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From great pains arises great compassion
Sometimes, you have to tear yourself in half to fi...

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Life, viewed sideways. Emotions, amplified. Answers, questioned. Me, between the lines.

- A Wounded Heart, Who Can Bear?
- Drowning Under a Tidal Wave
- Clawing My Way to the Sunlight
- Yes, Santa Claus, There Is a Virginia
- Fugu
- Touching the Spirit
- A Hole in the Universe
- Riding on the Dreams of Others
- Turning Into a Shark
 - A Heart, Ripped Asunder
- Surrendering to the Roller Coaster
- Hunting in the Jade Forest
- Dodging the Shark
- Dancing With Invisible Partners
- The Captain and the Harliquin
- Courting the Devils
- The Captain Makes His Mark
- Mad Dog to the Rescue
- Innocent in the Big City
- Dropping the Ball Briefcase
- Scrambling Brains
- Cheating the Reaper, Again
- What If the Man Behind the Curtain Is No Wizard After All?
- All of Us Have a Soundtrack
- Working With Broken Machines
- Happy Anniversary, Baby
- Standing on Stars
- Running the Film Backwards
- Identity Crisis ("Who am I?")
- Can We Ever Really Admit the Desires of Our Heart?
- Forgiveness is a Rare Thing
- Having Your Heart Caressed By the Creator
- Working With Broken Machines
- A New Leg to Stand On
- The Real Spirit of Christmas
- Chatting With Infinity
- Absence Makes the Heart Grow Fonder
- We All Have a Great Capacity for Loss
- Brushed Lightly By Might Have Beens
- We See the World Through Our Own Looking Glass
- Every Storm Passes Eventually
- Accidents Can Introduce Destiny Into Our Lives
- Freedom Depends on the Walls Around Us
- Pulling Aside the Velvet Curtain
- Riding the Razor's Edge
- Dying With Strangers
- In Your Face
- Between the Lines
- The Bobcat
- Angel With a Coffeecup
- Innocent in the Big City
- Chains of Gossamer
- Playing With Knives
- Stumbling Through Memories (Ooops)
- Picture This
- Running the Film Backwards
- Playing the Score, Tasting the Music
- Coins and Corals and Carved Coconuts
- My God, I Confess
- Exotic in Thin Air (Part 1, Speechless)
- Exotic in Thin Air (Part 2, Taxi)
- Exotic in Thin Air (Part 3, The Pan American)
- Exotic in Thin Air (Part 4, Guano)
- Exotic in Thin Air (Part 5, The Andes Express)

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"From this hour I ordain myself loos'd of limits and imaginary lines, going where I list, my own master total and absolute, Listening to others, considering well what they say, Pausing, searching, receiving, contemplating, Gently, but with undeniable will, divesting myself of the holds that would hold me."

Walt Whitman (1819-92)

"When I look back now over my life and call to mind what I might have had simply for taking and did not take, my heart is like to break."

Akhenaton (d. c.1354 BC)

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Tuesday, April 08, 2003

What If the Man Behind the Curtain is No Wizard After All?

Function: adjective
Date: 1810
1 : Characterized by the alternation of manic and depressive states [a bipolar affective disorder]
2 : Me.

I have what is called "Bipolar Type I Disorder." This used to be known by the name "Manic/Depressive." For me, the diagnosis represented the awakening from a 35 year long nightmare.

I want to share some of the details of this, particularly the past few months, in the event that it might help you or someone you know. Remember as I describe my experience that this is not a "mental" disorder caused by bad parenting or anything, it is a BIOLOGICAL condition, caused by chemical imbalances just like Parkinson?s or Diabetes. Unlike Diabetes, which affects the pancreas, this disease affects the brain and the nervous system, as well as other body systems.

All my life I have been "moody." During certain periods of my life, I would be all active and goal driven, the very picture of the guy that the motivational seminars want you to believe is your "potential" and what you should be like. I would work till late at night on grand projects, write 50 emails a day, whatever. In other periods, I would be pretty much normal, level headed. But in still other times, I would be VERY depressed, sad, and even entertain thoughts of suicide. Those times my online presence would be minimal, the websites would gather dust, things would go undone.

