To his family - not sent

Hi Papa, Mama, Sam, Billy and Julie,

Can both families please have a chance to talk family to family?

So far conversations about me and our marriage had happened in silo and without my participation. At first in December, my family did not know that Sam and I had huge problems. So when the big change happened, both my family and I took time to understand it.

I can't utter how sorry I am for the hurt and damage I had created for all of us so far, especially for Sam. If I could give anything to undo it, I would give all I have. 

My family and I understood that this was all very tough for you all. It is for us as well. We appreciate the grace you have extended. From Jan till now, we took Sam and Papa's kind advice to take a break, and respected Sam and your family's space to take some time to think. 

So much conversations, thinking and perhaps decision-making had happened in the past few months, yet my family and I haven't had a chance to really speak with you. 

Sam, we have been together since we were 21, 12 years ago. I still have the UM card in my wallet with the picture I took the first day I showed up at UM in my wallet. That was the day we met. 

Please give us a chance to explore what happened as families. Please do not make decisions based on silo conversations and possibly incomplete understandings.

When you guys asked me to see a doctor back in Jan, I didn't think I had a neurological disorder. I thought that all the fights we had were due to couple disagreements or my low self-esteem or I was not happy about life, like you had thought. Out of all our fights and conversations, mood disorder and bipolar had never entered our conversations. Sam and I didn't even know what it was.

Then, I saw the psychiatrist you referred and started learning about myself and my "mood cycles". With the doctor and my family, we've identified the up and down cycles and how they affect me. The doctor confirmed the diagnosis. We learnt about other people with the same condition experience similar ups and downs, and face different life challenges.

Some basic information about bipolar II:

• It's neurological. It is primarily a biological disorder that occurs in a specific area of the brain and is due to the dysfunction of certain neurotransmitters, or chemical messengers, in the brain. These chemicals may involve neurotransmitters like norepinephrine, serotonin and probably many others. As a biological disorder, it may lie dormant and be activated on its own or it may be triggered by external factors such as psychological stress. source
• It's real to the person who experiences it: see Stephen Fry talk about bipolar 
• We cannot use our will to change our mood dysfunction, just as we cannot will ourselves to be full or empty in the stomach
• I had developed chronic depression for at least 2 years before it became cyclical bipolar disorder. The psychiatrist identified and confirmed this pattern.
• You remember Sam that about 4 years ago I started to lie on bed watching Taiwanese tv day and night and didn't want to get up to do anything days on end? I would watch anything I could find so I was spending hours and hours on bed. I was unbearably sad even one program ended and the second hasn't started. So I made sure I could switch as fast as possible. I also started crying inexplicably for little things all the time, remember? I am sorry for giving you all those pains and complaints. Those were not due laziness or low self-esteem, those were signs of depression, stemming from a dysfunction of neurotransimitting activities. At that time, I firmly believed I had valid reasons so be very very sad because my brain was down all the time.
• Bipolar disorder is not a character flaw or sign of personal weakness, as it is commonly misunderstood. We had unfortunately misunderstood it too. source
• Bipolar bearers go into cycles of low times and up times. To me it felt like my brain's CPU is either running in full capacity and cannot move (down state) or it runs so fast it executes functions in mad speed and cannot stop (up state)
• It takes about a year to get back to normal. With meds and therapy, it should not recur.

How Bipolar affects a person and their loved ones:

• I was not able to feel any happiness and joy - this is an effect depression has on people. In any documentation about depression you would see descriptions like "People tell me everything was going fine, that I have a good life." But the bearer of depression would not be able to experience it
• I was not able to feel any sense of accomplishment; I felt like I was failing others' expectations all the time. Every thing I encountered seemed a criticism of me.
• When I finally got out of the up and down moods, I felt compelled to make changes so I don't fall back into the dark holes again. The psychologist said I used "over-planning" to try to control the issues (I am so sorry Sam).
• However, decisions made during extreme mental states often leave mood disorder bearers in bigger life troubles, creating more stress and aggravating the condition, which in turn lead to more reckless decisions. This creates a vicious cycle.
• When I am in a up and good-feeling episode, bipolar people feel anything is possible and become reckless, or we are agitated inexplicably (very sorry)
• During a depressed phase, symptoms include: feelings of sadness or hopelessness, loss of interest in pleasurable or usual activities, difficulty sleeping; early-morning awakening, loss of energy and constant lethargy, sense of guilt or low self-esteem, difficulty concentrating, negative thoughts about the future.
• People with a mood disorder often find it hard to express to people close to them that they are unwell. Others often make the assumptions that the sufferer is weak and overly sensitive, leading to delayed treatment and more stress.
• Since the bipolar sufferers are in extreme moods, the sufferers and their family are often confused and didn't know how to react to these big changes in moods and attitudes.

