Hearing voices

I have heard voices for a long time, probably as long as I can remember. At age 2 or 3 I had my first imaginary friend, as I grew older I developed more characters who became part of an ever growing colourful inner world. For the longest time my voices where mostly just that, “imaginary” usually secret friends who spoke (inside my head) as opposed to auditory hallucinations that appear to come from an external source, external voices did happen but not frequently. In the past year the pendulum has swung and external voices have become part of my norm.

My imaginary friends where like extensions of my own personality, they were useful and kind to me (most of the time) and often I would become one of my imaginary friends when I had a stressful situation to deal with. They could just pop out, take control of whatever was happening and deal with life for me. Perhaps this started out as play pretend (I can’t remember) but as they developed and I interacted with them, they became more and more real. I now have this vibrant world in my head that I can indulge in for hours. There is always dialogue and voices as each of these friends converse with each other and me. I am much a part of this imaginary world as they are, and they are as much a part of the real world as I am. I know longer know where I end and they begin, or if there is a distinction between them and me anymore. They are part of me and I am real, therefore they are also real.

I have seen therapists about this “problem”, although it no longer is a problem for me. One therapist after talking to me for some time believed that I fit the criteria for multiple personality another thought Schizo was a more suitable label and I’ve had another doctor tell me that I just have very strong ego states and a creative imagination. I left therapy after a while because I realised that I didn’t want to “get rid” of my friends. I developed ways of coping with some of the problems they could bring, mainly memory lapses when one took over and I fell back and more importantly I learned to embrace them and stop seeing myself as a freak. I limited the time I spent indulging in conversations with them, and the ones that had destructive or negative tendencies started to relax more as I worked through their issues as if they where my own, and at the end of the day their issues are my issues.

In my teens I heard my first “outside voices” auditory hallucinations that do appear to come from an external source. I also had my first high/mania, and acted recklessly. The outside voices where always fleeting, lasting only a few days, or weeks and so it was easy to forget about them and get on with my life once they left. My mood has never been stable, always up or down and I was diagnosed with Bipolar and put on Lithium. It was hoped that this would calm things down. Unfortunately my last bout of Mania was bad, I lost my grip on reality and the voices came back. When Manic they were little angels who were talking to me and telling me that Rick was the Buddha. I started to believe this was true and I started to believe that if I hurt myself he could heal me. Not fun for Rick but thankfully I didn’t do anything too drastic because I had a lot of support from a home treatment team and from friends, family and Rick. The cocktail of meds eventually settled things down and my mood started to drop. The voices didn’t go away this time but because I had switched from mania to depression I thought that when my mood was eventually stable they would go away again.

This has not been the case, in-fact they started to get worse. Nowadays I have a real appreciation for people who have to cope with this day in day out because it’s not fun. The external voices are nothing like the voices that come from my internal world in-fact most of the time my outside voices are not friendly. There is a man and a woman and they talk back and forth about me, sometimes stating my thoughts out loud which feels intrusive and embarrassing due to the fact that my perception picks up the voices from somewhere external and therefore it feels like everyone else can hear them too. Sometimes they talk about my appearance or comment on what I am doing. They have many thoughts and ideas but mostly they tell me that other people are trying to hurt me. They have come up with all sorts of extra ordinary beliefs, that there are cameras watching me, someone is trying to poison me, people are out to cause me a lot of harm... It feels as though my ears are picking up sound from somewhere to the left side of the room as if a radio or speaker has been left on. They follow me everywhere and the result is I can’t work or do my job without feeling paranoid that bad things are happening in my workplace. I can’t relax at all and if someone even hints at being annoyed at me the voices jump on that and push it to the extreme. I’ve finally had to take some more leave from work to give myself a chance to overcome this.

My psychiatrist no longer thinks that I have Bipolar, the manias, depressions along with my vivid inner world (inside voices), socialising problems, outside voices and delusions that are not mood congruent have made her diagnose me as Schizoaffective.

http://www.mind.org.uk/help/diagnoses_and_conditions/schizoaffective_disorder

That label scared me a lot, more than any I’ve been given before. There is something about being told that I’m Schizo that makes me feel like my mind is fundamentally flawed. Yet at the same time it is a relief to finally have a psychiatrist who I trust, who I am willing and able to work with long term and who claims to have a clue about what is going on. I’ve switched psychiatrists so many times I can count 6 in total and this is not because I am fussy, the psychiatrists I got through the NHS in the past just never stuck about in the same place very long and so the consequence is I’ve been given many different labels and meds.

My current doctor and CPN are amazing, they have really taken the time to get to know me and my history and are hopefully going to stick around long enough to get me stable. I started a new anti-psychotic (Risperidol), to take along with the lithium and Amytriptaline and so far it seems to be having some effect. I feel calmer, and the voices are less frequent, I am hopeful that I will be able to cope better.

Currently I seriously have to re-evaluate my life. Can I continue working? In my current state, not really. What that would mean for us financially if I don’t get better will be catastrophic and so I am really keeping hope that this will be controllable and these outside voices will go away. At the moment I’m learning to distract myself by blocking my left ear, blasting my ears with music and keeping busy so I’m not focusing on the voices negative remarks. I popped into a hearing voices group last week to get some advice about dealing with them until the meds work. At the moment I want to stay confident that they will work and this isn’t something that will be permanent. Distraction techniques are working to an extent, when I’m at home it is possible to block them out but it is impossible to do anything meaningful or keep concentration. Reading, meditation, and studying are all nearly impossible and my relationships with other people are suffering more than usual. This past year I’ve felt completely isolated from everyone, it feels like I am on a different planet and if I talk about what’s going on in my mind people look horrified. It seems that it is not socially acceptable to talk about hearing voices. I know statistics say that many people are voice hearers but where are they? I am guessing they are either keeping very quiet, or are on the outskirts of society and I haven’t come across them yet.

