Notes on a Banana

by David Leite

  “May I borrow this?” I asked Rachel.

  “Of course.”

  That afternoon while Alan was at work, I slipped under the covers of our bed with the book. Somehow, I’d needed the safety of our home to face Jamison’s words. Ariadne curled up against me in that upside-down way she had, like Rusty had so many years before. When I was done, hours later, I picked up the phone and dialed Rachel.

  “I think I’m manic-depressive.”

  A very long pause. “Bipolar disorder is a serious diagnosis. If I were you, I’d be very careful about whom you talk to; there are consequences to something like this.” My medical records, she explained, would forever show I was manic-depressive, which could be reason enough to deny me life insurance and disability insurance, affect employment, and more. “Are you ready for something like that?”

  I was too worn out not to be.

  I sat in David Lindsey’s office, with my own copy of Jamison’s book on my lap. It was the first time in months I’d felt good in a session. “David Leite, you are not manic-depressive,” he said.

  “But there are so many similarities,” I protested, offering the book. “You should read it.”

  “I don’t need to read it.” He said that, yes, there had been times when I’d walked in wired and spoken of effortless flows of creative ideas, as well as times when I had looked and sounded depressed, despite my refusal to acknowledge it. “But that doesn’t necessarily make you manic-depressive. I’ve behaved like that, and I’m not manic-depressive. Now, if you want to tell me you think you suffer from a depressive disorder, I’m all ears. That I could see, and I’ve been saying it till I turned blue in the face. But I haven’t witnessed one episode of mania in all the time you’ve been coming here—unless there is something you’re not telling me.”

  I persisted: “I really think I might be.” One thing David Lindsey did better than Dr. Copley or Kim Mueller was protect me from myself. He’d helped me see that I always harbored a secret belief that I was sicker, more frail, more broken, than I was. There were times I was willing to abdicate myself, or as he poetically described it, “You’re all too quick to throw up your hands and fall through your own asshole.” But he was wrong this time.

  “Don’t you think if I’d smelled even a whiff of mania, I would’ve said something?”

  “Of course, but—”

  “Have you written a novel this thick”—he held his fingers several inches apart—“from start to finish in two weeks?”

  “No.”

  “Well, one of my bipolar patients has. Have you spent entire nights cleaning your apartment—ceiling to floor—washing walls, waxing floors, using a toothbrush to clean the grout and moldings?”

  “No.” I was almost belligerent.

  “Another bipolar patient. These things are all about degrees, about where you draw the line.”

  “But David Lindsey—”

  “Look,” he said gently. “I’m willing to consider it, but you’re going to have to prove it to me.”

  Veneta swirled in my chest. But it was the good kind. The kind that propels, rather than destroys. The kind that, when focused, is unstoppable and magnificent. “Fine,” I said. “I will.”

  My self-diagnosis made sense. Manic depression was that single, elegant Theory of Explanation I’d been searching for since I was a kid that summed up everything. I’d suspected it; the book confirmed it. Nothing before had ever made so much sense to me. Nothing. Now, I had to find a way for it to make sense to him.

  There’s a yellow-and-black sign on the corner of West Seventy-Second Street, high above Gray’s Papaya. It reads, “Depression is a flaw in chemistry not character.” It offers an 800 number to call. I had looked at it every time I went to the subway, disgusted that it gave an easy out to people who didn’t have the balls to deal with life. Blaming your mood on chemistry was just another way of exonerating unfinished projects, failed marriages, people with rotten dispositions. But now, after having read Jamison’s book, I secretly hoped that the sign was true, and that it might be true of me. Maybe I wasn’t broken. Maybe I just had bad chemistry.

  33

  DIAGNOSIS: MENTAL LITE!

  Neil De Senna was a professor of psychiatry at Columbia University Medical Center. He was also an acquaintance. Alan and Neil’s wife were friends, which is why it hadn’t dawned on me to reach out to him for a psychiatric evaluation. I only knew him sitting across tables filled with half-empty glasses of wine, plates pushed back, as I licked my fingers and dotted the tablecloth to pick up the last crumbs of bread.

