Review: Ellen Forney’s Rock Steady

I started out by really, really wanting to like this book. I adored Ellen Forney’s graphic memoir, Marbles: Mania, Depression, Michelangelo and Me, which came out a whole six years ago. So I was excited when a friend told me that Forney had a new book out called Rock Steady: Brilliant Advice From My Bipolar Life.

But I also kind of didn’t expect to like it, because generally I’m not keen on advice guides. They tend to be just too prescriptive, and the American ones I’ve read in particular seem to be very heavy on the “take your meds, keep to a routine” approach with little room for nuance.

I tried to keep an open mind.

The book is rendered in a combination of text (hand lettered, there is no standard print until you come to the resources section at the end) and cartoons, with some illustrated characters or features recurring throughout. Forney draws herself much as she does in Marbles, for example when showing herself interacting with her doctor, but as much of the advice is directed at any person with a mood disorder, people are usually represented as generic, well, person shaped figures (or occasionally a teddy bear). There are lots of tiny, quirky comments in the margins, some of which made me laugh out loud.

The main thrust of the book is that if you are stable, you might well relapse in the future, but you can improve your odds of staying well through self-management. Forney distils the basics of her programme for staying well into the self-consciously clunky “SMEDMERTS” – sleep, meds, eat, doctor, mindfulness, exercise, routine, tools, support system. Uh oh, I thought, mindfulness. Uh-oh, I thought, routine. Here we go.

Only every time I expected Rock Steady to become rigid or prescriptive, it – didn’t. There’s a healthy pragmatism throughout. Sure, it’s better to stay off devices late in the evening if you want to get a good night’s sleep. But the book doesn’t preach; if setting them aside “isn’t an option”, it suggests you might want to adjust the colour palette on your phone or find an a pair of blue-blocking glasses. I also liked that the book isn’t prudish – it suggests that giving yourself an orgasm is a perfectly nice, acceptable way to help you to get off to sleep. I’ve never seen that in a self-management book before.

OK, we all know that drinking alcohol when you’re on meds is not a great idea, but I do it, and lots of other people do too. Rather than just tell you that alcohol is BAD, Forney focusses on whether a person’s drinking is problematic in its own right, rather than yelling at you. There’s a healthy separation throughout between the ideal and the possible. It’s all about finding solutions that work for you. Can’t do a 15 minute mindfulness mediation like Forney does each morning? Well, guess what, she hasn’t always been able to either, and sometimes a walk in the forest can be just as nourishing.

In Forney’s world, it’s OK not to know what you want. It’s OK to feel multiple things at the same time. “Once when I was really low, I was conflicted… I really wanted a stuffed animal, but I was already struggling with feeling like a big baby. Then I had an idea for a stand-in: big soft fuzzy pillow.” It’s OK to have a complex blend of feelings about meds, and the book is careful not to assume that meds will always be a part of someone’s treatment package.

One thing I found particularly useful was the metaphor of “red flag poles” (things that could be triggers for an episode and that you need to watch yourself around) and “red flags” (warning signs that are running up the flagpole and may suggest you’re becoming unwell). I’ve already used this with my Community Psychiatric Nurse, because I’ve had a few red flagpoles recently, including losing my job and mega sleep disruption caused by a nasty cough. And just in the past few days there have been red flags. Feeling full of energy despite lack of sleep. Me, a notorious hater of housework, wanting to clean from the minute I wake up. The need to dance. Huge irritability. The CPN suggests I use the model when completing my crisis plan because it clearly makes a lot more sense to me than the format on the plan itself.

There’s a lot of “been there”, hands-on wisdom. How to swallow your meds easily. How to cut pills. Techniques for better sleep (and even this hardened insomniac is planning to give some a go). A massive range of helpful phrases to keep telling yourself to help you to hang on. A lot of the practical advice doesn’t really apply to a UK audience, though, as it involves choosing a psychiatrist and/or therapist, finding a hospital that will take your insurance, etc (although the way the NHS is going, perhaps we will all one day need this advice).

Should you buy this book? Obviously it will be of more benefit to those recently diagnosed with a disorder on the bipolar spectrum (the books does take care to mention major depression and dysthymia, but it’s really most useful for those with ups as well as downs) but even this old hand found some practical tips and some general inspiration for cleaning up my act a little bit in terms of looking after myself.

Put it this way: a young relative of mine has recently been diagnosed with bipolar. Rock Steady doesn’t come out until 29th May, and today is the 24th. I’ve already pre-ordered him a copy.

