Madness

by Marya Hornbacher

  "You have bipolar disorder."

  I sit there. "Is that the same as manic depression?"

  "The very same."

  "You're joking."

  "I'm serious."

  "That's crazy. I mean, manic depression: that's crazy."

  He shrugs. "Depends on how you look at it. I wouldn't say it's crazy. I'd say it's an illness."

  "Bipolar disorder," I repeat. "Do you take Prozac for that?"

  "Not a chance," he says. "You're right that the Prozac makes you feel crazy. I'm going to prescribe a mood stabilizer. It should help."

  My chest floods with a mixture of horror and relief. The relief comes first: something in me sits up and says, It's true. He's right, he has to be right. This is it. All the years I've felt tossed and spit up by the forces of chaos, all that time I've felt as if I am spinning away from the real world, the known world, off in my own aimless orbit—all of it, over. Suddenly the solar system snaps into place, and at the center is this sun; I have a word. Bipolar. Now it will be better. Now it has a name, and if it has a name, it's a real thing, not merely my imagination gone wild. If it has a name, if it isn't merely an utter failure on my part, if it's a disease, bipolar disorder, then it has an answer. Then it has a cure. At least it has something that should help.

  And then the horror sets in. All that time I wasn't crazy; I was, in fact, crazy. It's hopeless. I'm hopeless. Bipolar disorder. Manic depression. I'm sick. It's true. It isn't going to go away. All my life, I've thought that if I just worked hard enough, it would. I've always thought that if I just pulled myself together, I'd be a good person, a calm person, a person like everyone else.

  I think how impossible it seems that I have never connected the term manic depression—I guess they're calling it bipolar—to myself. For that matter, it seems impossible that they would never have applied it to me.

  What if this Beedle fellow is right? What if my good moods are the same thing as mania? And what if, God forbid, the lows are the same as depression? And what if manic depression means crazy? Well, obviously, it does.

  So. I'm crazy as a coot. Mad as a hatter. End of story. That's all, folks, now you can all go home. I'm sure, sitting here in the doctor's office, that there's no final cure for the truly insane. I am no longer young, wild, crazy, a little nuts. I'm a crazy lady.

  I knew it all along.

  "Went to the doctor today," I say, yanking the cork from a bottle of wine. Julian is sitting in the breakfast nook, reading the paper.

  "Are you sick?" he asks, taking the glass I hand him and glancing up at me before looking back at the front page.

  "In a manner of speaking," I say. "He says I have bipolar disorder. It's the same thing as manic depression."

  "Is it serious?"

  "I don't think so. But it sort of explains the last few months."

  "How so?" He sets the paper down and takes a swallow of wine.

  "The rages," I say, stirring something on the stove.

  "This was a psychiatrist you went to?"

  I nod. "Named Beedle."

  "Beedle," he muses.

  "Right," I say. "Anyway, he gave me a prescription."

  "For rages? What do they prescribe for that?"

  "Mood stabilizers." I look at the prescription slip in my back pocket. "Depakote. I think it's supposed to help, you know, sort of all around. With the moods. And things."

  "Ah yes," he says. "The moods. And things."

  "So I should be a little less crazy."

  "All right," he says, and bites into an apple. "When's dinner?"

  By the end of the evening a miracle has occurred, and I'm feeling fine. All those years of changing my thoughts! improving my attitude! have suddenly become very useful. By my second glass of wine, I have chosen a new perspective! as follows:

  Bipolar? Kind of an overstatement, but whatever. Just another name from yet another shrink. Interesting, but not really relevant to my day-to-day—after all, it's not like I'm sick. I'll take the meds, though—they'll get rid of the rages, and the afternoon lows. Back to normal in a jiffy, back to my usual good mood. And surely no one needs to know; why focus more on what a fuckup I am? They'll take it wrong and make a fuss. This is really no big deal. I'll be good as new.

  I'm immensely pleased with myself for changing my thoughts in this so-healthy way.

  ***

  My insurance doesn't cover Dr. Beedle, so he refers me to someone it does, a Dr. Lentz. I like him—he's mild, cheerful, seems awfully concerned. He asks how things are going; I've got to get rid of the rages and lows, so I tell him about those and he fiddles with my dose. He asks me, for some reason, how much I drink, and tells me if I drink a lot, the meds won't work, but since I'm not an alcoholic or anything, his question has no relevance.

