Chicago Tribune Feature – Published Sun., Aug. 26

08/26/201208/26/2012 ~ Harlan Didrickson ~ 14 Comments

No rhetoric; no sublime style; no lexicons or etymology. Pure and simple disclosure of disquieting issues.

Please, REPOST THIS ON YOUR BLOG. Personally, I prefer privacy over publicity; I exposed my life in the hope that the stigmas of mental illness, obesity, and homosexuality might be reconsidered to be human conditions worthy of respect and empathy.

http://www.chicagotribune.com/health/ct-met-bipolar-20120824,0,3948031.story

Bipolar II disorder: Another Chicagoan’s story

Like Jesse Jackson Jr., Harlan Didrickson has the illness and has had weight-loss surgery

Harlan Didrickson poses outside his Rogers Park home. (Chris Walker, Tribune photo / August 17, 2012)

By Barbara Brotman, Chicago Tribune reporter, August 26, 2012

Harlan Didrickson was a model of middle-class stability.He lived with his partner of more than two decades in a handsome Victorian on a leafy North Side street. He worked as manager of executive and administrative services for a high-powered architectural firm, where he made hospitality and travel arrangements for large meetings and oversaw budgets that ran into millions of dollars.He was not the kind of person who would go to lunch with friends and come home having spent $4,500 on a puppy and a month of obedience training.

Or who would get up at 2 a.m., go to Dunkin’ Donuts, then drive to Indiana and back, snacking on Munchkins.

But that’s who he became.

Four years ago, his life was upended by bipolar II disorder, the same illness recently diagnosed in U.S. Rep. Jesse Jackson Jr.

This is not Jackson’s story. People with the disorder — nearly 6 million in the U.S. — have unique experiences with the illness, which cycles between moods of manic energy and deep depression.

“The symptoms of bipolar disorder can be very different from one person compared to another,” said Dr. John Zajecka, a psychiatrist with Rush University Medical Center who specializes in mood disorders.

Manic states leave some people euphoric, others irritable. “There are people who can function their whole lives in these hypomanic states,” though they may lose marriages, jobs and money, Zajecka said.

Depression, too, can appear in a variety of ways. Some sufferers stay in either mania or depression for decades; others cycle between them many times a day. And people respond differently to treatment.

But Didrickson’s struggle provides one look at how bipolar II disorder and its treatment can affect a life.

And he does have one key factor in common with Jackson. Like the congressman, Didrickson, 54, had weight-loss surgery before being diagnosed with bipolar. He had a gastric bypass procedure; Jackson had a duodenal switch.

It became a serious complication in his treatment. The weight-loss procedure, which causes the body to absorb fewer calories, prevented him from absorbing the full dose of his antidepressant medication.

Didrickson’s illness began when he started feeling extremely stressed at work. He considered himself skilled at his job but felt beleaguered by office politics.

“I felt as though I was fighting a lot of fights on different fronts in my life, and that I didn’t have the wherewithal, the energy,” he said. “I was profoundly unhappy.”

He changed jobs, twice. He still felt miserable. And he also felt trapped, having to do work he now found unbearably stressful.

More than 60 percent of people with bipolar engage in substance abuse as they try to self-medicate their inner pain. Didrickson was among them. At night he would wash down some hydrocodone, an opiate he had been prescribed for a back injury, with beer. He would stay up till 4 a.m. watching TV, then take Ambien to fall asleep.

“At 6 o’clock I woke up, got dressed and went to work. I was probably still high,” he said. “Then somewhere around noon, I would crash. I would go to the men’s bathroom, go sit on the toilet and fall asleep.”

His partner, Nick Harkin, a publicist with an entertainment and lifestyle marketing firm, had no idea how deeply troubled Didrickson had become.

But then Didrickson didn’t show up on time for a planned out-of-town getaway. When he arrived the next day, he was morose, secretive and exhausted. “It was a very abrupt shift,” Harkin said. “It was quite obvious that something was very seriously wrong.”

