Friday, January 30, 2009

A Way of having Manic-DepressIon: Creativity & the Myth of the Self

This piece was originally written in 2002 then published at, an online arts publication by people living with mental health conditions, in 2004.

CREATIVITY & the Myth of the Self

Lovers & madmen have seething brains,
Such shaping fantasies, that apprehend
More than cool reason ever comprehends.
The lunatic, the lover, and the poet
Are of one imagination all compact.

A Midsummer Night's Dream

My grandmother always said I was such a happy baby. I was. All those smiling pictures prove it. They reveal nothing about the circumstances that stimulated my brain to create certain sensations, and made sustaining the happiness pathways more difficult. That I have manic-depression was not distinguished until I was in my thirties, though certainly since adolescence I had had fits of moodiness, melancholy and occasional moments of such joy as I cannot describe. My family had chalked it up to congenital eccentricity and teenage angst. For me, the world I felt came from Soul and spoke to me powerfully through art, music and, especially, the literary arts. Writing made sense of my life, brought me great happiness, and created a conversation with deepest self that is not to be found anywhere else.

As I re-examine my creative journey it is impossible for me to distinguish the peculiarities of manic-depression from a more universal experience of the creative process. Not coincidentally the poets, and all the great artists, to whom I was most drawn were ones I later learned shared my "mind" (having depression or manic-depression)—and it was their truths that moved me and revealed most poignantly the nature of life. (Michelangelo, Van Gogh, Handel, Emerson, Robert Louis Stevenson, Henry James, Blake, Coleridge, Wordsworth, Keats, Whitman, Joseph Conrad, and Virginia Woolf, to name a few.) Do I know what I know, or do I know what I know because of manic-depression's chemical circuitry?

I was a joy junkie from the start. From earliest memory I was agitated by an aesthetic sensibility: by this I mean the shape color motion and design of the world burned into me. Without knowing exactly what was "beauty" or ugliness" I reacted profoundly to an inner judgment of beauty and ugliness. It began for me with the memory of a slant of sun on a gray slate floor when I was two. My memory was acute, my feelings raw. I sought the agitation my sense of "beauty" excited in me. I found it in certain frames—a particular line between the red barn and an old maple growing up out of its foundation, twisted bits of rusty metal, my father singing me to sleep, the sound (oh, glorious!) of certain words!

I must have been three or four when unknowingly I became a reverent initiate into the Word World. Through songs, conversations, books, the music of that world came to haunt me sweetly. "Soporific" was my first big word, thanks to the lettuce-eating Flopsy bunnies. It intrigued me. "Truncated" came next. Driving to pre-school one morning I asked my father what the funny "baby" busses were. He gave me the word, and counting "truncated" busses became our morning ritual thereafter. What words! They tasted. They sounded what they were, and I sensed their power (it was not a great conceptual leap later, when manic, to understand why chanting and incantations have such energy.)

Once I overcame an initial difficulty learning to read, I busied myself with acquiring more words. I was voracious. Any books too difficult, I demanded to be read to me. Obligingly, I was introduced to Treasure Island, A Little Princess, the exotic streets of Kim (the indoctrination of an anglophile.) There seemed no disjunction between my rugged life as a tomboy and the heady world of books. I was strong-willed Jo March, sly Odysseus even as I was a little girl growing up in the privileged ease of a patrician New England town. Living in Concord, I took history for granted, accepted the fine education, learned Emerson by osmosis and loved the sturdy long civilized land of river, fields and trees. My friends and I were master-frog catchers, tree climbers, and swing jumpers. Yet, the hours in books were as real to me. Their beauty was distilled by the filtering sensibility of the author, while life demanded constant vigilance to fashion as the dictate of my inner aesthetic demanded. Then too, I needed the escape.

This idyllic childhood was punctuated by disjunctive sorrows—my mother's "nervous breakdown" and hospitalization when I was four, my parents' ensuing divorce—respective remarriages, my uncle's suicide when I was twelve, my mother's brain aneurysm when she was thirty-seven which left her in a vegetative state for sixteen years until her death. All these could have been enough to engender depression, but in the proverbial family closet were relatives with alcoholism, agoraphobia, manic-depression and practically every eccentricity imaginable.

