“Depression is a thin coating, it’s a thin sheet of reflective ice concealing an ocean. It corrupts our ability to Reason, and without that ability we can’t defend ourselves against the thoughts inside our heads, so we find excuses we can live with. People with our disease are excellent at rationalizing unreasonable behaviour to fit situations we can’t understand.”
“kicking at the darkness until it bleeds daylight“; Me (Nov 16, 2006).
At some point, usually before we really understand the need for a recovery plan, people who have been diagnosed with manic depression ask how much of ourselves are we willing to give up to get better. Most of the time the answer is nothing.
For most of my post-diagnosis / pre-recovery period I self-medicated with Lithium. I had what amounted to an open ended prescription… when you walk into a Clinic and explain to them your diagnosis they’ll give you a script for a one to three month supply. Walk up to any pharmacist and do the same and you’ll get four to seven days worth of free pills.
So when I decided my life was so far into the toilet only some kind of treatment would work, the only one accessible to me was Lithium. But it would only last until I felt a Change coming on, then I would get worried about losing my ability to write or think fast — which, at the time, was where I thought my talent came from. Then I’d either put the pills away or forget to take them…
For awhile I really didn’t need to go to a clinic or a pharmacist because at any one time I had six weeks worth of Lithium tucked away in a shoe box… there was a period of a few years when, if I was lucid for a few days and could think rationally, I’d just dip into my pill box and down a few days worth of Lithium.
But after a few days, or a couple of weeks, the question always came back… of the things about me that I like, of the things I consider to be Who I Am, what am I giving up to not have the crippling depressions and the manics?
And the answer was always “too much.” I could, I decided several times, live with the Disease. Then I’d go back to my rooming house, kill a few roaches and wonder why I had nothing to eat…
What it comes down to is how much of the Disease do you consider to be You and what I’ve learned from the experiences I’ve had is none of it is Me and I haven’t given up anything of me to be rid of It… I’ve gained more of Myself the more I’ve rid myself of It. I would suggest that the parts of you which want to be better are the parts that are You and the parts which want to stay the same or get worse are the Disease.
When you think about the disease, when you think you are what the disease tells you who You are, You’re not what it says you are at all. Christ, the disease is really just a tiny piece of something in your brain… little microscopic drips of chemicals that are just a little bit out of place or about four out of a trillion neurons sparking once instead of twice.
Seriously, get an eyedropper and drop a single drop onto a piece of glass… that’s the disease. That’s what has you thinking about cutting and dying and Not Being. Manic Depression is just a couple of out of place hormones and chemical reactions. That’s all there is to it… its power is an illusion which can be beaten, there is no bogeyman. The natural, clinical depressions can be treated, Will be treated, just get the two separated so you can focus on what’s real and what’s a reflection.
There’s something really wrong about the idea of “giving something away” to get better… it makes sense in terms of addiction: “I’m an alcoholic so I’m giving up alcohol in order to get better”, but in terms of getting better from a disease “giving something away” doesn’t really seem to apply. Like cancer… “I’m giving away / up my hair so I can get better”, but if you get better you get your life and your hair back.
With manic depression I’m not even sure what it is we “give away” to get better… to me the question means we’re contemplating a sacrifice of some kind, like there’s something we really, really want that we’re going to lose forever in exchange for this other thing of equal or somewhat greater value.
“Giving away”, in my head, just has too many negatives attached to it… also, by attaching ‘sacrifice’ to recovering from the disease it seems to lend certain anthropomorphic qualities to the disease. Like you’re Rocky and it’s Clubber Lang and to win you have to take body shots for the first nine rounds… or maybe this works better, like you’re a farmer trapped under a tractor and the only way to survive is to cut your arm off with a nail file. So you file it off, hobble back to the Village, have a pint, marry your sweetheart and, thirty years later, you tell your grandkids how you sacrificed your arm so they could have life but then you die from blood loss because you forgot to have the wound sown up. Or something.
When I was off the pills most of the little poems and stories I wrote were asking the same question in different ways… like, “what if I lose my ability to write?” or “what parts of my personality will I lose if I take these pills?”, but the questions were really me rationalizing staying untreated using my apprehensions and ignorance as proof.
I honestly believed it was important to write ‘Pro v. Con’ lists because, unmedicated, I thought there were Pro’s to having manic depression… and I was wrong.*
*About 60% of this was lifted from a comment I left on Exact Science‘s blog.
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...salted lithium. 
I have been waiting on this post!
How much of yourself do you give away in order to be well?
The rhetoric as you know sits on most of my blog posts. And I am still going to meditate on it, less now as it becomes so clear the answer is nothing.
I was “giving away” a lot of things but was just treading water, I wasn’t getting better. The disease as I see might help the realisation of some things, that you are a talented artist – because a manic spree saw you buying an easel. But once it was gone, the bipolar, the talent will always be there.
