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Some Thoughts on Manic Depression

posted 15 May 2015, 02:11 by Carol Conway

Earlier this week I received an unexpected email from my older brother with the most honest, moving and courageous reflection on his experience of Manic Depression.  As I read it (bizarrely in a hairdressers chair while I “improved” the colour of my crowning glory), I laughed, I cried, and I gained a real insight into what it is like to live with this reality.  Having grown up in a family where Manic Depression is the lived reality for both my brother and my father, I’d like to think that I’ve made an effort to be both educated and understanding about it over the years.  I now realise I’ve never really had a clue!

Moreover, I personally find this account so valuable that I thought it should be more widely shared and my brother has readily agreed (another act of courage as far as I’m concerned).  So it was with a wry smile at the “serendipity” of it, that I realised we are also in the middle of Green Ribbon month, a National initiative to get people talking openly about mental health problems in May 2015 – how apt!

Without further preamble, and with deep gratitude t my brother, here are his thoughts which I hope may prove useful to others who are living with this either personally or through a loved one:

 

Some thoughts on Manic Depression.

First a pet peeve. I like the term "manic depression", it's apt. "Sometimes manic, sometimes depressed." Yep, that's what I've got. Nowadays the fashionable term is "bipolar disorder". "Two poles in the wrong order." Huh? What? Perhaps "manic depression" sounds harsh and unpleasant. Well it IS harsh and unpleasant. For the people who have it, and those who have to put up with them. But I don't mind if you prefer "bipolar disorder".


What is manic depression like?

Imagine there are two compartments in your mind [1]. One deals only with the negative: bad memories, problems that beset you, things that might go wrong. The other deals only with the positive: happy memories, things that are going well, hopes for the future. A healthy mind balances both sides.

Being depressed shuts down the positive side. Everything is shit. Everything. The times you thought you were happy were a hollow sham, you were a fool to believe life could ever be anything but shit. Anything of value that is left in your life will soon be lost. Nothing you can do will help. It will never get better. There is no way out.  There Is No Way Out.

Being manic shuts down the negative side. That might sound like fun, and it is! But it is just as dangerous. Why not bet my life savings on that 10 to 1 horse? I'll win a fortune! Why not drive 150kph on the highway? I'll get home quicker! Why not try the dodgy drugs this weirdo I just met is selling?  I'll expand my consciousness!

[Disclaimer: these are not things I have done. They are hypothetical examples, but not unrealistic. OK, maybe the driving.]

People rattle on about being positive and not being negative but the truth is you cannot live without both. Losing either cripples your mind.

 

What can a manic-depressive person do?

Drugs help, at least they help me. I'm talking about medication here, not recreation. But it's not that simple. The first problem is that when you are manic you know you don't need them and when you are depressed you know they won't work. So it can take a while and some false starts before you even try.

If you get past that, the second problem is that going up and down is a constant feature of your life. It's hard to tell if the drugs are making you better or if it’s just the cycle. Often the possible side-effects of the drugs are also possible symptoms of the disease (sleep problems, anxiety etc.)  Different drugs work for different people and there are a LOT of different drugs. It takes time and experimentation to figure out what works.  It took me several years. Then, a good many years later, it stopped working and I had to experiment some more. Now it works again.

If you get past all that, and you start to feel somewhat normal BEWARE. "Hey I feel perfectly normal. Normal people don't need all these drugs, why don't I just..."  YOU FEEL NORMAL BECAUSE THE DRUGS WORK! Only change meds if you start to feel abnormal.

People are (wisely) hesitant to use "artificial", "unnatural" drugs, especially to keep their mind functioning. Some meds can have nasty side effects. People say "it's just a crutch". There's no doubt that not needing drugs or crutches is better than needing them. But if you only have one leg, Use The Damn Crutch! It is not perfect, it is not a real leg, it may chafe your armpits, but it is better than dragging yourself across the floor on your belly.

