Shyness goes, the right words and gestures are suddenly there, the power to captivate others a felt certainty. There are interests found in uninteresting people.
Sensuality is pervasive and the desire to seduce and be seduced irresistible.
Feelings of ease, intensity, power, well-being, financial omnipotence, and euphoria pervade one's marrow.
But, somewhere this changes. The fast ideas are too fast, and there are far too many, overwhelming confusion replaces clarity.
Memory goes. Humor and absorption on friend's faces are replaced by fear and concern.
Everything previously moving with the grain is now against.... you are irritable, angry, frightened, uncontrollable, and emerged totally in the blackest caves of the mind. You never knew those caves were there. It will never end, for madness carves its own reality.
It goes on and on, and finally there are only other's recollections of your behavior.... your bizarre, frantic, aimless behaviors..... for mania has at least some grace in partially obliterating memories.
What then after the medications, psychiatrist, despair, depression, and overdose? All those incredible feelings to sort through. Who is being too polite to say what? Who knows what? What did I do? Why?
And most hauntingly, when will it happen again? Then, too, are the bitter reminders..... medicine to take, resent, forget, take, resent, and forget, but always to take.
Credit cards revoked, bounced checks to cover, explanations due at work, apologies to make, intermittent memories (what did I do?), friendships gone ordained, a ruined marriage.
And always, when will it happen again? Which of my feelings are real? Which of the me's is me? The wild impulsive chaotic, energetic, and crazy one?
Or the shy, withdrawn, disparate, suicidal, doomed, and tired one?
Probably a bit of both, hopefully much that is neither. Virginia Woolf, in her dives and climbs, said it all, "How far do our feelings take their colour from the dive underground? I meant, what is the reality of any feeling?"
Kay Redfield Jamison is a professor of psychiatry at the Johns Hopkins School of Medicine. Her most recent book is Exuberance: The Passion for Life. She was honored with a prestigious MacArthur Fellowship in 2001.
Excerpted from her book An Unquiet Mind
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Comments: 29
I'm bipolar and have never gotten myself into financial ruin.
The most expensive item I've purchased while manic, was a printer.
if you want to read it. I'm glad you posted this. Now I want to read Dr. Kay Redfield Jamison's work. ^_^
Life is so much nicer when you can relieve yourself of accountability, isn't it?
I've known more "sane" people who behave the way you describe in it than I have people who are bipolar or suffer any other mental illness. Those of us with brain disorders struggle minute-by-minute to accomplish what should come naturally to those without, yet on a daily basis I see the "healthy" behave with exactly the lack of self-control of which you speak.
I guess accountability is relative.
But when these people manipulate the system, go into and out of treatment because they know how to play the game, then go back and destroy the lives of people that love them, it's difficult to feel much sympathy.
Your two comments here are not just insensitive, they are inaccurate. Don't act as though you really believe that your experience is the scope through which all of us should be viewed. That is an arrogant, narrow-minded, and judgemental viewpoint.
You're not first hand. I am first hand.
I am Bipolar. Read my article.
I have never been in trouble with the law.
I have never suffered or caused financial ruin.
I have a happy, healthy marriage. My husband and I have been together for 10 years.
I am a mother of 1, mom of 3 happy healthy kids.
I have a job, at which I am training for management.
No one around me has had their lives destroyed by me.
I work very, very hard to keep the symptoms of my disorder from controlling my behavioral choices. I control my temper better than most "healthy" or "sane" people I know.
In the meantime
I have suffered and seen my family suffer as you have described, all at the hands of a "sane" person, whose life choices get paid for out of my family's budget. For 11 years this person has lied, cheated, stolen from us, slandered us, harassed us, torn at our family and our household's sanity, yet has never suffered a single consequence.
No one wants your sympathy, Dan, but if you can't take a more broad view, you should remove the words "open minded" from your name, as it is false advertising.
Also, if you are going to apologize for something, it should be an actual apology, not an excuse.
However, there are people very close to me who have hurt me and others in our family -- including their own children -- by their irresponsible acts. The laws don't help much. As you probably know, a 302 commitment generally lasts about 2 weeks, mostly because the person quickly learns the "system" and how to get out in as little time as possible. I just wanted to make sure that we acknowledge that it is not only the bipolar person who suffers.
However, to you I do sincerely apologize for my use of the broad brush. In retrospect it was cold and insensitive. And, as I said above, you are apparently working very hard to manage your ailment.
This could be ANYONE, it doesn't REQUIRE Bipolar Disorder to happen. A person can have any multitude of disorders, or be able to mimic those disorders, and cause this to happen. Being bipolar doesn't make you a sociopath, which is the behaviour that says
"I'm the most important person in the world, and I don't have to be worried about how my actions effect other people, because they don't matter."
Try looking outside of your own little world for some perspective before you decide to degrade an entire set of people.
