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Self-Compassion.

i’ve been well. I’ve been well for a long time now and I’m getting used to it. I’ve been working longer hours lately and I find that my mood is low at the end of a punishing week. I feel drained and i want to withdraw from the world. But this is not depression. It’s simply fatigue and everybody suffers from it. The cure is easy; rest and recharge the batteries. And once I’ve rested, I begin to feel more alive. Like I say, I’ve been well.

The challenge then is to maintain that sense of well-being. I’ve listed previously the various methods I use to stabilise my mental health. I don’t want to bore you with them again but I do want to mention something that I realised recently. To hold on to this feeling of wellness I must develop a sense of self-compassion.

As a Buddhist, I am encouraged to meditate every day. I don’t achieve anywhere near this but I do my best. One of the practices is called the Metta Bhavana which means “The development of loving kindness”. It’s a really lovely idea and during the meditation there are five stages. In the first stage you generate loving kindness for yourself, then for a good friend in stage two, a person neutral to you in stage three and for stage four you must think kindly of a difficult person. In the fifth stage you develop kindness for all four individuals equally and expand to include all people you care about and ultimately all living beings.

I have been meditating in this way for nearly two years and I have noticed an interesting benefit only recently. When I began, I found it very difficult to practice stage one and generate loving kindness towards myself. Part of the meditation involves repeating the following phrases to yourself: may I be well, may I be happy, may I be free from suffering, may I grow and develop. I felt very uncomfortable reciting this to myself. What right did I have to be happy? Why should I be well and free of suffering? I didn’t feel worthy. In essence, I didn’t really like myself.

And this lack of self-esteem infected other areas of my life. I didn’t feel worthy of my wife. I never felt good enough for her. I thought of myself as a burden and I carry a great weight of guilt over the many difficulties I have visited upon her and my family.

But in recent months this has changed. The first stage of the Metta Bhavana sits more easily on my shoulders now. I can meditate in comfort. I have learned self-compassion and I am beginning to value myself. There is a small flame of self-love burning within and I am coaxing it to grow all the time.

Not so long ago I was at a dinner dance with my wife. She looked truly beautiful and we had a great night. We even got the chance to dance together and that was a bonus. I met many of her friends and enjoyed their company. I am very fond of a few of them and it was lovely to see them. When I woke the next, as I reflected on the evening, it dawned on me that not only am I fond of them but they are fond of me too. They like me too. It was quite a revelation.

So if you are reading this and you suffer from mental illness, go easy on yourself. You are worthy of more than you believe. You are not a burden. You are loved by others and you deserve to love yourself. It is very hard to maintain stability without self-compassion. Take it from someone who has only learned the lesson recently.

I’ve always loved my wife. Only now do I know that I deserve her and she deserves me. We are a unit and we couldn’t have come to this point in life without each other. Undoubtedly, there are times when she carries me but sometimes, just sometimes, I carry her too.

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Family.

I drove to Limerick yesterday afternoon. There was a celebration for my uncle’s sixtieth birthday in my aunt’s house and I decided to go along. I’m glad I did.

My uncle is a barber. I spent most of my teenage Saturday’s working with him. I washed customer’s hair and kept the salon tidy. It was fun. My uncle played a very important part in my formative years. He was funny but wise and occasionally very sensitive. He supported me at times when I was having a tough time. He listened to me and gave me a shoulder to cry on. He had a great love of music and gave me some of my first albums. I always admired him and it was good to see him yesterday.

In addition I got to meet up with family members I haven’t seen in years. My aunts, cousins, partners, friends and some of my immediate family arrived. It was lovely to see them all. Some of them asked me how I was doing and they were genuinely concerned for me. They know I have had difficult times but there was no pity. Just a kindly support.

I had forgotten but I am the eldest grandchild in the family and I posed for photographs with the youngest. The atmosphere was festive and unfortunately I had to leave early. I had decided to be home in Dublin for midnight. The traffic was light and the drive was easy.

I spent quite a bit of time chatting about a recent cruise to Norway, our family  summer holiday. It was so relaxing, pain-free. The fjords of Norway are spectacular. We spent twelve days being treated to scenery that was breathtaking. I began to take it for granted in the end. We visited beautiful glaciers and strolled in picturesque cities and towns. We fully recharged the batteries.

In my last post before we went on holidays I told you that my mood had turned for the worst and my medication had been changed. I think that this in combination with the holiday has done me the world of good. Life has been without stress and excepting a few bad days, my mood has been better.

