Sunday, February 7, 2016

Three Settings on the Dial: What Bipolar Disorder Feels Like

I am a person who tends to like to share things with others. I like to trade ideas and compare experiences; to learn. So I decided to write a piece about the three facets of bipolar disorder - depression, mania, and balance - and how they feel from my perspective, that is, how they feel going through them. Yes, that's right, three facets. Bipolar disorder typically focuses on two facets:  mania and depression, but I believe that balance can be achieved. It doesn't have to be Zen, and it's not necessarily always bliss, but to be able to escape the pull from the other two is in itself quite the reward and worthy of consideration.

I'll start with depression since that was what I fought with the most for so long. When I hear the word "bipolar" I usually think about the bouts of profound depression I have experienced, rather than episodes of hypomania or mania. Officially, there are two types:  Bipolar I and Bipolar II. I'm not going to get into the differences. They are functionally similar, yet each unique.

I thought of the analogy of a black hole. But first, how should I use this metaphor? Is depression in itself a black hole? Or does experiencing it make you feel like a black hole? I'll start with the latter first and say that it's like falling into a black hole and save the "is a black hole" metaphor for later.


Growing up in southern California, I can recall having anxiety, which is really a precursor to depression, as far back as sixth grade, with feelings of depression following in seventh and eighth. When I started high school, I had no friends. I only really had a few in eighth grade, one group, but we had a falling out at the end of the school year, and since I refused to capitulate to the "leader's" demands to return to the group, I walked away. My freshman year in high school I walked home for lunch alone everyday and strategically planned my path to my classes to avoid the gauntlet of bullies. The area we lived in seemed to be some kind of gladiator school for bullies. It was later in my ninth grade year that I started taking naps; after school at first, but eventually I started just not returning from lunch, my mother would just call in for me. This was about when the black hole located me, This was the threshold scientists call the accretion disc; when the evil pit set it's sights to draw me in. When we moved to Oregon, and I transferred schools, I was able to keep my orbit very loose. Things started getting better for me, after a while, but eventually I found myself wanting to sleep more than go to school, or hang out with my friends, or anything for that matter. But by the end of my senior year of high school, I had made more friends than I ever had in California. The problem was that the closer we got to graduation, the more I realized that my world was going to change, and this scared the hell out of me. My whole way of life was coming to an end and my mood began to fray. On the one hand, I felt this satisfying sense of accomplishment, like everything I've done was for this moment. On the other, I felt an overwhelming sense of dread as I can only imagine the ancient Greeks felt as they were exiled from the city-state during the ostracism rituals. My orbit shifted. It was no longer a tentative flirtation, I was firmly caught; drawn.

I was able to anchor myself once again when I started college. A new school, a new way to go to school, new classes, new subjects, a new extracurricular activity I really enjoyed, and then, a new girlfriend, I'll call her Jennifer. Now, I must go on record and say that in high school, I had thought the cure for my depression would be a girlfriend, however, after my senior year I was wound so tight I could never make anything ever happen. Jennifer was someone I had met in high school, and was a friend of a friend. So a lot of the initial dating anxieties were already pushed to the side. She made me happy, and I started to feel a sense of balance. For the first few years of college, my orbit slowed to a crawl. In retrospect, she was only part of the equation. I was in college and doing well; I was very active in my extracurricular activity as a police Explorer (a sort of internship for youths and young adults interested in pursuing a career in law enforcement); I had a job; and her. Having all those things going on pulled my focus away from the depression and allowed me to sort of right myself, to be myself again.

