Therapy is not for wimps. True, but…

I recently read an interesting article, “Therapy Is Not For Wimps”. 

In it, author Gerti Schoen makes a few excellent points.  In the modern era there’s a general assumption that anyone who seeks therapy is “weak”.  They’re not strong enough to stand on their own, they have to ask for help.

Be honest.  Have you ever needed help?  Do you know anyone who has never needed it?  The assumption that therapy = weakness is a social bully tactic.  It actually takes a great deal of strength to seek out therapy given the stigma against it.

Very good point, Ms. Schoen!

However…

Like all good things, it’s very important not only to know when to seek out therapy, but when to say “enough is enough”.

First, what’s “therapy”?  It’s a more difficult question than you may think.  Though the stated goal of all therapy is to help the patient better understand themselves, there are hundreds of ways to go about this.  I’ll describe the top three.

  1. sigmund_freud_portraitPsychoanalysis.  When they say “old school”, this is what they’re talking about.  This style of therapy was developed by Sigmund Freud and operates under the assumption that all problems are rooted in the subconscious, usually implanted in your “formative years”.  Usually the libido is involved.  Through the analysis of actions, mistakes, dreams and symbols it’s possible to better understand the root (subconscious) cause of psychological illness and therefore achieve an appropriate treatment.  If you see a character in a movie laying on a couch talking to a therapist about his mother, that’s Psychoanalysis.
  1. Cognitive-Behavioral Therapy (CBT).  This is (arguably) the most popular form of therapy in modern times.  In a nutshell, this type of therapist believes awareness can change behavior.  Rather than delving into the past to focus on the root of a dilemma, CBT isolates a specific problem, caused by an irrational thought process or incorrect perception.  By becoming aware of the incorrect perception through a progression of mindfulness exercises, the patient can overcome, or at least constructively manage, their disorder.
  1. carl_jung-glassesAnalytical Psychology.  There are so many contenders for 3rd place, I’ll just pick my favorite.  Carl Jung was a contemporary of Sigmund Freud.  The two of them met several times, each influenced the other.  The big difference between Freud and Jung is that while Freud placed special emphasis on the influence of the libido in psychological disorders, Jung went in another direction. His approach is famous for it’s focus on dreams and through them, archetypes.  His idea of the “collective unconscious” assumes that people develop through life experience rather than incidents rooted in the formative years.  While the psyche is self-regulating, it can become ill, driving a person to become psychotic.  There must be a balance between the conscious and the unconscious functions of the brain by moving beyond ego, achieving a higher awareness.

Each of these schools of thought has value, and can benefit the patient.  Who can deny that specific events in childhood had a lingering effect in their adult years?  And certainly, becoming aware of the impact of a skewed perception can be extremely helpful.  A greater awareness of the world in which we live, and our place in it, is always valuable.  Therapy has helped me become much more self aware of my behaviors, and to occasionally modify some of them.

Dolores_UmbrigeA medical doctor looks at a tumor and can see immediately that this is wrong.  It should not be located in the body.  It may be painful, but it must be removed so that the body can heal.  The problem I have with therapy is in the application of this philosophy to the human mind.  It is very possible to see a behavior as beneficial or harmful.  But almost all therapists I’ve met moved beyond “this seems to help, this seems to hurt you” and into the language of judgment: simply, “I’m right, you’re wrong.  That’s why you, the patient, are here.  Not only that, but you know you’re wrong, but you may not want to admit it.  Let’s start there.”

Yikes.  It reminds me of Harry Potter talking to Delores Umbridge.

So while it takes strength to seek out therapy, a patient needs to be strong and self-aware while dealing with their therapist.  If they see a benefit from the therapy – wonderful!  But if not, it’s not the patient’s fault.  They need to move into a more constructive situation.  Unfortunately, by the very nature of their condition, most patients are in no position to self-advocate in the presence of a therapist.

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Bipolar and the creativity connection

There is a great deal of respect given to the medical profession.  I wish equal respect was given to the incalculable value of individual creative expression.  The “triage” reaction in the psychiatric community of “return the patient to a controlled state as quickly as possible, deal with the consequences of the drug’s side-effects later” comes at a considerable, perhaps unnecessary price.

twfWhile there are plenty of articles speculating on the connection between creativity and mental illness, the majority are at least 10, if not 20 (or more) years old.  There’s even a book – “Touched with Fire: Manic-Depressive Illness and the Artistic Temperament” by Kay Redfield Jamison that attempts to connect bipolar with great artists like Van Gogh and Beethoven.  However, the book was published in 1996.  It makes a good case, but it’s not conclusive.

celebrity-bipolar-intro-400The pop culture take on it tries to connect diagnosed celebrities such as Catherine Zeta-Jones, Linda Hamilton and Carrie Fisher with public symptoms exhibited by others, such as Britney Spears, Lindsay Lohan and Kurt Cobain.  They may have a case, but the point is that the connection between madness and creativity is openly acknowledged.

