Amanda Nicol Different Stories

A dialogue with a diagnosis

Book cover image: 'Shore' by Nicola Oliver
Book cover image: ‘Shore’ by Nicola Oliver

The madness, the craziness, all the text book symptoms come to life. The seductive dreamlike internal logic of psychosis. I’d been fast-tracked to a dazzling paradise armed with cosmic insights you wouldn’t believe.

 

 

 

 

And then it happened again … and again, but gradually with less force, settling into something familiar. It’s made of the same stuff as creativity, but now it’s at a therapeutic level, without the delusions or loss of touch with grounded reality.

These days the aftermath might mean a few days with my feet up enjoying some sort of work satisfaction or on a bad day exhausted and overwrought, but knowing what I need to do to stabilise, to get the balance back. And I’m getting better at that with every year that goes by.

Twenty years ago its effects were cataclysmic; the mother of all post party regret, the tattered life, another broken relationship, a head full of medication and scattered memories, as impossible to piece together as the contents of a china shop after a visit from that bull. Maybe when your head clears after a party you might remember, and unless you have done anything really extreme, it will be filed away by you and your mates as just a bit of fun. Not so with this. No one regards this as a bit of fun. In fact, it scares people to death. You can see it all over their faces. And as anyone who wakes up from a drunken night knows, the uncertainty of what you may have done or said is pure head-in-hands stomach turning torment. Going mad blasts embarrassment into a new dimension. And that was the good bit.

What goes up must come down. Or in my case, what goes down must come up. The down came first. If there can be an opposite of the extreme high of mania it’s being suicidal: that unspeakable personal apocalypse, the excruciating state of being for which taking one’s own life seems the only solution. How much more sympathy there would be for the suicidal if ‘normal’ people could experience for just five minutes what the suicide endures for months, or longer.

But, like the dizzy heights of mania, the bottomless pit is not somewhere I visit these days. In fact these days I suffer less from even the ordinary blues than most people I know. Again, there was an easing over the years. And there has been a ‘mixed state’ too, but now I’m in the driving seat. I have my tendencies, proclivities, susceptibilities, sensitivities, whatever – I’m an organism in an environment making the necessary adjustments, tweaking levels of this or that to thrive. It’s only doing what every living thing does. Trying to get comfortable – looking after myself.

Things blur with medication. Large chunks of time disappear into black holes, parts of the story of your life, ripped out like censored pages of a book. The very part of the story you wish to read has gone, forever. Crippling side-effects that scared the living daylights out of me – I had them all, and I couldn’t handle it. Illness was scary, but not half as scary as its so-called cure. Others may tolerate medication, but for me, there had to be another way.

No one can help you with the decision to come off medication. And no one will be pleased about it. No one tells you that you’re brave when you decide to take your health into your own hands. But my second psychosis occurred when I was on lithium, so as far as I was concerned it didn’t work. Had it ‘worked’ up until then? Was I well because of lithium, or well in spite of lithium?  No one knows how lithium works. But then many things work without us really understanding how, like love, for example, or life itself. After all, human beings have been medicating themselves since the beginning of time without knowing how things work, only that they did work. Or in some cases, didn’t. But until relatively recently the substances or treatments available were not industrial, and where there is industry there is vested interest, needing a persuasive orthodoxy to survive.

Initially I could accept lithium; after all, it was a natural substance, used for its calming effects since way back. So have lots of other things, some of them known to be very bad for your health long term, and some not. It looked to me like lithium fell into the first category. So, for the long haul, I just couldn’t comply. It might be OK for five years, ten, but what about fifty, sixty even? I was 22 years old. When I asked how long I would have to take it, I was told with a shrug that they couldn’t say for sure at this point, but, ‘Maybe for life.’

Toxic. Toxicity levels. Blood tests. The shakes. The horrible metallic taste in the mouth that toothpaste can’t touch. Weight gain. The thyroid issue. The toxic to a foetus issue. The leaden deadness. The extreme fatigue. The sapping of my creative flow. The inability to read. Suddenly it seemed that all the things I needed not just to feel good, but to be me, were prohibited. Vitality was to be a thing of the past, a preserve of the ‘normal’ people. Whose sort of health is that? Society’s? The family’s? I had been treated and dealt with; some unruly part of me had been tidied up and put away. Great if your idea of health is a suppression of symptoms. It isn’t mine.

