03/21/07

The buzz word is DUAL DIAGNOSED or DUAL DIAGNOSIS, and the condition (in my case) applies to mental illness with addiction.  It is a condition which is tough to identify clinically and a hundred times tougher to treat.  The treatment for mental illness is quite different from the treatment for addiction, and it seems that almost no one treats both concurrently.  Dual diagnosed individuals may end up wasting years of life in frustration and misery, perhaps even death.  Yet my experience with my own dual diagnosis will demonstrate to you that you don't have to spend your life imprisoned by these troublesome and incurable diseases.  Time, however, is the enemy as regards treatment, and self-help seems useless.  Read the book, BLESSED TO BE BONKERS and explore some of the truths and insights I have employed to manage my dual diagnosis and to find happiness. 

BLESSED TO BE BONKERS

IS NOT A SELF-HELP BOOK

If you want a self help book see the appendix after Denny's Story (below).

This page of CEREBRAL STORM focuses on dual diagnosis bipolar addicted alcoholic as it may apply in Denny's story to adolescence or early adulthood.  The NIH cites that bipolar affective disorder most commonly sets in during early adulthood on the average at age 25.

http://www.nlm.nih.gov/medlineplus/ency/article/000926.htm

 PAGE UPDATED 03/21/07

I have another website http://www.blessedtobebonkers.com/ on which I have posted several episodes of a story called "Denny's Story."  For the current episode, click on the button "To Bonkers." 

Denny's Story is a fiction based on my experience and the experience of others like me.  The events, issues, situations, and information in Denny's story should not be contrued as truth, nor should they be considered clinically accurate.  The story is a dramatization about a fictional character named Denny.

DENNY'S STORY

by James Rist-- © 2006 www.blessedtobebonkers.com

DENNY’S UNEASINESS HAD COME ON SO GRADUALLY…,

beginning perhaps in the midst of his freshman year in high school. It had progressed so slowly from brief episodes of anxiety to constant intense anxiety with peaking of his senses so severe at times that his motor nervous system literally to quaver with frenetic energy.

The dilemma was that no one knew, no one could see what was happening to Denny. And Denny himself could feel these tormenting sensations, but he had no real awareness of them, because they had come on so subtly. Now in his junior year; his grades had taken a dive; he had pulled out from the football team; and, despite the very active past in his social life, Denny had been avoiding his friends. The only part of his experience tangible and comprehensible to those familiar with Denny was the drop in his grades. Friends reasoned that the pressure of his academic standing accounted for the change in his disposition and they understood, because they too had begun to feel the pressure--especially those college-bound students.

Denny’s parents had seen the changes too. Denny had become moody and at times angry.

Denny’s parents had practiced nurturing and encouragement throughout Denny’s childhood, and they had always reigned him into the family circle whenever he faced great decisions. They had put great energy into communication with Denny, steering him toward what experience told them would be the best direction and admonishing him in matters in which they saw some risk to his welfare. Denny’s parents had sought to establish an organized life for Denny, and they had encouraged and even cajoled him to maintain some activity in church, in boy scouts, in part time employment, and in school organizations.

Denny’s father had graduated from a secular private college and had gone on to secure a masters degree and then a job which had put him in a key position with an accounting firm--a position which promised a partnership. Denny’s mother had also graduated from college with a liberal arts degree and had continued with post graduate studies in business management which had given her entry into her job as associate manager of operations in a construction firm.

Since both his mother and father were working professionals, Denny’s parents had income sufficient to employ a series of nannies and au pairs throughout Denny’s childhood years. Although Denny no longer needed a nanny, his parents still employed a housekeeper and liaison, present in their home virtually from dawn to dusk.

Denny and his family lived in an upscale, quiet, and secure community with little visible crime, little discernable poverty--a community abundant in resources, medical services, local commerce, and well-funded, actively-supported educational facilities.

In summary, Denny apparently lived a balanced active life, lacked no resources for happiness and achievement, enjoyed friends and academic privileges, and had an active line of communication with his immediate family.

Denny, however, had begun some intense changes, changes which had given parents, friends, and teachers some concern, but changes, nonetheless, which all the people in Denny’s life had explained away with cursory comparisons and instinctive faith in Denny.

This is not an actual case, and Denny is a fictitious boy, a composite character whom I have created to dramatize the plight of perhaps a bipolar youth. I have optimized Denny’s profile, so that it is clear to you that he has no logistical disadvantages or barriers to happiness and success as a well-balanced adult. I will try to use this parody as a platform to stage some of my own feelings and dilemmas as they arose in my own life. I will also try to incorporate some of the problems which researchers and healthcare providers observe in the profile of a youth with a mental health issue such as bipolar disorder or addiction.

I will continue with Denny’s story in my next post.

It would be so much better and perhaps much more beneficial to have actual stories--stories other than mine--YOUR stories. Please find the courage to send me your stories. Let me know if you would care to post your story here--anonymously. I am not interested in who you are, but we are all anxious to hear your experience with bipolar recovery, addiction recovery, or both.

Please! You really aren’t so unique, and you certainly are not alone!

Here are some informative pages you might wish to visit: 

http://www.bpkids.org/site/PageServer?pagename=lrn_100704

http://www.cincinnatichildrens.org/health/info/mental/diagnose/manic.htm 

http://www.mentalhealth.com/p13.html 

Or use www.google.com search term "bipolar addiction childhood" to open relavant pages.

MID-DECEMBER’S OMINOUS DARKNESS…

had settled on the dinner hour. Lingering low-settling gray clouds had brought dense, wet snow showers to deepen the darkness.

Denny opened his notebook to work on his semester project, due in just two days. The project had become his nemesis. In class, the teacher had proctored each student in turn to insure their progress, but Denny had avoided the teacher’s assistance, dreading to admit that he just could not get started while observing that the other students in his class were putting finishing touches to their own work.

Owing to the snow, Denny’s parents had not yet returned from work. Denny himself had skipped dinner to work on his class project, and the housekeeper had left the table set and dinner on the stove for the family in order that she might herself get a start against the storm to return home. Now Denny was alone in his room, alone with the meager start he had managed with his project, and alone with the mounting dread which had now formed as a stifling pressure within his chest.

All during the day, Denny had anxiously rushed from class to class, to gym, to study hall, to assembly, to work, and then home through the oppressive snowy melee of crowded streets and somber skies in order to mount a last ditch full assault to finish his class assignment. In front of where he sat were piles of library books resting under the corona of light from the solitary desk lamp. All around him the deep receding shadows imprisoned him with solitude and deafening silence. Denny’s arms and legs and face and fingers and all his internal parts began to twitch and tighten, and wave after wave of nausea rushed through his stomach.

In the past Denny would have undertaken and finished such an assignment with ease and aplomb. He would have gathered nightly at the library or the internet café with friends to work and share collectively the chore of a class assignment until each among the group had come to the point of mutual reassurance that they had prevailed over the demands of the teacher. The assignment would not have been a chore so much as a joyous challenge and a sense of shared fulfillment. These days however there was no camaraderie, no sharing of burdens, no joy in challenges. For Denny, life had become a nightmare of dread and a tumultuous sea of fear.

Denny reached with his hand to trace the contours of a trophy he had received in his freshman year--"All Conference Champions, Junior Varsity." He set the trophy back in its place at the corner of his work area. Tears began to form in his eyes, and a lump, in his throat. Sobbing followed with the tears. Denny clenched his fists and cried out in furious desperation. He rose to his feet and, with one frenetic sweep of his arm, he catapulted the books from the surface of his desk into the wall and onto the floor. He whirled around and around, issuing epithets of profanity in search of another target for his rage. A profusion of sweat flowed from his forehead and from his scalp down the back of his neck. Denny recovered his stance now and tightened his fists. He stood thus staring at the pile of books and papers scattered around the floor. He lifted his eyes to a large mirror on the wall--a mirror covered here and there with banners and pictures and news clippings. Between and among the paraphernalia on the mirror, Denny could see fragments of his own image.

On the chair rail beneath the frame of the mirror lay a pocket knife, a memento of his boy scout days. Denny retrieved the knife and opened it. The nickel plating on the knife had become mottled where it had peeled away as a result of frequent use and sharpening. He carded the point of the knife with his thumb. Its discreet sharpness felt good--reassuring--an unfailing ally amid the crumbling pillars of his life. Denny focused again on his image in the mirror and lifted the hem of his shirt, exposing his abdomen. Denny slowly and lightly drew the point of the knife across his skin, watching the process in the mirror. When he had finished the stroke, he paused to observe how the laceration reddened and to observe the droplets of blood forming in its furrow. Then he repeated the act over and over until shallow incisions crisscrossed his belly. The blood began to form rivulets, like gathering raindrops on a window pane.

Denny moved to his bedside and collapsed into a sitting position. The skin on his face began to tighten where the tears had dried. With his fingers he traced the welts which had formed under the wounds on his stomach. The itching stinging pain had in his mind become an appropriate counter-measure for the failure he perceived within himself. The momentary feeling of peace he had felt as a result of self punishment had now surrendered to more tears, and Denny rolled into his bed sheets, facing the wall. There he sobbed himself to sleep.

When at last Denny’s parents had arrived, Denny’s mother responded to the silence in the house by seeking out Denny in his room. There she observed the discordant appearance of his room, an effect which had become commonplace with her formerly tidy son. Denny’s mother dismissed her uneasy predilection, and, taking a nearby comforter, she covered her sleeping son. Days would yet pass before she would see the blood stains on the sheets.

[Story continued in the next post….]

MIDNIGHT CAME AND THE SNOW HAD STOPPED.

