I didn’t know it at the time, but Rod was in the early upward spiral of a manic episode when I first met him in the summer of 1996. He was talkative, generous, had a self-deprecating sense of humour, enjoyed the local pubs and was very good company. But it didn’t seem quite right. He played music, always very loud; he liked taking baths at unusual times of the day and night; he was very much into the ‘significance’ of numbers; he drove fast and spent hours offloading various confessions (some trivial, others not so) into the early hours of the morning when all I craved was sleep.
There wasn’t much we didn’t talk about – his twenty-three years in the navy, including two and a half years serving on board HMY Britannia, retiring early with the rank of Commander, and his subsequent travels to Antarctica and the Middle East. There was nothing obvious to rouse my suspicions, and even though he mentioned his mother’s attempts to continue controlling his life – they were obviously very close even though she apparently still had the ability to irritate him over small things – I just thought that’s what some mothers do. I was fascinated by this person who had achieved so much but who had no whiff of pomposity or self-importance.
Not long after, Rod had to leave for a week in the United States. The day before he was due to fly out, Rod casually told me he was a manic depressive. That day I also learned from Rod that the severe injuries to his legs, with chunks of missing muscle reminiscent of a shark attack, were actually the result of a close encounter with a lorry several years earlier. I didn’t like to ask too many questions in case it was still a very sensitive subject and seemed ghoulish. It never occurred to me that the accident might have been deliberately engineered; only months later did I realize it had been an attempt to put an end to the excruciating mental torture that had developed during one of the most severe episodes.
Rod then told me that he had written a book which he would like me to read while he was away. The book, called Walking with Angels, introduced his ambitious mother, whose own potential had never been fulfilled and who then sought to succeed through her son. It was also a roller-coaster account of his time in the navy, burning the candle at both ends yet still being able to perform highly specialized roles in naval intelligence. Then came the exact moment when he first realized he was suffering from depression, triggered whilst working for an uncompromising Dutch admiral down a nuclear bunker nicknamed ‘the hole’ at NATO HQ at Northwood, Middlesex. Several more bouts of severe depression followed before Rod then became psychotically manic. The bizarre recollections of these episodes, especially those in France, swung me to and fro, from deep sadness to hilarity and back again. The book was impossible to linger over slowly. Written with such speed and momentum, it demanded to be read at a break-neck pace. This was the way Rod did almost everything, fast and furious, and I had to read it numerous times for everything to make sense and fall into sequence. On his return, Rod came to stay for a few days. Rod’s mood was definitely elated, and even though I had read his book, I wasn’t fully aware what this might be leading to. He was still taking his daily lithium, prescribed to stabilize his mood, but by now Rod’s drinking had leaped to epic proportions; all part, he said, of his programme of self-medication. His in-depth knowledge of the illness, obtained by talking to numerous consultants, reading and analysing Kay Redfield Jamison’s books and listening to others, was enough to convince me he knew what he was talking about, but I didn’t like what was happening. I now know that Rod was becoming psychotic and occasionally paranoid, suggesting friends, strangers and even I might be evil. It all seemed very much at odds coming from someone whose mood had just been lively and exuberant a few weeks before. With little sleep for the both of us for nights on end while Rod talked, played music and became increasingly ‘revved up’, I was beginning to feel stretched to the edge of my limits; I felt powerless to intervene and could not suggest an alternative, yet strangely, I never felt threatened or at risk at any time.
It had got to the point where I asked him to leave home, but then there was a call from his mother, informing me that Rod had been sectioned in Glenbourne, Plymouth’s psychiatric unit, and was asking to see me. I did as I thought any good friend would do and called in to see what had happened and what I could do, if anything, to help. There followed almost a month of severe depression. Rod’s animated ‘life and soul’ mood with the occasional flashes of psychosis had flattened out to become one of total tiredness and dejection. Various types of medication had been tried in the past and this time with a cocktail of different tablets, each one causing various unwanted side effects, Rod managed to come through, spurred on by the burning desire to fulfil another promise and help a friend get aid to Tibetan refugees in the Nepalese camps. Kathmandu must be one of the most inaccessible destinations for a man with very limited mobility, yet Rod, true to form, managed to struggle along and came back exhausted but successful a fortnight later. I realized that Rod could not ignore injustice and inequality in any shape or form.
