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Thank you for visiting. Content MAY BE TRIGGERING ESPECIALLY FOR THOSE WHO HAVE EXPERIENCED ABUSE, STRUGGLE WITH SELF-INJURY, SUICIDE, DEPRESSION OR AN EATING DISORDER. Contains graphic descriptions of suicidal thoughts, self-injury and emotional, physical and sexual abuse. Do not read further if you are not in a safe place. If you are triggered, please reach out to your support system, a mental health professional or call 911.

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Disclaimer: Although I have worked with persons with mental illness for twenty years, I do not have a Master's Degree or a license. This is not meant to be a substitute for mental health care or treatment. Please obtain professional assistance from the resources listed on the right of the page, if needed. And call 911 if you or someone is in immediate danger.

A key word that you will see:

Fragmentation: a mental process where a person becomes intensely emotionally focused on one aspect of themselves, such as “I am angry” or “no one loves me,” to the point where all thoughts, feelings and behavior demonstrate this emotional state, in which, the person does not or is unable to take into account the reality of their environment, others or themselves and their resources. This is a term that my therapist and I use and is on the continuum of dissociation.

Monday, June 30, 2008

Bipolar Disorder aka Manic Depressive Disorder (for us old folk)

My therapist and I get into some really odd topics. But, I guess after 21 years or so, we probably have a pretty odd relationship. He is the odd one. Anyway, a while back we were talking about the weather and how it was changing 30 degress in two days 40 degress in a week. It was driving me crazy and to be even crazier, my therapist started talking about the weather being manic-depressive (okay we are old) as it was characterized by extreme highs to lows. (I know my thinking is a bit odd...don't all of you think of weather in terms of mental illness?)

I was frustrated, I had fall, spring and summer clothing all over the
place in my bedroom and day to day or week to week, I did not know what I was going to wear. Also, I could feel it in my sinus, my body's temperature was really weird and basically, I think, it affected my emotions. Well, if you had manic-depression, which is now called bipolar disorder, this is sort of what it would be like on a day to day or weekly basis depending on the exact diagnosis, not knowing how you are going to be day to day. I don't mean to minimize the severity of bipolar disorder by comparing it to weather. It is just how this article started.

For those not on medications or with rapid cycling bipolar disease. Imagine having so much energy that you don't need sleep because you are not tired, everything seems like it is racing, you feel like you can't keep up with the billions of different thoughts in your head, you can't focus, you speak constantly, you feel like you are just bouncing off walls, your behavior is impulsive and think you can do anything. Then, without any warning signs, you crash hard. Everything seems dark, cloudy, sad and heavy. You don't want to do anything including getting out of bed or eat. You feel like you are in a black hole with no end and that you will never feel better. You probably have suicidal thoughts. Then, without warning, you have super duper energy again, but this time everything seems to irritate you, and you are filled with rage. Imagine, living like this and never knowing which way you will feel. Also, there is very little "normal" feeling in between. For those not on medications and for most who do not cycle rapidly, this is maybe a week or so between "moods."

This is the way it is for many people with bipolar disorder and their family, friends and coworkers. The manic phase is also when people do outragous things because they think they can. I know someone who went to work early and began painting a huge mural on the wall at work. Many go on shopping, gambling, alcohol, drug, or sex binges. It tears familys apart and they lose friends and can't keep a job and have major financial problems.

Most people's symptoms are noticed and begin to interfere in their lives during late adolescenes and early adulthood. Although, in hindsight, most people can see signs in their childhood. With proper treatment, people with bipolar disorder can be treated for this illness and can lead full productive lives.

Medication compliance is one of the most difficult issues and is necessary to stablize the chemical imbalance that occurs in the brain to cause such symptoms. Especially, during the manic phase because many do not want to stop from being on such a high. Medication is also tricky because what works for one person may not work for another. Also, what works for a while may stop working and then they have try new drugs or dosages. It can be very frustrating for everyone. Also, medication does not take away all of the symptoms it usually reduces them enough for someone to learn how to cope with their illness. Remember, their illness is not an excuse for their behavior and some can be responsible for it and others cannot. If you are living with someone or know someone with this illness, you can still set boundaries. It is never okay for someone to abuse you physically, verbally, emotionally, etc.

