Everything Else

by Elliot Gavin Keenan, 11/29/16

Originally published in gravel magazine in 2017; as of 9/24/21, no longer available on their website.

Mozart was crazy. Flat fucking crazy. Batshit, I hear. But his music’s not crazy; it’s balanced, it’s nimble, it’s crystalline clear. There’s harmony, logic. You listen to these, you don’t hear his doubts or his debts or disease. You scan through the score and put fingers on keys and you play. And everything else goes away. Everything else goes away…

— “Everything Else”, Next to Normal

My favorite confessional poet is Anne Sexton, who committed suicide by carbon monoxide poisoning at age 45. A book of her poetry, published posthumously, featured her therapist: 

I have words for you, Dr. Y., / words for sale. / Words that have been hoarded up, / waiting for the pleasure act of coming out, / hugger-mugger, higgiliy-piggily / onto the stage.

When I was in kindergarten, a boy hit me in the forehead with a toy truck during playtime because I asked to play with him. I sat in the corner and cried. Eventually, the teacher called me over. What’s wrong? she asked me. I don’t have any friends, I replied, sniffling. The teacher called all of the kids to the front of the classroom and asked them to raise their hands if they were my friend. Everybody raised their hands. I don’t know why, but this was probably the moment that I became crazy. 

Or maybe I was crazy all along.

She laughed when I told her this story. She said it was incredibly sad and funny. I’m glad she saw how funny it was. Then she asked me, have you ever written about this?

Eunoia is a dated term for mental health. Literally, it means beautiful thinking. However, some of the most beautiful thinking has been done by people with mental illness. Consider the incredible artistic achievements of people like Vincent van Gogh, Virginia Woolf, and Sylvia Plath. And if you look for mental illness in artists, writers, poets, musicians; the list goes on.

We were running about Whole Foods. I say running because she kept forgetting things on her list and going back. We probably circled around the store three or four times, picking up various items along the way. She was in constant motion. Couldn’t stand in one place. Got excited over a jug of coffee. Perhaps she didn’t even notice, but I did: a slight fidget, balancing on one foot at the cash register. We looked at the things she’d ended up buying and laughed. Talking constantly. I am attuned to these kinds of things. She had told me, though, that she felt manic. I wished I felt as manic as she did, but I was not; rather, I was plagued by a familiar moroseness, a heaviness.

Asked about JS, I mused well, I think you’d win a fight with her.

A few months after the breakup with JS, I fucked a fashion designer from the city. He was kind of cute, dyed hair and a stutter. He slept in my bed with his arm around my waist. I slept uneasily. In my dream, I saw JS. It was the first time in a while I’d seen her face in my dreams. I don’t remember what she said, but I woke up all at once warm and shivering, cold sweat dripping down my forehead. I snuck out from the boy’s grasp and went into the bathroom and splashed cold water on my face. Looking into the mirror, I thought how strange it was. I started to cry. He gave me his shirt afterwards.

I don’t usually see people’s faces in my dreams. I rarely ever learn a person’s face. This is a condition known as congenital prosopagnosia. In fact, I only come to individualize the faces of people I’m in love with. When I told her this, she said it was very romantic. I did not tell her that I had come to know her face.

There is a thing known as a flow state: when words come out of your brain like blood seeping from a tapped vein, an insatiable passion for the task at hand. Manics often get into flow states. The world is poetry, you breathe it like air. Maybe this is part of why we are so successful in art. Love is also like a flow state.

She’s a doctoral student in the psychology department. But she told me that she used to write as if seized by a certain fervor for it, for the language, for poetry. I imagined Van Gogh and his passion for painting, his insatiable hunger. I thought I wanted to kiss those lips stained with yellow paint. Yellow, the color of the edges of a street, the boundaries of a self crossed like two neurons, the actualization of a synesthetic dream. To imbibe it is to take all of that in, the passion, life thrust under your tongue. I wanted that. 

When I was a child, I sat by myself at recess. The teachers saw that I was always alone; they gave me chalk to draw on the sidewalk. My hands dusted with pastel yellow, I would watch the other kids play. It’s not easy for me to admit, but I hated them. I truly hated them. My heart was so full of hate that I couldn’t bear to watch them anymore, and I would go to the bathroom and cry. I’ve never been a good person.

