Sunday, November 23, 2008

Best of: Religious Psychosis and Bipolars

From May 24, 2006:

Late last night I began to feel a little better; I began to talk with Kathleen a bit, was able to listen to music and read. This is normal with clinical depression. Just as patients with infections often have fevers only at night, likewise those mired in clinical depression often only feel better at night, the later the better (which makes me wonder whether the legend of vampires, like the term, "lunatics," was partly based on bipolar disease).

Nevertheless I woke up this morning nervous. Despite this or because of it I told Kathleen I'd drive to town to get the Sunday paper. I turned on the radio, thinking I had punched a public station but instead found a fundamentalist church service. The congregation was singing, "Slow me down, Lord," which is exactly what lithium and other anti-manic medications do. You can't make this stuff up! Meanwhile, my internal motor was sputtering and going into overdrive. Let me explain this.

A "mixed state" occurs when a bipolar is unstable and can go from manic symptoms to depressive symptoms rapidly. A patient can start out weeping, for instance, become anxious and possibly paranoid, change to hysterical laughter and hilarity, and all the while feel propelled forward by an energy that is ego-dystonic--a fancy psychiatric term for "unpleasant," though unpleasant doesn't cover it. Often when a bipolar is about to flip back into normal mood he experiences these hints and guesses--brief periods of feeling normal mixed with anxiety, sadness, and an internal energy that seems to be pushing him, of being driven. In its worst form, as described by Kay Jamison in her book, An Unquiet Mind, it can turn into a "black mania"--a psychotic depression with all the energy of mania, a horror that is nearly indescribable to the average person. It is hell. I have not experienced an extended black mania, thank God, but I have come close to it, briefly, in mixed states. Back to my story.

On the way back from town I put on a music station but was tempted to go back to the religious station, where the minister was preaching from the Gospel of John about the extended metaphor where Christ is the vine and we are the branches. In exposition of the term "abide," used eight times in the passage, the preacher explained that the sense was "to conform or comply"--which turned the passage into evidence to me of damnation, i.e., I cannot conform or comply with Christ's teachings, much less abide in him, with any confidence, especially when depressed, where all turns against me. I should know better than to have listened; religion is risky at best to the symptomatic bipolar. Thus the sermon had the opposite effect than intended, just as when depressed I always leave church feeling more guilty than I came in, paradoxically damned by my shortcomings rather than lifted by God's love.

It is well known that bipolars and schizophrenics often have severe religious delusions. (There is a book called The Three Christs of Ipsilanti where a psychiatrist actually had three patients in group therapy who all thought they were Christ). Religion can be extremely toxic to the bipolar, and it certainly is for me, because after I heard this portion of the sermon I broke out in tears, praying or crying out loud, "I can't conform to you, Lord, I can't comply with you, can't you abide with me? Please abide with me Lord, Oh please."

The redeeming aspect of this, thought the experience was painful, is that I did turn the tables on my self-condemnation; I was able to add a Lutheran flavor of grace to my mental suffering, that I was a helpless sinner dependent on grace, therefore by faith God should abide with me--not that I believed it with any conviction, but I did feel a little better afterwards. At least I stopped crying by the time I got home.

When I was younger, and before I was diagnosed, I was hyper-religious, mistaking my bipolar symptoms for nearness or distance from God, fasting and praying when depressed (fasting was not hard since I lost my appetite) and rejoicing and sharing my faith when manic. After electroconvulsive therapy at age 30 I didn't darken a church for nearly a decade, wanted nothing to do with any inner conception of religion, fearful that it would worsen my disease. My attitude was, "if God is interested, let him come to me." In Mexico over the last three years I have been able to attend church but only because it was Episcopal, where the form of worship took from me the personal burden of connecting with God. The symbol of the Eucharist became my main affirmation of faith and singing bass in the choir was my contribution. And luckily, during my time in Mexico, I had no extended depressions, only brief ones, just as I had brief manias, the main reason being that I knew from experience how to medicate myself quickly in order to prevent the extremes of cycling.

If I were in my right mind, I think I would tell religious bipolars that God grants us a special dispensation to avoid any intense involvement with religion. We're much better off doing good deeds and loving our neighbor than daring the insanity any form of Pentecostalism or mysticism may bring on. God loves us no less for our illness, it is only our self-hatred, chemically based, that makes us sometimes feel abandoned by God, just as the inappropriate inflation of self-love may convince us we are God incarnate. I've been through both.

I wish this disease on no one. Untreated it has over a 30% mortality rate lifetime. That's a bad number, not to mention lifetimes of relative disability because of it, like that poor composer, Schumann.

I'll conclude today's epistle with poem dealing with my past religious psychoses:

An Ex-Pentecostal Examines His Psychosis

God was a pet who lived in my head
and told me what to do
just before I thought of it,
as if the idea were His.
I heard: Go to the store, not,
I think I’ll go to the store.

Has God ever told you
to order a hamburger?
My God did– with pickles and lettuce.
(He knows if a sparrow falls
so a hamburger’s no big deal.)

More than a sparrow fell
when I dropped from that nest,
that mares-eat-oats-and-does-eat-oats
sick haven and all the rest.

I want no personal God;
I might mistake him for me.
If there’s a God, and he’s listening,
I pray he ignores this poem.

(published in Magma)

Thine in Bipolar Depression,



  1. C.E. - if you have the chance, I'd love to talk to you via email - I'd like to pick your doctor brain for a moment.

  2. Of course, any time. I mailed you. Hope I didn't end up as spam.

  3. Psychiatrists often treat patients with psychotic disorders who are religious or spiritual in some way.

    Bipolar Support Group


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