Punishment

Two people (real people, but I can’t give details) were talking about the mental health system.  One mentioned that hospital had felt like a punishment, and the other took that literally.  “Oh,” she said, turning to me.  “I get it.  So hospital is like a punishment for the ones who don’t get it.”  I explained that hospital is for people who need more support than can be given in the community.  After several explanations she “got” it and I felt relieved.

And then I remembered.

I remembered how much, at the time, hospitalisation felt like a punishment to me.  That purgatorial state.  The way the nurses and doctors could be unkind, dismissive.  The way that I often felt I was there because “nothing else could be done” with me, that I was there because there was no chance of me getting better.  The loneliness, the restrictions on when I could see the people I loved, the constant pumping of medication I didn’t want (and didn’t think I needed) into a system undernourished by depression.  I could see why she thought it was a place for the hopeless ones, the last-ditch-attempt ones, the ones who were effectively being punished for being unwell.  Because at the time, that was exactly how I felt.

I saw through my own arguments, how weak they seemed in the face of the facts.  Even though hospital is a place for “getting better”, it definitely doesn’t always feel like that.  I understand why she took that comment literally, and I wish I didn’t, and I wish she didn’t have to.

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Truth-telling Time


I promised to be honest on this blog, a long time ago.  So here’s the truth.  I’ve been going through a hard time lately.  Various mental health symptoms have shaken every part of me, to the point where I’m not sure where my outline is.  Though I hate to admit it, I need the medication I refused to continue taking back in January.  I’m “welcoming” back the sleeping pills, the medication, the visit to A&E, the interventions I’ve been avoiding like an actual plague (bubonic/ zombie-creating/ whatever).  I’m torn (again) between these two things: (1) the medication may make me less like myself but (2) I can’t be myself if I’m not really surviving.  If I actually, literally, don’t survive.

I haven’t blogged because I feel like a hypocrite, who gives out advice about how to cope with mental distress, but actually refuses medication and becomes really, really unwell.  And although I’ve spoken again and again about how mental unwellness is “nothing to be ashamed of” I have been deeply, deeply ashamed of having fallen back into the trap it has laid me.  I feel like a total mess.  I have some great support around me, and without that support, the place I’m in would be a million times darker, even though that feels impossible.  I’m exhausted but I’m fighting.  I don’t have some inspirational sentences to draw from that, because I’m not inspirational.  I’m just medicated and moody.  Needy.  It’s an embarrassment I can only overcome enough to write this because even though it’s rubbish, I’m hopeful someone, somewhere, will feel slightly less alone because they feel like this too.  Even that seems unlikely right now.

 

Peace & love.

Misconceptions

Recently, someone I know to be an otherwise compassionate and intelligent person made a comment that seemed to be minimising the seriousness of Bipolar II. The comment itself is not really important, and it’s possible that I read the tone wrong (although I did not mishear the content). The way it was made reminded me of a friend I once had who dismissed bipolar as a “casual illness.”  It wasn’t that the comment was made in an unkind way; it struck me as uninformed.  This surprised me, because it was not said by someone I would expect to be uninformed, and not said by someone I have known to be dismissive; yet the comment was both.

Essentially, the person suggested that Bipolar II is not a “serious” illness and doesn’t cause “severe vulnerability”, as compared with other illnesses which are much harder to “recover” from (my thoughts on “recovery” are available here and I believe, and have seen, that people can and do experience recovery from and within all sorts of illnesses, even those deemed most severe).  I hear this kind of thing a lot: “just” depression, “just” [insert any number of illnesses].  But in my experience, “just” depression, “just” Bipolar II, are things that can actually kill.  As in, quite literally, cause death.

What I wanted to say/ should have said/ didn’t say to this person, is that I don’t have the luxury of taking bipolar lightly. On more than one occasion, I have almost lost my life because of it.  On more than one occasion I have lost friends, jobs, opportunities, because of it.  I will probably be taking medication for the rest of my life.  I will always be sensitive to the changes in my mood, the way a sailor learns to be sensitive to the wind.  I cannot afford to take any period of wellness for granted, and  I can’t afford to be flippant about it.  If you can, then count yourself lucky, and educate yourself on the topic before you say something.  (The person, by the way, did acknowledge that there were things that s/he didn’t know about bipolar/ depression.  Which is absolutely fine, most people are not walking medical encyclopedias.  But if you don’t know something, it is probably better to do a superficial google browse before dismissing as casual the illness of a person you know has that illness, in front of that person).

