I haven’t written a column here in some time. I haven’t felt like I’ve had anything to say. I still feel that way. Like nothing I say is important or matters. Sounds like I’m depressed. Everybody around me says I’m stable. My psychiatrist, my counselor, my partner and my friends all think I’m fine. And I guess I am. Only in so many other ways I’m not. I was originally diagnosed with bipolar II, with mixed states and rapid cycling. I’m not sure if I fit the technical criteria for mixed states and rapid cycling or not. But it sure is my lived experience. And it happens all the time, every day. Or so it seems. In actual fact I’m sure it doesn’t, but I’m often in a mixed state, and the mood changes often happen more rapidly than I can easily handle. It feels like I’m bouncing around all the time.
I’ve been keeping a mood chart lately. I’ve also been charting my pain level next to it. The two so often go together for me. It’s been interesting, even though it’s only been a month. I’ve broken up the days into two or three or four hour sections. I put down a word to describe my mood and a number for my pain level. My pain has been pretty consistent at six or seven. With a few jumps up to eight or more. But my mood descriptors have been all over the place. Lots of Good’s and OK’s. But most of the entries seem to say Mixed or Depressed. When I fill in the space at the end of the day for overall mood and pain levels I have a lot of Seven’s and Mixed’s. What I want to focus on here are the Mixed days.
In bipolar disorder a mixed mood basically means you experience both the highs and the lows at the same time. That’s been a significant part of my experience for months and months now, maybe years. I’m not there all the time, by any means. But I’m there way too often for my comfort. I can be having a wonderful, cheerful conversation with my partner about how beautiful the garden is, while my internal dialogue tells me I don’t deserve to live in such a beautiful place or have such a lovely garden to tend. This constant back-and-forth makes me feel unsettled much of the time. Add to that the crippling social anxiety I experience as part of the PTSD, and the bipolar fueled rage that makes me feel like exploding half the time, and you can see why it doesn’t feel like I’m doing as well as I appear. And underlying it all is the constant low grade depression of the dysthymia. I may look fine but inside I too often feel like a basket case.
Fortunately my high times don’t ever approach major hypomania these days. But in my low times I go as deep as I’ve ever gone into the depths of depressive despair. In seconds my heart can plummet to the floor and my outlook becomes unbearably bleak. By then I can be in full suicidal ideation mode. Often there’s a trigger that sets me off, but just as often there isn’t one. To me it feels like it just happens in an instant, without any conscious thoughts on my part whatsoever. It’s very hard to pull myself out of that state. But I do it every time I have to, every day. Right now I wouldn’t even try to pretend I’m not depressed. I’ve been this way for a couple of days. But even now, if it was required, I could pull myself out of it and act normal, at least for a little bit. That’s why everyone thinks I’m fine. I maintain too well for my own good.
In reality it’s a lie I perpetuate out of shame, fear and embarrassment. At the moment I’m experiencing all of those emotions as I prepare to continue writing this piece. Because, as much as I’m embarrassed and ashamed to say it, I still don’t think I’ve come to terms with this fucking bipolar disorder. It will be 24 years next month since I was diagnosed. I thought I’d dealt with this and had come to terms with having this illness and accepted it years ago. Now it feels like I didn’t really get rid of the fear at all. In some ways the longer I’ve known I’ve had this disorder the more afraid of my perceived mental deterioration I’ve become. I say perceived because I know my brain itself is just fine. It’s my thinking that is disordered. I feel stupid. I know I’m not. But right now I feel ashamed of having bipolar disorder, especially the depression. And that’s just stupid.
As a gay man I know that coming out is a life-long process. The same is true if you have a mental illness. You may think you’ve come out but then you find yourself in another situation where you have to come out again. This has happened repeatedly for me as far as being gay. It’s not really an issue for me here in liberal Seattle, but when I go to conservative Eastern Washington it’s a very different story. It’s even more so for mental illness. Again, especially for depression. When I’m hypomanic everybody loves me because I’m charming, cheerful, charismatic, positive and full of life. When I’m depressed I’m afraid to even tell anyone because I feel so negative and boring. I’m sure no one really wants to even be around me. That often includes my partner Louie. I know he’ll love me forever regardless of my emotional state. But I’m still terrified that I’ll burn him out on me if I’m too depressed too much of the time. I know that’s crazy thinking, but it’s got me bad. So I hide my feelings, even from him.
