Now Available as a Paperback

From Therese Borchard, author of Beyond Blue:

I kept saying to myself, "Did he just write that?" "Did he really just write that?" until I got to the third chapter and expected the pages ahead to be full of the same playful, entertaining .... um .... original prose that preceded it.

Anyone can jot down the bizarre thought patterns that are floating between their brain lobes. I guess what makes McManamy different is that he has taken a tour of Dante's Inferno and, while there, jotted down some funny notes that people who had been to Dante's Purgatory--or maybe even the first layer of hell--might appreciate, read in the bathroom, or digest like their favorite comics because the stories simply make them feel better. They are written by an intelligent man who has suffered and has been able to translate that suffering into hysterical laughter.

Funny is good. And this man's outrageous stories make me laugh. Sometimes they even make me forget about my day's trauma. Now that's a miracle.

Purchase paperback edition ($9.95)

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Revisiting the Normal vs Crazy Thing

Last night, I had a nightmare that I danced like a white man. This was way worse than my recurring dream where I’m married to Sarah Palin. Naturally, it was a huge relief to wake up and - oh crap! - well, at least I’m bipolar.

Most of you know what I’m talking about. We have a different way of perceiving reality, which of course affects our behavior. Too often, the result is outsider status. No one wants that. On the other hand, I bet no one ever told you this: “You’ll really love So-and-So! He’s so normal!”

Funny thing about our doctors. They may inform us that they will have us back to normal in no time, but they never actually say, “We’ll have you normal again.”

“Normal” is a reference to the status quo, how things are going “out there.” This is the world we need to learn to function in. But we don’t necessarily have to be “normal” to function in “normal.” This is hardly a condition we would aspire to. I always sort of knew this, but the light bulb went off last year when I read Nassir Ghaemi’s 2011 “A First-Rate Madness.” Dr Ghaemi pointed out that normal merely represents a statistical average and hardly an ideal.

How about crazy, then? I love that 1997 Apple ad. “Here’s to the crazy ones,” it starts out. "The misfits. The rebels. The troublemakers. The round pegs in the square holes.”

We see short clips of Einstein, Edison, Amelia Earhart, and others. These are “the ones who see things differently. ... They change things. They push the human race forward. And while some may see them as the crazy ones, we see genius. Because the people who are crazy enough to think they can change the world, are the ones who do."

I keep coming back to crazy vs normal again and again. What prompted today’s piece is a comment from Liz in response to my recent repost on Darwin and evolutionary psychiatry:

I have been struggling for a long time to try and figure out how it is that bipolar disorder was somehow an evolutionary advantage. This comment of yours really hit home and brought tears to my eyes:

"I like to contend that it took a crazy person to run into a burning forest and enthusiastically bring a flaming souvenir back to the cave."

I know that as a bipolar person I am able to experience a different reality and range of emotions than people who have chemically "balanced" brains. It's helpful to hear an anecdote about how this difference in reality perception can actually make being bipolar useful rather than a burden.

Liz, I hear you. We are a minority surrounded by the chronically normal. It’s not easy living in a world where everyone dances like a white man. The only thing worse is actually dancing like a white man.

Further reading from mcmanweb

Normal - Highly Over-Rated
Creativity
Intuition
Psychic Perception
You See Four; I See 28

Here's to the Crazy Ones

An Apple ad from 1997. The crazy ones: Albert Einstein, Bob Dylan, Martin Luther King, Richard Branson, John Lennon, Bucky Fuller, Thomas Edison, Muhammad Ali, Ted Turner, Maria Callas, Mahatma Gandhi, Amelia Earhart, Alfred Hitchcock, Martha Graham, Jim Henson, Frank Lloyd Wright, and Pablo Picasso.

See my blog piece from Thursday: Consumer? Call Me Crazy, Instead.

