Crazy, Like Me

A more disturbing trend, however, is the recent surge of criminal court cases in which bipolar disorder is cited as the cornerstone of the legal defense strategy. Mary Kay Letourneau used her bipolar disorder diagnosis as a defense against the charge of child rape, albeit unsuccessfully. I'm pleased to note that while I am presently 36 years old (the same age as Mary when she sought comfort in the arms of a 13 year-old student she'd taught), I strictly adhere to a policy of seeking carnal knowledge only from those who can legally consume alcoholic beverages within the United States. (I may, however, be forced to reduce that standard to the legal drinking age in Canada should ever choose to become an expatriate and depending on which Province I choose... only time will tell.) The condition has also been employed as a defensive gambit in several trials for murder, attempted murder, financial misconduct and other such noisome mayhem. With regard to these transgressions, I offer the following for consideration in my own defense: (a) I have yet to acquire a body count (despite what anyone else might claim); (b) I limit my violent gun play to the use of a toy laser pistol in an enthusiastic attempt to rid the world of those new, hideously offensive, chartreuse VW Beetles; and (c) I have an obsessive tendency with regard to balancing my checkbook, often accomplishing this astonishing feat several times each week; I've also managed to enjoy a debt-free lifestyle for more than a decade. (As for the general category of "mayhem," well, perhaps I've enjoyed more than my fair share, but I've successfully avoided arrest to date.)

So, really, what is bipolar disorder (also commonly referred to as "manic-depressive illness")? The simplest answer is this: the individual's moods are generally independent from the life events they are experiencing and are difficult to manage, sometimes even beyond control. The National Institute of Mental Health presents the following description: it is a biochemical imbalance that "distorts moods and thoughts, incites dreadful behaviors, destroys the basis of rational thought, and too often erodes the desire and will to live. It is an illness that is biological in its origins, yet one that feels psychological in the experience of it; an illness that is unique in conferring advantage and pleasure, yet one that brings in its wake almost unendurable suffering and, not infrequently, suicide." Because of the dangerous and impulsive behavioral tendencies associated with this condition, it is theorized that persons with bipolar disorder are the population most likely to attempt suicide when compared to the statistics for other affective disorders (e.g., depression, schizophrenia, etc.). At present, it is believed that one out of every five people living with this condition will attempt suicide.

What's it like to live with bipolar disorder? In a word, challenging. Each day I awake, conduct a brief inventory of my mental state and mood, and carefully reinvent my reality. Based on this self-assessment, I then get to the business of planning my day. If I am feeling manic, I leave my checkbook at home, avoid caffeine and alcohol, and exercise a focused degree of care in my interactions with other people. If I am depressed, I do everything I can to appeal to my physical senses. Tangerine juice serves me well as liquid sunshine; french fries are my eternal "comfort food". I play an ongoing game with myself where I seek out and recognize instances of beauty in the world around me. I exercise to trigger an endorphin boost and focus on caring for my physical health. I ignore the random suicidal ideation that occasionally roams through my thoughts, choosing instead to focus on my curiosity about the people and world around me. I am the ultimate chameleon -- on occasion, I have been so successful at masking my emotional storms and controlling my behavioral symptoms that my closest friends have expressed genuine astonishment on the few occasions when I've given voice to extreme depression or suicidal thoughts.

Although the negative aspects of this condition undeniably outweigh the benefits, I do celebrate the silver lining, the gifts I believe it can bring. I am creative and passionate. I have been gifted with an uncommon degree of intuition and am able to grasp abstracts, symbolism and subtleties at lightning speeds. I can feel the emotional content of music and colors without chemical stimulants. I am easily amused by the non-sequiturs that frequently pepper my internal narrative. I am blessed with an abundance of willpower; for me, quitting the game has never been an option. Above all else, I am far from anyone's definitions "incapacitated", "incapable" or "disabled".

I am engaged in an ongoing effort to identify allies within the bipolar community. There are those who romance their medications, living within the confines of "disability" on a check-to-check basis, essentially content if they have enough money to keep a good supply of cigarettes on hand. There are also those who are generally more functional, holding down jobs, working to maintain their relationships and marriages, daring to untangle their own thread of the tapestry that is the American Dream. And then there are those who keep themselves busy by attempting to avoid hospitalization or making court appearances, ruining their credit, flinging damage into the lives of those around them and derailing all attempts for an improved condition with an amazing degree precision - these are usually the members of my tribe who grace the news headlines, unfortunately.

