Day Nine

Day Nine

No anti psychotic medication. Still taking the anti-depressant and mood stabiliser

One of the things I’ve been thinking about over the past couple of days is that rather than coming off the meds, staying on the meds, represents a change for me. Most of the time, since my diagnosis of Bipolar in 2013, I have only taken the meds for the shortest possible time. The introduction of the anti depressant has only taken place since I moved to Wales three years ago. My shrinks in London said I couldn’t have one as they believed one of my episodes had been triggered by that medication.

My consultant in Wales however, really listened to my post manic episode despair, and prescribed one that is okay for people with Bipolar. Because of this it has been only the last two years that I’ve taken one. The mood stabiliser — lamotrigine — is an epileptic drug that has recently been given to my type. It isn’t particularly heavy, I don’t think. But then I’ve never been prescribed any of the more controversial mood stabilisers such as lithium.

Therefore, I think this diary can be more usefully framed as the diary of someone suffering with this illness who has given in to the fact that she needs medication. In the past, not having anything to relieve my depression, I simply couldn’t stand it, and chose a certain amount of mania over the pain of living with depression. This was a risky strategy, because I ended up being regularly hospitalised. I always told myself that it wouldn’t happen again, and had tried to keep meds on the ready in case I spun out. This strategy also failed.

I’ve never found the medical establishment heavy handed. I don’t know why. Maybe because I’ve always been pretty co-operative and my episodes were often pretty short-lived. I didn’t smash up shops or assault people. I would literally have a good sleep, and the next day return to normal. But this was not always the case. It’s truer to say that my episodes might go on for months, but then they would suddenly build, and I’d have a day or so of total madness and get sectioned, usually by the police.

I wasn’t ever violent, mostly I just caused a disturbance and people quickly realised I was out of it. Not on booze or drugs, I have never been sectioned when I was drinking. But I would be acting like a drunk, and I would have total blackouts, or partial blackouts, which was pretty scary. In that sense it was a bit like drinking.

People in AA might call this a “dry-bender.” But I don’t subscribe to this sort of thinking. It isn’t medically ordained. There is no research on the “dry drunk.” Doctors don’t say, “this is a case of someone not working the steps of AA properly. I prescribe a tough love sponsor, not one of those namby pamby therapy types who don’t do things properly.” It’s just not a viable or respectable point of view and is usually professed by people who are basic nutters. That’s my opinion anyway.

That doesn’t mean that working the steps isn’t good or beneficial. I have worked the steps and doing so is certainly a learning experience. I’ve picked up excellent tools for recovery along the way. Some people swear by them, like my closest friend S. for example. And there have been times when I would probably have been one of those quoting the big book and saying the steps were the path to freedom. There is certainly some truth in that point of view. Spirituality is key. But so is recovering from trauma, if that is possible, and I’m not certain that it is. Like I said before, some people do need meds. Just people, not necessarily recovering alcoholics. Those that end up in the Emergency Suite, which is where they take you when the police section you, for assessment. It means: a safe place.

I once wrote a non fiction book called Emergency Suite. But not being all that well at the time, I couldn’t tell is it was non fiction or fiction. I was confused.

I should say, Ruth Sargent is not my real name. It was given to me by a consultant psychiatrist at the Maudsley, when I became a patient in 2009. The reason was that at that time I was working at the Maudsley as a Healthcare Assistant and he didn’t want people that knew me from my job spying on me.

I later discovered that Hugh Jones had broken protocol in doing this. He was supposed to have gone through all sorts of paperwork. In reality, on our first session, he just sat at his computer and said: “What shall we call you? It has to be something that you can remember.”

I like that he did this and I’m glad that he did. Although it did cause some issues. Because on one particularly bad manic episode I did not remember it and I don’t think I really tried. Consequently it took the doctors and nurses at that Emergency Suite in Victoria ages to find out who I was. Until they worked that out they couldn’t transfer me to a hospital because everyone gets admitted depending where they live.

In adopting a nom de plume I feel free to express myself without worrying too much. Without it I don’t think I could write frankly. It would cause too much anxiety, even if I didn’t have more than one or two readers.

For example, there is a thing in AA called The Tradition of Anonymity. About which I could say quite a bit actually. But in this context it means that at the level of “press, radio and films,” I should remain, as an AA. This is for myriad reasons, but perhaps the most important one is that I don’t come to appear like I am representing AA recovery. This could bring AA into disrepute, be ego-serving, and be against the very spirit of the twelve steps of the fellowship.

