• Juan-Fernando Duque-Osorio

For Writing About Bipolarity I was Adopted by a Beautiful Patron in the Suburbs of Bogotá

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Summary: Juan-Andrés is a bipolar who publishes a book that turns out to be a failure, but as a result of which he receives a call from a patient because this book talks about his anecdotes as bipolar. They begin to have counseling sessions because Juan-Andrés already has a very well worked bipolar contition. After a year of consulting, they fall in love and Juan-Andrés is struck by the combination of beauty and opulence of his client, María-Juliana. Can two bipolars form a couple?

Key Words: #BipolarAffectiveDisorder #UchronicAutobiographicalBook #VideoConferenceCounseling #SentimentalInvolvementBetweenCounselorAndClient #BipolarCouples #OpulenceAndBeauty #FamilyAcceptance.

It is mid-2017 and Juan-Andrés Gutiérrez-Duque is very happy because he was finally able to publish a book whose idea had occurred to him almost 10 years ago because as a rehabilitated bipolar, he had many crazy anecdotes to tell. Around 2006, when he was still a student at the Universidad del Valle in Cali-Colombia, he told a professor in the philosophy department who, supposedly, was going to be his doctoral tutor, about his idea to write an autobiographical book. Dr. González told him:

- If you want to tell about your neuroses in a book, invent a character to represent you and do it in a sneaky way.

Juan-Andrés is a social communicator and master in basic medical sciences. He specialized in science dissemination. As bipolar that he is, he was very restless and by 2006 he saw that the only way to coordinate all the fields of knowledge in which he had briefly ventured was through philosophy, since he saw knowledge according to the following pyramid:

And that is why he had contacted Dr. González, head of the philosophical anthropology group of the philosophy department of said University. Dr. González told him that he could do a doctorate (PhD) with him because he wanted his research group to also venture into biological anthropology. But above all it would be a doctorate in philosophy that Juan-Andrés would do in professor Guillermo González's research group.

But in November 2007, just a month after graduating from his master's degree in basic medical science, he lost his father to a metastatic liver cancer. For no apparent reason, because his father was very judicious, he did not smoke nor drink alcohol.

They were very hard years for him. In mid-2010, and as an assistant to a graduate course in philosophy, Juan-Andrés made a presentation on human behavior [1] based on center-right Anglo-Saxon authors such as Edward O. Wilson [2-4] and Richard Dawkins [5] which drives Professor González mad because he, intellectually speaking, is from the French left tradition. Then Juan-Andrés, no matter how skilled he was getting along with people on the left, understood that he would not be able to have professor González as a tutor. In this a day in June 2010 and he knew that, after 20 years, this would be his last conference at the Universidad del Valle.

The relationship with his girlfriend after five years of duration was going badly and returning home after that conference, he decided that it was better to leave everything and move with his mother to Ibagué because in addition to these two things, they were very alone in Cali because their relatives live in his mother's hometown.

The following weekend they were already in that city looking for an apartment. They saw several new apartments, but Juan-Andrés decided on the first one they showed him. It was within their reach and it is also in the most beautiful neighborhood of Ibagué and has many amenities such as gym, Turkish bath, sauna, swimming pool and barbecue, etc. This residential complex is called “Puente Alto del Vergel”. In less than two months they were already living in that apartment.

A few months passed and Juan-Andrés adapted and made good friends through a single childhood acquaintance he had in a old neighborhood, “La Pola” in Ibagué, where his mother's maternal home was located. The psychiatric parameters were improving little by little and by 2015, after overcoming a tenacious obsession with getting married, she was already feeling well. Then he began to write the so-called uchronic autobiographical book in which after a particular point in history (Jonbar point) an imaginary timeline was created. He had learned that anyone can publish a book on Amazon. And according to the idea that professor González had given him in 2006, which included inventing a character and changing the names of key people in the story and so on, in mid-2017 manages to publish this book:

Juan-Andrés believed that his writing career began with that book and began planning n-books to publish on Amazon. Well, this book turned out to be a failure and except for some family and friends, nobody bought it. At that time, he no longer had a doctoral projection and also his supposed writing career had started as a failure. It was obvious that he would not make good money publishing books on Amazon. He was left without a productive life project.

Then he began to wonder what he would do when his mother was gone? In addition to the great emotional and affective shock that this loss would suppose, how was he going to maintain his living standards when her mother was absent, at which point the pension her father left them would end? So, he developed what he called his geronto-financial complex.

In 2018 he received a call from a woman who asked:

- Am I speaking with Álvaro-Andrés Gutiérrez?

And Juan-Andrés replied:

- No, the only person I know with that name is a fictional character that I made up in a book I published a year ago.

- Yes, regarding the book I am calling you. So, the bipolar is Álvaro-Andrés. What a pity that the said book is a fantasy because I am bipolar and this book impressed me a lot and I would like to speak with someone who has suffered such anecdotes, with which I feel partly identified.

- My book is autobiographical and most of the anecdotes are real. You can talk with me. I am also bipolar. What is your name?

- María-Juliana.

- It’s a pleasure.

- I need guidance because I am very confused and I want to talk to someone who has felt things similar to those I have. That is why I liked your book so much.

- And where did you find out about my book.

- On the Facebook page of the Colombian Bipolar Association.

- Oh ok. And how are you feeling today.

- Fine. But at any moment my mood will rise or fall. This instability makes me anxious.

- And are you medicated?

- Yes, but I do not fully adhere to what the doctor prescribed me because I do not like to take drugs and they don’t help stabilize me. I take them there, reluctantly, to please my mom. And you?

- I do take my medications very judiciously and I already found the right formula for me.

- And what drugs do you take.

