Recently a friend wrote to me the following:
“Everyone has a fault in their perfect self, a line running somewhere between conflicting feelings. For some, it is evenly distributed, in the middle of yin and yang, creating balance “IF” they can stay very close to either side of the line. For others, there is a yearning for dichotomy, a departure from the average of averages.”
When I read these words they hit me like a ton of bricks—they struck me because without hesitation I recognized myself as of the later breed.
When I was a child, and school wasn’t stimulating enough, I would create extra “homework” for myself. The construction paper art project on the American flag became a handmade quilt on which I meticulously sewed dozens of patches, one for every state of the Union. The one-page essay on Native American history became a movie I would write, direct, act in, and edit. The ordinary was not sufficient for me—I was only satisfied when I could stretch far away from the line.
In college and medical school I became consumed by mostly academic and physical challenges, directing a relentless focus toward school and performing on my college’s water polo team, and then later competing in masters swim meets and water polo tournaments.
The significance was not that I set goals, but rather the way I pursued them. As I matured, I learned I could most efficiently achieve my ambitions not by using strenuous willpower, but by encouraging a certain mind state where energy poured out of me like water released from a dam. In this state I could take on new projects eagerly, not out of obligation or obsessiveness or perfectionism, but out of pure excitement and joy.
By the time I reached residency, I had developed sufficient self-awareness to understand that these ebbs and flows were a regular pattern of my personality. I knew all I had to do was wait for the next burst of energy and enthusiasm to come, and then direct it toward a meaningful goal.
During my highs I felt there was no challenge I could not take on. During my intern year, even while I was working close to 80 hours a week, I taught myself how to design, build, and code websites. When I had made enough websites for myself and my friends, I started a business making websites for other people. During another burst of energy I taught myself to play the ukulele, and later the guitar. During another I started to study French. This blog, and most of my writing on it, has been a product of these creative bursts.
In many of these cases, after a period of weeks to months, my enthusiasm would inevitably wane and I would unceremoniously put the project to the side. (As I said to a friend after my experiment making websites came to an end, “What am I doing? I’m a doctor, not a web designer!”). The lows were never too low, and acted as periods of rest for me to recharge until the next natural shift in energy occurred. I was always able to course-correct before I became too taught—too stretched away from the line—restoring balance and resting for the next swell of energy and motivation.
But, after being diagnosed with cancer, these shifts became extreme. Reflecting back, it is clear to me that in these last few years I have existed in mostly two utterly contrasting states.
There have been the high highs, characterized by overzealous optimism about my prognosis and future, by idealism about other’s motivations bordering on naiveté, and by unwavering confidence I would get my life back, just as it was, if not “better,” than before. There have been the low lows, characterized by crippling self-doubt, by shame and anxiety, and by fear that I was worthless and permanently broken.
On the days when I felt on top of the world, even while my body was exhausted from chemotherapy, my mind felt sharp and focused, my mood was euphoric, and people seemed drawn to me with an almost magnetic force. I would write essays and songs and raps that I couldn’t wait to share with the world (seriously though—I did recently write a rap about cancer, and it’s pretty fucking amazing—I will post it soon).
But on other days I have wished I could curl up into a tiny ball—one so small I might even disappear—and the idea that anyone reads the words I write, let alone knows I exist, has felt abjectly terrifying.
Looking back, though, I can also say that with time the amplitude of these oscillations has evened out. More recently, instead of careening from one extreme to the other, I’ve been able to notice and course-correct before veering too far away from the line.
However, the essential problem still exists. There are two sides to me, and each has her own distinct perspectives, views of the world, and views of herself. And each day, the voice I hear in my head feels like the one and only absolute truth. So, which one is the real “me?” Which one should I listen to? Which one should I trust?
And am I too bruised to ride the highs like I did before? Must I cling more closely to the line?
Not being judgmental but are you bipolar?
Hi everyone! Thank you so much for your messages and comments. Just to clarify, I am not Bipolar — rather I wanted to describe this experience of extreme emotions that I’ve found is common among those recovering from a major trauma such as cancer.
Thanks for your posts – they help me face my own fears.
Hugs,
Everyone is a mood disorder expert, because they have read about symptoms on webmd. ? We all experience mood changes, and the amplitude of those changes do not define someone as having a diagnosis.
Who hasnt feel euphoric, when they got accepted into med school?
Or devastated when they found out they missed passing their specialty board exam the first time by 5 questions out of a total of 800 questions.
When we succeed, we are not responsible for the outcome.
When we fail, we are not responsible for the outcome.
Its hubris to think our intentions and actions are the only causal factors that determine how the universe works.
Yes, determined focused intensity is more likely to produce a particular outcome in some cases., and avoidance is definitely not going to accomplish much.
