So this is Christmas – and what have I learned?

[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.

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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 2013. Winner of the World in Mentalists Mood Disorder blog 2012. Regular guest blogger for the International Bipolar Foundation http://www.internationalbipolarfoundation.org/ Expert by Experience working with Mind training department. Working on The Incoming Tide, a bipolar memoir. Find me on Twitter @BipolarBlogger or at my Facebook page http://www.facebook.com/BipolarBlogger
This entry was posted in Bipolar, Crisis care, Depression and tagged , , , , , , , , , , . Bookmark the permalink.

27 Responses to So this is Christmas – and what have I learned?

  1. Viv says:

    I wish you a better year in 2015 than 2014 was for you.

  2. fiona says:

    I hope your wish for a better 2015 comes true.

  3. Thanks for your interesting blog and article about Christmas on the BBC website.

    ‘No one severely unwell could undertake the badgering required.’ I found this line particularly poignant. I have suffered from mental health issues for as long as I can remember, from some point in childhood, and a co-morbid problem with alcohol. I have mostly given up with trying to get help via the NHS for the problem as it seems to exacerbate the sense of learned helplessness – ‘there really is nothing i can do’. I feel that the side effects of anti-depressants have, over the years, added to the problems and so I no longer take them.

    In 2014, a person with mental health problems is still, in the eyes of the large majority, a bad person. A drain on the resources of all. Things are changing slowly but in the 20 years of being an adult with depression, really not that much. Its still, mostly ineffectual, anti depressants, long waiting lists for counseling services, or pay for that ‘luxury’ yourself.

    Christmas is a very difficult time of the year, when you have to deal with a lot of things on top of a heavy load. I hope you get through it ok. Thanks for your work. It all helps.

  4. Lil says:

    Charlotte, I don’t have mental health problems, but Xmas leaves me crying and never wanting to leave my room again. The competitive consumerism is just awful. You are not alone in this, though that is probably not much comfort. Wishing you a better year next year.

  5. David says:

    I just wanted to say i’m glad i’ve found this blog, and appreciate how clearly you can articulate what’s going on. I wish I had the courage to do this.

  6. christosuk77 says:

    Just read your article on the BBC news website, thank you and well done. Interesting that you are a Mental Health First Aid trainer, I have already completed the course myself.

  7. Paul Woods says:

    I, too, found you via The BBC.

    I have found in my personal experience of mental health difficulties that the best improvements come from concentrating entirely on doing nothing but improving my mental health for periods of time about two weeks long. More time and it becomes too arduous, although I think arduous it ought to be. Less time and I don’t ‘find the right zone’ in time to get the work done and make changes, or I don’t reach an appropriate point of introspection from which to begin, and then have time to effect change.

    On the point of arduous: as people with mental health problems, we must put in most of the effort ourselves, for reasons that are unavoidable, as I’ll explain. In the medical industry, many scientists work very hard to generate, and companies strive to be successful in generating, medications that might help, for both physical and mental illnesses. But because of the inherent difference in mental illness as compared with physical illness, we cannot expect a magic pill to cure what ails us, much like penicillin might cure an infection (and then not all infections, note). The reason is straightforward: our mental difficulties are deeply personal; it’s very much a highly customised disease. The greatest facility for fixing the machine that is our mind, is our mind itself, purely because of its extent of self-knowledge. Some things will work for you, some other things will work for me. Combinations of pill-form medication, perhaps, for some, with seriously introspective CBT for all, gives us the best chance on this battlefield.

    CBT here stands for Change of Belief Therapy. By examining precisely what it is that Cognitive Behavioural Therapy is designed to achieve in its best-implemented forms, I have renamed it, to make it easier to understand. The new name makes it clear what the goal is. A step back from the name and a brief period of introspection should give the first clues as to where you need to start with the therapy. Once the target, problem, beliefs are identified, the method of change is bound to be highly personalised, and it absolutely certainly has to be executed by the person being cured. We might take encouragement and assistance in exploration of methods from others, but it will be us that effects the actual change, by necessity. Maybe we’ll find useful help from ‘experts’ that haven’t found themselves mired in a few examples of what happens to have worked for other people in their therapeutic history, but the curative method is self-administered.

