Khaleej Times: IN TWO MINDS, When mind is the matter

For many sufferers of bipolar disorder, surfing on the emotional highs can be unpredictable and addictive — but the spiral into depression is just as real

Afew years ago, coming out to say you have a mental disorder would have been unheard of, the very stigma ensuring that the only other person who knew — your shrink — was sworn to absolute secrecy. Today, however, it’s become almost trendy — bandied about carelessly every time someone wants to describe an odd or unusual character.

Bipolar disorder especially has 
become a bit of a buzzword, much to the consternation of those who suffer from the real deal. A mood disorder characterised by alternating periods of extreme elation (mania) and depression — swings that happen without warning or, even, any apparent reason — it is perhaps the one that’s been in the news most of late, thanks to celebrities like Catherine Zeta-Jones, Stephen Fry and Demi Lovato coming out to talk about life in all its bright and blue shades.

British author Kit Johnson, who’s been battling the disorder for the last 45 years, is one who believes far too many people are being diagnosed with bipolar disorder these days — and it’s something that really “grinds [his] gears”. The 61-year-old, who splits his time bet-ween the UAE and the UK, explains, “It’s not that I want to be part of this per-secuted minority — but it’s seriously annoying to see people piggybacking 
on a condition, in the name of creativity, and therefore, diluting its currency for those who actually have it.”

The condition that Kit has is cyclo-thymia — a sub threshold form of bipolar disorder — which basically involves rapid mood cycling all the time, and though he’s tried both medication and therapy, neither really worked for him. “You go through some monumental ups and downs. It’s a pretty self-centered, self-absorbed condition at times. You can go from feeling euphoric and 
omnipotent — like you’re capable of anything, which makes you very arrogant because you actually believe it — to the exact opposite: self-loathing, hateful and suicidal.”

As he puts it, for someone who’d been “fired more times than a cannon, and with 15 houses, three ex-wives, umpteen messed-up relationships, 37 cars and Lord knows what other ‘if only I had this’ purchases”, Kit concluded his life was bizarre. The turning point came after his second serious suicide attempt four years ago, with a car exhaust pipe and a closed garage door. Fortunately for him — though he was furious about it then — a neighbour found him in time, dragged him, unconscious, out of the 
car and took him to a nearby hospital. “During the attempt,” Kit now says, “I was thinking of the ‘great white light’ that people in Hollywood movies kept talking about, before death. So as I was coming back around, with this thought subliminally in my mind, all I could see was someone peering closely at me… and he had a beard and a white turban on. I did actually say, ‘Is that you, God?’ And the man — a nice guy he was — said: ‘No… I’m afraid it’s not. It’s Dr Singh!”

Kit recalls being “seriously pissed off” to have been brought back at the time. “I’d had yet another relationship breakdown and I’d had enough. I didn’t want to live. So there I was, tearfully recounting this story to a really good friend, not long after. But by the end of it, he was positively howling with laughter. I couldn’t believe him — then I too saw the absurdity of it all, both of us collapsed in hysterics, and that was the turning point for me right there. I realised I had to do something differently.”

That’s when Kit took to writing (his book, Dodging Suicide, published in 2011, is available for purchase from his website www.kit-johnson.com) and it turned out to be a great option for him. “I realised that God made me bipolar — but He also made me funny, so perhaps I should use that to help others.” Today, Kit continues to provide encouragement — and laughs — through his blog as well as at various speaking engagements. Laughter is very much underrated, he says. “It may not always be the answer and it may not work for everyone, but it does make you feel better if you can find out what makes you smile. My granny used to say: if you can manage to genuinely laugh before 10 in the morning, you’ll probably have a good day. I think there’s probably some truth in that.”

As can only be expected, a condition like bipolar disorder does take its toll on relationships. Kit, who’s been divorced three times himself, says he understands it can be very difficult to live with. “But there are plenty of people who’ve managed relationships very well because they’ve been lucky enough to have the right support structure. That’s the key.” Especially when it gets too overwhelming to bear at times. “You want to die because you can’t bear the thought of waking up to one more morning of the misery,” he states. “Death becomes a much more powerful preference. That’s when you need someone to find some sort of mechanism that works for you.”

Like, how he recently told a Twitter fan, who was feeling low, to get her lipstick, go into the bathroom and write three words on the mirror: It Will Pass. “She didn’t feel up to it but I insisted and just writing it out, made her feel better already. Get in touch with the right 
community,” he urges. “Surround yourself with a positive support system, where you can help lift people out and they can do the same for you.”

MEDICALLY SPEAKING

Dr Hartmut Herbert Kollikowski, senior consultant in neurology and psychology for adults at the German Neuroscience Center in Dubai, speaks of the difficulty of diagnosing someone with bipolar 
disorder quickly, as there are “no clear biomarkers for the disorder — and that’s mostly because the cause is not yet known”. His strong recommendation to anyone experiencing changes in moods and activities as well as sleep disturbances is to consult a psychiatrist as soon as possible.

While he attributes the genesis of 
bipolar disorder to multiple factors, he quotes studies that suggest a genetic disposition may be involved, among others. “For instance, there are twin, family and adoption studies that indicate first deg-ree relatives of bipolar disorder patients are 7-10 times more likely to develop the condition than others,” he says. “There may also be external factors such as stress at work or other life events that could trigger the onset of the phase.”

Blessing, curse or both?

For Lebanese expat Ahmad, that trigger was the beginning of college. “School was easy,” he says. “But when I got to university, there was this huge pressure because suddenly the responsibility to do well and be successful was all on me.” Depression followed over the next few years till he was finally diagnosed with bipolar disorder in 2000 and hospitalised. It’s not an option he’d recommend. “The worst thing you can say to someone is that you’re doing it [hospitalising them] to help them — but it’s not, bec-ause the doctors don’t have the medical paradigm to do anything more than lock you up and put you on medication.”

