Episodes of sub-psychotic rage…

and possible Tourette’s *

It struck me yesterday that I have had a whole month without medication. That might not seem like a big thing to you, but it is something I have been working towards for five whole years.

For those of you who don’t know, I was diagnosed with bipolar disorder in 2007 after years of treatment for depression. I’ve been treated for mood disorders on and off since 1991 and, like many people, managed to ride through the good times and only saw the doctor when it got really bad.

I’ve always tried to be both honest and sensitive about it. It doesn’t define who I am as a person, in the same way as having diabetes doesn’t define who anyone is. But, there’s no stigma to diabetes. Yet I have had to have several intense occupational health interviews to check I was ‘fit’ for the classroom.

It’s ironic, really.

I had three days off in fifteen years of teaching. After the first three years of teaching, I never once had a performance review that was less than perfect. When I finally handed in my resignation, with nowhere really to go, my boss said I was a flawed genius. I laughed. Of course I am flawed. I am a human being. And a genius? Not so much. He was the same boss who, when I told him I was being treated for severe and suicidal depression, told me it couldn’t possibly be true because I was the happiest person he knew.

Having seen a very close friend be hospitalised and only later realise she was in the flings of the most crazy mania, I vowed I would never be secretive about it ever again. I spent such a long and exhausting time covering up my illness that it made my life nigh on impossible.

At best, it is absent from me completely. I forget that I am anything other than just me. At worst, I barely make it through the day. My moods are glacially slow, with rapid shifts within them – I tend to follow a huge curve up or down for a year or so, more sometimes, and then within that, I have hours which deviate from the general trend. This is actually a good thing. It makes it easier to manage.

I tried for a very long time – between 2003 and 2007 – to be med-free when I really, really needed to be medicated. I tried to manage it myself, and when that failed, I tried cognitive behavioural therapy – which did little for me. I was too far lost for it to even make the slightest impact. Thoughts and moods snowball and you are taken over by a tsunami of whichever mood prevails. At first, the medicine wasn’t enough. I could manage, but it wasn’t a therapeutic dose. The doctor upped my dose and eventually, I began to feel like myself again.

That’s the worst part, I guess. Sometimes, depression takes every single thing you are and turns it upside down. For a generally happy, sociable, lively person, depression turned me into a secret zombie. I say secret because like many people with a mood disorder, I was very good at hiding it. It makes me tired and defeated and sad and apathetic.

You can see why someone wouldn’t want to feel like that.

Hypomania, however, is a beautiful thing. You float, you are filled with energy. Everything is lovely and it feels like the universe is conspiring to give you love and positivity. A notch higher and everything seems too slow, frustrating, and anger rises to the surface instantly, pushing you over the edge into aggression and ugly, awful behaviour.

Finding something to take the edge off isn’t an easy task.

Plus, like many people with a chronic, medically-controlled disease, you long to be free from medication. And even though you could be, you know you have to do it right. You can’t just stop. No. You have to tail off. A long tail. Many drugs give you something I call ‘the zaps’, which kind of feels a bit like someone has an electrode in your brain and is jolting you from time to time. Plus, come off too soon and it’s like taking a plaster cast off too soon. You’re just not fixed yet. So over an 18 month period, I have cut my dose little by little until I was on so little that it would be barely noticeable. Then I stopped. Now it’s a month later.

Strangely, I second-guess my moods in ways I never did, even when I was on the smallest dose. Am I sad? Is it just grief? Is it something else? How tired am I? How am I sleeping? How am I eating? What am I eating? How am I coping with the long nights? How am I keeping? How are my energy levels? It’s like running a constant diagnostic in the background, and then trying to analyse if what you see is ‘normal’ or not. And I wonder at my motivation for wanting to live without medication. Plenty of people live medicated lives for all of their life. Nobody said to me that it was time to drop the dose or that I’d had a period of wellness conducive with removing one or both of my medications. It was just a thing I did. So then I experience all of this doubt about whether it was the right decision or whether I should keep taking them. Sure, I feel tired and a little rundown. I wonder whether it’s just my immune system after the beating it took at Christmas. I wonder if it’s the winter.  On days like Monday, where it was 8° and blue skies, the world seems like a wonderful place. Then the clouds come over and I feel lethargic and frustrated. I’ve worked a 14-hour day and I’ve had enough.

