World Bipolar Day

I’ve been fairly private on this front for the past year regarding my ongoing struggle with bipolar disorder.  Behind the scenes, I’ve become a host for Postpartum Support International, leading a group for women in the perinatal period who struggle with bipolar disorder and am partnering back up again with Bipolar Support Club International this time as a wellness coach, which I am very excited about.  I’ve doing Podcasts, writing articles, and it feels deeply satisfying to be working behind closed doors and face to face with others who are truly struggling.  Not to mention I have always deeply admired people who have the ability to reach out and ask for help rather than my own tendency to withdraw inward.  But over a year ago, I slipped over the edge after desperately trying to cling to whatever surface that was left for me to grasp.  The fall seemed to be happening in slow motion.  In my mind, there always seemed to be enough room for me to be hopeful that I could regain control until it became painfully evident that I could not.  I was exhausted but rather than hit the floor, I seemed to just enter this state of free-fall where I lost perspective of any sense of time or space or reality around me.  I landed in a psychiatric hospital and oddly the only thing that kept me from losing my sanity even more was that this was at least a familiar place to me. 

I knew how to present myself (or so I thought), what to do and what not to do, and what to say to the people that mattered.  I was left in a holding room for about 6 hours on my admission and this was honestly one of the hardest parts.  I thought they had forgotten about me several times and I started to feel desperate and panicky. I shook the doors and shouted, asking for someone to come help me and at least tell me what was going on.  I was ignored.  I began looking for ways to escape, although I knew that would lead to nothing good and an even longer stay, so I abandoned that idea after a deep struggle not to act on the impulse.  Finally, a nurse heard me as he walked by and as calmly as I could I told him I had been locked back here for hours and to please find out what was going to happen or when I was going to be allowed to a room.  He kindly apologized and went to find out what the problem was and told me they were preparing a room and it should only be about another 20 minutes.  2 hours later I began shaking the doors again and found him walking by a second time.  “You’re still back here?!?!”  He apologized profusely and asked admissions what the problem was.  A woman came to talk to me and with every ounce of self-control in me I told them the situation as calmly as I could.  She explained shift change was happening but she would alert the nurse to come get me as soon as possible.  I commended myself for not smacking her on the spot and considered this progress made and a sign that I was obviously cured.

Ten minutes later my admitting nurse made her appearance and took me back to the ward.  She was very kind and my anger melted away as she began talking to me.  By now it was 8pm and it had been a long day.  I completed the intake interview with her, complied with a brief body search, curled up in a freezing cold room and went to sleep.

The next morning, I awoke and learned that I had been placed on a detox ward because the other units were full.  I was surrounded by people who were there to get clean but were otherwise functional, social, and motivated to utilize the support.  I on the other hand was isolative, unable to communicate with the other patients due to my mental state, and hanging on by the thinnest thread imaginable to keep any semblance of composure.  I walked along in silence with the group to the cafeteria and tried to eat, but only managed a few bites.  A few people asked me what I was there for and I mumbled something about being having bipolar disorder, which was received with a few understanding nods.  After arriving back on the unit, I sat in a chair and waited to see some sort of practitioner so I could explain this was all a mistake and I could surely be released that afternoon.  However, since I had arrived on a Friday and a holiday weekend at that, I saw the Nurse Practitioner.  When she called me back to the office, I thought to myself that now my chance to shine.  After all, I knew exactly what needed to be said in order to make it look like I was not as sick as I was.  I had, after all, been in much worse shape than this so how hard could it be?  The interview lasted a whole 5-10 minutes and I got hit with statement that there will be no discharges until after the weekend when the doctor can see me.  Still, the interview went well and I came out thinking that I had survived the situation and perhaps even came away looking half way decent.  If I could just make it to Monday, I would be ok.  I then retreated back to my room and got directly back in bed.

This routine played out for days.  Mornings were not as bad as afternoons.  Every day after lunch a panic and deep heartbreak would consume me.  I wanted to see my children.  I wanted to go home.  Anxiety would overtake me and flashbacks of the events that occurred up until my hospitalization played over and over in my mind.  Panicked and explosive texts to David that I was going to die, complete inability to take care of, feed, or bathe my children or myself, screaming and rocking myself back and forth in a corner of the house for hours believing that I was dying of a rare blood cancer that I had brought on myself, and complete reserve and belief in the fact that if I killed myself, the misery would be over for everyone and they could be free again.   I had felt trapped with no way out and the hospital triggered that same feeling.  I was too scared to ask for anything to help with anxiety for fear they would see the simple need of it as a bad sign.  I had no control over anything.  Nothing.  I felt at the complete mercy of people who didn’t even know me.  The Nurse Practitioner upped one of the medications I was on but in hindsight it was a weak decision.  Still, it helped a little and over the days in between begging to be released and the medication having some effect, I was able to participate in groups a little and occasionally talk to my peers. 

