Living With the Stigma

And then,… he said it,…. “I think you’re bipolar.”

My initial reaction, as I listened to him tell me exactly what he thought was wrong with me, was to think, “Well, with all due respect, doctor,… fuck you.” I, of course, didn’t say that. For all of my faults, I still have some sense of tact and decorum. My mother did as good a job as she could have done raising me. For that, I will be forever in her debt. But hearing this man say this to me,… a man who had known me for a grand total of forty-three minutes,… floored me. It felt like a personal insult to me. How on earth could anyone hear what I had said for the previous hour and come up with this conclusion? I was paying $200 for this affront to my character and personality?

Bipolar Disorder is for crazy people, isn’t it? It’s not for people like me! I’m just going through a rough patch right now. I have an IQ of 141. I test out at the genius level for christ sake. I’m too smart to be fucking bipolar. I sat there trying to make sense of what he had determined was my diagnosis. I sat for a long time. I think at one point he even wanted to say something just to break the uncomfortable silence. “Did you hear me”? seemed like it would have made sense at that point. But he said nothing. He just waited for me to digest the statement and react to it on my own. Many more seconds passed. It might have been a full minute before I said anything. And then,… finally,… something astounding, provocative and insightful came from my mouth,… seemingly without me even having to think about what it was:… “Really?”

I couldn’t possibly be bipolar, I thought. I experienced no episodes of mania. I didn’t have periods of euphoria. I never indulged in unwise binges of reckless spending of money. I had no delusions of grandeur. I hadn’t thought of myself as superhuman. I was certainly never in need of less sleep. I didn’t feelings of excitement about anything, for crying out loud. Where in the world does the Mania part come in, doc? What the hell are you thinking, exactly here?

But this psychiatrist—I was growing less-and-less confident in his skills (did your degree come from Belize or Haiti, sir? Please tell me you’ve had more than eight weeks of practice in this field, because I’m not overwhelmed by your powers of perception. Can I actually see your degree from an accredited school, because the only things on the walls of this particular room were that shitty artwork I had noticed before you came in. For crying out loud, YOU’RE WEARING BROWN SHOES WITH A BLUE SUIT, YOU JACKWAGON)—stood behind his analysis. He explained to me, in no uncertain terms that the manic periods of can manifest themselves in a variety of ways. Hadn’t I told him that I suffered from bouts of anger that eventually led to fits of rage? Didn’t I explain to him that the anxiety and panic attacks that I experienced lead to abnormal behavior that negatively impacted my ability to control myself? Didn’t I admit to an unexplainably elevated sex drive? Hadn’t I expressed feelings of dramatic swings between these feelings and my episodes of major depression and crying fits that left me immobile? Mania didn’t have to mean excessive happiness, he told me. In my case, he determined, it came out in irritability, anger and hyper-anxiety. These, in conjunction with the debilitating depressive states made me an almost text-book case of manic-depression.

Also this,… he had a solution,… a plan to combat the disorder.

“Well, doctor—if that is your REAL profession—that’s all fine and good,” I thought to myself. “But you’re not the one who has to cinch up his big-girl panties and go out into the world and admit to everyone he comes into contact with that he is, indeed, a fucking nut-job whackadoodle.”

Everyone that would find out that I had been diagnosed as bipolar would consider me to be a pariah,… untouchable in the world that surrounded him. I knew what my conception was of bipolar people, and it could be summed up in one word: “FUCKING CRAZY!” (Okay, that’s two words,… sniff my bag.) Socially, the stigma attached to just the word “bipolar” was going to drive me even further into the deep end. It was like admitting failure,… failure that I had felt time-and-time-again throughout my adult life. Bipolar was the sentence for the crime I had committed: the crime of not being able to deal with the stresses and occurrences of everyday life. I had my very own label,… and I didn’t like it,… not one bit. Go to Google and look up the words stigma and bipolar together, and you’ll come up with more than 3.7 MILLION web pages that contain both terms. Everyone, seemingly, has an opinion on the people who are diagnosed with Bipolar Disorder, and most of them just ain’t good. And now,… here I was,… one of them. Of course I resisted it. Obviously I questioned the veracity of the doctor’s analysis. But I couldn’t make myself say anything about it. I just sat there silent,… like the lumpy pillows behind my back. Stunned. In utter disbelief.