- Forgive me, but there I am going to make a correction; not because you have offended me but because it can help you a lot. Drug is different from medicine. Drugs are taken recreationally, they cause pleasure, they are addictive and they are harmful. In contrast, properly prescribed psychiatric medications are generally non-addictive, non-pleasurable, and good for your health. Medicated bipolars can be medication-dependent but not drug addicts [6].

- Oh, okay. Well, I'll remember that when I take my pills again.

- It must also be remembered that the difference between medicines and drugs is not in their legality or illegality, since alcohol and nicotine are legal, and that does not mean they are not harmful as drugs that they are.

- Then you neither smoke nor drink.

- I gave up tobacco three years ago because on March 15, 2015 I smoked my last cigarette. And I don't drink. The only drug I take from time to time is caffeine.

- Is coffee harmful?

- Not for most people, but for us bipolars who have such a fragile sleep, it can keep us awake, especially if taken after midday.

- I want to keep talking with you.

- Of course, but now I can't go on because I'm in the pool where I live, it's sunny and my iPhone is already complaining about the temperature. Now that I get to my apartment and have lunch and everything, I will call you to make an appointment.

- Ok.

It was a Tuesday, the next day Juan-Andrés was going to be busy doing errands, the most important of which was to go to his monthly medical appointment so that his EPS (Health Provider Company) could give him his psychiatric drugs for the month. They arranged to meet for Thursday afternoon to talk on Skype. At about 3:00 pm the video-conference began. Juan-Andrés was impressed by the beauty of María Juliana:

She had spectacular Jewish-Arab features. Juan-Andrés couldn’t help flirting with and greeted her:

- Hello pretty, how are you?

- Fine and you?

- Are you of paisa descent?

- Yes, how do you know?

- Because of your beautiful features and because you are bipolar. Do you have a boyfriend?

- No and I'm not interested in getting one. The truth is I would like to continue talking to you about bipolarity and your book but I don't like being flirted. If you want, we can agree to a price per consultation so that we can make this in the most serious way possible. How much would you charge me per session? And let me tell you that money is not a problem for me.

Juan-Andrés was surprised and thought that he would not be able to have her as a friend, much less as something else, but he was going to earn money. They agreed that Maria-Juliana would pay her 180,000 Colombian pesos (about U$50) for each one-hour session that would begin at 3:00 pm on Sundays, which was the day Juan-Andrés had more free time and it was the time of the week in which Maria-Juliana felt more melancholic.

They finished fitting the details. And the following Sunday they met again on Skype. They talked about various things. María-Juliana managed to say that she was 30 years old and that she was divorced. That she had lost her dad at 15 in a car accident. Obviously, she had paternal problems, and maybe because of that and her bipolarity, she had not been able to consolidate a lasting relationship with another man. Among the conclusions of that first session, Juan-Andrés told him that she had to keep a regular schedule every day and above all take her medications at the same time. And that this was called Interpersonal and social rhythm therapy [7-11]. Then, at the end of the session, María-Juliana asked:

- So, to be well regarding my bipolar disorder, should I do the same thing every day? That’s tedious.

Juan-Andrés answered her:

- Of course not. The idea is to have the same time structure, but do different things every day.

- What’s time structure.

- Do the key things of the day at the same time. This includes taking your food, psychiatric medications, and going to sleep at the same time. But the content of each day will be different or else it would be like suffering what happened to Bill Murray in the movie of the “Groundhog Day”.

- That movie caused me despair because of the repetition of the same day. But I liked it a lot.

- So, you are an artist?

- Yes, I am a graduate of plastic arts from Universidad Nacional, but I rarely practice my profession because of my mood and sleep swings. But when with I am in an elated mood, some really cool things occur to me.

- Then by stabilizing the schedule, your mood will be better and you will be able to produce, artistically speaking, in a more consistent way.

- But I'm financially fine. I don't need to work.

- But we humans, like any animal, evolved to fight, so you need to do something challenging. Or else all your days will keep being the same story of laziness and bad vibes, and that would be very boring. Also, art is very therapeutic.

- Yes.

- So, even if you don't need to work, you should do something that allows you to be in a state of flow and, at the same time, serve as occupational therapy.

- I see.

- And speaking of that, I'm going to leave you two books as a bibliotherapy. "Emotional Intelligence" by Daniel Goleman [12] to start managing your emotions and learn what it is to be in a state of flow and “The Nature of Happiness” by Desmond Morris [13, 14] so you can learn that our moments of happiness are related to our biological evolution and that we must set realistic goals to feel proud and happy with what we achieve in our lives.

- Ok

- Then, begin reading and follow the same schedule every day.

- The latter sounds difficult but I will try.

They said goodbye and met on Skype the following Sunday. After greeting each other, Juan-Andrés asks her about her schedule. María-Juliana replies:

- The truth is that I haven’t been very judicious. The first days of the week I tried to take my meds at the same time, but after seeing no results I messed up again. Sometimes I think there is no cure for this.

- In that you are right. Bipolarity has no cure. But it can be organized a lot. I tell you from my experience.

María-Juliana lights a cigarette and Juan-Andrés says to himself - this is going to be much more difficult than I initially thought: - I have to be patient -. He asks her:

- How many cigarettes do you smoke per day?

- Somewhere between 5 and 10.

- I was smoking the same amount before 2015.

- And how did you quit.

- On March 15, 2015 I told myself this is the last cigarette and I never smoked again.

Juan-Andrés was going lecture her for smoking, but he did not want to become a nag and lose her as a client. He continued:

- But since 2008 I started trying to quit smoking and I succeeded seven years later. The faster you let it go the better. The three great milestones that have allowed me to improve my bipolarity have been to stop smoking, standardize a schedule and adopt a relatively stable neuropharmacological formula.

