It's the second day of our garage sale and I'm scavenging around looking for more stuff to put out. I come across two old bathrobes hanging on the back of our bathroom door. One of the robes is made of blue terrycloth. I got it for Christmas when I was a junior in high school. The other is black velvet with white satin trim. I bought it for our wedding night. I have a white satin nightgown with spaghetti straps that goes with it.

In the garage I fold the bathrobes and place them on the table with my other clothes. Like everything else stacked up on the tables, there are memories that go with them. I wore the blue one at the hospital when I was on the psychiatric ward. I was eighteen and had had a psychotic break. After being in and out of the hospital for nine months, I was eventually diagnosed with bipolar disorder. Fourteen years later I had a second break, and I wore the black bathrobe during it.

Our family doctor prescribed an anti-depressant called amitrtyptline. A powerful name, a powerful drug, but my disease was stronger. I refer now to the thing eating away at me as a disease, but at that time I didn't know what was wrong with me. I had an idea that if I could just get to Florida, it would get better. So I emptied out my bank account, which was housing my graduation money, and convinced my brother to take me to the airport. I arranged to meet someone I had met on spring break the year before. He owned some small condominium rentals on Anna Maria Island, and he let me stay in one of his units for a week.

While I was there, I did some things that were pretty uncharacteristic of me. For example, I wandered onto a dock and invited myself to go deep-sea fishing with a group of five strangers. Everyone on the boat was really nice. If they thought I was weird, they didn't let on. One of the men helped brace me while I pulled in a really big kingfish. It took a long time to get it up over the rails and onto the deck of the boat. And after all that, it had to be thrown back because it was regulated.

I also remember wandering around a parking lot thinking I could hot-wire a car to take me further South. I had no previous experience with how to hot-wire a car.

A week later, back home again, my state of mind hadn't improved. I was hospitalized. By then I was hallucinating and fully delusional. My first night in the hospital I remember looking out the window of my room. Instead of seeing a parking lot lit up with lights, I saw fiery orange and red, like an ocean sunset. Only the entire sky was lit up like this, like a tie-dye shirt. Like the color of hellfire. A single black raven hung in the middle of it--the same one associated with Poe's madness. In fact, in the poem, "The Raven." Poe speaks to the bird,

    "Prophet!" said I, "thing of evil!-prophet still, if bird or devil!-
    Whether Tempter sent, or whether tempest tossed thee here ashore,
    Desolate yet all undaunted, on this desert land enchanted-
    On this home by Horror haunted-tell me truly, I implore-
    Is there-is there balm in Gilead? Tell me-tell me, I implore!"
    Quoth the Raven, "Nevermore."

Looking back, I guess I can say that at least my raven wasn't talking to me.

Because I was eighteen, I had been placed on the adult ward alongside people struggling with their addictions or with the stress that comes with life's losses. One man, for example, had lost his job after many years of faithful employment. A woman was going through a divorce. I remember her crying on the telephone a lot. A manic-depressive was getting his meds regulated. And then there was me, pacing in circles, my blue bathrobe flapping around me like a whirling dervish.

I was in and out of the hospital for the next nine months. At one point I was admitted to the psychiatric intensive care unit (PICU), where I saw things you only see in movies. I was fairly lucid during this time. Looking back, it would have been better if I wasn't.

Sometimes patients were tied down to their beds and injected with Haldol. One day I was strapped to a chair. It looked like it belonged in an airplane and had a faded, pink material covering it. The attendant on the ward that morning who did the daily "reality check" had asked me what day and year it was. I answered that I didn't know. "Maybe this will help you remember," he said, as he strapped me into it.

There was Sudie, a schizophrenic woman with gray and black greasy hair and watery eyes who would make grand appearances in the dayroom. She would shuffle in and announce over and over, "We're having Big Mac soup for lunch." This she intermixed with saying, "Roy Rogers and Dale Evans are coming." One day she asked me if she could have my orange juice. I said okay.

Mr. Johnson, an elderly black man with yellow, crusted toenails could never seem to stay awake, but when he rose from his slumber, he always woke up laughing. His protruding belly poked out of his hospital gown. It reminded me of stomachs in Ethiopia that I had seen in magazines or on television. Stomachs full of hunger and parasites.

