I now know for certain that my mind and emotions, my fix on the real and my family's well-being, depend on just a few grams of salt. But treatment's the easy part. Without honesty, without a true family reckoning, that salt's next to worthless.
It's difficult. I take a low dose of lithium nightly. I take an antidepressant for my darkness because prayer isn't enough. My therapist hears confession twice a month, my shrink delivers the host, and I can stand in the woods and see the world spark.
I've been accustomed to mysteries, holy and otherwise, since I was a child. Some of us care for orphans, amass fortunes, raise protests or Nielsen ratings; some of us take communion or whiskey or poison. Some of us take lithium and antidepressants, and most everyone believes these pills are fundamentally wrong, a crutch, a sign of moral weakness, the surrender of art and individuality. Bullshit. Such thinking guarantees tradgedy for the bipolar. Without medicine, 20 percent of us, one in five, will commit suicide. Six-gun Russian roulette gives better odds. Denouncing these medicines makes as much sense as denouncing the immorality of motor oil. Without them, sooner or later the bipolar brain will go bang. I know plenty of potheads who sermonize against the pharmaceutical companies; I know plenty of born-again yoga instructors, plenty of missionaries who tell me I'm wrong about lithium. They don't have a clue.
The uncomfortable, as well as the miraculous, fact about the human mind is how it varies from individual to individual. The process of treatment can therefore be long and complicated. Finding the right balance of drugs, whether lithium salts, anti-psychotics, SSRIs or other kinds of treatment can be a very hit or miss heuristic process requiring great patience and classy, caring doctoring. Some patients would rather reject the chemical path and look for ways of using diet, exercise and talk-therapy. For some the condition is so bad that ECT is indicated. One of my best friends regularly goes to a clinic for doses of electroconvulsive therapy, a treatment looked on by many as a kind of horrific torture that isn’t even understood by those who administer it. This friend of mine is just about one of the most intelligent people I have ever met and she says, “I know. It ought to be wrong. But it works. It makes me feel better. I sometimes forget my own name, but it makes me happier. It’s the only thing that works.” For her. Lord knows, I’m not a doctor, and I don’t understand the brain or the mind anything like enough to presume to judge or know better than any other semi-informed individual, but if it works for her…. well then, it works for her. Which is not to say that it will work for you, for me or for others.