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Normality. 

It’s good to feel normal. I know that “normal” is very subjective but this is about as normal as I get. What do I mean by that?

Well it’s best understood by looking at what is absent. The pain has gone. It’s as simple as that.

Life feels easier. Work is enjoyable and time with my family and friends is fun. I have energy, I’m active and I have a sense of achievement at the end of each day. I have the energy to go to the gym, go for a meal with my wife and the energy to laugh. It feels good.

I have so often in the past taken this phase of my Bipolar Disorder for granted. Most people feel normal every day and expect their lives to remain that way. For me, it is one phase in an ever-repeating cycle. It never lasts, which is why I need to make the best of it.

After such a difficult year, mainly battling with depression, it is such a relief to get a break. And the effects are felt by more than just me. My family are getting some well deserved breathing space too. The atmosphere in my home is so much happier and brighter than it has been in a long time. My wife doesn’t look so tired.

I’ve seen it suggested that you have to experience the low points in life to be able to truly appreciate the benefits. I’m not so sure about that. It seems a little masochistic. I don’t feel any increased acuity of my senses after my depression. Having said that, at this moment, I do have a greater awareness of the gifts that have been bestowed upon me. I have a palpable sense of gratitude for my wife and family, my friends and, ironically enough, my good health. I have peace and calm. I feel lucky. I have it good.

This is a period of recovery, a time to recharge. I’ve used the phrase before but it is a time to recharge my soul. That inner energy will sustain me during harder times. Love is the source of nutrition and I am fortunate to be loved and supported by so many and I include some of the readers of this blog in that number. Sometimes I forget it but I am never alone.

It always gets better! I say that for anybody who is reading this and lives with Bipolar Disorder, or any other psychiatric illness for that matter. Mostly I say it for me. The worst of days and weeks and months will eventually pass and there will be a time of improvement. It may be temporary but the struggle gets easier and there is an opportunity to heal. The memory of better times will sustain me when my life is in turmoil. I just need to cling on. I just need to have hope.

I’m in the eye of the storm. Calm seas surround me but the clouds are visible in the distance. If the usual patterns apply, I will be hypomanic before Christmas and face the new challenges that phase brings. For now my thoughts are free, free of distortion and free of anguish. I intend to enjoy it fully.

I’m going to sign off now. I plan to take my car for a spin. I’m going to listen to soothing music and think of my wife. Maybe I’ll stop by the sea and have a coffee. Maybe I’ll call a friend and maybe when I get home, I’ll walk the dogs. It sounds a little mundane, but that is all I need.

 

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Holidays. 

It’s been a period of ups and downs. I didn’t spend too much time in hospital. Just over two weeks. I had an incentive to get out. My family summer holiday to Spain was due at the start of August. I didn’t want to miss it. 

Early on, there was the distinct possibility that I wouldn’t be out of hospital in time and my wife and I had discussed our options. Would we cancel the trip or would the family go without me? Neither option seemed very appealing. 

But in the end it all worked out well. My mood improved quickly after adjustment of my medication and I was discharged with a few days to spare before we were due to travel. 

I was still a little down in the dumps and unsure of how I would react to the change of scenery and the inherent activity of a foreign holiday. My wife and I agreed that we would take things slowly. We would match our activities to my mood and my capacity to be involved without stress. If that meant lounging by the beach for two weeks then so be it. After all, it was a bonus that we were on holiday at all. 

I am truly grateful for the absolute support that I get from my wife and family. But I was conscious that my teenage sons would be disappointed to stay in the same place for the entire holiday. Nonetheless, I was the centre of attention and would dictate the pace of the holiday. I think that was a very loving decision by my family and I truly appreciate it. 


As it happens, the holiday was a fantastic success. We are approaching the end of our adventure and we had a great time. Yes, there were days we stayed by the beach (and they were thoroughly enjoyable) but we had a number of excursions as well. In that way, the boys were entertained too. 

We visited a theme park and I happily watched my sons enjoy the extreme rides. Wild horses wouldn’t have enticed me to join them. We rented a boat and cruised in the bay and my sons went swimming in clear blue waters. They tried a bit of fishing, caught nothing but spent a really lovely afternoon together. A highlight was a Segway tour in Barcelona which was as educational as it was fun. 

