Tag: health

“You Brought This On Yourself,”

~ Harlan Didrickson ~ 3 Comments
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My mother’s back: her way of avoiding conflict.

That’s what my mother used to say, her back to me, and her hands wrist deep in dishwater.  I needn’t see her hands to know she was wringing them upon hearing my news; I could tell by the way the muscles in her forearms were flexing.  There were several of these confessions at the kitchen table over the years, and I always found her reaction astonishing.  She was incapable of ever helping me solve whatever dilemma I disclosed.  The scope of my problems were well beyond the dimensions of her upper-flat apartment and any collateral influence her small circle of single-mothers might discover.  No, my mother lived a small, tightly wound existence, and like those gated-communities with elaborate, electronic gates and guard-posts manned by ex-militia, she’d honed the art of deflection, quickly interrupting my admission like a towering volley ball player blocking an opponents spike, by conjuring up the standard retort to unwelcome news, “You brought this on yourself.”

Which in many instances was both honest and obvious.  Most people don’t find themselves in a pickle by being an innocent bystander.  Most pickles are borne of poor planning and even poorer execution.  But not all admissions warrant my mother’s standard suppression.  For instance, the admission that you suffer from a mental illness in which you slide from a manic state to a depressive state as easily as Ferrari’s change lanes on the Autobahn. And that stress is a definite trigger, especially if that stress is a direct response to particular issues, situations, or circumstances.

What I’d like to know is whether other bipolar patients are accused of mania by a friend or relative when attempting to communicate important (and potentially volatile issues), and if so, does your intensity escalate in direct response to their continued defensiveness about the issues you are attempting to discuss?  And if the discussion derails and car after car of well-intentioned-but poorly-stated-examples jump track and pile atop each other deeply burying your initial point, does the person with whom you are now arguing with pull out the trump card, the ace-in-the-hole, the Coup de Grace and draw the conclusion that your passionate (implication: ridiculous) and persevering (implication: absurd) diatribe is characteristically manic, therefore you are literally, ranting like a lunatic, what do you do?  Back off as proof of your sanity (thereby recusing your accusations)?  Or stand firm and mad which guts the rationality of your point-of-view?

I recently cautioned a close friend that, out of desperation, played that card, and immediately quelled my interrogation.  But later, when civility returned, I quietly cautioned him of setting this precedent: “If I’m defenseless or simply tired of fighting, and he is intent at satisfying his blood lust, I’ll shut him up by asserting he’s Manic.”  Because most likely I’m not manic and accusing me of being manic in the context of an argument is cowardly and insensitive.

And lest you’ve forgotten, my mental illness is a disease not a strategy; it’s not my power play.

I’m out of control and therefore, by the very nature of the disease, am incapable of rational thought or reason; and the last thing an irrational person wants to hear is he’s behaving irrationally.  Talk about a dog chasing its tail!

Any thoughts?

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Recovery: A Saw Blade and Alpine Climbing (Journal: July, 2008)

~ Harlan Didrickson ~ 1 Comment

I had thought that an increase in medication would signal a decrease in depression. But my psychiatrist corrected my logic and chose two separate metaphors to describe my recovery: 1) A hand saw; and, 2) Alpine Climbing.

Picture a well-made 26″ cross-cut hand saw with its blade facing upwards.  Don’t look at the teeth but look at the blades carefully honed angle-of-rise as its surface broadens to eventually equal the width of the handle.  And the teeth are hand-shaped on a grinder causing the familiar serrated edge which means there are several contact points (peaks and valleys) along the saws blade.  My mind when in major depression is like a serrated cross-cut hand saw blade. There’s a consistent up hill climb but in order to achieve the handle one needs to live through a number of peaks and valleys.

Similarly, the Alpine Climbing endeavor is peaks and valleys to which I am ignorant: I am not a mountaineer, having lived for 50+ years at or slightly above sea level.  But something odd occurred recently: my sea level suddenly rose skyward and I, lacking any previous experience went tumbling like poor Jill after Jack tripped showboating his coronet.  And then there it was, sea level, way up there, beyond tree canopies, even higher than some clouds.  It wasn’t until my psychiatrist explained that sea level remained fixed; it was I who had tumbled downward, spiraling like bath water down the drain.

From its approach I studied the aspect or face which I would climb to reach my first base camp.  The first leg I climbed alone (except for talk therapy and psychiatric medications) and joined my psychiatrist/sherpa at base camp where he was waiting with our racks.  We left the dark despair and feelings of hopelessness at base camp in mid-July, 2008.  We lightened our load by leaving behind my feelings of worthlessness and the idea that my life has collapsed, I am invisible in my own life and I would be better off dead. We both agreed that we didn’t need to drag those thoughts with us to the summit. We shouldered our racks and tightened the harnesses, checked and rechecked; thus began my apprehensive and cautious attempt to the distant summit of Peak Recovery.  The trek had been an exhaustive challenge across an unfamiliar landscape filled with dark crevasses of suicide and treacherous, newly fallen snow provided a dense foothold for our crampons, but which also hid the setbacks of insufficient dosages. But the activity of climbing and breathing the thin, cold air provided a sense of refreshment and newfound challenge.

