The strange calculus of success and loss with bipolar disorder.
By Michael Simpson
[Trigger warnings: detailed description of suicide attempt and suicide, stressful relationships, blunt emotional expression]
Today, I celebrate an anniversary. In a sense, it is a celebration of living, but that’s only because of great physicians. But it is really an anniversary that should not be celebrated, because it is two years since I tried to end my life. Yes, I attempted suicide.
I never wanted to be one of those people who write too much about their personal selves on Facebook, a place filled with “friends” who know little or nothing about me personally. But a few individuals there are family. A few are real life friends. And a few are people to whom I’ve become connected through mutual interests and fascinations.
I wanted to tell this story to both virtual friends and real-life friends for some unknown reason. Maybe as a catharsis from the pain that I feel. Maybe to help others. Maybe just because I’ve been lying about what happened two years ago for too long.
My most recent long-term relationship (the longest romantic relationship of my life) was with a wonderful woman who is the head of the trauma department of a major southern California hospital. She knows what happened to me, and she knows how I recovered. She’s not in touch with me much, but she knows my story of the past couple of years. She said something to me once about suicides, “either you’re dead, or you didn’t want to die.”
My situation was different, but isn’t it always the case? I knew what to do to end my life, and I knew how to do it without turning back. It was going to be peaceful and in my terms. It was going to be where I could be at peace.
I travelled to Big Sur, California on my motorcycle, two years ago today. I am a type 1 diabetic, so I threw out all of my insulin and other medications I had been taking for years before I departed. I knew that I would eventually go into a state of diabetic ketoacidosis (DKA), which would lead into a coma, and I would die, essentially in my sleep. I would be in an isolated part of California, and my end would allow me to see the beautiful Pacific sunset. I had a delicious fish and chips dinner (get more of those carbs into my blood) as my last meal. I had left a long video message on my laptop for my daughters and other people. I had written long letters of explanation to my friends and anyone who might have cared. I actually didn’t think anyone would care. I didn’t write anything on Facebook as a last message, so that no one would be sending out the police.
All that was going to happen is one day I would be alive. The next I would be dead. Consequences be damned.
Well, the DKA didn’t kill me on day 1. Nor on day 2. What it did do was deplete my blood potassium, which caused a worse problem, an uncontrolled, and very painful heart rate. You see, I didn’t quite think this through as carefully as I should have.
Through a strange force of will (not to live, but just to end the pain), I rode my motorcycle to a hospital and admitted myself to an emergency room. It’s truly a miracle that I didn’t pass out on my motorcycle, driving 100 miles to the hospital, and die along the route. My blood sugar was in the 500s, and my heart rate was 180-190. Once I got to the hospital, I finally fell into a coma and coded three times, revived all three times by the ER staff. Although I had given specific orders that no heroic measures be taken to save my life, the weakness in the system is that someone had to actually inform the staff, and I wasn’t in the position to do so.
About a week later, I was discharged from the hospital, with my life unchanged. The reasons for wanting to die unchanged. And with the same issues in my mind unchanged.
You see, I’ve been diagnosed with bipolar disorder. Not this year. Not last year. But over 20 years ago, though I’ve probably had it since I was a teenager. For those of you who don’t know what this scary sounding disease is, it is simply a mental disorder where the mind switches randomly from manic phases to depressed phases in responses to triggers, which can be anything from stress to who knows what. No one knows what causes it, no one knows really how to “cure” it.
The manic phases can be highly productive, which they were for me. I was the Master of the Universe during my manic phases, which would last anywhere from an hour to six months. I got a biology degree from a major university. My grades were either A’s or C’s, depending on whether I was manic or depressed. I went on to graduate school, where I barely survived. My doctoral thesis, when I first wrote it, was nearly a single run-on sentence. Someone had to help me re-write it, and basically they gave me a degree just to get me out of the place.
I would go on a job interview and knock it out of the park. When I was an executive for a publicly traded corporation, I would put in 48-hour days, managing financial forecasts, talking to investors, hiring employees, and writing emails to lawyers. I became a highly successful person in the pharmaceutical and medical device industry. But only if you consider success as a string of higher salaries and job titles.
