Saturday, October 21, 2006

Break in Transmission

If I could draw, I would draw a little skull and crossbones at the top of this post, like they used to have on pirate flags and poison warnings, but the skull would have closed eyes, and a little warning underneath would say "Contains Extremely Boring Material".

Because that's what you're going to get. Narcolepts, look away now. The brain is not doing what I want it to - the motor's cold, the plugs are dirty, there's sugar in the tank.

Metaphorically speaking, of course. It's not quetiapine time yet.

Things being how they are I have taken a few days off work. Because of the bipolar I almost never take holidays, reasoning that it's better to have a vast amount of leave stored up than to be caught short. The downside of this is that the time other people spend trekking the Himalayas or perousing and carousing in the wineries of the Dunwich valley, I spend lying around the house, hiding from my friends, gorging myself and moaning about how I'm bored, flabby, lonely, fat and when is someone going to do anything about it?

Anyway. I have noticed a difficulty making decisions, a few episodes of poor concentration, nurses having to repeat bits of the patient history to me that I normally would have picked up the first time, a bit of primitive, concrete thinking - so I have taken a few days off. With a bit of luck I should be back tomorrow, which is one day, and a relatively slack one, and then the weekend. And maybe back seriously on Monday.

And maybe not. Things are not exactly good.

Anyway. When I started this blog I had this vague idea that one of the things, one of the purposes was to give anyone who was interested an idea of the whole bipolar thing. In that I suspect I have failed, but it is possible that I have failed because the task was actually impossible. The idea, the actual experience of an episode of inappropriately disturbed mood, let alone a full-blown mood disorder is something that I have been unable to put across to those (admittedly few) people who have experienced it.

My ex-wife, for example, knows that I have bipolar. She knows because we have two children together, and because she saw, from the outside, some of the worst of it. But as far as I can work out, she has never felt anything like it.

I am not saying she has never felt sadness, or loss, or rage, or anything - living with me would have given her every opportunity. And I am in no way suggesting that her emotional life is poorer than mine, that my feelings are somehow deeper and realer and more important because of this stupid thing I have. And I am not saying that Ruth lacks any atom of sympathy or empathy or any other kind of -pathy*.

But it's the whole "feeling sad when there's nothing to feel sad about" thing that she doesn't get. That's the thing that is entirely alien to her, out of her experience, something she does her best to believe in without understanding. She has not had, and I hope she never will have, the experience of a continuously bouyant mood in the face of ongoing catastrophe, or the endless, grinding "seasons in the abyss" that a small, slim, middle aged man told me about five years ago in Shipton's psych ward. Long periods of dark and cold, when outside everything is bright and sunlit.

That always struck me as a particularly horrible mental image, an idea of months under a black sun and a silent sky, stunted vegetation, sour soil and things that creep.


I spoke to someone once, someone who had taken a lot of methamphetamines over about three years, in a heroic, if misguided attempt to deal with not wanting to be a lawyer any more. He had always swallowed the stuff, rather than injected, and had been "clean" otherwise, and it was usually only a weekend thing, didn't effect his work, and his wife didn't know about it. And one morning he had woken up early and lay in bed in his large, spacious bedroom in Double Bay, read the Sydney Morning Herald, drinking his coffee and wondering about getting tickets to the Ashes. And as the late morning sun came in the windows his wife stretched and yawned, and rolled over in bed to talk to him, and instead of her face she had a writhing mass of grey tentacles.

Things were different now. The breakdown had been painful, but perhaps necessary, even beneficial. The divorce was through, the allegations of violence withdrawn, and he had a decent little house in Dunwich, and the thing about a law degree was it was fairly versatile, you could do different kind of work, start again, start something new. Less money, smaller city, more restrained, but new.

But the thing I got from listening to him was the horror he felt. He knew at the time that what he was seeing was a hallucination, but he was too scared and too desperate to escape to do anything about it, too scared to think straight. The monster with the tentacles looked real, and the internal voice that was telling him it was not real was small and thin, and the terror was deep and unmanningly primal. Five billion years of assuming that normally, when you see something, it's because light is bouncing off it, neurons firing, the whole mechanistic explanation - there's something there.

