Thursday, February 25, 2010

Bipolar Collapse

A few nights ago, a friend asked me to read something her friend Ed* wrote. Ed is 77 and has just enrolled in his first writing class. His teacher gave his students an assignment. “Write an essay which starts ‘I am not a doctor, but….’ ”

Ed wrote about his wife’s bipolar disorder. I was riveted. I was taken back to my mom’s first psychotic break caused by her bipolar disorder.

My mom had arrived for a visit from out of state. She arranged on my fireplace mantel the plastic dinnerware she’d taken from the airplane. Her bizarre behavior terrified me. The next day, a psychiatrist friend met with her and told me that Mom was having “a psychotic episode.” The next week she was diagnosed with bipolar disorder, a lifelong but manageable illness.

Like Ed’s family – our’s was never quite the same.

I am not a Doctor
By Ed

I am not a doctor, but it was evident that something was drastically wrong. She was a ballet teacher and choreographer who was suddenly reduced to a frenetic shell of herself. She was no longer receiving inspiration from the great classical ballets in which she had danced, or that she had lovingly adapted to the lesser talents and limited capabilities of aspiring school girls. Now, she was receiving messages of inspiration, and instructions for tasks to be accomplished from strange voices in the ether through her beloved pet German shepherd dogs, Rommel and Diana.

The imagined voices were loud. They were frightening and demanding, and they were incessant. Now, instead of Swan Lake, she was choreographing the objects in her bedroom. All the normal objects usually found strewn around a bedroom or on anybody’s bedroom furniture and she was adamant, nearly hysterical, that, once positioned, it was vital and imperative that nothing could be moved or changed. These were the simple objects that had been there every day, and, indeed, are the same as those in many other homes. The lipstick vial, the moisturizing cream and makeup containers, the perfume atomizer, the Chanel cologne bottle, a couple of paper clips, a handkerchief, the Meissen porcelain figure of a ballet dancer I gave her for a birthday gift, an unfinished letter and the Montblanc pen with the tiger eye barrel that had been used to write it. These inanimate and innocent objects were suddenly the essential elements in an eerie and mysterious dance production being choreographed in her highly agitated and wildly stimulated thinking. Her awareness of the world around her had snapped and collapsed into a jumble of symbols and characters woven into what was a previously unfamiliar religious allegory.

Suddenly, out of nowhere, she was communicating with Saint Martin, a wise and benevolent entity who existed only to assure a life of goodness and happiness for her and her two pet dogs that, in fact, channeled St. Martin’s guidance.

Colors were categorized and she assigned symbolic meanings to many. They were no longer just pleasant hues to be matched or savored. Colors were symbolic of emotions and actions to be taken, or clues, or omens of things to come. Red was the color of all things intense and passionate. Purple the color of spirituality and wisdom, and the other colors of the spectrum had similar assignments.

In her universe, there was nothing that was not symbolic of something else. A tiny porcelain owl that sat mutely and innocently in the dining room china closet for years was now elevated to be the avatar of knowledge. Important questions were answered with a whimsical, “The owl knows,” and she meant it.

There was nothing in the universe that was not assigned some arcane value that somehow promised to lead her to esoteric solutions for the mysteries of life. In the skies, the clouds formed themselves into images of dead loved ones beckoning from the great beyond, and the occasional contrails formed by jet aircraft piercing the atmosphere at 35,000 feet, in her distorted mind’s eye, formed religious symbols.

In an instant, her world changed from the orderly daily routines of a housewife and ballet teacher to an entirely unfamiliar and chaotic kaleidoscope-like jumble of color and sound and movement. That which had been entirely comfortable and familiar was now alien and threatening.

Her thinking was severely agitated by the heightened cognizance of everything in her environment, from the most mundane objects to the most animated. Nothing was simple. Every thought tumbled and bumped into the next thought, and generated another thought. The voices controlled, and they never went away. There was no rest. Sleep was a precious commodity that became rarer as her thinking patterns accelerated. As thinking patterns accelerated, comprehensive thought retreated, and coherence of thought was not to be found. Sleep was not permitted by the voices. Sleep deprivation sapped her stamina. Finally, she succumbed. With the last vestiges of her survival instinct, she agreed to do whatever was needed to get some relief, but more importantly to her, to get some sleep.

We arranged for her admittance to the local mental health facility and began to exchange information and work with a psychiatrist. I’m no doctor, but I knew this would be an onerous diagnosis. After three days of testing and observation, the conclusion was that her problems exceeded the capabilities at the local center, and the recommendation was made to move her to a private psychiatric hospital a hundred miles away. On entering the hospital, she was immediately put into an induced sleep and a rigorous course of drug therapy was initiated. The bad news was that it was diagnosed as Bipolar Disorder with schizophrenic affect. She was in a manic phase. Her recovery would be long and arduous, and I knew that for the family nothing would ever be the same again.

*Ed’s name has been changed to protect identities.

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