This is a story about personal responsibility...
I often like to think that I'm 'cured' of bipolar, but the reality is that I can have incredibly functional periods, where it certainly appears to the outside observer as if I'm perfectly healthy. However, the stability of my life - and my mood - is not due to having received treatment, nor is it accident or pure good luck. There are a lot of choices, deliberately made, which keep me functional.
We must accept that whether I'm functional or not, I do experience a mood disorder: bipolar. I can be suicidally depressed but working productively at my desk, with my colleagues blissfully ignorant of my distress and the danger to my life. I can be fighting to control my hypomania with every fibre of my being, desperate to unleash the 'high' episode and experience a period of incredible creativity and productivity, but I know that my colleagues would bear the brunt of my irritability, and their suspicions would be raised by my fast speech and general intensity... I would be told to go home; I would be told I'm working too hard, and I would ignore them, only to subsequently crash.
I'm prone to taking huge risks. I'm prone to depressions that leave me unable to leave my bed or face the world for long periods. I'm prone to hypomanic episodes where I take on ridiculously huge projects, and somehow manage to complete them, but at great expense to my health and stability.
Nobody could say that I don't have to be aware of my bipolar disorder at all times, because it always threatens to plunge me into suicidal depression, or make my hypomanically high - neither state is compatible with a regular 9 to 5 Monday to Friday office job.
Luckily, nobody employs me because I'm a slow and steady guy; nobody employs me because I plod along doing nothing much in particular, keeping a low profile. The reason why I get employed is because I get stuff done. I get a lot of stuff done. I get things done that people say couldn't be done. Then, one day "I can't even" as the kids say. Yep. That's a complete sentence. I can't even finish a sentence properly when I'm having one of those episodes. I become dysfunctional if I don't manage my illness. There's no denying that I'm unwell when I get so sick I can't leave my bed, answer my phone or send an email: I go AWOL.
For years I struggled with the different episodes. I allowed too much of my hypomania to be conspicuously visible in the office. I allowed too much of my depression to overspill from my private life. I was in the office when I shouldn't have been and I wasn't in the office when I should have been. I allowed my mood to dictate my behaviour, as so many of us do, because it's virtually impossible to behave otherwise.
I tried being my own boss, so I could work as hard as I wanted when I was hypomanic, and sleep as much as I needed when I was depressed. Things got worse, not better. I tried tablets. I tried so many tablets. Things got worse. Things got so much worse and I became so dysfunctional that my life fell apart, but nobody believed me. I was sleeping rough in Kensington Palace Gardens - a complete mess - but because I sound posh and intelligent, and I've had a great career, nobody believed that I was losing my battle with my mental illness, and I was incredibly vulnerable. I desperately needed help, but to outside observers, I seemed to have some semblance of the self-reliance I'd always had... everyone assumed that I was as competent and capable as I'd ever been, and that I could take care of myself.
Things got very bad. I was hospitalised several times, both for medical emergencies due to physical health problems which threatened my life, and for the seemingly unending mental health crisis I was suffering. The fact I was alive was taken as evidence of my resourceful nature and self-preservation instincts - my ability to be responsible for myself - but it's pure blind luck that I'm not dead, along with a heck of a lot of skill, effort and energy by a vast number of medical professionals, who've saved my life during various organ failures, seizures and generally near-fatal awfulness which took place in high dependency hospital wards and intensive treatment units.
Today, my life gives few clues about the journey to this point. I have two large scars on my legs and a tattoo behind my ear. The tattoo is something that any observant person might see, as a tiny clue that I've been though some pretty appalling stuff, but the scars are usually hidden beneath my clothes.
The length of time that I've spent working closely with a close-knit group of colleagues, and what we've achieved together as a team, is the basis for the impression that people have of me, along with my general demeanour. I'm lucky enough to have retained my full faculties and suffer no impairment due to the horrors of the past. My colleagues see a competent and capable individual who they have come to depend upon - they trust me and the seek out my opinion. In this sense, you could be forgiven for thinking me 'cured' of bipolar.
I'm hoping that I will stay in my new home city for a long time, and I will build an ever-increasing circle of friends, neighbours and other acquaintances, who see me going about my daily business; who have pleasant normal interactions with me. My existence is clearly no longer full of crises; I'm obviously much more stable than I was, and that stability has proven reasonably reliable.
None of this is an accident. None of this is pure chance.
