Detour from Normal (42 page)

My collapse also resulted in a heightened awareness referred to in psychological texts as a "watcher" or "witness." Most of the time I feel like a regular person, but at times of heightened emotions, I feel as if I'm two people: one experiencing the emotion and the other weighing its
validity. Having this newfound ability to detach from emotional situations has not only allowed me to retain a low level of negative emotions, but it also has helped me to dampen anger, block fear, and remain keenly alert in chaotic and frightening situations. Though this may simply be a greater awareness and trust of my subconscious resulting from my experiences, I must admit that it feels markedly spiritual. That part of me is highly intuitive and picks up on subtle cues and synchronicities in my life that I would previously have missed. It also seems to subtly nudge me toward a certain path without, unfortunately, giving any clues as to where that path might lead. Because of the positive effects of this phenomenon, many choose to refer to it as a spiritual awakening.

This all sounds wonderful, but let me describe the reality of it with a few statements. It's a solitary journey—there is a sense of aloneness, of being the only one. People don't accept or believe you, and they suspect continued mental illness. Instead of voicing joy over your good fortune, you must remain silent about it. As a result I found myself in confusion as I struggled alone to make sense of a gift that became mine only by happenstance.

This solitary path has been shared by all the other authors I mentioned. It took each of us years to understand and accept our gift. None of us were searching for, or were prepared in any way for, the gift that we received. Remarkably, all of us awakened in much the same way and published books as a result, with the intention to lead others toward a better world.

I've learned that what happened to us can result from any number of traumas, from medications, and perhaps even by choice, but that it is little understood and rarely spoken or written about. I hope that by introducing readers to this subject, it will lead to more open discourse
and eventual acceptance. There are many trapped or soon to be trapped in the same cycle of confusion we all faced. Nothing would please me more than to smooth their transition through what I consider a normal and natural process, which, when better understood, may indeed lead to a treatment for many dysfunctions.

Making Sense of Crazy

Whenever I entered any new state of mania, it was extremely disorienting to be suddenly missing huge chunks of memory and abilities. I had no realization that I'd lost anything; I just could no longer do certain things that I had been able to before, and I had to find different ways to do them. Oddly, it seemed that my mind left facades of everything I'd lost, perhaps as placeholders or to make it less traumatic. Take the map I encountered at Pinecrest for example: I knew what the map was and its purpose, but I had no clue how to use it. The facade of map knowledge was there, but the knowledge behind it was disconnected. I had similar issues with camera memory cards, among other things. I knew what they were, but I had no ability to use them. I also could use the Internet just fine but couldn't execute a program or find a file or directory on a computer. Luckily, without negative emotions, I had a sunny attitude toward workarounds and was not embarrassed at all to ask someone to help me do something I no longer could.

When my Seroquil was doubled the first time at Pinecrest, it seemed to single-handedly bump me up to the next level of mania. When the same double dose was given to me again the next day after I tried to escape, I clearly showed many adverse reactions to the drug. Many times
during my institutionalization, it seemed that the treatment plan for me was completely wrong. At the same time, it seemed that no one was really consulting my medical history or listening to information Beth or I were trying to convey. I later learned of the term "confirmation bias." It's the tendency of people to selectively favor information that confirms their hypotheses while ignoring everything else. It was a favorite practice by Dr. Davis and one of the reasons I disliked him so much.

During emergency mania and peak mania, everything that was not necessary for survival was disconnected. In some cases that even involved my memory of my wife. While writing this book, I learned that at certain points at Phoenix Mercy, my wife was right at my side, holding my hand and comforting me, yet I have absolutely no recollection of her being there. I may have recognized that she was there at the time and interacted with her, but my mind did not record anything about her even though it was recording other information in vivid detail.

The most interesting realization was how important Dana was to me. It was as if I had reverted to childhood and he was once again the big brother fending off bullies. I would have followed him anywhere or done almost anything he asked regardless of the outcome. For my imploding mind, he was the only beacon of hope I recognized although my wife was frequently at my side. It's clear that, even though love is strong, in a crisis, what your mind perceives as what is going to save your life is more important than emotions.

One of the most humbling discoveries I've made from this experience is that I am not in charge of this machine that houses my small consciousness—I am simply a passenger. Not only do I not have conscious control over what's going on inside my body, when it comes down to it, I have very little control over what goes on in my mind. On the
other hand, I can't ignore the fact that there seemed to be a purpose to the things that happened to me. There was an organization to it, and the worst was consistently pushed out as long as possible. Though my body and mind seemed to work in tandem to give me the best configuration possible in my extreme circumstances, my emotional reaction to what was happening was a totally different story. As far as my body and mind were concerned, however, that reaction was merely an annoying byproduct. Their goal was simply to allow me to function and to protect me at the highest level possible.

On the day I went to Phoenix Mercy, I had reached the summit of the mountain. My mind reached its narrowest functionality, my senses were at their highest, and my body was at its weakest. From there my mind and body slowly recovered, but other areas of my life continued to deteriorate because of people's reactions to my behavior and because no one involved had the necessary knowledge or skills to help me. I certainly wasn't out of the woods, but after that day, my mind slowly began expanding back to normal, and my senses dropped closer to where they had been originally.

After June 3, when my heart rate and blood pressure finally started to drop, I was well on the road to recovery. If I hadn't been in a situation where sleep was hard to come by, I could have gotten enough sleep without Ativan. I didn't need lithium; I just needed time. For whatever reason, it took time to turn all of my brain back on even though parts had been disconnected in an instant. I believe that once disconnected, those areas needed to be stimulated to be turned back on again by attempting to use them—it didn't seem to just happen automatically. The neural pathways apparently needed to be exercised to build them back up to their previous levels.