Then we broke up, twice actually. The first time was for about 4 days, and then she decide she couldn't live without me. Ultimately I think she liked the idea of having a boyfriend more than the boyfriend himself. The second time we broke up, I made it stick. Once again, I tried to fill the hole in my life with other girlfriends but the sparks never lit a fire. Jennifer graduated from her college and I from mine and we found each other again, for one last blissful summer. But once again, I found myself standing at a precipice. I knew at the end of the summer Jennifer's path would take her away. The job I had was crap and I faced a huge unknown starting classes at a new university, in a new town, completely cut off from my family and friends. I developed an overwhelming sense of social anxiety that made it difficult to make new friends. Alcohol just made it worse. It didn't work out, and I had to come back to my parents. I was miserable. Over the following years I felt my orbit careening out of control, circling ever closer to the event horizon with each day. The anxiety was bad enough, but the anger was completely out of control. And like a broken record, I thought I would find balance in a relationship, however once again, I was wound so tight nobody wanted anything to do with me.

In the early 2000s, I distracted myself with endless partying, trying to live vicariously through my brother. The friends I had were all his friends for the most part, and looking back, I think some of them just tolerated me. I'd watch them hook up with girls we met when out on the town. I could never make that happen. So I just figured if I was drunk, I wouldn't notice. But at the end of the night, I would just go home with this empty feeling. Then my brother met his wife and suddenly the partying was all over. Kind of reminds me of the song "Closing Time" how everyone just went their separate ways. That's not to say that my brother and his wife caused the end of that era. And not to say that my sister-in-law was a Yoko Ono; she was anything but. Always the life of the party, she broke the ice better than Kristi Yamaguchi. Life happens. But again I felt like a disenfranchised freak. I had no real connection to anyone or anything, and I was stuck in a shitty dead-end job at Comcast that I hated. I mean I LOATHED getting up everyday to go to that job, and right about this time they fired me. Things started spinning out of control, and my orbit tightened. I was deep in it now. All the while, from the time I left the University, I found myself looking for pleasure in food. They say the closer an object gets to a black hole, the more massive it becomes. Once a skinny bean pole, I am now a giant.

A few years later, an old girlfriend (if you want to call her that) found me on Facebook. And about a year later, we rekindled our relationship. It was toxic. (It seems that the older that I got, the more messed up women I attracted) This woman, I'll call her Betty, was like spent plutonium. She had more baggage than Louis Vuitton, two rugrats and a head full of bad wiring. Oh, and she was married, so I had to deal with all the sneaking around bullshit. At this point my orbit was way past safe distance. I was entering the danger zone. I had lost all sense of self worth, abandoning even my most sacred morals and values, and was desperate to find something, anything, to anchor to; to stop my descent. For about a year I did as I had done all my life; I tried to fill a giant gaping black void with a person. I later realized I never even loved her, I was just hoping that she could stabilize me. It turns out, she was the singularity, that is, there was no further I could fall after her. All that animosity and anger at the end of the relationship eventually cleared and I realized just how important she was. She showed me the bottom. And when you hit the bottom, the only way to go is up, right?

DEPRESSION is a state of low mood and aversion to activity that can affect a person's thoughts, behavior, feelings and sense of well-being. People with a depressed mood can feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, ashamed or restless. They may lose interest in activities that were once pleasurable, experience loss of appetite or overeating, have problems concentrating, remembering details or making decisions, and may contemplate, attempt or commit suicide. Insomnia, excessive sleeping, fatigue, aches, pains, digestive problems or reduced energy may also be present. Depressed mood is a feature of some psychiatric syndromes such as major depressive disorder, but it may also be a normal reaction to life events such as grief, a symptom of some bodily ailments or a side effect of some drugs and medical treatments. (Wikipedia)

So far I've showed you points along my journey, a section I named My Odyssey because I felt a bit like Odysseus, besieged on all sides by monsters. Can you see the themes that recur throughout my life? I'm a movie guy, and I love movie quotes. The most profound movie quote ever came from Yoda in Star Wars: The Phantom Menace, when he said:  "Fear is the path to the Dark Side; fear leads to anger; anger leads to hate; hate leads to suffering:" Most of the major episodes of depression in my life were triggered by a big change in my life. I feared the change (anxiety), which led to anger (which are precursors to depression), which led to hate (of myself), which led to suffering (depression, hopelessness). And in that suffering, I reached out in desperation to fill the emptiness with love; the wrong kind of love. But unlike Anakin Skywalker, instead of destroying everything around me, succumbing to The Dark Side, I turned it all inward; I chose to destroy myself. But again like Anakin Skywlaker, I reached a point in my life where I chose to return to The Light Side. I'll get to that later.