I don't have any caffeine. I know that alcohol is bad for me, and I avoided it for months, which was very beneficial to my health. I try to sleep as much as possible - 10 or 12 hours a night whenever I can. I keep to a routine... I keep to a REALLY STRICT routine if I can. Mealtimes, when I get up, what I wear, what I eat, writing every day, quiet time before bed, glasses to filter out blue light, dietary supplements... these are some of the things that are working well. I know I need to exercise more and I know I need to get more natural light too. It would be healthy to have regular social contact with people outside work. It would be good if I had a local support network.
My job often bores me, but I put up with it. I'm often too depressed and anxious to get out of bed and go to the office but I force myself. I often find there's not enough time to watch films and documentaries, or do anything other than write, eat and get ready for bed, after work, but I'm trying to do more.
I've gotten tired. Really tired.
Last week was incredibly exhausting. Work was immensely stressful and demanding. Some relationship difficulties cause me to lose a lot of sleep, as well as being very emotionally demanding and stressful. I got a kitten, which has been extremely rewarding and exciting, but also a disruption to my delicate routine and an additional set of responsibilities.
Adrenalin has carried me through the past few weeks and I've managed to skip almost entire nights of sleep on several occasions, seemingly without consequence, but it's all caught up with me.
I haven't been looking after myself.
I've broken my rules.
I've broken the rules which keep me safe, healthy, secure and stable. I've broken the rules which have kept me functional for a very long period of time. I've broken the rules which I invented to end the crises and the dangerous highs and lows. I've broken the rules and I've paid the price.
I'm not sick but I'm not well.
I underestimated the damage it would do to my health, drinking too much and staying up all night. I overestimated my ability to cope with extra stress and big changes. Suddenly I have a girlfriend and a kitten, where previously I had nothing but a big empty house. My life is immensely more pleasant and enjoyable, but it's also suddenly become incredibly fragile. I'm suffering bouts of insecurity and occasional outbursts of frustration that my comfortable stable security and safety margin of spare energy has been exhausted, leaving me irritable and impatient.
It's my responsibility to make sure that I'm getting enough sleep. There aren't enough hours in the day, but I can take some holiday. I've worked non-stop since I got home from Mexico at the start of January. Nobody can work so hard, move house, get a girlfriend, furnish a home and get a kitten, without having a holiday. I've been relentless. I've acted as if I've got limitless energy and a superhuman ability to achieve impossible feats at incredible speed. To all intents and purposes, I've pulled off almost everything, but the cracks are showing - I'm heading for disaster.
Whether I've already gone too far, allowing myself to become too tired and letting myself become unwell, remains to be seen. I was irritable and unpleasant last night, and there might be consequences. Who knows what damage I've done?
I'm going to sleep until lunchtime tomorrow. I'm going to recharge my batteries.
I know that a few extra hours sleep is not enough. I need a whole week of lie-ins. I need a whole week of afternoon naps. I need at least a whole week of being free from the relentless demands which I've faced this year. I desperately need another holiday. I've left it too long, as usual, but I hate going away on my own.
That's another part of the non-pharmaceutical treatment for my bipolar disorder: holidays. I genuinely need holidays for the sake of my health, but when my life was chaotic I would work as hard as I could for as long as I could when I was well, because I felt so much pressure to earn as much money as possible, to support me during episodes of illness. I've come to realise that it's incredibly unhealthy to have 6, 9, 12 and even 18 months without a proper holiday. I need a week away. I need a week of rest and relaxation, and ideally that would be with my girlfriend, if I haven't p*ssed her off and upset her with my unstable mood already.
I wonder if I'll make it - last long enough - to be able to go away on a nice holiday to recharge my batteries. I think that I need to start taking evasive action immediately. I need to be strict with my bedtime. I need to be strict with alcohol. I need to take some mornings off work to catch up on sleep. It might be advisable to take a whole week off and just do nothing for the sake of my health. I know that I've let my health get into a precarious state.
I haven't looked after myself and I need to act.
I could spend a week pottering around my lovely house, with my kitten to keep me company. I think my health would benefit significantly. I need to loosen my grip on my work. I need to relax. I need to rest and recuperate.
Burnout is not good. I'm so sick of burning out. I'm so sick of episodes of mood disorder. I can regain stability, but I need to recognise that I'm not well and I need to act immediately. Yes, I could cling on until the end of July for a holiday with my girlfriend, but there's a huge chance I could get really sick if I try to wait that long. I'm going to have to take some time off work, for health reasons, and it's not the end of the world.
I hope I write again soon that I did the sensible thing, and that I'm getting on top of managing my health. I hope to write that I'm regaining some safety margin, so that I can remain cool, calm and patient, and not be irritable and unpleasant. I hope to write that I'm treating my girlfriend nicely, not being an exhausted wreck, full of insecurity and instability.
I feel super bad that I've mismanaged my illness, but all I can do now is to try to look after myself.