Never forget that you are my hero

Save this for a rainy day

For new readers, hello and thank you for joining.

To put you up to speed, I was diagnosed with bipolar disorder back in 2017. I documented my long and raw journey of fighting this illness here in Happilydepressed.blog. Despite repeated hospitalisations and endless cocktails of psychotropics, I was getting worse. Luckily, in 2019, my husband stumbled across a new approach to treating bipolar, a mix of rTMS sessions (repetitive transcranial magnetic stimulation), and life long high-dose Levothyroxine. If figures, bipolar patients suffer from a lack of Thyroid hormone due to a gene mutation that is compensated by high-dose thyroxine. Slowly but surely, and thanks to this treatment, I was able to regain my life back. For more information on this treatment approach and to better understand the link between thyroid and mood disorders, you can refer to this research article published in 2021 by my treating psychiatrist Dr Andy Zamar.


Last week, I tried reducing for the second time this year my dose of levothyroxine (from 700 to 650). My idea was that I might be able to function as well, now that I have been stable for a long time.

It started fine, I was ok. All of a sudden, hell broke loose without any warnings. I was bed-ridden, crying, not eating, and suffering tremendously. My negative thoughts were spiralling. Nothing seemed right. I even doubted my previous stability and all what I had achieved fighting bipolar for 5 long years.

I was aggressive, repulsive, talking in monologues and saying hurtful things. Three days in, I agreed to shower and listened to my dear husband, who was trying to convince me to increase my dose to the initial 700.

Soon enough, the dark cloud began to disappear and I found myself regaining the confidence I had lost.

I made a list of what I learned and what I should remember if I ever have another relapse. I try to give meaning to my suffering, and perhaps if I do, I will manage to avoid it in the future. So here you go, you might want to save this for a rainy day:

  1. NEVER UNDERESTIMATE BIOLOGY: As much as bipolar disorder is defined as a psychiatric disorder, it is really a genetic illness with psychiatric symptoms. There is so much one can do in face of a biological deficit. Ask yourself, am I fighting the right battle?
  2. HEALING IS RARELY LINEAR: Growth, development and healing are not linear phenomena. You do need sometimes to regress to move forward. I am not telling you anything new. Look at the big picture, not just at an arbitrary snapshot.
  3. REMEMBER YOUR PAST TO APPRECIATE YOUR PRESENT: Never forget where you are coming from. Be humble and grateful. Have you been worse? If your answer is yes, then try to get up.
  4. MENTAL WELL-BEING IS NOT A FAD DIET: Fast results fade fast. With perseverance you will reach your goals. When has it been any different? So hang in there and get back on track.
  5. LOVE YOURSELF WHEN YOU ARE LOW AND PLEASE DON’T CRINGE: Be kind to yourself. Being harsh, unrealistic, and idealistic won’t help you one bit now and you know it. Don’t make it harder than it already is.
  6. REMISSION IS NOT A RACE: Why compare to others? When was this a reason to move forward? Did it ever make you a better person? No? So, give yourself a pat on the back and praise what you know how to do best. There must be something you do well. Now, go do it.
  7. BE GRATEFUL (DON’T GRINGE): Count your blessings, and recount them. You should count them again, especially if you are feeling low. Imagine if the little (or plenty) you had disappeared? Believe me, it can always get worse. So be grateful and get up.
  8. BE HOPEFUL: As long as we are alive, as long as there is a place for hope. If you have been to the other side (no need for me to be more explicit to avoid any triggers), then you know that today is better than many other days you have managed to live. No one is telling you this, you know it in your bones. So get up.
  9. NOW GO COMPARE YOURSELF TO THOSE SUFFERING FOR “REAL”: If you think you suffering has reached its peak, and that you are in intolerable pain, get up and go see some real suffering. Visit a hospital, hospice, an orphanage, special needs school, or just walk in the streets of the less privileged parts of your town. Get up and go help others.
  10. YOU ARE A SURVIVOR: Ultimately, you are a hero. My hero. Waking up for some of us is already a huge achievement. So for my sake, get up. You have done it so many times before. I love you too much to see you not doing what you do best: When you fall, you get up again.

TBC

Thank you ❤️

I was diagnosed bipolar 5 years ago. My life was worse than hell. Suicide was constantly on my mind. I was lost, scared, and hopeless.

I have been given a second chance at life and for this I am and will always be eternally grateful.

I have been stable for two years now. When I say stable, I mean I have lived two full years without any depression or mania. This was simply unimaginable to me a during the peak of my illness.

My life is actually normal, with normal feelings; happy and not so happy all proportional to my circumstances. Perhaps the most precious thing that I earned back is to have dreams and ambition.

My ambition is to share my healing journey with others who cannot see a way out. My dream is to tell people there is hope, and that suffering is not meant to be eternal.

