One of the things that got me thinking about writing down my own experiences was the fact that I couldn’t find much literature on bipolar mood disorder – besides Kay Redfield Jamieson, whom I worship for writing The Unquiet Mind. I think it’s the definitive account of bipolar disorder from the point of the person going through it.
Whenever I go to the psychology section of a book store I find hundreds of books on codependency, alcoholism, bulimia, having a bulimic partner and a bulimic aunt, surviving cancer and surviving bankruptcy. Not too much about mental illness. I think that as a society we’re somewhat embarrassed about and awkward around mental illness – possibly because psychiatry is such a young profession, possibly because mentally ill people are so unpredictable, and possibly also because of the issue of proof.
Where’s the evidence that you’re sick? Once, talking to a friend, I mentioned something that had happened while I was in a funk. He said, ‘What, you’ve even given it a name?’ He’s not an unkind person, just uneducated. I’ve had friends tell me that I need a life coach to come kick me up the ass and into shape.
Gigi told me a story about a friend of hers, a very successful lawyer, who suffers from anxiety disorder. As this disorder becomes more common, so, too, it becomes more treatable. Being a responsible, self-realised person, Gigi’s friend took herself off to the doctor, who put her on Aropax, a very effective anti-anxiety medication. Nobody really was any the wiser. The panic attacks stopped and she was pleased.
Then she decided to take out life insurance. On the form, under medication, she honestly disclosed Aropax. Her insurance was denied. Well, she thought, she didn’t need an insurance company like that anyway, and forgot about the whole issue. Then the law firm she worked for promoted her to partner with share options. All they needed was life insurance. Again she was honest. Again her insurance was denied.
Her boss called her into his office to say that without insurance she couldn’t become a partner. Her boss had just had a heart attack, but that wasn’t seen as a problem. Another of the partners was diabetic, another had a gastric disorder. All that was cool. Smoking was cool. But throw in one panic attack and the corporate world, and society as a whole, shifted nervously away.
For a long time I was ashamed of being bipolar. I perceived it as weakness. I was convinced that if I would just stop feeling sorry for myself, if I could pull myself towards myself and exercise mind over matter, I could take control and expel this ‘sickness’ from my life. It was only when I accepted it as a part of me that living with the symptoms became more manageable.
In my experience, bipolar people rebel against any sense of imposed order. We’re drawn to an external chaos that mirrors the internal one: extreme sports, stressful careers, damaging relationships. We’re people with a predisposition to insomnia, so crazy hours attract us. But the behaviour necessary for leading a stable life is the antithesis of all this.
I’ve grilled myself in the art of living a routine-filled life. I need the canvas of my external world to be tranquil and calm. I need a quiet place where I can seek refuge, away from the bedlam in my brain, and this is only achievable in a predictable, seemingly rather dull existence. It took strength to learn the necessity of these elements, because I felt that I was being robbed of my spontaneity.
I need eight hours of sleep a night, and I need to be in bed and asleep at the same time every night. Alcohol doesn’t work for me. Exercise is a religion. If I’m exercising a lot, my mood is more robust. Some experts say this has to do with the release of endorphins. Exercise seems to keep a kind of protective wrap around my mood. It’s my drug. It makes me high if I do enough of it. I’m no expert on the subject, but the way I’ve come to understand it is that when you’re depressed, your brain stops producing protein. In fact, some of the cells shut down. Sometimes, I can actually feel it happening; I feel myself slipping into a fog of dumbness and dementia.
In a depression, all I can manage are DVDs. Usually a voracious reader, I barely succeed in getting through housekeeping and fashion magazines. I read adverts in newspapers.
I have an aversion to recreational drugs. Mind you, people smoking grass are funny and I enjoy being around them. I love a stoned person. But other recreational drugs frighten me. It’s not a rational fear, but a hysterical, instinctive one. Many bipolars go through their lives as alcoholics or drug addicts when, in fact, they’re undiagnosed manic-depressives. Robert Downey Junior is my favourite example. I wish I could sweep him away, far from the madding crowd. Have him over for Friday-night dinner and get him some decent medical care. (I suspect this is a fantasy women all over the world share.)
I used to love Obex, a diet pill. It was the only medication that brought me remotely close to the powerful and euphoric state of complete mania. Whenever I felt my elusive mania slipping away, I’d start knocking back the Obex. Eventually I could take as many as six a day and still my low-energy mood would win out over the drug.