Having bipolar disorder can be both a blessing and a curse, according to him. The PR professional has experienced full-blown mania on several occasions and calls it “almost addictive”. The episodes would typically involve massive highs, during which you’d feel “on top of the world, invincible, twice as prod-uctive, out of control… sexually, financially… It was like being on drugs.” And there was substance abuse, he says, but it only made the highs higher and the lows lower. “One minute, you had it all; the next, you were destroyed.”

The symptoms are often extreme. “It’s the hardest thing to get up in the morning, if you’re depressed and suicidal. Your loved ones tell you to snap out of it… that it’s mind over matter. But that’s the worst thing you can say when your mind is the matter.”

At the other pole, with mania, you become impulsive and obsessive (Ahm-ad started five businesses that “never saw the light of day”). Mania has its positive side, he feels. “Creativity, 
empathy, passion and energy are on an all-time high. The problem is: you know you have a Ferrari — you just need to learn how to drive it, instead of parking it in a garage like the doctors tell you to. If you can channel all that energy into something positive, nothing like it.” But he cautions that mania can also be 
dangerous, if you’re not careful. “You get more social, looking for risky excitement. The kind of people you befriend during this time is very different from your regular crowd. Your judgment is almost always off — and you could end up being 37 with nothing in the bank.”

There’s a fledgling support group for bipolar disorder in Dubai, says Ahmad, who’s been a resident for the last 12 years. But he wouldn’t call it a “community” because they don’t really get 
together as a group — and he imagines the coordination such an effort would require to be a total head-spinner. “Say, for example, my friends make plans for a week after… Do you know the number of times I’m going to change my mind [about going] between now and then, on the day, in the two hours before I leave, during the drive there and all through the meal, depending on my mood? Can you imagine trying to get 30 such people in a room on a given day?” he laughs. “I meet up with a couple of fellow sufferers occasionally, but that’s it for now.”

Unlike the others though, Ahmad does recommend the medication. “I 
resisted meds for 20 years. You can try to control it mentally and you’ll manage — but your quality of life will suffer greatly. So if you’re fighting diagnosis, don’t. There’s no need to. But there’s help, and you can try it out. Medication is just the beginning of the answer.” Admittedly, it took him 15 years just to find the right dosage, but “a lot of that time was spent rejecting those drugs instead of trying to find out what worked.”

His family and friends have been great through it all, he says, gratefully. His advice, if you have a loved one suffering from bipolar disorder, is to realise that it’s not all ‘just in their heads’. “Be gentle and give them their space. Step in only if you see them exhibiting dangerous 
or uncalculated behaviour — especially where money is concerned. They’ll thank you for it later.”

Keeping mum

The social stigma is what made Dubai resident Thomas (name changed) choose not to tell anyone about his condition since he was diagnosed in 2010 — not his friends, not even his parents. The negatives greatly outnumber any good that could come of it, he feels. In fact, it took him more than a month for himself to accept that he had a disorder — perhaps because his diagnosis came almost out of the blue.

“I’d had a few issues with depression since childhood and at least a couple of maniacal episodes (where you swing from extreme happiness to extreme 
depression, without cause),” he begins. “But mostly, I’d have rapidly cycling mood swings that I couldn’t explain and a heavy sense of loneliness all the time. I wouldn’t feel like I belonged — even though I’m no introvert and used to be around large social groups often.”

At the time of the diagnosis, Thomas, who is in his 20s, was studying in the UK and once more, experiencing depression for inexplicable reasons. “I’d wake up in the morning and just focus on negatives. Or I’d be at parties, having a good time, when suddenly the moment would swap in front of me and I’d start feeling miserable, believe everybody was being fake and want to leave.”

There’d be other symptoms too, 
such as time lapse (“I slept for 26 hours straight once and woke up with the genuine belief that only an hour had passed”) or the feeling that death was better. “The problem was: everything was going fairly well for me. I had no reason to be low.”

He eventually confided in a friend — who happened to be doing his PhD 
research in psychology — who convinced him to talk to his professor, a senior psychiatrist with much clinical research experience in the field of different mental health disorders. “The doctor gave me a set of extremely detailed questionnaires and activities to do over a week. After collating the data, he calmly told me that I seemed to be suffering from an acute case of bipolar disorder.”

Thomas’ first reaction was to angrily reject the results. “I’m not mad,” he 
remembers telling the doctor heatedly. “I didn’t appreciate what he was telling me at the time because I was scared of the social stigma. If you’re from the subcontinent, you’ll know that having people find out you’re on medication for something like this is the worst thing you could do. Social alliances, friendships, career prospects — all of it could go for a toss, if people came to know.”

The Indian expat has since returned to Dubai but continues to deal with his situation without meds or therapy. “There are various stages for the disorder. I’m only on the threshold of Bipolar 1, so I can do without the meds. But I’ve taken a very hard stance with myself instead. I’m very socially active and try not to sit idly or let my imagination run wild. Both can lead to mood swings that feel like you’re flowing into this endless warp of sadness and fear. So as soon as I sense the onset of these ill feelings, I try to fight them off and keep myself occupied instead of letting it consume me or waiting for it to pass, as I used to.”

To the community at large, he says, “If you know people who are bipolar, treat them normally — but always be mindful that they can be in the wrong mindset at the right time. For example, there may be times when you expect them to be happy but they will react with rage instead. It’s not because they’re mad… They’re just experiencing a diff-erent facet of their minds. Some things are beyond their control and you just have to accommodate that. It may be the best thing you can do for them.”