RealMental

From the Vancouver Sun –

A new antidepressant being tested in Canada appears to do what no other drug can — increase connections between brain cells within hours to swiftly improve symptoms.

The finding by Yale University researchers may explain how one dose of ketamine can reduce symptoms of depression within 40 minutes among the hardest-to-treat cases, and could help spur development of quick-acting antidepressants.

Mathematician and Physicist Percy Paul is afflicted with severe Bipolar Disorder. He believes that his manic states allow him access into creative thought patterns. The curse is the resulting depressions that endanger his life.

Watch a 2 minute preview here.

It’s not until he mentions it that I realize that he’s funnier than he’s ever been before.  I’ve been sitting here, drinking coffee with him—my middle brother, 3.5 years my junior—for an hour, maybe.  And I’m just now realizing that I’ve been laughing with him far more than I usually do.

Funnier, yes—and talking fast, loud.  I can barely get a word in edgewise as he quips, his words darting faster and all around me.  He pulls faces, laughs, then stops.

I feel stupid, because I maybe wouldn’t have noticed if he hadn’t said anything about it.  Quieter, now—“I’m going to go see somebody, one of the counselor’s at school.”  He talks about how he’s fucked things up, how he lost his girlfriend of more than a year by being stupid.

He’s the same age I was when I fucked things up.  21 and change.  The age where everything starts to come together, when your body feels electric with the burden of the future and the prospects of freedom and responsibility start to wind themselves around your ankles.

And I envy him, if only a twinge, before I am suddenly scared for him.

***

(remember)  What it’s like to be told in a room by a man that you have a chronic illness that will never go away.  And it’s something that’s inside you—it’s something that you’ve always thought is you.  Because it’s in your head—in your brain—it’s hard to separate out the sick part.  You start the never-ending data-mining, the perpetual jump through funhouse mirrors—you decide what to keep and what to put away in a box marked “other.”

You are stricken by two dual forces.  One.  You would never wish this fate on your least favorite person.  Think about childhood bullies and mean bosses.   You may wish for them to die, but you’d never wish for them to feel this way.  Two.  There’s a genetic component.  A much higher likelihood than you’ll admit that someone you love will do this too.

These forces get inside you and they explode your heart.  Pieces of it go everywhere, flying into all of those they love.  You understand that quote about your heart walking outside of your body.  You live with it every day.

***

And still, I dare to dream about a normal life, ignoring the fact that I took a left turn from normal years ago.  Once upon a beautiful time, I had a coherent line of sight.  I was engaged, had a wedding planned for June 14^th, 2008.  I wanted to go to school, get married, start thinking about children.

The words “bipolar disorder” make everything so fucking complicated.  When they find out that we’ve been dating for seven years, even casual acquaintances ask about a ring.  I laugh it off.  I say that we’re taking our time.  I don’t mention that we were engaged.  I don’t tell them that we’re not engaged now because I contracted a case of the crazies and went about fucking schoolboys while my fiancé worked at 5 AM on Saturdays to pay for my ring.  When I think about it, my jaw starts to hurt from the clenching of my teeth.  My lungs are filled with air that won’t be pushed out.  I take a look at the path at the fucked-up path of burnt-out bridges that lay behind me.  How do you explain this?  How do you make sense of something that feels so senseless?  How do you do anything but move forward, blindly, spouting platitudes and bullshit about taking your time.  Taking the long way.  Going the whole distance around your ass and still, somewhat improbably, coming out ok.

***

In the review session for my neuroscience final in my first year of medical school, the question is posed: “What is the heritability of Bipolar Disorder?”

The answer I’ve learned to parrot is:  “Autosomal dominant, but with partial penetrance.”

In my head, it sounds more like: “You are playing Russian Roulette with your future children’s lives.”

In these moments—among others—I am forced to contemplate the ghost-children who will someday tumble out of my womb, with so much potential for brilliance and pain lying latent their skin.

In the dark, I will whisper to them that my genes do not determine their fate.  Then—and now, even now—I will whisper it to myself.