- Relatively? Don't you take the same medications and doses every day?

- Not really. Of four medications that I take, two are immovable and the other two I vary according to how I feel.

- And you vary them without the guidance of a psychiatrist?

- During the last consultation with my psychiatrist in Cali in 2010 he told me that it was time for me to treat myself. He gave me a broad neuropharmacological formula and with it I arrived at the EPS to which I joined here in Ibagué.

So, you can help me with the medicines I should take to get better?

- I wouldn’t go that far because for taking the advice of my psychiatrist, in 2013 I had a tenacious insomnia crisis that got complicated because I started to experiment with new medicines I hadn’t take before, just by reading about them on the internet and buying them in the desire to leave to medications, entirely, the mission of fixing my sleep. So, I don't want to start experimenting on you because I can make things worse. I can help you as a kind of counselor, but for now we're going to respect the medications your psychiatrist prescribed you. Speaking of which, when was the last time you went to your psychiatrist?

- About three years ago when I got really sick because of my divorce.

- I see. And you don't adhere to your pharmacological treatment.

- When I feel really bad.

- Well, we have to see all these things with calm. For now, I want to do three things and forgive me being so repetitive: stop smoking, do the key things during the day, especially taking your medications at the same time and go to see a psychiatrist.

- But I have already done that kind of things before and they have not worked. I thought you could recommend something different.

- María-Juliana, there are no magic and quick formulas for almost no problem in life and in particular to manage a condition such as bipolarity. A year after I quit smoking I began to apply strict sleep hygiene and it was only at the beginning of 2017 that I managed to stabilize myself, which allowed me to finish the book [15] thanks to which we met. It is a slow process. For now, I will settle with you taking your medications at the same time every day. For example, I take my medications every day at 7:00 pm to go to sleep at 10:00 pm. For now, promise to be judicious about your medications and your schedule. That would be a very good initial step.

- ¡Ooookayyy! With such a speech I will have to obey you.

- And how did it go with the books I prescribed for you.

- There I was more judicious. In my moments of stability, I am a good reader. I liked “The Nature of Happiness” [13, 14] by Desmond Morris because is short and I was very impressed by the pleasure that things like intellectuality and art bring.

- How good! I congratulate you. The next thing to do is starting an art project without thinking about money.

And they kept talking about books and so on. It was obvious that the bibliotherapy worked with María-Juliana.

And so, several weeks passed and María-Juliana was gradually applying the advices that Juan-Andrés gave her. She began to see the first benefits of taking her medication at the same time every day, which in turn began to stop being so monotonous because Juan-Andrés taught her to enjoy her artistic projects even if they did not produce money. It is very difficult to earn large quantities of money being and artist, unless you are very good and become very famous. But María-Juliana, in the midst of how confusing her life has been, studied something not lucrative like the plastic arts because she likes it, but later, when she saw that she did not need money, she stopped making works of art. Now she recognized its value as occupational therapy. Progress was already beginning to be seen, but there was still a long way to go.

Juan-Andres convinced her to go to the same psychiatrist that María-Juliana had gone to a few years earlier. Although they had continued to communicate almost every Sunday, that day in mid-December 2018 was special because Christmas was already coming and because the psychiatrist had updated her formula. They greeted each other and Juan-Andrés asked him:

- How did your visit to the psychiatrist go?

And she replied from the other side of the screen:

- Fine. I told him that he was being counseled by a consummate and rehabilitated bipolar. I talked about you and he said that that was very good. But he asked me why I didn't go to a support group of the Colombian bipolar association, of which there are several here in Bogotá.

- That’s a good question.

- I told him that I don’t feel comfortable talking about my psychological intimacies to several strangers and preferred to do it with a person who earned my trust like you.

- You are talking to me affectionately.

- Does that bother you?

- On the contrary, I like it because that means that there is already a more established counselor-client relationship.

- Besides, I woke up happy today. I do not know why but I want to speak to you affectionally because you have helped me a lot.

- And there is still a long way ahead of us. I hope we continue to have such a good relationship. But tell me what the psychiatrist prescribed you.

- Triptych, I think, but I'll see.

- It must be trittico which is one of the commercial names of Trazodone.

- Yes. He prescribed me 50 mg every night.

- That helps your mood and sleep. What else did he arranged you.

- Lamictal 200 mg/day.

- The generic name, that is, the active ingredient, is Lamotrigine. I like it because it is the only anticonvulsant mood stabilizer that works as an antidepressant. Others stabilize the mood downward.

- And he also prescribed me Quetiapine 400 mg/day.

- Quetiapine is an atypical antipsychotic that also will help you sleep. From what little I know, I like that formula. And he did not prescribe a benzodiazepine, like the one I take, which is Clonazepam, that requires a controlled formula. So, although it is advisable to go to the psychiatrist with some frequency to adjust the doses, eventually you will be able to become independent from the doctor because the three medications he prescribed are available over the counter. Also, he didn’t prescribe you so many medicines or in high doses. I believe that you are a cyclothymic with a tendency to depress you as I see in this formula.

- What is to be cyclothymic.

- It is the mildest form of bipolar disorder. I am also cyclothymic, but with a tendency to have an elated mood.

- I see.

- But if we don’t take care of ourselves, we can become manic-depressive or worse still, schizoaffective and then we would be really sick.

- But isn't being cyclothymic to be sick?

- I learned, during my time as a graduate student at the Univalle Health Division, that one gets sick, that is, one becomes clinical, when they have to take one to the clinic. In that way, I have never been sick regarding my bipolar condition.

