The first part of my talk - "The Problem Patient" - went somewhat better.
'Marilyn walks into your office," I began. "She reveals her moods have been all over the place. Everything points to bipolar. Okay. How do you treat her?"
Believe it or not, no one raised their hands. I was the one who had to suggest that a mood stabilizer might be a good idea, then I had to make sure we had a consensus. Then I went to the catch, namely how does the most important person in the equation - the patient - feel? After all, even the best med in the world is useless if patients won't take it.
Maybe we need to ask Marilyn a few more questions, I suggested. Consider:
Marilyn is literally larger than life. Over the top is her baseline. It's a legitimate part of her personality. How long do you think she is going to stay on her mood stabilizer if she thinks her personality is getting medicated out of her?
Hypomania is the first thing to come to mind when thinking of Marilyn, but the operative word from the DSM regarding this type of behavior is "uncharacteristic."
"For someone else to act like Marilyn," I said, "that may be hypomanic. For Marilyn to act like Marilyn - that's normal."
"Keep in mind," I said, "a lot of us view the world through the eyes of artists and poets and visionaries and mystics. Not to mention through the eyes of highly successful professionals and entrepreneurs. We don't want to be like you."
How can I describe the look of surprise from my audience? Like I had let rip a roof-rattler and they were too polite to laugh - I think that best sums it up. Honestly, I’ve experienced seaweed with more personality. Then I blurted out: “To me, you all have flat affect.”
Kelvin grade frozen stony cold silence. And this is the part of my talk that went over reasonably well, mind you. At this point I should have tossed away my script and tried to engage them in a dialogue. “Why should this be a surprise to you?” I should have asked. “Let’s talk about this. Tell me where you’re coming from.”
We - those of us living with bipolar - are obviously a lot more animated than the general population, but the way I see it is that not all of this is pathological. Quite the contrary - the rest of the world should be more like us.
A year after my talk, I was in LA touring the brand new Grammy Museum with a good friend of mine. Louis Armstrong happened to come up on the film display. “I love this guy!” I enthused. I practically levitated off the floor.
My friend does not have bipolar, but, for lack of a better term, I would describe her as having a “bipolar personality.” She sparks and sparkles. Not surprisingly, she is drawn to similar people. My over-reaction to Louis Armstrong was music to her ears. She wasn’t dragging a block of wood around the museum with her.
“Look at that!” she blurted out, several exhibits later. “Three of these people had Martin guitars!” Yes! I had just noticed the same thing!
From my point of view, I felt emotionally safe. I did not have to worry about a disapproving reaction. I could be myself. I could experience the moment. More important, I had someone I could share the moment with. Neither of us have time for boring. Smart, funny, intellectually curious, creative, and lively are just some of the traits we are drawn to.
But there is the obvious downside, especially when it comes to romantic relationships. But life with the “flat affect” people? I can’t even begin to imagine it.
Two years later, I would be addressing a Depression and Bipolar Support Alliance (DBSA) state convention in Kansas. The audience were mostly individuals living with either illness. "We are peanut butter people trying to fit into a tofu world governed by Vulcans," I related. I had to pause for the laughter to die down. They got it instantly.
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