The City Wire Special report: The bipolar world

Editor’s note: This is the fifth in a series of stories on mental illness issues. Throughout 2010 The City Wire will attempt to post at least one story a month on this often hidden affliction.

Previous articles in the series
• Mental illness hits one in five persons
• Robert’s colors and Asperger’s Syndrome
• Tonya’s world
• A preachers crusades for a medical clinic

story by Marla Cantrell
[email protected]

Annette, 37, used to be invincible.

She had a never-ending conga line of thoughts, and talked so fast even her mother couldn’t understand her. She drew things, landscapes, portraits, house plans. She jumped from a moving truck, took a trip to California on a whim. The world seemed small to her then; everything was possible.

Annette called those times, some as long as four years, her “up” time. She did have bouts of depression, but those were usually short-lived.

Then, at 26, she crashed.

“It’s like going 60 miles an hour down the interstate and then all at once you stop,” Annette explained.

The episode that finally uncovered her bipolar disorder did involve an interstate.  Annette was high — she’d been “self-medicating” since she was 13 — and decided to take a road trip. Her truck broke down near Stillwater. She called her mother and waited. For three days.

“When they did come I was so down. I’d been going up and down, having a mixed episode,” Annette said. “I had a loaded .45 in my truck under my seat. I was barricaded in the truck and I said, ‘I’m going to kill myself. You make me wait three days and now you’re going watch me kill myself.’”

Her mother had seen enough of Annette’s behavior not to be overwhelmed by it. She and Annette’s brother let her ride in her truck, which was loaded on a trailer. She kept her pistol nearby.

When they arrived in Fort Smith, Annette performed an encore. But this time the police came.

“The next thing I know my truck is surrounding and they said, ‘Let us in or we’re breaking the windows.’So, I let them in,” Annette said. “They took me to Harbor View. It was the most frightening thing that had ever happened to me. I’d never been in jail, but when they shut that door, it was like, Dude, what happens now.”

The following day she was diagnosed with bipolar disorder. The illness causes extreme shifts in mood and behavior. More than 10 million people in America have the illness; it affects men and women equally and is generally a life-long condition with recurring episodes of mania and depression that can last from days to months.

According to the National Institute of Mental Health, bipolar disorder often develops in a person’s late teens or early adult years. At least half of all cases start before age 25. It is not easy to spot in the beginning. In fact, Annette was misdiagnosed twice: once in the second grade, when she was given an EEG and told she was hyper-active and again in her senior year, when a counselor attributed her problems to family matters.

Annette was taken to court after the episode in her truck. She was sentenced to 45 days in the Arkansas State Hospital. Three weeks after she was released her mom called police again. Annette had stopped taking her medicine. The medicine she was taking was lithium. But she also kept using marijuana and methamphetamines. The mix wasn’t working. In 1999, while she was manic, she bought a bus ticket to California, ended up on her uncle’s doorstep, and was quickly turned away.

“The Lord was watching over me,” Annette said, describing the two weeks that followed. “I was homeless. That first night I noticed the Visalia Police Department. There was an overpass nearby. I took off my jacket, rolled it up into a ball and went to sleep. I thought, if something happened to me at least they’d find me.”

She spent a year and a half in California, receiving court-ordered mental health care. During that time she was hospitalized six times. She came back to Arkansas after promising to continue treatment.

In 2001, the voices started.  When they told her to jump from the back of a Suburban, she obeyed and broke her leg in three places.

“That’s when I quit self-medicating,” she said.

The following year Annette realized just how bad her life had gotten. She enrolled at the University of Arkansas at Fort Smith and hopes to work in the architectural field one day.  She’s already earned her associate’s degree.

It’s still hard. She recently voluntarily committed herself after contemplating suicide.

“I don’t remember Christmas,” Annette said. “School started on the eleventh of January. I don’t remember nothing in January.”

Right now, her medications — all eight of them — are working. She has a counselor who is helping her cope and she attends monthly National Alliance on Mental Illness meetings in Fort Smith.

There are things from the past that still bother Annette. She has regrets about her childhood. Even her twin sister, who does not suffer from mental illness, distanced herself when Annette starting smoking pot at 13. They’re close now; Annette can’t imagine life without her. Annette doesn’t date and often feels alone, no matter how many people she’s with. Bipolar disorder, it seems, is hard to explain.

Her mother, whom Annette said she’d take a bullet for, also suffered. She had a child she didn’t know how to help.

“My mom has a letter I wrote when I was seven or eight. I said, ‘I will try to do better’, but I spelled it ‘beater.’ She’s kept that all these years. I could always tell I wasn’t the same as the rest of them, but I was trying harder. I beat myself up trying.”

Sometimes Annette misses the manic episodes but she knows the consequences of feeling unstoppable. She’s getting used to the new mix of drugs, which slow her down and keep her even. Sometimes the medication makes her slur her speech. But she’s able to concentrate. And the voices have stopped.

Annette believes she’s lucky.

“Look at kids with cancer,” Annette said. “Man, I’ve got it good. And they never give up. They don’t throw their hands in the air. … I’ve chosen to live in the moment. We’re not promised tomorrow.”