By default, the bipolar community is something of a "secret society" due to the stigma associated with this condition which remains as firmly entrenched as ever. While our society seems to value the creative edge associated with bipolar disorder and holds an undeniable fascination for the celebrities linked to this condition, the entertainment industry continues to ridicule or sensationalize mood disorders as a rule. Additionally, a new brick is added to the wall of tainted perception each time the popular media links an individual's negative or criminal behaviors with this diagnosis. Those of us who strive to live relatively normal lives are constantly defending ourselves, routinely being compared to the minority among us who are the genesis of the stereotype.

I am encouraged by the fact that the legal system may actually serve as the catalyst for a much-needed change in the perceptions and attitudes of our society regarding mental illness. In Washington State, the King County Mental Health Court was a pilot program initiated by Superior Court Judge Jim Cayce in 1999. It has since been adopted as a model for approximately 100 other mental health courts nationwide, and federal monies have been allocated to fund the Law Enforcement and Mental Health Project to sustain these courts. U.S. Rep. Jim McDermott (D) has praised Cayce's program, which takes mentally ill offenders out of the criminal court, instead placing them in a courtroom setting where they can be linked to appropriate community/support services and monitored until the case is either closed or dismissed. To date, approximately 750 offenders have gone through the King County Mental Health Court; most were diagnosed as being bipolar or psychotic.

As an individual who has been diagnosed with bipolar disorder, I wish to make it known that I enjoy a generally successful, even occasionally extraordinary existence -- without medication or psychiatric care, by the way. I am living proof that the diagnosis should not be interpreted as the sum total of an individual's identity. Realize, also, that those of us who share this diagnosis are more than capable of functioning within society's mores and norms if we choose to do so. I believe it is time we eradicate our culturally-based stereotypical and simplistic thinking regarding the workings of the mind and what constitutes "mental illness". We must begin to look under the surface to discover the depth and complexity of the human condition -- to do otherwise is unjust and senseless.

	Suprisingly similar (5.00 / 1) (#4)
	by westgeof on Mon Sep 17th, 2001 at 11:54:17 AM PST

	Sounds like a description of myself. Growing up everyone just thought I was 'a little sensitive,' it wasn't until I was in college that I met someone else with this disorder and I realized that that was what had been wrong with me all these years. Since then I've read a lot about it and managed to get it mostly under control. I still have the battles inside my mind, and it's a rare night when I lie in bed without at least pondering suicide, but for the most part I've improved greatly. I can especially agree with the chameleon aspect. I carry it out to such an extreme degree that almost no one ever knew I was ever even unhappy. Either I was having a manic-moment and bouncing off the walls, or in a deppresed phase and overcompensating for it. I took pride in being the wild one, who would do anything at even the slightest hint of a dare. It was only a few years ago, after having a wonderful relationship end in a horrifying manner, that I let my guard down and basically went into full fledged depression. Even when I was manic I was still hurting, so instead of bouncing off the walls, I was banging my head, or my fists, against them. (I actually broke three bones in my right hand on one particularly bad day.) Since then, pretty much all my friends know my little secret. I've also been good at subtlety and insight, grasping whle concepts from the simplest hints. I've yet to meet anyone with a better grasp of spacial relationships and abstract manipulations. I think that may very well be a side-effect of the disorder itself. In learning to dectect and act on minute changes in my own mind I may have been training myself to spot such minute changes everywhere. I also agree with the stigmata placed upon us, both by the courts who portray us as 'bad people,' and the media, who basically ridicule us by making it a disorder of the week. And for the record, I don't consider myself crazy. As long as I can maintain control of myself without any type of medication or psychobabble, I save that label for others. (I do smoke, however, so I'm not quite perfect. It's just too effective at calming me, every time I try to quit everyone around me insists I start up again.) As a child I wanted to know everything. Now I miss my ignorance.

	diagnosed (none / 0) (#8)
	by Anonymous Reader on Mon Sep 17th, 2001 at 06:27:05 PM PST