- Then neither I haven’t. Good to know that.

- However, in my case, indirectly if I got sick concerning my bipolarity because in 2002 my large intestine got perforated. What happens is that in the colon can find metabolites (residues) of excitatory neurotransmitters such as adrenaline, histamine, acetylcholine, etc. To cut the story short, I had so much the ups and downs, and emotional stress because of my bipolarity during adolescence that my colon failed, I got peritonitis and I was left with a definitive ileostomy. I no longer have a colon.

- And then how does that work. How do you defecate.

- When I have more confidence and we meet in person I will explain with an anatomy book in hand [16, 17].

They kept talking, they finished that session very satisfied and with only minor adjustments to her pharmacotherapy María-Juliana continued very well and her progress was evident. Almost six months later, and with the insistence of Juan-Andrés she had finally developed a whole ritual for her sleep hygiene and around it she developed a stable 24/7 schedule. She embarked on increasingly successful artistic projects and began to build a Foundation to treat children with psychological problems and others through art and with the help of other types of professionals. So, her social life had also reached healthy levels. The moments of depression were less and less durable.

One Sunday in June 2019 and after communicating for almost a year, Juan-Andrés told María-Juliana:

- We are going, with my mother and stepfather, to spend the whole summer in New York to visit my sister, whose name is Victoria. I hope that one day you meet her.

- ¿Is she bipolar as well?

- No. I inherited my bipolarity from my mother through the X chromosome. I think my sister also has a mutated X chromosome for bipolarity, because she is very intelligent, but the other one is normal. So, the doesn’t express the condition. We men are XY. We don't have a spare X chromosome.

- So, I have my two X chromosomes mutated?

- Probably, although that is not entirely clear since there are other candidate genes for bipolarity in other chromosomes [18, 19].

- So, if I had had a child, he would have been born bipolar like me.

- Not like you. He would turn out to be more bipolar, because an hereditary condition, and due to a phenomenon called genetic anticipation [20], gets worse from generation to generation.

- Luckily, and I don't know if I already told you, my uterus had to be removed and I can't have children unless I rent a womb.

- You better not have children. I have a world of reasons for not having children that I will calmly explain to you. But resuming the beginning of this conversation, our communication will be difficult during the remainder of June, July and August because, although and logically I will have internet, NY is crazy in summer, there is a lot to do and also so much hot weather and cool activities puts me in hypomania so I will not be a suitable advisor for these months to come.

- And why do you know that you're going get hypomanic in New York this summer.

- Because it's happened to me before. And I know why it is. Bipolarity evolved, phylogenetically speaking, as an over-adaptation to the harsh seasonal regime of the Pleistocene [21, 22] where the most adaptive thing was to be in a high mood during the short summers to do everything like hunt mammoths, neutralize enemies, access members of the opposite sex, etc. And the best thing in the long winters was to be low in activity so as to not waste energy, which at that time was precious, in an environment that only offered ice and snow.

- So that explains the symptoms of both extremes.

- Exactly. That is why I am carrying a lot of anticonvulsants and other depressant medicines so as not to get out of control during this summer in NY, which as “El Gran Combo de Puerto Rico” says is literally a very happy madness:

María-Juliana asked:

- Then we will talk a few times, but they will be very fun.

- Exactly. Don't be surprised by elated mood.

- No, don’t worry. Additionally, you leave me way ahead in managing my bipolar condition. Thank you very much for your counseling sessions.

- But I hope we will continue with them when I return to Colombia and I have calmed down.

- We will see about that because the truth, I already feel very independent.

And they kept talking for a while. Days later Juan-Andrés left for New York with his mother, Azucena, and his stepfather, Clímaco. It was the summer of 2019 and they had already passed 15 years without having gone to NY because the last time they went was in 2004 for Victoria's marriage.

Everything was going very well during those vacations. The hypomania Juan-Andres got during that summer in NY was manageable. They were having a lot of fun. Until in early August he received a WhatsApp call from María-Juliana from Bogotá. She was crying. Juan-Andrés answered her from NY:

- Did something serious happen? Why are you crying?

- Nothing has happened. I just started to get depressed since July, according to what I can see in the private log that you taught me to keep.

- But are you sure everything is fine? How is your mom.

- She’s okay. Everything is fine. This is endogenous, unless …

- What…

- That I need to see you.

- Well, right now I will connect to Skype with my sister's computer.

- No, I want to see you in person.

- I also want to see you in person. But that will not be possible until the end of this month. Could you go to your psychiatrist in the meantime?

- I already did that and it didn't help. It goes beyond bipolarity. It's just that, I don't know how to express myself. I had not called you before because this started in July and was very gradual. At first it started with small feelings of melancholy, especially on Sundays when we did video-consultation. And progressively the melancholy spread to every day of the week.

- And why didn't you call me before.

- Because I feel embarrassed.

- Embarrassed? After all the intimacies that we have spoken about?

- It's that, the thing is, I think I fell in love with you!

And María-Juliana burst into tears. There was a moment of silence and she asked:

- Are you there? What a shame with you.

And Juan-Andrés replied:

- Yes, here I am. And calm down. I like you a lot and I'm attached to you too.

- But you're not in love!

- But that can happen very easily. What happens is that in the middle of a summer hypomania for me it’s difficult to be romantic. But rest assured that you are reciprocated. Now what we have to do, while I return to Colombia, is to stabilize you and get you out of that depression. I will try to with you communicate every day.

- ¡Thank you!

- Meanwhile you can do other things to improve your mood. How are you sleeping.

- I'm fine regarding that. I'm sleeping a lot and very easy.