I understand all that. I wouldn’t want any drunk to read this and go, “Bloody hell that AA sounds awful,” and consequently die of alcoholism. That is why we aren’t supposed to promote ourselves as the face of AA. Nobody is the face of AA. Celebrities that come out and say, “I’m in AA” are breaking the twelfth tradition, which states that we should be anonymous.

By nature I am a codependent people pleaser type, rather than a narcissist. Received wisdom has it that these types attract each other and are opposite. Therefore the thought of upsetting the bastions of AA recovery really really frightens me. Some people take the twelfth tradition very seriously and I have lost valuable friendships due to this very principle when I have behaved in ways, (not publication issues), that contravened it. But that’s another story.

As a writer and artist I need to be able to speak my truth and not just by sitting in meetings talking about stuff. I need to write, and not just to write for myself. I want to speak and be heard. I have a lot to say and in relationships and real life I have found that very often there simply isn’t the time, and it’s not appropriate, to do that. And in not being able to that I very often don’t feel like I am not getting to the opportunity to speak my truth, to cite a cliche. I want to and I feel that I need to, so here I am.

I never planned to write all this. I was going to talk about how my life in London has come back to haunt me these past three days. This is new as I have rarely thought about that large chapter since I moved away, except to shudder and be grateful I managed to escape. But in reality that my life was simply awful, although true, isn’t the full story. And even if it is, it is still a large part of my story, and I can’t black it out.

It could be true that because I am taking my meds I’m achieving a degree of stability that means memories are starting to surface. Not in a way that’s too much, but simply as a matter of course. I’m remembering people I cared about before, as always happens with me, it all went terribly wrong. Things going terribly wrong seems to have been my “core narrative.”

It’s very sad really. Somehow, writing is a bit of a compensation for me. The fact that I am sitting here today on this overcast morning in Wales writing about life means that I survived. I write about these things ‘mental health’ because these topics have been my life, and I don’t have anything else.

I lived to tell the tale. Perhaps this is enough.

Day Eight

No Change in medication

It seems increasingly unlikely that I am going to come off any of my remaining medication: I don’t want to take any risks. I can’t have another manic episode. I just don’t have it in me.

The meds don’t completely eradicate my depression. They take the edge off everything. They make life bearable. They keep my extreme emotions in check.

Coming off the anti-psychotic has been okay. Feeling has increased, but not to an extent I can’t cope with. I feel better because I have a bit more energy mentally and psychically. That said, I’ve actually been feeling quite poorly the last week and haven’t done much of anything except read and watch TV. That has thrown me back on myself and some memories about stuff I really haven’t thought about in years came up for me. This hasn’t been exactly easy, but I feel back to the new normal today. Old normal being how I used to feel before, when I lived in London, and had not let go of my insane family. Some of these memories I’ve being contending with related to that time.

I don’t think this regression was about the lack of my meds. It was because I’ve had little contact with anyone and have not attended to my usual routines. It was odd though, a bit like entering a dream landscape. A timeless zone.

I’m wondering how I can keep up this blog now that I’ve come off all the meds I’m going to stop. Maybe I’ll just change the theme. I’m not sure. If you have any suggestions I’d be happy to hear them in comments.

Day Seven

Why?

This exercise is taken from Matt Haig’s The Comfort Book

I want a boyfriend.

Why?

Someone to chat with and do stuff. I’m bored. I do the same stuff every day: TV, sleep, read, write.

Why?

I get bored on my own, I feel like a failure.

Why?

It’s just my thoughts going round and round my head the whole time. I have no money, no job, not too many friends. I don’t have worldly approval and success; I’m not that good at anything.

Why?

I spend most of the time being alone. I’m on the dole. I don’t meet that many people. I get bored really easily. I’m not all that enthusiastic about making new friends. I have no energy.

Why?

I find a lot of people unappealing. I don’t have much energy or interest in things.

Why?

I feel old now. I can’t be bothered any more. I’m tired out from all the stuff I’ve endured. I don’t have hope, goals, dreams.

Why?

I tried so hard and only damaged myself. I’ve endured years of loneliness, poverty, isolation and contempt in AA.

Why?

I was obsessed with D. and writing.

Why?

I thought he’d love me when I was a proper writer and then I’d be happy.

Why?

He was everything to me.

Why?

He was gorgeous, great fun, really interesting and successful.

Why?

He was able to earn a living creatively, bi-lingual, worldly, popular, extroverted, committed to AA.

Why?

He liked it.

Why?

He was extroverted and sociable.

Why?

I don’t know.

Day Six

Day Six

No Anti-psychotics, all the rest: anti-depressant, mood stabiliser

I have a clean flat. There is a reason for this, apart from the flat I tidied it up. A psychological reason.

