The Curse of the Strong

Depressive Illness.
“The Curse of the Strong”
by Dr. Tim Cantopher, Consultant Psychiatrist, Priory Healthcare Services
We all feel depressed at times. I certainly do, particularly on Monday mornings. But, because we all know how the emotion of depression feels, we tend to assume we know how someone feels who is suffering from a depressive illness, or clinical depression. In truth though, we haven’t the first idea of what a victim of this illness is going through. At its worst, it is a glimpse of hell which the rest of us, thank goodness, will never come near to experiencing in our lifetimes.
There are many misunderstandings about clinical depression. One of the commonest is that people who get it are in some way weak. This is ironic as in fact the opposite is true. Stress induced clinical depression does not happen to weak people, but is an affliction of people who are too strong. There are several different causes of clinical depression, but by far the commonest and the one I will deal with here is stress. Life, sadly, is getting more stressful and as it does so an epidemic of depressive illness is underway – up to I in 3 consultations in general practice involve patients with the disease.
And yet it can be prevented, is not difficult to treat and can be prevented from recurring in those who are unfortunate enough to suffer an episode.
This illness nearly always happens to one particular type of person.
He or she is strong, reliable, and diligent, with a strong conscience and sense of responsibility. But he is also sensitive, easily hurt by criticism and has a self-esteem which, while it may look robust on the outside, is in fact quite vulnerable and easily dented.
This is the person to whom you would turn in times of need, and she would never let you down. When the going gets tough, this person gets going.
Why should this type of person be the one to get ill? The reason becomes clear when one understands what clinical depression is. Here is the key: clinical depression is not a psychological condition or a state of mind. It is a physical illness.
A depressive illness happens when one part of the brain, called the limbic system, malfunctions. The limbic system is a set of nerve fibres arranged in a circuit. Essentially this circuit acts like a complex thermostat which controls a number of systems and functions in the body. Probably the most important of these is the control of mood. It usually works well with mood returning to normal reasonably quickly after most of the day to day ups and downs of life. But like any other physical system, the limbic system has a limit and if it is stressed beyond this point it will break. When this happens, the part of the system that fails is the transmitter chemicals, serotonin and noradrenaline. These are the chemicals which allow the electrical impulse to pass from the end of one nerve fibre to the beginning of the next. In depressive illness their levels fall rapidly, resulting in the circuit coming to a. grinding halt.
So what happens if you put a whole lot of stresses on to someone who is weak, or cynical, or lazy? The answer is that he will immediately give up, so he will never get stressed enough to become ill. The strong person on the other hand, reacts to stress by redoubling his efforts, pushing himself way beyond the limits for which his body is designed. When he starts to get symptoms, because he is sensitive and fears criticism and failure, he still keeps going, with the inevitable result that eventually something must give way. What gives way is the limbic system. If you put 18 amps through a 13 amp fuse, there is only one possible result.
Stress related depressive illness is essentially a blown fuse.
The symptoms of clinical depression (you don’t have to have them all to have the illness) are depressed mood, feeling worst in the morning and better as the day goes on, and a host of “Loss-of’s”.
That is, loss of:
 Sleep
 Appetite
 Energy and enthusiasm
 Concentration
 Confidence and self-esteem
 Drive
 Sex drive
 Enjoyment
 Patience
 Feelings
 Optimism
 and almost anything else you can imagine; pretty much everything goes.
So you have identified that you have a depressive illness and you recognise that it is a physical illness. What do you do now?
Answer: exactly the same as you would with any other physical illness; rest and take the prescribed treatment.
The trouble is that on the whole the people who develop this condition have overcome every problem they have encountered in the past by extra effort. The concept of giving in to the illness is anathema. Yet you wouldn’t normally try to overcome pneumonia through only the exercise of your resourcefulness. Neither can you with clinical depression.
Beware family and loving friends. However well meaning they will often give you the benefit of their homespun wisdom: “Go on, pull yourself together, get more interests, get out more, get more friends, come and have a party, we’ll cheer you up”. If you take this advice you will probably get worse.