Many people, I’m told, have succeeded in turning their perfectly stable state into bipolar see-sawing with enough drug abuse. Getting high on cocaine or Ecstasy, brimming with confidence and energy, is a kind of chemically induced mania. Then, coming down the following day, sleeping it off, waking up paranoid and feeling self-loathing, is all together like a mini bipolar episode, compressed into a couple of days. The notion that anyone would voluntarily do that frightens me. I think drugs detach a person from his or her spirit.
A psychologist once told me that coke closes down your heart chakra. People I know and trust can take a drug and suddenly become weird, alien beings. And it’s artificial, so I feel I can’t access the person inside. The drug obscures them. I’m too thin-skinned, too vulnerable a being to take drugs. I get scared. I’m so exposed, and the person I’m interacting with is so obscured. And I’ve done coke in the past, so it’s awful to think about. Considering how drug mules carry the stuff, it probably came to me via someone’s bum. It then got chopped up, was added to a bit of Ajax washing powder and I snorted it, straight up into my third eye. Gross.
Yet my relationship to my bipolar disorder isn’t totally liberated. Sometimes I’ll say, ‘Oh, I was in hospital because of my thyroid.’ Other times I’ll overcompensate. ‘Hi, I’m Rahla, I’m Jewish, I love popcorn and I’m psychiatrically impaired.’
I have found out this truth: I may think I can jeté across the fondant icing of life, pirouette through pain. But every awkward, clunky feeling I’ve denied has become a part of me, an organic part of me. Left unattended, it grows like James’s Giant Peach. And eventually there’s that distinct tap, tap, tapping of anxiety playing percussion in my body. They say that the best thing for panic attacks is a brisk walk. Walk off the adrenaline. And it certainly helps, but not enough. I once saw a psychiatrist who was convinced that I wasn’t bipolar but rather had panic disorder. It disorientated me. I think my life has been deformed by the disorder of the day.
Had I been correctly diagnosed at the beginning, I imagine plenty of heartache could have been avoided. For instance, I’ve been told that, nowadays, if psychiatrists see a hyperactive child, they’re alerted to the possibility of bipolar disorder, especially in girls. It is also apparently specific to hyperactivity as opposed to attention deficit disorder (ADD).
Also, I developed what was assumed to be anorexia on two separate occasions. This was brought on by mania. Mania renders you invulnerable to the physical needs normal human beings experience. In the olden days bipolar sufferers died – not because they were depressed, but because they were manic. They died of exhaustion and starvation. Manic people talk, talk and talk. The brain speeds up. Speech speeds up. You know the expression ‘raving lunatic’? It’s real. We rave about anything and everything.
Manic people write symphonies, read minds, perform heart surgery, control vast corporations, fathom impossible mathematical equations and confidently believe that they can change the world. Preoccupations with inane details like food and sleep don’t enter the vastness of the equation. Maybe it’s because of all the feelings of false grandeur. You feel you’re immortal and you don’t need food and sleep to sustain you. Mania is the absolute antithesis of Zen. It’s a preoccupation with largesse, fullness and speed, multitasking, places to go to, people to see, things to do.
I used to wake up, eat one Côte d’Or chocolate and then go, go, go, spinning like a whirling dervish through the hurly-burly of my mania, oblivious to physicality. Once, during a manic episode, I hung out with drug addicts. If they were on enough speed they could just keep up with me, but the moment they were clean, I had to seek out new entertainment. If only this were a measured commodity. If only it could be handed out in degrees. If only it were sustainable. Inevitably, it runs out. Everything runs out.
When you’re manic, you’re a million dollars’ worth. The projects that I’ve embarked on, the cash I’ve spent! In the lobby of a very expensive hotel, I once told a suave foreigner my dream of having an orphanage. I’d found the right building, a hugely impractical rambling old mansion that was most definitely not for sale. I sold the suave foreigner every detail of my preposterous fantasy. I was shocked a few days later when a woman phoned from his office to enquire where the orphanage’s trust fund was and how they could go about making a donation.
That particular occasion could have had a comically pleasurable repercussion, but there were others. Oy! The bills, the relationships left in tatters, the physical toll on my body. Not too cool. Not too cool at all.
