The woman in the crumbling mask

[TW: suicidal thoughts]

As Christmas approached I was cautiously optimistic. I’d been doing so much better since starting lamotrigine, feeling like myself for the first time in who knows when. I saw no reason why that shouldn’t continue. Of course I was a bit concerned that the “festive season” might somewhat destabilise me as it has sometimes done in the past, but that was OK. I had strategies in place, strategies so sensible and helpful that I saw fit to share in them in an article for the BBC.

That article was read by thousands. Countless readers contacting me by tweet, blog comment or the “contact Charlotte” tab, people who wanted me to know that they also struggled at Christmas, who wanted to tell me that what I had written had made them feel less alone, that it had validated the choices they had made about how they would look after their own mental health over the “festive season”.

This left me feeling like a fraud and a hypocrite when Christmas proved harder than I could have imagined. Every day over the past week I have felt myself grow more and more unwell and every day I have had to try harder and harder to hide it. I did not want my children to know how awful I was feeling, so I put on a mask. I began to hate myself for becoming unwell again as Tom is dealing with the fact that his mother is in hospital some distance away, and worrying about the lack of clear information as to whether she in fact has a brain tumour. I have not wanted to be another worry for him. I hate the thought a burden.

But try as I might to hold it back, my mood has dipping and my anxiety rising. This was not helped by receiving a very much unwanted Christmas card from a relative with whom I have made it clear I want absolutely no contact. I spent about a third of Christmas Day crying and trying to disguise it (I cut an awful lot of onions that day). Boxing Day things eased a little, but by the 27th of December I was in such a state of desperation that I was distracting wildly. I feared that if I let myself experience the full level of my despair I would start screaming, just screaming out loud, and not be able to stop. Much as I adore my children the strain of trying not to seem increasingly, screamingly mental was immense. While I cooked or played a board game or watched a Christmas film all the time I was thinking, “How can I do this? How can I possibly do this? This is Hell, how can I carry on living in hell?” When the children left yesterday I told myself that I only had to wear the mask for one more day. One more little day, just so I could accompany Tom and his daughters on the six-hour round trip to see my poor dear mother-in-law.

I got up on time this morning. I ate breakfast. I washed and dressed. I did my hair and indulged in a quick spritz of perfume. And then I realised I could not cope for even one more day. I could not put that mask on again, and if I did it would be liable to crack long before we reached the hospital. And I still have some semblance of pride. I could not stand to become that screaming, howling thing I feared, could not bear to feel less than human in front of my stepdaughters. Tom was anxious about my decision to stay at home, maybe even angry. He did not feel it was safe to leave me alone; I did not feel it was safe to leave (it would hardly have been possible for me to return on my own if I couldn’t cope).

This afternoon I rang Home Treatment Team and bawled down the phone for 20 minutes. I had so much to cry about. How very disappointed I was to be so unwell again when I had felt that I was on an upward trajectory. How disappointed I was at my inability to enjoy most of Christmas. My shame at my inability to just be well, to be normal and supportive, to be the kind of steadfast partner Tom needs and deserves with his mum so unwell. The fear I feel noticing that every day thoughts of suicide creep a little closer. The plan I had before was so detailed, so careful that I find myself easily resurrecting it. I am aware of wondering how I can get hold of medication without anyone noticing, how I can stockpile cash. As I sobbed to the HTT nurse – who was, I have to say, amazingly kind – I don’t want this. I don’t want to be back in that horrendous, lonely place where I am all by myself, cut off from the rest of humanity, out in the cold. The though terrifies me.

I know that it is early days as far as the treatment plan goes. I am only taking a quarter of what the doctors consider a therapeutic dose of lamotrigine and I do understand why the titration has to be slow and careful. But I don’t know how to do the here the and now, let alone move into 2015. Staying at home today was the right choice today, but it’s brought huge guilt. And I don’t know how to stop the encroaching thoughts of it being better if I weren’t here; that I am a useless burden to Tom and the children; that I just cannot live with my bipolar into 2015 and beyond.

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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
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22 Responses to The woman in the crumbling mask

  1. Martin Baker says:

    No words of mine can ease this for you. I wish they could but I know better than that, or to offer platitudes. So I offer what I can. I hear you, Charlotte. You are my friend and I hear your pain. A hand to hold. x

  2. The Millers Tale says:

    Not going to offer advice.
    I am so sorry it is so bloody tough. Not fair.

