Euphoric or Dysphoric? Ramblings… I’m Probably Nuts.

Looking at this post in the daylight I can definitely tell it’s been hypomaniacally induced. Sorry to anyone who read this post earlier, to those reading it now – it could’ve been worse.

*CRINGES* What an awful week. It’s been is an emotional riot, my emotions lashing out, stress setting them free (or the anti-depressant which has been added to my cocktail…), the dissent is definitely making itself at home.

I’m pretty sure I experienced a hypomanic episode for all of one day, I think. Wanting to rearrange all my furniture at 9pm at night and starting to sand back other furniture for my DIY projects is usually a giveaway for me. It’s like I have to do something, but not any of the things I’m meant to be doing (sorry university work, you will still be there in the morning). After recognising this and my annoying/over the top behaviour which my partner told me was annoying, not to mention talking too fast and having snowball like ideas – they are always great ideas, anyway – point being I quickly took all my medication because I didn’t want to sleep (doubling the sleep meds) and proceeded to knock myself out. Waking up the next morning I felt extremely normal, except the following days I became so discontent that I’m just not happy with anything, it’s usually furniture (I swear I can be obsessive compulsive sometimes). I’m still discontent, I don’t want to go home and deal with my head being even more unhappy. I’m currently in my university’s 24hr library at 1am, who needs sleep anyway?!

I actually had a point to this post which wasn’t meant to be drowning in my current whinging and whining state. POINT: I liked to believe that to experience hypomanic symptoms you were meant to have the episode for 4+ days, they failed to mention that these mood extremities could take place daily and leave as quickly as they came without being classified as an ‘episode’. Some people only experiencing (hypo)mania once, others (apparently) have daily mood swings regardless of their diagnosis into our ‘categories’, each individuals pattern is distinctive. My only hypomanic episode was one which lasted around a week, I’m now realising that other times I have experienced the same symptoms for shorter durations – “hypomanic episodes tending to last a few hours or a few days”. I’m under the firm belief that I don’t have rapid cycling; instead I have fluctuating moods based on stress levels.

John Preston, PsyD, Psychology: “During euphoric hypomanic episodes, people have a heightened sense of well-being and are very productive and gregarious. During dysphoric episodes, people are agitated, pessimistic, and restless.”

“Even people who always take their medication and are careful with their health can still have mood swings from time to time. That’s why it’s important to catch changes in your mood, energy levels, and sleeping patterns before they develop into something serious.” – What arseholes.

“People with bipolar disorder are seven to eight times more likely to experience an unwanted, extended period of extreme mood shift — failure of their usual coping mechanisms — in response to a stressful life event,” says Dr. Bennett.

Ramble: Appetite suppressants have been linked to manic episodes…great, no quick fix skinny pills for me then.

Interesting abstract from a site I found:

“Anxiety, mood and energy, all waving up and down, sometimes with each other, sometimes one going off without the others:  a total mess, right?

People with such instability have big changes in their mood, or energy, or creativity over time. Here the green curve represents mood, the red curve represents energy, and the black curve represents “intellect” (speed of thought, creativity, ability to connect ideas).

As you can see, if they all go up together — and far enough “up” — this would be what is commonly called a manic or hypomanic episode, as shown at point A on the graph. If they all come down together, far enough, that would be an episode of “major depression”, as shown at point B. But now we can see how “agitated depression” could be part of a bipolar problem, when the energy curve is up while the others are down, as at point D.

Point C represents an unusual combination usually recognized only on inpatient psychiatry units, when a person is agitated yet hardly moves, so-called “manic stupor”. But imagine what a milder version of this would look like: the person would know she needed to get moving, indeed she would be thinking of many things she needed to be doing, and she might really want (in a very powerful way) to be doing them, and yet her body would refuse to go along. She would be lying there on the couch, miserable yet not really depressed, wondering what was wrong with her and why she couldn’t get herself going.

Point B represents another very important combination we psychiatrists see commonly: the energy wave is up, but the mood wave is down (in this case, the timing is such that the intellect wave is up too, but not as high as the energy — yet there are many combinations, as you’ll see in a moment). This could be called “dysphoric mania”: energized, as in a usual manic phase, but mood is very negative.”

**********

Okay, new point:

• Bipolar Disorder is clearly handled with medication first, bipolar-specific psychotherapies coming second.
• Self-harm: Isn’t always about the excessive depressive/self-hate/suicidal times, sometimes it’s an attempt to ‘treat’ severe agitation or as a punishment. The behaviour often disappearing quickly when the agitation is reigned in.
• It’s getting sadder, the more I have to face my own reality, I can’t deny Bipolar Disorder anymore, it’s becoming too blatant and overbearing
• Caffeine can cause hypomania ‘like’ symptoms…yay…
• Current evaluation: I get super excited for particular activities (DIY/buying furniture etc), start doing a bunch of things, only to run out of steam, spending way too much money, asking myself why am I doing this?! I have much more important other things that need to be completed – needless to say, I’m here typing instead of doing all the important things, looking up journal articles about Bipolar Disorder to seek comfort in knowledge.