The social assumption that a genius is crazy (or “touched by the Gods”, however you wish to put it) goes back to the dawn of written tradition.  There’s been a clinical theory that connects creativity and mental illness for decades.  But only in the last 3 years have there been large, comprehensive studies on the connection between bipolar disorder and the so-called “artistic temperament”.

In 2011 there was a study of 300,000 patients diagnosed with either schizophrenia, bipolar or Depression.  The results of the study found that there was an “overrepresentation” in creative fields for those diagnosed with either schizophrenia or bipolar, as well as their undiagnosed relatives.  Those who suffer from Depression did not, on the whole, feel compelled to go into the arts.

This is a good start.  Even better, in 2012 there was a study of one million patients by the Karolinska Institute in Sweden.  Their conclusion?  “Creativity is closely entwined with mental illness”.  My favorite quote: “… the findings suggested disorders should be viewed in a new light and that certain traits might be beneficial or desirable.”

NOW we’re getting somewhere.

Pills2In my mind I’m about 15 years behind where I ought to be.  Before I was diagnosed I was writing like a fiend, and it was certainly good enough for publication.  But my mind was firing without direction, and I couldn’t focus long enough to go through the steps necessary to be published.  After my breakdown and subsequent incarceration, I was heavily medicated.  I used to call it “being placed in a creative coma”, but in truth it had more in common with a literal coma.  Unsure what to do with me, my doctor put me on twelve different medications. Lithium, Geodon, Depakote, Thorozine, Topamax, Paxil, I forget them all.  You name it, I took it, frequently combined.  I gained 150 pounds, my hair fell out and I sometimes forgot how to blink.  I could barely walk, much less write.

It took me 10 years to recover enough to be able to think, and a good deal of that recovery was to get rid of the drugs.  I went through a series of doctors, begging to find a less invasive cocktail.  One of them said, to my face, “if you’re alive long enough to complain about the side-effects, you’re a success”.   That… wasn’t constructive.

It was my OB/GYN who finally cracked the code.  She’s the one who figured out the best way to get my symptoms under control while allowing my mind to function.  I won’t offer the specific details here for two reasons.  1. I’m not a doctor and offering anything that might be considered medical advice in a blog is a bad idea.  2. We’re all different.  Even though it worked well for me, it might not do a thing for you.  Sorry about that.

Once the worst of the drugs started to clear my system, a miracle happened.  I started writing again.  My “voice” came back.  Slowly at first, but with growing confidence as the months went by, I regained my former creativity.  Bipolar is incurable, as are all the other illnesses I’ve been diagnosed with.  I’m still on drugs and always will be.  But at the very least I can think again, long enough to pound out a few paragraphs here and there.

That we’re drugging ourselves into oblivion is a given.  We’re starting that trend earlier every generation.  We’re now diagnosing children as young as age two with bipolar.  No doubt I had it since birth.  And yes, had I been diagnosed much earlier my life may have been easier.  But two years old?  Judge Judy notes, with some exasperation, that people aren’t “cooked” until age 18, if then.  Giving a child such invasive drugs during (or before) their formative years fills me with an essential horror.

In the article “Soaring Numbers of Children on Powerful Adult Psychiatric Drugs“, Dr. Peter Breggin notes:

“In a comparison between the years 1993-1998 and 2005-2009, prescriptions of antipsychotic drugs for per 100 children (0-13 years old) rose from 0.24 to 1.83. That’s more than a sevenfold increase. Given that most of prescriptions are for the older children in this age range, the rate would be substantially higher among preteens and 13-year-olds. For adolescents (14-20 years old) the increase was nearly fivefold.”

According to the Karolinska Institute, “… disorders should be viewed in a new light and that certain traits might be beneficial or desirable.”

Drugging patients into oblivion is good business for Big Pharma.  But what are we sacrificing in the process?  How many Van Goghs and Beethovens have been drowned in a sea of Ritalin?  I do understand the need for psychiatric care.  In fact, it saved my life.  But there must be a balance between our “pop-a-pill” social mentality and a creative individual on a destructive mood swing.

I’m crazy, not stupid

Stating the obvious, there are many frustrations that come with being mentally ill.  For me, one of the worst is the lack of understanding, even among medical professionals, of what mental illness actually is.  Mental illness is caused by a chemical imbalance in the brain, but that’s as far as it goes for specifics.  There is no consensus what causes this chemical imbalance to occur, much less any idea how to either cure it, or prevent it.

blackamena.deviantart.com

blackamena.deviantart.com

One of my most frequent frustrations when dealing with the public (and this includes members of the medical profession as well as “civilians”, especially in the Emergency Room) is the assumption that crazy somehow equates stupid.  There have been times, when I explain I’m bipolar and suffer from memory loss, where people will slow down their speech.  They have over-enunciated their words.  These same people often call me “dearie”, “sweetheart” or “honey” and frequently punctuate their suggestions with a pat on the back (one time, heaven help me, with a pat on the head).

