This is the third, and last, post in a series that I’m writing for Geek Mental Help Week. The first post dealt with why I find it so hard to talk about my mental health and the second dealt with how the condition I have, cyclothymia, affects me when untreated. This post is the story of the last year and half where things came to a head and I started to get help.
This post has been the hardest for me to write, and not just because of the subject matter. The period that I’m about to write about is a bit scrambled in my head and I can only really remember the stand out points, and even then not necessarily in the order that they happened. To be honest a lot of it feels like it happened to someone else.
After the birth of my son in April last year my mental health started to deteriorate. I would go from feeling utterly miserable to completely enraged within the space of a few seconds. I couldn’t explain it. I was overjoyed to have another child (we also have a daughter) and the little boy was gorgeous. He was quite hard work in those first few months though, as most babies are. He suffered from colic and so would spend hours at a time crying. However Erin had been similar for a while and I don’t remember losing it as badly with her. It got to the point where I realised that something was wrong and so I made an appointment with the doctor; saying it was for a headache because I couldn’t bring myself to say what it really was.
Once I explained what was actually going on to the doctor, he suspected depression and gave me a questionnaire to fill in and a CD of relaxation techniques. I had to fill in the questionnaire and make another appointment for the following week to discuss. At the follow up appointment, based on the results of the questionnaire I’d filled in, the doctor diagnosed depression; most likely of the Post Natal variety (who knew men could get that too). I wasn’t keen to take medication and so was prescribed Cognitive Behavioural Therapy sessions instead. Around this time, I had been talking things over with a good friend of mine, Philip Roberts, who I knew was also experiencing problems with depression. He recommended me a good therapist and I started weekly CBT sessions. More on those later.
At home things were going from bad to worse. I was all over the shop and things eventually culminated in a huge, blow out argument with my wife. As part of the resolution of that argument I agreed to try medication. I booked an appointment with the doctor and was prescribed Fluoxetine, otherwise known as Prozac.
The Fluoxetine took around three weeks to kick in, and by the end of the third week I found myself getting hyper (or actually hypo as it turned out). I felt like I was rushing, like I’d taken a mild amphetamine or something. It felt great, like I was wired directly into the universe. I remember walking the dog along the beach and running along the edge of the water, kicking the waves and grinning like an idiot. Whilst I realised that this was probably not the desired effect, it was certainly a welcome change from how I’d been feeling. If it wasn’t for the fact that I started getting twitchy and irritable too, I might have been tempted not to go back to the doctor. However I did, and when I explained what had been happening I was swapped over to Citalopram instead.
The Citalopram seemed to agree with me a bit better. It took the edge off of the depression to the point where I could start to sort things out at CBT. I can’t recommend CBT highly enough. I think everyone should try it, whether they have a mental illness or not. I’ve heard it likened to pair programming for the brain, and I’d certainly agree with that. It gave me a way to discover behaviours and beliefs that I had that were negatively affecting me and then supplied the tools to help me deal with them.
Eventually, towards the end of last year, through talking things over at CBT, and also with my wife between sessions, I came to realise that the depression was only one side of things. I had definite peaks and troughs, rather than just troughs. Over the last few years I had fallen into a pattern where I would start to massively overwork for periods of time, something I had put down as workaholism. I’d even given a talk at a few conferences on perfectionism, a trait that had been growing in me that was pretty out of character. It had never occurred to me until then that the two things might be related, and be symptoms of a larger condition.
Basically, I would have periods of time when I wouldn’t be able to sleep and so I’d get up, go through to my study and start working. I’d work straight through the day and not stop for meals, often not even showering for days on end. Eventually I’d burn out and spend a few days in bed ill and exhausted. And, although I would have denied it at the time, depressed. I ignored this at the time because I thought that I was just struggling to get the work-life balance right, as so many of us who work from home do. However, even when I got an office job again with a company that believed deeply in sustainable pace and work-life balance, I would from time to time turn up in the morning to work with a bunch of code that I’d written “on the bus” that actually I’d spent the wee hours working on, which is not great when you’re pairing. In fact, it’s pretty rude and bad form.
These “hypers” had been getting worse of late too.
Once I’d recognised that this was going on I spoke to the doctor again, in case the medication still wasn’t right, and he sent me for a psychiatric assessment. In the UK these appointments take a few months to come through. I had thought that this happened last year. As it turns out it was actually January of this year. I went along to the assessment expecting to be told that it was nothing; I was fine; nothing to see here etc. The psychiatrist had me fill in a more detailed questionnaire than the one I had from the doctor and then interviewed me for almost an hour. She then reviewed the results with a colleague whilst I waited. When they returned they told me that they suspected that I had a bipolar condition called cyclothymia, which I’d never heard of, and explained the symptoms. It felt like a bit of a gut punch if I’m honest, especially as they went through the symptoms and I recognised each and every one of them. It was all a bit surreal.
I spent the next few days in denial. They must have it wrong. I was imagining things. I knew at least one other person that was bipolar and they had much more pronounced and serious highs and lows. However, on reading more about cyclothymia I knew that the psychiatrist was right. I just had to figure out how I was going to deal with it.
The psychiatrist took me off of the Citalopram (which took a while to wean myself off) and changed tack instead to an anti-psychotic called Chlorpromazine (known as Thorazine in the US). When I started to feel a hypomanic phase coming on I was to take one or more of them (depending on severity) and it should head things off at the pass. If I caught it in time then that should hopefully cancel out the depression on the other side, or at least make it more manageable. This has turned out to be mostly true, although the trick is recognising the hypomania in time, which is not easy.
Fast forward to today and have now completed a course of CBT. For the most part, I am able to manage my cyclothymia. This doesn’t mean that I don’t still struggle from time to time (the last few weeks have been especially tough due to circumstances in my personal life), however with the help of great friends, a loving family, the right medication and the tools supplied by CBT I find myself in a much better place. Not healed, but better equipped.
As I mentioned at the top of this post, this is the last (for now) in this series of posts. If you’d like to talk to me about anything I’ve covered then please feel free to email me. The absolutely best thing you can do in a situation like this is to talk to someone. I don’t know what I would have done without friends and family during this period, so please feel free to reach out if you want to.