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Madness: A Bipolar Life

22 September 2008
Latest memoir by Marya Hornbacher documents her rollercoaster life with undiagnosed mental illness.

madness2.jpg “Madness: A Bipolar Life” is the third book for author Marya Hornbacher. Her previous books were “Wasted: A Memoir of Anorexia and Bulimia,” which was nominated for a Pulitzer Prize in 1998, and the fictional book, “The Center of Winter.” She wrote “Wasted” when she was 22. At the time of her success with “Wasted,” Hornbacher had no idea what was at the root of her problem. At age 24 she was finally diagnosed with the most severe type of bipolar disease, Type 1 Rapid Cycling Bipolar. Finally the pieces started to come together.

There is a great debate out right now on diagnosing children with bipolar disorder. Medicating children with pills that were designed for adults can have a devastating consequence. PBS’s Frontline program aired a show called, “The Medicated Child ,” (which is available on DVD from the Prescott Public Library,) speaks to this issue in great depth. However, Hornbacher remembers that even as a toddler she couldn’t sleep at night, talked incessantly and wanted to go outside to play in the middle of the night. She writes, “I am four years old and I like to stay up all night. I sing my songs, very quietly. I keep watch. Nothing can get me if I am awake. I sleep during the day like a bat with the blinds closed and then they come home. I hear them open the door, and I fling on the lights and gallop through the house shrieking to wake the dead all evening, all night.” Her mother quiets her down by sitting her in a warm bath until she is calm again.

Hornbacher says that the other children knew she was different and, “The other kids say it, twirl their fingers next to their heads, Cuckoo! Cuckoo! They say, and I laugh with them and roll my eyes to imitate a crazy person, and fling my arms and legs around to show them that I get the joke, I’m in on it. I’m not really crazy at all.”

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At age 10 she discovers alcohol and tries to use it as a mood stabilizer for many years. And her life continues to spin out of control. Drugs, promiscuousness, alcohol, cutting, and at one point, in the hospital and weighing 52 pounds and given one week to live.

One of the astounding things about Hornbacher’s diagnosis is that it took so long for someone to see what was actually wrong with her. She went to many different doctors over the years, from childhood into adulthood, was in psychiatric hospital numerous times, and even visited with an expensive psychiatrist in San Francisco who doesn’t take insurance. She tries to tell the doctor that she can’t handle her mood swings or the anxiety. The doctor gives her a prescription to Klonopin, a tranquilizer. Hornbacher asks the doctor how much of the addictive drug she can take. The doctor says, “Take as much as you need. I’ll write you a prescription for more.” When Hornbacher tells the doctor that she feels she’s drinking too much, the doctor says, “I think that’s a little melodramatic.” Hornbacher writes, “A psychiatrist with any wits at all would be alarmed at my own admission that I was drinking too much, and would make the obvious connection between the fact of the drinking and the fact that my meds weren’t working. But apparently she doesn’t have any wits.”

At the end of her book, Hornbacher gives a list of Bipolar Facts, which she said came from a number of sources. Among those facts:

American adults who have bipolar disorder: 5.8 million
Life expectancy of an adult with serious mental illness: 25 years shorter than that of a person without.
Bipolar patients who attempt suicide: 25%
Approximately half of all suicides in the U. S. can be attributed to bipolar
Average age of onset: 23
Average age of correct diagnosis 40
Annual direct and indirect costs of bipolar disorder in America: $45 million

Research funding from the 2008 National Institutes of Health:

Bipolar: approximately $250 million
Diabetes: slightly over $1 billion
Depression $334 million
Schizophrenia: $363 million
Alzheimer’s$ 642 million
Other brain disorders $4.7 billion

So the funding is there, but it’s near the bottom of the list.

There are no secrets between the reader and Hornbacher. She giver her own bipolar facts:

Current medications: Lamictal, Tegretol, Geodon, Wellbutrin, Trazodone, Ativan, and supplements
Weekly cost of her medications: Around $300, one third of which is out of pocket.
Weekly cost of therapy: $217 (out of pocket)
Psychiatric visits: $300 per session, (at least two per month, sometimes more), only partially covered by her three forms of insurance
Cost of last hospitalization: $45,000 covered by insurance, $10,000 out of pocket.

Hornbacher’s book has a lot to offer for anyone who has a family member with bipolar, or a friend with the diagnosis. Beyond that, as the population from children on up seem to have the diagnosis more and more frequently, it’s simply something to be more aware of. This very personal journey sometimes makes you angry, (at the medical profession), frustrated, (at Hornbacher for her horrible decisions), and glad, (she’s found a way to live with the diagnosis). You have a sense of pride that Hornbacher has not only made it, but made a career for herself and a success that anyone, bipolar or not, would envy.