Suspended Sentence

by Janice Morgan

  “Hey Arlo, I’m just here talking to my mom now. Yeah, man, I’ll talk to you tomorrow.”

  I encouraged him to take advantage of his support group; he couldn’t do this alone. When he was about to go, I gave him a hug, told him he had a whole circle of support around him, people who cared about him, wanted him to do well. He had to be back before curfew at 10:00, so I drove him home. One last thing: as we were pulling up to his apartment, he told me that he hoped that his actions didn’t make me too upset; he didn’t want to ruin my life with his actions. That was the first time he had said something like that.

  “No, I’m not worried about you,” I told him. “You have to worry about yourself. What you do, Dylan, won’t prevent me from having a good life.”

  “OK, Mom, because if I thought my actions were ruining your life, that guilt on top of my own guilt would just make my situation worse, not better.”

  I told him I understood (another lie), and we said our goodbyes.

  Back home, I sat on my couch in a daze. The picture of events was getting clearer, but my feelings about it weren’t clear at all. On the one hand, Dylan had finally confessed his relapses to me that very evening. I knew Dylan had kept silent about this for well over a week now—at least with me. Was that because he was ashamed and tried to deal with it on his own? Or was it because he was afraid it would prevent my helping him get a vehicle? I felt a slow burn coming on: should I be angrier about the concealment, or be relieved now that he opened up and finally told me the truth?

  My mind went over the timeframe. OK, so Dylan had had his first drinking scene with Jeremy prior to our meeting with Darlene Winchester. She knew about it, and Dylan must have already taken his sanction, a weekend in jail. I knew nothing. Then, as it turned out, hadn’t the second relapse occurred the evening after our brilliant, soulful talk with Darlene just last Friday afternoon? The irony of that prickled under my skin. It couldn’t be, but it almost seemed that Darlene was in collusion with Dylan. Why didn’t they both tell me about the original relapse? Or was Darlene expecting him to do it on his own? Knowing her policies, I figured she wouldn’t intervene in something she felt was his responsibility to make a decision about.

  True enough, I was angry again. Why did Dylan seem to take these wrong turns after speaking so convincingly, and with such insight, about his own psychological situation the day before? Did our meeting together make him over-confident? I felt scorched by the slap to my own naïve mother-trust ways. Sometimes, my son acted like the type who would walk right next to the top of a high cliff, as if tempting fate to take him over the edge. It was maddening as hell! And why was he always drawn to these hard-luck, high-risk guys like Jeremy in the first place? Didn’t he already know that being with Jeremy would bring him trouble?

  Yet another irony: this was the tattoo artist who had done Dylan’s recovery tattoo, the one that read, “To thine own self be true.” Yet I saw why my son felt bonded to him—not just because of the tattoo. It was because he knew Jeremy bore the same invisible mark of Saturn on his forehead, too. The sign of the hard-luck, misfit persona Dylan had taken on as a teen. It rankled me to think that these two guys understood each other to the core in a way I never would. Their psyches clicked into place like two molecules looking to exchange electrons.

  So what about my role here? Had I been too accommodating through all this? Maybe I was wrong about always trying to be the wise, steady Rock. Maybe I should have yelled a few times or kicked over a chair. Well, at least I would ask more questions next time. Moments later, I decided to deliver another message to Dylan. “I hope you will graduate from Drug Court,” I texted sternly. “I think that is even more important than graduating from college.”

  Not long after came his reply: “I agree. I will do it. Good night.”

  CHAPTER 23: HOW FAR IS IT STILL?

  A few days later, in the late afternoon, I fielded another call from Dylan. I knew immediately from the bright tones in his voice that he was doing much better than the last time we’d talked. He told me he’d been to see Dr. Peltay, a minor miracle since the lone town psychiatrist was always booked solid for months. A last minute opening came up so Dylan was able to get in. After the appointment, he requested a lift to the pharmacy to fill his prescription. On our way, Dylan admitted “a little bit of denial” in his previous consultations with the physician, who had now prescribed Lamictal for him. Dylan had good associations with that medication, as he’d had his best quarter at UC taking it.