    As with the aggressively non-passive nature of finding and using cures for physical ailments, as mental health sufferers, we should be willing to put in plenty of work in the search for a cure. Indeed, we should readily admit that we will have to. The personal nature of each illness guarantees this. We can use medications to make sure we’re in a state of mind to go about the curative procedure, whether things to quell our anxieties or to lift our depressions. But the ultimate aim, as with physical ailments, should be a cure, which means ending the use of medication, within the boundaries of currently understood scientific possibilities. As with some physical ailments, there are bound to be some conditions that require permanent medication, but this should be seen as a last resort, and where possible, we should be using education as a preventative tool. We are not truly ourselves if we are unnecessarily dependent on medication; it is a hollow and meaningless victory to find a pill that removes the symptoms of the illness but has side effects that change us where we didn’t need changing. Death, after all, is the most extreme solution of this ilk.

    I sincerely hope that we can all find the strength to tackle our mental illnesses, whether from somewhere inside or from the support of others. But the truth is that we must each tackle our own illness, because no matter how well-labelled each mental illness is, it is invariably and unavoidably the most personalised of any possible illness. The good news is that the cures are just as personalised, targeted and effective, and they live within each of us.

    • Hi Paul, thanks for taking the time to write but I think we have very different philosophies. I’ve actually already been through CBT, CAT and MBCT and spent years using cognitive behavioural interventions with clients when I working criminal justice, so I’m pretty familiar with it all. Despite that it’s not anything I feel is particularly helpful for me. My moods switch sometimes in an instant, when I’m in a rapid cycling crisis they can change a couple of times a day. There is no “better thinking” that can address that. Without meds I think I would certainly be dead. CBT is not right for everyone and I feel I am one of the people for whom it is not suitable. C

      • Paul Woods says:

        I’m sorry to hear you’ve had no luck with it – I found I was having luck with the original CBT I was taught for shorter and shorter intervals until it wasn’t working at all, but then the system and its reasoning, origin and workings as regards the evolution of the brain were all explained to me, along with a very much more detailed type of CBT (what I now call Change of Belief Therapy) which involved exactly the right instruction on how to experiment with different levels of exposure, different ways of thinking afresh during those exposures and how to solidify the relationship between the two, as well as tying up any loose emotional ‘feelers’ so that an emotional state always had something specific to attach to rather than be left dangling to attach to the nearest thing, mentally-speaking. I then found it was great, although the experts that taught me these things came at great financial expense (and two months of time). I really should review the literature properly and see if the methods I have developed are anywhere to be found. Alas, with largely renewed health, my concentrations lie elsewhere, but I will try to find the time. And like I said, as with physical ailments, even the best possible system may not be for everyone – in fact, when a mental health problem is as such, and has found no method of address in the other common methods, it probably ought to be classified as a physical health problem, which it may well be – we just don’t know enough about the brain and its chemistry yet to be certain. And all the while, mental health patients seem to be acting as, essentially, guinea-pigs at best and lab-rats at worst.

      • james says:

        Hello.This evening I read one of your blogs about DWP and ATOS.I only stumbled upon because I am doing some research.The thing is I have a job interview with ATOS in a couple of days,hence the research,to be a disability analyst.I am not going now.I am an experienced staff nurse.I couldn’t do those assessments for ESA unless I was confident that they were fair.They don’t sound fair or reasonable at all.What I don’t understand is this.The DWP have ATOS to do these assessments on their behalf.ATOS follow DWP instruction.ATOS say they have no motivation/monetary benefit to be unfair to those they assess.From what I have read it looks to me that the DWP have outsourced their dirty work.So my conclusion is that the DWP are the guilty party.If they gave ATOS a fair and common sense framework from which to work then these assessments would not have caused such controversy.It also makes sense that if the assessments were going to be fair then they would not have been outsourced and would have been done inhouse.So as usual it is all about MONEY.So I wont be attending the interview in Belfast on Monday.Think I will play golf instead!!!!!

  8. Val says:

    I found you via the BBC article. I was diagnosed with depression 21/2 yrs ago and taken Citalopram for most of that time. During this time my mother died and I was sole Executor of her Estate so spent the following 12 months dealing with everything. I’ve had CBT on the NHS and recently paid for some Counselling myself. As I felt so much better I decided to stop taking my medication (slowly coming off it) I’d achieved this and was looking forward to Christmas and a New Year, when my beloved dog had to be put to sleep. I can’t begin to tell you how this has affected me. It has triggered a rapid decline in my mental health I am fighting with myself as to whether I should start taking my tablets again (I really don’t want to)
    I sit here now ready and waiting to go to my husband’s ex works Christmas party I REALLY DON’T WANT TO GO!! I don’t sleep properly and frankly, don’t want to be here at all.
    All I can do is focus on the New Year, hope I can put it behind me and hope the madness stops

    • Ceebers says:

      I always say, don’t be too afraid of the medication if you need it. If you had a headache, you’d take a paracetamol. If you had high blood pressure, you’d be medicated. You might be able to keep at a lower dose and for a shorter period of time, so it will be easier to come off again. Also, you could be better heading it off before it gets worse, as can happen.

