A patient’s view of bipolar

A passage of her book that Marya Hornbacher read on MPR’s Midmorning this morning, described pretty well why I tend to think people who battle depression and bipolar disorder are some of the most courageous people among us.

Here’s the hell of it: Madness doesn’t announce itself. There isn’t time to prepare for its coming. It shows up without calling and sits in your kitchen, ashing in your plant. You ask how long it plans to stay, it shrugs its shoulders, gets up, and starts digging through the fridge. But even that implies some sort of lag time between the arrival of madness and the actual experience of it.

In the early years, it’s like a switch flips on and though only a moment before you were totally sane, suddenly you’ve gone mad. But as you learn to manage madness, you begin to notice sooner that it’s on its way. I lick my finger and hold it up to detect the direction of the wind. Madness is in the air. I can smell it like I can smell snow. It’s in the vicinity though I don’t know where or long it will be until it comes.

The trick is to shut the gate, throw sheets over the roses, go inside, lock all of the windows and doors and go to the basement and sit on a chair and wait. Sometimes these preparations are enough. The locks on the windows and doors are tight, you’ve taken the medication faithfully, you’ve exercised to induce a sense of Dopamine calm, you’ve put every lamp in the house in your office and flipped on the light box (it mimics sunlight for people who get depressed in winter.),and the room is lit up as if by floodlights and you’re so hot you’re working in your bra.

You’ve stayed off the coffee, you’ve taken the supplements, you’ve worked starting at the same time for the same length everyday. You’ve interacted with human beings at least a few times this week. You’ve gotten yourself to the point where you can sleep in the normal timeframe from night until morning, and your mornings are not a horrible struggle to stay out of bed, and you make the bed so you aren’t tempted to get back in it. You check off the entires on the list that runs your life.

But sometimes the system fails. Maybe it’s a chemical shift in the brain that the medications don’t block. Maybe it’s a stressor in your life that you didn’t expect. Maybe there is no reason and you’re just going mad for the hell of it, but you try not to think about that because that would imply that no matter what you do, no matter how tightly you batten the hatches, madness can get in.

You wake up one morning and there it is, sitting in an old plaid bathrobe in your kitchen, unpleasant and unshaved. You look at it, heart sinking. Madness is a rotten guest. You can tell it to leave ’til you’re blue in the face, you follow it around the house, explaining that it’s come at a bad time and could it come another day?

Eventually you give up and go back to bed, shutting the door. But, of course, it barges in and demands to be entertained. Before you know it, it has strewn its stuff all over the house, and there are sticky plates in its bed and it has refused to change its sheets. Madness lounges all day in front of the TV, watching Oprah, and munching on a bag of chips, and drinking milk from the carton and getting crumbs between the cushions of the couch.

Soon, your life revolves around it. You do everything you can to keep it comfortable because you don’t want to upset it. You tiptoe around the house and wait for it to leave. In most cases you wake up one morning and it’s gone. There’s minimal damage. You pick up its mess and get on with your day. But sometimes it settles in to stay. Immediately it is all demands: it starts bossing you around, interrupting your conversations, refusing to let you out of the house. The phone stops ringing. Soon it’s just you and madness. You circle each other like boxers, throwing punches to the jaw, but sometimes it takes round after round and you lie on the living room floor, unable to get up.

It refuses to let you sleep. You run out of food. It draws all the blinds and stands peering through the slats. It convinces you you’re in danger. It says that people are coming and they will hurt you if you let them in.

Soon, madness has worn you down. It’s easier to do what it says than to argue. In this way it takes over your mind. You no longer know where it ends and you begin. You believe anything it says. You do what it tells you no matter how extreme or absurd. If it says “you’re worthless,” you agree. You plead for it to stop, you promise to behave. You are on your knees before it, and it laughs.

A rather frightening account.