Motherhood, mental illness and beyond

Posts tagged ‘cyclothymia’

To my children

I know that you may never see this, but I need to write it even so. Because you are my wonderful, funny, loving children and I feel that I owe you this.

At the time of writing you, DD, are just a couple of weeks away from your fifth birthday; you, DS, are two and a half. You’re both loud, boisterous, confident and happy children and I love watching you play together. Your peals of laughter and the tenderness you show each other melt my heart; so too does the way you snuggle up together with a storybook. I love you both more than I can ever say, and more than you can ever imagine (and yes DD, even further than the edge of space).

At the moment Daddy and I are having a tough time because we’re both a bit poorly. We’re both a bit grumpy at times, Daddy often can’t play with you as much as you would like and I’m not as good at funny games as I used to be. You’re both very accepting of this but I know you don’t really understand. And why should you? You know that I always have a sore back but how could you possibly understand the vagaries of mental illness?

I can’t figure out a way to explain to you what bipolar means, or that Daddy’s medicines keep changing because his psychiatrist is trying to find the right balance to bring him back to himself. I don’t want to tell you that sometimes medicines can make you feel worse and not better, and that that’s why Daddy has barely left the house for the last fortnight. You don’t yet need to know about anxiety, or panic attacks that are sometimes so bad that Daddy has to shut himself in the bedroom for a while so you don’t see him shaking and crying for no apparent reason.

If this was all that was wrong, if you had a mentally healthy mother, perhaps I wouldn’t feel so bad. But having to look after Daddy all the time as well as trying to stay bright and cheerful for you is taking its toll.  My cyclothymia, usually fairly well controlled by anti-depressants, is flaring and my moods are all over the place. I can be happy one day, one hour, one moment, and cast into the depths of despair the next. It makes taking care of two lively children very difficult at times and I hope you never realise just how much I sometimes want to scream at you to leave me alone because your questions, bickering and noisy games make me want to claw off my own skin. I’m deeply ashamed of feeling this way and I worry that occasionally you might have an inkling of what I’m thinking, that you might catch a glimpse of the distress I’m trying so hard to hide from you.

I know that I’m not a dreadful mother and that you could be in a far worse situation (and that many children are). On the whole you’re happy, bright and playful children who are capable of making me laugh until the tears roll down my face. I know you love each other (even when you’re arguing) and that you know that Daddy and I love you very much. I just can’t help wishing that things were different, and feeling guilty because they’re not.

The day’s not far off when “Daddy’s just not feeling well” and “I’m a bit poorly today” won’t be enough of an excuse. DD, already you’re questioning why Daddy is ill so often and soon I’m going to have to work out how to explain a little bit more of what’s really happening. But I want you both to stay ignorant of this reality a little while longer. I don’t want you to know that there are some things that can’t be fixed, and that having a kiss and a cuddle doesn’t always make everything better. I want to protect you from this difficult truth, because once you learn it your innocent trust and faith in the omnipotence of your parents will be forever tarnished. And I’m not ready for that just yet, so please let us carry on this deception a while longer. I love you both, always.

Mummy.

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It’s time to talk

Today, the 6th February 2014, is “time to talk” day. This is run by the charity Time To Change, which is led by both Mind and ReThink (mental health organisations). The idea behind today is to open up and be honest about mental health, to start a conversation and to help break down stigma. This is my contribution.

I’ve had mental health problems almost 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). But what does this actually mean?

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:
image

The psychiatrist who diagnosed me explained that cyclothymia often 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 or fidgeting, my thoughts race and I constantly have new (usually impractical) ideas about what I want to do next. 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.

Cyclothymia isn’t just having hypomanic highs and depressed lows, though; there’s a reason it’s also known as “rapid cycling bipolar”. Although moods can last for days or even weeks, they can also change in the blink of an eye. Some days I can cover the full mood spectrum in a matter of hours, never knowing how I’m going to feel from one moment to the next. This isn’t in response to anything – I can be having a really good day and suddenly plunge into the depths of depression. It’s unsettling, not just for me but also my family.

Then there’s the anxiety. Mostly my anxiety focuses on my family – I live in perpetual terror that someone I love is in danger or about to die. If DH is late back from the shops he must have been run over. If the phone rings it’s obviously going to be DD’s school telling me she’s had a serious accident. At night I wake up repeatedly to check that 2yo DS is still breathing, and his recent surgery was almost more than I could bear.

