YOU ARE YOUR OWN EXPERT

 

 

THE UNEXAMINED life is not worth living, Socrates famously proclaimed. Socrates also gets credit, along with the Delphic Oracle, as the author of the injunction, “know thyself.” Back in 2010, I wrote:

We may have all the book knowledge in the world, all the street knowledge, but the simple fact is all the accumulated wisdom on the planet means nothing without self-knowledge.

Knowing thyself is where recovery begins. It is through self-knowledge that we convert book knowledge and personal experience into inner wisdom. Not only are we better able to face life's daily challenges, but we are better equipped to engage in our own quest for meaning and purpose.

So where do we begin?

In my first book, NOT JUST UP AND DOWN, I give the example of two women dancing on tables. The issue is less about behavior than about identity. One of the women represents your stereotypical librarian, the other is Marilyn Monroe.

Marilyn is just being Marilyn – exuberant, larger than life. Perfectly normal, in other words. Her sense of normal may not necessarily conform to society's sense of normal, but she is perfectly in control, at ease, comfortable in her own skin. She will wake up fine the next morning, good to go.

The librarian, however, may be operating well outside her own personal sense of normal. Not only may she lack her usual judgment and control, but she is treading on unfamiliar ground (or wood or formica). Where she ventures next may ruin her day - or her life.

Here we see a classic distinction between "state" and "trait." The state is hypomania (mania lite), one phase of bipolar disorder. The "trait" is exuberance or "hypothymia," what may be a legitimate part of our personality or temperament.

Now let's change the scenario. In this situation Marilyn and our librarian are home in bed, reading. The librarian is fine. She is bookish and a deep thinker and is thoroughly in her element.

Maybe Marilyn is fine, too. But it would be wise to check in on her. It could be she is sliding into a depression.

Conventional psychiatry would have us believe that our ups and downs occur in isolation, with no connection to our personal nature. The reality is that trait shapes state. The two are constantly playing off each other. Abraham Lincoln's depression is not going to be the same as everyone else's, and neither is yours.

"Bipolar" is a totally misleading term to describe our illness. "Cycling" is far more apt. You might say we are extremely sensitive to the cycles in nature - from sleep to our circadian rhythms to the change in seasons.

Our brains are in a constant state of perpetual motion. Nothing stays the same. Way back in 1851, the French psychiatrist Jean-Pierre Falret came up "la folie circulaire." In 1921, the pioneering German diagnostician Emil Kraepelin described manic-depression (his term) as including "the whole domain of so-called periodic and circular insanity."

In other words, we don't just bounce from pole to pole. We need to look at our ups and downs in relationship to one another, each exerting a gravitational pull over the other. Typically, we are experiencing both at the same time – a sense of unease or agitation or anger – what psychiatry describes as a "mixed state."

Add into the mix the wild card of genes and environment. We are buffeted by life's unpredictable forces. Too often, our vulnerable brains let us down. Then our cycles take on a life of their own.

Even in "normal" there is no escape. The wheels are still turning, our moods shifting, our thoughts and feelings and energy levels in a constant state of flux.

What are we supposed to expect when we land on "normal," anyway? For many of us, normal can be a pretty terrifying place, where we find ourselves driven by fear and anger. Others may experience a sense of being out-of-place, of being different, not belonging.

But do we really want to be like everyone else? People around us - including our doctors - have a hard time understanding this. Sure, we need to adjust to people's expectations, but "normal," I submit, is highly overrated.

So who the hell are we? Knowing our illness makes no sense without knowing ourselves. It’s not enough to assume that once we get our bipolar under control that we can simply navigate our way back to normal. Especially if we have no concept of our own true normal.

The biggest surprise by far in writing NOT JUST UP AND DOWN was the emphasis I gave to "normal." Several chapters into the book, I realized I had to treat "normal" as a mood episode in its own right, as part of our cycling, to be accorded the same status as depression and mania.

Normal, in other words, cannot be taken for granted. It may be frightening. It may let us down. But it is also the repository of all that is good inside us, together with our hopes and dreams. It is the key to knowing thyself. And knowing thyself is where recovery begins.

I take this further in my second book, IN SEARCH OF OUR IDENTITY. Here, in addition to knowing thyself, we need to know others. I give as an example my failed attempt to adapt as an introvert to an extravert environment in a new job. The effort and the stress led directly to a manic episode which rendered me unemployable.

Thus we have an example illustrating the dynamic between personality trait and mood state. Our lives are filled with these pitfalls.

Indeed, my readers have told me that they have more problems in their personal and work relationships than in managing their illness symptoms. Until we understand what's going on, we are programmed to fail.

Is it our genes? Is it our environment? Both, actually, in a never-ceasing two-step. I do not hesitate to go into full nerd and geek mode, here. It is vital we fully understand how the micro word of genes-cells-circuits and the macro world of evolution and environment play out in our everyday world. Only then, can we begin to make some real headway in our recovery.

So here we are, feeling like we don't belong here. Even our stellar traits tend to isolate us. Our intuition, our creativy, our capacity for empathy. The world out there is too normal for us. But the normal occupy the majority, so the onus is on us to adapt to their strange customs. But can we do it and still stay true to our real selves?

Maybe we can never fully fit in. Maybe we shouldn't have to. But we can still live satisfying lives filled with meaning and purpose.

Our lives pose a major challenge. But that's why we're here.

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