Tongue In Cheek Responses, But, they are still reponses. Often, when I "come out" and talk about my bipolar disorder and conversation does turn in the direction of humour because with mental illness in any form there is a humorous side. Not everyone sees the humour but that is true of all kinds of humour--some see it and some don't. Anway....here is the next instalment for whatever purpose readers on this thread may have.-Ron in Australia
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2.7.11 These behaviours, this depression, at the age of 19 or any of my behaviour before that last year of my teenage life(1963-1964), did not result in my receiving any medical attention. The first formal diagnosis of my illness was labelled a schizo-affective disorder(SAD) in 1968. SAD is a sort of hybrid condition between bipolar disorder and schizophrenia, although this distinction may be somewhat artificial. It may be inappropriate to have a discrete cut between the two disorders when both may represent part of a spectrum and symptoms of both disorders were part of my experience during the last half of 1968. This situation involved the possibility of a serious risk of harm to myself or others and required in July 1968 what is termed involuntary commitment to hospital. This case involved a severe BPD episode with dangerous-violent and aggressive behaviour as well as depressive episodes in August with suicidal ideation.
In retrospect, I now see the autumn of 1968 as the first formal diagnosis of my BPD, although I was not to personally receive/read that diagnosis until 1970 when I visited a psychiatrist in Kingston Ontario. At the age of 19, though, I was given lots of advice from religious to common-sensical: diet, exercise, prayer, vitamins, interesting leisure distractions/interests like horse-riding, watching TV, music, et cetera. After several months to several years, 1963 to 1968, the emotional aberrations disappeared or could be said to be sub-threshold at least for a time. My episodes over those years and in the years December 1977 to June 1980 seemed to exhibit quite separate and distinct tendencies and patterns from those I had experiences in the 1960s.
2.7.12 Hypomania(H) was always characterized by elation and D was always characterized by varying degrees of very low moods. Such an observation seems now to be so obvious as hardly to require a mention, but at the core of my experience of this problem was either D or H and the impact of their various symptoms. The boundaries between normality and abnormality, health and pathology are also blurred and indistinct. In addition they shift from person to person, doctor to doctor and decade to decade making one’s understanding of the problem more complex, more difficult. Within those five years, 1963 to 1968 though, the permutations and combinations of emotional variation were enough to being tears to the eyes of a brass monkey, as my mother used to say. Looking back in retrospect at those last years of my formal education, I see it as a miracle that I ever got my BA degree and my teaching qualifications labouring under such emotional chaos from time to time and often, week after continuous week in a variegated pattern.
2.7.13 Although the pharmaceuticalization of the post WW2 modern world had began in earnest by the 1960s, it had not taken off that earnestly as applications to the behaviours and symptoms that I exhibited back then. The most successful treatment I received, though, was pharmaco-therapy and this continued to be the case for the next forty years.
2.7.14 Sometimes there was a return of incapacitating symptoms; sometimes I simply exhibited impetuosity or lack of emotional restraint; at other times my moods were expansive, quasi-manic. Perhaps, as some of the BPD literature suggests, I was affected sporadically by the extremes of a psychomotor retardation and agitation which is characteristic of this illness. Combinatory, lateral, uneven, unusually sensitized thinking, particular sensitivity to energy levels and a state of increased awareness were all part of my experience in these five years. It is difficult to describe these five years in retrospect given the bizarre and chaotic nature of the experience. Given, too, a general context of a degree of normality and the inevitable routine and quotidian nature of life that went on inspite of everything, inspite of the emotional problems makes the description of the details of these experiences, after forty years, difficult.
2.7.15 In the years 1969 to December 1977 the symptoms of my BPD were sub-threshold, non-existent or not as extreme. I coped and my behaviour did not require or even suggest medical intervention. In the 1977 to 1980 episode, the next major episode, H and its various symptoms like elation and good feelings, were rare and varying intensities of D were common. The episode lasted from December 1977 to June 1980, some two-and-one-half years. The first episode had lasted off-and-on from October 1963 to December 1968, a little more than five years. This second major episodic-period only lasted half the length of time that the first had lasted, but this was only due to the lithium treatment that put an end to my symptoms quick-smart. Without the lithium which I began to take in the first week of May 1980—who knows what the BPD symptoms would have been? The sixth leading cause of disability and lost years of healthy life for people aged 15-44 years in the developed world is BPD. I had lost only fifteen months of employment due to hospitalization(6/68-12/68 and 5/80-12/80), although much more time of varying degrees of decreased functioning. In addition, taking an early retirement at the age of 55 and going on a disability support pension at 57 until I was 65 could add another ten years onto this one year of unemployment due to BPD, if I wanted to make a fully comprehensive statement of the affects of BPD on the total years of my unemployment.