You can follow Ellen on Twitter (@ellen_forney

Image shows a red book, spine and open pages (sourced from Flickr, credit

Posted in Bipolar, Book reviews, Books and reading, Medication, Mindfulness, Mood disorder, Self-management, Treatment planning, Uncategorized | Tagged , , , , , , , , , , , , ,

I reached out, but no one grabbed on

Once again, social media is full of exhortations to talk about it, to talk about depression and suicide and mental health in general, with the core message being: reach out. Because even if you don’t feel like it, somebody out there cares. It’s brought to my mind a very dark period of my life when my children were tiny, and how I sought help again and again, only to be continually rebuffed. Many mothers with serious mental health problems worry that their children might be taken away from them; I needn’t have had any concerns, as agencies didn’t seem to care enough about us to notice the impact of my appallingly poor mental health on my kids. 17 years on and I get much better care, but you can bet that there are parents all over the country living through a nightmare of postnatal illness and being told that they’re OK.

Anyway. Here we go. Three vignettes of seeking help.


As promised, the Community Psychiatric Nurse came to my door. I had no idea what to expect as I’d never met one before. I really wasn’t sure what her role was. I was hoping she’d have some sort of plan, a package of support she could offer that might just help me carry on, but she opened with a question. “So, what is you want from me, Charlotte?”

I was nonplussed. How was I supposed answer, when I didn’t yet know what she could do? “I don’t know,” I said. “I just…so I just came out of hospital because I took an overdose, and I’m trying to deal with that, I suppose.”


“I don’t know,” I repeated. “I’m not sure where I go from here.”

The nurse looked annoyed and gave a kind of chuckle of irritation. “Look, Charlotte, this is a service for people with serious mental health conditions.

I flinched, probably visibly so. It had never occurred to me that taking a big overdose when I have very small children might not qualify as “having a serious mental health condition”. But clearly it didn’t, because the nurse was already standing up and putting on her jacket. “I don’t think there’s anything we can really do for you,” she was saying, “so I’ll feed that back to the team. If you need anything else, it’s back to your GP, OK?”

I nodded, and showed her to the door. I had felt like I was drowning in my feelings, but now I felt completely numb. Was that an improvement?


We tried yet another drug, sertraline this time, and Dr Fiore sent the Health Visitor round. I knew I had met Pat a couple of times when Alice was very tiny, but I didn’t feel as if I knew her at all. I made her a coffee and we sat and talk about normal things – how the children were growing, what a lovely sized living room I had – until she asked about my situation.

I decided to be honest. “I can’t cope,” I admitted, shrugging slightly. “That’s the bottom line. I can’t cope and I was stupid to think I’d ever be able to, with my mental health history. I should never have had kids.” Pat was already looking slightly shocked, but I persisted. Since I’d already started divulging all these awful, unsayable things I may as well carry on until I’d aired them all. “This is not how I wanted my life to be. I am a terrible mother.”

“Oh, you’re not!” Pat exclaimed reflexively, reaching over to touch my knee. “You’re a lovely mum!” I cringed, feeling I’d been told to keep my emotional messiness to myself. “I think, though,” she continued, rummaging in her bag, “we’d better just do this Edinburgh Postnatal Depression Scale, is that OK? I’ll just pop today’s date on the top… You can use my pen, look. Have you got something you can lean on?” I reached for Max’s dinosaur encyclopaedia, which was always handy.

As you are pregnant, the form stated, or have recently had a baby, we would like to know how you are feeling. Ha! Thank God somebody did. I was instructed to read through each question and consider how I’d been feeling over the past seven days. I looked down the list. Had I been able to laugh and “see the funny side of things?” Well, but I wasn’t really sure what funny side was to being trapped in a house with two completely dependent children I was incapable of looking after. Had things been getting on top of me? I sighed and tick the box marked, “Most of the time I haven’t been able to cope at all.” Yes, I’d had difficulty sleeping. Yes, I was miserable and crying most of the time. Jesus. What a fucking pain I must be to live with. I paused at the last question, then decide to tell the truth: the thought of harming myself had, again, occurred to me “quite often.”

Alice stirred, grizzled. I handed Pat the form and put the baby to the breast while she reviewed my answers. “Hmm,” she frowned, rechecking the score, “you’ve come out very high. But I think that’s just because you’re so self-aware.” She put the lid back on her pen, satisfied. Oh. That was all right then. I’d be OK being suicidal as long as I knew I’m suicidal.


