Tag 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.

 

 

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Three Months of Freedom. I’m Back.

It’s been three months without thinking about Bipolar Disorder. Three months ago my psychiatrist started to think that I could potentially be Borderline Personality Disorder comorbid with Bipolar Disorder, it’s taken me two months to even acknowledge this. Borderline Personality Disorder can often co-occur with Bipolar disorder, having numerous overlapping symptoms. My psychiatrist sees the disorders linked in some people, existing on a mood spectrum where they interconnect. I’m against this analysis, I was mad, I’m still a bit mad. I slowly began to take myself off my medication. I cancelled all my other upcoming appointments, in my mind it was a big f*** off to mental health. I was good, I was on university holidays, no stress, nothing to trigger mood instabilities, and it was nice. University went back 4weeks ago, so I took myself back to the doctors, my psychologist, in contrast to my psychiatrist she doesn’t believe I’m BPD, but reaffirmed her belief that I need to monitor my moods and stay on top of my emotions. My psychologist forced the importance of Bipolar Disorder awareness back into the forefront of my mind. I’m still medication free, but the reality of mental illness is scary.

For anyone else who is or potentially has both Bipolar Disorder & Borderline Personality Disorder.

Development/Nature of the Illness:

Borderline personality disorder is a type of “personality disorder” which essentially means that it is a developmental condition – something that has evolved through the entire development of a person’s emotional/behavioural infrastructure.

Bipolar disorder is an illness that presents acutely or sub acutely (less than acute) sometime in a person’s life and is not, at least as we define it now, a condition that is part of a person’s core personality structure.

Course/Presentation of Symptoms:

Borderline symptoms are present as a person’s baseline– their difficulties with mood regulation and impulsivity, their ups and downs, are part of their life all the time. They are always up and down.

Bipolar symptoms present in episodes that must be a change from the person’s baseline – that is part of the diagnostic definition. Their episodes of depression or mania are a change from who they are when they are feeling well.

So the most annoying part of all of this: HOW CAN I BE BOTH! Uh… Having to exist on a spectrum with both, I don’t exhibit all symptoms of either.

Would love to hear from other people’s experiences.

Hope everyone has been well and happy. Love Alice.

*image by ahermin

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).

KraepelinWavesAs 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.

Dear Sleep: You Suck. Love Alice. (Happiness And Other Stuff, You’re Still Cool)

Are you coffee or vodka? Maybe you’re both. Happiness, hormones and sleep. 

Swallowing my sleep chemical cocktail, wishing it was wine. The booze was better than this tablet induced hangover. My elusive sleep plagued by parasomnia.

1 tablet
Nothing.

2 tablets
Nothing.

3 tablets
Nothing.

4 tablets
Sleep.

On the bright-side I’ve taken a proactive approach towards a healthier lifestyle…minus the drugs, but other than that I’ve been exercising and eating right. Fighting the bulge of medication, 1kg at a time. Life is better, the positives out weighing any negatives. I know I complain a lot about medication, but truth be told I’m too scared to go off them, afraid that it might ruin my nice new balance I have going. I’m vain enough that I care about my weight, my BMI normal, but that is never enough, I’m a perfectionist, I want my mind and body to reflect my current happiness. Sometimes it’s a hopeless intangible pursuit, other times anything can be possible. I’m writing less, no longer driven by the need to put my emotional turmoil of feelings into words, no longer motivated by depression. Depression makes good writing. Whinging is unbecoming, but it is also the recognition of dissatisfaction. Maybe I am just on the upwards spin of the bipolar spectrum, but all the same: I just don’t care; life can be good without it having to be on any emotional spectrum.

