Tristimania (4 page)

I tried to spend time outside, and I was managing to run again. One morning I saw a robin singing in a high branch, and the angle of its beak was the angle of hope: those extra degrees beyond the necessary and the abundance of bird-joy and robin-poetry made me cry for its song of well-being. The sheer goodness of nature for the sick psyche is incomparable; there in green one is not judged, one is accepted, with consolation and company. Nature gives you the exalted, tender ordinary – as of right.

‘Buy lemon drizzle cake for Ann,' it says in my diary on one of those early days. It is the kind of jotted reminder of a day-to-day, welcome task of friendship. These utterly ordinary plans, undemanding and easy, become to the disordered mind something like an impossible
quest, a fight with Grendel's mother or the giant on the bridge. I had to blow on the palms of my hands, let my mind take a warrior stance, as the job of leaving the house and buying a lemon drizzle cake was like engaging in mortal combat. It was the same with Christmas tasks: organizing presents for my nephews and godchildren had an immensity and implacable necessity which made me feel sick with dread. Looking back, I at first could not understand why I didn't just say to myself and others:
Sorry, guys, I'm not well.
The tasks became vitally important to perform because not being able to do even the simplest of things is a measure of how low you're scoring in the competence stakes, proof-brutal that what you fear is true. You are mad. You can't cope.

For the same reason, I did housework doggedly, with white-faced intent, as if my life depended on it. Psychoanalyst and author Darian Leader notes, in his superb book on the precise motifs of manic depression,
Strictly Bipolar,
that one feature of manic depression is ‘the ubiquitous obsessive phenomena of tidying and ordering' and, for myself, if I could see myself functioning in the most basic of ways – the washing-up done, my socks clean – then I could imagine I was keeping madness at bay, at least in its visible signs. Dirt was the evidence of non-functioning. Cleaning would hold back the signs of madness. It would wipe away the tell-tale fingerprints of insanity. Of housework, Leader writes: ‘It would be difficult to find a case of manic-depression where this activity does not have an important place . . . it [is] a way of creating an elementary binary, of separating good and bad, dirty and clean.' I was grateful to read this, because it was so precisely my experience; a bipolarity not just of temperament but of categorizing. It is common knowledge that one's emotions – agony or ecstasy – tend to polarities, but one's
ideas
seek polarity, too. Devils and angels, or hell and heaven, seem like
ideas created by a manic-depressive divinity. Black and white as a piano keyboard.

The piano keyboard itself was a key image, if you'll excuse the pun. I play the piano and, at this point in my madness, I saw the mind like a piano, where the range goes from the lowest bass notes of grief, rising towards sadness, then the ordinary reticulation of difficulties, then up into tranquillity, further up to happiness and – tops – an ode to pure joy in the treble notes. But manic depression plays the mind an extra trick. It is as if depression is an invisible and inaudible octave below the lowest notes on a keyboard and mania is an invisible and inaudible octave above. The mad mind, playing in the ranges inaudible to others, is only too audible to itself, and in mixed states the resonances of the highest notes appeal to the lowest, which in turn hurl the sweeping arpeggios straight back up again.

As well as the antipsychotic, I was also taking a mood stabilizer, Depakote. I was grateful, and they were certainly effective: if my mind was a small boat in stormy waters, it felt as if the antipsychotic stopped the boat rising and falling while Depakote calmed the sea itself. But I hated taking them. Why would you ever want to dampen this incandescence? How could you allow your flight-feathers to be trimmed? Obviously, my friends said, because you will crash, and the crashes are dreadful; that is what you are medicating. But mania cannot recall depression, as drunkenness cannot recall hangovers – and as depression, in its own way, cannot recall ordinary happiness.

During these days I received an email from a friend of mine who is an author and psychiatrist, asking how I was. I kept it brief, describing this episode, and I think I mentioned wings. ‘Angels are present but the destroying angel is also there,' he wrote back, in a
sobering message. (Rilke called angels the ‘almost deadly birds of the soul'.) More than anything, he urged me over and over to take all the prescribed medication. This was hard.

