Lithium and Love
Author of Out of Darkness
Dave is an engaging speaker who isn't shy about the condition he believes took hold of his life nearly a half-century ago.
"I'm manic-depressive. I'm just not comfortable with calling it 'bipolar disorder,'" he says. "Bipolar makes it sound gentle. There's absolutely nothing gentle about it."
Dave began experiencing its highs and lows at 13. Life scenarios would trigger a bout with depression, at times to the point that he didn't want to leave the house.
He would often rebound within months, feeling extravagantly well with powerful highs and energy - a mood swing that may have been an early, unrecognized symptom of his illness.
Over the years, he engaged in some unhealthy behaviors, including drinking heavily on weekends.
The alcohol abuse, he now sees, was one strategy to soften the sharp turns his moods would take in what his doctors have described as rapid-cycling bipolar disorder II.
Dave’s treatment path has been a long one, including several specialists. But it wasn’t until he was prescribed the drug lithium that he felt a seismic shift. "It's like the rain stopped," he recalls of the drug, which he says made him feel better within days.
For the first time in his life, he says he realizes what feeling normal is like. "It's like whoa," he says, leaning his head back in surprise. "So this is how people do it."
Dave is a frank, engaging speaker who isn’t shy about the condition that he believes took hold nearly a half-century ago. “I’m manic-depressive. I’m just not comfortable with calling it ‘bipolar disorder,’” he says, swiping his palm through the air as if brushing the term away. It’s a softening of the harsh reality of what is a debilitating disorder that has you oscillating between hypomania or mania and between mild, moderate and severe clinical depression. “Bipolar makes it sound gentle. There’s absolutely nothing gentle about it.”
Dave, who owns and operates a coaching business in which he helps executives develop their leadership skills, dresses like an elder statesman in tailored suits, handmade shoes and starched shirts. While he helps others craft elegant messages, Dave doesn’t object at the nickname an old friend uses to address him with in group texts: “He calls me ‘Crazy Horse.’” Dave is one of an estimated 4% of North Americans who have the illness.
He recently began exploring his genealogy online, and points out his Scottish forebears who also lived with mental illness. One grandmother died in an Edinburgh asylum, and an aunt had a lobotomy. A grandfather was also manic-depressive, and Dave describes his father as having cyclothymia, a mild form of bipolar disorder.
“And a lot of others were described as ‘dour Scotsmen’,” he says. “Dour is just a fancy word for depressive.”
While a formal diagnosis would take decades, Dave began experiencing its highs and lows at 13 when a local bully began to beat him relentlessly. Dave fought back for a year, but at 14 he finally withdrew into what he now recognizes as his first bout with depression. At 17, he fell in love with a girl who jilted him a year later, and he grew so despondent he didn’t want to leave the house. A few months later, he rebounded, feeling extravagantly well, a mood swing which may have been an early unrecognized symptom of his bipolar illness. At 20, he enrolled in university and began studying theatre, hoping to channel his powerful emotions and energy into acting. But by 23, he crashed again into despair, recovering a few months later into a terrific high. He made impulsive purchases and had plenty of girlfriends until he married for the first time at 28. He drove his car far too fast, and drank heavily on weekends.
The alcohol abuse, he now sees, was one strategy he used to soften the sharp turns his moods would take in what his doctors have described as rapid-cycling bipolar disorder II. He’d begin some mornings feeling fabulous and optimistic, full of plans for the day’s accomplishments. A few hours later, though, he’d become annoyed that others stood in the way of his productivity. That would simmer into frustration about his unrealistic expectations, and by evenings he would be ready to explode. Sometimes, he did. Others would respond negatively, of course, and Dave would end the day feeling ashamed and regretful. “It’s like an Al Pacino performance,” he says. “You’re thrown all over the place.”
Despite his struggles, Dave became a junior executive at a large North American insurance company. But his temperament had a way of interfering. He once cursed at a senior executive in a meeting, and another time, he picked a fight with a coworker who had been spreading gossip about him.
He began seeing a doctor who was also a psychoanalyst at age 30, and worked to control the mood cycles with talk therapy for five years. But at 37, he fell into a depression so grave that he wanted to take his life, and was referred to a psychiatrist who diagnosed him with manic depression. She explained that his shifting moods had settled into their swift pattern as the result of neuroplasticity, the brain’s ability to reorganize itself due to one’s environment, behaviour, emotions and thought patterns. Dave could manage the cycle by taking lithium, a chemical salt used to stabilize the moods of those with bipolar illness.
While psychotropic drugs often take weeks to kick in, the lithium, for Dave, worked within four days of his first pill. “It’s like the rain stopped,” he recalls. “It’s like you’re in a thunderstorm and all of a sudden -- it’s not that you came inside -- it’s that the storm stopped. It’s beautiful and sunny out and you’re on a Caribbean island.”
For the first time in his life, he says, he realized what it was like to feel normal.
“It’s like whoa,” he says, leaning his head back in surprise. “So this is how people do it.”
As he reflects on life before lithium, he realizes the endurance it required. “It was emotional whiplash,” he says of his rapid mood swings. “You feel like you’ve run a marathon every day because there’s so much corrective action you have to take. There’s so many things you say or do, something that’s not appropriate, and then you try and go back and correct it. Or you simply don’t and that’s when you end up basically out on the street, or wherever, in an environment where you don’t have to justify what you’re doing.”
