Graphic Representation of Manic Symptoms

The diagram below shows at a glance the twenty eight symptoms of mania that I experience and also how they are interlinked. It’s a quick reference, if you will.

Click on the picture below to get a larger image. Use the back button on your browser to come back to this page.

Chart with mania symptoms

Alternatively, you can go to the itemised list of symptoms that I have when I am hypomanic or manic, which describes the symptoms in detail.

Eighteen Symptoms of Depression

Here is what I go through when I’m depressed. These aren’t exactly the official symptoms, but they give a better feel of what it is really like to be depressed. See if any of this sounds familiar.

The First Signs of Becoming Depressed are

1» I start waking up later. At first it doesn’t slip by much, just 10-15 minutes. But after a few days I may be getting up as late as half hour to an hour later than usual. Then when I wake up, I feel slow, as if I haven’t gotten enough sleep, although I have gotten 6-8 hours of sleep. Or sometimes even more.

It also becomes more difficult to follow my usual morning schedule of getting changed and getting out of the house. I often leave the house late, with some regular morning tasks undone, and often in more disarray than usual.

2» It becomes harder to do things. I know what I have to do, but I just can’t seem to take the next step and actually do it. For example, I might know I have to put the garbage out, but I just can’t get around to actually doing it.

I would see a set of books to put away, but there would be no true connection between the mess and the need to clean it up. I might understand in an abstract distant way that the two should be linked, but I still don’t actually link them together in any concrete terms of desire or need or obligation.

It’s not laziness or forgetfulness – it’s more like the idea of taking action keeps slipping out of my mind immediately after I think of it.

Alternatively, immediately after I think about doing something, I feel an equal impulse not to do it. It’s not that I don’t think I should do the task, it just feels as my body / mind is rebelling, and often it feels as if my chest or muscles tense up in refusal.

3» It becomes harder and harder to understand the task I am currently doing, and what the next step should be. My attention doesn’t wander – I just can’t figure out what is going on. It’s as if my intelligence level starts falling.

This affects even the day to day tasks that I can usually do effortlessly. They start to feel very difficult and if I can get away with it, I’ll put off whatever I’m doing until tomorrow. This inability to concentrate will affect any work or studying that you are doing.

4» Any decision becomes harder to make, from complex issues at work to simple things like whether to go to the supermarket this evening. Very often I waver back and forth on what to do and usually I tend to put off making any decisions at all. Or if I have to do something, I’ll take the path of least resistance.

For example, if I’m driving home, I’ll keep on changing my mind on whether to stop off at the supermarket (or the drug store, or the dry cleaners, or to visit a friend) until I pass it – and then decide I won’t go today. At office, I’ll put of decisions until the next day.

5» I forget things. If I realise I have to do something, I might forget about it within minutes. I might have something to do this evening and realise tomorrow that I forgot completely about it. I may have to meet someone tomorrow and forget about the meeting until they call to find out where I am.

There is no rhyme or reason for the forgetting. And I can’t say I’ll write it down because either I won’t (see item 2), or I’ll forget to look at my reminder list. Really. This happens.

As you can imagine, this can create havoc at work, and upsets friends whom you have stood up.

 


Very often these symptoms start at a low level, so I don’t notice them. And any or all of the symptoms could be mistaken for tiredness or not having the time to finish things in our modern fast paced life.

So if I left stuff off for later because I felt tired or if I don’t feel like doing anything because I had a hard enough day already, what’s wrong with that? This feeling of being justifiably excused for not getting things done is particularly strong if I’ve just come off a manic high where I’ve been incredibly productive.

It’s possible to continue for quite a while (measured in days or weeks or months) in this state of low level depression. Particularly if you have activities that must happen, like going to work, or carrying children to school and taking care of them. You’ll just feel tired all the time and all the optional things you have to do or would like to do just don’t happen. Your life gets dull, boring, lustreless.

Well, in addition to the lustreless life, you’ll start piling up lots of things, big and little, that need to get done. The groceries will sit on your countertop, your credit card bill won’t be paid, you won’t have carried the car for servicing, you won’t get around to buying the tickets for the concert you want to go to, you won’t have done laundry, you won’t have gone through the pile of papers on your work desk yet, you won’t have called your friend or your client. The dogs need to get bathed, the house needs to be swept, the DVDs need to be returned to the rental shop. You’ve been missing classes. You won’t have picked up a present for the birthday party. You won’t have watered the plants or collected your clothes from the dry cleaners.

 


You get the idea. No single thing is a critical problem, but you won’t do any, and you’ll find your life starting to crumble around you because of all the things you are failing to do. You’ll be aware of all the things that need to get done, but you just can’t get around to, well, doing them. And this is going to really really stress you out.