My dream is a big dream and I might not be equipped to fulfil it. I don’t know where and how to start and I let go of it many times. Just yesterday as I started writing this post, I felt that whatever I will write will not make enough impact, that it will be a small drop in an endless ocean…

I was happily surprised when I accidentally met two brilliant women, friends of friends during dinner later that evening. With small talk we started with the usual questions, and it led to the dreadful “so, what do you do?”.

I was never really good at coming up with a good answer to this simple question. I am a full time mother (yes, a stay at home mum), a psychologist (yes, I don’t practice anymore), and an occasional writer (yes, hence this blog).

I was asked about what type of writing I do and I always worry that I will be sharing too soon with strangers the very special nature of my blog. I worry that this would be seen depressing or simply uninteresting. But no, the universe sent me a clear message yesterday in the midst of my doubt. When I started describing my blog as a place where I write about my journey as a psychologist who has survived bipolar disorder, they wanted to learn more. A few minutes down, I tell them about levothyroxine and how it saved my life. It figures that both women have issues with their thyroid – and accordingly clearly understood me and my journey.

To be honest, 9 out of 10 times when I tell people about my blog, they start sharing with me their own mental health issues- or those of loved ones. No one is “safe” anymore. Unfortunately, the hype behind “getting help” does not really help everyone. Many psychologists tackle issues that seem important on the surface and fail to see the real problem. Not to mention psychiatrists that over prescribe and misdiagnose. It is a shame really.

When I mention that psychiatry as practiced today is an obsolete science, it resonates with most of people. When I talk about my experience with antidepressants, anxiolytics, and antipsychotics; people draw parallels. When I say that no one understood me at the time, or knew what was wrong with me, they relate.

When I tell them that bipolar 2 is a biological problem with psychiatric symptoms, I get their full attention. When I tell them that I quit all psychotropics, and now only take levothyroxine, they are in disbelief. And finally, when they know the very high dose I am on, they are in awe. 

I cannot say it loud enough, please don’t embark on the journey of taking psychotropics before you are a million and one percent sure you have exhausted all other options. Even then, read and ask questions. Make sure you educate yourself and know what current research says.

Join forums and follow blogs, listen to yourself and to fellow sufferers. Not all advise is medical grade, yes we can’t trust anyone, but stay open to new ways of healing. Many things won’t work with you, maybe the majority won’t, but you will find a way out.

Never give up. Set up email alerts for your disease and read them all religiously. Get the latest books and ask family or friends to read and summarise for you. Write your symptoms and your medication. Take notes of what works and what doesn’t. Believe that you can be better, even better than before.

To all my community, thank you for supporting me through out these tough moments. Thank you for being there listening to my rumbling mind that was faster than the speed of light. Thank you for not letting me end my life, for it is indeed beautiful. Thank you for trusting me that orthodox psychology and psychiatry were never the solution. Thank you for bringing my smile back. Thank you for allowing me to have dreams again.

Special thanks (not in order of importance or love): Hassan El Shabrawishi– my beloved husband and father of my two beautiful children. You are my beacon of hope, my rock, my inspiration and my magician. No words can describe how much I love you and how lucky I am to to have crossed your path 24 years ago. Ahmed Loutfy– my adored father: you have listened to me, believed in me and helped me every single day ever since. You are a living example of unconditional love. I am blessed and honoured to be your daughter. Doctor Andy Zamar– my brilliant psychiatrist: I owe you every single happy moment in my life since the day I met you; may you always find joy and peace of mind. Fatma Hamdy– my one of a kind mother in law: without your prayers I wouldn’t be where I am today. Thank your for never judging me. My friends– you were not only there for me but for my children, I love you for believing in me and never pitying me. I always saw myself the same in your eyes. My children– my illness robbed us too many days. Ever since, I make sure to be fully present, enjoy you, and watch you grow into two exceptional human beings.

Thank you ❤️

On raising children

Being a parent is a joy. It is a also a blessing. Parenting is fun. It is mechanical, and creative. It is demanding and exhilarating.

Being a parent means you are always on the clock. There are no days off, no working hours, and definitely no job description.

Being a mom is a whole different league. It is natural to many, difficult for all. Being a mom (and sometimes being a dad too), means that you have to be omniscient: you must know it all! You are a 24 hours caregiver, a cook, a cleaner, a storyteller, a nurse, a magician, an entertainer, a teacher, a driver, a policewoman, a judge, a coach, a love blanket, a problem solver, a listener, a worrier and a warrior…

All these skills come with the job. You either have “The Instinct”, read books, or learn as you go. We will be better in some skills, and worse in others. We will prefer some skills, and loath others. We will all eventually feel our way through the years and manage to our raise children into becoming independent beings with adequate skills to survive.

