The end of the beginning

I began posting here last spring, when someone in my peer supervision group, seeing what an impact the experience of having been ill was still having, suggested I tell my story in 18 minutes and record it, like a TED talk. I meant to do this - tried, in fact, to do it - but I ended up here, with the written word.

I only wanted to do one thing: I wanted to say, this is what it was like. And I've sorted almost 150 vignettes into Tumblr, tagged so that I can (I hope) piece them back into a story, later. It has let the poison out, which I hoped might happen, and slicing and dicing sentences again, something I always did for fun, before, has been a huge joy. I'd forgotten how much delight that could be.

But I meant this to be a record, not a diary, and, at the moment, I don't have a lot to say; worse, I find I'm hunting out things to say. When I do have more, I'll log on. I expect it'll be soon.

The role of the church

The sorceress is pharmacologically aggressive, but she's smart, and she knows her way around the drugs. She's also unconventional, which is fine by me. When one of my sister's friends, a clinical psychologist, hears who's treating me, she rolls her eyes and says, “She's craaazy. Did you know she bought a church?”

My sister presses her for details, and she says, “yeah, she was just driving past one with her husband when she noticed it was for sale, so she bought it.”

Now, this may or may not be true. I learned this after the last hypomania, so I haven't been able to do anything with it. I'm not aspiring to get hypomanic any time soon - not because it isn't an awesome, silvery feeling (it is), but because bipolar disorder obeys the laws of classical physics, and whatever goes up inevitably comes crashing down again, hard. But, if it happens again, at least I have something in reserve for the inevitable diagnostic runthrough:

“Have you been making a lot of impulse purchases?”

“Do you mean things like Coke and chocolate bars? Or more like… a church?”

He said, in a voice like the computer off 2001,

“He said, in a voice like the computer off 2001, ‘Rob, why do you think we’re here? Why do you think we’re here in the hospital, Rob?’”

“And I said, ‘Well, I’m bipolar, and I presume you need the fucking work.’”

Still watching Rob Callaghan

This bit's from 7 mins 30 secs to 8:40. The video's fuzzy, but it's fine on audio only.

Screaming with laughter

I had a post all prepped up (on buying a church - it's Lent, after all), but never mind that: I've discovered Rob Callaghan, a wickedly funny comedian who has - three guesses! - bipolar disorder. I screamed with laughter the whole way through, headphones notwithstanding. He had me from the first moment an audience member murmured "Oh-h" in empathy and he machine-gunned back, "Right response! Someone's not on lithium..."

A clawhold on my dreams

Even sleep is no escape: my mind is dredging the far past and flinging it at me, nights. Yesterday, I dreamed I was competing in a sport I haven’t touched since uni. Someone who was once a friendly acquaintance had asked me onto his team. I did not prepare, and I let him down. I drifted up through clouds of apologies and admissions - I’m sorry. I’m sorry. I let you down; I'm sorry - and, waking, knew exactly where I was: in the backlash after my talk with Krista.

A child relies on you. It relies on you for everything. You can’t let a situation like that happen.

She has a clawhold on my dreams.

Sheep-Shearing (III): Flipping through the mirror

“I think if you love your kids, and you genuinely try to do right by them, then you can’t go far wrong.” - Krista, back when none of us had any kids at all, and it was all theoretical.

The thing is, Krista, kids are born everywhere. In refugee camps, in communes, into poverty. To single mothers and to religious fanatics and to fathers who rape their kids. And, yes, to educated, married couples who get on well with each other, have the support of the grandparents, and work for a global corporation so large  that it can provide flextime and job security and a career all at once. And an on-site kindergarten, and an income that’s large enough to pay a nanny.

But don’t you see that that isn’t the benchmark? That - even though most people you know fit that description - that’s just your little petri dish? It isn’t the median. And it isn’t the comparator.

All my life, I have loved doing what I call flipping through the mirror: understanding how another person sees the world, from the far side of their eyes. Krista, I have tried for ten days to line myself up with what you were thinking, in order to say what you said. You can’t have seen what I thought you saw: the language witch, funny, geeky; someone who (quirks aside) is fine and just like us. Now I know that’s only true if we add, as long as she doesn’t… I’m not, I do get it, your equivalent, not equi-valent on all the tiles of the board.

