What is bipolar disorder?

Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Symptoms of bipolar disorder are severe. They are different from the normal ups and downs that everyone goes through from time to time. Bipolar disorder symptoms can result in damaged relationships, poor job or school performance, and even suicide. But bipolar disorder can be treated, and people with this illness can lead full and productive lives.

Bipolar disorder often develops in a person's late teens or early adult years. At least half of all cases start before age 25.¹ Some people have their first symptoms during childhood, while others may develop symptoms late in life.

Bipolar disorder is not easy to spot when it starts. The symptoms may seem like separate problems, not recognized as parts of a larger problem. Some people suffer for years before they are properly diagnosed and treated. Like diabetes or heart disease, bipolar disorder is a long-term illness that must be carefully managed throughout a person's life.

Note: 

The terms "manic depression" and "bipolar disorder" are synonymous. The latter is preferred. The illness is a mood disorder in which patients alternate between severe depression and mania (some examples of mania are having ideas of grandiosity, taking dangerous risks, and spending large sums of money). It's a serious illness; people experiencing severe depression can be at risk of suicide. Although there is no cure, there are medications that can help control the symptoms. Anyone who suspects that he or she has manic depression should see a medical professional immediately.

http://chronicle.com/article/Mania-AcademeRedemption/124570/

September 26, 2010

Mania and Redemption

By Eric G. Wilson

Close to midnight, about a year after the birth of my child, I found myself, once again, shocked awake. My wife and daughter were sleeping in the bedroom upstairs. I was lying alone on the floor of my study, and I quickened for what was coming: the electric desperation to heave myself upright, flick on the lights, fire up my computer, and convert my brain's rising mercurial spirits into words, luminous and sharp—typing, click-click-click, until my wrists cramp and the sun climbs and I don't hear my family rise and my head feels feverish and I stare at the sentences I've made and try to shut my eyes but can't.

I craved this consuming surge, even though it would ruin my morning class on Coleridge, the departmental meeting I had to chair, and my afternoon child-care session. I had to have this productive rush, or I would lie there in the colorless air and become the emptiness, devoid of care for anything.

There was either more—more writing, more promotions, more honors—or nothing. There was the push of Faust—strive higher—or the negation of Godot: Why bother?

Such was my unreasonable rift during the worst of my disease: that laceration that psychiatrists call bipolar disorder. Since college, that mental illness had prodded me into a vicious, futile, exhausting battle between monomaniacal mania and solitary despair. Not surprisingly, the conflict had severely damaged my life, alienating me from my wife, goading me toward alcoholism, and tempting me with suicide. But my condition, miserable though it was, also offered what I erroneously thought was a major boon: early and continuing academic success.

When the depression dominated, I descended into extreme apathy. The leaves of springtime elms, brisk bluish flies, my toddler's first triumphant stumbles—all of these were ciphers, ennui's clutter. But when the mania kicked in—and it did, frequently, in my rapid-cycling variation—my whole heart howled: The world was not vapid then but monumentally significant, a profound drama of struggle and reward.

The mania pushed me into increasingly ambitious goals. I welcomed the price I paid in loneliness, delirium, and constant fatigue for straight A's, fellowships, a publishable dissertation, and a tenure-track job at a prestigious university, followed by well-reviewed monographs and articles in distinguished journals, early tenure, a quick promotion to full professor, and then a fast advance to an endowed professorship.

My storming of academe began, innocently enough, when, at 18, manic for success in sports as well as academics (and not yet diagnosed), I applied to and was accepted at the United States Military Academy. I was at West Point only hours before I concluded, in a rare moment of clarity, that the military was not for me. The academy required new cadets to remain at least 30 days, so I had to endure basic training before I could leave. For me, the strain of training was exacerbated by the depression into which I soon fell. Disheartened, confused, and unable to sleep, one night I retrieved the only book I had brought with me, hoping that reading would calm me. All I knew about the volume was that it had a picture of Bill Murray on the cover. My mom had bought me the book as a going-away present, assuming that it was about my favorite actor.

As I made out the pages, barely, by the moon and the light on my digital watch, I realized that the book wasn't devoted to Murray at all. It was The Razor's Edge, by W. Somerset Maugham, the novel on which the actor's latest film had been based. The story enthralled me. Its protagonist, Larry Darrell, was a young American who suffered trauma in World War I and returned home feeling unhinged. He read philosophy voraciously, rejected a high-paying job in a brokerage firm, broke his engagement with a gorgeous socialite, and embarked on a quest for enlightenment.

The character catalyzed an identity that had lain dormant in me, one that could reject societal conventions to sound the mysteries of the soul. By the time I finished the book, I was no longer uncertain about my resignation from West Point. I was keen on a higher calling—the hunt for healing knowledge. My path was clear: I would study literature and philosophy and become a professor. I had it all figured out.

I held to my plan, but failed to mirror Maugham's sage protagonist. Hounded by my mania, I perversely torqued books into vocational tasks. Writing was not an organic process for me. Once I became an assistant professor—that happened in 1997—I felt I had to subdue texts, corral them into interpretations that I could discipline into legitimate scholarship.

I awoke each morning at 5 and wrote until 8, even when I was depressed. After a six-mile run and breakfast, I went to the campus, where I divided my time between teaching and research. I usually returned home around 7. My goal was to complete one book manuscript per year that would then be published by an eminent scholarly press. I also hoped to turn sections of these books into articles—at least three a year—that would gain acceptance in reputable journals.

I almost reached those unreasonable goals. By the time I had been a professor for eight years, I had published six monographs and 21 articles. The work, by scholarly standards, was commendable, leading to awards, invitations to lecture, and a prominent fellowship.

