I have lived with Bipolar Disorder for as long as I can remember, though I was not formally given the diagnosis until the age of 23. When I was young, my mom tried to explain away my frequent, often explosive mood swings as products of my creativity, curly hair, and Italian heritage. In her mind, I simply possessed a more temperamental personality than most kids. My illness developed gradually through my high school and college years until by my early twenties there was no denying that something was seriously wrong.
Until I was finally put on medication, it seemed that I was always either at least a little high or a little low. I remember suddenly feeling “normal” the first time I took an antidepressant medication. Throughout my childhood, I walked around with a heavy ache in my heart that got worse on the occasions that were supposed to be the happiest, like birthdays and Christmas. I often went from being crumpled on the floor sobbing, to giggling, to rage in the space of fifteen minutes. I worked very hard to prevent my mood swings from interfering with school because I was a perfectionist, driven to excel in all the activities in which I took part. Having to do everything at 110 percent power, however, left me sick with anxiety. I had a headache nearly everyday, and frequently threw up before or during the school day. At eight years old, I was diagnosed by the pediatrician as “stressed out.”
The more laid-back atmosphere of college brought me some relief from all of the anxiety I had experienced in elementary, junior high, and high school. In fact, I remember college as being the best time of my life, in part because of the multiple periods of undiagnosed hypomania I experienced during that time. My sophomore year, in particular, was marked by high moods, frenzied reading and writing, and a very full schedule of extracurricular activities. I felt ready to take on the world, and served throughout the year as the president of multiple school groups and honor societies. Writing papers and reading came easily, and I would work through most nights into the early hours of the morning, then pop out of bed a few hours later eager to get on with the day. Because I seemed to need so little sleep, I became convinced that other students who slept eight hours per night were simply lazy. I also ate very little, keeping myself on a very strict diet though I wasn’t overweight, and when I wasn’t studying I spent hours running. Punctuating my good mood were bursts of rage that often led to me senselessly screaming obscenities at my roommate and best friend for no reason at all. I had no idea that anything was wrong with me, and she had no idea why I would keep her up at night with my bright desk lamp and rapid typing. So, after the year was over, we never spoke again. Our friendship was ultimately ruined by my disorder.
Alternating with my soaring mood and high energy were periods when I would crash, overeating and sleeping all day and all night. For a while the manic days still outnumbered the days when I was slowed down, but over time my mood shifted and I became depressed for a period of several months. When the incredible vitality that I had been living with disappeared, I tried my hardest to recapture it. But, I didn’t understand then what was happening. Because my moods had always been mercurial, it didn’t seem that unusual that I was now feeling depressed. I had lived with that dull ache in my heart since childhood, and by now it seemed like just one more aspect of myself.
It was during college that I began to see a therapist. My mom insisted I talk with someone when I became intensely irritable and subject to frequent episodes of extreme rage. I liked going to my therapy appointments, but it never occurred to me to tell the therapist about the changes in my moods that had caused so many problems with my living situation the year before. I just wasn’t able to put together the pieces of the puzzle at that time, and I had never heard of Bipolar Disorder. Still, my therapist was able to see at least some of my experiences for what they really were, and he told me that my highs were higher and my lows lower than those of others. My family doctor put me on an antidepressant, which made me feel suddenly clear and full of happiness again. The most amazing thing about going on medication was that the ache in my heart finally went away. I finished college on a high note, and prepared for the move across the country for graduate school.
At UCLA, I picked up where I had left off in college, feeling motivated, energized, and excited to discover where my research would lead. My first quarter of graduate school was an exhilarating experience, and I happily and breathlessly told the tales of this new part of my life when I went home for the holidays. It was the last time I would feel joy for many, many months.
During my first week back at school in January, I was sexually assaulted in a women’s restroom in my school building. At first, I seemed okay, but post-traumatic stress and depression crept insidiously into my life over the next couple of months. The depression I entered was incapacitating in its severity. I developed symptoms of psychosis for the first time, and for several years after was never quite free of hallucinations, voices, and various delusions. My first psychiatric hospitalization came in the midst of my deepest, extremely suicidal depression.
Over the course of my seven years of graduate school, I was hospitalized six times for depression, mania, and psychosis. During this time, I was given multiple diagnoses ranging from Schizoaffective Disorder to Borderline Personality Disorder, until the doctors finally settled on Bipolar I Disorder in addition to Generalized and Social Anxiety Disorder and PTSD.
My illness robbed me of my optimism and self-confidence. For years, I barely spoke around my friends and colleagues because my thinking was so slowed by medication and depression, and my confidence so shaken, that I felt unable to contribute anything worthwhile at all to conversations and social gatherings. Because I felt so worthless and hopeless, I could barely fathom why on earth anyone would want to be around me—I didn’t want to be around myself. I was very fortunate to have one of the most supportive groups of friends and colleagues that anyone could ask for, but I was suffering from extreme paranoia that made me suspicious of everyone around me, and that caused me to believe that the people who knew me were conspiring against me.
There were periods in the midst of my depression during which I felt happy, and then felt happy about being happy. At least, that was how I described it. In reality, I was hypomanic and giddy. Colors seemed more vivid, perspectives more sharply defined, and the whole world around me seemed to pulse with life. I became intensely creative, and did some of my best work during these reprieves from my sadness and utter agony. I learned to cherish those times of clarity and happiness, though they were, as before, frequently interrupted by bouts of rage of sobbing. Still, anything was better than the horrible depression that always seemed to be lurking around the corner, ready to swallow me up again.
