Bipolar Expeditions (13 page)

Two beings coexist inside this patient: herself and her “extra sister.” Watching her “extra sister” do poorly in school, she yearns to become the “real me” who is a good student. Only then would she have her “life back.”

In support groups, people frequently described both becoming a different person and, at the same time, missing the person they once were. In these cases, one person gives way to a different person while the original person, present in the same body, remains helpless and frustrated—aware of the change but unable to do anything about it. In an evening meeting in Orange County, Brenda, a woman who was there for the first time, told me before the meeting that she was desperately depressed because she had tried various drugs for a year, to no avail. When the meeting began, she was the first to speak.

I miss my self, I miss my personality.
I was once a bubbly, happy outgoing person, then I got depressed, then I went on Paxil and herbs and I was doing well, I felt then like
I had my self back.
Then I had to go off the Paxil because of the side effects, and since then I have been depressed.

Brenda lost her self, got it back, and then, having lost it again, she now misses her self. In a Baltimore group, Caroline also spoke of losing her self as she descended into depression: “It is like breaking apart, like falling into a thousand pieces, like dying inside, [to the group]
you
know what I mean.”

The Bipolar Experience: Interruption

In these last few examples, a false, depressed person seems to replace the real person at a single point in time. Because my fieldwork focused on manic depression rather than major depression, I more often heard people describe feeling like they had more than one person inside at the
same
time or swiftly alternating with each other. This brings us to the second characteristic feature of mania—interruption. The conception of the ideal person in U.S. culture involves constancy: the person may develop or improve over time, but such changes are seen as manifesting more of the person's original self rather than revealing a new self. As the anthropologist Atwood Gaines puts it, “Constancy is a positive attribute. It is an assumed characteristic of the normal self.”
¹⁹
Given this cultural assumption, if the constancy of the person seems lost, personhood itself seems interrupted. In one support group, Jane, who sometimes acted as the group facilitator, asked to speak.

Everything was going fine this week. At work I passed a clerical test, and I was feeling good about that. I had started going to a singles' over-fifty group, and a couple of older men had called. I assure you there was no reason, there was no reason, none at all. I was feeling life is good. I was also looking forward to going out with friends last night, and visiting Thousand Oaks to see other friends over Easter. But a few days ago I woke up in a depression. Now I only want to sleep. I am still going to work, and acting normally then, but all the rest of the time I sleep. I know now I cannot have normal relationships. I cannot have them because there will always be—
this interruption
—and normal people do not understand. No matter what they say, normal people do not understand. Suppose I had already been dating someone and this happened, what could I do or say? If I told him … people do not understand, and it would end it to say I am mentally ill. I know it is chemical, it is the chemicals starting in … I feel hopeless, useless, loveless.

Jane was distressed because her self, which she assumed must have a certain coherence over time to be intelligible to another person, kept on being interrupted. Tom, a regular member of the group as well as a former leader of the organization, tried to soften Jane's belief that her “interruptions” made her unable to have “normal” relationships. He reframed her story by leaving out her reference to having an interrupted self and describing her problems as ordinary: “‘Normal' people are not so different. ‘Normal' people also have problems, and also have bad relationships.” Whereas Jane took the ruptures she experienced as a sign of deep abnormality, Tom urged her to recognize that everyone experiences ruptures in the continuity of the person from time to time.
²⁰

Looking back over a long adulthood of such interruptions leads John, a Vietnam vet, group leader, and writer, to speak of being different people at different times. We had been talking over a leisurely meal in a small restaurant.

When I find I am getting stressful, when the demons are bursting out, I feel pressure building from the inside. The world is not pressing in, you are percolating, your inside temperature is rising to an earthquake, and you have a molten core. Now you are getting down to Dante, the molten core, and there is lava spewing forth. I was Jonathan for a while, the poet. Then I adopted that as a name, a name to write by, and I lived by that for a while. I became John Dante Prescott, that was kind of nice, and so I went through the years. After I was born, I had four different names: I was born John Robin Prescott. At five, I became John Frank Randall, because the father who adopted me was Frank Randall.

