Going off meds may be a sensible and responsible personal decision for you - with the emphasis on sensible and responsible. Tragically, too many of us opt for crazy and irresponsible. Whatever choice you make, first you need to be reading my friend Judy's book, which I very strongly recommend for anyone living with a mood disorder, including loved ones. This review first appeared on my website in 2005, then I ran it here in Oct 2009. Definitely worth a re-rerun:
A sobering reminder of the heartbreak and hurt we can inflict on our partners comes through loud and clear in the poignant memoir by Judy Eron, "What Goes Up: Surviving the Manic Episode of a Loved One." Judy and her husband Jim, whom she had known for nine-and-a half years, were well on their way to realizing their dreams. They had uprooted from Tennessee to build their little hideaway in the desolately beautiful Big Bend region of Texas. There they planned to spend most of their time together in splendid isolation, but no sooner was their homestead ready for occupancy when Jim went off his lithium.
"It is a strange set of circumstances," Judy begins, "when a wife wakes up every morning wishing her husband would get severely depressed or arrested." Or has an automobile accident that sends him to the hospital or is caught running naked in the streets.
Anything that might take him out of his destructive mania.
By the time they reached Washington, their summer retreat from the Texas heat, Jim was already behaving strangely – first the pressured talking, then rudeness and impatience soon escalating into grandiosity, infidelity, dangerous behavior, and abuse. No one was going to tell Jim anything was wrong, least of all his wife.
Writes Judy: "If Jim had met another woman and fallen out of love with me, I could have coped somehow." Her life experience had at least prepared her for getting jilted by the proverbial blonde, but despite being a psychotherapist this was totally new. It was as if the mother ship had switched her loving and caring soul mate for an alien impostor somewhere out over the Texas desert. The eggshells she found herself walking on started to crack and she had no choice but to seek refuge in her friends and family.
Through an agonizing year she waited in vain for the crash that everyone said would happen or the 911 situation that would put him in the hospital. Or for Jim to come to his senses on his own. But the man she loved was far too in thrall to his "natural" self, even if that meant, ironically, trading his prescription drugs for recreational ones. Many a time Judy allowed herself to get her hopes up as the situation appeared it might resolve, only to end up bitterly disappointed. There was nothing she could do except take care of herself. Kay Jamison, herself, had told her exactly that. People in a state of mania, by definition, are out of control.
The book’s title implies that Jim must have come down. But we’ll never know that. He could have remained up. No one was around to see him crash. Judy assumes he must have, but mania has a way of turning on its victim, of creating an energized hell that leaves only one way out. One clear October day in the Texas desert – perhaps depressed, perhaps manic, most likely a combination of both - Jim took that only way out. It was an inevitability rather than a choice.
It was the Jewish Day of Atonement. At-one-ment. Jim had completed his tortured path to spiritual wholeness. For the woman he left behind, putting back the shattered pieces of her life was only just beginning.
Dealing With a Loved One’s Mania
Judy’s penultimate chapter is entitled "Woulda, Coulda, Shoulda." In a cruel twist of the knife, survivors inevitably end up blaming themselves for failing to respond with the impossibly precise measure of support, patience, compassion, confrontation, and tough love. As if they somehow foolishly left the eggs out of a recipe for baking a cake. In truth, Judy did everything she could have done, just like all survivors. There are no manuals, no guarantees.
Having said that, Judy does proffer some useful advice, based on her experience and research, principally:
- You should not try to deal with mania by yourself. Forge a strong alliance with a psychiatrist and build a support network.
- Know that you are dealing with someone out of control, who can no longer be trusted.
- Be ready to take responsibility for being the decision-maker.
- Look after yourself. Keep your life going.
- Read as much as you can about the illness.
- A manic person "will hammer on your weakest spots to bend you to his way of thinking, namely that he’s not sick."
- "Without a doubt, you will be abused emotionally. You may decide to bail out … You are only human. Love is powerful, but in the face of mania, it is not all-powerful."