My Experience Only. YMMV.

Posts tagged ‘books’

Depression, Mania, and Mystery

Writing a book takes a certain amount of mental stability. Also, you have to be a little crazy.

Despite the fact that in the popular imagination, creativity is linked with insanity, having a mental disorder is not all that conducive to productive work, particularly to the sort of sustained, focused writing that a book requires.

Still, bipolar, OCD, schizophrenic, and other writers have managed to write books – and some very good and highly acclaimed ones.

I have taken on that venture myself. I am writing a book.

Now, settle down. I am not (yet) asking you to buy this book. It is still only a book in process. Nothing has been published. Maybe nothing ever will be. Nevertheless, I persist.

Actually, I have two books in the works. One is out of my hands now. It is languishing at a publishing company, where it has languished for a year, waiting for them to determine if their interest in it will lead to actual publication. That book is a memoir of sorts, based on these blog posts. Unless I want to start pimping it to agents and other publishing companies, there is nothing more to do with it right now.

In the meantime, my attention has turned to the other book. It is a mystery, and has nothing to do with bipolar disorder. Except that the writing of it has everything to do with bipolar disorder.

First depression. Depression is great for writing certain types of scenes – deaths and reactions to them, for example, which are good for mysteries. Depression, however, periodically leads to the “this book is shitty” phenomenon, which I understand is not exclusive to depressive writers.

When depression leads me into that trap, I stop writing. Instead, I do “research.” If I am not too depressed to read, I delve into books about the craft of writing – plotting, description, etc. Or I study the works of writers that do things exceedingly well – dialogue, word choice, narrative voice. I highlight examples of good technique. Then, at some point the depression lifts and I try to put what I have learned into my manuscript. Of course this means lots of rewriting and revising, which slows my progress, but, I hope, makes the manuscript better.

Then there’s mania. Or at least hypomania, in my case. It carried me through the first eight chapters of the mystery before the depression hit. If it’s a truism that depression lies (it is and it does), mania is a liar as well. Recently I was tootling along at about 500 words per day, and it occurred to me that, at that pace, I could reasonably expect to have a rough draft by July 4, ready to send to my beta readers.

This was mania talking. Lying, rather. In fact, there was no way I could maintain the pace, meager though it was, of 500 words per day and not a chance in hell that I could meet the self-imposed deadline.

What came next? More depression, of course. More research, this time into how various authors use dialogue tags. And a confusing attempt to improve the pacing by scrambling the order of the chapters.

Until writing mania sets in again, I plug away at scenes I know need to be written, even if I don’t know where they go, and keep my eyes and ears open for both the depressive lies and the manic ones. I have over 45,000 words written and refuse to abandon them now.

So I don’t know all that much about whether bipolar disorder is a help or a hindrance to creativity (I would suspect it is both), but I do know that it is possible to work around it.

Eventually, if I’m lucky and persistent, I’ll ask you to buy my books. Someday.

Bipolar Robbed Me of Reading

I don’t remember a time when I couldn’t read.

Except when bipolar disorder took it away from me.

I was what they call a “natural reader” – someone who learns to read without being taught. Someone who just picks it up out of the air. And for me, reading was like breathing. It kept me going, kept me alive. Reading was part and parcel of my identity. I was never without a book within reach. I read while eating, walking down the hall, going to sleep, riding in a car.

Throughout my undiagnosed childhood years, reading was a way for me and my brain to play nicely together. If I was depressed, I could lose myself in escapist fantasy. If I was hypomanic, I could soar on adventures. And during the in-between times, I had access to unlimited worlds – places, people, situations, ideas, conversations – both familiar and strangely new. Reading was my joy and my solace.

For many years, reading was therapeutic. I could not only lose myself and escape the unpleasantness of my disorder for a time, I could learn more about depression and bipolar disorder, compare my experiences with those of others who struggled with mental illness, discover how medicine and law and psychology and sociology could shine a light on my experiences. I could even (God help me!) read self-help books, which were popular at the time, and learn all sorts of theories and techniques that didn’t improve what was wrong with me.

Books and words were my life. I got degrees in English language and literature. I read for work and for fun. I edited magazines, wrote articles and (occasionally) children’s stories, worked on textbooks.

Then my brain broke and reading went away.

I had a major depressive episode, which lasted literally years, and during that time I found it nearly impossible to read.

Why? My old companions, depression and hypomania.

