Writing Is My Therapy

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Writing has always been an important part of my life. I remember filling notebook after notebook with reams of ideas and stories as a kid. Writing was my escape. As I got older I continued to write and it became a release from the depression that had suddenly manifested into my life. I even decided to go to University to study creative writing.

As an adult, I’ve had many struggles with mental illness. The symptoms of bipolar ran my life and my attempts to control the highs and lows were in vain.

I began to write, but this time, it began as a journal. I’d never kept a diary before. I just started to write, and soon everything was laid out. How much I’d been struggling, how guilty, helpless and ashamed I felt. it helped me immensely. I felt a release to see all these thoughts that I’d bottled up committed to paper.

Writing became my own private therapy.

I’ve had therapy, CBT (Cognitive Behavioural Therapy) a couple of times. The first time round it really helped. I went to the sessions to help me deal with panic attacks. I learnt some important techniques and a new way of thinking about the experience. I use them to help me deal with nighttime panic attacks . The panic attacks subsided afterwards, and now I very rarely have one, maybe only once a year.

My second experience of CBT was not so positive. It wasn’t long after I’d been diagnosed with bipolar disorder. I was offered group therapy and wanting to know more about the condition, and share experiences with others, I said yes. The course didn’t help. It was basic, and didn’t teach me anything new about the condition. There was never any time to share our experiences. I still felt alone.

I continued to write, but now I wanted to share what I’d written. I started a blog, this blog. Although now I don’t always write about my personal experiences, writing still helps me.

It gives me focus and a sense of purpose when I’m depressed. It helps me to stay calm and concentrate when I’m manic. It drowns out the voices and helps me process the experience when I’m psychotic.

I’m not in therapy at moment. A lack of therapeutic styles on offer from the NHS means I’d have to seek private therapy. I can’t afford to do that, so my option is talking therapies; that didn’t go well last time

So for now writing will have to be my therapy. I’m sort of ok with that. I’m annoyed that I can’t access actual therapy, but at least I’ve found something in my life that helps me.

 

I Gave Up Alcohol For My Mental Health

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My last psychiatry appointment was a tough one – I was told with certainty that I should, no, needed to give up alcohol. My response was a hopeful one, surely half a bottle of wine on a Saturday night was alright? The answer was a definitive no, even that amount of alcohol was far too much. We agreed that I should go sober, and I agreed reticently. I left feeling dejected, grumpy and silently cursing my psychiatrist. Although I felt fed up, I had known before my appointment that this change needed to happen.

Why go sober? 

My psychiatrist explained that alcohol reduces the effectiveness of many medications. Alcohol is a depressant, and pretty much cancels out the work my mental health medication does. In other words, I might as well not bother taking my medication every time I drink. If I have three days in a row of drinking, then that’s three days without medication. For me that can cause the beginning of withdrawal symptoms, that feel like having the flu. Or, more seriously, it can cause a bipolar episode of severe depression or mania.

The mental and physical effects

After a heavy weekend, or a number of days in a row of a ‘few’ drinks in the evening to help me unwind and relax I start feeling the negative effects of alcohol. I’ve noticed a correlation between heavy drinking and heart palpitations, that often leads to a full blown panic attack. Panic attacks are a debilitating and exhausting experience, and I’ll feel drained for days afterwards. Another experience I’ve had after drinking is psychosis. Earlier this year I drank heavily over my birthday weekend and at the end of it began to hear voices. I wrote about the experience in this post, My Hearing Voices Journal Alcohol free, I wouldn’t have gone through these experiences, and would have stayed mentally well and stable.

How I did it

I literally just stopped! Seriously though, it’s been tough, especially on nights out and at family celebrations. I’ve been drinking since I was fourteen, so to just suddenly go completely sober was a massive challenge. I was open about it with everyone, and my partner, family and friends have all been extremely supportive. I reached out to the twitter community and was given heaps of advice and tips on non alcoholic drinks so I wouldn’t feel like I was missing out on nights out. Soda and lime cordial has been my saviour when I’m out at a bar, along with flavoured sparkling water when I’m having a night in. It’s taken a terrific amount of self determination and will power, but I knew it was something I had to do for my mental health.

How I’m feeling now

Two months later and I feel fantastic! I’m clear headed, have more energy and haven’t had any palpitations or panic attacks. I’ve been stable and haven’t experienced psychosis or any depressive or manic episodes. I feel physically healthier and I’ve lost weight. I know my medications are working as they should be now, and that’s given me the impetus to stay sober.

