Is Early Onset Bipolar Disorder a Myth?

I’ve always been curious about a child’s ability to exhibit all the required symptoms of Bipolar to meet the criteria. The other possibility involves the symptoms developing over time to eventuate into Bipolar disorder with the component of environmental factors and the individual traits of the child. My own personal example is severe childhood insomnia and anxiety, aided by my genetic predisposition to the disorder (biological father had BP1). I then question whether the insomnia was merely a symptom that demonstrated that Bipolar disorder was present during my childhood but in varying degrees. As a child I was a very clean individual that would cry at people not washing their hands or leaving a mess, I would also go into a ‘seek mode’ to find particular objects with an obsessive stubbornness that didn’t abate until I had found what I had been searching for, during these times I would also have head and neck aching pain – which was a generalised discomfort or pressure in those areas. Looking back at these times as an adult they highly correspond to my symptoms I currently exhibit during an episode of hypomania.

The psychiatrist who wrote this abstract (40years experience in clinical child psychiatry) believes that prepubescent Bipolar disorder is a misdiagnosis, ascertaining that the children diagnosed with Bipolar Disorder are predominantly based on violent outbursts which are produced by chaotic home life (Kaplin, 2011). The critique by Stuart Kaplin promotes the argument that there is no conclusive biological test for any psychiatric diagnosis. Kaplin further argues that paediatric Bipolar Disorder doesn’t even meet the DSM-IV criteria, stating that children don’t exhibit the appropriate levels of mania and depression that define Bipolar Disorder, bipolar is characterised by extreme contrasting mood poles. Kaplin does recognise that the DSM-IV largely ignores different symptoms that should be based on age and their psychological development, instead the DSM-IV takes a simplistic approach to all ages of development and has one set of criteria, a very ‘one size fits all’ approach.

Children that are diagnosed with Bipolar Disorder don’t seem to display the clear-cut episodes that the disorder is primarily based on. Etiology of psychiatry is always based on the psychiatrist’s perception of the symptoms, presenting ambiguous diagnoses based on areas of ‘grey’ within science. Children that are diagnosed with Bipolar disorder additionally display constant symptoms, episodes not deviating from their usual behaviour. Even with children meeting the manic criteria through their irritable mood, the irritable mood usually isn’t from a distinct period of time, not different from their normal functioning. Children displaying bipolar-like symptoms can also be categorised under a series of other disorders, fitting each accordingly. If a child also exhibits grandiose behaviour or euphoria it can also be attributed to the ability for the majority of children to present ‘grandiose’ orientated behaviour through their games and high imaginative ability.

Overall no objective science can adequately diagnose children to have early onset Bipolar disorder even if they have some symptom indicators, usually in my opinion it’s the environment factors that enhance the childhood symptoms to further develop into the classic Bipolar Disorder standards that are recognised by the DSM-IV.

This is just my opinion. 🙂

The Bipolar Diet?!

The yearnings ‘no no’s’ of Bipolar.

-Alcohol (ah goodbye my friend)
-Recreational drugs or excessive caffeine intake (Think caffeine is my biggest loss)
-Toxic friends (even the ones you don’t realise, or they need to get with the new positive program)
-Discontinuing medication
-Bad sleeping habits (easier said than done to fix!!)

My bipolar express is starting to slow down, my slow descent into the pit of despair boring life.

I’m creating positive reinforcements in my life to combat social anxiety (replacing word associations – ‘awkward’ with ‘awesome’ – good self-esteem improvement). Removing the friends whose negativity makes me more withdrawn. Realising that I’m content with who I am, I’m not the extrovert, nor do I see a point in conversing with some people, usually those conversations are futile. Just because I choose not to participate in some useless group interactions doesn’t make me ‘awkward’ or ‘autistic’, there are just different types of people in the world, I just happen to ‘choose’ to not talk to people that are of little value to me. Harmful relationships are a massive negative that are likely to trigger more mood episodes, intensify the risk for self-destructive behaviour and contribute to the attitudinal perception towards yourself that undermines any stability and wellness you have achieved. Cheers, friends suck.

Mr Lamictal, How Lovely You Are.

Lamictal (lamotrigine) is AWESOME.

