Tag: mental illness

My wife gave me that look again yesterday. It’s not really a bad look, but it is specific to certain situations. I like to imagine that at some point General Custer was talking about whether to ride down to Little Big Horn or to just go home and drink beer. And I like to imagine that during that discussion Custer’s aide looked at him the way my wife looked at me last night. It’s the look that says, “I don’t know why you’re saying these things, but I hope we end up having a party instead of pulling arrows out of each other.”

I started off by telling her I had an unimportant question, and then I asked what the idiom “the carrot and the stick” means to her.

“It means you reward someone to get them to do something, and you punish them if they don’t do it,” she said.

“Yeah, that’s the common definition,” I said, “but that’s not the way I learned it. The carrot is a reward, and the stick holds the carrot in front of the donkey where he can’t get to it. He just keeps pulling towards it.”

I paused to let my wife say something in response. Instead, she gave me that look.

“Nobody gets punished,” I said.

She kept that look trained on me, even though the cat chose that moment to dig his claws into her leg and launch himself across the den like a cruise missile.

“You don’t hit the donkey with the stick,” I went on. “The stick just hangs there.”

My wife rubbed her perforated trousers leg and said, “Is this for something you’re writing?”

“No, I’m just thinking about it.”

She leaned away from me a fraction, the way you’d stand back to get perspective on a magnificent tree, or to get perspective on a manic person who’s talking about pudding enriched with brain-strengthening vitamins.

“Really! Think about it!” I said. “If you hit a donkey with a stick, you may get bit. Even the stupidest donkey in the world isn’t going to think the stick hit him by itself.”

I paused again for my wife to speak, but she just gave me a glacial nod to continue.

“But if you just use the stick to dangle the carrot, the donkey won’t get pissed off and bite you. Even if he gets aggravated, he’ll probably just bite the stick. It’s better all the way around.”

My wife crossed her legs and said, “Okay. And why did this come up?” Followed by the unspoken, And were you stockpiling food and Geiger counters at the time?

“No particular reason. It’s just, you know, the donkey never sees the stick that’s holding the carrot. So, when I look around here I can see the carrots. Where are all the sticks?”

“Are you complaining because you can’t see invisible sticks?”

“No! But if I’m working for carrots that I can never get because some hidden something is keeping them out of reach, I want to know what that something is and do something about it!”

My wife leaned back another fraction. “Are you complaining because you can’t see invisible sticks and then bite them?”

“Well… yeah. Kind of. Not literal sticks. The sticks are metaphors.”

She waited for a bit. When I didn’t continue, she said, “Metaphors for what?”

“I don’t know! That’s what I want to find out!”

“Should I clean out another closet so you can fill it with bottled water?”

“No, you’re missing the point!”

“Which is?”

“It’s hard to explain,” I said.

“Does it have something to do with the donkey? You have to give the donkey a carrot before all this, or he won’t know he likes carrots.”

“Yeah, it goes without saying that the donkey likes carrots!”

“And if you don’t feed the donkey sometime he’ll die.”

“Just forget about the damned donkey!”

“You’re the one who wanted to talk about the donkey. I was watching TV,” she said.

The truth of that statement kicked me in the larynx, and I stopped talking for a moment. Then I said, “You were right, this is for something I’m writing.”

I saw her shoulders relax. That look disappeared from her face like a pricked soap bubble. “Oh, okay. Anything else?”

I shook my head, kissed her, and went back to my office, where I further contemplated the question of donkeys and invisible sticks. That question had become secondary, though. My primary interest had become appreciating the complexity of my wife’s job.

My wife contributes to our partnership in a lot of ways, and one of them is observing my behavior. She doesn’t so much observe it as she scans it with the diligence of a forest ranger. But she’s not scanning trees for signs of fire, she’s scanning what I do and say for signs of an irrational brain that needs tweaking. You could say that she’s a Brain Ranger.

It’s a hard job. People pay me to say things that no one would expect a normal person to say. Even when my brain is working fine, I sometimes say things that make everyone stop for a moment and then look away. How can a Brain Ranger tell when I’m malfunctioning and when I’m just being my normal, strange self?

I can’t explain how she does it. But I will say that for a person like me with an unruly brain, a vigilant, no-bullshit Brain Ranger is invaluable. There’s nothing like having someone who can listen to you talk about your metaphorical donkeys and invisible sticks in the context of your metaphorical forest and figurative fire, and assess whether your behavior is abnormally weird or just regular weird.

Someone's Brain Ranger has some exciting times ahead.
Someone’s Brain Ranger has some exciting times ahead.

Public domain photo by Karen Murphy, U.S. Fish and Wildlife Service

via Wikimedia Commons

Writing brings out the mental illness in me. My wife can testify to this.