Depression made me dull. I didn’t care about anything and found no happiness even in the books that had always been my refuge. I remember picking up a book that I more than loved and had returned to dozens of times, that had shaped my life in many ways, thinking that the familiar words would touch something still buried inside me. But this time there was no magic. Not even interest. The words were flat and dull, mere ink on the page. Reading – engaging with an author’s ideas, imagining characters, following plots and dialogue, discovering facts – was beyond me.

And hypomania? My version, instead of bringing euphoria, brought anxiety – an overwhelming twitchiness and fear of the unknown, jumping not just at shadows, but at the idea of shadows, things that had never happened. My attention span shrank to nearly nothing. I could barely read a few pages, not even a chapter, and when I was finally able to get back to a book, I was lost, disconnected.

Now that I am recovering from that episode, I am glad to say, I can read again. I read myself to sleep at night once again instead of crying myself to sleep. I devour entire chapters, keep at least two books going at once (one fiction, one nonfiction), delight in revisiting old favorites and seeking out new authors and genres (YA fiction and steampunk) and topics.

Not everything I read is uplifting. At the moment I’m deep in Octavia Butler’s Parable of the Talents, a post-apocalyptic science fiction dystopia that is eerily prescient for a book published in 1998. But I can tell when it’s getting too deep and frightening and switch off to Jasper Fforde’s Thursday Next literary fantasy Lost in a Good Book before the strife and struggle can drag me down.

And I can tell you this: It’s better to be lost in a good book than lost in your own broken brain.

 

A Bipolar Child

I suppose I was a bipolar child. I don’t really know, but I assume I was, because now I’m a bipolar adult.

I think I was more of a depressed child, which actually makes sense, since I have bipolar 2, with depressive episodes far outnumbering hypomanic ones. There were some times, though, when I would laugh loudly and inappropriately in class, triggered by a word that reminded me of something funny I’d read. There were times I’d walk around with a village-idiot grin because of some minor accomplishment like winning a live goldfish at a school fair.

Depressed child with toyBut mostly I remember misery. Tears. Loneliness. Hysterics. Confusion. Isolation. Hurt. Despair.

I’m fairly sure my depression wasn’t reactive, mostly, although parts of it surely were. The bullying, betrayals by friends, not understanding social conventions – all these were things that could easily make a person depressed, regardless of brain biochemistry.

But by and large my life was what would be considered pretty damned idyllic. I had stable, loving parents, a comfortable home in the suburbs with good schools, all the food I wanted, and as many toys as I could play with. I had a sister and a neighborhood full of children my age, but I remember being perpetually lonely. I had a good education, but looking back I realize that my illness prevented me from getting the most from it. There was no sexual or physical abuse or neglect. No one close to me died or suffered major trauma, at least until I was in high school and my parents suffered illnesses. Even then, they did a good job of keeping life as normal as possible. At the time we never felt it was a tragedy. It was just something we got through together.

That just leaves endogenous depression. Or at least the depression half of bipolar disorder. I remember one day walking home from elementary school and thinking, “All these houses look so pretty, but the people in them aren’t all happy.” It was somewhat of a revelation to me.  I had several major meltdowns, which I’ve written about before, and hundreds of smaller depressive episodes (http://wp.me/p4e9Hv-6J). I had nervous twitches and tics, and was prescribed Valium for them.

During my high school years, it was suggested that perhaps I ought to go to the school district’s psychologist. (This was probably during the episodes of inappropriate laughter in class.) My parents, who were not really familiar with mental illness and psychiatry, asked me if I wanted to go. I didn’t. I probably should have, although back then – the seventies – it’s fairly unlikely that I would have been diagnosed with bipolar disorder, of any type. I might have gotten some help for the depression, though. They might have taken me off the Valium.

Like most lonely and misunderstood kids, and perhaps most depressive children, I found my salvation in books. They were friends, distractions, instruction manuals on how to survive, food for my emptiness, a place to lose myself when the world was too much with me. By and large it worked, at least as well as anything could – a self-prescribed and self-regulated form of instinctual bibliotherapy.

These were not books on how to make friends, or ones that promised to teach a child how to cope with emotions. They were for the most part pure escapism. Fantasy and science fiction, mysteries and adventures, literature and bestsellers – a complete mishmash of classics and trash. Those were my doctors, my therapists, my Prozac, my mood stabilizers.

I look back now on myself as a child – mentally disordered, undiagnosed, untreated – and wonder how I survived  as much as I did.

If I were a child these days, would I get the help that I needed then? Would my parents recognize that I was not just odd and unhappy, but mentally ill? Would I have been diagnosed properly? Medicated properly? Counseled properly?

