Old School Hollywood Manic Depression

July 20, 2008 at 1:26 am 25 comments

I’m not sure how I feel about people writing about their mental illnesses, or how helpful it is in getting other people to understand these conditions. The trouble is that everyday mental illness – the kind that most mentally ill people suffer from – just isn’t very exciting. Sure the lows can be real low and suicide attempts make for drama, but the everyday life of a depressive mostly revolves around building up the energy to get dressed. Hypomania can lead to some good stories; delusions ironically don’t – describing irrational thoughts is a bit like describing a dream, you kind of have an idea of what was going on, but every story ends with “What was I thinking?” Substance abuse has its moments of intrigue. Waking up in a pool of your own vomit with no memory of the previous night and a vague realisation that your blood-alcohol content was on the cusp of being fatal is reasonably interesting. That was my thing and it happened a few times, but I get the feeling most drunks don’t follow this pattern. For every time you pass out on a beach in the middle of December and somehow avoid dying of hypothermia, there’s fifty times you pass out in front of the TV with a half-eaten take-away going cold on a plate on the floor.

Which is a long way round of introducing my thoughts about ‘If you’re manic depressive, Hollywood is a good place to hide’, a piece about Terri Chaney, author of Manic in the Daily Mail. Obviously the Mail is picking out the more sensational bits and I haven’t read the book itself. But it’s fairly obvious that she’s not a typical manic depressive.

Terri Cheney has lived with manic depression since she was 16. Her memoir, Manic, is at times so emotionally lacerating that you can’t help but wonder how she has managed to survive. She very nearly didn’t: she made countless suicide attempts, went through painful electroconvulsive therapy and suffered a brutal rape. Perhaps most incredibly of all, she managed to keep her condition a secret as she held down a high-powered job with a top Beverly Hills law firm.

Yes, people with manic depression sometiems have high powered careers. Most don’t, because, well… they have manic depreesion and it gets in the way of things like studying and working and so on. I guess her depressive phase didn’t hit while she was taking her LSATs or her bar exams.

For the past five years she has been on medication that keeps her illness at bay – a cocktail of around 25 pills a day, ‘which I assume I’ll be on for the rest of my life’. To Terri ‘the pills are a gift. People tell me that I’m on more of an even keel. My depressions don’t last as long. I haven’t been manic in five years, and I don’t even entertain the notion of suicide.’

I’m not sure I could even name 25 medications for mental illness. The medications aren’t named in the article (though presumably they are in the book). But I’m curious, so let’s try to work out what this cocktail of substances could be. Let’s be generous and assume that she’s taking a couple of pills per substance, which leaves us with 12 different medications. Lithium plus another mood stabiliser is a popular combination, so that’s two. Let’s add an antipsychotic for three. Add in a couple of anti-depressants (mitazepine is a popular add-on to other SSRI’s) and we’re up to five. One benzodiazepine for anxiety and another for sleep makes seven. Let’s give her some more anxiolytics ‘taken as needed’ for eight. Maybe she takes vitamin B and omega-3 as is the fashion these days. That’s ten. And we’re still two short.

If anyone’s read the book and wants to tell me what these medications really are, I’m intrigued.

Suffice to say that very few people with manic depression take this amount of medication. I can’t help but wonder if this isn’t a my-meds-are-bigger-than-your-meds thing.

At Vassar, Terri also developed an eating disorder which continued for many years. ‘When I’m manic, I don’t eat anything for days, but when I’m depressed, the hunger just can’t be sated. I would eat anything – packets of instant iced coffee, baking soda, artificial sweetener – to keep the void filled.’ She recently underwent an operation to remove most of her colon as it had stopped functioning properly. ‘I still have trouble with food and I have to eat very small amounts at a time.’

Baking soda? How many people with eating disorders eat baking soda? That’s not being hungry – that’s pretty much Pica. And while this kind of behaviour linked to depression isn’t unique, I think it’s fair to say that it’s completely atypical of both bipolar disorder and eating disorders.

