Archive for February, 2012

What can we say?

What can we say about a course of treatment whose success relies, in part, upon the patient forgetting the person they once were, and what it was like to be them? Monstrous, obscene, evil, a sacrilege, a crime against humanity?

And yet we submit to it, but why? Because the disorder itself can manifest in monstrous, obscene and evil ways, as sacrilege and crimes against families.

We are trapped. All we can do is hope that we never forget what it was like to be free. Small wonder we sometimes want out of our cages, i.e., refuse to take our meds.

Nope, for me, and for others too, I suspect, ‘hate’ doesn’t begin to capture the full extent of what I really feel towards my madness, for in some respects I truly love it and cherish it. It has enriched my life beyond measure. And to know that in some not so small way I have something, however indiscernible, in common with the Beethovens, Plaths, Twains, and Van Goghs of the world  brings me joy and takes some of the sting out of being mad, no?

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Is the bipolar life a tragic one?

After the initial shock of having been diagnosed with bipolar disorder wears off, as if it ever could wear off, we are faced with the daunting task of finding the right psychiatrist and the right meds to restore some semblance of normalcy to a life alternately shrouded in unvintageable sorrow or hyper-illuminated  in incandescent frenzy. The search for the right meds is a joint, cooperative venture, with the psychiatrist choosing the path and the patient providing the feedback that the path chosen is indeed the path forward, for sometimes the selected meds, while effective, have intolerable side effects. And far too often the selected meds are neither effective nor tolerable. It is not possible to know a priori if a given med is going to be effective or tolerable, for every instance of manic depression is unique both in how it presents and how it responds to treatment. The process of finding the path forward is largely one of trial and error, relying heavily on the experience of the psychiatrist and, as well, the native intelligence of the patient and the quality and articulateness of the feedback s/he provides. Ultimately it falls to each of us to decide if the quality of life ON meds is better than that OFF meds, taking into account ALL the side effects of both. It’s been my personal experience and that garnered at the forum that once we’re diagnosed, life (fate?) has a knack for systematically cornering us with this decision staring us in the face, and that no matter how we squirm to get out of making it, no matter how delicious or destructive the episodes may be, or how unpleasant the side effects of our meds, in the end the truth will prevail, that it is better for us, that we have a greater quality of life on meds than off. It is the responsibility of the psychiatrist to bring us gently to the brink of acquiescing, and then see us safely and successfully to the other side. Sometimes a little (or a lot) of hand holding is in order.

Make no mistake; this is no trivial decision in any sense of the word. For the sake of stability, we’ve been asked to forgo having a sex life, risk diabetes and to put up with a chronically dry mouth, blurred vision, tremors, slurred speech, constipation and/or diarrhea, and a diminished intellective function. In exchange for these sacrifices, we get to form attachments, experience kinship and kindredness and know true love, i.e., have a real life.

Sooner or later the manic depressive realizes that s/he cannot begin to have any kind of a real life w/o meds. And it is at this point, the brink, that s/he must decide which it’s going to be: sex, a flat stomach, a sharp wit but with frequent rage or never-ending sorrow punctuated with sieges of derealization and depersonalization and a pervasive fragility that leaves them eminently vulnerable to over stimulation, OR love and connection, and a place in the sun with your fellow man but with having to tolerate the intolerable.

Basically it is that we are at war with our madness, an enemy that takes no prisoners. For the creative ones among us, it’s encouraging to know that there is a medicated middle ground, a no man’s land, the penumbra between frenzy and oblivion, a place more suitable and conducive to art, and yet a place from which one will never emerge intact, sane and whole, where truly the only viable exit is death by one’s own hand.

Is it hyperbole for me to suggest that to live the bipolar life is to live a truly tragic existence? I don’t think so.

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Am or have?

From time to time we manic depressives get into heated debate over this question: is being bipolar something we are or is it something we have? I used to be of the “am bipolar” school of thought, but my therapist pointed out to me how elitist that kind of thinking is, as if I belonged to this exclusive club, and that made me better than everyone else.

So, with input from her, I’ve rethought my position. At birth, bp is something you have, it’s a condition. But just as Jewish babies, say, acquire Jewish culture, something that affects the way the brain develops, so too, ones bipolar condition will affect the way one’s brain develops, and the structures that are formed (this is well known following fMRI studies of bipolar folks, bipolar brains exhibit differences in structure vis a vis normal brains, and work differently than normal brains). So, to the extent that we are formed as we develop by what we have when we’re born as well as by what happens to us, it’s fair to say “am bipolar” just as it makes sense to say “am Jewish”.

So, to conclude. Is it “am” or is it “have”?. Kids, it’s both. Bipolar disorder is something you have and ultimately becomes something you are.

