s inferred, and it’s clear why she called my perinatal nurse. It’s that she didn’t trust me with my baby, because I had a diagnosis and scars, and because if you have those things, no matter what you do, your behaviour will be pathologised.

The perinatal nurse was, thankfully, bemused. I was so clearly fine- tired, grumpy and desperate to go home- but fine. She asked Robert if he was worried and if I’d been okay. Because you can’t trust mental people to tell the truth. Nor women. Robert said I was fine but that he was angry about the constant interruptions and had been going mad himself, and that we just wanted to go home now. But what if he hadn’t been there? Would I be on my way to the Mother and Baby Unit? (One of my midwife team agreed with my perspective on this, and said sadly, I was always going to face these issues from ignorant people).

The nurse had no concerns. And I have to emphasise here for anyone going, “but, but, but” that I was geniunely not acting in unusual way at all- I was tired, but, apart from to the maternity assistant- in good humour and polite. There was no reason for them to call. The experience shook me and I felt very upset. I felt like I’d been doing really well and realised that, forever, I was going to be judged upon having scars and diagnosis and that this midwife won’t be the last person to think I was a danger to my child. I place part of the blame for why I failed with breastfeeding at that midwife’s feet. After that, I was worried about showing any sort of annoyance or impatience in case they thought I was mad and called the perinatal team on me again. And ultimately, I did fail. I was with the midwives postnatally for 4 weeks and on the third, getting help every time but not cracking it, the baby hungry and me exhausted, and sick, sick, sick of being touched, I said, enough. Stop. I had only intermittently managed it with him and was expressing every hour. I’d had it. ¬†I still feel like an utter failure for it, I still grieve for not breastfeeding, but I was beginning to dread every time he woke up. It hasn’t affected my bond with at all- I don’t think I could be more bonded with him if I put him back in my uterus. I adore him.

But me and baby both infection free meant we were discharged later that day, hooray! We played him this and both cried:

Now

Robert’s brother drove us home- it was a full moon that night.

So, eleven weeks in and I’m good. I’m still trying to make my peace with failing to breastfeed, but he’s thriving, which helps. He’s amazing- I’ve become one of those boring bastards who Facebooks their child’s every fart, but they are such lovely farts. He’s a smiley, happy, beautiful little thing.

(Despite having to attend 2 funerals before he’s even 2 months old- the first of my granny, the second of Robert’s. From 3 great-grannies to 1, within 2 weeks).

Mentally, I’m okay. I’ve been having a bit of resurgence of my anxiety. ¬†I worry about things happening to him and get some frightening intrusive thoughts. My death anxiety has come back, because a baby makes you even more acutely aware of your own mortality than before. I’m coping with it, though. I’m struggling a lot with my medication and wish I was off it but my team don’t support that in the slightest right now, and I’m worried about doing anything, “wrong”. Robert does all the night feeds, as I’m too drowsy. I did try, and dropped the bottle, and him. I feel quite useless sometimes, but coming off it will entail brutal insomnia so I guess now isn’t the right time. I see my perinatal nurse every fortnight and she’s been hugely encouraging and supportive. I’m glad she’s been there. The midwives who were with me pre, during and postnatally were also amazing, and I’m making them a nice card (because I’m 5).

And c section recovery wasn’t too bad. Pain and stiffness and weird bladder numbness but mostly fine now.

I have a whole ‘nother blog about parenthood, so I’ll end this one now at- fuck me, 4500 words! I bet your screenreader is steaming. Here’s some cute baby pics as a reward for sticking with it!

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Today!

Today!

Today!

Today!

Today!

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My Big Fat Bipolar Pregnancy 2: A Video Blog on “The Birth Plan”

…or perinatal care plan.

Whoops, this is 2 months late, I’m sorry! I didn’t want to just leave the last entry hanging, but I’ve had horrendous writers’ block on this subject for reasons I explain in my very first video blog!

I am as shattered as I look. My first go was much better but Robert walked in in his pants. This video talks through, “The birth plan” that was coming up in my last entry. So, I explain what perinatal psychiatry would like to do when the baby comes, and my feelings on that. And if the baby ever comes- I’m 40 weeks and three days now!

I hope you find it helpful, please do share if you do, there’s not a lot of talk on this about.

My Big Fat Bipolar Pregnancy- feat. the perinatal psychiatry team and The Fear

Mental illness isn’t the bogeyman.

I’ve been quite quiet here. It’s not as though I haven’t been trying.

See?

See?

Those drafts were mostly interrupted by bouts of exhaustion and blankness. I’d tried to write something funny and light,¬†but it felt quite forced.

What’s prompting me to write today is the heartbreaking death of Charlotte Bevan and her four day old daughter, Zaani.¬† What’s known is that Charlotte had a history of mental health issues- namely schizophrenia and depression, according to her family- was severely sleep deprived and had stopped taking her medication as she wanted to breastfeed. She left the hospital in clinical slippers without a coat, her baby wrapped in a blanket. ¬†They both died, in this freezing December, near the Clifton Suspension Bridge, a common suicide spot.

I’m not going to speculate. I’m not going to say that I recognised- viscerally- the hollowness in her eyes as she walked past a series of CCTV cameras. Nor wax, too much, about my own terror of visiting that lonely place. ¬†I’m not going to pontificate on mental illness or womens’ agency, paternalistic attitudes or breastfeeding. ¬†I’m not even going to post a screed on the woeful provision of perinatal mental health services in this country.

Hint: areas in the red have no perinatal mental health provision. I live in an orange bit.

Services and support which should be available everywhere- to every woman- who is pregnant or has given birth.¬†I’m not going to talk about the senselessness of this when a woman’s risk of suicide is highest in the year postpartum. Nor that it’s any woman- not just a woman with a known history of mental illness.

So what I’m going to do instead is tell you- maybe selfishly- about my own experiences of being a pregnant woman with bipolar disorder, whose mother had postpartum psychosis, who is therefore under the perinatal mental health and considered a high risk pregnancy. ¬†I’m going to explain how that feels for me, and about the kind of choices I’ve had to make. ¬†I’m going to talk to you about what’s happened to me since I peed on the stick and found out I am expecting a son (not a daughter- that was a bit of surprise at the anomaly scan. I have grown a penis. Whole other blog in that and how I shamefully have far more gendered ideas than I thought I had).

One of the reasons I’ve kept my pregnancy related bibblings confined to my Twitter and Facebook is because this blog is, and always has been, a mental health blog. ¬†And my mental health has governed my life for the past decade. Every major life event has been impacted in some way. I only got 7 GCSEs because I had a breakdown. I was then kicked out of college because I was a rambling, nonsensical whirl of mania. I moved to London in its midst. My father’s death was followed by my admission to hospital. A series of job losses, four years on benefits. I dropped out of my mental health nursing degree partly because I had become suicidally depressed. The good stuff, too. I won an award for a play based on this blog. Not me, and not my life, but my own fractured narrative of mental illness. I’ve had writing opportunities because I write about mental health in a way that people enjoy and relate to (thank you). But that’s all anyone has ever really been interested in about my writing. Or about me.

Here I am, pregnant. And it’s such an abstract thing, though increasingly less so over the weeks. 29 have passed- from a feeling, a line, a long stretch of sickness (which is also why I have been more comfortable with the microblogging of Twitter- constantly vomiting and general exhaustion doesn’t render you the most capable of stringing together a….se), to now experiencing flutters and rolls and bumps. It’s still so strange to me that this “being pregnant” will become, “giving birth” (argh!), to a newborn, a tiny little stranger, who will become my son, and I will become their mother. And they’ll have words, mannerisms, be a sovereign human being in their own right, have memories of me, and I’ll have memories of them. Hopefully one day we’ll talk about them together. And they’ll have a name.

And this is mine. It’s all mine.

It doesn’t belong to a doctor, it doesn’t belong to a CPN, a diagnosis, a theory, a plan, a pathology, a movement. It belongs to me, and to my husband, and to the people we love who are sharing in this with us. ¬†Of course, it’s pregnancy, a highly medicalised event. It has its own language, it’s own pathology, its own plans. But they have been so reassuringly, wonderfully, vividly familiar to me. Here is a path my mother walked down. And you. And you. As disempowering as the experience can be, as lonely, as radicalising to my feminist ideas of myself as a woman and a female, it is ordinary. ¬†It is so ordinary that when I vomited my breakfast in a yellow arc onto the black and white tiled floor of my local cafe, the women who worked there didn’t flinch. “It’s okay, we’ve been there, we remember what it’s like”. I felt part of some great tradition, and here was the initiation ceremony.

But Charlotte Bevan’s tragedy can’t help but make me think of my fear of the future. ¬†I haven’t been the perfect pregnant woman by a long stretch. She is slim, she eats organic food (except eggs, cheese and raw fish), she doesn’t drink, nor smoke, nor get stressed. She does 30 minutes of gentle exercise a day (maybe yoga or pilates), she doesn’t dye her hair nor pet her cats. ¬†She doesn’t take any medication, not even for one of the numerous headaches she’s likely to have. She does all this not just because she is told to, nor because she is “good”, but because she became a mother at the moment of conception. She’s the selfless mother, the ideal woman. She’s not a person but a habitat from when sperm meets egg. ¬†That’s the perfect pregnant woman, and she’s still not perfect enough.

I am so far from that ideal that it’s hard not to feel like a failure already. I’m obese from years of psychiatric medications. It doesn’t matter that I have no weight related problems (as rigorous testing, hypotension and seemingly endless urine and blood samples will confirm). It was enough for me to be told, almost accusingly, that I WILL get gestational diabetes and pre eclampsia and that they’ll need to keep an eye on what I eat (which was pretty easy- just check the floor of the train at Tulse Hill station). ¬†I smoked and drank, I drink more caffeine than recommended because for half of the day I am in a fugue from the antipsychotic medication I’m still taking. I get stressed and more than that, I have a diagnosis of mental illness, I am struggling to exercise due to exhaustion and I cuddle my two silly, wildly affectionate cats. I don’t feel like a mother yet, and I wonder when I will. I don’t think in terms of, “little angel”. ¬†I didn’t undergo some sort of transformation as soon as I became pregnant. I still haven’t.

I have been reminded so frequently of my own imperfections as a woman that I have felt that my, “maternal habitus” is a cesspit. I have, at every stage, thought, “This is when I lose it”. Blighted ovum, then miscarriage and now I’m petrified of stillbirth, after that, it’ll be SIDS.¬†So I’ve been afraid to bond with the little Bean in there, even though he’s growing wonderfully, booting away and, usual pregnancy niggles aside, I’ve had a pretty easy go of it. ¬†The anxiety has at times been so bad that my psychiatrist has added a brand new diagnosis to my pregnancy notes- generalised anxiety disorder. ¬†The anomaly scan was supposed to be a turning point, and it was. ¬†It looked like they had a rare and serious birth defect called esophagal atresia. We spent the next few days, waiting for a rescan, in a fog of terror. My husband ran ahead from me as we returned from hospital to hide the little leopardprint coat we’d bought them and to put away the box of baby stuff that had been donated to us. ¬†All our images of taking our baby home after the birth, the mundanity of feeding and changes, were replaced with immediate operations, long stays in the NICU and a possibility our baby would have a potentially life-ending chromosomal disorder. (The rescan was clear. Subsequent ones have been, too, but we still can’t relax).

As much as this does not belong to mental illness, mental illness does belong to me. I can’t, as much as I want to, separate that from the seismic physical and emotional changes I’m going through right now. ¬†The problem with being in the mental health system for a long time is you’re told so many different things are wrong that eventually, you believe nothing is. And you can be a bit shocked when others don’t share that belief. ¬†Initially, I resented their intrusion. Imagine what I would be writing if they didn’t exist in my area.

In the beginning

Due to the, “holy fuck, what is this, am I dying” nausea I experienced until 23 weeks, I knew i was pregnant pretty quickly. I got a positive test at 5 weeks. The first thing I was worried about was my medication- I had no idea if it was safe to take, but also no idea how I’d cope without it. ¬†The first few weeks were the hardest emotionally. We’d just been told we were being evicted and had to find somewhere else to live. That stress coupled with the (happy) shock of being pregnant and the hormonal surge meant I spent the first month oscillating wildly. But it wasn’t really anything unusual- it was a reaction to the situation we were in and biological fuckery. (What is unusual for you? Write that shit down now. Give a copy to¬†the people close to you).

I went to see my GP, who congratulated me, said she couldn’t definitely advise me on my medication and referred me to the perinatal psychiatry team. ¬†She told me to continue to keep taking my medication, and so I did (and still do). ¬†At the moment I’m only on Quetiapine, which is an antipsychotic. ¬†She didn’t seem fatalistic or concerned, which cheered me up. I’ve written before about some of the fears I had about pregnancy. Mostly, they’ve been unfounded, but I’m still afraid.¬†

The perinatal psychiatry team

Midwife number 1

Risk, risk, risk. You have a high risk pregnancy. ¬†No fancy home birth for you (fuck that, I want TEH DRUGS). Your BMI is over 30, you’ve smoked and you’re mental. The midwife took my history as I shrank into my chair. She wrote, “SLASHES ARMS SINCE AGE 14”, something which shocked me so much I asked her to correct it. It’s inaccurate- I haven’t self harmed in 5 years- and the word, “slash” is such an ugly, deforming word that I didn’t want associated with me, or my pregnancy. She apologised and changed it, saying she wanted me to be comfortable.

A few weeks later, wearing my Baby on Board badge with my sleeves rolled up in the sweltering heat on the tube, I saw people clock- with disgust- my scarred arms and the badge. And realised that I now have the rest of my and my child’s life with this. Flashes of bringing them to the swimming pool and being stared at. School gates. Grief.

Fuck ’em.

The perinatal nurse 

I had to give a different history to the perinatal nurse who came to visit me at home. This was the story of my life, told, lightheaded from nausea, in my garden. It was summer then, and we were just getting settled into our new flat. Robert was asleep upstairs after a nightshift. ¬†I offered tea, which she refused. ¬†She has that light, almost incredulous way of speaking that some mental health nurses do. I’m already familiar with them- I did a few days with the perinatal nurses when I was a student, and they seem altogether more gentle than their CMHT counterparts. She said, “Oh, what a lot you’ve been through. It’s no wonder you’re so anxious and worried about getting attached”. At this point, I was correcting people who said, “You’re having a baby!” with, “No, I’m pregnant. It’s different”. ¬†I wasn’t really sure what to say to that. I know people mean well, but my life hasn’t been¬†that¬†bad and I don’t like it when people head-tilt (the IRL version of¬†italics)¬†or feel sorry for me.

She taught me some breathing exercises for panic attacks (my panic attacks abated somewhat for a while. Being so busy does that. They’ve returned a bit lately) which don’t seem to come close to controlling the death terrors I experience at night, and made an appointment with the psychiatrist for me.

Before she left, I felt like I needed to ask.

Will I be referred to social services?

Midwives can sometimes be a little cautious with women who have mental health issues, she admitted. But no, the midwife hadn’t made that call. “Are you planning to?” No, not at the moment. If we’re worried that you might need more help in coping then it’s something we can talk about.

I still haven’t been referred, though my psychiatrist admitted that when I called them (having to reschedule that first appointment as I didn’t receive the letter with the date), they had considered doing so. ¬†But I am coping, and if I continue to, good. “Will they take my baby away if you call them?” No, that’s not what they’re there for. Sometimes, we can need a bit of practical support. ¬†We want to keep you and baby together, not separate you. It’s usually better for both mum and baby to stay together. We’re here to support you in staying well.

While I’m glad I didn’t get an automatic referral, I know this¬†may be partly due to my diagnosis. My perinatal psychiatrist believes that bipolar I disorder is the right diagnosis, and that’s what we’re working with. I tend (these days) to be okay for ages, then get kicked right up the hole with it. That’s where the, “risk” largely is- bipolar disorder has a high relapse rate during pregnancy, tricky management and is more likely than depression to lead to postpartum psychosis. My mum also experienced psychosis after birth, which kicks my risk up past 50%. So, it’s a pretty shit diagnosis to have during pregnancy. It does have an advantage- throwing medication at it can work quite well (as long as you aren’t stupid enough to throw just an antidepressant in there)¬†Everyone’s different, but depression, mania and psychosis generally have quite obvious triggers, and well tested treatments. ¬†It’s not more or less “real” than other mental health issues. There’s no, “real” one, really. We still don’t know what causes any of them, but some are viewed as more biologically based than others, and that makes them, if not easier, then more predictable to doctors..

Some women I know who are as functioning as I am, but who have a diagnosis of personality disorder, have been referred to social services.¬†¬† This isn’t fair, and I think it’s partly to do with the stigma surrounding it, and partly because it might be viewed as less predictable than bipolar disorder. It could also simply be their trust, doctor and nothing to do with their diagnosis. I did actually have borderline personality disorder as a diagnosis in the past, but it hasn’t been one I’ve ever been treated for. I don’t believe I have it, nor does the perinatal mental health team, who noted it was historical, not a concern and that I seemed stable. I felt like an arse for being glad about this. It’s partly due to the fact that when it’s flashed up on the screen in the past, I’ve had a lot of irrelevant, tedious questioning about self harm (not in years) etc. You may as well be asking me about a decade-old leg break.

But these means that women who have been referred and monitored very closely might have a different story to me. I’ve been largely okay so far, but that’s the shitpantsingly scary thing about mental illness and particularly mental illness in pregnancy- it can descend with terrifying swiftness and brutality.

The mental health midwives

When I was referred to perinatal psychiatry, my care was transferred from the community midwives to a specialist team called the Brierley midwives. They’re 8 community midwives who specialise in two things:

1) Home births

2) Women who have a history of mental health issues

I felt pretty smug as half the yummy mummies in East Dulwich want the Brierley midwives and I got them automatically for being mental! Some perks of the job, eh.

They’re a small team, split in two. So I essentially have 4 midwives. I have my named midwife, my first port of call. Throughout my pregnancy, I’ll meet all the rest in the team of 4, so when I go into labour, the midwife won’t be a stranger to me. That’s pretty good and a relief for someone like me who has been struggling with anxiety and likes to know things in advance.

I have the normal midwife appointments with them, but can also have a few extra if I’m nervous. They’re not trained in the same way mental health nurses are. They’re more holistic in their approach, and take care of your emotional health as well as the health of the pregnancy. They’ve been great, and are always very keen to let me listen to that lovely little horsehoof heartbeat sound. They’re not hugely different from ordinary community midwives.

The perinatal psychiatrist

The perinatal psychiatry team are situated in the same hospital as the maternity unit. It’s a rather unpleasantly long walk down a thousand blindingly shiny corridors that seem to swim and shimmer to the exhausted, teary-from-vomiting eyes. The reception area has always been empty when I’ve arrived. There’s only about six seats and my burgeoning behind means I need two.

I’m instinctively, defensive around psychiatrists. I’ve worked with them professionally so I know they’re human beings. Mostly, they’re also compassionate human beings. As doctors, though, they are drawn to the mechanical and the explainable. It’s sometimes disturbing to feel you’re a puzzle to be solved rather than a human being, too. They have so much power over the lowly mental that it’s extremely hard to let your guard down. ¬†This time was, at least, quite different from when I’ve seen psychiatrists attached to the CMHT. I hadn’t been summoned there like a naughty child to the headmaster’s office. I was well and there to take advantage of their support- conversely, it meant I was also a little resentful of having it forced upon me.

Alongside quite a few leaflets. I keep them in the living room for easy reading for us both. Got a spare minute with a cup of tea and want to terrify yourself?

Ta-da!

Ta-da!

Can I take psychiatric medication throughout pregnancy? Can I breastfeed?

