What makes you believe you are manic-depressive? How long have you known about your disorder? Do you have a place to live? Where are you living (or who are you living with)? Is your therapy free, or if not, how are you paying for it?
When I was first diagnosed, I was willing to take meds even though, for most of my life, I thought that meds for the mentally ill was for lazy losers. By the time I was diagnosed, however, I was crazy. Crazy depressed. Crazy touchy. Crazy anxious. Very different from the frame of mind I’d lived with in the five decades of life prior to then.
I still had some lingering reservations about drugs. Most of it was because I didn’t really believe it was an organic condition. For all my life, I’ve experienced my mind as something I had control over. Yet here I was, having a difficult time recognizing myself, and not knowing why. I thought I was unhappy with my marriage, and I was. But I never imagined that such unhappiness could have made me go around the bend.
The first symptom was rather subtle, although classic. My mind started going faster and faster. I noticed it and wondered about it. I thought maybe I was getting brain cancer, and my mind was doing as much as it could as fast as it could before it was disabled. It’s odd, now that I think about it. Most people like their manias. I didn’t. It was quite disturbing.
The next symptom was also subtle, although I also noticed it. I found myself getting more and more irritable with my son when helping him practice piano. He seemed to be not trying, and I thought that it was all right if I got really angry, because he’d remember it, and try harder. I got so angry that I scared myself, and went out for a long walk, thinking that no one in the family really cared any more whether I was there or not.
Another symptom was also subtle. My desire for sex was getting more urgent. I wanted love, and I wasn’t getting it from my wife. I started masturbating more and more.
Then things started getting out of hand. I was on the internet looking for sex. I was falling in love right and left. I was ready to leave my wife (though not my children). Around Christmas time, I got the first really weird, very noticeable feeling. I had this deep sadness and this weight right over my heart. It felt like someone was about to die. I even called my parents to make sure they were ok. I was supposed to go to a neighborhood Caroling party, and I begged off, unable to imagine trying to be happy, like those songs.
A couple days later, I found out that an old colleague had gotten the news that he had a fast moving cancer, and he only had a week to live. I started feeling bad right around the time he got the news. Could I be psychic, I wondered?
In the following four or five weeks, the shit really hit the fan, bouncing between high highs and deep lows (which I now know is called a mixed state) and ending with my wife taking me to a shrink, and getting diagnosed, and put on lithium right away.
The weirdest thing, for me, was that these things were happening to me. I had no control over them, although I tried. I just felt powerless. I was watching myself go crazy, and I didn’t even know what to call it. It was like watching my personality disappear in the distance, and being taken over by a me I didn’t recognize.
The prescription was meds and therapy (both individual and couples). The meds made a dramatic difference. Within a month my depression had receded to a point where it was bearable. I still didn’t understand how a person could be happy or like themselves, or even think they were anything more than a turd stuck on the back of an elephant’s ass.
They messed with the meds, adding Welbutrin, which, as I saw it, moved me close to the surface of the water I was under. The surface was neutral. Anything underneath was depression. Deep down is a depression so deep you don’t even believe the surface exists. That’s when I wanted to die.
Getting close to the surface was good, but still, every day seemed difficult. I did little. I went to work and sat there all day typing to people on social networking sites. My desk at work was getting buried deeper and deeper beneath unfiled papers. I’ve never been a total neatnik, but I would generally neaten up the office two or three times a year. I was in a job that required organized thinking. A messy desk was a sign of my messy mind.
Finally, my wife convinced the shrink to add Lamictal, and that brought me up to the surface. I still don’t believe I’m much more than shit, but I’ve learned not to think about myself. It does no good. I know the thoughts don’t make sense, and that I make many contributions—my family, work, fluther, music, etc, but they don’t seem to matter when I think about my worth.
Anyway, in therapy I learned about “mindfulness” and while I don’t think I practice any official version of it, I have learned to do something different with my depressing thoughts and judgments about myself. I can’t stop them. However, I can control how much attention I pay to them, and I’ve learned to let them come and go. I am no longer so attached to them. I see them coming, and I don’t fight it (because that never worked), but I know it’s not real unless I make it real, and while the urge to make it real can be strong, so far, I’ve managed to let those thoughts float by without stopping to visit them.
