Good-byes

This is my one-hundredth post to my blog. It is also my last. It will remain available on Facebook and Blogspot, but I doubt that I will add anything to it.

I’m stopping here because I think I’ve shared all that I need to share (also, one hundred is a nice round number). In TV talk, I’ve “jumped the shark.” (I vividly remember that episode of Happy Days, and thinking that Fonzie had gone too far).

I started this blog for selfish reasons. I needed a forum in which to open up, so that I would feel less shame about my illness. I wanted to help my family and friends understand me better. I needed to feel that I was doing something useful while my wife was in hospital and I was off work.

I was expecting a handful of readers. Instead, I got several thousand.

The internet is a crazy thing.

You have been reading Upsy/Downsy along with people from twenty different countries. Most are from Canada and the U.S., but there are also readers from Santiago, Chile; London, England; Paris, France; and even more in Norway, Finland, Venezuela, Croatia, New Zealand, Romania, South Africa and on and on. I enjoyed receiving e-mail from around the globe.

Mental illness exists all over the world. I worry about the stigma in Canada, but know that it is much worse in many other places.

I hope that all of you who have read Upsy/Downsy, if you aren’t already, can share a little bit of your understanding with others - to help lift some of the burden from the shoulders of the mentally ill around you.

If you are living with mental illness, I hope that this blog has provided some comfort, and that you find the tools and the support that you need to heal.

Thanks for reading. Be well, my friends.

D’Arcy

Turf Wars

When I was released from hospital, I had to have some supports in place. I didn’t have a family doctor, so was told to go to the same walk in clinic each time. I was assigned a psychiatrist, and got a referral to a therapist.

My first stop was the therapist.

“Do they have you seeing a psychiatrist, too?”

“Yes.”

“Are you on medication?”

“Yes.”

The therapist clucked disapprovingly.

“So, they’ve got you on the medication merry-go-round.”

I must have looked confused.

“Look – these psychiatrists will just get you hooked on medications, and keep you drugged up the rest of your life. You really should just be in therapy.”

Next was my appointment with my new psychiatrist (I’ll call him Dr. No).

“What are you doing with a therapist?” he asked with a big smile. “You don’t need one. Don’t waste your money. I don’t treat people who see therapists – it gets too confusing.”

I was weak and vulnerable. All I knew was that the hospital psychiatrists had saved my life. So I called my new therapist and told him sorry, I was going to have to stop seeing him.

It was like a weird love triangle. The therapist was furious with Dr. No. I was being forced by both of them to make a choice. Looking back, I think either choice would have been bad.

Dr. No began by taking a detailed history of my ethnic origins. He drew a complex chart. This, he explained, would help him decide how to treat me best.

He prescribed entirely different medications than I had been given in hospital. When I asked why, he said that they were older, more proven, and cheaper.

The side effects were horrible. I had weight gain, sleep disturbances, was tired all of the time, and had to wear sunscreen as my skin had become highly sensitive to sunlight.

When I went to see Dr. No for my weekly appointment, I would start off by talking about how I was feeling – then he would cut me off. “We’ll simply adjust your medications a little,” was all he would say. Then he would get weird, and talk about his failing marriage.

Then I learned that a possible side effect of Imipramine is sudden death from cardiac failure.

Dr. No had not explained this to me.

So I fired him.

I went to a walk-in clinic. I saw a doctor and told him my story.

“Will it kill me or irreparably harm me if I quit my medications - cold-turkey?”

“Well,” he replied, looking concerned, “you should really talk with your psychiatrist. If you do quit, you should taper the doses. If you are having psychiatric symptoms, they may return.”

“I’m sorry, but you didn’t answer my question. Will it harm me or kill me?”

He hemmed and hawed. “It won’t kill you. But you will feel like hell for two or three weeks.”

I went home and threw all of my pills in the garbage. I was super sick for two weeks.

The symptoms returned, but were manageable.

Since then I have met many amazing psychiatrists (most are – Dr. No was a rare dud), who use modern methods, modern medications with few side-effects, and recommend counselling. Still, I come across some therapists who look down their noses at psychiatrists (but they are becoming rarer).

When your life is at risk, turf wars can kill you.

You need every tool available to survive. 

Support

My wife is finally home. It has been a year since her first hospitalization. The last twelve months have been, to say the least, a huge challenge for everyone in our family.

I am so proud of how hard she has worked to get to this point. There is still a long way to go – right now she is getting daily visits from nurses, and a once a week house call from a doctor. (They still do that! It’s like Little House on the Prairie – except we don’t have to pay him with apples or a chicken). Our goal is to keep her out of the hospital.