So just in case anyone is reading this blog who experiences voices I thought I would end with some useful links,

Hearing voices in your head is so common that it is normal, psychologists believe.

http://news.bbc.co.uk/1/hi/health/5346930.stm

Hearing Voices Movement is a philosophical trend in how people who hear voices are viewed

http://en.wikipedia.org/wiki/Hearing_Voices_Movement.

Reputation

“A great deal of suffering arises because we are conflicted about reputation. Instead of being concerned about the reality of what we are, we’re concerned about what other people think of us. We’re too outward looking.” Lama Yeshe

I thought I’d write a blog about reputation because recently it’s been a concern for me and at least a few of the people I know. It made me think about why this is an issue at all. Why do I care so much about what other people think of me and does it do me any good to cultivate a good reputation?

I am not what one would regard as popular. Although I do have people who like me and who I get on with and I am blessed with a few incredible close friends who know me well enough to see past my social difficulties, it is unfortunate that in most social groups I am never someone people feel warm too. There are numerous reasons for this, principally that I make lots of childish mistakes when interacting with people. I say and do the wrong thing, I have in the past reacted to stuff in a way that’s too fanatical and I’m just not blessed with the social ease that some people have. I never learned what parts of my life I should keep quiet and which parts I should be open about, so I’m usually open about everything and I am starting to learn that apparently this is not the best way to win allies. When it comes to my opinion it has stumbled out of my mouth far too quickly and I usually manage to offend people and put them off within a couple of months of meeting. (I’m working on this) I want to learn to interact with others in a more positive and meaningful way, but I also want to let go of any feelings I have about my reputation.

Despite what it might look like I do care what people think, I would like to be liked or feel wanted in a group and even if it seems like I’m acting in a way that puts people off its never my intention.

My reputation is usually not great, I’ve ether slept with 2 many boys, I’m too mentally ill, or in engaged in some sort of social taboo such as polyamory that make’s people think on the whole I’m a bit of a freak. Recently someone even took the trouble to write to me and tell me I’m a mess and should be locked up. It bothers me that my reputation is usually bad and yet why? Regardless of what my reputation is my character always remains the same. So when someone says something that is true about me, then it was true anyway and if someone says something that is untrue then it remains untrue. I don’t suddenly become an inferior or superior person because of what others believe. What I am remains the same regardless of anyone’s opinion. I know I have some issues I need to work on, but I also know that I have some good qualities that I am trying to develop.

I’m starting to understand that it’s a dangerous game valuing oneself exclusively on reputation. Believe me I have tried and in my situation it just left me depressed and with little or no self esteem. However I also realise that the reverse is true, that if I happened to be well liked then simply believing that I am a good person because other people seem friendly towards me, regardless of my mind or motives is just as destructive. Reputation is an idealistic way of fooling ourselves. When I contemplate this in more depth I recognise that if I built my self esteem around my reputation, good or bad, my entire view of myself would have no basis at all in reality and that would mean that I would be completely unable to make progress spiritually as a person, or a Buddhist. If I believe that everyone likes me therefore I must be good then why would I look in any more depth at my actions and motives? Other people’s opinions are forever changing depending on the situation, how they feel at the time, even just having a bad day can make someone feel less fondness for others, so opinions are empty of permanence and therefore unreliable.

This contemplating started with some negative comments on this blog. It managed to agitate my mind for a day and then I read the quote at the top of this page by Lama Yeshe and I grasped how absolutely pointless it was for me to feel anything at all about the comment be it good or bad it did not change one thing about me. It inferred something that wasn’t true but the anonymous person stating this made no difference at all to the reality of who I am or what is the truth. The comment did not suddenly become true just because it had been written or said and it did not become true because one person believed it to be so. Their continuing to think negatively about me did not have to disturb my mind at all in-fact taking the effort to write the cruel comment had done more harm to their mind than it could ever do to mine.

Loosening my interest in what other people think of me seems to have some very good advantages. It stops me focussing needless energy into acting in ways that will please people for the sake of it and means that I will be more genuine in my interactions with others. It means my actions stop being all about me. Instead of thinking about me, my reputation and what other people think about me, I can turn my attention to things that actually matter.

I’ve decided that rather than try and make other people like me, I will try and cherish them. I want to find a way to appreciate others regardless of how they appear to me, even those people who might harm me. So the person who wrote that comment whoever they might be I want to feel fondness for them, and appreciate their situation rather than waste my energy focusing on irritation or hatred. Perhaps I have done them some harm and they are angry at me, or perhaps they truly believe that what they wrote was true and felt that they were doing some good in informing me what they thought about me. They could have been trying to do me a kindness to change me for the better.I'll never know but it does me no good to believe I have been got at for no reason.

"We ordinary individuals share the characteristic of having our attempts to gain happiness thwarted by our own destructive self-centeredness. It is unsuitable to keep holding onto the self-centered attitude while ignoring others.
If two friends find themselves floundering in a muddy swamp they should not ridicule each other, but combine their energies to get out. Both ourselves and others are in the same position of wanting happiness and not wanting suffering, but we are entangled in a web of ignorance that prevents us from achieving those goals. Far from regarding it as an "every man for himself" situation, we should meditate upon the equality of self and others and the need to be helpful to other beings." Ven. Lobsang Gyatso

Everyone has their story and everyone is searching for the same thing, to be happy, and even if they are engaging in a harmful action it’s almost always because they believe what they are doing is right and can make them happy. I’ve been in this situation myself many times, doing something I have later learned was destructive because at the time I genuinely believed that what I was doing was correct and just. I’ve put my own happiness above others on countless occasions (usually without even being aware of what I’m doing) so I can understand how easy it is to fall into this trap. We all do it without even thinking twice about it because in our head we are usually looking to meet our own needs and we aren’t thinking about other people. This understanding makes it easier for me to feel sympathy for those people I see doing harmful actions, they are just increasing there own suffering in the long run. Fundamentally deep down everyone has some goodness, I want to appreciate this inner quality in everyone rather than focus on their delusions or bad qualities.