  OK, so he was admitting he did need a mood stabilizer. This was significant. I remember that he’d said to me repeatedly over the last few months, “I really don’t think I have mood swings.” Well, he would tend not to if he were taking the proper medication. Unfortunately, the good results often became the excuse to go off the medication that brought them. He’d also mentioned at least once that Darlene Winchester didn’t think much about the diagnosis of bipolar. But then most people didn’t know much about it, didn’t want to know. Trouble was, if you happened to be in a smooth period of your bipolar, then you could have an invisible illness that the world didn’t notice. Not only that, but you could go further and convince yourself you didn’t really have the dreaded illness. Sooner or later, that tends to be a big mistake.

  “This last episode, though, really scared me,” Dylan said. “The slump I was in just went on and on. When I get down like that I can’t think straight. Everything seems bad, like it’s never going to change. I can’t seem to get out of it, no matter what I do.”

  I remembered that when he first started going to AA, he rebelled against the idea of “I am helpless and can’t do this by myself,” but now maybe he’s starting to accept that in his darkest moments—not all the time—that is exactly how he feels. “Weak, totally defenseless,” he said.

  According to him, it wasn’t all biochemical, either. There were plenty of real-life causes to be depressed, too. Things could go wrong, like the budding romance with the young woman at AA. “My expectations were unrealistic,” he admitted. “You can’t have unrealistic expectations like that.” Next, his former housemate Connor had gotten kicked out of Drug Court for being dishonest, and of course, Jeremy was right behind him, after his drug test results came back. Dylan himself had gone through first one screw-up with drinking, then another. It was almost like a snowball effect. He knew now there would be sanctions; he just hoped they wouldn’t be too bad. I asked him about how his boss would react. “I think he’ll try to work with me, as long as I’m not gone for too long,” he said. Then, after a pause, he said, “You know, I made these mistakes but I have to remember overall, I’ve done well. I mean, these last couple of weeks, at least I went to work; I kept up with things. I kept it together for the most part.”

  We both remembered times at the University of Cincinnati when he’d go through serious dips like this. He’d close himself off from friends, disappear into his apartment, not even opening the door to go to class—even though up until then he’d been doing well. He didn’t tell anyone about it, either. It was as if he’d turned into another person, a total recluse with no energy. We parents would only hear about it afterward, when he came out of it. Other times, he could go into an anxious, hypomanic state. That was as bad—lots of energy, but all going haywire. He could get irritated over the smallest trifles, too. That could be a dead giveaway. At those times, he’d raise his voice, make big gestures, scare people, all the while barely realizing what effect he was having until someone pointed it out to him, or else scurried away. They say people with bipolar need someone close and trusted enough to be able to cue them when things start to drift toward the edge. Sometimes, they don’t even know it’s happening.

  “Dylan, you really need to stay on your meds, especially the mood stabilizer. If it makes you feel sluggish, ask the doctor to lower your dose—but keep taking it,” I told him.

  “Yeah, you’re probably right. Well, I’m starting Lamictal today.”

  I’ve always tried to understand ho
w it happened that Dylan could have solid plans for his life, then suddenly make decisions that went completely in the opposite direction. How could the same brain, the same mind, be so out of synch with itself? I read David Eagleman’s book Incognito: The Secret Lives of the Brain and learned that decision-making in the mind is not purely cognitive at all, but in fact involves different specialized parts of our complex neuro-circuitry interacting with each other. So the way the mind works actually involves different actors, different forces, each one receiving inputs in his/her own sensory language. With all this input data, each subunit then argues more or less strongly for a particular mode of action to respond to life situations. It sounds downright political, doesn’t it? The neuroscientist likens this phenomenon to President Lincoln’s Cabinet members, often at odds with each other—so much so that historian Doris Kearns Goodwin called them a “team of rivals.” Lincoln preferred this arrangement because, as President, he could listen to the crossfire of different viewpoints, then choose the best course of action after weighing the possibilities, gaining some insight into the likely consequences of one scenario or another. This is essentially what any group leader has to do, whether CEO or President or, as in the case of a human brain, the prefrontal cortex (PFC). Eagleman gives many examples of how different subunits of the brain each present their most compelling arguments, with the executive PFC intervening, comparing, and often negotiating to get the best deal between them all. And, of course, sometimes the PFC has to just say no.

