Mittwoch, 16. Oktober 2019

Burning Earth


So here I am standing on a cliff and watching the smoldering ruins of the world – my world – that once again went up in flames. No, that once again I burned down. I start to float out of myself, watching myself standing there, crying and finally make that small step towards salvation. And then I wake up.

I do get these visions a lot lately. Each time I’m standing on the platform at the train station and watch the train approach, I think about how easy it would be, just one small step. But I don’t do it, obviously because I’m writing this text, but furthermore because there are people that I love and I wouldn’t want them to feel even more pain because of me.

“I can’t exclude bipolar disorder”, she said. I was at the psychological center of my university because my girlfriend at that time told me I seem depressed and my Doctor told me to go there. “All that anger”, she continued “we have to do more testing.” I was perplexed, I never heard of the term bipolar, didn’t understand why my anger was an issue when clearly, I needed help with my depression. Still I did two more sessions with that psychiatrist – she actually turned out to be really good at her job as I realized years later – and finally told her that I’m not going to continue the sessions because she clearly didn’t know anything about her field. Two months later I started treatment with antidepressants for my depression (It’s pretty easy to get a prescription without further testing here).


After struggling with studying and not really being able to work or even concentrate, I moved back to my parents to escape all that pressure and hopelessness. I couldn’t really make sense of the things that were happening. The doctors told me the meds should help. When they didn’t, I just got a different prescription, different pills. Any color you like. I developed arrythmia. And I developed different symptoms. 

One day I realized I could think clearly. No not only clearly, I suddenly could thing faster and more efficient than ever before. I wrote my bachelor’s thesis on two nights (without having slept more than four hours every night for two weeks) and got an amazing grade for it. Suddenly nothing could stop me. No one could stop me. I was on top of the world.

And had the longest fall back to earth. And this would continue for a while. A series of ups and downs and I felt like being split in two. I felt like two persons fighting for the control over my body. And I was stuck between them, lost between them and not really knowing who I am anymore.
When I was down, I couldn’t function. I used to sit at home, playing computer games where I used to simply zone out and play on autopilot (I accumulated over a thousand(!) hours on Binding of Isaac during that time). Studying wasn’t possible. It was so stressful that I used to get nosebleed from it. One time I got so angry that I started punching a wall again and again until I had to go to the hospital to have my hand x-rayed.

When I was high (not the funny kind) on the other hand, the world changed. Everything got more colorful (still not a funny high) and more intense. I loved that I started to feel more self-confident. I aced my last exam without breaking a sweat (the one I almost broke my hand for). I won a poetry slam. And I remember that last applause which should determine the winner, my applause. I just stood there in the middle of the stage, closed my eyes and smiled contently. I was on top of the world and loved it. On the way home I had my first real hallucination. And afterwards I lost a lot of friends.
It was always the time after a high phase that I had to send a lot of messages about how sorry I am about what happened. It was also the time when I tried to find help. Any help. One time I even asked to be taken to an Imam that would exorcise me (didn’t work). That was the level of my desperation. And yet I longed for another high, for all that creativity and productivity that I was missing.

Jimi Hendrix came to my help. I don’t remember where I was driving to, but I had my phone hooked up to the radio and with his sweet guitar tunes he sang:

Manic depression is searching my soul
I know what I want
But I just don't know, honey
How to go about getting it

Feeling sweet feeling
Drops from my fingers fingers
Manic depression is captured my soul

Woman so willing the sweet cause in vain
You make love
You break love
It's a all the same, when it's
When it's over

Music sweet music
I wish I could caress caress caress
Manic depression is a frustrating mess

Manic depression. It did something inside of me. I realized I was crying and didn’t know why. All I knew was, it felt great. I felt relieved. Later at home I googled “manic depression” and the first result said: “Bipolar disorder – Wikipedia”. I made an early appointment at my psychiatrist.

