Yet Why Not Say What Happened?

IF 5 2区 医学 Q1 CLINICAL NEUROLOGY
Jacqueline W, Ayal Schaffer
{"title":"Yet Why Not Say What Happened?","authors":"Jacqueline W,&nbsp;Ayal Schaffer","doi":"10.1111/bdi.13515","DOIUrl":null,"url":null,"abstract":"<p>In “An Unquiet Mind,” [<span>1</span>] Kay Jamison explains the complexities of sharing her story of manic depressive illness while also being a Professor of Psychiatry. I will forever be grateful to the doctor who recommended this book, which became a lifeline for me. It helped frame this illness as something to be feared but also carefully harnessed and fully embraced. It empowered rather than frightened me. It explained parts of me that I had never understood despite how hard I had tried. In the prolog, Jamison quotes a question that provides her comfort about her decision to publish her story. The question, from the poem ‘Epilogue’, by manic depressive poet Robert Lowell is, ‘Yet why not say what happened?’</p><p>My sister is on the verge of being restrained in hospital. Her husband had her involuntarily hospitalized which is understandable because she has become a danger to herself and is no longer able to listen to reason. Though her story is hers alone to tell, I can't help but be returned to where I was 3 years ago. If this is anything to go by, my sister is currently experiencing her version of my most traumatic memories. I tried so hard to protect her from the harrowing process of being taken against your will, but that's not how this works. How this works is the people who love you watch with increasing helplessness as you are trapped by the wiring of your own mind and they are trapped by the whims and inconsistencies of an overstretched and uncomprehending health care system.</p><p>My younger sister and I are both clinically known as Bipolar 1. Personally, I prefer the old school ‘Manic Depressive’ label. A label that I feel much more aptly and beautifully describes the gripping intensity of both the manic energy and the depressive void. My sister has been highly manic for almost two months. She has been hospitalized twice in the last month. Both hospital stays were far too brief and left her worse than when she went in. My baby sister, younger than me by five years, is strong and beautiful and smart and funny. She is physically active and the loving mother to an adorable toddler.</p><p>With her as with me, she was okay, she held it together, until she wasn't and she couldn't, and now my mind keeps returning to where I was, and what lies ahead for her.</p><p>Right now, at this very minute, the police are knocking on her door and there is nothing I can do. Nothing. So here I am. Not drinking through this feeling. Not numbing myself with pills. Just standing and staring into my backyard with the door wide open wanting to pounce. I want to listen to Rage Against the Machine and tear my kitchen to pieces. Instead, I am standing tall and strong with adrenaline in my veins that I do not know; this is not a feeling I am familiar with.</p><p>They will be getting her down on the grass to cuff her because my sister, like me, ain't going anywhere she doesn't want to without a fight. The understanding that it's not up to her will come. This much I know. I can feel it in my bones and I know it from my own life.</p><p>After half an hour of discussion with the two gentlemen officers at my door, I realized all at once that I couldn't talk my way out of going to a psych ward with them. This was happening regardless of how I felt about the matter. Upon this realization, I politely informed them that they would have to put the cuffs on me because I would not be going anywhere with them willingly. ‘Come on, Miss,’ one of them said, ‘This is a nice neighborhood. You don't want your neighbors to see this, do you?’ I think I responded something to the effect of, ‘I don't give a fuck what the neighbours see. I'm not going anywhere with you, so you do what you gotta.’</p><p>And that is exactly what they did.</p><p>They placed me in the back of a cop car and drove me, kicking and screaming, to the nearest hospital. I pleaded with them to take me anywhere but that hospital. That hospital, where I ended up the night my ectopic pregnancy ruptured my fallopian tube, and I had to have emergency surgery so I wouldn't die but the baby already had. Please take me anywhere but that one, I pleaded.</p><p>Maybe it's because I put up such a fuss. Maybe I wasted too much of their time trying to explain why I really was okay and didn't need to go to the hospital. Or maybe they chose that one just to punish me. Initially the plan had been to go to a specialized centre but that hospital, the ‘anywhere but there’ hospital is where I landed.</p><p>When they put the IV in my arm to sedate me without my consent, I ripped it out and my blood went everywhere. And when I wouldn't change into the damn hospital scrubs, they had four men tie me down and threaten to ‘change me themselves.’ I screamed that I was on my period so I hoped they would enjoy it. This was a lie, but an effective one that I don't feel bad about because in the end they didn't forcibly strip me. Even in my state of insanity, I knew how to take care of myself. To comfort myself. To try and take away some of the shame I knew I would feel when this nightmare ended, to hold a claim on the familiar part of myself that is a mother, a teacher, a person who pays bills, buys groceries, makes dinner. I followed the rules and did everything I was supposed to do: had friends, was kind, tried hard, went to school, got a job, a husband, a house, a kid.</p><p>Yet, this is what happened.</p><p>I spent the following days locked up alone in a red room covered in the graffiti of previous inhabitants. It was during COVID, so I was isolated, food left on a tray outside the door. I didn't know cameras were there, watching me, until maybe day four. I didn't know what the medication was that they were giving me. I didn't know what day it was or if it even was day and not night. I didn't know how long I'd been there or was going to be there. But I did know, I could only walk if I held myself up by using the walls for support. After a week of this, I received a care package from my older sister. Among other things, it contained pens and paper, which I used to write to the doctor, pleading my case: I would behave, I would get better. Eventually he released me against his wishes, just as he had held me against mine.</p><p>Right now, as I write this, I relive all of it as I watch helplessly while my baby sister fights the battle I had hoped to protect her from—the one that gets you in a red graffitied room at the beginning of a long, hard journey.</p><p>The depression that follows a long manic high is so bleak and just so dark. I have no other words to describe it, but I do have a scent. I keep an empty jar of hand cream from that time in the bottom drawer of my bedside table. It is the scent of suicide. It is the scent of slowly stepping in front of the evening train that runs by my house each night. It is the scent of so many different pill combinations and too many doctors appointments. The scent of shame and self-hatred and guilt and total, numbing apathy.</p><p>Sometimes I open the jar and smell it just to be reminded of how close I really was. All I wanted was death. I prayed for it: an accident or aneurysm. I couldn't kill myself because I have a son. Not that I thought I could add anything of value to his life, but just so that wouldn't be his story; his thing to never fully understand despite constantly trying. I thought I would stay around another night for him. The darkness of our minds can get us to a place where we think our children are better off without us, so we're actually doing them a service by departing. Keep away from the tracks, stay in the house. Night after night I made that choice.</p><p>I think about all of these things while I wait to see how this will go for my sister. I think about what I can tell her about picking up the pieces of yourself and putting them back together, about how even if you're only staying alive for your child, only for one more day, then that's reason enough for now. Other reasons will come. Over the past few years, I have grown to understand that living with bipolar disorder is so much more than just navigating the extreme highs and lows that so many seem to focus on. Every facet of my life was and is affected by my bipolar brain. The continuous craving to not be in my head. The constant yearning for something to calm my own unquiet mind.</p><p>This diagnosis and all that came with it has slowly taught me to be gentle with myself, to listen carefully, to slow down, to wait patiently, to ask for help, to look inward, to feel it all, to say no, to breathe deeply, to pray, to not be so damn afraid, and to create my own quiet beauty on the days not defined by those intense highs and lows. There are still dark days for sure, but at least now they hold some sense of meaning.</p><p>I will share this with my sister when her world has brightened a little. And hopefully one day she too will feel well enough to say what happened.</p><p>Many people with bipolar disorder have a family member that shares the same condition, often a grandparent, parent, or child. Clinicians commonly view these family histories in the context of risk for bipolar disorder and to provide a hint at possible response to treatment. Yet two family members with the condition share much more than genes, they share common experiences, knowing all too well what the other has dealt with or will need to face. Siblings in particular share a unique bond and may have overlapping time frames for their illness experience. This poignant and powerful narrative explores the complexity of seeing a younger sibling reach a difficult phase of the illness, what emotions and memories it elicits, and how it can shape the distinctive support that only a loving sibling can provide.</p>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 3","pages":"251-253"},"PeriodicalIF":5.0000,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.13515","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bipolar Disorders","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/bdi.13515","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

