Oh the damage I’ve done. Bipolar disease is a mental illness, no question. But it does have physical aspects in many ways. The mental facet does have chemical, physical causes. The chemical imbalances and the way that the brain function works are definitely a root cause of this illness. That’s why the medications work the way they do. Antidepressants raise serotonin or dopamine levels. Anti-epileptic medications change the way that the synapses fire in the brain and for some reason acts as a mood stabilizer. Admittedly though, it’s called a mental illness for a reason. It may have a physical cause, but the results are definitely emotional.
But that’s not what I’m talking about. I’m talking about the physical effects on the body that come from being bipolar.
Depression has had its effects on me for sure. When I split up from my last wife, I couldn’t eat at all. Part of it was because I was unemployed and broke, but it was mainly emotional. Even with food in the house, I could not make myself hungry or force myself to eat. In just a matter of a few months I lost almost 50 pounds! I’m not a big guy to begin with, and 50 pounds is more than significant. I became skin and bones. My waist and muscle mass got so small that I couldn’t keep any clothes on, and I had to go to the boy’s department to find anything that fit. I had a 29” waist! I remember going on a job interview one time, and being so embarrassed that I had to cinch my belt so tight to keep my trousers on and how my suit jacket hung on me like it was 4 sizes too big. And it was 4 sizes too big.
Mania has had its own impact on me too. My mania’s create an enormous amount of energy, and I’m sure generates a huge adrenalin surge. And the mania’s can last for months, keeping the body functions in high gear constantly. In fact, a few years ago I was hospitalized with what was ultimately passed off as a heat stroke. I was working in an extremely hot environment, and in some ways it did look like a heat stroke. In the hospital however they couldn’t find any evidence that is what really happened. My electrolytes were fine, potassium levels were normal, sodium was fine; yet my body was shutting down. My heart rate dropped to under 30 bpm, respiration’s were 10 per minute, and one by one my organs were shutting down. I now believe that I was suffering from an adrenalin overdose. I had been in a manic rage for weeks and weeks; an uncontrollable rage and boundless anger. And I think that after all that adrenalin my body just said ‘enough’. I’m sure that all those stimulants have to be damaging to the internal organs. The body has a way to protect itself, and I think that’s what happened. My body shut down to keep from burning out.
But there’s another physical side to mental illness too; the self inflicted ones.
Sometimes the damage was a side effect of the emotional state; particularly the rages. I’ve put my fist through walls, slammed my head down on tabletops, even punched a steel door so hard and so many times that I dented it. There’s no telling how many times I’ve broken fingers that way. That’s not intentional though, it’s a byproduct of the mood.
Then there are the times when it is on purpose. I have had times where I deliberately tried to break something. I’ve repeatedly hit my hand with a hammer as hard as I could, leaving deep bruises but fortunately never actually breaking anything. Sometimes the punches were intentional. I’d find a place where I could lash out where it would hurt but not do any damage to the target of my actions. I’ve banged my head against walls, slapped myself, and run into closed doors just to release some tension and anger.
And I’ve cut myself.
Oddly enough, that didn’t start until about the time I was diagnosed as bipolar in my early 50’s. I think the first time I did it I carved a “V” into my chest. I have no idea why I chose that letter, but there it was. It wasn’t deep or anything; more of a scratch really. In that particular case I don’t even remember what prompted it; I just did it.
But it got bad when my ex and I split up. The pain I had was just too intense to endure, and I had to find some release. So I would spend hours cutting into myself with a razor blade. I was not a slasher; my cuts were slow, repetitive and deep. I would go into the same wound over and over; getting deeper and bleeding more severely. I wasn’t generating a lot of red blood, it eventually came out so dark as to be almost purple; arterial blood I think. And it took a long time to stop bleeding too; sometimes a day or more. So why did I do that? What was the motivation or hoped for result? I think the answer is twofold. One, it was a distraction. I was not only agonizing about my situation but I was unemployed and isolated 7 x 24. That’s way too much time to think, and no way to get away. Focusing on the process of hurting myself, then dealing with the resulting wound kept my mind occupied on something else besides the intense pain. But it was more than that I think. I was so overwhelmed with emotion I needed a way to convert that into something tangible. I was feeling a pain that was physical instead of emotional. The bleeding was physical evidence to the pain. It wasn’t a way to get attention or sympathy either; I was alone, and the sites I chose to cut were hidden under my clothing. No one, not even my therapist knew. It was my own personal hell.
Now, I don’t believe that self harm is a symptom of just bipolar illness. In fact, it may have nothing to do with it at all, but come from another disorder or condition totally unrelated. I do know that there are plenty of people who do this that aren’t bipolar at all. I definitely have more going on than just being bipolar, so who can say what drives me?
The intense emotional pain one feels is much like steam pressure in a boiler. It can build and build until it’s at the point of exploding. But like that boiler has a steam release valve; we find other ways to release that pressure before getting completely engulfed. That release might come from lashing out in anger, abusing alcohol or drugs, even through positive activities such as running or exercise. And sometimes it’s an active choice; a choice to hurt ourselves.
Like suicide, I’ve often heard that cutting is just a cry for help. And I’m sure that is the case many times. But I don’t believe that’s always the reason. I know I went to great lengths to hide my evidence, and never, ever admitted it to my therapist or doctor while it was going on. It was my safety valve.
Don’t believe for one minute that my explanation is acceptance or encouraging this behavior. I absolutely do not condone self harm under any circumstances. Not only are you damaging you body in ways that may never be recovered, but open wounds are susceptible to diseases and infection. Broken bones may cause permanent damage and disability. It’s called ‘self harm’ for a reason; it’s harmful! And it may seem like it helps at the time, but really it’s just a way to avoid the real problems. It’s a symptom, and a very unhealthy and dangerous one. Don’t do it, Get help! It’s just not worth it! Ever.
Part of my healing and maintenance of my disease is admitting to myself that I’m in that kind of trouble, and seeking professional help. It’s been years since I’ve had any urges to hurt myself, but the last few times I did, I went to my doctor before I acted out on them, and dealt with the real problems before they got to that point. It’s a difficult thing; but every aspect of mental illness is difficult. It took years and years for me to accept that I was bipolar and follow a treatment plan. But eventually I did, and I’m as healthy as I’ve ever been, with every reason to believe that I will continue to be.
Physical effects such as these can have lifelong consequences. The strain on the organs, the fluctuations in weight, changes in blood sugar, and the scars can be permanently damaging. I certainly have my share of scars, inside and out. The scars inside, both emotional and physical are not good, and I’m committed to do all I can to control it and limit further damage by staying true to my treatment. The same is true with the visible ones. But, for me anyway the results of self abuse and harm are the worst of all. In a strange way though, I’m proud of them, for they show I’m a survivor. I’ve been through such terrible times that I had to resort to intentional injury, yet here I am; I’ve persevered and overcome. But really, the best way to deal with self harm is to never let myself get to that point where I just can’t help myself. It may seem effective, but there are many more ways to cope.
I believe that self inflected pain is a physical manifestation of emotional pain. And the best way to prevent that is to deal with the emotional pain before there’s a need to cause self harm. Ultimately self harm solves nothing, and at best only provides a very temporary relief. I’m healing, growing stronger, and getting better at conquering my disease very day. I’m determined to never, ever let myself get to that point ever again.
I have enough scars already.