Bipolar Me

Introduction

BACK WHEN my diagnosis was depression and anxiety, I secretly envied the manic-depressives, as they were called. At least if I had a manic phase, I thought, I could get something done.

Then I met Kerri, who was bipolar. She was not stabilized on medication to say the least. My envy lasted through her ambitious plans to make identical green velvet Christmas dresses for her three daughters, and vanished when I saw her tear them apart, recut them, start over, change her mind multiple times. You can write the ending to this one. There were no dresses, not by Christmas and not ever.

Kerri was riding the roller coaster (perhaps the most common metaphor for bipolar disorder) the peaks and troughs, swooping crashes, anticipatory climbs, stomach-clenching vertigo, and, for some, an abrupt stop at the end.

Type 2 bipolar, which my most recent psychiatrist diagnosed me with, is not like that. I never got the manic jags of exaltation and excess that typically go with type 1 bipolar disorder. I mostly didn’t even get the brief flurries of purpose and mini-jags of elation called hypomania that can accompany bipolar 2. Instead, those symptoms came out sideways as anxiety. I know it’s hard to picture being apathetic, despairing, and anxious all at the same time but I was for weeks, months, even years at a time. It’s no way to live, and some people choose not to.

The heights of the mountain are frightening. The depths of the pit are unrelenting. The challenge is to stumble down and struggle up until you find level ground.

Author’s Notes

I AM NOT a psychiatrist, a psychologist, a psychotherapist, or even a psychology major. I am a person with bipolar disorder and these are my experiences. Nothing in this book should be taken as medical advice. I am not recommending any of the medications I discuss. Your Mileage May Vary.

In this book, you will often see me refer to Spoon Theory. I didn’t invent it, but I’ve found it enormously useful in describing the effects of bipolar disorder to people with no experience of the condition. Here is the origin: http://www.butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/. It started as a metaphor to explain invisible illnesses and why people who have them are limited in what they can do.

Here’s a quick synopsis: Every day you get a certain number of spoons. Every day the number of spoons is different. You use them to perform everyday tasks that most people think nothing of, things like getting out of bed, taking a shower, getting dressed, finding something to eat, fixing that something, and all that is without even leaving the house. Some days that's all the spoons you have and when you've used up your spoons, that's it.

Other days you can manage to do all that and leave the house, go to work, run errands, and assorted other normal activities. But for those of us who have chronic illnesses, such days are few and far between.

You hear depressed people talk of not being able to get out of bed, and for the most part that's caused by lack of spoons. I am usually notoriously low on spoons. My husband now understands Spoon Theory and we use it as common shorthand for I’ve hit the wall or That's all I can handle right now.

This is the way I remember events and conversations happening. Other people involved may remember them differently. I can’t say they are wrong, especially given how much my disorder, my medications, and the intervening time have affected my memory. If they want to write books from their point of view, they are welcome to do so. But these are my perceptions, presented as honestly as I can. Some names have been changed to protect the privacy and self-regard of various persons.

Chapter One: Brain Games

Me and My Brain: A Story of Love and Dysfunction • Mind Like a Steel Trap • A Little Bit of This, A Little Bit of That • My Brain, My Books • The Teen in My Head • Creativity and the Bipolar Brain • Sensation in the Brain • Senses and Sensitivity

Me and My Brain: A Story of Love and Dysfunction

AS THEY SAY, of all the things I've lost, I miss my mind the most. Or anyway, a properly functioning brain.

I love my brain, despite all the trouble it's given me. For many years I thought it was the only measure of my worth, the only thing about me that made me special, the only thing that I could truly rely on.

I reveled in learning, in thinking, in reading, in questioning, in contemplating, in discovering. My body was not dependable; my brain was.

Little did I know the biochemical pitfalls that were waiting for me. Little did I know that my brain was ill. Disordered. Unbalanced. At the very least, uncooperative.

For instance, my brain decided other people were always pointing and laughing at me. Sometimes they were, of course, but that paranoia became my baseline assumption. Shrinks call that ideas of reference. I just called it life.

My brain played back for me every socially awkward or embarrassing thing I ever did, randomly and at the worst possible moments.

My brain made me cry at the stupidest times, at an upbeat sitcom theme song, when someone mentioned foreign travel, when opening boxes from the garage, when thinking about my college years, or at birthday parties. Whenever I was confronted with how damaged I am.

My brain had irrational thoughts. Bad thoughts. Self harm. Worse.

Eventually my brain refused to let me live any kind of a normal life, to go out, talk to people, care for my house or my pets or myself, or even read, which was once the greatest joy of my life.

But my brain also worked just well enough to send me looking for the help I needed. I've gotten back parts of who I was and what my mind was. And for that, I'm grateful. Even with it disorderly and uncooperative, it's still the best part of me.

Mind Like a Steel Trap

RUSTY. UNHINGED. Not good for trapping things. Especially memories.

That's not quite true. I have that uncanny ability that all depressed people seem to have to remember every stupid, clumsy, embarrassing thing I've ever done as well as every trauma. It's like a mental recorder that stores them up, then plays them at random moments. Or maybe not so random. Maybe just when I think I'm doing okay.