Yet, parenting doesn’t end there. Think of all the previous time consuming, physically demanding, repetitive and thankless tasks as basically the fun half of your job as a mother, as a father…

Parenting beyond immediate need fulfilment

So what now? My child eats alone, bathes alone, cleans his room, and studies alone. They don’t depend on me to drive them everywhere. I don’t wrestle them to go to bed, or to comb their hair. No more purées, teething, or boogie man under the bed. No more fighting over toys or sippy cups. No more diapers or wet sheets to change in the middle of the night. No more small feet to kiss. No more sweet baby smells. No more good night kisses. What could be more needed? Why isn’t my job complete?

Yes, I had forgotten to mention that a parent perhaps needs to be a psychic too!

I used to ask myself over and over again: are my children happy? Are they fulfilled? Content? How will they be as adults? Are they resourceful? Grateful? Resilient? How much can I teach them? What shortcuts can I offer them? How can I sooth them? What can I promise them? What problems will I be able to solve for them? What can I do to make them happy? How are my actions influencing the way the think, act and dream? What mistakes should I tell them to avoid?

The second part of parenting, doesn’t demand immediate attention. It is ongoing, endless, evasive, and intentional. It is about ensuring the psychological well-being of our offspring. How much nature and how much nurture is at stake here! Is a child inherently good? Born happy? What parts am I really screwing up? Can I fix it?

You got it. There is no straight answer to any of the above.

It is quite difficult to assess whether our children are happy, traumatized, anxious or fulfilled. What behaviors they will outgrow, and what will remain as a personality trait. We can’t know their future coping mechanisms, their resilience, empathy or whether they will grow to love themselves. Dwelling on these questions alone didn’t serve me much.

Parenting and mental illness

One not so beautiful wintry day, mama fell very ill. Mama could not even do the one percent of the chores of basic parenting. No more cooked meals, drop offs, help with homework, or bath time. Mama was in bed or in the hospital – almost always crying and in her pjs.

They weren’t the best times.

Years later, and without much details, and with a lot of effort and luck I got better. So much better that I could start thinking of the effect of my mental illness on my children. For more details on this journey you can refer to previous blog posts.

I was ridden with guilt, shame and of course fear. If I was scared before my illness of how “well” I was raising our children, now you can imagine how I felt. I knew that what they saw, what they lived cannot be forgotten.

I found myself taking a whole different perspective now that the “harm” was done.

We cannot undo events. They already happened. The question is, do we let all this pain pass without learning?

I still don’t know how to answer all of the above. Yet, children might as well be better adults now that they have witnessed within their family mental illness. I have to highlight though that despite how ill I was, I tried within my capacity at the time to shield them as humanly as I could from how I was feeling. But children are very smart at detecting and feeling things even if unspoken.

Parenting and transcending challenges

We talked with my daughter (as her brother was just a toddler at the time) and explained things to her. We told her about my illness in child-friendly words. We talked about depression, anxiety, and mood swings. We talked about neurotransmitters and the side effects of the medications I was taking. We answered her questions. We listened. We tried to make it more human and less scary.

I didn’t think it was enough, or that it would be useful. Like I said, this type of growth is not linear. Yet, one day my 10 year old comes back from school telling me her friend had a panic attack and that she helped her through it.

You can imagine how I felt at the time. How can she know what a panic attack is, how can she help another 10 year old breathe! How can she handle this with such a grace and à savoir faire that doesn’t match her age?

Although this singular event does not mean much in the grand scheme of things, it helped me put things into perspective.

Kids have a level of resiliency that is far higher than what we assume. They internalize negative emotions and it will show on a whole different set of behaviors. They could have trouble at school, night terrors, or start losing stuff. It will show on them in a way or another.

The key here is not to forget why they are “acting” this way suddenly. Connect the dots and don’t feel guilty. It won’t help. Don’t scold and punish. It won’t help. Understand and explain. This is a much better approach.

Work on yourself first as you are a priority. Yes, you are the sun and moon to them, and everything in between. You won’t help them if you don’t help yourself. There are good days and bad days. Try to achieve normality and mundanity as much as you can.

Show them glimpses of what used to be before. Explain again. Tell them you love them and always will. Make their existence a reason to live for. Never forget how much you love them or how much they love you. Tell them they are not the reason you are feeling this way. Tell them you will win this fight. You will do it just for them.

Believe in the power of love. Hugs can go a long way, without much words needed. With love and care they will feel safe again. They cannot be ignored or assumed too little to understand. It is better to say the truth, even partially, than leave it to their assumptions.

Parenting without a crystal ball

So yes, we won’t know if our kids will be happy when they grow up.