We tried to introduce a little culture by visiting  a Roman ruins in the early days and later again whilst in Barcelona. It was a total failure but what else do you expect from teenage boys?

My mood improved daily and soon the only remnant of depression was a feeling of anxiety in the morning. Depression and anxiety are joined at the hip. The anxious feeling would pass within an hour and I’m not really sure what caused it but I can speculate. 

Holidays can be a stressful time for me. Foreign country, foreign language and culture and I feel out of kilter for a few days. I like routine and the safety of my own home. I am deprived of these abroad. It takes me a while to settle in to a new place. 

I worry about things. I worry about having enough money when I’m out, that the SatNav will bring me to the right place or that one of my family will get into difficulty swimming in the sea. I don’t think I’m alone in thinking like this and I definitely deny that I’m neurotic. These are normal fears and I don’t let them control my life. 

Mostly, they are easily overcome. If I’m worried about money, I take a credit card. Worries about a catastrophe can be challenged. How likely is it that someone I love is going to drown? And I guess you just have to take your chances with the SatNav. That’s the same for everyone. 

So sometimes I get anxious. I’m also very particular, a pefectionist, a bit obsessive. These are some of the traits that make me who I am. It makes me careful and conscientious. It makes me dependable. I hope it makes me a better doctor. 

Before we came on holiday, I asked my psychiatrist to adjust my medication even further so I might feel more upbeat. He argued that the holiday alone would make me feel better. He was completely right. 

Two weeks away with my family is better than any little pill. 

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Readmission.

“I Am The Damned

I Am The Dead

I Am The Agony Inside

The Dying Head

This Is Injustice

Woe Unto Thee

I Pray This Punishment

Would Have Mercy On Me”

                                     “Who is it” – Michael Jackson 

                                  ——-

It was too good to be true. It didn’t last. The burst of energy I experienced a few weeks ago is gone. Certainly, I felt better for a while but not for long. The fog drifted down over my eyes again, the lethargy reappeared and the black ball is stirring within. 

When I left hospital I was full of enthusiasm. I got back to work (which took a significant effort to begin with), I was doing all the right things: taking medication, getting exercise, watching my sleep and spending time with my wife and family. We had some lovely days out together and all was good. I even signed up for guitar lessons. 

But over a period of weeks, everything began to slow down. Work became a drag, exercise reduced to nothing and the guitar lessons died a death. Conversation became laboured and I started to isolate more and more. I would spend long hours in bed on my days off work and entire afternoons lying on the couch listening to sombre music. Even the simplist of tasks became troublesome chores. 

More recently, my wife, obviously aware of the deterioration, encouraged me to contact my psychiatrist. But I refused. I didn’t want to admit defeat. I was foolish. Instead I languished until my mind finally turned to thoughts of ending the pain. That was the final straw. 

So now I’m back in hospital again. It’s only been a few months since my last visit and I feel like I’ve failed. But that idea will pass and slowly my reserves will be replenished and, with the right help, I will recharge body and soul. 

I am surrounded by people who are dealing with their own personal torment. Men and women from all walks of life trying to get better. Guidance, medication and the passage of time can allow them all to improve and live fulfilling lives. And so can I. 

It seems this bout of depression isn’t finished with me yet but I’m not finished either. 

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Survived another cycle.

And finally it lifted. The fog has moved on. The beast is sleeping and the black ball is quiet.

As predicted, life has improved. I’m not back to normal yet but I’m so much better than I was. I feel like I have a little energy again. Life has renewed flavour. I’m beginning to learn how to have fun again.

I’ve said before, and reiterate now, that I’m lucky. The length of my periods of depression can be measured in weeks. Some are not so fortunate. Some measure in months, maybe even years.

But that is not to belittle my time spent in the misery of depression. It is energy sapping, it tests my endurance and it tests the people near to me and, in particular, my family.

About two weeks ago I was feeling deflated and frustrated and gave out to my wife that she didn’t talk to me enough. She replied that it was very hard to hold a conversation with me at the moment. You see, I didn’t show interest in any conversations, I hardly smiled and I rarely laughed. My wife wasn’t being cruel. She was just fed up. Just then she was finding it tough too. It’s not much fun being depressed but it’s not much fun being around someone who is depressed either. In her defence, my wife always reminds me that it will improve, it will get better. She is always right and she believes in me even when I have lost all belief in myself.