This morning, sitting drinking my tea, I played the imagination game. I talk to myself a bit like I would were I writing a journal. The sort of thing I always used to scribble. Usually around desire: what I wanted. A way of imagining possibility and change.

I was fantasising about what I would do if I got eight thousand pounds. My ex recently received a tax rebate for this sum. It was a mistake, that he had to pay back in small amounts, but he’d managed to spend the lump sum on stuff he needed. A large interest free loan.

My imaginings circulated around Toast. All the stuff I would get. A lot of dresses. Shoes. Falke tights. Underwear.

This left me feeling a bit empty and frustrated. A bit poor. I had to reason with myself. We’re I to buy even one dress I would have so little money I would feel awful for the next two weeks. I would be in a constant state of worry. I wouldn’t buy the food I wanted and need. I wouldn’t feel good at all. So I decided to dream the dream onwards, as they say in Jungian circles. I asked myself what next? Imagine I have all the clothes strewn about in my bedroom. What do I become?

I went blank for a while. I thought about living somewhere else, but this didn’t really generate any imagery. I decided that as a result of having all these beautiful new things my place would be really clean and tidy. I didn’t give myself reasons. Would you drink tea and coffee? I said. Tea, not coffee, I replied. So that is what I proceeded to do: make my place clean and tidy and drink tea but not coffee. The result was that I felt a lot better than I have been feeling. I had to reason that perhaps this is what my fantasy about Toast clothing symbolised. Newness. Cleanliness. Fresh ness. I can honestly report that since I’ve achieved these tasks I no longer crave these things I can’t afford.

This exercise springs from my reading in Jungian psychology. There’s a Jungian author and analyst, living in New York, called Michael Vannoy Adams. He’s written a book called The Mythological Unconscious. He’s says, in this book, that the analysts job is to analyse the patients unconscious in dreams and fantasy. He records a clinical vignette in which this patient he has dreams of Nike yellow shorts. He get the patient to explore the significance of the shorts by asking her what she would be able to do if she wore the shorts. That’s what gave me the idea for the active imagination I engaged in with the Toast stuff. Jungian analysts point to the teleological function of psychic imagery — dreams and fantasy. It take the person forward. Helps them to become the potential they have inside them.

Day Five

No Olanzapine, 60mg Duloxintine, 100mg Lamtotrigne 2 x daily

How It’s Going

Today I am happy to report that in Wales, where I live, it is living up to its reputation of having a permanent rainy season. Anything is better than that stifling heat.

Basically having a brain back has its down side.

I don’t regret reducing my meds, but I feel a bit sad today. Sitting here, writing about my experiences as a Bipolar sufferer has a way of bringing it home. My life has not been easy. The idea that what I’m saying is being heard has the side effect of making it feel realer than ever.

Yesterday, talking about being a person living on the Welfare, it made me reflect on just how difficult that is for me. At times, it has felt like a worse stigma than having a major mental health condition. Not only do people feel uneasy about associating with someone on the dole, the financial help is certainly not willingly offered. This is well-known, but it only adds to the hardship of being ill, no doubt about it. It makes it twice as hard. Even my last therapist saw it as her role to get me back into work. This was one of the boxes she wanted to tick as proof of my recovery thanks to the work we were engaged in.

I’ve made a list of topics for my blog today. The theme has grown from coming off my meds, to the subject of mental health more generally. Mental health might be more reasonably re-framed as living with mental illness, but somehow that’s a less appealing tag-line.

I’m not sure where to start today. The good thing about talking about my meds, it certainly narrows the field. Scope is never something I have struggled with. It’s more a matter of reigning myself in. In psychiatric parlance, this would be known as tangential thinking, or flight of ideas.

Possible topics that have occurred to me are: psychotherapy, having readers, the side effects of writing a blog and my last relationship. I think I’ll start with that.

My Last Relationship

It’s significant in this context because my last proper relationship (it lasted a year) was someone who was a fellow sufferer of Bipolar.

My last relationship proper was actually with a famous psychotherapist, my ex doctoral supervisor, but this affair only went on for two months. It ended with mutual consent and was relatively painless, compared to the man I fell in love with: My Last Relationship.

Part of the reason I fell in love with T. was because he was a fellow sufferer. Being in the same boat as someone else, someone that has experienced many of the ramifications of living with this condition had a major impact on me. I never felt so understood, or such love for another person. The problem with this was that whilst I had largely accepted my lot in life and perceived the relationship as some kind of silver lining in the cloud, my partner did not. He really wanted to transcend his condition in a way that I couldn’t relate to. He saw it as a source of shame to be eradicated. This meant that I was viewed as similarly stained and in the majority as a source of shame to be hidden from view. This factor was very hard to take on board, and it caused me a lot of pain.