With all that needs to go right and all that can go wrong during the process, it feels like getting help for a bipolar child certainly was – and perhaps still is –pretty much of a crapshoot. I made it through, but I hope it’s easier for a kid like me these days.

 

What Is Sanity?

And who is sane?

Negatives Positives Computer Keys Showing Plus And Minus Alternatives Analysis And Decisions
These are questions you don’t hear much anymore, at least outside of judicial proceedings. Even there, the phrase “guilty but mentally ill” is gaining currency. “Not guilty by reason of insanity” made people think a criminal was getting away with something. And indeed, the “insanity defense” has been misused.

We’re much more comfortable talking about health and illness, concepts we all understand, than about seemingly fixed states like sanity and insanity. They sound so final. At least illness can be treated; health can improve.

Before the deluge of psychiatric labels and the DSM, how to tell if a person was sane or insane was a vital question. The insane were put away – in an asylum if they were poor or kept discreetly out of sight at home if they were wealthy.

But were all the people in asylums insane? And what kind of treatment did they receive? Investigative journalist Nellie Bly determined to find out. Her 1887 exposé Ten Days in a Madhouse was a muckraking revelation.

Bly feigned amnesia and delusional fears, was reported to the police by her landlady, and declared incurably insane.

While she was at the Women’s Lunatic Asylum on Blackwell’s Island, she experienced cold, hunger, brutality, and no diagnosis or treatment. Several of the other inmates were, like Bly, sane by any modern standard, but poor, friendless and alone. The newspaper she worked for arranged to have Bly released, but the other women remained to be beaten, choked, starved, humiliated, not treated and driven insane if they weren’t already.

Bly’s ordeal and testimony did prompt a grand jury to recommend an increase in funding of $850,000 – quite a large sum in those days – for the Department of Charities and Corrections, which oversaw asylums. (It is ironic to note that the word “asylum” originally meant a place of protection, safety, or shelter.) But it mainly went for better physical conditions – warmer clothes, edible food, more and better-trained nurses – rather than actual diagnosis and treatment of the women’s “insanity.”

The question of who is sane and how you can tell was revisited in 1973 by psychologist David Rosenhan. A professor at Stanford University, he devised a simple experiment. He sent eight volunteers, including both women and men, to psychiatric hospitals. Each person complained of hearing a voice saying three words – and no other symptoms.

All – all – were admitted and diagnosed, most of them as schizophrenic. Afterward, the “pseudopatients”  reported to their doctors and nurses that they no longer heard the voices and were sane. They remained in the psychiatric wards for an average of 19 days, beating Nellie Bly’s experience by nine days. They were required to take antipsychotic drugs as a condition of their release.

Rosenhan’s report, “On being sane in insane places,” created quite a stir. Indignant hospital administrators claimed that their staff were actually quite adept at identifying fakes and challenged Rosenhan to repeat the experiment.

This time hospital personnel were on their guard. They identified over 40 people as being “pseudopatients” who were faking mental illness. Rosenhan, however, had sent no volunteer pseudopatients this time. It was a dismal showing for the psychiatric community.

Times have changed, of course. Few people are confined in locked wards for life. Diagnosis is, if not yet a science, less of a guessing game, backed up by the DSM and assorted checklists of symptoms. And insurance companies hold the keys to psychiatric units as much as medical personnel do.

Still, the fundamental questions remain. Are neurotics sane and psychotics insane? I have bipolar 2. Am I mentally ill? I would have to say I am, since my condition will require treatment, barring any dramatic scientific advances, for the rest of my life. And my illness does affect my ability to function “normally.” Yet I think that few would consider me insane (unless I were suddenly to start shooting people in a public place, of course).

Speaking freely about mental illness and mental health is, presumably, supposed to make such disorders more understandable, less fearsome, less stigmatized. I suspect, however, that there are those who would rather we remained out of sight – if not locked away in asylums, then restrained in the virtual straitjackets of strong psychotropic medication.

And while group homes and other sorts of assisted living situations are now more available (though not nearly as accessible as the need for them would require), the general public prefers that such facilities, along with halfway houses for addicts and parolees, be constructed “NIMBY” – Not In My Back Yard.

Out of sight, out of mind.

Maybe the conversations surrounding such issues are reducing the stigma of mental illness, or insanity, or whatever you choose to call it, but I’m dubious about the level of success. There’s still a long way to go.

 

Trigger Warning: Trigger Warnings

What is a trigger warning?

Let’s start with a more basic question. What is a trigger?

