bipolar

Day 277

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Hannah Brencher’s mother always wrote her letters. So when she felt herself bottom into depression at college, she did what felt natural. She wrote love letters and left them for strangers to find. The act has become a global initiative, ‘The World Needs More Love Letters’ which rushes handwritten letters to those in need of a boost. She delivered a TED talk on the project last year.

Tremendous amount of unexpected kindness has come my way over the last year. This time last year my son’s Bipolar illness was showing us it’s ugly face. My elderly parents had the misfortune of witnessing it at its worst. It was traumatic for them but they were patient and kind.

When I wanted to get away from London for a few days, friends of friends in Bournemouth hosted me for a weekend. I had never met them before. They were good listeners and very generous with their time. I will never forget their humanity.
Another friend took me out on a cycling trip by the seaside as he knew it would cheer me up like nothing else could. So thoughtful!

Since my son’s death, so many people have reached out to me through cards, letters, notes, visits, e-mails, songs, sharing his pictures and videos. All of them mean so much to me. Each one is so special that I feel like framing them and covering all the walls of the house with them.

“What was that thought?” asked my partner.
“What thought?” said I.
“The one that just ran across your face.” said he.
He knows when I don’t speak about something that is important to me. He can tell because he puts his attention on me. He knows I don’t want to be someone who constantly needs cheering up or talks about the same thing or makes pathetic company. That stops me from sharing my thoughts all the time.

He cares enough to notice these small things.
I am grateful beyond words.

“Unexpected kindness is the most powerful, least costly and most underrated agent of human change. Kindness that catches us by surprise brings out the best in our natures.” – Bob Kerrey

Day 261

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For a while my friends and I have been planning to make a YouTube film for prevention of suicides. Here is the proposed script for it. It is inspired by http://www.metanoia.org/suicide/. I would be grateful for your comments and feedback.

“I am not a therapist. Only someone who knows what it is like to be in pain. Just like you.
I don’t know who you are. But right now you are here, which is good.
You are not alone.

I assume you are feeling pretty bad and considering ending your life.  If it were possible, I would be there with you at this moment, to sit and talk, face to face and heart to heart. But let us just do this for now.

I have 5 practical things that I would like to share with you.

In the deepest darkness of despair, being unsure about dying is okay and normal. The fact that you are still alive right now means you are still a little bit unsure. It means that even while you want to die, at the same time some part of you still wants to live. So let’s hang on to that, and keep going for a little longer.

Suicide is not chosen; it happens when pain exceeds resources for coping with pain.

That’s all it’s about. You are not a bad person, or crazy, or weak, or flawed, because you feel suicidal. It doesn’t even mean that you really want to die – it only means that you have more pain than you can cope with right now. If weights are piled on your shoulders you will eventually collapse if enough weights are added, no matter how much you want to remain standing. Willpower has nothing to do with it.

What might be bearable to one person may not be bearable to another. The point at which the pain becomes unbearable depends on what kinds of coping resources you have. Individuals vary greatly in their capacity to withstand pain.

When pain exceeds coping resources, suicidal feelings are the result. Suicide is neither wrong nor right; it is not a defect of character; it is morally neutral. It is simply an imbalance of pain versus coping resources.

The five things to think about are:

  1. Firstly, people do get through this, even people who feel as badly as you are feeling now. Statistically, there is a very good chance that you are going to live. I hope that this information gives you some sense of hope.
  2. Give yourself some distance. Say to yourself, “I will wait 24 hours before I do anything.” Or a week. Remember that feelings and actions are two different things – just because you feel like killing yourself, doesn’t mean that you have to actually do it right this minute. Put some distance between your suicidal feelings and suicidal action. Even if it’s just 24 hours. You have already done it for 5 minutes, just by being here. You can do it for another 5 minutes by acting on the advise here. Keep going, and realize that while you still feel suicidal, you are not, at this moment, acting on it. That is very encouraging to me, and I hope it is to you.
  1. People often turn to suicide because they are seeking relief from pain. Remember that relief is a feeling. And you have to be alive to feel it. You will not feel the relief you so desperately seek if you are dead.
  1. Some people will react badly to your suicidal feelings, either because they are frightened, or angry; they may actually increase your pain instead of helping you, despite their intentions, by saying or doing thoughtless things. You have to understand that their bad reactions are about their fears, not about you.

There are people out there who can be with you in this horrible time, and will not judge you, or argue with you, or send you to a hospital, or try to talk you out of how badly you feel. They will simply care for you. Find one of them. Now. Use your time to tell someone what’s going on with you. It is okay to ask for help.  Try calling:

Samaritans UK- 08457909090

Hopeline UK- 08000684141

Calm UK – 0800585858

Carefully choose a friend or a minister, rabbi, imam or anyone else who is likely to listen.

Don’t give yourself the additional burden of trying to deal with this alone. Just talking about how you got to where you are releases an awful lot of pressure and might be just the thing needed for you to regain your balance.

  1. Suicidal feelings are traumatic. After they subside, you need to continue caring for yourself. Therapy is a really good idea. So are the various self-help groups available both in your community and on the Internet.

Well, it’s been a few minutes and you’re still with me. I’m so glad.