If I feel afraid of burning out Louie, imagine how I feel about my neighbors and people in general. I’m bloody terrified. Most people still think depression is a failure of character or will power. Of course I know that’s nonsense. But it doesn’t stop me from buying into their opinions in some situations. When you’re already feeling vulnerable it seems crazy to make yourself even more vulnerable by acting depressed. People think you’re weak if you’re depressed and when you’re already vulnerable you can’t afford to look weak. This attitude seems to be shifting a bit in our culture now. But our cult of pull-yourself-up-by-the-bootstraps rugged individualism is still too strong to allow for those of us with depression. It takes a lot of guts to be who you are in this world. I say this as a privileged white boy. Imagine how much worse it is for a person of color, a woman, a trans person or anyone else who doesn’t fit society’s definitions of what it means to be a man, a woman or any other sexual identity. Or what it means to be mentally healthy and functional.
Everyone I know would tell you that I’m a high functioning individual who just happens to have bipolar disorder. That’s what they see and I have no desire to try to change those opinions. Except I sort of do. I want to feel free to exhibit my depression whenever I feel it so strongly. I want to be real and true and honest about who I am. But I’m scared. I’m afraid people will think less of me if they see me being depressed. I have what is often called a shame-based personality. That doesn’t mean I feel ashamed all the time, but when I do it can be overwhelming. I once told a counselor that I thought shame had stopped me from becoming manic at times. He laughed at me and told me mania was too strong to let shame stop it. I’m sure that’s true for full-blown mania. But shame has definitely kept me from acting out some of my worst hypomanic impulses. In some ways it has actually protected me from losing it. What a weird fucking paradox.
I rarely feel much strong hypomania these days. But even so when I’m feeling really really good I tend to ascribe it to hypomania rather than just a good mood. I don’t really act out the grandiosity but I certainly think of myself in that way at those times. A part of me still thinks I’m hot shit. It feels good to feel that way, which is why people like mania. Especially since I’m depressed so often. I can still go way overboard with the hypomania if it strikes me that way. My “episodes” rarely affect me for just the four day criteria needed for a diagnosis. They tend to be more diffuse and spread out over days, weeks, months and even years. A couple of years ago I spent about three months in a hypomanic state that I didn’t even know I was in until it was over. Balancing my checkbook was the clue that I’d really overdone it. I was chagrined and embarrassed that I had let myself get so carried away. Because underlying the hypomania was the usual depression, and I really didn’t feel that good about myself. I was in a mixed state.
I hope I’ve given you some idea of what it’s like to live with mixed states. As I’ve said, it can be a real challenge. In my high times I tend to do things and make promises that when I’m depressed just fall apart. I’ve always tried to be a very responsible person and to walk my talk. I think I’ve mostly been pretty good at that. But as I look back over my life I see so many times that I blew it. In fairness to myself I also see plenty of times that I did OK. Most of my life I’ve lived in a hypomanic haze, with periods of depression now and then. I’ve been able to function really well and I’ve created some good things in my time. But the last 24 years have been really hard. I haven’t been able to hold a real job in that time, even though I’ve done some good work now and then. This really affects my self image. I feel like a failure even though I know I’m not. Feeling good, feeling bad, feeling good, feeling bad – it’s a constant merry-go-round of emotion, especially when both things are happening at the same time.
My hope is that I will continue to learn that when I’m in a mixed state I need to moderate my behavior as much as I do as when I’m depressed or manic. Sometimes I think I’m doing really good at that. I’m depressed right now so everything looks pretty bleak. But if I know anything about depression, I know that it doesn’t last forever. One of these days I’ll start feeling better again, maybe even today. Mixed states give me a different perspective on reality than most people get to have. Just having bipolar does that. So I could view all this as a good thing. I’m trying hard to do that. Sometimes I’m even successful. I hate to be trite, but yes, there often is a silver lining. It’s pretty dim right now but with any luck it will get brighter in the near future. I won’t say I have much hope, but I do know that the wheel of life keeps turning, and sooner or later it’s bound to come up roses.
With mixed emotions,