Denny stirred from his sleep. He could hear his parents preparing to retire to bed. Denny’s mother appeared briefly in his room to say goodnight. "Do you want anything, Sweetheart, before your dad and I go to bed?"

Denny answered faintly, "No, Mom, I’m okay."

After his mother closed the door, Denny rolled to his side and dropped his legs over the edge of the bed. As soon as he sat up, he turned on the light. Again the room became quiet and solitary, yet, somehow the silence was different from before when he had experienced his rage. Oddly the details, even the recollection of that rage, had nearly faded from his mind.

Oblivious to the blood stained shirt he now wore, Denny felt suddenly energized, even inspired. With confidence, he bolted upward from his bedside, and proceeded to gather the books and papers from the floor, again with little recollection of how they had got there. In his mind the all-elusive details of his school project rapidly began to take shape.

Denny moved the chair and sat down to his workstation. On the screen of his computer, the video game was still running from two days before. Denny finished the current game level in a distracted way, while ideas raced through his mind as if they were a flock of birds settling for an interlude of feeding during the course of their migration. Still, as he finished the game and closed the window, he felt too restless, too agitated to begin his work. Yet Denny was bursting with confidence. "Why…, WHY didn’t these ideas come to me a week ago!?" he thought.

Denny proceeded down to the kitchen to find a drink and a snack. The house was mostly dark and quiet. Denny liked it that way--no confrontations, no interruptions. With snack and drink in hand, he returned to his room.

Once at his desk, Denny began to roll through the class project with great self-assurance and speed. From time to time his hand would pass over the wounds and the bloodied shirt, moving in a detached way as though connected to some other part of Denny’s brain.

Two AM came, then three, then four, until at five AM Denny had nearly finished typing the rough draft of his paper. During the progress of his effort, Denny had constantly reviewed his work. It had seemed coherent and well developed, inspired and insightful. In reality, all the necessary information had made its way to the paper, but it had a disjointed and nebulous pattern--flighty, like the mind that had assembled it. Outside in the streets, cars passed by the house and the day began its early start. Denny assured himself again "With a few finishing touches, it’s ready!", and a sense of relief fell over him.

Denny put his work in the folder and arose to shower. He entered the bathroom and, as the light clicked on, he began removing his clothes. When he took his shirt off, the blood stains caught his attention. Detached at first, he turned toward the full length mirror on the door. There were the wounds he had inflicted in his earlier rage, tangible and starkly apparent to him. The sight of the clotted streaks on his abdomen at once filled him with fear and loathing for himself. In a panic and frantic to erase the evidence of what to him had certainly been madness, Denny retrieved some scrap paper from the waste can and quickly wrapped his shirt to conceal it with the rest of the refuse in the waste can. Just as quickly he entered the shower and began with his hands to scrub away the blood from his belly. Suddenly Denny knew that he couldn’t show up at school, especially not for gym class. He would have to persuade his mother to call and report him off ill for the day. Denny stood motionless under the warm stream of water, fixated on the marks on his abdomen. He would never explain this, not to anyone. He could not even explain it to himself.

[to be continued in the next post]

AT THIS POINT, YOU CAN PROBABLY SEE SOMETHING EXTREME

in Denny’s story.

I am simply not privileged to know many stories from the very secret side as I have written it here with regard to Denny. But I have gained some insight into the relationship between his definition of perfection and the irony of his self-destructive behavior. Yes, I suspect that Denny’s story is somewhat extreme and somewhat more overt in its demonstration of destructive behavior than most of our stories.

My own self-destruction played more subtly in the theme of my addiction to alcohol (In retrospect, I drank to die.). I have chosen to make Denny’s behavior more explicit, simply to dramatize the secrecy associated with self-deprecation in both bipolar behavior and addiction behavior. The point is that these diseases tend to hide themselves in such secrecy, to the extent perhaps that our friends, associates, and loved ones, despite suspicion that something is wrong, cannot see the whole picture of our disease. They especially cannot see the vital symptoms of our disease when those symptoms hide within us. We are very good at hiding and at times putting on a "good face."

I suspect, based on my own experience, that pride (critical comparison of himself to others) and denial (refusal to see and to admit the illness that commands his behavior) have had a great influence on Denny’s behavior.

Note also evidence of Denny’s detachment when he inflicted wounds on his own body, and later when the details of his actions escaped his conscious recollection almost as though he had merely been a bystander to his own injury. Something in our minds permits us to bury the pain and reality of such moments. Is it a form of psychic defense, an innate mechanism for denial? Later, when Denny is challenged to explain his injuries, you can see how easily he is able to dismiss the event and to elude the gravity of his actions, thus not only deluding himself but also allaying further concern on the part of teachers, parents, and friends.

Now to continue with Denny’s story….

At six AM, Denny’s parents arose to prepare for work. Denny had finished showering, and now appeared at the breakfast table dressed for school. As Denny’s mother served breakfast, she could see the distress on Denny’s face.

"Are you feeling well, Sweetheart?" his mother asked.

Denny’s father turned his gaze toward Denny. "What’s up, Sport? You look a little flushed. "Feeling okay?"

Denny saw in their questions a possibility for escape. "I think I have the flu or something. It came on in the middle of the night. You know I felt sort of antsy like you do when a cold is coming on, and now I feel real nasal and kind of whipped. While I was up I did finish my class project," Denny said in defense of his next ploy "but I don’t think I should go to school today, in case I might give someone else the flu."

Denny’s mom paused what she was doing and asked "Do you think you should see the doctor?"

Denny responded with as much control as he could muster, because he was beginning to feel that anxiety, the tingling twitching kind that made him quiver and shake. "Not right away, Mom. Let’s see how bad it gets first. I have to turn in my project tomorrow, and the doctor might not let me go to school, even it I feel okay and I don’t really have the flu or anything…. Let’s just wait, okay?"

Denny’s father took the situation on face value. "Well don’t play with your health, Dennis."

Denny’s mother, however sensed something deeper in her son’s disposition to remain at home. His request aligned with all of his other strange and reticent behavior. Once again, the alarm sounded in her heart, but she dismissed it in deference to, of all things, her need to get an early start to work. "Well, use your own judgment, Denny, but don’t hesitate to call the doctor, if you get much worse. And…call me at work!"

Denny’s mind began immediately to race into the immediate future, but he managed a distracted response. "Okay, Mom."

Denny’s mom seated herself and hurriedly plunged into her light breakfast. "Besides," she continued, "Phyllis will be here today to fix you something to eat, if you need it, and you can just stay in your room and rest. "

Denny excused himself, again anxiously, unable to remain in the company of his parents and under their casual scrutiny for even one more moment. "I’ll be okay." he said as he departed the kitchen. "Will you call the school, Mom? I feel a little guilty about calling off, you know, in case this is just a false alarm…?"

"I’ll call," Denny’s mom assured. "You don’t need to feel guilty, Sweetheart. You know the school’s position on spreading communicable diseases. I think it’s thoughtful of you to show that kind of consideration for your classmates…." By the time his mom had finished, Denny was out of earshot and, for the moment, safe.

[story continued in the next post]

"DO YOU THINK DENNY REALLY HAS THE FLU?"

Denny’s father merely raised the question out of concern, but in the mind of Denny’s mother the question sounded dialectical. She had perhaps projected her own mounting curiosity onto her husband. She mused in her mind, "Is this the third or fourth time this year…? I just can’t remember Denny’s ever being off from school that much!" Quickly however her thoughts returned to her husband and preparation for the day ahead.

Denny’s mother responded, "Well this IS the time of year for the flu and colds and stuff…. We have always emphasized consideration for others, and maybe Denny is also a little fatigued and overwrought with his junior year. Terri [a neighbor] says her girl has been complaining about the pressure of her college prep courses. Don’t forget that these kids have a lot more to learn than we did!"

Denny’s dad heard his wife’s conversation, but he did not really attend to what she had said. After all, this was the worst time of day to mull over family problems--Denny’s problem, the neighbor girl--whatever. He hadn’t really heard the note of doubtfulness in his wife’s monologue, the vocalization of a mother’s instinctive concern. In any case, concern for Denny had now taken second place to the imminent demands of the workday, and the couple were soon off to the trenches.

Denny felt free for the moment as he vaulted up the stairs toward his room. In his room he catapulted himself through the air and landed in bed on his back. From the kitchen and the foyer downstairs he heard the finale to his parents’ ritual departure for work. In an hour, Phyllis the housekeeper would arrive and perform her usual Friday magic, getting the house spotless for the weekend. Everything about a normal Friday was in place except that the picture did not usually include Denny. The peace of the moment gave way all-too-quickly to a growing feeling of guilt.

Denny cupped his hands behind his head and continued to lie thus on his back. His thoughts now began to reform the events of the past twenty-four hours. For an hour or more his thoughts continued under mounting tension. He had created for himself a situation in which he felt trapped. Denny’s nature had been more or less unaccustomed to lies, but now he had begun to knit a daisy chain of deception. In his mind the most critical issue had become the matter of secrecy about the madness of his behavior. He had focused of course on the behavior itself in his best unconscious attempt to give form to his emotions. He could not, at this point in his progression, with any certainty identify the emotional torment underlying his actions. Denny lacked awareness of his psychic dilemma, and his environment easily permitted his isolation from the seed of that awareness.

Some clinicians speculate that intervention at this point in a child’s life may indeed rescue the child from further emotional and psychic damage. However, at this point, the child [Denny] had become invisible. The moral and social implications in this episode are really up to the reader’s own survey. The fact of the matter in Denny’s case is that his environment may well deprive him the help he seems to need.