♩ ♪ ♫ ♬ ♭ “Everything that kills me makes me feel alive…Everything that drowns me makes me wanna fly” ♩ ♪ ♫ ♬ ♭

Medication: 400mg Lamictal, 25mg Quetiapine & 3mg Haloperidol. Mostly taken consistently.
*image by angrymikko

 

The Rise Of Psychiatry Has Augmented The Rise Of Madness Through Medicalization

When psychiatry is ‘curing’ the deviants of society and is invested in the restoration of normality.

It’s been a long while since I’ve last written, I’m not exactly sure why. Maybe, just maybe it’s because I’m not feeling too high or too low, the lows always lasting longer than the highs. Psychiatry has been playing on my mind lately, pills and potions; we’re overdosing, sick, sick, sick, I hear them say it. The pills fail to fill the void, has the void always been there or are the pills’ telling me that something needs to be fixed.

I was never meant to fix myself, the bruises on my thighs are like my fingertips, eerily matching the darkness that I feel. The darkness is like beautiful cherry blossoms that are always about to bloom, they are always so pretty, but they are always gone too soon. 

An attack on psychiatry: The original rise of asylums has allowed the confinement of madness to be ‘treated’, reclassifying a non-medical problem as a medical problem. Medicalization is the defining of non-medical problems in medical terms, usually as an illness or disorder, and usually with the implication that a medical intervention or treatment is appropriate (Zola, 1972). Medicalization leads to “normal” human behaviour and experience being “re-badged” as medical conditions. Rebadging “deviance” as a series of medical disorders, the engines driving medicalization have been identified as biotechnology (especially the pharmaceutical industry and genetics), consumers, and managed care. The hubris of psychiatry, believing originally that they could cure all psychological problems with psychoanalysis, psychiatry still failing to improve the average levels of happiness and well-being in the general population. Psychiatry is able to pump out psychotropic drugs, not save mankind, attempting to alleviate our ‘age of disenchantment’.

We are treated, analysed and regulated scientifically, living by a manual which fails to understand the sociological impacts and failings of society. Have we potentially been manufacturing our own madness? Postmodern psychiatry seems to have become a tailor-made diagnosis for an age of disenchantment. Are these psychiatrists potentially manufacturing madness? Is the medicalisation of madness reducing creativity, the creative aspects of people commonly misinterpreted as deviants? Centuries of creative people from all modalities have suffered from mental illnesses, resisting treatments which could potentially ease their conditions, fearing that it could cloud or alter their mind, drugging them into submission, proceeding to quash their inner creative impulses.

Edvard Munch: “I want to keep my sufferings. They are part of me and my art.”

Van Gogh: “Men have called me mad; but the question is not yet settled, whether madness is or is not the loftiest intelligence, whether much that is glorious, whether all that is profound, does not spring from disease of thought, from moods of mind exalted at the expense of the general intellect.”

Psychologist Maureen Neihart: associates the shared characteristics amongst creative production and mental illness, which include mood disturbance, a tolerance for irrationality, greater openness to sensory stimuli, restlessness, speed of thinking, and obsessiveness of thought.

Marcel Proust: “everything great in the world is created by neurotics;”

Seneca quoted Aristotle as having said, “No great genius was without a mixture of insanity.”

Many psychologists believe that artists use their work to heal and soothe their minds. But if drugs heal artist’s minds for them, is their work still needed, or would it even be produced, would their work even be needed? I always found that my over-sensitive and stimulated mind would always find so much more beauty in the world, glimpsing the magical and maniacal way of being present. Sometimes the pills keep me from spiralling into the abyss of the rabbit hole, the terror, but also the creative language which comes from seeing both sides, the place that is sometimes so warm and comforting but at the same time cold and hard. We’re definitely a pill popping society, whether it be vitamins or hard core anti-psychotic sedatives (Haloperidol…I’m talking about you, you’re such an exhausting and all-consuming prick). I’m not writing off psychiatry as a professional form of medicine, I just believe that they are infested with conflicts of interest, most commonly the extensive influence of the pharmaceutical industries over modern medicine.

End note: I do not mean the use of the word “madness” to be taken in any offensive way; it is used in the same way that sociology and psychology have referenced it in academic journals.

“We Were Born Sick, You Heard Them Say It”.

Looking at the cultural sociology of mental illness.  

Mental illness can be interpreted as the most solitary of afflictions to the people who experience it, but it’s the most social to those who experience its effects. It becomes difficult to draw and define specific boundaries around mental illness and distinguish it from eccentricity or mere idiosyncrasy. It’s nearly impossible to clearly differentiate  an obvious line of difference between madness and malingering, mental disturbance and religious inspiration. Erving Goffman sought to dismiss mental illness as a purely socially constructed category, limited as a mere matter of labels. By exploring the quintessentially individual act of suicide an expansion from Gothman’s mere labels can be  expounded upon. Suicide is directly linked with mental illness, by examining this relationship the most florid manifestations of mental disturbance can be observed.