- Typical bipolar depression. I am in the opposite position. So, look, you need to cut your sleep hours. You fall asleep, like me, at 10:00 pm right?

- Yeah, I practically copied your circadian schedule.

- Then we are going to talk every day until midnight. Speaking with me will comfort, jeje.

- Jeje.

- But seriously, I'm going to help you cut your sleep hours. That's why I need you to also set a scandalous early 6:00 am alarm clock.

- And what does sleep have to do with all this.

- It's called sleep deprivation therapy [23, 24]. It is a shock therapy to alleviate a strong depression quickly.

- Okay. I get it. And can we start talking late today?

María-Juliana asked weeping. Juan-Andrés replied:

- Of course. And what do you want to talk about.

- About the two of us.

And they kept talking. Juan-Andrés tried to be as romantic as his hypomania allowed him, even knowing that it was most likely that María-Juliana, when her depression passed, would stop feeling love for him. They hung up around 12:00 at night and although his profession was not the psychiatrist, Juan-Andrés was aware of the ethical problems that the counselor-client attachment could bring.

They continued talking almost every day of that August 2019 to keep María-Juliana calm. In one of those video conferences, she asked Juan-Andrés:

- So, about the two of us, what we are now?

- Whatever you want. At a biological level, men function as suppliers and you women as clients. And in our case and on a cultural level, again, I am your provider and you are the customer. And even though I'm violating various ethical rules, I can like you however you want. As your counselor, as your friend, or as something else.

- I want us to be more than friends. Let's be girlfriend and boyfriend.

- Huy, so fast? I’m flattered and delighted. But is it because you're depressed that you have romantic feelings for me? Because a romantic relation with a girl as beautiful as you would be taken by me in a very serious manner.

- How good. I really like that. And it's not just romantic feelings that I feel. It also involves sexuality.

- Well that has to do in part with your bipolarity because ...

- Do not interrupt me anymore with your theoretical psycho-speeches. We are going to be girlfriend and boyfriend, yes or no.

- Sure, whatever you say. I like you a lot.

- So, we are a couple now?

- Yes.

Very good. That reassures me a lot.

They kept talking every day, in a mixture of romantic and erotic conversations and with less and less theory about their bipolar conditions. But what did not fit Juan-Andrés was that while she was in a low mood she felt sexual attraction because in addition to only having seen him on a screen; bipolar patients generally have low libido when they are depressed [25].

August passed and Juan-Andrés, along with his mother and stepfather, returned to Ibagué. María-Juliana was already calm, but she continued to express her romanticism towards Juan-Andrés who thought that just a year ago she had made it very clear that she wanted nothing more than his counseling. And now she was romantically attached to him. After so much insistence, in mid-September that 2019, Juan-Andrés finally goes to visit María-Juliana. She, with her driver, picked him up at the Bogotá airport around midday. María-Juliana tells him inside the Audi brand car of her property:

- We finally meet in person.

And Juan-Andrés answers:

- I hope not to disappoint you now that you can see how old I am from a physical point of view because from an emotional point of view I am still a child.

- You look great. In addition, as the humorist Alejandra Azcarate says "nothing like the mature charm of a childish man." Because you still like dinosaurs and franchises like Star Trek as I see on your Pinterest account.

- I see that you’ve been gathering intel about me.

- Yes, and a lot. I don't understand why this sudden obsession.

- We Bipolars, change very fast, we can quickly fall in love, making an exaggerated idealization of the loved one, and more if you are depressed.

- But I'm not depressed anymore and I'm still attached to you.

- And my NY summer hypomania passed and I keep falling in love with you. Then it can be true love. Anyway, we must be ready for either of us to be disillusioned at any moment.

- On my behalf you will no problems.

- Problems we are going to have, like all couples, bipolar or not. The important thing is to solve them with civilized and very respectful discussions.

- I like that.

And they kept talking about all these couple things. They went to the "Gran Estación" commercial center at Calle 26 with 62 in Bogotá. They had lunch at “El Corral” hamburgers and stayed all afternoon shopping in this mall. Around 6:00 pm María-Juliana said:

- Let's go since my mother has us a special dinner and we are poor and we live far away.

Juan-Andrés laughed and asked her:

- Seriously, where do you live.

- I live with my mother in a residential complex called "Altos de Yerbabuena" on the suburbs of Bogotá.

- Yes, an aunt of mine has a friend in that place. There are big and very nice houses, but I have never been there.

- Yes, our house is kind of pretty.

They took the north highway and after passing the "Puente del Común" they began to climb a hill. Juan-Andrés thought - this girl really lives far away -. Around 7:30 pm they arrived. Some employees took his suitcase and a lady told him:

- Welcome Juan-Andrés.

And he relied to Maria-Juliana's mother:

- Thank you very much Rosalía.

Rosalía was a lady in her 70s. They finished greeting each other and went to the dining room. His mother-in-law told Juan-Andrés:

- You have had a great impact on my daughter's life. In a year you manage to repair her, but recently she was depressed because for you.

María-Juliana said:

- Mom please!

And Juan-Andrés said:

- Rosalía is right. I never thought I would influence your daughter so much. That has to do with the fact that I am neither a psychologist nor a psychiatrist or anything like that and that is why I did not know how to keep the distances that the ethics that these professions carry.

- But my daughter told me that you are a graduate of a health school.

- Yes, I am a Master in Basic Medical Sciences, which refers to the scientific part of medicine, but I have no training to treat patients. Also, I liked your daughter since I saw her for the first time on my computer screen and all these things made it difficult for me to set limits.

- Although my daughter is already and adult, because at 30 she must already know what she is doing, I am worried that she will have another failure with a man because she is very sensitive and her divorce four years ago left her very bad.

