Stable and Reflective

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27 June 1999 – Diary

Since I came back from New York two weeks ago, life has been wonderful. I wonder if it feels this way for everybody else. If I choose to do something I can do it without a fight. There is no secondary pressure stopping me from doing it.

I think – “Let me make sure that the company’s radios are in order” and I can handle it – getting the information I need, making a decision, and implementing it – without being caught in indecision or being stuck on the simplest information or being sidetracked by something completely different. I can start something…and I can finish it. You cannot believe how difficult that used to be in the past.

Things which have been sitting on my desk for the last two or three months have been cleared up. Things at home are being done. I don’t get caught in trying to do five things at once – I can organise them one by one and complete them. I can order tasks and plan for the future. These capabilities simply did not exist before I started taking medication.

I am not perfect. I am lazy and I procrastinate like any other person. But at least now if I make the effort, I can get something done. In the past if I could not do something, it meant just that. There was no choice. Not only was any effort to try to do it fruitless, but often I could not summon even the ability to make the effort – even if I knew intellectually / abstractly the task had to be done.

I have not felt like this since I was fifteen or sixteen, when the bipolar symptoms started to emerge. For the first time I feel that my capabilities can come to a full flowering. I am exhilarated by the potential and scared that I will lose it. It is to one of the most precious things I now own.

The medication does not seem to have taken away anything essential. I have my gift of words, I am left with sensitivity to colour and form, I can think clearly and articulately. Perhaps even more so than before. I am only now beginning to realise how narrow, how dull, how closed my life had become because of the mood swings. I have lost years to mediocrity when I could have done so much more. That’s the curse of being manic/depressive. It steals your life, your real life, and gives you a paper cutout that you use as living and believe that it is true.

The mania only gives the illusion of depth. Any project taken on without the benefit of careful thinking and research is one-dimensional. Mania prevented me from doing either and I had the passion but not much else.

And the depression shut me down completely.

7 July 1999 – Diary

My brother is away, and I am in charge of the office. I keep on expecting the mania or depression symptoms to show themselves, but they don’t. Rather I feel rock solid. Not hypomanic in which I do everything either superbly quickly, or rush around and around, or think of the one hundred things I want to do. Rather a slower paced, steady feeling that allows me to take one thing at a time and deal with it and then move on to the next thing.

I can prioritise and choose what I want to do – something I cannot do with the mania. I can stick with one thing to completion – something I cannot do with the mania. I can take a deep breath and relax and decide, something I cannot do with mania (which just pushes me along). I can deal with people and assert my personality and my decisions as I am supposed to do as a manager, without feeling stressful chatting with people (when in depression).

I can also force myself to do the obligatory things, visit people, make telephone calls, go swimming. In the past as the depression kicked in, these would become more and more difficult to do until they became impossible to do.

In the last two weeks, I have been feeling as if I have regained the identity that I moved away from when I was sixteen. How I act is starting to match my sense of identity, the person who I have always seen myself as being. I feel as if I have returned home, that I am finally back to being the real me.

I am quietly enjoying this new sense self, reinforced by my actions, but sometimes I want to go into the park and shout at the top of my voice into the sky for the sheer joy being me again.

This is a cause for celebration certainly, but I am also aware of a sense of loss, of bitterness. In some way – between seventeen and thirty three – a part of me stopped growing, or grew for a while and faded. Or perhaps grew twisted. Being bipolar has left sixteen years of my life, if not wasted, then curiously incomplete.

I don’t know exactly what was lost but some part of me, some part of my personality is still sixteen years old when it should be thirty three. In all the my current triumphs, I cannot overlook that I am proud of being like a sixteen year old, even though I am twice that age. I now have to mature the part of me left behind at sixteen when the bipolar symptoms started appearing, and merge it with my thirty three year old identity. I know I can do this, but I do not believe that this part of me that needs to grow up will do as well as a person who has lived through those years. There will always be something missing.

The major parts that need to mature are those parts most affected by the mania; self-centredness and a lack of concern and empathy for others (and thereby problems with all the social interactions), as well as those curses of depression – poor self confidence and a low sense of self worth.

The current model for depression / bipolar disorder is that it is the inability of the body to properly regulate and balance some of the chemicals in the brain. Well, perhaps. But the effects of bipolar disorder cannot be fixed simply by helping the body to rebalance these chemicals. Bipolar disorder is something other than me, but nevertheless it contributed to shaping who I am today. Even if I do not like what it has done to me and even if I am on medication to release me from its thralls, it will still take quite some time (and therapy?) for me disentangle my true identity / self from the person I appear to be now, and to reshape habits bent by being bipolar.

10 July 1999 – Diary

On the edge of slipping from stability into being depressed. Or rather have started exhibiting qualities of being depressed, but still stable enough to take action to centre myself. Like all borders, like all shorelines, it is an interesting place to be, if at least for a while.

