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Donegal. 

Life is good. I’m feeling great. I haven’t a care in the world and I’ve been feeling like this for a while. I’m very grateful. 

For the long weekend, I travelled with my family to Donegal. I’ve never been before and the drive was long. But it’s worth it. Our hotel is on the beach. It’s 7.00am and I’m looking out at the waves breaking on the shore. It’s invigorating. 

We have no great plans for the day. My wife might take the kids surfing this morning but I won’t be joining them. I don’t swim. My aim today is to drink coffee, chill out and maybe read a book. We might do a little sightseeing if that’s what everyone wants but there’s no major agenda. And that suits me fine. 

It’s a little bit of a concern that I’m up so early while on holiday. It could be the sign of impending hypomania but I’m not really worried. I’ve been sleeping well in recent times and one early morning is not a cause for panic. If I have persistent early morning waking, then I will have to give it some consideration. But not now. 

I mentioned before that I had a renewed interest in meditation. It’s been going very well. I practice most days and regret when I miss a session. For a small effort on my part I gain a deep sense of relaxation and paradoxically, I always feel more alert and refreshed afterwards.  It seems to be working for me at any rate. It’s nourishment for the mind. 

Looking out at the sea, I delight in how peaceful and contented I am. The feeling is priceless. Wherever you are reading this, I hope you find a little peace and calm in your day. May you be happy. I’ll be in touch. 

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It’s all good. 

  1. I haven’t posted for a while. I haven’t had much to say. You would be forgiven for thinking that I am feeling low but actually it’s the opposite. Everything is going really well for the last few months. I don’t know myself. It’s easy to write when I have something to complain about but less so when my mood is balanced.

This is the longest stretch of euthymia that I have had for years and I am truly grateful for the opportunity to recharge the batteries. It’s a welcome relief. Not that I don’t get bad days, I do. But that’s all they are. Days when I’m off form. They don’t persist. Doesn’t everyone get days like that?

Life is not a struggle right now. There is no effort involved in everyday activities. Work is fine, my home life is peaceful and I look forward to each new day with energy and enthusiasm. I’m enjoying myself. Long may it last.

Recently I took a holiday to South Africa with my family. It was lovely. We visited Cape Town and went to all the usual tourist attractions. The highlight of the trip was two days we spent on Safari. It was spectacular. We had a great time.

This time last year, I was in hospital. If someone had told me then that I would go on safari within twelve months, I would have suggested that they were mad and advised them to book into hospital with me for treatment.

There is no over estimating the beneficial effects of the passage of time. I don’t think about my admissions to hospital that much, there is no point. But I’m struck by how much better I feel, how much stronger, just one year later.

Everything changes, nothing lasts forever. Depression, hypomania and euthymia all come and go. I never know what’s just around the corner. My life is unpredictable and maybe that’s what makes it so interesting.

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Blessed.

I really am very lucky. I’m not always conscious of this. I forget all too easily. When times are hard it becomes increasingly difficult to remember. But things are good at the moment and it’s important to reflect on my blessings.

Life has been good for the last few weeks. My mood is good and I have energy. I’m enjoying life. Work is easy and I’m sleeping well. I’m euthymic, normal. It’s payback time.

Recently I went on a skiing holiday with my family. It was lovely and we all enjoyed it. The weather was good, the air was crisp and the scenery was stunning. I’m not much of a skier but I stuck to the beginner slopes while my wife and sons attempted the more challenging slopes. But what I enjoyed the most was the time spent with my family. Time spent swapping stories of our experiences during the day on the mountain. Time having long meals together. Time spent laughing. There was no hassle, no depression nor hypomania, no worries. It was life at it’s best. It was fun.

I’ve started meditating more regularly this month. I aim for twenty minutes a day. I’ve dabbled with meditation before but I got lazy. My practice dwindled. Now I’m focussing on it again and giving it more attention. I enrolled in a five week introductory course, once a week for a few hours and I find it very helpful. I look forward to meditating every day. For a short while I can calm my mind and tune in to how I’m feeling. Immediately afterwards I fell more focussed and relaxed for a while. The experts assure me that with regular sessions, that same feeling of serenity will persist for longer during the day. It’s worth a try and it can’t hurt. Let’s see if I can keep it up when I’m not feeling so stable. That will be the real test.