It has been a very busy time in our house in the last few weeks. My eldest son graduated from Secondary School and is preparing to sit the Leaving Cert. examination. A second son is preparing for the Junior Cert. and my youngest son just made his Confirmation, signalling the end of Primary School. It has been hectic and I found myself with a choice to make. I had a number of social engagements to attend, ceremonies and celebrations. I could decide to enjoy them or chose to just tolerate them.

It is amazing what can be achieved simply by force of will. All of the ceremonies I attended, all of the people I met, nobody would have suspected that I was depressed. I appeared fine. I blended in.

The amazing thing is that we are surrounded by people who suffer with depression and you would never know. People with mental illness become experts at appearing “normal”, at wearing a mask. They save their true feelings for their loved ones, their families and for the times when they are alone. That is the worst part of depression – the loneliness.

But for me, it got easier and the most recent celebration was my son’s confirmation yesterday. It was genuinely enjoyable, it was fun and there was no acting involved. It was the first time that I truly realised that I had shaken off the chains of depression. It was the first time I felt truly alive in a long time.

So I decided to write today to tell you that I was over the worst, that I have survived. I was in hospital not so long ago followed by a period of depression and now that cycle is over. Now I get to savour the good things. Now I can give a little back to my family. Now I get to laugh.

It will come back again but I don’t know when and there is no point in worrying about it. I will take every opportunity to recharge my body and soul in the meantime. I will be ready when I need to be.

Right now is time to be grateful for friends, family and the many gifts life has given me. Right now, life is good.

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Self denial.

It’s been a tough few weeks. Things are going slowly. I find it very difficult to show interest in anything, to hold a conversation, to relax. My days are devoid of enjoyment, enthusiasm. Life seems devoid of fun.

I’ve been reading back on recent posts and I realise that I was doing really well in hospital before my discharge and for a short time later. I talked optimistically about being balanced and euthymic. But I definitely don’t feel like that now.

However, I could have predicted this low mood. In hospital, I showed evidence of a mixed state, a hypomanic episode with symptoms of depression. After every hypomanic episode I have experienced, I have suffered an episode of depression. After every high comes a low. It is the cyclical nature of my bipolar disorder.

The good news is that it doesn’t last forever. I will wake up one morning and the weight will have lifted. It can be that sudden. I will have energy again. I will feel alive.

In the meantime I try to be as active as I can. I still wash and shave every day. I try to make myself presentable. I do a little exercise, listen to music and play the guitar. I meet my psychotherapist and my psychiatrist. I take my medication. I try to do the right things. And I wait patiently for my wife to return from work and the hug she will give me. I draw strength from her and recharge my soul. I couldn’t survive without her.

This week I returned to work. It wasn’t easy. I was filled with trepidation. I usually take a while to find the right gear when I return to work after a two week holiday. Imagine what it was like after eight weeks leave of absence. But I survived it. The anxiety subsided once I got started and like all jobs, it soon became like riding a bicycle. I could do it in my sleep. That’s reassuring and made me question the need for the sleepless night before going back.

Two things were apparent to me when I went back to work.

Firstly, when I was busy and concentrating on my patients, I had no time to think about myself. I had no time to think about my mood, no time to feel depressed. I think this illustrates that my depression is pretty mild compared to that suffered by many and it also shows the power of distraction. If my mind is occupied I don’t feel the effects of depression so severely. But, as soon as I finish the days work, I slump. The adrenaline has all been used up and I arrive home spent. It does give hope for the future though. Hopefully, as I get back to a regular routine at work, my mood should improve. I’ll let you know how that theory pans out.

The second thing I noticed was that I lied to everybody I met about why I had been absent from work so long. Many people welcomed me back but remarked that I had been missing for some time. To every one of them I had the same reply – I took some time off, I needed a break, I felt tired. I didn’t tell the full truth to a single person. There was no mention of bipolar disorder or depression. There was to mention of admission to hospital.

I believe in being prudent with my personal information but this form of denial of self just demonstrates the level of stigma attached to mental illness. I can write publicly about my illness from the safety of my computer but I can’t be honest with the people I work with every day. It’s hypocritical.

Having said that, depression is common and I have never heard one other member of staff, at the hospital I work in, admit to suffering from it.

Some day, admitting to depression will be the same as admitting to suffering a chest infection.

Some day, there will be no shame.