Incidentally, while my manic side is noted for an irrational anger that would rival The Hulk, I still maintain that no jury in the world would have convicted me had I acted on my impulses with that one.  But I digress.

While looking into the link between Bipolar and creativity, I came across multiple references to high IQ’s.  For example, in the article “Creativity tied to mental illness” (published in the Harvard Gazette), William J. Cromie notes:

“Some students who scored unusually high in creative achievement were seven times more likely to have low scores for latent inhibition. These low scorers also had high IQs.

“Getting swamped by new information that you have difficulty handling may predispose you to a mental disorder,” (Shelly Carson, Harvard psychologist) says. “But if you have high intelligence and a good working memory, you are more likely to be able to combine bits of new information in creative ways.”  … “Carson notes. “We saw creativity increase as IQs climb to 130 (the average score of Harvard students), and even up to 150.”

Ahem.  Just for what it’s worth, the last time I was tested I scored just over 150.  But again, I digress.

At the end of the article Cromie includes an old joke that perfectly sums up my inner “Forrest Gump”.

for“A man is driving past a mental hospital when one of the wheels falls off his car. He stops and recovers the wheel but can’t find the lug nuts to secure it back in place. Just then he notices a man sitting on the curb carefully removing small pebbles from the grass and piling them neatly on the sidewalk.

“What am I going to do?” the man asks aloud. The fellow piling the pebbles looks up, and says, “Take one of the lug nuts from each of the other wheels and use them to put the wheel back on.”

The driver is amazed. “Wow!” he exclaims. “What a brilliant idea. What are you doing in a place like this?” he asks, nodding toward the mental institution.

“Well,” the man answers, “I’m crazy, not stupid.”

“That’s exactly what our research is about,” Carson comments. “It shows that, to be creative, you can be bright and crazy, but not stupid.”

If “stupid is as stupid does”, it’s time not only to take another look at creativity, but also at “stupidity”.  Acting outside the norm is not necessarily “stupid”.  The social connection between “stupid” and “crazy” simply strengthens the stigma against the mentally ill by reinforcing the stereotype.

I’m heartened to see so much new research being conducted in the last 5-10 years.  What took so long?

Today is my anniversary

A “Jubilarian” is someone who is celebrating something special, especially the anniversary of something special.  Today is one of those special celebration days.

One year ago today, at this very hour, I was starving.  I hadn’t eaten anything since 7pm the night before.  I was standing in a carport, it was snowing, my head was pounding and I was having a full-blown panic attack.  They’d predicted snow, yes.  But only flurries.  This?  This was not flurries.  Flurries are not measured in inches.  Several inches, by the look of it.

I was waiting for my father, because I couldn’t drive myself.  No one drives themselves to surgery, much less something this big.  But if he couldn’t make it through the increasing snow, the rush hour, if there was just one accident, I wouldn’t make it.  They’d cancel the surgery, I just knew it.  I’d have to somehow live with this pain longer.  Maybe I could call an ambulance… could they do pre-op on the road?

As each minute passed my anxiety increased, my blood pressure rose and the pain reached new levels of “Kill Me Now”.  This was to be my second spinal surgery.  The first was on my lower spine to repair a ruptured disk (the other, still inoperable, remains to this day – probably the subject of surgery #3).  This one was to repair a rupture between C5-C6-C7.  Without the procedure I felt as though I’d been shot through the shoulder, close range, but somehow the shoulder was still attached.  My left arm was on fire and my migraine had a migraine.  I smelled pain, I chewed pain, my entire world was pain.

Suddenly, there he was.  Late, yes, but not by very much.  I was shaking with relief, nearly babbling gratitude.  Now all we had to do was make it across town, in an unexpected snowstorm, at rush hour.  I don’t know how we did it.  No one else was expecting heavy snow either – the normal procedure of “set your clock an hour early to get to work on time” hadn’t been factored in.  And yet, somehow, promising to hire a team of huskies if he had to, my dad got us through.  I checked in exactly on time, headed for my bed in OR… and waited.

And waited.  And waited.  And waited.  And oh my heavens waited some more.  The nurses continued to update me as best they could.  The previous surgery was taking longer than expected.  No, the doctor started on time, she was just being thorough.  She was thorough to the tune of an additional six and a half hours past when I was scheduled to go in.

The nurses were so grateful I was taking the delay so well, they bought my family lunch.  I wasn’t taking it well.  What they didn’t know is that I’d handcuff myself to that bed if I had to.  I’d wait until midnight if I had to, just don’t cancel the surgery.

Still, six empty hours is a long, long time to contemplate your mortality.  Oddly, this is the first surgery I’ve ever done that.  I’ve had my tonsils out, my knee operated on, I’ve had windows put into my sinuses and of course the first surgery on my back.  Sad to say, I’m no stranger to the OR.  But I’ve never thought I’d die, until this one.  In fact, I was so convinced I might die that I set up my will and signed a DNR.  I asked the staff to offer a prayer for me (it’s a religious hospital).  I even set up a “If I Die” app on my Facebook page.  I don’t know why it hit so hard this time.  Maybe just the words “spinal fusion” were enough.  Or just thinking about it.  She was going to slit my throat, push my vocal cords over, and fuse my spine from the front.  Really?  How?  I didn’t want to know.  I still don’t

I didn’t die.  In fact, the surgery was a blazing, almost startling success.  But 1 year ago right now I didn’t know that.  1 year ago right now I was in so much pain I couldn’t see.  1 year ago right now I had zero quality of life and very little hope.