It is usually said that stress causes depression. I think this is flat out wrong. My experience is that depression causes stress, because low level depression creates all of the little problems that add up over the course of a week or two or more to create one big heaping pile.

Then you’ll really be stressed.

And the stress then makes the depression worse. For me, it takes only about one week of deepening depression and skipping out on the little things to create a huge enough backlog to drown me. If you have a hectic lifestyle, it can take even less time to derail you.

To make matters worse, you will also have annoyed your family, friends and co-workers by not doing what you are supposed to do. So in addition to knowing that you are failing on your responsibilities and your competence, you have to deal with angry people.

Depression is very much a downward spiral. The worse things are, the worse they get.

 


Incredibly, so far the things I’ve been describing, I classify as mild depression. The following are additional symptoms that I also get. I tend to think that they appear later in the depression episode. But it’s not so clear cut.

I suspect that all the symptoms all appear at the same time, but when the symptoms are mild, the following are either easier to miss or easier to overcome / work around. Then as the depression worsens, these start becoming more apparent because I can’t work around them any more.

So as depression episode deepens, what happens next?

1-5» More of the same. The 5 signs / symptoms mentioned above continue to happen. Of course by now, my life is starting to derail in a big way and I am now clearly recognising that I cannot fix what is happening because of these depression symptoms.

6» My self confidence falls drastically. I don’t feel as if I will ever succeed in anything. Which of course is made worse by the fact that I’m currently not succeeding in anything.

The loss of self confidence is not just because things are going wrong – it seems to be an intrinsic part of the depression itself. But like all parts of depression, the two pieces feed upon each other. You won’t do something because you don’t feel confident to do it, and then not doing it lowers your self confidence even more.

My self confidence usually fails to the point that I don’t like seeing myself a mirror. I try not to look in one, and when I do look, I do not see myself in the mirror, just a face that had no particular meaning to me.

7» I start losing a clear sense of identity or who I am. I feel as if I am acting in public all the time, or putting on “a public face,” or wearing a shell which does all the chatting and smiling, when all I feel like doing is staying at home and not talking to people.

It’s quite an effort to pretend to act like normal in public, but nobody seems to notice how fake my actions are. Which somehow makes me feel worse.

8» I begin to feel slightly lightheaded all the time. Everything feels as if it were a bit distant or dreamlike. I see and understand everything that is going on around me and will have a coherent discussion if someone asks me anything, but I don’t feel completely connected – as if everything around me isn’t quite happening to me.

Other people can notice this sense of disconnection – someone who talks to me will feel as if I am not paying attention or as if they are talking to someone who is not completely there. Or as if they are talking to a blank wall or a black hole. I’ve been told that this can be extremely disconcerting or very annoying.

9» I get anxious and nervous dealing with people. I feel as if everybody is going to accuse me of some little thing I did wrong, or shout at me. I feel as every little thing I do is being judged and that I am going to be criticised for doing it stupidly. I feel as if I ask for help or a favour I will be turned down or laughed at.

It doesn’t matter whether I’m at work requesting information from someone else, or if I am asking a friend if they want to go to the movies this afternoon. It doesn’t matter if I actually did something wrong or if I am doing a favour for someone, and it doesn’t matter if what is being discussed is important or trivial or silly. I always feel as if I am going to be yelled at.

There is no logic or sense to these feelings – the sensation comes from inside me, not from what is actually happening. As a result I send to avoid calling people or answering my phone, or even opening letters.

10» I stop talking much with friends and family or I don’t attend any social functions, even if I have told people I would go. I beg off at the last minute or I simply don’t show up.

This is a combination of three things – nervousness in dealing with people (item 9), the inability to think make decisions (item 4) and the sheer inability to get things done (item 2). It doesn’t manifest as the separate symptoms – I just think “I don’t want to go out – it’s too much effort to get organised,” to “There will be so many people there and I don’t want to deal with them,” to simply not being able to decide what to do, so I eventually end up with the default and stay home.

I can understand that attending the function is important – like a sixtieth birthday for an uncle – but I just won’t be able to get my my act together to go.

11» I tend to want to break off relationships. I feel that the relationships are too much work, or that I am not good enough to be in one, or that I don’t have the energy to spare to cope with a relationship while the rest of my life is failing.

Usually, up to this point I am still able to act and move around in public. I’ll be slower starting off and not getting all that much done as I should and not dealing with people well, but I’m still functioning of sorts. By this point, however, it is taking huge amounts of my energy and willpower to maintain a semblance of normal life. But at some point I fall into what I would call serious depression.