I’m in control of my behavior almost all the time. As Mark Twain said, “For business reasons, I must preserve the outward signs of sanity.” If I wake up to find my brain mired like a mammoth in tar, I can trick my brain into sucking itself free and stomping onwards across the plains. I rarely buy extravagant, useless things, because I have a rule. If I want to buy something that costs more than a couple of hundred dollars, I can’t buy it until I think about it for at least six months. I almost always follow that rule. Almost.

Judiciously applied chemicals are my friends. Free range chemicals and alcohol are not welcome in the home of my brain, apart from the occasional tequila shot or pomegranate martini. Come on, I’m not a nun or anything. But my best friend is me acting the way I want to feel, no matter how my brain tells me I feel, or at least doing my best to create the outward signs of sanity.

It works pretty well at this point in my life.

My wife refrains from trying to convince, trick, or bribe me into not behaving like a crazy person. It’s my job to take care of all this. She’s happy to help if I ask, and she demonstrates philosophical acceptance when I suddenly fill up the office closet with 30 gallons of bottled water, or when without warning I decide we need some more cats. Not only is she tolerant, she’s smart. If she tried to manage all this for me, I’d probably explode like a hand grenade.

Writing screws all this up. Well, not all writing causes problems. I can write a thousand words, declare success, and smile as I move on to something else. It’s the big projects that make me crazy. I’ve written three novels in the past three years, and the insanity they create goes like this.

I get an idea for something I want to write. It’s the best idea for a book that anyone’s had in the past 100 years, or maybe ever. I’m so excited that I talk to my wife about it almost every minute we’re together. I lay awake thinking about it and even consider waking my wife up in the middle of the night to talk about the greatness that is my idea. This goes on for about three days.

I begin the planning and research required to bridge the chasm between having an idea and writing words. I realize that my idea is rubbish. It’s less creative than a bucket of vanilla pudding. If brought to reality, it would be less popular than asphalt-flavored baby food. I feel shame. The only reason I keep working is that I talked it up so much to my wife I’d be embarrassed to never write a word of the thing. This goes on for about a month.

I start writing the first draft, expecting that after one chapter I can honorably surrender to the fact that my idea was horrible. After the first thousand words I find that I’m amusing myself, and I start to feel better about the project. I read the first chapter to my wife. She doesn’t say anything bad about it, which confirms my growing suspicion that it’s a work of magnificence. I begin laughing and hooting like a fool as I write, and I find I’d rather write than eat or sleep. This goes on until I finish the first draft, or about two to three months.

I put the manuscript aside to cool, planning to begin editing in about six weeks. Within 24 hours I realize that I was engulfed by irrational euphoria this whole time, and in fact my manuscript isn’t fit to wipe the ass of a sweaty heroin addict living in a ditch in Bangkok. I try to put this debacle behind me and concentrate on ideas for my next project, but I can only generate enough motivation to watch Saving Private Ryan and eat pie. This goes on for about two months.

Some grisly sense of obligation forces me to open the manuscript and pretend I’ll edit it before I trash it and funnel my creative urge into learning the ukulele. After reading three pages I can’t believe I’ve forgotten how brilliant it is. I perform several rounds of edits like one of those yipping dogs that never stops to sleep. I’m afraid that if I take a day off then the magical spell will be broken and I’ll once again see that the manuscript is just a snap-toothed yokel with mismatched shoes. This goes on for about six weeks.

The manuscript is finally as good as it’s going to get without an editor. I begin writing query letters, synopses, overviews, biographies, and the other artifacts that agents and publishers want to see. I become profoundly convinced that any agent would be more impressed if I just sent her an envelope full of fish guts. I grit my teeth and push on. I’ve come too far now. I’ll just send out the queries and then take my beating in cowed embarrassment.

Then it’s time to start a new project. And even though it means starting the cycle of crazy all over again, I don’t mind all that much. Not everybody get to experience three days of knowing that their book idea is absolutely the most perfect and radiant idea of the last century. It feels great. It’s entirely worth the subsequent months of the despair when you understand just how appalling your idea in fact was.

Really. I’m not joking.

Outward signs of sanity, dude.

Photo courtesy of cutedogs.com via wakpaper.com.

Inspiration sucks. It’s like that five dollar macchiato you drink every morning to get yourself going. Then one day the cat barfs on your shirt and makes you late, and you don’t have time for Mr. Macchiato. You can’t get yourself going without it, and at work you just stare at an imaginary point hoping no human comes near you before noon. The professional writers say that inspiration is for suckers. Just start working and let the work take care of itself.

So I felt really bad today when I sat down at the keyboard uninspired, depressed and communing with that imaginary point rather than attacking the keyboard like I was John Henry. I squirmed in my chair and felt shame that I was attempting to use the same alphabet used by Mark Twain. I’m a man of my time, so when I have a problem I do what the people of my time do. I go to Google. I searched Google for inspiration. By the way, the word “inspiration” produced 107,000,000 hits, and I don’t think any of them are at all inspiring.

