I got to thinking the other day about how although most people who read this blog already know me in real life, there are a few who dont. Those who dont know me in person actually know more about my experiences with bipolar disorder than they do about me, so i decided to take the time to remedy that today...

So, here goes: a collection of random facts about the Girl Behind the Blog!

My name is Gemma, im 27 years old. I spent the first 20 years of my life in a small town called Orpington, which is in the South-East of England. Although i spent the longest portion of my life there, i dont consider it to be my "home town" as such, because a few years after moving away from Orpington i moved to the Isle of Thanet and fell in geographical love. The Isle of Thanet, and Westgate-on-Sea in particular, will always be my "home town".

By nature im a very stubborn person. I love cats and photography, i have an irrational phobia of moths and butterflies and i'll probably die of exposure before i admit its cold and put on a coat. Im a certified chocoholic and i find it hard to settle on anything. I like most kinds of music, and i tend to prefer songs to bands. Two of my favourite books are "The Handmaid's Tale" by Margaret Atwood, and "Girlfriend in a Coma" by Douglas Coupland. I like books that get me thinking, even though there are some that frighten me just a little!

On the subject of frightening myself, im good at that! I love watching scary videos or TV shows and then spending the whole night awake with the lights on, although i dont think Josh is particularly fond of that particular hobby... I love Dr Who and House, and up until they released Universe i was a huge Stargate fan. I still am, but i refuse point blank to watch Universe!

I used to be a qualified Holistic Therapist, and once believed that this was where i wanted my life to go... i learned fairly quickly that im not cut out for a life spent massaging people! It was fun to learn, and the experiences i had during my studies are still among some of my best memories but ultimately, although im glad i did it, i dont think its the career for me. 

I change my career plans on a regular basis, usually in accordance with any mood changes, so right now i have no idea what i'd like to do with my life. Im considering psychology or psychiatry (for obvious reasons) but im trying to really think it out, something i have never really done before!

Anyway, thats enough about me for now... Just wanted to write an entry that wasnt solely about the bipolar for once.

I chose the title for this entry from the song "Who Needs Sleep?" by the Barenaked Ladies. The first time i heard this song i just about died from laughing, just because who ever wrote that song Gets It. Whoever wrote that song has suffered from some kind of insomnia or sleep issues and perfectly described what it's like to lie awake night after night trying to sleep.

Of course i barely count as the "career insomniac" i used to be, thanks to the wonders of Seroquel, but last night was something of an interesting exception. I found myself completely awake at 3.30 am, so as i write this i have already been up for 3 hours!

The thing about insomnia is, its only cool if you actually have something to do. When Josh was in Afghanistan and i was alone in the house, i would frequently find myself awake, with the radio on, doing laundry or making something for a craft project at some ungodly hour of the night. I remember experimenting with papier mache at 4 am once or, another favourite, doing sit-ups on an exercise ball while watching episode after episode of the West Wing. The point here being, actually being able to move around and make some noises without disturbing the whole household.

Where we currently live, things are slightly more difficult. Our house is no longer detached, so i have to bear in mind that our neighbours may not appreciate me using the washer or dryer, having the radio on, or generally making a lot of noise during the small hours. And now that Josh is home, i have to remember that there is someone living here who actually has to get up for work in the morning.

Cue many nights of sitting quietly in the dim light of my laptop, trying not to make a sound.

Insomnia can be great creatively, too. I've written some of my best papers, done some amazing craft work and generally had my "creative hour" as the late hours of the night. Something about the lateness, the dark and the perpetual quiet is almost soothing. Personally , i love working at night because i find things flow more, i have more thoughts and ideas. Maybe its because the ingrained feeling of "its night, i should be sleeping" acts as a balm to my constant flow of thoughts, slows me down a little or something. Who knows, but i've always found it helpful.

Still, this is very rambly and im not 100% sure where im going with it, so i might stop here.

I think when it comes to mental illness sometimes there is a little temptation on the part of others to use it as a "get out of jail free" card in certain situations. Its easy to forget that just because we're ill, doesnt mean we arent still human. We still have regular emotions, we still get mad/ happy/ sad etc. And it isnt always a direct result of the bipolar or any other illness. 

I guess its can just be frustrating to genuinely be happy about something and be asked if im manic, or be upset by something and have someone excusing my behaviour as being caused by my bipolar. Yes, i have bipolar disorder. Yes, it factors into my life more than i'd like because it is not yet fully managed, but it isnt all there is to me! I am still allowed to enjoy something, or get angry or feel sadness, it wont always be a symptom.

