Manic Depression is at times very difficult to cope with and in those moments of struggle, could be considered a terrible gift. But it is a gift, for it also holds within it a life experienced with an intensity known to few. It is a life of poetic heights and valleys, of immense joy and profound suffering and in it lies the potential for a deep investigation of one's very existence.

Dear Vincent,

One thing I have noticed is that it can be very difficult to distinguish between mental and physical well- being, or, unwell-being. If happy, the body feels strong, if manic, the body, not just the mind has boundless energy and capacity for physical activity. Never have I been as flexible in Yoga class, as when hypomanic. My whole being buzzes with joy when I feel well. On the flip side of course lies depression, and frequently bi-polar depression is expressed in form of horrible, horrible fatigue and lack of any energy. When I am depressed I mentally have to whip myself to get out bed, into the shower, to work, etc. When I am depressed I need an inner drill sergeant to be able to function. Mailing a letter becomes an insurmountable obstacle and a trip to the grocery store like crossing the river Hades. Those times are dreaded, they are so exhausting and require so much effort, so much invested energy, where there simply is none. These depressions are tearless, they are awful, flat and hopeless, all of which is also reflected in how the entire body feels- heavy, aching and exhausted. And there is the catch- if the body feels heavy, exhausted and aching, it could be a terrifying precurser to sliding into depression. Other people might assume they are sick, go to bed and take their temperature. Not me. Because of this particular brain chemistry I initially assume my unwellness is related to depression, or medication side effects. And I try to tough it out, I keep pushing myself to try and overcome whatever is going on and it will take me a minimum of a week to figure out that I am sick. With a fever. And that my symptoms weren't those of feared depression, but flu..... I wonder how common this is.

Madness is terrific I can assure you, and not to be sniffed at; and in its lava I still find most of the things I write about. It shoots out of one everything shaped, final, not in mere driblets, as sanity does.
-Virginia Woolf

Diagnosis and medications

One of the challenges in managing manic depression seems to be the actual acceptance of the diagnosis. Despite repeated major episodes of mania, despite immense struggles with concentration and overwhelming fatigue, despite the fact that maintaining normal functioning took almost all of my energy, there was part of me that just did not want it to be so. Who would want to be "mentally ill"? Certainly I must be strong enough, self-disciplined enough to beat this thing, through sheer will power, by balancing my chi, with herbal supplements or acupuncture. Mindfulness meditation , exercise, enough sleep and a healthy diet combined with excellent therapy was going to reset my chaotic mind without needing the assistance of medication, hated for their side effects, numbing quality and mostly the fact that taking them was proof of the illness. So stubbornly I repeatedly, and against the wishes of several doctors, weaned myself off of Depakote, Zyprexa, then Trileptal, Lamictal and Depakote again. I gained and lost many pounds, cried every time I washed my hair because it was falling out by the handfuls and lamented the fact that I could no longer read more than half a paragraph, never mind write a sentence. It was miserable. Off of medication I would feel alive for a few months, just to get reactivated into mania as daylight hours were increasing and my need for sleep was decreasing. Soon enough I would be up for days on end, and life would start to take on a dreamlike quality, heralding another round of psychosis. Fortunately my wonderful and trusted friends and my doctor see things more clearly than me during those times and following their advice I begrudgingly turned to the one drug I had not yet tried: Lithium. I took bare trace amounts of it, 300 mg daily, was able to halt an episode in the making, and functioned well for a year. Then came chemical storm #3, with a vengeance and lightning speed. My baby amounts of lithium were not going to cut it, not anymore. So up and up I went, until I reached therapeutic blood levels at 1200 mg. Now I was dealing with acne for the first time in my life, and controlling my shaking hands can be a bit of a challenge, especially since I am a professional artist and teacher, who regularly has to demonstrate in front of students. But none of that was anything compared to the psychic pain that started to ensue. Lithium does well controlling mania and to a degree depression- but it does nothing for mixed states, and my crafty brain chose those as it's next adventure . Clearly so far the most intense suffering I have experienced, so painful, I was begging for medication. Anything to make it stop. So I did not put up the slightest struggle when I was put on additional ability, and lo and behold: a miracle. Within a week I felt great, or should I say normal, again, for the first time in 10 months.