Mental illness has been interpreted as a product of sociological factors, an ‘anomie’ or the failure of sociological order to adequately regulate the beliefs and behaviors of its members. It has often been questioned whether people should take the Thomas Scheff approach, whereby the medical model of mental illness is dismissed and replaced with the societal reaction model, wherein patients were the victims of psychiatry. Advances within the cultural sociology of mental illness encompasses the progressive abandonment of the prior commitment to the segregative responses to serious mental illness and the run-down of the state hospital sector, the collapse of psychoanalysis – replaced by biological basis, the psychopharmacological revolution, the so-called neo-kraepelinian revolution, and the rise of the DSM to the position of overwhelming importance  – worldwide.

Sociology demotes psychiatry to a belief in vague predispositions to nervousness or madness, with no proven bodily cause, promoting their lack of clear-cut laws pertaining to their biological research, dealing with symptoms, not signs.  Diagnosing a person’s mental illness becomes based on the judgments generated through their communications, their treatments based off their diagnosis lacking widespread specificity. Psychiatry relying on psychoanalysis also called depth or psychodynamic psychology, proposes that the mind is divided in conscious and unconscious parts and that the dynamic relationship between these gives rise to psychopathology (the study of the manifestation of behaviors and experiences which may be indicative of mental illness or psychological impairment).

Psychoanalysis becoming paradoxical because it’s concerned with the notion that we are all ill – psychopathology is ubiquitous, varying between individuals only in degree and type. These norms discerned within psychoanalysis mediated by the intrapsychic mechanisms. Norms within society imply that an ideal notion of mental illness exists, although it would be limited by its susceptibility to be meaningful to those only in a culture who subscribe to their theoretical premises, emphasizing its lack of unity and ineffectual distribution on a wider scale. Cultural notions of mental illness also initially linked  early biological psychiatry immediately with the mad, the bad and the dim. Sociology further attacks the definitions given to mental illness, arguing that the inter-dependent constituents are not defined or explained in relation to their classification of impairment, disturbance, disability, disorder etc.

“We were born sick, you heard them say it”. To reiterate the heading and these fantastic lyrics – I think that they reinforce the schema that is associated with mental illness and to an extant the relationship/pattern between cultural/environmental influences on the etiology of mental illness.

Lately I’ve been living in the daydream just behind reality’s veiled curtain. The unsuspecting whore of mental illness, my ability to be both a victim and a rational opportunist. The victim to the triggers that my mind shudders against, the twisted opportunist that seeks the deep dark insights pertaining to the inner turmoil and joy. It’s a pretty twisted sick cycle, but its ok at the moment. It’s more of an ongoing ‘normal in training’ session. I keep wondering if my psychiatrist will ever give me a ‘gold star’ or tick of approval or whether we are all merely the embodiment of an epic psychoanalysis that perceives all as ill. Relying on my psychiatrist as my state-licensed drug dealer who specializes in ‘mood-altering’ drugs, hoping to create a balance which has to be practiced every day. Do we take the early sociological stance that no one is mentally ill or abide by the strict categorizations of mental illness that are created and regulated by so few. Life is to constantly challenge all that confounds you, rejecting the notions of those who remain unsubstantiated and to remain skeptical of those wishing you to blindly follow their ideologies.

Playing Devil’s Advocate With Key Religious Figures And Mental Illness Correlations.

Disclaimer: Not my own thoughts, the research is from the Journal of Neuropsychiatry – The Role of Psychotic Disorders in Religious History Considered. This blog entry is me playing devil’s advocate to provoke debate; I’m not in any way trying to undermine a person’s religious beliefs, simply trying to encourage discourse underlying subconscious preconceptions of mental illness within religion.  

Thoughts to be considered before reading:
-Why would it be so bad if the inspirational figures in religious history experienced mental illness?
-Why do we subconsciously reject the thought that God wouldn’t work through people who have mental illnesses?
-Does being mentally ill make you exempt from God’s work and unable to meaningfully participate in worship when one in four people have been statistically proven to suffer from mental illness at some point in their lives.

The awkward moment when it becomes plausible that Jesus suffered from Schizophrenia (Just to clarify: this wouldn’t in anyway take away from his religious position, history and achievements).

A study was conducted by psychiatrists when they were presented with a concept by a paranoid schizophrenic patient, who claimed that he could read minds and was selected by God to provide guidance for mankind. The patient refused to take the medication because they stopped the voices, presenting his doctors with the question: “How do you know the voices aren’t real…How do you know I am not The Messiah…God and angels talked to people in the Bible”. The patient raised interesting questions, how does one distinguish between people with mental health disorders and those of religious figures in history?