But meanwhile;

  1. Know that life works in mysterious ways: what could seem like a huge ordeal now and a real impasse, is in fact a hidden real opportunity for growth.
  2. Guilt and shame will make everything worse. Don’t feel guilty, and please whatever you do make sure your kids don’t feel it either.
  3. Build empathy during your interactions with your children. You need to show understanding,
  4. Perhaps the most powerful thing I have done with my daughter is telling her that each new experience gives her a new tool in her toolbox. Whenever she faces a challenge, she has to look in this toolbox for something that will help her navigate the situation. She has really good tools now that she uses regularly.
  5. Accept that your offsprings’ mental health and happiness is also beyond your control. You can’t be “responsible” for each single aspect. You role is to help, and not to control.
  6. Let them do their own mistakes. Many things are learned by doing and not by preaching, just like falling in love.
  7. Be there for your children no matter what. Say this out loud, repeat it, and then say it again. They have to know this on an organic level. They know you will be there to pick up the pieces. We all need someone to do that sometimes.
  8. Be the first one to cheer and root for them. Tell them you are and always be their number one fan.
  9. Understand that no matter how you look alike, they are independent and different human beings. They will have their own dreams and make their own mistakes. You won’t make an apple tree an orange tree. The sooner you realize this, the sooner everyone will be happy. Listen to their dreams and dream with them.
  10. Forgive and love yourself. Work on yourself. Be the better version. Learn from your mistakes and aspire for more. This is a precious life-long action that your children will see you do. Basically, let them learn by watching.

In short, we all tiptoe through parenting. Don’t be too harsh on yourself. The world wasn’t created in one day. Take a breath and make the best out of today instead of worrying about things you cannot control. Remember that each day brings new opportunities for learning and for healing. Enjoy the process, it is actually fun.

On waiting for remission…

Waiting sucks

Waiting sucks. Whether waiting for a bus; your turn in a public restroom; your birthday present; your dessert in a restaurant; or even waiting for yourself to finally fall sleep. Waiting sucks when you did well, when you didn’t do well, or when you didn’t do anything at all.

Waiting is seen essentially as a waste of time. It is the place between two radically different states. Waiting is ambiguous, monotone, and yet interesting,..

The interesting stuff lies between where you were before needing to wait and where you will be after waiting is over. It is like a twilight zone, where we discover things we didn’t know before…

How can waiting be active ?

If waiting were passive, life would be so dull. We wait all life long for things to happen: some of them we want and some we are very keen to avoid. We learn to wait as soon as we are born. We wait to be fed, cleaned and cuddled. We even wait to die…

Waiting changes as we grow. We discover sooner or later that our needs and wants are not instantly met by the world.

Frustration builds up as we face negative experiences where waiting was not just long, but led to an undesirable outcome. We resort to prayer, to superstition, to therapy and sometimes we end up in depression; waiting.

Waiting and expectation go hand in hand. The higher the stakes, the higher is the expectation associated with waiting. Waiting for a bus is unlike waiting for remission. The first is bound to happen (the bus will eventually come no matter how late). Yet, some other waiting is tricky. What happens when you wait for remission? For better health? For a better future? For a full life?

What to do while waiting other than waiting? What can be done before waiting to make waiting more bearable? What can be done to make waiting matter, so that it makes sense?

How can we wait for remission?

I have learned so far that waiting for remission boils down to two main factors. The first, is wanting to get better. (For the sake of simplifying things, we will assume that we actually and truly want to get better). Interestingly, the second factor is accepting not getting better.

It was so confusing to me. The more I wanted to get better, the more frustrated I became. After being frustrated waiting, I gave up hope, which definitely didn’t make waiting any easier or quicker.

Waiting is a skill that sooner or later we better learn to master, especially if we are waiting for something of such great value such as remission.

We could complain or wait in silence, while we are shattered internally with each second bringing us closer to the end of a bottomless void. We can swim in the darkness and sink deeper as the pain never lessens. This would not mean that we are accepting this reality, but rather that we give up. We give up hope, we can’t see any other possible scenario. This is it. And if this is the case, remission will never happen.

Yet, if we surrender, maybe things could change. We surrender to and accept the pain, the guilt, the remorse, the shame, the pity, the ugliness of it all. We accept the status quo while knowing that nothing stays the same forever. We need to know this in on our bones. Like seriously know that nothing ever stays the same forever. It is not over, until it is over. Repeat it, feel it, believe it, know it.

We should never give up hoping to get better. I always say, if I feel better for a minute now, next time I will feel better for two minutes, then three, then an hour and so on. Yes I will get worse, but then I will get better again. Hope cannot be taken out of a person unless they decide to give up. One single minute lived without pain, means more minutes will come. Just wait.

Bottom line

Wait actively. Listen to your soul and body. Don’t undermine your thoughts. You are still creative even if life is putting you down. You still have a mind, even if you are drugged down by the doctors. You know what it is that is really wrong with you. Better still, you surely know what is really good with you. Yes, there is plenty. You are just looking the other way.

Wait while searching. Dig deep, and take it step by step. Work on everything you know how to solve, and leave the rest to time. Work it like a puzzle. Your life is a giant Lego. Do the easy parts first. No one will fix you. You need to fix yourself. There is no perfect scenario. Life is not black or white. Accept being in the grey zone.

Make your bed, shower and eat real food. You can do that. Do your laundry and get a hair cut. Get back to this thing you used to like before. Was it writing , painting, composing, gardening? Pick up something you never had the chance to do before, but always wanted to learn or do. Make waiting count.