In recent months I have been frequenting the Dublin Buddhist Centre. I’m a regular feature at weekly open night meetings and I now consider myself to be a Buddhist. Not only do I find the meditation practise helpful but it has added structure to my life. An added bonus is that I have made new friends and a few of whom I am very fond. Every little bit of support helps.

Today, I am feeling very grateful. I am grateful for my friends but especially today for my family. We all take our family for granted and I am no different. But when it comes to the crunch they will be there for me when all else have turned away. And I will be there for them. It is important to have family when you are in trouble but it was even better to celebrate with them when things are good. The balance is important.

I’m in good form today and life is good. I’ll take that and try to hold on to it. I’ll deal with tomorrow when it comes. Right now, I know I’ll be okay. Actually, it’s more than that…I am okay. Best wishes for now.

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Reminiscing.

As the year draws to a close and a new one begins, I find myself reflecting on the past and aspiring to the future. My mood has been flat in recent weeks, tending towards depression but thankfully not quite reaching it. I have had a good Christmas but my thoughts are inclined to be negative and I am conscious of this as I write. It is an effort to be balanced.

This year saw me and my family face many challenges. I had two separate, though related, hospital admissions and for this reason, 2016 would seem to be worth forgetting. I was depressed for much of the year but found time to fit in a manic episode as well. I sunk so low that I was ready to throw in the towel. But I’m still here, I survived.

It may sound paradoxical but I am grateful for my health. I know I suffer from bipolar disorder but this is an old foe and I am familiar with the rules of engagement. I’m glad I don’t have any new illness like diabetes , heart disease or cancer. There is a long list of conditions I would consider worse than bipolar disorder. Even more, I am glad that my family are well and in particular, my sons have not shown any signs of mental disturbance. For that I am truly grateful. It is a source of some concern.

My wife is still with me and if anything our relationship is stronger than ever. That is both a small miracle and evidence of the existence of guardian angels. Over the years I have given her ample reason to leave me and yet she remains. Her love and compassion are unerring and sometimes the only things that keep me going. I would be nothing without her.

The year at work has been fairly straightforward. A few patients gave me cause for worry but in the main my days were routine and mundane. I have learned to value the routine days as I become more experienced. As an anaesthetist, I used to relish excitement in my younger days. Now I avoid it like the plague. Thankfully I was in a position to take time off work when unwell and return to it after recuperating. Not everybody with mental illness is so fortunate.

I had some lovely holidays with my family this year. We were skiing and we spent a lovely time in Spain. The memories will serve to support me when things feel hard. I have recently spent time with my family over Christmas and spent a few days with my wife’s family just afterwards. I wasn’t in the best form but nobody asked me to be. I still managed to function and be involved and I had a lovely time. I’m happy that people can accept me just the way I am. I don’t have to act. I can just be.

This is the first year that I have kept a blog. I have been humbled by the number of views that my posts have generated and by the attached messages and comments. It is hard to believe that so many people are in my corner and care about my welfare. Your support means more that you know. I count you all among my friends and wish you a happy and peaceful New Year.

Finally, I started writing this blog in the hope that it might help someone struggling with bipolar disorder. Now I know that it already has. When times get tough, I can read back on these pages to remind me that things always get better. If it helps no one else, at least it helps me and thank you all for joining me on this adventure.

2017 is full of promise. It promises less depression, less hypomania and the enduring love of my family and friends. It promises to give me at least one of my three wishes. After that we’ll just have to wait and see…..I’ll keep you posted.

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Flawed intentions. 

It was “Suicide Awareness Week” earlier this month and it has prompted me to describe my experiences today. I don’t like discussing suicide. I think it to be the most negative manifestation of Bipolar Disorder and other psychiatric illnesses. I thought long and hard about whether I wanted to publicly admit that I had tried. I am very ashamed of my attempts.

But maybe writing this will allow me to organise my thoughts. Maybe someone will relate to my description and find in it some small element of support. I write only of my struggle and my opinions. I don’t pretend to understand everybody’s journey.

I’ve tried to kill myself a number of times in the last decade. Some attempts were more likely to succeed than others but in each case the intention was clear – I wanted to die. Equally obvious in every case was that I was very unwell.

Mostly I was very depressed, when I tried, but I can remember one occasion when I was in a mixed state. For me, mixed state can be almost as destructive as pure depression.

There is no logic to the thoughts that precede a suicide attempt. Invariably I have been very low and sought a way to escape that pain. It is difficult to accurately describe the agony of despair, hopelessness and crippling loneliness that I feel sometimes.

But this isn’t the main goal of wanting to die. I would persuade myself that I was a burden to my family. They, and the world, would be better off without me. So there was both selfish and altruistic motives to my plan.

