I’ve been a high-functioning depressive for most of my life, but I think if you are reading this you already know that. It’s an inextricable part of my public persona. It’s part of the “Alex Character” that appears on Reply All. It is foundational to me, woven not just into my genetics but at an atomic level. Every nanometer of me has the sads. If you know anything about me, besides what my voice sounds like and my love for my kids and my love of synthesizers, you know I’m a sad boy.
I spent the majority of my life unmedicated and unmotivated. Depression mixed with undiagnosed ADHD is a pretty heady cocktail, and it makes it hard to really do anything. I watched doors of opportunity slam in my face for years, feeling I was smart enough but somehow mentally incapable of doing the work. I remember beginning every semester of college with renewed determination to do things like keep a calendar and take notes in class. I still have notebooks from college which usually start with a page or two of notes, followed by weeks worth of topic sentences surrounded by doodles, until the doodles metastasize, crowding out all but a couple huge headlines like “JOURNALISTIC ETHICS” or “SCIENCE FICTION OF THE 1950’s.” (I graduated two years after I left school, when I finished some incompletes.)
A few years after I’d moved to New York City and taken up a career as a network administrator, I would get performance reviews that consistently brought up my habit of drawing during staff meetings, a habit which I was incapable of halting because I simply could not listen without having some way to distract my brain.
Looking back at it, my resistance toward medication was a real head-scratcher; I simply couldn’t let go of the notion that I somehow should be able to fix myself without help. I find it baffling in the rearview, but I imagine it’s the weepy boy equivalent of refusing to ask for directions on a road trip. Some kind of emo toxic masculinity.
It wasn’t until I was in my early 30’s that I actually relented and started taking medication regularly, and even then it was only with significant effort on my wife’s behalf. I don’t even remember at this point what anti-depressant I was on at first, but it was an SSRI, and all of those feel pretty similar. Zoloft or Paxil or something like that. What I do remember is an afternoon in the parking lot outside the train station when I realized I felt lighter. Anti-depressants hadn’t cured me, I was still a hunched over little troll, but up until that point it was like I was walking around with a lead blanket on my back, and drugs gave me the permission to put it down and walk just a little more upright.
This preamble about depression anti-depressants is important, because I feel like I need to say that I believe in the power of pharmaceuticals. They have materially changed my life for the better. They have grounded me, relaxed me, and protected me in my worst moments.
And they also royally fucked up my life? Maybe?
In the spring of 2021, I was diagnosed with ADHD. I have known that I had it for years, but having ADHD makes actually finding time to get a clinical diagnosis really difficult. But in those few months after PJ left Reply All, while the show was shut down, while we were trying to get our bearings, every day kind of felt the same. They were gray, unfocused, with no sense of what the future was going to feel like, or if there even was a future.
ADHD makes unstructured time very difficult. So I started doing the things I always do when I can’t figure out where to focus — I fucked around. I would turn on my keyboards and make zoomy noises. I played hours and hours of Team Fortress 2. I noodled on my guitar. I read music forums. I got really into celebrity gossip. I played through Halo 2 on legendary, which any Halo fan knows is less a fun challenge than it is self-flagellation. And then, when all that finally bored me, I made an appointment to get diagnosed for ADHD.
ADHD diagnoses are basically just a series of questions about how happy you are, how comfortable you are sitting still, and how badly organized you are. And I passed with flying colors. Or maybe I failed. Whatever I did, I got the diagnosis, and they put me on the lowest dose of Adderall, 5mg.
Every couple of weeks, I would check in with my shrink and be like “hey, this is ok, but I think I need to go a bit harder.” and she would bump me up 5mg. The range of doses runs between 5-60mg, so I had a lot of room to grow, and I finally hit the brakes right in the middle, at 30mg.
I would take it every morning and say “is this even working? I don’t know.” But a weird transformation happened without me even realizing at first. Having been unable to finish a song for almost a decade, I banged out an album and a half in about 5 months. Reply All story edits, which at one time made me want to crawl out of my skin, suddenly felt more manageable. It was the same as anti-depressants — I wasn’t cured, but I no longer felt like I was being punched in the organizational lobe if I really needed to focus.
