Everyone Assumes You're Violent: Realities Of Being Bipolar
Mental illness is a lot like sex, in the sense that you hear about it all the time, but almost everything you hear is wrong. Just look at bipolar disorder -- a seemingly straightforward disorder that causes wildly veering periods of mania and depression. For reasons of laziness, and the generally low number of practicing psychiatrists who are also screenwriters, it's often portrayed by Hollywood as "generic crazy person's disease." As a result, people with the disorder are forced to deal with the double-decker suck-bus of a life complicated by mental illness, and having everyone around them think they're a dangerous lunatic just waiting to bloom.
We sat down with Wren Williams, a woman who suffers from bipolar disorder, and here's what she told us about living with one of the most stigmatized illnesses in the modern world:
Medications Can Be As Dangerous As The Symptoms
There is no cure for bipolar disorder -- medication helps (and may save your life), but let me run down just a few of the delightful side effects I've experienced swallowing pills to try and balance my brain:
*Tegretol, which I took for two years, made my arms and left leg go numb;
*Topamax made everything taste like metal;
*Prozac made me so nauseated that I could hardly move and caused depressive episodes whenever I changed doses of other medications I was taking (Prozac is like a cranky old city council member -- it doesn't like change);
*Lamictal made me faint;
"Well, technically, if you're unconscious you can't have any episodes ..." -- Lamictal Slogan
*Seroquel made me gain (and then lose) 100 pounds in the span of three years;
*Abilify made me clean my apartment until I collapsed from exhaustion;
*Latuda made me unable to experience the sensation human beings refer to as "fun";
*And finally, Lithium, the old standby, just straight up poisoned me.
"Well, technically, if you're comatose, you really can't have any episodes ..." -- Lithium Slogan
So, yes, the medicine I take to treat my disorder often gives me new symptoms that then have to be treated with more medication, like a farmer unleashing a pack of wolves to go after the dogs he had brought in to take care of the cats (you know, the ones that were there to fix his mouse problem). If I'm lucky, the side effects of those pills won't make the entire cocktail unlivable, but, more often than not, I'll end up with dry mouth so bad that it worries my dentist and vision so blurry that I'm essentially blind. I can't do my homework (I'm a grad student) or even write an email.
Actually, just take a moment to listen to this gentle announcer run through a list of Abilify side effects that lasts longer than the ad itself:
Yup, antidepressant meds can actually make you suicidal. It's like God's cruel joke.
Some of the medication I've been on has a chance of causing tardive dyskinesia, which causes you to suffer from involuntary twitching for the rest of your life. Others can cause liver failure, so doctors have to run blood work every one to three months to make sure my organs aren't shutting down ("catastrophic organ failure" is a disturbingly common side effect among medications -- you'll see it in the fine print).
But, let me repeat -- I need the medication, and taking time to find the right one is absolutely worth the brutal trial and error. That's because ...
A Single Bad Episode Can Ruin Your Life
Six months ago, I went through the worst depressive episode of my life. This is the part that is almost impossible to explain to a healthy person, who tries to compare it to the time they were depressed for a week over a bad breakup or death in the family. This isn't just being extremely sad, tired, and hopeless -- at least in those situations, you have some external event you're able to focus on, something you know you have to get past. This is being rendered immobile, for no reason. It's as if, suddenly, the air has turned into a thick syrup, to the point that just moving your limbs requires tremendous effort. And the syrup then oozes into your brain, too, so that even forming a thought is a grinding, frustrating slog that leaves you desperate for a nap.
I stopped eating, drinking, bathing, and moving, even though everything in my life was going perfectly well. My apartment fell apart around me, and basic tasks became impossible. Brush my teeth? That would involve being able to see my disgusting self in a mirror. Mail a letter so I could continue receiving unemployment benefits? Hell no! That would involve pants and being in public. The couch is much safer. That's the feeling -- everything but this couch, and these clothes, is an unendurable torture.
Even the remote was glaring at me.
The worst part of it was that I knew I would feel better -- if I could only force myself to move. There is always a little voice in the back of my head being perfectly rational when I'm in the middle of an episode. It's less helpful than you might expect because it always turns into Sensible Me trying to convince Sad Bastard Me to change out of the pajamas I've been wearing for eight days straight. That's 192 hours of living in the same clothes, just so you know.
Like this -- but 65 hours longer, and the boulder crushing me was an emotional one.
That letter I couldn't mail wound up putting my unemployment eligibility up for review, so I had to attend an interview to explain why I missed my paperwork deadlines. My interviewer was nice enough, although things got super awkward when I brought depression and suicide into the conversation. It was very clear that she didn't understand how I could be too depressed to mail a letter. As it turns out, you can actually be too depressed to do anything at all, including "getting out of bed" and "continuing to live." Not surprisingly, the government was less than sympathetic with my situation. I was told they wouldn't pay me for the late weeks because "the facts available do not show that you had good cause for submitting your forms late." After all, it was clear that my body was physically healthy, so what could possibly be wrong with me?