(One of my favorite family stories concerns my father's great-grandfather, a successful, beloved and upstanding citizen by all accounts. He was a bear of a man--three-piece suited, tall, longhaired and bewhiskered in 19th-century fashion. On summer eves, he would sit himself near the edge of the pond at the back of his farm, a bamboo rod in hand. He would ring a great cowbell. Before the last clang had faded, the water's smooth surface erupted in purposeful ripples. In a moment, a dozen giant bullfrogs arranged themselves at his feet. A wriggling white mouse was proffered to their beamy mouths. I have a photo—the mouse a blur of frantic motion at the end of the line. He lived into his nineties and enjoyed a swim each day, especially when it required a hole to be cut in the ice….)

My personal sorrows were unsought for and out of my control, to say nothing of the ones I would make for myself. As a child, I sailed through them with the joy of imagination as a strong yet opaque veneer over the sorrow I sensed life to be. Then, becoming myself and finding my voice was not nearly as neat as my narrative suggests. My fascination with expression began with "making" things. I had a neat hand and was a fine draughtsman by the age of eleven. Both my parents drew well, and since my architect father's office was at home, and abundance of pens, paper and markers were available to me. Both parents encouraged me. My mother took me to art museums, my grandmother to symphony and church, and I looked and looked, and listened and listened until I thought I would burst with it all. I loved playing with clay, the rolling, molding, rubbing smoothing, and squeezing provided both a visceral and kinesthetic pleasure (if not a sadistic one—when exasperated, I could flatten it in a moment.) I knew then I would be a sculptor.

The dabbling with art and music, the years of writing required journals for 7th and 8th grade gave way to angst-ridden (dread purple) prose of adolescence. I had made a transition from being required to write to wanting to write, until I noticed one day, during college sometime, that my paints and inks had grown dusty with neglect. Journals were piling up. I understood then that words most accurately created and reflected an inner vision. I had found my way.

Language, then, became the medium of my most personal expression, the one I felt most skilled in and therefore, I suppose, it felt most effortless. Through the great painters, musicians, and poets who had inspired and called to me, I came to recognize a certain brutality in beauty. Beauty is an insatiable and jealous master (or mistress, as the Rose in Le Petit Prince reveals). This may point to an explanation for why creative people are often so difficult to live with. They reach after some ecstatic sensation only achieved through original recognition. Some artists, in the throes of mood swings, are compelled by the penetrating quality of mania to capture it. No other experience will do. It is there in Coleridge's moment of epiphany, Woolf's moment of being—once perceived already past. Ordinary reality prevails so another apprehension of joy must be sought.

This seeking requires a single-mindedness that brooks no interruption; this reaching after beauty knows no rest, and it is this that makes it brutal. It demands all, and gives nothing but some dangerously addicting inner satisfaction—the Holy Grail a manic often resists giving up. As a young child I had sought that feeling by climbing fragile treetops, intoxicated by daring. I had run fast through field grass, until exhausted, to test my limits of endurance. In winter, I would skate fast in an ecstasy of speed until I fell against black ice. Pain did not deter me. I made pain to be as essential as night to recovering that suspended place of joy. I was ignorant then that for a nature such as my own, the debt of depression was yet to be paid.

Writing my undergraduate thesis on Virginia Woolf, I began unraveling Woolf's understanding of her own process and discovered a way into articulating my own. I found in her a kindred spirit; felt often as if I was her, so parallel was her reality to mine. I knew my process had much to do with memory, something to do with inspiration and time passing. And much to do with sustained struggle. The process is anything but linear. There is overlapping, backtracking, swerving in unexpected directions (some fruitful, some not) blind alleys, bright byways, so that creating resembles not so much a straight line, as it does a drunken man's path through an unknown city to an unknown hotel.

I emphasize remembering because it is the source of creation, even if it is the fiction we make of what we remember. Creating is a natural extension for the manic-depressive mind: it looks to make everything fit into a cosmic theme somehow (the imagined South of Faulkner, Shakespeare's Denmark, and Homer's Troy) through seeking patterns, connections and meanings. In the beginning there was darkness…. It invents everything—all our myths of Self. It chooses light, dark, light, dark light, light dark… and all the exotic shades and colors in between. Hypergraphia drove me. Writing and my aesthetic sensibility saved me. What I felt and could not understand found voice and acknowledgment on the page. So I too picked up my pen and sought redemption—there.

