My Favorite Clausewitz Quote

Originally published in Blog Them Out of the Stone Age on April 27, 2005

In a previous post, I alluded to having a mood disorder called bipolar disorder, once known as manic-depression.

Note the formulation: "I have bipolar disorder," not "I am bipolar." Though I'll need to sketch some background first, the thrust of this post turns on that distinction, and on the utility of combat as metaphor in making the distinction helpful.

Bipolar disorder is, strictly speaking, a malfunction of one's biochemistry whereby the mind is tricked into varying degrees of euphoria or despair with scant regard to the actual circumstances of one's life. I have often been discouraged by health care professionals from regarding it as a true mental illness at all. I tend, however, to regard such admonitions as well-intentioned efforts to spare me from the shame of mental illness. But rather than duck it, I'd rather work to dispense with the shame itself. If a tenured professor cannot summon the modest courage required to do so, then I don't know who could reasonably be asked.

Most of the stigma derives from the "mind/body split," the view that the mind and body are two almost completely different things and that the one does not influence the other: thus you cannot meditate your way out of a physical malady, on the one hand, and a physical malady does not affect the operation of your mind, on the other. While most people nowadays would reject so extreme a formulation, within broad limits the idea remains influential because it reflects our common experience of everyday life.

And because the mind is where we primarily locate our identities, a physical illness or impairment does not so readily shake our sense of who we are. There are always exceptions. An athlete might find her or his sense of self profoundly changed by the loss of a limb, for example. But a mental illness offers a fundamental challenge because it hits us where we are most intimately ourselves. The diagnosis of mental illness therefore confronts the affected individual with a basic choice: Is the illness something external to self, or is it a part of self? Most people, if asked, would promptly reply that the former is the correct formulation, but I have seen many instances in which people with bipolar disorder choose implicitly and sometimes explicitly to imagine the illness as a part of them. And why not? The whole thrust of the "mind/body split" argues that it is.

I have therefore always worked very hard to locate bipolar disorder as something external to myself, notwithstanding the fact that the biochemical fluctuations influence my moods and therefore my subjective experience of life.

As it happens, I can think of at least one other area of human life in which moods are artificially, systematically, and powerfully modified: war.

Indeed, I have found that war offers a very rich metaphor for understanding the illness and mobilizing one's resources to manage it. I consider myself to be in a permanent state of war against an enemy that will never cease in its efforts to kill me, one way or another--which is about as strong an "othering" of the illness as I can imagine.

"In war," wrote the Prussian military theorist Karl von Clausewitz, "the best strategy is always to be very strong, first in general and then at the decisive point." (On War, Book III, chapter 11) This point seems incredibly obvious, but like a lot of obvious points, it is easy to miss.

I have met my full share of people with mood disorders, for example, who were reluctant to take their prescribed medications because they thought they should be able to control the disorder by themselves. This sort of thinking is exactly like a general needlessly going into battle with only half his forces. Stupid, right?



Meet Maj. Gen. Joseph Hooker, a Civil War general who famously did go into battle with half his forces--and got his clock cleaned as a result. Indeed, as Clausewitz observes, "It seems incredible, and yet it has happened a hundred times, that troops have been divided and separated merely through a mysterious feeling of conventional manner, without any clear perception of the reason."

No self-respecting military historian wants to emulate Joe Hooker in any area of his life. Consequently, when a person with bipolar disorder is offered such things as medications, therapy, self-help books, support groups and/or the support of friends and colleagues, the correct response is not which of these resources to select. The correct response is to take as many of them as possible and to be continually on the lookout for even more.

Moments of Decision - Pt 2

Originally published in Blog Them Out of the Stone Age on April 14, 2005

I have Bipolar Disorder : what used to be called "manic depression."

I was diagnosed with the disorder in September 1986, shortly before my twenty-seventh birthday. I have since concluded that the actual onset of the disorder most likely occurred almost a decade before that, in the winter of my seventeenth year.

Friends, colleagues and, indeed, almost anyone who has ever met me face-to-face will be unsurprised by this information, since from the outset I made the decision never to act as if I were embarrassed or ashamed to have the disorder. Close friends also know that I have long been looking for the right moment to "go public" with this information. I myself have known, since the day I began keeping a blog, that one day I would be composing this post. On the whole, I am surprised I wound up waiting as long as I have.