When talking about medication, I told her that I’d tried to come off it numerous times but suffered such awful withdrawal (insomnia, itching, eventual quasi psychosis from sleep deprivation) that I’d always returned to it. ¬†She frowned and said Quetiapine didn’t have any withdrawal symptoms. As I tried to elaborate, she picked up a copy of the BNF and began flicking through it to disprove me. That was a strike.

As fat as I am due to it (Quetiapine doesn’t cause weight gain, she said. Strike 2! Tell it to the people suing the company that makes it for their diabetes), it’s the one medication that has helped me stay sane, and largely because it means I can sleep. I am a natural insomniac and very prone to hypomania and hyperactivity because of it. Getting regular sleep has been the lynchpin. Although I went into the appointment to argue my case for coming off it, I was secretly hoping she’d tell me it was okay and I should stay on it, as the thought of going through withdrawal and insomnia was unbearable.

She did. ¬†Quetiapine is a category C medication in pregnancy. It means risk can’t be ruled out, and it can’t be ruled out because it’s unethical to test on pregnant women. ¬†Case studies so far indicate the risks are gestational diabetes and diabetes 2 (I have been tested twice for GD- I don’t have it and won’t be tested again) which can cause a high birthweight. ¬†Confusingly, the consultant obstetrician (I get one of those due to being a high risk pregnancy), says it can cause low birth weight. So go figure. ¬†There’s also evidence that it can cause slight respiratory problems after birth, sedation and babies may be a little behind developmentally for a few months, but catch up. Their APGAR score is generally 9 or 10, which is great.

These are all scary sounding things and I’m still scared of them. I do feel a sense of failure and wish I was, “normal” and didn’t take psychiatric medication. I think about how sedated and dopey I am and feel a huge sense of guilt for what it might be doing to my baby. And because there’s no long term studies, I also have no idea what it’s doing to their developing brain.

But. I have to try and put my faith in…something. Myself to keep well, which cannot be done by willpower alone and especially not now. ¬†In the perinatal team. ¬†As much as she initially rubbed me up the wrong way (I warmed to her a lot in subsequent appointments. It’s never easy to go in and tell your whole life story to a stranger), she is the consultant and I trust her opinion. Most importantly, I’m being closely monitored- and so will Bean when they’re born and afterwards.

So, breastfeeding.

Breastfeeding is great. Boobs make milk! How mad is that? You’ve had them your whole life and then, when you’re pregnant (or taking Risperidone), they inherit this magical superpower. MILK! It’s food! Holy shit!

But some women’s boobs don’t make milk. Some women find it too uncomfortable, painful or downright weird to breastfeed. Some can’t, some don’t want to, and that’s all fine. Because you know what else is great? Making our own choices about our own bodies. Breastfeeding is not the be all, end all, and the medical establishment- and frankly, other women- have a lot to answer for in downright shaming women about breastfeeding.

It’s better than formula in some ways (and not as good in others- formula has added vitamins our bodies don’t make, formula is very convenient too). It does help with things like shrinking your uterus back (ping!) and as for bonding, I don’t know. You can still do skin to skin contact with a bottle and bond that way. Breastfeeding doesn’t give you nor your baby immortality. But I can understand why women- even if you sort-of discount that intense societal and medical pressure- really want to breastfeed. I do. I want to do to it because I haven’t done it before and it’s a new experience. I want to do it for the benefits it does have. ¬†I want to do it because it’s cheap and we’re skint. I want to do it because boobs, milk, weird.

The general blanket advice for women taking medication, particularly psychiatric ones, is don’t breastfeed.¬†Please get a specialist opinion on this if you can.¬†Some resources include Drugs in Breastmilk from the Breastfeeding Network.¬†¬†If you know someone who is facing this question who isn’t getting good advice, try to help them find it.¬†Because it’s a big one. Women are being encouraged- and deciding themselves out of pressure, desire, guilt, complex, personal reasons I would never want to judge or belittle in any way- to stop taking medications which are potentially keeping them safe and stable so that they can breastfeed. This is wrong. I don’t mean medically, I mean morally. Women should be encouraged to put¬†their health first. Believe me, I understand that, especially when you’ve struggled with your mental health, you so want to do the, “right” thing, the, “natural” thing, the thing to bond and connect. But formula is not going to kill a baby, whereas a relapse could kill the mother. That’s as brutal as it gets, but it’s true.

I got specialist advice from my psychiatrist who says I can breastfeed. A very tiny concentration of the medication will be in the breastmilk. This study reports 0.1% of my dose and no adverse effects.¬†I’m on the lowest dose of quetiapine I can get away with, but it’s likely that’s going to increase as it’s working less effectively as time goes on. So again there is a little risk with breastfeeding. I’ll be monitored (awful word) and if it’s having effects on the babe, then I’ll switch to formula. Will be upset and disappointed? Probably. But what I am repeating to myself, in my rational mind, is my health first. ¬†I can’t look after my baby if I’m unwell.

The Birth Planning Meeting- making a mental health advance directive

I last saw my psychiatrist about 10 days ago. ¬†I’m doing pretty well so we won’t have any more appointments individually, nor will I be seeing my perinatal nurse again unless I ask to. I will be seeing them on the 15th of December to have a birth planning meeting.

This is essentially where your whole “team” (including your future health visitor) gets together to talk about your birth plan and what you want to happen afterwards, especially if you become unwell. ¬†As rationally as I’m writing this, as ticking-along as it’s been, that’s a possibility. What do I want to happen, what do I¬†not¬†want to happen? Would I be okay with an increase in antipsychotics, and if so, are there ones I don’t want to take? (This may largely be out of my hands if I do get sick, but my wishes will be taken into account). ¬†We’ll also discuss treatment options should I get sick, such as the mother and baby unit. There will also be general discussion about labour, like with any woman.

I’ll know more about this when I actually attend it, but I feel quite reassured by it. Robert will be there too, and no doubt find it all quite bizarre.

What will be happening is that I will continue taking medication after the birth. And there is a huge concession here- it means my husband has to give up work when the baby’s born. You can imagine how financially shattering this will be, it’s maternity leave (I can only take 6 months at the very most, and that’s a huge struggle) on one salary. But he works nights exclusively, and hasn’t been able to find a day job. I work full time and want to return to work. The “team” agrees that although I’m likely to have sleep deprivation like any new parent, it is completely essential that I get as much sleep as possible to stay well, and this means Robert will have to stay at home with me and do nights with the baby so I can take my medication and sleep. ¬†My doctor and midwife are pretty worried about me going back to work so soon, but I don’t really have a choice as we can’t afford otherwise. I only get 3 months maternity pay and have been saving up otherwise.

The Fear

When I got home from work tonight, I broke down crying for the first time in months. Despite all this planning and all this support, I am terrified of becoming unwell after the birth, terrified of it happening now, too. It does feel so frighteningly out of control, even after writing 5000 words as to how it isn’t. I feel like I don’t really have control over anything.

I am scared of how quickly women become ill after pregnancy and scared it’ll be me. Scared I won’t be able to ask for help, scared I’ll be beyond even recognising I need it. Scared Robert won’t be able to cope, scared of being alone (it is the loneliest place in the world), scared of not being able to care for my baby. Scared of being a failure. Scared of not being able to bond. Scared of feeling trapped, scared of what I’d do if I did. ¬†Scared of the fact I have made the one irreversible decision of my life. ¬†Scared of a lot of things a lot of women are scared of. ¬†That spiky sea urchin in my brain is a saboteur and a liar and I make a conscious effort not to listen to them.

But having support does help. It does make a difference. I have a partner, which is support a lot of women don’t have. I have an understanding workplace, too. I have the perinatal team. I have these clear things in my head, here, and in my notes. It isn’t the quivering inarticulate terror of when I became pregnant. It isn’t the kind of fear and uncertainty I imagine many women who don’t have support feel. I don’t know what support Charlotte Bevan had. I hope her family have some support right now for what they’re going through.

All women need and deserve support when they’re pregnant and afterwards. ¬†A check up at 6 weeks is not good enough. A questionnaire will not cut it when we are so ashamed of how we’re feeling and so afraid. Feel free to ask me anything here or on Twitter- ms_molly_vog. If you’re pregnant right now, or thinking about it, please reach out if you’re struggling. To someone- your GP, your midwife, a friend, even a forum or Twitter if you need to talk. ¬†I apologise for you in advance if your GP or midwife are shit, if your mental health provision is shit. It’s not right, it’s not fair, and it’s not how it should be.

It’s 1am now. Tears largely dried. Time to sleep, if searing heartburn allows. I am feeding Bean a fine selection of curries when he’s 18. Sweet revenge. Night.

*bump*

*bump*

Pregnant, Mental and Fat

Bloody hell. It’s taken me 18 weeks to write this post. I imagined a dam would burst when we told everyone at week 12.¬†And I, who diarises everything and have done since I was a child. Anyway- better late than never. This is my news…

Whomp whomp whomp she says

Whomp whomp whomp she says

I found out I was pregnant on the day Rik Mayall died. My already not inconsiderable boobs seemed to have become zeppelins of ache, so I decided to grab a pregnancy test on my way to work to¬† wee upon in the peaceful surroundings of the disabled toilet. I yawned as I waited for the results, expecting it to be negative like all the others had been. It wasn’t.

The first person to find out wasn’t my husband, but my much beloved friend at work, Ellie. Robert had just gotten off his week of nightshifts and as I’d left for work, had been barbecuing in the garden with his friend Ben.¬† As I waved goodbye there was the, “hhsssstt” of an opening can and a peal of already-rather-drunk laughter. (In fact, this was him that very morning:

I bumped into her as I was dashing across to the Superdrug to buy another four pregnancy tests. I’m one of those incredibly unlucky (or lucky, depending on how you see it) people to have gotten a false positive pregnancy test (two in fact- fuck you Sainsburys own brand). That positive test was met with jubilation, calls to buy fizzy wine, shock. This time it was rather different. I got home from work, having sent Robert a few subtle, “Hey, you sober now? Wow, about that Rik Mayall eh?” texts throughout the day. When he texted back to tell me that he was turning into an otter, I thought it was best to break the news in person. Which I did by shaking him awake at 7pm and quietly telling him the news. It took him a while to shake off the alcohol haze and for the news to be understood.

We had approximately 19 hours with which to enjoy the news and to imagine a future with a child. The next day, our bastard landlord. the criminal scumbag Gabriel Edun whose negligence could have killed us in the house fire it caused, was heard casually talking over the garden fence with the landlord next door about their offer on the flat. He was selling. We confronted him and he admitted that he would be serving us with a section 22 notice of eviction. We’d only lived there 3 months, and those 3 months we’d lived in a sooty, fire damaged whole, taken days and days off work, not just for hospital treatment after the fire but to sit around waiting for this lazy piece of shit to come and make the flat breathable again. We’d only endured it because the flat was very cheap and he had assured us, repeatedly, that he wouldn’t be selling and we could finally have somewhere to make a home.

Fucker. We left him this as a present.

Sincerely, motherfucker.

Sincerely, motherfucker.

(The shitbag scumlord couldn’t had evicted us legally anyway- he didn’t protect our deposit and I got it back when I threatened him with court. I had spent the day cleaning his shithole and as I left, he offered to carry the hastily packed bags of an unwanted house move to the bus stop because of my “condition”. I declined).

We could have waited three months until he served the eviction notice, but in the three months since we’d moved to Lewisham, we’d already been priced out of it. We had to move quickly. The next weeks I could barely sleep, and could barely eat because I was throwing up everything that passed my lips (“morning sickness” my HOLE. All day sickness.¬† All 15 weeks of endless dizzying sickness). We were both hysterical, me crying often, totally screwed financially having spent everything we had on moving three months previously.¬† It absolutely ruined the first month as all I could think about was where we were going to live and what we were going to do. We ended up having to borrow money, and kind friends helped, too, and finding a place in Streatham, far, far more than what we were paying but still below market rent. What a fucking joke London is. (Incidentally, we moved to Streatham to be close to Robert’s family, who are now all moving out of fecking London).

Having to move also meant that I had to end therapy. I had *just* started therapy (finally) for panic disorder.¬† I was struggling to get to appointments on the bus due to sickness, so she said she thought I’d be better referred to Lambeth, which I agreed with. Couldn’t transfer, had to do a new referral. Which I’ve yet to do. ¬†Because…

This got long. In the next entry, I’ll discuss the NEVERENDING APPOINTMENTS you can expect if you’re both pregnant and mental!¬†

And I’ll also talk about how GREAT it is being FAT and how you’re basically told you’re KILLING YOUR BABY just by EXISTING WHILE FAT!¬†

MARVEL as you VOMIT for 15 weeks! 

To be continued…¬†

Mentalism and Motherhood

I get emotional over the tree in our tiny garden in Peckham.  Which is silly.

But I watched it bloom into beautiful blossom in the spring…

and drizzle pink flowers every time the breeze blew…

…and, to my surprise, the delicate butterfly-blossoms became apples, which twatted me on the head every time I went to hang the washing up…

Not pictured: me swearing.

Not pictured: me swearing.

…and grew big enough to be picked (or picked up, as in this case) and eaten.

And the apples will disappear, and the tree become bare and anonymous like it was when we moved here last year, then it’ll blossom again and, again, become laden with fruit. ¬†And the cycle will repeat. We didn’t do anything to make it happen. I thought the tree was dead when we moved in. All it’s had is rain and sun, and it lives on.

My friend Ben insisted it was just a useless little crab apple tree, but it wasn’t. (And crab apple trees aren’t useless anyway).¬†

I want to be part of a cycle. ¬†Of that cycle: of renewal and birth and endlessness. ¬†Even though I have PCOS, I just assume it’ll happen. Granted, those aren’t great reasons to have kids. But recently, I’d been broodier than usual (as has my husband). Awwing at the photos of babies my friends post on Facebook, wanting to be part of that seemingly perfectly imperfect life. My friend, a mother of two, wisely told me, “Having kids is like a bomb going off in your relationship”. But I want to be standing in that wreckage. Not the sometimes-inconsequential feeling neatness of now.

If you follow me on Twitter (I am there as brain_opera), I probably depressed you the other day by posting the heartbreaking Daksha Emson inquiry. Daksha Emson was a psychiatrist who committed suicide, in the violent way horrifyingly typical of women with postpartum psychosis, by stabbing herself and her baby daughter, Freya, then immolating both of them.  Daksha survived for 3 weeks before succumbing to her injuries, and Freya died at the scene. They were both found by her husband, David.

Daksha died in the perfect storm. ¬†A psychiatrist, she worked in a profession with stigmatises their own having mental illness. ¬†Whose illness was downplayed, “doctor to doctor”. Daksha had bipolar disorder, and, although she experienced periods of unwellness where she was hospitalised (and had ECT, on one occasion), she managed to excel in her field. She took medication and didn’t have a relapse in the 8 years she and her husband were married until she became pregnant.

When I was a nursing student, I attended a conference on perinatal psychiatry. ¬†If I’d stayed in nursing, it’s where I’d have liked to specialise. It was a fascinating day. ¬†Firstly, we looked at how infants develop, and how vital those early attachments are. ¬†It’s why mother and baby units, which keep them together and help support the mum and partner, are better than just chucking the mother into a psychiatric ward.

We watched a video of some mothers who were experiencing psychotic and depressive symptoms while caring for their children in a mother and baby unit. ¬†We saw the baby’s increased agitation due to the lack of reaction from the mothers. ¬†The Still Face experiment illustrates this:

Then, we saw the improvements, in both mum and baby, a few months later when the women had recovered. ¬†We learned (or at least, I did), how peri/postnatal mental illness can often strike those who one would least expect; first time, middle class mothers in their thirties. And this in itself is where women like Daksha were let down. How could this high-achieving psychiatrist and mother become mentally ill? ¬†As the inquiry says, isn’t mental illness for, “the great unwashed”? And when the great unwashed do get pregnant, they don’t experience the trauma those professional women do of becoming a mother, the role that’s been created for them since the universe began, which they must now inhabit fully, and which everyone is else is watching you shape yourself into. Surely?

Dr Margaret Oates (who has a mother and baby unit named after her) was there. She spoke acidly of cases where women, clearly unwell, were discharged from services with the label, “personality disorder”. One mother, who was previously diagnosed with bipolar disorder, was deemed to instead have a personality disorder and sent home with antidepressants. ¬†“And what happens to a woman with bipolar when you just give her antidepressants?”, she snapped. She got worse, walked into incoming traffic and died.

Daksha Emson had bipolar disorder. ¬†Postpartum psychosis is so closely linked that it’s sometimes called postpuerpal bipolar disorder. The inquiry into her death states that doctors must assume one will become ill, not the other way around. Therefore, it’s all about that lovely phrase we all know so well as patients and practitioners; risk management.

But that’s complex in itself. A woman who becomes unwell in pregnancy, or who was already taking medication for a pre-existing mental health problem, might be limited in her choice of treatment. ¬†Then they may have to- or want to- stop taking medication so they can breastfeed their child. They can become unwell astonishingly quickly. ¬†There’s also the shame factor. The shame factor that permeates all mental ill health, but especially mental ill health when it’s supposed to be the happiest, most wonderful, shiny, Mothercare advert time of your life. ¬†Where do you even start with that? We’re shamed anyway for having mental health problems, then further shamed for being women- how much shame and guilt must a new mother feel?

Then the father of the child, if he’s employed and you’re with him, might have to go back to work after two weeks. ¬†It becomes easier to hide how bad things have become. In the shadows, they disintegrate. And the stress of looking after a new life, utterly dependent on you, would take its toll on anyone- lack of sleep, worry about the infant, recovering from childbirth, financial implications, everything.

Afterwards, I asked to spend the day with the perinatal psychiatry team at a local hospital.  The nurse explained who was referred to their team.  I felt the blood rush to my head as I read:

Referrals are essential for women with:

  • Bipolar Affective Disorder
  • Schizophrenia / Schizoaffective disorder
  • Previous Postpartum Psychosis
  • Severe Depression
  • Other psychotic illness
  • Family History of Postpartum Psychosis

I have (or probably have, I haven’t had a hypo/manic episode for 2 years and my recent psychiatrist who has only seen me well and heard me speak with a very, “I’m okay” now spin on things) bipolar disorder and my mum had 2 episodes of postpartum psychosis. It was strange to see it in black and white. ¬†Here is your future. ¬†This is what your pregnancy is going to look like. ¬†Someone asking you questions. ¬†Somewhere, you’re going to be a file and they’re going to be watching you. Someone’s going to come and visit you and someone is going to know more about you that you’re comfortable telling them. They might take your baby away. They might take your baby away. They might take your baby away.

I should have felt relieved. ¬†Isn’t for the best that I’d be referred if I was pregnant? ¬†Isn’t it good I’d be looked after and had some support? But it still scares me because it feels like an intrusion- another intrusion in a lifetime of intrusions- by mental health services into my life. ¬†Resenting bitterly that mental illness may steal another part of my life, that mental health services may be the ones who define it at all.

When I was initially diagnosed, I was advised to think twice before even becoming pregnant. I did, briefly, a few years ago and I did become unwell, first with depression, then with hypomania, but that could have been the circumstances of the pregnancy rather than any sort of organic reason. What would happen now? ¬†No matter what has gone before, I have imagined myself pregnant and beaming with a wanted child. Well, happy, blooming then fruitful. ¬†I blot out the fact that pregnancy and having children is one of the most stressful things a couple can do and that a quite shocking amount of partners have affairs during these periods. ¬†And that my husband isn’t great at coping with me when I’m not very well (but he’s getting better, and I know he’d be an amazing dad). ¬†And that I live in a tiny flat and I’d have no money and wouldn’t be able to cover the rent on SMP. And that I take antipsychotic and antidepressant and mood stabilising medication and have tried to kill myself. And suicide is the leading cause of maternal death.

