All of us can fly in our dreams. We are weightless beings of light, exhilarated, free of the limits of reality and, if the mythology of childhood is to be believed, we will surely die if we do not wake before falling.

Of course, no one ever did die from falling in a dream. Falling is just where the nightmare takes over. For many people with bipolar disorder this is an apt parable of their waking life.

“As high up as you can go in high mania, you will come down twice as far and you will crash deep down,” said Margaret Trudeau, public advocate for mental health issues and a bipolar disorder patient herself.

“It’s very important to understand that with bipolar — or manic depression as it used to be called — the depression is 80 per cent. You spend much more time in the depressed cycle.”

Dr. Brian Snider, psychiatrist with the Canadian Mental Health Association confirms the fact, adding that manic episodes tend to be more noticeable because they are on the extroverted extreme of the cycle. When depressed, most people become introverted and withdrawn, losing interest in many things they otherwise enjoy and often preferring to be alone.

“Loneliness is a key indicator of depression,” he said. “Patients feel very isolated, worthless and those feelings perpetuate the cycle downward so the person feels even more worthless and withdraws even further.”

“I would imagine life at 24 Sussex would have been very lonely; a very busy and important husband, diplomatic expectation and the restraints of public life ... it would be hard to manage depression under these circumstances.

“I think Margaret Trudeau is a great spokesperson for mental health.”

In speaking about her own experience with bipolar disorder Ms Trudeau is hoping to create a culture of understanding about mood disorders and mental health issues.

“Stigma around mental health issues comes from ignorance: it comes from a lack of understanding: it comes from fear,” she said. “I want to help demystify it and let people know mental illness is very treatable. No one thinks twice about seeing a doctor if their body is hurting but it is very hard to find the courage to seek help for their mental pain. People need to know they don’t have to live in the grey-zone.”

Originally diagnosed with postpartum depression in the ‘70s, Ms Trudeau began what would become a long-running battle with mental illness, her symptoms — not
recognized for what they were — became headlines for the next three decades.

“At the time, not a great deal was understood (about depression) and I was treated — not very effectively — I had some very unpleasant experiences with the mental health system before deciding to go it alone.

“This was a mistake. And I’m hoping people can learn from my mistakes.” Going it alone certainly speaks to the infamous Maggie T: the globe-trotting party-girl remembered for her marriage — and too-public separation — with former prime minister Pierre Trudeau, partying with the Rolling Stones and a scandalous, often speculative, series of companions that included Mick Jagger, Ron Wood, Ryan O’Neal, Jack Nicholson and Ted Kennedy.

Now a 58-year-old grandmother, she offers no apologies or qualifiers as she smiles; 

“My life has always been rich and interesting and exciting,” she said,” but it has never been balanced. I’ve made mistakes.” The biggest being her decision to self-medicate.

“It is a tempting mistake,” she said. “When you’re depressed who wouldn’t want to get high? Who wouldn’t want to feel light and euphoric? Unfortunately, it doesn’t last. There’s a crash and if there are drugs involved, it’s a terrible crash.

“My drug of choice has always been marijuana. I thought it was benign. I started smoking in the ‘60s but I fell into it later when I couldn’t cope.

“There’s a undercurrent in our society now that it is more acceptable, that it’s no big deal — and maybe it isn’t for some people. But I know it’s a big deal for people who have mood disorders. Regular marijuana use for a person with a mood disorder is like a diabetic making a steady diet of Black Forest cake.”

“In either the manic or depressive cycle marijuana, alcohol, drugs in general ... can produce psychotic symptoms: delusions, hallucinations,” said Dr. Snider. “Clinical studies show this to be true and while there are medicinal uses for marijuana, these are largely for pain relief. There is no mental illness for which marijuana would be recommended.”

By definition, mood disorders affect the patient’s ability to cope with reality.

Of all the recognized mood disorders bipolar disorder is the most complex.

Anxiety and post-traumatic stress for example, tend to have very specific triggers and predictable patient responses. In most cases, the patient can readily recognize these and develop coping mechanisms to help them deal with the situation appropriately.

Bipolar disorder, however, is often a cycle in itself with patients moving from one emotional pole to the other without necessarily having a specific trigger causing the shift. Responses to their reality then can vary according to which point in the cycle they are in at the time: sometimes being overwhelmed and withdrawing from a situation or rising up with an air of infallibility.

For Ms Trudeau, there are no triggers. She simply responds in an extreme.

