I haven't blogged in a while, as I previously said I had little more to say about manic-depressive disease. Below an offering for today that may relate to others afflicted with either pole of affective disease.
For the second morning I woke with akathisia (related to "restless leg syndrome), which I described to K as feeling like "an overfull bladder spasming." Indeed, this is how it feels, as if there is an uncomfortable energy in every limb that constantly begs for movement, as if you were a marionette being vibrated on a string, helpless to stop your craving for motion. I took some medication and it calmed down. But it did wake me early and I have stayed awake, finishing a wonderful novel by Elizabeth George entitled "What Came Before He Shot Her." Great descent into the modern slums of London.
This is my 56th year, the eighth cycle of seven. I knew it would be a revolutionary year, but had no idea it would begin with a return of depression. As my sister Elise says, “Chaffins need to work.” I think everybody does. It’s a shame so many people have jobs that bore them, that don’t challenge them, though if they do their jobs to their utmost there will still be some satisfaction in it, however small. It’s estimated that 85% of American workers don’t like what they’re doing. How much this has to do with life choices and how much with one’s attitude toward the universe is not clear. Some people are eternally dissatisfied instead of being thankful for the process and hopeful towards some result.
The linearity of life is inescapable; so time wears us out, so death summons us all, and our last years are in many ways the least fulfilling, with little work and less ambition. I would prefer to work until my dying day, especially since I have had such a long break from it. And who better to promote sanity than one who has been to the other side and come back? Who knows the fragility of the human psyche better than I? Not many practicing psychiatrists, I’ll warrant. And this gives me the great advantage: personal knowledge of extreme psychiatric symptoms—both manic and depressive psychoses, two sides of the same coin of narcissism—in one you are superhuman, in the other sub-human. Whether I gather the courage to return to training and later, practice, is a huge question I can't deal with here in view of my deserved disability status. But I harbor a small hope it could come true someday.
I must remind myself that even while depressed I have not proven incompetent. I just think I'm incompetent. I think my writings and communications make no sense; I fear any advice I give is mistaken; I feel I don't have the right to say anything about anything to anyone. I need confidence during my depressions if I should return to work someday and the illness arise. Enduring depression has to be the centerpiece of my planning. This would be the hardest thing for me, guaranteed.
And how much would the kindling of patients with affective disorders vibrate sympathetically with mine? Here is a danger as well. I must construct a routine and a reliable personality to sustain me through dark times. As Kathleen said, “Whether depressed or not, you’re still Craig.” There is an essential Craigness to me which others can see while I’m depressed but I cannot. Of what does this continuity consist? To the depressed it appears as only a semi-functioning persona, a convenient fiction meant to represent a person who is either not real, not deserving of existence, or not able to cope with any emotional contact. The bell jar may be thought of as more opaque than Plath described it; instead of being exposed to all, perhaps we hide from all under the shield of their habituation to elements of our personality. Others may perceive a solid where we see absolute permeability, as if any influence could pass through us at any time and feed the winds of our perpetually descending cyclone, that all stimuli are caught in the vortex of self-negation so that each stimulus is acutely painful, more than anything expressions of love from others, as the feeling of love, or its benefit, is entirely incomprehensible to the depressive, which explains my religious feelings of shame and guilt—I am like the sinner who not only would not lift his eyes to heaven but would grovel before the altar like an animal begging euthanasia. How can a psyche like that receive the love of God? It would be a bloody miracle if it did; it would go against the grain of everything depression stands for, everything of which it is the incarnation, the prison of self, the door locked from the inside forever.
Metaphors fail in this illness as everyone who has suffered it knows. Being only three weeks out of severe clinical depression (8 kilorats for those who have followed my blog), it is not surprising that at times I have frissons of terror, of falling back into the snake pit, of instant regression to a depressed state. But I think euthymic kindling is taking place, like a new green shoot in the gray soil of my brain, perhaps reorganizing the actual architecture of my cortex; perhaps my brain is plastic enough that this good kindling can last a good while, as it has in the past, though the relapse rates even for even adequately treated bipolars is usually one year or less.