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Rage swings into a stuporous sleep, and sleep swings into the awful morning sun. My head slides off the edge of the bed, and my mood plummets from shrieking high to muffled low, my heart beating dully on the inside of my ribs. I fall out of bed and stumble down the stairs, heading for coffee, but get too tired on the way and lie down on the living room floor, a painful hole yawning open in my chest. This old, familiar ache does not feel so much like sadness as it does like death, if death is blunt and heavy and topples into you, knocking you flat.
Julian comes in, carrying a cup of coffee. He sees me there on the floor. “Do you want help up?”
I mean to shake my head no, but my face is pressed into the carpet, and it would be too hard to shake it anyway. He picks his way through the wreckage of the night before, clears a chair of debris, and sits down, crossing his legs, an action I find futile and absurd. Slowly, I lift myself up. I’m dizzy—I always am after a rage—and I try to focus my eyes. I look around me at the mess: there’s a jagged-edged half of a wine bottle, a pile of green glass shards nearby. There’s a circular stain of wine on the wall, streams running down as if it leaked blood, and a puddle-shaped stain on the carpet below. There are the remains of a couple of smashed glasses. The bookshelf is cockeyed, leaning precariously on the back of the couch. Books everywhere. The couch has moved across the room from where it’s supposed to be. I peer at what looks like a hole in the wall. I look at Julian.
“Lead crystal clock,” he explains.
I nod, still looking around the room. “This is bad,” I finally say.
“Not good,” he agrees.
“Sorry,” I say.
“It happens,” he says.
“It does,” I say, bewildered. “I don’t know why.”
He leaves—does he even understand what’s happening? I certainly don’t—and I stand barefoot, alone in the mess. I go over to the hole in the wall and stub my toe on the aforementioned lead crystal clock. I pick it up and turn it over in my hands. Wedding present. Ugly. I marvel that it didn’t break. I set it down on the table and look out the window. My shoulders slump.
I shake the fog out of my head. Get a grip, I think. I’m fine. It’s little-boy Julian who’s making me crazy. No one could cope with his dependency, his lack of drive. It’s stressing me out, this game the two of us play, his kicking back, jobless, using my money, embracing the identity of kept man.
No, I correct myself. He’s my savior, companion, the husband, the rock. Our life is normal, balanced. We’re just like everyone else.
I cling to the persona of the good wife, the disciplined writer, the hostess, hanging on with both hands. But even I wear down eventually: the constant fighting, the afternoons crashed out in bed, the sudden spells of ruthless energy—they’re just too much.
I give in. I call for help.
The Diagnosis
April 1997
I page through the phone book surreptitiously, looking out the window to make sure Julian hasn’t pulled up to the house yet. For some reason, I don’t want him to know I’m calling a psychiatrist. Maybe that would confirm the incredibly obvious. Or maybe he hasn’t noticed that I’ve gone completely nuts. I run my finger down the column and stop at one Richard Beedle, M.D. I like his name. A man named Beedle can’t be all bad.
I sit in the waiting room, paging through an old Time. It’s the same Time they keep in every waiting room. There is only one, and everyone has it, and it is sorely out of date. Bored, I slap it shut and study the painting of flowers on the opposite wall. It looks like every other painting of flowers on every other wall of every office of every psychiatrist, psychologist, nutritionist, behaviorist, et al. that I’ve ever seen.
He calls me into his office. I take my usual place in the usual chair on the usual empty afternoon. I study him the way I always study them. Some of them are mean, some very smart, some idiots, most a little hurried, but some just plain old nice—your usual cross-section of humanity. This Beedle looks to be okay. He has one wandering eye and wears a brown suit. I watch his eye while he settles into his chair. Does he get to see two whole scenes at once? Is one part of him having a conversation with me while another is looking out the window at the new green leaves on the trees?
He mispronounces my name and I correct him, as usual. This is how all psychiatric visits start. He looks friendly enough, so I decide to give him a chance.
“What brings you here today?” he asks.
“I’m going crazy.”
“Well, don’t beat around the bush,” he says. “Jump right in.”