The only way to do this is to stop worrying about my own reputation, because if I am worrying about this then all my actions become about me and my mistaken belief that my value changes because of other people’s fleeting opinions. If I’m concerned about what other people say or believe about me then that opens the door for me to get angry and frustrated when I hear negative things said about me. It blocks me from cherishing others because if I am upset about my reputation and what people believe then it will be hard for me to cherish those same people. I need to accept that I have a certain social awkwardness due to my introverted personality and mental illness which unfortunately makes it a little harder for me to fit in, that does not have to make me obsess about what other people think and it doesn’t stop me from cherishing them.

Next I need to work on letting go in the same way when it comes to Rick, because currently I am more likely to get disturbed if someone says or does something negative about him than myself. I’m working on this.

sad

it appears some people don't understand that it is possible to have more than one health problem at the same time and in-fact some disorders can be connected. What's more saying mean things anonymously is in my opinion cowardly.

On a different note, I haven't had much to say via blogging of late because I am still recovering from the depressive side of Bipolar, after the mania there is for me always depression. That sets off some of the other issues as well and so its not been an easy time.

Fortunately I have great support in place and good friends and family around, Rick is as always amazing.

Jools

madness quotes and poetry

"but I don't want to go among mad people, Alice remarked.

'oh you can't help that' said the Cat. 'We're all mad here. I'm mad, You're mad.'

'How do you know I'm mad?' said Alice.

'You must be,' said the Cat. 'or you wouldn't have come here' "

Lewis Carrol

Like a Manic Cow

A distorted heap of schizoid mania,

the bedlam coiled in the corner

of the bedroom floor.

Breathing

wildly,

Like a manic cow.

Come down, come down, from this dastard high.

Seductive, sly, like a snake slithering

Little by little.

Just one more moment. Please!

Wretched hunger for more of this poignant drool

oozing out of minds liqurious pie

and dribbling like chronic diarrhea of the mouth.

Come listen to what has no meaning

give caution to my consciousness,

Be with me hard,

Against the bathroom wall.

I will fuck you're mind in ways you never imagined.

By Julianne Renne aka me :P

And some quotes on mental health since my last few blogs have been on the subject :)

“I felt like a race horse in a world without racetracks or a champion college footballer suddenly confronted by Wall Street and a business suit, his days of glory shrunk to a little gold cup on his mantel with a date engraved on it like a date on a tombstone.” Sylvia Plath "I shut my eyes and all the world drops dead; I lift my eyes and all is born again." Sylvia Plath "I'd rather be mad with the truth than sane with lies" An anonymous psychiatric patient and poet Magnus. by ~flesh-box When you open up my body, You're fingering my heart I'm waking up at night-fall And crawling darkened halls Just to escape you, Magnus, Just to be alone, I'm suffering just for you, And I'm doing it on my own. You lick my flaking lips, Magnus You tickle my torn-up tongue, You've got me in your grip, Magnus I cannot resist anymore. When you open up my body, You linger in my veins, I love you like a lover And yet I hate you more each day because You cut me to the bone, Magnus, You cut me to the bone... All those nights together, Magnus When I'm really on my own. http://flesh-box.deviantart.com/#/dsnuof

Bipolar

I feel like a fugitive from the law of averages. ~William H. Mauldin

What does it feel like to be manic, to slacken ones grip on reality and for a few days, weeks, or even months and erupt into an altered world from the rest of the human race. I’m not sure I can explain it in terms that people will understand, because I’m not sure I can explain it to myself using metaphors and words. It’s like the world around me has suddenly become so bright and stimulating my mind can’t keep up no matter how fast it races and yet the world is actually exactly the same and it’s my mind that’s been turned up a notch (or at least that’s what the doctors keep telling me).

I feel like I am rejoining the normal world. It’s a slow process... the meds don’t work instantly. I don’t just pop a pill and all of a sudden my brain starts to work conventionally again. In my opinion I’m not even sure that it was working wrong in the first place, there is a part of being manic that feels good, at least its not depression, which in my opinion is the nasty side of Bipolar. Who wouldn’t want to be europhic and feel like they have the strength to lead the world into the next spiritual and emotional revolution? Obviously it has its down side, being that everyone else was so terribly alarmed, but for me at least 50 percent of the time I was happy (the rest of the time I was either frantic, confused or anxious)... still the intense elation was (almost) worth it and I repeated “at least I wasn’t depressed”.

I’m starting to feel well again, because my agitation and anxiety have lessened to a more manageable level. My doctor told me a couple of days ago that he is pleased with my progress, he tells me I’m about 25 percent on my way to being well I was thinking more like 75 percent but I’ll take what I can get. I ran into someone I work with today when I was walking to my appointment in town and I swear she must have thought I looked perfectly happy and well. I felt the need to inform her that it wasn’t my choice to be off work so long but it’s hard to explain. Hypomania is wonderful, it’s like mania with only a fraction of the hassle, and I think many people with Bipolar want to stay hypo manic (to some degree). Unfortunately according to the psychiatrist it’s not good for you. I realise that there is a scale of mania, and I did not reach the top of that scale because I was able to have my rational moments, all the same it is scary to recognize in retrospect just how high I got without any self awareness of what was happening to me.

