Category Archives: Bipolar

“I Have a Mental Illness” Project

Please come visit my new posting site (and podcasting site) ihaveamentalillness.com. I am a cofounder, though not the initial founder, that honor goes to another.

We are trying to educate the community. Please visit, and leave comments so that we can be a better bastion as time goes on.

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Tardive Dyskinesia

Some of you probably know what this is.

I may be developing/have developed this.

For those who aren’t familiar, tardive is a potentially permanent side effect of antipsychotics. Presents as minor mouth tics, muscle tension and generally feeling physically uncomfortable. It’s on wikipedia, you can look it up if you’re interested.

Anyway, I’m apathetic now. I just am so used to shit hitting the fan I don’t care that it’s raining shit.

I hope any of you reading this will never run into this condition. It’s a nasty bit. And any of you who have switched antipsychotics know that the process can be very, very harsh.

Good luck,

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The Square Circle: Consciousness, Mental Illness, and Local Understanding

In Dr. Sacks book “The Man Who Mistook His Wife For A Hat“, in precisely the case of the man who mistook his wife for a hat, we see consciousness.

Or at least, insofar as I can perceive consciousness.

And this is precisely the problem. We cannot conceive consciousness for, if we did, it would be akin to conceiving a square circle.

There is a mathematical analogy here, and I beg my non-mathematician readers to allow me this as I do not know how to otherwise describe it without referring to persons, but as soon as I have done that I have forgotten the possibility of a square circle, indeed I may very well be, in some sense, actively supressing the square circle.

There exists, within the mathemato-cosm, an idea known as a “smooth manifold”. These are, essentially, surfaces on which we can create a calculus, in the same sense as we “create” a calculus in 3 dimensional space. Or, for those to whom calculus does not help understanding, imagine that we could generalize speed and acceleration and distance on this body.

“Locally”, in a mathematical sense, a 3 dimensional manifold looks like our common understanding of three dimensional space. We must be careful here in explanation because “Locally” and “Globally” are vastly different and often hard to understand.

Imagine that you were walking on a road and all of the sudden your understanding of speed and distance suddenly failed you, to such a degree that you could not even tell if you were moving. But once you reacclimated yourself to this spot, everything came back into view.

This is my current understanding of consciousness. Globally we are systems, locally we are individual persons. This would seem contradictory and backwards if interpreted incorrectly, so let me explain…

When I say locally here I do not mean one in a crowd or a persons feature. I mean the entire person. By global I mean, in effect, a surveillence under which personhood cannot be understood. Like the manifold it is not real 3 dimensional space, but rather only recognizable at local understanding. Similarly, from a personal view, that is a view that assumes ones own personhood, others are visible as persons. But insofar as we cannot understand our own personhood we cannot understand or comprehend personhood in the other either.

This allows for an interesting understanding of mental illness. If we saw “ourselves” as something that does not admit a legitimate understanding of “ourselves” mental illness would be self-understood to be an abberation in nature. That is we would perceive, rather than a distorted worldview, a distorted brain chemistry which affected this being that we cannot legitimately call “myself”.

The experience of mental illness is the experience of our understanding of self fighting for legitimacy as a being in a complete sense rather than an “Ikea Disaster” (if there really is such a thing as an “Ikea Success”).

Given this understanding the necessity of psychotherapy of some sort in addition to psychiatric care is readily apparent. Should we recover from the brain chemistry error, we must also recover from the self-conception error, an error developed in defense of personhood during a time of self-crisis.

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Psychiatric Medication: A Primer In Medical Frustration

Imagine you have something like leukemia.

In order to know you have that the doctor has to in effect prove that you have it. Which can be done (though I know nothing of the complexity involved in diagnostic).

Now think if the doctor had to diagnose leukemia without modern instrumentation, so he’d have to just watch you and see what happens.

