Molly Smithson

The Mechanic in the Machine

Molly Smithson
The Mechanic in the Machine

“I’m a bi-sexual, bi-polar, bi-pedal woman. I guess I just like pairs.” 

It's a joke I'm running. After a show the other night, an audience member asked me if I believed I was a champion for mental health.

I don’t think I’m a champion of anything. I’m maybe the heat winner who comes in 2nd or 3rd in the final race at the swim meet.

In fact, that joke is more about my diagnosis and my sexuality being a fact of my personhood, not defining it. 

I have a cache of premises and stories about my mental illness, but I never know how to break down the wall between making these observations and sharing them. 

Like the time I decided to move across the country in ten days.

After a summer of roller coaster mood swings, I was at my peak hypomania. The day before I was set to leave, I woke up at a friend’s lake house at five a.m., itching to go paddle boarding. In my excitement, I dove from their dock to the board, imagining myself a lithe water nymph. But I forgot I had my glasses on and they sunk to the bottom of Lake Wylie. I woke my best friend Chloe in a panic, who was in the midst of moving herself, and had her drive me to a Walmart optometrist. Then to go with me to sell my car. Then the next day, drive back up to Asheville with me for her birthday party/ my moving party. I started the drive cross-country at 6 a.m. the next morning. 

It was a sitcom episode full of quirky mishaps. We even wrote a lyric for the 80s opening credits jingle. 

“A little hungoooover, a little bipooooolar, the story of Molly’s liiiiiiife.”

It’s a good tale, but I don't exactly know the point of telling it. If I throw my hat in the ring, what do I say that hasn’t been said before? 

Our brains are machines. Cars, toaster ovens, clap-on-clap off light switches: we each have a unique use but come down to the fundamentals of electricity and physics, light and sound, matter built over matter.

A brain stalls like any machinery. Maybe we’re idle for too long. We sit in a dusty corner of the garage, rolled out only a few times a year.  Maybe we’ve been overworked, too many hours, too many tasks, too many expectations. 

I have bipolar II. Sudden starts and stops stall my machine often. 

“High episodes of euphoria and low episodes of depression, together known as hypomania” is how the DSM 5 classifies bipolar II disorder. 

“Hypomania differs from mania in two important respects. While hypomania can affect functioning and quality of life in all facets of life for an individual with bipolar II disorder, it is not as severe as manic episodes, which may require hospitalization. Second, hypomania does not involve psychosis.” 

Bipolar 1: Bipolar 2 :: Britney Spears : Christina Aguilera

They both started in a frenetic rise to the top. While Britney’s career had a slight downturn (see Personal Struggles and Blackout section on Wikipedia), she bounced back.  But through good management and purely different chemistry, Xxxtina’s time in the limelight dropped quickly to a sad state of being a judge on the voice while not releasing an album for six years. 

I kid and I shouldn’t. Many doctors believe that a Bipolar I’s severe mania, depression and psychosis can begin with bipolar II, and be triggered with stressors like trauma and extreme chemical changes, such as suddenly going off medication.

A lot of people think of bipolar people as tortured artists, like Sylvia Plath or Van Gogh. I often think of the houseless people rambling to themselves as we cross paths under the Hawthorne Bridge, me on my way to meetings with clients, them going who-knows-where. 

While I don't know their exact situations, fate could have led me there, but out of pure luck and privilege, they didn’t. My parents knew the warning signs after I went on and off a SSRI during a very wild freshman year of college. We were privileged to have health care that allowed me to go on medication and see counselors to learn behavioral therapy techniques. 

Still, it's hard to be honest with others and yourself about mental illness, sometimes even harder when you feel guilty about how it could be worse.

I owe a lot of success to hypo-manic periods. I have felt shame for claiming an illness not as bad as others have it. In general, people also express a lot of confusion and judgment about a chronic, invisible illness. 

I once had a queer co-worker who rightfully corrected at me when, out of a strange place in my brain I called something ‘gay.’  At the same time, I resented her when she said something was 'bipolar,' because I couldn't find the words to tell her about my illness, to say why or how it bothered me. 

