[Content note: discusses suicidal thoughts]
Yesterday I was looking through some photos and came across pictures of Tom and I took in Bavaria last Christmas. Looking at them gave me a strange jolt. It suddenly felt like no time at all since we met St Nicholas (OK, it may have been the hotel manager in a bishop’s mitre) during our Christmas Eve dinner – yet at the same time this year has been so difficult, so gruelling, it seems to have lasted forever. In all of that hard slog, I had almost forgotten our trip.
There is a poignancy to recalling it. I remember that over Christmas I felt happy, that we built some remarkable memories. A torchlit walk in the dark, the burning pine sticks casting flickering shadows on the snow. A visit to King Ludwig’s Neuschwanstein, the inspiration for Disney’s castle. Hearing the group in the next room unexpectedly break into “Stille Nacht, Heilige Nacht”. Yet I was just days away from realising that depression had been creeping up on me, that I was already starting to think about taking my own life before it could really get a grip. It was a depression that would stick around, causing my first crisis of 2014, morphing into rapid cycling that did not lift until mid-April.
There has in fact been no point during this year where I have been fully well. Even during the summer, when I felt sure I was in remission, I now realise that I was simply marking time between crises. I have also had to acknowledge that my excessive energy (walking up to 15,000 steps per day, plus working out five days a week) and massively abnormal sleep (waking up every hour throughout the night for months on end), all while on 650mg of quetiapine, suggest that I was in fact a bit high. This was not at all clear to me at the time. Then came a September wobble that became an October crisis and I remain under the care of the Home Treatment Team to this day.
Not having any true stability is nothing I haven’t experienced in recent years. But the detail of my suicide planning and the incredibly disconcerting experience of rapid cycling have been new in 2014. I don’t believe I have been this bad for perhaps 13 years, when I attempted; Tom certainly feels that he has never known me to be so unwell in the decade we have been together.
If anyone had asked me during this year whether I felt I was “learning” from the experience, I would have been deeply offended. I am emphatically not of the mindset that pain is a teacher, that we emerge from it somehow spiritually more evolved. It would have felt a grotesque misunderstanding of the senselessness of condition. Yet I have learned some things from my experiences – some good, some neutral, some downright scary.
I have learned that as much as I try to pin my bipolar down, build up strategies to deal with my symptoms, it can contort itself into shapes I never would have believed possible. Shapes that I simply do not know how to respond to, that even Consultant psychiatrists have not known how to tackle.
I have learned that without an advocate (and Tom makes a pretty damn good one) it remains impossible into today’s NHS to get much done by yourself, in crisis, particularly when it comes to trickier cross-border referrals or payment authorisations. No one severely unwell could undertake the badgering required.
I have learned that all the times I thought had been really, truly suicidal were as nothing compared to the cold planning and sense of estrangement from myself and from others during the autumn of this year. This scares me; perhaps there is still worse I have not yet imagined. It reminds me of my second experience of childbirth, something I entered confident in the belief that I had done this before and knew how bad it could get. I remember being unable to stop screaming, and a detached part of me marvelling at the previously unknown scale of the pain. I feel like I have been screaming half the year.
I have learned that after being very resistant to the idea of Home Treatment Team I was probably cutting my nose off to spite my face. It felt like a massive to step to let them into my life – I certainly never dreamed I’d need them twice this year. But they have turned out to be the most amazing resource (with the exception of one or two nurses who need to zip their lips and engage their ears more).
I also learned that after twenty years of steadfastly refusing admission, I am capable of getting to a point where I am prepared to beg for a bed. I didn’t, because Tom took two weeks off to care for me and that just bought me enough time to drag myself some way out of the suicidal pit. But I would have. The sort of stubborn pride I once had about only having friends and family care for me is long gone.
I have learned that by standing up for myself calmly (OK, relatively calmly), it is possible to sometimes challenge and change a psychiatrist’s view of you, and yours of them. Earlier in the year I felt all trust between the Home Treatment Team Consultant and I was broken, that we could never have a therapeutic relationship. I’m not condoning his conduct in the spring; I still think it was awful practice. But expressing that, rather than withdrawing from services as I initially wanted to, has lead to us being able to work together.
I have learned that even if I have to take time out or hand back work – and I have loathed doing this, after working hard to build up my professional reputation – anyone really worth working with will continue to offer you opportunities.
I learned that Tom really will stick by me through anything. I am ashamed now by how meticulously I planned to leave him, and my children, and the world behind. I don’t know if he was just trying to appear as if he took it all in his stride but he certainly did a good job of seeming unshockable. I’m not sure I could have coped with being the one to hear such calculated ideation.
Does any positive learning or the interesting things I’ve done make up for the year I’ve had? I don’t think so. Nothing could make the past year feel like it was anything other than horrific, traumatic. I would not wish the experience of the past twelve months on anyone. So there is nothing left for me to do other than what I always do: look forward with hope and optimism to the New Year ahead. And hope for better.