Replying to a Mother’s Rueful Response

awrittenletterDear Mrs. Donahue (names are changed),

Thank you very much for your kind words. I wish I could take credit for my writing style but alas, like my blue eyes, my writing was implanted long before I discovered it. And I doubt that beautiful language is lost on you: my job is to inspire the reader to take action or offer empathy. See, you took action! Your comment had a tremendous effect on me; it was your honesty and so, in return, I will attempt to answer your concerns as best I can.

Is your very bright son Bipolar I or Bipolar II? It’s generally thought by those who have been diagnosed with Bipolar Disorder that life feels better when they’re off medication; which it does at the onset of mania. But (in my case) mania begins to spoil quickly (like peaches), and then the paranoia, insomnia, and hateful accusations begin to fly; if there’s no intervention (hospital, doctor, therapist) my thoughts begin to darken like storms in Nebraska; my withdrawal begins like clouds gathering on the horizon and continues to descend getting ominous and threatening; until the eventual cloudburst of suicidal ideation, developing a plan, and at its worst, scheduling a date. Your impression of his life on and off medications may be accurate, but rather than compartmentalizing your observation, let’s look at it comprehensively: ON MEDS: Ability to function (personally, academically) and a sweet disposition; OFF MEDS: High degree of intelligence and violent. It’s important that your son understands that mania is a false reality often unpredictable and usually misleading. Mania joegordonlevitt-manicprovides “out-of-the-box” thinking, grandiose ideas, risky behavior, and poor judgment. Contrary to what patients who abandon their meds think, their manic behavior is not their true behavior: It’s their mentally ill behavior gratifying their indulgences and oblivious to any consequence. You might want to read my post “Bipolar is not an insanity defense.” Whatever actions he takes while manic and unmedicated will be his responsibility. If he breaks the law he could find himself in a lock-up, brought to trial, and sentenced to the general population of a county jail or state prison to serve his time. And our It’s a risky and poor decision. We all hate our meds: for some, it prevents mania, for others it prevents suicide. His meds keep him safe.

He’s got to come to grips with his “new normal” or he’ll always want to transgress to the embolden and manic life. In the past four years, I have ingested a surprising number of medications (29 pills daily), all of which failed. A friend mentioned Adderall. I now take a tightly monitored volume of Adderall’s generic cousin. It’s the only medication which plucked me from the depths of my depression. Adderall makes you very focused, like an English Pointer zeroing in on a quail; too focused sometimes, almost to obsessive, waving off distractions, even meals. I’ve thought that I’m merely a puppet following Adderall’s direction.  But it’s the only medication that’s made a significant impact on my mood. Every morning I have two choices: 1) Swallow it; or, 2) Don’t swallow it. I swallow it because I’ve weighed the consequence of not swallowing it, and the outcome is, in a word, glum.

When your son turns old enough to be an adult you’ll have to let him go. I strongly suggest that you find some kind of parental support groups, perhaps a therapist to work with you. But remember, it’s impossible to reason with a manic person and it’s impossible to reason with an unreasonably depressed person. When the bipolar patient’s behavior indicates he is manic or depressed and living out-on-a-limb they forfeit rationality and decisiveness; they adamantly oppose responsibility as a clumsy and conspicuous trick by law enforcement or psychiatrists to admit their participation in some wacky activity; they denounce medications as a straightforward blitzkrieg against their mental resistance.  At some point we all return to face, with shock and awe, our manic (or depressed) annihilation of what-was-formerly-known-as-life, understanding that some relationships sustained too much damage and were bulldozed; while others weren’t inhabitable without repair. That’s when you face the costs of abdicating meds to unleash the real you.  And yet you know that the real you would never destroy relationships which you affectionately admired.

He knows precisely what to do because you loved, cared, and taught him.

Now, it’s his life to live complete with failure and success.

Oh yes, and bipolar disorder.