Me and My Mood Disorder Not Otherwise Specified, Part 5

Part 1 is here.

Part 2 is here.

Part 3 is here.

Part 4 is here.

Mental illness carries a stigma for two reasons: first, as I've already discussed, we often confuse it with a personality or character flaw because, well, it profoundly affects personality and character. Second, it disturbs us (even more than other illnesses) because it fucks with our ability to read other people. Your social instincts and skills, honed over millions of years in an evolutionary sense and over your whole lifetime in a more personal one, often spit out a big DOES NOT COMPUTE when confronted with someone with a mental illness because, well, their responses and social cues don't make a lick of sense. And people that don't make sense are unpredictable, and that's scary.

Is he going to kiss you or bite you? Hug you or eat you? You just don't know.

My problem with the stigma attached to mental illness isn't that it isn't fair -- although it often isn't -- it's simply that it often keeps people from getting the treatment they need. People don't want to admit to themselves that they're crazy or broken, that the essential them they know and love is nuts. And so they put off getting treatment, and wind up miserable at best and dead at worst. Which is why I try and be as open as possible about my own condition.

I don't wear "Has a Mood Disorder" like a merit badge, and I don't tell everyone on the street about how well my meds are working. But I do try to treat it casually, like any other chronic, treatable medical condition. Like diabetes, say. It's not necessarily everyone's business, but I'm not afraid to mention it in conversation if it's relevant.

The couple times that people have opened up to me about their own experiences with mental illness because I was open about mine have been extremely gratifying. Let me tell you, it doesn't get much better than having one of your students tell you you "saved their life" by being a friendly ear, and a hardass about making sure they kept going to treatment.

If you have a mental illness, my advice is, wait until you've got it handled -- until you're getting treatment, until you feel like you're starting to master the beast. And be careful about it at work. I work mostly in the performing arts and academia, where the reaction is usually not "You have a mental illness?", but rather "What's your dosage? Because I had some real problems with Restless Leg Syndrome when I was taking 250 mg". Not having a mental disorder of some kind is looked on with just a hint of suspicion. But in other industries, people can be real dicks about it. So watch your back.

But that aside? Pay it forward. People are dying from this every day, and living the kind of lives where they might as well be dead. I don't know if you owe them anything, but you can help.

Oh, and if there's anyone out there wondering how the people close to you will react if you "come out of the closet", as it were? Trust me, you were the last to know.

"What would they think if they knew the real me?"

Finally, I'd like to close with a little bit of advice for people who have to deal with people who are mentally ill:

1) It will take time. A lot of time. Like, years.

2) It is perfectly normal to want to beat them to death with their own leg. Mentally ill people are irritating as fuck.

3) Be prepared to forgive anything but avoiding treatment or not taking meds. Someone with a mental illness cannot be responsible for a lot of their behavior... but draw a line in the sand when it comes to doing what it takes to get better. My wife puts up with a lot... but if I skip meds, accidentally or not, her wrath comes down like the fist of an angry god. As well it should.

The last time I skipped meds.

4) Talk of harming oneself or others is not to be fucked around with. If you're asking yourself if they really mean it or not, they do. Call someone.

Get well, be well. Remember, Better Living Through Chemistry is still Living Better.

-- The Prolix Wag
Better Living Through Being Smarter Than You

Advice to People with a Mental Illness

My muse struck, and I must follow where she leads. Back to the series about my mood disorder tomorrow. At least this is related.

Advice to people with a mental illness:

1) Keep telling yourself that it is what it is: a disease. Not a personality flaw, not a thing to be ashamed of. You won't believe it for a long time. That's why you have to keep saying it to yourself.

2) Get treatment. You know those annoying people who bitch and bitch about how their tooth hurts but won't go to the dentist because they're pussies? Yeah, that's you, except instead of the tooth it's your personality, and it's making everyone miserable. Suck it up and be responsible for your own health. GO TO THE DOCTOR. You deserve to get better. The people around you deserve a you that isn't such an annoying, irrational asshole.

N.B.: The first step should be to go see a regular old internist to get some blood work. If it's (say) a thyroid problem that's causing the ruckus, you can treat that a lot quicker and easier up front. Once you've exhausted what your internist can do for you, go see a specialist. Just like you would for any other illness. (Funny, that).

