Detour from Normal (43 page)

Because I no longer had problems with my heart rhythm, I no longer felt out of breath going up stairs, and my lungs felt as if they'd been Roto-Rootered. The heart and lungs work in tandem, and when your
heart has trouble, your lungs often do as well. My lung troubles were too subtle to notice until I was taken off lithium. After lithium, taking a deep, clear breath gave me an immediate rush.

Overall I had much more energy, endurance, and clarity. My mind was much faster and more creative, and my memory improved as well. Even some of the abilities I had discovered when I was manic reappeared, but at a much subtler level—in particular, being "slapped in the face," recognizing when people are utilizing selective hearing and being more in tune with my intuition. On top of everything else, I had deep and restful sleep.

I also no longer had tremors. While on lithium I could put my hands under a certain amount of muscle tension, and they would shake uncontrollably. Sometimes the tremors interfered with writing or some fine motor skill such as screwing a small screw or threading a needle.

There was one thing overwhelmingly different about being off lithium: my mood was much the same as when I was manic yet my mind was fully functional. Apparently, my collapse of ego had lasting effects. What does that mean exactly? It means that it was perfectly natural for me not to worry about things like money, dying, or what happens after death. It means that I didn't feel a need to hold grudges or feel guilty over something from the past. I didn't dare tell anyone because of concern over being institutionalized again. After being that way for months, I grew used to it. It didn't make me fundamentally different; I just lived more in the moment.

I did come to realize that negative emotions are still part of the human experience no matter how immune you think you are to them, but once you are aware of them and the expectations that lead to them, you can stifle their impact. Whenever I do experience a negative emotion, it no longer feels authentic. Instead it feels as if I'm standing beside
myself watching the new me trying to act like the old me. Whenever that happens I refrain from reinforcing the emotion, and it soon fades.

I know that my thoughts on the collapse of the ego and losing negative emotions are difficult to swallow. Not surprisingly, discussing those subjects with friends and loved ones makes them very uncomfortable. To keep from alienating them and making them worry that I'm still mentally ill, I avoid those topics even though I think about them often. If it makes it any easier to accept, I don't think of them as miracles; I just think of them as rare reactions to severe trauma during which the mind has to shut down anything that gets in the way of lifesaving measures. Given enough physical or psychological stress, anyone could experience them.

Something else I've recently noticed is that I no longer have the same fight-or-flight response that I used to have. In situations that would have gotten my adrenaline pumping and my heart racing, I've found myself instead in a controlled, heightened state of awareness. It's as if the fight-or-flight chemicals or hormones are flowing, but they are intentionally "capped." I can't help but wonder if, while I was struggling with their effects before and during mania, my body figured out a way to regulate them—much like developing immunity to a disease. Perhaps that ability will one day prove to be a built-in insurance policy against experiencing mania again. I have read of others who've gone through mania without medication and have developed such a resistance to future manic episodes.

Living with a Stranger

If your loved one becomes manic, don't assume that it's hereditary or by their own choice. In my opinion, there is
always
an underlying cause.
The more aggressively you pursue that cause early on, the better. As time passes, medical evidence will be lost, and bias and prejudice will take over, making the search impossible.

Accept that there is no instant fix for mania, and prepare for the person to remain manic for several weeks, returning to normalcy gradually. Have all those involved educate themselves on mania. Don't blindly depend on professionals—their decisions may be counterproductive. If you have a sound understanding, you will make better decisions and your stress level will decrease.

In general, substance-induced mania will subside within four weeks. There is no consensus among the medical community regarding initiation of treatment for mania using medication, so it would be prudent to wait at least that amount of time without medicating unless behavior becomes too extreme. If medications are used, take a conservative and gradual approach, monitoring closely for negative side effects. Treatments that allegedly halt mania rapidly could be dangerous, catapulting the person to the opposite extreme: depression. In that state they may attempt suicide, and they will certainly be labeled bipolar from then on. Bipolar disorder has a much greater stigma than mania alone, and after that diagnosis it will be difficult, if not impossible, to convince anyone that the person shouldn't be medicated for life.

Because mania sufferers talk fast, change subjects often, and conjure up unfamiliar ideas, people have a difficult time listening to them, leaving them feeling frustrated and isolated. Don't abandon or ignore them. Instead interact with them much as you did before; be a rock for them. Ask questions about how they feel and what they're thinking or experiencing. It may be more educational than any amount of research and, if done early, will provide a baseline so you can monitor for signs
of recovery. You might consider keeping a journal for future reference. It could be especially helpful if the person ever has a recurrence, particularly if you were able to solve any problems previously. My wife kept a journal, which was very helpful in writing this book.

Don't take offense at what the manic person says. They may no longer be capable of acting in the way you have come to expect. Common courtesy may in fact be blocked from their memory. At some point I recognized that people reacted negatively to some of my actions. I called that recognition a "slap in the face." I had to re-teach myself common courtesy from scratch with only that phenomenon for feedback.

It may be difficult or impossible for manic people to get a full night's sleep. Encourage them to sleep whenever they can, and provide an optimum environment for them to do so. Even though I wasn't sleepy, I knew I needed sleep to prevent matters from getting worse. Sleep was such a priority for me that various forms of the word "sleep" are mentioned close to two hundred times in this book.