Oh, that.

But then I wish someone had been there when my mum was suffering when she had my brother and sister. I can’t remember what happened (particularly when my sister was born, because I was still a far-off idea at the time), but I do remember she thought there were rats in the bath, blood, that my brother was some sort of god and that she was mad for years after- still is, really- and that my dad’s drinking got worse and worse until it killed him. ¬†I try to tell myself that just because it happened to her, it doesn’t mean it will happen to me. ¬†I’m not married to my father, and my father was an alcoholic, and I’m not. I’m not living her life, in her circumstances. I’m not her. I’m not her.

And even if I was, how badly did having two parents with a mental illness affect me? ¬†On a good day, I’d say, “Ach, hardly at all”. On a bad, I’d be flung back into a cobwebby corner of my memory where I’m hiding behind a door with my hands over my ears listening to my parents scream at each other, and the years that followed where I spun in my mother’s confused untruths, not sure what was true, not sure what wasn’t and remember my joyful time in CAMHS.

I have my brother and sister, though. I have them.

On balance, though, I think my experiences have had a positive impact on my personality rather than a negative one. I grew up to be compassionate, to want to help people, to be independent since we largely had to look after ourselves, to value creativity as a way to express myself when I lived with people who could be wordless, and to be someone who stands up for themselves and for others. On the downside, I’m one of those people who struggles to make close relationships (and this scares me about having kids- who would help me? Who could I ask?), who runs away when people try to get close to her, who is super-sensitive, who seeks validation too often, who feels overburdened with a sense of responsibility and guilt for things I can’t control, and who shuts down if someone shouts at me as it throws me back into the centrifugal force of my parents rage. (And yes, I’m aware that my traumatic upbringing and subsequent traumas have probably contributed a fair bit to me being mentally interesting. But I certainly don’t blame my parents for that. They’re people, first). But those things don’t hold me back to any huge degree and the slightly reclusive part of my personality is one I’d miss having, too.

And they weren’t always like that. Sometimes, my parents were wonderful. ¬†It was something I was wildly jealous of when my dad died- other peoples’ memories of their parents. I had friends who lost their parents to cancer at similarly young ages to when I lost my dad. ¬†But their parent, “battled”, was, “brave”. Was proud, was strong, had friends, were blissfully and memorably ordinary. They had coffee with their parents and bought them places, to events that didn’t end with them screaming at them to stop, slumping into sobs. ¬†I was so jealous that, then, all I had left of my dad were horrible memories. ¬†They were the ones that floated to my mind when I thought of him. Memories that drenched me in shame and regret, regret of such a short, wasted life, and shame that we weren’t enough for him to want to live for.

But as time has passed, I remember more good about him.

I understand he couldn’t, “just” stop drinking. I thank him for the good influence he had on me. To be silly, to be strong, to read. I mourn that my children won’t have him as a grandad, to be bounced on his leg like he used to do me. ¬†Now whenever I talk to my somewhat transformed mum on the phone, I ask her to think about getting herself a wee fella. ¬†I hate the thought of another life not being lived, being wasted without love, without someone, even a good friend, to share with.

And on the plus side of me not really being close to many people, I have a lot of love. ¬†Tons of it, pouring out of me, for anyone to have if they want it. ¬†So that’s something.

But my parents were never really helped for their problems. ¬†No-one really supported them when they needed it, when we needed it. How different things might have been if someone had recognised they needed help. These somewhat self-regarding entries are a protection. ¬†A way of acknowledging what could happen. ¬†Save yourself by being self-aware in case there comes a time when you can’t be. ¬†So it doesn’t come.

So I think I need to give up any expectations I have of pregnancy or motherhood, both good and bad. I may not suddenly have a giant gleaming kitchen and long, russet hair (it’s purple right now, but for some reason, when I think of my hair when pregnant, it’s long and not falling out like it does during pregnancy and russet and smells of apples, the latter being a probability considering we are currently buried in them) and have that kind of flattering slimness that accentuates my bountiful bump (I’m newly obese again, so that’s not going to happen anyway). ¬†I may not have a husband who’s endlessly patient with me and who listens to my stomach like a shell for the sea and sings to me (I fucking hope not- he’s the most effortfully bad singer I’ve ever heard) and keeps everything clean and is never bad tempered and never misses sex or the nights out with his previously young wife and the nights in with his previously girlfriend. He won’t become depressed himself and will continue to bring me coffee and breakfast and call me beautiful.

Likewise, I may not go mad and may not end up struggling to bond with my baby, and may not be like my mother, and may not spend every waking minute thinking I’m a shit mother and a shit person and shit feminist, and may not have to come off my medication and if I do, I may be fine, and it may, may be, just a gloriously ordinary time of my life, like it is in the lives of lots of women, like it is for lots of women with mental health problems, too. Apart from panic attacks, I’m fine now. I may continue to be fine. And even if I wasn’t, it’ll all be worth it in the end.

I hope so.

P.S: I’m not pregnant, don’t worry.

P.P.S: Daksha Emson is an exceptional case, hence the inquiry. ¬†Although women can be so unwell they commit suicide and take their children with them, it’s incredibly rare. ¬†And what has changed since they inquiry? ¬†Not much.

P.P.P.S: If I’ve depressed the shite out of you with this entry, here’s some Eddie Izzard:

The Legacy of a Label

On my sick note is scrawled, “BIPOLAR DISORDER”. The medication I’m prescribed is for bipolar disorder. ¬†And yet I still struggle to say, “I have bipolar disorder”.

In 2007, I said it a lot. ¬†Newly diagnosed and in that unavoidable, “overidentification” phase (which you may after, or instead of, denial).

Now, even with psychiatric and doctorly and friend-o and husband-o opinion agreeing with that, I still can’t say it without much hesitation and an immediate feeling that I have just told a terrible lie.

Some of you may remember that a few years ago, and after listening to the Radio 4 play based upon this blog (that sounds arch and insulting, but apparently it was part of the rationale, though having spoken to him in the past year, I give more credit than that and may have misinterpreted), my psychiatrist at that time said I did not have bipolar disorder but borderline personality disorder. This was a punch in the gut.  I had always been open to the idea that I had borderline personality traits (I certainly did when I was younger and I cringe thinking back to some of it) but I had accepted I had bipolar disorder.  I spent years on punishing medications, which is one of the reasons I think he changed it to BPD, without knowing that I was quite uncompliant most of the time, because the side effects were horrendous.

This diagnosis came at a time when I was doing very well, was stable and quite happy and had actually approached with to ask if I could have help coming off my medication. Which he said I didn’t need. ¬†And said I shouldn’t, “self diagnose”, a punch that missed the stomach and went straight for the balls as I had sat in room after room being told not to have children (and this was a factor in my having a termination), not to drink, not stay up late, not to work, all at the tender ages of 20-21, when my mind was full of future of children, and fun, and work. To be told it when the carer/patient dynamic was one of the things that destroyed a relationship, to be told it when I had gained so much weight and was puffy and glazed and had sat in baths while my hair fell out on Depakote and retched and shivered with Lithium toxicity and watched my sex life dwindle on antipsychotics; became the way a, “mental patient” speaks, the way a, “mental patient” looks, in clothes too small because cloth can not keep up with quetiapine, and ever shaking hands. Humiliating letters sent to my family to explain my diagnosis. Care plans, there forever.¬† Applying for benefits, attending soul crushing medicals. All for that.

I left feeling shocked. And BPD¬†was fine. It was the, “Self diagnosis” thing that really killed me. It was the feeling of judgement, of dismissal and also of profound misunderstanding. I had been diagnosed with bipolar disorder while in a psychiatric hospital. ¬†I did not do that to myself.

I felt feeling like a fraud.  Especially as my blog and my writing had gathered a little following and I had accidentally made myself a bit of a spokesperson for bipolar disorder.  People asked my advice, people listened to me.  I had never meant for any of it to happen but found value and meaning it.  Some people said I was a professional victim, but I have never and still do not feel like a victim.   I was embarrassed.  I was ashamed.  Not of the diagnosis itself (though I was a bit ashamed) but that I had so voraciously championed having bipolar disorder. Like a tit.

It was no accident that I went from writing here constantly and getting to 1 million hits and then stopped writing and hid. Although the diagnosis changed nothing about who I was, I had, and we all do to an extent, internalise it. I felt, simply, that I was a charlatan and had no right speaking up about bipolar disorder.  And to an extent, I still feel that way.

I felt ashamed that I had spent most of the time of being treated for bipolar disorder in a relationship in which he had to counsel and care for me, and had used it to understand my experiences.  It is still a kind of shame that I carry.

Most of all I was ashamed it mattered at all. Something that meant nothing years ago now did.

When I visited my GP, they spoke to me like dirt. ¬†They asked me if I had been self harming (I hadn’t in quite some time) and made me prove it by pulling up my sleeves, which was traumatic. Nothing I said had credibility, and I wasn’t allowed more than weekly prescriptions in cased I overdosed, except that I had only done so once since 17 year old experimentation, and even that was written up in hospital (I later found) as, “because she had a fight with her boyfriend” which absolutely untrue. ¬†So I didn’t go to that GP anymore.

Since I didn’t need my medication (it was Seroquel, one I did¬†take faithfully for a year or so, which I still do, though I’m trying to get off it), I came off it. ¬†I became quite unwell, if you can call it that, because it was largely fun. ¬†I stopped sleeping, I became fixated with selling my flat (that I didn’t own) and moving to Paris and in pursuit of sleep took a holiday, instead walking up and down the beaches at dawn. I went to social worker appointments with a tiny dress, no pants and my period, spinning around on disability bars in reception, upside down, revealing myself, laughing, have a lot of sex and talking a lot. And it was good.

She urged me to take my medication again, and I did, patchily, and the sleep did help somewhat, but not entirely. It curbed some of it, but then it changed. ¬†By the end of the summer I was roaming the streets with wine bottles, restless, and became quite paranoid. My good mood faded, replaced by rage. I would smash my head against the wall and roar, kick doors and throw things out the window. ¬†I started hearing voices talking and I kept having to go and check the hall to see who was there, standing, calling, never to be answered. ¬†I paid for a downloaded software to analyse where my emails were coming from because I didn’t believe they were coming from my friends, that they were lying and replaced.

It all sounds severe, but I started taking antipsychotics again and then crashed into a bad depression. ¬†So that was fun. I actually called my social worker, something I had never done before, and she told me to come in where I sobbed, something else I had never done before. ¬†I felt terrified, despite having been through that before, I didn’t expect it, and it was terrifying. I had a choice between admission and crisis team, so chose crisis team. In the meantime, the massive freefall into depression from months of being chirpy, active and talkative, then a bit mental, tore a hole in my relationship as he struggled to understand what had gone on. It was as though I had been replaced by a different person. ¬†I sat miserably on my birthday, he having actually gone out to get me my favourite meal, some fizzy booze, and felt fucking suicidal. It was awful.

Knowing my now-husband did not understand and was struggling, my social worker had a meeting with both of us and explained to him…bipolar disorder.

So, I was prescribed a short term of antidepressants, and it helped. ¬†Within 2 months, I was much better. ¬†I had to go and see a GP- it was a different one this time- though I can’t remember why, I think it was to explain I didn’t need a new prescription.

“But you must keep taking your medication”.

“Why? ¬†I don’t need it. ¬†I have borderline personality disorder”.

“No, you have bipolar disorder, it’s very important you take your medication”. ¬†And there it was, on the frigging screen. And still is, apparently, and I have been treated as such by psychiatrists and GPs. Either it was changed back, or it was the covert, “bipolar, but we really mean BPD” thing, which they often do.

Ever since, I have been wary of doctors. ¬†I have been treated with kindness- my first appointment with a GP here whom I sadly never saw again bought tears to my eyes with kindness. ¬†I was doing fine, as I mostly have been save for recently, and she said it was good I understand my “triggers”, my, “red flags”, that they were always there for me and I could call anytime. ¬†It was comforting.

The older I have become, the more I think that bipolar disorder, or at least mood disorder, is correct. ¬†I fundamentally misunderstood bipolar disorder myself when I was younger. ¬†I said I had ultra-rapid cycling. ¬†I had, in fact, never been diagnosed with this (I have been diagnosed with rapid-cycling bipolar, however). I diagnosed myself *shakes fist at psychiatrist* because I misunderstood the nature of bipolar disorder.¬†That was because, to me, when I was diagnosed and over-identifying and looking for a reason, every mood was an, “episode”.¬† I’d have a night of drinking and being loud and spending too much and think, “Ooh! I was hypomanic!”¬† But I wasn’t (I was 23).¬† And I would excuse shitty behaviours with the same excuse, and I shouldn’t have.¬† If it lasted a day or less, it was emotions, and it was emotional instability.¬† Not moods.¬† Mood is the overriding thing and while someone can have ultra rapid cycling, I think it is rare. At the time I was pissed by the, “unstable sense of self” thing because I have been quite the same person forever, and was irritated that my dyeing my hair was, “unstable” when I’ve been doing it since I was 13, and it’s largely because I don’t really like/can’t afford clothes so it’s a nice way to freshen my look. But in retrospect, I did have a sense that I was, “evil” or, “good”. Not really anyone else, but me. ¬†When I was much younger, I was also a total liar. ¬†I was trying to big myself up, to be more interesting than I was. I also told bad lies to cover worse truths.

Now I am the opposite- I am completely honest with people and with myself. ¬†(Some of my, “lying” took the form of psychosis when I was 16). I wasn’t great with being left alone, but I am now. ¬†I am quite settled in who I am, I like being alone, I feel incredibly secure in my marriage and so on and so forth. But at one point, some of it was true. And realising that was actually very helpful as it meant I stopped and checked myself. I did sometimes react super-quick to anything, whereas these days, I’m quite mindful and moderate, and that was a wonderful thing in my life, even though it means I have also become quite boring. I wondered at the time, “Was my reaction to this diagnosis because bipolar had become assimilated into my identity?”- a self awareness I was not credited with, but one I think was true. ¬†And it meant I began to step back from the importance of bipolar as a diagnosis.

Part of me was also grateful for the borderline diagnosis, as, when I had been told about it, I was told I had also recovered from it.¬† When I actually sat down and thought about it, my reasoning was, “Okay, so, if I’ve recovered from this, I don’t have a shitty, life long illness.¬† This is GOOD news”. And once I stopped fixating, things got easier.

But. On the background of that instability were moods. The instability stopped, for the most part, during proper mood swings. The moods are different.  Emotions swung from despair to anger and back again, but my moods swung from depression and despair to normal to elation and irritability and lasted a much longer time. Affected everything. From awakefulness to neverwaking. Were not who I was.

So it was all complicated by this instability that existed within me, and my general personality, which is to be analytical in the first place, and a bit of hyper vigilant. ¬†When I look back, it is clearer to me now. The very long period I have had of being high functioning, groovy, mostly stable (save for normal stresses) without a whiff of BPD nor bipolar disorder beyond the medication effects and my general social awkwardness, makes it make more sense to me. ¬†My moods, in the absence of the instability and other youthful behaviours and coping mechanisms, have become more sharply polarised and more noticeable as being, “different” from the way I normally am. ¬†When I think back to my late teens, I was unstable, but I was also the person who used to¬†infiltrate¬†classrooms and talk and talk, until the break ended, constantly to whoever listened and stayed awake, laughing, breaking things gleefully, half my boobs out, indiscrete then believing I was a famous comedian. Before that was a depression that meant I missed most of my GCSE years. That period got me kicked out of college for being bizarre and hyperactive. ¬†I forget that sometimes, why I am a 27 year old student, and am sad for it.

But overriding it all confusingly was emotional instability. ¬†It was the start. ¬†And I have found it difficult and confusing to separate myself, and had hoped that when that went away, everything else would, and it didn’t.

But that diagnosis before has made me so reluctant to get help when I need it, for fear of being dismissed. ¬†And that is not a problem with me, but in the way personality disorders are treated and it pisses me off. ¬†I almost want to say, “Yes, it’s not bipolar, it’s a personality disorder, so go on, treat me with the kindness that you just did”.

Recently, I have been depressed and it came as a shock. ¬†I get the, “typical” bipolar depression of sleeping too much, eating too much, slow speech, slow thoughts, ¬†guilt, feeling better in the evening, episodes being relatively short, etc.

At the moment, for the past 11 days, I’ve on Lamictal (as well as Seroquel). I am supposed to titrate up to 200mg, but I was so desperate to feel better, I thought, “Fuck it, I’ll start at 200mg”. ¬†Which worked. ¬†I am less depressed, but I think a lot of that also has to do with not working shifts, getting regular sleep and generally being able to take care of myself in a way I wasn’t able to while being a student mental health nurse. ¬†And that gives me a lot to think about, that I may really have to deeply consider that I might have limitations I need to accept. ¬†At the moment I am drowning under stress due to my habit of consistently taking too much on (moving house etc), still on a bit of a knife edge and feeling weird, and I know it’s not the time for big decisions. ¬†This may not be recovery, this may be the effects of a high dose of a medication I have newly put into my body and on a dose I shouldn’t have. ¬†This feeling better is fragile.

It has worked and been very activating (for a few days counteracting Seroquel to the point in which I could not sleep, at all, which felt weird after months of barely being able to get out of bed and crying myself to sleep) but I am now going to titrate properly as it seemed to be having a bad effect cognitively- yesterday I kept falling over, mixing up words and generally being dumb as fuck. ¬†Today, I feel somewhat better, although I am so paranoid about THE RASH that I freaked my husband out so much he didn’t want to go to work yesterday.

But I still go, “Why am I taking this?” and feeling a flash of anger that I was put on medications so young for an illness I may not have, but probably do. ¬†I wonder what the hell they did to my brain and if I should chuck them all away. I also feel flashes of anger that my language was taken from me.¬† Since I was 20 I have been talked to and speaking in terms of medical things; hypomania, depression, hypersomnia, etc. I no longer have the language to describe succinctly- this is why these kind of posts exist. Emotions and moods stripped to diagnostic criteria.¬† And once you begin to think that way, it’s hard to stop. Especially in my profession too.¬† One of the reasons I’m thinking of dropping out and doing psychology; I know there is a language, but to me, it is a more humane one.

And it has also given me suspicion of the medical model, which has come partly from age and education, and being more mature. ¬†I was quite dogmatic at the beginning, and now I have a better understanding of my own experiences and how they contribute to who I am. I was keen to blame everything on a fabled chemical imbalance, while trying to minimise the trauma I had experienced, something I still do.¬† A friend of mine called me, “Rubberband Girl” due to the fact I could snap back from stuff which would knock people out for good.¬† But it took its toll, I just never really liked to admit to it.¬† I have been through a crapload of trauma and difficulty, and instead of feeling proud of surviving it, I pretended it didn’t matter. (You will not be surprised to learn- it did. And does).¬† I just suppressed everything and, in a way, hid behind the bipolar label.

I am more in touch with that now.¬† Recently, with moving, my husband says I get, “itchy feet” and finds it ridiculous that I enjoy looking up domestic things like curtains, that I pore over them, find them important.¬† I get itchy feet because I am used to being moved around.¬† This is the first time in my life it has been my choice.¬† I enjoy domestic things because for so long I was incapable of them.¬† I get a lot of pride in being responsible, paying bills, caring for myself.¬† I had a bit of an emotional storm during the wedding planning and the weeks before, when my past just seemed to hit me. I cried and shouted and raged, and it was what I had needed to do for a long time.¬† I am very self obsessed, I know this.¬† It was a self obsession I had to cultivate to keep my emotions in check, and, later on, my moods.¬† Psychiatry teaches you to be self-obsesssed while at the same time condemning you for it.¬† It tells you to be aware of yourself while at the same time telling you to stop thinking so much.¬† (My mum, when I was younger, used to say of course I was mad, I was a genius.¬† I wish she still thought that).

