As it always seems to, the recent shooting massacre at Sandy Hook Elementary School in Newtown, Connecticut has sparked not only another wave of gun control talk but also discussion of our need to recognize and treat mental illness. Tying mental illness to events like these horrifies me because the risk is making all of us with mental illnesses into something to fear; but talking about the subject at all, recognizing that we don’t acknowledge these illnesses and certainly don’t do enough to make treatment available, might be worth the risk. If I hadn’t recognized and treated my own illness, I’d still be suffering the way I did for a decade and a half before admitting the problem.
I was first diagnosed with bipolar disorder in 1999. The illness was originally called manic depression, ostensibly by way of describing the polar opposites of extreme emotion that sufferers bounced between. By the time I was diagnosed, psychiatry had come to understand my condition as more of a spectrum of illnesses than a discrete diagnosis, so bipolar disorder, which ostensibly was meant to sound less severe, became the new term. Each new edition of the Diagnostic and Statistical Manual of Mental Disorders (think of it as the Bible of mental illness) seems to add a new rub. Now we call it a mood disorder because not everyone has truly manic highs and suicidal, depressive lows.
I began suffering from my illness shortly after entering seventh grade. Mood disorders often kick in with the onset of puberty, but I suspect the radical change in environment –- one classroom with one teacher and a relationship with that teacher and my classmates changed to rotating between many different classrooms with many different teachers and no relationships with anyone -– had an effect as well.
I remember talking to my best friend about wanting to kill myself. God bless him for having the patience to listen and to tell me, “You’re not going to kill yourself,” because he was always right and made me face it. I remember flying into manic white-hot rages peppered with extremely violent thoughts over my dissatisfaction with the typical way popularity contests and cliques dominated the social structure of my high school. But I never understood the full measure of just how ill I was back then until I met up with my first ex-girlfriend a few years ago.
We started dating when I was a junior in high school and she was a freshman. She followed me to the same college a year after I started attending classes there and we dated for a few more years. Our relationship was tumultuous at best. My mood swings often resulted in what could fairly be called mental abuse, like losing my temper at her for no reason at all and yelling at her until she burst into tears, and then apologizing profusely when the manic state petered out.
We broke up after I discovered she’d kissed another guy in my fraternity. Instead of trying to work things out, I flew into a rage, tossing the belongings she’d had in my dorm room at her as she squatted against the door, sobbing hysterically, begging me not to throw her out.
We lost track of each other after college, and once I got into treatment and began taking my meds and stabilizing, eventually I started thinking about how awful my first relationship had been and that I finally understood the reason. I wanted to explain to her why everything that had happened between us had happened. I wanted her to understand what I now understood about my illness, not by way of excuse but explanation. I wanted to apologize and so desperately to be forgiven. When I finally made contact with her and explained about my diagnosis and the psychoanalysis and the medications I was on, she told me about discovering that a close friend of hers had bipolar disorder, and she did understand why I’d done what I’d done, treated her the way I’d treated her, and she forgave me.
We exchanged emails now and again after that, and we arranged to meet and catch up over lunch during a business trip she was taking to Boston. At one point, I’d been her best friend. In another universe where I had never gotten sick, we’d probably be married with kids right now.
My wife knew I’d been in contact with my ex and luckily supported my trying to face past demons. The idea of having a chance to have a normal conversation with the only person I’d ever loved prior to meeting my wife and to demonstrate that I was healthy probably meant more to me than it should have.
I sat on a bench in front of the Legal Seafood restaurant in Boston’s Prudential Center. I saw her part through the crowd and I smiled.
“We’re not actually going to have lunch,” she said. My heart sank a little, but I asked if we could just take a walk down Boylston Street so that she could tell me why. As we walked and talked she said, “I don’t want this anymore.” What’s this, I asked? “This. This emailing, being in touch.” She’d been talking about it with a friend and decided she didn’t want to be in contact with me. And she explained, I realized why.
She looked at me with the eyes of a trapped animal, her gaze darting back and forth between my irises, checking for something, maybe a hint of a coming explosion of anger at the sudden change of plans.
We walked further down Boylston Street to Copley Square, making small talk, and then sat down on the steps of the public library. I told her that I understood and while her decision made me sad, I would of course accept it. When she got up to leave, she paused.
“I’m worried that when I leave you’re going to follow me or something,” she said. Of course not. Why would I do that?
“I was afraid to have lunch with you because I thought maybe you were going to poison my drink or something,” she said, with a half-smile to hide her nerves. Why would I do something like that?
And then I remembered the rages after we broke up, when I discovered she was dating another, different member of my fraternity. I remembered one night when I called to talk, and she complained that her new boyfriend didn’t understand why she’d been so upset at a poor grade on an assignment, whereas I understood how seriously she took her studies. I asked her over to my room and slept with her, in part because I knew my fraternity brother would find out and I wanted to rub his face in it. I remembered the veiled threats I had made to her when she rejected my entreaties for us to get back together.
