Late onset bipolar disorder is increasingly being linked to transient ischemic attack (TIA) or mini strokes. This is my story.

A 50^th Birthday Present

Around my 50^th birthday I was sitting on the couch at home reading the newspaper when a strange sensation coursed through my body. It was like painless electricity, which sent my heartbeat on a soaring tattoo and caused my vision to rainbow at the periphery.

The sensation was gone in less than an hour and the following day I went to see my doctor. A battery of tests were done, but nothing was found. However, my life would never be the same again.

Growing Disillusionment

At this time I had been married for over 20 years and had two beautiful daughters who I doted over. I was a successful, prolific author with a wide circle of friends who I loved to entertain with lavish Sunday lunches that would go on late into the night. And I was financially very comfortable with a sprawling home in Johannesburg’s Northern Suburbs. Most of all I was happy and in love with life.

But after the strange health scare I began to slowly fall apart. I took less-and-less interest in the kids; upped my alcohol consumption from social drinker to nearly a bottle a day; started smoking again after having quit for 29 years; began feeling an air of growing disillusionment; and I started a string of affairs, including one with a very good friend’s wife which made the Sunday lunches very interesting dos.

Mid-life Crisis

I also started walking, having eschewed exercise for the better part of two decades. I did not know it then, but I have since found out that this is a sign of restlessness accompanying depression. And my walks were not just around the block; they were daily 20-30km journeys. The general consensus was that I was having a mild mid-life crisis and I would get over it.   

It was very easy to think this; because of the 15 signs of a mid-life crisis the only box I did not tick was getting a tattoo. The only problem was that I was not a candidate for this because I had a creative career and had not just been satisfied with life, but delighted.

An Inner Journey

I booked my first session in my life with a psychologist who recommended meditation. Going on that inner journey, however, made me feel even worse about my lot in life. To counter this I increased my already dangerous alcohol consumption levels and reintroduced myself to dagga.

What I really needed, I convinced myself was more adventure. As a travel writer I had explored a large part of the world, but one of the things I had never done was sail the high seas because the idea terrified me. So I wangled my way onto a hundred year old tall ship for an Indian Ocean odyssey that only fuelled my need to experience more.

Climbing Mountains

Shortly afterwards I was in Cape Town to meet my publisher, who was also a close friend. Over dinner we had a flaming row and after she stormed off I took a bottle of Chivas Regal and two cigars to my room on the wine estate where I was staying. Very drunk, and getting drunker, I looked up at the nearby mountain and realised one of the other things I had never done was climb a mountain at midnight.

In my inebriated state it did not occur to me to take my cellphone; though I did remember the whisky and cigars, which would be perfect to toast the sunrise on the summit. Just before I reached my goal I was given a very painful lesson in why climbing mountains in the dark while drunk is not an excellent idea.

I fell and smashed my ankle; amongst other injuries. To make things worse I had to roll down the mountain to be able to get help. Along the way I came face-to-face with a porcupine and was savaged by a great Dane out for a morning walk. I needed two operations to put me back together again, but my need to keep moving was so overwhelming that before the cast was off I was walking 15km per day.

Something Wrong

I knew something was psychologically seriously wrong with me. Super affable before, I was now getting into more-and-more fights with people. And my friendships, some as long as 30 years, were beginning to seriously bore me. I sought out wilder people.

What I was not aware of were minor physical occurrences. Sudden losses of balance to the left, forgetfulness, loss of motor-function. All these were very temporary and I put it down to too much alcohol while pouring another drink.

Bonnie & Clyde

Then the ultimate family man walked out on his family and undertook a Bonnie & Clyde frolic around the country. My behaviour was also becoming more extreme and amongst other things I had a brush with a member of the Hell’s Angels. And I bought a very powerful, very loud motorbike.

I was aware that my money was running out fast, but cushioned this by using my excellent credit history to take loans. Then I cashed in my life policies and moved to a hideout in the country. There I began to hate the idea of clothes and spent days walking round naked.