Didrickson was thinking of ending their relationship, he told Harkin. And he wanted to move to California’s Death Valley. He wanted to start a new life.

“I was falling apart,” Didrickson said. “It was this desperate: I will do anything to get out from under this pressure.’ It was like having a heart attack, and if you don’t get out from under it, it will kill you.”

Back home, he called a friend who had once been his therapist. She asked if he was suicidal.

“I was, like, ‘Of course I am. I think about it all the time,'” he said. “‘It’s the only comfort I have.'”

She told him to see a psychiatrist. He did, and was told he had depression — a common initial diagnosis for people with bipolar, who generally seek treatment during a depressed phase of the illness.

The antidepressant the doctor prescribed didn’t work. Didrickson developed memory problems, to the point where he forgot how to do simple tasks like using a phone.

“I could not take a shower, because I couldn’t recall the sequence of activities … turning on the water, stepping into the spray, getting wet, washing,” he said.

He lost 40 pounds and neglected bathing and grooming. And yet there were also times when Didrickson felt powerful, energetic, nearly like a superhero. He could do anything he wanted, no matter how dangerous or destructive, with no consequences.

He ran red lights. He drove the wrong way down one-way streets. “I felt like I was back to being in charge, like I was back to saying, ‘It’s going to go like this because I said so,'” Didrickson said. “I felt kind of emancipated.

“I thought, Wow, this (antidepressant) Paxil is really working.'”

But it wasn’t. A psychopharmacologist gave him a new diagnosis: bipolar II disorder, a form of bipolar disorder with less extreme mood swings.

His new doctor told him to stop self-medicating — Didrickson said he hasn’t had a drink or abused a drug since — and put him on a mood stabilizer. And then began the painstaking process of trying to find the right antidepressant: six weeks getting to a therapeutic amount of a drug, then six weeks being weaned off when it didn’t work, again and again.

“My symptoms came back. I just felt terrible,” he said.

He was still manic, once getting up at 4 a.m. to drive to Lake Shore Drive to look at newly fixed potholes. He spent money recklessly. He spent hours obsessing over the paper stock to use for custom stationery.

The manic states always turned dark, ending with him lashing out at people — usually Harkin.

“When I begin my mania, it’s a great party,” he said. “But when it gets to be months into it, it gets uglier and uglier and uglier, to the point where you really are a monster.

“Mania isn’t happy; mania is crazy,” he said.

No antidepressant worked. Then a friend with bipolar recommended Adderall, the stimulant often prescribed for attention deficit disorder.

His doctor prescribed a standard amount. It did nothing.

So Didrickson took another dose. And he felt a little better.

“I started to feel buoyant,” he said. “I always talk about feeling underwater. I felt like I was finally breaking the surface.”

He didn’t know why he needed a higher dose. But then he came upon online message board postings by people who had undergone gastric bypass surgery and then found that their antidepressant medicines stopped working.

The gastric bypass surgery he had undergone years earlier to lose weight, he concluded, was keeping his body from absorbing the medicine.

Indeed, Zajecka said, gastric bypass surgery can change how people absorb medicines given for bipolar disorder.

The Mayo Clinic statement announcing Jackson’s diagnosis also noted that the weight-loss surgery he had “can change how the body absorbs food, liquids, vitamins, nutrients and medications.”

Didrickson’s doctor would only marginally increase his dosage of the notoriously abused amphetamine. It wasn’t until he switched doctors because of a change in his health care coverage that he got what he found to be an effective dose.

His longtime internist, Dr. Eric Christoff, assistant professor of clinical medicine at Northwestern University’s Feinberg School of Medicine, gradually increased Didrickson’s dosage, with weekly appointments to check his blood pressure.

The depression lifted. He has been on the higher dosage for a year and a half.

“We have never seen any evidence of drug toxicity or high blood pressure,” Christoff said. “He’s really not absorbing much of any dose he’s taking.”

Many people with bipolar disorder are able to resume their previous lives.

