In 2001 when I was 45 years old, after a much-loved uncle died and I endured a traumatic marriage break-up, I was diagnosed with Bipolar 1 disorder. The diagnosis was made following a manic episode, two suicide attempts and my admittance to a psychiatric ward. I was in such mental agony that all I wanted to do was ‘pull the plug’ on my life.
At the psychiatric ward I had two sessions of Electroconvulsive Therapy (ECT). This procedure is done under general anaesthesia where small electric currents pass through the brain causing a brief seizure which seems to change the brain chemistry. There was stigma and fear attached to early treatments of ECT because high doses of electricity were given without medication, which had serious side effects. Nowadays mood-stabilising medications are also used to treat Bipolar disorder including Lithium and Epilim. However, it is important to have regular blood tests to check on lithium levels for toxicity and there can be side effects such as brain fog, fatigue and tremor.
The first ward I was admitted to was in an old wooden building and had no locks on the toilet doors. The ward reminded me of the movie One Flew Over The Cuckoo’s Nest, housing a range of patients diagnosed with mental disorders including Bipolar disorder, anorexia, depression and schizophrenia. There is still a fear in society about being admitted to a psychiatric ward and being ‘locked up’ or called a ‘raving lunatic’ even though the word ‘asylum’ comes from the Greek word ‘asulon’ which means ‘sanctuary’ or ‘refuge’.
My parents told me that they felt so guilty when they were driving me to the hospital for admission. Apparently I was terrified, crying in the car and begging them not to admit me to the psychiatric ward. Prior to this they were really concerned about my behaviour and I was initially assessed by a mental health team. Despite my family telling the team why they were so worried about my behaviour and that I was also working at the time, I managed to hoodwink the team into believing that I was perfectly okay. Apparently I was also exhibiting signs of paranoia about people in my workplace and I had grandiose ideas. My family was devastated and when my mother visited my local GP, he was also seriously concerned that I had not been admitted to the ward.
Manic behaviour
During the manic episode that preceded my admission I remember throwing a party at my home ‘for all the beautiful people’ and inviting some local retailers, friends and men to the event. The only prerequisite to the invitation was that they had to be one of the ‘beautiful people’. At the party I was dressed in a short black dress and flirting in a way that was totally out of character for me. I also decided it was necessary to mow my lawn before the guests arrived wearing the black dress!
Prior to this I had stayed awake for most of the night dancing in my candlelit lounge, drinking heavily and I even bought a $750 painting along with designer luggage because I thought I was going on holiday to Tuscany.
Being in a psychiatric ward is not always ‘doom and gloom’. One day, another patient and I were allowed to walk to the local shops. We arrived back with two huge bags of clothing from the op shop and decided to have a fashion parade. We had a compere, music, non-alcoholic drinks, refreshments and created a temporary catwalk for the patients who were the models. My parents were invited and I am sure the show provided much amusement for the spectators, including the nursing staff!
The stress on my parents’ relationship was huge, including managing my personal affairs. My mother was visiting the ward daily and my parents’ relationship with my psychiatrist in the hospital was fraught. They felt that he had a ‘one-size-fits-all’ approach to his patients instead of treating them as individuals. My mother refused to sign the consent form for more ECT treatments after the first two sessions. My parents also found the psychiatrist’s advice that I could still drink alcohol alarming. I later switched to another psychiatrist who decided I was mentally well enough to go home. I have been alcohol-free ever since.
Gradual path to recovery
Recovery was painful and slow. When I returned home I felt enormous shame, remembering my past behaviour in public. I also felt I had a label on me announcing to the world that I had a mental illness. I was put on a sickness benefit as I was no longer employed. I also had home visits from a mental health nurse and eventually enrolled in a business administration course. I know now that it is possible to make a full recovery, but at the time it felt like there was no hope for the future.
Bipolar disorder usually starts in your twenties but can sometimes occur even earlier. There are two types of Bipolar disorder: 1 and 2. Bipolar 1 is diagnosed because it consists of ‘at least one manic episode that may come before or after hypomanic or major depressive episodes’. Its symptoms include lack of sleep, disinhibited behaviour, rapid speech, spending sprees, sexualised behaviour that is often out of character, grandiose ideas and even psychosis when a loss of reality occurs. The ‘free fall’ when you come out of the ‘high’ can heighten the risk of suicidal behaviour.
Bipolar 2, which is often under-recognised or misdiagnosed, consists of at least one hypomanic episode and depression.
In hindsight, I realise now that my first manic episode occurred while I was on my overseas experience in London. Because I was overseas my family was not there to witness my manic behaviour. I made irrational and impulsive decisions and had very risky behaviour followed by periods of depression. Throughout my life I’ve often changed jobs, and had many ‘ups and downs’ in my moods and thought it was possibly a form of self-sabotage. I’ve had counselling because of my ongoing depression but was never diagnosed with Bipolar disorder.
The key to management of my Bipolar disorder is creating ‘order’ in my life. The three top daily ‘non negotiables’ are taking my medication, a regular sleep routine which includes taking a sleeping tablet at night, and absolutely no alcohol. My bed is made up to look welcoming with a bedside lamp on, a book to read and my alarm is set for the same time each morning unless there is a change to routine.
I avoid using the computer at night because exposure to blue light in the hours leading up to bedtime can hinder sleep and suppress the body’s release of melatonin, a hormone that makes us feel drowsy. This is also why I don’t have a television in my bedroom and am selective with what I watch on TV at night before sleep.
I have a daily power nap after lunch if I have had a disrupted sleep over a couple of nights because I am aware that my mood can elevate. If that’s the case I have less social contact the following day such as reducing phone calls and doing quieter solo activities like gardening, reading … even cleaning.
I always double-check that I have taken my medication and the pack is kept in an obvious but safe place away from children. My prescription is renewed three-monthly when I visit my GP and I have blood tests to check on my kidney function. My medpack is refilled weekly and I double-check the contents. Nowadays I am on an anti-depressant medication as well as Epilim, a mood stabiliser with no side effects. I exercise regularly at the gym and pool, eat a well-balanced diet at regular times, reduce caffeine, stay well hydrated and have non-alcoholic drinks.
Staying well
I review my diary so I don’t overload myself with appointments and have a small but manageable ‘to do’ list each day which I prioritise. Keeping in touch with nature and the senses is also on my ‘feel good’ agenda. Sometimes first thing in the morning I like to walk outside and feel the dew on my feet. I can look at the flowers in my garden and if my roses are in bloom, drink in their perfume.
I enjoy listening to music, walking on the beach and savouring good food. I have been able to travel successfully and I am now fortunate to have a wonderful husband who attends my medical appointments with me. I have a loving family, supportive friends and an excellent GP. I believe my friendships should be ‘healthy’ ones where the focus isn’t on my disorder most of the time but on living life in a positive way.
Currently the beautiful painting of a waterfall in New Zealand that I purchased on my spending spree hangs on the wall of my parents’ lounge. It is a tranquil reminder of where I have travelled to on my mental health journey. I am now living well with Bipolar disorder. Every day is a gift and I can’t wait to open it!
For more information on Bipolar disorder, visit blackdoginstitute.org.au/resources-support/bipolar-disorder
Authors name withheld by request.