At my mom's insistence I was transferred back to the adolescent ward. That's where I was when my parents' insurance money ran out. I was subsequently diagnosed as a manic-depressive and started on lithium. Within forty-eight hours of taking my first lithium pill, my thoughts were clearer and I could sleep through the night.

Bipolar disorder can be fatal: an estimated 15 percent of people with the illness commit suicide. For those that live with it, there can be variations of the disease that range from severe (bipolar I) to less severe (cyclothymic disorder) to mixed (bipolar not otherwise specified).

Francis Mark Mondimore notes in his book, Bipolar Disorder, that "Children of persons with bipolar disorder have about a one in four chance of developing some kind of mood disorder, and about a one in ten chance of developing bipolar disorder" (p. 195). However, the exact cause of the disease is unknown. The prevalent theory during the last few decades is that there is an association between the brain's neurotransmitter system and bipolar disorder. Research supports the idea that an excess or deficiency in the level of neurotransmitters such as serotonine, norepinephrine, or dopamine is to blame. Other studies indicate that it is an imbalance in the ways brain cells communicate. Another possible cause is an imbalance in hormones. New brain-imaging techniques that allow for noninvasive study of the brain are helping to clarify the causes of the illness. One thing, however, is for certain, drugs called mood stabilizers, which alter the brain's chemistry, allow bipolar patients to shed their symptoms and function again.

Of course, the history of bipolar is littered with less scientific "causes." The ancient Greeks believed that an imbalance in the four main bodily fluids or "humors" caused mania and depression. Mondimore writes: "According to humoral theory, depression was thought to be caused by an excess of black bile and mania by an excess of yellow bile" (p. 61). During Medieval times, the cause of mental illness was thought to be a result of witchcraft or demonic possession. It was not until the middle of the nineteenth century that two Frenchmen published papers suggesting a modern definition of bipolar disease: "a mental illness characterized by alternating periods of melancholia and mania that were separated by periods of normal mood" (p. 63).

Psychiatrist Emil Kraeplin is credited with first calling the mental illness "Manic-Depressive Insanity" and was the first to convey the idea that all mood disorders, from depression to hysteria, were related. In the 1930s and 1940s, however, most physicians treating mental illness adhered according to the non-biological, wholly psychological theories of Sigmund Freud and his successors. Nevertheless it was during this time that John F. J. Cade, M.D., of Victoria, Australia, asserted "manic depressive illness was a biological disorder, not a psychological one," (p. 68). He also discovered that lithium had a profound effect on his manic-depressive patients, although it wasn't until the 1970s that the United States Food and Drug Administration approved it for the treatment of bipolar disorder.

The year that followed my first hospitalization is fuzzy in my memory, but I do know that my recovery was slow. I was living at home. I began to take classes here and there and hold down jobs. My friends had already been at college for a semester, and I remember feeling as if I were one step behind everybody else, as if I had been forgotten. I put on a significant amount of weight, a side effect of lithium. I was working two fast food jobs, which didn't help matters. Eventually, I went away to college at Indiana University in Bloomington, Indiana, and studied English literature, particularly enjoying my creative writing classes. After graduation and a short period of drifting, I finally got grounded in a good-paying job, where I met my husband.

It's challenging living with a mental illness, but along the way there have been many happy times. In January 2001, a little more than two years after we got married, my husband and I adopted two little boys, ages two and three, from Ethiopia. I'll never forget the magic of holding them for the first time in my arms at the airport. In May of that year, I earned my master's degree English literature.

There were long stretches where I didn't even think about having the illness unless I was reminded of it. For example, there was the time when a coworker saw me taking my medication at lunch and asked me about it. Someone at the table drew his attention away from me, and I was relieved not to have to answer. I didn't like telling people I was a manic-depressive. Once when I told a guy I was dating in college he asked, "So does this mean you're going to come over in the middle of the night and burn down my house?" Not surprisingly, he didn't call me after that.

When my husband and I started dating, I told him about my illness. It didn't faze him, at first. Then I gave him a couple of memoirs on bipolar. One was by Kay Redfield Jamison and the other by Patty Duke Astin. After reading them, I asked my husband what he thought. "I'm just worried I'm going to lose you," he said. "I'm afraid the illness will make you stop loving me."