You will become frustrated and wonder why they make the same "bad" decisions over and over again? Why haven't they learned by this time? Why can't they see the senselessness of their behavior? They seem to get it together and then bottom out. Those without this illness and I will never be able to fully understand what their world is like. It isn't like a broken leg or open wound where you can see where it hurts. Their brain is very different than yours or mine.

(shows normal, manic and depressed activity in the brain)

Even though you cannot see their wound, they do show you. You just have to listen to what they say and do carefully. An excerpt from Bipolar Disorder Today states, "However hear their pain, listen for red flags always of any danger signals were you may need added assistance...Anytime a loved one does not seem in touch with reality (seeing, hearing, sensing, and thinking things that are not true), or seems at risk for suicide, homicide or any high risk behavior, you need to call 911 or their counselor or doctor. Explain what you are experiencing and your concerns."

  1. talking about feeling suicidal or wanting to die
  2. feeling hopeless, that nothing will ever change or get better
  3. feeling helpless, that nothing one does makes a difference
  4. feeling like a burden to family and friends
  5. abusing alcohol or drugs
  6. putting affairs in order (e.g., organizing finances or giving away possessions to prepare for one's death)
  7. writing a suicide note
  8. putting oneself in harm's way, or in situation where there is a danger of being killed.
The most important way to assist a person with bipolar disorder is to treat them with respect and care and to become a part of the treatment team if the person will allow you to do so. Then, you can speak with the psychiatrist and find out the best way to support the person because it is individualized. In the meantime, you can educate yourself. Websites will be provided at the end. Do not become codependent or enabling with your loved one. Remember that you do not have control over someone else. (Hmmm...need to do post on codependency)

The following is taken from the National Institute on Mental Health:

Signs and symptoms of mania (or a manic episode) include:

  • Increased energy, activity, and restlessness

  • Excessively “high,” overly good, euphoric mood

  • Extreme irritability

  • Racing thoughts and talking very fast, jumping from one idea to another

  • Distractibility, can’t concentrate well

  • Little sleep needed

  • Unrealistic beliefs in one’s abilities and powers

  • Poor judgment

  • Spending sprees

  • A lasting period of behavior that is different from usual

  • Increased sexual drive

  • Abuse of drugs, particularly cocaine, alcohol, and sleeping medications

  • Provocative, intrusive, or aggressive behavior

  • Denial that anything is wrong

A manic episode is diagnosed if elevated mood occurs with three or more of the other symptoms most of the day, nearly everyday, for one week or more. If mood is irritable, four or more additional symptoms must be present.

Signs and symptoms of depression (or a depressive episode) include:

  • Lasting sad, anxious, or empty mood

  • Feelings of hopelessness or pessimism

  • Feelings of guilt, worthlessness, or helplessness

  • Loss of interest or pleasure in activities once enjoyed, including sex

  • Decreased energy, a feeling of fatigue or of being “slowed down”

  • Difficulty concentrating, remembering, making decisions

  • Restlessness or irritability

  • Sleeping too much, or can’t sleep

  • Change in appetite and/or unintended weight loss or gain

  • Chronic pain or other persistent bodily symptoms that are not caused by physical illness or injury

  • Thoughts of death or suicide, or suicide attempts

A depressive episode is diagnosed if five or more of these symptoms last most of the day, nearly every day, for a period of 2 weeks or longer.

I often wonder about the genius (or creative talent) of the world and the fantastic artwork created by those with mental illness. If there were medications during their time, would we have had Beethoven's 9th Symphony, Van Gogh's Starry Night or The Scream by artist Edvard Munch. Both had bipolar disorders. Just something I ponder from time to time. I am definitely not saying that medication should not be used. On the contrary, I believe that medication can save lives, assist them with leading full lives, and can stablize symptoms. For bipolar disorder, it is essential.

