Just When I Thought
I Was Stable

10 July 1999 – Diary
On the edge of slipping from stability into being bipolar. Or rather have started exhibiting qualities of being bipolar, but still stable enough to take action to center myself. Like all borders, like all shorelines, it is an interesting place to be, if at least for a while.

I often think that depression is a physical disconnection between the ability to think and the ability to act. It was as if a gear was slipping. Of course, the physical problem does not manifest as a disconnection. Rather the brain finds other ways of interpreting the disconnection.

Thus I couldn’t shave because I didn’t like to shave, not I couldn’t shave because the thought process for getting my body to shave was failing. Or I couldn’t eat breakfast because I couldn’t make up my mind what to have, not I cannot get my body to putter around the kitchen.

And as the gear slippage got worse, the brain created more elaborate metaphors for when it couldn’t get things done until finally the disconnection got bad enough and voilá, depression.

21 July 1999 – Diary
Was on the cycle through depression then mania then depression since the 10 July. What can I say. I've stopped being anxious about it happening and have just let things happen (or not happen) as best as they could. And what don't get done, don't get done. This attitude seems to have done the most in keeping me centered.

So I did have a mild depressive period from 8/9 Jul to 13/14 Jul, then a hypomanic one from the 14 Jul to 16/17 Jul and to and then a depressive one from the 17 Jul to today. The period are short though, just about five days each, about two days shorter than normal.

I stopped going to exercise almost immediately when the cycles started back,. By Fri 13 Jul was not functioning well enough to take medicine anymore, which probably didn't help matters.

I would have said in the past that I hate this, and I probably do, but substantially less so nowadays. Actually I take it with a bit of resignation, with patience and with the knowledge that it will pass. It always does. But the positive feedback cycle is annoying, it makes it difficult for me to assert control.

I was telling my psych that this feels like a physical disease. And a lot of it is physical I think. The tremors of the hands, which I get mildly (though sometimes they are so bad I cannot write or sign my signature), the sensation that my heart is racing, the headaches, the unspecified anxiety, the periods of restlessness, or sleeplessness, or sleepiness, or food cravings, once they are isolated and examined are so unrelated to what is going on around me. Even the overheated thinking, or the overreactions emotionally, the loss of memory, the feelings of pity/depression have a slightly unreal, slightly forced feeling to them. And they cannot be really quieted by self control or relaxation. Even my most persistent problem, that of being unable to translate thought to action - like thinking of taking my medication (or shaving) and actually doing it - feels mechanical - as if there is a gear slippage in my brain that prevents me from hooking the two together.

Nevertheless, although these things are outside the identity of who I am, they have over time become part of who I am simply because I have to cope with them every day, have to live with it every day. The external problem has merged with the sense of my identity. And therein lies a lot of the trouble of being bipolar. Starting to take the medication was helpful, but only as helpful as pulling a crash victim from a burning car. At least the victim won't burn to death now, but you still have to treat the wound that happened before you pulled the person from the car.

Medication is not enough to cure being bipolar. Therapy is still needed to disentangle the identity issues and separate out the disease from the sense of self. My greatest problem had been that I had taken on the disease as flaws in my identity, when it fact it wasn't so.

All flaws people have affect their identity. I keep on thinking of a scale in which at one end there is a person with a broken leg who has a temporary change in the sense of self/of identity. A person with asthma is closer to the middle of the scale, since the condition imposes its own liabilities on the person. But it is still distinguishable as "other than self." Near to the other end of the scale is being bipolar where the sense of identity and the disease are so tied together that they can't be separated.

Notice with being bipolar, you can only be bipolar, you can never have bipolar, like you have asthma or a broken leg. Our language binds it intimately to the person.

The problems that being bipolar bring on are so subtle and appear so gradually that you learn to live with them, that they are accommodated and become part of you. Freeing yourself from being bipolar requires you to unlearn parts of your personality to disentangle the destructive parts. It means erasing/relearning part of your identity. No wonder dealing with it is so confusing.

29 July 1999 – Diary
I'm back to being out of control, drifting. Definitely depressed. Just as I thought things were going to work out. My mom is worried that I have lapsed, that I am no longer well. But I am not. I have been here before. I am annoyed though, and upset that stabilizing over the long term is apparently going to take longer than I had hoped.

I drifted off the medication. during a high stress period about two weeks ago and I'm in a positive feedback cycle - the worse it gets, the worse it gets.

I was in charge of the office and the work was extremely high stress. After a week I had to spend so much energy concentrating on the work that that I couldn't find the focus necessary to continue taking medication. This didn't matter for about a week until I went hypomanic. Which also didn't bother me because it was so helpful in handling the work.

Or so I thought - but decisions had gotten harder to take and I was having a hard time focusing on any single thing at a time. I nearly lost us a client due to irritability - I wanted to stop our contract because he was arguing over a minor matter - but still had enough common sense left to back off and let someone else take over.