I think its just the easier thing to do sometimes... when your experience of a person has always been that they can be a little "unstable", and that they do experience extremes in mood, it is very tempting, and very easy to just automatically assume that any new behaviour is just an extension of that. Usually it can be pretty easy for the sufferer to explain the situation, to explain that in actual fact they genuinely are NOT symptoms, just regular emotions.

The problem starts when you are not believed.

If im asked if im feeling manic and i say no, it would be nice to be believed. I know that due to the very nature of my illness makes me hard to trust at times, but i like to think that i've done a lot to earn back some trust. I take the medications (albeit grudgingly lol), im compliant with just about everything my shrink asks me to do, so then to not be trusted when i say im not manic is a little frustrating. Likewise if i lose my temper or get upset... its frustrating when people think that automatically they are in the right because im probably just "being unstable and bipolar" and that im probably just blowing everything out of proportion, and therefore refuse to accept that maybe they really were out of order or in the wrong.

I think its just worthwhile remembering that not everything is an illness. Sometimes a bad day is just a bad day. Sometimes i really am just happy because im happy. Not everything is because i have bipolar disorder.

I had a plan... i planned to post one entry per day for the entire duration of Mental Illness Awareness Week, which runs from October 4th to October 11th. In an act of pure irony, it was actually my mental illness that got in the way of that. I have been pretty depressed for the last 6 weeks or so, wavering up and down between fleeting moments of normality, then back down into the pit again. Exhaustion and lethargy have been my constant companions, which isnt exactly helpful for blogging. This past week has been particularly bad, with a lot of symptoms i havent seen for a while creeping up on me again.

Today, as it happens, is National Depression Screening Day, and honestly i feel this is a wonderful resource that should be used. So many people go through their lives without being even diagnosed, let alone being treated. So i wanted to include a link here in case anyone reading here has concerns, or is just interested in knowing more:

So, onto Mental Illness Awareness Week. As is probably very evident from this blog, awareness is something i am very passionate about. I think its important for 2 reasons; first, if more people are aware of the issues surrounding mental illnesses, there is more room for understanding and from there, it also means that if the stigma is removed, more people will feel able to get access to any diagnoses or treatments they may need. 

The second reason is actually a personal bugbear of mine: Ignorance. So many people have no idea about mental illnesses, and at the worst case treat the sufferers as jokes, as objects of ridicule. Sometimes, though, the ignorance is not intended to be malicious but the result is the same. Someone hears a "fact" about an illness, tells other people under the guise of knowing a lot about it and before you know it there are a lot of people who know nothing real about the illness in question but still perpetuate ridiculous stories that can actually be very hurtful to the sufferer. Some of the things i've been told are "facts" about bipolar disorder actually make me laugh, although really they arent funny... I'll share some here just because i want to show how ridiculous some of them can be:

I've been asked "which personality are you today?" by people who have explained that they thought bipolar disorder meant two personalities. This is actually a very common misconception, that sufferers of bipolar disorder have multiple personalities. I always make the effort to explain that this is not the case.

Another common misconception is that a person with bipolar will be all smiles one minute, then freaking out and throwing plates the next. Now, there are some people who do have incredibly rapid cycles, but this is rare, it is not the norm. And while everyone's case is different, it is more common for someone with bipolar disorder to have the mood changes over a much slower period, building through mania, then down into depression. Sometimes lasting months at a time. But still this image lingers, the one of someone laughing like mad, then turning on a sixpence and sobbing or screaming. It's a frightening image, both for the very rare cases for whom it is very much like this on a day to day basis, and for those of us who are not like this, but who are all lumped into the same category, and not trusted or understood as a result.

This last example i included just because of the ridiculousness of it, and for a much-needed laugh: 

I have been told as a "fact" that "all bipolar girls like to take it up the ass". This one actually shocked me, but also made me burst out laughing because i couldnt possibly understand where that conclusion could have come from. I assume that the person figured that since people with bipolar tend to be more risky, and often can be hyper-sexual, then from there it had to mean that someone with bipolar would do anything in bed.

I've talked to a lot of people with regards mental illness, and one thing that astounds me is the number of people who claim to be suffering from various illnesses, and yet it turns out they have actually self-diagnosed. Although this is not a something that has come about as a result of the internet, it is certainly something that has increased since the internet became widely available. In the days before so much information became available at the click of a mouse, a person would usually suspect something was wrong and either visit a doctor or their local library. Depending on the circumstances, they might decide to get help, or read books on abnormal psychology and try to figure out for themselves what was wrong. And although there would always be people who would read these books and decide they had the condition they were reading about, for the most part going to the library consisted of just as much energy as going to the doctor, and wouldnt be pursued by as many people as an option.

