Showing posts with label manic-depressive illness. Show all posts
Showing posts with label manic-depressive illness. Show all posts

Saturday, February 27, 2010

More Thoughts on Manic-Depressive Illness


My last post, written after reading Kay Redfield Jamison's An Unquiet Mind: A Memoir of Madness and Night Falls Fast: Understanding Suicide, ended with three questions:

  • How can I conceive of a God who would design our brains to be capable of the horrifying pain of an unraveling mind as happens in severe mental illness?
  • What does God expect of a person with severe mental illness?
  • What does God expect of the spouse and family of a person with severe mental illness?

Another way of asking the first question is to ask how severe mental illness fits with a view of the world as gracious, as opposed to hostile or indifferent. As I think about this, I realize that Kay Jamison herself provides an answer. She says that, as excruciatingly painful as psychosis and depression can be, this is out-weighed, for her, by the joy she has experienced in life. Kay actually values her mania, at least in its milder manifestations, and she sees her depression as the price she has to pay for the mania.

When Kay first experienced symptoms of manic-depressive illness in her teens, the mania was not extreme. It allowed her to think fast, to feel euphoric, and to be exceptionally productive and creative. In subsequent years, the mania become more extreme, but Kay remembers even some of her psychotic visions with joy. Here is what Kay says on pages 90-91 of An Unquiet Mind:

People go mad in idiosyncratic ways. Perhaps it was not surprising that, as a meteorologist's daughter, I found myself, in that glorious illusion of high summer days, gliding, flying, now and again lurching through cloud banks and ethers, past stars, and across fields of ice crystals. Even now, I can see in my mind's rather peculiar eye an extraordinary shattering and shifting of light; inconstant but ravishing colors laid out across miles of circling rings; and the almost imperceptible, somehow surprisingly pallid, moons of this Catherine wheel of a planet. I remember singing "Fly me to the Moons" as I swept past those of Saturn, and thinking myself terribly funny. I saw and experienced that which had been only dreams, or fitful fragments of aspiration.

Was it real? Well, of course not, not in any meaningful sense of the word "real." But did it stay with me? Absolutely. Long after my psychosis cleared, and the medications took hold, it became part of what one remembers forever, surrounded by an almost Proustian melancholy. Long since that extended voyage of my mind and soul, Saturn and its icy rings took on an elegiac beauty, and I don't see Saturn's image now without feeling an acute sadness at its being so far away from me, so unobtainable in so many ways. The intensity, glory, and absolute assuredness of my mind's flight made it very difficult for me to believe, once I was better, that the illness was one I should willingly give up.

When Kay first began to take lithium to control her psychosis and stabilize her moods, she was appalled at the flatness of her emotional life. She now takes a lesser dose of lithium that controls the extreme fluctuations in mood but does allow for some mood amplification followed by some mood dampening, in other words, slight mania and slight depression. The dampening is worth it to Kay because of the benefits from the amplification. Apparently, you can't have the amplification without the following dampening--you get the full cycle or none.

So, back to God. Here are some things I notice.

  • ABUNDANCE. God deals in abundance--there is an abundance of beauty and variety in minerals, plants, and animals. Within that abundance, there are things that I as an individual may not like--poison ivy, mosquitoes, manic-depressive illness. These are, nonetheless, part of the abundant whole.
  • EXTREMES. God deals in wide ranges with vast extremes--from sub-atomic particles to super-nova, from the monotone gray of an overcast sky to a flaming sunset, from the silent rabbit to the roaring lion. Manic-depressive illness is an extreme of human experience.
  • NATURAL PROCESSES. God deals with natural processes that unfold dispassionately. The universe does not reconfigure itself to avoid harming a person in the path of an avalanche, a tornado, or an out-of-control automobile. Manic-depressive illness is part of the gene pool and manifests itself in individuals with those genes.

It may be that, if God had to edit out everything that humans find unpleasant or harmful on the physical plane, the world would not be as beautiful, stunning, and fascinating.

It also strikes me that God's intentions are not necessarily our intentions. I, for example, consider a good life to be a life of financial security, physical comfort, and mental interest. God, I expect, considers a good life to be one of compassion and character growth.

I probably don't need to concern myself with the question about what God expects of a person with manic-depressive illness because I am not that person.

