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  Author’s note: To the best of my ability, I have re-created events, locales, people, and organizations from my memories of them. In order to maintain the anonymity of others, in some instances I have changed the names of individuals and places, and the details of events. I have also changed some identifying characteristics, such as physical descriptions, occupations, and places of residence.

  Copyright © 2020 by Terri Cheney

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  Library of Congress Cataloging-in-Publication Data

  Names: Cheney, Terri, 1959– author.

  Title: Modern madness : an owner’s manual / Terri Cheney.

  Description: New York : Hachette Books, [2020] | Includes bibliographical references.

  Identifiers: LCCN 2020014355 | ISBN 9780306846304 (hardcover) | ISBN 9780306846281 (ebook)

  Subjects: LCSH: Mental illness—Popular works. | Cheney, Terri, 1959–

  Classification: LCC RC460 .C46 2020 | DDC 616.89–dc23

  LC record available at https://lccn.loc.gov/2020014355ISBNs: 978-0-306-84630-4 (hardcover); 978-0-306-84628-1 (ebook)

  E3-20200729-JV-NF-ORI

  CONTENTS

  Cover

  Title Page

  Copyright

  Dedication

  I. GETTING STARTED INTRODUCTION

  II. SYSTEM OVERVIEW MANIA

  Journeys That Take You Too Far, Too Fast

  Judgment Day

  The Big Con

  Manic Cheat Sheet

  DEPRESSION

  Every Day, Everyday Miracles

  Pistol-Whipped

  Three Enormous Words

  HYPOMANIA

  The Prozac Years

  Seduced by a Ripe Red Plum

  Where the Neon Lights Are Pretty

  MIXED STATE

  The Torpedo Red Blues

  Bipolar Disorder’s Nasty Secret

  RAPID CYCLING

  Thorns Today, Roses Tomorrow

  The World’s Worst Party Guest

  SUICIDALITY

  The End, and Then

  I Didn’t Plan to Go to the ER That Night…

  Never Be Fooled by a Smile

  THE MIND-BODY CONNECTION

  When Your Mind Won’t Let Your Body Move

  The Botox Cure

  Hooray! I’m Really Sick!

  III. USER PRECAUTIONS STIGMA

  Doc Shock

  The Rich and Famous and Desperately Silent

  Self-Stigma: When the Mirror Lies

  You May Soon Be Unremarkable

  TERMS AND DEFINITIONS

  Call It What It Really Is

  Vaguely Bipolar

  Spitting on P.C.

  IV. INSTRUCTIONS FOR USE RELATIONSHIPS: GENERAL INSTRUCTIONS

  Don’t Fix Me, I’m Not Broken

  Relationships Are Simple: Never Do This

  Etiquette for the Ordinary

  Relationships Are Simple: Just Do This

  RELATIONSHIPS: SPECIFIC INSTRUCTIONS

  Limiting Manic Fallout

  Tell Me Where It Hurts

  Is Depression the New Plague?

  It Isn’t “Just” Anxiety

  The Rules of Suicide

  Random Acts of Kindness

  I’m Not Sick and You Can’t Make Me

  V. TROUBLESHOOTING BAD COPING SKILLS

  Going Underground: Isolating

  Bad Bedtime Stories: Self-Blame

  The Web: Obsession

  Blame It on Basic Instinct: Impulsivity

  A Walking Wound: Rejection Sensitivity

  The Virtues of Being Rude: Bad Borders

  GOOD COPING SKILLS

  A Dose of Beauty

  Why Not Try the Truth?

  Thanks, I’ll Have the Usual

  The World in an Uproar: Noise

  Scheduling Sanity

  Vigilance: Am I Too, Too Wonderful?

  The Happiness Hustle

  VI. MAINTENANCE MEDICATIONS

  Mixology: The Medication Cocktail

  There but for the Grace of Meds…

  Choose Your Poison

  Side by Side by Side Effect

  Mind Candy: The Epidemic of Overprescribing

  Bliss or Lithium?

  THERAPY

  Annoying Epiphanies

  The Right Fit

  Tried and True

  VII. WARRANTIES ACCEPTANCE

  Diagnosis: The Good News?

  Shades of True Light

  HOPE

  New Love: Handle with Care

  Coming Back/Going Forward

  The Past Is Just the Beginning

  VIII. APPENDIX RESOURCES

  Acknowledgments

  Discover More

  About the Author

  Also by Terri Cheney

  Praise for Modern Madness

  To Nancy Bacal and Dr. Geoffry White, who have kept me just sane enough all these years

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  SECTION I

  Getting Started

  INTRODUCTION

  I WAS SITTING NEXT TO Michael Jackson, admiring his feet. Michael Jackson had surprisingly big feet—farm boy feet, with some heft to them. They didn’t match the rest of him: the delicately chiseled nose, the whispery voice and waif-like persona. I was mesmerized. I kept picturing him defying the laws of gravity and motion, sliding up and back and off the floor like he was wearing invisible ice skates, ice skates with wings.