In spite of all I knew of my family's history, it never dawned on me to think my frequent bouts of depression to be anything other than a protective response to very real sorrows. Many people suffer more than I, some less, but in the end the past must be past and life lived. I had reasons to be sad, and many more to be happy. Even my first (Harvard-trained) psychiatrist failed to pick up the mania piece when I described a strange experience that occurred when I was twenty-seven: for a few days I had the sense of spiritual connection, a seeing through reality that distinguished every "thing" my eyes beheld (from a broken branch, "Yield" signs, chemical names on the back of a medicine bottle, etc.) as a sign of Grace, accompanied by internal religious/literary visions, sleeplessness and obsessive writing. I described this after coming to her with depressive symptoms three years later. She thought my episode an isolated psychotic break. It wasn't until I was thirty-six and seen by a doctor while in a second manic episode that I was correctly diagnosed. The clues had been there all along: at times, little need to sleep, the incessant urge to write, periods of high productivity, self-confidence and well-being and the subsequent sloughs of depression, which I felt not so much as weepy sadness, but as lack of energy and affect. Life as a suffocating straightjacket—the gray, fuzzy, unfulfilling monotony slowly, and ever, tightening.

I am fortunate that despite my family's fears, they cared for me when the mania was acute and didn't infantilize me when well, despite any personal misgiving or concerns they might have had. Of course, depression was not seen as anything but the low end of normal and, since I have always had "walking" depression (fulfilled my duties, so to speak), that aspect of the condition had not been judged as troublesome, except by me. I have responded well to medication, though changed my mood stabilizer to one that does not seem to have the accompanying lethargy and tiredness that some drugs do, and I have kept the depression at bay with an additional amount of anti-depressant. The slight aphasia and hypographia is annoying, at times frustrating, but worth it compared to symptoms and more enervating side effects.

I have tried going off medication a couple of times, but the pleasure of hypomania exacted too high a price. The one exception was when I was pregnant. I never felt so satisfied—happy, patient, even-keeled. I have shared with all my doctors since that if I could be pregnant the rest of my life, not only would I no longer need meds, but I would no longer need therapy! A side condition for me, beginning in adolescence, has been binge-eating somewhat mitigated by regular exercise but by no means licked. This too disappeared during pregnancy. Without trying to or not trying to, I was only two pounds over my usual weight after I delivered. Unfortunately, the halcyon days following the birth of my daughter were paid for in months-long malaise after that.

I miss the hypergraphia. Instead of writing being an urgent expression in my life, I must plan and work for it like ordinary mortals. Still, the memories of being one with a larger Consciousness, the flights of knowing experienced in mania, will never leave me and continue to sustain and inspire me. I draw on them all the time. I liken mania to the epiphanies of the spiritual master's deep discipline. It occurs to me that a master's vision is regulated by practice over time, as the mind is made ready for the experience, so that it can be translated to others in an understandable way. Mania is a strike of lightning—brilliant and dazzling to the one struck, but frightening to those who behold it. Mania's sudden revelation, without the containing practices, is overwhelming, and thus my attempt to describe to others in the moment interpreted as "lunatic." This by no means invalidates the "truth" of the experience; just as knowing love has a chemical trace in the brain by no means devalues it.

What I learned was in what I felt—Love is at the source of Everything. And we have the choice to be one with it or not. As Milton so brilliantly put, God made us strong enough to stand but free to fall. I read once that scientists had discovered what they initially thought were mushrooms peculiar to a large area out West. It turned out they were a single underground fungus of which the heads were the only visible part. We are the single heads who, once born as individuals, forget our Cosmic Oneness, and our work here is to remember it. My plea to researchers is to investigate more qualitatively—to study the interface between spirituality, manic and epileptic experience. And to clinicians—not to be so dismissive of the visionary reality of the condition, even as continued and closer partnership with researchers creates more precise protocols for management of the most dangerous symptoms. What great future achievements of mankind would be compromised if the genes were disabled?

My stand is for the possibility of wellness—for altering the conversation about mental health in society, and for people with mental health conditions to get that they are a contribution no matter where they are on the illness/wellness spectrum. How would life look if this were realized? We are not our diagnoses, but people living with a chronic condition. We would relate to ourselves as managers rather than as patients. Clinicians and researchers would be partners in our health and well being, just as they are now to people with diabetes or heart disease. Suicide would be a conversation, not an option. We would be whole and complete just as we are—flaws and all—rather than something to be fixed. We are a gift in the world, and our "difference" would be a missing in the experience of what it is to be human if we were not here to express it.