After a while, like a lazy, willful mule, I started looking for anything I could use as an excuse for not writing at all. I landed on bipolar disorder. That was promising. I figured I could whine about it for at least a couple of paragraphs and be done. But then I found a page listing the best things about bipolar disorder, which isn’t your normal kind of post about a mental illness.

I think the “best things bipolar” list contained some fine and illuminating stuff, but it didn’t quite capture my experience with my friend bipolar. That’s what led me to create this alternate list of The Ten Best Things About Being Bipolar.

  1. Since you’re manic sometimes and depressed at other times, bipolar can be claimed as the reason for almost anything you’ve screwed up or don’t want to do.
  2. After being manic for a while, you can tell people what it’s like to write the sequel to Lord of the Rings, invent the perpetual motion machine, and fly without an airplane.
  3. You have a wide selection of pills in decorator colors, so there’s no need to remodel the bathroom.
  4. You can finish a day’s work when other people are still asleep, and you can think faster than reality occurs.
  5. When depressed, you get plenty of health-enhancing rest for long periods of time, in rooms darkened by curtains that block out harmful UV rays.
  6. You can openly pay someone to put up with your shit and react in a patient, thoughtful way, because it’s more acceptable to do this with a psychiatrist than with a prostitute.
  7. There’s no substitute for being the smartest, most charming, most articulate, sexiest and most creative person on Earth for a while. It’s worth the embarrassment of later looking back at what you did and wondering what the hell you were thinking.
  8. If you make bizarre money decisions, buy ten thousand pairs of bowling shoes, lose your home and possessions, and cause all your family members to abandon you, that’s just an unambiguous sign that God wants you to become a monk.
  9. You give your spouse lots of opportunities to develop patience, tolerance, and the discipline to not hit you in the face with a frying pan.
  10. You get to identify with scads of famous people who might have been bipolar too, like Abraham Lincoln, Marilyn Monroe, and Tigger. That’s got to be good for your self-esteem.

So there’s a poke in the eye for you, inspiration.

It sometimes surprises me how many people like their bipolar experience just the way it is. Yet plenty of people don’t like bipolar, and they can get pretty angry that anyone might say positive things about it. So, I’m happy to see your comments, but please try to keep them civil, or at least more civil than a religious war.

The suspected-of-being-bipolar President Theodore Roosevelt. Is he manic here? Depressed? You decide.

My brain and I are no longer on speaking terms. He’s given me the central nervous system equivalent of a sharp kick in the shin. Or to put it another way, if he were my roommate he would have just stolen the last piece of my birthday cake from the refrigerator. I’m quite put out, and refuse to have anything to do with him.

I used to rely on my brain’s unfailing companionship. He figured tips, and he remembered who Archimedes was, and he knew how to spell “eviscerate”. He once took over and completed a 3 ½ hour essay final exam on Differential Mortality, Gender, and Agrarian Economics while I looked at the cute girl by the window. That was real friendship. He even got an A.

But it hasn’t all been marshmallows and kittens. My brain has occasionally led me astray, like the time he said, “I’m 19 and smart enough already—who needs to finish college?” (That one was fairly painful to fix.) Or that time he said, “Three months is plenty of time to get to know each other—go ahead and get married!” (That one was extremely painful to fix.) He tends to approach all problems with an A + B = C mentality, and I suspect that’s not always the best choice.

So for a while my friend the brain has been yanking me around, as he sometimes has done in the past. I don’t know where the hell he goes at night, but during the day he walks around all the time with some kind of freaky hangover, which is pretty annoying. Don’t get me wrong, I understand that brains get a little weird when your body produces a smidge too much of something or other, or when things get out of whack in the lobes, or sometimes really for no reason at all. But there’s only so long you can go with your brain making you act like a crazy man before you say a dignified, “Enough.”

I’m not positive what my brain has to say at this point, because we’ve only been communicating through my thyroid. For example, I’ll say to my thyroid, “Hey, ask my brain how to calculate the distribution of a chi square test,” and the thyroid will come back a little later and say, “Your brain answered, but it was just a bunch of squiggly symbols I don’t understand. How about some extra hormones instead?” That’s not as helpful as I might wish.

I am now accepting applications from other organs interested in replacing my brain. I imagine there will be many fine candidates, because the job of brain is pretty prestigious, the hours are good, and you get excellent access to the eyes in case anything interesting comes on TV. I might even solicit an organ or two to get the process rolling. Is the uvula an organ? I’m not sure because I’m no longer talking to my brain. But it’s welcome to send me a resume anyway.

This is what’s left of me after five weeks of my thyroid running things.

 

 

This week I refrained from crushing a surly cashier, even though the Dr. Pepper cases stacked behind him into an Olympic torch were the perfect weapon. I showed immense restraint, and I would like a cookie as a reward. I didn’t even speak harshly to him, although I silently called him a marrow-sucking cluster of rat filth scraped from beneath a refrigerator. I could have come up with something better, but my ice cream was melting. And what thing did this blemish on the butt of Tom Thumb do? Not a single damn thing except for being a bit snotty about my rewards card, which might have been a little bent if you want to get technical, so in the eyes of some pedantic people it could have, maybe, been kind of my fault.