“I’m going nuts. I mean, I am nuts. I’ve always been nuts. They’ve been telling me I have depression for years, but they’re wrong. I used to have an eating disorder. They’re always giving me Prozac. I know, I know, you’ll probably give me Prozac too, which, okay, I understand, you have to give me something, though I should mention that if you had something other than Prozac I would be open to trying it, just so you know. In fact, I’m open to pretty much anything, at this point. I’m kind of desperate.” Weirdly, I laugh. “I mean, kind of really desperate. Not to make a fuss or anything. I don’t want to overstate my case. I don’t want to be malingering. Do you think I’m malingering? Once a nurse told me I was malingering when I told her the Prozac was making me crazy.” I pause. “What exactly is malingering?” I ask.
“It’s when you’re making a big deal out of nothing. Making symptoms seem worse than they are.”
“See?” I say, and throw up my hands. “Exactly. I don’t want to be malingering. I definitely don’t want to make something out of nothing.”
“You’re not malingering.”
“Well, that’s good. But anyway, really, now that I think of it, this really is nothing. It’s not such a big deal. I mean, I’m not crazy crazy. I’m not wandering around with a grocery cart full of newspapers and cans talking to myself. I mean, I talk to myself a little, but not in a crazy way—doesn’t everybody talk to themselves?” He nods. He sits with his hands folded on his desk. He hasn’t written anything on his notepad and appears, oddly, to be listening. I appreciate his attention; it’s very courteous of him. “By the way, oh my gosh,” I say, suddenly flustered, “I’m going on and on. I know you’re busy. I know you must have a million patients. Have I already used up my time?” I ask, a little panicked.
“No.”
“How much time do I have?”
“As much as you want. This is a private practice. I’m not an HMO, so no rush.”
“Well,” I sigh, collapsing back in my chair—I notice I’ve been sitting bolt upright the whole time—“thank goodness.” I take a little breather.
“May I ask you something?”
“Sure,” I say, feeling magnanimous.
“Do you always talk this fast?”
“Yes.”
He nods. “Okay,” he says. “Go on.”
“What was I saying?”
“Feeling crazy, but not crazy crazy.”
“Right,” I say. “So I guess that’s it. Do you mind if I look around?”
“Not at all,” he says, so I get up and go over to his bookcase and read all the titles and look at the framed photos and laugh at the little framed cartoon—a man is lying on a couch, yammering on, and the doctor’s writing TOTALLY NUTS!!! on his little pad—and I go over to the window and hop up on the sill and swing my feet a little, then hop back down and come back and sit in my chair.
“All better?” he asks. I laugh. “Has anyone ever mentioned the word mania to you?”
“Nope,” I say, folding my hands across my middle.
“They haven’t,” he says. “I find that a little odd.”
“I mean, I’ve heard the word, obviously,” I say. “I’ve just never heard it applied to me. Is that what you’re saying?”
“It was, yes. Out of curiosity, what does mania mean?”
“Mania—well, going around like a maniac, I guess.” Now that I think about it, that doesn’t sound so far off.
“Sort of,” he says. “Anyway, you’re right, you don’t seem depressed right now. You seem like you’ve got lots of energy.”
“I do indeed,” I say. “Indeed I do.”
“An unusual amount of energy,” he replies.
I shrug. “Pretty typical for me,” I say. “I like to keep busy.”
“What do you do to keep yourself busy?”
“Oh, working, mostly. Or seeing friends. Cleaning, laundry, things like that. I like to have a clean house. Very clean. Unusually clean. Spotless, in fact. I’m an extremely good housekeeper. Most of the time.”
“Except?”
“When I’m not. I go through stages. Sometimes I don’t clean the house for months. But usually,” I say, not wanting to give the impression that I’m a lazy slob, “it’s pretty clean.”
“What else happens when you go through those stages?”
I furrow my brow. “I don’t know. Nothing. It happens in the afternoon, usually. I just want to crawl into bed and hide from the entire world and stop thinking. My brain empties out. It’s kind of an effort to breathe. It’s like time slows down. It feels like I’m flattened. I don’t want to do anything. I can’t concentrate. I feel like a failure. I sort of hate myself.” I shrug. “It goes away. Then I get energetic again.” I fiddle with my ears, not wanting to tell him about the rages. I feel like I’ve said too much already and come off as crazy. Can’t have that.
“Is there a pattern to the swings?”
“Swings?”
“What did you say? Stages. Do you have any idea when the stages come and go? I mean, you know when they happen during the day, right? Do you see any pattern over, say, a few months?”
