Going home?

I’m full of mixed emotions today. All being well, I’ll be discharged from my psychiatric hospital tomorrow into the care of the Home Treatment Team. After 4½ weeks as a patient here in The Priory, it will be a great joy to go home, and in particular to be home with my family for Christmas. But, alongside the excitement, there is also the fear – the fear of coping alone without the specialist support of The Priory team around me. 

Given that this is my second admission to The Priory, I had expected not to have this reaction. But, I have been taken by surprise.

Tee joy is very real and I can hardly contain my excitement. But the fear is real too. In part, it is because one begins to get institutionalised having spent a lengthy time in hospital. In part, it is the fear of losing the encompassing support of doctors, nurses and therapists. But in greater part, it is the fear of becoming unstable – of beginning to modulate again as I have done so much these last weeks. 

The last few days, however, have been good days – glimpses of myself shining through. And I will have the backup of the Home Treatment Team and a wonderful family.

So tomorrow will be a step of faith. Faith in the skill of my psychiatrist and the power of my medication. Faith in the psychological tools I have learned. And faith in God – and what better time of year to be called upon to do that. 

The narrative so far …

It all began in March 2013 with an admission to The Priory hospital in London, UK. Or did it? It turns out that this was only a step on the journey and not the beginning.

But, to resume the story, after 3 months away from work with symptoms of exhaustion, I was referred to a psychiatrist because I was getting quite low and frustrated. This was fortunate because my mental health quickly spiralled out of control. Before long, I was psychotic and unsafe and needing hospital admission. I was fortunate to be admitted to The Priory, a truly wonderful hospital – I cannot speak too highly about the care and professionalism of this place.

I was initially diagnosed with severe depression with psychotic episodes. Then began the process of finding the right meds to control my symptoms. Fortunately, I had an excellent psychiatrist who is a genius with a remarkable ability to prescribe the optimum meds. Moreover, she has a wonderful sense of humour which kept me sane.

Despite my initial determination not to enter into any of the group therapies, I was soon engaged and benefitting enormously from the CBT group sessions. Of course, as much as anything, I grew to value hearing the stories of my fellow patients. And these stories soon prompted my own faltering storytelling. There followed much heartache and hard work – successes and setbacks. A recovery emerged – along with deep, deep friendships.

Eventually, after 7 weeks, I was well enough to be discharged supported by regular sessions with my psychiatrist who is also a practising psychotherapist.

Then the story gets interesting. In July I had an hypomanic episode witnessed by my psychiatrist. Thereafter I was re-diagnosed with type II bipolar disorder. That was a crushing blow. I’m not sure why? Unipolar depression can be every bit as chronic as bipolar. But bipolar has those suspicious, dark overtones in the popular imagination by which even intelligent observers (dare I claim myself to be intelligent?) are influenced.

So the summer was spent adjusting medication and adjusting my perspective.

The meds we settled on were: flupentixol, olanzapine, and venlafaxine. Eventually I got myself well enough to return to work, though it took a long time until I had the stamina to return to 100% working. Although the meds did a great job of keeping me stable, the tiredness associated with the olanzapine was really debilitating.

Just when stability seemed to have been reached, disaster struck. I developed a really bad rash and my physician thought it might be associated with the olanzapine. So I stopped taking it. Within a few days, I had crashed. I was so poorly, I needed readmission to The Priory, from where I am writing this post.

My wonderful psychiatrist took the opportunity to adjust my meds to try to get round the side effects of the olanzapine. This was not a simple process because I was modulating quite badly. Eventually we settled upon: aripiprazole, fluoxetine, lamotrigine and lithium.

Which brings us, 4 weeks later, to today in this story. As I write, I am wondering about the likelihood of being home for Christmas – a hospital Christmas seems more likely. I think I am resigned to that.

I have had the benefits of more group therapy and some wonderful new friends, lots of whom are bipolar too. And with my diagnosis of bipolar II more tightly confirmed, I have had the opportunity to reflect much more on what it means to be bipolar. This has proved to be a blessing.

I’m beginning to understand and interpret previous life events through the bipolar lens. This has made sense of numerous patches of severe ill health. And also times of remarkable activity and creativity and grandiosity – times which I can now understand as hypomanias.

For better or worse, bipolar is part of my narrative. I can rebel against it and pretend otherwise. Or, I can embrace it, and accept it wholesomely as an integral part of me.