Between two poles
A piece on bipolar disorder from 2015, slightly revised.
Dear Subscribers,
I’ve been so busy this week setting up my private life coaching practice that I haven’t had time to write! I didn’t want to leave you in the lurch so I dug up this piece I wrote back in 2015. I hope you find it both engaging and encouraging. Thank you for your continued support.
Yours,
Miriam
I was first diagnosed with Bipolar Disorder II ten years ago, when I was 25 years old. A few months into my treatment, my then psychiatrist decided to change the diagnosis to Unipolar Depression, and I have been on anti-depressants and anti-anxiety medications ever since. When my current psychiatrist brought up changing my diagnosis to Bipolar Depression, I paused, quickly scanning the last ten years for signs of being at two poles rather than just one. I didn’t really find any, but decided to give myself some time to mull over his opinion.
After thinking about it for a few weeks, I decided to go with my doctor. I had just been through quite a year, and it was very possible that my brain chemistry had been deeply affected by it all. Six months prior to the visit above, I had battled knee surgery, a panic attack, a kidney infection, aseptic meningitis, and a post-lumbar puncture headache, all within two weeks of my second child turning two. My psychiatrist was probably shocked by all the news, and very concerned about the changes in mood I had been reporting. He even took the time to review my original hospital records from ten years ago, and felt strongly that a new drug regimen was at least worth a try.
Ironically enough, just previous to my physical breakdown, I had read a book on the effects of psychosomaticism called The Body Doesn’t Lie by Vicky Vlachonis. I was thus very intent on figuring out just what my body might not be lying about as I recovered from the various ailments of the last year. A change in diagnosis might get me a little closer unto that end, I thought, or maybe be the end in and of itself. I also trusted my doctor very much, and knew that any changes would be implemented slowly. Should my mood not react very well, the changes would be simple enough to reverse.
I am happy to report, now six months in, that my body is doing well with the change. I am almost finished tapering off six years of Prozac (after about four years on Lexapro [I had switched to Prozac after wanting to get pregnant with my first child]), and am slowly working up to my prescribed amount of a drug called Latuda, the only FDA-approved drug for Bipolar Depression.
Suffice it to say, I’ve thought a lot about mental illness in the last ten years, and likely a bit before. Looking back on it now, I don’t think I really ever accepted that I had depression, and/or that it might be something I would have to deal with long-term. Sure, I was incredibly relieved at finally being able to put a name to what was increasingly debilitating my everyday life, and entered a 7-day psychiatric hospitalization quite willingly. My hospital stay actually ended up being the best vacation I had ever enjoyed up to that point, as I was completely cut off from the outside world with no need to do anything but realize where I was.
After the initial phase of diagnosis and hospitalization, I continued to experiment with my psychiatrist and tried every medication he thought might help me. I also began the task of excavating my childhood with a very good therapist, who I ended up seeing every week for four years. I also believed deeply that I could be cured of my depression by the will of an omnipotent God, and my small church community was there for me and my husband at every up and and at every down. Not surprisingly, I saw my mood lift from the very beginning of my recovery, and believed that my depression was a temporary impediment.
There was, however, another subtext to all of the above, and it read: “Miriam, get the hell out of here (depression). And never come back. By age 30. [A 5-year assignment.] Go.” And I did. I blazed! Well, experimented. Mostly through a succession of jobs that I would never have imagined myself working, but also by exploring almost every arm of the self-help industry possible, and delving obsessively into the non-musical arts. I think I believed that in order to achieve a pristine bill of mental health, which I was desperate for, I needed to be the opposite of who I was before I was hospitalized--too intellectual as to find a job outside academia, too much of an emotional pushover as to speak up for myself, and too “holier than thou” as to enjoy something as superficial as fashion.
But as luck would have it, by the time I reached 30, I found myself not only uncured of my depression, but deeply enmeshed in every important relationship I had at the time. I had just moved to a new city not far from my hometown, but somehow felt I was living in a completely different country. I had also just given birth to my first child, who I adored caring for, but who needed his mother to teach him how to find happiness in life. My 5-year plan had failed by almost every account, and I hated myself for it, just as I hated myself at 25.
My husband and I had also hit a very rough patch. We found ourselves diametrically opposed in opinion concerning an important situation in our lives, and had never quite experienced such estrangement. We had been raised to believe that a successful marriage was absolute union on absolutely everything, and hence judged our current situation as quite unsuccessful. We had sought counseling from mentors and friends before, but something was different this time around. After many an argument over the issue, my husband finally said, “We’re not going to be able to figure this out on our own. We need help.” And so entered Claudia, a licensed M.F.T. recommended to us by a trusted friend.
Seeking and starting marital counseling was very scary, even for a seasoned therapee like me. I felt incredibly anxious before each session, as I was afraid of what would come out. “Have we really reached this low?” I thought. “Would we have to separate over this issue? Were there even more serious issues underneath? Are we over?” I knew that there was no way to actually answer these questions until we started, so we began the counseling as soon as we could and slowly whittled away at the issue at hand.
