I lost control. I’d actually already been ill for several months, firstly without realising it, because the episode started with mild hypomania. As my mood switched to anxiety and depression, I began to be aware that I was unwell, but was still able to retain control in the sense of continuing to work and carry on with family activities. It took until March 2011 for that to unravel, and until November for me to be back in a place I had not been since 2001 and had hoped never to be in again – utterly out of control in an agitated, suicidal mixed episode, struggling to explain myself to a strange psychiatrist on a duty rota, and having to blurt out all my distinctly abnormal thoughts in from of my partner. I have had some degree of choice and control over what medications I have taken this year, but of course I have very little over the side effects. I was able to mitigate the intense lithium-induced nausea, thanks to advice from Twitter friends (don’t ever take it without a little starchy snack like porridge, cereal or crackers), but I can’t seem to do anything other than give in to the thirst it generates. The quetiapine causes me drowsiness, difficulty in waking up in the mornings, slowed down thinking, an alternately stuffy and runny nose, a dry mouth, constipation, and engorged and painful breasts that produced unwanted breastmilk. When I briefly tried sodium valproate, it made me dizzy and sleepy and gave me rapidly-changing hallucinations. By the end of 2012, I have also come to feel very out of control of my own body, and I suppose with quetiapine and lithium both noted for causing weight gain, the odds were always against me. I have found it extremely difficult to get a sensible exercise routine going, with my energy levels very much dependent on my mood state and level of sedation. Unfortunately, I also appear to find it very difficult to control my eating; old issues of “If I can’t eat perfectly, it’s pointless, so I’ll just eat anything “ and “I’m having a crappy time, I deserve to eat this calorie-laden food” have resurfaced. I am scared to go near the scales, but I know most of my clothes don’t fit.
I was no longer able to define myself by my work perhaps the biggest learning point from this entire episode. For the past few years, my job role has been the means by which I measure who I am. I’m not just talking about whether or not I regard myself as “successful”, although that is undeniably a part of it (and one of the hardest points of 2011 was when, after being off sick for a few months, my contract as a middle manager – my first ever foray into management – was not renewed). It’s also the fact that I tend to do jobs which I feel are “important” and “worthwhile” in some way, and have therefore only ever worked in the public or charity sectors. What I do with my working life is how I feel that I matter. But as my sick leave has gone on and on I have felt increasingly distanced from my job role, leaving me to face the question: without my work, what is the point of me? I love my partner and I love my children, very, very much; but I don’t want to get into defining myself as “someone’s partner” or “someone’s mum”. And I don’t really believe in any sort of higher purpose or plan for humans. So what? Why do I even bother to stick around? Surprisingly, this blog – along with undertaking small, manageable pieces of voluntary work for my Trust and some of the mental health charities – has allowed me to find some sense of having a purpose after all. Because the amazing thing about blogging openly and honestly about mental health is that even if I write about something that I’m sure nobody else in the whole world could understand/accept/relate to, even if I tremble as I hit “publish” because I think people will hate or despise me for what I’ve written, people still contact me via the blog or Twitter to tell me that they are I so glad I wrote that post because now they feel less alone. I’m not fit to work at a paid job role, but it turns out that being a sick and confused me is enough to make a difference to some people. This has astonished me more than anything else in the past 12 months.
I stopped being a reader. I used to regularly read one or two novels a week, more if on holiday and at Christmas. My Twitter bio made a point of what a voracious reader I was, and many of my original buddies there were people I followed because they had similar tastes in books. In fact, when I started this blog, I envisioned it as a place where I would talk about books and reading (starting with some of the best-loved books of my childhood); blogging about mental health was not in the plan. During 2011, my sense of myself as “a reader of fiction” has completely disappeared. Stress, anxiety, depression and hypomania have all in their own ways left me struggling to concentrate on a storyline, and the sleepiness caused by the antipsychotics has exacerbated this. I have become increasingly embarrassed by my ever-growing “to be read” pile, and by the way that books which normally take me a few days to get through now take weeks or go unfinished. The things I have successfully read are a few young adult novels, humorous books (including How to Leave Twitter and How to be a Woman) and the fantasy series A Song of Ice and Fire (recently adapted for TV under the title of the first instalment, A Game of Thrones). I have read the whole series back to back up until the most recent hardback release, A Dance with Dragons – which I received in the post this morning. With short chapters, narrative strands that jump back and forth between a group of interesting characters, and plenty of cliff-hangers, George RR Martin’s series is the epic fantasy that even those with compromised attention spans can enjoy. When in years to come I think of my reading experiences in 2011, I will no doubt picture myself on public transport, clutching a 700 hundred page paperback and flipping from the maps at the front to the genealogies at the back in an attempt to keep the characters’ movements and allegiances straight in my head.