And as for the drugs I was given for my acute symptoms, well, that they were poisonous was obvious to me and anyone who saw me on them. Tongue twisting and writhing uncontrollably. Eyes rolling. Memory in a centrifuge. The almighty crash as the tranquiliser kicked in. Suddenly perking up like some sort of robot, twitching, unable to sit still. Aching legs. Splitting lips. Lactation. Sunshine burning skin. Skin turning to wax. All the poor old girls together in the loos in the morning suffering audibly with their chronic constipation.

A constant craving for sugar as the body desperately tries to pick itself up out of this toxic sludge. The inebriated feeling calling for endless cigarettes. No legislator who had been on anti-psychotic tranquiliser could, in good conscience, ban smoking on a ward. And yet it has been. And all of this after being pinned down, trousers ripped off in front of a mixed ward and injected in my backside. I wasn’t being violent or endangering anyone. But I was as high as a kite, and at that point I most definitely needed sedation. But might there have been a gentler way? Definitely.

Why didn’t anyone tell me about side effects, or, let’s tell it as it is, the impairment of brain and body function very possibly leading to long term brain and other damage? Many trials on primates show this. That these drugs are tested on animals is in my view bad enough, but testing them on humans? Is this acceptable? Evidently yes, in a society that is willing to medicate children. No one told me about manic depression either or even, for that matter, where I was. That was the healthcare that by coming off lithium, I was potentially inviting on a regular basis (although I believe that things have improved since the late 80’s, and even then I’ve no doubt this was done by good people with good intentions).

That was my fear and not an unrealistic one. It seems to me that once the initial crisis has abated, medication of this sort should be a last resort when all else has failed. And those wishing to come off medication should have the option of doing this as an in-patient, or under supervision at home in the care of a range of therapists, offering psychological, physical, emotional and nutritional care and advice for the inevitable, difficult and without a doubt frightening period of ‘cold turkey’ and beyond, tailored to each person, with time spent healing a human life out of balance – not its symptoms. I wonder what the results of a thorough and far-reaching cost-benefit analysis of this approach might be. Or should that be profit benefit analysis?

By staying on lithium, I felt I could never really heal. Never move on or away from this experience. It filled me with despair that from this point onwards part of the definition of myself lay in a packet of Priadel. I refused to accept that my sanity was to be found in a bubble pack of pills that would damage my health long term. Proud, stubborn, maybe. A risk taker, probably. But I had assessed that risk. I had met long-term psychiatric patients and it seemed to me that many were being hospitalised on a regular basis despite medication. So they were not ‘getting better’. They had a label, and it all became a self-fulfilling prophecy. It was desperately sad to see. As my husband said the other night when we were talking about this, ‘Maybe hospital did work for you!’ Well, I’d never thought of it like that, but he had a point.

I think I suffer from survivor’s guilt. On seeing others still on medication and stuck in a revolving door scenario, I could almost believe that I must have been a fake. A fraudulent lunatic, a psychotic skiver. But a long drawn out clinical depression, two suicide attempts, two major psychotic episodes, three stays in hospitals, being held under Sections 4, 2 and 3 (although I was released before its end) of the Mental Health Act and a quick look at my old psychiatric notes remind me that I was, once upon a time, in a very bad way indeed. Recently I heard of a study which suggested that people on no medication whatsoever had an eight times higher rate of recovery from psychosis. Maybe I’m not such a fraud after all.

Have I struggled with mental illness? Or fought a battle with bipolar disorder? Not really. I called this piece a dialogue with a diagnosis because in a sense it has been and is still that. Starting from a very low point in a very bleak place I begin to explore what health was, what health meant to me. My health, and all of it, mental, physical, and spiritual. It meant taking responsibility for the decision I made. For the sake of my family and all those close to me, if I was to choose to do this another way then I had to get serious about it. But that makes it sound like a regimen, which it wasn’t. But it was a commitment. And I certainly didn’t turn into a clean living fitness fanatic overnight.

With my self-esteem at an all-time low (having been sectioned is hardly a great selling point), the remainder of my twenties was a painful, often terribly lonely quest for oblivion, and preferably in similar company. Stigma and shame are not the best building blocks for recovery. As with the stigma, which you, as a member of society, brought up with all that society’s fears and prejudices, share, you have to fight hard with yourself against the shame of it; that belief that you are on the scrapheap, washed up forever. That is why I so desperately needed my faculties, physical, mental and creative, to keep boosting and bolstering that battered and bruised sense of self-worth.

I succeeded. But it was a gradual process. Things happened, life changes as it does, and slowly things reveal themselves. Things happen from the inside out. I got a dog. I had a dependant! I wasn’t going to leave him in the lurch in a hurry. I didn’t feel better, therefore got a dog; I got a dog and eventually realised that walking him twice a day, rain or shine, was making me feel good. It was fun, and he loved me. I met people and had something else to talk about, and without even noticing, all that drug weight just fell away, effortlessly. I was back in touch with the changing seasons, nature’s own mood swings.