- There are several things there. First, she is reciprocated on my part regarding the love she feels for me. We have talked extensively during our sessions about her separation and with me she will not have the same problems that she had with her previous partner. First, I do not want children and second, I am not a super executive who keeps absorbed by his work as to not really take good care of her.

- Aha. That "super executive" you are talking about is a family friend who works in our companies holding.

- Oh ok. I apologize. In any case, and not to your magnitude, my financial future is relatively assured and it is a matter of leaving my writings a bit, as I have done in recent months, and I will continue to give the attention and respect that such a pretty girl like María-Juliana deserves. Which her previous partner didn't do.

- I hope so because my daughter wouldn’t bear another failure.

María-Juliana questioned again:

- Mom is enough! I am not a girl and Juan-Andrés, being bipolar also, has understood me very well. This time it will be different. Let's rather talk about other things!

And Rosalía told Juan-Andrés:

- I hope you like beans.

- Of course. This dinner looks delicious.

And they began to eat. María-Juliana and her mother live in a giant house. Juan-Andrés never imagined that the “Altos de Yerbabuena” residential complex would be so luxurious. In fact, he had never been in such a luxurious house in his life, except to see them on television.

Taken from https://www.metrocuadrado.com/casas/venta/chia/altos-de-yerbabuena/

Juan-Andrés is then surprised by the opulence of Rosalía and María-Juliana's house and decides that one day he will marry the latter because that combination of feminine beauty and financial wealth he will never find again in his life. Besides, it seems that Maria-Juliana really loves him.

But there was no sexual action during Juan-Andrés' first week in this house. They talk a lot and he discovers that the problems between María-Juliana and Rosalía go beyond the usual. Rosalía didn't want her daughter to end up without a partner like her but she didn't want to see her get hurt again. And having grown up without a father, María-Juliana's paternal problems begin to become apparent. Then Juan-Andrés begins to inquire about how Don Pablo, his girlfriend father, had died. It turns out that, about 16 years ago, returning from a meeting where some friends north of Bogotá in which Don Pablo had had a couple of whiskeys, he fell asleep for a few moments and they collided with a pole, being shocked in his head. His death was instantaneous. Rosalía was wearing her seat belt and suffered minor injuries. Then, in the middle of Rosalía's story, Maria-Juliana interrupted:

- It was a totally preventable death.

Rosalía, apparently agreed with her daughter and continued talking:

- Yes daughter, at that time the rules were not so strict and it was normal for people to drive and drink a little and even more so to the northern outskirts of Bogotá. Unfortunately, in the residential areas of these country houses the police presence is rather scarce since the security work is carried out by the network of private guards of these residential comple…

Maria-Julian abruptly interrupted her mother:

- You could have driven back from that party.

- But daughter I had also had a couple of drinks.

- But you were not as tired as my father who at the age of 65 was still working hard at our construction company.

- But daughter, how would I know? It was unpleasantly haphazard.

- No mom. It was not fortuitous. And you…

And Maria-Juliana began to cry and locked herself in her room. Rosalía ran after her and knocked on her door, but all she heard were the sobs of María-Juliana asking to be left alone. Juan-Andrés told Rosalía in a low voice to leave her daughter alone and went to converse in the dinner room. Her mother-in-law told her about Juan-Andrés:

- This girl had never reacted like this when remembering the details of her father's death.

He replied:

- She had more urgent and superficial psychological problems that I helped her to solve during our video-conferences of the last year.

- But then she just got worse?

- No. Take it easy. Getting all these things out of her subconscious is painful but very beneficial.

- But why is she so angry with me?

- Obviously, and subconsciously, she was blaming you for her dad's death.

- And then what should I do - Rosalía asked crying.

- Just be understanding with her and the process of recovering from that wound, that was hidden, began tonight. Now, consciously, María-Juliana will realize that it was not your fault that her father to die so prematurely and the relationship between the two of you will be much healthier.

The next day and after a long night's sleep, María-Juliana woke up, greeted Juan-Andrés affectionately and said to Rosalía:

- Mom, forgive me for yelling at you yesterday. I didn't know I had that clog inside me. And it's obvious it wasn't your fault that my dad died prematurely. Today I am much more relieved.

- Oh, thank goodness daughter that you woke up well. I was worried that you would wake up depressed or upset, but everything happened as your boyfriend predicted.

And Juan-Andrés said:

- But I didn’t think you were going to elaborate that false conception about your father’s death so quickly.

And they continued talking about the subject in order to continue the story and conversation which had begun the night before, but this time without drama.

Another week goes by and Juan-Andrés says that he is leaving because his mother needs him as the “executive secretary” that he is to Azucena. But he didn't really want to go. He was having a great time and told his mother to send photos of all the bills to be paid online. Also, Maria-Juliana tells him:

- If you promise to stay, at least one more week, I’ll give you a surprise.

He accepts and that same morning while he is making payments with the help of his tablet and smartphone his girlfriend arrives with a gift. He said:

- Did you buy me a computer? Thank you very much, but that was not necessary. I was doing the urgent things with my iOS toys, but thank you very much. What an exaggeration, but thanks again.

- And I have more gifts for you if you decide to stay longer.

- Please. Take it easy.

Apart from that, she bought him a buildable table and seat. Juan-Andrés was addicted to setting up offices where ever he arrived. His girlfriend hit him on the spot. But it was not the only surprise. That night, when Juan-Andrés was already asleep and after having played around with his new computer a lot, he felt noises in his bed and got up like a spring. A voice told him:

- Relax, it’s me.

- But your mom can ...

