Art Therapy

It was in hospital that I first started being creative again. In a previous life I participated in a number of  creative activities; I sung in bands and choirs, wrote music, learned instruments, painted, did scrapbooking and card making, enjoyed sewing and knitting and writing. But somewhere along the way I started to let go of my hobbies. I didn’t have the time, I didn’t have the energy. I had an assignment to write, a newborn to care for. Somehow the little things I enjoyed became less and less important. I became less and less important.

In hospital I started knitting, I found pastels and drew wild colourful pictures, I painted and wrote and brought in my guitar to sing. I don’t profess to be in any way to be any good at these things, it was more a release. I could draw or write how I was feeling far better than I could say it. I loved sketching frantic wild pictures and then blowing the rainbow dust off of my hands. It was about creation and expression rather than production of anything to be proud of. 

I realised recently that I have neglected the creative side of me. That part of me of me that was so important and so therapeutic lay dormant. Looking back I have rarely sung or created any type of artwork for anyone but myself. During my school years I became very involved in singing, so much so that it ended up a chore. Another performance, another exam, another piece to learn. Something I loved started to become an effort. So when I left school I vowed to never succumb to pressure again. If I joined a band it was for me. If I painted or sewed or knitted or scrapbooked, it was for me. Steven has not heard all of the songs I have written, perhaps he never will. Those songs are important, and they are for me, not to showcase.

So I have started unlocking that creativity once more. I sing and write every day. I have started crafts again, and have many little projects that I am undertaking. I’ve moved all of my art materials into a cupboard that is easily accessible.

Suddenly I feel content. If I’m angry, or sad, or happy, or excited I have an outlet. I can write about it, sing about it, paint it. I can get the feeling out and understand it. I can look at it. I can release it

Yesterday I was doing some crafts with my Mum. It was the first time we had done anything like that in years and I was in my element. I got all my materials out, planned my design and then gleefully muttered to myself “I can tell already this is going to be GREAT”. Mum laughed, “you always were so over confident about your work”. I thought about it for a while. I did used to feel fairly optimistic about my creative activities. But I don’t think it was to do with thinking I was especially talented or artistic. I enjoy the process more than the end result. I enjoy he feeling of creating something through words or art or music. But most of all I know that if it turns out to be a disaster I can chuck it away and start again. There’s always another blank canvas.

There’s always room to start again.

Flashbacks and Nightmares

I keep having these flash backs. It’s strange. I’ll be going about my normal business when suddenly it will hit me. I’ll feel like I am *there* again. It’s not entirely unpleasant. But not entirely pleasant either. For the briefest moment I’m propelled back into the past. I feel it again, the blackness, in the pit of my stomach. But at the same time I know that I’m safe now. I’m OK now.

In one of the flashbacks I have just been admitted to hospital. I’m sitting on the bed, my head resting on my knees. I can’t describe how I feel. Relieved. Finally someone believes me. Finally someone is going to help me. Perhaps I have a chance. Perhaps I can keep going. But I’m so tired. I’ve held myself together for so long. Now that I’m safe, now that there are people looking after me I feel I may simply fall apart. Steven wants me to unpack my suitcase so I feel more at home. But I’m just so tired. I had to tell people today that I was going to hospital. I had to admit that I had a problem. I had to pack a suitcase not knowing when I would be home again. What if the people out there judge me? What if they think I’m weak.  A failure. Hospital is my last chance. My last ditch effort at saving myself. What if it doesn’t work? I’m so incredibly exhausted. I just want to sleep.

In another I am in the art room furiously painting a picture. I’m talking to my doctor who is carefully colouring in a stained glass window. I’m asking her if I am crazy. I had a dream about South Korea and the news article on TV was about South Korea. I walked in at that very moment. Surely that means something. Why would I dream about South Korea if it didn’t mean anything? I must be able to predict events. My dreams must be predictions. My dreams are important. I’m telling my doctor that I must be crazy. I must be crazy because of what I am thinking. I’m telling her how angry I am. She tells me this is the first time I have talked to her. Said something other than ‘I can’t keep going’. She says this is progress.

In another I am waking up from a vivid nightmare. I’m soaked in sweat, my hair sticking to my forehead. I’m hyperventilating. I want help but I remember I am on isolation and can’t leave my room. I can’t breathe. I pace around the room then spy the emergency call button. I’m just about to punch it with my fist when a nurse opens the door. I’m shaking and pacing as the dream haunts me. I trip over my dressing gown and the nurse steadies me. I just can’t breathe. I tell the nurse about my dream, how I need to put pictures of my loved ones on the wall. If I don’t put them on the wall they will die and I will be responsible. I could have prevented it. But I don’t have pictures, and I don’t have blue tack. The nurse doesn’t understand how important this is. She gives me some pills but I’m scared to fall asleep. She holds my hand and stays until I drift away again.

