Monday, September 22, 2014

The Times That Try: A Scholar in Crisis—Part I

It's hard to believe that September is already past its midpoint, much less that fall has finally come once again. This is, in part, due to the fact that still-summery weather had only recently—and so suddenly—been replaced with the cooler days and chill evenings that presaged the impending arrival of autumn. Still, there are some warm days left in the forecast yet, and the summer has seemed longer, in many ways, than those of some years past. The quietude of June seems a lamentably distant memory. Indeed, it seems impossible to fully detail the events of the previous three months and their combined effect without enlisting the help of a novelesque backstory replete with specific dates, locations, and various dramatis personae. This season has truly been a dark one, and an integral chapter in the overall book that has become my life.


A bad moon's rising...

Although one of my aims as a writer has been to openly explore the struggles I endure as a sufferer of Bipolar Disorder, I must admit that thus far I feel I've barely paid lip service to the daily battles waged by myself—and others like me—against this debilitating condition. For my part, I'm fortunate enough to face only rarely the still-prevalent societal stigma with which so many mental health sufferers are confronted on an all too regular basis. In truth, the fight against this stigma is every bit as important as the fight against mental illness itself, for, as long as the afflicted are maligned for the very fact of their sickness, the pursuit and potential success of treatment will remain hindered, if not impeded entirely. To live under the conditions which these maladies impose is challenge enough; to do so in secret, as if in shame, is to invalidate so much of the dignity and humanity to which we earnestly cling, and of which we risk losing sight altogether.

I believe it is with these tools—what dignity and humanity I can muster at any given time—that the invisible prison walls of social stigma can best be dismantled. Dignity, humanity, and candor. The story of my summer is very much the story of a life lived under the pendular whims of Bipolar Disorder, and it is hoped that, by telling it, I might offer more than a simple update on my life as a writer. Although I must, for reasons beyond my control, remain vague in regard to certain details, I should very much like to convey the severity of the season's tumult, its debilitating impact and, finally, how it is I found myself back on solid ground.


A Case History (Abridged Version)



Life is, in many ways, a conspiratorial procession, a summation, of the events and conditions which, over the course of its unraveling in time, come together to inform the steadily changing concept of the Self. As Sagan remarked, "If you wish to make an apple pie from scratch, you must first invent the universe." So it is with people, though we of course tend to excise the portions of our own stories which predate our births. While I've no wish at this juncture to present a thorough exposition of my mental health issues over the course of my entire life, I should like to preface with the most immediate—and ongoing—portion of that journey.

The current course of treatment began nearly a full seven years ago, and represents the longest such term in the 25 years that have elapsed since my first encounter with professional mental healthcare. Though at first I had considered myself to suffer only from severe and persistent anxiety, after sorting through the background noise of several aggravating factors it was deduced that an underlying thread of mood disturbances facilitated the majority of my issues, and I was diagnosed with Bipolar II Disorder. In short, am subject to sudden, often inexplicable shifts in mood, vacillating between sustained bouts of depression and startling fits of hypomania, which while not as severe as full-blown mania still presents enough disruption as to contribute to the condition's overall unstable and debilitating nature. After suffering adverse effects at the hands of a variety of medications, which only served to exacerbate my condition, it was decided that my treatment would be comprised solely of regular therapy sessions. Over the course of the ensuing years I have been exposed to various forms of psychotherapy, all of which proved fruitful, and all of which were administered by one extremely capable therapist—until earlier this year. 

I understood fully her reasons for leaving, and sincerely believed that she should have been—and, as best I could manage, wasafforded the freedom to depart without concern for my ability to continue my progress with her replacement. Still, the transition period represented an extremely turbulent time for me. My life during those first six years of treatment had been riddled with upheaval, and on more than a few occasions it was the consistency of my regular therapy appointments which helped me survive, hopping from one appointment to the next like following a stony path over churning waters. In the uncertain time between my last session with her and the building of a functional rapport with my new therapist, the instability of my condition began to grow to unmanageable proportions. It has been an almost miraculous bit of good fortune that her replacement has proven every bit as capable as she had been, but this fact did not emerge until tested by the events that transpired this summer.