Sadness is part of the human condition, said one of my writing professors, a woman who seemed perpetually rather flummoxed by the world. Without it, you’d be a monster. I wanted to ask, with sadness, am I not a monster?

For me it was different. I, too, was seized by passions; but they occurred for me in successions, a pattern sometimes disapprovingly called serial monogamy. I was like that with my writing, too. But when I was engrossed in the page, or lost in her eyes, everything but the space between my canvas and I disappeared. Everything else goes away

I wrote constantly when I was in love with JS. Everything I felt was transferred to the page. She was my muse; she was the gasoline to the fire behind my eyes. 

Kay Redfield Jamison wrote an entire book about the connections between mental illness, particularly bipolar disorder, and artistic talent. It’s called Touched with Fire.

My heart has holes in it. They’ve been there for a long time; before JS, I’m sure. But maybe I could have ignored them before that. Not anymore. I wanted to patch them up, fill them with cement, or gorilla glue the pieces back together and pretend that it was the same as it was before. A clean canvas, a blank page, a fresh start. But it’s never been the same. I’ve always been different from other people. Maybe that is why I write. To escape the sadness of being alone. The desolation, the emptiness, the misery of a life condemned to this certain loneliness.

Sometimes I try to fill the holes with other people’s loneliness. It never works. I knew right away that she wouldn’t be a suitable shape to fit there, like a square peg in the round hole of what I really needed. I was filled with this dread of knowing. But when I looked at her I would forget. 

Everything else goes away.

I was ten years old when I first decided I was going to kill myself. I wanted to slice off my arm with an old circular saw, patched with rust, and die in a pool of blood on the hard cement floor of my garage. I daydreamed about it, wondered endlessly what it would be like to die there, cold and alone and smeared with bright red, a baptism in blood.

It was Anne Sexton’s therapist, Dr. Martin Orne, who encouraged her to write poetry. Perhaps he thought that poetry would be a form of healing, a way to expel her demons through the pen, exorcism in the act of creation. Put your ear down close to your soul and listen hard, she said. I am a collection of dismantled almosts, she said. Suicide is, after all, the opposite of the poem.

But suicides have a special language.
Like carpenters they want to know which tools.
They never ask why build.

Lithium is like an emotional straightjacket, or at least like wearing a shirt that’s too tight. You can’t breathe. You can’t feel the way you felt before, not manic or depressed or happy or sad or anything. You wonder if you can even write. I didn’t write for months after I started taking it.

She told me she feels sadness only fleetingly. We’re opposites, I guess; two sides of the same coin. I live in a state of melancholy permeated briefly by manic interludes. But I wonder if mania is really like happiness. Or is it like a saccharine substitute for happiness, itself almost a deeper form of sadness?

I remember hanging upside-down on one of the hospital couches and pacing up and down the long hallway, smiling cheerfully at anybody I passed along the way. The doctor informed me point-blank that I was manic. I’m happy, I said. There’s nothing to be happy about, she told me. 

Although the official diagnostic term was changed to bipolar disorder in the DSM-IV, maybe this is why some people identify more with the older term manic depression.

Vincent Van Gogh’s stay at the little yellow house in Arles, France, from February 1888 until he was committed at the St. Remy asylum in 1889, was arguably the most prolific period of his entire career as a painter. He believed that the growing disruption of his inner chaos stirred within him this compulsive creativity: The more I am spent, ill, a broken pitcher, by so much more I am an artist… a kind of melancholy remains within us when we think that one could have created life at less cost than creating art. His time in Arles culminated in an episode wherein he cut off a portion of his left ear and attempted to give it as a gift to a prostitute, requesting she keep this object like a treasure

Perhaps, in the end, this is the ultimate display of love: to give a piece of oneself to the other. To be something more than a memory, something tangible, something real. It’s a distinctly human error, this drive to be treasured.