Switching metaphors:  depression transforms you into a black hole. Like a dark metamorphosis, the trigger events change you. They hijack your personality. For me, wanting to fill the void with a girlfriend, I essentially felt that drawing someone in could help lift me out. I didn't love myself, so I thought that if someone else loved me, I could learn to love myself; to feel better about myself. Science tells us that black holes warp space-time and bend the laws of physics altogether; the more we learn about them, the less we know it seems. Its the same with depression.

But here's where the metaphors converge:  when you are both the black hole, and in the black hole, you can't see things for what they are. Your reality is askew, and it's impossible to get a true picture of anything. As the black hole, the triggers are never really extinguished and more continue to come. Things begin to become heavier and heavier and you begin to fold in on yourself. The greatest danger comes when you begin to think that you are completely disconnected from everything, cut off, lost in the abyss of the event horizon. No one knows what it looks like inside a black hole, but I can only speculate that the perspective must look something like a fun house mirror, the images distorted and twisted.

Some people have the misconception that depression is synonymous with sadness. It's not that simple. People don't go through depression because they had a bad day at work, or broke up with their girlfriend, or lost a loved one. Yes, these can be triggers, but depression is an inwardly reflecting kind of turmoil. It's a dark, remote, isolated place where hope, or at least the perception of hope, ceases to exist. So yes, it is sad, tearfully sometimes, but there is much more to it. Much of the time pride, shame, and fear of stigma stand in the way of  getting any useful help. Likewise, seeking help from the wrong source can only serve to worsen the situation and further isolate you. You find yourself vulnerable, and some will choose to take advantage of that. And the "snap out of it" response is the most insulting thing to someone experiencing it. Getting passed over for a promotion at work or getting turned down for a date can put you in a bad mood, but you can recover pretty quickly from those kind of superficial abrasions to your ego. When the triggers become too heavy to handle and you begin to internalize things instead of effectively processing them, you can't just "snap out of it."

Orbiting the black hole of depression feels like some kind of dark magnetic attraction; something that is unseen, that is always just out of reach and inescapable. And as you fall closer to the singularity you start to feel what relativity really is, as you watch all of your friends and family members go on with their lives an find happiness, find themselves in their careers, have relationships, get married, have kids, go on fun vacations, etc; all while you're stuck on first base. From your perspective, everything changes except you. At some point, when your orbit gets close enough to the singularity, you lose sight of what you love. It no longer matters because you are so far down in a hole you lose all hope. Socializing becomes so increasingly awkward you give up on it. How many times can you go out to dinner and order the cheapest thing on the menu, or go out for a night on the town and order just one beer? How many times can you tell your friends you can't go out with them because you have no money because you can't hold a job? Like Caligula, the monster of depression begins to snatch up everything in your life and destroy it. Basic tenets of humanity such as accountability, reliability, and responsibility become blurred like watercolors. The ability to reason and process things breaks down, so you begin to obsess over even the most mundane of details. This creates an enormous bottleneck in your thinking that can affect every level of performance in your life. In addition, all the people you know can see your descent, and in turn, start to avoid you, because you become the black hole that nobody wants to get caught in. You find it impossible to have any conversation without complaining about something. In my opinion, the most dangerous part is just before you reach the singularity, when you've abandoned all hope. Although you feel like you can't fall anymore, inevitably the bottom always drops out, causing the misconception that the descent will never end. Oftentimes the person suffering can't even ask for help because they don't know how nor do they know even what would help.


