The next time I was manic I knew. I knew and I could not have been more pumped. I pumped it up on that train car, the one headed home to Norfolk with nobody on it but me and my headphones and my dancing. The streetlights whirring past the window were like fire, a rave, glow sticks tossed into the sky across the moon. I’d never seen anything so fucking cool.
“Ma’am?” The train man tapped me on the shoulder. Why was he blocking the fire dancing? “You should sit down. We’ll be stopping at Norfolk soon.” I sat, and right as I was about to invite him to hang out he walked out of the car, his stupid little hat bobbing. Asshat. He should be watching me. I stood up again. Forget that guy. Next time I’d be on a plane: maybe Florence, maybe Dublin, or I could go to Korea and beat up my brother’s ex-fiancé, that bitch who took the ring with her. I took another swig from a tiny liquor bottle, the one from the dining cart, because I wanted to be drunk for this party but the stupid booze they sold me didn’t work and I still felt more goofy, not less.
I was planning my own reality show again, where people could watch me having a great time on an empty train car and everybody would be jealous because I’m hilarious and I can have fun anywhere. No one knows how to have fun like me and I have something to teach the world, something so brilliant because I’m smart and I’m fun and I’m sexy even after hours of traveling. The train man with his stupid hat will tell all of his friends and family that he was lucky to ever see me live in the flesh with the cameras following me.
When the train stopped in Norfolk my boyfriend Andy was waiting to pick me up. I jumped out and ran over to him and told him how much fun I was having and all of the songs I wanted to listen to on the way home and wouldn’t he just dance with me in the parking lot. We’re only a few blocks away from home, he kept saying, so lets take a few deep breaths, and drive home. We got in the car and I kept yelling that the ride was taking forever and I wanted to get out and dance because I was on fire.
“Don’t joke like that!” His voice was louder than I’d ever heard it. He wasn’t calm like he always is. “Don’t scare me like that, telling me you’re on fire.”
He didn’t get it because I felt like I was on fire and I wasn’t actually on fire and if he had listened closely he would’ve understood the feeling. There was a warm hum to my veins that I recognized from Ireland when I wandered off by myself before I knew what was really happening and who I really was. I was manic—flying high again despite my stack of meds. This burning feeling rushed through me and every second became so slow like those few blocks to home were hours too long. If time stayed this slow I could accomplish so much I could learn and teach and do so much.
When we got home I threw my shoes off and walked outside. Andy was out walking the dog and wouldn’t know. I wanted to feel everything as I walked past and I couldn’t do that in sneakers and I needed to feel the grass and the air around me. I could sense my dog and my boyfriend together but I had to stay away from them so I could explore. The textures everywhere were so different: pavement, grass, asphalt. The air was always the same—smooth, damp, summer stale. I could move so fast it was almost like I was gliding instead of walking, or riding on one of those moving walkways at the airport. That’s where I should go next—the airport. Hawaii still awaits—or Florence, or Korea. Once I finished my walk I’d find a flight.
On my walk I found a black bag. I stopped to look. It was a pet waste bag from the dispenser, but it had been placed here, right in front of me, right where I could see it. I closed my eyes and tried to communicate with my dog. Surely he left this here for me. What did he need to tell me? What did this mean? I wished the cameras were following me so I could discuss it out loud. It felt like a warning, an ominous message. I walked faster then, trying to reach where Andy and my dog would be, but I couldn’t find them and I was so worried and what did it all mean—
“Babe? What are you doing out here?” Andy was behind me, leaning over to pick up our terrier’s poop with one of the bags. Maybe that’s what the sign was—I needed to go back to find them. My dog ran up to see me, jumping up on my legs, licking my knuckles. He was safe. He just needed to see me. He called for me with the bag. He called me home. I took a deep sigh of relief and went inside.
I’d been on mood stabilizers for six weeks but still had my ups and downs. There were other meds too, and I took them every day like the doctors said, like the therapist encouraged. The crazy shit, allegedly, was going to stop; the real crazy shit, anyway. There’d always be symptoms. I could still keep my spark.
“How do you feel about trying Lithium?” Lara, my Psychiatrist, was smiling, her beaded necklace jingling. Around her office were exotic rugs, photos of children from other countries.
“I don’t need any more pills.” I was angry that she even asked. I had chosen her because she was a hippie doctor, one who dressed like a college student and had an office full of frivolous decorations. I liked her beads, her dark curly hair, her love of dogs. Her belief in random vitamins. Her asking me how I feel. Though I’ve never believed in alternative cures, I knew a doctor like this wouldn’t throw pills at me, wouldn’t drug me to shut me up. A doctor like this would only prescribe what was absolutely necessary. But here she was, throwing the “L” word in my face.
