The first blog post I ever wrote about mental health was back in April 2011. Entitled A Tale of Two Beasts it was written at the point where I had finally had to admit defeat and take sick leave. I hadn’t really recognised or understood the mild hypomanias I’d been having and I was yet to experience more serious highs. My life felt dominated by the swift, nippy Little Beast (anxiety) and the slow, lumbering Big Beast (depression) and I wrote about them more as a means of coping than anything else.
I recently had cause to revisit this post when writing for the International Bipolar Foundation. I was interested in trying to tease out whether my anxiety was part and parcel of my bipolar, or something separate. As my moods remain stable I am becoming firmly convinced that my anxiety is comorbid, occurring alongside my bipolar rather than being a feature of it. I had extreme anxiety years before I developed bipolar, and the less I am now troubled by hypo/mania and depression, the more anxiety seems to have room to flourish. I have been more anxious in the past few weeks than I remember feeling for years; it’s becoming a struggle. A minor event or chance remark causes a debilitating spike of anxiety and the belief that something truly terrible is going to happen.
I recently wondered my daughter had a mild infection. I didn’t even know if she had any kind of infection at all, yet the following train thought immediately arose:
She is going to get really sick > it’s going to cause permanent damage to her body > I should have noticed and sought treatment > because I didn’t, I am guilty of neglect > my kids are going to be taken into care > I am going to arrested for neglect and go to prison
All within about 10 seconds!
At the weekend there was a very minimal confrontation between my son and my partner (my children’s stepparent, not their dad) over what to buy at the supermarket. My mind immediately started up:
They are never going to get on > my son moving in with us was a terrible idea > he’s going to feel unwanted and unhappy > he’s going to get depressed and maybe this will trigger the emergence of bipolar > he’s going to drop out of school > he’ll struggle to have a career.
Again, 10 seconds, although this one was a real delight since it had an additional element:
My partner and I are going to fall out over this > the three of us will be unable to live together > my partner and I are going to split up and I will lose my biggest support in dealing with my mental health.
Other potential catastrophes include:
- I am going to completely relapse and I will never work again
- Even if I do work, I am going to embarrass myself by have a panic attack in front of clients or failing to meet deadlines
- I am getting fatter and fatter and I no one will ever find me attractive again and so (of course!) my partner will leave me
- My partner will leave me for one of many reasons and I will end up taking my own life
- Even if I am well enough am never going to attract more work and I am going to run out of money and we won’t be able to pay the mortgage
Disaster after disaster.
I am trying to fight back, to look for evidence for my beliefs, to challenge thoughts of calamity by remembering the reality of my circumstances; the full on cognitive counter-attack. The trouble is, by the time I hit back, some damage has already been done. So far I have been able to stop myself from spiralling higher and higher towards a full-on panic attack, and believe me I am very grateful for that, but nevertheless having once imagined myself imprisoned, dead or in penury it takes me hours to recover.
I’m not sure what to do about this. I’m looking into primary care options for short, focused CBT or other simple interventions, but I don’t know if they will take someone with a bipolar diagnosis, even if though I have been discharged from psychiatric support. I would prefer not to go back to my consultant if possible, and I am even less keen to tinker with my meds after taking about two years to get the drugs and dosages right. But I need to something. I can’t carry on living ten seconds away from catastrophe.