Getting Well From Depression and Manic Depression

Written by Mary Ellen Copeland, M.S., M.A.

Getting well is a process that began for me a long time ago. I never expect to finish. Given different responses from responsible adults and health care professionals in my life, my journey might have been very different. In this article, I want to share what did happen and how I actually am getting well. At the conclusion of the article, I will share some perspectives on how I think my life could have been different (and a lot of pain averted) and how symptoms of depression and manic depression might be more appropriately dealt with to keep us from becoming "chronic mental patients". ( I feel that psychiatric disorders, as with all disorders, have a physiological and a psychological component. Response to particular treatment, management and self help scenarios varies with each individual. There is no one answer for everyone. We have to each search out the right path for ourselves.)

When did my mood instability start? I think it began when I first felt that I was different from other kids in school. I didn't know what was different about me, but I knew something was different. Was it because my friend was hit by a car and killed when I was walking home from school when I was five years old? Was it because my mother was in a mental hospital? Was it because I never felt wanted, affirmed or loved? Was it because there were two older male relatives who harassed me and molested me for many years? Was it because a caretaker kept telling me all the things that were wrong with me? As I look back at pictures of me when I was a little girl, it is clear that I looked like any other kid. What was it in my mind that made me different?

Sometimes I gave in to the despair and spent as much time as I could, alone in my room, crying uncontrollably. At other times I responded to the bleak circumstances of my life by being a "too bright and cheery" overachiever. There never seemed to be any middle ground.

Even back then, as a child and as a teen-ager, I was looking for answers-ways to feel better. I became an avid reader of self help magazine articles and books. I tried diet and exercise. I constantly tried to achieve an elusive perfection. Nothing helped much.

But I got by. When I finished school, I did all the things women were supposed to do in those days. Go to college, get married and have a family. Sometimes everything seemed so hard. Other times, everything seemed so easy. Was everyone's life like this? Trying to keep going or going too fast.

Then there came a time when the depression got too deep. I couldn't get out of bed, much less take care of my five children and administer the small private school I started when I was feeling "up". I went to see a psychiatrist. He listened to my story and said there was no question about it. I was manic depressive like my mother. He said lithium three times a day would take care of the whole problem. What an easy answer! I was thrilled.

For ten years, I took my lithium and continued to do everything I could to improve myself. My life continued to be very chaotic. But my ups weren't so up, and my downs weren't so down.

Then I was overtaken with a dangerous episode of lithium toxicity. Why hadn't anyone ever told me that if you keep taking your lithium when you are dehydrated from a stomach bug, you can get lithium (Eskalith) toxicity? Come to think of it, I knew very little about this substance I was so religiously putting in my mouth. Although I was doing everything in my power to keep myself well, I still felt that the ultimate responsibility for my well-being was in the hands of my psychiatrist. I was totally trusting that he was making the right decisions in my behalf.

After the experience with lithium toxicity, my body didn't seem to want it anymore. Every time I tried to take it, the symptoms of toxicity returned. And without it, those deep dark depressions and periods of high achievement returned. Only now they were overwhelming. The depressions were dark and suicidal. The mania was totally out of control. Psychosis became a way of life. I lost my job. Friends and family members backed off. I spent months on the psychiatric ward. My life felt like it was slipping away. They tried one drug after another, usually several at a time. Nothing seemed to bring me back to life.

Through the haze, I was searching for answers. I wondered how other people with these kinds of episodes get by. They couldn't all be like me-unable to work and almost unable to take care of myself. I asked my doctor how people with manic depression get by on a day-by-day basis. He told me he'd get me that information. I looked forward to my next visit with great anticipation, fully expecting to find some answers. What a disappointment! He said that there was information on medication, hospitalization and restraint but nothing on how people live their lives.

I took this dilemma to my vocational rehabilitation counselor who was trying desperately to find a place in the world for this mentally ill woman. I described to her a dream. A dream of finding out how others with depression and manic depression keep themselves stable. To my surprise she supported my ideas. With her as my back-up and the help of a Social Security PASS plan, I began a study of 120 people who agreed to share their strategies for keeping themselves.

As information started coming in, my foggy brain got scared. How was I going to compile this data and put it into any kind of format that could be useful to me and others like me? I kept plugging away. The information was so fascinating that I was drawn to it. Once again, I had something meaningful to do. I think my return to wellness may have started there.

The first and most important thing I learned from compiling this data was that there is lots of HOPE. Contrary to popular belief, people with recurring episodes of depression and manic depression, get well, they stay well for long periods of time and they do what they want to with their lives. This message of hope, which I had never heard, must be spread by all of us who know it is true.