Book Review: Electroboy: A Memoir of Mania by Andy Behrman

Electroboy: A Memoir of Mania

Published in 2002, Andy Behrman’s personal memoir, Electroboy: A Memoir of Mania, about living with Bipolar 1 Disorder throughout the 1970’s, 80’s and 90’s, is not an easy read. I’ve been a psychotherapist for 20 years and seen and heard the stories of many people’s intimate lives, and it was still difficult for me to witness the collapse of this creative and talented young man due to undiagnosed and untreated BiP1 disorder. The suffering the unidentified disorder caused him and his family and the people around him is significant and real. BiP1 cost him decades of his life.  I was happy when he reached his eventual proper diagnosis and treatment.

It can take literally years to diagnose bipolar disorder

The reality of BiP1 is that it can take literally decades for a clear diagnostic picture to properly emerge. Plus individuals with BiP1 usually don’t think they need help and won’t look for help. If they do seek help, over years, they may jump from provider to provider, so the current professional doesn’t see the whole diagnostic picture at once. Once there is a diagnosis, getting the right mixture of medications can literally take years. 

Mr. Behrman’s life with BiP1 was like watching an historical timeline about the evolution of the diagnosis and treatment of bipolar 1 disorder (BiP1) over those three decades. It’s starkly evident how little was known about the etiology of BiP1, how confusing the symptoms can be and how few mental health professionals were/are trained to perceive those presenting symptoms of BiP1. 

Bipolar has bio-psycho-social components

Today, we know BiP1 is a chronic disorder with emotional, psychological  and physical symptoms. It has a strong genetic and biological component component and partial symptoms can emerge early in life.  The constellation of symptoms including definitive mania, can be triggered by host of biopsychosocial stressors such as the use of drugs or alcohol, puberty, the transition to college, childbirth and other major life events.  An overall attire of denial and a lack of a healthy and structured lifestyle contributes to mania maintaining its grip on a person. It’s imperative the treatment plan takes a multi-pronged approach.  A treatment plan for BiP1 includes: medication management, strict adherence to healthy lifestyle habits, supportive cognitive behavioral talk therapy and, sometimes, hospital based electro-convulsive therapy (ECT). 

For decades, the disorder hijacked Mr. Behrman’s life, until he was properly diagnosed and began receiving and accepting all of the forms of treatment mentioned above. 

Mr. Behrman’s mental health story begins in childhood, in, I believe, the early 1970’s.  In retrospect, we can see the beginning symptoms of the mental illness that would later come to dominate his life. 

As a young boy, he was considered gifted. In first grade, he was reading at a fifth grade level. He had a quick mind, which was always racing with curiosity,  ideas and questions about the surrounding world.  At the age of 6, he was pulled out of regular classes for special instruction in reading, art and writing. This fed his sense of being special, entitled and grandiose. Even as a young boy, he had excessive anxiety and was enveloped by symptoms of obsessive compulsive disorder. He spent copious amounts of time obsessively cleaning his room until it was spotless, even pulling out drawers in order to clean deep into the tiniest corners.  

The constellation of symptoms for bipolar disorder include feelings of grandiosity, high anxiety, compulsions and risky behaviors fed by high energy.

In the 1970’s, BiP1 was called manic-depressive. In 1980, BiP1 was added to the Diagnostic and Statistical Manual (DMS) as a diagnostic category. In the 1970s’ it was a poorly understood disorder. Mental illness was not an open topic in the popular culture and there wasn’t much peer group discussion of mental illnesses such as BiP1. 

Societal attitudes are more open as more people speak publicly about their struggle with mental illness. Today, Mr. Behrman has a public account on Twitter (https://twitter.com/electroboyusa?lang=en) where is an advocate for mental illness awareness and fights to eliminate stigma and improve access to treatment.

In addition to describing how he felt in early childhood, Mr. Behrman shares with us a bit about his family history of mental illness. Here’s the thing. He is from a happy and close knit, loving family. But, in his family history, there are multiple signs of the genetic strain of bipolar disease. His father was obsessive compulsive about cleanliness and physical fitness. He relentlessly polished, cleaned and ordered the house and laundry in exacting and exhausting detail and exercised obsessively. Although he never met his paternal grandftaher, Mr. Behrman heard about his famous moodiness and bad temper.