So, I was nice to him, even though I wanted to pull out his entrails, wrap them around my shoulders, and have someone drive me up and down the street while I stood on the hood and screamed, “I’m the King of the World!” I even thanked him after I bagged my own groceries, so yes, god damn it, I deserve a cookie.

I don’t often have this anger problem, but this week my brain has decided I need to be enraged at each individual molecule in the 46 billion light years-wide observable universe. I have a separate grudge against each one of them. My brain decides to do this once in a while. I think this irrational anger phenomenon is well known to many of us who have brains. It may happen a little more to some than to others, but I’m not sure that makes much difference. One thing I am sure about is that I’ve been on alert for anyone who screws up in some tiny way, so I can leap on him like a tiger with a chainsaw tied to each leg. When no one is around who might provoke me, I spend time imagining situations in which I’d be justified in being so mean to someone that they would just cry for the rest of their life.

But I haven’t been acting on those things either.

I have been vicariously enjoying expressions of inappropriate rage. Last night a woman on live TV said something that got bleeped. Even though her gaffe was just a couple of seconds long, I told my wife I thought the woman said, “Jesus g*d d**n f*****g Christ on a m***********g crutch!” My wife patted my leg but didn’t say anything. She’s seen my brain like this in the past, and she doesn’t even look up anymore unless I swear using at least five curse words, two bodily functions, and a barnyard animal.

I try to be nice to people when I’m like this. Just because my brain is mean as a Gila monster, being randomly cruel to people is unfair. It’s not that I really care about what’s fair, or about most people either, but I have learned that acting angry doesn’t help me much in most cases. I say stupid stuff I don’t mean, and I have unhappy, resentful people to deal with afterwards. It’s like building a chemical volcano in the living room. It’s fun for a minute or so, but a whole lot of mess to clean up for the next few days.

So far this week, I’ve refrained from excoriating, assaulting, and murdering about 150 people, so what do I do with all that anger I’m not expressing? Exercise? Scream when I’m looking at Facebook? Grow an extra organ from the stress? Those sound pretty good, except for the organ one, but I believe that anger and creativity make a fantastic combination. When I’m deranged with fury, that is the time to do something creative. For example, I’m rewriting a story now. In this past week the villain has gone from being cruel to being nasty, vengeful, and horrific. Even better, the hero was a nice, creative guy who was reckless. Now he’s a nice, creative guy who’s reckless and happy to plot the murder of someone just because that person might kill him first. It’s a family story.

Soon I expect my brain to stop vibrating with anger and sending out waves of fury to bounce around inside my skull. That’s less fun than it sounds, and it doesn’t exactly sound like Jim Beam and a hayride. Until then, I’ll see if I can incorporate some more vindictive rage into my story. Also, when I’m around real people, I’ll catalogue the ways in which I could make them regret existing in the same universe as me, all while smiling at them and maybe saying nice things about their shoes.

This sure is a lot of fun. To hell with the cookie. I want a trip to Vegas. And a pony.

Ponies fighting over the privilege of belonging to me. Or maybe they saw a bug. Hard to say.

 

 

I’m participating in Six Sentence Sunday, a cool effort that invites authors to post six sentences from one of their works on Sunday morning. Six Sentence Sunday will then link the post on their site. It’s a slick concept, and I encourage everyone to check it out. This post is six sentences from my essay “I Hate My Brain,” which is available in my book Bring Us The Head Of The Velveteen Rabbit.

Don’t get me wrong, I understand that brains get a little weird when your body produces a smidge too much of something or other, or when things get out of whack in the lobes, or sometimes really for no reason at all. But there’s only so long you can go with your brain making you act like a crazy man before you say a dignified, “Enough.” I’m not positive what my brain has to say at this point, because we’ve only been communicating through my thyroid. For example, I’ll say to my thyroid, “Hey, ask my brain how to calculate the distribution of a chi square test,” and the thyroid will come back a little later and say, “Your brain answered, but it was just a bunch of squiggly symbols I don’t understand. How about some extra hormones instead?” That’s not as helpful as I might wish.

Again, please check out some of the other authors linked at Six Sentence Sunday.

Some people have told me my blog isn’t very personal, but I’m not sure that’s true. A lot of the stuff I’ve posted is about what I think and do and experience. But I admit it’s not too immediate. I don’t tend to write about the fact that there’s a cat lying on 15% of my keyboard right now, misspelling words and opening unneeded menus with her ass. She’s keeping my wrists warm though, which is good because I got up stupid-ass early and it feels cold (yes, even here in Texas).