	Have you been diagnosed with bipolar disorder? What you describe does not sound like bipolar disorder at all. Many people have periods of hyperactivity and depression. Bipolar disorder indicates that the reasons for these periods are biochemical in nature, and not being "a little sensitive". If you've been diagnosed by a psychiatrist, hey, good enough, but if not I don't think you should consider yourself bipolar.

	yup (none / 0) (#14)
	by westgeof on Tue Sep 18th, 2001 at 08:28:52 AM PST

	I was diagnosed about 5 years ago. It's not an extreme case, but far from a light one as well. I wish it wasn't, it would make things a lot easier, especially during the depressive phases. No one knew what it was when I was growing up mainly because I never lived in the same place for more than a year, and I was pretty much ignored by my parents (big family, and the squeky wheels got the greese). I'd always be off in some corner reading a book or something, I had pretty much perfected the art of being invisible. Everyone thought I was just too sensitive because I'd get upset over the littlest things, and I rarely had the freedom to cut loose on manic days. As a child I wanted to know everything. Now I miss my ignorance.

	OK (none / 0) (#20)
	by Anonymous Reader on Thu Sep 20th, 2001 at 06:03:55 PM PST

	The only reason I ask is because your brief description seems to fit 5 of the 9 DSM-IV criteria for Borderline Personality Disorder. And I know two friends of mine who were diagnosed with Bipolar Disorder and then later with Borderline Personality Disorder. I am not a psychiatrist though, so obviously I would defer to your psychiatrist since you were actually diagnosed with Bipolar Disorder. --- Growing up everyone just thought I was 'a little sensitive. 2. Anger that is inappropriate, intense or uncontrollable. it's a rare night when I lie in bed without at least pondering suicide 3. Self-destructive acts, such as self-mutilation or suicidal threats and gestures that happen more than once I can especially agree with the chameleon aspect. 1. Shifts in mood lasting only a few hours. I took pride in being the wild one, who would do anything at even the slightest hint of a dare. 4. Two potentially self-damaging impulsive behaviors. These could include alcohol and other drug abuse, compulsive spending, gambling, eating disorders, shoplifting, reckless driving, compulsive sexual behavior. It was only a few years ago, after having a wonderful relationship end in a horrifying manner 7. Unstable, chaotic intense relationships characterized by splitting Even when I was manic I was still hurting, so instead of bouncing off the walls, I was banging my head, or my fists, against them. (I actually broke three bones in my right hand on one particularly bad day.) 4 Everyone thought I was just too sensitive because I'd get upset over the littlest things 2 ---

	levels of severity (5.00 / 2) (#5)
	by motherfuckin spork on Mon Sep 17th, 2001 at 12:15:28 PM PST

	I work with someone who is bipolar. He requires medication, and you can tell when the dosage has not been administered properly. However, over the past 6 years working with him, I (and all coworkers) have noticed an overall mellowing of his personality, leading us to believe that he may indeed be getting less severe - lessened trips to the doctor by him also agree with this notion. It is well known that bipolar disorder is vast and complex. Some people with it function perfectly well in the world, others not quite so. It all depends on the individual. I am not who you think I am.

	Yes, there are degrees (5.00 / 2) (#6)
	by Peter Johnson on Mon Sep 17th, 2001 at 12:27:41 PM PST

	Some people definitely require medication and psychiatric care, others do not. No one should take this article to imply that you can or should abandon a plan of treatment without consulting your physician/psychiatrist. Also, mild (as in not requiring medication) bipolar disorders are often described in other terms. My therapist (back when I had one) use the term "hypo-manic." --Peter Are you adequate?

	Medication can often be of benefit, undeniably. (5.00 / 3) (#10)
	by chloedancer on Mon Sep 17th, 2001 at 09:40:31 PM PST