“Not pathological!”
“What does that mean?”, I asked him
“It means the symptoms are not representative for mania”
“But…”
“Did you have varying sexual partners during those phases?”
“No. But…”
“Did you spend so much money that you had financial troubles?”
“No. I can’t…”
“Not pathological! You should try behavioral therapy or hypnotherapy.”
“But I…”
“You can get everything else from the front desk. Everything will be all right.

I did the therapy where during one hypnotherapy session the therapist herself fell asleep. As I was sitting there, I first asked myself, what the heck I’m doing there and secondly if I should get a blanket for her. Nothing was “all right” and shouldn’t be for a long time.

I went back to the psychiatrist because I didn’t know where else to go. A similar dialogue ensued. When I realized, that he isn’t going to help me, I asked him to give me a referral to the local psychiatric hospital. I made an appointment and got the last spot on Friday the next week.

It’s hard having to do all these tests and all these questionnaires. It’s even harder when you must do them all alone. It’s not that I didn’t have the support of my family and friends, I guess they just didn’t know how to help me. So, I sat alone in that waiting room, when the doctor came in and asked me to follow her. I loved her immediately. I loved her even more when I realized that she cared.

“Burning earth!”, she said
“Excuse me?”
“You’re burning earth. The earth under your feet to be exact. Everything that you work for, every relationship, all those people you love the most, you burn all of that.”
I was devastated. Finally, someone seemed to understand what was happening inside my head. Although the appointment was intended for 45 minutes, we talked for nearly two hours. In the end she broke my heart.
“I’m sorry to tell you that, you clearly have a Problem, it’s probably bipolar disorder but we can’t help you here.”
“Who can help me?”, I asked devastated
“You could go to our main clinic, but you needed to be either in a manic state or suicidal. Or you could get a referral from your doctor.”

A doctor that didn’t care. 

I had the diagnosis now, more or less, so I started to inform myself online. Wikipedia, random google searches, reddit. I learned about all those artists, that suffered from the same illness. I tried to drown myself in art. Tried to challenge all those things onto paper and canvas. I became lonely. Tried to protect myself and especially I tried to protect others from myself. I chose not to make any new friends. I was scared that any stimulation could trigger another mania. I started to be afraid of feeling happiness and compassion and love. I was scared.

“You should try this doctor.”, he told me. “If he can’t help you, he’ll know someone who can.”

His doctor’s office is really confusing. There are of course your typical Items:
  •  Desk
  • One office chair for the doctor
  • Two chairs for patients
  • A bed thingy
  • Etc.
But there are other things. Pictures. A lot of pictures of his four children. He’s divorced. A lot of religious symbols. Crosses, pope beer, pictures of the pope. He’s religious. Various items from different countries. Cuban cigar. Japanese tanto. He travels a lot.

I tried to be Sherlock Holmes and deduct those things about him and only got the obvious ones because the foreign items were only gifts. But there he was finally standing in front of me and shaking my Hand. He sat down and asked:

“So, what do you have?”
“Bipolar disorder”, I answered dreading another rejecting answer.
He was opening my file on his computer and just stopped, turned his head around and said: “Scheiße”, which would translate to “shit” ore better still “fuck”.
I just nodded, not being able to utter a word.
“You’re fucked”, he continued, destroying all my hopes. “But we will beat this.”

He sent me to a hospital where they did all the diagnostics. Not only psychological test but also brain scans, genetic markers and everything else to finally find the cause of all that pain and suffering for so many people around me and not only me. And in the end, I held that letter in my hands with the words “bipolar disorder” written on it and thought back to that first doctor who was right all along.
I did regular checkups, got new prescriptions, was told that all those antidepressants could’ve had negative effects on my disorder. I made regular visits to the clinic. One year went by but I felt like a zombie. 

Those meds have a lot of adverse effects. I guess the most common ones would be dizziness. I slept for 11 hours a day. And the rest of the day felt as if I was moving underwater. I gained a lot of weight, was often nauseated but I guess I wasn’t really depressed or manic. I was just dull. And I felt stuck, so I applied for a master’s program and got accepted.

