By Amanda Saunders, co-author of ‘Bipolar Disorder: The Ultimate Guide’

When we wrote the first edition of ‘Bipolar Disorder – The Ultimate Guide’ in 2008, Sarah mentioned her six-month bout of postnatal depression. I, on the other hand, had experienced nothing more than a couple of brief episodes of stress, which I’d shaken off without needing therapy or medication. My grandfather, mum, uncle, cousin and cousin’s son had or have bipolar, so I felt lucky that I’d escaped the grasp of our family’s genetic fault line. 

I was wrong. Five years ago, those lurking genes were kick-started by personal trauma, workplace stress and a heap of related issues.

Insight can be one of the first casualties of depression. Your senses dull as the fog creeps in and swallows your self-awareness. So, despite witnessing my mum’s depressive episodes, it took months for me to realise what was happening. I dragged myself to my GP but it was already too late, and I sank even deeper. Below are fragments from the journal I tried to keep: 

It’s come for me. So slyly done… I’ve been caught unawares, smothered by degrees, by stealth. I’m invaded. It’s taken over my personality, thoughts, behaviours, everything. I don’t exist as me… Mornings are the worst. I hate opening my eyes. It hurts so much. Moving my body is like dragging a dead horse through sand… The pain overwhelms me, crashing through me in black waves. When it peaks, I can feel a stone throbbing hard inside my chest, pulsing relentlessly, until I think it will punch a hole in my lungs. This morning I just lay face-down on the bedroom floor, my eyes clenched, breathing into the carpet, until the pain receded a bit. It took hours. 

And as my depression deepened, my mood swings and agitation accelerated. It was like despair on speed: 

I get in my car and drive and drive and drive. As if I can outrun the pain. Or outrun myself. Or lose myself completely… I’m fuelled by a burning, impulsive energy. I’ve done some reckless things – way out-of-character, paranoid, risky – without being able to stop myself… I’m drifting in and out, in and out, in and out, of self-awareness. I don’t trust what I may do or say next… 

A psychiatrist’s diagnosis of cyclothymia was inevitable, given my family history. In the DSM-5 (the manual used in the UK for categorising and diagnosing mental health conditions) it is defined as “depressive and manic symptoms that last for two years that are not severe enough to qualify as bipolar disorder”.

The diagnosis was a relief – the first thing that made sense in a long time. By this point, I’d been signed-off sick from work and was a daily outpatient at a psychiatric unit, undergoing months of intensive cognitive behavioural therapy (CBT) sessions, group counselling and medication therapy. It’s a jumble of memories now, but the treatment (which I was lucky to have) eventually worked. My depression began to lift, just as the mood swings and agitation gradually subsided to a murmur. And so, I stumbled back to reclaim my life.

How am I now, five years on? I’m well and working full-time in central London, doing a job I love. I have avoided any relapses and my mood is stable. But I’m forever changed. 

One positive is that I’ve developed a much deeper understanding of mental illness. After co-writing the book, and supporting loved ones with mental illness, I’d felt I was pretty well informed. But just as antenatal classes can’t prepare you for the visceral reality of childbirth, nothing prepared me for the impact of depression and mood disorder every single hour of every day. The physical effect was savage – my whole body, not just my mind, was battered by my breakdown.

My experiences, of course, added new insight to our book’s second edition, which was published last year (2019). You could say I’d been doing very personal fieldwork.

Mental illness leaves a watermark, even when its waves have receded. Vulnerability lies just under my skin, like a faint bruise. So, when I say I’m ‘well’, I mean I’m ‘currently well’. I stay balanced with the twin support of regular psychotherapy and a low dose of daily medication. Alcohol is not my friend, not even moderately at the weekend, and so I now avoid it completely. Sleep, on the other hand, most definitely is, and my years of boasting I only need five hours’ a night are long over. My current job is hectic, enjoyable but sometimes stressful, with many priorities to juggle – so I try to pace myself, delegate and not over-promise my time.

It’s hard to imagine that five years ago I was curled up in the sunny gardens of the outpatient unit, sobbing into the weeds. I don’t want to go back there – so to stay ‘currently well’, I’ve made life changes. I owe it to myself and those who love me to do everything I can to avoid sliding into a full-blown bipolar diagnosis. So far, it’s working. I’ll never be a completely calm person (just ask my kids) but right now my cyclothymia remains a manageable background murmur.

In other words, I have learnt to live by the book. Our book.

The 2nd edition ‘Bipolar Disorder – The Ultimate Guide’ is being released as an audiobook. It’s launching on 8th October to coincide with World Mental Health Day on 10th October2020.

 

Blogger details:
Amanda Saunders is co-author (alongside her cousin Sarah Owen) of ‘Bipolar Disorder - The Ultimate Guide’ (Oneworld Publications)

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