“Would you like to hear my suggestions for dealing with this,” he asked me,… almost sincerely.

“No,” I thought, “I’d like to smack that fucking beard right off your face.” However, what I said was, “I imagine so.” I IMAGINE SO??? “You sawed-off, capitulating piece of garbage,” I thought to myself, “you’re going to sit and listen to this guy tell you how to combat the craziness he thinks you suffer from even though you currently detest him for telling you you’re something you don’t even believe you are? Fucking pansy.”

“I’m going to start you on a regimen of medication which begins with a mood-stabilizer. Specifically, Lamictal.” Lamictal actually turned out to be Lamotrigine because that’s the generic for Lamictal, and I, of course, have no health insurance and couldn’t possibly afford the real stuff. “We have to slowly let your body adapt to the intake of this new medication. We can’t start you off at a high dosage of this med, so we’ll have to go slowly and ramp it up every two weeks or so. You’re going to start at 50 milligrams of this, and, in two weeks’ time, we’ll go to 100 for another two weeks. I’d like for you to come back in four weeks so we can determine the efficacy of the drug, and we’ll see where we go from there. I’m also going to give you a prescription for some Ativan, which will help you deal with the anxiety and panic” I had already been prescribed xanax by my personal doctor for the anxiety, so I knew I needed something like that,… but a mood-stabilizer? Really? REALLY?? SERIOUSLY??? “I’ll see you in four weeks. The good news is, every subsequent visit is only going to be $80.”

Wonderful, it will be more cost-effective for me to be told what a loser I am in the future.

I left feeling utterly defeated. I was done. It’s over, Johnny. You ARE crazy. This guy you just sat in front of knows it,… the pharmacist is going to know it,… your wife is going to know it,… and sooner or later, everyone is going to know it.

And you’ll be alone.

Next time,… it gets worse before it gets better.

It begins

Several months ago, I started feeling poorly. I wasn’t ill in the traditional sense. I was gloomy, depressed, nervous and irritable all at the same time. I have had bouts of depression in the past before. I’ve even been put on medications to try and combat what a doctor told me was a “brain chemistry imbalance.” I don’t recall the medication ever really having any effect on me.

However, this was different. Christmas was not enjoyable. Neither was New Years. I felt indifferent to the football playoffs (of course, it didn’t help that the Buccaneers were a terrible team last year), which I had always watched from the first kickoff to final whistle of the Super Bowl (please don’t sue me for using your copyrighted phrase, NFL—I know I’m supposed to call it The Big Game or some other such stupid shit because you want to protect your stupid words,… then again, kiss my ass, NFL,… sue me,… I don’t have a cent anyway). I was unemployed yet finally working toward my Bachelor’s Degree (yes,… twenty-or-so years too late, I get it!). I was applying to graduate school and taking the GRE (which I smoked, by the way). But I didn’t enjoy anything. I totally lost interest. I insulated. I started ignoring my daughter, my wife, my house, my dogs, bathing, the television, porn,… you name it, and I forgot about it.

Then I got a job. I really thought that this would make a difference in my life. I thought if I felt like I was trying to make a contribution to the success of a new organization—as well as to the finances of my own household—I would feel different,… feel better,… finally pull myself out of this funk.

Except for this,… it was a job waiting tables. I hadn’t waited tables since the early 90s,… and I had forgotten how much I hated it. I once read a study that said the Number 1 most stressful occupation in the US at that time was being a Dentist,… the Number 2 was being a waiter. Jesus-Christ-on-a-Pony I hated that job. It certainly didn’t help that the upper management in the place was so trigger happy that they continually seemed to fire people at an alarming rate. I saw people fired in the middle of a shift. I saw servers fired in the middle of the dining room in the middle of a shift. I was told at one time (by someone I won’t name out of discretion,… okay it was Chef Jeremy,… I’ve never been good with discretion, fuck it) that I was, “fucking retarded and didn’t know how the fuck to do my job.” I would walk into the restaurant every day wondering if it would be my last,… if I would screw up so significantly that mine would be the next head on the cutting board (they didn’t use chopping blocks because they would have been too expensive).

