Mon 23 November

Helen has headed out for a morning outing to Southbank with her friend Peta. This sounds deceptively positive as unfortunately she is in pretty bad shape. I feel like the flip-side of the mania is coming down on her with a vengeance and she is feeling terribly anxious, self critical, and worried pretty much all the time. Right at the moment I feel she is pretty much as distorted in her thinking as she was when she was manic - just the other side of the coin and it is very uncomfortable for her. I realise posting this may worry you all but have decided it's better for people to know than not. The positive things are still there including eating well, sleeping well, ears have healed up fully and so has the skin on her back so no more yucky dressings needed. Her hearing is still significantly down but she can wear glasses again so reading is possible. She managed to call her friend s Hans and Martina yesterday in Austria to wish him well for his 70th birthday which was something she really wanted to do - and even negotiated speaking a little in German. I am hopeful that her medical team will decide that they can risk antidepressants because it seems like a chemically driven mental state to me - for all that there are good and reasonable reasons to feel worried, anxious and sad it seems to have the wrong flavour for that. Anyway - for the time being distractions are actually good. If you are wanting to spend time with her try to do something active - ideally involving light physical exercise and eating food rich in protein and calories. Don't offer liquids as she is back on the 1 litre fluid restriction and is very worried about it so it is stressful to have to decline kind offers of tea and juice all the time. Having a chat is pretty stressful because really what she wants to do is go over the lists of things she is worried about and check whether she is forgetting anything so it just revs up her anxiety. Take her conversation and worries with a grain of salt - if you engage fully with them you too will become worried and I don't think they are fully real so this isn't a good idea for either of you! She really needs scheduled activities to fill the day and as I say distractions are good.

I hope to be able to post better news soon - things keep changing day by day and that's really the only thing we can be sure of.