She sighs, writing the order in my chart. "I think you'll find the Prozac will help your depression a great deal. It has almost no side effects."
"Except the one where it makes a lot of bipolar people psychotic!" I tie myself into a tighter knot in my chair and chew my knee in frustration.
"You know," she says, glancing up, shaking her head and looking concerned, "I read your first book. I am just really sorry that you had such bad experiences with therapy and psychiatry. That's really uncommon." She looks totally baffled.
I stare at her. "Right-o," I say.
"I see here you've been having trouble sleeping. Do you want something to sleep?"
"I take trazodone. It works okay."
"Why don't I put you on Ambien?"
"Because I'm an addict and I'll start abusing it. Doesn't it say that in my chart?"
"Yes. I'm sure you won't start abusing it." She writes an order for Ambien in my chart. Now I'll have everyone staring at me tonight while I argue with the nurse about whether or not I'm going to take my meds. I feel like throwing the DSM-IV at her and telling her to look up Axis I: bipolar disorder; Axis II: substance abuse.
"I won't take it."
"So you're saying you're going to resist treatment." She sighs dramatically.
"No. I'm saying I'm going to continue the treatment my doctor has laid out for me."
"What about your depression? I don't think he's really looking at your depression. Untreated depression is a terrible thing. In fact, I suspect your eating disorder may have reemerged because you are very depressed."
"I'm done now," I say. I untie my legs and shuffle out of the office and down the hall to Snack. I hate the world.
I get discharged in December. I've broken the cycle of the eating disorder and remember how to go back to living without one. The mania, too, has broken. I feel like I'm broken myself.
But I do my best. I go home to my empty condo, buy some real food, and eat like a normal person. I pay the bills that have piled up, return the phone calls, get back to work. I write the lectures that I'm scheduled to give at a couple of universities in February and March.
It's winter. Winter brings the blues. I'm afraid of them coming, and I know they will. My only hope is that I can get through the winter without going back to the hospital. If I can do this, then maybe I can stop hating myself. I think, if I just keep going, keep doing what they say, take the meds, go to sleep, use the light box, get out of the house, get some exercise (as opposed to working out four hours a day), eat enough, try to avoid stress, then maybe I can do it.
They don't tell you how to manage grief. And I miss Jeff so much it's killing me.
But there's nothing I can do about that now. All I can do is keep going forward. Maybe this way I can make it to April. Just this once.
Winter 2006
Seven A.M. I wake up in the dark. There are so few hours of daylight—the sun will start to fall at about three o'clock in the afternoon, and it will be fully dark by four. It is hard to want to leave the house, or work, or live, in Minnesota during the winter months. The suicide rate goes sky high. All over this snow-blanketed city, there are people who lie in bed well into the flat gray afternoon, turning this way and that, slogging in and out of sleep. They may drag themselves up around dinner, when a spouse or partner comes home; they may attempt to dress, or they may not. February is the worst for me, but it's not February yet, and today I am hoping to spend the hours of light at my desk, trying to pretend the lack of sun isn't pressing in at me, pushing me into catatonia, a failure of the will to live. And so:
Eight A.M. I go into my kitchen. Take my handfuls of meds. Take the supplements they tell me will help. Take anything they tell me to take. I eat the food they tell me to eat; a little protein, they say, takes the edge off the anxiety, the ever-present morning fears. I go into my office and turn on the light box, which blasts a blinding fluorescent light into the room. I stare at it, drinking my coffee, for the allotted half-hour—enough to block the depression, with luck, but not so much that it will trigger mania. The balance in winter is hard to strike. All these years, every winter I've slipped into a mixed episode, a devastating depression coupled with the frenzied, chaotic energy of mania. This is what we are trying to avoid. I am not certain I can. I doubt it. But I have a little hope. And so:
Nine A.M. I sit down at my desk to work. I'm not writing well, but I'm only writing for myself. This is to make me feel functional, a feeling I lost during those years of total disability, so that at the end of the day I can feel good about the fact that the day did not pass me by. They want me to be functional. My doctors' goal, ultimately, is for me to return to a normal life—well, not return, for I've never had such a life, but to build the skills that will help me function at a level acceptable to me. They know that my functioning may have been damaged by the severity of the episodes over the past few years. I'm still holding out hope that I will return to those two good years when Jeff and I were first married—the constant parties, the spotless house, the boundless energy, the endless, unstoppable work. They have tried to tell me that I might not have that, and even that it might not be desirable; they are trying to explain to me that such a life may be exactly what triggers the episodes. But I don't want to believe it. I believe that life is normal. That, to me, is functioning. I don't listen when they say I might have to adjust my expectations for myself. To me, this sounds like You will have to accept failure. You will never be good enough again.
Ten A.M. to six P.M. I work like a demon. I work, and work, and work. At the end of the day, I don't know what I've written, or how much. It almost doesn't matter. What matters is that I am still writing. I am still able to get up and do my job every day. Every week the doctor asks me if I'm working. If I am, he's pleased. If not, he worries. For me, the first sign of oncoming madness is that I'm unable to write. I stare at the computer, type a few lines, delete them in increasing despair. I believe my mind has dried up, that I will never write again. Most people would call this writer's block, and that's partly what it is—if only it didn't also signal the beginning of something else, to wit, the loss of my ability to function. When my mind leaves the room, the words are the first things it grabs on its way out, leaving me at my desk, terrified, hating myself, dreading what's next. And so, today, I write as if my life depends on it, because right now it does.