I don’t know if I’m comfortable with blog-immediacy, because that creates intimacy between me and whoever in the whole damn world runs across this blog and wants to read it. My wife likes to say that she’s an open book–what you see is what you get with her. She also says that if she’s an open book then I’m a closed book with straps that lock, and tiny print inside along with maybe some indecipherable drawings, and arcane symbols on the outside, and a general air of “get out of here, you god damn kids” around the whole thing. I used to be worse, but living with her has loosened me up a bit.

So, I’ll give this a try. Yesterday afternoon I was parallel parking, which I’m good at, while telling my wife a story about work. I don’t tell stories all that well while I’m parallel parking. I thought the story showed my fantastic qualities in my job, under insanely crappy circumstances, and I admit I was selfishly looking for some positive reinforcement. I was like a kid bringing my mom a watercolor that might be a horse or might be a Ferris wheel so she could exclaim how great it was and put it on the refrigerator. The main message of my story ended up being, “I didn’t kill anyone yesterday,” and her quite logical response was, “do you want reinforcement for not doing something illegal?” I need to work on my “pathetic plea for attention” technique.

We’d been invited by some friends to a “contra” dance. This kind of dancing is sort of like square dancing, except there’s a lot of spinning and stomping involved. The dancers behave less like  the cast of Hee Haw, and more like cowboys off the trail in Dodge City, although they laugh more and shoot people in the head less. They were really nice. I’ve danced a pretty long time, so I picked up the steps easily enough. The style was harder for me. I danced like a flamingo who knew all the steps. But the night before I’d been a moron, and as I leaned over the side of the bed to kiss my wife I tried to be cute and ended up hyper-extending my knee. Yes, I’m fairly old.

So I danced one dance, sat one dance, danced one dance, etc. for a while, and I got to waltz with my wife (and we realized we need more practice). Then everybody took a break, so we talked with our friends and had a good time. This was three hours of contra dancing, which is really aerobic and just like getting your heart muscle kicked in the nuts. I wanted to dance some with my wife, but as soon as each dance ended somebody else asked her to dance within the time it takes for light to travel from my right nipple to my left nipple. My wife is a lovely and popular dancer. So I kind of hung back and rested my knee. Occasionally I drank water using a hand that shook to a moderate degree, which is something I’m led to believe I’ll be able to enjoy for many years into the future.

After the dance, we and our friends ate dinner at Chili’s. We chose it for its menu, which provides nearly everyone something they’d like to eat. That really is genius, you know. No wonder the place is always full. I ordered grilled salmon, which was charming and surprising. I’d have expected good grilled salmon at Chili’s just as much as I’d have expected good Beef Wellington at Taco Bell. Just goes to show you. After dinner we went back our house, which was close by. We all sat on the floor in our only room that has no furniture at all, and we played with cats and looked at art books for a while. Two of our friends intended to go back to contra dance for the second three-hour session, which proves that they are tougher men than me. My wife planned to stay home and work a while, so I weaseled another of my friends into going on a mission with me once we dropped the others off.

On the trip back to the Palace of Contra Dance Pain, I called my mom, who is in a rehab hospital. I’d missed visiting her that day  and called to see how she was. She broke her 75 year old femur a month ago, and I’ve been trying pretty hard to help her rehabilitate. Unfortunately, she’s done almost nothing to help herself and thinks that as soon as she gets her cast off everything will be peachy. In the meantime she enjoys whining, groaning, laying in the bed, and looking pathetic. Honestly, she is worse than any 3 year old I have ever seen. I fully believe that she’ll never get out of the bed again and will be dead of pneumonia by Christmas (or shortly thereafter, since people often hang on until after Christmas).

After dropping off our other friends, I revealed the nature of our mission to the friend who was ferrying me around. This was a booze quest. More specifically, this was a quest for the ingredients to make fuzzy navels and pomegranate martinis. The former were for my wife and our friend, and the latter was for myself. I’d had such martinis in restaurant, liked them a whole lot, and wanted to know how to make them myself. I figured it was important to have the ability to make myself these drinks since the majority of my family members are alcoholics. We hit the grocery store for staples such as lemons and pomegranate juice. We laughed a lot about stuff that was really in no way funny. However, I was crestfallen to find that Kroger doesn’t carry a wide selection of pomegranate juice. In fact, they don’t carry any of that shit. They do carry a pomegranate/blueberry juice blend, with some other juices like apple and mango thrown in. My friend was for going to Central Market, but I figured, what the hell, my palate isn’t that sophisticated anyway.

We next hit the liquor store, looking for citrus vodka and peach schnapps. We looked for the cheapest damn liquor we could find, on the shared theory that all of our palates lacked sophistication. There were a few drunks in the store, virtually crawling on the floor to find the cheapest booze on the bottom shelves. I laughed a lot and fit right in, until I realized that my laughter was a little hysterical. I toned it down. We carried our goods to check out, and on the way I picked up shakers that both of us were nearly certain would be ineffective for any task we might ever have. The store closed up about the time we left, which astounded us since it was only 9:00 p.m.