It was all I could do not to burst into tears as she walked away -- fading into the busy Boylston Street crowd, thankfully not looking over her shoulder to see where I was -- because I couldn’t blame her. Memories of the person I’d been started flooding back after years of being locked away because I didn’t want to remember it. That wasn’t who I was anymore, not for a long time, but I still couldn’t blame her.
I had been such a monster.
The first time a psychiatrist prescribed medications to me I was scared. I worried that taking meds would change who I was, that I wouldn’t be me anymore. A close friend who had been taking meds for many years told me, “Meds don’t change you. They let you become who you’re meant to be.”
I am no longer the person I was when I was with my ex-girlfriend. That was me riddled with mental illness. The man writing to you now is the me I was meant to be, and I would never abuse someone mentally or otherwise.
That’s why I eventually did burst into tears when my wife picked me up from the train station after that meeting with my ex-girlfriend. I had so wanted my ex to see that I wasn’t that guy anymore by way of validating my healing, but it was too late. The damage was done. And the fact that I did that damage to people I loved, friends and family and lovers I’d covered in emotional shrapnel for years is why I got myself into treatment in 1999. I hadn’t wanted to be that guy anymore.
Psychiatric medications are not treatment for mental illness in and of themselves. They are half of a formula. The meds get you to a point where you’re stable such that therapy and the understandings you gain and the techniques you learn to manage your mental illness have a chance at being successful.
Whatever we will call my condition in future editions of the DSM, I am convinced there is a biological component. The human mind is not meant to work the way mine did when I wasn’t diagnosed and on medication, which is why in most people it doesn’t work that way.
Most people experience brief states of euphoria when they hear really good news or do something fantastic in their lives, but that’s not mania. Most everyone experiences sadness when they hear really bad news or someone dies or something similarly awful takes place, but that’s not depression. Happiness and sadness are normal, human experiences.
The emotional states that I suffered and bounced between for over a decade as an un-medicated mentally ill person were not normal. Normal is not thinking about killing yourself several times a day almost every day because you are so depressed and feel so hopeless. Normal is not flying into boiling rages over nothing that warrants such a state.
Taking meds evened out those highs and lows and gave me the ability to talk about my issues in a calm and thoughtful manner, first during four years of four-times-a-week psychoanalysis and now during weekly therapy sessions, tearing into the psychological influences and structures that helped feed my mood disorder like proverbial fuses for the powder keg.
Thanks to taking those meds I can actually feel a mood change coming on, step back from the situation to observe why I might be getting upset, and ask myself whether it’s worth it or not. It takes an extraordinary amount of stress and pain to inspire a manic episode, and even then it's a very brief flare compared to what it used to be. My disorder leans heavily towards the depressive side and that’s mostly what I continue to deal with.
I would not be able to say any of this without being on my meds. I would not be gainfully employed, able to handle the stress of two very different careers, maintaining friendships (I keep track of a handful of people from high school and no one from college, and I can’t discount that my difficulty in establishing friendships worth maintaining had something to do with my constant irritability and ranting anger), sustaining such a loving and fantastic marriage, or remaining so close to my parents. None of that was even possible before I was treated.
My friend who'd told me not to fear medication was right. Taking meds didn’t change who I was. It allowed me to become who I was meant to be. I was no more meant to suffer from a mood disorder as my natural state of affairs than I would be meant to be on crutches forever if I broke my leg and didn’t have the bone set. Not taking meds, to me, would be as foolish as not getting chemotherapy if I had cancer.
Mental illness ruins lives, or makes them much more difficult than they need to be. Untreated mental illness is largely responsible for the size of our homeless population in the United States. I am thankful I’m privileged enough to be able to afford treatment because for all I know without it I’d have long since followed through with the ideations of putting a shotgun in my mouth and pulling the trigger because I couldn’t deal with the shame and the pain and the hopelessness anymore.
It is absolutely true that modern medical science does not understand nearly enough about how the mind functions chemically to produce psychological states. It is absolutely true that many of the medications prescribed to people like me are not 100% understood in terms of why they work.
But they work. For someone like me who benefits so assuredly from them, that’s all that matters. My wife is no longer showered with the frequent outbursts of anger for no reason whatsoever that she was exposed to when we were first dating, or forced to watch as the person she loves most in the world despairs and talks about killing himself.
I don’t care too much about how the meds work. For me, they work.
When I hear people who are lucky enough to have access to psychiatric medication say they’re going off of it, I think about the people I’ve met who have mental illnesses and can’t get their lives in order owing to lack of access to medications and treatment. I think about the members of my family and my friends who had mental illnesses and had their lives turned around when they found the right combination of prescriptions and therapy. I remember who I was before I got into treatment and what I had done to people, and I can’t imagine voluntarily returning to that.
I wish I could hold myself up as a success story because I was “cured,” but there’s no such thing. I will be dealing with this for the rest of my life, but I’m thankful I have the resources to do so. It’s about time that everyone has the same opportunities I did to get well, so that everyone can be who they were meant to be. And maybe be a lot happier in the process.
Dennis Scimeca mostly writes about geek culture and video games, but sometimes writes about other stuff. He can be followed on Twitter: @DennisScimeca.