The minor focus of my anxiety is quite common: I often struggle with social situations and talking to strangers, which is utterly ridiculous when you consider that I worked in the civil service for 6 years and used to present at high-level meetings and international conferences! But for now that’s how it is at the moment. I recently had to describe my social anxiety to a friend:

“Chatting to people at playgroups, in cafes, even the school run can be torture. When I have to speak to someone unfamiliar in a social situation my heartrate increases and my breathing gets shallow. My mouth goes dry and I feel as though my throat is closing up. If I can’t escape then I usually end up having a full-blown panic attack”.

Obviously this causes problems when it comes to having a social life of any kind! Although I sometimes manage to meet people for a casual coffee, in the last year I’ve only managed to go out with a group of friends once. Just once, to a local restaurant, and even then I could only stay for about an hour and a half before getting overwhelmed and having to leave.

So there you go. That’s me. Mood zipping around like a demented pinball and perpetually anxious. 🙂 I’m happy to answer any questions or comments that you may have, both here and in person if you know me. So come on – let’s talk.

Is it me?

I’ve had mental health issues for as long as I can remember, from compulsive binge-eating and self-harming at the age of 7 to depression which began in my early teens and my current diagnoses of cyclothymia, generalised anxiety disorder and binge-eating disorder. Despite my mental peaks and troughs I’ve always been able to function, hold down a good job and socialise with friends.

Until recently. The birth of my daughter, four and a half years ago, plunged me into a pit from which I’m still struggling to escape. Not because I didn’t want her or love her, but my postnatal depression (PND) was so absolute that it seems to have altered my mental state almost permanently. After a couple of years and several therapies I felt pretty recovered, only to succumb to antenatal depression (AND) while I was pregnant with my son. Unsurprisingly after his birth I was once again plunged into depths of PND. Once that was resolved I was referred to a psychiatrist who diagnosed me as having cyclothymia (or rapid cycling bipolar disorder) as well as anxiety issues.

At the time of writing I am fairly functional most days thanks to medication and a heightened awareness of my mood state. I do however really struggle with social situations and talking to strangers, which is utterly ridiculous when you consider that I was in the civil service for 6 years! But for how that’s how it is at the moment. I recently had to describe my social anxiety to a friend:

“Chatting to people at playgroups, in cafes, even the school run can be torture. When I have to speak to someone unfamiliar in a social situation my heartrate increases and my breathing gets shallow. My mouth goes dry and I feel as though my throat is closing up. If I can’t escape then I usually end up having a full-blown panic attack”.

Obviously this causes problems when it comes to having a social life of any kind! In the last year I’ve managed to go out with friends once. Just one time, to a local Thai restaurant, and even then I could only stay for about an hour and a half before getting overwhelmed and having to leave.

My current state seems to be hard for friends to cope with. Over the last few years I seem to have misplaced quite a few peripheral friends but also 2 very dear, loved and trusted friends. These friends knew everything about me, about my struggles with mental illness, and encouraged me to be open with them. But in the end the burden of my problems became too much for them to deal with on top of their own lives, and they disappeared. Now I may be losing another good friend, someone I’ve been friends with for over 20 years, because of my mental ill health.

There are only so many times DH can tell me that these losses are not my fault but theirs, before it starts to ring hollow. If it’s not my fault then why does it keep happening? Maybe I don’t try hard enough – I’ve been told in the past that I wallow in my depression instead of fighting it. Or maybe I’m too truthful, I’ve been told that by being honest about my struggles I’m making others miserable and overwhelmed. I wonder whether it would be the same if I had a long-term physical illness? Would friends still drift away or would they cope? Am I the problem? Am I asking too much of my friends? Am I too needy, too confiding, too overwhelming? Because to be blunt, it’s pretty bloody overwhelming being trapped inside my mind day in and day out. At times the despair (will I ever recover?), the self-loathing (I’m so pathetic!) and the constant self-examination (is that a rational thought or is it my illness talking?) are so overwhelming that I would do almost anything for just a few minutes peace. Even my nights aren’t restful, thanks to frequent and vivid nightmares.