The missing element at this point in Denny’s life is something called cognition--the very self-awareness to which I have referred. That cognition in the case of mental illness, gives the afflicted a built in alarm--a warning when something is wrong or unhealthy with one’s feelings or behavior. Cognition is not necessarily an antidote or cure for ill-feelings or ill-behavior, but to those who practice [practice is the key word] self-awareness with their mental illness, the practice establishes a signpost which often directs the individual to seek help. Here Denny is effectively hiding from help. While a child, perhaps, must first see himself through the eyes of others, trusted others, before he can learn to see himself with any practical perception, our culture seems to make the process uncomfortable.

We teach our children to react to criticism with pride and arrogance. We teach them, with the best of our intentions, to fight back when they perceive negative input from others. We teach them a form of self-assurance that persuades them that they can do anything and be anybody on the strength of self-will, and we thus foster in them personalities which are reticent to ask for help. Obviously, when they first face a situation in which self will cannot prevail their reticence to ask for help forces them to choose one of two alternatives--failure or denial. Ironically, our culture teaches by example that failure is taboo, but denial is okay. Denny was in denial. Clearly Denny now was compelled to reinforce his denial with more lies--lies to himself and lies to others.

As in the case of the "moth and the flame" Denny’s denial was about to delude him into taking his first steps into hell.

[Denny’s story will continue in the next post.]

FOR A MOMENT A SOUND INTERUPTED THE CHAOTIC THOUGHTS

in Denny’s mind. It was 8:15 AM, and the housekeeper had arrived with a slam of the front door. Phyllis, the housekeeper, had not yet become aware of Denny’s presence in the house as she set about her usual Friday ritual. At that same moment, Denny’s cell phone began to play Beethoven’s Fifth at full volume.

Denny grudgingly dropped his feet over the side of the bed in search of the intruding cell phone. Denny thought frantically, "Where the hell is my cell phone! Why did I let that geek Jeff download that classical junk on MY cell!?" Stress built to a frenzied search, and Denny blasted toward his work area, knocking his chair over with a loud thump. "Where the hell IS it?" Denny lamented while the phone kept repeating, "Duh duh da duh….duh duh da duh…."

Phyllis felt and heard the thump of the chair above the ceiling in the study. She immediately dropped her coat in a pile and raced with alarm to see what had made the noise.

Meanwhile, Denny found the cell phone and answered with a brusque, "YEAH? Who is it!?" His voice disclosed his irritation.

Outside his room, Phyllis heard the voice. "Dennis? Is that you?"

"YEAH!! It’s ME…! Stay out Phyllis--I got the flu!" Denny managed amid the confusion of his room.

"Well I heard a noise…, and I thought…is everything okay?" Phyllis continued with concern. "I mean…I didn’t know you were home today, Dennis…!"

"Well now you know…, and I’ve got the flue, so stay away!" Denny warned Phyllis away with an impatient and biting tone of voice.

Denny returned the cell phone to his ear, and as he did so the voice on the other end spoke, "Dennis? This is Jennifer." Jennifer was a girl in his class whom Denny had dated, but who was more a friend than a romantic interest. "Where were you this morning!?"

"Jen? Wait a minute, I’ve gotta sit down." Denny settled to the edge of the bed. "Jen?" he repeated.

"Yes, Dennis…" Jennifer said with some annoyance, "it’s me--you know--your FRIEND? You were supposed to give me a ride to school this morning! I waited and waited…until Brandon and Tonya came by and offered me a ride. I couldn’t wait…! It was getting late!"

Dennis thought sarcastically to himself, "RIGHT!! Brandon to the rescue in his BMW--Big Macho Wimpmobile! What a jerk! Quarterback!! The ‘toad’ couldn’t quarterback the PEE WEE league!"

Now both Phyllis and Jennifer both had witnessed Denny’s agitation, a mood which neither one of them could easily associate with Denny’s former easy going attitude. Jennifer paused to avoid reacting angrily to Denny’s tone of voice, then she continued to question, "Where were you?" then she added hastily to head off the obvious storm of Denny’s emotions, "I’m not mad. Like…I got a ride and everything’s okay, but I was worried when you didn’t show up…. Did I hear you just tell someone you have the flu?"

Denny gained some control and simply responded with "Yes" followed by silence. He felt his body trembling all over, and he began to think perhaps that he really did have the flu or something. He had the feeling, but he did not recognize that it was rage--rage of the same kind as the instantaneous rage he might have formerly felt when, in a football scrimmage, an opposing linebacker had surprised him with a body check. In the matter of his current unrecognized rage, Denny, given an insight as to the feeling itself, would not have been able to identify its cause. The feeling, whatever its definition, now dominated his senses.

"Right, Jen," Denny continued, "I’ve got the flu or SOMETHING…I don’t know…." Then quickly he added, "My mom made me promise to stay home today." Hearing the half-truth from his own lips seemed to settle Denny for the moment.

Jennifer took some reassurance from the restored calm in Denny’s voice and she continued tactfully to register her disappointment. "We were going to go over our projects in the library this morning…. I was hoping we would, like, get to compare notes or something. I mean I’m not real sure I’ve got it right. Did you get your project done?"

"God, Jen…! I forgot we were supposed to go to the library, but, anyhow, I gotta stay home. The project’s due on Monday. Maybe, if I feel better, we could, like, get together on Sunday--or maybe even Saturday…." Denny sounded apologetic, even remorseful now. "I’m really sorry about this morning," Denny continued, ironically with tears forming in his eyes.

Denny now felt suddenly all confused. "What’s with this CRYING!?" he thought.

Jennifer had forgotten her momentary anger with Denny and she offered some consolation. "Do you want me to skip out of last period study hall and come by your house? I mean, I could, like, bring you something or something--if you need anything…."

"NO!" Denny said emphatically. Then he softened up, thinking about explanations and afraid he might have to own up to his weird feelings and behavior. "I mean, that’s okay. Don’t come over--today anyhow--you know , like, I might really have the flu or something that you could, you know, catch from me. Really…, no, Jen. I’ll call you tomorrow…. I just better sleep and stuff today."

Dennis began nervously to envision his classmates at school all day, doing all the usual things and looking forward to the weekend. He began unconsciously to tap his foot. Harder and faster, the tapping continued until the vibration rattled his car keys on the work station. Downstairs, Phyllis became irritated with the persistent tapping on the ceiling above, but she dared not approach Denny in his current state. She thought, "…best to let a sleeping dog lie. It can’t be only the flu that’s got that kid upset. I just wonder what’s going on with him…!"

Finally Jennifer broke the silence. "Well, okay, Denny. I gotta go now. Please take care of yourself, and maybe I’ll see you tomorrow. Call me if you need anything. Gotta go."

With that, Jennifer ended the call, and Denny felt a great and crushing loneliness.

[The story will continue with my next post.]

THE SILENCE OF HIS ROOM COMMANDED DENNY’S SENSES.

The cell phone remained in his hand. Denny thumbed through the directory of names and numbers--again and again and again. Finally it occurred to him that all his friends were unavailable to receive calls from him. Then there again was his mother’s work number and his father’s work number and the number for the grocery store where Denny worked. The small, purposeful sculpture of the cell phone occupied his attention and focus until its shape burned itself into his retinas, so that, when he closed his eyes, he could still see the contra positive of its image.

Denny dropped the phone at his side and slumped back into the supine position on his bed. The ceiling had the brushed pattern that the plasterer had originally imposed when the plaster was fresh. Again he riveted his gaze, now to the ceiling, studying it until its random pattern formed into imagined shapes. Beside his bed the battery powered analog clock spoke in its monotonous cadence, "tck…tck…tck…tck…tck…." Its infinitesimal progress around and around the dial beat out Denny’s agonizing journey into the darkness of the stranger who had taken up fresh residence in Denny’s mind.

This is the story of Denny, a young man in high school who has recently experienced uncontrolled swings from desperation to rage, touching on the entire troubled spectrum of emotions which lay between those extremes. Denny is a fiction--a composite of my experience and the experience I have perceived and heard from others with my disease. I am bipolar and addicted, and I am preparing to place Denny on a similar voyage in order to demonstrate in the third person the burden that my kind of mental illness has placed on me and others in our youth.

Denny now drew back the hem of his shirt to feel the contour of the healing wounds--wounds he had earlier inflicted on himself in an episode of rage. He reasoned that his wounds would not heal by Monday, by his next planned day at school. His ruse at sickness today in order to avoid a Friday at school would not give him escape on Monday, and Denny now searched his mind for a plan, an excuse, a dodge from the ugliness under his fingertips and the mounting storm in his racing mind.

Nine-ten AM. Denny thought about his trig class, which had started at nine AM, and he pictured the classroom in his mind and his classmates seated quietly at desks, taking notes. He even imagined that he could smell the concrete floors and the omnipresent essence of text books and paper and cafeteria smells and occasional wisps of cologne and chewing gum. In his mind, he began to rehearse conversations with his friends and classmates in which he offered explanations for his absence. Over and over, he put the words together and repeated them in his thoughts, until his rehearsal seemed to form a framework of truth, a subterfuge-turned-reality in a delusional way. Thus Denny’s feigned illness became HIS truth and his comfort in defense of his malingering flight from scrutiny.

Ten AM. Denny had now spent nearly an hour with thoughts racing and anxiety growing. His senses tingled with maddening energy, and he could no longer sustain a position at rest. Quickly he rose from his bed and began to poke at things around his room and to pace nervously. It seemed to him that the room had grown painfully small, that he had to escape it--to race through the house. Now he stood at the door to his room with his hand grasping the door knob, but he hesitated to open it. Listening for Phyllis, the housekeeper, Denny realized that roaming about the house might diminish his credibility. He had after all railed on Phyllis claiming that he had the flu. It would not do to appear to feel too well. Denny backed away from the door, now unconsciously wringing his hands. He suddenly felt imprisoned in his own room.

