Video Transcript: What is it like? Part 2

Welcome to Mental Health Integration. Week three, part two. What is it like? In  the last section, we talked about my own experience with bipolar disorder and  what it felt like. And in this section, we're going to talk about other people's  experiences, what they feel like, what they go through. And then we're going to  start asking some questions about different things that come up through this  process, things like, how do I process my own pain? Do I have questions about  how I get through this? Do I have questions about who I am? Do I have  questions about who God is? What are the things that come up and what can I  trust, and what can I not trust? So today, we're largely going to cover that. It's  not just about the pain. It's kind of about what are the questions, what are the  underlying issues? Why is it happening? How? And then we're going to walk  through that. After this section, we're going to start talking a little bit more about  who gets treatment, what that looks like, and long term, what happens. So we  begin this section with a quote, and this quote is by a personal hero of mine. It's  by Kay Redfield Jamison, who is a psychologist, and she is at Johns Hopkins  University. Now she was doing her doctoral work when all of her symptoms of  bipolar disorder set in, which created this really weird situation where she is  incredibly smart, incredibly gifted at one of the best research hospitals in the  world, and also dealing with these incredibly terrible things. When I was 14  years old, I was sitting on a couch reading Kay Redfield Jamison's book, hoping  that I could make it through my own case of bipolar disorder, and I decided at  that point, if she could make it, I could make it. And I might not be a PhD  researcher person. I might not ever be in that kind of situation, but I didn't need  to be. I was a 14 year old between my freshman and sophomore years of high  school, I needed to know if I could live. And she said, I have bipolar disorder and I can live, and I decided to believe that. So with that, she she wrote a number of  books. Her this quote is taken from An Unquiet Mind, which is her memoir, her  basically seminal work around bipolar disorder, and she is one of the key people that got bipolar disorder talked about and moved into the limelight where we can discuss these things more often. She says there's a peculiar kind of pain,  elation, loneliness and terror involved in this kind of madness when you're high,  it's tremendous. The ideas and feelings are fast and frequent, like shooting  stars, and when you follow them until you find better, and you follow them until  you find better and brighter ones, shyness goes and the right words and  gestures are suddenly there. The power to captivate others. Felt certainty there  are interests found in uninteresting people. Sensuality is pervasive in the desire  to seduce and be seduced. Irresistible feelings of ease, intensity, power, well  being, financial omnipotence and euphoria pervade one's marrow. But  somewhere this changes the ideas are far too fast. There are far too many  overwhelming confusion replaces clarity. Memory goes humor and absorption on friends' faces are replaced by fear and concern. Everything previously moving  with a grain is now against it. You are irritable, angry, frightened, uncontrollable 

and enmeshed totally in the blackest caves of the mind. You never knew these  caves were there. It will never end, for madness carves its own reality. There are a few things that I want to touch on in this quote. So I'm going to flash back and  forth to this slide a couple times to talk about it. When Kay talks about this, she's talking about mania and depression. She's talking to begin with, with mania, this  madness that starts as something really beautiful. I have capacity. I can do  more. I can be more. Everything is easy. I don't have any problems anymore.  These things that used to hold me back Don't hold me back anymore. I can jump right in and just do it. Comes with a sense of confidence, almost an arrogance,  that I could solve the world's problems, that I can solve my own problems, that I  can think fast, that I can be fast, that I can do things fast, and if the world could  keep up, it would be good. But then she talks about how it shifts and changes.  Look at it right here in the middle, but somewhere that changes the fast ideas  are far. Too fast. She's shifting from this place of hypomania, hypomania being I  still am in touch with reality, but I feel like I have extra oompf spot, extra ability to attack it, and full mania, which loses touch with what's real, and begins to grasp  and move so fast that I can't keep up. And then from that, she moves and begins to see her friends fade. She sees their faces begin to move down, because  instead of being excited and invited into her life, they are distressed by the life  that she is living, and then you see the Depression hit as it carves new ways of  pain, new ways of hurting, new darknesses that she didn't know. I want to touch  on each one of these things. Okay, hypomania starts, and in many cases, it  used to be joked around that if you looked at a bunch of CEOs, you would find  incredibly high rates of bipolar disorder. And in some cases, that's true, CEOs  have much higher rates of bipolar disorder than the general population does,  and it's because, if you look at it, people who are willing to take risks and do  things that are hard and feel like they're unstoppable. Well, it sounds like a  Silicon Valley CEO, if you ask me, they just like do those things. I will be  powerful and go and exude confidence and get things done. That said, there are also correlating depressions with those things, and those highs don't last  forever. You also see that high. She says that sensuality is easy and irresistible.  There's a lot of risk taking behavior that takes place, oftentimes with mania,  hypomania. It's whether that's sexuality or whether that's compulsive spending  or gambling. There are elements of things that often come alongside with  manias and hypomanias that really kind of ruined your life afterwards. I had a  friend in college with bipolar disorder, and she had spent 10s of 1000s of dollars  on shoes when she was manic, and now she was a freshman in college, she  was piling up student debts, and she had 10s of 1000s of dollars of consumer  debt on top of her student debt already, and she was only 18-19, years old  When you spend 10s of 1000s of dollars on shoes, it's pretty easy to have  buyer's remorse afterwards. And in her case, a lot of what she said were very  cute shoes. Now, when you also hit full mania, you jump into that space where 

