Group Therapy

As a psychology student writing a thesis on group processes I suppose it was only inevitable that I became quite interested in our group in hospital. Eight mothers with serious mental health issues living together must surely result in some friction. But no. In the eight weeks I was there I don’t recall any altercations or even complaints between patients. Remarkable really considering the stressful circumstances. Then again, perhaps we just took it out on the staff.

When I was first admitted I was scared of being out in the public areas. I stayed in my room and avoided other patients (my fearfulness was probably not helped by the community psychiatrist who saw me prior to my admission and told me that the MBU was “not a place he would want to be”, and that it was full of patients who were so far gone that they “would think you were a martian”). At the beginning of my stay there were quite a few younger patients my age, and after a while I began to sit near them. I enjoyed being part of their group, but not necessarily having to contribute to any conversations.

One day I found some knitting needles and a ball of wool. I found knitting really helped with my agitation level. I was knitting away, eavesdropping as usual, when one of the girls asked me where I found the wool. It was one of the first times I actually conversed with another patient. Before I knew what was happening I was teaching her how to knit, and the other patients wanted knitting needles as well. For a few weeks we would spend the evenings knitting and chatting and watching TV. Sometimes nurses would ask us what we were knitting.
“I’m knitting my baby a hat!” said one patient.
“I’m knitting a scarf.” Said another.
“I’m knitting something which shows that we are not perfect because nobody’s perfect, and you can see this has holes so it’s not perfect, because none of us is perfect and that way it’s not a lie....” said another girl.
“I don’t know.” I said.

But all in all we were comfortable with each other and any eccentricities we may or may not have. We were readily accepting of each other.

Then one day one of the girls had a meltdown. I can’t remember the specifics of the situation but there was lots of shouting and crying going on. Eventually two burly security guards were called to control the situation. Predictably, in my delusional and ever egocentric state I dissolved into tears as soon as I saw the guards. “They’ve come for me!” I cried.

There was chaos after that. Everyone was upset. Afterwards most of us went to our rooms and stayed there. The whole weekend was horrible. Nobody talked to each other. Everyone was in a bad mood. I suppose the incident with security reminded us about where we were, and how easily our control could be taken away.

Later on in my stay I was part of a different group of women. But these women were very depressed and rarely talked. As a group we sat silently at the dinner table eating. No knitting here. One day a younger girl arrived. Despite her problems she had the most remarkable sunny personality. People couldn’t help but open up to her. No matter how you presented, or what you looked like, she would come over and have a chat with you. She asked us to join her when she walked to the shops, or baked a cake. We started taking an interest and talking to each other. All it took was one person to make us a group again, rather than eight individuals.

Perhaps, though, it was the stress of the situation that brought us together. Ever been to an exam and suddenly people you haven’t talked to all semester start conversations? Or witnessed a shocking incident in public, and suddenly you are talking to all the strangers around you? It’s cohesion. It’s solidarity. It’s “us” against the exam, the bank robber, the system, the “them”. It’s only natural really. 

And you don’t mess with the people who are on your side. You don’t fight with your own team. I felt both joy and sorrow with every discharge from the hospital. Happy that they were feeling better, sad that I wouldn’t see them again (and that I wasn’t the one going home!). I felt apprehension and curiosity with each new admission. Would they be nice? What will they be like? But most of all I felt a sense of comfort that there were others who were going through this too. That I wasn’t alone. And maybe, just maybe, if they had been able to get to a point where they were doing well – perhaps I would be able to as well.

Cabin Fever

Around the seven week mark I came down with a little cabin fever. One morning when the familiar bell sounded for meditation, I literally groaned out loud. I had been there so long I knew every single meditation tape off by heart. Plus, my baby had just gone down for a nap. I didn’t want to spend my baby’s precious nap time meditating!

So I hid. And believe me, hiding in a psychiatric ward is a remarkably difficult thing to achieve. I heard the nurses calling for me and looking for me but I stayed hidden until the coast was clear. Later on, a nurse found me in the art room and asked what I was doing. “writing.” I told her nonchalantly. She wasn’t impressed. I found out later that the nursing staff got into trouble over my antics that day. Something I still feel bad about!

That evening in the living room I whispered to Steven; “you have got to get me out of here! I can’t stand this anymore! This whole place is bullshit!”

“You know I can’t do that,” he told me.
“Yes you can! Just sign me out. I’m better and I just can’t stand this!”

“No. I can’t do that. You will be discharged when you are ready.” He told me again. I pouted.

“I could run away, you know.”

“Oh yeah. And how would you do that?”

“I could jump the fence. Go for a walk and just .... not come back?”
Steven snorted. “You? Jump a fence? Besides, you know what will happen if you try anything stupid.”

Boy, did I. After prowling the perimeter, searching for any weak points and coming to the disappointing conclusion that the unit was unequivocally escape-proof, I had asked a nurse what would happen should I try to run away. Her face grew very grave and she assured me that police would be sent to find me, and that I would be transferred to a more secure facility without my baby. As much as I wanted to be back in the outside world I knew an escape would be stupid. I have never felt so trapped in all my life.