Denny sat down to his workstation and placed his hand on the mouse. He began to move the mouse in circles, watching the cursor on the screen of his monitor as it swept in a matching circular motion over the icons in front of his face. For five minutes, he continued to move the cursor thus until he became almost mesmerized by the movement. Suddenly from downstairs, he heard Phyllis turn on the vacuum cleaner. Instantly his reverie was broken, and he bolted for the door of his room and exited to the upstairs hallway. While maintaining his grasp of the door knob he lingered to survey the hallway and to attend the sounds from Phyllis’ cleaning activity. She seemed to be in the downstairs guest room, far away from the staircase leading up to the bedrooms. With no apparent purpose in mind, Denny moved toward his parents’ bathroom, his nerves now peaked, sweat forming on the back of his neck. He felt like an intruder in his own hallway striving to avoid detection by Phyllis.

[Story will continue in my next post.]

DENNY ENTERED HIS PARENTS BATHROOM.

It seemed strange to him to be in this room. It was not that this place was in any way forbidden to him. It just was that it was his parents’ domain. He generally had no reason to be there.

The room seemed foreign to him. The first thing that drew his attention was his father’s under shorts, draped over the edge of the clothes hamper and trapped under the lid. He could not ever remember seeing his father in under shorts. In fact, it began to occur to Denny that his parents had a life entirely separate from his own. The general smell of the room, the colors-blue and beige and baby blue, the paraphernalia on the toilet and on the vanity counter all seemed to belong to strangers, to visitors to the house.

The top edge of the wide blue bathtub was lined with lotions and shaving cream and bath oil, and it smelled like his mother in the morning. The smell was the humid, freshly showered smell--the once in a day essence that connected Denny to the family, the fragrance that mingled with the smell of fresh coffee at breakfast and floated down the hallway during the minutes following the sounding of his parents’ wakeup alarm. Without any special provocation, Denny stepped into the bathtub. His bathroom had only a shower. He settled into the tub, still dressed in his school clothes and in his stocking feet. He reached out his hand and rubbed a finger trail through the soap residue on the tiled wall, and then he studied the powdery substance on his fingertip. He rubbed the residue around his nostrils, drawing comfort and identity in the way perhaps that a cur rolls on the ground to incorporate in its fur some compelling odor, comfort from a world or entity which, though invisible, had left a clue to the next passerby--evidence of its presence.

Denny felt safe here, surrounded by the resinous blue tub and the matching satin shower curtain with its cold vinyl liner. From the remotest part of the house he could hear Phyllis, still vacuuming--the vacuum sound pulsing with a rhythm like the labored breathing of some beast struggling against a great burden. Still Denny sensed emptiness, the emptiness of a vast dwelling waiting to receive its fill of life and memorabilia and family history and the lingering invincible smell of time and flesh and food and old fabric, of happiness and sadness. Despite the sound of Phyllis’ cleaning downstairs and the familiar smell of this room, Denny’s home was a hollow structure waiting for a real family to fill it with spirit. It was a lonely place, and its crisp, all-too-new, well kept interior had become a "fortress of solitude." Denny felt as Superman must have felt--alone, searching for remnants of and clues to his identity, lamenting that things had changed and that there was no going back.

After several minutes, the makeup tray on the back of the toilet caught Denny’s attention. From the level of where he sat, Denny imagined that the tray full of cosmetics resembled the skyline of a miniature city. Denny arose and stepped from the tub. He hadn’t noticed that the sound of Phyllis vacuuming had ceased.

Denny now immersed himself in the study of the cosmetics on the tray. Eyeliner, foundation, lipstick, face powder, little brushes and sponges to accommodate his mother’s morning regimen…they all seemed like little pieces of intimate art--icons of the woman who emerged daily into the business world, and, again, evidence that Denny’s parents had a vast life apart from the life they had shared within the walls of their home. Denny picked up the foundation sponge which his mother had perhaps used earlier. He rubbed some of the substance on his arm, curious to see if its artificial flesh tone would blend with his own. He was surprised that it did not feel oily. Rather it seemed to merge seamlessly with his slightly freckled skin.

Denny replaced the sponge and worked his finger tips over the layer which he had applied to his own forearm. Rather than rubbing off, he found that the material adhered and blended even more into the texture of his skin. With some inspiration, he moved in front of the mirror and lifted his shirt. Denny again rubbed his arm, then he traced the lesions on his abdomen. Soon he reached for the sponge and the tube of foundation. Generously he applied the foundation to an area of his wound. He had the idea that liberal application would be necessary to hide the discoloration of the clotted lacerations. To his amazement, he had applied far too much, and he began to work it outward from the area to which he had first deposited the makeup. It was working, and Denny stood back from the mirror until his back touched the opposite wall. By Monday gym class, he perceived, some healing and the application of this foundation stuff would camouflage his wounds sufficiently to remove his shirt. The inspiration brought some relief for his anxiety.

"Dennis…! You startled me! …thought you were in your room!" Phyllis was standing to the side of Denny, in the doorway to the bathroom and at an angle from which she could not clearly see his stomach.

Himself startled, Denny quickly drew his shirt tail over his abdomen, and labored to explain his presence. As he was about to blurt some perhaps lame and suspicious declaration to Phyllis, she spoke again. "Call me when you are finished. I would like to take the towels to the laundry and clean this room. …no hurry…!"

Then Phyllis left the doorway to gather clothes in the master bedroom, and Denny slumped against the wall with a sigh of relief. This episode and every other moment from the past twenty-four hours in his life had taken on larger-than-reality proportions in his mind. His amplified perception and emotional state had exaggerated all that he experienced in confluence with his extremes of mood and sensitivity.

[Story to be continued in my next post.]

I HAVE BEEN TELLING "DENNY’S STORY" FOR SEVERAL DAYS.

Denny, however, is not a real person. He exists only in my imagination for the purpose of dramatizing some of the problems I and others have encountered with bipolar disorder and addiction.

My character, Denny has, over a period of two or three years, undergone a notable personality change. Denny, now perhaps sixteen and a junior in high school, demonstrates extreme moods, rage, desperation, isolation, self-deprecation, alienation from friends and parents, and uncharacteristic lack luster performance in school. A formerly gregarious and outwardly well-adjusted youth is now going through some painful transformation, and, given his age, one might attribute some of the change to hormones, some to social pressure, some to shifts in his family relationship--all normal factors in the process of maturation.

The question is "Does Denny need help? …what kind of help? …from whom? …with what objective? …aggressive or passive? …intervention?"

Furthermore, who in Denny’s life is in a position to see the big picture of his affliction? …to see enough of the picture, at any rate, to give or seek direction appropriate to respond to Denny’s needs? If direction and perhaps treatment for Denny’s condition is indicated, who can enlist Denny’s own awareness of his dilemma and his cooperation to follow direction and to accept help? Should all those in his life allow Denny time to perceive his own problems and to muster his own will and resources to cope and emerge from his crisis?

In short, assuming the reality that Denny has acquired a psychic problem, should he be allowed on his own to recognize the problem and seek help, or should someone marshal control and impose help on him? Perhaps something between these extremes--an effort to enlighten Denny , to point out the aberrations which have developed in his nature and behavior, to make help available to him on terms that enlist his own initiative….

Clearly many remedies are available, once Denny has taken the first step; but what about that first step? How does that come about in Denny’s situation or, for that matter, in anyone’s situation early in the process of mental illness.?

Statistically and clinically speaking, Denny’s chances for recovery or management are good at these early stages, given treatment and continued support and follow up. Therefore, however one describes or defines "the first step" to recovery, the first step seems to require some judgment, assessment from a rational and informed source, and , most of all, Denny’s willing participation. So assume that Denny needs help.

What about objectives for treatment of Denny’s condition? Should he seek to restore his baseline nature and behavior from his pre-adolescent years, or should he continue forward with the process of growth and maturity which had already started to remove him from his adolescent state? Would an environmental change give him any benefit? What process of diagnosis, observation and measurement is appropriate? What standards exist, if any, which have demonstrated their capacity to evaluate Denny’s condition and to give a reassuring prognosis? Assume Denny’s prognosis is favorable but that to achieve that prognosis he requires treatment.

What’s the track record for various treatments--drugs, holistic, spiritual, psychotherapy, or combinations? Do treatments available universally account for the individuality of the person receiving treatment? Will those who treat Denny have clear and identifiable models of Denny’s condition on which to base his treatment? To what extent do various treatments demand fundamental psychic change, not only from Denny, but also from those intimately involved with Denny’s life? Will the chosen treatment provide an effective avenue to the required psychic change in Denny’s nature. Finally, given a favorable [or even unfavorable] prognosis, will Denny and/or those intimately involved with Denny accept the necessary change?

I do not have answers for these questions, but there are enough authoritative resources at least to give some clues to the answer. I do know that the "clock is ticking" for Denny, and I can see by Denny’s recent history that his affliction has continued to progress in severity. I do know from my own experience with bipolar disorder and addiction, that the cornerstone in the response to Denny’s condition is recognition and awareness that something is wrong. I know that the root of awareness is communication, and I know that the fundamental element of communication is shared experience. It seems to me, if nothing else, that Denny needs the wisdom and compassion of someone who has experienced first hand what he is experiencing.

Once again, I am not the expert. I am the afflicted. I pose the questions. You all seek the answers.

