Me talking self harm on Metro’s “Mentally Yours” podcast

Absolutely lashing with sweat due to illness, and having just burst an eardrum by being stupid, I went to a restaurant in West London to meet Yvette and Ellen of the Mentally Yours podcast in which, now having listened, I was surprisingly coherent in retrospect.

I don’t find self-harm the easiest topic to discuss. It’s pretty hard to without getting a bit graphic, so a warning that this podcast does have some fairly graphic language, as well as a few fucks, because it’s me. I haven’t self-harmed in 8 years, but because I live in a scar suit, the reaction my body gets from both the public and the medical profession means I may as well never have stopped.

It’s also not an easy topic to discuss because everyone is so different.  The hardest question I was always asked when I self harmed was, “Why do you do it?” I know the circumstances I self harmed in, the houses, the rooms, the ritual.  But the why, the visceral, deep down why, is mostly a mystery to me even now. I tried to explain here as best I could, the same way I tried when I was a teenager and was confronted, badgered, hectored with the, “Why?” from everybody who in turn wanted to understand their own anger, rage, disgust at it.

I talk about why self-harm might be on the rise in young women, on which I wish I’d said more. What I didn’t mention was my feeling that there’s an earlier sexualisation of young bodies, and self-harm can be both a fuck you to that, and a way of acting out self hatred.   I also touch a bit on the trivialisation and dismissal of childhood and teenage emotions, and of their trauma, and the unfathomable things children endure and can’t express (and bear in mind I blocked someone on Twitter for asking if I had self-harmed due to something like a teenage crush on Boyzone, so do refrain from making fucking stupid comments like that please).

And I chat about coping with scars and what led me to stop, how I stayed that way, and some advice to anyone who might want to hurt themselves.

Thanks for having me, Metro! Have a listen.

 

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.

Living in a Scar Suit- the summer edition

Edit: Before I start, I want to say that these are my feelings on my own self harm. I’m not talking about yours, or anyone elses’. This is my post about my body and my experiences.

Just a bit of a whine really.  When I’ve written about self harm here before (take a wee look at the comments page of this entry, it’ll lead you to the others), it’s been with reflection and optimism. I don’t feel that way today about my scars. Just pissed off. Stupid. Now that the sun is out, I look like a bloody zebra. A slither of sunlight on my arms turns my skin red and the scars whiter. Freckles pop out. It looks terrible, and it makes me feel like a fucking fool for what I’ve done to my body.

I can’t buy into all this, “your scars are a reminder you’ve survived” stuff, and all the other things self harmers tell themselves so they can live in the scar suit. I don’t view them with any profundity, though I’ve tried to. Increasingly, I see my self harming as a teenage folly gone way, way too far. Perhaps that’s just me trying to protect myself from the reality of what I did- to distance myself from it so I don’t get lured in again.  I would have stopped at the self-conscious scratches in my early teens, I think, if I hadn’t been practically dared to go further as a way of proving that I was in real distress, not just faking it. People dismiss scratches but not the deep, lacerating gorges I eventually wrought onto myself. I was only 13 (or 12?!) and was experiencing the start of getting mentally unwell, and the anger imherant in encroaching “womanhood”. What a stupid thing. A stupid thing especially because after the experimental scratches  (the reason I started self harming was because I’d read an article about how self harm was awful yada, but what I focused on was that they said it helped them when they were depressed) which got a, “What the fuck are you doing?” responses, I hid my self harm.  I was proving nothing to no-one, I was just getting deeper into a terrible coping mechanism for my mental health. And when it was discovered by my parents I was still self harming, they went mental, my mum especially. Having pleaded, cried and hidden all the razors, she kicked the crap out of me in angry fright.

I haven’t self harmed in years.  I have sometimes been close to it, but present enough in my mind where I can think about the pain, the embarrassment, the difficulty hiding.  Not the pain during- it rarely hurts during for me- but afterwards.  Of getting clothes on and wincing, fabric getting stuck and reopening the cuts like a zipper every time it needs to be torn off (every time, every day, every night), of crying from pain the bath and shower, of shrinking away from touch and not being able to stop myself yelling out if someone touches me, of trying to get into bed covering my cuts and being so ashamed of them I put pyjamas on that I have to peel off in the morning. The embarrassment of feeling like a dickhead, of people noticing and giving you that look (I’ve never gone to A&E for my self harm though on multiple occasions I should have. But I’ve heard enough stories of how shitty people are treated there to put up with the disfigurement and pain than to get myself help- I do not advise this and I wish I had gone sometimes). It was, to put it bluntly, a pain in the hole.

