When you’re manic you hand things like this to your psychiatrist. I did so five years past.
A printout of a webpage you made that explains, clearly, how your brain has been infected by a computer program you wrote years earlier.
Your mania is so infectious that you’re sitting on the floor of a nurse’s office having convinced her to happily print off hundreds of pages of documentation to support your claims.
She thinks this is absolutely necessary.
You convinced her it was.
When you hand it to your psychiatrist, she doesn’t read it. She just makes a note in your chart that says:
..the patient continued to have some overtly psychotic ideation and presented me with many notes which confirmed his psychotic thought process..
Mania sometimes includes psychosis.
Your brain is infected with a computer program?—These things make perfect sense to you when you’re psychotic.
Then, later, they seem irrelevant. I am currently completely disinterested in the possibility that a program has infected my brain. To be rational, I must accept the possibility that one has. But the truth or falseness of this idea is of zero interest to me at the present time. Maybe a program has infected my brain; maybe it hasn’t. It makes no difference to me anymore.
A funny, forward-thinking, insightful presentation on bipolar
I found this presentation on bipolar disorder by Dr. Jay Carter, a psychologist, which I think is unusually good.
If you have time and interest, watch the video. If not, please consider skimming my notes, below, which quote and summarize some of Dr. Carter’s ideas.
“It’s a medical problem rather than a psychological problem.” In 2008, five prominent psychiatrists met and “decided that bipolar disorder was not a psychiatric illness. It is a medical problem.”
Lack of sleep (as in mania) would cause irritability and delusion in anyone. “Any one of us in this auditorium who didn’t sleep for a week would be hearing voices and seeing things that weren’t there.” “The worst symptoms aren’t really symptoms of bipolar disorder. They’re symptoms of..sleep deprivation.”
“If you want to know what it’s like to be manic, drink seven cups of..coffee or take some amphetamines.”
“The person’s prefrontal lobe goes out, so they don’t see the consequences of their actions. They’re thinking six or seven times faster than normal—so they’re brilliant—don’t argue with them, they’ll win. But they don’t really see the consequences of what they’re doing. They don’t see the bigger picture of things. They don’t have insight, foresight, or hindsight.”
“If it’s bipolar disorder, it’s not anxiety..it’s agitation.” You need to know this in case a doctor tries to give you anti-anxiety drugs for your agitation. What will help reduce agitation in a bipolar patient is a mood stabilizer.
“Many decades ago we thought that diabetes was a mental health problem. People would have low blood sugar and they’d be acting weird, they’d be acting drunk, they would have fits.” Employers didn’t want to hire anyone who had fits. “Now we know different, and now we have insulin which manages the diabetes very well and the person can lead a normal life. With bipolar disorder, we’re not there yet. First of all, we’re still calling it a mental health problem—a psychiatric problem—and it’s not, it’s a physical problem. And the person might act a little funny or weird, but they’re not funny or weird. That’s just how they’re acting at the moment, just like a person with diabetes. The problem is, for most people with bipolar disorder, the medication doesn’t make everything ok. With insulin, sometimes that insulin’s going to make everything ok. With bipolar disorder..for some people it might, but for most people all it does is manage” the illness.
“Anyone who would say to somebody, ‘Well if you just took your medication, everything would be ok’..that’s not really true.”
You see three things from a manic person “that really turn people off”: ego, arrogance, and entitlement. (As opposed to esteem, confidence, and purpose.) “With bipolar disorder, through, you cannot tell what a person’s personality is like when you see ego, arrogance, and entitlement. You’re always going to see that. That’s a symptom of bipolar disorder.”
His daughter has bipolar disorder. “She’s the most gentle, compassionate, empathetic, and quiet person you’d ever meet. But when she’s manic: ego, arrogance, and entitlement. .. They can’t help it.”
The suicide rate for bipolar is 1/5. Counting the percentage of undiagnosed, it’s more like 1/4. Most suicides happen in the first two years of onset of the disorder.
1.2–3% of any population has bipolar disorder. “There are some evolutionary psychologists who think that mother nature is up to something. Because there really are people who think faster than you do. They get impatient with you because you don’t talk fast enough. There are people that don’t require as much sleep as you do. And they can be very sharp and witty and charismatic.” This might be mother nature experimenting with the next evolution of humanity.
