Interesting post at Furious Seasons recently (heh, as if there were not an interesting post there nearly every day!) regarding manic depression as a dangerous gift, as a personality disorder, and as something from which one can completely recover.

I know I am going out on a limb here that someone will likely chop off for me, but I believe that much of what we call bipolar disorder is in fact a personality disorder or constellation of behavioral issues.

I’m not looking to chop off this limb. I view manic depression as a dangerous gift as well, and as something that maybe at least some people can completely recover from. I also understand that Philip is not saying all a person with bipolar disorder has to do to recover is pull themselves up by their bootstraps:

I think bipolar disorder can be a personality disorder–and, nitpickers be warned, I am using the term very broadly–more often than it is a mental illness.

Depression–and here I am not discussing major or clinical depression–is widely known as having a huge personality component.

Mania itself–and here I mean the bad old wild delusions, hallucinations and declarations of Godhead mania–is not a personality disorder. When it’s in full flower, mania is straight-up insanity.

Dysphoric mania is possibly the least fun thing in the world, but there is at least one good thing about it: once you’ve recovered from an episode of psychotic dysphoric mania, it’s really hard to convince yourself that it was a character flaw. You can easily convince yourself that you weren’t depressed, just stupid and lazy, and that you weren’t hypomanic, you were just being a silly, reckless whore… but after having auditory hallucinations for a few weeks straight, once I finally stopped, I realized that something had been really wrong and that this time it wasn’t my fault.

I was aware that most of the time, medication either made me a zombie or made my moods even worse. So sometimes I would stop taking medication, be fine for a few months, and then be much, much worse than before. I learned to do things that sometimes stopped mood episodes, but more often just allowed me to cope with the symptoms I experienced, so that I functioned very well as one of the walking wounded. For quite a long time, I honestly believed that there was no such thing as getting better, there was only becoming a better liar, so that you could hide your pain from others and even from yourself. Or at least I thought that was the only option for me, because I’d read about other people who were asymptomatic for long periods of time, who claimed to experience “growth” and “healing.” I didn’t disbelieve them, but I didn’t think that anything would work for me. I tried CBT, DBT skills, family therapy, couples therapy, group therapy, exercise, meditation, hospitalization, acupuncture, journalling, medication, medication, medication, and other stuff… but the hits just kept coming. I kept getting depressed, I kept getting hypomanic, and I kept getting manic.

Some of those things helped. Some didn’t. (Acupuncture, for instance, was supposed to make me less stressed, but instead it turned me into a stressed person with needles in her ears.) For nearly a decade, though, none of them prevented me from having mood episodes, which I dealt with using a combined method of actual coping skills plus being way, way too hard on myself. I have been essentially non-syndromal for the past year, though, and it seems to be solely because I’m finally on medication that’s working for me.

I am better, and I want this to be an accomplishment. I wish this were something I could take credit for. But it’s not.

The journey to get to this point was so long and arduous that I want the current solution to be complex. (I say “current solution” because although this has been the solution for the past year, I don’t assume it will be the solution that works best for me forever.) It’s not complex, though. It’s not intricate. I-take-two-pills-a-day-and-now-I-am-well. If I am experiencing any side effects, I am not aware of them. I still have emotions. I can cry when really bad things happen, I can take joy in something as simple as seeing furry gray squirrels race across tree branches, and I can write really bad fiction.

Despite how hard I tried to get better, I still can’t take any responsibility for it. It’s true that I learned plenty of things along the way, including just how vast the extent of my own ignorance is (and how ignorant many of my doctors were), but nothing I learned was instrumental in my actual recovery. I tried and tried and tried to save myself, yet I did not.

I wish I’d fixed it. I know I should be careful what I wish for. I’ll say that I wish I’d slain the dragon myself and the next thing you know, the meds will poop out and the dragon will pop back up, all scaly and fire-breathing, saying, “You called? Here I am, bitch. Come and get me.”

But still. I wish I’d fixed it.

I just spent over two fucking hours writing a post about Howard Hyde, a man diagnosed with paranoid schizophrenia who died in a jail in Dartmouth, Nova Scotia thirty hours after he was Tasered by police, when Wordpress ATE IT. Or my computer ate it, or something ate it. It just disappeared while I was working on, I swear, the last sentence of it. It should have been autosaved, of course, but somehow it’s still gone.

How about you read a couple of news articles while I curl up in the corner of the room and cuss at technology in general for a while?

• Police informed of tasered man’s psychiatric illness - widow
• N.S. orders Taser review after inmate’s death: Halifax police reluctant to link 45-year-old man’s death to weapon
• Man jolted with Taser needed help, widow says: ‘I really don’t want this to happen to anyone else’
• Panel urged to include mentally ill person: Taser review report will be examined by experts: province

My original post had actual opinions! And more links! And quotes from articles! But I’m not going to bother trying to reconstruct it, because that would just annoy me.