And the issue was this: I found it unconscionable at the time that my husband would side with anyone other than me, especially himself, on such a difficult issue. I was used to his total support in everything and relied on his strength for much of my own self-worth, and thus felt deeply betrayed by his exercise in personal freedom. As for my husband, he was caught between me and another actor, and felt it was completely unfair that I relied so much on him so as not even be able to give him the space to even find his own thoughts on the matter. It wasn’t the first time I had put him in this position, and he was tired of it.
One of the many discussions of the issue we had with Claudia soon turned into a fighting match one evening, and after a minute or so of us screaming at each other, Claudia interjected with the following statement:
Stop! [Dramatic pause.] You are not going to get anywhere unless you acknowledge the elephant in the room, which is, Miriam, your having been completely unseen, unheard and uncared for by your parents as a child.
Now if I had to choose just one time ever to use the term “W.T.F.,” this was it. “No way,” I thought to myself, shell-shocked at her words and unable to speak aloud. “Absolutely not,” my thoughts continued. “I have not just spent the last five years agonizing over my mental health, which has led me to understand that my childhood was absolutely horrible, for you to tell me now that it was all for nothing. That this issue that is driving me apart from my husband, who is everything to me, actually is again because of my godforsaken family? This cannot be happening.”
I found my voice a minute or so later and decided to scream back:
Well what am I supposed to do about it? I’ve been in therapy, I’ve been reading the damn books, having the difficult conversations with everyone, doing everything you tell me and you are now telling me that I am still dealing with the same issue?
Ever the yogi, Claudia answered:
Yes. That is what I’m telling you. And there’s nothing you can do about it, Miriam.
The meeting ended somehow and we left Claudia’s office. We walked down a long flight of stairs onto a very busy city street, and there I was, 30 years of age, but really my 7-year old self--completely alone and closed in on myself, staring at the wall of my childhood bedroom.
My husband and I had agreed before we started the counseling that we would walk home holding hands after each session, no matter what, but that night I let go of his hand and walked home by myself. Knowing him, he probably trailed me just to make sure I was safe, but I think he knew to keep a very good distance.
A few days after our session, I drained myself of the last tears, and repeated what Claudia had said: There was nothing I could do about it. The past had come and gone, and had left me with just the present. So I did the only thing I thought I could do in that moment, which was to try to pick up the pieces and begin again.
I decided to tell a few trusted friends what had happened, and they listened and offered their support. I mustered up the courage to believe that my husband and I were allowed to have different opinions on very deep matters, and that his freedom did not equate a betrayal of our union. Quite the contrary, as we would learn through our time with Claudia; we needed to learn to individuate, then come back together, then individuate again, and then come back together again. Apparently that is relational health.
We continued counseling until the main storm passed through. I then started seeing Claudia as my individual therapist and my husband would join me for a session when our schedules allowed. She actually retired back in the spring of this year, after five years together. I remember thinking after her last words of advice, “Do I flip her the two birds and say, ‘Thanks for nothing! And enjoy $40k that should have gone to my kids’ college fund!’” But I didn’t. I think I said something like, “I would have never known the kind of happiness I see possible now without you.” It was a good goodbye. And not a long one as I optioned some Skype therapy just four months later.
As for the nugget of truth she shared--that the crux of the issues I was having with my husband centered on my own childhood--I continue to explore in depth. To be sure, there are many ways to deny the truth, but my way was to try and fix my way out of a very difficult truth--that I was deeply depressed and coped by trying to make myself perfect, thinking that it might just bring me the absolution I needed. It worked well enough in adolescence and into early adulthood, but stopped altogether the day I found myself in a psychiatric ward. And little did I know that I got right back to it when I came out of the hospital by trying to perfect myself psychologically.
I also sought absolution in a very kind man who devoted himself to me. But even he could not fill the need indefinitely, as he too is a finite being. I was so scared by this, and sometimes still am; in the crisis above I sought to punish him for seemingly abandoning me, but with much help and support, found another way of being in relationship with him. I’m thankful to be past all that, and to know that there might actually be very many “different kinds of happy”1 for us to enjoy with one another now, and in the future.
I’ve read that denial is the classic first stage of grief. True to form, though my last ten years have been an incredible amount of time and effort toward a worthy goal, they have ultimately been based in denial of the truth. And I think that’s what my body might not have been lying about as it kept breaking down last year; namely, that I needed to stop trying to fix myself and find self-acceptance.
It is thus very apt to me now that I am back dealing with Bipolar Depression. When starting this post I thought I would call it “At Two Poles” instead of “Between Two Poles,” as I thought that was the essence of my expression of the disorder--the incredible anxiety of being at two extremes at once. But I ultimately chose the word “between” rather than “at,” with much hope, as I would love to see the spectrum of things this time around, rather than just the poles. But we’ll see. I don’t believe that hope is considered a virtue for no reason.
Thank you for visiting.
A line from one of my favorite songs by one of my favorite singer-songwriters, Sara Groves.
Thanks for sharing this.