“A person can be perfectly sane and totally psychologically healthy..and still have a manic or depressive episode. It has nothing to do with a person’s psychological fitness.”
“3.4% of families have bipolar disorder. And those are the exact words I mean. I don’t mean an individual has bipolar disorder. It’s genetic—how much more family can you get than that? If you’re in the family and you didn’t get it, you’re just lucky. I don’t know of any families where one person has bipolar disorder [where] it doesn’t affect the whole rest of the family. And that’s the secret to treatment of bipolar disorder. You treat the family. Not the individual. The individual has the poorest outcome, whereas if you treat the family, that has the best outcome.”
People with bipolar disorder self-medicate more (60%) than people with any other mental health disorder: cocaine for depression and alcohol for mania.
Those are some of his more interesting points, to me, from the first 20 minutes of the presentation. The whole video is an hour and 40 minutes long, but if you have bipolar in your family, I recommend watching it.
Meghan’s post prodded me to release some of my own ideas along the lines of mania isn’t better.
I listen to YouTube videos of people with bipolar talk about mania and sometimes I feel like I am listening to a pyromaniac romance fire. They’re more creative, colors are brighter, experiences in general are more intense. Their best ideas come to them when manic. Sex is more pleasurable. Mania is “wonderful” they say—but then they always add a modifier: “mostly” “sometimes” “but but but.”
Mania is pressured speech that drives everyone around you crazy. I mean literally not being able to stop speaking, and for some of us, not being able to censor our antisocial thoughts, thereby ruining relationships with all people who are sensitive to social norms—that’s almost everybody, including the people we work for, our families, our lovers, our friends.
I drank for many reasons—mania is one of them. Trying to slow down and dampen the unbearable sharpness of one’s brain so that one can fit into society is one reason to drink. Trying to heighten and lengthen the experience of mania is one reason to do cocaine and crystal meth—to go further into the crazy, so we don’t have to let it go.
Mania is not sleeping. Now, your first few nights staying up for an entire 24-hour cycle (or two or three) is a novel and educational experience, but—for myself—being unable to sleep, due to drugs, simple insomnia, or mania, is one of the least pleasant experiences I have had as a human being. We are made to function within the cycle of a day. When we don’t get that break in consciousness every day, critical biological and psychological things don’t happen. When this lack of sleep is expanded to weeks or months, as in mania, it is very bad. We hallucinate. We go insane. The mind needs breaks—often—and when it doesn’t get those breaks, it doesn’t function normally, and the experience of living within it is far from pleasant. It’s irritating. It’s disorienting. It’s depersonalizing.
Now, it’s tricky, because mania does have its upsides. I’ve written huge amounts of prose when manic—biographical prose that when she read it, caused my sister to end her relationship with me. But the writing?—It’s good, it’s really really good. Lol. You see what I’m saying? The writing is so true that it ended my relationship with my sister. So if you view me as an artist, then maybe that mania was great! If you view me as a human, then maybe I’m just more and more alone. And the truth is I’m both.
For some people, mania means grandiosity. (It does for me.) It means I think I’m smarter than everyone and not only can solve all the world’s problems but that I can save the world from its ignorance. For some people, mania means they literally think they’re Jesus. Tell me how that is helpful, how that is better, than sanity.
Manic people are often delusional. We think our family members are trying to kill us. I’ve experienced this—locking myself in my room in terror because I think my mother wants to kill me. This is a common delusion—watch YouTube videos of people describing mania and you will see it surface again and again. People jump out of moving cars because they think their father—instead of driving them home because they had a manic freak out at college—is driving them to the woods to kill them. That’s an actual example.
Yes, people love us when we’re manic. People come up to me in the grocery store and start talking about their children and they cry openly in front of me because they can feel my readiness to accept them. People fall in love with manics. They think that our skewed view of life is beautiful—and it is—and they want to be a part of it. Nothing is more attractive than a moderately manic person: they are spiritual, optimistic, bright, open. A little bit of mania is a wonderful thing.