Whatever the reason may be, with a couple of notable exceptions I’ve stopped confiding in friends now, and even with those exceptions I’m careful about what I say and how much I reveal. I have a couple of trusted family members and of course I’m completely honest with DH, but as I explained in my last post he has his own issues to deal with at the moment. My only other real solace is Twitter, where hundreds of people who barely know me are kind and supportive. How odd, that I can be so open with virtual strangers yet have to be so wary around friends.

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:

image

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.

The fidgets

I’m all over the place tonight. It’s like when I’m unmedicated and having a mixed episode but not as severe. Earlier I felt very low, very apathetic, slow of thought and melancholy for no reason. Moving took a lot of effort. Eating took a lot of effort. That low feeling gradually wore off but has now been replaced by the dreaded fidgets…

I am unable to keep still, both mentally and physically. I spent most of the last hour restlessly twitching my legs, sitting with my legs crossed and jerking a foot rhythmically. If I became aware of what I was doing I’d stop, but that felt weird so I’d have to start again. Even now, lying in bed, I’m rubbing my feet together. My mind is racing, flitting from one thought to the next. One moment I’m mentally drafting a blogpost or two and then suddenly I’m composing a shopping list or working out what needs to be done tomorrow or thinking about a book I read or a programme I watched or craft things to do with the children or any number of other things.

Writing things down doesn’t help when my brain’s so active, for every 1 thing I note down another 2 pop into my head. I perpetually have music in my head and tonight it’s an irritating song from one of DD’s singalong CDs. I can’t concentrate enough to crochet or knit or read a book; my mind just skitters off in a different direction. It’s frustrating as hell and probably means it’ll be past one o’clock before I eventually doze off, and then I’ll have weird dreams. Still, that’s better than the frighteningly vivid nightmares that I often have these days.

Hopefully I’ll be on a more even keel tomorrow. I don’t fancy fidgeting my way through half-term!

An open letter to my friends

There are few questions that make me quake as much as a simple “How are you?”. My automatic response is to say that I’m fine, I’m ok, I’m doing well, whether I am or not. It’s like a Pavlovian response and it’s the same no matter who’s asking. I consider myself to be a fairly articulate woman; I have 2 degrees, worked as a forensic scientist and as an analyst for part of the Foreign Office. My blog posts seem to be quite well-received. And yet there are days when I really struggle to communicate with people on even the most basic level.

A dear friend may send me a lovely chatty message via Facebook and I want to reply – but can’t summon the mental energy. The words won’t come out. Another friend may call for a chat and I find myself racking my brains for something to say. Face-to-face encounters can be awkward as I try to maintain a semblance of normality but can constantly feel the panic rising in the back of my mind.

Social media has been a godsend. Facebook helps me keep in touch with friends who live far away, while Twitter and Mumsnet both have very supportive communities. Weirdly I can spend ages on Twitter or Mumsnet, talking with virtual strangers and dipping in and out of conversations. Facebook is a bit trickier as it houses people who know the real me instead of my more confident online persona. Sometimes I can chat to friends for ages on Facebook but sometimes I freeze up for days at a time.

The other question that strikes fear into my heart is “Do you want to meet up?”. Don’t get me wrong, I’m actually a pretty sociable person and I’m fortunate to have some wonderful friends. But no matter how optimistic I am when arranging a social visit, the closer it gets the more nervous I become. Some days I can force myself to just get on with it and go, and I’ll generally have a good time. But some days I just cannot make myself go. It’s so stupid. I can chat superficially with the other preschool parents while we wait to collect our children, but I struggle to meet a friend for coffee.

I need to get this under control so here’s my plan. There are a few playgroups in the area that I can take DS to, it’ll be good for him to socialise with children his own age. Even though the thought of it makes me about as comfortable as jabbing pins in my eyes, I need to screw up my courage and do it. So that’s next week’s task. This week’s is to take DD to a friend’s house after preschool on Friday. She really wants to go and her friend’s mum is a good friend of mine. Yet already I can feel the unease roaming about in the back of my mind, no matter how much I try to squash it.

If you’re a friend who gets exasperated with the constant stalling and excuses as to why I can’t meet up, I’m sorry. I will try harder. But please understand how hard it is for me at the moment; the medication is controlling my cyclothymia but as yet my anxiety remains untreated and at times it is overwhelming. So don’t take it personally if I drop off the radar for a while or cancel on you. As the saying goes: it’s not you it’s me.

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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