A Therapist’s Journey Through Bipolar Country

As both a mental health professional and a psychiatric inpatient, I’ve seen mental illness from both sides. I was nearly thirty and a respected licensed clinical social worker and psychotherapist in San Francisco when I had my first manic episode.

In Rockaway, New York, for my sister’s wedding, I became psychotic and missed the ceremony. An ambulance took me to a snakepit psychiatric ward. Heavily medicated to a zombie-like state on Thorazine for eight days, I thought it was all a mistake and blamed my mother.

Back at work, some coworkers stigmatized me; others were supportive. Gradually, I regained respect and became the agency’s family and couple therapy expert. I presented a paper I wrote about my work with alcoholic family systems at a national conference on alcoholism and other drug problems.

A year later, I went to New York to be maid of honor at my childhood friend’s wedding. Back in San Francisco, I became manic, distributed gifts to colleagues, interrupted coworkers’ therapy sessions, and behaved strangely with clients.

Colleagues arranged for my admission to the Langley Porter Neuropsychiatric Institute, where the psychologist said I was manic depressive, which is now called bipolar, and had to take lithium or my career would be ruined. I didn’t believe him, thought I’d been under much stress, and discharged myself A.M.A.

During my first two psychotic experiences, I believed that the therapist I’d been seeing for some time loved me, and we were about to get married. Six months after Langley Porter, I became psychotic again. I believed my boyfriend and I would get married, although he had never mentioned that. My mind kept racing. A former psychology intern I’d supervised arranged for my admission to St. Mary’s Neuropsychiatric Institute.

Three of my dear friends and my then-boyfriend visited me here. They begged me to follow the advice of the hospital’s psychiatrist and start taking lithium. My friends’ love and concern touched me deeply. I trusted them and started taking lithium.

I did fine on lithium but was now a persona non grata at work. I was stigmatized more than before. A male coworker taunted me in front of others, saying sing-song, “I know what you’re taking. It starts with an “L” and ends with an “M,” and it’s spelled “L-i-t-h-i-u-m. Lithium!”

I was a vulnerable target and experienced sexual harassment on the job. This was before the #MeToo movement. Complaining officially would not have helped. I kept my nose to the grindstone until I was recruited to work as a senior psychiatric social worker on a psychiatric ward at San Francisco General Hospital!

I continued to do well on lithium and excelled in my new job. I had exceptional compassion for the patients because of my experiences as a psychiatric inpatient. I told no one there about my diagnosis or hospitalizations. But one day, a patient I’d played ping-pong with at Langley Porter was admitted to the ward and recognized me. I acted ignorant when he said he remembered me from Langley Porter.

Because of my role in training psychiatry residents at SFGH, I was nominated for and received a clinical faculty appointment as a lecturer at the University of California San Francisco School of Medicine.

When I worked at my next job as executive director of a family service agency in Oakland, I decided to go on a salt-free diet. But I’d forgotten that salt potentiates lithium, which I’d learned at a professional conference about manic depression. Lithium was the drug of choice for this illness back then, although it is no longer routinely prescribed because of its potentially harmful side effects.

When I stopped eating salt, I had my fourth manic episode. I was psychotic and embarrassingly inappropriate with my staff. Again, I had the delusion that I would marry soon, this time an ex-boyfriend I hadn’t seen in six months. They stabilized me on lithium in a psych ward at a Marin hospital that used to be in the town of Ross. I was discharged in three days. Back at work, I said I’d been home with a cold.

Six months later, my board’s president asked me to resign “because they wanted to move the agency in a new direction.” I never learned if the real reason for my getting fired was because of my manic episode that no one discussed with me or because I’d begun to discipline a long-term popular but insubordinate employee who’d consequently mounted a campaign to force me to resign.

For a long time, I was ambivalent about marrying, yearning for a husband but fearing I would fail at marriage. My mother was devastated when my father divorced her and quickly remarried a younger woman. My maternal grandmother, Yetta, was a poor, non-English-speaking immigrant and pregnant with my mother when her husband abandoned her. When my mother was a baby, Yetta could not cope. My mother and her older sister were placed in an orphanage, and Yetta spent the rest of her life in an institution for mentally ill people in upstate New York.

Shortly before leaving my executive director job, I began seeing a psychiatrist for therapy to help me get past my fear of marriage. He and other mentors helped me become happily married. When I was trying to become pregnant, he said to discontinue lithium because it could harm a fetus. I was petrified to stop because of what happened during my salt-free experiment. But I did stop taking it and never needed it again. I’ve been doing fine without medication for about thirty-five years.

During each of my four manic episodes, I had a delusion that I was about to get married. Did I need marriage to stabilize me? That’s the best explanation I can come up with, but something else might have changed my brain’s chemistry.

I caution others not to change their medicine without a competent professional’s advice and close monitoring.

I hope sharing my story contributes toward reducing the stigma around mental illness, which was the most hurtful part of my experience.