See, this is why I think these mental-illness memoirs are so useless at educating people about the conditions involved. Bipolar disorder is always presented as having the most extreme highs “a huge manic episode of about four weeks where I barely slept, and shopped so much I had nothing left in my savings account” and the most extreme lows “she made countless suicide attempts, went through painful electroconvulsive therapy and suffered a brutal rape”. Because the everyday experience of living with any of these mental illnesses doesn’t sell books, but casting yourself as some kind of Byronic hero does.

And now people are going to read this – both the article and the book – and think that four week shopping sprees and eating baking soda and ending up on twenty five different medications are what you should expect with bipolar disorder. And sure, some people do the massive financial disinhibition thing, and there’s probably at least one other manic depressive out there whose depressive phase involve pica, but it’s at the far end of the scale. towards. I don’t know exactly what a typical manic depressive looks like, but I’m certain it’s not Terri Chaney. Generally, think mental illness blogs are better at avoiding some of the self-dramatisation that these misery-memoirs gravitate towards. It’s no insult to say that they (and I include my own blog here) capture some of the everyday dullness of mental illness (because mental illness often means sitting in your flat alone all day and wondering if you can be bothered to switch the TV on). And high powered lawyers engaging in multiple suicide attempts while mingling with the beautiful people of Hollywood is entertaining, but it’s a world away from most people’s experience of mental illness.

Entry filed under: Chimp vs. World. Tags: , , , .

We Apologise for the Inconvenience Where is my mind?

25 Comments Add your own

  • 1. David Moyer  |  July 20, 2008 at 3:44 am

    Your comments are on the mark.

    I will do you a favor someone did for me on line. Check out truehope.com.

    David Moyer

  • 2. Rose  |  July 20, 2008 at 4:03 am

    I think ‘madness memoirs’ are most useful as aids to ‘downward comparison.’ “At least I never got so bad I ate the baking soda.”

    I’m pondering your comments on blogging about these issues. I find that even with the thin anonymity affording by blogging under a pseudonym, I’m reluctant to write about the parts of my life that are full-on whack. I have met with so much disbelief in my “real” life I’ve no desire to invite more from strangers.

  • 3. experimental chimp  |  July 20, 2008 at 4:35 am

    David: Thanks. I’ve heard of TrueHope. I’ve also looked at the evidence for various vitamins and minerals. As a result I take a supplement of 800µg of folic acid, since it’s the only one of the many vitamins and minerals in TrueHope’s EmPowerPlus with any significant evidence behind it that I could find.

    Rose: I can understand that. Everyone who writes a blog has their own reasons for doing so and confronting uninvited disbelievers probably isn’t too high on anyone’s list. It’s always a trade off between what you want to talk about and what you’re prepared to talk about in public.

  • 4. colouredmind  |  July 20, 2008 at 5:28 pm

    Bang on. The mania portrayed in such books often sounds glamerous and creative- my experiences have been scary and dangerous, depression is boring. Just day after day of existance. x

  • 5. auralay  |  July 21, 2008 at 1:06 am

    It annoys me how glamorized mental illnesses are. Most people don’t realise that the actuality of it is incredible subtle… if you’re not the one experiencing the day to day of it.
    When I was first diagnosed with major depressive disorder and anorexia, my mother thought that I had been playing the doctors because I wasn’t stick thin, hadn’t held a gun to my head and tended to have a good day twice a week or so. To her, a depressed person couldn’t even manage to get out of bed, much less manage the grades I was yanking out in school and an anorexic couldn’t even bear to sit at a dinner table, much less eat a small meal like I did.
    For most people, in order for something to be real, it has to exert all the extremes.
    I took a psych class my last semester and we delved into bipolar disorder quite a bit and the main point I distinctly remember the professor hammering into the class is that the disorder was hardly what the media made it out to be.
    Long story short, I agree with your disgruntlement about the media’s darling of mental illnesses.

    On another, slightly related note, I started reading your journal because a- I stumbled across it, b- I enjoy your writing style and c- you seem to have a similar issue with sleep that I do (except I’m not bipolar) and I thought that I might be able to glean some coping skills for that off of you 😉

  • 6. Gabriel...  |  July 21, 2008 at 5:08 am

    “I’m not sure I could even name 25 medications for mental illness.”

