The Day of My Diagnosis

This is the text of a speech I delivered on September 22, 2016

Twenty two years ago, when I was almost thirty six, I woke up one morning and said “Lynn, I’m sick.”. I had been in bed for weeks. I’d lost my appetite. We made an appointment with the psychiatric department at Kaiser Redwood City and by the end of the following week I was on Prozac.

Prozac was amazing stuff: I was cured the next day. My psychiatrist was surprised but because i had never told him about my other symptoms — the irritability, the paranoia, the rapid speech, that time in college when i had gone up to San Francisco with my girlfriend and come back with my girlfriend and they were two different people — he let things be. In time, our insurance changed, so I came under the care of a nice gentleman in Menlo Park who also had no clue about my other symptoms so he made no changes. Then we moved down here and I found a new psychiatrist who also made no changes because I never told her about my other symptoms either.

Then one day the Prozac stopped working, so she changed me over to Effexor. I found myself in a burning darkness. Two things happened. First, an editor was taking forever to get back to me on a story. Second, I overheard Lynn saying something about me to her sister. My irritability merged with my despair. I went for a walk in Whiting Ranch, called a friend — who found my anxiety funny for some reason. So I texted my last will and testament to Lynn, making special note to leave some possessions of my father to my nephew and asking her to be sure to be sure to get my poetry published after my death. Then I sat down on a sycamore log, studied my veins, and prepared to bread my glasses.

My cell phone rang. It was my psychiatrist. “Are you all right?”.

“No,” I whimpered. She told me to go down to South Coast Medical Center. Lynn picked me up and drove me to Laguna Beach

After spending several hours in the emergency room getting my chest x-rayed because I was wheezing, they took me down to the behavioral unit where I left Lynn at the door. They took away my shoelaces and my glasses, then showed me my room.

I came out after an hour. “I am diabetic,” I yelled. “I need my blood sugar medicine!” I can only imagine what was going through their minds — “this guy was brought here because he was preparing to commit suicide and now he wants the medicine her takes to keep himself alive” — but I am sure they took careful notes.

The next day when i went to group i was the happiest person there. Everyone was miserable except for me who was laughing at the fact that he had attempted suicide and lived to tell about it.

After group, I waited around until I was called into a consulting room. A psychiatrist joined me there. He took a few minutes to read over the notes the ER doctor and the nurses had made. Then he looked at me and asked in a very gentle voice “Had anyone ever told you that you were bipolar?”

And that is when my recovery began.

What Does it Take to Make a Diagnosis?

There are a couple of people who sometimes respond to my threads who don’t like it when I say we shouldn’t be calling people mentally ill just because we don’t like them or act in ways that we don’t like. I think it is time for me to outline what is required to make a diagnosis:

  • You have to be trained as a psychiatrist or a clinical psychologist. (Most “experts” or the “peanut crunching crowd” are not.)
  • You have to have actually examined the person. This goes beyond watching them on television or reading about them in magazines or newspapers.
  • You have to use proper diagnostic criteria.
  • You must be neutral. Most of the pseudo-diagnoses that I have seen fail magnificently on this score. In my experience, progressives are the worst, but this does not exonerate others including conservatives.
  • You must have the patient’s welfare in mind, not an opportunity to insult.
  • You must avoid stigmatizing people with mental illness who are not anything like the person you are diagnosing. E.g. By saying that terrorists are mentally ill, you are implying that people who are mentally ill are like terrorists. (Research shows that people with mental illness are less likely to be violent than the normal population.

The Flatland Dilemma in Interpreting Bipolar Mania.

People in mania are known for flights of fancy and the rapid association of ideas. Of all the forms of intelligence that we may possess, it is only the ability to recognize analogies and build associations that suffers when we go on mood stabilizers. I think it can be a mistake for outsiders to believe that this ability leads to wild, random, and unusable linkages in our mind. I find that my ability to write poetry — meaningful poetry — suffered after I started taking lithium; I lost insights. Of course, many other more negative traits like my irritability, grandiosity, and racing thoughts disappeared so I consider it a net gain.

The things we bring back from our adventures in mania land aren’t all rubbish. Poets such as Shelley and Byron depended on their manic states to generate compelling material. Some scientists have conceived startling new concepts. Isaac Newton is a classic example of a maniac whose insights transformed the science of his day and enabled him to revolutionize mathematics with his invention of calculus. The trouble comes when we try to bring our insights back from the fine and private place of our sickness.

