The day I was invited to write regularly for Robert Whitaker’s website, Madinamerica.com, alongside the best mental health writers in the country, I felt like I’d been called up to the Major Leagues: honored, recognized, and very proud.
But 30 years after my last manic attack, I still worry that sudden flattering happiness might lead to exhilaration, then mania But my first thought was to make sure I did not confuse happiness and mania.
So before I raced to the laptop to start my first blog for him, or tell my friends the wonderful news, I took a nap, and washed my clothes at the Laundromat.
Confusing Happiness and Mania Is Dangerous
Long ago (1978-82), when I still experienced damaging mood swings, I learned it was dangerous to confuse happiness and mania. My biggest challenge was learning to live with severe, sudden, sometimes crippling mood swings. The hardest part was learning the difference between happiness and mania.
Theoretically, my life depended on knowing the difference soon enough to stop the racing mind before it got out of control. Getting it wrong made a mess I had to clean up, and often caused humiliation, job loss, and setbacks in my recovery.
The Mood Swings Were Distress, Not A Disease
Though it’s clear today that these mood swings were caused by trauma, severe distress, loss, isolation, and hopelessness, I was diagnosed with the worst kind of manic depressive disease (now called bipolar disorder): combined form, rapid cycling, with psychotic overtones.
The diagnosis was an accurate description of my feelings and behavior. Only the chemical cause was wrong, and the disease label, manic depressive, was hopeless, stigmatizing, and misleading. It said what was wrong with me, and ignored what happened to me. Psychiatrists treated me with a mood stabilizer and anti-depressant, and the medicine stabilized my most extreme moods, without noticeably limiting my ability to think or feel. I was lucky.
Medication seemed to create lots of miracles in hopeless cases back in the early ’70′s. The docs thought they were on the verge of finding a pill for every psychiatric disease.
When I was first treated in 1977, doctors knew manic depressive disease often responded to mood medicine, far better than the major tranquilizers that turned people with schizophrenia into zombies.
“If you have to have a mental illness, manic depression is the one you want. It leaves the intellect and creativity intact, and over time, it treats the disease, not just the symptoms,” a psychiatrist told me around 1980.
If My Meds Ain’t Broke, Why Fix ‘Em?
I took my meds, and never questioned my diagnosis, until I read Anatomy of an Epidemic by Robert Whitaker.in 2010.
Though I knew many people who reduced or withdrew from medication because they were having bad long-term reactions, my meds never interfered with my life, I thought. (They did, but not enough to notice until I put my fear aside and started taking less, under medical supervision.)
Why risk trying to fix something that wasn’t broken, I thought.
Thriving on Reduced Meds
By April, 2012, I had stopped my sleeping medication and was cutting back my anti-depressant under medical supervision, I was thriving: sleeping better and waking up brighter than ever, writing a ton, editing other people’s writing, watching classic movies and TV reruns on cable. I had good friends, and strong community connections.
An op-ed I published in the Concord Monitor newspaper was getting good response, and my Internet following was growing. But after 30 hours’ work in two days, I had trouble forcing myself to stop, In the old days, that was a warning not to confuse happiness and mania.
After a normal night’s sleep, I knew I was not manic. I was having a normal reaction to the declining health of my aging parent. Working was how I distanced myself from my unpleasant feelings.
I was sure I was OK the next morning, when I started feeling myfeelings. I also noted that I’d been eating and sleeping normally.
Differences Between Happiness and Mania
The first psychiatrist who treated me with bipolar medication in 1978, Emanuel Mirel of Brookline, Mass, was a wise older man, who learned his craft treating patients before medication.
In hour-long therapy sessions, we explored my emotional patterns and triggers. He taught me to recognize early warning signs, and react right away by popping an extra pill. That was good advice in 1978 that saved me more than once. After a couple of stable years on medication, I became pretty sure I was OK if I was taking my medicine, and eating and sleeping normally. But that test was not foolproof.
Dr. Mirel taught me a test that has been foolproof for 35 years. I paid a high price each time I ignored it:
“Nobody complains to the doctor about feeling good, but ‘manic depressives’ have to. They can’t always tell the difference between happiness and mania.”
The surest way to tell the difference, he taught me, was that happiness comes from joy: family, accomplishment, nature, children, etc. With mania, there’s desperation because some part of you knows you’re going to crash. You want to squeeze in as much fun as you can. There’s no joy.
That served me well before mania stopped bothering me. It was in my mind when the invitation to write for Whitaker came. Was I heading for a humiliating fall? Thirty years after my last experience of mania, I still don’t completely trust myself when I get sudden, wonderful, extremely flattering good news.
So I made sure I was rested, then did the most mundane domestic chore to stay grounded. Then, I went home and started enjoying my success.