I am going to leave this post on my site for a few days. I myself am having difficulty with my bipolar disorder, problems which I need to address and manage before they become too extreme to handle. I will, as things stand, never escape the burden of my mood swings nor will I ever be cured of my mental illness or my addiction. The salvation for me is that I am aware of their impact on me and I know how and where to find help. That’s progress.

So I leave you with some vital and critical questions, and I will continue with Denny’s story when I have settled myself down to some manageable level of chaos!

AS I HAVE PREVIOUSLY WRITTEN,

my character, Denny has, over a period of two or three years, undergone a notable personality change. Denny, now perhaps sixteen and a junior in high school, demonstrates extreme moods, rage, desperation, isolation, self-deprecation, alienation from friends and parents, and uncharacteristic lack luster performance in school. A formerly gregarious and outwardly well-adjusted youth is now going through some painful transformation, and, given his age, one might attribute some of the change to hormones, some to social pressure, some to shifts in his family relationship--all normal factors in the process of maturation.

Denny again stood alone in front of the mirror in his parents’ bathroom. Again he lifted his shirt and looked at the wounds on his stomach, satisfied that the application of his mother’s foundation makeup provided adequate camouflage in the event on Monday that others in his gym class might tend to notice the wounds.

With that, Denny observed that Phyllis was still attending to his parents’ bedroom, and he exited the bathroom to return to his own bedroom. Denny closed the door to his room and sat down at his workstation. He tapped the mouse cursor to bring up his PC display, and he also absently laid his hand on the class project. To the observer it would seem that he was about to put the finishing touches on the project in preparation for class on Monday, and perhaps that is what Denny intended at the moment. However in the same moment the monitor screen lighted up and displayed the statistics window from his last game of Vortex. Denny held the rough draft of his class project, and he began to recall some of the details of his early morning frenzy to finish it. Tension and anxiety began to build to the level again which had him literally quivering with energy and intensified sensory acuteness.

Denny laid the class project aside and opened the game of Vortex. The introductory music to the game began to play in a discordant irritating minor key chiming with almost sub-audible base that reverberated from his custom Bose speakers. The program application began to load with demonic screams and strobe-like kaleidoscopic graphics, and the deep base of the synthesized voice proclaimed, "Few have entered the vortex and returned to tell their story…! To start the countdown, click on the flaming orb of destiny!"

Denny thought that it had been some time since he had managed to navigate through all the game levels to Level Zeta and the worm hole that loops back to the present. The class project would have to wait. Denny’s excitement now vaulted to a frenzy.

The Vortex game had emerged on the market four years before, a version of a then-popular arcade game. Denny was twelve, and, at the age of twelve, video games had a special enchantment for boys of Denny’s age. Denny had visited with one of his peers from the neighborhood during an unsupervised period of his summer vacation. It had been for Denny a revelation of childhood to have a portion of the summer at home alone and without the scrutiny of his parents. His friend Zachery and a few other boys and girls from the upper middle class neighborhood had planned and finally implemented an all-day party of sorts at Zachery’s house, while Zach’s parents vacationed in England. Amid junk food and loud music, the adolescent melee took shape and gradually escalated to raids on the liquor cabinet. Denny had partaken of the booze enough to feel its magic effect, and it was at that point that his friend Zach acquainted Denny with the game of "Vortex." The game had since remained for Denny an icon from a good summer, and a continued mode of release for his pent up discomfort with young adulthood and the growing responsibility which had attached to his high school years.

Denny now began to play the game, and he quickly advanced to Level Delta. The creators of the game had assigned each level an alphabetical letter with a greek-sounding name to correspond to the letter. It was at the level Delta that Denny paused the game. He felt a compelling uneasiness, and that feeling had interrupted his zeal for the next level. Denny arose and opened slightly the door to his room. He peeked into the hallway to see if he could hear any evidence of Phyllis cleaning activity. He could tell that Phyllis had started the bathroom cleaning, and he knew that she was fastidious in this aspect of her work--that she would remain in the bathroom for several minutes.

Denny carefully exited his room, quietly escaping down the hallway, every movement with a clear purpose, yet a purpose which had not overtly disclosed itself to Denny. He was driven for the moment by some unconscious cue from the game or some subtle connection between the stimulus of the game and his current frenzied state of mind. For whatever reason, Denny advanced quickly down the stairs and toward the pantry, off the kitchen.

Once inside the pantry, Denny surveyed the shelves, muttering to himself, "Soup, flour, sugar, tuna, chips, mayo,…," and so forth, as if he were taking an inventory of the supplies. Denny clearly felt an obsession for…something, which, at his age and state of physical development, would most certainly have been something to eat while he played the game. Denny’s clandestine approach to the pantry gave an additional clue to the special "something" which he sought, a clue that the "something" was perhaps a forbidden something, requiring stealth and discretion in securing it. Ironically, though he was certainly driven, Denny had little clue as to what he would find to match his obsession. Not surprisingly, his eyes finally found it.

It sat there, on the back of a corner shelf in the half light with its magic looking four-color silvery label. …One point seven-five liters of vodka, a fortuitous two thirds full--not quite full, not quite half empty. It beckoned, and its presence gave Denny a fluttery feeling in his stomach and a tight knot deep within his throat, feelings not unlike the feelings he had when Jennifer once playfully teased his hand inside the top of her swimming suit.

[I will continue with Denny’s story in my next blog.]

http://www.cincinnatichildrens.org/health/info/mental/diagnose/manic.htm 

http://www.mental-health-matters.com/articles/article.php?artID=453 

http://www.healthyplace.com/Communities/Addictions/Site/transcripts/addictions_dual_diagnosis.htm 

DENNY, HOWEVER, BALKED AT REACHING FOR THE VODKA,

and he continued for a few more moments to peruse the pantry. His heart raced, while the compulsion to retrieve the bottle continued to dominate his instincts. Finally, his hand returned to the vodka, and, with a fleeting afterthought, Denny also removed a bottle of fruit punch. Now he could feel the flush of excitement rising through his face and into his head.

A dilemma arose, in that Denny needed now to move through the house with the bulky bottles and without arousing Phyllis’ attention, should he encounter her on the way back to his room. The situation, for Denny, had become unbearably intense. Vaulting tension joined up with Denny’s waning nerve, but, ironically, at no time did he consider returning the vodka to the pantry and "scrubbing" his mission. Then he spied it…. Lying in the extra chair at the kitchen table was his book bag, full of books.

Denny paused nervously, warily listening for some sound from Phyllis. Endless and agonizing seconds passed, as he maintained his position, frozen in the doorway, short of the point of no return. Still, he heard no sound from upstairs. It was critical now that he confirm her location in the house. Sweat began to form rivulets from under his arms, and he became aware of the rapid pulsations in the arteries of his neck.

Carefully, Denny now eased the bottles to a resting place on the floor next to the inside of the pantry door frame. From there, he quietly and slowly edged toward the book bag. Suddenly Denny heard a sharp cracking sound. He became instantly paralyzed by the startling sound. The refrigerator motor had been running and had shut down. The motor contactor had broken the circuit with a not-too-uncommon arc, a spark of inductive force which made its characteristic "popping" noise. Denny remained, again motionless, for several seconds. Beads of perspiration formed above his cheeks near his eye sockets, while fear and excitement remained briefly in balance, one with the other. At last, he heard the sound of rushing water in the pipes behind the pantry wall. Phyllis, he reasoned, was still in the upstairs bathroom.

Quickly, Denny advanced and, in one continuous movement, secured the book bag and returned to the pantry.

In the pantry, Denny quickly removed the books and replaced them with the bottles of vodka and fruit punch. Just as quickly, he gathered the books and organized them out of sight behind a box of laundry soap. Then he closed his book bag and moved into the door frame, holding the book bag with one hand and bracing himself against the doorframe with his other hand. He paused to listen once more for Phyllis, but he could hear nothing. He calculated that she surely would not have left the bathroom in the short interval which had just elapsed.

Denny straightened his posture and wiped the perspiration from under his eyes. He exited the pantry once more, noiselessly closing the door behind himself. He proceeded toward the kitchen exit and, as he rounded the corner into the dining room, he collided squarely with Phyllis.

Phyllis screamed, "Ayeeee…! DENNY! What ARE you doing!? You nearly scared me to death! That’s the second time this morning! I SWEAR…I’m going to get a COWBELL to put around your neck!"

Denny’s heart rocketed through his throat. Startled beyond reacting and unable to speak, he dropped the book bag to the floor beside Phyllis. In his state of amplified senses, he could hear the swishing of liquid from within the bag, as though it were a raging torrent in some swollen river. Before he had a chance to regain his composure, Phyllis stooped, retrieved the book bag, and handed the bag to Denny. Denny’s knees now nearly collapsed with the shock he felt, but Phyllis had not hesitated in handing him the bag.

The event again pumped his heart at a furious, almost arrhythmic rate. Finally Denny managed to respond with a breathy "Thanks, Phyllis." Then he raced to his room.

Phyllis collected her senses and continued into the kitchen to make coffee and to take a break from her chores.

The encounter in the dining room had unsettled Phyllis enough that she welcomed the opportunity now to rest with a cup of coffee. The incident had also triggered an instinctive curiosity.

All summer Phyllis had spent interims of time in the presence of Denny, and she knew that one of his qualities was NOT stealth. Denny in fact was the noisiest, most gangling kid she could imagine. Besides that, Phyllis and Denny had had many long and animated conversations, at least early on; and she knew, if anything, Denny had not been inordinately shy of her. True, as summer wore on, Denny had become less talkative, and that also had caused Phyllis to wonder if there might not be something amiss in Denny’s existence. Despite growing misgivings on Phyllis’ part, however, Denny had in no way avoided her until this day, when it seemed as though (Perhaps she had misjudged him.) Denny had now made a special effort to move about in secrecy. Certainly he was as much surprised as she by their collision in the dining room, when, otherwise, each might in anyplace in the house have expected to encounter the other.

