I don’t know whether you’re familiar with Raymond Briggs‘ Father Christmas (he’s on the front cover of the Christmas Radio Times this year). If you’re not, you’ve been missing out. The original book was published the year before my birth and my copy was a Christmas present – what else? – from my parents when I was very young. Briggs’ version of the character is irascible, reclusive, and very English, despite living in the Frozen North. He has a greenhouse and a tea cosy, uses a hot water bottle, listens to Gardener’s Question Time and keeps two reindeer in a coal shed. Nothing has given me greater delight than introducing my own children to Father Christmas’s grumpy approach to his role (“Blooming chimneys!”). Even though they are now teenagers we still reference the book often. We also like the animated version; the late Mel Smith does a good job of voicing the character, although according to my children he doesn’t manage it quite as well as I do.
Despite his gloomy outlook, there is one thing Father Christmas really does enjoy, and that’s choosing a break from it all. In the sequel Father Christmas Goes on Holiday we see him mulling over his options as he browses brochures. The trouble is, once away he has to be careful – getting away from it all means making sure people don’t guess who he really is. His seemingly inspired plan of converting his sleigh into a reindeer-powered motor home results in being rumbled by first French, then Scottish and eventually American kids, but he manages to have an amazing time at an opulent Vegas hotel in the end. Despite the pleasures of the trip, Father Christmas’s first reaction on returning home is relief that his holiday is over with for another year.
Like Father Christmas, I have to be careful on holiday, although this year I got to go away while he was in full-on work mode. Fortunately I don’t have to hide my identity, but the daily decision-making that goes with taking potent medications for a lifelong mental health condition creates a sense of continual caution which sometimes making it difficult to enjoy my time away.
It started with managing expectations. Bipolar’s mix of negative and positive affect means it’s not just bad stress that can be destabilising. Looking back over my life in the process of writing my book, it’s become clear just how often episodes have been precipitated by good stressors like excitement and happiness. New jobs, new babies, holidays and yes, even Christmas, can send me at the very least hypomanic. In the fortnight before our trip I had to keep an eye on any elevation of mood and ensure I wasn’t rushing around or getting too anxious about finding the “perfect” present. Next came making sure I’d got enough drugs – not just the usual eight pills a day, but extra to cover loss or theft of my rattling dosette box or handbag. And then I needed to ensure I hadn’t left myself too depleted on my return as we were due back in the tricky period between Christmas and New Year when access to GPs is limited.
Next, the perennial worries about my bowels. My antipsychotics are essential, but their effect on my intestines is ruinous and I have to be vigilant to prevent things slowing too drastically. In the case of a genuine bowel obstruction, our travel insurance would not pay for even emergency treatment; nothing connected to my bipolar, including my medically-induced bowel problems, was covered (while my partner’s diabetes was waved through without question). I could have found a company who would have covered me, but only at what I consider an iniquitous cost, especially as I was only travelling to western Europe. The choice then was which of the prescribed remedies to take, and how much. With two and a half days in the car looming with loo breaks hours apart I had to be careful not to overdo things. Yes, bipolar. Such a trendy accessory of a condition.
My partner Tom had booked us into a fantastic hotel in Germany for a five-night Christmas break. One of the things I was most looking forward to was use of the spa area, but I reminded Tom that I would have to be careful in the sauna and steam room these days. I stayed in too long the resulting dehydration could lead to lithium toxicity, while quetiapine (my antipsychotic) can impair the body’s ability to effectively regulate temperature, leading to heatstroke in extreme cases. Both heatstroke and lithium toxicity are potentially life-threatening; neither would be covered by our insurance.
The first night in our hotel I lay wired and wakeful next to a slumbering Tom. I was overstimulated from the travel, the excitement of discovering how lovely the hotel was, and by the group walk we had taken in the snowy, starry night, everyone clutching burning pine torches. As first midnight then one a.m. came and went I knew I’d have to take extra drugs. Because, you see, I have to be careful. Even one missed night’s sleep can send me spiralling into mania.
Sadly, I hadly had an opportunity to use the spa facilities as I started to feel unwell on Christmas Eve and was in bed with a virus over Christmas Day and Boxing Day. More caution was required as a raised temperature meant that I lost a lot of fluids. Despite forcing myself to consume drinks I didn’t want I knew from monitoring the quantity and colour of my urine (again, a fashion must-have, I’m sure) that I was dehydrated. In the end I decided the risk of toxicity was greater than the risk to my mood of slightly lowered dose, so I dropped my lithium dose slightly for a couple of days.
In the very last panel of the second book Father Christmas leaves off complaining about the weather and the letters that children send him earlier and earlier every year, beaming, “At least I’ve had a blooming good holiday!” And despite everything, so have I. Wonderful. It just gets wearing to have to continually manage not just my bipolar, but the drugs I’m given to treat it. It’s tedious to have to be careful, all the time, every day. Looking forward into 2014 I can’t help but wish for remission, even just a few months of it. I’d like a chance to just be.