by Donald Kern, MFCC


Dancing to a Different Tune:
Awakening to Health



      I listened to my client relate the difficulties of being manic and his quandry of having to accept it. I reflected on my own experience in coming to terms with being Bipolar. Listening to my client, I was reminded of the years I spent trying to deal with competing attitudes of sickness and health and the dilemma of having a mental illness. Finally admitting that I was Bipolar was the most important event in my life. It only came after more than ten years of struggling to understand what was happening with me, to accept the need for ongoing medication, and to begin to rebuild my life once I had achieved some stability.

     I never heard of any members of my family having mental illness, other than my mother's occasional bouts with depression. I grew up in a lower middleclass household and was expected to pursue some type of professional career. I had a penchant for art and music and was creative in this way. I was prone to a moodiness in adolescence, which I can see looking back, was a harbinger of things to come. I went into the military during the Viet Nam War and spent several years working as a counselor. After discharge, I returned to college, where I majored in psychology. I felt like I had the strength to do anything I wanted to do, including moving to the country and building a house of my own design. Alas, it was not to be.

     I had my first manic episode during this period. This was around the time of the energy crisis in 1973. I was 25 years old. My world took on a grandiose flavor. I began to live a reality much altered from normal everyday experience. I thought myself telepathtic, in touch with some higher intelligence and that I was part of an army of like-minded others who guarded the universe. I took to wandering the streets of San Francisco, making speeches to buildings in the Financial District, imagining myself to be communicating telepathically to the executives inside. My thoughts became, in my mind, my voice to the outside world, only all was kept inside me, like a fountain of fire, roiling beneath the surface of what appeared to be a placid exterior.

     In the next few years, I lived in flophouse hotels or camped out in the woods. I had little money and found it difficult to work. My strong exterior, my convictions and self-confidence had disappeared. I finally had to admit I had a problem; that my fantastic reality was not real, and that I needed treatment. The Golden Boy had, indeed, become tarnished. I went on medication and so began my ten-year struggle to stabilize.

     I began the straight and narrow path of working a forty-hour week and trying to fit in. When the psychiatrist would take me off medication, I became manic again, listening to my inner psychosis until at last I could not work. At one point, I saw a psychiatrist who told me that I might never regain my past status, that though I was a college graduate and a skilled jewelry craftsman, I would have to be content to work a manual labor job in a warehouse, as I was doing at that time. I felt disheartened and broken. I felt as if my life had ended, or were ending before it began.

     At first, being "better" meant being non-delusional, rational. While this meant being on medication, it felt somehow separate. I found myself in a flat, grey reality, devoid of meaning or charm. Being on medication was associated with a lack of excitement, a loss of spontaneity. It simply seemed as though I went from a life of bright pastels to greyness. It was like knowing abstractly that you lived in a valley with high mountains all around, but experienced life through a smog so thick it seemed you lived on a flat plain, unable to see the mountains through the greyness.

     I found that the only way out of the greyness of everyday life came from having a goal to attain. It wasn't for many years before I found goals I wanted to achieve which helped to dissolve the bleakness of my early recovery. Hope came hard and only after years of struggling. I see now my awakening was not one incident, but rather, a series of events, one of which was a period of day to day struggle to attend to the mundane. This period of my recovery, I called my "walking suicide." I didn't have to kill myself because I was already dead, or so it seemed. Again, only through pain, did I begin to define what I wanted, to attain an independent, professional career as a therapist and a close family life.

     Typically, I would go off medication. This was not always at my behest, but rather, my psychiatrist's. Being on antipsychotic medication, I was running the risk of Tardive Dyskinesia, a disorder characterized by involuntary tremors. Because of this, it was felt at that time (mid 1970's) that one not be sustained on medication indefinitely. I, of course, was willing and heartened by going off medication,since I associated taking pills with illness. A second piece of the recovery process, my awakening, came from finally successfully reversing this thinking to associating health with a lack of manic episodes. The only sustained way of avoiding episodes was to stay on medication. This evolution in my thinking came from finally being hospitalized.

     After a particularly bad manic phase which caused a resolution in my thinking, I was finally able to resolve my psychotic fantasy. This was a watershed event. During each of my many manic periods, I felt as if I was having a spiritual experience. I was continually left bewildered by the psychic pain inflicted and the feelings of emptiness and abandonment left after the mania passed. In this, my last episode, I was able to reach an insight that where there was pain inflicted, God would not want me to suffer such anguish. This insight enabled me to finally put away my manic episides as an aberration. It was then that I saw medication as an avenue to health by promoting my stability in the real world, devoid of extreme swings in mood. Those insights went hand in hand with my being hospitalized.

     Being hospitalized helped me overcome my fear of institutionalization. The worst thing that could happen to me, ending up in a mental ward, had finally happened. Finding myself surviving it , my recovery was enhanced. I finally recognized I had mental illness and came to terms with it.

     Instead of the visions of a "snake pit" institution with long rows of beds and drab, dirty rooms, I found myself in brightly painted, cheerful pastel rooms and hallways. While there were some patients acting out, yelling or scowling, most of the patients were calm, many depressed. My image of the hospital as a dumping ground for society's rejects was offset by the reality of compassionate staff who were interested in the patient's rehabilitation. My fear of going into a mental hospital and never coming out again was my preconception of what it was like to be labeled with a mental illness. Hospitalization was the end point in a monolithic government conspiracy to protect society by hiding away its genetic mistakes. All this was disspelled by the reality I found in being in a mental hospital.

     Not that I felt particularly optimistic at the time. On a high dose of Haldol, my arms and hands trembled uncontrollably. I was so anxious in the beginning, I continually paced the hallways, chain smoking because I could not endure sitting in one place for more than a few minutes.

     Over the course of two weeks, I began to feel calmer and with a new medication, my tremors became less pronounced. I took part in daily exercising and support groups, and talked to my doctor about leaving and going home.

     In working as a counselor with clients who are manic-depressive, I have found a common theme in our awakening to mental health. In being able to let go of the highs of manic episodes, knowing their cycling is inevitable, leads the way to seeing the help available through medication compliance. By letting to, I have found the comfort of stability. While difficult to accept in the beginning, letting go leads to a time of reawakening of feelings, along with a steadiness which was not there before. There is a return to normalcy coupled with hope. While the first rays of sunlight may be blinding and so fraught with a numbness, further along the road, we come to a place of enduring warmth; if only we will be patient to let the process unfold.

     My thoughts returned to the here and now. It's fifteen years later and I am sitting here with a client, talking about his manic episodes, my thoughts intent on intervention strategies. I'm struck by the similarity between my delusions of fifteen years ago and the resultant present reality of my professional attainment. So close, the telepathic doctor becoming a therapist, a healer.

     Now, I take my medication twice a day and go on with my life. I want to continue feeling right about myself. I want to facilitate healing by educating others. In the end, it's learning about each other and the fact that we all spring from the same fountain, that humanity marches towards a more just society. We struggle to accept ourselves in all our diversity. I play my role of educator, but I wrestle with fear beneath the surface. It goes with the territory.