One day I flicked through the Yellow Pages, looking for support of any kind. The drugs were ineffective, Pat was hopeless and I was desperate, so I decided I’d call a parenting helpline. They would have heard it all before, surely? Maybe they could give me something to go on, some nugget of wisdom that would keep us all OK, get us through this afternoon? I occupied Max with yet another cartoon, feeling shitty about the TV as babysitter thing, and waited until Alice was asleep. I sat on the rug with the directory open beside me. The phone was weighty in my lap and it was a struggle to make myself lift the receiver and dial, a further struggle not to slam it quickly down again when a woman’s voice answered. She wanted to know why I was calling, so out it all spilled: the toddler who screamed all day and the baby who cried all evening, the sense of being trapped in my own house by the chill of winter and the unreliable public transport. How I mostly lacked the energy to go out anyway, and when I did I had to endure the humiliating supermarket tantrums and the frosty mums at the toddler groups. How desperate I was.

“Parenting is hard!” asserted the call handler, tutting. “You sound just like my daughter. I said to her, what did you think parenthood would be like? Little House on the Prairie?”

I pressed my finger down to end the call. No one. There was no one.



[Image shows an outstretched hand. Copyright Emanuele Longo via Flickr


Posted in Bipolar, Depression, Family issues, GP, Hospital, Medication, Memoir, Mental health, Mental health services, Mood disorder, Parenting, Primary care, Suicide, Uncategorized | Tagged , , , , , , , , , , , , , ,

Hi ho, hi ho, it’s off to work I – oh :(

Recently I decided that I was ready to get a job. Aside from the freelance stuff I did a couple of years ago, I haven’t worked for a long time. The last time I worked for an employer was in 2011, when I left following a spectacular relapse and was never able to go back, so there was a lot of agonising involved in my decision. What if I found it so stressful that I lost my recent, fledgling stability? What if I loved it so much I soared, then crashed and burned? (This has been a pattern in my work history.) To make things even more complicated, for dull reasons it had been made clear to me that if I ended my claim for Employment and Support Allowance, I was not entitled to anything further. We can get by on Tom’s money but losing an independent income would be a big deal to me.

I looked around. What could I do, with such a big CV gap? Having moved to a rural area job opportunities were thin on the ground, particularly for someone who can’t drive. I settled on looking for admin posts, and a couple of weeks ago I unexpectedly found myself accepting a job as a receptionist at my local GP surgery. The “local” bit was problematic. I was told I would have to change GP practices and register with another nearby. Two were accessible by bus: in the first, one of the GPs at the first is my next door neighbour, and the second is out of catchment for my new Community Mental Health Team (CMHT) and would mean a change of Community Psychiatric Nurse (CPN), something I really wasn’t keen on as she and I have only just met and I feel we get on well.

Despite all this, I was willing to give it a go. More than that, I was excited! I was pleased and proud to announce my start date on social media. I mentally projected into the role, imagining myself helping people and being indispensable to the doctors.I bought work clothes in anticipation of wages I had not yet earned. In particular, I bought two pairs of comfy shoes, knowing that I would be on my feel at the front desk most of the day, and tops in the “uniform” colours.

I lasted just four and a half days before today, by mutual agreement, I left.

From day two onwards I had woken up with dread in the pit of my stomach and needed diazepam to get me in a fit state to go to work. I had endless conversations with Tom about it being very very early days, and needing time to settle into it, but I quite quickly began to fear that I had made a horrible mistake.

Today I made it in OK, but by mid morning I was trying not to cry in front of patients, which would have been the ultimate humiliation. I went, with a sickening sense of déjà vu, to cry in the ladies’ loo. When I tried to splash water on my red eyes I found that the cold tap was stuck and wouldn’t turn. It would be obvious that I’d been crying, so I preempted any questions by almost literally grabbing the senior receptionist and telling her that I did not think I could do the job. She took me back into the ladies as there was no other private space and took stock of the state of me. There was no way I was going to be going back onto that desk, so she told me to go upstairs to the staffroom and wait for my manager. It was intended to be supportive but I felt like I had been summoned to see the headmistress.

I had expected the job to be stressful. I had thought about all the complexities of juggling patients, sluggish IT systems, and constantly ringing phones. But it was the things I hadn’t thought of that were unmanageable. Part of my obsessional anxiety is about getting into trouble; another component is about causing harm to other people. I sometimes find it very hard to cook for others because I fear that I will poison them, and Tom has had to endure many a rubbery chicken dish because I let my anxiety overrule the stated cooking time. Recently I cooked for a group of mainly elderly people and almost didn’t give them anything because I was so frightened that they would die as a result of eating my lentil salad. I had to talk myself down from simply throwing it away, and because I fed it to them anyway I lay awake in the night, awash with waves of unbearable anxiety. I even ruminate about harm I could had caused, but didn’t; the time I held a baby after a glass of wine and could’ve dropped her, that time I left the bedroom window open by mistake and my young daughter could’ve fallen out. We are talking 12 or 15 years ago here. I frequently fear being found out and even sent to prison for past or current misdemeanours.