    She’s not saying 25 medications, she wrote “25 pills”. I take thirteen for the MD, another for the diabetes plus five vitamin pills, so 19 altogether.

  • 7. experimental chimp  |  July 21, 2008 at 10:11 am

    auralay- I think one of the ways that parents protect themselves from their children’s mental illnesses is by playing down its seriousness.It’s scary to think that your child is hurting themselves or feeling awful, so if you pretend they’re relatively OK, it’s easier to deal with (though not necessarily easier for their mentally ill child.)

    With the sleep – I don’t have any coping skills for it, unfortunately. Maybe I’ll have some tips after my exciting trip to London (well, a sleep clinic there) coming up at the end of August.

    Gabriel: So you take 13 pills for the manic depression then? Also, I kind of make the same point you do in the rest of the paragraph. I still think 25 pills a day is ridiculously high. For that matter, 13 seems like a lot.

  • 8. Gabriel...  |  July 21, 2008 at 11:23 am

    Lithium: 7 pills at 300mgs each
    Seroquel: 4 at 25mgs
    Wellbutrin: 2, one 100mgs and one 150mgs

    Equals: 13 pills per day. I could cut back to ten pills per day if I was to take a single 100mg Seroquel. If I was to take Lamotrigine instead of Lithium I could cut it back to four or five. I may be on the higher end of the spectrum but hardly near the top.

    “…which leaves us with 12 different medications.”

    She could be taking “around” 25 low-dose pills of one medication. Unlikely, but possible… all I’m saying is you’re assigning a lot of medications to this woman, then saying it’s a ridiculous amount when it could just be four or five medications at various doses. Twenty-five pills is not unreasonable.

    Anyway, I just sent an email to her asking about her medication regimen, so when / if I get a response I’ll let you know.

  • 9. experimental chimp  |  July 21, 2008 at 12:08 pm

    Divided doses do push the numbers up a bit, particularly lithium. (I hadn’t realised how many doses lithium gets divided into.)

    But anyway… The newspaper article presents the 25 pills per day thing as significant and the whole intention behind the statistic is to make people go “Woah, that’s a lot of pills.” So it might not be unreasonable, but it’s definitely not representative of the medications most bipolar people get prescribed.

    I hope you do get a response – like I say, I’m intrigued.

  • 10. Gabriel...  |  July 21, 2008 at 12:37 pm

    This is what I sent, I kind of screwed up by not straight up asking for an interview:

    “My name is Gabriel and I just finished reading the feature about your book on the Daily Mail’s website, and another older feature on phillyBurbs.com. I’m fascinated by your story and have every intention of finding your book. I do have one question in the meantime that I was hoping you could answer.

    “I was wondering about the medication regimen you’ve been prescribed. In the Daily Mail article the reporter wrote “For the past five years she has been on medication that keeps her illness at bay – a cocktail of around 25 pills a day, ‘which I assume I’ll be on for the rest of my life’.”

    “But they don’t go into detail. I write a fairly successful blog about my own recovery called Salted Lithium (http://saltedlithium.wordpress.com) and I’d like to write something about your recovery and your book. I think the details of your personal regimen would be of interest to my readers.

    “Personally I was diagnosed with manic depression in 1988, started treatment in 2002 and now take 2100mgs of Lithium, 250 of Wellbutrin and 100mgs of Seroquel everyday.

    “I hope this isn’t too personal a request…

    “Thanks for your time.”

    And now we play the waiting game…

  • 11. thestranger  |  July 21, 2008 at 3:04 pm

    My exes life is quite interesting, but very sad. People have been watching her spiral downward online for a long time and they see it like the Jerry Springer show. It seems like people don’t understand or recognize mental illness unless its severe and extreme and going along with how Hollywood might portray it.

    My own issues and disorders are severe to me, but also boring and unexciting and people don’t even notice. More often than not they’d think there was nothing wrong at all.

