Trauma

There is no doubt in my mind that trauma played a part in the development of my bipolar illness. I am not unique in this regard, but families tend to deny that trauma causes and worsens mental illness. And, in our society, we are discouraged from speaking the truth about our families. But, I cannot continue to honestly write about my mental illness without addressing this topic. I have talked about it in therapy for years, and I have come to terms with it, but it will always be something I have to deal with because the unpleasant memories will always be there.

From my earliest memories, I have experienced terror and insecurity in the care of my family. I remember being locked in my room for hours and locked outside "to play" and hosed off before I was allowed inside. My parents always put themselves and their needs first and my sister and I suffered for that. I was never treated with respect although my basic needs were mostly taken care of. If I complained of headaches or cramps, I was told I needed to toughen up. My physical pain was never taken seriously. And I often did not have warm enough clothes for the winter. I was told not to complain.

Because of my father's work, my parents traveled internationally for weeks, and sometimes months, at a time while I was left with relatives I didn't see often or know well, or complete strangers. I did not have many regular caregivers except for my grandparents who I would see several times a year. I was sexually molested by a 16 year-old neighborhood boy who babysat me when I was 6 years old. My family also moved 10 times to different states and Canada before I turned 15. I went to different schools every couple of years and never had time to become part of any community. I went to the same high school for three years.

My father was sexually inappropriate with me. He pinched my nipples and snapped my bra strap starting at age 14. He would "accidentally" walk in on me when I was showering and changing and I found him in my bed at night in his underwear or sitting in a chair across from my bed in his underwear staring at me while masturbating. Once, when on vacation in Hawaii, he demanded that my sister and I change into our swimsuits in front of him while he sat on the bed staring. I refused to do so, but watched in disgust as my sister followed this command. I was 16 and she was 14. I think she was too young to understand how abnormal this was. He also masturbated in bed on all of the vacations we went on as a family. It is hard not to notice such behavior. You can hear the wetness and the yanking. I complained to my mother about all of these things and she said that I was "overreacting and making things up".

Because of all of the discomfort in my home, I could not wait to go to college. I excelled in school as this was promoted as an escape route to a desirable life. It seemed so easy, I just had to do well in school, get a good job, find a good husband, have some children, and have a great life! I knew how I wanted my life to unfold but I didn't realize that I did not learn the skills to make that happen from my family. I didn't realize how much I missed. I was miserable from my earliest memories, but I always had hope that things would get better when I could be in charge of my own life.

I thought I wouldn't have anything to worry about because I excelled in both school and sports, was good-looking, in shape, knew how to eat a healthy diet and cook, and knew how to dress well, be well-groomed, fix my hair, and apply makeup. I enjoyed traveling, going to museums, and I appreciated art, theater, science, photography, reading, and learning. I started working at 14, driving at 16, and felt that I was well-rounded. I was even a National Merit Finalist. I didn't realize how far behind I was socially until I got to college and was surrounded by classmates who had lived in the same communities for their entire lives and had strong and healthy relationships with their friends and families.

When my friends' fathers' hugged me without rubbing their penises in my crotch and pulling me in too closely, I was shocked because that is what I had gotten used to at home--and what I recoiled from. It was also my family's custom for everyone to kiss each other on the lips when greeting and I hated this as I did not know any of my family very well, and they made jokes about how "incest is best", and the men in my family talked about having gone to the same whorehouse together as a family outing.

In college, I observed people who were members of loving and supportive families. They felt comfortable at home and missed living with their parents. It all seemed so foreign to me. I learned how far behind I was because of my upbringing and how much I would need to learn and experience before I could have a normal life. At about the time that all of this was dawning on me, I experienced my first psychotic break at the age of 19. It was a huge disappointment.

My biggest fear had always been "going crazy" but receiving my diagnosis led to years of treatment and therapy and finally to the understanding of mental health recovery and learning how to stay well enough to work full-time and support myself without having a mental breakdown every couple of years. I have had many setbacks in the learning curve of learning to live with my mental illness, but finally, at the age of 48, I feel like I'm where I should be in terms of self-care and independence. Looking back, my delayed growth makes sense because my growth had been stunted by my family circumstances until the age of 18. I am fortunate that I possessed the intelligence and drive to continue to grow even though I missed so much growing up.