I see with increasing clarity what the disease does to me, the benefit of insight, a diagnosis and a med regime that works. I see where I end and it begins, and from where I end I’ll happy excise.
but g, did you have a point or points where meds temporarily inhibited your creativity and thought organization(s), because it would seem that would be something to be addressed/considered. it’s often a topic of discussion and debate.
is there a ‘hump’ to get over, so to speak?
of course i’d only throw this out to you because you’re a pro at deciphering such things.
Allo Dame: There is a time, as the body adjusts, where the treatment and the Disease overlap where things feel like they get worse… just like going into rehab and having sobriety interfere with the addiction. At a certain point the worst parts of the medical side effects hit us at the same time as the not-so-great aspects of the Disease, but with proper treatment — and finding that proper treatment is key — it clears and we end up left with the best of ourselves.
Bonjour Exact Science: Yeah, me too. Too many ideas and not enough time, it’s the curse of not having a competent staff. You’re asking yourself an important question, it’s something we all go through for different periods… it took me a long, long time to figure out the answer. I like that image of treading water… what’s the value of the things we give up as we spend so much time wondering how much we’ll give up if we get treated.
Wow. I often have struggled with the idea of “If I take the pills, will it change me? Is it making me someone different? Will it impair or slow down my creativity or my ability to think outside the box?”
I decided a long long time ago, that without the medications to level me and put me in the land of reality (no huge seesawing up and down) I was really only living a fraction of what I could be. Being committed to taking medications really meant that I was able to stay in touch with my creativity and to stay focussed on it.
I love your analogy of the disease being nothing more than a drop of water on a glass slide. Often when I speak to health classes, I always emphasize to them that there is me, and then there is this teeny tiny part of me that is the illness. This was one of the hardest lessons I learned – after all, if one becomes ill enough to require treatment, it can be that one’s life then becomes something to be “treated” – you are pathologized. Stepping back and learning that I was more than the illness was a huge leap towards grasping hold of wellness and never letting go.
I’ve never given much thought to the idea of “giving away” something to be well. It’s true though. I’ve written those same pro and con lists that you mention. And now in hindsight, I think the only thing I gave away by agreeing to treatment was something I didn’t want in the first place – an incredibly unhappy and unstable life. Is that something one would really want to keep?
Ahhh.. probably not making too much sense. Great thoughts though. I love it when someone else writes something that makes me go “hmmmmmm…. “
I have a question. If you are on lithium, doesn’t it take care of the mania and the depression, or do you have bipolar disorder and clinical depression?
Or do you mean depression, not the disease, just the “I’m sad because this terrible thing happened” type depression?
Hello Kitty… Lithium is a mood stabilizer. The best way to understand how it works is to think of moods on a scale of zero to 100 with the range between 40 and 60 as “typical”. Manic depression pushes and pulls us on average into the 20 to 80 range. Lithium puts a cap on the ups and downs so we function in the 30 to 70 range. It doesn’t prevent manics or depressions, someone with manic depression who is only taking Lithium will still go high and low. Lithium is generally prescribed in the beginning to simply get the person under control, then the doctor will add something like Seroquel or Wellbutrin later on…
I know Lithium is sometimes prescribed for “clinical depressions” or “unipolar depressions”, but it’s still not common.
Either way it takes about two weeks of dosing to get the Lithium level in your body to optimum levels, then a few months for the beneficial effects to start showing but in the between-time the side effects can be… not nice. Going the other way it only takes missing four to six doses for the Lithium levels in your body to go away.
Lithium is not something anyone should take to get over normal depressions. It’s actually toxic to your body when the levels aren’t maintained properly with regular blood tests.
Okay, I think I am understanding this better.
I didn’t know lithium didn’t cure all of the manics or depressions.
Your knowledge of the disorder and abiltiy to bring it down to street level is impressive, Gabriel.
Brilliant post.
I didn’t give up anything, really. In fact, I had more to gain! I was so non-functional, initially, I had to get well! I could barely perform at work and I needed that paycheque.
At other times, as well, I have been pretty non-functional, but pre-diagnosis (and pre-correct diagnosis) things were definitely awful.
Beyond that? What have I really “given up?” Well, probably some “insane” and dangerous behaviour. That’s a good thing, though.
However, when you backslide a bit, you can still do some things that aren’t so “smart.” Or, at least I can–but certainly nowhere near the level/s when I was untreated!
Side effects? Alright, I’m more clumsy and my brain’s a bit slower because of the ACs but really…a small trade off for being better mentally!
So, no. I haven’t given up anything. As above, I’ve gained, I suppose. It’s not that I’m thrilled to have all of this head shit (more beyond just the BP/MD, as well.) No, I’d rather not have any of it at all, thank you very much. But, I do.
So, that being the case, do whatever the hell I can to make it as bearable as possible. It hurts enough as it is, right? I really don’t see it a great challenge to take my meds and see my doctors etc…
Perhaps, for me, the greatest challenges lie in “personal issues.” I think that’s a different story, and much more complicated, though. Some things are so deeply embedded, and buried within us. Dealing with things like that…much more complex than just sticking to a “treatment regime.”
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