Motherhood, mental illness and beyond

Posts tagged ‘anti-depressants’

My net

Trigger warning: suicide.

For ages now I’ve been pottering along, coping ok with the usual day-to-day stuff and seemingly well thanks to my anti-depressants. Until a few weeks ago, that is. For no discernible reason my mood took a nosedive and I began to have suicidal thoughts for the first time in almost 3 years. I’m not saying that I wanted to kill myself, I didn’t. But thoughts of suicide were continually popping into my head and I found myself dreamily considering ways of ending my life. Needless to say, this terrified me. Which, in a way, was a good sign – when I’ve been truly suicidal these kind of thoughts have been welcome, even comforting. But this time they were intrusive and frightening.

I’m lucky to have a great GP, who managed to squeeze me in at short notice. She listened sympathetically, checking that I felt able to keep myself safe and that I had people I could turn to if that changed. She increased the dosage of my anti-depressants and fired off an urgent referral to the community mental health team (CMHT). Much to my surprise they called me later the same day and offered me an appointment with a mental health nurse the following morning. The appointment went well and the nurse was reassuring. She agreed that I seemed able to keep myself safe despite the suicidal thoughts, and gave me the details of the CMHT helpline in case I started to have difficulties with that. She also referred me back to a psychiatrist for mid-April, just to be on the safe side.

Gradually my mood began to improve, and I went from barely being able to move off the sofa to throwing myself into the housework with an enthusiasm that’s most unlike me! I haven’t had any suicidal thoughts for days now. I’ve seen my GP again and she’s happy that I’m safe and managing far better. For now I’ll continue on the higher dosage of anti-depressants, but if I start to get too high or notice an increase in hypomanic episodes we’ll try lowering it again.

I consider myself to be very lucky. I have nothing but praise for the NHS, my GP and the CMHT, who saw me so swiftly. DH is my rock, and my wonderful sister and parents are supportive. My dear friend Sutton is a treasure beyond compare and I also have some amazing friends on Twitter who, although we’ve never met, are kind and caring and incredibly supportive (you know who you are!). I am so grateful to all these people; for listening and reassuring, and for being the safety net that stopped my headlong plunge into darkness. I really don’t have the words to express how thankful and humbled I am by their love and support, so I’ll just say this, from the bottom of my heart:

Thank you.

Relative normality

I’ve had mental health problems all my life. As a child I self-harmed and binged; I’ve had depression since my early teens. My current diagnoses are cyclothymia with underlying depression,and generalised anxiety disorder (GAD).

Cyclothymia is a mild form of bipolar disorder. Where most people’s mood averages out as a straight line with occasional fluctuations up or down, this is what my unmedicated moods look like:

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The psychiatrist who diagnosed me explained that cyclothymia usually requires treatment with mood stabilisers as the hypomania (the highs) can be pretty disruptive. But because I have the peculiar combination of cyclothymia and depression, my base line is lower than most people’s. For example, at the moment I am a bit hypomanic. But instead of displaying the usual symptoms of hypomania I am what most people would consider to be normal. I’m enjoying playing with my children. I’m getting the housework done, I’m singing along to the radio and I’m able to talk to other parents in the school playground. I still find it hard to sit still without fiddling and my thoughts race. But for the most part I am “normal”.

Of course unfortunately this means that my low moods are lower than the average. When I’m in a trough I struggle to get out of bed, I struggle to interact with anyone and playing with the children is an almost unbearable ordeal. But this is also a kind of normal for me; this is what I’m like when I’m unmedicated and the depression strikes.

So which is the real normal? My unmedicated, depressed pit of despair? My hypomanic and twitchy productivity? Or the same normal that most people meet so effortlessly, with minor ups and downs but generally trundling along the same level path? I don’t know. To he honest, these days even I don’t know what’s normal for me.
But I don’t think it really matters all that much. What we perceive as normality is just the top of the bell curve, the result of statistical homogeneity. For something (or someone) to be considered normal they just have to be in the majority, no matter how slight the margin may be. No two people are exactly alike – and that’s normal.

But you don’t seem the type…

Friends are often surprised when I mention my mental health problems. To me it feels as though I’m walking around with a brand on my forehead, marking me as separate from all the ‘normal’ people. But others never seem to see me this way; typical responses include “But you’re so cheery!”, “I would never have guessed” and my personal favourite “But you don’t seem the type!”.

Then once it’s out in the open a lot of people never mention it again. Which is good in a way, because it hasn’t affected our relationship. But it also means that I don’t know what that person is thinking – whether they are comfortable around me still or whether they’re just going through the motions, waiting for me to  ‘go mental’.

In contrast to this are the reactions I get to my physical disability. I have degenerative disc disorder and frequently need to use a walking stick. I get a lot of sympathy and friendly interest from strangers as well as friends. No-one has ever told me that I “don’t seem the type” to have a physical condition, although as a woman in my thirties using a walking stick I do sometimes get odd looks. 🙂

So what’s the difference? Stigma, misconceptions and ignorance. One in four people will suffer a mental health problem at some point yet it is still taboo; people talk about mental illness in hushed tones and using euphemisms. Depression is often seen as a sign of weakness and thanks to misconceptions and inaccurate media portrayals many people are scared by illnesses like bipolar disorder or schizophrenia.

A physical injury or illness is usually more obvious than a mental illness and more easily understood. Because of the taboos surrounding mental illness quite often people don’t understand what it can be like. You can understand what it would be like to have a broken leg, right? Can you understand how it would be to have depression so badly that it’s impossible to get out of bed or speak to people?