When people talk about the side effects and long term damage of medication, they often forget to factor in the side effects and long term damage of being insane. Chose what works best. Perfect is not on the menu. Manic depression is serious. I think I made it, but not everyone does. I'd rather risk taking medication for my liver at 60 than be found hanging in my basement at 40.

Other things may help: exercise, diet, food supplements, meditation, support groups, therapy. Those things are good for you anyway (or at least not bad for you) so there's no harm in trying. I liked group because I could say things I would NEVER say in public, and people would nod and smile instead of looking at me like I was insane. Meditation helped me a lot. Therapy was pleasant but I'm not sure it made much difference. I'm not saying any of these things will or won't help somebody else, I'm saying: Try Everything, Do Whatever Works.

The trick with these things is that when you are manic you know they will solve all your problems. When you are depressed you know they are a waste of time and you stop doing them. I still don't know for sure: did meditation help me get out of the depression, or did I start meditating again because I was coming out of the depression? In any case, I got to like meditation and I'm convinced it did help me with my attitude to life. I stopped doing it, I don't know why. I may start again.

 

What can you do when you are depressed?

Absolutely Nothing. Sorry if that's a shocker. Yes drugs etc. can help in the long run. They can smooth the ups and downs and even get you to a point where you don't get depressed any more. But you are depressed Right Now, not in the long run. And there is nothing you can do Right Now except live with it.

I have read, and it fits my experience, that part of the horrible mechanism of depression is that all your attempts to fight it, escape it, or deny it feed new messages of failure and despair to the negative side of your mind. The more you struggle the worse it gets. If you stop struggling, that will NOT make it better. But at least you will not voluntarily be making it worse.

Accept. Acceptance is not condoning, ignoring or minimizing horrible things. It is recognizing that the horrible thing is already here. It is the reality you must deal with if you are to move on to something less horrible.

Wait. It WILL pass. You WILL feel better. You DID feel better in the past and you will again. At some point I came to believe that, even while I was depressed. Believing it does NOT make you feel any better. But hopefully it makes you willing to wait it out.

The flip side of this insight is knowing that when you are happy, that won't last either. You will become depressed again. So what? You're happy NOW! Enjoy it while it lasts! That's not sarcasm, it is an essential strategy for survival and happiness in an uncertain world, whether you are mentally ill or have delusions of sanity. Enjoy It While It Lasts! All of it!

And now the delicate subject of suicide. I have never made a plan to kill myself. I did reach a point where I knew that if things did not get better I would eventually have to kill myself. I also used to think about suicide "in the abstract" way more than most people do. The doctors call this "suicidal ideation" which I find funny. "Ideation". Silly word.

Here is what I would say to someone contemplating suicide. It may sound insane to a sane person. It is not hopeful because giving hope to a depressed person is like turning on the light for a blind person. Here goes:

----

Don't rush. Wait a bit. See what happens. You can always kill yourself later.

Your life is worthless, so what does it matter if you waste another worthless day? You are certain it will never get better and there's no way out. You might be wrong. I'm sure you will agree that you've been wrong about a lot of things. Something good might happen someday. Maybe. Maybe not, but give it another day. What have you got to lose? Hahaha. You can always kill yourself later. There's no rush. You don't really care about anything anymore, do you? Not even yourself. So what does it matter if you suffer a little longer?

Even if you are right, and life never gets better, it is not forever. Nature will kill you soon enough. Suicide is unnecessary.

----

I feel a bit "out there" writing that down. I know this is not how people normally think. But suicidal people are not in a normal state of mind. I don't know if I would really say this to a suicidal person. But it works for me. I know now that I will never need to kill myself.

 

What can you do when you are manic?

Depression was a bigger problem for me than mania. I did some stupid manic things but thanks to the intervention of wiser people on some occasions, and dumb luck on others, I never paid a high price for them. The drugs worked on the mania much quicker than the depression.

Depression and mania are extremes, with lots in between. Maybe somewhere in there is "normal", but I don't think it even matters where. What matters is finding a way to live the life you have.

There is a point between depression and mania that is just FANTASTIC. My mind is genuinely sharper and faster. My sense of humour is better. I am full of great ideas. I enjoy life! Life IS great, I can SEE that. Really great not delusionally great.

