By Craig Adkins
The doctors have all told me that I am one of the lucky few as I completely understand Bipolar Disorder and know when my symptoms are presenting. I don’t know whether this is a testament to my tremendous insight or the biggest line of shit that I have ever been fed. How can there be anything lucky about living with a mental illness? Believe me, it is not easy and has cost me quite a lot in this lifetime. Mental illness is so often misunderstood causing heartache and pain for both the sufferer and their love ones. The stigma attached to having a mental illness often leads to shame or guilty feelings that make recovery an even more difficult process. I hope that by openly telling my story, without pulling any punches, others will come to understand Bipolar Disorder, its symptoms and its treatments.
Bipolar Disorder is a mental illness that causes the sufferer to go through severe mood swings (the high, or manic phase, and the low, or depressive phase). I was initially diagnosed while serving in the Army. It was determined that I probably had it well before I had ever enlisted. Looking back now, I would definitely agree with that assessment. I vividly remember being in psychology class during my junior year in high school and finding the definition of what was then called “Manic-Depression.” As I read the blurb in my text, I thought that it sounded a lot like me and when I told Mrs. B, the psych teacher, she coyly reassured me that there was no way I that could possibly have it. I’m really kind of glad she didn’t get the guidance counselor position after Mr. F retired. Be that as it may, I can remember always being a very hyperactive child. I was never officially diagnosed with ADHD (and I really doubt that I ever had it), but there is a strong correlation between childhood ADHD and adult Bipolar Disorder. I also had several bouts of depression at a very early age. I was in the first grade after my parents were divorced and I was a very depressed little boy. My class picture that year isn’t that of a normal, smiling, happy child. The posture, and the blank face, and sad, vacant eyes tell the whole story. It still bothers me when I see that damn picture. Schools weren’t really up on things like they are today and it was assumed that I had a learning disability. So, I ended up repeating the first grade, which did little to improve my situation.
Leaving the Army was very tough for me as well. I was actually given the choice to continue to serve without treatment or receive treatment but take a medical discharge. Being in the Army was all I ever wanted since childhood. It was how I identified myself and I was thankful (and still am) for every hour that I served. But, I decided that it would be best for everyone if I were to move on. I have often regretted this decision. I have even gone as far as taking hours upon hours of psychological exams to prove that I wasn’t Bipolar so that I could return to service. But, like they say, you can never go home again. My last few months in the Army were demoralizing. There was a change of command and my old commander and first sergeant who used to count on me to be their “go to guy” were replaced by a new command who just saw me as some piece of crap who couldn’t hack Army life. I just try to remember the good times because there were more of them than the bad ones. However, I did leave with an honorable discharge, which may not have been guaranteed had I remained untreated. It all worked out for the best I suppose.
I have a family history of the disorder and never knew about it until after I had been diagnosed. There are a strong genetic links associated with bipolar and unipolar (depression only) disorders. Bipolar Disorder is fairly prevalent on my father’s side of the family and my maternal grandmother had depression issues. It is highly probable that my father was an undiagnosed, self-medicated sufferer of the disorder. Many sufferers do go undiagnosed and instinctively use others drugs to balance their moods. Many slip into alcoholism or become addicted to other drugs and often go untreated for Bipolar disorder.
Now, before beginning with the “scary stuff,” I think it wise to start by stating that the vast majority of the time I am completely asymptomatic. I can walk amongst the world of “normal” folk undetected for the most part; I just have to take good care of myself.
The symptoms for my mania can vary quite a bit. I usually cycle (begin having symptoms) in what is called hypomanic phase, which is a higher functioning level of mania. I am very expansive in my mood and the world is my stage. I generally am very elated and am in an overall state of euphoria. I’m very active and my creativity blossoms. As a matter of fact, I owe some of my best writing to this state. But, there are some down sides as well. My thoughts race and I have trouble slowing them down enough to concentrate. I have trouble focusing on tasks and can’t sit still.I often loose control of my spending. Generally, I am very frugal with my money; but in the hypomanic phase, I may decide to drive two hours to drop eighty dollars on dinner for one. This type of behavior has ruined some big plans that I had for my savings in the past. There have also been problems with my spontaneous “comedic improv” disrupting activities such as classes. Granted, it is fun in the right time and place, but I have gotten some grief for causing distractions. At the time I didn’t care because I was riding high, but afterwards when I came down a little, I sometimes felt embarrassed because my actions. I have also found that my sex drive kicks into a higher gear. This isn’t uncommon for Bipolar sufferers and can (but by all means, not necessarily) lead to promiscuity, infidelity, or unwanted pregnancy. In my opinion, the spending issues and my “performances” are the most troublesome aspects of my hypomania, but I try very hard to behave myself during this phase and can usually keep myself under control.
