Writer and mental health campaigner Rikki May recounts his difficult relapse last year and shares with us some of the invaluable lessons he learned.
What does relapse mean? To many, it means failure and falling back into a time in your life that you’d rather forget. The dominant emotions are guilt, sadness, hopelessness and, above all, frustration. Five steps forward, six steps back. It hurts so much and can seem like an overwhelming defeat.
In February 2014, I tried public speaking for the first time. For someone suffering from Generalised Anxiety Disorder, this was quite an achievement. My presentation was part of the University of Portsmouth’s first annual Mental Health and Well-Being Day and I talked of my tough, prolonged battle with mental illness from my teenage years all the way to my early twenties. I plucked up my courage to tell a crowd of strangers that I’d attempted suicide and spent a short time in a psychiatric hospital in September 2012.
At that time, things were going well. I felt like I’d overcome the cycle of weeks of depression, poor appetite and weight loss followed by periods of contentment and intense sessions in the gym. I had a wonderful network of people supporting me – a girlfriend, family, friends and colleagues. I was now in a full-time job that I loved and I was finally feeling consistently good – or at least level.
Then, one day in August 2014, my life deteriorated quickly, and I had no idea why. I felt as bad as I had when I’d admitted myself to St James’s Hospital two years before. I can’t recall the exact order that things happened during that terrible week, but I can vividly remember all the emotions I felt at that time.
I was suddenly feeling so down that I was finding it harder to get up in the morning. I eventually called 111 and the doctor asked me about my general health. From my answers he concluded that I was chronically dehydrated as I’d recently been taking hefty amounts of antibiotics after having a bad tooth removed. He had a theory that the antibiotics had “flushed out” the two types of medication I was on – anti-depressants and strong mood stabilisers. He advised I take an extra tablet of each medication and rehydrate myself with salt, sugar and water. ‘Make sure you eat something too,’ he added.
He then asked, ‘Are you feeling suicidal?’
‘Yes,’ I replied.
‘Are you likely to act on this suicidal feeling?’
‘No,’ I said.
He advised me to see an out-of-hours GP. The only way to do that on a bank holiday was to go to A&E, so I did.
I waited for two hours and was the last person to be seen that day. I walked into the office of a kind doctor and promptly broke down. I couldn’t hide my frustration that I’d relapsed so badly after making such progress. I told the doctor I’d attempted suicide before and that I’d rebuilt myself from the bottom. I told her that I was capable of rebuilding again, although I had no idea why I was here or how to interpret what was happening to me now.
The doctor smiled and said, ‘You might be in pain now, but I know you’ll be fine soon.’ She upped my medication dosage.
The days wore on. I remember feeling better for brief moments when, I guess, the medication was taking effect. My misery was punctuated by glimpses of hope and reason, when I’d know I was OK and nowhere near the mess I’d been in two years before.
I was referred to the crisis team for monitoring and checked in with them every other day for the next week. Each time I saw them, I felt more and more like myself. I soon understood that what I’d been through was a harsh and abrupt cold turkey-like withdrawal from lack of medication in my system. I left the hospital and explained what had happened to my line manager at Portsmouth University. I returned to work a few days later.
Looking back on my relapse, I realised that in no way did it make me a loser or a failure. People experience knock-backs all the time and in many walks of life – it’s inevitable. Depending on the circumstance, it can take a little while to get back up on your feet, but the right attitude helps
I could have stayed down on the ground for months after what happened, but I was adamant I’d return to normal life. I kept in contact with my doctor, even when feeling well again. I maintained a healthy diet, exercised regularly and made the most of my support network. I had a good working life and a positive relationship with employers and colleagues. I never touched drugs and I rarely drank. I got decent nights of sleep and took my medication every single day. I knew that by sticking to these good habits, I’d have the best chance of staying well.
If you ever find yourself in the same situation I was in, I’d like you to remember one thing: You are not a failure. Look in the mirror and be proud. See how far you’ve come on your journey. Reflect, think back. You’ve made it this far. You’ll continue to make it, too.
I’d like to offer some advice on how to prevent a relapse.
1) Acknowledge early warning signs
Although I couldn’t work out why I was flagging so fast, I knew I needed help. I couldn’t fight alone. If you’re starting to feel the same as you did at previous low points and your thoughts and behaviours are changing, then take note of these changes, don’t ignore them.
2) Continue to take your medication, even when you’re well
Medication is a big contributor to keeping you mentally well. If you’re starting to feel good again, don’t stop taking the meds. The side effects aren’t always pleasant, and I’ve tried coming off of quetiapine several times as I didn’t like its sedative effects. The conclusion I’ve come to now is simple: I’d rather feel slightly woozy in the mornings but try to make something of my day, than risk feeling low. Try to acknowledge the greater good.
3) Use coping methods
Find your passion and make it central to your life. My passion is exercise. I love it and I couldn’t do without it. In my opinion and many others’, it’s the best natural antidepressant out there. Ensure you get enough sleep too. Learn some relaxation techniques to calm yourself down and keep things in perspective. Play or listen to music, go on walks, meditate or visit a friend.
4) Identify stressful situations
I was co-presenting at a mental health workshop recently at the University of Portsmouth. One of the other presenters was an occupational therapist who explained the simple concept of “the vulnerability scale”. She talked about how life’s shocks and variables can stress us out no end. If at a particular time you have a lot of different things on your plate, you may be more prone to stress at that time than others. Everybody has a breaking point. It’s important you try to manage situations before you get to that point.
5) Manage stressful situations
Give yourself time and invest that time in doing whatever you want to do. Try to make sure that your expectations are realistic. It might be worth cutting back on certain responsibilities you have. There’s no shame in that. If you take care of what takes care of you, then you will be taken care of.
6) Seek medical help when these feelings persist
When things are extremely challenging, self-help/management may not always be enough. This is where doctors can help and there’s no shame in seeking that professional help. We can’t always make it alone. Mental health is a flaw in chemistry, not a flaw in character. It is certainly not a weakness.
Photography by Sarah Cheverton.