Bipolar businesspeople are often interesting. A guy I knew seemed to have it all figured out. He lived with his family, who monitored his mood at all times. He opened glamorous businesses – IT companies and impossibly trendy restaurants – kept them going for a few months and then, as his mood was about to crash, he’d sell and clear out.
A girlfriend of mine once found herself in London redirecting traffic. Alerted to her increasing mania, her father flew out to rescue her, only to find her in the middle of winter glamorously kitted out in a strappy sundress and Manolo Blahnik sandals. Often people used to ask her in a patronising tone exactly what it was that she suffered from. When she explained, they’d go, ‘Oh wow, I also get down one day and am up the next. I think I’ve got this bipolar thing too.’
‘And do you hear voices?’ she’d ask.
Being manic is like being Prometheus unbound or Icarus in free flight. Instead of fearing the sun’s rays, you bask fearlessly in its splendid warmth, drawn like a moth to a flame, closer and closer.
The feeling is addictive. Who wouldn’t be addicted to such exhilaration? Life! Alive, alive-o! All senses are heightened. Colours are brighter, people become iridescent and the brain is a marvel. It’s like being on Ecstasy or cocaine, I guess, but more exhilarating, because the feeling is not chemically induced. It’s a gift from the gods and you think it will go on forever.
That’s why we don’t like medication in mania. And here’s the bummer: in my experience, medication isn’t as good at preventing the lows as it is at hindering the highs.
At twenty, during that first major manic episode, I danced myself into a tornado and felt on top of the world. Skinny and sexy, I convinced a really dim bank manager to give me a chequebook and loan me enough money to go to Cape Town on holiday – with results that make me a bit nervous around a chequebook even today.
The manic episode lasted a couple of months, with cheques bouncing behind me like basketballs. Over the years the debts I’ve racked up are astonishing. People always trusted me, gave me credit; kind, good people trying to make their way in the world, and I abused them all. From vets to banks to pharmacies, I was indiscriminate. I just consumed and shopped and consumed and shopped my obsessive–compulsive hat off.
Years later my drawers are still packed with white, famous-brand initials on black lacquer lids, black initials on gold boxes, Chanel and Yves Saint Laurent, as shimmery and shiny as the Hollywood sign. I shopped relentlessly until I’d bought double of every available makeup product. It was shocking. It was thrilling. My loving husband worked like crazy to pay off the cosmetic bills alone. It was insane. If I live for another hundred years I’ll never run out of lipstick (and I practically sleep embalmed).
Jason used to joke that he could drop me off in a Third World country and within a week the economy would go into a boom. I could buy anything from anyone. When I’m manic, I could buy sand in the Sahara. Why do manic people do this? Why do we need to procure and acquire useless glittering things? More and more meaningless stuff, as pointless as drug addicts determined to get one more fix. Drug addicts go into a space where only the addict and the next fix exist. People exist only to make the fix more accessible, and if they can’t do that, then they can piss right off. I’ve been like that with shopping.
There’s a scene in the film Mr Jones where the bipolar character, played by Richard Gere, walks into a music store and insists on buying every single piano in the store. Why? It is what it is – mania is not a Zen state of being. There’s unbounded consumption of people, of things, of life – just not of sleep or food.
If only the frail human body was designed to sustain this lifestyle. Maybe the physical exhaustion contributes to the inevitable crack-up. None of us is invincible. It’s a cruel illusion played on us by the sickness.
Another aspect of mania is how profligate, thoughtless and irresponsible it is. There’s a sense of recklessness that leads to car crashes, a lack of regard for mortality, for life and the feelings of other people. Often the damage to relationships, careers and entire worlds can’t be undone. My sister Gigi says that it was only after I was correctly diagnosed that I began to live in the real world, to successfully coexist with its inhabitants.
I was all of twenty-eight – some eight long years after my first manic episode – when the Happy Potter doctor casually announced to me the two words, ‘bi’ and ‘polar’. Separately they’re not as ominous as they are combined. Bi can mean so many things. It implies a certain sense of sharing. Polar I associate with Polar Bear ice creams, vanilla-flavoured, coated in chocolate. Put bi and polar together, however, and it’s a pretty off-putting diagnosis, so much so that I initially rejected it. This diagnosis came after ADD, hyperactivity, remedial problems, dyslexia, anorexia nervosa and bulimia. As I took in the words ‘bi’ and ‘polar’, all those previous diagnoses suddenly seemed, while desperate, at least commonplace.
