On being discharged from the mental health system

I’ve been seeing a consultant psychiatrist for about 10 years.  I had a catastrophic crash and was given an urgent appointment.  Three days later I was sat in a room with a friendly man who pitched his questions carefully to gauge the level of my understanding of my illness.  In the letter that he sent both my GP and myself he described me as high functioning and high intellectualising.  This meant that, whatever the final outcome, I had a better chance than most of surviving into old age.  Bipolar Disorder is a killer and I didn’t want it to kill me even though, at times, it has come close to doing so.

At my first meeting with him he asked me what I’d like to gain from the sessions.  I wanted to get to know myself better, to find out who I was.  Even though I’d been diagnosed 10 years earlier than that meeting I was still angry at the diagnosis and I combed psychiatric journals in the hope it was something else.  Being diagnosed with a major mental health problem is like being told that the you that the person you thought you were has died and a stranger has taken your place.  You have to go through a grieving process and I’d got stuck on anger.  My only real chance of moving forward was to find the real person inside and get to know her.  A tall order indeed.

I can’t remember how we started but family and the poor relationships within the family figured prominently.  The partner I had at the time was spoken of and he occasionally attended appointments.  I do regret him being there now.  It was a relationship that appeared to be good but he was psychologically abusive.  I don’t think it’s any coincidence that when I finally broke free from him I began to improve substantially.

I had lost touch with quite a few people which, to be honest, was only partly to do with Bipolar Disorder.  It is difficult to keep in touch with people when one person is commanding your attention and you feel that the only positive thing in your life is of being useful to them.  I had no fear of telling people I had Bipolar Disorder, there was no sense of shame but it was easier and simpler not to talk.  Between that relationship and the illness my thinking became quite warped.  I couldn’t separate myself from the symptoms and I blamed everything on an illness that was almost a refuge.  My partner blamed everything on my personality so between us I got pretty much destroyed.

I had learned very quickly how to hide behind Bipolar Disorder and as it was the line of least resistance I was unwilling to give it up.  Having something to blame for not attempting to live is too easy.  Something had to change.  Having a psychiatrist who wasn’t afraid to challenge my thinking was a bit of a shock and I did answer back.  He has nearly always won but then he has nearly always been right.  Both he and a good friend were right to tell me that I hid behind my illness.  It was one of the most important things that I learned.

I was encouraged to build up a strong support network.  You don’t have to ask people to be part of your support network.  If you see the same people regularly and they anchor you in to reality then they support you.  Some people are more formal members of your network: GPs, nurses and psychiatrists all become part of that network.  Two of the mainstays in my support network and the two lovely people who hold Lasting Power of Attorney for me.  Their selflessness gives me a safety net, a permission to retire from the world when it overwhelms me.

I never quite saw the point of taking small steps.  I wanted to take large steps and make changes that I could see straightaway.  A friend kept on at me to be satisfied with small steps.

I lived in chaos.  I couldn’t get my flat tidy and there was always at least two days worth of washing up to be done.  I got the vacuum cleaner out and it stayed our for a couple of weeks at a time before I used it.  This was probably the reason why it lasted for 15 years.  There was always piles of washing to do and I had to do them by hand because I didn’t have a washing machine.  My finances were a mess and my utilities were on key meters which cost me extra money.  How could I make sense of all that, how could small steps make a difference?

Although as and adult I had always practised meditation I was encouraged by my psychiatrist to start using a method called mindfulness and he gave me a CD to get me started.  I took to it quickly and easily and still use it on a daily basis.  It focuses the mind on the here and now: make plans but don’t project, have memories but don’t live in the past.  It works.  Small steps.

I began to regain enough confidence to start doing some voluntary community work and I really enjoyed it.  My life was still chaos but I had a routine outside of home to hold on to and to remind me that there was a life outside of mine, I was not the centre of the universe.  When I finally freed myself from my destructive relationship I did more and progressed well.  My swan song, when I had to give up entirely due to the effects of stress upon the Bipolar Disorder, was to act as a trouble shooter between traders and the contractors on a retail street refurbishment.  For someone who had trouble stringing two words together at one point it was a major achievement.  Small steps.

I became involved in moderating a mental health forum.  It was disastrous but I learned a lot from it.  Positive lessons don’t have to come from positive experiences.  Small steps.

I became involved in speaking to the media about mental health.  I really enjoy it and have had a full page article published in my local newspaper, had tiny pieces in the Guardian and the Independent, been on local and national radio countless times and appeared on television.  I’m now on the producers lists at LBC and the BBC which allows me to speak to big audiences.  Being interviewed on Radio 4, BBC News 24 and the breakfast show on LBC is a fantastic achievement for that person who couldn’t string two words together.  Small steps.

About 5 years ago I got in touch with a friend who I’d lost touch with.  It was a happy thing for both of us and we found we hadn’t lost the ease with which we talked.  As a financial adviser he was more than happy to pass his skills on to me.  People with Bipolar Disorder are almost expected to have problems with finance.  A few years ago it became clear that I was having problems with money and my memory was suffering as an effect of the illness.  I approached this person and a GP friend about taking up Lasting Power of Attorney and they both agreed to it.  Under my friend’s guidance I changed the way I approached money, I became less fearful of it and have gone from someone who always spent up to my income to someone who has a savings account with money in it.  Small steps.

As a result of being financially secure I could buy a washing machine.  If I have a pile of washing today it’s because I’m late in doing it this week.  As the pile reduced my bedroom became tidier and I worried less about it.  I was advised to find a level of chaos that I could live with and never exceed that.  I accepted that and found that I’ve become a lot more tidy as a result.  The pressure has been taken off.  I am never as chaotic as I have been in the past.  Small steps.

As a result of my media work and my willingness to take part in research I was approached by NICE to write personal evidence for the committee on self harm.  I wasn’t happy with the guidelines that they provided and felt that they encouraged a stilted testimony not a natural one.  I challenged them on this and forwarded the URL of my blog post on self harm to the chair.  As a result NICE now accept blog posts as testimony re mental health and it’s a change I’m really happy to have been able to influence.  Small steps.

As a result of all these small steps becoming big changes I was able, at the meeting with my consultant today, to ask to be discharged from mental health services.  We talked about my support network, the input from my GP, medication, future problems and future successes.  We underlined that I’m not cured, I have limitations and going back to work at some time in the future will never be a viable option.  I will never have periods of remission, I will always be in a state of illness but because I’ve taken these small steps I am in a position to be, controversial word though it is, recovered.

I will always have limitations but then so will anyone.  None of us are completely capable and we all fail at something.  It’s part of the human condition and I’m part of the human race.  I will always speak up as a mental health advocate.  I will not be silenced by an illness and I will not be silenced by prejudiced fools.

Had I not been forced into early retirement I would not have bought a camera and not discovered my favourite way of spending time.  Had I not had this illness I would not have had time to write, take part in research or learn the truth about myself.

The truth about myself is that whatever problems I face, whatever successes I have are mine.  They can be come more complicated because of Bipolar Disorder but it is not responsible for everything that goes wrong or anything that goes right.  It does not make me creative though it probably does help me to push boundaries from time to time.

Today I am happy to be out of a system that, at one point, I would not have been able to live without.  Gone are the suicide plans, the endless ways I devised to die.  Self harm is currently just a memory.  I’ve recovered.  I am not well but I am recovered.  This lunatic has finally taken over the asylum.

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