Now I don’t know why I didn’t think of this, but there are so many important mistakes you can make as a GP receptionist. You can book the wrong appointment for the right patient, or book an appointment for the wrong patient entirely. Your actions can mean that they miss a critical blood test or that their elevated blood pressure goes unnoticed. You can give someone the wrong test results, causing them needless worry or generating false reassurance. You can forget to send a message to a doctor asking for a phone call to be made to advise a patient on what to do next. Any of these could result in harm coming to somebody. This fear of risking the health of the population of largely elderly patients built and built in me to the point where I was anxious about every single action I took. And this morning I did make a mistake.

Is there any way I could’ve been better supported to cope with the job? Well, yes. I never had my induction last week as my manager was – through no fault of her own – absent. And the team was so short staffed that I was pitched into the middle of things with no real training, the approach being to have me deal with phone and face to face enquiries, booking appointments, etc as best I could and ask for help when I got stuck. In other words, get into it and get on with it. Important general questions I wanted to ask just never got answered as there never seemed to be time for anyone to sit down with me and explain how certain things worked. Maybe I should’ve been more assertive, but whenever I asked I was told that I would get an induction next (this) week.

But this week is too late for me. When my manager came to the staff room I explained why I wasn’t coping and she suggested the job wasn’t right for me. I told her that my primary goal was to stay out of hospital and that I felt like the job was making me sick, and she felt that in that case the job really wasn’t worth it and that I should go home and “draw a line under it”. I’m not 100% sure whether I quit or whether I was gently let go. Maybe a bit of both, but I can’t do the job either way so it doesn’t really matter I suppose.

I’m feeling pretty raw. It’s hard not to feel like a failure as an adult when you can’t even do five days at a job before you lose it (in both senses of the term). I feel like I gambled massively and I lost. I just rang the DWP and now I have to reclaim ESA with no guarantee of getting it back. Like I say, we’ll survive, but it’s a big chunk out of our joint income. Now I get to stay with the same GP practice, but I have the humiliation of going in and knowing everybody as a now ex staff member. At least there will be no question now of having my CPN replaced with a stranger.

What I do now, I have no idea. Maybe do a little volunteering. Hide away. Lick my wounds. I suppose that if I do ever get to a point in the future where I feel like I can work again, there is some learning to be had from this, but really if you ask for support and the support isn’t there, what can you do? Disability was flagged up at interview and I still ended up in this pickle.

Bipolar 1, Charlotte 0

Posted in Anxiety, Bipolar, Employment and benefits, GP, Mental health, Mood disorder, NHS services, Primary care, Recovery, Stress, Uncategorized | Tagged , , , , , , , , , , , , , ,

Some people find psychiatry helpful… and that’s OK

I grew up very close to a Victorian asylum. It began to close in the late 1980s, when I was in my teens, but even as a child I was aware that some of the people I saw wandering the village had been done a gross disservice by psychiatry. Many were elderly, having been admitted decades before, often for spurious reasons and with little hope of living in the community again. Recently I saw some accounts of life in that hospital. You will be unsurprised to learn that an unwarranted number of the wards were locked, and patients hugely overmedicated.

The first time I saw a psychiatrist was just a few years later. I was 19 years old. I had been referred by my GP, who was concerned about my depression, but I had been reading abnormal psychology textbooks in the university library and was beginning to suspect that I might have bipolar. I can’t begin to say how unhelpful and upsetting I found my encounters with that consultant. He was sexist, and obsessed with achievement and status. He was dismissive. He called me a liar. He implied that I drank too much. His brief but efficient gaslighting was such that after an hour’s assessment I barely knew what was true about myself. My mum came to the second appointment because I could not face going back alone. He told her I was like a silly schoolgirl and sent me off with a prescription for fluoxetine (Prozac) which he said would send me “as high as a kite” if my “red herrings” about elevated mood were true. I stuck with the antidepressant through two weeks of sleeplessness, agitation, despair and suicidal ideation, all the while thinking that I was far worse off than if I’d never asked for help.

