Pam Kazmaier
A Day In the Life of Bipolar Disorder
Today was a good day. From the outside, I look normal. I got up and got the kids off to school, and saw my husband off to work. I cleaned the house, even organized the linen closet. I threw some clothes in the wash. I drove to work and felt, at the end of the day, I had done a good job. I’m writing this after helping the kids with their homework, while they’re eating dinner, with a group of friends, at the dining room table. Normal, everyday stuff.
Some days haven’t been so good. My dad was diagnosed with manic depression in the 1960’s and started on lithium. He didn’t believe he was ill. He was always raging. Nights were the worst. He’d storm around the house, in the dark, yelling, moaning and saying he was going to commit suicide. As a kid, I was helpless to do anything. I’d bury my head under my pillow. This went on for years. Sometimes my little sister would come to my bed, and we’d hide together, in the dark, trying to comfort each other. Dad was never happy or well. We were relieved when he died. My mom had psychosis after surgeries, and one doctor said mom had bipolar disorder also. Mom used tranquilizers and alcohol to self-medicate. We never had much money. Sometimes I wonder how I survived.
When I was a teenager I spent a whole summer hearing voices. I didn’t understand that’s what it was, then. It was terrible. I was trying to take a typing class. I was bothered with visits from three men who wouldn’t leave me alone. They pestered me all summer. They’d tell me how stupid I was. How I was never going to make anything of myself. They made fun of me. They would talk to each other about me. They’d laugh at me and point their fingers. They were bald and had pink skin, sometimes green. They’d watch me constantly. I felt discouraged. During breaks, a friend tried to talk to me. They’d block her and I couldn’t hear what she was saying. This happened again in my twenties. I never told anyone. I thought they were real.
Throughout my twenties and thirties I worked at a great career. I graduated from college. I got married and had two sons. I’ve been married for twenty-eight years. I thought I had PMS. I couldn’t sleep at night. I was conscious and awake all night long. I dreaded the nighttime. Instead of getting tired, I had energy surges.
There’s a difference in being tired and being sleepy. Normal people don’t know that. I’d be tired but not sleepy. During the day, I’d be irritable, exhausted, and jumpy. I asked a doctor for sleeping pills. He refused. I asked other doctors. None of them asked about my family history of mental illness. None of them recognized the mania. I started using alcohol to sleep. It worked pretty well. I drank a lot. I also got very religious. Over the course of thirty years I joined seventeen religions. I saw psychologists to help with the anxiety. Talk therapy didn’t help.
Nineteen years ago, I went to a psychiatrist. That was difficult. The hardest part of having mental illness is being ashamed. It’s the only illness we make fun of. I didn’t want to have a diagnosis that had anything to do with mental illness. I felt sorry for my husband and sons. I didn’t want them having a family life like I did. I tried different kinds of medicine. Some made me very sick. Nothing helped for a long time. Then I had a breakdown.
Caring for a son with bipolar disorder, while having bipolar disorder, is dangerous. For years, we went to Psychiatrists, tried medicines, had our blood drawn. Neither of us slept for eleven years. My son hallucinated and tried to commit suicide by jumping off the top floor of the mall. I found him with ropes around his neck. He was on stimulants and anti-depressants that made him worse. I kept a navy blue suit in the back of his closet for his funeral. Mesa Public Schools do a terrible job of educating children with mental illness, though a great job with one-third of the kids who are normal. The hardest part of raising Zack has been the daily war with the school staff that is uneducated with psychiatrically ill students. I have written weekly letters of advocacy for my son, attended meetings. I grew exhausted. Bit by bit, I began losing my mind.
The summer of 2003 I began to feel something big was around the corner but I didn’t know what it was. I began making all kinds of preparations as if I were going somewhere, somewhere for a very long time, somewhere I wasn’t coming back from. I felt a real urgency to get my affairs in order. I made all kinds of preparations and appointments so that my kids had their affairs in order. My son was being weaned off one of his medications. He was unstable for all of September. I had just made sure his new school year would be a good one. He had a great IEP. I had had such high hopes. His school year unraveled within a few weeks. Teachers were threatening not to keep him.