Rest, especially in the early stages is crucial. This doesn’t mean going to bed or sitting in a chair doing nothing, that would give you far too much time to ruminate. It does mean avoiding any unnecessary challenges and only, where possible, doing what is easy. If it is possible to take time off work, do so. If you can get someone to clean up, look after the kids and do other chores, do so. Cancel social events that you are not looking forward to. Watch more TV or do anything else that comes easily to you.
Another difficult issue is antidepressant medications. While there is no doubt that they are an important part of treatment, they have had a very mixed press and people hold strong views about them. Again, misunderstandings abound.
Maybe I can dispel a few. Antidepressants are not addictive, though if you come off them too quickly you can get withdrawal symptoms; withdraw them slowly by tapering the dose over several weeks at the appropriate time. They don’t work straight away, usually taking a few weeks to kick in properly. They don’t give you a false high, Or make you a better, more creative person, or turn you into a murdering psychopath. Prozac is a good antidepressant but doesn’t deserve either the cult following or the condemnation it has attracted. Above all, if an antidepressant helps you get better, don’t stop it as soon as you get well. It takes the limbic system several months to heal properly, even though the symptoms of clinical depression have gone. If you do keep the drug going for long enough, you are unlikely to relapse when you come off it, in the same way that, when a plaster cast is taken off a broken leg which has healed, you can walk without a return of pain.
Once recovery starts, things get more complicated. You need to start doing a little more, but how much? The truth is, I don’t know. But you do, because at every stage, your body will tell you. You can divide activity into three categories: mental, physical and social.
 At your body’s physical limit at any point of recovery you will start to feel heavy and lethargic.
 For mental activity, you will find you don’t take anything in.
 At social events, you will start to find it difficult to talk sensibly.
At this stage, or before, stop. If you do you will continue to recover, if you don’t you will feel rotten for the next 36 hours or so. The harder you push recovery, the slower it goes. So take it gently and listen to your body.
Even following these instructions you will get ups and downs, but they will be minimised. At the beginning there aren’t many good days. In the middle Of recovery some days are nearly back to normal and others almost as bad as ever. Nearing full recovery the bad spells become shorter, further apart, less bad and eventually peter out.
Beware extremes of emotions during this period. Your first good day isn’t the end of your problems and the rotten day that follows it doesn’t mean you will never be well. Don’t overdo it on the good days and don’t despair on the bad ones; this is normal recovery, and in any case, the bad days are often a message
that what you did yesterday was a bit too much.
Once you are somewhere near full recovery, it is time to ask some basic questions, such as: What is it all for? Do I have to run my life this way? Can I say ” no” occasionally? What do I want from life? Why do I always have to be everything for everybody? etc., etc.
These are difficult questions and there are many more. They involve you identifying the choices you have in your life and making them. If you don’t think you have any choices, because of your commitments and responsibilities, you are wrong. However you may have to give up your image of yourself as the perfect mother/father/employee/friend etc. to find them. If you do, you can stay well.
It isn’t always possible to achieve this on your own. This is when a psychotherapist comes in. There are a great many different forms of psychotherapy, but mainly they can be divided into exploratory (or psychodynamic), cognitive and behavioral. I won’t go into these therapies here, as that is another article, but they all work for different people, depending on their particular route into the illness. The essential point though is that effective treatment isn’t a matter of drugs or change of lifestyle or psychotherapy, but is often a combination of all three.
After that it’s down to you. If you have changed the way you operate and maybe the way you think, you have a great chance of remaining not only well, but happy too!
 It is primarily a physical not a mental illness
 It happens to strong, not weak people
 It is not the same as “feeling depressed and fed up”
 You don’t know how a person suffering it feels unless you have had it yourself
 You cannot pull yourself out of it
 It gets better eventually, sooner or later
 It gets better quickest if you rest
 Anti-depressants are not addictive. Anti-depressants usually take a few weeks to work
 Don’t stop your anti-depressants as soon as you feet better
 When recovering, increase your activity slowly, as your body dictates
 in order to stay well following recovery will need to make changes to the way you operate, and possibly the way you think.

