In sickness and in health

The house was quiet as I began to wake and stretch out across the bed. I could feel the warmth of the sun beating through the window onto my face. Sunday's were the best day of the week: no work, be as lazy as I want, no plans, just relaxing. I opened my eyes fully and saw the other side of the bed hadn't been touched. He'd been out all night again.1

Getting out of bed I pulled my pretty pink robe on and wandered downstairs. Again, silence. It was only when I got into the kitchen that I noticed something odd; the back door was wide open. I looked out but couldn't see anyone and screwed up my face. Had he been home and left again? Had someone tried to break in? Nothing looked out of place. 2

I ran back upstairs to get my slippers and back down to the kitchen then stepped outside. The fresh morning air felt nice. I started to walk down the garden path, noticing the gate was open at the far end. As I walked, I could hear a slight rumbling sound coming from the garden shed. The closer I got, I realised it was the sound of someone snoring. I peered through the window and there he was, no doubt too drunk to know what he was doing, fast asleep in a wheel barrow!3

I rolled my eyes and opened the shed door. "Mark!” I shouted, pulling at his trouser leg, "what are you doing in here? Get up!"4

The creaky shed door fell back against my legs. He didn't stir and was clearly still completely inebriated. ‘Sod it’, I thought to myself, ‘he can stay there’.5

I went back indoors and put the kettle on. Sometimes he drove me absolutely mad. Things were supposed to have changed once we had got married; it was time to start growing up and acting mature. Not for Mark though, if anything he had got worse. A lot worse. His moods were strange, some days he was perfectly normal and it was that which made me think I was exaggerating his 'off days'. He had a history of depression and had been being treated for it since before I had met him. When we had first got together he told me he was diagnosed with depression and anxiety at seventeen, and had been on medication ever since. There had been a couple of episodes where he had become very bad over the years, and had even attempted to take his own life. Intensive therapy and some short hospital stays seemed to have sorted him out, and eventually he would go back to normal again. Although he still took medication, he had only had brief spells of depression over the five years we had been together. I wasn't too worried about it.6

Now he was twenty six. We had been married for eight months, and almost since our wedding night he had been acting strange. No longer depressed, he was now full of life. At first I thought it was the joys of getting married, the excitement of the big day, the fun we had shared on our honeymoon. Over the past few months it had grown from him being very excitable and never stopping talking, to this overgrown adolescent. He would kick off at me when he didn't get his own way and throw tantrums like a teenager. I never knew what sort of mood I would find him in anymore. He wasn't working at the moment, so my wages had to support us both and pay all the bills, but this didn't seem to reason with him. He would demand I gave him money so he could go out with his friends, new friends that I didn't know. He would stay out all night and not tell me where he had been. I asked him one day if he was having an affair and he denied it over and over, begging me to believe he was just having fun. 7

"God,” he had moaned, "you hated the thought of me being depressed and now it's wrong for me to have fun. Can't I do anything right?"8

So, for the past six months I had put up with the ever fluctuating moods. Everything had come to a head two months ago when I had been out clothes shopping and my credit card had been declined. I was extremely embarrassed and demanded they phoned my bank. There had to be a mistake.9

There was no mistake however. £5000, my entire limit, had been spent on flight tickets for what appeared to be an around-the-world trip. I almost cried in the middle of the store as I told them there was a mistake, I barely touched my credit card and had certainly not booked any flight tickets.10

When I got back home that day I found Mark frantically typing away on the computer. I slumped down on the chair opposite him and burst into tears. He asked what was wrong and I told him what had happened with my card, how humiliated I was, and how I was now going to have to wait until they investigated to see if someone had hacked my account.11

He didn't show any emotion at all as he said, "Oh that, yeah that was me. I fancied a holiday. I've changed my mind now. Too many other things to do."12

I had gone absolutely bonkers at him. He’d run up £5000 of debt on my card, without permission, made me look like an idiot, and he didn't even care? What the hell was wrong with him? But he just shrugged and said he was busy, told me to get out the room and leave him alone. Over his shoulder I saw he was looking at tarot cards and writing a load of notes down on the paper in front of him. There was no point in arguing with him when he was like this, so off I went to phone the bank and try and sort the mess out.13

