Tag Archives: Bipolar disorder

“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.

unconstructed

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To my fellows on the battlefield

(I am not referring to war here, at least, not the kind of war people first imagine)

I want to send out a message of hope to my mentally ill compatriots, especially those who cannot speak about their illness for any number of reasons.

Keep fighting.

Stay strong.

I wish you the best, and hope that some day you can be relieved of the battlefield situation. But if you never do… you have my respect. And I hope that means something.

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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.

 

unconstructed

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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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Concentration and Mania

Have you ever not been able to read during your adult life?

It’s extremely frustrating. To look at a page and just having a mental wall you can’t seem to get over.

It’s hard to even write this post, it takes a lot to keep my concentration.

I think, though I’m not sure, that this is a product of hypomania (bipolar II version of mania). I just can’t concentrate. My mind will not let me. Even these small sentences seem to show this.

I took two tylenol, hopefully it’s just a tension headache.

Sadly even if it’s that it could be a result of hypomania.

I hate this.

I don’t want to go through this anymore.

But I don’t have a choice.

I’m going to try to write a few more lines but my body is trying to stop me.

Hopefully I can make it.

I hope people have an amazing week!

I’ll try my best to have one…

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Mental Illnesses: Perspectives From The Mentally Ill

I’m working on putting together a new page on the site. This is for people with mental illnesses to describe their understanding and their experience of mental illness. I want to cover at least:

Depression, Bipolar (I and II), Borderline Personality Disorder, Adult ADHD, and Fibromyalgia.

A person on ProBlogger thought of this. A page to describe mental illness in a personal way, rather than a behavioral diagnostic of webMD. Not to disparage webMD by the way. They provide a good service. But they don’t have a personal description. They don’t have implications the illness has on everyday life.

We need that. The world needs that. The mentally ill and those who are not need that.

Message me at

archangel.associate@gmail.com

with a story. I won’t necessarily post them, but if I do I will not edit them. By that I mean the person will tell their own story as they see it. Editing the work would make it partially mine, and not fully theirs.

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Online Communities for the Mentally Ill

First, in case this invokes a tldr response, here’s the group that I visit

http://www.abrilliantmadness.org

It’s quite good, I highly recommend it for those who have mood disorders. Just remember that A) it is not run by professional psychologists/psychiatrists, that misses the point and B) I would ask that you  go only if you suffer from a mood disorder or related mental illness (personality disorders and the like), it’s not a zoo. If you have questions about mental illness I will gladly accept and try to answer them. That is not the job of the site.

I said a lot of what I wanted to say in this post already…

Online Communities are a very welcome idea in my mind. We can talk with a therapist, but at some point it’s therapeutic to speak to those who have the illness and to feel a heightened sense of normality, in the sense of “I am not alone”.

Two things that are especially helpful are the anonymity and the distance.

In a community group in a physical location, people do live near to you. That may frighten some people, especially if they feel the need, sometimes very legitimately, to hide their mental illness from some people. In the online setting there is no “close distance” problem (well, most of the time this is true).

Further, consider age for a moment. It’s quite hard in my opinion to commiserate in a physical location with people far older or far younger than you. In the online community that isn’t staring you in the face all the time. You can speak as you would around friends (possibly limiting vulgarities). If I had been in a physical room with some of the people I chat with, I would find it very hard to keep a conversation going. Granted, this may show my own biases with regards to age, but I think these biases are not uncommon. You don’t have to “act your age”. You can speak your mind. I may come back to the age gap in a later post…

The anonymity is similar to distance. If you don’t want people to know your physical location/age/career/whatever, they don’t have to. You don’t have to share that information.

Think also about appearance biases. I will admit that some alternative body styles can really cause me to stereotype very early. If someone has tattoos I have a small amount of this thought I can usually keep that one at bay. But I get uncomfortable around the highly pierced for example.  In the online community it doesn’t matter. The person can be themselves, in all their humanity and fragility. And from this we lessen our fragility and strengthen our feeling of being a person among others, not an outlier who no one could understand. You don’t have to be tough. You don’t need to keep your “shields” up, you can lower them because no one knows who you are or why you have shields up in the first place.

What if someone was severely disfigured? Severely disfigured people are still people, but I must admit that I really have to work hard to keep myself normative around someone who it may even be, sadly, hard to look at in a certain sense. I am no saint with regards to this. I have looked away when talking to someone who it’s hard to look at. Imagine the elephant man. Online he’s just a guy. Offline people are frightened of him. Perhaps if the elephant man had an anonymous, blind group he wouldn’t have ended his own life.

A final note. Always remember that people in chat are people. Respect them as such. Respect that they make mistakes and that they suffer from mental illness which may lead them to making more mistakes. We are all human. We all screw up from time to time.

Be well,

–Unthought

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Quick note on mental health diagnoses

I thought of this when I read this blog’s entry on bipolar diagnosis..

http://counselorssoapbox.com/

I think he makes some very interesting points, and this guy knows his stuff from the counselor/psychologist point of view, so definitely if you’re interested in that he seems like a good guy to follow.

What I personally want to talk about is behavioral diagnosis.

Let us, for lack of better terms, draw a line between “physical” illnesses and “mental” illness. Physical illness usually invites us to consider a cause. A broken leg, for example. The cause of the pain is the broken state of the leg.

With mental illness however we don’t diagnose this way. We look at a patient and classify his behavior. Why? Because the brain is notoriously complex and we don’t always have the luxury of time.

Does this make the diagnosis any less real? Any less relevant? No, of course not. Just because we don’t know the combination of things causing these high level behavioral problems doesn’t mean they don’t exist.

And even if we could diagnose directly, how do we use that information? In the end, we have medications that help with certain conditions. These conditions are defined behaviorally. We won’t have medicine where “if neuron 17 is firing too fast we administer N17-Fire-Slower-XY” (all medications need excessive letters).

If someone is depressed, an antidepressant may help. One of many antidepressants may help.

And unfortunately at times none of them help.

I just think the behavioral vs physiological diagnosis leads people to come to the conclusion that mental illness isn’t really there. And that should be corrected. Hopefully someone will benefit from this.

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The Problem of Mania Assumptions

I was just watching a show that Stephen Fry put together for the BBC on bipolar disorder, or manic-depressive disorder (an older term).

The one problem I had is that they kept describing mania as “fun” or “exhilarating” without going into the idea that some don’t experience it that way. I experience it myself as extreme irritability and I have trouble focusing. They did, however, talk to a woman who once attempted suicide by drilling into her skull with a power drill.

This resonated astoundingly to me. I can see the pain. I know that feeling. When your own mind won’t leave you alone, you feel helpless and at great pain. It’s so painful that people like myself accept moderate to severe side effects of medications rather than live with that pain.

I’m going to write more on medicinal side effects and the depressive part of bipolar 2 as I experience it, but I wanted to note this to A) promote Stephen Fry’s documentary and B) to correct what I saw as problematic due to its pervasive use of an understanding of mania that I do not share.

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