Spouses and friends of mania sufferers can easily be run into the ground. If friends or family are helping, take turns so everyone can recover and attend to their own needs. Watch each other for signs of physical or mental distress. Be prepared for the long haul; there's no telling how protracted the episode may be.

Prepare for extreme behaviors such as grandiose schemes to make money by taking early control of credit cards and finances.

Manic people frequently have a high level of sexual desire, and a heightened level of sensation and enjoyment of sex. They also have lowered inhibitions and therefore may seek out other sexual partners.

Manic people's minds work very quickly, and they may have increased creative capacity. They will have complex ideas that they've
never had before. Let them explore their ideas as long as they don't hurt anyone.

Don't treat manic people disrespectfully. It was not their choice to become that way. Several people described me as "gone" or even "totally gone." With all the details I've included in this book, it is undeniable that manic people are instead highly functional. If you think at times they are speaking gibberish, consider that their minds are configured differently than yours. It may be impossible for you to keep up with the speed of their streamlined minds or comprehend their intuitive thought processes. Accept, too, that what they are experiencing is new to them, and they are doing their best to make sense of it. After a lifetime of good mental health, it is unimaginably confusing to experience things for which there are no explanations.

Avoid institutionalizing manic people as long as possible. Once your loved one is committed, you will have little or no control over their treatment, potentially worsening their situation. I was the only manic patient in the three psychiatric facilities, and there was no treatment at any of them geared toward mania. Their programs all focused on addiction.

Caring for someone who is manic may prove to be too challenging or dangerous, and you may be forced to commit the individual. Or medical insurance and short- or long-term disability requirements may require you to. Regardless of the reason, research your options before making a decision. There are basically three options:

• Voluntary: The person will go to the first bed that opens at any facility.
  
• By petition: Patients will be held at a psychiatric holding facility (like the PDC) where they will await a bed at a more secure facility.
  Once there, they will be medicated and monitored for a minimum of seventy-two hours. If they refuse medication, they will be held until they are compliant or will be court-ordered to comply. If they still refuse, they will be forcibly restrained and the medication will be injected. They will then be monitored for progress.
  
• Private care: This is generally not covered by insurance and could be prohibitively expensive. It may, however, provide the best transparency and quality of care. If you are considering such a facility, here are some things to look for: opportunities to be outdoors to exercise, play, garden, or relax; reasonable sleep accommodations; chances to write or work on crafts; a holistic treatment approach with medications used sparingly and only when necessary; a willingness to consult with outside experts; flexible meal plans for changing caloric needs; an engaged and compassionate staff; classes in meditation, yoga, tai chi, etc. for exercise, flexibility, and stress reduction; and groups geared specifically toward mania.
  

I hope that you are able to provide your loved one with a better path to recovery than I had. I sincerely believe that my recovery would have been faster and healthier had everyone been more knowledgeable. It would have greatly reduced their fear and helplessness as well. One thing to keep in mind: eventually the mania will end, and you will have your loved one back.

Rising from the Ashes

I originally wanted to talk here about all the broken relationships I have as a result of my mania—how my family is hurting, how my friends have
built up walls or moved on, and how my relatives are holding their breath waiting for me to go mad again. I wanted to recommend counseling or support groups, but honestly those things weren't very effective for us and they may not be for you either. Instead I'm going to take a leap of faith and recommend something that I believe is the truest and best advice I can offer, not just for those hurting in my life but also for everyone.

My very first thought after my collapse of ego was "Negative emotions are the source of all dysfunction." Why on earth would a random manic person have something like that pop into his head? It wasn't the kind of thought you'd expect from someone who was manic—it was short, sweet, and to the point, and I never forgot it. It made me really wonder about negative emotions. What are they exactly? They are baggage, every one of them. To make matters worse, we can't seem to let go of that baggage. Over time our pile of baggage continues to grow, except when we go on vacation, play sports, or party with friends. Why? Because at those times we are living in the moment, the present. The way we feel then is the way we could feel all the time if we did one thing: learned how to live in the present.

All that baggage has one thing in common: it all involves the past or the future. You may feel hurt, angry, or worried at this very moment. But look around you. Is there anything actually making you feel that way, or is it something from the past or the future? The trick is that the past and future don't exist. They are fabrications of our mind. The only thing that truly exists is the present. So what's my radical proposal? Start living in the present. When we do that, we stop worrying about the future—it doesn't exist. We stop feeling the pain of the past—the past doesn't exist. Only
this very moment,
the present, exists. Each of us spends an inordinate amount of time feeling guilty, sad, or angry about past events or
worrying about things in the future over which we have little or no control. As a consequence we have all but forgotten the present—the most important and real part of our lives. It's impossible to rid ourselves of all those past hurts or future fears one at a time, but that's what we typically try to do. To make matters worse, we create new pain and fear as quickly as we deal with the old. The only way to really stop the madness is to shift our focus to the here and now. By doing so, the pain of the past and worry of the future will eventually subside, and the joy of the present will fill our lives. Here are a few tips to get you started at living in the present: