August 24, 1981, was my first day on this earth, and it was the day that my serious genetic predisposition for bipolar disorder began. More than thirty-one years later, I’ve experienced multiple personal revisions, all with nerves stretched thin in the pursuit of common but persistent desires. At times, I’ve sunk lower than I thought possible, and at other times, I’ve soared. I’ve discovered versions of fortitude previously unknown.
I grew up in a family that hid behind a veil of normalcy. Within our immediate family, the topic—bipolar disorder—was rarely discussed. My father’s coworkers, friends, and neighbors were unaware of his illness, which further strengthened his carefully guarded secrecy. Unfortunately, you can’t hide from biology. Having a parent with bipolar I increases the likelihood of a child getting it by a range of 10 to 15 percent. I imagine that my parents made Christian, missionary-style love sometime around the holiday season in 1980, and then August came around, and there I was—a tiny new Minnesotan with a little potential problem in my brain.
Because there was so little communication about my father’s illness, our family knew next to nothing about the specifics of the disorder. We did not learn about any signs, symptoms, or details surrounding his first documented manic episode at the age of thirty-two. Any knowledge my mother had of his symptoms did not lead her to a worried preliminary diagnosis. However, his sleepless nights, intensive running regimen, insurgency of goals, and flight of ideas were all congruent with symptoms of mania (e.g., decreased need for sleep, excessive involvement in certain activities, and grandiosity).
My father usually expressed his depression and anxieties with anger and emotional distancing. My mother could not hear the muffled tones of his depression when his voice would rise. At a young age, I listened to some of those arguments from an upstairs bedroom, my arms clasping a pillow that absorbed my tears. At the age of six, I did not know that divorce was nearly insurmountable for a marriage that has one spouse with bipolar disorder. If I had, I would have felt a lack of reassurance when my mother tried to console me. She would come into my room, sit with me, and say, “Don’t worry; your dad and I are not getting a divorce.” I looked at her through rain-soaked-windshield eyes.
I did not ascertain the real stories behind my father’s experiences until I was much older. My brother recalled a day in the spring of 1983 when my father walked out of our bathroom without his signature black mustache. My brother didn’t even recognize him. I’ve still never seen him without the Wyatt Earp–style facial hair. Police apprehended my father near Minnehaha Falls in South Minneapolis hours later. He was preaching to a group of senior citizens in the middle of the afternoon. His topics ranged from overblown religious proclamations to Regan, a character from The Exorcist. My father’s pressured speech and flight of ideas landed him in a psychiatric hospital. The name Regan was phonetically misinterpreted by witnesses and police officers to mean Reagan. After he was brought to the hospital, the Secret Service wanted to interrogate him about his comments, many of which were thought to be about President Ronald Reagan. His psychiatrist, an apparent Hippocrates enthusiast, honored his oath as a physician and refused the Secret Service’s requests, based on patient confidentiality. If my manic-depressive father had been speaking about arms deals with future terrorists, or the president’s nascent role that produced an eventual recession in 2008, he might now be declared a living prophet. Instead, he was diagnosed with a severe and persistent mental illness. At the hospital, the doctors gave him the antipsychotic medication Haldol, which reliably eradicates psychotic behavior. They also slowly administered lithium, which is known as the gold standard treatment for bipolar I disorder. While in the hospital, he made a beautiful leather wallet for my older brother. For me and my older brother, this simple, tangible artifact was the sole reminder of the event for many years.
Other than his own self-medicating with drugs and alcohol growing up, my father was not treated for bipolar I disorder until this psychiatric hospitalization. More recent dialogues with him speak volumes about the presenting symptoms that we had been seeing for many years. It makes me wonder. How did my mother overlook the signs prior to his hospitalization? She had significant knowledge about psychological disorders from her undergraduate schooling, but this disease is both seductive and deceiving. After caring for two young boys full-time, she eventually got a physical therapy position and immersed herself in her own career. Working enabled her to look past the fact that her husband was becoming ill. In the ’80s, information about mental illness was not as ubiquitous or obtainable as it is today. There was little media coverage, and there were few available resources concerning interventions. Antipsychotic medication did not have advertisement campaigns or trademarks that included icons with smoothly paved roads leading up to new name brands. Today, ostentatious commercials for pharmaceutical companies have butterflies or people walking down beaches while negligent descriptions of mental illness symptoms are narrated.
To simplify a little, I will use the term “bipolar disorder” throughout the majority of this book, despite the existence of two types. My father and I were both diagnosed with bipolar I disorder, which requires at least one manic episode. A depressive episode is not required for bipolar I disorder, but such an episode often accompanies the mania. This means that some might describe an individual who has bipolar I disorder but lacks a depressive episode using an ignorant vernacular: “That guy is soooo unipolar.” The basic difference between the two types is that bipolar II disorder requires at least one major depressive episode in addition to one or more hypomanic episodes. A hypomanic episode is a less severe form of mania and often goes untreated. The lack of treatment is usually due to the individual being more organized and productive and less irritable. The diagnostic criteria surrounding bipolar disorder are listed in the appendix of this book.
There are several reasons why I decided to write about my experiences with bipolar disorder. One reason is purely selfish: it is a way of self-disclosing. I hope that this book can be a stimulus for the expansion of awareness in my social and professional networks. Increased awareness creates a built-in safety net in the event I begin to have symptoms. Here is a potential excerpt from a future instant message on Facebook between two friends: “Wow, Archer is acting like a lunatic; we should send him a text.” In addition, I can offer deep insight from a personal and professional perspective. I have input in the areas of causation, successful treatments, and interventions with respect to both types of bipolar disorder. My intention is to exhibit what can, will, and should happen when behaviors present themselves, as well as valuable tips about what not to do. I believe individuals diagnosed with bipolar disorder, their families, students (in psychology and social work especially), and mental-health professionals will all benefit from this information.
The original title of this book was Mastering a Mental Illness. The idea behind the title was that I am constantly in the process of mastering the illness in order to remain stable. I used the present tense because it is not possible to completely overcome the illness. The illness needs constant maintenance and attention. Malcolm Gladwell said that in order to master something, one must practice it for at least ten thousand hours. A decade has passed since I was labeled “bipolar.” Diagnostically speaking, I have had the disorder for about ninety thousand hours. However, my therapy (about 250 or so hours), psychiatric and doctor visits (about 50 hours), successful graduate school experience (not sure how to quantify that), and guest lectures on bipolar disorder—minus many years of drinking, drug abuse, and emotional avoidance—do not seem to add up to anything that could be meaningfully described as a victorious conclusion. A lifelong, chronic mental illness takes time, proactive treatment, perseverance through times of instability, and a heavy dose of familial as well as social support.
LIKE FATHER, LIKE SON
Music, sweet music
I wish I could caress, caress, caress
Manic depression is a frustrating mess
—Jimi Hendrix, “Manic Depression”
4/15/05: As I walked out of the Dane County Jail after sixteen days—fourteen in segregation—with borrowed boots and blurred vision, my first visitor greeted me outside. After living in a concrete cage, the feeling of warm sunshine was like the intense satisfaction you feel from a sip of cool water when you’re stranded in a desert.
My father is one of the survivors. An extremely successful real estate agent, he was the breadwinner in our family. When I was a child, my dad hid most of his mood episodes, or his behavior was subtly nuanced from his regular demeanor.
I do remember him experiencing manic symptoms one night when I was about thirteen. Unable to sleep, he thought he would have a better time in my bedroom, which was basically a pitch-black cave in our basement. He quickly rolled in a makeshift bed, creating a darker version of a Royal Tenenbaums sleeping-arrangement scene.
At that point in my life, I recognized aspects of his madness. The effect on me was equivalent to a paralytic state one undergoes when a monster is chasing one during a nightmare. I could not escape the fear as I listened to my typically composed, logical father ramble on, with short periods of self-provoked, maniacal laughter. I pulled the pillow over my head eventually and regressed emotionally to an almost fetal state of being. Morning came, and my father left for work. I cried in the kitchen, telling my mother that the new sleeping arrangements could not happen again.
My father was more animated and embarrassingly funny when he would reach the high end of the pole, also known as mania. No devastating events occurred as a result of his illness other than his initial hospitalization. He didn’t read many books about bipolar disorder. Instead, he learned about how to be successful. He practiced goal-oriented daily living techniques that developed into strong internal motivation skills. These adaptive characteristics are not mutually exclusive from today’s standard treatment regime for bipolar disorder, but they are certainly unorthodox. My father found the structure he needed by immersing himself in the real estate business, and achievement soon followed. He sold a lot of houses in Minneapolis for nearly twenty-five years. He took lithium. He went to Catholic Mass.
After seeing my father’s mania and sharing a house with him throughout my childhood, my attitude toward him set in during high school. I decided I did not ever want to turn out like him. As a parent, he was often emotionally shallow and distant. As someone with bipolar disorder, he frightened me. To some degree, the comprehensions of his symptoms were intuitive. I was a terrified adolescent with little comprehension of either bipolar disorder or healthy parenting styles. To me, bipolar disorder was my dad, and he was bipolar disorder. I didn’t have access to different experiences, schemas, or other perspectives about this illness. Regardless, I knew I didn’t want to go through the ups and downs, instability, or quick temper that characterized his demeanor.
In hindsight, the warning signs for my bipolar disorder were all there. Identifying childhood red flags is becoming a focus in the mental health field to prevent the onslaught of largely adult symptoms. From the beginning, I would cry inconsolably for hours as an infant and small child. I was blatantly dishonest at an early age. “You lied about everything,” my mother recently disclosed. I participated in many risky behaviors, including theft on large scales (I’m not talking about pennies from the dish at the counter), drinking, and drug use.
One night during my senior year in high school, I had a panic attack that was induced by caffeine. The attack was precipitated by staying up all night for a homecoming sleepover. Later in the morning, after the anxiety subsided, I found myself in a state of extreme confidence, high energy, and loss of inhibitions. The anxiety in my life at that time was distributed across my exercise regimen, schoolwork, and overall sense of vanity. Perfectionism drove these vehicles, all of which were directed at the hope for peace of mind. Unfortunately, these ideals perpetuated my anxiety and convinced me, despite my being in impeccable physical shape, that my body did not look good. These are all budding symptoms of bipolar disorder but do not meet full medical criteria for the diagnosis.
The warning signs and development of bipolar disorder can be missed because of a lack of information as well as flat-out denial of things in our environment. We miss what is right in front of us, because our attentions are focused on something else. We miss or marginalize changes in the person. We choose not to believe that bipolar disorder could happen to our sons, daughters, siblings, or partners. The illness is too devastating to conceptualize within the framework of someone you love. Passionate cries like “Why me?” or “This can’t be happening!” or “This isn’t real!” and “I don’t deserve this!” echo throughout this text.
I recall talking to my girlfriend outside of our high school one day around the age of seventeen. We were sitting across the sidewalk from the idling bus that would transport our school’s basketball team to any number of white suburban high schools in the surrounding area. For the life of me, I cannot remember what provoked the conversation other than intense anxiety and depressive symptoms. We sat for many silent minutes together on a bench with a slotted wood base. I could not look at her directly, because the noxious feelings elevated to the top of my throat. These feelings begged for verbal expression. She was my confidante and definitely my world, especially during times like that.
The tightness in my face told her how wrong something was. When I was finally able to speak, the words came out as splattered shards of glass. I began crying and attempting to tell her that I thought I had bipolar disorder and was “like my dad.” I was realizing what I had feared—that I was turning out to be like him. That moment is a very lucid memory for me. At the time, I saw crying not as an expression of deep introspection into one’s feelings but as a loss of control that happened only during the darkest of times—the vulnerable times.
In my mind, from up above this scene, there is a physically fit, almost adult figure who is reduced to a small boy. My girlfriend fades away without a response. The boy is abandoned like a left-behind child who has just fallen off of his bike. It was too quiet to cry anymore, and the only escape for me was to crawl onto the bus. I did not know where to go, how to ask for help, or how to heal the pain. I didn’t know how to regain my strength. I caressed the tears with my hand to disguise what had just happened. I entered the bus and went to my basketball game. My mind somehow swept away the depressing, frightening thoughts so that I could maintain some form of emotional homeostasis.
When I felt good, I found it easy to abandon my girlfriend for ephemeral dating experiences with other girls or to take her for granted. Despite her being the “it girl” at my school, I thought she was never really good enough for me. I did not know what good enough for me was. We stayed together for many years. Staying together made life easier, because she knew everything about me. She was a first for everything during those years, and we shared an immense amount of time together. We told intricate communal lies to our parents so that she could spend adult nights with me. The bond we created at such a young age, in hindsight, disallowed me from developing a strong, healthy ego.
I mention this detail because vulnerability is a key factor in the development—or, more so, activation—of manic and depressive symptoms. Our eventual breakup years later, which led me to develop a depressive episode, gives weight to this theory. A stronger ego or sense of self might have changed my behaviors and thoughts about the breakup. I absolutely needed mental stability to continue to be successful in high school. A shield of popularity and hedonistic behaviors would keep me safe—or so I thought.
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