William Knowland’s Flatland — which was written to explain the difficulties inherent in Faith — presents a useful allegory for our struggle to explain what we have found. Imagine a two dimensional figure, say a square. Imagine that it is you. Your perceptions are limited to two dimensions, so while you can make out one dimensional figures such as lines and points, you cannot appreciate three dimensional ones. If you were one dimensional, squares would appear as lines to you. Angles and other aspects of the square would invisible.

Read More

The Progress of My ADD Treatment

Diagnoses come to me long after the illnesses have wrecked my life. I received the label of “Attention Deficit Disorder” a few months back when I asked to be evaluated for it. My psychologist passed the information on to my psychiatrist who put me on Vyvanse.

I like to say that my mood-stabilizers put down a floor that allowed me to put up a house based on healthy changes in my life. Vyvanse created doors and windows that let air and light into the rooms.

The effect of the medication was apparent on the first day. I accomplished many tasks that I had been putting off and kept the motivation going for the rest of the week. When I started running out of things, I looked around the condo and found others to do. I compiled a list of future projects.

One by one, I checked them off and added more.

Read More

Twelve Myths About Bipolar Disorder

2 Comments

I have to rebut these when they are said by family members, fellow patients, and random members of the public. Every one of us who lives with the condition has heard some if not all of these time and again. You might even have a few of your own to add. You may note that I don’t include “It’s all in your head” (though the issue of faking is covered below). It is all in my head! Bipolar disorder is an organic brain dysfunction and the brain resides inside my skull. So I don’t count that a myth, just a misapprehension of the truth.

Here are my twelve most common myths:

Bipolar disorder is just something psychiatrists made up so that they can get rich.

Not too long ago, a Fox Radio commentator told a caller that she had been duped by her psychiatrist. They just made it up to get your money, he told her. She begged to differ but he was having none of it. Even when he was forced by his employer to apologize, he equivocated.

There are a few things wrong with this belief. The first any person with bipolar disorder can tell you: the highs, the lows, the paranoia, the hallucinations, and the delusions are all too real. Physicians have observed the disease in patients since the time of Hippocrates. And patients have suffered, suffered mightily.

Read More

11 Commandments for People Living with Bipolar Disorder

Recovery from bipolar disorder is almost like a religion or an ethical system. Certain devotions must be part of our lives if we are to recover our balance.

  1. I shall hold myself accountable for all works of my body and my mind including those which I wreak when I am in episode.
    It is important, I feel, not to separate the illness from ourselves. We did the things that happened while we were in episode. There was no second soul seizing control of our bodies. Our mind is a stream that flows continuously, sometimes over rough ground, sometimes in placid stretches, and sometimes over cliffs. We own all these states of our being.

    2. Read More

My Name is Not Bipolar Disorder

worldbipolarday

The roller coaster analogy never really spoke to me. I didn’t experience a thrilling ride. It was more like a tornado or a hurricane, a central column of madly swirling air that threw everything in its path asunder only to die and leave a still, bleak landscape of broken trees and shattered homes where no one could live. “Things fall apart,” goes the Yeats poem. “The center cannot hold.” Mania causes us to lose sight of our center and depression causes us to forget that we ever had one.

I count myself fortunate that I never ended up in jail though perhaps some might have made a case for it. Drugs and alcohol, at least, never presented themselves as ways to temper my emotions — I distrusted them. I let whatever flew out of the maelstrom hit me square on and I did nothing to numb the pain except hide in my room or rage unexpectedly.

Bipolar is one of those illnesses that everyone who has watched a Lifetime Channel movie thinks that he or she knows, but they have no clue. The illness doesn’t make us evil. Most of the things that I did in my rages and panics were moved by an innocent heart. I have found the same to be true of others. But often what we do is hurtful. It is no wonder that outsiders see us as brutes. When I have acted with the most vigor and erraticness, I have done so the name of one or another great crusade, marching against problems that often only I could see. Heraclitus once said that “The waking have one and the same world, the sleeping turn aside each into a world of his own.” Bipolar creates in that waking world a sub-world that we who labor with the illness experience on our own. In it we sleep a sleep of wakefulness. Perhaps this is due to the restlessness of mania that keeps us up night after night, day after day.

Eventually things fall apart and we find our minds in bizarre places.

