A few months ago my mood tipped the scales into hypomania, dangerously verging on mania. This is an issue for me because once hypomanic I very quickly become chaotically manic. Fortunately I wasn’t bad enough to lose all insight and didn’t stop taking my medication which most definitely would have ended in psychosis and hospitalisation. It happened suddenly – literally overnight. I woke up from a short sleep with my head in the clouds flying high and was doing all the typical things I do when I’m elevated.
Fortunately for my parents I was pleasantly manic and not combative or non-compliant. However, unfortunately for them (not for me at the time because nothing can be unfortunate when you’re euphorically elevated) my psychiatrist was away for a month. This hasn’t been a problem in the past only because when my psychiatrist has been away, I’ve been so unwell that the covering psychiatrist knew about me and I would often have appointments with her (twice she’s admitted me into hospital).
The last appointment I had with my doctor before she went away I had been stable for over a month and everything was going well. I was taking my medication, on track with my studies, sleeping eight hours a night and back at work. There was not even a hint of elevation or depression, which is rare for me. I didn’t “need to be babysat” by the psychiatrist covering her patient load.
In the past I have dealt with other psychiatrists. I was under the care of others while my own has been away and had once been re-assessed by another psychiatrist regarding transporting me to a different hospital with higher security. Although I have not doubted their abilities and opinions, I prefer my much trusted and well-respected psychiatrist. This makes me worry for the future. I love my psychiatrist even when I’m manic or mixed – times when I have been non-compliant and argumentative. I trust her completely and would not want anyone else looking after my mental health.
This recent time when I unexpectedly went from 0-10 over night has scared me. I was stable and not needing the weekly help of psychiatrists and psychologists - it was blue skies and clear sailing and I was the captain of the ship. It has shown me that this illness can rear its head anytime, even when it is seemingly controlled. It’s taught me how quickly an episode can occur out of nowhere, and highlighted how much I depend on the mental health professionals looking after me.
When unwell, I have been reliant on my psychiatrist and our weekly appointments were always a beacon of light for my family and me. It was comforting knowing she was just a phone call away and she would make herself readily available. In the hospital I would long for the evenings when she would come to re-assess me and I felt safe and well cared for.
The problem is since I started seeing her I have been unwell most of the time so we have worked closely together and I wouldn’t go a fortnight without seeing her. This was the first time I was to not see her (or any other psychiatrist) for a month and I was fine with that. I was excited actually. I was gaining independence with this illness and beginning to be capable of controlling it. My dependence was lessening.
When I became elevated enough to need the help of a psychiatrist my parents were on tenterhooks about making the decision to see the covering psychiatrist (which I didn’t end up doing). I found myself back at the start and it felt like I had become dependent on others again to keep me well. My newfound independence had evaporated.
However I’m proud to say that I managed my elevated mood with extra sedatives and when my psychiatrist returned she put me on an additional anti-psychotic that made me slow down and sleep, preventing a major mood episode.
When someone is involved in scary, uncertain, sad and traumatic times, it’s hard not to grow dependent on them – especially when they’re the ones who hold your hand and walk you through those tough times. I view the role of a psychiatrist as similar to that of a parent. At the beginning (when initially diagnosed) they are very involved and you are completely dependent on them for guidance. As you grow and become more experienced, so too does your independence until one day you’re not constantly relying on them for advice. And when sick, just like a parent, they pick you up, care for you and make you better, no matter how old you are (or for how long you’ve been living with bipolar disorder).
If this happened a year ago, I probably wouldn’t have been able to manage the elevation at home while waiting for my psychiatrist to return and the mania would’ve grown into an unstoppable force. So with that in mind, I have learnt and am getting better at balancing on my bipolar tightrope - something I’m sure that will continue to improve with time and experience.