As I have mentioned, black holes are largely theoretical. Since not even light can seem to escape them, we cannot actually see a black hole; we can only see the effects. Not unlike depression. Astronomers say they can see gravitational patterns that show a convergence of stars, dust and gas; but a convergence to what, we don't know. Matter and light are sucked in and feasibly destroyed, never to be seen again. However, in our universe there exists nothing that does not have an opposite, which begs the question:  if depression can be likened to a black hole, then what is the opposite of depression; what is the opposite of a black hole? I have heard theories of a "white hole." Something that is forcefully creative in nature, adding matter and light to the universe rather than taking it out. However, this would be a faulty parallel in the matter of bipolar disorder.

If you were to cut a snip of string and hold it between your hands, it would feasibly be an accurate metaphor for bipolar disorder. On the one hand you have depression, on the other mania, and somewhere in between is balance.

MANIA is the mood of an abnormally elevated arousal energy level, or "a state of heightened overall activation with enhanced affective expression together with lability of affect." Although mania is often conceived as a “mirror image” to depression, the heightened mood can be either euphoric or irritable; indeed, as the mania worsens, irritability often becomes more pronounced and may eventuate in violence. (Wikipedia)

The most obvious misconception is that mania is a pleasant and desirable state of mind. A faulty postulation based on a lack of understanding and sometimes ignorance. If that were the case, drug companies would be making trillions of dollars (that's right, trillions) manufacturing drugs to artificially produce it. We'd all be super-focused geniuses altruistically reshaping the planet for the betterment of all, right? So far the closest I've seen Hollywood come to creating a story about this is the film Limitless, with Bradley Cooper. In the film, the character Eddie Morra is given a drug by a less than reputable source. The pill essentially mimics all the positive effects of hypomania, with none of the bad of course. This miracle drug allows Morra to become a better version of himself - strike that, the ideal version of himself. Although the story is very interesting and entertaining to watch unfold, I would classify it as a cautionary tale because nothing exists without consequences.

Based on the definition of bipolar disorder and it's symptoms, mania is often associated as the opposite of depression. Mania is only ever the opposite of depression in classifying bipolar disorder. The only true opposite of depressed would be "NOT depressed," or balance. Logically the same would hold true for mania; the opposite of manic would be "NOT manic."

Mania has historically been a difficult thing for me to explain, which is why I chose not to include manic episodes in My Odyssey. Depression, many doctors will tell you is usually a temporary state of mind. There are of course different kinds, but my interpretation is that if you are depressed, even profoundly, it will pass. Medication, therapy and a number of things can help. For someone like me, I've had long periods of profound depression with intermittent periods of question marks. That is I can remember times in my life when I wasn't so depressed, or even felt balanced, and periods of "not miserable," so to speak,  but not happy." However looking back, I know for certain that many of these intermittent periods were manic episodes which masqueraded as feelings of balance due to my lack of understanding at the time.

There are generally three stages of mania, the first two being the most characteristic of bipolar disorder. I'm not a doctor or a scholar, so I'll just classify them as hypomania and mania. Hypomania is the first stage; the precursor to mania. Although I do believe there have been periods in my life of balance or "more balanced than depresssed," the last decade, and then some, was when I truly learned about mania.