"That will never happen," I assured him.

But later, in a way, his prediction came true. After my second psychotic break, I became so depressed I felt numb, empty, and unable to feel love. In January 2003, the week before the break, I had been teaching an eight-hour-a-day class at a local college in Indianapolis. It was a three-credit-hour elective offered to student's in a week-long, intensive format. I had a ninety-minute commute to get to campus and was staying up very late to prepare and drinking a lot of coffee. A month earlier I had started seeing a new psychiatrist. We went over my history and I told him I wasn't sure that I was bipolar because I hadn't had any mania for fourteen years. He said I could go off my medication "to see what we're dealing with."

As a result of the excessive caffeine, lack of sleep, the stress from teaching the class without the buffer of medication, I was becoming manic again, but I didn't know it. A manic episode is not the same as being psychotic, but for some people like me, it can lead to that. For the person experiencing mania, nothing seems wrong. In fact, I can't put into words how wonderful it feels. In an instant everything makes sense. Long-held grudges are forgiven. Music sounds better. Colors are more vibrant. World peace is not only probable, it's likely.

During this time I called up the contractor who had remodeled our house the year before and announced that we needed to read Tom Robbins' Still Life with Woodpecker together. I said that all of life's answers were in that book, and we needed to get the whole world to read it. I told him to get his copy right now and start reading. He said he didn't know where his copy was, so I pulled out my own and started laughing hysterically as I read it. He asked me if I was okay, and if my husband was home. I assured him that everything was fine. I got out my acrylic paints and started painting with my children, laughing as paint got on the hardwood floor and in the grout on our white tiled table. We were painting rocks.

My husband was afraid I was getting manic, and took me to my therapist, Suzy, to get her opinion on whether I needed to be hospitalized. It's common to have a psychiatrist who prescribes medication and a therapist who listens and provides feedback. (Therapists do not prescribe medication.) Suzy's office is cozy with lots of plants, large pillows, and a gurgling fountain on the table between two chairs where my husband sat and I attempted to sit. I was so excited that I couldn't remain still. I stood up and gave her a white plastic bag filled with things like CDs, return address labels, a newspaper, and a children's book. I thought each object was proof that I had reached enlightenment and handed them up to her like an offering. Before she could respond, I grabbed the bag back from her and dug out the children's book and gave it to her.

"This is why I'm here," I said. I waited for her to tell me that she knew from the beginning that I was "chosen," thinking that she had been waiting to help me when I reached enlightenment. She asked me whether I felt I needed to go to the hospital, to which I assured her I didn't. Suzy suggested to my husband and me that we wait a few days to see whether things would get better.

They didn't. When I went completely out of touch with reality, I began wearing my black velvet bathrobe with white satin trim because I thought my husband was dead and that I should wear it to mark the end of our relationship in this lifetime. I somehow thought we were splitting into several parallel lives. I knew that we would find each other again because we were soulmates, but I was still angry that he had died. He was becoming John Mellencamp (his favorite singer) in one life, and getting back together with his ex-wife in another. They would live and work together at the Exotic Feline Rescue Center in Center Point, Indiana. In reality, he was busy sweeping up the colorful fragments of the Fiestaware dishes I threw against the wall. I don't recall doing this. It was a detail my husband filled in for me. I don't remember everything, just bits and pieces like loose beads I catch and thread together.

In one of my parallel lives I became Natalie Maines, the lead singer of the Dixie Chicks and began singing, "Cowboy take me away, fly this girl as high as you can into the wild blue, Set me free oh I pray, closer to heaven above and closer to you." I kept running outside into the snow in my bare feet and bathrobe. Our neighborhood in Bloomington, Indiana, was heavily wooded with large 2+ acre lots. I don't think any of our neighbors saw me. I was looking for the cowboy who would take me in a Winnebago to Madison, Wisconsin to be part of a six-person think tank to save the environment. It was going to be headed by the writer Lorrie Moore. Once I got into the Winnebago, I'd have no memory of my husband, the pain of losing him, and our souls would be set free to meet again in another lifetime.