  • 12. Pole to Polar: The Secret Life of a Manic Depressive  |  July 21, 2008 at 10:05 pm

    Pretty much. It’s why I read blogs. Boring or not, I can relate to them.

  • 13. Gabriel...  |  July 22, 2008 at 3:44 pm

    I received a response this morning. She doesn’t get into doses, but she takes seven different drugs to fight the manic depression and its immediate symptoms, plus some others “for non-bipolar reasons.”

    According to her (very pleasant) response she takes:

    1200mg Lithium, 30mg Abilify, and 400mg Provigil. As a sleep aid she takes 1mg Xanax and Restoril 30 mg. She also takes 10mcg of Cytomel and 150mcg Levoxyl for hypothyroidism.

  • 14. experimental chimp  |  July 22, 2008 at 9:13 pm

    Thanks Gabriel – that’s certainly interesting. The Provigil is kind of surprising, too.

  • 15. i was normal (once)  |  July 23, 2008 at 3:10 am

    you hit that spot on. i was just having a conversation about this with my mom the other day, as she’s reading ‘madness: a bipolar life’ and she’s just in awe of what that woman had to go through and yet, ‘look how far she’s come! and constantly reminding me of the inspirational bipolars who have ‘overcome’ their disorder and you can too!
    i hate to burst your bubble, mom, and others, but when a handful of bipolars write a book or some succeed as lawyers and such – we don’t hear the stories of those who don’t. because those are the ones who can barely get out of bed, let alone lift a pen to write about it.

  • 16. Margaret  |  July 24, 2008 at 3:12 pm

    “I’m not sure how I feel about people writing about their mental illnesses, or how helpful it is in getting other people to understand these conditions. The trouble is that everyday mental illness – the kind that most mentally ill people suffer from – just isn’t very exciting.”

    I began reading your blog, quite a long time ago now, because I was increasingly finding myself ill equipped to deal with clients at my work place, clients who were often suffering from mental illness and were sometimes extremely distraught. I could have done/still could do with a great deal more training.

    I carried on reading your blog because you write very well. That was the most important thing. You are able, because of your ability to use language, to convey your experience in a way that makes it easier for others to relate to.

    I think your blog has done a great deal to help me understand mental illness more. Most of all, it confirmed that we are all in the same boat, to a greater or lesser extent. The label hides the fact that people with a mental illness are (in varying degrees) as kind or caring or selfish or intelligent or stupid or funny or boring, or irrational or logical, or conservative or whacky, or anxious or sad or angry as the person next to them who does not have a mental illness. Some of the clients I have found most rewarding have been those who have been most ill. I often watch them with their friends and marvel at the honesty, the searing honesty of their friendships where the worst has been seen, and the friendship survives. There is often more authenticity in their interactions than in the superficial interactions I see elsewhere.

    It may be unrealistic to hope that everyone will make a complete recovery, or will make the awesome progress that you are making, but is it wrong to hope that everyone gets better? I don’t think so. If the happy endings help just a few people keep on trying to get better, I don’t think we should knock them. We all need hope.

    Carry on writing!

    And think about getting this blog published.

  • 17. experimental chimp  |  July 25, 2008 at 11:52 am

    Thanks Margaret. That’s one of the nicest things anyone’s said about my blog and my writing.

  • 18. DeeDee Ramona  |  July 26, 2008 at 8:36 pm

    Elizabeth Wurtzel actually talked about this in Prozac Nation. The media and the arts tend to portray mental illness as some sort of glamorous lunacy or what Seaneen describes as “a colourful little sunflower trembling with creativity”.

    Wurtzel points out that mental illness, or madness if you will, is actually dull, plodding and pedestrain, and very very ordinary, frighteningly common. About as interesting as walking for miles in the freezing cold and driving rain without a coat on.

    Unfortunately, the endless stress and pain of trying to manage illness while trying to live your life doesn’t make for interesting reading.