“We have to change the prescription. I can’t study if I continue sleeping all day.”
“I expected something like that”, the doctor answered quite cheerfully. “Did they suggest something at the clinic?”
“Lithium.”

I'm so lonely but that's okay I shaved my head
And I'm not sad
And just maybe I'm to blame for all I've heard
But I'm not sure
I'm so excited, I can't wait to meet you there
But I don't care
I'm so horny but that's okay
My will is good
Yeah, Yeah, Yeah, Yeah, Yeah, Yeah, Yeah

“I also expected that.”, he said and gave me an already printed and signed prescription.
And then he stood up and hugged me. And I love him for that and always will be thankful.
My therapist on the other hand was more like “Maybe it’s too hard to start studying again. Maybe you should wait another year.” And you guessed it, I didn’t really like him and thankfully got another one.

I wish it could end here. I got my medication and my therapy and started feeling good, finished my degree, met a girl, married her, had 3 children, a dog and a cat, lived a happy life and died from old age.

Then why would my world be burning in the beginning of this text?

I want to focus on different things in this last part. I want to show you the thought process during these episodes and want to show you other underlying problems that can enhance the problems during the episodes.

Well, I started taking Lithium and I started studying at that new university. The first rule I set for myself was: “Do not make Friends! Just finish this thing.” I was afraid that if I get close to new people, sooner or later they would become victims to my manic side. And I knew the closer a person would get to me, the harder it would hit them.

But there was this one girl, a really strange one, to be honest, but an amazing person. She didn’t care about my rule, at all. When I told her about my condition she just shrugged and said, that it’s all right. She showed me that I am accepted in her world even though I felt like I had this monster somewhere inside of me. We became best friends.

One day I woke up and felt great, not like manic amazing but just good. Like normal good. I hadn’t felt like that in eight years. It’s called euthymic. After two weeks I hesitantly told my new psychiatrist about it and told her that I fear jinxing the feeling by telling anyone.

Correlation and causation are things that many people get wrong. Just because two things correlate, doesn’t mean that one causes the other. Of course, there’s an XKCD on it here: https://xkcd.com/552/
If I would have asked my doctor, he clearly would’ve told me that we finally found the right combination and dosage of meds, also the new lifestyle with more activity and purpose is helping. But there was this underlying thing, something that predates my bipolar disorder, that goes back to my childhood.

Let’s now get back to that one girl and use her as an example for a lot of prior friendships and relationships to a multitude of people. Let’s see what I would answer when asked what I think about her:

She is one of the best friends I’ve ever had. It’s not only that I can trust her, it’s also that I feel great when she’s around. Just sitting next to her in the lecture hall makes me feel good because she told me and showed me that it’s okay to be the way I am.
She is the reason I’m feeling great. Without her my grades wouldn’t be this good because the prospect of seeing her motivates me. She makes me sane. I want to, no, I need to be with her. I need her or else everything is going to be awful again.

The right part happened mostly subconsciously, still I think, I could have and should have realized this earlier. But in a twisted corner of my mind she didn’t only correlate with me feeling well, she became the cause of it. And looking back this happened with a lot of different people.

Exams. Stress. A lot of coffee. (Caffeine can decrease the lithium concentrations in the blood by increasing the renal activity. Or simply drink more coffee, pee more, lose more lithium via your urine.) Something triggered a new phase. At first it felt like the beginning of mania but suddenly changed and was pure depression. I started rapid cycling. Switching between depression and mania in days. On good days studying was easy, on bad days impossible. 

subjective mood during episode

She asked me on one of the bad days, if we want to meet up after the final exams. Guess where I thought the cause lied the next day after I started feeling productive again.