	But I can say, from my own experience, that the side effects of the medications used to treat this condition leave much to be desired. Depakote (aka Valproate), for example, introduces a significant risk of liver damage; and Lithium intolerance can be a nightmare. If the perceived benefit to a person being treated with medications outweighs such risks, then it is logical for that person to continue such a course of treatment. (I note, also, that my withdrawal from pharmacological treatment was carefully orchestrated and medically supervised.) It should be noted, also, that even when an individual is taking medication as prescribed, it can become ineffective in controlling the disorder -- stress, hormonal shifts, environmental changes, biochemical changes, etc., can all cause even the most conscientiously medicated individual to fall outside of the therapeutic range of treatment. I do question, however, if medication has become a substitute for other possible avenues of treatment. It is well documented that persons taking medication for this condition will, on occasion, consider themselves to be "cured" and quit taking their medication as a result. (Dr. Kay Redfield Jamison, also a bipolar, describes at length her own experience with this phenomenon in her book titled An Unquiet Mind. She's a Professor of Psychiatry at the Johns Hopkins University School of Medicine who readily admits that she's fallen prey to this syndrome, as well.) Instead, I advocate that while medication may or may not be required and/or beneficial for all individuals diagnosed as having bipolar disorder, actively practicing behavioral modification may be of benefit for anyone living with this condition. My treatment, at present, is based on the philosophy of "Constructive Living," which emphasizes accepting reality (including feelings), learning to co-exist with unpleasant feelings, re-focusing on purposes/goals and objectives, and then doing what needs to be done. In accepting responsibility for my actions, and understanding how those actions may impact others, I shift the focus of my attention from myself to living in agreeably with the people and world around me. The roots of this approach are from two Japanese therapies called Morita and Naikan, both based on the careful study of human behavior from a Buddhist psychological perspective. The best analogy I can present is this: I look outside the window and notice that it's raining. There are any number of actions I can take as a result of what I've noticed: I can choose to stay at home (which will minimize my risk of getting wet, but also limit my productivity if I'm expected to go to work, for example); I can complain about it and devise some feeble attempt to stop the rain (which would be pointless); or I can grab an umbrella and boots and go on about my business (the most practical response). If the situation is more complicated, I can always call someone for a "reality check" before taking action. It's a simple principle, but one that requires self-awareness and a willingness to take responsibility for my actions -- it also requires ongoing effort, self-discipline and practice (but, hey, at least I'm never bored!). Finally, there is a new body of research focusing on the connection between thyroid functionality and bipolar disorder. My father-in-law, also a bipolar, has been a victim of what I like to call "medication roulette". None of the medications work well for him; he also has a tendency to build up a tolerance for the few that have provoked the least serious side effects (or his biochemistry shifted to a degree that the medication he was taking no longer had the desired effect). He started a course of thyroid treatment about a year ago and has been enjoying a continued degree of stability unparalleled in his previous "psychotropic treatment only" history. In short, a "pills-only" approach isn't the best answer, and this needs to be realized. While taking medication may be part of the answer for some, it isn't the only option available. Present treatment modalities leave much to be desired if these medications no longer provide the desired therapeutic affect; it is at these times that an individual with bipolar disorder is at greatest risk, particularly if sufficent coping mechanisms or behavioral practices aren't in place as a second line of defense.

	Schizophrenia? (5.00 / 1) (#9)
	by Anonymous Reader on Mon Sep 17th, 2001 at 07:19:54 PM PST

	I have not read the original document, but if Miss Heche claims she is actually two people, that would classify her as someone who suffers from Disassociative Identity Disorder (DID for short). This, as far as mental afflictions go, is very rare, with only a few actual cases that psycologists have worked with and studied since it was proposed as a unique disorder. The Snake Pit, I believe, is a film about a woman with DID, and the treatments she undergoes at a hospital. More information can be found in the DSM. As far as I know the most recent edition is 4 (revised). Most libraries should have a copy. Cheers, C. M. Laidlaw (claidlaw@tulane edu)

	Source (5.00 / 2) (#12)
	by chloedancer on Mon Sep 17th, 2001 at 10:56:25 PM PST

	The only description of the "20/20" interview I was able to locate via the 'net was from this source: Heche; it represents a small portion of the entire broadcast, unfortunately. Subsequent to her appearance on the TV program, speculative reporting in the media regarding the description of her experience included discussion of bipolar disorder, schizophrenia and multiple personality disorder (now known as Disassociative Identity Disorder per the Diagnostic and Statistical Manual of Mental Disorders [DSM-IV], if I'm not mistaken). I appreciate the factual clarification of your post, however. I chose to use Heche as an example because of degree of implausable speculation bandied about by the popular media subsequent to her appearance on the TV program -- in and of itself, it was another example of the sensationalistic nature of media coverage of these issues.