Back at home my wife was wrapping up her work. She organized all her stuff for the next day, since she is the most organized person I have ever met or even heard of. Without her, my life would look like a stagnant bayou floating through variable gravity. My friend watched the digital picture frame in our kitchen, the one I finally set up in July after giving it to my wife for Christmas. Meanwhile, I began mixing drinks. That required an iPhone to reference the measures of ingredients, a knife and cutting board, several measuring spoons, a lemon, an iPad for generally browsing the web to locate miscellaneous information, several bottles of alcohol and juice, a steel chopstick for mixing, glasses, ice, and two useless shakers. As I attacked the drinks, my wife came in to converse with us. This was awkward since I have trouble thinking and talking at the same time. I sort of withdrew from the conversation and didn’t laugh hysterically anymore, which was kind of a relief.

I started with the fuzzy navels. I required about five minutes to make them, which was embarrassing since it turns out they’re easier to make than a glass of Alka-Seltzer. After delivering the fuzzy navels, I started on the pomegranate martini. It had just four ingredients, but it seemed more difficult to mix than a voodoo death potion, including chicken eyeballs. Finally I held half a glass of oddly lavender martini, which tasted pretty damn good to me, although when my wife tasted it she shook her head as if a bug had flown up her nose. Well, it was a bit strong, and I might cut back on the vodka a little when I make it again.

We sat around the dining table and talked for an hour or so. Mainly my wife and our friend talked. I’m a little slow on the trigger in casual conversation, so I didn’t find too many openings I could jump into. Occasionally I said stuff that made sense, but mainly whatever I’d been thinking had been rendered obsolete by the time a large enough break in the action came along for me to slip in. My thinking wandered away now and then, and I nursed my martini. It was nice to hear my wife talk so excitedly. She likes to converse when everyone talks on top of one another, and I was trained that if you did that then bad things would happen to you. Sometimes I don’t make such an energetic conversationalist for her.

After midnight we decided we’d had the required amount of fun, and our friend began packing up her crap. My wife noticed that one of our cats, not the ass-typing cat, was laying around lethargic for the second day in a row. This sucked because she has an enlarged heart, and for a couple of years the vet has told us she might throw a clot and keel over any minute. A couple of months ago the vet examined her and proclaimed her a miracle cat, with a moderately repaired heart. Why did it repair itself? No one has any god damn idea. But since we thought her death sentence had been lifted, this laying around like she was half-dead was concerning. We talked it over and decided to hold off on a trip to the emergency vet until the next morning, just to see if she got any better in the night.

Our friend left with hugs all around. I wandered to the bathroom to slam down my pills that would fly like pin balls through my brain for the rest of the night. I tucked my wife into bed and hung out in the living room for a bit, communing with the ass-typing cat and her friend the whipping-his-tail-into-your-eye cat. I sat a while in the recliner with my laptop, and before I crept to bed I contemplated a foolish Facebook post in which I mentioned the great job I’d done at work the day before, just in case any of my friends wanted to put the watercolor up on their refrigerator.

Miracle Cat
Ass-Typing Cat
Whipping-His-Tail-Into-Your-Eye Cat

I’ve been trying to understand mental illness for a long time. I’ve come up with some observations and opinions, but understanding is still bouncing around like a deer in the forest of my ignorance. Even though I’ve researched and directly observed mental problems, I have concluded that understanding mental disease is really hard.

Other people think that understanding mental disease is hard, too. I’ve heard them say so. They say a lot of the same things that I’ve said over the years. We’ve said that everyone’s got problems—the folks who are mentally ill should just suck it up like the rest of us. Or if they can’t do that, they should get some medication and stop doing these disturbing things. Sometimes we’ve said that there’s really no such thing as mental illness. It’s just a conspiracy between psychiatrists and drug companies.

I think these statements contain some truth, but they contain a lot of falsehood, too. Like I said, I have observations and opinions, not understanding. Certainly some people understand more than I do, but here’s my perspective for the heck of it.

I’ll start with whether mental disease even exists. After all, if it doesn’t then we can stop here and grab a drink. Some folks point out that no biomarkers or laboratory tests exist to diagnose mental illnesses. Therefore, there’s no proof that they really exist. That sounds pretty damning. But a little research made me ask myself whether Alzheimer’s really exists. Or Parkinson’s Disease, or angina, or migraines, because no biomarkers or lab tests exist to diagnose any of those. Heck, there’s no lab test for the common cold. So, I admitted to myself that just because you can’t perform a lab test for a disease, that doesn’t mean it’s imaginary.

By the way, sometimes diagnosis is shakier than we’d like. If you live long enough, you’ll probably hear a doctor say he doesn’t know what’s wrong with you, despite blood tests, x-rays, brain scans, and cameras up your bottom.

