Thursday, August 04, 2011

Brainstorm, continued...

It's been a year since my mania began; it was on August 3rd, 2010, when I experienced an unexpected healing in a shamanic ceremony, led by a local who specializes in such things.

I had an out-of-body experience and saw my body dissected down to muscle and the yellow fat flowing down to drip off of my feet.  In the ensuing mania I lost fifty pounds, thirty of which I've since regained in my depression.  Later the shaman told me that sound, on occasion, could ignite a mania--he heard this from a fellow student at a course in the use of music spiritually.  But by that time I was already gone, so it couldn't have been this event that launched me.

This is a problem in mania; sometimes real things do appear to happen, as in my weight loss, something I'd wanted for a long time in my fight against the metabolic changes wrought by simple belly fat--"the metabolic syndrome."  It could as easily be called "the retribution of abdominal obesity," but the word "obesity" could offend the afflicted, so like most terms in medicine it has been sanitized into a syndrome--which results, of course, from lifestyle--overeating and a sedentary existence.

In any case, if we call that the beginning of my mania, the whole thing lasted five months, a personal record.  It was, per usual, interrupted briefly by a forced hospitalization when I was transferred to the hospital in handcuffs.  I've been forcibly arrested and incarcerated for mania thrice, though I've had other minor brushes with the law not related to mania.  The longest term I spent was forty days and forty nights in hospital and prison back in August of 1987. 

Curiously one daughter maintains that a close relation, also bipolar, has had a tendency towards mania in August, which raises the suspicion of Seasonal Affective Disorder as another provocation for the outbreak of the up side of the illness.  Of my three protracted manias, two began in the late summer and continued into the fall, but another began in the spring, the one that resulted in my forty-day incarceration-- when I had my only experience of prison (as opposed to temporary jailing).   But I digress, which is a good sign, since in depression I am usually afflicted with a paucity of thought.

Back to the reality of mania: Besides the weight loss I had a number of supernatural experiences, some confirmed by witnesses.  For instance, one night from the bluff a friend and I witnessed a Viking boat lit up with lights heading southwest at night.  We saw the same boat on another occasion, and he will swear to its reality.  But there is no Viking boat in Mendocino, so was it a shared delusion or was it real?  On another occasion, standing on the apron of rock that makes up our shores, a rogue wave seized me and I was transported upwards and entirely disappeared from my friends, suspended in a tube of whitewater where I spun like a cat and landed, mainly unharmed, in another place  on the rocks.  I disappeared from sight in the wave.  Whether my manic reflexes saved me or I was just lucky, I don't know.  But the episode certainly approached the supernatural, or at least supernaturally luck.  I could have easily broken my neck and drowned.  In my subsequent depression I have often wished that were the case!

Of course, what goes up must come down--"Riding high in April, shot down in May"--and I had a great crash in January that eventually necessitated hospitalization because I was acutely suicidal.  I have rarely felt so bad, and considering the source, that means very bad.  I was hospitalized for 45 days, including 12 EC T treatments, with little benefit save that when I was discharged I was no longer "actively suicidal" though I suffered greatly from suicidal thoughts and have since. 

Which brings me to the present, which often seems an eternity in my intense dysphoria.  I like that word, "dysphoria."  It means mental hell of such depth that it is indescribable to those who have never experienced clinical depression.  But there should be a better word.  William Styron, in "Darkness Visible," agreed that "depression" is hardly adequate to describe such a state, and compared it to a seizure or brainstorm--a complete failure of the normal neuronal circuits so that the mind turns to itself in an orgy of self-destruction.  Is there a better word?  Global revulsion?   The bell jar just won't cut it--feeling disconnected is one symptom, but disconnected and thoroughly suicidal is another depth.  There is no adequate word for depression, but I have a poem that explores the subject, maybe my best poem about it:

Eternal Recurrence

Psychologists call mania
a defense against depression
but I find that silly.
There is no defense
against depression
and no adequate metaphor
for its recurrence, but I’ll try:

You love someone with all your heart.
They are brutally murdered.
After an interminable grief
they magically reappear
and you fall down on your knees
and thank God with tears.