“It’s an exaggeration of your emotions,” explained Ms Trudeau. “You’re not happy, you’re very happy. You’re not sad, you’re very sad. You go too high, you fall too low.”

“I haven’t had too much mania, but it’s been serious when I have had it. In most cases, I’ve had to be hospitalized.

“There’s a state called hypo-mania: probably one of the nicest states for a human to live in because your not crazy-manic: you’re just euphoric, you have lot’s of energy, you don’t sleep too much, you feel very alive, you have lots of projects going on on, you’re creative ... unfortunately, it escalates. Hypo-mania is the first stage, then there’s into-mania ... if you could just stay in hypo-mania, how wonderful! Everybody would like to have a bit of hypo-mania in their life because it’s vivacious. But it escalates to a very scary place.

“I describe it as a nuclear bomb going off in my family when the disease took me there.”

Though only 10 per cent of the bipolar cycle is spent in mania, this is the hardest aspect of the disorder to treat. When depressed, the patient is more apt to recognize the withdrawal as unhealthy and, while she may not seek help, she will be more likely to accept it if offered. In the manic state, the patient cannot recognize the behaviour as unhealthy — in fact, she never felt better: an offer of help or suggestion of disease is contemptible. Even patients in ongoing treatment may stop taking medications or attending counselling when the manic phase begins and they believe themselves completely cured. In her last bout of high mania before the final crash, Ms Trudeau made the news for an obsession with princes William and Harry.

According to reports, she publicly claimed an acquaintance with the Royal Scions, which simply didn’t exist. Adamant, however, that the princes intended to visit her on their scheduled ski vacation to British Columbia, Ms Trudeau booked herself into the exclusive resort town and awaited their call. While not familiar with the situation or the specifics of Ms Trudeau’s diagnosis, Dr. Snider says it is not uncommon for bipolar disorder patients to experience such optimistic delusions while in the manic cycle of the disease, with some becoming so entrenched in grandiosity they believe they are not even limited by gravity: They can fly.

“Certainly having a heightened sense of self is a classic symptom of the manic cycle,” he said, “and any substance abuse would have made it worse.”

Sources said Ms Trudeau was quite despondent when the young Windsors did not call: the roller-coaster of bipolar disorder crested the hill and began its descent. This time, however, the ride would be profoundly different — and the crash; life-altering. Ms Trudeau does not detail the personal horror that followed, nor does she have to: what happened next was tragic by any standard.

As she made a metaphysical fall, her  23-year-old son, Michel made a heartbreakingly literal one; dying in an avalanche on the Kokanee glacier in November 1998.

Remembering Michel, both warmth and sadness show in her ever-expressive eyes. “Oh, he was such a wonderful young man, such a wonderful child,” she said with tender pride. “He was very close to my heart. He was such a free spirit, as I’ve always been. He loved nature; he loved to laugh; he was a very special, special young man. I can’t bear the thought that he missed the chance to live life to its fullest. Our family was devastated and shattered by his death.

“It was very difficult to regain myself after the death of my son,” she said. “I completely lost my footing, lost my balance. This was actually where I started to turn things around, where I found the help I needed.”

Fate, however, seemed indifferent to the struggle.

Shortly after the loss of her son, his father, ex-husband Pierre Trudeau, also died, succumbing to prostate cancer at the age of 81. In the same year, her second husband, Fred Kemper, with whom she’d had another son and daughter, also died.

In a very bitter twist for the still grieving mother, Mr. Trudeau’s flag-draped coffin left Ottawa for Montreal in official ceremony on what would have been Michel’s 25th birthday.

The despair was relentless and Ms Trudeau finally, and literally, collapsed under its weight. In the very dark place she found herself, Ms Trudeau solidified her
decision to get off the roller-coaster once and for all.  “I had to make strong choices about how I was going to live. I had to live a very good life. I had to live a very balanced life. I had to chose sanity.”

Treatment for bipolar disorder can be a lifetime commitment but  Ms Trudeau emphasizes it is also a commitment to living. “Treatment has come so far since I was treated in the ‘70s and I think a lot of people suffer because they don’t know they can feel better almost at once. “Once you accept who you are and what your limits are, it frees you to live.”

For Ms Trudeau, taking positive action has been very helpful to her recovery.

Together with her son, Justin, she supports the Avalanche Society, which raises awareness of the safety issues around mountain and glacier sports and builds shelters for the extreme sportsmen and back-country skiers who venture in growing numbers to the snow and ice of the B.C. interior.