  I'm delighted with these meds, and I usually take them. When I feel bad, anyway—that's what they're for, right? To cheer me up? It's those depressions I hate, and the rages, and the spinning thoughts—what I want is to hit that perfect high. That's my normal self.

  And I'm getting happier and happier all the time, working constantly, keeping the house spotless, throwing parties that feature gales of laughter and me at the very top of my game. These meds are a miracle! I tell him how much they're helping. Perhaps I'm a little too happy? Why, no! He raises an eyebrow as I babble on about how inspired I am, so I tone it down—obviously not too happy, I say, dismissing the thought with a wave of my hand. I'm just back to normal! It's summer, after all. This is the way I'm supposed to be! I'm always high as a kite in summer!

  I wonder what difference it might have made in my life if I'd taken my bipolar seriously right then. If I had, in fact, stopped to think about it. Maybe read up on it. Maybe learned something that might have changed the way I lived, something that in turn might have altered—maybe dramatically—the way the following years played out. I sit here now, writing these words, just out of the hospital for the umpteenth time this year. My vision is blurry, my speech is slurred, I can hardly keep my fingers on the keys. I'm not safe to drive, I can't make a phone call; I woke up the other day in a hospital bed, staggered out to the nurses' desk, and demanded to know how long I'd been there. "Eleven days" came the calm reply. "Eleven days?" I shouted. "What have I been doing this whole time?" The nurse looked at me. "Well, you've been sick," she said. That means I've been sleeping for days on end, when I wasn't running around like a demon possessed, and getting electroshock, and being wheeled through the ward with my head lolling onto my chest, and downing Dixie cups full of pills, and slurring through the haze of medication and chemical malfunction to my hospital psychiatrist (who is nothing short of a saint and who makes a regular practice of saving me from the vicissitudes of my mind), and falling back into bed again, and launching myself out, and running around; eleven days, twelve days, fourteen. It happens like clockwork, every few months. Hospitalizations lately: January 2004. April 2004. July 2004. October 2004. January 2005. April 2005. July 2005. December 2005. January 2006. July 2006. September 2006. October 2006. November 2006.

  It's April 2007. I haven't been in the hospital in six months. Okay, I was completely out of commission, living in my pajamas, moving from my bed to my office, sitting with my head in my hands, trying like hell to have one coherent thought, for February and March. But I stayed out of the hospital. I'm doing fucking great.

  For years after I was diagnosed, I didn't take it seriously. I just didn't feel like thinking about it. I let it run rampant, and these are the results. But what does it matter, what might have happened? What might have happened didn't. This is what did.

  The Break

  July 1997, Nine A.M.

  One hot, sunny morning, three months after I first hear bipolar disorder from Dr. Beedle, I am suddenly, floridly mad. Just like that. Mad. I am going along, minding my own business, when I find that I have gone completely over the edge. Why today? Who cares? I am not thinking a bit about that, because, as I said, I've gone insane and couldn't possibly care less why. You do
n't wonder, when you've completely lost it, how. You were going about your morning, and now you are mad, and you can't remember what it was like before. You will never really remember. Your life breaks in half, right there. Sure, I've been crazy before. I've been crazy all along. But this is different. This is fucking nuts.

  Because I haven't told Lentz about the suicide attempt in 1994, he's diagnosed me with bipolar II. Bipolar II is a little milder than bipolar I (though it's still hellish); bipolar II has more depressive episodes than manic ones, and when the manic episodes occur, they're not as severe. I don't know it yet but I'll soon find out: what separates bipolar II from bipolar I is a manic break. Bipolar I is harder to manage, harder to treat, and often, because of the extremity of the disasters caused by full-blown mania, more likely to mess up the patient's life. On this summer morning, I experience that defining break. I go from bipolar II to bipolar I just like that. A doctor might put it this way: I go from sick to really, really sick. For the average Joe, I go from having an illness "just like diabetes!" to being flat-out crazy.

  But I, cheerfully mad as a hatter, am entirely unaware that something has snapped and will never be put back together. Here we are: it's Tuesday, and now we are quite mad. Not mad as in moody. Mad as in under the impression that I am God.

