The List: Flashbacks and Failures

“Just write a list. It’s easy for somebody of your calibre. You could write a list right now.”

The last words she heard from the psychiatrist’s mouth as she tried to stand and gather her belongings and her dignity to respond. ”With all due respect, doctor, if it were that simple I would not be here.” The hot rise of despondency as words fell on deaf ears, and the tears fell too, too long held back. Gathering as many shattered fragments of her soul as she could, she stood tall, opened the door and walked, away, every fibre of her being wondering if she could survive another day.

That day passed in a blur, like so many before, hijacked by careless words and actions that her diminished state felt acutely. And she’s walking on the edge of the cliff. This is familiar territory as internal war wages. Go or stay? Go or stay? The two parts in full-scale battle followed by a stalemate freeze state, and then the day’s gone; plans sidelined like so many before. Timelines collapse and she doesn’t know if it’s then or now, or how she got here, or there, as traumas bubble in cells neither interested, nor aware, of time, past present or future, just now, and her body is struggling, her mind is struggling, her soul is struggling.

The spiral!
It’s luring her in.

Hit pause.
Breathe.
Reframe.

It’s been four years since I escaped the haze and maze of psychiatric medication.

It’s been eight years since the episode of mania that I’m still trying to recover from.

It’s the morning of the 27th of June 2025, and I’m sitting in the GP’s waiting room. Four years, to the day, being free of psychiatric medication, and I’m rattled. My brain is telling me that it is 2025. I can see very clearly by calendars and phones that it is 2025, but my body is jumping and hopping, trembling and panicking like it’s 2017. 2017, the year of mania and unspeakable terror, and try as I might to soothe, I can’t seem to return to any sense of safety. They call it PTSD in medical terms. I wonder, will I leave the appointment with a psychiatric prescription? A war wages inside me. I try to sit calmly.

Following that one episode of ‘mania’ that I am still working to untangle and integrate, and the severe episode of ‘depression’ that followed, I was referred to ‘community mental health’. I guessed at the time that I needed it given that I was now living with ‘Bipolar 1’. I was in such a medicated haze I didn’t really know what was going on. I was discharged from the hospital, and the private sector too, it seemed. It was March of 2018. My body walked up and down to appointments. My soul was somewhere else entirely.

I remember the first psychiatrist I saw there. I was at the lowest I’d ever been; the extreme low after the extreme high. Every breath felt a struggle; every fibre of my being hurt and even getting out of bed was hell. Not one part of me wanted to be alive. I had lost everything: my friends, my family, my dignity, my integrity, my hope, my spirituality, even my body felt like it belonged to someone else; slow, heavy, aching and with that ever-present slight lithium tremor. I was convinced I was about to lose my home. I had lost much of the contents, or discarded them rather, in fits of rage and fear, whilst I was ‘high’. I was a shell; living in a shell. I was the ultimate walking dead. She said, that first psychiatrist, ”You have PTSD from what happened when you were manic.” I think I still do!

That’s about all I recall from those early visits. There were blood tests for serum lithium levels; something about salt and water and toxicity. There were leaflets and the ‘day hospital’. I was almost bemused by the day hospital. I guess, in hindsight, the idea is to get people out of bed and out of the house and back to some semblance of a routine, but I felt dire. There was a morning puzzle, jigsaws with pieces missing, tea, and word games, cooking where I was shown how to cut an onion, walks on a Friday, and one or two of the days there was art. I liked the art. The other patients were mostly kind. The nurses were mostly kind too. I was a sedated slug. I needed to get back working. If I wasn’t able to successfully kill myself then I better get to work because I knew I was not fit for the streets, the streets I was fully convinced were beckoning me.

By May 2018 I had secured a new job; a fresh start. I still have no idea how I mustered the tenacity for that. I threw myself into it and found some spark in the caring of others. I began volunteering with a charity that visits elderly people in their homes. I joined a local choir. Bit by bit I began to rebuild something resembling a life, trying so hard to be something resembling a human.

I kept attending the service. Doctors came and went. That first one left and was replaced by a lady the same age as I was. What an odd pairing we made. ‘Friendly’ chats interspersed with strange power struggles. Lots of the appointments blur into the others, days become weeks, become months, become years, but some stand out, none more so than ‘the rather curious incident of the contraception and the paper clip’. It was during a period of relative stability and I was getting ready to leave a consultation when this exchange ensued.

“What contraception are you on?” she asked.

“I am not on any,” I replied.

“Why not? You need to be on contraception,” she continued.