Since you have made it this far, you deserve a reward. I think you should gift yourself a coping resource. Remember, earlier I said that the idea is to make sure you have more coping resources than you have pain. So let’s give you another coping resource, or two, or ten…! until they outnumber your sources of pain.

Now, while this may have given you some small relief, the best coping resource we can give you is another human being to talk with. If you find someone who wants to listen, and tell them how you are feeling and how you got to this point, you will have increased your coping resources by one. Hopefully the first person you choose won’t be the last. There are a lot of people out there who really want to hear from you. It’s time to start looking around for one of them.

Now, I’d like you to call someone. Please.”

Day 258

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The brain is the least understood organ in our body – billions of nerve cells reaching out to millions of others forming a web of staggering complexity. Many thousand distinct cell types and trillions of synapses somehow make sense of the world around us, form memories, give rise to hopes and desires, arrange sleep, hunger and thoughts, imagine scenarios and create musical scores or plans to self destruct.

Neurotransmitters govern the interactions between the various cells and regions of the brain. They also connect the brain to the body. No one knows how many of these chemical bridges exist and how tangled the relationships among them are.

Serotonin (5-HT) was first located in the human Central Nervous System in the 1950s. It was later found to be associated with functions such as sleep, temperature regulation, feeding, pain, sex, memory, learning, movements and biological rhythms. It was also intricately involved with mood disorders such as anxiety and depression, particularly of the suicidal type.

5-Hydroxyindoleacetic acid (5-HIAA) is a breakdown product of Serotonin. Its levels in the fluid surrounding the brain and spinal cord are presumed to reflect the level of serotonin activity in the brain. Consistently low levels of 5-HIAA are seen in patients who have attempted to end their own lives. Low levels are also consistent with risk taking, excessive aggression, violence and impulsivity.

Suicidal acts are often impulsive. Research shows that even if the plans are well formulated in advance, the final decision to act is often determined by impulse. Studies have shown that those who killed themselves were three times more likely to have had a history of violent behavior. The 1999 incident of the Columbine High School massacre is an extreme example.

Its puzzling how the same tiny molecule can be responsible for maintaining order and for creating chaos. This is one of many, known and unknown benefactors and troublemakers.

I don’t know why I go looking for every little fact associated with suicide and bipolar disorder. It makes me feel closer to him. I fool myself into thinking that if I know more about it, may be it will hurt less but it doesn’t work.

The pain is in the heart that knows nothing but love.

Day 255

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Once again, Stephen Fry was on radio being interviewed by Kirsty Young on Desert Island Discs (BBC Radio 4)

His honesty and verbal dexterity were endearing as always. The book that my son was halfway through when his demons got the better of him was ‘More Fool Me’ by Mr Fry.

He spoke about his fear of being found out, about his loving mother and orthodox but fiercely intelligent father, his very naughty school years, a visit to prison, artistic sensitivity, exciting times at Cambridge, his friendship with Hugh Lawrie, his clumsy dance moves and much more. I was delighted to find out that one of my favourite tracks is his too – ‘I Wish’ by Nina Simonne.

He first attempted suicide at the age of 17.

What would he tell his younger self? To calm down and not be so miserable. He would also tell him that he admired his emotional engagement with everything, as though the world was on fire. And it was.

He said that Hypomania is like being a tiger in a very small cage.

He described depression as a tightness in the chest. “My heart beats so that I can feel it all over my chest. Of course, there is darkness. It’s like something is being sucked from you – energy, hope, a sense of the future. No sense of the future at all. It seems meaningless and black. There is no prospect of it being anything else.”

He admitted to using alcohol and street drugs to cope with his mood changes due to his undiagnosed illness while not making the illness an excuse.

When asked if he would rather not have the illness, after a preamble of reinforcing the seriousness of the situation, he quoted W.H Auden, “Don’t get rid of my devils because my angels will go too.”

I feel a tiny step closer to understanding the dreadful illness that is Bipolar Disorder.

One of the main distinctions for me was that the depression he described came not from the past but from a perceived lack of future.

Day 252

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‘Regret’ seems to have been the flavour of the month for the past few months. No matter how much I have tried to run away from it, it has caught up with me in one disguise or another. However painful, pointless and unproductive the sentiment, it has been with me most of the time, right from Day 0.

Sometimes I would get so stuck on one thing that I found it impossible to take it in my stride. For instance, I have this hang-up about the kitchen sink being clean in the morning. When my son was home, I would get really annoyed to find dirty utensils in the sink when I got home from work. I could not understand why he could not leave it as clean as he found it in the morning. Now, in light of knowing how dreadful he must have felt, I feel ashamed to even admit it. I regret not having the compassion to properly understand his condition.

Today I found out the top 5 most frequently expressed regrets of people on their deathbeds.

  1. I wish I hadn’t worked so hard.
  2. I wish I had stayed in touch with my friends.
  3. I wish I had let myself be happier.
  4. I wish I had the courage to express my true self.
  5. I wish I’d lived my life true to my dreams, instead of what others expected of me.

It’s wise to learn from other people’s mistakes.

The third point above really stood out for me – letting myself be happier. It is a choice. Allowing it to happen is up to me. Often we hold other people responsible for how we feel. But ultimately, the responsibility is ours, no one else’s.