 


The I’m Seriously Depressed Symptoms

The onset period of serious depression for me is very sharp. It usually starts on an afternoon when I return from work into the safety of my house. I would have been fighting the depression symptoms for a few days, but when everything becomes a burden to do, I can fight for only so long. Once home, I stop fighting, because I can’t keep it up any longer, and I let the depression take over. It’s a battle lost. It’s a battle I always lose.

What happens next is

12» Communications fail completely. I don’t call my family or friends, and I don’t return phone calls.

I don’t answer my cell phone – if it is ringing I will ignore it or hide the phone under cushions so I can’t hear it. I’ll turn it off or put it in silent mode or not bother to recharge it when it discharges. I’ll unplug my land line from the outlet so I don’t have to hear the telephone ringing.

I don’t listen to my answering machine. Heck, I’ve asked the telephone company to deactivate my voice mail because I’ve realised it is pointless – I never listen to the messages.

I don’t read text messages or my e-mail and I don’t reply to them. I may lurk on social networks but I will not actively respond to any requests to contact me.

I may or may not answer my door bell.

I don’t want anyone to get in touch with me and I don’t want to get in touch with anyone. This includes my parents, my brother, my partners, my closest friends. Nobody.

I can’t call for help because by the time I realise that I won’t be able to fight the depression anymore, my ability to communicate or reach out to others has already failed.

13» I become terrified to talk to or hear from people. When I say terrified, I mean terrified – the fear factor is huge. I cringe at the thought that someone might talk to me. This is item 9, but magnified one hundredfold.

14» I hide in my house. I don’t go to work and I don’t go visiting people. I don’t want to go outside for any reason.

Any activity that requires me to leave the house stops happening. I stop going to the gym, I stop meeting with friends, I stop talking walks.

Well, I go out when I need food. But that’s I usually after I have rummaged through the entire house and eaten everything that is in a box or bag that needs only microwaving.

But

When the fear becomes high enough or when I have not left my house in a few days, I become scared that my family or friends might come looking for me. I no longer feel that my house is a safe haven. So I disappear.

I get in my car and go driving. I can drive for hours. Or go to the beach, or anywhere the people don’t know me and won’t talk with me. Or I might hang out in a KFC or a restaurant where they won’t throw me out and read for an hour or two.

I’ll stay out until very late, often going to a late movie so I have somewhere to be. I’ll return at midnight or later so I won’t have to see anyone. I sneak up to my apartment to see if anyone is there. If anyone is there, I don’t go inside. I get back in my car and go driving.

If there is no one there, I gratefully get into bed, but the next day I’ll wake up and leave the house early so no one can see me. And so the days go. From my family’s point of view, I disappear completely.

When I disappear, I don’t relax. The purpose is escape and all I want to do is to put my body somewhere reasonably safe and comfortable so I can shut my mind down to escape the terror I feel.

I spend days like this with an almost completely blank mind. Just enough of me is alive to make sure I eat and sleep and to be cunning enough so that the average person doesn’t suspect what is going on.

Because my mind is so blank, I usually have a hard time remembering what went on. I can only remember if I put a bit of effort into it.

On some occasions the terror factor was so high that even though I am home alone, I have hidden under my bed and read and slept just so that in case someone comes visiting, they won’t find me. This was when I was 35 years old.

15» I spend a lot of time trying not to think. I read the same magazines over and over again, and I read a lot of trashy sci-fi novels. Good science fiction, good literature and text books are usually beyond my ability to understand properly.

I watch television six to ten hours a day if I get the chance. Or more. I can easily watch television from 5 pm to 4 am without even getting up for dinner.

I can’t study or do anything productive that requires concentrated thought.

I don’t have the desire to do anything. Everything piles up to do. Clothes to be cleaned, dishes unwashed, garbage to be taken out, books strewn everywhere, bed unmade, clothes in the living room. You name it, it’s not done.

The inability to do things is not just for housework. It includes studying, work, social activities, brushing my teeth, bathing. I may abstractly think they might be important, but really, I am not thinking enough to care.

16» My sleep patterns become odd. I stay up until two or three in the morning, reading. I like being up after midnight because no one will bother me and so I feel “safe.” I dread that in the next few hours another day will start and people might want to talk with me.

I can spend sixteen or more hours a day sleeping. I would often sleep hoping I would not wake up, or that the world would disappear before I woke up.

17» I tend to crave food, particularly sugar. I can eat an entire box of chocolate cookies in half-hour. And then be disgusted with myself. And nauseated because I don’t particularly like sugar.

I tend to eat a lot. I can put of 2-6 pounds over the course of a three week depression. Which really doesn’t help my self confidence.

18» I become self destructive because I stop caring enough about anything. It’s not important to me if my relationship fails, or if I don’t go to work.