In my experience it is largely progressive. Like depression, the triggers can be internal or external, meaning it can be caused chemically, or by something experiential. For example, like depression, taking too much medicine, or street drugs, or other substances; or having a really great day at work (in a sales job for example) or a really great date can cause what I call "spin-up." I actually adopted the term from science fiction:  in Battlestar Galactica, whenever the fleet would jump to light speed, Commander Adama would give the order to "spin-up the FTL drives," essentially an order to rev-up the engines. This lends itself to be a perfect metaphor, because that is exactly how it feels to me, like my brain is revving up like a turbine. First I feel very focused, and very clear at the same time, like a cloudless sky. I can begin to feel my thinking stratify, and I'm able to focus on many different tasks at the same time with accuracy and acuity. Oftentimes that leads to a creative bloom. Sound desirable? That's about where it ends. As my thoughts begin to race, my focus shifts, productivity takes a fall. Irritability becomes apparent. Having conversations with people is difficult because as my thoughts race, my speech tends to pace, and I appear to be overly excited, oftentimes nonsensical. 90% of the time, when this happens, people think I'm on drugs; the other 10% think I'm just crazy. There are physiological symptoms too like hot flashes and cold sweats, but the most common is insomnia. I have gone entire weeks without sleeping more than 10 hours (sometimes even less) because I could not stop the spin; my brain simply wants to solve every problem I have in my life, and then do it all again over and over (obsessive thoughts). I have in the past called the crisis line because I could not stop obsessing over a conversation I had years ago. Shopping sprees are another thing. When I'm spun up, I can't resist maxing out the credit cards on stuff I don't really need, or, overbuying things I do need. I had a doctor once who was Chinese. We were talking about my disorder. He asked me if I go on "mind sprees." I had no idea what he was talking about. I later realized he was saying "buying sprees," and it was difficult for me to discern because of his accent, but "mind sprees" actually sounds like a cool "sci-fi" euphemism. Insomnia, in my opinion is one of the most dangerous symptoms because it can cause issues with safety at work or behind the wheel. I nearly totaled a car because of my inability to stay awake while driving to work. Going without sleep for days on end has often caused what I call a "crash," an acute depressive cycle, or it can lead to rapid cycling (quickly shifting between depressive and manic cycles). If you asked me which I felt was most dangerous in general, depression or mania, I would say they are equal.

These are examples of what has happened to me with mania. I've been involved with group therapy in the past. Some of the stories the others would tell about manic episodes were really scary. For example, many of the others had been arrested or jailed for various crimes, including assault and other forms of violence.

Revisiting the black hole metaphor, the manic side is a similar parallel. Once you start down the manic cycle, it's hard to stop. And the closer you get to the singularity, the closer you get to complete self-destruction. Doctors talk about mania being an elevated mood state, but when you look at it from another angle, it's just as much a descent. A manic episode is something you can fall into like a black hole, but as a state of mind, it will cause you to become the black hole as well, drawing in things like your family, your employer, law enforcement; the list goes on, and bad things tend to happen when it all seems to coalesce.


So far I've talked about black holes, my experiences with depression, and what mania is, is there something in between? That's a good question. Because I get the feeling that some people, doctors included sometimes, think that you're either at one end of the string or the other, all the time. The fact of the matter is that many bipolars, myself included, chase the Holy Grail we call balance.

Contrary to what most believe, it doesn't exist in the midst of chaos, rather just outside of it. It is not simply the eye of the storm. It is more like the passing of one storm before the arrival of another; that point where you realize you are not depressed, while at the same time, not anxious or spun up. Balance in the eye of the storm is fleeting; it's more like connecting the two ends of the string together:  a feeling of balance can occur anywhere on the loop, but you've never really left the cycle.

People are like ships on the ocean, and bipolars are like ships drifting in an endless sea, it's only when they drop anchor that they can stop the drift and take control. Which is why, in my experience, it's been so important to find something to anchor to. I find that it's best to anchor to a job, (paid or volunteer) or a hobby rather than to another person, which usually creates more problems than it solves. When you think about it, it makes sense; ships don't anchor to other ships, they anchor or tie-off to something more secure. Anchoring yourself to a relationship, in my experience, only leads to disaster.

Balance feels calm, normal, if there is such a thing. There are no voices, and no obsessions. There is no self-loathing nor doubt; no racing thoughts; no spin-up; and your head is clear. It's as if the sterile ground of your mind is now a fertile garden, once again producing the fruit of  free thought, creativity, contentment, and natural sleep. Peace. In recent times, I have been able to stop the sleeping pills and benzodiazepines. I sleep like a normal person now.

