Category Archives: anxiety

Subthreshold (Hypo)Mania As A Precursor To Bipolar Disorder

The new Bipolar Spectrum.

“There is growing clinical and epidemiologic evidence that major mood disorders form a spectrum from major depressive disorder to pure mania.”

Subthreshold mania can be seen as a precursor to Bipolar Disorder, subthreshold Bipolar Disorder is defined as “recurrent hypomania without a major depressive episode or with fewer symptoms than required for threshold hypomania” (Merikangas et al, 2007). Bipolar disorder should be suspected if prominent behavior problems, anxiety, and substance abuse were present during childhood in someone with recurrent depression and a family history of affective disorders. For example, the prevalence of anxiety in children may be prominent in early-onset Bipolar Disorder and may predate affective symptoms. Children with a parent with Bipolar Disorder are more likely to be at risk for early-onset Bipolar Disorder, along with anxiety, depression and other disorders.

Studies have shown that offspring of people with Bipolar Disorder are at high risk for developing Bipolar Disorder because they have a parent with the disorder and generally have significantly higher rates of subthreshold mania or hypomania (13.3% versus 1.2%) or what is known as bipolar disorder not otherwise specified (BP-NOS); manic, mixed, or hypomanic episodes (9.2% versus 0.8%); major depressive episodes (32.0% versus 14.9%); and anxiety disorders (39.9% versus 21.8%) than offspring of parents without the disorder. Subthreshold episodes of mania or hypomania (those that resemble but do not meet the full requirements for bipolar disorder in terms of duration) were the best predictor of later manic episodes.

It should be noted that the American Journal of Psychiatry has a multitude of studies that suggest that people who suffer from Major Depressive Disorder (MDD) have a higher susceptibility to Bipolar Disorder and that subthreshold hypomanic symptoms that are found in people suffering from MDD should be taken into consideration when diagnosing. Placing these people instead on a bipolar spectrum, hence altering their treatment plan by incorporating a mood stabiliser which can also assist with the present MDD.

 

 

The Morning After I Killed Myself, I Woke Up.

*Thought this was a pretty epic story by Meggie Royer – for anyone who has thought about the day after it’s all over. 

I made myself breakfast in bed. I added salt and pepper to my eggs and used my toast for a cheese and bacon sandwich. I squeezed a grapefruit into a juice glass. I scraped the ashes from the frying pan and rinsed the butter off the counter. I washed the dishes and folded the towels.

The morning after I killed myself, I fell in love. Not with the boy down the street or the middle school principal. Not with the everyday jogger or the grocer who always left the avocados out of the bag. I fell in love with my mother and the way she sat on the floor of my room holding each rock from my collection in her palms until they grew dark with sweat. I fell in love with my father down at the river as he placed my note into a bottle and sent it into the current. With my brother who once believed in unicorns but who now sat in his desk at school trying desperately to believe I still existed.

The morning after I killed myself, I walked the dog. I watched the way her tail twitched when a bird flew by or how her pace quickened at the sight of a cat. I saw the empty space in her eyes when she reached a stick and turned around to greet me so we could play catch but saw nothing but sky in my place. I stood by as strangers stroked her muzzle and she wilted beneath their touch like she did once for mine.

The morning after I killed myself, I went back to the neighbors’ yard where I left my footprints in concrete as a two year old and examined how they were already fading. I picked a few daylilies and pulled a few weeds and watched the elderly woman through her window as she read the paper with the news of my death. I saw her husband spit tobacco into the kitchen sink and bring her her daily medication.

The morning after I killed myself, I watched the sun come up. Each orange tree opened like a hand and the kid down the street pointed out a single red cloud to his mother.

The morning after I killed myself, I went back to that body in the morgue and tried to talk some sense into her. I told her about the avocados and the stepping stones, the river and her parents. I told her about the sunsets and the dog and the beach.

The morning after I killed myself, I tried to unkill myself, but couldn’t finish what I started.
By Meggie Royer

Go Away Anxiety, You Have No Friends.

Having an anxiety attack is no walk in the park, it’s really quite disturbing, you believe that something is physically wrong with your body. I begin by having non-stop over-analytical thoughts followed by light headiness, limp arms and heartburn/palpitations that can last hours (I never get heartburn unless I’m experiencing anxiety), to say the least it isn’t a cup of tea. In my own way I triggered my anxiety by having distrust in another, I couldn’t stop myself. Anxiety can be like a dictating sovereign, ruling your moves and planting seeds of doubt in your foundations. I start to see every opposing and unbalancing situation in my life as a battle, a battle that has to be won, sacrificing your casualties and making the most of the fighting force that you have left. Why does everything have to be war though, bleak, desolate and crippling.

The aftermath of a war sometimes having more devastating consequences than the actual battle. We learn from war, we learn what we can do better next time, we learn what worked and what didn’t and how to best remain afloat. To be brutally honest during this war on anxiety I was a bitch, leaving causalities strewn in my wake. Today I realized what I had done, the thick curtain of anxiety lifting, the storm had past, now I need to workout what I do and don’t have to apologize for. I’ve been trying to get off my medication, but I’ve failed and the embedded reliance and unsubstantiated belief in the worth of psychiatry and psycho-pharmacology has won out.

anxiety-girl-funny-quotes

The Hidden Masquerades & Mutuality.

My story is about a friendship I formed two years ago, it seems like much longer. We were two sad little girls sitting all alone with attachment issues.

One of my many nights of drinking, excessive drinking. ‘Classily’ indulging in two bottles of wine to myself, past the point of inebriation. Tonight was new, it was her house. She was this small eccentric ball of fun, like a small child chasing the butterflies. She was beautiful, so comfortable and alluring in her uniqueness. In my own way I was fascinated and mesmerised by how she drew people to her. I didn’t realise then the underlying toll that she was putting on herself by being part of this social gathering, by pretending to fit in.

Social_anxiety_by_FallenRox

The hours slowly passed and I was drunker(I wonder how that was even possible), thinking that I might make a pass at her but undecided if she was interested. It wasn’t what I expected when I walked into the dark room where she had been sitting, quietly isolating herself from the others with tears falling down her face. All my intentions quickly dissipated, this was different, this was real. Her body shook, physically racked by her emotions. I sat across from her, waiting for her to speak, uncertain if I should embrace her. Through the tears and jumbled words I found out that today was her dad’s birthday, her dad who had willingly taken his own life, like my own had.

I understood too well the pain that the selfish action causes to those around them. I asked her about him, trying to calm her breathing, I later confided in her something that only a handful of my closest friends new, the inner workings of person who also suffered from the abandonment of one’s parent, the build of attachment and trust issues. The deaths created foundations for our negative mental health. In her, I saw myself, I was the quieter subtly version of her, but we were still the same. Our friendship grew on the mutual hurt created by our parents. No one else understood in its entirety, no one could relate.

Her anxiety ruled her every day, not always able to leave the house. She would sit under all the covers on her bed, waiting for the day to be over, finding some comfort in the warmth. Her heart would start beating so fast, the quick panic written on her face, I could rarely calm her. The simplest of things would make her over-analyse, layer and layer of potential bad would fill her thoughts. The triggers making her fight the waves of nausea and the shaking confusion that would afflict her. I couldn’t make her panic go away, she was immune to the calm voices around her, the panic amplifying. I loved her and I still love her, she is a beautiful person that is slowly finding stability now, being more comfortable and happy for the first time in a year. I saw her the other day, the difference was overwhelming. In my own way I was the extremely proud mother.

1381394_839421942734750_954659834668011364_nMy pocket rocket.