	Not necessarily (none / 0) (#19)
	by Anonymous Reader on Thu Sep 20th, 2001 at 05:45:41 PM PST

	Dissociative Identity Disorder generally is only diagnosed when the two personalities are completely distinct and suffer from at least partial amnesia from each other. The way Heche described it, voices told her that she was someone else, and she was fully aware of both identities. The disorder was that she was hearing voices which (presumably) did not actually exist, which was probably due to Schizophrenia, not DID.

	Schizophrenia is not multiple personalities (none / 0) (#23)
	by John Milton on Sat Sep 22nd, 2001 at 11:10:23 AM PST

	As the son of a schizophrenic male, let me correct this myth. Schizophrenia is no longer categorised as a multiple personality disorder. They are two very seperate disorders. Although many schizophrenics do suffer from both, it is not necessary. -John Milton

	For the record... (5.00 / 3) (#11)
	by chloedancer on Mon Sep 17th, 2001 at 10:17:21 PM PST

	The author would like to make it known that she, in fact, did not tell "bc that she thinks he's cute" (that's a figment of someone else's imagination, no matter how ya slice it). Truth be known, it's a wholly dishonest representation of an unrelated, innocuous circumstance combined with my own damned stupidity in response to having been asked "Do you object to our adding a poll with options that ridicule and demean you?" by a member of Adequacy's esteemed editorial staff. May I remind the presumed guilty party that cheap shots lack artistry, and express my profound disappointment. C'est la vie.

	let the record stand (5.00 / 3) (#13)
	by jsm on Tue Sep 18th, 2001 at 01:38:38 AM PST

	An unrelated editor would like to point out that bc is cute, and that no sensible discussion of the rights, wrongs and wherefores of poll posting policy can be carried out on any other basis. ... the worst tempered and least consistent of the adequacy.org editors ... now also Legal department and general counsel, adequacy.org

	what is this (none / 0) (#16)
	by alprazolam on Tue Sep 18th, 2001 at 02:11:26 PM PST

	C'est la vie is the bourgeois version of HAND?

	Humbug (5.00 / 2) (#15)
	by Peter Johnson on Tue Sep 18th, 2001 at 10:22:27 AM PST

	You're being revisionist here. I mentioned that bc was insecure about his looks (which he is) and asked for your opinion with the implicit assumption that I would forward this to him. You replied and said that he was "stunning" (which he is) and authorized me to pass this info along. Which I did. I think you're splitting hairs here, and I hardly think that my behaviour constitutes a "cheap shot." --Peter Are you adequate?

	Jihad on Self-control (none / 0) (#17)
	by Duke Machesne on Wed Sep 19th, 2001 at 11:04:45 AM PST

	And then there are those who keep themselves busy by attempting to avoid hospitalization or making court appearances, ruining their credit, flinging damage into the lives of those around them and derailing all attempts for an improved condition with an amazing degree precision - these are usually the members of my tribe who grace the news headlines, unfortunately. Aye, my comrades in neuroflux. What good are advancement, acceptance, "success"? If anything, I say the natural lesson to be taken from manic-depression is the most obvious one to anyone who experiences it: no matter how much we struggle for the peak, you, me, and Sisyphus's monstrous crack-rock will always roll back down, kicking and screaming if necessary. Like Leary said all those years ago: Chaos is good. Chaos creates infinite possibilities. If you spend your whole life holing up your "disorder" and trying to be like all these other boring fuckers, trying to function their way in their society, you may as well spend your life cursing the day you were born. Which is why I keep a steady flow of alcohol regardless of mood: to counteract the conditioned social-preservation response playing down the highs and playing up the lows. When I'm high I run through the streets screaming love to empty heads, and when I'm low I sit in the back corners of public places cursing God loud and obscene, weeping for the eternal suffering of living hell. Bullshit makes the flowers grow, mates, and that's beautiful. In reality, bipolar existence models the existence of our world, our galaxy, our universe; bipolarity indicates the hard truth of both civilization and humanity itself. In a world where the floods hit every couple thousand years and the lightning strikes every day, only the pheonix is being realistic in its expectations. __________________________________________________ once you've remembered, you'll never forget

	lol (1.00 / 1) (#22)
	by Anonymous Reader on Fri Sep 21st, 2001 at 08:35:45 AM PST

	Chaos is at the root of change. And change is always resisted. In resistance we test our character, by returing Order. So, as far as I care, Chaos as an agent for Order, is fine. Chaos to beget chaos, is bedlam. Ah, to be young again, Ken Murphy was an optimist --Source unknown.

