Goodness, it's been nearly three months since I said I was going to post the first instalment of my BPD story. Sorry about that.
___________________________

1. Preamble and Introduction:

1.1 This is both a longitudinal account, going back to my birth, and a short term account taking in my most recent experiences in the last several months or so, of my experience with manic-depression(MD) or bipolar disorder(BPD) as it has come to be called in recent years. Some of my personal context for this illness over the lifespan in my private and public life, in my relationships of family of birth and of marriage, of work and now retirement and particularly some of my personal circumstances as they relate to my values, beliefs and attitudes on the one hand—what some might call my religion as defined in a broad sense and my wife’s illness and my/our many moves over the years on the other, should provide mental health sufferers, clients or consumers, as they are now variously called these days, with an adequate information base to make some comparisons and contrasts with their own situation, their own predicament whatever it may be, and thereby gain some helpful knowledge and understandings.

1.2 Many do not feel comfortable going to doctors, to psychologists, to psychiatrists. Perhaps this is part of a general distrust of certain professional fields in our world today. Perhaps it is part of a general public being more critical. Still others do seek help and try to work things out themselves. They often find the journey through the corridors of mental health problems so complex, such a labyrinth, that they give up in despair. Suicide is common among the group I refer to here—the sufferers from MD and BPD. This account may help such people obtain appropriate treatment and, as a result, dramatically improve their quality of life. I think, too, that this essay of more than 15,000 words is part of my own small part in reducing the damaging stigma associated with BPD and what might be termed “my coming out.”

1.3 The wider context of my experience which I outline here is intended to place my BPD in context and should provide others with what I hope is a helpful perspective, as I say above, in relation to their own condition, their own problems and situations. This essay of some thirty-five A-4 pages(font-14) is written: (a) for doctors and various medical professionals who have dealt with or will come to deal with my disorder and who are now, at this present time, involved with my treatment, (b) for internet sites and those registered/inquirers on the www at a range of health and mental health sites, especially the sections dealing with depression(D), MD and BPD, (c) some of my friends and associations over the years with whom I still have contact in these years of my late adulthood(60-80) and to whom it seemed relevant to give such a statement; (d) for government departments and Baha’i institutions who require such statements for reasons associated with our relationships; and (e) for myself as a reflection, for my own satisfaction, to put into words the story, the results, of an illness, a sickness, a disorder that has influenced my life for over half a century. Originally written in 2003, this piece of writing has been revised many times after further reflection on original and earlier editions and drafts; after feedback from various doctors, friends and internet respondents and after an increase in my own knowledge of the illness as a result of further study.

1.4 I do not claim to possess a specialized and/or professional expertise in the field of the study and treatment of D, MD or BPD. I do not work with people who have such problems, nor do I have a desire to do so, except as a participant at a number of internet sites concerned with relevant mental health topics and with people who cross my path serendipitously with various related problems. This long piece of writing, too long I’m sure for some, not as sharply focussed on my actual experience as some respondents on the internet have already indicated, is but one of my many pieces of my writing these days. The vast majority of my writing has nothing to do with this disorder. After more than 60 years of dealing with this medical problem in my private and public life I am only too happy to put it to bed, to put it into some final corner and forget it. Sadly I can not do so because I still suffer, even after 60 years, with problems that are part of this disorder’s long history in my life.

2. My Experience of Manic-Depression: Phase One--The First 36 Years
1944 To 1980________________________

2.1 In the first 36 years of my life I had many episodes of various kinds of emotional imbalance or disorientation, themselves of varying lengths and intensities, varying from a euphoric, impetuous, expansive or high mood to a depressed, gray, low energy or mood. Sometimes they affected my day-to-day life severely and negatively and sometimes the affect was insignificant, hardly noticeable. After many experiences on the fringe of a normality that was my usual modus operandi or modus vivendi, as it is said in Latin , on the fringe of what I saw as my general everyday experience of life, an experience that is sometimes called the quotidian by writers, poets and novelists, I was diagnosed as a MD in May 1980 in the process of treatment by a psychiatrist. I had often been on the fringe of this disorder, as I say above, a borderline zone, a limen as some historians call it, a border territory, a zone between normality and various behavioural extremes and eccentricities from my birth in 1944 to 1980.

