Modern Madness

by Terri Cheney

  “I’m really sorry to disagree with you all,” I said. “But I think labels are great. I wouldn’t be here if it weren’t for my bipolar label. I’d still be getting the wrong kind of treatment, and the wrong medications, and I’d probably have committed suicide by now. So if it’s a choice between being labeled and being helped, I’ll choose the label any time.”

  The audience fell dead quiet, as if someone had spit on their glow. Which I suppose I had. The moderator started to cut in, but I was just warming up: “And I don’t care if that’s the ‘right thing’ or not,” I said. “We can’t allow political correctness to get in the way of communication. Sometimes social change can simply be a conversation between two people. Let’s just talk to each other, okay?”

  Sweat was starting to form on my upper lip, and I could feel it snaking down my back as the room and the panelists and the moderator said nothing. And nothing still, for the longest moment ever. Why do you always do this to yourself? I thought. Why choose advocacy as a career, when it makes you so uncomfortable? But then, as if they’d been cued to react, the audience came alive and began to clap. Their applause felt deafening to me, and I wanted to do something dramatic, like drop the mic and leave the stage. But I didn’t; I just blushed furiously.

  Afterward, a swarm of people came up to me. I was expecting them to argue with my position, or at least to assert their own opinions about what’s right and not right to say. But they didn’t. Instead, to a person they thanked me: “I feel that way, too, only I don’t like to say it,” was the recurring theme of their comments. I could certainly empathize—I don’t always like to say what I feel, either. But when silence can be construed as consent, I think it’s a sin not to speak. Even, or especially, if it makes you sweat.

  SECTION IV

  Instructions for Use

  RELATIONSHIPS: GENERAL INSTRUCTIONS

  “Everything that irritates us about others can lead us to an understanding of ourselves.”

  —C. G. Jung (1875–1961)

  “To know even one life has breathed easier because you have lived. This is to have succeeded.”

  —Ralph Waldo Emerson (1803–1882)

  Mental illness has an exponential impact. One in five adult Americans lives with a mental health disorder and comes into contact with scores more people, in varying degrees of intimacy. Loved ones are obviously most affected. A diagnosis is like a third party in any close relationship with a person who has a mental illness.

  The American Psychological Association acknowledges that “it’s normal [for loved ones] to feel a range of powerful—and often unpleasant—emotions,” including shame, embarrassment, anger, self-blame, and guilt. Aberrant behaviors can be hard to understand and deal with, and it’s tempting to believe that they are volitional, when in fact they are not. In a perfect world, this would be readily apparent; in the world as it is, we have to constantly work to remember that the illness is the enemy.

  Difficult as any relationship can be, the marvelous thing is that friends and loved ones can make a profound difference in the life of a mentally ill person, by educating themselves and maintaining a positive attitude. They can contribute mightily to recovery—not only improving that person’s life, but maybe even saving it. The investment is significant, but the dividends are so rewarding.

  DON’T FIX ME, I’M NOT BROKEN

  The number one symptom of depression for me is my inability to get in the shower. Once I’m in there I’m okay, but it takes a gargantuan effort on my part just to turn on the faucet. I lie in bed contemplating that simple movement of twisting the knob; nothing, and I mean nothing, can incentivize me to actually do it. I know I’m not alone in this because I’ve Googled “hating the shower” and there’s a whole community out there that identifies with this phenomenon.

  I was struggling with it again when a good friend called me. He knows about my bipolar depression and is pretty well educated about its symptoms and triggers. I told him I was having trouble getting up and getting into the shower, and to his credit he asked, “Why?” I stumbled into an explanation of how much I despise the sensation of the water striking my bare skin. That my nerves are too sensitive to take that onslaught. That it feels like an invasion, a flogging, or at least some kind of corporal punishment.

  “You need to get a new shower head,” he said. “One that feels like a gentle rainfall. Just go on Amazon and look around. They have hundreds of options, you’ll find something there.”