People call me/I call myself Laura.

I see myself as scatter-brained but loving. And loved.

If I thought you cared and you were listening, I would tell you I have a bipolar depression and anxiety disorder diagnosis. Sometimes I wonder if the drugs are working, or if it’s a misdiagnosis because I feel pretty good these days. Then I forget to eat or take my meds or I drink too much and I fall down the hole again. Some days I want to do so many things, and others I want to do nothing but sleep. I can’t focus on getting good at one thing, or getting one thing done well. Why can some people manage and lead well but other struggle?

I am struggling with so much distraction. And I eat too much to soothe my anger and frustration. I want to get unstuck and feel untrapped.

Something I have been keeping a secret is how upset it makes me that I don’t have a child, and how I am so frustrated with my husband. I would like to adopt a child but he has said that is a deal breaker. I have examined, at length, why I want a child so much. Is it selfish to want a kid? Is it selfish to not want to raise a child? I’m not right with this. I put on a happy face to make my friends feel comfortable, my husband happy, and my parents satisfied.

I am trying to think positive and something I’m good at is connecting people. And I love learning new things and meeting new people. Pretty simple.

By Dianna

Where do I go from here? Once again I feel my life spiraling out of control and have nothing with which to stop it. I am a logical person. I know what I should do to make myself feel better, however I seem to have no way of stopping myself from doing what I shouldn’t do.

When I get nervous and feel disliked in a situation, I drink. When I am manic and feeling like the world is mine and everyone should bow to my amazingness, I drink. When I drink, I inevitable fail and the all consuming guilt spirals into depression.

This weekend I celebrated my friend’s birthday. Her friends don’t like me. Perhaps the best thing was not for me to point out how one particular friend of hers doesn’t even say hello to me and shoots daggers at me with her eyes. They make me feel uncomfortable and she herself, always seems to want me to act a different way, or be a different way, and I try to tell myself it’s all in my head and than I feel bad, but perhaps maybe it isn’t.

That night, I separated myself from the group. Instead of talking to them, I talked to strangers. People who didn’t make me feel disliked and uncomfortable. People who listened to me and didn’t tell me I was talking too loud or act as if I was embarrassing them. They left me at the restaurant and I had to find my own way to the bar. Then, they left me at the bar and I had to get myself home. No matter how poorly I was behaving, how can that be the way to treat a friend?

Here I go again. One more friend down. When you only have 3 left it’s a sad and lonely place to be.

Being bi-polar is not conducive to friendships, and those you do find generally are engaged in the same self destructive behavior you should avoid like the plague. It gets you nowhere real fast. Yet, no matter how many times I am told “it’s not my fault”, no one else seems to believe it or wants to take the effort to understand that. And sometimes I just don’t believe it.

Whose fault is it if not mine? I’m the one who chose to have sex with strangers, to put things up my nose that shouldn’t go there and to put that glass to my lips over and over again.

Today I made it out of bed, albeit late, and I will drag myself to the gym and remember each hour that passes is another chance to begin again.

My mom has an incredibly annoying habit of starting conversations with me with the phrase, “What’s wrong?”

Example:  It is the day after Christmas.  I have been downstairs eating cake for breakfast in my pajamas.  I walk up the stairs and see my mom.  Startled, she looks at me.  “What’s wrong?”

Nothing. I say.  I was just eating cake downstairs.  Everything is perfect.

Example:  My mom calls me on the phone and leaves a voice mail.  I return her call.  She answers the phone—no “hello”—but “What’s wrong?”

It wasn’t always this way.

***

I don’t know what it is, what makes her do this.  It unnerves me to no end, makes me feel like she’s always on edge.  I have my theories, of course—that our relationship is forever changed by the knowledge of my mental illness, that she feels guilty that she didn’t know I had so many problems.  Guilty because she discouraged me from getting treatment the first time around.  Scared that it could happen again, a snap of the crazy finger and everything changed, or gone, again.

