Modern Madness

by Terri Cheney

  Now here’s a more delicate situation. When I get really happy about something—it happens, I’m human—people who aren’t bipolar often try to kill my buzz. Doctors and friends look at me with worried faces and warn me that my mood is changing, that I may be too chipper for my own good. It makes me want to smother my joy, and leaves me feeling alone, embarrassed, and misunderstood.

  I get it, to a certain extent. Sometimes it’s hard for even me to distinguish between safe euphoria and the beginnings of a dangerous manic episode. Only time can truly tell for sure (although one good clue is, has something objectively wonderful happened? If so, we can probably all rest easy). But that doesn’t mean I don’t just wake up out of the blue some days and feel all bright and sparkly for no reason, and want to share my elation with the world. I shouldn’t be deprived of my fair portion of dizzy-headed delight. For that brief period of time when I’m in a plain old good mood, please, let me enjoy it. I’ve probably earned a tryst with happiness.

  At its core, etiquette is based on consideration for the other person’s feelings. Or as my 1938 first edition of Manners for Moderns says, “Politeness is to do and say/The kindest thing in the kindest way.” If I were to step out tomorrow into a society where everyone had pledged to honor that maxim, I’d be eager—no, hell, I’d be thrilled—to make its acquaintance.

  RELATIONSHIPS ARE SIMPLE: JUST DO THIS

  I’m frequently asked, “What’s the best way to love someone with bipolar disorder?” Usually the person asking me has the traces of a frown on his face. I empathize. We’re not the simplest bunch of souls, the 5.7 million of us with bipolar disorder. But then, simplicity isn’t what you fell in love with in the first place, is it?

  No. Most likely you were attracted to the volatility, the edginess, the uncertainty. Loving someone who’s bipolar means loving a panoply of characters: the girl who’s overcast one morning and the one who’s radiant by mid-afternoon. There’s an excitement about never being able to predict the emotional weather; it calls on all your relationship skills.

  So what does it take to love a bipolar person? A little specialized care and feeding. We may be challenging at times, but if you’re after easy, superficial emotions, perhaps you should look elsewhere. Or, at least, read on.

  1. LET A DEPRESSED PERSON BE DEPRESSED

  Depression is a powerful demon, one that demands its rightful due. It may skulk away in its own good time, but while it’s present you have to acknowledge it. Telling a depressed person they’re not depressed, or that they have no reason to be, is simply illogical and rude. Ask the person how they feel, and then listen—really listen—no matter how hard it may be not to interrupt. This is where trust, that frailest of flowers, begins to take root.

  2. EDUCATE YOURSELF ABOUT THE ILLNESS

  If you were dating someone from Spain, you’d learn a few words of Spanish, right? The same reasoning applies. Bipolar disorder is a strange and exotic world, and it’s very lonely and frightening to feel like you’re traveling through it solo. I guarantee you that the respect and love you exhibit by learning the basics of this condition—elementary things, like the difference between mania and hypomania—will pay off in spades. All the people I’ve ever adored have asked me about my illness with genuine curiosity. They know what rapid cycling looks like, and which events are likely to be triggers. Sometimes they can even help me identify what mood I’m in when I’m not quite sure myself.

  3. APPRECIATE THE UNEXPECTED ADVANTAGES THAT BIPOLAR DISORDER BESTOWS

  Far too many bipolar people live secret-shrouded lives, and never get to exhibit the amazing gifts they’ve been granted along with the intense mood lability. If you can establish the rapport necessary for the bipolar person to open up and show you what’s really going on inside, I think you’ll be surprised. It’s a dangerous disease but it has its perks, like a bad job with good benefits. Creativity runs rampant through bipolar blood. Bipolar eyes see the world in a unique and fascinating way. And because we’ve known what it’s like to struggle, we’re very generous with our empathy. If you love someone with this illness, you’re only a heartbeat away from sharing these riches.

