Let’s Talk About Mental Health

Alexandra writes that we need to normalise conversations around bipolar disorder, put simply we need to talk more openly about mental health.

Social media and judging people

With the rise of 24/7 click-bait news cycles, we have been conditioned to categorise people and situations without any more than a few short lines of text flashing across our screens. We don’t know the people on the other side of the story, so we are not in a position to ask for further information. We just make a judgement, align ourselves with one side or another, and move on to the next article.

But what about the people we do know? In a world dominated by prettily packaged social media accounts, we constantly make the same split-second value judgements of the people whose lives we see on our screens. Alongside judging them, we compare ourselves – using metrics as trivial as popularity, prettiness, and exotic holiday destinations to cast harsh judgement on the mundane reality of our own lives.

But our daily lives do not have filters – and a world in which this surface level interaction serves as ‘connection’ is a dangerous one.

This has become particularly clear during 2020. As our nation entered into lockdown, we were encouraged to pick up the phone and ask how people were doing. But how many of us have really listened to those answers? How many of us have seen behind the filtered veneer of “I’m fine, how are you?”, and heard the quaver of loneliness or doubt in someone’s voice? How many of us have noticed someone withdrawing from in-person contact, when in-person contact is no longer viable? How many of us are really talking with one another – openly and honestly – about our mental health?

The truth is, it’s difficult to have these conversations. They require something from the listener that we no longer feel we have the right to demand, in a world where updates have been reduced to a single filtered photograph in a fashionable location. They demand from the speaker untold levels of inner strength and bravery – an openness, honesty, and rawness that we no longer see in day-to-day interpersonal connectivity.

And the hardest part of having these conversations? The fear. The quick, ill-informed judgement of others. It’s hard to step outside of those prettily packaged boxes and reveal something unfiltered and real. What if I’m the only one who feels this way? What if I really am alone? How will I be seen, after this? What impact will this have? What label will they give me now?

We need to talk about mental health

But we need to talk about mental health – now more than ever. And that is what I am going to do.

As those close to me know, my partner suffers with Bipolar Affective Disorder (Type 1), and throughout 2019 I was his sole carer through a period of acute illness. My partner had been diagnosed with Bipolar Disorder in his late teens, but rejected medical intervention at the time as he was resistant to the diagnosis (a common problem with Bipolar patients). He went on to enjoy great success in his 20’s, with a high-flying, globe-trotting career in a heavily sales-based role. Our mutual acquaintances universally described him as “brilliant”, with those who liked him going on to shrug and say that he was “a little eccentric”, and those who didn’t like him denouncing him as “completely mad”.

Depression eventually hit in his late-20s and, when we met, he was very open with me about his struggles with mental health. Working and living amongst high achievers and creatives in the arts, this was not particularly new territory for me – many of those close to me had battled with anxiety, depression, or eating disorders at some point in their lives. As I quickly discovered, however, my partner’s mental health journey was a little more complicated than most.

To me, he felt like an amplified version of a person. Everything seemed exaggerated or stretched in some way – whether it was a high, a low, an anxiety, or an idea. Being around him during an episode of (what I now know to be) euphoric mania could be intoxicatingly exciting – he saw colours more brightly, and his mind would work at warp speed on some higher plane of intelligence that others could not access. Together it felt like we could accomplish anything. The first few months of our relationship now reads like a blur – a whirlwind of colour, brightness, possibilities, and an endless optimism that was contagious to be around.

As with anything, though – what goes up must inevitably come down.

Nine months into our relationship, things began to unravel. He had somehow ended up involved in two companies – his own consultancy company, and a high-pressure tech start-up. He was taking two or three flights per week and sleeping 2-3 hours per night in a desperate bid to keep up with the competing demands on his time. I could see that the increasing stress was causing something to change within him – like a steady rise in temperature over a prolonged period of time. To me, it felt like living with a volcano that was about to erupt. Something was bound to snap. I was beginning to find new levels of camaraderie with the girlfriend of The Incredible Hulk.

The crisis of a mixed episode

Eventually, something did snap, and things began to spiral out of control. His professional life imploded, with ensuing legal and financial implications that served as further points of stress. Pretty soon, the man I had previously just about been able to hold together was descending by the day into a madness that neither of us could understand, much less control. As contagious as the euphoria had been, the dark, guilt-ridden depressions – infused with sparkling electrical currents of agitation, anxiety, paranoia, racing thoughts, and psychosis – infiltrated every corner of our home. He was in the midst of what I later came to understand as a ‘mixed episode’ – where mania and depression hit at once.

Because mania can be not only euphoric, but also dysphoric (extremes of anxiety/panic/terror, or irritability/anger/rage), Bipolar patients often experience bouts of explosive behaviour. During these episodes, their brains betray them – their resultant actions/reactions fuelled from an illogical position entirely outside of their rational control. During episodes of illness, their personalities can completely change, potentially becoming abusive or violent, and studies show that more than 40% of Bipolar patients find themselves in trouble with the law at some point in their lives. Furthermore, due to the difficulties in identifying, treating, and managing the illness, and the isolating effects it can have on those around them, it is thought that on average at least three people with Bipolar Disorder commit suicide every day.

I found it difficult to talk openly about things with my friends, many of whom unsurprisingly looked on in horrified confusion as I bounced from one catastrophic moment to the next. His friendships also felt the strain, with many falling by the wayside entirely – even the most stoic supporters eventually wanting space from it all. I was lucky enough to have a select group of people who provided iron-clad support in my dogged pursuit of finding a working solution for my partner’s illness, offering what practical help and advice that they could. However, despite the severity of an already diagnosed and acute psychiatric condition, it was impossible for either of us to access the right levels of professional help and support.

Thanks to an incredible level of care, my partner has now been entirely stable for more than a year now, helped by medication and a wonderful medical team. During the last 12 months there has not been so much as a raised voice in our household, despite the stresses and pressures of a global pandemic and national lockdown, much less any mania or depression. After a lengthy battle, I am pleased to say that the man I fell in love with is firmly returned to good mental health. There is still a long road ahead to get to the point of him being well enough to return to work (recovery from an illness like this is a little bit like suffering a major stroke, leaving you having to learn to walk – or in this case, handle stress – all over again), but the total and complete remission from the symptoms of Bipolar Disorder that has been achieved here is already more than either of us could have dared to hope for. More than a year later, it still feels like a miracle.

However, parallel to the battle of getting my partner well again, I have simultaneously been fighting a very different war – against the shame, stigma, and misunderstanding surrounding mental illness. In remaining committed to my partner and his recovery, I have been labelled many things – carer, victim, idiot, anti-feminist, and weak. But I don’t feel weak. In fact, as I look back over this journey, I actually feel incredibly proud of what I have discovered about the significant strength of my character. I am proud of having managed to hold onto myself in the most adverse of circumstances. I am proud that I am still able to do what has always come most naturally to me: give love with my whole heart.

However, despite the severity of an already diagnosed and acute psychiatric condition, for a long time it felt impossible for either of us to access the right levels of professional help and support. In the end though, thanks to an incredible level of care, my partner has now been entirely stable for more than a year now, helped by medication and a wonderful medical team.

I hope that, after reading this, you not only ask how people are, but that you truly listen to the answers you are given – and that you also have the compassion to dig a little deeper from time to time.

With love, Alexandra