I was sitting across my kitchen table from her. She was wearing my pajama pants and my sweatshirt, an oversized blue one that falls in folds around her thin wrists. I thought it looked better on her than it did on me. She had a look of deep consternation as she studied. I was quiet. I was watching her mannerisms, an absent-minded gesture of her fingers as she stared into the screen. The harshly azureous light of her laptop illuminated a sharpness in her almost perfectly symmetrical face, a ubiquitously beautiful face.

Perhaps it is not simply that the artistic temperament comes in tandem with emotional pitfalls, but that inner turmoil fuels the creation of art. If Van Gogh had not been crazy, would he have painted at all? Perhaps, like his brother Theo, he would have settled to be an art dealer, and never dirtied his hands with the business of creation.

Do you ever feel like I do, that you know a lot of people, but you’re still very lonely? But sometimes, maybe just when the stars align quite right, I meet someone that sees me. That looks at me like I’m not invisible.

She came up to me in the courtyard one day, a small green space in between the psychology buildings that’s mostly overgrown with ivy and shrubs. I was pacing back and forth, taking long drags and blowing smoke into the October sky. She asked me to bum a cigarette and smiled and said, I’ve seen you out here. You have a very thoughtful walk. 

You always say the right thing, Elliot. You toss out aphorisms like you’re handing out daisies, she said. (Aphorism: either a pithy observation that contains a general truth; or, a concise statement of a scientific principle.)

And you know it’s just a sonata away. And you play, and you play. And everything else goes away. Everything else goes away. Everything else goes away…

She says she finds solace in her loneliness. I wonder if I could ever come to view things the same way. I’ve been alone for a long time, since my childhood. It wasn’t a tragic childhood. But it was solitary. For my whole life, I’ve wanted to find whatever it is that breaks down this invisible wall that divides us, that brings the fragments of people together into one, into a mosaic of shared humanity that I’ve never quite fit into.

I feel like I can tell you anything, she said. You’re very understanding. I feel like you understand me. I smiled sadly.

Is talking easily about something the same thing as healing a wound? About her family, about foster care, about the scar on her thigh? She gave a small laugh, like it wasn’t really a big deal. It’s not my place to say something like are you really okay? No. I couldn’t heal her. She couldn’t heal me. I just wanted to listen, to understand you in the way I have never been understood. That’s why I write.

Balanced there, suicides sometimes meet,
raging at the fruit, a pumped-up moon,
leaving the bread they mistook for a kiss,

I thought to call JS. It rang only twice; I knew she’d blocked my number months ago. I wanted to say, but I was always there for you. I wanted to say, but I loved you. I wanted to say, but I need you, I need you, I need you. Please. Two rings. Silence.

leaving the page of the book carelessly open,
something unsaid, the phone off the hook
and the love, whatever it was, an infection.

She told me about enneagrams, a theoretical model of personality. She told me that I was a type four, the individualist, which she qualified as the suffering artist: expressive, dramatic, self-absorbed, temperamental. In love chiefly with my sadness. I wanted to say, and you are not?

I’ve changed, she says.

But why are you still here?

We read Maggie Nelson’s Bluets. Her voice grew incredibly impassioned as she read aloud: I say something about how clinical psychology forces everything we love into the pathological or the delusional or the biologically inexplicable, that if what I was feeling wasn’t love then I am forced to admit that I don’t know what love is, or, more simply, that I loved a bad man.

Sometimes I would wait in the spot where JS and I would always meet together before class, as if she’d appear there again if I waited long enough. She never did. I found myself there, cold, alone, staring at the sky in its seemingly infinite vastness. Eventually I stopped waiting.

I want to write again, she told me one day, sitting outside the front of her house, smoking a cigarette. The smoke drifted into the gray sky and faded like the unintelligible, inexplicable fragments of a dream upon waking. You should, I said. It was the best healing I knew of.


Dirty Dyl (Art Therapy)

Dirty Dyl (Art Therapy) by Elliot Gavin Keenan

Dirty Dyl (Art Therapy)

I.
Dirty Dyl, known for his ostentatious attitude
(typical of a manic persona)
wants to have a rap battle
in the middle
of the TV room.

Dirty Dyl, who lost
phone privileges on his first night
dialing 911:
I’m being held
hostage at South Oaks
Hospital
, he said
& then screamed &
shouted & started to cry —

I ask him if poetry will do.

