What to expect when reading bi-polar wife

Thoughts and feelings of living with bi-polar as a wife, mother, and person in the world.

Saturday, 27 March 2010

Feeling suicidal and being suicidal are 2 very different things

"A great many people think about suicide, but the majority do not go on to kill themselves. Like them, you can help yourself and you can get help from other people. There is no feeling so terrible that it cannot be changed. There is no difficulty that is insurmountable." (WWW.Mind.org.UK)

It's easy enough reading that statement, but when you are right in the middle of it, it really isn't as clear cut. For me, I have a readily available mind list of reasons not to die tonight. I also have a suitcase of CBT techniques, a raft of friends and family, and a stubborn streak a mile long. Mostly my focus  is my children and my loved ones. I follow the rule of, "If I can endure this for the next 12 hours, I can get through it until tomorrow, and tomorrow may be a different day." Even with all of these safety skills, it hard work.

The desire to terminate your life isn't a fluffy and whimsical dreamy thought that passes through your mind. It's a leaden and violent intrusion, that crashes in to your entire being and suffocates you. You cannot get away from it and it taunts you. I remember when I was first in psychiatric services, my husband requested that I don't kill myself as he couldn't bear the thought of finding me dead on the sofa, and then having to explain it to the children. I can see why he felt that way. I wouldn't want to explain a dead wife to 2 children under 5 either. But a suicidal thought sits piggy back on your head, and it natters incessantly about doom and that dying is really the best thing to. It'll put you and everyone else out of their misery. 

I am terribly aware that suicide is a very dark and rather taboo subject. So instead of random fear, lets do some statistics to ease you in.

"Although the overall rate of death by suicide is falling, more than 4,300 people still die by suicide in England and Wales each year.[...] In the case of depression, studies have shown that, on average, the risk of suicide is about 15 times higher than the average for the general population. [25] However, this is likely to be an underestimate, as many who die by suicide may have been experiencing undiagnosed depressive illness. The Mental Health Foundation estimates that 70 per cent of recorded suicides are by people experiencing depression, [26] often undiagnosed. [...] Depression is often accompanied by thoughts of suicide; indeed suicidal ideation is an important element in the diagnosis of depression. The deeper the depression, the more likely a person is to experience suicidal ideation. However, suicidal acts become more likely when a person is coming out of a depressive episode and energy levels and motivation become stronger" (WWW.mind.org.UK)

This all sounds a little contradictory - I'm too depressed to kill myself, but when I feel better I'll do it. To be honest, you can never truly know the mind of the person who is feeling suicidal, and a very small thing could push a person over the edge. The other thing I have learnt is that if someone really and totally wants to end their life, there is very little you can do. This is a tough one, particularity if it's someone you love and treasure. But what I do want you to focus on here, is that suicidal thinking is not necessarily suicidal doing. You don't have to panic.  It takes strength, courage and absolute conviction to end your life. And it takes a while to go that far down that particular route. Thankfully, for those of us with a CPN and family support, you can talk through your thoughts and know that if you cannot handle it alone, they can get you help.And if necessary, very quickly. I my experience, to spend 6 weeks, trying your best to not buy into the thoughts in your head  about dying, takes incredible effort. It takes patience, trust in the process of recovery, and a belief that eventually, your life will be worth living again and the thoughts will go away. For those people who have no support, either family or health, their chances are probably less than average.

What really annoys me is when you're on the tube in London, and the announcement comes over the tannoy about "A fatality" or "An obstruction on the line." You hear a lot of sighing, and phrases such as, "Oh how selfish", or "Why couldn't they do it somewhere less inconvenient." Nobody wants to see behind the inconvenience; the son or daughter, the mother....what tragedy and despair pushed them to deciding that death is the only option. I pray that you be a little less unloving and rash next time you here the ping-pong tannoy spring into life.

So here is my 6 weeks of hell in a few short bullet points - its easier to bear that way:

1) First 2 weeks, loud speaker volume on channel death, 16 hours a day whilst awake, but thankfully, off whilst asleep. Do the very basic stuff that I have to do and sit still and wait for it to pass. Rule for living - Do NOT act on thoughts.
2) Mid-phase week 3 and 4: Mid level noise pollution from channel death, with a few special intrusive thoughts from "hang yourself weekly" magazine. Functioning better, but still waiting for the madness to pass.Rule for living - sleep a lot, eat, rest and keep it simple. Do NOT act on thoughts.
3) Entering the calm phase - week 5 and 6: Someone has found the remote control and the noise is barely audible. Every now and then a few noises pop in but they are drowned out by reality and the mundanity of the normal, and slightly more sane, life. Rule for living - Remember There is no feeling so terrible that it cannot be changed.That there is no difficulty that is insurmountable. The insanity will pass. Get on with the business of living.

...and relax. 

Tuesday, 23 March 2010

Finally - a diagnosis of bi-polar

On reflection, my mood has never been truly stable, and in periods of hyper mania, I've either got on peoples nerves, exhausted them with my energy,  or left them feeling baffled and confused. I can clearly remember being told to slow down, and actually not being able to. So where were we? Oh yes, going to the psychiatrist.

So, I book a taxi to take me to my psychiatric appointment as I'm not allowed to drive after my operation, and request that he wait for me to take me home after. On arrival I sit in the waiting area, and scanning around the room, realise I've been booked in on what looks like geriatric mental health afternoon. I must be the youngest by about 40 years, and wonder if this is where I will be in the future. Everyone one looks disorientated and vague - maybe this is actually a good frame of mind to be in?