One of the examples the doctors used in their journal article was Jesus, by examining passages within the bible they located specific areas that presented symptoms of mental illness:
Paranoid-type (PS subtype) thought content: Matthew 10:34–39, 16: 21–23, 24:4–27; Mark 13:5–6; Luke 10:19; John 3:18; John 14:6–11

Auditory and visual hallucinations: Matthew 3:16–17, 4:3–11; Luke 10:18; John 6:46, 8:26, 8:38–40, 12:28–29

Referential thought processes: Mark 4:38–40 (Figure 3); Luke 18:31

Within the New Testament Jesus exhibits behaviours that closely resemble the DSM-IV-TR– Auditory hallucinations, Visual Hallucinations, delusions, referential thinking, paranoid-type, (PS subtype) thought content, and hyper-religiosity. Through the text Jesus also displays signs of disorganization, negative psychiatric symptoms, cognitive impairment, or debilitating mood disorder symptoms. The article poses the question about whether starvation and metabolic derangements caused some of the behaviours as Jesus experienced hallucinatory-like visions whilst he fasted for 40days in the desert (Luke 4:1–13).

Jesus’ experiences appear to have occurred over the course of at least the year before his death. There is a notable lack of physical maladies which suggest psychiatric aetiologies as more plausible. There is a 5%–10% lifetime risk of suicide in persons with schizophrenia.  Suicide is defined as a self-inflicted death that has intention to end one’s life. The New Testament recounts that Jesus was aware that people intended to kill him.  Jesus took the steps to ensure that his followers were aware that his death was necessary for his return (Matthew 16:21–28; Mark 8:31; John 16:16–28). These passages appear to present Jesus to deliberately place himself in a situation wherein he anticipated his execution. Schizophrenia is often associated with increased risk of suicide.

There is a term called ‘suicide-by-proxy’, any incident whereby a suicidal individual causes their own death to be carried out by another person.  Jesus’ behaviour before his death has parallels with someone who premeditates a form of suicide-by-proxy. In the passage Mark 3: 21: Jesus was on occasion viewed as mad or “beside himself.” People from Jesus’ hometown and the religious authorities of the day also did not accept his message. Subsets of individuals who have psychotic symptoms appear to be able to form intense social bonds and communities, despite having distorted views of reality. The study analysed the religious figures from a behavioural, neurologic, and neuropsychiatric perspective. The research indicates that the experiences of the individuals coincide with psychotic symptoms, suggesting that manifestations of their experiences had a primary or mood disorder-associated psychotic disorder basis.

A main goal of this research was to evaluate the influence of individuals with mental illness and their effects on shaping the Western civilization, hoping that the findings will help to increase compassion and understanding in relation to mental illness. Within the research it should be noted that they did use explicit passages from the bible, but each passage should be examined in its own context. It is generally acknowledged that biblical scholars are not unanimous about the literality of the scriptures nor are psychiatrists completely unanimous about the DSM (basically the bible of psychiatry). The research conducted a form of psychological profiling by people that aren’t saddled with the preconceived notions and biases that encumber those that have studied their field in depth, allowing a fresh take on ideas that have been overanalysed by people in the same area of study.

Only by joining multiple areas of study can any true concept of history be interpreted, attempting to remove the elitist theories that dominate popular thought. It needs to also be acknowledged that historians aren’t the sole area of study that can interpret history, other fields of study have valuable insights that historians can lack.  The article didn’t stipulate and designate that religion was the cause for psychological symptoms, neither did it go into the scientific explanation, but it still needs to be acknowledged that religion does play a dominating role for some psychoses, especially with delusions. Does the motivating factor of religion in mental illness make it a definable feature??

I’m increasingly intrigued by the article when it encourages speculation on our inability to disprove that a person who is schizophrenic is a mouthpiece of God or is suffering from psychoses. The opposing opinions from both sides need to be taken into consideration; biases from long term studies ultimately detract from the viability of the research. The study showed the correlations that religious historical figures had with the current DSM, they acknowledged their limitations, like either psychological or biblical should do, my main question is this: why would it be wrong if they had suffered from a mental illness, it doesn’t detract from their accomplishments or their religious foundations, each person’s beliefs will always be grounded, who’s to say that God didn’t use psychoses to achieve his end.

I didn’t want to post this all week, didn’t want to ruffle anyone’s feathers. I came across this article, it really interested me, I understand its controversial, I am in no way promoting and detracting from either side and hope my post won’t be interpreted as such. Thank you.

Author and Article Information

From the Dept. of Neurology, McLean Hospital, Harvard Medical School, Belmont, MA (EDM, BHP); Dept. of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA (MGC); Dept. of Neurology, Massachusetts General Hospital, Harvard Medical School, Belmont, MA (EDM, BHP).