compadres-

One of the more profound experiences of hospitalization are the temporary friends one makes. We are community creatures, us humans, no matter how confused or even deranged we might be at times, and there is enormous comfort in reaching out and sharing. Togetherness is possible, for many anyway, even under dire circumstances. All of a sudden painting each other's toenails in rainbow colors becomes an immense luxury and total delight. Hospital lunches are gourmet meals and the daily dazed walk around the building offers a precious taste of freedom. Remarkably one encounters more heartfelt sweetness between total strangers, more care, more sharing of real laughter and profound tears in the closed wards, than in any other situation. Maybe because everyone is so raw, so out of control, so unable to hide their emotion... I never saw much rage. Despair, yes, anger, not so much. But of course that is probably due to the heavy medications everyone is on.
None of my hospitalizations were voluntary, and there is nothing I'd like to avoid more in the future, but despite the trauma of those experiences, the people I have met, have left a lasting impression in my heart and mind, and I often think of them. Each person I came across was dealing with enormous mental suffering, each one of them was in their own way trying to put one foot in front of the other, and I can honestly say that there is not much as moving as a scrappy bunch of mental patients singing hotel california, accompanied on guitar by nurse Bob.
There was Rose, she and I cleaned up stray cigarette butts and I couldn't quite understand why she was there, she seemed so sweet and happy. Or Cecilia, who had the bearing of a proud hacienda owner, with her powerful voice and her controlled manner of speaking, a straight-backed dancer in her own world. Robert with his far-away eyes and a lovely smile was enduring his pained mind confined to a rolling bed. Jeffrey and Niomi, the young lovebirds, about 18 years old and homeless, were exchanging secret kisses, amazing that even in mental lock-down romance can flourish. Sharon said she lost her only child in 1985. Since then she no longer wanted to live. She went in and out of reality. You could tell by her hair, it iwas either neatly put up, or flying loosely around her shoulders. At some point she started screaming to leave and ended up sitting completely fallen into herself by the exit door. On the ground. Shrek, I don't know his real name, wore camouflage clothes day and night, and would communicate only through his Shrek doll, whom he hugged like a baby. Tom obsessively collected towelettes, and proudly announced one day after lunch: "I don't smile, but it helps." Very dear and funny was Kayla, a former tv production assistant whose only desire was to get electro-shock treatment, the sooner, the better. I can only imagine her level of struggle. And there were so many more. Profoundly depressed, schizophrenic or manic depressive people, all under one roof for a brief period of time. I often wonder what has happened to all of them, where did they go? Who picked them up? I did run into one person from ", a woman whose name I did not know because she would not talk. I sat next to her on a bench, on which she more than likely lived, and we drank coffee together. She still did not talk much, mostly she cried.

A flash from the past- 2005

So many things have happened, so much has changed. I plunged into mania and almost drowned in a sea of thoughts, ideas, and grandiose delusions. The inside of my head exploded into a series of at times magnificent, at times horrifying fireworks which had me reeling until I ended up in the hospital. I have new found respect for the power of the mind, a different understanding of reality, for what I perceived was not real, and yet I was convinced it was. The details of what occurred are imprinted in my mind, and it is hard not to be ashamed of my outrageous behavior, all in the name of art, and in the name of love. One could say I made quite a spectacle of myself, but in a case like this all one can do, is accept the experience into one's history as past and move on. And learn from it what can be learned. And I have learned many things. I have learned the meaning of true fear, being tied in full restraints while screaming for someone to help me, and then waking up in the closed ward two days later, not knowing where I was or what day it was, I have learned how much worse off many of my fellow "inmates" were, but how this scraggly community, thrown together randomly got along well, how the patients were kind to each other, and how one can feel a sense of joy and belonging even after just having been through hell. But more than that, I have learned how you are treated AFTER you get out. I have learned what the meaning of stigma is, why there are people walking in the streets talking to themselves who don't have a home. I have learned how harsh people's prejudice can really be, and how grossly misinformed some people are when it comes to issues of mental health. I understand the word heartless fully now. I am lucky, I have a good job with insurance benefits, and I can get treatment and medication, but many people who suffer from a mental illness, don't. Yes, of course there is public mental health, but unless you have family to help you through the system, you're likely to fall through the cracks, especially if you're current status is not stable...