"Personally, if I can't see a problem right in front of my face, it might as well not exist."
When it comes to mental health, this is still where we are, as a society. Which also means ...
Most Hospitals Are Not Prepared to Help You
All of that depression was being caused by my medications, which my doctors and I were working to adjust. But, by that point, I was so down that I couldn't stand it anymore, and so it was obviously time to die.
Intellectually, I understood that this was a stupid decision that my emotions had made, so I mustered my remaining energy to get the help I needed: I asked my fiance to take me to the emergency room. I then spent 48 straight hours on a waiting list for a psych ward that would accept my insurance. When I finally got through, I was told all of their beds were full.
That's not uncommon, by the way. It's even worse for people without insurance because the number of beds in some public psychiatric hospitals dropped by approximately 50 percent from 2005 to 2010.
This was on top of already shifting away more than 50 percent of the their inpatient budget from 1986 to 2005.
This is all part of our government's proud tradition of slashing funds for mental healthcare, so we can pay for fun things such as the Vietnam War and Reagan's wacky space lasers. (In other words, "Fuck your brain health! We need napalm and laser beams!") Since there were no beds for me, the nurse at the facility advised me to check into the emergency room in order for the staff to watch over me while I waited for my lucky number to come up. So, I packed an overnight bag, and my fiance drove me to our local hospital ... where I was promptly yelled at by the intake nurse.
"Hurry up and get happy, we need these rooms for people with real problems."
See, here is what no medical professional ever tells you: If you're having a suicidal crisis, only go to hospitals that have their own psychiatric facility. Otherwise, you may end up sitting on a gurney in a hallway for three days. The hospital I had chosen didn't have their own psych ward, which is why the intake nurse was so frustrated. They couldn't send me to a different hospital, but they couldn't help me, either. This kind of thing happens constantly, all over the country.
My hospital stay started with a security detail who left me on a bed in the hallway closest to the nurses' desk, right where I could hear them refer to me as "the mental patient." One of my security guards took pity on me and kept bringing me water. He also tracked down socks so my feet wouldn't get cold. The guard who came to relieve him, on the other hand, spent his entire watch staring at me and shifting nervously every time I moved. He had a stun gun on him, which he was keeping in easy reach just in case I decided to try and go on a killing spree with my bedpan. Multiple nurses asked me if I was "homicidal," which, in addition to making me feel awesome, is a ridiculous question. If I was homicidal, I probably wouldn't tell you, right? The Joker doesn't tell anyone he's going to kill them until it's too late to stop him.
"'Burglar'? Oh no, I'm just ... cold."
All told, it took 11 hours for them to find a ward that could take me. I was there for four days, at the end of which, I'm happy to say, I was no longer suicidal. The bad news is that even after you're out ...
Nobody Wants To Hire You
Being bipolar makes you hyper-sensitive to everything your co-workers say about it or mental illness in general. I had a co-worker who was open about his bipolar disorder, and everything he did was judged through that lens. If he got upset at something, missed a day of work, or did anything unusual, he was obviously "off his meds." If a long stretch went without incident, his medicine was working, not him. It never occurred to anyone that a person could have self-control that worked alongside their medication, yet still be capable of having a bad day like other humans.
He and I could easily tell which behavior was the person and which was the disorder (since we had been living with it ourselves). But, our ill-educated co-workers were left analyzing our behavior against what they were familiar with, which unfortunately tended to be maniacs in heavy-handed suspense movies, such as Single White Female and, um, Psycho. What this means is that when you're trying to advance your education or career, your superiors are also going to be working off pop culture's concept of mental illness, not medical science.
Thanks a lot, Hitchcock.
In my case, I was in grad school to become a teacher. While it's illegal to deny someone a job purely on the basis of a mental illness, bipolar disorder is one of those areas where "the law" and "reality" don't quite meet in the middle. When I was starting graduate school, my disabilities counselor warned me, "Don't, under any circumstances, tell your professors that you have a mental disorder. They will attempt to expel you." When I expressed doubt that this was true, because laws, my counselor added, "It's against the rules, but they can always find a reason. And if they think you've got a mental problem, they will try to keep you away from the kids."
The thing is, everyone agrees that someone with, say, Repeatedly Stabbing Children Disorder should be barred from teaching. But, I've never been the least bit violent. It doesn't matter -- in a lot of people's minds, any mental illness might as well be "Child Endangerment Syndrome". There's a reason 60 percent of mentally ill people portrayed on television are violent criminals, even though the mentally ill are actually way more likely to be victims of violence than perpetrators. People assume "mentally ill" equals "crazy," and that "crazy" equals "willing to stab whoever, due to the voices in their head."