I may have left my psychiatric appointment with a feeling of dread and wondering how the hell I was going to go sober, but I’m so glad I stuck with my decision.

How I Learnt to Deal With Nighttime Panic Attacks

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I wake up with an intense nausea that floods my system. Running to the bathroom I’m convinced I’m going to be sick, but I’m not. Then comes the pain. It stabs at my chest and upper back to the point I can hardly breathe. I went to bed feeling relaxed and contented, but now I’m pacing the house, my heart pounding terrified I’m having a heart attack. The reality of panic attacks is the physical pain that cuts through you in great swathes. Having a panic attack at nighttime is very different to having one during the day. At night everything feels more intense, the atmosphere changes to one that is ethereal and other worldly. People that you count on to talk you through the experience are asleep and unavailable. You feel alone and desperate and not sure if you can get through the night. I’ve learnt some techniques to help me cope over the years, that have quelled the panic attack before it becomes too difficult to manage.

Thinking Logically

I know this is a panic attack. I know it’s painful but it won’t kill me. Twice I have been taken to hospital by ambulance because of the unrelenting pain I was in. Twice I’ve spent hours having multiple tests to find what was wrong, for everything to come back clear. What I know now is that although I have found myself in a great deal of pain, it won’t turn into anything sinister. I will talk myself through the situation by repeatedly telling myself this. I have to say it with conviction, to convince myself it will be okay.

Getting Out of Bed

Lying in the dark in bed during a panic attack is the worst possible thing I could do. The pain is all the more intense as I lie there, with nothing else to distract my mind. All the worst scenarios run through my head and all I achieve is making myself more and more anxious. I force myself to get up, go into another room and turn the light on. I force myself to have a drink of water and to do something, anything, rather than staying in bed worrying.

Therapy

I had CBT (Cognitive behavioural therapy) to manage my panic attacks, and to understand why I was having them so frequently. Therapy helped me to realise that I wasn’t dealing with stressors in my life, and that my worries and anxieties were manifesting as panic attacks. I learnt to face what was causing me stress in a situation and to deal with it there and then. Panic attacks for me often occurred after a stressful event. Once my body and mind were relaxed again, like going to bed on a Friday night after a difficult week, I would wake up in the middle of the night with a panic attack. It became vital to realise when I was going through a stressful time, so when that stress had disappeared I wouldn’t end up having yet another nighttime panic attack. I was taught breathing techniques to calm myself, which I still use today

Distraction

If thinking logically doesn’t work on its own and I’m up and out of bed, I’ll try and distract my mind. It might be watching a favourite tv show, something light and entertaining that I’ve seen before. I might sketch or get out a colouring book, that keeps my hands busy and forces me to focus. I love to play video games so I might turn on the console and try and figure out that Zelda puzzle that’s been bugging me. If I occupy my mind effectively and for long enough, I won’t even realise the pain and panic has gone.

Using these techniques has cut down the amount of nighttime panic attacks I have drastically; I haven’t had a serious one in a year and a half. What I’ve leant in therapy often preempts an attack completely. Changing the way I manage stressful situations and work through them has had a significant positive impact on my life.

My mental illness Q & A

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1. What is your mental health issue?

I suffer from Bipolar Affective disorder. It first manifested as depression, but I was later diagnosed with Bipolar. As part of Bipolar, I also have psychosis, where I have times when I experience auditory hallucinations. I also suffer with panic attacks and bulimia.

2. Do you have medication and/or therapy?

Currently, I am only receiving medication for Bipolar. I take lamotrigine a mood stabiliser, aripiprazole, an anti psychotic and sertraline, an anti depressant. I am hoping to receive some form of therapy organised through my psychiatrist.

3. What therapy/medication have you tried and has any worked for you?

The combination of medications I listed in the last question are undoubtedly the most effective of all the medications for Bipolar I have been on. The side effects are minimal; they make me extremely tired, but I take them before I got to bed so they help me to sleep. Before this I was on quetiapine, which I can only describe as making me zombified. I was constantly tired and lived in a haze of forgetfulness and had a complete lack of concentration. I was then on respiridone, which initially worked well, but because of a hormonal balance I had to stop taking it.