The principal reason for waiting is that while I figured I would go public with the news in this medium--and by go public I mean to share this information with people whom I cannot look in the eye as I do so and gauge their reaction--I wanted the focus of the blog to remain unchanged. My principal concern continues to be to assess the prospects of military history as an academic field. It's simply that I wish now to introduce the "canon of military history" as I have experienced it personally: a very rich set of metaphors by which to manage and survive the inevitable struggles of life. True, I could use other examples, but to do so would feel so much to me as if I were dodging the most obvious example that I would be violating my first rule concerning the disclosure of my having bipolar disorder: when, within a given context, the most direct response involves acknowledging the disorder, always acknowledge it.

Acknowledging it, however, turns out not to be the same thing as accepting it. The rest of this entry was composed in November 1997, a day or two after my return from a weekend staff ride on the Antietam battlefield with officers and cadets from West Point. (If you read Starship Troopers, Civic Virtue, and the American Civil War you will be reading an essay that I dashed off in twenty minutes, gave improvisationally to a group of thirty plebes who cheered me at the end, and then revised into present form all while hypomanic . As you'll see, initially I failed to make the connection between my mood and the manic episode in 1986 which led to my hospitalization and diagnosis. But look at my choice of wording and examples when I finally, reluctantly, did make the connection. You'll begin to get an inkling of the ways in which I routinely use combat as metaphor.

***
Three O'Clock in the Morning Courage

It is said that by the age of forty [I was then thirty-seven], every human being has the face he deserves. What is perhaps also possible is that by the age of forty, most human beings have the life they deserve. I never realized how literally that could be the case until now.

About eight hours ago, I was obliged to do the one thing we humans hate: face facts. There is nothing harder. For ten days now I have been amazed to discover how very intelligent people, namely my colleagues within the academic profession, can so readily run from the facts. It never occurred to me to realize that I have spent eleven years running from the facts. Yet that is what I've done.
There is no doubt in my military mind--the phrase, at the moment, is exact--that I am at present in the throes of hypomania. I wasn't in much doubt even when [my wife] and I went to see Don ______ [a close personal friend who was also a psychotherapist] this afternoon. I am in no doubt whatever now.

There'll be time later, I hope, to write down some of what I've thought during the past several days. For now I want to say only that this evening I had a long talk with my wife, and then by phone with my brother, and then by phone once again with my sister. All three in their ways have given me courage to accept what I must: that bipolar disorder is not something I must accept because, however stale the diagnosis, the DSM-IV [Diagnostic and Statistical Manual of the American Psychological Association, 4th edition] yields no way to undo the diagnosis. Rather, bipolar disorder is something I have in the here and now. I've always had it, at least since 1986. As my father would have said, "Mark, even you can learn something if you're hit over the head with a two by four."

From maybe 6 p.m. this evening onward (we left ______ Psychiatric Services at 5 p.m.), I've been seriously coming to terms with my discussion with Don this afternoon. Don is a little too client-centered to say his full piece if the client isn't ready to hear, but as soon as I asked Don what he'd do in my place, he said without hesitation that he'd make an appointment with a psychiatrist and get on meds [medication]. I agreed to make such an appointment. I have one in the morning at 9 a.m, which is why I can permit myself the luxury of writing these words now. Because I'm writing them at 2:29 a.m. in the morning (by the computer clock). I feel fully rested and refreshed, yet I went to bed just three hours ago, and washed down an over the counter sleep aid before doing so.

When I awoke about twenty-five minutes ago, I was certain it must be near dawn. I was amazed to look at the bedroom clock and note the actual time. I could feel a slight "buzz" around my cranium, somewhat the way it feels when you've been wearing a hat for a long period and then remove it. Your head feels like the hat is still there. So too with me, though I can feel the sensation ebbing now. I'm beginning to feel a bit sleepy again, and as soon as I can jot down two more thoughts I'll head back to bed.

The two thoughts are: First, when my family first moved to Columbus back in 1972, my father read us Flowers for Algernon, by Daniel Keyes. In it the main character is a mildly retarded young man named Charlie. He has an operation that makes him normal--indeed, supernormal, because his intelligence expands prodigiously and eclipses even that of the brilliant man who performed the operation. But Charlie's great intelligence only enables him to see more quickly than anyone else the facts: the success is temporary. His findings indicate that his new intelligence is eroding, that he will become retarded again.

