Filtering.

I got my diagnosis six months ago, in April. 

I think I've always had bipolar disorder, and I can point to specific symptoms and even states. These will probably become clearer over time. But my most obvious depression episode came when I was fifteen, and my most obvious manic episode came when I was sixteen and seventeen. 

I think the full onset was after my son,  Oliver, was born. His birth was a traumatic one. In the deliver room, I found out that I had severe preecclampsia with HELLP syndrome. I couldn't have an epidural, Oliver's heart rate was dropping rapidly, and even once I managed to release him, the doctor tried to remove the placenta with her hands (without pain medicine) but had to do surgery anyway. For the first few weeks afterward, my mood was fine. Then, I plunged into the deepest depression I'd yet experienced. I remember very little of Christmas. I had no idea how I ended and started semesters. I slept any time I could. 

After two or three months of this, I asked my friend Melissa when she began to feel like herself again, like she wouldn't shatter at a touch. She said she felt fine again basically when she got home from the hospital. I told her I still felt so fragile, and she asked if it could be postpartum depression. This hadn't occurred to me, but it made perfect sense: a cause for this contained, intense darkness. I struggled but called my OB, who started me on Wellbutrin. 

It had a dramatic effect, one that I didn't know was called switching: throwing bipolar disorder into the opposite state. Suddenly, I was recognizably manic. But who was going to recognize it? I felt bright and capable. Eventually, I felt almost supernatural. I taught a heavy and varied load of courses. I stayed late most days. I stayed up far into the night writing proposals and idea lists for new courses I wanted to teach. I put together a thick literary magazine with only one student's (tremendous) help. I didn't mind the resulting attention. I breastfed and pumped at all hours, ensuring that Oliver wouldn't need formula even with my long work hours. I got thin quickly. I was chatty and charming. My husband, Josh, noticed my increased interest in and energy for sex, but who would worry about that? I shopped. It was almost always work clothes, so even though it was excessive and beyond our means, it at least made some sense. The only part I hated was the feeling of a low current of electricity in my body, how I could sit still at my desk and feel my heart pounding, my body shaking, and my thoughts exploding so quickly that I couldn't catch a good glimpse of any of them. At those times, I couldn't even begin to think of what to do next, even turn on my computer. 

This continued for months. The charm and ability eventually shifted into extreme anxiety, paranoid thoughts, and a general imprisonment. I was teaching an interactive television class for the first time, and this terrified me. Something about the cameras or the screens or the sense of more people watching would have me sick the whole day of the class if not the day before too. I was fairly certain I would lose my job though I had no basis for that. The idea of getting fired has always been extremely frightening for me. I think that at some point in my childhood, I came to think that getting fired would ruin me, make me unlovable, much as I thought of smoking. My brain grabbed some story or movie, probably, and did wild things to it.

Eventually, I couldn't bear this, and I went to my regular doctor with a complaint of anxiety. He added Zoloft at a medium dose. For a couple of months, this helped. Last spring, the depression got worse. My doctor doubled my Zoloft dose after talking to Josh on the phone, so Josh must have been worried. Again, this seemed to help for a while. 

Near the end of last year, my thoughts started racing. As I often have when my thoughts and irritation reach a fever pitch, I cleaned. I cleaned and organized, all the way down to decorative labels and color-coding. Cleaning is not my thing. At this time, I needed to be focused on finishing grades and ending the semester. I couldn't. I was also researching relationships and creating a bizarrely complex assessment that had no practical purpose. Around Christmas, I deemed a relatively new (and deeply necessary) connection unworkable. My mom remembers thinking this was skewed logic. Maybe my brain was trying to pitch anyone who might take notice and help.

By March, I was sick enough to take my doctor's advice and try Viibryd, a fairly new and strong antidepressant, to replace Zoloft and to take a referral to a local psychological services group for testing. Bipolar disorder runs in my family, and I'd begun to think it might explain my situation. 