It's important to realize that bad behavior doesn't just happen with Bipolar Disorder, and also that Brain Disorders in general often get misdiagnosed, as a fair number of them have some symptoms in common with each other.
It can take years of treatment before an individual receives an accurate assessment of his or her symptoms and is able to receive proper treatment. This means that some folks may suffer the full symptoms of a disorder for longer than they have the strength to manage them before they receive any actual help.
Another issue with treatment which can perpetuate a cycle of bad behavior/hospitalization/release/return to bad behavior is the very same thing which can perpetuate the cycle substance abuse/detox/sobriety/falling off/return to abuse. It is vital to the health and well-being of those close to a person with a Brain Disorder, as well as to the sufferer of the disorder, that we not confuse understanding of the symptoms with a need for tolerance of abusive, self-destructive, or otherwise damaging behavior. Abuse is not the victim's fault regardless of the perpetrator's state of being. However, an adult who tolerates abuse is an enabler. Abuse within an existing relationship between adults cannot continue without an enabler. While the behavior of an enabler does not in any way excuse the behavior of an abuser, it does contribute to the cycle.
Dan, a couple of other points:
You wrote: You seem to be an accountable person who manages the ailment. And I know others that do, as well.
Thank you for acknowledging that.
I feel, however that it's important to point out that Bipolar Disorder, like the rest of the full spectrum of other brain disorders which exist, is a disability. Failure to manage the ailment does not necessarily mean that a Bipolar person is not making an effort.
First, the ailment itself varies broadly both in severity and in sets of symptoms. I lucked out... my particluar diagnosis includes the word "mild" rather than "severe" or "profound." This designation represents a huge difference in the individual's capability with regards to facing the many challenges presented by this disorder. It's a lot harder for an individual with false sensory input to deal with moderating mood-swing-induced behavioral impulses than it is for someone who is fortunate enough to be able to trust the reality of the world he or she perceives. Add a secondary brain disorder diagnosis, an addiction, or another disabling condition, and what you've been treating as a molehill may have just become a mountain.
Second, circumstances with which the sufferer is faced greatly affect the individual's experience and perception of symptoms and those symptoms greatly affect the individual's experience and perception of circumstances with which he or she is faced. A stressfull environment can make symptoms worse, which, in turn, causes more stress. The sudden arrival of a big new stressor can trigger the onset of an episode of worsening of existing symptoms or even the suffering of new ones.
A Bipolar person who is diagnosed early, encouraged to stand up to the disorder, is matched up to the right medication quickly, and has a good support network will fare much, much better than someone lacking any of these factors, especially in the case of someone who doesn't respond well to medication. I would like to point out here and now that medication for the mentally ill is barely even a science, much less an exact one. In most cases, it's a system of trial-and-error in which the patient acts as a guinea pig, switching from drug to drug until one happens to work, and the doctor has no way of knowing what will or will not until we've tried it and seen the results, which can sometimes be worse than the original symptoms... and while this is going on, our insurance companies interfere with the process, complecating and often terribly hampering the search for a working treatment. I know folks who have literally gone years without finding something that works. I've also watched a friend of mine become a totally different person because of a change in medication insisted upon by her insurance company (not her doctor) despite the effectiveness of the treatment she was using at the time.
You wrote: However, to you I do sincerely apologize for my use of the broad brush. In retrospect it was cold and insensitive. And, as I said above, you are apparently working very hard to manage your ailment.
I am not just offended personally. At first I thought I was, but re-reading your set of comments, along with what Liz said, brought up a few points for me, and I see that you are still using a pretty broad brush. The statements about hospitalization told me that. Not all sufferers need hospitalization. Those who do suffere severe symptoms, and are often just as severely handicapped by those symptoms. It is more than insensitive to say that someone who doesn't get better just because you had them committed has no desire to exercise self-control. Such a statement is a display of ignorance as to the nature of the disorder.
You wrote: I just wanted to make sure that we acknowledge that it is not only the bipolar person who suffers.
Your comments do not read as statements in support of the sufferer's loved ones. In fact, no matter how many times I read them or from what point of view, I can't find that within them. The first one, to me, read, "Bipolar people run around using a diagnosis as an excuse for hurting others without fear of being held accountable for their actions" and the second one read, "you don't know what you're talking about... Bipolar people are terribly abusive without any reason, and get away with it because of their diagnosis, so I get to judge them any way I want." The paragraph preceeding your statement "I just wanted to make sure that we acknowledge that it is not only the bipolar person who suffers" does the same thing, especially when taken in the context of having read your previous two comments. It communicates an assumption that all people with Bipolar disorder are sneaky liars who "play" the "system" in order to get back to the fun game of hurting their families, which they do not because the symptoms of their disorder affect their behavior, but out of a lack of desire to act responsibly. Such an assumption indicates a belief that the disorder is not real, the symptoms are not experienced, and the sufferer is not suffering at all.
