MY PSYCHIATRIST IS this pert petite pixie. Excuse me: when I'm manic, and I am manic at the moment, I'm drawn to alliteration like a moth to a flame. Also, to tired analogies. She has a corona of taut blonde curls, perfect teeth, and these clunky brown German-looking Mary Janes that belie her otherwise professional demeanor and let the patient know, let me know, that she engages in hippie activities in her free time: burns sage incense, wears hemp, perhaps dons a patchwork vest. I don't know why this matters, why she matters at all. Because, despite the fact that I could fold her along her creases, this little doctor of mine, tuck her into a corner of her office behind the red chairs with Nordic names and then take over her life, prescribe my own medications, dictate my own future, I can no longer function as a thinking person on medication.
I will tell you how I came to be medicated, how I came to be unmedicated, and how I came to once again, finally, be medicated. This is my last attempt at writing while medicated: yes, my last attempt to write, because I'm bipolar, and it's fucking everything up.
IT ALL BEGAN – let's do it this way – when I was eleven. I'd been festering with Lyme disease for a year by then, but I didn't know it. But that is another essay I've already written, a good one, back when I could write. When I was eleven, jangly joints and supplicating palms, I tended to have these...episodes...wherein my mind would become a starburst of neurotransmitters and dendrites, and I would yammer and tap my feet and clench my fists to my temples, and curl up at the top of the stairwell that led to my attic bedroom. My parents would stand at the bottom of it, craning upward, Dad's eyes bugging, Mum's narrowed, and they would, well, yell. Because what else could they do? Bec, if you don't stop, you're grounded! my dad said. I remember that. The words twittered into my ear canals and sluiced through my temporal lobes, and around and around they went, parsing into their letters and then into smaller pieces, the sticks and curves that made up the letters, which lodged into my synapses and made shrill siren sounds, and I screamed.
That's how the bipolar first manifested.
And now I'm twenty-seven, and I have this doctor who urges me to take pills that happen to make me fat, because what does she care she's itsy, and other pills that make me sludgy: that is, my mind is sludge, my thoughts are sludge, I cannot think, I cannot find the words, the words I want to use to traverse the distance between you and me, and I am stopped in my tracks.
I am struggling in graduate school. I mean, really struggling, in a way I never have before in my education. The words people say are fibrous and twilled and catch in my throat when I try to say them, too. Words like 'iconoclasm' and 'exegetical' chap my lips. My dearest friends turn to hulking threats when they tease out codified meanings from dense texts and expound on them extemporaneously, while there I am juxtaposed with my lower lip glistening with saliva, my tongue dry with panic, my eyelashes bristling. My thoughts going around and around, as they always do these days.
I am in the doctor's Ikea-inspired office, the sun licking our respective hippie shoes, and I begin to cry. I never cry in front of the doctor. I am a stoic sufferer, standing on a cliff face, squinting against the winds of my malady with true bravado. She tells me where my life will go, and I go there. But the other day in my readings course, I went under. There's this chick in that class with trendy bangs and slim arms, and she spouts hyperbole like it's her fucking job, except she gets away with it, because she's verbose as hell, and her sentences are striated, and getting to the meaning of them is like digging down to the Precambrian era and finding a hominid skull. It's just...killer. And it was like that with everyone. Everyone had a schtick. Except me. I hunched over in my wobbling plastic chair that threatened to crack under my new Zyprexa weight and looked from one mouth to the next like a spectator at a tennis match and I might as well have been lipreading, it was all so inscrutable. I was silent. This was surely Afrikaans or Tagalog, not English. The words were meaningless to me. I am not exaggerating for the sake of this last-ditch attempt. I was lost.
So I bend over double in my doctor's office and cry until droplets of black mascara tears lob onto the carpet fibres, and I toe over them with my moccasins, embarrassed. 'You know there is another option,' the doctor says. I look up mid-sniff. 'We could reduce or remove your medications,' she says. 'You would have to completely change your lifestyle, but there are a lot of bipolar people who live this way.'