One evening, I was leaving my friend Bruce's house, and I saw a man in my car. He was young, Indian, handsome. He had glasses with thick black plastic frames. The light inside the car was on. This didn't bother me; I thought I must be looking at the wrong car. But I looked up and down the row and didn't see another car that looked like mine. When I checked the car again, the light was off, and no one was there. I walked over and checked the backseat. Nothing. Apparently, I'd had a hallucination. I still wasn't really disturbed, except that I worried I'd see something else while I was driving, and I'd wreck. Nothing happened. 

I had a long talk with a PsyD, and she scheduled testing that would focus on executive functioning and other aspects that bipolar disorder would affect. She and I did a quick overview of my whole life, including all (or most) of the rough events. I had a feeling that she would base a lot of her diagnosis on that talk rather than any tests. I was worried, though, because I knew I seemed a lot more stable than I felt or would feel at any moment. That night, I cried for the first time in two months or more. I wish I could cry more than I do.

Two days later, something happened that upset my expectations and disappointed me. I didn't feel able to express how much it bothered me--it didn't seem normal. Suddenly, I was crumbling. I was both disoriented and hyper-aware. I couldn't speak. Bruce came to talk to me, and I couldn't look at him. I didn't want him to look at me. I didn't want the comfort or presence of any of the most important, safest people. I had a photo of Josh, Oliver, and me on my desk. As I looked at it, I realized that the girl in the photo wasn't me. She looked like me, but she was someone else. When the same started happening to Josh in the photo, I turned the frame face down. I went to a reading, and the place and people seemed vaguely threatening. An administrator had a painful-looking, peeling, scabbed burn all over his face. It disturbed me much more than it should have. It seemed sinister. Later, maybe days later, I asked Bruce what he thought could have caused the burn. Bruce didn't know what I was talking about. 

Bruce drove me home. He said, "I don't want you to think about anything but getting up the stairs to your apartment. And if you can't do that, I'll carry you." I don't think I was vocal at that point, but I felt a little less anxious. I also realized that, even though he was scared, maybe he really could handle whatever came.

Josh had read some of my texts to my doctor. I had said that I felt like fire behind glass. Josh spoke to my mom too. The doctor wanted to switch me from Viibryd to Abilify, and Mom was ready to take me to the hospital. Once I got home, I calmed down and avoided both actions for the moment, mostly because I agreed to see a psychiatrist. 

Josh got me an appointment with a psychiatrist in the same practice, so the doctor had access to the PsyD's notes. We talked for ten or fifteen minutes, and he diagnosed me with Bipolar II Disorder and with Panic Disorder. It seemed so easy and obvious to him. As I told a few people, I felt stunned about having answers, but the answers themselves seemed right. I was mostly relieved. Now, I had something I could learn about and maybe learn to manage. I started lithium that night. 

Later, my testing paperwork showed that the PsyD had diagnosed me with Bipolar I and Anxiety Disorder NOS (not otherwise specified). It made sense to me that some of my symptoms might seem like mania or panic. I was just relieved to have confirmation of the general diagnostic categories. Now, though, I think the psychiatrist suspects Bipolar I too.

Finding out gave me a way to find some answers. My whole life, whether actually or only in my perception, people (including me) had said, "What's wrong with you? Nothing's wrong with you!" I seemed to have all these strange symptoms and qualities but no valid explanation for them. I should have been able to snap out of it, but I couldn't. Now, I knew why. Of course, learning about my disorder also meant learning that it would never go away. I can treat it, but it's a part of me (and therefore a part of everything I do and everyone I love) for life.

Brume.

I recently finished reading The Dark Side of Innocence: Growing up Bipolar by Terri Cheney. Though I read An Unquiet Mind shortly after my diagnosis, reading the remembered perspective of a child felt important. It might help me address a few of the questions that are so dense in my mind that I can only decode some of them.

