Remission & Relapse
Historians tend to refer to continuity and change, the mainstay interpretations of what has happened and what it means (at least at A-Level). I wonder if Doctors (of mental illnesses) are as concerned with continuity and change, their obsession with relapse and remission being an inevitable legacy of any contact with them.
Remission
It had been a long time since I had been in a place like that. Easy chairs and a socially anxious patient, falling over himself to open the door for the other patients coming in and out, and thanking them for the shared experience.
I’d never been able to appreciate the seeming competition between patients to chatter to themselves audibly above the others- presumably, I was doing the same before. Their carers smiled, sometimes kindly or out of sheer necessity to appease, mostly to maintain their professional distance from this rabble. One patient announced, ‘I’ve had my injection now, and I’m going to go, thank you so much!’ to the entire waiting room, another with very few teeth who exited periodically to vape, checking his Nokia type phone unironically and incessantly, piped up, ‘You’re welcome!’.
- Some people either volunteer or are elected to receive injections rather than take medication themselves.
My Dad had come with me because, much like everything else, parking could be a nightmare around here. He stood stoically as there were no plastic-covered loungers left, apparently not observing the circus until we got home, at which point he said ‘Wash your hands’,
- Not without kindness.
Previously, I had been the patient holding the door, or crucifying themself because I might’ve thought I should have done that. Now, sitting in the multi-purpose Doctor’s office, the questions came, including ‘Do you (do anything) for work?’
- ‘I’m a paediatric Speech and Language Therapist. ’
Dr. looked up from his paperwork and repeated the conceit. He began to apologise for the questions, ‘They’re standard ones’, trailing ‘we ask everyone’,
- ‘Are you suicidal? Thinking of hurting anyone?’
He racked the table, ‘God forbid, God forbid you get ill again, call the Crisis Team’. I agreed and left the office, wishing I had a big wooden desk to grip in anticipation of what lay ahead. Shamefully, comforted- that, God forbade a relapse.
Relapse
The Doctor I saw soon after the first episode had referred to the popularity of the condition (at the time) in an apparent effort to comfort me.
‘I’m always having to tell young people they don’t have Bipolar Affective Disorder,’ he skipped, ‘with psychotic symptoms’.
Like I’d won the lottery, genetic or otherwise, something…
I had recalled in the Private Hospital, that Bipolar was what Silver had, for at least a few episodes of 90210, and for a few moments, revelled in the glamour. That was until the psychosis took the field (the Marching Band refused to yield), once again to reduce me to a shred of some imagined former self. A support worker bustled through the door without knocking.
‘It doesn’t matter, it could be in a year, or ten years, you will relapse; this will happen again.’— My Psychiatrist.
He was proved right two years later. It was like he’d set out an impossible current- like the man-made, life-threatening storm from The Truman Show, intent on destroying me. This was only the diagnosis, of course, but it felt as if disclosing those words to me made him like the bearer of a couple of rods of lightning, somehow responsible for the electricity they bore-
Remission becomes a game of trying to outwit my own nature, to run, to evade kidnappers for years at a time. Although this prophecy felt about as real and accurate, as contemporaneous, as one I’d been given as a teenager in Thailand- ‘Like a broken tree, you will split in two’- except that it actually mentioned being healed, once again.
I think most people now think they can identify with dramatic fluctuations in their mood, horrible lows with intense levels of anxiety, intrusive thoughts, and being under what appears to be a random selection of prescription drugs. Serious Mental Illness, though, is different. Lithium is different. Bipolar is different. Psychosis, it’s different.
Recovery is filled with a kind of uncomfortable drag from all of the regular manifestations I described. I’m not sure why I call it recovery, in the sense that I never really graduate from that state into recovered, fully (I thought I had at one time). Anyway, in recovery, all of this is admittedly much worse, due, I’m sure, to having to acclimate to the Lithium. They’re heavy-handed with the dosage, too, because the psychotic episode was never going to shift on its own. It’s funny, though, I take almost the same amount of the stuff now, now that I work and do all the regular stuff, as I did on the peripheries of absolute mania. We’re all so scared to let those voices creep into my head again.