I started taking essential fatty acids and read up about diet and health. I still sought out ways of escape, but eventually, in some way I got the better of myself, rediscovering the wellness that I had lost somewhere in an angst-ridden and confused pre-mad adolescence. I became interested in natural health care and the effects of body chemistry on the brain. I realised how sensitive I am to blood sugar fluctuation, to hormonal changes, to the emotional consequences of the insomnia I seemed to suffer so often and to the effects of caffeine and alcohol. Moderation became my watchword. I came to realise I didn’t need the things I thought I needed.

I didn’t keel over without my props after all. Of course, there were setbacks, lots in fact. Periods of deep anxiety and one terrifying spell of panic attacks. Again, my fear of medication sent me in search of a natural solution, learning about stress and what it can do to the body and therefore how to avoid it, and if not avoid, then anticipate, manage and develop strategies for coping – strategies whose side effects are beneficial. I began to understand how my life events had affected me, and how conforming to society’s so-called norms had repressed an enormous part of me. Unpicking your life is a long journey, but the rewards are off the scale.

This interest in my health soon broadened into an interest in and concern for the broader environment. Or maybe it was the other way round. An interest in the environment and ecology eventually came together into a holistic view of myself as part of nature, subject to its laws. We can see all too clearly what a toxic environment does to an ecosystem, what long term damage can be inflicted, whether by misguided good intention or motivated by greed or profit. We don’t know what we’ve got till it’s gone. Whether that is sanity, health, or the wider world, we have to learn how to work with what we’ve got, with what we are, sustainably. In observing nature, we can begin to understand healing and its timescale. The impulse of nature is to recover and be well. That is a mighty force on your side. I believe there is such a thing as a psychological immune system that can guide you if only you take time enough to listen.

We all thrive in the right situations and circumstances. We all become unwell if this isn’t the case. Pour in some chemicals for the quick fix, but know that there is no such thing as a free lunch. There is no pharmaceutical that we can put into our brain that will not affect the whole. Health has to be systemic, holistic, all-encompassing. Perhaps mental and other illness and treatment could be avoided if more time was given to understanding the subtle mechanisms of our amazing bodies, of which the mind is a part, not some separate fragment. We are not machines, we can only look at each case individually, and only really know through lived experience. So many aspects of modern life are patently crazy, and yet we capitulate willingly, handing over our personal power to doctors and pills.

Now I live by the sea, and with the changes in the weather, I’m reassured that mental weather is normal. And that extreme weather conditions are rare, they are special, they are frightening, and they cause havoc and destruction. They are natural, and yet we can bring more of them about by our mismanagement of our planet’s finite resources, and the same goes for ourselves and the precious resource that is us. But at the end of the day, when that storm comes, that mighty power, the over-riding thing to feel is awe. Isn’t it amazing that that can happen? Amazing that your head can take you so far out? It is deserving of respect, that’s for sure.

Maybe one day a psychotic episode will be treated as just that, an episode, not a life sentence. It could be there will be many such episodes, with all their sometimes not so crazy insights, notions and paranoia. Maybe in this altered state, the doors of perception are opened. Perhaps there is an element of mysticism in there somewhere. After all, William Blake, considered to be our greatest visionary artist and yet thought of as mad by many in his day, liked to sit naked in his garden and saw angels in the trees. Where would we be without our bows of burning gold and chariots of fire?

Perhaps these things could be viewed as psycho-spiritual crises, as rites of passage even, with something important to tell us. Clinical depression we could all do without for sure, but even in that there was a lesson – it was a cry from the very deepest depths of myself telling me I was way, way off course. And my psychotic highs showed me in no uncertain terms the lavish beauty of the Earth and the connectedness of all things. It gave me the courage to try things and fail (after all, what did I have to lose?); released an enormous amount of creative energy, and maybe most importantly gave me a non-judgemental compassion for people who are at rock bottom. I have always found people with mental health issues to be some of the most open and kind people around. Not the knife-wielding psychopath of popular mythology, but maybe in some way society’s barometer: sensitive souls out there on the psychological front line – canaries down the mines of modern life.

© Amanda Nicol 2010

 

A version of this essay is included in ‘Our Encounters with Madness’ Grant A, Biley F, Walker H (eds) 2011. Ross-on-Wye: PCCS Books; Amazon

 

 

 

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