questionnaire

My new favourite pastime seems to be playing state-change detective.

A dip in energy levels? Do I need a rest, a double espresso perhaps? Or could this be the beginning of the end? Feeling anxious when I wake up with a jump start at 5:43 am? Will the anxiety dissipate on its own, or with the help of a small blue pill? Or am I backsliding?

Filling in the “bilan clinique” questionnaire for my next appointment with the psychiatrist provides a useful distraction.

questionnaire

The hypomania section is really easy: a multitude of ticked boxes.  When I’m “up” – shorthand for hypomanic – I’m textbook. Except that at this stage I know myself well enough to avoid certain patterns of behaviour. For example, I contain the impulse which could lead me in the direction of casual sex – a.k.a. the “never join Tinder” rule.

In the depression section, I feel pleased that I don’t have to tick anything really nasty. Sure, I’ve gone through periods where my brain convinced me I was failing atrociously on all the fronts that mattered (work, marriage, motherhood, life in general). I’ve seen the world through a negative, warping lens. I’ve been lethargic, reluctant to go outside (bordering on agoraphobia) and physically unable to socialize.  But, even so, I don’t think words like “despair” and “hopelessness” really apply, and I can say with absolute confidence that I have never considered self-harm, let alone suicide.

I think that may be one of the reasons why I went undiagnosed for so long. I didn’t tick enough boxes to qualify as clinically depressed, but I never went to see anyone when I was feeling the opposite. Show me a bipolar person who dislikes feeling “up”, even if the “up” is so extreme that it is quietly frying their brain cells.

My worst times have been more like an anxiety fever dream: worries (both real and  fabricated) surge out of nowhere and take me over, becoming obsessions; reason begins to circle the plughole. The anxiety disrupted my sleep, affected my weight, and sometimes brought on a form of paralysis.

I have a vivid memory of sitting hunched over on my bed one evening after work, staring at my feet, unable to make my children dinner. Deciding what to eat was simply an impossibility. I waited until my husband got home, and he found me there, weeping. Silently of course, because I didn’t want my kids to worry.

It’s the temperament section of the questionnaire that I find the hardest. The psychologist who explained it to me was very insistent that I should answer these questions not as “up” me or “down” me, but try to get beyond those versions of myself, to my baseline, default state and habitual behaviour.

It’s so difficult for me to do this that I pack the papers in my suitcase and enlist the help of my mother.  But even she – the Expert – struggles with some of the questions.

For many, I could confidently tick a box to describe me when I’m “up” (off the charts optimism, multi-tasking ability, energy, drive to socialize, boundless creativity, memory recall, empathy – in short, superpowers)  or “down” (patchy memory, loss of self-confidence, indecisiveness …)  But when I’m neither-nor, I haven’t a clue how to respond.

I kind of wish there was a “meh” column. I opt for a few question marks, instead.

Is total absence of a baseline temperament a thing?  Is there a blank space where that is supposed to be? It’s a bit like the nauseating aura I get before one of my migraines. There are flashes of light and colour, as if I’ve looked at the sun – or a light bulb – for too long, but also blind spots.  However hard I try to focus on something right in front of my eyes, it is simply not there, as though it’s been photoshopped out or blurred, like a child’s face in a French paparazzi shot.

This is all very disconcerting, and could potentially lead to a “who am I?” or “do I even exist?” type existential crisis that I’m not quite ready or equipped to have right now, thank you very much. So let’s just leave it at that, and say I have a number of questions for my therapy team.

The worst part, however, comes near the end where there are a series of statements that cause me to question whether any of me is actually me, and not some sort of symptom of my disorder.

I’m translating from the French, but standout examples include:

My biting sense of humour has got me into hot water. Hmm. Well, I did get fired for mocking my boss’s sock suspenders online, so that probably counts. Although I managed to turn it into a positive, eventually.

I swear profusely.  Fuck yeah (not on paper, but plenty IRL). Unless I have my parental control filter switched on, which is not, contrary to what you might imagine, when I’m parent-ing, but when I’m in the company of my own parents.

Do you mercilessly rip the piss out of people you barely know? Um, well, only every boy I’ve ever tried to “charm”.

Is nothing sacred? Are all my favourite things about myself going to fall away, one by one?

I’m prepared to accept that where disorder, temperament and personality meet, there may be a fuzzy space, without clear boundaries. I’m prepared to accept that bipolar people may be more likely to be or do this or that.  I’m prepared to allow that my personality traits may be exaggerated by bipolar ups or downs.

But, that said, I really want them to remain mine nonetheless.

plea

I sit in the back of my parents’ car, my son gently snoring in his booster seat to my right. I marvel at the tiny freckles peppering his nose, and make a mental note that his hair has suddenly reached the too-long stage, even though it looked just fine yesterday.