He ended it. He ended it quite a few times, but I always managed to persuade him to take me back and given things another go. Inevitably the end eventually came, bringing with it the most excruciating pain I have ever known. It is no exaggeration to say it hurt like being run over by a lorry, and I know what I’m talking about because I have actually been run over by a lorry. I was lucky to survive. Emotional pain can be easily as hard as its physical counterpart. And I’ve know my fair share of both. Actually I’m not sure sure they can be neatly separated.

This is coming out quite doomy today, which gives you an idea of how I’m feeling.

But when I first started going out with T. it was incredibly exhilarating. Not only was he definetly the most handsome man I had ever clapped eyes on, he had suffered many of the things that I have had to endure. Some might say misery loves company (my last AA sponsor springs to mind) but it really wasn’t like that. There was an incredible feeling of freedom. Because I thought he was so wonderful, the effect was of feeling that I could still be loved, even though I had lived for many years under the crunching weight of isolation and shame.

But it wasn’t to be because for T. I wasn’t the soul mate that he was looking for. T. saw me as a failure, like I said. In the end it turned into the precise opposite of what I had originally envisaged.

Things with professor X were not dissimilar. He was constantly rehearsing ways to make me plight appear more socially acceptable: I was looking for a job, even if I couldn’t get one (living in a tiny town and all). My family were big in theatre (my grandfather was a major player in Royal Variety and my mother was in a well known community theatre company). I was writing a novel. I was an artist.

All of the narratives he came up with to produce for his swanky friends only made me feel more unacceptable. The good thing about the professor though, he wasn’t afraid of my thinking. I could be myself and have a go at him about this need to paint me in a better light. I had been hoping that, as a very accomplished shrink, I would be met with a greater degree of understanding. I was quite surprised that I wasn’t. But all of that said, he didn’t do me any harm, and in many ways he provided a lot that I could have wanted. He bought me loads of beautiful clothes for one thing, and even took me to Claridges for cocktails, which would have been okay if I wasn’t an alcoholic.

So much for finding a soul mate! Finding a soul mate has probably been the defining narrative of my life and has got me into more trouble than you can possible imagine. But that perhaps is for another day!

Day Four (part 2)

Once I have no support, that places me in a precarious position, which might increase my stress to unbearable levels. I know this because it is how I felt in my last full-time paid position at the Maudsley: I lived each day fearing how I could continue to manage and not end up living on the streets. This is perhaps ‘Catastrophe Thinking’, but it definitely assailed my every waking thought.

This leads me to consider some ethical issues. One: do I take the meds because I am afraid that if I don’t I’ll end up on the streets eventually, rather than because I feel like I need them? And the answer, I’m afraid to say, is that I do. The logical consequence of this is to say that I take the meds for money, which puts me in a rather poor light. And this affects my self-confidence. It makes me feel ashamed.

But why should I not have the condition I do have and be free to choose whether or not I do take medication? I should say that I am not in such a position that, unlike some people, I would be sectioned for the simple fact of not taking my medication. I’m not sure why that is, other than I am able to talk a good game, unlike your regular schizophrenic, say. So there is some degree of choice here. But then, there is no certainty at all that were I to stop the rest of my meds I would not end up being sectioned on account of my erratic behaviour. Behaviour that it would be true to say has, in past times, made me a danger both to myself, and other people. There’s no denying it. And since the last occasion of this was only three months ago, how likely it is that this will have changed?

So, bearing in my these few considerations; of potential homelessness and the welfare of all concerned, it may be that the best outcome would be that I am content to carry on as I am any remain partially medicated, with recourse to going back on the liquid lobotomy should the need arise. With that it mind it gives rise to the question, the new question, of how I came to be in this position in the first place. What does the label itself actually denote? What do we talk about when we talk about Bipolar?

This answer to this though broadly applicable; there are a certain set of given symptoms that will earn this label, it is, of course, particular. I myself think Bipolar is incurred as a result of sustained traumas. Bipolar is trauma raising its face to the light and showing itself to be seen. It is trauma that cannot be repressed. One cannot be a ‘Functioning Bipolar’. Someone with Bipolar tends to end up hospitalised. This trauma is not a set of medical conditions, it has a story. It is different in every case. I say this with some knowledge of how it affects others, from my time working at the hospital. I also say this with a lot of knowledge and experience of the machinations of the mental health world from my education as a post graduate and that of a mentally unwell patient. I say this as person with friends and a family who has had a life. I have something to say about it, which is why I am writing this blog.