I was taking my sons with me to Madison. I laid out their cowboy vests and hats for them to wear. But while I was packing, I got sidetracked and emptied all of the contents of their bathroom into the bathtub. I started taking down pictures from the walls. As I took them down my husband put them back up. I packed sunblock—something useful for Wisconsin in January. As I hurried from task to task, my husband trailed behind me putting stuff away. At the time I couldn't understand this, because I thought he understood about the parallel lives, and the need for me to get ready for the Winnebago to pick us up.

That night I also thought my friends and I became witches flying off into the falling snow, taking with us the powers of our mothers from the north, south, east and west. My mother was the witch from the north, and I had to be careful because her powers were strongest. (We would meet up for our annual visit to a home where a baby was being born.) We all had jobs to do. Mine was to clean the new mother's house and put on the coffee.

Everything seemed to be moving in slow motion, as if I were floating through time. In reality, it was late at night in January 2003, and I was racing through the house in my bathrobe at a manic speed. I had just put on a pot of coffee and was vacuuming the hall runner. My husband turned off the vacuum. "You're going to wake up the boys, dammit," he said. He then tried to coax me to lie down, which I would agree to do for about five seconds. Then I'd jump up and be off performing some other "necessary" chore. Once, while lying in bed, I ripped the tiny silver cross with diamond and emerald chips in it from my neck. My best friend had given the necklace to me for Christmas. My husband was getting frantic. At one point, I remember him sitting at the desk in the kitchen looking through the yellow pages for the name of my doctor. Another thing I remember is him hitting me on the backside once in an effort to calm me down.

The Winnebago never arrived, and instead my husband put me in his truck at three o'clock in the morning. I remember peering into the jump seats and seeing my two boys, four and five, in their superman t-shirts, smiling like angelic cartoon characters. What excitement it must have been for them to be awakened in the middle of the night, dressed, and put in the car. They had seen me break dishes and run around the house. Later they told me, "You were bad, Mom." They're young. I'm hoping that in time they'll forget.

Two men (I thought one was a young Frank McCourt and, the other, one of his brothers) were in the waiting room at the hospital. I threw a Kleenex at the woman who checked me in because I thought she was someone I disliked from my past. I was strip-searched, and one of the attendants looked at the other one and said, "I've seen worse." I don't know if she was referring to the state of my body or my brain.

When I saw the other patients and staff, I raised my palm and moved my hand back and forth like I was dribbling a basketball. I chanted, "Set me free, set me free, set me free," as I blessed them. They took me to the gym to play basketball in the hopes of calming me down. I made all my shots.

I thought I saw my cousin, my dad, my sister, and Jerry Garcia. They took me outside for cigarettes with another patient. I thought the attendant was Martin Luther King and the patient who had bright red hair was the man who would kill him. As the attendant lit the man's cigarette, the shot went off, and then a flutter of birds rose from the bushes. I cried out, "No! No!" The attendant reassured me that he wasn't dead. "Look at my eyes," he said. "What do you see?"

"My son," I said. Now Martin Luther King was my grown-up son.

Later, I stood motionless underneath the television that was bolted to the wall. I was waiting to get sucked into it.

I was in the hospital for about six days. There are large chunks of time and events that I don't remember, like when my psychiatrist, the one who took me off medication, came to see me. In the immediate aftermath of my hospitalization, two of my friends came to help, one driving all the way from Atlanta. I was on a very high dosage of Depakote, as well as two other medications that made me feel like a walking zombie. My dad and stepmom offered to help in any way that they could. I also confided in two aunts, one sister, and a few friends but largely kept the hospitalization under wraps. I was ashamed that I had lost control.

It surprises me now that I am writing about my experiences. The only reason I can figure out is this: I believe God made me and He has to have a reason I have the illness. Maybe writing about my experience will help other people with similar experiences. Maybe that's what I'm supposed to do.

After the hospitalization I became severely depressed, which is common after a manic episode. I could write a separate essay on it. Depression like mine takes a heavy toll on a family. Often over dinner prayers, our sons would say, "Thank you for this food. Help us have a nice day, and help Mom not be sad any more." This made my eyes well up with tears. They were such a blessing, and yet I couldn't fully enjoy them at this point. The worst part about being depressed, for me, is feeling like I'm missing out on the joy of parenting—my time with them is passing by.