My music is turned up too loud in my headphones and I have my sunglasses on, even though it’s 8 pm and the sun is low-slung over the horizon. At this precise moment, the world is just too bright; I need to dial it down.

I’ve been remembering the recurring daydream I used to retreat into as a teenager whenever my family went on a long car journey. It was an out of body experience: I would run alongside the car, sprinting through fields, leaping over hedges, somehow keeping pace. My hair, in the daydream, was long. It streamed out behind me as I ran.

I always thought that waking fantasy was about escape – in a figurative sense, or maybe a mundane and prosaic one. An escape from the nausea-inducing fug of my father’s pipe tobacco?  Irritation at my sisters bickering in the back seat? Interesting, though, that I wasn’t actually running away, but always chose to chart a course parallel to our car. Something to discuss with my therapist, perhaps.

Today has been another perfect day; the latest in a long, unbroken sequence of good days. A morning visit to one of my oldest friends. Rummaging together through a treasure trove of photographs while our children bent their heads over an iPad. Watching my son gleefully peeing in the bushes with his cousin (“look how far my wee sprayed, mummy!”) Chasing a giggling toddler in circles around the garden, growling like a tiger with strep throat, and not caring how stupid I looked.

I’ve been off the meds for six or seven weeks now. At first, there were a few really unpleasant physical withdrawal symptoms. Even now, a full night’s sleep is only possible with the help of a dose of melatonin.

But the overwhelming feeling I have is as though I’ve hit the un-mute button.

Food tastes amazing. The world throbs and glows. I see the beauty in little things, constantly pausing in the street to take photographs. I give money to beggars. I strike up conversations with the lady on the checkout or the mother peeping through the school gates into my son’s playground. I dare to reach out and make new friends, or rekindle old friendships. I make travel plans. I smile at strangers for no reason. The words flow from my fingertips.

At this halfway point in my life, I feel certain, today, that the blank pages ahead will be populated with friendships, loves, adventures and possibility.  Looking over my shoulder, instead of a succession of failed relationships and long periods of time working in jobs that made me miserable, I’ve rediscovered the ability to focus on the positives: my girl and boy, people I’ve met, places I’ve visited, things I’d forgotten I’d done or written that now make me feel proud.

The mood stabilisers filtered out the lowest frequencies but also the highest. The darkness lifted but the lights remained dimmed. It’s too soon to tell whether I can function, long-term, without them but I so desperately want to believe that I can and I will. Because while I was in their thrall, I had to sacrifice too much.

Please don’t let me be a ticking time bomb. Let me choose this version of myself and settle in for the duration.

a-levels

When I see a new psychiatrist or psychologist – and in the almost three years since my diagnosis, I’ve seen three – one of their first questions is usually whether I’m able to pinpoint when I had my first real “episode”.

It’s not too difficult for me to pinpoint, actually, as it involved a debilitating panic spiral and a prescription for beta-blockers.

The context was Sixth Form College, I was 18-years-old, and it was a few days before I was due to sit my A-Level exams.

I’d always been a grade A++ student in every single subject, bar sport (and we’ll get into that, at some point, as I’m now realising that my motor for being so consumed by and obsessed with academic achievement, my need to be “best” or “top” or to get 100%, can likely be linked to my bipolar).

At this juncture, a few days before the exams which would determine whether I would go to university, my first serious boyfriend decided to end our relationship.

Now, just to be clear, I’m not blaming him for this episode.

When I look back on that time, it is with a great deal of fondness, even if the memories are now viewed through a lens of mild embarrassment. Chiefly because I’m not sure anyone who knew me at the time can remember what my face looked like, as it was pretty much super-glued onto his, and I’m sure there were plenty of people in the Sixth Form common room who frequently wished we’d just “go get a room”.  It was my first sexual relationship, and I think that’s all you need to know in that department.

But he was also my best friend, and I know we were good for each other, for the year or 18 months we were together.  I remember writing the letter that landed him a Saturday job in a computer store in town. Recently, he credited me and another friend of his with being the impetus behind his decision to go to university. We are still friends, albeit Facebook friends, and I’m happy to see, from afar, that he’s done really well for himself. No regrets, ever, is my motto.

But I don’t have a great track record with impulse control – which is another point we’ll be revisiting – and I’d been unfaithful to him while away on a week-long French residential course at a place called Villiers Park, to study French literature.

My memories of Villiers Park don’t involve much French literature. Instead, they mostly revolve around evening visits to the local pub, listening to “Mixed Up” by The Cure, a trip by coach to see “Dangerous Liaisons” at a theatre in London, and a tall, dark-haired boy called James with a biting wit, which slowly reeled me in.