"the intensity, glory, and absolute assuredness if my mind's flight made it very difficult for me to believe once I was better, that the illness was one I should willingly give up....moods are such an essential part of the substance of life, of one's notion of oneself, that even psychotic extremes in mood and behaviour somehow can be seen as temporary, even understandable reactions to what life has dealt....even though the depressions that inevitably followed nearly cost me my life."
— Kay Redfield Jamison

So what is it like being manic, I think coming down I am in a good place to give a little insight into what actually happens because I can still remember, and to some extent I am still experiencing much of the symptoms just to a much lesser degree than before. For me (and I understand it can be manifest in different ways for different people) it started with a decrease in my natural need for sleep. This is not the type of insomnia one generally complains about because it feels like you don’t need sleep. You don’t feel tired and there are so many wonderful and colourful ideas speeding through your mind that sleep seems like an enormous waste of time. So I started to get up in the middle of the night, just thinking about all the things I wanted to do. I had ideas about opening my own shop, I had ideas about work and how I could improve things for everyone there, and I felt exceptionally productive and happy.

Slowly I started to feel like I had a small adrenaline rush going on most of the time. This wasn’t a bad feeling because it was the type of adrenaline that makes me perform better. A little nervous zeal is often a good thing when it comes to getting stuff done. It was the kind of excitement that I could compare to going on a rollercoaster, or the anticipation of waiting for something really fantastic to happen. My heart would race and I felt exhilarated. It started gradually until I was feeling “exhilarated” most of the time.

Around about this time the anxiety kicked in. So I started swinging from exhilaration, to extreme anxiety. Usually at home or at times I spent in areas of my life where I was free to do as I pleased I was exhilarated and at work and places where people where expecting things from me I was anxious. I also felt really irritated when people where asking me to do stuff, I felt like what was going on in my head was far more important than anything other people might want or need me to do and so I would snap at people and just feel really irritable. It felt like if I was left alone to do as I pleased the world was full of colour and potential, everything else was holding me back from doing something really profound and interesting. Note at this point I was feeling like the most important person in the world. For anyone reading this with any knowledge of Buddhism; I was “self grasping” on a whole new level, in-fact it was way past self grasping, I had a God complex. Unfortunately and ironically my Buddhist knowledge of self grasping was useless because I was becoming deluded at this point into believing that it was justified and thinking I may in-fact be the personification of God, or the very least his little helper. I would like to add that in my less manic mode of being I don’t actually believe in that kind of God, still nobody said I’d be rational J

It was around this time that I noticed something wasn’t right, predominantly the anxiety and irritation where bothering me and those where the symptoms I wanted treated. With the mania came lots of glorious and eccentric ideas, I wanted to be outside all the time (but when outside I felt paranoid that I was being watched), I wanted to talk to people and socialise but the anxiety and irritation made this difficult. I was also aware that some of my thoughts were a little strange. At this point I had the wherewithal not to share those thoughts with other people but they where building in the background. I realised that I couldn’t cope with work because I was close to panic much of the time I spent in an environment that had expectations of me. My impulse was to simply walk out the door most of the time and that impulse was becoming harder to control. I was feeling suspicious and mistrustful believing that people where out to get me and this was especially related to work. People at work where noticing something wasn’t right and that made the paranoia even worse, in the end after talking to my GP who immediately noticed I was manic, convinced me that time away from work was essential if I wanted to keep my job. (I don’t want to dwell too much on what went on at work for me during that time because I am hoping to go back and repair some of the damage in the future).

When the doctor mentioned possible mania it did make some sense because I have been manic before and after taking some time to reflect I noticed the feelings I was experiencing now where very similar to how I felt back then. Years ago after taking Prozac for the first time it pushed me into a manic episode, however because it was after taking Prozac that I experienced mania the doctors did not want to assume I had Bipolar because it is possible that I was just sensitive to this type of anti-depressant. I had other issues that where causing depression and anxiety and I was working at resolving those or at least learning to live with them. After stopping Prozac I quickly crashed to depression again and the episode of mania was soon forgotten.

I agreed to see someone more specialised in Bipolar to find out if this was Mania and if so to see if they could help me calm down. This is despite the fact that my experience at the Royal Edinburgh hospital in the past, (through depression/mania) was not a positive one, In-fact I was meant to be monitored after my last episode of mania to see if it did happen again but I had been so royally messed around that I had stopped attending appointments and forgotten all about it. I had little faith that the mental health profession could or would help me (my faith has since been restored and I have been lucky enough to have the support of 2 lovely psychiatrists and a team of Psychiatric nurses all of whom have been respectful of my wishes and kind). In the mean time all sorts of wonderful, frightening, crazy things where taking shape in my head. To list some of those things;

I started to hear people whisper my name, I would be on the bus and people would be whispering Julianne under there breath, at home alone the same thing would happen it was peculiar, and creepy at the same time. The voices where coming from outside my body so it was like they where actually in the room with me (not in my head) and sometimes when I was really high they would tell me to do things, such as draw a picture of an eye, or to recite prayers.

I started to see colours and shapes at the corner of my eye,

I saw shadows move around the room,

I had the feeling that I was being watched. Sometimes I would see a person in my peripheral vision just watching me,

The TV started to give me special messages about things that would happen in the future, so did books I read, adverts I passed in the street and anything stimulating all had a hidden message. The messages usually revolved around Rick being the next Buddha, spiritual religious leader. He was “apparently” about to become enlightened and start a profound spiritual revolution.