      Good luck and be kind to yourself, it sounds like you’ve had some tough times x

      • Sorry, I don’t follow… I’ve been continuously medicated since 2000 and currently take quetiapine, lithium, lamotrigine and thyroxine daily for my bipolar and diazapam PRN quite willingly…?

  9. Hi Charlotte,
    Like the other people who have read your article I have found you through the BBC article “Christmas and depression just don’t go”.

    I don’t know if you realise how much your words here on the screen help others salvage their lives, something that 99.9% of other things that our presented to use via the media can not do.

    Thank you.

    There’s no doubt about it – it is incredibly tough. Mental illness can take away many things but one thing that we can insist to hold on to is hope. You have been an extremely strong person to get through this year and have probably never needed to be so strong before.

    Whatever 2015 brings you I pray you hold onto your hope and remain strong.. whilst also reflective.. but hey that’s another whole post right there!

    Love
    Josh

    P.s. Tom sounds like a world class chap!

    • Hi Josh and thanks for your kind words. I suppose you could say I am guardedly optimistic about 2015. I am so much better than I was a month ago, for a start. I’m always quite optimistic whenever I start a new drug, I try to keep an open mind despite all the past side effects and problems! So we’ll see that takes me. Best wishes, Charlotte x P.S. He is, but I’m not going to tell him you said that or he won’t be able to get his head through the door 😉

  10. Kevin Thorpe says:

    We have decided to avoid Christmas altogether. The dire financial position added to all that pressure is just too much. Luckily my family understand

  11. Ryan says:

    Hi, I just read your article on the BBC. The details in your writing take me of back to my less stable times, and as someone who will always be ‘maintaining’ my mental state, I wish you the best as you navigate through the on-going strain and commend your other half for his strength and support.
    You got me thinking about some choices I have made which helped me through this difficult time of year, perhaps they’ll help you or another reader.
    I recall my own switch to sending vouchers and have to say, this is now my standard present for all but my partner and her closest family, I’d urge you to consider maintaining your approach, as knowing you have an accepted (by yourself) standard plan in place each year does contribute to a reduction in the dread; I still ask what type of vouchers would be appreciated, and I do now feel everyone is just as happy to receive the gift, as any other present. Another thought, if you’re like I was, I used to spend a good portion of my holiday break travelling around the country to meet all my friends who were quite happy to always expect/let me do it – this has been knocked on the head, as it dawned on me the visits were never recriprocated. Reduce the dread of writing the Christmas cards if you’re notoriously ill prepared; make sure you put everyone’s addresse you wish to write to in your phone contacts so that the process doesn’t involve days of dread/fear, followed by scrabbling around for hours in a growing panic, and prepare a shortlist of names to write for in your phone notes, so it too is ready, re-used each year, it removes the need to think sbout who to write to; it took me two or three years to transition to that point, but now I’m there, it helps.
    Intentionally reeling back in your ‘obligations’ that you feel you should be meeting, makes a massive difference; I can now cope for most months, just by accepting my own limits and simplifying Christmas.
    Best wishes!

  12. Diogo Macêdo says:

    Dear Charlotte,

    My name is Diogo Macêdo, I’m from Brazil and I’m 24 y.o. Well, recently, I was diagnosed with Bipolar Disorder and, of course, I’ve been searching everything that claims that subject. I was on my Facebook when I saw on “BBC Brasil” your blog’s “advertisement”. First, I felt so bad about you, but I then I realised that I was understanding how hard must be for you and, now, for me. Here in Brazil, specially in the city where I live, there’s no snow nor cold weather and others ways to remind “Christmas season”, but there are, of course, many parties and special occasions. Since when I was 17, I’ve been dopping myself for not to be “awake” at the parties or commemorative dates, as well as at my birthday. I take sleeping-pills, ’cause I have insomnia and when a “happy day” is coming I duplicate de dosage and, consequently, I don’t participate on it at all. When I was reading your blog, I felt that sensation that “you’re not alone” and that I have to carry on. So, Charlotte, I finally would like to express my deep gratitude for your strenght and courage to share with the entire world the real life of a depressed person. God bless you, dear. And, why not?, a special and happy Merry Christmas.

    Atenciosamente,

    Diogo Macêdo.