The memories can be as traumatic as the time other children threw rocks at me or as trivial as the time one person asked for a glass of water and I gave it to someone else.

Unfortunately, the recording feature only works for bad memories. Most of the good ones are MIA. I don't remember huge chunks of my childhood except as stories that family members have told me. I don't really know if the memories are mine or theirs. And I'm scared to compare notes.

My theory about these childhood memory deficits, and to tell the truth, all the way through those of my teens and early twenties, is that when you are profoundly depressed, memories don't imprint the way they're supposed to. Whatever synapses and neurochemicals are involved in memory making are out of whack. I'm also afraid to do the simple Googling required to find out whether this is even a plausible theory. If it's not, I don't think I want to know. I have an explanation that makes sense to me, and the memories won't come back if I learn my theory is wrong.

Later in life, medication has helped controlled the depression and the other effects of bipolar 2. But if I thought my memory was going to function properly, I was wrong. Some of the drugs left me with a memory like Swiss cheese.

My memory lapses seem more random now. Good things, bad things, neutral things, all disappear into the Swamp of Unavailability. Sometimes they are embarrassing, like forgetting a friend's father had died and asking how he was. Other times they are more distressing, only scraps left of trips I've taken. Sometimes they're heart-searing, a total non-recall of a never-to-be-repeated sexual encounter.

Good and bad, gone.

Oh, yes, said the doctor. That drug will do that. You can stop taking it now.

I guess I'm lucky. If I'd had electroshock, as my doctor once recommended, my memory would probably be as raggedy as old underwear. And about as useful.

A Little Bit of This, A Little Bit of That

I’VE NOTICED that a lot of my friends who have a psychiatric diagnosis display at least minor symptoms of other conditions as well. Depression with a side of Tourette's. Bipolar with a helping of OCD. OCD with a smidge of anxiety disorder. PTSD with all the above.

The symptoms of the secondary problem are usually not severe enough to warrant a second diagnosis and a separate treatment regimen. Most likely the add-ons are noticeable only to the person who has them, or possibly to very close friends.

I don't exclude myself. I have little rituals that help get me through the day, a certain order I do things in. I have a couple of words or phrases I mutter under my breath to keep me centered when I am stressed. Kittens for mild stress and jumping for more than mild. I suppose that if I ever get into kinky sex, I could use those as my safe words.

Do these mini-disorders ever grow into major ones? I don't know. They could be coping mechanisms or side effects of medication or routine habits or personality traits.

Mostly I think I should ignore them until they start causing problems with my life. My husband, formerly a certified addiction counselor, says when drinking or drugs start causing problems in finances, work, relationships, legal matters, and so on, that's how to tell when drinking or drugs they have become a problem.

For now, they're just little quirks, reminders that my brain has an alternative wiring scheme.

My Brain, My Books

IT USED TO BE that I could never be found without a book within arm's reach. I had a purse book, a nightstand book, a bathroom book, and a car book at the very least.

Now that I have an e-reader, I have hundreds of books with me everywhere I go, but I'm doing a lot less reading.

I think it's due to my lack of concentration. Whether that's the disorder or the meds I couldn't say.

I do know that when I was in the depths of my most recent breakdown I barely read at all. I watched moronic reality shows like Trading Spouses on the theory that these people's lives were bigger train-wrecks than mine. I watched cooking shows because they were calming. Not that I ever tried any of the recipes.

During an earlier meltdown, I tried to watch sitcoms but the relentlessly upbeat theme songs made me weep.

Now I must hoard my concentration like I hoard my spoons. I am fortunate enough to be able to work freelance from home. But it's the kind of work that sometimes has deadlines. On days when I can force myself to work, I can concentrate for about 2-1/2 to three hours at a spell. Some days I have to do two sessions like that with a nap in between, if a deadline is approaching rapidly.

But when it comes to non-work activities, I can usually only concentrate for an hour at the most. Sometimes I try hard so that I can watch a movie. I usually stick to hour-long shows at most.

Reading takes concentration too. I do a lot of my reading in bed at night. I know you're not supposed to do that because it keeps you from falling asleep but it's a life-long habit.

My mind flitters, the brain hamsters and sometimes the stomach badgers stir, and I find myself several pages along with no idea what happened. At that point, my need for distraction and my attention span collide and I have to find something moderately absorbing but short-term to do. It's a good thing I have some games on my e-reader.

Reading has been one of the great joys of my life since I was four. It bothers me that I no longer have the ability to immerse myself in it the way I used to.

But, like so many other things, it's something I'm having to learn to live with. Or without.

The Teen in My Head

THERE IS SOMEONE else living inside my brain.

I don't have Dissociative Identity Disorder. I just have another me who pipes up from time to time. And man, she can be annoying!

She's 14 years old, and she doesn't have a name. I don't know when I acquired her, but I do know when she acts up.

She's the one who frets when a friend doesn't answer my message. When he does, she squees, He noticed me! He noticed me! She's the one who wants to buy ridiculous, useless, but amusing things. She makes me eat that extra chocolate cookie, then frets about getting fat and pimply. She's the one who is hooked on all the stupid internet games.