I got messages telling me that we where being watched by the governments economists who wanted to prevent Rick reaching enlightenment because if he did so people would stop buying things and making weapons. I believed they had plans to kill us both if they suspected he was anywhere close to enlightenment.

I started to believe he was not only the reincarnation of the Buddha, but also Jesus, Allah, Guru Nanak and every other world religious figure. I started to truly believe that he was going to unite all the world religions and that he had the power of the universe to do so.

Everything great in the world is done by neurotics; they alone founded our religions and created our masterpieces. ~Marcel Proust

I believed I was the reincarnation of Mary Magdalene, and the Buddha’s wife.

The list goes on and on, I had many special and powerful beliefs some of which made me feel really europhic and others made me feel terrified. I did have rational moments too when I would stop and say, “What am I doing/thinking”, “I MUST be very ill” and then I would have some not so rational moments where I felt the need to share my views with people and wanted to do something to prove to the world that I was right. Such as but not limited too, hurting myself so Rick could heal me.

In the mean time I also saw a lovely psychiatrist who very firmly told me that this was Mania and I was Bipolar and so I MUST take medication. He was very keen to put me in hospital which I was very determined to avoid. Trust me the Royal Edinburgh is not a fantastic place to be crazy. I don’t care if it’s a mental hospital I am certain that had I been admitted I would have gotten worse and not better. My Psychiatrist, who is exceptionally nice, was kind enough to give me the option of having help from the “Intensive Home Treatment Team” who basically visit people at home and are available 24/7 to anyone who would otherwise be in hospital. I can tell you it is the strangest experience ever to go from being a support worker myself helping people in there own homes, to being a service user. Nonetheless I am incredibly thankful because these people have really helped me, kept me out of hospital, and I am starting to feel like I am on the road to recovery and on the bright side the experience of being at the other end of a support service has given me a tremendous insight.

I’m not back to my usual self just yet but I am getting there. Mainly I am aware that the medication is keeping things at bay, but not completely. If I am over stimulated I quickly become more and more high. Meditation, mindfulness and a shit ton of Chlorpromazine and Quetiapiene are keeping things at a level where I can think rationally, however the odd beliefs still come (I’m just able to ignore them most of the time). I still hear people whisper my name and at time it still feels like I’m in a different world to everybody. On the plus side there are far more rational moments and the meds that I have really are helping keep me calm. I can mostly function if I plan my day well and keep my environment calm.

My confidence is in ruins and the idea of going back to work and taking on any kind of responsibility is frankly terrifying, but I know that eventually I will be ok and life will get back to normal. When I saw the Psychiatrist yesterday and he told me that he thought I was 25percent better I felt really positive. I can’t be objective so there are moments when I believe I am completely well and there are moments when I know that I’m not. In reality I am relying on other people to tell me what they think and thankfully I have people I trust around me who will be honest. The doctors think that once this episode is over if I take the medication and work hard to pick up on the signs that mania is returning then I should be able to get back to normal and hopefully lead a normal life or at least minimise the damage to my life if and when this happens again. From everything I have read I know that it won’t just go away, there isn’t a cure but it can be managed and the good thing is that now I know that I have Bipolar a lot of the problems that I have put down to my past issues are actually part of Bipolar and so can be treated with Bipolar medication.

I’m not quiet ready to re-join the rest of the world, I have another 4 weeks to work with the home treatment team and to get used to my medication but there is definitely a light at the end of this tunnel. My main worry, and I am sure it’s a big worry for anybody with Bipolar who is trying to come down from Mania, is that I’ll crash to depression. Without medication this would usually be my pattern but I’m hoping that I might escape that at least this once, now I am doing everything I can to manage things with meds and lifestyle. Hopefully I will have something else to write about other than my general craziness soon J

Thanks for taking the time to read

Jools

Mania

Mania,

I wrote in my last blog a little bit about mental illness, I thought it might be useful for me to update a little, even though I’m not actually sure I’m going to be able to write anything that will be useful to anyone else reading.

I’m still not feeling myself but the good thing is that I am getting treatment and this time I really am going to stick to it no matter what because I know that my being like this is making everyone around me stressed , including Rick and I feel like this is just so unfair on him.

I’ve been treated in the past in regards to my mental health but that has always been mainly for anxiety, depression and sorting out issues from the past. (Lets be honest we all have something to mess with our heads and some are better at dealing with that kind of shit than others) – I didn’t used to be so good, but I thought lately I had got better and any problems I did have where under control and I was happy. I am happy; my problem at the moment is that I’m too happy.

I’ve been like this several times before, and the one time that I did get treatment for what they call Mania was soon after starting Prozac and so my doctor presumed that the mania was likely to be a reaction to the Prozac and took me off it pronto, I got put on another med and was given follow ups with the hospital to make sure the Mania didn’t come back and all was good. The problem was the hospital didn’t seem so helpful, (cancelled appointments, changed times and shitty receptionists) and some doctor and nurse making me feel like the biggest waste of space to walk the earth. .. so I never did follow up with that fully (after a few months I said fuck it and stopped going) I did carry on seeing my GP and things seemed ok in my head mostly so I felt that it was ok, I’d take the meds I was given and hope for the best. Any other issues were all under control.

A number of weeks ago I had a familiar feeling building up. It was a nice feeling, an excited feeling, an indestructible feeling. I knew I’d felt it before, it was mixed with anxiety and all of a sudden I couldn’t sleep anymore. My mind started to race, and race, and race, until all these connections started to happen between what was going on around me, books I was reading, adverts on the TV etc... I have moments of believing Rick is the next religious saviour (I know it sounds crazy but in my head it makes sense) feeling like people are spying on us, or that he is the reincarnation of something important like Jesus or the Buddha.