As for the spouse and family of a person with manic-depressive illness, it strikes me that our U.S. American society is at the far extreme of individualism, expecting individuals to manage their own problems and expecting families to manage their family members on their own. But, just as it takes a whole village to raise a child, it probably takes a whole village to contain a person with manic-depressive illness. Instead of making this the responsibility of an overwhelmed spouse or family, if this were considered the responsibility of the whole community, then the weight would be far less, and compassionate and workable solutions would far more likely emerge.

Sunday, February 21, 2010

Thoughts & Questions about Manic-Depressive Illness


I have recently read two books by Kay Redfield Jamison: An Unquiet Mind: A Memoir of Moods and Madness and Night Falls Fast: Understanding Suicide. Kay is a Professor of Psychiatry at the Johns Hopkins School of Medicine. She also has manic-depressive illness, which she is able to control by taking lithium.

Kay describes what it is like for someone with severe mental illness to watch their mind unravel. It is absolutely horrifying to be trapped inside an unraveling mind. One cannot control one's thoughts, which race so fast that nothing makes sense. One sees and hears things that aren't there, often very frightening things. One watches the distress on the faces of one's family and friends, who simply cannot comprehend one's behavior. One behaves in ways that cause one intense shame.

One often ends the pain by committing suicide.

Some of the things Kay describes, particularly concerning mania, seem incredible to me. Someone in the early stages of mania feels on top of the world. She feels invulnerable. She is full of over-the-top energy, putting her on a high. In this state, things make sense that would never make sense in a normal mood. A person in mania will often dress provocatively, initiate unwise sexual encounters, and spend thousands of dollars on unneeded merchandise. When the mania ends and a normal mood returns, this person is faced with the shame of what she has done and with the bills she has accumulated for appalling purchases that made perfect sense in the manic state but which now make no sense at all.

If the illness is not treated, it escalates. The mania becomes so intense that the person cannot stay still, cannot sleep, and cannot control her cascading thoughts. The person may become paranoid and even violent.

Eventually depression follows the mania with its all-encompassing heavy blackness that sucks all joy from life. Life becomes unbearable, and suicide is often the result. The pain of an unraveling mind and the inability to do anything to stop it is excruciating.

Yes, there are now treatments for manic-depressive illness, but for centuries there were no treatments, and even today, not everyone responds to the treatments. For some people, the current treatments don't work.

Descriptions of losing one's mind--as happens in manic-depressive illness, in depression, in schizophrenia, and in Alzheimer's disease--are truly horrifying. For me, this raises an important question: How does God fit into this? How can I conceive of a God who would design a brain capable of such horrible suffering?

I can at least begin to understand other types of physical suffering that keep the mind intact. People are able to endure these, sometimes with great grace and courage. I can also begin to understand suffering inflicted by humans. Again, people do endure this, sometimes with remarkable love and forgiveness. But how does one endure an illness that causes one's very mind to unravel. Without a functioning mind, with what does one do the enduring?

So it's hard for me to envision a way of seeing God that includes severe mental illness. It makes me wonder why on earth God couldn't design a brain incapable of such unraveling.

And what does God expect of someone with severe manic-depressive illness? It's clear that a person in mania often violates normal standards of morality in the areas of sex, finances, and kindness to others.

And what does God expect of the spouse of someone with manic-depressive illness? I don't see how it's possible to live with a manic-depressive spouse who has sex with others, runs up impossible bills, and is violently paranoid. Manic-depressive illness is devastating to the spouse, family, and friends of the person with the illness. A good friend of my mother's had a daughter with severe mental illness who simply refused to take medication to control her illness and absolutely drove her family nuts with her uncontrollably wild behavior. She also had a number of unwise pregnancies and brought babies into the world with no means of providing for them. Yes, I understand that a person with manic-depressive illness is truly ill, but what is the person's family supposed to do with a person who causes utter havoc in the lives of everyone around her? Is the family supposed to just exist in utter havoc? What does God expect of the spouse and the family in this situation?

So these are my questions:

  • How can I conceive of a God who would design our brains to be capable of the horrifying pain of an unraveling mind as happens in severe mental illness?
  • What does God expect of a person with severe mental illness?
  • What does God expect of the spouse and family of a person with severe mental illness?