Murray, E., Cunningham, M. and Price, B. (2012). The Role of Psychotic Disorders in Religious History Considered. JNP, 24(4), pp.410-426.

New Research On The Aetiology Of Bipolar Disorder.

John D. Pettigrew and Steven M. Miller argue that the underlying pathophysiology for Bipolar Disorder remains elusive, the disorder being strongly heritable but acknowledging that genetics are complicated. Pettigrew and Miller use the term inter-hemispheric switching which looks at trait-dependent biological markers associated with bipolar disorder. Proposing that bipolar disorder is the product of genetic propensity of slow inter-hemispheric switching mechanisms which can become ‘stuck’ in one particular state. Pettigrew and Miller state that slower switches are more ‘sticky’ in contrast to faster switches, hypothesising that the clinical manifestations of bipolar disorder can possibly be explained by hemispheric activation, which could be caught on the right (depression) or the left (mania). The research is based on rates of perceptual alteration in binocular rivalries that appears to be slower in bipolar disorder subjects who are in euthymic states in contrast to the normal controls.

The research data showed that bipolar disorder patients clustered on the tail end of the distribution indicating a slower alternation rate. The Rivalry Alternation Rates: Bipolar Affective Disorder (n = 18) vs  Non-Clinical Controls (n = 49). Subsequently the euthymic state of the bipolar subjects at the time of testing suggests that slower rivalry rates can be a trait marker for bipolar disorder. Limitations of this study are related to subjects that have unipolar depression who demonstrated slower rivalry rates, although these subjects were to a lesser extent in contrast to bipolar subjects. The model of “bipolar disorder slow switches are ‘sticky’ switches because the intrinsic channel abnormalities that cause the slow oscillation rate also make the switch more likely to be held down in one state by external synaptic inputs”. A neuronal sensitivity with bipolar disorder argues that it would “lead to increased hemispheric output (in response to a stressor) and might therefore increase the likelihood that the switch will be held down (‘stuck’) on the side favouring that hemisphere”.

Pettigrew and Miller propose that the data suggests that bipolar patients have an increased ‘stickiness’ due to reduced intrinsic currents and greater extrinsic synaptic inputs from stressors, resulting in the patients being ‘stuck’ in a depressive or manic episode as a consequence of a stressor. The research proposes that the wide variety of data is indicative of hemispheric asymmetries of mood and mood disorders. Overall the results of the tests in inter-hemispheric switching might also be applicable to understanding the physiological rhythms of mood, cognitive style and other aspects of human brain function. Pettigrew and Miller outline that there have been reports that creativity is enhanced in subjects with mood disorders and also their relatives in contrast to the general population.  The controversial reports of increased creativity raise the potential for an understanding of the consequences associated with slower inter-hemispheric switching and the rhythms of cognitive style that could reveal neural mechanisms of human creativity.

Please note: this is not an academic essay merely a series of different research I found interesting.

Related/interesting sources:

Altshuler, L., Suppes, T., Black, D., Nolen, W., Leverich, G., Keck, P., Frye, M., Kupka, R., McElroy, S., Grunze, H., Kitchen, C. and Post, R. (2006). Lower Switch Rate in Depressed Patients With Bipolar II Than Bipolar I Disorder Treated Adjunctively With Second-Generation Antidepressants. AJP, 163(2), pp.313-315.

Bost-Baxter, E. (2013). ECT in Bipolar Disorder: Incidence of Switch from Depression to Hypomania or Mania. Journal of Depression & Anxiety, 01(05).

Bottlender, R., Sato, T., Kleindienst, N., Strauß, A. and Möller, H. (2004). Mixed depressive features predict maniform switch during treatment of depression in bipolar I disorder. Journal of Affective Disorders, 78(2), pp.149-152.

Buckley, P. (2012). The Neurobiology of the Switch Process in Bipolar Disorder: A Review. Yearbook of Psychiatry and Applied Mental Health, 2012, pp.388-392.

Calabrese, J. (2001). Drug-induced switch rates and their impact in bipolar disorder. European Neuropsychopharmacology, 11, pp.S95-S96.

Goldberg, J. (2010). Substance Abuse and Switch From Depression to Mania in Bipolar Disorder. AJP, 167(7), pp.868-869.

Kauer-Sant’Anna, M. and Yatham, L. (2007). Comment on “antidepressant treatment-emergent switch in bipolar disorder: a prospective case-control study of outcome”. Rev. Bras. Psiquiatr., 29(1), pp.86-87.

Koszewska, I. (1995). P-2-65 Pharmacotherapy in depression during switch from depression to mania in patients with bipolar affective disorder (BD). European Neuropsychopharmacology, 5(3), p.296.

Niitsu, T., Fabbri, C. and Serretti, A. (2014). P.2.d.031 Predictors for manic switch at depressive episodes in bipolar disorder: the Systematic Treatment Enhancement Program for Bipolar Disorder. European Neuropsychopharmacology, 24, pp.S431-S432.