Visited another psychiatrist a few days ago, a very lovely and friendly man, he is 80% sure that I am Bipolar 2, but wishes to monitor my progress for the next year or so, because there are so many “areas of grey” in diagnosing people. It took one day for my life to crumble and the label of Bipolar to be assigned to me, my psychiatrist is hesitant to fully diagnose me because it’s been such a short time since I first started to see my psychologist and only 2months since I first approached my GP about anxiety, which opened the cascade for Bipolar. My severe reaction to such a low dose of Avanza makes him hesitant to add anti-depressants to my mood stabiliser, but thankfully I’m changing from Epilim (apparently a top shelf mood-stabilizer – but has weight gain side effects) to Lamictal (very little side effects).

Epilim made my memory extra foggy and drowsy; I’ve started tapering off and have introduced Lamictal which will eventually be increased when I’ve completely tapered off Epilim. Lamictal is actually making me feel a lot better than normal, I had a brilliant day, my head feels good and I can actually see light at the end of the tunnel. I sometimes wonder if I should pick up the rest of my script for the anti-depressant just to see if it will cause hypomania again, I’m not exactly denying Bipolar, I just want more evidence for myself. I should just be happy that I’ve finally found a medication that makes me feel so good, I know that mood-stabilizers can’t always hold off depression though, but its nearly summer in Australia, so the sun if bright and my mood is good, guess I will wait for next winter to truly find out.This is one of the longest times (3weeks) in life where I haven’t been thinking about suicide, I’ve thought about suicide since I was at least 7years old, to some it might seem weird, but it’s always been on my mind somewhere, at the moment with Lamictal it is blessfully absent. I read recently on ‘crazymeds’ that Lamictal can make people go into an extremely good mood for the first few weeks of being on it. I think that’s where I’m at, I’ve been exercising a lot, I’m more pleasant to everyone, I’m motivated and energised . I do still have messed up sleep, jolting awake and thinking something is wrong, acting out my dreams, waking up thinking I’ve forgotten something or I’m late. I’m not usually a good sleeper but having this EVERY night is getting a bit much, in the past I would generally wake up twice a week randomly at 3am and do weird things, now it’s all the time.

“That “without the risk of mania” is only after you’re taking enough, usually 200mg a day. You might get a little too happy the first couple of weeks. Or too irritable, anxious and otherwise unpleasant to be around.”

Anyone had any long term side effects from Lamictal???

The Sobriety Of My Mind.

It’s becoming more and more tedious, the constant unchangeable level of emotion. I want my creative passionate highs and my long nightly social jaunts back. My apparently ‘euthymic’ stage is getting tiresome, the appeal of sexual debauchery is so high, the appeal of reckless driving is growing more attractive, not in a fundamentally hypomanic way, I miss the old highs. My mind has become sober and is craving its old haunts. I want to enjoy the trappings of my former life. It’s as if my old life has been put on ice and I’m currently experiencing the oxygen withdrawals and the hypothermic low temperature when I usually enjoy the heat.

I realize that when my stable ‘sober’ mind reappears it will have a lot of explaining to do, but I’m stable now and I’m bored, I’m bored of myself. I’m starting to recognize that I like who I am regardless of a mental health diagnosis, my ups and downs serve to reiterate and make me value the better times, I believe people can’t experience true happiness without first experience true sadness. I’m sitting at home twiddling my thumbs thinking “so what comes next?!” I’m not happy or sad, just an in-between irritating state. How is this normalcy?! I’m not even on anti-depressants, yet it feels like the atmosphere has a monotonous ambiance, with a dreary lacklustre song playing on repeat in the background. Not to mention my current feelings of asexuality, I’m like a vegetable that has a gender but lacks the incentive to do anything (had two very nice men ask me on dates, refused both with a nonchalant response, I just couldn’t be bothered).

I’m aware that this sounds like anhedonia (a symptom of depression,  loss of interest in previously rewarding or enjoyable activities) but I’m not depressed, I haven’t been crying, I’ve been participating in a modicum of social activities, yet it’s just different.

Is Mania A Defense Against Depression?