My situation is not exactly like that, but it is similar. (Both [my brother and my sister] picked up on this when I mentioned the book this evening, though [one] relished the analogy while [the other] seemed slightly disquieted by it.) I could have used this manic high to embark on grandiose projects. Instead I used it to investigate the age-old question: Something feels wrong. What is it? The conclusion: Something is wrong. I've been cycling through manic and depressive phases for years, not wildly, as Mom did, but within a mostly functional range. I was surely hypomanic on March 4, 1992, the day I gave the job talk that one graduate student called a "tour de force," and which wowed the Department so greatly that it took the unprecedented step of hiring a tenure-track faculty member directly from its grad student ranks. So far I've managed to get through the cycles through my ability to cope, though at what unnecessary personal cost I cannot imagine. How long can I expect my luck to hold? I'd better get with a psychiatrist and do what the hell he directs.

The second thought will seem unrelated and perhaps inappropriate to the context, though I assure you it is not. The second thought is that, while neither I nor anyone else could ever prove it, I think I now know why General Robert E. Lee halted his army on the Sharpsburg ridge on September 15, 1862, rather than do the "prudent" thing and recross the Potomac River. Instead he turned to face his much larger enemy and fought a pitched battle (the bloodiest single day of the Civil War) with a wide, unfordable river about a mile to his rear. Military historians have wondered ever since why he did it. Most of the explanations (which I won't waste time rehearsing) center on operational or political factors. But is it possible that Lee stood at Sharpsburg because something in his own personal history combined with these impersonal factors to compel the decision he made? If so, I think it was his father.

Light Horse Harry Lee was, in some respects, a more successful man than Robert. He was a hero of the Revolutionary War and a governor of Virginia, among other things. Yet Harry Lee wound up dying far from home and penniless, for reasons that have to do ultimately with a refusal to face facts or to stand and face the consequences of his life. He fled the country rather than go to debtors' prison for debts he'd contracted in a series of risky land speculation ventures. In September 1962, Robert took a risk by crossing the Potomac and embarking on a raid into Maryland while his army was reduced in numbers and ill-equipped. After the defeat at South Mountain he should have departed from Maryland as soon as he could. But perhaps something in him resisted the idea of running from the consequences of the risk he had taken. Perhaps he realized that if he did so his future generalship would be compromised. (Generals are human beings first of all; the same psychological dynamics that affect the rest of us affect them.) Perhaps in a much different way than I am doing, Robert E. Lee was also facing facts when he made his stand on the high ground west of Antietam Creek.

Part 1 - Part 2

Moments of Decision - Pt 1

Originally published in Blog Them Out of the Stone Age on April 13, 2005






Bullfight critics row on row
Crowd the enormous plaza de toros
But only one is there who knows
And he is the one fights the bull.

-- Translation by Robert Graves of a poem by Spanish matador Domingo Ortega

(Photographs by Lester Silva)

Part 1 - Part 2

What This Blog Is About

I have bipolar disorder -- specifically Bipolar I. It was diagnosed shortly before I turned 27. However, the most likely time of onset was the winter of my 17th year. I've always made a point of being up front about having the disorder. For instance, I'm a college professor, and when appropriate I've disclosed it to my students. I've talked about the disorder with undergraduates in a psychology course and have written about it from time to time, most notably in a column in Inside Higher Ed entitled "An Inappropriate Illness," which appeared in September 2006. I've also discussed it on my principal blog, Blog Them Out of the Stone Age (here abbreviated BTOOTSA), which is devoted to academic military history and national security affairs but which occasionally addresses bipolar disorder (as well as battle stress injury), under the category "Facing the Demon." Which of course inspired the title of this blog. For the sake of convenience I'll republish the relevant posts here. If nothing else, that will save me a lot of repetition.

Over time I've discovered that it helps others as well as myself to be candid about having bipolar disorder. If in a large lecture course I have over two hundred students, then statistically two of them have been or will be diagnosed with the illness. Indeed, in the past whenever I've disclosed that I have the disorder invariably one or two students approached me afterward to talk about it, because they too had the illness. Usually they felt rather isolated. They found it difficult to discuss the illness with others or they had trouble feeling understood. They also wondered about its implications for their future. Would they be able to lead a normal life? And usually they had questions about how best to manage the illness. The same thing has happened with adults as well.

A few days ago I posted the following on BTOOTSA:

If you scroll down far enough on the sidebar of this blog, you'll find a section labeled "Twitter Updates," thanks to a widget I installed a few days ago. The question is, how does this relate to military history?