Nowadays, you only have to have access to a computer. And the internet quizzes i have previously ranted about in this journal dont help because they plant ideas in people's minds, and now it is so easy to research that condition and convince yourself you have it.

I was talking to one guy who told me that he had bipolar, so i got chatting to him and asked him which type he has. Not all people know, but online especially its a good question to ask. It usually can help weed out people who are piss-taking, people who have self-diagnosed etc. Anyway, i asked this guy which type he had and he said he didnt know, so we carried on chatting. He asked me what drugs i took, and i told him. He told me that he managed his condition without drugs, and felt that bipolar was not a condition that needed to be treated with drugs at all. He said he just brings himself down from the highs, and up from the lows. I told him how i wished i could do that, but i cant. He told me how he thinks psychiatrists are useless etc, and it came out that he was not diagnosed at all, that he had self-diagnosed. I told him how i feel about people who are self-diagnosed, that i feel that if there are people like him going about making it look like such a trivial condition, something like the common cold that anyone can diagnose themselves with, then it makes people who definitely, really do have the condition less credible. Less believable, harder to take seriously.

To me, its very simple. You wouldnt self-diagnose cancer, would you? And if someone were going about claiming to have cancer, but then saying that no doctor had diagnosed it, you just knew from your symptoms that you had it, you'd be angry at them, wouldnt you? You'd tell them to see a doctor before they went about saying stuff like that. So why is it ok for people to self-diagnose mental illnesses, when those very illnesses are just as serious, and just as deadly as things like cancer? Awareness, to me, means that mental illness would finally be able to achieve the same status and credibility as physical illness.

Well, there's another blog that went ranty... Brief update on my own illness front, my depression is lifting. FINALLY. I'd been down for over 6 weeks, saw Dr M on monday and he gave me a short-term dose of Trazodone, just for 2 weeks to see if it lifts me. Im only allowed to take it every other night, because he fears that it'll send me manic, and i can see why! I took it tuesday night, and wednesday i was pretty bouncy. Today, i am still feeling very bouncy and i take it again tonight, so im pretty excited. Its nice not to be sitting around in a funk all the time. 

So, stay strong and i will try to update a bit more in future!

For the last few days i have been... i almost dont dare say it: Normal. I was depressed for over 2 weeks, still enjoying the much shorter mood cycles that the medication gives me. Then i bounced up to a very strange day when i was unbelievably hypomanic, accosting my husband at the door with a thousand ideas, talking a mile a minute, all the usual.

Then it happened. I woke up the next day and felt NOTHING. Well, not nothing. I wasnt flat and emotionless as feared. I had a normal day. I felt cheerful but not euphoric. I listened to music without feeling like it spoke to me and me only, without that need to dance crazily around the house singing. Something upset me in the afternoon and i felt sad. But later, i felt better.

I've had normal periods before, so its not like i've never felt it before, but some part of me is clinging to the hope that this is OVER. Like the end of a storm when you're watching the rain and wind slowing, trying to gauge whether or not they're slowing down. Hoping and praying they are, sticking a hand out the window to feel how big the drops are. Realistically, i know this is not over. I know this is the rest of my life, but i want the medication to slow it right down. Take it to the point where i just take the drugs to control it, but i never see it. My psychologist keeps reminding me that this will probably never happen, but oh how i wish it would!

So, for now, im enjoying this tenuous moment of normality, embracing for however long i am granted it, the feeling of being just like everyone else. Im not a genuis, or some chosen spiritual being. Im not a piece of crap that should die just to liberate her loved ones from the strain of dealing with her. Im an ordinary person today, and i absolutely love it!

Lately i've been very "protective" for want of a better word, of my bipolar diagnosis. The main reason for this is that for the first time in my life, i am being treated with a medication regimen that WORKS, that isnt just another antidepressant regimen that pitches me into a manic episode.

When the consultant at the psychiatric hospital in London tried to diagnose me with Borderline PD, i freaked out. BPD is usually treated primarily with psychotherapy, and medications given for it are usually a last resort and consist of very low dose mood-stabilizers and antidepressants. Knowing how i've reacted to the "therapy and antidepressant" route in the past, i really, really did NOT want to go there again.

As a result, i've become quite adamant to express the differences between these two disorders, often being quite scornful of BPD, which really isnt fair. It is a horrible thing to have, and i want to be sure people understand that im not saying it isnt a real condition or anything like that. I just dont want anyone thinking *i* have it.

A close friend of mine is a classic borderline. Like, from everything she's told me, you can pretty much read down the list of borderline symptoms going "yup, yup, yup, oh definitely she has that!". Im proud of her because she is seeking help, and trying to get a diagnosis, because no amount of guesswork on our part can replace a psychiatrist's analysis.

