How Bipolarity Prepared Me For The Panic And Confinement Of COVID-19

Even if inadvertently, mental illness is helping me survive the loss and isolation dealt out by a pandemic.

When I first heard the word “self-isolating” some weeks ago, I thought “self” was a clever prefix. It implied agency, volition. By confining ourselves to our homes, we were willingly taking part in a project which, if successful, would save not just ourselves but the world. The government’s lockdown orders might well have had their roots in authority, but our sequestering was something noble, proof that we still cared about a greater good. Perhaps only tricked into falling in line, we did learn that responsibility matters.

It’s with some concern, though, that I’ve seen a month’s confinement corrode the resolve of those who, on March 24, thought themselves brave enough to weather India’s lockdown storm. No longer pliant, they seem victimised by inconvenience and boredom. Most penal systems across the world share a common belief—few other forms of punishment are as harsh as boredom. Films like The Shawshank Redemption and web shows like Sacred Games remind us that the boredom of solitary confinement is ruthless. It can break the strong and weak alike. It’s boredom that makes home a prison.

As loved ones now complain about the trauma of inertia, my empathy has its limits. I even feel relief. But this isn’t because of misanthropy, I know. It’s a result of my suffering. Since 2007, the year I was diagnosed as bipolar, I’ve been committed to institutions six times. Taken together, I’ve spent almost nine months of my life locked away, with no access to my phone or the internet, coping with an illness which, like COVID-19, has no known cure. In comparison, today’s self-isolation feels a touch too gentle.

FAR FROM THE MADDING CROWD

Asylums, penitentiaries for the delusional, unpredictable and violent, are usually always found on the outskirts of cities. The removal of the insane from society has to be physical and geographical. Most of the mental health institutions I was admitted to were also fairly far-flung. Inmates instinctively knew escape was futile, but the desire for a life elsewhere usually prevailed. On one occasion, I hoodwinked a sleepy guard, braved barbed wire and ran as fast as I could. Five minutes later, while being dragged back by my collar and falling trousers, I realised there was no ‘away’ to find.

I have recently read astronauts and submarine commanders detail the strategies they employed to cope with isolation, but unlike them, my confinement was never a choice. It usually always felt like captivity. While lockdowns have recently made popular the headline ‘Together Alone’, those interned in institutions are perhaps more familiar with this sentiment than most. The sense of community that addicts and the mentally afflicted stitch together is often fragile. We’d share stories but never our cigarettes. Conversations barely soothed our loneliness. We each wanted out quicker than the other.

Once every few years, my bipolarity makes my mood swing from calm to euphoric and, eventually, to belligerent. The isolation offered by a mental health institution tames my anger and anguish. Even though my days spent in these modern-day bedlams signals a disruption—I lose jobs and partners—they also force me to introspect, to imagine futures that are sometimes bleak and at other times, better. With no access to the several worlds I call mine, I have sat on inordinately hard beds and contemplated the (in)sufficiency of my relationships. Invariably, I have left institutions better prepared for tomorrow.

Confinement, I feel, necessitates a dialogue with oneself. You first initiate this dialogue grudgingly. Guilty for the excesses of your madness, you berate yourself constantly, but the self-torture does have some benefits. No longer abstract, your pain becomes tangible and easy to articulate.

In The Trauma of Everyday Life, psychiatrist Mark Epstein writes, “When we stop distancing ourselves from the pain in the world, our own or others’, we create the possibility of a new experience, one that often surprises because of how much joy, connection, or relief it yields.”

Epstein’s interest in Buddhism helps him transform pain into a catalyst for relief, but in my case, it was institutionalisation which first made me come to terms with the Buddhist truth—suffering happens.

My response to suffering has hardly ever been high-minded. In 2013, when confined for three months, I was fortunate enough to have been allowed my iPod. I created a playlist of pop songs that I played on loop. In 2018, when interned near Bombay for seven weeks, I read and re-read the six books that came packed with my clothes.

Amused by Justin Timberlake, I was later consoled by JM Coetzee. My immersion in art was more than diversion. It helped me survive my isolation and sleep for seven hours.

I was manic again in February this year when my insomnia turned stubborn. A rehab near Gurgaon took me in. The facility doubled up as a sleep clinic of sorts. In my ten days there, I slept for five. With no books or music for company, I obsessively watched CNN and BBC in my waking hours. Wuhan had just gone into lockdown and the virus had now reached Italy. Experts dropped the words “panic” and “pandemic” often. It was clearly just a matter of time before India, too, would be fighting this global fight.

