Interview Series: Marya Hornbacher

I was recently given the honor of interviewing New York Times Best Seller, Pulitzer Prize and Pushcart Prize nominee, Marya Hornbacher.   Her second memoir, Madness: A Bipolar Life is ah-mazing, thought-provoking and intense.  I read the entire thing in one sitting y’all.  One sitting.  (It’s amazing considering three small kids, a dog, a blog, and a husband–who is wonderful and thankfully so patient with me. And maybe I should start cleaning my house sometime soon).  Her book was intense and such a good read. It’s an understatement to say she’s a talented and inspiring person and writer.  I’m thrilled that this outstanding author gave me the opportunity to interview her.

Hornbacher Headshot1

Marya Hornbacher

1. Finding a good psychiatrist and therapist is essential for a bipolar person.  In your book, Madness: A Bipolar Life, you tell about your experience— from really good to unbelievably bad— with psychiatrists and therapists.  What advice would you offer a bipolar person on finding, keeping and dropping a psychiatrist/therapist?

First, and I don’t mean to be picky, but I tend to use the term “person with bipolar” rather than “bipolar person.”  It’s a small difference, but it does allow that we are more than our illness, which obviously is the case; bipolar is not a cultural or personal identification but one that indicates a disorder, and as such is not in itself something with which I tend to identify my personhood… {Point well made}

That said!

The importance of both a solid psychiatrist and a very good therapist can’t be overstated–and whenever possible, we do benefit enormously from having both, not just one or the other. People just getting into recovery might be unsure whether it’s really necessary to see one person for medication management and physiological supports, and another person for psychological and psychodynamic recovery strategies, but the research really does bear out the theory that work on multiple levels of ourselves gets us to optimum health.

INSURANCE: Finding mental health providers is an unbelievably variable process–it will depend, first, on whether you have insurance. If you don’t, make sure you’re getting information on the insurance plans available to you under Obamacare–this is critical. Look into Medicare, Medicaid, Medical Assistance, any form of insurance, because you really do want the backup of hospital coverage should need arise. If you are waiting on insurance, there are some excellent low-cost or sliding-scale fee mental health clinics in all the major cities and many small towns; if you need help finding one one, get in touch with your local mental health support chapter such as NAMI.

PROVIDERS: What I think most of us are looking for–at least many people I hear from in my own life & in my work as well–are providers who hear us. The model of mental health care that’s getting a lot of attention these days is the “collaborative care model.” This is a huge shift from the top-down approach of telling patients what they have to do–increasingly, providers are aware that they need to both listen to and educate us. Communication needs to go both ways. So when you’re looking for psychiatrists, therapists, and group leaders, look for people who listen; look you in the eye; speak with you rather than at you; and address the concerns you raise.

STRATEGIES: Come prepared. If it will help, bring a member of your support system, but speak for yourself as much as you possibly can. Bring a list of topics you’d like to discuss in your session, and be specific–don’t just raise general problems; be clear about your concern and your ideas for solving it, and be ready to listen to what the provider has to say. Bring a list of symptoms you’re experiencing, and how those are affecting your ability to function. Note things others have observed as well. In therapeutic settings, know your goals for the session and clearly identify them, enlisting the help of your provider and/or group in helping you meet those goals. YOU ARE YOUR OWN ADVOCATE! Be assertive, not passive or aggressive; ask (appropriately, constructively) for help!

2.  You seem to have a good support system, (your husband, parents and friends).  What advice would you give to the loved-ones of a bipolar person?

My parents, family, and friends (and ex-husband :) ) are amazing. The first thing I’d say to the loved ones of someone with bipolar is: EDUCATE YOURSELF. Knowledge is power, and knowing about bipolar disorder will help you know your loved one better, because you’ll know more about what he or she is experiencing, both positive and negative.

Next: COMMUNICATE. Listen carefully to your loved one, your partner or spouse, your other children; and also speak clearly about what you’re observing and what YOU need.