 

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Same old struggle.

“I told you to be patient
I told you to be fine
I told you to be balanced
I told you to be kind”

“Skinny love” – Bon Iver

I haven’t posted in over a week. I haven’t felt like it. That youthful burst of enthusiasm I enjoyed when first I left hospital has vanished. The adrenaline is spent. Depression is in the air again, but then, it never went too far. Life is a drudge.

But just to be clear, I’m not that bad either. My thoughts are negative, my mood is low but I am still functioning. I’m still fighting. But I’m getting a little tired of fighting all the time. I’d like to visit “easy street” for a while.

Anhedonia is the word which best describes how I feel – a lack of pleasure in normally pleasurable activities. It’s a fancy way of saying that I feel like shit. There is no joy, no fun.

And believe me I’m trying! I’m doing all the right things. I drag myself out of bed every morning and wash and shave even though I’m moping around an empty house and no one sees my face. I take my medication, I play my guitar and I’ve been to see my therapist every week. I’ve been cycling and I spend as much time with my wife as I can but even that doesn’t give me a lift. And when did it become her responsibility to cheer me up all the time?

Sometimes I think depression is just something that has to be suffered. Something that has to be survived and out-lived. External factors won’t necessarily give me immediate satisfaction but they will prevent me from getting worse. The day I start to isolate myself, avoid daily activities, simply don’t bother to shave is when I take a step towards severe depression and the damaging negative thoughts it brings.

I’m due to see my psychiatrist in a week. I already spoke to him on the phone in recent days. Maybe we can alter my medication to help but in reality we probably can’t. I don’t respond well to antidepressants. They make me hypomanic which is only replacing one problem with another. We are unlikely to reduce my current medication so soon after being hospitalised. So in essence, I just have to put up with it until it burns itself out.

It’s important to remember that it is self-limiting. I’ve been here before and it always gets better. I will have good times again and they will last longer than the bad. I will be happy again and I have many happy memories to support me on the way. I have people in my life who will help me get there and simple though it seems, the recent spate of good weather will do me the world of good.

The negative voice in my head reminds that when I overcome this time of depression, I will earn a period of balance followed by hypomania and then depression. The cycle will repeat for the rest of my life. It sounds demoralising. Thankfully that voice is small. Every last remaining cell in my body strives to be happy. That’s where the real strength lies. Therein lies the future.

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Discharged.

“Take these broken wings
And learn to fly again
Learn to live so free”

“Broken Wings” – Mr. Mister

—–

Today I was finally discharged from hospital. I was an in-patient for five weeks. I feel stronger but not back to peak condition yet. I tire easily and nap repeatedly during the day. To be able to sleep so easily is a pleasure. It is in stark contrast to the insomnia that accompanies hypomania. I am simply working on the considerable “sleep debt” accrued in recent months. It is pay-back time.

My mood is balanced, euthymic. It has been a difficult period. A lot has happened and recovery is slow. The process is on-going and the aim is to prevent any further admissions for the foreseeable future. If I do not learn from my time in hospital then it is all for naught. So what did I learn?

Once more, I have proven my resilience. When my back was to the wall, I came out fighting and beat bipolar disorder once more. I have proven that it is a smaller part of my personality than I sometimes care to think. I have proven that there is always light at the end of the tunnel and that the bad times will pass. It is hard to remember this especially when looking up from the depths of depression. But this essential fact can give me hope in the future and guide the inevitable recovery. I have proven, that against great odds, I can succeed. And so can every individual who struggles with mental illness.

I have learned that I am not alone. There are more people who support me, who care for me, than I can easily count. My wife and family are to the forefront but among my allies are my sisters, work colleagues, my in-laws and college friends. I have rekindled old friendships and strengthened some others. In my time as an in-patient, I never had time to get lonely. There was always someone in contact with me and for that I am deeply grateful.

In addition, this blog went public during my time in hospital and the response has been overwhelming. The messages of support and good-will have been humbling. I hope I can continue to share my experiences with you for some time to come.

The most important lesson I have learned is at once most simple to understand and most difficult to correct. It has become obvious to me that I do not have the luxury of allowing myself to get lonely. Some people are introvert and enjoy their own company. I am obviously extrovert in nature. Any more that one to two hours alone and I start to crave human company, human contact.