Pettigrew, J. and Miller, S. (1998). A ‘sticky’ interhemispheric switch in bipolar disorder?. Proceedings of the Royal Society B: Biological Sciences, 265(1411), pp.2141-2148.

Alice & Her Attempt At Leaving Wonderland.

It’s been cold in your shadow, my shadow. Never having sunshine on my face, your face. I have always been content to let you shine, to let me shine. I always walked a step behind myself. I was the one with all the strength, a beautiful face without a name for so long, a beautiful smile that hid the pain.

Having an epiphany when two facets of yourself become one, the one the world knows and the quiet self-conscious one inside, the one who stared out of the windows of life, not participating, merely watching and wondering why I couldn’t be both.

(Featured image: Girl walking up hill – by me 🙂 )

My new thoughts consist of pretending that I’m the normal person in the crowd, my boyfriend has found out the truth though, he has seen my scars, he holds me, asking me if I’m alright. The quick answer of “yes” always ready. Last night I told him I was fine, that I was bipolar and that it doesn’t affect me. These are the nice lies that I also tell to myself. He tells me that my scars and disorder hasn’t pushed him away, but I always wonder. It’s nice to know that someone doesn’t see me for my scars. My quick smiles use to hide the sadness in my eyes, but now they are simply smiles. I won’t cut tonight, in my mind that chapter is slowly getting closed.

I don’t need the balance that I found in the blade and the simple ritualistic movements. The never-ending perplexity of non-suicidal self-injury. My happiness and depression making me question what really separates the genius from the madman? New ideas and thought processes are created by people living on the edge instead of the norm. I’m stumped that Bipolar Disorder keeps on getting referred to as a ‘beast of an illness’, it is what it is, you make the most of it, the negatives are only what you make of them. Someone once told me that I’m a ‘beautiful tragedy’, it made me completely disheartened, this happened even before my diagnosis, this was an asterism (a manner of deriding another), these conflicting words made me realise that the only real tragedy was them and their ignorant concept of beauty. At that point in life I was incapable of helping or ‘fixing’ myself, yet people asked me to fix their problems…ironic.

There wasn’t any room left for tears. I’m not that person anymore, thankfully. It’s become silly and trivial, I’m 22 and bored with the useless criticisms from myself and others, life is simply too short. Feeling ‘happiness’ has allowed me to no longer feel like the abandoned shipwreck, finding deep inside a small seed of happiness that I could allow to grow. There seems to be constantly different peaks in my life where at times I feel like I’m running an emergency room without morphine. I’m actually happier than I’ve been in over a year, I’m slowly replacing all my excessive black clothing with the colours that I had squashed to the back of my wardrobe, with the purpose of never finding them or needing them again. People start to get in a cycle where they stop believing in the possibility of being happy because the darkness becomes so consuming and comforting.

The Mental Illness Soapbox.

It’s beginning to feel like I’ve been in a long term relationship or dead-end marriage with mental illness. The bipolar black hole is so intense and consuming, eh…I’m even sick of myself. *Bipolar has officially killed the prom queen*

The Blame Game: Antidepressants Cause Bipolar Disorder?!

Previously the older anti-depressants were notorious for triggering or precipitating (hypo)manic episodes in Bipolar patients, newer antidepressants such as SSRIs, bupropion and venlafaxine, do not appear as likely to precipitate mania. Both the mood stabilisers lamotrigine (Lamictal) and Topiramate (Topamax) don’t carry a risk of inducing mania.  In the DSM-IV and DSM-V (Diagnostic and Statistical Manual of Mental Disorders) stipulates that diagnosing a person with Bipolar Disorder has to fit these criteria:

Criteria F: The episode is not attributable to the physiological effects of a substance (e.g. a drug of abuse, a medication, other treatment).
Note: A full hypomanic episode that emerges during antidepressant treatment (e.g. medication, electroconvulsive therapy) but persists at a fully syndromal level beyond the physiological effect of that treatment is sufficient evidence of a hypomanic episode diagnosis(My note: most* antidepressants other than Prozac are out of your system in a week). However, caution is indicated so that one or two symptoms (particularly in creased irritability, edginess, or agitation following antidepressant use) are not taken as sufficient for diagnosis of a hypomanic episode, not necessarily indicative of a bipolar diathesis.

Very sneaky phrasing of words.

It has been asserted that antidepressants can act as triggers for (hypo)manic episodes in people who have a higher likelihood of Bipolar Disorder (depression, history & environmental factors etc.). It has been argued that having a (hypo)manic reaction to an antidepressant is not necessarily a symptom of Bipolar Disorder, arguing it’s a manic reaction to the antidepressant. This form of argument can only be assessed by being aware of what antidepressant you’re taking, newer antidepressants have very little chance of inducing mania (rare side effect : <0.1% chance mostly). I had initially blamed the antidepressant for causing my ‘bipolar symptoms’, this has now been changed, I was on Mirtazapine (given to me because of a family history of Bipolar I – this antidepressant had the <0.1% chance of inducing hypomania, agitation, aggression, risk taking, confidence, confusion and insomnia. All of which I experienced long after the antidepressant had left my system).

