(Trigger warning – suicide)
In some ways, 6th form – the years in the UK school system between ages 16 and 18 – was the best time of my adolescence. I made some fantastic friends, some of whom are still important to me today. I was exposed to interesting educational opportunities, became heavily involved in school music and drama, and was given support in applying to top universities. I remember those years as exciting and fun. I know that it was also a hard time for me emotionally, that sometimes I was not mentally well, but looking back as I near 40, I have tended to view it as a generally positive time.
Last week, I found a box of my old diaries in the loft. I haven’t even touched the box for nearly a decade, let alone looked through the contents. It’s like doing archaeology, sifting through the layers of the past. The diaries start at age 11 and carry on until I am 20. At first they are pretty bland reading, mostly concerned (I’m embarrassed to say!) with discussing the boys I had crushes on. I know I had bipolar symptoms from 11 or 12, but mental health gets only the briefest of mentions until I am 16.
Last week, I got the diaries out to assist in my current writing project, a bipolar memoir that starts when my first symptoms appear. Prior to the project, I knew little about how adult bipolar differs from the experience of children and teenagers. I now know that young people can be ultra-rapid cyclers, moving through mood states within hours, rather than weeks or months. I also know now that the clingy, anxious separation anxiety I displayed as a younger child is a common precursor to bipolar. It is sad to see that at the time, I thought I was “mad” or “deranged” and that even by age 13, there are references to feeling suicidal. By 15, the diaries include possible suicide plans. But it was after I turn 16 that I really started to write about my mood difficulties and how they affected me. Re-reading, I realize just how much I had forgotten – as well as how obvious it now seems that bipolar was the problem.
“Boys and friends seem so far away from real life at the moment. Not having had a bad patch for a very long time, I’m not used to it, and the present one has hit me very hard. I talk to my friends, and they listen politely, but I know they don’t understand. I tried to tell them about how I am pulled towards death, and on my bad days I can’t resist the pull so well. My friend said she’d contemplate suicide if she broke up with her boyfriend. I tried to explain that she still hasn’t got the idea; the pull I feel is for no reason.
So here I am, directing a school play, exams next week, completing my application to Oxbridge, the “ideal 6th former”… But my alter ego, the other side of the coin, is desperately clinging to a ledge to resist the pull. For the past 6 months I’ve had both my arms and both my legs firmly against the rock face, nails dug into the earth, resisting the force. I’d done it so much, I’d got used to it and it had become easy. But with my mind on so much else, I’ve begun to let go. I relaxed my grip and loosened my muscles, and it’s got me again. I’m hysterical a quarter of the time, efficient and business-like a quarter of the time, quietly depressed another quarter and manically, insanely mad and funny the rest of the time.
And it’s not for any reason, but no-one will understand that. Anyone reading this will come to the conclusion that I am quite obviously deranged, mixing up fantasy with reality. Well, I’m not! I’m the only one who knows what’s going on. I became hysterical in front of my drama teacher the other day, and I didn’t care, because suddenly I felt one of my hands lose its grip. I thought, Oh my God, if it gets any worse I’ll lose all my footholds and I’ll be falling, and I don’t know what’s at the bottom, but I know it’s something terrible. In a way, I wish someone would read this diary, maybe they would understand, but more likely they would ship me off to a shrink, more doctors obsessed with my hormones, more counsellors asking me how that makes me feel. I don’t want that, I want to be helped, sure, but I don’t want to be patronized or made to feel uncomfortable or treated as a freak, or a silly girl, etc. I just want to be helped quietly and discreetly. I’ve been writing for an hour, but I’m still not tired. I must go to sleep, because if you are physically well and fit you can hold on better – if you are fragile in both departments, you probably will fall off.”
By the time I was 17, I had some vague notion of what was going on, but had no idea of how to access useful treatment:
“I’ve just read the postscript to my last diary entry. I can’t believe how my state of mind switches constantly from exuberant optimism to total despair. This morning, I was bad. This afternoon, fine, in fact over the top, practically high. Now – I’ve plummeted to rock bottom. I’m not hysterical or anything, not like on Friday when I felt dreadful suddenly, and I got in a panic and couldn’t breathe properly. Luckily no-one saw me. Maybe I’m a manic-depressive. A friend said to me a couple of weeks ago, Whenever I think of you, you’re always either crying or grinning that insane grin! I alternate between working very hard and upsetting myself about grades, and not caring at all. I can be very self-destructive (only this week I have failed to fix up a university open day in time, failed to complete the personal profile on my application and failed to do my English coursework). It’s partly that I am sure I will not make it to a uni of any sort. It doesn’t seem to matter whether I complete these tasks, because I CANNOT ENVISAGE MYSELF LIVING LONG ENOUGH. When I was younger and I felt the pull to kill myself, the feelings terrified me on my good days in case I did it on one of my bad days and wasted all the good days of my life ahead. Now I have bad weeks rather than days, what I worry about is if the good days surface and I discovered that when depressed I have failed to do essential tasks to secure my future (if I make it). If I were to kill myself between now and the end of term, that would be best, although that’s only a few weeks away... The other day it struck me that I could – no, I can’t write it down. It’s all in my head anyway.”
“Last night as I lay in bed about midnight, I heard people coming out of the pub. But my imagination convinced me that it was not just that. I felt quite sure that if I looked out of the window, I would see the playground full of trees festooned with lights. Between the trees would be groups of dusky satyrs and fair nymphs, dancing in a ring, from which the drunken shouts and shrieks of laughter came. I even crept to the window, carefully keeping myself out of view, but there was nothing there when I looked, just a void which I knew was the playground. When I returned to bed, the sounds began again. This sort of thing is very worrying. The flights of fancy may help my writing, but they also add to the opinion that I am mad.”
“Dear Diary, I don’t feel too good. I rather think it’s the result of not eating anything for 48 hours. Also, I haven’t slept at all well for the past few nights. I was awake for hours last night, as tense as anything. My fists were clenched and I just couldn’t rest because my heart was beating really fast. When I got up this morning, I felt the same. I left for school too early, and walked it in 2/3 the normal time. I just couldn’t keep still when I got there, and I kept talking really loudly. When I looked at myself in the mirror, my eyes were open so wide I couldn’t believe it, and my heart was racing faster than ever.”
It’s easy to write off adolescent mood problems as being the result of hormones or exam stress, or just being a normal “moody teenager.” There’s a lot of concern about medicalising children’s feelings and giving very young kids serious mental health labels and strong psychotropic drugs. But it’s clear reading back that my level of suffering could have been reduced had I had a meaningful diagnosis and some sort of treatment plan as teenager. I never did go to that top university, even though I was offered a place. I try not to think about what might have been, had I had successful treatment at 18, rather than 28. From where I am now, at 38, I am just glad I have a good psychiatrist, a working diagnosis, and drugs that finally seem to be having an impact.