in mind

Hello, it’s Kate here.

I know many of you have been keeping me in mind. Thank you so much. I’m a little better now, so I felt I should let you know what’s been happening.

For the past year, I’ve been really struggling with my bipolar. Most of you probably had no idea I had this disorder, though I’m sure many of you will have noticed me talking about phases of depression here, or may have read about the psychotic episodes I suffered prior to my stroke in Handywoman.

Bipolar is something I’ve dealt with all my adult life, but haven’t talked about much publicly (I’ll say more about that later). It became a problem in adolescence and early adulthood when I found myself suffering from recurrent bouts of depression which alternated with hypomanic phases. Most people know something about what depression looks like, but probably much less about hypomania. My hypomania manifested itself in intense creative productivity, a highly chaotic sex life, and kleptomania – all of which are classic symptoms of young people with this condition. Back then, because I only ever went to see a doctor or counsellor when I was depressed, the depression was what was focused on and treated, and the treatment not only didn’t help me, but often made things worse. So I stopped seeking help for my low moods. And when I wasn’t low, I always functioned pretty well (albeit often fuelled by hypomania) working my way through three degrees and securing academic jobs. My mental health problems were always there, yet despite my random and often risky lifestyle, I somehow never came to any actual harm. What I’m saying is that unlike many young people with this condition, I was never hospitalised or arrested, and my hypomanic behaviour was simply regarded by myself and those around me as me just being me.

I was finally diagnosed with Bipolar II in my thirties (the linked page gives a reasonable summary if you know nothing about it). You might think that being diagnosed with a chronic relapsing mental health condition – something I’ll have to manage all my life – could be something of a burden, but I actually experienced it as an enormous relief. At last I made some sort of sense to myself! I also finally understood why standard treatments for my depression had always proved problematic, and, most importantly I was able to gain insight into, and a critical sense of distance from, my condition (which believe me is the key to managing it successfully). Learning more about bipolar, I could learn to not always follow where it wanted to lead me, or to trust it. I was still trying to learn these lessons at the time I had my stroke.

Recovering from my stroke went hand in hand with learning how to deal with my bipolar. Sometimes managing my physical and mental disabilities were much the same thing: I discovered, for example, that maintaining a regular and rigid sleep pattern (always going to bed and getting up at the same time whether I wanted to or not) had remarkable benefits in restoring mental balance as well as physical energy. I found out a lot about my capacity for patience and forbearance by dealing with my new post-stroke body (which is also useful when dealing with depression); realised that booze was bad for my brain in all senses (I no longer drink alcohol); and discovered that practical techniques of non-identification are equally relevant whether one is dealing with discomfort of a physical or mental nature. Being able to take work at my own pace (slowly developing my own business rather than working in a high-stress academic environment) helped me mentally as well as physically, and I’d also argue that my hypomanic energy (though it can be counterproductive) often drove and focused my physical post-stroke efforts, first toward recovery from my brain injury, and then in learning how to manage the disabilities it had caused. Simultaneously managing the symptoms of my stroke and my bipolar over the past nine years has never been easy, but despite it all (and with Tom’s help) I have got on with things and enjoyed my life.

Seasonal transitions into, or out of, the darker winter months have always been difficult trigger points for me, and the winter of 2017/18 was particularly long and particularly hard. All through that winter, I was working intensively on two large projects (West Highland Way and Handywoman), sleeping less (and less well) and losing a lot of weight (which I should have noticed as a warning sign far earlier than I did). By the time spring finally came around in 2018, I’d completed my two books, experienced a severe post-project slump and then began cycling into and out of depression. Despite my efforts to get things under control, these punishing depressive cycles became more rapid and more serious, and finally culminated a few months ago in a very severe “mixed episode”, in which features of my depression and hypomania coexist together.

The particularly noxious combination of agitation and despair I experience during a mixed episode is hard to describe. It is a terrifying, and potentially very dangerous state to be in, and I’m glad to say I’ve been there only twice previously: once in my early twenties and then later, in my mid thirties, during the period immediately preceding my stroke. In my “normal”, balanced state of mind, hypomania can be a powerful source of creative energy that simply helps me get things done, but in a mixed state, my hypomania sparks off my depression, sets a big fire underneath it, and lends it more fuel to burn. And then, when my depression seems to be finally fizzling away to embers and ash, my hypomania helpfully picks up an axe, chops several more logs, and throws them on the fire, just to ensure the continuation of a steady blaze. The fire of this particular episode has been burning for a few months now and things have not been good for me at all. Normal life has ceased. I’ve not been able to work or run the business. I’ve not been able to see or even speak to my friends and family. Thank goodness for knitting (always there for me); walking (however terrible I’ve been feeling I’ve mostly been able to make myself get out and walk for an hour each day) and writing (in my experience, simply getting stuff down on paper can help to arrest racing thoughts and break dangerous ruminative cycles). I’m still not well, but I do feel things are finally under control, and as I was beginning to feel a bit better, Tom took me away to Berneray. We’ve been there for the past week with the dogs, getting out in big Hebridean skies and open spaces.

Thank goodness for these guys.

And for this one too.

So that is how things have been for me of late. If you are surprised by what I’ve written here, or are wondering why I’ve never talked openly about my bipolar before there’s a very specific reason. Those of you who’ve read Handywoman will know that when I was taken to hospital after my stroke, my paralysis was initially treated as functional, not organic. That is, my psychiatric condition led those that treated me to assume that my problems were all in my head; that my bipolar had somehow caused my paralysis, rather than the serious brain injury I’d actually suffered. The first 24 hours after my stroke were the most terrifying of my life: not only was I unable to move one side of my body due to part of my brain having been destroyed, but I was told that my bipolar mind was so very unwell that it had actually paralysed me. Once I was finally put in an fMRI scanner, my stroke was correctly diagnosed, but as you might imagine, this raw and rather brutal experience of the prejudice against, and the complete misunderstanding of, my mental health has made me rather cautious. Because of this experience, I am now very wary of health professionals and the medical establishment more generally. I am also wary of being judged for my bipolar, and of being seen by anyone through its defining lens. I have enormous amounts of admiration and respect for those who discuss their mental health openly. I know very well that the more this is done, the less stigma will be attached to conditions like mine, and the less they will be the focus of prejudice and misunderstanding of the kind that resulted in my stroke’s misdiagnosis. But to be completely honest – I’ve just not wanted to talk about it. My bipolar is part of my everyday existence, but it can also be incredibly tiring (and tiresome) to deal with. Sometimes there are things in one’s private life that one wants to keep – you know – private. Yet, now I’m feeling a little better, and coming out of this awful phase, it is actually a relief to be able to talk about things here. Perhaps I’ll be able to be more candid about my mental health going forward. Perhaps that would be, in the long run, much more healthy.

Over the past few months I’ve felt very lucky to have such a great team around me here at KDD.  I’m also thankful to all of you who have kindly written to us over the past few months. I’ve not yet been able to look at or read any of your messages, but Tom and Mel have told me of their numbers, and I know they have both felt cheered by your support. So thankyou, all of you, for keeping me in mind, and I’m looking forward to reading your messages when I’m able. I’m not out of the woods yet, and I’m sure you understand that I still need some time and space to manage things – so although I’m, so to speak, “back” I may not be here very often as I focus on getting well. Because I’m not yet able to read or respond to messages comments here are closed.