“No. Sometimes they happen, sometimes not. I’m just kind of moody. Which,” I say, “is kind of the issue. I’m really insanely moody right now. I mean, I’m out-of-my-head moody. I can’t stand it. I’m going nuts. As I said.”
“What’s happening?”
“I’m having these rages,” I finally confess, embarrassed. “I kind of go into these insane rages and wind up smashing all kinds of shit and throwing things and hollering and crying.”
“Any particular reason?”
“No. That’s the thing. It just happens. It comes out of nowhere. Well, it happens at night, usually. At night I’m crazy, in the morning I’m flat. So at night I have these rages and destroy all this shit and am horrible and awful, and then in the morning I wake up and look at it and kind of want to die. I mean, not die die,” I say. “I never want to really die.” I lean forward, wanting to set the record straight. “But I’m not depressed, for God’s sake. You said so yourself. They’ve always said I was, but that doesn’t make any sense. I’m usually pretty happy,” I say, sitting back in my chair, waving my hand, suddenly aware that that sounds a little ridiculous at this point. “I mean, seriously. It’s not like I lie around all day. How could I get up every morning and work, and do all this stuff, if I was depressed?” I laugh in disbelief.
He nods amiably. “Ever wish you were dead?”
I consider it. “I wish I wasn’t crazy.”
“Ever attempted suicide?”
“Not exactly.”
He raises his eyebrows, then skips on. “Let me ask you a couple of questions.”
The questions are endless, and with each one, I feel a little crazier. But I also start to feel like he might know what’s going on. Which means there might be something he could do.
“You say you had an eating disorder? How long ago?”
“Started when I was nine. I finally started getting a handle on it a couple of years ago, when I was about twenty.”
“What about cutting, any history of cutting?”
“A little bit. Ages ago.” I’m torn between wanting his help and not wanting to seem crazy. The cutting was crazy. I don’t care to elaborate.
“What about drinking? Drugs?”
“Drinking? I suppose so, yes. But not too much. Nothing that would cause concern.” I’m thinking, Drinking? All the time. Until I can’t see. Until the crazies go away. I drink myself sane. I’m not about to tell him that. That’s the last thing I want him to know. I’ll tell him anything he wants to hear except about the drinking. It’s my last hope to keep myself from going totally over the edge. “No drugs,” I say.
“Do you have a habit of being impulsive? Things like shopping, making snap decisions? Taking sudden trips?” The more he asks, the less I can answer. Snap decisions? Always. Shopping? Until I’ve nearly gone broke. Trips? I just took a trip. Lit off at night, drove six hundred miles to see an old friend, on a whim.
“What about sex?” I slept with the friend, too, without thinking about it, then felt like shit. “Not to pry, but would you say you sleep with a lot of people? More than you mean to? Sometimes it feels like you don’t want to but can’t stop?” For as long as I can remember. I can’t begin to count the beds, the nights when it felt easier just to close my eyes than to get myself home.
“Do your thoughts race?”
I sit up. “That’s it,” I say. “That’s what I mean when I say crazy: I can’t get the thoughts to stop. It’s torture. It’s hell.”
“Do you ever feel like you’re not in your body, like you’re numb?”
“Yes.”
“When?”
“Sometimes during the rages. Sometimes when I get really happy. It comes and goes.”
“Does it bother you?”
“I don’t know. It’s just weird. It feels like I might just go flying off.”
“Does anything make the feeling go away?”
“I pinch myself.”
“Does it work?”
“Not really.”
“Do you ever cut yourself?”
“Not anymore.”
“When you did, did it help?”
“Yes,” I say flatly.
“Good for you for not doing it anymore.”
“I slipped once. Nearly killed myself. I’m not interested in doing it again.”
“Slipped?”
“Slipped.”
He lets it slide.
“How far apart are the mood swings?” He keeps saying that! What’s he talking about? “Every few months, weeks, days?”
“I wouldn’t know about mood swings,” I say. “It’s nothing that specific. It’s just, I don’t know—” Now that I think about it, it’s obviously fucking mood swings. “More like I just go flying around, up and down. Sometimes days. Hours. Minutes. So fast I can’t keep track. I’ll be going along in a perfectly good mood and suddenly I’m pitching shit all over the house. I’ll be lying in bed feeling like I’m dead when suddenly I’m up and running around. It’s maddening. I’d give anything to be just normal for an entire day. Just a day. That’s all I’m asking.”
