I do not think that there can ever be enough books about anything and I say that knowing that some of them are going to be about Pilates.The more knowledge the better seems like a solid rule of thumb, even though I have watched enough science fiction films to accept that humanity’s unchecked pursuit of learning will end with robots taking over the world.-Sarah Vowell

Monday, August 22, 2016

Marbles, Mania, Depression, Michelangelo and Me: A Graphic Novel by Ellen Forney

In 1998, not too long before turning thirty, Ellen Forney, an artist, finds out that she is manic depressive and is in fact having a manic episode. Her psychiatrist wants to put her on medication but she worries that the meds will effect her art and creative mind, so she refuses at first.  She does research into other artists who have been mentally ill and if she's a manic depressive, it's pretty cool to be included in the "crazy artist" club, which includes such people as Gaugan, van Gogh, Gorky, Michelangelo, Munch, O'Keeffe, Pollack, Rossetti, Rothko, Baudelaire, Blake, Burns, Byron, Dickinson, Eliot, Hugo, Keats, Millay, Plath, Poe, Sexton, Tennyson, Whitman, Hans Christian Anderson, Twain, Conrad, Dickens, Faulkner, Fitzgerald, Hemingway, Ibsen, James (both), Mary Shelley, Tolstoy, Williams, Woolf, and Zola.

While she studied these people she found that a lot of them spent time in asylums, made suicide attempts, or succeeded in killing themselves.  Some stats she picked up: the suicide rate in the overall population is 11.2 in 100,000 and attempts is 8-25 per every suicide death, while in the manic depressive population it is an estimated 25%-50% for attempts and 3%-20% for successful suicide death rate.  [Most people cite 15%, but that can vary depending on many factors (On the low end for non-hospitalized groups, on the high end when illness is combined with alcohol abuse, low end for medicine takers, high end shortly after onset of illness, etc...)]   As manic as she is at the moment she views her disease as a superpower or a gift to her creativity and its a good thing that the depression isn't a problem of hers. 

While she's on a manic high, she doesn't feel as though she needs any meds; that she will be fine. She forgets completely the crash that always follows the mania or how out of control the mania can get.  For her thirtieth birthday she decides to throw a huge party to coincide with the release of her first book, a collection of her weekly comic strips, "I Was Seven in '75".  She held it in a club with a local band, had party hats, a friend to emcee the event, a host of different acts to perform on stage, as well as a spin art booth, games, and prizes. 

Afterwards she tells her father and brother, as her mother, a doctor, is the only one knew up until then, except for a few friends.  It turns out mental illness runs in her family and her mother is a bit Cyclothymiaic [Alternating Hypomania and Mild Depression].  The official terms are Bipolar I: Alternating Manic and Depressive Episodes (Ellen); Bipolar II: Alternating Hypomanic and Depressive Episodes; Unipolar Depression: Single of Recurrent Episodes with No Mania; Dysthymia: Chronic, Low-Grade Depression.  The mood chart goes: Mania (Up! Up! Up!); Hypomania (Up!); Mixed States (Up and Down at the Same Time); Rapid Cycling (4 Or More Episodes Within 12 Months); Euthymia (balanced, "Normal"); Dysthymia (Chronically Low); Mild Depression (Low); Depression (low, low, low, low). 

Mania includes the symptoms: inflated self esteem or grandiosity, decreased need for sleep, more talkative or pressure to keep talking, flight of ideas or racing thoughts, distractability, increase in goal oriented activity, excessive involvement in pleasurable activities that have a high potential for painful consequences (gambling, hypersexuality, buying sprees, etc...). Depressive symptoms include: depressed mood every day most of the day, markedly diminished pleasure in all or almost all activities, weight loss or gain, insomnia or hypersomnia, fatigue and loss of energy, feelings of worthlessness and inappropriate guilt, diminished ability to think or concentrate, and recurrent thoughts of death or suicide.

Sure enough she crashed into a major depressive episode not long after the birthday party.  That is when she asked her psychiatrist for the lithium. The lithium, however, works best on mania, not depression.  It also has lots of fun side effects like: weight gain, hand tremor, mental slowness, poor concentration, memory problems, acne, "cognitive dulling", liver toxicity (which means you have to drink 3 liters of water a day. In this book, she tries other medicines such as Klonopion (for sleep and relaxation), Depakote (which, like lithium requires blood draws to check on certain things), Celexa, Neurontin, Zyprexa, Tegretol, and Lamictal. Today there are lots more to choose from with lots of side effects. They can all cause weight gain, possible drowsiness, memory loss [manic depression itself causes memory loss], stomach issues, sexual side effects, and many, many more.  You can end up taking more than one medicine.  Perhaps one for depression and one or two to stabilize your moods or mania.  You may also need a sleep medication or something for anxiety, which is also common in those with manic depression. 

While depressed she still made it out of bed and to the couch and maybe that was good enough for that day.  Her mother and psychiatrist were very supportive of her and the friends she told became so too.  She loved to swim and eventually that would be what she would do three times a week like she used to do.  She would learn to find a way to do her cartoon strip no matter how much effort it took her or how long it took her, as this was how she made her living and the rent had to be paid.  There would be an incredible chance to interview a favorite author of hers and she will have to figure out if she can manage that or not.  Before when she was manic she has signed up to do the Danskin Triathlon and she still wants to do it even though she stopped training for it when the depression hit. Will she be able to get out of bed to do it and if so will she be able to finish the race?  There's also a great deal of embarrassment and shame that comes from being manic depressive.  You don't want people to treat you differently or think that you are crazy. 

This book perfectly illustrates what being a manic depressive is like. Forney expertly draws what goes on in the mind of a manic and what it really feels like to be depressed.  You get a real sense of this in her book. She also provides a great deal of useful information for those who fall in the spectrum of manic depression/depressive illness to use to see what is going on in their lives and how to get help. Most important she shows that this is a livable disease and that you can soldier on and make a life for yourself, even if it takes a while to find the right medicine combination.  She also shows that you don't have to be ashamed of being manic depressive. 

Link to Amazon:  https://www.amazon.com/Marbles-Depression-Michelangelo-Graphic-Memoir/dp/1592407323/ref=sr_1_1?s=books&ie=UTF8&qid=1472050475&sr=1-1&keywords=marbles+mania+depression+michelangelo+%26+me+a+graphic+memoir

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