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On the Ferreting out of Would-be Bipolars

One of my pastimes or I guess you could call it a hobby is the ferreting out of famous would-be bipolars, and two of my latest finds are Mary Baker Eddy, the founder of Christian Science, and Newt Gingrich, politico. According to the wikipedia bio of Eddy, as young teen, she began to hear voices, and she was always high strung and emotional then too, professor Wiki continued. What does that sound like to me, given how always at the ready I am to examine the world about me through bp-colored glasses? Her childhood is certainly suggestive of the presence of a mental disorder of some kind, and given that such symptoms are often found in the bipolar, and further, given how hyper religious she was all her adult life, hyper religiosity being right up there with hypersexuality and compulsive behavior as hallmarks of a bp disorder, I’m thinking she was in fact bipolar. It certainly is a strong possibility.

But how about Newt? What’s my “thinking” here? Well I recently stumbled across this Amazon book ad,  “Duct Tape & WD-40: A Parent’s Guide to the Mysteries of a Bipolar Child. When the Fix-It Approach Doesn’t Work. [Paperback] David A Brown (Author), Newt Gingrich (Foreword).” Why would any author invite Newt Gingrich to write the foreword to his book about parenting the bipolar child if in fact he didn’t have some experience at same? That’s a good question, but I’m unwilling to part with the bucks in order to read Newt’s foreword, assuming he divulges therein why he was asked to write it. Stumble #2, Newt’s mama, Kit, who died in 2003, was bipolar, and a cursory search of the internet will reveal this. So here we have a man who is more or less notorious for his grandiose thinking whose mother was bipolar and who likely has a bipolar child of his own. I rest my case.

Brenda Fassie, the South African pop singer who ODed on cocaine in 2004, at age 39: What makes me think she was bipolar? Well, she was more or less notorious for her outrageous behavior, and I see her long and sustained love affair with cocaine as some kind of self medication. In her brief life, she attempted suicide three times, and I think her cocaine OD was a fourth and successful attempt. She once assaulted a paparazzi. She was difficult to supervise, known for it. And equally known for her hypersexual ways. Journalist Bongani Madondo characterized her as “Princess Diana on hyper-active pills.” And  she was known to have battled her own demons. This account is not very well written. I need to take the time and read a good biography of her. Anyway, I’m leaning heavily towards the presence of bipolar disorder. I’m on thin ice here, I know. I guess what really ices it for me is her singing—I don’t believe it’s possible to sing like that and not be bipolar.

Brad Delp, the lead singer of the rock group, “Boston”. With Delp, it’s more than a feeling. In his case, he’d actually received a dx of bp some short time before he committed suicide, and the supposition is that this dx may have triggered the depression that caused him to end his life. Suicide is 40 times more likely to occur in bipolar persons than in those suffering from depression. So that Delp committed suicide is more likely to be a sign of bp than not.

12/2/12 James Joyce.

I’m adding Joyce to my list because he closely meets the four criteria for bipolar disorder hashed out in Nassir Ghaemi’s latest book, “A First Rate Madness”: genetics, treatment, symptoms, course of illness. To begin with consider the genetics. Lucia, his daughter, was diagnosed with schizophrenia in 1930, at the tender age of 23. That was then, and nowadays she would’ve been diagnosed as suffering from bipolar disorder. And his mother died in a state of delirium, whatever that is. Did Joyce ever seek out treatment for his depression and anxiety? No, not that I know of, but he very likely self medicated these ailments with alcohol, i.e., he was a notorious boozer. But did he exhibit any symptoms of bipolar disorder himself? He has been adjudged in absentia as suffering from schizotypal personality disorder, the key features of which are: a need for social isolation, anxiety in social settings, odd behavior and thinking, unconventional beliefs, and a reluctance to bathe. As the reader may know, these features are equally well the features of bipolar disorder. Finally, as far as the course of his “illness” is concerned, his depressions/anxieties were recurrent. And so, on the basis of the above observations, I maintain that James Joyce should be added to my list of would-be bipolars.

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On Reading James Wood in TNY

James Wood is a professor of literary criticism at Harvard and a regular contributor to The New Yorker magazine, which I read with a fervor that smacks of some sort of intellectual religiosity, and to which I subscribe with commensurate piety. Although it was Wood’s article in the November 7th issue, “Shelf Life,” that’s led me to this moment de désespoir, just about everything I have to say about it could just as well be said about the entire magazine. Basically, to date my reading experience has been singularly discouraging to my literary ambitions in that the quality of writing, and its intellectuality,  is so high and so superior that I, a died in the wool wannabe writer—I. with my puny lead pencil (HB) and yellow, lined legal pad—can’t begin to compete. So why do I persist in my efforts to write, or at the very least, why do I willingly engage in the self flagellation implicit in my continuing to read TNY? Well, just as a moth is drawn to a flame, I’m helpless to resist its brilliance. The New Yorker in general and this article by James Wood in particular are so intellectually stimulating that only a dolt could fail to be moved by them. I’m not exactly the village booby, far from it, but I know in my heart that I don’t measure up.

So, what was it that Wood wrote that I found so utterly painful? He wrote, in referring to the huge personal library of his recently deceased fathier-in-law, “What a little thing a single human life is, with all its busy, ephemeral, pointless projects. All ruins say this, yet we strangely persist in pretending that books are not ruins, not broken columns.” I’m left thinking that my macindog website, my last ditch effort to have my mind known by others, is naught but a ‘busy, pointless project” and merely my life’s ruins.

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