I was about 14 when I first went crazy. Sitting in the bedroom of my
parents’ G.I. Bill house, a bolt of noxious energy exploded around me
and the air turned grainy, like reality was suddenly an ugly, 16-mm
film. Terrified, I saw the universe beyond my small room as endless and
black, occupied only by a malign Presence. I screamed, batted my face
with my hands, but the world wouldn’t get right. The Presence was
swallowing me. My mind separated from my body, what mental health
professionals call a dissociative state. My parents quieted me with a
Valium, but for weeks I lived in nauseous terror of reoccurrence
— until a remedy appeared, presaged by no rational thought. The
remedy was Electric Light Orchestra’s “Ma-Ma-Ma Belle,” a silly
pop-rocker but with an essential difference — a huge,
super-distorted guitar.
That guitar — with its rich, enveloping harmonics — was
like an elemental ally. When I had those inevitable next episodes, I
kept returning to that song, to the Guitar that halved the Presence’s
power and my fear. The graininess would clear, my heartbeat returned to
normal. It was freakin’ awesome.
A few years later, a similar episode occurred, this one at band
rehearsal. This was the 1970s; nobody seemed to know jack about bipolar
disorder, which is what I would be diagnosed with 30 hard years later.
The bedroom panic had matured into the Terror, like the moment of panic
one might feel before someone shoots you, but stretched out forever. It
struck mid-song, in front of my band mates. Again, and with the same
lack of thought, I found refuge in sound. I leaned my face into my Sunn
amplifier, played hard and in a flood of distorted noise, the electric
terror faded. Just a bit, but fade it did. A few years later, when
debilitating depression joined my symptoms, I retaliated with
Magazine’s Secondhand Daylight and Siouxsie and the Banshees’
The Scream. What matters: A lifelong means of dealing with the
world had set in.
Twenty years later, despite hard work in therapy and a failed go at
lithium, I suffered an epic, full-blown mental meltdown, a four-year
lost weekend of compulsive suicide attempts, self-mutilation, manic
acting-out, hospitalizations and paralyzing depressions. It was like
the part of my brain that controls crazy, self-destructive impulses
— what science calls the limbic system — had taken a
permanent powder. The few times I was lucid I was pole-axed with shame
over my behavior. My sole tether to reality was Jane Siberry’s When
I Was a Boy. It’s not an exaggeration to say that Boy, along
with very patient friends and my shrink, are responsible for my
survival.
Another grinding decade of therapy, of enduring the side effects of
many failed medications, and I finally met the right, very patient
person, found the right meds. Mostly, I’m OK. But news of the release
of The Soloist — the Jamie Foxx and Robert Downey Jr.
movie about a journalist’s relationship with Cleveland native Nathaniel
Ayers, ex-Julliard cellist gone homeless schizophrenic —
triggered two realizations: 1) That I cannot think of a single friend
who struggled with mental illness where music did not play a crucial
role. 2) That I’d have been history long ago were it not for music.
And so I’m wondering: What is madness? What is its connection to
music? How did I know to “prescribe” myself this non-drug made of
oscillations in the air without a single thought? Am I alone in all
this?
More than 20 percent of the U.S. population suffers from a
diagnosable mental disorder; that’s about 57.7 million souls. In 2004,
the most recent year of accounting by the National Institute of Mental
Health, suicide claimed 32,439 of us. On average, we die 25 years
younger than the general populace.
Musicians who are mentally ill — or “MI” because it’s easier
to type — and are out about their illness include DMX, Sinead
O’Connor, Of Montreal’s Kevin Barnes and Charley Pride. Suicide-wise,
MI is hideously egalitarian: Ian Curtis and Elliott Smith, soul legend
Donny Hathaway and blues-jazz shredder Danny Gatton all took their
lives.
I have my own losses. There was Ellen, a great writer, music lover
and manic-depressive. She bought into the old saw connecting madness
and creation, went days without sleep while mixing psychotropic drugs
to keep her tweaked. Three months ago, at the age of 41, her heart
simply gave out. There was Mary (not her real name), a brilliant artist
with whom I crafted a half-hour long song cycle about child abuse, who
called one day because demons were crawling the walls and calmed down
only when I played her some Brian Eno. And, unfortunately, others.
Dr. Robert Conley, adjunct professor of psychiatry at the University
of Maryland, believes that although schizophrenia, depression and
bipolar disorder are very different, at least some of the underlying
causes are similar. Along with genetics and developmental factors,
another thing these diseases have in common is lousy connectivity
between the “middle brain” or limbic system, which controls emotions
and memories, and the cortex, which deals with reasoning, planning and
controlling moods. “In a sense, the limbic system kind of comes up with
suggestions and the cortex is kind of editing and saying, ‘Yeah, do
that, don’t do that,'” he explains.
