Essay: Mood Disorder

Updated: Nov 9, 2021

Michael K Laidlaw About 3 000 words

#406 3524 31st NW

Calgary, Canada T2L 2A5

Email: 4451moana@gmail.com

Mood Disorder


by


Michael Kamakana

I suffer bipolar symptoms from organic brain damage, or at least this is the last diagnosis I recall, this is the last description I readily agree to. I know from the brain injury I have brain damage, though after clarity of the coma, certainty of near-death, exactly what this damage is has not been clear. Perhaps I have just misunderstood or understood selectively or there have truly been several, changing or evolving, apprehensions of what is damaged in my brain and what to do about it and what I should be expecting. I have decided some time ago to let the professionals assess and consult and suggest or insist on treatment, which hasmeant years, then decades, of various medication regimes. I have decided this because I do not trust my own perception, as someone inside burning house may not see the best way out, so I do not keep track, cannot name, know not even the family of, many of the drugs prescribed. I know the family of ‘SSRI’s that I think are supposed to deal with my depression but only seem to make me more depressed and certainly kill my energy, my libido, my sex drive. I seem to have been on variations of SSRIs for many years, though surely such is my internal sense of time rather than calendar, surely that they are not working is something I mention, something that is changed, though then again I have been negligent in reading up on what this should result in. I trusts professionals. I do not always trust myself...

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I suffer bipolar symptoms from organic brain damage, and perhaps this fact my disability have clear, readable name, should comfort me, but mainly I break it down poetically and ask myself what each aspect names, ‘bipolar’ well yes I have heard of those psychological extremes of ‘manic’ and ‘depressive’, ‘symptoms’ well sometimes medicine can only control symptoms and not offer cures, ‘organic’ well that is biological material, ‘damage’ well neural tissue do not, yet, I undestand, heal... so as years pass I have become familiar with the term...

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I suffer bipolar symptoms from organic brain damage, though the ‘bipolar’ aspects do not seem very new or necessarily connected to any injury, any brain damage, as I have often swung wildly between depression and manic excitement, when thinking and creating art of any sort, respectively, though for most of my adolescence I suffer ‘low-grade depression’. This is the diagnosis in retrospect, as mostly I seem to have successful if moody years unmarked by teenage adventures in alcohol or drugs or violence. I do well in school, academically and socially, never worryof my marks, makes both an academic trivia TV team, something like Jeopardy, and the basketball team, have friends etc After graduation I have trouble somehow in ‘growing up’, that is, assuming adult responsibilities and actions, but manage to push any reckoning back by first attending University then living with girlfriend then living in far Montreal, when I return I goes to a psychotherapist and this is very helpful but at the time of my injury I am on antidepressants, I pass through the coma, I survive. After the brain injury I am disabled as some people, on waking from the coma unable to stand let alone walk. I retain clear memories of once being moderately coordinated and at first this disability, this ‘physical challenge’, seem an error of which I have had some role, some moral responsibility, some fault, and this presumption that there must be some parallel between result and cause, something I have done, is commonly voiced by many who now meet me. If I fall down the stairs, if not car accident, am I drunk, am I intoxicated, am I etc. If I have a brain injury am I on drugs, am I drunk, am I intoxicated etc. If I have an aneurysm how is it possible it comes out of nowhere, are there no symptoms, are there no warnings, can you not get to the hospital etc. I prefer to say ‘aneurysm’ rather than ‘contusion’ for if caused by a blow to the brain within the skull, what is the blow that causes it, if falling down stars, well why did I fall down the stairs. There is of course no certainty, there is no witness, to my brain injury, and by nature of the injury I have no memory of it. I am told by nurses and doctors and therapists that cause is not relevant, for the result is all the same, the result is something I must work on very hard, the result is ‘closed-head brain injury’, that is, there is no wounding object introduced to the brain but it is just brain against braincase. I learn over time to accept this diagnosis...

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I suffer bipolar symptoms from organic brain damage, and this is perhaps not clear during the years in rehabilitation and in fact worries some professionals with my unreasonably positive emotions, such they worry about areas of the brain still injured beyond their first appraisal, but in fact I am simply very happy. I have something to do, I have physical project, have this disability to measure against ability etc. Here I discovers the limits of my disability, the possibilities, and the challenges. Here there are other disabled but soon the offered volunteer class is not enough and I wants to come five times a week rather than two, and this is possible. I stationary cycle, I row, I stairclimb, I do cable weights. I have found physical project which have no confusion or doubt of value, which in fact is of great value to me at this age, for I am twenty-five years ten months when injured and at loose ends for purpose. After the brain injury I do indeed seem to have this purpose. I must walk again. It is after I leave the regimented and comforting security of the rehabilitation hospital, after months living alone, under the stress of returning to University, that I go the first time to the Psychiatric Ward, this time for about five weeks, and this is when it becomes clear my brain is injured and I am not entirely well...