And of course, there was the hospital. It’s not Cuckoo’s Nest anymore, I heard on American TV. I’m sorry to say that here, in the UK, there’s reason for comparison. The first time I got ill, I got lucky in that the local NHS Unit was full and I got to go to a private hospital, not that they’ve had great press recently.
It felt like I might recover there. Some pretty glamorous-looking people came in and out again, and in all honesty, I think I was the scariest one to grace the entire space. Talking to myself, screaming, relating all the heinous news articles to myself- making me front and centre of whatever that day’s national, collective nightmare was.
When I got better, I was allowed to go to classes, I went to art, yoga & pilates, and a games evening with the eating disorders ward. The other patients from that part of the hospital were so kind, so consumed with their own difficulties it seemed, they didn’t treat me like a mental patient at all, they just appeared grateful when I volunteered an answer on the team’s behalf so they might not have to subject themselves to an opportunity for cruelty, however trivial or unimportant the staff would promise them it was.
I was confused, and thought I was in prison- but without my own cell, when I did go to the NHS unit. A lady on the ward, one I was particularly intimidated by, swung herself wildly through the corridor, with this awful laugh- taking her stoma bag with her, which she threatened to drip on me, somehow. It’s hard to know if it actually happened. Another paraded through the ward wearing one of my dresses when my family came to visit. She had it on over a tracksuit, so my Dad basically wrestled it off her. The staff provoked the situation. When the patient appealed to her, the nurse pointed to my Dad, saying, ‘He’s just done it, not me’. We got rid of the dress when I got home.
There were occasional activities; I have a memory of really getting ‘stuck in’ to what seemed a never-ending game of table tennis. The girl I played was a bit younger than me and so relentlessly polite, we were both told not to apologise for scoring points against each other. I must’ve been much better when that happened.
The National Trust
We visited lots of those places when I was ill, that’s what I’d say- to fill the vacuum of a year or two in my timeline, when I was ill. Like a kind of convalescence, I suppose? I didn’t tell people about the National Trusts per se, bad coffee, interiors, and appeals to become a member.
Needless to say, I left the first one with a membership and a uniquely bound copy of Orlando I had no hope of ever completing. It was something I could quietly throw money at, right under my parents’ noses. Lithium and the fact that I could afford it dulled the thrill, but it was a little thrill, at least. I read half of it a little later. A milestone for my attention I’ve not revisited since, now the buoyancy in my energy levels is back, (I’ve not learnt yet that medically speaking it is called ‘Mood’). Reading is a rarity. Thankfully, buying books is widely accepted as a separate hobby.
Of course, some people still visit. They weren’t friends before, but now that they can heroically pay for the large (caramel syrup) latte, toastie, and millionaire shortbread for you (as opposed to the inaccessible Americanos of your previous self that they saw looking at them with contempt, apparently) they’re here for it. Sometimes they gave me a done-with magazine or nail polish they weren’t sure of.
‘I thought, Zoe’s into fashion’ – stirring tea admirably whilst smiling, with the kind of will-power I can’t exert even at the most special of occasions these days. ‘Th-Thank you!.’ I couldn’t corner off utterances neatly anymore, craft and shape ordinary sentiments to make them that, rather than awkward. Sometimes when someone buffed up my nails nicely, I could ease a bit more easily into something, but that’s a script, right? It’s a dialogue, you’ve read the lines beforehand, and the context gives each moment of the conversation a giant hug and flowers, like it was a groundbreaking performance.
I think she liked seeing me out like that. I normally had the wrong nail colour. Therefore, she could compliment it again and again, repeating it conspicuous enough that even I could see it wasn’t ‘different’, just a waste, like a big sister or something. I did have a big sister, of course, and my sisters had never been much interested in clothes, but she, the other she, said the right things about my stretch marks and all that surplus flesh Olanzapine had gifted me, it seemed irreversibly, then. So I let her play in my wardrobe. She picked out a dress I really loved, but clung, throwing it on with one hand, still fingering the other hangers as if there was a competing client in there with us.
‘You can just take it, looks better on you than it ever did on me.’
A pretty face of shock, lips leaning into the curl of the cheek but pinned there, respectfully. Not entirely true, I didn’t think, but since I’d been so wrong about so much I thought happened, I thought it wasn’t really a great loss.