When I had the appointment with the psychiatrist, he had told me that Depakote wasn't something he'd prescribe for women of childbearing years but that it was fine for someone like me, who hadn't wanted children. To me, his remarks seemed off-hand and presumptuous, and I felt hurt. I had dearly wanted a child and, in all my depression, this was an unquenchable sadness. Every time I'd taken the Depakote pills, I had thought of the psychiatrist, and that made me detest the medication even more. Putting those pills in my mouth was like swallowing his words. I told my doctor this, and from then on he used a good-natured sleight of hand, mentioning that the generic name for Depakote was ‘sodium valproate', a term which did not have negative associations for me. So he simply persuaded me to take sodium valproate. I don't know if he consciously did that or whether his easy instinct for persuasion supplied the ruse under his own radar. But it worked. I let myself be persuaded by the feint and involved myself in a willing suspension of backchat.

Meanwhile, my psychiatrist friend made himself available by email and I leant on his sagacity. His first career was in English literature, but then he had retrained as a doctor and psychiatrist. From one discipline, he understood the individual mind, co-influent with world-mind in poetry and music, and from the second he knew the necessity to take medication as a matter of life and death.

It is well known that people with bipolar disorder are often not ‘compliant' with medication. This is a dreadful term to use. While it may be spoken with a precise and simple medical meaning (i.e.
someone not taking prescribed meds), it is heard in its general lay meaning: someone being obedient, conforming, trying to please, fitting into the system. Although manic depression has some shared motifs, yet the experience of it can also be flamboyantly idiosyncratic, and those in the middle of an episode are indeed the opposite of a compliant character.

Also, simply, we're having far too much fun: in one's own head there are fireworks and firewords, high-wire acts and high-wired arts, ecstatic stars in a precession of delirious hilarity; a party, an opera, an explosion of exuberance. Why on earth would you want to come back down?

It was obviously wise to take medication, but mania – or, possibly, one could say the manic personality – loves a dare, is seduced by audacity. Risk winks broadly. Boldness allures. That daredevil mania is compelling: it is ravishing and beguiling, licking its lovely, illicit lips to invite you to play.

Meanwhile, the integrity of the self feels compromised on pills. Taking antidepressants, I can feel like a puppet on a string: the higher the dose, the more I dance; the lower the dose, the more I collapse. Taking antipsychotics and mood stabilizers was oddly humiliating: I was flattened and numbed by something outside myself.

Where does self end and illness begin? Is manic depression a quintessential part of oneself, or quite the opposite: an illness which skews you to its own image? Does the medication alter who you are? Does one become inauthentic in taking these mind-altering substances? Is it ‘natural' – that heavily contested word – to take drugs like these?

Usually, we think of our ‘self' as including both body and mind,
and not one without the other. But my mind was a runaway in mania, and a stowaway in depression: either way, not fully present, even while my body was providing its alibi: Look, I am still here: see my hands (although they are unguided), see my feet (although they are undirected).

A friend of mine, a philosopher keen on questions of selfhood, asked if manic depression felt like my self or like something external taking over, like being possessed by something. It's something which concerns me. If you take bipolarity away from one's sense of identity, what else must you take away? One's artistic ability? Temperament? Sensibility? Empathy? Capacity for friendship and communication? To me, the experience of having had manic depression can never be separated from my sense of who I am. It runs through me like wine through water: everything is coloured (or tainted) by it. Most of the time, I feel as if the self is semi-permeable and can, up to a point, take in elements of the outer world and yet keep its selfhood intact, like drinking alcohol, so alcohol is outside the self and, once consumed, the expression of intoxication is one's own. But this is true only up to a point, beyond which one drunk person seems much like another; similarly, at the extreme of depression, one deeply depressed person is very like another, the symptoms outshouting the individual. In depression, I feel I have been taken over and have lost my self entirely. Instead, a rude incumbent has slumped into my life, leaving half-eaten sarnies under the sofa and stale smells in every room.

