I recently logged in to Twitter for the first time in 10 weeks, and in a weird twist of fate I saw "#MentalHealthAwarenessWeek" trending; this has prompted me to finally post something that's been sitting in my drafts for a couple of weeks.
If this helps just one person realise that help is available, and that things can improve, then it will have been worth it. Beware though, this may be a long one, and it's also a bit of a tough one.
Admitting that there was a problem.
At the end of February I found myself standing in my local A&E, awkwardly staring above the head of the nurse opposite me, before muttering one of the most chilling sentences I've ever used:
I have Bipolar Disorder, and I've deteriorated to the point in which I feel like I pose a genuine risk to myself.
The journey to this point had taken 3 long and miserable years, years that I'll never get back, and years that I never want to visit again. My low mood had steadily spiraled to the point whereby it was all encompassing: I saw no future, and I certainly saw no respite.
Last year things had grown more intense following the unexpected death of one of my closest friends, this resulted in a downward trajectory - one that would ultimately lead me to the brink of suicide. Although the concept of suicide had been on my mind for a few months though, it wasn't until December that it looked to become a real possibility.
I began planning and putting my affairs in order, and I set out to minimise the disruption that would occur to my loved ones. Then finally, after a phone call informing me it was likely the last chance to see my grandmother before she passed away, I realised that I had both a best friend and two loving grandparents waiting for me.
Fuelled by the realisation that it could soon be over, I drank to try and escape and clear my mind.. fortunately it became too much, and I began repeating it louder and louder to my partner: I couldn't do this anymore, and I needed to make it stop - I wanted to give in and it's all I could think about.
Within 24 hours I'd taken myself to hospital.
The days immediately after the initial assessment at A&E were difficult, and multiple discussions revolved around the potential need for inpatient care. I considered writing an "Advance Statement" at the time, and told the psychiatrist that I'd discussed my wishes in length with my family - so should I decline to the point whereby my decisions no longer hold any sway, there are individuals with an understanding of my wishes.
One of the primary concerns I had was that - under no circumstances - did I want to be subjected to ECT; when I informed the psychiatrist of this she told me not to be so hasty, and that nothing should be ruled out. I was terrified.
Ultimately neither ECT or inpatient treatment were required, and I was placed in the very capable hands of the local Crisis Resolution Home Treatment Team (CRHTT). This team provides "intensive mental health care and support" in order to prevent hospitalisations from occurring, however via their bed-management liaison they're also able to rapidly assist anyone who deteriorates to the point of requiring inpatient care.
I saw this team daily for about 6 weeks, during which time I was regularly provided with small boxes containing a couple of doses of my medication - not enough to do any real damage with - and also given daily sessions with different members of staff. No stone was left unturned, and through the diligence and patience that the staff displayed, I soon began to appreciate just how severe the situation had become.
One such realisation occured during an assessment with the team's psychologist; upon being asked numerous questions I seemed unable to respond with little more than "I don't know" - I seemed to have a mental block that prevented me from thinking. I apologised profusely for wasting her time and coming across so useless; she responded with a smile as she closed her notebook and said "You've said more than enough, and I think you'll agree that you're not well enough to really talk at the moment, and I'm sure you'll appreciate that you've got a lot more to do before we can even think of any form of therapy".
Despite this minor setback, progress was swift and within 6 weeks I was discharged from the team, and - reluctantly - found myself under the care of a Care Coordinator (Social Worker).
Discharge, and beginning a new journey.
By the time that the discharge came around, I was taking mood stabilisers at a full/therapeutic dose, and was no longer being provided with Clonazepam to deal with the more anxiety-based symptoms. (Although I never actually took any of the Clonazepam, I certainly appreciated the safety net that it provided.)
The official outcome was "Recurrent/Major Depressive Disorder" - something which seemed more logical than the previous diagnosis of Bipolar Disorder (II). In addition to this diagnosis, they had documented a "stress response to previous trauma", exasperated by a "period of prolonged and excessive alcohol consumption" - i.e classic self-medicating.
Although the term PTSD was explicitly used multiple times during the treatment period, the clinical staff stopped short of officially using it in the discharge paperwork - perhaps due to my own dismissive attitude. (I greeted the first mention of PTSD with a quick "I've hardly been dodging bullets and bombs.")
I made sure that I got the nursing staff a thank-you - in the form of some chocolates and a card - as I'm under no illusion that not only did their intervention and treatment provide me with a remarkable recovery, but it also likely saved my life.
After three sessions the Care Coordinator agreed that there was little with which she could help me with: I had literally turned my life around. Without any guidance I'd began to employ some CBT-style techniques to challenge my views and adapt my behaviour, I'd also began working again, I was medication compliant with no issues, and I was unrecognisable from the nervous and awkward looking man she had originally met. I was officially discharged from all services.
Continuing the journey solo
I'm now working again, and have been for around two weeks, and I can honestly say that I'm living with a clarity that I've missed for around 3 years. I'm actually doing stuff at the weekend, I'm not fazed and angry during my commute, and I'm sociable and friendly again.
I'm still on a journey, and it will take time; losing the ability to function for months comes at a price - both financially, physically and socially - and it's subsequently left me with something of a task to rebuild my life. This rebuilding effort is daunting, and I'm acutely aware that the more progress I make, the more I look set to lose should I find myself relapsing in the future.
That said - I'm now better equipped than I've been in years, and I'm actually myself again: the joy of hearing loved ones claim that they've got "their Fergus" back again is something special.
Had I got help earlier then both the severity and duration would have been lesser, not to mention that I'd have felt like this - i.e "normal" - for a lot longer. So this Mental Health Awareness Week check yourself, and don't be afraid to get help.