Thank you. (This is the way some of the psychiatrists at the Maudsley rather quaintly end their psychiatric reports).

Day Four

Day Four

Olanzapine 0, Duloxetine 60mg, Lamotrigine 100mg 2x daily

One of the side effects of anti-psychotic medication is massively muffled thinking. It made me feel like a lump of meat. I had no imagination. The last two days I have revelled in the return of imagination and lucid thinking. This points to one issue with the Bipolar: too much imagination. Imagination that poses as reality.

This return to imagination explains why I have felt a need to concentrate my creative energies writing. As I only have so much creativity at my disposal I no longer paint.

One of my main focal points, imaginatively, going about my business yesterday, was to imagine that it was my last day of life: what would I do if such were true, I speculated. As only one day left seemed somewhat unrealistic, I changed it to six months.

My first thought was of my friends: Sean, Liz, Rosey, Poppy and Roland. I would want to see them. This would involve travel, as none of these folk live near me. Would I buy some new clothes from Toast? No. I would need my cash for the travel. I thought about getting a bus down to the beach. Swimming in the sea. Yes I would read. Yes I would write. I found this fantasy immensely satisfying. It also made me realise I do have relationships that are important to me. I do have friendships. (Sometimes I engage in the fantasy that I am all alone in the world.)

This morning, scrolling my twitter feed, I spied a short reel of a woman in possession of large quantities of glamourousness. I had to stop and stare, as she was really quite beautiful. This caused me to stop for a while and imagine myself into a life in possession of so much worldly power. I tried to see, in my minds eye, how such a person would have fared in some of the disagreeable situations I have been subjected to in past times. Would it have made a difference ifI were posed of such physical power?

In order to imagine my way into such scenarios, it was first necessary to alter the way she was dressed: I would never wear such an outfit, even if I was in possession of such an altered appearance. This changed the narrative. The hair would be styled differently. Less make-up. I pictured her at the AA meeting I used to frequent sitting on a plastic chair. How would the man I was infatuated with have responded to this new me? Would he have fallen in love with her? Given how unavailable he was on an emotional level it seemed unlikely, a perspective that surprised me. So there really was never any hope!

I pictured her walking to the cafe up the road I used to sit in and write. How would this new creature have coped with such degrees of concentration and austerity? I didn’t know. The more I thought about it, the more she became the person that I truly was. Dressed differently, engaging in my life, she was met with the same fundamental reception in the world that I had been offered.

I had to put her in receipt of state benefits. This was the real game changer. Being subject to mental illness and the loss of social power associated with that, not exactly a life choice, even the most beautiful person in the world would suffer.

In the end I could not say with any certainty that being in possession of extreme would have really made any difference at all. That elusive quality I have so hankered after, believing it would alter my experiences of life, did not in fact change very much at all. After all, she had in fact to be just like me in order for the experiment to function. She would have been subject to my parents! In this way I was able, through powers of imagination able to bust one of the great fantasies of my life in all of about five minutes. I heartily recommend this exercise.

Needless to say perhaps, but since I write these entries in the morning, ‘Day Four’ would more accurately be titled, ‘Reflections on Day Three’.

I’m not sure how long it will take me to become completely medication free. There are various factors to consider, the most pressing of which may be financial. When it comes to filling out my various benefits forms, I am required to state what medications I am taking for my condition. My feeling is, whether or not it is the case, is that if I write “None”, this will reduce my likelihood to be eligible for support. I don’t think this is negative thinking. Becoming medication free doesn’t necessarily increase my capacity to hold down a regular job.

After twelve years without paid employment I’m not sure I am able to work full-time now. My Bipolar does make me kind of unstable. Having no commitments I am able to function, to a degree, but I’m not convinced that if I got a job stacking shelves in Tesco, I would be fit to keep to the arrangement. I’m not even sure they would give me a job in Tesco, but that perhaps is for another blog.

Day Three

How It’s Going: No Olanzapine, 60mg Duloxintine, 100mg Lamtotrigne 2 x daily.

I’m sleeping deeply. My sleep feels more real. Not quite sure why: my dream life hasn’t altered. Maybe it’s because I didn’t conk out yesterday. I did feel tired. I wanted to sleep around 4pm. So I lay on my bed in my cool bedroom (were my TV is) and listened to my upstairs neighbour having a beer and chatting to her friend in the yard. Knitting is only interesting for so long, so in order to rest (I wasn’t sleepy), I decided to watch Virgin River on Netflix. This took me until about 10PM. 

Watching TV is one of the ways I learn about relationships, I realised lately. I learnt NOTHING about intimacy growing up, and I still know virtually nothing.