Further questions arise: if manic depression has a signature, recognized between ‘sufferers', then that signature is not part of an individual's discrete identity. It gives every sufferer a similar script, even though that script is enacted and accented very differently by each individual. Perhaps, then, it might be more accurate to think
of manic depression less as a part of the individual mind than part of ‘world-mind', which wants to communicate, to speak, to step over boundaries between self and self, not just between one ‘sufferer' and another but beyond, outwards, to branch out like art in all its manifold forms, to speak, link and connect mind to mind. Darian Leader's work on the signatures of manic depression includes the ‘sense of connectedness with other people and with the world . . . The exhilaration that the sense of connectedness brings must be communicated . . . [in an] unquenchable thirst for an addressee'. He quotes Terri Cheney, manic depressive and author, writing: ‘manic sex isn't really intercourse. It's discourse, just another way to ease the insatiable need for contact and communication.'

Is manic depression even an illness? One definition of illness is that it impairs normal functioning, but in the foothills of mania normal functioning is enhanced. If ‘illness' is something unwanted, then manic depression is certainly not always an illness: if I medicated myself to median, middle C, all the time, I would miss myself. If I didn't have this condition at all, I would miss a world. This is a very common response in people with bipolar disorder, as Stephen Fry illustrated in his documentary
The Secret Life of the Manic Depressive,
when he asked each contributor whether, given the chance, they would press a button to rid themselves of the condition. All but one said they would not.

Manic depression is both artist and assassin. While it plays artist, it is on your side: generous, generating, connective and vital. But then the psychomachy begins, a battle between a God and a Devil for the possession of the soul, and the artist stealthily becomes assassin. In depression, the mind feeds on itself, self-cannibalizing. The soul-loss of depression is well attested, and many people in the anguish of depression know that familiar cry: ‘I hate my self.' At
this point, when it is destroying, deathful and endangering mind and life, it no longer feels like ‘me'. The changeover happens incrementally, like gatecrashers arriving one by one at a party until there are more gatecrashers than friends. It is no longer your party. The house is ransacked, the food truffled up, the wine drunk.

I had snatches of competence when I could read emails and reply, but these moments were unreliable. If there was a little clearing in the cloud, I'd send and receive, then my mind greyed over again. My writer friends wrote me messages which acted like spells: one wrote to say, ‘I feel as if I am standing next to you, holding hands wordlessly, watching the holiness together.' Another sent me intelligent and wise comfort many times over the worst months, and the hugs of an armoured bear. But no one – no one – can walk with you in the landscape of nightmare.

Nightmare is a realm sadistically tailored to your own psyche; bad enough when you're well. But when I was sick and insomniac, the few hours of sleep I had were Mafia-attacks, boiled heads with grotesque and fearful brutalities, as if Hieronymus Bosch were twisting day thoughts to night terrors. In one, I was stabbed by a misogynist mob, and then I had to watch a writer friend being crucified; I was helpless as he hung by his wrists on meat hooks.

A friend and I went to the sea one day, and every encounter seemed freighted with enormity; a flock of starlings swooped over us in their hundreds, and I felt the rush of wings like the breath of a God I do not believe in. There was a makeshift shrine tucked into the cliff, dedicated to ‘Our Lady of Craig Lais', with stone circles and mosaics, spangly scarves, candles, feathers, ribbons, painted rocks, joss sticks and gorse petals. This was how my mind felt, as if its wholeness were fractured in mosaics of starlight at the cliff edge of feeling; as if my
mind were perched on the windswept shrine, a feather for every wind, sometimes dazzled by the brightness and brilliance of the world and then – all is chiaroscuro – demented by the dark rocks of cliff caves where the deep water hurled itself to hurt.

Mixed-state hypomanic episodes affect the mind's sight; one moment you cannot see because you are blinded with light and the next because you are blinded with darkness. A midwinter scene gashed with light: blackness of an eclipsed sun in midsummer. It may be midnight at noon, or noon at midnight, but the light flips twofold so light is always darkening and dark always lightening, in the two-light or twi-light of the mind.