For a while, though, this friend thought she was bipolar. And this actually made me angry! I could see how very borderline her behaviour was, and her saying she thought she was bipolar blurred the lines more than i was comfortable with. If she was actually so very borderline, but got diagnosed bipolar, then could that mean that i was mis-diagnosed? Or that some opportunistic psychiatrist in my future could do like that consultant did and change up my diagnosis again? Send me back into the hell of cycling moods and all that?

I took to reading up on it on the internet, trying to reassure myself that these conditions were different enough from eachother that my diagnosis would be "safe". I read that nobody really knows. Some psychiatrists think that BPD is another variant of bipolar disorder, like cyclothymia et al. Others think that they often get confused together, but are very different conditions. They also said that there are clear "identifiers" for borderline, such as profound fear of abandonment, just like there are clear "identifiers" for bipolar such as mania etc. So i breathed a sigh of relief, as i have never feared abandonment, and i definitely suffer with manias.

It makes me sound like such a hypochondriac to write this, but you have to understand the change in my life that has occurred post-diagnosis. I can almost function in the real world again, with a bit more adjustment etc i will have my life back. I take 6 little pills a day, and as a result i've been released from a Hell created by my own brain chemistry. I dont fight daily with my husband any more. I dont have anxiety attacks about leaving the house. I dont see and hear things that arent really there any more (well, not as much... still working on that lol!). I dont tell people im a genius or on a mission from God any more. Yes, im still having manic and depressive episodes but they are much milder than before. Im starting to see a light at the end of this tunnel, and the thought of having that taken away is unbearable. I never thought i'd say that, but i am.

So i hope that explains why i get funny about borderline personality disorder. If anything, it felt good to write this!

So i've been pretty depressed these last few days. My manic streak finally came to an end in the middle of last week and i steadily dropped down. Yesterday was particularly bad, i spent all day laying on the sofa completely unable to move myself off the couch, couldnt wash myself or do anything. A triumph for me yesterday was making a sandwich for lunch and then later on taking a shower, which says a lot!

Depression is always harder for both of us to deal with than mania. Mania always feels more like the "golden" option for us, because although im loud and i can get into trouble, im euphoric and bouncy and optimistic almost to a fault. Im not sitting around wishing i was dead, which is always a risk with depression.

Depression always carries a fear for us, it brings back the memories of my hospitalization, which occurred over the 4th July weekend. I was actually reacting to Risperidone, but at the time we didnt know that. I was just so terrifyingly depressed, wandering around in my pajamas, threatening to kill myself and actually planning to do it. My mind was consumed with thoughts of death, there was no light at all. Just death. I couldnt stop crying, and in the end my psychologist, Dr W, decided that i would be better off going into hospital. I was admitted on the thursday night, about 2 am. The hospital was in London, but for the sake of privacy etc i will not name it. The admitting doctor finished talking to me at 4 am, and i went to sleep in an observation room where they checked on me every 10 minutes. Before i was left alone, two nurses came in and silently went through my things, taking away any pills, razors etc. I was terrified and couldnt stop crying, but nobody even came to comfort me. For a private hospital, the standard of care from the nursing/ medical staff was shocking!

In the morning, a nursing assistant came to see me and tried to get me to have some breakfast, the room was baking hot (like to the point where you broke a sweat just walking in there!) and i was drenched in sweat. She convinced me to shower, although the shower room set aside for the people in the observation rooms was pretty gnarly and had water all over the floor. I did the best i could to wash, then went back to my room to try and dry off, dress etc. The door had this weird glass observation panel which meant that everyone could see me getting dressed, i ended up hiding behind a chair in the corner to dress. Then i went to get some breakfast, then came back upstairs. The room was still boiling but i didnt know where i was allowed to go, i had to be escorted to breakfast and back, so i didnt know if they would take me moving as an attempt to abscond or not! I sat and looked out of the window until a nurse came to see me. She and i talked for a while, and she told me i would go to the ward proper in the afternoon, if my consultant said yes.

Eventually my consultant came to see me. He was not a nice man, had very rude body language (slouched in a chair, no eye contact etc) and disregarded anything i said about having bipolar. He was convinced that i didnt have it (after 30 mins of talking to me!) and told me he felt i had borderline personality disorder instead. He took me off risperidone (the one good thing he did! although he did it because he was "concerned about my weight", not because he suspected a reaction) and told me that he might take me off carbamazepine too, then left. A nurse came to take me down to the ward proper.

