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Monday, Jan 18, 2016 07:00 PM EST
Going off to college is always hard; going off with a major mental illness is another challenge altogether
When I was 17, I decided that I wasn’t going to get out of bed anymore. It was a grey morning in March, and I woke up feeling lifeless and sad. There was nothing particularly wrong with my life; I had a great group of friends, I was involved in several clubs, and I was set to graduate in three months with straight A’s. I knew my misery was completely unjustified, but I couldn’t move.
My dad dragged me to a psychiatrist and I was diagnosed with major depressive disorder. This wasn’t a shocking revelation for me. It was pretty obvious I was a sad kid. I had figured out that I was probably depressed years ago, but until the diagnosis, my family had dismissed my lifeless demeanor as typical teenage angst. I was almost proud to hear a doctor say that I actually had a mood disorder; it made all my mood swings seem legitimate and, more importantly, fixable. I was going to be prescribed a happy pill, feel better, and go back to my life like nothing had happened.
The doctor wrote me a prescription for Prozac. I took the pill diligently every day and it only took two weeks to see improvements in my temperament. Within the first month, however, my mood had escalated from happy to exuberant to totally delusional with inexplicable joy. I’d stay up until 4 in the morning writing what I thought was the next great American novel. I’d sleep for an hour at most and then go for a three-hour run. I couldn’t sit still in school. My thoughts were fireworks. I started and ended three different relationships in the span of a week. I talked too much and laughed for too long. I didn’t care. Everything was amazing. The future was beautiful. I was brilliant, confident, perfect. I had it all figured out.
A few weeks after I graduated, I tried to jump in front of a train. My good mood had dissipated and while I still wasn’t sad, I wasn’t happy either. My brain was submerged in a cold, thick sludge that rendered it numb and apathetic. The fireworks in my head had burnt out. I felt detached and distant from everyone around me. I don’t remember deciding to go to the train station; I just ended up there, barefoot and determined to jump. A construction worker saw me teetering on the edge of the platform and asked me if I was OK. I realized I was sobbing. He called 911 and an ambulance came to pick me up. One of the EMT workers was in my graduating class, so I tried to act normal and start a casual conversation about college applications, but I don’t think I was speaking coherently.
After the ambulance unloaded me at the hospital, I was shuffled from one doctor to another and had to repeatedly recount my explanation of why I was there while they scribbled notes on their clipboards. I mentioned how great I had been doing on the Prozac just a month prior, and, after taking a few notes, a doctor told me that I had bipolar disorder. Long story short, the Prozac had triggered a manic episode, hence my excess of energy and delusional overconfidence. When the mania wore off, my mood spiraled and I decided to die. It wasn’t an uncommon sequence of events for bipolar patients, apparently.
While my prior diagnosis had been a relief, I wasn’t entirely comforted by the new one. Being labeled “depressed” made sense, but the word “bipolar” didn’t suit me. I obviously had some sort of mood disorder, but not to that extent. Bipolar people are crazy. Serial killers are bipolar. Drug addicts are bipolar. Angry homeless people in the subway are bipolar. It didn’t make sense, and it terrified me. Maybe I was crazy. Or at least on my way to being crazy. Crazy-in-training. If someone had told my childhood self that I would end up sitting barefoot in a psych ward when I was seventeen, I would have laughed at the ridiculousness of the idea. Yet here I was. How could I predict where I would be in a few months, let alone years? What if my mental health only continued to deteriorate as time passed? There was no way of knowing how I would progress, and the uncertainty terrified me.
The doctors put me on lithium carbonate, a mood stabilizer. They explained that lithium is one of the oldest, most well known drugs for treating bipolar symptoms. It’s been around forever, and it’s supposed to level out the ups and downs of your moods. It can also cause nausea, dehydration, shakiness, and kidney failure. I wasn’t sure if that was a fair trade-off, but I was too overwhelmed by the situation to complain.
I spent ten days in the hospital. When my dad picked me up, I figured that that was the end of my bipolar adventure. I was diagnosed, I was medicated, and now I could start college with the rest of the happy sane people.
The beginning of my first semester was a whirlwind of new friendships, classes, and adventures. Although only a month had passed, my time in the hospital seemed like a distant memory. Halfway through the semester, my depression returned. I spoke with the campus psychiatrist and she suggested that maybe my meds needed to be adjusted. It turns out that it can take a long, long time to find the combination of medications that works best for a bipolar person’s brain. And even if you find the perfect combination, it might just stop working one day. Your brain could develop a tolerance for that perfect combo after weeks, months, or even years of stable functioning. This was my first time realizing that I had a real chronic illness. I had been so optimistic about my treatment initially, but now I realized that I might be fighting an endless battle, that there was no way to estimate when I’d be “better,” if ever.
