By Patrick Vecchio
I sit on the couch. K sits in a high-backed chair, listening, asking questions, commenting, taking notes. She dresses in black and wears her shoulder-length black hair pulled back. She parks her parti-colored glasses low on her nose and looks at me over the lenses. Only at the end of the session, when she writes prescriptions or a card for my next appointment, does she look through them.
This is the best Iâ€™ve felt for a long time, I say to her. The last prescription was the answer. With the other meds, I felt good for a while but always slipped back. This was the missing ingredient, I say. Iâ€™m sure of it.
I am at that moment trying to convince myself I am sure Iâ€™m going to continue feeling good. Itâ€™s certainly possible. But maybe I wonâ€™t. Maybe Iâ€™ll be back to Square Zero before our next appointment. Thatâ€™s how life is for me. I have bipolar disorder.
I am, of course, not alone. The National Institute of Mental Health says:
About 5.7 million American adults, or about 2.6 percent of the population age 18 and older in any given year, have bipolar disorder. Bipolar disorder typically develops in late adolescence or early adulthood. However, some people have their first symptoms during childhood, and some develop them late in life. It is often not recognized as an illness, and people may suffer for years before it is properly diagnosed and treated. Like diabetes or heart disease, bipolar disorder is a long-term illness that must be carefully managed throughout a personâ€™s life.
I remember when K first said she thought I had bipolar disorder. I immediately went into denial, because although she said â€œbipolar disorder,â€ I immediately thought â€œmanic depression.â€ That older term sounds harsher â€” scary, even â€” although itâ€™s more descriptive. Until I better understood the condition, I couldnâ€™t accept her diagnosis.
Accepting the â€œdepressionâ€ part came first. It explained why Iâ€™d go home from work in the afternoon, go to bed, and not get up until the next morning. It explained why the simplest tasks seemed overwhelming. It explained my lack of motivation. Although they seem obvious, I didnâ€™t recognize them as symptoms of depression. I didnâ€™t know what I was dealing with. All I knew was my core skills (organization, time management) were disappearing. I didnâ€™t think I was going to be able to continue teaching because I lacked energy and patience with myself. I felt I wasnâ€™t doing a good job, no matter how hard I tried, and as invigorating as the classroom was, making the slightest mistake would tumble me back into the pit. And the pit was scary. It was as if the world had gone flat, and although I wasnâ€™t standing on the edge, I could see it.
At other times, though, I felt as if I were living in the front seat of a rushing roller coaster â€” and I donâ€™t like roller coasters. Life was an overwhelming, onrushing blur. At these times, I lived between frustration and rage because life was coming at me too fast to handle. The not knowing what was wrong, the ups and downs, were getting to be too much. I was ready to get help, which led me to K. But even after learning about depression, I still wasnâ€™t ready to believe â€œbipolar.â€
One reason is that I thought the roller coaster rush should be just as severe and prolonged as the depression. With me, thatâ€™s not the case. Usually, my mania is mild (a state called hypomania), and itâ€™s like driving a car 10 mph over the highway speed limit but feeling in complete control. Although he probably wasnâ€™t singing about it, Lyle Lovett once described hypomania perfectly: â€œItâ€™s one of those days when those great ideas, they just seem to fall out on you.â€ Energy, confidence, ambition, optimism â€” all are in ready supply. When those days came along, I would ride them with a breathless smile.
Eventually, after doing some research and talking with K, I recognized my hypomania and occasional mania for what they are: not simply â€œgood days,â€ but part of the bipolar cycle. At last, her diagnosis made sense. I also began to notice a cause-and-effect: On occasion, the car I was driving through life at a comfortable 75 mph would hit 85 or 90 mph and turn the trip into a death-grip-on-the-steering-wheel ride. Right after, I would plunge into the darkness so quickly I almost could feel it.
Hereâ€™s an example: A colleague started a writersâ€™ group last spring where students and faculty could discuss literature and creative writing. One night I read my favorite poem: ee cummingsâ€™s â€œi sing of olaf.â€ One of our guests was from the English department, one of the universityâ€™s most beloved professors. He and my colleague took apart â€œolafâ€ and showed me things Iâ€™d never seen, even though Iâ€™d been familiar with the poem for nearly 35 years. It was an amazing, invigorating night. But as I drove home, I began to get down. How could they see those things in the poem while I couldnâ€™t, even though I knew the poem so well I could practically recite it from memory? Why werenâ€™t my reactions to their comments anything more substantive than â€œwow!â€? By the time I reached home, I was back in the shadowland.
As was always the case, I managed to crawl out of the shadows after a few days. That was another reason I had initially been in denial about my condition. Because I always managed to emerge from the pit and have stretches where I felt fine, I had assumed for years that my highs and lows were normal, the ups and downs everyone goes through. Eventually, I realized that was not the case. Since Iâ€™ve been seeing K, Iâ€™ve learned how to distinguish routine ups and downs from the extremes.
A couple of months ago, she asked me to remember what I felt like the first time I saw her, in October 2006. â€œLike a shopping cart full of motorcycle parts,â€ I replied. Iâ€™m back together now, but the reassembly included 21 months of prudent pharmacology. The meds havenâ€™t eliminated my cycling, but they have raised the lows and lowered the highs. And during those 21 months, K and I have been talking about experiences that have shaped who I am and how I think. Now, all the work is returning rewards.
These days, life is a gift again, not a burden. But it took patience to get here. I had to learn how to avoid situations that trigger my depression. I also had to learn how to keep hypomania in check. Most important, Iâ€™ve learned this cycling probably never will go away. I still see K for brain maintenance.
Earlier this year I wrote about dealing with obsessive-compulsive disorder. I did it to give people information they might find helpful and to try to destigmatize mental illness by talking openly about it. The topic has changed, but my motivation hasnâ€™t. Bipolar disorder is part of who I am â€” but with therapy, medication and knowledge, I live a productive and happy life. If this story helps anyone, it has been worth the telling.