  “Yes, of course,” he said over the phone. “Meet me at my office.”

  I settled into a chair across from him. I was suddenly glad David Lindsey had asked me to prove I was manic-depressive, because if I was it would be something I had discovered, and that could never be taken from me. I’d walked into a shrink’s office, not unlike this one, when I was fourteen, looking for answers. I couldn’t think of a better way to honor the courage of that scared, freaked-out kid.

  Neil turned to me, pen hovering over a pad. Here we go.

  Did I ever have rapid, repetitive thinking?

  Yes. I told him about all those times in the shower, or walking to work, or lying in bed awake, the force building in my head as so many thoughts and ideas pressed on one another, like a trash compactor, threatening to crack my skull.

  Did I ever talk fast, sometimes so fast people couldn’t understand me?

  “They called me Chatty Cathy in high school,” I said. When I was in our senior plays, I’d had to work with a woman to slow down my speech. She wasn’t successful. “Yes.”

  Had I ever been so irritable, I shouted at people or started fights or became violent?

  The cop came to mind, of course. But there were also all of the arguments I instigated with my parents, Alan, friends. Then there was the time I’d bitten my cousin Barry so hard he was bleeding. “Yes, plenty.”

  Had I ever had a decreased need for sleep? If I slept just a few hours, did I feel great?

  He nodded as I recounted the four to five hours of sleep I’d gotten at CMU and Hunter, and even at Birch Grove summer camp.

  Did I ever engage in risky behavior that endangered my life?

  I hesitated. Neil was a friend, someone I would see again socially. Did I have to be completely honest? Screw it. I told him of my adventures of the flesh at the gym. It isn’t like I’m the only guy doing it was how I had justified it to myself. The steam room and sauna were packed with bodies, giving new meaning to the term “cheek by jowl.” It had never occurred to me it could be part of some larger issue, something that had nothing to do with being queer or horny.

  I looked up. He met my gaze, level and nonjudgmental. “Next question, please.”

  Had I felt unusually self-confident in myself and my abilities? Did I ever experience grandiosity?

  Let’s see, where to start? Believing I could direct a film based on an F. Scott Fitzgerald story, when I knew nothing about directing? Or film? I’d say yes. Thinking I was part of a divine group of people chosen by God to protect the planet would certainly count. Since I’d been a teenager, I’d started small companies only to abandon them when I lost interest, or when it finally dawned on me I lacked basic business acumen. And there was that time I’d finagled my way into an important position in advertising when I wasn’t qualified.

  Then came the questions that made me queasy: Had I ever had morose, violent thoughts?

  I explained imagining vomiting on people, plunging knives into their rib cages, cutting off my fingers with a cleaver.

  Had I ever contemplated suicide?

  A quiet “Yes.”

  Had I ever attempted it?

  “Thankfully, no.”

  Had I ever lost interest in things because nothing gave me pleasure? Were there times when I was very interested in being with people, and other times when I wanted to be alone? Did I have crying jags, anxiety and panic, trouble falling asleep or staying asleep, bad
feelings about myself?

  Yes. Yes. Yes. Yes. Yes. Yes to it all. David Lindsey had been right: I’d been depressed, many times, and seriously.

  As Neil questioned, I could feel something give inside, like those push puppets, their muscles elastic strings running through limbs and body, and when you press on the bottom of the toy, they collapse. I didn’t have to strain anymore, always bracing for impact. My mind was lighting up, new connections and relationships suddenly shaking hands.

  It was a long evaluation. When it was over, he said, “I think it’s safe to say you have bipolar disorder. Specifically, bipolar II.” He said the medical community no longer used the term manic depression. It felt it was stigmatizing.

