As she slept, I was left alone, wide awake, antsy as hell after doing everything in slow motion alongside her, and all I wanted to do was go running.
I tiptoed into our room, fished out a pair of running shorts, and silently suited up. Her doctor had repeatedly told me that it wasn’t smart to leave her alone, for fear of what she might try to do to herself, but she was asleep, so I grabbed my headlamp and snuck out the front door.
I walked the 10 blocks to the beach, breathing deeply the whole way to force myself away from my interminable worry. When I made it to the sand, I tossed off my shoes, disappeared into the darkness of the beach, the lights of the city a faint glow over the dunes, and I started running. Five minutes in, I had sweat on my brow and I felt free, and for the rest of the hour, I wasn’t my wife’s caregiver—I was a runner.
My wife, Giulia, was hospitalised with acute psychosis during our third year of marriage, when we were both 27 years old. She had no history of mental illness in her family, and no warning signs that she would succumb to a deep psychosis. It was triggered by a new job: the work stress quickly became overwhelming, and in her anxiety she stopped eating and sleeping. Her mind raced to all realms of impossibility, and she began to rant and rave about religious delusions. With no idea of what might be happening, I took her to the ER, where she was admitted to the psych ward.
I visited her every day during the 90 minutes of visiting hours, and spent the rest of the day stunned in my tangle of grief, fear, and concern. I filed for an extended medical leave from work.
After 23 days, she came home on a heavy dose of antipsychotic medication. The psychosis was under control but not completely gone, and I confronted the lonely and all-consuming life of a caregiver. My whole world was her recovery. We spent all day together, moving along at the slow pace that was a byproduct of the medication she took.
I hadn’t done much of anything else besides be with Giulia, and I needed action. So I began to run barefoot on the beach, late at night and by myself. I hit full stride once I got down to the hard-packed sand of San Francisco’s Ocean Beach. I ran from one end of the beach to the other and back again, music blaring at full level in my earbuds, my headlamp turned off to run in the darkness. I sometimes saw figures blur by in the dark, other night wanderers who came to the beach to empty themselves of feeling. Low tides were the best: the ocean retreated back into itself and left an expanse of glistening wet sand. It was like running on a mirror held up to the universe. I foolishly ran while looking up at a sky reflected below my feet and pleaded to the world, please get us through this mess.
She stayed in a state of suicidal depression for nine months, and I stayed at her side, her watchful and exhausted caregiver. I ran at night most of those months. Eventually, the doctors found the right chemical cocktail for Giulia, and even more suddenly than she slipped into psychosis, she was back to her usual self, and we picked up life where it had been.
Except it clearly wasn’t the same. We were both deeply traumatised by Giulia’s illness, and I needed something bigger to help me through the work of patching up a relationship redefined by an intense mental health crisis.
I decided to go for a long bike ride. Granted, I had never biked more than 50 miles in my life, and didn’t know how to change a flat tire, but I decided to bike down the California coast, from the Oregon border back to our home in San Francisco. A pilot friend dropped me off and I set out by myself, my gear strapped to my bicycle, map in my pack, no agenda except to eventually make it home.
On my bike I realised that the exercise itself wasn’t enough. It had to be outside, surrounded by the majesty of the outdoors. So many months of caregiving had me over-inflating our sense of tragedy, but the thousand-year-old redwoods put our suffering into the greater context in a way that no gym ever could. It felt good to be so small against the landscape of enormity.
After the bike ride, I signed up for my first and only triathlon, a full Ironman, all 140.6 miles of it. My exercise ratched up another notch—not just outdoors, but for ungodly amounts of time. Nature forced me to be humble; endurance allowed me to control my suffering. Giulia’s unexpected plunge into psychosis had upended our lives, and we had suffered in unexpected and uncontrollable ways. Eighty mile bike rides and 3 hour runs put me in charge of how much I hurt. I could stop when I needed to—Giulia’s mental illness did not offer a similar luxury.
Since her first hospitalisation 7 years ago, my wife Giulia has been hospitalised two more times, both for acute psychosis, both followed by a crushing depression. Our son was 5 months old at her second hospitalisation, 2.5 years old at her third. It’s been more than two years since her third psychotic episode, and while we hope there aren’t any more, her diagnosis of bipolar disorder means it’s a possibility.
Through it all, I’ve realised how much I can depend upon exercising in the outdoors. It started with night running on the beach, and has morphed to trail running on Mt Diablo and mountain biking on poached single track trails. They are my greatest therapy, my moving meditation, my chance to feel challenged and humbled and bewildered and optimistic all at once.
Bipolar comes and goes like the tide, and life at home isn’t always hard. But when it is, and the months of caregiving stack up and wear me down, I know that I can go for a good run, and return home with my cheeks flush with adrenaline and a renewed spirit to get back in there and love my family.