Since that day I had to get new bank cards. I kept them with me at all times so he couldn't access them. It was like having a child as I gave him a set amount of pocket money each week. I urged him over and over to try and get a job; I was really struggling now to pay the rent and food and all the bills, as well as the credit card repayments. But it was like speaking to a brick wall. Nothing went in, no acknowledgements made. We were like passing ships in the night as I came home from work and he left, saying he had things to do. By the time I had gone to bed at night he still wasn't home. I felt like our new marriage was falling apart.14

So here we were, another episode of being out all night, him lying asleep in the garden shed. As I sat drinking my coffee I decided enough was enough. We couldn't go on like this. I went back outside and opened the shed door ready to drag him into the house and have some firm words with him. When I opened the door, it was empty. No sleeping beauty in the wheel barrow. No Mark. He hadn't come back in the house. He'd simply disappeared again. But as my eyes moved down towards the ground I noticed a trail of pieces of paper, each folded into little squares. I picked them all up and opened them out. Each piece had a passage or quote from the bible on it. I stood there feeling extremely uneasy. This was weird. Neither of us were religious, why did he have all these bible quotes written down? I stuffed them into my robe pocket and went back indoors.15

In our bedroom we had the wardrobe which we both shared for our clothes and a chest of drawers each. I went to Mark's set and started looking through. Nothing seemed out of the ordinary, all his clothes were folded neatly just as I had left them. I went over to his bedside cabinet and opened the top drawer. His beloved notepad sat at the top. I sat down on the bed and opened it up to find page after page with bible quotes, chemical equations, tarot card meanings, mathematical sums, just random scribbles everywhere. Why was he writing all these down? Why was he acting so damn weird? He spent hours in front of the computer while I was at work. He thought nothing of spending all the money I had on my credit card. He was writing down page after page of bizarre scribbles. He went out all the time saying he had 'things to do' but could never tell me what. What the hell was going on?16

The next few days continued to get stranger. He would be gone when I got home from work and come home once I was in bed. I would hear him banging about downstairs and could hear the tones of him talking away. I couldn't tell if he was on the phone or talking to himself. Sometimes he would only come back for a few minutes then go back out again. God knows where he was going at 2 and 3am. He never seemed to sleep anymore and I couldn't understand where all this energy was coming from. From what I could tell, he hadn't touched any of the food in the fridge either. I was really starting to feel like I was losing my husband. 17

It was the following Friday after the garden shed incident and I was at work when my boss came into the office.18

"Rachel, there are two police officers in reception. They want to speak to you. It's about Mark.” She said sympathetically. My stomach churned; terrified he had been in an accident. I rushed downstairs to reception and took them into one of the empty meeting rooms.19

They explained Mark had been arrested after they received complaints about his bizarre and intimidating behaviour. He had been in town and approaching all the shoppers who passed him, reciting bible quotes, telling them he was bringing messages from God. When a woman had ignored him he had become aggressive with her; grabbed her wrist tightly and demanded she listen. She had struggled with him and eventually he loosened his grip as she ran off screaming he was a nutter. From there, security CCTV in the street saw him take off all his clothes. He stripped completely naked and began running around the streets laughing hysterically and screaming he was the ace of wands - one of the tarot cards. The police had received complaints and picked him up. As soon as they tried to put him in the van he became violent and started shouting incoherent, random nonsense at them. Then he punched a female officer full force on the head.20

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I arrived at the police station and wasn't allowed to see him. I told the man on the front desk that I believed he was ill. I begged them to send a doctor in to assess him. Eventually they agreed.22

It took hours for the locum psychiatrist and police doctor to arrive. I explained to them about his recent behaviour, his history of depression, the spending, the notes, the being out all night. I recalled Mark’s apparent lack of empathy or understanding for anyone around him. As it all got too much, I began to cry; I just wanted my husband back, not this strange empty shell of a man who now shared my home.23

