Sane Enough to Know I'm Not: Depression

Please link to ParsleysPics (HERE) if you are interested in reading this installment. This has turned out to be a much larger - and longer - series than I had anticipated and I'm not comfortable hogging all the space on The Swash Zone. Thanks.

Sane Enough To Know I'm Not: Bipolar 101

MRI of the brain during "normal", manic and depressed moods

So I’m bipolar. So what? How does this make me an expert? It doesn’t. I’m no authority on the subject whatsoever. I can only write about what my experiences have been and about what I’ve learned while searching for answers to this very complicated multifaceted mental illness.

There are several stock responses when I tell someone I’m bipolar. “Oh, my dear, I can just imagine the hell you go through.” Or, “Oh sweetie, talk to me anytime. My great-aunt/mother/brother/wife/ daughter has it. I know all about it.” Well meaning but it’s pure horse hockey. You ain’t got a clue unless you have it.

Another is: “We all get blue sometimes.” True, “we all” do just that. Someone dies, we lose our job or our kid gets sick. Or our house burns down while the firefighters stand there and do nothing. Any of these things alone is enough to depress anyone. But . . .

It is a situational depression. It is nowhere nearly as extreme in intensity or longevity. It isn’t so debilitating that you don’t want to get out of bed for weeks or months at a time. It doesn’t cause you to self-mutilate, or worse, to kill yourself. It may even last for a couple of years but not for a lifetime. And you can’t just talk yourself out of it.

Another is, “Well, gee, I have periods when I’m more energized than at other times.” Of course and that’s perfectly normal. You just got a raise, won some money, moved to that farm you’ve always wanted. Or, maybe it’s something simple like the sun shining and it’s a beautiful spring day. But . . .

This feeling of elation is thousands of miles away from the intensity and destructiveness of a manic episode. You don’t lose your judgment. You don’t make reckless decisions, spend boat loads of money you don’t have, or dance naked in a fountain, or self-medicate with drugs and alcohol.

Oh, there’s one more: “Well, I’m sure if you pray and talk to the Lord, you’ll be just fine.”

So what is this thing called manic depression anyway? What causes it? Is it contagious? Can’t you just take a pill to get rid of it? What are the symptoms?

According to the National Alliance on Mental Illness: “Bipolar disorder, or manic depression, is a medical illness that causes extreme shifts in mood, energy, and functioning. These changes may be subtle or dramatic and typically vary greatly over the course of a person’s life as well as among individuals.”

Too clinical. Too cut and dry says I. What are missing here are all the complexities of mood disorders, all the varieties which come in all sizes, shapes and even colors and the multitude of symptoms which overlap. There’s major depression. There’s manic depression. There’s schizophrenia. Each of them presents themselves differently and all of them have similarities, making diagnosis a complicated affair.

Even manic depression has variations on a theme. One is rapid cycling where moods go up and down like a roller coaster ride. The other is mixed states where mania and depression are experienced at the same time. Mixed states are bad enough. Rapid cycling is pure hell and they're both hard to control because just the tiniest dose of a medication, too much or too little, can send a person spiraling in the other direction. And there are even a few more, but that’s really getting too technical for this blog.

Scientists have been trying to find a genetic link to bipolar for decades, but so far it has eluded them. There was a huge study of the Amish about 15 years ago because they have such a high rate of bipolar and not a small amount of inbreeding. The study was a dud, unfortunately. But clinical trials continue at Columbia, John Hopkins, Duke and other major universities and centers. It is well documented that manic depression, and related mood disorders, is passed down through the generations.

A few cut and dry, but revealing, statistics from NAMI:

- Approximately 20.9 million – or 9.5 percent - of American adults over the age of 18 have some form of mood disorder.

- Manic depression affects about 5.7 million adults in America, or about 2.6 percent.

- The median age of onset is 32. (Note: children as young as six or seven are being diagnosed. More about this later).

- Ninety percent of people who commit suicide have a diagnosable mood disorder.

As mentioned earlier, bipolar is such a complex disorder that it is impossible to do it justice on a blog. What you’ve seen here and in my previous post (HERE) is a superficial look at best. But I think readers need this tiny bit of information to understand what follows.

