Tag: Euthymic

I haven’t posted for a few months. I’ve been busy. I also had a technical issue with the site that I have only just resolved. So I’ve been off the grid for a while.

Things have been good. Christmas was spent in the happy company of family and friends and passed without incident. I was a little bit high which is not unusual for that time of the year but it was very manageable. Being aware of it was half the battle. My medications were increased slightly and it all settled down quickly and I’m back on an even keel again. I feel good, I feel content and it has been a good start to the new year.

This time of year always causes me to reflect on my blessings. A degree of gratitude helps sustain me and face the difficult times ahead. Chief among assets is my family. Thankfully they are all well, happy and dealing with the vicissitudes of life. They bring me constant joy and are an unerring source of support. We live in a lovely home and we have no financial worries. As a bonus, I have a job that I enjoy.

And that is what is on my mind today. I read somewhere that 50% of people with a psychiatric illness are unemployed. It seemed like a very high figure to me. And what are the reasons for it?

Undoubtedly, some individuals with mental illness are so severely affected that they are not able to work. That is a sobering reality and it saddens me to think of someone who suffers that much. Some people must face discrimination because of their illness but I like to think that this is becoming less frequent. And I have to feel that some people just don’t have the necessary support.

It got me to wondering about my own employment history. My first episode of mania was as an Intern at the age of twenty four. I became convinced that the IRA were sending me coded messages over the radio. I was very unwell and ended up in a psychiatric ward. After that episode I was off work for nearly a year and was advised to “go to England” to continue my career. This was my first experience of stigma and so much would be different if I heeded the advice.

But I stuck to my guns and eventually restarted my career in an Irish hospital. In 1998 I began training in Anaesthesia and I’m still a practicing Anaesthetist today. My working life has been punctuated by periods of ill health since then but I have always managed to resume employment once well again.

Why is that the case when so many others are unemployed?

Is my bipolar disorder not as severe as the next patients? Well, I would question that. I’ve had my moments. But thankfully I have had extended periods of stability and doubtless that is a factor.

But more important, in my estimation, is the level of support I have had over the years that made all the difference. My wife, who is immensely strong, has been by my side all the way. I have a wonderful relationship with my psychiatrist without whom I would still be struggling. Years of psychotherapy played a part (I recently parted company with my therapist by mutual agreement and I’m doing fine without the extra help he gave me). The surgeons I work with were patient when I was absent and the hospital gave me the space I needed to heal. It is the blessing of all this support that I think about and for which I am grateful.

So I think it is a combination of things that keeps me working. But it is the love of my family and friends that makes the biggest difference.

Of course you need something else. You need to be resilient. You have to get back up when you’ve been knocked down. Sometimes I have a cry and then I try again. It gets better with time. Sometimes you need a sense of humour. Sometimes you need to be able to say…….fuck ’em if they can’t take a joke!

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.

“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.

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.

 

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. 

“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!

“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.