Just as a literal trigger activates a gun, a figurative trigger activates your mental disorder. It’s a stimulus that sets off either a manic or depressive phase, or a bout of PTSD.

Triggers are usually unique to the individual. What sets you off may not affect me at all.

Over the years I’ve learned what my triggers are, and so do most bipolar or PTSD sufferers. Loud noises and large crowds trigger my anxiety, which is why I could never work at a Chuck E. Cheese. My depressive phases don’t often have triggers except for bad dreams about an ex-boyfriend. Most of my depressive episodes just happen without a trigger.

Generally, one avoids triggers, because who needs more manic or depressive phases in addition to those that occur naturally, with no prompting?

A trigger warning is something else. It is a notice that someone puts at the beginning of a piece of writing to warn readers that the subject matter may be intense. Ordinarily, trigger warnings are given for major life events that have caused trauma and may cause flashbacks, severe stress  or other extreme reactions.

Some of the most common trigger warnings are for graphic depictions of rape, suicide, self harm, or physical or sexual abuse. The trigger warning says to a potential reader: If you don’t want to encounter this material, if you think it will make your illness worse, or cause you undue stress, don’t read any further.

Although we call relatively minor stimuli triggers, they usually do not require trigger warnings. If you’re going to write about having a fight with your mother, you probably don’t need to put a trigger warning on it. If your mother hit you in the face with a frying pan and sent you to the ER, you might need to place a trigger warning on your post about it.

Online, the standard form for trigger warnings is first to state, often in all caps, TRIGGER WARNING and state the type of trigger it is – TRIGGER WARNING: SELF-HARM, TRIGGER WARNING: SUICIDAL THOUGHTS, etc. To be extra sensitive, the writer leaves a number of blank spaces or a few dots before beginning to write the difficult material. This gives the reader the choice of whether to scroll down and read it or not.

Trigger warnings have become controversial, particularly in schools and colleges. Many pieces of literature and even textbooks on history or sociology discuss difficult topics that may be triggering. For example, a novel might feature a rape as a plot point, or a history text might discuss slavery.

Some people believe that a trigger warning will help a prospective reader know whether reading further will provoke a strong reaction. Other people believe that trigger warnings are a way of coddling the weak and letting students avoid challenging material that is necessary for the class.

My own opinion is that a trigger warning is like chicken soup: It won’t hurt and might help. It may mean that a student asks for an alternative reading or assignment, but it also may mean that the student simply wants to be in a safe space – not surrounded by strangers, for example – before reading the material.

People that believe trigger warnings should not be given have usually not experienced the kind of emotional breakdown that can result from unexpectedly confronting a traumatic topic. Very likely they have never even been in the presence of someone who has had such an extreme reaction.

I suppose that ideally, we could all read any material and simply brush it off if we found it troubling. Unfortunately, for those of us with mental disorders such as bipolar illness, PTSD, and anxiety disorders, this is simply not possible. A trigger warning may prevent someone from having a public meltdown and others from having to witness one.

I don’t know why that should be controversial. It seems like simple courtesy to me.

Those Science Fiction Crazies

There has recently been a huge kerfuffle in the science fiction community regarding the Hugo Awards. You don’t really need to know much about it and probably don’t want to. Suffice it to say that two groups had it out over the past and future direction of science fiction and fantasy, and the meaning of the asterisk.

The awards have now been given, but still the blogosphere is full of recriminations, sour grapes, and schadenfreude.

What does this have to do with mental health? Aside from the fact that very smart people can behave like vicious toddlers, it’s interesting to note that the various sides in this dispute did not always, shall we say, acted rationally. You probably guessed that from the asterisks.

This phenomenon is not unique to the Hugo Awards. If you have never been to a science fiction convention, let me tell you about it.

Most of the people there will be very intelligent, obsessive about their particular fields of interest, lacking in social skills to various degrees, and will have a history of being outcast or bullied in their youth.

Does any of that sound familiar?

I’m not a psychologist (nor do I play one on TV), but I can’t help thinking that if you tested everyone at one of these events they would score higher than a random group of people on the autism spectrum. Simply put, the SF community appears to have more than its share of Aspies – and a fair sprinkling of bipolar, depressive, and OCD people.

When their oddities are carried to the extreme – and they often are – SF fandom can devolve into incivility that results in unconscionable threats and exceedingly ugly online behavior.

When you see these kinds of behavior, it is tempting to dismiss science fiction fans as being the caricatures that the media have instilled in us – clueless losers who live in their parents’ basements, show up at jury duty dressed in Star Trek uniforms, and insist that Harry should have ended up with Hermione.