Bipolar disorder cannot be fixed by positive thinking or talk therapy

We now know bipolar disorder has a genetic and biological components. It’s important to realize that love cannot save someone from bipolar 1 disorder. It’s a disorder of the brain that is not yet completely understood. BiP1 affects thoughts, feelings and behavior. It cannot be fixed with talk therapy. Expert medication management is needed, plus healthy lifestyle management, and CBT and supportive psychotherapy. The individual needs help in ongoing acceptance and coping with the extensive work of managing the disease. 

As Mr. Behrman approached puberty, he found he was omnisexual, that  “…everything turned him on…”  including his own body, women and men and spent lots of time obsessively masturbating and thinking about sex.  As a teenager, Mr Behrman, developed trichotillomania, a disorder where he pulled his own scalp, eyelash and eyebrow hair out. He describes the feeling of pulling out the hair as being in a “…deep trance, the fitment was intense, like an orgasm…”  In his senior of high school, he had his first visit with one of many psychologists he would see over multiple decades.  He sought help as he was exhausted from his obsessive behaviors, his anxiety, his dissociation from reality and his hyper-sexuality. The psychologist didn’t refer him to a psychiatrist nor did he give him a mental health diagnosis. But he saw him for talk therapy for six months, until Mr. Behrman went off to college. 

Hypersexuality is another one of the constellation of symptoms of BiP. And we now know that talk therapy alone is not enough to manage BiP. 

Medication and conscious, ongoing lifestyle management are part of the treatment for bipolar disorder

As is often the case, the psychosocial stressors of college, with more responsibility and freedom, brought out more of his bipolar symptoms. Predictably, Mr, Behrman found his way to a variety of stimulants and used them all excessively: caffeine, alcohol, drugs (cocaine, marijuana), all night parties, excessive socialization, hyper-sexuality. He began staying up all night. He missed copious amounts of classes and sabotaged his academics. He then experienced bouts of dark depression and the high of mania. During manic episodes, he felt good, he felt invincible.  This hyper energy got him through school. He was miserable enough to seek help from the campus counseling center and he found a therapist who worked with him for those years. But again, there was not an accurate diagnosis for the presenting symptoms of mania and depression and his  bipolar 1 disorder still went untreated.

He went to school in close proximity to New York City, where he discovered the city’s numerous live sex shows. The  city that never sleeps was a perfect place to feed his mania and hyper-sexuality. New York’s 24/7 world became his obsession for years. He began a dual life there in NYC as a sex worker by night, and student by day. Eventually, he lived in NYC and worked in public relations and marketing in the art world by day and kept up a night life fed by mania. In turn, his mania was fed by the night life. 

Throughout over a decade, until 1994, Mr. Behrman saw a variety of psychologists and psychiatrists, who did not diagnose him with manic depression or bipolar 1 disorder. Tragically, he became sicker and sicker, he experienced multiple debilitating and frightening psychotic episodes. His judgment became more and more impaired, his disorder fed by a a lack of effective treatment and a very stimulating and unhealthy lifestyle. 

He hid the worst parts from his family and friends. Eventually, his mania and resulting poor judgment fed by grandiosity, landed him in jail for fraud. Around his time, at rock bottom, was when he started to get the help he needed, as he couldn’t hide the effects of his disease any longer. This was in the 90’s and he found a psychiatrist who diagnosed him with BiP1 and provided an explanation for his extreme lifestyle and mood swings. Treatment with medication began. This was a roller coaster as he and his doctor struggled to find the right combination of medications for him. Eventually, in 1995, his psychiatrist suggested he try electro-convulsive therapy (ECT). 

ECT is also used as a treatment option for bipolar disorder

ECT is by no means an easy therapy and it carries risks. It’s usually a final option for people with psychological disorders who have not responded to other treatment options.  70 – 79 % of people show improvement.  Side effects and risk factors include headache, fatigue, anxiety, confusion, nausea, shakiness, muscle stiffness, jaw pain, and memory loss, which may or may not be long term. 

ECT helped Mr. Behrman. I was glad to see his success. The book was published in 2002. I see him around Twitter and I hope to catch up with him for an interview about how things are going!

For another inspiring story about recovering from and managing bipolar 1 disorder, please take a look at the book review of Dyane Harwood’s life story, Birth of a New Brain. She was diagnosed with bipolar 1 disorder, postpartum onset.

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