I tend to end up in a loop of destructive thinking – “Nothing matters anymore,” or “I don’t care” or “So what, I’m failing anyhow.” Or if the idea is sufficiently painful or requires thinking, I let it slip from my mind and I don’t think about it – because if I don’t think about the problem I don’t have to deal with it.

I become suicidal because of a combination of not caring and because it feels too difficult to continue living. And yes this happens in every depression. Most times I don’t do anything about it, but sometimes I try.

Official Signs for Depression and Manic Depression

The following are the official signs of what consists a manic or depressed episode and what Bipolar Disorder is. The information is taken from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (DSM-IV), published by the American Psychiatric Association.

Personally, I think this information is confusing or vague and is not quite as useful as the signs of mania and depression I’ve noticed in myself. However, since this is the information used by psychiatrists to decide whether you are depressed or manic or bipolar, I’ve decided to include it. Continue reading Official Signs for Depression and Manic Depression

My Early Teenage Signs

I would suspect that it is nearly impossible to tell if a teenager has bipolar disorder. First off, there usually is no reason to suspect it. Which parent thinks to themselves “My son/daughter has been acting moody lately and their grades have been slipping and OMG, they must be manic depressive.” What teenager thinks so.

In fact, unless there is a complete meltdown, parents and friends are unlikely to notice that things are starting to go seriously wrong. They’ll notice things are different, but they may not realise how bad / difficult things are really getting. And at the early or mild stages, from the outside – and even the inside – manic depressive signs look very much like normal teenage issues.

However, I remember the following happening to me. So if you are a teenager and start having some or most of these signs, it may worthwhile to check to see if something might be wrong.

1. Studying / Classes Got a lot Harder.
I used to be able to effortlessly do very well at classes. I would have to put in the time to read the stuff, but once I read it, I understood it. However, at around age 16 1/2 – January of my final year at high school –  I found myself having to struggle to understand the work in my physics and chemistry classes. If I thought I understood a topic, and then revisited it a week or two later, I’d realise I still didn’t understand it clearly. Or at all.

I was also easily distracted while trying to concentrate, moving to some other topic or just daydreaming. At the time, I just thought the studies were just getting harder because, you know, they tend to do that. I did worry about the fact that I had to put in much more effort to keep up, but I just responded by putting in more time and effort (hey, I was a good student). I do know that the topics that I covered in the last six months of my final year in high school, I don’t know as well or as comprehensively as work I did earlier.

Perhaps most importantly, from the outside these problems never showed up. Because I had so much momentum of the previous six years studying, it carried though and I did very well in my final year exams.

However, when I had to start over studies with new topics at university though, it was a disaster.

2. My Memory started Getting Worse
Again, this was most noticeable in studies – I would have an exceedingly difficult time remembering facts and figures. In fact, if there wasn’t a pattern to the facts and figures, I had a hard time remembering them.

Because patterns were subject specific, it turns out that those with strong patterns – like math and physics – I’d be good at. Those with no clear pattern – like history – I’d be spectacularly bad at because while I could remember the narrative of what happened, I couldn’t get the dates or names right (Did Christopher Columbus reach the Americas in 1492, 1498 or 1342? Did he land at San Salvador or St. Lucia?).

Subjects with a mixture of patterns and facts – like Chemistry and Geography – I could do well in, but I would have to sweat to learn the stuff – hours and hours of reading and rereading the same stuff just to memorise it. And I could still get it wrong in an exam.

I had an amusing workaround for memory problems in Math and Physics exams. I’d memorise formulae just before the exam, and as the exam started, I’d spend the first 5-10 minute just writing down what I just memorised. So obviously I knew there were memory problems, but I didn’t really do much more than adapt to it.

The memory problems also happened on social occasions. I was known for repeatedly getting times and dates wrong – Did we say we’d meet at 4 pm or 5 pm, or was the movie starting this weekend or next weekend. And it didn’t just happen once or twice, it happened frequently enough that my friends got into the habit of getting a second confirmation from other people if I mentioned dates and times. I also had a hard time remembering the names of people that I met. But lots of people of people do this so I didn’t consider it abnormal.

Did I consider any of the above memory issues a problem. Not really – I simply gravitated to subjects that were easy for me – so I studied the hard sciences rather than the social sciences or languages. Lots of my friends were doing this too, so it didn’t feel odd at the time – I’m adding explanations years after. I was terrible at languages because of memory issues, but everyone else in my family were also terrible at languages, and it felt more like keeping up a tradition rather than being a problem.

