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Archive for July, 2009

Comfortably Numb by Barber“[Major depression is] immediately detectable to people who know what they are doing. It is an advanced psychological state of despair that one can see in the patient’s eyes, in their slow movements, in the sense that they are in physical pain…” “There is no covering up; they exude naked and pure pain, like a wounded animal. There is absolutely no pretending that everything is okay. All pretense of normalcy goes out the window.” “Comfortably Numb: How Psychiatry is Medicating a Nation,” by Charles Barber

The title is not exactly true.  I’m not really apathetic.  I’m hopeless.

Anyone who’s ever studied depression has come across the maxim: depression is anger turned inwards.  I beg to differ.  I believe that the major cause of depression is the loss of hope.

Anger is a feeling.  Depression is about the loss of feeling.  I know.  I’m in it right now.

I can’t write to save my life.  Nothing matters.  And if there is anger, perhaps it’s caused by the hopelessness.  A dozen topics swirl through my head but I can’t choose one to write about.  None of them matter.  Nothing I have to say on the subject will make any difference to me or to anyone else.  I don’t matter.  And that makes me feel hopeless, which, yes, makes me feel angry (but not the other way round.)

If given a choice between angry and hopeless, I’ll take angry.  Part of that is not a choice but a symptom of being bipolar, irritability, which can easily escalate into anger.

I watched it happen this past weekend over something stupid: a walk with the dog.  My ADD was acting up and while I was doing my best to get ready and out of the house, my partner got impatient.  He made a couple of comments (and a few exasperated facial expressions) and a switch was flipped in my head.  Literally an on/off switch.  I got as angry as a person can get and I refused to go.  And there was no turning back, nothing he could say or do that would change my mind, that could fix it, that could flip the switch the other way.  I became “invested” in my anger.

I have seen that over the years, that willingness to “cut off my nose to spite my face.”  Why?  Because the anger feels good.  It feels great.  It’s HELL, but it’s better than apathy.  If you’ve been walking around like a zombie for weeks or months, the opportunity to feel anything is a welcome respite.  And anger can be delicious.  Intoxicating.

I spent the rest of that day by myself nursing that anger.  Not because I wanted to, but because I couldn’t control it.

I think suicidal thoughts are like that too, when you suffer from chronic depression.  For me, suicidal thoughts were never so much thoughts of suicide, but the idea that, if it ever “really got bad,” there was an option.  Just knowing that I could end it if I needed to was like having Xanax in my side pocket (knowing it’s there can reduce the anxiety and thus the need to take it.)

I always looked at suicide as a free-floating life raft, never seriously contemplating it because it was always there in my side pocket.  But ever since taking Lamictal*, another switch has been flipped, one that put suicide on the table as a real option.  It’s like those images—vase/face or young woman/old woman.

Rubin vase:face

Old woman:young woman

Once you’ve seen both you can never go back to seeing only one.  And once you’ve seen suicide as a real-life (pun not intended) tangible option, a way out of the hell that you are in, you can’t go back to pretending it isn’t.  You can’t go back to the day when taking your own life was like a pill in your pocket because you’ve tasted the sense of relief lingering in those thoughts.

Today I am stuck in a state of mind(s) I’ve been in for a couple of weeks now, somewhere between hopeless, depressed, angry and suicidal.  And occasionally manic.  Thank God (I can’t believe I’m saying this) for mania, otherwise it might have been several more weeks before I was able to make another post.  So please pardon my brain-dump, but I felt that after a two-week hiatus, a rambling, nonsensical post was better than none.  And I wanted to make sure that those kind people who worry about me when I disappear for a period of time know that I’m still kicking.  Thank you for your support.  You are the reason I got out of bed today.

*Note: From the Lamictal website: “Like other antiepileptic drugs, LAMICTAL may cause suicidal thoughts or actions in a very small number of people, about 1 in 500.”

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Applause I’m a thousand different people, every single one is real

I’ve a million different feelings, OK but at least I feel!

And I feel rotten, yet covered with roses

Younger than springtime and older than Moses

But alive, but alive, but alive!

“BUT ALIVE” (From Applause)

Lyrics Lee Adams/Music Charles Strouse ©1970

I took a road trip the other day, a few hundred miles up to the mountains.  I needed a little quiet, a little break from the noise.  A cabin in Tahoe where there is no Internet and no TV to speak of.  No updates on Sarah Palin’s “genius” career move.  No magazine subscriptions arriving in the mail containing partially nude photos of Levi Johnston.  No Michael Jackson retrospectives, no quick, but unfortunate glimpses of Rush Limbaugh, Dick Cheney or Governor Sanford as I speed date through five hundred channels. 

AHHHH!!!  Two days later I am a new person.  Refreshed.  Focused.  Ready to take on the world.  Okay, so I’m a little manic, operating on only three or four hours of sleep a night.  But the truth is, that’s all I need sometimes.  Why do I continue to try and live under other people’s circadian rhythms?  

