Read an Excerpt

Chapter 1

Living with Bipolar Disorder



Is it possible to turn suffering into genuine human achievement? Nancy Rosenfeld now answers yes to this question, but it took her many years of struggling before she arrived at that answer. She was well into adulthood--married, with two grown children and a grandchild--before she truly understood the positive aspects of her illness.

Over the years Nancy often asked herself why life is unfair to people who don't deserve to suffer. In her search for an answer, she was introduced to Rabbi Harold Kushner, whose son Aaron had died from progeria, a condition that produces rapid aging, just two days after his fourteenth birthday. After Aaron's death, Kushner explored this very question in his book When Bad Things Happen to Good People. The rabbi wrote, "God gave me the strength and wisdom to take my personal sorrow and forge it into an instrument of redemption which would help others." In the wake of a personal tragedy, he discovered the resiliency of the human soul. Through strength and courage, Kushner rebuilt his life. Rabbi Kushner became an inspiration to Nancy.

Nobody is promised a life free of pain and disappointment, but our capacity for strength and courage enables us to survive even the greatest of life's tragedies. Although bad things don't happen for a good reason, Rabbi Kushner found meaning in the very experience of them. If life was free of pain and sorrow, we would have no way to measure and test our strength and to explore the outer limits of our capabilities. We live in an imperfect world, but we too are imperfect. Acceptance of our own mortality enhances the meaning of life and, as Kushner reflected, gives each of us the opportunity to be productive and to impact others, so we'll be remembered as having contributed to this world. Knowing that our time is limited gives value to the things we do.

Can those of us who are afflicted with bipolar disorder, a mental illness characterized by alternating periods of manic and depressive behavior, accept our own frailty and imperfections? Are we prepared to meet rejection from others who don't understand our issues? Can we assume responsibility for our disorder without using it as an excuse for our actions? Regardless of the pain dealt us in life, can we focus on the positive and minimize the negative?

Many individuals who have suffered harshly have learned to survive great losses and find new ways of living full and productive lives despite their misfortunes. How does one cope with shame and humiliation, a grave illness, a disabling accident, disfiguring surgery that involves the loss of body parts, or the death of a loved one?

You will discover that it is possible to transform a serious loss or human affliction, such as receiving a diagnosis of bipolar disorder, into a positive and meaningful life experience by understanding and mastering the principles of a positive mental attitude. The human mind is resilient and capable of reversing a negative situation even in the midst of pain and cruelty. By learning how to live again and overcoming seemingly insurmountable obstacles people can emerge stronger and more self-reliant, with new goals and a renewed purpose in life.

Paraplegics, who have lost the use of limbs, often discover the ability to lead fulfilling, productive lives. Others, who have lost their sight or hearing, gain a deeper sense of perception in the aftermath of their loss. Likewise, many who are afflicted with bipolar disorder rise above their illness by adjusting to new lifestyles.

A diagnosis of bipolar disorder, which is also known as manic depression, can leave permanent scars. People with the disorder feel branded or stigmatized. The illness carries a bad connotation; it sounds awful and can be frightening. The mere mention of bipolar, or any mental illness, can adversely affect relationships, summoning as it does visions of the most severe forms of emotional disturbance. At the same time, each individual has a unique personality that influences his or her attitudes and conclusions regarding a given diagnosis, so everyone reacts differently.

A survey conducted by the Depression and Bipolar Support Alliance (DBSA), the organization which Jan Fawcett helped found in 1986, concluded that over 1.5 percent of the adult population in the United States (more than 2.5 million people) suffer from manic depression.

Nobody is immune--young or old, rich or poor. People from all walks of life are vulnerable, and bipolar disorder has confronted high-profile individuals in all fields of endeavor. The revelations of these people clearly indicate that financial resources, status, gender, intellect, and even the devotion of friends and family cannot prevent the illness. In their candor they reflect exceptional courage and boldness, and their disclosures are gifts to those who feel they are suffering alone.

Many celebrated individuals have educated us, helping to reduce the stigma surrounding bipolar disorder, and supported those of us who believe we are outcasts feel less so. In addition, they have offered us hope that through openness and compassion we can more easily make sense of a mental illness such as manic depression. In this book, we will meet these people and discover how they have learned to cope with their illnesses--from unipolar depression to bipolar disorder. Here they candidly reveal their stories, specific symptoms, personal concerns, and reactions to being diagnosed with a mental illness.