I don’t mean to be pessimistic but it won’t last. It never does. That’s my reality. That is why this time is so special, why it tastes so sweet. It’s been a rough twelve months and it is wonderful to wake up happy, without a care in the world. Maybe it’s a blessing to have bipolar disorder. Living through tough times allows you to appreciate when it’s good. Maybe you can’t understand the highs until you’ve been low.

I find myself checking my mood every now and then. Am I too happy? Am I getting hypomanic? It’s a natural fear but I think that right now I’m just balanced. It’s normal to be content some of the time.

Either way, I’m very grateful for what I’ve got and I’m going to make hay while the sun shines!

 

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Hanging in. 

The new year didn’t start out as I had hoped. A lingering sense of lethargy and disinterest prevailed. I don’t think I was clinically depressed though at times I was close to it. I just had no energy, no joy in life. My wife calls it “flat” and that’s a very good description. Life just felt harder than it needed to be. 

Earlier in the month, I took a few days off work. I felt guilty about it and agonised before making the decision. Part of me believed I was malingering, dossing but the sense of relief when I knew I had a few free days was wonderful. 

It is suggested that you should keep active when depressed. You ought to keep on going to work, try to socialise, try to exercise, try to live. I think this is good advice but I also recognise that there are times when I feel overwhelmed and I need to take a step back from the world. It doesn’t happen too often. It’s about recognising the need to relieve the pressure. It’s about taking care of myself. It’s about being kind. 

In my case, the few days of freedom did me good. I was refreshed afterwards. I regained a little energy. The associated guilt passed. Now I’m glad I did it. 

Recently, I was talking to my sister about my mood for the last while and she made the point that most people feel a bit down in January. The “January blues” are a real thing. Maybe this time of year is depressing for people and even more so for those with bipolar disorder. But I don’t believe that fully explains my mood. When I look back over my blog, I can see that my mood has been low since before Christmas. Depression differs from the “blues” in severity and duration. However, it does seem to be worse in the winter months, a feature that is well described. 

A few weeks ago, when at my lowest, I contacted my psychiatrist and we agreed a tweak in my medication. It’s taken a few weeks to take effect but I am noticing a difference in the last few days. The days have been a bit brighter too and maybe that helps. I continue to see my therapist and that supports me through the tough times though it can be a difficult process. In my opinion, if you find psychotherapy easy, you’re not doing it right. 

I’ve also noticed that I feel better when I get up early in the morning. On days I have no work, I have a tendency to rest in bed until 11 a.m. or later. I get up feeling anxious and maudlin and it takes hours before I feel human again. My head is clearer when I rise earlier. It’s a small observation but a simple habit to start. I simply need to set an alarm. 

As I said, I’m feeling better the last few days. Hopefully it will continue to improve and soon I will be in a “normal” place where life is easier and fun. 

I have a lot to look forward to this year. In a fortnight my family will go skiing. It’s always an enjoyable holiday and I invariably find it invigorating.

Things always get better. I just need to hang in there. 

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Freedom.

“Your eyes are soft with sorrow
Hey, that’s no way to say goodbye”

“Hey, That’s No Way To Say Goodbye” – Leonard Cohen.

The fog has lifted again. Another bout of depression survived. It wasn’t so bad this time. Maybe six weeks. I’ve had much worse but I’m not complaining. I’ll take bearable any day.

I feel a new sense of freedom. Freedom to engage with the world again, freedom from isolation and the freedom that comes with clarity of thought. I’m free to live my life once more. It’s a welcome feeling and I am most grateful.

I don’t know what I did to get better this time but I know that I didn’t do it on my own. My wife’s continued support amazes me. She tolerates my moods with superhuman understanding and tolerance. I know it is frustrating for her. She has seen me in pain and admits that she doesn’t know what she can do to help. Mostly there is nothing she can do and sometimes I want her to do nothing. Sometimes, just being present is enough.

I was in contact, more than once, with my psychiatrist during this latest episode. We agreed changes to my medication twice. I know that helped but it doesn’t explain everything that led to my improvement.

I’ve been meeting with my psychotherapist weekly recently. The sessions are hard. There is usually tears and grappling with the pain that sits deep in my stomach. It is a physical pain born of emotion and hard to soothe. But usually after these sessions I get some relief, a softening of the knot, an easing of the anguish. It allows me to continue a little longer.