  From what I’ve observed, it seems like this: usually a bipolar brain’s executive function can step in and solve the problem in an acceptable way. However, given that some of the message systems aren’t always working so well, it happens that the PFC isn’t always at the top of its game. And that’s apt to occur at a moment when a sudden overload of wayward impulses and differences of opinion need to be to settled among the team of rivals. What if the PFC gets confused by all the data? Or can’t maintain rational controls over unruly subjects? Then what? Well, it’s not going to be a good day at company headquarters.

  To conceptualize a “team of rivals” scenario that might take place in my son’s bipolar brain, I imagine something along the lines of a New Yorker-style cartoon, one featuring a corporate boardroom meeting. The two factions are seated around a seminar table, where the emotional, limbic system members are seated on one side and the more practical, analytical cerebral cortex planners are on the other. Both memory archivists are there: the Hippocampus, with long poetic locks and his gold-leafed journal, and also the Amygdala, who looks quite a bit shaggier, more like he just got out of bed. As we know, in any boardroom cartoon—no matter how fraught or absurd the meeting may turn out to be—the CEO will remain calm and in control. Not always the case in real life for a PFC. Definitely not for a bipolar brain having to manage the pressure of internal events. And if you’ve got internal noise going on, how will you be able to listen clearly and make good decisions about things happening in the external world?

  When executive function goes awry.

  In my imaginary live-action version, Dylan’s PFC appears today as a harried, nerdy CEO right in the middle of a tense drama. He’s wearing a nice suit, but his glasses are getting foggy from sweat, his tie’s askew. He’s running his hands through ruffled hair, trying to calm down a bully Amygdala who’s up from his chair and yelling loudly. The Amygdala—he’s a muscular jock type of guy—has appointed himself ringleader of the entire limbic system today: “No, this is too much talk. We got too much stress around here. We need some relief. We gotta take action NOW!” This is not surprising, coming from him. Either he’s terrified and wants to head for the hills, or he’s on overload and wants to head for the nearest tavern. Not only that, but he has only a stimulus-response memory, so if he isn’t listening to the Hippocampus and the PFC, he doesn’t know anything about weighing consequences or doing risk analysis. Right now, he’s making so much noise that the strategic planners are shocked into silence.

  Meanwhile, the PFC isn’t feeling so well at the moment. Only this morning, the accountant turned over some bad news—bills to settle and not enough revenue to do it. Both of them feel a migraine headache coming on. Problems, problems, problems. Against his better judgment, the PFC says he has to leave the office and lets the Amygdala—along with the whole limbic system gang—have their way. An ill-advised series of motions gets made. Disaster ensues. The young man visits the nearest casino with an out-of-recovery addict instead of attending his AA meeting.

  Another possible scenario: this one occurs when the PFC is feeling underpowered and somewhat disoriented. Meanwhile, the nucleus accumbens (the brain’s pleasure/reward center) is restless and militating for action. So he pipes up in a heavy Bronx accent: “Hey, I remember feeling really good when we bought some new clothes. Yeah, what we really need now is to go out on a little shopping spree: shoes, clothes, upgrade on the cell phone, new auto parts to jazz up the car a bit.” The limbic system crowd is loving it, especially the Amygdala. Things have been so dull lately. “Yeah, or how about a trip to Vegas to win some cash and round up some girls?” In no time, the whole Pleasure Unit is ready to amp up on overtime. Whoa! It just so happens that now the brain circuits are all on fire, every voice clamoring for action, no matter how ill-advised. Ideas, desires, motivations are racing around like Formula Ones at the Indy 500. The Prefrontal Cortex is buried in noisy commotion; he can’t even get the attention of the rowdy assembly! It’s as if the mind is driving a vehicle with a Ferrari engine but only Ford brakes. Result: the executive function has been pre-empted again. Not surprisingly, disaster ensues once more: accounts overdrawn, DUIs, arguments, fights, somebody in jail, etc. None of the family members around the person with this kind of hijacked brain can figure it out. “What?! I can’t believe it!” they say. “Why did he do that? He seemed so calm yesterday. In fact, we had the best conversation, and he was making solid plans for the future.”

