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Mind swings - recovery from mental illness

Posted by | July 31, 2007 .

I felt like a werewolf growing claws. A migraine headache generated blinding spots in front of my eyes. The rustling Florida palms outside the kitchen assaulted my ears as I tried to wash dishes. The year was 1994, and I was visiting my mother’s home near Tampa. She quietly asked me a benign question, but her words stabbed like a knife. In response I crashed a cast-iron skillet in the sink and turned the silverware into weapons of mass destruction against defenseless plates.

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My mother, a retired nurse, assumed the mask of a cool clinician, but bewildered eyes betrayed her confusion. She watched me edge toward my bedroom, one hand cupped around my temple and eye, trying to block the painful glare of the dimly lit room and the violent sound of near silence. I fell on my bed and lay for days in an all-encompassing somnolence.

Episodic mood swings were nothing new to me. Typically I was an extroverted whirling dervish of productive energy–sometimes to the extent that people asked, “What are you on? “I’m just on a natural high,” I happily responded, then spun away. But, from the age of 13, the seven to ten days before my menses were often distressing. Once a month I faced the possibility of metamorphosing into the thing with claws.

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Occasionally, the onset of my period added an irritable, agitated kick to my euphoria and I verbally–sometimes physically–tried to mow down anything in my way. I did not realize then that these shifts were only partly due to premenstrual syndrome (PMS), which subtly masked a mood disorder that left untreated would become even more debilitating.

I was 16 the first time I put myself in therapy, and by 1994 I’d spent more than two decades swinging from various kinds of highs to increasingly crippling lows. It was the verdict of at least seven doctors I had consulted since high school that I was a Type A, overachieving, stressed-out-from-work woman with a traumatic family history. That may have been true, but as I got older, talk therapy failed to stop the exhausting highs and debilitating plummets. Despite long periods of stability, my body chemistry was awry, and it was more than the hormonal frenzy of PMS. The frequency of my mood changes, which worsened with age, convinced me of that. I couldn’t have PMS 24-7, 200 days a year.

As a journalist and author trying to fulfill a second book contract in 1995–and three years behind on the deadline–I was alarmed by a new inability to concentrate and write consistently. I would stare at my computer screen for eight, ten, twelve hours a day, in a sterile writer’s trance. My fogged brain grasped at jumbled thoughts that evaporated with each effort to nail them. At the end of a frustrating day, I fell into a sleep from which I was often awakened by pains that throbbed deep in my joints. Compelled to get up to go to the bathroom, I would linger in front of the mirror, intrigued by the hideous woman I saw there–her features a fun-house mirror distortion and her pinpoint pores, a particular preoccupation, cavernous. Staring at my image, I wanted to take a razor to my throat.

DIAGNOSIS: MANIC-DEPRESSION

Just after Thanksgiving in 1995, I dragged myself, in tears, to my internist, demanding that she refer me to a female psychiatrist. (I’d been completely alienated by the paternalistic male clinicians I’d seen previously. And I wanted drugs prescribed if necessary, something a psychologist cannot do.) At the department of psychiatry of the Washington University School of Medicine in St. Louis–a leader in the diagnosis of bipolar disorder–I met with Devna Rastogi-Cruz, M.D. I immediately felt at ease. “I feel so tired,” I said during our first appointment. Despite my fatigue, words tumbled from my mouth at emotionally jacked-to-the-max Energizer-bunny speed. “I’ve got to finish this book, but I’m years behind….” Then I backed up and gave Rastogi-Cruz the history she needed.

Every two or three years since I was about 13 years old, I would crash, I said, recounting the story I had told previous doctors. I would come down with a severe respiratory ailment and become irritable and withdrawn. Those episodes usually followed intense, exhilarating months of work and socializing. After my crashes I’d regain my equilibrium.

“I trained for years to be a musician,” I continued, “and sang on major concert stages before I was 18. Singing was all I ever wanted to do. But in the seventies I caught the tail end of the Black cultural-nationalist movement and embraced it zealously. I am often zealous. I abruptly abandoned music and changed my major to journalism. I decided I could have a greater political impact as a journalist than as an opera singer.” I stopped to look at the doctor. “You with me.?” Yes, she nodded.

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