article, source unknown read at Swanage Depression Support Group in May 2017

review of he book by Cantopher is on this site


Bi Polar Disorder and Self Management

I have not blogged much over the last 9-12 months which makes it glaringly obvious that I have not had my finger on the pulse, especially where my Bi Polar mood swings are concerned.

I became ill at Christmas 2016 and descended into a mire of depression immediately. I had felt well for months. In fact I had felt supremely well for months. Sound familiar? During the hypomanic phase which can last for a considerable time I am extremely productive and experience ‘flow’ but eventually this becomes more than a healthy state of mind and can gain momentum leading to lack of insight, rash decisions and can send your life spiralling out of control. Only it doesn’t go out of control in your mind. You still think your life is normal and you are well while everyone around you is muttering behind your back that …

‘something has to be done’.

My family and my partner tried to alert the medics but without success something that the Psychiatrist found appalling. I eventually wrote a letter to my GP asking for a referral. My psych then always visits me at home for good reason – I am at the stage when I can’t leave the house. He then returns in a few weeks after which appointments are made at the nearby cottage hospital.

In the letter I said the family had been refused access to the Psychiatrist and to the GP. We now have a procedure in place which, in future, will ensure that family do get to express their concerns. Changing my GP is also on my to do list!

I had been on a Living With Bi Polar course not once but a second time as a refresher, but could only present him with a small piece of paper with four ideas of how to get well. Drink more water, go to the shops for a few things etc.

There is nothing on here about doing something you enjoy, he said.

Of course, when depressed, we no longer enjoy anything, so all our hobbies are now forgotten or our brains cannot cope with the challenge or necessary concentration.

Leaving me with a list of about 9 things to do on an action plan, he departed saying he would be back in three weeks. After all recovery has to come from me and I know that. I was to do relaxation exercises three times a day on the floor or more often when sitting in a chair. I was to get back to yoga, using my CD and go for walks, extending the distance each day. I was to review the course material from the Bi Polar management course and he stressed it is all about self management. By this I know that we should do the opposite ie if we feel high and energetic we should do yoga, go to bed early, read, calm ourselves down, cut down on activities rather than increase them. When depressed and unable to move out of the bedroom we should get up, move about and go out in the fresh air. We should exercise.

In reality I exercise and go out a lot when I am high. I socialise extensively and talk a lot. I make plans. In fact, what I should do is socialise less, listen to music so I do not talk so much, watch romantic films to keep me seated on the sofa. When low I sink beneath the duvet and do very little s

In Depressive Illness, The Curse of the Strong, Dr Tim Cantopher provides many ideas for helping us work through our depression. One idea he gives is to refrain from supermarket shopping which may be overwhelming but to go to the corner shop and buy a few items, a trip which is more manageable.
Dr Cantopher describes the build up to depression as likened to a thermostat which overheats. Those of us with Bi Polar do not make the chemicals in the brain which stop us overdoing things. We cannot regulate our brains which is why we continue to talk fast, go out to much, take on too many activities and commitments when our brain is about to fuse whereas those without this mood disorder will actually release chemicals which stop them before it is too late.

This was heartening to me as I have always blamed myself. However, it is still up to me to manage the condition.

Sleep, relaxation, keeping occupied, attention to diet, exercise and mindfulness all contribute to managing the condition.

Over the next few weeks I compiled my own manual using the course materials, the internet, blogs on mental health, library books, self help books and leaflets from Mind. I did my own research. As a writer it was good to have a writing project that centred on my mental illness. However, we are all individual and the condition is unique to us. We all respond differently and I have found that each episode is slightly different and requires some fine tuning. For example, sometimes puzzles can keep me occupied as I work my way out of the mire. In another episode the puzzles irritate me and I find another way, perhaps writing a diary or listening to music.

Next time I descend into deep depression the family and my partner know to push my manual in front of me and tell me to read it. In the book I have simplified all the advice and information that is out in the public domain.
In my next post I will explain how I achieved this, what the manual contains and provide an overview of strategies to help stay on an even keel.

Do let me know of your experiences with mental illness so we can share information for all those affected.

Di Castle

Di Castle has Bi Polar Disorder and has struggled to manage the symptoms over the years. Self-Management is the key and she hopes her posts on this blog will help others. She welcomes feedback.

Her debut, Grandma’s Poetry Book, is available by post via dcastle32@talktalk.net or on her website http://www.dicastle.co.uk .
This poetry collection spans sixteen years capturing the experience of a first-time grandmother on her sometimes wobbly journey in her new role. It includes many facets of unmissable moments and childhood milestones, some humorous and others more poignant, even sad. Such treasured times can easily be forgotten so the book acts as a nostalgic memoir. Touching and funny in turn, readers will be reminded of the joys of witnessing childhood development and the effect o n their own lives. Even those yet to reach grandparenthood including fathers, aunties and primary school children have already enjoyed reading this book. Grandma’s Poetry Book makes an ideal gift for new grandparents, birthdays, Christmas and Mothers’ Day and many readers have returned to buy more copies for friends and relations. Each poem has its own laugh-out-loud illustration by an artist who has been likened to E H Sheppard.

Some comments have included ‘Pam Ayres meets Winnie the Pooh’, ‘made me laugh, made me cry’, ‘charming book’ and ‘every grandparent should have one’.