“Did your mood or emotional state differ gravely during the Episode?”, is what doctors always ask. And that was the case with more and more new symptoms:
  • I was anxious before some exams, literally shaking
  • I was irritated all the time and got angry for the tiniest reason. I almost got run over by a car because the driver took a turn without signaling with really high speed and I saw that and ran in front of his car just because I was angry that he didn’t signal. He wouldn’t have been able to stop if he didn’t swerve to the sidewalk and I still continued walking and staring angrily at him.
  • I dissociated from myself, which isn’t new per se, but I also dissociated other people, mainly the physical person and their messages on my smartphone. Suddenly smartphone people were someone else and not clearly defined. I got some texts from a friend and kept staring at the name not being able to make a connection
  • I lowered my lithium dosage. I don’t know why I did it and I don’t even get why I lowered it and didn’t simply stop taking it at all. But not all things make sense.

I got lost to these feelings and mood changes. I sent a lot of hurtful messages to friends. I argued with family. I stopped shooting pictures in the middle of my cousins wedding because I thought that all those people, all my relatives, were unthankful. I snapped out of it at times, like a drowning person breaking through the surface to get a bit of air, only to be swept under by the next wave. I wasn’t just hurting others; I was also hurting. And I wanted it to stop, badly. I started hurting myself with a rubber band around my wrist that I kept pulling and releasing against my skin, just to be able to think clearly. Physical pain helped, but soon even that stopped working. I was desperate and then I turned to her.

A few months prior, during a concert, I met one of her friends. We talked about a lot of psychological stuff and I told her about my symptoms, the delusions I’ve had and all those obsessions towards other people. I told her that this was the thing I feared most because it ultimately meant that I would definitely lose that person. (Mental note: none of my psychiatrists ever thought to address this issue. They just put it aside as one of my manic symptoms.)

I obsessed. I got needy. And when I didn’t get to see her, I became hysterical, sending her message after message late at night. She tried to distance herself, protect herself. I mean who wouldn’t run away from all that craziness. We met and talked about everything. But I was still in that episode, still rapid cycling. And so, I hurt her again, just like before. “This is disturbing”, she told me.

Disturbing. That’s what I am. That’s how others see me. I’m not amazing, not great. I’m not on top of the world, even though I feel like it. Suddenly I am alone. Suddenly I realize that those things I said, didn’t show anyone how much I liked them. They hurt them. I hurt them.
You can’t really say, you snap out of one of these episodes. You have the realization that everything is wrong. And then it’s like trying to wake up, when you’re still way too tired. It took me a couple of days to be able to go to the doctor and afterwards I thought about hospitalization.

The Bipolar Disorder Survival Guide. A book. A fucking book that I could’ve gotten at any time. And it was completely random, too. I saw a post on reddit, a recommendation, and then I ordered it and read the introduction(!) and learned that I didn’t have a clue about what my illness does. And no one ever really tried to tell me what would or could happen.
Bipolar disorder is a mood disorder, that I did know, because my mood is always all over the place. But furthermore, there’s some difference in processing of emotions (and this one is really interesting). So, when a normal person has an intense emotion the brain keeps firing all kinds of neurotransmitters and activating areas in the brain and it activates the prefrontal cortex, which handles memories and emotions and stuff like planning. It is basically a supervisor for all that stuff that happens through that emotion. Now a bipolar brain. When a bipolar person has an intense emotion, the brain keeps firing all kinds of neurotransmitters and activating areas in the brain and it activates the Amygdala, your lizard brain, that just isn’t good at regulating emotions. Same thing happens with the perception of strong emotions, you just don’t know how to handle them. I told my friend the last time we talked about it, that I wasn’t just angry, but I also had this fight or flight like response, and that is something the Amygdala does. You don’t have that supervisor anymore and every emotion can be way too much. It’s a physiological problem not a psychological one. It’s like a chronical disease, like high blood pressure or diabetes. It can be managed efficiently through medication and therapy. But most importantly it can be managed by understanding the effects and acting accordingly.

I used to think, I had a monster inside of me, a dark side, that’s part of me. I used to think I’m fundamentally bad. I thought the diagnosis would mean that I should live in fear of another mania, of losing my self-control, for all my life.
My solution was to hide myself. To fear any emotion (even fear, lol) and try to avoid them. My solution was apparently to just exist without doing anything meaningful. And a book had to tell me that I just didn’t understand my condition and that life can be good.
And through the book I recognized that other condition.