I, however, thought of all this as "normal" for everyone. Like a lot of people, I just barreled through it, dealing with these moods and periods of my life (sometimes lasting months at a time) as best I could. In the meantime, those around me would deal with ME as best THEY could. Relationships deteriorated during these up and down periods. Frankly, I was just too high maintenance. People began to distance themselves from me. During down periods, I would assume that I was worthless and be lonely. During up periods I would look at the very same circumstances and assume it was a sign of respect!

What I did not realize was that it was a sign of being gravely ill.

Four years ago I had treatment for coronary blockage and almost had a heart attack, which was only discovered because I developed "Sudden Onset Panic Disorder." Later I found I was diabetic, and then proceeded to have continual problems with the diabetic medications. Never did I glance the man behind the curtain, but God wanted the root of all of this to be brought to light, and about 10 months ago He set in motion a string of circumstances that, in hindsight, may have been the only way to do it.

At that time, my panic disorder had been in remission for almost two years. That is, until one Sunday night when I had the grandfather of all panic attacks...heart racing, blood pressure at the ceiling, the feelings of impending doom, all of it. And it did not stop. All night long it went, then on into Monday while I went to work. After over 12 hours of it I finally went to the doctor and begged for something to stop it. So they gave me a short-term medication to knock it in the head.

But then, they also gave me a long-term antidepressant, called Celexa. For an antidepressant, it?s a "big gun" and works really well. For a person with a bipolar disorder, it is a free ticket to hell. A person with bipolar disorder has no "governor" on their mood states as a normal person does, as you will see. Up or down, we just keep going and going and going...

About two weeks into the medication, and it takes almost that long to start working, our company started an external audit. Being the acting controller of the company, it all had to do with me. At the very same time I had an extremely weird experience. While walking through my house, I had the feeling as if I had "awakened" where my senses got more intense and emotions take on more dramatic dimensions, and it happened like snapping my fingers. Suddenly, it all was clear! Everything made sense! And I was the guy for the job, too, whatever it was!

And it felt great. I quickly regained a lost musical ability that I had not had in 20 years, and also regained my extravagant personality from that period. As a matter of fact, it felt as if I had been asleep for 20 years. This was not my house, not my wife, not my car, not my job, not my coworkers, not my life. And it was all ripe for the picking. Oddly, I found that my feelings for people in my life intensified...casual friends became fast friends, and some friends became an obsession.

Stress levels went up at work while the audit gained steam and I effortlessly handled the increased workload, sometimes working 18-20 hours a day for days on end. I was being handed, or rather was grabbing, increased responsibility every day. I felt on top of the world.

In the psychiatric literature, this is called a "manic" state. Manic means hyperactive, not crazy, but the result is often the same.

As the weeks passed, things got worse (or better, from my viewpoint.)

I was taking charge of everything around me, and even making what I thought was a brilliant effort to become CEO of my company. Needless to say I did myself a great deal of damage, which I absolutely did not see. I had also begun seeing a counselor during this period, because the intensity of my emotions had gone through the roof. I attributed this to that earlier event, which I started calling the "flip." She said I should see a psychiatrist because she thought I might be bipolar, and my response was to drag my wife in and we both argued with her that her interpretation was wrong.

Good move, huh? Unfortunately, its also a classic symptom of the phase I had now entered, "Severe mania."

I now was sleeping maybe two hours a night and waking up feeling refreshed. I was working out for the first time in 20 years. I was eating hardly anything at all. Weight was falling off of me; I dropped almost 45 lbs in a month and a half, and fell 4 pant sizes and three shirt sizes. My wife thought I looked great, I thought I looked great...

...but I was very very sick. And I did not have a clue. Well, the newly arrived voices in my head, which I ignored as just my own hashing out things, bothered me a bit, but I shrugged it off.

About Labor Day, I convinced my doc to take me off of the Celexa. The audit was winding down, and I was obviously not ill! So he weaned me off of it, and about three weeks later it left my system entirely.