SHOULD I WEAR FLORAL and other poems on Life, Love and Leaving, By Di Castle and illustrated by Denise Horn.
You can follow her on twitter @dinahcas and on Facebook https://www.facebook.com/pages/Di-Castle-Writer/266866193324409parted16formation o


My Staying Well Plan

In January this year I suffered a serious relapse. I had been managing my Bi Polar Disorder well but looking back I was seriously hypomanic for most of 2016 dipping occasionally and taking some days ‘off’ unwinding sotospeak but just before Christmas I began falling out with people, became stressed and tearful. I still did not see what was happening but hopefully, since going on an Early Warning Signs course, I shall recognise what is happening and take action earlier in future.

When my psychiatrist visited me at home he was surprised that the two Living with Bi Polar Courses that I had attended had not resulted in me managing the disorder more effectively. He told me to revise the course material. I did this and came up with the idea of making a personal manual.

The first two pages list what I have to do to stay well. Requested by Swanage Depression Support Group after I shared my list. I have edited it somewhat and added extra items.


  • Accept the phase when you need to lie in bed most of the morning. Your brain needs to rest. This prevents further stimulation.
  • Read the first few pages of Depressive Illness, the Curse of the Strong, Dr Tim Cantopher. An excellent understanding of the true meaning of depression.
  • Note Dr Cantopher’s point that something has to change if you are to stay well and not relapse. People relapse as they have not made changes to their routine, action or behaviour which may have been maladaptive
  • Put on Smooth radio or Classic FM
  • Keep off the computer for a while and, if you cannot bear it and are frightened you will have to give it up altogether, remember you will come back to it.
  • Play CDs, dance, use party CDs
  • Play relaxing music in the background when writing or reading.
  • Use lavender oil and massage temples and neck each night
  • Keep occupied
  • Do some tidying every day
  • Do some clearing out every day, just one shelf or a drawer. One small step
  • Drink more water
  • Eat healthy food. Cut out junk.
  • Use 3.75 Zopiclone and if necessary take 7.5mg and then reduce after one month. 8 hours sleep minimum is essential for Bi Polar Disorder
  • Shop each day for a few things. Use the local corner shop if the larger store is overwhelming
  • Don’t spend unnecessary money. WAIT
  • Walk each day. Once and then later go out twice. Increase the distance each time
  • Use a relaxation tape, 3 times a day on the floor if anxiety is crippling
  • Do yoga. Arrange for a lift to a class if you cannot drive. Use the yoga CD if you cannot go out.
  • Practise deep breathing all the time, when waiting in shop queue or watching tv.
  • Do puzzles, crosswords.
  • Don’t read the news in newspapers. Look for the funny comment columns or the letters page.
  • Read self help books to revise relaxation, stress reduction and get positive ideas.
  • Watch tv on catch up, not live, If attention is poor you can watch a short part at a time.
  • Do NOT watch the news while anxious or depressed
  • Go to bed 11-11.30 Read for half an hour after tablets
  • Visit the library and sit with a book, just feel the warmth, feel the nearness of the company and the ambience of books around you.
  • Use the internet for following mental health blogs and self help. Look at the MIND site and read what people have written. Contribute your own positive idea which will make you feel good.
  • Print out anything useful and put in your Getting Better file.
  • Face up to Finance. Instead of regretting overspending, look at your accounts. It may not be as bad as you think.
  • Write a diary of what you have done each day.
  • Keep a notebook/diary of thoughts, feelings, actions, what you did each day and write helpful things down.
  • Write down 3 things you want to do tomorrow
  • Write down 3 positive things that happened today.
  • Sing
  • Sort out some books you no longer want and take them to Oxfam
  • Make notes from previous courses, reduce them and put them in the Manual
  • Do something you have not done before
  • Use Power Work Out DVD (Keep Fit) £1.50 on Ebay
  • As you feel better start to speak to people when you are out.
  • Go for Reflexology
  • If you are a writer (I am) ease the block by reading through some work on the computer and start editing small parts. The creative urge will return.
  • Use the idea of the Morning Pages (from The Artist’s Way by Julia Cameron). Write 3 pages each morning of the first thing that comes to mind, even rubbish. Free association. Do not try to write something serious until you have emptied your mind first.
  • Visit the Library 2-3 times a week, take a few books out and return those that do not appeal. Stick with those you like after the first three pages. Try to sit down to read several times a day.
  • Start to listen to talking radio when you feel up to it eg Woman’s Hour and other discussion programmes. Use catch up for the periods you could not bear the inner noise of talking radio.

Remember that eventually you will get back to some semblance of normality (as it applies to you) and you might even begin to write a helpful mental health blog such as this one.

Please comment and add your ideas to this staying well list.