At this moment I am looking out over a gentle bed of new snow.  My fingers are a little cold and I really should have worked out last night.  I’m training for my first 5K.  Apart from the fingers I’m in great shape.  My head doesn’t hurt, my shoulder is fine, I can feel my arm and the shot gun feeling is a distant memory.

Without going through that, I would not appreciate sitting here.  Sitting still, without the pain.  I’m grateful for the perspective.  I’m even more grateful I don’t feel like that anymore.  I’m grateful for modern science.  I’m grateful I had the opportunity to have this surgery that even a decade ago would have been much more complicated.

My attitude is one of gratitude this morning.  This is wonderful, and I can handle whatever comes next.

We are not alone

PrincessAt age 11 I was hooked on classics.  No, not Bach.   Asimov.  Heinlein.  Bradbury.  I was heavy into Science Fiction then as now.  May 25th, 1977 was the day everything changed.  That’s when Star Wars came out.  I pity anyone who hasn’t seen it in a theater.  That first scene, when the Star Destroyer goes overhead, the audience looked up.  The damn thing was so big, the shot so amazing, so convincing, we were sure it was only a few feet over our head.  3P0 walked, talked and worried.  And a lovely princess stood up to a black beast and made us all cheer.  NOTHING would ever break this girl.

CarrieI’ve had an intellectual crush on Carrie Fisher for 36 years.  When I heard she was Bipolar I was horrified.  She was diagnosed in 1980, but didn’t accept the diagnosis until 1985. There she was, bright eyed, that lovely voice rolling with laughter with an undercurrent of steel that helped the Rebels win, telling the entire world not only that she had a severe mental illness, but she was fine with it.  It’s one of the things that makes her who she is.  She’s not blowing it off, but she’s dealing.  Not only that, but she’s being honored for that fight.

Princess Leia and I fight the same battle.  Every single freaking day.  Way to go girl!  She gives me hope.   (Notice how I avoided “A New Hope”?  I hope you appreciate the self discipline that took.)

Brandon MarshallIs sports more your thing?  Let’s talk football, and another inspiration of mine.  Brandon Marshall, the former Denver Bronco. You might think he’s an odd choice, as he was essentially run out of town.  Drafted in 2006, he was charged with misdemeanor battery in 2008 (jury found him not guilty) and arrested for disorderly conduct in 2009 (charges dropped).  When he played for the Dolphins he was stabbed in the stomach by his wife.  The Dolphins traded him to the Bears after he was accused of hitting a woman in the eye.  Why does he inspire me?

Brandon Marshall suffers from Borderline Personality Disorder, which is another issue I suffer from as well.  And let me tell you, I HATE that name.  You can’t imagine how many times I’ve been asked if I’m “borderline crazy” and when I’ll know for sure, one way or the other.  Ha. Ha.  It is to laugh.  BPD may have the silliest name of any mental illness out there, but it is a very serious disease.  It’s defined by black-and-white thinking.  You love someone one day, they’re your bitter enemy the next.  There is NO gray area whatsoever.  It leads to very intense, highly unstable relationships resulting in, among other things, a lot of job changes if you’re not diagnosed.

But Brandon Marshall IS diagnosed.  It took a while, and 2 jobs, but he got there.  He’s even married still.  Considering the strain BPD puts on all relationships, that’s a miracle.  *applause*  He told the press in 2011 not only that he has it, but that he hopes to spread awareness about BPD by becoming a spokesperson for the illness.

Royce whiteFootball isn’t your thing?  How about basketball?  Another name has been added to the list of heroes, and I’m so proud of this young man.  Royce White, rookie player for the Houston Rockets.  Talk about gutsy!!  He didn’t just tell the public he’s mentally ill (he suffers from an Anxiety Disorder).  He told the Rockets, with quiet dignity, that a mental illness is exactly as legitimate as a physical one.  He has special needs, they need to be addressed.  The Rockets disagreed, a labor dispute ensued, he was suspended for 3 weeks.  He held his ground.  On January 26th 2013 Royce White was reinstated, the two having come to a “mutual agreement”.  He put his entire career on the line to prove that mental illnesses are legitimate, and won.

weWOW!!

Princess Leia can handle this.  Brandon Marshall is dealing with it.  Royce White just fought so people after him might be taken seriously.  I can do this.  So can you.  We’re not alone out there.

The life changing diagnosis, part 1

Where were you when Kennedy was shot?  The death of Elvis?  John Lennon?  Princess Diana? How about Michael Jackson?  Whitney Houston?