Severe Manic Phase

I've been hospitalized for mania three times in the past ten years, the last time in 2010. This post is an account of a mania that occurred in 2002. I chose to write about this manic phase because I happened to have my camera with me a lot, and I took pictures that may help you to understand what I was going through. 

In this picture, I'm standing on a beach of  Lake Michigan in Chicago. I had recently started a new job and was hanging out with my ex-boyfriend a lot (didn't make much sense). Anyway, he was gearing up for a really busy time at work and wanted to visit Chicago before he became swamped. 

We decided to go to Chicago for the day and drive back late at night. It was a ten hour drive round trip. I know that lack of sleep can trigger mania in me, so I always try to make sleep a priority. For this reason, I was afraid to make the trip since it seemed unlikely that I'd get enough sleep, but my ex-boyfriend said, "Don't worry, you can sleep in the car on the way back," and I stupidly agreed to go. This picture was taken shortly after we got to Chicago, and I was feeling very happy and even-keeled.

I ended up staying up all night in Chicago and didn't sleep as my ex-boyfriend drove back to Louisville. When I got home, instead of sleeping, I decided to drive to my favorite part of town, park, and wander around. I didn't have any plans to go anywhere specific or meet anyone. I just walked around talking to strangers and taking pictures.

The people below are a very nice couple I met and chatted with at a coffee shop. I'm a friendly person, and I often make eye contact and smile at strangers, and even exchange pleasantries when appropriate. This was beyond that. I was engaging people in long conversations. I'm not sure what they thought. I'm lucky that people in Louisville are polite compared to many of the other places I've been.

After I left the coffee shop, I hopped on a trolley where I spoke with these young men.
 

When I got off the trolley, I met this man on the sidewalk.

I had quite a long conversation with these two guys, although I don't remember what we were talking about. The one with the beret asked me out for ribs. I got in his camouflage truck and he drove me about 30 miles from my parked car. We had fun eating ribs and drinking beer - by then I was fully manic and didn't take the "no drinking" advice from my doctor seriously. I don't recall any wild drinking, but I remember having a couple of strong microbrews.

After the ribs and beer, he invited me to his apartment and off we drove. When we got there, he put on some 80's music and started dancing. As I was taking everything in, I noticed he had a lot of knives on display. All of a sudden, I felt uncomfortable and realized that I wanted to leave. I asked him to take me back to my car and he did. I'm really lucky that he was a nice guy. 

You may notice that, in this picture, I'm still wearing the outfit that I was wearing in Chicago. I tend to wear the same clothes for days when I'm manic.

I thought this young girl selling candy was really cute.

The next day, I returned to the same neighborhood for more roaming. I was having some religious delusions that I can't remember very well anymore. For reasons that made sense at the time, I decided to walk into my church. The door was open and I found a few friends there and had this picture taken with one of them. I was wearing a t-shirt that says, "City of Louisville - 1778." I remember that it meant something special to me at the time, besides it being the year that Louisville was founded. It seems like everything becomes an important symbol when I'm manic.

After I left the church, I walked to a park with a large fountain. I left my purse on the ground and jumped into the water, completely immersing myself and imagining some kind of self baptism. I got out sopping wet and wandered over to a picnic area where I started talking to random people and families.

The family below was really nice. Reflecting on the situation now, I'm sure they assumed that I was mentally ill, homeless, or both. They were really soft spoken and gentle and offered me food and drinks. I stayed with them for a while.

When I left the park, I walked back to my car, which was parked several miles away, and drove back home where I made some potato salad to take to a party. I'd been up and active for many hours, but I still had energy at the party and remember having a good time.

I don't remember how I landed in the hospital, but I did. I was in for a week. I almost lost my job, since I had just started a few weeks earlier, but I talked them into giving me a chance to work, and I ended up working there for two years until I completed my master's degree and began teaching.

I asked my mother if she could remember how I ended up in the hospital in 2002. She said, "No, it all runs together for me." Hearing her say that made me realize, yet again, how hard it can be for family members to deal with the instability that bipolar disorder can bring, and gives me another, in a long list of reasons, to keep my commitment to staying well.