I know where I’m fortunate, by the way.  I know that (especially at the moment, not being consumed by any particular mood) I am lucky, and I have zero interest in playing a game of comparisons.  I am also aware that some people are impacted much more severely by bipolar (I or II) than I am (currently).  My point isn’t that my particular mental state, at this particular time, is better or worse than that of anyone else.  My point is that it isn’t the name of the illness that should shape your perception of it.  “Personality disorder” or “bipolar” or “schizophrenia” or “PTSD” are all different conditions.  The severity of each varies from person to person- not necessarily from diagnosis to diagnosis.  No two people, with the same diagnosis, will be impacted in the same way by it.  People can and do have periods- even long periods- of stability within the trajectory of their illnesses of any kind.  Some illnesses have higher “recovery rates” than others, some have lower “relapse rates”, the likelihood of recurrence varies.  But you should never put the word “just” before anything.  It disrespects the experiences of the person with the problem.  It makes you look like you don’t really care.

Psychosis

Today, I spoke to a nurse at the Central Access Point.  We talked about how I have been (which isn’t great) and then he asked me, given the medication I am on, whether I have ever experienced psychosis.  I said, not really, but I’ve been paranoid.  And he asked me to describe my experiences.

I described two.

1) When I lived in Kent,  I once went into my bedroom. I felt anxious and shaky. I saw something vibrating in the corner of my eye and when I looked, I realised it was my red suitcase.  I unwillingly opened the suitcase, and maggots spilled out.  I raced from the room, only to realise minutes later that the maggots did not exist.  I had an utter conviction at that point that if I told people certain things, someone dear to me would be killed.  Quetiapine and a night at the university’s nursing station were the suggested remedies for this.

2) At 23, living in Edinburgh,  I worked as a cleaner at Murrayfield stadium.  One day, feeling a little distressed and unsteady,  I went into work.  I was cleaning offices that day and I felt as I walked in that everyone had been talking about me.  I didn’t even know these people.  I was frightened.  In the next office, I felt certain that the people in the first office had been communicating with those in the second, either telepathically or on the phone (I couldn’t be certain which).   Their smiles made me afraid.

The nurse I was speaking to paused for a moment.   “What you’re describing, ” he told me,  “are real psychotic experiences.”

This, in turn, gave me pause.  Throughout my life I have had brief experiences like these.  Unwilling to appear dramatic, or to make mountains out of molehills, or to compare my own experiences to those of people I considered much worse off, I had never termed them psychotic experiences. I always shrug them off as nothing. Though I was put on the Quetiapine and subsequently aripiprazole, I had convinced myself that these were prescribed to me purely for their mood stabilising properties.

Yet, I can’t say truthfully that I am surprised.   His words, which, surprisingly,  nobody had ever used on me before, resonated.  They made sense of something I have avoided.   I have heard voices.  I have held strange beliefs.  I have known the earthy taste of fear.  Those experiences were what they were.

I write this because, like many people, I  feel frustrated by the popular, sanitised narrative of mental illness.  The kind characterised by the slightest aberrations or diversions from “Normal”.  The kind in which a person recovers fully.  The kind in which We Are Not Scary…  because the thing with scary people is that they are usually scared people.  When the world stops making sense to you, it is terrifying. This is why psychosis is one of the parts of mental illness that frightens people most- we assume we have such a tight grip on our own solid realities that any loosening of that grip seems a terrible thing.

What I mean to say, is that I have endured some really scary things.  I want people to know that it happens.  That The Scary People can wear “Normal” faces too.  I do.  That if you are looking (but really looking) The Scary People are not Scary People. At all.  I know, because I am one.

The Politics of Scars

 

At work, I keep myself covered up.  Still, there are the occasions when my sleeves slip up and I wonder whether anyone- staff or resident- has noticed.  Nobody has ever said anything but I have my defensive responses at the ready:

What do you think happened?
Well you know [insert resident name]?  I used to do the same.
It’s nothing to do with you.
I did battle with a tiger.
[burst into tears]
It’s a long, boring story.

I have no idea, if it came to it, which of these things I would say or do.  I also have no idea what the response would be.  There would probably a lot of “whys” and so on.  Probably a lot of judgement, too.  You would think that there was less judgement when working with people with mental health problems.  There isn’t.  My workplace is as judgemental as any other place. Sometimes more so.

*

Summer.  Both at work and outside of work, summer has always, always, always (we’re talking sixteen years of always) been a problem for me.  I want to wear short sleeves, do what other people do, look how other people look.  But the truth is I don’t- will never- look how other people look.  In certain situations (work, certain family gatherings, meeting family of partner) it is basically the smarter thing to stay sleeved (and wearing long trousers).  The thing is, that starts to seem unusual as the year grows hotter and hotter.  People start to ask, and the excuses tend to get more and more bizarre (“I’m cold,” I tell people as sweat starts to bead at my hairline).  Truth be told, I am dreading the hotter months at work because I don’t know how long I’ll be able to lie.  People have a terrible habit of intruding on personal space.