Events like this shake a society by bringing it face-face with its own mortality.  It doesn’t always happen on a personal level.  When it does it’s usually good material for an After School Special, a Movie of the Week, or a “very special episode of…”.  Lucky me, I’ve never won the lottery, but I’ve had the life changing  conversation with my doctor twice.  For those of you who have never had that conversation, I’ll try to describe what the first one was like.

I had just turned 30 when I moved to New Orleans.  I got a job as a tour guide.  I used to walk miles every day.   I lost weight, I was in great shape. Then my back started to twinge.  Just a little at first, now and again.  And my left leg kind of hurt.  No big deal, just walk it off, right?

I walked and I walked and I walked and it got steadily worse.  After a few months I couldn’t sit, stand or lay without pain. Nothing I did made it better, and nearly everything I did made it worse. I had no health insurance, no access to a doctor, and no Web MD.  I carried on until I collapsed.

I vaguely remember standing in line at the ER of Charity Hospital, but I don’t remember how I got there.  By then the pain was so bad I was having trouble seeing, or even breathing. The flaming pain started somewhere at my hip and radiated down until it defined every second of every day.  Eventually, I fainted.  I don’t remember hitting the floor, but I do remember two bands of steel suddenly wrapping around me.  I was told later that one of New Orleans’ Finest saw me go down and got me to a wheelchair.  I don’t know who you are, kind stranger, but from the bottom of my heart I thank you.

I worked my way through the Charity system, which could best be described as “hurry up and wait”.  I was immediately scheduled for an MRI, but the first available was over a month away.  I waited.  I didn’t have a car, or a cell phone.  The MRI department was in the hospital basement, and I remember nearly dragging myself down a long, very cold hallway, only to be told they had tried to call me – my appointment was cancelled.

I burst into tears.  They gave me the MRI anyway.

That’s when things got surreal.

I believe it was the next day – I got a call from a neurosurgeon.  He’d seen the results and we needed to talk.  NOW.  Could I come in that day?  No?  How about tomorrow morning?

When I had answered his call I had picked up a normal phone.  When I put it down it seemed to weigh as much as a bowling ball.

The next morning I wasn’t directed to the hospital clinics, but to a floor of private offices. The surgeon walked in with a colleague, and the two of them were very serious.  I was immediately put through a series of simple tests.  Push, pull, stand, sit, can I stand on my toes?  I could do all that.  But when they asked me if I could stand on my heels… I could not.  I didn’t know that – how often do you stand on your heels?  I couldn’t do it.

Then my world changed.

When they said “degenerative disc disease” I didn’t know what it meant, though it sounded dreadful.  “Ruptured disc” got the idea across with more clarity.  There were two of them in my lower spine.  One was inoperable.  The other needed immediate surgery.  In addition, I suffered from a rare birth defect.  Normally it wouldn’t matter – unless I needed spinal surgery.  In this case if the surgery went wrong I had a good chance of ending up a paraplegic.  It could even kill me.  Without the surgery the pain would only get worse, and I was already crippled from it.

How did next week work for me?  They left the room to let me think it over.

Most people, when talking to strangers, try to be friendly.  I was smiling and nodding throughout the conversation.  After they left I realized I was still smiling, as though they had been talking to someone else, saying something else.  Subconsciously I was waiting for someone to pop out from a hidden door and say “just kidding”.  When I stopped smiling everything just seemed to… freeze.

It was as though I could hear the air, or the colors in the carpet.  I remember the fabric of the chair was burgundy, and slightly rough.  The carpet was made of tight little wine colored loops.  The frame of the window was black and the glass had tiny bubbles in it.  The people on the street below were walking in the sunlight, the cars were driving by like everything was normal, and fine.  Oddly, it was as though I was seeing a chair, a window, a carpet, even sunlight for the first time.

In retrospect I’m sure they’d seen a similar reaction before.  The surgeons left me enough time to get a grip, but not enough time to panic.  The surgery was scheduled for the following week.  I thanked them, and left.

I don’t remember getting home.  As I didn’t own a car then I took the streetcar everywhere.  Not easy with ruptured discs.  But I don’t remember it, or calling my parents, or telling my housemates what was going on.  My memories are all strangely specific, like the light and shadows forming cracks on the sidewalks, or the sound of people talking, but not their words.

My emotions were locked in a crazed merry-go-round loop.  I could be dead in a week, or paralyzed.  There was no getting out of this, it would never get better.  My choices were stop where I was or go through this nightmare of hospitals, surgeons and recovery, knowing that it was the first surgery, not the last.  My traitor back had become a dangerous hurtful thing I could not escape.

I had no choice, which was confusing.  Surely there had to be options.  Where was the guy who would pop up and say “just kidding!  Here’s a prescription – pop this pill for a week and you’ll be fine”?  I kept waiting for that guy.  In truth, a little part of me is still waiting for him.

Of course, I lived through it.  Or, more accurately, I survived.  I didn’t know it at the time, but the person I had been, the one who took things like good health and long life without pain, died that day.

