This is the 4th post by Anna on being a carer. Earlier posts are The Depression Dialog, Know the Enemy and Trigger Unhappy.

I’ve been asking James to take our old mattress to the waste dump for about 4 months. Today, I decided enough was enough. I asked an understanding friend (whose husband also has depression) to help me transport it. She has a car with roof racks. It took a while but we got it onto the roof, and tied it down with baling twine. It was not exactly satisfactory, but James had taken the rope to work and left it there.

So we drove that way and the mattress stayed on for about a mile before sliding. We checked it, and checked it again, and continued like this until we were nearly there, when a truck passed us with speed and the mattress flew off altogether. (Queen size by the way.) The twine was still intact, but the mattress handles were shredded. So we eventually limped in to the dump, mattress carefully balanced on top and hazard lights on. It was a funny experience and we had a lot of laughs.

I’ve written about this because it says a couple of things about how I handle my role as a carer.

Know the limits of what your partner or friend can do
Removing a mattress was overwhelming for James. He put it off, and ignored it, and put it off some more. The reason was that the task - mental as much as physical - was insurmountable to him. It’s quite different from laziness, as anyone with depression will know. But the mattress was stopping me from getting to my wardrobe and it had to go. My frustration was building up, despite knowing what was going on in James’ mind. I decided to just do it myself rather than let it become a big issue. That’s not to say I’m being a doormat. When I stop and think about it I recognize what’s happening under the surface and take a practical approach.

My support network is crucial
I have a small network of friends who will help me in this sort of situation. Through bitter experience, I know that some people are understanding about mental illness and others are not. My close friends are. I also know not to wear them out, so I share my problems around. They give the emotional support I need when I’m not getting it at home. They let me vent, they help me in practical ways, and they still share good times with me. They also think highly of James even though they know how awful he can be. That’s very important to me. I’m very fortunate as a carer to have supportive people around me. I know that many people are struggling along without much help. I can’t emphasize enough how important it is to develop those supportive relationships, for friendship, for emotional support and for practical help for things like moving mattresses.

My mental health is crucial
I have to be proactive about having time out, having a break from the intense times, and even some fun. I used to feel guilty about this, but it’s actually wise to keep looking after your own health. My family are good with giving me practical help, like taking the kids, when I need to do something on my own.

Learn to forgive and grieve
It’s easy to feel sorry for myself, but I’ve learned to forgive and move on. James forgives me for a lot of things too; it’s not a one way street. I’ve had to mourn the life that I thought James and I were going to enjoy together. He is not at all like he was when we married. But I always remind myself that I should be thankful for what we have, and what I have, and not dwell on what we don’t have, and to pray on all occasions.

Click here for the fifth and final post in this series, Loving the Person You Care For.

This is the third post by Anna on being a carer. Earlier posts are The Depression Dialog and Know the Enemy.

I used to get so mad with James when he had major mood changes. Trivial little things seemed to set him off, but I saw no rhyme or reason to the whole mess. I staggered from one day to the next, not knowing what was coming, feeling like a punching bag.

In my last post I wrote about the diary I kept for 2 years; it was the key to working out what caused James’ mood swings. We made some breakthroughs just by reading it back from time to time, but most progress came from charting the data in an Excel spreadsheet. This gave us a clear, visual way to see the relationships between triggers and symptoms. We discovered a couple of major depression triggers this way, and also found that small things that were minor irritations would snowball with other events added in.

The trick for us was to discover which triggers were the most important ones, where the threshold was before they would have an impact, and what we could do to reduce their effects.

Here’s an example. We used to have a busy social life. Through my diary, I began to notice that 2 days after a meal out, James would spiral downwards very quickly and experience a period of depression for 5 or 6 days. It was a very strange, but consistent pattern. We eventually discovered that certain food additives were a trigger; things like preservatives, artificial colors and artificial flavors. Adjusting our lifestyles and upending our diets was difficult, but by doing so we pretty much eliminated one of his major triggers.