I’d gotten past the biomarker/lab test objection, but that still didn’t convince me that mental illnesses really exist. In fact, I had to ask myself why anyone would even come up with the idea of mental illnesses in the first place. I’m going to slide right past Freud and the super-ego here in favor of something more down to earth. I suspect that two things led us to the idea of mental illness. First, someone saw a bunch of people doing the same strange and harmful things over and over for no obvious reason. Second, a bunch of people described having the same strange and harmful experiences for no obvious reason. I agree that this explanation seems pretty weak. Watch people do stuff and listen to people describe stuff? Come on.

Yet I was shocked to find that doctors watch what people do and listen to what they say in order to help diagnose physical diseases. Doctors do this a lot, and they have for hundreds of years. Chronic fatigue, hallucinations, confusion, sleeplessness, loss of appetite, pain, and many other symptoms are good enough to diagnose physical illnesses, even though a doctor has to see them happen or ask the patient to describe them. So I expect that these kinds of symptoms may mean something when we’re talking about mental illnesses too. If a hundred men hallucinate because of brain tumors, and another hundred men hallucinate without brain tumors, does that mean the non-brain tumor guys hallucinated for no reason at all? Or maybe there really is something organic going on with these fellows, but we just don’t have a lab test for it.

By this point I was nearly convinced that mental illnesses exist, but my nasty, skeptical brain had to wonder if they’re just a concept invented by the pharmaceutical industry. Drug companies are making an ocean of money from the armada of drugs they sell for mental diseases. These companies aren’t known for turning down a buck, and they might have marketed some unnecessary drugs once or twice. Based on the explosion of psychiatric illness and medications, I suspect that mental illness is diagnosed too often, and psychiatric drugs are over-prescribed. Not every unruly child has ADD, and not every person with ups and downs is bipolar.

But drug companies also push all the drugs they can for physical illnesses—it’s not just a mental illness phenomenon. Doctors observed mental illness long before drug companies sold drugs for them. Hey, drug companies didn’t invent bipolar disorder—manic depression was identified in the late 1800s, long before anyone thought about selling Depakote. (Actually, manic depression was identified and named in 1875 by Jules Falret.) Despite my skepticism, I can’t buy the idea that thirst for profits has led to a gigantic mental illness hoax that practically every medical professional is in on.

So which folks are saying that mental illness just doesn’t exist? I skated around the internet for a while—admittedly a dubious source of information. But I wanted to see what these guys said about themselves. I found some organizations whose sites explained that mental illnesses are no more real than sugar plum fairies. They mainly said it was all a drug company conspiracy, and they used the biomarkers/lab tests argument as evidence. They tended to be a little lax about their research—one cited “a Surgeon General’s report.” I suppose it could have been the Surgeon General of Botswana—no way to tell. Some sites promoted the owner’s tell-all book. Sometimes I had to dig four layers deep to find out the site was owned by a noted research organization such as the Church of Scientology.

And who goes around saying that mental illnesses exist? I wasn’t surprised to find the usual suspects: government organizations like NIH and CDC, research hospitals, medical journals—and of course, drug companies. I understand that just because a lot of people say something’s true, that doesn’t make it true. But overall I found what seems like a lot of evidence on the “yes, mental illness exists” side. So I was convinced. Apart from the other arguments, I couldn’t swallow a giant conspiracy among almost everyone, leaving the Church of Scientology alone in the wasteland preaching the truth.

So if mental illness is real, why don’t the mentally ill just suck it up and stop bothering everybody else? I hear people say they’ve dealt with pain just as awful as any pain the mentally ill might have, and in my opinion they’re probably right. Mental illness doesn’t deepen someone’s capacity for emotional suffering. Most people deal with the pain in their lives and move on sooner or later. Why can’t mentally ill folks just decide to do the same?

Actually, a lot of them do. Some mentally ill people don’t realize or accept that they’re sick, even if the symptoms make them miserable. Others know they’re sick but decide to live without treatment for one reason or another. They may find ways to live a reasonable life. Some hold it together at work and go a little crazy at home—or a lot crazy at home. A few find jobs where outrageous behavior is accepted or maybe even expected. Some drink, or snort coke, or drive fast to self-medicate. There are lots of ways to more or less cope, some pretty benign and others pretty destructive. A lot of these behaviors are the ones that the rest of us find frustrating and that make the lives of mentally ill people unpleasant. Some people don’t cope so well, and they just bounce along out of control, wrecking their lives in colorful ways.

In some cases people will keep going like this their whole lives, and never consider treatment. Others tough it out for a few years or a few decades before they decide that doing something different would be better. Some try treatment and abandon it.

I learned a fascinating thing about mental illness and pain. Mental diseases are incurable. You have them forever, like that candy dish you got as a wedding gift. So the pain from mental illness isn’t exactly like the pain of grief. We know that grief will end; that’s part of what helps us get through it. Pain from mental illness isn’t any more intense, but it’s not going to end—or at least it’s always going to come back, and the owner of that pain knows it. The pain’s more like chronic arthritis and less like slamming your hand in a car door.