As I understand it, this connectivity is vital to how we think and
act, while people with MI brains “have somewhat fewer connections
between the cortex and the rest of the brain,” says Dr. Conley. “Or the
connections are a little less efficient.”
An example Conley likes: Show a person without depression a sad
image. Her brain’s neurons will fire normally until the cortex kicks in
and essentially says “This is just a picture,” and the mood passes. Not
so much for the person with depression, as I understand it: The same
image, the same nerve firing, but something goes flooey and the mood
persists.
Now imagine when that compromised brain is confronted with a lost
job or death. Then imagine that mixed with amped-out mania, and you
have people such as Tiffany Lee Brown, Mike Doughty and, well, me.
Tiffany Lee Brown is a longtime fixture of the Portland, Oregon,
underground, indie, performance and spoken-word scene, whose bands have
included Black Orchid and Brainwarmer; she’s now working on a
6,480-hour music “soundtrack” with Eric Hausmann called The Easter
Island Project. Brooklynite Mike Doughty, meanwhile, enjoys a
successful solo career highlighted by indie hits like “Looking at the
World From the Bottom of a Well” after his time leading Soul
Coughing.
What we share is music and bipolar disorder. Like some cruel joke of
nature, bipolar’s symptoms often first present during adolescence, at
the same time kids are hormonally crazy anyway. And, yes, it probably
has to do with a brain-connectivity problem — in this case, the
way teen brains routinely “prune” away the brain cells of childhood.
Brown had her first bipolar episode at 14; her first “balls-out,
super-manic episode” at 17. Busy with music, a job, college, the school
paper and the school play, Brown found herself “angry and depressed and
hyper … all at once,” she says.
“What we in the bipolar business call a ‘mixed-state episode.’ It’s
like you’re Dorothy being grabbed by the tornado and swooped up. It’s
kind of exciting — you might land in Oz, or you might just get
dropped and land on your head.”
And here’s bipolar’s dirty secret: Sometimes, mania feels awesome.
“It’s like the best drugs you’ve ever taken,” says Brown. “Combined
with the best sex you’ve ever had, combined with the best music you’ve
ever played.”
Doughty, who says his relationship with music has “always been
essentially medicinal,” has a more modulated view. “Sometimes I went
into creative jags when I was manic,” he writes in an e-mail. “But I
rarely wrote anything worth keeping. It’s kind of like being high in
that what you write at the time seems really brilliant, but is really
actually cruddy in the harsh light of day.”
We all struggled with all these things for years. For Brown, it
almost killed her. She was 24, enjoying a way-fun lifestyle of
music-making, writing, tech support, clubbing and sleeping very seldom.
Then she crashed. The world started to look like “that dark hellhole
you always expected it was,” she says. At a New Year’s Eve party, close
friends suddenly looked “revolting.”
The next day, Brown meditated, listened to Dead Can Dance, and then
she slit both wrists, the vertical incisions of the determined. Often,
suicide really is a “cry for help.” But for Brown, it was something
more dangerous — a solution. “It was like, ‘I don’t have to be in
pain all the time,'” she remembers.
If you do survive, you get to enjoy MI’s big punchline: Getting
better is hell. You might end up hospitalized, where “You don’t do
anything,” according to Alan Sparhawk of slo-core favorites Low,
speaking to The Onion in 2007, in reference to his
hospitalization after a massive breakdown. “There were no lyrics
scrawled in the cold hospital bathroom that later turned into
ballads.”
Inevitably, you’re going to search for the right medication. This
takes forever. For Doughty, it started 10 years ago with Prozac, which
seemed a “miracle cure” before plunging him into mania; it turned out
bipolars usually need a complimentary mood stabilizer and/or
antipsychotic when taking with drugs like Prozac. Oh well.
Since not taking meds just led Doughty back to depression and
“brutal obsessive thinking,” he went back to trying out, mixing and
adjusting the dosages of sundry meds and dealing with the god-awful
side effects until he stabilized on his current cocktail.
Even if psychiatric medication is, in the words of New York
psychcopharmacologist (and my doctor) Dr. Carlotta Schuster, in “the
middle ages” of its development, I’ll still stick with Seroquel (side
effects include drowsiness, dry mouth, constipation), Klonopin
(amnesia, hallucinations, hysteria) and Trileptal (somnolence, nausea,
tremor), as opposed to suffering the alternative. When you’re bipolar,
there really isn’t a choice; the same applies to schizophrenia, only
more so.
For many people, schizophrenia is the scary mental illness.