I spent some time yesterday engaging in one of my feel-good activities, or addictions — scrolling through the Toast website. 

Toast is a women’s clothing company that sells expensive natural fibres cloths to well off middle class women. I’m not well off, being in receipt of state benefits. I’m probably not middle class either. 

I’m no longer suffering with Olanzapine related depression. This is not a side-effect that they warn you of in the little pamphlet the company provides in the box, but I was definitely suffering. That is to say I was wallowing in no small degree of self-loathing. Especially body-image targeted disquiet.

I have more energy and have interests again. One outcome of this is this blog. I want to read related literature, such as Philipa Perry’s book: The Book You Wish You Parents Had Read and Adam Kay’s Dear NHS. If you’ve read either of these publications, I would be grateful to hear you thoughts.

As I am now writing, this means I have stopped painting, which is a relief because that work was both boring and arduous: not a good combination. Even if the finished article was compelling. 

One of the outcomes of this experiment that I need to keep my eye on is a potential relapse. What this means in practice is another manic episode and subsequent hospitalisation. Whilst depression could never be said to be a walk in the park, I personally have never been sectioned for straight depression. So I need to be careful.   

My relapse triggers, as discussed with various health care professionals past and present, are principally: not eating and not sleeping for more than one week. Various behaviours and associated ideas tend to be repeated with pretty much uniform consistency when I am in relapse mode, which can go on for weeks. The only variation on the theme is quite how extreme the outcome of said behaviours. I’ll spare you the gory details for now, but will simply note some bullet points:

  1. Preoccupation with a fantasy man with whom there is some, though usually not a great deal of connection.
  2. An all pervading feeling of not being good enough for said fancy man.
  3. This poor self-image leads to a fixation with shopping that leads to spending money on clothes, haircuts and make-up that is well out of my league.
  4. The fantasy that I am being spied on/watched (online usually) by ‘suitor’.
  5. Spying on/watching my ‘suitor’ online: Twitter/YouTube/Facebook.

I think these particular symptoms arise from the fact that, as noted previously, I have little sober experience of important relationships. That’s why I watch so my tele: it’s company. I really love television. This is probably my principle activity when not ill. Some would probably call it an addiction.

Day Two

I’ve run into an early set back with my blog: I’m now unsure if going medication free is such a great idea. But I still want to write it!

One thought I had yesterday was how this exercise is a little bit like writing notes in Patient Journey, which are the records the NHS keep on the psychiatric patients. I know this first of all because of my job at the Maudsley Hospital in south London.

I used to really enjoy this aspect of my job. It’s all relative I guess; it was the aspect of being a Healthcare Assistant I most enjoyed, with working in the Emergency Suite being the least appealing. For my notes I had to record exactly what the patients told me. The consultant psychiatrist who oversaw the patients had given us all direct instructions to record “exactly what the patients say”. This had the unforeseen result of being extremely funny because the sense that someone that is acutely unwell, said in their own precise way, came out with was not every day. I’d love to give you an example, but this activity required note-taking, and I didn’t keep any of the notebooks I used to carry about.

Of equal interest to me were the patients stories as summed up by the psychiatrists. Most patients had quite an involved one. Patients that had ‘been through the system’. Upon discharge, one of these extensive reports would be required. Shrinks have all these elegant labels for the most extreme psychiatric states. Let me see if I can remember a few of them: flight of ideas, religious ideation, ideas of reference, tangential thinking. Phew, I do have a few brain cells remaining.

In another lifetime I would have liked to been a shrink. I’ve certainly got a lot of information about the field, for an artist. It began with two books I read in my late teens: Fat is a Feminist Issue and The Road Less Travelled. Both of these books are written by shrinks; if you use the term shrink in its widest sense. One of my shrinks, the Jungian Analyst Christopher Hauke, did use it in its widest sense calling Professor Andrew Samuels, who was my doctoral supervisor and a psychotherapist, a shrink. At the time I found this puzzling because Andrew is technically speaking not a shrink. He is a therapist. But Chris’s use of the term cut across cultural hierarchies that say someone with a medical training is better equipped to help people that a mental health professional. It probably helped that Professor Samuels was famous.

You can see with that paragraph that what began with a couple of non fiction books flowered. I went to art school and there I was introduced to psychoanalysis as practiced by the Cultural Theorist. But psychoanalysis was not news to me, even before I read Orbach’s famous title. I grew up, for some of the time, in a commune. One of the residents was another shrink called Marie Maguire. Marie has written books and, along with Orbach, helped set up The Women’s Therapy Centre in the 1970’s. So you see, I have been steeped in the mental health world my whole life.