'No,' I say. 'There's no way.' I am still in the old mindset, for another five minutes. The must-be-medicated mindset.
'What you would have to do is change everything,' she continues. She ticks things off on her small fingers. 'You would have to take omega-3 fatty acids and B-complex vitamins, you would have to exercise every day, you would have to get at least seven hours of sleep every night, at the same time every night, you would have to follow a routine every single day, you would have to follow a healthy diet, you would have to avoid stress and employ stress management, and, most importantly, you would have to bring your friends and family in on the plan. You would have them as a support system. You need to tell them what you are doing, Becca: you need to tell them you are going off of medication and ask them to know the warning signs of mania and what to do in case it happens.'
I stare out the window as she talks, at the sun shimmering off windshields in the parking lot, which make these ephemeral nimbuses that rise up and hover there, a few feet above the ground, waiting for me to make my decision. Although it seems I already have. I think about telling Jenny and Amy and Annie and Jess and Sara, my girls, about the dark depths of my bipolar, which we have only really touched on in a delicate way since there has been no need – the medications have kept me rather stable. And once I tell them how bad it really could be, I would have to tell them that I need them to watch for it to get that bad, and take care of me if it did.
'Fine,' I say, like a sulking child. But really, I am beyond excited. 'Let's do it.'
LET ME GO backwards again.
I was ecstatic about turning thirteen. From what I understood, thirteen was the year I would become a teenager. And teenager meant that I would be driving a car, staying out late and going into Manhattan to crawl the clubs, and having sex. Essentially, I would be turning into the version of my mother from family lore: young but not too young, with long tangled hair, smooth skin, a sad scowl, bellbottoms. Thirteen would be the year of my Bat Mitzvah, which was going to include a party with a DJ and two hundred guests.
But my transition to the land of adolescence was not the fairytale I had been anticipating. On my thirteenth birthday I had a cold that roped my limbs and dripped through my sinuses. The shivers wouldn't let up. A celebration had been planned: my family was going to go into the city to see Blue Man Group perform their wily intertwining cobalt dance. We had been planning it for weeks, maybe months; it is difficult to remember these details, especially considering what happened afterwards.
So we went. On the dark drive into Manhattan we stopped at a Duane Reade drugstore, at a corner where two overdressed black men screamed at each other, and while the car idled my mother ran in and got some cough mixture – the red, bitter kind.
At the time, the only real damage the syrup seemed able to inflict on my body was its sinister taste, which pricked my taste buds and inspired the greatest gag reflex I'd ever experienced. Everything inside me rushed up toward the surface, through my narrow throat, gag said my body, and I spat the medicine back out into the vicinity of the plastic cup. My little sister cackled next to me, totally unsympathetic only because she knewexactly what I was going through, having been sick before.
'Drink it!' said my mother, who had purchased tickets to Blue Man Group and god help her we were going to see Blue Man Group at seven o'clock if it meant parting the seas, realigning the stars or merely curing my fucking cold.
Somehow I got the medicine down my throat, and that is when its true assault on my body began. I went mad. And let me tell you: the last place you want to go mad is in a dark room where bald blue men dance around and beat on drums filled with brightly coloured paint that splashes up and splatters everywhere. The world swirled. Sounds screeched. My brain spun on its axis. At the end of the show the Blue Men decided it would be a good idea to throw rolls of toilet paper out onto the audience, roll after roll, so that we were covered in haloes of translucent white paper, peering up into the spotlights, which seemed like suns. I screamed – but no one heard me because everyone was hooting in delight, and applauding – and I grabbed my mother's arm, hard. I remember that.