Look up the signs and symptoms of Leukemia and take out all those that require physiological testing outside of visual analysis.

http://en.wikipedia.org/wiki/Leukemia#Signs_and_symptoms

“All symptoms associated with leukemia can be attributed to other diseases. Consequently, leukemia is always diagnosed through medical tests.”

So if you don’t have medical tests, you have nothing to go on.

Now think about the brain. How do we know what part of the brain does what? Two ways that I know of are analyzing case studies of people who had brain damage at a specific location and look for deficits or stimulate that part of the brain and analyze what the person says he or she is experiencing.

And that’s just the low level analysis.

Consider than how difficult it is to diagnose something like bipolar, which is diagnosed via the DSM IV (or V if it’s out yet).

 

  • The presence of a hypomanic or major depressive episode.
  • If currently in major depressive episode, history of a hypomanic episode. If currently in a hypomanic episode, history of a major depressive episode. No history of a manic episode.
  • Significant stress or impairment in social, occupational, or other important areas of functioning.[13]\

 

How many of those do you think can be explained via medical testing? The answer is, at present, none. The other problem is that it’s not at all clear that bipolar II has the same cause in all cases.

So we now approach medication.

In our leukemia example, there are treatments that attempt to control it to the point of remission. Granted, this is very very hard to do and leukemia is a terrible disease, however…

How does a psychiatrist pick a drug for bipolar II?

He can’t. Or at least, he can’t obviously pick one. Except possibly in the case where only one medication exists for the specific noted behaviors. In bipolar II this is not the case. Further consider that a few of the major drugs for bipolar were originally used for epileptic patients to keep their seizures controlled or at least lower the occurrence.

This is not to say that psychiatric intervention doesn’t work. I myself am currently on a medical cocktail that seems to work (although lately I’ve been experiencing a level of depression that I haven’t felt in a while…).

But I’m on Pristiq, Wellbutrin, Lamictal, Provigil, Adderall, Cogentin and Abilify.

That’s a lot of meds.

Now what do I do when something goes bad like it has recently?

All of those drugs are working to keep my bipolar in check.

So how do you figure out which one is failing to help? Or how do you switch out one med for another?

It’s not easy. On the patient or the psychiatrist.

This becomes extremely frustrating.

And this is all without mentioning the fact that many of these medications have extreme side effects. In many cases the patient has to decide what they’re willing to live with. Do you accept the possibility of Tardive Dyskensia? Or do you accept psychosis? Do you accept the possibility that one of your drugs will stop working, because at the moment it works pretty well?

These are all hard questions.

And I don’t know the answers.

 

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Life And Chronic Illness

It’s a bit cold… hopefully my fingers won’t freeze ><

Consider for a moment chronic illness. I know I mentioned this last post but I think a more thorough investigation is in order.

It currently seems that I will be bipolar and on some sort of meds for the rest of my life. I didn’t really realize what this meant until yesterday. Like I said last post, it’s been 5 years… and it’ll be another 5 and another 5 and another 5… (assuming my meds don’t catch up with my liver…)

So what does this mean? It’s strange to think about. Chronic means until you die. I suppose then, I have a chronic illness, bipolar, and a terminal illness, existance.

It’s quite hard to process.

But this life is the only one we have on this earth. We don’t get a second shot free of illness and death.

I recently saw a video on youtube by AronRa talking about his granddaughter who died at three years of age.

Three years.

Now I’m not asking you to compare that to your situation. I find all such comparisons useless in general. “Oh he has it worse” doesn’t mean anything really. You don’t have a choice between his life and your life.

Children in Africa born with AIDS have it “worse”.

But that doesn’t really matter when I consider my own situation. I must not dwell on the sufferings of others. I don’t mean to ignore them, if you have the ability to help in impoverished regions or donate to some charitable organizations please do.

However all the sick children in Africa do nothing for my bipolar.

We can compare all day long.

But that won’t help our condition. We must live our lives as best we can. We should enjoy all that we can and mitigate our symptoms when possible.

We can’t change our chronic illness.