Chad is more likely to be the cause of danger to your child's well-being than I am.
So, at one point, the medicine I was taking to halt my mood swings caused such severe numbness in my hands that I couldn't hold a pencil, which meant that I took notes via computer. I was pulled into meeting after meeting with my professor and the dean of the program to discuss "concerns" about why I was typing so much in class, and why I had missed a class for a medical procedure that had been booked six months prior. The stress from this sent me into a downward spiral at the time. Not the illness -- people's reaction to it.
Thankfully, the dean was a sensible human, so I was able to graduate and get my teaching certification, but, by that point, I didn't want anything to do with education. As it turns out, I was lucky to graduate at all: Only 16 percent of bipolar sufferers who attend college actually manage to finish. That's less than half the rate of the general population.
You Have To Plan Your Life Around The Next Mood Swing
One thing I learned during that short stay in the psych ward? The many, many ways people can kill themselves. Those handy tips didn't come from my fellow patients: They came from the staff. It started with my intake nurse. When you're checked into a psych ward, they go through your belongings and only allow you to take what is considered "safe" to your room with you. Unfortunately, you are right there with them while they do this, which means learning how many of the innocuous everyday items in your life can be turned into tools of self-murder.
Anything with laces, including the fabric bookmark in my notebook? Suicide tools. Pens, binders, just in case I felt human enough to do some classwork? Nope, those are dangerous too. My shoes with no laces? Nope, they could get around my neck if I really tried, so I can't be trusted with them. Suddenly, I was looking at the items around me as possible tools, rather than just accessories. Things I would need to keep away from myself, if things got bad. That's a huge part of coping with a mood disorder: predicting your own bad decisions. You essentially have to become Edward Norton in Fight Club, trying to thwart Tyler Durden.
"I should probably just take that glass bottle away from you ..."
A few years ago, I was put on Ativan to make it easier for me to sleep. My doctor asked if I had a history of suicidal behavior because she "couldn't prescribe the Ativan if I did." I, of course, lied and told her no because I was feeling fine other than being sleep-deprived. But, that thought nestled into the back of my mind, and the next time I was depressed I started stockpiling my Ativan, just in case I needed to overdose and get the hell off the planet. Don't worry -- I came to my senses and had my doctor put a note in my file saying, in essence, "DO NOT TRUST THIS PERSON WITH ATIVAN."
And here's the thing: You have to do the same advance planning for the manic states. People tend to confuse mania with a good mood, which means not only do people seem to like me more when I'm manic, but I get less help, even though I'm engaging in behavior that can be more destructive than anything I could do while depressed. Sure, depression can end in suicide, but the results of a solid mania can wind up ruining aspects of your life for years to come.
"Welp, apparently you can laugh to death. Who knew?"
My most common manic behavior is "manic spending." I'm typing this on a tablet that I bought during a manic swing, and that's a modest purchase in comparison to my worst, which would be the time I bought a goddamn car. A driver side-swiped my old Saturn SL2 and left me with two choices for getting a new one. I had enough insurance money to buy a used car straight out ... or I could put a down-payment for a new car! I chose the new car, even though I was a graduate student and didn't have a steady job. Here's how the decision looked in my brain:
"You're about to graduate! And then you'll get hired because YOU'RE AWESOME and YOU WILL HAVE MONEY FOREVER!"
Predictably, a year later my car got repossessed. They were able to auction it off for enough to cover the rest of my debt, but I'd still dumped 10 grand into a car I no longer had. By the way, that's after I begged my friends for money to help me keep the car, fucking up their lives and finances, too! Great job all around, manic me!
There's not really a Hallmark card for, "Sorry, the chemical imbalance in my brain
is greater than the imbalance in my bank account." And even if there was, I couldn't afford it.
Today, I've put some preventive measures in place. I live with a close friend of mine, someone I trust to "check" my sanity and verify that my choices aren't super dumb. I also refuse to keep credit cards, for fear of going on a Nicolas Cage-esque spending spree. Recently, my fiance and I combined our checking accounts -- because the only thing more powerful than the urge to spend while manic is the guilt I know I'd feel for wasting money that didn't belong to me. Let's hope that works.
Meanwhile, I've started participating in medical studies, in hope that my experiences will help figure out how the disorder is inherited and which medicines are most effective. Bipolar disorder isn't always the life-ruining monster so many people (and Hollywood producers) seem to think it is, but it's still a rotten bastard. And if I have the opportunity to help deliver a medical sack-tap to that fucker, I'm going to take it -- unless I'm in the placebo group.
Robert Evans runs the Cracked personal experience article team, and he also has a Twitter.
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