  The last thing I needed was hundreds of options. Nor could I imagine myself expending the energy necessary to scroll down endless screens when I could barely move.

  “Yes, but I’m too depressed to use the computer,” I said.

  “You’re being your own worst enemy,” he said. “Just go look for the right shower head, and they’ll deliver it straight to your door. You don’t have to do anything but help yourself.”

  I didn’t want to help myself. I wanted to lie in bed and moan about how I couldn’t get in the shower. I did my best to explain this.

  “It’s not about the stupid shower head or the way the water comes out,” I said. “It’s me; I can’t go through the ordeal.”

  “You could if you had the right kind of spray,” he said, beginning to sound annoyed.

  “No, I couldn’t.”

  “You won’t even try.” I could hear the disgust and anger mounting in his voice, which frightened me. He’s an integral part of my support system, and I couldn’t risk his abandoning me, which has happened before when he’s gotten mad. I realize deep down that it’s his frustration at not being able to cure my depression that really bothers him, but that knowledge came later and didn’t help me in the moment.

  “I would try, but I’m too depressed,” I said. I also realize how irritating depressed people can sometimes be, with their inevitable “Yes, but” responses. Yes, but… Okay, but… I can hear when I’m doing it, but that never seems to stop me.

  “Now you’re just being stubborn,” he said.

  “Maybe, but you don’t understand. It’s the forward movement that’s required; I can’t bring myself to face it.”

  “You could if you had the proper shower head,” he insisted, and I sighed and gave up.

  “Fine, I’ll go look on Amazon and see what they have,” I said, knowing that I’d never get within fifty feet of my computer that day.

  “I have to go now,” he said, and hung up without saying good-bye.

  I was so frustrated I started to cry. This was one of the few people in my life who understood my illness, who’d read everything I’ve written on the subject, and knew my essential rule for when I’m depressed. I’ve repeated it over and over, but I guess it needs to be said again because it’s so contrary to human—especially male—nature.

  The rule is just this: Don’t try to make it all better. Don’t cheer me up or attempt to talk me out of it. Just let me talk about my pain. I don’t know why this works so well, I only know that it does. It’s so simple: I don’t want to be fixed—I’m not really broken. All I want is to be heard.

  Yes, but… It can be so hard to listen.

  RELATIONSHIPS ARE SIMPLE: NEVER DO THIS

  Hello out there, normies! That’s insider’s lingo: what many members of the bipolar community affectionately call those of you who don’t have a mental illness (or haven’t been diagnosed with one yet). You’re reasonably sane, relatively predictable. You’re the control group in those double-blind studies. You’ve got it all going on, except… Sometimes you run across those of us who aren’t considered—quote, “normal”—and you just can’t figure us out. Maybe we’re your best friend, your employee, your boss, your sibling, your child, your lover. You’d really like to treat us well, but let’s face it: We can be hard to understand. We’re ticklish emotionally. We do strange things and don’t even realize it. It’s not always easy dealing with us. We know. So here are some insider’s tips—a few things you should avoid doing at all costs in a relationship with a bipolar person:


  1. NEVER THROW PLATITUDES AT US

  When I first started practicing law, I noticed that a great many lawyers relied on boilerplate language: phrases or even whole documents that had been used before, so many times they weren’t even looked at anymore, just skimmed over in a brief. One day I asked a senior partner why the use of boilerplate was so endemic, and he told me, “Real writing means you have to actually think. Who has time for that?”

  Take the time. Think. Don’t subject a bipolar person to the dregs of your intellect. If he’s going through an episode, don’t tell him, “It’s all in your head,” or “Everything will look better in the morning,” or “Time heals all wounds,” or “Try making lemonade out of lemons” (a good friend actually said that), or the zillion other platitudes that are unfortunately available.

  With kindness, look the situation in the face and let your words reflect what you see. Bipolar people have been subjected to so many clichés in place of concern, they’ll appreciate any effort on your part to express what you’re really feeling.