Many famous people have been diagnosed with bipolar disorder. These are only those who have been confirmed as having this illness: Adam Ant, Ludwig van Beethoven, Lord Byron, Dick Cavett, Kurt Cobain, Samuel Tayleor Coleridge, Ray Davies, Charles Dickens, Richard Dreyfuss, Patty Duke, Carrie Fisher, William Faulkner, Stephen Foster, Macy Gray, Alexander Hamilton, Linda Hamilton, Mariette Hartley, Ernest Hemingway, Abbie Hoffman, Margot Kidder, Kristy McNichol, Edvard Munch, Issac Newton, Florence Nightengale, Sinead O' Conner, Ozzy Osbourne, Jane Pauley, Edgar Allen Poe, Charlie Pride, Axl Rose, Nina Simone, Britney Spears, Robert Louis Stevenson, Mark Twain, Jean-Claude Van Damme, Vincent Van Gogh, Kurt Vonnegut, Brian Wilson and Virginia Woolf.

Remember if you or anyone else recognizes any of these symptoms talk to your doctor and seek professional medical treatment and psychotherapy. If someone seems to be in immediate danger, call 911.

My hope is that this was informative and gives people a new perspective on bipolar disorder and mental illness in general. All information in this post was from personal/professional experiences, http://www.mental-health-today.com/, http://www.nimh.nih.gov/, http://www.bipolar.com/. You can go to any of these sites for more information or assistance. Also, you can educate yourself further from the book, the Bipolar Disorders Survival Guide by David J. Miklowitz, Ph.D. (All this because we had some major weather swings...you never know where my inspiration to write will come from...this one is a bit strange, I have to admit.

(Disclaimer: Although I have worked with mentally ill persons for twenty years, I do not have a Master's Degree or a license. This is not meant to be a substitute for mental health care or treatment. Please obtain professional assistance from the above resources, if needed. And call 911 if you or someone is in immediate danger.)


Tempy said...

I like the weather analogy!

Thanks for commenting on my blog :-) It was helpful to see comments sitting there this morning, I had felt odd about all the information I posted yesterday. Thanks again!

Anonymous said...

Thanks for the visit and comments. I stick with "down" and "downer," as moods go. The two times I have felt hypomanic were both related to increases in the same antidepressant. I think that my current depression is due both to perceived loss and to a screw-up in meds. Insurance no longer pays for extended release forms, so I have to maintain a steady state by nibbling on half tabs of two generics throughout the day. I think your post was excellent and should be of benefit to anyone who reads it.

Peace, Doc

Clueless said...

@tempy. Yes, the weather analogy...my brain works different than most I think. I'm glad that my comment helped. I was really impressed with how you just started with your history. What a horrendous childhood.

@doc. Thanks for reviewing my post. I like the "down" and "downer," that also fits me more. Eeew, nibbling on meds what an awful taste. I am glad that you are feeling better. I love your site. It is very enjoyable.

Cristina C. Fender said...

A thorough examination of bipolar, CC. Well done!

Wanda's Wings said...

This was a great post. It still seems my doctors have a lot of trouble with my meds. I going to see if I can get my son to read your post so he can better understand what is going on.

Clueless said...

@chica. Thanks. That is a real compliment coming from you!!!

@Wanda's Wings. I hope it helps.

Tempy said...

Thanks for your comments today. It was comforting to know that I am not the only one that relies so heavily on environmental factors to judge stability! This blog community is turning out to be so helpful! Thank you

Clueless said...

You are welcome and I hope this blog community helps. I know it has helped me.

Bradley said...

I use the weather analogy all the time. I think it works very well.

As for your entire post: I am standing and applauding for a job well done.

Clueless said...

Thank you, Brad. I really appreciate your feedback. Not being bipolar or having direct contact with someone made this post a bit scary for me...I wanted to do it justice and inform people. Hooray!! The weather thing works really well for out here, huh?

Anonymous said...

Great information. The analogy is a great one. As a parent of a son with mental illness, it is so difficult to watch him struggle with life when things seem so clear to me. I know he feels different and his self esteem is low. I believe that a lot of folks like you describe are "gifted" and cursed at the same time. I believe they are creative and extremely intelligent but struggle with maintaining life due to their illness.

The idea of writing the codependency article is a good one. The is a fine line between advocating for someone and enabling.

Clueless said...

@laurie. "gifted?" Yes, a codependency article would be helpful...a very fine line. Just as long as people get to the point of it being a choice!! Thanks for visiting again.

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