For panic attacks, I found CBT (cognitive behaviour therapy) to be helpful. It helped because the panic attacks I was experiencing at the time were environmental. After stressful periods of time I would have an intense and painful panic attack. It taught me how to change my thinking when I was stressed.

4. How long have you had problems for?

I was first severely depressed when I was fourteen. I became a school refuser, and was referred to a psychologist. I had multiple bouts of mania (which I didn’t realise was mania at the time) during my late teens and twenties. I was finally diagnosed with Bipolar aged twenty seven.

I started experiencing panic attacks when I was twenty, and developed bulimia during my early twenties.

5. Do your family/friends know?

My family and friends are all aware of my mental health problems. I encourage them to talk to me and read my blog if they are unsure or confused about my illness.

6. Does this affect your work and daily living?

In a word, yes. I am currently unable to work a full time job, with my income coming from sporadic freelance writing jobs, selling my artwork on Etsy and DLA (disability living allowance), now known as PIP (personal independence payments). Daily life can be a struggle if I’m in a depressive episode, where I’m unable to do anything, let alone work or socialise with friends. Relationships can become strained when I’m unwell. I’m difficult to be around, because I either shut down completely, or become angry and rude.

7. What makes you feel calm?

Listening to music, especially alternative eighties and nineties songs, as they remind me of happier times. Bubble baths are my absolute calming, safe space to be in. Snuggled up reading a good book, especially an old favourite.

8. What do you do in crisis?

The number one thing is to tell someone I’m in crisis. Being alone during these moments can be unbearable. I need someone to give me a hug and talk to me, even if it is innocuous and dull.  If I’m alone I’ll ring or message my husband or my mum. I try and distract myself from the intense feelings I’m experiencing.; whether that’s listening to music, having a bath, or playing a video game. Sometimes this isn’t enough and I have to ring the local crisis team, or my psychiatrist, who is awesome at organising emergency appointments when I’m in crisis.

9. What advice would you give to others suffering?

My advice is to find support as soon as possible. At appointments sometimes you need to be confident and assertive to be taken seriously and to be given a diagnosis or support you need. I know it’s incredibly difficult to do that when you’re ill, so take someone close to you that understands what you’re going through.

Become an expert on your mental illness. The more you know, the more you will understand and find solutions to combat your mental illness.

10. What makes you smile?

My husband, my family and friends. My hyperactive cat, Matilda. Animals, especially ducks, bears and otters. Nature, hot summer days, music and art.

11. Describe your mental health issue in 5 words –

Debilitating. Bewildering. Complicated. Painful. Terrifying.

12. Insert a picture to make people smile –

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My First Panic Attack

I had my first panic attack when I was 18. It was Christmas time and I was back from Uni. I remember being in bed when I suddenly felt a wave of nausea. The feeling built up gradually, to the point where I was convinced I was about to vomit. I rushed downstairs to the bathroom but nothing happened. My Mum had heard me coming down the stairs and appeared at the doorway to check if I was ok. That was when the pain hit me. A sharp, intense pain penetrated my chest; it felt like I’d been stabbed. I began to pace the house but each step I took the pain resonated from my foot up to my chest. With every action, the pain continued to intensify, as did my desperation. By that point I was crying with fear. I was convinced I was having a heart attack; that I was going to die. My Mum at this point rushed to the phone and rang an ambulance. Unable to control my breathing, I began to hyperventilate. Again this was a new experience and again I was terrified. Anyone who has experienced this knows how difficult to reign back in your breathing pattern is, especially when you don’t understand what is happening to you. I didn’t understand that I needed to calm myself and try to relax and that by doing so would release some of the pain. The ambulance arrived whilst I was sitting on the sofa, hunched over with my hands clamped over my head. The paramedics were incredibly calm and patient with me, especially as it took about 15 minutes for them to convince me to move. I’m a very prideful person and even in the state I was in, I didn’t want to be helped or go to the hospital.

It was my mum who first suggested it might have been a panic attack In hospital the doctor took an ECG, which came back normal and then ordered an x-ray of my chest, that again, came back as fine. His opinion was I’d pulled a muscle in my chest. My conclusion; he had no idea and was bullshitting.