In the context of Bipolar Disorder there are high comorbidities associated between perfectionism/ anxiety and their relationship with bipolarity. Bipolar Disorder has a high co-occurrence with eating disorders, eating disorders often linked with a need for perfection. I’m not sure if people diagnosed with Bipolar Disorder have a higher likelihood of being perfectionists (would love to hear people’s personal experiences), the perfectionism of Bipolar Disorder is often motivated through anxiety, anxiety causing the person to see the inadequacies of their life. More often than not, binge eating is common among people with Bipolar Disorder, I will admit I have binge eaten, often in the search for a quick endorphin fix which will starve off negative emotions for a short time. The quick “fix” of endorphins can be seen through, sex, drugs and over eating/exercising, becoming a quest for endorphins. We try to manufacture our own happiness, these addictions often a response to depressive emotions. Through endorphins we experience contentment and euphoria. Realising that you can’t be a seeker for the bigger endorphin rushes, endorphins should become a more natural balance to encourage long term contentment.

endorphin_by_lepusplus-d80chg6Apparently people who are deficient in endorphins should eat protein with each meal, but I’m not sure how scientific that belief is. However, dopamine is released by foods with high protein, dopamine being a positive mood enhancing hormone. Looking at the more natural ways to deal with anxiety/depression – sunlight (serotonin),  exercise (endorphins), protein (dopamine), Phenylethamine (chocolate) and Ghrelin (for relief of stress – released when we are hungry, although this needs to be balanced by normal food intake, over-eating doesn’t maintain good levels). All these hormones can only be long term effective if you fix the root cause of your unhappiness, over doing it with any one hormone will not be beneficial in the long run. Moderating and persistence is key.

This was meant to be a post that focused more on sleep, as usual I get side tracked, and I also intended the post to be short…whoops.

Image by ElusiveDreams07 titled ‘Sleep Paralysis’

Image by Lepusplus titled ‘Endorpin’

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

My New Meditation Crutch, The Surprise Attack Of Psycho Girlfriend Syndrome.

Yesterday I was told that I need to treat myself like a car that can only take the best premium petrol, other cars can run smoothly on any fuel, yet if I don’t take particular care with what I put into my ‘car’ it won’t be running smoothly anymore. My psychologist used that metaphor, she is right, after all the festivities from Christmas, New Year, Australia Day and successive family birthdays, my body has been given foods that haven’t made me feel good. Alcohol and less time for stress relieving exercise have also played a role in my current emotional levels, the alcohol was in moderation and the exercising was down to 2days a week instead of my 4-5days. I guess it still mattered. My body and mind is tired, filled with lethargy and a bloated feeling of disgust. I forgot that my psychologist can actually have good insights sometimes. I didn’t realise that things that didn’t matter before like overindulgence and laziness actually had larger implications for my ability to maintain emotional stability.

Emotional stability is the hardest thing to maintain in my life at the moment, it’s a never ending battle; the slightest change in the breeze can change the emotional tide. I’ve been dating this guy for a few months now; I had actually forgotten what it meant to be in a relationship. It’s hard, it’s harder still to try and play it cool, failing to hide the constant anxiety over the things that he has reassured me about numerous times before. Avoiding the easy clingy nature that can develop, I don’t text often in general and I only make plans to see him a few times a week. I still feel like I’ve gone a tad ca-razy though, insecurities and tears coming all too easily. I’ve been meditating like crazy, trying to relax, searching for a mental balance. The meditating keeps me relaxed for a few hours, but after those hours its back to the same battle to reach a rational mentality – when he hasn’t spoken to you in six hours, realising that this doesn’t mean that he isn’t interested in you anymore – he works 15hr days – it’s hard to regain a rational front seat again, but it does eventually kick in.

My life has been filled with an incredible series of emotional and mental extremes, with beautiful thunderstorms and stunning sunrises. Meditating is all well and good, but it can’t be the crutch to get you through each day. I need to change the way I see things not just relieve my anxiety. Controlling my emotional triggers should be my main goal; everything else would eventually fall in line after that. I’m still constantly surprised that being in a relationship can change you into a sensitive over-reactive emotional mess. Cheers Bipolar, thanks for making life more difficult, again.

On a plus side – I baked brownies today, exercised and meditated twice today (argh what a lame crutch). Happy Monday all.

psycHOTic is a thing right?….

Best meditation apps I use:
– Stop, Breathe & Think (best one)
– Guided Meditation
– Citadel

I also like relaxing to Buddha radio on my phone.