Issues

Two Short Pieces

Musings on fate and accountability.

First Piece

Not long ago, Mary, who has had two full-blown manic episodes, posted this thoughtful and provocative comment on this website:

"The issue of personal responsibility during hypomanic and depressive episodes is critical - even if only to our justice system. Here is my take on it: Though I sometimes have felt quite out of control, even in serious fog, I find that certain REALLY important considerations can break through, such as the welfare of my children, basic compassion for my pets, the need to drive safely to not injure others, the need to not hurt others' feelings. Therefore, I have concluded that, short of raving psychosis, I must be responsible for my actions. I submit this because I see a trend toward using mood disorders as an excuse for all kinds of heinous behaviors."

She goes on to say: "Short of a frontal lobe injury or a documented psychotic episode, it would not be wise to count on the justice system letting anybody off when a bank is robbed or bankruptcy is declared. The issue of personal responsibility goes to the heart of who we believe we are - a pile of biochemical charged synapses, or thinking, soulful being? Don't neglect your soul while you are trying to find an admixture of pharmaceuticals that works for you."

There was something about what Mary said that jolted me into one of those Newton under the apple tree kind of revelations: Namely, what gets us into trouble much of the time is not doing wrong in a manic or hypomanic state, but committing an excess of doing right. We give things away, we give our employers incredible productivity, we embark on great projects, we light up the lives of others, and we pursue a spiritual path to its extremes. In these states of mania, our moral compass gives us a false reading - our actions and behaviors are in perfect alignment with that inner arrow pointing true. Something in our judgment is fundamentally flawed, but the mind in pure rhapsody over mania's great abundance abdicates its usual dominion.

Sooner or later, our doing right comes at the expense of someone else. The following was reported in the media where I live, so I'm not breaching any confidences here: A person in my support group had his first introduction to mania as a financial officer in a large corporation. He embezzled some $500,000 of his employer's money and gave most of it away to charity. If we are to accept Mary's view, the sheer immensity of this theft should have intruded a sense of reality into his otherwise delusional state. But what was his moral compass telling him? That he was a modern day corporate Robin Hood? That's how he described himself.

Suffice to say, he would have found no ready takers for an insanity plea. According to the NIMH, the insanity defense is used in the courts only one percent of the time, and is argued successfully only a quarter of the time. Two states - Montana and Idaho - have abolished the insanity defense entirely. Meanwhile our chickens come home to roost in the form of wrecked relationships, ruined reputations, unemployability, and impoverishment. As for the person in my support group, he accepted full responsibility for his actions and is now doing time. I'm sure he will be looking to put his life back together when he gets out. Unfortunately, I suspect his first job will
involve saying, "Do you want fries with that?"

Some days, accepting this illness can be a bit tougher than others.

Second Piece

Please," writes Daniel, "may I have my life back and start over again."

For more than a year now, readers have been posting their thoughts on this website, sometimes in response to the articles there, other times in response to specific questions, and other times still because they feel the need to be heard. Significantly, my readers are more apt to write about living with their illness than the illness itself. As BG describes it:

"It's humiliating to me to have to admit that there is something wrong with me mentally ... I hate living his way. I have hope that I can be fixed or healed, but how can I face the people I love and apologize for my behavior and ask for forgiveness?"

The isolation and loneliness can be worse than the illness. Christine writes: "I ended up losing my job, my boyfriend, making my kids feel confused and afraid. I am still trying to recover of all of it and unsure about the future." And in a similar vein, a year after being diagnosed with bipolar, Barry
writes: "I only just about manage to hold a job down. I'm frustrated that my boss and my co-workers are unable to understand how I feel and, as yet, have been unable to tell my family for the same reason - a lack of comprehension. I would just be told to 'pull myself together'. For the most part I feel lonely, isolated and paranoid of other people."

Some of us are fortunate enough to live and work in pockets of enlightenment. Anonymous writes: "I guess I have been luckier at work the past three years than for most mentally ill. My boss is understanding because she occasionally has to take time off for migraines ... As my boss pointed out to me, everybody has their limitations. She told me once I was the most stable one in the lab."

The knowledge that one is leaving Planet Normal for an uncertain destination weighs heavily on the minds of those considering seeking help. As Stacy explains: "I have my first psych appointment on Monday. I am scared, nervous and freaked out about everything. I feel like everyone around me doesn't care what I am feeling, especially my husband. I mean, I know he cares, but when I try to discuss things with him it seems like he tunes me out, looks right through me."

And the fearsome visage of the beast forces many of us to look away before we are willing to face it head on. In Jayme's words: "When I started going through my episodes of depression and mania, I explained it off. Even five years ago, when I attempted suicide and was committed for a week I wouldn't face it. As soon as I was free, I tried to pretend it wasn't real. That all came to a halt last Thursday. On the advice of a friend, I visited a psychiatrist he knows. He confirmed what I most feared: I am bipolar. Why did I seek help now? I'm tired. I'm tired of trying to fight alone. I'm tired of lying to myself."

Let us not forget the innocent bystanders, the families of those with mental illness. From Anonymous: "My dad quit taking medication about five years ago. He quit cold turkey. Today he says he is Jesus Christ and calls my mom the black eye devil and wants to put her six feet underground. He wants to kill her. He prays and shouts and listens to gospel music and turns it up as loud as it will go. My mom is out of the house now and is safe. We called 911 and they went to his house but did not take him. He needs help. Nobody will help."

Then there is the slow-motion suicide of Bridgette: "I am more tearful now than ever before, I see no hope in sight. I really believe that I would be better off dead, yet I am too cowardly to kill myself, so I turn to alcohol, and drugs I guess to slowly get rid of myself. I am worried for myself, as well as my children."

But the final word goes to David, who, in response to Bridgette, writes:

"It is a daily war against giving into the darkness. The impulses, and constant voices in your head saying how unworthy to be here, how unworthy of life push into you. But, each day we win, we survive, and those who have not these forces pushing them have no concept of how strong you are, we all are, for winning a war daily against things that would immobilize any of them. I have had family tell me how weak I am, and I know, in my heart anyway, that they would never get out of bed, if for a moment they were shown what really goes on inside. Each day we survive is another victory we can draw on. Don't give up on yourself. You're 37, that means many years of victories. We can't lose sight of what it means to live each day out, when your own body conspires against you. We are not weak. We are strong. By surviving, daily we show how strong we are."

Published 2002, reviewed Feb 11, 2008

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