Getting back into a routine is good news!

Christmas is over for another year and even though I was pretty unwell for a lot of November and most of December and still not 100% now, I managed to enjoy quite a bit of Christmas. 

I have had 2 weeks off work and don’t go back until Tuesday but I am actually really pleased to be getting back into a routine.  However good a break is and yes, after the last couple of months I have had I certainly needed one, I am now though craving a routine.

Whilst quite a few of my friends are cursing setting the alarm after two weeks of lie ins – I am looking forward to returning to work and the structure that it brings me most of the time. 

Over the last couple of weeks I have been going to bed later and getting up later – my sleep hasn’t been too bad but over the last couple of evenings I have become very depressed with no warning at all and then had to ensure that I got on with lots of jobs for Brownies or Church as a distraction to try and keep the depression at bay.  This was a sure sign I was ready for work again! It will do me good to get a better bed time routine in place as I don’t want the depression to slowly creep back at other times of the day as well and sleep is crucial to this.

Eating is also something that needs to be in a routine for me! Christmas food is lovely, however it makes me feel a bit bloated and then I give myself a hard time that I am putting on weight which doesn’t do my self confidence any good either. 

I haven’t worked full time hours since November as I had a bad bipolar episode and so of course I am a bit anxious about going back but I am pretty sure that I am well enough to cope and also seeing my GP tomorrow. I have been under the care of the community mental health team for the past month and it pleases me to say that they have been very supportive. They have for the first time in years listened to what I needed, not over complicated the care they gave me (which was my request) and worked with me to get to the position of going back under the care of my GP from tomorrow.  I feel in control of the situation and that is often half the battle.

So as I pack away the Christmas decorations for another year and stop tidying cupboards for the sake of tidying it will be with a smile that I go back to work!

I am a great believer in creating good memories for the future and in the last two weeks I have certainly done that! 

It is the small things that often matter …

So today was a huge first in I don’t know how many years. Yesterday afternoon I received a call from the community mental health team. The call was an acknowledgment of the referral by my GP only 36 hours before, so to say I was stunned and impressed was an understatement. 

The call yesterday was fairly brief but had a few simple aims, firstly to establish my safety, secondly to ensure I had contact numbers of support if I needed them and lastly to arrange a time to call me today for a telephone assessment.  

Today the same person (note the consistency) called to assess me.  This followed a fairly typical mental health assessment format but was so different to ones I have experienced before. It was carried out with understanding, empathy, support and also helped on a practical level as well. I have to admit I was very sceptical but then who would blame me after the last few years of one bad experience followed by yet more bad experiences. I was able to be completely honest with the person on the phone, I was able to tell them my deepest fears and even though they felt they hadn’t done much at all I was eternally grateful for this support at what seems an impossible time.  

The other thing that made such a difference was the honesty of the person I was speaking to.  Never has a mental health professional said to me: ‘I will try and call you back today after I speak to the doctor, but if I don’t it may be due to an emergency or not being able to speak to the doctor but I will call on Monday’.  A typical scenario is that they say they will call back and don’t and then deny ever saying that! 

Well he did call back (yes the same person)! He checked again I had all the numbers I needed and understood my fear of going to accident and emergency and seemed to join me in a determination to try and stop this from happening. He had spoken to the doctor and has some ideas and for the first time in years I am even willing to discuss a possible new medication. 

He is calling me on Monday and we are reassessing the situation then.  In the meantime I am so grateful for what he has done over the last couple of days to help shine a bit of light and hope in a rather bleak situation. It is very rare for the professionals to be the bearers of light and hope – this is often only generated by my amazing family and friends! 

Not only is this a first in so many years during a crisis situation but also I was properly listened to by a professional. I wasn’t judged because I work or because I could articulate what was happening to me. My distressing symptoms were acknowledged and not once was any aspect of my illness belittled. It will obviously take a while to gain my full trust, after so many years I have learnt to protect myself and to be cautious but feeling like I do, this support is hugely significant. 

So yes the small things do matter, I ensured that I told the mental health worker exactly that today. Sometimes things can get over complicated and the wrong help given as a result but today I received what some would consider a small amount of support but it made the world of difference. 