“It’s one of the most treatable illnesses we have in medicine,” Zajecka said. “If it’s diagnosed properly and treated appropriately, there’s no reason they can’t get back to resuming a normal lifestyle and their normal goals in life.”

But Didrickson has been unable to go back to work and still has periods of depression and mania, though much milder ones. He manages the house, cooks and has taken up woodworking.

“Going out in the evening can be very, very, challenging for him,” Harkin said. “If we go to a concert or a dance performance and it’s too noisy, he’ll have to leave. If … there’s someone in a film who’s violent or cruel, that’s very upsetting to him too.”

“It’s nothing like I thought my life would be,” Didrickson said.

“The good thing, I guess, is that I don’t hold on to yesterdays,” he said. “That’s a blessing, I think, frankly. But I also don’t have tomorrow. My life isn’t about tomorrow.”

He has gone back to writing, which he did in college. He writes a blog about his experiences with bipolar, under the name T.M. Mulligan. The moniker stands for “Taking My Mulligan.”

“I’m having my do-over,” he said. “I’m taking the second chance.”

Chicago Tribune Feature – Set to Appear This Week

08/23/201208/23/2012 ~ Harlan Didrickson ~ 7 Comments

Early last week I was contacted by a staff reporter from the Chicago Tribune newspaper asking if I’d be willing to share Life With Bipolar II.

I’m a private person by nature, but also an author rummaging through his past looking for experiences which, when written in my style will leap from me and land on you resulting in some degree of change expressed through your thought or action. I don’t write for the sake of writing. I write with purpose; with hope that my style captures your attention; and with honesty so that a kinship occurs as you read and when finished actually feel something whether it be acknowledgement, empathy, entertained, or moved. If you don’t experience any shift then I have failed you as a writer.

So many people know so little about mental illness generally, and Bipolar specifically, that to decline the opportunity to be featured in a full-page story in one of the top five newspapers in the country (not too mention their on-line edition) would be foolhardy. There’s no possible way that I and this blog occupying a little corner of the internet could reach the number of readers that this article will touch.

I have spent ten hours on telephone interviews; two hours of photography here at my home; my partner’s been interviewed, and so has my physician. The process has been, frankly, unnerving and profoundly confronting and nowhere near as safe as if I’d been writing it. But I agreed because too many American’s need to understand that mental illness is a disease. Doctor’s need to understand that a post-gastric by-pass patient won’t respond to medications as expected. Patients living with mental illness need to believe that sharing themselves with others is the only way to dilute discrimination based on mental health.

Please watch for it!

The Night My Liberty Was Nullified (Thursday, July 10, 2008)

08/21/2012 ~ Harlan Didrickson ~ 5 Comments

Thursday, July 10, 2008 started out normally: cotton had been stuffed between my ears sometime throughout the night; my body had gained an enormous mass as well, its weight pulling me deeper into the feather bed, my heavy legs swinging to the edge like cast iron bells; my feet encased in iron felt ready for the ocean floor; I pushed my body upright using arm strength and sat motionless for five minutes in a kind of stupor; a man with no goal; no alarm; no schedule; no deadline. Simply a man with time. And this time continues to tick, on and on, and in this stupor it doesn’t stop, it simply continues to drum, and I am oblivious to its march. In the mornings time fails to exist; there’s simply the stupor and the weight and me, or what I think is me, trying to read the details of an unfamiliar map in poor lighting and without spectacles.

It took two hours to complete my morning routine which Nick and I have outlined on two cards and placed in the bottom edge corner of my medicine cabinet. The cards remind me of the order of bathing: brush teeth, start shower, hair, body, face, shave, squeegee, towel dry, brush hair, after-shave balm, deodorant, patch, hang towels. If I fail to use the list I forget where I am in the sequence and either stop altogether or restart from the beginning. My inability to concentrate on even the most menial activities is another symptom of my depression. I suppose I’m fortunate though, in this fog I find myself in, I don’t really judge the degree of my disability. It’s not as though yesterday I had two legs and today one. This disease is invasive: it’s a brown-out; not quite a black-out, but enough surge to switch off delicate systems and place them in a suspended mode. Next came dressing. The simple selection of items was daunting. Incapable of processing difficult code, I simply grabbed shorts, shirt and sandals and hoped I wouldn’t look like a clown.