JUDGE SOL WACHTLER: ON THE OTHER SIDE OF THE BENCH

One example of a powerful personality who suffered from bipolar disorder is Judge Sol Wachtler. Judge Wachtler began his government career in 1963 when he was first elected to the city council of North Hempstead, New York. Wachtler advanced to the New York State Supreme Court in 1968 and in 1972 was elected to the Court of Appeals, New York's highest court. In 1985 Governor Mario Cuomo appointed Wachtler chief judge of the State of New York and the Court of Appeals. In an editorial for the New York Times, Alan Dershowitz wrote, "Sol Wachtler was not a good judge . . . he was a great judge."

Just as Judge Wachtler was on the threshold of becoming governor of New York, a cherished dream, he became instead Sol Wachtler, federal prisoner, assigned to solitary confinement. How did this happen?

The story of Sol Wachtler is one of illicit love and clandestine meetings, compulsive behavior and drug abuse, rejection and deceit, shame and self-reproach, depression with an attempt to self-medicate, and the fear of stigma--of being branded mentally incompetent.

Although it was a reckless act of compulsive behavior that abruptly led to Wachtler's self-destruction and ultimate fall, the root of Sol Wachtler's problem was his bipolar illness. It wasn't until 1992 that Judge Wachtler finally received the correct diagnosis, but by then his unchecked illness had destroyed his professional career and his life.

Though he made a courageous comeback from the abyss into which he had plunged, he dismisses any sentiments regarding the achievement. "I don't feel as if I've reclaimed my life," Wachtler says. "I've got a long way to go, and it will never be the same as before. I will always have deep scars. Take, for example, the times I hear myself talking to my students about 'my' court. But suddenly I realize that it no longer is my court. It was my court for twenty-five years, but that's all gone now."

Five years after his diagnosis, Judge Wachtler went public in a book about his experiences, After the Madness: A Judge's Own Prison Memoir. In it, he maintains his dignity and sense of humor without excusing the actions that resulted in his arrest and conviction. Judge Wachtler's personal story can serve as a deterrent to others, as well as an inspiration.

There is no debating the pathological nature of manic-depressive illness. The disorder can unquestionably destroy lives, not to mention relationships. At the same time, the energy and the creativity that spills forth from this otherwise devastating condition can yield dividends for the afflicted and those who witness their lives.

In 2000, Judge Wachtler flew to Chicago for a personal interview with Nancy, Bernie Golden, and Deborah Bullwinkel.1 At that time, Wachtler was teaching law again, twice a week, at a small college in New York, while also working at a mediation firm, writing his next book, and traveling extensively to lecture about bipolar disorder and his experience. Here is Sol Wachtler's personal account of his fall from grace.

Judge Wachtler was incarcerated in September 1993 for harassing his former mistress. At that time, he was a walking time bomb and was placed in solitary confinement for two weeks under close observation. The second and only other time that Wachtler was confined to solitary was for his own protection, after he was stabbed by another prison inmate. Although Wachtler never condoned his deviant behavior, it is clear that his bipolar disorder and abuse of prescription drugs contributed to his wrongdoing.

"Don't misunderstand," said Wachtler. "Bipolar is not, and should not be, an excuse for criminal conduct. If someone afflicted with the disorder commits a criminal act, that person should be stopped or arrested before more harm is done."

Wachtler's eminent position in the outer world did not earn him special treatment in jail. He was subjected to all the forms of inhumanity prisoners endure, including strip searches. During imprisonment, what he longed for most was privacy and freedom. "This loss was far greater than power or prestige," he said. "Prison was tough. Everything and every day was a constant reminder that I was a prisoner behind bars--the guards, the keys, mail call. At one time I considered suicide but quickly ruled it out as a viable alternative. Suicide takes courage, but I had none."

"It took more courage to live," observed Nancy.

"Perhaps. But I was stuck in the here and now, and with no future image. I saw nothing beyond life in prison. Days were endless, and each seemed like eternity. All thoughts were negative. I worried about what I'd do when I got out and how I'd make a living. I was also a patient in the mental health unit, and the treatment there was deplorable." Wachtler credits Prozac with keeping him going during his thirteen-month incarceration.