We married on my birthday in 1999 with close family and friends present. Initially, Rod’s episodes were every one or two years, seemingly triggered more often in spring but occasionally in autumn as the days lengthened or shortened, and as the clocks went forwards or back, disrupting his sleep patterns and making him much more vulnerable to emotional highs or lows. At their peak, they could be terrifying and he would fly into rages, drive off with tyres squealing, dissolve into heart-shattering sobs. Occasionally he would self-harm and continue to suspect friends as well as total strangers of being ‘black angels’.
These particularly harrowing times were, I believe, made worse by the alcohol which was still part of his self-medication. He would seriously believe he was either the Archangel Gabriel, or a god from Norse, Roman or Greek mythology. He was particularly attracted to Mars and Thor, though even he didn’t know why. Brewers Dictionary of Phrase and Fable never left his side as he looked for reasons, connections, coincidences and number patterns that would send him into even more bizarre thought processes.
Rod would look forward to hospital: many of his friends would be there and instead of me nagging him into behaving at home, he had full rein to act out and play up to all his weird ideas. I had realized very early, especially after visiting Rod in hospital and seeing other patients who regularly came and went and were readmitted again soon after, that manic depression is never cured, it can only be treated with various degrees of success that depend on the sufferer accepting that there is a problem. Few will seek help in the rising stages of mania when they are all-powerful, all-knowing and hugely entertaining so, unfortunately, professionals will usually only see patients when they present on the deep downward slide into depression, making a true diagnosis that much more difficult. Once carers can be brought in to help recall previous patterns of behaviour, manic depression that may have gone untreated for years can be correctly identified and help offered. Before that point, it may be confused with substance abuse or diagnosed as just straightforward depression.
When Rod is well, which is now ninety-five per cent of the time, he will spend an inordinate amount of time trying to improve inpatients’ conditions, having been co-opted on to the Friends’ Committee of the local hospital and working as an inpatient visitor to the acute and intensive wards of the psychiatric unit. His own experiences and role as an impartial go-between have helped identify a whole range of different needs. One of his greatest interests is being included on interview panels for mental health service staff, imagining their surprise when someone they last saw as an inpatient is now well enough to be helping to decide their future.
In the last few years, while Rod’s episodes may have become a little more frequent, on the positive side, they are less severe. Although Rod still feels he is entitled to them, he has started to take control and tries to stop them before the mood swings take him into full-scale mania. He will talk about ‘parallel worlds’ and what I believe to be utter rubbish because I can’t understand it.
So in the last few months I feel at last that things may be changing for the better. After years of dreading Rod’s pattern of mania and depression, I may eventually be able to relax. It will be a huge relief to know that Rod has not only accepted the condition but has gone that much further. When things were at their worst, I would become a thoroughly unpleasant person, partly because I desperately needed sleep when it was the last thing on Rod’s mind. It surely wasn’t Rod that I detested but the illness that overtook him; the poor chap just happened to be in the firing line for my increasing irritability. Perhaps it was subconscious: by being sympathetic at the height of mania would I have been condoning his drinking which often caused total memory black-outs and a tendency to over-adjust his medication, in turn causing hallucinations. Could it have been a barrier to protect me from some of the unintentional hurt and worry I knew I’d be facing in the following few weeks? Did I know I would need to save all my resources of sympathy and understanding when the depression took hold, as it inevitably did? I cannot really explain, but after Rod’s most recent episode which he himself recognized very early on, I hope that this unkind side of me will never re-emerge.
We have both been particularly fortunate in that our local GP surgery and with it the team of community psychiatric nurses and consultants have always been tremendously supportive of Rod through all his stages of illness and well-being. Decisions on Rod’s care have been made by all those concerned, including myself, and everyone is kept fully in the picture so that when there is a problem looming, we’re all prepared.
I am immensely proud of Rod and his achievements, for the way he has overcome such severe physical and mental pain and damage after his accident, for his understanding of his condition and for his overwhelming desire to help others similarly afflicted. He has rebuilt his relationship with his son and daughter and has mounted a crusade to help de-stigmatize a condition that many people, both famous and unknown, seem to have to some degree or another, but are scared to admit to. He has given so much time to help carers and consultants, medical students and the media to realize that sufferers are real, functioning people who can be assisted in coming to terms with their illness, given a little more time and knowledge of manic depression. As Rod would say himself, there is no stigma attached to having a chemical imbalance in the digestive system, leading to diabetes. Why should a chemical imbalance in the mind, resulting in manic depression, be any different?
Excerpt from ‘The A-Z Guide to Good Mental Health: You Don’t Have to Be Famous to Have Manic Depression’
Jeremy Thomas, 2008