I was exhausted by the time I made it to the garden. Nick was there working on a crossword and presented me with a cup of coffee. I opened my laptop and quickly discovered I was unable to concentrate on even simple navigation. Pulling myself up from my chair I hoisted myself onto the sofa and fell back asleep.

During sleep I began to hear the quiet invitation of the river. “Come to the river,” it asked. “Come to the river, it’s quiet here,” it pleaded.

I heard Nick’s voice far away, in the distance, miles behind me, “Harlan,” he yelled. I awoke, looking longingly for the river but all I saw was Nick, “I heard your yelling outside, about going somewhere; where were you going?” he asked. “To the river,” I said, “It was calling me.”

After a number of telephone calls I found myself in our car speeding to the hospital to be admitted. By this time exhaustion had overtook me. My resolve against the disease, its voices, its demons and magic and trickery had ceased. I was a harm to myself. I was in significant danger and unstable and required hospitalization in order to save my life from itself.

Upon entering the hospital the stark reality of mental illness was immediately evident. Once announced that you require psychiatric care you are moved through a well-oiled machine. I was placed in a triage room and asked a simple question: have you had homicidal or suicidal thoughts? A simple “yes” answer thrust my welfare to the front of the line: papers were shuffled, calls were made, registration was completed, body searches conducted, personal belongings and shoes removed and bagged, a personal security guard assigned, and the single most powerful yet profoundly simple right was revoked: my right to freedom. I had now become a legal liability requiring constant supervision in a small waiting room with other psychiatric patients. And I was incapable of leaving without seeing a doctor. I had been incarcerated by my own volition.

I found it impossible to sit in the holding cell with severely psychotic patients: one yelling someone was stabbing her; another rocking and laughing/crying; a third belching and retching; a fourth pacing like a caged cat. I asked to sit outside, right next to the pen. My guard agreed. About two hours into this episode there was a guard shift-change and I was ordered – ordered to get back into the holding pen. When I flatly refused the guards began to don rubber gloves and said, “Don’t make us lay hands on you, sir! Do not make us lay hands on you!” as though I were a criminal. I said, “I’m simply depressed! Christ, had I known it was going to be like this, I’d have simply killed myself!” and Nick and I walked back into the cell.

Nick and I sat in that holding cell for a total of five hours until at last my name was called and we (Nick, my guard and I) were escorted back to an empty emergency examination room. A nurse threw back the curtain and asked Nick to step out while she interviewed me. She was an angel, I thought, looking at her compassionate eyes and heavenly smile. She inquired as to why I found myself at the ER and I explained the days events. I told her that my language got out of hand, I talked of suicide but had spoken out of turn, and I really just wanted to go home with Nick and did not wish to be admitted.

A platoon of doctors came and went and finally I was discharged honorably into the night. It was determined that I was not a suicide risk and would see my personal psychiatrist the next day and that Nick would have to remain at my side until that time.

This mental illness has kidnapped my sanity; it has revoked my right to free thought and happiness; it has sentenced me to life with a chance for parole only if I continue to absorb Paxil at night before bedtime. But even this mindful incarceration, this disease and its disability pales in comparison to the penal colony operating under the guise of patient safety. Having willfully turned over my right to freedom was the most eye-opening, chilling, humiliating experience of my life and one in which I will not soon forget.

