The following is an excerpt from Karen’s new book, “Up All Night: One Last Blast of Mania” available on

Chapter 1 – The Descent

For twenty years I had taken lithium. For twenty years I stayed out of the mental hospital.
Then everything fell apart.
I had told my husband that I hoped that he would die. He did not take it well. He told me that he wanted a divorce. After twelve years together, I was on my own.
Feeling suicidal many months later, I decided that I would jump off of the ten-story building I lived in after we separated. It was a low-income housing building in Overland Park, Kansas, filled with elderly people. I qualified to live there because my income now was quite low; Social Security Disability for classic Bipolar 1: Manic Depression. My psychiatrist called it “an emotional disorder”. I was the youngster on my floor, at the age of 42. My elderly neighbors kept dying.
I had my cat, Mikki. Tim and I had watched the visiting vet put our beloved black Lab mix dog, Willy, to sleep in our home. He had been sick his whole life, throwing up a lot, and the low-income housing place wouldn’t take a dog that big. So, I decided to put him to sleep. Tim helped carry the body out to the vet’s car. I felt like I had lost my best friend, like Willy had been a person I depended on even more than God. We had been sick together for years.
Then one day Mikki got sick and I needed to take her to the vet. The vet gave Mikki steroids, which she was not supposed to have. It caused her to get diabetes. I couldn’t handle the idea of giving the poor cat insulin shots, so I decided to put her to sleep. I begged Tim to emerge from his mother’s house and accompany me to another animal hospital. The vet there was inept and had great difficulty in ending Mikki’s life. I couldn’t bear to watch, but Tim finally confirmed that Mikki was dead. I had this awful fear of her being still just a little bit alive…and feeling it when she was incinerated.
So, my marriage, my dog and my cat were dead. Medical tests showed that the lithium had begun to damage my kidneys; the doctors told me I could not take it anymore. They tried everything to replace it: Depakote, Trileptal, Neurontin, and on and on. But I had become so afraid of new pills that I refused to pursue any of them. I believed I was allergic to all of them. And so I got very, very depressed.
When it was time to renew my annual lease at the low-income housing place, I felt like I was moving in slow motion. I put forth the needed documentation. I signed the papers. On the surface, the process looked like it was going fine, but the lady helping me didn’t know that I didn’t care about it. I didn’t care about anything. Now instead of wanting my husband to die, I wanted to die.
I trudged up to my second-floor apartment. I lay on my kitchen floor. Night was falling, and I prayed. I had prayed so much that my hands should have been locked together permanently. I envisioned myself taking the elevator to the tenth floor. I figured that if I jumped off of the terrace on the tenth floor, it would kill me.
“God,” I prayed “please help me.” And the phone rang.
It was my mother, calling from Santa Fe, New Mexico. Interesting timing. I told her that I needed help. I told her that I couldn’t function anymore. My mother loved me, so she told me to get on a plane and come to her house. Get on a plane? Not likely. I was afraid to drive my car a few blocks – how was I supposed to get on a plane?
Fortunately, I had a wonderful neighbor named Melody who was willing to help me. She had lived a couple houses down from Tim’s and my house, and she said it would break her heart if I killed myself. I asked her if she would come and help me pack, and she said yes. Thank God I had someone to help me.

My kidneys kept reminding me that they weren’t working properly. I felt like I lived in the bathroom, all day and all night. And everybody kept saying “Karen, you’ve lost so much weight!” I wore sweatpants, so I didn’t notice it that much. But after losing about thirty-five pounds in just a couple of months, I finally went to a doctor. I found out that the lithium had damaged my thyroid, too. I was told that I had hyperthyroidism. No matter how much food I ate, I lost weight. It was like my mind and my body had decided to rebel against me. Or maybe everything had just blown out because a year and a half after my divorce, I finally came to the realization that my wedding vows had turned to crap.

This is an excerpt from Karen’s new book, Up All Night: One Last Blast of Mania, available on Karen is a survivor of anxiety, panic disorder and bipolar disorder, and the author of Swing Low: One Woman’s Journey Through Manic Depression. She lives and works in Albuquerque. Karen can be contacted at