Later, we were pulling out of the parking garage when my father slammed on the brakes to avoid running over a man who I now realise must have been drunk. I screamed, shrill and singsong, and began to heave and cry and accuse my father of terrible driving, and from there the ride home dissolved. There was yelling, and there were tears, and no one understood at the time that my behaviour couldn't be helped. But late that night, maybe at one in the morning, I stumbled downstairs, still unable to sleep, and found my father on the couch in the den. 'You had a bad reaction to the medicine, I think,' he said. 'No more
THERE IS SOMETHING called 'aphasia', which is a difficulty in speaking or understanding language. Doesn't that word sound like a fairy child's name? Aphasia. The medications give me aphasia. Here I am, writing this last-ditch attempt, and I am scrabbling to find words that elude me, right-clicking on the menu bar to get at the synonym list whenever possible, and walking away from my computer frustrated for snack breaks more often than I should. One of my medications, Topamax, which I also take for migraines (the kind that, in a creeping crawl, edge a filament into the right side of my face and then begin to drill with a high-pitched drone), is colloquially known as 'Dopamax' because it is so notorious for its aphasia and other cognitive deficits. The words are out there, I can almost see them, like opalescent shimmers on the air currents, like the tail ends of dreams, and I reach out with my fingers, I open my mouth to catch them on my tongue, but they swim away, giggling. Instead I settle for the stocky words, the thick black words that have floated down through the ether to the bottom of the world, and sit where even the least educated of us can kick through them with our bedroom slippers. Words like 'management', and 'hammer', and 'truncate'. Blah, blah. What I want are the classy words, the words that convey the meaning in one syllable and throw it into doubt in the next. Hip-shaking cadence. A mouth-feel. Gimme those words.
AND WHEN I was fifteen, a big scary boy locked me in a room and molested me, and after, I became severely depressed and couldn't get off the couch for months, and fuck school, fuck that, I watched the sun filter in through the window for two months and thought it was the darkest thing I'd ever seen. The doctor put me on an antidepressant and diagnosed me with post-traumatic stress disorder and I laughed, because Idid feel like a veteran, oh goodness, yes, but it had very little to do with being sexually assaulted. Nothing had felt right in five years. I was not the golden child anymore. I was hurtling toward some fucked-up end and everyone in my family knew it and when my dad looked at me it was with dismay and that just made me feel more fucked up and angry. My thoughts went around and around and I wanted to rip my own hair out and sometimes I did.
So the doctor put me on Zoloft, which was kind of like the Dextromethorphan in Robitussin but a hundred times more potent. Zoloft is an antidepressant, an upper. What happens when you give an upper to someone who cannot regulate his or her ups and downs, someone who is prone to being up in the first place? (Because even though I was depressed at the time, I am primarily a manic.) They go speeding past okay and into happy and sometimes past happy into manic and even past that into psychotic. Which is what happened to me, except the depression decided to linger too, so I was in what is called a mixed state. Though no one at the time saw it for what it was.
Forget the science of it. I gave low, gritty screams that ripped up my throat, and I threw dishes at the walls, and then screamed some more when they didn't break. I took an old screw and carved up my arms. My intellect was bright and blinding, my thoughts were loud and staccato, and the insides of my ears hurt from the volume. I think I tried to kill myself. Or I tried to try. Or I tried to pretend to try. Or I just gave up and let my mother take me in to the mental hospital.
I SEND MY friends an email that includes the following:
The Mayo Clinic website should give you a lot of information about what kind of stuff to look for in terms of mania, but here are some other personalised clues that I might be manic:
– Dressing inappropriately or wearing shirts that show off my boobs
– Laughing excessively
– Extra witty and funny
– Talking very quickly/excessively or interrupting a lot like I had lots of coffee
– Being up all night (so if you get emails from me in the middle of the night, that's a clue)
– Going on lots of dates/flirting with everyone in sight
– Hygiene out the window or, alternatively, excessive make-up
– Becoming obsessive about something
– Decreased appetite.
Okay, that should give you a good idea. But I think we're going to be okay. I'm hypomanic right now and I'm doing fine. It's just a matter of watching out for real mania that's the problem. I think everything will be fine, really! But I just wanted this all to be set up, just in case. And again, I thank you for being so supportive. Love you.
