Q & A: How does one taper off bipolar medication?

Great question! I did this and I’m very glad I did. However, as I’m sure you’re aware, it’s a dangerous process. Be very careful. And, of course, I’m not a doctor. I’m a patient. I can only tell you what I did – your mileage may vary disclaimer disclaimer disclaimer.

My doctor might have been a great doctor, but he sucked at listening. His opinion was that if I wasn’t broken I wouldn’t be there. He wasn’t broken so I listen to him and say as little as possible aside from the occasional “Yes sir”. I tried to visit an ER once while under his care. They wouldn’t admit me because I was on the wrong drugs (from him) and legally they’d have to continue them while I was there. They wouldn’t do that.

Finally I had a long talk with myself. Mental health is incredibly important, but I was sacrificing too much of my physical health to accommodate the mental side of things, and it wasn’t working out great. I’d gained over 100 lbs for a start, and I didn’t see really great results mentally anyway.

The first thing I did was have a very long talk with my partner about why I thought this was a good idea, and why I thought not talking to my doctor about this was also a good idea. – he wouldn’t listen, wouldn’t think about it, he’d just say no then threaten me if I tried (this wasn’t speculation.  During one of my visits he specifically told me that going off my medication or disobeying him would result in him calling the police.  I’d either be arrested or taken to a psych ward.  He was quite serious – his practice had done it once already!)  Having lived with me for a good long while she was opposed to both. Finally I convinced her to back me in a 1 month experiment. Go off the drugs and just see.

I read about how to go off each one, and of course all were different. It ended up taking about 3 months for the initial detox, then going through another 3 months to just see what my body would do. The mood swings returned, but I got them more or less under control by taking fish oil capsules (my doctor’s idea, actually – he told me they naturally stabilize mood swings as well as increase the IQ). I also went on progesterone pills every day to level out the hormones.

It worked for me. The mood swings remain, and sometimes yes I lose control. But it’s not nearly as often or as violent as before. Meanwhile my creativity has slowly returned, my libido is recovering and I don’t feel “poisoned” all the time. If I could lose the weight brought on by the pills I’d be in a pretty great place!

Best of luck.

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Q & A: How does comorbid bipolar disorder work for people with autism?

Interesting question! My first diagnosis was Bipolar I. When they finally got around to “no, really, you have Asperger’s” my initial thought was, “well, thank goodness I’m not actually Bipolar!” Ha! Isn’t it interesting that I can still be happily naive at 51?

Anyway, having them both gives rise to what I fondly describe as “The Beast”. Sometimes I’m asked if I have multiple personalities, because I refer to my diagnosis or symptoms by a name like that. But no, it’s simply that sometimes the illness takes control. At times like that the rational part of my mind gets the hell out of the way because there’s just no stopping it.

The main symptom of Bipolar – wild mood swings – are bad enough. When I’m manic I’m likely to lash out at others. When I’m Depressive I’m likely to lash in at myself. It’s always in the background. Asperger’s adds an extremely short fuse to the mix. I can be easily overloaded by the strangest things, like someone cracking their gum, or a shrill child’s voice. If I hear an animal in distress I can go from zero to 11 in about 4 seconds flat. The entire world seems like an overload trigger in the right circumstance.

Combined – you get the Beast. If I’m Manic and something triggers an Aspey emotional overload I’m likely to attack. Sometimes at random, but more often I’ll go for the (often) hapless source of whatever triggered it. It sometimes works in my favor – I’ve saved dogs from hot cars. I stepped into traffic to save a wandering flock of geese with such authority that drivers stopped to help me get them out of the road. But usually it works against me. I’ve been kicked out of tons of places, banned from a few of them. I got kicked out of college twice and never finished my degree, in spite of starting as a Sophomore and having a 155 IQ.

In Depressive mode I’m likely to attempt suicide. My hatred for whatever triggered the response wells up to the point where I simply must destroy something, if only myself. I’ve got quite a few scars from episodes like that.

For me, awareness is key to survival. I’m amazed I lived long enough to get to my diagnosis. Now that I know what’s happening, more or less, I can act as my own voice of reason most of the time. When that fails my support network kicks in and can usually calm me down or get me to a safer space.