	I celebrate your way of living, believe it or not. (none / 0) (#26)
	by chloedancer on Mon Sep 24th, 2001 at 10:47:52 PM PST

	From the eloquence of your post, it obviously works for you. I am intimately aware of what Walt Whitman meant when he wrote "I sound my barbaric yawp over the roofs of the world" and consider myself fortunate because I get to shine every now and again in a way that only few can ever hope to understand. I cherish the electricity, vibrance and texture it adds to my life. I am aware of the cyclical nature of myself and the music of the spheres. I know my primal self, choose to work for my own synthesis with the world around me, and accept the reality that my existence is an ever-changing point in the continuum between. I also accept responsibility for myself within my culture. I do not believe that these things are mutually exclusive, however. My next tattoo is a lower back piece, a phoenix, a riot of color. I've been planning it for years, waiting only because I wanted my favorite skin artist to do the work. It is a symbol I claim also.

	Conditions (5.00 / 2) (#18)
	by Avicula on Thu Sep 20th, 2001 at 07:08:10 AM PST

	Yes, being different has become very popular in nowadays modern, western society. In order to appear normal -it seems- one has to have some sort of "mental condition", meaning to have a "disorder", "dysfunction". Celebreties are no different. After all, actors may have an internal need to show themselves, to attract attention, to get into public life and into your homes. They want your attention, your care, your love. Honestly, I can understand that. I would love to be babied by everyone, to get to hear that this is poor me and I am cared for and loved so much. An illness can sometimes be a way to get what I just discribed. We have become a society of of sick people, asking "How are you?" -"Fine." and then secretly going to to a psychologist, psychiatrist or psychotherapist. Or openly going into a talk show. We are so accepting someone with difficulties, so caring, so relating, so understanding, so sharing... while we sit back and think "I am so happy I don't have to take any medication!" After all, it may go deeper than that. It is a theory that people are changing, countries are changing and disorder has entered our world as it never has before. Confusion is the result. Until one can adapt to new conditions, there is confusion, maybe curiosity but in any case: one doesn't know what the heck is going on. Everyone should know that from puberty. Suddenly, your parents become total assholes, noone understands you, sometimes not even your closest friends. And in order to stay "popular", loved you do the chameleon. Always cheery, funny; just don't let yourself be known (you could be harmed, injured, hurt). ...and then, when something happens, noone could have even guessed. "I wish I had known..." is a common phrase among family members and friends after a suicide attempt or a successful suicide. Ask yourselves one question: Are you strong enough to know and then to support, instead of accuse and doubt the condition? Don't rate this. If God the Lord wanted you to rate, He would have put appropriate buttons on each of us. Praise the Lord - for He is great!

	Indeed (1.00 / 1) (#21)
	by Anonymous Reader on Fri Sep 21st, 2001 at 08:16:41 AM PST

	I have my ex-girlfriend's commitment papers framed over my study. As a nostalgic reminder, and as a lesson to future lovers. Please note: If your a crazy lady, be prepared to go where crazy ladies belong. Lovingly Yours, Ken

	It's a matter of perspective, really. (none / 0) (#27)
	by chloedancer on Mon Sep 24th, 2001 at 11:06:15 PM PST

	To be involuntarily committed where I live, one must be (a) a danger to themselves, (b) a danger to others, or (c) a danger to significant property. For me, life is knowing how far to go without crossing a line. I belong out in the world, just like anyone else. If I were ever subjected to a commitment review, I have no doubt that I'd fare better than most of the so-called "normal" folks around me.

	lol (1.00 / 4) (#28)
	by Anonymous Reader on Wed Sep 26th, 2001 at 12:18:11 PM PST

	no doubt darling. Life is short enough without worrisome jealousy --> a sure sign of neurosis. But, we must add to your deinfition, "emotional damage" not just property damage. If the bitch is out to ruin lives -- of those around her or <gasp> her own children -- then surely as a hundred dollar bill removes a speed ticket -- the judge will see to it that "evidence was sufficient." In miami, we have lots of crazies. And in turn, laws to handle them. And, of course, means to circumvent such laws. None the wiser, ken