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I suffer bipolar symptoms from organic brain damage, but what this means is never unambiguous. I trust professionals. I do not always trust myself. I am sometimes correct and sometimes mistaken in these judgments, for generally doctors are perceptive and know what meds to order but then they can only respond to my self-reported psychological states, which are generally truthful but also skeptical, as I refuse to believe my mind is simply mass of chemical and/or electrical interactions, then also, one way in which I am correct not to trust myself, I have for many years ongoing difficulty in following directed order of medications. I will discover I can miss one day, miss two even, but when I am having trouble sleeping it is useful to check, whatever my memory says, if indeed I have taken the meds. I do much better when I discover how to have meds only once a day. This irregular pattern combines with some uncertainty as to which meds and what dosage is called for, and the fact medication regimes must be spread out in time so each is measured at full strength, rather than as conflicting with previous meds, to cause the process of finding the correct treatment slow, seeming over years and not months, frustrating and bringing more skepticism. I trust professionals. One time it is a mistake to trust professionals, is when one doctor believes I am altering and trying out various meds on me and it is the pharmacist who alerts me the doctor is repeatinghimself, though here it is the professional pharmacist I trust, though again I am doubting myself for letting the man apparently sleep through our infrequent appointments, wondering if it is my fault that I want to not need meds so like that the other do not see me needing any...

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I suffer bipolar symptoms from organic brain damage, though considered relative to what could have been brain-damaged, I consider myself lucky. Aside from ‘higher level executive functions’ that could have rendered me more vegetable than animal, I could have been made blind or deaf or had my memory severely truncated, though most of the damage is physical, that is, as I am what is called a ‘hemi’, that is ‘hemiplegic’, one side of the body is of normal coordination, in my case the left, and the other is injured and of lesser coordination, the right, so I may no longer run or play sports etc. I do not like to think of the ways my vision and hearing and memory have been compromised by the injury. I am uncertain what ‘bipolar symptoms’ means and it is only through years I come to accept this is actual and not something I can fix by just thinking a certain way, though when I see others diagnosed with the same, I want to protest, want to insist, that I am I- specific, individual- and not some human probability of anonymous ‘patient’ or worse, ‘client’. I want someone to understand this. I decide that relevant professionals see evidence according to that sort-of-Kantian scheme of ‘synthetic a priori judgment’, that is, according to how evidence fits in relevant causal categories, relevant psycho-pharmacological orders, where the point is to bring brain chemistry to health before worrying about thoughts of that brain. And for me, as writer, as subject, there is no clear distinction and in fact such attempt to make distinction might be part of this error. For I never like the term ‘mood’ until I read Heidegger and I realize ‘mood’ accompanies all life experience, all attitudes, but is that how poetic precision is used here, is it clear this is more my existential core than my fleeting ephemera... on the other, unlike some coma survivors, I show little sense of intensified awareness of mortality caused by near-death but rather, despite being surrounded by death, by dying, by hospital life, I have assumed contrary pose of immortality. I do not seem to be affected by that ‘finality’ said by existentialists to ensure meaning in our human lives, rather I renew my writing projects with further complications and endless rewriting and it is only decades later, when moved to organize my drafts, that I see it has always been the first few drafts that are best and came closest to original impulse, are the drafts I should have sent off to editors, though of course I do not have an editor. I am writing but not moving to publication, obsessed with abstruse and experimental literary qualities not of much interest to anyone, say my mother, and only abstract to my father. When I am finally published this is because my father expresses how much I would like to see me in print, my father offers to help send my work for publication, so over four months I write my book in three or fourteen drafts. A literary small publishing house at which the wife of one of my father’s former students edits, accepts my work, despite being assessed as ‘science fiction’, and in the coming year it is published. Unfortunately by this time my father’s Alzheimer’s have so degenerated he cannot read it more than a few pages...