Q & A: Do you ever feel like you’re leading a double life by keeping your depression diagnosis from your friends?

GREAT question!! Totally fabulous.

I was initially diagnosed Bipolar I. And for a while I thought I’d keep it to myself. My neighbors already knew I was the lady with the hair-trigger temper. I’m the one they all talk about anyway. Why make it worse?

But then I thought hey! Why am I leading this double life? Aren’t we all adults? Why not tell them? Then they’d know that I’m ill. Maybe they’ll sympathize and we can start a constructive dialogue!

OMG, I totally crack myself up!

Yeah, I told them. In fact, I made it a policy for a while to tell everyone. Hell, I’d tell strangers in the street! I told my family, my friends, I posted it on Facebook, and certainly I told my neighbors.

Here’s what happened.

With my family it was almost immediate. I instantly transformed from “The Bitch” into “The Scapegoat”. No matter what the argument / problem was about, it was my fault. Why? I was DIAGNOSED! With a MENTAL ILLNESS! Case closed. It didn’t matter who started what, what they said, how they behaved or even what the point was. It all came down to me because I was officially crazy.  And if I wasn’t blamed, I was dismissed.  I could offer any suggestion, fact, theory.  You name it.  I might as well have been talking to myself.  What could I know about it?  I’m crazy!

Most of my friends vanished, as well as my extended family. Of the few who remain I can trust three of them. The rest (especially my cousins!) treat me with pity and only deal with me because it’s their “Christian Duty”. Is that worse than being The Bitch? Arg.

And then there’s my neighbors. Their idea of a constructive dialogue is to avoid me completely. To the point where if they see me coming they’ll actually turn and go the other direction. I went from being the loudmouth with the temper to a complete social pariah.

I STRONGLY recommend the double life.

Q & A: Do You Believe Bipolar Is Real? If So, Why?

That’s an interesting question.

When I was diagnosed as Bipolar way back when I was initially relieved. Finally there was some way to explain what was happening to me in a way others could understand! But while some understood that a chemical imbalance affects the brain, others completely dismissed the diagnosis. This included some members of my immediate family!

Too often the term “mental illness” is thought to be an excuse, someone covering up an obvious character flaw. I’ve been told (in various ways) that psychiatrists tell patients like me that it’s ok to be a bitch. They are quacks who enable weak minded losers. These are the same people who tell people with Clinical Depression to “cheer up!”, “Look on the bright side!” or “Get over it! Everyone gets depressed!”.

You would never ask someone who is blind if they “believe” they can’t see. You would never tell someone with no legs that they can’t run a marathon because they’re not trying hard enough. You would never tell someone with cancer that it’s all in their head. And yet, this is what someone with an invisible disability deals with every day. It’s not enough that they’ve been diagnosed with a serious illness. They also have to deal with people who reject the very idea of it simply because it can’t be seen.

Bipolar is not a matter of faith.  Bipolar disorder, also known as manic depression, is a mental illness that brings severe high and low moods and changes in sleep, energy, thinking, and behavior. I’m glad you asked.

The well-intended, completely pointless TWLOHA movement

I just found out that March 1 is “Self-Injury Awareness Day.”  I thought that was interesting.  March 1st is my biological birthday, and I’ve got hundreds of scars across my arms and legs due to cutting.  I thought I could do an interesting tie-in for a new blog post.

While I was looking up information on “Self-Injury Awareness Day” I saw a link pop up to the “To Write Love On Her Arms” site.  I’ve seen this phrase all over the place.  I had no idea what it meant.  In fact, I thought it had something to do with “Twilight”.  It seemed like something Edward would say to Bella … “I love you SO much I’ll write LOVE on your arms!”  “I love YOU so much I’ll wear LOVE on my arms!”  *shudder*  So I didn’t really look into it.

This morning I followed my nose to the “TWLOHA” site.  The folks running this site seem like very nice people.  Here’s their mission statement:

“To Write Love on Her Arms is a non-profit movement dedicated to presenting hope and finding help for people struggling with depression, addiction, self-injury and suicide.  TWLOHA exists to encourage, inform, inspire and also to invest directly into treatment and recovery.”