But then, when I was having a brief interlude from marking, I watched an episode of The Big Bang Theory. The one where Sheldon takes Penny to hospital and is filling out her medical form. He asks about her mental health. She snaps at him. He writes down “episodes of sub-psychotic rage” and when she calls him an ass, he writes “possible Tourette’s”.

It makes me smile because not only is it funny, it reminds me that everyone – even fictional characters on sitcoms – have moods that can be interpreted one way or another. Normal is impossible to judge even as a trained professional. It’s ten times tougher when you are in charge of managing your own moods.

So far, I think I’m doing okay. I know the warning signs well enough by now and this time, I’ll be first in the queue for treatment, not desperately holding on to some idea that “normal” = unmedicated. Still, I will be very glad when the current batch of marking is out of the way and I can relax a little. I hate doing it. Really, I need to find myself a non-stressful, rewarding and relaxed job that pays well enough to cover the bills.

If you know of one, can you let me know?

I jest of course. I am lucky to have a non-stressful, rewarding and relaxed job. Most of the time, anyway.

Ironically, whilst there are very few ‘triggers’ for moods, stress is definitely one for a lot of my bipolar friends. And work-related stress is a biggie. If I had a wish (apart from wishing for unlimited wishes, of course) it would be that everyone in the world could do whatever job they found rewarding for 35 hours a week, and that the universe would still function.

I’m a complete hippy at heart.

Anyway, I wanted to share my mini-milestone with you. I thought about not sharing it or saying anything, but then it kind of goes against my plan to talk about it if it’s relevant.

If you notice any episodes of sub-psychotic rage, be sure to let me know!

What bipolar is and isn’t…

Most of the time I don’t think about the fact I suffer from a mood disorder, same as the fact I don’t think about the fact I have a ‘congenital abnormality of the hands’ or I have a calf-lick in my fringe or I have the Oakden chin. More often than not, someone else reminds me of all of these things – it’s like I become unconscious of them – and when people remind me, I get a bit indignant.

So, can I first say: I’VE NEVER BEEN SECTIONED. Not once. Not ever. I’VE NEVER BEEN KEPT WITHOUT MY PERMISSION IN ANY PLACE (except a cupboard for a short while and the head teacher’s office). I’VE NEVER BEEN FORCED TO TAKE ANY DRUGS I DIDN’T WANT TO TAKE. Well, except when my mum made me take aspirin and it always tasted horrible. And even though my bother-in-law threatens me with haldol from time to time. Not that I’d be ashamed of being sectioned. It’s not to be ashamed of. If you are forced into hospital with a heart attack or a stroke, it’s not to be ashamed of. Neither is it for mental illness. But I thought it was time to clarify some things.

But I guess to the outside, ‘mental illness’ is a confusing thing. And believe me, bipolar can be scary, especially when you first learn you have it. For me, it was a relief. The ancients believed once you knew the name of something, you could conquer it – this is why they’re funny about saying God and stuff. Once you name him, you reveal his secrets. And it was a bit like this for me.

So what even is it?

It’s two extreme moods that you might get – just you control yours and I can’t always control mine so well.

And people who think ‘depression’ is the blues… it’s not. I wouldn’t wish it on my worst enemy. To me, it’s a mind-cancer. It takes every good thought and value you have and corrupts them, turns them foul. You can love life as I do, and depression makes you hate it. You can be social and depression makes you seek isolation. It’s not just feeling sad. There have been times when I longed – longed  –  to cry. And I just couldn’t. It’s like longing to drown. Longing for peace, for rest.

And many people don’t understand hypomania or mania. Unfortunately, idiots like Kerry Katona have a lot to answer for, as does the media.

Hypomania is quite lovely. You’re filled with energy. The world sends you positive messages. The world is kind and lovely. Things seem harmonious. You feel like you can achieve anything. You’re blessed with creativity. Things are beautiful and nothing seems impossible.

Take this a step further. You’re talking nonsense. Nobody understands you because not only are you going too fast, you’re missing out steps. You are frustrated and aggressive with people who don’t understand you. The need to take risks is through the window. All sensible and rational behaviour seems ridiculous. Recklessness takes over. You do stupid things and don’t care about the consequences. You get in dangerous situations.