When I came back after the manic depression in 1970–71, I became John Abraham Prescott, so my initials were the same as my sister. I was going with a Jewish girl, so that's the Abraham. Then I became John Dante Prescott. I promised my grandmother I would be a Prescott. Having four names, it works for the stages of my life. It is like being born again, and each of those people who died are friends, still incorporated within me, even though I couldn't do the things I did when I was them.

John undergoes the interruptions in his self sequentially, and, as with Jane and the other examples above, his different ways of being coexist—as he puts it, like friends who died.

Sometimes a person will apparently embody multiple ways of being simultaneously. Members of a California support group often commented on how beautiful they considered one of their regular members, Terry, to be. She was very tall and thin, with fine, golden, shoulderlength hair, sculpted chin, and large eyes. When she smiled she looked like a movie star and she smiled frequently. When she talked, her face became animated, but—and this was the disjunction—her words did not match. At one meeting, she spoke of her extreme pain.

I am aloof, as usual, and I really don't ever know what I feel. [Flash of a brilliant smile.] I am in trouble at work, and this has upset me a lot, though I am trying to want what God wants for me at work. I struggle with alcoholism, drug addiction, and now it is so bad I physically can't drink alcohol. I bought a bottle of champagne but couldn't even swallow it, so I ended up pouring it down the drain. I am not willing to turn myself over to AA and get a sponsor, I am just not ready to follow that, and I guess I feel overwhelmed by them.

She gave the impression of having a huge, pent-up, tightly controlled rage, somehow poised between her inner anguish and her outer radiance. When I returned to visit the leader of this group a few months later, he told me the group had been disbanded. Terry had killed herself during the winter, and other conflicts in the group had grown unmanageable in the wake of her suicide.

While this group was still together, Ann, an athletically youthful woman in her fifties, spoke intensely about her dread and fear of an approaching manic episode, describing it as an outside force that threatened to take over her self.

The last time I had [a manic episode] it ended in a hospitalization. At that time my Christian neighbors who talked about Satan and said they were praying for me influenced me. I ended up throwing furniture out of the house because I thought Satan was in it. I had visions of Satan. Now I am facing a trip to Las Vegas and I feel something similar is going on. The neighbors are praying for me again. It feels like an irresistible force, like it is inevitable, like I will pretty soon get so tired of fighting it, I will give up. I want to break all the rules, just throw them to the wind. There is an irresistible force pushing me to do the irrational. My doctor isn't much help; he just sits there fascinated, saying, “Tell me more,” but you can tell he is titillated.

Ann describes mania as if an outside force that takes over her self was possessing her. She fights but eventually gives up and, possessed by the manic force, begins to act like an irrational person. In Ann's case, the crowd inside is composed of two entities, herself and the manic force.

In another Orange County group, Gerta also talked about the condition of manic depression as a force that takes her over. It disturbs her when her friend greets her descriptions of how she feels with, “Oh, I know just what you mean, I feel the same way.”

This just refocuses the conversation over on her. But it isn't the same, she doesn't know what it is like. It is more extreme and it is frightening. It is a lifelong sentence. When somebody has an ordinary illness, even something serious like cancer, they want to look into it, they want to find out more, they want to explore that territory. But with bipolar,
you
don't find out about it,
it
finds you, it finds you, it finds you.