Admittedly, to a certain extent that is true. If you look around at a convention you will almost certainly see a number of people who conform to that stereotype. I myself have a relative who could be Queen of the Get-a-Lifes.

What you may not see is that, despite the cluelessness, rudeness, sometimes elitist or misogynistic behavior, obsessiveness, and disregard for the feelings of others, the science fiction community is actually, at heart, a place where the non-typical person can find a group of like-minded individuals to talk with, obsess with, bond with, and occasionally practice social skills with. It fullfills a very real social and psychological need. Without the science fiction community, whether online or in “meatspace,” many of these people would have little or even no place to have much of a social life at all.

Certainly the stereotype is not true of all members of fandom. Most hold regular jobs in technical, creative, or other fields, have families and close relationships, and negotiate their way through modern society as well or poorly as anyone else. But there are consistencies in their background. Most are incessant readers and have been since childhood. Many have been the targets of cliques in school and the workplace. A number would be described by their neighbors as quiet loners (though this is not to imply that SF fandom harbors more spree killers  than any other group). They have odd senses of humor or in some cases none at all. In a very real sense, sf fandom is for them, as one song would have it, made up of “My Thousand Closest Friends.”

So if you happen to be in a hotel and find the meeting space is overflowing with people dressed as Klingons, robots, and giant furry animals, remember that they are mostly harmless and enjoying a moment of fitting in to a part of society that celebrates and honors their differences and shares their pride in their oddness. Where they can relax and be themselves, without worrying about seeming weird or threatening or being put down, avoided, or scorned. Think of it as a support group with parties, art shows, panel discussions, music, costumes, movies, and chocolate.

A lot of us with mental disorders are glad to know that such places exist. A lot of us wish we could find or make such places, too.

Maybe Another Manic Monday

The great Abilify experiment continues. I’m still roller-coastering, which is “normal” for me, but I really can’t tell whether the drug is affecting the ups and downs.

The highs and lows do seem to be higher and lower (respectively). I am dubious about this being a Good Thing. For several days I was so thoroughly depressed that I was ready to call Dr. R. and tell him I need to stop taking the drug. Then I leveled out to my usual place on the continuum – functioning, but not spectacularly well or consistently.

Now I think I’m starting to get manicky. One way I can tell is that I actually had fun, laughing and playing with my husband the other night and exulting in getting an old friend to walk straight into an awful joke. (Me: Have you heard the new Ebola joke going around. Him: No, what is it? Me: Eh, you probably won’t get it. Him: No, c’mon, try me. Me: That WAS the joke. Him (in evident pain): Oh! Oh! Oh! Oh! Oh! Oh!)

But the real clue that the upswing may be swinging more than it should. I’m thinking about starting more blogs.

I already have two – this one and a general purpose blog called Et Cetera, etc. (janetcobur.wordpress.com, if you’re interested). For over six months I met my goal of posting something in both of them once a week.

Then the big low hit me. But I’m back on track now, after several weeks’ absence.

The thing is, I have ideas for two other blogs. I just don’t know if I could handle them.

One would be Cats, Etc. – stories and anecdotes about life with cats, cat care and health, and so forth. We have three cats right now (Louise, Garcia, and Dushenka), plus many former fur-family members, so there would be no shortage of material.

The other idea is Books, Etc. I’m an avid reader, and though the bipolar has sapped my concentration so much that it varies between 20 minutes to two hours at a time, I’m starting to see some progress. And I find myself wanting to write about what I’m reading – maybe book reviews, maybe lists or quotations, maybe even some lit crit (my original background).

But could I maintain them? And not have them drain off the limited energy that I should use to do the freelance work that pays the bills.

I think it is a sign that I’m still fairly well anchored that I haven’t rushed off and started them already. But the yearning to do more reading and writing keeps getting stronger. Maybe I could keep my current two at once a week, and do the others on alternate weeks. But that would still mean three blog posts per week, plus the freelance. Frankly, I don’t know if I could handle it. I keep asking myself, should I try? Or should I wait to see if my moods level out on the Abilify and it becomes clear whether they are Good or Bad Ideas, or even possible.

Words – both reading and writing them – have sustained me for most of my life. It was a sign of my most profound depression when I found myself unable to maintain enough focus to read. Now that I can again read and write to some extent, do I dare to push myself, push the boundaries? Can I? Should I?

Good thing I see my psychotherapist today.

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