It is 7:40 am. I wake up five minutes before my alarm clock, feeling generally well-rested. I have two cups of coffee, read the news, and check my email. I start working at 8:30, and at 9 a reminder pops up on my phone. It reads: Take medicine and meditate. Most days, I’ve already done these things. But it’s important enough that I keep the reminder, because I know what forgetting can do to me. I know what it can do to the people I love.
Two years ago, when I was off my medication, this kind of morning would have been unimaginable. I now have a routine. A stable, productive, healthy routine. Sometimes I look at myself and wonder who I have become.
Eight years ago, I was diagnosed with bipolar disorder. I was 20, halfway through college, and I had suspected for years that something about my mind was very different from my peers' — my behaviour more reckless, my moods more unpredictable, my sleeping and eating patterns more irregular.
My mother always suspected bipolar disorder, which is characterised by episodes of mania and depression. My grandmother also had it, so my mom was well aware of the signs: Manic episodes can lead to reduced sleeping and loss of appetite, racing thoughts, excessive happiness or irritability, and extremely risky behaviour and poor decision-making. Depression, on the other hand, leads to antisocial behaviour, lots of sleeping, feelings of extreme sadness and hopelessness, and the inability to complete basic tasks like getting out of bed and taking care of personal hygiene. I had them all. From my drug use to my fits of (often violent) rage, I was dangerously close to going off the rails. My mother told me once, while I was lying in a hospital bed suffering from a drug-related kidney infection, that she was afraid I was going to die. I was afraid, too. She encouraged me to seek treatment, but I refused.
I had a million and one excuses: they’d just try to medicate me, and the pharmaceutical industry was evil and exploitative; I didn’t have time to see a therapist; other people had bad experiences with seeing a shrink; and, the most transparently misguided, there was nothing wrong with my lifestyle and my behaviour. Or, if there was, it certainly wasn’t something a psychiatrist could fix.
I never shared the real reason, probably because I didn’t acknowledge it myself for a very long time. I was afraid of losing myself, of numbing myself, of watching my creativity and sincerity and uniquely empathetic nature disappear.
For a while, I scraped by without the help I needed. It wasn’t until my entire life started to fall apart that I admitted I needed to do something before it was too late. Severe cases of bipolar disorder can include psychosis, wherein one loses connection to reality. Because I had gone untreated for so long and the illness continued to worsen over time, I was suffering from the most serious and terrifying symptom that bipolar can unleash on your mind.
It was this last symptom that ultimately brought me to the too-brightly-lit, beige, cramped office where I sat across from a young blonde woman completing her residency for a PhD in psychology. She was warm and disarming, and I immediately felt at ease with her. This was important, because I was about to tell her something that shook me to my core, something deeply embarrassing and frightening.
“I’m hearing voices, and I feel like things are talking to me.”
“What kind of voices?” she asked.
“All kinds. Angry and sad, loud and quiet. Sometimes they’re saying things, mean things like how I’m worthless, and other times I can’t really tell what they’re saying at all.”
I also felt like inanimate objects were trying to communicate with me — not voices, necessarily, but ideas and warnings. I knew what they meant. The refrigerator told me to get off the internet and do my homework. The stop sign told me to quit chain smoking and napping all day. The leaves rustling in the wind told me God was watching.
I was afraid of losing myself, of numbing myself, of watching my creativity and sincerity and uniquely empathetic nature disappear.
After probing deeper, asking my about my childhood and my teenage years, my history of extreme substance abuse and my irregular sleeping patterns, she recommended an appointment with a psychiatrist. A few days later, my psychiatrist diagnosed me with bipolar disorder and prescribed a common anticonvulsant with minimal side effects.
Within a few weeks, the psychosis was fading; it wasn’t gone altogether, and it took nearly a year for the voices to subside and the refrigerator to keep its opinions to itself. After a few months, though, I noticed how even I felt. No sleepless nights or lonely days in bed. No racing thoughts, no crying episodes that lasted for hours. A year later, I realised that my fears had been unwarranted. I hadn’t lost myself at all. I had found myself.
But then, I lost my health insurance and, subsequently, my ability to see a prescribing doctor. So I stopped taking the drugs. And for a while, it seemed okay. To me, anyway.
In a few months, I noticed small things changing. More sleepless nights and skipped meals. More pyjama days and TV bingeing. I was calling in sick from work nearly every week, and I was drinking more than I had at any point in my life. I’d stopped reading, something I always loved to do. If I wasn’t working, I was either in bed dealing with depression or out until late in the evening, drinking too much, talking too much, thinking too much. Manic. Depressed. And back again.