  Looking back, there was indeed something extraordinary in that room, only it had nothing to do with Michael Jackson’s feet. It was the mere fact that I was sitting there as one of his attorneys, representing him in a big, messy lawsuit involving one of the most successful albums of all time. That was me, all right—counselor to the stars. The voice of reason and restraint, in a gray Armani suit and a gorgeous white silk shirt I’d bought especially for the deposition, because it had these long, elegant French cuffs th
at would just about hide the virulent red slashes across my wrists I’d acquired from a recent suicide attempt.

  Hiding had become an art form with me. I covered up the damning signs of depression with a thoroughness and frenzy that is painful to remember: pleadings prepared by flashlight in the dead of night, so no one could see how ravaged I looked; prolonged disappearances due to increasingly fictional ailments; lies piled upon tottering piles of lies. But the mania was a different story. The mania was always on full display.

  I thought faster, I wrote better, I could argue the devil out of his soul when I was manic. I was glorious, bionic, at the top of my game, and I knew it and used it against anyone who came too close. Sex was mine for the asking, money and influence, too, and I owed it all to mania—including my proximity to Michael Jackson and his like. But no matter how lofty and impervious I appeared, depression could swoop in and lay me low without a word, without warning: the devil demanding a rematch.

  Then it was back to hiding all over again.

  Bipolar disorder wasn’t a familiar term back then. It was still called manic depression, and it was something someone’s batty old uncle once had. Certainly no one admitted to it by choice, and I wasn’t about to start. Nobody knew what was going on with me—for a long time, I didn’t even know myself. I just knew that something was terribly wrong; that something had always been terribly wrong; and that the world wasn’t ready to find that out.

  It took a whole lot of horrible to bring me to truth: serious run-ins with the law, immense amounts of alcohol, multiple suicide attempts, demolished relationships, financial ruin (mania’s costly gift), and all the other detritus that accompanies a severe mental illness. I finally grew desperate enough to seek help, and after nearly a decade was awarded a diagnosis. But that did little to stop the entropy. I wound up in a mental hospital at UCLA, for three unimaginably long years and multiple rounds of electroshock therapy. That’s when everything really started.

  It was a frightening, at times mournful and demoralizing place: gray walls, gray faces, the omnipresent sound of doors being locked. I remember looking around me, wondering why nobody seemed to be getting well. Even the brightest, most impressive patients struggled, often in tears, to describe their pain. The less advantaged simply lapsed into a zombie-like silence. I felt suffocated by all the things that weren’t being said, especially by me. Then one day it dawned on me. It wasn’t the patients’ fault. They simply didn’t have a vocabulary for their illness. Why should they? Mania, suicide, psychosis—such things were hardly the stuff of polite conversation. None of us knew how to express ourselves because mental illness was a long, inarticulate howl. It needed a voice. It needed words.

  And so, to save myself, I started to write. I wrote down everything I knew about bipolar disorder: the symptoms, the treatments, the various theories of origin. I read everything I could lay my hands on, even attended Grand Rounds lectures with the doctors. Then I threw away all the clinical stuff and wrote what it felt like inside my own body, how the illness skewed my view of the world. Seven years later, I emerged with a book called Manic.

  Never in a million years could I have expected how favorable the response to Manic would be. It catapulted to the New York Times bestseller list within a month. It was optioned by HBO for a TV series and translated into eight foreign languages. I was deluged by messages from people all over the world, asking me for advice, inviting me to speak, begging me for comfort, and always, always, telling me their own stories. During those proverbial fifteen minutes, I was the poster child for bipolar disorder. For the very first time in my life, I was no longer hiding—I was out, in a very big way.

  But my story doesn’t end there. I didn’t stop being bipolar, just because I’d tasted some success. For sanity’s sake, I’ve had to make some sweeping changes. I’ve stopped practicing law to write full time and act as a mental health advocate, in order to satisfy my need to do something worthwhile and lessen the stress that had kindled my illness into full flame. But the biggest change by far has been my willingness to accept that I have a condition that isn’t yet curable, and that may require a lifetime of treatment.

  I don’t always see this as a liability. I recognize the tremendous impact bipolar disorder has had on my life, for richer or poorer, and there is a surprising amount of richer in that equation. Without it, I doubt I would possess those qualities I truly like in myself, like creativity, empathy, and an outsider’s eye. It gives me great joy to say this: after all these years, all this suffering, this incandescent struggle, I’ve finally reached a point, not only of acknowledgment, but of ownership. This is what happened to me. This is my truth.

