I am Manic Depressive

I'd like you to know more about manic depression, so you can better understand the other manic depressive people you know, and if you're manic depressive yourself, I'd like to offer you a bit of encouragement and companionship. Eventually I should have some useful resources linked from here.

I have been through some very difficult times. But through hard work, therapy, and medicine, I am able to live quite a good life. There are also some positive aspects to manic depression that I will tell you about.

More specifically, the diagnosis I was given, when I was finally diagnosed, is that I have "schizoaffective bipolar depression". Bipolar depression is a more modern and clinical term, and meant to indicate that one is experiencing depression that comes in two phases. Bipolar people alternate between two extremes of mood, from deeply depressed to the wild euphoria of mania. I
don't particularly like the term "bipolar" because it lacks the romantic flair of "manic depression".

The "schizoaffective" part of my diagnosis indicates that I also have certain symptoms that are experienced by schizophrenic people. Sometimes, fortunately rather rarely, I hallucinate and get paranoid. One friend of mine, who was a psychology student, said that I am schizophrenic because I hear voices. Whether I'm schizophrenic or not depends on your school of psychology, I
suppose, but I don't think of myself as schizophrenic.

I have wanted to write about being manic depressive for quite some time. I have been hesitant to do so for several reasons - it's hard to write something good enough to get into print in a magazine or a book. It's much easier to put my writing on the web. I'm afraid I'm also quite worried about what some people would think of me. I tell my close friends that I'm manic depressive, but I usually don't tell the people that I work with. On a few occassions I've told my employers. Most people I tell are very accepting of it, but a few have been very uncomfortable talking about it.

But I hate keeping secrets. I sure don't like living in a closet. There are a lot of people in this world who are discriminated against because of their race, their religion, their sexuality, or their political beliefs, and many of these people have been able to improve their lot by working together and making their voices heard. But crazy people don't stick together. In fact we are usually quite isolated, from each other and from normal human companionship. I think this is bad for us. We need to be known, and to be heard. There's really only one way for us to change that, and it is for each of us to individually stand up and speak out.

I decided to put this page up right now in particular because of something that has happened that has quite shocked and horrified me. This is the mass suicide of the Heaven's Gate cult in Rancho Santa Fe, near San Diego, California. It's not quite right to say I'm inspired to write because of this - more that I'm disturbed enough by it that I need to write.

Part of this is because of the suicide itself. Manic depression can be a lethal illness. I have been very profoundly depressed, and struggled with suicidal feelings. I spent quite a long time unable to get thoughts of suicide out of my mind. This is something all manic depressives experience. Many manic depressive attempt suicide, and some do kill themselves. Hearing about this suicide has brought back a lot of painful memories, memories that I would much rather avoid.

It also disturbs me for a deeper reason. Most people think that the things they experience and that they believe are real. The Heaven's Gate members were not depressed - in fact most of them seemed quite happy on their videotape - and they seemed to sincerely believe they were doing the right thing. In fact, on their web page they seem to say that to have failed to "shed their
vehicles" at this time would be to commit suicide. But I believe they were wrong, and were very deeply deluded.

The news depicted this event as something very unusual, strange and uncommon. What disturbs me though, is not that this is so unusual. Not that big groups of people poison themselves all the time, but that I think that the grip we have on reality is a lot more tenuous than most people believe. By "we" I don't mean just mentally ill people, I mean everyone - including average, normal people. Including you.

In some ways the mentally ill people have the advantage; once we have been through some time of treatment, we learn to construct a reality that is more reliable than the one that just happens to everyone else.

About one percent of the population is manic depressive. That might sound rare, but really it's a fairly large number. You probably know more than a hundred people. I can reasonably say that one or two of the people you know are manic depressive. If this statistic is right, over two million americans are manic depressive. A somewhat smaller, but comparable number are schizophrenic. This is a lot of people. Some of us, at any one time, and all of us eventually are far divorced from reality.

Cults have existed throughout history, as have millenarian movements - groups of people who believe that the end is near. Sometimes entire nations are descend into mass violence, hatred and genocide, as happened in Nazi Germany and Communist Cambodia. Some of the people in cults may be mentally ill - I think that the leaders of cults, and people like Hitler, have a sort of mental illness that gives them both a talent and desire for leadership - but most of the people in cults are otherwise normal people.

What most people do not realize is that reality, as we experience it, is not something that just happens to us, but that it is something we construct. There is an objective reality, but it is not something we can experience. There is too much of it. There are infinitely many things happening around us, none of which have any meaning outside of that which we assign it. We have to
filter out tiny pieces of this reality - first by physical selection, by seeing only that which is visible, or hearing that which is audible, then by biological processes and finally by cultural and personal preferences. In a sense, you can only hear what you want to hear - the things you don't think are important, or that you don't believe, you will not pay attention to.