But there is also the little, “Your mum is mad and probably has manic depression, you grew up with her depressions and psychosis and you grew up with her cleaning the house at 5am, screaming, hyperspending and consistently getting us into debt and moving us around, your dad was an alcoholic, you probably¬†inherited¬†this, too” voice inside me. But it would say the same thing if I had borderline personality disorder.

I know it doesn’t matter, to me, in my heart. ¬†I’m still me. My own sense of self does not rely on a diagnosis and, if anyone, the experience made me realise how fluid they are, how okay I actually was. The diagnosis helped me to be more honest with myself, and honestly, at that time, I was pretty okay.

But it does matter in some circles. I’ve been told constantly, “labels aren’t important”. But they are, and I found that when I had those two GPs. ¬†I will find it when I register with my new one when I move, and get right in there with an appointment to discuss some physical stuff before they’ve had a chance to see my records and before they judge me based upon them.

It also matters in the sense that I have never quite shaken that idea that I have no right to talk about bipolar disorder. ¬†At the time of the change of diagnosis, I saw some blogs which expressed their surprise. ¬†Some people used the phrase, “bipolar poster girl” and it made me cringe. ¬†I had never intended for that to happen. I never intended to be a poster for anything, and I don’t think everyone’s experiences are so similar that anyone can be.

There are better blogs out there now, I have mostly been fine for years, and I have faded into relative obscurity as a blogger.¬† But because this blog is still here five years later, I sometimes get approached asking me to speak upon it, and I usually refuse. When they ask me about my experiences of living with bipolar disorder, I say I don’t want to use that phrase- not just to avoid labelling myself (I was, “bipolar writer” to people, which annoyed me, which will ever shall be, but I don’t blame them, because- well, I write this blog) but out of shame that if I say it publicly, someone is going to “out” me.

And regretful.  I took a lot of joy and meaning from what I used to do. I very strongly identify with the experiences of people who have bipolar disorder.  Nowadays, my interest has become academic and I love mental health. Whatever happens, mental health (implicitly linked to me with social justice, human rights) is the area I want to work in, in whichever capacity I can be helpful.

At the same time, I have to hide my own mental health problems working in, “the system” and am in the double bind of wanting to say nothing and wanting to shout it at the same time because I am sick of hiding that I am drowsy due to antipsychotics and that I really honest to god cannot do late-earlies and night shifts because I cannot mentally cope with not having a regular sleeping pattern, which keeps me sane. I am sick of hiding the fact that my concentration and energy wax and wane, that yes, I did self harm, and rather badly for years, but I don’t have the plague, so please, let me pull up my sleeves without you staring at my arms because I am hot and itching under this. ¬†I am sick of hiding that a lot of my sympathy and compassion comes from the fact I was a service user for such a long time, and when I hear shit chatted I want to butt in with the truth that, “us and them” is in fact “us”.

I want to start speaking out again.  I want to start writing again.

But I still can’t say I have bipolar disorder.

How My Dad Died.

Originally written in April 2007

I was asked in comments to write a story about my dad here.

The way my mind is working at the moment, I can only think of negative and horirble stories, doused in alcohol and soaked with sickness.

I have very few specifically positive stories of my dad. Plenty of lovely memories, but they are fleeting, small events like him making us Toasted Toppers or his insistence that Graham Chapman deserved a better looking boyfriend than David Sherlock.

Wedding Day

I’d never been to a wedding as a Grown Up. Nor a reception or any suchlike thing. The first wedding I remember was that of my aunt and uncle, Anne and Brian. Anne is a blonde model who appeared in speeding adverts, I’ve seen her in a bridal gown only once before, and that was on an advert on Ulster Television- “40 miles an hour!” with blood rolling apologetically down her dress. She used to come back from filming in England (“You’ve been to England?” we’d gawk at her) with those fat red dummy rocks in clutches for us. My uncle Brian is a big nosed, fresh-faced lovable man who has raised his three children to have quiet country burrs which is somewhat exotic to me when he brings them begrudgingly to their aunt’s house.

At the time I was nine years old and wasn’t taken to the wedding. My granny Molloy looked after me that day, in the only time she had ever been to our house. I remember her with her red slim face, which always looked like a warning triangle, taking my hand and us walking to the Dairy Farm, a supermarket near my house, where she bought me a pink keyboard. Then we went to the library where I proceeded to be kicked out as I was too fascinated with my first ever musical instrument. I managed to retain my dignity and my Asterix books, whereupon I rechristened myself Cacophonix.

That day I seemed to inherit a new family. At the wedding my mum met some of her family, The Mallons. Edna had a sharp tongue and fast humour, then there were her three daughters- Angela, Ceri and Michelle. Their ages corresponded roughly with the ages of me and my older sister. Michelle was the youngest so we were expected to get on. We were utterly different people so were never close.

So one wedding created a new family. The next was the day after my 18th birthday, the wedding of my uncle Michael to a quite well-to-do middle class girl called Fiona. Her family were much more respectable than our rough West Belfast one.

My uncle Michael looked like Damon Albarn. My sister Paula and I used to boast to our school friends about this. His fianc√©e was a social worker, tiny, buxom, blonde and beautiful. I first met her at a bedside vigil for my granda. I’d never met her before and remember feeling insulted rather than touched that she had come here while my grandad was so sick. In that respect, I’m quite traditional. For all my running-off-to-London, I believe in the family and find “outsiders” intrusive sometimes.

The wedding was in Bangor, and my dad was determined that we weren’t taking a feckin’ train that day. We got a taxi, god forbid, all of us piled into one black cab. He wanted us to be stylish, just as good as them, he said. But he was brimming over with happiness, as he always did when we were all together.

We found ourselves outside the church with a half an hour to spare and a bit peckish. “There’s a reception on later, Da,” says Michelle. Imagines of vol-au-vents, quiche, delicately decorated salmon en croute filled our minds.

But it would be hours before we had the chance to eat.

In our new clothes, we went to KFC and smeared ourselves with greasy chips and microwaved gravy. We sipped flat coke out of enormous buckets and liberally ate cold chicken.

We went at breakneck speed to the fancy Gothic church, stinking of fast food, gravy on our lips and the odour of old plastic seats sticking to our arses.

Twenty minutes later my other uncle Brendan (sarcastic, amusing vegetarian, much beloved of Paula, much resented by me for wrecking my carefully constructed house of cards) shows up, late and distressed and bangs on the window, Graduate style, to be let in. The priest shook his head and we all froze in horror and laughed as he strained to watch his baby brother getting married through a window, occasionally letting loose a fly of words that made the choirboys blush as he batted unruly twigs away from his face.

I wish

I could end the story there and that it would be Full O’ Larks. But of course with my dad in tow the day turned ugly.

He got drunk, completely pissed, and refused to be told otherwise. He was loud, embarrassing, abusive and disruptive. We ended up having to look after him, pleading, begging and crying.

I don’t think, until that point, his family believed us when we said his alcoholism was severe. But as the evening progressed and his behaviour got worse, I think it finally clicked that for all those years, we had not been exaggerating. Michelle, Paula and me were just exhausted, exhausted, humiliated and depressed, wanting to be a Proper Family out at their uncle’s wedding, instead of three ringmasters in the arena of my dad’s illness.

I have a lot of guilt concerning my dad. Not just that everything we did didn’t stop him from dying. But for childish things.

My mum and dad had prolific and devastating fights almost every night. My dad would eventually stumble upstairs, screaming obsenties. And my sisters and I would huddle in their bedroom and talk about how if we pushed him downstairs, we wouldn’t have to put up with it anymore.

We had many comical scenerios as to how we’d get rid of my parents. And they were comical, we didn’t actually want them to die but craved silence.

My dad rang me up on my 16th birthday. It was one of the periods he wasn’t living at home and I had assumed he was calling to wish me a happy birthday. Instead, he told me he was going to kill himself.

Sometimes I wish he had done. There were times when I violently wished that something, anything would end his and our suffering. I knew always that alcoholism was a disease and an addiction but it’s scant comfort when you’re in the living room with your little brother and sister trying to block out the crockery breaking in the kitchen.

I wanted something quick and painless and it would be over.

I was outside work once. At the time, a friend of mine was suffering from serious depression and they had rang me earlier to tell me they were going to kill themselves. This was sometime during 2005. I took the phone outside and tried to talk them down but I was petrified and shaking.

When Vicky died, I prayed to whatever gods there were that I would never have to go through it again. The stark memory of sitting down on the chair being told she had hung herself, the starker memory of walking down the forest the same night, vision blurring with tears, standing on the roadside we had walked upon destroyed me.

I got off the phone to my friend and lay back against a wall with a cigarette.

Suddenly, the image of someone calling to tell me my dad had killed himself flew into my head and took my breath out. All those times I wished it had happened pulverised me and I felt like the worst person in the world. The reality, the already-grief of his dying laid me on a fold up chair in tears.

I had always believed he’d get better. I held that hope to my chest, to my heart, to every minute of the day. I believed that with our help and willpower, he would recover and live to say, “When I was an alcoholic”…

The Reality of it

When it happened, I didn’t know what to do.

My dad had been in hospital for two weeks or so. It started innocuously enough. I was on the phone to my brother when he made a joke about my dad looking like one of the Simpsons. I asked him what he meant and he said, “He’s bright yellow”.

That night was a Saturday and I was alone in my flat. And for some reason, I got my mum on the phone and said, “I think daddy has liver failure”.

She didn’t really take me seriously so I told her I was going to call NHS direct. I described my dad to the nuse on the phone. Jaundice. Alcoholism and, in the background, his slurred voice.

I rang my mum back and told her I was calling an ambulance. I rang them in London and asked them to transfer me to Belfast. Rang them up and sent them to the house.

I was on the phone when they came. I heard my daddy protesting that he had an appointment with the doctor in June (it was the end of April) and that he was fine. I told my mother to keep trying and spoke to the ambulance staff, telling them I think he’s very ill and please make sure he goes.

He didn’t. He refused the ambulance and my mum called someone else, I can’t remember who, I think it was psychiatrist services. He finally went.

A few weeks passed. Phone calls here and there. I didn’t go home as nothing sounded serious. He was filled with fluid and had acute liver failure. I assumed he would get a transplant.

I had a holiday to Belfast booked on the 18th of May to introduce Rob to my parents. It had been booked for a while. I had spoke to my daddy on the phone and he was looking forward to seeing me and Rob on the 18th. He sounded fine.

On the 16th of May, while I was in work, my sister Michelle sent me a text saying daddy was dying now, right now, and to get home.

I called her, then called my sister Paula who was in the airport on her way back to London. She didn’t want to make a fuss so I called the nurse to make sure Michelle wasn’t being hysterical.

The nurse told me to come home.

Paula turned round and went back to the hospital. I had no money whatsoever and couldn’t change my flights. Jo and my boss at work started printing out train and flight times. I appealed on Livejournal for someone to help me get home. A friend lent me the money, I booked my flight, kissed goodbye to Rob and flew home.

I met my friend Tracie at the airport. She had some ham sandwiches and a bar of chocolate for me. I was filled with dread. I couldn’t, would not think of my dad dying. We sped down the long, dark, 10pm roads. I laid my head against the passenger window and stared at the greyscale countryside.

I met my sisters in hospital. I was not prepared for what I saw.

My dad was so clearly and obviously dying. I burst into tears.

When my grandad died, my drunken, grieving father shouted that the next funeral we would be at would his own.

I had not believed him. And here it was, his dying.

He was so afraid of death and that’s mostly what was on my mind. Did he know? A nurse leant over his bed and told us it wouldn’t be long. I was horrified, what if my dad heard? Was he afraid?

He was yellow and ancient and couldn’t breathe- he couldn’t see or talk and he was so clearly dying. I started crying as soon as I saw him, held his hand and tried to tell him I was here but I don’t know if he knows I was. I thought at least he would be able to talk, there was so much to say. He looked so different and my sister assured me he had only become this bad within the past 24 hours. Before that, he was able to talk and I hate myself for not going home 24 hours earlier.

We stayed the whole night in the room, holding his hand, talking to each other, going to the smoking room and watching his monitors. I’d bought him the issue of Kettering- I had thought he would be conscious enough for me to read him to him, he had wanted to read my Neil Innes interview, because he was a fan and he was proud. He’d gone round telling everyone I was interviewing him. I had been so hopeful he would be conscious. I desperately wanted to speak to him. Wanted to hear him say my name.

Michelle left to sleep and Paula left to smoke and I tried to tell him that I love him, he made no sign he’d heard, just groaned and fiddled with his breathing mask.

He kept trying to take his mask off, and we kept putting it back on. A few times he’d clutch his head, like he had a headache, like something so normal, a headache. He tried to sit himself up a few times. He tried to sleep.

He must have known we were there. He kept holding Paula’s hand while I stood on the other side and stroked his hair. It made him sleep. In his sleep, he said our names. All our names, his five children.

He said. And he did say, although my sister denies it, “I don’t want to die”. It could have been a trick of the ears but I am sure he said it. And my heart cracked in two.

He was obviously in a lot of discomfort but the doctor said he wasn’t in pain. He kept pulling out his wires and tubes- he was so scared of ending up like my granda that Paula told me he’d been pulling them out since the beginning. He always believed he’d be going home and on some level, so did I. I thought this would be a lesson, he would stop drinking and get better. I thought he was brilliant because recently he’d been sober more, and he was going into rehab this month.

Hours passed of him taking off his mask, falling asleep, waking up. The morning came, we hardly knew. About eight am or so we called our mum and asked her to come take our place for an hour while we ate something. We didn’t want to leave, we agonised over it but we needed something to eat. We expected to be there days, we were getting ready for it.

Before we left, Paula stroked his arm and said she’d see him soon. I kissed his forehead and told him we’d be gone an hour but we’d be back.

At about 8am, our mum came and we went home to get some food.

A half an hour later, the nurse phoned and told us to come back. We tried to wake our little brother up but he wouldn’t wake up. After some exhausted, frustrated screaming at him, he got up and smashed the china set my dad had bought for my mum.

We got to the hospital. Liam went to the toilet and we went up to the ward. Tacked on the curtain was, “NO VISITORS”. And my dad had died there, without us at about 9am on 17th May, a day before Rob and I’s visit. Aged forty seven, a month before his 48th birthday.

We howled. I had to go and find Liam and tell him. He was in the corridor and I didn’t know what to do or say. I just had to tell him that his dad died. How do you tell a fifteen year old that?

I remember standing by my brother and sisters and crying, I remember hugging my uncles, his brothers, and his mother, who had lost her sister two weeks ago and her husband seven months ago. It is not fair, I remember thinking that over and over.

A nurse came in and said, “Did he have a wedding ring on?” Nothing else- “NO” and then, “Did he have any gold teeth?” “NO” get out of my sight and she did and I hated her so much.

They took him away and kept hassling us saying they needed to do it now. We said wait because his brother isn’t here yet, my uncle Michael was on his way. Before they took him away we said our separate goodbyes and had our time with him. No-one will ever know what we all said, and I am glad.

They took him and we organised the wake at my grandmother’s. It was best to be there, it was his real home.

I slept after that and the next day Rob got here. We spent the next days at my grandmother’s. He met everyone in my family, except my dad. I wrote the obituary with my little sister and it appeared in the paper with many others, and flowers arrived and two big wreaths, “DAD” and “BROTHER”. I got away with much as a lot of my extended family and friends didn’t realise I was his daughter, so there weren’t many, “I’m sorry”s or tearful hugs. That hurt me slightly because I wanted some hugs but I had Rob, my sisters and uncles and brother and that’s all I needed, all we needed.

The coffin was in the room and they did a good job, he looked like my dad. I couldn’t understand why he was there, none of us could.

The priests came and went and on Friday night, Paula, Brendan my uncle and I stayed with him on his final night. We talked about a lot of things, not really my dad, and didn’t sleep. Everytime the automatic air freshener went off, we jumped.

The funeral was on Saturday and at first I didn’t think I could do it. My sister held my hand as we listened to the priest before they took him away. I couldn’t stop crying. I said goodbye again, I said I’m sorry.

My fifteen year old little brother had to carry his dad’s coffin.

On the way up to the church we noticed one of the men carrying the coffin had something written on his bald head and neck in green marker. He didn’t know he had it.

After the funeral, we went to the PD, a Republican bar my dad and our family went to often, and had a buffet and a drink. Since then, I’ve felt very little. I’d been sleeping in his bed and going through photographs, taking some and not taking others in the knowledge he’d kill me. But he isn’t here now and I can’t really understand how. As time wears on, the truth of it, the real truth of it, is beginning to dawn.

I don’t know what to do now. There’s years ahead without my dad but I still feel as though he’ll be back. I never want to remember him as that man I saw in the coffin. I hate Catholic services. I’m worried about the future for my mum and the kids. I’m worried about my granny. I don’t know what to do without my dad. He’s the one who understood us and helped us. He paid my rent once and bought our Christmas presents. He taught us how to read and ride our bikes and taught us how to write and taught us our history. He got me into comedy and music. I have all his David Bowie vinyls now, as promised.

The last time I saw him was Christmas 2005 and he had stayed sober, it was lovely. There is a photo of him in the bedroom, arms outstretched and smiling and you’d think he didn’t have a trouble in his heart until you notice his wrist, a huge gaping wound. He was not a happy man and that kills us. We tried. We love him so much.

My sisters joked we should put lots of IOUs in his coffin with him because he helped us with money when he got ourselves into scrapes. I wanted to put his comb in there with him. Paula could barely look at him but when she did it was to fix his hair. He would be mad at us if he’d known we didn’t shave his head for him.

The last October snowfall in London was in 1934 so I celebrated with my camera, a cigarette, a can and a complete stranger

Which probably indicates something apocalyptic about climate change but I don’t care.

I’ve just had one of those lovely experiences that makes me grateful for both life and London. ¬†I have a big smile on my face.

Firstly, I should say that thanks to your incredible generosity (see a previous post for what was going on), I paid my bills (two yesterday, two on Friday) and had enough left over to pay half (one half being Rob’s) of a second hand camera. ¬†That felt a bit cheeky but it was ¬£verylittlemoney. ¬†I felt like I’d lost a limb when I lost my camera. ¬†Well, a finger, maybe.¬†¬†So thank you from the bottom of my granite pebble heart for helping me out. Things are settled and back on an even keel now. ¬†My bills being sorted is such a load off my mind, I had really been panicking over it and eyeing up things to sell (my body, for example. ¬†A packet of crisps and a some cigarettes, in all likelihood. ¬†But I like crisps. ¬†It’s a fair trade). ¬†I was going to post that yesterday but wasn’t sure how to crowbar it in between zombies and Kerry Katona. Thank you too for understanding how uncomfortable it was for me to make that post and being very tactful. And everyone seems to love Dead Set, even amongst my contrary circle of friends I have yet to see a bad word about it.

Secondly, sorry for yet another off topic post. ¬†After an extremely traumatic fortnight, I’ve really needed a break from the intensely analytical mentalist posts. ¬† I have a lot to talk about on Thursday (The Reckoning, oh dear), so it’ll be back to business as usual. ¬†I’m sure that you’ve, er, missed the posts about mental illness? ¬†It must be dull…not reading about it? ¬†Really, what’s the etiquette for mental health blogs? ¬†When people feel better and spend their days flicking through books rather than streaking down the street in their flimsy underwear, do they apologise for it? ¬†It’s a tricky medium.

