Read the book: «Madness: A Bipolar Life»

PROLOGUE
The Cut

November 5, 1994

I am numb. I am in the bathroom of my apartment in Minneapolis, twenty years old, drunk, and out of my mind. I am cutting patterns in my arm, a leaf and a snake. There is one dangling light, a bare bulb with a filthy string that twitches in the breeze coming through the open window. I look out on an alley and the brick buildings next door, all covered with soot. Across the way a woman sits on her sagging flowered couch in her slip and slippers, watching TV, laughing along with the laugh track, and I stop to sop up the blood with a rag. The blood is making a mess on the floor (note to self: mop floor) while a raccoon clangs the lid of a dumpster down below. Time hiccups; it is either later or sooner, I can’t tell which. I study my handiwork. Blood runs down my arm, wrapping around my wrists and dripping off my fingers onto the dirty white tile floor.

I have been cutting for months. It stills the racing thoughts, relieves the pressure of the madness that has been crushing my mind, vise-like, for nearly my entire life, but even more so in the recent days. The past few years have seen me in ever-increasing flights and falls of mood, my mind at first lit up with flashes of color, currents of electric insight, sudden elation, and then flooded with black and bloody thoughts that throw me face-down onto my living room floor, a swelling despair pressing outward from the center of my chest, threatening to shatter my ribs. I have ridden these moods since I was a child, the clatter of the roller coaster roaring in my ears while I clung to the sides of my little car. But now, at the edge of adulthood, the madness has entered me for real. The thing I have feared and railed against all my life—the total loss of control over my mind—has set in, and I have no way to fight it anymore.

I split my artery.

Wait: first there must have been a thought, a decision to do it, a sequence of events, a logic. What was it? I glimpse the bone, and then blood sprays all over the walls. I am sinking; but I didn’t mean to; I was only checking; I’m crawling along the floor in jerks and lurches, balanced on my right elbow, holding out my left arm, the cut one. I slide on my belly toward the phone in my bedroom; time has stopped; time is racing; the cat nudges my nose and paws at me, mewling. I knock the phone off the hook with my right hand and tip my head over to hold my ear to it. The sound of someone’s voice—I am surprised at her urgency—Do you have a towel—wrap it tight—hold it up—someone’s on their way—Suddenly the door breaks in and there is a flurry of men, dark shadows, all around me. I drop the phone and give in to the tide and feel myself begin to drown. Their mouths move underwater, their voices glubbing up, Is there a pulse? and metal doors clang shut and I swim through space, the siren wailing farther and farther away.

I am watching neon lights flash past above my head. I am lying on my back. There is a quick, sharp, repetitive sound somewhere: wheels clicking across a floor. I am in motion. I am being propelled. The lights flash in my eyes like strobe. The place I am in is bright. I cannot move. I am sinking. The bed is swallowing me. Wait, this is not a bed; there are bars. We are racing along. There are people on either side of me, pushing the cage. They’re running. What’s the hurry? My left arm feels funny, heavy. There is a stunning pain shooting through it, like lightning, flashing from my hand to my shoulder. It seems to branch out from there, shooting electricity all through my body. I try to lift my arm but it weighs a thousand pounds. I try to lift my head to look at it, to look around, to see where I am, but I am unable to. My head, too, is heavy as lead. From the corner of my eye, I see people watching me fly by.

I am in shock. I heard them say it when they found me. She’s in shock, one said to the other. Who are they? They broke down the door. Well, are they going to pay for it? I am indignant. I black out.

I come to. I am wearing my new white sweater. I regret that it is stained dark red. What a waste of money. We have stopped moving. There are people standing around, peering down at me. They look like a thicket of trees and I am lying immobile on the forest floor. When did it happen? What did you use? they demand, their voices very far away. I don’t remember—everyone calm down, I’ll just go home—can I go home? I feel a little sick—I vomit into the thing they hold out for me to vomit into. I’m so sorry, I say, it was an accident. Please, I think I’ll go home. Where are my shoes?

Am I saying any of this? No one stops. They bustle. I must be in a hospital; that is what people do in a hospital, they bustle. For hospital people, they are being very loud. There is shouting. The bustling is unusually hurried. What’s the rush, people? My arm is killing me, as it were, yuk yuk, though I can’t really feel it so much, am more just aware that it is there; or perhaps I am merely aware that it was there, and now I am aware only of the arm-shaped heaviness where it used to be. Have they taken my arm? Well, that’s all right. Never liked it anyway, yuk yuk yuk.

No one is getting my jokes.

I realize I am screaming and stop immediately, feeling embarrassed at my behavior. I have to be careful. They will think I am crazy.