Consumer? Call Me Crazy, Instead

Last year, here on Knowledge is Necessity, I ran a poll that sought your opinion on the term, “crazy.” Contrary to conventional wisdom, only one in four of you replied that “the term is highly stigmatic.” By contrast, four in ten let me know, “it’s better to be crazy than an asshole” while three in ten informed me, "screw being PC. You should see me when I'm crazy."

I would be the first to acknowledge that “crazy” used in a thoughtless and hurtful way is deeply offensive, but I have far stronger objections to that other term foisted on us to describe individuals living with a mental illness, and, I suspect, so do you. Let’s get started ...

Consumer

If I ever come across the sanctimonious bastard responsible for inflicting this sorry piece of the Indo-European language group on us, I swear I will show him no mercy. I will abduct him off the street, chain him to a chair in a room of Thomas Kinkade paintings, and force him to listen to Frank Sinatra singing Leaving On a Jet Plane.

The term, we are told, came from the mental health movement. Really? Do you think we would actually choose the same word used to describe shoppers going comparison shopping for mouthwash at Walmart? You’d have to be crazy to believe that.

As if we actually had the option to go comparison shopping in the first place. Joke: How do you make a mental health administrator laugh? Tell her you want to get well and stay well.

Really, what choice in services to we actually have?

To go with the mouthwash example: Companies that market products and services actually listen to their customers - those who consume. They do surveys, they run focus groups. They seek to anticipate the consumer’s needs and wants, then they come up with a product they hope will deliver, such as vanilla-flavored mouthwash. Then they go back and check if this same population of morning-garglers had positive experiences contending with a disinfectant laced with a cake icing ingredient.

Tell me, when was the last time someone invited you to participate in a Risperdal or Abilify focus group? When was the last time your psychiatrist asked you to fill in a customer satisfaction survey?

Consumer? Ha!

One More Thing

Consumer is all about taking and not giving. Is that us? Ingrates who suck the rest of this planet dry? Don’t we actually have something to offer humanity? Such as perhaps the Sistine Chapel, the Choral Symphony, Great Expectations, the discovery of the laws of gravity, the Federalist Papers, the Emancipation Proclamation, alternating current, and rock ‘n roll?  

One More Thing on Top of the One More Thing

Whenever we hear consumer used in the same sentence as family member or clinician, it’s the poor consumer who always - always-always-always - comes off as the very junior partner. The term is an open invitation for the smug to point fingers at us and cast judgment: We lack insight, we go off meds because we’re addicted to our highs - yeh, yeh, yeh.

Here’s the deal: You want to call me a consumer, then do what the mouthwash people and all other marketers of products and services do - listen. You might actually learn something.

Patients

A little coda to this: I used to favor this term over consumers and used to apply it to myself. Then I read somewhere that not all of us wish to identify as patients. Knock me over with a feather. Neither do I.

I may have a chronic illness, I may face challenges in getting through the day, but these days, I neither feel dependent on the medical profession nor do I feel my condition defines my life. That was not always the case, and indeed should I ever find myself in crisis again or struggling with a beanball out of nowhere that Mother Nature just threw at me I will go back to referring to myself as a patient.

In the Meantime ...

Call me crazy. You got a better word?

Joshua Walters - On Being Just Crazy Enough

This guy spoke at our NAMI San Diego several months ago. Enjoy ...

Mel Gibson: Asshole, Not Bipolar

I don't have a TV in the new place I moved into two months ago and I don't intend to change that. Drama and voyeurism I can do without, particularly the interminably ridiculous Mel-Oksana melodrama that is diverting our attention from things that really matter, such as Lindsay Lohan (did I just say that?). But - alas! - people are linking Mel's tirades to bipolar, and here I have to step in. A few points:

People say crazy things when their relationships head south.

This is a normal response to an abnormal situation. Heaven help if my life were on tape - or yours. Yes, Mel said things you or I would never dream of saying, but we also know - deep inside - that there is not much that separates us. Philosophers have been debating this stuff since the first practical application of vocal chords, and Shakespeare's entire body of work is based on that fine dividing line between the God inside us and the beast inside us.