But we still can live… even if this life is harder than it would be for someone without a chronic illness.

We have to live.

Living is a direct attack at bipolar itself.

“Oh, you want to bring me down? Well f—- you! I’m not going down! I’m going to do the best I can, regardless of what life throws my way. I may have limitations, but I will not define myself by them. There are some things I will never do, but that’s ok, there are lots of things I can do.”

Live while you can. Life is precious and short… sometimes far too short as for that three year old mentioned above. While we should not compare our situation to the girl or her family, we should live in memory that we may not last another day. If this is our last day on earth, fine. We will not go into that darkness thinking “If only I had not been bipolar” but rather “I lived. And that is all that matters”.

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Chronic Means It Doesn’t End

Anybody else realized this?

Chronic doesn’t end. Chronic Illness ends when I end.

I was diagnosed about 5 years ago. And I haven’t really thought about the next 5 years.

Or the next 5

or the next 5…

Chronic doesn’t end folks.

I don’t know what else to say really

Why am I sad???

Depression isn’t fair.
Mental illness isn’t fair.

We shouldn’t require happiness of ourselves. Depression is not about emotions, not at its core anyway. Depression is an illness, depression screws with brain chemistry.

It’s like if you had a glass of wine, and suddenly someone replaced it with a glass of cod liver oil. No matter how much we “should be happy” about getting wine, we’re not getting wine. We’re getting cod liver oil, and there’s no real way to choke down the stuff and think it’s wine (at least, I don’t think so, I’ve never had cod liver oil ><).

I see this in myself and in some of my compatriots at times, we’re mad at ourselves for not being happy in a good situation.

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Anger and Stress and Mental Illness

I must admit that this topic is not well decided/understood in my own mind, but I feel it’s important.

Anger and stress exacerbate my condition.

As does caffeine. Which I’m now attempting to rid myself of. I’m not moralizing about this, this is a connection that is present in my own mind, it’s helpfulness to others is debatable.

It leads to an interesting question though. How does an individual who has… well, an itchy trigger finger, have a conversation about conflicting ideas that does not end badly?

I’ve gotten better about it. But I see bettering myself from this point on as just avoiding unnecessary conflict. Which in principle isn’t a bad thing until you consider that a little bit of conflict is ok. Really a little bit of conflict is good for you at the idea level. It’s problematic though. I’ve turned off the comments on youtube (look up No Comment on google chrome for the add-on) because I get aggravated by stupid people. Even stupid people who are obviously trolls.

I don’t watch much TV anymore. I can’t stand it, though not for the normal reasons. I actually liked a lot of the crime shows, it’s just that as my illness has progressed, it became more and more evident that watching it was untenable as it left me in a very odd position. I can’t stand to watch people argue. I can’t stand to watch shouting. Weird thing is I’m pretty good at shouting. I have a huge, scary voice.

But, like a cornered pit viper, I hit hard to those things that push me into the corner. The worst part is I may even be right. It’s very hard to show people that you’re cool and calm and have the correct point of view when you’re shouting at the top of your lungs.

Here’s what I’ve come up with so far… in case anybody’s interested

1) Physical Awareness: Don’t strain your body while straining your brain. Pain in the body will just irritate you more.

2) Avoid Law & Order: That just seems to be a must for me

3) Be self conscious about your language. Not in an obsessive way, and DO NOT require this of other people’s language. You can’t change them. But you can look like a cool and collected person rather than a bumbling fool like myself if you can keep your cool.

4) Apologize. This last one is specifically if you get in a fight with a friend and you realize that your manner was not controlled. You can avoid losing friends this way.

So two things in the end:

1) Sorry G, I’m shaking with irritability right now, so I’m sure I said some stupid shit that I didn’t even realize I said on top of that that I do know about.

2) Be well, and think twice.. or three times.. but not over seven.

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A Toast To Life

Life at times seems a petty thing to me. There have been and are days when I have no or very little will to live. Thankfully most of these have landed in the apathetic rather than suicidal side of things.

