Monday, March 21, 2011

On Coming Out Bipolar

the more I learn, the more I learn / the more I cry, the more I cry / as I say goodbye to a way of life I thought I had designed for me... / and I see you standing there, wanting more from me / and all I can do is try
           - Nelly Furtado, "Try"

what you thought you lost was just mislaid / all the poems written in your skin
           - Goldfrapp, "Some People"

Silence = Death
            - ACT UP Slogan

I was having a conversation with my therapist last Monday about a feeling that I have fairly regularly these days - the need to explain the circumstances of my life since I moved from Los Angeles, effectively ending my graduate school career, back to my childhood home in South Carolina. Whether I'm catching up with a friend or getting to know someone new on a more than superficial level, there's a dialogue that I have with myself whenever someone asks me how the return came about.

On the one hand, there are ways of crafting the explanations in a fairly socially acceptable way. When I first started getting the question, it was easy to respond, since my time in South Carolina was first intended as a simple leave of absence, and I would ostensibly be resuming classes at the leave's end. Even as I would explain this, though, I knew that it was a lie of omission - given my psychological state and the material resources it would take to have the return to California come to fruition, the chances I would return were slim. It was one of those gut feelings.

And now, as we approach the two-year anniversary of my return, the urge to disclose what's really going on is rearing its head on a near-daily basis. But back to the therapist's office: when I told her that I had begun having this need to be more explicit about the issues that have been going on in my life, I asked her a question - how should I handle it? What should I tell people? What is the appropriate level of disclosure? How do I explain all of this?

Her response: "How do you explain it to yourself?"

I paused for a second; my first thought was, "that's a really therapist-y thing to say." But after a few moments of silence, my cynicism began to evaporate. I spoke: "That's really the question, isn't it?"

"Yes, Charlie. What would you tell people if you had cancer?"

Another pause. I begin to intellectualize things, which is what I do when I feel like I know the "correct," on the nose response to a therapist's question but I want to say something smarter.

"I wouldn't have a problem telling people that. That's..."

"That's what?"

"That's... that's real."

. . . . .

I am a Fat, Queer, Southern, Spiritual, Feminist, Cisgendered Man.

And I have Bipolar Disorder.

. . . . .

I've written this post over and over again in my head, and every time I sit down to write it for real, it just never carries the same weight. I stop and start. I self-censor. Perhaps the most crippling aspect of the whole endeavor is that I feel the need to put things perfectly, to illuminate everything all at once. As I put it to my therapist, I'm feeling the need to say the definitive thing about what I'm feeling, and that pressure has often kept me from saying anything at all. Of course, the truth is that I'm learning new things about myself and this disorder every day. The beautiful thing about journal-keeping is that you record, over and over again, versions of yourself that exist in an eternal present, available for access at any time that follows. So this is where I am now, forever.

Prior to graduate school, I was primarily a depressive, with spurts of hypomania that allowed me to do enough to function in an academic setting. Academia was the organizing principle in my life, to such an extent that in both my senior year of high school and college, once I had secured a place in the next step of my scholarship (college and grad school, respectively), I descended into blackness. I'd be curious to see how many days I missed of senior year exactly, but I'd put the number somewhere between 50 and 80. College was similar, though I was able to hide the depression from the world through scheduling a light, Tuesday/Thursday only schedule in my final semester. In both cases, I had built up enough goodwill at the institutions I occupied that I was able to scrape through.

As anyone who has undertaken graduate study will tell you, however, there's far more to accomplish and far less structure in which to do so. In 2006, at the end of my first semester of graduate school, my sister suddenly died, and in a certain way, that threw my priorities into sharp relief – before I’d inflate the importance of academic output to such an extent that not doing it seemed impossible, but having this happen gave me a very compelling reason to not give a fuck on a moment-to-moment basis while still being aware of the school obligations that hung over my head. After a year of agonizing over making up the incompletes that had accrued in the wake of Stephanie’s death, I eventually gave up. I wouldn't admit this to myself, let alone the people in my life, but that's exactly what happened. I was in such a state of numbness, grief and depression that it was an achievement to leave my house, let alone do readings and attend classes. It was like swimming in sand.

Once you achieve a certain level of study, there is a sharply reduced sense of the day-to-day accountability that characterizes high school and (to a somewhat lesser extent) undergraduate life. Furthermore, in college and high school there is the motivation of keeping a transcript that will allow you to go on to the next level of study, but the feeling I got in my grad program (and from my close coterie of academic advisors and student colleagues) was that in time, everything was fixable, even expired incompletes. I could write when I was able.