As soon as the flashbacks arrive they leave again, and I’m left with a strange sensation. No matter how I try to push the memories away they bubble up to the surface when I least expect them. Often things, moments, that I thought I had forgotten. A little reminder. A bitter aftertaste. A motivation to keep myself stable.  

Bipolar: The Facts

All this time I’ve been talking about bipolar, mania and depression...but I’ve never actually formally described what these things are. I suppose I have assumed my expression of the experiences I have had have provided a description of the disorder. And I do believe experiences trump a cold clinical description any day. But there is so much misunderstanding and stigma surrounding Bipolar disorder, so today I thought I’d look at the facts. :)

Bipolar disorder is a universal mental illness. It doesn’t discriminate. People of all ages, nationalities and from all walks of life can experience bipolar. Perhaps this is due to the genetic component of the disorder. Scientists have identified several genes, including the Dysbindin, Neuregulin and G72  genes which when damaged contribute to Bipolar disorder. As such, bipolar tends to run in families, although episodes can be triggered by significant stressors, and in women, childbirth. It is estimated that about 1.1% of the population suffer from bipolar disorder

People with bipolar disorder are 50 times more likely to commit suicide than the general population. That is huge. The suicide rate for the average population is around 0.01%, in the Bipolar population it is around 13%. What’s more, nearly half of individuals with Bipolar disorder will attempt suicide at least once. Extreme depression and psychosis resulting from lack of treatment are the usual cause for suicide.

A bipolar depression is nothing less of horrific. Unlike Major Depression, often there is no apparent cause for bipolar depression. A bipolar depression can persist for months and may become so severe that psychosis results. Traditional anti-depressants used alone generally have little effect, and can even trigger manic episodes. Unfortunately, because many individuals affected by bipolar seek help during depression rather than mania (which may be enjoyable), they are often misdiagnosed with Major Depression and treated accordingly. Individuals who present with mania may be misdiagnosed with Schizophrenia. Consequently bipolar is one of the most difficult mental illnesses to correctly diagnose.

Symptoms of mania can include pressured speech (or talking REALLY fast), racing thoughts, needing less sleep and not feeling tired, grandiose beliefs (for example, I started to believe that I was superior to everyone else because I didn’t need sleep to function but they did), and general euphoria. People may become impulsive (e.g. spending lots of money, quitting their job) and promiscuous.  But there is a dark side to mania; during a manic episode people can quickly turn irritable and even aggressive. They may experience hallucinations and delusions.

There are three main types of bipolar disorder; Bipolar Type 1, Bipolar Type 2, and Cyclothymia. Bipolar 1 is often described as your classic manic depression. Individuals experience episodes of depression and ‘classic’ mania. Episodes are generally severe (particularly manic episodes) and often result in hospitalization.

Bipolar 2 is often described as a less severe form of Bipolar. But I’m not sure I agree with that. People with Bipolar 2 spend more time experiencing depression, which can be incredibly severe. While individuals with Bipolar 1 may have months or even years between episodes, those with Bipolar 2 are more likely to rapid cycle between episodes and experience chronic mood swings. People with bipolar 2 are also more likely to take their own life. However people with Bipolar 2 do not experience full manic episodes. They experience hypomania instead. Symptoms of hypomania are similar to mania, but on a lesser scale, and there is rarely any psychosis. As it was described to me once; during a board meeting someone with hypomania may talk excitedly and present many ideas. On the other hand, someone with mania may dance and sing upon the table. Hypomania is difficult to detect because it can be disguised as productivity. Hypomanic individuals often feel creative, complete many tasks and feel exceptionally confident.

Cyclothymia (or ‘Bipolar Lite’ as Stephen Fry once described it), is a milder of form bipolar where individuals experience mood swings from mild depression to emotional highs chronically over many years.

If you are wondering what type I am...I’m not actually sure ;) Out of curiosity I have asked two psychiatrists whether I am a Type 1 or 2 and neither were able to answer. One told me that she didn’t believe in ‘typing’, that if an individual had bipolar, they had bipolar. The other told me that it was very difficult to fit people into a specific box, that everyone experiences their own illness differently. Looking at the symptoms I can’t even decide for myself what I would be, and I’m guessing this may be the case for others too.