  3. Val says:

    I don’t know what to sat other than keep on going. Scream if you have to. You WILL come out the other side I don’t know you but I wish I could hug you. Know you are NOT alone and whether we know you or not, no one wants a fellow human being to feel as you do. Be strong xxx

  4. Angry Grandparent II says:

    Sounds like a terrible time that I can identify with, the only two humans I have interaction with are my grown up daughters, I’m so frightened to the point of panic attack of the world outside that it takes a monumental effort to even get me to go out to Costa with my children.

    Could I suggest something maybe? When I commented on your post linked to the BBC, myself like so many others suddenly saw you as confessor as well as fellow sufferer and pouring out their heartfelt, that is a whole load of negativity encapsulated in a concentrated form and deeply empathetic people don’t just read them but feel their pain and can see the misery therein. If you are already in a “bad place” then reading some of others peoples “bad places” could bring on more than just a bit of despondency if you were not in the right frame of mind.

    This of course is just a general thing as I don’t want to appear condescending or patronising as I don’t know anything other than what I have seen in your pages so please forgive me if it does come across as that as it is not intended that way at all.

    Have you read any of Szaz’s works? A lot of it comes across as a bit strange but it does give an alternative point of view to think about, I did my nursing finals on the anti-psychiatrists which was my way of saying to the examiners that I accepted in the whole that as a medical professional we were still groping in the dark when it comes to the mind.

    My consultant want’s to try me on that drug as Venlafaxine is OK per se but isn’t really effective and I am now on the recommended highest dose and the ill feelings are punching through the barrier so to speak and I am finding it harder and harder to dismiss the inner voice, the compulsion to harm myself, I have long term agitated severe depression and PTSD which this drug is supposed to quite good at addressing and since the Venlafaxine isn’t helping as much the choice is to be “over” prescribed on that or move onto the next level which is a little frightening.

    The only advice I could say is to survive the day, get through the day, get through the night and await the next days challenges and it sounds like you have a very good crisis team, my MHT are very good in that regard as well and it really does matter to sufferers to have just that right person at the end of a phone, its not a cure but it is a damned essential lifebelt.

    Keep strong.

    • It’s a good thought re other people’s pain, but that’s really not how it was. Many people didn’t share their “bad places” at all, they just said that the article had helped them to feel less alone, or to understand a loved one with depression or bipolar. No, it was their gratitude that I found overwhelming. If people took the time and trouble to email, tweet or comment then I felt that their effort to make contact should be recognised. So I ended up feeling that I had to respond to each and every comment or email. With the tweets, I again felt should acknowledge people taking the trouble to tell me that they liked the piece and/or sharing it – it just feels wrong and rude not to answer when someone says, “Great piece, thanks for writing it!” or words along those lines. But I quickly realised I couldn’t keep up with it all, it began to feel overwhelming and then I felt like I was letting down people who’d cared enough to make contact – some from the other side of the world. So that was the issue, really x

  5. I don’t know what to say. I’m in awe of your eloquence and feel so angry that you – we – have to suffer in this way. Good days are tinged with fear. Bad days seem unending and unbearable – and they always come as a surprise. Why is that?! You’d think we’d be used to them.

    I suppose I just want you to know I’m thinking of you and sending you all the strength and love I have.

  6. A says:

    Your thoughts and comments are no less valid now than they were before Christmas. Your comments were honest concise and heartfelt. So you are not a fraud.

  7. Keep strong, it’s not hypocritical of you in the slightest to feel that way after the article. With severe depression and anxiety, I was so proud of how I was doing as well and boom. I hit a wall right around the week of Christmas and it’s been extremely uphill since. It’s not like we can fully predict these things. Good luck, and stay strong! Blogging about this helps more people than you know.

  8. Paul Winkler says:

    Poor Charlotte! It is terribly hard to cover up for the sake of others, and almost worse when we can finally drop the pretense.

    Gosh I wish I could fix it for you. I know what it feels like, and I assure you that your words let us all know that we are not alone in this illness. You mean a lot to me, and to many, many others.

    We are here and listening. You are not alone either.