I was panic-stricken; I called his psychiatrist. I e-mailed her. I was at her office four times that month getting different medicines for him. His mania scared me. His doctor laughed at it though and said, “You’re going to have to learn to live with it.” I knew we couldn’t live with it. I called four hospitals to get him help. One hospital said we were on the wrong side of the county line. One hospital wouldn’t take him because he was under the age of 13. One hospital wouldn’t take him because he wasn’t also a substance abuser. The last hospital said they didn’t take children. I slid the white insurance book across the kitchen counter to my husband and begged him to get our son a new doctor. He refused. I sank into despair. There was no way out. Our situation was hopeless. I remember the exact moment I snapped. Just like a rubber band that gets stretched, especially when it’s old and stiff, maybe one that’s been weathered a little.
I felt like I was treading water in the deep end of a pool with my son on my back. I had treaded water as long as I physically could, and we both began to drown. He was getting bigger and stronger and heavier, but I was weakening and couldn’t support us. I just couldn’t continue. It was too much for too long. I was way past the breaking point. There had been so little time over the years, for myself, I had forgotten that I was even there at all. I had died somewhere along the way.
Looking back to that day, I got up early as usual, nothing out of the ordinary, except that I wore no makeup, and just let my hair fall in gray threads. I wore black. No color at all. My husband and older son were at church. My younger son came up to me and said, “Mom, let’s kill ourselves!” He was smiling. We were like two weak ice skaters holding onto each other for support. When one falls, he pulls the other with him. It never occurred to me to call anyone for help. Some days with bipolar disorder don’t make any sense.
There is no logical explanation for what happened next. I felt like I was falling backward down a hole. The room got dark, even though it was morning. I couldn’t focus. I was very slowed down, uncoordinated. “OK”, was all I said.
I felt it was my duty as a mother, to go with him to the other side, so he wouldn’t be alone. If he was finally going to kill himself, I must get over there too. I wanted him to feel relief. I didn’t have the ability to get us to the other side. Maybe we could just sleep. I told him we could take our meds. We could take a little extra.
In the past, I had followed the advice of a therapist who told me, when I was having a bad day, take my meds early, take extra, and go to sleep. Her theory was a person didn’t really want to die, just black out. It had worked for me. I had never tried to help anyone else do this. I didn’t want to kill Zack, just give him relief from his mania.
My son was used to taking his medications four times a day. I didn’t have to help him. I was concentrating on swallowing as much medicine as I could. If he was going to the spirit world, I needed to be there for him. It was like I’d hold his hand as he crossed a busy street. I had stopped him, so many times over the years, from taking his life. This time, I was going with him, so he wouldn’t be alone. A few months earlier, my brother’s son had committed suicide, at the age of 14. I had felt sad that he had died alone.
I was getting sleepy as we wrote our notes to say goodbye, in case we didn’t make it back. They’d be better off without us. Their whole lives revolved around our mental illness. Without us, they could live normal lives. We pushed a heavy dresser in front of the bedroom door and locked it. We didn’t know if we were going to have enough time to get to the other side. We took a picture of Jesus off the wall and laid it between us and lay down on the bed and held hands. It was a picture of Jesus holding a little boy as he is helping an older girl up out of the river. We slept. I lost consciousness.
When I first tried to open my eyes, all I could see was white. Then I recognized the metal curtain track. I never got passed the ceiling. I couldn’t use my left hand. It was tied to the bed. I was so sick. The next three days I was in and out of consciousness. I remember my husband saying our son would be OK. Occasionally people would come to the bedrail and ask questions: doctors, social workers, a chaplain, policemen reading me my rights. I remember a visit from a friend who said, “Why didn’t you call me?”