Yes.  Very nice.  Pointless, but nice.

And yes, I really do know how that sounds.  So let me clarify – it isn’t pointless to those who wish to offer support.  I’m thrilled they are investing in treatment and recovery.  It’s desperately needed.  But let’s be very specific about what this, and movements like it are.  TWLOHA does not support people who suffer from “depression, addiction, self-injury and suicide.”

TWLOHATWLOHA is a support group for supporters.  It’s a place where well-meaning people can join together with like-minded souls to talk about how they want to help people.  And I’m all for that.  Those who suffer benefit from talking to their own kind.  People offering support suffer.   Their job is thankless and so difficult it seems next to impossible.  Talking to other care-givers will help them.

But does it help those who are diagnosed with Depression?  No.  At least, not initially.  Would it help me now?  Over 10 years into my recovery?  Maybe.  I’m seeing a lot of blog posts from people who, like me, used to cut.  I can see the benefit in that case, sharing your stories with others to help them learn, to help you grow.  But for someone actually going through it right now?  No.

Let’s look at the mission statement to see why.  They’re a movement “dedicated to presenting hope…”

STOP.  Right there.  That’s far enough.  If you’re “presenting hope” to care-givers, this is a good thing.  If you’re “presenting hope” to the diagnosed, it’s almost insulting.  I wrote about this before in a larger post.

“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.

“Depression” (capital “D”), one half of bipolar,  is a non-negotiable chemical imbalance in the brain. It is not a “case of the blues”.  It isn’t a lack of perspective.  Rather, it is the absence of hope.  Depression 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.”

The root cause of mental illness is a physical impairment, not a character flaw.

This cheerfully optimistic, determined, extremely well-intended group goes on to say:

“We live in a difficult world, a broken world. My friend Byron is very smart – he says that life is hard for most people most of the time. We believe that everyone can relate to pain, that all of us live with questions, and all of us get stuck in moments. You need to know that you’re not alone in the places you feel stuck.

We all wake to the human condition. We wake to mystery and beauty but also to tragedy and loss. Millions of people live with problems of pain. Millions of homes are filled with questions – moments and seasons and cycles that come as thieves and aim to stay. We know that pain is very real. It is our privilege to suggest that hope is real, and that help is real.

You need to know that rescue is possible, that freedom is possible, that God is still in the business of redemption…”

screamMust.  Control.  Primal.  Scream.

Note to readers – I just deleted my first three attempted responses to this “Vision Statement”.  It has taken me over an hour to write all this.  Please understand I’m REALLY trying here.

Maybe expanding on that idea will help people who are not diagnosed understand why statements like this are so infuriating.

roaring_lionMy hands are shaking.  My heart is pounding.  I feel a tightness in my chest and a sincere desire to physically lash out.  The Beast is clawing inside me, raging for a chance to speak, to howl until it IS heard.  I’m controlling it by an act of will, but I am grateful, so grateful, that my partner isn’t awake yet.  Because of the destruction of our apartment (thank you SO much HOA… that’s another blog post…) her desk is only inches from mine.  She would be very upset to see me so agitated.

But now The Beast within is calming.  He’ll have his chance to speak.  My heart is slowing, though my chest still aches from the attempt.  I don’t need to take my blood pressure, I know it’s still through the roof.  But it’s getting better.

Ok, folks.  You may not have understood that reaction, but rest assured it’s very real.  I will do my best to explain.

hulkThe fury within me is the definition of Bipolar.  When the fury lashes out I’m in manic phase, as I am right now.  When it turns inward, that’s Depression.  But, like the Hulk, the fury is always present.  And the best way to trigger it is to attempt to invalidate my struggle.  Especially by telling me that if I just see things from a different angle I’ll suddenly cheer up and understand the light at the end of the tunnel.

TWLOHA is the finest example of that I’ve seen in quite a while.

“You were created to love and be loved.”  Thank you.  I know that, you really don’t need to tell me.