Schizophrenia is Norman Bates; it’s whomever is killing people at the
mall — forget the fact that the vast majority of sufferers hurt
only themselves, if anyone at all. For an accurate view of the illness,
Keven McAlester’s 2005 documentary of the hard life of Roky Erickson,
You’re Gonna Miss Me, is essential.
Erickson’s band, the 13th Floor Elevators, cranked out pioneering
psychedelic-rock brilliance until Erickson was hospitalized at 21 for
schizophrenia. Soldiering on solo, Erickson continued creating very
strange delights until a consuming terror of being chased by aliens,
among other delusions, stopped the music in the early 1980s. In the
movie, we see Erickson change from the archetypical Dionysian rocker of
the ’60s, into the distracted, gray-haired man of today, his body
paunchy, I assume, from antipsychotics. McAlester came to
understand/accept the disease’s hard laws. “There is no test for it,
just a collection of symptoms that could be interpreted in multiple
ways,” he writes in an e-mail. “There is no medication for the disease,
just for some of the symptoms.”
McAlester has no time for the mad musical genius myth. He asks us to
consider “Duke Ellington, Paul McCartney, Vladimir Horowitz. All
studiously sane. [Frank] Sinatra, [Elvis] Costello, Stevie Wonder.
Ditto. You have to go a bit down the list to get beyond the eccentric
(James Brown) to the truly troubled (Roky, Nick Drake, Chet Baker).
“Meanwhile, go into any mental hospital,” he continues. “How many
geniuses do you run into walking those halls? The truth is that the
intersection between madness and genius is no more common than the
general intersection between humanity and genius; it’s just a better
story.”
McAlester’s film ends on a tentatively optimistic note; visit
rokyerickson.net to witness
Erickson resurgent, back on the count despite his illness. Still, why
has Erickson, like Brian Wilson and jazz great Tom Harrell, prevailed
when so many others have stalled?
Again, it’s about brain connectivity. For schizophrenics, this is
literally exhausting, making the fact of creating or enjoying music
seem miraculous. I don’t entirely understand the science Dr. Conley
runs by me, but the gist is that the compromised brain has to interpret
incorrect information from the limbic system — often manifest as
hallucinations — and the infinite minutia of the real world. Even
with something as simple as reading, the schizophrenic brain is
“typically working 30 to 40 percent harder” than the non-schizophrenic
brain. Conley stresses that this has “nothing to do with intelligence.
It’s really, truly just a physiologic difference.”
Then there’s that most basic existential thing, figuring out what’s
safe. What the schizophrenic person comes up with may not make sense to
us; what matters is it works for them, as just moving from one room to
another can be debilitatingly terrifying. For a person with a
schizophrenic brain, change is the enemy of safe. It’s why The Soloist’s schizophrenic cellist prefers his poverty-stricken
stretch of downtown L.A. over an assisted-living apartment. And, it’s
reasonable to guess, why Roky Erickson prefers staying in the home he
grew up in. The better place just isn’t, in their minds, the safer
place.
But in many, perhaps most cases, music literally is. During our
conversation, Dr. Conley and I talked about the schizophrenic’s need
for safety when we stumble onto an exciting possibility. “One of the
good things about music,” he says, “is as you learn things, it’s the
same and yet different at the same time. You can keep re-examining
pieces, playing them over again, learning new things about them, but
it’s built on a substrate of a thing you know very well.”
I think about being freaked out, about ELO, whose music I knew, and
“Ma-Ma-Ma Belle,” a song I didn’t. And being wigged and working that
out on an amp and guitar I knew. Then I recall a recent article
reporting that music causes the brain to produce more dopamine, the
body’s own substance of pleasure. And finally, something else Doughty
said about music, how it “just brings me into a soothing kind of
focus.”
So it helps you experience terrifying stuff and be safe all at once?
“Yeah,” says Conley. “You can explore those new things in a very safe
way.”
Later, in an e-mail correspondence, I run this notion past Petr
Janata, a University of California-Davis associate professor in the
psychology department and Center for Mind and Brain, focusing on the
relationship between music, emotion and memory. “Music,” he writes, “is
free to impact some evolutionary deep networks [limbic system: anterior
cingulate and amygdala], while the cortex can appraise the situation
and render it safe, thereby giving it overall positive valence.”
I choose to read this as validation. But it doesn’t explain why
music has helped me so much, while failing so spectacularly, so
tragically with others — with Ellen, with all the other friends
who struggled hard with MI in their own ways and lost, and how totally
out there I’ve been at various junctures and still survived. For that,
I think Brown has the ultimate answer. It’s no good and it isn’t fair
but it sounds about right: “We’re very lucky.”
This article appears in Apr 29 – May 5, 2009.