3. I started having trouble being in Big Groups of People
This probably should have been a tipoff that something was wrong. I had a huge family – 19 aunts and uncles and over sixty cousins. And when I was young we were all close – so much so that I still joke that it took me until age 14 to realise that you could have a party and invite people who were not family. And on top of all that we were a loud family. If there was something that I learned early in my life was how to get along with large amounts of loud friendly people all competing for my attention.

However somewhere around age 15/16, I started finding that I couldn’t cope with large groups any more – whether they were family or friends. They were too loud, too distracting, to energetic. I couldn’t function in them any longer. More specifically…

(a) I found that I would pick up the energy of the group and it would make me hyperactive. So if everyone was noisy or excited, I’d get louder and more boisterous and hyperactive (and irritating to other people). I wouldn’t be able to control becoming hyperactive either – to calm down, I’d have to leave them and go somewhere quiet for a while. And if I came back into the group I’d become hyperactive again.

(b) Unlike in the past, I wouldn’t be able to keep several conversation going simultaneously (something one learned in our family early on). Instead, I’d start getting confused as to what conversation I was following. This may not be a symptom in its own right as much as a combination of memory issues and being hyperactive and easily distracted.

As a result, being part of a loud group would become hard / painful / irritating instead of fun and enjoyable. I started avoiding being parts of large groups of friends and family and started gravitating to quieter one on one conversations or just staying away from crowds of people. Being in a car with a bunch of excitable friends and loud music was also hard to cope with – I remember one time when we were going to the beach and I told the others in the car “You’ve got to calm down so I can can calm down.”

4. I had periods when I Wanted to be Alone
Mind you, this never felt like a problem. When you come from a busy involved noisy family like mine, quiet time is a luxury to be treasured. I only consider this as a sign because it was sometimes mentioned by my mother or aunts – “Oh, J. likes to have quiet time to himself.”

In retrospect, these were probably either mild depression episodes, or just wanting to get away from the noise/energy of other people to protect the stability of my moods. But during these times, I never felt depressed or down. These were times I would just sit in the back garden or go for a walk by the river, and come back feeling recharged. And that sounded pretty normal to me.

5. I Complained of Vision and Hearing Problems
For my entire high school years from about 12 onward, I used to complain of not being able to see properly or be able to hear properly. In fact I complained en0ugh that my parents got me tested many times over a five year period by both eye and ear doctors. Each time I’d come back with reports that my vision and hearing were perfectly normal.

Here’s the thing. Nothing I mentioned above would appear to be a problem – they could all be taken as part of normal growing up, or be the kinds of things a teenager might experience. None of it sounds like mood swings or being bipolar – it’s only with hindsight I recognise them as signs.

These are the signs that I first showed. Other signs showed up when I went to university – around 18/19 but I supposed these could show up earlier in some people. I’ll talk about those in my next post.

Does This Sound Like You?

When my life started to spiral out of my control in 1996, I didn’t know the cause. All I knew was that everything I did, every bit of self-control and discipline I exerted made no difference. My close relationship with my family was disintegrating, I was seeing my friends less and less, and work was something I frequently dreaded to go to. I often felt tired or restless for days on end. And then there were the odd periods when I would disappear for a few days. Definitely not normal.

I knew things weren’t normal, but strongly resisted going to see a psychiatrist. After all, I wasn’t crazy or mentally ill. It was just that I was having a difficult time with the amount of work I was doing, or I had just finished a project and I was tired, or I needed some time alone away from people, or…well there was always a reasonable excuse.

But one day, after a period in which everything had gone horribly wrong, I looked at myself and realised how far I had drifted from the image I held of myself. My own image was of a relatively quiet, intelligent, creative person who had a reputation for being reliable and responsible. In reality, I actually was a somewhat irresponsible, occasionally lazy person who could finish no long term task. Who was fun to be with, but was always late, missed appointments or parties without notice and couldn’t remember anything. And unreliable.

That was not who I had intended to be or wanted to be. I was horrified enough to start seeing a therapist recommended by a friend soon after that. I found that therapy was useful in its own way for helping me sort out existing problems. But it didn’t stop the continuous mood shifts I was having at all and the problems they were creating. Finally, after one holiday during which I nearly lost two of my best friends because I was incapable of even the barest of social niceties, I asked my therapist to refer me to someone who could prescribe medication for depression.

The psychologist ran me through some tests (very basic, I thought), pronounced me “Bipolar Type II, possibly Cyclothymic,” and gave me a prescription for Tegretol (carbamazepine).

The diagnosis was a mixed blessing. On one hand it was a relief to know there was something recognisably wrong with me. I could be treated. I could get better. On the other hand, I was mentally ill. In the same category as the people you see in the movies, moaning, and acting crazy. It was not something I wanted to be associated with.