Now millions of people deal with arthritis pain without snorting coke or engaging in other bizarre behaviors. So what the heck’s wrong with all these mentally ill people? Can’t they do the same? Here’s another fascinating thing about mental illness. It affects your mind. It literally impairs your thinking machinery so that it can’t function at optimum efficiency. That doesn’t mean that mentally ill folks can’t think and make good decisions. But sometimes, when the disease is slamming them hard, their decisions may suck. It’s a bit like asking a diabetic person to make decisions using his pancreas. They won’t always be good decisions.

Another mental illness fun fact is that symptoms often hit for no obvious reason. Your average person may be devastated because his dog died, and that’s understandable. A mentally ill person may be devastated for no damn good reason other than his brain said it was devastation time. That’s hard to understand, especially when his thinking machinery’s impaired. I once observed a person with a severe mental illness, and I saw two things in her eyes: the realization that something was wrong with her, and the pain of not being able to understand what was wrong with her.

Before I talk too much about how difficult life is for the mentally ill, let me observe that dealing with mental illness isn’t about excuses. Any human can use anything as an excuse. Mentally ill humans are no different. In my opinion, dealing with mental illness is about decisions. That doesn’t mean that a mentally ill person can just decide to be well, or have no symptoms. And it’s true that his brain may not always produce the best decisions. And the options he has to choose from may range from reasonable to horrific. (A situation not limited to the mentally ill by the way.) But those are the options he has, and that’s the only brain he has handy to work with.

And that leads us to decisions about treatment, and especially about medication. Any mentally ill fellow has to decide whether to get help. That decision may seem more obvious if he can’t get out of bed for days, or he sees monsters that aren’t there, or he compulsively spends his family into bankruptcy. But even people with less severe symptoms look for treatment, and treatment is out there.

I personally have thought, “Hey, there are pills for this kind of thing. Take a pill every day, get this under control, and move on.” I thought that before the reality of brain chemistry revealed itself to me like a blossoming flower made of rancid Spam. How can I describe this? Say that prescribing cholesterol medication is like cooking a turkey. You’re dealing with just a few, well-understood factors like the size of the turkey and the oven temperature. You can still burn the heck out of a turkey, but it’s straightforward for the most part. Prescribing medication for a mental illness is more complicated. Instead of cooking a turkey, it’s like cooking a turkey of unknown weight in your neighbor’s fireplace by remote control from your own living room. You are dinking around inside a brain, so you have a lot more complications that are harder to see and less well understood. It’s often a trial and error kind of thing, maybe combining multiple drugs and trying different dosages before you find something that works. So it’s not exactly a “take a pill” proposition.

During the trial and error phase, the mentally ill person often feels worse than before, as an incorrect mix of drugs in the wrong doses careen through his brain like flying monkeys at a tea party. A fair number of people just give up on treatment at this point. Treatment that makes you feel worse seems like bad treatment, right? They go back to living their life without treatment and coping the best they can.

But some people stick with it and get to a drug combo that helps them a lot. That’s great, because now they’re not doing those things that the rest of us find so annoying, and they may be enjoying their lives more. Everything’s going smoothly, so naturally a bunch of them stop taking their drugs at this point and slide right back into all their awful symptoms.

Why the heck would someone do that? It seems crazy. Well, in fact there’s some bad decision making behind it, and we know he can have problems with his decision-making apparatus. But to put ourselves in the mentally ill person’s place, he now feels pretty good, so there’s a strong temptation to stop taking the $500 a month drugs that give him uncontrollable shakes and make him impotent.

As another side note, insurance companies are covering psychiatric drugs less often these days. The new ones are really, really expensive. The old ones are cheap but often have nasty side effects. So for people who can’t afford to pay a lot of money for drugs, there aren’t many great options.

Even with all of that crap going on, a lot of mentally ill people find a medication balance that works for them, and their lives get a lot better despite whatever side effects they’re willing to live with. That may or may not last. Brain chemistry changes, and the drugs that work for someone today may not work for him in five years. But if he hangs on for another round of trial and error, he can usually find another combo that works pretty well.

But there’s really no simple “take a pill” option. And the “just suck it up” option isn’t always realistic, depending on the severity of someone’s disease and their situation.

I still don’t have what I would call an understanding of mental illness, but I do intend to keep all this in mind the next time a mentally ill person is annoying me and I wish he’d just get his act together. As I said before, I think mental illness is about making decisions, not making excuses. A mentally ill person may have some great choices to select from, or all his choices may be appalling. That’s true of everybody though, mentally ill or not. The mentally ill have been metaphorically kicked in the crotch with regards to decision making ability, because their minds aren’t always in the best shape to make good decisions. But in the end, either they make the best decisions they can, or somebody else makes decisions for them, and I know which one of those I’d choose.