	A question (none / 0) (#24)
	by Ryvar on Sun Sep 23rd, 2001 at 05:10:52 AM PST

	As an individual with a reasonably strong (and well-documented) case of type I bipolar disorder, I can attest to the validity of both your approach and the psychotropic pharmaceuticals approach having spent three years and then two years on each, respectively. My personal means of dealing with the disorder consists of recognizing what symptoms seem most severe this particular season (I cycle both seasonally and daily) and responding to that appropriately. If mania is an ongoing problem - and it is almost never otherwise for me - I find that between 900 and 1500mg of Neurontin (Gabapentin) is an excellent counter. When facing depression I counter it with a moderated increase in pleasure-seeking behavior, usually computer games and sex. I will admit that I go to an unusual amount of trouble to remove stress factors that may destabilize me any further from my daily experiences. I work from home as a contract programmer and 3D modeller, usually going weeks without speaking to or seeing anyone but my partner (a type II with the patience of a saint), and have my entire life avoided any use of alcohol or recreational drugs. I would like to thank you for posting this story - it was nice to see someone else take pleasure in the benefits of the disorder. Clearly however, my comment here will be useless if it does not initiate some meaningful dialogue, so allow me to pose a question: do you notice an increased degree of detachment from people and objects as a direct result of your disorder? Even my partner comments frequently on my seeming inability to form any feelings on those whom I neither love nor hate. In the same vein I find that the importance people attach to objects, more specifically 'their' objects, is one I fail to share to a degree that is sometimes alienating. This can lead to some rather awkward social scenarios due to failure to anticipate another's concern for a given physical item. While manic depression often seems, like ADD, to be a label slapped carelessly onto a number of seperate disorders, I am wondering if you (or any other people here with the disorder) have some firsthand experience with this particular manifestation? Personally, I've attributed it to the nature of poor monoamine reception, believing that routine inability to achieve a serotonin cascade and similar chemical symptoms simply didn't allow much in the way of feelings outside of the extremes. I am curious as to your thoughts, --Ryvar

	RE: Degree of detachment & general response (none / 0) (#25)
	by chloedancer on Mon Sep 24th, 2001 at 09:11:00 PM PST