3) Do what the doc tells you. Self-medication is one of the tools in your toolbox -- Winston Churchill got through WWII with Bipolar by medicating his downs with booze and his ups with bricklaying.

"It was either this or bomb Dresden... by myself... without a plane."

...but it's only one tool among many, and a lot of ways of self-medicating have nasty side effects (the carpal tunnel from obsessive gaming is not that bad... heroin is not so kind). Remember what I said about medicating your brain being like taking a ball peen hammer to a malfunctioning watch? Still true. But using a fifth of bourbon instead is like dropping a wrecking ball on the thing.

4) If you don't like what the doc tells you, say so. Even though there will be vast swathes of it you won't be able to be objective about (see number 9 below), you know your disease better than anybody. Speak up, and speak up often.

5) If you still don't like what the doc tells you, get another doc. Giving up on treatment entirely because your last psychiatrist/therapist was a moron buys you nothing but an excuse to stay miserable. Congratulations.

6) Your disease will lie to you. It's what it does. It is, by definition, irrational and stupid, although your rational mind laid on top of it can make it very, very crafty. Those little voices telling you to kill yourself? They lie. Tell them to fuck off. They won't. Do it anyway.

7) Exercise. I hate this one. I fucking despise it with the passion of a cat thrown into water. But it works. Do it when you can.

Yeah. Pretty much EXACTLY like that.

8) Be patient, and be kind to yourself. This shit will take time. Serious time. It took me close to two years to find a blend of meds that really worked for me, and it's under constant revision. Be patient, and don't blame yourself when you don't get better right away. Blame the disease.

The perfect pill for you is that one. No, wait... that one.

9) Find an advocate. Find someone who can speak for your interests when you're not being rational. Someone who can go to the psychiatrist with you when you just can't face it alone. Someone you can trust when they say "you're not thinking straight". Then believe them when they say it.

10) Get laid. This will often involve the person from number 9. I have no idea if this has any therapeutic benefit, but it always helps my mood.

Above all, find someone you can talk to about it. If you don't have someone, message me. I'll tell you exactly what I said here, but it will be personalized. I understand that helps some people feel special.

-- The Prolix Wag
Don't hate me because I'm smarter than you. Hate me because I'm a dick about it.

Me and My Mood Disorder Not Otherwise Specified, Part 3

Part 1 is here.

Part 2 is here.

I can remember the exact moment I figured out that my psychiatrist (the one who diagnosed me) knew what the hell he was doing. It was when, in the course of asking all the usual psychy-psychy questions ("Do you ever think about hurting yourself or others?", "On a scale of 1 to 10, how severe would you say your depression is?", "Do you like the new couch?", etcetera), he asked this one:

"Do you like puns?"

Which took me aback a little bit. Because I do. Quite a bit. Especially when I'm in a good mood.

"You're kinda freaking me out, doc. What gave it away?"

See, it turns out an enjoyment of/engagement in/freakishly annoying obsession with puns and wordplay is one of the symptoms -- or, shall we say, "characteristics" -- of a manic episode. And here I always thought it was just part of who I was.

"Fortunately, they have a pill for that now."

As I noted in Part 1, if it were up to me, I would stay in my manic mode all the time. My wife is very glad I can't. When I'm manic, I talk faster; I use more words; I do weird, spazzy things (nothing too crazy -- I might, say, do the Safety Dance around the living room apropos of nothing -- but... spazzy); I focus obsessively on somewhat grandiose tasks (I once dug and built a stonework path in our backyard "just because", and wrote an entire play in a month); overall I get a little... intense. For those of you who've been around me and thought I was just a little too much, now you know why. As my wife will be happy to tell you, I can be very, very annoying when I'm manic.

But, like I said, I love it. I talk faster because I think faster. I'm smarter and funnier. Almost all of my good writing gets done when I'm manic (the editing is another story, but that's neither here nor there). If you notice a post that goes on and on and on just a hair too much, then I was probably manic when I wrote it. I've got just a little bit of an edge right now, for example.