  4. REMEMBER THERE’S A TOMORROW

  It’s scary when symptoms manifest, and it’s frustrating for everyone when they don’t go away. But the weird blessing of bipolar disorder is that it’s in constant fluctuation. Eventually, a mood will shift, or a medication will start to take effect. I know this intellectually; I forget it instantly when I’m suffering. What I need the most when I’m going through an episode is to hear from someone I trust that relief is coming down the line. In the midst of my pain, I’m not always capable of sustaining that belief, so someone else has to be its custodian. A simple reassuring reminder that change is inevitable—it’s happened before, and will happen again—works wonders for my recovery.

  Loving someone with a bipolar diagnosis may be one of the most intriguing things you ever do in your life. It’s a quest well worth the treasure because bipolar feelings run deep and true. I grant you: the course isn’t always smooth. But when is it ever, with love?

  RELATIONSHIPS: SPECIFIC INSTRUCTIONS

  “You don’t develop courage by being happy in your relationships every day. You develop it by surviving difficult times and challenging adversity.”

  —Epicurus (341–270 BC)

  “Love is no assignment for cowards.”

  —Ovid (43 BC–AD 17)

  How do you deal with someone who’s floridly manic, or desperately depressed, or severely anxious, or suicidal? Or worse yet, in denial of any or all of the above problems? These are real conundrums that demand real-world, practical solutions. But for most of us, that means giving advice, and therein lies a conundrum all its own.

  Rather than helping people in trouble, advice can often backfire. It can constitute what author Robert Bolton defines as “a roadblock in interpersonal communication.” It can even activate the brain’s limbic (threat) system, by signaling challenges to our status and autonomy. Research on reactance theory shows that whenever someone tells us what to do and how to do it, we respond with defensive defiance (https://www.psychologytoday.com/us/blog/do-the-right-thing/201407/giving-people-advice-rarely-works-does).

  That’s why “You should” is a terrible way to start any sentence. It inevitably places the advice-giver in a superior position. “I know better than you,” it says. Not that people consciously intend to create these dominant/submissive roles. But it’s a sad if undeniable truth that you can mean extremely well and hurt someone anyway.

  So—and the irony is thick here—don’t give advice is sometimes the best advice, even in the most challenging relationships. But there are other ways of helping that don’t elicit the same knee-jerk defiant reaction. Instead, listen closely. Educate yourself thoroughly about the situation, so you can explore possible options. Ask thoughtful questions. Consult experts. Encourage the person’s own sound contributions. Model the behavior you hope to inspire. (See the Harvard Business Review for more tips on this “subtle and intricate art,” at https://hbr.org/2015/01/the-art-of-giving-and-receiving-advice.) You’ll learn far more about the person and the problem than you ever would have if you had simply resorted to giving advice.

  LIMITING MANIC FALLOUT

  Here’s what it’s like to be around me when I’m manic, according to witnesses who have seen it and survived. It’s like talking to Minnie Mouse: The timbre of my voice goes way up and my speech is pressured, as if something were goading me to chatter at hyperdrive speed. You find the machine gun rapidity of my ideas and emotions delightful at first, even inspiring. You can almost see what I insist upon: that there are connections everywhere, to everything. We hold chaos theory conversation—from Manet to butterflies to trade policy with Mexico, all in the flicker of a few sentences.

  You’re flattered by the intensity of my attention—the way I touch you frequently to make my point, and sear you with my eyes, which are only for you. You feel incredibly witty and fascina
ting because I seem thrilled by everything you contribute, eagerly interrupting to question you further. And all the while you’re talking to me I’m in motion, pacing or tapping my fingers or jiggling my legs. Energy radiates out of me and galvanizes everyone in my vicinity. You can’t help but think, I’ll have what she’s having.

  But at some point our conversation evolves into pure self-expression because my ideas become too scattershot to follow. That’s when things begin to shift. Where you once felt engaged in an intense rapport, you now feel left behind. This gives way to an unsettling sense that something is off, something doesn’t quite feel right. You realize you’re no longer a participant in a dialogue, but strictly an audience for my grandiose proclamations and visions. You exist only as a vacuum to suck my words up.