In the old days I flew past that point at top speed. As I get higher my mind and my speech get faster till people can't understand me. The doctors call that "pressured speech". That probably sounds odd, but I know EXACTLY what it means. I don't sleep much, I have tons of energy and too many ideas to fit in my head. I've never heard the phrase "pressured thought" but I know EXACTLY what that means too. It is exhausting. But it turns out you can be mind-numbingly exhausted and at the same time driven by unstoppable energy and floods of ideas. It's not as much fun as it sounds.

I try to be calm and patient. It's hard. I try to practice the gentle art of Keeping My Mouth Shut even when I have something devastatingly witty or astoundingly insightful to say. I try to slow down.

The following strategy may sound familiar: Wait. Don't rush. If it's a brilliant idea now it'll be a brilliant idea later. No harm in re-reading it tomorrow, I can send it then. I'm sure it is essential but no need to buy it right now, I can get it next week. No need to buy a year’s supply, even on special (but it's on SPECIAL!!!). Let’s just get what we need now and come back later.

The very best strategy I have ever found is Listen To My Wife. It's hard sometimes but she's usually right. When you can't trust your own mind, find people you can trust and listen to them even when you know you are right.

There is a thing the doctors call a "dysphoric high". I have had that misfortune. All the energy, racing ideas and poor judgement of standard mania but instead of everything being great, everything is irritating. It all just makes me ANGRY. This is the worst. Not for me (I'm insulated by layers of delusional, self-righteous anger) but for my long-suffering wife. I am amazed and forever grateful that she never packed up and left. It would have been justified, perhaps even well-advised. Thanks Denise.

The only advice I can give for this condition is Keep Your Damn Mouth Shut. Some people say that communication is always best. They are wrong. I agree it is usually best, but right now Shut Up. Go stew in your room. Take a walk. Have long protracted arguments in your head with all the people you think have offended you. You will probably win those arguments. But Do Not Say Them Out Loud. Concerned people will ask, what’s wrong? Do Not Tell Them. DO NOT. Tell them it’s not them it's you. Tell them you'll be fine. Tell them you'll talk about it later. Lie through your teeth. At one point I took to telling my wife "it's that time of the month".

Wait. There's no rush. If they are out to get you, if you really cannot tolerate their behaviour any more, it will still be true tomorrow or next week. Take your time. You may change your mind. You regularly do, remember?  Maybe there is something that needs sorting out, but sort it out later. You can talk about things that bother you but NOT NOW. The arguments that you won in your head? You WILL NOT WIN in reality. Nobody will. Everybody will lose. You will cause terrible harm that will be hard to repair, if you're lucky enough to be able to repair it. I know. Thanks Denise.

 

What can we learn from manic depression?

One of the things I have learned from manic depression is that I do not control my own mind, and I cannot believe everything it tells me. I suspect this applies to everyone in a subtle way. In my case it is not subtle.  Apparently this is well known in the mind sciences and Buddhism, but it was a bit of a shock to me.

Of course I still have to trust myself. I still do. My mind isn't trying to deceive me, it is doing the best it can. Sometimes that is great. Sometimes not so much. Urgency and desperation are clues that maybe it isn't great right now. So take a deep breath. Put that aside for later. Talk it over with someone. There's no rush. My mind works, I just have to be patient with it.

Manic depression has taught me the value of patience. I don't always do it, but at least I know it is a good idea.

Life is unpredictable. We can't control it, and not everything about it is good. But a lot of it IS good. If we make the best of the good, and try not to be fooled or overwhelmed by the bad, we can be happy. At least some of the time. And so it goes with the mind.

I have learned to live peacefully with my mind (which includes having learned to take my meds.) It doesn't always behave but nobody's perfect. Nowadays I am happy most of the time. I wish everybody the same.

 

Footnotes:

[1] The two compartments metaphor is adapted from a lecture by Dr. Patrick McKeon,     you can find it at https://www.youtube.com/watch?v=FaAX2gAMGao

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