  2. NEVER THINK THE ILLNESS DEFINES US

  I think whether someone elects to say “I am bipolar” vs. “I have bipolar disorder” is strictly a personal choice. But it’s inescapable that once you’ve been diagnosed, the condition becomes part of your life. Some people are more symptomatic than others, of course, so for them it plays a bigger role. For me, it’s a constant companion. That said, I am so much more than my diagnosis, and so are all the other bipolar people I know. I accept the illness as a part of my identity—it’s the lens through which I see the world, and for a writer that’s essential—but a slice is not the whole. Being bipolar doesn’t exclusively define me any more than, say, my passion for Sherlock Holmes does.

  That’s why stereotyping a bipolar person is sure to lead to misunderstanding and mistakes. If I’ve learned anything from the slew of people I’ve met, there is incredible variety in the bipolar universe. We are not just “the mentally ill.” We are doctors and lawyers and students and teachers and politicians and celebrities and entrepreneurs and artists and I could go on forever. The illness plays no favorites. But if you must stereotype us, consider this: people with bipolar disorder skew highly intelligent and unusually creative—and are always intriguing, if you’re bored with the obvious.

  3. NEVER UNDERESTIMATE THE DANGER

  Numbers tell it like it is. Here’s what studies have shown:

  • At least 25 percent to 50 percent of bipolar individuals will attempt suicide at least once;

  • Over their lifetimes, the vast majority (80 percent) will have suicidal ideation; and

  • 75 percent of people who died by suicide expressed suicidal feelings in the weeks prior to their deaths.

  In my own life, I’ve earnestly attempted to kill myself several times. Sometimes the pain is just so bad, death seems like the kinder option. I’m much better now, but I share these facts because you need to know that suicide is a real and ever-present risk with bipolar disorder. People don’t just talk about it; they do it. An attempt isn’t merely a cry for help—it should be considered a clarion call to action.

  So if someone you know or love talks about suicide, even jokingly or in a passing remark, don’t get angry. Stop and listen. Ask him if he has a plan. Ask if he’s stockpiled medication or has a gun in the house. Ask how you can help—even, or maybe especially, with menial tasks, like doing laundry or picking up a prescription. Sometimes the smallest alleviation of daily stress can work wonders where suicide’s concerned. Above all, take it seriously. The statistics do.

  4. NEVER GIVE UP HOPE

  When I’m far, far gone down the blackest hole of depression, I know the phone will eventually ring, forcing me to move. Or when I’m so high my ceiling can’t contain me, I know I’ll eventually have to come down to answer the persistent chimes of a text. I have people in my life who love me, and they annoy me when I most want to be left alone. God bless them. They refuse to go away.

  To be frank, I don’t get it. I probably would have given up on me around about the third suicide attempt. But no, they hang on. They drive me to the doctor, they read about the illness, and they listen with their hearts wide open. They tell me stories that start out, “Once you’re feeling better…” and they look me in the eye while they’re saying that. They believe in me, and in a future that doesn’t revolve around doctors and drugs and hospitals.

  And I believe them because they’re supposed to be “normal” and so they must know what they’re talking about. That’s why if you want to be in a rewarding relationship with a bipolar person, you must never, ever give up hope. You must hold it in trust for those of us whose vision is slightly blurred, who can’t quite see the path, who need a dose of hope every now and then to make it through the day.

  ETIQUETTE FOR THE ORDINARY

  My mother once told me, “If you were the witness to a lineup, you’d always pick the guilty man.” She wasn’t praising my perspicacity; she meant I go for men who’ve been in trouble. True enough. The men I like usually do have some history, enough scars to tell good battle stories—provided those scars are in the process of healing. I admire anyone who’s in recovery, of any form. To be in recovery means you have to admit that you’ve got a frailty, and I think that bodes well for any relationship. I’m drawn to people who have the courage to surrender.