My husband and I have grown closer and grown apart. I do, by the way, believe we are soulmates. We're closer in having gone through the difficult times together. My husband was terrified by the idea that I had to be hospitalized and it was very hard for him while I was gone those six days. My subsequent depression drove a wedge between us. I felt disconnected from everything. During the worst times, my husband would sometimes say, "I'm waiting for my wife to come back."

"I am too," I would answer.

There were days when I'd take the boys to school and then stay in bed until it was time to pick them up again. Or I would be up during the day but go to bed at 6:00 p.m. My husband would often have to get carry-out for us because I couldn't cook.

In addition to taking a toll on my family, depression made me feel disconnected from God. I was unable to be creative or experience joy. I wanted to be able to multi-task again, to experience serendipity, and feel how everything is connected. When you're manic you experience these things in extreme. Everything is wonderful, beautiful, spiritual. During this time I tried everything to help with the depression. My psychiatrist increased my antidepressant twice. I prayed. I saw a naturopathic doctor who counseled me in nutrition, taught me how to detoxify heavy metals with dead sea salts, gave me vitamin B-12 supplements, and did numerous other things in an attempt to help me with my mood. I also tried energy healing, working with a life coach, seeing an herbalist, and reading self-help books.

I began reading Ted Andrews' work. He says that if you just pay attention to nature, you will discover your animal totems. My main totem is the spider. According to Andrews, because spiders spin their webs and wait for their food, "They remind us that if we do our work, the results will come." As a writer, I find hope in this. I often see a spider at critical points during my work. It's a good way to look at healing too. Anything really, that's a process.

It's been two years since I was hospitalized. I am climbing out of the pit of depression. I attribute it to a combination of things—especially prayer. I'm writing more, and I'm enjoying my family again. We're going to be moving soon, hence the need for a garage sale. I'm a little worried that the upheaval might send my life spinning out of control. When I talk to friends and family about moving, they usually remind me that it is one of life's most stressful experiences.

I know now that stress triggers manic episodes. Teaching that class right after the holidays during January of 2003, without the buffer of medication, was what triggered my last episode. I was also under a deadline that week for an article I was writing. Ironically, the article was about the world's oldest pathology building on the grounds of the notorious Central State Hospital in Indianapolis. In the hospital's heyday, surgeons would often treat mental illness with lobotomies. There are brains in glass jars on display there, and an autopsy room. It's scary to think that if I had lived in an earlier time, my brain might be on display today.

I do worry about growing older with my illness. It can become progressively worse if not treated properly. I recently read that Abilify, the mood stabilizer I take, can over time can trigger Tardive Dyskinesia, a movement disorder that is usually caused by medications. I've read that it's symptoms can include tongue thrusting, lip smacking, lip pursing, grimacing and chewing movements, rocking of the trunk, pelvic thrusting, rotation of the ankles or legs, marching in place, irregular respirations, and repetitive sounds such as humming or grunting. I can see myself in a nursing home, an old lady sticking her tongue in and out, marching in place in a stained and tattered bathrobe.

In the end, no one bought my bathrobes. They were taken to goodwill to face a future I will never know. While I got rid of the bathrobes, I cannot get rid of the illness. The best I can do is try to keep it at bay. I'm also learning that maintaining wellness is a delicate balancing act. The right combination, or cocktail as they say, of medications is paramount. I need to take care of myself especially during times of stress. Eating well, getting plenty of sleep and monitoring my caffeine intake also are essential to my well-being. Even with all that, there is a chance that I will become manic in the future. Thank God for my husband. He knows what to look for, signs like insomnia and rapid speech. Hopefully, if I do become manic again, I'll get help before I lapse into psychosis. My goal is to stay out of the hospital. But if I do become "sick" again, most likely I will be wearing my sweats.

   Andrews, Ted. Animal-Wise. Jackson, TN: Dragonhawk Publishing, 1999.
   Holmes, Leonard, Ph.D. "Tardive Dyskinesia", Mental Health Resources.
   Mondimore, Francis Mark, M.D., Bipolar Disorder. Baltimore, MD: The Johns Hopkins University Press, 1999.