On the cusp of fabulousness…

Ok so I jest when I say on the cusp of fabulous because I know only too well the devastating impact mania and hypomania can have but I mean that stage before it gets too horrid, the bit where you feel like you could take on the world and win the universe. The bit I wish I could bottle.

I am not poorly, far from it, but I am aware that a couple of warning signs are just rearing their head. Everything seems that little bit brighter and colourful, everything tastes amazing, my head is ok at times but buzzing at other times with ideas and song lyrics and jokes all on a loop. I just feel energised but I know this is something I need to put a stop to before it goes too far.

So far no one has probably noticed the changes in me, I’m not speaking any faster for instance. Subtle is not a word I would generally use to describe me but I think the changes so far are just that. I know I am different though, this morning my husband had to bring my meds to me at work as I had totally forgotten to take them which is something I have never done before I am usually obsessive over meds. I was flippant suggesting I would just skip a day but thankfully hubby brought them too me. I have too much to lose to become poorly again, deep down I know that. Two days ago I felt exhausted now that couldn’t be further from the truth despite it should be the opposite being true.

At the moment I feel great, just like an exaggerated version of me, but I know I need to give that up. We have gone from hot decking to individual desks which we are allowed to personalise… now permission to personalise when I am feeling like this may lead to some hilarious Amazon or eBay parcels! The temptation to ride the wave is phenomenal, like being hungry and someone putting your favourite meal down in front of you and saying you are only allowed to smell it no tasting. I want to taste, I want to devour the steak but I know it is bad for me. That steak will make me ill.

So my plan is extra meds and early to bed, two disturbed nights are the likely cause of this so that is their first thing I need to rectify, telling a couple of people too so that I have accountability to others if God forbid I do slip further (or rise to the stars but you know what I mean!).

World Mental Health Day 2018

Today, 10th October, is World Mental Health Day 2018, allow me to share with you what that means to me. This is nerve racking for me as this account is fairly anon, if someone googled/searched my name it wouldn’t come up but this message felt important to share. These two pictures were taken one year apart, one where I am looking my best for a party and one when I was being savagely attacked by depression. And no that description is not over the top. That time was horrendous but do you know what? The day to day is tough too. Living with bipolar disorder means I have to manage my illness on a daily basis; I need to have an alarm set to remind me to take my meds each day, it means I need to drink enough throughout the day or I develop a tremour, it means I need to think twice before I make arrangements with friends even if it’s stuff I want to do because I need to be careful not to over stimulate myself. It means I need to have my blood taken regularly so as not to develop dangerous toxicity. It means sometimes I need to leave events early if I have had a late night or a disturbed sleep the night before because sleep makes a huge difference in my wellness. It means I worry everytime I laugh too loudly or am having a bad day that people will assume I have relapsed. It means I worry that too. It means that even when well I put in an exhausting level of effort to stay that way. It is every minute of every day. It’s not all misery but it’s important I share that equally bipolar is not just happy and sad, it’s everything in between and a bit more. I have experienced psychosis with depression and that was the most terrifying time in my life so I’d just ask you to think before you use ‘psycho’ as an adjective in fact don’t use any mental illness in that way you ARE NOT ‘a bit bipolar’ or ‘totally OCD’. The most important things in my wellness are medication, sleep and most definitely the friends and family I surround myself with… To them I say thank you for accepting me as I am and not just tolerating my quirks but celebrating them!

Inpatient care – my experiences

To start with I should lay my cards on the table as to where this blog comes from; I am a mental health nurse (currently community based although I have worked on an acute ward in the past) but I have also experienced two lengthy admissions to mental health wards. My first admission was to a mother and baby unit for five months and my second was to an acute ward for four months. I have certainly seen inpatient mental health care from both sides of the coin.

When I became a nurse I did so for the same cliche reason so many others do ‘to make a difference’ except I knew what differences I wanted to make, I knew I wanted to influence care to ensure that when enduring what is often the worst time in a persons life we as professionals don’t make that harder. My experience of being a mental health inpatient was a positive one on both occasions I had overall good experiences however it was also the most deeply dehumanizing experience in my life. 