I’ve also been working on a more personal post on an entirely different subject, but it’s been difficult to write because it’s painful for me. Luckily, the draft of that one is still intact. Don’t expect it to be an insightful work of art when it’s finished just because it’s taking me so long. It’s hard enough for me to write it; it would be impossible for me to write it well.

Stumbling back, blinking confusedly and wondering what happened to the past week.

My brother was released from the hospital after nine days there. My mom says he is doing okay, but she worries about him all the time. She is worried about what he’ll do the next time he and his girlfriend have a fight. They’re always fighting. He told her that if she took that job this summer, he’d kill himself. She took the job, he didn’t kill himself or try to kill himself, but he did have to spend nine days in the hospital.

I’m a bit hypomanic. Nothing extreme, mainly I’m kind of hypersexual and I’m also feeling like it’s stupid to be taking my medication. Usually, if I’m not taking my medication properly or if I stop taking it altogether, it really is because of the side effects. I am not the stereotypical “she stopped taking her pills because she thought she didn’t need them anymore” manic-depressive. (Almost nobody is, by the way. People just think that we are because they don’t actually believe us when we tell them how bad the side effects are.)

But I am that stereotype right now. Or at least I would be if I actually stopped taking my pills, which I have not. I want to, though. I feel so good right now. How could there possibly be anything wrong with me? Why would I possibly need drugs?

Twice in the past, I went off all of my meds without telling my doctor. I didn’t think that I wasn’t manic-depressive; I just thought I could handle it better without the drugs. Both times, I felt fine for a little while. Both times, things changed. The first time was a bit more gradual. It started out as mild paranoia, then moved to severe paranoia and delusions, and then added auditory hallucinations. Now, that was a fun six months. The second time was much more sudden. A case of severe insomnia turned overnight into serious suicidality and helped set off a chain of hospitalizations. All of that funstuff is why I decided that although I would try taking lower dosages of medication, and although I would stop taking Dope-a-max and atypical antipsychotics, I probably shouldn’t take no medication at all.

Right now, though, I feel like I’m talking about someone else. I have a hard time believing that I was ever ill. It feels like it was all a dream. I am fine. There’s nothing wrong with me. Why would I need pills?

Some brief thoughts, most about the Virginia Tech shootings. Most are interrelated, but some kind of aren’t.

• Postmortem diagnosis of someone you’ve never met is stupid and pointless. This doesn’t mean that I’m entirely uninterested in it (hey, I have a copy of Touched with Fire, too), but I doubt its usefulness.
• I’m a good Canadian girl and I like gun control. I am not very interested in discussing this point any further in general, and I’m certainly not interested in doing so right now.
• I am shocked and appalled that Virginia Tech didn’t lock down campus and cancel classes after the first shooting incident at 7 a.m. I have a hard time imagining that a university wouldn’t do that. It’s terrible. I know the police thought they had apprehended the perpetrator, but shouldn’t the university have done something more just in case there was more than one shooter or the police had the wrong guy, which just so happened to be the case? I disagree with a lot of things that one of the universities I attended has done, but I’m positive they would have cancelled classes and done a better job of warning people.
• It is fucking hard to be mentally ill in university, but I think that might have had surprisingly little to do with the Virginia Tech shootings. I’m crazy, I was really ill in university, and most of the treatment I received only made me worse. But I’ve never killed anyone. My mom thinks that better mental health treatment for university students could prevent further mass murders; I don’t necessarily agree. I do think that mental health on campus is a very serious problem, though, and solutions like threatening to kick me out of residence for cutting myself superficially don’t help anyone.
• People have talked about how the people around Cho should have reached out to him. It seems, though, that some people did reach out to Cho while he was at university. He merely ignored and brushed off any attempt at friendliness. It was pretty nice of people to try to talk to him at all, since he scared the shit out of plenty of other people. I like to think I’m a generally nice person, but if there was some guy who followed girls around and repeatedly sent them emails or whatever after they’d asked him to stop, and surreptitiously took photos of girls and blamed it on other guys, and ignored people who spoke to him, well, I don’t see that there’s any problem with me being too scared of him to try to “reach out” to him. (As a side note, one of the guys who raped me, I later found out, had a previous history of stalking other girls when he took classes at the local university. This was not at the same university I have referred to previously, we were not on campus when he raped me, and he was not even a student when he raped me… but he did later get a part time job on that campus, despite the previous complaints that he was a stalker.)
• I do think, however, that Cho really could have used some compassion when he was younger. Maybe if his peers and other people had been kinder to him in high school, or junior high school, or elementary school, it would have helped him and he wouldn’t have become the twisted person he eventually did become.
• Since I’m very fond of freedom of speech and freedom of expression, it doesn’t bother me that Cho Seung-Hui’s plays were violent, profane, and bizarre. It bothers me that they were poorly-written and pointless as well as being violent, profane, and bizarre. This is not me poking fun at bad writing; this is me writing badly myself as I fail utterly in my explanation of why I do agree that they were somewhat disturbing. Mainly I guess, they seemed like the kind of thing that someone who’s 23 should have moved way beyond.
• In theory, I have absolutely nothing against the idea of briefly hospitalizing someone involuntarily if she is judged to be in imminent danger of harming herself or others. In theory, I am all for this. In practice, sometimes it even saves lives… but other times it’s extremely damaging. I could go on and on about this, but since it wouldn’t fit into point form, I’ll have to get back to it another day.
• People are responsible for their actions unless they are so completely psychotic that they honestly can’t tell right from wrong. You know, the legal definition of insanity. This doesn’t happen all that often. I have been that way only once, and this one time where I had zero chance of controlling myself lasted only for minutes. I had been psychotic nearly constantly for several months at that point, but the actual insanity lasted only minutes.
• At that point, I snapped back to being 99% out of control. And at 99% out of control rather than 100%, you are responsible for your actions. At that point, it’s extremely difficult to talk yourself out of things you’re about to do, but it’s not impossible. At that point, psychosis is an explanation for your actions, but it’s not an excuse.
• I am generally harder on myself than I am on anyone else. Additionally, not being in anyone else’s head, I don’t know how I’d judge whether they were 99% or 100% out of control. But if I did have a way to judge that, I’d hold other people to the same standards of responsibility to which I hold myself.