Mental illness is often viewed as a sign of weakness, that if the sufferer merely pulled themselves together they would be fine. But no-one thinks this way about physical illnesses because it would be ridiculous. No-one tells a diabetic to stop taking insulin and yet people taking anti-depressants are often encouraged by friends and family to stop.

Is there a point to this rambling ranty post? Yes, a very simple one. If someone tells you that they or someone they know is suffering from a mental illness, please pause before you react. Think, would you react this way to news of a physical illness? Having a mental illness can be incredibly isolating and a lot of sufferers feel ashamed – together we can change that.

Stigma (n.): from Latin ‘stigma’ meaning to mark or brand

When you hear the words “mentally ill” what’s the first thing that pops into your head? I bet for most of you it wasn’t a friend, neighbour or colleague but someone violent, scary or strange, possibly in a straitjacket or shuffling around like a zombie because of medication. And yet at any given time 1 in 4 people are likely to suffer from some kind of mental illness. So why is there still such a stigma about it? Why the stereotypes and ignorance?

It’s a complex issue but I think that it may be partly due to unease that our ‘sense of self’ can so easily be altered. We humans live inside our heads and have a self-awareness that is unique. We are acutely aware of who we are and our place within a group, and yet mental illness can alter that ‘self’ very easily. This makes people uncomfortable. And when something makes people uncomfortable they often seek to distance themselves from it.

There’s also the problem that mental illness isn’t easily fixed the way a broken leg can be. The human mind is unbelievably complicated and we are still only beginning to understand how it works. A common misconception about mental illness is that the sufferer should just snap out of it, switch it off, that they’re seeking attention. But who would dream of saying such things to someone with diabetes or kidney disease? Physical illness attracts sympathy; mental illness often merely attracts impatience and scorn, as though it is a sign of weakness. Anti-depressants are often demonised as being addictive and handed out far too easily by doctors. But strangely few people would make the same criticisms about painkillers, which are often available over the counter instead of by prescription.

The media is also partly responsible for the ignorance and stereotypes surrounding mental illness. I can think of very few films or programmes where a person with mental illness is portrayed sympathetically. It’s all too common to have the violent murderer, the weird loner or the crazy kidnapper. It’s not just fictional media of course, the news media is just as bad. A common incidence is when a violent or terrible crime has been committed (parents killing children for example) and the journalists will ask “Were they depressed?”, “Was there any history of mental illness?”. Now, of course people with mental illness commit crimes. People without mental illness also commit crimes. But the way that the media glibly imply that only someone who is mentally ill could do such a thing infuriates me. I’ve been mentally ill for most of my life and the most criminal thing I’ve ever done is accidentally run a red light.

Talking to friends and family about mental illness is difficult. Some will be sympathetic and understanding; some will be sympathetic but won’t understand. And of course there are those who withdraw from you as a result. Membership of the matter group isn’t always due to ignorance either, I lost a very close and trusted friend when I had PND after the birth of my daughter. This friend had also had PND previously but couldn’t cope with me struggling for so long and withdrew from me.

It takes a lot of courage to be open about mental illness. I don’t mean online – I’m very open about my problems here. But I tend to hide it as much as I can from people I know in real life. I don’t want them to look at me differently; I don’t want them to see me as a diagnosis first and a person second. I don’t want to lose any more friends. And yet there are those who know and are extremely supportive. My husband, my mother and sister, 3 friends whom I can talk to honestly about absolutely anything and know that they will still be there.

The more open we are about mental illness the less stigma there will be. But in order to be open we must run the gauntlet of that stigma, of being branded as ‘other’. It’s a difficult cycle to break but I am trying – I am starting to be more open about my problems and so far it’s been ok. No-one’s run away screaming yet. 😉

(This post was inspired by the Time To Change campaign).

Ladies and gentlemen, please fasten your seatbelts

At the moment I’m like an aeroplane tossed around in turbulence; dropping like a stone one moment and bouncing back up again the next. Never knowing when the next air pocket will take me by surprise. I just want a nice smooth journey where I can get up and stroll around and maybe have a drink from the trolley. Maybe even pilot my own aircraft for a while instead of having to rely on autopilot medication to give me a smoother journey.

I took the first step towards this today when had my psychiatric assessment. It was much easier than I had anticipated – I think I had built it up in my head as a big scary confrontation with a besuited bloke sitting in judgement behind a large desk. In fact the guy wore jeans and a shirt and was very affable and friendly.

He was very thorough and at the end of the assessment he told me that in his opinion I have generalised anxiety disorder. He’s pretty sure I don’t have bipolar 2 as my GP suggested but wants me to keep a mood diary for the next few weeks to check for possible cyclothymia. He’s going to refer me for CBT (hopefully the proper face-to-face one this time instead of the crappy computer one) and suggest to my GP that she increases the dosage of my anti-depressants.

We spent quite a long time discussing my mood cycles and their effects and at some point it dawned on me that I have no idea what it’s like to feel normal. I don’t know whether my upswings are what a regular person would call normal, or whether they take me higher than that. Fortunately the mood diary has a detailed scale in it so I just have to find the appropriate box to tick.

It did make me wonder though. I keep saying that I want to be normal, that I want to function normally. But somewhere along this road I lost sight of what ‘normal’ feels like. I have had depression off and on for nearly 20 years; I have self-harmed for about 25. Would I be happy being normal? Would I even recognise it? What is normal anyway? When it comes to mental health does ‘normal’ even exist?

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