Di Castle has Bi Polar Disorder and has struggled to manage the symptoms over the years. Self Management is the key and she hopes her posts on this blog will help others. She welcomes feedback.


My debut, Grandma’s  Poetry Book, is available by post via dcastle32@talktalk.net or on my website http://www.dicastle.co.uk .

This poetry collection spans sixteen years capturing the experience of a first-time grandmother on her sometimes wobbly journey in her new role. It includes many facets of unmissable moments and childhood milestones, some humorous and others more poignant, even sad.  Such treasured times can easily be forgotten so the book acts as a nostalgic memoir. Touching and funny in turn, readers will be reminded of the joys of witnessing childhood development and the effect o n their own lives. Even those yet to reach grandparenthood including fathers, aunties and primary school children have already enjoyed reading this book. Grandma’s Poetry Book makes an ideal gift for new grandparents, birthdays, Christmas and Mothers’ Day and many readers have returned to buy more copies for friends and relations. Each poem has its own laugh-out-loud illustration by an artist who has been likened to E H Sheppard.

Some comments have included ‘Pam Ayres meets Winnie the Pooh’, ‘made me laugh, made me cry’, ‘charming book’ and ‘every grandparent should have one’.

OUT SOON  SHOULD I WEAR FLORAL and other poems on Life, Love and Leaving, By Di Castle and illustrated by Denise Horn.

You can follow me on twitter @dinahcas and on Facebook   https://www.facebook.com/pages/Di-Castle-Writer/266866193324409


Bi-Polar, Depression

Depressive Illness – The curse of the strong

IMG_5311Depressive Illness (The curse of the strong)   Dr Tim Cantopher   Sheldon Press 2003

I picked this book up at our local support group and from the very first page I knew that this was the best book on Depression that I have read over the years.


His introduction starts with typical Monday morning blues after a restful weekend as he explores all the feelings this brings. The point he makes is that those who feel down on Monday mornings or dip into low mood occasionally, for example when they are tired or getting over a virus, are not what the medical profession would call ‘depressed’ although many people do use this expression to describe their moods. He cites those who say ‘oh I get like that and I just pull myself together and get over it’. They don’t ‘get it’ and he comes down heavily against people who make such comments to those with depressive illness. It is not helpful.


This book is not as heavy as some I have ploughed through. It is accessible and an easy read. Cantopher has an engaging tone and he certainly knows what he is talking about. He describes what happens to the brain when people fall into the depths of. In depression, the levels of the chemicals in the synapses of the limbic system plummet and the nerves get less sensitive to the chemicals too. This is usually brought on by stress or other triggers. Basically if the limbic system is taken beyond its design limits it will malfunction and a gap will appear between the end of one nerve and the other (the synapse)


His list of symptoms is the most comprehensive I have seen. Most symptoms involve ‘loss’.

Loss of sleep, appetite, energy, enthusiasm, concentration, memory, self-esteem, sex drive, drive, enjoyment, patience, feelings, hope and love. However, loss of memory, according to the author is caused by the loss of concentration and does not mean the memory is impaired.


Chapter 5 is What to do when you get ill and he devotes three pages to ‘rest’, likening it to a thermostat which has got too hot and has to be switched off. While he accepts that sufferers initially spend long periods in bed, he advocates a preference for plonking yourself on the settee and watching mindless day time tv or romantic films ie nothing too taxing.


His chapter on Staying Well is excellent. If nothing changes and the same choices continue to be made in your life then the depression will come back to hit you again and again. He equates ‘crisis’ with a ‘time of opportunity’ as it allows you to switch off, cancel your busyness and all those activities which led you to ignore your self-care. This is the opportunity to make changes. If nothing changes, everything remains the same.


Once recovery has begun the author describes a stage when he visits a patient and finds the hoover in the middle of the room. We feel better and the mess is at last irritating us and making us want to ‘clear up’. However, we get the hoover out and start hoovering only to find that within 5-10 minutes we are exhausted and abandon it. We can’t even put it away.


When I recounted this stage to my partner he immediately recognised it. The spirit is willing but the body has not recovered enough. The lack of exercise over even two or three weeks will take its toll. Also lethargy is one of the symptoms. Rather than hoovering the whole house and leaving ourselves exhausted and back ‘down the hole’, he advocates increasing such activity slowly. For example, rather than push yourself to go to the supermarket and feel drained, make your first outing a trip to the shop on the corner. Oh yes, I have found myself there a few times since Christmas.