Six P.M. I go to the gym. They tell me the gym will help stabilize my moods—the adrenaline and the dopamine rush that exercise triggers will level out the rises and falls, interrupt the cycles that can lead me into and out of episodes and extreme moods. They tell me it will make me happier. They tell me it will decrease the ever-present, crippling anxiety. And that's what it seems to do. The only trick is talking myself into leaving the house. I've been in here peacefully all day, maintaining my marginal grip on the world outside of my house and head; but now I have to get dressed and go out into the freezing cold dark. I force myself out of my chair, bundle up, and drive to the gym, skulk into the workout room, onto the treadmill, glancing around me to see if anyone's watching. On good days, they aren't. On bad days, I know they are, and I am terrified of them. Dr. Lentz says no one is watching. So I say to myself, chanting along with my footfalls as I run in place, No one is watching, no one is watching, all's well, no need to worry, level the mood swings, increase self-image, protect against episodes, you need to be here, and I finish my run—and I am elated, out of breath, feeling alive, feeling at peace. It works every time. When I do it every day, the peace builds up, and I go through the day not quite so crippled by anxiety as I usually am.
Eight P.M. I'm eating dinner when Jeff calls. My heart freezes in my chest when I hear his voice, then starts up again. I can hardly understand him. He's crying. Sobbing, really, hysterical. I drop my fork and it clatters on the floor. I stand up but then am paralyzed and can't move. My throat closes. I want to hang up. I want to help him. He's living in a hellhole, his—our—house is trashed, filthy, full of boxes and the detri
tus of the three renters who've moved in in my absence. He is hiding in a ten-by-ten room with windows that don't close all the way, and the icy wind gets in, and he shivers there, under the covers in bed in his clothes. His room is full of dirty dishes, he's compulsively spending money on things he doesn't need, things that arrive and are abandoned wherever they land, the kitchen, the bathroom, the hallway, towering stacks of boxes, a thick film of dust over it all. I've only been there twice since I left, and it made me incredibly sad and worried for him; he's slipped into the depression that has dogged him all his life and that was violently set off when we split, and now we are quite a pair, crazy as hell and deep in sorrow and fear. I stand frozen in my kitchen, waiting for him to take a breath, but he doesn't—Jeff. Jeff, you've got to stop for a second, I can't understand you, what do you want? Are you all right? And obviously he is not all right. Can I come over? he begs. And I say yes.
Nine P.M. Jeff is in a ball on my living room floor, rocking back and forth. I am terrified. I think he may be suicidal. I am numb. I cannot force myself to feel. I hate him for being like this. Finally, with an enormous effort, I make myself go over to him. I lie down on the floor at his back and curl my body around him. I say, Let's get off the floor. Let's go to the couch. Is that okay? And, his face tortured and red and wet with tears and snot, he nods and gets to his knees and crawls over to the couch. He lies down and I put his head in my lap. He is screaming in pain, incomprehensible strings of words pouring out of his mouth. Can't take it is all I hear him say. Need you, I hear. And then he loses the power of speech again and dissolves. I don't know if I should call an ambulance. I want him to be safe and I know if he leaves he will not be safe. But he won't let me call, and he won't let me take him to the ER. Finally I convince him to stay with me. His breathing slows. He nods. He falls asleep. I sit there with his heavy head in my lap, staring down at his face. I feel nothing. I know that I love him and want to help him, but we have grown so far apart. I don't know what to do.
One A.M. He sleeps heavily in my bed. I stand at the window, smoking, looking out. There is cloud cover—no stars, all black. I want to stay sane. We cannot both be mad. We can't end like this.
Two thirty-four A.M. I watch him sleep, his mouth open, peaceful at last. I don't know how, but right then I realize that we will make it. Our life will include mental illness, its absurdities and devastations, the laughter and destruction it causes, the level of functioning it allows. We will have to accommodate it. That is a great deal to ask. But it is the way it has to be. And I believe we are up for it.
Just not tonight.
Megan and I have coffee. I ask her what it's like to have a friend with bipolar. She looks at me, then at her hands.
"It's unlike any other friendship I have," she says. "In most ways, there's nothing different about it. You're just the way you are, and I accept that absolutely, and I don't think of you as crazy, and I don't feel like you're a burden, for God's sake, like you always worry about." She thinks a minute. Then she says, "But there's the one difference. With other friends, I'm not constantly aware that they could very easily die. With you, I am aware of that. I am always aware that you have come so close to committing suicide, someday it might happen."
"I won't," I say.
"I know," she says. "But you might. You could. And so I have to try to understand how I feel about that. And this is how being friends with you is different. I would be devastated if you died. Completely devastated."
She thinks another moment, trying not to look away from me. She is trying not to cry.