I started researching what being Bipolar was about. Although I came up with many excellent resources on the net, I was left unsatisfied. There were descriptions on how to determine if I was bipolar, descriptions of the medications I was taking, and suggestions on what I could do to cope with being bipolar and get on with my life. However, I came across very little on what living a bipolar life would be like.

I wondered what happened to other people like me. Did they overreact emotionally to daily incidents in their lives. Did they have periods of mild mania that allowed them to be super-efficient and charismatic at work or play. Did they have depressions that prevented them from going to work. I wondered how other people coped with all this. What had others learned to counteract the effects of being bipolar. What tricks did they use to get around any limitations.

I found support groups on the net that were invaluable in helping me, but due to the inherent instability of my mood swings I was unable to remain with them. Mostly I have had to cope with this on my own. Friends and family have been very supportive, but they don’t live being bipolar.

I have muddled through, sometimes doing well and sometimes doing very badly indeed, but surviving and doing better than I was before. This site contains my experiences and some of the things I have learnt along the way.

If you are coming to grips with it all,

  • You might see bits of yourself here
  • You might say – “that sounds familiar”
  • You will know that you are not alone
  • You may find something or two you can use to help you along

I’ve built a rather large site. You can go back to the  New to the Site page, or you can

  1. You can use the menus on the top right of the page where the information is ordered into neat categories.
  2. You can use the tag cloud on the right to look for specific words you might be interested in.
  3. You can use the search box on the left (but don’t look for ‘depression’ or ‘mania’ – you’ll get every page on the site).

Or some suggestions,

  1. If you were recently diagnosed and are looking for ideas, try this page on What you might do next.
  2. If you wish to read about my experiences, start with my bipolar diary.

Hope you find stuff that is helpful. Cheers.

jinnah

Why I Went to a Psychiatrist in the First Place

You can fool yourself on a lot of things. Even unintentionally.

For all the years since I was seventeen, I had mood swings that were damaging to me in every part of my life and it never occurred to me that there was a problem. Never. But that sort of luck does not last forever.

In October 1996, I lost the capability to cope. Or rather, I was doing so much that I couldn’t cope with it all. At the time I was the manager of the major downtown park in my city – a high maintenance, long hour, high stress job.

I was also the secretary of the Planning Society in my country; was instigator for setting up a web site for my old high school; was laying the groundwork to open my own company offering City Planning services; was helping rewrite the payroll software for the family business; and together with a close friend had just finished coordinating one of the largest celebrations ever held in my country of the Hindu festival of Divali.

I can do all this when I’m in my hyperactive (hypomanic, mildly manic) state. But my mood swings are fairly rapid. So for one week I would be hypomanic and really capable and efficient. Then the next week I would be depressed and accomplish very little. And then the mood swing cycle would start over.

For a while the amount of work I accomplished in the hypomanic parts of my mood cycle was able to compensate for the periods of depression in which I did very little. However, by October 1996 my depression episodes had become severe enough that I stopped going to work during them. So work and undone tasks started to pile up.

And then my depression episodes got really bad.

Sometime in November 1996 I disappeared for two weeks. No one could find me, not the people at work, not my friends, not my parents or my brother. No one. My parents thought I had been killed by car-thieves. When I eventually resurfaced, in apparently good order, my family was too happy to see me to ask many questions – none of which I could answer sensibly anyway. I was the prodigal son returned.

I took back up life as normal. The vast majority of the people either didn’t notice I was missing or thought I was just working so hard that I didn’t have time to go out with them. I was the manager at my workplace so no one questioned my disappearance. And incredibly, I didn’t think anything was wrong. It was as if there was this blind spot over my memory that prevented me from seeing what had happened and realising I needed help (I still have trouble remembering such episodes).

My parents persuaded me to see a psychiatrist, an old skinny man a generation or two before my time who asked me a few questions, explained in a perfunctory manner that depression could be alleviated by medication, and prescribed Paxil, an antidepressant. By the end of the session, I had decided that I did not like him, that I clearly could not be suffering from depression, and that this was a waste of my time. But I got the medicine anyway, took it for a week, and then stopped it when it seemed to have no effect.

Christmas 1996 was a miserable time. Everything limped along at work. Nothing went badly but none of the plans I had for making Christmas special took place. I knew things were not right in my life but I was unable to do anything about it. My life felt broken, as if pieces of my dreams and plans and work and social life just lay scattered on the floor with nothing holding them together and no connection between one piece and the others. All I felt I was doing was dealing with what seemed to be crisis after crisis.

I also felt as I if I was an observer of my own life, standing behind a piece of glass and watching myself stagger through daily life. I knew exactly what was wrong but I was unable to reach through the glass to get the me who was living to change habits or actions.