"What piece of work is man ... "

Bipolar is the crazy diagnosis, not the asshole diagnosis.

I have bipolar, which makes me prone to doing crazy things if I am not careful, and sometimes even if I am. But I'm not an asshole. Big distinction. I sometimes find I have to correct people who get the two confused. They see someone acting inappropriately and next thing I'm hearing the B-word used to explain that person's behavior.

No, that's not bipolar, I cut in.

Then what is it? they ask.

That's being an asshole, I reply.

There exists a whole range of personality disorders that can singularly or collectively be defined as "the asshole diagnosis." In the past, I have received angry comments along these lines: "As an asshole, I take great umbrage to what you say." So let me set the record straight:

We all have personality issues in abundance. The world around us is a very scary place to negotiate, particularly when we lose our sense of control. We typically compensate by distorting reality and assigning fictitious traits to others. The eastern mystics put it best when they say that life is an illusion fabricated out of our thoughts. Inevitably, things go wrong. Some of us are more skillful at avoiding life's many pitfalls than others. Others are not.

It's not easy being an asshole. It's also not easy being around one.

Crazy is not related to personality.

Just about every diagnosis in the DSM notes that the behavior in question is "uncharacteristic of the person when not symptomatic." If you are a humanitarian, then, bipolar is not going to turn you into an anti-semite. If you are a closet anti-semite, however, bipolar may expose you as a raging anti-semite. Something like this happened to Mel Gibson three or four years ago. Who knows what was going on in his head. Bipolar may or may not have triggered the outburst, but his loathsome bigotry was of his choosing. 

But crazy and asshole do overlap.

There is no doubt that bipolar both complicates and amplifies the situations in our lives. Anger is often a justifiable reaction to our sense of outrage, but those of us with bipolar are skating on thin ice. We get triggered too quickly. Our vulnerable brains overload, and next thing we lose it. And once we get going, it's very hard to stop. Our racing thoughts take over. 

Maybe something like this happened to Mel Gibson. Or maybe he's just being an asshole. When you're on the receiving end, you shouldn't have to make the distinction. I frequently have to remind those with bipolar that when it comes to relationships, "the bipolar excuse" simply doesn't cut it. The best we can expect are certain accommodations.

It works both ways.

Those of us with bipolar are extremely sensitive to negative situations in our lives, whether from the depressive end or the manic end or those hellish mixed states in between. Our built-in amplifier has a way of turning a barely tolerable situation into one equating to being trapped inside a burning building.

Two weeks ago, I had no choice but to end a personal friendship. She was the "normal" one, but she exploded on me. It was a very painful choice, but one essential to my well-being. I may be "crazy," but I don't need crazy in my life. The world is crazy enough as it is.

Also see Therese Borchard's take on the matter at BeyondBlue.

Another Look at "Crazy"

A recent blog piece examined the way we use "crazy." I am strongly on the side of "screw PC, you should see me when I'm crazy." But I do acknowledge that context enters into the picture. There are times when the term can be highly inappropriate. Then again, so can "isosceles triangle."

The last couple of days have afforded me a new opportunity to assess "crazy." It concerns an individual I know - call him Ishmael - who is not in good shape right now, which brought back memories of some of my journey through hell.

The reason I was in hell, of course, had nothing to do with me. I had long suspected I had bipolar, but then again, bipolar people were crazy and I wasn't one of them. You locked up crazy people in institutions. Besides, everyone had their ups and downs, right?

So in hell I stayed, with occasional day passes to planet earth. 

The day I finally came to terms with my bipolar set the scene for meeting myself for the first time. "Crazy" tentatively stepped forward and introduced himself. We hesitated, we embraced.

Of course, being crazy meant I had to forever rule out the possibility of friends or relationships or a career. Only normal people could aspire to things like that. Instead, I would have to drastically scale back my expectations and come to terms with life on the margins.