  Well, that’s just it; yesterday, things were different in the Dome of Reason. Nothing was triggering the Amygdala, so he wasn’t running his anxiety loops and pressuring for action. And yesterday, the pleasure/reward center at the nucleus accumbens was doing just fine with the work-out routine at the gym and a nice grilled chicken sandwich. But not today. That’s why the meds are important, as is a therapy like Cognitive Behavioral Therapy (CBT). If impulses are going to be stronger than usual, then the cortical controls have to be jacked up, too. The Ferrari engine needs Ferrari brakes, or there’s going to be a crash.

  I can imagine all this, but I can barely imagine what it must feel like to actually live with these 180-degree re-orientations, especially if they happen unpredictably. No wonder Dr. Kay Jamison prefers the older term “manic-depression” to the bland term “mood disorder.” The earlier term conveys a sense of the psychic centrifuge a person can be subjected to. If I had this illness, would I learn to read the signs of my instrument panel in enough time before my craft started to tailspin? And even if I could, wouldn’t I need training in how to come out of it so I could land safely, the way pilots have to do?

  Just as we were leaving the drive-through of the pharmacy, precious packet of mood stabilizer in Dylan’s hand, the two of us saw an amazing apparition. It was a wide, long behemoth of a car making a turn into the road just a few yards ahead of us. Yes, the topic of vehicles was right there in front of us again. No doubt, this one had once been a sleek beauty in its day, but now, with its debonair, 60s-era fins looking a bit worn, its paint job in need of repair, the low-down, lumbering bulk of it made us both burst out laughing. What a beast! Watching its pale blue mass turn into street traffic was like watching an aging hippo ease into a broad river somewhere in Tanzania, something you might see on the Discovery channel.

  “Hey, Dylan, there’s a car for you. Maybe that one wouldn’t cost so much.” He laughed again at my joke.

  “Yeah, well, if I don’t finish Drug Court, if I go the wrong way, that’s the car I’m going to be driving.”<
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  I smiled but caught the side implication: if I go the right way, I want to drive something way better. By now, most of his native optimism was back. He said he’d had to remind himself that for most of the past year, he’d been staying on track. He had slipped off badly but was back on it now.

  “Well, I hope this incident isn’t going to set me back in terms of getting a car,” he went on. “I don’t even know yet what the sanctions are going to be.”

  “Me either,” I said. “We’ll see.”

  Dylan soon found out about his sanction at Drug Court: go to jail for seven days. He would report for lock-up the next day at noon. “Might as well get it over with now,” he told me. He was glad he’d called Darlene to make the first move to come clean. She’d told him she saw the results of the drug test where his had come back dirty, and she wondered what was going on—especially a second time so close on the first one. They talked for a while. Dylan’s voice sounded tired, ragged around the edges, but he was resigned. He knew what he had to do.

  “With Darlene, we talked about how if I had to make a mistake like this, it’s better that it happen now and not later. If I got all the way through the program and into after-care, and then started drinking again when I wasn’t being drug-tested as often, then I’d really be in trouble. I wouldn’t get the checking, the help to get back on track.”

  “I know,” I told him. “Sometimes when we talked about the future, it sounded like you planned to stay on your path for two years and then after that, you weren’t sure if you would go back to drinking or not.”

  “Oh no, I’m not. This is something I had to go through. My intentions were good, but my actions weren’t, so now I have to take the consequences. It doesn’t look pretty, but hopefully, this will lead to something that looks way better later on. Darlene said that when I come out, I can talk about it with the group.”