And Maria-Julian covered his mouth with a kiss and what had to happen days ago, happened. They made love all night. Neither of them slept for a while. Towards dawn Maria-Juliana told him:

- We are going to wake up exhausted and sleep all day after a night with so much action.

Her boyfriend replied:

- On the contrary. So much action and such late night will make us euphoric at least all day. Our sleep got disordered.

- So, you didn't like spending the night with me.

- On the contrary. I really liked it. Now what follows is to see how we do to sleep together and really rest. Because this super-pleasant rhythm, I can't follow it every day.

Maria-Juliana got up annoyed. And Juan-Andrés told him:

- Please, understand me. I'm happy that we spent the night together. Too happy. And now I feel in hypomania just a month after having overcome the one of my summer in NY. Rather, come back to this bed and I'll explain calmly.

- It’s obvious that you have never been married. Those things are fixed on the fly and over time. But it's okay. I forgive you, but over one condition.

- What.

- That you stay with me at least one more week.

- Okay. I cannot resist such an offer. But come here I'll pamper and explain you.

Then Juan-Andrés told him about his chronic inability to sleep accompanied, that the longer they stayed woke up night, the more their moods would rise. Then the depressant medicines had to be increased and this would complicate the action in bed, etc. In short, he told her:

- We must drink from this bottle of pleasure, which is our life as a couple and that we have just opened, calmly. Also, I want this relationship of us to go on for a long time.

Being the 31st birthday of Maria-Juliana on 02-Oct-2019 Juan-Andrés stays until the first week of October at Rosalía and Maria-Juliana's house. At the end of his stay, Maria-Juliana puts up a fight so she doesn't have to feel her boyfriend's departure so much. And so, he begins to alternate a month in the apartment of his mother, Azucena, and another in the house of Rosalía and Maria-Juliana.

Maria-Juliana's extended family begins to ask who her boyfriend was. Where her family was from and what did they do. They realize that he is an ordinary guy. In a family reunion María-Juliana said:

- He understands me very well, among other things, because he has the same condition and is very cultured and intelligent. He gives me the place that I deserve and I have never felt so good with a man. He has his financial situation defined, even if he is not a multimillionaire and with all that, I am happy. He pulled me out of the depression that I was in. So stop the gossip because I'm too old to choose who I'm going to marry or not..

- You’re getting married? - asked her mother.

María-Juliana had missed to conceal this great little fact that was a state secret. But she continued:

- Yes, we are getting married. Not now, but next year. I don't want to lose the well-being that Juan-Andrés has brought me in addition to the fact that I love him. And I will say no more.

And he left the dinner angry, before finishing it. But this frees her from the gossip of her relatives.

December 2019 arrives. Juan-Andrés doesn't like these Christmas because on those dates it is the time to look good with everyone and he has never had a really happy Christmas. He wonders - Will I spend it with my mother and stepfather or with Maria-Juliana and Rosalía -. But also, the latter will spend it with other relatives of them and he knows that he is not entirely to the liking of his girlfriend's extended family. Then he tells her about his dilemma with the intention that she would set him free, at least this first Christmas of their romantic. Maria-Juliana says very happily:

- Well, come with your mother and stepfather.

In the typical fast, spontaneous, easy and unconscious tone of a bipolar patient. Juan-Andrés answers:

- Won't it be too soon?

- What you don't want is to spend Christmas and New Year’s Eve with me.

- Of course, I want to. I feel ashamed with your mom for being so untimely.

- Do you or don’t you want to spend Christmas with us.

- Yes.

- So, I’ll talk to my mom. Anyway, she wants to meet your immediate family.

- But my sister will also come from NY.

- Then all the four of you will come.

They organized the logistics, permits and others and they went to Rosalía and María-Juliana's house during those 2019 December festivities. They had a super-good time. On December 24, they exchange gifts and more, and María-Juliana likes her mother-in-law very much. Azucena gives María-Juliana a book on self-improvement [26] and talks about others. Maria-Juliana discovers that her mother-in-law knows a lot about self-help and they have long conversations on this topic. In one of those moments she says to her boyfriend:

- I should have talked to your mom from the beginning. She does know how to treat a patient.

And Victoria, the sister of Juan-Andrés, says:

- Yes, the pig that is my brother, is a fraud.

And they continued joking about the subject. The fact is that Maria-Juliana became a super friend of Azucena. In the following months, she even begins to consult her from time to time.

The Christmas holidays passed and Juan-Andrés and his family returned to Ibagué, but with María-Juliana on board. She spent all of January 2020 in Juan-Andrés's apartment. They had a wonderful time, although our protagonist began to miss his days of quietness in which he dedicated himself only to reading and writing. But María-Juliana loves to enjoy Ibagué with her beloved. They take advantage of the sunny days to go down to the pool of "Puente Alto del Vergel", where Juan-Andrés lives, they go shopping in the malls, they accompany Azucena and Clímaco to run errands. She was happy in Ibagué because of the weather, the friendliness of the people and the easy movement in the city. That February was very busy in Ibagué.

This fact, being correspondingly in love and the relative warmth weather of Ibagué make her go into hypomania because she was used to the cold and low field activity in Bogotá, since at home she has a messenger and driver who do all the errands for her.

Then in March María-Juliana returns to her home in Bogotá to “cool down” a bit. The COVID-19 pandemic begins to rise but on the advice of Juan-Andrés she does not watch the news so as not to be distressed by them. She barely realizes that the Colombian government decrees a mandatory preventive confinement at the end of March. Then she asks Juan-Andrés by phone:

- How are we going to meet in April?

- I don’t know. Most people think that the confinement lasts about 15 days, but judging by the situation in countries like Italy and Spain, I think they will lengthen it. Be prepared for the worst.