Surprisingly, this environment didn’t help with my emotional state. Shockingly, I didn’t feel any better at the end of a shift than I did at the beginning, regardless of the fact that I may have pocketed a whopping $140 or so on a decent night. In fact, I felt worse. Much worse. I started having anxiety spells,… anxiety spells that began to incrementally become more significant,… anxiety spells that eventually led to full-blown panic attacks. There were times I would go into my walk-in closet, close the door so it was completely pitch black, curl myself into the tightest ball possible and cry uncontrollably for nearly an hour at a time. I was losing it.

And so I made a decision to try and cope more successfully with my contemporary situation by doing what I was absolutely certain would work: I drank more. Surely, increasing my alcohol intake would make me feel better. Yes, I know that alcohol is “technically” classified as a depressant. But I knew what the fuck I was doing and who the fuck were you to question me on how I wanted to live my life? I had identified my new coping technique,… and it tasted like beer,… lots of yummy, delicious beer. I had always been a beer drinker. I had a period in my early twenties where I tried to become more refined,… I attempted to drink scotch or bourbon or some-other-such brown drink because that’s what REAL adults did. But when I did, I became belligerent and difficult to deal with—and the hangovers were so much worse. I went back to beer. And I stayed in a beer bottle for the next twenty years. I would submit to you that I never went a full three days without drinking at least a couple of beers a day for that entire period of time. I drank beer,… it was what I did,… it was part of who I was,… it was just a natural extension of my personality, wasn’t it? In fact, it enhanced my personality,… the only problem was that my personality was that of a complete asshole.

The moods started swinging between depression so debilitating that I couldn’t even leave the closet,… much less the house,… to anger so sharp that it developed into a rage that made me unrecognizable to myself. I truly felt like I was losing it. I was not going to be able to hold on to my waning grasp of reality for much longer. I REALLY WAS GOING CRAZY! I haven’t even mentioned the developing mistrust of everyone and paranoia I had started experiencing.

That’s when the people I love and who—I’m pretty sure—love me stepped in. They urged me to go speak to someone about my condition. Then they begged and pleaded with me. Then they threatened to put me into a 72-hour observation period in a hospital against my wishes (the infamous Baker Act here in Florida).

I got it finally, and an appointment was made to see a fully-licensed, competent, highly-recommended psychiatrist. This guy was going to be a mix between Mister Fucking Rogers and Doctor Fucking Phil, I thought. Oh, it was going to be all candy and nuts for Christmas, I thought. I resented people for demanding this drastic step of me. I didn’t need this. I wasn’t so bad off that I needed to go see a psychiatrist.

Then there came the weekend that I had to call off from work three days in a row because the panic attacks were so deep that I thought I’d never get out. Tranquilizers prescribed my regular physician weren’t enough to combat these attacks. I truly thought the only way to feel any better was to keep taking these tranquilizers until I could finally catch my breath. Until this thought occurred to me,… one more of these tranquilizers, and I might just get so relaxed that my lungs would decide for me that breathing wasn’t so necessary for me anymore. Okay,… so maybe the psychiatrist was an option after all.

I went to see him the following week. I sat there for an hour filling out paper work and then another fifteen minutes waiting for him to come into the examination room. It was a comfortable little room with really shitty paintings hanging on the wall. Now, I’m no art critic, but if this was what this guy considered real artwork, I’d have to reserve my judgment on anything he said being worthwhile. I sat there and guzzled water out of liter-sized bottle and coffee out of the largest cup 7-11 had to offer. I didn’t like this guy already and I hated him for what he represented in my mind—failure,… failure so significant that I needed to seek someone out just to help me whistle my way through a cloudy fucking day.

He came in. He smiled. He introduced himself. And I found myself liking him,… the smug jagoff. He listened to me for about forty-five minutes. I explained my current situation very similarly to the way I’ve written it here. I talked to him about my previously diagnosed Clinical Depression from a dozen years ago. I told him how the medication never really seemed to help back then, but that talking to a mental-health counselor weekly did provide me some relief—at least temporarily,… for a day or two. He listened. He nodded. He pecked out notes on his shitty little laptop with a screen that certainly was no bigger than nine inches—I remember thinking for the very first time that size, indeed, does matter. He handed me Kleenex for the tears and coasters for the water and now-empty coffee. And he let me finish. Then it came time for him to speak.

He told me that he thought I had been misdiagnosed all along. That clearly what I suffered from was not simply Clinical Depression. That I was having to deal with more complex issues than an anti-depressant would combat.

And then,… he said it,…. “I think you’re bipolar.”

Next time,… living with the stigma.