It’s bitter winter here now, and I’d had my thick drapes shut all day, warming my hands on cigarettes and strong cups of tea. ¬†Then Rob called, telling me it was snowing. ¬†I opened my curtains, and there it was, fat flakes storming to the ground. ¬†When it snows in London, due to the heat of pollution, it’s just farty, feathery little scraps that dissolve as soon as they touch solids. ¬†But this was proper snow.

I threw my coat on, without any socks, pulled my hood up and tore downstairs with my camera swinging around my neck. ¬†I live on the Holloway Road, possibly one of the least picturesque locations in London, but it was beautiful, the snow was swirling around the street lights and I must have looked slightly odd standing in the street, laughing my head off, with my arms outstretched at 10.30pm. ¬†The insurance with actually being mad is that you never mind if someone stares at you, you’re used to it. People were shuffling by clutching umbrellas, and then a man wrapped in a tartan scarf walked past, spotted me and gave this great, big beaming smile, and we looked at each other and laughed with pleasure. ¬†I love the fact that snow brings the child out in some people. ¬†(I know that at twenty three I am technically a foetus. ¬†I find new nubs of flesh every day).¬†Some people sneer at it, but fuck ’em.

While I was snapping and giggling, a blonde girl appeared and commented on the brilliance of the rare London snow. ¬†I’d never seen or met her before, but it turns out that she’s my neighbour and lives next door to me. ¬†We chatted for a minute, introduced ourselves and then made the snap decision that we should go to Highbury Park.

We were both fagless, since we’d just leapt out of our flats in the spur of the moment (and the streets were pretty dead), so she ran indoors and grabbed some cigarettes, then reappeared with gloves for me (my hands looked like cuts of meat) and some cans of booze. ¬†Then off we went, smoking our fags and swigging our beer, looking like tramps.

It was still snowing by the time we got there, and looked beautiful. ¬†Highbury Park runs incognito behind the main road into Finsbury Park. ¬†It’s lined with expensive looking houses that belong in a Richard Curtis film and black Victorian streetlamps. ¬†The snow had settled on the grass and cars and a few footprints muddied the white asphalt. ¬†Our hands were frozen as we clutched our beers but only one other person was around and we were alone the haze, and the park was untouched. ¬†Only the heads of the blades of grass peeked out The snow had started to lessen and sleet, so we would be the only people to see it like this, carpetted and lovely.

I wrote my name on a car windscreen (childhood habits haven’t left me; I also valiantly attempted a three line cock) expecting the alarm to go off and for us to end up sprinting and sliding home. ¬†It was so quiet, and everyone had their curtains shut.

We were freezing so had to turn back onto the main road with cars slooshing by.  It was a drizzle by then, with people hurrying home.  We had a victory cigarette, wiping wet hair out of our eyes.  By the time we reached our doors, it has almost stopped.  We said cheerio and hurried inside.

I’m glad I ran outside and played in the snow before it disappeared. It’ll be gone in an hour, and it might not snow again all winter. ¬†And what a lovely way to meet your neighbours. ¬†It’s made me really happy, even though I’m freezing and I’m using the cats as slippers.

Here’s some blurry, excitable, shaking hand photos.

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Photobucket - Video and Image Hosting

Photobucket - Video and Image Hosting

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Dead Set / Pitchforks out for Kerry Katona

As I write, I’m listening to Gnossienne No. 1 by Erik Satie. I’m very fond of Satie, who is an incredibly imaginative writer, as well as a wonderful composer. However, the room appears to have shrank and, try as I might, I can’t seem to squeak out a crumb of humour as it’s playing, which is a disservice to the man himself.¬† My mind has been clouded over with Royal Dalton.¬† There’s something about classical piano pieces that render the listener hypnotically earnest. I couldn’t fathom a having a dinner party while this kind of music was on in the background. I’d imagine that even those not from England would lapse into affected Sloaneyisms. They’d voice opinions that they don’t even have on modern art, and I’d be stood there, out of my depth, wondering if its impolite to chain smoke in my own flat, ashamed of my Northern Irish accent that makes everything I say sound like a threat. I can’t ever say the word “knee” in any context because people stiffen and ask, “Did you say you were going to do my knees?” Jesus, of course not. I have family members to do that for me.

(I couldn’t have a dinner party anyway, unless everyone wanted to sit on the floor picking cat fur off their trousers and drinking warm Londis wine from an ancient cracked mug that was sprouting pale green downy fur).

Ah, Pulp! Much better.  

Yesterday, Rob, myself and my rather fetching facial herpes toddled down to Piccadilly Circus to attend the premiere of Charlie Brooker’s Dead Set. Some people had come dressed as zombies but I had no desire to relive the four days of utter discomfort in which I was so saturated in fake blood that I had to use a jack to prise my legs apart every time I got a spare second for a wee. I hung around in the foyer with my head in a trough of popcorn, occasionally having, “Oh, that’s her” moments when my eyesight wasn’t obscured by hot butter.

Dead Set is a short horror series starting tonight on E4 (watch it or I’ll burn your family) and gorily climaxing on Halloween. I had my reservations about it; the setup consists of the end of the world with what may be the last survivors battling for their lives in the Big Brother house. There’s the plucky runner, the bastard producer and the hapless housemates whom we hate on sight but then eventually grow to care for, or at least not break into rapturous applause when they’re ripped in half.

It could have been a compendium of amusing verb-noun swearing (“You fucknut! You complete shitbasket!”) self consciously signposted with clunky satirical swipes. As it stands, though, I’m surprised that E4- home of American exports like Desperate Housewives and uselessly frothy list shows- agreed to make it. It starts off as sharp commentary on the underbelly of television and then descends into brutal, kinetic gore. It’s relentless, tense, hopeless and genuinely horrible. With the occasional amusing verb-noun swearing. It also featured newsreader Krisnan Guru Murphy, who seems to be my generation’s Patrick Allen.

What always irks me about zombie films is that they never use the word zombie. If you’re setting a zombie film in 2008, then your characters would know what a zombie is. The skipping around it with “the undead”, the “living dead” and, “Oh fuck, it’s THEM!” is lost on me. Likewise, Dead Set followed the 28 Days Later school of shaky camera work, which is distracting and irritating because you can’t actually see what the hell is going on. Maybe that’s the point, but a few times last night I was confused when zombies poured in from nowhere and became a blur of blue skin and bad teeth while I struggled to grasp who, if anyone, they were eviscerating.

I really enjoyed Dead Set, if enjoyed is the right word for leaving the cinema checking the irises of people’s eyes. Oh, and if you want to see me in it, just look for a flash of pink hair at the end. ¬†It was also a testament to the power of television. ¬†I hadn’t had a fried egg sandwich in six years. ¬†I’ve had two today.

After the premiere, we stopped by the aftershow party to sample its free bar. Through the glaze of wine I had more of those, “Oh, it’s her” moments. I haven’t watched a series of Big Brother in five years but I still recognise the housemates as most of them spent a while plastered on the front cover of Heat magazine. I strolled up to a few of them to say hello and they were all obscenely friendly and sweet, even though next to their blonde, designer litheness I felt like a full stop, given that I was dressed particularly badly at the time. I met Andy Nyman, who I admire an awful lot, since I’m a fan of triangle headed modern day witch Derren Brown. He’s about five foot five tall and I was quite grateful to drape myself across his shoulder for a photograph, feeling like I’d stumbled into the land of My People, those without thirty yards of legs separating their oxygen starved heads from the ground. I said hello again to the make up girls, the director and Charlie Brooker, and was quite flattered that they all remembered me, even though it was hard not to since I was sporting a pink mohawk and my breasts had been determinedly wriggling out of my dress all day. ¬†They were also effusive and lovely. ¬†I said hello to Kevin Eldon, too, who I can’t look at without imagining in a nappy (not a weird sexual fetish of mine, just something from The Day Today). ¬†I don’t get star struck and generally speak to everyone in the same way but I was a little by Kevin Eldon.

Saturday was a good evening, too, being the first of two days in which I found myself pleasantly tipsy. I’ve actually been in a good mood throughout the weekend. Yesterday before going out I watched “Boy A”, in which a former child killer tries to rebuild his life, and cried my eyes out. It’s one of those dramas where you find yourself pounding your fists against the screen howling, “WHY? YOU COULD HAVE BEEN ALRIGHT!” and your neighbours ring the bell and ask if everything’s “okay”, and then you fall into their arms mumbling something about bridges. In my actual day to day life, I rarely cry, even if I’m very depressed. I’m one of those depressives who gets the classic “flat affect” rather than bawling. When I’m depressed, I look like this:

and my vocabulary extends to grunting and gesticulating. But sad songs and films make me cry like a twat. Even not sad ones. I cried when I watched Ratatouille. Something about a cartoon rat not being accepted by humans, I don’t know. It’s a METAPHOR isn’t it. Likewise, I laugh when I really shouldn’t. At my grandad’s funeral, the priest was straight out of Father Ted, dully intoning something or other about god. He occasionally hiccuped and kept referring to my grandad as “she” and I burst out laughing. When we were given the body of Christ (a wafer thin mint), it got stuck to the roof of my mouth and I was uselessly trying to prise it off with my tongue. It finally dislodged and fell into my hand with a tiny wet slap, so I had to shove it back in a swallow it. Regurgitating the body of Christ like a mother bird. Then I performed the trick that all Catholics forced to sit through endless masses in their childhoods know about; bow your head as though you’re overwhelmed with piousness and laugh into your lap. If people behind you see your shoulders shaking, they’ll assume that you’re so overcome with love that you can’t control your emotions.

You can’t do that in America, though. When I was there on an exchange trip, rather than pretending to pray on my own, they made me hold their hands in the air and stand up so I felt like we were in the Wicker Man and that the alter was going to split open like Predator’s mouth and reveal a giant wicker Jesus. Aged twelve and precocious, I had written an exasperated note to myself in the bedroom talking about how I didn’t believe in god anyway, and I had told them as much. They found it and subjected me to an angry tearful lecture. Ah, happy memories.

In today’s non-news, Twatty Britain has been dusting off its pitchforks and driving themselves into a judgmental (quite literally, in this case) frenzy over a TV appearance by Kerry Katona. She’s a singer and reality TV star that appeared on a magazine show called “This Morning”. It’s broadcast at about 10.30 after the Jeremy Kyle show so is therefore watched by those who like the sensation of being repeatedly punched in the face.

Kerry has manic depression and is being treated for it. This was the appearance:

To me, it’s immediately clear that she’s still under the influence of medication. She takes an antipsychotic (which are taken at night time) and got to bed late. It’s early in the morning and of course she’s still going to be doped up. I am exactly the same at that time since I also take an antipsychotic. In my past job, they thought I was an alcoholic as I’d arrive at 9am and still be slurring my words. You have to take that type of medication really early if you want to function in the morning.

Kerry even responds to the presenter’s tactless questioning by naming the medication she’s taking. And yet, even with this, she’s being lynched over here, being called a drug addict, alcoholic slut and bad mother. The video is on Youtube in different guises and each one contains a ream of astonishingly ill-informed, abusive crap. Here she tries to speak out and says that people are prejudiced against those with bipolar disorder, which, as we all know, is bloody true (and in every sense; we can’t do jury service and those of us with the severe form of the illness can’t adopt or foster or work within certain places like British defence organisations). And yet the article is still rollseyes. Even the more rational people who accept her explanation are saying that bipolar disorder isn’t an “excuse”.

I don’t have much affection for her given that she’s a vapid, frozen food hawking popstrel with the voice of a haunted five year old but I feel really sorry for her here and angry on her behalf. People are ignorant, and some of the abuse (like calling her a slut and slag over and over- isn’t it great to be a woman?) is like a bad day out in BBC’s Have Your Say (the internet home of, “Get back to work you fucking scroungers!”) and makes me want to gouge my eyes out.

As her protests aren’t really endearing herself to anyone, I’m expecting a sobbing Jade Goody-esque TV appearance sometime soon in which she apologises for somehing she didn’t do.

Well, I feel a bit daft.

(this post has been edited a million times)

Hello chaps. ¬†Feel I owe you all an explanation. ¬†I am, as you can see, alive. ¬†This account isn’t that reliable because I was totally out of it. ¬†Rob has filled me in a lot of it.

Firstly, thanks for all your comments and concern. ¬†Special thanks to Neil and Laura for keeping everyone updated and Cathy for sending an ambulance and Angel, Ed, Miriam, Rob, Dan, Jo, Francesca and Sarah (for hoover lendage, my floor looks class), and my friends have been amazing, though I do expect that some people will be angry at me, an that’s okay and I totally understand. ¬†I’m back home already. ¬†My blood tests came back clear which surprised me as it was a pretty massive dose. That means no lasting damage although I feel like total crap today! ¬†Four hours elapsed before anyone (well, Rob) found me and I was vomiting an awful lot so I think that helped.

So, this is what happened.

I had been depressed for months and suddenly, I got the energy.

I wrote the previous post completely out of my mind, it wasn’t for attention or for help. ¬†Luckily my friend Francesca read it and updated Rob. ¬†Rob had been planning on going to the pub and I often don’t answer my phone so he would have gone to the pub anyway. ¬†Please understand that this wasn’t an attention thing. ¬†Hence pulling the phone out of the wall.

As you know, I have been really battling intrusive thoughts recently, along the lines of killing myself, mostly with the pills I had in my shoebox. ¬†Like I’ve said, it’s an itch you want to scratch, just to make it stop.

I lost it yesterday. ¬†Completely lost it and I couldn’t bear it anymore; couldn’t bear the voice in my head telling me to die, telling me I wouldn’t die if I took the pills, I’d be fine, but die, but take the pills, be fine.

I had handfuls of pills and I took them in quick succession. ¬†I was considering getting some alcohol too but I don’t really like the taste of it and I would have been really out of it. ¬†I didn’t see any of your comments yesterday.

As I said, I took Lamictal. ¬†Most of my Lamictal is 50mg, but there was a lot of 100mg so that was about sixty five pills, or thereabouts, and I took quite a lot more after I wrote the post. ¬†30mg of Risperidone was fifteen, but again I think I took more and the forty Zopiclone was earlier in the day. ¬†To be honest, I’m hazy on the doses because I was in a weird place when I wrote that entry. ¬†The dose was “a lot”. I vomited most of it and am used to Lamictal an Zopiclone so hence my not being dead. ¬†I’ve taken two overdoses in the past but this was the worst.

Pretty much as soon as I wrote the post on my blog I started vomiting, all over the place. ¬†Then I collapsed off my chair, smacked my face on the table and onto the floor, where I vomited some more. ¬†At this point, my eyesight and co-ordination went and I could barely move, and couldn’t see. ¬†I had a few spasms and a mini fit and kept vomiting. ¬†I couldn’t stand up, couldn’t really move at all. ¬†I did try to phone an ambulance (I was really sick and in a lot of pain) but I’ve pulled the phone out of the wall and had turned off my mobile. ¬†My co-ordination was completely gone and I couldn’t see properly, so couldn’t plug the phone in. ¬†I started just hitting numbers, none of which were 999. ¬†I was crawling about but couldn’t stand up. ¬†I started shouting for my mum (who is in Belfast)¬†and I have a slight memory of calling out for my daddy, too,¬†then I think I fell unconscious because it didn’t feel like four hours.

Apparently Neil got through on the phone and I was incoherant and he was shouting at me because I went silent (must have passed out again) and thought I had died. ¬†Then he couldn’t get through so I must have knocked the phone out accidentally. ¬†That must have been traumatic as fuck for him. ¬†I feel awful about it and don’t remember it all (he told me about it). ¬†To be honest, I thought I was dying too. ¬†I hope Brendan’s family don’t find out.

When I came to, I shouted for Rob but he wasn’t here yet. ¬†He had found out from my friend Francesca so he got here quickly after work. ¬†I was curled up on the floor so he thought I was dead and was drifting in and out of awakeness. ¬†I had woken up a few times to vomit and was still vomiting when he got here. ¬†I was out of it so didn’t know what was happening and my clothes and room were covered in sick.

Rob rang an ambulance straight away and was trying to comfort me. ¬†They arrived very quickly but I wasn’t really sure what was going on. ¬†I kept being sick and they took my clothes off (mortifying! they saw me in the buff) and Rob grabbed new clothes for me to wear. ¬†I don’t remember the ambulance journey but I think Rob and the paramedics were jokey to calm me down. ¬†I do remember the blonde woman paramedic asking me why I did it, because I was a “beautiful girl”. ¬†Don’t know why she thought that since I was covered in puke! ¬†I think I was lying down or maybe sitting up so I didn’t choke and I know that they cleaned my face.¬†I remember that she was allergic to cats. When we were going into hospital she said, “This is your fault” (to another paramedic about cats) but I thought that she was referring to me. ¬†They had their sirens on.

I think I was lying down or maybe sitting up so I didn’t choke and I know that they cleaned my face. There were straps on my arm and stomach which I think is why my ribs hurt.¬†¬†I feel like I’ve been beaten up. ¬†Rob explained to them and the doctors that I had severe manic depression, that I wasn’t thinking straight, that I’d been having intrusive thoughts and that my moods are largely beyond my control. ¬†I’m just sick. ¬†If I wasn’t sick, I wouldn’t have done it.¬†I sometimes don’t take it seriously and make too many jokes and drink when I shouldn’t but I’ve realised it is a life or death thing and I need to get well. ¬†When I’m not experiencing severe mood swings (beyond hypomania, beyond depression) I am not like that, I’m a naturally giggly, enthusiastic person which is why this illness is so devastating to me. ¬†It is the illness, it is not me. Sometimes it takes over and it is terrifying for and for Rob. It doesn’t mean that I don’t do everything I can to get better but I really underestimated how unwell I was.

I don’t remember being admitted but I did get a bed straight away. ¬†I was out of it. ¬†They didn’t pump my stomach because it had been a while since I had taken the pills so they were absorbed by then. ¬†I had a mad craving for a Snickers. ¬†After a few hours they said I could eat but I threw up straight away and had been throwing up since I was admitted. ¬†They took my blood and I was hooked up to a drip thing and blood pressure thing and a heart monitor.

Angel and Ed, two of my friends, came pretty much straight away, but I don’t remember much of Ed being there as I was still out of it. ¬†Angel was brilliant and stayed the whole time, stroking my hair, helping me stand up when I had to (I was very, very dizzy and would have fallen over otherwise) and she stayed with us until two in the morning.

My friends came and visited too. ¬†Again, I’m a bit foggy on the details but was very embarrased, lying in the hospital be feeling like a dick for what I’d done. ¬†I was so grateful, though. ¬†They offered-and did- clean the flat so Rob didn’t have to face it. ¬†It was probably one of the most lovely things anyone has ever done for me, and they did it for Rob, too. ¬†They didn’t go to the pub (kinda ruined their night, there) and they all went as a group, with Sarah lending a hoover. ¬†I guess all my paranoia that people didn’t like me was wrong. Neil and Laura rang too from Belfast. ¬†I’m not sure how people knew I was in the hospital because as far as I know, Rob didn’t tell them. ¬†Today I got a new keyboard and phone because they were a write off from sick. ¬†I’m a bit pissed at the expense! ¬† Could have spent it on new clothes as I ruined my hoodie! ¬†Arf. ¬†Or barf in this case.

The doctors and psychiatrist came. ¬†I am foggy on that, too, but I did bullshit a bit because I was desperate to get out of there. ¬†I had pretty much vomited my body weight but couldn’t keep water down and managed to chuck up outside.