I don't feel like I can discuss mental illness because I don't have more severe symptoms, but I’m terrified of them. A few weeks ago, I put a box of spaghetti in my freezer. When I couldn't find it, I cried out of frustration and fear that I was losing my mind. 

It's scary but I have to confront it. The most human thing that we can do is to figure out how to fix the machine when it stalls so that maybe someone else can use our manual to feel whole and functioning again. 

This disorder lives in my synapses, but my stressors and habits either care or neglect my machine. Objectively, I have observed this pattern for Bipolar II coupled with my high-functioning anxiety:

  1. Get on a mood stabilizer and/or an SSRI (what you may refer to as an anti-depressant).
  2. Start feeling great and productive because my brain is being regulated by some sort of chemical magic. 
  3. Get distracted from taking my medication because I’m distracted by my newfound enjoyment of life.  
  4. Begin feeling anxious or distracted because I’m no longer on the medication and may be getting overwhelmed by the enjoyment mentioned above. 
  5. Get depressed, crash and realize that medication helped before. 

Two years ago, this cycle domino'ed from getting the confidence and strength to end an unhealthy relationship, then going off medication, the manic summer, powering through the aforementioned lost glasses and cross-country move. 

But the dominoes looped back around. By last spring, I had gotten back on my prescription, begun a great relationship, started a business, and run 2 half-marathons. I didn't think I needed my mood stabilizer, which made me never want to eat.

A few months later, I began to get extremely anxious. I sat alone in my house during the day and drank too much at mics and parties each night. I was able to stay active in commitments, but the myopic drive and overindulgence drove me into a depressive cycle.

At the time, I was on OHP, a low-income state-run Medicaid with fantastic benefits. Certain plans allow you to see mental health professionals free of charge, which was especially good considering my counselor had recommended meetings every two weeks. In order to see a prescriber to get on a mood stabilizer, you have to attend two counseling sessions. But when I called, there was a 4-6 week wait until a counseling appointment was available. My prescriber appointment was 2 months after my counseling began, four months after I had first called for an appointment. 

Like a lot of people, bipolar II makes me forgetful and less detail-oriented. I missed my prescriber appointment because it was the day before my counseling appointment, but I assumed I had scheduled it on the same day. I teared up in the waiting room, then rescheduled it for another 2 months later. 

I got back on medication at the beginning of December. I’ve gone five months without forgetting medication for more than a day or two. It’s the second-longest time I’ve been able to do this, by only a few months. 

Every day, a reminder pops up at 8 a.m. to take my lamotrigine. I pop a dusty pill in my mouth. It’s sort of sour and doesn't always go down. Sometimes they break and I have to piece together a whole dose, but I do the best I can. It makes my skin break out in rashes, but it could be way worse. 

Because my parents moved to a different county, my coverage stopped working at my counseling office. It took me two months to receive Oregon Health Plan documents needed to complete my ObamaCare application, which I sent in today. 

I have to see my prescriber every 3 months, so if my application doesn't go through, I could be without a mood stabilizer until at least January. 

I cry out of fear and anxiety almost every time I think about this. I don't know what my brain will do over six months. The logical part of me knows I'll need to exercise, meditate, keep track of notes, not overextend myself and talk to my friends and family about what I'm feeling. I'm getting better about it. But deep beneath that, like a mermaid luring sailors to their graves, I can feel my brain chemistry pull at me. I wish I could say, I refuse to let it stand in the way, but that's the thing about chronic mental illness: at some point, you just have to accept it'll always be there and hope you can tamper its siren call in that moment. 

My dad once told me that depression was all about riding the waves, about staying on your board instead of wiping out. So to answer the question posed to me at the beginning of this, I hope my championing mental health helps you or someone you know to get back on the board. 

If you would like to give your time, money or talents to mental health organizations that help less-opportune people cope with mental illness, I recommend National Alliance on Mental Illness (NAMI), Albertina Kerr , or Outside In. Shout out your favorite organizations and I’ll add them to the list too.