“What about sleep, do you sleep? Can’t fall asleep or can’t stay asleep? Wake up early even when you don’t want to?”
“I would sell my soul for one good night of sleep. I lie awake for hours, then prowl the house all night. By morning everything feels surreal.”
“Nightmares?”
“When I sleep.”
“What about work, what kind of work do you do? Do you find it hard to work? Easy? Can you stop working? Or do you just keep going?”
“I’m a writer. I write and write. I would write until I was dead, the way some dogs will keep eating and eating until they die. I can’t stop. And then, suddenly, I have nothing to say. It goes away. The words are gone.”
He’s studying my face.
“Do you ever feel hopeless?”
The word yawns open in my chest. “Not really,” I say, looking out the window.
“But sometimes?”
“Sometimes.”
“When?”
I still don’t look at him. “When I stop to think about it.”
“About this?”
“About any of it. About being crazy.” I chew my thumbnail and look at him. “It’s getting worse,” I say. “It’s getting harder not to think about it.”
“Does anything help?”
I snort. “A drink?” He doesn’t laugh. “Not really,” I say. “No.”
Nothing. Nothing makes it go away.
He finally scribbles something on his notepad and clicks his pen. He looks at me.
“You don’t have depression, that’s for sure.”
“No shit.” What a relief.
“You have bipolar disorder.”
I sit there. “Is that the same as manic depression?”
“The very same.”
“You’re joking.”
“I’m serious.”
“That’s crazy. I mean, manic depression: that’s crazy.”
He shrugs. “Depends on how you look at it. I wouldn’t say it’s crazy. I’d say it’s an illness.”
“Bipolar disorder,” I repeat. “Do you take Prozac for that?”
“Not a chance,” he says. “You’re right that the Prozac makes you feel crazy. I’m going to prescribe a mood stabilizer. It should help.”
My chest floods with a mixture of horror and relief. The relief comes first: something in me sits up and says, It’s true. He’s right, he has to be right. This is it. All the years I’ve felt tossed and spit up by the forces of chaos, all that time I’ve felt as if I am spinning away from the real world, the known world, off in my own aimless orbit—all of it, over. Suddenly the solar system snaps into place, and at the center is this sun; I have a word. Bipolar. Now it will be better. Now it has a name, and if it has a name, it’s a real thing, not merely my imagination gone wild. If it has a name, if it isn’t merely an utter failure on my part, if it’s a disease, bipolar disorder, then it has an answer. Then it has a cure. At least it has something that should help.
And then the horror sets in. All that time I wasn’t crazy; I was, in fact, crazy. It’s hopeless. I’m hopeless. Bipolar disorder. Manic depression. I’m sick. It’s true. It isn’t going to go away. All my life, I’ve thought that if I just worked hard enough, it would. I’ve always thought that if I just pulled myself together, I’d be a good person, a calm person, a person like everyone else.
I think how impossible it seems that I have never connected the term manic depression—I guess they’re calling it bipolar—to myself. For that matter, it seems impossible that they would never have applied it to me.
What if this Beedle fellow is right? What if my good moods are the same thing as mania? And what if, God forbid, the lows are the same as depression? And what if manic depression means crazy? Well, obviously, it does.
So. I’m crazy as a coot. Mad as a hatter. End of story. That’s all, folks, now you can all go home. I’m sure, sitting here in the doctor’s office, that there’s no final cure for the truly insane. I am no longer young, wild, crazy, a little nuts. I’m a crazy lady.
I knew it all along.
“WENT TO THE DOCTOR today,” I say, yanking the cork from a bottle of wine. Julian is sitting in the breakfast nook, reading the paper.
“Are you sick?” he asks, taking the glass I hand him and glancing up at me before looking back at the front page.
“In a manner of speaking,” I say. “He says I have bipolar disorder. It’s the same thing as manic depression.”
“Is it serious?”
“I don’t think so. But it sort of explains the last few months.”
“How so?” He sets the paper down and takes a swallow of wine.
“The rages,” I say, stirring something on the stove.
“This was a psychiatrist you went to?”