During all those years I have been asked a lot of times about childhood trauma. And my answer always was: “Not that I could remember.” And I guess I’d still answer that way. My childhood was actually good, my parents loved me, I got to watch a lot of TV and even had a Sega at one point (maybe my parents didn’t love me after all) and I had friends, not a lot, but I got to see them every day.
Looking at other families my “being loved” at that time seems a little odd. My dad was relatively absent, which was a cultural(?) thing, I guess. No one saw a problem, so it must have been somewhat normal. I still got to do a lot of things with him, maybe not as much as I wanted, but I knew he cared, and I cherish those memories (like that one time when he built me a bow and arrows in the woods).
My mother, on the other hand is a different story. She had her own psychological problems. I suspect she does have the same disorder as I do, since it’s highly probable. Her relationship to her mother was always disturbed. And we learned the same thing through her. She had these fears, that we’re going to abandon her and so she clung to us and conditioned us to be dependent. And it left traces inside of me at least.
I still love both of my parents, don’t get me wrong. Sadly, there isn’t a book called “Life Survival Guide” that shows you how to do everything right.

Now I realized why I became so obsessed with others. Why I always tried to project every positive thing onto them and made my well-being dependent on them. Suddenly so many things made sense. It’s like turning on a light switch and finally being able to see. Obsession based on emotional dependency and fear of losing someone. And even if it’s unconscious during my normal days, it’s the main thing that appears during mania (obsession) and depression (fear of loss).

It took eight years from the first time I heard of bipolar disorder to the basic understanding of the illness. I don’t know how many more years before that I have struggled with at least a minor depression. But it makes me furious to think that all those doctors I visited, all those therapists, not even one of them could take the time and tell me what the fuck was wrong with me. I needed to go on reddit and see a post about a book and be in a state of desperation where I only thought of either killing myself or continuing to struggle for the people I love, to order it. And finally understand what kind of illness I have and how to deal with it.
For the first time in all those years I feel hope. I still do have trouble and a lot of work in front of me, but I started drastically changing things because now I understand them. Maybe it’s wrong looking back and imagining how everything could’ve been different if I had known these things beforehand. I probably would have finished university way earlier. I maybe wouldn’t have lost all those people that I hurt during all the manic phases. I definitely wouldn’t have obsessed over everybody who showed me the tiniest bit of affection and who I made responsible for my well-being. I would have known the difference between feeling good when I’m with someone and feeling good generally. What a difference that would have made.

So that’s basically what happened to me. Afterwards I reached out to people, asked for help. At the lowest point I cried out into the world. Friends and family showed me how much they cared. Even complete strangers that I only knew via social media, sent me messages like: “We don’t really know each other but if you need anything just ask.” Suddenly all these other people showed me that I’m not alone, that I’m loved and made me feel accepted with all my trouble.

What happened with that one friend you ask? I get to see her now and then during lectures. Sometimes we take the same train and talk a little bit about life. It feels pretty normal, these moments I mean, like nothing changed at all. But I have a feeling that the friendship is over.
It’s sad, not in a “please don’t leave, I can’t live without you” kind of way, that feeling, or idea, is simply gone. It’s sad because it was a damn good friendship, with an amazing dynamic, maybe even the best one I’ve ever had. But I accepted it and didn’t feel scared or hysterical. Maybe something really did change.

What remains is drawing a lesson out of all these events. That’s why I decided to write this text. Even if I can help only one other person with their struggle, then it was worth it. We all struggle one way or another. Most of us don’t show it. Not everyone is able to talk about his experiences and talk about all these personal things, even I wasn’t up until now.
I guess the text is a little bit messy and confusing but still thank you for taking the time and reading it!

So here I am standing on a cliff and watching the smoldering ruins of the world – my world – that once again went up in flames. No, that once again I burned down. I start to float out of myself, watching myself standing there, and behind me are standing so many People, cheering me up, encouraging me. “We’re still here”, they say “let’s build a better one!” And I smile.