When I get depressed, I get stupid. I can't think of the word for incredibly obvious things (like "cabinet"), and whatever I try to write comes out clumsy and off, especially if I'm trying to be funny. It's incredibly frustrating. If you've ever read a post or a message from me that felt forced, and just plain wasn't funny, I was probably depressed when I wrote it.

Blech.

So, like I said, I'd be manic all the time if I could help it. Fortunately for my wife, I'm not.

How I feel when I'm manic...

....and what my wife actually gets to deal with.

It's interesting to me that, essentially, what I'm doing when I take my meds is regulating my personality. Changing it. Frankly, there's some stuff about the pre-medicated me I miss. I was weirder, for one thing. Most other people didn't seem to like that as much, but it was who I was. I'm still me, but... a different me.

I'm less creative, in some ways. I'm probably a better writer and actor now, but it isn't always quite as much fun. I heard somewhere that mental illness is far more common among artists... that close to half of all professional poets were somewhere on the bipolar spectrum.

I don't write much poetry any more.

Right now, psychiatry is kinda like taking a ball peen hammer to a malfunctioning Swiss watch -- it may very well get it to run better, but no matter how gently you hit it, your tool is less subtle than the internal mechanism by several orders of magnitude. Don't get me wrong, my meds work pretty damn well, and I'm glad I have them, but I do wonder what life will be like when we can medicate with greater precision. When we can change personalities on demand, and get exactly what we want. What if we could make people "artistic"? Or "nice"?

Who would you want to be?

Who would they want to be?

...

Next time, the Ugly Truth About Depression, Which Is Even Uglier Than You Thought, or "Why Sara Kane's Crave is the Worst Play in the Universe".

-- The Prolix Wag
I know more about it because I've lived it. I would know more about it anyway, but let's not quibble.

Me and My Mood Disorder Not Otherwise Specified, Part 2

Part 1 is here.

Let us begin Part 2 with Aristotle.

And what a huge dick he was.

Father of philosophy, great uncle of rhetoric, second cousin of math, huge dick. Huuuuuuuuge.

Why was Aristotle such a huge dick? Well, first and foremost, he was pretty much the inventor of dramatic criticism. Which subsequently led to the invention of drama critics. So, q.e.d.

It also led to the invention of the Neoclassical Unities, which is directly responsible for me having to read Racine's Phaedra in college. Which, as we all know, is The Worst Play Ever Written, Except For Sara Kane's Crave.

"Oh girl, hold on! Are those shoes on sale?"
"I have no idea, but thank god we're not doing Crave."

He also thought women were a lower form of life who could never be fully human, but some of our finest Supreme Court Justices believe the same thing, so let's just chalk that up as "controversial". No, the thing that made him a truly huge dick is the only thing I remember from my dabblings with philosophy in undergrad, which is drawing a big line from his name to "Mind/Body Dichotomy in Western Thought" in my notes.

See, we're stuck with this deep-seated belief that the mind, the Self, that-which-you-think-of-as-"me", is fundamentally separate from the body. Which, as anyone who's ever had to deal with any kind of neurochemical imbalance knows, is complete and utter bullshit.

The usual argument for their separation goes something like this: "You are yourself. Would you still be yourself if I cut off your arm? What about your leg? What about all your arms and legs? So, wouldn't you still be yourself without your body?"

Problem is, a brain is not a leg. Heck, a pancreas is not a leg. We cannot have a direct experience of what it is to be without a body, which is why the concept of life after death is exceedingly hard to debate... but we can have an experience of what it is to be without a self.

Let me turn that argument around: "You are yourself. Would you still be yourself if I cut out that part of you that feels happiness? What about the part of you that thinks? What about everything that you think of as consciousness? Would you still be yourself without a mind?"

And if you don't think we can do any of that, you've never met anyone that's had major depression. Much less a lobotomy.

"Oh, McMurphy! If your pneuma and your soma were not indissoluble, this would totally be a depressing ending!"

We don't like to think about this idea too much, because it has certain disturbing metaphysical implications (if "Self" is an expression of "Body", and "Body" can end... well, let's not go there), but it bears talking about because it has direct bearing on how we think about mental illness. Because "mental illness" is a panoply of diseases and injuries that attack the parts of our body (mainly the brain, but also the endocrine system) that create "self", and therefore are diseases and injuries that attack the "self".

