I’m taking some time out at the moment to care for my elderly mother who, in addition to suffering from bipolar disorder, is beginning to show increasing signs of dementia.
it is a bit of a challenge to determine where the bipolar ends and dementia might begin, because my mum has always been incredibly disorganised and was never really able to cope with the housework at the best of times. Over the years, our attempts to help her – for example by trying to make her kitchen and particularly the fridge, counters and sink more sanitary, tended to be met by anger and accusations of wanting to control her life/ steal from her/ hide her things/ some other nefarious motive. It has always been hard work. In fact my brother said recently that the relatively new term ‘Bipolar Disorder’, replacing the old ‘Manic Depression’, really just not do the illness justice.
Recently, though, she seems to have had a ‘crash’ (what might once have been called a ‘breakdown’) and due to chronic insomnia, has very suddenly accelerated her memory loss and confusion, and instead of being consistently high or low for weeks or months, has started ultra rapid cycling of moods and what appears to be mixed states of mania and depression at the same time. In short, she can’t function at all. What we didn’t realise, because she hadn’t let on, was that it isn’t just the sudden memory loss and confusion – that part of the problem has been coming on for months and months. We only discovered it because with this ‘crash’ she had to admit she needed help.
Over the few days I have been here, she has run the gamut of all possible emotions. At the weekend when my husband was here, she behaved appallingly – swearing and violence – and I was very embarassed. Anger, crying, despair, laughing, singing, and obsessing about God and the devil (she has had a whole life’s worth of unhelpful religion, and is often convinced that her illness must be demonic in nature). It is exhausting to be around.
But I do also know, to a lesser extent, how exhausting it is to experience first-hand. I don’t have any kind of diagnosis, and I certainly don’t believe I have full-blown BPD, but children of parent(s) with BPD are at increased risk both genetically and in terms of the emotional environment they grow up in to experience difficulties with mental health generally and BPD in particular. There have been occasions – when I have been prescribed various prescription medicines and also some alternative medicines – when I have experienced symptoms of BPD. Fortunately, I recognised it and the symptoms disappeared as soon as I stopped the medicines.*
I obviously have a vulnerability there, so I do need to take care to look after myself and practice self-care – get a good amount of sleep, eat as healthily as possible, exercise, and exercise emotional intelligence in all my relationships! (Easier said than done, of course, for all on that list).
I was worried that being around my mum would be bad for my own mental health, and I think that would be true if I stayed here for long. But in the short-term, apart from worrying me that I must take more care, it has made me realise actually how well I am. It has always been a worry in the back of my mind that I might ‘end up’ like my mum. But I know I am not my mum, and hopefully it’s an unfounded fear that I don’t really need to worry about.
Now, though, we have the enormous task of finding a suitable and acceptable long-term solution to looking after my mum who is really very difficult to live with, now that she seems to need not only help with day-to-day washing, housework and shopping, but constant supervision and company round the clock. The best and most logical solution, since I live 200 miles away and can’t be much help on a regular basis, is for my mum to move in with or near to us in Cornwall, but she really doesn’t want to. Is it awful that a part of me feels relieved about that?
* Incidentally, the medicines that threw me for a loop were: Amlodopine, prescribed for blood pressure – not known for affecting the brain perhaps, but it obviously didn’t agree with me, and St John’s Wort – a well-known traditional remedy for depression which I took for PND, but oh boy, that made me ‘crazy’, in a word.
Additionally, Gabapentin, which I was given for pain, made me feel suicidal when I was on it regularly last year. It is known to have risks for people with BPD, but is often prescribed nevertheless because in people with BPD it has the ‘off-label’ effect of reducing anxiety. I’m not overjoyed that my mum has been given that particular medicine, but anxiety seems to be of particular concern at the moment, since it seems to be what is causing the insomnia, and the local Psych team don’t want to try any anti-depressants until the sleep is sorted out. The wheels of the NHS turn incredibly and frustratingly slowly. It’s a pretty nerve-wracking time for everyone involved.
I am looking forward to getting home to Cornwall and to my kids, but I don’t know when that will be.