“You were meant to live life in relationship with other people, to know and be known.”  I know that too.  The fact that you put this in a vision statement tells me that you do not understand why a person suffering from Depression pulls away from the world.  If only you remind me that I should be in a relationship with others, I’ll suddenly say “ooooh, wow, I never thought of it like that before!”  Really.  No.  People with Depression pull away from the world because of the cataclysmic lack of understanding, combined with well-meaning people who try to offer us a “perspective check”.

“You need to know that your life matters”.  My eyebrow is starting to twitch.

“We live in a difficult world, a broken world.”  And?

“My friend Byron is very smart – he says that life is hard for most people most of the time.”  Good for Byron.  If I meet him I’ll give him a gold star and a cookie.

“We believe that everyone can relate to pain, that all of us live with questions, and all of us get stuck in moments.”  That’s nice.  In return, I believe that if you have never suffered from Depression (as opposed to “depression”) you can not relate to the pain I feel, as it is utterly irrational.  It is based on a chemical imbalance in the brain that does not allow me to operate as a typical human being would.  I do not suffer from a lack of perspective.  To say that Depression is similar to being “stuck in a moment” is like telling a blind person that they just need a fresh perspective and they’ll suddenly see the colors of the rainbow.

(I’ll skip the next paragraph – I’m sure you get it by now)

“You need to know that rescue is possible, that freedom is possible, that God is still in the business of redemption.”

WHAT?

sugar-addicts-total-recovery-program-kathleen-desmaisons-paperback-cover-artThis is NOT a 12-step program.  If I just cast my doubts aside, my worries to the wind and believe in a power greater than my own, I’ll somehow, suddenly understand hope?  That doesn’t even work for addicts, as most of them are also caused by a chemical imbalance – EXACTLY like mental illness.  Look up “sugar addiction“.  You’ll see what I mean.

Please try to understand.  Please.  I know you’re trying hard, members of TWLOHA.  I really appreciate the effort.  But… there’s a commercial out there that has a person stranded on the side of the road.  They call for a tow truck, a pizza delivery guy shows up.  Please try to understand I do not need pizza.  You can bake the most delicious pies all day long.  They’re lovely.  They’re yummy.  But I’ve still got a flat tire.  No matter how fabulous your pie is, what I really need is a mechanic.

I do not need a “Perspective check”.  I need a doctor.

Get it?

lovePS – My partner woke up as I was editing this post.  She asked what was going on.  When she saw me turning colors she patiently sat down and listened to me read the entire post aloud.  Then she nodded and offered thoughtful suggestions about how I could make it better.  That’s how you do it folks.  That’s how you make it through the day.  She is love.   No writing of arms required.

Oh, those wacky bipolar performances!

In a recent article I addressed the challenges of “coming out” in public.  Do you tell people you’re mentally ill and face the resulting backlash?  Or do you pretend that everything is normal while still displaying symptoms?  Neither seem like a good option, and there’s no third choice.  I’ve also mentioned how much I admire Carrie Fisher (as well as many others who speak in public about mental illness).  Her straightforward attitude regarding her struggles gives me a great deal of courage.

carrie fisherMs. Fisher was briefly hospitalized recently after an incident on a cruise ship.  According to reports she appeared drunk, her behavior erratic.  Was she drunk?  Maybe.  Or she might have been on one of any number of mood-altering drugs commonly prescribed to bipolar patients.   Look at these headlines:

Carrie Fisher Heads To The Hospital After Her Wacky Bipolar Performance On A Cruise Ship! (Perez Hilton)

Carrie Fisher briefly hospitalized after bipolar episode during bizarre performance on cruise ship (NY Daily News)

Vs.

Carrie Fisher briefly hospitalized (CBS News)

Carrie Fisher discharged from hospital after bipolar episode on cruise ship (Toronto Sun)

Arg.