I am more than willing to acknowledge that it is not only the bipolar person who suffers. It's not only the disabled person who suffers in the case of any disAbility. Do we blame people with Cerebral Palsy for the suffering of their loved ones? How about in cases of MRDD? Blindness? Deafness? Stroke survivors? Do you get angry when a developmentally disabled adult behaves in a manner which is not appropriate for a "normally" developed adult? When a blind person doesn't respond to your wave, a deaf person does not answer your spoken question, a stroke survivor can't remember your name or says something undignified because she can't remember how to say "I have to use the restroom?"
Families of people with disAbilities face challenges which other folks don't. Some stroke survivors are able to recover lost functions. Others aren't. We don't accuse those others of failing to try to manage the symptoms of their disorder. We don't blame the challenges we face on the disAbiled person.
We know that not all disAbilities are the same, and not all people start out with the same capacity to fight, either. My high school football team had a legally blind guy on it. He also attended regular (not special-ed) class every day with the rest of the students. I sat next to him in American History and watched him read with a magnifier that made the 12 point text in our books look two inches tall. Does his ability to do these things mean that blind people who are totally disabled are just "playing the system?"
My Grandmother recovered most of her faculties after her first stroke. Then, she fell and broke her hip. She was put under general anesthetic during the procedure to fix it, and really never came back. It is possible that while under, she had another stroke, but we don't know. After that, she had serious memory issues and never walked again. Was she "playing the system?" Should I have been offended when she called me by my mother's name? How about when I had to be called home from work when she was asking for "the other Lyndella," meaning me, because she did not remember my mother aging past her 20s? Should I have told her to work harder to manage the symptoms of her condition? Should I have blamed her when I got written up for leaving work to help her through the situation?
As family members of the disabled, it is our job to encourage efforts to overcome the particular disability's unique and various challenges, to discourage acceptance of surmountable challenges, especially when such acceptance is damaging to anyone, and to handle in a mature, adult manner instances of relapse, recurring episodes, "progression" of degenerative disabilities, and other setbacks which will occur. We should not ever assume that all people with the same disability are alike, and we should never throw blame for the suffering of ourselves and our families due to the challenges we face in relation to our own disabled loved one onto the heads of others who share a common diagnosis with him or her.
Suffering due to the actions of a person is not an excuse to form a negative opinion of all people who have a major trait in common with that person. It's not an excuse whether you are using it to base your bigotry on religious belief, ethnicity, sex or sexuality, or presence/type of disability. No more should you say that Bipolar People are irresponsible, "playing the system," or lacking in desire to control themselves, than I should say that Men are wife beaters, Christians are intolerant, Lesbians are man-haters, or Germans are Nazis. It's insulting to all of us, and it's wrong.
It took me nearly two hours, too... and I cut a lot of it out right before posting it. XP
I thought it was pretty well assumed that Grandma had blood marrow poisoning from her broken hip. It causes stroke like symptoms and generally can't be recovered from.
The most amazing thing about Grandma's journey through the aging process is that she managed to keep both her sweet disposition and her sense of humor the whole time. I hope I can do that, at least with the sense of humor. (I figure I'm out on the sweet disposition... I haven't got that now, LOL)
Jami-Gma do you know who I am
Gma-Yep.
Jami-Who am I?
Gma-Christina
Jami-Leaving in a huff
Gma-Just kidding...
I read Kay Redfields-Jamisons book about 11 years ago. I felt what a great contribution she has made by becoming a doctor, not to mention her being the professor of psychiatry at John Hopkins. I also didn't know that she has written another book.
Thanks for the article.
Karen~
Just add this to drug addiction, alcoholism and liberalism (oops, that slipped out), which are also considered diseases where everybody gets blamed except the "patient".
Clearly Dan has it all figured out... anyone with a mental illness that they can't just "snap out of", is a burden on society and should just die. Then the rest of the able-bodied can continue living the life they're entitled too, because, of course, they'll never become mentally ill in any way shape or manner! Am I right, Dan? Real men don't get mental illness! And if your son or daughter becomes chronically depressed? Or mildly schizophrenic? (Seriously, if they're your son or daughter I'm already worried about them...) Well, clearly, they don't deserve to live any longer! Oh, but of course, that won't happen to you Dan, because real men don't have children who are might suffer a mental illness. Am I right, Dan? And if your son or daughter serves two or three tours in Iraq, Afghanistan and comes back a ticking time bomb, they better just suck it up, am I right, Dan? That's what our military is telling them, and I guess you'd say the same, am I right, Dan? All those returning vets who are commiting suicide while trying to get even a modicum of appropriate treatment through the VA are just weak, am I right, Dan? I guess we can all breathe a bit easier knowing that there are real men like Dan in the world to help delineate right and wrong. But I really feel for anyone who has to live with him... maybe they just choose the all-American route and drink themselves into a stupor so they can be numb to his arrogant stupidity. That's at least the honorable route, am I right, Dan?