  I am driving through the city. I am speeding. It seems that I have had a good deal to drink, to calm my nerves, for I am just a touch nervous. I woke up this morning and things were a little off. I went to the kitchen for a cup of coffee and stopped in the doorway. Glass covered every surface. I vaguely remembered throwing the coffeepot at my husband's head. Hell. No coffee. There was blood on the floor; I checked my feet, which were covered with shallow cuts that were more or less painless. I wondered absently if they really were painless, or if I was numb.

  It occurred to me that I had to leave immediately, and I went upstairs to collect my purse and shoes. I made it as far as the car when I noticed that I wasn't wearing any clothes. Oh, for goodness' sake, I thought to myself, and went back into the house shaking my head. I put on my blue-flowered sundress, and then realized I ought to shower, so I took a shower, and stepped out soaking wet, my dress clinging to me, and then there was a fold in time and now I am driving, very fast. I am downtown. I am speeding through a parking lot, honking at nothing. I run inside a building and find I am at my husband's place of work. I kiss everyone hello, despite their surprise (perhaps they are surprised because I am all wet?), and I babble excitedly and my husband calls Dr. Lentz and kindly escorts me back to my car and sends me on my way, and it is very important that I put on lots of lipstick, it's always good to look nice for an appointment with a shrink, it makes one look much more sane, and I am pacing in his office, Please sit down, Marya, really, would you sit down? Have you taken your meds? Are you suicidal? Have you been drinking? Does your husband know where you are? Did you drive here? No, you certainly cannot leave—

  Inexplicably, I am in the car again. From out of nowhere, Julian is here and is driving and I am bouncing up and down in my seat, we are going on an adventure! We're going to California! I want to move to California! Or New York, let's move to New York! I find a bottle of vodka under the seat and drink most of it because I am clearly a little agitated and shouldn't be seen like this, it's embarrassing. And now we are at a hospital. Why are we at the hospital? My husband looks worried. I am sitting on a gurney and they are taking my blood, which apparently I don't care for because I bat them away and shriek that they are invading my privacy and this is still America and they can't just do whatever they want. Then, for no reason I can see, I am being wheeled along a corridor. I say I can walk perfectly well and hop up and wheel the chair myself, though the person in the blue pajamas declines to get in; and they unlock a large door and we are in a safe place and they take my shoes.

  I sit here in the hospital room painted the shade of pink that is supposed to make people calm. I examine, enchanted, my feet in their blue hospital footies, while someone speaks in soft tones to me and says I am psychotic, but it's going to be all right. I put on my hat, unperturbed, and ask for some crayons.

  Unit 47

  Same Day

  "For all is well in our little tiny town," I sing, my hands a blur as I deal out the millionth game of solitaire of the night. I stand up in my chair, sit down in my chair, hop out of my chair, do a little Snoopy dance, my hospital gowns flapping about me like wings—I've grown inordinately fond of these gowns and am wearing several at once, "for dramatic effect"—and I sing the Snoopy song, stand on my chair again, imitating Snoopy as vulture, plop down. "I never did like Peanuts much," I remark to the catatonic man who sits across from me, "but when I was little my parents took me to see the Peanuts musical, and I liked that, but I thought it was kind of ridiculous that all the kids were played by grownups." I look at the man, who is just off an unfortunate suicide attempt, and, feeling bad for him, I climb onto the table and deal him a game of solitaire too, very pleased with myself for doing so upside down. I spit tobacco juice in a little cup, this nice man having loaned me some chewing tobacco since I am not allowed to smoke. "I don't mind that stuff," I say, my lower lip full of chew. "Here," I say, climbing off the table and coming around to the back of his chair, "old chum," I say, banging him on the back, "you play like this. You pretend that all the face cards are aces, and so when you get a face card you put it here, and then you go through the deck looking for all the twos or fours, which you use as wild cards, and when you do get an ace, or a joker, we're playing with two jokers, see, then when you, like I said, do get an ace, you turn the face cards upside down on it and call it a double ace, and after that you flip the cards upward, like regular solitaire"—I am leaning over him, my hands flying over the table like a blackjack dealer's, my arms on either side of his head, and I'm stacking the deck and shuffling the deck and stacking it and shuffling, and flipping up the cards—"and you start going for a flush or a full house." I fan out my hand, the result, apparently, of the above machinations, say, "See?" and pound him on the back. "It's very grand!" I cry, and go skipping down the hall, am shushed (nicely) by the very nice night staff as I skip by, skipping backward back to the desk; "You're very nice," I say, "I like you very much," and I skip on, skip straight on till morning.