In “An Unquiet Mind,” [1] Kay Jamison explains the complexities of sharing her story of manic depressive illness while also being a Professor of Psychiatry. I will forever be grateful to the doctor who recommended this book, which became a lifeline for me. It helped frame this illness as something to be feared but also carefully harnessed and fully embraced. It empowered rather than frightened me. It explained parts of me that I had never understood despite how hard I had tried. In the prolog, Jamison quotes a question that provides her comfort about her decision to publish her story. The question, from the poem ‘Epilogue’, by manic depressive poet Robert Lowell is, ‘Yet why not say what happened?’

My sister is on the verge of being restrained in hospital. Her husband had her involuntarily hospitalized which is understandable because she has become a danger to herself and is no longer able to listen to reason. Though her story is hers alone to tell, I can't help but be returned to where I was 3 years ago. If this is anything to go by, my sister is currently experiencing her version of my most traumatic memories. I tried so hard to protect her from the harrowing process of being taken against your will, but that's not how this works. How this works is the people who love you watch with increasing helplessness as you are trapped by the wiring of your own mind and they are trapped by the whims and inconsistencies of an overstretched and uncomprehending health care system.

My younger sister and I are both clinically known as Bipolar 1. Personally, I prefer the old school ‘Manic Depressive’ label. A label that I feel much more aptly and beautifully describes the gripping intensity of both the manic energy and the depressive void. My sister has been highly manic for almost two months. She has been hospitalized twice in the last month. Both hospital stays were far too brief and left her worse than when she went in. My baby sister, younger than me by five years, is strong and beautiful and smart and funny. She is physically active and the loving mother to an adorable toddler.

With her as with me, she was okay, she held it together, until she wasn't and she couldn't, and now my mind keeps returning to where I was, and what lies ahead for her.

Right now, at this very minute, the police are knocking on her door and there is nothing I can do. Nothing. So here I am. Not drinking through this feeling. Not numbing myself with pills. Just standing and staring into my backyard with the door wide open wanting to pounce. I want to listen to Rage Against the Machine and tear my kitchen to pieces. Instead, I am standing tall and strong with adrenaline in my veins that I do not know; this is not a feeling I am familiar with.

They will be getting her down on the grass to cuff her because my sister, like me, ain't going anywhere she doesn't want to without a fight. The understanding that it's not up to her will come. This much I know. I can feel it in my bones and I know it from my own life.

After half an hour of discussion with the two gentlemen officers at my door, I realized all at once that I couldn't talk my way out of going to a psych ward with them. This was happening regardless of how I felt about the matter. Upon this realization, I politely informed them that they would have to put the cuffs on me because I would not be going anywhere with them willingly. ‘Come on, Miss,’ one of them said, ‘This is a nice neighborhood. You don't want your neighbors to see this, do you?’ I think I responded something to the effect of, ‘I don't give a fuck what the neighbours see. I'm not going anywhere with you, so you do what you gotta.’

And that is exactly what they did.

They placed me in the back of a cop car and drove me, kicking and screaming, to the nearest hospital. I pleaded with them to take me anywhere but that hospital. That hospital, where I ended up the night my ectopic pregnancy ruptured my fallopian tube, and I had to have emergency surgery so I wouldn't die but the baby already had. Please take me anywhere but that one, I pleaded.

Maybe it's because I put up such a fuss. Maybe I wasted too much of their time trying to explain why I really was okay and didn't need to go to the hospital. Or maybe they chose that one just to punish me. Initially the plan had been to go to a specialized centre but that hospital, the ‘anywhere but there’ hospital is where I landed.

When they put the IV in my arm to sedate me without my consent, I ripped it out and my blood went everywhere. And when I wouldn't change into the damn hospital scrubs, they had four men tie me down and threaten to ‘change me themselves.’ I screamed that I was on my period so I hoped they would enjoy it. This was a lie, but an effective one that I don't feel bad about because in the end they didn't forcibly strip me. Even in my state of insanity, I knew how to take care of myself. To comfort myself. To try and take away some of the shame I knew I would feel when this nightmare ended, to hold a claim on the familiar part of myself that is a mother, a teacher, a person who pays bills, buys groceries, makes dinner. I followed the rules and did everything I was supposed to do: had friends, was kind, tried hard, went to school, got a job, a husband, a house, a kid.

Yet, this is what happened.