The treatment regime in 1980 was lithium carbonate, an antimanic medication. It was the first really successful mood stabilizer used by doctors to treat MD, for an illness that in the 1990s began to be called BPD. My history to that point had been far from smooth and linear as my remarks above indicate. Those thirty-six years had often been bisected, polarised and traumatised and perhaps at a future time I will attempt a more detailed account of these years but, for now, I outline here a brief sketch of particular episodes. My experience of these all-too-common everyday personal emotional extremes away form the norm, from my norm, is only part of my story. Everyone has their story for everyone experiences all sorts of abnormal eccentricities in life, some people of course more than others and some more traumatic and intense than others.

My account of those years from 1944 to 1980 follows. I try in writing about and in summarizing these first 36 years of my life, not to overstate my case, nor to understate it, but give an account of those first 36 years which I refer to here in this general statement as phase one of my bi-polar life.

2.2 In some ways the inclusion of the names of those doctors who treated me over the years in this first phase and in later phases would personalise this account, but names are not that important and to include them here in this narrative causes confidentiality problems for some readers and for people in my own past who might not want to be mentioned. This question of confidentiality is especially true at some internet sites where posts are rejected if names are included in any posting at the site---and so I leave names out. Those whose names I could mention would not be troubled by their inclusion here, not now, not in 2007 after an extensive destigmatization of the disorder in recent years.

Since I was so tardy in posting that first segment, I'll post this 2nd one--in a series of perhaps 10 segments--tonight:
))))))))))))))))))
2.2.1 I certainly appreciate the medical and clinical work of: (a) several of the doctors I went to in my childhood and adolescence, (b) the psychiatrists who have treated me since June of 1968, nearly four decades ago and (c) many family members, friends, colleagues and associations, some known well and others hardly at all, who have helped me ride the waves when the disorder raised its head yet again along the way, the road of life.

2.3 Comments on Childhood and Adolescence: 1944-1963

2.3.1 As I refer to above, I had some experience of what may well have been BPD in childhood as far back as infancy and at the toddler stage, all of the pre-school years, 0-5, of early childhood development. My mother nearly died in the first month after my birth, the implications of which it is not my intention to go into here, indeed, if there are any significant implications at all. Before the age of five there is evidence that my behaviour had some of the features of what is now called Attention-Deficit/Hyperactivity Disorder (ADHD). Perhaps in a later edition of this essay I will attempt a more detailed outline of what I recall from these years of early childhood, but my recollections are minimal and it is not my intention to comment further on these early years.

Through middle and late childhood into the puberty cusp of 12/13 in 1956/7 I did exhibit personality features, behaviours or symptoms that had bipolar aspects, at least to a limited degree, or so it could be argued if not proved: (a) a lack of control of my emotions, impetuosity, lack of emotional restraint and (b) a far too intense activity threshold what is now called hyperactivity, mild mania or hypomania. I recall at the age of 12/13 exhibiting inappropriate or precocious sexual behaviour, although the particular manifestations only involved one groping episode and one atttempt to kiss a girl who did not want to be kissed.

It was not until much later in life, though, that I began to see these aberrant childhood behaviours and new aberrations at puberty and during adolescence as possibly having a link with my future mental illness. It was not until I was 19 in 1963 that any characteristics of this illness became quite clearly apparent and, in retrospect, could be called part of a BPD and given that medical diagnosis, but only in retrospect. At the time no doctor would have given that diagnosis. Looking back to the age of 19 in October of 1963 I felt a depression so deep it was like ‘a sickness unto death,’ never before experienced, like death not warmed over, as one could say colloquially. The desire to die was overwhelming, but little talked about to anyone, except perhaps my mother, although I honestly can not recall. She knew I was depressed but neither she nor I really understood its dynamics or its intensity. I think it was assumed that I would grow out of it. And I did. By December it began to lift and I continued with my first year university studies.

2.3.2 These behaviours, this depression, at the age of 19 or any of my behaviour before that last year of my teenage life(1963-1964), did not result in my receiving any medical attention. The first formal diagnosis of schizo-affective disorder(SAD), BPD and/or D did not take place medically until the autumn of 1968 when I was 24. I was given lots of advice from religious to common-sensical: diet, exercise, prayer, vitamins, interesting leisure distractions/interests like horse-riding, watching TV, music, et cetera. After several months to several years, 1963 to 1968, the emotional aberrations disappeared or could be said to be sub-threshold at least for a time. My episodes over those years and in the years 1978 to 1980 seemed to exhibit quite separate and distinct tendencies and patterns. Hypomania(H) was always characterized by elation and D was always characterized by varying degrees of very low moods. Such an observation seems now to be so obvious as hardly requiring a mention, but at the core of my experience of this problem was either D or H and the impact of their various symptoms. Within those five years 1963 to 1968, though, the permutations and combinations of emotional variation were enough to being tears to the eyes of a brass monkey, as my mother used to say and, as I say, looking back in retrospect. It was a miracle I ever got my degree and my teaching qualifications labouring under such emotional chaos from time to time and often, week after continuous week.