But the manic phase has its awful demons. I had terrible personal relationships. I could be incredibly charming, but those relationships, whether with friends or lovers, would be tenuous, often temporary. I had dozens of romances over the years. I would be serially monogamous, but that might mean monogamous for a day. A week. Maybe a year. I probably got engaged to be married 15 different times. I remember them all, and I know why I love them all, but it’s clear that I destroyed lives far beyond my own.
Manic phases had other terrible tribulations. I would spend $250,000 over a weekend on watches, cars, furniture, whatever I wanted. I would buy a new Porsche one weekend, be bored with it in a month, and trade it in for a new one. I bought 25 cars from one dealership in California over a period of 3 years. Twenty-five cars. Who needs 25 cars? OK, I didn’t have them all at once, but I believe I once had 6-8 at one time. I bought them with cash, lease, credit, whatever. One weekend, I went to an open house, and bought a $1.5 million dollar house with cash. This is not how a normal person lives.
Honestly, my mania did allow me to be incredibly successful. I could spot a marketing trend without even thinking about it for more than a few minutes. I could identify a business opportunity within incredible precision. I could analyze complex pricing and financial scenarios in 1/100th the time of Harvard MBA’s when I was manic. And people would pay me immoral gobs of money to do so, which my manic side would spend just about as fast as I cashed the checks. Psychiatrists like to describe my type of bipolar disorder as “high functioning”, but when I look back over it, it feels like “high destructing.” When I was manic, I felt like I was running in a marathon, but without getting a rest.
One of the signs of a truly manic person is spending money that you don’t have. I was spending money I did have, which I contend is much worse, because today, I know how much I’ve lost.
The downside of mania is that the brain needs to decompensate, and I would fall into a severe depression that would be the mirror image of the manic phase. If I was manic for a month, I would be depressed for a month. And when I became depressed, I would become sad (of course), irritable, and isolated. I would enjoy nothing. And I just wanted to die. I hated the ups and downs.
The upside of being a manager or executive is that I could make excuses for myself for my depression. I could schedule a business trip and lie in a hotel room for a few days, not being bothered by anyone. I wouldn’t answer the phone. I wouldn’t reply to emails. I just would lie there in sadness.
It was clear that my manic self made promises that my depressed self could never honor.
I was married once during a major manic phase but suffered through serious depression during most of the marriage. My ex didn’t understand how much pain I was under, probably because she herself was in pain from my own depression. But even today, I don’t think she understands, and I’m certain she doesn’t care about what has happened to me. All I feel from her is blind hatred, which is probably deserved.
Like I said, I wasn’t clueless about being bipolar. In the late ’80s, I was diagnosed as “manic depressive” by a psychiatrist provided by a Big Pharma company for whom I worked. When I was first diagnosed, I simply told the psychiatrist to “fuck off.” Yes, you can quote me. I thought, “how dare some asshole shrink tell me that I had some mental disease. Look at me. I’m MASTER OF THE FUCKING UNIVERSE.”
If only I had listened. If only.
I had contemplated suicide, what the shrinks call “suicide ideation”, at least 100 times over the past 20 years. I would plan it out and write out letters to everyone who mattered. I wish I had kept them all, they would make quite a book. “Michael’s Book of Great Suicide Notes.”
I did find one hidden in the deep dark recesses of a hard drive on my computer:
“Dear Hilary, Sachi and Anna,
The three of you are so young, so I hope that you will read this letter when you’re older and can understand what happened to your father. For your prom. To see you graduate from college. To walk you down the aisle when you get married. To be there when you just need your dad.
Unfortunately, I can’t. I hurt inside. Every day, I wouldn’t know if it was going to be a good one or a bad one. I wouldn’t know if I had the strength to get out of bed to call you. I just couldn’t know.
I really enjoyed my life. I was there when each of you were born, and I knew that you were the three true loves of my life. But because of the sadness in my life, I was never there as you grew up. And I’m not sure I would have been good for you.
But all I want you to do is love life. Do the best you can. And know that your father loves you.
Dozens of letters just like that. Maybe 10 times a year. I would delete them, because I wanted to make sure that no one would find them.