Next: BALANCE. It’s important to keep the power dynamics in all relationships healthy and appropriate. Attempting to “control” the person or their illness by force of will is ineffective; so is letting the relationship be dictated by the needs of the illness. Your person is entirely capable of having and developing healthy relationship skills, just as you are. Please respect that person, and respect yourself!

Next: SELF-CARE! You cannot be supportive of anyone if you’re not supporting your own mental, physical, emotional, and spiritual health. Make sure you do (at least!) one thing extra to take care of yourself every day. Take time for yourself, go for a walk, have a bath, get or give a massage, make yourself a treat, take a nap, meditate, spend time with your own friends, family, and partner. If your person is struggling a lot today, make sure you don’t forget yourself!

3. You talk a lot about alcohol in the book.  Can you tell me what your thoughts are on alcohol and bipolar disorder?

The statistics on alcohol and bipolar are grim: more than 50% of those of us diagnosed with bipolar I or II will meet the criteria for substance abuse at some point in our lives. Alcoholism and addiction tend to cluster in the same genetic trees as the mood disorders–look at the family history of a person with bipolar or depression, and you’ll find a fair number of people who struggle with addictions as well. They’ll know what that link is as they learn more about what mental illness really looks like at a genetic level. For now, it is my belief–both experiential and research-based–that people with bipolar disorder would do well to steer clear of alcohol. Those of us genetically predisposed to addiction will have that triggered when we drink, and our already-volatile mood systems often go careening completely off the rails. Those of us who are NOT predisposed to addiction will nevertheless be pouring gasoline (call it alcohol) on a fire (call it the bipolar brain). Why make a tough situation a complete disaster? I believed I was managing my moods with alcohol. Actually, I was just making my moods impossible to control–or tolerate–at all. Basically, what I know is this: whatever your mental health concern, drinking or taking substances that effectively kill brain cells and destabilize chemical equilibrium is flat silly–at best. I had to quit drinking completely before I could make the slightest dent in restoring my mental health. Once I did, the peace of mind, chemical stability, and life skills that had eluded me since I was a kid were things within my reach. With time, I got ahold of them–and I’m not about to give that up for a drink!

4. Here is a brilliant and touching excerpt from your book;

    “Sometimes I have an uneasy feeling that I am fooling everyone. In the middle of a gathering of friends, at a party, at a show, on a walk with Jeff, I’ll remember the past.  It leaves me a little shaken, bewildered by how I’ve gotten from there to here.  I feel it in the pit of my stomach, the shame of it, the feeling that I am getting away with something, living a life I don’t deserve.  It’s someone else’s life.  I’ve snuck in and am squatting in it.  I’m wearing someone else’s wedding ring, occupying someone else’s house, and everyone loves the woman I’m pretending to me, not me.  Who would love me?  I hate the person I was.”

In your experience, are these feelings something that come with the bipolar territory?

I think they’re very common, yes. The experiences that sometimes come with having bipolar can lead a person to serious frustration & eventually elements of shame, not least of which is imposed by the stigma that we live with and that we internalize. A lot of the project of recovery is the restoration of faith in oneself and one’s mind. We have pretty awesome minds, bipolar or not–they deserve our care & respect, and so do our spirits. I’ve had to spend an awful lot of time in therapy re-framing my sense of who I am–BEYOND someone with bipolar. I needed to (and keep working to) develop a sense of my own integrity as a person with a solid, excellent self at the core, NOT as someone defined by a way in which I’m “disordered.” My chemistry can get disorderly, true–but my core self rocks. :) So does everyone’s, and we have spent way too much time apologizing for who we are. That doesn’t mean we get to let our mental health go running around unchecked and steamrolling everyone else’s stuff–not at all. It just means that we have choices: we have the choice to care for our health, and when we make that choice, our choices of how we get to live, what we get to do, and who we get to be exponentially increase. The first order of business is self-care–but then we get to become ourselves. That is a joyful process, and it heals us, body and soul.