But we deal with the uncertainty of the human condition: of health and illness.
Of awareness and denial. Of love and hatred.
My life changed twice: once on August 25, 1985. And then again on July 21, 2007.
Both times I found out I had a life defining disease.
IM STILL HERE. Not because of my own efforts.
Sometimes we have to surrender to win.
Find a mantra. like the Serenity Prayer.
Acceptance
Courage
Wisdom.
Its ok to be afraid. You know that but we all need to be reminded of the things we know inherently when we are scared
And we all get scared more often than we are willing to admit.
This is why God invented a sense of humor 🙂
Im reminded by my friends in recovery that on any given day when I think my life sucks, that there is someone else who would pray to have my problems.
Or as it was put to me once: “Steven, you have all the right problems. But if you focus on the problems, all you are going to see is the problem. Try focusing on reaching out to others, and on the solutions, and the problem wont be so scarey”
Steven
truth
The first thing, the photos, hit me like wow. You are so so beautiful. It’s the inner/outer thing combination.
Yes the label bipolar occurred to me as well but mostly I loved how you describe your creative energy ~”where energy poured out of me like water released from a dam.” And I wanted that haha
So good to see you in my inbox today.
Be well, Elana xoxo
Seems a lovely description of bipolar 2 and how you embrace it in yourself and cope so well. I imagine your extensive exercise in college and medical school allowed you to ride the waves of your two extremes. Gives me tremendous optimism for my patients. Would love to know if anyone has suggested that you have bipolar 2 and if so, whether you take meds.
Lovely to see you’ve been busy writing a book!
Patty, truth, right there.
Same here…I guess, having insight into and being present during both of the states helps to embrace either of them and stay productive. I enjoy both melancholy and the exaltation, but the days in between seem to be lower in intensity.
Is it bipolar? Cyclothymia? I don’t know. As long as daily functioning is not impaired – it doesn’t matter.
Yes, having been through the cancer thing as well, I understand the line, and attempting to find balance on either side.
It’s taken me several years since I completed treatment – the whole chop, poison and burn – to realize that things won’t be the same. It took at least 2 years to recover some energy even though my mind said yes my body said no. That’s also a lesson I’ve had to learn as I age as well. The cancer bit just put it into more focus.
Then there’s the whole ‘busyness’ thing, just for the sake of being busy. Now I’ve learned to slow down, observe, forgive myself if I’m feeling guilty about taking time ‘off’ from my projects to just chill. Time has been re-framed.
Now my travels from that line are not so drastic and I feel the better for it. Besides the cancer journey I also learned a lot about living from my indigenous friends who have quite a different outlook!
The journey of the self is fascinating and for me, gets better as I get older. Although it does take work.
Safe journeys for you.
Gila’kas’las
So are you bipolar?
I find that you are a remarkable human being. The fact that you pursue growth, learning, and mastering everything that you find interesting is not bipolar, but the germ of genius. A true genius is not someone who is great at one thing, but at all different kinds of things and this is part of who you are. The times when you are down are only because you realize that if you lived for a thousand years you could not learn and master everything there is. And you have persisted in this even when you were sick. i have nothing but admiration for you and hope you keep doing that. There are not many people who will keep pushing to live life as you do, to the absolute fullest.
You look so very beautiful.
Dear Elana,
Thank you for this insightful and thought provoking expression. Let me add a bit to it:-
From the day we are born, we go on acquiring habits till we die. So, life is the process of re-living our acquired habits over & over again. Among these habits, some may be good while some others may not be so good. Occasionally, we may rescind certain habits for whatever reasons. BUT, overwhelmingly, we just repeat our acquired habits, and call it living our life!
There comes a time we feel comfortable with the good while feeling uncomfortable with the not so good. We form our perceptions accordingly. That is called maturity. It is this maturity which helps us to comprehend the world around us better. However, as a Buddhist I believe that certain habits which seem to be within us quite naturally, are the habits we have brought with us from our previous births from wherever.
Circumstances we face in this world may either reaffirm such habits in us or cause us to alter them. The rule to be mindful of is: If any or all your habits are good for you and others too, go on reliving them. If however a habit is harmful to you and perhaps even to others, it better be rescinded. Overall, be happy “come-what-may” that you possess the power within you to decide what is good for you as well as others or otherwise.
Never forget the fact that one fine day sooner or later when we bid good bye to this world under whatever circumstances, the only things we can & do take with us are these good or bad habits we possess. This means, we start our life in the ‘hereafter’ basically through un-bundling these very same habits. If they are mostly good you’d be fine. If otherwise you would have a tough call.
Enjoy life!