But that day, that ability, didn't come, and slowly but surely the incapacity to write, to do anything
worthwhile, was a voice that took permanent root in my head.

To add insult to injury, by my second year of teaching - my third year of grad school, the first was a fellowship year - my evaluations had gotten so low that not only was I constantly berating myself for not being able to produce anything, I was also required to come into the Writing Program's offices and "check in" every week. (One sage piece of advice: "The way to get grading done is to just fucking do it.") At the time, I resented this level of surveillance, mostly because it caused me to dedicate so much emotional energy and time to teaching preparation that I had a significantly reduced amount of time to do my own work – not that I was using what time I had effectively.

My graduate career felt unfixable. My life felt unfixable. I didn't even bother trying to write the papers for Fall 2008, resigning myself to more incompletes and retreating into hazes of self-medication.

. . . . .

Manic symptoms are generally divided into two classes: hypomania, which presents as a mild elevation in mood or irritability, and full-blown mania, which is characterized by losing touch with reality, paranoia, and even hallucinations and psychosis. The difference between Bipolar I and II is the presence of a full manic episode as opposed to the hypomanic state. Up until February of 2009, I had only experienced hypomania – and the beginning of ’09, in retrospect, was a reoccurrence of that mild upswing in mood.

Just before New Year’s 2008, I was having more than a few beers with some high school friends of mine, and somehow the subject drifted to my “disappearance” in senior year. Although I was rather drunk and do not remember the particulars of the conversation, I do remember that I cried that night for only the second time since my sister had died (the first had been in the Fall of 2007, nearly a year after the fact), and that I emerged feeling somehow healed, like I had spoken my piece about having been so disconnected during that time and that a newfound closeness had been forged. Up until then, I had kept a cordial friendship with several of the people there, but afterwards I realized how much they had my back.

(I suppose I should interject here that much of my depression in high school came from feelings of isolation surrounding being queer. I’m pretty sure that was a big part of the catharsis I had that night, telling them just how alone I had felt and how much I had needed them, and how, even though they weren’t there in high school, I was grateful that they were right there, right then.)

When I arrived back in LA at the beginning of 2009, I began to have days in which, for no explainable reason, I just felt great. The night with my friends had spawned an energy in me that made me feel like everything was going to be OK, that I would be the best teacher that I could be, that all the work I’d avoided so completely was going to get done. On a moment-to-moment basis, nothing practical was happening to support those feelings, but my zest for life was such that I was just riding the wave and enjoying the moment.

At a certain point, the “good-feeling” reached more of an elevated intensity, and I began to lose touch with reality. I was crying with joy on a fairly regular basis; I became strongly opinionated; my inhibitions lowered. I smoked pot one night and actually felt like I was speaking directly to God. I stopped sleeping and eating, becoming obsessed with the purity of my body. I called friends, asking coyly if they believed in possession by good spirits. I tried healing people telepathically. My energy seemed limitless, and goddamnit, I was going to use it while it was there.

Soon, though, I became more afraid than anything. My previous entry captures well when that turn began to happen. I called a friend a couple of nights after those events, asking if I could just spend the night – I was scared to be alone with myself. That night, she fed me, the first meal I had eaten in about 3 days. I slept for 6 hours, the most I had in about a week. For a couple of hours the next day, I felt better, and decided to give going back home a try. Within about an hour of returning, though, I knew that things were still seriously amiss. While eating a few good meals and replacing all the electrolytes I had flushed during my "purity" kick had given me some relative calm, the paranoid, racing thoughts were still there.

That evening, I checked myself into Cedars-Sinai for a 72-hour observational stay, and was put in the crisis wing. I was diagnosed Bipolar that weekend, and put on a combination of Depakote, Abilify, and Klonopin. For the moment, things seemed to have stabilized. The hopefulness of the hypomania of earlier in the year stayed, tempered by a raw vulnerability that felt etched in my soul. I had survived this. What more was there to bear?

. . . . .

When you re-enter the house you went crazy in, it feels like a war zone.

Shattered glasses on the floor, candy wrappers (my last at-home sustenance before the hospital) scattered over the desk, my mattress in the middle of the living room floor, a bowl of water on the floor beside it. Nothing in order, everything with a chilling story. A chance for a new beginning, an opportunity for painful progress. Clean slate, dirty house.

The process of cleaning up was therapy in itself. I could change everything now, I thought to myself.

(Mania doesn’t leave wholesale. The way down is one of those multi-arced water slides.)

Generally, the institution I attended was accommodating. They replaced me as the teacher of the composition class I was responsible for and assigned me to a schedule in the Writing Center, where students came in by appointment and you could leave your work at work. It was decided that I would take a leave of absence for the next semester, but I would finish the current one so I wouldn’t face the burden of having to return student loan funds.