    I’m keeping you in my thoughts, and hoping this episode passes right quick.

  9. I can relate to how you are feeling. I had made a lot of headway in my recovery process. But then suddenly I wasn’t. I was going backwards. I took more steps backwards then I’d care to admit. I slipped and fell. And there are so many theories as to why, Christmas, outside stressors like starting a new job, my theory that my meds stopped working. But these don’t help me. Just as me expressing how I can relate doesn’t help you.

    All I can say is, you aren’t alone. Even though you may feel alone in a room of thousands, you aren’t alone.

  10. Paul says:

    If it makes a difference, your newly discovered blog got me through a usually triggering Christmas. As such the rest of the family and I enjoyed it more. I was diagnosed a year ago but have yet to receive any real treatment besides being put on lamotragine. I has worked to an extent but softens the lows, but does not prevent them. Luckily for me I have an ultra rapid cycle meaning I can hang in there either at work or home and get through it most of the time. But suicide attempts due to the lack of support by even my family and bringing me closer to a possible end. So, don’t feel a fraud, you made me feel less alone, you helped me get through Christmas and you lessened the chance of me ending my life. Be strong, stick with lamotragine (it gets better at 200mg) and remember this is not all that you are. You are still someone who has achieved so much and made such a difference to so many. There is no reason we cannot be hear for you too.

  11. skinnyhobbit says:

    Wishing you an easier time ❤

  12. Gill Kilgallon says:

    Hi Charlotte, I too read your article just before Christmas and it helped me very much. I have had mental health problems for the past 16 years. Had numerous hospital admissions and many encounter with the HTT. I have mixed views of the HTT to be honest. In my area the general feeling is that there sole purpose is to keep people out of hospital. I hope they we may be friends. Gill x

    • Hi Gill, I was very anti HTT for many years and resisted until I could resist no more this spring and either had to be under them or go into hospital. I would say my first experiences were a mixed bag (if you look at posts from around March this year), but second time around they are just invaluable. I simply don’t know how I would cope without them. Most of the nurses are great and the SHO in particularly is marvellous. Sounds like where you are they are sort of gatekeepers to stop beds being used up, that’s really not what they are supposed to be (I looked into their evolution here, if interested: https://purplepersuasion.wordpress.com/2014/06/23/a-bath-a-brew-and-a-benzo-is-this-what-home-treatment-teams-have-come-to/). I know I am very lucky with mine. They genuinely see time spent talking things through with me as important. Anyway, nice to “meet” you! C x

  13. Gill Kilgallon says:

    Thanks so much for replying Charlotte and for the link. Really interesting read. Love the brew,bath and benzo phrase. One of the nurses that visited me was really good. She would come out walking with me and my 2 dogs. She would happily walk with me for miles even in the pouring rain. But the rest of them, total numpties, drove me crazy with their advice ” let’s do some deep breathing exercises”, “would you like to bake a cake” . Err no funnily enough I wouldn’t…

  14. Rosie Pearce says:

    Sorry Christmas was so difficult Charlotte..lots of love Rosie x

  15. Ed says:

    Hi Charlotte ,

    I’m sorry your not well at the moment . One thing when reading in your blog that you had developed rapid cycling within the last year , put on weight even that you felt the cold a lot on your previous med was that the rapid cycling might have developed associated with insulin resistance . An article published this month in the BJP indicates that the treatment resistant rate trebles to 50 % in bipolar 1 & 2 with diabetes and is only 2 % less at 48 % for the insulin resistant , the rapid cycling rate also trebles to 36 % .

    If your blood pressure is on the high side , you have relatives with metabolic syndrome or who died relatively young from cardiovascular disease then it might be a real possibility for you .

    My father died at 53 years old following a stroke ,I’ve had a problem with anxiety and depression in the winter since my teens but the last few years medication that previously had helped was less effective and my mood was low in the summer unlike the past and I definitely wasn’t functioning well .

    Now having been diagnosed with diabetes last May , taking Metformin and eating a low carbohydrate diet I’ve been able to lose over 2 1/2 stone and it is only very recently that there has been any sign of the anxiety that usually is the first sign of problems starting in the winter , Even then its relatively mild and at the moment irregular although I’ll probably start to take an antidepressant next week as a precaution . In fact my mood at times has been surprisingly good , if I were further along the bipolar spectrum nearer your end there might be a concern of my being destabilised .