Madness: A Bipolar Life

Madness: A Bipolar Life

5. I must share a couple excerpts from your book about memory loss.  There were a few parts in the book where I literally had to stop and re-read half a page or so to my husband.  We were giggling hysterical (because we totally relate!) when we read this story about you and your husband, Jeff. (Referring to memory and time loss)

(However, he periodically makes things up and insists that they happened— Of course they did! You can’t remember that?— and then her laughs so hard he cries when I panic, hopping up and down and saying, What? What? I did? I did not! I really did? We’re on a plane and a movie I’ve wanted to see comes on— Hey, look! I cry, punching Jeff in the arm, that movie I wanted to see! And he glances up and shakes his head and sighs.  But you already saw that! he says. Did not! Did not! But you did— and to this day I have no idea if he’s just fucking with my head for fun, or if I really did these things, went to these places, said these words.  He finds it endlessly entertaining. Jerk.)

On a more serious note when discussing memory loss, you say elsewhere in the book, “Madness strips you of memory and leaves you scrabbling around on the floor of you brain for the snatches and snippets of what happened, what was said, and when.”

This is something I completely relate to. I too have time in my life that I don’t remember, that is lost, from days to years.  Could you share how you feel about having missing sections of your life?  Do you think the loss of memory is some form of repression?

If I knew more about repression, I’d be able to answer that better, but I know very little about the psychology of that. I do know that as I’ve spent more time in recovery, my memory has improved dramatically. The brain is positively remarkable in its ability to restore itself, and much of what heals it is maintaining health over time. I think there are some solid chunks of my very ill years that I’ll never have a great grasp on, but I know that my healthy years are nice and clear. My effort, then, is to store memory carefully as I go: this is done, in part, by living NOW, not worrying about what happened back then or what’s going to happen tomorrow, but by taking really exceptionally good care of TODAY. I find my memories stick around better these days, and there’s a lot more I’m glad to remember. :)

6. What advice do you give to someone newly diagnosed with bipolar disorder?

DON’T FREAK OUT. All will be well. People do this all the time. Mental health disorders are NOT a death sentence! Like any other medical problem, this takes education, effort, and management. The most important thing, for starters, is to take the diagnosis seriously; don’t think you can ignore it, and don’t try to be your own psychiatrist. Beyond that: 1. Ask for help, AND do your part. 2. Educate yourself on what your options are for optimizing treatment–this doesn’t have to be just a matter of popping pills and learning to “maintain.” You can feel a hell of a lot better, steadier, and more productive than you have–medication will probably be a part of that, but look at a holistic, whole-person treatment approach. 3. Be patient with the process. 4. Laugh. A lot. 5. Do. Not. Give. Up.

7. At the end of your book you say “I relish my life. It is a life of which I am fiercely protective.  I have wrested it back from madness, and madness cannot take it from me again.  I will not throw it away.”  What does STABILITY mean to you?

Stability means a couple of things. It means not being so swept up by moods that I lose my footing–so it means maintaining a healthy level of detachment from those moods, and being able to take action to keep myself steady at all times. It means knowing that sometimes I’ll be steadiest in bed, meditating and chilling out. It means knowing sometimes the right thing is NOT chilling out, but doing something active. It means healthy relationships! That might be the biggest joy of stability–the ability to really give back to and take delight in the warmth and mutuality of friendships and love. It means making myself useful. It means being defined by LOTS of things–not just my brain disorder–in fact, that’s probably what defines me least of all. I’m not ashamed of it, but it’s not the core of me, any more than it’s a core fact of me that I’m short. No question, I’m ridiculously short! But who cares? Same with bipolar. I learn to live better with this thing every day–it takes acceptance, humor, support, love, and commitment to my own happiness and that of the people around me, so it’s a lot of work. But it is absolutely worth it. Never question that. Even the rough days are worth it. Hang in.

Peace,

Marya

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To learn more about this author and her work, visit her website at maryahornbacher.com

A sincere thank-you to Marya Hornbacher for this interview,

Mrs Bipolarity

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