Obviously, I was obsessed with work because it repelled the worthlessness I frequently felt. But my intensive labor also defended me against overwhelming sadness—about my sundered life, my suffering marriage, my loneliness. The grinding exertion, mechanical in its monotony, kept my focus away from my unruly and potentially debilitating emotions and furthermore gave me the illusion of total control. No feeling, I believed, could derail my engine.

If vulnerability is what makes us human, inspiring hunger for love and the ability to empathize, then I, in refusing to acknowledge my insecurities, was monstrous, a machine with a moribund soul, a man with cogs for organs.

In 2002, when my heart was almost congealed, my daughter was born. I did not rejoice. With my work habits threatened by the duties of parenting, I doubled my labors, thus impoverishing my fatherhood and further blighting my marriage. I wanted to die. When my daughter learned to smile, I began to grin at her, hoping she would respond in kind. My jaws were sore for days. Once I caught my grin in a mirror—I looked deranged.

After much resistance, I joined a therapy group, and it was there that I was finally called out, broken, and exposed. A woman in my group told me that my self-absorption was murdering my daughter. "It's men like you who ruin the world," she said. "You're a piece of shit."

I had been slapped awake. Whatever its origin—be it genetic or environmental or a series of bad choices—my depression had, through its debilitating fluctuations between torpor and anxiety, hindered my ability to reach imaginatively beyond myself to empathize with others and thus kept me isolated and divided from those with whom I might enjoy mutually rewarding relationships. I had been stupid and blind not to see it. Kierkegaard is right: "What characterizes despair is just this—that it is ignorant of being despair."

At last, on my own initiative, I visited a psychiatrist, who diagnosed me as bipolar, prescribed an effective combination of drugs, and recommended a good psychotherapist.

One morning I walk in a park with my 3-year-old daughter and we see a mole disappear into the ground. Another time I am alone reading Coleridge's "Frost at Midnight," a poem about a rueful father's affection for his infant son, and I want to cry, so intense is my longing to be with my own child. Such occurrences began to soften my carapace.

I entered a season of epiphanies, each catalyzed by the literature I had tried to harden into rungs on my career ladder. Keats's "Ode on Melancholy" taught me that there are degrees of gloom: depleting despair, yes, but also melancholy, a richer state, attuned to the mournful marriage between death and beauty. The fragility of the morning rose moves us to appreciate its brilliance right now, before it's too late. This was a category of sorrow that encouraged me to find in my affliction moments of loveliness.

Around the same time, in preparing a class on Emily Dickinson, I came across this line: "Water, is taught by thirst." Lack here is not a hole in the soul but emptiness that informs us of the nature of fullness. Why couldn't, in my case, alienation turn into empathy's mentor?

It was Blake, though, who shattered my shell. Four years ago, in 2006, when my daughter was still 3, I was drowsily reading the poet on a dreary February afternoon, when this passage startled me: "Mutual Forgiveness of each vice, / Such are the Gates of Paradise."

It occurred to me that forgiveness is a way of knowing. When we forgive someone, we suspend judgment, refusing to reduce the person to either his or her transgression or a fulfillment of our sense of right. We try to witness him as he is, free of our own prejudices, fears, desires, and hang-ups. Doing so, we open to the irreducible complexity of this particular being and to the exuberant intricacies of the universe. We get close to the real—not stable substance but sublime possibility. We experience paradise: the infinite in the finite, the "World in a Grain of Sand, ... Heaven in a Wild Flower."

Blake made me think that I might actually forgive my bipolar disorder, weird as that sounds, and, in forgiving myself, enjoy a more capacious existence. For most of my adulthood, I had blamed my depression for my inadequacies—my workaholic habits, for example, and the attendant exhaustion, irritability, and selfishness. I had turned my depression into the sinister source of my woes, a vigilant tyrant.

Now I tried to suspend that negative projection and so liberate my mental illness from demonization and myself from subjection. I soon understood that my sickness isn't a curse but a part of me no different, in a way, from my hands or my lungs—an element of my constitution, no more and no less. I also sloughed off victimhood and gained some agency, realizing that I could exert a degree of control over my condition, creatively inflect it one way or another, and be responsible for the results.

Stripped of its dictatorial force, my manic depression showed positive potencies counterbalancing its negative ones. It had made me contemplative, for instance, pushing me into desolate places where I gained knowledge that otherwise would have eluded me. It had revealed to me what I most needed to become human: vulnerability, the need to love and be loved. Most important, it had disclosed to me the requirements of fatherhood and the beauties of my daughter.

The scholarly calling that almost killed me restored me to life. For years, academe had proved a perfect breeding ground for my mania, an arena that rewarded the obsessive egotism that divorced me from my emotions. Indeed, the academic environment in which I strived rarely displayed generous humanism. It was mostly a sphere of brutal competition where intense careerism pushed aside the pursuit of truth.

But the wisdom books abide in their abundance, regardless of our petty condensations. Their glorious passages recall us, in those moments when we are charitable, to the reason we chose to be scholars in the first place: We wished to emancipate the world from despotic ignorance. Certainly my own learning, in fortunate instants, liberated me from deadly blindness and granted a more genial vision.

Eric G. Wilson is a professor of English at Wake Forest University. This essay is adapted from his most recent book, The Mercy of Eternity: A Memoir of Depression and Grace, just published by Northwestern University Press.

Book Description:

http://www.amazon.com/Mercy-Eternity-Memoir-Depression-Grace/dp/0810126850