OK, so. December.
Riley is hospitalized, in so much pain that whispering hurts his head. They had the poor kid pumped full of everything in the kitchen sink, all in an attempt to get the pain under the control.
And then Jake called: he was in trouble again. Big trouble. He had made such bad decisions, his actions so foolish and damaging that his future was now at risk. It took many conversations and much sending back and forth of documents for me to get to the bottom of what he had actually done, and I was shocked by the depth of his bad judgement. There was no logic to Jake’s actions. None. Only someone very, very unintelligent or someone very out of touch with reality would think they could behave this way and not suffer terrible consequences. Jake might have become someone I didn’t recognize: dishonest, angry, unethical, arrogant, and aggressive, but he is definitely not unintelligent. And then is when it hit me: I was seeing mania.
This mania didn’t look like the mania I’d always heard of. It wasn’t sky-high euphoric good-time crazy. Jake was more like a machine running too fast and hot, churning out oily, acrid, smoky clouds of hostility, agitation, and bad judgement. A quick internet search provided me with a precise list of every behavior I’d seen for the last eighteen months, and a name for it: dysphoric mania.
I sat in the dark hospital room with Riley sedated next to me, shocked by my realization and appalled that I had missed something so obvious. With close family members who are bipolar, I knew to watch for this in my children, and yet I didn’t see it when it was right in front of me. To have one of my boys end up carrying the heavy burden of bipolar disorder has always been a parental fear of mine, but now it seemed almost a relief to know there was a name and a reason for Jake’s behavior. He wasn’t really all the things he had seemed to become, he was just very sick, and the real Jake was still in there somewhere.
I called Jake to ask him if he would consider that he might be bipolar. After a few moments of quiet, he said, “I think I might be,” and started to cry. When he had returned to UNC in the fall he had begun counseling, and Jake now told me that his counselor had questioned this, as well. Within days I pulled Jake out of Chapel Hill and brought him home.
Confirmation that we were on the right track came with Jake’s first dose of mood-stabilizer. After the medicine knocked him out for the better part of twenty-four hours, Jake awoke and said, stunned, “My head is….quiet.” Over the next several days Jake’s dosing schedule was changed, briefly causing the mania to return one evening. After having a short break from mania, its abrupt return sent Jake into a panic. He likened it to every radio and every television being turned on to every station at top volume in his head, all at once.
It’s been a very long six months, and cycling through medications to find the right medicine and dose has been horrific. We’ve had manic Jake, zombie Jake, deeply depressed Jake, irrationally angry Jake. Now have our old Jake back, and things are getting better around here.
He has agreed to live at home until he is stable for at least six months, and true stability just began about a month ago. He has agreed that when he does return to school, it will be to a school near a family member with whom he can check in on a weekly basis. He’s running again, he’s attending support groups, he’s rolling with the unpleasant side-effects of medications, he’s working to build habits which will allow bipolar to have as little negative effect on his life as possible.
He’s also dealing with deep shame and trying to come to terms with his behavior while manic, and all he’s lost because of that. I wish I could wash that shame away, and I ask him to please remember how it felt that evening at the beginning of his treatment when the mania came flooding back. That, I tell him, was not a brain anyone could control. If this was a genetic bullet you were going to take, I tell him, then it is better that you took it now before you had built a whole life to destroy.
For my part, I feel as if I should have known sooner, and thus prevented the worst of his life path-altering behavior. I gave this genetic burden to him, and then didn’t see it when it presented. I feel like I should have known. For my sake–because this is killing me– Jake has allowed his Dad and I to help him untangle the mess that occurred during mania. While Jake felt he should not have help and should take the full consequential hit for his behavior, I see it differently. He might not get handed a Get Out Of Jail Free card, but he was a 19-20 year old kid away from home and suffering through the onset of major Bipolar I, and he deserves compassion. Everyone involved in this untangling seems to see it the same way that I do, and I am touched by the compassion of an institution as large as UNC Chapel Hill.
Jake has handled this with such honesty and grace, and I cannot imagine I would have found similar strength within myself to hold such a burden at the age of twenty. I am so proud of him.
Silliness and laughter are returning to our home, in part because Jake is our Jake again. The other reason is that Riley is getting better, and on Monday I will tell you about the road he’s traveled since December’s hospitalization.
Have a wonderful weekend! Riley is almost healthy and headed with Matt to the beach, my oldest guy is safe to leave by himself, I’m able to start work again, and I’m headed away for the weekend with a man who has loved me through all of this. I’m pretty lucky, and so I’m going to have a good weekend, too! There will, hopefully, be margaritas.