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I suffer bipolar symptoms from organic brain damage, and recall that after the coma my father had warned me I had ‘an early midlife crisis’, by which he means ‘things will never be as you dreamed as a kid’, which I decide is probably an accurate portrayal of my health, my future, though I am not reconciled to this state. I am very happy when I am learning to walk again, when my energy, and persistence, even anger can be applied so directly and obviously. After the first time in the Psych Ward I find there is no such clear goal and I flail around unable to accept my disability, or rather paranoid that everyone else have decided I am hereby disabled and I should just adjust or accept or be realistic about my limitations. At first I can understand this, for my physical disability is clear and not leaving any time soon, but in hindsight I wonder if I should have done more therapy, if I had given up too early, if I had not truly tried hard enough. My father even suggests once that we go to tai chi together and I will learn to move smoothly, but my father leaves the planning up to me and seemsto forget I cannot simply telephone for appointment let alone drive to the gym, so nothing comes of this. I will wonder if allowing other people to do things for me has not been lifelong deficit, that I have yes always accepted less rather than strived for more, that for some reason I adjust to limitations rather than tries to ambitiously overcome, that I observe and adjust rather than fight tochange situations. I do perhaps decide without consciously deciding or agree without consciously agreeing that indeed I have ‘an early midlife crisis’, by which I means ‘things will never be as I dreamed as a kid’, and do instead my best to be a good ‘rehab’ patient, which means, again, I will trust professionals...

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I suffer bipolar symptoms from organic brain damage, when I am almost twenty-six, I am in the hospitals two years relearning to walk etc. before the coma I was in University for three years, lived with my girlfriend for two, lived in Montreal for part of one, but after the coma, in my thirties, events slow down considerably, for in the interests of rehabilitation I attend a brain injury program on the far side of the city and begin to read, begin to write, begin to stall... in fact, my thirties seem blank after my twenties, in which many things happen, as I believe I should be building my career but somehow this is not happening. I have one consistent companion whom I meet at the hospital, but then several others not consistent, not long-lasting, not meaningful, that I do not sometimes even remember how met, but the main frustration is I feel I should be somewhere, I should be writing, I should be published, but I am doing nothing in this direction. I am yes writing but it is over and over and who knows how worthwhile. I am yes in and out of the Psych Wards. I am yes in and out of beds, hers and others, but I do not love her and certainly not the others. I feel I should not even bother with the brain-injury program but at the moment have nowhere else to go. I suffer again low-grade depression. I am moody...

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I suffer bipolar symptoms from organic brain damage, and this is persistent injury, not something readily or gradually fixed as broken leg or rupturedtendon, something that will inform my way of life, my being, for the foreseeable future. I am hopeful, or just willfully ignorant, when I wake from the coma and everyone seems so positive and encouraging, that maybe some kind of medical ‘miracle’ will contradict their reasoned diagnosis and expectations, but the store of miracles seems to have exhausted itself in bringing me through the coma. I am, assuredly, lucky to be alive, lucky to have survived the coma so well. I am able to accept this as positive outcome through my gradual physical rehabilitation my learning to walk again etc, but as the years pass such remarkable survival seems too often an incomplete state, some error of which I have had some role, some moral responsibility, some fault, and this presumption that there must be some parallel between result and cause, something I have done, is commonly voiced by my internal thoughts. As years pass, I find crossing the city to the brain injury program too annoying for what I get out of it, though later I try to remember if I did ask for their help, any help, at getting my work published, but I think I did and am told they do not know how to help and it is up to me. And my father, do I ask for help, I do not remember, only that my Aunt gets an early draft of my injury and rehabilitation which is in retrospect far too much journal and not story, so I never follow it up either. As years pass I have become convinced perhaps I have always been in error, I have thought I could write but in fact I cannot, I have thought I wanted to write but no there are other things I want to do, which are now too late, for which I am now too old, and this is in my thirties. As years pass time seems to speed up and soon it do not seem possible but it is ten years of nothing since the coma...

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I suffer bipolar symptoms from organic brain damage, and I have in some way given up aspirations I once have to be a writer, or bury these aspirations under daily routine no more exciting than now regularly attending a coffeehouse that is run also as a mission for a megachurch, where I read, now committed to writing and constructing some deconstruction of an epic fantasy series of novels, though again I have no editor and no publisher and no clear future for this work. One day this routine changes when I chat up a shy young woman on the bus, when I charm her, and this is the beginning of brief, intense relationship, loving relationship that would probably have led to marriage had she not died, but she does die, time flows on, loss gathers, and this is just another reason for again low-grade depression...

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