Senaka
First of all I love your picture. All my life I experienced the behavior you described and I loved it. But the older I got the less intensive they were. Maybe it’s similar in your situation. But I loved any one of them and all the experiences involved. Life is grand…even if it sometimes doesn’t look like it! Barbara
Dear Elena. Its been a while sice i recived a post from you. Im so glad to have got the recent one. You are such an inspiration to me. I just learned that my MS is actually a mercury poisoning. Now its a whole new battle. What you say of your process (perfect self) so resonate with me.
Love the new hair. 🙂
Embrace both! You ARE those 2 Elanas, unique and beautiful in their own ways… If you’d like to go back to the basics, begin by writing about what made you start this blog in the first place. I like knowing that you are doing well. When I don’t hear from you for a while I tend to worry (that’s sooo me). Maybe that’s one of the reasons I started following you in the first place, your approach on psychiatry in a more natural/zen way.
Elena you are so beautiful!! I am so happy to learn you are ok!! I have been following you as well, since right before your diagnosis… I found you on the web after researching for alternative psychiatry for a member of my family. I instantly became hooked on your creativity, honesty, and passion for life!!! A month later you announced your diagnosis and I prayed for your success. I am also a cancer survivor; something I am learning to embrace as a strength that goes beyond the physical. I have been studying the mind/body connection in relation to fighting disease and reaching enlightenment of not just the soul but also of the body in order to reach a whole and complete connection to others. You are an inspiration to us. Keep doing all that you are doing through your amazing mind and spirit. -~Meredith
You are a beautiful soulful being Elana. Thank you for sharing the striking self portrait. I can so relate to the tug of war. As a recovering alcoholic (20 years), I have to remind myself regularly to not become too obsessed about any one thing–avoid obsessive thinking and obsessive behavior. I have not been diagnosed as bi-polar or with OCD. Even though I stopped drinking, the “isms,” such as obsessive thoughts and behaviors continued. I became an exercise-aholic, a workaholic, and obsessively interested in one pursuit, hobby and skill after another. They were seemingly healthy addictions, but still I was indulging in obsessive behavior–my quest for being “enough.” After 20 years of self-work and transforming myself by living and practicing the 12 steps as a design for living, I have reached a place of balance with sustained periods of contentment, creativity and joy from living. For me and in the 12-step school of thought, addiction and obsessive behavior is all tied up in ego/self and the best thing I can do to get out of “self,” is to be of service to others.
Thank you, Elana. I have had these two me’s too. It has gotten worse since my cancer journey. I delight in the highs. And the lows take me to a place that literally makes my body hurt because I stop being active (that curling up into a little ball) and my joints stiffen up. The lows are exacerbated when I don’t spend enough time with friends, when I don’t spend enough time doing the things I love and when I fall flat in the self care department and don’t eat well or exercise enough. In me I see the high times are often related to accomplishing things and the satisfaction that goes with it. Then I get a strange pain in my body and my mind immediately goes to “oh shit..what’s that”? Sometimes I can snap myself out of it and sometimes I don’t.
For me I see that when I gravitate toward the things that inspire me I feel more like the “real me”. I know this and even so I am not the best at making a conscious choice toward inspiration when I get knocked off balance – further from the line.
Thank you for helping me look at this.
Oh yes…by the way you do look beautiful and that is inspiring!
Hi and here’s an interesting site , another young woman MD with lymphoma, cancersurvivorsrule.blogspot.com
Namaste <3
Only two? Sounds like the typical Gemini to me. 🙂
I can relate from my own behaviors. I can be very mercurial. I get joyfully obsessed with an activity and take it as far as I can. I do try to maintain the skill, however, even if I can’t get any better at it. I’ve made significant inroads in my quest for self-actualization this way.
I’ve also been described as a quintessential funambulist. I guess there are times when walking the line is a lot safer.
I appreciate your thoughtful writings.
Can’t wait to hear that cancer rap!
I’m going to send this to my mom. She’s recovering from cancer as well and says she’s been experiencing some very extreme emotions. I hope your post can speak to her.
Hello! I have missed your posts and am so happy you are sharing yourself with us again. Your hair is gorgeous!
I don’t understand why some individuals label others bipolar just because they experience emotions and experiences deeper than others. You are one of the bravest people I know. Here you are battling for your life, but still baring your soul to the universe. Many of us out here have learned so much from you.
Thank you for being you! Much love to you.
I think we all have these natural states and we don’t need to label or pathologise them. I have had bipolar patients and it looks very different. When I was younger my highs and lows were partly borne out of narcissistic overvaluation and devaluation. Now they are just part of the ebb and flow of life and I can meet them with more patience, awareness and do a lityle steering as you say. If we have these cycles we would be robots
I meant if we didn’t have these cycles we would be robots
Great post! Have nice day ! 🙂 rrxmx