Some things that are yet to be explained about what happened (not even with character or cultural reasons):

• Why have I started hiding myself suddenly two years ago? Before that I went to all of your cousins weddings (last one was Nathan's). I was there during Christmas unions. We had travelled to Macau, Vancouver, etc. Since two years ago, I started hiding not only from you guys, but from my family and my friends? Everything we did together Sam seemed hopeless to me

• Why over a year ago I suddenly wanted to get a divorce? Then decided not to. Then decided to try working in Hong Kong for a year, and wanted Sam to come with me? 

• Why did I think I could not live in Seattle anymore and had to live on Lamma Island, and wanted to spend the rest of my life on Lamma Island? Why did I get much worse when I finally made it there?

• If I really want to get a divorce, and it's premeditated, why would I know not what to do afterwards? Why do I find myself taking meds everyday, going to therapy every week, trying to stay alert at work everyday, and managing my cycles every day? I ask myself every day.

• Why did I feel compelled to resolve problems between Sam and I day after day, night after night? Then cry uncontrollably?

• If I only wanted a better life and that's all I was after, why would I want to move to Hong Kong? Sam knows that I had to take a big paycut and the company I joined was inhumane

• Why did I cease to have love feelings? Wanted to be alone all the time?

• Why was I so eloquent about my pains, but couldn't even plan for the next day? 

• Why couldn't I feel your pain Sam? Why couldn't I understand what people could clearly see as overly passive and overly aggressive? For these I blame myself every day and night.

• Why were my episodes only shown to you and seemingly not others (it turns out to be not true)? It was not fair.

• What percentage was the disorder? What percentage was cognitive problems?

• Is it true I will never change? Can I get better?

Because the last 2 years were proceeded by over 2 years of chronic depression, the illness actually went beyond the past 2 years and it was 3-4 years in the making.  While all these seem to be different problems, they are all affected by the same issue. I reacted mostly by watching tv before, I really didn't mean for it to affect Sam when I was still relatively calm. When it did affect you so badly, in my negative destructive way, I tried to "fix the problem" all the time. You saw correctly the issue was laying within me - Neither of us would have even guessed that it was neurological. I didn't know I didn't have control over my neuros failings, and I/we didn't know could get help battling it. For over 4 years, the disorder troubled me and I tried a lot of different things but had no way to combat it. We didn't know to ask for help. I am so sorry Sam that you had to suffer with me and because of me. 

You remember all the efforts I put into to feel better before?

- I tried volunteering

- I tried making new friends

- I tried changing my job to a non-profit one - I even got a second in

- I tried traveling to different places with you

- I even tried starting a business

Still the depression continued.

The key is: I don't have to be like that. Sam, you would notice that I had extreme moody episodes a few different times before 2 years ago, but overall I was stable, and now, with med and therapy, I don't get to extreme moods. In fact, I cease to be like this even though my situation now is ions worse than a few months ago. Nobody should be like I was before. It was a malfunctioning in the program, a bug in the brain, but none of us knew or had the terms or understood how to treat it. And Sam had to suffer. Really suffered. I pains me to feel your pains, and if I can give anything I have to undo it, I would. I would give everything. I would bear all the pains you felt before, now and after for you if I could.

But no one should be like that, no one who has an healthy mind should.

Please understand that I am not excusing my behaviors. My behaviors were horrible, and they should not be tolerated. In fact, research showed that tolerating mood disorders, going along with it, ignoring it, and abandoning the patient all made the condition worse. The best way to get better is through family support, medical treatment and clear goal-setting with the patient.

Imagine this had happened to your best friend. He is having these huge mood swings and making fast big plans that would uproot or even destroy his and his family's life. If you knew about mood disorders and their effects on a person life and family, you might be able to help him and his family understand the situations and its effects clearly, so the person suffering from the disorder and their family could get proper help.

The problem was, no one had thought I had become chronically depressed years and needed treatment before. Not I nor you, Sam. If I had a flu and I yelled that I wanted to take off my clothes, eat ice cream and turn on the air-con, without knowledge about what the flu is you might think: she seems to be suffering and she wants to get cool, let her be. Knowing what a flu is and how it works, you wouldn't recommend her doing that. We were in the former situation.

And that was the problem. I had a mild tendency of bipolar, my condition was not supposed to get so bad; it was a flu undetected and unattended, got worse and worse and turned into pneumonia and eventually TB. We as a society doesn't know enough about the effects of mood and mental disorders, and when they hit, we are entirely unprepared and unprotected from them (I am sorry).

