One of the things that I think very few of my readers know about me is that I am bipolar. I’ve hesitated to say anything about it because I’ve always feared that if people knew, they would simply discount anything I had to say.
So, why have I decided to be public about it? Well, there are a number of reasons.
I think I feel like finishing my masters was proof that, even though I’m not particularly normal, I can function intelligently. It is as if society has vetted me: everything I say is not rubbish (although I’m sure it sometimes is.)
I also wanted my readers to know why I go through long periods in which I shut down and don’t write. I write when I’m manic, and find it impossible to do when I’m depressed. It’s as if my ability to generate ideas plummets by 90%. And those I do get, I discount as being second-rate. When I’m manic, I become incredibly productive. I’m blessed with a type of mania that allows me to focus intensely and for long periods of time. Hence the multi-part stories that come out in great big glouts. But why can’t I finish them? I still haven’t been able to answer that.
Another reason I wanted to come clean about it is that there are a lot of people who suffer from bipolar disorder, who feel like they won’t make it through. The suicide rate for us is very high – astonishingly high for those who don’t get treatment. And, when we do get treatment, many of us feel like half of who we are has been cut out with the insanity. You see, we love the highs.
I was diagnosed with the disease almost 20 years ago.
Once I understood the illness, I realized that I had been sick since I was about 14. But going into the music business is a perfect place to hide if you are bipolar; it’s an industry that accepts the flights of mania as a performer’s natural state, and forgives the depression as poetic. It wasn’t until an international record contract I had been signed to fell apart, that I plunged into a trough so deep, I could not – for anything in the world – find a reason to go on living. I spent eight months in bed, watching TV, listening to a walkman and playing game-boy all at the same time to drown out the rushing, horrific, death-obsessed thoughts that ploughed through my brain like a never-ending freight train. If I tried to force myself to go out, I’d have raging panic attacks during which I was absolutely sure I was facing imminent death, right there in the middle of the snack aisle in the supermarket. Then I just stopped trying to force myself.
One morning, at about 5 AM, I lay in bed and looked at my open closet and, very calmly, decided that the rail was indeed high enough to hang myself on. It seemed the sensible thing to do.
Some very small corner of my mind spoke up and said: “Wow, this isn’t normal.” It saved my life.
I put my coat on, over my pyjamas, laced my sneakers on my bare feet, and walked down the street at dawn to the closest hospital. I walked up to the emergency counter and told them exactly what I was thinking. Luck must have been smiling down on me, because the woman behind the counter nodded her head, said, “Follow me.” And walked me up to the psych ward.
Another stroke of luck was that, although I was initially diagnosed with major depression, my regular doctor suggested I go and see a friend of his – a very old Czech psychiatrist who had been kicked out of his chair at a prestigious university for testing a new drug on manic-depressives.
At that time, the drug of choice – the only drug – for treating manic depression was lithium, which is a salt. It works, but the dosage you have to take to get results is very close to a toxic dose. It has terrible side-effects: your skin goes grey and lumpy, the muscles in your face that relay your emotions stop working, you have constant stomach problems.
After being diagnosed as bipolar, this rebel Czech put me on a drug called carbamazepine. It wasn’t a new drug – it had been used to treat epileptics with grande mal seizures for many years. He believed that it had great potential for helping with manic-depression. The only problem was that, in a very few number of patients, it could plummet their white blood cell count. Most psychiatrists felt it was a dangerous alternative to a drug they knew that worked. Lithium might be uncomfortable, but it didn’t actually *kill* the patients who took it.
I spent about five years on “tegretol” (carbamazepine). And the drug worked brilliantly for me. But, as I mentioned earlier, even the new treatments all have a significant downside that I feel a lot of psychiatrists don’t fully understand. The drugs stop us from behaving abnormally – but they also have a severely negative effect on creativity.
It is ironic to speculate that, if I hadn’t been diagnosed and treated, I might have been writing brilliant things for the last 20 years. On the other hand, if I hadn’t been treated, I might just have easily been dead. And that’s the catch, because finding a balance between living productively with un-medicated manic-depression and dying from it is such a tricky thing.
I went off my medication about ten years ago. Partly because I felt a great deal better, and partly because, with the help of an extraordinarily good psycho-therapist, I learned to listen for the tell-tale signs of an approaching season of either mania or depression.
I learned, for instance, that sleep is incredibly important in keeping me mentally healthy. I don’t need more than about six hours a night, but if I don’t get it for a couple of nights in a row, or my sleep is interrupted – and especially if I start to experience early-morning waking – it’s time to think about going back on the drugs.
Another important thing I learned was that one of the biggest triggers for me is a certain, very specific, sort of stress. I actually enjoy high-stress situations where I feel challenged: deadlines, budget constraints, and heavy workloads, having to operate at the edge of my capacity. I find situations like this invigorating and life-affirming. But I cannot bear the stress that comes from being in a position of responsibility with no authority; a situation where I can’t succeed because I don’t have control or power to actually meet the expectations or the goals set. This type of stress is poison for me and it will trigger a descent into depression within three or four days.
There are a few other minor danger zones, but those two are the most perilous. And in the past 15 years, I’ve learned to avoid them very cleverly. I always have sleeping pills on hand in case I am not sleeping well, and I know enough to walk away from situations in which I feel I’m being set-up to fail.
That self-knowledge makes it possible for me to live without the medication, which, in turn, allows me to write creatively. But it also means that I am not ‘normal’. And I do actively navigate the milder highs and lows.
I’m sensitive to the times when the lethargy and chill of depression creeps into my life, and I’m equally aware of when the volume and frenetic thinking of mania pushes at the edges of my balance. I have to admit to riding them. And I’m not always as quick to recognize the over-reaching, grandiose thinking that signals mania, as I should be. For instance, about two years ago I decided that it would be absolutely no problem to take a certificate of jurisprudence, and do my PhD at the same time. Two days later, I leveled off and realized just how dumb that idea was. Sometimes it takes me a day or two to realize I’m not thinking sensibly, but I get there, and stop myself.
The lows are a little harder to recognize, because I don’t get “sad”. It’s more that a strange sort of creeping mental paralysis takes over. I don’t want to go out, I don’t have the energy to engage with the rest of the world. But when I start bargaining with myself about getting out of bed in the morning, I know what’s happening and I force myself to go out, get involved, teach my classes. Being around people – especially my students – pulls me out of it. Just by being who they are, they show me the light at the end of the tunnel, and very soon, the sense of futility lifts.
It’s with a certain about of embarrassment that I write this blog post. I know a lot of people blog about their personal problems, and I think that’s fine. But it isn’t usually what I use mine for. But equally, I just felt that after eight years of writing extremely intimate stories online, I kind of owed you some openness.