I am already hypomanic when I write that email – that is, I am all jazzed up, all thrumming limbs and humming heartbeat, helpless grin turning up the corners of my lips, thoughts whittled down a little smoother and cleaner than usual, but it is nothing compared to what is coming.
What is coming is mania, which is like eating spicy food too quickly, or running down a steep hill. It's fuckingfantastic at first, the wind in your face, the sun in your hair, the seat warmers on in your car. It's like being buoyed up on the Dead Sea. Floating, when you should be sinking. I laugh a lot
when I shouldn't be. I make a lot of inappropriate jokes that seem hilarious to me. I insult my student ('when you are older you are going to be so solipsistic that all your friends will leave you'). I am disrespectful to authority, to doctors, to my bosses. I am crass and don't cringe. I am oblivious. I am acutely aware of every dust mote in a beam of light and every hair on a peach skin.
And what's more, my coat rack transforms into a sweet Virgin Mary. Violet and magenta light streaks banter in the air and chaff me, flitting away into the night. My dead Uncle Irwin appears in the hallway while I am on the toilet, beckoning to me through the doorway. I blink, hard, and he goes away.
IT WAS 2005, November, and I was working, in all places, in a lab that studied the precursors of schizophrenia. My job was to call potential crazies and ask them questions from a diagnostic questionnaire: 'Do you ever feel strange bodily sensations, such as your head floating above your body?' 'Do you ever feel like people might be out to get you?'
The subjects for the most part laughed and said no, and I moved on to the next question, but with each interview my guts clenched tighter, until I was a walking fist, a gritted thing waiting for some answer as to why I was thinking yes to the questions even as I asked them to the sane strangers on the phone. With the diagnostic powers granted to me by the esteemed principal investigator, I diagnosed myself as schizophrenic. I spent my Fridays in the lab and I went home and I wept into my dirty pillow and I lay in bed while my uncle talked to me from the corner of the room, where he was all black like a silhouette, and I couldn't hear him but I could hear him, and I felt paralysed. I felt like I could not move so much as my lower lip, my little toe, a dilated pupil, because I was and always would be a catatonic failure. My uncle told me the story of all the bad things that had ever happened to me, and I listened, and I waited for hunger to fade into nausea to fade into nothing.
This is from an email I sent the principal investigator:
Since you are the expert on these things, here goes. I think I'm starting to go crazy...let's just say I would have been very positive on the screener I was giving to the study subjects over the phone. I've become very paranoid and withdrawn, and I very often feel certain about magical things, like moving things with my mind, or people controlling my thoughts and actions. I guess the fact that I can say it here is a good sign. I don't know how I didn't see this before. Whatever it is, it's getting worse. Every month it gets a little harder to function normally...It's getting fairly difficult for me to know if something's real or not. Anyway. I hope you don't think this is inappropriate. Honestly for most of the past year I've had trouble gauging what's appropriate, which is absolutely out of character for me. Something is very wrong.
He called a psychiatrist for me. It wasn't schizophrenia, but it was something. And thus I was finally diagnosed a bipolar.
AH, MY LAST-DITCH attempt. I just want to write well. That is what I want most in life. To write the sentence that aches in your molars because it is so, so sweet, and so, so bitter, too. I want to capture the shine off a candy wrapper and the taste lingering on the foil. I want to write the satisfying pop of bubble wrap and the sigh of a dog going to sleep and the smell of just-boiled pasta and all those other disgustingly lovely truisms that we want so much to capture and pin down to the paper, yes, I want that, I want that.
Here's the thing. My doctor entrusts me with discipline. She tells me to change my life. And I do, I swear it, for two weeks. I walk my dog, Lux, for an hour every day along the bike trail near my house. I eat only nutritious food. I don't drink, or smoke, or do drugs. I avoid stress. I meditate. I sleep at night. I am good.