The second time I had that conversation, it was even worse.  But that’s for another post.

What is “Bipolar”?

Disclaimer:  I am NOT a doctor. Nothing in this journal should be considered medical advice.  It is my opinion alone.

***

A man I know once described his emotions, with a smile, as being “bipolar”.  Why?  He was having a hard time making up his mind.  A young lady I know once told me she was bipolar. Some days she really likes something, like cupcakes, and other days she can’t stand them.  Thank you for trying.  But that’s not bipolar.

I was diagnosed in 2001.  I had to ask the doctor what he was talking about.  After a good bit of jargon, he finally leaned forward.  “Ever hear “Manic Depressive?”  I had.  “Well, it’s that, only we don’t call it that anymore.  Now it’s Bipolar.”

I’ve been bipolar nearly 50 years.  If I had such a hard time understanding it, I’m not surprised how often it’s misunderstood by the public.  Initially I received one of two reactions if I told someone: syrupy encouragement or defensive hostility.  The encouraging ones told me to “cheer up, it’s not really that bad!” (with a hug). Those in the hostile camp would tell me (in a stern voice) to “get over yourself, everyone has a bad day now and then.”  Thank you for trying.  But that’s not bipolar either.

We’ve come a long way in a short time.  The word “bipolar” is no longer foreign. In fact, today it’s so common it’s used in casual conversation.  For example, the Salt Lake Tribune ran this article last Wednesday:

Kirby: Deciphering America’s bipolar position on guns

Students can be suspended from school for making “pow” motions, but a guy can walk through JC Penny with a rifle because he “supports the 2nd Amendment”.  Both show extremist thinking, which is the only real relation a social contradiction has to bipolar disorder.  It’s wonderful that the public has (for the most part) accepted that it’s real, enough so that it can be used in a headline.  It would be even better if people knew what they were talking about.

According to the American Psychological Association, bipolar disorder is “a serious mental illness in which common emotions become intensely and often unpredictably magnified.  Individuals with bipolar disorder can quickly swing from extremes of happiness, energy and clarity to sadness, fatigue and confusion.  These shifts can be so devastating that individuals may choose suicide.” (Bipolar Disorder, n/d)

This is complicated.  Worse, most people think they understand what bipolar is, even though their understanding is incomplete or flat out wrong.  I’ll try to break it down so it makes sense.

Under normal circumstances human beings occasionally suffer from “depression”.  Lower-case “d”.  They’ll get the blues or mope around for no good reason.  They feel sorry for themselves.  They have a bad day now and again. A person with depression can be cheered up by things around them.  If you tell them to “look on the bright side” it makes sense, even if they’re bummed out.

Capital “D” Depression is a clinical diagnosis.  It’s the type of diagnosis a guy with an MD must make, not a therapist.  It can work in conjunction with little “d” depression, but it’s not caused by having a bad day.

Capital “D” Depression is caused by a chemical malfunction in the body.  Something isn’t firing right in the brain, which does not allow a chemical to reach its destination.  So a person literally, PHYSICALLY, can not experience happiness.  It has nothing to do with a lack of perspective and will not change, even if you say “look on the bright side” 1,000 times.  And it is physically painful.  The only thing I’ve experienced similar in feel is a car accident.  It causes the entire body to ache, even blinking hurts.  Also, I found that everything seemed heavier, and in some cases I couldn’t lift everyday objects.  Even my own limbs were sometimes too heavy to manage.  Consequences be damned, there was no reason on earth to move, except to try to end the pain.

Mania is the flip side.  When most people hear the surface description of mania, they think it’s great!  Wow, tons of energy!  Loads of enthusiasm!  Start a business!  Enroll in classes!  Clean the house!  Shop for hours!!  WHEE!

While that may be what it seems like on the outside, here’s what it seemed like, for me, on the inside.  I’d start a project I couldn’t hope to finish.  I’d take on an obligation that I could not possibly follow through on.  And don’t try to talk me out of it.  It’s likely my enthusiasm would flash into towering anger.  I’d target anything that moved until you got out of my way, often to the point of physical violence.  Begin again.  Register for classes!  Run for office! Organize a committee!  Arrange the entire kitchen alphabetically!  Run up those credit cards!

I could also start whirlwind relationships.  When I got engaged I took extreme measures to break it off, terrified he’d actually expect me to go through with it.  When I got married it lasted less than 2 years (though it seemed like a fantastic idea when I said “yes”.)

As the cycle progressed and lucidity temporarily returned, I somehow had to explain everything that just happened.  Either I couldn’t get out of bed (sometimes for days) and so I had lost my job (again) or flunked out of school (again).  Or I had promised to lead a cheerleading clinic in Chinese, but I never showed up.  Of course, as I was undiagnosed, I couldn’t explain any of it.  That was the worst part.  There was no rational explanation for my behavior at all, and it never crossed my mind that I was mentally ill.  Typically, the person suffering from the illness is the very last to know (if they ever do).  So my “lucid” phase often flashed between defensive anger and crushing guilt.  This is one of many reasons those who suffer from bipolar disorder have so few long-term friends, or have been abandoned by their family.  How much can a rational person be expected to take?