Actually, I had called her. I told her many times: Zack killed animals, set fires, kicked in doors, threatened to kill us, blow us up with the propane tank. He wasn’t sleeping. He was suicidal. He cut himself with knives just to see the blood. He collected knives. I protected my older son by installing a lock on the inside of his bedroom door, as he was frightened for his safety. Zack didn’t fit in at church. He didn’t fit in at school. We never had a fun family time in all our life. I had told my husband, my friends, I told church leaders, scout leaders. I told the doctors. I told the ladies that drew our blood. I told the secretaries and receptionists. I told the specialists. I had called family over the years. No one could help us. Every day was a fight. Looking back now, I should have changed his psychiatrist. We later found out her license was suspended due to drug abuse.
After three days in ICU I was shipped off to a psychiatric hospital, alone. My husband had had enough of me. He didn’t accompany me or help me. All I had on was a hospital gown. I was barefoot, cold, terrified. I had no socks, no underwear, no shoes, no hairbrush, no makeup, no clothes, no money, no family, and no friends. I sat in the lobby for hours before being admitted. It was the middle of the night. I overheard the staff laughing about other psychiatric patients and the funny ways they had tried to kill themselves, through hanging. That scared me. I had been on psychiatric medicines for twelve years. Now it was several days without them, having been totally purged in the ICU. My teeth were chattering. I was cold. My skin was crawling. I was paranoid. I tried several times to phone my husband but he never answered. Later he said he had had enough and I was on my own. He had seen an attorney who recommended Kevin divorce me, take full custody of the children, and put me away. I couldn’t blame him.
Early in the morning I was admitted to a locked ward. There were crickets, the bathroom fixtures dripped, dripped, dripped all night long. There was a red light over my bed that never shut off. The mattress was only an inch of plastic, as was the pillow. I dreaded the nights. I wasn’t given any medicine and I never slept. It was torture, never being able to rest or sleep, being manic, without meds, the red light, the dripping, the crickets, the miserable plastic, the cold, my skin cold and crawling, being jumpy. Being locked in with other symptomatic patients.
I was absolutely frantic about my son. He was in the same horrible place somewhere on a children’s unit. Was he sleeping? Was he eating? Was he drinking? Was he as scared and lonely as I was? I was hysterical to get to him until one of the staff told me he was doing well. He was eating and drinking and sleeping and had made friends. He was sleeping? He had friends? That was new! He had night terrors for eleven years. Our entire family had not slept for eleven long years.
The first thing Zack’s new psychiatrist did was change the medications ordered by the old psychiatrist (which had caused Zack to be manic/suicidal.) This hospital psychiatrist stabilized Zack quickly by discontinuing the anti-depressants/stimulants that had induced instability in Zack. Zack was immediately placed back on Tegretol, the mood stabilizer the old psychiatrist had discontinued in September (which had de-stabilized him to the point of mania/suicide) was placed on a new medicine, called Geodon, an antipsychotic. He went home and back to school in a few days. Each day, my son improved. It has now been six years. He has not been suicidal once! He is doing well! Geodon has been a miracle for him! Zack is now a senior in high school and has friends. With special education classes, he’s moving forward, yet still requires intense weekly advocacy with Mesa Public Schools, as they are still ignorant in teaching psychiatric students. Zack has goals for the future of graduating, working and living independently. In spite of his school, we support his goals. We still take him to that hospital psychiatrist who stabilized him so quickly.
I had to stay in the psychiatric ward for a few weeks, and then I was arrested and handcuffed, booked and chained to a bench in jail. I was indicted on a class 5 felony of Dangerous Crimes Against Children, carrying a mandatory 34-year prison sentence. Many people with mental illness end up in the criminal justice System. It’s devastating. The reality of mental illness is discrimination and blame. It’s the only illness we blame people for having. It doesn’t happen with a heart attack, just a brain attack. The police and courts don’t understand how much worse they make life for those with mental illness. For two years I went back and forth to court as a defendant. I’m shamed, embarrassed, defeated. I am a social reject. I’m an outcast. I feel lower than low for my bad judgment of that day. I wouldn’t mind serving the rest of my life in prison for what I have done to my children.
