In April 2007 I switched from lithium to sodium valproate as my main medication due to the creatinin levels in my blood which had been too high for too long—for about a year. These creatinin levels were indicators that readers of this document can read about in the bi-polar literature to see just how the kidneys are affected. This kidney difficulty could have led to serious health problems had I not gone on to the new medication. As I write this revision of my story I have been on the sodium valproate for one month without serious or even minor problems.
5. Other Physical Difficulties:
Five years ago in 2002 I was diagnosed with chronic obstructive pulmonary disease(COPD) or emphysema which gives me a shortage of breath when I exert myself even mildly. Many millions of people have died from this illness in the last several decades; there are various statistics. My form of COPD is not a serious one. It probably originated in my smoking on average one package of cigarettes every day from the age of 20 to 50. I did suffer from a mild RSI which I have since treated with exercise, thus lessening the effects. These two conditions exacerbated the remaining bi-polar symptoms by making it difficult to engage in an activity for more than short periods of time. The memory problem also contributes, as you can appreciate, to many practical problems in day-to-day life. I mention these things because, although my bi-polar disorder is largely treated, there is a constellation of physical and psychological difficulties remaining. I do not want to emphasize these problems, though, because such descriptions detract from the central theme of this account. Their relevance is indirect.
For the most part in community life I rarely talk about my bi-polar disorder and most people who know me have no idea of my medical history or the difficulties I have lived under physically. I have for many years regarded these difficulties as part of my own spiritual battles that I must face. And they are difficulties that have largely slipped into a low gear in the last several years and do not trouble me significantly. I should mention that a spiritual attitude which has been part of my belief system since the 1950s has helped me more than I can appreciate. This is especially true of the attitude to tests and difficulties in life which the founder of my religion says are often "like fire and vengeance but inwardly light and mercy."
In the last decade or two there has developed in psychiatry what has been variously called a Recovery Model for treatment and care. This model puts the onus on the person with the disorder to work out what is his or her best way to cope, to survive, in society given the conditions of their illness. Such an individual must work out the techniques and strategies for day-to-day living. With each individual the disorder is idiosyncratic; individual consumers of mental health services must work out what is best for them in terms of these services and in terms of what activities are appropriate for them within their coping capacity in life’s day-to-day spectrum with help from specialists as they think necessary. this, too, is a complex question but I don’t want to dwell on it here unduly. It is my hope that my story may help others work out their own particular regimen of treatment programs and daily coping tools.
6. My Wife’s Illness:
My wife Christine, now 60 years of age, also has not been well for many years--since we moved from Tasmania north of Capricorn in Australia’s Northern Territory in 1982 some 25 years ago. Although she, too, has a long history of different kinds of problems which I won’t go into here, it is the more recent ones that I mention below and that affect our life-style in more ways than one. The doctors do not know what the cause or causes of her physical problems is/are, but they are problems that have made life difficult for her and our life together. Her symptoms have included: dizziness, nausea, back-ear-and-eye ache, headache, among some two dozen or more maladies that I have put down on paper to try and monitor on a daily basis and try and find some pattern. Sometimes, with the aid of steroids or some new drug, or some alternative medical treatment, she seems to recover for a time, but her symptoms eventually return, sometimes mildly and sometimes not-so-mildly. At present she seems to be going through one of her best periods of symptom absence.
Perhaps the one advantage my wife’s ill-health, if there is any at all, is that it allows me to focus on her problems, to talk about her problems, when the subject of health and fitness comes up in our personal and community life as it so often does and has. This keeps the focus off of my own disability and I can talk about exercise and diet this avoiding the reference to my own disability. Consequently, people have little idea of the physical problems I face and much more of an idea of hers. I don’t mind this for I am not particularly interested in talking about my disability. After 60 years it has become somewhat tedious in the telling and the thinking.
It is well known that people with bi-polar disorder are disinclined to talk about their problem in public. Such a situation has the disadvantage that people have little idea of the battles I face in my personal life and, in the end in life, we all face our battles alone—hopefully with a little help from our friends as the inimitable Joe Cocker used to sing over forty years ago. This lack of public admission or opening-up can also have disadvantages. I have a core of friends with whom I can share a broad range of intimacies. Mostly, though, these friends do not tend to inquire and I do not tend to expose these battles any more except to a limited extent. I have little need to ‘dump’ on people, as we used to say, not after 60 years anyway. On occasion and with encouragement I do.
7. Creativity and Writing:
When I finally came to accept lithium without any mental reservations by the early 1990s; when I began, too, to see the end of my teaching career on the horizon and when there was a coincidental reduction in sexual frustrations due to taking up masturbation, I began to write poetry a great deal. One could say I was obsessed; my wife certainly would use that word and I have come to accept that word as a realistic description of my behaviour, especially now that I am retired and devote all of my waking hours when possible to reading and writing. The drive to create never seems to leave me and other activities, domestic and social, serve to provide a useful backdrop and alternative to the constant demand. The demand is relentless, obsessive, compulsive, disinhibited, but, on the whole a relaxed and energetic activity: emotion recollected in tranquillity as Wordsworth once put it. Since the early 1990s until this year, 2007, perhaps a total of some 15 years. the output has surprised me. Fame and fortune, though, have not come my way. This does not really concern me for the act of writing is enough of a motivator. The fluvoxamine, since 2001, has enabled me to work after 11 pm and into 2 to 3 am without the black moods. If I wake up at 4, 5 or 6, say, a degree of emotional blackness/worry is present but the transition to sodium valproate seems smooth.
8. Concluding Statement:
This brief and general account summarizes both the long history of this illness and where I am at present in what has been a life-long battle. I think it is important to state, in conclusion, that I possess a clinical disorder, a bio-chemical, perhaps even an electro-chemical, imbalance having to do with brain chemistry. The transmission of messages in my brain is simply or not-so-simply overactive, not smooth. With increasing diagnostic skills and knowledge and depending on what study you read, some five per cent of the population suffers from this illness. The extremes of this illness have been largely treated by lithium carbonate, sodium valproate and fluvoxamine. This has been my package; there are of course, as I have said, other packages of medication. A residue of symptoms remains which I have described briefly above. The other factors that describe my personal situation I have also outlined and need to be taken into consideration as well to provide a thorough overview of my present context. This overview will help others in various ways, ways I have also outlined above.