And so I think what you see when you look at me is the deficits: you press your own ideal onto me as though it were a cookie-cutter, and when you take it away you see I’m missing too many bits of Play-Doh to be of any use for children. Is that it? A heap of minus signs?

(I’m still turning this over in my head. Such a close friend. How could I have so badly misunderstood what I seemed to her to be?)

The receptionist practises diagnosis

"My doctor emailed me to say that I have an appointment with you at one o’clock on Thursday," I say. "Is that right? I don’t think I got your letter because I’ve moved."

"All right," says the voice on the other end: a woman’s voice, slightly sharp-edged. I can almost hear the bifocals being pushed up. "Let me find you in the computer. Now. What’s your new address?"

"I –" This part never goes well. "I don’t have a new address, as such, exactly, but really I wanted to ask whether we could bring the appointment forward on Thursday. Even by, say, a couple of hours."

"You can’t come in the afternoon?"

"I’m going to Australia."

"To Australia!" she says, taken aback. I might as well be off to Iraq. "When are you back?"

"On Friday," I say, "but –"

"You’re going to Australia for two days?" I think I hear a brief pause. "Well, then we can reschedule for next week."

By this point, I can see the oncoming train. “Yes,” I say, “except that I’m moving early next week to [The Megalopolis at the Other End of the Country]”

"Okay,” she says. I really do hear a pause now. “You’ve moved, and you don’t have an address right now.”

"Mm-hmm."

"And you’re going to Australia for two days tomorrow, and then when you get back you’re moving to The Megalopolis at the Other End of the Country." She pauses again, a really deliberate pause, as though someone were waving a sign, PAUSE! at the audience. "Now!" she says brightly, when the pause has stretched impressively. "Do you know what I’m going to do? I’m going to go and get the doctor for you right now. I’m sure she’ll want to speak to you straight away. Don’t worry about a thing. I’m sure we’ll sort all this out, and you’ll get all the help you need.”

Locked wards

Now look at this: a common room, a sitting room: hard to place, exactly. Is it a common room? A waiting room? Note the tissues by the window, white against the radiator. And squinch your eyes to look beyond the windows at the fence. It rises in strands, then slopes back in barbs above you. This is a locked ward (though it wasn't being run as a locked ward when I was there). I didn't take the photo in the Clinic in the Alps, but much further east, above a long lake in winter.

If it had been locked, this would be the rec area, cold and bleak as the twilight outside (but hey: you'd be too ill to notice it):

And this is the breakfast area. (This is what I mean when I say that being ill in Switzerland teaches you nothing about the experience of Anglo-Saxon psychiatry):

Sheep-Shearing (II)

I have been trying to write this entry for days. Morgan, like the witch you are named for, you have the gift of working transformations. Thank you for being so outraged. Thank you for being so understanding. Thank you for being so very on my side.

“But you could come back to Switzerland,” Krista is saying. It is Sunday morning, the day already muggy outside, and we are messing about idly before breakfast. Krista is one of my closest European friends; I am godmother to her third son. I could bat the question away, of course, but she’s genuinely interested; she really wants to know what I’m planning and where I’m going. She’s a friend: she doesn’t deserve a lie by omission.

So I tell her: I’m about (or very nearly about) to start an IVF cycle.

The change in her is instant. At once, I see that a face as black as thunder is not just a simile: somehow she actually darkens; her body, sprawled contentedly on the floor, draws in and condenses, and she rises to her knees. And then it starts, and I feel it like thunder, like the kind of hail that will smack on the roof and bounce.

---

“You’re not well enough.”

“But you’ve seen me –“

“I’ve seen you for a few days,” she says. Somewhere, we have lost the logic. “A child is forever.”

 ---

“You have no idea of the exhaustion. You have no idea.”

“My sister has two kids,” I say;” I’ve watched her; I’ve seen what she’s gone through –

“No, you haven’t seen it,” she says. “You haven’t seen it, or you'd know you couldn’t do it.” (I know, a priori, that you couldn’t manage, so it follows that whatever you’ve seen, whatever conclusions you’ve reached, are irrelevant.)