  He explained that there are two types of bipolar disorder. Bipolar I is the more severe form, what Kay Redfield Jamison, the author of An Unquiet Mind, has. In it, the manias are screechingly amped up and oftentimes dangerous. They’re emblazoned with inflated self-esteem and billowing grandiosity, a marked decrease in sleep, a pressing need to talk, sometimes with odd features such as “clanging,” where speech loses meaning and follows a pattern of rhymes or sounds. Someone suffering from full-blown mania can be grossly distracted; battle racing, looping thoughts; and engage in potentially dangerous and deadly activities, such as unchecked buying sprees, risky or anonymous sex, foolish business dealings, and reckless driving. All the while, psychosis—a disconnection from reality—can be skulking in the background, just waiting for a pause, an opening. These manias can disrupt a person’s life to such a degree that jobs are lost, relationships implode, families disintegrate. Hospitalizations usually follow.

  “What you have, bipolar II,” he continued, “is a milder form of the illness.” While the depressions can be just as deep and disabling, he said, what makes the difference is the quality, degree, and length of the high times. With bipolar II, a person suffers from hypomania. Elevated, expansive moods that are seductively attractive to the sufferer and the people around him, hypomanias are a watercolor version of bright-neon manias. Through it all, life isn’t disrupted to the same degree, and there’s never a psychotic break. Hospitalizations aren’t common.

  “It can be very, very difficult to diagnosis hypomania,” Neil said. “Especially in type-A people who are normally goal-oriented, high energy, and creative. Their personalities can mask the illness at times.”

  “Where on the continuum do you think I fall?”

  “From what I’ve seen of you at dinners and parties, you’re very high-functioning, and my gut is you’re probably more on the depressive end of the spectrum, with occasional periods of mild hypomania.” It’s all a matter of degree.

  Then he joked, “I’m envious. I wish I had a jolt of hypomania once in a while. I could use it when I’m on deadline for writing a grant.”

  I smiled, I think for the first time that afternoon.

  “Here’s the name of a colleague who might be a good match,” Neil said, writing on a prescription pad. He handed me the paper, and I slipped it in my pocket. As with all the other psychiatrists I had seen, Neil’s guy dealt only with medication management. “So if you want to work through this in therapy, which I recommend, you should continue with your shrink,” Neil said.

  It was hard to look him in the eyes. “Thank you.” He nodded. I would like to think he understood what he had just done.

  Sitting on the subway hurtling back home, I could feel the relief that I was finally understood, demystified, and categorized being edged out by sadness and veneta. How could it have taken twenty-five years, and more than a half-dozen doctors, before a proper diagnosis was handed down that explained what was wrong with me, as far back as that dark movie theater in Fall River? There was Dr. Copley. Had there been signs then? I think so. He knew that I heard breathing and saw that demon face in the window. He knew of those blissful times in high school when, without reason, a heavy, musty tarp lifted, and I could breathe again and everything became easier. And Kim Mueller of the Eames Chair? She’d definitely seen me down, although I have no recollection of her ever uttering the word depression. She most certainly knew of the Magical Mystery Tour I took in the Carnegie Library, when I came to believe I was one of God’s Elite Task Force. Her response? Nothing. She was tying herself into knots, trying to get me to admit I was punishing my mother by being gay.

  What of Jack Constantinides, Dr. Orenstein, Dr. Patronization, and a few others not worth mentioning? All of them medical professionals—board-certified psychiatrists—trained in differential diagnosis: the art and science of distinguishing between conditions that share similar symptoms. Even after evaluations as long and as detailed as Neil’s, they had all come to the same conclusion: anxiety and depression. No surprise there. They had expected to find anxiety, because I’d walked in telling them I was riddled with it. They were sure they’d excavate depression because of what David Lindsey had told them over the phone even before I said hello. I hadn’t been withholding information—they’d never asked the frigging questions that had needed to be asked. They hadn’t gone deep enough into me, their patient, the person who was paying exorbitant amounts for their expertise. They’d stopped the moment they found what they expected. Then they’d treated the symptoms, not the patient. Scripts had been dutifully scrawled for benzodiazepines and SSRIs, and when the anxiety and depression hadn’t evaporated as they had assured me they would, they weren’t just flummoxed; they were annoyed. My lack of psychiatric response was looked upon as a challenge to their unassailable medical authority. It wasn’t just David Lindsey who had missed the mark—it was every doctor I’d ever seen.