you're no longer just productive, you're also losing touch with reality, it can be  really scary for the people around you. It's like watching a tornado go through  your own house, because there is so much activity, so much movement, and it's  not helpful or beneficial. It just cycles and spins and it can break the things  around it. It's in some cases, terrifying the only hope for that person that you  have at the time is I hope that it stops before they do a lot of damage, because I  don't want them to do a lot of damage with us. But that compulsiveness and that confidence, all of it is still wrapped up in those feelings, even if they don't have  any grounding in reality anymore. And then when Kay talks about the  depression, it's just boundless and it just hurts. We talked about that in the  previous section, so I'm not going to spend a lot of time now talking about how  the lows are so low that you can't imagine it being lower. And then it is, and then  it is again, and then it's lower still, and it keeps moving down. So when you have this kind of pain and this kind of brokenness, there's some interesting questions  that come up. One of the questions that comes up is, what is real, and that's  because whether this is depression or bipolar disorder, or whether it is OCD or  any other mental illness, most of us, for our entire lives, have trusted our brains.  We've trusted what's between our ears to form our reality, to inform our reality  and as a trustworthy guide in navigating that reality and with these major mental  illnesses, suddenly that is not a reliable tool. Suddenly you can't trust the thing in your head. My head said You're awful, you're terrible, you're. Worthless. You're  also invincible, and you're Superman, and you can conquer and do anything.  And I didn't know which one it was at any given point in time, I would be well into a mania before I knew it was going on. I would be well into a depression before I knew it had hit. And so I had to form an external locus of control. I couldn't trust  my own brain because I didn't understand what it was doing. So I had to trust  other people with my brain. I had to trust other people to know what was going  on with me, and to hear me and to care for me, and to know enough about me  to say, Brandon, you are manic. And I'm not the only person I met like that. It's  really hard when you lose trust with something that you need to trust. And it also brings up further questions, like, Can I trust my own judgment? I'm thinking  about buying a house. Can I trust my own judgment about buying a house? I'm  thinking about getting married. Can I trust my own intuition about getting  married? Is this me being a little bit manic, or is this a really good person? I am  feeling like quitting my job? Is it because this is not the right job for me, or  because I'm depressed? Can I trust myself? The question is, Is this me or the  bipolar in other people's case, is it me or the OCD? Is this actually what's right,  or is this something else? So in the cases of a many, in the cases of many  people I've known with mental illnesses, we have to form these external realities to inform our internal realities, instead of the other way around, because we  can't trust our heads. Now I want to continue this with another quote that kind of  illustrates and shows this a little bit. Alyssa Reyans says, bipolar robs you of 