I can not speak for Carrie Fisher.  But I have taken a drink more than once. I don’t like alcohol and I hardly ever drink socially.  But when the anxiety of a manic phase becomes too much, when the buzzing gets too bad, I have few options.  Narcotics?  Sure.  I have bottles full of the things, a different color for every occasion.  Problem is, one pill can last for hours, sometimes days, long after the symptoms have worn off.  In almost all cases the side effects from a tranquilizer are much worse than the symptoms of mania.

bacardiberry5 Alternative?  A shot of Bacardi.  I was doing that LONG before I was diagnosed – all through college in fact.  For a while I was worried about becoming an alcoholic.  I used to just grab a fifth and down a few swigs.  Yeah, Janice Joplin lite.  The effect is nearly immediate, it doesn’t last nearly as long as pills, and I can FUNCTION.  The buzzing emotions calm down.  Now that they’ve started flavoring the rums, it almost tastes good.  Sort of.

Of course, there are a few downsides to this.  Empty calories for a start.  During my heavy drinking period I pudged out quite a bit.  Not pretty.  And, of course, alcohol is addictive.  Once you reach the point of addiction any benefit a person may receive from doing a shot is negated.  Now you have two problems – you’re still bipolar and now you’re an alcoholic.  Joy.

There’s also a third downside which only becomes apparent as the cycle progresses.  I only need to drink when I’m manic.  I get the jitters, I start to spaz, I need to calm down  fast.  But when the mania phases into depression… then what?  I start to feel awful, I reach for a shot.  And I immediately feel worse.  What makes the manic phase bearable makes the depressive phase a living hell.  But it’s not always obvious when the phases have switched, except in retrospect.

 
we Carrie Fisher, wherever you are this morning, I salute you.  As always you give me courage.  Courage to write, to get the word out, to continue to champion the cause of those who struggle with mental illness.  It’s not a sexy fight, but hey – someone has to do it.

“Coming Out” as Mentally Ill – the psychiatric Catch-22

c22If you enjoy black humor or satire, you’ve probably read Joseph Heller‘s classic “Catch-22“.  Published in 1961, it describes the paradox of a situation that is contradicted by its very nature.  In the story a soldier wants a doctor to declare him unfit, because he does not want to fight.  The problem is that anyone who wants to fight is insane, and so by definition is “unfit”.  If you do not wish to fight, then clearly you’re sane, and “fit for duty”.

These days, “Catch-22” has expanded to cover just about any no-win scenario.  In the case of the mentally ill, one of the basic questions every person diagnosed must face is “do I tell anyone?”

prideAnother commonly used phrase in pop culture is “coming out”.  Usually it is applied to someone who’s gay.  If they don’t tell anyone, they’re “in the closet” and subject to a great deal of speculation, along with a fair amount of contempt.  However, if they “come out”, let the world know they’re gay, the inevitable reaction from many becomes “why don’t they keep that sort of thing to themselves?  Why involve “normal” people?  Who cares?”   Catch-22.

Applied to the mentally ill, it’s even worse.  Currently there is a strong push toward social acceptance in the LGBT community (Hurray!!).  There is a determined support network out there that refuses to be denied.  But among the mentally ill, while there is a support network, there is only a very limited attempt to raise awareness.  Usually it’s only temporary until the next crisis comes along.

6032ed90_01-its-a-secretFor the first several years after my diagnosis I made a determined effort not to tell a soul outside my immediate family and circle of friends.  It was our “dirty little secret”.  Of course anyone who knew me even in passing understood there was something “not right” about me.  I just wasn’t “all there”.  It was acknowledged, but never openly discussed.  I was “just that way”.

I can’t remember making a conscious decision to “come out”.  I do remember being very frightened to say “I’m bipolar” out loud.  But at the time it seemed the best of bad options.  Do I let people continue to talk about me behind my back?  Or do I take the bull by the horns and essentially say “Yes.  I’m crazy.  I have a chemical imbalance that affects my brain, which in turn affects my behavior.  This is who I am.”?

bipIf I never admitted it, it does not give society permission to address it either.  Even though people would talk behind my back, no one said anything to me directly.  I used to think that was easier.  But by saying “I’m bipolar.  I’m trying to deal with it.  If you’re in my life then do the same” I took a small measure of control.  It opened up opportunities for dialogue.  I don’t feel ashamed of what I am anymore.  I’m not bad.  I’m sick.  BIG difference.

