Note: The information in this book is true and complete to the best of our knowledge. This book is intended only as an informative guide for those wishing to know more about health issues. In no way is this book intended to replace, countermand, or conflict with the advice given to you by your own physician. The ultimate decision concerning care should be made between you and your doctor. We strongly recommend you follow his or her advice. Information in this book is general and is offered with no guarantees on the part of the authors or Hachette Go. The authors and publisher disclaim all liability in connection with the use of this book.
Author’s note: To the best of my ability, I have re-created events, locales, people, and organizations from my memories of them. In order to maintain the anonymity of others, in some instances I have changed the names of individuals and places, and the details of events. I have also changed some identifying characteristics, such as physical descriptions, occupations, and places of residence.
Copyright © 2020 by Terri Cheney
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Library of Congress Cataloging-in-Publication Data
Names: Cheney, Terri, 1959– author.
Title: Modern madness : an owner’s manual / Terri Cheney.
Description: New York : Hachette Books, [2020] | Includes bibliographical references.
Identifiers: LCCN 2020014355 | ISBN 9780306846304 (hardcover) | ISBN 9780306846281 (ebook)
Subjects: LCSH: Mental illness—Popular works. | Cheney, Terri, 1959–
Classification: LCC RC460 .C46 2020 | DDC 616.89–dc23
LC record available at https://lccn.loc.gov/2020014355ISBNs: 978-0-306-84630-4 (hardcover); 978-0-306-84628-1 (ebook)
E3-20200729-JV-NF-ORI
CONTENTS
Cover
Title Page
Copyright
Dedication
I. GETTING STARTED INTRODUCTION
II. SYSTEM OVERVIEW MANIA
Journeys That Take You Too Far, Too Fast
Judgment Day
The Big Con
Manic Cheat Sheet
DEPRESSION
Every Day, Everyday Miracles
Pistol-Whipped
Three Enormous Words
HYPOMANIA
The Prozac Years
Seduced by a Ripe Red Plum
Where the Neon Lights Are Pretty
MIXED STATE
The Torpedo Red Blues
Bipolar Disorder’s Nasty Secret
RAPID CYCLING
Thorns Today, Roses Tomorrow
The World’s Worst Party Guest
SUICIDALITY
The End, and Then
I Didn’t Plan to Go to the ER That Night…
Never Be Fooled by a Smile
THE MIND-BODY CONNECTION
When Your Mind Won’t Let Your Body Move
The Botox Cure
Hooray! I’m Really Sick!
III. USER PRECAUTIONS STIGMA
Doc Shock
The Rich and Famous and Desperately Silent
Self-Stigma: When the Mirror Lies
You May Soon Be Unremarkable
TERMS AND DEFINITIONS
Call It What It Really Is
Vaguely Bipolar
Spitting on P.C.
IV. INSTRUCTIONS FOR USE RELATIONSHIPS: GENERAL INSTRUCTIONS
Don’t Fix Me, I’m Not Broken
Relationships Are Simple: Never Do This
Etiquette for the Ordinary
Relationships Are Simple: Just Do This
RELATIONSHIPS: SPECIFIC INSTRUCTIONS
Limiting Manic Fallout
Tell Me Where It Hurts
Is Depression the New Plague?
It Isn’t “Just” Anxiety
The Rules of Suicide
Random Acts of Kindness
I’m Not Sick and You Can’t Make Me
V. TROUBLESHOOTING BAD COPING SKILLS
Going Underground: Isolating
Bad Bedtime Stories: Self-Blame
The Web: Obsession
Blame It on Basic Instinct: Impulsivity
A Walking Wound: Rejection Sensitivity
The Virtues of Being Rude: Bad Borders
GOOD COPING SKILLS
A Dose of Beauty
Why Not Try the Truth?
Thanks, I’ll Have the Usual
The World in an Uproar: Noise
Scheduling Sanity
Vigilance: Am I Too, Too Wonderful?
The Happiness Hustle
VI. MAINTENANCE MEDICATIONS
Mixology: The Medication Cocktail
There but for the Grace of Meds…
Choose Your Poison
Side by Side by Side Effect
Mind Candy: The Epidemic of Overprescribing
Bliss or Lithium?
THERAPY
Annoying Epiphanies
The Right Fit
Tried and True
VII. WARRANTIES ACCEPTANCE
Diagnosis: The Good News?
