My upbringing conditioned me to believe that family physicians primarily existed to help us with physical problems. My Roman Catholic background conditioned me to believe that personal problems were to be endured and/or shared only at the confessional. In the 50s and for a long period of time, we did not have access to school or private professional counsellors or psychologists in our small northern Ontario community.
Having experienced a few traumatic experiences during my early childhood due to my father’s social drinking and resulting misbehaviours, I became quite a sensitive and anxious youngster. However, I was a very docile child, a good and assiduous student. As an adult, I began to realize that I had hidden many of my true feelings as a child, even though I genuinely felt the love of my parents and siblings.
I was also raised to believe and to feel that I had the inner moral strengths to resolve my own problems, without outside help. This was even though I dedicated my entire adult life helping other people to effectively deal with their own problems as a professional social worker. Quite ironic!
CREST.BD’s upcoming #TalkBD livestream will talk about the basics of bipolar, including what people who are just diagnosed should know. I’ve been reflecting on what I wish I had known to prevent my dive into mania.
Takeaway # 1: Seek out a compassionate sibling or friend whom you trust when you encounter stressful moments in your young life.
The only person who comforted me when I felt scared due to my father’s arguing with my mother when he occasionally abused alcohol was my six year older sister. And she’s still one of my favourite and most reliable and empathetic confidants.
Being the youngest of thirteen children, I considered my dad too old for me to confide in, so I turned to an older brother who was most helpful. However, he lived too far away from me when I experienced my most serious emotional and mental health problems to offer me some of his wise guidance which I most desperately needed at the time.
During my four years of attending a seminary from the ages of seventeen to twenty-one, I was in a “so-called protected setting”. For the first time, I was privileged to have access to a priest who provided me excellent guidance and a good listening ear when I experienced emotional problems.
Takeaway # 2: Sharing personal problems to a confidant does indeed further reveal our deepest humanity.
Being somewhat of a dedicated workaholic, (no pun implied), I experienced a work burn-out in 1974 when I was Chief Social Worker at the Northeastern Regional Mental Health Centre in Timmins Ontario. Previously to my joining this setting, I had worked six years in a Children’s Aid Society where I carried a mixed caseload of protective services, childcare, foster care, and adoption services. I was primarily assigned to fulfill administrative and community development duties rather than clinical responsibilities even though I had previously performed clinical duties on a sporadic level. At the time, I had been experiencing seriously stressful and profound problems with my first wife. Upon the recommendation of my supervisor, the Director of Psychiatric Services and my family doctor, I took a two month leave of absence. I was prescribed Valium which seemed beneficial. Upon consultation with a professional counsellor, I separated from my wife shortly thereafter.
“What would have happened if I’d been offered counselling services during these stressful times?”
Takeaway # 3: Do your best not to become an abuser of alcohol or unprescribed drugs. Never hesitate to seek help from professionals if you feel inclined to do so.
Other than some of the usual problems associated with a separation and eventual divorce, I managed to regain my daily functioning without overextending myself. I watched my diet, took martial art classes, nurtured my spirituality, maintained regular positive visits with my family doctor, and entered into a new mutually gratifying relationship which lasted twenty-four years.
This is not to undermine the problems I experienced during the separation and divorce processes, especially with regards to not being able to visit my two children when their mother had decided to move to Windsor, Ontario, some 637 miles from Timmins. Fortunately, I managed to receive regular reports from their dentist who became a friend of mine.
It was smooth sailing thereafter. Even more so once my eldest son, who had just turned sixteen, received his mother’s permission to call me after seven years of only being able to obtain news about their development/progress from their dentist. By this time, my new partner and I had moved to Kingston Psychiatric Hospital where I became the Director of Social Work and Coordinator of Community Development Services until I took an early retirement in August 1998. Prior to doing so, I had volunteered for a seven month assignment with the Provincial Ice Storm Committee of 1998, monitored by the Ontario Ministry of Municipal Affairs as a representative of the Ontario Ministry of Health.
I had good experiences in Kingston. I even established my own Martial Arts Club which I operated until I moved to Ottawa. I remarried in 1977 and we lived in the country from 1988 to 1998 on a lakeshore which was very good for our health. During this time, I managed to see my two children more frequently. I was thrilled when my eldest son told me he was moving to Kingston to attend Queen’s University where he has now been working for many years, thus giving us the opportunity to meet much more frequently. My youngest son works in Toronto as an elementary school teacher and even though we don’t meet as frequently, we maintain regular contact through other means.