I began to prefer my own company. Anyone who knows me in real life will tell you that this represents a massive shift. I used to loathe spending time by myself, and would sometimes joke that I am like a sociable pet dog: go out without me, and I’ll end up whining underneath the front door and chewing the furniture in a frenzy of lonely misery. In nine months of being at home alone every weekday, however, I have felt lonely only a handful of times. Partly this is because during 2011 I developed a fantastic set of friends and supporters online; but it is also true that I have come to like my own company more, and to sometimes actively prefer it to going out and meeting up with people. I began to take long walks on my own (particularly sections of the Capital Ring) and to prefer to visit open spaces such as parks and formal gardens on my own. In the past, I would have felt some sadness at being in such places by myself, but this year I have found being solitary easier to deal with than crowds (due to my bipolar superhearing and difficult anticipating people’s movements) or casual conversation (“How’s work, then?” “Errrr….”). It’s undoubtedly a good thing that I am now able to feel positively disposed towards time spent alone. However, like so much in the bipolar life, there’s a fine balancing act to undertake – being comfortable alone can easily tip into preferring to be alone due to social withdrawal, and my obsessive traits have definitely come to the fore as I have developed my own, rather fixed, routines for the day. Something to keep an eye on.
I became a mental model. “Mental modelling” was the name of the introductory piece I wrote for the photography project I worked on during October and November towards my friend Helen’s MA in Photography. I say my friend Helen, and she very much is now; but at the beginning we were strangers, introduced by a tweet from Time to Change about how Helen was looking for women with lived experience of mental illness to take part in an anti-stigma project. I have already blogged a couple of times about the process, but to summarise, the idea was to take pictures which represented my experiences of bipolar in a metaphorical way. So depression came to be represented by me as a princess who cannot laugh, stuck in a tower (linked to a blog for the International Bipolar Foundation on bipolar and fairytales); mania came to be represented as a champagne-quaffing, narcissistic debutante; the part of me that has become increasingly solitary was represented by a shoot of me seeking out quiet, undisturbed spaces in Kew Gardens. For someone who is usually camera-shy, it was a distinctly weird (but good!) experience, including the exhibition itself. I felt very odd as I stood in the gallery watching people discuss framed prints of photos of me, then move to a sofa where they could look at a scrapbook containing more photos juxtaposed with some of my blog posts, or listen to audio of Helen and me discussing how mental ill-health has affected our lives. Occasionally, strangers would say to me, “That’s you!” and I would talk to them about the process of working on the project and what we hoped to achieve. When Helen has the time, I am still hoping that she can and I can host an online gallery so people who are interested can see the results. For now, here’s the home page for Helen’s work in the exhibition: http://www.neithersnakenorlizard.co.uk/photographers/rimell.html
Twitter kept me alive. Yes, that sounds dramatic, but I’m not exaggerating. 2011 was the year when people who cared, despite have no knowledge of me in real life, and talked me through crises minute by minute. I’ve struggled mightily this year to adhere to my own mantra, “Don’t hurt yourself, don’t kill yourself, don’t run away” and I am not sure how I could have managed it in the dark of the dead of night in a mixed episode, or the stressful wasteland of an afternoon in the school holidays when gripped by depressive despair, without Twitter. When I reached a point of feeling that I simply couldn’t live with the pain I was experiencing, it was a Twitter friend I texted, because I knew she would understand. Over the course of the year Twitter friends with personal experience of bipolar and other disorders have helped me compose impromptu suicide preventions plans, make decisions about whether and how to tweak meds in a crisis, and decide what to prioritise and what to let go when I was feeling overwhelmed. There is nothing I can say to my Twitter friends that isn’t familiar to somebody, so I just don’t get the reactions of shock and dismay that “civilians” can display when I disclose a new treatment plans or your darkest thought patterns. Although I’ve found this year very hard, I cannot feel that it has been a total write-off when it had led me to meeting such fantastic people
I’m not sure what I wish for in 2012. So many things are out of my control that I daren’t do too much in the way of planning. The plans I made in 2011 were often impossible to keep to, and this has left me nervous of committing to anything beyond a few days into the future. So maybe I’m better off with broad aspirations, something which indicates hope and intent without requiring timescales. Better for me to think that I would like to get back to work, rather than to feel that I must, because worrying about running out of sick pay, being faced with disciplinary action at work or becoming completely unemployable makes a return less, not more, attainable. I’d like to return to exercising regularly and lose some of the weight, but if I set myself a target of losing X stone by date Y a mood change or a med change will intervene and leave me feeling that I have failed. So let’s keep it simple: I’d like to feel better.