It’s very hard for me to keep blogging every day. But it’s worth doing. It’s worth doing because it gives me something to be doing and something I do because I believe it should be done not for the will of some other being or power.

Of course, anyone looking at the dates of the posts will see very quickly that I have missed days.

But I’m still trying.

And it’s this trying that’s the important bit. Depression or depressive phases can beat you to the ground, leave you lying on the cold pavement of life bloodied and bruised. There’s a movie with Cuba Gooding Junior where he has to walk some odd steps in a giant diving suit, and half way either his leg breaks or is badly injured it seems. But though tears of pain are on his eyes he keeps going. I think this is apt because of the pacing. He just had to make the steps. He didn’t have to do it quickly. If I were him I’d have to take it one step at a time. One burst of pain at a time.

We must toast to life.

And we must live life. One step at a time. Even if we break our legs we need to keep going to get to where they can be repaired.

If you’ve suffered depression you’ll know that there are days when getting out of bed seems damn near impossible.

But we just have to keep going. It is not in living that we should find our purpose but rather in the steps we make while living. The steps we make against the tide, through the pain, and toward tomorrow.

Let us make it to tomorrow.

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Speech: The Strong Indicator

An inability to speak, or even just a speech related malady, triggers something profound in us. The only comparable feature I know of is the face. Disfigurement of the face is more disturbing to me than spasticity, even though spasticity would (most likely) physically have more challenges.

But everything is speech to us.

So much so that we demand a freedom to speak.

Think about that. Think about the utter necessity of self expression and aphasia. Broca’s aphasia  or Weirnecke’s aphasia. In my case it was psychsomatic aphasia.

I also had bouts of muscular retardation, which was incredibly embarrassing, but it wasn’t nearly as frustrating as not being able to speak.

Think about people with Down Syndrome. We can identify them by facial aspect and vocal affect. Or at least that’s what we relate to them.

For some reason pathology in speech, even though I have had it myself, instantly provokes a strong disturbance in me. I assume, sadly, that the person is retarded. How wrong is that? I mean people with aphasia can be perfectly intelligent but I personally for an instant assume retardation until I think about it for a second.

I wish this weren’t the case.

But I don’t think I can help the immediate assumption, just the one second later understanding.

Perhaps internally we don’t want to understand that speech can be lost and all other faculties maintained. Because that means it could happen to us and we would be, in some sense, trapped inside a broken machine.

If there are any of you that don’t like the use of the word broken, I do not apologize, you either are trying to be stupidly optimistic or just lacking understanding of the magnitude of the damage.

I would say the same thing for those who don’t like the idea of the “illness” part of mental illness.

If someone is a paraplegic I sincerely doubt you would say that he wasn’t broken.

Broken has nothing to do with intrinsic self worth. Broken is the condition. They are worth everything anyone else is worth intrinsically.

For the love of all that is good and holy never use the phrase “handicapable”.

A broken leg is broken. It’s not some strange “feature”. This truly is a bug and not a feature.

I’ve heard this sort of thing before. Usually talking about bipolars in particular because there is, in some cases, an artistic aspect that seems to be connected with the manic stage.

Remember that those are just the ones you hear about. Most mania and depression is far from an “inspired” state.

Yes, I am sometimes more productive in hypomanic states, even the very minimal version I have these days with medication. I also am more irritable. I often have trouble concentrating to the point of not being able to read. I often sustain a hypersexual state that generally is just an incredible annoyance if not worse.

I’ve mentioned this before. Most mania is not a “good” mania.

Yes, I do live in a fog. Yes, there are severe side effects of the medication. But I don’t have another acceptable choice. Suicidal is not an acceptable state. Severe depression and severe mania are not acceptable states.

This post seems incoherent. Could be since I’m on very little sleep.  And hypomanic.

If nothing else maybe this will give an understanding of uncomfortable and unwanted mania.

Sometimes I just need to vent.

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