Climates of the Mind

Introduction Although my behavior since early childhood might have raised suspicions, I was not diagnosed with a mental disorder until my sixtieth birthday. Until then, I believed that my frequent and inexplicable mood swings were par for the course. Insofar as I knew, no one in my family took my frequent rants seriously and most likely were unaware of my occasional periods of depression. I suspect they figured I’d grow up and out of my “temper tantrums” soon enough. In the 1930s and ‘40s, the term “bipolar disorder” had not yet been coined, and would not enter the language for decades. For hundreds of years scientists had treated mental patients for “mania,” “depression,” “melancholy,” and even “circular insanity,” eventually discovering that mood disorders were genetic in origin. Eventually, the term “bipolar disorder” replaced “manic-depressive disorder” as a diagnostic term in the 1980 Diagnostic and Statistical Manual of the American Psychiatric Association. I experienced one of my first major mood swings during the summer following my graduation from junior high, when my family moved from Washington, D.C., to suburban Silver Spring, Maryland. Although only ten miles or so from our old neighborhood, it might as well have been in another country as far as I was concerned. With his income and health failing, Dad grabbed at an opportunity to share ownership in a new supermarket in the burgeoning suburbs. We moved from our row house in northwest Washington, where I had lived since I was four, to an apartment within walking distance of the new store. Mom, who wasn’t driving yet, made the short walk to the store each day to cashier. The market was the only one in a new residential area and business was steady, but all that mattered to me was that my dream of following my junior high classmates to Roosevelt High in D.C. had evaporated. Throughout the summer, I pleaded in vain to be allowed to live with my grandmother, so I would be eligible to join my friends that fall. My parents wouldn’t hear of it, and that summer became a silent and torturous one for us all. I rarely spoke to my parents and, even worse, spent hours sprawled on the sofa with my head buried in a pillow as they went about their business. I sighed and moaned to no avail. I was miserable and wanted my family to understand that. If I could drive them bananas with my behavior, perhaps they would change their minds. The idea of having a heart-to-heart talk didn’t occur to me—or to them. One Sunday, afternoon, Dad told Mom to take my sister, Roberta, for a walk, and to stay out for at least an hour. Alone with me in the apartment, he demanded to know why I was acting so strangely. I clammed up. I figured that I already had given him plenty of clues, so why bother explaining? Demanding an answer, he chased me from room to room. I remember screaming when Mom and Roberta walked in. Horrified by what she saw and heard, Mom put her foot down, which was quite out of character for her, and told Dad to quit bothering me. I felt a small glow of warmth in knowing that at least she was concerned, even though nothing really had changed. In September, feeling like a fish out of water, I began attending Montgomery Blair high school. By my sophomore year, my circle of friends had improved and, with it, my disposition. In my senior year, Dad died of cancer at the age of forty-one. Though I sensed that we were standing on shaky ground, I was more concerned about Mom’s survival than about the death of my father. Mom seemed so helpless that I felt it was my duty to take charge. When Mom used the proceeds from Dad’s small life insurance policy to lease a candy business in Silver Spring, I promised I would help her make the store a success. Before long, I was telling her how to run the business and bugging the hell out of her. That fall, I began my freshman year at the University of Maryland in College Park. Before the academic year was over, I threatened to quit because I found running the candy shop far more interesting than attending classes. Of all people, it was my grandmother who insisted I stay in college, and this time I listened. How different my life would have been had I dropped out! In college, I began to recognize how petulant I could be one moment, and how wildly happy the next. I took this as a normal part of my personality. In those days, most folks believed that psychiatrists treated crazy people, and I wasn’t crazy by any means. And so I survived adolescence, fulfilled my two-year military obligation, fell in love and married, had two children, and drifted from the advertising business into higher education. More and more, my extreme mood swings were greatly diminishing my ability to enjoy life and to act in a rational manner. I would blurt out words without first considering their consequences. Though I loved them all, Belle and the children were forever getting on my nerves. I was beginning to hate my work, question my professional abilities, and shy away from large groups of people. In desperation, I called our family physician, who asked if I would agree to psychiatric therapy. His referral laid the groundwork for the diagnosis that helped me survive, while learning a great deal about the causes of my erratic behavior. The exact cause of bipolar disorder has not been discovered, but many experts believe that multiple factors may contribute to the condition. My therapist was careful to define my mental state in terms I could understand. He began by explaining that a chemical called serotonin, a neurotransmitter, connects the cells of the brain by sending electrical charges between them, so the brain can make meaningful and logical connections. When serotonin levels are fairly constant, the result is clarity of thought. In a brain with the bipolar gene, however, serotonin levels tend to rise and fall in unexpected patterns. When they fall precipitously, the brain begins to lose focus and finds it difficult to perform the most basic tasks, since the links between brain cells have begun to weaken. My therapist compared this state to a brownout in a town’s electrical system. In the human brain, the faulty circuits lead to confusion and depression. At this point, the adrenal glands, sensing the low serotonin levels in the brain, rush to the rescue by pumping huge amounts of adrenalin to the brain to raise serotonin levels. With just the right amount of adrenalin, the individual will feel energized but calm. But when the adrenals overcompensate, the brain is besieged with anxiety, panic, and mania. The sudden “rush” felt by the individual ultimately overloads the circuits, resulting in paranoia, feelings of worthlessness, and a recycling into another period of depression as serotonin levels drop once more. The cycle repeats itself endlessly in a catch-22 bipolar nightmare.