Everything with us is an extreme. There's no such thing as smooth sailing. It’s a stormy sea with periods when a body, mind and soul can be pushed to the depths, raised up in turmoil and only occasionally have peace and calm.

Sane Enough To Know I'm Not: Introduction

The individual who coined the phrase “you never see anything on the Interstate” must have just finished driving through Kansas. In all directions are fields of grain which dance with wind that never takes a break. Trees, probably planted to break the never ending bluster, have few leaves. The highest structures are an occasional silo or overpass.

The state with its hard working farmers and wonderfully warm and friendly people is flat, boring and monotonous as hell.

I left Kansas City, elev. 774 ft., one sunny morning and headed west for Denver and the beautiful majestic Rocky Mountains. After passing through Topeka the monotonous terrain began to cause my eyes to droop and my spirits to sag. With each mile it became increasingly hard to stay awake and it took every ounce of will power to concentrate on the driving.

My body began to feel sluggish and I had to fight to stay awake. I yawned, I squirmed, I opened the windows and turned the volume up on the CD player and then switched to the radio searching for some upbeat music. Nothing helped and the noise of the music was more an irritant than a benefit, so I turned it off. And then I turned it on again. Off again,on again. I just wanted to crawl into a warm cocoon and go to sleep for a long, long time.

For hundreds of miles of unbearable boredom I battled the overwhelming desire to snooze. I tried gallantly but unsuccessfully to fight off the sinking spirits which were threatening to consume the whole of my body and mind. As hard and fast as I tried to drive there was this little black cloud that seemed to be weighing down the car and its driver and pulling them back. The speedometer read 80 mph but it felt more like a sluggish 35.

By the time I reached Colby the little cloud had turned into a huge black turbulent mass that sat on top of bright blue skies. Perfect conditions for a tornado. The car automatically headed for the little town out in the middle of nowhere and to the well-known motel that I already knew offered solace in the way of solid food, lively music and drinks as powerful as the ones at the Denver Press Club. I had a good time with my old friend Jack for a few hours before crawling into that cocoon I had longed for all during the day.

The sky is endless in Kansas and the next morning the sun shone brightly as I headed for my car. Just as I was getting in I noticed my little black companion hovering nearby. I knew I was looking forward to more of the same and sank into the driver’s seat feeling totally deflated. More boredom. More tediousness. More flat land. More depression.

Over 200 miles later, I stopped in Burlington, Colorado for gas and a bite to eat. The man behind the counter bragged about their historic carousel. “Not bad for a tiny town on the plains with an altitude of 4,219 feet,” he said. An altitude of 4,219 feet? Who was he kidding? Not once did I feel I was gaining in altitude.

Even though eastern Colorado is a mirror image of western Kansas, I began to feel a tingle of excitement as I started out once again. My spirits rose higher and higher with each mile and the little black cloud began to dissipate. I slammed down on the gas pedal and soared toward Denver. No longer did the car feel sluggish. No longer did I feel lethargic. No longer did I feel flat. I was flying. I was in control.

Several hours later I could see the snowy peaks of the Rockies and became even more excited but didn’t dare drive any faster. And then the Denver skyline started taking shape and I could hardly contain myself. I was about to burst wide open and began singing at the top of my lungs with Willie, “On the Road Again.” God, it felt good to feel good.

Since I had a few days before I had to report back to work I recklessly decided to head for Estes Park, the "Gateway to Rocky Mountain National Park." I couldn’t contain my energy and impatiently honked at Sunday-go-to-meeting drivers as I barreled past giving them the International Sign Language. Once I got through Boulder the traffic thinned and I was Queen of the Road. I drove up steep curvy mountain roads as if I was back on the flat straight interstate in Kansas.

I was euphoric. I was energized. I was as manic as a gerbil on a perpetual motion machine. My mind was taking off in flights of one fancy after another. I was going to do this, buy that and create this, that and the other. In the meantime I kept increasing my speed. I was no longer in control.

The crash was sudden and hard. I went careening down a steep embankment into a big black hole where the sun didn’t shine.

NOTE: Congress declared the first week of October as Mental Illness Awareness Week in 1990. Because of all the voodoo surrounding this subject I am going to dedicate a few posts to bipolar illness over the next few days. It is what I know best. I hope I can bust a few myths for anyone who cares to read about it.