My worst psychotic episode happened when I was working over Christmas break in college. The world became a maze of passageways like I see in my dreams, the doors to the rooms hazy and difficult to find. I believed that I was God and that I had messed up the world. Once that a coworker asked me what was wrong. I did my best to deny that the veils between us did not exist. It was a tricky maneuver but I pulled it off. Every night I returned to my room and found darkness. When the other students returned, I felt less lonely, but I felt I wasn’t one of them. I hid in my room, held my tongue and kept my condition to myself. They knew nothing of my obsession or the distortions that blurred my cognition. Sometimes they would find me staring into space and wonder if I was on drugs. I was stone cold sober. An ill gift of prophecy settled over me. I believed that I could predict what people were going to say. I became sensitive to the occasions when people would utter words that I had encountered in my reading with no connection to the class or the context. My skin jumped at their mention and my shivers from remembering the incidents of my day kept me up. The episode slowly lifted over the semester, though I did have to drop a class.

Sixteen years passed before I sought the aid of a psychiatrist. Eleven more needed to turn over before I started telling the truth about my experiences. Oh the rages, the insomnias, the dark nights of the soul, and the mind-crushing paranoias that troubled me even though I took antidepressants and thought myself cured! The word “bipolar” was, at last, used. During the eleven years of denial, I refused to believe that it applied to me though I numbered it in others. One day in the hospital, it caught up with me, though. The new attachment to my identity electrified me. I read all I could, kept finding myself between the pages, and in the end surrendered to my diagnosis. Then I took my pills as prescribed, dieted, exercised, and broke down the walls that kept the world outside of my dream.

Though my doctors named my condition, my condition was not me. I had always had doubts about this wreck of a brain that always seemed to say and do things against my better judgment. Outsiders sometimes tell me that mood stabilizers erase the personality. They have no clue. When I got on lithium and it started working, I found myself able to be the me that I knew I always was, free of the control of the randomness-loving demon who operated my body like a slot machine whose prizes were shame and sorrow. Over the years, I have added and subtracted more medications to my cocktail until I had a firm foundation upon which I could finally build a brick house. When the madman tried to seize control of my inner weather, I had a series of steps that I could take to seal myself inside my house and wait out the storm. This security enabled me at last to separate myself from my illness. I knew, at last, who I was. Life was no longer a bad dream.

Joel Revealed

Because Quinn posted a brief introduction, it falls to me to do the same. The sketch of who I am runs like this: I am 57 years old, a graduate of a prestigious undergraduate school, and a graduate school dropout. As you might expect of someone with my illness and an idealistic bent, I chose the wrong major — Anthropology — which made it hard to get a job after my academic career crumbled. My immediate emotional support network consists of my wife, a Boston Terrier, and a gray tabby cat. For years, I could only brand myself as a failure.

My diagnosis with bipolar disorder (I don’t do numbers) came when I was 47 years old. I had texted my last will and testament to my wife then sat down on a log in Whiting Ranch Wilderness Park to ponder just how to slice my wrists. The phone rang. I answered. The voice of my psychiatrist spoke into my ear and asked me if I was all right. She persuaded me to get down to South Coast Medical Center (now Mission Laguna Beach Hospital) and commit myself. The next day a staff psychiatrist asked me if anyone had ever told me that I might be bipolar. I sat for a long moment and wondered just where I had missed this message in my life.

It isn’t as if it wasn’t there. I took Prozac for 11 years. One day and I was out of my depression. That was a warning. People told me about the dangers of the SSRI such as suicidal thoughts, but though these infested my mind, I disregarded them. My wife kept telling stories about people with bipolar that she had known or read about even before I sought the help of a psychiatrist. Once I had that depression diagnosis that is where I wanted to stop. People told me that I acted crazy. Some asked if I had been taking drugs or drinking. It wasn’t until that day when the hospital psychiatrist asked me the big question that I realized that people had been hinting about this all along.

Oh, I could –and will — tell you stories from the time when I was in college and thought I was God — but with the catch that I had messed up the Universe and couldn’t fix it — to my various failed schemes and plots. Today I volunteer at various activities, lead Meetup hikes, and help other people with mood disorders get a grasp on their illness through DBSA, the Bipolar_Blogs Twitter account, and various chatrooms. Note that I use the word “illness” — bipolar is not a character flaw, but a disease of the brain. And I call myself a patient not a consumer, one of a growing number of us who rebel against this terminology.

I hope to have other voices from our DBSA Chapter writing here, telling you the stories of their lives, sharing their discoveries, and commenting on culture. It is not an easy step to come out as living with a mental illness, but I hope more of us will take it. Too many people think wrong things about what kind of people we are. If we want truth to rule, we need to tell you who you are.

And I am Joel. I live with Bipolar Disorder.