Tag: health

Bipolar Diagnosis Is Not An Insanity Defense

~ 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.

What Flavor Is Your Mood Disorder?

~ Harlan Didrickson ~ 2 Comments

“What’re you having?” the rakish twenty-something asks.  Still staring into the fluted dish before me, spoon in hand yet inactive, I respond, “I’m not sure exactly.  I asked for a double-scoop of Desire and was handed this.”

The twenty-something turns so his torso, while dissected by the cafe table, is visible to me, “What’s it taste like?”  Turning my head in his direction I realize he’s: 1) That “guy-in-the-tuxedo” from my cousin’s Mystery Date game; and 2) Sans the tux!  I asked myself, why would “Mr.-Mystery-Date-Man” be sitting in a soda fountain, at a table next to mine, wearing only a smile?  My chagrin whips my gaze back to the disappointing confection now taking the shape of a poached egg.  “Well,” I stammer, still shaken by his cheeky immodesty and dismayed by my immediate craving for carnality, carousal, and covetousness, “It hints at Desire, but clearly an inferior attempt; the delicacy of Desire is overwhelmed by the coarse texture and indulgence.”  I decided to shift my chair and face the tempest of his proximity head-on, “What’s that you seem to be enjoying?” I ask, sounding foolish.

“A Raspberry Restraint,” he said as the spoon scraped and clanked against the spotless bowl.  “I have at least one every day.  I could probably eat fifty.  Moderation, that’s what I hear, everything in moderation.  Who’re they trying to kid?  I can spell; and I assure you that there’s no Mania in moderation,” he said as he slid slowly forward in his seat, the heat of his knees gently toasting my flank; “Sounds like they did the switcheroo. . .gave you a two-scooper of Licentious Lingonberry; they do that when they’re out of Desire.”

Flabbergasted, I now understood why I was staring at the freshly filleted fellow, splayed before me like an all-you-can-eat-buffet stocked with preprocessed food.  “But I wanted Desire. . .gentle, demur Desire. . .subtly prurient, hopeful and hungry. . .Desire. . .in general terms!”  Sounding exasperated, I wave my hand indicating his wanton availability, “Licentious Lingonberry?  No wonder it tasted so obviously. . .bitter. . .each spoonful made me thirstier. . .and there you were, the perfect glass of ice-water.”

I pushed my chair back and stood up trying in vain to disguise my arousal, “Sure, you’re lust personified; carnal; and after, I’m right back here; the one place where we can savor those flavors of humanity lost to us; before we go back to our senseless mockery of life,” I said as I began to leave.

“Sounds to me,” Mr.-Mystery-Date-Sans-Tux shouted, “like you ought to have ordered the Passion Fruit!”

An Open Letter to U.S. Representative Jesse Jackson Jr.’s Mayo Clinic Physicians

~ Harlan Didrickson ~ 3 Comments

Dear Dr. So-and-So, et. al.:

I read with tremendous interest and a degree of de ja’ vu the front-page story written by Ms. Michael Sneed in the Sunday, August 5, 2012 Chicago Sun-Times which reported that U.S. Representative Jesse Jackson Jr. recently collapsed and had become completely debilitated by depression.  Upon reading the story, I experienced a staggering degree of recognition, for I too, have (and continue to do so) hit the same kind of wall as Representative Jesse Jackson Jr.: A crippling mental illness diagnosis, specifically major depression (changed later to Bipolar II) following gastric by-pass surgery.

The story reported that Ald. Sandi Jackson (wife of Representative Jesse Jackson Jr.) doesn’t know if her husband’s depression is connected to his weight-loss surgery.  As a person who finds himself in a very similar situation the development of major depression after elective gastric by-pass surgery) I would like to suggest that determining the cause of this on-set of depression is irrelevant and nearly impossible to determine.   Based on the past four years of failed orally administered pharmaceutical treatment attempts, I strongly suggest that you titrate the dosing levels of psychotropic therapies dramatically (50%-75% higher) or increase the potency of the psychotropic therapies to compensate for the substantial degree of malabsorption (the basic tenet of Duodenal Switch Surgery) caused by the significant reduction in stomach volume (up to 70%) and the dissection and rerouting of a large percentage of the small intestine (which is largely responsible for caloric absorption).  If the goal of the Duodenal Switch surgery is to limit volume and reduce absorption of food ingested orally, then common sense suggests that anything ingested orally will greatly lose its effectiveness (especially if the drug’s efficacy during clinical trials was based on subjects that did not undergo weight-loss surgery).  Except now we want the body to absorb what it’s ingesting!

I endured two needless years of trial and error attempting to discover pharmaceutical regimen which would lift me from depression and put a lid on my mania.  My psychopharmacologist knew I’d undergone gastric by-pass surgery a decade earlier yet refused to consider malabsorption as the cause of the ineffectiveness of every single prescription.  Frustrated by my psychiatric team’s myopia, I returned to the care of my internist; he was the first doctor to consider that my body’s ability to absorb oral treatments had been reduced by as much as 75%.  If an increase in dosage is impossible, then a different delivery system (IV, inhalation, transdermal patch, suppository) must be manufactured.   Please don’t waste Representative Jesse Jackson Jr.’s time prescribing the usual litany of drugs at their recommended doses: It’s akin to trying to stop a charging elephant with a water pistol.

