Partial

Approximately four months ago, my psychiatrist placed my Bipolar 1 Disorder in partial remission.  Since, I have struggled, grappled, with the word “partial.”  How is it possible that I am only partially towards remission?  Where is the line drawn in the division of these categories, where does the curtain fall – symptomatic, partially symptomatic, fully asymptomatic?  The application of “partial” poses discomfort for me on several levels, the very first being my perceived lack of control.  As the entity experiencing the disorder, how can an outsider peer in and see the inner clock working, ticking, turning of my mind and know, with a certainty, I have progressed up the ladder?  I feel quite wary of such a distinction.  I see mental illnesses as fluid disorders, not remaining in exact, crystallized forms for extended periods of time.  Thus, as I continue to have episodes of mania and depression, I squirm with angst and frustration that such emotions should have been annihilated by now, as I am in partial remission, correct?  I am constantly flowing in and out of states, and these two words attempt to hit a fragment of my existence like a dart to a bullseye and obliterate all outlying symptoms.  At least this is how my mind perceives it to be.  Rather, as I have discovered in the medical world, labels are just an issue of semantics, present only for clear and consistent communication among medical professionals and for the direction of effective treatment.

If I can entertain the notion of casting all labels aside and truly examine my progress, there rests marked improvement.  One year ago, I was still receiving electroconvulsive therapy treatments, and much of my episodes surrounded suicidal thoughts and intrusive thoughts of self-harm.  Episodes lasted weeks, even months, despite aggressive treatment.  If asked what my greatest worry for the future was, I most likely would have answered suicide.

I had my final official meeting with my psychiatric nurse case manager yesterday.  We were discussing my progress and impending ability, due to vast improvements, to be discharged from the intensive care program.  She posed the question, what are you most worried about in the coming year?  My immediate, knee jerk response was “not getting into grad school programs.”  What a departure from a year ago, twelve months ago, three-hundred sixty-five days ago.  It was in this moment that I could see how significantly my perspectives have changed, have shifted.  Instead of contemplating the unsure existence of life in the near future, I imagine a place in which I live, I am successful, and I humanly exist.

To battle words is a futile battle.  One must recognize that words only hold the power that you allow or wish for them to hold.  And why can words not be fluid as well?  In consideration, can the word partial possibly be considered fluid and dynamic, for does it not imply a sort of limbo?  How more advantageous it would be to see it as a realm of existence where I can experience a spectrum of differing symptoms, yet still exist in a space of reduced symptomatic expression.  I do not have to imagine lines and curtains, theatrical representations of the process of remission.  The underlying, driving emotion in this wrestling match is fear, in two parts.  As I progress into partial remission, does there lie an impending regression into severe illness once again?  Or alternately, as I move from partial remission to a possible full remission in the future, will I lose the mind I have and hold so dearly, or my depth of experience, as well?

I can take a shower and perform morning ablutions without washing my hands repeatedly to avoid contamination.  When things do not occur within increments of four, I no longer freak out.  It only takes me a few minutes to leave my apartment, checking all faucets and appliances and the door only a few times.  These rituals, but a small part of my cornucopia of symptoms, were all-consuming.  The other day I realized I did not massage my scalp to the count of four as I was shampooing, and that was okay.  Anxiety had abated, and I could wash my hair without the abacus clicking within my head.  Instead of focusing on semantics, I vow to focus on my improvements, my victories in the face of crises.  Why get hung up on words when I can drink the sweet wine of life?

Praying for the Pendulum

Equilibrium.  My breath flows gently, evenly, soft as the lunar pulling of the tides, scented sweetly with rose and tulip fragrance. I am unlabored.  My limbs, my kinesiology, function at optimum level, joints bending, muscles pulling and releasing.  Pathology is a topic taboo, unspoken, for why should it exist?  Clouds shed ample water to nurture and cultivate crops for a plentiful harvest.  Hush, the fertile ground whispers to the girl, fear not, as pain and suffering are banished to the periphery, antiquated tales told solely to draw remembrance to what has passed and what could come to be.  Words and phrases escape my lips in dances of restraint, tight waltzes danced by lovers who do not misstep.  My mind turns with clockwork efficiency, correctly chiming hours, half hours, quarter hours.  My lips curve into smiles soft as rolling hills, relaxed and unstrained, manifesting and subsiding with consideration and precision.  I do not swing but stand with determination, yet permanency and consistency are not components of my vernacular.

The pendulum begins to sway.  My ship is crushing against tempestuous waters, waves of salty tears spilling across wooden decks.  I attempt to steer the mast, yet my efforts are of little avail.  My breath reeks, betraying the sweet utterances I spew forth, exposing the lies frolicking in glee.  I am adept at hiding, at foolery, but the putrid sewer water seeping through the gaping pores in my diminishing and cowering epidermis offer no refuge.  I am exposed, burnt to blisters by the harsh Saharan sun, and I can no longer withhold the fluid from my weeping sores.

The swinging pendulum peaks to the left.  The putrid sewer water has inundated my lungs and my alveoli can no longer sequester oxygen from the once sweet inhale.  Rather the poison pumps through my vascular system, slowly failing organ by organ, each destined to the same fate.  I open my mouth to speak, yet all that escapes chapped, bleeding lips are gurgles and coos, my linguistic powers reduced to that of an infant.  Regression draws me to the land where the happenings of the physical world are insignificant and no longer relevant.  I am relegated with joy to death row, accompanied by the sickest and most depraved of criminals.  Yet I know with undying conviction my own sickness, the crimes of which I am guilty, punishable to the fullest extent of the law.  My stomach begins empty.  What nutrition and sustenance shall I need in death?  The initiation of slow starvation prepares my mind and body for the realm of the dead.  Why fight what is soon to pass?

The pendulum swings to the right.  My body miraculously reverts from a stage of deprivation to a stage of plenty.  Where words were once defiled or absent now pour forth with the gushing and arcing of arterial spray, lifeblood coursing through expanding vessels and illuminating the world in a splashing splay of vitality and increasing wellness.  The taste is palpable, metallic yet pleasing to the tongue.  Stagnant neurons in my brain receive incessant telegrams, synapses once dead springing to work and shooting newfound energy through thirsty cells and across unlocked barriers.  The signs flash “Open for Business,” and the clockwork turns.  However the dance quickens, gains in speed and momentum.  The dancers begin to misstep, trip, fall.  The music quickens to a deadening roar.  Moles dig their way into my brain and nibble and snack on my neurons, jumbling the thoughts and connections.  What was once pleasurable has metamorphosed into decimation.  The gray matter of my brain rebels, wielding sledgehammers to escape what has now become a camp for prisoners of war.  The question lies, will there be veterans?

The pendulum swings once again to the left, and then to the right, rapidly diminishing in the distance to which it travels.  Finally, in an answer of prayer, the pendulum reaches equilibrium.  The pendulum will sway once again and threaten to decimate my existence, yet I pray, let there be an eventual equilibrium, for the pendulum can only swing so many times.