In my recent treatment I have seen some awful things. It is (or should be) harrowing to see somebody sedated through an intramuscular injection they have not consented to, or subjected to any form of restraint. I once saw a man taken to seclusion by a phalanx of eight or nine staff. The patient was doubled over inside a sort of cage of nurses, the nurse leading holding his head down so that he could not see where he was being taken. I’m sure there were serious risk issues involved because this response was very swift, but it was nonetheless shocking. I have seen people so sedated that they could not talk, could barely move, could do little except drool. I have seen people on antipsychotics gain multiple stones of weight with no support for managing this. I have seen people detained without understanding why, moved from shorter s2 (of the Mental Health Act) detentions onto longer s3s without understanding why. I have seen many, many people given one drug or another without ever knowing the reasoning behind prescribing, let alone having actively participated in the decision-making or meaningfully consented to the side effects.

I have met (online and in real life) people who have been saddled with diagnoses they did not ask for, words which have made them the subject of others’ fear and misunderstanding. Labels that have led to professionals writing them off as hopeless cases or branding them as manipulative, that have reduced their employability, that have made them doubt their own experiences.

Well, now it looks like I’m talking myself round to thinking that a system that employs so much coercion and is arranged so hierarchically must be outright unacceptable. It’s easy to understand why there are so many people who feel themselves to have been abused and degraded by some of the things done to them in the name of medicine. Let me be very clear on this: I hear them. I think that psychiatrists should damn well hear them. I believe that their suffering must never be downplayed, and that doctors must accept that their intention to manage risk and alleviate suffering is not experienced as such by many patients.

Probably some of the psychiatrists I know online or in person are a bit disappointed in me by this point. Well, I can only tell it as I see it. But wait, there’s more. I just can’t go around saying that psychiatry is awful, because then I’d be denying the very real help it has given me, particularly in recent years. This may be entirely due to the fact that the psychiatrists who have cared for me (and I do believe they have truly cared) since my relapse in 2011 have been good people – although that’s still not uncomplicated. The same Home Treatment Team consultant who has helped through endless crises was at one point painfully paternalistic, thinking up a new diagnosis and sticking it in my notes without telling me. The same ward consultant who worked with me to find a better drug regime prescribed for some of those patients given meds that they did not understand.

But many, many aspects of their input have been beneficial. My current diagnosis, formulated with my input, has been particularly helpful. A psychologist opined on Twitter recently that psychiatric diagnoses were “meaningless”, by which I think they meant that there was no scientific evidence base for them. Meaningless? Not to me, they’re not. My diagnosis is the context within in which I understand my life. Strange behaviours and inability to honour commitments, often the cause of much guilt further down the line, make sense in terms of bipolar mood cycles. Without thinking of myself as bipolar, I had assumed I was just a terrible person. Without thinking of myself as bipolar, I cannot see the same behaviours coming and try to take action to curb them. Online I have found my “tribe” of other people whose experiences and behaviours I recognise, a kind of kinship established by a shared label/context. I have seen the same kind of connections made among people with, among others, diagnoses of depression, anxiety, obsessive compulsive disorder, and yes, borderline personality disorder. A lot of people find labels oppressive; for some people labels can be liberating. Liberation is not is meaningless.

The drugs… the drugs help. At least some of the drugs, some of the time. I have taken a large number of medications, some of which were never helpful at all. Some were a little helpful but came with such horrendous side effects that on balance I decided to stop them. Right now I have a better quality of life than I have in a couple of years thanks to a combination of two mood stabilisers, an antipsychotic and a little kick for my thyroid function. Yes, I take a lot of pills, no, that doesn’t really bother me if it allows me to just about manage. In fact there are lots of people out there who also feel that their quality of life has been enhanced by psychiatric medication, with many stating that their drugs actually keep them alive. This is clearly an aspect of psychiatry that many people value to some degree . I’ve also seen “good news stories” in an inpatient setting, the use of antipsychotics turning around the lives of young women whose psychosis had placed them in very real danger from physical accidents or sexual exploitation. They were sent on their way in a week or so without labels, with a (hopefully) one-off psychotic episode resolved.

Personal relationships help. I have been with the same community consultant for six years and he has been consistently patient and supportive and warm. He continues to be optimistic (in my view, wildly so) that my functioning can be improved and is open to trying different drugs and seeing how that aspect of treatment can mesh with insights gained in psychological therapies. I didn’t have a care coordinator for five of those six years, and he essentially provided that function although it wasn’t his job.