    • Hi Diogo, thanks so much for getting in touch. I was having a conversation recently with someone in New Zealand, he was saying the same thing, that many things we associate with Christmas come from European traditions and don’t really work in the southern hemisphere. But I guess the thing is, wherever you are there will be some sort of expected way to behave or “enjoy yourself” which can feel really difficult. As to feeling you’re not alone, I started writing more as therapy but I was already reading other people’s bipolar blogs and actually that was one of the first things I did when I got by bipolar diagnosis back (I had another one before), read other people’s experience because it helped me feel less alone. Somethings that I knew were normal I realised were normal *for someone with untreated bipolar disorder* which really helped me make sense of things. I hope the season is as kind to you as it can be. (I’m pretty sure we won’t have snow here either, by the way, it never seems to show up until January!). Best wishes to you, C x

  13. S says:

    Derren Brown shared your BBC article and I felt compelled to respond despite being very private about my own Bipolar story – unless manic!
    I have been in the mental health system almost 10 years and have had to rebuild my life twice after two debilitating hospitalisations ‘on the ward’ following bouts of crippling mania with a touch of psychosis.
    I am a successful professional with a middle manager job, but sadly lost a great career, I studied for 5 years in my chosen field but am now only able to manage a rudimentary role in my field.
    Without the support of my previous CPN, who liaised with DWP and secured DLA, brought me food parcels from the foodbank and generally went above and beyond what a typical mental health professional would do I would be lost.
    (Unfortunately I live in a different trust now and their budget does not allow me to have a support worker.)
    Thankfully I have the support of my fiancé and am fairly stable at present. (Debilitating highs and devastating lows can be a bleak life. Anti-psychotics and lithium therapy have uncomfortable side effects. )
    It upsets me that the Bipolar Badge is worn by an array of celebrities to mask chronic substance abuse (just read any interview with someone in the public eye and I guarantee if they have displayed any irratic behavior then Bipolar is often cited as the cause.)
    I will follow your blog with interest and I wish I was as brave as you to share my story.
    Wishing you and your family a lovely Christmas and stable New Year.

    • Good to “meet” you I take antipsychotics and lithium, the sides effects of the APs are indeed dire so I’m just starting lamotrigine with the idea of then reducing the APs. They’ve helped a bit but I would really like them out of my life! Thanks for the good wishes, and the same to you. C x

  14. Ceebers says:

    Thank you so much for this post and its honest portrayal of how bad it can be. It’s a pretty good description of the year I’ve had. I don’t have a ‘Tom’ though, and have waited 8 months for a therapy referral and been told as a crisis plan to call the police…. I wonder how many people who are set on ending their lives stop to call the police, considering the state of mind you’re in? After reading this, I think I’ll push for more support, so thank you again x

  15. Another excellent piece, Charlotte.

    As you know, I don’t have Bipolar Disorder but instead (officially) have GAD, Depression, problems with SH and problems with food. So it seems fair to say that some of our symptoms and therefore emotions and feelings, overlap to an extent. For example, I know what it is to be so desperate that you almost wish detainment upon yourself in order that someone will take over and do everything for you.

    I am so glad, though, that you have huge support in the form of your partner, and that HTT are doing right by you.

    Wishing you as restful a Christmas as possible and sincere best wishes for 2015.

    xxx

    • Same to you, dear Nerdfighter! Thank you for coming by to leave a comment here and I look forward to tweeting with you in 2015 even if I sound like I don’t look forward to much else I do really value my Twitter friends xxx

  16. libertasbpd says:

    Hey sweetie, this has been an extraordinary year with ups and downs galore for us both. The fact that we are both still here, preparing for christmas and spending time with our children shows how hard we have worked.

    I’ve seen how your mood dropped and how incredibly difficult things became for you. I am thankful that you have Tom to keep you safe and that you have surfed this tidal wave so well.

    My wish for you is that Christmas will be a happy affair where you feel loved and needed and that the new year will bring with it a large ray of hope for a better, happier more stable future.

    It’s been a privilege to get to know you this year and i am looking forward to meeting you IRL.

    Sending you warm hugs and much love,

    Lib xxxxx

    • Thank you so much, darling, I am holding on to the fact that i have made some progress and i wont be workimg much until Feb. Hopefully that means I’ll be able to recuperate. And it also means I have lots of free Janurary days for meeting friends 😉 xxx

  17. Fliss says:

    With all good wishes for a much better 2015 for you and family. Your determination shines out and it sounds as if you have already made so much progress. Best of luck.

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