Your Unique and Beautiful Brain

United States of America

At first glance, when you meet me, you'll find a successful business sustainability consultant, women's empowerment leader, and Shadow Work coach. Since 1993, I've led large systems change initiatives at more than 50 enterprises. I live on a dozen acres—organic garden, solar panels, trout stream, sugar shack—in the woods of Western Massachusetts. We had two feet of snow this morning, and when I've finished writing this, I'll strap on my skis and head out the front door for a romp. I'm a mother of grown twins, recently launched to college, and have been married to a "stand-up" guy for 27 years. It looks like a blessed life, and it is.

Come closer though, and I'll tell you this: I've suffered from a debilitating brain disorder for four decades. Like Persephone in the underworld, I have been caught in the grips of an overpowering force. For months on end, prisoner of the darkness. A relentless, burning terror.

Twenty-five years into this struggle, I learned that I have a brain pattern known as "bipolar II." The roman numeral "II" here is the key distinction. Because bipolar II presents itself clinically as "normal" depression, it is mostly undiagnosed or misdiagnosed. The results are deadly, as the standard meds for Clinical depression—SSRIs such as Prozac and Lexipro—are like poison for the bipolar brain. Now picture the psychiatrist who is convinced that what you have is "regular" depression. He prescribes you the poison meds and sends you off. Only to find you sicker the next time you come to his office. "More depressed," he thinks, "let's up your dosage of the SSRIs." It's a vicious cycle that could leave you psychotic, psych warded, electric shocked, suicidal or worse.

Lucky for me, the fifth—yes fifth—psychiatrist I found when I was hanging to this life by a thread, Dr. P, is an expert on the bipolar spectrum. During my first appointment, he gave me a bipolar diagnostic test, a simple 14-question protocol. With this tool, it took all of 20 minutes to diagnose what had eluded the medical world for a quarter-century. "We know what to do," Dr. P said.

Dr. P was unequivocal in his diagnosis that I had bipolar II. This form of bipolar disease doesn't manifest in mania—I never had the characteristic wild highs, shopping sprees, sex adventures. But it does show up in dark, persistent, debilitating depression. And because it shares the symptoms of typical depression—low mood, weight change, loss of memory, no joy in life—it is most often misdiagnosed as unipolar depression. Dr. P's clarity and the meds he prescribed, Lamictal and later Lithium, saved my life.

When I was mercifully on the other side of the crisis and able to reflect, I asked Dr. P—a six-footfour, white-haired gentleman—"How did you get right what so many others got wrong?"

"They chose to stop learning," he said. "I felt too much responsibility to my patients to do that—it's about life and death. I kept studying. Still do."

In his December 2020 column "The Hidden Fourth Wave of the Pandemic," New York Times columnist Farhad Manjoo writing about the stress impacts of COVID-19 says, "America hasn't begun to face this year's mental health crisis." I believe he's right, and by the time this article is published, sadly, thousands, if not millions of more people will be in breakdown. For those experiencing mental challenges—and who isn't at this point—I want to offer some of what I've learned. If condensing 40 years of wrestling with bipolar II down to a fivepoint plan seems reductionist, it is. But this is meant to be a triage intervention to "stop the bleeding" in a moment of crisis. It goes like this:

Before the Crisis:

Identify a "Brain Buddy." This is someone you trust fully and loves you no matter what. Contract with your Brain Buddy that when you are in crisis you will text them "Code Red." This means...