So we know that psychiatry can do and has done things that patients perceive as harmful, and it’s OK to fear or hate a medical specialism if you feel that it has treated you badly. It’s important to note that finding psychiatry personally helpful does not cancel out the bad experiences of others. But it’s also OK for a person to feel positively about psychiatry, or at least about the aspects of it that have helped. It’s OK to feel positively about the psychiatrists they work with, if the interactions are sensitive and empowering.

It’s not OK to shout down some people’s good experiences on the grounds of other people’s bad ones. It’s not OK to take away words that gives people a sense of meaning and a framework for understanding their own lives because the same words are not helpful for other people. Overall I am (mostly) positively disposed towards psychiatry, and despite what some people on Twitter may say I cannot be wrong on this, because I cannot be wrong about my own experiences. Denying the validity of people’s lives and self knowledge is at the core of oppressive practice, but this cuts both ways. You don’t get to pick which type of experience is “correct” and simply brush aside anyone who find their diagnosis, or their psych meds, or their psychiatrist helpful because it challenges the idea that psychiatry is and must always be inherently brutal.

I totally get that it’s hard for some people to understand why I might be broadly positive about psychiatry, but tweets about good relationships with doctors, “life-saving” medications and enlightening diagnoses show I’m hardly the only one. Rather than rejecting that, shouldn’t those who raise their voices against terrible care be celebrating the fact that care can sometimes be good? Some people find psychiatry helpful. And that’s OK.



Featured image is of a hand drawn Facebook “like” icon and was sourced from Flickr with licence to use commercially and/or with modification. Posted by SigNote Cloud.

Posted in Antipsychiatry, Diagnosis, History of mental health, Hospital, Inpatient care, Medication, Mental health, mental health debate, Mental health services, NHS services, Psychiatry, psychology, Treatment planning, Uncategorized | Tagged , , , , , , , , , , , , ,

And what do YOU do?

Nothing. I do nothing. I can count on the fingers of one hand the number of days I’ve worked in the past 18 months.

When I was well, I had a career with professional training, and was promoted every two years.

During the first few years of this episode, I was able to build a portfolio career of sorts, a patchwork of service user led activities including research, patient participation, freelance writing, public speaking, training and other bits and pieces. All of it drew on my lived experience. It was interesting and vibrant. I did some media work, sometimes on behalf of the big charities, sometimes just invited to speak or write because that was what I did.

In the past year and a half, I have been really ill. Now work is no longer and option, I can’t focus enough, I’m not reliable enough. I did write one unpaid essay for publication recently. Despite being descriptions of some of my own life experiences it was like pulling teeth and had it required being more analytical or logical it would have been totally undoable.

A couple of weeks ago I wrote to Mental Health First Aid England and formally resigned as an instructor. I can’t deliver any courses, let alone enough to keep my registration up, and I can’t make the professional development events.

I’m also just about to resign from the Coalition for Collaborative Care, an NHS England supported patient involvement organisation I’ve been part of since day one – actually before day one, from the event at which it was first proposed. Again, there’s little point in retaining membership of its Co-production Group. I can’t get to any of the group’s meetings, and if I can’t get to the meetings I can’t represent the Group at other meetings with partner organisations, at conferences, in service development. I can’t even blog for the Group’s website.

All the emails I still get from both organisations only serve to make me feel awful about myself. I see other people doing interesting, sometimes extraordinary, things and I can’t contribute. It’s like another world; I’m trapped inside a fishbowl, a world I can’t touch moving around me.

I feel really bitter about this.

When people asked me what I did for a living I used to say, “I’m a mental health consultant”, because really a lot of my work was a kind of consultancy and it was easier than trying to explain all the different things I did. Now I don’t get asked very often, because I rarely go anywhere to meet new people, but when I do I just say, “I’m not working at the moment.” What people make of this, I don’t know. Maybe they mentally label me as a “housewife”. Maybe they assume I am at home full time with children. Maybe they think I’m actor between jobs. What’s the cliche, that when actors are out of work they refer to themselves as “resting”? Well, I guess that’s what I am actually doing. Enforced resting. Recovering, supposedly, but those who follow me on Twitter will probably know that I’m really not a big fan of the recovery model.

So nothing, actually, I do nothing. I miss having a purpose. Having only recently come out of hospital for a third time in 15 months I can’t see a return to form happening in my medium term future.

Yes, I’m totally aware that this is a boring, whiny post that doesn’t address any big or entertaining questions, but sometimes I just need that. I can barely blog at all now; every now and then I’ll get a flash of inspiration, but mostly – nothing, and I feel diminished by it. Thanks for reading, if you got this far!

