At the end of the summer, I rented a house on Cape Cod for a family vacation. My 21-year-old son Ryan joined my daughter, Liz, and I when he returned from traveling with friends in Europe. It was clear he hadn’t slept for days. At dinner, he was anxious and rambled on and on. He spent a sleepless night on the couch, watching The Godfather: Part II, shouting, “Al Pacino is the man!” This odd behavior continued for days.
When we arrived home in California, he was afraid to be alone and didn’t want to sleep in his room. He set up a mat on the floor next to my bed and stayed awake all night, talking endlessly. And when I awoke, he was gone.
I called my ex-husband Jerry to see if Ryan was at his house. He wasn’t. Several hours later, Jerry called to say that Ryan had jumped on his bike at dawn and pedaled 30 miles up the Pacific Coast Highway to prevent an earthquake.
When Ryan came home, I asked him why he rode his bike up the coast. He responded, “I was trying to exhaust myself so I could fall asleep. If I don’t get some sleep soon, I’m going to lose my mind. I also had to get as far away as possible from you and Liz, because if I didn’t, the San Andreas would slip.”
“You can’t cause an earthquake,” I said gently.
“Oh, yes, I can. An earthquake’s coming. I can feel it.”
The next morning, Liz and I took Ryan to the hospital. He was transferred to the psych ward where he stayed for two weeks. He was treated with various medications, attended daily group therapy sessions, met with psychiatrists and social workers, and talked endlessly with his friends by phone. On the tenth day of his hospitalization, his psychiatrist, Dr. G, called a meeting with Ryan and the family.
“My diagnosis for Ryan is bipolar disorder, manic depression.” She looked at Jerry and me. “Is there a history of alcoholism on either side of your families? I ask because many undiagnosed bipolar patients self-medicate by using drugs and alcohol, trying to manage their mood swings.”
I spoke up: “We both have alcoholism in our families.”
Dr. G nodded. “That fits the pattern. Fortunately, the disorder is treatable with proper medication. But it’s not something to be treated lightly.” She then asked how we felt about the diagnosis.
I could barely breathe, but I swallowed hard and looked at Ryan. “I’m grateful there’s a diagnosis for Ryan’s behavior, because you said it’s treatable.” I paused. “Isn’t lithium fairly successful in managing the disorder?”
Dr. G nodded and then turned to Jerry. “What about you?”
“I don’t believe it,” he said, shaking his head and looking at Ryan. “I think he’s just an addict.”
“Why don’t you believe it?” Dr. G asked.
“Because if he has a mental illness, I’d have to look at that in myself as well.”
I was stunned. “You’d rather see Ryan as an addict than as having a treatable mental illness?”
“I’d rather see him control himself,” he replied. “I think he can choose to live his life differently; I don’t want him on medication for the rest of his life.”
Dr. G must have seen this before and made no comment—she simply went on to explain that most bipolar patients live successful, functional lives if they take their medication, learn to monitor their mood swings, adjust their medication as needed and abstain from alcohol and illegal drugs.
“But,” she continued, looking at Ryan, “bipolar patients who refuse to take their meds—because of denial or the desire to recapture the euphoria of the hyper-manic mood state they love—often endure multiple hospitalizations.”
Ryan didn’t look at her. “I don’t have an illness and my family had no right to hospitalize me. I just got some bad dope in Amsterdam—that’s all.”
“Well, then, if that’s the only problem,” said Dr. G, “I’d like you to go into a 30-day rehab program. Go into addiction treatment while you stay on the medication I prescribe. Then we’ll see how you feel.”
Ryan stood up. “I’m not going into rehab. I want to get out of this place as soon as possible and start grad school.”
“I can’t keep you here against your will,” Dr. G. explained, “You’re an adult, and at this point you’re not harmful to yourself or anyone else. But unless you stay on your meds and get serious substance abuse treatment, you’ll be back. I guarantee it.”
Two days later, Ryan left the hospital against medical advice, with an unfilled prescription for his bipolar diagnosis.
Though, Dr. G.’s prediction was right: Ryan did eventually come back. And after many hospitalizations and addiction treatment programs, he finally learned how to manage his mood swings with the proper medication.
Ryan is now stable, has a job, does yoga to manage anxiety and is becoming certified as a drug and alcohol counselor. As his illness has matured, he has matured as well. Now his purpose is giving back to others.
Meg McGuire is a mother, writer, psychotherapist and the author of five internationally published nonfiction books. She is an activist in mental health and criminal justice reform and teaches memoir in southern California. Her newest memoir, Blinded by Hope: One Mother’s Journey Through Her Son’s Bipolar Illness and Addiction, shines a light on mental illness, illuminating the shadow of family dynamics that shame, ignorance, and stigma rarely let the public see.