Don’t be the same person once waiting is over. You would have lost double the time. Either way you have nothing to lose.

The goal is to rediscover yourself beyond your illness. There is an “I” behind the illness. You are not the illness. Who is it who is waiting for remission? What will s/he do if they were not sick this very second? What would have happened if they hadn’t fallen sick? What is this bloody and agonising state trying to tell me?

Don’t wait for an answer. You already know it.

Think. Cry. Fall. Shout. Rise. Create. Pray. Write. Paint. Run. Sing. Build. Forgive. Love. HEAL

Make every second waiting count.

Forgiveness and recovery

The blog has shifted gears. My writings were sometimes exercises of introspection – reflecting my state of mind during my struggle with depression, anxiety, and bipolar disorder. Other times, I would write about what I thought was wrong with the medical system as it stands today; not seeing the person as a whole or just silencing and over drugging the mentally ill till they slowly lose themselves in an array of side effects and endless adjustments of dosages. I also wrote about misdiagnosis and malpractice, and how our lives could change just by being given one very wrong label or another.

In my last few posts I started sharing with you the lessons taken home. There is no pretentiousness or ‘I know better’ in my words. I try to repeat this one way or another because it is so important!

So here goes…

Today I want to talk to you about a pivotal moment in my recovery.

You know getting better is not linear. If anyone tells you so, then they either don’t know what they are talking about, or they are simply really very optimistic, or just they were super lucky and are the 0.01%.

Recovery has so many elements. Naive, I used to think about it like a finish line. It was actually more of a destination, and to get there you have to take a bumpy ride.

To recover, I of course needed be on the right medication. I was supposed to find stability. Yes little by little I didn’t have anymore mood swings. A small relapse here, a little adjustment there…

I relate to this as trivial compared to what I went through. I didn’t feel depressed or have this huge void eating me up; true. Yet, I felt surprisingly guilty. Probably not surprisingly.

I was not able to feel relief. Why aren’t you happy now? Good question! I was faced with two major problems.

One: the aftermath of what ‘I have done’ to my family witnessing all this suffering. Two: the immense fear of this ordeal happening again. Three: I know I said two but I also had memory issues, self-confidence issues, brain fog, and 20 plus kilograms to lose to fit in my old socks because of all the meds I was taking before finding the right treatment, tapper off a few others, and of course I had to reintegrate into society.

After spending time feeling stagnant in these negative thoughts, I talked to my psychiatrist who suggested that these signs are very well similar to those of Post Traumatic Stress Disorder (PTSD). In brief: the experience of illness is so intense that in itself it becomes traumatic and creates guilt, fear and flashbacks. Are you familiar?

He suggested I undergo a few sessions of EMDR – Eye Movement Desensitisation and Reprocessing therapy. It is non invasive, simple and fast method of psychotherapy. I was skeptical at first but I tried and It worked really well on my trauma. Highly recommend it if you find a qualified therapist.

Relief was not immediate. But at the time I decided that I needed to open a new chapter in my life if I am to recover. Again this does not happen over night. It is a process. You plant the seed.

How can I ask those around me to forget what happened if I am constantly thinking about it? How can I be ‘normal’ if I am living every moment waiting for another attack? How can I expect to be ‘forgiven’ if I cannot forgive myself?

Forgiveness was the magic word. And trust me it is everything but cliché. 

I had no choice. I internalized this and repeated it to myself for the millionth time. Mental illness could happen to anyone at anytime. Mental illness is not a choice. Mental illness teaches you how to be human and humane. This experience showed us all how we are connected and how we love one another and how blessed I am to have my family and loved ones. They also used to tell me the same, but you know guilt…

Before all this, I had to forgive myself for the pain I went through. I decided that I will allow myself the suffering that passed and say it is ok. I don’t judge you. You were hurting and you are fine now. Again, you water the seed.

I gave myself a pat on the back and a big hug for the long road travelled and I said it is ok. I looked at all the things I have learned. How strong I have become. How loved and cared for I was and how things could have turned much much worse.

I looked at my family hoping day in day out that what dwells inside my soul will reflect into my behavior. Little by little, things began to change, and a new normal appeared.

The seed grows into a plant.

My dear reader I decided to be kind to myself because I had suffered enough and I invite you to do the same even if you are not in recovery, or even if you are not mentally ill. We have all suffered one way or another. We deserve to live guilt-free.

Allow yourself the gains you have achieved though little they may seem; for today is a good day and we only hope we replenish the well a little more tomorrow.

What does self-care actually mean?

I talked in my last post about self-care and its importance to mental health and well-being:

Today I would like to elaborate a little bit and dig deeper and try to tell you what I really mean by this concept.

Superficially, self-care is really simple to understand. It entails taking care of yourself. If you google the term you will find diagrams and articles giving examples of self-care including eating well, good sleeping habits, going for a walk, listening to music, and so on… Basically, it is about any action you do to take care of yourself.