The second time is worse.

After the third funeral
you dread their resurrection
as much as their death
and love becomes a poisonous thing.
You would drive a stake
through their heart
if only you could.


Yesterday I saw my psychiatrist and finally persuaded him to put me on a stimulant in addition to all my other medications.  He had been reluctant to do so, fearing mania.  But I promised to see him weekly after I started it so he could satisfy himself that the risk was decreased.

Incidentally I just read a new review of the treatment of bipolar depression in the Psychiatric Times, and there is really nothing new and no good treatment for the malady, why there are so many treatments--the proportion of treatments of a disease are proportional to the inadequacy of such treatments.  Nevertheless, in a couple of trials, Modafinil, a new type of stimulant, proved somewhat helpful, so maybe my review of the research led my psychiatrist to relent.

Another thing that helps short-term is sleep deprivation, so I tried to stay up last night and got very little sleep, followed by my first dose of the stimulant, why I had the courage to blog this morning, so it seems.  But my fragility is intense--if I get a couple of days feeling slightly better I start to make plans, which immediately fail me when the darkness returns.  This is intensely frustrating.

In my last post-manic depression writing helped me rise out of it, especially when I started getting published a great deal, and the literary Net became my sustenance.  Perhaps returning to workshops there might be of some benefit to me, but I have nothing to post and limited confidence in my critiques, though likely enough to participate.  Anything that occupies my mind is welcome, however much the struggle.  For the most part I've been reading semi-trashy novels and "cowering in my cubicle," a phrase invented by my good friend, Ralph.  Most tasks I initiate I can't complete and are then forgotten.  This morning I summoned the courage to face my backlog of e-mails but found myself blogging instead.  Whether I have any remaining readership is not important, only that I write something.

Perhaps daily blogging will help, but I won't demand of myself to do it daily--presently it is a huge burden to even shower, and I've been failing at flossing, often my last boundary before complete oblivion.  I have never achieved a catatonic state, where the patient cannot respond to anything and goes completely silent and may cease to function altogether, soiling themselves and as helpless as a newborn--though I imagine there is some relief in that infantilization.  My ego, though tattered, is too strong, I believe, to descend to such a state, at least so far.  In "Noonday Demon," a book I strongly recommend to those interested in my malady, the author at times could not even feed himself and his father had to cut up his food and fork it into his son's mouth.  I haven't been that bad behaviorally, but I have certainly been that bad internally.  I can't tell you how painful this illness is--refer back to the poem above--and only suicide promises an end to pain, though who knows?  Certainly medieval thought reserved a special purgatory for such an act, but at least purgatory ultimately holds the hope of salvation, something a severely depressed person cannot imagine.  Having some hope is better than none at all.  If I knew there were an end to my torment I could suffer it more stoically, perhaps, and I remind myself that this is a cyclic illness and I will likely get better someday--perhaps even today!  Still, with every recurrence there is greater chance of recurrence, and autopsies reveal that those who have suffered severe, recurrent depression suffer loss of brain tissue, particularly the amygdala, an important organ in regulating mood and many other important synthesizing operations.  I fear my amygdala has shrunk, and I suppose the amount is proportional to the amount of shrinking I have required to survive.

Here ends my epistle for the day.




It’s not for flaw of character I weep
But for a flaw of chemistry, my dear.
Inside the gyri of my brain it creeps
Infecting all connections, engineer
Of all the darkest petals of the mind
Blighted and browned, hideous to behold,
A monster to myself, a worthless rind
Upon a garbage heap informed by mold.
The green fuzz on the peel is the thing.
But shouldn’t fungus more concern the dead?
I feel its hyphae in my reasoning;
Can’t someone suck this poison from my head?
If brain were foot I’d apply fungal cream
Or perhaps I should begin with trephining.

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