Shades of True Light
HOPE
New Love: Handle with Care
Coming Back/Going Forward
The Past Is Just the Beginning
VIII. APPENDIX RESOURCES
Acknowledgments
Discover More
About the Author
Also by Terri Cheney
Praise for Modern Madness
To Nancy Bacal and Dr. Geoffry White, who have kept me just sane enough all these years
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SECTION I
Getting Started
INTRODUCTION
I WAS SITTING NEXT TO Michael Jackson, admiring his feet. Michael Jackson had surprisingly big feet—farm boy feet, with some heft to them. They didn’t match the rest of him: the delicately chiseled nose, the whispery voice and waif-like persona. I was mesmerized. I kept picturing him defying the laws of gravity and motion, sliding up and back and off the floor like he was wearing invisible ice skates, ice skates with wings.
Looking back, there was indeed something extraordinary in that room, only it had nothing to do with Michael Jackson’s feet. It was the mere fact that I was sitting there as one of his attorneys, representing him in a big, messy lawsuit involving one of the most successful albums of all time. That was me, all right—counselor to the stars. The voice of reason and restraint, in a gray Armani suit and a gorgeous white silk shirt I’d bought especially for the deposition, because it had these long, elegant French cuffs th
at would just about hide the virulent red slashes across my wrists I’d acquired from a recent suicide attempt.
Hiding had become an art form with me. I covered up the damning signs of depression with a thoroughness and frenzy that is painful to remember: pleadings prepared by flashlight in the dead of night, so no one could see how ravaged I looked; prolonged disappearances due to increasingly fictional ailments; lies piled upon tottering piles of lies. But the mania was a different story. The mania was always on full display.
I thought faster, I wrote better, I could argue the devil out of his soul when I was manic. I was glorious, bionic, at the top of my game, and I knew it and used it against anyone who came too close. Sex was mine for the asking, money and influence, too, and I owed it all to mania—including my proximity to Michael Jackson and his like. But no matter how lofty and impervious I appeared, depression could swoop in and lay me low without a word, without warning: the devil demanding a rematch.
Then it was back to hiding all over again.
Bipolar disorder wasn’t a familiar term back then. It was still called manic depression, and it was something someone’s batty old uncle once had. Certainly no one admitted to it by choice, and I wasn’t about to start. Nobody knew what was going on with me—for a long time, I didn’t even know myself. I just knew that something was terribly wrong; that something had always been terribly wrong; and that the world wasn’t ready to find that out.
It took a whole lot of horrible to bring me to truth: serious run-ins with the law, immense amounts of alcohol, multiple suicide attempts, demolished relationships, financial ruin (mania’s costly gift), and all the other detritus that accompanies a severe mental illness. I finally grew desperate enough to seek help, and after nearly a decade was awarded a diagnosis. But that did little to stop the entropy. I wound up in a mental hospital at UCLA, for three unimaginably long years and multiple rounds of electroshock therapy. That’s when everything really started.
It was a frightening, at times mournful and demoralizing place: gray walls, gray faces, the omnipresent sound of doors being locked. I remember looking around me, wondering why nobody seemed to be getting well. Even the brightest, most impressive patients struggled, often in tears, to describe their pain. The less advantaged simply lapsed into a zombie-like silence. I felt suffocated by all the things that weren’t being said, especially by me. Then one day it dawned on me. It wasn’t the patients’ fault. They simply didn’t have a vocabulary for their illness. Why should they? Mania, suicide, psychosis—such things were hardly the stuff of polite conversation. None of us knew how to express ourselves because mental illness was a long, inarticulate howl. It needed a voice. It needed words.
And so, to save myself, I started to write. I wrote down everything I knew about bipolar disorder: the symptoms, the treatments, the various theories of origin. I read everything I could lay my hands on, even attended Grand Rounds lectures with the doctors. Then I threw away all the clinical stuff and wrote what it felt like inside my own body, how the illness skewed my view of the world. Seven years later, I emerged with a book called Manic.
Never in a million years could I have expected how favorable the response to Manic would be. It catapulted to the New York Times bestseller list within a month. It was optioned by HBO for a TV series and translated into eight foreign languages. I was deluged by messages from people all over the world, asking me for advice, inviting me to speak, begging me for comfort, and always, always, telling me their own stories. During those proverbial fifteen minutes, I was the poster child for bipolar disorder. For the very first time in my life, I was no longer hiding—I was out, in a very big way.
But my story doesn’t end there. I didn’t stop being bipolar, just because I’d tasted some success. For sanity’s sake, I’ve had to make some sweeping changes. I’ve stopped practicing law to write full time and act as a mental health advocate, in order to satisfy my need to do something worthwhile and lessen the stress that had kindled my illness into full flame. But the biggest change by far has been my willingness to accept that I have a condition that isn’t yet curable, and that may require a lifetime of treatment.