Same thing with the mood disorders. You can oppose the feelings, tell yourself things are not as they feel, they are as your "sensible" mind tells you they are. You can reason with yourself, say that it is unlikely that everyone loathes you, that you harm everything you touch, that this ground truly is corrupted with your steps**... but the mood tells you different. You see tentacles, the cause of the image (the tentacles) must be there. You feel hatred and contempt and loneliness, so the causes of those feelings must be there. You must be hateful and contemptible and deserving of dying alone.

Voices, obviously, must still when you walk into the room. Those side-long glances - what can they be but contempt? And why not, when so much deserved?

Anyhow. I remember wondering about the evolutionary advantage of depression (and I know there doesn't have to be one - spandrels and side effects and so on). But I wondered how come something apparently so damaging was so widespread.

Was it a side effect of the development of our big smarty-thinky-type brain, the thing the Neanderthals did without so well for so long***?

Is it a modern thing, a consequence of tribal, pre-stone-age brains in an electronic high-population density environment, a kind of high blood sugar of the emotions, a consequence of us living in a way for which we are not suited?

Is it something that's always there, but we only notice it when all our other needs are silenced, our psyche's background radiation?

There are about thirty things wrong with each of those ideas. But one thought I had recently is that depression, at least in its milder form, is still with us because in some situations it gives us a better view of the real world.

Try this idea. Inside my head sits an audience, watching a film (again, I am speaking metaphorically), something projected onto the back of your frontal bone, or maybe where my eyes should be looking out. The film is a dramatic, engaging, emotionally gripping - it's a propaganda film. The film is all about me, and it's jolly gripping stuff. In the film, my prospects are good. My actions have significance, my promises are largely kept, I - the hero - am a decent and trustworthy man. Gratifyingly, people love me, I make a difference to their lives, and it is good and important that I go on doing what I am doing.

And like all propaganda, it leads to redoubled efforts, increased troop morale, that kind of thing.

But in depression - at least in the mild to moderate form - maybe the projector breaks down. Maybe the "audience" peers out unfiltered though the eye sockets and sees what's really going on. The hero, they see, is an emotional cripple, his achievements un-noticable, his life a single endless season of insignificance. He loathes himself and is justly loathed by others.

There are certain cognitive tasks the depressed do better at, tasks where they have to estimate how much of an influence they have, how much what they do matters. Confronted with a task where you make no difference at all, the non-depressed still believe they matter. As one person said, they walk around with a rose-coloured bucket on their head. We, the depressed, know when to cut and run.

Maybe that's why we're still here.

Anyway. Even I can tell I've written enough today. And I am aware of the inadequacies in this argument for severe depression, psychotic depression, the alternate searing days and moonless nights of bipolar. I am not saying this is what I reckon is going on, this is just thoughts, and the thoughts of someone who is probably should be giving his brain a rest, letting another organ steer for a while.

Right everyone, pull over, change seats. Brain, have a nap, let's see where the pancreas leads us.

Anyway. More later. Hopefully much later.

Thanks for listening,

*Except Binswangers encephalopathy, one of the causes of a common form of dementia. Definitely doesn't have that. And I have seen little evidence of cowpathy, "a little-known form of medical practice which uses medicines prepared from the "five products" (milk, curd, ghee, urine and dung) of cows".

**The weird thing is, you read this and you read Shakespeare at the time, and there is no way you would say that Shakespeare was going to end up as the better author. Marlowe at the time, seemed to show so much more promise. But he was stabbed just over the eye in a drunken duel, didn't see thirty, all that light went out of him, and the other guy, the less promising one, went on to change the English language.

*** They had a bigger brain, but they used it different. This is a fascinating area to read about. They buried their children surrounded by flowers. I think we ate them - the Neanderthals, that is.


Blogger Niamh Sage said...