If my case had gone to trial, it would have cost thousands of dollars we didn’t have. Our medical and attorney bills took our life savings. My sons and husband would have had to take the stand and repeat their original statements against me. My husband told the attorney I wasn’t worth the $50,000 it would have taken to go to trial. This whole incident has been a huge embarrassment to my husband who is a lieutenant with Mesa Police Department and its Bomb Commander. I plead guilty and am now a felon. I’ve had to surrender my RN license and can no longer pass a criminal background check. My voting rights were stripped away, with self-esteem.
I feel badly my husband has had to be married to a person with mental illness, raising a son with mental illness. I read somewhere that 80 percent of the marriages raising a special needs child end in divorce. Some days my husband warns me he can never go through this again. He says I embarrass him. He says he thinks of being free of me. I can’t blame him. Our 28-year marriage has been a strain. If I knew then what I know now, I’d never have proposed to him so very long ago. He is a good man and deserves more. I feel like a ball and chain to him.
I took classes with NAMI. I found better psychiatric care. NAMI gives Arizona a “D” for Mental Illness services compared to other States. In our state, the public psychiatric system is better than the private. For a couple of years I really struggled to get back to normal. Then I realized, back wasn’t normal.
Our family was out of balance. I’ve tried to take better care of myself. I got angry for a while. I quit our church. Church is harder on women than men. I actually think it’s set up for men. They like having the women do all that hard work for them. I found a job. I got my own bank account. I started exercising. I got my hair done. I freed myself from the slavery of housework. It was killing me. My husband is stepping in and being a parent. Imagine that. My boys are doing their own laundry and cleaning their own rooms. They cook or buy a pizza. All that work and sacrifice was unhealthy for me. My enmeshment in their lives was impeding their development and independence. Hopefully, I am no longer an overinvolved, problematic, mother.
For the first time in many years, I want to live. I’m happy waking up in the morning and having a job to go to. I have pursued my goal of working in Mental Health Rehabilitation. I have gained more education and became a Certified Psychiatric Rehabilitation Practitioner. I work for Triple-R Behavioral Health and encourage our clients that there is a life after a nervous breakdown, psychiatric hospitalization, criminalization. I have a paycheck again. I’m on a medicine that doesn’t make me sick.
I moved to a condo up the street from our family home where the disaster occurred. The memories of living there are too much for me. My condo is a quiet retreat, decorated in soft, soothing colors. I rest there, feed my birds on the patio, and water my plants. I read a lot of books by women who have also overcome many challenges. I listen to women’s music. I eat better and exercise. I take care of myself, a new concept after 55 years of taking care of others. I am making progress, moving forward. Life is good now. I have learned we women have to take care of ourselves because no one else will. I believed a lie for a long time: love a man, nurture him, and he’ll take care of you. That is such a lie and women believe it all the time. I’m taking care of myself now. The breathing space between my husband and I has given us a renewed friendship with each other.
Every day after work, I go over to see Kevin and Mike and Zack. On Sundays and holidays I spend more time with them. We’re all doing well and making progress in our lives. We’re more honest and open with each other and support one another. Our living arrangements sound odd to others. When a family struggles with mental illness, extraordinary choices need to be made. We have gone through hell with bipolar disorder. We’ve learned the wrong medicine can be dangerous, but the right medicine can be life changing.
Like Rosa Parks who drew a line in the sand and refused to go to the back of the bus, I’ve taken a stand in my life, too. It’s time to stop blaming people with mental illness. Mental illness is a medical condition, not a legal/criminal matter. A criminal history denies a patient work, an apartment, and recovery. The hardest part of having mental illness is being ashamed. It’s the only illness we blame people for having. We don’t criminalize people with heart attacks, just brain attacks. This shame prevents patients from taking the medications that are 80 percent effective. I made a bumper sticker that says, “Mental illness isn’t a sin or a crime – it’s an illness.”
Pam Kazmaier is a certified psychiatric rehabilitation practitioner and public speaker whose most recent speaking engagement involved educating police officers about mental illness. An article based on Ms. Kazmaier's story appeared in the Metro Phoenix area's East Valley Tribune. That article, written by Mary K. Reinhart, won a Mental Health America Media Award Recognizing Excellence in Mental Health Journalism in 2008.