July



As July approached, a sense of excitement and optimism began to build within me. It has, historically, been a good month for me, particularly these past few years. I had finally established a steady rhythm after the months of uncertainty surrounding my therapist's departure, and had distanced myself sufficiently from a number of other troubling events which had thrown the first half of the year well off its intended course. This sense of relief was noticeable in every aspect of my life; it was if the sun had finally risen after months of darkest night. Sleeplessness gave way to full nights of rest; a constant nausea subsided and the joy of eating returned; after allowing months to lapse without writing a single word, I suddenly found myself tallying over 10k words that I'd characterized as exactly the sort of work I'd always dreamt of doing. After months of intolerable malaise, life had finally become livable again. And so, as I awaited July's arrival, my mood continued to brighten until, just days from the first, it finally erupted into the most severe hypomanic episode I'd suffered in years. 

While in the throes of a hypomanic episode, I am fortunate enough to avoid taking full leave of my senses; this state is lacking in the grandiosity of mania. However, I do become possessed of an amount of energy that far exceeds my capacity for containment. There have been many instances in which this aspect of the condition has come in handy, whereby a mild hypomania, triggered by a sudden realization or the generation of a rare good idea, facilitated a level of productivity lacking in the weeks or months that preceded it. There have been many more instances, however, in which I merely became too excitable for my own good. Rational thought is dispensed with, and poor judgment reigns supreme until the repercussions set in and bring me tumbling back to earth. The hypomanic episode that occurred at the end of June was neither middling nor extreme, but sufficient to leave me feeling exhausted for the few days that followed. 

The exuberance of that single evening left me weary, and emotionally raw. I remember the psychosomatic manifestation of the plummet quite vividly: my body aching and weak, my extremities numb, my heart feeling heavy and drained. Though on the mend two days later, I was still extremely vulnerable, having not yet found firm enough footing to contend with much of anything, and certainly not what eventually transpired.

It's here that I must resort to an obnoxious degree of vagueness. Given the presumably ongoing nature of the situation, it might not be in my best interest to go into fullest detail. Hopefully, it suffices to say that I witnessed a transgression being committed against those close to me and, despite having seen said transgression as it was in progress, have yet to find a just and proper resolution to the matter. You see, there's more to being an eyewitness than mere seeing. Although what I saw was plain enough for the average person, in the very technical and specific court of law it would, apparently, not have been enough. It took no more than a few seconds after hearing this for the self-recrimination to begin: I could have done more. I should have done more. I could have done a better job. It was my fault that nothing will come of this.

Of course this line of thinking is both natural, and irrational, yet it persisted. Helping to pick up the pieces in the aftermath of such violation, burdened with an entirely unchecked sense of guilt for my failure, and all of this being experienced in the raw and vulnerable post-episodic state...I was thrown headlong in the opposite direction, into an anxious depression which arrested my thoughts, abolished my focus, and left me unable to escape a compulsive revisiting of that day's events. Even in my sleep, I attempted to pursue the culprit, and even in the best of those dreams I still failed. Convinced by my therapist that no feeling can last so long as we hope or fear it might, I waited as patiently as I could for an abatement of this agony, always mindful of the month's impending closure, as a duration of longer than one month could mean a state of post-traumatic stress. I had to be mindful of how far I allowed this damage to go, lest it become just one more unanswered crime added to the list.

But there was hope—near the end of July, I found I could make it through most of the day without obsessing or brooding. I began to sleep again, and dream my own dreams. Before the month was out, I even experienced an entire day on which I all but fully forgot about these things well beyond the scope of my influence. Rational thought returned. What's more, August would bring with it a closure to matters that predated this terrible event, and would force us to leave the entire scene behind. I felt ready to move on, to move forward. As relief finally began to set in, I turned an optimistic eye to the new months' arrival—and was thus entirely blindsided by the new, and far worse circumstances it held...


Rising still...

To be continued...


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