Once, when I was 21 and in the middle of the arduous task of being diagnosed with bipolar disorder, I spent the night at home.  It was Daylight Savings Time, the one where you spring forward and lose an hour, the same lost hour that started everything the year before.  The boy and I were both upset—him with me, and me with myself.  In the middle of the night, I slipped out of my bed and left a note saying I had gone to sleep at his house.  Later, in the early hours of the morning, someone shot a gun outside my house.  My parents awoke, saw I was out of bed, and immediately feared for the worst.  I got my mom’s panicked call on my cell phone, out-of-breath and hysterical.

I’m here. I said.  I’m alive.

But it was eye-opening, having a glimpse into the fears they had about my life and my illness.  The fact that they thought it could have been me has always shaken me to my core.

***

An essay on suicide and its presence in my life:

In 2002, a month before starting my senior year of high school, one of my best friend’s fathers committed suicide in the woods outside their house while no one was home.  Her mother, out of town and worried that she couldn’t contact him, called my friend on the phone and my father, brother and I drove home with her.  While we were in transit, he was found dead.  One of his employees knew me and knew that I was a friend of his daughter.  Trying to track her down, they called me.  We were halfway there.  We pulled over in the rain and I got out of the car.  At the age of 17, I had to tell this girl that her father died, that he’d committed suicide.  And then there, in my arms, were the pieces he’d blown apart with his gun.  I held the one who’d been left behind.

Last week, one of my closest friends called me—after a string of numbed-out half-started words, he finally choked out that he’d lost his college roommate.  I went over to his house and we sat outside as he smoked cigarettes.  He told me about the questionable nature of the death, about the erratic driving and an overcorrection of the steering wheel that flipped a car and left its driver DOA.

“His father told me that he’d been on pills, and I knew that he was having some problems.  But nothing like this.  And he never told me how he was feeling.  He never told me.  Why wouldn’t he tell me?”

He was asking because he knows about my experiences with mental illness, because he knows that I’ve been depressed.

So, I told him the truth.  That sometimes we don’t tell the people who are closest to us because we don’t want to change their perceptions of us.  We don’t tell them because we can’t bear the sideways glances, the frightened looks that make us feel crazier.  That we can’t stand the thought of hurting and worrying the ones we love.  That when we tell the closest ones, that’s when it really hits us.  That’s when it’s real.

It’s easy to tell strangers and people you’ve just met.  They don’t have any emotional investment in you or your well-being.  They don’t worry at night or when you call them on the phone.  They never will have to ask you, “What’s wrong,” and be scared of what the answer might be.

So he’s quiet and drunk and upset—all the things I’ve been before, when someone I knew unexpectedly died.  And he looks at me, and repeats himself.  “I just wish he had told me.”

And here I am, once more—holding in my arms one of the ones who’s been left behind.

***

It’s not my intention to proselytize or blame.  I’ve been on both sides of the matter, flipping back and forth like a metronome from experience to experience.  I know what it’s like to wallow in desperation and sadness that feels like it will never end.  I’ve visualized it in my head a thousand times—what it would look like to rake a razor down my wrist, what my feet would look like hanging from a rope or the moment of clarity I would have just as I jumped.  I’ve wished for cars to hit me in crosswalks, and I’ve thought incessantly on rough days of turning the steering wheel and careening into a tree.

But I know, too, about the ones we leave behind.  Friends, family, teachers and acquaintances.  The ones who will sit in doorways, mouths drooping with cigarettes and veins running with vodka, the ones who will ask “why” and “how” and blame themselves, no matter what anyone else tells them to the contrary.  I’ve been there too many times, and the pressure of these times is always enough to push me back.

But in the light of this most recent experience, I feel guilty for being so frustrated with my mother.  She asks “What’s wrong?” because she worries that the time she doesn’t is the time it will matter.  I want desperately to tell her that she shouldn’t worry.  That the truth is that, if that time came, she wouldn’t be the one to know.  No one would.  Our hearts are full of secrets and lies, of deceit and worry and fear, of questions that have no answers.