Bipolar Diagnosis Is Not An Insanity Defense

08/14/2012 ~ Harlan Didrickson ~ 4 Comments

I’ve been paging through comments left recently at Chicago news sites regarding the recent revelation that Representative Jesse Jackson Jr. (Congressman, Illinois) has been diagnosed with Bipolar II and is currently experiencing a major depressive episode and is being treated at the Mayo Clinic. He’s been on a leave-of-absence since June when he was discovered by his father, Rev. Jesse Jackson, exhausted at Rep. Jackson’s Washington, DC home. The family took Rep. Jackson to Sierra Tucson Treatment Center in Arizona, then moved him to the Mayo clinic where he remains, undergoing treatments for his significant depression.

If the picture I just painted was about your husband or wife, your child, a relative or neighbor, teammate, fellow parishioner, acquaintance, sister-to-the-father-of-your-daughter’s-fiance’s-birth-parents, or celebrity, your reaction, most likely, would contain differing degrees of empathy based in part on your knowledge of mental illness, specifically Bipolar II. But what if the picture I just painted was about a politician in a state known for its bipartisan political corruption. The reality that 20% – one in five – of the last century’s governor’s have been indicted or convicted of felonies in Illinois is a damaging statistic to all Illinois politicians. Damaging is one thing, but suspicion on a federal level and a House Ethics Committee investigation for ties to imprisoned former Illinois governor Rod Blagojevich is quite another. This federal investigation provides a significant foothold of suspicion in Rep. Jackson’s June disappearance and yesterdays news story confirming his diagnosis and treatment for major depression (one-half of the mental illness, bipolar).

The vitriol posted in comment sections of Chicago area TV stations extolling Rep. Jackson’s disclosure of mental illness and gastric by-pass as a creative and sympathetic smoke screen hoping to derail the federal investigation or, at the very least, to mitigate its voraciousness. The assertion? That Rep. Jackson was in the middle of a hypo-manic (the other half of the mental illness, bipolar) episode which characteristically emboldens the patient to behave dangerously, generate grandiose plans well beyond his normal specter of life, and indulges in dangerously poor judgement particularly in highly sensitive or personal areas of the patients life. If Rep. Jackson never mentioned (prior to the Blagojevich sting) that he’d like to advance his political career by winning a senate seat and then suddenly (and privately) begins the high-stakes game of buying (rather than campaigning for) a senate seat, Rep. Jackson could defend his uncharacteristic behavior as that of his manic-self (though at the time he was unaware of his mental illness), and that if his bipolar diagnosis was being properly treated (and he was compliant) he would’ve steered clear of any illegal activities.

Which is, by the way, a creative and sympathetic defense. But our legal system does not recognize bipolar disorder as insanity, and therefore cannot be used as a defense in legal proceedings. It could pluck on the heart strings of those on the House Ethics Committee, but any preferential treatment Rep. Jackson hopes his bipolar disorder might garner will be sanctimonious. However, if the Committee (and subsequently Federal Prosecutors) sense blood in the water, Rep. Jackson’s recent disclosure of personal and private information will be sympathetically and respectfully noted. And then the hounds will be unleashed and will, eventually, tree the red fox.

But what I find the most deplorable is the velocity and distribution of judgement by every-day citizens whose faith in politicians has been crushed by an unending parade of scandal, corruption, and greed. Jesse Jackson Jr.’s job is a congressman. Jesse Jackson Jr. also happens to be human, a husband, a brother, a son, a friend, and now part of my bipolar II world.

It is shameful that the suspicious and the quick-to-judge deny their empathy to the mortal and vulnerable Jesse Jackson Jr. who is suffering horribly, whose life is teetering on pharmaceutical roulette, who goes to sleep dreadfully depressed and wakes to the loathsome, disastrous, and painful reality that he must learn to live with bipolar disorder, not suffer from it. To those casting stones, humanity and empathy aren’t yours to keep; they are given. I pray that one day you won’t stare into the cold eyes of a stranger wholly disinterested in your immediate suffering because of a far-off suspicion of guilt.