I don’t always see this as a liability. I recognize the tremendous impact bipolar disorder has had on my life, for richer or poorer, and there is a surprising amount of richer in that equation. Without it, I doubt I would possess those qualities I truly like in myself, like creativity, empathy, and an outsider’s eye. It gives me great joy to say this: after all these years, all this suffering, this incandescent struggle, I’ve finally reached a point, not only of acknowledgment, but of ownership. This is what happened to me. This is my truth.
My story is bigger than bipolar disorder, though. I’ve come to realize that I belong to a much vaster community: the mentally ill. Regardless of the particular diagnosis, we are all dealing with divergent experience, a life beyond the norm. Stigma encompasses all of us, as do pressing issues with relationships, coping strategies, etc. That’s why I’ve aimed this book at the broader target of “madness,” a word I know may be controversial, but that I frankly adore. It assumes a spark of genius, a familiarity with things not quite of this commonplace world.
I recognize, from the countless heartfelt stories and questions I’ve been privy to over the years, just how complicated and frightening mental illness can be, for everyone concerned. We all need explanations, illustrations, analysis, instructions on how to build a better life in the face of exceptional challenge. Hence, this owner’s manual—and I hope it can provide some of that for those who are seeking solace. This includes not only individuals with mental health issues but also the people who love and sometimes want to strangle them; the health care professionals trying to help; and the millions of other people whose lives are affected by mental illness in one form or another and don’t understand what it is, or more important, what the hell to do about it. I offer this book to you.
The biggest advantage I can claim as a storyteller is that I’ve been there and I know the terrain. I write what I know, and I know I’ve been lucky. I should be dead a dozen times over, yet something has conspired to let me act as a witness to my inexplicable survival. But then, I’m no stranger to amazing events; I’ve met quite a few on my travels.
Take the phenomenon in that long-ago conference room. The wonder isn’t how Michael Jackson could dance like an angel on farm boy feet. It’s that I’m still alive to write about that moment, all these many years later, with some degree of compassion for the young woman who sat at that conference table, tugging at her shirt cuffs to hide her scars. There was a lot of peculiar talent in that room, and not all of it belonged to Michael Jackson.
The time has come to own it.
SECTION II
System Overview
MANIA
“One must still have chaos in oneself to be able to give birth to a dancing star.”
—Friedrich Nietzsche (1844–1900)
The latest edition of the psychiatric bible, the Diagnostic and Statistical Manual of Mental Disorders (“DSM-5”), describes mania as “a distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently goal-directed behavior or energy.” Clinical symptoms include
• Inflated self-esteem or grandiosity;
• A decreased need for sleep;
• Pressured speech or talking more than usual;
• Racing thoughts;
• Flights of ideas;
• Distractibility; and
• Engaging in risky behaviors, like unrestrained buying sprees and sexual indiscretions.
Mania used to be defined by the American Psychiatric Association as “excessive involvement in pleasurable activities…,” which sounds fabulous, until you get to the end of the phrase: “that have a high potential for painful consequences.” That’s one of the problems with mania—it starts out feeling so great, you never think about how it might end.
JOURNEYS THAT TAKE YOU TOO FAR, TOO FAST
Only Monday, and already it was a lost week. The piles of important and neglected papers on my desk had copulated in the night, producing even more piles. My house was a shambles—how long since I’d cleaned it?—and I was too tired to snap to and take charge. I went to bed cranky and frustrated. But when I woke the next morning I felt it—that dazzling surge of energy that makes me long for a project, any project, to devour. I ripped through the tedious papers, making brilliant observations and uncanny deductions, signing my name with a flourish. True, my handwriting was on the verge of illegible, and the words just kept coming and coming at me till I had to scream to make them stop—but still. The whole mess was over and done with, in less time than it takes to squish a gnat.
Then I turned to the house. Not a speck of dirt or dust could escape my darting eyes. I Lysoled and Windexed and Pledged and Febrezed until the entire place reeked of ammonia and pine. Such a heavenly scent—proof positive that whatever else may be wrong with me, I am irrefutably clean. The rewards began to diminish, of course, when the whole house was so spotless I couldn’t find anything else to polish or dust. That’s when I got out the Q-tips, so I could get to that last tiny crevice inside the microwave. That’s when I found the magnifying glass, so I could kneel down on the bathroom floor and inspect the grout between the shower tiles. That’s when I ripped off my rubber gloves and scrubbed everything I’d already scrubbed with raw bleach, until my knuckles were bloody.
That’s when clean began to feel dirty.
I had to get dressed and get out of there, away from the suffocating fumes—some place big enough to let me breathe. I’d stripped off all my clothes long ago because they constricted my movements; and I wasn’t quite high enough to go outside naked, although it made a lot more sense to me than putting on something I’d only have to remove again later. My tousled hair was up in a ponytail, my face and body covered in sweat. But my mirror lied as sweetly and smoothly as a best friend.