  If you’re a stranger, you may decide at this point to exit the interaction altogether, and feel relieved if guilty about your escape. Don’t worry, I probably won’t even remember our encounter. But if you’re a loved one and are committed to seeing this through, then you should be aware that you’ve now crossed into dangerous territory. As with any risky expedition, it’s important to know the obstacles ahead and steer clear of them whenever possible.

  Let me draw you a map, so you can avoid the worst patches of quicksand.

  In mania, people are drawn to speed and excitement and anything rash. So keep me away from riptides and the edges of cliffs, both actual and metaphorical. Do your best to stop me from drinking or driving or dating (there are no sexual limits in mania). Shopping—especially online shopping because it’s instant gratification—is particularly fraught and should be actively discouraged. This can be hard because money feels like an infinite resource to me then, however strained my finances may actually be. I shower it on everyone: valets and waiters get jaw-dropping tips. I may give my entire wallet to a homeless person on the street, but not without first eliciting his life story and communing with his universe.

  Maybe you’ll get lucky and be able to redirect my raging seductiveness toward you, assuming you’re my lover already. But don’t make the mistake of submitting to my advances if we’ve only ever been friends. You’ll probably enjoy it, but regret it later. Try to shift my focus to something that uses up my excess energy but doesn’t get me into trouble—like writing the Great American Novel, or cleaning my house (or better yet, cleaning yours). Any kind of organizing is great: filing in particular attracts manic people like flies; it’s a real buzz. Music, of the right kind, can also calm turbulent passions. Avoid the Sex Pistols, bring on the Bach.

  Mostly, I shouldn’t be left to my own devices—and that’s where all the trouble starts. You have to explain to me why I can’t just follow my impulses, and that means using the loaded phrase, “Because I think you’re manic.” Telling a bipolar person she’s manic is like telling a falling-down drunkard he’s had enough. True, perhaps, but them’s fightin’ words. I’ll resent you and hate you and not hesitate to tell you so, loudly and in public. I’m a real challenge to be around then, although I’ll eagerly debate you on that: I’m right, you’re wrong, and my trump card is, you don’t know what it’s like to be bipolar so shut up.

  So why are you still hanging around? Is it worth all this energy and aggravation to save one soul from herself? This is where you have to know your own limits, and be the conscience and the memory of the relationship. You have to understand that none of this outré behavior is volitional, even if it looks like free will run riot. It’s the symptom of an illness, a nightmare that must and will come to an end… But where? In a foreign country, or in some stranger’s bed? By intervening, you protect a sick person’s safety and dignity. It’s a noble act, however little it may be appreciated at the moment.

  Ultimately, the best counsel I can give you for dealing with someone who’s flagrantly manic is to put up storm walls when symptoms aren’t present. Make a solemn contract with your loved one that if things get too out of hand, it’s okay for you to call their doctor—and make the doctor aware of this in advance. Get the person to write down ahead of time: “I give you permission to tell me I’m manic.” With this blind trust comes an inherent promise that you won’t use their illness against them, ever. You promise to fight fair.

  In truth, it’s very hard for me to know with absolute certainty what it’s like for you when I get manic because I’m too flooded by my own sensations to take anyone else’s into account. The foregoing is based on hearsay, and while I trust my witnesses, I can only see the situation from my point of view. I accept that it’s a difficult undertaking. I accept that it’s a severe test of tolerance. But after a lifetime of relying on the courage of others to protect me, I have to admit: I don’t believe in tough love. I simply believe in love. It’s the only reason I’m still here.

  TELL ME WHERE IT HURTS

  When you’re depressed, it often feels like nothing anyone can say will make any appreciable difference. And sometimes that’s true. When you’re really, really down, you simply can’t take it in: your ears are too full of other sounds, harsh grating noises only you can hear. But one thing truly does make a difference. I’ve written about this time and time again, but I’m going to keep repeating it until I think it’s finally caught on.