My daily struggle is maintaining a healthy balance: between stabilizing enough to be able to return to work, and supporting the woman I love in her recovery. Both of us need to get healthy for ourselves, our family and our relationship. But there is no doubt that she has suffered more and needs much more support than I do.

What I’ve been learning to do, no matter how guilty it makes me feel, is to rely on others for help. When she is having a hard time and I am low on resources, I will get her to phone a member of her care team. I have to admit to myself that I can’t do everything for her, or for our family. That’s why there are professionals, and that’s what friends and extended family are for, too.

One of the reasons my first marriage broke up was that my partner didn’t understand my illness, and the strain of living with a sick person became too much. She expected emotional resources that I couldn’t give, and in return couldn’t give me the support that I needed to be well.

Some people have said that I must be a patient man to live with a person as ill as my wife.

I say that she is the patient one, slowly and with great effort moving herself towards recovery.

No matter how difficult things get with my wife’s illness, it is so much better having her home than in hospital. She lights up the house and everyone is happier - even the cat.

I am working on my balance so that I can continue to get well, and provide the resources my wife needs. I want to support her in the way that I wish I had been supported when I was so sick.

She deserves nothing less.

Didn't You Get the Memo?

A lot of what you learn as a psych patient to manage your illness can be applied to everyone. We all go through periods of sadness, worry, anxiety, anger, despair, agitation – yet most of us are not taught techniques to navigate through these tough times.

Because psychiatric patients have to deal with super-sized versions of tough times, they are given exercises and tools to help cope. But these tools are useful for everyone, and if they were made more widely available would lead to less stress and more happiness.

Why shouldn’t mindfulness, meditation, dialectic behaviour therapy, and cognitive behaviour therapy be included in the physical education curriculum in high school? The teenage years are when most mental illnesses begin to manifest themselves. Why not give teens some tools to stay mentally healthy and happy? It wouldn’t even take much time – say eight to twelve hours over two or three years. A small investment with a big payoff.

Why should this be in physical education? Anima Sana In Corpore Sano (“A sound mind in a sound body”). Okay, it’s Latin, and I stole that from the shoe company Asics (it’s the brand of jogging shoe I wear). But it’s a great slogan, isn’t it? You can’t have a healthy body without a healthy mind.

Here are two techniques I learned today that I think could help anyone.

Write a note to yourself when you are happy. Say something about how happy you are, how sadness will pass, and how you can feel happy again. When you feel really bad, pull it out – it’s a memo from your past to the present, and it will help you feel a little better.

Make a list of all of the things that are true about yourself, even if you don’t believe them. This includes things others have said to you. Things like “I am smart,” or “People like me.” When your self-esteem hits bottom, pull that list out and read it out loud to yourself.

I cannot thank enough everyone who has taught me this year. I have a long way to go. Not every technique I learn is useful for me, but will be useful for someone else.

One very important thing I have gained is an understanding of the need for routine in my life. I am looking at the clock – it is bedtime.

Thanks for reading. See you in the morning. J

Obsessing

I’m slowly learning more about anxiety. There are a number of specific anxiety disorders (I’ve been labelled with two of them), but in reality symptoms overlap and it seems that anyone with severe anxiety can have a number of symptoms from a variety of categories.

People who live with Bipolar Disorder tend to have accompanying anxiety disorders. For me, my diagnosis of bipolar came with an accompanying diagnosis of Generalized Anxiety Disorder (GAD) and Social Anxiety Disorder (SAD). But really, those categories don’t tell the whole picture.

For years my wife has told me she thinks I have Obsessive Compulsive Disorder. That is also an anxiety disorder, characterized by obsessive thoughts and compulsions to act on certain behaviours.

Now I don’t have most of the symptoms of this disorder, but it turns out that it is common for people with anxiety to have some of them. A common one is obsessing over intrusive thoughts.

Everyone has intrusive thoughts. But for someone who is anxious, intrusive thoughts can become obsessions.

I obsess over intrusive thoughts, but much less than I used to. When I’m depressed and anxious, a thought might pop into my head like “What if I stepped in front of a bus?” I will feel guilt for even having that idea, and think about it over and over and over, unable to stop, until the it becomes a compulsion. There are techniques I can use now to prevent that. Focusing on something else that requires great effort and total concentration (like who will win “Dancing with the Stars”) is the best one for me.