Suicide

Then I crashed emotionally into a depression the likes of which I cannot describe. It was a black, hopeless hole in which there appeared no salvation. It was a painless pain that was more awful than even my smashed ankle. In fact, certain psychiatrists are trying to have the type of depression I was experiencing classified in the same pain bracket as the most vicious cancers.

So I decided to end it all. My whole life I have been highly allergic to aspirin and I took 50 extra-strength. It cured my allergy and the only affect was a headache-free two week period. I tried to crash my bike by flipping it and I rigged myself to a gas bottle not realising that the deadly substance in household bottles has been removed. It did clear my lungs, though.

It was at this point that the few people who still cared for me got me to a psychiatrist, who diagnosed me with late onset bipolar disorder. This is normally found in young people, but what was once known as manic-depression can manifest at around 50. But he was concerned that I did not show any of the classic symptoms.

Miss Teen

Somewhere along the way, downhill fast despite medication, I hooked up with a former Miss Teen SA who had a serious drug problem. On our way to Hillbrow early one morning to get her a fix and some ecstasy for me, we had an accident. It was not serious, but I emotionally flipped to such an extent that my daughter had to take me in.

But I fought with her and left late one night. The next morning I was riding my bike through Rosebank when I noted a STOP sign read POTS. As I looked around everything was reading backwards. I had finally gone mad; confirmed a short while later when trying to write a cheque at the bank when my hand started writing stuff other than what my brain was telling it.

Transient Ischemic Attack

In a complete panic I phoned my psychiatrist, thinking he would have me institutionalised. On the contrary, he was delighted because he had finally worked out what was wrong with me. For five years I had been experiencing what is known as transient ischemic attacks or TIA.

TIA is normally a very mild heart condition that manifests in people at around 50. What happens is that there is a very small valve malfunction that causes plaque to build up behind it. At some point little pieces start breaking off and enter the blood stream. Those that find their way to the brain cause very minor strokes known as transient ischemic attacks; the effects of which disappear in a few hours which is why doctors could find nothing wrong with me when I had the first incident.

Life-changing Catastrophe

About a year ago researchers studying TIA in Alzheimer’s patients came across a link between TIA and late onset bipolar disorder. What they found was that TIA in people with the bipolar gene was devastating; elevating a minor, treatable condition into a life-changing catastrophe.        

People with the bipolar gene have an excess of certain chemicals in the brain, which go on a riot when a bit of plaque zaps you somewhere in the head. When they splash upwards you think you can climb a mountain at night when drunk; and when they splash back you enter a deep, dark hole. Then the next one hits, then the next…until your doctor makes the link and puts you on very mild heart medication.

Dysfunctional Western Medicine

The misdiagnosis of TIA in people with the bipolar gene (only a fraction of people with the gene develop the bipolar disorder) as having late onset bipolar disorder highlights the dysfunction of Western medicine. Medical practitioners say we are made up of three components – body, brain, mind. Doctors, generally, train in one area and have little knowledge of holistic health.

This works most of the time as it is seldom that a medical condition crosses over. Where one affects all three components then we have what could be the perfect storm. In this case, a fairly mild heart condition affects the chemicals in the brain which devastates moods in the mind. And the cycle becomes more frequent and serious because the stresses placed by the mind on the body mean more pieces of plaque break off and journey to the brain.

There are doctors who are starting to think that a huge number of people diagnosed with late onset bipolar actually suffer from TIA. The symptoms are the same as for bipolar, but the treatment is radically different. The tragedy is that thousands upon thousands of people are in institutions or receiving cocktails of mood stabilisers, tranquilisers and antidepressants when they could be happily taking a mild heart medicine.

Mental Disorder Stigma

I now look back and laugh and cry as I try to put my life back together. What I do know, which I did not know before my 50^th birthday present, is that deep depression is the most awful thing that can afflict a person. I would rather have had cancer. The pain would have been more manageable and people more empathetic.

It has also made me aware of the stigma attached to mental illness. I cannot remember how many times I was told in those terrible five years to get over it or get a grip. We would never do that to a cancer or heart attack victim, even if they smoked or ate fat-laden steaks every day.