I often think that depression is a physical disconnection between the ability to think and the ability to act. It was as if a gear was slipping. Of course, the physical problem does not manifest as a disconnection. Rather the brain finds other ways of interpreting the disconnection.

Thus I couldn’t shave because I didn’t like to shave, not I couldn’t shave because the thought process for getting my body to shave were failing. Or I couldn’t eat breakfast because I never eat breakfast, not I cannot get my body to do all the things required to organise breakfast.

As the gear slippage gets worse, the brain creates more elaborate excuses about why it can’t get things done until finally the disconnection gets so bad that the brain gives up trying to keep the world stable / comprehensible. And then, voilá, depression.

21 July 1999 – Diary

Cycled from depression to mania to depression from the 10 July to now. What can I say. I’ve stopped being anxious about my mood swings and now I just let things happen (or not happen) as best as they could. And what don’t get done, don’t get done. This attitude seems to have done the most in keeping me centred and preventing me from being a nervous, stressed out sod with poor self confidence.

So I did had a mild depressive period from 9 Jul to 13 Jul, then a hypomanic one from the 14 Jul to 18 Jul and then a depressive one from the 19 Jul to today. The periods are about five days each, about two days shorter than normal. I stopped going to exercise almost immediately when the cycles started back. By 13 Jul, I had stopped functioning sufficiently that I had stopped taking my medication, which probably didn’t help matters.

In the past, I would have said that I hate the mood swings and the disruption of my schedules and projects while I am depressed. I still do, but substantially less so nowadays. Now I take the mood swings with a bit of resignation, with patience, and with the knowledge that any depressive episode will pass. It always does. My current feeling when I am starting a manic or depressive episode is “here we go again…”

I was telling my psych that being manic depressive feels like a physical disease. And a lot of it is physical I think. The tremors of my hands (which are sometimes so bad I cannot write or sign my signature), the sensation that my heart is racing, the headaches, the unspecified anxiety, the periods of restlessness, or sleeplessness, or sleepiness, or food cravings – once they are isolated and examined, they are so unrelated to what is going on around me.

Even the overheated thinking, or the emotional over reactions, or the loss of memory, or the feelings of self pity / depression have a slightly unreal, slightly forced feeling to them. And they cannot be really quieted by self control or relaxation. And my most persistent problem, that of being unable to translate thought to action – like thinking of taking my medication but not actually doing it – feels mechanical – as if there is a gear slippage in my brain that prevents me from hooking the two together.

Nevertheless, although these things are “not me,” not an intrinsic part of who I am, they have over time become entangled with who I am simply because I have to cope with them every day, have to live with it every day. The external physical problems have merged with my sense of identity. And therein lies a lot of the trouble of being bipolar. Starting to take the medication was helpful, but only as helpful as pulling a crash victim from a burning car. At least the victim won’t burn to death now, but you still have to treat the wounds that happened before you pulled the person from the car.

Medication is not enough to cure being bipolar. Therapy is still needed to disentangle the identity issues and separate out the disease from the sense of self. After I was diagnosed, the greatest difficulty I had in coping was that I had taken many of the symptoms of being bipolar to be flaws in my character / identity, when it fact there weren’t really part of me at all. It took a long time (and is still happening) to believe that I was a better person that my actions showed, and that many of the silly / stupid things I do would go away as I brought my mood swings under control.

Physical disabilities or medical conditions affect a person’s identity. Someone with a broken leg who can’t move around easily thinks of themselves differently from when they are well. Chronic conditions like asthma or a heart condition affect people even more. I keep on thinking of a scale in which at one end there is a person with a broken leg who has a temporary change in the sense of self/of identity. A person with asthma is around the middle of the scale, since being asthmatic imposes its own ongoing constraints on what the person can do. But asthma is still distinguishable as “other than self.” An asthmatic attack is clearly a physical problem – it can’t be mistaken for a character flaw.

However, many of the symptoms of being bipolar are so intertwined with our actions that it is almost impossible to distinguish them from character or personality (hence the oft heard “if you would just make an effort…”). Bipolar disorder is near to the other end of the scale where the sense of identity and the disease are so tied together that they are extremely difficult to separate.

In regular speech, you can be asthmatic or diabetic or you can have asthma or diabetes. But you can only be bipolar. Talking about having bipolar disorder sounds odd or incorrect. Our language binds being bipolar or manic or depressed intimately to the person, it is not some physical thing they just have.

The problems that being bipolar bring on are so subtle and appear so gradually that you learn to live with them and they are accommodated into your daily habits. Freeing yourself from being bipolar requires you to unlearn some of your habits and to disentangle the destructive ones. It means erasing / relearning things you have been doing for years. No wonder dealing with being bipolar is so confusing.

Next: Chapter 5: It’s OK to be Depressed
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