While the coffee brewed, Phyllis entered the pantry and removed the laundry soap from the shelf where it had hidden Denny’s school books. She saw the books of course, but their presence on the pantry shelf had not registered with her.

Phyllis rested the laundry soap on the kitchen counter, while she poured her coffee and took a seat at the table. Phyllis felt a growing uneasiness about Denny, but she could not quite organize the feeling into a logical thought process.

[I will continue Denny’s story with my next blog.]

If you have been one of the two three (God love you!) daily visitors to my site, please forgive me that I have not kept even this simple project up to date. My bipolar disorder has put me in a dysfunctional state for many days now. Keeping up with daily posts has been my plan and my intended therapy, among other things. I am not making excuses, but I do want you to know that we all may suffer the same dysfunctional nature from time to time, and it’s okay--it "goes with the territory." We should not worry about that or beat ourselves up over our shortcomings. I have expressed my dilemma in my group and among my network of friends. It always helps to restore me when I have others like me to talk to--others besides my therapist or my doc. Please keep coming back, and, when you get bored, send me an email using the link in the other column. I like to get emails!

DENNY ENTERED HIS ROOM WITH A SIGH OF RELIEF.

He quickly kicked the door shut behind himself, and plopped into the chair at his workstation. His breathing labored briefly to regain its normal cadence, almost as if his chest had been bound tightly and then suddenly unbound. Still clutching his book bag, Denny felt a sudden panic. He realized that he had no glass in which to mix the booze and the juice, and, at the same time, he experienced some instinct as to the insanity of his actions. He became confused as the conflict between reason and obsession played itself out in his mind. At the peak of his conflict, Denny’s cell phone rang.

Denny glanced at the face of the analog clock. 11:34 AM.

"Hello?" Dennis spoke absent-mindedly into the phone.

"Dennis! ‘S’up!?" the voice on the phone hailed him by name.

"Ryan?" Dennis finally asked. "What’s happening?"

"I heard you’re sick, Buddy…." was Ryan’s response.

Ryan had been Denny’s close friend since grade school days. The sound of his friend’s voice became a wake-up call, summoning Denny’s basic compliant nature and highlighting the uncharacteristic defiance he demonstrated by taking the vodka from the pantry. Denny was again quivering--his nerves unhinged and tightly wrapped around every fiber of his body.

"Yeah…," Denny started to reply, "well, to tell you the truth…,"

Denny paused, on the verge of confessing his deception to his friend, from whom he generally had kept no secrets. Something inside him, however, compelled Denny to respond with the lie he had planted earlier in his parents. "…to tell you the truth, Ryan," Denny repeated, "I could have the flu, and you know the policy on bringing stuff like that to school…."

"Yeah. I know!" Ryan chuckled. "It’s almost WORTH it to get sick. The school is so ‘easy’ about skipping. They don’t even ask for a doctor’s excuse! Talk about paranoid!"

Ryan knew his friend well enough, however, to suspect malingering. The thought brought a smile to Ryan’s face. Denny’s obedient "goody-goody" nature had always made Ryan a little uncomfortable with his own foibles. Ryan was the epitome of devil-may-care, and he had often resented Denny’s reluctance to join in. He was encouraged at present to perceive a change in that aspect of Denny‘s nature.

"Well," Ryan continued, "I just thought I’d call and find out how you’re doing, and to tell you that we had spaghetti for lunch--you know…, worms in catsup! Besides, I figure tonight you’ll be feeling a little better--maybe even good enough to go for a pizza?"

"No, really, Ryan. I’ve got something, and I’m just gonna hang around at home."

Denny could have recanted, but the conflict in his thinking, coupled with a feeling of guilt, persuaded Denny to stand by his story. Ironically the guilt Denny felt was not connected so much to the lie he maintained as it was associated with erosion of his self-esteem. He simply did not feel worthy of any social activity, given that all his classmates were at school experiencing a normal day and dealing with the demands of a normal day. Denny just didn’t feel that "normalcy." He actually felt rejected by the normal current of life, a rejection spawned not by others among his circle of friends but rather by his own failure to live up to standards he had set for himself--standards by which in his perception others would measure his worth.

"Well, if you change your mind, you know where to find me!" Ryan thus offered one more chance to Denny, but, in Denny’s mind there was no turning back.

"Sorry, Ryan, but…I can’t. Thanks for thinking about me. Maybe you can get somebody else to go with you." Denny offered his final decision with a tone of dejection which was not lost on Ryan.

"Okay…! I guess you’re not faking…." Ryan paused for a reaction.

"Yeah, it’s the real thing alright, but I’ll be okay after a couple days. Talk to you later, Ryan."

"Right! Later, Dennis!"

With that, Dennis turned off his cell phone. He did not wish to receive anymore calls from classmates.

{Denny’s story will continue in the next blog.]

I REMIND YOU ONCE AGAIN, THIS IS A STORY.

My character, Denny has, over a period of two or three years, undergone a notable personality change. Denny, now perhaps sixteen and a junior in high school, demonstrates extreme moods, rage, desperation, isolation, self-deprecation, alienation from friends and parents, and uncharacteristic lack luster performance in school. A formerly gregarious and outwardly well-adjusted youth is now going through some painful transformation, and, given his age, one might attribute some of the change to hormones, some to social pressure, some to shifts in his family relationship--all normal factors in the process of maturation.

It is interesting to note from previous episodes that a number of people close to Denny have observed aspects of Denny’s change. Denny’s parents, the housekeeper, his friends, his teachers--all have seen aberrations of his moods and behavior, but, lacking real insight, none has challenged what he has observed. None has reached out to question Denny nor to call to his attention what has become more than subtly apparent.

I may only guess at what underlies the reluctance of friends and loved ones to take an active role with respect to troubling signs in an individual in Denny’s situation. I had previously in my writing entertained the notion of denial and its universal effect not only with the afflicted but also within the social circle of the person who may be afflicted with a mood disorder, and emotional problem, or any other alteration of his psychic nature. I suspect sometimes that the reluctance is a response to cultural restraints. One of the caveats our culture seems to espouse is the idea that we must leave matters of intervention and critical interaction to designated authorities--in this case perhaps, to professionals. The practice of that caveat, ironically, leaves the afflicted individual often to find his own way to seek help. That requires such an individual to somehow get through the process of recognizing his problem, acknowledging his problem, accepting his problem, and finally learning about alternatives in dealing with the problem. But…does the individual have an innate capacity or self-awareness, under the circumstances, which will allow him to see the problem without an intervening source to demonstrate and enlighten him.

Sometimes a psychic dilemma of Denny’s type has uncomfortable social consequences, consequences which result not in our embracing a troubled individual with love and concern; but rather those consequences result in our shunning the individual, thus perhaps to isolate the individual and the problem from view, until that problem grows and finally insinuates itself among us in a tragic and imperative way. Another thing which is significant in my mind is that the process of isolating the troubled individual and leaving him to his own devices is a process which often drives that person to seek relief rather than cure--relief from the most visible resources, alcohol or drugs. If nothing else the pain a trouble person feels is a pain which they cannot ignore--a spiritual, mental, or emotional pain which hammers that person senseless as to reason and eventually drives him into simple survival. Unfortunately his perception of survival becomes distorted, ignoring true physical and emotional needs in a driven quest for pain relief.

That premise is not so extreme.

Look with me again at our culture. We seem to be flooded with appeals from sources of relief--sources promoting everything from aspirin to the latest concept in prescription drugs. Liquor, wine, and beer advertising seduce us to leave our "quiet desperation’--to escape to some realm of fulfillment through mood alteration. …and the MESSAGE is all BUT subtle, isn’t it!? Beautiful people, our icons of successful living, party endlessly right in front of our eyes with smiles and laughter, helping us to substitute their images for our own demeaning self perception. It is, I admit, healthful to me to have some form of occasional escape. By escape, I mean healthy, restorative diversion temporarily from focusing on life’s obstacles. Escape? Yes…but to what extreme!?

I interrupted Denny’s story at a point where Denny is sitting alone in his room, burdened with an emotional and mental dilemma, and he has a bottle of his parent’s vodka. He is about to spend the balance of the day using solitude among other things in an attempt to find his footing, perhaps more than anything to escape.

[Denny’s story continues in my next post.]

DENNY SETTLED NOW IN FRONT OF HIS PC DISPLAY,

ready to open the next level of the video game which he had started nearly a half hour before. He lingered with his hand on the game control, then, before proceeding, he removed his hand and spun his chair around. He paused, staring at the book bag for several moments, then in a gesture of exasperation he smacked his forehead with the butt of his hand.

"I forgot to get a cup!" he muttered to himself.

After his startling encounter with Phyllis downstairs, Denny felt somewhat leery about returning to the kitchen for a cup.

Meanwhile, Phyllis herself had relaxed at the kitchen table to savor her freshly brewed coffee. As she did so she reflected on her surprise collision with Denny. Her lips spread into a smile with the realization of how comic the incident had been. She recalled the priceless expression on Denny’s face, and she imagined her own reaction must also have been quite a sight. And when he dropped his book bag and froze as if he had seen a monster…. Suddenly Phyllis had a revelation of sorts.

She thought, "What were Denny’s books doing in the pantry!? They should have been in the book bag…!"