Once I was finally able to see a doctor, I was feeling quite confident in my ability to prove to her I was ready to go home.  She, on the other hand, was not as easily convinced.  I remember her looking at me curiously and telling me that she’d like to keep me for a full 2 weeks.  My heart sank.  I desperately wanted to begin working on repairing the damage I had done to my family.  I worked hard to fight off tears and the sense of crushing disappointment I felt.  She paused for a moment and then said, “The NP spoke highly of you and it is her testimony I have ultimately decided to go off of.  The team wants you here until next Friday but I am willing to let you go tomorrow if you see your personal psychiatrist the day you return home.  I also expect to you to have your therapist set up for this week as well.  Please have them call the hospital and confirm these appointments in order for your discharge to take place.”  My heart leapt and I immediately got on the phone to set everything up.  Release of Information forms had been in place so both the therapist and doctor were able to call to confirm my appointments.  The hospital slapped yet another Bipolar I diagnosis on me this time with a psychotic depression episode after it and prepared for my discharge the next day.

The next morning David arrived to pick me up.  His dad had flown out from Hawaii the day I went into the hospital to help with the kids while David worked.  He took them to swim team each day, brought them home, fed them, bathed them, and put them to bed.  When I arrived, John was still there thankfully and his presence was a huge comfort to me.  I felt like I was still on very shaky ground and not quite able to stand on my own two feet again.  He helped me with the kids, talked with me, and is just the kind of man who makes you feel like everything is going to be alright.  He never preached or gave me advice.  In fact, the day I got back from the hospital he and I drove to the pool for the kids to go swimming the most he asked me was, “So how are you feeling?” which in all honesty was about the most personal thing he had ever asked me before. I still hadn’t quite worked out the answer to this question so all I was able to say was that I was confused.  I had been great at my job when I worked as a psychiatric nurse and yet there I was not able to maintain a drop of stability over my own life.  John laughed quietly to himself before saying, “Elizabeth, that is exactly the problem.  Your patients don’t belong to you.  You can stay detached.  But with your own family you are immersed in that life and perspective gets lost.”  Then he told me a story about the power of breath and breathing through pain or singing of that’s more your thing.  That’s all that he and I said about it and that’s all that needed to be said.  The rest of the time I listed in fascination to his Airforce stories, watched as he played basketball with the kids, and devoted his presence to being there for us.  What greater gift is there anyway?  The gift of presence.

After John returned to Hawaii, my family and I surveyed the damage.  I had dropped out of school, lost credibility at work, and had a very delicate foundation of reality to stand on at best.  Slowly as the months went on, we were able to put the pieces back together but not without several speed bumps.  My recovery didn’t get stronger and stronger and stronger.  It took about 9 months of continued instability to reach my old self again.  I now have a team I work with consisting of a bipolar specialist, my regular psychiatrist, and therapist who would all love to see me back on lithium but I just can’t bring myself to do it again.  They really do love that drug and while it worked well for me, the dose necessary to keep me stable carried with it side effects that were just too difficult to tolerate at the time.  If things ever head south or too far north again, I’ll consider it but as for now I am doing well.  I’ve re-enrolled in school with a firm promise to my family to pull the plug on it if I start to destabilize.  I’m back working at a place I love and seems to keep me in a therapeutic state of mind, which is good for me.  I’ve been functioning well at home and able to take care of my family and find joy again in my life.

I don’t tell this story for sympathy, shock value, or validation.  I need none of those things.  What motivates me to share this is to help people to see that mental health/wellness/illness deserves compassion.  It’s become almost hip to talk about it now.  Everyone relates to anxiety or periodic depression but as soon as you mention that you hear voices or say the word bipolar or schizophrenia or schizoaffective, etc., everybody awkwardly shuts up.  We don’t deserve to be dismissed or looked at as the problem for all the violence in society.    But we do deserve to be listened to without fear.   And for me, World Bipolar Day is a good place to start.

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