A friend sent me the link to this great series by Stephen Fry on bipolar disorder. Worth a watch if you’re curious about how bipolar disorder manifests in someone’s life and some of the research into bipolar.
May my creativity be restored
On all levels
In all areas
When the Madwoman is transformed from destructive paths and embodied in creative ways, a woman will not give up her vision. Rid of the resentments, paranoia, and isolation that result when her anger is suppressed or goes unrecognized or unacknowledged, she will be free to create. Her vision will be clear and congruent, and she will have the courage and wisdom to embody it in the world. — Linda Schierse Leonard, Meeting the Madwoman
I am just finishing up reading this book, and if anyone would like to read it, I will be happy to send it along to you. Just leave a comment here and I’ll get in touch with you for a snail mail address.
Wow. Just go live at the Agonist today – Ian AND Stirling are on!
At the end of World War II the US had about half the world’s economy. Admittedly that’s because Europe had been bombed into oblivion, but even when Europe rebuilt the US was still far, far ahead. The US was insanely rich and powerful. See, when you’re rich you can do stupid and unproductive things for a long time. There are plenty of examples of this but the two most obvious ones are the US military and the War on Drugs.
The War on Drugs hasn’t reduced the number of junkies or drugs on the street in any noticeable way. It has increased the US’s prison population to the highest per capita level in the world, however. It has cost hundreds of billions of dollars. It has gutted civil liberties (the war on terror is just the war on drugs on crack, after all). And after 30 years does anyone seriously say, “Wait, this doesn’t work, it costs billions of dollars and it makes us a society of prisons”? Of course not. If anything, people compete to be “tough on crime.” What’s the definition of insanity, again?—Doing the same thing, over and over again, and expecting different results.
Then there’s the US military. It costs, oh, about as much as everyone else in the world’s military combined. It seems to be at best in a stalemate and probably losing two wars against a bunch of rabble whose total budgets probably wouldn’t equal a tenth of one percent of a single US appropriations bill. And it is justified as “defending” America even though there is no nation in the entire world which could invade the US even if the US had one tenth the military.
But the US could afford to have a big shiny military and lots of prisons, so it does. (Note that the US no longer can afford these things, but they still persist.) Lots of people get rich off of both the prison and the military industries, lots of rural whites get to lock up uban blacks, and lots of communities that wouldn’t exist otherwise get to survive courtesy of the unneeded military bases and prisons which should never have been built.
Insane: believing things that aren’t true.
Insane: decision-makers cut off from the consequences of their decisions. In fact, they receive reverse feedback: as things get worse for most Americans and as America gets weaker and poorer, the elites are the richest they’ve ever been.
Insane: no one will stop doing things that clearly don’t work and are harmful, because people are making money off the insanity.
All of these particular insanities combine to make predicting the US so surreal. It’s not just about knowing what the facts are and then thinking, “Ok, how would people respond to that?” You have to know what the facts are, what the population thinks the facts are, what the elites think the facts are, who’s exploiting the situation for profit, and then ask yourself if these facts are having any real effect on the elites and if that effect is enough to outweigh the money they’re making off of failure. (For example, how many of them have children serving in Iraq?—Right, so Iraq is not urgent to fix.)
And then you have to go back to the facts and ask yourself, “What effect will these facts have even if they’re being ignored.” Facts are ugly things: they tend not to go away.
All of which makes the US damn near impenetrable, often enough even to Americans.
But here’s what I do know: you can get away with being nuts as long as enough people benefit from you being insane. When the credit cards are all maxed out, when the relatives have stolen even the furniture, when suddenly all the enablers go away then the knee-breakers or the men in white pay you a visit. At that point you can live in the real world, or you can go to the asylum.
I wonder which way the US will go?
I first discovered this article in May of 2003. I did a search on my posts for the word “present”, and this is the second post that came up. The first is this one on a trip to Disneyland. This seems to be around the time when I actually began to wake up from my deep depression.
Perhaps what it is really all about is simply learning to be present, to be here now, as they say. It seems trite, but once you’ve really learned that, everything else becomes so much easier. Just to be present with yourself, with how you really actually feel in the moment, seems to be what makes us most alive.
The experience of certain feelings can seem particularly pregnant with desire for resolution: loneliness, boredom, anxiety. Unless we can relax with these feelings, it’s very hard to stay in the middle when we experience them. We want victory or defeat, praise or blame. For example, if somebody abandons us, we don’t want to be with that raw discomfort. Instead, we conjure up a familiar identity of ourselves as a hapless victim. Or maybe we avoid the rawness by acting out and righteously telling the person how messed up he or she is. We automatically want to cover over the pain in one way or another, identifying with victory or victimhood.
Usually we regard loneliness as an enemy. Heartache is not something we choose to invite in. It’s restless and pregnant and hot with the desire to escape and find something or someone to keep us company. When we can rest in the middle, we begin to have a nonthreatening relationship with loneliness, a relaxing and cooling loneliness that completely turns our usual fearful patterns upside down.
There are six ways of describing this kind of cool loneliness. They are: less desire, contentment, avoiding unnecessary activity, complete discipline, not wandering in the world of desire, and not seeking security from one’s discursive thoughts.
