Category Archives: Mental Health

In Focus

I took my bicycle out today, for the first time in a long time. Usually I use it as a means to an end; a conveyance from point a to point b. This evening, I just cycled. Until recently, I would have said one of my favourite sounds was the noise of horses’ shod hooves clip clopping down the road – as a child I would have literally run out to see the horses pass by if there had ever been any down my road, which there weren’t.

Ever the thrill seeker, I rode horses, in part for that sound. Time passes, things change. As I rode my iron horse out, wheels turning, I reflected that perhaps now, my favourite sound might be that of my thin road tyres spinning round on tarmac. There’s not a word to describe that noise exactly; it’s not a hum, but like hooves it has its own music.

How little we know ourselves, as we change, almost impercetibly.

Earlier today, I had to fill out a form. It caused me to ask questions of people who know me.

Do I do this? I said.

Do I do that?

Yes, they said.

I thought about it. When I work with people who have bipolar disorder I think, to myself, sometimes I ask them directly, Do you know your bipolar cycle? (Keep up at the back, I’ve moved on from penny farthings.)

Today, for the first time in a long time, I directed the question to myself. Do you know your bipolar cycle I said.

In my late twenties, my psychiatrist (and I was lucky really to have had that one and not another who I had post-natally and who liked me to hope for the best and prepare for worst) asked me to keep a mood diary for some months. He made it as easy as possible for me, I only had to rate my mood with a number on a daily basis; it didn’t take long to complete every day. I think it was when the diary was eventually reviewed during a consultation that he mentioned the phrase rapid cycling bipolar to me. It was the first time I had heard it, and it was of only passing interest. My up and down life continued on its rollercoaster ride.

Before my diagnosis my moods followed what might have been considered typical bipolar, weeks if not months of lows, followed by the same period of highs. My behaviour was classic for both sides of the pendulum, although I never was psychotic – although some on the receiving end of me at that time might disagree.

I am now approaching twenty years of diagnosis. I now accept, as my doctor told me a long time ago, that I fall into the category of ultradian bipolar (where the cycle is broadband speed, hours rather than days even). I’ve also nearly accepted that this is it: mercurial moods are never going to leave me.

Yet after twenty years of managing moods, and where did that time go to for goodness sake, the strangest thing has happened – strange to me anyway. Firstly, the more I have become alert to the mood upswings and downswings, the shorter the periods of the highs and lows. That’s not the strange part – when I know where I am with it, I can do things to counteract the pendulum, and get myself back onto an even keel more quickly. No, the strange thing is that the more I have noticed my moods and managed my moods, the more I have crystallised the very moment of the sudden slip down – I am not quite as sensitised to the rapid ascent up, although talking loudly and quickly is a sure sign that others are quick to point out and take refuge from…

The slipslide downwards is an extraordinary feeling. And it is just that, a feeling. One moment I can be ok, and then suddenly the old unpleasantly familiar feeling creeps into my bones, its bulk pressed in my chest, its hands round my throat. I am reminded then of Philip Larkin’s poem Toads.

For something sufficiently toad-like
Squats in me, too;
Its hunkers are heavy as hard luck,
And cold as snow,

However, as slimy yuck and toadlike as the feeling is, it is the rapidity of the change in internal weather that throws me off. It’s like crashing your mood car straight into a brick wall, on a fine day, on a good road. Of course, with depressive feelings I know mainly know what to do, and I do it. Hence the bike.

Maybe in another twenty years I will have worked out my triggers. I am often heard to say that I am a very slow learner, but maybe it is more that we really are, in larger parts, often a mystery to ourselves.

dandelion clock

My daughter took this shot, and I love it. The mood and subject speaks of time and focus – like how we drift in and out of focus to ourselves. I have wanted a DSLR camera myself for years, but because of all of the above, I have become wary of purchasing big ticket items, particularly for myself, in case it is feeding a small mania. My daughter recently became a teen, and even as a proud parent, I would say she has an eye and a feel for things. I bought her the camera for her birthday and she’s doing an interesting job with it.

‘This is Water’

This was the title of David Foster Wallace’s commencement address given nearly a decade ago, on May 21st at Kenyon College in Ohio. I have not yet been able to read Foster Wallace in long form, but I have read some essays and articles, which I admired.

This is Water threw me. It is so true, and that is what scares me. In the speech Foster Wallace speaks about our reality, how we all choose the meaning we construct in each everyday moment and how, without self-awareness, the meaning that is often automatically constructed is a negative, solipsistic one.

He knew what I know. He, like me, probably happened upon it the hard way. He called it the Capital T Truth of Life Before Death. He knew that it is easy to star in one’s own show; easy when you are young, beautiful, witty and so on. Of course it does not mean that you are any of those things, rather than as the star of your own show, that’s the role one is apt to cast oneself in, at first.

No stranger to depression, did Foster Wallace, like me, kick that persona to one side on a regular basis when the shadow self strutted centre stage. Did he, like me, shrink to the sidelines to watch the world float by, the water, whilst he gulped for air and clung to some mental piece of driftwood each minute, hour, day…

What scares me is that Foster Wallace knew well that there was always more than one way to see the world, and a myriad of interpretations for the self in it. He described in This is Water how to do those cerebral backflips that I do every day: the rigorous workout of the pre-frontal cortex, endlessly seeking alternatives as the meaning of any and every particular reality that will not suck my marrow. What he could not do, it seems, is survive the great weight of feelings that eventually dragged him down. All those headfuck acrobatics could not ultimately escape the gravity of mental pain, which is actually physical, and beyond all other things immeasurably tedious.

So my own prescription is this: choose your thoughts wisely, but feel the pain at least a little every day – and, sadly, some days a lot. There is no real escape. The ultimate avoidance of what seems infinite pain is allowing the shadow self centre stage just a moment long enough to enact a brutal amplification and a passing on to others. It is, as Karen Green, David Foster Wallace’s widow said, always a mistake.

Let the feelings drip, drip, drip. Take the antidotes where one can. For what else can we do? After all, This Truly is Water and This is all there is.

Boat: Starry Night

Boat: Starry Night