I’ve thought about blogging so often in recent weeks, with several abortive attempts. I considered writing about the therapeutic benefits of having a companion animal – if you don’t follow me on social media, I now have a cat! She’s just over a year old, small and black, and she’s called Cinnamon (or @MissCinnamon6 on Twitter). We’ve had her just over two months and she’s changed my life. I feel excited to see her when I get up in the morning, and I feel special and loved when she’s sitting on my lap, purring away (yes, yes, I am excited to see Tom in the morning and he does make me feel loved and special!). I get so much from having her living with us – except when she brings in live birds.
So there’s been good stuff to report but, sad to say, much more on the bad side. About four weeks ago, I woke up depressed. No rhyme, no reason, just low mood from the get go. Everything became a struggle. Sometimes even lifting a fork to my mouth felt like too much effort. I had no motivation and woke up every morning wondering how on earth I was going to get through each long, long day until I could go to sleep again.
Things worsened. My mood dropped further, and the inevitable suicidal thoughts began to creep in, quickly switching to active planning. I saw my consultant a week ago, and she asked me to rate my risk on a scale of 1-10. I estimated it at a 5; the thoughts were intrusive but I did not feel like my life was not worth living. We discussed whether the dose of my antidepressant should be increased, but Dr A was worried that this could lead to mania, so we agreed – slightly reluctantly on my part – to keep my medication regimen intact.
The next day, my risk assessment changed. I began to feel more emotional pain that I had done in years. When I cried, it was not just in sobs but in howls. When my Community Psychiatric Nurse visited three days ago I let it all out, how much distress I was in, how I couldn’t live with it, how Tom would be better off without me so he could marry someone who could be a proper wife to him. If people knew, I said, if they knew the despair I was trapped in, they would want me to be released from my pain. You wouldn’t let an animal suffer that level of physical pain, why should I have to bear this level of mental pain? By this point I estimated the risk at a 9.
Despite my anguish I was trying to be sensible and mitigate that risk, because my goal for 2019 is to get through an entire calendar year without a hospital admission. By the time I saw my CPN, I had voluntarily surrendered my phone and laptop, because I was using them to research ways to make my death easier. Later that day, I gave up my bank cards, because I didn’t trust myself to run off to Cardiff or London to take my life. I suppose you could say that meant that I didn’t really want to die; from my perspective, it was more a fear of failure, of being picked up by the police and ending up sectioned in a ward hours away from home. I didn’t trust myself to be competent enough to do it right.
My CPN was really concerned as I explained that now I had given up my access to money and the internet I felt stupid, that I had trapped myself and now had no way out, exacerbating my desperation. She’d seen me low before, but never like this. At this point I was thinking that I actually would need to go into hospital. There was no discussion about whether to involve the Crisis Team; she stated that she was going to make the referral and that they could come that evening if needed. With Tom at home we decided that the visit could wait until the following day. She also made the decision that she would speak to Dr A because it seemed like the antidepressant should probably be increased after all, because it was clear that the risk of mania was less than the risk of, um, death.
By yesterday, my first day under the Crisis Team, my despair had lessened somewhat – I think as result of unburdening myself to Tom and my CPN so that I was no longer alone with my grim plans. I was still relieved to see the nurses, both of whom I had met before during my last stint as a CT patient, and still quite tearful. They were reassuring. They felt that I had done the right thing in gviving up my internet access and back cards, and they approved of me taking 5mg diazepam three times a day. They were pleased to hear that I was doing all the clichéd distraction stuff – aromatherapy baths, reading, watching TV dramas, colouring in. Thank god nobody mentioned mindfulness. They agreed that they would come again tomorrow to check on me.
And then this morning I woke up and I was cured. OK, not cured of bipolar, but cured of despair. Not a sniff of misery; in fact from the moment I opened my eyes I felt wonderful. I had never felt less like killing myself in my life! I felt like singing all the time. I felt wildly enthusiastic about the weekend break we have coming up next month (something I had sobbed to my CPN I couldn’t bear to think about). Tom quickly noticed that I had got my sparkle back – and then some. The only worry on my mind was that the CT nurses would think I was a massive fraud and a waste of their time. In fact, they were great. Naturally they were a bit surprised, but they recognised that my mood is elevated and that elation is pathological in itself. We all agreed that given the circumstances, upping my antidepressant was not a smart move, a consensus that the nurses planned to feed back to Dr A.
We discussed what to do over the next 24 hours. I came under (respectful) pressure from Tom and the nurses to keep taking diazepam to reduce the mild elation I am feeling, but I said no. I’ve been in hell in the past week, and a colourless, confusing wasteland for weeks before that, and now I’m out of that, I want to enjoy it. In fact I feel that I downright deserve a bit of elation after my recent suffering. And it’s not enough; I want more. It’s pretty much how I was in August – reluctant to take my mood stabiliser and antipsychotic because they’re inhibiting my chances of hypomania proper.
Round and round I go. I guess I did fairly well, going about three months with my mood essentially stable (OK, I still had utterly debilitating anxiety every single day, but hey). I think there are probably people who find it had to believe that I really can wake up in a completely unexpected mood state but that’s the really disabling part of rapid cycling. I can’t see depression coming, and I can’t see hypomania coming. Bam! There it is.
The plan now is for the Crisis Team to monitor me until my CPN comes back to visit on Monday. They’ll be phoning tomorrow (Friday) and possibly visiting on Saturday or Sunday to check how I’m going and that I’m not going higher. So I feel well supported. The challenge for me is to behave. I know that my part in all this should be to implement my longterm hypomania management plan, but, but…
Image shows a sign with arrows pointing to “down” and “up”. Sourced from Flickr, commercial use and modifications allowed. Credit to https://www.flickr.com/photos/smallcurio/