Symptoms of (hypo)mania need to persist after the life of the antidepressant: A manic reaction to antidepressants is not a symptom of bipolar, it’s a manic reaction to antidepressants. Therefore people who have a diagnosis of Bipolar Disorder who have a manic reaction to anti-depressants, doesn’t consequently mean that it’s Bipolar Disorder.  Symptoms of bipolar (hypo)mania are sometimes about being more irritable, edge and agitated, but these symptoms don’t mean it’s bipolar, they are generally symptoms of the antidepressant or its withdrawal. Sometimes it’s about surviving psychiatry. A test study about the activation of (hypo)mania states that it occurred approximately 0.2% (3/1299 patients) of Remeron-treated patients in US studies. Although the incidence of mania/hypomania was very low during treatment with mirtazapine, it should be used carefully in patients with a history of mania/hypomania.

The following symptoms, anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, and mania, have been reported in people treated with (older)antidepressants for major depressive disorder. Before being prescribed antidepressants your doctor should be aware of your medical history or family history of psychiatric disorders (e.g., bipolar/manic-depressive disorder), history or family history of suicide attempts. To be diagnosed with Bipolar Disorder the new DSM-V has included the criteria that the person has to not only have the presence of elated or irritable mood but also the association of these symptoms with increased energy/activity.

Personal analysis: I’m not sure if I had suffered from hypomania before, every summer I would work out excessively and sleep little, this was only for the past 2years, but after Remeron (Mirtazapine) everything changed. My research was carried out on the premise of proving my psychiatrist wrong in my diagnosis. I had slowly put together my argument until I had looked up my antidepressant and the time it takes to leave my body. I now have to acknowledge that I no longer have an argument; my hypomania lasted well after the antidepressant had left my system and later returned when my mood stabiliser dose was reduced so that I could change medications. If anyone else has doubts about their diagnosis it is well worth the research into the causation of your (hypo)manic episode, if it was from an antidepressant find out how long your episode lasted and the time is takes for the antidepressant to leave your body.

To make up for this realization is the knowledge that I had an awesome day in Luna Park at Sydney, here is some snaps 🙂

An Attempt At Being Truthful About Suicide & Media Correlations.

I would think about suicide often, with a morbidly intense curiosity, never with the ability to carry out any plans. I couldn’t stop myself from thinking about the day after the act, thinking of what I would be doing. My misconceptions of death were my driving interest, pivotal to understanding the finality associated with death which I clearly didn’t comprehend. I started to think of suicide at 7 years old, not in any strong capacity, a more unhealthy preoccupation about something I didn’t understand. Death scared me, the thoughts kept me up late at night; I would always think “what if I wasn’t around? Would things be better? Would I be better off?”.

A child is given the simple idea that when people die they go to ‘sleep’, they look asleep and as far as their parents are concerned the pets went to ‘sleep’ when they were put down. Early on we are given these ideas, fragmented concepts that hide actual truths. All through my school life my preoccupation was present, not always in the forefront of my thoughts, but always present none the less. In my mind I doubt I would ever have the nerve to carry out the act, the thought of blood stilling or hearts stopping makes me recoil away, intentional death becomes a monstrous act. It’s a monstrous act because most intentional acts of death are forms of violence and anger, sometimes premeditated or acts of manslaughter. Society negates death in such a light that even for ethical reasons it will always be frowned upon.

I write this after successfully drinking a bottle of red wine and finding out that a work colleague had opening tried to commit suicide on numerous occasions, publicised in our local paper about the realness of teen suicide and awareness. It made me wonder if I was just like her, except I wasn’t, I might be more sadistic and morbid, but I had no intentions, my suicide ponderings were not only during depression but also during times of great happiness in my life. I start to question why a person who is happy actually contemplates suicide on a regular basis. No person can adequately contrast their personal experiences or their inner turmoils, each individual is innately different with how they interpret and experience life as a whole. I start to wonder if this is a normal state for people or am I outside the norm without realising it, can it simply be that the norm is whatever a person wants to make it, what is normal for one person isn’t always normal for another.

I’m starting to question my own mental health awareness advocacy, I want people to be aware, but what they do with that information is entirely up to the person. It’s strange that I actually frowned the whole time of was reading my colleagues article, whose work pretence was good I will admit, but does admitting mental illness to a wider audience actually help yourself or is it merely about raising a generalised awareness to a public that is generally overwhelmed with other stimuli offered by media that dominates their thoughts? My pretence is focused more internally, I prefer to write, be anonymous, protecting myself, protecting my family from the hurt if they knew the truths from my writings. Putting an article in the local newspaper is following a new trend to make mental illness a ‘trending’ topic, highlighting its need for change and help.