And when I see one of my girls at coffee shop and she asks how I am doing with a hand on my shoulder, I pat that hand and I say, 'I am fine. I am a little manic, but I am okay.'
She says, 'Are you sure?' maybe because I am talking fast or something, I don't know, and I nod and smile my too-big smile and order a Strawberry Sunrise smoothie. But like I was saying, here's the thing: once I become slightly hypomanic from the lack of meds in my system, all discipline goes out the window. Fuck the smoothies – I get coffee! And I can't get enough chocolate or fried foods. I grow lazy from all that grease and dairy and I stop walking Lux on the bike path. I start smoking again. There I am, a bipolar with almost no medication, out on a tightrope with no supports and a high wind blowing in from the west.
I remember my sister driving me to the emergency room once because the psychiatrist I had then had put me on something that made my whole body stiffen up. I jerked around my kitchen like a puppet on strings, my mouth a grimace and my tongue coagulated in my throat. I called my sister and slurred my way through 'Take me to the hothpital.' Once there, I saw Mickey Mouse wave to me through a privacy curtain and a man gleaming with productive sweat race by in nothing but iridescent blue jogging shorts. It took several starts and stops of cognition before I could make myself understand it wasn't real.
I remember her taking me again to the hospital because, because, I don't know why, I don't know anything about that time except I remember being up on the cot, like up on a stage, and the nurse was on a stool so far below, and my sister was off to the side somewhere, sitting low, talking deliberately to the nurse about my situation, trying to get me admitted. The psychiatrist, this totally inappropriate woman who keeps in her office a Goliath of a dog that makes me sneeze, that makes me edgy, this doctor who gives my mother attitude for asking questions when we have an appointment together in later weeks ('Well, now, if you're going to ask questions, I just don't know how this conversation is going to get anywhere...'), who goes behind my back and tells the hospital to admit me should I appear on their doorstep, had spoken to my sister on the phone and told her to do as much. And all I really remember of that visit is the nurse talking to my sister, while I looked around the small room at the cabinet with the glass front full of medical articles, tongue depressors and gauze, all useless items to a manic, and laughed hysterically at some internal joke only discernible to me. Laughed so hard I almost choked. And I remember being acutely embarrassed, but unable to stop. The nurse and my sister stopped their conversation for a moment to look up at me on my cot, and then continued with their murmurs. Somehow, I was not admitted, but released back into my little sister's helpless care.
I remember the police taking me to the hospital another time, because I had been calling my best friend Erica over and over again, the phone piercing her night maybe twenty times in an hour, and all I wanted to do was tell her how angry I was at her, and who knows for what. For what, I don't know. We were bitter friends. And I was manic. So she called the police. The police came, and I pretended I had been asleep, and when the policeman came into my room to wait for me to collect my things so he could take me to the hospital he charitably ignored the open beer bottles on my desk (which weren't even mine, in fact), even though I was only nineteen or so, and helped me get my things together in what resembled an organised way. 'I'm fine,' I said to him, and laughed. 'I was sleeping! This is really rather ridiculous.' I think he believed me. I think he believed me when I said that my friend Erica was just a malicious cad. The people in the hospital believed me too, and an hour later, the policeman drove me home. Sometimes, I'm a good pretender.
Most of my visits to the hospital I don't remember. Sometimes I'm admitted, mostly not. Mostly when I'm admitted, it's like a holding cell, a place to cool my heels while the bipolar shakes itself loose, unmoors itself, the hinges creak shut and my mind closes itself with a sigh. And then I sleep for a long time, the drugs whispering through my blood-brain barrier and hushing into the folds of my grey matter. And that is what happens now.
SO THE DOCTOR put me back on medicine.
I just reread my last-ditch attempt so far, and it occurs to me that maybe I am totally full of shit, maybe I am as verbose as I wanna be, maybe I am using words like 'extemporaneous' and 'juxtaposition', and what the fuck do I need with a thesaurus? I'm fine. Maybe this isn't so much a last-ditch attempt as a reclaiming of what is mine, my ability to write, my proclivity for words, the compulsion that moves me forward in life and forward in this document at the same time.