There is much more in the book to explore. As the author says, if you are reading it when you are first unwell just read the first five pages in two or three efforts. Even the most avid reader cannot concentrate on a complicated novel when they are depressed.


I have to return the book in ten days time so I intend getting my own copy.


Do try it and see if it makes a difference to you. I did it for me!


Alternative Therapies


Many years ago when I was ill for the first and second time, I knew little about strategies for regaining my sense of well-being. I was only offered tablets but, while in hospital, I did go to relaxation sessions. However, there was nothing more on offer. This was in 1989 and the early 1990s.

How much has changed now. Mental Health is on the agenda and discussed openly. Only this weekend, a Times Journalist wrote in the Times Magazine about his descent into and recovery from depression. Sports personalities also discuss their own predisposition to this debilitating condition. We are often surprised as we have only seen them as successful sportsmen.

However, stress and over activity can tip successful people away from being at the top of their game and they can find this difficult to cope with.

Over recent years I have used yoga and, more recently, Mindfulness, to bring myself back to some sense of normality. I have also found a therapist who is trained in several techniques. I have had Indian Head Massage, full massages and facial massage. The latter is wonderful when anxiety is at its worst and I wake up to puffy eyes.

But the most recent therapy I find beneficial has been Reflexology. This, I found more relaxing than a body massage. After one session about two years ago I walked home completely disconnected with the world around me, save for a wide smile on my face. The feeling of well-being was immense. I stopped at the cash point, inserted my card, requested the cash and took my card. I walked away without the money only to realise half way down the street but when I ran back it had gone. Luckily my bank was able to resolve the problem.

A few years ago I visited a Reiki therapist and found it helpful. The therapist then moved away. My love of reflexology over the last few years has caused me to forget that experience but when I discussed my recent acute anxiety with my therapist she suggested that I try Reiki again and, at the end of my reflexology session, she gave me five to ten minutes of the technique.

We have decided that I will have 50/50 Reflexology and Reiki for the next few sessions. I try to visit her once every three to four weeks but during a bad phase I will go more often. I am not rich but I have learnt how to economise in other areas of my life to enable me to afford these treatments. They are the gold dust.

Reiki is apparently particularly beneficial in dealing with anxiety.

I will be writing about my Reiki treatments on this blog so watch this space.


‘Down Days’ or normal life?

What are ‘Down Days’?

I follow a mental health blogger, Natasha Tracey, and, while some posts don’t resonate with me every time, most of what she talks about I can identify with completely.

Many people will refer to being ‘down’ and they do not have clinical depression or a Bi Polar diagnosis. Sadly, these comments do not help those with serious mental health conditions as they trivialise what is, for those of us with such disorders, something debilitating and immobilising.

In her latest blog, Natasha talks about someone referring to ‘Down Days’ and she makes the point that hers are not days but more likely weeks and months. You can read her blog here and, if you find it of interest you can follow her and receive updates in your inbox.


I, too, don’t have ‘down days’. I know immediately that my mood has dropped. It will follow a period of busyness, project building, possibly excessive spending which, at the time, seems absolutely necessary but, in the time that follows, reality tells me that I did not need whatever it was I spent my money on.

I used to ruminate about recent spending but have learnt over the years not to take off labels, to keep receipts and seriously consider returning items, if that is possible. If I decide to keep some dubious purchases, I have discovered that a few months or a year or two down the line these items can be used and are not a waste. If you suffer from this behaviour, take heart that all is not lost.

But back to ‘Down days’. I recently had an email from a ‘friend’ who referred to her ‘highs’ and ‘lows’. She does not have Bi Polar or mental health issues. Her ‘high’ was related to a holiday or some success and her ‘low’ was linked to losing a relative to cancer. And this is where the boundaries between what is normal and what is a serious mental health condition become blurred. Hers were the ‘normal life’ happenings with natural emotional responses. Mental illness is something else altogether.

I do wish those who do not have mental health issues would not trivialise the emotional states of those who do by referring to themselves, as if they suffer the same states. They do not. The extremes with Bi Polar are so great that normal living becomes almost impossible. A high state can result in losing sense of reality and psychotic symptoms such as believing you can achieve the well-nigh impossible or drift into some paranoid state whereby one believes the people waiting on the street are police about to arrest you, when in fact, they may be Jehovah Witnesses discussing where next to visit. The ‘crash’ that follows a ‘high’ involves much regret at spending or actions taken and are far deeper than simple ‘down days’.

I know that some people suffer rapid cycling and can experience both high and low states in one day or in a few weeks but most people with Bi Polar will go through a period of wellness when their activity increases, their happiness is unbounded, optimism is high and life is good. That is fine until the mood slips slightly higher and the behaviour is more erratic.