"But I would understand," she finally says. "I don't mean that I'm giving you permission. I just mean that I really understand how deeply and painfully you struggle. I won't let you do it. But I would understand if you did."
But I won't.
I won't.
February and March are difficult. The depression deepens past the point where I can wrest myself out on my own. Dr. Lentz puts me in outpatient treatment for a few weeks, and I sit in my little groups, nearly comatose. All I know is that I'm going to stay out of the hospital if it kills me. Lentz changes my meds, changes them again, finally resorts to another round of ECT. Between that, the Herculean efforts of family and friends, and my own pigheaded refusal to give up, I manage to keep enough of a handle on reality to stay out of the psych ward. Finally, the snow begins to melt.
And Jeff starts to emerge from his own hell. As spring begins, somehow the two of us are able to build a little closeness, a tentative trust, enough that we can lean against each other, staggering around inelegantly, but somehow on our feet, and together.
Spring 2007
I come bounding up the steps in front of our house: the lilac is blooming! I rush into it, fling my arms around it, bury my face in the heavy-scented flowers. I look over at the garden: the snow is gone, and the beds are bare but for the broken gray stalks and dead leaves that fall left behind, but the lawn is green, and a few bulbs have sent up tiny shoots, barely there, and there are two absurd yellow tulips, blooms bobbing in the soft spring breeze, leaves and stalks an urgent green. The tulips say it's spring, so I say it's spring. And with spring comes the joy that lives beneath the difficult times. The joy is an absurd yellow tulip, popping up in my life, contradicting all the evidence that shows it should not be there.
I open the door and walk through the house. Wide swaths of yellow-white light flood through the windows and fill the rooms. The groggy dogs glance up from their sun spot on the floor, glance at me, yawn, and flop their heads back down, exhausted by their miniature day.
This is my house again. We packed up the boxes and books from my condo and carted them back home. Jeff went on a mad cleaning spree to sweep out the dust, the boxes, the dirty dishes, the old newspapers, the broken stereos, the debris that filled the house while I was gone, and now it is clean, new, and there is room for us both. We circle each other, still uncertain, and laugh, startled, when we touch, when we speak. We are new. We do things this new way, a way we can't exactly describe, but a way in which we both seem to have enough space to exist. This is not another honeymoon. There is something serious underneath, a knowledge that things are fragile, incomplete, that things can be ruined and lost; and a knowledge that we will do anything to not let that happen again.
I wake up a little terrified every day. An old fear sends out shoots in my body that wind around my ribs, filling me with anxiety. But it will pass. As spring goes on, the fear will recede. I can almost remember a time in my life when the fear wasn't always there. I can almost imagine a life without it. The idea makes me a little dizzy; it seems so foreign, so unfamiliar, as if I wouldn't know how to live that way.
My new therapist tells me that I don't know how to live without crisis. She's right. I ask her questions: What do I do with my days if things are all right? How is it possible that one can get through a day without the rigid need for absolute perfection? What do you mean, "You let some things go"? How can I tolerate myself if I do something wrong?
"What do you mean, wrong?" she asks.
"Well, so, I almost had a perfect day the other day," I say. "I did everything right. I worked for hours. I paid all the bills as soon as they came. I unloaded the dishwasher right away. I picked up a piece of paper off the floor the minute I saw it. I went to the gym. And then it all went to hell." I flop back on her couch, defeated.
"How so?"
"I forgot to take the chicken out of the freezer!" I shout, flinging my hands in the air. "I totally fucked up!"
She laughs at me.
"Not funny!" I say.
"But it is," she says. "Do you know that normal people don't have to be perfect every day? I have never had a perfect day. I figure, at the end of the day, that I did pretty well, and that's fine."
"That's fine for you," I say. "But not for me."
"Why on earth do you get special rules? Are you so unique?"
"It's not that," I say. "It's that your pretty good is better than my perfect. I have to be p
erfect just to measure up. To be as good as someone normal. Just look at the last few years."
"You've been sick," she says.
"I've been a total fuckup. I couldn't do a single basic thing that normal people do every day without falling apart or having a nervous breakdown. Normal people just do things. It's not a big deal."
"So now you have to make up for it," she says.
"Yes!" I shout. "Exactly!"
"You don't, you know. You didn't do anything wrong. You were doing the best you could."
"And that wasn't good enough," I snap. "For example, I have this dentist, right? And he works downtown. But every time I have to go, I have a total meltdown and usually cancel. I've canceled my last four appointments. And then there was that day where I had a bunch of errands to run, and I got scared, so on the way here, I called you to cancel, because my meds were making me fall asleep, and I called to cancel the dentist, because I was giving up and going home. But then I felt better so I called you and the dentist to tell you I was coming after all. Then I went to get a manicure, but I fell asleep while she was painting my nails, so I called you and the dentist to cancel again. But then by the time I went out to my car I was feeling more awake, so I called you and the fucking dentist to tell you I was definitely coming. But then on the way to the dentist I got scared of downtown and the parking garage, so I had to turn around and go home because by then I was totally insane. Because I'm a complete idiot and I freak out over nothing. I don't like downtown. I don't like parking garages. I can't deal with a fucking parking garage."
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