It was night time before they finally came back to speak to me. They were waiting on a social worker to arrive. Mark was going to be sectioned under the Mental Health Act. The doctors believed my husband was in psychosis, a serious mental disorder involving a loss of contact with reality. They told me he was suffering with hallucinations and delusions, and was convinced he was a messenger for God. God spoke to him and gave him messages he had to pass on to people. The tarot cards had come to life in his head. Voices told him what to do. He was very, very sick and needed immediate help. The doctors were going to arrange for an ambulance to collect him and have him transferred to the Royal Park Hospital. I followed them in my car and spent several more hours in a grim waiting room. By the time the psychiatrist finally came back to inform me Mark would be fully assessed in the morning, it was almost midnight. Mark was now sedated and sleeping and I was ready to do the same.24

When I finally got home that night I cried myself to sleep.25

Back at the psychiatric hospital the next day they told me the first step was to treat the psychotic episode. They had given him an anti-psychotic drug called Chlorpromazine in a fairly high dose and also injected him with tranquilizers to keep him sedated. The most important thing now was for him to rest. Under the section they could keep him there for up to six months for treatment. The psychiatrist seemed like a nice old man, maybe in his early sixties with a short grey beard and shiny bald head. He said it was difficult to make a full diagnosis at the moment, although it was definite Mark was in psychosis. The events over the past few months sounded like he had been becoming more and more manic, which pointed to a possibility of bipolar affective disorder. The other possibility was schizophrenia; but right now the combined history of depression, bouts of relative stability, and the mania all pointed to one thing. Bipolar.26

He took me through to see Mark who was very drowsy on the bed. His face kept twitching and Dr Stapes told me it was a side effect of the medication. I stroked his arm gently, "Mark, Mark it's me Rachel, I've come to see you."27

He slowly opened his eyes and his pupils were like little pin dots. They fixated on my face and he stared at me with an eerie look on his face.28

"If you ever make the Queen of Swords get me again, I will kill you,” he said in a very matter of fact tone. His brow was soaked in sweat and I felt like I was frozen to the spot as I gently pulled my arm away from his. The doctor gave me a sympathetic look and walked over to stand in front of my husband.29

"Mark, the tarot cards are not real. This is your wife Rachel. She loves you and you are not well right now. You need to have some rest until you feel better, none of this is real my friend."30

His response was just more ramblings. Looking very pleased with himself but staring into space, he began to recite lyrics from a U2 song: 31


"I cried to my Daddy on the telephone,
How long now?
Until the clouds unroll and you come home,
The line went,
But the shadows still remain since your descent,
Your descent.32

The saints are coming, the saints are coming,
I say no matter how I try, I realise there's no reply,
The saints are coming, the saints are coming..."33


He got quieter and quieter until he was talking in whispers. Then he turned over and picked the flaking paint on the wall. The doctor wandered off and left me there with him. I attempted another couple of times to speak to him but he just ignored me. 34

For the rest of the day I sat next to Mark's bed. He mostly slept but occasionally woke up and began more nonsensical rants. He blamed me, he said, for stopping his special bond with God, and when he got out of this hell hole he would get it back. It would be him and God, he didn't need me. I was evil, he said with a demonic look in his eye. I had to keep telling myself over and over that this was not Mark talking. He was sick. He would get better. He had too.35

In the evening a nurse brought him a tray with some dinner. He sat up immediately and looked at it. His hands began to shake as he tried to grip his cutlery and he started to laugh saying "ah, what do you need forks for anyway?!" With that he picked up the full chicken breast in gravy and smeared it all over his face, laughing hysterically. I got up to try and calm him down and take it off him, telling him to eat his food properly. But as I got just inches from him he started picking up his peas and firing them at me. As I dodged the stream of tiny green balls, he kicked his heels into the bed and laughed so hard that he sent the tray flying across the floor.36