I tried to finish that semester on a positive note, I really did. But soon enough, I began experiencing side effects from the Abilify – specifically, I was unable to sit still for more than 20 minutes at a time without feeling extremely fidgety. This made my seminars into torture. I tried to do the readings. I tried to write the papers. I couldn’t.

Had I known then what I know now, I’d have been able to forgive that lack of industriousness. After a manic episode, the brain enters a sort of “sleep mode” that can last a year or more. I thought I was just lazy. What I was was healing. And healing from mania isn’t a pretty picture.

I know because I’m still doing it. Because a year and three months later, already deep in the despair of having lost the career I’d worked my life for, I had another manic episode, this one involving psychosis, handcuffs, police, commitment rather than voluntary admission.

That was nine months ago.

. . . . .

But this isn’t a piece about my manic episodes themselves, not in the detailed way it could be. That will come with more meditation, more memory-seeking.

This is about coming out.

I have Bipolar Disorder.

I am the “crazy” homeless person you see on the street. I am Charlie Sheen. I am Kurt Cobain, and Patty Duke, and Ernest Hemingway, and Vincent Van Gogh.

But most of all, I am me, and I am fucking lucky to be alive.

I said that cancer would feel more "real" to my therapist because when a person with bipolar, or anyone with an mental illness, is in a state of relative stability, it can often appear like they are not ill at all. But as someone who has suffered multiple manic episodes, I can tell you that they change who you are. Every moment of stability becomes a mixed blessing, colored both by the happiness of the moment and the fear that it will end. Moments of elation are tempered by the real possibility that something horrifying might be around the corner, and when the bottom falls out, there's the chance that rock bottoms past mightn't have been that rocky after all.

And much of the time, mental illness is invisible to the outside world, which is why I'm finding coming out to be a relevant metaphor to co-opt. A wise woman once told me that "writing is fighting," and if that's true - which I think it is - what I'm trying to fight now is the idea that the mentally ill are somehow incapable of articulating their subjectivity. It may not look like I’m doing much with my life right now, but I woke up this morning, did my laundry, took a shower, went to my therapist, and now I’m writing this. I am trying. I am trying so fucking hard to build something from what feels like nothing.

And boy, does it feel like nothing sometimes. If I had a nickel for every time I’ve told myself I was lazy, that I was worthless, that there’s nothing worth living for, I’d be a very rich, very unhappy man. But this blog, this entry, is a fight against that, a salvo against the paralyzing, deathly silence that I’ve relegated myself to for much of the past two years. If you are battling mental illness, you are not alone, because I’m here, and I’ve got your back. You may not have showered in a week, you may barely be able to get out of bed in the morning, it may be a battle every time you want to leave the house, but you are loved. I know, because I have learned to love myself, and I’ve been in all those places. I’m still there sometimes.

But I’m trying. And all I can do is try. And sometimes, that has to be enough.


  1. Beautiful post, Charlie. I feel I understand some things a lot better from reading it, and I'm sending you much love. <3 <3

  2. Ditto. (I got the link from A.'s twitter feed.) Thank you for writing this, Charlie! I've never heard bipolar disorder so cogently described - I learned a lot from reading this. This will be helpful to many people I bet.

  3. Thanks Charlie. This helps me understand both you and another important person in my life who is bipolar. I send you love. Emily

  4. Great post, Charlie. I'm a psychiatrist who these days mostly teaches. I plan to print off this entry and get my registrars (aka residents) to read it so as to have a better understanding. Hope that's okay.

  5. Thank you all so very much for your responses! It means a lot that this piece is getting out there and reaching people. And @fizz, you're more than welcome to use the piece for that purpose - thank you for stopping by! :)

  6. Hey Charlie. I'm sorry I haven't been in contact as much as usual. I've been busy with "life". Give me a call sometime man. We need to catch up!

  7. charlie, i just read this, i'd had no idea. i had my own struggles during grad school, an unending war with major depression and occasional mania (the latter drug admittedly induced) but nothing compared with what you went through. stay strong, brother! if it's any consolation (and this is not meant as a platitude even if it comes across as such) there's is in my mind a truly powerful and peculiar link between bipolar disorder and genius -- some of the most amazing people i've known in my life suffer from some form of the disease. for those with the less debilitating form, it's made them profoundly creative, and has helped them access arenas of the mind that few others can.

    i hope this doesn't sound too naive. over the years i've just come to think of mental illness as both a curse and a gift. i'm hoping your condition is such that over time it become less a curse and maybe more of a gift. crossing my fingers. <3