  My story is bigger than bipolar disorder, though. I’ve come to realize that I belong to a much vaster community: the mentally ill. Regardless of the particular diagnosis, we are all dealing with divergent experience, a life beyond the norm. Stigma encompasses all of us, as do pressing issues with relationships, coping strategies, etc. That’s why I’ve aimed this book at the broader target of “madness,” a word I know may be controversial, but that I frankly adore. It assumes a spark of genius, a familiarity with things not quite of this commonplace world.

  I recognize, from the countless heartfelt stories and questions I’ve been privy to over the years, just how complicated and frightening mental illness can be, for everyone concerned. We all need explanations, illustrations, analysis, instructions on how to build a better life in the face of exceptional challenge. Hence, this owner’s manual—and I hope it can provide some of that for those who are seeking solace. This includes not only individuals with mental health issues but also the people who love and sometimes want to strangle them; the health care professionals trying to help; and the millions of other people whose lives are affected by mental illness in one form or another and don’t understand what it is, or more important, what the hell to do about it. I offer this book to you.

  The biggest advantage I can claim as a storyteller is that I’ve been there and I know the terrain. I write what I know, and I know I’ve been lucky. I should be dead a dozen times over, yet something has conspired to let me act as a witness to my inexplicable survival. But then, I’m no stranger to amazing events; I’ve met quite a few on my travels.

  Take the phenomenon in that long-ago conference room. The wonder isn’t how Michael Jackson could dance like an angel on farm boy feet. It’s that I’m still alive to write about that moment, all these many years later, with some degree of compassion for the young woman who sat at that conference table, tugging at her shirt cuffs to hide her scars. There was a lot of peculiar talent in that room, and not all of it belonged to Michael Jackson.

  The time has come to own it.

  SECTION II

  System Overview

  MANIA

  “One must still have chaos in oneself to be able to give birth to a dancing star.”

  —Friedrich Nietzsche (1844–1900)

  The latest edition of the psychiatric bible, the Diagnostic and Statistical Manual of Mental Disorders (“DSM-5”), describes mania as “a distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently goal-directed behavior or energy.” Clinical symptoms include

  • Inflated self-esteem or grandiosity;

  • A decreased need for sleep;

  • Pressured speech or talking more than usual;

  • Racing thoughts;

  • Flights of ideas;

  • Distractibility; and

  • Engaging in risky behaviors, like unrestrained buying sprees and sexual indiscretions.

  Mania used to be defined by the American Psychiatric Association as “excessive involvement in pleasurable activities…,” which sounds fabulous, until you get to the end of the phrase: “that have a high potential for painful consequences.” That’s one of the problems with mania—it starts out feeling so great, you never think about how it might end.

  JOURNEYS THAT TAKE YOU TOO FAR, TOO FAST


  Only Monday, and already it was a lost week. The piles of important and neglected papers on my desk had copulated in the night, producing even more piles. My house was a shambles—how long since I’d cleaned it?—and I was too tired to snap to and take charge. I went to bed cranky and frustrated. But when I woke the next morning I felt it—that dazzling surge of energy that makes me long for a project, any project, to devour. I ripped through the tedious papers, making brilliant observations and uncanny deductions, signing my name with a flourish. True, my handwriting was on the verge of illegible, and the words just kept coming and coming at me till I had to scream to make them stop—but still. The whole mess was over and done with, in less time than it takes to squish a gnat.

  Then I turned to the house. Not a speck of dirt or dust could escape my darting eyes. I Lysoled and Windexed and Pledged and Febrezed until the entire place reeked of ammonia and pine. Such a heavenly scent—proof positive that whatever else may be wrong with me, I am irrefutably clean. The rewards began to diminish, of course, when the whole house was so spotless I couldn’t find anything else to polish or dust. That’s when I got out the Q-tips, so I could get to that last tiny crevice inside the microwave. That’s when I found the magnifying glass, so I could kneel down on the bathroom floor and inspect the grout between the shower tiles. That’s when I ripped off my rubber gloves and scrubbed everything I’d already scrubbed with raw bleach, until my knuckles were bloody.

  That’s when clean began to feel dirty.

  I had to get dressed and get out of there, away from the suffocating fumes—some place big enough to let me breathe. I’d stripped off all my clothes long ago because they constricted my movements; and I wasn’t quite high enough to go outside naked, although it made a lot more sense to me than putting on something I’d only have to remove again later. My tousled hair was up in a ponytail, my face and body covered in sweat. But my mirror lied as sweetly and smoothly as a best friend.