“He was really nice. He said I’m not a classic case, but that I still could benefit from treatment.”
My friend looked skeptical. She had flown in from Boston to stay with me after I had posted to Facebook that I was losing weight and not showering. She knows me well enough to know these are bad signs. “Seventy-two hours of mania with a mixed state, followed by two months of deep depression is a pretty classic case, I’d say. I’m glad you like your doctor, though.”
I knew what she was saying was true. Everything in my medical record confirmed it. The evidence piled up in social media history and my journals. Even the ink and scars on my body spelled out the same terms, starting with B and rhyming with schmipolar. I resisted the label when it was first applied to me as a teenager. I resisted it for years afterward, because I couldn’t believe my struggles were related to anything more than emotional immaturity and outright brattiness. I got a bad grade in chemistry and attempted suicide. I had a baby and started talking to ghosts. My boss berated me in a meeting, and I became convinced my new phone was trying to control my behavior (I had proof).
Even now, I have trouble believing it. It’s been 18 months since my last big episode; the one that concerned my friend enough to fly across the country to see me. I’ve had a few blue spells and maybe a brief hypomania that required a bit of damage control, but nothing debilitating. I’ve learned to manage my symptoms. I’ve implemented the much-maligned “lifestyle changes.” I am the rare, unmedicated manic-depressive, and I feel fine.
To be clear: I am not against medication, as a concept. I’ve just, quite literally, never had the stomach for it. I have tried dozens. Some of them worked, but most just made me ill or bat-shit or mentally slow. The one that seems to work best for me, the only one I can tolerate, is now on the no-fly list until a specialist can tell me if it’s safe to take in light of some new physical symptoms I’ve developed. Getting old sucks.
I make it work. A few years ago, my psychiatrist informed me that patients with bipolar disorder show greater mood stability and fewer episodes when they adhere to a strict waking schedule. This was a game-changer. I’ve found that, for me, this practice makes my entire wellness routine possible. When all is well, my coping mechanisms work together beautifully, allowing me to eat and sleep and perform intellectual tricks for money like a normal human being. Waking at the same time every morning, regardless of when I go to sleep, seems to be the key to a routine that keeps me sound and functional. That is, until sometime in November when all my instincts scream hibernate.
I don’t know if it’s the cold, or the waning daylight, that sets the cycle in motion, but it starts with a profound need to lie under a quilt. This leads to falling asleep on the couch while my kids watch age-inappropriate shows on Netflix after dinner. I start waking up in the middle of the night, bleary-eyed with stiff hips, instead of at 5 a.m., bright eyed and proverbially bushy-tailed. My morning routine becomes a chore. I quit writing. I quit practicing music. I quit cleaning. I don’t exercise. I communicate only in growls and dirty looks. By mid-December, I hate everyone, and I’m pretty sure the feeling is mutual.
The latter side of the solstice always seems darker, even though that runs contrary to all meteorological evidence. I hoped, I really did, that I would stop falling asleep on the couch at 7:30 p.m. once the sun god returned and all the Christmasing was finished. Alas, my circadian rhythms are as slow and unfunky as ever.
It’s hard to build stamina during the winter. I plan every morning to get up early and do an ab workout or something. Write a novel. Fold all the laundry, or whatever it is productive people do. I vaguely recall there are better ways to generate a day’s worth of energy than to lie in bed until there’s enough daylight to count all my split ends, but surely it didn’t actually involve making breakfast? The mind, it plays tricks.
Winter is brutal for everyone, I’m told, and I have no reason to doubt it. It’s that one time of year when the mental playing field is leveled. How you like that soul-crushing slowness, normals? Let’s bond over our shared misery for now: This darkness! Can you stand it? And, gosh, it’s chilly.
Come spring, you’ll shed your layers and cheerfully comment on the warmer weather. If I’m lucky, I’ll start making biscuits before sunrise and avoid a solar-powered launch into the psychological stratosphere. I bought myself luxury coffee for Christmas this year and a fancy new mug. I fully intend to put the “class” in “classic case,” and such ambition requires an early start.