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THE SUMMER OF 1994
Dear Matt,
One of the worst problems psychiatrists face with bipolar patients is keeping them on their medicines. Think about it for a minute. If the lack of medicines gives you energy and confidence and no need for sleep, who is going to take pills? Notwithstanding my anxiety, I’ve always missed some aspects of mania. Thus the opportunity that presented itself in 1994 was too good to pass up. I was told to stop all my medications. For months I had been complaining to Dr. B. about fatigue. I was certain I needed more antidepressant therapy. He thought I was experiencing daytime drowsiness and wanted to have me take a sleep study. In spite of his better judgment he went along with my request and increased my antidepressant dose. It didn’t help. I agreed to the sleep study. I was told to stop all my medications for the study. I did so two weeks before I went to the sleep lab. I was manic by the time I arrived for the study. I sat with the staff in the control room, talking away until nearly 3:00 AM. They finally forced me to go to bed, where I slept about three hours. Sure enough, I had severe sleep apnea, the kind where I would just stop breathing for close to a minute at a time. I think that so distracted Dr. B. that he didn’t make sure I had started back on my medications. I had not. The Five S’s came back to life. Let me use spending as my primary example of the bipolar mania that followed. The first of the many events of the summer of 1994 was a trip to San Francisco that you and I took in May. We had a great trip staying at the posh Le Meridian Hotel. We saw the sights that we liked from our previous trips and spent money with abandon. I was planning on working urgent care for a clinic all summer, and I didn’t anticipate money being a problem. I recall distinctly how expensive breakfast was, and I didn’t give it a second thought. Less than two weeks after we returned, the whole family loaded up and headed for your uncle’s wedding. The wedding included Old West costumes and a brief ride on a steam engine train up into the mountains. We stayed at a nice lodge. I hadn’t started working my summer job yet. Two weeks later I was cruising the San Diego Harbor enjoying a sailing course with J World. I had a splendid time learning to sail; it had become my latest loony passion. The week on the water couldn’t have gone better. Unlike my usual sleepy driving, I sped along to California without a drowsy blink, making a short home movie for Callie of my trip. I had that manic need for little sleep. I felt like a competent sailor by the end of the course. I was now ready to buy a boat. Life without medication felt good. Through June I worked lots of extra hours at the urgent care clinic and piled up the money, or so I thought. I wasn’t keeping very close track of income and expenditures, however. I was manic, and my concept of money was all screwed up. I was sped up again. I wasn’t sleeping, and sex was at the top of the interest list. Our eighteenth anniversary in July was spent at a resort lodge in the mountains on an expensive “romance package.” It was romantic and indulgent. Our family vacation that same month took us through Arizona to California. In three hours I bought a beautiful Catalina 22 sailboat at a brokerage in Phoenix. I didn’t just buy it—I had it upgraded for a couple more thousand dollars to include a jib roller-furler and a new hatch. The financing was bound to be a problem, since I hadn’t arranged it before. For the rest of the trip I faxed forms back and forth to our bank to get the boat loan set up by the time we finished our visit to Los Angeles and San Diego. Disneyland was on that agenda, and I threw money around there like it really was Tomorrowland. Two days after we returned from California I took Ryan with me to Pittsburgh and a lousy meeting of emergency medical service physicians. We spent over one hundred dollars a day on baseball games and more on great meals. We traveled downstate and visited my father’s family. Ryan and I stayed at the ritzy Hyatt Regency Hotel. While we were returning home your mom left for a rafting trip with her sisters. By this time she was becoming increasingly concerned about my spending and vague reassurances. She had never seen me spend so much money so freely since being medicated. I think she was having visions of Acuras. When your mom inquired I told her with confidence that I was earning more than enough working all the extra hours. But I wasn’t sleeping, and there was a twenty-two-feet sailboat parked in the yard awaiting a marina slip. It was soon gobbling up hundreds of dollars per month. I estimated that by the time I sold the boat it had cost us more than two hundred dollars every time we had taken it out for a sail. Your mom returned from her trip with her sisters just in time for us to leave for Denver, where we stayed at a large Sheraton Hotel for more vacation and a soccer tournament. We dined out with the teams and enjoyed the sights of Denver. Once again the money flowed in one direction: out. As the summer drew to a close, the boat was in an expensive slip, and I was becoming worried that I might be in some financial trouble as the credit card balances grew. Your mom’s suspicions had blossomed, and she called Dr. B. to talk about me. He hadn’t seen me for months and probably understood what was going on without more information. He called me in for a visit. I was busted. I hurriedly started back on my medications, knowing he would want blood levels, and mine would be zero. The jig was up. My leash was shortened to monthly visits and closer blood level monitoring. The worst part, though, came with the credit card bills and the boat loan. My income from the urgent care clinic was generous, over twenty-two thousand dollars in three months of part-time work. My bills for the summer exceeded forty-six thousand dollars as best as I could figure. Now I think that it was probably much more than that. I didn’t really want to know then. I don’t want to know now.