I spent the following days locked up alone in a red room covered in the graffiti of previous inhabitants. It was during COVID, so I was isolated, food left on a tray outside the door. I didn't know cameras were there, watching me, until maybe day four. I didn't know what the medication was that they were giving me. I didn't know what day it was or if it even was day and not night. I didn't know how long I'd been there or was going to be there. But I did know, I could only walk if I held myself up by using the walls for support. After a week of this, I received a care package from my older sister. Among other things, it contained pens and paper, which I used to write to the doctor, pleading my case: I would behave, I would get better. Eventually he released me against his wishes, just as he had held me against mine.

Right now, as I write this, I relive all of it as I watch helplessly while my baby sister fights the battle I had hoped to protect her from—the one that gets you in a red graffitied room at the beginning of a long, hard journey.

The depression that follows a long manic high is so bleak and just so dark. I have no other words to describe it, but I do have a scent. I keep an empty jar of hand cream from that time in the bottom drawer of my bedside table. It is the scent of suicide. It is the scent of slowly stepping in front of the evening train that runs by my house each night. It is the scent of so many different pill combinations and too many doctors appointments. The scent of shame and self-hatred and guilt and total, numbing apathy.

Sometimes I open the jar and smell it just to be reminded of how close I really was. All I wanted was death. I prayed for it: an accident or aneurysm. I couldn't kill myself because I have a son. Not that I thought I could add anything of value to his life, but just so that wouldn't be his story; his thing to never fully understand despite constantly trying. I thought I would stay around another night for him. The darkness of our minds can get us to a place where we think our children are better off without us, so we're actually doing them a service by departing. Keep away from the tracks, stay in the house. Night after night I made that choice.

I think about all of these things while I wait to see how this will go for my sister. I think about what I can tell her about picking up the pieces of yourself and putting them back together, about how even if you're only staying alive for your child, only for one more day, then that's reason enough for now. Other reasons will come. Over the past few years, I have grown to understand that living with bipolar disorder is so much more than just navigating the extreme highs and lows that so many seem to focus on. Every facet of my life was and is affected by my bipolar brain. The continuous craving to not be in my head. The constant yearning for something to calm my own unquiet mind.

This diagnosis and all that came with it has slowly taught me to be gentle with myself, to listen carefully, to slow down, to wait patiently, to ask for help, to look inward, to feel it all, to say no, to breathe deeply, to pray, to not be so damn afraid, and to create my own quiet beauty on the days not defined by those intense highs and lows. There are still dark days for sure, but at least now they hold some sense of meaning.

I will share this with my sister when her world has brightened a little. And hopefully one day she too will feel well enough to say what happened.

Many people with bipolar disorder have a family member that shares the same condition, often a grandparent, parent, or child. Clinicians commonly view these family histories in the context of risk for bipolar disorder and to provide a hint at possible response to treatment. Yet two family members with the condition share much more than genes, they share common experiences, knowing all too well what the other has dealt with or will need to face. Siblings in particular share a unique bond and may have overlapping time frames for their illness experience. This poignant and powerful narrative explores the complexity of seeing a younger sibling reach a difficult phase of the illness, what emotions and memories it elicits, and how it can shape the distinctive support that only a loving sibling can provide.

