Interview 13

Age at interview: 69

Age at diagnosis: 39

Brief Outline: Has only recent seen himself as getting better, being helped by therapy (eg. Cognitive Behavioural Therapy, Gestalt), a clairvoyant therapist/doctor, the learning of meditation techniques, and medication (Effexor 75mg, Lithium (400mg/day).

Background: A retired 69 year old male who has suffered bipolar disorder since young adulthood, and severe bouts of depression requiring hospitalisation.

Was restless in hospital, and remembers that he felt such self-hatred that he feared he would...

And I was also very restless at one time in the hospital I'm'..I later found that I was'I'd been diagnosed as manic depressive, and that was a bit of a surprise to me. But I can remember being so restless [papers rustle] during my stay in hospital that I couldn't sit down, I wouldn't sit down for a meal. I would just have it on the hoof sort of thing. I wouldn't sit beside anyone to talk to them, I can remember that.  

And that may have been part of the manic thing, I don't know, but it was partly because I felt I was such a horrible person that I would contaminate anybody somehow by sitting, even sitting beside them, they would somehow be able to tell how awful I was if I sat beside them. 

So it was something to do with that sort of feeling of self-hatred and it was so painful. I had a feeling if they did talk to me, they'd only be doing it because they were sorry for me, I was absolutely convinced. So that, that period in hospital was, it was like being in hell.

Sings a song where he wrote the last verse.

This is, it's a folk song, I'm into folk but I also, I made up the last verse of it its called 'The Nightingale''

One morning in spring by chance I did rove

I lay myself down by the side of a grove

And there I did hear the sweet nightingale sing

Never heard so sweet, oh I never heard so sweet.  No I never heard so sweet as the birds in the spring.

All on the green grass I sat myself down

And all the sweet nightingale's echoed around.

Oh say don't you hear how they quiver the note

Never heard so sweet, oh I never heard so sweet.  No I never heard so sweet as the birds in the spring.

Well I'll sing like a nightingale all of my days

For why should birds only be singers of praise?

And so I do now like a nightingale sing

So I do sing sweet oh yes I do sing sweet.

Oh yes I do sing sweet like a bird in the spring.

He tends to become depressed when he tries to come off lithium, although his last depression wasn...

Right yes since 1993 when I was first diagnosed manic depressive I've been on Lithium Carbonate, 600mgs that seems to have'

Once a day?

Once a day, and though I've had periods when I've stopped taking it in the past, it usually ended by my getting depressed again. So I've tended to just stick to it. But I know that it's very powerful stuff, and I don't believe that I can really get better while taking something like Lithium. But on the other hand, I've found it has had very uncomfortable consequences for me, even when I've reduced it gradually the last time, I mean since 93 I have had one or two periods when I went several months reducing the Lithium. 

The last time that happened was about four years ago I reduced it to the point where it was really having hardly any effect on me at all. And then I went' I found myself going into a depression, so I got back on the Lithium but of course it's' but there was a period of about a month before it really fully takes effect. 

And in that time I was suffering from moderate depression which was so much better than the previous times when I'd been in hospital, that although I wouldn't say it was exactly pleasant it was still' it gave me a feeling that I've got some control now of this thing. And I was having some experiences like increased sensitivity to things like noise and colours and feelings.
 

Describes sensing a warm energy in his body from doing Tai Chi.

And later on, as I went on, I began to be aware of energy moving in my body like electric' sort of feeling of electricity. But I did Tai Chi and I could feel the energy. Actually when I got the, a movement right or a stance right, I could feel this, this sort of warm energy sort of coming down through my head and coming up through my feet.

Cognitive behaviour therapy (CBT) helped him focus his thoughts on his successes, however small,...

And that [cognitive therapy] was by the chap he was the best' he was supposed to be the best one of the cognitive therapists I was told. And I did find that, find that very useful.

How so?

Well that I could change my thinking and I could thereby change my feeling.

Can you give me an example?

A particular example was he said, when you go lie down to go to sleep, he said, "You tend to look back on your day and think of all the failures," and he said, "why don't you just think of everything that's been successful?" He said, "With the proviso that for someone like you, who's severely depressed they could just get out bed in the morning and that is a victory." So' and I started doing that, and every night I would just lie there I'd think well I shaved today, you know I was down in time for breakfast, and I did a crossword puzzle and so forth," Well you know actually you've done quite a lot you know. And then I woke' wake up in the morning with the memory of that. So just things like that, a few things like that with cognitive therapy. You know I think they helped quite a bit.