I'm finding it hard to sit still and am literally jumping in my seat and cannot concentrate. All I attempt to focus on is the request I have in my mind which is, "Can you help me?" I feel erratic, agitated and so deeply depressed, I feel as though a force in pushing me down into my seat and I can hardly see. I just want it to end. I feel breathless and frightened. I finally get called in, and get a whiff of TCP and old cigarette smell as I pass the old duffers into the waiting room. I sit on my designated chair, hunched over and fractious. I must look like a rabbit caught in headlights. My lovely psychiatrist has a slow, smooth voice and he asks me what is going on and requests that I communicate to him my thoughts and feelings. This is actually quite difficult and I've got so much going on in my head I can't seem to hold on to a train of thought for very long. He keeps asking me if anything has happened, other than the accumulation of stress incidents. I keep telling him no, and continue to try and describe the pictures in my head. I have an internal visual world that is like an I-MAX cinema screen and I attempt to translate these pictures into words of explanation. I am speaking so fast I can hardly keep up with myself, and at the same time, break down in sobs as I feel so depressed I am actually ready to give up.

Sitting there, I feel that I had lost touch with my insight and turned into a raving, rambling thing, with no consistency, boundaries or understanding. I am out of control. What brought me back into the moment was my psychiatrist picking up the phone. I immediately panic, thinking he is ringing the mental health ward, and my legs literally begin running on the spot, ready to run for it. But then he speaks to reception, and asks if my old CPN is around, and could she come down. For a second I feel some relief, but then think she is being summoned to give me a lift to the psychiatric unit. The tension and fear is unbearable. I'm still rambling when she comes in the room, and immediately she says how awful I look. It must be odd for them as most of the time I'm functioning at a reasonable level. To see me on my knees, babbling and gesticulating wildly in some ways is a reassurance. They kept me in services for the 3-5 year window for exactly this reason. They needed to see me this way, instead of me just telling them how I can be.

What happened next was both a relief and a moment of despair. My psychiatrist says I am having a manic episode, mixed with a severe depression which is known as a mixed phase episode. He politely explains that I have Bi-polar disorder, and that I am going to have to take a mood stabalising medication today and for the foreseeable future. The cpn and the psychiatrist both start talking to each other about different types of medication, trying to agree what would be best to level me out. At this point I feel left out. They both turn to me smiling like weird parents, and tell me I have to take a medication called quetiapine. It will bring down my mania and will work well with my anti-depressant. Apparently, although mentally I will be better off, I may gain weight, twitch, have a dry mouth and constipation, feel sluggish and generally a bit naff. For a while. My response is, "Great! I'm going to be mental and fat." Well its either that, or get even worse and go on a mental health holiday for 6 months. Maybe not.

Although throughout my mental health journey up until this point, there was a possibility of being diagnosed as Bi-polar, to actually have it confirmed is devastating. Life as I know it has changed beyond recognition and the fall out will be significant. I know my illness is treatable, but to take anti-psychotic medication feels like the worst thing that could happen. Its a confirmation of being seriously mentally ill that bothers me. I know it makes sense, the diagnosis, the medication, but I don't actually want to be like this. It feels so very final.It won't go away. I wonder if people will now categorise me with the stereo typical serious mental health image - the one where I shuffle, poke my tongue out uncontrollably and scare small children by my general demeanour. I take my prescription resentfully and scurry off with my head in my boots.

The taxi driver is still in the car park and the charge is huge. I've actually been in the centre an hour and I now have to go home via the chemist. When I hand over my magic slip, the pharmacists face changes slightly and says, "Oh we don't have this in normally so I'll order it for you and get it delivered to your house tomorrow." I feel like shouting, "Yes I'm fucking mental, so fuck off!" I think I have some residual anger regards my new diagnosis.

All I want to do is go home and go to bed. For a long time. This is where my mania will stop and the period of suicidal depression will begin. I'm entering 6 weeks of living hell.

Monday, 22 March 2010

and the nightmare continues

The whole family go to my mother-in-laws for the weekend as I am unable to function. I lay about on the sofa feeling slightly spaced, but I'm grateful for the peace and quiet, and I don't have to do any lifting or carrying of children. I have both boys at home with me on a Monday, so I ask my friend and her son if they would like to help me out whilst my husband is at work. She agrees and the day starts well. The sun is out, I feel a little better and all of the boys are playing in the garden together.

As we drink coffee and chat in my dining area, we can watch the boys running about through my big patio doors. It feels warm, cosy and almost idyllic. Then a scream rips through the clear air and my son comes flying down the garden holding his arm. Even from a reasonable distance away I can see it is horribly bent. He has just become a re-break statistic. He is absolutely beside himself and wailing, and regardless of my stitches I lift him up to my chest and hold him. I am appalled and distressed, but manage to get my friend to get the phone as I ring an ambulance. They're going to want me to set up an account at the rate we're going. When they arrive, they look annoyed as I think they thought we should have driven ourselves to A+E. I explain that I've just had an operation, cannot drive and will need someone to look after my other son as I go to the hospital. They are all apologetic and confirm that yes, its really broken and we'll have to go back to hospital and go through the whole procedure again.

I begin to get paranoid in the ambulance and wonder if they think I'm abusing my child or am emotionally absent and don't look after him. The whole "Its my fault" self esteem trigger is through the roof. Its horrible to know he's going to have to have yet another operation, a full arm cast, and to top it off, he'll be in plaster for at least the first 2 weeks of school.  When I call my husband he is furious, and is even more furious that he's got to do the whole hospital thing again. I feel like giving up. There have been too many stressful events going on and to be honest, my grey matter is imploding. And I slowly have the dawning realisation that I am in mental health free fall. I'm hanging on by my finger nails. When I said to my cpn that I could make it for a few weeks before seeing my psychiatrist, I really thought I could. I'm now beginning to wonder.