For myself, I would not change anything. Having manic-depression has allowed me to see through my identity to that recovered place of Joy. I manage my condition now by choice. To stay on drugs, despite the loss of the hypergraphia, is generated by my commitment to not waste any more of my life being depressed. That has been too costly. I choose the process of wellness; work at being present to my daughter, my friends and family knowing it is ongoing and never complete. Medication, meditation, exercise, therapy, sharing with friends, traveling, involvement in work that gives back to others and moves me—whether it be volunteering at my daughter's school, being active on two boards, or participating responsibly in programs for transformation—all these create and sustain a life I love. I must make my happiness rather than depend on the sudden, unpredictable rush of chemicals. The experience of manic-depression has made me who I am—connected me to others and, as my daughter would say, to the "piece of God" in all of us. It has opened me to the journey of Consciousness, to a vision that once had "must perpetually be remade" in the heart and life of now.

Wednesday, January 21, 2009

Seeking Service: E Pluribus Unum

With the events of yesterday still filling me, I have been moved to re-read some of my favorite poets: Walt Whitman, “Song of Myself”; Wallace Stevens, “Notes Toward a Supreme Fiction” and “The Man with the Blue Guitar” (It must be this rhapsody or none,/The rhapsody of things as they are.), Derek Wolcott, “Love after Love.” For it is the poets who remind us in their work of our link with the Eternal. This is the gift too, of great orators—that we are lifted out of our routine selves and have the experience of timelessness. It is what we remember. In this too, we are blessed with President Obama, whether you agree or disagree with his politics. He declares us to be bigger than we know ourselves to be and to join together not only as family, friends, towns, states and country, but to be—like himself—a global citizen, accountable not only for the good, but the harm we do; not only for the great but for the least among us.

Not a whit, we defy augury: there's a special
providence in the fall of a sparrow. If it be now,
'tis not to come; if it be not to come, it will be
now; if it be not now, yet it will come: the
readiness is all….

As a nation, we have defied augury, and we are ready, whether we know it or not. This seems a time of fear and anxiety. For many in the world who wake each day without shelter, food or water; who live amidst rubble or war; who experience or perpetrate violence (physical or emotional); whose every day is or threatens trauma, a lost home or job—is there no new day for them? As the Buddha said, Life is suffering. Yet each day, the Heart of the World opens further, contains more, heals some. The Heart is an infinite house.

So I ask, as I listen to the early plans of our new First Family, to open the White House and to be more open in the White House, that we do likewise. That, like them, we open, listen and support a new conversation. Simply, find your passion and commitment. Look within. Hear the inner conversation that runs your life (you know, that voice inside that never stops, and usually has something critical to say…?) and see what serves or doesn’t serve your Self.

My friend Craig shared a quote with me, that I’ll misquote here, but I heard as “there are no walls between people; there are only the walls we build to keep others out.” Stuff happens. I feel pain, and I can’t change that, nor would I if I could. But I can change how I relate to what happens. Will I choose to become more compassionate or will I become more rigid and shut off? Sometimes the former, sometimes the latter, but I’m beginning to find my heart more readily and easily each day. Baby steps for me. For our country. For the world.


Saturday, January 17, 2009

The Impact of Mental Health Conditions on Society

Evolutionary psychiatry and breakthroughs in neuroscience are rapidly blurring the lines between adaptive and maladaptive changes. (See the provocative Survival of the Sickest by Dr. Sharon Moalem; also Quantum Change by Miller and C’ de Baca and Spiritual Evolution by Dr. George Vaillant) If your life has been touched by mental health conditions through work, family or friends, I would appreciate your comments and feedback to help forward my commitment to altering the conversation for mental health. Here it is a new year, a new administration, a new opportunity to create a future for ourselves and our children that we would be proud to leave as legacy. Yes, we can!

An open letter to President Obama

Please update your statistics and revisit your policy on Mental Health. As a person who successfully lives with bipolar disorder, I have a commitment to altering the conversation for mental health. Mental Health parity is only a belated beginning to creating procovery structures for people living with mental health conditions.

The NIMH states that 26.2 % of the US population has a mental health condition which translates into 1 in 4, not 1 in 5 Americans, as stated in your website. Quoting from NIMH "Mental disorders are common in the United States and internationally. An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year. When applied to the 2004 U.S. Census residential population estimate for ages 18 and older, this figure translates to 57.7 million people. Even though mental disorders are widespread in the population, the main burden of illness is concentrated in a much smaller proportion — about 6 percent, or 1 in 17 — that suffer from a serious mental illness. In addition, mental disorders are the leading cause of disability in the U.S. and Canada for ages 15-44. Many people suffer from more than one mental disorder at a given time. Nearly half (45 percent) of those with any mental disorder meet criteria for 2 or more disorders, with severity strongly related to co-morbidity.