By the time the coronavirus reached our shores, we were already gripped by a collective urgency. Even though I tried to analyse available data, I discovered the stoicism I would sometimes chance upon when institutionalised. The lockdown, thankfully, left me unruffled. I could still communicate with everyone I held dear. I had my headphones and my library. Besides, the nine months of being locked away had somehow trained me for these weeks of being locked in. I knew how to stop worrying about loneliness and love my solitude, but deep inside, I also felt there was more to this crisis than my paltry triumph. Yes, lockdowns leave you bored, but pandemics remind you of something more profound: Mortality.

ALL GOOD THINGS MUST END

In Being Mortal: Medicine and What Matters in the End surgeon Atul Gawande makes the case that people hardly ever view their lives as an average of all its moments.

“For human beings,” he writes, “life is meaningful because it is a story. A story has a sense of a whole, and its arc is determined by the significant moments, the ones where something happens.” Without the therapy I underwent for a decade, the fragments of my life would have not become a story. I would have never been able to tame the chaos of my delirium or despair, and I would’ve surely not discovered the joy of significance.

For nine years, I sat across from my Freudian psychoanalyst, captivated by her bookshelf and lamp. Freud’s critics were possibly more obsessed with Oedipus than he was, but his theories afforded a strange freedom. I could talk about sex, pleasure and death in my analyst’s dimly lit room with total abandon. Finding me somewhat fixated with the prospect of dying, she gently cooled my obsession. She suggested I look at death as an impetus. Rather than fear death’s obvious limits, I could view my mortality as reason to make better choices, decisions that could add up to psychological well being.

One of Being Mortal’s most startling insights is deceptively simple:“Our ultimate goal, after all, is not a good death but a good life to the very end.” Stories of respiratory distress and desperate suffering only frustrate that desire for “a good life to the very end”. COVID-19 deaths seem neither just nor natural. As thousands die, their deaths are reduced to a body count. Few are given an obituary, and even fewer are given the funerals their abundant lives deserved.

There can be no loss more definitive than death, and for the anxiety it exacts, there can be no cure. As we try to spend our lives distracted from mortality, it takes a pandemic to show us that death can neither be denied or overcome. “People are disturbed not by things, but by the views they take of things,” a cognitive behavioural therapy practitioner once told me, quoting the philosopher Epictetus. Such aphorisms bring little comfort to the dying and hungry, but for the rest of us,they are a reminder—we’ll have to learn how to live with (and despite) this pandemic. We each mourn differently, but acceptance, that liberating seventh stage of grief, is an end we must perhaps now all work to.

The cognitive behavioural therapy practitioner I met had the fortunate habit of keeping her advice simple. Breaking down that Epictetus quote, she said I must always ask myself what is in my power and what isn’t. While she was sage enough to warn me that there will be circumstances over which I will have no control, she also added that at the other end of the spectrum, there will be situations over which I will have some influence.

“Give things your best,” she told me, “but be mindful. There is no point wasting time, trying to fix things you never could.” It has taken a pandemic for me to fully appreciate this “let it be” wisdom.

Tracking the news, fearing for those I love, I have felt powerless and inconsequential, but all those years of therapy have belatedly come to my rescue. Mental illness, sadly, exaggerates the primacy of one’s identity. My bipolarity, for instance, perpetuated an isolation that only ever wanted to prop up a wounded self. If it weren’t for my therapists, I would never have realised that relationships aren’t just antidotes to my loneliness. To make them work, one therapist told me, ’’I’d genuinely have to meet the other in their predicament.” I try and keep this in mind when engaging with family and friends these days. I can’t reverse their loss, but I can finally try to keep them company.

HOW TO BE BOTH

Now on medication for 13 years, I often stop to marvel at the alacrity and empathy of my psychiatrist. He doesn’t just concern himself with my behaviour and personality, he is also interested to know if I have been eating and sleeping well. At times when my mood threatens to spiral, he tweaks his prescription repeatedly, trying to find that fine balance, that perfect calibration. Drugs like Lithium have helped me discover a sometimes-elusive stability, but more importantly, they have encouraged faith in medicine and science. While looking at figures of those infected by the coronavirus is undeniably distressing, I find more consolation in estimates of those who have recovered.

By giving my suffering and successes his full attention, my psychiatrist has also led me to believe that we human beings are a sum of all our physical and psychological parts. I thus find it hard to think of this pandemic in purely corporal or material terms. The feelings of anxiety and sadness result in crises that can affect body and mind. If we are to immerse ourselves in living again, we must know that vaccines or pills will never cure all our suffering. We need togetherness, too. My bipolarity has taught me that.

Shreevatsa Nevatia is the author of How to Travel Light, a bipolar memoir.

If you or someone you know needs help, mail icall@tiss.edu or dial 022-25521111 (Monday-Saturday, 8am to 10pm) to reach iCall, a psychosocial helpline set up by the Tata Institute of Social Sciences (TISS).