I of course agree with all of the above. Who wouldn’t? But I like to stretch the concept a little bit more to include some other essential elements to our well-being that we tend to overlook.

Self Care is about Self Acceptance, Self Forgiveness, and Self Love.

Self-care is also essentially about self-acceptance, self-forgiveness, and self-love.

If we don’t accept, forgive and love ourselves we will not be able to truly care and mend our wounds, and ultimately start unfolding to meet our true self.

My new year’s resolutions, my goals, were almost never achievable not just because I lacked the will and the motivation to reach them. I discovered it was because I was rarely true and honestly accepting where I was at; I was not forgiving myself for my “mistakes” and I was judging myself for “lagging behind”. I didn’t love myself wholeheartedly and doubted that I could ever achieve anything.

We also get dragged and pulled by negativity right and left. We are consumed by toxins and more importantly by toxic relationships. We spend hours tending to these tasks while we could be using this vital life energy on our beings.

Self Care is about using our intelligence and intellect; our senses and sensibilities.

Self-care is about using our intelligence and intellect; our senses and sensibilities. We know down deep inside what we need to develop; what capacities we lack in order to become stronger and more complete.

I discovered along the way that my anxiety would reduce exponentially when I would “work” on myself away from the attacks. I had to accept me and forgive me and love me.

Another attack was bound to happen. Anxiolytics had to be stopped – they were threatening my life; I was becoming “addicted”. At the time, pain equaled pill: it was unbearable.

Putting thoughts into compartments helped me a lot. I blocked the negative energy coming from outside. I protected myself. I set boundaries. This is very important in self-care and it is not selfishness.

Along with compartmentalization, prioritizing, labeling my emotions, and repeating that I want to be happy and that I can be happy were all part of the package.

I repeat that I am under treatment and that I am very lucky that I found a good one that works for me. The final result would not have been possible without it.

But for months during my illness I suffered from severe brain fog. I was not able to think clearly. It was the residue of all the bad chemicals in my system – yes even after I quit them. It was the strangest feeling. Still deep under the person was still there; the process was in place.

The real you is always there. Your beautiful self is there, whispering and waiting to be heard.

I am telling you this because no matter where you are at now in your journey it is never too late or too early. Despite the heavy meds you are taking, despite the pain and the rejection you are feeling towards yourself: you can stop, assess and reconsider.

The same goes if you just feel that you are not in-synch with yourself. If you feel you are unhappy, starting a mild depression. Stop. Assess and reconsider.

I invite you not to wait till it bubbles up into something that becomes more organic and more difficult to manage.

“There is no higher or lower goal. There is only one goal, Self-Realization”

Meher BABA [The Answer 26]

The importance holistic of self-care

Tear and wear as we approach our mid-thirties and forties not only gets to our bodies but also to our minds. 

Life has such a demanding rapid pace. It leaves us a few moments for reflection and decluttering. We rarely put ourselves first; we say, later, just let me finish one more thing first. We silence the rising alarm saying “I am tired” until we become unhappy and eventually psychically and psychologically unwell.

Small droplets form oceans. 

These oceans form because of events that are out of our control. Life is not easy. Yet, we are at fault too. We rarelystop, assess, and reconsider our strategies before it is too late. We ignore our intuition and end up caught in vicious circles leading to more physical and mental pain. 

I learned throughout my journey that in order to break free from negativity, it is imperative to decide to be self-critical and assume responsibility. One has to want to be genuinely happy, or at least try to. Being passive brings us no good. 

The wish is the beginning of the realization of the dream. 

Quite often, in conversations with people, I see how they are absorbed by hopelessness. They simply cannot see any different outcome. Circumstances seem like a life sentence. They don’t put themselves first and gradually become someone else. 

We carry too much on our shoulders, and we either give up or wait for things to miraculously change. 

We forget that our mental health affects our physical health and vice versa.

When we become emotionally unbalanced, we develop all sorts of illnesses. Our immunity weakens. Look around you. Chronic back pain, migraines, indigestion, weight problems, fertility issues… Dig deeper. You will probablyfind a lot of emotional turmoil too like sadness, remorse, fear, anger, and guilt. Later these develop into anxiety, depression, PTSD, and eating disorders. 

We might not be able to avoid everything. But there is always something we could work on: caring for ourselves. 

We cannot take care of others if we don’t take care of ourselves. 

Remember that a bad day will always end. Small real changes go a long way. Recognize the importance of yourmental well-being and know that some choices though hard to make are for your best.  It is never too late to be your first priority. 

Our mental and physical well-being are closely related. When we feel overwhelmed by physical pains, we should stop and think: is my body trying to tell me something? Is there a psychological reason for my physical suffering? Often, when we dig deeper, we discover that many illnesses are due to feelings of guilt, fear, and anxiety. Take a breath and reconsider.  As Jalāl al-Dīn Rūmī said, “What you seek is seeking you.”