"The burden of mental illness on health and productivity in the United States and throughout the world has long been underestimated. Data developed by the massive Global Burden of Disease study conducted by the World Health Organization, the World Bank, and Harvard University, reveal that mental illness, (including suicide) accounts for over 15 percent of the burden of disease in established market economies, such as the United States. This is more than the disease burden caused by all cancers." (my emphasis) The WHO (World Health Organization) shows that Depression is one of the top ten diseases in every nation and increasing worldwide.

Presently, the prevailing view of psychiatric disorders is mostly occupied with despair, danger and drain, particularly in the wake of the Virginia Tech campus shooting in the U.S. and like incidents. Little media attention is paid to acknowledging those who contribute to the social good in spite of, or because of, living with a mental health condition. A case in point, TIME magazine's 100-most-influential-people has listed Dr. Craig Venter, the genome maverick, for two years running. Though he has quite publicly self-described himself as having Bipolar Disorder (see The Hypomanic Edge, by John D. Gartner, Simon & Schuster, 2005), there was no word of this in either article.

Philip Burguières, a former Fortune 500 CEO who has had major depression, now works with executives who have mental health conditions. From a Newsweek article (2/26/07, p.44): "Today he is fully recovered and spends 10 hours a week counseling other CEOs. 'The way you get to those positions in today's world, you have to be a little more obsessive, more driven. Those qualities are things that lead to depression.' He's met hundreds of CEO's and boldly estimates as many as half of the people running Fortune 500 companies have the disease." (my emphasis)

Largely missing in the public discourse is the recognition that many people successfully manage their mental health issues. Who might be inspired to seek treatment or create structures for wellness if there were more discussion? How would health care protocols and delivery be impacted? How would people with mental health conditions be viewed and how would they view themselves? What would be available to us as human beings? Even without modern treatments for depression, Abraham Lincoln served as President of the United States and Winston Churchill as Prime Minister of England.

Physical health cannot be maintained or obtained without first addressing issues of mental health. The most cost effective and therapeutically effective protocols have been proven to be evidence-based practices. National implementation of these community-based, integrated approaches is being supported by NASMHPD (National Association of State Mental Health Program Directors) and SAMHSA (Substance Abuse and Mental Health Services Administration), but it will take continued political will to have these procedures supersede the dependence on medication alone. As a leading advocate and researcher, Dartmouth's Dr. Robert E. Blake noted in a recent Harvard Psychiatry Conference lecture, science is driven by biases that dollars should go to medication rather than studying self-help and support though we know they work (lower incidence of relapse, and less time in hospital if relapse occurs). Add lifestyle choices like exercise, nutrition, meditation and other awareness or spiritual practices and routine management of these conditions could become the norm.

As President of DBSA-Boston, one of the oldest and most successful chapters of the Depression Bipolar Support Alliance--the leading peer-led support group organization for mood disorders, I see the efficacy of our programs every week. Procovery is a process and requires many partners. I hope that your administration will meaningfully address mental health in the next four years.


Our world is created in language, and altering the conversation begins with re-languaging how we speak about mental health conditions, the people who have them, ourselves. I choose “procovery” over recovery for several reasons. Most importantly, recovery infers a return to something, a looking back to what may or may not have been. Procovery begins in the here and now. I wish I could take credit for the concept but it belongs to the work of Kathleen Crowley. ”The fundamental focus of Procovery is one of moving forward when you can no longer move back, of letting go of what was and rebuilding new dreams. …Procovery offers individuals diagnosed with serious or chronic disorders an approach to attaining [and maintaining] a productive and fulfilling life….” (From the website

Friday, January 16, 2009

Mental Health NOW (Networking, Opportunity, Wellness)

What would be possible if mental health conditions were viewed as a necessary process of brain evolution rather than as neurological pathology?

What if researchers, clinicians, policymakers, government agencies, insurance and alternative providers, educators, medical schools, businesses, consumers and other groups invested in healthcare, quality of life and wellness issues aligned as a single community--partners in mental health and wellbeing?

How would healthcare protocols and delivery be impacted? How would people with mental health conditions be seen and how would they see themselves? What would be made available to us as human beings?

These, and related questions, will be the continuing inspiration for this blog. Let the games begin!