	You're welcome. While it wasn't the easiest story to write, it was genuine. I'd not written anything for "public consumption" in several years, but I've yet to back down from any good challenge. I'm still researching the connection between cycles and potential triggers (do triggers have an effect on cycles, or are they unrelated, anomalous events?). Your comments re: stress factors and destabilization hit home; increased stress is also something I've identified as a trigger for mood swings, but I've yet to discover a pattern as to which way the pendulum will swing (sometimes I'll shift into mania, sometimes it's a precursor to a downward slide). My efforts re: self-awareness have paid off in this regard; I can usually adjust quickly enough to compensate, regardless of the angle of the bounce I experience. Has the disorder, in and of itself, created an increased degree of attachment from people and objects in my experience? I would have to say no, actually. During the timeframe when I was medicated, however, I became severely detached -- enough so that it was one of the primary factors in my decision to seek another approach. This sounds like an inverse of what you've experienced, if I'm not mistaken (or are you describing your experience while medicated?). I tend to connect with other people fairly easily; I "read" other people fairly well in general, and occasionally experience a greater degree of empathy than I'd prefer in certain situations. With regard to objects/property, while I don't "get" certain things about the relationships others have with objects, it hasn't created any awkwardness in my experience. I've never been particularly invested in the material world, but I've always viewed this as a matter of personal or perhaps even philosophical choice (I have lived by the doctrine of "voluntary simplicity" for most of my adult life). In regard to my own physical body, however, I'd have to say that there is a definite sense of detachment. I would say that I "live in my head" more than most people do; my physical sense of self can best be described as detached. I generally don't like other people touching me, even casually, unless they're someone with whom I have an emotional investment. I've never had a "normal" pain response -- things that other people complain about don't even register consciously for me (I've had several teeth pulled without anesthetic, for example). My physiological response to pleasure can be equally curious at times -- I generally derive more "satisfaction" from the reaction I'm capable of drawing out of another (or the pleasure I perceive them as experiencing) than whatever pleasure I'm capable of perceiving myself. While I can't say specifically that this sense of detachment is directly related to the disorder, I do personally believe it is related. In general, I find other people to be fascinating, whether or not they're someone I love (or hate). While I am an introvert by nature, I think it is this curiosity that prevents me from becoming isolated. I also tend to appreciate others' emotional states if only because I am generally incapable of correlating what I'm feeling with the events in my life -- what I see others experiencing is more real to me, in a sense. Whenever I do experience something I can identify as a more genuine emotional reaction in myself (something where I can identify both the cause and the effect), it can only be described as being intense. Relationships with other people, for me, however, are not a simple matter. It's easy to love me when I'm manic -- I can be very social, generous, spontaneous, funny, charismatic, sensual, etc. It's the people who don't run when I am depressed, coarse, angry or unloveable that I'm grateful for. This "wear and tear" factor is often unaddressed; it can be painful to see fear in an old friend's eyes when they recognize that your mood is shifting yet again. And it just plain sucks when someone falls in love with you when you're up, only to leave once they realize that it's not a constant state. It takes a certain fortitude to hang with me for the long term -- I try to invest my time and energy in those relationships where I have some faith that the other person involved can "keep up with me and put up with me, no necessarily in that order." While I have been described as being "fiercely loyal" to the people I care about, my long-term allies are few. In my mind, this is one of the most alienating aspects of being bipolar. I've learned to appreciate whatever I have at any given moment whether or not it lasts; it helps me to keep putting one foot in front of the other. Although it might be tangential, I do feel a strong connection with the universe at large (even if that seems a bit ironic). I occasionally visit a local spa that features sensory deprivation tanks, particularly whenever I'm feeling a little too cranked up. One of my favorite "meditations" (for lack of a better word) is to imagine myself as a tiny speck of light in an infinite night's sky. While this sense of smallness or inconsequence might be uncomfortable for some, it brings a peaceful sensation for me and can be very calming. It is in those moments that I have no doubt of who I am or that I truly belong, as I am. Until recently, I'd been experimenting with my diet to see if it can positively impact/affect my serotonin response. It has been suggested that protein and complex carbohydrate intake can be manipulated to provide a greater degree of mood stabilization. For about two months' time I ate a minimum of two ounces of protein every four hours and then snacked on carbs in between to trigger a serotonin release. My conclusion was that it was successful in reducing the extremes of my own cycling (I didn't seem to go as high or as low), and it reduced my tendency to go into "rapid cycling" while manic (kept me from bouncing off the walls, really). It was difficult to continue this experiment during the past few weeks, however, due to an insane work schedule and a general lack of appetite (I tend to quit eating when I get stressed). I have also benefitted from taking therapeutic levels of B vitamins on a daily basis; it is theorized to have a positive impact on serotonin reception capability and may be related to the thyroid research I'd noted in another posting. While this may be its own form of "medication," the side effects are far less detrimental than what I'd experienced with the more traditional psychotropic pharmaceutical approach. I don't know if this is helpful for you, Ryvar, but it is an honest response. In keeping with the behavioral aspects of living with the disorder, I believe that your ability to recognize and observe the awkward situations you've described enables you to devise a strategy for either preventing repeated instances or modifying your response if such a situation should occur again. You don't have to feel the same way about objects as others do, for example, but you can choose to consciously recognize that other people do have an emotional investment in their things and then act in a manner that respects this, even if you don't understand it personally. You've already figured out the difficult part -- the causal factor in a situation you find to be awkward -- that's the part most people would have trouble with, truth be known. While behavior can be learned, awareness is more of an innate skill, in my opinion. Remember, too, that the only real definition of "mental illness" is to do exact same thing over and over again while expecting a different result. (I find this to be true time and again whether or not someone has been formally diagnosed in any manner.) In the whole scheme of things, is it really important if you don't have an emotional response to those you neither love nor hate? If it doesn't bother you, I'd say it's unimportant. In general, my belief is that if anyone can find a way to live comfortably and work toward the goals they've set for themselves, they're the ones who are winning the game.