Radical acceptance

Well into my twenties, I thought I would always be ill. Years of experience had taught me that the best I could hope was to have an acute mental health episode only every other year, rather than yearly. And the older I got, the worse the episodes seemed to get. In 2001, I had my most destructive  episode to date, ending up in a medical ward where doctors worked to try and prevent long term organ damage from the overdose I had taken.

Somehow, things got better after that. It’s very difficult to say exactly what did the trick, because I made so many changes to my life – I changed relationships, I changed careers, I change psychiatrists, I changed meds. Maybe it was a combination of things. All I can say for certain is that from 2002 until 2010, I was pretty much asymptomatic. Of course I had wobbles. I found it hard to cope after a relationship breakup and I struggled to adjust to living without a partner. But that was OK, because I felt low for a reason. That in itself was a revelation; so very different to the depressions that had descended upon me throughout adolescence and early adulthood, depressions that seemed to have no obvious cause and, therefore, no meaning. I still saw myself as psychological vulnerable, however, and was quite content to carry on taking my prescribed medication.

As the asymptomatic years passed, I grew more confident. I started taking risks, going forward for promotions, pursuing the kind of relationship I really wanted, relocating from where I grew up to London. I took on new hobbies, successfully auditioned for an a cappella singing group, trained for and ran a charity 10k race. I started to feel that I had somehow really cracked it, that I was cured and would never now go back to the dark days of my earlier life. I even began to feel that I was a bit of a charlatan to have declared a disability to my employer under the Disability Discrimination Act (now superseded by the Equality Act 2010). Because I was so well!

A lot about mental health is chicken and egg. So I can’t now tell you whether I started to become unwell in July 2011 because I had been tinkering with my meds, or whether I started thinking that I could manage without the meds because I was already slightly hypomania. I can tell you that there was definitely some grandiosity involved, that by this point I had moved into thinking that I had cured myself. I began to think semi-seriously about writing a self-help book for all those poor, unenlightened people who remained depressed because they didn’t have my magic formula. I was the furthest away I had ever been from thinking of myself as “a disabled person” or “a mental health service user”.

In April 2011, I went to my GP. I was finally ready to admit that after around eight months of trying to hold it together, I had lost control and was sliding rapidly into my first depressive episode since 2002. I was happy to be referred on to a psychiatrist, because I knew what I wanted: a medication review that would help me get past this blip, and get on with my life. By “my life”, I meant everything I had built over the past eight years; a solid relationship, an ability to parent more consistently, rapid career progress and salary increase, absorbing hobbies and a vibrant social life. Initially, I asked for a medical certificate for just two weeks. The sooner I got back on track, the better.

18 months later, by mutual agreement my contract with my employer is about to end. The DWP may have found me fit for work, but my workplace cannot accommodate someone who still has weeks, rather than days, when they are unable to come in, nor someone who is very sedated until 11am. I am yet to find a medication regimen that even dampens my symptoms, let gives me complete relief. In spring of this year, I started to feel that I might finally be making some progress; yet over the summer, I feel that things have worsened. Part of the suicidal feelings I struggled with over the summer arose from a realisation that this may be it. All this time, I have been thinking of my 8 years’ remission as the norm, as “the real me.” But my moods have now been unstable for more than two years. What if the remission, and not the relapse, is the anomaly? What if I have been holding out for “recovery”, only to find it never arrives?

A few days ago, I got up in the night to quench my thirst (thanks, lithium!). As I blundered about, bumping into walls (thanks, quetiapine!) it suddenly occurred to me that I needed a radical shift in how I saw recovery. “Recovery” is perhaps the buzz word in mental health at moment; mental health teams are being renamed “recovery teams”, and are expected to employ the “Recovery Model”. For over eighteen months now, I have been using the word “recovery” to mean “getting back to exactly how I was before I relapsed.” This has got me to a point where yearning for, striving for, my version recovery is doing more harm than good. As long as I use “the real me” of 2002-2010 as the yardstick by which I measure myself, I will continue to fall short, and from there it is a short hop to feeling that my life is over.