II.
I read my poem in art therapy.

Soon, three other patients are
scribbling in the small hospital-issue
composition notebooks
& the backs of napkins
in pencil, crayon, or markers
(the washable, non-toxic kind)
simply
because
it’s better than passing the time
weakly magnetized by television
game shows.

III.
I know Dirty Dyl,
or at least I know his face
from a gay hookup app.
He with his
crooked swagger &
snapback caps
is Not My Type.

Only I know
he is bisexual. Only I
know that he fucks
people like
me.

Somehow,
maybe
just in Dyl’s mind,
being the keeper of
this secret
inspires
trust.

IV.
Depressives squint at their words
with tired souls,
heavy hands & looks of
consternation. It’s not
beautiful, you know — it’s
bedhead & stubble &
hospital slippers with the little
treads on the bottom —
but as they write, they are
inspired,
their eyes grow bright,

they know of ink
on the page, the spark
of a fire in their
blood & they are increasingly,
if just a little bit,
alive.

V.
Dyl went home before I did.
I saw him the other day.
He got his job back at the dining hall,
where he once came to work on shrooms.
He smiled at
me & asked,
How’s poetry?

I smiled politely
back, thinking of
a line from Whitman

(I too am not
a bit tamed, I too
am untranslatable)


Happy World Bipolar Day!

I am bipolar type 1. 🎭 That is the most severe form of bipolar disorder. (Bipolar 2 can have very severe depression, but because it doesn’t have severe mania it doesn’t progress along the same course. Something like that.) I’ve been inpatient 18 times, and I’ve been discharged from the ER a few additional times as well.

Interestingly, I don’t have what most people would think of if you said “classic bipolar disorder”. I have mostly dysphoric manias (and sometimes euphoric hypomania), so no grandiose delusions or belief that I can see the flow of energy that connects all things. Just bugs that… may or may not be real. 🐜 But, the dysphoric mania type is actually sliiiiiightly more common than euphoric (feel-good) mania in real-world bipolar 1 people, according to one study1

The main reason my bipolar is unusual is that it is so FAST. My psychiatrist describes it as “brittle” — a medical term often applied to highly unstable diabetes patients, where blood sugar skyrockets but then drops with intervention but then skyrockets again. It follows the same kind of course.

Blood sugar in brittle diabetes

Usually, I think my cycle (including both mania, which almost always comes first for me, and then depression — most bipolar people have one type of episode almost always come first, but it’s a 50/50 split which one2) is 2 to 4 weeks long. If it’s a lot faster than that it’s considered a mixed episode.

I rarely ever have euthymic (normal mood) periods and I don’t have any asymptomatic periods. (I have persistent problems with memory and executive functioning and other stuff.) 

💊 Currently every day I take: lithium, Thorazine (chlorpromazine), Zyprexa (olanzapine), Valium (diazepam), and Adderall (amphetamine salts). 💊

What causes bipolar disorder?

A lot of research links bipolar disorder to various things:
a) circadian instability, sleep problems ⏰
b) inflammatory processes in the brain 🔥
c) epilepsy 📈 — they have a lot in common, and medications used to treat epilepsy are often used to treat bipolar disorder; I think you can think of bipolar as being similar to some kind of epileptogenic brain activity but on a more macro scale. Similarities to Temporal Lobe Epilepsy include age of onset and genetic cause among other things and they do have a very very high comorbidity rate.
d) genetics 🧬 — 97% of bipolar disorder is explained by genetic variance alone and it is more heritable than autism or schizophrenia (I believe it might be the most heritable psychiatric disorder in DSM-5)

Most people get bipolar disorders in their 20s, but I got it early. I had suicidal depression sometime before the age of 10 and had my first clear hypomanic episode when I was 16. My parents were anti-psychiatry, so I wasn’t in treatment until I went to college and I almost became an emancipated minor because I was still 17 and it was that serious 🙃

Unlike autism, which is a fairly new concept (although autistic people have almost certainly existed for thousands of years) bipolar disorder is a very old idea for a distinct illness that occurs in all cultures that I know of. Other English names for it have been “manic depression” (a term I actually prefer), “manic-depressive psychosis”, “circular insanity” 🔁, all referring to a highly organized and unusually patterned occurrence of severe disturbances in mood.