Over time, my hypomanias became more extreme, and I gradually cycled into full-blown mania. Unlike the hypomanias, the mania was frightening and confusing. I could not properly process the world around me, so everything seemed distorted and sinister. My psychosis was pronounced to the point that I believed that the people on television were talking about me, that there was a tape recorder in my head so that the FBI could monitor my thoughts, and that everywhere around me were signs and symbols to be interpreted. I was surrounded by whispering and jeering voices that seemed absolutely real, though part of my brain knew that they couldn’t be. I still look back on that time with a feeling of dismay and wonder that my mind could possibly have become so disordered.
Probably in part because moodiness was accepted and even valued in the arts and humanities, I managed to write my dissertation and finish graduate school in 2007 despite my continuous emotional upheaval. I was hired for my first teaching job at Case Western Reserve University, and did my best to believe that I would have a more stable future. The next two years brought moves to the University of Michigan and back to CWRU.
Throughout my first three years out of graduate school, life was remarkably calm. The worst thing afflicting me was anxiety about teaching. I often missed work because I was sick with dizziness, nausea, and headaches brought on by anxiety. But, I managed well enough to maintain my employment.
In September of my first year of teaching, something that I had wished for throughout graduate school happened—I adopted a three-month-old Pug named Gus. Gus is truly my “little miracle,” and now, three years later, he is my Psychiatric Service Dog. I was determined to give Gus the best possible dog life, and in doing so my identity at long last became slowly disentwined from my illness. Training and caring for my puppy gave me confidence and purpose. Gus became very ill with inflammatory bowel disease in the first weeks that we were together. For many months, I had to get up every hour, every night to take him outside for potty breaks. His stoic acceptance of everything that was happening to him inspired me to be strong, too.
I stayed healthy for three years, thanks to Gus. Then, recently, I experienced a Mixed Episode of mania and depression. When I visited Ann Arbor for my annual Prechter study visit, it was recommended that I go to the emergency room for a psychiatric evaluation. Because I was uninsured, the options open to me were the nearest state psychiatric hospital or a crisis stabilization center. I was not actively suicidal, so I was able to opt for the crisis unit. My experiences there were surreal. Many of the people I was housed with were homeless, waiting for spots to open up in group homes. I met with social workers who got me started with the process of applying for Disability, Social Security, and Medicaid. Being uninsured made me realize just how privileged I had been up to that point. During each of my hospitalizations, I looked around me and felt grateful for what I did have, and that was never more true than during my stay at the crisis stabilization unit. I had become one of the many uninsured patients with a disabling mental illness, and I was forced to ask for help.
When I came home from the crisis unit, I decided that I would train Gus to be my Psychiatric Service Dog. Gus was already a therapy dog, and we had visited several hospitals and nursing homes together as a volunteer team. The difference would be that now Gus would be focused on helping me rather than other people, and that he would be able to accompany me everywhere I went. Psychiatric Service Dogs came into being when the Americans with Disabilities Act recognized mental illnesses as disabilities. These dogs are partnered with people with a wide variety of disorders, including PTSD and autism. Any size or breed of dog can be trained as a PSD, as long as he or she possesses the right temperament and affinity for the training.
In order to be considered a service dog as opposed to a therapy dog or a pet dog, Gus has to learn to do tasks that mitigate the symptoms of my illness. We are involved in the training process right now, and he is learning to do things like nudging my hand or leg, leaning against me, and sitting on my feet to distract and ground me when I am anxious; sitting facing backwards to “Watch My Back” while I am washing my hands in a public restroom or standing at an ATM to address the hyper vigilance associated with PTSD; waking me up in the morning and bringing me his leash to keep me going when I am depressed; and reminding me when it is time to take my medication. The training process is fun and therapeutic for both of us, especially because Gus has always been a star student. Having Gus with me in public places gives me confidence, and often leads me to connect with strangers who have questions about what he does (it is not every day that people see a Pug in a service dog role!). Gus gets me out of the house when I am suffering from severe anxiety, and motivates me to go for walks and do other positive things when I am experiencing symptoms that might otherwise cause me to shut myself off from the world.
Recently, I completed the extensive application for Disability and Social Security, which is the first step in the process of applying for Medicaid. The process forced me to confront the many things that have changed in my life since I became ill. Motivation and energy often elude me now; I have a very hard time being active because of medication side effects, including a weight gain of seventy-five pounds; and it is difficult for me to manage my finances, to shop for and prepare food, and to do other daily tasks of living that I once took for granted. Gus might not be able to balance a checkbook or cook healthy foods for dinner, but taking excellent care of him encourages me to take better care of myself as well (for example, I brush his teeth almost every day so that I remember to floss my own; and since I am very careful with his diet, I try to remind myself to be better aware of what I am putting into my body).
I know now that I will always need medication and treatment for my Bipolar Disorder, and it may continue to be a struggle for me to manage even simple things in my daily life. But, I have a partner by my side whose strength and enthusiasm for life inspire me. Gus is teaching me to use positive coping strategies to deal with my symptoms. Together, we have and will continue to weather the storms of my illness.