“I’m not a battery,” I said, looking away, “and I already eat a lot of salt. And I already take a lot of pills.”
“But you’re still having breakthrough manic symptoms.” She was still smiling. “Adding a small dose of Lithium can stop that. Lithium and Lamictal—your mood stabilizer—work very well together.”
“Will I get fat?” I stretched my shirt down, hiding the weight I’d already gained. I couldn’t risk packing on any more.
“Liz, we’re just going to put you on a small dose. There shouldn’t be any side effects. You may develop a small tremor, but at this low dose, you probably won’t.” She wrote out the script then, by hand, the word “Lithium” bold and legible. “And these manic breakthroughs should stop.”
“What if I like them?” At the time I felt it was unheard of, a new thought no bipolar patient had ever asked. I felt original, special, like someone who had discovered the big secret.
“Everybody likes them.” She put her pen down, dismissive. “But we both know you can’t be running around in the middle of the night barefoot, by yourself, looking for attention.”
I didn’t respond. I didn’t see the problem with any of it.
“And, well, this is Norfolk, you know.”
I took my script and left.
I left the prescription sheet on the dining room table, under a pile of junk mail. I put a salt shaker on top of it so it wouldn’t get lost. It was safe here, beneath the clutter; Andy and I were far from neat freaks. We only used this table for parties and poker games. Later, when we got a miniature pool table to put there, it became a great hit among our friends. No one looked under piles of junk mail or beneath novelty pool cues. No one knew it was there. I hated how it said “lithium carbonate,” in perfectly legible handwriting, so anyone could read it. I wished it had some other name, some generic science formula that I couldn’t recognize.
I wanted to go fire dancing again. The Lithium, surely, would take that away; I’d gain more weight. I’d get a weird tremor like some sort of junkie. Maybe I’d drool and forget my own name and look like a total loon. People took street drugs to feel the way I sometimes did. Expensive, dangerous drugs. Nature had given me a high for free. Maybe I shouldn’t waste it. There was so much tempting about it: I could be the life of the party, the party myself, and feel more joy than most people do in their lifetimes. If I could just muscle through the downside, I could be some sort of legend, the happiest person that ever lived. Maybe they’d develop a drug that took away my crushing depressive cycles, but left my fire alone. Maybe I shouldn’t fill the prescription. Maybe I should just wait.
“Are you okay, babe?” Andy opened the door, standing next to me at the sink. “You’ve been in here for awhile.” He looked concerned; he must have noticed.
“There’s something wrong with my face.” I felt like I should be more upset—cry, maybe, hug him. All I could muster up was mild confusion. This wasn’t the way my lips were supposed to go. My cheeks felt heavy.
“You look tired.” He rubbed my shoulders. “And, well…you aren’t…” He studied me for another moment. “You’re not smiling.”
That’s what it was. The smile. That was the problem. It was always there, no matter what emotion lay underneath. As a child, I’d been prone to wild mood swings, from euphoric to inconsolable and everything in between. My mother responded by signing me up for acting classes. On stage, she thought, I’d be a natural. I responded by training my face: I’d smile until it hurt in an attempt to reorganize my muscles. In time, it worked. My cheeks began to relax upwards, my mouth slightly open. Always keep this smile, I told myself. This will be my constant. Even when I was spacing out in class, I wanted people to see me smiling. When I passed them in the hallway, they wouldn’t ask how I was doing; they’d see the smile. They’d assume. I considered it an acting exercise, something I could use for my new drama lessons. Maybe I’d get a lead role out of it, become a bubbly ingénue.
I didn’t expect it to work as quickly as it did. I discovered it was amazing what people will believe when they see a smile. Strangers told me they admired how I was always happy, how I could always see the bright side. A classmate nicknamed me liquid sunshine, which I later learned was a drug reference. You brighten a room, one teacher declared. I was thrilled. I didn’t have to wear the ups and downs on my face. I wore a constant, passive smile and received dozens of compliments. I never broke the habit. Into adulthood, people were still telling me how upbeat they found me. It was the best secret I ever learned: a smile always works.