The low period that follows such a ‘high’ period is not just a ‘down day’. It can suddenly envelop you in total inertia, lack of motivation and anxiety which can lead to an inability to get out of bed each morning. Even when up and moving, the brain and body are so slow that taking a shower is a major undertaking and simple activities such as making a cup of tea become increasingly difficult. The weight on my shoulders is so great that, after a cup of tea and a small breakfast, I am so exhausted I have to lie down and this repeats itself through the day as I try to overcome the lethargy and feelings of ‘walking through treacle’. Minor day to day happenings can appear insurmountable.

I dread the warning sign that I am sinking low as, unless I am very lucky and can stop it in its tracks, I know I am in for at least a month, possibly two when normal life will cease. It is, as I have said, more than just a ‘down day’, more like a ‘down month’. Luckily my medication means that I rarely go into deep depression for longer periods and I employ strategies to bring me back to a fully functioning human being. However, I am not complacent. I know that I could sink for longer periods as I did in the past.

But I have had help and advice, counselling and support.

So I know the following:

SLEEP is the key. If necessary I will take a small dose of Zopiclone for a few days to regulate my sleep pattern. I can increase my medication slightly .

RELAXATION is absent but must be reclaimed. I have a reflexologist who also has trained me in ‘tapping’ techniques. One or two visits will set me on the path to recovery.

EXERCISE is vital. Mornings are rubbish so an early lunch and then a long walk in the afternoon is called for. I combine this with sitting in the sun watching the waves roll in – the joy of living at the seaside.

CREATIVITY is absent so I try to write in my notebook each day. The entries make sorry reading later but I do include TO DO lists and the POSITIVES of each day. Re-reading these entries demonstrates how each time I sink low I need to explore why this has happened and how I can reclaim my equilibrium.

YOGA is essential for my wellbeing but is something I have often neglected before this phase. I start with 20 minutes on a blanket and try to increase it each day. This can strengthen the muscles which when we are inactive become weak.

DAYLIGHT is another essential. Sitting outside in the daylight, walking or gardening all helps.

DEEP BREATHING – also used in yoga – helps anxiety and aids relaxation.

LISTENING TO MUSIC is a recent addition to my strategies. Listening to classical music has been found to have positive effects on the brain. Uplifting music and dance tunes can also help. You may find yourself singing or jigging away, perhaps even dancing. Creating your own music ie playing the piano or another instrument can take you out of yourself.

As a writer, I need to WRITE but this is hard at these times. This when I turn to blog posts such as this which I hope will help others. One thousand words is an achievement. Of course, I would prefer it was a chapter in a long abandoned novel but it is keeping the creative writing juices lubricated.

COMMUNICATION – is so important, with family, friends but is one of the hardest parts of the illness. Keep TALKING even if only to yourself while out walking. I try to talk to someone every day when I am out for a walk. It keeps me connected.

Depression is often a state of disconnectedness where we have lost some of our ability to relate to others and the world around us. However, it will return. It will pass.

What helps you cope with these low periods?



I have a bad spate of Anxiety at the moment. I don’t really know where it came from only that I became anxious about a holiday I had booked that I felt might go wrong … and it did. Well some of it went right. On a positive note we went to Portugal and flew from our local small airport which is the antidote to a fear of flying. Complete absence of stress, an easy journey, no overnight hotel stop, easy parking – we drove the car to a space and walked across to departures – how easy is that? Of course, security was still a nightmare as the boundaries keep moving. This time it was finding I had packed a lithium battery in my carry on. No problem if I was going to carry it on but, no, they wanted some passengers to put their carry ons in the hold and apparently that is where lithium batteries cannot go. So a major reshuffle at check in and a once-tidily-packed case resembles a bomb site until the errant battery is located and then relocated into my hand bag.

On another positive note, I will never forget standing at the viewpoints at Praia da Rocha and marvelling at the red sandstone and the large rocks with a sudden blast of sunshine that was horribly absent for the rest of our stay. Stunning is the only way to describe the view. Similarly, we loved visiting Sagres, the most westerly point with its fantastic views, again in a window of sunshine.

But things had been going wrong before this holiday. I should have expected Anxiety to rear its ugly head as I had just passed through several weeks of stress until I managed to stand back from what I had committed to and hold my hand up and say ‘I just cannot do this’. Of course, once the stress was removed, I expected to feel better straight away but that is not how Anxiety works. Being on red alert for several weeks is doing invisible damage to one’s mental health and mine was seriously compromised. I knew it would take time. It will pass … my main mantra for overcoming anxiety or depression or both. I am still waiting.