Well, but I'm not on the kinds of meds I was on for the past three years. I'm off of them mostly, now, and on the rare occasion I have to take one of them I notice the effects in a mighty way. The chemicals tug on my eyelids and flick at my fingertips, yank at my wrists so my hands flail this way and that. They weigh on my heels so I shuffle everywhere I walk, and my mouth hangs open and my puffy tongue threatens to burst out like a worm from a rotten apple.
And everything I am eludes me sometimes, even with all the medicine in this world, or maybe because of all the meds, and I sit down at my computer to write about it, yeah, yeah, and nothing comes out. I won't go so far as to say it is writer's block, because it's not. I've never had writer's block and I never will. I don't even know what writer's block is, really, because as long as I love to write, and I do, I will never suffer from that malady. There are times when I sit down at the computer and nothing comes out, as I said, but hell, I just come back a few hours later and the words trickle from my fingers and onto the screen. Trickle is the wrong word. It is more of an onslaught of words assaulting the keyboard. I've written in the presence of other people and I've gotten funny looks, comments like, 'My, you type fast, don't you?' But, like I was saying, sometimes nothing comes out because I don't even know who I am anymore. And how can you create something from nothing, if you don't even know who you are? How can you start from scratch if scratch is you and you are empty?
This is who I am: I am four years old, a colicky, finicky, neurotic four years old, surely pre-bipolar, and I am writing. I am taking coloured pieces of construction paper and gluing them together at the edges so they form a booklet, and I am writing my first novel. It is called Dog Dots. It is about a Dalmatian who loses his dots. The book is complete with an author bio and photo, reviews on the back, and a blurb. All done in crayon.
And this too: I am in eighth grade, and our assignment is simply to write a short story. I write one about a girl who gets lost in a blizzard on her way to school and finds herself at a magical cabin with a magical old man who grants her wishes. My teacher reads it and, aesthetically sated, begins to sob, fat tears rolling down her heavily made-up cheeks. I stare at her, stunned and empowered. Hmm, I think. Writing.
And finally this: I am twenty-one, and I have returned to my parents' house for a year to convalesce. I have Lyme disease. I have a tube in my left arm that wends its way to my heart, and is attached twice a day to a bag of antibiotics, which drip into me over the course of thirty minutes. There is not much to do while the antibiotics enter my bloodstream, except stare into the blue glow of my laptop and let my fingers flicker over the keys. In the background, someone on television says something snarky about having pizza for breakfast and just like that, my career as a writer begins.
That's it, I think. Or rather, I don't even think. I move. I type, 'In our house we ate pizza for breakfast and painted on the walls when it struck our fancies.' That becomes the first hundred pages of a novel, which I ultimately trash, but who cares? I wrote it.
Being a writer feels so good that my joints are swollen with joy, blood sloshes thickly through my vesicles; even when I'm absolutely miserable, I grin at awkward moments, I think I'm lucky, I'm blessed, I'm a-okay. And so, when I take stock of my situation in early 2009 and realise that I haven't written anything exciting in more than three years, in exactly the time that I've been diagnosed as bipolar and, more importantly, beenmedicated for bipolar disorder, my heart twirls around in my chest because I realise that somewhere, hiding deep inside of me and also so far out that it's lingering where the stars are hot and fiery, so expansive that it is twined around the sun like a lamp cord, is my talent, just waiting for me to remember its existence and call it back to me. So I do. And I've told you that part of my story – the grand plan to go off of the meds, the return to the meds, and here I am now, lightly medicated, and writing okay, decently, if I do say so myself.
It will have to do. Because this is the thing of it: I cannot be any less medicated than this, and I cannot bear to write any worse than this. Dearest Universe, I need things to stay exactly like this, please. Okay? Okay.