So I have made a conscious decision to instead embrace “recovery” as the Model defines it: a recognition that “while people may not have full control over their symptoms, they can have full control over their lives. Recovery is not about ‘getting rid’ of problems. It is about seeing beyond a person’s mental health problems, recognising and fostering their abilities, interests and dreams.” This sounds to me like “radical acceptance”, a concept drawn from Buddhist meditation practices I was first introduced to during a course of Mindfulness Based Cognitive Therapy. Radical acceptance involves seeing things as they really are – no matter how painful – and simply accepting, rather than trying to resist, deny or change, them. The best-known exploration of radical acceptance is the book of the same name by Tara Brach, but it is also a key part of Dialectical Behavioural Therapy (DBT).

What might it mean if I began to practice a recovery model based on radical acceptance? For a start, it would mean beginning to see myself as worthy of love and respect, even if I don’t have an income; even if I never return to a full time job; even if my I never get my moods under complete control again. It might mean looking at how I might seek out alternative forms of work that I can manage even if my moods are still fluctuating. It might also mean trying to figure out what my limitations are and how to live a good life within them, rather than constantly willing those limitations to melt away so that I can resume my old life.

That really does feel radical.

About purplepersuasion

40 something service user, activist, writer and mother living with bipolar disorder. Proud winner of the Mark Hanson Prize for Digital Media at the Mind Media Awards #VMGMindAwards
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7 Responses to Radical acceptance

  1. Part of the deal with me is that I have always disliked being seen as “so and so’s mum”, “so and so’s partner” – although I am those things, I have always preferred to be seen for my own accomplishments and work, rather than in relation to someone else. The loss of a work role is therefore a big blow to that. Plus having been continuously unwell now for two years, I am well aware that I am a less good mum and partner than I was when I was in remission. I just don’t have the spoons. So I have to figure out what’s left and how to feel that I still have a life worth living. Some days I feel that it really isn’t, and I despair and, of course, instantly contemplate suicide, because it’s a completely logical step if life is going to go on being unbearable. Other days I feel like it would be OK – not optimal, but OK – if my life was like this all the time. Hoping to get some more therapy to help me bring it more round to the “OK” position.

    • Henry Dunn says:

      Yes, the loss of a role, or the inability to do it as well as you want to can be very hard to take. Like me, you are probably very hard on yourself. As a therapist I can talk the talk, but not always walk the walk. As a Christian however, I believe in a God that accepts me completely, just the way I am, and who doesn’t need to prove himself. I don’t want to preach at you, that’s not my style, just share how I manage to find acceptance. God’s love, I believe, is completely unconditional and is not dependent on anything we do. We can’t do anything to make him love us more or less. I find this very liberating. It can also put my suffering into perspective sometimes – my future is totally secure, even if it’s crap right now. This isn’t pie in the sky stuff – life can be really shitty, but it reassures me. Sorry, said I wouldn’t preach, just sharing what makes me tick.
      So far I haven’t lost any roles permanently, unlike you, so it’s easy for me to say all this. I hope you find satisfaction in whatever roles you can manage. And keep Baching (woof!)

  2. Henry Dunn says:

    I think the role that is most upsetting not to fulfil is parenting. It is so much more important than any else in the world.

    • Funny, I don’t feel that way at all. Although I adore my kids and am proud and lucky to be their mum, it’s just one aspect of me. I think maybe I felt much more like you did when my kids were small, when they were babies and preschoolers I was totally absorbed in my mothering role. But when you parent teenagers you are acutely aware of their growing independence; in just 3 short years my son will be off to uni (fingers crossed!). Having watched my stepdaughters leave home I feel very strongly that it’s incredibly important to have other things that are a part of you. We only borrow our children for a little while, and he have to hand them onward more quickly than you would believe when they are tiny. When my second child heads off to uni, I will be just 44… that’s a lot of life ahead of me!

  3. sionnanmaree says:

    Reblogged this on The Sinful Vanity and commented:
    This is a brilliant post about mental health and ‘recovery’ – have a read.

  4. Pingback: Living on the edge | purplepersuasion

  5. Pingback: Childhood Bipolar Symptoms | Is Bipolar Hereditary

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