Moments of Decision - Pt 2

Originally published in Blog Them Out of the Stone Age on April 14, 2005

I have Bipolar Disorder : what used to be called "manic depression."

I was diagnosed with the disorder in September 1986, shortly before my twenty-seventh birthday. I have since concluded that the actual onset of the disorder most likely occurred almost a decade before that, in the winter of my seventeenth year.

Friends, colleagues and, indeed, almost anyone who has ever met me face-to-face will be unsurprised by this information, since from the outset I made the decision never to act as if I were embarrassed or ashamed to have the disorder. Close friends also know that I have long been looking for the right moment to "go public" with this information. I myself have known, since the day I began keeping a blog, that one day I would be composing this post. On the whole, I am surprised I wound up waiting as long as I have.

The principal reason for waiting is that while I figured I would go public with the news in this medium--and by go public I mean to share this information with people whom I cannot look in the eye as I do so and gauge their reaction--I wanted the focus of the blog to remain unchanged. My principal concern continues to be to assess the prospects of military history as an academic field. It's simply that I wish now to introduce the "canon of military history" as I have experienced it personally: a very rich set of metaphors by which to manage and survive the inevitable struggles of life. True, I could use other examples, but to do so would feel so much to me as if I were dodging the most obvious example that I would be violating my first rule concerning the disclosure of my having bipolar disorder: when, within a given context, the most direct response involves acknowledging the disorder, always acknowledge it.

Acknowledging it, however, turns out not to be the same thing as accepting it. The rest of this entry was composed in November 1997, a day or two after my return from a weekend staff ride on the Antietam battlefield with officers and cadets from West Point. (If you read Starship Troopers, Civic Virtue, and the American Civil War you will be reading an essay that I dashed off in twenty minutes, gave improvisationally to a group of thirty plebes who cheered me at the end, and then revised into present form all while hypomanic . As you'll see, initially I failed to make the connection between my mood and the manic episode in 1986 which led to my hospitalization and diagnosis. But look at my choice of wording and examples when I finally, reluctantly, did make the connection. You'll begin to get an inkling of the ways in which I routinely use combat as metaphor.

Moments of Decision - Pt 1

Originally published in Blog Them Out of the Stone Age on April 13, 2005






Bullfight critics row on row
Crowd the enormous plaza de toros
But only one is there who knows
And he is the one fights the bull.

-- Translation by Robert Graves of a poem by Spanish matador Domingo Ortega

(Photographs by Lester Silva)

Part 1 - Part 2

What This Blog Is About

I have bipolar disorder -- specifically Bipolar I. It was diagnosed shortly before I turned 27. However, the most likely time of onset was the winter of my 17th year. I've always made a point of being up front about having the disorder. For instance, I'm a college professor, and when appropriate I've disclosed it to my students. I've talked about the disorder with undergraduates in a psychology course and have written about it from time to time, most notably in a column in Inside Higher Ed entitled "An Inappropriate Illness," which appeared in September 2006. I've also discussed it on my principal blog, Blog Them Out of the Stone Age (here abbreviated BTOOTSA), which is devoted to academic military history and national security affairs but which occasionally addresses bipolar disorder (as well as battle stress injury), under the category "Facing the Demon." Which of course inspired the title of this blog. For the sake of convenience I'll republish the relevant posts here. If nothing else, that will save me a lot of repetition.

Over time I've discovered that it helps others as well as myself to be candid about having bipolar disorder. If in a large lecture course I have over two hundred students, then statistically two of them have been or will be diagnosed with the illness. Indeed, in the past whenever I've disclosed that I have the disorder invariably one or two students approached me afterward to talk about it, because they too had the illness. Usually they felt rather isolated. They found it difficult to discuss the illness with others or they had trouble feeling understood. They also wondered about its implications for their future. Would they be able to lead a normal life? And usually they had questions about how best to manage the illness. The same thing has happened with adults as well.

A few days ago I posted the following on BTOOTSA:

If you scroll down far enough on the sidebar of this blog, you'll find a section labeled "Twitter Updates," thanks to a widget I installed a few days ago. The question is, how does this relate to military history?

As long time readers of the blog are aware, I have bipolar disorder. The subject is covered in the category "Facing the Demon," along with battle stress injury -- not because I think the two are identical: one is an illness, the other an injury -- but because both require management and both carry a perceived stigma that requires a degree of courage to address. In my own case, I was diagnosed with bipolar disorder when I was twenty-six and have probably had it since the winter of my seventeenth year. It took a long time to come to grips with it. Until I was thirty-seven I didn't fully accept the reality of the disorder -- that it was something I had and would always have and that it needed to be managed precisely as one would manage any other chronic illness, such a diabetes, which in some respects it resembles. Both are abnormalities in one's biochemistry.