Maybe Bruce Banner, Tony Stark, Logan, Bruce Wayne & Clark Kent Were Bipolar

08/12/2012 ~ Harlan Didrickson ~ 6 Comments

I’ve identified the significant trigger, which, if pulled, catapults my otherwise sensible, responsible, and respectful self into a derivative of me, but one which possesses out-of-this-world dynamism akin to superhero’s or mutants. The physical me doesn’t change, just the degree of acumen and acuity I’d refined in furtherance of a twenty-year career playing The Fool to a cadre of Somebody’s. These heavyweight’s attained their ascendency via marriage; owning an avaricious, pugnacious and predatory law firm; partnership with an iconic architectural firm; ruthless attorney for corporate raiders. Not one cared about procedure; they simply expected what they’d requested. Failure was my burden to bear and under which I would suffer.

Only once did I return empty-handed: “I flew to Florida; drove to the grove; oranges are out of season; no juice.” She pushed her Eames chair away from her desk and stood in front of me, “Do I look like an idiot to you? I mean, when you think “idiot,” is it this face you see? Because that’s precisely what you so deftly hand-delivered. But I didn’t ask for an example of an idiot, did I? I mean, if I did, which I didn’t, but if I did then you could get a mirror from one of the secretaries. You wouldn’t simply fire-up the Ol’ Gulf stream and coast to Florida (at $2,350.00 per flight hour plus pilot time, hotel, fuel,, and food). No, no explanations: I asked for orange juice from “Lily’s Grove,” of which I own by the way: Oh! Didn’t you know that? What? No investigation before you saddle-up and zoom to Miami? When I’d heard from Jorge that a “chiquito desmandares” demanded that he sell him orange juice for his “gillpollas cacia” the only conclusion I could draw was, “Mulligan must think I’m an idiot!” Since you’re absolutely certain there’s no orange juice from Lily’s Grove, just for fun, let’s see if I might know someone who could help. . .Buenos dias, Jorge. . .”

That lesson (failure) provided an essential insight: if a heavyweight asks for something that has the appearance of impossibility, they already know where and how to get it. They simply aren’t interested in doing it for themselves. Self-effacing, tenacious, and propriety could be helpful behaviors in discovering a source for this item.

Only when forethought (plan B, escape route) is absent and I discover that I’m in a wholly defensive position with no options does this derivative of self appear. This derivative is my super-hero or, as I now recognize, my manic-self (who I will name “Heartless”). “Heartless” has a single purpose: self-preservation amidst unyielding stress, confusion, and fatigue, the by-products of an extremely complicated problem or series of problems which causes inescapable mental burden and my organic belief that failure cannot be considered because of its dire consequences and the real-life ramifications to everyone involved.

“Heartless‘s” appearance goes unnoticed and the logjam that promoted his incantation begins to loosen and the stalled efforts discover renewed vigor, and less and less sleep is needed, and more and more and more organization and meticulous paperwork are demanded. “Heartless” remains present for varying lengths of time: Sometimes 3 months, sometimes a year. But his denunciation follows the same pattern: “Heartless” turns his attention away from the situation of which he was borne, and on to me, which he sees as the real victim of the entire circumstance. And then he uses every weapon in his arsenal to create as much collateral damage as possible: spending huge amounts of money on items which I’ve wanted, yet dare not buy (dog, tattoo, Rolex GMT II, 55″ TV, fully outfitted wood shop, custom-made Japanese fountain pen); ingesting too little or too much of my medication; abhorrent social behavior; and the worst and most pointed, vehement, and hateful: accusations and ceaseless arguments with my spouse.

The moment someone, anyone really, recognizes that I’m in the midst of a manic crisis, “Heartless” disappears. And all that’s left behind is a meandering trail of damage, some salvageable, some not. Destruction is definitely his foot print. But I’ve considered too, that perhaps “Heartless”buys and says and behaves in ways some tightly-tucked-away part of me wants to behave or say or buy. But I, like so many of us, have toed the civil line and buried our uncensored selves in a nook no one will find. Wouldn’t it be tragic if we’ve been taught that decorum dictates that superhero’s remain in comic books and not shopping at Prada.