为什么不说出发生了什么?
在《不安的心灵》一书中,凯·贾米森(Kay Jamison)解释了作为精神病学教授分享她的躁狂抑郁症故事的复杂性。我将永远感激向我推荐这本书的医生,这本书成了我的生命线。这有助于将这种疾病定义为一种令人恐惧的东西,但也被小心地利用和完全接受。它给了我力量,而不是让我害怕。它解释了我从未理解的部分,尽管我多么努力。在序言中,贾米森引用了一个问题,让她在决定发表自己的故事时感到安慰。在躁狂抑郁症诗人罗伯特·洛厄尔的诗《尾声》中,这个问题是:“为什么不说出发生了什么?”“我妹妹在医院里快要被关起来了。她的丈夫让她非自愿地住院治疗,这是可以理解的,因为她已经对自己构成了威胁,不再能够倾听理性。虽然她的故事是她一个人的故事,但我还是忍不住回到了三年前的样子。如果你还记得的话,我妹妹现在正经历着我最痛苦的记忆。我很努力地想保护她不让她经历违背你意愿被带走的痛苦过程,但事情不是这样的。这是怎么回事呢?爱你的人看着你被自己的思想束缚,而他们被一个过度扩张和不理解的卫生保健系统的突发奇想和不一致所束缚,他们越来越无助。我妹妹和我都是临床上的双相情感障碍患者。就我个人而言,我更喜欢老派的“躁狂抑郁症”标签。我觉得这个标签更贴切、更完美地描述了狂躁的能量和压抑的空虚。我妹妹已经狂躁将近两个月了。上个月她住院两次。两次住院时间都太短,使她比刚入院时更糟。我的小妹妹,比我小五岁,强壮、美丽、聪明、有趣。她身体活跃,是一个可爱的幼儿的慈母。和她在一起,就像和我在一起一样,她很好,她很坚强,直到她不行了,她不能,现在我的思绪不断回到我的位置,以及她的未来。就在此时此刻,警察正在敲她的门而我却无能为力。什么都没有。所以我在这里。不通过这种感觉喝酒。而不是用药物麻醉自己。只是站在那里,盯着我的后院,门大开着,想要猛扑过去。我想听《愤怒反抗机器》把我的厨房撕成碎片。相反,我站得又高又壮,血管里充满了我不知道的肾上腺素;这种感觉我并不熟悉。他们会把她拖到草地上铐住她因为我妹妹和我一样,不反抗是不会去任何她不想去的地方的。她会明白这不是她的决定。我只知道这些。我能从我的骨子里感觉到,我从自己的生活中知道这一点。在我门口和两位绅士警官讨论了半个小时后,我突然意识到我无法说服自己不跟他们一起去精神病院。不管我对这件事的感觉如何,这都发生了。意识到这一点后,我礼貌地告诉他们,他们必须给我戴上手铐,因为我不愿意和他们一起去任何地方。“来吧,小姐,”其中一个说,“这是个不错的社区。你不想让你的邻居看到吧?我想我的反应是,“我才不管邻居们看到什么。”我哪也不跟你去,你去吧。他们就是这么做的。他们把我放在一辆警车的后座上,带着我又踢又叫,去了最近的医院。我恳求他们带我去医院以外的任何地方。在我宫外孕的那天晚上,我的输卵管破裂了,我不得不做紧急手术,这样我就不会死,但孩子已经生了。请带我去任何地方,除了那个地方,我恳求道。也许是因为我太小题大做了。也许我浪费了他们太多的时间,试图向他们解释为什么我真的没事,不需要去医院。或者他们选择那个只是为了惩罚我。最初的计划是去一个专门的中心,但那个医院,“无处不在”的医院是我降落的地方。当他们在未经我同意的情况下将静脉注射在我手臂上给我注射镇定剂时,我把它拔了出来,血流得到处都是。当我不愿意换那该死的医院工作服时,他们就派了四个人把我绑起来,威胁说要亲自给我换。“我尖叫着说我来月经了,希望他们能喜欢。这是一个谎言,但是一个有效的谎言,我不觉得糟糕,因为最后他们没有强迫我脱光衣服。即使在我精神错乱的时候,我也知道如何照顾自己。安慰自己。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Bipolar Disorders
Bipolar Disorders 医学-精神病学
CiteScore
8.20
自引率
7.40%
发文量
90
审稿时长
6-12 weeks
期刊介绍: Bipolar Disorders is an international journal that publishes all research of relevance for the basic mechanisms, clinical aspects, or treatment of bipolar disorders and related illnesses. It intends to provide a single international outlet for new research in this area and covers research in the following areas: biochemistry physiology neuropsychopharmacology neuroanatomy neuropathology genetics brain imaging epidemiology phenomenology clinical aspects and therapeutics of bipolar disorders Bipolar Disorders also contains papers that form the development of new therapeutic strategies for these disorders as well as papers on the topics of schizoaffective disorders, and depressive disorders as these can be cyclic disorders with areas of overlap with bipolar disorders. The journal will consider for publication submissions within the domain of: Perspectives, Research Articles, Correspondence, Clinical Corner, and Reflections. Within these there are a number of types of articles: invited editorials, debates, review articles, original articles, commentaries, letters to the editors, clinical conundrums, clinical curiosities, clinical care, and musings.
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