So there it is. A description of Bipolar disorder. I promise I will write about something more meaty next time ;)

An accurate representation of Steven and I ;) 

Toxic

I'm fine, but I'm bipolar. I'm on seven medications, and I take medication three times a day. This constantly puts me in touch with the illness I have. I'm never quite allowed to be free of that for a day. It's like being a diabetic.

- Carrie Fisher

Hats off to Carrie Fisher! I couldn’t have said it better. For me, medication is a daily chore. No different from brushing my teeth or making my bed. I’m on four different medications twice daily. I take up to ten pills a day.

I am bipolar in my attitude towards medication. On good days I will dutifully take my pills, thinking how much they have helped me. On bad days I will complain about them, how they make me feel flat, how they shackle my creativity, how they nauseate me.  Perhaps I’ll ‘forget’ to take a dose.  But it’s less of a choice and more a responsibility. A trade off between side effects and stability.  I have a little one to look after now.

After a night of violent vomiting a few weeks ago, I came to the conclusion that I must be suffering from lithium toxicity. It seemed the only logical explanation for my nausea, mood swings, and shakiness. My recent bout of illness and dehydration could have easily resulted in concentrated blood levels. It all made sense. Lithium toxicity can be serious, even fatal. My nurse was at my place to assess me within an hour of my phone call to the hospital.

I was told to stop the Lithium, and because I was worried (and because I was angry at the potential effect that medication had caused) I stopped all other medications as well. That was a mistake. I spent the weekend grumpy, depressed, and dissociating so badly that it was hard to walk.

When the blood results came back I wasn’t toxic at all. In fact, quite the reverse. My level’s were too low. So I restarted all the pills and quickly returned to my ‘normal’ (but really, what is normal? ;)) self.

How did my lithium levels become too low? Partly, I suppose, due to the IV fluids I was given during my recent hospital visit. But mostly, I suspect, due to my careless attitude towards the medication. Skipping a dose here, a dose there. I’m not crazy anymore. I don’t need that stuff.

I seem to hold a deep distrust in the opinion of the medical profession. Somehow I believe my limited knowledge on psychopathology and pharmacology is superior. Then I get upset when my  medication experiments backfire. Funny that ;) Recently I have been seriously questioning my diagnosis. Am I really bipolar? Was I really that unwell? Perhaps it was all a strange dream. Now, while I am stable, I simply cannot believe I became that unwell.

I talked to both my psychiatrist and psychologist this week about this issue. I remarked to them that I felt like I was making the whole experience up. I can’t imagine feeling that depressed, or that unstable. I felt angry that I couldn’t remember aspects of my experience. But the recollections I had and others provided just didn’t seem like *me*. Rather than telling me to move on, that the past is the past and the present is the present (what I have been telling myself!), they both explained that I had been through a kind of trauma. Not the hospitalization itself, as my experience there was a positive one. But the very fact that I became so unwell and so unstable. I had assumed my inability to remember key parts of my hospitalization was due to being...well...mad ;) I had also assumed my somewhat flattened affect and reduced emotionality now was medication induced. But both are apparently symptomatic of those who have experienced some kind of emotional trauma. 

Now don’t get me wrong, I don’t feel traumatised. Not in the least. But I suppose that is part of what is going on. I don’t really feel any emotional response to what I have been through. It’s just something that has happened, no different to going to the shops for groceries. Apparently this will change, and my experience will become integrated with my sense of self.

Writing, talking to people, and my weekly therapy all help me piece together this puzzle of myself. It’s fascinating. I have learned more about myself in the last three months than I think I ever knew. I say now, and I will say again, that the experiences I have had (however apparently traumatizing they may or may not be) are one of the best things that have ever happened to me. I feel a confidence in myself that I never had before, and I have learned what is important in life. I’m happy being me, something I wasn't for a very long time. 

I assumed I had lithium toxicity when really it was the lithium I needed to become well. I assumed that a diagnosis of bipolar disorder was negative, when it resulted in an area of personal growth I may never have attained otherwise. It’s funny how something so potent, something so seemingly toxic can actually be the remedy.

If It's Hurting Me...It's Hurting You

I realised today that I have written very little on my depression, the very thing that saw me hospitalised in the first place. From a creative perspective I find my depression very difficult to write about. Depression for me was bleak, cold nothingness. How can I begin to describe the pain of nothingness? I usually try to inject a little humour into my writing, in an attempt to make it more ‘readable’. But there is absolutely nothing humouress about this particular depressive episode. Nothing at all.

