When the Black Dog’s psychiatrist walked into the room, I became worried that I was going to have to deliver her baby for her. Susan was as pregnant as I have ever seen anyone that wasn’t in a maternity ward. The doctor had lovely straight brown hair left out, slightly freckled skin and that unmistakable pregnant woman glow, along with a cute smile that made me feel very comfortable. If Susan wasn’t so pregnant, I would have felt more comfortable being attracted to her. She was not at all what I was expecting. Since leaving Sally’s office I’d done some reading, and by now I was already confident I was bipolar. It explained so much. But I needed to hear it from Susan and the Black Dog Institute. As it turned out, this was an interview as much as anything else.
Susan: Have you ever had periods of clinical depression for over at least two weeks where you were unable to work?
Ryan: Yes. A number of times.
Susan: When was the last time this happened?
Ryan: Right now.
Susan: What do you experience when you are depressed? What does it feel like?
Ryan: It feels like one of those black Dementor characters from Harry Potter has flown in from Azkaban Prison and sucked out my soul. I don’t want to eat, I can’t sleep, but I can’t get out of bed either. I feel hopeless; I can’t concentrate. It’s like the gears in my mind have ground to a halt and all I want to do is hide away and be a sloth, so that’s generally what I do.
Susan: When you are like this, do you ever have suicidal thoughts?
Ryan: Not that I would act on. I have questioned whether this life thing is worth all the effort. But these days I have a kid who needs me, and I have good memories that give me enough hope to believe things will always get better.
Susan: Do you think you have mood cycles? Do you also feel ups as well as these downs?
Ryan: Yes. Absolutely. Sometimes it’s like my world lights up. I love everyone and I can see beauty in everything around me. I imagine, with extreme clarity, plans for things very big and I put plans in place. I start conversations with strangers. I can’t get enough work; I can’t get enough play. I get ravenous for sex and feel connections with every beautiful woman who passes by. Sometimes I will approach them. Everything is doable and I will try to do everything. The world is sublime and mysterious and laced with colour, and it’s all mine.
Susan: Okay then. Using a scale of 1 to 10, I want you to rate the following statements for their truth – 10 being the highest and 1 the lowest.
Susan: When you feel high do you feel more confident and capable?
Ryan: Yes. 15.
Susan: Do you see things in a new and exciting light?
Ryan: Yes. 10.
Susan: Do you feel very creative with lots of ideas and plans.
Ryan: Yes. Off the chart.
Susan: Do you become over-involved in new plans and projects.
Ryan: Yes. That’s off the chart too.
Susan kept the questions rolling in. Every one of them provided their own answers, so they stood alone as revelations in their own right. I never said no. Not even once.
- Become totally confident everything you do will succeed? 10
- Feel that things are vivid and crystal clear? 11
- Spend or wish to spend significant amounts of money? 9
- Find that your thoughts race? 10
- Notice lots of coincidences occurring? 9
- Note that your senses are heightened your emotions intensified? 10
- Work harder being much more motivated? 10
- Feel one with the world and nature? 11
- Feel carefree, not worried about anything? 11
- Believe that things possess a special meaning? 10
- Say quite outrageous things? 10
- Feel “high as a kite” and elated? 10
- Have much-increased interest in sex, both in thought and action? 11
- Feel very impatient with people? 10
- Laugh more and find lots of things funny? 10
- Read special significance into things? 10
- Talk over people? 10
- Have mystical experiences? 11
- Do fairly outrageous things? 11
- Take unnecessary risks? 11
- Sleep less and not feel tired? 10
- Sing? 9 (not in crowds)
- Feel irritated and angry? 10
Questions complete, Susan then took a different tack. She asked me about any recent occasions where I felt high and what happened. Scanning back, I homed in on a single memory that would shape the rest of the diagnosis session. There were many times over my life which I could have chosen but this one was recent and unforgettable. I thought Susan might be interested in the day I decided to become a performance clown.
This is an excerpt from Ryan Heffernan’s recently released book “The Clown and I”