Takeaway # 4: Accept Mother Nature’s gifts of nurturing your being. Take walks in her forests, in her parks; admire her incessant beauty: her sky, her clouds, her sun, her moon, her stars her flowers, her animals, her insects. Go canoeing, sailing or swimming, etc. Let Mother Earth embrace you and, in turn, protect her.
I continued to meet my doctor regularly primarily to control my blood pressure. Unfortunately, my wife became ill in the last 80s and that, plus two other incidents the nature of which I can’t reveal, took a heavy toll on me to the point that I experienced a mild depression in 1992 and 1993 during which I didn’t receive any medication, but still saw my doctor on a regular basis. I never told my doctor about my problems, nor did she ask if I had any. She simply took my blood pressure and checked my other vital signs. In all fairness, I should have maybe been more open with her about my personal problems. Being a professional social worker and strongly inclined to be a self-sufficient person, that may be the reason why I didn’t confide in her. Or were shame and stigma gnawing at me? But what would have happened if I’d been offered counselling services during these stressful times?
Takeaway # 5: Never hesitate to share your feelings with your doctor or a trustworthy confidant.
Takeaway # 6: Trust and believe in yourself. You are in all probability much stronger than what you believe yourself to be. Never lose hope! And nurture your good sense of humour.
Takeaway # 7: Expect your doctor or your confidant to attentively listen to you, although they may not be able to give you concrete advice on how to improve your situation, but never underestimate their capacity to do so.
In 1995 and 1995, I once again felt mildly depressed. I began to overreact to my wife’s illness and the stress became too much of an emotional burden. However, I survived this episode by concentrating my energies into my work, but continued to watch my diet, maintain a beneficial exercise program. But even then, I never confided my problems to my doctor or a confidant.
Shortly thereafter, I dove deeper in my creative writings, prose and poetry, which had spontaneously began in 1993. This hobby consumed more and more of my time, even interrupted my sleep patterns. I became fascinated with the Chinese Theory of the Five Elements (Wu Hsing) which brought me to believe that I had discovered a possible source of understanding and interpreting the meaning of languages regardless of its source.
Takeaway # 8: Keep a close eye on disruptions of your sleep patterns and of your suddenly expanded bursts of creativity. These may be precursory signs of advanced hypomania or full-blown mania.
I had literally plunged into a hypomanic phase, on the fringe of mania, but I yet managed to function at work relatively well and socially with friends and strangers alike. However, many erratic behaviours and decisions of mine caused irreparable damage to my marriage. My wife could no longer put up with my “shenanigans.” I continued to meet regularly with my doctor, but never shared any of my personal problems with her.
Once this doctor retired, I was transferred to another doctor who provided an extensive listening ear to me. I met with him every third week. After listening to what I was experiencing emotionally, he told me that I was in all probability a “spiritual transformation”, and that my wife and I were on “two separate levels, like two ships flowing in opposite directions.” He even went as far as suggesting to me that I should meet a psychiatrist who worked at the Mood Disorder Unit of the Royal Ottawa Mental Health Centre to get a better idea of what I was experiencing.
I did so shortly thereafter, but after having listened to me for about an hour, he never acknowledged that I was experiencing some form of bipolar disorder. Upon the advice of my Kingston family doctor who believed I was going through a major life crisis transformation, he suggested that I voluntarily meet with a psychiatrist who worked in the Affective Disorder Unit of the Royal Hospital, now known as the Royal Ottawa Mental Health Centre. Because of the high degree of respect and trust which I had in my personal physician, I agreed to follow his suggestion.
“This psychiatrist never told me that I may be experiencing hypomania. The term bipolar disorder was never mentioned.”
According to this psychiatrist, he did not told that I was experiencing a major mental health problem at the time. I guess that I must have been extremely convincing or quite skillful in hiding my present deteriorating state of mind. In retrospect, I consider this to be typical behaviour for someone in the midst of a progressively increasing hypomanic episode or alternatively, I may not have wanted to hear nor understand what he was trying to tell me – the real truth about my mental state.
Shortly after this visit, I started to write poems for different staff members on my own time. Some enjoyed me doing so. Others didn’t and complained to my supervisor, the Chief Psychiatrist. In the fall of 1997, he and the Head of Personnel Services expressed their concerns about my rather “unusual” behaviour. It was recommended that I consult a psychiatrist of Queen’s University which I did. After listening to me, he prescribed “olanzapine”, a psychiatric medication to control my increasing mood swings. Because my disorder was swiftly progressing and I was in full denial, I became quite angry at my wife for supporting my supervisor’s recommendation that my mental state be assessed by a psychiatrist.