I've heard the theory that everyone has a mental age that they get stuck at. No matter how old they get, they always picture themselves at that age. Mine is somewhere between 28 and 34. So how did I end up with a 14-year-old?

My theory about her existence is that she is there to try to do what I never did when I was 14, all the regular teen-age angst and frivolous stuff: mad crushes and pouting, self-obsession and discovering her sexuality, in-jokes with best friends and trying out fingernail polish.

When I was 14, I did none of that. I was in a prolonged downward mood swing, made worse by puberty and the horrors of junior high school. I wrote depressing poetry and read French existentialists. If they had had hipsters back then I suppose I would have been one.

When I feel her popping up in the back of my skull, most of the time I put her in a box and sit on the lid. It's scary to let her take over. She's rapid-cycling, impulsive, and, worst of all, unmedicated. (I don't know why my meds don't affect her, but there you are, they don't.)

Once in a while I let her out of the box. I let her enjoy some mad crushes, as long as she doesn't do anything about them. I let her buy things that cost $20 or less. One time I let her talk me into fake fingernails. I let her have some of the fun that I never had at that age.

The thing is, I don't know if this is a me thing, a female thing, or a bipolar thing.

I know I'm not completely alone in having a teen ride-along. I do know a man with dissociative identity disorder who has an alter that is a teen girl. I could tell when she was out because she giggled a lot and bought junk food. A friend of mine who has suffered from depression also has a 14-year-old in her head. She has given her teen a name: Innie Me. Hers behaves a lot like mine.

I also don't know whether having a teen living in my head is a good thing or a bad thing. It could be good, because it does give me access to the feelings and experiences I never had as an actual teen. My teen is better than I am at having fun.

On the other hand, I know it would be a bad thing if I let her have her way all the time. She needs that box and I need to sit on the lid. The trick is knowing when and how and for how long to let her out.

On an episode of Scrubs, one character remarks that no matter how old a woman gets she always has an insecure 14-year-old inside her. I suppose that men experience similar phenomena. Most people are said to have an inner child. I think my husband's inner child is usually about seven or 11, tops.

Certainly, my teen is insecure. There's no question about that. But she's also enthusiastic, engaged, and energetic as well as moody, dramatic, and confused. I think she may be related to the hypomanic part of myself, although I'm also sure some of my fits of apparently reasonless weeping have been caused by her acting up.

My therapist knows about my 14-year-old. We have discussed her and her behavior and her moods several times. Dr. B. has never expressed surprise or shock or puzzlement at the idea. She does think it's good that I'm learning to sit on the box lid when I need to. We've talked less about when it's a good time to let her out. That's something I still need to work on.

I guess I'll have to learn to live with my 14-year-old, because I don't think she's going away anytime soon. And I don't think I really want her to.

Creativity and the Bipolar Brain

Sun or shade

feel or know

safe or strayed

stall or flow

Thought or whim

drought or rain

sink or swim

heart or brain

Stop or start

bound or free

light or dark

bipolar me

I HAVE A LOT of friends who are creative, writers, musicians, singers, woodworkers, knitters, and other artists and craftspeople. I also have a lot of friends who have assorted mental or emotional disorders: depression, bipolar, PTSD, OCD, and probably many more that I don't know about. In many cases, the creative and disordered categories overlap.

Common wisdom holds that there is a link between creativity and madness. Look at Van Gogh, for example. People have spent years debating what specific disorder he may have had, but nearly everyone agrees that he had something. The question is, would he have been the great artist without the mental or emotional disorder? Or, perhaps, would he have been an even greater artist if his brain functioned in a more typical matter? Science so far has given us no answers.

Many creative people realize that their everyday functioning is impaired, but they are reluctant to seek treatment for it. They fear that tampering with their brain or thought processes will somehow inhibit their creativity, somehow make them less than they are in some fundamental way. When you start tampering with brain chemistry, who knows what will happen?

It's a valid concern.

Throughout my life, my brain has been all that I have. My intelligence and creativity were the things I was most proud of. How could I risk losing those simply because I was eternally miserable? The question seems absurd now.

Eventually I decided that I had plenty of brain cells to spare, and that if taking Prozac took away a few of them or lessened their ability, I could live with that. I took up pursuits that are supposed to strengthen the brain just in case. Things like math puzzles, word puzzles, music, and of course writing. Not everything I tried was a success, but I hoped they stretched my brain muscles.

My experience with that first psychotropic med convinced me that Better Living Through Chemistry is not just Dow’s slogan. It turns out that (surprise, surprise) thinking more clearly and feeling more well-adjusted actually empowers one's creativity. My output changed from poems full of young adult angst to creative nonfiction, personal essays, and the occasional short story. I now make my living doing freelance writing and editing, a style of work that I couldn't have made a go of before having my mood disorder treated. The ability to concentrate, to focus, is what enables me to sustain a creative effort.

So, to all those people out there who wonder if they are sabotaging themselves and their creative impulses by seeking treatment, I say you have nothing to lose but your immobility. You have everything to gain: the ability to create, expressing yourself and doing it clearly, and the possibility of creating something truly wonderful.

Sylvia Plath was a poetic genius.