“JOHN McMANAMY has produced a brilliant book, north of normal, south of crazy. It’s as good an education about depression and manic states, and about psychiatry in general, as I’ve seen in one place, written from a first-person perspective of someone who’s experienced what he’s writing about. It’s well-informed, based on careful study, explaining complex concepts simply but not simplistically, citing all the right people, and the wrong ones too (on purpose). Read it, and it’ll cure you of your average-itis.” – Nassir Ghaemi, Professor of Psychiatry, Director, Mood Disorders Program, Tufts Medical Center
MY GOAL in this series is to help make you an expert patient. Here’s the deal: Patients who take the lead in learning about their illness and in managing their own recovery fare far better than those who simply wait for something to happen. This applies across all chronic illnesses, not just bipolar disorder.
Bipolar is not an option. A manic episode from the late eighties snatched away my career. Suicidal depressions from the nineties drained me of my soul. My erratic behavior from both decades cut me off from humanity. My only option, at age 49, was to reach acceptance with my condition and learn to live with it.
By bipolar expert, I am talking about you. My first two books in this series look at mood and behavior in depth. We have all been told pretty much the same story, but what if I were to tell you that story is at best half-true?
Later books in this series will explore behavior, treatment, recovery, science, and relationships. But before we can make any headway in those areas, first we need to know ourselves.
My name is John McManamy. Let's get started.
WE HAVE been told that bipolar disorder – which used to be called manic-depression – is an episodic illness characterized by dramatic mood swings from depression to mania.
The view I present is that bipolar disorder – which used to be only one-half of the manic-depression equation - is a cycling illness with our brains in a state of perpetual motion. This forces us to look at even our most subtle moods in a dynamic relationship, each exerting a gravitational pull on the other.
It also forces us to look at everything else that is going on, including how our personality traits enter into the picture.
The research literature most convincingly supports this all-encompassing view, along with our own personal experiences, but to my knowledge no one has tied everything together and made it available to patients and loved ones. My twist to all this is that we need to consider "normal" as a mood episode in its own right.
Trust me, you can write a book on this. I just did …
THERE HAVE been plenty of books written on bipolar. And tons of books written on behavior. This is the first that covers both.
According to my readers, dealing with people poses greater difficulty to their recovery than managing their illness symptoms. It's as if we were born on a different planet and are unaware of the local customs. Certainly, a lot of us feel a deep sense of disconnect.
Is this a failure in our genes? Or did evolution take a wrong turn at agriculture?
And then there are the qualities that make us special, but also leave us feeling isolated and alone.
We won't always find answers, but in asking the questions we may stumble upon meaning.
DON'T LET my Map of Reality intimidate you. In my new book, I will walk you through the map, every step of the way. (Note: If you are reading this on a smartphone, you will have to scroll down to see the map.)
Just by way of a quick overview:
The middle circle in the map represents cycling. "Polarity" takes us in the wrong direction. We need to think, instead, of bipolar as a cycling illness, with our brains in constant motion.
The three vertical red lines feeding in and out of the cycle represent the two main types of bipolar – I and II – plus recurrent depression. This is part of the "bipolar spectrum," which includes much of so-called unipolar depression. The idea is not new. It's been around since at least 1899.
That green line at the bottom represents personality and temperament. This is an overlooked dimension of bipolar, which we will delve into at great length. For right now, it pays to know that our personal traits profoundly influence our moods.
The top part of the map represents how our genes and environment influence our moods and behavior.
Note how all the lines on the map feed into each other. The trains are running in all directions
WHEN I am not writing about mental health, I am out in nature and playing my didgeridoo. This keeps me mentally and physically healthy and socially and spiritually connected.
I've dealt with bipolar pretty much all my life. The early warning signs were there as a child and a teen, growing up with a sense of being different and experiencing crushing depressions. I crashed and burned in college during the early seventies. After several lost years, I resurfaced in New Zealand, where I started a family, obtained a law degree, then embarked on a career as a financial journalist.
Everything came crashing down on me in Australia in the late eighties. It was only much later, back in the States in early 1999, following a series of suicidal depressions, that I finally sought help. With acceptance came healing. Soon after, I reinvented myself as a mental health journalist. Suddenly, my life had a sense of meaning and purpose.
Bipolar still represents a major challenge in my life. Over the years I have learned to accept the fact that I will be more depressed than I would like to be and more animated than those around me would like me to be.
There are days when I would gladly return my brain to the customer service counter of life. But for what purpose? To wake up normal, shorn of my personality?
For better or worse, this is who I am.
I WENT to lie down, only to experience an acute shortness of breath, chest pain, and a tingling in my upper left arm. This was mid-July, 2016. I called my brother, who drove me to the nearest ER. I was half-expecting to be sent home with a baby Aspirin. Three days later, a highly dedicated medical team cracked me open like a lobster and performed quadruple bypass surgery.
A week after my hospital discharge, my cardiologist asked me if I had any questions. "Only philosophical ones," I found myself replying. I had graduated from being an expert patient to a philosopher patient.
Around the same time, my living situation collapsed on me. It was time, I realized for me to hit the road. First I needed to recover from my surgery. Then from eye surgery. By the middle of November, I was able to joke I was bionic. New heart, new eyes. For the first time since age 10, I was able to get around without glasses.
This brings me to my road trip. Soon, I will be leaving San Diego, which has been my home for ten years, and will be heading east into Arizona and New Mexico. I will take my time and let the land heal. I will also be establishing face-to-face contact with those in the mental health community, including a lot of my readers, not to mention making new friends with the world of cardio patients. In addition, I'm looking forward to meeting all and sundry.
I am looking forward to a new life of discovery - discovery, healing, and connection. Just as coming to grips with my bipolar has turned me into a different person, so has my heart surgery. I literally died and became reborn. You can't help but become a philospher in the process.
There will be a book coming out of this, based on insights I pick up on the road. I also look to be blogging along the way.
I will continue on through the south, and look to winding up in New York and New England in the spring. Then over the northern states in the summer. From there, who knows? Life is an adventure. It has to be.
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