I have argued with Krista plenty of times, have had her cross with me more than once, but I have never experienced this, not this judgment and fury, with its unrelenting, lashing quality

  “There are also the interests of the child to consider,” Ole says, in his measured way; in sync, Krista flings at me, “Haven’t you thought about the child? I’m telling you this because I am your friend. Don’t you know how it damages a child when its mother can’t cope? (How irresponsible you are to be thinking of giving a child a mother like you.)

--- 

“And what about passing the illness on to the child?”

This provokes me. “Look, I wouldn’t have wanted to be aborted,” I say sharply, because this stings. (Isn’t it better not to be than to be like you?)

---

Suddenly, she is hurling everything at me. “Forget about finding intellectual stimulation,” she says. “You’ll have to go back to the provinces; you’ll have to –“ (I am very sure about how you will have to live your life.)

 ---

“If you do try it, you can - I can’t do much from Europe, but you can ring me up,” she says widerwillig, against her will. This whole time, we have been speaking German, but now she breaks into English: “Mach’s, wenn du’s musst, but –“ and now her voice is heavy, and her accent strong “– without my blessing.” We could be re-enacting a story from the Brothers Grimm: I have stumbled across the tripwire to a spell, and nothing any of the three of us does manages to sweep the cobwebs off the day.

 ---

Later, when the two of them meet a friend for lunch, I say I will walk from Matakana Winery, where they are beginning a sculpture trail, to Snells Beach. It is over eight kilometres, a two-hour, undulating walk in the noonday sun; when I arrive at last, and collapse into a cafe for lunch and wine, I am completely zonked. Later, they and their friend pick me up, and we head back to the winery. Daunted by the small talk that I know will follow if I go in with them, and sleepy from the wine and the hike over the headlands, I say that I will wait in the car, and doze.

Instantly, Krista whips round. “And how are you going to manage that with a child?” she asks acidly.

“I won’t go for a two-hour walk in the blazing sun,” I say.

  But the fabric between us is well and truly torn. The easy joking that has always characterised us, the shuttle of wordplay and laughter and the weft of deep conversation, of what we really think, is gone. In its place is silence, and a kind of closed hostility.

Wise things people have said

Sheep-Shearing (I)

From across the Pacific, Jonathan pings me:

Oi! Why no blog posts?

I’ve been awhirl in work, but it isn’t really that: Krista and Ole, close Franco-German friends, have been out here, and I have come alive again. Speaking with them, leaving English behind, I have been shrugging into the person I once was. While they were here, I forgot the polite diplomacy I need to negotiate the everyday, and fell back into the web of years: all the time we share, all the words that bind us.

Odd: it used to be the other way around. When I arrived over there, I felt as though I were the one making first contact with aliens. (The envoy from the wind lands, I would say to myself, as I took in their cobbled and half-timbered towns with all of my eyes.) But I stayed too long: like a rogue anthropologist, I went native, nearly-native, until I got sick, lost my residency permit, and was catapulted home, an alien again.

Now, though, with Krista and Ole, I am instantly back Before; who I once was is sparking like a magnesium flame. They give me a book with the untranslatable title Was Scheren mich die Schafe, by a German who travelled to New Zealand.

Waiting for them to wake one morning, I send them rapid-fire text messages:

Was scheren Euch die Schäfchen? Habt Ihr Euch ausreichend Schlaf beschert? Soll ich Euch die Schläfen scheren?

I know I could go on and on like this, punning on Schaf and scheren, sheep and shear, and it’s all I can do not to laugh out loud in delight. I am truly me again.

And so it goes on, wicked and wonderful, until the very last day, when I say something else, something truthful and honest, and it all goes badly, terribly wrong.

Power of attorney

"She won’t give us a power of attorney," I say. My sister, her partner and I are discussing my mother’s increasingly unruly papers. "At least, not to either one of us alone." My mother is afraid, quite reasonably, that my sister will try to ‘put her in a home’.

"But I’ve got a power of attorney for Dad," my sister says. I glance up at this, and the air between us bends slightly, like metal on a summer’s day.

"He, ah, he thought you might be sick," she said. "He said, what if she’s in hospital?" It’s been seven years, but hey: I wouldn’t want to give a crazy person dispositive power over my life, either.

I am perfectly aware that I am being unreasonable, illogical: if I faced up to being diminished, if I accepted that I no longer quite count as much as the others, I would feel calmer. But it cuts: that he has done it, and that he has never told me.