There’s a post at Furious Seasons today commenting on the Portland Identification and Early Referral programme in Portland, Maine and an Associated Press article about the program. My personal favourite part of the programme’s web site is the line “Mental disorders are diagnosed in the same way as asthma, diabetes and cancer.”

Ah, so mental disorders are diagnosed with a pulmonary function test? No? A blood glucose test? No? A biopsy? No? Is there any type of biological test that can conclusively prove someone’s particular psychiatric diagnosis? Again, NO.

I was in an early psychosis programme when I was nineteen. The psychiatrist I was seeing for depression when I was eighteen thought I might be schizophrenic, so she prescribed me Risperdal, only saying that it would “help my concentration” and not bothering to tell me that she thought I had schizophrenia. Six months later, she moved away and my GP referred me to the psychosis prevention programme based on whatever was in my file. The next summer, another psychiatrist I saw told me that my file said the first shrink thought I might be schizophrenic because I had told her that I was bullied in junior high school and sometimes I still worried that people might not like me. That was the basis upon which she had prescribed me an antipsychotic: she somehow mistook my occasional worries caused by past trauma for delusional paranoia. The best part is that the bullying was something I had mainly worked through and it bothered me so little at that point in my life that I didn’t even remember mentioning it to her. It was just something I’d said in passing.

During the psychosis prevention programme itself, I saw a psychiatrist and a psychiatric nurse and talked to them about my depression. I knew the programme had something to do with psychosis, but didn’t know why I was in it. Nobody told me that my previous psychiatrist thought I was psychotic. Nobody told me I wasn’t psychotic. Nobody told me they thought I might become psychotic. Nobody provided me with any education about psychotic disorders. Nobody thought they should take me off my Risperdal, so I stayed on it (and my Zoloft, which has been nearly ever-present in my life for the past eight years). I think I just quit seeing the psychiatrist and the psychiatric nurse on my own without them referring me elsewhere; I think my psychologist eventually referred me to my next shrink.

So I wound up in a psychosis prevention programme because I made an offhand remark about sometimes worrying that people might not like me. Even before I was in the programme, I wound up on an atypical antipsychotic because of that same remark. I was not schizophrenic then, and I’m not now, although I was tentatively diagnosed as such at the time. I was not psychotic then, nor was I showing any signs of psychosis. I didn’t get psychotic until years later. My worst psychotic episode was when I’d been off all of my medications for months, but I’ve been more mildly psychotic while on antipsychotics, too. I was misdiagnosed, unnecessarily prescribed heavy-duty medications, and kept in the dark about everything. I don’t believe AAPs caused my eventual psychosis (although such a thing is not impossible), but I sure wish I hadn’t been taking drugs with such serious side effects for years before there was ever any real sign that I might need them. In the long run, being prescribed antipsychotics at eighteen didn’t stop me from getting psychotic at twenty-one or twenty-two. I’ve also been off AAPs for over a year and a half without having any serious episodes of psychosis in that time.

Years later, I reread some old journal entries from the three weeks I was taking Zoloft but hadn’t yet started taking Risperdal. I seem pretty damn hypomanic in them, which I didn’t realize at the time. Although my behaviour shortly before being prescribed Risperdal wasn’t entirely normal, it appears that the only rationale for the prescription that my psychiatrist actually bothered to write down was that one comment I had made. Either that was her entire basis for considering me a possible schizophrenic, or she mistook my hypomania for schizophrenia and did a really sloppy job documenting it.

P.S. I should have knocked on wood while I was writing yesterday’s post. I didn’t sleep very well last night.