Curious now, and needing to verify that she had in fact seen his books in the pantry, Phyllis arose and took another look. "There they are…!" She mused. Again she surveyed the shelves in the pantry, and she found herself faced with an even more compelling mystery. "But what was in that space on the shelf above?" The incongruity of an empty space in an area which was normally so over provisioned as to put such space at a premium began to vex the housekeeper.

"I should know this pantry like the back of my hand, but I can’t for the life of me picture what would be in that space!" Phyllis puzzled. She would spend the rest of the day, ironically, unable to fill in the missing piece of the picture, thus further perplexed by the mystery.

Then as Phyllis backed out of the pantry rubbing her jaw with a feeling of consternation, Denny returned to the kitchen for a cup. Phyllis moved toward her chair, while Denny secured a cup from the cupboard.

With a quizzical look, Phyllis spoke to Denny. "Do you know that your schoolbooks are in the pantry?"

Denny’s heart sank, and for a moment he remained facing the cupboard, away from the direction of Phyllis. After a brief and quiet breath, he turned and replied, "No. What would my books be doing in the pantry!?"

"That’s what I’m wondering…?" Phyllis pondered. "…and now that I think about it, certainly your book bag (Phyllis was remembering their earlier collision) must have felt awfully light…?"

Denny tried to remain casual in his response, "I really didn’t pay any attention--didn’t even notice. "

With a crooked and forced smile Denny continued, "That’s funny. You’d think I would notice something like that. …Must have a lot on my mind!" Then he forced a little laugh.

"Well I would still like to know what those books were doing in the pantry behind the laundry soap," Phyllis persisted. " It almost seems as if they were hidden! I would really like to know how those books got THERE, of all places!"

Denny truly wished to end this "investigation" that Phyllis had undertaken. Quickly he contrived an explanation.

"Maybe Mom put them there this morning…to get them out of her way." Denny offered uneasily. Then with a little pretend chuckle he added, "You know Mom…! Sometimes she does some ‘ding-y’ stuff!"

Hastily then Denny declared, "I have to get back upstairs and finish my class project."

"I thought you’d be too sick, I mean, that you’d feel too bad to study. Didn’t you say you have the flu!?" Phyllis continued to question, and it seemed to her that the situation was getting more and more confusing.

Denny, however, did not respond. Instead he hastened from the kitchen.

Phyllis merely finished the conversation to herself. "HE’S going back to his room to study, but his BOOKS are still in the pantry! …and my coffee’s cold! I’m getting too old for this. I’m sure glad MY two [kids] are grown up!"

Phyllis poured her cold coffee into the sink, and with some resentment she returned to her chores.

Denny had barely escaped scrutiny, and the event, though comical in Phyllis mind, emphasizes the dilemma of misperception among our closer associations with others. The whole matter of seeing behavioral anomalies in our loved ones is almost like the case of being too close to the forest to see the trees.

[I will continue Denny’s story in my next post.]

SECURE NOW IN THE FAMILIAR TRAPPINGS OF HIS ROOM,

Denny settled again at his work station. He removed the bottles from his book bag and placed them discretely at his feet under the desk. He set the empty cup next to his keyboard and then he lifted the bottle of vodka from the floor and carefully removed the cap. He placed the opening of the bottle near to his nose and inhaled the curious and volatile odor. The vapor delivered an exotic sweetness to his senses, and it evoked a strange feeling of excitement.

Denny poured a generous amount of the clear substance into the cup, noting that, by doing so, he had depleted the bottle by a noticeable quantity. Again he faced the paradox of having what he craved but escaping detection.

Throughout the years, his family life and the attitude of his parents had reflected sober values--ethics, professionalism, decorum--and the use of alcohol had been an infrequent and mostly ritual activity during holidays and on special occasions. Denny’s parents generally limited their consumption to wine, with most temperate self-control, and often innocently shared the wine with their son. That innocent sharing had occasionally exceeded Denny’s tolerance to the intoxicating effects, and it had an impact on his metabolism--a pleasant impact which had, in the long run, left him vulnerable to wanting more. The vulnerability to alcohol as yet had not become an obvious and compelling influence, but, as many who have succumbed to its charm will testify, "the seed had planted itself."

Denny lifted the cup cautiously to his lips, curious to have his first taste of the vodka itself. As he placed the cup to his mouth the vapor again wafted to his nose, but it’s essence was different from when it had still been in the bottle. It now had a cloying, almost forbidding aroma. The smell was still ether-like and sweet, but now with a dusty and stale overtone. If I can translate based on my own experience, I am inclined to say that the effect of the vodka was not so pleasant and was perhaps even daunting to his senses. Ironically, where others might respond to that general unpleasantness by putting the cup down and forbearing the experience, Denny continued past the sensory caveat and carefully tasted its source.

The first swallow had the predictable burning effect all the way down to his stomach. His stomach responded in a normal physiological way with a slight spasm of contraction. The vapor pressure of the alcohol forced the volatile fumes back through his nasal passages briefly stealing his breath, and caused Denny a momentary wave of nausea. With a fleeting awareness of these reactions, Denny’s imagination compared the experience at hand with the romantic appeal of advertising for alcoholic beverages, and vodka in particular. His conclusion? More expensive vodka would probably be smoother. His reaction? Denny quickly placed the cup on his desktop and hastened to add the fruit punch. Most ironic of all, despite the negative impact his sensory experience tended to induce, Denny began to experience a calm and comforting feeling.

Denny finished the concoction with ease, and, even before its intoxicating result could take place, he already had a sense of well-being--a kickback perhaps to earlier experience with mild intoxication, and a conditioned and instinctive expectation for what would follow. These things and many other factors now began to bring Denny from his unbridled state of chaos into a circle, however brief, of focus and purposeful-ness. He immediately mixed another drink, and began to attack the next level in the challenging video game.

Compare the first result Denny experienced merely by the act of imbibing the alcohol. Note the contrast between an unpleasant raw sensation and the promise of the more esoteric sensation of comfort and relief--even of excitement--which accompanied Denny’s first interaction with the drink. Try to imagine and compare the empowerment which, despite the implications of his rebellion to ethics and sensible behavior, Denny now began to feel. This is the very aberration in thinking which accompanies the addictive nature--empowerment, escape from chaos and emotional pain, redirection of malevolent energy to a perceived state of purpose and clarity. The distortion of thinking which permits the addictive nature to transcend reasonable responses to emotional pain and negative pressure is very similar to the delusional and obsessive condition of a bipolar individual in a heightened manic state. Thus the addition of an intoxicant or a narcotic or a mood enhancing drug such as cocaine or amphetamine becomes a natural adjunct either to alter or enhance the individual’s mental condition.

My own bipolar and addictive nature turned me on to these chemical substances and eventually taught me that I could apply them also to periods of deep depression with similar mood changing or mood enhancing benefits. For many years, I experienced what seemed to be pleasant and appropriate comfort for my psychic distress as a result of booze and occasionally drugs. Underlying the deception in the practice of my addiction and hidden from view was the tragic progression of my mental illness. This illusion is a clue to the single most dangerous aspect to both mental illness and addiction--denying and ignoring their presence. That’s why in this context it may be said that bipolar disorder and addiction are diseases which tell me that I am okay--a lie which I am more than willing to believe.

Denny is, as I once was, at the beginning of what for me became a long and painful journey--a truly unnecessary journey fraught with torment and decades of wasted emotions and wasted energy.

[Tune in for more in the next blog.]

THROUGHOUT THE AFTERNOON,

Phyllis found it difficult to focus on the housework. In the same way that a familiar tune may dwell in the mind, the vexing "space in the pantry" had consumed Phyllis with thought. Again and again, she attempted to picture the organization of the shelves, until she had driven herself into a mild and annoying state of anxiety.

Phyllis understood obsession, for she had lived with the burden of obsession for years. That burden had actually been responsible for the unlikely switch from a prestigious job in community development planning to her current vocation. The life Phyllis now led would, for most in this upscale area, be considered mundane and perhaps even denigrating. Phyllis saw her occupation and her role merely as one more form of community service on a more personal level.

Phyllis had been just able to meet her needs, often working seven days a week, frequently "on loan" to the friends of Denny’s parents. It had taken her many months at the outset of the changes in her life to restore any feeling of self-respect which she had lost with the loss of her job with the county planning agency. It had taken her even longer to accept that the changes in her life and her status had been the logical destruction resulting from the many poor choices she had made in her later life--choices which had cost her not only her job and her status, but also her family, her home, her friends, and her lifestyle.

It was ironic, after forty years of a well-balanced and productive life, that, through a series of weeks, Phyllis’ world had literally turned upside down. With no identifiable events or illness in her profile, Phyllis had "had a breakdown." that was the term her friends, family, and employer had used to describe her mysterious change--her condition. In truth, Phyllis had experienced an episode of manic-depression. The onset of the mania appeared to everyone, including Phyllis, to be a great burst of energy in her career and social life. In a less obvious sense, she was also beginning to have emotional collisions--events in which she would feel sudden anger or anxiety, sometimes with co-workers, sometimes during romantic moments, often with her children and family. The rage, the anger, anxiety, impatience, frustration--all the emotions associated with heightened mania began to wear Phyllis down emotionally and physically; but she had taken the condition as a "sign" of overwork. Finally, Phyllis scheduled a vacation, a break from her taxing routine.

Phyllis had made a fortuitous choice to take a vacation. Often the manic nature does not see the one alternative from which he/she might draw some redemption--that is, to remove himself from the melee of the manic episode. My friends in recovery often quip, "Remember that one of your choices is always to say ‘no.’ " In my manic states, I could not stop my driven behavior, I could not defy my delusions, and I could not deny my obsessions. Phyllis was lucky, and, I suspect, her choice was based on a well-practiced professional discipline which had in the past always included a vacation--a practiced and perhaps habitual choice. Fortunately for Phyllis and many people who experience mood disorders, her profession and her personal regimen gave her some "bedrock" on which to deal with forthcoming problems.