I nod. “Named Beedle.”
“Beedle,” he muses.
“Right,” I say. “Anyway, he gave me a prescription.”
“For rages? What do they prescribe for that?”
“Mood stabilizers.” I look at the prescription slip in my back pocket. “Depakote. I think it’s supposed to help, you know, sort of all around. With the moods. And things.”
“Ah yes,” he says. “The moods. And things.”
“So I should be a little less crazy.”
“All right,” he says, and bites into an apple. “When’s dinner?”
By the end of the evening a miracle has occurred, and I’m feeling fine. All those years of changing my thoughts! improving my attitude! have suddenly become very useful. By my second glass of wine, I have chosen a new perspective! as follows:
Bipolar? Kind of an overstatement, but whatever. Just another name from yet another shrink. Interesting, but not really relevant to my day-to-day—after all, it’s not like I’m sick. I’ll take the meds, though—they’ll get rid of the rages, and the afternoon lows. Back to normal in a jiffy, back to my usual good mood. And surely no one needs to know; why focus more on what a fuckup I am? They’ll take it wrong and make a fuss. This is really no big deal. I’ll be good as new.
I’m immensely pleased with myself for changing my thoughts in this so-healthy way.
MY INSURANCE doesn’t cover Dr. Beedle, so he refers me to someone it does, a Dr. Lentz. I like him—he’s mild, cheerful, seems awfully concerned. He asks how things are going; I’ve got to get rid of the rages and lows, so I tell him about those and he fiddles with my dose. He asks me, for some reason, how much I drink, and tells me if I drink a lot, the meds won’t work, but since I’m not an alcoholic or anything, his question has no relevance.
I’m delighted with these meds, and I usually take them. When I feel bad, anyway—that’s what they’re for, right? To cheer me up? It’s those depressions I hate, and the rages, and the spinning thoughts—what I want is to hit that perfect high. That’s my normal self.
And I’m getting happier and happier all the time, working constantly, keeping the house spotless, throwing parties that feature gales of laughter and me at the very top of my game. These meds are a miracle! I tell him how much they’re helping. Perhaps I’m a little too happy? Why, no! He raises an eyebrow as I babble on about how inspired I am, so I tone it down—obviously not too happy, I say, dismissing the thought with a wave of my hand. I’m just back to normal! It’s summer, after all. This is the way I’m supposed to be! I’m always high as a kite in summer!
I WONDER what difference it might have made in my life if I’d taken my bipolar seriously right then. If I had, in fact, stopped to think about it. Maybe read up on it. Maybe learned something that might have changed the way I lived, something that in turn might have altered—maybe dramatically—the way the following years played out. I sit here now, writing these words, just out of the hospital for the umpteenth time this year. My vision is blurry, my speech is slurred, I can hardly keep my fingers on the keys. I’m not safe to drive, I can’t make a phone call; I woke up the other day in a hospital bed, staggered out to the nurses’ desk, and demanded to know how long I’d been there. “Eleven days” came the calm reply. “Eleven days?” I shouted. “What have I been doing this whole time?” The nurse looked at me. “Well, you’ve been sick,” she said. That means I’ve been sleeping for days on end, when I wasn’t running around like a demon possessed, and getting electroshock, and being wheeled through the ward with my head lolling onto my chest, and downing Dixie cups full of pills, and slurring through the haze of medication and chemical malfunction to my hospital psychiatrist (who is nothing short of a saint and who makes a regular practice of saving me from the vicissitudes of my mind), and falling back into bed again, and launching myself out, and running around; eleven days, twelve days, fourteen. It happens like clockwork, every few months. Hospitalizations lately: January 2004. April 2004. July 2004. October 2004. January 2005. April 2005. July 2005. December 2005. January 2006. July 2006. September 2006. October 2006. November 2006.
IT’S APRIL 2007. I haven’t been in the hospital in six months. Okay, I was completely out of commission, living in my pajamas, moving from my bed to my office, sitting with my head in my hands, trying like hell to have one coherent thought, for February and March. But I stayed out of the hospital. I’m doing fucking great.
For years after I was diagnosed, I didn’t take it seriously. I just didn’t feel like thinking about it. I let it run rampant, and these are the results. But what does it matter, what might have happened? What might have happened didn’t. This is what did.