• When did I "become" bipolar? 
• Did I have the disorder before the actual onset? 
• When was the onset? 
• Was I born with this or only with the tendency or possibility? 
• Can my diagnosis explain any of the childhood experiences that I've only recently begun to recognize as strange? 

But that isn't what I'm going to write about now. One of the most fascinating aspects of Cheney's book was that, even at age seven, she referred to her experience of bipolar disorder as "The Black Beast." This surprised me because I'd never thought of it as a separate entity, as something that pushed me or taunted me, as something whose appetites I had to endure or satiate.

But I've since realized that this is much more accurate than I thought. I think in part, I'm beginning to separate myself from the disease. Of course, that's difficult, confusing, nearly impossible...because the disease is me. It is a part of me, and it colors who I am and every aspect of my life. It always has. That's part of why I find myself trying to re-frame every memory, every trait, as it returns to me.

But. Something shouted numbers at me in 10th grade math class. Something was desperate to do, find, grasp what I didn't even think I wanted. Something pointed out my enemies. Something made me struggle to act appropriately. Something also made me stronger, braver, more competent, and more confident than I ever would have been alone.

I think of my brain and my mind separately. I first thought this way when I began to realize that medication was not going to heal me; medication might help fix my brain, but it wouldn't help fix my mind. The disorder lives in my brain. My mind usually lives there too, so my mind is damaged. I don't know how I'll ever untangle it. The body is involved too, and of course, it's directly under the brain's influence. I can't necessarily trust the body to tell me the truth or to help me.

So. Bipolar disorder does not seem like an animal or a person, even another version of myself. It's not that clear and concrete. It's only recently taken any real shape at all. Maybe it will solidify eventually. For now, though, it's fog.  A fog. The fog. Sometimes, it's thick and choking and ghostly. Anything could be in it. It keeps me from seeing and concentrating. It throws me off course. It subdues me. Depression is a traditional fog.

Other times, it's the kind of fog from a fog machine. It makes everything more dramatic and exciting. It can have the perfect lights or pyrotechnics in it. It's fantastic, really, like a fantasy. But then, it can become too much. The strange fog machine smell is overpowering. The fog is full of neon flashes, strobe effects, dissonant music. No clear air exists, and the fog itself seems laced with heart-pounding, head-spinning drugs. Mania is gorgeous and then horrific, and I trample myself trying to escape it. The doors are locked.

And sometimes, I don't know where I am. The fog spills off a black-lacquered stage in the middle of an ice-crisp field. It all happens at once, or it switches rapidly. This is the mixed state, or the state with mixed features, which is where I think I spend most of my time.

It's not particularly original. But I always find names comforting or validating. I needed a name, a technical term, for how others categorize what happens to me. And I need my own name for the changes, the ambushes. Okay. Fog...or maybe the literary version, brume. Naming something is the first step to defeating it. Or to loving it.

Pour.

A metaphor: A small volume of something vital, pure, beautiful, and surprisingly powerful is hiding in a fragile vessel--one that can slice if chipped or shattered. 

A reminder: One way to combat this, or perhaps negotiate with it on an ongoing basis, is to establish rituals that elevate the ordinary. These embroider tiny ties to earth, people, sanity, and self.

A rule: The goal is to move away from coping mechanisms (automatic, thoughtless, and potentially desperate and harmful) and toward coping strategies (deliberate, constructive, and healthy). This includes a continued commitment to avoiding hazards I've already identified. Safe equivalents exist.

I write this in a spirit of hope greater than what I feel. But that is why I'm doing this. I need a place to grieve, to scream, and to wrestle with this through (often mixed) metaphor and art but also to synthesize information and to begin drawing a map for myself. It won't be a map out of here. I have to learn how to travel and travel on as the terrain and weather change. Right now, I'm cheekbone-deep in rain and mud, and I'm too wet, tired, and wind-sliced blind to climb. If I don't start some kind of swim, I will drown.