Another psychiatrist had to be called but I saw him much later. I asked Angel to leave the room because I was quite embarrassed. ¬†Rob’s used to my mentals, though. ¬†Again I bullshitted¬†(not really about my mental state. I told him I was seeing someone. I just needed to get out of there)¬†a little bit, especially when it came to food and eating. ¬†I don’t know if you know this but I haven’t been eating properly (lost my appetite due to Effexor) and I have a laxative addiction that replaced vomiting bulimia, which I’m trying to kick (thank god I didn’t, er, evacuate when I was sick). I wasn’t sure what day it was (and wasn’t thinking straight) so I said I was seeing my CPN today when I had actually missed my appointment yesterday).

He said he wasn’t going to admit me to hospital but said that I should be with the Crisis Team and asked Rob to look after me. ¬†I told him that I saw my CPN every week, which is true.

They let me go, although I was unsteady and foggy and also exhausted. ¬†Ed had come back with Rob’s keys and lent us enough money to get a taxi. ¬†We got home, had a fag, had some water and fell asleep. ¬†The place was completely clean, even the bathroom and kitchen. ¬†I nearly cried. ¬†I can’t believe they did for us and put so much effort in, I don’t know how I can repay then. ¬†“Thank you” doesn’t do it justice.

I had a very fitful sleep and Rob didn’t really sleep at all. ¬†I didn’t chuck up again but felt very, very sick and disorientated. ¬†Today I feel a better, have got my balance back and am keeping water and bland food down. ¬†I am still quite foggy, bruised and for some reason, in quite a lot of pain over my body. ¬†Rob is napping on the sofa.

Anyway, this post may sound quite robotic but it’s because I am still a bit out of it. ¬†I’m not sure if I would have survived if I’d drank because I would’ve passed out quickly and probably choked on my vomit. ¬†But vomiting my body weight probably saved me.

Effexor is bad for me.

More than anything, I just feel daft! I feel absolutely fucking awful for what I put them and Rob though. ¬†I’m not sure how to face people but I’ve had overwhelming support and love from my friends and this blog, so really, really thank you so much. ¬†And thank you Anna for dropping fags off! Sorry we weren’t in, had gone get a replacement phone and keyboard.

Anyway, so that’s it. ¬†Hopefully the nausea, dizziness and pain will go away and I’ll be back to my old self again. Rob is with me, so I’m safe. ¬†I have no more extra medication and I’m on weekly prescriptions.

Hilariously, this happened near my two year anniversary of leaving the mental hospital. ¬†I can’t get the bracelet off my wrist, nor find the scissors. ¬†I hope at least posting this on this blog might help people realise the reality of it and not do it themselves.

The crappiest thing about yesterday is that I lost the eBay auction for the camera that broke on me. I miss it so much! ¬†Ah well, I couldn’t afford it anyway.

(rest assured I will be making jokes about this)

My Review of The A-Z Guide To Good Mental Health: You Don’t Have to Be Famous to Have Manic Depression

…and other such delights are available in the new issues of “One in Four” magazine.¬†

One in Four fights stigma and exclusion by challenging negative images of people with mental health difficulty, dispelling myths and increasing understanding.

Go and look, it’s the Bran Flakes of publishing, full of good stuff! ¬†

For those who cannot be bothered to click the above link (and shame on you), this is what I wrote (the edited version).  

Oh, what I didn’t mention is that it had a foreword by Stephen Fry. ¬†So it has a forward by Stephen Fry.

When I was first diagnosed with manic depression, also known as bipolar disorder, my well-meaning psychiatrist adjusted his geography teacher cuffs and penned an extensive reading list that he hoped would help educate me about my condition. I found myself lost in Waterstones, too nervous to ask the shop assistant which book would be most helpful. I skimmed the titles, sidestepping at least five¬†Madnesses¬†‘, a few¬†Angels¬†and, worst of all,¬†How to Love Someone With Bipolar Disorder¬†, as though people like me were an exotic subspecies who required our cages cleaning out every two days. ¬† There was also the bafflingly titled¬†How to Survive Bipolar Disorder: What You and Your Family Need To Know¬†, a book crying out for a Protect and Survive style television marketing campaign.

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Libido

Cocks and boobs immortalised in tiny soaps.  I have no idea where I got these from.

It’s really embarrassing to admit to this, but…

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The Motherland

Hello.¬† I’ve returned from the Motherland.¬† How I wish it were the Fatherland.

Belfast was great.¬† It was lovely to have us (my siblings, anyway) all together for Orlaigh’s sixteenth, which I still refuse to believe has come to pass.¬† I spent not as much time as I would have liked to with my siblings since I also wanted to briefly catch up with my three remaining friends there.¬† On Friday, I nabbed free food at Paula’s work and spent the rest of the day watching rubbish TV with her (which always makes me happy) and playing with her black Tonkinese cat, imaginatively called “Cat”.¬† Given that my cats are called “Boy Cat” and “Girl Cat” (and Hobbes, who lives with Rob), you can see the poverty of original thought that exists in my family.

My little brother, Liam, was there before donning his rags (not so much “glad”, he’s a crusty punk with a pungent yet not unsettling aroma) and heading out.¬† I have never met someone who is so confident in his appearance as my little brother is.¬† He is, naturally, gorgeous, as are all my siblings.¬† He knows it, though, but it’s disarmingly charming rather than irritating.¬† He kept me up until five in the morning to show me photos of himself.¬† An actual quote from him was, “Stay out of that mirror, that mirror is all ME!”¬†It was tongue in cheek, but only just. If I have Body Dysmorphic Disorder, my brother has some sort of inverse.

On Saturday I extracted myself from sleepiness in order to be a tourist in a warzone. I took my camera and my friend Stephen onto the Falls Road, my stomping ground when I was growing up, as I went to school there. The Falls Road is a working class, ostensibly left-wing Republican area, full of interesting political murals and daubings. My own politics- unsurprisingly, lie upon the far left, and I do correct those who refer to me as British, as I’m from Nationalist West Belfast and was raised with Republican ideology and the Irish language.

It felt quite strange taking photos of things that I used to see every day and think nothing of, but I always regret not doing so.¬† Here is an example; it’s one of the murals just past my school.

That mural depicts the Easter Rising (which is what √Čir√≠ Amach na C√°sca translates to), and that building there is the GPO in Dublin, which was the site of the uprising against the British Army. It was unsuccessful, obviously, or else the “Troubles” would not have been.

For those interested in politics, murals, art, myself, Belfast and etc, I have uploaded a whole set of photographs that I took of murals, my old school grounds and my friend here at Flickr.¬† I am too tired at the moment but when I’m more awake I will write descriptions so you know what you’re looking at. For the extra nosey, I’ve uploaded two more sets- one of my sister’s birthday and one of photos of my old haunts in Belfast, featuring me holding some scones.¬† (I have been feeling especially hideous lately, but am putting these up for memory’s sake.¬† Please don’t poke the soft bits with sticks).

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Readers!

 

Who are you?¬† Tell me a little bit about yourself.¬† Even if you don’t normally comment, and even if you do.¬† I know I’m toss at responding to comments but I do read them.¬† And I wonder where you’re all from.¬† Where do you live, do you like films, what’s your background, how has your day been?

It would be good to hear from you out there, in the great beyond.

I’m Seaneen, by the way, aged twenty seven standing four foot eleven inches high in my stockinged feet, , with a penchant for flamboyant men and equally flamboyant women. ¬†My lifetime’s ambition is to out-sarcastic Charlie Brooker in a TV-watching competition. ¬†My favourite films are the nigh on stock student response- Brazil, Withnail and I and Monty Python’s Quest for the Holy Grail.¬† I also love Bedazzled, the original Cook and Moore version, not the godawful Crazy Frog lookalike Brandon Fraser’s version.¬† I want to watch Gaslight again and I’m very fond of Blithe Spirit.¬† In general, though, it’s music, comedy and books that tickle my fancy and I really don’t have much to say about films.

Please carry on talking to me here so that I may be deliciously nosey about you all and compile a dossier about you on my return.  For all those suffering from paranoid psychosis out there, I mean YOU.

Inside the Iron Maiden

I don’t like self pity.¬† Least of all my own.

“Bravery”, in terms of illness, is will. If you don’t challenge your own negative thoughts, you lose.¬† The trouble with depression is that you tend to keep the thoughts to yourself.¬† Positive thoughts don’t squeak through.¬† There is no challenge.¬† You swallow up whatever your mind is serving you.¬† You have no allies.

It’s a shock, for a second, in the room, with its large windows spilling light onto a bricked up garden incarcerating spindly, infant trees anorexic from lack of sun.¬†¬† My head is almost between my knees I am so slumped.¬† I examine the detail of my shoes, count the hairs on my hands, anything to pull my thoughts elsewhere.¬† The chair is comfortable, the fabric is blue with scratches upon the arms.¬† And then there is a human voice slicing through the inhuman one-

“It controls you, but it’s not all of who you are.¬† You are more than this.”

faraway-

“The voice is wrong”.

Quietness, for a long time.

“I know that depression is difficult and you feel as though you’re a burden on other people.¬† But that’s not why they stay around…”

It feels almost like a dream-

“It’s because of who you are, all the good things about you, because they love you”-

My head rises, a millimetre.  I feel like I want to cry.

“There are no good things about me.¬† If you could see their faces.¬† How disappointed they look. They are so tired of me, and I am tired too.¬† My family, my friends, Rob.¬† They don’t know what to do.¬† I have put them through so much.¬† I hate myself.¬† I make their lives worse.¬† So what is the point? I don’t want to be this way anymore.¬† I hate talking about this.¬† I hate it”.

“Has anyone ever told you this?¬† Has Rob ever told you that you’re too much for him?¬† Why would he stay with you if he didn’t love you?-”

“He is depressed now, too.¬† And the others”-

I almost break into sobs as I force this sentence out.

“Are so ashamed of me.¬† I am so ashamed of me.¬† I am useless.¬† I could have been so much more than this.¬† I fucked up everything.¬† Everything people hoped for me. This never ends.¬† It never will end.¬† For the rest of my life.¬† I could get better for a few months.¬† Maybe a few years.¬† But it will happen again.¬† It always does and it is so easy. What is the point?¬† Why don’t people understand that saying, “You’ve got through this before?” is not comforting?¬† It is damning.¬† How many more times?¬† I’m twenty two years old.¬† How much longer?”

“You have so much to give to the world.¬† You are more than this.¬† It’s depression that is telling you that you’re not. It’s not true.¬† When you get through this-”

I smile, for a second.¬† But it’s not what she said that made me smile.¬† It’s what I was about to say.

“There’s a building opposite my flat.¬† It’s high, higher than the top flat in this building.¬† And I see it at night, the gates are often open with people coming in and out.¬† I could get to the roof.¬† In the night, I could climb up to the roof and jump off.¬† It wouldn’t work from my window, I’d just break something”.

This in monotone.  We make another appointment, soon.

I told her that I am afraid to die but that I still find the thought of suicide comforting.¬†¬† I told her that I hated myself for that as Vicky’s suicide, Brendan’s suicide and my dad’s slow suicide are, to me, the most painful experiences of my life.¬† I am angry at them and for them.¬† Still, I think about it constantly.¬† I am under no illusions, I don’t think I am going to arrange myself beautifully on eiderdown with a bottle of pills and a tearstained poetry book.¬† I don’t go in for that kind of melodrama. It is just an end to something that feels completely unending.

I need to view my illness as a separate entity or else I could not cope.¬† If it is just me, then there is no fighting it because I will never be my own ally.¬†¬† So there is “it”.

Sometimes I imagine that my ribs are made of steel and that inside is my heart in a dull metal box.  It is like being locked inside an Iron Maiden.

The placid, public face that gives no indication of what lurks inside.  If you move, it hurts.  If you shout, no-one can hear.  How long for you can withstand it, with your eyes shut, pretending to be somewhere else.  When you open them, blackness.

The thing that almost wrecks me with sadness is that I don’t think I am this person.¬† It is alright to say that this is not the entirety of who I am but it is the most obvious, most recognisable thing about me simply because it is always there, when many other things are not. Things that other people might say are fundamental to who I am (my sense of humour, for example) are simply not there a lot of the time.¬† Because the one big thing that chips away at me is.

I think I might be an optimist.¬† So many bad things have happened to me, in my life.¬† I have forgiven everybody.¬† I am angry at people rarely and even then it’s easy for me to stop being angry. When other people are sad, I am there with my freshly baked batch of upside. ¬† I still love people who hurt me, I probably love people who don’t love me back.¬† But I don’t mind.¬† Love is always positive.¬† I am funny, I think.¬† I think I have interesting things to say.¬† I see things in a different way than most people.

Am.  Was.  Might not be.  Definitely not at the moment.

I miss the “upside” of my own illness.¬† At least before it went to rot there would be times, wonderful times, of wallowing in sunlight, intense, glorious joy. But I can’t have one, or the other. If I have one then I will have both. The “happiness” needs to be natural for the depression not to exist.¬† If I had the choice, none of this would ever have existed.¬† My basis for comparison would be a happy day, and a sad one.¬† There would be no illness, there would never have been.¬† I’d never have met my CPN, never have been in hospital, never have been kicked out of college, never wrecked my exams after being off for six months, never have been so psychotic and sick that people thought I was fictional.¬† I don’t deal with this with “bravery”.¬† I want it to never have existed in me.

I am just locked inside. It is difficult to articulate this without melodrama. It is not sepia with my moon-toned face peering from a dusty window. It is just flatline. Dull. Very dull.  Dull voices that float through paper and glass.  Dull lights.  Noticing blonde hair.  And not caring.

Therapy Assessment

Or, “One hour of me feeling defensive and being asked questions like, “Why do you use labels like manic depression”?

Because I have this treatable illness called “manic depression” and you were asking about it? I’m fairly well read when it comes to psychiatric diagnosis, mostly because I write this blog and like to be informed. Using the “label”of manic depression comes naturally to me, because I write about it so often. I also find the whole thing easier to understand and explain if I can use the bloody words that describe the illness. I hate this about psychiatry- I do my best living with this, but it does affect my life significantly. I don’t “let it”, I’m not weak, it just does because that’s what it does to me. Just because it affects me and I acknowledge that, it doesn’t mean that I define myself by it. I use the phrase, “I have manic depression” rather than, “I am manic depressive”. If I had another illness that significantly affected my life, nobody would call it a fucking label. People are always very suspicious if you know anything about psychiatry. I have the internet, a library and a curious mind- if I’d been diagnosed with any illness I’d have found out everything about it by now. It is how I make sense of it and deal with it. If it was still this faceless thing, like it was, it would be harder.

They also asked if I was showing them my scars. I wasn’t, I was fiddling with my bracelets because I was nervous.

I did talk about eating issues and body issues (which I find nigh on impossible talking about in the flesh- manic depression, fine, it’s almost my job to talk about that) but fucking hell, that was so traumatic and I feel completely shaken and tearful. I really didn’t expect for it to be so hard, and sitting there in front of two impassive faces was just fucking horrible.

They asked me what I wanted out of therapy. I told them Rob was worried about me, and I wanted to make an effort to try and sort out my eating and body issues as much for him as for myself. And because dysphoric mania is too easily triggered by antidepressants, I’d like some help in coping with depression since I can’t take medication for it. In short, just some help coping with things.

I just hated that whole hour and feel shaken by it. They were nice, it’s just so fucking hard to talk about that kind of stuff in front of strangers when you’re not absolutely pissed. Here’s why I prefer to write than to talk.

I’m repeating the experience next week.¬† Ah fuck.

At least I went, though! I was so nervous beforehand that I chainsmoked for two hours.

The Sane Guide to Living with Mental Illness: Medications

I was watching cigarette advertising from the 1950s onwards on Youtube today. It’s all very aspirational, grand cars billowing Camels smoke from the driver’s window, doctor extolling the virtues of Chesterfields and such like. So I made my own non-aspirational cigarette advert.

Anyway…

Here is another one of my more sensible guides to mental illness, this time, medication, from someone who’s been on most of them and suddenly packed in nearly all of them. (Although I am on 50mg Lamictal with Seroquel now to see if it dents my mixed episode). I guess a lot of you who are already on medications won’t find this helpful, but some other people might.

So!

The Psychiatrist has decided that you’re mental. Well done! By now you’ve probably been told what flavour of mental you have. The flavour favoured by most is bipolar disorder but you may have been told you have schizophrenia, depression, anxiety, a personality disorder, obsessive compulsive disorder or an eating disorder. Or even more than one of those things! That’s good, it means you’re extra special.

What will happen now is that they’ll hold a little conference behind your back to determine whether you’re going to be prescribed medication, going to be referred for therapy or whether you’re going to be kicked out of their office.

Chances are, you’ll be prescribed medication. It’s likely that they’ll be an antidepressant, antipsychotic, anti anxiety drug or mood stabiliser. Or pick and mix from all of the above.

So, here is the guide to medication.

1. You’re taking them because…?

Psychiatrists sometimes have a habit of thinking that their patients won’t understand clinical terms like “psychosis” or, “you’re flipping the fuck out”. So they might use helpful little phrases to explain to you why you’re being prescribed a certain medication, and they try to avoid frightening you by implying that your behaviour is a little…let’s say, off?

“This will calm you down”- “You are vibrating like a badly drawn cartoon”.

“This will help….even you out”- “You have burst into tears six times and then burst out laughing another ten for the thirty minutes you’ve been said here”.

“These should help lift your mood”- “You tried to kill yourself with my stapler”.

“These will help alleviate your compulsive behaviour”- “I’ve noticed that you’ve been counting the vowels I use in my sentences” (That was twenty three).

“These will help with your strange beliefs”- “You’ve referred to yourself as The Queen for the duration of this discussion”.

2. Know your enemy

Occasionally, a doctor will withhold a diagnosis from you or whoever bought you to the psychiatrist in the first place. Generally, you can guess what’s up with you via your medication. Antipsychotics, like Risperidone, Quetiapine, Amisulpride, Haloperidol and Olanzapine are generally used for psychotic disorders like schizophrenia, schizoaffective disorder, delusional disorder, manic depression, some types of personality disorders, some sleep, anxiety and compulsive disorders and occasionally, depression. Antidepressants like Prozac, Citalopram and Effexor are used for depression, some personality disorders, panic and anxiety. Anti anxiety drugs (the ones that are benzos, not antidepressants like Paxil) like Valium are for anxiety and panic and mood stabilisers, usually anticonvulsants, like Lithium (which is an antimanic), Depakote, Carbamazepine and Lamictal are used for some types of depression, personality disorders and manic depression.

If you have the interweb, and you do, since you’re reading this, research your medication. But be prepared to find out some things you didn’t want to know about…

3. Side Effects

Psychiatric medications are notoriously awful to take for some people and chances are you’ll have side effects. In short:

Get used to drooling. Antipsychotics and anti anxiety drugs can be really sedating and make your body go a little bit floppy, though it probably feels as though your limbs are made of lead. They can also cause you to slur your words, so, a little bit of spit might make a dash for freedom.

You will feel weird for a few weeks. Lots of medications take a while to work on the illness they’ve been prescribed for. In the wilderness of waiting, you might feel weird. You might feel blunted, spaced out, anxious, irritable or you might be having some odd thoughts. Tell your doctor.

You will sleep forever. If you’re taking antipsychotics, anyway.

Avoid the scales. It’s a shitter but psychiatric medication can make you gain weight. Antipsychotics are worst, anticonvulsants like Lithium and Depakote are pretty much wank too, antidepressants can be tricky and anti anxiety drugs, well, the benzo type, aren’t meant to be used for more than a week or two, so you shouldn’t gain weight from them.