Which is a bitch and a half, believe me.

One of the hardest things to wrap your head around as someone who has a mental illness is that there are thoughts and behaviors "you" are not responsible for... even though "you" are the one feeling and doing them. But it's vital that you do, because otherwise you spend all your time blaming yourself and feeling guilty for things you can't possibly control. I mean, if I break my leg, do I feel guilty about the fact that I suddenly can't walk without crutches? Heck, no. But I've had mornings when I could not -- and I mean could not -- get out of bed because of what was happening chemically in my brain. And blaming myself or feeling guilty about that wasn't just wrong-headed, it was incredibly counterproductive. It kept me from getting treatment for a long while.

The brain is an organ, like any other, and like all the other organs, it can break. When it breaks, it stops working... and that lack of function can make you sick, or even kill you. It's a very counterintuitive idea, but one that makes mental illness something you can treat just like any other injury or disease, instead of a fundamental fault in someone's being. And if you want to see the consequences of treating it one way instead of another, just look at the US Army. Treat PTSD like a brain injury? You get treatment for your soldiers. Treat it like a personality flaw? You get suicides, murders, and a generation of veterans that hate the service that betrayed them.

And if you've ever known anyone who's committed suicide due to a mental illness, it's a lot more comforting to think that they died of a disease, than that they chose to do it.

Next up, what "manic" means to me, or: "It's like there's a party in my pants... in my head!"

-- The Prolix Wag
The Gold Standard of Deviation.

Me and My Mood Disorder Not Otherwise Specified, Part 1

Several years ago, I was diagnosed with a Mood Disorder Not Otherwise Specified, which kind of surprised me at the time since the Moods in question were always Pretty Damn Specific, if not Predictable, Appropriate, or Pleasant.

What it basically means is that, if I'm unmedicated, my mood swings from depressed to manic to various places in between and back again completely detached from the actual circumstances of my life. My highs don't go quite as high as someone with full-blown Bipolar Disorder would (if it were up to me, I'd live my entire life in my manic zone, even though my wife would probably be forced to kill me after a couple days for the sake of her own sanity), and I have other moods that don't really fit on either end of a scale, like "agitated" (manic but irritable), "cranky" (depressed but energetic), and "WHARRGARBL".

Wharrgarbl.

You can think of me as Bipolar But With Longer, Gentler Swings, or as Depressive With Occasional Highs. Or, as most people thought of me before I was diagnosed, Weird.

One of the dirty little secrets of modern psychiatry is that they don't really make diagnoses the way other doctors can; they don't really have diagnoses. They have categories. When a doctor says "you have strep", there's a strep virus he can point on a big picture on a flipchart with one of those metal pointing things, and lo, that's what's wrong with you. The fever, sore throat, et. al. are symptoms. They can be markers of the underlying condition, they can help your doctor figure out what the underlying condition is, but they're the effect, not the cause. Although it annoyed my psychiatrist no end when I pointed this out, neuroscience is very much in it's infancy, and psychiatry is in many ways still a "Black Box" endeavor. In other words, they toss a few pills into the Black Box that is your neurological/system, shake it around a bit, see if it works or not, change up meds, and try again until they get a result they can live with. There's a reason I have a Mood Disorder instead of a Mood Disease; they don't quite know what my disease is, yet. There is no blood test for depression.

Oh, if only we knew. If only.

Mind you, they're working on it, which is great, but until they suss out the underlying causes, the way they figure out whether you've got a mental illness or not is in many ways subjective. The dividing line between a mental illness and what we call, oh, a "personality"?

Is it interfering with your life?

Or, as Peter D. Kramer noted about Sarah Palin's supposed "Narcissistic Personality Disorder", "If a personality style gets you a devoted husband, admiring children, a loyal circle of friends, a governorship, and a vice-presidential nomination, can we really call it a disorder?"

In any case, my Mood Disorder was definitely interfering with mine. Thankfully, they have a pill for that, now. But more of that anon.

Next time, I'll tackle the dualistic mind/body divide in Western thought and why my Mood Disorder has caused me to conclude that it's total bullshit. Or, "Why I Want to Cockpunch Aristotle for More Than Just Poetics."

-- The Prolix Wag
It's called erudition. Look it up.