Your loving father,Dad
Dear Matt,
One of the worst problems psychiatrists face with bipolar patients is keeping them on their medicines. Think about it for a minute. If the lack of medicines gives you energy and confidence and no need for sleep, who is going to take pills? Notwithstanding my anxiety, I’ve always missed some aspects of mania. Thus the opportunity that presented itself in 1994 was too good to pass up. I was told to stop all my medications. For months I had been complaining to Dr. B. about fatigue. I was certain I needed more antidepressant therapy. He thought I was experiencing daytime drowsiness and wanted to have me take a sleep study. In spite of his better judgment he went along with my request and increased my antidepressant dose. It didn’t help. I agreed to the sleep study. I was told to stop all my medications for the study. I did so two weeks before I went to the sleep lab. I was manic by the time I arrived for the study. I sat with the staff in the control room, talking away until nearly 3:00 AM. They finally forced me to go to bed, where I slept about three hours. Sure enough, I had severe sleep apnea, the kind where I would just stop breathing for close to a minute at a time. I think that so distracted Dr. B. that he didn’t make sure I had started back on my medications. I had not. The Five S’s came back to life. Let me use spending as my primary example of the bipolar mania that followed. The first of the many events of the summer of 1994 was a trip to San Francisco that you and I took in May. We had a great trip staying at the posh Le Meridian Hotel. We saw the sights that we liked from our previous trips and spent money with abandon. I was planning on working urgent care for a clinic all summer, and I didn’t anticipate money being a problem. I recall distinctly how expensive breakfast was, and I didn’t give it a second thought. Less than two weeks after we returned, the whole family loaded up and headed for your uncle’s wedding. The wedding included Old West costumes and a brief ride on a steam engine train up into the mountains. We stayed at a nice lodge. I hadn’t started working my summer job yet. Two weeks later I was cruising the San Diego Harbor enjoying a sailing course with J World. I had a splendid time learning to sail; it had become my latest loony passion. The week on the water couldn’t have gone better. Unlike my usual sleepy driving, I sped along to California without a drowsy blink, making a short home movie for Callie of my trip. I had that manic need for little sleep. I felt like a competent sailor by the end of the course. I was now ready to buy a boat. Life without medication felt good. Through June I worked lots of extra hours at the urgent care clinic and piled up the money, or so I thought. I wasn’t keeping very close track of income and expenditures, however. I was manic, and my concept of money was all screwed up. I was sped up again. I wasn’t sleeping, and sex was at the top of the interest list. Our eighteenth anniversary in July was spent at a resort lodge in the mountains on an expensive “romance package.” It was romantic and indulgent. Our family vacation that same month took us through Arizona to California. In three hours I bought a beautiful Catalina 22 sailboat at a brokerage in Phoenix. I didn’t just buy it—I had it upgraded for a couple more thousand dollars to include a jib roller-furler and a new hatch. The financing was bound to be a problem, since I hadn’t arranged it before. For the rest of the trip I faxed forms back and forth to our bank to get the boat loan set up by the time we finished our visit to Los Angeles and San Diego. Disneyland was on that agenda, and I threw money around there like it really was Tomorrowland. Two days after we returned from California I took Ryan with me to Pittsburgh and a lousy meeting of emergency medical service physicians. We spent over one hundred dollars a day on baseball games and more on great meals. We traveled downstate and visited my father’s family. Ryan and I stayed at the ritzy Hyatt Regency Hotel. While we were returning home your mom left for a rafting trip with her sisters. By this time she was becoming increasingly concerned about my spending and vague reassurances. She had never seen me spend so much money so freely since being medicated. I think she was having visions of Acuras. When your mom inquired I told her with confidence that I was earning more than enough working all the extra hours. But I wasn’t sleeping, and there was a twenty-two-feet sailboat parked in the yard awaiting a marina slip. It was soon gobbling up hundreds of dollars per month. I estimated that by the time I sold the boat it had cost us more than two hundred dollars every time we had taken it out for a sail. Your mom returned from her trip with her sisters just in time for us to leave for Denver, where we stayed at a large Sheraton Hotel for more vacation and a soccer tournament. We dined out with the teams and enjoyed the sights of Denver. Once again the money flowed in one direction: out. As the summer drew to a close, the boat was in an expensive slip, and I was becoming worried that I might be in some financial trouble as the credit card balances grew. Your mom’s suspicions had blossomed, and she called Dr. B. to talk about me. He hadn’t seen me for months and probably understood what was going on without more information. He called me in for a visit. I was busted. I hurriedly started back on my medications, knowing he would want blood levels, and mine would be zero. The jig was up. My leash was shortened to monthly visits and closer blood level monitoring. The worst part, though, came with the credit card bills and the boat loan. My income from the urgent care clinic was generous, over twenty-two thousand dollars in three months of part-time work. My bills for the summer exceeded forty-six thousand dollars as best as I could figure. Now I think that it was probably much more than that. I didn’t really want to know then. I don’t want to know now.
Your loving father,Dad