As long time readers of the blog are aware, I have bipolar disorder. The subject is covered in the category "Facing the Demon," along with battle stress injury -- not because I think the two are identical: one is an illness, the other an injury -- but because both require management and both carry a perceived stigma that requires a degree of courage to address. In my own case, I was diagnosed with bipolar disorder when I was twenty-six and have probably had it since the winter of my seventeenth year. It took a long time to come to grips with it. Until I was thirty-seven I didn't fully accept the reality of the disorder -- that it was something I had and would always have and that it needed to be managed precisely as one would manage any other chronic illness, such a diabetes, which in some respects it resembles. Both are abnormalities in one's biochemistry.

In the years since, I've gradually become conscious of the fact that in dealing with the illness I instinctively draw upon a number of concepts derived from a lifetime steeped in military history, strategic studies, and my own modest military experience. The most basic insight derives from Clausewitz: "In war, the best strategy is always to be very strong." This translates metaphorically into identifying as using as many tools to combat the illness as I can. Many of them are predicated on a crucial decision I made as soon as I received the diagnosis; namely that I would acknowledge it openly. As I've written elsewhere:

People often think that because I’m so up front about having bipolar disorder, that being candid about the illness must be an easy thing for me to do. In fact, it scares me. I’m up front about it only because I’m convinced that candor is better than the alternative. Being open with my colleagues, for example, populates the department with observers who have a decent chance of identifying unusual behavior as an artifact of the illness rather than erroneously attributing it to something else: simple high spirits instead of hypomania, for example. It enables me to ask for help when necessary without having to explain the illness from scratch. And it gives me a chance to combat, in a small way, the stigma that still attaches to mental illness. If a professor protected by tenure cannot summon the modest courage required for such an act, I do not know who can.

So where does Twitter come in?

I've decided to use this social utility as a way to discuss the illness, not abstractly, but as it affects my day to day life. (The updates, by the way, appear not just on the blog but are immediately cross-posted as a status update on Facebook.) Since I find the prospect of doing so a bit daunting -- it is one thing to state publicly that I have the disorder, quite another to state on a given day that I'm depressed -- I've begun with something reasonably safe: namely to keep public track of my workouts at the gym (and other forms of exercise). This has more to do with bipolar disorder than one might suppose. Coping with bipolar disorder involves more than taking medication. There are things one can actively do to manage the illness, among them getting enough sleep and getting enough exercise, which releases beneficial endorphins.

So announcing each trip to the gym is not based on vanity or the assumption that people are fascinated with the mundane details of my life. It's the early stage of what I expect will be a larger experiment in publicly sharing the experience of managing bipolar disorder, partly as a means to expand my network of support, but primarily to model in practical terms how one goes about it, and to treat the illness as one would any other: not something of which to be embarrassed or ashamed but a simple fact of existence.

It would distract from the main purpose of BTOOTSA to constantly inject posts about bipolar disorder, but without supplying context the near-daily announcement that I'm going to, or have returned from, the gym would seem banal. Consequently I've created this blog in order to supply the context.

Mood Watch - 47

Still OK. The only thing I’ve noticed is that between last Friday and Monday, I felt rather sluggish and tired. I wasn’t in poor spirits and I was getting plenty of sleep, but somehow I never felt rested. Just prior to that, however, I was just the opposite: more energized and focused, and although sleeping sufficiently, was wide awake as soon as I got out of bed.

In both instances, the differences were such mild departures from “normal” that, were it not for the knowledge I have bipolar disorder, I doubt I would have noticed them at all. Still, when managing this illness, it never hurts to keep on your toes. In fact, it’s foolish to do anything else.

Mood Watch - 46

My mood continues to be good these days. Only caveat (and there always seems to be one) is that for the past couple of nights I have slept less than usual — maybe 3.5 hours/night. I was able to break that emerging pattern, though, by increasing my sleep medication to the maximum allowed by the prescription, and by working extra hard to maintain what is artfully known as “good sleep hygiene.”

As is so often the case, in recent weeks I’ve been in touch with three people, two of them undergraduates here at OSU, who sought me out because they have bipolar disorder and have felt they have know one in their lives who understands the disorder, or, at least, understands it from the inside. Talking with such people always makes me feel as if I’m doing something worthwhile, and I’m proud to have the chance.

Mood Watch - 45

I had a change of meds almost three months ago and by and large, it’s improved things greatly. My one caveat is that in early February I had a couple of anxiety attacks that initially presented as something like the flu, because the main thing I noticed was a lot of nausea — in fact at one point I actually vomited.

Once I caught on to what was really going on, however, I took 2 mg of clonazepam (the generic equivalent of klonopin), followed by 1 mg each day for the next couple of days. I was amazed by how promptly and completely that took care of things. Which just goes to underscore the fact that, despite the stigma that clings to it, this is a biochemical illness.