So, in the summer of 2011, six months after my first actual attempt at suicide, I took a trip up to Mt. Lassen National Park. There was still 10-15 feet of snow on the ground. There were smelly sulfur hot springs everywhere, the remnants of the volcanic explosion about 100 years ago. Sitting there, alone, I knew I was really close to two decisions. End my life (this time, I had figured out a much less painful way of going about this). Or maybe enjoy life without the bipolar disorder. The former was a valid choice, in my mind. And honestly, on bad days, it’s still tempting. The latter is possible, but medically, bipolar is not curable. It’s just managed.
I’m writing this article, so you can presume I chose to live. I still get manic, just less so. I still get depressed, just less so. But it’s hard. Being manic is like the best drug ever. You literally do feel like you’re the Master of the Universe. Every day, I’d rather be manic than not. Seriously, it’s almost impossible to explain.
I don’t know what to think of my life. I’ve visited 78 countries. How many people can say that? I’ve been a minor character in a best selling book (complicated story). I’ve shared a holiday dinner with Gloria Estefan (an accident, while entertaining a cardiologist). I’ve invented a medical device that’s saved hundreds of lives. I’ve made millions of dollars. I’ve raced a BMW on the Michelin test track in South Carolina. I’ve had life fulfilled.
But I’ve lost my children. My oldest daughter no longer speaks to me. My youngest daughters have no real emotional connection to me. They don’t understand what I’ve suffered, maybe they really shouldn’t know. I’ve lost many friendships over the years. I don’t trust myself with romantic relationships, because why would I want to be in a romance that could be my manic-self speaking? And there’s a sad tendency that bipolar individuals seem to be attracted to other bipolar individuals.
So who am I? Am I just the sum of my life, which would be not so bad? Or am I someone with a mental disorder that made it through life through sheer will, intelligence, and probably some good luck?
I have a real-life friend whose husband was bipolar. They had a close loving relationship, and one day she returned from a business trip to find that he had shot himself on the dock behind their house. I have always been unsure as to whether to keep her my friendship with her at an arm’s-length distance because she never knew that I nearly did the same thing.
I told some friends what I had experienced but it was difficult and met with mixed results. I kind of did it because when I disappeared for several months in the summer of 2011, my best friend decided to fly out to California to try to find me. Another friend had contacted the county sheriff who had looked for me at my old address. I wanted to make sure everyone knew I was alive and maybe just to hear some sympathetic words.
Of course, not everyone was quite as sympathetic as I had hoped. After I called an ex-girlfriend, with whom I had kept in contact all of these years, she decided that anyone who was bipolar should be locked up. She actually called the police, and the county mental health department knocked on my door the next morning to determine if I was going to harm myself or others. I was in shock. The social worker was kind and helpful and understood how I was getting treatment. We decided that just some people were hateful towards those of us with mental health issues. Sometimes, I even wonder if I was one of those hateful people.
So I move forward. Unfortunately, my failed attempt had some consequences. They caused some damage to my kidneys and heart that physicians are attempting to fix. It’s possible that I might die within the next few months from heart failure if some medical treatments don’t work. How ironic. I did everything I could during my life to make certain that I wouldn’t get heart disease. But I make a choice to end my life, I make another choice to save it, and I caused damage to my heart that may not be repairable. Now I want to live, and I may have removed that choice from my life.
It’s surreal what seems important to me now. I want to find out who the mother is in “How I Met Your Mother?” Yeah, I watch that. I want to know who survives in “The Walking Dead.” I want to know if the Cubs will win the World Series. OK, that’s probably not going to happen.
And I’d like to see Syracuse win the NCAA Basketball Championship again.
And maybe, just maybe, my daughters will find it in their hearts to accept me for who I am, and I can be a part of their lives. I can only hope that I’ll be alive when they do.
Michael Simpson has studied biochemistry and endocrinology at the undergraduate and graduate level. He has worked in sales, marketing, product development, research and development, manufacturing, distribution and executive management in small and large pharmaceutical and medical device companies in the US and Europe. He now spends his time writing, blogging and consulting to medical companies on new product development. A version of this essay originally appeared on Facebook.
Photo credit: Wikimedia Commons, public domain in the US.