Also started losing the capability to hold to a regular day schedule. My sleep schedule had gotten out of this world - I would go to sleep anytime from 10 pm to 5 am and still wake up for 6:30 am with no ill effect.

Then I started getting depressed and in fact I am still depressed. The world has slowed to a crawl - I don't talk to anyone unless absolutely necessary, I don't write to C. anymore (after sending mail daily), I've stopped going swimming, my eating patterns are mostly KC and take away Chinese, and I hate going to work and have taken to skipping days. When I am at work my productivity is way down, perhaps less than half of normal and I can't wait to go home and hide in my house on afternoons. Sometime I sneak out early. I don't like myself and I have been getting unsettling visions of me slitting my wrists or crashing the car while driving to work. I feel like breaking up with C. even though every sane part of me knows that we make a good team and that we are good for each other.

I would call this classic mild depression. It's a damned nuisance.

But I did manage to assemble, design, write and edit the first part of this website while hiding away from people in my house. Does this count as a silver lining, or am I just clutching at straws?

My cycles are confused, no longer the one week up / down. I think the medication, which I now take erratically because I can't always get the motivation, is upsetting the regular rhythm. I can't say I like the unpredictability of what might happen next and I fear that my depression may last for far more than the usual week.

I don't feel guilty about what is happening anymore. Some part of me is able to say - "This is a medical problem, not a personal problem, and should be sorted out as such." But it does disturb me that this is two years down the line from when I started treating my bp and I am still having weeks where I am functioning so little. Will I forever be having to start over and over. Will I never reach a stage where I can say I am stable now - the medication is finally working?

I think that ever since I was diagnosed, I held the quiet hope in my breast that it was just a matter of time before I came on the right combination of medicines that would stabilize me and I would be cured. This is apparently not going to happen. Just one more of the illusions shattered.

I am only now getting used to the idea that perhaps I will have to live with medication as the base support for my stability, but also I will need a substantial and careful change in my lifestyle and in the things I do in order to remain stable as well. I am not sure I want to do this. Sounds like I will be having to change an awful lot.

I'm glad I told my friends that I am bp early on. They don't expect me to be perfect and when they call me they are concerned, but not intrusive. And I can tell them to call to remind me about meeting them, and they don't fuss if I show up late for Scrabble. They know I try my best and that some things are just not possible. My office staff know I don't make it out on days even if thy don't know exactly why, so when I don't make it into office I don't feel as much pressure as I used to. My brother understands and fills in for me without comment.

My parents give the most trouble. They so want me to be better that sometimes it is a nuisance trying to pretend to be better for them, even when I so clearly am not. Can't they see that.

3 August 1999 – Diary
Well, I'm still depressed. Which is about a week too long. The hypomania which was supposed to have jump started things has not happened. I am waiting, but nothing is happening.

Work is slowing down as I lose the ability to concentrate. Quite frankly if I were my boss I would fire me.

I finished reading this excellent book on being bp called "An Unquiet Mind" by Kay Redfield Jamison. In it she talks about the relationship between love and being bp. I think about my relationship with C. and I realize she is right. Love is a Healer, as Donna Summer says.

C. and I have been together and apart because of where we live, but the periods we have been together correlate with my most stable periods. The times we have been apart correspond with periods of instability. Of course there is too much going on in my life to ascribe cause and effect, but the pattern is there.

I have been reading my old notes and I realize that in the past I used to fear the mania and survive the depression. Now it is the reverse - I can handle the hypomania very competently but I fear the depression. I suspect that I have focused on one aspect to being bipolar only, now I need to learn how to deal with depression. Clearly I am handling it very badly.

5 August 1999 – Diary
Well, I started back taking medication yesterday. My cousin came in from Canada and I was able to use the excitement to bootstrap myself into taking the first dose of medication again. I was also able to use his presence to absent myself from work and its stresses for a day and a half. And my cousin was staying with me so I had someone in my house all the time, which always stabilizes me. The combination of the three elements had its effect, and things are starting to work out. I only dread how much lost time I have to recover.

The depression feels like a sandstorm which has blown through me, clouding all my faculties and thought while present, then moving on leaving me clear thinking and still. And leaving behind also all the damage it has caused to my plans, projects and self confidence.

I really hate being bp. For each week I lose to depression, or half a week to hypomania's lost productivity, it takes about another four days to salvage what I can from what had been left undone. Then it takes me another few days to start back any tasks / projects I was in the midst of. If I can remember what I was doing- I can't always. All the start back up work being done in addition to my existing work of course.

Basically each time I go depressed / hypomanic I lose about fourteen days overall. Since I rapid cycle, this happens frequently. I figure I lose about three to five months of my real life each year to being bp. Not including all the failed plans and intentions that simply were not followed through.

This time around, in two weeks I put back on all the weight I laboriously lost over the previous five week stable period. I have to start back and I am despairing of ever beating this creeping weight gain. The only thing that keeps me going is that I want to be able to roller blade barebacked. In New York. On the West Side. With C.

continued