Princess Diana had made bulimia famous, and really, you hadn’t lived if you hadn’t experienced the childlike frailty of anorexia. In a funny way, there’s a sense of divine control that comes with anorexia. But bipolar, uh-uh. That seemed more like schizophrenia or psychopathy. I’d never really known anyone who had it. Or maybe I had, but they didn’t have the T-shirt or drive a car sporting the bumper sticker, so I wasn’t aware of it.
I’d always felt neurotic. I still often do – a hypochondriac, a naughty child. Did being bipolar confirm all of these fears? No, altogether this shoe didn’t fit. This tiara didn’t sparkle. I rejected the diagnosis and returned to my wayward ways: drinking, drugging and crazy living.
Tequila, oh my God, how I loved tequila. Tequila isn’t like any other alcohol. People don’t just ‘like’ tequila. No way, it’s like Quentin Tarentino; it evokes strong reactions. You don’t casually sip on a little tequila over dinner. It’s hard-core stuff. It doesn’t make you drunk; it makes you high.
When I met Jason, I had a blemish on my right hand from where I used to pour Tabasco sauce. I used to drink a dollop of Tabasco and then follow it with a double tot of tequila. He said that if that’s how Tabasco corroded the skin on my hand, imagine what it did to my stomach. God, I loved it; it was the coolest party trick!
How the fact that I was manic, even if only slightly so, eluded the psychiatrist and clinical psychologist I was seeing for so long still puzzles me. My shopping seemed more excessive than that of Imelda Marcos. In my pyjamas at 2 a.m. I’d walk up and down the road, garden secateurs in one hand, spritzer in the other, picking the neighbours’ roses. And what did my psychiatric team at the time give me? Antidepressants and Ritalin. Didn’t touch sides. If anything, they made me more manic.
Eventually, with the resounding crash of enthusiastic toddlers playing percussion, I collapsed and was forced to go back to the Happy Potter doctor, eating a great stale slice of humble pie and looking more sincerely into the ominous diagnosis of bipolar disorder.
Medicating this disorder is an intricate art form, a balancing act. I have the greatest respect for those practitioners who succeed in getting it right. The human brain is a delicate, vulnerable thing. The chemistry of the mind is like those tiny Russian gymnasts seemingly effortlessly cartwheeling over precariously raised bars.
We take our minds so much for granted and we’re so gloriously unaware of the detailed workmanship that goes into a sustained performance. When I’d down a tequila and the effect was so instantaneous, it never occurred to me that something else might be being compromised. I’d sit around with a bunch of friends, motherlessly stoned at 4 a.m., and one of them would say to me, ‘Shew, hey, Rahla, you’ve got to get off those psychiatric drugs, man, they’re bad for your brain.’ Duh!
I’ve learnt to respect the magical intricacies of the human mind and psyche and I’ve learnt to respect the magicians who painstakingly and successfully manipulate the fragile ecosystem of the mind. When things don’t work, when our mood is erratic, we’re too consumed with self-loathing and anger to consider the possible causes. Maybe it’s as much as we can bear, living as we do in such a highly specialised world. We know so much about nothing that we know nothing about everything. We don’t take into account the fact that stress goes somewhere, not somewhere out there, but somewhere in here.
Even at the peak of my dancing years, I couldn’t do the splits. One day my teacher said to me, ‘Somewhere in your life you experienced pain and, rather than work through it, you thought if you ignored it, it would go away. Instead it’s remained inside and is blocking your body, preventing those muscles from stretching.’ I stopped dancing, but a few years later, happily married and generally a more evolved person, I returned to the studio. At the end of my very first class, I almost fell into the splits. I think that my heart was full and my spirit supple. Doing the splits is not merely a physical act.
Often I hear people saying things like, ‘I was quite uptight that day, so I took an extra half a Valium,’ and I despair for the poor doctor whose formidable task it is to eradicate that person’s anxiety. Medicating the mind is not a hocus-pocus affair. When I was diagnosed with bulimia, I was put on Prozac. It’s a great drug and very effective in the treatment of bulimics when administered in high doses. It helped me out of my bulimia, it helped me out of my depression, but I suspect that it also helped me into a full-blown manic episode.