Five years after the bipolar diagnosis of someone close to me, two years into a happy marriage and six months after quitting my job to pursue a long-held wish of being an independent journalist, my mind started to play tricks on me.
I have switched between being a primary and secondary caregiver to a family member battling a debilitating mental illness since 2014, and suddenly it was catching up. Nothing was good enough, nothing fell into place and nothing turned out as I had expected. Taking care of someone who had a tendency to skip medications, experienced yearly manic episodes and dealt with addiction issues felt like a constant uphill climb. There is no getting better or worse; it is what it is. I could go on week-long meditation retreats, be patient or spend all my savings on medical treatment, but nothing changed. Finally, I took an appointment with a psychiatrist for myself.
Caregivers are repeatedly told to maintain a schedule because the one whose mental health is compromised will benefit from routine. But, timetables are a house of cards when neurotransmitters are imbalanced. And yet, routine building persists. This exercise can turn the caregiver into a control freak, or rigid beyond repair, or simply anxious. All three happened to me. The psychiatrist told me, “You have caregiver’s fatigue.” He advised, “Be like a journalist. Observe, don’t absorb the trauma.”
Caregiver’s fatigue usually does not need to be treated with prescription drugs. It calls for a life-altering practice alien to most in the early stages of caregiving. The psychiatrist called it ‘drawing boundaries’, prescribed cognitive behavioural therapy and directed me to a psychologist who would charge ₹3500 per session. It was an exorbitant price to pay when one is just starting out as a freelance writer. I didn’t need medication and decided psychotherapy could wait.
My decision, to some extent, mimicked the behaviour of the person I was caring for. Caregivers are used to hearing—“I stopped medications. I don’t want to be dependent on them for the rest of my life.” The side-effects of medicines include trembling hands and weight-gain; indicators which fuel the decision to reduce dosage or wilfully stop taking them without informing anyone.
I was doing something similar. Instead of meeting a psychologist, I was satisfied with the bursts of dopamine when my story pitches would be accepted, or the serotonin rush on short trips to the mountains. On the flip side, there were episodes of burning rage, numbing migraines and long periods of inaction.
Few months later, I fixed an appointment with a therapist and as a regular diagnostic procedure for psychological assessment, I was asked to fill the Millon Clinical Multiaxial Inventory (MCMI) II form. The results predictably revealed severe anxiety, but two words stood out: ‘psychopharmacotherapy recommended’. In other words, medication.
Despite knowing better, I found myself chanting, “I will not take medicines.”
“You don’t need medicines,” said the therapist and started with cognitive behavioural therapy. The months that followed passed in a whirl of thought-challenge exercises, belly breathing practice and above all distancing myself from the family member with bipolar. By that time, I had switched from being a primary to secondary caregiver, but the need to check on them at least with one phone call a day remained. “Stop that,” said my therapist. Her advice was to not speak to the patient if I was anxious.
“But, it’s my responsibility,” I protested.
“You are your responsibility,” she said.
“But I can gauge their mood better,” I said.
“What about your mood?” She questioned.
“But this person is in the hospital,” I fought back tears.
“Here, drink a glass of water,” she said.
Water is my xanax. Sometimes it’s lemonade and at other times it’s sickly sweet Mangola or hot chocolate. A month ago, when I got a call saying this family member had set fire to their clothes, a sure sign of a manic episode, I craved ganne ka ras. Sports writer Rohit Brijnath compares caregiving to long distance running in a story for Lounge. My coping mechanism leads me to water. I have learnt to focus on the sound of waves crashing against rocks during walks on seaside promenades in Mumbai. These sounds dissipate the clanging of a noisy mind.
Last weekend, I spent an hour speaking to my loved one, who is now recovering from an extended manic episode. We talked about setbacks, the money spent and the time lost. We discussed daily routines again and devised another plan to keep the mind steady despite the perils of chemical imbalance in the brain. We realised when it comes to psychological illnesses, paying attention to mental wellbeing is the only constant; money and time are smoke and vapour.