Writers on Mental Health gives a window into real experiences to paint a picture of mental health without taboo, stigma or caricature.
Topics include therapy, medication, depression, anxiety & more. Each installment takes the form of an essay or interview.
Episode VIII: An essay by Samantha Stiers
In this installment, Samantha Stiers talks bipolar disorder and lithium.
When Dr. D told me I was bipolar, a classic case, just classic, and prescribed lithium, I was thrilled.
Strange things were happening. The world had ended and everyone I met was a ghost. I had knotted myself two necklaces, one that took me to heaven and one that took me to hell--where I met people who said they were my doctors and therapists, but I knew were really Jesus, Nazis, my father, and Mother Earth.
I didn’t think there was a problem, or want any of these strange events to stop. I wasn’t self-aware enough to reflect on what was happening to me.
I was thrilled because I believed lithium was a magic potion that would stop global warming, and my body had been chosen as the conduit of this healing.
For the next few days, I wandered around my front yard in long skirts with nothing underneath, watering the damaged earth with my lithium-laced urine, soothing the fires of climate change.
That was what mental illness did for me. I didn’t become a tormented genius, but I did lose my toilet training. Mentally ill characters in books and movies suffer beautifully, but all I did was gain a hundred pounds on that drug or the other and stop brushing my teeth because germs didn’t exist, and pee all over my lawn in broad daylight. I was less like River Tam or Sylvia Plath and more like those people on the bus everyone is scared of.
Self-esteem and sense of self do not rebound quickly or easily from such blows.
After days? weeks? on lithium, I began to doubt that Dr. Mengele ran the hospital where I got my lithium levels checked. The city stopped being heaven and hell and just looked like Boulder again.
One day in the car I turned to my mother and asked, “I’m on earth, right?”
“Welcome back, Sam,” she beamed.
I could not for the life of me understand why she was so happy and proud.
After the mania, that winter, I lay in bed and cried. I did not get dressed or clean the house or change the cat box. Close friends no longer called, blocked me on Facebook without explanation.
My face in the mirror looked unfamiliar. My body was numb. I had been stolen by the faeries and in my place they had left a slow-moving, unintelligent decoy with no thoughts or emotions.
I hated this new person.
I looked through the files and files of poems and half-finished stories on my computer. They had been written by the old me, the one who had passions and interests.
So many words made my head spin.
Shelves of books lined my tiny apartment, books I could no longer read. My whole life had been books; they were the only things worth living for, and I could no longer read, and worse, didn’t care.
Mania changes the brain—damages, psychiatrists claim. My brain had been to a place brains aren’t supposed to go, it had seen and felt things it could not handle, and in shock it had shut down.
I contemplated shamanism, soul retrieval.
I took lithium--a “crisis dose.” I took the bus in the snow for my biweekly shot of an antipsychotic. I went to Art Group at the treatment center, where we “checked-in” by drawing our feelings in dry-erase marker.
A magazine I admired solicited me for their feature on Interruption. They didn’t know I had gone from aspiring writer to full-time mental patient.
The irony of the topic was not lost on me. I tried to write, crumpling up papers, starting over, deleting, erasing. Where my thoughts used to be fluid, now I plodded.
I did not reply to the magazine.
I decided the problem was lithium. Lithium was why I felt so numb, so emotionless, why I couldn’t read or write.
While manic, my words had been a constant flow; I spoke so quickly I couldn’t understand myself. I was not above the (romantic? true?) thinking that perhaps I had to preserve just a touch of my bipolarity in order to write. That bipolarity could not be stricken from me without destroying more valuable things. I read the work of manic-depressive researcher Kay Redfield Jamison, who found high proportions of writers to be mood-disordered, and who theorized the creative process as a sort of hypomania.
Maybe, I thought, my mania had been a state of too many words, a pathological overflow, and lithium had overcorrected, shut down the language part of my brain in a way that depression or antipsychotics never had. I spoke less now. My vocabulary was simpler. I still could not read, much less take pleasure in books. Trying to write confused me.