Shake, shake, shake. The anticonvulsants will give you the shakes, listed on the PI sheet as “tremors”. It can be a bit embarrassing as people might assume, like they did me, that you’re an alcoholic. Try not to take sugar in your tea as it just causes confetti.

You might not think as clearly as you used to. Most drugs affect how your mind works. Even caffeine does, so psychiatric medications will. Well, they’re designed to. For the first while taking them, your head might be a bit foggy and…

I had a point here, but I don’t remember what it was… because I’m taking antipsychotics.

4. Don’t expect miracles.

Some drugs work on some aspects of illness very quickly. Antipsychotics are good for getting people out of psychotic and manic episodes pretty fast. Antidepressants can lift your mood within a fortnight.

You have to take drugs in order for them to work. If you’re not taking the medication as prescribed, the medication isn’t “not working”. You’re just not taking them.

There is more to mental illness than direct symptoms and medication isn’t a cure for them. The chances of you being suddenly completely better are slim, and because of this, medications will be changed, doses will be adjusted and other treatments will be drafted in alongside them.

You don’t actually have to take medication if you don’t want to. There will be times when you will have to- i.e if you’re under section, but aside from that, you can choose. Of course, if you’re under the care of a psychiatrist or mental health team, you will be strongly advised to take what they’ve prescribed you.

But, you can weigh up the pros and cons of medications. If the side effects are too much, say so, because another medication can be tried. If you hate the way they make you feel, say so, same applies. The decision is ultimately yours, though.

In reality, it’s best if the decision is ultimately yours and someone elses’ because getting ill again- relapsing into mania or psychosis, for example- means that you won’t be in the place to decide if you should be taking them because you might feel that nothing is wrong. It’s always good to have someone else tell you that you’re mental when you don’t believe it yourself.

5. The medication Hissy Fit.

Yeah, chances are you hate your medication, even if it is helping. You’ll want to flush them down the toilet, chuck them into the Thames, strap them to a rocket, etc etc etc. Have your hissy publically with the doctor before you decide to do the above, as they will be only too happy to tell you what a pain in the arse you were when you weren’t taking medication.

6. If you’re going to continue medication, DON’T:

Drink. Alcohol and psychiatric medications are a ridiculous mix. They make you a lightweight and you’ll be drunk a lot quicker, but be less inhibited so you’ll drink more. That way lies making a total dick of yourself in front of your friends, passing out in the street and pissing yourself or ending up in hospital.

It can be dangerous to drink alcohol while on certain medications like Lithium and Depakote.

And alcohol is a CNS depressant and it will generally make any mood unstable. There’s no point in taking an antidepressant to make you feel better, only to get wasted and feel like shit.

Take drugs. Because you’re already pumping powerful chemicals into your body and you don’t need more.

Drive. Don’t even attempt to drive if you’ve just taken an antipsychotic as it will result in a DUI and probably the end of your car. Don’t cycle either, because, like me, you might find that you’ve forgotten how to steer and career into the pavement of the Seven Sisters Road.

and DO:

Get a pill organiser. One of those cheap plasticky things you can get from chemists for the princely sum of ¬£4.99. They sort your pills out by day so you can’t forget or take too many.

Keep tabs on them. By recording how you feel every day. Or ask someone else to do it for you if you don’t trust your own insight.

Drink lots of water. Because they can piss about in your blood stream, liver and kidneys.

7. And if you’re not going to continue taking medication:

Do it slowly. Don’t come off medications suddenly. They are drugs, and like any drug, they might have withdrawal. Do it slowly.

Look into other treatments. Like therapy, for example. For some people therapy works as well as or better than medication.

Tell someone. If you’re in the right frame of mind to. Quitting medication can cause a relapse that you might not notice but other people will. Subtle things, like stripping to your knickers and running into traffic.

Anyway, that’s my Sane Guide to Medication. Anything you want to add?

Friends of the Madosphere

A question I get asked a lot in relation to this blog is- “Have you made any new friends because of it?”

The rather blunt answer is, “Not really”. There is one actual friend that I have made from this blog, and a few acquaintances who I might be friends with if I was not so notoriously bad at keeping in touch with people. I love my readers and commentees, who are, by turns, hilarious, caustic, sympathetic, helpful and massively intelligent. And are pretty much the reason I continue to write here. I would have stopped a long time ago if not for them.

I do talk to a few people off the site but I am now cautious about such things as, on one hand, a few people have plagiarised me and pissed me off (I’m not linking, but discussions have been had) and on the other, when I publicised my MSN address, I was inundated with people telling me they were going to kill themselves, and I had no way of helping them. Considering I recently lost one of my best friends to suicide, I just can’t cope and I don’t use instant messaging anymore. So I don’t have much opportunity to speak to people off the site, aside from lurking on their Facebook profiles (which I do). So, sometimes, for sake of self preservation I necessarily keep a distance.

The two friends are:

Mental Patient: Or the artist formally known as Tony Nunn. Tony’s forty two, literate, a total lifesaver to me and he has schizoaffective disorder. I haven’t seen Tony in a while but we do keep in touch and very occasionally meet up in various caf√©s where we eat food, he disapproves of my smoking and we both argue the toss about the joys of being mental. I enjoy being around Tony a lot. He’s similarly mental to me- we’re both frequenters of intense paranoia and have suffered through some similar delusions, therefore we’re both unshockable in regards to each other’s stories. We both have very rapid cycling so there’s no need for hurried explanations on the pitfalls of being a moving target. He has a big laugh and he likes wine. There is something very classy about him, it’s probably his manners. Tony is partly responsible for my continuing existence in London, so blame him.

Zarathustra of Mental Nurse: I’ve known Zarathustra for five years, long before he was a nurse and before I knew I was manic depressive. Faltering communication and very different geographical locations mean that we don’t see or speak to each other often. We met on a Manic Street Preachers forum, back in the days when I was a precocious mentalist. He has had the pleasure of meeting me while I was submerged, or should I say, stratospheric, in a manic episode. We once ran a piss-poor satirical website together which lasted for about five minutes.

And notable acquaintances:

Lou: Lou is one of my readers. She lives in Northern Ireland, not far from my stomping ground. She has been unbelievably supportive and I sometimes read her e-mails when my finger is hovering over the “delete” button of this blog.

Scott: Scott writes Exact Science. We only seem to talk very late at night when we’re both feeling hysterically bad.

Wife of a Schizophrenic: She doesn’t publicise her name so I won’t, either. Not only does she run one of the best mental health blogs there is, she is also an amazingly lovely woman.

There are loads of other people I speak to occasionally, (like Nessa) and a few whom I used to, but have lost touch. There are some blogs I still want to add to my blogroll and there are some people out there I am too shy to speak to. And various people have donated to this blog and helped me continue to live somewhere that isn’t a cardboard box and I’m indebted to them.

I have entertained fantasies about having a Mentalist Meet Up, somewhere posh. (Namely, I was dying to get loads of my readers and fellow bloggers together at the impossibly posh Berkeley for afternoon tea. I just love the idea of a ton of bottom-barrel (by that I mean “perceived as by certain factions”) mentalists like me in fancy clothes mingling with the rich and never had to budget for teabags).

I would love to meet a lot of you in person. And, in my own narcissistic way, I also wonder what you’d think of me in person. I vary wildly depending on what mood I’m in, as most people do. Sometimes I am utterly withdrawn, almost belligerent, tingling with agitation, and sometimes I am forthcoming and funny. However, I am always shy, I just deal with it in different ways.

If I’ve missed you off my list, don’t be offended. It feels rather cruel of me to make the list in the first place. I am getting better at keeping in touch and responding to e-mails so if you ever do want to talk to me, e-mail me and I shall happily respond.

In Happier News

Edited the link- I’d put the wrong one in there.

But in good news, I received my copy of One in Four today, which I wrote for!

In hindsight, the article I wrote is far from my best work but I’m still proud to be a part of it. The magazine itself is fantastic and is available free in various places (mental health trusts and the like) so keep a look out. Mental Nurse also feature in their web review.

I’m not right now at all

Oh look! A lyric.

I keep writing posts and then deleting them. It comes down to this: things are not going too well here, in terms of shoddy and desperate mental health, so I might be an absentee for a little while.

I’d say, “Oh no! I don’t know what’s wrong!” and look innocent and bereft. But I do. I do know what’s wrong. And I am sick of it.¬† Agitated depression, I guess you would call it.

I’m not asking for help or advice here. I just wanted to fill you in. I can manage, I am okay. I am just so frustrated and beaten that I want to go and throw myself into some traffic.

And that’s all the weather.

Admitting to feeling like crap

This was a private post but I’ve decided to make it public instead.

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Thanks

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Labels and language

Bipolar disorder is “just a label”.

Not to me.

I know mental illness is culturally and personally complicated. A faction, a rather large vocal faction, don’t believe in the existence of mental illness. There’s another debate about this over at Mental Nurse. I stayed out of it.

It’s fair enough to hold your own opinion but to me, it’s insulting when people refer to bipolar disorder as a label. The same is true of schizophrenia, some people refer to it as a label, but, more often than not, there’s a little get out clause stating that “oh, but schizophrenia, that’s an illness” because it is more obviously destructive and indiscriminating than bipolar disorder. “Learned” types don’t make this distinction but the laymen do.

One of the problems is that bipolar disorder is seen as a middle-class illness. Its famous sufferers are by and large educated, artistic people. Schizophrenia, on the other hand, is an illness that is known for affecting people from working class backgrounds. Its very image is of the mad bag lady, or the unwashed black man gibbering on the bus. This is a stereotype, not from me but from society as a whole. Schizophrenia is the poor man’s disorder, and manic depression is the rich man’s disorder. Because manic depression tends to be publicised as an artistic disease, it’s easy to see it as a label that auguments this image, rather than an illness like schizophrenia.

I can see why some people prefer to see mental illness as a label.

Mental illness, particularly schizophrenia and personality disorders, come with stigma attached to it. The public’s perception of schizophrenia isn’t a sympathetic one. It’s wrongly associated with violence, and people fear those affected by schizophrenia.

Because of the stigma attached to mental illness, it’s better to see it as just a psychiatric label with no real meaning to the individual. Being “a schizophrenic” or being “a manic depressive” says something about you, something that might be seen as negative. Labels you can get rid of. Labels are interchangeable and unreal. The causes of mental illness are unknown, so maybe it isn’t worthy of being called illness at all, and sometimes diagnosis can vary from person to person. There’s no way of proving that somebody has a mental illness. A label that says, “Something is wrong with you” is insulting and unnecessary. Lots of people believe that psychiatric labels are just imposed on someone because society doesn’t know how to cope with them. In my own experiences, some people have considered me to be arrogant because I explained that I had manic depression. Implying that I have a real problem, and am not just a contrary, melodramatic woman.

I see this as real. As real as any other illness.

I think seeing mental illness as being as real as physical illnesses is the way forward in reducing stigma. A lot of people don’t agree with me, though. If mental illness is real, then your diagnosis does mean something. And you can be defined by it. And people are defined by mental illness, far moreso than they are by physical illnesses, because a mental illness lives in your control tower, pulling the switches that make you who you are. But if mental illness is real, then it’s not the fault of the person who has it. They didn’t do anything to make this happen to them.

But if people just dismiss mental illness as a label, it devalues those problems. It implies that any suffering the person is experiencing is not real. It’s all part of a disposable label. If someone kills themselves over a label, well, that’s just stupid. Mental illness can be treated. (Although the actual wanting to be treated for it is another problem altogether). And, although there’s no real scientific evidence of yet that shows that mental illness is hardwired into the brain, there are a lot of physical illness that cause symptoms of mental illness. Dementia, epilepsy, MS. So there is something in the mind that causes hallucinations and mania. People suffering from hallucinations that have been triggered by a physical cause aren’t fashioning coping methods, so why are people with mental illness supposedly doing just that?

I don’t think that I’d be “free” if I thought of manic depression as a label rather than an illness. I don’t think I’d be liberated from all that manic depression implies. This feels like an illness to me. It feels like an infection. It swept through my body eleven years ago, it weighed down my bones and dissolved its sickness through my body and mind. This feels absolutely physical to me. I don’t just become depressed sometimes and manic at others. It’s not an isolated syndrome. It affects everything and it is not a case of “letting it”, no more than a person with cancer can “let” their cancer destroy their body. My energy is affected by it. My perceptions and my abilities are affected by it. Days I can’t sleep, and days I can’t wake, and days I can barely walk more than a few yards, and days when my hands shake so badly that I can’t hold a cigarette, and ash is confetti. It isn’t “all in my head” because it’s not confined to my mind. It’s in my body, too.

There is a theory that people develop mental illness to cope with unbearable stresses in life. There is one illness in which I support this theory: Dissociative Identity Disorder, because, overwhelmingly in those who suffer from it, there has been a massively traumatic event that has happened to them, and I can see and understand why someone would want “alters” in order to escape, in order to cope.

I don’t believe that other mental illnesses are caused by stresses in life. Certainly worsened by them, as any human emotion is affected by the life around them. In my case, I’ve had those traumatic events. A lot of my life was a nightmare. But, in a way, I deal with that well, just like I’m good at dealing with emergencies, I get on with it, and I always have. Nothing “triggered” my first episode, the same way that nothing has triggered all my episodes since. And I did not just “become” manic depressive when I was twelve. I can see its roots stretched back as far as my childhood, which makes me believe even more so that this is just an illness that I was born with.

If mental illness is real, then the people who suffer from it are not just burdens on society who got there on their own volition by being fucked up and reckless. It just happened to them, like cancer happens to other people. Because a lot of people with mental illness drink and do drugs to cope with it, well, the image of mental illness is unfavourable because we’re all alcoholics and druggies, on the bottom rung of society. They didn’t do anything for this to happen to them. It’s not their fault.

If mental illness is real, it can be treated. Maybe one day cured. If I saw this as a label, a label that was destroying my life, not because I let it (believe me, I try, very hard, every single day, to not let it do anything), I’d have no hope. I probably wouldn’t have accepted the diagnosis in the first, probably wouldn’t be treated for it, probably wouldn’t have a CPN, probably would never have spoken to Rob about it, probably never would have started this blog, probably would have killed myself the second I left hospital.

I don’t believe in the “Big Pharma”. All huge businesses are corrupt, and a lot of people shouldn’t be on psychiatric medications. But some people should, and for some people, it does help. Of course, because it’s a label, psychosis, mania, depression, it’s all good, it’s all someone “experiencing” stuff. But those experiences can be so destructive. And sometimes, people need a drug to pull them out of the depths and heights of these experiences. It’s not coercion (although I do agree with detractors that in the past, “inconvenient” people were put into hospitals), there is a need for antipsychotics and hospitals to help stop someone ruining their lives, or taking their lives. Of course people should be allowed to, but it’s unlikely that once you help someone ease back into a more rational frame of mind that they’d want to.

Another thing is that being “ill” grants you a “victim” status that those who espouse the label theory don’t like. I’ve written before about the survivor/victim mentality so I’ll just let you read that instead.

And there is, of course, the language of mental illness. Words that you are not supposed to use, lest you be a “victim”:

  • Mental illness, as opposed to mental disorder/mental distress/fantastic thing that makes me so unique
  • “Suffering”. You’re not allowed to “suffer” from mental illness because if you do, you’re a victim
  • “Medication can be helpful”, no, medication is EVIL.

I understand the reason people refer to mental illness as a label. But it is insulting to me. And it’s insulting to me when people comment here and tell me to take a bit more exercise and eat my greens and do a bit of yoga and I’ll be fine, as if I did this to myself by sitting around, did this to myself by not eating enough leafy vegetables. Over eleven years, I have done all the good stuff, done the exercise, got my vitamins, had a “positive attitude” and it didn’t help. I did not do this to myself. If I did this to myself, I would undo it to myself. Oh, yeah, and if you want to be in my bad books forever, do come here and tell me three things:

1) Pull yourself together, I did, it’s just a label, think positively, your diagnosis doesn’t mean anything, etc etc

2) DIET and EXERCISE? Oh, and YOGA and REIKI and other bollocks? It worked FOR ME. You don’t need ANY OTHER TREATMENT AT ALL. In fact if the above doesn’t work for you, YOU’RE WEAK, AND BEING CONTROLLED BY THE BIG PHARMA!

3) Your illness is an EXCUSE for you not to live a NORMAL LIFE because obviously due to your EXCUSE you must not ever tell anyone that you LOVE them or PLAY WITH YOUR KITTENS or ANYTHING since you spend ALL DAY just being MANIC DEPRESSIVE.

4) How dare you use the words SUFFERING and MENTAL ILLNESS. It is “MENTAL DISTRESS” and saying that people SUFFER from it makes it sound BAD.

For those people, I can use other words, like “fuck” and “off”.

The only thing that my illness is an “excuse” for is for my slurring my words occasionally on medication. I’m not defined by my illness, even if I don’t consider it a label. It’s part of me. Part. It does hold the reigns on my life, but hey, whatcanyoudoaboutit. Not much more than I am doing, really. I think therapeutic exercises like yoga and whatsit are important as supplements to actual medical treatment (indeed, I am getting a prescription to exercise to help my energy), but not the be-all, end-all. I don’t like to be made to feel like a failure just because I’m in psychiatric treatment, and just because, so far, I’m not better yet.

It doesn’t mean that I define myself as “manic depressive”. I don’t. I think of myself as someone with manic depression.

I still don’t feel very well so that may account for the tone of this post, and the fact that it doesn’t make that much sense. Although at least I managed to get out of bed before 4pm today.

Shout Back

For no reason at all, tonight I’ve got suicide on the brain, which is why I’m sat over here typing because my head is screaming angrily at me. When I have a nice, blue skied, life-is-here kind of day when I feel depressed, I get the idea that it’s a good place to “leave it”. A quiet night at the end of a sunny day.

I’m pissed at myself for this and trying to rally other parts of my brain to shout the voices down. How much of a slap in the face to people like Rob are these thoughts? Spending one day with someone, let alone three years, is taking time out of your life. What is the point when that other person would just kill themselves? What’s the point?

Ah, spiral of guilt. I hate myself for thinking like this. I hate my mind for working this way.

I still want to stop taking medication. You’d probably think, “Yeah, don’t”, but sometimes I get stuck thinking that it would somehow be the solution to all my problems. For all my rhetoric and analysis, I still can’t help thinking in this way.

Wah. Anyway. I have something else on my mind that I’ll write about tomorrow.

EDIT:¬† It’s 4am and I’m still not asleep, but exhausted.¬† I have a craving for Coco Pops.

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.

The Insane Guide to Living with Mental Illness: Psychosis

I’d written a long, detailed Insane Guide to Psychosis, but WordPress logged me out and it didn’t save.

If you would be so kind as to hallucinate the post and be under the delusion that it’s here, that would be great.

The Sane Guide to Living with Mental Illness

Wow, this blog has gone right off topic recently. Flippin‚Äė friends dying, they‚Äôre so inconvenient.

I am still nowhere near caught up on e-mails so please excuse me if you haven’t received a reply from me.

I am fairly sane at the moment.

This is somewhat of a revelation; I can’t remember a time in my life when I have been fairly sane. Oh, glimmers of sanity have squeaked through the black tarpaulin of madness but by and large, even my most coherent writings have come from a chaotic planet.

I am not incredibly depressed, nor am I manic. I’m not fantasizing about suicide- it’s been a few months since I’ve white-knuckled safety railings at the riverside.

Anxiety and paranoia, yes, excessive worrying- well, that’s just me- and my ongoing battle with weight and eating continues. A lot of sadness and sorrow and anger at recent events. But mood-wise? Steady, in a mildly depressed kind of way.