But a lot of mania is a horrible thing, at least if you want to interact with normal “healthy” “sane” people. Because mania makes this impossible. You know, if everyone was a little manic, then a little mania would be better. Mania is a state that has much to teach us. In many ways it is better than normal. Once you’ve experienced it, it becomes clear that normal consciousness is in a way quite dead. But extreme mania, if you want to fit into this world at all, is not better. It is untenable.
If you want to go “all the way”—if you want to be a prophet wandering the street—then stop your meds and let the mania happen. Frankly, we need prophets. But for some of us, we have a need to straddle the crazy and the normal, and be a bit of both, and for us mania isn’t better.
Last week we had an extra psychiatrist meeting to discuss whether I was becoming manic. We decided together that I should re-start therapy, which was fine with me. I am on 10mg of Lexapro as of late as opposed to 5mg, which I was on for months. Antidepressants can push bipolar people into mania—that, simply, could be the cause of this. And maybe in the morning when I take my medicine, I’ll just drop my dose down to 5mg myself. That has been discussed between my psychiatrist and me, and she is fine with that as a short-term measure.
I am having some of those manic-type thoughts: I would abandon some family members with extravagant email but I’ve already abandoned all the family members I wish to banish. I feel I am special—especially hard to understand—and I feel that this therapy session on Friday either has to be the start of a long relationship in which we really get down to some things, or it might as well be canceled, because we’re not going to get very far with me in an hour. Honestly, I don’t even want to talk to the guy. I feel like canceling that appointment and sending my psychiatrist a 3am email saying I did so. It’s actually really hard to be bipolar (at times) and often I feel like the feedback I get from others mostly has to do with how it inconveniences them. Try having a disease that destroys all your relationships and makes you want to kill yourself. Now tell me again what is so hard about your life?
I could go on a tirade here about specific family members and branches that I can’t stomach anymore, but I don’t feel like it, so just imagine that I went on a 20-line rant about specific family members and branches that are fucking crazy and I don’t have the patience or motivation to be in relationship with anymore. End of paragraph.
I’m dreading the morning, because my mom will ask or be able to tell that I’m manic. I’m a good actor, good liar, but I can’t act away mania. It operates at such a basic level that it lies below my ability to intentionally control my performance. She will know. She will ask. I will say yes. She will suggest an emergency psych appointment or phone call. I will not want to do either because I won’t believe that either will help. I am tired of having bipolar disorder. I am tired of talking about it. I hate the word “manic.” I hate talking about my moods and my sleep and my delusions and my hallucinations with doctors and my only functional parent (really my only functioning immediate family member). I hate that the focus will be on me. I hate that I will be around people who are trying to solve a problem that basically can’t be solved. And it’s a drastic problem: the last time I was manic, it was for five months, it was major, and it drove my mom to ask me to leave our shared apartment, which needless to say was very stressful for me!
I probably should have found another living situation (one for crazy people) before mania stuck again.
I hate that I might, in my out-of-control mania, say more things that hurt my mom. I vow not to write any of my excommunicated family members, even to ask for help. I excommunicated them for good reason (or they excommunicated themselves) and those reasons have not changed. I am better off without them in my life. I wish them the best. Just not with me.
I wrote in my journal how unique I feel, how incompatible. This is not cool. This sucks. And it is and is not me: it’s the grandiosity symptom of mania.
I’m experiencing the symptom of mania wherein you don’t think you’re manic; the symptom of bipolar wherein you think your diagnosis is wrong..that you don’t have bipolar.
You’re not necessarily supposed to be able to know that you’re manic—not knowing that you’re manic is one of the signs of mania. But if you read the symptom lists enough times, sometimes you can recognize it when it comes. I know it tonight. It scares me. I don’t want to go to a hospital. I don’t want to get kicked out of my apartment. I’m sick of fucking doctors. I’m going to do my best to resist the urge to pack a backpack and get on a plane to a city where I don’t know anyone—or somewhere I’ve lived before—and try to start a new life. My physical disability dampens some of this impetus: I can’t walk properly, I can’t stand properly, I can’t sit still. A voyage by plane, for me, right now, would be an Odyssey.