It really only makes us equal: legislation allows clinicians to consult with family in the case of a compulsory admission, and I have have told the sorceress, in a small concession to general encouragement to make an advance directive, that I do not want anyone taking my father into their, or my, confidence. He would only do whatever he thought was good, was *in my best interests*, but, if you have escaped from a violent abuser once, you are reluctant to go back.

And so we circle each other, subtly, warily, pretending to shake hands.

Vocabulary (an occasional series): disclosure

Coming out is a much better term for it, and, hey: coming out even has its national day. But the jargon is disclosure, which infuriates me several times over. It has the sober ring of the Victorian clerk laying cards on the table. It's something - in a legal context, anyway - with a resoundingly negative ring: almost always, disclosure means telling someone something they could use against you later if you weren't upfront at the start. I hate it because it's a dessicated term for something that, like cool water when the swimmer dives, is always a flood and a shock.

And I hate it because it's cut and dried, because it implies that it's something you do once, and then that's that. But coming out - as the LGBT network at the firm I once worked at always said - is a process, not an event. I have bipolar disorder. – Oh, really? Disclosure is one thing. But it's another to drop out for six weeks because a change of medication went wrong. Or, in a salary review with the head partner, to put your feet up onto the negotiating table, swept away by confidence, or to say nonchalantly that you're looking for other jobs. It's when you go through that with another person that they really get what's up. And that's not disclosure. It's coming out.

Vocabulary (an occasional series): breakdown

I have to admit it: breakdown is way up there on the list of the words I hate. It's partly the aura of swoon, of collapsing Victorian maiden all a-shriek, but it's also because it implies grinding to a halt, and - worst, for me - a sort of I-can't-cope disintegration.

Well, and what would be wrong with that? I ask myself sharply. Okay: I did grind to a halt - slowly at first, after Prozac flipped a switch inside me and I accelerated through that inexorable summer. I did grind to a halt, or very nearly: I got to the point where I could do one thing a day - buy a potato, for example, or a can of Coke - and where, though I managed to drive to The Clinic in the Alps, I could not focus my thoughts once I got there to fill out half the forms.

But breakdown? Isn't that when you, you know, lose the plot? When it all becomes too much for you?

Long after, a filament surfaces in Facebook's web, and I regain contact to Marc and Dorothée, a couple I met at a sign language course in Lyon. We catch each other up; responding to my email, Dorothée writes, in the clear and elegant French I admired her for even then, "Thank you for telling me about your breakdown."

My eyes zing back and forth over this sentence like a knitting machine. My what? But, however unconsciously Dorothée has used the word, she is a psychologist, and writes with authority.

And of course it doesn't matter. I have always hated status hierarchies, but once again I find myself re-enacting them out of pride. These pointless gradations that mean so little and so much.

Have you ever harmed yourself?

And have you ever harmed yourself?

I hesitate. Self-harm - particularly with a blade - is often taken as pathognomic for borderline; once in the notes, I know, it will resurface again and again.

The answer is straightforward, but I am not sure that I can explain it concisely to a doctor. As a postgrad in Lyon, frozen in depression long before I started taking drugs for anything, I developed an irrational conviction - okay, a delusion - that I was hollow, empty, a void under skin. I knew that this was wrong, and yet I could not unbelieve it. I would tighten my fingers and watch the back of my hand ripple. Nothing. Once, I took down the standard medical dictionary I had been using for my course, flipped to the anatomy of the forearm, and looked from the picture to my arm. Nothing. Nothing. Skin and void, you are skin and void.

And then, one evening, I took down the candle from above my desk. It was a hypothesis: I lit it, waited, and tipped the melted wax into my palm. I clenched my fist to contain the heat. Two beats later, the pain shot through my hand: it was intense, a rod, an anchor, and in that moment I felt real. I was solid, a thing thrung through with sinews and tissues and all the lacework of a human being. I tried it again.

I did this, I think, for a couple of evenings. But it was clear to me that it was not a long-term solution: in fact, the idea of carrying a medicinal candle with me was enough to unlock the laughter I often found in depression. And evenually the depression wore off, and that was that.

So, when she asks me, have you ever harmed yourself? I want to say, deprecatingly, no, not in any serious way. I mean, only as part of a psychotic depression, as part of a scientific experiment to invalidate a belief that I was hollow. Not for anything serious. And I sigh, inside, and think, Mm. Good luck with that.