I share because that’s who I am. I believe in honesty. I believe I’m also incredibly bad at hiding my moods. They seep out. I share because I didn’t know one of my closest friends Elizabeth was in the midst of a full-blown mania until she was sectioned for things that were so out of character I almost couldn’t believe them. I share because mental illness is still stigmatised. It’s noble to have ‘suffered’ cancer; it’s shameful to have ‘suffered’ depression. I share because I don’t want anyone who is ‘mentally ill’ to feel like nobody gets them. I share because I want people to understand this is biology, not psychology. I could no more ‘stop’ my moods without drugs than a diabetic could stop their disorder without insulin. I can ‘manage’ it, like diabetics do. I can do sensible things and maintain routines, just like diabetics do. Yet diabetes isn’t shameful. Nobody ever sends nasty, gloating messages about those who are physically ill. Yet joking that I’ve been sectioned seems to be fun. Nobody would joke about someone being admitted for chemo.

But sadly, some people think mental illness is a laughing matter. They think it’s all kinds of things – a personality disorder, something psychological, something that makes me ‘twisted’. It’s not. I’m actually very straightforward. I’m not ‘mental’ or ‘mad’ or ‘insane’. They forget that I have achieved what I have achieved in spite of mental illness. They forget that in my life I have been commissioned to write books, that I have consulted for the Government, that I have led complex human resources consultancies, that I have achieved amazing grades on all manner of things (incluing a Hay-Mcber ‘Emotional Intelligence’ test that I aced… maybe I’m being silly to say I got ‘cluster strength’ for all emotional intelligence competencies – but it’s my one piece of evidence that says above everything else that I manage to be a well-rounded individual DESPITE mental illness – and more of an emotionally intelligent person than most people who don’t have mental illnesses are – and I think a lot of that is to do with being bipolar) I have a Master’s degree. I learned Japanese. I feel a Donald moment coming on, saying I’m proud of myself. I’ve done it because my family have let me stand on their shoulders and they taught me not only to do that but to stand on my own two feet. And, as I’ve said before, as Ginger reputedly said: “I did what [they] did, just backwards and in high heels.”

So don’t judge me. I have a big enough critic. She’s called LJ. And she’s harsh.

I’m going back to picking cherries now and commenting on world (would-be) leaders. It’s far nicer in that world. Please, if you have something nasty to say about my mental health, don’t hide behind a pseudonym. That makes you crazy, not me.

Switching the big brain off…

Despite what Steve says about my brains and mind (or lack of), part of being bipolar means that you are sometimes overwhelmed by thoughts of whatever variety. My ex, Dale, was about the only one who got how that can be. He used to say ‘if only you could switch that big brain off’ – and I wish I could. It’s a lot like a computer when it gets too pre-occupied and it’s too full – it just freezes. And that happens to me. Sometimes, I need a hibernation like my laptop – and sometimes I wish I could just switch off.

Sometimes bipolar thoughts are great: your mind is swimming. Your mouth and hands work super-fast to create whatever. Nothing seems impossible when you’re hypomanic. The universe is wonderful and an inspiring place. Thoughts come quickly and easily. Keep that going, multiply by ten and you physically can’t keep up with your mind. That’s where frustration sets in and thoughts go from A to R in a flash of lightning, never mind B or all the letters in between.

Other times, you are overwhelmed by a tsunami of sad thoughts that come thick and fast. In fact, this is what I call my bipolar when it controls me rather than the other way around. Tsunami life. Sometimes, you surf it for a little while, getting the biggest kick of your life, like Patrick Swayze in Point Break. Sometimes, the sea is static… like being in the horse latitudes, dead sea, waiting for a trade wind, knowing something will happen and dreading what it is. Sometimes, you are overwhelmed and drowning – and being at the mercy of a big brain swimming with thoughts, drowning in them, unable to get air. And that’s how it feels. The Stevie Smith poem that ends ‘not waving but drowning’ is exactly how this feels.

And you don’t know when it will end or whether you will come up for air.