Steven tried another tactic. “What is it exactly that you don’t like?” he asked.

“The food! The beds!  Night checks! Stupid meditation. How I can’t go out for a walk without signing a million documents. My room, God, I hate my room. The fact that every time I want to shave my legs, or charge my phone, or dry my hair, or wear my shoes I have to go and collect them from the nurses station. It’s ridiculous!”

“Why don’t you just ask for that stuff back?” Steven suggested. I was stunned, that thought hadn’t even occurred to me. So I marched to the nurses station and asked. To my amazement, after a quick call to my doctor, my possessions were returned to me. I squealed,  it felt like Christmas.

The next day I decided to ask my doctor if I could move rooms.
“What is it about the room you don’t like?” She asked.
“Just everything. This is a ‘special’ room and I’m not on ‘special’ anymore. It just has horrible memories.” I replied. My doctor looked thoughtful.

“You’re right. You’ve been in here a while and I think a change would do you good. How about we leave this room for another ‘special’ person?” She said with a wink.

And so I was moved to room number five. The medical team interpreted my restlessness and eagerness  as a positive sign that I was on the mend. As such, after another week of tentative home visits and discharge planning I was finally released. Ironically I only spent 5 nights in my new room before I fell asleep in my own bed. Ready for the next chapter in my life. :) 

Three

 

Over the past few months many people have asked me whether I will have another baby. My answer? “Of course!”

There is a reasonable chance, I suppose, that I will succumb to another ‘episode’ post partum. I also have a higher than average chance of developing post natal psychosis. But as cliché as it sounds, it’s worth it. He is worth it all, and I would do it all again in a heartbeat. Many mothers who undergo even the most traumatic of births choose to do it all again. This is no different to that.

If you had asked me a few months ago, my answer would have been “Hell, no!” I remember my doctor talking about future pregnancies while I was in hospital. I shut her down and told her I didn’t want another. I simply couldn’t go through this again.

But now.... I honestly don’t think I would go through it all again. The difference between now and then is that we know what we are dealing with. I have a diagnosis, I know which medication works for me. I have also been informed that any future pregnancies will be classified as “high risk”, so I will be taken care of by a clinic at the state’s main maternity hospital who specialises in mothers with severe mental illness. I have also been told I may be transferred back to the MBU following childbirth for a week or two so doctors can keep a careful eye on me.

 In other words, there is a huge amount of support out there. If I showed any signs of instability I would have access to help. The people closest to me are aware and supportive. I'm certainly not alone.  

The other week I asked my doctor, out of interest, about future pregnancies and the medication I am on. She looked vaguely horrified and encouraged me not to rush into things, and to just concentrate on maintaining my stability for now.

But I’m not rushing into things. I’m not ready for another baby now. There are things I want to achieve before being a mum of two. I also want to savour this time with David. I missed out so much of his first year through being so unwell. I want to enjoy now and him and us for a little while.  

One day we will be a family of four, I have no doubt in that. But right now I’m enjoying the three of us. Me, you, and toddler too.

Feeling Good

It's a new day, it's a new dawn, it's a new life
For me.
And I'm feeling good. 

- Nina Simone

I knew something was going to happen because my eye kept twitching. Twitch, twitch, twitch for four days, like a ticking bomb. When I was in hospital the exact same symptom preceded my manic episode.

I didn’t even realise I was immersed in it until it was over. But let’s get the facts straight, this certainly wasn’t a full manic episode. I never lost touch with reality, I never believed to have magical powers. I didn’t put myself in danger.  To the best of my knowledge I didn’t irritate the people around me.  Infact, I don’t think even the people closest to me realised anything was any different to normal. Maybe it was the more discreet ‘hypomania’, which literally means ‘below mania’. Perhaps my symptoms were prodromal of mania. Perhaps it was just one of those things.

What I did experience was euphoria, and ideas, projects. Despite the fact that I was physically very unwell, I couldn’t sit still. I had to start these projects. The only thing was, while I was in the middle of one project, I would spy something else that needed to be done and would move onto that. My ordinarily organised life was becoming somewhat chaotic. Highly productive, but chaotic. I absolutely loved playing with my little boy, we laughed and laughed together. I felt confident in myself. I felt in control. I felt good.

Of course there were some down sides. I  started experiencing psychomotor agitation again. All the pacing, twitching, jogging that I remember from before. I had amazing problems sleeping. When I went to bed my body suddenly felt like it wanted to run a marathon. I would get so angry at this that I would leap out of bed at 2am, storm into the kitchen and take two or three times my normal dose of medication just to try and get some shut eye. Sometimes it worked, sometimes it didn’t. My thoughts raced, or sometimes I would just have one thought that would repeat over and over again in my head. I seemed to get bored easily, even when doing things I usually enjoy.