Morbidly obese patients who were diagnosed as depressed and were being treated successfully through oral medications prior to gastric by-pass surgery discovered that post surgery their depression worsened and their pre-surgery oral medication treatment failed to reproduce the expected degree of pre-surgery success and relief.   Your patient is in crisis; your patient is experiencing a major depressive episode; your patient’s natural ability to absorb what he ingests has been compromised to the degree of ineffectiveness; your patient needs an extraordinary, preposterous, wholly unimaginable antidote, not a boilerplate solution. 

I salute the Jackson family for supporting Representative Jesse Jackson Jr. through this difficult period and wish them all God’s speed.

Called Life This Morn: Took A Sick Day

~ Harlan Didrickson

It took me much longer than I’d expected to find their number.  Having never actually called before, it took me a while to figure out how to reach them.  Liz, one of my friends who decided to resign all together said that they found her.  “Oh yeah,” Liz said, “as soon as I took the exit, there they were at the stoplight.  Waiting.  Walked right up, smiled like we’d known each other forever.  I’m thinking, easy-sneezy: this guy’s going to give me directions!  Then he pokes my shoulder and says “You didn’t call this morning,” he said sounding serious, “Why is it, do you think, that people don’t call?”  I said I just wanted to quit.  Figured if I never showed up you’d get the message.  Then we were nose-to-nose, “The only time I get a message is when people don’t call.  Then I’ve got to waste my time to come out here and drag you back. . .”  That’s when I became aware. . .aware of my failure. . .aware of all the facial. . .”

Liz never finishes that story; she always stops right before she describes her consequence, which is evident when you meet her, but of which she just can’t describe.  The best she can do is, “I avoid mirrors.”

Because I couldn’t find the number and when I did, I was still on the fence about calling and just punching in, I greatly increased my chances that someone would answer.  It’s Saturday I thought, maybe they’re off.  Slowly I dialed the number; by the fifth ring I knew I was in the homestretch and could leave a mes. . .  “Department of Human Services, Life speaking,” he said, and then repeated, “Human Services, Life speaking.  Hello?  Hello?”  Uhm, yes. . .Life this is T.M. Mulligan, I said sheepishly.  “Yes Mr. Mulligan, why do I have the pleasure of this call?” he asked.  I told him I was ill and taking a sick day.  “So you’re taking a day away from the human race, Mr. Mulligan?”  His interrogation could be found on any page of a dime-store detective paperback.  Yes, I replied, I’m just not up to the task today; not even the battalion of amphetamines could take command of depressions beachhead; everyone’s at a block party, my spouse made brownie’s, the dog’s been there twice already.  I just can’t go.

“Can’t be part of the party?  Rather be alone?” Life asked.  Today, yes.  Not every day.  Just today, I answered.  “How many people do you think call Time and tell her they’re taking off?  And Birth, do you think those kids call Birth and threaten a sit in?” he asked.  Well, I don’t think they have phones in there. . .  “Or Death?  Death never answers, and they don’t have voice mail; they’ve dumped their phone into a trash can and threw it in the closet.  But Life?  Life’s phone is always answered; even if I personally believe you could act as if you were having fun, you’ve had your share of suffering recently and, except for once in July, 2008 you’ve always managed to drag yourself out of abysmal despair and try to live life.  I’ll mark you down as sick today, and we’ll see you tomorrow?”  Yes, I stammered, yes I’ll definitely be in tomorrow.  “Until tomorrow, then.  By the way, I’ve sent you a little sunshine.  Good-bye, Mr. Mulligan.”

The line went dead and then the doorbell rang.  Cupped in the hands of a delivery person was the essence of Life: A bouquet of sunflowers.

The Rough Patch

~ Harlan Didrickson ~ 1 Comment

The thoughts washed over me like a warm dishcloth in the hands of my mother, softly scrubbing the days grime and grit away.  The thoughts brought comfort and tenderness.  The thoughts eased my anxiety.  The thoughts allowed deep breaths out of shallow breathing.  The thoughts had me wonder, “would anyone care?”  The thoughts came to me through cupped ears, uncertain of the message and always certain of the sound.  The thoughts came to me in hushed tones, as though they were being spoken in a pew in church, or a movie theatre, or a play.  The thoughts popped into my head like bread from a toaster, but with less fanfare.  The thoughts came to me like a piccolo in the distance or the bark of a dog through a curtained open window in summer, somewhere far away, present and avoiding distance.  The thoughts always came to me as I was thinking of nothing else, crept in like an intruder or a rapist.  But the thoughts were always the same, “it would be better if you were gone.”

When you live with mental illness, you also live with suicide.  Not as a threat, or a cry for attention, or a misdirected plea for help.  A life with mental illness means a life with suicide.  And thinking about it daily is a good thing.  For me (and many of my friends who live with mental illness), we understand the destruction, the collateral damage, the years of anguish suicide dumps onto those left holding the bag; this bag, now empty, once held a precious life to those it touched.  But to the person to whom it belonged?  It became too heavy to carry or too light to matter, too crazy or too solitary, too depressed or too manic, too congested or too separated, too observed or too ignored, too involved or too bullied.

To those of you without mental illness a word of caution:  Suicide isn’t the end.  Suicide is the beginning of horrific nightmares, overdue and now regretful answers to calls, lamentable hours sorting things which recently were belongings but no longer hold meaning, the gash of your disappearance which takes years to heal (if ever).  It will never be an answer: it can only be a question.