My depression was, and remains to be a uniquely personal experience. I rarely talk about it to anyone, including my nearest and dearest. I seldom like to think about it. Irrational as it is, I’m frightened that a thought could suck me down into the darkness again. Because this is the darkness that nearly killed me. This darkness was, without a doubt, the most horrific thing I have ever experienced.

I didn’t really cry much when I was depressed. I’m not sure that I even felt sad. I just didn’t feel anything. I was completely numb from my soul outwards. In a way this is what allowed me to carry on untreated for as long as I did. Robotically, I carried out everyday activities. I did the things I needed to do. I created a facade that I was fine.  

Occasionally I would break down, the numbness would melt away and all I felt was pain. Anger. Grief. Sadness. I started having panic attacks regularly and dosed myself on Valium until I had built up such a tolerance that the drug didn’t work anymore.

One day I was in a near car accident that would have been entirely my fault.  I wasn’t concentrating and made a stupid decision. Fortunately all I received was a loud honk and an angry gesture. Afterwards I felt completely calm, I felt no adrenaline rush, no guilt or remorse. It was then I realised how truly ambivalent I was. When faced with what could have been a serious accident, I felt nothing. I didn’t care whether I lived or died.

Eventually I began to give up. I stopped eating, stopped sleeping. Steven frequently had to leave work to care for David and I. I kept experiencing this bizarre sensation where I felt I simply could not keep going. I couldn’t take another breath. I couldn’t take another step. If I was out when it happened I felt I was going to physically collapse and someone would have to come and get me. They would have to come and get me and I would be stiff as a board, carried out on a stretcher, not even able to move my limbs. In a plea for help I started telling the people around me, over and over, “I can’t keep going. I just can’t keep going.” I think they interpreted this as “I don’t want to feel like this anymore.” When really what I was trying to say was “I don’t want to be alive anymore”.

I was consumed by guilt and a pure hatred towards myself. One morning I woke up, listening to the two people I loved more than anything in the world sleeping peacefully. I decided I needed to leave. I couldn’t do this to them anymore. They both deserved so much better than me.

So – out of pure impulse – I grabbed the first article of clothing I could find, a dress, and threw it on over my pajamas. I slipped some shoes on, quietly opened the front door and left.

Halfway down the drive I realised I was wearing odd shoes. So I slipped them off and continued to walk barefoot down to the road. When I got to the road I looked around. Now what? I had no money, no phone, no plan, no SHOES for Christ sake. What on earth did I think I was doing?

Defeated, I dutifully checked the post box and started walking back up the drive. On the way I passed a tree. One of those weepy trees with long concealing branches. Before I knew what I was doing I sat inside the tree, huddled in the dirt. Suddenly I felt safe. I could see people go past, joggers, people walking dogs, women with prams...but they couldn’t see me. I felt like a child once more.  On the off chance that someone may see me I concocted a story where I was doing some weeding. The fact that I was in a dress, with my pajamas visible, barefoot, with no gardening implements in sight didn’t really concern me.

Suddenly our front door burst open and I heard Steven running down the drive. When I saw him he looked absolutely frantic.

“Steven?” I called out. He stopped. Looked around, clearly confused, then spotted me under the tree. He paused for a moment and then parted the long branches.

“What are you doing under there?” He asked calmly.

“Just...sitting” I said nervously. At this point I knew I had screwed up. Big time. Wordlessly he held out his hand. I hesitated and then took it, climbing out from underneath the tree. We walked back up to the house and I tried to explain that I felt safe there, that I wasn’t going to do anything bad.

Steven just turned to me and said “do you have any idea how worried I was?! Don’t ever do that to me again. Ever.” I cried, told him how sorry I was. He just nodded and walked away.

I felt truly terrible. I realised what it must have looked like to him. My phone still at home. My (odd) shoes left in the middle of the drive. I realised that this couldn’t go on.

When I went into the bedroom Steven was laying face down on the bed. I apologised and we held each other. I saw that he had been crying, or at least close to it. “do you think I’m bad if I go in to hospital?” I asked him. He looked at me “Quite frankly, I think you would be selfish if you didn’t go in and continued on like this” he said.

Suddenly I realised the effect that this must be having on him. Working fulltime, constantly on edge that he was going to get a call from me saying that I need him. Coming home and cooking dinner every night, feeding and bathing and putting David to bed. He had come to appointments with me, taken me to hospital, taken days off work to look after David. He had never once lost his patience with me. This man is a saint. I realised that he looked tired. I had been so consumed with my own despair that I hadn’t even considered him.

I realised my problem, my illness, was hurting him just as much as it was hurting me. I vowed to put an end to this. I decided I needed help. I made the decision to go into hospital.