*

I am planning a wedding (yes readers, you heard it here first- Becky Bee is engaged!)  Yet I have fears around buying a dress.  Why?  Because I want a long-sleeved dress to cover my arms.  Because I want a short-sleeved dress because I have seen some I liked.  Because I don’t want people looking.  Because I don’t care if people look.  I don’t want my partner’s family to thing that she is marrying some kind of a crazy (although, of course, she is).  And I don’t want my own family to feel embarrassed/ surprised/ hurt/ whatever.  But I do want to be able to choose a dress that I love because I love it, and not because it adequately covers parts of me of which I am ashamed.

*

What is it that fascinates/ horrifies/ alarms/ disgusts people about the scars of self-harm?  I know for many people it is simply inconceivable that a person would want to hurt him/herself.  It doesn’t make sense.  Sometimes even I, when I think about what I’ve done, feel a kind of detached disbelief.

But as M (partner… fiance) always says: every scar represents a story.  A story where you might not have made it, but you did.  When someone asks, you can say “I fought a long battle with myself, where I could have lost, where I could have failed to make it through, and these are my battle scars… because they remind me that I made it.”  And, she says, “you’re my tiger.”

Bipolar II

The sub-category Bipolar II was created in 1994, by a man named Allen Frances.  Imagine that- my diagnosis is younger than me.

There are many criticisms of the DSM and one of them is that, in its various incarnations, it has created a “false epidemic” of mental illness.  By adding new disorders and subcategories it has, it is argued, medicalised many of the normal emotions of everyday life.

Sometimes I feel as though bipolar II is belittled, both in terms of the minimalisation of its severity and in terms of some people thinking it isn’t an illness at all, not in its own right.  In turn, when I am depressed, that makes me feel guilty. So, my diagnosis isn’t even a thing.  So, why take medication? Isn’t it normal to soar and fall?  Isn’t that what life is?  What if, after all, I am drawing resources away from the people who really need it?

But I am brought out of this by the very depression that leaves me guilty in the first place.  Because it isn’t normal.  It isn’t normal to feel suicidal and it isn’t normal to have your thoughts race at fifty kilometres an hour, or to sleep four hours in two days for two weeks running.  I am not a little off-kilter, not “just” suffering from the stresses of the modern world.  When I am ill, I am ill.

I have to admit scepticism at the ever-expanding catalogue of mental illnesses and at the number of people diagnosed (a study showed that children born towards the end of a school year are many times more likely to be diagnosed with ADHD, because nobody had taken into account their relative immaturity).  But as a sub-category myself, who am I to judge?  If a person can put their finger on a diagnosis- even one whose creation seems arbitrary- and find it fits them perfectly, then they should probably try the recommended treatment for that disorder.  I guess.

One thing I do know is that my medication works for me.  Call it a placebo effect if you like.  Call it whatever.  But as they say, if it ain’t broke don’t fix it.  Psychiatry may well be broken but I’m not, and in part that is due to my treatments.

Perhaps I should stop reading up on placebo and the failure of psychiatry.  Perhaps it is making me unduly paranoid about diagnoses and treatments.  I’m a curious person, though, and I like to read up on those things which affect me.

One thing I will say, is that I would never scoff at another person’s mental distress.  I have slipped through cracks into misery and it is not a pleasant place to be.  Bipolar II may be younger than me, but that doesn’t mean it doesn’t exist. 

Mental Health Awareness Week I: Reactivity

A friend of mine once made a suicide attempt.

Afterwards, a nurse asked my friend whether the suicide attempt had to do with “a fight with a boyfriend, or something.”  In the week that followed, my friend was asked this on three separate occasions.  (As an aside, I wonder whether a man would have been asked that same question so many times)

This makes me want to say two things:

  1. Often, depression is reactive (a response to life events).
  2. Often, depression is not reactive.

Of course, many people with a mental health problem will tell you that there are triggers for a relapse (just as many people, with or without a mental health problem, will tell you that they have triggers for their moods).  But many times, there may be no (at least obvious) trigger for an episode of depression, or psychosis, or (hypo)mania.  Just as mental illness doesn’t necessarily stem from trauma, a suicide attempt isn’t necessarily a reaction to a circumstance, or set of circumstances, that contribute to a person feeling suicidal.  So for my friend (who was not actually experiencing “trouble with a boyfriend, or something”) there may or may not have been other triggers that led her to be in that situation.  The point is, it is important not to jump to conclusions about people and their mental health.

If we can’t get away from the big “why” (“why do you feel like this?”) we risk isolating people who simply don’t know why they feel the way they do, except that they do.  Putting pressure on someone to come up with reasonable explanations for how they are feeling is simply not helpful.  It could be that there is a trigger that someone doesn’t actually want to share with you.  It could be that they will share it at a later time, when they are ready.  Or it could be that there is no trigger– and that’s OK.  To be there for someone, you don’t need to know why, unless they need you to know why.  You need to know what they want to happen next and how you can support them.  You need to know when is the time to intervene and you need to know who they want to be involved.  You need to know where they’re at in terms of how they’re feeling and whether they’re in danger.  But you don’t always need to know why.