Although I don't remember how I ended up in the hospital, I can tell you that most of my manias have degenerated into hallucinations, delusions, paranoia, irritability, and uncharacteristically aggressive behavior. For an account of that, see Relationships. I'm sure the lack of sleep and drinking alcohol contributed to this mania, and I'm sure I missed some doses of medication during the days I've described.

Sleep

Shortly after I was diagnosed with bipolar disorder, my psychiatrist told me that he thought it would be a good idea for me to sleep between 10 p.m. and 6 a.m. every day, even on the weekends. I was a 19 year old college student and I knew that would kill my social life. He tried to convince me that nothing good happens during the hours he thought I should sleep, but I knew that was not the truth. Even dinner parties often lasted until at least 11 p.m. My psychiatrist's unrealistic sleep suggestion is part of the reason I was, for the most part, a non-compliant patient until I was 24.

Even though I chose not to sleep between those restricting hours, our talk about sleep did make me think of the importance of sleep, but I didn't change my sleep habits much. It wasn't unusual for me to go for weeks just sleeping 3 or 4 hours a night. I would often go to sleep around 2 a.m. and wake up at 6 a.m.

As a college student, I was hospitalized for one serious psychotic break. There were a few days when I thought I was going to another planet. I was making preparations and going through elaborate rituals in order to hasten the time that I would go to The Great Unknown, as I was calling it. I also did a few things I don't remember, like walking around the neighborhood naked, knocking on neighbors' doors, also while undressed, and trying to jump off of my friend's deck.

Although they lived in another city, my parents sensed that something strange was going on, so they took out a mental inquest warrant and the police came for me and took me to the hospital, where I was locked in a room by myself for three weeks, and given major doses of multiple medications. When I finally came to my senses, and was released from solitary confinement, I couldn't believe the extent to which I had lost control. I got back to normal, but I was haunted by the memory of having completely, but temporarily, lost my mind.

Near the end of my college years, I found a psychiatrist who specializes in treating athletes and musicians. She is one of the rare psychiatrists who prescribes medication as well as providing talk therapy. I told her that I was afraid for my future. I wanted to know how I could ever trust myself not to break down like that again. We thoroughly discussed the details of my breakdown and she asked me if I could see a connection between my lack of sleep and my psychosis. I couldn't really. I told her that I thought that lack of sleep would just make someone tired and irritable, but not psychotic. She then explained that I had been seriously sleep deprived. She told me that, in their training, Navy SEALS are kept awake for 36 hours and made to complete strenuous missions. She said that many of them experience hallucinations and delusions, and that is expected, and considered to be part of the training. That information provided a moment of clarity for me. Instantly, I realized that I could have more control over my bipolar disorder, and I was no longer afraid of having a psychotic break at any moment. That story gave me a lot of hope.

After I graduated from college, and began working, I realized that I needed more structure in my life than I had provided for myself as a student. I worked as a student, but only in restaurants and other casual settings. Professional environments are much different. In the real world, I realized that I would have to work regular hours and be consistently dependable and polite. It was at this point that I decided to start taking my medication as prescribed. And since I knew that sleep was so important, my medication included sleeping pills. I took Restoril for many years. An older pharmacist once smiled and winked at me and said, "Restoril is great, and it's cheap. I've been taking it for 30 years." One day though, my psychiatrist said, "There's a new sleeping pill I want you to try. It's called Ambien. It works really well." I asked him why I couldn't continue to take Restoril and he said that he was concerned that it could be habit forming. So I started taking Ambien. It put me to sleep, but it didn't give me the pleasant feeling that Restoril had. I took it every night, just as I had done with Restoril.

For the past year, I have been seeing a psychiatrist with a different perspective on sleep. She doesn't prescribe any sleeping pills. She believes that if you're not sleeping well, your other medication needs to be adjusted, or you need to change your lifestyle. I was worried after she told me that she wouldn't be prescribing sleeping pills. As it turned out, I was hospitalized for mania last fall, and was then depressed for about three months, but, since then, I have been sleeping well. I have cut down on my caffeine, am getting regular exercise, and keep regular sleeping hours. On weeknights, I  am always in bed by midnight and, on weekends, I am always in by 2 a.m. This sleep routine is working out well for me. It has taken 20 years, but I have finally learned how to sleep!