Being watched 24 hours a day is difficult beyond belief, someone watching you bathe and on the toilet, even if not on ‘obs’ you are still being observed all the time and just like I refuse to believe those on big brother who say they forget the cameras are there you don’t forget. All decisions require permission even whether you can take in some fresh air so the small things become huge, if your biggest decision in a day is whether to have jam or marmalade and then there is no jam only honey it can feel like the world might end. Seems ridiculous doesn’t it?

The noise on the wards is as deafening as the silence with other people who are unwell in their individual ways often making noise 24/7, a restful environment it is not. I wanted to disappear into silence yet the hustle and bustle of ward life punctuated the that and dragged me back into the world, into life.

On both occasions when I was admitted it was the right thing to do, I was depressed to the point of struggling to function and my cognition’s were so slow yet so very negative.  I was admitted for ECT both times and both times it saved my life but whilst the admission may have saved my life the ward left me desperate. I saw things which traumatised me, especially on the mixed sex ward for my second admission, I’m so thankful care in my area has moved to single sex for a time in life when a person is so vulnerable. 

Crisis services have kept me out of hospital on another couple of occasions when both depressed and when elated, I am so thankful for this. I had ECT whilst staying at home with family and plentiful jam and marmalade to choose from even when in a mental state which means that choice was not one I could manage.

When I first qualified as a nurse I worked on an acute ward and I was asked to present at an Mental Health Act Tribunal, I was nervous for my first time and you couldn’t make it up but the community clinician also presenting was someone who had nursed me as an inpatient and who had watched me on the loo and taking a shower!!!!! Mortified…

I am hoping to go back to an acute ward environment soon as a ward manager (cross everything/say a little prayer etc) so the full circle would have been completed, I would get to affect real change in an inpatient environment, to ensure real personal, individualised care is delivered. To ensure that no one else describes care as dehumanising because even the most invasive observations can be done with dignity and inpatient care can be hugely positive when needed.

Diagnosis or Diagnonsense?

Diagnostically defined?

No thanks. I’m so much more than that. The first thing to think about is language, I never say ‘I am bipolar’ rather I say ‘I have bipolar’ usually followed up with a rant about how much I hate this part of me. A part of me it is though, just like my size seven feet or my fine wispy hair which never looks smart.

It was depression with a side order of occasional anxiety before it was bipolar, it was even depression with psychotic symptoms for a while, if we were playing diagnosis bingo whilst I wouldn’t shout for a full house I reckon I’d get a tenner for a line!

What does it mean though? Can I not treat the symptoms without a label? I guess I could but for me naming it gives me something tangible to fight with; my arch nemesis. Me against bipolar and sometimes I have to settle for the small wins.

I can see for some people that may not be the case but I can only talk for me.

I was furious when I was given my bipolar diagnosis, mainly because I lacked insight and did not believe I was experiencing mania but partly because I had spent nearly a decade avoiding this. I knew deep down what was wrong, I’m a mental health nurse I should do, but I treated this at home when it reared its ugly head with sedatives when needed and other than once in that decade I managed to stay away from services for mania or hypomania. I did seek support when depressed but that’s ok right? Plentiful campaigns with the standard head clutched photo permitted me to seek help for that. Stigma gripped me anyway like a hug from an arm wrestling champion; I didn’t like the diagnosis depression either.

I wanted (and still want I guess) to be normal, labels are for jars not humans but at least with a name I know with whom I need to fight.

I know some people don’t believe in diagnosis at all and others would rename some labels which I wholeheartedly agree with but I can only speak for me and my experiences here, I guess this is more of a brain fart than a blog post!

When to tell people is my next worry, I’ve applied for a new job and can’t help but wonder at what point I drop this in to conversation, obviously not until successful but do I mention in person or let the occupational health report drop that little nugget into the mix? Would I worry if I had a physical health condition, I doubt it, my worry is that they would correlate my illness and my competence. At this point I’m back to ‘its just a label’ with an indignant tone! I guess a label is easier to share than a full explanation of my behaviours when poorly to a new boss (well fingers crossed!)…