“Much madness is divinest sense-
To a discerning eye-
Much sense – the starkest madness”

– Emily Dickinson

Is mania a counter- defensive action against depression? Depression is simply symptoms that underlie a disorder, mania in many instances appearing as a series of transitory flights that create euphoria. Mental disorders are usually artfully denied, the denial acting as gauze; willful denial acting as an opiate. The people around me actively participate in the denial delusion, crediting external influences for my current mental state. Depression and paradoxically the psychotropic drugs (medication that can induce anxiety, nervousness, impaired judgment, mania, hypomania, hallucinations, feelings of depersonalization, psychosis and suicidal thoughts, while being used to treat the same symptoms) all cause the self (in my experience) to become a sub-form of itself.

Others perceive mania and hypomania to reveal horrifying parts of themselves. People often find it difficult to reconcile with the behaviors that are being presented during these episodes, perceiving these behaviors to be part of their denied inner psyche. Their ‘sick’ self has no accountability and the later ‘improved self’ has apologizing and explaining to do. Ultimately both mania and depression represent defensive actions of the self to counterbalance and stabilize (to an extent) the unstable mind. Often the transformation of the self that is experienced by the person with the mental disorder is the most disturbing part about being ill. Patients often find that doctors don’t engage with the topic of ‘self’ in their target to stabilize their patient, but for me I have to believe that my idea of ‘self’ has to be there in its completeness to truly feel well.

Losing your ‘self’ is a grief issue and needs strategies in place to either remedy the situation or for the patient to come to terms with their ‘new self’. Strangely I don’t feel like the same person I was 6 months ago, but I also believe that’s about progressing through life, but when your ‘self’ is altered through depression/mania and medication it is perceived differently from growing into a new person. It becomes a forced transition through the experiences and environmental factors around the person. A man with bipolar disorder said “Because everyone there was grieving over the loss of another person. I was grieving for myself. For who I used to be before I got sick and who I am now.”

It is my honest perception that mania and depression are defenses against each other. Manic-depressive patterns surround the struggle against personal annihilation. Mania embodies a transitory liberation from a subjugated, annihilating tie to emotionally important others, whereas depression represents the reinstatement of that tie. The liberation versus reinstatement is a constant mental struggle and retaliation, more importantly does this illustrate the chemical imbalance trying to over-rectify its irregularities? These are just my over analytical subjective bipolar musings.

**My thoughts are a bit haphazard today and hazy, sorry if some stuff doesn’t make sense, eh Epilim is really making it difficult to not become a marshmallow.

MEDS Debate: Bipolar IN Order VS. Bipolar Dis-Order

Being bipolar without disorder.

Tom Woottom “I would rather be on meds with Bipolar IN Order than off meds and still in Dis-Order.”

The simple ‘checklist’ that defines my life, the DSM gives an exceedingly brief checklist to illustrate depression, mania and hypomania, how can I now be defined by these symptoms?!! The list serves to reinforce the confounding issue that the authors can’t empathise with the experiences of those with Bipolar disorder. Symptoms don’t define the disorder; symptoms serve to find a reason why they are suffering or incapacitated. I don’t believe that having the symptoms of depression or hypomania always equal an ‘illness’, if the disorder is managed (medication) and you are merely cycling through emotional stages without having a dysfunctional life, than that to me isn’t a disorder, instead it is a very well controlled series of symptoms that the person is living with but isn’t being incapacitated by. Yes I am bipolar, but with the medication I don’t classify it as a ‘disorder’, disorder implies an unmanaged condition.

The dogmatic science behind the DSM is supported by commercial interest, lacking deeper understandings and direct experiences. Don’t let yourself be trapped by dogma, whereby other people’s thinking determines how you live. To be successfully bipolar isn’t to ‘cure’ it or be off medication, it’s about the ability to function while depressed or manic, even when taking medication.

Tom Woottom: “Medicine can help moderate the intensity during the Freedom Stage of Bipolar IN Order, but they cannot get you IN Order by themselves. The role of medication becomes more peripheral as one moves through Freedom Stage to Stability and is largely irrelevant once one reaches Self-Mastery. There is no point in taking something to lower the intensity when intensity is no longer an issue.”