In her memoir, Kay Jamison eloquently describes the feeling of bifurcation that she experienced in manic depression: “Which of the me's is me? The wild, impulsive, chaotic, energetic, crazy one? Or the shy, withdrawn, desperate, suicidal, doomed, and tired one?”
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When a single person encompasses within herself such extremes of emotion and behavior, she exceeds the limits of “rationality.” I am arguing thatrecognizing the multiplicity and interruption often experienced in manic depression makes the judgment that it is an irrational state more comprehensible. Given common cultural assumptions that the normal person has a controlled and constant self, how could it be judged any other way? Paradoxically, when we understand the reasons for finding manic depression irrational, we simultaneously gain an interpretation (based on grasping the experiences of multiplicity and interruption) that might make us question how “normal” the controlled, constant self really is.
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The multiplicity we are discussing here needs to be considered in light of the regenerative character of manic depression we discussed in
chapter 1
. The inextricableness of manic depression's highs and lows, the unnerving experience of mania always being twinned to depression and depression twinned to mania, also entails multiplicity. Both forms of multiplicity may draw on specifically Protestant notions that good and bad are inextricable: heaven implies hell; God, Satan; the saved, the lost; and perfection, sin. In my fieldwork, John was not the only one who spoke of manic depression as Dante's heaven and hell: Richard also told me that when he is manic he sees the world engaged in a great battle of good versus evil, as in C. S. Lewis's
Chronicles of Narnia.
He can see the conspiracy of evil, the works of the devil and of God. Others living under the description of manic depression told me that their Protestant neighbors often thought they were inhabited by diabolical forces and in
chapter 5
we will meet Mary, whose neighbors helped her cast out the devil they believed possessed her.

Pulling all these threads together, Jane told her California support group that she relied on Christian inspirational literature to help her through the first five minutes of feeling suicidal. Later that evening, when the group reconvened at a diner, she added, “Once in a Christian bookstore I found a section on manic depression which said manic depression was Satanic! The manic person was doing it on purpose, there was no evidence there was any biological aspect to it. My mother and I objected, and the shop clerk said she would ‘red flag' the book.” John sympathized with Jane: “Those Apollonian Christians can't stand the Dionysian manic depressives!” Reflecting his knowledge that mania was once considered possession and that possession was not always considered negatively, he added, “But we were once the shamans after all!” Christian views of life and death are relevant here, not in a strict doctrinal sense, but in the sense that American culture is imbued with them. They are part of the deep background that flows into the social life surrounding the multiplicity and interruption of manic depression.
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Sounding a Second Voice

People who experience themselves as containing multiple centers of action could be said to be capable of performing many different roles. In support group meetings, I initially found it startling that what seemed to be deliberate enactments of manic behavior occurred quite frequently. At one evening meeting, a group was sitting around a table watching a video called
Dark Glasses and Kaleidoscopes,
produced by Abbott Laboratories, the makers of Depakote, a new drug found to be effective in the treatment of manic depression.

As they watched the video, people in the support group were dismissive or hostile, criticizing and mocking the film's optimistic promise that if you take your medications, your life will be so normal that you can have a job or a profession, even if you are diagnosed with manic depression. Some of their comments were: “That's an ideal world!”; “It's bullshit that medications can be fixed to keep you ‘just right'”; “Yeah, you can work in a profession as long as you don't tell your employer [you have manic depression]”; “Go ahead and call the 1–800 number as long as you can block a tracer on the call.” There was allaround scoffing and scorn when the video showed a person with manic depression saying, “Losing the ability to monitor my own behavior is what having manic depression is.” Depakote, according to the video, restores that ability and allows the person to adapt to ordinary life.

When the video ended, one man began to turn the tables on the video's story by changing the definition of who needs to be medicated: ‘You know what I always say, the whole world needs a dose of lithium.” Someone else chimed in, “Yeah, put it in the water, put it in the air!” The next moment, a man who had come to meetings week after week, but who always sat quietly, saying nothing, with a gloomy expression and dejected appearance, said, “I usually don't say anything at all, I have been silent here for weeks and weeks, but tonight I realize I can't hold it all in. I have to let it out.” Then he launched into a string of shockingly barbed and funny jokes. Startled, everyone looked around the table hesitantly. Smiles bloomed as a rapid “eye flash”—eye contact that moved rapidly around the group—signaled the start of a hilarious session of joke telling that took up the entire rest of the two-hour meeting.
²⁴
Every now and then someone would say plaintively, but obviously not really seriously, “What are we doing? What if someone wants to share?!?” Virtually every person there told raunchy, gross, lewd, or insulting jokes about Catholics, Jews, Poles, blondes, wives, the elderly, or the pope. Everyone shrieked with laughter and frenetic energy built and built. Food and soft drinks cascaded over the room and people gave up their seats in a tidy circle to lounge on tables, chairs, and the floor.
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