But on this day, my face wouldn’t assume its usual position. Something wasn’t right. I tried, again, to be upset, thinking that a good cry might loosen my face muscles. I could only feel annoyed, like I’d messed everything up. I wanted to go back to bed, but I had therapy in an hour. I picked some clothes off of my floor, threw them on, and wandered to my car. It was like walking through butter; I felt every ounce I shouldn’t have gained with every step. It felt wrong to be behind a car, like I wouldn’t remember how to use it. I felt like a confused idiot.
My therapist, Kim, knew just from looking at me. I wondered if it was the smile. Once I explained things to her, she told me she knew this was coming.
“What do you mean?” Nothing made sense. “Nothing bad is going on. I’m not upset but I feel numb. I should feel something. I can’t figure it out.” I squeezed my face in frustration, covering my eyes. “I don’t know why this is happening.”
“Liz,” she said, meeting my eyes, “This is happening because you’re bipolar.”
“No, no,” I told her. “Nothing like that. Nothing triggered me. I should be fine. This shouldn’t be happening.”
“Last week you had a hypomanic episode. Now you’re crashing into a depressive one. Liz, this is happening because you have a chemical imbalance in your brain.” She paused again. “This is happening because you’re bipolar.”
“I didn’t do anything wrong.”
“I know.” She smiled then, sympathetic. I was jealous her face knew what to do. She looked down at her chart, and then up at me again. “You have an illness. You know what you can do, though, now?”
“Fill the Lithium prescription.”
The next morning I felt worse. My body felt heavier, exhausted and restless at the same time, like dead weight. Dead, useless, flailing weight. I called my boss and told her there was no way I could teach our class with her. I wasn’t feeling well, I said, vague. She told me I sounded terrible and should get some rest. The guilt was horrible: I should be teaching, working, getting things done. I was letting her believe I was actually sick in bed with a fever or headache or something socially appropriate. I was letting her believe I’d be back to some degree of normal by our next class.
Part of me wanted to tell her. Surely she would realize, one day, that no regular person gets migraines, food poisoning, or the stomach flu multiple times a semester. I was running out of excuses. The thought of getting out of my bed was terrifying; I just wanted to lay down and think about how useless I was, how a person who can’t keep her head on straight did not deserve a university scholarship or a teaching position. Feeling this low immobilized me. Maybe it was a terrible price to pay, just for some soaring highs.
That was the morning realized I couldn’t tough it out. The depressive days are just too crippling. I couldn’t hide from them. I couldn’t sit in a dark cave waiting for flames to send me dancing again. My brain needed to find safer ground.
A few hours later, I mustered up the energy to go through the Walgreens drive-thru window. I handed over my prescription. I was ready to fill it.
The pills looked old-fashioned: a purple gel capsule stamped in black ink. When I held it in my hand the white powder inside tumbled back and forth. I tried to think positive. It this drug gave me back my stability, I could get more work done and miss less days at school. I could keep my happy face. Maybe this wouldn’t be so bad.
I tried not to think about freaky side effects, or the fact that I was about to take Lithium, a label that made me nervous. I’d need blood tests every few months now, to make sure the Lithium levels in my body weren’t too high. When I took my first dose that night, stayed up for hours worried that if I fell asleep, I’d wake up and be somebody else. Eventually I had to trust that one dose couldn’t change everything.
A few weeks later, I discovered that Lithium did, in fact, start to change things. I didn’t have a cycle after I started taking it. Sure, I still had my mood swings, which would always be there. The real crazy shit, just like they had told me, had finally stopped. Now I had more control. I was feeling very positive—I hadn’t been missing classes or work as I had before. I was tempted to tell the whole world, announce that no one should be afraid of a drug like Lithium because of its stigma. From my standpoint, Lithium was great.
“Do you know how long people normally take this stuff?” I asked my therapist, Kim, after sharing my positive results.
“You’ll have to ask Lara about that,” she responded, “but most bipolar patients need continuous medication to have a normal life.”
“Continuous?” It was such a vague word. “Are you trying to say forever?”
“Well, yes. But these drugs have given you so much relief from your symptoms, and allowed you to function again at school—”
“Forever.” I didn’t like the sound of it. I pictured the pill bottles on my dresser, the stacks of new scripts in my purse. “I’m twenty-three. I’m too young to know what forever means.” Side effects, weight gain. Cycles, mood swings, the medication game. Forever.
“You can live with this, Liz. You already are. You have been for a long time. Now you have the tools you need to help you.”
Somewhere I knew she had the right idea, but I was stuck on forever. I was stuck on my spark. I was picturing the train ride again, how the street lights looked like glow sticks tossed above me. The warm buzz I felt under a bright moon. That flicker was the only forever I knew.