When I returned from my Villiers Park interlude, I confessed to my transgressions. Predictably highly-strung teenage melodrama ensued, and my boyfriend and I broke up for a while. (Meanwhile, James sent me red roses, and we tried to keep things going via letter and phone for a time, as he lived a couple of hours away by train, but long-distance relationships have never been my forte.)

My boyfriend and I ended up getting back together for a few weeks, or maybe even months, but I think we both knew that we were broken; that I had broken us. When he finally ended it, he told me he knew he’d never be able to trust me when we went away to our respective universities at opposite ends of the country.  He was clairvoyantly right about that, of course. My track record only worsened over time.

After we broke up, I spent hours howling into a wet pillow.  The despair – over losing him and the entire circle of friends that was part and parcel of being with him – spiralled out of control and morphed into something else that took hold of the reins and made me seriously question whether I was losing my mind. I couldn’t focus or concentrate. Revising was out of the question. The voices were telling me I was doomed. I was going to fail everything. My future was over before it had even begun. I was locked away in a place of hysteria and panic, and my mind, busy doing those ever-decreasing circles, had thrown away the key.

A family friend, who was also a Doctor, and whose kids I’d babysat for on numerous occasions, was prevailed upon to come and see me. He listened to my wails, then prescribed me with a course of beta-blockers; enough to see me through to the end of my exams.

They worked. I sat my exams, in a strange parallel state of sedated, detached calm. I got my straight A’s, after all.

Like many people, in times of stress, my most frequent nightmare involves an exam I have to take that I haven’t been able to revise for.

But it’s only years later, with the clarity of hindsight and the armed with the knowledge of my diagnosis, that I realise this was my very first journey into mixed-state territory.

birthday

It’s not easy to forget the date, as the diagnosis came on the eve of my 42nd birthday.

I was signed off work for 15 days, initially.  But those days stretched into weeks, then months. I finally felt sane and stable enough to make a decision and negotiate my way out of my contract in early January, signing the exit papers in March, a full (*counts on fingers*) 7 months later.

That day remains a bit of a blur, to be honest, but here are the things I do remember.

It was a Monday.

I was a mess but I dragged myself to work because, for the first time in my life, I found myself afraid to be at home alone.

I’ve never come close to contemplating self-harm, but that day my brain was racing around in ever decreasing circles, like the needle on a record, and there were voices (well, my voice or, to be more accurate, a whole cacophony of my voices) echoing in my head.  I couldn’t pick up the phone or write an email. I hadn’t slept. My heart was racing. My palms were sweaty. I’d lost about 7 kilos (a stone!) in a single week.

But despite all this, I didn’t want to stay at home, even though a note from my GP, allowing me to do so, was burning a hole in my pocket.

I spent a good deal of time that day in the staff toilets, head firmly wedged between knees, trying to focus on breathing.  I spoke to the nice lady from HR, at length. I went for a long walk at lunchtime (because eating wasn’t an option). I took Lysanxia after Lysanxia, but the drug no longer seemed to be having any discernible effect.

Mostly I waited. For my appointment in the late afternoon with a psychiatrist at the Centre for Stress and Anxiety, conveniently located close to my place of work.

Extract from an email to my Mum, at 00:07 on Sunday: “I had some blood tests today – well actually it’s yesterday now – just in case thyroid or some deficiency could be to blame. In the meantime I have some pills to calm the adrenaline (remember my A-levels) and am seeing the psychiatrist I saw once before on Monday.  I think I’m willing to get some proper medical help with my ups and downs which are getting a bit too extreme for me to cope with.”

I’d seen the same psychiatrist exactly a year previously. September always seems to be a bad month. Back down to earth with a crash after the holidays. Back to work for me. Back to school for the kids.

The last (and also first) time we’d met, I remember her asking me some questions about the highs and lows I’d been describing. Did I spend more money during the highs? Did I engage in any risky sexual behaviour? A colleague of hers had been seeing me on and off for “anxiety issues” for the past three years, but I think this lady put her finger on the problem that very day and, if memory serves correctly, the word “bipolar” was even spoken aloud.

I didn’t return to see her for a whole year. I must have felt better, shortly afterwards. Or perhaps I wasn’t quite ready to face the music just yet.

The day before my birthday, when I returned to see her, I tried to explain how out of control I was feeling, in between the sobs.

Gently, she explained to me that I was experiencing what is referred to by psychiatrists as a “mixed state” – a state combining features unique to both depression and mania. The despair, blended with fatigue, contradicted by the racing thoughts, the flight of ideas, the nervous energy, the depressive ruminating (moo!) … all this madness could be labelled, explained, and even knocked on the head, simply by taking a small, white pill.

As I walked along avenue Marceau, prescription filled, I called my husband, in floods of grateful tears.

There was something wrong with me, but I wasn’t broken.

I could be fixed.

olanzopine 10mg