Friends of mine and especially Nick have asked why I would’ve been so lucid for so long, then after meeting my psychiatrist it seemed as though my bottom gave out. It wasn’t until this afternoon as I write this entry that the reason occurred to me: I had spent the better part of two years in an utter state of unhappiness; unhappiness in my job, unhappiness in my relationship and unhappiness in my life. Yet, everyone in my life thought everything was swell and marvelous and happy! I had tried everything I knew how, from changing jobs, to self-medicating, to alcohol abuse, but nothing would erase that consistent gnawing pain I felt in my heart, or quiet those scratching, irritating noises in my head. Right up to the end I tried desperately to hold on, to simply hold on to the last end of rope, my fingers bleeding and numb. Until I saw my psychiatrist for the first time and he said, “there’s nothing to be ashamed of when you ask for help. You cannot possibly do this alone.”

It was then, right then, that I knew the futility of my fight; it was right then that my heart recognized kindness and a serene noiselessness smothered the incessant clamor filling my head.  This epiphany of surrender brought an end to my life as desperation.  When I released my hold my consciousness experienced a forced power-off; a reboot in safe-mode.  When I eventually opened my eyes there stood my psychiatrist who helped me to my feet and said “Now we can start at the beginning rather than the end.  The end which you fought valiantly to avoid never would’ve been avoided. Life starts when labor ends.  We all start on the heels of the end.”

My recovery continues to be slow with delays and disappointments along the way.  And yet, as we stop to rest I tell him of the anger and disappointments in my life. My psychiatrist/sherpa listened intently and then offered the most important advice of all: “Climb this mountain as though your life depends on it, because it does.”

Whew! 15 Minutes Is A Long Time!

~ Harlan Didrickson ~ 3 Comments

Being the subject in a feature article which appeared in the first section of the Sunday edition of a US major newspaper like the Chicago Tribune was wholly a great experience, but also one in which I am relieved is diminishing in attention.  Like a child standing abreast the Sundae Buffet Bar at a local eatery piling one bizarre topping atop the last, the news cycle here in Chicago has a short attention span, especially when the subject (me) is an unknown (me).

It was the condition (bipolar); its manifestations before diagnosis; the odd behaviors preceding a mental breakdown; the swath of tawdry details, hateful accusations, and trust-damaging honesty laid bare which piqued their interest. The reporter who, with an eye focused on sensitivity, remained intent to anatomize sequential events like they were the identifiable behavioral ingredients required to produce a blue-ribbon breakdown pie.  She often returned to the timeline which, like a mooring buoy, guides a diver safely to the wreck.  However, my timeline represented a fall from grace, a clawing desperation numbed by opiates, acts of treason undermining my relationships; and finally, any semblance of sanity or allegiance to life was pitched like an unwanted circular.  The drilling for details only struck bedrock when trivial yet salacious activities, freely offered as context, had to be included in the article to highlight the stakes of my all in bet.

Absolutely not!  I would not be drawn-and-quartered on page 8, section 1, the entrails of my privacy displayed like human anomalies hawked at second-class side-shows!

I made it very clear: I’m not ashamed nor am I proud of my behavior, the pain it caused others, my professional devastation, the annihilation of trust, or the surrender of an identity.  But there’s a difference between honesty and privacy when it involves my life and the lives of those dearest to me.  I have been candid and explicit and straightforward.  But if your newspaper can’t respect what I say is private, then they must not respect what I’ve determined to be public.  In which case they can’t have any of it!

And that stand on my own behalf was my take-away.  Before 2008 I always felt like I had too keep going, had to get promoted, had to make six figures, because there was always somewhere to go, a place just beyond my reach that would be better, easier, calmer.  And on I went, like so many of my friends, pursuing. . .something. . .

After 2008 that place which had been so important to get to disappeared along with the constant gnawing I heard, and the “coveted by others” baubles bought to fill an expanding void where truth-to-self and character once resided, and year after year after year of acrimonious evaluations designed to hobble my self-worth.

I find great joy and comfort and silence knowing there really is nowhere else than right where I am.

 

Chicago Tribune Feature – Published Sun., Aug. 26

~ 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.”

Copyright © 2012, Chicago Tribune

Chicago Tribune Feature – Set to Appear This Week

~ 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!