“Because I’m not currently sexually active. If that changes then I’ll consider it,” I responded, becoming slightly agitated. I was holding a paper clip in my hand that I had picked up from the desk in front of me earlier in the appointment and was fidgeting with it. This was not unusual for me. I tend to be restless by nature. I was bending it back and forth and it broke in my hand. I was looking around for a bin to put it in when she continued with:

“What if you are attacked? You need to be on something. Lithium will make the baby deformed.”

I was aghast. ”Why would I be attacked?” I asked. ”Is your assumption that because of my past traumatic history, I am at greater risk of being raped or sexually attacked?”

I don’t recall what she said next. I do recall the wry smile and my pressing and panicked pull to get out of there as soon as I could.

In a subsequent appointment there was a sideways apology, a claim that she was scared as I had a ‘weapon’ (the aforementioned paperclip), and the statement that she finally “got to see the PTSD.”

It wasn’t great; but it wasn’t all bad either, given where I was. She wasn’t all bad, and I wasn’t all good, or bad. If only it was that simple. I met some wonderful people there from all the different disciplines from the home care team, nursing team, social workers, psychologists, occupational therapists. I had a serious suicide attempt in late 2018. I remember the general hospital and the move to the psychiatric building with all the locked doors. There was something black in the toilets. I learned later I had been sectioned. I had thought I was there voluntarily. I remember seeing that doctor walking around. Perhaps it was her who discharged me back to the community. I don’t remember.

I kept attending appointments.

I did some Caminos in Spain and met some wonderful people during 2019.

I kept attending appointments.

I was a bit ‘toxic’ then I wasn’t.

I carried medications with me at all times.

I changed jobs.

I kept attending appointments.

Fast forward to 2020 and I had another bit of a wobble early on in the year. It led me to the general hospital but 70+ rivotril wasn’t serious enough for the psych ward, thankfully. Soon after, by my recollection, that doctor moved on. Yet another took her place.

She seemed interested. We met in a larger room to allow space between us as the world was in the midst of all that 2020 brought us. She asked about my history, medical and otherwise. She asked about all the medications and whether I was happy with them. She made some changes. I felt respected, insofar as one can within the psychiatric setting.

I could not manage to wear a mask when the world demanded I had to. She understood the origins of this, or at least was kind enough to say she did. She wrote me a letter to excuse me from wearing one. I had to get a lanyard in the hope that members of the public would leave me alone. Not all of them did. It was a difficult time. My ‘mental health’ suffered. She questioned the bipolar diagnosis and said she saw no evidence of it. She wondered if it was a once-off, possibly brought on by withdrawals. She said the trauma was visible. I could not disagree. I was underweight and anxious. It reached another crescendo in late 2020. A weekend in the asylum was ordered; for safety. It was then that I learned I had been sectioned the time before. This time was ‘voluntary’.

It wasn’t great but I was slightly more aware than when I had been there before and that allowed me to see it very differently. As usual, there was the mix of kind and not-so-kind. As always there were rules, so many rules, official and unofficial, with some just for the sake of them, or at least that’s how it seemed. One particularly bizarre one still makes me wonder. I was bearing a black bra when I was admitted. There was an identical white one in my bag, which was locked away, for safety. I was allowed access to it, under supervision, to get a change of underwear, clothing etc. after a shower. A couple of days in when I was getting items from it I picked up the white bra. I was told to put it back. I said I was wearing the identical one, and asked if I could simply swap them. I even said I would do it in front of the nurse. The answer was no. I still don’t know what the logic was!

That hospital stay was my most recent. My last, too, I hope. I vowed to try get off meds and to distance myself from the system as soon as I could after that weekend stay. I had no idea who I was without it all. The taper began in early 2021, supported by the aforementioned doctor. It was not without challenges but I persevered. I continued to check in with the clinic. My appointments became further and further apart. The doctor stated numerous times that I was much better without medication. She also stated that when studying psychiatry, there was no mention of trauma or its possible impacts. How strange that seems to me; to her too, in hindsight, I imagine.

The years moved by. I had ups and downs, lower spells and okay spells. I replaced medication with cold water dips, homeopathy and shamanic healing, prescriptions for more poetry, conflict for connection, as much as I could. I started writing about my experiences. Some flowed easily. Others brought my attention to what still needed to be healed, understood, and integrated. 2017 kept knocking; the shame and confusion and fear of it all never too far away. It was holding me back, I felt. I self-referred to trauma therapy again. The doctor agreed it was a good idea. That was late 2023. The waiting list was long.