Billy, Julie: as esteemed reporters and writers, perhaps you could consider spending some time to do a little research on mood disorders? If you do, and if you ever have a chance in the future, it'd be great if you could consider writing about mood disorders so more people would know. All the people who suffer from all forms of the disorder would really appreciate it. Because without the concepts and the terms, we would be trapped in our own sieged city, and helpless family wouldn't know how to help. My brother and I have read only too many reports of desperate people feeling hopeless in their disorders. While in fact this kind of bug in the mind could be amended, they could be so detrimental to the person suffering and to family (I am very sorry). It's too much to price to pay for ignorance. 

My family and I have talked with other bipolar patients in Hong Kong. One girl had the symtoms to cry unexpectedly and inexplicably when she was down, and spend loads of money when she was up. Now she is facing a debt rebuilding. Did she intend to spend so much money on clothes and shoes? She said she wouldn't do the same thing if she was not affected by her up episodes.

We bearers of mood disorders are not confused in thinking, only we constantly get the wrong warning signals in our brain. It's like a warning siren about earthquake or something, once it's turned on, you cannot turn it off. If you didn't know that it was a bug, you would think you are in distress all the time. Imagine you get the distress signal day after day, month after month. 1st year, you storm it off. 2nd year, you try to ignore it by watching TV. But by the 3rd year, you would try very hard to make it stop or you'd feel it's hopeless, wouldn't you?

In fact, Sam, one of our more close friends had experienced the same in their marriage. One of them was diagnosed with bipolar 6 years ago. They had big fights, harsh times, same as us, but they asked for help. They both went to therapy and came out stronger as a couple. 

The most important thing I wan to tell you: Sam, I do love you. When I felt that clearly after my treatment started I was so happy. That means I did love you and we were in love. That means our wishes before, just the night before the last horrible day, had came true. With my mood storms gone, I could feel love again. I can access the amorous feelings that other people can enjoy easily. And although I am sad I am not angry or feel hopeless. I think about you in the most loving and grateful way day after day.

I want to tell you that all the things you said to me and the support you had given me, the book you sent, the charts you drew for me, they helped after my big mood swings are stabilized. You are my super hero. I am so sorry you tried to tell me that before and it didn't get through. I was trapped. In my depressive and manic days, I've left you very lonely and helpless Sam, I am very sorry.

You remember the first time I tried to throw you out? I was in my worst state. My knuckles were constantly black from hitting myself. Afterwards I was calmed enough to say I was really scared. I said: I didn't want to you go. I didn't want to you go to Cheng Chow. Yet the whole thing felt like an ongoing hell to me, and I to you. That's the real me coming through, only too rarely those days. I didn't have the words and could have the words to ask for help. And when I did at that times and at all the other times, they sounded like half-baked remorse that were not backed by actions. Because soon I went into another up or down state again, and I hurt you all over again. I feel so guilty I don't know what to do. I am sorry for my actions and all my shoutings to you. 

We took the past months to go through treatment, do research, check and recheck until we have a good enough grasp of the situation. It took 4 months. We only send this when we are sure.  We are not sending these letters and writing these learnings lightly. I am not writing this in a up or down state. This is months of careful learnings and thinkings.

With continued medication and therapy (clinical data show from 9 months - over a year), the symptoms of my disorder are not expected to recur. That means my disorder won't affect you, Sam, or anyone else anymore. However, without you or your family's support, I cannot heal. We cannot heal as families. If we had knew that I had depression 3 years back and we understood how it affected us, we could have nipped this problem in the bud and that could have saved you from many troubled nights. Unfortunately, we did not understand mood disorders enough to get treatment. In the past few months, my family and I took all the time and and all effort to help me recover. I wish we could have figured all these out sooner, but it took months and it will take more months, as illnesses often do. Please do not forsake me. I have made many hurts - I am immensely sorry. Of all the years Sam and I spent together, I have never had asked for your help. If I had the words to ask for help and knew what to ask a year ago, I would have. Now I ask all of you for your support as my husband and my family. There are well researched roads to recovery and reconciliation. We don't have to be alone on that road any more. Please help.

We are not sending this email to push for a certain response. On the contrary, we hope you'd take some time to think and talk with us. We have communicated sparingly in the past 4 months (2 phone calls, a short email exchange in April, a longer email we sent recently), and in the most respectful way. 

There's so much that we have yet to communicate. To make the decision with one-sided conversation and assumptions could be prudent. Please consider the 10 years before when you think about the last 2. All of the days we've shared. The future has hope. 

We are all grateful for your kindness so far.

Thanks in advance and much love,

Hoiyin & Family