There are many difficult things about living with bipolar disorder. One of my least favorite is what I call “living against the grain.” Every human being has to strive for homeostasis, but people with bipolar disorder live the issue more onsciously and probably more profoundly. Living against the grain is not always necessary, of course, but there is enough truth in it to talk about it here.
It is a simple idea. Whenever you feel strongly compelled to do something, truly inspired to pursue a relationship, when you find yourself salivating over buying something — just don’t. That way lies danger. And the reverse – when you feel like you can’t live one moment longer, if you don’t have the energy to get out of bed, and when you genuinely do not care about brushing your teeth or even world peace, it is time to do exactly what you do not want to do. It is time to get up and out of the chair and out the front door at least once a day. And it is essential to find ways to compensate for the self-absorption of severe depression instead of drowning in your own emotions and troubles.
Joseph Campbell used to say, “Follow your bliss.” He was a very smart guy and I trust that his dictum might be inspiring for some people. But it feels idealistic and potentially dangerous for someone with bipolar disorder. And for someone like me, who has tendencies towards extreme mania? Follow your bliss and you will end up in the ditch. Follow the siren call toward the impossible, toward ecstasy, and there will be ruination, empty checking accounts, and broken relationships.
So instead of following my bliss, when the extremes arrive I get to live against the grain, to swim against the current of my biochemistry. When I am pulled toward depression, it’s time to get out of bed and go for a walk. When I feel like I can conquer the universe, it’s time to sit alone, quietly, in a forest next to a gentle stream. I have learned that if I feel a wicked wind pulling strongly one direction and then another direction, I need a counter force pulling the opposite direction in order to stay upright.
Trying to anchor our lives to healthy behaviors and find a steady equipoise can feel like the tedious tick tock of a metronome when our veins are filled with liquid fire. Bor-ing! Changing our pace from a mad dash to a sedate stroll can feel deadly dull, uncreative, and even stifling. But the cost of our high octane bliss is too high, particularly for our loved ones. It may be better to settle for semi-bliss, decaffeinated excitement with 2% instead of the triple mocha ecstasy piled high with self-indulgent whipped cream.
It’s not easy to do this. It is not fun to put your foot on the brakes when you’re having a joyride or to drag yourself up the hill when your face feels just fine in the ditch, thank you very much. It is the last thing that I want to do, every time. It feels unnatural. It is unnatural. But that is the disorder I have.
Finally, it is important to apply moderation in our course corrections. In particular I have seen this in hospitalized manias. It has always seemed to me that psychiatrists throwing a sledgehammer of antipsychotics at a bipolar with mania in the hospital was like slamming on the brakes. In my (too) many years of bipolar experience it has been my observation that the main reason for this is because of insurance and financial constraints. This became worse relatively recently because typically psychiatrists only treat inpatients or outpatients. So a psychiatrist who slams somebody with antipsychotics in the hospital does not have to live with the long-term outcome of that short term gain. They do not have to live with the biological whiplash from slamming the brakes on mania.