Image shows a slightly mournful-looking goldfish in a bowl by Carrie Little via Flickr

Posted in Bipolar, Employment and benefits, Mental health, Mood disorder, Recovery, Stigma and discrimination, Uncategorized | Tagged , , , , , , , ,


In past times when I have been very ill a bed has been found at my local unit – and quickly. I think one was sourced within the day the first time around, and the following day at the start of my second admission.

Today marks day five of waiting for a bed. During this period only one other bed has come come up within my Trust, and that was over an hour away by car and two hours by train. I was worried about feeling lonely, but with hindsight I wish I’d just taken it. The only other beds on offer have been ECRs (basically, private hospital beds paid for by the NHS to take patients on a temporary basis) which haven’t been guaranteed and have been further away than that.

Yesterday there were no beds in my Trust at all. Not one. I looked at the Wikipedia page for each borough my Trust serves and came up with a population of about about 1.5 million people under the Trust’s remit (I suppose this isn’t that surprising given that like a number of London Trusts, it covers some areas out of the capital and let’s face it, there are 8.6 million Londoners to start with).

Anyway. There you have it. This is the bed crisis in real terms.

Every day Home Treatment Team push for a bed for me on my usual unit. Every day they are so sweetly apologetic about the fact that no, there still isn’t one, even though we all know it’s hardly their fault. Every day we talk about what to do.

I met the consultant today. Essentially my options are:

  • Carry on in the community with Tom watching me 24/7 as I become increasingly distressed and exhausted in the ongoing hope of a local bed
  • Ask for an ECR bed with the risk that I could be moved back to any Trust inpatient unit when one opens up – both could be far away
  • Choose to take up any other bed that opens up within the Trust, wherever it is, and stick it out
  • Choose to take up any other bed in the Trust with the agreement that I come back to my usual unit as soon as there is a bed.

None of the options feel good. I don’t know what I want.

And unfortunately not knowing what I want, or think, or feel, is the whole problem. In the grip of mixed mood again I fluctuate from mildly hypomanic to sharply low within the day. I shift from thinking that I am fine, that I don’t need to be in hospital, that Tom should just go back to work, to sobbing that I am totally overwhelmed and can’t manage in the community a moment longer.

In the moment, I mean it. I believe it. I believe that I am fixed, that in fact there was probably nothing ever wrong with me, that I am a fraud even. I announce happily that I have never felt less like killing myself in my life, then get irritated when others are sceptical, when they gently point out that just that morning I was saying I couldn’t shake the thought of buying lots of pills on the internet, for the specific purpose of an OD. And wasn’t I just saying that it was not viable for me to be in the community, wasn’t I just crying out, literally, for a bed?

Conversely, in great distress, I feel I can never be happy again. It’s this that’s behind the pills thing. I am not prepared, no, cannot do, another round of bipolar depression. I have explained this. If the only way to avoid it is to take myself out of the equation, so be it. Unless Tom will take me to a euthanasia clinic that deals with mental health issues, and I think we have clearly established that he will not.

I cannot trust myself. I don’t know if what I feel at any given moment is true or right or reasonable. It churns and churns away, and the bed issue is contributing hugely to the rumination. What should I do? How far away can I cope with going? What if it’s awful? Whatever I never get to come back to my own unit? I have never felt so confused. I described it to my dad earlier as being a mental washing machine; a pink sock rises to the top, but with the next spin a green one takes its place.

My biggest fear is that I take a bed and end up somewhere awful. Previous admissions have taught me that informal admission is very Hotel California – when you arrive you sign a piece of paper stating that you can check out any time you like. Then just try to leave. How can I make this decision, when I don’t even understand what or how I think at the moment? Maybe I need somebody to make it for me, but apparently nobody can.

Part of me wants to go in to give Tom a break. He says it’s not, but it must be so boring and stressful hearing me go through these loops again and again, all day every day. I worry about him.

He and HTT suggest taking it a day at a time. The goal is to distract, distract, distract, so I am colouring in, taking loads of baths, doing a complicated jigsaw puzzle. Blogging. If things get markedly worse, then a private bed might be the only option. Or by an immense stroke of luck, a local bed may come up. Maybe there is someone waiting to go home as I wait to go in. Maybe.