How do I judge my own sanity? By not comparing myself to other people. I’m never going to be Completely Sane. The lovely thing about the world is that you’d have to look a long way to find someone who is.

I‚Äôm never going to not have manic depression. Even now, with a somewhat clear head, there are ‚Äúresidual symptoms‚ÄĚ.

Anxiety and paranoia. An ongoing battle with weight and eating habits (and not-eating habits). Still having trouble sleeping. The reckless nervous energy that is 50% me and 50% manic depression. A mild, niggling, irritating depression that blunts my experiences and emotions. Intrusive thoughts and panic. Narcissistically worrying about being narcissistic.

But this is good.

It was only a few months ago that I was ravingly psychotic, swallowing a huge dose of Lithium and on the verge of utter annihilation. Every little victory- the return from self-destruction- I cherish. To judge my sanity, I compare myself, to myself.

Every time I cast mind back to six months, a year, a year and six months, I’ve been ill. For most of my life, I’ve been ill. I’ve clung on to the merry-go-round of madness and am barely alive because of it.

So, while I‚Äôm feeling relatively together, here‚Äôs my sane guide to living with mental illness. Bear in mind it‚Äôs from the perspective of ‚Äúbeen there‚ÄĚ rather than ‚Äúbeen told‚ÄĚ. Feel free to ignore everything, though!

1. In times when you feel better, don’t expect the unexpected.

If you‚Äôre like me, this is much easier said than done. I‚Äôm a born worrier. I worry about everything. When I click ‚ÄúPublish‚ÄĚ, I‚Äôll worry about that, too. Talking about myself all the time? How self-obsessed. And in my self obsessed way? I‚Äôll worry about that. I worry about everything I say, everything I don‚Äôt say, and everything I don‚Äôt do, and everything I do.

So I find it hard not to worry about the next episode of illness.

I know it’s probably coming, so I find it difficult to enjoy not being mad for a change. Experience has taught me that these lulls in time are the calm before the storm. I’m a rapid-cycler, and pockets of sanity are brief for me.

But, this time, I‚Äôm trying to think, ‚ÄúMaybe this will last longer than a few weeks‚ÄĚ. You never know. So don‚Äôt try to will your next psychotic breakdown or manic episode. Relax, if you can. Take your medication, try to be okay.

2. Keep taking your medication, even if you feel better.

Ah, this old chestnut.

I‚Äôve only been treated for manic depression for the past year and a bit. But every time I‚Äôve felt ‚Äúalright‚ÄĚ and decided to ditch my medication and miss appointments, I‚Äôve become ill again, very, very quickly. It has nearly always resulted in a messy hypomanic or manic episode and has meant that my antipsychotic gets upped to deal with the ‚Äúcrisis‚ÄĚ. Or, there are times I‚Äôve quietly skipped my medications and lied about it and become suicidal.

Something I believe, and have emphasized a lot here, is that mental illness is partly biological.

Sure, nature can embellish it, but I strongly agree with the idea that there is a biological basis for most mental illnesses- almost certainly some forms of depression, manic depression, anxiety, schizoaffective disorder, addiction, schizophrenia (their symptomatic similarities to biological illnesses such as epilepsy only strengthens my conviction) and possibly personality disorders, eating disorders and DID.

I don‚Äôt subscribe to the belief that mental illnesses are ‚Äúlabels‚ÄĚ. Cancer, diabetes, asthma, etc, aren‚Äôt labels, they‚Äôre illnesses. And so it mental illness. Once I got past that, I found it easier to write with conviction, without worrying about ‚Äúlabelling‚ÄĚ myself. I have got manic depression. Whoop.

I‚Äôm not on the gravy train of the ‚Äúmedication is evil‚ÄĚ. It doesn‚Äôt mean I like to take them, though. I hate taking my medications, I always will. I hate the ritual, I hate the weight gain, I hate the exhaustion. I can see the argument- especially in countries where you pay for healthcare, such as the USA, and where medications are advertised like sweets. But if you take something and it makes you feel better, well, I think that‚Äôs okay.

And I don’t think people appreciate how difficult it is to continue taking medication for mental illness. On one hand, the side effects can be close to unbearable. I do entirely understand the stance that medication can numb you. But if I hadn’t been treated for manic depression- and medications are a huge part of that- I would most likely be dead.

So on the other hand, we come full circle to…

It’s not a cure. It’s to help you cope and live with your illness, to alleviate some of the more frightening and terrible symptoms that you are living with.

So when you feel better, don’t stop taking medication and don’t miss appointments, however tempting it might be. You might be feeling better due to sheer force of will, help from people, or maybe your illness just shifted somewhat, but, if you’ve been taking medications for a while, there is almost certainly something in them that is helping, too.

3. If it’s not working, say so.

Lithium made me physically sick and didn‚Äôt help at all with my illness. But because it was the ‚Äúgold standard‚ÄĚ for bipolar 1 disorder, I didn‚Äôt speak up, and quietly waited to feel better.

I never did and after the third or so bout of vomiting, shaking and passing out, I told the psychiatrist that I didn’t want to take it anymore.

Likewise, Seroquel helps me sleep, quells psychosis for the most part but it‚Äôs ‚Äúantidepressant properties‚ÄĚ are non-existent in my case and it turns me into a zombie. So I am being slowly switched to risperidone instead.

Of course, there may be times you can’t tell your medication or treatment in general isn’t working. So this one’s for those around you who know you- if you can, let someone know. I was manic for a while on Lithium and it was Rob who noticed I was, not me. Insight is an occasional companion sometimes.

4. Get support.

It can be isolating to live with mental illness. And not everything is as culture tells us it should be; lots of people don’t have close friends or family to rely on. And that isolates us further. Sometimes, family and friends don’t understand. Sometimes, you just don’t want to talk to them anyway.

There are support groups around the country that you can speak to and make friends at. The Manic Depressive Fellowship (now the much more PC Bipolar Organisation) holds regular local support groups, and The Support Line has some links and phone numbers for people with depression. Rethink also offer support groups for illnesses such as manic depression, depression, anxiety, schizophrenia and personality disorders, amongst others.Other ‚Äúservice user‚ÄĚ groups include The Perceptions Forum, run by mad people for mad people, centering around the psychosis experienced by people with psychotic illnesses.

There are also tons of online forums that exist to support people with mental illness. A great one is The Mood Garden, which has forums for depression, self harm, anxiety and panic and substance abuse.

There are other good forums and support groups for problems such as anxiety and eating disorders.

5. It’s good to talk. Therapy is important too, but if you’re not going private, bring a book.

I was diagnosed with manic depression over a year ago and I’m still not in therapy. Medications can be good, but I think therapy is just as important. Having someone to talk to, learning ways to cope with an illness that you might have forever and taking the strain from ear-bashed loved ones is valuable.

I am finally speaking to a therapist soon- about friggin’ time an’ all. As biological as mental illness might be, sometimes, treatment is complicated. For example, I can’t take antidepressants. It’s been done a few times, and each time has been the same- hello mania. Treatment, then, is needed to help me cope with depression. I also have, as you know, Body Dysmorphic Disorder and problems with eating disorders, that pills don’t really help.

And even if you have a tidy mentally interesting diagnosis, life still happens, and it’s hard. Quite aside from regularly lapsing into depression because of my illness, there are life-things I struggle to cope with.

And again, it’s a little-thought line that dealing with the diagnosis itself it very difficult indeed. I still have trouble accepting my illness, however lucid and sage I seem here. Like any life-long illness, coming to terms can be hard.

The fall-out from episodes of illness can often be extremely hard to cope with. The strain it can put on your relationships, jobs, physical well-being, finances and other areas can sometimes be the beginning of a downward spiral. (After bad episodes of illness, I hate myself and feel so guilty and worthless I want to top myself. But there are always people I can’t look in the eye, and I find it very difficult to speak to friends and to manage the practical aspects). Psychotic episodes, in my experience, can be the worst as it’s a side of you people may have never seen before, and may find very hard to understand. It is really good to talk these things through.

So, if you‚Äôre being treated, push for therapy. You might have to wait a while, though. If you have specific issues (or your loved ones do), such as bereavement, substance abuse and ‚Äúyouth‚ÄĚ related problems, there are many free counselling services around that you won‚Äôt have to wait so long for, such as Cruse and the Mind Guide to Counselling.

Also, never forget that if you feel you have no-one to turn to, there are confidential counsellors available by phone and e-mail such as the Samaritans. It’s their job to listen, and they can really help in a crisis.MIND also offer free counselling.

6. Mentalist- know thy services.

It’s not inevitable that you’ll need to go into hospital in an acute episode of illness. Whereas sometimes it may be the only option (such as needing to be sectioned for your own safety, and the safety of others), hospitals can be extremely traumatic. They are boring, above all else, and the surroundings can leave a lot to be desired.

If you, your ‚Äúteam‚ÄĚ and those around you think you may need somewhere safe to be for a while, there may be other options. For example, there are crisis centres. I am lucky to have (and to be visiting next week with the CPN) a women‚Äôs only crisis centre.But look up mental health services in your council directory and ask questions. There may be a crisis centre near you.

You can also enlist the help of a crisis team if you want to avoid admission to hospital. Most councils have a community mental health crisis team who can give you ongoing support and evaluation at home.

7. If you can’t work, get benefits advice and help claiming them. And get someone to keep an eye on your finances.

I have been too disorganised and unwell to even begin to sort out my benefits. My CPN played a huge part in helping me, as did Islington People‚Äôs Rights. Now I’m finally on Income Support, Housing Benefit and DLA.

If you’re able, find out what to claim and how, and try to get independant help and advice from local people’s rights services or from the Citizen’s Advice Bureau. If you have family or friends, enlist their help in getting forms for you and helping you fill them out. There are also online services and resources such as the Advice Guide and Rethink.

When you have a mental illness such as manic depression, borderline personality disorder or schizophrenia, you might be, like I have been, impulsive and reckless with cash. When I‚Äôve been working I‚Äôve gone on many a manic spending spree and completely cocked up my finances. The ‚Äúoh no‚ÄĚ bank statement is not your friend, so, embarrassing as it might be, it can be a good idea to ask a friend or someone close to keep an eye on your spending for you.

8. If you’re reading this, you’re alive. Nice one.

Mental illness can equal terminal illness. It’s true that many people with mental illness will go on to commit suicide. Even with the best of care and support, it is not altogether unavoidable.

But being alive, day after day, is a victory. It‚Äôs not a failure, it‚Äôs not ‚Äúbeing weak‚ÄĚ. Whatever help you receive, it‚Äôs ultimately you who is responsible for yourself. So if you‚Äôre managing to continue living, no matter how horrible things get, even if in the past you‚Äôve tried to commit suicide, you are alive and you should try to have some pride in your self.

Again, this is an ‚Äúeasier said than done‚ÄĚ rule but I think it‚Äôs worth pointing out.That‚Äôs all from me for tonight- jesus, it‚Äôs a Saturday night. I‚Äôm going whip out the media player and turn on the lights so I can pretend I‚Äôm at a club or something.

I’ll be writing more trying-to-be-helpful things about living with mental illness in the future. Please feel free to suggest stuff.

Mental Illness and Mortality

Last night when my brain was car-crashing, I was reading about 10 articles per five minutes. One them was this about serious mental illness and mortality.

That was the article that triggered my panic attack. Here’s another:


 

Clinical & Research News

Death Data Have Researchers Searching for Answers Eve Bender

People with serious mental illness are dying at higher rates and at earlier ages than people in the general population who don’t have mental illness.

Metabolic dysfunction caused by some medications may play a role. People with serious mental illness in one sample of psychiatric inpatients had more than three times the rate of death of those in the general population without mental illness and died an average of 32 years earlier.

The leading causes of death among people in the sample, most of whom were diagnosed with a psychotic disorder, were heart disease, suicide, accidents, and cancer.

The findings call for increased screening and monitoring of patients with serious mental illness for medical comorbidities, according to the authors of the study, published in the October Psychiatric Services.

Researchers collected medical information on 20,018 patients hospitalized on at least one occasion at one of nine hospital sites associated with five behavioral health care organizations in Ohio’s public mental health system between 1998 and 2002.

They matched patients’ hospital records with death records from the Ohio Department of Health and identified 608 patients who died during the four-year period (hospital deaths were included in the sample).

The patients who died had been diagnosed with a number of mental disorders, including schizophrenia (134), schizoaffective disorder (128), alcohol abuse (101), bipolar disorder (87), alcohol dependence (85), major depressive disorder (80), cannibis abuse (59), other mixed or unspecified drug abuse (56), and cocaine abuse (35). The majority of patients in the sample died from heart disease (126), suicides (108), accidents (83), or cancer (44).

Researchers also measured years per life lost for those who died, which is a measure of premature death based on the current mean survival age for a cohort matched by age and gender in the general population. Patients with serious mental illness died an average of 32 years earlier than patients in the general population, according to the findings.

The average age of death for the people in the sample was 47.7 years. When researchers calculated the standard mortality ratio for patients in the sample who died, they found 3.2 times the rate of death as that of the general U.S. population.

The most prevalent comorbid medical conditions for patients in the sample who died included obesity (144), hypertension (136), diabetes (70), chronic obstructive pulmonary disease (62), and injuries (39). Among the 126 patients who died of heart disease, leading comorbidities included hypertension, obesity, diabetes, chronic obstructive pulmonary disease, and disorders of lipid metabolism.

Previous research has yielded similar results. For example, a report released by the federal Centers for Disease Control and Prevention in April said that patients with schizophrenia or bipolar disorder lose as much as 20 years off their average life expectancy compared withsimilar individuals in the general population without seriousmental illness and had elevated rates of heart disease (Psychiatric News, July 7).

At a 2004 meeting convened by the American Diabetes Association and attended by several APA members, the organization issued a consensus statement confirming the risk of metabolic changes associated with second-generation anti-psychotics and calling for careful monitoring of patients on these medications.

In the study of hospitalized patients with serious mental illness in Ohio, researchers could not draw conclusions about cause of death. They speculated, however, that underlying factors may have included medication-induced weight gain, poor personal hygiene, reduced physical activity, increased prevalence of smoking and substance use, and inadequate social support, according to C. Bayard Paschall III, Ph.D., chief of the Ohio Department of Mental Health’s Office of Performance Improvement.

“The question is how we tease some of these characteristics away” from others to be able to associate them with cause of death for patients with serious mental illness, Paschall told Psychiatric News.

Study findings indicate a need for closer collaboration between psychiatry and primary care, according to lead author Brian Miller, M.D., M.P.H., a PGY-2 psychiatry resident at the Medical College of Georgia. In ideal circumstances, patients with serious mental illness could walk from their psychiatrist’s office to an office across the hall to see a primary care physician “who might screen them for some of the comorbid medical conditions we observed in our study,” he said.

In addition, he suggested that psychiatrists and other physicians treating patients who take second-generation antipsychotics carefully monitor these patients for side effects associated with metabolic dysfunction and also write orders for tests of fasting blood glucose, lipid profiles, and liver and thyroid function. Miller and Paschall are conducting further research on some of the factors that may be contributing to excess death rates among people with serious mental illness.

 


 

I’m not sure what to draw from that as they don’t mention if the alcohol/drug abuse is co-morbid with mental illnesses. Still, it is sobering and frightening. Especially given just how low on the agenda mental illness is in Britain.

My dad died right on the money- aged 47.11 years.

Body Dysmorphic Disorder- “Say what?”

“Born dead, darling”. My ex boyfriend scrawled that over a piece of art work he had created about me, many years ago. I turned the page upside down and scrunched my nose up. Born dead, darling? Quite offended, I had a well-earned sulk. Then he directed me gently to the first letter of each word…

B.D.D.

Body Dysmorphic Disorder was my first ever Mentally Interesting diagnonsense. Long before any doctor saw that I was suffering from depression, eons before a doctor even got a sniff of my mania, I was told I had Body Dysmorphic Disorder.

Body dysmorphia is disabling, but little known. From a psychiatric point of view, it is an Axis III disorder defined in the DSM-IV as:

Preoccupation with an imagined defect in appearance. If a slight physical anomaly is present, the person’s concern is markedly excessive.

The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The preoccupation is not better accounted for by another mental disorder (e.g., dissatisfaction with body shape and size in Anorexia Nervosa).

A.
B.
C.

The DSM-IV is as dispassionate as always, there.

I tend to think of Body Dysmorphic Disorder as a type of OCD. My symptoms flared up when I was 12- around the same time I had my first manic depressive episode. I would spend all day indoors applying make-up, fixing my hair, my skin, picking away and then I would go outside. I only went outside when it was dark, heavily made-up. In the summertime, I would have an hour or so of socialising before I went back indoors. I waited all day for the moon to rise.

As time went on, I began self harming. I cut the skin I didn’t like, which eventually became everything. I wore huge anoraks all day, every day, to try and hide my repulsive shape. I would get hysterical if anyone tried to take a photo of me. My particular focuses were my weight and my nose. I hated my nose and tried to break it once by slamming my face against a wall. I cut my stomach to try and claw out the fat.

Sounds crazy, I know.

I became a recluse for a long time, and only went out when that manic energy took hold. I loathed every single atom of my flesh.

For the sufferer of BDD, the body is a prison, a horrible, malignant prison.

And I still do, but I’m different now, and this is why.

I never did go to the doctor for treatment. I had a brief period of counselling but my heart wasn’t in it. When I moved to London, my dysmorphia was in full-flight. I hated going out, was terrified of people seeing me. I’ve always worn excessive make-up in an attempt to hide myself.

I began obsessively taking photos of myself. Scrapping photos I hated, treasuring the ones I liked. I showed them to my friends. They would say, “You look like that”. Over and over again, “That is you”. And I liked that image.

I still hate it when people take photos of me. But there are images of myself I like, and cling to. The ones I hate, I abuse, shout at, hiss at. It may seem ridiculous, but this stops me from taking something sharp to my face. In a photo, I can focus my hatred. I have broken down in tears at the sight of my body in a photograph. Yeah, I know.

BORING!

I hear you cry. How many bloody issues can you have, woman? Many, is the answer. But I try not to let my issues PWN! me, as you crazy Internet kids would say. Over the years, I’ve learned to be doctor and patient with myself, getting a neccessary amount of distance to deal with things. I know it’s horrendously self-obsessed. But it stops things from completely taking over. And really, my horrendous self-obsession only exists in Blogland, where I come to lay it all on the table and have a damn good word with it.

Wrongness

Here is a pile of photos of BDD sufferers. Not a bad looking one among them. Still, I think, “I’m the exception. They’re beautiful and I’m ugly”. Nothing special, no big deal as I expect everyone who suffers from BDD things exactly the same thing.

If you click the above link, though, prepare for your, “Hah, people with Body Dysmorphic Disorder are just vain” preconceptions to be proved partly right. In that particular thread, there is a lot of assurance seeking. But people with BDD do geniunely believe they’re ugly. It may surprise you, what with my being level-headed and detached an’ all, but I believe I am geniunely ugly and no amount of flattery and assurances will change that. But that’s my crap to deal with. I have, at least, moved on from thinking that everyone who said I was pretty was a vicious liar. Now I nod sagely with a deflating, “Well, that’s your opinion”.

I am much better than I was. I sometimes don’t wear make-up because my boyfriend says I am pretty without it. A few years ago, I would have thought that people would have been vomiting in the streets at the sight of me without my slap-on. It’s baby steps. But you work through it.

It’s scary to be at war with yourself, and to find cause to wage it. It’s scary to look in the mirror and see nothing but rotted, ugly flesh.

The scariest thing you will ever do is look in the mirror and say, “I look good”. Once you say that, you’re no longer a victim. You’re stronger. You win. So say it.

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