You can add to this inventory my years as a member of AA. Obviously this doesn’t qualify me for anything. But it does mean that, having read a lot of the literature, and listened to the ‘shares’ of thousands of members, I have applied deep thinking to matters pertaining to alcoholism and its recovery. Probably, my interests in the remit of mental health gelled me to the ‘fellowship’, I just didn’t realise it at the time. Apart from my time at the hospital, which I undertook because I was seriously considering the profession of art therapy, most of my forays into the mind had seemed to be at the service of some other need: as a patient, artist, recovering alcoholic, researcher of artistic methodologies and being a child living in a commune.

These are my credentials for being a Mental Health Blogger — my new job description. Now, back to the business in hand: Living with Bipolar and no meds. Now I need to explore some contradictory thrusts living in my ‘breast’.

I am given cause, by writing this blog, to recall that I have, for most of my life — if you consider Bipolar a lifelong condition — lived medication free. The far smaller segment of my experience has been a Bipolar existence taking a mix of different substances. It is only in the past two years that I have been continually dosed up. First of all with the Lamotrigine mood stabiliser and then with the anti-depressant and anti-psychotic. But I have taken all of these substances before.

You can add to the list Diazepam and Zopiclone. These drug have been prescribed as ‘PRN’. I’m not sure what that stands for but it means: take as and when required. And I have taken them, quite liberally, in the past two years.

When I first became ill with Bipolar I was twenty-four. I was an undergraduate at Chelsea Art College experiencing significant grief after my much beloved grandmother died. There were a number of profound shocks in connect with my loss. Firstly, my Nan, who was rich, didn’t leave me a penny in her will. Actually that is not quite accurate because she left me two thousand pounds (according to my resentful mother this was the same amount she had left to Battersea Dogs Home). Compared to the hefty sum I had been anticipating two thousand pounds felt like a few pence.

The second shock was that my mother, who inherited a lot of money, disappeared to Africa without a trace. This action had two shocks folded up inside it. The first was that my mother could abandon me at an especially vulnerable time in my life and essentially abdicate all parental responsibility (not that she had ever been an advocate for parental duty). The second was that she was not the lofty artist unconcerned with material reality I had always taken her to be.

The cumulative effect of all these shocks, read: traumas, was that my whole identity and sense of feeling I could read life was ripped from beneath my feet. It was at this point I had what the doctors at Springfield mental hospital called a Manic Episode. I may go into this further at a later date. I may tell you what actually happened. I may tell you the story. But for now lets stick with that elegant psychiatric diagnosis and leave things with the two word description of Manic Episode. These are, after all, just introductory thoughts.

I should say in passing that there was a precursor to my episode that ensued at the age of seventeen. It’s the sort of thing I always outline when I begin new sessions with one of my many psychotherapists (I’ve seen ten). That would be, and I’ll use my own prognosis here, my Drug Induced Psychosis. It sent me running through the doors of my first doctor, or shrink, who was an archetypal Jungian living in Tooting Bec.

I say this shrink was archetypal only on account of the fact that he ‘amplified my material’ by comparing me to a myth concerning some female figure or other stuck in the Underworld. Despite the fact that this comparison terrified me, it remained a troupe in my self-mythologising for a great many years to come. We may get to that at a later date.

I started telling you about all this because I wanted to contextualise the medication issue from when it became a serious consideration: my first admission to psychiatric hospital aged twenty-four. The Manic Episode.

A few weeks prior to the manic episode I had gone to my GP complaining about an eating disorder, saying I wished to be referred to a treatment centre. I knew about treatment centres from AA. The doctor told me that I was actually depressed and prescribed, or attempted to prescribe anti-depressants.

My reaction to this first diagnosis of a major mental health condition was outrage. My mistrust of the medical establishment (at that time my thinking was not nuanced enough to elide the distinction), indoctrinated by my mother in childhood, and cemented by my (at that time) four years in AA, reared it’s confused face and I refused the GP’s offer of assistance. This was obviously before I became stridently ambivalent about meds, at least for others, if not myself.

I’m starting to feel the pull of the present, having gone so far back in my medical history. This is day two of the experiment in stage one of my medication free life, let us not forget. Yesterday, when I sat down to write to you, it was not my intention to write a life story. Recently, I had some dealings with my old doctoral supervisor Andrew Samuels, who said: You live too much in the past. He said a lot of things that pissed me off during our two month affair, and this was no exception. But I guess that with a lot of things that are wont to piss a person off there is a ring of truth in it. So lets get back to the present and the matter in hand.

On day two without my anti-psychotic medication I’m not feeling as energetic as yesterday. That said, after really not exactly feeling to pull of this blog, I’ve actually conveyed quite a few of my experiences in psyche: psychology, psyche wards, psychiatry. Day two I’d decided down-beat.