For the next 3 years, I had numerous panic attacks, I couldn’t honestly say how many. I found heat of any kind soothed the pain and calmed me down. I would take a shower, sit on the floor with my back to the radiator in winter. Finally I bought a lavender pillow I could heat up and then place on my back or chest. The attacks would feel like they lasted for hours, and some did. Most attacks would occur in a cluster of two or three over the space of a week. The most frustrating element of the panic attacks was they would nearly always happen in the early hours of the morning. After each bout, I would be utterly exhausted.

I was finally offered CBT (Cognitive Behaviour Therapy) when I was 21. Before this, I was fobbed off many, many times by doctors who knew what was wrong with me. They’d say have a relaxing bath, drink some herbal tea before bed…blah, blah, blah. What I really needed was to learn why this was occurring and what I could do about it. The six CBT appointments I had were incredibly helpful. I learnt to accept that this was something that happened to me and that when it did, I could control it. Each time I had an attack, I would say to myself, ‘I know this is a panic attack. I know nothing terrible is going to happen to me. I know it is up to me to control and stop this.’ My counsellor showed me relaxation techniques and how to regulate my breathing so I wouldn’t hyperventilate and help calm my thoughts. My favourite relaxation technique was to tense and then relax my body starting with my toes and moving up to my neck.

Since CBT, the amount and severity of attacks have diminished and now I rarely suffer from them. This year, I have only had one major one. What I’ve realised is the anxiety and panic attacks are intertwined with Bipolar. They are part of the cycle; it often starts off with mania, that then subsides to a point where I feel devoid of energy. The offshoot of this is either a massive panic attack, a deep depression or both. I now look at panic attacks as my body’s way of saying ‘No, I’ve had enough of this nonsense, you’ve been using my reserve battery for too long, so I’m fucking you up for a bit.’ One piece of advice from my time talking to Gp’s that wasn’t entirely useless was having a bath. When I’m stressed or panicky, I’ll run a bath full to the brim with bubbles overflowing. It’s my safe place. Lying back in that warm water soothes me and distracts me from the pain and pressure I’m feeling. I lived in a house with only a shower for three years, but now I have one again I make sure I take a bath every single day to relax.

You can watch my video about panic attacks here

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How much is too much: Alcohol and Bipolar

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I love a good drink. Alcohol plays a major role in how I relax and how I socialise. Over the years, as my moods have changed, so has my relationship with alcohol and my consumption. When I lived alone, I was in a manic state nearly the entire time and I drank often in my flat when no one was around. After it became a problem, I made a promise to myself never to drink alone again. I’ve kept that promise, well as much as I could. I’ve had  some rare slip ups to this rule when I’ve been feeling very depressed. Alcohol was there and I knew it could numb the pain I was in.

Anyway, the point of this post is to explain how alcohols effect on me has changed recently. Take yesterday evening. I was sat at home, after having more than a few drinks the night before, I thought I’d have a quiet night in to myself. I’d been feeling slightly delicate that day, probably because we had started with beer and then graduated on to whiskey. Though feeling a bit rough, it wasn’t a problem; until about five that evening. My heart began to race. It felt like it was going to explode. There was a sharp, shooting pain in my back that radiated into my chest. It felt like the beginning of a panic attack. I sat as relaxed as I could taking deep breaths through my nose and exhaling out my mouth. The pain refused to dissipate. To calm myself, I ran a bath. The bath has become my safe place and the heat soothed the pain I was in.

I knew it was the alcohol that was effecting me because this wasn’t the first time this had happened. Before Christmas, I was drinking heavily. The nearer we got to the festivities, the more often I was having panic attacks. Move forward to Boxing day evening and I was in terrible pain, my heart again racing at a ferocious speed. I had to retreat upstairs to the spare room I was staying in and cry. I sobbed, sitting on the bed, feeling that I could no longer cope with these nearly incessant bouts of panic. The next day, with my husband, we made the connection between the panic attacks and alcohol. Without fail, the day after drinking I would have these attacks and it seemed to be the only explanation.

We decided it would be in my best interests to not drink until my birthday at the end of January. It worked and I didn’t have a attack for the entire month. I saw my psychiatrist during this time and he agreed it was most likely alcohol making me feel this way. I was also severely depressed and he felt the alcohol had contributed. Alcohol, he said, interfered in how the medication I was taking worked.

The depression has lifted now and I’ve decided only to drink on special occasions. Unfortunately this means dealing with the fallout the next day and I need to decide whether having a few drinks is actually worth it.

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