Why Was I Healthier in Costa Rica?

The Peculiarities of Bipolar Disorders

Disclaimer: I am not claiming that you will be healthier in Costa Rica. Especially if you do not use sunscreen!

Background:

In September 2005 my blind seventy-two-year-old mother and early-forties little sister bought the Pato Loco, a boutique hotel and Italian restaurant in Playas del Coco, a gritty little tourist town/fishing village on the northwest coast of Costa Rica.

If that sentence was a lot for you to digest, the reality was for me, too. I mean—read it again.

There were members of the family who had their reservations. Others whose attitude was “You go, girls!” We universally agreed that this was exactly the sort of thing these two do.

So my wife Helen and I packed our bags a few months later and headed south for a two-week visit. In September 2006, we bought a little house in a Tico neighborhood, half a mile away.

What can I say? Exactly the sort of thing we two would do.

[In both cases, it might have been a clue about my mother’s mental health and mine.]

Thus began eighteen years of my life of one or two trips a year, four to six weeks at a time, to live in a little bit of paradise.

My mental health was failing when we made this life change, and by 2009 I was on disability, soon to be diagnosed with bipolar disorder NOS. The “NOS” means “Not Otherwise Specified.” My symptoms didn’t clearly align with classic descriptions. Experts in the field later told me I was “on the spectrum.”

So what business did I have traveling away from doctors and sometimes my primary caretaker wife (who still had a day job) to live by myself in Costa Rica? That’s what my disability carrier wanted to know too.

There is a lot to commend Costa Rica: its breathtaking beauty, its laid-back lifestyle, its kind and gentle people. “Pura Vida” is the national motto: Pure Life. People come to Costa Rica, spend one or two weeks of non-stop frantic tourist activity: fishing, zip-lining, birdwatching, walking on the beach, visiting volcanoes, drinking. They head home sunburnt, exhausted, and exhilarated.

These are not the activities that explain why I was healthier in Costa Rica. These are the activities that I rarely engaged in, and at the risk of my health.

So here’s the deal about bipolar. There are three basic dysfunctions in the bipolar brain:

· Dysregulated neurotransmitters and hormones

· Wonky wiring among the networks

· Irregularities within and between cells

You can read more about that in plain English in my first book, Prozac Monologues: A Voice from the Edge—the chapter called, “Balancing Act—The Science Chapter.”

Frederick Goodwin and Kay Jamison wrote Manic-Depressive Illness, the bipolar bible, where you can find a more detailed version of this description in head-spinning vocabulary, down to specific locations on DNA strands. They and others who are actually making progress figuring out this disorder say the bottom line has to do with the brain’s ability to regulate its responses to a whole range of processes to maintain homeostasis, which is to say, to balance.

And there is the key to why I was healthier in Costa Rica—balance.

Day after day, month after month, the sun rises at 6 AM and sets at 6 PM. The temperature determined my daily schedule: up at 5:30 to pray and walk, breakfast at 7, chores until 9, then off to the office (air conditioned) to write, while the heat in the rest of the house rose to 95 degrees. Short walk to the market 11 AM. Lunch, followed by shower and siesta in the other air conditioned room, the bedroom. Back to the office at 2 PM, break at 4 PM, walk to the Pato Loco as it started to cool off, then home again (maybe a detour to see the sunset on the beach). Quiet evening, bed at 9 PM. Rinse and repeat. Every day.

It was the life of a monk. It was a schedule that:

· regulated my dysregulated neurotransmitters and hormones;

· limited my exposure to the stresses where my wonky wiring would be exposed; and

· fed my mitochondria with healthy fresh food.

Most people benefit from medication for bipolar. Many of them absolutely require it. But medication can’t carry the whole weight, if lifestyle keeps throwing a person off balance, life circumstances keep exposing the brain’s inadequacies, and poor diet starves the power plants inside the brain cells.

Alas, in my case we never found a med that was effective at a dose I could tolerate. So the lifestyle measures were and remain crucial for my well-being.

But Costa Rica—no complaints about that prescription!

More coming in the coming months…