8 March 2015 – The Role of your Primary Carer(s)

If you have Bipolar Disorder and are lucky like me, you will have a primary carer in your life.  In my case this is my husband, Daniel.  The way I look at it he wears multiple hats, one for husband and one for carer (and probably a few more too).  When I am unwell, he takes off his husband hat and dons his carer hat.  This of course does not mean he stops loving me, it simply means that he needs to put those emotions aside so that he can focus on getting me the treatment I need to regain my health.

Depending on the severity of my ill health determines what actions he needs to take as my carer.  In the first instance in most cases it is simply organising an appointment with my psychiatrist.  Because we live in a remote town this appointment happens over Skype and in the majority of cases my husband will sit in on that appointment with me so that he can tell my psychiatrist his observations of the changes in my behaviour.  In the majority of instances this simply results in a change in my medication to balance out a minor depressive episode, manic episode or mixed state.   As my carer, my husband will then oversee the changes in the medication and ensure that I take the correct medication and that my behaviour stabilises.  A follow up consultation with my psychiatrist a few weeks later often sees that everything is well and I then revert back to my standard medication regime, but on occasion this is not the case and my behaviour has worsened not improved and we then have to look at further treatment options.

In this case my husband, once again acting as my carer, will inform my psychiatrist of his observations of my depleting mood and will be involved in the decision making process regarding a course of action.  This could include further medication changes, in-patient care at the private mental hospital where my psychiatrist has admitting rights, electroconvulsive therapy as an in or out patient at that same hospital or even some lifestyle changes, temporary or permanent.  In any case whatever action is decided upon, my husband oversees me undertaking it.

During this time I am always very anxious plus being manic, depressed or mixed.  So it is very difficult for me to understand fully what decisions have been made and why and consequently I am often not very cooperative in fulfilling the requirements of the decision made.  It is during this uncooperative time that my husbands role as my primary carer really comes into full swing. He gently guides me in the right direction, explaining and re-explaining things to me in a number of ways so that I may understand.  He looks after every detail of my well being, ensuring that I am eating (or at least having sustagen shakes), that I am showering, brushing my teeth etc etc.  He ensures that I am taking my medications and at the right times.  If I am going to Brisbane for care he ensures I have packed everything I need, not just necessities but also items that will make me feel more at home.

 Because he works on a two week on two week off roster, he will (if at all possible) arrange to take me to Brisbane for care on his two weeks off.  If I am an out-patient (which I always try to be because I hate being an in-patient) I will stay with his parents.  All of our animals will come with us and Daniel will stay for as long as he can before he has to return to work.  When that happens, his parents take over as my carers and do all of the things I have listed above as well as ferrying me to and from the hospital for day patient care (e.g. electroconvulsive therapy).   Daniel will be back in Brisbane as soon as his shift finishes and will take over my care once again and this cycle continues until I am well again.

We have learned not to go home at the first sign of improvement but rather to wait until I am completely well again.  The risk of relapse is just too high and it is not worth it for the inconvenience.  The decision of when to go home is my husbands primarily (as the carer) but I also have input too because I am well enough to have a say by the time we get to that point.

Some people (who shall remain nameless) believe that my husband caring for me in this way is actually his way of being overbearing and controlling of me.  The fact is however, that I need him to care for me in this way because I am in no state to take care of myself.  If I didn’t have him (touch wood) I would be an in-patient in a mental hospital almost immediately when I have an episode (manic, depressive or mixed), and the nurses would care for me in the way that my husband does.  I am simply very lucky to have a husband (and in-laws) that are prepared to do this for me in order for me to avoid having to be an in-patient.

When it is all over, and we are home, he puts his husband hat back on (which I love) and he is the most amazing husband a woman could possibly imagine.   He works hard and long hours to provide me with everything I could ever want, he nurtures me, he makes me laugh and condoles me when I cry, we share many interests and we spend almost all our spare time together.  He also helps with the household chores as well as looking after the boy jobs – mowing the lawn and servicing the cars.  He is truly a wonderful husband, but when I need him to be, he is also a pedantic carer and I love him for that (too).