2.7.16 In early December 1968 I had left the mental hospital in Whitby Ontario on a mild sedative. I think it was called valergan; but I’m not sure; I have forgotten its name after nearly 40 years. In the nine years from 1968 to 1977 I tried: exercise, diet, giving up smoking, sex, radiesthetics and hair analysis, jogging and play therapy, among a range of treatments to prevent or alleviate any incipient symptoms reoccurring.
2.7.17 In the episodes from 1977 through 1980 the constellation of: fear, paranoia(P) and the extremes of D were often as low as I had experienced in the sixties, in those chaotic years of that episode from 1963 to 1968. I experienced in those years 1977-1980 a range of emotional swings, but they were largely, at least as I recall looking back a quarter century later, at the D and P end of things. A psychiatrist in Ballarat prescribed stelazine or trifluoperazine, an antipsychotic drug. It was at first administered in early 1978 and it seemed to make things worse. In December 1978 I moved to Launceston with my wife and three children and, after a series of two or three quite severe emotional swings at both the H and the D end from January to May 1979, a psychiatrist at the Launceston General Hospital prescribed lithium. After just two or three days my symptoms were relieved never to return in the same form.
2.7.18 I include the above observations and comments on this second major episode because they throw some light on the first episode and place my childhood and adolescent experience of BPD, if indeed I had that disorder at all in those years, in a helpful perspective at least for me, if not for others who read this statement. Depressive episodes for those with BPD tend to have a median length about 6 months with manic episodes usually beginning abruptly and lasting for between 2 weeks and four to five months. My episodes of depression and mania were certainly within this range.
It is helpful to me to express my disorder this way, that is in longitudinal, retrospective, terms as far back as my childhood and this I hope will be helpful to other BPD sufferers and some readers of this document for other reasons. My account here may appear somewhat complex and labyrinthine for general readers and I would advise such readers not to try and follow all the permutations and combinations of my description of this disorder. My description is quite difficult for some to follow and for me to outline in detail and to understand in general. As I go about relating this story, I go about trying to place this narrative into some coherent form. It has taken these seven editions over eight years to get some sense of coherence, some sense of continuity, into what some biographers and autobiographers sometimes call a ‘chaos narrative.’
2.8 From My First Episode of MD in 1963
To My First Institutionalized Care in 1968:
2.8.1 The episode in 1963 continued in a complex series of forms up to and including 1968, as I have outlined above. This episode was not diagnosed as either MD or BPD in those years. This episode, part of my first phase of BPD as I see it in retrospect, did not receive any professional psychiatric diagnosis until June of 1968. From June 1968 to November of that year I received institutional care in: the Frobisher Bay, now Iqaluit, General Hospital; the Verdun Psychiatric Hospital in Montreal; the Scarborough General Hospital in a Toronto suburb and the Whitby Psychiatric Hospital about a 30 minute drive from Toronto. The story of those years from 1963 to 1968 and those four psychiatric units and hospitals were my years of university study and the first year of full employment. The story of these years is long, stony and tortuous and I will not write the account of these five years in any more detail since no medical diagnosis was given to me in writing or verbally. I did receive a great deal of advice and types of treatment: (a) more exercise and prayer, (b) a better diet and sex, (c) drug therapy, 8 ECTs and other types of therapy from talk to art and manual activities. I do write of these six months in these several facilities in my memoirs in much more detail than I do here. To write of it here would result in prolixity.
2.8.2 In June or July of 1968, though, one member of a battery of doctors, psychologists, psychiatrists and other care givers who were then providing my treatment program in Montreal Canada at the Verdun Psychiatric Hospital took a personal interest in my case. He was the first attending psychiatrist in my life about whom I remember anything at all. He was a Baha’i, a religion that had its origins in Iran in 1844; he was one of perhaps 4000 Baha’is in Canada at the time and perhaps its only psychiatrist. He was himself at the outset of his own career in psychiatry. I had been serendipitously institutionalized here after the onset in late May of 1968 of an episode of BPD which was given no name at the time, although colloquially I recall it being said I had become “bushed” or, as they say in Australia, “gone tropo.”
2.8.3 I had been working with the Inuit at the time in Canada’s high Arctic as a grade three classroom teacher. Looking back it seems highly fortuitous that this first institutionalized care that I received was, in part, from a psychiatrist who shared the same belief system as I did, the Baha’i Faith. I remember him taking me out into the community to meet some of the Montreal Baha’is and their friends. Such an exercise, I assume, he felt was a normalizing experience.
-------NEXT INSTALMENT TO COME WHEN AND IF DESIRED-----
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