That’s actually what I study now in my PhD program! I’m looking for patterns in bipolar disorder. I’m very good at patterns 🧩

References

1.  Grant BF, Stinson FS, Hasin DS, et al. Prevalence, correlates, and comorbidity of bipolar I disorder and axis I and II disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry. 2005;66(10):1205-1215. doi:10.4088/JCP.v66n1001

2. Koukopoulos A, Reginaldi D, Tondo L, Visioli C, Baldessarini RJ. Course sequences in bipolar disorder: Depressions preceding or following manias or hypomanias. J Affect Disord. 2013;151(1):105-110. doi:10.1016/j.jad.2013.05.059


After a suicide attempt

Caution: this post contains explicit discussion of suicide

Two days ago (on September 10th) was World Suicide Prevention Day. Although it is important to address prevention of suicide attempts, the strongest predictor of a fatal (or “completed”) suicide is a history of previous, non-fatal suicide attempts. The risk factors for suicide attempts are more diverse and include: family history of suicide, early onset of bipolar disorder, extent of depressive symptoms, increasing severity of affective [mood] episodes, the presence of mixed affective [mood] states, rapid cycling, comorbid Axis I disorders, and abuse of alcohol or drugs1

Most suicide prevention effort focuses on people who are naive to psychiatric treatment and have reached a crisis point: people who don’t already have a psychiatric point of contact, and usually people who have never been treated in an inpatient setting before. In my experience, most people do not continue using crisis lines or similar services after they have been hospitalized once. Surmounting the fear and stigma around hospitalization itself is a primary reason crisis lines exist. Crisis lines are staffed by severely underqualified volunteers, who are usually following a script, and only have two action moves: call an ambulance, or tell you to go talk to someone else (sometimes your health insurance company). Yet, people find calling a crisis hotline less formidable than simply admitting themselves voluntarily.

But what about those of us with chronic illnesses, with volumes of psychiatric history, who have been admitted many times? This service is clearly not meant for me. If I spoke to a crisis line on what to me is an an average day, I might find myself being dragged to the ER and with an $800 ambulance fee to boot. There is no exception for chronicity. The stakes of a mistake are high, and the crisis line operator is equipped with a high school diploma.

There’s a gap between services for first-episode patients and services for profoundly disabled people who live in an institutional setting. After my close-to-fatal suicide attempt about two and a half years ago, I had to navigate what exactly life looks like after a serious suicide attempt. I consumed an amount of lithium equal to the 50% lethal dose in rats, and an antidepressant that is also a potent anti-emetic (anti-vomiting) drug. I knew I would absorb more of the lithium if I delayed the onset of (inevitable) severe vomiting.

I was hospitalized for only 16 days. The attending physician treating me thought I should go to a residential treatment program, but I was supposed to be at an academic conference and I begged to be realized in time to go. The head of the clinic evaluated the situation and decided to release me. I was discharged within hours of my flight to Europe. After the conference, I was enrolled in a partial hospitalization day program. The official length of the program was 8 weeks; I was probably enrolled for 4 months. My psychiatrist met with me nearly every day.

We tried a lot of medications, but for quite some time I was not permitted to take lithium. This was unfortunate, because lithium is probably the single most effective drug I take. I have cycled through almost every atypical antipsychotic: Seroquel, Abilify, Vraylar, Zyprexa, Saphris, Geodon… I’m sure I’ve forgotten something, it’s more than I can keep track of. I tried Depakote and Lamictal. Nothing has the same effect as lithium. Ironically, lithium also has a specific anti-suicide effect.

I continued to be suicidal throughout and beyond the partial program. I am lucky that my psychiatrist works well with me.

Chronic suicidality is probably more common than people realize. It doesn’t appear in the media. It’s taboo. You fear to acknowledge it exists somewhere. When we talk about improving mental health services, let’s give a little more attention to the people for whom posting a status update with the s-word in it is reason to panic and report it to Facebook headquarters.