- Well it will be a long month without seeing each other. What a boredom without you.

And they kept talking.

May came and the confinement continued. Juan-Andrés was calm but his girlfriend's situation was different. She told him:

- Not seeing you is hurting me a lot. I can't go on like this. I have been thinking and this attachment to you is not healthy and even less in this confinement that I think will go on for about two years more.

- Well that's an approximate time for some powerful country to make a safe and effective vaccine. But I was reading an article…

- No more theory. Either we get together completely or we open up.

- But what can I do?...

And María-Juliana hung up the phone. Juan-Andrés, got prepared for the worst and aspired to the best. That ending could be something impulsive typical of María-Juliana's bipolarity or, by her very condition, her love for him had been completely extinguished. It hit him hard, but ever since she came forward in the summer of 2019, he knew something like this could happen at any moment.

May passed and just 10 days after Maria-Juliana’s ultimatum, she called him crying and exclaimed:

- I cannot live without you. I got depressed again. And this damn confinement doesn't end and I don't know what to do …

- Calm down. I understand you. I also miss you a lot. But try not to do things so impulsively because that may hurt me and I may lose my patience with you.

- Yes, excuse me. What are we going to do!

- We have to wait. What else can be done.

- How do you manage to be so calm? It seems that you don’t love me the same as I love you.

- Yes, I love you the same or more than you do. What happens is that I have learned to control myself over the years and I get nothing with getting upset with situations that I cannot control such as your impulsive behavior or the duration of confinement.

- I can't control myself!

- Of course, you can. You have been learned a lot. Are you taking your medications?

- Yes. And I've also followed my schedules. But I have nothing to do. They do everything for me. Sometimes I think this billionaire life is a curse.

- Don’t say that. You must be grateful to life. And calm down I will complicate your life. I'm going to fill you with problems and questions, even if they are just philosophical.

- I want to live with you completely, even if we both get COVID-19.

- That's a bit of an exaggeration.

- Livon together is an exaggeration for you? Is that how little seriously you take me? It can’t be! I am definitely not reciprocated by you!

And she began to cry. Juan-Andrés realized that he had to be very careful when talking to his girlfriend:

- The exaggeration is that both of us had to get COVID-19. If you calm down and if you want, we will start living together as soon as the confinement is over.

- Seriously?

- Yes. But cut the drama please.

And so it was. As of July 2020, they began to live together in Maria-Juliana's house. At the end of 2020 they got married in a private civil ceremony and on the same day they held a virtual meeting by Zoom with family and friends because in times of pandemic a big party couldn’t be made. And this was better for Juan-Andrés who did not want to go through the scrutiny of Bogotá's high society to explain repeatedly, at a luxurious party, that he conquered María-Juliana just for being a simple bipolar blogger.


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6. Duque-Osorio JF. Los bipolares medicados somos farmacodependientes mas no drogadictos y otras divagaciones televisivas y políticas del 2018. 2019. Available in: https://bit.ly/2Y6uup9. Accessed on 11-Ago-2020.

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12. Goleman D, Raga DG. Inteligencia emocional. Kairós, Editorial S.A.; 2018.

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14. Morris D. La naturaleza de la felicidad. Editorial Planeta Mexicana; 2006.

15. Duque-Osorio JF. Las Anécdotas de un Cuarentón Bipolar en Cali-Colombia. Amazon Independent Publishing; 2017. Available in: (Amazon: https://amzn.to/31AkVxR| Google Books: http://bit.ly/31EYOXg).

16. Netter FH. Atlas de anatomía humana. Elsevier Health Sciences; 2019.

17. Netter FH. Atlas of Human Anatomy: Latin Terminology E-Book: English and Latin Edition. Elsevier Health Sciences; 2018.

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19. Barnett JH, Smoller JW. The genetics of bipolar disorder. Neuroscience. 2009; 164(1): 331-343.

20. O'Donovan M, Jones I, Craddock N. Anticipation and repeat expansion in bipolar disorder. In: American Journal of Medical Genetics Part C: Seminars in Medical Genetics: Wiley Online Library; 2003: 10-17.

21. Duque-Osorio JF. Evolución Darwiniana de las Condiciones del Gradiente Afectivo Bipolar. El Blog de JFDO; 2020. Available in: http://bit.ly/2O0IRGh. Accessed on 11-Feb-2020.

22. Duque-Osorio JF. Darwinian Evolution of the Bipolar Affective Gradient Conditions. JFDO's Blog; 2020. Available in: http://bit.ly/2vmiTGR. Accessed on 11-Feb-2020.

23. Berger M, Vollmann J, Hohagen F, Konig A, Lohner H, Voderholzer U, et al. Sleep Deprivation Combined with Consecutive Sleep Phase Advance as a Fast-acting Therapy in Depression: An Open Pilot Trial in Medicated and Unmedicated Patients. The American Journal of Psychiatry. 1997; 154(6): 870-872. Available in: http://ajp.psychiatryonline.org/cgi/content/abstract/154/6/870.

24. Ebert D, Albert R, Hammon G, Strasser B, May A, Merz A. Eye-blink Rates and Depression. Is the Antidepressant Effect of Sleep Deprivation Mediated by the Dopamine System? Neuropsychopharmacology. 1996; 15(4): 332-339.

25. Phillips RL, Jr., Slaughter JR. Depression and sexual desire. American family physician. 2000; 62(4): 782-786.

26. Santandreu R. El arte de no amargarse la vida (edición ampliada y actualizada): Las claves del cambio psicológico y la transformación personal. Penguin Random House Grupo Editorial España; 2018.

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© 2020 by Juan-Fernando Duque-Osorio. MSc. Ibagué-Colombia