Living with The Beast on the teeter-totter

"The Beast” is how Sharon Brown-Carruthers, a registered hospital nurse, described what lived with her as a girl in Saskatchewan and British Columbia in Canada and as an adult in the US. “Something is not right with me.

The idea kept whirling around and around in my head,” she pondered as a second grader. “I’m not like the other kids. Once I start crying, I can’t stop like they can.

Why?” Even as a child, Sharon showed signs of carrying The Beast – bipolar affective disorder (BAD) – on her thin shoulders.

Her unusual and strikingly frank autobiography, written with great clarity in her 60s with writer Corrine Vanderwerff as a 330-page, hard- or softcover volume titled The Teeter- Totter, has just been published by WestBow Press (available at amazon.com).

After decades of endless teeter-tottering of her moods, Sharon is now retired in Shawness, Kansas, with Douglas, her loyal and devoted husband of 42 years. Contrary to her many tortured decades struggling with the psychiatric illness of manic-depression, she enjoys a stable and productive retirement, volunteering in a hospice and organizing and leading depression seminars and Bible study groups.

Thus the book has a happy ending, but most of its pages are full of her mental zigzagging between giddy highs and desolate lows, even an attempt to leave her loving husband.

BAD affects nearly six million Americans aged 18 and up in any given year (2.6 percent of the population) and tens of thousands of Israelis, some of them undiagnosed and untreated despite years of suffering.

Bipolar disorder is not easy to spot when it begins, as the symptoms could appear as separate problems, not recognized as parts of a larger problem.

It’s a brain disorder that causes unusual shifts in mood, activity levels, energy and the ability to carry out routine tasks with serious symptoms that have no similarity to the the normal ups and downs that people go through from time to time.

Bipolar disorder symptoms can result in damaged relationships, poor job or school performance and even suicide.

But bipolar disorder can be treated with regular monitoring, and managed with medications and other therapy, and its sufferers can nevertheless lead full and productive lives.

Bipolar disorder often develops in the late teens or early adult years, with at least 50% of cases appearing before the age of 25. Yet there have been reports of BAD in children.

Both genders and all races are affected equally, and it tends to run in families. The first episode in men tends to be a manic episode, while women are more likely to start with an attack of depression. Younger patients first may suffer cyclothymia, which is basically a less extreme form of bipolar disorder characterized by hypomanic and mild depressive episodes. Although people with cyclothymia display less intense symptoms, nearly half of them will progress to having a full manic episode.

The cause of bipolar disorder is not entirely known, but researchers now believe it is mostly a biological disorder that occurs in a specific brain region and is caused by malfunction of the chemical neurotransmitters such as serotonin, norepinephrine and others. It can lie dormant until triggered by external occurrences like psychological stress, life events or taking certain drugs or drinking alcohol.

A person who has a non-identical twin with the illness has a 2 5 % chance of BAD, while one who has an affected identical t w i n (with the s a m e g e n e s ) h a s e i g h t t i m e s the risk of BAD as a non-identical twin.

The mood swing to highs appears as a heightened sense of self-importance; exaggerated positive outlook; much less need for sleep; lack of appetite; rapid speech, impulsivity and swift changing of the subject; impaired judgement; poor concentration; hallucination; too much involvement in pleasurable activities; spending sprees; and aggressive behavior.

The swing to lows show up as sadness or hopelessness; lack of interest in pleasurable activities; poor sleeping behavior; lethargy; a feeling of guilt or low self-esteem; possible weight gain; problems in concentrating; negative thoughts about the future; and thoughts of suicide or death. Behavior patterns may change along with the different seasons of the year.

As there are no blood or other biological tests for BAD, it has to be diagnosed by a mental health professional.

Patients many times resort to lies to hide their actual condition and actions.

There are a number of useful medications, including lithium, for the long-term condition, but when someone with BAD is in the manic phase, he may be so elated that he refuses to take pills because he “doesn’t need them,” while in the depressed phase, he can be persuaded to return to them.

While lithium usually does not have serious side effects, antipsychotics, anti-depressants and anti-anxiety medications usually do but can help stabilize patients.

Psychotherapy may also be beneficial, or it may not. Most people respond positively to a medication and or “cocktail” of them. Family members are often turned into policemen by the need to make sure the patient follows the prescribed regimen.

Sharon’s case was quite typical, except that she felt she was “different” at an unusually young age. She has a twin sister, Carol, apparently nonidentical because Sharon describes herself as being taller, and an older brother, Ron.

Both of her siblings were unaffected by the disease. Her older sister Darlene died of diphtheria.

The family were Seventh Day Adventist Christians with deep faith.

When the twins were only five years old, her mother, Ruby, was asked by friend Hortense Perfecto why Sharon “doesn’t like to play with other children... I’ve never heard her say one word to anyone.. She just sits near you and listens to our conversations. Doesn’t that seem a little abnormal”? “That was true,” Sharon wrote in her book. “I didn’t like to talk – not to other kids, not to grownups, and sometimes not even to Mom and Dad. But I could talk as easy as anything inside my head and to Carol, who[m] I let do all the talking to the others... I looked across the room to Dad.