‘Are you suuure?’, folding it carefully into her tote.
The Nanny
When Speech and Language Therapy didn’t initially turn out as I’d hoped, I tried a nanny job. Benefitting from pseudonyms, I’ll continue.
Fredrick clambered out of the ground-floor window with a kind of athleticism I had assumed was beyond him (outside of the safety of the family’s swimming pool- where he had so often lapsed into one-sided rollie polies and just as diagonal handstands). I surely must’ve known that I was fired at this point? The rent and car payments had evaporated with the clarity of Freddie’s footing on the hundreds of years old ledge and waning sash before Tara and Bobby’s very eyes. They liked to have the television on in the kitchen when I was hovering there uncertainly. The father, Bobby, gestured toward it, gesticulating.
“I can’t stand Lewis Hamilton.”
“Oh really, why’s that?” all too aware of the revolting sentiment that he was about to share with me, almost tentatively- (perhaps not a just concession).
“Black Lives Matter, hugely im-port-ant, of course, yeah, but who paid his way [refers to white man unbeknownst to me] Just- just be grateful, you know?”
Was this a question? I thought. And with the seconds I pondered it, the shame had time to gather its many men and occupy my head for the rest of that day- At having mumbled something incoherent about, ‘It being what he does in his spare time’. She should have put this b—-eugh- in his place, articulated the thing itself, that
‘Really, taking the knee isn’t about Lewis Hamilton’.
Ukraine– Relapse
I play,
sticking my leg in the air at a not uncomfortable
angle with my toe pointed as far as possible, it’d be pretentious if it was
done deftly
and I had any talent. In the kitchen,
I dither in various
poses and positions,
revelling in my ability to flex
and extend myself, I toy
with a vague memory of a half marathon, that this posturing proves
indelibly I could do again, twice over, full with the all too fragrant
sensation of self-worth; a sunny slant on importance.
Grateful that the new kitchen hides my habituals in endless cupboards
and one of those fridges I forget where I’ve put it.
The radio brims with arms fire which has moved, lapsed rather
into our side of things. Close, I inhale again with some newish
perspective that has at other times grated. Gifting
me a new way of coping with inconvenience-
I nauseate myself with visions of how I might help. When I consider the
bombing,
missiles too
vividly, I’m struck even more by my permanently shaken hands,
Stuffing bullets that would be lost to bad aim within seconds into a
shoddy issue gun- and the stress of the actual day dissipates a little.
Nails
Everyone’s a nobody in the nail shop. The fact that you think you are someone is enough, sitting there all regal, having your cuticles sorted at the expense of the technician’s sanity and stomach for their lunch. But oh, I did feel that. I remember the exact shape and colour, infills, when I had my big break (between episodes of psychosis), an interview at Conde Nast, to be a phone monkey or something, but it was a graduate scheme. Rose Gold, rounded. They see us for what we are.
I still partially attribute not getting the job to my then-long gold hair being enticed by a particular false nail, which it made short work of, prying from its place when I was in the shower. I thought I hid it quite adeptly during the one-to-one though, someone must’ve spotted it in the personality test.
I’ve not given anywhere near as much thought to my pressured speech, collapsed rules of social nicety, and fear I was secretly being filmed in the run-up, the thing itself, and subsequent days and weeks. And the outfit. A Diane Von Fursetnburg patchwork shift dress, a Reiss red-brick suede blazer, and 70s blue heels with ankle straps. I’d commit a multitude of sins to have all these garments back and return to the moment (without them in such a sorry mish-mash).
The interviewer must’ve looked at me with pity and some embarrassment. I pinned up the rejection letter I got on that nice Patrick Bateman-like paper and copy— I must’ve sensed I’d need it in the near future as evidence, retracing steps like I might get lost. In retrospect, I did refer to it as my ‘sanity folder’. Shreds of evidence: I was a person with some standing in life, not a mental patient.
