…salted lithium.

“Today I am off the medication and all of this is useless. I need help. My sleeping pattern is completely reversed: I am sleeping from 6am to 6pm, I never know when to take my medication anymore so I usually don’t bother… I have my rent money but cannot take a bus across town to pay the landlord… I have a cheque for the phonebill but cannot motivate to get to their office. I am a BiPolar Manic Depressive and I am off my medication, I need help.”
Gabriel [saltedlithium].
May 9, 1992, Age 22

“I am a Manic Depressive (bi-polar) and I still don’t know what that means. I know it’s supposed to be genetic, which only means I can blame somebody else for it. I know that Lithium helps, but the “Why Bother Syndrome” takes hold if I miss one dose. I really don’t like lying awake until 6am every night, sleeping until the afternoon everyday, the suicide fantasies I dream up when I’m alone, the writing I produce — yet it all lends itself to an air of mystery, an addiction to the depth of character. Do I feed off the disease or vice-versa? Why don’t I want to heal?”
Gabriel.
November, 1992.

“A depressive phase is a sign for [people with BiPolar Disease] and people around them to look at what is causing them to worry, boost emotional support and get help to get the emotional needs met. This is so obvious but is incredibly important and can’t be said enough times.”
The MindFields College Blog

“More than one in three Canadians treated in hospital for some form of mental illness are back in hospital within a year of their discharge, says a report that raises questions as to whether patients with psychiatric disorders are getting appropriate care.
“About 37 per cent of people with mental illness were readmitted within a year, and that compares to just over 25 per cent that were readmitted following admission for other types of disease or conditions,” [said Ian] Joiner [manager for rehabilitation and mental health at the Canadian Institute for Health Information].”
Canadian Institute for Health Information Press Release, Nov. 29, 2006.

“Don’t let me die while I’m
living in my mothers basement.”
One Star Cop, Grand Theft Auto: San Andreas

We can spend so many years trying to convince people of how sick we are then, when we’re finally diagnosed, we’re left by the health care system to fend for ourselves as if our family and friends network was fully formed and operational, as though we have a working understanding of what the disease is doing to our minds and bodies, as though we should know and understand what the medications will do to our minds and bodies.

It’s not just Manic Depression, it’s every mental illness. Obsessive Compulsives, Panic and Phobia Disorders, Attention Deficit Disease, Bulimia, Anorexia. We spend, on average, years trying to break into the Mental Health System. The only time we’re taken seriously and pushed into “hyper-care” is if we’re chronic: a teenage girl with Anorexia slips below 90lbs and the symptoms become too extreme to not notice anymore gets placed into a special home or is hospitalized. A young man is taken over by his Manic Depression and is found with slashed wrists is hospitalized and entered into an Out-Patient Program. A young woman gives into the schizophrenic voices and hurts her children and is immediately medicated into a coma which she’s unlikely to ever be allowed to come out of.

I keep hearing and reading about “Perfect World” responses. In a perfect world someone with manic depression would have understanding parents, a group of witty friends who look and act like Emma Thompson and Hugh Grant, a doctor who is available on a moments notice, medications which work the first time exactly the way the available literature says they’re supposed to work. Well, what the fuck? What other disease, or group of diseases has to rely on a Perfect World scenario to get the patient through their initial treatment phase? And when — just when — just one fucking time has it ever happened that a person with Manic Depression has ever had a “Perfect World” scenario? Why are we, the mentally ill, left to the vaguaries of the Perfect Scenario? Why are our doctors, once THEY’VE made the diagnosis, not making sure our families are in the room so the explanation can be made by THE DOCTOR as to why we’ve been such shitty fucking children over these many years? Why are our doctors not bringing dietitians into our appointment if diet is so important to our recovery? Why are we not being handed massive amounts of Vitamin D along with our Lithium? Why, if sleep is so all fucking important to our recovery, are we not being handed a sleep aid along with our Lithium and Vitamin D? Why does it take so fucking long for people to tell us that, “yes, in fact, your bizarre sleeping patterns are, in fact, quite abnormal and, yes, in fact, there are ways to manage your sleep with medications, in fact”? Why, with a disease that fucks with OUR MINDS, is it assumed that we have an understanding of the disease on par with that of the doctor? Why is it left to us to inform family, friends, co-workers, bosses about the effects of the disease as though we had written the DSM-IV?

In the minds of the people around us, as soon as we’re diagnosed our problems are over. Parents have something they can tell friends when they’re embarrassed “Oh, don’t mind little Bobby, he’s got the manic. Yes, it was going around his class last year and he hasn’t managed to shake it yet. Apparently you treat it with salt.” All you have to do now is take the fucking pills and everything will be Norman Rockwell. As if your brain was no longer working against you which, until this very fucking morning when you had that twenty minute suicide fantasy, it was. But, hey, the doctor says everything should be fine now, right? Because that’s how it works with cancer, or diabetes, or genital warts, or the Bird Flu. You get diagnosed, the doctor says here, and you do what he says because, obviously, any right thinking person would want to get better. When you get the Bird Flu your brain, obviously, says “hey, we should get that taken care of.” When you “get” Manic Depression your brain tells you “hey, you’re worthless, lets crawl into a corner and I can show you thirty different ways you can kill yourself.” Where’s the “Perfect World” scenerio there?