It didn't turn out that way. Yes, it was a different life I now led, one where I had to learn to accept my limitations and recalibrate accordingly. I wasn't living the life of my original aspirations, but - of all things - I was living a way better life than the one I ever had, or, for that matter, even knew was possible. It was a life of compromises, but hardly a compromised life.

And - crazy thing - having acknowledged "Crazy," it is much easier to pass myself off as "normal." Which is not to be confused with pretending I'm normal. No way. Didn't work then, wouldn't work now. More like just be myself, which sometimes manifests as a bit crazy, which is okay. After all, who wants to be normal?

All this is a long way of saying that once I accepted that my life was in ruins for reasons that had to do with me, then I was no longer perpetually pushing a rock uphill. Crazy? I'm fine with that. My friend Ishmael? He has a long way to go.

Is "Crazy" Appropriate? Yes, You Say.

What's in a name? queried The Bard. The rose was the object of his discussion, but here we're talking crazy. Throughout May, on Knowledge is Necessity, I ran a reader poll. The question was simple:

Crazy: Your Take.

57 readers responded. Of these, a quarter of you (14) replied that "the term is highly stigmatic." This was the smallest group in the survey. A much larger group, more than four in ten (25) let me know that "it's better to be crazy than an asshole," while three in ten (18) informed me, "screw being PC. You should see me when I'm crazy."

The major surprise was that to the overwhelming majority of you, the C-word does not equate to the N-word. Or maybe it does to a lot of you but only some of the time. It's all about context, and had I provided the option my guess is a lot of you would have checked off all three answers.

I for one lean strongly on the side of "screw being PC." I have also used the phrase in conversation, "better to be crazy than an asshole." But I'm also on record as having rebuked Oprah in a blog for inappropriate use of the term.

A time and a place for everything. When someone uses the term to differentiate us vs them, I would say that "crazy" is entirely inappropriate. But it's not the word that's offensive to me; it's the hate and ignorance behind the word. "Isosceles triangle" applied with the same venom or lack of regard would be equally repugnant.

"Crazy" is also a matter of perspective. A brilliant idea of mine, for instance, might be viewed by others as crazy. Sometimes they're right. But often they fail to see over their limited horizons. Nevertheless, on occasion, I have been known to sail off the edge of the world. Call me crazy.

One twist to this is there are occasions when crazy is normal. Our brains were built to over-react to abnormal situations. Even "normal" people are entitled to go crazy every once in a while. Sometimes, though, our behavior is just plain - well - crazy. Got a better word for it?

My diagnosis happens to be bipolar, which I interpret to mean that I am prone to crazy behavior if I'm not careful. In this sense, crazy is not part of the true me. I'm basically a decent person, thank God, not an asshole.

But in another sense, crazy is the true me, the good and the bad. It is part of my "normal" behavior. The "good" crazy (my creativity, sense of humor, etc) I take pride in, but I also have to come to terms with my "bad" crazy. It's hardly the only word by which I choose to define myself, but it is one of the words. So screw the PC thought police. They are not going to take away my identity. They are not going to choose how I am supposed to define myself.

So, like most of you, I do not object to the word crazy. In fact, I would prefer people call me crazy. What really gets my goat is when people refer to me by clinical terms. I used to hear "grandiose" back in the old days. This was when I was a nobody with the crazy idea of making a living writing about my illness. Once, of course, I became a somebody (with a book and a major international award), I had to be a "narcissist" (or "arrogant" to people who couldn't spell narcissist). With certain people, you just can't win.

"Hypomanic" is sometimes fine with me, but the term is frequently misapplied to those of us who are simply in a very good mood (or the flip side, justifiably angry). I once emailed a friend with fantastic personal news. Instead of congratulating me, she cautioned that I was hypomanic. Well 'scuse me for breathing. I didn't realize being happy was a diagnosis.