“I never gave informed consent,” I complained to Dr. D. “I was so psychotic I didn’t know what was going on.”
“This is a major ethical and legal problem,” she said. “How can informed consent be given by a person who is out of touch with reality?”
Over the spring and summer, I tapered off the lithium. By July I had a weird feeling like ticker tape was running in front of my eyes, a clear stream of thoughts and energy, moving too fast to capture. But I was writing again, just like old times, ecstatic. It was the writing of my pre-lithium self, or so I wanted to believe. In reality it was slightly jumbled, incoherent notes for stories about Egypt and risperidone and Q-tips and the planets. I carried a fat notebook everywhere, wrote while I walked, knelt by the side of the sidewalk to write.
As fall approached, my joy turned to terror. I was afraid of sound, light, blackness, void. Primitive fears, annihilation. I had come off all the lithium and was reducing the antipsychotic.
I decided to replace the medication with natural remedies. I went to the health- food store for skullcap tincture; I put it in my water several times a day.
One weekend, disorganized, I let what remained of my medication run out. Later that day I found myself crouched in the middle of the Pearl Street Mall--the boundaries between my body and the world erased, chaos rushing in--screaming for someone to call an ambulance.
Manic panic, the doctor at the hospital called it. (There is a misconception that bipolar involves only two poles, when in reality manic-depressive mindstates are as frighteningly and beautifully diverse as the ecosystem of the Galapagos.)
“The research is very clear,” he said. “Manic-depressives who go off their (that maddening pronoun!) lithium will continue to disintegrate. Their episodes will become more frequent and more severe, with recoveries in between which are less complete.”
Good Lord. What would “more severe” look like?
I didn’t want to find out.
I have taken lithium for four years. Sometimes I hate lithium, and the other drugs I take. Sometimes I hate myself. I grew up in a hippie town in the mountains where my father fed us kale from the garden and gave us catnip tea for stomachaches instead of Tums. Growing up to become a human pharmacy was not in my agenda.
I read Robert Whitaker. He says medications are the problem. I feel naïve when I read his books, like I have been very stupid, Big Pharma’s guinea pig.
I sometimes doubt the validity of my diagnosis, since my mania was precipitated by heavy doses of antidepressants. I bristle at the thought that I have merely a “brain disorder,” since it seems reductionist and dehumanizing to discount the emotional trauma, identity confusion, and spiritual conflict which preceded my episode.
I read the blogs of people who have successfully come off medication. I admire them, I envy them. Maybe if I cut out grains, if I exercised more, if I meditated, I could come off everything, or most of it. I could feel alive again.
I have a new psychiatrist, Dr. S. I tell him I feel blank. He diagnoses me with drug-induced anhedonia—anhedonia, the inability to feel pleasure. He says the culprit is probably the antipsychotic, not the lithium. With his agreement, I reduce the antipsychotic by slivers—1/8 of a milligram, 1/16.
Sometimes little shoots of life poke their way out of my mind: feelings, abilities, joys, which are really just parts of the self I remember from years ago.
Writing was easy for me before I went on lithium. I worked under what some might call inspiration--that is, I wrote only when I felt like it. The occasional piece got finished or published, but most of my writing lay unfinished, the product of midnight passion, no more.
In its perverse way, lithium forced me to develop a work ethic. I decided that, drugged or no, I would write. Sometimes it is hard to work through the fog. But when I do I see that writing isn’t something manic depression gave me and it isn’t something manic depression can take away. Writing is a relationship. Like any relationship, it won’t last on passion alone. It thrives when you put time and love into it, and withers when you ignore it.
I harbor hopes of going off lithium someday, but do not dare skip a dose. I long for the joy and ease I once felt while writing, and I live in terror of my ability to travel between heaven and hell. For now I take lithium and stay on earth—dull, ordinary, wings-clipped, life-giving earth.