A Fine Kind of Madness 2.

Time to bore you all with personal drivel. Stability has, sort of, lasted. A fortnight of down has been pulled out of. Productivity has occurred. I might even manage my own ridiculously high standards one day. I stress that I am inordinately lucky, my idea of failure is not everyone’s, my experience of mental illness is not everyone’s. I’ve only lost about a decade of my life to reduced capacity (so far?), and my reduction was/is not what it is for everyone.

There is, however, a little personal tragedy. Well, more of an annoyance. The deteriorating state, status and job opportunities of UK pharmaceutical chemistry have finally convinced me to change careers. There are other, personal factors, but like an awfully painful number of my colleagues, it’s time to get out whilst the getting is good. And I really don’t want to. However, positive steps have been made. I’ve paid for my first module of an Open University Natural Sciences (Biology Pathway) degree, and thus, I am retraining to become a biomedical research scientist. So shifting from chemistry to biology. It’s my intent to try to get a research career focussed on biological/psychopharmacological aspects of mood disorders. I won’t be losing the chemistry, I’ll be using it as an adjunct to the main field of research. Added value, so to speak. That hurts, I love chemistry, but I think it’s a necessary “evil”.

There might be quicker ways to achieve this goal, but for a variety of reasons I want to have the most rock solid foundation possible. I’m too old (in numbers, not spirit) to pull off another major career change, in my opinion.

So how is this related to madness? I have to check, double check and triple check my mental state. Goal oriented actions, project oriented actions, plans, enthusiasms and what have you are potential features of a bipolar high. This is one of the things people without this condition, or similar ones, rarely fully grasp. The uncertainty about oneself. The realisation that one is stood on shifting sands. In the various self-help groups to which I belong I try to communicate the message that there are three pillars that support recovery from/management of mental health issues (drugs, therapy, self care). In my view, they are all needed and I could easily go on a political rant about how two of the pillars are undermined by various things, but that’s a digression.

The self care pillar is what I am referring to here. Part of managing bipolar disorder is being able to (and not everyone is fortunate enough to do this) recognise the prodromal symptoms of shifts in mood. It’s a skill that has to be learned, and can be learned, and is often well taught by good and competent therapy. Even simple things like making a basic decision about your career has to be examined carefully. Not for the ramifications and perfectly normal aspects of any decision (i.e. is it the “right” decision), but for the simple act of planning and deciding itself.

With no hint of exaggeration, unexamined decision making and planning can kill me. It can be the foothills of hypomania, or worse, mania. It can be a prodromal symptom of fluctuating mood, an indicator that something is wrong. This is not “oh woe is me”, or self pity. I actually think such self analysis is good (if a bit of a burden), it has made me a better version of my former self. I am mentioning this thing because people don’t understand mental health. Because there is stigma. Ignorance. I’m not saying that people without bipolar disorder don’t have to examine their decisions, of course they do, just that the nature of the disease is such that people with it have to analyse decisions in a way and to an extent that is both qualitatively and quantitatively different in some fashions.

People at no risk of diabetes or similar diseases, people without diabetes too, don’t have to check their blood sugar. They can act in the absence of that self examination. People without bipolar disorder can act without this kind of self analysis. The consequences just aren’t there. If you have no chance of mania, why examine yourself for signs of mania on a routine basis?

Getting these unseen, difficult to detect differences across to people without mental illnesses is important. Mania is not mere hedonism or lack of impulse control, depression is not mere sadness or laziness. One of the things people without these mental health issues need to grasp is that there can be serious differences in both thought and need for self care/analysis in people with mental illnesses. What people need to do is recognise that in a constructive and helpful way.

So no gaslighting, no silly, patronising “help” (would you patronise a diabetic the way people with mental health issues are patronised?), no removing of agency from people with mental health issues, just the simple recognition that your experience is not binding on them. Ask what you can do to help and listen, because the likelihood is they are experiencing something you simply have no knowledge of or experience of managing.

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