Once he began taking the lithium, Dave’s moods began to stabilize -- mostly. The ruminative thoughts that plagued him during depressions disappeared, and within months, his thirst for alcohol vanished entirely. “It dried up like a piece of parchment and blew away with the wind,” he says. But occasionally, his impulse to kill himself would briefly surface. One day, during a holiday in Scotland, Dave hiked up into the hills of Edinburgh. He was healthy and fit, had a great career and friends and family who cared for him. But for an hour, as he perched high above the city, he contemplated leaping out into the steep drop below. As the wind howled around him, Dave dug his heels into the black volcanic ground beneath him. His mind flashed with remorse over broken relationships, intellectual and emotional confusion, as well as the fear of death. But then a sudden gust caught him off guard. His arms flailed and he windmilled to keep his balance as he pushed against the driving breeze. He caught his breath and looked out at the vista before him. “It struck me that once you’re gone, you’re gone,” he says. “I realized, I still had living to do.” He climbed silently back down the hill.
A few years later, he met a beautiful Scotswoman, Anne, whom he married at 41. The couple relocated to Scotland, where he ran a business consultancy. Over the next few years, Dave felt rooted in the security of his marriage and his fulfilling work. He delighted in his ancestral homeland, and the couple’s house overlooking the North Sea. On weekends, he lugged tons of stone to rebuild a 150-year-old walkway in his garden, a lush mix of thistles, Scots pines and meadow grasses. He felt so settled and fulfilled, in fact, that he stopped taking his medication. Doctors who treat bipolar disorder say that this is not uncommon. The side effects of the drugs used to treat the disorder can be unpleasant, causing weight gain, sluggishness, drowsiness, and a lack of interest in sex. While they soften the blow of depressions, they also blunt the energy, quick thoughts and heightened sensations patients experience during hypomanic periods.
“You’d think any sensible person would stay on the drug,” he says now. “But twice I became convinced after a few years that I was cured and there was no need to be on this stuff anymore.”
He also felt tired, bloated and docile, and believed his work would benefit from the keener thinking that accompanies hypomania. “You feel euphoric and sharp when you’re hypomanic,” he says. “Who wouldn’t miss that?” The first time he quit taking the lithium, he fell into a depression so deep that once again, he contemplated jumping from the cliffs above his home. But he lacked even the energy to make the 20-minute hike. Instead, he phoned his psychiatrist, and was admitted to the psychiatric hospital. This time, it took months for the lithium to take full effect. Eight years later, he persuaded himself that he had recovered fully from his illness – he thought he’d “outgrown it,” he says – and stopped taking his medication again. This time, he drove too fast and got into a car accident. He spent a few thousand dollars to repair his car, just enough to convince him to return to the lithium.
Since then, Dave has returned to Toronto and been mostly stable. He has two dogs he adores, West Highland terriers named Alfie and Eddie on whom he and Anne dote. He immerses himself in books, devouring biographies and history. He also reads about his own condition, about which he has an encyclopedic knowledge.
Dave is a deep admirer of the American scientist and author Kay Redfield Jamison. She has written extensively about bipolar disorder, which she has herself. Much of her work explores the connection between creativity and manic depression, and Dave embraces her theory. “She believes that the clash between hypomania and depression provides a prism through which creativity flows,” he says. “With bipolar disorder, you’re constantly having to reestablish your world view, and out of that comes the creative insights. You are always having to reconsider what constitutes reality as opposed to your objective perception.”
He says relationships also need to be reestablished when living with bipolar disorder.
After 23 years together, Dave and Anne have separated. But they live 12 floors apart in the same building, and see each often for meals and to trade custody of the dogs.
“Dave is wonderful guy,” Anne says, sitting back in a chair in his living room. “He is very kind and very loving and supportive, and it’s very easy to get caught up in his highs and lows. I care about him very much.” She takes a deep breath, seeming to weigh her words. “But I just got tired of not knowing which Dave I was coming home to. Sometimes it’s SuperDave who’d done everything – the laundry, taken care of the dogs, and dinner. He’s an awful lot of fun. Other days he might still be in his pajamas when I come home from work.”
“It can be draining,” Anne says, looking at Dave. “My feeling was, I needed some ‘me’ time, some quiet time.”
Eddie and Alfie tilted their heads toward her, as if in concentration. “A perfect example is Dave’s interest in genealogy. It’s a be-all and end-all. It takes over, and it’s exhausting. But it’s this month’s project. Next month it could be another one.”
She gets up to go, bidding him a good night. He takes her place in his chair, petting each dog’s head as he speaks. “I do have obsessive interests,” he says softly. “I research everything in depth, and I become an expert and talk about it. Sometimes it’s fascinating to her at first, but I understand what she’s saying. It just never ends.”
Dave is doing what he can to take care of himself. His apartment is meticulous, with a kitchen full of exotic teas, and his washroom is stocked with his old-fashioned shaving kit and fragrant soaps. “My feminine side,” he says. He looks ahead to warmer weather, when he can pot his variegated grasses on his balcony. The way they move, rustling in the wind, reminds him of his Scottish garden.
There have been good years, ones where Dave played The Who at decibels he shouldn’t. There have been medium ones-Beatles years. And there have been others so desperately dark that only Dylan and Paul Simon would do. This spring, Dave will turn 62. The number isn’t magical, but it is significant to him. “Every milestone I hit, every year I live, is a triumph.”