that, which is you. It can take from you, the very core of your being, and replace  it with something that is completely opposite of who and what you truly are,  because my bipolar went untreated for so long, I spent many years looking in  the mirror and seeing a person I did not recognize or understand. Not only did  bipolar rob me of my sanity, but it robbed me of my ability to see beyond the  space it dictated me to look. I could no longer tell reality from fantasy, and I  walked in a world no longer my own. What she's saying is her bipolar disorder  started dictating her life. It dictated what she saw, what she focused on, what  she was enmeshed in, how it dictated her life. I have two notes about this. First,  we have a lot of quotes here about bipolar disorder, and it's because Bipolar  disorder is bad, like it has really bad symptoms. We talked about how it's a  severe mental illness in the last section. Because of that, when things are really  bad, we write about them. So there are so many quotes and so many books and so many resources about bipolar disorder. It's astonishing. And part of that is  because if something hurts this bad, the world should know about it, so people  like me tell their stories. A second note is that Alyssa describes this feeling of  being focused on something, and I used to describe it like a microscope. It's like  there's something on a slide, and we are so cued into looking at what that thing  is, that it's all we can see. All I can see and be consumed by is I'm a miserable  person, or this thing is so important, even if the rest of the world is going on, I  just become numb to that because I'm so hyper focused on this one thing. It's  the only thing that matters. And that's really common with bipolar disorder, but it  happens in some cases with other disorders as well. We can fixate on  something because that is the answer to our problem. That is the answer to  what's going on, and it becomes consuming. Now, in Alyssa's case, she also  took years to find the right medications, and during those times she was walking through, who am I? What is it going on? I don't even know who I am. This idea  that I don't know what's real, I don't know who I am. I don't know what connects  to me. I don't know how I can trust myself. You can see all of these pervasive  questions, and this question of, what is what is my reality? Not just what is real  to me, but who am I in? My reality starts coming up. Brings us to the next  question, How bad is it? How long is it going to take better. How long is it going  to take to get better? Here's a quote by Jenny Lawson from a book Furiously  Happy, which is a ridiculous book if you've never read it, and is terrible and.  Hilarious when you come out of the grips of a depression, there is an incredible  relief, but not one you feel allowed to celebrate. Instead, the feeling of victory is  replaced with anxiety that it will happen again, and with shame and vulnerability  when you see how your illness has affected your family, your work, everything  left untouched while you were struggling to survive, we come back to life thinner, paler, weaker, but as survivors, survivors who don't get pats on the back from co workers who congratulate them on making it, survivors who wake to more work  than before because their friends and family are exhausted from helping them 

fight a battle they may not even understand. I hope to one day see a sea of  people all wearing silver ribbons as a sign that they understand the secret battle  and as a celebration of the victories made each day, as we individually pull  ourselves up out of our fox holes to see our scars heal And to remember what  the sun looks like, the problem with mental illness isn't just that it's hard,  because we've established that it's really hard, but it's the news keeps going. It's like if you broke your leg and you went to the doctor, he said, Ah, your leg is  broken. This is terrible. We're going to try something. It's gonna be better. So  they put it in the cast, send you home. They say, don't walk on it for six weeks.  You don't walk on it for six weeks. You go back to the doctor and they say, ah, it  was so close. We thought we had it nailed, but it wasn't set, right? So we  actually need to re break it, reset it, recast it, then we're going to try it. So this  time it's going to be a little bit longer, because you have some problems,  because it was already set me eight weeks. So you go, they break your leg, you  get it reset. You spend your eight weeks. You're still waiting. It's been 14 weeks  now. You're so excited to get back to your life. You go to the doctor, and they go, ah, there was a problem. This other thing happened. Now you have an infection, and because of that, we have to do another surgery. Now it's going to be  another four to six weeks until you're better. Okay, you get the surgery, and then  you're sitting there waiting these weeks, going, how long is this gonna last? Like, when I had this happen to begin with, they said four to six weeks. And I thought  that was bad enough, but it's been 20 weeks. It's been I mean, we're coming up  on half a year here soon, and I am still not doing well. And you go back to the  doctor and they say, I'm sorry. It turns out that when we fixed your leg now you  have muscle atrophies in all of your muscles. You basically don't have muscles  in this leg anymore, so you haven't moved it for half of a year. Half of a year. So  it's going to take you another extended period of time to get these muscles back. So you need to start physical therapy, and it's probably going to be three to four  months before you're back, and then finally, after nine months, you're better. But  you expected it to be four to six weeks. And the same thing happens all the time  with mental health issues. You go to a doctor and you get your meds, and you  say, Oh, this is going to be so fast and so easy. Look at this. They've got meds  already. They say they take two to three maybe four weeks to start working. I'll  start. It'll be great. So you go, you take the pills, and it's not great, and you go  back to your doctor, and they say, ah, that didn't work. Let's try this other thing.  And then that works or it doesn't, and then you need to go back, and then it's  additional time. The thing about it is you don't know how long it's going to be the  first medic should the first medication could work, and it could be phenomenal.  Or the eighth medication could work, or two years into the process it could work, or six or seven, and that all assumes that you're a good client who takes your  pills and takes care of yourself. This can be an incredibly long, hard process,  and we know that it can get so hard, not just because of the mental illness itself, 

