In 1977, when I was 29, I was hospitalized, diagnosed, and medicated for “manic depression, combined form (bipolar I and II), rapid cycling, with psychotic overtones.” No doc has ever challenged or questioned that label, but I know many people who have had five or more labels and drug regimes. I didn’t question it myself for 25 years, but the evolution of my feelings about being bipolar reads like a micro-history of the recovery movement.
I added post-traumatic stress disorder (PTSD) to my label on my own, when enough people convinced me emotional trauma was often as bad, or worse, than natural disaster or physical abuse and neglect. By then, I had not been manic for 15 years, but still had problems with previous traumas a few times a year. (I stopped calling it PTSD in 2000 because it’s a normal reaction to abnormal events, not a disorder.)
Now, I think I never had bipolar disorder. It was all trauma all the time from the beginning, I believe.
At first, the label made perfect sense to me, and was a big relief. I’d been a homeless, hallucinating cab driver in New York City for two years, with devastating mood swings and rage, until I could not work at all. I had lost my career, savings, marriage, Manhattan apartment, friends, and community and nearly died from a ruptured appendix. I kept making bad decisions.
The docs did not think trauma could cause such terrible symptoms without help from a chemical imbalance. In fact, the idea that trauma caused mental illness was even more out of style among docs than it is today. They refused to listen to what was happening to me, just told me what was wrong with my brain and my arrogant, resistant attitude.
My Mother Had It
My mother had been one of the first “lithium miracles” just seven years before, after going in and out of hospitals from 1957 to 1969 about every 24 months, with what looked like a drug-free, spontaneous, unprovoked LSD trip. They tranquilized her and she came home healthy in a few weeks.
Her first hospitalization, in 1957, lasted six months, and she came home healthy and more assertive. In 1969, they tried a new drug, lithium. The docs said it was not a tranquilizer. It treated the chemical imbalance, not just the symptoms, the docs said. She said she had the sensation of a cloud leaving her head.
She got well, stayed well, and stopped the lithium about five years later. If you believe bipolar is real, very serious, and extremely rare, she was a rare, classic case. Maybe the tranquilizers contributed to the relapses, but there was no abnormal trauma in her life anyone could see.
What was going on with me in the ‘70’s looked nothing like my mother. I was going crazy over something, and had the impression manic depressives had to go crazy over nothing. But everybody knew manic depression ran in families.
But when a doc suggested a label, and said there was medicine that might help, I embraced it. It meant I had a real disease, with a name and treatment that had cured my mother. I WAS NOT JUST A SCREW-UP WHO MADE BAD DECISIONS.
I did get better on the medicine. At exactly the same time I started lithium, I got off the streets, and moved to New Hampshire, where I found family, friends, community, and my first professional success in years, in a job that led to a professional career in newspapers. We never connected the improvement in my circumstances with the improvement in my bipolar disease,
The fact that medication seemed to help me was the final proof that the diagnosis was correct.
An “Inexplicable Relapse” In 1995
In 1995, at the newspaper, I started having anxiety attacks, and taking an anxiety drug. The more I took, the worse they got, until I couldn’t take them anymore. So the doc started increasing the lithium, until I could not sign my name or control my bladder. I took a disability leave that ran to a year. I told myself the bipolar drug that allowed me to pull my weight at a daily newspaper for years had mysteriously stopped working.
The doc told me about another drug, but said he was afraid to give it to me because it might give me seizures. So he kept piling on the lithium, and I kept getting worse. Some days, I thought I was going to die. Other days, I felt so bad I was afraid I was NOT going to die, but would have to suffer forever,
Finally, I told that doc I was switching to the other drug. The handout I got from the druggist said its first approved use was as an anti-seizure medicine.
I stopped getting sicker and started getting better. I tried going to back to work part-time, but it was too much. I ended my newspaper career.
It would have ended within a couple of years anyway. The paper had started downsizing, letting go of all the experienced people at the top of the pay scale, replacing them with kids out of school, or not replacing them at all. It stopped being a nice place to work.
I knew I was not in their long-term plans, and thought I had no place to go because newspapers everywhere were downsizing. I stuffed those feelings, and did not look for alternatives, because I could not admit it to myself, and was sure I had no alternatives. That’s where the anxiety attacks and “relapse” came from. The paper was very kind to me when I quit for reasons of health.
My Real Recovery Begins
I was hospitalized again soon after that. It took them a few days to adjust my medication; then they referred me to their “day hospital,” instead of the street, I went to groups there for a few hours a day, and that’s where my recovery began. The nurse practitioner treated me for trauma, and gave me the insight that started my recovery.
Janet Potenza ARNP said, “You keep doing everything you’re supposed to do, the rug keeps getting pulled out, you fall on your face, and just stuff your feelings. Then they come out at times that are inconvenient and damaging to you.”
It sounded like she was saying all the terrible things that happened to me, since my mother went to the hospital when I was 10, and all the rejection, loss, and mental illness since then, were my fault.
“No,” Janet said, “when terrible things happen to you, it’s not your fault, but it’s your choice what you do next. Anger, blame, and being a victim are seductive choices because the terrible people and things were really terrible, and really happened. But those choices keep you from moving ahead with your life. There are other choices.”
Then, we started examining my life as my choices, not terrible people and things that happened to me. I understood why I made those choices when I did, almost always for good, understandable reasons at the time, knowing what I knew then. Overnight, I became a happier person, able to forgive many of the people who hurt me over the years. The change was obvious on my face to everybody in my group.
A week or two later, I carried that insight and new sense of well-being to a community mental health center. Right away, we started identifying my “recovery assets” — strength-based treatment. No clinician had ever talked to me about anything like that. They want me to get well, I said to myself.
Next, the clinicians sent me to a 36-hour peer-led Wellness and Recovery Action (WRAP) workshop, and the second meeting of a peer support agency that had just started to form.
WRAP redefined wellness and recovery for me, and I became a WRAP facilitator. The PSA relieved a lifetime of isolation. Through them, I became a mental health activist on the state level, and began to balance my life.
At the newspaper, I’d been symptom-free, stable on medication, with my dream job, but I was isolated and angry. My life was my work, and my work was my job. On weekends, I visited my family or went out to dinner and a movie. I had friends at work, and people in the bar after work who liked my writing. I knew I was a good writer, but had no self-esteem except for that.
I thought that was as good as it gets. Then I stopped being stable and symptom-free, and lost my job.
Today, I play washtub bass, sing in two choirs, and am active in my faith community. I still write non-fiction every day. I cook, entertain, and have dear friends who are always there for me because I’m always there for them. I don’t know many 64-year-old men as happy with themselves, their lives, and their achievements as I am; whether they’ve had a “mental illness” or not.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.