I work three days a week. This certainly allows me to recover from the stresses of my job, recharge the batteries and get ready to start again. Once a week, I volunteer with Childline. It’s my way of giving something back and I enjoy doing it. That leaves one day a week when I have a lot of time on my hands. It is important that I find something to do to fill in that time. It might be cycling, playing guitar, reading or some other activity I haven’t considered yet.

The key is distraction. When I get bored and ultimately lonely, my thoughts become negative, I catastrophise, believing the worst possible outcome for any given situation and finally, I get paranoid. I believe that the solution is to keep active, to meet with people, to keep in contact with my friends. I must prevent myself from just sitting and ruminating. The challenge is finding the motivation to do these activities especially when my mood is low. No one said it was easy.

So, my time in hospital is behind me for now. The future looks bright. It’s time to get busy living or get busy dying. I choose life!

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Weekend leave.

“Well, I hear the music
Close my eyes, feel the rhythm
Wrap around, take a hold of my heart”

“Flashdance” – Irene Cara

—–

I haven’t written in my blog for a few days. I didn’t think I had anything much to say. Then I remembered that I met my psychiatrist on Thursday and we decided that I would be discharged from hospital this week. Isn’t that good news and cause for celebration?

My discharge is dependent on how I manage while at home for the weekend. Weekend leave from a psychiatric hospital is more than just a break from the hum-drum of the institution. It is a test. It is officially called “Therapeutic leave”. It is an opportunity to determine how well you deal with the stresses of everyday life when you come home. If you manage well, then maybe you are ready to go home for good. If you find it difficult, an extension in your hospital stay may be necessary.

I’m glad to be able to report that I have been fine, I’m doing well in fact. I feel decidedly “normal”, balanced, euthymic. It is particularly boring.

As I suffer from Bipolar Type 1, my mood swings tend to the hypomanic. This recent admission is an exception as depressive symptoms were a key feature. But mostly, I lean towards excessive energy, grandiose ideas and impulsive spending. The early days of a hypomanic episode can be great fun. It can be exhilarating and euphoric. But the inevitable crash always comes and hypomania is closely followed by depression. Fortunately, my depressions don’t last too long and are relieved by the calm and peace of balanced state, euthymia. Again, this recent admission was unusual, with an extended period of depression. But i feel calm again. Its a blessing.

Sometimes when I am balanced, I miss the energy of hypomania. I miss the excitement and I yearn for it’s return. This is only wishful thinking. It’s easy to forget just how destructive I can become when elated.

So, I have been immersed in the banal this weekend. I brought my youngest son for a haircut yesterday. This was imperative as he attended a teenage disco last night. I collected a suit for my oldest son in town. He is preparing for his graduation from secondary school. It’s hard to remember where all the years have gone. I’ve hardly seen my middle son. He’s a typical teenager and out with his friends all day. He barely talks to me at the best of times. I played guitar quite a bit and I went for a cycle to Howth with my wife. It was invigorating but cold. Last night the two of use had a meal in a local restaurant and we thoroughly enjoyed it.

So that’s it. Nothing special. I have rejoined the world of “normal” people and it feels good. I will be discharged from hospital this week and I must take time to build the defences, to try and prevent a repeat of this episode. It will take time and it won’t be easy but I’ve done it before. And I won’t be alone.

I can feel something new creeping in. Something bright and beautiful. Something I had forgotten about. I can feel healing. I can feel hope.

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Day 28.

“I don’t ever want to feel
Like I did that day”

“Under the  Bridge” – Red Hot Chilli Peppers

——

Four weeks have passed since I was admitted to hospital. A lot has happened. It has been a rough ride.

I’ve had to deal with depression, dysphoria, mania, hallucinations and paranoia. It has been a hell of a fight and I wasn’t able to battle without help. So many people have been with me on the journey. Foremost of course is my family. Their support has been unerring. The medical team that care for me have been exemplary. The nursing staff superb. And with all their help, I have survived yet again. I am still alive. I am victorious.

I have rekindled friendships along the way. I’ve made contact with old college friends to whom I hadn’t spoken in years. There have been encouraging words from work colleagues and the successful public launch of this blog. My parents have helped enormously in minding my children while they were on school holidays at Easter. My sisters have helped to keep me going, my oldest sister and her husband are stalwarts in particular and regular visitors. They kept me supplied with Pringles and sparkling water. In short, I have not been alone and I am truly grateful.