Posted in Bipolar, Crisis care, Depression, Hospital, Hypomania, Inpatient care, Mental health, Mental health services, Mixed mood, Mood disorder, NHS services, Politics and current affairs, Psychiatry, Rapid cycling, Suicidal thought, Suicide, Treatment planning, Uncategorized | Tagged , , , , , , , , , , , , , , , ,

Me me me

Dullness warning: I am going to assume you’re at risk of boredom here, not just because I have already posted twice in a week, but also because this is going to one of those posts that’s using writing as therapy in attempt to work through some stuff.

Trigger warning: I will be talking a lot about suicidal thinking.

One thing about having been a blogger for a long time is that I can look back at old posts and see what has changed over time. But I can also look back and see that in a way nothing has changed, that I just go through loops. I’ve blogged in the past more than once about a situation very similar to the one I find myself in, but I need to get it all out again, so no need to read on if you’ve heard all this before.

I am at war with myself. I have at least three separate thought processes going one. One is just me, normal me, but another is obsessed with suicide planning. I can run the primary script without it being noticeable to anyone that the obsessional one is going on in the background. I can talk about the future, whilst planning to make sure I don’t have one. I do at times feel pretty low, but in no way am I sitting around feeling that my life/pain is intolerable and therefore I need to take myself out of the equation. In fact, the planning part of me feels eerily calm. It tells me that making an attempt is just something I have to do, have to get over with, like I must do my tax return before the deadline.

The third script is slightly psychotic one. In the past week I have had a couple of really terrifying moments where I realised that “They” had started messing with me again (it’s too complicated to explain the whole “being persecuted by extra-dimensional beings” thing here, so if you are a newer reader or would like you memory refreshed, you can read an account here). I have had the frightening feeling that They have implanted the thoughts of suicide into my head because they want me to kill myself. I have become aware of things that always frighten me when  I am clinically paranoid: banana skins, twins, weird tech glitches, being alone of the top deck of a bus. This has extended towards being scared to even see an empty top deck on a different bus, and to worrying when the post comes about what seem like messages on the outside of the envelopes. Always, my Them sense is tingly, although thankfully it is not as bad as it has been in the past. I have also experienced periods of mental confusion, which has happened in the past when I have had what my consultant calls “psychotic-type” experiences.

I had been doing so well! Not well enough to work, and unwell enough to have to be careful with myself at all times, but nothing like this since about September last year. I can only attribute my current situation to stress. Some time ago Tom and I decided to relocate so that we could enjoy his retirement away from the hubbub of London. Unexpectedly, the perfect house popped up in a perfect location in Wales, and we decided to go for it. In the space of two months we have seen viewed the house, had an offer accepted, got our pace ready for the market, and accepted an offer. It’s been so swift because we hadn’t expected to find somewhere to move to so soon, so our flat wasn’t even in a fit state to be sold. I couldn’t even begin to guess how many hours we have put in cleaning, painting, wallpapering, sorting possessions, packing them up, driving to the dump, putting things in storage. It’s been a very pressured time. Mid May is my deadline for an attempt because that when contracts are due to be exchanged and it feels quite sensible not to create more legal mess by doing it after that point.

The intensity of the suicidal thoughts ebbs and flows, but I have found myself doing more and more researching, and giving more and more consideration to which part of previous plans might be useful. So the normal part of me is beginning to consider myself at risk. I know that things are not as far gone as when I wrote this post back in November 2014 (November 2014? I have been going through this same shit for two and a half years?!) but it’s the same pattern. I’m trying to nip it in the bud but it’s so, so hard. It’s so, so hard to open with Tom about it, but I probably more successful than in the past. As you imagine, part of me doesn’t want to hurt him, and the sneaky part of me’s not keen keen to share because it might/will shut down my options.

Yesterday while Tom was sleeping I found myself crying and crying because I don’t feel that I will ever get to live in that beautiful house in Wales. The normal bit of me was pointing out hat I could avoid that disappointment simply by not killing myself, but more and more I feel that it’s out of my hands, that I have to go along with the plan.

I’m concerned enough that I have have my Trust’s triage number in my phone, because that’s how you access Home Treatment Team these days, self-referral. Part of me longs for the HTT, to be back under that close monitoring so I don’t have to do all the monitoring myself, and yet I remember how at times I railed against it, how fed up I got with going back to them time after time. My Care Coordinator is ringing on Tuesday, but it’s a Sunday as I write this and I don’t think I can wait that long, so I’ll be calling tomorrow.



Image shows three odd shoes and is course of in pastel via Flickr

Posted in Bipolar, Crisis care, Depression, Mental health, Mental health services, Mood disorder, Psychosis, Stress, Suicidal thought, Suicide, Uncategorized | Tagged , , , , , , , , , , , , , ,