Tag: bipolar Identity

A Thousand Steps…

If we take a thousand steps, we’ll have travelled some distance whether we’ve reached our destination or not.

Woman descending steps on a mountaintop

Three months ago, I relapsed into a mixed mood state, having symptoms of depression and hypomania at the same time.  This took me by surprise since I had been psychiatrically stable for the past several years.  Why I slipped into this destabilized state, I do not know.

Losing myself

In response to this, the recommendation from my psychiatrist was to double the dose of one of my medications and within a few weeks my mood symptoms resolved and I felt back to my usual self.  Or so I thought.  Sometimes, it’s only in retrospect that I realize that all has not been not so well.  It was only after a month of being a good patient and taking the elevated dose that it was obvious that something was wrong.  I wasn’t having mood symptoms but I was lifeless without any interest in doing anything at all.  I’d just lay around all day not writing, cooking, exercising or otherwise engaging in my life.  This wasn’t depression, it was a side effect of the medication.  I made the decision on my own to return to the lower dosage and a few days later, emerged from my deadened state.  I was alive again.  I know that despite feeling better, on this current regimen, my mood symptoms are going to express themselves and I will become ill again.

The half or zero dose guy

If halving my medication caused me to re-awaken, how could I be sure that the remaining dosage wasn’t having some deleterious effect?  If I stopped taking it all together, might I become even more alive?  Who am I? Am I the half dose guy or the zero dose guy? Am I still trapped beneath the weight of this smaller pill I take everyday?  I’m tempted to experiment and stop all my meds and find the answer.  I understand non-adherence to recommended care.

A thousand steps…and more

I continue to face what many who have psychiatric disorders face.  Still searching, after so many years, for that combination of medications that will stabilize my mood yet won’t suffocate the real me.  As a psychiatrist, I understand the challenges of this delicate balancing act.  That said, I’m rather frustrated and pissed off that I’m forced to continue this wearying journey.  It seems, at times, that there is no end in sight but I have no option other than to soldier on in this (so far) elusive search. I don’t think my feelings arise from a place of self pity. They are instead a sober realization that a thousand steps hasn’t been nearly enough.

I Miss the Mountains

Hijacked by my Brain

I took a hike a few months back in the Blue Ridge Mountains, outside Asheville, North Carolina.  Having scaled one of the peaks, I sat and saw the expansive valley below from my lofty perch.  The sunshine warmed my face as I inhaled the cool, crisp air.  I was on top of the world.

As all others living with bipolar disorder, I had periods when I was driven down to the abyss of depression and then episodes when I was elevated to the heights of mania. I couldn’t predict when my neurotransmitters would hijack my brain but they inevitably would. I was being repeatedly kidnapped.

The Mania of Love

Though my manic periods were ones of agitation and irritability, they were also times of euphoria and grandiosity.  I was the smartest guy in the room, walked with a bounce in my step and felt that I was capable of doing things that were, in reality, well beyond my reach.

When we have a huge crush on someone, the world falls away and all that is rational is replaced with heady infatuation.  In this state, we behave in ways we wouldn’t otherwise, throwing all caution to the wind.  Everything feels tingly, as if we are living on the edge of ecstasy.  This is a small glimpse of what mania is…an other-worldly intoxication.

As a psychiatrist, it was my duty to un-manic my patients.  I was required to shift their state of giddiness into, at times, one of bland sobriety.  I was like a thief in the night, robbing them of what they most loved.  Turning the tables, when my psychiatrist recommended lithium to me in our very first session, I was literally being given a taste of my own medicine.  The psychiatric perpetrator had become the psychiatric perpetratee.

Mountaintop Highs

A few years back, there was a Broadway show called Next to Normal about a mother living with worsening bipolar disorder. Once she was medicated and mood-stabilized, she longed for those periods when she was mountaintop-high manic. She sings:

Mountains make you crazy

Here, it’s safe and sound

My mind is somewhere hazy

My feet are in the ground

Everything is balanced here

And on an even keel

Everything is perfect-

But nothing’s real, nothing’s real

I wouldn’t trade my current mood stability for my prior elevations given the havoc and heartbreak it caused those around me. But, there are moments when I long for my now-medicated-and-absent euphoric core to rule the day and carry me upward toward that place far above. I love ascending the North Carolina peaks but sometimes, I do miss those mountains.

Bipolar identity: Jekyll or Hyde

Before i was mood stabilized

Before I was stabilized on medications for bipolar disorder, I was very confused about my identity. I was a “moody” guy with good days and bad ones, had periods where I was productive and other times, not so much. I had episodes when I expressed a lot of energy and other times, I felt dragged down. But everyone was like this, I told myself. I was just a moody guy. I didn’t question it. After all, why ask whether it’s dark out at night or light during the day? It just is.

Picture of Dr Jekyll and Mr Hyde in the 1931 Movie

When I finally admitted that I had bipolar disorder and was mood stabilized, I saw my true identity on the inside as even keeled but that I had neurotransmitters that kidnapped my genuine self, pushing me downward into an abyss or hoisting me up to irrational highs. It was a relief to know that I was, at my core, “normal” like Dr. Jekyll but it was awful to know that I could be transformed into the deranged Mr. Hyde whenever my “sickness” expressed itself.

The medications

The experience of having one’s true personhood abducted by their brain is common in those who have bipolar disorder. Our neuro-chemicals cause us to question who we really are. Just as bad, though, the medications we take add to our identity-confusion. Over the years, many of my patients with bipolar disorder have told me that the pharmacopoeia I was prescribing was robbing them of themselves. The pills were causing them to be less fun-loving and their true creative self; their lives weren’t as rich and vital as they were without treatment. Despite my best intentions to help them, I was a perpetrator of their distress. I understood them. I had walked their walk.

Humans must have a clear sense of who we are, defined by our values, ethics, core beliefs and behaviors. Having such clarity anchors us in our world. We can’t have satisfying relationships or meaningful vocations when we don’t know who we are. It’s simply impossible to have a shifting sense of self and live a stable, happy life.

Mood stability

After years of mood stability, I was finally certain about the difference between medication side effects and the genuine, authentic me. I felt good: bipolar was a healthy aspect of my identity. I was fully integrated with a solid sense of self and this provided me with a comfort that I never had experienced before. Perhaps in the future I will have a hypomanic or depressive episode and Mr. Hyde will reappear. When I become stable after that period ends, though, I will know that I am neither Dr. Jekyll nor Hr. Hyde. I am both. I am now a doctor living well who happens to have a mental health condition. It’s as simple as that. Full acceptance of all aspects of my authentic self allows me to have inner peace. I am now whole.

Are you Jekyll, Hyde, neither, both?