2.3.3 In the years 1969 to December 1978 my BPD was sub-threshold, non-existent or not as extreme. In the 1978 episode, my next major episode, elation was rare and varying intensities of D were common. The episode lasted from late December 1977 to May 1980, some two-and-one-half years. The first episode had lasted off-and-on from September 1963 to November 1968, a little more than five years. This latest episode only lasted for half that time, but this was only due to the lithium treatment that put an end to my symptoms quick-smart. In early December 1968 I had left the mental hospital in Whitby Ontario on a mild sedative. I think it was called valergan; but I’m not sure after nearly 40 years. In the ten years from 1968 to 1978 I tried: exercise, diet, giving up smoking, sex, radiesthetics and hair analysis, jogging and play therapy to prevent or alleviate any incipient symptoms.

2.3.4 In the episodes from 1978 through 1980 the constellation of: fear, paranoia and the extremes of D seemed to often be as low as I had experienced in the sixties, in those chaotic years of that episode from 1963 to 1968. I experienced in those years 1978-1980 a range of emotional swings but they were largely, at least as I recall looking back a quarter century later, at the D and paranoia end of things. A psychiatrist in Ballarat prescribed stelazine or trifluoperazine, an antipsychotic drug. It was at first administered in early 1978 and it seemed to make things worse. In 1979 I moved to Launceston with my wife and three children and, after a series of two or three quite severe emotional swings at both the H and the D end, a psychiatrist at the Launceston General Hospital prescribed lithium. After just two or three days my symptoms were relieved never to return in the same form. That was in May 1980.

2.3.5 I include these observations, these comments from this second major episode because it throws some light on the first episode and places my childhood and adolescent experience of BPD, if indeed I had that disorder at all in those years, in a helpful perspective. It is helpful to me to put it this way as it may be helpful to BPD sufferers, although it may be somewhat complex for general readers who are advised not to try and follow all the permutations and combinations of my description of this disorder which is quite difficult for me to understand. As I go about relating this story, I go about trying to place this narrative into some coherent form. It has taken this third edition, now in its fifteenth draft, to get some sense of coherence, some sense of continuity, into what some biographers and autobiographers sometimes call a ‘chaos narrative.’

2.4 From My First Episode of MD in 1963
To My First Institutionalized Care in 1968:

2.4.1 The episode in 1963 continued in a complex series of forms up to and including 1968. It was not diagnosed as either MD or BPD in those years. This episode, part of my first phase of BPD as I see it in retrospect, did not receive any professional assistance until June of 1968. From June 1968 to November of that year I received institutional care in: the Frobisher Bay, now Iqaluit, General Hospital, the Verdun Psychiatric Hospital in Montreal, the Scarborough General Hospital in a Toronto suburb and the Whitby Psychiatric Hospital about a 30 minute drive from Toronto. The story of those years from 1963 to 1968 and those four psychiatric units and hospitals were my years of university study and the first year of full employment. The story of these years is long, stony and tortuous and I will not write the account of these five years in any more detail since no medical diagnosis was given, just piles of advice from more exercise and prayer, to a better diet and sex, but I do write of these six months and I do I do write of this experience in my memoirs in much more detail than I do here. To write of it here would result in prolixity.

2.4.2 In June or July of 1968, though, one member of a battery of doctors, psychologists, psychiatrists and other care givers who were then providing my treatment program in Montreal Canada at the Verdun Psychiatric Hospital took a personal interest in my case. He was the first attending psychiatrist in my life about whom I remember anything at all. He was a Baha’i, a religion that had its origins in Iran in 1844; he was one of perhaps 4000 Baha’is in Canada at the time and perhaps its only psychiatrist. He was himself at the outset of his own career in psychiatry. I had been serendipitously institutionalized here after the onset in late May of 1968 of an episode of MN.