  But many of the people in my life aren’t in recovery and don’t have any official mental health diagnosis. Ironically, I often find these “ordinary” relationships to be far more difficult than the ones with the so-called difficult people. I have to explain things that seem perfectly obvious to me, simple things like feelings are there to be probed, not ignored; introspection isn’t narcissism, it’s necessary. They disagree with me, sometimes vehemently, because they haven’t known what it’s like to be hijacked by emotion and the disaster that can result.

  It isn’t their fault that they’re ordinary. It isn’t my fault that I’m not. But the clash between the two extremes gives me a walloping headache sometimes. There must be better ways for us to get along, and I think the answer may lie in good old-fashioned etiquette. It is, after all, the great social lubricant.

  Ever since I was a little girl, I’ve collected books on etiquette in an attempt to demystify the polite norms that everyone else seemed to take for granted—yellowing, dog-eared editions about how to properly nibble a canapé, how to hide your handkerchief up your sleeve, or gracefully dispose of an offending piece of gristle. Such information comforted me no end, and I used to peruse those books for hours, happy in the knowledge that in this tumultuous, chaotic world I at least had mastery over a moment of gristle.

  But manners are about so much more than knowing how many tines there are in a salad fork. Good manners help us converse with other people. They suggest how to physically interact. They smooth the rough edges of close contact. So, in the spirit of rapprochement, let me tell you how I would like to be treated by ordinary people when difficult situations arise.

  It’s tempting, when I’m upset, to throw my diagnosis at me. For example, an ex-boyfriend of mine used to rile me up all the time. He was devious, insensitive, and a host of other things that his gorgeous green eyes eventually didn’t make up for. I’d behave like most people when I got angry at his misbehavior: fast words, furious emotion, tears. It was catnip to him. “You’re wrong!” I’d sputter. “You’re cycling,” he’d say.

  For good reason, most bipolar people are skittish about revealing their illness—including me, and I’ve been ridiculously public about my travails. The problem is, we never know when stigma will erupt, so we live in silence way too much of the time. Even I don’t discuss the daily details of my condition with just anyone in my personal life. I choose, quite carefully, who gets to know what, and I’m thrilled when they want to know more.

  But when someone I’ve confided in tries to use that information as a weapon against me—watch out, we’re in for big trouble. Knowing about my illness is a sacre
d trust. Please don’t abuse it. Because hey, sometimes I’m not manic at all. Sometimes I’m just dead right.

  Another situation that always causes difficulty is when people repeatedly insist that I try this or that remedy because “It’s natural. It can’t hurt you—they sell it at Whole Foods.” How many times have I heard that one? I suspect most bipolar people have. And how many times have we gone out and bought that vitamin, that supplement, that herb, etc., only to find out that it triggers mania, or adversely interacts with our other medications, or is in some way deleterious to our mental health?

  It’s axiomatic: Just like prescribed drugs, these substances can affect the brain’s chemistry (that’s why you buy them, after all) and therefore may also have bad side effects. In fact, according to the New York Times, there are numerous cases of serious and even lethal side effects from herbal products. Worse yet, manufacturers of nonprescribed substances don’t need FDA approval to market their products. There’s no quality control, and no pressure on them to ’fess up the truth.

  I know that people who recommend these things mean well, but “natural” doesn’t always mean safe. So please resist the urge to play doctor—it’s dangerous, and bipolar people are sometimes too desperate to grasp that.

  Well-meaning people are also quite voluble on my need to exercise when I’m very depressed. I know, I know. I know all about that clinical study that showed exercise can be just as effective for moderate depression as antidepressants. I think it’s wonderful. I’d be out there in a minute pumping iron and doing push-ups and swimming laps and working myself up into a therapeutic lather, if only I could move. There’s the rub: My brain sincerely wants my body to move, but my body refuses to listen. If I could manage to do a Warrior One, I wouldn’t be depressed. So let me rest. Breathing in and breathing out is challenging enough.