My mum told people that our trip to the nail shop was better for me than the daily due diligence visits from the Crisis Team. Cormac (I called him McCarthy) used to come with his laptop and type up his notes at our kitchen table while I was talking, hours it took. Until recently, I thought he was transcribing my speech, but from experience working in the NHS, I now know he was most likely catching up on the day’s notes during that time. He would’ve had a few words to encapsulate how I was presenting, which was unlikely to include these lengthy direct quotes.
‘You’re obviously paranoid…’
He said a little into our visit when I’d asked to see his ID at the door. My dad told me to do that, not that I could really have decided whether it was genuine or part of an elaborate and tasteless Halloween costume.
Oxford
I almost kicked my mum’s beautician in the face as she was painting my toenails when I saw an ‘Oxford’ number flash up on my phone screen. I’d sent an application with a late modernist poetics essay on Harryette Mullen; I was proud of it. Oxford told me about the scholarship in African Studies, and even though I was climbing down from the mania, my pulse quickened, and my ego visibly spiked. Iconic red, square. She talked me down to earth calmly, always had said she’d wished she’d done psychology.
The formal letter offering me a full scholarship made it into the sanity folder. It didn’t really look as real, full of promise as you might expect. I think it was an email that went into janky formatting when I printed it myself. It looked fake, like it had been written by a Nigerian Prince. Actual royalty, I’m sure, were at the lecture I was invited to attend.
I sat through over an hour with no outbursts. I even took notes. Attempting to speak intelligently with the professor was less successful, but it’s not like he could withdraw the offer from St Anthony’s College; if I’d known that at the time, it might’ve helped. I came out with some sweeping statement about literature I was hoping to conceal as something clever. The social worker who used to sit herself on our sofa in a way that made me irate added insult to injury.
‘Well, I have a master’s degree and trust me, you won’t be able to do it just now,’ she tried to assure me. I was convinced she was just mad her patient would have a more impressive higher education than her, although lots of them do go to Oxford and Cambridge for their undergraduate. After, condescension to take a ‘Conversion course’ that whips up all that academic excellence to be cooked into an ever-tricky soufflé of theory and life experience, a whole year’s worth. It’ll make a great story that you can frame in line with your (perhaps shifting) political leanings, eg, It’s so sad, or the health/justice system is corrupted, it’s broken.
‘I’ll lose my scholarship if I don’t take it this year’ (backed up by all my communications with the university).
In retrospect, I do have a vague memory of filling out the scholarship eligibility criteria in the midst of the high— “One armed, lesbian asylum seeker”, in all fairness (if I did), it was a badly executed repetition of Dawn & French. That might be why they didn’t respond to the emails I sent over five years later, quietly (loudly) seething that they wouldn’t let me take up the opportunity the following year, more than four years ago.
A Tinder-Box
I’d been diagnosed, undiagnosed, and weaned from lithium (by a more optimistic or at least more prejudiced physician in Brighton, who’d never seen a case like mine), freeing me to pursue some of the life I’d missed through an app. I had an overbearing boyfriend at the time, and I was becoming less and less grateful for him by the day, hour, and once he was shaken from me, I met people, and we had fun.
Of course, my original diagnosis was unearthed when I returned to the hospital having crashed through a nanny and retail job in Sydney, and I had to return to the apps with it as some huge indemnity, alerting every possible man to my defection, like I owed them.
I’d always flag it and try to explain if they’d let me.
She Came to Stay
Sitting on the sofa reading She Came to Stay in the aftermath of that episode was glorious. I didn’t understand all of it, but catching some of De’Beauvoir’s images (curled lips-raised brows) and reading them a few times over after all that turbulence (that is deliberately, not out of necessity, created by many lapses in attention) – it was luxury. Like finding a message in a bottle, completely out of context but entirely urgent. My dad had tried to get a grip on the mania by getting me to sit and read something
Blood and Sand
I could manage a page or two aloud, and he sat too, desperately aware I didn’t retain what I was reading, with his face occasionally collapsing with exasperation. But mostly, he sat patiently. Congratulating me sincerely on each paragraph and steering me away from the competing voices that made me transgress from the autobiography onto other things (I rallied against whilst knowing nothing substantial about them). I was here, there, everywhere, neglecting only the place I happened to actually be, physically.
Photo by Jana Shnipelson on Unsplash