From now on I will embrace the dark, working well past midnight, or dive into the day, even though it’s only four AM.  

Perhaps I am enjoying the mood because of a spell I was put under during the drive, thanks to XM radio.  I was tuned into a Broadway musical station for a short while (God there have been some bad shows) when they played Lauren Bacall singing “But Alive,” from Applause.  Now I loved it because she can’t sing for shit, but here she is, on the Broadway stage, in a musical.  The star of the musical.  (note: this might seem contradictory to my comments about people not deserving fame, but the woman “earned” her celebrity as an actress years ago.)  Not long after that they played some song from “Hairspray” with Harvey Fierstein on vocals.  Now I love Harvey, but he can’t sing either.  In fact, compared to Harvey, Lauren has a great voice.  (note: Harvey also “earned” his celebrity long before he was staring in musicals.)  But I digress.

My point (does there really have to be a point?) is that I was energized by hearing “But Alive.”  Not only is it peppy and uplifting, it’s got a great message.  A message that I also found hysterical.  Me, driving alone in my car trying to balance out my moods and listening to Lauren Bacall singing (rasping) about multiple personalities.  

If it isn’t already, I officially nominate it for the Bipolar Anthem, to be played at all conferences, seminars, meetings, therapy sessions, or any damn time we feel like it.

So, here are the lyrics.  Just watch the first couple of minutes of the video.  After that it gets kind of weird and requires all kinds of disclaimers about portrayals of homosexuals (kind of “Boys in the Band” meets “All about Eve”).  ‘Nuff said. 

I feel groggy and weary and tragic

Punchy and bleary and fresh out of magic

But alive, but alive, but alive!

I feel twitchy and bitchy and manic

Calm and collected and choking with panic

But alive, but alive, but alive!

 

I’m a thousand different people, every single one is real

I’ve a million different feelings, OK but at least I feel!

And I feel rotten, yet covered with roses

Younger than springtime and older than Moses

But alive, but alive, but alive!

 

I feel wicked and wacky and mellow

Firm as Gibraltar and shaky as Jello

But alive, but alive, but alive!

I feel half Tijuana, half Boston

Partly Jane Fonda and partly Jane Austen

But alive, that’s the thing, but alive!

 

This kaleidoscope of feelings whirls around inside my brain

I admit I’m slightly cuckoo, but it’s dull to be too sane!

And I feel brilliant and brash and bombastic

Limp as a puppet and simply fantastic

Frisky as a lamb, lazy as a clam

Crazy but I am … alive!

 

This kaleidoscope of feelings whirls around inside my brain

I admit I’m slightly cuckoo, but it’s dull to be too sane!

And I feel brilliant! Bombastic! Super! Fantastic!

Alive! Alive! Alive! Alive!

“BUT ALIVE” (From Applause)

Lyrics Lee Adams/Music Charles Strouse ©1970

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The Outliers by GladwellThe people who stand before kings may look like they did it all by themselves.  But in fact they are invariably the beneficiaries of hidden advantages and extraordinary opportunities and cultural legacies that allow them to learn and work hard and make sense of the world in ways others cannot.  It makes a difference where and when we grew up.  The culture we belong to and the legacies passed down by our forebears shape the patterns of our achievement in ways we cannot begin to imagine.” “Outliers: The Story of Success,” by Malcolm Gladwell  

The world seems to be conspiring against me.  Seems to want me back on medication.  Do you have any idea how hard it is for someone who is bipolar just to get out of bed some days?  The highs are tolerable, but the lows, those deep periods of depression are often unbearable.  

But the world demands that we get out of bed regardless of our frame of mind, get dressed, try to be productive.  And so I do.  I shower, I shave, I get dressed.  I turn off the TV because I cannot bear to hear all of the mindless conjecture about Michael Jackson.  Was it murder?  Suicide?  Assisted suicide?  Accidental drug overdose?  

Later, in my car, out on the open road and trying to let the cool breeze and sunny day lift my spirits, I am again badgered by the public radio station with details of deaths in Iraq, nuclear threats from North Korea and the latest unemployment figures.  Then there are special reports about global warming, AIG’s request to give out more bonuses, and the state of California’s mandatory furloughs (really?  furloughs?) and its unfortunate need to hand out IOU’s instead of checks. 

I really want to be well informed.  But at what cost?  For whatever reason I am sensitive to such negativity.  It doesn’t trigger sadness in me.  It doesn’t trigger anger.  It detonates any sense of hope and that triggers depression. 

So I’ve turned everything off, at least temporarily.  I just need a brief respite from all the negativity.  Some time to regroup.  To rebalance my energy.  Then I can tackle that global warming issue or go shopping to try and help Schwarzenegger refill the state coffers.  