Going to the gym to force myself to get a little exercise was difficult but always followed by a sense of achievement. I went only once or twice a week but I think it was important in my recovery. I am thankful to my personal trainer for his patience in recent weeks. He provided me a much needed distraction from the misery I was experiencing.

But I think that the most important ingredient in my recovery was the simple passage of time. All of the influences I have mentioned played a part but ultimately my bouts of depression are self-limiting. I’m lucky, the worm always turns. If I was granted one wish it would be to travel back in time and remind my suffering self to “Hang in there! It always gets better.” Maybe I should write that on a Post-It and stick it to my bathroom mirror. It is definitely the take-home message of this post.

I was saddened to hear of the passing of Leonard Cohen this week. I have been listening to his music since college and regret that I never saw him live. I have always found consolation in his music particularly at times when I was depressed. His melancholy arrangements have touched me and soothed. I don’t know whether I listen to Leonard Cohen because I am depressed or whether it depresses me further. I believe it is the former. Cohen spoke openly of his struggle with depression in his life and maybe I sense an understanding of my plight in his voice. He has been more than a singer to me, he has been my companion on a difficult journey. I hope he is at rest.

It’s a time to be happy, a time to be content. I have the energy to celebrate my family, my friends and my life. It is a passing phase I know but all the sweeter for that.

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Disturbed. 

I’m tired. I’m tired of struggling. I’m tired of wishing life was easier. I’m tired of putting on a brave face.

In the last two weeks my mood has changed again. I’m feeling low yet irritable, agitated and frustrated at the same time. I think I’m in a mixed state. That horrible combination of feeling depressed with concomitant symptoms of hypomania.

I spoke with my psychiatrist during the week and we’ve tweaked my medication. I’m aware of a measurable improvement even after a few days but it will take a few weeks for the full effects. Inevitably, I may start to feel a more pure form of depression. Hopefully, the landing will be gentle. Time will tell.

I feel robbed. I had been doing so well. Since August I have been enthusiastic and energetic. Two months of enjoying life. I was getting used to it. I know that Bipolar Disorder is cyclical in nature but I thought I deserved a longer break. My family deserve a longer break.

I’m trying to keep it together. I’ve been off work this week but in some ways that’s a disadvantage. The distraction of activity can be therapeutic, I find. I’ve arranged to meet my therapist more frequently for a while. The sessions are more difficult when I’m low but they bring relief.

I’ve been trying to exercise in the gym. A few weeks ago my wife suggested that I sign up with a Personal Trainer. It was a good idea. Even when I don’t feel up to it, a fixed appointment motivates me to train when I wouldn’t bother if left to my own devices.

So I’m trying to support myself as best I can. It’s not so bad, I can still function. Everything just requires more effort, more energy and the rewards are smaller. Thankfully my sleep is still pretty good and hopefully it will stay that way. Sleep patterns are my best indicator of a mood swing gone out of control.

As mentioned, when mixed I get irritable. I get angry and, if left unchecked, I get destructive. I’ve put much effort over the years in psychotherapy learning how to deal with anger. I’m still working on it but I can control it better than I used to do. I try to analyse the source and have found that mostly I am angry with myself. At something I am feeling, something I have said or done or of something I’m afraid. By understanding that most of my anger is self-directed, I can channel it and consider what I really want to happen and aim for that instead. It usually works but not always. I frequently need to apologise and mend bridges. Anger in Bipolar Disorder is well described but irrespective of the cause, I am still responsible for it and for taming it. It’s a work in progress.

I listen to a lot of music when I’m not feeling well. I find it soothing. Sometimes I find it emotional and a tune or vocals can touch a raw nerve. It can raise the hairs at the back of my neck. It can move me to tears.

I recently heard a version of “The Sound of Silence” by the band “Disturbed” as played on the Conan Show. You can listen to it here if you are so inclined. It touched me deeply. Somehow it brought me comfort. Someone knows how it feels. Something in the singers voice reminded me of the anguish of depression. The pain that is rarely talked about. Though I think that’s changing and people are less afraid to speak out.

Next week is “Mental Health Week”. Hopefully it will do some good. The key message is that it’s ok not to be ok. Talking helps.

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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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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.