Ideas started to crop up in my head, things that I could rationalise and yet things I knew where odd. The idea that something big was about to happen to us religiously, spiritually, I felt people where watching us (I still do) I felt excited and wanted to share this with everyone, I can’t calm down. I still have the ability to rationalise things when I talk to people or Rick but at the same time what I believe is making sense (to me if not anyone else) and there are moments when I’m not even sure what’s real anymore. I hear people whispering my name when I know that can’t be possible. I see things out the corner of my eye and I feel elated most of the day and if I’m not elated I’m terrified or anxious.

I’m lucky that I have people around who encouraged me to talk to my doctor and she confirmed what I already knew deep down that I was manic again. This week I have been assessed by a lovely psychiatrist who confirmed that this 2^nd (official) appearance of mania in my life means that I most defiantly have Bipolar. This is a good thing and a bad thing. The good thing is that it’s treatable and many of the issues I thought where just personality traits or hang-ups for things long past are possibly treatable now.

Currently I feel confused as hell. I trust Rick, I trust my doctor, and yet everything I feel and believe at the moment feels so real to me that it’s hard for me to accept its all just mania. Currently it makes perfect sense to me that Rick might be about to channel a cosmic universal power into the world and save everyone and yet Boy do I know how crazy that makes me sound.

I have hang-ups about being Bipolar, I feel like a disappointment and a failure and then I hate myself for feeling like that because it seems so unfair that I should hold myself to that stigma when really it makes me no more of a bad person than any physical illness. Part of the reason that I am writing this update despite that feeling of” OMG what will people think” is because no matter how manic I may be my intellect is still very much in-tact and I am very aware how vital it is that the sort of stigma attached to mental illness is crushed.

At the moment for me there is a constant adrenaline rush, and a feeling of urgency. My heart is racing and is now (according to the doctor today) tachycardic which can be a symptom of mania itself and can be made worse by the various medications given to treat mania. It means he is worried about putting me on a higher dose of medication but at the same time he wants to get the mania under control and so it’s a catch 22. I need to calm down but I can’t. Someone asked me today if I could just try grounding myself in the present and calm my mind down. If I could calm down I would, I want to relax!

The good thing is that I know I could be worse; I could lose my ability to rationalise with myself at least some of the time and thus lose my entire grip on reality. At present although there are periods where I have no rational there are still periods where I can talk myself down from a crazy idea by talking to Rick, my doctor and others. Going over what my head is thinking with some people I trust seems to help me ground myself back in reality. I have medication now and I just have to find the right tablets and the right dose. So this will pass, (eventually) and normal life will resume. In the mean time I am lucky enough that I don’t even have to stay in hospital I have a choice between that and being visited at home. Staying at home is really good for me, I have been in hospital before and it was an exceptionally stressful time although I’m sure much good work is done there, I am terrified of going back and being locked in, kept away from Rick and my home.

In the mean time, really sorry to anyone who has spoken to me in my less than rational moments and hopefully I will be back to normal soon.

Mental Illness

Pharmaceutical wonders are at work
but I believe only in this moment
of well-being. Unholy ghost,
you are certain to come again.

Coarse, mean, you’ll put your feet
on the coffee table, lean back,
and turn me into someone who can’t
take the trouble to speak; someone
who can’t sleep, or who does nothing
but sleep; can’t read, or call
for an appointment for help.

There is nothing I can do
against your coming.
When I awake, I am still with thee.
–Jane Kenyon, “Credo,” from “Having it Out with Melancholy”

I’m not in a good place psychologically at the moment, so I thought it might be a good time to get round to writing a blog about mental illness. I had been intending to do this for a while but its difficult because, although with some people I am very open about what difficulties I have, there are still many friends and groups of people in life, work and family who I still feel uneasy discussing things with or even being around when I’m not feeling right. It’s not that many of these people are bad people who are particularly judgemental or hard-hearted, its simply the case that there is a stigma to having this kind of illness and no amount of caring and sharing will change that reality.

What my actual problem/diagnosis was and still is really isn’t important. Anyone who has any kind of mental health issue goes through similar stigma and has much of the same difficulties when trying to lead a normal, fulfilling, happy life. So it doesn’t matter if I have Bipolar, Depression, Schizophrenia or any other condition, I want this blog to relate to everyone and anyone in this group and not just focus on my own specific problem.

First I want to explain what it’s like living in my head and what I imagine it’s like for many people who have a mental illness. My main symptom (the one that is currently causing me the most disruption) is anxiety. Now when I say anxiety most people imagine a bit of stress, work related, money worries that kind of thing. What I mean when I say anxiety is more than that. The only way I can explain it is to ask you to imagine this:

You’re on a plane and it starts having difficulties in the air. At first you are only mildly bothered, (in-convenient turbulence) but then the seat belt signs come on and the plane gets even more erratic, you notice that the air hostess is looking worried. Perhaps now you are feeling mildly panicked but you have faith in the pilot and you believe that it will all be over soon. Then you realise that there is smoke in the plane and the engine is starting to fail, people are getting thrown around, everyone around you is starting to panic, the pilot instructs everyone to prepare to crash land and you realise that the plane you are on really is about to crash and you are more than likely going to die. Imagine the adrenaline rush that would run through your body at that moment of this realisation. Almost everyone has had some instance in their life when the fight or flight response has kicked in (remember that just now as it will help you get a picture of what I’m trying to explain), the feeling of wanting to vomit, the shortness of breath, the smashing heart beats, the stomach pains, sickness and sweating and imagine that those feelings are coming over you for no reason that is logical. It comes and it rushes over you and then it gradually subsides and you think that it’s over but then a little while later it happens again. It wakes you up in the night, it happens when you are on the bus, at work, in your own home, no place feels safe anymore this intruding feeling interrupts everything you do, when your trying to relax, shower, eat, read, it keeps happening over and over again, and there seems to be nothing you can do to stop it.