Another example is our “feral hour”, around dinner time when the kids are tired, hungry and cranky. Very loud noise is another trigger, since it causes James to become very irritable. If it becomes all too much he will disappear until the kids are calm again. He can now recognize when his irritability is rising, and so takes preventative action. The key is that we have agreed that he can do this when needed, so I don’t feel resentful for lack of help. Leaving me to handle “feral hour” alone is better than suffering another bout of depression.

This knowledge continues to be very helpful to us. We know the little things that can snowball, and we take action when, or before, these little things happen. It’s a preemptive strike, so to speak. Whenever a trigger or potential trigger comes along we have a specific plan to remove its effects. As a result James’ depressive and manic episodes have become more intermittent.

Click here for the fourth post in this series, Keeping Your Mind Together.

A conference call focusing on bipolar disorder was held during the week, hosted by Tim McCann from Revolution Health. It is available as a podcast from the Revolution Health website.

It is an interesting, wide-ranging discussion on bipolar disorder, that touches on many subjects that are worth pursuing. There is a small section at about the 45 minute mark, on being a carer of someone with a mental illness, which ties in nicely with our current series of posts.

In response to a question by Therese Borchard about being a carer, Stephen Propst from the Depression and Bipolar Support Alliance made some excellent points.

• There is no substitute for education about the illness. This is critical for the carer, in order for their subjectivity about the person to be replaced by objectivity about the illness. Understanding the illness and the behavior it causes helps the carer to separate it from the person.
• Mental illnesses are not solved in the short term; they present a long term problem. A carer has to have patience to stay with it over the long term.
• Carers need to look after their own well-being, to remain effective and minimize their own difficulties. They need to set boundaries with the ill person, and enforce them.
• Carers should never give up hope.

Anna’s next post is on recognizing and reducing the triggers that affect the person you are caring for.

This is the second post by Anna on being a carer. Click here for the first post, The Depression Dialog.

Know the enemy. Sounds awful, doesn’t it? But I’m talking about the illness, not the person who is sick. When that dawned on me, that the illness is the enemy, I started to have more control over my anger and resentment. Why? Because I had something I could fight, and yet still love my husband James. I’m not saying that he isn’t responsible for his behavior; but I could now explain it, or most of it, by his illness.

Our third child was born in 2003 just as things were at their worst. James had left another job, he had a go at crashing his car, and our other kids were showing signs of distress. I had to think about leaving him for a while to protect myself and the kids emotionally. I felt alone, scared for our future and worried sick.

It was at about that time that he was diagnosed with bipolar, which prompted me to thoroughly research depression and bipolar. There is an awful lot of junk out there, so I sifted through until I found some great sources. Then I learned as much as I could. The best thing about this learning process was a much better understanding of the illness, so I was less frightened and more assertive in handling his behavior.

The resources that I relied on most are:

Loving Someone with Bipolar Disorder by Julie Fast
This book helped me more than any other. It is written for carers and has great, practical solutions, especially in the area of talking to each other. James was on board with the idea of trying the suggestions in the book so that helped. Most of the content is readily applicable to depression.

It’s a love it or hate it book. I love it. I’ll write a review as the last post in this series.

Dealing with Depression by Gordon Parker
I continue to rely on this book for my medical understanding of mood disorders. James reviewed the book in an earlier post.

Black Dog Institute
I use this website for finding all kinds of reliable information on mood disorders. The Black Dog Institute is headed by Gordon Parker (above).

The next break through was keeping a diary of James’ moods and things that happened each day. I did this every night for almost 2 years. It sounds a bit keen I know, but it was also therapeutic. After only 3 months or so, I was able to see patterns of behavior emerging. His illness was looking somewhat predictable! The progress over those 2 years was very slow, but just having some noticeable improvements gave me hope. I could stop living from day to day, wondering what would hit next. Also, and even better, I was able to see what was triggering his mood swings. Things like certain foods, certain people, and certain social situations.

Armed with this knowledge we started changing our lives to avoid triggers. This is an ongoing process, but James continues to get better. We completely removed some problem triggers so they no longer have an impact, and he also copes better with the triggers that remain. I hope that we don’t sound perfect. The process is ongoing, and there are still many times when bipolar ruins things. But now that I know my enemy I can “attack” it, and get on with being James’ wife.

Click here for the third post in this series, Trigger Unhappy.