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Compliance. 

The days are flying by. It’s a good sign. My mood has been good. I’ve had a few days where I felt browned off but nothing serious. It didn’t last. It’s important to be able to distinguish between normal changes in mood from the pathological. It’s only when the changes persist that it becomes problematic. 

So things are good. I’ve had a long stretch of feeling well. Paradoxically, it can be a dangerous time. Doubt sets in. Do I have bipolar disorder anymore? Do I need to take my medication at all?

These may seem like ridiculous questions but the mind can play funny tricks on you when you’re feeling good. These doubts also arise in the early stages of hypomania when I feel energetic and full of adrenaline. It’s an addictive state. I don’t want it to end. But there is always a crash after a few weeks and the elation never lasts. The aftermath is never worth it. 

I have never stopped taking my medication. I accept that bipolar disorder is for life. Sometimes that is a bitter pill to swallow. But nonetheless, it is better to make peace with the fact that bipolar disorder is forever rather than fool myself that it will somehow resolve. 

I have seen the results of non-compliance over the years. On every admission to hospital I have met at least one patient who has become unstable and deteriorated because they stopped taking their tablets. They have the unenviable task of starting again from the beginning in an effort to regain stability. It seems like such a waste of time and unnecessary pain. 

I understand why some people do it. I can understand the appeal. Feeling good can be seductive. It’s easy to hope it will never end. But experience has taught me that another mood swing is just around the corner. But I know that medication will reduce the frequency and severity of these events. 

When I have prolonged periods of balanced mood, my psychiatrist will slightly reduce some of my medication but never do I stop completely. Usually, they will just be increased again next time I become unstable. My treatment is tailored to my needs but it is never ceased. 

Taking tablets is part of my daily life. Occasionally I resent it but mostly I recognise the improvements they have brought me. It’s not easy to be compliant all the time. Some of the drugs I take have side effects. Some side effects are obvious while others remain unseen. 

For example, I take Lithium. It gives me a tremor in my hands. It’s not very obvious but I’m conscious of it and it bothers me. Because I have Diabetes Insipidus, I need to pee hourly. It can be a pain on long journeys. And every three to six months I have blood tests to check on damage to my kidneys especially but also my thyroid gland. And that’s just one of the medication I take. 

But for all it’s disadvantages, Lithium has changed my life. I don’t think I would be here writing this blog without it. In short, the benefits far outweigh the side effects. 

So if you’re reading this and you suffer with mental illness, think twice before you stop your medication. Talk to your doctor about it and be sure that it is the right move for you. 

One of the things I have to do to keep well is to take a few pills. It’s easy and I’m going to keep doing it.  

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Behind the scene.

I haven’t posted for a while. I’ve been lazy. I haven’t a whole lot to say. Things have been going well the last while.

I was a bit depressed in August. It was very mild. It didn’t exactly stop me from doing anything but it just made everything a bit harder. It just required a bit more effort to function. At times like this I tend to isolate myself. I don’t want to go out. I have no interest in activity, no interest in socialising. Ironically, the very act of doing something usually makes me feel better. Just taking the first step, although difficult, can be rewarding. There can be a perceptible lift in my mood.

This is where my wife comes in. She is keenly in tune with my moods. She can tell when I’m feeling down and she is my greatest supporter. She knows only too well that gentle activity will do me good and she persuades me to get up and partake. It is a balancing act. If she is too persistent I get too irritable and will refuse to do anything. But she has a way of getting around me and I am truly grateful for her patience and care.

My boys are in tune with my moods as well. They know when to approach me for something and when I just want to be left alone. Sometimes they are at the receiving end of my irritability and I always regret those moments. They make my life easier when I need it most.

You see, psychiatric illness doesn’t just affect the individual, it affects the whole family. Mental illness is pervasive and colours every aspect of your life. I couldn’t survive without the tolerance and support of my family. I owe them a great debt of gratitude.

That is why it is so important to celebrate when I’m feeling well, as I do right now. As I said, I was depressed in August but my mood lifted in September. That was helped by a visit to my psychiatrist and some juggling with my medication. Life has been easier for the past month and I’ve been feeling more enthusiastic. Not a lot has changed at home. My sons are all teenagers and they do there own thing with little input from me or my wife. But there is no hassle at home. There is a palpable sense of calm and they don’t have to walk around me on tip-toe. It is a welcome break for my wife too. I am less of a burden on her. There is an injection of a vital ingredient for a happy life. There is fun.

So I’ve been keeping as active as I can and I feel I have more energy as a result. I had a lovely day when invited to my cousin’s wedding in Waterford at the end of August. My mood was starting to lift and I had a wonderful time. The bride and groom were so happy and it made me reminisce on my own wedding day. I met with my family, cousins, aunts and uncles and I got to dance with my wife. Any day that I get to dance with my wife is a good day.

So I’ve been trying to keep myself well. I’ve been going to the gym and I even got out on my bike a few times in the last fortnight. I’m careful about my sleeping habits and I continue to see my therapist. Taking my medications every day is a given. I meditate almost every day. I miss the odd day but not often. I believe that meditation helps keep me balanced.

I have a “Mitra” ceremony in a few weeks at the Buddhist Centre. Mitra means friend and the ceremony essentially denotes when I commit to being a Buddhist. I then become a “friend” of the Buddhist community. It’s a lovely idea and I’m looking forward to it. My involvement with the Buddhist community in the last while has been very good for me.

When I was first diagnosed with Bipolar Disorder, it was explained to me that it would affect me mentally, physically and spiritually. I didn’t really understand at the time and it is only in recent months that I have started to address all three aspects of the illness.

All of the efforts I make to limits the effects of my illness are important. From taking my medication to getting exercise and socialising, all play a part. But the most important stabilising factor is the love and support of my family. They have been there every step of the way.

I am never alone. I’m a very lucky man.