This kind of anxiety for me is hell. The fight or flight response is continually being activated for no reason and any small amount of stress sets it off again. I’m only just calming down and it starts all over again. I’m trying to think of a reason why this is happening because if I could find out why I’m afraid maybe I can logically think myself out of it but really there is no reason. When I talk to people who are close to me about it they will try and help by asking me what I’m stressed about and logically talking to me about any stresses in my life; but in reality the stresses in my life are not the cause and there is in-fact something chemical going on in my brain that’s making me feel this way. That means no amount of logic can take the feeling away. If this goes on for more than a few days, maybe even weeks then my mind starts to fill in the blanks. I’m afraid, really afraid and my body is ready to fight or run away and so there must be something to be afraid of. At this point I haven’t slept for more than a couple of hours at a time, for days or longer, it’s becoming increasingly difficult to think clearly. I start to fixate on small issues, maybe I fixate that the people at work don’t like me, or Rick is going to leave because he’s had enough, perhaps the there is a person on the bus with a bomb, or the man behind me in the street is a murderer. So I have to double check things, ask people if they are annoyed to seek reassurance that everything is ok. However because my thought patterns are disturbed any reassurance I get from those around me doesn’t sink in and I start to repeat myself, driving everyone around me as crazy as I am. The longer this feeling lasts the more illogical my thought patterns become until the lines between what’s real and what’s just my own mind are blurred. Reality being blurred is not cool. It’s not blurred in a good trippy LSD kind of way, it becomes like a nightmarish out of control hell. Paranoia kicks in and throw in some auditory or visual hallucinations and before I know it I’m in the middle of a psychotic episode.

Anxiety is a symptom that is part of most mental health issues. I have met a lot of people with a rainbow of issues and I can’t remember one person that didn’t feel anxious.

When you’re suffering from that kind of anxiety the world becomes a scary place and it gets even harder when you have to start explaining to people what’s wrong. It becomes necessary to hide away because the truth is that no matter how open minded a person thinks they are, this country is, their group of friends are, their workplace is, their church is, (fill in blank here) there is always stigma.

I remember telling a family member years ago that I was having therapy. At this time in my life I was having therapy only because I was training in person centred therapy myself and therefore it was necessary for me to undergo therapy as part of the course. This person had no idea I had any kind of problem myself and the therapy was only mentioned in passing in regard to my coursework. However the reaction I got from this person was disgust, I was immediately challenged “why do you need therapy, what a waste there’s nothing wrong with you, you just need to get a grip” needless to say this person isn’t someone I would ever involve myself in a conversation about mental illness with again.

The problem with mental illness as opposed to physical illness is that people who don’t have a mental health problem seem to suppose that you can just snap out of it; that if you were a strong person, or if you had a good upbringing, mental attitude, you wouldn’t have this problem. Let me put the record straight now. I know many strong, creative and wonderful people who have had a fantastic upbringing, who also have a mental illness. Nobody would challenge someone with a condition like asthma, or diabetes and say “snap out of it” “think yourself better” and yet this is a shockingly popular attitude to mental illness. We are in the 21^st century, and it’s been shown time and time again that with almost all mental illness there is a physical/chemical imbalance within the brain and yet still people are coming out with this bullshit. The cause of an imbalance may vary, and yes it can come about from trauma and upbringing. I’m not saying circumstances and life events don’t play a part for some people, but whatever the reasons are there is still something going wrong in the brain of a person who is mentally ill that is NOT going wrong in the brain of someone who is not mentally ill, and therefore what right do they have to tell anyone to snap out of it! I would like very much for those people to have just one day with the same thing going wrong in their brain and then they will know just how impossible snapping out of it is!

http://www.youtube.com/watch?v=Dw_I-G1smoo

Then there is the problem of getting help. It seems simple, something is wrong with you and so you go to the doctors. You presume that the doctor will do whatever he/she can to help you get better and manage your symptoms. If you had a persistent upset stomach, or a sore throat you would go to the doctor and they would help, so it shouldn’t be any different with something mental? Doctors know how to treat mental illness these days so this shouldn’t be a problem right? Wrong. Doctors can have just as shit an attitude as everyone else. I have had some wonderful doctors and I have had some stupendously unhelpful ones. Going to see a doctor about a problem like this is exceptionally difficult task because by the time it gets to the stage when you are prepared to go to a complete stranger and tell them what’s going on in your mind, you’re already feeling isolated and scared about other people’s reactions to what you are experiencing. Chances are the erratic behaviour has already attracted some unwanted attention and a few people have already given some negative remarks about how you just need to, snap out of it, get a grip, open up, get on with it etc... So when you get to the doctor you’re frantic.

I was lucky because the first doctor I spoke too at least took me seriously and wanted to treat me. I was started on the standard med to treat depression (Prozac) I was also put on the waiting list for some therapy and sent on my merry way.

