Basic Respect

Recently, I had to go to the GP for some mental-health related stuff.  I went with my partner, for moral support.  We both introduced ourselves and we both explained who we were.  Soon after she realised what the appointment was for, however, the doctor began addressing my partner instead of me.  I drew her questions back to me, but it annoyed me that she clearly thought I wouldn’t be able (or willing?) to speak for myself.  Of course, I understand that when you bring another person into an appointment, it may well be because you aren’t comfortable/ confident to speak… but it shouldn’t be assumed that you just can’t.  Even when I had made it clear(er) that I had things to say, she continued to check basic details and actual details of symptoms with my partner, without actually asking me first.

In addition, the doctor asked the same questions over and over again- perhaps she was uncomfortable, or perhaps it was her way of getting to the bottom of it, or perhaps she had had a long morning but the experience was extremely frustrating, particularly given that not all of the questions were pertinent to the situation at hand.

Eventually some progress was made and I have to stress that without support, I would have left that office without a single plan in place.  I also have to note that the GP for her job, asking a colleague for support and realising (eventually) that something needed to be done.  

I just wish sometimes that people understood that mental health doesn’t prohibit a person from describing, explaining, or advocating something for themselves.

Advertisements

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.

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. 

JP

I’ve often wondered what it would be like to bump into JP (not the pope but my old therapist).  It’s been seven years since I saw him and given the circumstances (broke up with girlfriend, therefore had nowhere to stay and moved back to London) I never got to say a proper goodbye.  I think when I left we both thought I’d be coming back, so even our last phone call didn’t end in the way I used to think endings were meant to.

I’ve written to him over the years, tying the loose ends into neat knots that in real life usually unravel, though I would never tell him that part.  I wrote to him when I got funding for my MA (but not when I got ill).  I wrote to him when I quit drinking (but not when I started again).  I toy with the idea of writing now, but I think I left things in a good place for him, and a note of hope is where every Recovery Narrative should end, right?

The truth is, that man’s kindness saved my life.  At my most down, at my lowest weight, at the deepest point of despair (up until that point), he was there, unjudging, prodding only gently and letting me reach my own conclusions where I had to.  I think a lot of people could do with a JP in their lives.

Occasionally I catch myself wondering what he would think if he could see me now, working, writing and drinking in moderation.  Then I stop wondering, because he can’t, of course, see me and perhaps the best I can do to say thank you is to live, live, live.

Intrextroversion and bipolar

It may just be the people I’ve met, but I tend to experience others with bipolar as extroverted, larger than life, energetic, zany even.  I know this can’t always be the case but with the majority of people I’ve met, it often seems to be.

For me- possibly because I have type 2 and tend towards depression rather than mania, it often seems to be the other way around.  I guess to others- especially those closest to me- I sometimes (often?) seem to be that way: excitable, creative, full of ideas.  Yet to me it often seems that I am often introverted, even, occasionally, to the point of being shy.

It’s always been a puzzle to me, this blend of introversion and extroversion, being able on the one hand to walk up to a stranger in a pub and introduce myself, and on the other finding myself adrift in certain social situations.  Bipolar aside, I know this “introverted extrovert” thing is the signature of a large number of people:  I’ve read about it and I’ve seen it for myself. Still, in myself, it confuses me. 

It’s a bit like when I was young and wanted to be boyish, so that people would believe I was gay…

Because of the fluctuations (pre-lamotrogine) between hypomania and depression, I have experienced myself both as someone unable to stay quiet, and someone almost unable to speak.  Even without those mood changes, though, even in a state of relative stability, I experience milder versions of those traits.  I compare myself to others with this condition and sometimes it seems to me that they are all confident and brave- but I know from long experience that this is not necessarily the case.  That beneath bravado often lies a deep-seated insecurity or even fear: a fear of failing, a fear of relapsing, a fear of never getting/ staying well.  

I have to remind myself daily that energy is not necessarily a personality trait of bipolar outside of an episode.  That confidence doesn’t= mania any more than shyness= depression.  That personality is separate from bipolar, and we cannot all be the same, and that’s alright. That it is OK to be sometimes an introvert and sometimes an extrovert, with or without mood swings.  

And to be me: to be either one or the other, or neither one nor the other, is OK.  I’m only human, after all.