The ward was really very nice, more like a hotel than a hospital! My room had its own bathroom (!) and was very pretty, with a nice view (although you could only open a tiny portion of the window!). She showed me around the ward and explained that because i was on 10 minute obs (they checked on me every 10 minutes because i was a suicide risk) i couldnt leave the ward.

My darling husband called every day, and came to visit on the saturday. He was so wonderful, without him i would have gone to pieces. By then i was up to 30 minute obs, so i could walk outside but not leave the premises. Sometimes they even checked on me by just looking out the window to see where i was! I started to go to therapy groups etc and felt tons better. On the Sunday my sister and brother-in-law came to visit, and we had a long chat. I was manic again now that the risperidone had left my system and all i wanted to do was LEAVE! On the monday i was very manic, and very anxious, especially when my consultant did not see me as planned, i found out that they wanted to keep me in longer than the few days agreed on, and that he was taking me off carbamazepine, to replace it with another drug that i had not heard of, but was going to be given at a much lower dose. I freaked out, and discharged myself against my doctor's advice. On the monday night i came home with my hubby, having decided to keep myself on the carbamazepine until i saw Dr M again. Dr M was horrified at what the hospital did, and said he definitely would NOT want me coming off the carbamazepine!

So this is why depression is so scary to us. Because we're always afraid of how bad it might get, afraid of the hospital again, and what all that entails. Here's hoping it never gets that bad again, but you never know, and thats why its so scary.

When talking in terms of drug doses, titration basically means that your doctor has given you a modicum of control over the dosage of a certain drug. In my case, i have 6 25mg Quetiapine pills i can take in one day. 2 of them im supposed to take morning and evening, then the other 4 are PRN (as needed for us mere mortals!). If i really feel like hell on the 2, i can cut that down to just 1 pill a day.

This process is known as titration, and is a sign that your psychiatrist actually trusts you enough to let you be the judge of your own feelings. In my case, if i start to feel too manic, i pop a Quetiapine in and Bob's yer uncle... or something. Except i've just found a fatal flaw here: I freaking LOVE being manic! So, either my poor husband has to judge whether or not im acting manic, then coerce me into taking a pill (dangerous because of the possibility of festering resentment or downright argument) or i have to do as the poet did and kill the very thing i love. Right now im absorbed in beautiful music, my spirit is soaring and i can feel anything is possible. I am euphoric, i want to go outside and howl at the moon (quite literally, actually!) and there is no way on this Earth or Fuller's that im going to take a pill to even dull this down, let alone end it.

So, this might be the problem with titration. Well, everything's a learning curve, i guess...

Im afraid. A couple of people i know have read this and are now worried that they, too, have bipolar disorder. Please, please DONT use my journal to diagnose yourselves. If you have a genuine concern, talk it over with your doctor. And one thing to remember: EVERYBODY has mood changes/ mood swings. Nobody is on a completely flat, even keel their entire life. Everybody has ups and downs. Just because you have ups and downs doesnt automatically mean you have bipolar. Im not saying this because i dont want to "share" my illness or anything petty like that. Im scared because there are doctors out there that if you were to go to them and say "i think i have bipolar" they would just hand you a prescription without any further ado. And that scares the life out of me, being even partially responsible for someone being potentially mis-diagnosed and given drugs that, being blunt, fuck you up.

Wikipedia actually have a good description of bipolar disorder, which describes it better than i ever could:

http://en.wikipedia.org/wiki/Bipolar_disorder

Im not posting this so people can self-diagnose from it, the main reason im posting this is to put people's minds at rest. Being "up" isnt just having a good day, its being euphoric, thinking you'll never get caught, acting irrationally etc. I wanted people to see there is a huge difference between being "up" and being manic, and likewise being "down" and being depressed.

Im just really scared. I never started this blog to cause everyone i know to think they have bipolar. I started it so that i could have a place to write about what its really like. How i feel, and how i cope with daily life. I dont want to be responsible for potentially messing anyones life up..

Im sorry if this sounds accusatory, its not meant to. Im not accusing anyone of faking it, or not having a problem, im just concerned is all...

I FREAKING SLEPT LAST NIGHT.

Not crashed out in a depressive or drugged stupor for 14 hours, or lightly dozed and stayed up half the night; we're talking real, honest to goodness SLEEP.

Up until now if i couldnt sleep i would take Lunesta, which left me with a rancid taste in my mouth and a feeling not unlike a hangover the next morning. I would be groggy and disjointed all morning, and usually would end up sleeping for at least 10 hours.

Quetiapine makes me dozy enough to sleep, but because it isnt really a sleeping pill, once i go to sleep i can wake up normally. So far, i havent woken up at silly o'clock in the morning, long may it last!

Ok, THIS feels like a breakthrough for me