As well, she is the president of WaterCan; a Canadian non-profit organization that works with other organizations to help the poorest African communities develop clean drinking water and sanitation strategies. Recently returned from a trip to Ethiopia with her daughter-in-law, Sophie Gregoire, the journey was broadcast on television in May to show the work — and the work that needs to be done — in this part of the world.

“It has been very healing to get outside my own personal life, my own personal struggles, and try and help people who need it,” said Ms Trudeau.

“The villages we are working with are forgotten by their governments. They are very traditional people, living in extreme poverty. In some villages people walk as much as 10 kilometres to get dirty water to poison their children with — and they have no choice: it’s the only water they have.

“Water is something every human being on this planet needs and every human being should have access to clean water. It should be a basic human right.”

Closer to home, she encourages people to participate in mentally healthy activities, such as yoga, pilates and meditation as well as joining classes or clubs: “Anything that can get you out with other people so you don’t feel so alone,” she said. She also emphasizes the importance of being able to find support among family and friends.

“Your family and your friends need to help as well; when you’re lost, particularly in depression, it can be very difficult to find your way out alone.

“It’s no help to have people tell you to buck up and snap out of it — it’s not something you can do,” Ms Trudeau said. “If your family can recognize what you’re going through, they can intervene — either to encourage diagnosis or help in the treatment process. We have to educate ourselves to know what to look for in our children and in our spouse and in our family members and our friends and in our workplace so we can recognize a problem and be supportive.”

In addition to withdrawing from normally enjoyable activities, excessive sleeping, low energy, loss of appetite and drug or alcohol abuse are among the key indicators that a person may be depressed Dr. Snider says, agreeing that having a sense of acceptance from the people around you can make a world of difference in seeking treatment and sticking with it.

Greater social acceptance of mental health issues is another element that will foster  better care.

“As I go across the country, I see more and more volunteer organizations that help people with their issues, that help people get back on their feet. That shows that there is growing awareness,” Ms Trudeau said.

“Organizations, such as the Canadian Mental Health Association, provide a valuable grassroots access to care, so you don’t have to be in crisis to get help.

“Mental health call lines are another service we could use more of so if you’re in crisis, or if you need help, or even if you’re just terribly lonely and need to reach out — you can just pick up your phone.

“Ideally, I’d like to see mental health walk-in clinics — just like we have walk-in medical clinics — where you can come in off the street and see a doctor or a nurse or a nutritionist or a social worker: a whole team of professionals that can help you; way before you’re in crisis; way before you require medical intervention or hospitalization.”

Recent years have shown a decided improvement in quality of life for Ms Trudeau. Her moods have stabilized and, while she does “take the advice” of a psychiatrist, there has been no sign the roller-coaster will leave the station any time soon.

“Actually, I monitor those signs very closely. I don’t have triggers but there are signs that let me know if there’s been a shift. For me it’s sleep patterns: if I have trouble sleeping — not a once-in-a-while insomnia, but over a week or so — I know it’s trying to start again and I have the tools to stop it now.

“My family, my friends, they help too — they know all the signs. “I have come to a very beautiful place in my life,” she said, adding with laughter, “maybe its just maturity — that I have finally grown up — but its also that I have balance for once in my life. I’ve never had that before and it is ... wonderful. I am totally myself — I don’t fake it anymore. I know who I am.”

Still, and in the tradition of Margaret Trudeau, she expects that definition of herself to change as well. Her daughter is now 18 and moving on to McGill University and grandchildren await her doting affections in Montreal, where she is moving to be closer to her family.

“Life is a process: my role as a mother is coming to an end and my grandchildren are a new beginning. We discover things about ourselves right up to the day we die.

“Our legacy isn’t in dying, it’s in living — and it’s the people we know, the people we love: the people who love us — that’s where our legacy is. It isn’t with the biographers or  the journalists or the writers, it isn’t in the headlines or in the press. Who knows the truth? The truth is what you experience with your own eyes and in your own heart.

“I have five wonderful children, I have a grandchild and two more on the way, I have had two wonderful husbands, I have many dear friends, I also have my health — I have been blessed, blessed, blessed. I have had struggles, but mine isn’t a sad story. Even my bipolar I can see as a blessing because I have learned so much from it.

“Life will bring out different things in people at different times: it’s how you stand up when you’ve been knocked down — it’s about being able to get back on your feet — that’s living life to its fullest and that’s what I’m going to keep on doing.”

For further information on bipolar and other mood disorders, contact Canadian Mental Health Association at www.cmha-yr-on.ca or call 905-853-5700 ext. 2210.