The Smoking Gun

Before everything started I was a perfectly healthy, normal man with no personal or family history of mental health issues. One thing I haven't discussed is the link between my bowel surgery and my mania. Until July 22, 2011, there were no potential answers. On that day I went in for a colonoscopy to evaluate the general health of my repaired bowels. While in prep, awaiting anesthesia, I asked the nurse if she'd ever heard of anyone going manic after a surgery.

"Why yes," she said. "As a matter of fact, I think I have some information I can print out for you. I believe it's called steroid psychosis."

I was excited to finally have a lead. It turns out that steroids given during surgery can result in mania within days or weeks. Genetics are not a factor; it can happen to anyone, even people who have been given steroids previously with no ill effects. While I was having my colonoscopy, the nurse printed and shared that information with Beth. While I was at work the next day, Beth dug through the thousand pages of medical records we'd obtained from Desert Hope, trying to find the suspect steroid.

She eventually found it: the corticosteroid Decadron, which was given to me during surgery to prevent inflammation. She called me with the news. We were both overjoyed! It meant that I wasn't just a random case of mental illness; there was a potential reason why I went manic. Astoundingly, I learned there were twenty-seven drugs given to me during my hospital stay. I researched all of them to determine their side effects. One drug, Levaquin, a powerful antibiotic, is in the top three of all drugs that cause adverse psychiatric effects. It is the focus of multiple lawsuits. Perhaps that was part of the reason for my surgeon's
reluctance to be further involved with me—I must have been given a gallon of Levaquin. It came in a large bag and I was given several bags intravenously in the days preceding my surgery.

Seratonin, a neurotransmitter produced in the bowels, is another likely culprit. Since my bowels were certainly disturbed during my surgery, that may have stimulated the production of extreme levels of serotonin leading to serotonin syndrome or serotonin toxicity. Symptoms of serotonin syndrome include agitation, hypomania, mental confusion, hallucinations, high blood pressure and heart rate, nausea, tremor, twitching, seizures, dilated pupils, and inhibition of REM sleep. Seroquel and other SSRIs (selective serotonin reuptake inhibitors) are particularly notorious for causing this syndrome. I was lucky that I got off Seroquel so quickly. Already in a compromised state, I went downhill rapidly once I was given that drug. Many patients react adversely to SSRIs, which are commonly prescribed for depression and anxiety. In extreme cases they have been linked directly to violence, suicide, and even murder.

A final potential culprit is the inhibitory neurotransmitter GABA (gamma-aminobutyric acid). The brain becomes over stimulated when GABA levels are too low, resulting in rapid speech, insomnia, hypersexuality, excessive spending, reckless decisions, risk-taking behavior, and grandiose ideas. You feel so euphoric that you may consider yourself a heavenly spirit, an intellectual genius, or in possession of extraordinary powers. In that state impulsive behaviors are no longer overruled by logic or reason. You may also suffer from seizures. Here is the most eye-opening revelation of all: My positive reaction to Ativan was demonstrated repeatedly during my ordeal. How does Ativan work? It acts on GABA receptors in the brain causing release of the neurotransmitter GABA. Another
way to raise GABA levels is to consume alcohol. A test or even a temporary solution to my problems could have been the simple act of having a few beers. How unfortunate it may have been for me that I rarely drink. Although I've pointed toward adrenaline often throughout the book, I suspect that low GABA levels could have been the real smoking gun. Sadly without test results to confirm that theory I will never know for certain. A NeuroBasic panel blood test can be requested to measure levels of both inhibitory and excitatory neurotransmitters including serotonin, GABA, dopamine, epinephrine, norepinephrine, and glutamate.

The Most Seductive Drug

Would I ever want to be manic again? Months after my mania ended, I went for a walk around my neighborhood. I found myself imagining the perfect breeze, stars too numerous and bright to be real, and perfect palm trees. I thought about the evening in my home when everything was so wonderful. I thought about how my dogs clung to me as if I was suddenly more special than anything else in their lives. I thought about the afternoon my wife and I made love. I cried when I walked that night. I cried because there were so many amazing things I experienced that I will never experience again. I cried because I knew that just as I'd fought against the use of drugs in my life, now I would have to avoid mania equally as hard. Ironically, something I'd never given a second's consideration to my whole life was the most seductive drug I could imagine.

When I was manic, I had passion and enthusiasm by the truckload. Things I had trouble with in normal life were a breeze for me. I felt
perfect, better than at any time in my life. Anything I may have had to give up in order to feel that way was far from my thoughts. The truth, however, was that it was all a lie. Mania took away my ability to recognize all that had been sacrificed in order to feel good about a few things. It both stole my life from me and convinced me that my life was the best it had ever been at the same time. I fear that if I was ever under its full influence again, I would be equally powerless to regain my life. No matter how much you know or how smart you are, mania will take away your knowledge as it sees fit. Anyone will prefer being manic to being normal because it is such a perfect ruse.

Chapter 36

HOPE

Life Without Lithium

I'd had a conservative goal to begin weaning myself off lithium gradually under psychiatric supervision starting on the one-year anniversary of my court date: June 7, 2012. When I was instead told on February 1, 2012 that I'd taken my last pill, I was very concerned that I might instantly relapse. Instead, being off lithium was amazing. When I was first taken off lithium, there was a feeling that I was suddenly me again. For starters, I was no longer on the verge of tears all the time. Beyond that I noticed that my positive emotions seemed unbounded. Within a few days, I'd experienced such heightened joy that I was in tears. I couldn't believe how wonderful it felt to experience joy again. I did grow a little concerned during some of the really over-the-top joyful experiences, until I realized that without drugs controlling my emotions, I was going to have to relearn how to regulate them myself.