Our culture plays a very large part in our construction of reality. Our culture comes from the people around us. We tend to associate with those who believe and feel as we do. It can happen that a group gets isolated, and insular, and has no one to correct its course as it both reinforces its own beliefs and drifts farther and farther from the average. Not the norm - I do not believe that there is any "normal" reality, only an average one. This can happen to anyone. It is what happened, in an extreme way, to the people in Heaven's Gate, but it can happen to anyone. It does happen, throughout society.

This bothers me.

To recover from an illness like manic depression, one must learn to construct a better reality, and to keep ahold of it even as the forces of one's own feelings struggle to overturn it. There are things that can help, like medicine and psychotherapy, and I use these, but ultimately it is up to the individual to learn the skills - or not, and experience madness and maybe death.

There are some medicines that help manic depression. The first drug discovered to prevent mania was lithium, just plain lithium salts like lithium carbonate or lithium citrate. Much later (in the 80's) came the anticonvulsants - tegretol and depakote. Lithium makes me feel naseous all the time. For several years I preferred to not take anything; since a major manic episode I have been taking depakote.

For depression there are the antidepressants. There are many of these - I've taken elavil, ludiomil, wellbutrin, paxil and imipramine. It is hard to find a good antidepressant; some don't work on particular people, some work too well, driving one to the opposite extreme of mania.

For acute mania, and for the psychotic symptoms of hallucination and paranoia, there are the antipsychotics. I've had haldol, prolixin, stelazine and risperdal. Antipsychotics can have bad side effects such as sedation, tremors and seizures. I had a seizure so bad from haldol that all my muscles locked up and I had to be carried out of the room and injected with cogentin. Risperdal,
in my opinion, is the miracle drug - it stopped a severe manic episode in just a few days, and does not cause seizures or sedation. I do have some trembling in my hands from it. It has only been available for a few years.

The medicines are not completely effective though. Staying sane takes work.

I just finished a little particularly challenging bit of that work. My parents came to visit, and I showed them my nice office and successful company, my spacious house in the Aptos Woods, and had a dinner in a Thai restaurant. All very genteel activities calculated to set the parental mind at ease over the mental state of the prodigal sun. I had printed out this web page and planning on showing it to them. I was shaking and sweating this whole time, and came very close to canceling it. But in the end
we were able to talk about it, with great difficulty and much shyness and embarrassment. I think this may have been the first time they actually were able to understand my condidtion in the thirten years since I was diagnosed, and in the twenty years since first I expecperienced major depression.

The Creative Illness

There is an ironic twist to being manic depressive. We are often creative and intelligent people. Poets and artists have long had a reputation for being moody and tormented people. In her book Touched With Fire psychologist Kaye Redfield Jamison presents statistical studies that show that manic depression is found more frequently among artistically talented people than among the general population.

I hate to brag about it, but I think I can say I'm a creative person. You can find examples of my art, photography, and music on my web site. I work as a Macintosh programmer - you can see a list of programs I have written. I studied physics and astronomy at CalTech and UC Santa Cruz, and have co-authored a few scientific papers.

While I can look back at my drawing books and the bookshelves full of software that I have written, my own experience of my life is that it usually going at an interminable crawl. When I get depressed, I get bored. Nothing is fun. I cannot think of anything to do that I would enjoy doing. Nothing ever seems to be happening. I struggle to keep myself occupied. Then from time to time I look back and see all the things I have done and am quite surprised.

There is a difference, though, between feeling creative and actually being creative. When I am mildly manic, I get very inventive. During one mildly manic period I invented a new method of compressing computer graphic images, and lay awake nights scheming of ways to get the compressed files ever smaller, only to get up and stay up all night long writing insanely clever code.

When I get highly manic, I start to think in rhymes. This is one of the ways I know I am manic; when I'm normal I can't compose poetry at all, but when I'm wigging I can talk at length with rhyme and meter.

Here's a little manic poem:

                                            Pitter patter
                                            Flitter flatter
                                        Wop de who de who
                                            I am magic
                                            Life is tragic
                                        Who the Hell are you?

The problem with manic creativity is that there is usually little substance to it. It is brilliant but it lacks a solid foundation. A great deal more work is required to implement an idea than to conceive of it, and it is hard to stay focused when I am manic. Projects are started and soon abandoned for new projects, or I start something very ambitious and then come crashing down into depression and abandon it. Very little of what I have accomplished was accomplished when I was manic.

It is also hard to work when I am depressed. I get bored with what I am doing, and find it difficult to overcome frustrating obstacles. Computer programming can be terribly frustrating work - bugs occur all the time in software, and they are usually not cooperative towards efforts to find and fix them. The single most important skill I had to learn to become a programmer was to overcome frustration, but this is very difficult when I am depressed. The slightest obstacle fills me with despair.

Yes, manic depressive people are creative, but the real creativity does not come when we are manic or depressed. It comes in the in-between times when we are feeling alright but not high.

~by Michael David Crawford

Mike's Web Site
Email Mike: michael@geometricvisions.com


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