These ideas are flawed. Suicidal ideation has always arisen at time of distorted reasoning, at times of poorly controlled mood swings, at times of crisis. My poor judgement has frequently been further distorted by alcohol. I drink when severely depressed, looking for a solution but finding only a reinforcement that my life is worthless. It’s simple, I can’t drink alcohol.

In recent months I took an overdose of my prescription medication. I hoped I would peacefully fall asleep and slip away. I had a romantic notion that my wife would hold my hand and reassure me, that my children would say goodbye and I would find serenity.

There is nothing serene or romantic about suicide. My family were in the house when I overdosed. When they found me and saw what I had done, there was fear, panic and anger. The sense of betrayal was palpable.

Thankfully, I didn’t take enough tablets to succeed but I became violently ill. I suffered profound side effects and ended up in the A&E of a general hospital. What I remember most about that night is of being very afraid. This wasn’t how it was meant to be. This wasn’t a solution. I had only made things worse.

In any event, I survived and ended up once more in a Psychiatric Hospital. The rest is history.

Some people who survive a suicide attempt get a semicolon tattoo as a reminder of their experience. I bought myself a gold signet ring. It is engraved, behind the band, with “30th March 2016, the date of World Bipolar Day. It reminds me that I have survived. It reminds me that I have come through the storm. It reminds me to be grateful.

Every time I look at that ring I think of all the good things in my life and of the blessings that are yet to come. I want to grow old with my wife, see my children graduate and get married. I hope I will get to play with my grandchildren. It is easy to be grateful at the moment, I’m feeling well. The real test will be when I’m hypomanic or depressed. Will the ring on my hand remind me, perhaps convince me, that it always gets better?

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We are told that little things make a difference to our mental health. I sometimes think of a Snoopy cartoon where he suggests to Charlie Brown to focus on living instead of worrying about dying. In my version, Charlie Brown says “One day I tried to commit suicide and nearly lost everything” and Snoopy replies “Yes, but on all the others, you didn’t”

Somebody once told me that everyone has the right to decide to commit suicide but it is always the wrong decision. I’m in agreement. Lets hope I agree in future.

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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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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!

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Hospital.

“Let me go,

I don’t wanna be your hero,

I don’t wanna be a big man,

Just wanna fight like everyone else.”

“Hero” – Family of the Year.

—

I’m back in hospital. Incarcerated. Again.

It’s about three years since I was here last. Things haven’t changed much. The ward is the same, the nurses are the same, unfortunately, some of the patients are the same. It’s a grim reminder that the entrance has a revolving door. I never escape for too long before I return. I invariably violate my parole.

It’s hard to accept these new conditions. The lack of freedom, the admission of defeat, the sense of failure. I have been fighting a long time now and I am out of energy. I’m scheduled for a twelve round fight and it’s only the top of the tenth. My legs are like jelly and my vision is blurred. I can’t wait for the sound of the bell.

Acceptance is the key. I haven’t reached it yet, but it life is much easier once you grasp it. I know this from previous admissions. Coming to hospital is a necessary evil. It’s recognition that I am in trouble, that the fight is going on too long, that energy is low. It is submission but not surrender. It’s giving permission to allow support and help to come from the corner. It’s giving your body, mind and soul a break.

Recharging the soul takes time. It isn’t easy. There needs be tears and pain along the way. But it’s worthwhile. To finish the last two rounds might require a steroid injection but you get the chance to win the fight. There will always be another one, there are plenty of powerful contenders for the title. But, if you fight clever, dodge the blows and defend when needed, you just might keep the belt.

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Anxiety.

One morning during the week, I sent my wife a text – “I feel anxious”. Simple, but describing exactly what was most important for me in that moment. She replied that she would call me in a while. That’s all I needed. Something to keep me going. The knowledge that I was not alone. The ensuing conversation eased my nerves and I continued with my day, albeit a little subdued.

Anxiety and depression go hand in hand. If you live with bipolar disorder you will be no stranger to this combination. Occasionally I feel anxious in isolation but typically it coexists with depression. I’m not saying that I am crippled by anxiety all day long for weeks on end. It is usually worst in the morning and I have learned to cope with it. I can function and do what needs to be done that day. But, I am always conscious of it. I’m aware of it lurking in the background. It is very uncomfortable and always unwelcome.

I believe that anxiety is the physical manifestation of fear. The tension in the stomach, tightness in the chest and trembling hands are but the external signs of fear. Fear is at the root. Some of the medication I take serves to alleviate the symptoms but do nothing to treat the cause. The source is deeper.