Upon her return from vacation, Phyllis became deeply despondent over returning to work. Rather than to return, she took several "sick days" and stayed home alone. She sent the kids to her sister’s house. She drew the shades and avoided turning on the lights. When the phone rang, Phyllis did not answer. She felt sapped of energy, so much so that she could not change her clothes, she could not shower, she could not find the motivation to eat. Finally, after many days of total solitude, Phyllis wanted only to sleep.

Phyllis' sister, Christy, became concerned that Phyllis would not answer her calls. Christy visited Phyllis. Finding the entry door to be locked, she searched out the key above Phyllis’ front door, and made her way into the dwelling. The rooms were dark, save for the shaft of light entering from the open door. Christy immediately detected a smell which pervaded the house--a smell of damp dirty laundry and decaying food and body odors and mustiness. The smells evoked memories of a grandmother who had spent her dying days in a terminal care facility. The sensation from that memory was not pleasant for Christy.

Christy turned on some lights, and proceeded to the bedroom where she found Phyllis. Phyllis did not stir at her sister’s presence, but merely blinked her eyes. The eyes had a dull and gray look, and they did not seem to register awareness of Christy’s presence. Christy developed several tears as she sat beside her sister, taking Phyllis' face into her hands. The skin on the face had a dry rubbery patina, as if Phyllis had been through some time machine which had aged her rapidly. Under other circumstances, Christy would hardly have recognized Phyllis, and she suspected that her sis had some drastic disease--cancer, or organ failure.

Phyllis continued to demonstrate passivity and disinterest with Christy’s ministration, and Christy reasoned that Phyllis was in a state of shock. Quickly then she summoned the EMS with a call to 911.

The trauma center and the CCU at the hospital received Phyllis and proceeded to take care of her physical needs, with assurance to Christy that, aside from dehydration, lack of hygiene, and slight nutritional deficiency, Phyllis had no serious physical condition. The news both relieved and puzzled Christy, for, despite physical treatment, Phyllis remained more or less catatonic for several days.

Gradually Phyllis was restored to a level of awareness and vitality such that the psychiatric staff was able to interview her. As a result of the interview, the staff physician was able to diagnose deep depression. Later counseling would disclose the full scope of Phyllis’ condition--an episode of manic-depression.

There is more to Phyllis' experience and background, and I will finish telling you about that in the next blog.

There is saying which I have heard in my recovery: "When the student is ready, the teacher will appear." That has some reference to Denny’s story, in that Phyllis’ is a potential resource present in Denny’s own life and actually in his home! I am using Phyllis’ presence and profile to highlight my belief and my experience--that my environment often presented tools and resources for help--subtle and unseen by me. It almost seems to me now that all I need in life is within reach and I merely have to learn to reach out and receive it. The point is that my principal character, Denny, is in need of help, and my itinerant character, Phyllis, embodies an aspect of that essential help.

PHYLLIS, IN TIME, HAD IN A CLINICAL SENSE RECOVERED

from the episode manifest by her manic depression, although often "recovery" does not mean restoration necessarily to one’s former psychic frame of reference, called the baseline.

I have maintained contact with many individuals such as myself, who have received ongoing treatment for manic depression, and the period/periods of remission which followed for them frequently involves permanent changes in their former personality, motivation, and disposition. In many instances of successful remission, those whose stories I have heard, have often opted to change professions/occupations, social activities, relationships, and also many times to enlist ongoing support from group interactions, networking, and continued therapy. Very few seem to escape the continued use of mood stabilizers, tranquillizers, or one of a number of so-called cocktails of anti-depressant/mood stabilizer/anti-convulsive medications. All whom I have known live with a potential for relapse into periods of mania or depression or both. My long-term prognosis itself seems now to tend to the manic side with so-called mixed mode mood swings and rapid cycling.

Although Phyllis has experienced remission, she still continues to take anxiety medicine. She had during her early manic experiences sought relief for anxiety in the form, in her case of a then-popular tranquillizer.

By following her one episode with therapy and counseling, Phyllis had found a need to change her profession, and she had to endure changes in her family relationships in part due to the stress and uncertainty her condition had induced on her family, and in part because she had experienced an obvious change in her nature.

So the things I have written about give you a snapshot of Phyllis’ profile and experience. I will add that she is emotionally and psychically stable, reasonable, and well-adapted socially to the life changes she has made in the aftermath of her episode. I will add also an emphasis on the fact that Phyllis unlike some many bipolar people I have met, actively and successfully sought to change something in her basic nature--something which careful exploration in therapy had demonstrated needed to change.

I suggest that many of us have been reticent to identify the need to change; and that, to our detriment, our resistance to change, for whatever reason, has kept us state-dependent on our medication and has reduced our chances either to return to our supposed base line or to experience any lasting form of remission.

The point to my giving you a profile of Phyllis is that she has experienced an extreme of the mood disorder or, if you please, disease called manic depression. She is diagnosed with bipolar disorder (manic-depression), and she is in remission. Finally she has dealt with it openly and effectively, and, if it be true that Denny is now experiencing early symptoms of manic-depression, Phyllis is a logical tool for information and understanding--a tool easily within reach of Denny and Denny’s parents. You may argue that I have contrived this scenario (and I HAVE!), but I suggest to you that there are as many as thirty million Americans who have some serious form of mood or emotional disorder, and the probability is high that one of these individuals is an intimate or close element among each person’s circle of friends or family. In other words the phenomenon touches everyone in our population!

At any rate, Phyllis is at hand in this household, but neither she nor Denny, nor in fact anyone in Denny’s life, can as yet see Denny’s mounting dilemma. Furthermore, Phyllis has been discreet with the information in her resume to the extent that Denny’s parents are not aware of Phyllis’ profile in the matter of her bipolar disorder. That is not for Phyllis a matter of shame of secret-keeping, but rather an issue of prudence. The information about her disease is simply not relevant to her work or her working relationship to the household.

I’ve continued to "set the stage" for Denny’s story and I will resume the story in my next blog.

I invite you to visit the following websites or to use a Google search with the search terms: "anxiety diagnosis treatment" or "anxiety medication" or "valium Librium" or "manic depression anxiety."  www.google.com 

http://www.biopsychiatry.com/valium-librium.htm 

http://www.mentalhealth.com/dis/p20-an07.html 

http://www.faqs.org/health/Sick-V3/Obsessive-Compulsive-Disorder.html 

http://www.panic-anxiety.com/anxiety-medication.htm 

http://www.mental-health-matters.com/articles/article.php?artID=696 

http://www.anxieties.com/med.php 

http://www.breggin.com/minortranqs.html 

http://www.mentalhealth.com/book/p43-anx.html 

http://www.pendulum.org/ 

http://www.bpkids.org/site/PageServer?pagename=lrn_100704 

http://www.cincinnatichildrens.org/health/info/mental/diagnose/manic.htm 

http://www.mentalhealth.com/p13.html 

http://www.bpkids.org/site/PageServer?pagename=lrn_100704 

http://www.cincinnatichildrens.org/health/info/mental/diagnose/manic.htm

http://www.mentalhealth.com/p13.html 

OR use www.google.com  and search term "bipolar addiction childhood" to open relevant pages.

CAUTION: Please do not instantly adopt as truth everything you read on these topics. Please look for supporting information from other sources; look for authority and experience underlying opinions; look for research; and, most of all, please begin to talk with and listen to others who have gone through what you are going through. Find out what works for them. Become aware. This is not a time to hide your feelings or to ignore your instincts.

Phyllis had begun to feel her normal noon day fatigue, and she decided to break for lunch.

She returned to the kitchen and poured a cup of coffee. Phyllis settled into a chair at the kitchen table and wrapped her hands around the hot cup as if she were anchoring herself. The morning, normal in every way except for her encounter with Denny and his presence in the house, had imparted to her an instinctive sense that something was wrong. The insidious and troubling part for Phyllis was that she could not put her finger on the source of her discomfort.

Anxious now for the comfort of the still steaming fragrant brew, Phyllis forced the near scalding fluid past her lips and savored the flood of warmth which followed her first sips. As she continued to indulge the coffee, she studied the scene outside the kitchen window with passive attention. The previous day's snow had melted and the sky had continued overcast, bringing a cold dripping day, gray and misty.

The upscale nature of the large kitchen brought a reminiscence of her past, a past when life had given Phyllis more comfort and more assurance of material security. The kitchen had an abstract and cold solidness about it. Perhaps that effect arose from the still pristine condition of the general interior, space which had not really suffered much use--evidence of lives lived mostly beyond the front door, among circles of busy-ness which put the cultural importance of home life into the shadow of some future plan.

The rooms in the households of this suburban community all had names which signified their intended purpose--living room, family room, kitchen.... The rooms, however, had become icons of rather than evidence of the families' presence at home--families nourished by sitcoms, processed food, and superficial pursuits.

At length, Phyllis put aside her musing and finished her coffee. She arose grudgingly from the embrace of the kitchen chair and proceeded upstairs toward Denny's room.

Phyllis paused outside Denny's door. Beyond the door she heard the sounds of the video game which Denny had continued to play since he returned to his room. Again Phyllis was troubled by her gnawing instinct. Earlier in the kitchen, during their brief exchange, Denny had appeared ill and out of sorts. It seemed odd to Phyllis, given Denny's illness, that he was not now resting.

Phyllis knocked on the