However, this psychiatrist never told me that I may be experiencing hypomania. The term bipolar disorder was never mentioned. I don’t recall being given a follow-up appointment. Nonetheless, accompanied by my wife and eldest son, I picked up my prescription, but never took any of these pills.
Takeaway # 9: Take your pills as recommended by a psychiatrist and ask him/her why you need to take them, and what some of the side effects may be.
In January 1998, in anticipation of taking an early retirement from the Ontario Public Service scheduled for the end of August of 1998, I accepted a secondment to the Ice Storm Recovery Unit under the supervision of the Ministry of Municipal Affairs. This Special Unit was composed of staff seconded from different ministries. This secondment turned out to be a very gratifying and validating experience for me. I made new friends and even permitted me to open myself to another one of the team members who listened to me and greatly helped me with her words of wisdom.
I did my best to further control my behaviour and more closely monitor my health by frequently visiting my new family doctor whom I found very helpful. I was more discreet at work but kept on doing more creative writings which greatly bothered my wife. I even went as far as burning many of my creative writings which didn’t seem to appease her. Our problems of communications mounted dramatically between us to the point of my wife leaving me in late August 1998. Neither one of us felt strong enough to cope with the high degree of stress we were experiencing. We were both drained.
Takeaway # 10: Reach out to friends. Some will understand what you are going through. Some may have already traveled a similar journey.
Following the end of my involvement with the Ice Storm Unit, “all hell broke loose.” My hypomania exploded into a manic phase, with a gradual increase of all its classic symptoms to the point of psychosis in September 1998. When I moved to Ottawa during the fall of 1998, I met with a new family doctor who, once he became aware of my bizarre behaviours, thought I was displaying symptoms of schizophrenia. However, no medications were prescribed and no suggestion of a referral to a psychiatrist for an assessment was ever mentioned. We continued to meet regularly to monitor my blood pressure.
Takeaway # 11: All doctors should receive extensive mental health training in Medical School. This sure would have been most helpful for me. On the other hand, if I would have been more willing to share my deepest emotions and thought, he may have referred me to a psychiatrist or prescribed me appropriate medication.
Having not received any additional much needed guidance and support from professionals, despite my erratic behaviours, I was apprehended by the Ontario Provincial Police for allegedly making death threat to a “so called friend” residing in Gatineau, Québec in early December 1998. I did not offer any resistance whatsoever. I spent a night in jail at the OPP Office in Kingston. I was later picked up by the Gatineau Police where I spent a weekend in their jail before being transferred to “La Prison de Hull” following a brief court appearance, accompanied by a lawyer. I was then transferred to a locked ward of “L’Institut Pierre Janet” for a couple of months after being declared mentally incompetent to stand trial.
Takeaway # 12: Never resist a police arrest. If you suspect your rights are being infringed upon, contact a lawyer as soon as possible.
And this is where I heard, FOR THE FIRST TIME, the magical term, bipolar disorder. I soon received the diagnosis of“bipolar 1” which the psychiatrist clearly described to me what this term signified based on my past history, recently and currently observed erratic behaviours. The staff of this Institute provided me excellent care both during my inpatient and outpatient stages. It took me about a year and a half to gradually recover from this journey, which, thankfully helped me to rediscover my true self as a human being.
During and following my psychiatric hospitalization, I discovered that a paternal uncle had resided in a psychiatric hospital for a long period of time and another paternal uncle for a shorter admission. In addition, I became much more aware that other members of my extended, even immediate family also experienced severe mental health problems such as depression, hypomania and mania.
Takeaway # 13: Families should be more encouraged, through public mental health programs, to recognize early signs of onset of mental health problems without having to cope with the damaging issue of stigmatization.
Takeaway # 14: All health professional schools, even legal educational settings, including the public at large should receive adequate information regarding the prevention of mental health problems.
Takeaway # 15: Humbly welcome and accept the assistance being offered to facilitate your chances of recovery.
Raymond D, Tremblay, (Ottawa) Submitted to CREST:BD on February 17, 2022
About the author: Raymond Tremblay
Raymond lives well with bipolar disorder. He is also a prolific writer, having self-published more than 25 collections of poetry, largely on issues of homelessness. Raymond has a strong affinity to social welfare issues. He has had a fruitful career with both municipal and provincial organizations, including the Ontario Ministry of Health, based in Kingston Psychiatric Hospital, where he served for 20 years as, first, Director of Social Work Services, and later, as Coordinator of Community Development.
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