I used to deal with this by exercise. Lots of manic people exercise excessively. They can be stick thin, almost living on nervous energy. I used to run 100k a week. Sometimes, I would get in from work at about 6ish, go to the gym for 3 or 4 hours, scrub up and then come home. Sometimes, when it was really bad, I would get back when the gym shut at 10 and still be filled with energy. I would go to bed about midnight, knowing I had to be up at 6 and if I couldn’t sleep, I used to run. The loneliness of the long-distance runner. I used to have a track along well-lit streets that I would run – although in all honesty, having such energy means hypomania or mania and then you’ll take any risk. It doesn’t seem stupid to go running at midnight through dark city streets.

And I’d get back after about an hour, hot and sweating.

A couple of times, this wasn’t enough and I still couldn’t switch my big brain off.

But this physical exercise does one thing: it gets you ahead of the mental racing. Physical exhaustion leads to mental exhaustion.

I’m not a fan of cognitive-behavioural therapy where severe depression or mania set in. My friend Si says it’s like trying to learn how to hold the tide back with your hands. He’s right. You feel like Canute sitting telling the sea to stop and knowing it never will. But exercise leads to endorphins. This does two things. It can alleviate depression – nature’s own morphine – but it can worsen mania. Runners call it ‘the zone’ – where you’re so in the moment that your mind switches off and synchronises with your body – it’s all one. I loved the zone. But the zone probably worsened any hypomania. Endorphins are just as addictive as a drug.

Unfortunately, when you have stress fractures in your feet and your physio advises you against running and you still run and you worsen your injuries, then you end up not being able to run.

And then you get depressed. And depression leads you to need medication – or to seek it – because you can kind of live with a degree of hypomania – which is a lovely, blissful feeling of connectedness and synchronicity – but you cannot kind of live with depression because it will not go away so easily and it hurts.

But medication and lack of exercise means the weight piles on. And thus the cycle is worse. Skinny me is manic me. Fat me is depressed me. It’s that simple. Sometimes it’s medicated me and unable-to-exercise-me.

So, working the land has been a struggle. And it’s sometimes physically painful. Sometimes, my legs hurt. I do this old lady shuffle which Steve finds hilarious. Imagine an elderly Chinese woman who has just had her bound feet unbound. You might think that an exaggeration, and it is – a bit. But my feet bones have been broken and it’s still painful.

I wrote a letter to my depression once; part of it read:

“Outside and inside, there’s nothing I can do to myself to arouse any kind of sensation. I run on blistered feet, shins inflamed with over-use, only a few miles from stress fractures. I run with sore sides, aching hamstrings and achilles’ tendons that creak and feel like fabric that just might give at any moment. I push weights that put the men in the gym to shame. I pound ten rounds out of the punch-bag and then resort to an over-zealous abs programme designed for marines and inflicted on me by one of the men I actually pay to hurt me. You – you get to do that for free. And what I put my body through, you put my mind and soul through. An hour of judo combat or a ten mile run along the edge of the Pennines is nothing to an evening with you, where you put me through my emotional paces and set me on edge so I don’t know right from wrong any more.”

But the physical exercise is my mind’s only off-button. I find Tai-chi helpful too (but not yoga – too much still going on in my head!) because Tai-chi means you have to keep an eye on all your limbs and your posture and you literally can’t do it ‘unconsciously’ without thought until you’re very good – by which time, the process is calming and soothing anyway. So my blog has been a little empty recently – and much of this is to do with a (as I hope!) healthy level of physical exhaustion.

Having said that, I’m very much looking forward to my first quiet day in the wonderful hammock Deb sent me – letting my feet and ankles and knees and hip flexors and back have a rest. Tuesday, I’m going to lose myself in a book – my other way of switching the big brain off – and I’m going to let my legs have a well-earned day off. I am not going to weed, to prune, to clip hedges, to wash pots, to make ‘muse-bouches, to go to the supermarket, to work, to scrub floors, to hang the washing out, to walk the dogs, to do the laundry, to sweep floors, to clean windows or wipe down the cooker. I am going to sit in the hammock and I am going to indulge myself in a little escapism. I am going to thank the Lord for my feet having got me this far and still holding me up (mostly!) and I’m going to give them a break and find another way to reign the tsunami back in.

And nobody – but nobody! – better disturb me!