Now, during the manic phase of this illness I described above, I had been instrumental in getting the CEO of the company fired (another story I will not go into here.) Since we were renting space in a building he owned, and our plant management was not up to snuff, I had managed to get the board to agree to consolidate our staff to our plant instead of two locations. We fired the plant management one Friday afternoon and took over, and moved.

And that move corresponded precisely with the Celexa leaving my system.

I had offended every single one of my coworkers with my grandiose thoughts during the manic phase, another classic symptom. Understandably, they wanted me as far away as possible, and even though I fought it for all I was worth, my office ended up in a dark room in another building, with the dimensions of a good size closet.

And nobody wanted me anywhere close.

With this illness, a manic state is usually followed by twice as big of a depressed state, and one that was induced by an antidepressant almost guarantees this result. So I plummeted into the darkness of the soul for all I was worth, twice as far down as I had been up, and I had been way up. Contributing to this were the deprivation of social interaction and lack of light in my new office, and the new hostile attitude I sensed from coworkers.

I went down and down and down. And I think that this is when things at home began to crumble really bad, but bless her heart, my wife hung in there. I also started hearing voices in my head during this period a lot louder, and they would keep me up at night.

During the Thanksgiving and Christmas seasons, I began to do what is called "rapid cycling." This is when you swing wildly from one state up or down to another over just a period of days or even hours. One day I think that all my coworkers are out to get me, the next I am going to great effort to create a birthday present for one of them. When the depressions got bigger and bigger, I tried treating myself with St. John's Wort, an herbal antidepressant, and eventually talked my doc into putting me back on another antidepressant (I specifically asked not to be on Celexa!) Again, bad move. But this antidepressant was not as powerful, and the moods begin to blow through it. He also recommended that I go to a psychiatrist and I refused.

By about the 15th or 16th of January, I had lapsed into the deepest depression of my life. Now the voices are helping me plan my own suicide. I begin to prepare what will end up as over 100 pages of directions and instructions on how to do my job after I am gone.

By Friday of that week, I'm in bad shape. It has snowed and business is slow, so I go to the doc. I eventually tell him that there are "plans" going on in my head, so he adds another antidepressant. This is a fast acting one. He also gives me a referral to a psychiatrist for an emergency appointment and this time I try to get in touch, but they are closed due to snow.

I go to my house and plug in my laptop to work, its about 1:30 or so. At about 5:30 my wife comes home and I have not moved a muscle or tapped a key because the voices were so overpowering. The same thing happens the next morning while standing in my kitchen, and my wife finds me, but I make an excuse and she does not notice it.

Soon as the newest med gets into my system I cook all the food for two complete dinner parties, concentrating on tiny portion dishes sometimes with over 100 individual portions! I make a huge stack of food to freeze. Afterwards, I steam clean all my carpets. Oh, and this is all on one Saturday afternoon and evening! And the voices in my head were VERY approving of what I had done, thank you sir, this is marvelous and delicious you are incredible and so are your ancestors! Recognize the pattern?

By Sunday I had started to crash. I confided in a close on line friend, who talked me into sharing my depression with my wife. Sunday night I did, and it terrified her.

Monday, I train a coworker to do the company payroll. I am very depressed, but in my lucid moments know that I am in grave danger. I'm holding it all in, but I do tell my coworker that I had to train her because I felt I was gravely ill and might be gone a while. I tell her not to tell anyone else.

I finally get the psychiatrist on the phone, and they say yes they can see me for an emergency appointment. In April, over 90 days away.

I hang up without scheduling anything. I know I won't make it to April.

I call everyone in my HMO book and get the same response. I do all of this in secret, do not want anyone else to know who I am calling. My wife is calling me at work every 15 minutes or so, worried sick, and rightly so.

I call my counselor and share the situation with her. She gives me some more names but then recommends I go to the emergency room. I later learn that she rethinks this and tries unsuccessfully to call my wife and tell her to come get me, but can't get her on the phone. Meanwhile I am redlining at work and the situation is getting more and more dangerous by the minute, and no one around me at work has any clue what I intend to do.