New York MagazineBut as I sort through the mail I come across the latest issue of New York magazine.  That should lift my spirits, I think.  I’ll flip through it and get some ideas for a trip I’m planning in August.  Perhaps find a new restaurant or pick out a couple of Broadway shows to see.  Sadly, instead, only a dozen shiny pages into it, the will to live becomes a distant memory. 

An essay on Levi Johnston makes me want to go back to bed and bury my head under the covers.  This seems to me, given my current state of mind, the exclamation point on the downfall of society.  It is the epitome of granting a person celebrity status for no apparent reason. 

I guess it’s true, that being rich and successful is predicated by luck more than anything.  So why bother?  If you believe what Malcolm Gladwell has to say, and he has some pretty interesting details to back up his speculation, good fortune is the basis for success.  And while he focuses his comments on the rich and famous, there is no denying the same applies to the butcher, the baker, the candlestick maker.  Or the high school hockey player form Wasilla. 

The sense of possibility so necessary for success comes not just from inside us or from our parents.  It comes from our time: from the particular opportunities that our particular place in history presents us with.” “Outliers: The Story of Success,” by Malcolm Gladwell 

The truth is, I don’t mind wallowing in relative obscurity.  I have a roof over my head and food on the table, and that is a lot more than many do in what is supposed to be the greatest (or at least the wealthiest) country on the planet.  And I don’t begrudge anyone their fame and fortune.  If it’s deserved.  But perhaps that’s relative too. 

Perhaps I wouldn’t be so depressed by the news that Levi is getting movie deals and book contracts if someone could give me some (any) justification as to why? 

And in case you’re wondering, that is NOT a rhetorical question.

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Comfortably Numb.jpg“…recovery can exist within the context of illness.  In other words, recovery does not mean cure.  It means living with the illness, managing it, and getting better within certain limitations.”  “Recovery then involves both a coming to terms with symptoms—one hopes in the context of their gradual moderation, but this is not always the case—and finding a meaningful life in their midst.  For many patients, this is a decades-long process of acceptance and resolve.”  “Comfortably Numb: How Psychiatry is Medicating a Nation,” by Charles Barber 

Numb is a good word for today.  Of course it just might be a matter of semantics.  Numb?  Apathetic?  What’s the difference? Numb feels like an in-between state.  Not manic, not depressed, but also not “normal.”  It feels a bit like purgatory.  Not Heaven, not Hell, yet with this dim notion of eventual salvation. 

While I have come to the conclusion that there is no “meaning to life,” there has to be meaning for the things in life.   This strikes me as a very complicated, but important concept.  Books have meaning.  Friends have meaning.  Volunteer work has meaning.  Art has meaning.  But to try and apply meaning to life seems futile.  And while my life might not have meaning for me, it might, in context, have meaning for someone else. 

My point here I guess is that those things are inherently meaningful.  The meaning does not have to be applied.  It does not have to be justified.  It’s not trying, it just is. 

Long ago I stopped trying to live a “normal” life.  And I do believe there is a “normal,” a place on the scale of being that most people occupy.  I have felt it on occasion.  Not depressed.  Not manic.  Not numb (which oddly is yet another extreme.)  But normal, thinking to myself during those brief periods, “So, this is how the rest of the world feels most of the time, not happy, not sad, just being.”  

But my reality is something else.  My diseases, disorders, whatever you want to call them, make me who I am.  Sometimes it’s torture and torment.  But those are also the very things that make me the creative, reflective person that I am, that give my life, not meaning, but make it meaningful. 

Would I give up my disorders?  I’d have to know what the trade-offs are first.  I have some friends who seem to be happy, or at least content, but I would never want to live their lives.  They watch “American Idol,” read John Grisham books, and vacation at theme parks with their kids.  While they’re inclined to purchase tickets to “The Drowsy Chaperone,” I’d be standing in line for “Waiting for Godot.”  Now, just so there is no misunderstanding, I don’t consider my choices to be better, just different. I have always been that way.  Even as I child I didn’t see the humor in “The Three Stooges,” preferring instead to watch some Russian Dance troupe on the Ed Sullivan show

So I have to assume that I am hard-wired, both genetically and psychologically, to be discontent.  To always question the status quo.  To search for, but never find that Holy Grail, the meaning of life.  To always strive for something more intellectually challenging.  Part of my identity is the tortured soul, the reflective life.  It’s what I know, who I’ve always been.  Would I trade the angst seemingly inherent in me for a life that was less philosophical? 

Probably not.  I’ll just have to do the best I can with what I’ve got. 

“…some patients can actually say they are glad they have experienced an illness, within reason, as it has enriched their lives and appreciation of things beyond measure.” “Comfortably Numb: How Psychiatry is Medicating a Nation,” by Charles Barber 

Perhaps Mr. Barber might want to consider an alternative to the word “glad” in future editions.  Maybe grateful?

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