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INTELLIGENCER JOURNAL (Lancaster, Pa.)
Cover, Business Monday

Bi-polar illness:  What is it really like?  (Part one in a series)
According to the National Institute of Mental Health, more than 44 million Americans, age 18 and over, suffer from a diagnosable mental illness.  About 2 million of these individuals live with bi-polar disorder, a particular brain disorder that causes dramatic mood swings, from overly "high"   and/or irritable, to sad and hopeless, and then back again, often with periods of normal mood in between. 

Like other brain disorders, bi-polar disorder causes untold human suffering, particularly because it often is not recognized as an illness.  People may suffer for years before it is properly diagnosed and treated.

Living with bi-polar illness

Before diagnosis
Donna Thomas, 51, Conestoga, Pa. recognizes the symptoms of this illness all too well.  They started to cloud her world when she was only a teen, becoming most apparent in nursing school. 

In backtracking, she points to the back and forth rhythm of her academic success, which was particularly noticeable when she would have the same instructor during different semesters. 

One semester, she would be glowing as an A-plus student, she said.  The next semester, she couldn't think, couldn't follow directions. 

"I always knew there was something wrong and I always felt like a failure," Thomas said.  "I don't know how many self-help books I read.  I went on retreats.  I took relaxation and meditation classes to settle myself and not be so troubled.  But, somehow, I still wasn't free." 

Thomas's first acute psychotic break occurred in 1980, in her mid-twenties, when she believed herself to be pregnant with the new Baby Jesus, who would save the world.

Everyone thought her illness and the hallucinations she was experiencing were a once and done kind of thing triggered by the grief and stress brought on by the loss of her dad, who had just died of cancer.

As is the case with many individuals with bi-polar disorder, her illness was not diagnosed as bi-polar for many years, because it is a particularly challenging illness to recognize.

"After about six months, I stopped taking my medicine."   

Thomas was relatively stable over the next five years or so but, about that time, she married Andy Adams, moved to the country, and gave birth to a beautiful baby they named Amanda.  Adams traveled a lot so Thomas was alone, isolated on a lonely road with a new baby.

Between the hormones, the lack of sleep, and the isolation, the hallucinations returned.  This time, Thomas became paranoid, convinced that someone was going to steal Amanda.  Thomas bought a camping trailer that she parked in the yard so, together, they could go inside and hide.

During the hospitalization that followed this breakdown, Thomas was finally diagnosed with bi-polar illness.  Her doctors cautioned her never to stop taking her medicine, because this is a chronic illness and must be treated long term. 

"But the hard thing with bi-polar disorder is that you have intervals of normalcy,"   Thomas said.  "If you have a headache, for example, and the pain finally goes away, you stop taking medicine.

"So I stopped taking my medicine again. 

"I believed the same thing that other people believed:  If you pick yourself up, work hard enough, and try hard enough, that you can get past the need for medicine." 

On overdrive, then depression
For the next nine years, the young mother was on overdrive, caring for her child, and starting one project after another around the house.

"I'd start painting a room, then start rearranging the towels in the linen closet, then start washing the dishes. 

"Andy would come home from work and shake his head.  Then he would close the paint cans; put the towels back in the closet, and finish washing the dishes.

"I yearned to be one of the people who could finish a project, complete a task, but my mind raced too much.

"I was miserable. I honestly believed that because I wasn't psychotic, I was okay.  I knew I was miserable, but then being miserable runs in my family." 

And so she started drinking.  Soon she was hospitalized again, going through withdrawal from alcohol on top of everything else.

Discharged from the hospital because her insurance had run out, she was still very sick.  While the earlier presentations of her illness had been mostly in the manic phase, she now sank into a deep depression and couldn't leave the house for two years.

Adams still traveled during the week, so on weekends he stocked the kitchen with groceries.  Then he bought Amanda, then nine, a can opener and microwave oven and taught her how to use them.   

"When I look back, I remember that I could not even walk to the mailbox,"   Thomas said.  "In fact, I couldn't even open the door to sit on my deck. I don't know how it happened that I actually didn't kill myself.  I think I didn't have the energy." 

But it was the hallucinations that came during her breakdowns that, perhaps, were the most disturbing and the most difficult for others to accept.  During the periods she was psychotic, for example, she considered herself among other things, a camel, a movie producer, an angel.

The hallucinations and delusions of Russell Crowe in "A Beautiful Mind,"   a true story about a university professor, come to mind. 

"His hallucinations were classic,"   Thomas said. "You saw what he saw, but only in his mind.

"It was the most poignant, powerful thing I've ever seen.  Figuratively speaking, at least, it was the first time I thought others might understand what it was like to be in my shoes." 

This time, however, Thomas stayed on her medicine, started attending Alcoholics Anonymous (AA) meetings and, eventually, she began to heal.

Embracing bi-polar illness
"Bi-polar illness is one of those things where as unpleasant as it is to have and to own, if you deny it, you are going to stay sick,"   Thomas said. 

"If you embrace it, however, that's when you will get well." 

Thomas finally embraced her illness.  Like other "mental health consumers," the preferred way those with brain disorders refer to themselves, Thomas realized the therapeutic power of self help and embarked on a journey to understand everything she could about her illness.  She read and read and read.

She learned about healing relationships and the need to sleep.  She learned that it is risky for her to squeeze too many things into her calendar.  She learned that she cannot work full time. 

"I am, however, working part time as a nurse and I'm very good at it,"   said Thomas, adding that her thinking is expansive and very intuitive.  Because of her own experiences, too, she can empathize with patients and offer them hope.

Thomas hasn't been in the hospital since 1997.  As her health returned, she took on the challenge of teaching others about mental illness.  In particular, she speaks regularly in high schools, raising awareness and erasing the stigma that accompanies this illness. 

She works with police about approaching mentally ill individuals with gentleness and compassion when they come to offer help.  She and the police work together, too, to help keep mentally ill patients out of jail, where she almost ended up during one of her psychotic episodes.

And with her husband, she started an educational group that meets the first and third Monday of the month at the Mental Health Association in Lancaster.  The focus of the group is on maintaining a healthy lifestyle, while facing the challenges of the illness. 

There are several husband and wife teams, some cousins, a mother and daughter in the group.  Mentally ill individuals need to have the people who love them, understand as much as they can about this illness, and not patronize them with a list of things they "should do" to make them "feel better,"   Thomas said.

"We can do so much damage when we are sick that the most frightening thing for us is that someone might give up on us five minutes before we get well.

"Tell me you'll be there until it's okay again."  

"That's what we need to hear." 

There is considerable stigma and shame associated with mental illness, Thomas said, and it is hurtful.

"People are so compassionate and understanding about physical illness.  Over the years, I've watched a procession of casseroles, flowers, and balloons be given to friends and family with cancer and other physical illnesses you could see. 

"But when I came out of the hospital, I literally couldn't peel a potato.  Nobody offered to buy me a loaf of bread and bring it into the house." 

Despite having had to grow up more quickly than many children, Amanda is thriving. In fact, she is following in her mother's footsteps and is studying to be a nurse.

"Amanda just turned 21 and she's proud of me today," said Thomas.  "The greatest thing she has learned, in spite of the pain, is perseverance and courage. 

"She learned that we could all have given up a long time ago and we wouldn't have a life we have today.  And I wouldn't have the relationship with God and my fellow man that I have today. 

"I still go to AA meetings,"   Thomas said. 

"And I will never even think of stopping my medication." 

Read Part Two of the Series
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