2021 was a hard summer for me, but there was a minute there where I felt productive and proud, like the yoke of distraction had been lifted off for a minute. Making radio, making music, answering emails, even in the moments when I was unhappy (and there were plenty of those) I felt productive. Until November, anyway.
I’m not sure I even know the moment it first started, but what I do know is Thursday, the 21st of October (I know this from reviewing my work calendar), I came in hot. Which isn’t so abnormal. There are days when I show up to work on silly mode, and I’m just kind of hyper. This didn’t feel all that different. I was in a pretty good mood and working on stories I was excited about, what was there to worry about?
And then, at some time in the afternoon, I was in a private video chat with one of my co-workers, and they said “hey, are you ok?”
“Yeah, why?”
“You are very…punchy today.”
“I hadn’t noticed. Maybe too much coffee?”
“Maybe. I think it’s something you should keep an eye on.”
I didn’t give much truck to her concerns that afternoon. I didn’t sleep great that night, but I never sleep great. The next day I went to the gym, had another slap happy day at work, and didn’t get enough sleep. Still, by Goldman standards relatively normal.
Those first two days, I felt like I had some nervous energy, but I was expending it in ways I wanted to. The trainer at the gym remarked on how impressed he was with my reps. I was plunging ahead on Reply All stories, not in a “I’m dragging myself over the finish line” kind of way, but in an excited, interested kinda way.
But when Saturday rolled around, it felt less like I was in control, and more like I was being led around by the nose by this feeling. It was in control, and I was at its whim—it told me I needed to exercise, and then I needed to exercise more. It told me that sleep was a waste of time. I should be reading and making music. It told me that I didn’t have nearly enough music gear (I have a barely used MPC Live II which is a casualty this weekend — if you’re interested in buying it off of me, you can send me an email).
I figured out pretty quickly I was having a manic episode, because like any good child of talk therapy and medication, I had some inkling of the symptoms. But if you, like me at the time, are unfamiliar with two unique bipolar diagnoses, I can give you the shorthand. Bipolar I can produce psychosis, hallucinations, delusions of grandeur. I have an acquaintance who was arrested at Detroit Metro Airport for insisting he was a government official and trying to board a plane. Bipolar II, the one that it appears I had (or have - more on that in a bit), produces the less severe symptons of bipolar I: compulsive exercising, not sleeping, impulsive spending, risky sexual behavior.
but I had neither the time nor the inclination to figure out how to handle it responsibly. Instead, I decided the best course of action was to exercise until I expended all the free roaming energy. Over the course of that weekend, I did runs, I did yoga, I did high knees in the basement while watching horror movies.
It was about five days in that I began to feel my mood slipping. It’s so hard to describe this feeling. The best I can come up with is that it’s like the Boos in Super Mario Brothers; you can feel it following you while your back is turned but when you try to look directy at it, it hides. At least at first.
The last post I made on this substack was actually at the tail end of this episode. That night, standing in the crowd, I could feel myself slipping into darkness and the maudlin nostalgia of that post is a result. I was exhausted by the previous week, but I was also desperate to hold on to that feeling. I doubled and tripled my dose of adderall in the hopes that I could amphetamine myself back into equilibrium. It didn’t work.
This was, by far the worst I have ever felt in my life. By the end of the week, I couldn’t get out of bed. I couldn’t eat, I could barely sleep. My hypomania had used up every ounce of serotonin in my body. walking the 10 feet from my bed to the bathroom felt like crawling across a bed of nails. I knew, but couldn’t fully comprehend, let alone describe, the severity of what was happening to me.
On Saturday, October 30th, I drove myself to the hospital and told them I needed to talk to a doctor. Based on my previous experience with the psych ward (a frigid new england winter in 2002), I knew not to tell them I was suicidal, because then I would be committed without my consent. I just wanted to feel out whether it would be worse to be in there or to be out, on my own, left to my own devices. But when they finally did the intake with me, they sat me in a chair in a tiny c-shaped corridor full of patients in rooms only big enough for a bed, completely visible through plexiglass windows. The corridor and the rooms were stifling, and I knew that I would be much more likely to hurt myself in there than I would at home.