 “What you seek is seeking you.” Jalāl al-Dīn Rūmī

Happy and no longer depressed …

Many days have passed since I have written.

Today is a happy day. I come with message of hope. I want to tell you that there is a possibility of getting better.

I have been well for over 8 months now and this is the longest symptom free stretch I live so far since I got ill.

It might not seem much. But my Dr. told me that after 6 months without bipolar symptoms I should start feeling less worried. It means I could start relaxing.

I am…

I want to tell you my medical regimen – I take 750 levothyroxine daily and supplement with omega 3. No more antidepressants, no more anxiolytics.

Bipolar is not treatable with those.

I do rTMS now as maintenance, at least twice a year.

My treatment has been life changing but it would have never been possible without the help and daily support of my family. My amazing father and my husband nursed me like a newborn. They believed in me; they knew I would get better. I am blessed to have a very solid support system with my immediate family. My mother in law took me in like her own daughter.

But in this post I want to thank one person specifically- for without him, I wouldn’t have been able to make it.

Hassan – you are a saint. Your patience and love were and are unconditional.

If I am alive today it is because you trusted my judgement despite my illness that the medial system as it is today is wrong yet still fought for a solution.

Night and day, with the children around us you would make me laugh, juggling work and trying to find a way out of this endless night.

Today, I would like to say that I am simply happy and no longer depressed.

Thank you for your endless love and unconditional love.

You were my sanity when my thoughts were gone.

You taught me that impossible does not exist.

I would like to take this opportunity to thank everyone who reached out during these difficult times and wrote to me or called me. Each and every single message brightened my day and made a difference; you wouldn’t believe how much.

And now… let me end my post by a quote from Rumi “ whenever we manage to find love without expectations, calculations, negotiations, we are indeed in heaven”

The importance psychiatric empathy and engagement in patient /doctor relationship

Today I had a routine FaceTime appointment with my psychiatrist. I wasn’t expecting much. We were just going to discuss the usual.

Yet, the first thing he told me

was “I read your blog”.

I was taken back for so many reasons. I had no idea he would have such interest in his patients, or have the time really.

What is interesting is that I had written my last entry on how I am suffering from the side effects of the meds I am taking, especially how I have lost hope, and how I feel disabled mostly because of the antipsychotic quetiapine of which I take a significant dose. Although I had shared this with him before, reading my words seemed to have had a different impact on him I would discover.

Yes. My doctor told me something I would have never ever have imagined any medical practitioner to ever say. He told me I have failed to treat you.

I could not believe what I just heard. First of all we are far from being done. I am still being treated. And I am a thousand times better my dear doctor than the first time I saw you. I cannot even find words to describe the state I was in when I first talked to you and you said yes I will take you as my patient. I could barely speak, yet you were able to translate my pain and understood me.

Today my doctor showed me how he truly listens to his patients. I had talked to him over and over again about reducing the dose of my antipsychotic. He had refused categorically on many different occasions and told me if I did I would relapse. He told me I had to bare the side effects and be patient. He was extremely worried about me.

Today however, he told me that he thought long and hard about my blog piece and decided to change the treatment plan.

He decided to change it to accommodate to my needs and because he had already increased during the past weeks my levothyroxine. [My treatment is based on three pillars: levothyroxine, quetiapine, and rTMS]. I had also a few sessions of rTMS as a back up before this new treatment plan. He also told me that if I don’t respond well to reducing the quetiapine, he would shift me to another antipsychotic. This was all I needed to hear. Hope is the most powerful medicine of all.

I am sharing this story today because it is really a breakthrough on so many levels. I rarely hear of anyone admitting or alluding that they are wrong or even questioning themselves really- especially if they have any kind of authority over you. Two, who has the time to read or listen or care about their patient outside of the 15 minute appointment slot they have? Who cares what they feel, like or dislike? I have seen my share of psychiatrists and usually when I start slightly feeling uncomfortable it means that the relationship is going south and the end is near my friend.

I have all the respect and admiration to you Dr Andy Zamar, a great man, extremely bright and sensitive.

Mind you this is just the top to the iceberg. My admiration for this great doctor has no limit.

I only hope that he has the opportunity to train other fellow psychiatrists.

Thank you for your humanity.

TBC

Bipolar, Quetiapine & side effects

Like many days, I was thinking today long and hard about mental illness. How it infiltrates the body and gets deep into it before you even know what hits you.

You wake up one day and you don’t feel fine. You probably ignore it. How long does it take to develop a mental illness? A few months? A few years? Extenuating circumstances? What do you think?

I was obsessed, trying hard to search in my memory looking for the one moment where I became bipolar. Was it a moment to start with?

I recall anxiety, difficulty coping with everyday demands, depression, but I don’t recall mood swings. I also don’t recall a moment or an incident.