It has all gone downhill so quickly … But there is no mental health support to be found

So less than a week ago I wrote on my way home from a weekend away and things were difficult but not impossible. Today I drifted well into the impossible phase of this bipolar episode – however I certainly kept fighting. I find it frightening how I can wake up in utter blackness – it takes even longer than normal to see through the morning fog (Even when I am well I am not a morning person!). This morning it took 2 hours before I finally got out of bed and made tentative steps to work and to what was a fairly active if not difficult day.

I have contacted my GP who is my care co-ordinator as I am discharged from the community mental health team. She has upped some of my medication which I can take over the weekend to try and stabilise me and she will see me on Wednesday. There is no other professional support avaliable.  To me it would make sense to act now before I reach crisis point – but even then A and E is probably my only option and to be honest that is enough to exacerbate a crisis.

I am though, in the midst of the despair feeling truly blessed tonight and thankful that family and friends are providing me with so much support and love. This makes me think about those without a support network such as mine, those that are living alone with the pain of mental illness and those that like me have limited professional support but without the friends and family I am so lucky to have. 

Tonight I am angry – angry with bipolar, angry with myself as depression plays with my mind and so of course this must be my fault! But also angry with the system, the system that seems non-existent to so many, that doesn’t have parity of esteem with physical health care and the system that waits until a crisis before acting and stepping up to help. Even then it has severe limitations.  

All I can hope is that this particular episode of bipolar isn’t a long one and that I remember to take life in small chunks until I feel stronger again. 

Does getting away for a bit help?

I am writing this blog on the train coming home from a lovely quiet weekend in Harrogate with my husband. We have both been very busy lately and last weekend we had a family wedding to attend which was lovely but very tiring. It was also my husbands birthday this weekend and we often go away around this time of year before the Christmas busyness sets in. 

Over the last few weeks I haven’t been feeling that well. My anxiety and paranoia have steadily increased and become more and more disruptive and I have also experienced bouts of depression that aren’t constant (and are actually relatively quick) but when they suddenly occur they are terribly painful and often come with a wave of emotion that I struggle to control. 

As the train gets closer to London with the inevitable ‘back to a routine and normality’ that it brings, I am anxious, as I worry that whilst I had the same head with the same illness with me this weekend that it might seem all the more difficult at home. 

During dark times I often have the urge to ‘run away’. When I was younger I used to actually do that (probably causing untold stress to those that love me) but I was convinced that I could run from the depression and the anxiety that was building up inside me. It did though help a bit and even now when I get away on mostly pre-planned trips it does give me some breathing space and a chance to gather my thoughts before trying to fight this illness in the midst of work and ‘normal’ life. 

So as I return to work tomorrow I will do so after 48 hours of ‘getting away’. It hasn’t been always easy this weekend as reading and relaxing in general are pretty difficult in my current state of mind but I have been able to enjoy parts of the weekend and it is those things I need to hang on to through the despair of depression. 

What would help? What can we do?

Sadly over the past week I have become hugely anxious and paranoid and this is really starting to affect me a lot and is very debilitating. 

I have been so well for a long time and whilst I know it was unlikely to last for ever I am terrified that this anxiety might lead to an episode of depression and/or hypomania. 

I have already been to the doctors and started to put good support in place which has led to a medication increase which is helping with some of the symptoms.

I have also had so many offers of support and help and I am so grateful for these but I sometimes worry that I can’t always tell people what would be helpful or if there is something specific they can do. Sometimes the very simple things like a text or a chat over a cup of tea are enormously helpful and it is those spontaneous gestures that seem to have the greatest effect for me in combating the paranoia and very low self esteem.  I worry that people will think I am mucking people about or being a bit difficult when I don’t know what might help or what someone could do for me. 

In fact at this precise moment I am actually unsure what I really need or what could help as I am either still in a bit of denial that I feel unwell or just fighting all the thoughts going round my head so much that nothing makes much sense.

So to all those amazing people that try daily to help me and countless others with a mental illness – thank you. Please stick with us and apologies that sometimes I might appear vague about what would help the most, I am hugely grateful and just by being there you are helping so much.

What’s in a diagnosis ….