So I’m going to put up with the condescension, the inhumanity, of being treated by my mom and my doctors as a subservient object who, in their superiority, they are deigning to heal. I know they don’t mean it that way, but that’s the way it comes across. Just because I’m sick doesn’t mean I’m stupid, and I can hear your tone, I can feel your look, and it all serves to undermine these relationships from my end.
I just hope this doesn’t go where it went last time, because I don’t think my mom and I will survive another mania, and I love my mom, and I don’t want this to be the end of my relationship with her. This will sound narcissistic—and I don’t care—but she’s the only person in my immediate family who has anywhere near the maturity to interact with me, and even that’s a stretch. My littlest sister, my mom, they are so fucking full of themselves—they think they’re so far above me—but they don’t know the first thing about me.
The uninitiated think bipolar is mood swings between happy and sad. “This weather’s so bipolar!” Ha ha ha motherfucker. Try mania and depression. And mania ain’t happiness. Depression will make you kill yourself. Mania will destroy all your relationships. This is a devastating, deadly disease. It makes you jobless, homeless, dead. So don’t mind me while I dread the hell out of greeting my mother in this state tomorrow.
The imagination is a big sky. My imagination has been taken off the rails. I am pondering the unknown in ways that scare me. I can’t sleep. I dream of what I think about in the daytime, and it presents itself to me in symbols that stick with me long into the waking hours. I’ve had to cut off certain avenues of research because the possibilities they suggest in my crazy brain are so scary they make normal life impossible. What they call paranoia has reached ((sky highs)) in me, if you’ll allow the pun. I’ve tricked myself out with my own mind and am using an antidote of Indigo Girls and Hallmark Movies, safe videos I’ve watched before, safe texts, safe people on Twitter.
If you really think about it, there are ropes which loop back to make circles of logic—and those are ok. But there are ropes in this world—frayed strings—which do not loop back to form a circle, and when one encounters facts that shape themselves in these senseless loop-less forms, if you have the kind of big sky imagination that can fill in the gaps with handfuls of theories, then reduce the theories to those more and more likely, this world stops being a place that makes sense in the way that most people think.
People’s sense of what’s well is even informed by their sense of what’s crazy. But what’s crazy has been engineered to give us our sense of safety, and if you widen the net of your research and narrow, with a smart mind, your theories that explain the unclosed loops, this world stops being safe at all and there’s almost no place to rest, psychologically. Occam’s razor is wrong. The world is wild and complex and evil and glorious such that one small fact about it could kill you.
This is me on medication, uninterrupted, for years.
I don’t think I even know anyone I can talk to about what’s in my mind anymore.
Ok, elizabeth tobey, I will tell you my story. I didn’t know it was Mental Health Awareness Month. I didn’t know there was such a thing. But I support your efforts to help bring awareness to mental illness and mental health, and to that end I am sharing a few of my current thoughts in these domains, here.
One of my favorite mental health videos is from Bethany Yeiser, a story of schizophrenia, homelessness, and recovery. In it, she says, “I started looking for something more. I was losing interest in my studies. In order to try to search for something more, I decided to go to Nairobi and live with the poor for a couple of months. I loved Africa..but when I returned from Africa, I wasn’t the person who I had been when I left. I was traumatized..”
She goes on to conjecture that her trip to Africa was a turning point for her, from mental health to mental illness.
But I don’t think that’s how it went.
I think the turning point was when she experienced her brain “looking for something more..losing interest in her studies.”
See, I, too, have made a trip to Africa—to Liberia—and my month there changed me forever as well. But I think mental illness and some other types of growth (generative or degenerative) are like your head growing too big for your favorite hat. Some trips you go on..and come back. Some trips, though, are one-way trips. Like going to Africa. Or going crazy.
I think it is much more likely that the correlation point of Bethany’s schizophrenic development was with her looking for something more—it happened before she went to Africa. Going to Africa was a symptom, not a cause, of the onset of her schizophrenia.