    I hope this helps , check out ;

    http://bjp.rcpsych.org/content/early/2014/09/25/bjp.bp.114.152850.short

    http://www.news-medical.net/news/20141022/Insulin-resistance-linked-to-treatment-refractory-bipolar-disorder.aspx

    Take care and remember spring is only around the corner even if your not quite sure about the date ,

    Cheers Eddy

    • Thanks, but that’s really not it. I have my blood sugars checked regularly precisely because I am on an atypical antipsychotic and we are all mindful of metabolic syndrome – but they are normal, as is my cholesterol. My blood pressure is being treated and is technically still high but now much lower than it was. The overall treatment plan, which you may have missed, is to titrate me up on lamotrigine so that we can start reducing the antipsychotic precisely because of the risk of metabolic syndrome and because otherwise the weight gain has other ill effects, e.g. joints, and the AP itself badly affects my digestive system and remains sedating. It’s nice of you to care but I do have about 6 doctors looking after me at the moment and I promise you that with a partner with diabetes and a job as a mental health trainer we’re pretty much as “live” to this issue as possible. BW, C

  16. James says:

    I read your Xmas-BBC piece and was reminded of the existence of this blog. (As yet I’ve managed to read only a few postings). I intended to comment on the Xmas piece at some length, but feel that might have been insensitive in view of this ‘crumbling mask’ posting which has come later; and if coping with all the responses to the Xmas piece has perhaps already been like straws on a camel’s back for you. I can be pedantic, obscure and perhaps irritating but I hope not toxic to anyone who might read this in good faith. Having high self-esteem, I don’t really need acknowledgement or recognition. I’ve received a fair bit of praise in my life, and sometimes find that a bit wearisome, (probably because I was bullied even more for being a teacher’s pet).

    With your suicidal ideation, it might not be much comfort to be reminded that (from some perspectives at least) being able to experience a full range of emotions intensely (including negative ones) is actually considered a sign of relatively good mental health. You seem very human. The negative emotions have generally been the most important ones for me (probably a basic survival mechanism), and it was the depth of my anguish that helped drive me towards a positive turning point in my own severe depression (more than 30 years ago). I say ‘positive turning point’ because I am both alive and sane.

    If you have been troubled throughout much of your life then you probably won’t be aspiring towards any sort of quick fix, but you might attain a sense of ongoing progress which is only interrupted by relatively brief episodes of despair such as you have been describing (no-way would I ever want to be young again).

    I am particularly aware at the moment of two types of memory, the usual, cognitive recall of actual physical events, and a more obscure emotional trace which I’m going to call affective recall. There’s clearly some sort of association between the two. To make a small leap, I’m absolutely sure that an affective retraumatisation can hit us much harder than we might anticipate, pole-axing us even when we think we’ve got it all together. Not so long ago I was visiting a museum and saw a pre-war gas cooker similar to the one owned by my grandmother, who died in 1985. I simply started looking for a vacant corner of the museum because middle-aged men are not normally seen weeping in public for no apparent reason. The strangest thing was that I don’t know why – I don’t remember having any particular problem with the passing of my frail elderly grandmother back in 1985. This is perhaps then too obscure to be a very good illustration of ‘affective retraumatisation’, because often the details aren’t obscure at all, but brutally obvious, as in the recollection of intense family rows or bullying for example. Your unwanted Xmas card does sound suspiciously like this type of retraumatisation event to me. I have experienced this before; about 20 years ago a Xmas row hit me for about a week (and then I went down with a bad cold) – on another occasion I had read a book which I should have stayed away from.

    I shouldn’t be at all surprised if this ‘affective retraumatisation’ turned out to be the single biggest cause of relapse in both schizophrenia and bipolar. My intention after submitting this is (unless told not to) to write and submit another comment sometime, centering on your Xmas-BBC piece, before getting to grips, hopefully with the rest of your blog archive. Good luck

    James

    • Hi James, just to say I have only just seen your comment and I would love to respond properly right now but it’s very difficult – I’m away from home trying to support my partner as a family member is gravely ill. Not sure how long I’ll be away either. But I will try to get back to you x

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