Monday, September 14, 2009
Madness: A Bipolar Life - Marya Hornbacher
At the age of 24, Marya Hornbacher was diagnosed with Type I bipolar disorder. This realization of why she thinks and behaves the way she does did not come at the outset of her disease. Rather, it came after years and years of cycling through incessant mania and debilitating depression. Hornbacher recalls moments from her childhood, such as her terrible insomnia and inability to stop jabbering flying from topic to topic with no coherent train of thought. She tried to poke fun at herself as all the other children in her class labeled her crazy, but it was clear that while Hornbacher knew she was different, she could never quite figure out what it was that made her so. Hornbacher also had an interesting home life - with parents who were violently fighting one minute, and lovingly playing Scrabble with her the next. It is unclear from Hornbacher's stories what her parents were able to recognize in their daughter as unusual and what they engdendered as a result of their own erratic behavior. As she grows older, Hornbacher's episodes become more severe. She begins starving herself at a young age and develops anorexia/bulimia (the subject of her memoir, Wasted). To alleviate her internal suffering, Hornbacher turns to cutting - one time getting so out of control that she nearly kills herself and is rushed to the hospital. Once there, the doctors seem intent on labeling her as depressed - a common diagnosis for girls with eating disorders. But, the medications only seem to make Hornbacher more crazy. In response, the doctors increase her levels of medication. Hornbacher turns to her own brand of medicine, and within years she becomes a full-blown alcoholic. Her condition prevents any medication which may have worked, from having any noticeable effect. Finally, Hornbacher receives her proper diagnosis, but it is years before the realization of her illness sets in, and before she curtails her destructive and suicidal behavior. Madness is an interesting memoir. Repeatedly I found myself thinking, "Ugh! This woman is SO ANNOYING! She's self-absorbed and self-destructive. She is ruining the lives of those who are trying to help her and never listens to her doctors (even the ones who are intelligent enough to get the diagnosis and the med levels correct." But, then I had to remind myself that these behaviors are the direct result of her mental illness. In this way, I found Hornbacher's memoir amazingly honest. She did not pepper her stories with much self-reflection, and while frightening, it was refreshing to read this type of book from the perspective of someone who isn't deluded into thinking that she now has all the answers, or that she will lead a stress-free wholly positive life now that she has her diagnosis in hand. The issues raised by this book are numerous, but in particular I found interesting Hornbacher's memories of her childhood. People are quick to belive that children are "resilient," that they don't experience trauma like adults do, that they don't remember or internalize, that they simply can't suffer from depression, bipolar, or schizophrenia. Hornbacher's memories suggest otherwise. They suggest, at the very least, that there are indicators that the disease that may manifest at quite an early age. The question being whether treatment on children is safe or effective, and if anything can be done to prevent the progression of the disesase. Hornbacher's experience also emphasizes the relation between eating disorders, cutting, suicidal ideation, alcoholism, and other destructive behviors and mental illness - they feed on each other in ways that often make it difficult to detemine the origins of a given problem. Madness is written as a memoir - it is Hornbacher's story - it is not a clinical examination of bipolar disorder - and it does not answer many questions that I had about the history of bipolar treatment and the state of bipolar disorder in our country today- in terms of the research that is being done, the medication available to people, and how therapy can be used, if at all, to deal with the symptoms. But, what this book does do is open a window into an often misunderstood disease and ignite a dialogue that will hopefully lead to answers and more efficient diagnoses.