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The following is an excerpt from my upcoming memoir, BrainStorm: From Brutality to Blessing on the Bipolar Spectrum.

There are many sub-illnesses and pathologies that accompany Bipolar II disorder.  Here’s a story about one mine:  I experience “excoriation,” a symptom of OCD. This is just one way how Bipolar II disorder affects people who are suffering from it.

In February one of my closest friends, Lisa, comes to Florida to visit with her daughter Susan, who had been best friends with my twins Sam and Maya since they were in utero. Lisa knows I am in crisis. Not long after she arrives, I tell her about my dilemma of the moment: I have a new set of prescriptions from a psychiatrist who practices “integrative psycho-pharmacology.” That is, he prescribes allopathic meds as well as all kinds of herbal, nutritional and homeopathic supplements. But I had to travel fifteen feet from the room where I’d been speaking with him and taken some cryptic notes, to the kitchen, where I kept the numerous supplements he’d recommended. During those fifteen feet, I completely lost focus. By the time I reached the refrigerator to locate the supplements, I’d forgotten what he’d recommended. And I couldn’t follow my own notes on what to do.

Lisa recommends that I make a chart to track times, dates, and dosages of the various meds. This proves to be completely overwhelming. I can’t sequence my thoughts enough to focus on the task. But since my friend has come all this way, and is here to support me, I want to try for her. I struggle to remember what I am doing yet draw a blank. My expression must have reflected this as I witnessed the sad, compassionate wince on the face of this friend who knows me to be, in her word, “brilliant.”

“Wow,” she says, catching her breath. “I didn’t realize it was this bad.”

“It is.”

Stripped bare, vulnerable, in the depths of my dysfunction, I feel embarrassed and relieved. To be seen in the raw, in my inability to process simple information. Maybe having seen the real current version of me, Lisa can help figure out what to do.

That afternoon, Lisa comments on my bloody fingers. When my illness flares up, so does a corollary compulsion: I pick at the cuticles of my fingers until they bleed profusely. And no matter what I do, I can’t stop. I cover them with Band-aids and then pick the Band-aids off. I put gloves on at night and then resume the addiction in the morning. 

My kids see me bleeding and say, “STOP, Mom, your fingers are all bloody!” I am painfully aware of the example of self-mutilation this models for them, and still I can’t stop. My fingers burn with pain. Clothes, sheets and towels get bloody. Strangers look at my hands with conspicuous horror. My husband buys me white silk gloves. They get bloody and I lose one. It’s a horrible, embarrassing, excruciating compulsion but I can’t stop. 

My friend Lisa Googles the behavior and finds this: “Excoriation disorder (also referred to as chronic skin-picking or dermatillomania) is a mental illness related to obsessive-compulsive disorder.” It’s directly linked to chemical imbalances in the brain, the site explains, another example of how Bipolar II disorder affects people who are suffering from it.

“It’s not your fault,” Lisa tells me, and her kind words lift some of the shame. She prints out the results of her internet search. The text recommends a particular form of B vitamin. I try it in large doses. It does not help.

My fingers are outrageously painful, and I’m humiliated by my powerlessness over this compulsion. My fingers get infected. My life is unraveling, my brain isn’t working, I can barely care for myself, let alone the twins. I don’t think it can get any worse than this. I am wrong.
 Graphic as it may be, I hope this gives you a sense of how Bipolar II disorder affects people who are suffering from it. and what those sufferers may be subject to once the downswing of the disease sets in. If you or your loved one has bloody fingers, you are not alone.

*****

It’s 2021, fifteen years later. The twins are strapping college Freshman, surviving and thriving. I have been well — thanks at last to the right diagnosis and medication — for many years. It is a miracle that I’m grateful for every day. Much more to share about this in my upcoming book. I wrote to help heal folks who are suffering from BP II: save lives, reduce suffering, end the stigma.