Healthcare is full of them! However the more I chat with people who experience mental illness the more I see a disparity between giving a mental health diagnosis and a physical health one.

Whilst I appreciate that mental health is often difficult to diagnose and I recognise all the challenges that could come up I still think that some professionals are not taking the diagnosis of a patient seriously enough.

This seems to be a particular issue with people who have been diagnosed with bipolar but then because they don’t respond in the way that professionals expect or have strong opinions regarding their care they are then seen as difficult and sometimes without consultation their diagnosis is changed.  What makes this worse is that whilst it would be rare for a physical diagnosis not to be discussed with the patient or next of kin, I have lost count how many people I know have found out about a new diagnosis by letter or by seeing it on a computer screen at the GP surgery!  

It is so sad how some professionals can’t accept that a mental health diagnosis does not mean that people can’t be or aren’t capable of being fully involved in their care plan.  

The anxiety of this kind of surprise misdiagnosis stays with people long after the situation is rectified (which can take months or even years).  I still cautiously scan the GP screen to ensure the correct diagnosis is showing and every appointment with each professional adds to my anxiety because of past experience. 

I am well aware that this is not a practice that all mental professionals follow however I hope that those that do this realise the implications of their actions and those that sensitively discuss diagnosis after a full assessment encourage good practice with their colleagues.

This is an important step in ensuring parity of esteem between physical and mental health and one which could benefit the mental health of so many people. 

Coping with a 45+ hour working week…

Yesterday I decided to take some medication as part of how I am coping with a huge increase in stress and workload.

I think that I am coping pretty well and taking steps to manage this which include being pretty honest that it isn’t always a walk in the park.

Working in education in September is always busy and with an added audit means that everyone is under so much pressure, but with bipolar I have to ensure that I take good care of myself through this very busy time.

My steps to managing during this time are:

Ensure I have one break away from my desk each day – I have managed this most days this week but on the one day I didn’t, I felt my paranoia and anxiety increase. Yesterday a very good friend came and met me for lunch and next week I am already planning in breaks so they are harder to get out of.  It isn’t always easy and in the past some colleagues have been known to say ‘we are too busy to take a break’, but my health must come first, I am already working overtime and one break can help me and makes a big difference.

Make an appointment with GP or other care professional – I have all my care provided through my GP who I see monthly or every two months or more often when I am unwell. Even though I was very well when I last saw her a month ago I knew I had a busy time coming up so I made an appointment for a month so therefore I am seeing her this week. This not only reassures me but also those that care for me that a professional is keeping an eye on me.

Take PRN medication – In the past I very rarely took any medication to help with anxiety or other symptoms until I had experienced pretty bad symptoms. Whilst I feel pretty well I have also had some quite bad anxiety, especially this week and have already taken medication that the Dr has prescribed for such times. I now know that there is nothing wrong with this, I am not weaker for doing so but actually sensible and strong for acknowledging the little bit of extra help I do need.

Talking with managers/colleagues (where appropriate) – This isn’t always easy or possible and I have experienced appalling stigma in the past however I am hugely fortunate to have excellent managers at the moment who not only keep an eye out for staff but will ensure I am looking out for myself. As they said to me this week, they want me at work as they value me, if that means having the full lunch break that I am entitled too that is more than fine! I also manage staff myself so being honest with them and supporting them through this frantic time helps me as well and means that as a team we are more productive in the long run.

Find time for rest & fun – in addition to a huge workload last weekend I took my Brownies away for a 3 night holiday which was brilliant but also meant that my weekend had very little room for rest. This weekend I am enforcing quite a bit of rest on myself starting with a lie in today, plenty of tea breaks and nothing at all stressful to do either! Whilst there is a temptation to work I won’t as I need to have a complete break as next week and probably the rest of the month will be as busy. 

So working isn’t always easy and I have to be so careful, but I am coping very well and although taking a day at a time isn’t always possible I am managing to stay well and do a good job.  Maybe I am also challenging the stigma surrounding mental illness without even realising it! 

Why I am doing better – even though I am not 100%

This might sound a bizarre title for a blog – why would being 100% well or striving for full recovery be somehow less inviting than not feeling 100% or being quite on top? I am though feeling better and am much more stable than I have been for months but I am certainly not feeling 100% nor striving for full recovery.

