HEALTH Out of Order

THE BELLS CALLED US, AS IF TO morning prayers. We gathered, dutifully, for the now-familiar ritual. In line,
waiting for my daily medication with other patients at the small psychiatric hospital in New York’s Hudson Valley, I
knew my life had changed.

I was there because, my judgment gone, I could not perform simple functions, like adding two plus two, or working a
crossword puzzle. I was having an episode called a “crash,” and I was-and am-a manic-depressive.

My illness was first diagnosed sometime in late 1972, months before that first real crash. A psychiatrist with whom
I’d sought counsel for other reasons saw the pattern after a number of visits.

The manic-depression pattern swings from the “high” to a depressed state. The high is euphoria. “I can do/fix
anything!” Delusions of grandeur set in. You talk inordinately, inappropriately. You lack judgment and the ability
to sit still or to concentrate. Other symptoms are paranoia, sleeplessness, and spurts of inexhaustible energy. My
husband calls it “running around like a gerbil.”

In the depressed state, you can barely get out of bed.

Without recognizing the pattern, I had always been able to function to some extent in the highs and lows. My first
husband and I adopted two children, and throughout their childhood I did volunteer work, played bridge, did
household chores, worked on political campaigns, and helped out at my husband’s store.

By the winter of 1972, I began to recognize that my behavior was sometimes inappropriate-anger over little things,
frenzied shopping, or giving an acquaintance a too-expensive gift-but even after the diagnosis of manic depression,
it took months to convince me anything was really wrong. There seemed to be real reason for depression that fall. My
mother had died on Labor Day weekend and our store burned to the ground in late October.

As the cycle swung and I began cycling into the “high,” life made little sense. When the doctor made his diagnosis
and recommended lithium, drug of choice for manic-depressives, he said the dosage must be administered carefully. I
pictured grains of

medicine I would have to painstakingly measure into a teaspoon. He patiently explained that it was a usual kind of
pill. He convinced me that it was necessary.

But first, I insisted, I had to finish a massive project-a health conference to be held at the local community
college and the first official event of a legislator I had helped to elect. When the project ended, I said, our
family would take a brief vacation; then I would go on the medicine. I shouldn’t have waited.

The Saturday of the health conference arrived. As soon as it ended in late afternoon, the family would leave for a
few days of sight