I remember standing in an airport in 2002 listening to The Eminem Show on an awesome pair of headphones and that was the point when I decided to leave my high-powered options-trading job with a company in Philadelphia and move to Tucson to live in a tent in my friend’s back yard. The music charged something in me, and I stood, turning and turning, watching all the people go around me through the airport terminal, to and from their jobs, and I wanted something more, too—something more than an office and a secure salary. I had always wanted to be a writer (in fact, as I see it now, I already was one) but that moment was when I decided that nothing—bar nothing—was going to come between me and the writing and publication of my first book.
I was supercharged.
I felt superhuman.
The normal safety checks and balances that mentally healthy people have did not exist in my brain. I quit my job and moved to Arizona. I wrote my book. And, by pieces, I have written more and more—and gone more and more crazy—since that time.
I have abandoned cars, abandoned apartments, been evicted, voluntarily become homeless, quit more jobs until the point that I started getting fired from jobs because I just don’t believe in authority anymore. I can’t work for other people because in my mind they are not qualified to direct me.
The head has gotten too big—grown in some unhealthy way—and my favorite hat will never fit me anymore.
In California, I stopped going to work and stayed at home doing my own programming work which I believed would help the NSA catch terrorists. I stayed awake for seven days, watched The Truman Show on repeat, drank potato vodka—futilely trying to slow my brain—and I programmed some of the most incredible things I have programmed in my life. Then I crashed and called a suicide hotline. Police came to my house, handcuffed me, and took me to a psychiatric hospital. The whole time I was there, I was kicking myself: if I hadn’t drank so much, I wouldn’t have called the suicide hotline. It never occurred to me that no one else I knew, on that amount of alcohol, became suicidally depressed. They just went to sleep. A panel of psychiatrists told me the same thing: my drinking wasn’t the primary problem. Yes, I needed to stop drinking, but not because I was an alcoholic..because I had bipolar disorder, and disinhibitors and bipolar disorder don’t mix. Well, when they do, they mix as shotguns in faces and lethal overdoses and jumping off of buildings—that sort of thing.
You might think that one trip to a psychiatric hospital—especially with the police taking me there—was enough to at least convince me I had the disease. No. Cut to ten years later. Twelve inpatient stays in five different psych hospitals and only now am I finally starting to believe that the words “bipolar-type schizoaffective” apply to me.
Mental illness is no joke. We are not educated about it enough as a society. As early as the 10th grade, my classmates were telling me I had bipolar disorder. But I dismissed the signs because I didn’t know them. And my parents dismissed the signs because they didn’t know them. With bipolar disorder, it takes an average of 10 years from the first medical intervention until the arrival upon a correct diagnosis. As a world society, we can do better. So I am happy to learn that there is such a thing as Mental Health Awareness Month, and I throw my twig on the fire with this little story. I have read many textbooks and scholarly articles on my diseases, and that’s a good place to start learning symptom lists and diagnostics. But to truly learn about these illnesses, I have found my academic reading is given another whole dimension by reading and listening to the stories of people who have the illnesses. Some of the very best mental health bloggers I know of are:
I learn so much from listening to and reading these people tell what it is like to have their illnesses from the inside. It builds my compassion. It makes me feel less alone. I think that’s a key part of what we need to do as a mass of humans to become more of a human family.
Hats off to Medium for focusing on mental health this month. I will look forward to reading your stories and learning from them.
If you want to read more of my mental health journey, you can do so by reading my memoirs, each of which is focused on a particular aspect of my mental illness/mental health odyssey:
Can Orange Glasses Help You Sleep Better?—“ ‘My girlfriend thinks I look ridiculous in them.’ But Mr. Nicoletti insists that the glasses, which can block certain wavelengths of light emitted by electronic screens, make it easier to sleep.”
Blocking blue light during mania—“The transition to the blue-blocking regime was followed by a rapid and sustained decline in manic symptoms accompanied by a reduction in total sleep, a reduction in motor activity during sleep intervals, and markedly increased regularity of sleep intervals. The patient’s total length of hospital stay was 20 days shorter than the average time during his previous manic episodes.”
You don’t have to tell me twice. I went out and bought a pair. I just got them today, and I’m wearing them all the time, including during all computer use—except when retouching a photo or doing other graphic design work. We’ll see what happens—I’m optimistic!