The tutoring takes until the end of the day. I take great pains to make sure that I say my goodbyes to everyone as I felt I wanted to. I get in my car, life is black. There is no hope, no chance of any, ever. I now have to make a choice.

And I know that I do not want to go through with this. My wife is waiting at home to take me to the ER. I want release, I want it to stop, whatever the cost. It just hurts too much, the sadness is too unimaginably deep.

I can't deal with anymore struggle with it. It has won.

I am in greater pain than I have ever been in before. And this is where God steps in, I think. The thought enters my head to use my cell phone to call each member of my family one by one; my mom, my dad, then my sister. That added level of accountability is what brings me home, as I stay on the phone with them the entire way through my 40 minute commute, making the choice to go home instead of jumping off the bridge I had already intended to leap from that afternoon.

Once there, my wife takes charge. She feeds me then off we go to the ER. She drives, at my request. I figure they will give me some antidepressants and send me home happy. Six emergency room hours later they admit me as an inpatient to the psychiatric clinic for major depression, suicidal.


The doc sees me the next morning and determines I am depressed. They give me antidepressants again.

The psychiatrist suggests that I ask my closest friend from work to come visit me and see if I can start to put together a group that can support me. So I ask my wife to bring in the girl that I had just taught to do payroll, as she was my closest friend at work.

By the time they got there that evening, I was a mess. But I didn't know it.

One of the side effects of my particular bipolar disorder is paranoia, and it was clobbering me. So the poor girl walks in and I spend the next 45 minutes pretty much raking her over the coals, which she didn't deserve. She had also been in counseling herself for codependancy (and later I found that my behavior during the illness was a factor as well), and the end result was that she had her own problems, thank you, and I was going to have to deal with mine.

But all I had really wanted was for someone to say, "Hey, I know you are hurting, and I'm sorry." That didn't happen. And, apparently, it was not going to. When my coworker left, I was in far worse shape than when she arrived.

Later that night, I am speaking with another patient (now one of my best friends) who is telling me about her condition, which is bipolar disorder. She mentions in passing that if you give a bipolar person an antidepressant without also giving them a medicine called a mood stabilizer, they will go into a huge manic phase.

Oh REALLY???!? Amazing how a stray remark could possibly save your life, isn't it? She described mania. I saw myself.

All of a sudden, my life falls into place with a resounding click. Everything makes sense. I tell the doc the next morning about the events at work, which I had not gone into before, and he immediately changes my meds to treat bipolar. Things start getting better almost right away.

It would still be a total of 11 days before I returned home. The meds take a while to get into the system, and before that, I was still dangerous, so they kept me there until I was stable enough to let go.

Now there are no more voices.

And I've been researching this illness. Did you know that stress (either manic or depressive) causes arterial blockages? And guess what...my diabetes has been completely under control since about my sixth day in the hospital with no meds at all, and remains that way! One psychologist tells me that I may have had this since I was 8 years old. I know for a fact I had it in college, I had even named the manic and depressive cycles; the manic was the "Captain" and the depressive was the "Harliquin." (Yes, the spelling with an "i" is intentional.)

I now know who the man behind the curtain is. And I firmly believe that God orchestrated it in the only way it could have happened, because I was too stubborn and blind to do it any differently.

If you or anyone you know can identify with parts of my story, please go seek help. It has already changed my life and will have a huge effect on the rest of it. To bring the gravity of the situation home, consider this statistic:

Untreated Bipolar has a mortality rate of 20% from suicide.

Untreated bipolar in males has a mortality rate of 30% from suicide.

That's a sobering number. So this is serious stuff. And remember, this is a biological condition. No amount of character, personality, or faith can fix this any more than it can fix a host of other biological diseases. It takes a wise doctor and the right medications to handle it and stop the string of broken and wasted life that it leaves in its path. I think I have found those.


True silence is the rest of the mind; it is to the spirit what sleep is to the body, nourishment and refreshment. -- William Penn (1644 - 1718)

Permalink: 4/08/2003 11:25:00 PM |
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