You're probably wondering why the section of this article that pertains to balance is the shortest. Maybe it's because it's the simplest to explain. Most people, non-bipolars, probably can't describe balance at all, That's because they have no idea what imbalance is like. I found in My Odyssey that it is far more difficult to explain to someone that I could not go to work because I couldn't sleep for a week, or because I woke up in a cloud and couldn't seem to think, or that I had overblown and internalized some trigger so greatly that now I cannot function. Balance is a matter of perspective. You cannot see it until you step away from it. Balance is not in itself an emotion, it is the confluent harmony of all emotion that allows you to function, productively, in human society. Balance is achieved through not only medication and therapy, but through living. That is, getting out, doing things, going to work and doing the best job you can, setting goals, having healthy relationships, making responsible choices, and certainly not the least:  faith in a higher power.


In writing this article, my intentions were to show how bipolar disorder feels from my perspective. Not everyone's perspective is the same, and certainly not all bipolars are the same. What is s struggle for me, might be a triumph for someone else. That being said, I decided to write the article prior to doing a great deal of research. This is a blog, not a paper for JAMA, and there is only one patient: me. I have provided a number of links to other sites that I feel might be helpful, and I have provided the Wikipedia definitions of depression and mania. You'll notice that I only listed some of the symptoms in My Odyssey and other testimonials. I have done this for two reasons:  1) For the intended purpose of not suggesting that depression/mania consists of all of the aforementioned symptoms. 2) So as not to mislead my readers into thinking that I chose symptoms from a list; these are my experiences that I am sharing, there are no "textbook cases" here.

How did I achieve balance?

Like Odysseus, My Odyssey began long ago. What was to be a short mission turned out to be a tragedy that lasted a dozen years for Odysseus. And when he returned home, he found that everything had changed while he was gone. I too set out into this world, besieged at every turn by impossible obstacles. But my demons were inside. There is nothing about me physically that would have stopped me from having a "normal" life. The demons were empowered by my own internalization and sense of self-loathing. The harder I fought to get out of this mud, the deeper I sank. I tried to rely on my faith, but I failed it. That's right, I said I failed my faith; God was always there. Like Job, he was forging me in a furnace. Like Job, he took everything away from me; distractions, all of it. The more I worried about things, the more I lost. It wasn't until I stopped the worrying, that He lifted me up. He calmed the seas. I fought Jesus for the wheel, and when I cried out for him to take it, I realized he was driving the whole time.

For me, faith is the reason I escaped the black hole, why I achieved balance. However, I also took a lot of medicine and had a lot of therapy sessions. I think the combination is really the best way to slay the dragon. Bipolar disorder is largely a chemical imbalance, but can also be experiential and environmental. The whole point is that I achieved balance and you can too. I know that from what I have learned, the brain doesn't heal like bones or tissue, but I also know that the brain can sometimes rewire itself. I'm hoping that is the case for me. Because I would do anything to keep from falling into that black hole again. Rewiring aside, I know now what saved me. I know what the black hole looks like, feels like. And I know how to spot them, and avoid them.

Circling back once more to that question about the black hole metaphor.

I guess the best way to describe it is that bipolar disorder is that it is in itself a black hole that will draw you in and consume you. It will give you a false sense of hopelessness and make you feel alone as you slowly become the black hole. As the black hole you begin to draw in everything in your life:  your family, your friends, your career. As your perspective begins to warp, the lives of your loved ones begin to show stress from your overwhelming gravity. Unchecked, it will destroy everything. But unlike a stellar black hole, this black hole can be overcome. Escape is possible. Knowing this may provide a lifeboat to someone in need.




A week after I began to write this article, one of my best friends from high school passed away. He lost the battle with his own black hole. I dedicate this article to my friend Joe. May it give hope to those who are caught. I first met Joe (center) in the beginning of my senior year at a party in high school. He was a friend of a friend of a friend, or something like that. We were passing acquaintances until the day we graduated. Ironically, one the best friends I had in high school, I never actually became friends with until the last day of high school. In my turmoil, he showed me stability and loyalty. It was if he saw my pain, and did everything he could to relieve it. Joe was the kind of friend that would call me everyday to hang out. Being a heterosexual man, there have been very few times in my life have I ever said I loved a man other than my father or my brother, but those friends who stayed close to me, especially in my darkest moments, I love with all my heart, especially Joe.