Yesterday (back in the past again!) I cycled to Tesco, when for a walk along the Nature Reserve, started this blog and watched Safe House on Netflix. I was enthused. But it was actually last night that I started to feel so great that I wondered if it was only the relief of the anti-psychotic Olanzapine that was required. The Olanzapine really was like a death sentence. This is what I need to tell you about but I have probably written enough of my blog for today so I’ll save it for tomorrow, I promise.

Day One

Hi, my name is Ruth and I have been diagnosed with Bipolar type 2. Today I am coming off my meds. Beginning coming off my meds.

I’ve been enjoying a lazy Saturday sitting on my sofa reading the Guardian. I just finished an article called Daughters of Africa. It’s about a woman who started out writing a blog about African women’s experience of sex. What a topic! It gave me an idea that I could publish my thoughts about what’s going on for me right now, which is that I’m feeling empowered because I’m coming off my meds. Without consulting my doctor!

In fairness to me, I did call my Support Worker — a nurse called Sarah. But it being Friday, and with her not in the office, it didn’t work out. The receptionist didn’t seem too concerned about the state of my soul. She didn’t even ask me if I wanted to leave a message. As I simply could not go another day with my liquid lobotomy going on, I just went for it — last night, before bed, I omitted my Olanzapine.

Today, I actually feel alive again. I feel myself again, and I wasn’t on a very high dose either. If I had taken the 5mg of Olanzapine with my 100mg of Lamotrigine before bed, I wouldn’t be writing this blog for one thing. I’d probably be asleep and it’s only 13.27.

Last night, it took me a while longer to get to sleep without the meds. I lay in bed thinking about what a life without psychiatric medication could be.

I should say that I’m not someone who, as a rule, disagrees with meds. I used to work in a hospital, in a women’s acute ward (before getting my own diagnosis) and I saw the positive results of what meds can achieve. I’d grow up with parents who rejected all forms of western medicine and so I had this real (unexamined) fear of it. But working at the Maudsley, I had to think again. It did seem a bit of a price to pay, but a lot of those women, really needed those meds. Since that time, I’ve never been exactly anti prescribed medication.

I’m also a recovering alcoholic, and there’s a real, probably in some cases justified, skepticism about the value of psychiatric medication in AA, for people who are addicted to alcohol. Liquid alcohol, it’s called in the “Big Book”. Not everyone judges of course, but there is a real atmosphere of fear around it floating about in the meetings I have attended (for thirty years now).

Since I started engaging with the medication (rather than psychotherapy) side of the mental health world, I haven’t been stridently ambivalent. I’ve taken the Lamotrigine, for example, steadily for a couple of years. I had a suicide attempt you see, so I had to take the matter seriously. I’ve also been on an anti depressant called Duloxetine on and off for the past couple of years.

Duloxetine is one of the few anti-depressants that is supposed to be OK if you’re Bipolar. When I lived in London (I’m now living in Wales) and saw a different community team, and there was a bright red note on my ‘Patient Journey’ file that said: do not give this patient anti-depressants. I’d had a manic episode one time after they’d been prescribed, so that made my consultant adamant for me never to have them again. Even when I’d begged and pleaded.

Of course, I have been a little bit ambivalent. Olanzapine, especially on a high dose, has the side effect of near constant hunger. I hate gaining weight and am probably a bit eating disordered. So for me, this is a real draw-back. With the Lamotrigine, I think it’s just a bit of a muffler over lived reality. Duloxetine even more so. A while ago I was in a really painful relationship, and without any pain relief, it was practically unbearable.

Another side effect for me was that I lost the drive to write. To a degree with all the meds, but an anti-psychotic made writing like entering a swamp. This was A REAL loss. Writing with a cup, or cups, of tea was/is one of my greatest pleasures. I have written novels, years of journaling, poems, life stories and never lost my passion for writing, until I had to take prescribed medication.

I think all these meds do relieve pain. Sometimes, of course, that’s a blessing we’re in dire need of. Why suffer if you don’t have to? But perhaps, when life eases up a bit and things are steadier, why not try life neat?

I know from my time at the Maudsley that I could be making a classic mistake: life is better so we stop taking the meds. Thus begins another trip to the psyche ward. But I’m willing to give it a go because frankly, life has become unbearable on the meds. Especially the anti-psychotic.

I don’t know if I’ll go the whole hog. Judging by today’s out-put I may not need to — I’m enjoying writing again! I’ll see how it goes, and I’ll tell you how it goes. Any feedback would be much appreciated.