Bipolar is a cycle, and everyone is different in the duration of that cycle.  When I was diagnosed I was told Bipolar lasts 2 years, start to finish, more or less, with each phase lasting around six months.  The first phase is six months of Depression, phasing upward into lucidity and self-awareness for six months.  This phases into the Mania for six months, which then phases down into another period of lucidity.  Round this out by beginning a new phase of Depression, and repeat.  Of course, new study has suggests every cycle is individual, and can change without warning.  The only thing that remains consistent are the mood swings: violent, unpredictable, inexplicable.

For me, Bipolar is a combination of nearly lethal anger and hatred.  The difference in the two is direction.  Depression turns the hatred in.  At its worst I could easily kill myself.  Mania travels outward.  At its worst I could easily kill others.

I was 35 when I was diagnosed.  A person can do a great deal of damage in 35 years.  I’m lucky I lived through it.  If you have it, or know someone who does, I hope this helps.

Bipolar disorder (n/d) Retrieved from http://www.apa.org/topics/bipolar/index.aspx

When will mental illness get the attention it deserves?

My father wrote this.  It was published by The Denver Post.  For those in doubt, yes, he’s talking about me.  He’s an amazing man.

Re: “Mental illness touches every American,” Dec. 24 guest commentary.

Dr. Marshall Thomas’ Christmas Eve commentary on the dismal state of mental illness treatment in the United States (and even worse in Colorado) was disheartening.

The awful truth is that mentally ill Coloradans are invisible. Where are the campaigns to help the mentally ill? What color is the little ribbon people wear to raise mental health awareness? When can I watch a huge holiday telethon to fund mental health research? When will our political leaders demand change?
Like most people, I’d never really thought about these questions until someone who suffers from mental illness asked me. She is a lady with very modest resources and her struggle to support herself while coping with her illness is heart-wrenching. Without visible symptoms or wounds, it is a never-ending challenge to get help. Her last emergency room visit began and ended with a suspicious “I’m not going to give you any drugs!” She doesn’t want drugs. She wants help.

Dr. Thomas noted that Colorado is last among all states in psychiatric bed capacity, 30th in mental health funding and, not surprisingly, has the eighth-highest suicide rate.

Surely the events in Aurora and Connecticut show how this problem affects all of us. Our governor has made a start by proposing additional funding, but much more needs to be done. Please help before another tragedy reminds us that our society has failed and continues to fail the mentally ill.

Ken HallLittleton

Attack of the Menacing Black Ice!

So there I was, stalking the wild beasty known in the finer hunting circles as the Menacing Black Ice.   Ginger the Dog, my faithful scout, had already sighted several smaller specimens, but I was after a real beauty – a huge but stealthy monster seen only rarely.  So sneaky is this beast that it instantly blends with its environment, rendering it nigh invisible.  Until, of course, it’s too late.

As we prowled the urban back alleys (a favorite haunt of the Menacing Black Ice) I came upon a suspiciously clear patch of pavement next to the building.  Alas, little did I know the depths to which the MBI would stoop!  Or how clever my foe actually was.  Unbeknownst to me, the Menacing Black Ice can lay traps to lure the unwary.

I proceeded with caution, when all of a sudden there it was!  An enormous Menacing Black Ice – dead ahead!  This is when I came to know how treacherous this beast truly is.  This may be the first recorded account of a Menacing Black Ice working in conjunction with an entirely different species!  As the MBI was sighted, suddenly, without warning, the building next to me sprang to attack!

Fortunately I was quick enough to prevent the building from completing its charge – I was able to foil it in mid-leap with the quick and clever use of the right side of my face.

Thus, civilization was saved once again, and the attempt of the Menacing Black Ice to run rampant throughout civilization was once again thwarted.

Or, put another way, to use the simple yet beautiful language of the natives of this area…

“Ow.”

The Weeping Woman

I met another woman weeping on the street last night.  The last one was sitting at the bus stop, and she just wanted a “time out”.  This one was from that same complex, as it turns out.  Spyglass Hill.  I remember I nearly rented an apartment there years ago.  I decided against it and I’m SO glad.  It seems east Denver’s pit of despair.

It was about 2:30 am or so, just after “last call” in retrospect.  This girl was wandering down Monaco, barefoot with a light sweater on, huddled in on herself and weeping.  If you saw her, would you have helped her?  Lawyers, you know?  You don’t know what’s going on.  Best not to get involved.  I don’t understand people like that.

In any event I started talking to her quietly while my lovely partner took the dog back home and went to fetch socks.  I always carry a variety of street-legal weapons with me, and considering my height, weight, and batshit status I don’t fear many things on the street, regardless of the hour.  So when her boyfriend buzzed us a few times in his Bronco it didn’t bother me, even when she freaked out.  After some conversation we decided to relocate to our stairwell so we could sit and talk where he couldn’t see us, but without freaking her further by bringing her inside a strange house.