Another perplexing issue within the medication debate and the considered ‘disorder’ is the perception of depression, having a number of signs and symptoms of the depressive syndrome aren’t a diagnosis, instead people need to identify what disorder is producing the symptoms. There are two types of depressive syndrome: primary or secondary. Secondary is most commonly caused by substance abuse a medical illness (hypothyroidism etc), if no foreseeable aetiology can’t be found then the depression is diagnosed as primary. Overall mental health is usually completely misunderstood, at the moment I don’t think I’m suffering from a disorder, but that could easily change like the weather. I believe I’m on the path to mastering the dis-functionality that has plagued my life in the past, it’s not a short path, but I know it’s worth it and taking my medication definitely helps me to find the things in life that will make me more stable.

Epilim Killed The Sex-Drive.

My emotions have hit a mental wall. Am I meant to feel this way; the mental exhaustion is wearing thin. In the past few weeks I’ve become aware that the mood stabilizer I’m taking has killed my sex drive (libido). I don’t think I’m depressed, I just don’t seem to care either, not dispassionate, just lacking both my highs and lows, I’m not unmotivated but I’m not my usual perky self. The medication hasn’t affected my ability, but I’m not seeking anything either. I’ve looked at other reports of Epilim killing sex drives; guess it’s not only me.

Feels like I’ve been stabilized emotionally, but I’ve been stabilized in a mild depressive state. Epilim allows me to be less anxious and I also believe it made me cycle out of hypomania. This feeling of mild depression makes me less functional, for the first time in weeks I actually had an afternoon nap. The first weeks of taking 500mg to start off with had a lot of nausea, currently at the end of week two of taking Epilim and at a 1000mg dose the nausea seems to have abated. I’m hoping that my functionality towards tasks will increase again; I don’t want to let myself get bogged down. I’m not sexually promiscuous, but I can be a bit demanding, having that part of me missing is extremely bizarre and foreign. Epilim is a good mood stabilizer but I would like the small depressive symptoms to abate.

THE SICK TWISTEDNESS OF REALITY.

Today is the end of an era in my life, an end to something I thought was finished. Today is her funeral, my grandmothers, its overcast and way too early, the drive was exhausting. By breakfast the sun is too bright and the birds too loud, my hastily covered black chipped nail polish is a stark contrast and reminder against the quickly applied shade of white, the quick efforts of respectability failing at closer inspection. My hair hangs loosely around my shoulders as I try to make my numerous piercings less noticeable. After the over-religious service we are brought to the burial site, my sister and I don’t approach, choosing to stand yards behind the rest of the party even after being beckoned by the other members of our immediate family.

I will not approach that grave, not in these circumstances; it will be on my own terms when I choose it to happen. Against my father’s wishes he was buried at his mother’s behest at the hometown cemetery in a double deep grave. Today that grave was opened so that my grandmother’s body could be placed with his. The nauseous feeling within starts to well-up, the sick dread that they’ll spend eternity in a shared place. I have never been here before; I doubt I will be here again. Within my grandmothers casket I’ve been told that a porcelain doll has been placed over her chest. My grandmother can now take her treasures and her son with her to whatever destination she has chosen to foresee. I can feel everyone’s eyes on my sister and I as they notice that we stand apart, a deliberate isolation. Some of them not realising that there stands the open grave of a father I never knew, others watching carefully to see our reactions. Everyone here knows that it was his choice to leave this life.

The unreality of the situation feels like a mockery, my sisters and I being duped. It starts to feel as if we’re still too close; this twisted charade of a funeral is only enhanced by the shadows of the trees and the eerie chirping of the birds. Today is grandma’s day, I can feel it somehow, she got everything she wanted from today, and even in death she was the victor. I have to acknowledge that she loved us girls, her son was reflected in our eyes and looks, yet history can’t rewrite itself, this chapter in life can’t be told any other way. The family I never see and knew are all approaching, trying to make the awkwardness dissipate, trying to include us; my mind is yelling that we don’t belong here. I’ve paid my respects to Grandma, talking about my father makes me cringe, people who don’t know me start talking about my father, Grandma’s funeral doesn’t need this added tastelessness.