PROZAC otherwise known as flouxatine and probably countless other brand names, if it’s an SSRI then there’s a good chance it’s a Prozac type of med. In-fact I would go as far as to say that if it’s the first time you have been to the doctor with depression like symptoms and you come out with a prescription then if you double check the brand name its going to be from the Prozac family. From what I know Prozac is prescribed because it is cheap, it’s also not as harmful in an overdose as some other pills but I’m not deluded enough to think this is the main consideration here when the NHS recommended it be the first med prescribed. I’m sure it’s done wonders for some people with depression. That doesn’t mean it is the best course of treatment for any kind of mental health problem. Unfortunately it’s the first course of action for most patients presenting with depression and I was depressed as well as anxious. I was just glad to get help, I think at that point if they had prescribed me anthrax and told me it make me well again I’d have swallowed those pills. Unfortunately Prozac made me worse. It made me manic, so instead of being anxious, paranoid and depressed I became anxious, paranoid and feeling like I was permanently on speed! Let’s just say that this was not a good time. Luckily my partner at the time had the sense to urge me to go back and the doctor (something to do with me setting fire to the fridge and deciding that I could see dead people). The doctor quickly took me off those pills, and 9 meds later I finally found a combination that worked for me (most of the time).

The therapy I got also helped and I think that was thanks to the fact that I had an amazing therapist who I still have the greatest respect for today and the fact that it was psychoanalysis/person centred therapy and not the most common “NHS cure all” Cognitive behavioural therapy (CBT). I have had CBT with several different therapists during times when my symptoms flared up and although in the short term in helped manage some acute symptoms it did nothing for me long term. The thing about CBT is that its all about treating the symptoms, calming the patient down, “giving them tools to cope” and this is fantastic in the short term with things are really erratic but in the long term you never have time to get to the root of the problem . 12 weeks is usually the standard NHS CBT course of treatment (in my experience) and for many patients that’s just not enough time. It’s 40 to 50 minutes a time and it’s really impossible to get to know the therapist in that window. I have learned whilst undergoing my own counselling skills course that the reason the NHS mostly focus their therapy on CBT and not other modes of therapy such as PCT (person centred therapy) and psychoanalysis is because CBT is the only one that can show statistical results and its no secret that the NHS just LOVE statistics! “1 in 10 people have this and 1 in 3 people have that...”

With CBT the patient fills in a form at start of treatment, and fills in form at end of treatment. They get asked questions along the lines of ‘on a scale of 1 to 10 with 1 being calm and 10 being most anxious, how do you feel?’ If the CBT has worked in the short term then the person might have been 10 at the start and then 5 after treatment and the NHS thinks ‘BINGO! CBT cure all for mental illness’. From my experience the reality is that after 6 months the anxiety is back because the root of the problem has not been treated. With person centred and psychoanalytical treatment its more about finding the root cause, it takes longer (so costs more) and the patient tends to get worse before they get better (needs more support in the short term thus more money) and so the NHS thinks too expensive ‘off to the CBT bin you go’. The catch is that in the long term PCT and psychoanalysis is more likely to make lasting results but since most figures work on short term scales, the long term doesn’t seem to exist as far as the NHS is concerned. The psychoanalysis and person centred therapy I had has given me far more benefit in the long run than any CBT program I have been a part of.

I am well most of the time, that doesn’t mean that I’m symptom free because I have my off days but if I manage my medication carefully and I don’t go on all night benders and put myself in all sorts of stressful situations then I am more than capable of living a normal, active life, working, socialising and just generally getting on well in the world of sane people. The problem is that like other long term conditions that are managed by medication and lifestyle changes its still part of me. There isn’t a cure (sorry to break this to anyone who works for the CBT department in the NHS) at certain times symptoms that are not manageable re-appear for no good reason other than my brain feels like it reminding me that it has the ability to wreck havoc on my life. Sometimes a small amount of stress starts off bigger feelings of anxiety that lead me to having worse symptoms reappear (domino effect) and other times it can happen for no reason at all – perhaps some small, seemingly insignificant thing happens and the effect is destructive (butterfly effect). I am lucky I’m well most of the time, sometimes I can go for a year or more when I am completely well and happy. At the moment I’m not right, I know it because I’m highly anxious, fixating and feeling generally irrational. Every-time this happens I feel like I’m failing. I might know logically that this is an illness and it’s no more shameful than having a stomach disorder and yet the stigma and judgements do get me down. I feel frustrated, afraid, and isolated. At the moment I know I’m not right and even though I can have a few hours at a time when I’m ok, I’m swinging back and forward from being a logical rational person, to feeling high in a manic sort of way, or feeling extremely afraid, irrational and paranoid. I feel like all the hard work I’ve put in over the years to stay well and lead as normal a life as possible is being eroded away by this one set back. My relationships, my job, everything rests on me being well. The problem is my own fear of the consequences of my illness taking over completely, makes me more anxious which makes it more likely that I’ll get worse and so it’s a vicious cycle.

I’ve had to take a giant step back from my own life to deal with this which means letting certain people down until I get well again. That sucks and I’m annoyed at myself for not being able to work through it and still carry on with my usual day to day, but I can’t, and past experience has taught me that it’s not wise to try pretend like I can manage. I lost a job once through forcing myself into work in a similar mental state and I don’t want to do that again. I also know that I have been here before and come through it and I can get through it again. This time I’m being a little bit more open with people who I would usually hide away from when I’m not right. This time I also have Rick who keeps reiterating that I’m stuck with him for life and it doesn’t matter how crazy I am he still loves me (by far the most patient man on the planet but I know everyone has a breaking point). So hopefully it won’t last long and I’ll be back to normal soon. That means hoping I get an ok doctor next week who doesn’t decide to try something new and actually listens to me about what works for me and what doesn’t work, and hopefully have understanding people around me who don’t make me feel like I’m the biggest waste of space on the planet.

So please bear with me whilst I’m going through this, and I hope also having read this everyone will be more understanding and supportive of others who are facing similar difficulties.

useful links

http://www.mind.org.uk/ English charity but still has some useful Info
http://www.seemescotland.org.uk/about