For all my own emotional rollercoasting, I really have no idea what the things you describe feel like, but I may have got a tiny shred of understanding when I read the tentacles story.

Given the lamentable inadequacy of words to express personal experience in a satisfactory way, I think you do a pretty damn good job of giving us an idea of "the whole bipolar thing".

Sending hogs from afar.


7:07 PM  
Blogger Benedict 16th said...

I remember one person in charge of my training, when I actually disclosed some of my more morose feelings, her answer "snap out of it!".
I remember thinking oh, goody, I felt anger, there is a shred of ego/self esteem left.

One cheery thought, one on my "specials", poly substance use, favourite are stimulants, was saying how angry he got with his girlfriend for trying to sneak out of the house all the time. Why was she wanting to sneak out? "To get drugs from a dealer, she gets so desperate she sleeps with old blokes like you!, how sick is that?", pointing to me. Mind you he was a bit upset cos an old ex had just blown her head off (down near the Shipman).

I'm not the man I was last time you saw me! I'm down to below what I was when I started Med School!

Sows from not quite as far! (And Sows to you Camilliamh Sage).


9:12 PM  
Blogger TOBY said...

Ha! Imbecilic hu-mans! Even when do catch a glimpse of us in our true tentacloid form, you dismiss it as madness! This will make the invasion all the easier...

10:30 PM  
Blogger TOBY said...

Which is advantagous, since our English is obviously so poor. There was supposed to be a 'you' in that first comment. Damn. Must have a word with Tentacloid High Command about these translators...

10:36 PM  
Blogger Juanita J. Sanchez said...

I've seen bipolar, up close and personal. I know it's hell. Even though it's not in my head, I know it's hell for you and others who suffer from it. Lately I wonder how it is that I don't fall into a deep depression myself. My current circumstances could easily lead me there, so it's a strange thing. I have the reverse of your situation: Something terrible is about to happen to me, however I am not depressed. Yet. My mind is telling me "it won't be so bad, it can't possibly be that bad" when intellectually, I know it probably will. But enough about me, I sincerely hope you feel better soon.

6:28 AM  
Blogger Foilwoman said...

Can we send boars too? Or just hogs and sows? What about little peccaries and warthogs? Piglets? Oink, oink, oink.

I can't get my head around the manic side of bipolar: I think it must feel like the high-energy ADHD mode, but I'm pretty sure I'm wrong. High energy ADHD just is high energy. It's speeded up perception, and somehow more perception, but it isn't exponentially more.

I do get the depressed mode though. I've been the mayor of that town, as they say.

I hope things feel better soon, and if all the affectionate porcine shipments don't help out, well, have a hug too. A superheroine hug, which is a very superior hug.

1:05 PM  
Blogger Niamh Sage said...

What with all these pigs flying about the place, I can't help thinking we're about due for something *really* improbable to happen.

Goodie, just in time for Hoggowe'en! :D (Or Sowhain, as the witches call it ;) )


ps: "sozithoz" - the name of the demon of mild colds?

5:38 PM  
Blogger lauritajuanitasanchez said...

That idea of "why doesn't someone rescue me" is familiar...and then it sends me farther down because I ultimatly feel unworthy of rescue!

Fucking terrible thing, depression.

8:22 AM  
Blogger Benedict 16th said...

HEY BJ You made the News!!!!

Expert on addiction 'was drunk'
From The Northern Echo
A senior NHS manager recognised nationally for his work helping people overcome drug and alcohol problems has stepped down after an investigation found he was regularly drunk at work.

It concluded there was evidence David Cliff, head of County Durham's Drug and Alcohol Action Team (DAAT), returned from extended lunches under the influence of alcohol and behaved inappropriately.

One witness told NHS investigators it was common knowledge he drank at lunchtime and they had seen Mr Cliff and a colleague "both coming back, absolutely reeking of alcohol and giggling and the worse for wear."

Mr Cliff, believed to have earned £50,000 a year and controlling a £1.8m budget, has been suspended on full pay since last November. He left his post on October 16.

Thanks to Arbroath

12:37 PM  

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