For as long as I can remember, I have used tiny rituals to prevent bad things from happening. This is also a symptom of anxiety, but is not true OCD. I’ve managed to rid myself of most of these over the years, through self-talk and willpower. But I’ve kept some. I bet you have one or two as well – everyone gets anxious sometimes, and everyone has some sort of superstition.

Here are a few that I still have, but aren’t too bothersome:

-        I cannot have cutlery pointing in my direction.

-        Plates on the table need to have their designs all aligned the same way (plain plates are nice, but we own ones with a pattern).

-        Instead of “knocking on wood” I have to knock on my own bald head three times.

-        If I turn my body completely around one way (say, to the left), the next time I have to turn it the opposite direction, so that I don’t get “wound up.” (Good thing I’m not Zoolander and can turn both ways).

Anxiety is okay sometimes – it’s normal, and doesn’t mean you’re sick. However, when it starts to impair your day-to-day ability to function, then you need some help.

(This website is a great place to start – I just found it, and it looks amazing).

Now I’m going to go and pet the cat twenty times, and make a cup of coffee that fills the cup to exactly two centimetres below the brim.

There's No Comfort in the Waiting Room

Several weeks ago my wife was taken to hospital by an ambulance. She called me in advance, and I told her that I would meet her at the ER. This has happened a few times this year, but every time seems just as stressful as the last.

When my wife is suffering, I want to be with her and see her with my own eyes and hear her with my own ears. I don’t want to be told second or third hand what is happening. I don’t trust anyone until I have confirmation for myself that she is safe.

I arrived at the waiting room and waited in line. The clerk at the admitting desk had not heard of Teresa. I was pretty sure she was there – either that, or the ambulance was the kind that had to be pedalled.

I used the courtesy phone to call the central switchboard. They confirmed that Teresa had indeed been admitted, and was in Emergency.

She was so close – somewhere behind the secure glass doors. It was frustrating.

I asked a young lady who was volunteering if she could help. She headed off to find out where Teresa was.

I sat, staring at my shoes – eerily like the Death Cab for Cutie song “What Sarah Said.” The TV was entertaining itself, and nobody was looking up except when a nurse walked in announcing a name.

I became consumed with worries and “what ifs.” Finally, the volunteer returned – no, she couldn’t find anyone named Teresa.

I looked down the hall and saw two women come out of the Social Workers offices. One wore high heels, the other sneakers. I walked up and interrupted, asking to speak to the sneakered one (see my earlier post “Getting Support from Child Protective Services” for the reasons why).

I told her my problem. She smiled, and said “I’ll talk to the nurses and we’ll find her for you.”

In five minutes she was back with a nurse. They took me through the glass doors to where Teresa was, about twenty meters from where I had been sitting the whole time. The whole process had taken about forty minutes.

I saw many other worried and frustrated people arrive – knowing that a loved one had been brought in by ambulance, but not knowing where they were. The quiet anxiety in the waiting room is palpable.

If part of a hospital’s mission is to alleviate suffering, they could do a lot of work in the waiting room. A good start would be making a social worker available to help reduce the anxiety and suffering.

Just as long as it’s one who wears comfortable shoes.

Flashlights

For a mentally ill person, the right amount of sleep is critical. Having a regular bedtime and wake-up time, getting between 7-9 hours a night, and enjoying a sound sleep are all conducive to good mental health.

My worst periods of illness have come with severe sleep disturbances, where I get very little sleep followed by a crash into depression. But in some cases lack of sleep is used as a therapeutic device. According to one of my psychiatrists, patients that are not responding to an antidepressant may do better if deprived of sleep for one night.

Anyhow, the whole point of this is that generally sleep is good. I think we can all agree on that.

What I dislike about every psych ward is how hard it is to get a good sleep. First off, your door is never fully closed – so you hear everything that is happening (and stuff happens all night). There is light from the hallway. You usually have a roommate with some sort of apnea or snoring problem (that was me, actually. Apologies to all of my former roommates).

But the biggest disruptor is that every hour or so one of the nurses checks on you. With a flashlight. Aimed at your face.

I don’t know what they expect to see. I would have loved to have had a scary mask to slip on after I went to bed. The nurses can see perfectly well enough to know that there is a person there, and that they are breathing. So why the light to the face?

Even cheap digital video cameras have infra-red night vision, now. Why not use one of those if you really want to see my face while I’m sleeping?

Disrupted sleep combined with disturbing food. Both things, I think, could be improved. If you had to live at a hospital, it would make you crazy.

Which is kind of ironic when you think about it.