  Dr. Lentz has explained to me that I'm having the good kind of mania, a euphoric mania. Everything is beautiful, simply gorgeous, I am talking a blue streak and what I'm saying is nearly incomprehensible, seeing as I'm dashing through a thicket of random thoughts so quickly no one can follow (it's called flight of ideas). I am grandiose, delusional, I'm flinging my body about; I am, to the casual observer, clearly possessed.

  It would seem I'm a textbook case. Every symptom of mania I could have, I have, in force: the extreme, minute-to-minute mood swings, rapid speech, the grandiosity, the impulsivity, the delusions, the feeling of complete invincibility, and the absolute conviction that certain untrue things are true. I can hear my thoughts zipping and whistling through my head, and see them snap and sizzle in streaking red lines on a complex grid that was designed by God and given to me personally; I am a millionaire high-society lady and should be treated with the utmost respect due to my superior station; my car can fly. These and various other ideas flash through my head, passing as quickly as they arrive. What causes them? I'm guilty of every precipitating factor you can think of—no sleep, gallons of booze, not enough effort to stick with my medication, a complete inability to grasp the seriousness of my diagnosis—and, it turns out, I have a disorder that has gone untreated for too long. But from my perspective, a manic break is a fine, fine thing, and I can't for the life of me imagine why everyone is so upset.

  The staff of this hospital, at least, is experienced and trained (and did I mention that I like them very much?), so my batshit state is nothing new to them. I'm on Unit 47, where they put patients who aren't capable of being responsible for themselves—the suicidal, the very manic or profoundly depressed, the schizophrenic during a severe episode of
delusion, and the variously psychotic. They dose me with a powerful antipsychotic, probably Zyprexa. It's a stopgap to get me down off the ceiling while, over the next few days, Dr. Lentz works on figuring out what kinds of meds and how much of them I'll need long term. I don't mind taking it, not at all—these people are lovely, absolutely lovely, and so nice! I'll do whatever they say.

  Dr. Lentz makes his rounds in the morning. He sits on a chair in the center of the room and I sit on the edge of the bed, bouncing up and down. I come in and out of the conversation. I stop bouncing and fall back on my bed. I sit up again. I fall back, sit up, and keep finding him still there, sitting on his chair. I leap to my feet and start striding in purposeful circles around him, studying him from all angles, walking in and out of the stream of light coming through the window.

  And still, here sits Dr. Lentz. Amazing. He has not moved. He is a compact, square sort of man, and his pants are hemmed too short and show his socks when he crosses his legs, and his hair is gray and dense like a thick-haired poodle's shorn short, and he wears dated glasses and has an almost beatific look of kindness on his face. He is completely calm as I whip around the room in a frenzy, babbling, questioning, wanting to know what the hell is going on. Elated as I am, I am also mightily disoriented, and Lentz's calm manner — Marya, it really is going to be all right. Would you like to sit down? No? Well, perhaps you could hold still for a moment while we talk. That's better. Now, I know the mania is lots of fun, but here you are in the hospital, and you don't care for that. So perhaps you should try taking your medication all the time? Just to see how it works? Here's what I'm going to give you—is comforting, and gives me some sort of compass with which to navigate the truly weird waters I'm in.

  I do understand that I am locked in, but I am feeling particularly magnanimous about it. Maybe I'll stay. Every time I can get myself to hold still, as I am practically levitating, I again tell everyone—Lentz, the staff, the other patients, all my visitors—how very much I like them, and how much I appreciate their concern, and that I am sure we will get this whole thing sorted out soon. Then I expound on my theories, of which I have not a few, and they are elaborate, extremely logical theories evidencing the sheer scope and connectivity of my thoughts, which, I explain, exist as a complex web in my head, in 3-D, that turns on an axis, thus showing more clearly the precise connections between, and activity of, my thoughts.