IMG_0620

One of the nicest side effects of my stay in hospital is that I got to know my youngest sister better than I ever had before. There is an age gap of nearly two decades between us. I was away in college when she was born and she grew up without me sharing any life experiences with her. As she grew older, I became like a distant uncle who would visit intermittently and offer a few quid as a treat. I really had a weak relationship with her. She is in her twenties now and I have been delighted to discover that she is a beautiful, intelligent, spiritual and empathic young woman. She is happy and well balanced and sends me humorous messages on a daily basis and I have come to depend on them to brighten my day. I look forward to them. I hope she has enjoyed coming to know me better too.

I have learned a great deal during this admission. I have learned to appreciate what I have. I went for a walk in Phoenix Park at the start of the week and was struck by the beauty of the blooming flowers and I attach a few photos to share the experience.

IMG_0621

I hope I have learned to ask for help a bit sooner and not let my health deteriorate to the extent that I need to come to hospital. I’ve learned that sometimes a man needs to cry and that’s okay. The tears will stop when I need them no longer. I think that will be a while coming.

I like to think that my sons can learn from me. I hope they understand that all men have demons, have worries, have suffering. I hope they see that the mark of a man is in how he faces them. I hope they comprehend that you can not easily face them on your own. Maybe they see me kiss my wife, hold her hand, give her a hug and know that as a couple, we are strong. We have been together twenty years now and we have defeated bipolar disorder many times. We beat it every day. I hope they know we can deal with whatever life has to offer. I really hope they understand the power of love!

I am feeling much better. I am sleeping longer at night. The black ball is quiescent but I’m aware of it in the background. I feel calm and peaceful, something I haven’t been blessed with in a long time. I’m on the mend and I feel a renewed vigour. Today I have a date to go shopping with my eldest son and I’m looking forward to it. I’m proud that he asked me to join him.

I’ll be discharged in a few weeks. I can feel it. Look out. I’m coming home!

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Codependent.

“Life is an ocean and love is a boat
In troubled water that keeps us afloat”

“The Voyage” – Christy Moore.

——

I had a good weekend out of hospital. I tried to keep active. I went to town on Saturday and bought a jewellery box for my wife. It was a nice gift and she really likes it. I am trying to show my appreciation for all she has done for me, for how much I value her support. It is my lifeline.

I walked the dogs and played my guitar. I read and watched TV. Thankfully, my concentration is improving and completely gone are the hallucinations and paranoid delusions. I’m on the mend. I slept better than I have for weeks. The only negative is that I have gained about 5kg in weight since my admission. All I do is eat and I get little exercise. I find that demoralising.

But my wife was working over the weekend and I spent long periods of time alone. I’m not good in my own company. I tend to get lonely and depressed. This is a big problem for me.IMG_0612

Since I came into hospital, I have been taking a course which in essence asks you to focus on how to keep well when discharged and to consider what “triggers” can lead to relapse. Triggers are the events or situations which can destabilise your mood. Everybody can identify a few.

Christmas is one such trigger for me. I am always elated in the months leading up to Christmas and the associated hyperactivity usually allows me to have all my shopping done by early November. But this is in contrast to the depression which inevitably strikes during the Christmas holiday itself. That sense of depression persists into the new year and, on this occasion, was the reason for my admission to hospital.

But a more common trigger for me is loneliness. When I spend too much time on my own I get very maudlin. I’m not sure whether depression makes me feel lonely or the loneliness makes me feel depressed. I think it is the latter but the end result is the same. I know this is something I need to work on.

I believe I am codependent on my wife. I am too reliant on my wife for companionship, approval and sense of identity. When I am with her, everything is rosy in the garden. When we are apart, I start to feel low. We spend a lot of our time in each others company. We eat together, we watch TV together, we even exercise together. She is more than just my companion, she is my best friend.

Not a day goes by when I don’t contact her at least twice looking for reassurance. My evenings revolve around her arrival home. I am envious of her giving her time to other people when she could be concentrating on me.

It is an unhealthy state of affairs and one that will put a strain on our marriage. There is no magic tablet to cure this. I need to work on it with my psychotherapist. I need to expand my circle of friends and find ways to occupy my free time. I need to end this reliance on my wife for making me feel happy. I need to give her a break!