But the scars haven’t faded as much as I hoped they would. They’re still pretty severe, and there’s no way I can pass them off as anything other than what they are. There’s no hiding them if my sleeves are up. Crucially, most stupidly of all, I cut my face once, and I have little cat-whisker type scars on my cheeks. What a stupid fucking twat I was for doing that. Suffice to say, I was hardly thinking straight.  I was going through one of the worst times of my life, mentally. So I could let myself off the hook. But I can’t. Every time I look in the mirror, I think, “You stupid cow.  You’ve hated your face and your body all your life and you gave yourself a bloody good reason to”. Maybe that was half the point. I grew demented having body dysmorphic disorder but people telling me I’m beautiful. Liars, liars!  I *wanted* them to tell me I was hideous so I didn’t feel as if I were losing my mind. Well, here, you can’t keep lying to me now. Knowing, in retrospect, that my beliefs were quasi-delusional, makes me want to scream at myself even more for what I’ve done to my body.

Now it’s summer and the world is out in thin cotton dresses and short sleeves and I am, as usual, hoodied and cardiganed up in increasingly dark and dour clothes (having gained so much weight, I’ve completely lost my style, too. No idea how to dress myself at this weight. No money, either).  I have worn my sleeves up a few times outside, and in the garden.  I roll my sleeves up at work if I’m too hot (often, because I chronically overdress, and don’t feel comfortable or safe unless I’ve got a coat), which is progress.  But then again, I work at a mental health charity so you would expect them not to be shocked or discriminatory about self harm, which they aren’t.  No-one has ever commented and I’m sure I’m not the only one who works there who has self harm scars. But when my sleeves are up, I’m so aware of it, and so distracted by my own awareness that I tend to eventually roll them back down again.  When I was doing my nursing degree (I quit that last year- did I ever write about why? If not, maybe I will), I wanted to shrink into nothingness when I had my sleeves up.  When one nurse demanded of me when I was in a patients’ room with her (and the patient had taken a fucking overdose!), “WHAT HAPPENED TO YOUR ARMS?!” I wanted to disappear. I didn’t know what to say. I hated that, here was a patient and yet now because of my very visible marks of past distress, I’m the patient. One of my placement coordinators was also very rude about them and I felt humiliated. I have a good sense of humour- it’s my best defence- so responded in quips. But I felt like crying when she left the room.  Crying from shame and also anger.  Crying that for the rest of my life, I’m going to get comments on something which is as relevant now as an old leg break is. Permanent. Forever.

I’ve considered asking for surgery but they are too multiple, and it would leave me with new scars.  When I met another blogger who also self harms, she gave me some camouflage make up, which did a great job of hiding the colour (but not the texture). I may use it this summer. It’s not that I’m afraid of peoples’ reactions in the street (and you do get them), it’s the feeling of difference. My scar suit doesn’t suit anything. There’s nothing I can wear that makes me feel confident. Even with the (hot, itchy) make up, I know they’re under there.

I hate my scars. I think they’re ugly. I hate that when people see them, I can see their mind working. They’re filling in my past for me, and my future.  Abused, they think, unstable, they think, angry, they think, impulsive, they think, attention seeking, unsafe, unwanted, mental, violent, aggressive. They fill in the space where I’m standing with someone else.  Literally marked for life.  And it’s maddening.

It’s happened a lot with doctors and nurses, especially. Before I even open my mouth, they’re telling me my life story.   And I want to reply:

It’s one of the reasons why I find myself asserting all my little trappings of the Normal Person. LOOK, I’M MARRIED! SEE? FUNCTIONAL RELATIONSHIP! We watch Netflix! We do boring bullshit together! I don’t just sit there whacking chunks of my arm while he plays a sad song on a cello in our dank basement! LOOK, I WORK FULL TIME! AND WORKING FULL TIME IS WHAT THE MENTAL HEALTH GATEKEEPERS SAY MEANS YOU’RE A NORMAL SHINY RECOVERED PERSON WHO HAS NO PROBLEMS AT ALL! I’m not going to eat your babies! I’m worthy of being treated like a human being!  etc.

Yeah, I hate them. If I could go back 15 years, I’d do two things.  One, I’d smack the first cigarette I smoked out of my paw and say that I’m going to regret inhaling that more than anything else I’ve ever done in my life, even if Dearbhail looks cool doing it. And two, I’d have become distracted by a cat or something when I picked up that article. I never stood a chance, though, given I was also a fanatical Manic Street Preachers fan. Then I’d have scrawled somewhere in the notes of the Holy Bible, “Look, Richey was brilliant, but he was fucking miserable and he went missing.  If you’re struggling to cope with your mental health, and all the trappings of adolescence that will make you hormonal and even more unstable and confused and looking for something to cling to, then take up a nice, socially acceptable way of coping, like drinking heavily.  And then, in 15 years time, you can look back and laugh at it all with your mum and da…

Oh”.

 

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 fiancée 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 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.