SMIs

In London, I meet for coffee with a friend who is a psychiatrist. We talk idly about work and the weather, and he says, ... which is fairly common in people with SMIs.

What are SMIs? I ask. I am fairly fluent in the French and German jargon by now, but my native language, English, is peppered with holes.

Serious mental illnesses.

Oh. I think a moment. Is bipolar disorder an SMI?

Yes, of course, he says, surprised.

And I'm surprised, all over again. It was years before I could accept that what had happened to me was serious. Despite losing my job, failing miserably at the shitshop, having all the aspects of my life that didn't have anything to do with survival close down, despite the pain and the exhaustion and the agony, I couldn't say that it was serious. That bipolar disorder was serious. That I had had a serious version of it, at least until four years later, when we stabilised the drugs enough for me to work part time

It's not that I lacked insight into the illness, though there's a lovely, slangy word for that, krankheitsuneinsichtig, that I might have used in German with The Medical Director. I knew exactly what was illness and what wasn't. It's just that I couldn't see that it was slashing through my life like a jetliner ploughing through a cornfield. Saying, even in retrospct, that I'd been seriously sick, gravement malade, felt jumped-up, self-important.

And so I kept trying to do things that were too hard, or impossible. Which looked to everyone else, as my sister sighed, like watching a car crash into a brick wall over and over again.

Restraints and refraining

From the far northeast, across the Pacific and half the Americas, Jonathan sends me a link. A Yale student recounts how, having once cut herself and presented to student psych services, she was bounced from college for a year, and had to earn her way back in, being told that, having cut, we just can't have you here.

At midnight, I was strapped to a stretcher under the ashen ceiling of an ambulance, on my way to Yale-New Haven Hospital. There I was taken to the locked ward of the ER — guarded by officers with guns — stripped of all my belongings, including my pants (they had a drawstring), and shunted into a cubicle containing nothing but a bed. I was here for my own good, they told me. Rachel Williams, We Just Can't Have You Here, Yale Daily News

Truly, I do not know how inpatient psychiatry is practised in the wind lands. But, with three Swiss admissions silting into the past, I can say: what I know is a world away. I had a Swiss Army knife with me each time, as I always did in those days; though I was asked to surrender it on the second occasion, no one (as far as I know, and I think I would know) searched my luggage. No one touched me, no one sedated me; no one forced me to change clothes against my will. No one drew me into group therapy. No one locked a door before me; no one strip-searched me, no one took laces or matches or belts. No one diminished my privacy. No one interfered. (Even when I fought the urge to destroy myself, no one interfered.)

From far away I could hear the buzzer's blast echoing all through the other units, as the alarm pressed at our nursing station set off lights and alarms all over the hospital. Our staff had called for reinforcements. The big men were coming running. I could hear their footfalls pounding the stairs and halls. I could hear the thumping and grunting as equipment was being dragged into place. I could hear ice cubes rattling in a cooler. It was going to happen again. I was going to be cold-wet-packed. Cold-wet-packing was a form of restraint that was only used to calm the most violent and out-of-control patients. Most people quieted down under the influence of other methods. If the Quiet Room wasn't enough to keep patients from hurting themselves, patients were sometimes given tranquilizing shots, and then temporarily put in two-point restraints with their wrists tied. There was also four-point restraints, where wrists and ankles were bound to the bed. Sometimes patients were strapped into Geri—for geriatric—chairs, which were little wheeled contraptions usually used for propping up old people. I broke three Geri chairs by struggling. From experience, the staff knew that only cold-wet-packing would do for me now. The idea behind cold wet packs was to chill the patient thoroughly. As the body struggled to warm itself, it would use energy. And as the person tired from the effort to get warm, he or she would calm down, ultimately relax, and, it was hoped, fall asleep. In order for a patient to be cold-wet-packed, a doctor's order had to be signed. As the buzzer was sounding, the staff was paging an M.D. to come to the unit to write the order as quickly as possible. - Lori Schiller, The Quiet Room

It is a world away from what I read from America and Canada: locked doors, restraints, sedation. I simply know nothing of the kind. And what it is really like here, in the wind lands - if I am lucky, if the drugs keep working - I will never be forced to discover.