  As I turned onto West Seventy-Seventh Street, I remembered Dr. Bercoli, Neil’s colleague, and stepped off my soapbox and into hope. If he was half as kind and insightful as Neil, I would be in good and, finally, medically responsible hands.

  That next week, I sat in David Lindsey’s office, smug, and began flaunting the proof he’d demanded, even though I knew he’d already spoken to Neil.

  “Before you start, I have business I need to clear up.” He scooched forward in his chair, like he wanted to whisper a secret. I did the same, so our knees were almost touching. I’d never seen him so vulnerable. “I failed you. I apologize. I hope you can forgive me, and that we can work through this together and focus on getting you well.”

  He was making hating him so hard. Isn’t this what he’d always taught me? To take responsibility, to admit when I was wrong, to change my behavior? These weren’t just words filtered down to me from a twelve-step program he’d been in for decades; it was how he lived his life. His humility gutted me. We sat there, both crying. Both waiting, unsure of whether our relationship was over.

  I was the first to lean back. To begin again.

  PART III

  PROPHYLAXIS

  REFERS TO THE MEASURES TAKEN TO PRESERVE HEALTH AND PREVENT THE SPREAD OR WORSENING OF AN ILLNESS. OTHERWISE KNOWN AS BETTER LIVING THROUGH MEDICATION.

  34

  SHITS AND GIGGLES INC.

  It was as if I’d been handed a giant Christmas present, but after opening it had discovered it required big-ass assembly. I didn’t know how to wear this official mantle of bipolar disorder, which I preferred to call manic depression—it was more exact and descriptive of what I felt. At times, I was elated. Whenever I went up to Alan—we were back living together by this time—I’d say, “Do you realize you’re in love with a crazy person?” I think it was my way of getting comfortable, test-driving the diagnosis to see how it fit. I suspect I was also testing his limits, to see if he would finally run, giving him ample reason if he did. But at other times, I’d be horrified that my greatest fear, which I had carried around in a hard, shiny place deep inside since I was a kid, was true: I was mentally ill.

  While I waited to see Dr. Bercoli, David Lindsey and I decided my course of action should be to tell the people closest to me. Although this was the second time I would come out, it was by far the hardest.

  “Mom,” I said into the p
hone. Alan stood next to me, holding my hand. “Can you put Daddy on the extension?”

  “Why? What’s the matter?” It was her panicky voice.

  “I’ll tell you in a minute.”

  “Mannnnn-nnnnny!” she shouted, I assumed into the backyard, where he was tending his grapevines.

  A click as he picked up. “Hello?”

  How do you tell your parents something like this? I explained that I had been feeling really poorly for a long time, and had gone to a doctor for an evaluation. “I was diagnosed with manic depression.”

  “Manic what?” my father asked.

  “Manic depression,” I said. “They also call it bipolar disorder.” I gave a lay definition: mercurial moods, anger, irritability, sadness, fast speech, everything. I heard my mother weeping.

  “Why are you crying, Ma?” I tried to hide my exasperation.

  “Did I do this?” It was matter-of-fact and martyr-y.

  “This isn’t about you, Ma,” I said. “This is about me.” Alan pulled me back somehow. Blowing up at my parents while floating the idea that I’m mentally ill by them wasn’t exactly the best timing.

  “How do you get this, this bi-polo sickness?” my father asked. His voice was smooth and even, oil on her turbulent high seas.

  “It’s hereditary,” I said, then waited for the sobs. “They say it’s often from the mother’s side.” Right on cue.

  “I’m sorry.” She gulped into the phone.

  “Ma,” I said softly, “unless you can control your genes, you had nothing to do with it.”

  “Son,” my father added, “do what you have to do to get well.”

  “I will.”

  For my first appointment with Dr. Bercoli, I arrived early. Too early. Sitting there in the waiting room, I reviewed the list of questions I wanted to ask him. The first was: How does anxiety fit into all of this? I had an idea, because I had read Patty Duke’s book A Brilliant Madness, in which she outlines her illness, from her childhood to being in her midthirties and finally being properly diagnosed and treated.