At the end of 2024, an unexpected event unfolded right outside my house that seems to have catalysed a PTSD response. It was one of a number of stressors and reminders, and fuel for flashbacks and vigilance. When I went for a scheduled check-in with the psychiatrist in January of this year, she commented that I seemed very anxious and that she had not seen me like that in a long time. I concurred. She apologised also that calls to the service had gone unanswered. There was a mention of staffing and that there had been bad consequences for others. I informed her that therapy was to commence soon. Paradoxically, that could have been making me anxious alongside my hope of it helping. She said she was eager to put in supports in the meantime and we discussed what might be feasible.

She said she did not think medication was appropriate, given previous use and reactions. She offered nursing support as an option, whereby I would come and meet with a nurse a few times a week. I thought that intensity might amplify things but said I’d reconsider if I dis-improved any further. I agreed to occupational therapy and psychology referrals to give support as I waited. She said she would raise both in the Multi-Disciplinary Team Meeting later that day and give me a call to let me know the outcome. She scheduled an appointment to check in with her in March and said to ring at any time if things worsened or I needed anything. I thanked her. That was January 29th of this year. That was the last time I saw or heard from her.

The day before my appointment in March I had a missed call from the service, and a voicemail saying that my appointment had been cancelled, and that another would be sent in the post.

The next day a letter arrived for an appointment in April.

The day before my appointment in April I had a missed call from the service, and a voicemail saying my appointment had been cancelled. This was followed by a text message stating that my appointment had been cancelled.

No further appointment arrived in the post.

The stressors had been building. I was afraid I might buckle under them. I called the next week to seek support. It took that long to work up the courage. I was rewarded with curt responses from reception with no questions about my welfare. I was upset on the phone. I learned the doctor was not there. Then I learned she was out sick. Then I learned that they did not know when she would be back. I said I was sorry and asked what I ought to do. She sighed and said she supposed she could put me in with another doctor. I felt I was an inconvenience. I felt I was too much. I could feel the panic rising. I could feel the automatic stress response being activated. I was ready to fight or flee. I said, “It’s okay” and hung up.

Later that day I submitted a complaint about the service, for the first time, via an online forum called ‘your service your say’. I outlined the above as best I could. A week or so later I received a call from governance. It was early May. She said they had received the complaint and that it was one of many saying similar. They said the complaints about that particular receptionist were numerous. She said they weren’t sure when the doctor would be back and she gave some explanation as to her absence. I reiterated that my issue wasn’t her absence at all but the lack of continuity of care and the potential impact of that on me and on others who may be more vulnerable. She said she would be back in touch with outcomes. I haven’t heard from her since.

During that same week, almost immediately after I complained, I received a letter from the clinic. It was an appointment to see ‘your psychiatrist’. I phoned to see what was going on. The phone was answered. This in itself was unusual. It was a friendly, caring voice. She checked and said it is with a new doctor who will be filling in until the other returned. I agreed to attend. I attended. The first thing the doctor said when I sat down was “I know you made a complaint.” The appointment was okay. She said I was stressed. I said that I knew. I worried I was more than stressed. I was very symptomatic. I told her as much. She said to come back the next week. I wondered if there was a point. She said it would be supportive. I agreed and went back.

I was becoming increasingly overwhelmed. Stressors were numerous, too much and too personal to go into here; but my sleep and nutrition were suffering and I was finding daily functioning increasingly difficult. Again, I gave her much more detail than that. She suggested downsizing where I live and paying less rent, so I could work less. I said that I didn’t pay rent as I had a mortgage and that moving was not an option at that time. I told her I’d been almost twenty years in my house and that I hadn’t always attended psychiatry. She scoffed a bit and the talk of the list I could easily write commenced. That turned into a really difficult day. I’m grateful for friends who answer the phone.

I had a missed call and a voicemail from the doctor the following day. It said “Hi Nicola. This is Dr. ……… I hope you are alright, I will call you tomorrow.” I tried to call straight back. There was no answer. That was the 14th of May 2025. I have not seen or heard from her since.

The GP wrote to the service.

The psychotherapist wrote to the service.

I have not seen or heard from them since.

The GP did not prescribe psychiatric medication. She acknowledged the trauma responses. She acknowledged how dark things had gotten before. She listened, she was kind and she was reassuring. She prescribed rest and nature, and sea dips, and connection. She said, “You will get through this.”

I wonder if the version of me from 2017 just wants to be heard, understood, validated and integrated. Sometimes she knocks quietly, other times she rages and seems to be trying to burst out of me. One thing for sure though is that she is here and, despite it all, I am very much here too.