  • 19. jessa  |  July 27, 2008 at 12:56 am

    Yes! When I was anorexic and self-injuring, I read a lot of these memoirs, particularly for the part where people’s lives improved. Stories that were ostensibly about recovery usually were really about the disorder itself. Telling how it starts, how bad it gets, the crisis that made you change your mind about things, and then smushing recovery and life afterward into the denouement is not a story about recovery, it is a story about the progression of an illness.

    Because of those stories leaving recovery out and because I knew that there were other people looking for stories about recovery, I intended to write essays about recovery at different points during the process. But I didn’t. Failing at that made me realize why no one tells stories that are really about recovery: because recovery is boring. Although the illnesses themselves are boring too, there are dramatic crises that pop up and can make for a good story, even if it isn’t representative. But in recovery, having fewer and fewer crises is the Goal, there is less to tell (from an exciting narrative standpoint) as one nears the end of recovery.

    I’m beginning to work on an essay now about recovery, why it is boring, and why that is unavoidable. Let me know if you are interested.

    jessa DOT wright AT gmail DOT com

  • 20. E  |  July 30, 2008 at 8:02 am

    But it is entertaining which is why it sells.

    Does anyone remember a soap opera; I suppose it was, set in a psychiatric institution that showed for one series a few years ago. It was Holby city meets Bedlam. I think it was supposed to be a serious, yet moving, yet uplifting, yet poignant, yet amusing, yet ironic yet gritty, yet salutary look at life in a psychiatric institution/ acute admissions ward. It was in the event none of these things and only ran for one series culminating in the suicide of one of the central figures. I think the series died with him.

  • 21. experimental chimp  |  July 30, 2008 at 11:15 am

    Would that be Takin’ Over the Asylum by any chance?

  • 22. Zoe  |  August 7, 2008 at 2:12 pm

    Very funny and bang on the money post Chimp. I’ve often felt irritated by these kind of memoirs but wasn’t able to put my finger on why.

  • 23. Gabriel...  |  August 8, 2008 at 8:05 am

    There’s a quote I use a lot from Tim Lott “…real mental illness is boring. Depressives are toxic and dull. Manic depressives are irritating.”

    These memoirs are important precisely because 99.9999% of people with manic depression and recovering from manic depression will never have an opportunity to write a book or make a movie describing their experiences.

    When people like Elizabeth Wurtzel and Kay Redfield Jamison get published, sure there’s some sensationalism but that’s what sells books. And it’s a whole lot better than leaving public awareness of this disease to Law & Order where every person with bipolar disease is some savant or a maniac killer.

    I even saw some of my behaviour in a memoir about chronic depression and growing up gay during the 1950’s called “In The Jaws Of The Black Dogs” by John Mays.

    You take the chapters you identify with and drop the ones you don’t.

    These books don’t whitewash the image of manic depression into some series of orgies of mania and depression. They give the people who read them something to identify with. It’s like people coming to your blog, or to Salted and saying “I really see myself in what you wrote… except this stuff.” I see some of my behaviour in this blog, but not all of it. You cut, I burned.

    As for people without the disease reading these books and getting a warped idea of what manic depression is, I would hope that they wouldn’t stop with one source. But if someone who only read Terri Cheney’s book approached me and said, in a really concerned voice, “you bipolars have it so very hard, here’s $20 so you don’t have to eat baking soda”. I would not mind in the least.

  • 24. Making Strange Requests « …salted lithium.  |  August 14, 2008 at 9:41 am

    […] to a post by Experimental Chimp I found a book called “Manic”, a memoir by Terri Cheney, so I was already putting […]

  • 25. Thenightstoker  |  October 12, 2009 at 2:45 pm

    E-Mail Me What The Beutiful Dreim is we have tried mounten farme land an has not worked

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Hi, I'm James. I'm a 26 year old guy from England with bipolar disorder (currently well controlled). I also have a circadian rhythm sleep disorder (not so well controlled). This blog has charted my journey from mental illness, through diagnosis and, recently, into recovery. It's not always easy, but then, what is?

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As of 12th September 2008 it has been forty five weeks since I quit smoking. So in another seven weeks it'll have been a whole year.

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