References

  1. Hawton, K., Sutton, L., Haw, C., Sinclair, J., & Harriss, L. (2005). Suicide and Attempted Suicide in Bipolar Disorder: A Systematic Review of Risk Factors. The Journal of Clinical Psychiatry, 66(6), 693–704. https://doi.org/10.4088/JCP.v66n0604



Psychiatric disorders and discrimination by medical professionals

There is much that could be written about the damage done by bad psychiatrists, but this post will specifically focus on non-psychiatric medical professionals: doctors, nurses, everyone involved with it.

Once I presented to the ER with a large abscess from a skin infection, and in great pain. I told the triage nurse that I had this abscess, and showed it to her (it was not subtle). She proceeded to look through my chart and started asking me about my bipolar disorder. I told her what she asked, and of course we got to “Are you planning to hurt yourself?” and I said no, because I wasn’t, I just really needed my abscess to be drained by a doctor.

Naturally, then, she put me in psychiatry and had a psychiatrist come speak to me. I told the psychiatrist what I told the nurse and showed him the abscess. He was horrified by it, and said he’d call my psychiatrist. After he spoke to her, he moved me to the medical area and gave his psychiatric stamp of approval. Finally, a medical doctor arrived and drained my abscess.

In retrospect, is it a big problem? I think it is. What if my condition were even more time-sensitive? They wasted significant time getting me a psych eval when I was not presenting with any major psychiatric symptoms, I just happen to have a chronic mental illness that I will have in my chart forever. What if I was having a heart attack? Would I have to get a psych eval because I’m bipolar?

If you have a label like “bipolar disorder type 1” they will always look for a psychiatric cause for your symptoms, even when the evidence doesn’t suggest it’s psychiatric (like, the huge abscess). They assume you are professionally crazy and anything you say is cause for suspicion, instead of an honest report of symptoms. Putting patients presenting with tangible physical illness in the psych area just because they have a diagnosis, but are not presenting with symptoms, is discrimination.


Anxiety and mania

Recently, The Mighty published an article about the differences between anxiety and hypomania. However, I wanted to complicate the discussion by bringing up something that breaks the juxtaposition of anxiety and mania: primarily anxious mania, which is most likely a mixed episode associated with bipolar type 1.

The author describes how her anxiety leaves her “immobilized”. This can actually happen in mania, too — but usually not in hypomania. Hypomania is often very productive. Full mania is no longer productive — it’s frantic, potentially confused, and may be characterized by manic stupor. Emil Kraepelin used this term to describe a flight of ideas and elevated mood (not necessarily happy, but revved-up) combined with psychomotor slowness or immobility. I’ve been in this state, and I experienced it subjectively as intense feelings of anxiety paralyzing my every move. This might also be referred to nowadays as catatonia, and something similar can occur in severe depressive states; however, the catatonia that coincides with mania is likely excited catatonia (characterized by purposeless movements rather than being completely still).

Hypomania isn’t rare, exotic, or exciting to me. It’s just part of my life, and I take advantage of it when it comes around — which it will, no matter what. But, to me, full mania is to be avoided. Anxiety is also a daily part of my life, but the anxiety and paranoia I experience during a manic episode is even more excruciating than it usually is. Juxtaposing them as discrete, separate states can only take you so far in understanding what mania is and how it affects people.


One bipolar person’s drug regimen

Currently, I take 8 medications for psychiatric reasons. I’ve also been on many others — including most of the atypical antipsychotics, several anticonvulsants, antidepressants, and more. These are my current drugs ranked in terms of how essential they are (if, for example, I could only get some of them, perhaps due to a catastrophe):