but just because of the waiting period and then the hopelessness that grows as  that waiting period grows. So how long am I safe for this? We're going to look at  Elizabeth Wurtzel from her book Prozac nation. And I know new for sure, with an absolute certainty, that this. Is rock bottom. This is what the worst possible thing  

feels like. This is not some grand, wretched emotional breakdown. It is, in fact,  so very mundane. Rock bottom is an ability to cope. Is an inability to cope with  the commonplace that is so extreme that it makes even the grandest and  loveliest things unbearable. Rock bottom is the feeling that the only thing that  matters in all of life is the bad is one bad moment, rock bottom is feeling out of  focus. It's a failure of vision, a failure to see the world how it is, to see the good  in what it is, and only to wonder, why the hell things look the way they do, and  not and not some other way. There's another part of this. Thing is normal life can begin to lose the normalness of it. It can begin to lose the joy, lose the  goodness, lose the happiness, lose what makes it life. It's a grayness that slowly sets in and slowly takes over what the rest of life is. And so it's not just this is so  hard I'm dealing with this depression. It's I don't want to be around people  anymore. I don't want to be around things anymore. The stuff that used to bring  me joy just doesn't bring me joy anymore. I'm kind of tired, not just from the  fatigue of working through the illness, but the fatigue of the fatigue of working  through the illness, right? We have to work through how hard this is for how  long, and then when we think, Oh, man, we're gonna make it, maybe, possibly,  and all the doubt comes in, then there's still these pieces of but I don't enjoy the  Life I have now. What am I getting back to? And because of that, we lose  something else, which is we start asking questions like, Who am I? I am no  longer myself. I don't feel like myself, I don't look like myself, I don't act like  myself. I Am Not Myself. Myself was an honor student. Not myself got a 1.3  myself loved playing with my friends. Not myself didn't myself. Loved being  engaged in the world around me, not myself. Didn't myself. Had an uncanny  memory. Never had to write things down. Remembered things all the time.  Never forgot numbers or names or birthdays. Not myself forgets all those things. And the reality is that a lot of the time, my definition of myself is wrapped up in  what I can do, and because of that, I am not myself at all anymore. My  conception of myself is wrapped up in what I love and I don't love anything  anymore. My understanding of myself is wrapped up in how I care about what's  happening in my life and how I care for the people in my life, and I no longer  have the bandwidth to do those things. So who am I now? I don't know that's  part of this mental health thing is not just like mental illness is hard, but I have  lost my understanding of who I am as an individual. Me exists, but I don't know  who this me is. They're a stranger to me, and I can't, I can't fathom what that  looks like. And then it goes beyond that, because we can start asking questions  like, Who is God? Because our concept can start breaking down. We can start  losing touch with who God is, because when we start seeing these fractures 