I came to know fear at an early age. I was predestined to be afraid. Both my parents were afraid all their lives. Their fear leaked out and diffused throughout my home and touched every member of my family. I encountered fear away from home too. I never quite fit in with my friends. I was cautious and timid. I was ridiculed frequently and made to feel different. In school, I was bullied. It went on for years and was to have a profound effect on me.

I was academically bright and the expectation was always that I would do well in exams. A natural progression was “Fear of Failure”, a fear that persists today. In childhood, I taught myself a damning delusion. I determined that if I was good all the time, if I did everything right, if I was “Perfect”, then only good things would happen. But how does that make me feel if bad things happen? Does that make me bad or evil?

Catastrophising and paranoia are extensions of anxiety. Fear that something terrible is going to happen. When I’m depressed, I can become really upset that a dreadful accident is going to befall one of my family. A recurrent theme is that my wife will leave me or has found another man that she prefers to be with. These delusional thoughts can be very powerful and equally destructive. They only deepen my depression and put a strain on my relationship with my wife. Paranoia can be perceived as lack of trust.

Fear is essential to survival. It allows me to recognise danger and react appropriately. My work as an Anaesthetist is mostly repetitive and mundane. But during rare episodes of emergency, I am able to ignore my fear, think clearly and proceed in the best interests of my patient. This ability to disregard fear, and control any sense of panic, comes with long years of training and clinical experience. However, I believe that my familiarity with fear and anxiety, over the years, augments my capacity to react in these situations.

I experience fear a great deal. Mostly I suppress it, cope with it but I’ve done very little to resolve it. I cope in different ways. One response is anger. Anger is energetic and can be a tool to overcome fear. It works for a while but, when persistent, in my experience, it becomes destructive. Meditation helps and likewise exercise. Sometimes, all I need is to hold hands with my wife, have a hug.

Fear is deep within my soul. I fight my demons every day. Guilt, shame, loneliness, anger and fear engage in frequent battle. Mostly I win but occasionally I lose. The war has been ongoing most of my life and suppression is a poor weapon. There is a better way. Meet the enemy, attack the fear, in the citadel where it lives and derives it’s power. I must go to the source. But, I know that is easier said than done.

I just want to call a ceasefire to hostilities. I want a little peace.

 

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Music

IMG_0545I was at a Classical Guitar recital last evening with my wife. The guitarist was talented, the venue was small and intimate and the atmosphere was warm. I sat with my arm draped over my wife’s shoulders, hand in hand, and became lost in the music. It was fabulous.

I love music. Some people love books or theatre, others movies. But I really love music. That’s not to say that I don’t read or go to movies. I do. I like to read fantasy by J.R.R. Tolkien or Terry Pratchett. My favourite actor is Al Pacino and I can think of many great movies and actors. I don’t go to the theatre too often but when i do, I invariably enjoy myself.

But nothing compares to music. I can’t imagine life without it. I am deaf on one side for a long time and it would be the cruellest blow to lose hearing on the opposite side. So I try to mind it. Music speaks to my heart and touches my soul.

My Bipolar influences both the music I listen to and how it affects me. My choice of artist sometimes reflects the mood I’m in but it may also have a healing effect, if that’s what I need. I don’t just listen to music, I study it, dissect it and look for meaning in the words, tempo and rhythm. My favourite instrument is the guitar but a good bass line can really get into your bones. Mostly I try to absorb it and feel it move me.

My taste is fairly mainstream and I’m not going to bore you with a list. But, I will mention a few artists that have had a profound effect on me over the years. I listened to Leonard Cohen when I was in college. When I was down, he cheered me up. I felt that he understood. I wasn’t alone. When I needed to relax or found it hard to sleep, I played Enya. When I was high, I liked Mark Knopfler, Eric Clapton and David Bowie. When I was balanced, euthymic, I loved it all.

I’m reading a book at the moment, “Touched with Fire” by Kay Redfield Jamison. She investigates the relationship between Bipolar Disorder and creativity in some of the greatest authors, artists and poets. There may be a link but I haven’t finished reading it yet so I will have to get back to you. I don’t think I am particularly creative but I do have a good imagination. I think when you survive the peaks and troughs of Bipolar Disorder you gain a different perspective. I think that maybe you feel things differently and maybe a little more deeply than many other people do.

I feel music deeply and it helps me to survive. It helps to recharge my soul when it’s running low on energy. It allows me to connect with my emotions and sometimes I cry but mostly I smile. Music always makes me feel alive. And just occasionally, it gives me an excuse to dance with my wife. That’s when music is at it’s very best.