I started going to a support group for bipolar people. That was really helpful. I was finally surrounded by people who understood! They’d all been suicidal. Many had been much worse—hospitalized, delusional, paranoid, hallucinating. Some were or had been self-medicating—booze and pot, mostly. Some had done the sex thing, although there is an understandable reluctance to talk about that. Some have been bouncing from shrink to shrink, therapist to therapist, not finding one they can work with for a long time.
I learned that both meds and therapies are experimental. No one knows what is going to work for any individual. So the doctors keep trying different things until they find one that works. Sometimes they only work for a while, and then you have to find something new.
Some of the advice we tell each other is the same all the time. Exercise regularly. Exercise hard. Sleep regularly. Go to bed before midnight every night. Get yourself on a regular schedule. Take your meds regularly. Find a primary support person who will help you get to the hospital when you get bad, and advocate for you. This person will also help you take your drugs and be there for you when you need someone to talk to.
They also work on getting out of the house every day. Depression makes you sit and stare at the walls. Getting out and being with people fights that. It makes you feel as if you could be a part of society, even if you don’t feel like you currently are a part of society.
Insurance is a problem for many of us. You are probably eligible for Medicaid, but if you’re depressed, then jumping through the hoops to apply for it just makes you quit. You have to have someone help you. Also, if you get involved with a support group (go to the DBSA site to find one near you), there may be people who can help you get insurance, and who can help you get meds you need. They know where the cheap meds are. In addition, if it gets bad, you can check yourself into a hospital, and the hospital will provide the meds for a week or two.
Another thing you can do to help yourself is to buy books about the condition. The DBSA bookstore offers many choices. I recommend this one—The Bipolar Survival Guide. Everyone always recommends The Unquiet Mind by Kay Redfield Jamison, as well. You can find books about various therapeutic techniques, such as Cognitive-Behavioral Therapy and Mindfulness. If you educate yourself about the disorder, you will recognize lots of symptoms and be armed with mechanisms to deal with these symptoms.
I’ve been incredibly lucky. I have a wife who loved me even through the time I hated her. She got me diagnosed and makes sure I go to bed on time and I take my meds, and she helps me do work I can’t do, otherwise. I found an excellent psychiatrist—one of the leading researchers looking at the genetics of bipolar disorder. I finally found a good therapist—first time around (most people seem to go through half a dozen before finding one that works for them). I could afford to pay for treatment. I have health insurance. I didn’t lose my job. I never had to be hospitalized. I never jumped out my window on the 8th floor. I got taken care of before I divorced my wife or moved out and lost my kids, job, and life. Lucky, lucky, lucky. I am very grateful for that.
For some people, this kind of gratefulness is also a technique for combating depression. You spend some time—maybe only a minute in the morning, remembering things you appreciate in the world.
Some also find affirmations to work. You look in the mirror and tell yourself you like something you see. It doesn’t matter if it’s a bald-faced lie. If you keep doing it—so they say, over time, it will help you manage your depression.
CBT teaches you to combat depressive thoughts by analyzing them, and using logic to figure out what the reality is. Then you tell yourself that your thoughts are wrong. They say this works to help you fight off your bad thoughts.
I could never do the above techniques, but they do work for many people. For me, the meds did most of the heavy lifting. That’s because this is an organic condition. It is a disorder of brain chemistry. Meds can help fix it. However the good news for you, is that thinking can also change your brain chemistry. It’s more difficult, of course, but if that’s your only option, then that’s the one you use.
When I was depressed, I became very emotional. Everything with an ounce of sadness made me weep. I felt bad for everyone who was hurting. My eyes were welling up all the time. This is not necessarily a bad thing. I’m more understanding, now. I know more now. However, I am worried that, over the last few days or so, that kind of emotional lability has been returning.
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