But all in all, it wasn’t an unpleasant experience at all. I think I enjoyed it. Nobody was hurt in any manner, and I did get an awful lot of things done. Does that make it ‘disordered’? Is it ‘symptomatic’? Or is it just pleasurable?

Why? I would say it was something to do with the fact that I was physically unwell. Lithium will only work if a certain level of the drug is maintained in the bloodstream. Too much will result in toxicity, too little will result in very little at all. This is why if you are dehydrated, such as during gastro, you need to stop taking the medication. I had fevers for a week, and became very dehydrated. I also took medication which interferes with Lithium. I suspect that my blood lithium level went a little awry and precipitated this experience. The lack of sleep would have further exacerbated the symptoms.

My ‘high’ ended rather abruptly one night in a rather humorous manner. I woke up in the night, sure that something had bitten my rear end. Envisioning all sorts of poisonous critters, I leapt out of bed, turned on the light and thrashed around trying to see what had bitten me. At 4am, Steven was less than impressed, but still agreed to perform a thorough examination of the bed and my bum (have I mentioned that I love this man?). After, I lay in bed fuming. Now I had probably been bitten by something hideous, I’d have to go to the doctor AGAIN. Probably add another prescription to my collection. It was such a trivial thing, but I’d had enough!

Since then I’ve felt....flat. Certainly not depressed. But, it’s true, I miss the excitement and the euphoria and the energy. I miss being ‘high’.  The colours just seem to have faded. And as if for illustrative purposes, the sunshine outside has bleakened into rain. Steven calls this ‘the crash’. And in a day or so I will be fine.

I still feel like I am learning so much from this experience. I still don’t feel like I know the first thing about bipolar disorder, and my bipolar disorder in particular. I’m trying to chronicle and examine and evaluate what I feel. I’m trying to make sense of everything. Is it ok to enjoy the ‘highs’? Isn’t the high part of the problem? How can something that feels nice be a bad thing?

The mind, and the mind-body relationship fascinates me. Perhaps one day I’ll be a step closer to understanding it all J

Just a little patience...

I’m not a patient person. I’m really not. I’ve tried – believe me! But patience really seems to be a virtue that I don’t have.

Don’t get me wrong. I can be patient with people. Or with animals. But when it comes down to tasks, work, ideas and such, I just can’t seem to wait. I want things done now. No, I want things done yesterday.

I’m the type of person who, mid lunch, decides a yellow wall would look good in the dining area. I’m the type of person who leaves her lunch, goes out, buys gallons of yellow paint, and sloshes it onto the wall before her husband even comes home from work. “Surprise!” I’ll say, before telling him to stay out of the way because “I will do a better job”.

Steven calls me impulsive at best, occasionally silly, and always impatient. You see, Steven is the opposite of me. He’s methodological. Calculated. Careful. He spends months researching things before buying them. I can’t be bothered with doing all of that!

Anyway, where am I going with this?

If there is one thing that I have learned over the past 12 months, it’s that when you are a patient in hospital, you have to be exactly that. Patient. You wait to be seen, wait to be admitted, wait for a diagnosis, wait for a treatment plan. The waiting is seemingly endless.

When I was in the MBU I remember complaining to Steven one afternoon that I wanted to go home. I was so homesick it hurt. I’d had enough. “You need to be patient!” Steven told me. “you can’t expect things to change overnight.”

“But I’m not a patient patient!” I complained. “In fact. I’m an impatient inpatient!”

A few nights ago I ended up in hospital.  It was a combination of a nasty virus and severe dehydration – probably not helped by the fact that I had unknowingly taken medication which interacts with lithium. It was a long night for both Steven and I, longer for him though, it would seem.  I was surprised when I did the math. We were in hospital for around 12 hours. 4 of those hours were spent waiting in the emergency room. Add on perhaps another 1 hour for seeing the doctor and getting hooked up to an IV. That leaves SEVEN hours unaccounted for.

I asked Steven what I was doing, and he said that I was asleep.  Not surprising after a combination of narcotics, sedatives and anti-psychotics. The point of this is that my poor Steven waited for seven hours in an uncomfortable plastic chair by my bedside, without a single complaint.

You see, patience isn’t the ability to wait. It’s the ability to wait without complaint. And boy, this man has patience.  Through depression, through mania, through sickness, through hospitalisations, through psychosis and everything in between he has never complained. I wish I had the patience that he possesses.

It never ceases to amaze me the love and support that this man offers me. He lights my way through the darkest of days. He holds me down lest I fly away. He is always, always there for me. My best advocate, my greatest support. 

So Steven, I hope you understand that words are inadequate in describing the length and the breadth and the depth of the love and adoration I have for you. I know sometimes I am infuriating. I know that sometimes it may not seem like I appreciate you. But please, please know that I always love and adore you. I hope you know that I can never understand what you have been through – for in some ways I believe this can be harder for the supporter than the patient  - but I appreciate it more than I can ever describe. Every day I wake up, thankful that I have you standing by my side. Thank you for everything, my love. You are my world.