So what went wrong? For a few years my partner and I have enjoyed hotel breaks in Italy, Croatia and short breaks in the UK and in Krakow, at hotels where the Reception staff speak good English and there are other British holidaymakers around which makes for some semblance of security. We are collected at the destination airport and transported without any hassle to our holiday hotel. We do not have to worry about shopping for breakfast items or where to eat out in the evening as our hotels have been lavish in their care of our gastronomic needs. We are not averse to using local public transport to see prime locations and sightseeing tours. Reception staff are on hand with advice. We explore our surroundings and pride ourselves on being able to cope in any situation.

This holiday involved an apartment in a sleepy village in a remote part of the Western Algarve. It necessitated car hire to enable us to get to our accommodation. Years ago we hired cars in France, drove into Italy without any difficulty. I possess sufficient French to read road signs, traffic warnings and ask directions. I can decode a menu and make myself understood when we arrive at our bed and breakfast.

This time there was a sudden realisation that my now slightly older partner had lost driving confidence and our ‘bottom of the range’ car was manual and inclined to lurch over every pothole – of which there were many. In France the roads are excellent but for the main part of this trip we bounced in and out of potholes and the lack of signs ensured we ended up on industrial sites and waste ground with increasing frequency.

It was the quiet season and there were few people staying on the complex. My partner became ill with what can only be explained as ‘plane flu’ within 48 hours, shaking so badly one night that I feared he was having a stroke. We felt isolated and vulnerable and silently vowed never to embark on another independent holiday at our age, especially in a country where we do not speak the language, where road and roundabout signs are notably absent and where we had no point of reference. No reception desk. No travel company rep. I quickly realised why so many people in our age group go on cruises. The idea was suddenly very appealing. Within three days we could not wait to go home. The weather was the worst the country had experienced in 38 years. I told myself that if the sun shone we would feel better but it only made brief appearances in the afternoons following mornings of torrential rain.

As the week passed we consoled ourselves that we would relax when we arrived back at the airport which, to some extent, we did but we were feeling fragile following further illness. The deep sleep I anticipated on our first night home did not happen and I entered a phase of ‘not sleeping’ night after night. As someone with Bi Polar I need comfortable set routines, relaxation and the absence of stress. Stress can affect me badly. So very quickly Anxiety came banging at the door. The insecurity and nine days of being on ‘red alert’ had damaged my usual state of living in the moment. I was constantly wondering whatever would happen next and this feeling would not go away on our return.

This attack has shown me why Anxiety is often referred to as ‘crippling’. I seem unable to act to move myself forward. Eventually, I visited our library, leaving armed with five or six books on relaxation, anxiety and combating depression. The librarian on duty knew me and my heart sank as I saw her expression when she logged the books out on my card. Once home, I revisited all the advice I have read repeatedly in the past. I always think there will be something new … The Answer … but no. I am thoroughly bored with myself. I have listed the fears and worries, rated them out of 10, re-phrased the worry into a ‘can do’ statement. I have gone for walks, breathed the fresh air deeply, returned to my yoga practice on my lounge carpet, put on stress busting CDs and everything else that they recommend. I am so bored with it all as I have been here before. But when Anxiety bangs at the door, I forget all my positive strategies. I forget what it is I do when I am well.

Every time Anxiety bangs at the door and holds me in its crippling grip, I tell myself ‘this will pass’. This, despite being unable to get up in the morning and face up to what is happening in my life. But one mantra beats everything and that is …

‘Deal with it.’

The worries may be simple and not something that would bring any normal person to a standstill but ‘dealing with’ these anxieties one by one is the only way to get out of this hellhole of a trap. I force myself to make the phone call that I have been putting off. I answer the email that has triggered some concern. I go out to the shops with a small list – anything longer is unmanageable. I list my outgoings aware I have financial worries which will not go away until I address them. I cancel some of my less-needed standing orders. I google ‘Anxiety’ and find some consolation and tips on Pinterest and the web. I go for a walk. I force myself to smile and say hello to strangers. I write down things I should be grateful for. I list my recent achievements. I write a To Do list. It is all exhausting but I keep doing it as I know …. it will pass.

It is all these actions which will eventually change my negative thoughts to positive ones and build up to bring me back to a state of homeostasis where I am relaxed and happy about life and willing to face up to what is ahead of me, no matter what.

I know it will pass. It is just knowing what to do while I am waiting that is the problem!