In the years since, I've gradually become conscious of the fact that in dealing with the illness I instinctively draw upon a number of concepts derived from a lifetime steeped in military history, strategic studies, and my own modest military experience. The most basic insight derives from Clausewitz: "In war, the best strategy is always to be very strong." This translates metaphorically into identifying as using as many tools to combat the illness as I can. Many of them are predicated on a crucial decision I made as soon as I received the diagnosis; namely that I would acknowledge it openly. As I've written elsewhere:

People often think that because I’m so up front about having bipolar disorder, that being candid about the illness must be an easy thing for me to do. In fact, it scares me. I’m up front about it only because I’m convinced that candor is better than the alternative. Being open with my colleagues, for example, populates the department with observers who have a decent chance of identifying unusual behavior as an artifact of the illness rather than erroneously attributing it to something else: simple high spirits instead of hypomania, for example. It enables me to ask for help when necessary without having to explain the illness from scratch. And it gives me a chance to combat, in a small way, the stigma that still attaches to mental illness. If a professor protected by tenure cannot summon the modest courage required for such an act, I do not know who can.

So where does Twitter come in?

I've decided to use this social utility as a way to discuss the illness, not abstractly, but as it affects my day to day life. (The updates, by the way, appear not just on the blog but are immediately cross-posted as a status update on Facebook.) Since I find the prospect of doing so a bit daunting -- it is one thing to state publicly that I have the disorder, quite another to state on a given day that I'm depressed -- I've begun with something reasonably safe: namely to keep public track of my workouts at the gym (and other forms of exercise). This has more to do with bipolar disorder than one might suppose. Coping with bipolar disorder involves more than taking medication. There are things one can actively do to manage the illness, among them getting enough sleep and getting enough exercise, which releases beneficial endorphins.

So announcing each trip to the gym is not based on vanity or the assumption that people are fascinated with the mundane details of my life. It's the early stage of what I expect will be a larger experiment in publicly sharing the experience of managing bipolar disorder, partly as a means to expand my network of support, but primarily to model in practical terms how one goes about it, and to treat the illness as one would any other: not something of which to be embarrassed or ashamed but a simple fact of existence.

It would distract from the main purpose of BTOOTSA to constantly inject posts about bipolar disorder, but without supplying context the near-daily announcement that I'm going to, or have returned from, the gym would seem banal. Consequently I've created this blog in order to supply the context.

Mood Watch - 47

Still OK. The only thing I’ve noticed is that between last Friday and Monday, I felt rather sluggish and tired. I wasn’t in poor spirits and I was getting plenty of sleep, but somehow I never felt rested. Just prior to that, however, I was just the opposite: more energized and focused, and although sleeping sufficiently, was wide awake as soon as I got out of bed.

In both instances, the differences were such mild departures from “normal” that, were it not for the knowledge I have bipolar disorder, I doubt I would have noticed them at all. Still, when managing this illness, it never hurts to keep on your toes. In fact, it’s foolish to do anything else.

Mood Watch - 46

My mood continues to be good these days. Only caveat (and there always seems to be one) is that for the past couple of nights I have slept less than usual — maybe 3.5 hours/night. I was able to break that emerging pattern, though, by increasing my sleep medication to the maximum allowed by the prescription, and by working extra hard to maintain what is artfully known as “good sleep hygiene.”

As is so often the case, in recent weeks I’ve been in touch with three people, two of them undergraduates here at OSU, who sought me out because they have bipolar disorder and have felt they have know one in their lives who understands the disorder, or, at least, understands it from the inside. Talking with such people always makes me feel as if I’m doing something worthwhile, and I’m proud to have the chance.

Mood Watch - 45

I had a change of meds almost three months ago and by and large, it’s improved things greatly. My one caveat is that in early February I had a couple of anxiety attacks that initially presented as something like the flu, because the main thing I noticed was a lot of nausea — in fact at one point I actually vomited.

Once I caught on to what was really going on, however, I took 2 mg of clonazepam (the generic equivalent of klonopin), followed by 1 mg each day for the next couple of days. I was amazed by how promptly and completely that took care of things. Which just goes to underscore the fact that, despite the stigma that clings to it, this is a biochemical illness.