  1. Lithium — Big Pharma has yet to come up with something better. It could never be patented, it wasn’t paid for by anybody. It actually works. And it’s all-natural. But also, it sucks. Nature is brutal.
  2. Haldol — Indispensable, though I might be switching to Thorazine in the near future. I don’t picture myself living without an antipsychotic again. Typicals seem to work better for me than atypicals did, though I’ve notably NOT tried Risperdal (even though it’s a good fit for my symptoms) or clozapine. Both were considered, though.
  3. Ativan (lorazepam) — My symptoms tend to cluster around anxiety, insomnia, and irritability — maybe paranoia — all things helped by benzodiazepines. If it were not so problematic, I might have ranked it #2. It’s the best immediate symptom relief I can get aside from maybe sublingual Zyprexa (olanzapine).
  4. Adderall — I would never actually achieve anything in life without Adderall. That said, my need to do something with my life is inherently superseded by my need to be alive, which is why it ranks #4.
  5. Lamotrigine (Lamictal) — An anticonvulsant medication. It seems to be doing something, because I become depressed without it. Though I’m not exactly sure what it’s doing.
  6. Gabapentin — I’m supposed to be using it for anxiety to offset my lorazepam use. It’s also useful for severe headaches. I still feel the pain, but I kind of don’t care, like the pain just doesn’t command my attention.
  7. Clonidine — It’s a blood pressure med, but I’m using it for insomnia. I cycle through medications for insomnia because they all lose their effectiveness eventually. I haven’t been on clonidine before so I don’t know how long it will be useful for. Other drugs I’ve used for sleep: Trazodone, Remeron, Ativan, Seroquel (and other atypical antipsychotics)…
  8. Diphenhydramine (Benadryl) — An OTC drug! The original antihistamine. I take it as 50mg softgels (two of them, which is slightly more than the bottle indicates — consult your doctor). Sometimes works for sleep, not super reliable and fades quickly. Useful if I have a cold or flu because Sudafed is not the best choice for my wiring. Also potentially protective against Haldol-induced side effects. So overall, something I take regularly, but not every day.

Anyone want to share their regimen?


Dreams & Interpretations (part 1)

I didn’t used to have a lot of dreams. Over the past few years, I’ve starting having more, some of them very vivid and strange. In this series of blog posts I’m going to attempt to find common themes within these dreams. I’m not analyzing them in the psychoanalytic sense; I’m merely looking at the composition of the dream and how it relates to itself and my life.

Body Horror

Dream: I’m suddenly unable to talk or make any sounds. I try to cry for help, but no sound comes out. I open my mouth and feel a string coming out of it. Slowly, I pull the string, and realize that a tampon is lodged in my throat. I gag and continue pulling the string, and eventually the tampon comes out and blood gushes out of my throat. I wake up.


Interpretation: This is actually a recurring dream I’ve had, although I haven’t had it for quite some time. It’s probably the one of the most aggressively transgender dreams I’ve ever had.


Safety Checks

Dream: I wake up in the middle of the night in a hospital bed. Dark, shadowy figures appear in the little window of my door and then vanish. I wake up.

Interpretation: Another recurring dream, often at the end of other dreams, like the first one. This one I used to have after my discharge from South Oaks Hospital. I didn’t like it there, and this dream (a fairly accurate representation of nighttime safety checks) was the result of my stress.


Trust Issues

Dream: I wake up in my hospital room to an electronic jostling sound, like an InkJet printer, coming from the vent above my bed. I go to get my vitals taken and eat breakfast in the day room, mentioning to a nurse that there was this weird sound in my room. I retire back to my bed. Two people step into the room, wearing white coats, and I expect them to be doctors — but I don’t recognize them. One of them pins me to the bed and the other injects me with a strange liquid, which makes the world hazy. I realize that these people must be scientists and the InkJet printer sounds must be their machines. Their injection was supposed to make me lose my memories of it.


I wake up later in the day, with my memories still intact — the serum didn’t work. Thankful, I decide I better contact someone. I call my psychiatrist on the phone and tell her that alien scientists are on the ward. “There are?” she says. “How do you know they’re scientists?” The white coats, I tell her. She assures me she will get to the bottom of this, but as we hang up, I realize my mistake: the alien scientists will simply wipe her memory.


I walk back to my room, but am confronted by the scientists in their white coats; I run in the opposite direction only to be stopped at the double locked doors with their “AWOL RISK DO NOT OPEN” signs. I laugh. Since their injection didn’t work on me, they’ll have to kill me. “I guess being killed by aliens is a pretty cool way to die,” I say. Suddenly, a beam of white energy enters my body and comes out through my palm, striking one of the alien scientists. He crumples to the ground, and his body slowly changes, reverse-aging until he is merely a fetus on the ground.