There’s a program on A&E, an American television station, it’s called “Intervention” and it is the most gut wrenching, tragic program you will ever see: “Each documentary follows the lives of these addicts, taking an unflinching look at the impact of their addictions on their everyday lives, all the while the addicts are unaware that an intervention is being planned. (A&E)” These things will tear your fucking heart out. The addicts are at their very bottom, they are young women selling themselves for a bottle of whiskey, they are young men bleeding crack from their eyes. The thing is, these addicts remind me of mentally ill people* who have been fighting to get into the health care system for so long that they’ve given up… like the non-addicted mentally ill they’ve had all of the hope sucked out of their bodies, there is nothing left but the body and the drug / disease.

When the intervention happens the addicts are led into hotel rooms where a counselor and their remaining friends and family are waiting. What happens next is the amazing part… the last loved ones in the addicts life tell them about all the crap the addict had caused through their addiction, and what the bottom-line consequences are to not getting better. About 60% of the addicts agree to go to a centre where they can receive help, but it’s the hope… their eyes just open right up as they realize there are people left who care for them. And the promises the family makes, the friends make, to learn about their addiction, to attend AA, NA, AL-Anon, to read the pamphlets, you can see the addict just melting, giving in “everything, from this day forward, gets better and finally they will understand me”. So off they go to get help. And the ones who come back reunite with their families and friends… who have done nothing. Not a fucking thing. Not a pamphlet, not a meeting, nothing. There is no understanding beyond “Well, Jimmy was a raging crack addict, but now he’s fine. Sure, he’s hanging out with some of the same people, but what are you gonnna do?”

I was Clinically Depressed before I was Manically Depressed. When I was finally diagnosed in 1988/89 as having Manic Depression there were no explanations, there were no pamphlets, I walked around for years thinking I could, after forgetting for a week, just start popping the Lithium again and everything would be fine. If I missed a dose, I’d just double, triple or quadruple it up. When I tried to take control over the disease, and get back into the health care system I’d run into doctors who insisted on psychoanalysis, insisting on delving into the minutiae of my childhood, as if my Clinical Depression had any relation to my Manic Depression. These people were looking at a 20-year old kid, who had already been diagnosed with Manic Depression, who was on welfare, eating from food banks, sharing rooming houses with alcoholics, drug dealers and prostitutes and they insisted that my salvation from Mental Illness lay in my understanding of family events and breathing techniques rather than in medication and diet.

The first time anyone explained to me that Manic Depression fucked with your sleep was when I read “An Unquiet Mind” in 2000. The only book anyone in my family ever bought for me which dealt with depression was a memoir of an aged former journalist who suffered from clinical depression because he grew up gay in a community that didn’t appreciate homosexuals — even though I’ve never been gay, at that point reporting was not my profession, I’ve never been sixty and I was not raised in rural America. My mother has been to three doctor appointments with me since 1988, after each one she insists that I blame her for everything and that all of my childhood memories are suspect. After being on the pills and 99% sober for three years my family still asks me why I’m not drinking alcohol with our meal. None of my family have read any literature on depression, and my mother insists to this day that she knows all about the disease simply from having to deal with me.

To a slightly lesser degree, when I was diagnosed, I was that addict walking into his Intervention. All of those same promises, explicit and implied, were laid out for me: “We know what’s causing the shit in your life now, Gabriel. It will take hard work, and we’ll all do our part, but things will get better from here.” After surviving eighteen years with the glories of manic depression it was coincidence that finally got me into treatment: my mother was home to take my suicide call. Things are only easier in my family now because I’m not insane anymore. No more 4am suicide phone calls, no more “230lb Dark Gabriel sitting on the couch using the TV to drown out his depressions”. Now it’s “easy to get along with 238lb Light Gabriel” so everything must be better. “See,” they say, “that wasn’t so hard. Obviously you were doing something wrong before because all you had to do was take your pills.”

We fight so hard to get into that room and when we leave we’re convinced that, finally, everyone who is important to us, everyone who loves us and who we love, is going to ‘get us’, but they don’t. And that’s a crime. We need more than we’re getting, especially those right at the beginning of the process, and especially from a “mental health” system that has been leaving too much responsibility for too long in the hands of people who — for most of our diseased lives — want nothing more than to slide a fucking razor across our collective wrists.

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[*without a doubt addicts are mentally ill…]

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