However, there’s an unexpected downside to this public announcement.  By making it known I’m mentally ill, it gives people permission to speak freely.  Sometimes they forget that even though they can now talk about the illness in my presence, that does not make it any easier for me to deal with.  At first, when I started talking about it, it opened a dam.  I heard a veritable flood of stories that usually started with “Remember when you…” followed by a vivid description of my irrational behavior, accompanied by much laughter and eye-rolling.  Guys, I appreciate that you’re still in my life.  Thank you.  And I’m glad you can let off a little steam.  But… I’m still in the room, ok?  And I’m not cured.  I never will be.  So please think before you speak.  Let’s take this in small steps.

blue_meanie_chief_and_jeremy_by_mothmanboris-d4bd4g0While “normal” people can lose their temper or become frustrated, when I do it It’s often cause of immediate alarm – I’m “acting out”.  Err, no, at least not always.  Sometimes, yes.  But at times I’m just frustrated.  The world is an ugly place and sometimes I want to jump up and down like the proverbial Blue Meanie.  Now everything I do is subject to intense scrutiny. Is my behavior due to a manic phase?  A depressive phase?  Should I adjust my meds?  Should I call a doctor?  Which, of course, just adds to the frustration.  Arg.  In addition, the people who have dealt with me longest now have their own set of coping issues.  Being the support network to an out of control mental illness is #1 on the list of noble but thankless tasks.  So a bit of overreaction is to be expected.  Unfortunately, again, because of my illness, I’m not in the best position to deal with their overreaction of my reaction.  But I’m trying, and thank heavens so are they.

Another unexpected paradox is in the medical profession.  If I’m meeting a new doctor (my life is a constant succession of doctors) I’ll be very frank with them – here’s my diagnosis, here’s what it means, if you have questions ask.  Even though they’re doctors, unless they’re in psychiatry they probably don’t know how to deal with a bipolar patient.  Most are relieved I’m so up front about it, and many ask me questions not only about how I’ll react to something, but just how to address a bipolar patient in general.  Though we’re all different (of course), hopefully I can at least offer some insight – that’s cool.

The downside is that doctors can use this information like a weapon.  In my last blog post I wrote about how I was taken away in handcuffs early one morning because of this.  It has happened to me with medical doctors as well.  The latest incident was during a trip to a local Emergency Room.  Before I realized that the degenerative disc disease had spread to my neck, I wasn’t sure what was causing the blinding pain.  I felt as though I’d been shot through the shoulder, and it never stopped.  My doctor told me to go to the ER and get an MRI.  Ok.  I went to the ER and I described my symptoms.  I also, as usual, mentioned I’m bipolar.  This normally aids in communication.  When they asked me to describe the level of pain I was in from 1-10 I replied “11.  It’s so bad I could kill myself.”

3qedboNow, normally either they’d blow that off as hyperbole (which it was) or think it was a stupid joke to try to ease an otherwise tense situation (which it was).  But because I’ve admitted I’m bipolar, this team decided to inform me that any further statements of that kind would result in a one-way ticket to the nearest secure facility where I would be put on an involuntary 3 day psychiatric hold.  Then I was asked formally if I wished to revise my statement.  Grinding my teeth I simply said “my shoulder hurts”.

I understand their reaction.  In the days of happy-go-lucky lawsuits they have to be careful.  But guys, the knee-jerk automatic response isn’t required either.  A little common sense goes a long way.  Like – you could have just asked if I was kidding around.  And yes, I agree, under the circumstances I selected my words poorly.  I was attempting to describe the worst pain I’ve felt in my life, I wanted them to know I wasn’t wasting their time by being there.  I wanted the damn MRI.  Instead I was told they weren’t going to give me any painkillers of any kind (did I ask for any?  No.) and that I should return to my doctor.  If she thought I needed an MRI she could schedule one.

*sigh*

I don’t have a good solution to this.  Because my behavior affects every relationship I have, I maintain that telling people up front is a good idea if I’m going to spend time with them.  But some people do get weird about it.  Saddled with my own weirdness I’m not in the best position to help them deal with theirs.

And so it goes.

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.

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.

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