Mental illness is not a common cold. It creeped on me a little by little until I was totally submerged and couldn’t breathe. Only then did I know I was ill. I did not have the tools to detect it earlier. How about you?

This is why recovery is difficult. The longer the illness before detection and treatment (whatever the sort- especially if they screw you up) the longer the road to wellness.

Now am better. At least I know what is wrong with me. I am taking meds that work, albeit the fact that they do have side effects. There is no drug in this world that has no side effect.

My thyroid is inactive. So I take a lot and I mean A LOT of levothyroxine without much trouble. My main problem is Quetiapine of which I take 700 mg. I have gained so much weight on it and can’t lose it. It makes me lethargic, slow, drowsy, and I could sleep on it 14 hours plus naps minimum.

Yes I don’t have mood swings. Yes I am not anxious. Yes I am not depressed. Yes I am not hypomanic. But I have no initiative, my IQ is probably half what it was before, I am just plain yoghurt.

Yes I know all them drugs alienate you. But this one is so subtle. Or maybe it is the high dose that is making me unaware of how different I have become.

You know I just want to be me. I haven’t been me since 2016 when I was 36 and now am 39 and am still this other person I don’t know.

Do you feel the same? Are you on Quetiapine? Are you suffering from its side effects like me? Are you thinking of tapering off? Are you scared? Did you do it? Is the grass greener on the other side? Your experience is highly appreciated here from a fellow survivor to another

TBC

Bipolar – my disability

My illness is flagrant. It is clear as sunshine. Bright as a star. Big as a 10 cart diamond ring. Obvious to the naked eye…

Yes it is when I have an episode.

But when I don’t…

It is dormant. Blends with the background. Goes unnoticed. Quiet common. Just like the flue. It is a John Doe..

I tend to forget, for am human. And we humans tend to do so. A lovely quality we have. Makes us able to live, to turn the page.

When my illness strikes back, am always surprised. It takes me a few days to adjust. As if it is the very first time am experiencing the symptoms. All fresh.

The pain is new, yet the depth of the scar is familiar. I remember the fear of falling into the abyss of mental illness with all what it means – more meds, more symptoms, more side effects, hospitalization, days in bed, fear of losing my mind, fear of losing control, fear of finally giving in to suicide…

Yet I know I can’t. Something tells me this cannot be the end. I recall the conversations I had, the notes I wrote, specifically for these moments to remind myself not to give in.

I try to summon my strength, the strength I have and the one I don’t, and pretend to stand up. I rise in my dream above myself, above my tears, above my hospital bed and tell my doctors to let me live some more.

But if you are ill like me, you will soon learn that living isn’t the point really. So what is the point of having a life with such an illness that makes hell a walk in the park? On average I get two good weeks a month and if am lucky we can stretch them to three.

I am heavily medicated, but at least the meds I take do work.

I got PTSD. I am being treated for it, but I feel mostly guilty all the time for how my illness affects my loved ones.

That’s where am at now with my bipolar. I cannot always embrace it. I don’t rise above it. I wish I could say it differently, bipolar is my disability…

The New Business Model in Psychiatry

I checked myself yet again at the hospital. It became my full time job really.

Shame on me, I ain’t strong enough to survive outside more than a few weeks. But is it really my fault?

Not more than 24 hours later, yes you know it, I checked myself out. I wasn’t scared of the environment this time. I liked the room. I even met a couple of people with whom I could have a decent conversation – shout out to K, L, N and N!

My problem was the medical body. My sessions with them were more of open ended questions like in qualitative research. I felt time had no essence to them. Like progress cannot be measured daily.

When I went to London, and I am not being payed to say this – if you only knew how expensive it actually is to get treated there out of pocket – every single word I said was taken seriously. Every little side effect was looked at. I was seen as a person; a real person and not a spoiled brat complaining for no reason.

Secondly, the doctors would not dwell endlessly on what to do. They took calculated risks. Because if they agreed to the status quo then nothing would happen.

I was always reassured and never ever did anyone tell me this drug or this method works for 20% of the patients. I was given hope – in abundance and also had the opportunity to chat with other patients who are now truly healed.

While I was completely fitting the box of patients in the clinic, my individual voice and needs were immediately heard.

That is why I felt I was wasting time at the hospital and that is why I left 24 hours later instead of staying for a whole 10 days.

My business teachers at university always said a good product or service starts by answering a customer pain.

Very well, mental illness is filled with customer pain; be it the patient herself or her family members.

I have been treated and admitted to hospitals both in Paris and Cairo. Although the settings could be strikingly different; there are major similarities.

Patients have little control over the course of their treatment; unless they happen to well read – and still that could be interpreted as a personality disorder.

Here, business people, here is a business model for you to follow. Instead of keeping the one patient coming back for 10 years, you can have thousands of them and most likely very happy ones too. Am no mathematician but get your excel sheets out and do the works. It doesn’t need a genius to tell you where the money is; and coincidentally health too…

TBC