They couldn’t just let us be, some find comfort from talking about the dead. The dead are dead and they aren’t coming back. The imposter that is respectability lasts the day, the hoax serving to reinforce my mother’s reputation, my mother is a lovely woman, today was about representing her to the best of our abilities. Today we were the ‘perfect’ daughters of a widow; I will not let the sadness and anger about the cards I’ve been dealt to show through the cracks of respectability. The last connection to him is now over, my sisters and I can finally be done.

The irony on his tombstone: “He lived for those he loved”.

I realise that a lot of people won’t agree with what I’ve written here. These were the events of yesterday and part of my history. Sorry that there is so much anger, lack and of compassion and empathy, but we make our beds to the best of our abilities.

Happiness Isn’t Our ‘Natural’ State Of Mind.

The reason we want things isn’t because they will make us intrinsically happy, instead we expect them to bring us happiness. The paradox of happiness, whereby we can live in conditions that have improved significantly over the generations, yet our level of actual ‘happiness’ hasn’t been enriched. I’d call it ‘smoke with no fire’, people creating reasons to gain happiness yet no noticeable effect. What are the causes of happiness? Do the contents of our moment to moment experiences reflect a truer form of happiness?

People in some instances are incapable of finding their own happiness, always in pursuit. The idea of happiness becomes a fugitive emotion that remains intangible despite achieving successes. You have to examine what it intrinsically means to pursue happiness both morally and ideologically. It has been judged that the psychic damage is caused by the educational and economic systems, pretending to find logical solutions to human unhappiness. The perception of happiness is becoming entangled by social and intellectual idealisations. The pursuit of happiness has become naturally embedded within culturally acceptable norms. The psychological and emotional consequences of pursuing happiness in contemporary society analyses what constitutes as true happiness often contrasting with the over dramatized unhappiness.

People insist that the notion of happiness can’t be left in the dominion of vague feelings or inexplicable internal conviction, requiring empirical reasoning and calculation, and not merely left as an ambiguous sentiment.  Using empirical reasoning to judge happiness would neglect the subjective nature of happiness, interpretations of happiness often misinterpreting utilitarianism and hedonism as happiness. Andrew H. Mills poses the question:  “Suppose that all your objects in life were realized; that all the changes in institutions and opinions which you are looking forward to, could be completely effected at this very instant: would this be a great joy and happiness to you?’ And an irrepressible self-consciousness distinctly answered, ‘No!”.

We then can argue how reliably aware are we of our own happiness, often referring to past days as “happy old days”, but is that a reliable judge of emotion? Seeking happiness means to accept and commit oneself to examining the incompatible desires and values that are internally manifested. Is ‘true’ happiness actually attainable, or is it merely a pedestal sentiment that is unreachable, promoting people to keep trying harder to pursue ‘true’ happiness. Mills has further stated that mental cultivation and selfishness generates unhappiness. My belief is that to achieve a semblance of happiness people need to share the view that human life is imperfectly arranged, but that its wrapped in potential.

Charles Dickens: “Where is happiness to be found then? Surely not everywhere? Can that be so, after all? Is this my experience?”

Mania Of The Past Through The Lens Of The Present.

You can’t in any whole capacity understand the mania of the past through the lens of the present. What was originally termed ‘mania’ in the past currently exhibits little resemblance to the ‘mania’ experienced by people with bipolar disorder. Mania has always existed as a form of madness, in contemporary psychiatry ‘mania’ signifies as an episode or as a pole on the affective spectrum. There is a strong need to transform the image of madness, re-framing mental illness as a positive, at least the hypomanic edge that it correlates with. When you’re truly manic the repercussions of your actions never gain much thought, there is a certain amount of ‘glamour’ attached to mania, a sheen that creates easy oblivious actions which have little association to your ‘normal’ train of thought.

The bliss of oblivion. Many people would prefer to be the manic sprite instead of the depressive shade that haunts their homes when darkness encroaches. There are no romantic notions towards depression for those who experience it recurrently; depression is a beast that slowly eats away all the feelings inside, leaving you numb and vulnerable. The clinical terms used to categorise bipolar disorder act like an oversized ad-campaign sign on a main road that reads ‘manic-depressive’. It feels like an endless resistance to the labels, the labels becoming the straightjacket of mental illness, restrictive and confining.