He’d been chatting with the other men and was looking at me now with a strange expression in his eyes. Did he know that Mrs. Perfecto was right? Please Dad!, I said in the secret place in my brain... Say that she’s right!” “It wouldn’t hurt to take her to a psychologist and have her evaluated,” said Mrs. Perfecto.

But neither Ruby nor her father, Norman, ever followed up her suggestion. “In my prayers ever since I could remember I’d been asking god to make me like other kids,” Sharon recalled.

When Norman became unemployed as a salesman and Ron found work in a sawmill camp in British Columbia, the parents and the seven-year-old twins moved to be with Ron, who found his father a job as a lumber worker. The family temporarily lived in a primitive shack with an outhouse instead of an indoor toilet and running water. The girls studied in a one-room schoolhouse, where the teacher used a leather strap as punishment for poor learners. “Teeter-totter,” shouted Sharon in the schoolyard, an up-and-down swing she would later know in her head for many years to come.

A pile of lumber fell on Norman in a sawmill fire, leading to an infection of a leg and eventual amputation. But he managed with a wooden leg.

Ruby, who also took an office job at the sawmill, was hired to be administrator of a tiny hospital in the area. Sharon began to do well in her studies when she reached high school. Her ambition was to become a nurse. At 15, the sisters went to study at an Adventist high school and junior college in Alberta.

In her first year of nursing school, Sharon did very well and emphathized with the patients. But when she had a psychiatric rotation for weeks, she entered the department with great forboding. Her texts described BAD, “and the information strengthened my instinct about myself. I tried to brush the idea away, to tell myself I was wrong, that all I had to do was continue putting on the nursing persona I was developing, and that everything would always be right and good,” she recalled.

“But deep down, the knowledge was there – the sense that I truly was different, that I always had been.”

She struggled with the evidence that she herself was mentally ill. Her first onepatient- at-a-time assignment was a schizophrenic man.

“Instinctively, I saw myself as needing to be where he was.”

Her own mood changes began to appear, but she finished her education with high grades and became a registered nurse.

The head of nursing at a 21- bed district hospital in the mountains of British Columbia hired her on the spot.

Urgent decisions and responsibility quickly faced her, as a man walked into the ward with chest pains, and no physician was around. Sharon treated him and had him transferred to a larger hospital, where the patient’s life was saved with surgery.

Some time after Carol, who also became a nurse, married and moved to Massachusetts, Sharon met Doug – a hospital administrator with a business degree – on a blind date.

They got engaged, but a problem with a patient who went into a coma sent Sharon into an attack of depression. Yet, when called into another hospital when a pregnant woman’s heart stopped and went into clinical death and nobody else knew how to use a defibrillator, Sharon worked so competently to save the baby that she was hired.

Her mood greatly improved, even too much.

They decided to marry when both were 26, and Sharon thought she had successfully hidden the fact that she was suffering from a psychiatric disorder. But at the wedding, The Beast of lows returned. Doug never pressed her about her mood changes.They moved to an apartment overlooking a lake in Wakefield, Massachusetts, where Doug worked as an assistant personnel director at a hospital. The offer to be head nurse in a small cardiac intensive care unit in the hospital again raised Sharon’s spirits. But after a short time, the lows returned, and the hospital’s nursing director sensed something was seriously wrong. As she had many times, Sharon resorted to lies, insisting that it was only starting a new job that had gotten her down.

After six months, the clouds of depression dispersed, and she went into a high. Mania, she explained in the book, arrives “like a quick-energy rescue from the agonies of depression and filling you with the feelings of being able to accomplish almost anything.

The sudden release from the horrors of bipolar depression feels so heavenly that there seems no explanation other than its being a miracle.”

But then she returned to the rollercoaster of depression in the next cycle, and “the falling shadows rapidly shrouded me with darkness even more ominous than before.”

They both changed jobs and residences numerous times and didn’t remain in the same place long enough for her to be properly diagnosed and treated.

With her husband suffering from infertility problems, the couple adopted two boys. Coping with motherhood gave Sharon seven years of normality as they grew up. But an encounter with a Christian preacher who said the mentally ill have no right to h e a v e n because they are unaccountable for their deeds sent her into a downspin that made her seriously think of suicide.

As her condition w o r s e n e d into hallucinations, she decided to leave Doug, rented an apartment and left, but he patiently stood by her until she agreed to return. A friend at church finally suggested that she was suffering from bipolar affective disorder, and a psychiatrist put her on lithium.

But it took four more years before Sharon felt enough empathy to follow the regimen that kept her steady for many years as the boys grew to adulthood.

Yet another psychiatrist saw that lithium was not having enough effect and prescribed the anti-depressant Wellbutrin, but it too was not the answer. Only when she was given the anti-psychotic Seroquel XR did she finally stabilize.

“No more violent swings, no mania, no depression. I felt whole.”

Now retired, Sharon decided to write this book... and she and Doug live happily ever after.