form in our images of ourselves and our image of what we're capable of, in our  images of what life is, in our images of what's good, it can affect how we see  God too. That can begin to fracture and break. And we can lose not just our  concept of ourself, but our concept of God, our concept of religion, our concept  of what's beneficial. A lot of people will lose their community because they've  lost that hope in it. We can lose our our own world view, because suddenly it  doesn't stack up against what we're experiencing. And we can lose ourselves  because we just don't know what's going on. So suddenly, what I want to tell you is that everything is on the table. It's not just questions of how do I make it  through? It's not questions of what's the right thing. It's the question of, who am  I? Who is. God, who is my family? What do I care about? What are my  passions? How do I love? What do I What do I do in this moment? It's questions  about what my life is going to look like. Do I have potential anymore? Am I able  to meet that potential anymore? Questions about how I function. I used to do all  these things. I can't do these things. Everything is on the table, and there are no  easy answers. There's nothing straightforward and simple. We don't have any  answers. Like if you just do this thing, it's all better. And you get your old life  back, you never get your old life back with a mental health issue the way it was,  it will be deeper, it will be stronger, it will be better once you make it through. But the way that you exist before is forever changed because you go through  something like this, you can't un go through something like this. And so these,  these questions have teeth, they are very heavy, because they have changed  you forever. That is why there's so many quotes about bipolar disorder when it is so hard, because it changes us, and then we have to come to terms with how  that change has occurred and who we are now. But the thing to remember is  what my parents remembered, that we'll get through this no matter how hard it  gets, no matter how deep it gets, no matter how dark it gets, you can make it.  We can make it. But what we need to remember is really, really simple. We  make it through together. We make it through by working hard. We make it  through by being who we most want to be, and we make it by being faithful to  the process. We don't make it through just bare knuckling it and holding on and  thinking that there's no hope. We have to hold on to hope. We have to hold on to making meaning of good things. We have to hold on to life having purpose  afterwards. Viktor Frankl talked about how the people who made it through  concentration camps during World War II, they had a meaning. They had a  purpose that they were living for after they left, whether that was they needed to  finish a book or that was because they were a piano player, or whether that was  whatever it was, they had a meaning, a purpose, something they were going to  do beyond this and the same exists in mental health issues. There is something  that your life still means, something that you still need to do, and you have to go  do it, and making it through this thing gives you the opportunity to invest in that  thing, to do, that thing to make that thing to do that people go through all sorts of

different things. My friends with OCD talk about how their intrusive thoughts  have destroyed their lives. My friends with depression talk about how  depression knocked them off the rails completely, how it overwhelmed them,  how they lost their positions, how it destroyed them inside. My friends with  anxiety talk about how the panic attacks have just crippled them inside, and  they're so anxious about not just the things around them, but the panic attacks  themselves, that it drives them into a more anxious place. My friends with  personality disorders have talked about trying to unravel their own brokenness  and figure out what's at the bottom of it, because they can't relate to people in  themselves. Well, my people, my friends with autism, have talked about how it's  been so hard for them to relate to the rest of the world because the rest of the  world seems to march a little bit differently than they do, and the things that most people care about just aren't that they aren't the things they care about as much  everyone dealing with mental health issues is dealing with some way their brain  is different than the average person. I think the best reaction that we can have in that is one, if this is you, it's real and it's hard, and that's okay, not that it's a  good thing, but when we tell ourselves the truth, we have the opportunity to  heal. And if it's somebody else, we can believe them, because it really is that  hard, and there's no harm. So as we learn to love people, including ourselves,  we can take it seriously, but then you can also laugh at it. As a final note, you  have to see the humor in this stuff. After my wife and I got married. I was going  through some medical issues that played with how my meds were working, and  it means they didn't work quite as well as they had for the previous number of  years. So I would get a little bit hypomanic, and every time I did, we lived in an  830 square foot house, and it did not have a place for my tools. So we had two  cabinets in the laundry room that were filled with tools. Every time, every time I  was a little bit hypomanic, I would want to clean something up. And Eugenia  would say, Brandon, the laundry room, it's a mess. Why don't you fix it? And I  would go through, and I would reorganize everything, figure out where things  were, make things fit, make everything perfect. And then a week later, I would  be looking for a screwdriver, and I would ask Eugenia, Eugenia, my  screwdrivers are nowhere near where I used to put them. Do you know where I  where they are. And she'd say, Brandon, you clean it when you're hypomatic.  And I would just go, oh, man, it could be anywhere. There's no telling where I  put that thing. And at the time, it's not some sad thing. It was hilarious, because  it was my own fault. I had to go find my screwdriver wherever a crazy person  had put it, because I had been a little bit crazy and I had hid it from myself. So  as you come across these things, please remember to laugh at yourself and  laugh at things a little bit too. It is a little bit funny, and seeing the humor in it will  make it a lot more reasonable and a lot more palatable to get through, for lack of a better term. Thanks, and I will see you guys next time.