I come to and black out. I come to and black out. This lasts forever, or it takes less than a minute, a second, a millisecond; it takes so little time that it does not happen at all; after all, how would I be conscious of losing consciousness? Is that, really, what it means to lose your mind? Well, then, I don’t lose my mind very often after all. My arm hurts like a motherfucker. I object. I turn my head to the person whose face is closest to me to tell him I object, but suddenly he is all hands, and there is an enormous gaping red thing where my arm used to be. It is bloody, it looks like a raw steak, it looks like the word flesh, the word itself, in German fleish, and the Bastard of Hands has one hand wrapped around my forearm, his fingers and thumbs on either side of the gaping red thing, pressing it together, and he is sticking a needle into the inside part of the thing—Quiet down! Someone hold her down, for chrissakes—and he stabs the inside of the thing again and again and I hear someone screaming, possibly me. It does not hurt, per se, but it startles me, the gleaming slender needle sinking into the raw flesh. I realize I am a steak. They are carving me up to serve me. They will serve me on a silver-plated platter. The man’s hands are enormous, and now the hands are sewing the cut flesh, how absurd! Can’t they just glue it together? What a fuss over nothing—Oh, for God’s sake! I yell (perhaps, or maybe only think), now I remember, and I scream (I’m pretty sure I really do), Can you believe I did it? What a fucking idiot! I didn’t mean to! I plead with them to understand this, I was only cutting a little, didn’t mean to do it, sorry to make such a mess, look at the blood! And my sweater! I black out and come to and black out again. You’re in shock. Can you hear me? Can you hear me, Maria? She’s completely out of it, one says to the other. They tower like giants. They can’t pronounce my name. It’s MAR-ya, I say, stressing the first syllable. Yes, dear. It is, I say, it really is. Yes, dear, I know. I’m sure it is. Just rest. Fuming, I rest. How can they save my life if they don’t even know how to say my name? They will save someone else’s life instead! A woman named Maria! Why, I suddenly think, should they have to save my life—oh, for God’s sake! I remember again. I’ve gone and actually done it! Moron! How on earth will I explain this? The pair of hands has sewn the inside flesh together and is beginning another row on top of it. One row won’t do? Stupid, says the Bastard of Hands. I look at him, shaking his head, disgusted, stitching quickly. So damn stupid.

I want to say again that I didn’t mean it so he will not think I am stupid. I watch blood drip from a bag above my head into a thin tube that leads, I think, to me. I black out. I come to. There is a giant belly in front of me. It touches the edge of the bed. I follow the belly up the body to a very pretty face. Aha! Pregnant! Now I understand. However, why is there a pregnant woman standing next to me? Where is the hand man? Do you think you need to be in the psych ward? God, no! I laugh at the very idea, wanting very badly to seem sane. I prop myself up, forgetting about the arm, and collapse back on it, screaming in pain. Note to self: don’t use left arm. Why don’t you think you need to be in the psych ward? she asks. I didn’t mean to! I cry. It was a total accident, I was making dinner, accidentally the knife slipped, not to worry, I wasn’t attempting (I cannot say the word) (there is a hollow between words, which I fill with) (nicer, safer words). I am incredibly dizzy and I wish she would go away so I could go home—who lets a woman who’s just sliced her arm in half go home? Can you contract for safety? the pregnant psychiatrist asks. Who knew psychiatrists got pregnant? I can, I say, very earnest. You can agree that you will not hurt yourself again if you go home? Absolutely, I say. After all, I joke, I can’t very well cut open the other arm—this one hurts too much! I laugh hysterically, nearly falling off the bed. She doesn’t think this is funny. She has no sense of humor.

She lets me go home. Hospital policy is to impose the least level of restriction possible. If they think you can keep yourself safe, if they can keep one more bed open in the psych ward, they let you go home. And I’m very convincing. I contract for safety, swearing I won’t cut myself up again. I call a cab and climb into it, dizzy, my arm wrapped in thick layers of bandages. I return to a bloody mess, and as dawn fills the room, I tell myself I’ll clean it up in the morning.

I HAVE BEEN in and out of psychiatric institutions and hospitals since I was sixteen. At first the diagnosis was an eating disorder—years spent in a nightmare cycle of starving, bingeing, and purging, a cycle that finally got so bad it nearly killed me—but I’ve been improving for over a year, and it’s all cleared up (brush off hands). They think I’m a little depressed—that’s the assumption they make for anyone with an eating disorder—so they give me Prozac, new on the market now, thought to cure all mental ills, prescribed like candy to any and all. Because I’m not, in fact, depressed, Prozac makes me utterly manic and numb—one of the reasons I slice my arm open in the first place is that I’m coked to the gills on something utterly wrong for what I have.

I am probably in the grip of a mixed episode. During manic episodes or mixed episodes—which are episodes where both the despair of depression and the insane agitation and impulsivity of mania are present at the same time, resulting in a state of rabid, uncontrollable energy coupled with racing, horrible thoughts—people are sometimes led to kill themselves just to still the thoughts. This energy may be absent in the deepest of depressions, whether bipolar or pure depression; the irony is that as people appear to improve, they often have a higher risk of suicide, because now they have the energy to carry out suicide plans. Actually, an alarming number of bipolar suicides are unintentional. Mania triggers wildly impulsive behaviors, powerful urges to push oneself to the utmost, to go to often dangerous extremes—like driving a hundred miles an hour, bingeing on drugs and alcohol, jumping out of windows, cutting, and others. These extreme behaviors lead, often enough, to accidental death.

Who knows, really, what leads to my sudden, uncontrollable desire to cut myself? I don’t know. Is the suicide attempt accidental or deliberate? It certainly isn’t planned. Manic, made further manic by the wrong meds, I simply do it, unaware in the instant that there will be any consequence at all. I watch my right hand put the razor in my left arm. Death is not on my mind.

No one even thinks bipolar—not me, not any of the many doctors, therapists, psychiatrists, and counselors I’ve seen over the years—because no one knows enough. Later, this will seem almost incredible, given what a glaring case of the disorder I actually have and have had nearly all my life. But how could they know back then? With so little knowledge about bipolar disorder, or really about mental illness at all, no one knows what to look for, no one knows what they’re looking at when they’re looking at me. They, and I, and everyone else think I’m just a disaster, a screwup, a mess. On the phone, my grandfather demands, “So, have you got your head screwed on right yet?” Yuk yuk yuk, funny man, raging drunk. But you can’t blame him for the question. It’s the one everyone’s been asking since I was a kid. Surely she’ll grow out of it, they think.

I grew into it. It grew into me. It and I blurred at the edges, became one amorphous, seeping, crawling thing.