It was during this intake I was given the best explanation of why I would be part of the 5% of people who start showing BD later in life. They said they couldn’t possibly know for sure, but it was likely an adverse reaction to the combination of Adderall and my anti-depressants. It’s rare, but it’s something that happens sometimes and it’s good to keep in mind for the future, they said.
“So if it’s just my medication, it’s not actual bipolar, is it? It’s just some isolated incident?”
“Clinically, bipolar II is simply a manic episode followed by a depressive episode. So clinically, you have it.”
“That’s it? I have it forever now?”
“Well, I mean we should keep an eye on it. But clinically, yes.”
It was at that point, they asked me the question I had anticipated - do you feel like you are going to hurt yourself or anyone else - and I settled on no. Not just because I desperately wanted someone to buzz me out of this dystopian corridor of fishbowls filled with misery, but because as dark as things have gotten for me, I know better than to harm myself because of my kids, my family, my friends. I am a weepy, dramatic sad guy at my heart, but I can selfishly use the joy of my children as fuel to keep me going, an ever replenish clip of ammo against the darkness of whatever is happening inside me.
The kooks in the labcoats decided to take me off of Adderall, and so I went from feeling like I could do anything to feeling unable to finish everything. They then put me on something called Lamictal, a drug used both as an anti-convulsant and a “mood stabilizer,” meaning it is supposed to level me off and prevent mania and depression. From day one I’ve complained that it makes me feel like I am floating just outside of my body watching a stranger make decisions, but every time I’ve tried to titrate off of it, I start crying uncontrollably. In place of adderall, they’ve given me all kinds of drugs - Ritalin, some distant cousin of Ritalin, finally settling onVyvanse, which feels like the Methadone version of Adderall. It does something to be sure, but I feel like I will always be chasing the dragon of those couple months where thinking about something for hours on end didn’t give me headaches, and I could take notes, and I could push through distraction.
I’ve gone through a lot of changes in the past year, some public (ending Reply All), many private (none of your business), but lurking behind all of them is this specter of a bipolar episode. As far as I know, I haven’t had one, but this phantom diagnosis seems always just over my shoulder, casting a pall on everything I feel, both happy and sad. I live in fear of extreme joy, because what if that is mania putting its hand on my shoulder. So too, I live in fear that I will wake up after a fun night where I didn’t get a lot of sleep and feel so sad I can’t leave my bed.
Why am I writing about this now? What exceptional insights do I have into the diagnosis, the state of mental care, my life, my future? I wish I could say I had any. I wish I could say I have figured out how to keep it at bay. But finishing this essay is the first thing I’ve sat up in bed for for the last three days, with the exception of making halloween costumes, attending pre school halloween parades, visiting pumpkin patches. I feel the same vicious depression today that I felt a year ago. I can’t explain the eddies and currents of my mental illness. In spite of the exercise, mindfulness, journaling, CBT, talk therapy, medication, and the dozen or so other methods I’ve attempted to use to bolster my mental health, I am carried along by an unseen force, or at least a force very much out of my control. The current of my mental illness is motivated by the seasons, by other peoples’ approval or disapproval of me, by normal things that unwittingly trigger it in the moment.
It’s embarrassing to feel so out of control. It’s mortifying that I might have passed any of this on to my kids. It’s a desperate and lonely feeling. I don’t know how to wade through it without feeling embarrassed. But if I have one genuine skill that I have no qualms about declaiming, it’s that I’m rarely afraid to embarrass myself in public if other people will get something from it. So I hope you maybe get something from this.
I committed myself to attending a party today, and I feel good about that. It’s a small but important step right now. I hope everyone has a good halloween.
So beautifully written. I’m also Bipolar II and have ADHD and I replaced antidepressants with Adderall two years ago; it’s such a frustrating relationship to have, trying to hold on to what feels like a breakthrough in clarity. Your writing is beautiful and so much more than just your story with medication--thank you for sharing :)
I'm sorry you are going through this, Alex, but thank you for writing this. I'm glad you were able to finish it. <3