This is my 100th post. I’ve been racking my brains about how to mark the occasion, but have just been reminded that this week, 10-17 June, is Carers Week. What better use for my centenary post than a letter to my partner, M?
When I met you, I was doing well. Four years had passed since my last major episode and in that time I had survived debt, divorce and joint custody arrangement without becoming majorly unwell. I still remember trying to seem more “together” in the early weeks than I really was; even stable, I was worried I would frighten you off with my errant emotions. I also remember I was only able to keep that up for a few weeks. I admitted during a phone call that I had been concealing my real, emotional self from you. You said, “I don’t think you’ve actually been hiding it as well as you believe, my love.” I remember thinking: oh, but you’ve seen nothing yet.
My mental health felt like a tricky area. You were a senior manager in the field, a former ASW (Approved Social Worker) no less, who had made momentous decisions about whether people should be detained under the Mental Health Act. Sometimes it felt like we were on different sides. I was no longer under a psychiatrist’s care, but would always feel like a service user. How could I not? I was 30 when we met, and had spent the majority of the past decade overwhelmed by my moods and trying different medications. Things came to a head when we began planning for me to move in with you. You said it that if I became unwell it would be better to be seen by a different mental heath trust, that there might be a conflict of interest in being treated by the team where we lived. I thought this stigmatising. I pointed out that you never say that if you worked at a general hospital and I needed to see an endocrinologist or an ear, nose and throat specialist. I felt that you were ashamed of me.
In the end, that whole discussion seemed irrelevant because I continued to be so well. Living with you, I was soon happier than I had ever been. Relocating to London was a bit of shock, but I quickly began to access all kinds of new social and musical opportunities. I enjoyed my job and progressed quickly, with you cheering me on at ever milestone. I began more and more to feel like a person who was once mentally unwell. You had never seen me in an episode, and I began to believe that you never would.
Later on, we competed over “shoulds”. I felt that I should have accepted my problems were more than work stress, should have recognised I was becoming really ill. You felt that I couldn’t be blamed for that; a lack of self-awareness was part and parcel of the illness, whereas you were the mental health professional who should have brought to bear all your theoretical and experiential knowledge. It doesn’t matter. What matters is that neither of us spotted my relapse until it was too late. I finally understood I had reached a point of no going back one day I was out with kids and began to see “horror movies.” After a few hours of watching the images my brain was playing to me – images of violence and gore, of horrific damage perpetrated by myself upon myself – I came home to you and cried into your shoulder. “I’m really ill!” I said, hearing a note of child-like outrage in my voice.
“You are, aren’t you?” was all you said, holding me close, rubbing my back.
During that depression you did everything you could to stop me slipping further down. You sent me texts from work and encouraged me to wash and eat. You took the kids to their music lessons, so I didn’t have to face being asked where I’d been and how I was. You set me what I later came to realise were little tasks (a request to post a letter, buy some bread) designed to get me dressed and out of the house.
A few weeks later, when I was swinging upwards on our annual trip to Wales, I became worried about you. What must it have been like, I wondered, to be around someone unable to bear their own existence? We stood on a stony beach, looking out to sea. I turned, touched your face. “Are you OK?” I ask. “Looking after me – it must have been stressful. Who do you have to talk to?” You laughed at me. You saw taking care of me as simply part of your job.
As the episode wore on, and on and on, I kept waiting for you to leave me. I wasn’t sure how many mood swings you could take, how many med changes you could support. I felt endlessly guilty about money, as my sick pay dwindled from full managerial pay to full frontline pay, to half pay, and finally then ESA. This was not, I felt , what you had signed up for. We were supposed to be a double-income household and I was convinced I must a burden.
Yet you didn’t go away. In fact, the worse things got, the closer you stuck. Do you remember how we sat in that pokey room with the duty psychiatrist? I needed you to stay, yet hated having to tell her everything in your presence. You knew I was desperate, but I’d been careful not share the detail of my desperation. I’d told you of the pseudo-hallucinations, the “head music”, the terrible energy of my mixed mood, but I’d spared you just how much I daydreamed of death. I wanted to protect you. I noted the way the psychiatrist turned towards you, looking for a decision, one that would be more about me than by me. You said that you would take your entitlement of carer’s leave to look after me. The word hung, heavy, in the air. Were you my carer, now? Legally, I knew, you were my “nearest relative”. But I still though of you as my love.
Your reserves of patience have astonished me, especially as in many ways you are not a patient man. My next mixed episode came on the big family holiday we’d been looking forward to. I don’t like to think of it much, that fortnight of air-conditioned agitation and anguish. The only points I choose to think of are you bringing plates of food that had been carefully set aside for me, sitting on the edge of the bed and kissing my hands. You kept me alive, one diazepam at a time, and you did it cheerfully.
I can only think of a very few times you have really lost patience with me. Always, it has been when you think I should have made better choices, when I have failed to do my best to take care of myself. That is the essence of our bargain: you will do your best to take care of me, as long as I do, too. We have to work as a term. Withholding gets us nowhere, and the CBT helped me see that the urge to keep things from you is an alarm signal.
These days I know that you are anything but ashamed of me. I’m not sure which of us takes more delight from my current achievements. What a kick you got out of seeing me on national TV! You couldn’t wait for me to get home so you could show me the footage. I love it when you mention my new business venture or my “award-winning blog”. It’s true that because of your position I decided to seek care from the Trust next door, but in fact this only leaves you more able to proudly introduce me to colleagues as a mental health expert.
It sounds bizarre, but you’ll just have to trust me on this: even at my most depressed or my most panicky, even when I am preoccupied with suicide, because I am in a relationship with you I am still happier than at any other point in my life. In the past, I have had struggled with bipolar on top of relationship problems. Now I have a kind of underlying, baseline happiness that was absent before I knew you. I think I’ve stopped worrying that you are going to leave me. As I said to you the other day, if you were going to, it’s pretty obvious you’d have done so by now. I’m happy with your suggestion that we just go on and on, one taking care of the other when either of us is sick. After three years of my health needs dominating the agenda, you still see something that policies and professionals sometimes forget: for couples, caring is something reciprocal.