She’s very pretty, willow thin with long flowing black hair.  She told me that mom’s a full Ute while dad’s Hispanic.  She has the best of both, apparently.  She looks 18 but said she’s 24 and mother of two.  Sadly, my bullshit meter redlined within minutes of talking to her.  Nothing the girl said made sense.  She gave me three different names within five minutes (Crystal, Lisa and Melissa) and was in a significantly altered state.  That she was drunk was obvious, but there was something working underneath that was hard to pinpoint.  In any event by the time I got a coat around her Steph had once again ducked inside to provide water, Kleenex and a scarf.

Crystal Lisa Melissa was very unwilling to go home, or to contact anyone she knew.  Given her state it was hard to figure out if she was frightened or embarrassed.  She claimed fear, but it didn’t ring true.  I tried to encourage her to head to a shelter at least for the night.  But she declined in a vague way, and spoke of her mother, her aunt and more of her boyfriend, without being able to remember where any of them lived, unable to recall their phone numbers, and having no real desire to speak to any of them.  Truly a lost soul.

By the time she sobered enough to ask to use the bathroom I was weighing my options, most of which boiled down to calling the cops.  She couldn’t stay with us.  It wasn’t a question of being unwilling to shelter a stranger.  If I thought she was telling the truth I would have helped more.   As it was she stayed in my bathroom for a few minutes and I was compelled to check the medicine cabinet and my jewelry box.  She didn’t take anything, but she did try to put on my sweat pants as a jacket.

When I helped her back into her own coat it must have weighed about 10 pounds.  I asked why, and she produced two river rocks from her pocket, one the size of a cantaloupe and the other about grapefruit sized.  She said she wanted a rock to speak to her mother – she could “hear” rocks, but these weren’t the right ones.  She was very sad she couldn’t find the right rocks.

By then I figured that we’re not dealing with a drunk, though she was drunk obviously.  A drunk Ute is a very bad thing, but her boyfriend later confirmed my suspicions.  She’s severely bipolar and a habitually self-medicates.  She’s also, I’m guessing, mildly psychic and can pick up on vibes in rocks.  Most of us seek out special crystals but if you’re just starting out a river rock will do.  She drinks to put the Beast to sleep, which works until it wakes up again.  Meanwhile, being Native American, she’s also now a bona fide alcoholic.  Oh, joy.  The “undercurrent” I was picking up, which at first I thought was a weird drug, was the Beast, watching.  Waking up.  Assessing the situation.

I pulled one of my old coats out of the closet.  I was going to donate it to Coats for Colorado but this seemed a much better use.  Steph grabbed an old pair of shoes and we got her dressed for the cold, and then took her home to the “abusive boyfriend”, who pulled in almost immediately after us.  She had wandered upstairs to see if she could get back in without keys, so I took the opportunity to speak to him.  No monster this, just a very tired, stressed out and worried young man, with deep black pools for eyes.  He had one of her two kids in the backseat.  Not the “dead beat” she described, he was her best friend from high school and had been dealing with the Beast for the last 6 years.  He loves her, but not as a boyfriend, and he wasn’t the father of the kids.  I tried to be calm and supportive while offering what advice I could about dealing with bipolar, but I really had nothing to offer.  This guy has been in the trenches for years.  He knows everything I do, and he’s at the end of his rope.  She’s been committed twice already, but the moment she gets out she goes off meds and back to alcohol.

I looked into his eyes and saw the same conclusion I had already come to.  Unless she saves herself she’s going to die.  And she’s not going to save herself.  At that point she came storming back out, and I saw that the Beast was fully awake and in control.  She was furious and defensive, seeing me talk to him.  I assured her that I wanted to make sure he wasn’t going to attack her (as she had said) before letting him go up.  Caught in the lie, the Beast lashed out.  She attacked him, and then snatched the keys out of the ignition before darting off again into the night.  While upstairs she had taken off my coat, and Steph’s shoes, and was once again in a light sweater and barefoot.  I let her go.

In retrospect it’s hard to say I made a difference.  Her problems are profound, and no amount of gentle speech and common sense will help her now.  It took me 10 years to tame my beast and that was with constant support.  With a limited support network, two kids and alcoholism in her hand, it’s hard to see how she’ll win this one.  She has my phone number and I won’t turn her away if she calls, but I won’t seek her out again either.

So here’s what I really took away from this.  My ex-husband and I wanted a family.  Had we gone down this path, my eldest would be about her age now.  Perhaps just a little younger, but not much.  She spoke constantly of her mother, who’s name is Lisa, and who was born in 1966.  Perhaps the universe wanted to show me what my own daughter would have become, had I been so foolish as to pass on my damaged genes to another.  I didn’t really need confirmation, but there it was anyway.  So really, I’m just sad and thoughtful today.  I can’t help her, him or them.  But I wish I could.