Interpretation: It seems fairly evident that the “alien scientists” in their white coats and brandishing IM injections are a stand-in for psychiatrists. What complicates that, though, is the fact that when I am looking for someone I trust to call, the first person I think of is my psychiatrist. So, there seems to be a distinction between trustworthy and untrustworthy psychiatrists. The reverse aging beam seems odd until it is considered that at the height of my psychiatric crisis I was age regressed into the mind of a child (an older child, I’d say 10-12 years old). In a way, what I inflict on them was the same pain I’d experienced myself. This might be a metaphor for opening up to them.


I’m lucky to have my bipolar disorder

There are times that I’ve felt cursed by having ultra-rapid-cycling, somewhat-atypically-presenting bipolar 1 disorder. My mood episodes are short (sometimes as short as one day, although usually lasting a few days to a week) and they can be very intense. I also suffer from mixed episodes, which are agonizingly painful to experience, and at times I have had profound suicidality that has led to multiple suicide attempts — one of which left me in a coma for three days and nearly claimed my life. Doctors said I wasn’t going to make it. But I did.

During the worst of times I’ve wished to have “classic” bipolar disorder instead of my bipolar disorder. In truth, “classic” features may be relatively rare; but it conjures the idea of long, bleak depressions punctuated by shorter, but still somewhat long, grandiose and euphoric manias. Separate and distinct periods of each, usually lasting for months at a time, with bouts of clean euthymia (wellness) in between.

I haven’t really experienced prolonged euthymia, instead merely catching glimpses of it over the course of my continuous ups and downs. My manias are “dirty” and dysphoric, tainted with depressive themes. My hypomanias are very productive; but if my mood spikes too high, my thoughts become dark and gruesome. If I were to jump off a building, it would be to kill myself, not because I believed I could fly.

And I’m also a researcher. Without a doubt, my research in the area of bipolar disorder draws upon my insights as a bipolar person. If I had “classic” bipolar disorder, the research I have done (some of it relying theoretically upon data collection of my own personal changes in mood) would not have been possible. Because I’m an ultra-rapid-cycler, I was able to capture long-term patterns that might take many years to become evident in “classic” bipolar disorder. I believe the same patterns exist in both, but when moods last for months at a time, it is harder to see those patterns.

My ability to detect patterns has served me well in life (including in my professional career) and to some extent, my bipolar disorder trained me to do it. Predicting my own mood was not only possible, thanks to the accelerated timeframe, but essential to my ability to cope with them. Part of the devastation of mixed episodes came with the loss of my ability to predict with reasonable accuracy when moods would peak or change and in what direction. Even so, I learned new patterns and slowly became able to tell what a “mixed episode” felt like, and whether I was experiencing one. This was not something I could do at first.

Insight into the emotions, cognitions, and memory issues that come along with my bipolar disorder developed over time, starting at an early age (as I first developed symptoms around the age of 10). In turn, this level of insight has allowed me to hypothesize connections no other researcher has yet seen. I understand firsthand how bipolar disorder intersects with changes in thinking and memory.

I have the opportunity to discern cause and effect in relation to changes in my mood much more easily than someone with “classic” bipolar disorder, thanks to the immediacy of any reactions. Upon hearing from my psychiatrist that nitrates in beef jerky were causally linked to mania, I took note of my own reactions. I had known for quite some time that beef jerky had a stimulant-like effect on me, but I was surprised to learn it did not have this effect on everyone. (Too bad!) I experience this stimulant-like effect almost instantly, while I’m still eating. The temporal proximity of the cause and the effect makes them easier to distinguish.

My bipolar disorder is a blessing and a curse. I have struggled immensely to control it, but I wouldn’t trade it for “classic” bipolar disorder or no bipolar disorder at all. The knowledge and abilities I have gained as a result of my battle with bipolar disorder — my bipolar disorder, not someone else’s — have actually, truly been indispensable to my life and my career. Plus, that excessively productive hypomania is pretty good too.