I trust, judging by your responses, we're mostly in accord here. The C-word does not equate to the N-word, but there are certain situations when it can. Certainly there are far more insulting words (such as misapplied clinical terms). Maybe we're not thoroughly comfortable with being called crazy, but we know it's a lot better than having to deal with being an asshole or worse.

In the final analysis, the real answer is taking the time to listen to one other, taking the trouble to get to know each other. Then the correct words follow. "Crazy" may be one of them.

Pete Earley - Outrage in Fairfax

Pete Earley is the author of the highly-acclaimed “Crazy: A Father’s Search Through America’s Mental Health Madness.” Prior to turning his attention to mental illness, Pete, a former Washington Post investigative journalist, had achieved fame writing books on such topics as crime, criminal justice, Vegas, and spies. Then, one day, out of nowhere, ten tons of bricks dropped on his head.

Several years ago, Pete stood by helpless as his son Mike, fresh out of college, went off his Zyprexa and flipped into florid psychosis. But for doctors to treat him, first they needed his consent. Never mind that Mike’s condition had robbed his brain of all power to reason. Rules are rules. Of course, should Pete's son do something outrageous ...

A couple of days later, Mike obliged. In a highly delusional state, he broke into someone’s home and took a bubble bath. It took six Fairfax County (VA) police and a police dog to subdue him. Now a felony charge hung over Pete’s son. As Pete explained to a session I attended at the 2006 NAMI convention: “We’ve made them criminals as well as mentally ill.”

Pete’s wife urged him to do as a journalist what he could not do as a parent. Driven by his family nightmare, Pete did his own homework and turned in an eye-opening account of the degradation and horror visited upon those left to fend for themselves.

I’ve had occasion to meet up with Pete twice since then. (Pete was highly complimentary of my own book, and provided me, unsolicited, with a ringing endorsement.) He’s in high demand as a speaker at mental health conferences, and when he talks he leaves no doubt that the fire burns hot in his belly. Same with when he writes.

Yesterday’s Washington Post features an op-ed piece by Pete. According to the facts he presents:

In November, David Masters, 52, was fatally shot in his vehicle at a busy intersection after being stopped by police, who suspected him of stealing flowers outside a local business. On Jan 27, Fairfax Commonwealth’s Attorney Raymond Morrogh announced that his office would not file charges against the unnamed police officer involved in the shooting.

In Pete Earley’s words, Morrogh ...

... offered this stunning summary of what happened: "Unfortunately, we had a mentally ill man who was behaving bizarrely ... His family indicated he was behaving under delusions, that he might feel he was under attack if approached by the police. I think that's the explanation for his actions."

Pete is quick to point out that this is pure speculation on the part of the prosecutor, who apparently felt that an after-the-fact determination that Masters must have been crazy was reason enough to fire two rounds into him. As Pete points out:

The three officers did not know that Masters had been diagnosed with bipolar disorder when they confronted him. Many drivers open their jackets to retrieve their wallets when stopped by the police. The fact that a driver might be belligerent or challenge the police when confronted is not some automatic signal that he is mentally ill. What proof does Morrogh have that Masters was in the midst of a psychotic or delusional episode when he was stopped?

Pete also notes that “Morrogh's statement implies that individuals with mental illnesses cannot control their disorders and are prone to violence,” and that “even if Masters's disorder actually was a factor, there is an excellent chance that the officers who confronted him were not trained in how to determine whether someone acting ‘bizarrely’ is psychotic.”

Pete goes on to say that Crisis Intervention Training (CIT), which teaches police how to respond to situations involving individuals with mental illness, was offered to Fairfax Police in 2008, but has not been offered since.

Why are we not surprised?

(Note: Lest we rush to judgment, there is nothing in Pete's piece to suggest that the officer involved should be charged in the fatal shooting. That is obviously a separate issue. The concern here is the prosecutor's outrageous disregard for a citizen his office is charged with serving and protecting.)