In the past after a particularly bad episode I have always hoped and pushed myself to feel completely well again.  This has been encouraged by many healthcare professionals who have alluded to the fact that if I get everything right I will one day be ‘fully recovered’. This has immediately led to me putting myself under huge pressure and often leads to another period of illness much sooner than might be expected.  

So many professionals and even some charities now seem to be tailoring all care for mental health solely towards recovery and for some people this just isn’t possible. I believe that sometimes this can lead to some patients being ignored or sidelined, maybe even having their diagnosis changed in order to fit a particular model if they have recurring episodes and ultimately even when people are very well they end up feeling under so much stress that any good work or progress can be slowly undone. 

I am not saying that those with mental health illnesses shouldn’t be trying to get as well as they can and that looking at triggers, putting together a wellness recovery action plan can be very useful tools to help someone to stay stable but it is also important to recognise difficult days, thoughts or feelings and to share these with others. 

Sometimes when I had been really well for a week or so I would have a really difficult day but I wouldn’t tell anyone about it for fear of letting people down. Often this would trigger other symptoms and thoughts and over time develop into something much worse. 

More recently I have admitted how I feel to people, talked about worries and anxieties and admitted to myself that living with bipolar is a reality that I am coping well with, but one that I might never be fully recovered from. 

I often ask myself what feeling 100% well would actually be like …. But  does anyone really know? 

Where have I been?…

So after a long break from Twitter and from my blog I am back! 

There are lots of reasons why I decided to have a break but I think I made the right decision and I am proud of myself for making a few changes (both on and off line) that I hope will keep me well for longer and also help me to see the positives that I am experiencing as well.

Twitter is an amazing source of support, however I got a bit worried a month or so ago that it might of been fuelling my paranoia.  I don’t for one minute think that it was the sole cause but it was something that I was aware of and therefore that I could quite easily do something about. Other aspects of my paranoia aren’t always so easy to sort.

I also found myself getting quite upset about stigma on Twitter.  I started to take personally stigmatising comments and at times became anxious when I read certain tweets.  This wasn’t healthy and so therefore a break enabled me to realise that I couldn’t solve the problem myself and eradicate mental health stigma.  It also helped me to realise that I can do just as much in my life at Church, at work and within my own circle of friends and family to start changing the way people view mental health without challenging every reference on Twitter.  

I have also been incredibly busy (with very positive things) and I am slowly getting used to the fact that I am not 100% well but that is ok (ish). I have started swimming and eating much more healthily which is also having a positive impact on my life. I am still having the occasional day when I resent being ‘not quite well’ – where the anxiety prevents me from doing what I really want to do or the sleepness nights trigger a negative spiral of thoughts and I feel that I am going to become very unwell and therefore walk on eggshells for the next few days.

I am pretty realistic about the fact that I will be unwell again in the future but the period since my last serious depressive episode has been different. I am acknowledging my vulnerability but staying more positive than before. I am coping and whilst some days are better than others I am moving in the right direction.

Thanks for sticking with me! 

Out of the blue …..

Just a short blog to put down in words how hard it is when what I might refer to as ‘Early Warning Signs’ or difficult feelings/symptoms hit me out of the blue.  

Today I had to stay in my car and was unable to drive off as totally overcome by emotion, just cried for no apparent reason and this was hugely unsettling. When I am depressed this is sometimes expected but when I am feeling quite well it hits me hard and seems to knock me for six.

Earlier today I also had a mild panic attack which I could probably put down to having 3 meetings in a row at work and feeling under pressure (or thinking I was under pressure) but I wasn’t expecting it.  

Subsequently I now feel very fragile, like I am walking a tightrope and not sure whether I might fall off or not. I am sure this is just a small wobble but what I do know tonight and trying to hang on to is that I am feeling positive enough to have quite a bit of hope which is good.

So for the rest of this Mental Health Awareness week (#MHAW15) and in the weeks to come (as awareness us good all the time!) I am hoping that I can continue to raise awareness, have positive conversations and not experience too many more days like today!