But I want to reassure her.  I want to reassure all of them.  “Don’t worry,” I want to whisper.  And even if I can’t guarantee it, I’m pretty sure.  If I could, I’d write them all promises.  “No matter what, no matter how hard it gets—I won’t leave you behind.”

[This post is the kind that winds around itself and threatens to lose all who dare to follow.  I apologize, of course—but will try to bring it home.]

It starts—or ends—here, with a yellowing bruise on my hip the size of a half-dollar.  Unintentionally put there, a mistake that he didn’t realize he had caused.  If he had realized at the time, he would have switched his face immediately.  I’ve seen it a few times—a shoulder to the sternum or my hands contorted around my metal back—then the abrupt stop, the gasping gaping mouth.  The hands laid flat across my spine as I catch my breath.

***

Winter 2006—I was filling out one of those anonymous surveys on my stupid MySpace page.  I was supposed to be finishing a medical school application but was distracted.  By everything.

One of the questions asked, “What are you not?”  I was insanely jealous of the answer my friend Allison had put—it was so self-assured, so positive.  I thought for a few minutes before I answered.

A strong person, I wrote.

***

I was a feisty child, surrounded by rough-and-tumble brothers and built of a certain solid stock.  My body accumulated bruises and scars over the years—the gouge on my hand from a fight with my brother, the scars on my knees from rock climbing and dog bites, the permanently swollen knuckle and swan-necked finger that resulted from one memorable wrestling match, age 20, that required an entire month of PT to resolve.

But somewhere along the way, I lost that sense of fierceness.  I gave in to pushing touches and piercing glances.  Sucker-punched by words that were supposed to be compliments.  I felt so out-of-control.  So fucking weak.

“What are you not?”

“A strong person.”

***

I don’t know if he’ll ever fully realize how much he’s given to me.  There was just something about his constant challenges, the purposeful pokes that incite me.  There’s nothing like the feeling of an impending spar, the first things that make me stop and ball up my tiny fists.  I know I’ll never win—he’s much bigger and much stronger—but there’s something in the fight that thrills me.  There’s something about being pushed back and attacking again—raising my fists after hitting the floor, arching my back down and charging or kicking as I’m held above the floor.

I never had an older brother, but I imagine that this is what a childhood with one looks like.  There’s something brilliantly beautiful in the futility of it all.  There’s a certain passion that blushes up through me, that warms me up and makes me feel alive.  Alive and strong.

***

Sometimes, on Tuesday afternoons, I go to pilates class.  I’m not terribly good at it, but I am always inspired by the instructor.  She’s bubbly and thin, uses weird phrases for different muscles, and is unfailingly supportive.

So, one week, I push myself into a plank, and I hold there for a minute.  And she squats down beside me and places her hand on my back to steady me.

“Look!” she says.  “See how strong you are?”

And it hurts, but I nod and smile.

***

I will never feel invincible.  There is always something else, pushing and testing me.  There’s always a hurt or a need or an aching longing for something else.  There is perpetual stress, constant working and chronic exhaustion.  But on a Monday night, I spar in the living room of my best friend’s house, the room where I’ve been tossed to the floor and spear tackled onto the ottoman and dragged across carpet and picked up until I screamed in frustration.

It’s not until later that I notice my hip is in acute pain, throbbing from the force of being thrown sideways into a couch.  I realize that I didn’t notice it before because I was so engrossed in the fight, obsessed with picking myself back up and throwing myself back into a losing battle.  Over the next few days, a bruise blooms into the most lovely battle scar, a sore memento that I fawn and fret over.  That I’m proud of.

There are so many fights, you know—I fight to be treated fairly, I fight to get what’s mine.  I fight over silly things and important things, and I fight the world and myself equally.  And at the end of the day, worn out from fighting, I go to bed tired but filled.  Filled with a certain feeling of strength.

***

“What are you not?”

“A weak person.”

“Look at how strong you are.”

“I know.”