Over the next few weeks my life revolved around work and then going straight to the hospital. After three weeks of being in hospital, the psychotic episode had passed and he was now deeply depressed. The nurses had him on suicide watch as was telling anyone who would listen to him that he would kill himself. Every day I went in and took some of his favourite things from home, his CD's, his iPod, books for him to read. But he had no interest in anything. The nurses had to drag him out of bed, and he would refuse to wash saying there was no point. When things got to the very lowest point he wouldn't even bother to get up and take himself to the toilet. He would sit in the chair by his bed, wearing pyjamas, and wet or soil himself. It broke my heart.37

By now his medication had grown to an impressive list of anti-psychotics; Lithium to control his moods; anti-depressants to help boost his serotonin; tranquilisers to help him sleep. He must have been rattling. One day I went in to find his arms bandaged, the nurses told me he had pulled the wire out of a coat hanger and carved Jesus into his arm. Just five weeks after the psychosis ending and a period of suicidal deep depression, his mood was elevating again. This time the only mention of Jesus was when he had harmed himself. For a brief period it actually looked like he was getting well again.38

It was a Saturday afternoon and I was spending the day at the ward. He was up and dressed, even showered and shaved. He seemed very happy to see me and greeted me with a kiss. We sat and played some board games on the table by his bed and shared the lunch I had bought to take in with me. He seemed extremely upbeat and was laughing a huge amount of the time. I noticed he was laughing at things that weren't actually funny but after the previous weeks of depression I was just glad to see him smiling. He seemed irritable though and regularly got up from his chair and paced around the ward. He had something to say to everyone who he came across. Again the nonsensical ramblings started to come out, but this time it was about the great plans he had for when he got back home. He needed me to get him a bank loan and he was going to become a businessman. Each time I asked him what kind of business he was going to start it changed. It was only when he showed me his business plan that I had to present to the bank manager for his 'buying and selling tortoises' idea, that I knew he was ill. 39

‘Here we go again,’ I thought to myself, feeling disheartened.40

After two periods of depression, two episodes of mania, and one episode of psychosis, a formal diagnosis of bipolar affective disorder was made. He was manic again and full of energy, no longer interested in any food or sleep. All day, every day, he wrote out grand plans for me to present to the bank manager. I left the hospital with more and more sheets of paper that he had carefully written out.41

The doctors again increased his medications and tried to get him to rest. The facial twitches got worse, his legs jerked uncontrollably and his hands shook. They carried on with the lithium and he had so many blood tests he looked like a pin cushion. They told me there was no cure; it could only be managed and treated. The lithium was supposed to help prevent manic episodes but it didn't seem to be working. Maybe they would try Depakote, another mood stabilising drug.42

I realised that this was my future now. The doctors assured me that people with bipolar can be stable for long periods of time when they find a medication that works for them. I still loved Mark dearly and wished so much I could have the man I married back. But even the thought of snuggling up on the sofa watching a movie with him seemed so abnormal now. I had spent the past four months by then in and out of psychiatric units and had completely lost my husband. I hated to admit it but he was becoming a burden that I couldn't cope with. The thought of spending the rest of my life never knowing what sort of mood he might be in or coming face to face with his delusions again was just too much. 43

Was my marriage really over?44

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As I left the hospital I felt a mixed bag of emotions. The church bells were ringing across the street and I turned to watch a young couple coming out. They were newly married and their family and friends were throwing confetti. Two huge smiles lit up their faces. They all looked so happy.46

As a single tear made its way down my cheek I thought back to our wedding day. How different everything had been. I closed my eyes and remembered my beautiful dress, how smart Mark had looked, and the vows we had shared. In sickness and in health, I had promised. I twisted my wedding band around my finger and said the words out loud, "In sickness and in health,” I still loved him, I couldn't give up. Whatever lay ahead I would be there; underneath all of his troubles was still the man I loved. The only man I'd ever loved.47

Turning round to look at the hospital, I saw him watching me from the window. 48

"I love you,” I mouthed.49

He blew me a kiss and I put my hand out to catch it. He smiled at me and turned away from the window.50

My Mark was still in there somewhere, through all this mania and depression he was hidden. I just had to dig deep and find him again.