  Have your loved ones say these five little words: “Tell me where it hurts.”

  I’ve begged everyone around me to please, please remember that simple phrase. Don’t tell me I’m imagining things. Don’t remind me that a few weeks ago I was all moonbeams and lilies. Don’t recommend your homeopathic remedies, your cat videos, your diet, your faith. Don’t tell me about your sister’s best friend’s boyfriend’s niece, who was cured by Pilates. Please, if you love me, just say, “Tell me where it hurts.” Then sit down and really listen.

  Granted, it’s not an easy option, but it’s essential if you want to help. There’s something surprisingly healing about spewing forth the poison that’s been brewing inside, the acid corroding the soul. When darkness hits the light it can’t help but evaporate a little bit, and sometimes that little bit can mean the difference between giving up and going on.

  I know this runs contrary to every impulse. It’s human nature to flat-out refuse to hear that life is no longer worth living. It’s human nature to contradict someone when they tell you there are no options left. But do your best to suppress that urge because you’ll only stoke the fire. Depression thrives on proving everyone’s wrong, that the world is a genuine cesspool. And believe me, depression’s a wily beast, because it isn’t bound by reason. It’s capable of convincing the Pope himself that life is nasty, brutish, and short.

  “I love you and I want you to live” is a fine response to whatever you hear, no matter how many times you have to say it. Love isn’t constrained by logic, either, and sometimes it’s able to sneak past vitriol and seep straight into the heart. Maybe not right away, but in the nick of time. “I love you and I want you to live” is one of those phrases I’ve found myself remembering in the dead of night when I’m about to start counting out too many pills. It makes me pause for just that moment it takes to breathe another breath, then maybe another, until I find the infusion of air I need.

  A word of caution: The veneer that separates depressed and so-called normal minds isn’t that thick. If you ask a severely depressed person where it hurts, you’re almost certain to hear things that will frighten you, truths about life that in polite company almost always remain unspoken: like how helpless we all are against the unknown, and the inevitability and imminence of decay. Some say this harsh realism is what made depressives like Abraham Lincoln and Winston Churchill such great wartime leaders. Their vision encompassed not just glory, but gore.

  So proceed with care, but don’t let it stifle your compassion. Remember why you’re asking where it hurts: because you want to lessen your loved one’s pain. That goal is so exalted it will strengthen and protect you. Love may not always be wise, but it’s one hell of a weapon—and never forget, this is war.

  IS DEPRESSION THE
NEW PLAGUE?

  When a bad depression looms, it’s like seeing that tornado in The Wizard of Oz coming straight at me. My very first instinct is to jump into my imaginary basement and hide for dear life. It’s soothingly dark in the basement; best of all, I’m alone. No one can ask anything of me—I can’t hear the phone or the knock on the door or the computer’s nagging alerts. It’s just me and the fear and the frenzy, at least until it passes and it’s safe for me to emerge again.

  For years, people have complained about these extended absences I take from life. But my avoidance still seems worth it to me—more than that, it seems inescapable. When I’m depressed, I can’t engage in meaningful conversation. In truth, I can hardly speak. If you’ve never been seriously depressed, I doubt you’ll understand this. If you have, you’re probably nodding. At my most depressed, I’m Garbo-esque: I desperately want to be alone. But I also want—I need—to know that I’m loved, that somebody out there cares about me no matter how convinced I am that I’m the dregs of the earth and warped at my core and don’t deserve to breathe. It’s taken me years of therapy and countless mistakes to make this blatant contradiction work. Here’s a quick summary of what I’ve learned:

  First of all, it’s up to me to send a short message to the people who might be concerned about me, saying, “I’m going through a depression. I’ll be back in touch when it passes.” That may sound easy, but it takes enormous willpower to write those two trifling sentences—because it means that I’ve finally admitted to myself that I’ve crossed over to the dark side, that it’s back again and I’m about to be imprisoned in Oz. This is a terrifying realization, hence I usually never get around to writing that all-important communication until things are at their bleakest.