I see the publications as sometimes detrimental, people start to only see the negatives associated with mental illness, the overloading of negatives creating the stigma that so many people in the mental health awareness advocacy are trying to remove. The publications are trying to make the public more aware, but they are failing to educate to a higher extent, the public doesn’t understand mental illness to any great degree, they see and read its consequences and why it’s an issue, but they fail to understand why some people suffer from mental illness and why others do not. They can even read the symptoms that people suffer, but that doesn’t make the content relatable. Yes this is a depressing post, but it allows me to vent the rage about mental illness and media, in its own way it’s a form of censorship. Only those who experience mental illness can help others, public media doesn’t always have to be the way to achieve this, often categorising and pigeon-holing mental illness creating misconceptions. End rant. Thankyou wine for allowing me to write tonight.

Analysis Of Happiness & Mania. Part I

Analysis of Happiness & Mania

Defined:

To first understand happiness it needs to be defined. Happiness is seen as a complete, lasting and justified satisfaction with one’s life. Although if one has to justify their happiness it is no longer experienced subjectively, becoming objectively grounded. It has to be understood that there is no standardised rules to measure a person’s happiness as they are dependent on a person’s pre-dispositions.

Background:

Two philosophical schools who look at the concept of happiness, the ancient, which arose in Greece and survived until the 18th century, and the modern, which was created in the 19th century in Europe. Happiness was originally perceived as the possession of the highest goods, whether of a material or spiritual kind. Happiness later became subjectivized and relativized, based on a person’s overall satisfaction with life.

Happiness & Mental Health: The Darker Side of Happiness.

Happiness is usually conveyed as a source of good outcomes, highlighting the pursuit of important goals, social bonds, well-being and psychological health. In some instances the pursuit and experience of happiness can create negative outcomes. Happiness is generally highly beneficial but this is completely reliant on the context it is experienced in and the level of happiness.

“Getting angry . . . is easy and everyone can do it; but doing it . . . in the right amount, at the right time, and for the right end, and in the right way is no longer easy, nor can everyone do it.” —Aristotle, Nicomachean Ethics (II.9, 1109a27)

Potentially high levels of happiness can become a source of dysfunction, research often highlights that happiness is beneficial, yet psychologically it can become maladaptive. The maladaptive nature of happiness suggests that it has a possible ‘dark side’. People have argued that excessive levels of any mental state or experience—including happiness—can be undesirable and unhealthy. In relation to mania and the euphoric or heightened level of happiness (which is also experienced in hypomania) individuals are more inclined to engage in riskier behaviours, such as alcohol consumption, binge eating, and drug use. Extreme levels of happiness become a marker for emotional dysfunction.

The extremely positive emotion that is associated with mania undermines the person’s ability to experience negative emotions, trapped in a form of happiness overdrive and incapable of downshifting happiness. Excessive happiness leads to risky behaviour and neglect of threats and consequences. Extreme happiness seen through the lens of mania suggests that the emotion creates dysfunctional behaviours which result in poorer clinical functioning. The pursuit and achievement of happiness can no longer be seen as a hallmark for psychological health.

Subjective Bipolar Perception:

I had always imagined that happiness was a sign that I was getting better. After recently getting better from the pit that is depression, I keep wondering if this new happiness is real, or a daydream or merely a new page to living with bipolar. I have to remember that bipolar is part of who I am and why I feel things, but it never stops me from questioning the reasons for my emotional experiences and whether the emotions are manifestations of my illness or the signs of getting better. How can anyone fully differentiate between the two? It’s frustrating to say the least. To me there is great value in experiencing depression, without experiencing the worst aspects of your life you will never be able to completely appreciate the positive times. I can understand and relate to the all-consuming mania or hypomanic emotional overdrive, my personal experiences with hypomania made me incapable of understanding the consequences or perceive the drastic contrasts between my current state and depression, there was no room to understand other emotions.

This is truly my wonderland, a handful of pills keeping the bipolar at bay. The pills mediating a mid-line of emotions that are both boring and uninteresting. Unlike the majority of the population, people with Bipolar Disorder can actually reach the usually unobtainable level of happiness that society seems to always be aiming for, our level of happiness only becoming wrong when it makes us dysfunctional.

A Dark Side of Happiness? How, When, and Why Happiness Is Not Always Good. June Gruber, Iris B. Mauss and Maya Tamir. Perspectives on Psychological Science, Vol. 6, No. 3 (MAY 2011), pp. 222-233

Analysis of Happiness by W. Tatarkiewicz. Review by: E. R. The Review of Metaphysics, Vol. 32, No. 3 (Mar., 1979), pp. 569-570

Analysis of Happiness by Wladyslaw Tatarkiewicz. Review by: Max Rieser. Philosophy and Phenomenological Research, Vol. 38, No. 1 (Sep., 1977), pp. 139-140