There is another, more potent, side to my “highs” and I have always been very reluctant to speak of it. I’ve only brought it up with doctors, a few close friends and my family; it is the full-blown manic episode. It manifests itself in me in ways that may, or may not, be common in other Bipolar sufferers. It is an all-consuming primal rage during which I can actually feel my physical strength grow. Energy courses through my body and I can take on a very aggressive mindset. I pace back and forth like a cage animal. My sex drive becomes freakish. It’s like turning into a werewolf; a primordial, animalistic state of being and I would be lying if I said that I didn’t enjoy it. However, I won’t leave the house when I’m like this if I can at all help it. Sometimes, I’ll just go out and roam woods until it runs its course. Why risk having someone really aggravate me and then go off on them in public? I have never hurt anyone when I’m in this state (with exceptions perhaps being my brothers while growing up), but why take the risk? It is easy to see how someone in this state could get themselves into a lot of trouble. I have done some amazingly stupid and destructive things while in this state, but thankfully I’ve never hurt anyone or gotten arrested. Luckily, the full-blown manic episode is an exceptionally rare occurrence for me. I can count the total number of such instances on one hand since my diagnosis in 1992 and they usually only have a duration of a few hours, although that is often more than enough. I have noted a strong correlation between this state and external influences such as extreme stress, sleep deprivation, and lapses in medication; so, I give these areas close attention to prevent future exacerbations.
Unlike mania, depression is either an all or nothing deal for me. I’m either completely fine or in the languishing pits of hell.As much as I hate how the manic phase gets me into trouble, I hate how I feel in the depression phase even more. Many times, my depressions will immediately follow a manic episode. Sometimes this is due to the fact that I did something really dumb while in a manic phase, such as losing a job, and then having to face the consequences. Over the years my depressions have become much more severe in duration and intensity. I’ve lost approximately two of the last six years to depression. I can best describe the feeling of depression as hostility and hatred directed inward. I feel like nothing will ever be right for me again. I have no energy or motivation to do anything. I feel utterly alone in the world. I feel like I would be better off if I put myself down. Uh, oh, there it was; the big red flag. Yes, I brought up suicide. My brain constantly bombards me with thoughts of it when I’m depressed and has ever since childhood. Thank God for that “great insight” because I am able to see these through thoughts as just a part of my disorder. However, there is always a strong compulsion to carry out the act and it is increasingly difficult to hang in there at times. I had a cousin who was also Bipolar who committed suicide. I firmly believe that if he could have held out for just another five minutes he might not have done it. Suicide is such permanent solution to what is essentially a temporary problem. Hopefully, my control is always going to be there for me, but just in case I don’t keep guns in the house anymore. I also avoid the world as much as possible while I’m depressed, although that has more to do with the depression itself than any conscious act on my part. I simply just can’t bring myself to get up and do the things I should do. My bouts of depression have lead to poor academic performance, excessive absences from work and school as well as months of unemployment in the past.
Now, for the good news: Thankfully, it is a very treatable disorder and the first and foremost factor in keeping things that way is medication. My “psychotropic cocktail” consists of lithium and Depakote twice a day to control manic symptoms and to maintain a stable “mood baseline,” Citalopram in the morning to stave off depression, and at night, Quetiapine Fuminate, an anti-psychotic, which taken at lower doses, allows me to get the sleep that I need. Bipolar sufferers have a notorious reputation for going off of their medications that is somewhat deserved. I have been guilty of the offense more than a few times. It usually starts with missing a couple of doses by accident. Usually, I will begin feeling the high at this point and cease taking my pills altogether. Then the “crash,” or depression will hit suddenly and then it takes weeks or even months to recover. It is of the utmost importance that Bipolar sufferers maintain their medication regiment.
Adequate sleep and rest are the next most important issue. Sleep deprivation is a major stressor that causes my symptoms to exacerbate. I had a great deal of trouble summer quarter as I had temporarily moved in with my folks and was routinely kept awake until two in the morning every night when I had a statistics class at eight o’clock in the morning. My brain was misfiring quite badly and I was considering either clobbering my stepfather for watching “Sanford and Son” with the TV blaring into the wee hours or checking myself into the VA mental hospital. I ended up doing neither, but instead did something far wiser: I moved into an apartment by myself. A reoccurring theme with how I cope with my disorder is by avoidance. You can’t reasonably expect to avoid stress entirely, it’s just a part of life, but it is of tremendous benefit for the Bipolar sufferer to eliminate as many unnecessary stressors as possible. For instance, I no longer frequent internet message boards or chat rooms because people would post things that upset me to such an extent that I would literally begin to cycle. It’s not like I really miss those things anyway. I have also found being around certain people quite upsetting and have had to cut several “old friends” from the roster because they always found ways to push my buttons to bring out the worst in me. I don’t miss them either. My well-being is my number one concern.
Living with the disorder can be hard at times. Anyone who has it will tell you so. I’ve lost two careers as a result of my disorder and others probably have similar stories of the difficulties and losses that they have suffered because of it. However, I have found that one of the hardest things about living with the disorder isn’t the disorder itself, but how people react when I tell them. It is a stigma that so many others like me share. In the past I’ve always tried to keep Bipolar Disorder “my dirty secret,” but the stress of maintaining the “mask of normalcy” all the time often makes matters worse.
So, I now find myself asking if this literary “outing” has been a therapeutic endeavor for me. I spent an entire day away from the keyboard contemplating the answer. I’ve come back with a resounding, “Hell, yeah!”
It’s not my fault that I have this disorder; it wasn’t my choice. However, I do have the choice of taking care of myself and doing what it takes to keep my symptoms under control and to live my life with dignity.
To coincide with the publication of this essay
The author would like to make the following dedication:
In loving memory of
Allen and June
Wish you were here