Within three years, not only had the mania and depression come back, so had the psychosis. Angry voices screamed and whispered in my head, and I would lay in bed at 3 a.m. listening to that damn refrigerator. And even though I knew better, even though experience had taught me that I was completely wrong, I was afraid of treatment for the same reason that had stopped me years earlier. I was afraid I would lose myself.
In the fall of 2014, when I once again had access to health care, I sat in a psychiatrist’s office crying. “I’m sorry, I don’t know why I’m crying,” I told him.
“Are you sure?” he asked. I was puzzled. He gave me a knowing look, like he was stripping away my exterior and examining my soul.
“You’re afraid. You’re afraid you’ll lose something about yourself.” Now, I was sobbing, large tears dripping onto my thighs, shoulders heaving. How could he know that?
He knew because so many of us feel that way.
Mental illness isn’t just something that happens to you. It becomes you in a way that is both disturbing and comforting.
I recently saw a friend share an essay on Facebook that argued that our medical industry is killing our geniuses and prophets — that psychiatric pharmaceuticals are numbing our Vincent van Goghs and Sylvia Plaths. Of course, van Gogh shot himself in the chest and Sylvia Plath stuck her head in a carbon-monoxide-filled oven, but presumably the author found their unbearable suffering a reasonable trade for their contributions to history. The essay argued that treatment for mental illness would cast our generation’s geniuses into obscurity — that they would fade from history because their artistic potential was medicated away.
I was deeply hurt by this, because it played into every fear I had ever had about treating my bipolar disorder. I have many aspirations — to write a great novel, be a successful performer, to inspire my students to make meaningful change in the world. But I also hope to live a long, happy life with my husband, to have stable and healthy relationships, to see the world change in ways I can’t even imagine right now. Are those two desires so at odds?
The fact is, I am more productive, more creative, and have more potential since undergoing treatment for my bipolar disorder than I ever was before. My writing is better. I read more. I catch up with old friends and make dinner with my husband and even do my laundry once in a while. And even though my behaviour and my daily life has changed dramatically over the years, I’m not a different person than I was before. It wasn’t some kind of revolutionary change that altered my personality; it wasn’t a rebirth. I didn’t lose anything. I found everything.
I don’t mean to suggest that medication is for everyone, or to deny that some medications have the effect of numbing you, of stripping away your spark or making you feel like you’ve lost yourself. Not everyone’s experiences mirror my own, and I understand that. I’m very fortunate that my bipolar can be treated with an affordable drug that has very few side effects. Others aren’t so lucky. And of course, abstaining from medication is totally reasonable for some. But I will say, this drug saved my life.
For now, my life is lived mostly between the poles. I have mood swings, I make bad decisions, and I have anxious and negative thoughts. But they’re much more manageable, on par with most other people’s experience.
Mental illness isn’t just something that happens to you. It becomes you in a way that is both disturbing and comforting.
I’m lucky; too many others struggle with this and other disorders their entire lives without having a support system or access to treatment. The stigma attached to mental health is enormous, and it often keeps even people who are privileged enough to have access to treatment from seeking help. Nowadays, with growing awareness of the influence of the pharmaceutical industry and the dangers of unnecessary medication, even seeking treatment is often stigmatised by some. People should have the freedom to make up their own minds, as well as the respect and support necessary to heal and adapt to the struggles of living with something like this. We should be able to talk about it, to experiment and find what works for each of us, and we should be able to afford it.
In the spirit of talking honestly about mental illness, I should 'fess up. Because life is deliciously ironic, two days after finishing the first draft of this essay, I fell into a manic episode more intense than I have had in years. I saw the signs: the sleepless nights, the absent appetite, the euphoria and superhuman sense of self, the irritability. But I ignored it all; I pretended that it was just the heat or stress at work. I could have taken steps to lessen the symptoms, like taking my anxiety meds (which I’m supposed to use as-needed when I feel like this) and setting reminders to eat. But I didn’t. At the end of the day, mania often feels good. How do you fight against something that feels good, even when you know how horrible it will feel later?
It’s hard. Even after all of these years, all of my progress, I still struggle to admit to myself that this is me; this is my normal. I will always have bipolar disorder. I will always cycle. I will always face the imminent possibility that my life will derail, that I will have setbacks.
A week after my manic episode began, I found myself in my therapist’s office, crying uncontrollably, big soggy tears rolling down my red cheeks. I apologised for using all her tissues. She told me to stop apologising. She asked what upset me the most about this episode.
“It feels like I lost so much progress. I’ve worked so hard, and come so far, and now here I am, bawling and scared and tired. I’m so tired. And I feel like it’s my fault, and I’ve lost everything.”
I will carry her words with me to my dying day.
“You haven’t lost anything. All the work you did, all the progress you made, that is yours. It belongs to you. It is part of you. No one can take that away.”
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