After his release, Wachtler had to contend with the public opinion of his actions. "Subtle things happened which were hurtful," he said. "For example, as former chief judge of New York I was invited to attend the presentation of an award to Ruth Ginsburg, a justice of the United States Supreme Court. Before the actual ceremony, recognition was extended to all distinguished former recipients of that award who were in attendance. I listened and waited, but my name was never called. I checked the program, then discovered that it had been omitted from the list."

"As if you never existed," said Deborah.

"Yes. Like a blot in history that was simply erased," he replied. "Around the same time, Mike Wallace invited me to do a segment of 60 Minutes, but I declined."

"Why?" asked Nancy.

"He can be very rough," said Wachtler.

"What about your relationship today with Governor Cuomo?" said Nancy. "I know the two of you had been friends for years, but the friendship disintegrated and you sued him."

In 1991, Judge Sol Wachtler had filed a summons and complaint against Governor Cuomo in Wachtler v. Cuomo. The governor had threatened to cut the newly proposed budget of the state court system, which Wachtler had submitted to the legislature. At that time, Wachtler felt he "could not permit" Cuomo's budget cuts because of the damaging effect he believed they would have on the court system.

"There's been a warming since then," said Wachtler, with a smile. "Just two weeks ago we lunched together, and Mario confided, 'Once you sued me, I knew you were crazy.'"

"How did you view your illness?" inquired Bernie.

"Bizarre," said Wachtler. "But at that time I didn't consider my behavior strange. I thought they [others] were bizarre, not me. 'I'm not talking too fast,' I'd say. 'You're listening too slowly.' Looking back, I don't see how I could have entertained that thought pattern. It's incomprehensible."

In his memoir, Wachtler sums up manic behavior and the unrealistic overconfidence and grandiosity that accompany full-blown mania: "Have a speech to deliver? I don't have to prepare--my head is full of the world's greatest speeches--just give me a platform."2

On the other end of the spectrum, he describes his state of mind at the height of depression as like the inner surface of an abyss. The physical manifestations of his depression included loss of appetite, constant weeping, sleeplessness, and fluttering in his stomach.

Before his diagnosis, he had convinced himself that he was suffering from a brain tumor. An MRI (magnetic resonance imaging) scan in 1992, however, revealed not a tumor but a mass of unidentified bright objects (UBOs) in the right parietal region of his brain. The discovery of UBOs, as Kay Jamison reveals in her book, An Unquiet Mind, heralded the scientific conclusion that bipolar disorder is a biological condition involving changes in brain chemistry (see chapter 3).

"It's important for anyone with mental illness to recognize the need for professional guidance before behavior turns antisocial," cautioned Wachtler. "Not to seek help is foolish, stupid, and terribly destructive. My wife, a trained certified social worker, pleaded with me to get counseling." Wachtler eventually did, and Prozac freed him. "Had I accepted my wife's advice earlier, today I'd be governor of New York."

Wachtler resisted psychiatric help because of the stigma society imposes on those who "seek to remedy a defect of the mind." He recalled the lesson of Thomas Eagleton, the former U.S. senator and 1972 vice presidential candidate who was dropped from the ballot after it was leaked that he once received psychiatric treatment.

Psychotherapy helped Wachtler, and he still sees his psychiatrist regularly. "I'm on a maintenance program, but I also self-assess. I measure what I've done and how I've done it. For example, am I speaking too rapidly? I keep a reality checklist." Wachtler takes long walks for physical exercise, which also helps regulate his mood. Only now, looking back on the behavior that resulted in his public disgrace, can Wachtler see how out of control he was.

"I didn't realize the absurdity of my actions toward her [his mistress] until after I started on Prozac. I had low-level depression and mania prior to the relationship, but I was unaware of how ridiculous it was until later. Then I was helped to make sense of why I had sought out the relationship in the first place. I remember my wife's comment once that if ever I had an affair she didn't want to know about it. But then she read about my affair on page 1 of the New York Times."

"Do you worry about depression returning?" asked Bernie.

"Constantly. As soon as I see it happening, I return to the doctor so he can adjust my medication."