The psychiatrist wrote me a prescription for Seroquel, an antipsychotic. In higher dosages, it’s given to schizophrenics, but smaller dosages are useful for some bipolar patients. She warned me that the new drug might make me sleepy, which turned out to be a severe understatement. Trying to function while taking Seroquel was like walking around with a heavy, wet blanket draped over me. I was perpetually fatigued, physically and mentally. I’d sleep for twelve hours, wake up for food, and then sleep for another eight hours. When I was awake, I shuffled around campus aimlessly like a pajama-clad zombie. I couldn’t read, write, or even communicate with people; I felt like my thoughts and feelings were engulfed by a thick fog. Words had no meaning to me. I had stopped caring what other people thought of me as I dragged my disheveled self around campus. Sometimes I wondered if maybe I was going crazy. Maybe the Seroquel was systematically destroying all my brain cells. I wasn’t sad anymore, though. My doctor was pleased.
I slept through the next few weeks. My GPA plummeted as I missed classes, assignments, and exams. My psychiatrist recommended that I withdraw from the semester. I signed the Medical Leave form. My dad was livid. He thought I was making up excuses for my academic failure. In his eyes, I wasn’t sick; I was lazy. I didn’t need medication; I needed discipline. He made me wonder how much responsibility I should take for my shortcomings, and forced me to consider the idea that I might be imagining my condition. If my own father refused to believe that I was sick, then maybe I was just an inherently flawed person. Untreatable. Worthless. I slept through the car ride home.
Back in my hometown, I found a psychiatrist to help me treat my condition. Each appointment with her made me wonder if psychiatry was just one big guessing game. She had a giant book that listed pretty much every medication that existed. I’d describe how I was feeling and she’d thumb through the book until she found a pill that sounded suitable. Depressed? Try Celexa, Effexor, Nortriptyline. Anxious? Try Abilify, Latuda, Xanax. The list goes on. Some improved my mood a bit and then stopped working. Others didn’t have any effect at all.
I tried a few different drugs every month and started to feel like a slave to pills. I started and finished my day with them. I monitored my every thought and emotion, every second of the day, trying to see any improvement. I spent my lunch breaks at work researching alternative treatments for bipolar disorder. Fish oil pills, herbal mixtures, vitamin D supplements; I tried anything that might make even the slightest difference in my moods. I wanted to feel like a normal person, and I wanted to know that there was a real, tangible solution to my problem. I had definitely improved; I was more stable than I was before I started receiving treatment, and I was functioning well enough to keep a job and interact with people on a daily basis. But I was still always tired or irritable or apathetic or nervous. Nothing helped me feel like I had fully recovered.
I grew tired and frustrated, although I wasn’t sure if I was frustrated with my psychiatrist or with myself. My brain wasn’t supposed to sabotage me like this. It wasn’t fair that everyone else was allowed to be healthy and contented and fully functional while I went to sleep every night praying that the next morning, I wouldn’t wake up suicidal. All of my high school friends were scattered around the country, enjoying their first year of college, while I was bagging groceries every day and struggling to stay sane. The local Walgreens’ pharmacist was probably my best friend at the time. She’d talk to me about her grandkids while I paid for my drug of the week. Her stories weren’t that interesting, but it was comforting to be treated like a regular person when I felt stranger than ever.
As I struggled to accept the dismal state of my day-to-day life, I was haunted by internal doubts about who I really was and if I even had my own identity anymore. At eighteen, forming my own adult identity was difficult enough without the quandaries that stemmed from my disease. It seems absurdly unfair that so many major mental illnesses, bipolar disorder included, generally appear in patients during their late teens or early twenties, the exact time when our identities are in flux. I started to wonder if the person I was becoming was inauthentic. People’s thoughts and personalities are determined by chemical and electrical signals traveling through their brains, so was I cheating nature by adding all these synthetic chemicals? Did I have a legitimate personality? If I stopped taking all of my medications, I would be dysfunctional and, for lack of a better word, crazy. So is that who I actually am? Is my real self my unstable, un-medicated self? Or is the real me the sane version of me, the one who gets all her emotions from a bottle of pills?
While these questions did stem somewhat from my own personal uncertainties, they were compounded by a harsh societal stigma that became increasingly noticeable over time. It’s hard to avoid the disparaging attitudes so many people harbor toward mental illness, and the more I was exposed to them, the more I began to internalize them. I felt personally responsible for losing control of my emotions and for lacking the strength to keep myself stable and disciplined on my own.
Society has a way of trivializing the problems that mentally ill people face and making them feel that their condition is less serious than physical ailments. For instance, if I suffered from Type 1 Diabetes and needed to administer daily insulin injections, no one would accuse me of being overdramatic or hint that I was simply too weak-willed to regulate my blood sugar on my own. I’d probably receive sympathy for my condition. But because I was born with a neurochemical imbalance that resulted in a mental illness, I was pressured to hide my condition, to toughen up and deal with it on my own. There are countless stigmas against mentally ill people – we’re imagining it, we’re making excuses, we’re looking for attention – all of which place the blame on the bearer of the disease, rather than on the disease itself. As a result, my perception of my own identity was muddled and confused, and I constantly wondered if my ailment was legitimate.