I remember Christmas being lustreless. I dutifully purchased Christmas presents, at the last moment, gave them out and received my presents in return. There was no joy, no fun in seeing my niece and nephew get their presents – indeed it was almost unbearable to be in the noisy house with my parents and brother’s family and I escaped as soon as it was polite.

In keeping with my fluctuating moods, between Christmas morning and the following afternoon I somehow arranged with my cousins to have an Old Year’s party at my house. I remember it as special because my grandmother attended and surprised all her grandchildren by dancing through the midnight hour and keeping up with the best of us until the party finished around 3:30 in the morning.

Within the first week in January my grandmother became gravely ill and about one month later she died peacefully and I think happily in her bed surrounded by her sons and daughters and clouds of her grandchildren and angels.

When you are bipolar, you are often asked what stressful events in your life might have triggered your mood swings. I suppose that it could be said that Christmas 1996 and January 1997 had quite enough happenings that could cause my mood swings. But while I certainly grieved for my grandmother, it never felt as if any of these circumstances were causing my mood swings. And I was already having a pretty difficult time before my grandmother died.

During January and February 1997, nothing changed to improve my overall situation. My alternating periods of depression and hypomania were causing my work and my life to get more and more out of control in spite of the best I could do. I was sane in the conventional sense in that if you had spoken to me you would have seen me (more often than not) as an intelligent person with a good grasp of the problems and conflicts in my life and with an excellent grasp on how I should be solving them.

The problem was that I just wasn’t solving my problems at all.

I did not see my problems as anything other than overwork and procrastination on my part. What was actually happening was that I made the standard mistake of seeing each symptom of being manic depressive as a separate problem and not seeing the larger picture in which all the symptoms were connected. I was applying patch after patch to each problem / symptom as it happened without realising that I needed to fix a much larger problem.

And because I was blind to the larger problem, I did not realise that the very nature of being manic depressive would inevitably cause my method of patching up each crisis to fail.

By the end of February 1997 I had reached a position where I was not being at all successful in clearing up my problems. I would gain some ground during my hypomanic week but then fall even further behind during my depression week.

I know what failing is like because I’ve often been there. But back in 1997 it had reached an extreme stage. All my projects at work or outside of work were failing. Not most. All.

In a way that was mostly ok. Problems can be fixed. What was intolerable was that I couldn’t fix them. My projects weren’t failing, I was. During my depression episodes I felt that I would never be of value to myself or anyone else ever again. In my hypomanic periods I would scramble feverishly and in vain to do something, anything, to shore up the things I was doing. And while I was doing this I was also standing on the sidelines watching in horror as everything that gave my life meaning lost familiarity, faded, failed, and became meaningless.

By March 1997 the depression episodes had become ascendant and began to last more than one week. I began go out with my friends less, and do everything less. My house began to look like a student’s apartment as dirty clothes and dishes piled up and books sprung up everywhere all covered with dust. My garden transformed itself into a small forest. I began to live on fast food and I put on quite a bit of weight. I began to think of my house as a haven, a cave to which I could retreat at the end of work and where I stayed until I was forced to go to work. On weekends I did not emerge until Monday morning, and then only very reluctantly.

And eventually I stopped going to work. It didn’t happen all at once, but rather I would reach to work later and later until finally a day would arrive when I didn’t make it in at all. And on the days I didn’t make it in I would disappear. Basically, I would roam around the country in my car without telling anyone where I was – anxious because I was doing something I considered wrong, but not being able to stop what I was doing or even think coherently about it.

It turns out this anxiety is an inherent symptom of my depression, but I did not know that at the time and just chalked up my disappearing as yet another personal failure. Cowardice was added to my list of character flaws.

This disappearing or not wanting to see or meet with people got stronger the worse in each successive depression episode. In a way this felt like a reasonable response – my disappearing was something very stupid, I had no answer for it, and I really did not know how to explain it to anyone. The same anxiety that made me it impossible for me to go to work and caused me to disappear made it difficult to return home on afternoons to face the answering machine, my parents, a concerned friend, anybody. Eventually I started leaving home at seven in the morning and returning after midnight just to avoid having to talk with anyone.

And finally, one day in May I just did not return for two weeks. I almost did not return at all.

I usually tell people I don’t know what I do when I disappear and then reassure them that I did not do anything stupid. The fact is that I can remember everything I do when I disappear, but it is an odd sort of memory. Even immediately after it happens, it feels as if it happened a long time ago. I remember it as if it was an old home movie faded with time and with tears and other imperfections in the scenes. It takes quite a bit of effort to pull what has happened to the forefront and answer any questions about the times when I disappear.

