the dangers of being in the early 20s

Tonight a headline somewhere about James Holmes, the man who carried out the deadly shooting in Aurora Colorado about a year ago made me read more about him.  Nobody seems to know much but it seems pretty clear he was having psychiatric issues before planning and carrying out the murders/attempted murders.  He had apparently sought psychiatric help with 3 professionals prior to the shootings and  just looking at him in pictures you can see something is not right.  Behaviorally he went from being an outstanding student in a difficult field to failing.  Sometime prior to the shooting he texted a friend"Have you ever heard of dysphoric mania?  Stay away from me".

The biggest warning sign is that he is in the age group when the more severe cases of bipolar and of schizophrenia tend to appear.  I was 26 when diagnosed although my onset date is considered 14.  At the time I was diagnosed the dr. was  very  surprised that I didn't have a diagnosis some time before,  but my bipolar is atypical  enough that it wasn't easy to be sure.I too have dysphoric mania (I am  grouchy  and agitated instead of the better known overly happy,energetic,grandiose mania that more people have) and that looks like depression sometimes, especially when  there is rapid cycling so there is true depression as well.  I think the psychiatrist I had in grad school saw everything as depression with some variation in symptoms.

For  me,and for many people, as the early 20s pass, these illnesses become more overpowering.  A comparison of me at 20 and me at 25 or 26 is almost a different person and my memories of grad school are of a decline that I was aware of but didn't understand and which I couldn't articulate.  I remember clearly the spring of 2000.  I was taking a class that met on 2 weekends and completing my thesis proof-reading.   I  was babysitting a  few times per week and doing play therapy weekly with a child I had assessed in a prior class. I remember telling someone that something felt strange, that I felt different than usual and I didn't know why except that I wasn't sleeping well.  I remember the  agitation that I did not understand as well as the sense that something was slipping away.  Three months later I started my clinicals (6 months of full-time work in 2 settings) and while I did very well on my first one I could feel myself losing something during that time.  Just before those clinicals we went to the beach as a family and I saw in sharper contrast how off my mood is.  I have a picture of myself on that trip, taken without my knowledge, and the sadness shows clearly.  My 2nd clinical I didn't do as well in, although partly that was ambiguous expectations and little supervision, but it was also my ability to function changing.  I graduated in December 2000.  There is no way I could have done another year, probably not another semester, as a student. 

As I began working things declined rapidly.  I was 25.  I had the advantage of not having obvious symptoms for a while because nobody at my new job knew me and a lot of things could be forgiven as "stressed new grad in supervisory role".  However I knew that something was very wrong and I was terrified of it.

I was somehow able to hold it together for almost 2 years of working.  It was barely possible at times and I was terrified all the time of what was wrong since it seemed obvious that the belief that I just needed an antidepressant  for a while was wrong.  It wasn't me that held things together though.  I was on the verge of losing it more times than I can count and my memories aren't very clear of that time.

When I read about a situation like this my heart breaks.  What he did was terrible and if he is not severely mentally ill I hope he spends his life in jail.  But if he were not well medicated for some mental illness that he had just come to recognize then I pray that not only does he get the help he needs but that this tragedy helps others know that this diseases often appear in the early 20s and that bizarre behaviors or great changes in personality are warning signs that help may be needed and the person may not be able to seek it.  In may case I would seek it but I wasn't good at judging when it was not helpful until it was too late to easily extricate myself and then find the energy to move on.

It could have been me.  Not likely since i'm terrified of guns, but I could have done something bad before diagnosis.  It's a horrible illness.