2.4.3 I had been working with the Inuit at the time in Canada’s high Arctic as a grade three classroom teacher. Looking back it seems highly fortuitous that this first institutionalized care that I received was, in part, from a psychiatrist who shared the same belief system as I did, the Baha’i Faith. I remember him taking me out into the community to meet some of the Montreal Baha’is and their friends. Such an exercise, I assume, he felt was a normalizing experience.

2.4.4 I appreciate, as I say above, the interest, care and assistance shown by a long series of individuals, particularly the relatives and friends in my life, who over the years and as far back as 1963 when what has become, what I now define, as the first clear episode of MD or BPD began to manifest itself. The professional work of those doctors and the personal assistance of those family members and friends has been invaluable and I want readers to appreciate the primacy I give to the work of these special people for their help and support, their saving me from what in any previous age and time period would have been a horrific, virtually end-of-normal-life experience. I want, too, to particularly emphasise the personal care-givers in my consanguineal and affinal families, that is my family of birth and marriage, especially my mother, my first wife and my second. These three people were there to help inspite of the difficulties they experienced as a result of their care-giving attitudes and supporting activities. They were absolutely critical and significant others in that wider social context of family, friends and doctors over the years.

2.4.5 I sojourned in these first five years, in that first episode from 1963 to 1968, in a public and private world that was new to me. From time to time and beginning arguably on 29 May 1968 I sojourned in a place no less strange to me than if I had been among an exotic jungle tribe in Africa. It is the duty of some cultural anthropologists to report on their exotic travels and field trips, whether among the indigenous peoples of the Earth’s antipodes or to equally remote recesses of human experience among other culturally diverse groups. The account I write here, though, is not so much anthropological; it does not give an emphasis to the eccentricities, the absurd and the bizarre which SAD, D, MD and BPD accounts often do; it does not attempt to make a comprehensive statement of my experience. I leave this for my autobiography/memoirs and readers can find the story buried there in occasional references among the 2500 pages much of which is now on the internet in different forms, short and long, paragraphs here and pages there. I came, insensibly over several decades--and then only at some distant and abstract level--to associate the extremes of my BPD somewhat with the role of shamans among tribal, third world and animistic communities, people who relate their myths and their meanings by means of emotionally laden quasi-ecstatic visions.

2.4.6 On the personal level, I discovered in myself unexpected patience, humility and hope. I learned to treat life as the most precious of gifts, infinitely vulnerable and precarious, to be infinitely prized and cherished. I had not become a shaman or a saint, though; I still suffered; I was still impatient; I did not always appreciate life; I still got depressed. I had journeyed with my body, although I don’t think with my soul, into an underworld and come back, more times than I care to tell and certainly more times than I tell of here. But I have survived and lived to tell the story. This is not always the case for people with SAD, D, MD or BPD.

2.4.7 Mine was a spiritual drama of sorts—on a psycho-neurological, a psycho-pharmacological, a schizo-affective level and in 1968 the first psychiatric diagnosis, some five years after the beginning of my first episode, resulted in my suffering, my illness, having at last a label, a medical diagnosis, a name attached to it: a mild-schizo-affective disorder, for which I use the acronym SAD in what has become a somewhat long account. This mild SAD I could, as I say, narrate as a drama in religious terms and describe it as a purgatorial dark night. But, briefly, it was both a pain in the neck and a gift of the gods. Whatever it was and however I interpret its meaning in my life, it has unquestionably been a key part of my life. But it was not all my life. I do not define all my life in terms of this disorder. This account is of that part, that small but important part.

2.4.8 Stories in life, all peoples’ stories, are chaotic and confusing at a certain level of analysis, a problematique as some social scientists call the story of one’s life, especially in the absence of some kind of narrative order, an order imposed or simply narrated in a simple fashion. Even with some order, imposed or not imposed on one’s experience, one’s life is still a problematique. I tell my own story here as briefly as possible to help establish, for me, some of that sense of order. I tell of these events, as a storyteller might, of my experience of life, but it is a story not packaged for the media. It has been packaged, though, in several written forms for the internet at some 60 sites since 2004. At some of my postings there is only a brief statement and at other sites the statement is as long as this one. Without sequence or discernible causality, though, as I say, one’s story remains a bit of a jumble to say the least. Of course, not everyone feels this way. We are a highly diverse species and we see things in such different ways. Life has an element of mystery, of jumble, no matter how much knowledge and understanding we bring to our problems and whether we write an account of our life or whether we don’t. Such is my view, anyway.