Also, I remember these memories suffused with anxiety or terror to a level that has to be experienced to be believed. My mental state was close to how we think about an animal’s awareness, without true conscious thought, just an instinct for food and comfort and sleep. During the periods I disappeared, I don’t think I really ever thought about anything at all, and my intelligence was just used to solve immediate instinctive problems of finding food, etc..

I don’t try to remember or explain any of these times to anyone. One does not describe the antechamber of the court of madness to anyone.

I reentered the real world two weeks after I disappeared, when I crashed my car at about four o’clock one morning. I had managed to skid off the road, jump clear over a ditch, miss a piece of iron that would have ripped out the underside of my car (and probably me), run over four saplings and stick the front of the car about four feet off the ground on a fifth. I came away completely unhurt.

Even then I was at the stage of walking away from the wreck and continuing my disappearance. Fortunately, or unfortunately, a good Samaritan had been driving behind me. To my great annoyance at that time, he insisted on helping me disentangle my car and then calling someone to help me. He may have saved my life because I have never been sure what would have happened if I had walked away from the wreck.

My father came to collect me.

In all the favours that my parents have ever given to me, I don’t think any have ever matched the one they bestowed in not questioning me about what had happened over the two weeks I had been missing. I suppose they had their ideas or their worries but they never tried to verify any. They just accepted me back and wrapped their wings around me to protect me from the next few weeks.

I tried to continue my work. But my depression was too profound. About ten days after my return and trying to do basic work in office, and not really succeeding, I handed in my resignation. And then I did nothing for many months.

Actually, shortly afterwards I started to see a therapist who had been recommended by a close friend. I was jobless and I knew that something was wrong that needed to be fixed. But I still didn’t feel anything important had happened. Like all previous memories, this last episode had very quickly faded into relative insignificance. So once the anxiety wore off and I felt less stressed, I started questioning the need to be in therapy.

I was not in denial. I simply did not see that there was a problem.

Nevertheless I enjoyed therapy very much. My therapist and I met twice a week and after the usual first sessions in which nothing productive happened (I was defensive and uncomfortable), I started to admit that perhaps I was having problems. Over the course of a few months I began to feel that I was getting somewhere. The therapy did make it easier to handle the changes in mood. However, the mood swings did not stop, and as I started back to take on additional projects in my hypomanic periods the stress started to build again.

I suspect that I would have given myself another breakdown and scared everyone again if I had not gone on vacation in November 1997.

My vacations are my relief valves. I go on them, visit friends and come back refreshed to take on the world. Only this time it did not work out. Instead of my usual energised self, I found myself unable to enjoy spending time with my friends or indeed unable to coordinate my sightseeing schedule. When my friends weren’t with me I was very close to being a zombie, unable to decide what to do or go visit. I was in Toronto, but I don’t think I saw or enjoyed much of it at all.

I had promised very close friends in Miami I would visit them after Toronto on the way home, but I was so apathetic and full of anxiety about talking with people that I was unable to make the simple call to tell them when I would be arriving. Needless to say they were both annoyed by my basic discourtesy and when I did arrive in Miami was told off by them both for it.

You can always say you gave up a job because it was too stressful. Or that your memory loss is “just one of those things.” Or that you and your lover broke up for real or stupid reasons. Or that things are sliding because you are overworked or tired. But I had a difficult time explaining to myself why I was treating friends I valued so much so cavalierly.

Changing one’s life doesn’t happen all at once; it happens piece by piece. Nevertheless, if there was a single point I would point to and say – “There, that was when I admitted I was ill” – it was at the realisation that I could lose real friends if I didn’t fix myself.

When I returned to Trinidad, I asked my therapist to recommend a psychiatrist so I could be prescribed antidepressants. Four months before I would never had considered this, but the time spent in therapy had acclimated me to the concept. I still didn’t think I suffered from depression or manic depression, but I did think I needed something to tide me through.

The psychiatrist spent far less time in diagnosis than I expected. I was asked questions about myself, which I could readily answer since I had discussed most of them in therapy already. I was given a list of questions about mania and depression to answer, which showed clearly I was both, but not to any severe degree. What was also abundantly clear was that I moved from one state to the other quite rapidly. And in what I thought was an extraordinarily short period of time I was diagnosed as Bipolar II, possibly Cyclothymic.

I have never been satisfied with that initial diagnosis, even though it has been borne out as true. I have always felt that if I was going to be told that I was going to be crazy for the rest of my life it should certainly take more than one hour. And it should certainly be a more, well, technical process than chatting pleasantly with a very nice guy. I don’t think I have ever forgiven him for my diagnosis, and it probably was the major factor in eventually changing to another psychiatrist. Bearers of bad news often do get executed.

And so I started taking medication. The next pages are the experiences with those.