Describes getting helpful treatment and partaking in beneficial activities in an NHS hospital.

There were young psychiatrists on the ward who were prepared to listen to me for periods but it was just, I mean, it was just listening really, I don't think any' you know very practical thing came out of that. But then the, I was recommended for a thing called cognitive therapy. I was given ten-week course of cognitive therapy. 

While you were in the hospital?

While I was in the hospital, I think that must've been towards the end of my six months. So that, and that was by the chap he was the best' he was supposed to be the best one of the cognitive therapists I was told [papers rustling]. And I did find that, find that very useful.

So just things like that, a few things like that with cognitive therapy. You know I think they helped quite a bit. It was a sort of beginning of self, self-help, it was an experience that I could do something for myself. And I was also doing a lot of things like pottery and so forth, I was good at that. They gave me a few, some extra time to do that on my own because I was very keen on doing that. So I got back into painting which I hadn't done for many years, and I had a box of paints in the hospital and stuff by my bed that I could, that I could use. I mean I did drawings of other patients, even one or two people paid me for drawing their children which was very, which helped quite a bit.

Being able to paint and do pottery, how, how did that help?

Well it was something I' just something I loved doing, and being able to do something that I really loved doing, it made a huge difference I think.

He feels that hospital staff need to be more engaging and nurturing of depressed patients who...

As far as I was concerned I felt that the staff on the whole were too busy with their own affairs to want to pay any attention to someone like me. But a lot of that was probably me, rather than their attitude. I think the only thing I would say which I have said to a few nurses, I said, "The people who are in that very sensitive state need more reassurance of care than a normal person." 

Some, some nurses I believe, part of their training is to treat mental patients as being normal people. Well that's alright looked at from the point of the view of say you are capable of doing things like shaving yourself so' but on the other hand, they're not like normal people in that they' they're mostly having a very strong experience of their own worthlessness, they need to be built up. 

And I mean, there are one or two things like, for instance, the office on the ward, there's' you often have nurses who are sitting in there. They may be sort of on duty at the time, but they're sitting in there, and they're not welcoming to you they're sort of waiting for you to come in and draw yourself to their attention. Then it can make a huge difference, in fact to the whole atmosphere of the ward I think. If they are just sitting there, and there's a feeling, well I don't really want to be bothered with any patients at the moment, which I mean that happens as well and that is, it's, that isn't very good I don't think.

Describes a meditation that he uses to deal with anger more constructively.

What I've come to believe is that anger is the tool which people have been given in order to heal themselves and what anger is for is to keep out of your system, or expel from your system, something that shouldn't be there. You know, for instance if somebody is ...they get too close to you, then you feel anyway so you tell them to get further away. Well that's nature's way, it's giving you the energy to do that.  But where anger can be misused when' but I've learned that it can be used in a very constructive way, and I've used it to get hatred and anger actually out of my system.

And how do you do that?

It sounds funny that you can use anger to get anger out of you.

A concrete example of what you mean?

Well a concrete example is okay I, I've' because my mother had a lot of distorted religious ideas, when I'm in church, and I go to church quite often, this feeling comes over me of the stupidity of the Christian religion and a hatred of the other people in the pews with me because they, they're sort of buying it. But I'm' but I'm aware of that happening. What I do is I turn the anger that I feel sort of boiling up inside me against the concept about life which I think is partly a religious one which I don't believe in. For instance, God wants you to be miserable and I see those words upon like a signboard and mentally I throw things at the, at the board [laughs] and I let the anger sort of go in the direction of this idea. I say to myself, "That's a lie, it's a damned lie," [laughs]. And I imagine myself with a big axe chopping the board up and this sort of thing. Of course it's quite easy to stand in church or anywhere, nobody is aware of all this stuff going on. But what I've found is that it has a magical effect. At first when I did it all it did was it sort of relived the feeling of anger a bit, but now it very quickly, well it makes space for me to just think of these people that are in the church as people, and clear of that [distorted religious belief].

St John's Wort helped his depression, but he cautions about the side-effect of increased light...

I asked the psychiatrist if I could take St John's Wort instead of his antidepressant and he said, "Well it's up to you, but only, but you'll have to pay for it if you take St John's Wort." So I did take St John's Wort and that seemed to do the trick, and it was at a time of year when this thing about light doesn't, doesn't affect you because St John's Wort can make you light sensitive, some people become very light sensitive.

Tried various careers, including law, which did not suit him; once he left law he started to feel...

Anyway I had quite a varied life, but I tried to do various things like for instance, I tried to be a farmer and it was too' too much for me. And I had, I suppose you could call it; a sort of a breakdown when I was' that was when I was seventeen. So I had to give up the idea of farming. 

Then I went into my father's law firm, I got a university degree in law, which I found really hard but I did it. Went into his firm and after about twelve years as a solicitor I reached the point where I couldn't do the work any more at which'. And I used to be very angry with clients coming through the door, I just wanted to throw them out really. I couldn't concentrate on work. And so I thought you could get a pill to cure you of this if you went to a doctor. 

But whether' I didn't really want to be cured of it because I'd have to come back into law. What I want to do is leave this bloody awful job, which I should never have gone into in the first place. 

And so I left the left law and I had a bit of money, a relation of mine had left me some money, so I had enough money to keep going for a year or two without working, and so deliberately drifted. And I quickly felt better from the symptoms that had stopped me doing the law, and I went to an organic gardening school run by a private man who is a writer on organic gardening, and I did a year's training with this chap. And then I went to a Rudolf Steiner further education college and I got training in what they called biodynamic agriculture, which was'. it's a sort of organic plus.

This facilitator of a support group wants to encourage his group to master healing techniques as...

Because the difficulty is Damien that the [support group umbrella] is not a professional body, and these self help groups which are under the umbrella of the [name], none of us are professionals, and there are some pretty intelligent people, but they're not health professionals. And I have to be a bit careful. I have to be careful leading the group that I'm not, I'm not being a therapist you see. 

On the other hand, I am being a therapist, I'm using it' I don't really want to run a group just to comfort people with depression, I don't want to. If I wanted to do that, any of them could be the leader of the group if that's all it is. Because all they do is just meet, swap stories and think well it's nice being with people that understand. Well of course it is, and it can even be very therapeutic in itself for certain people. But then once they've got to that stage, when they've had the therapy of just the sympathy, then they need something else. And some of the people in that group are not the sort of people who go to a counsellor for one reason or another, and so I'm determined that I'm going to bring a lot of the techniques that I've learned into the group, and offer to them. It's up to them whether they do anything with them or not, but that's what I'm going to do.

Feels better at the age of 69 than he has ever felt before, and recalls life was grey from...

The most important thing in my mind at the moment is how much better I am than I've been in my whole life. It seems amazing at the age of sixty nine that I should be... feel as if I'm more healthy than I've been in the whole of the rest of my life. But I can remember back to when I was about four years old, and even then I was supposed to be a weak little boy, at least in the eyes of my mother. And from then onwards I was ill, I'd look after myself, life seemed to be kind of grey a lot of the time and I felt cold and I felt lonely a lot. 

When I was in secondary school I got, I was playing football and I got pneumonia, and as a result of that I got tuberculosis. And at that time you couldn't cure that easily, there weren't any drugs for it, so I had to stay in bed for about six months and I was a very active child. So I took that very badly, but as a result of the illness I became very interested in ways that I could get more healthy. Then when I got back to school after the illness I wasn't allowed to play games for some years actually, and that made me even keener to find other ways of getting stronger. Then I got very interested in organic food and whole foods, I used to bake my own bread... when I was about thirteen years old and this kind of thing. But it didn't seem to have a very obvious effect on my health.

He was taught as a child that pleasure was wrong, but later found out that life is about pleasure...

Well my mother was very keen on the Catholic religion and her interpretation of it was that people were meant to suffer in this life, and it was God's will you should suffer. And it was almost a feeling, certainly I got from her the feeling, that if I was really doing things that I really enjoyed doing-that was selfish, it went against Jesus' teaching.

Because of all the unpleasant experiences I've had psychologically, I've realised that that is a travesty of the truth, that what a person should be doing in life is what gives them the most pleasure, and if they don't, they're actually denying their life's purpose, and it's not surprising they start showing some symptoms of mental imbalance.

My father was a very melancholy character, and he had a very strong influence on me because I... I was aware very early on that if I was cheerful around him he didn't like it, in fact he really couldn't bear it. And so I got into the... into the way of sort of feeling sort of slightly sad when I was in his company so I wouldn't show any signs of exuberance, because I knew that then the atmosphere would get so painful.