Woke up with this phrase in my head this morning from my fuzzy dreams. After yesterday’s vivid lucid dreams, today’s were fairly tame, but in the last one I was enjoying an excellent dinner of steak and green beans with Tom and Jonathan and some wonderful beer. I have no idea what that means dreamwise but it was a great dinner… maybe I was just hungry.
The act or means of communicating any influence to the mind or heart; as, the contagion of enthusiasm.
Emotional contagion is the tendency to express and feel emotions that are similar to and influenced by those of others. One view of the underlying mechanism is that it represents a tendency to automatically mimic and synchronize facial expressions, vocalizations, postures, and movements with those of another person and, consequently, to converge emotionally (Hatfield, Cacioppo, & Rapson, 1994). A broader definition of the phenomenon was suggested by Sigal G. Barsade- “a process in which a person or group influences the emotions or behavior of another person or group through the conscious or unconscious induction of emotion states and behavioral attitudes”.
I’ve always been a bit immune to this kind of emotional contagion myself, although I’m almost hyper-aware of other people’s feelings (not that this stops me from stepping on them sometimes). I get suspicious if my mood seems to be changing for no apparent reason (a necessity in people who live successfully with bipolar), and end up doing a “heart check” to see if that is something I’m really feeling or just something someone else wants me to feel. So then I get called “distant” or “withdrawn” or “reserved” or whatever and people think I am not connecting with them. But I do see what they are feeling, and perhaps even deeper than they know. I’ve often known when someone’s latest love of their life was a passing fling, or when it could lead to bigger things for them. I’m the one who will be whispering, “careful” when another is about to tread on someone else’s sacred ground, or hook into a skeleton woman they really aren’t ready to handle. And I try to put in a “yes, THIS one!” whisper when a friend is with someone who really lights up their life. But when I attempt to dampen a flame, I end up losing friends, so I’ve stopped doing that. Sometimes you really just can’t tell people anything and you just have to let them find out for themselves what a mess they are making of their lives.
And it is one of my leading clues when I’m starting to slip into a “manic” state if I find myself more and more caught up in someone else’s emotions and problems, or worse, hyping my own mania by feeding off other’s emotions until it moves into the hypo-manic state. So I tend to require a lot of quiet time, time by myself and just to reflect, not only on my own emotional state but that of the people around me. I think it’s one of the reasons I surround myself with golden retrievers, because they are so sensitive and aware of other’s moods and emotions. Their reactions help me to judge and figure out my own emotions and those of other people. If they are shying away from someone, that certainly isn’t anyone I’m going to be getting near. On the other hand, my pest control service lady just stopped at the door and asked if she should do the back yard or not, since they are re-doing the drainage for the patio today, and she ended up petting Darwin for the ten minutes she would have spent on the yard and thanked us for the therapy time.
He was really cuddled up with her, so she must have needed it.
I’ve been reading about Skeleton Woman and how she draws flesh from the beating of the heart of the fisherman, and also reading Daniel Goleman’s “Social Intelligence” where he talks a bit about this way we directly connect through the amygdalya with the emotional expressions of other people. Apparently Goleman believes there is a direct link from our eyes to the amygdala and we can pick up on other people’s feelings even before we are actually aware of what we are looking at. Pretty fascinating idea.
It seems to have evolved into a bit of a pop psychology thing right now, sadly, where people are trying to force salespeople to be cheerful good-mood spreaders, or emotionally “handle” their clients, etc… Then there are those people who can’t stand to be around others that “bring them down” and want to remain in the perpetually cheerful state that eventually drives everyone around them crazy and leads to their own mental breakdown (after which they turn into wonderful truly joyful people)… as well as the “Eeyore” types that refuse to be happy no matter what and end up dragging everyone else down with them (but who are also full of great compassion and can be wonderful friends and lovers)… developing a healthy balance for one’s own heart and knowing yourself well enough to realize when you’re in danger of “catching” a wave of fear or panic or whatever is important.
And this time of year there’s the idea that we are all supposed to be happy and jolly when in fact it is a very difficult time of year for many people who have to deal with losses or unhappy holiday experiences of the past. For me, this time of year invokes more quiet reflection and watching the emotional “snow” settle in on my heart as I think of all the people I miss at this time of year, family who are gone and the friends who decided I wasn’t going to be allowed to be part of their lives anymore. We tend to have a small party to celebrate with those friends we hold dear, and that is always a bright spot in the dark nights for me, along with the beauty of Christmas trees and lights and the thoughtful, gorgeous Christmas music. I can rarely hear or sing “Silent Night” without a few tears. But really, the inflatable Santas and lighted reindeer and Jingle Bell Rock I can just do without, please.
So please make your holidays whatever you need them to be, and don’t give in to those who try to force you to make it into that happy jolly fun time you’re not wanting to celebrate, or the drudge through all the family history with drunken relatives again if you’re not up for that. But don’t be the Grinch either. Open your heart to the things that really matter and are important to you, and connect with the deep spirit of this season in the ways that will mean the most to you.
About the picture – this is part of my artistic evolution, which really goes back to taking Pamela Underwood’s body writing workshop. This was one of the pictures I chose that most affected me and resembles my own body image as a Rubenesque female. I actually painted in the critter on the left side into one of my works. These days, I lack a space to do art and the privacy to do it, and that is one of the things that is most bothering me. The materials are at hand and I want to do it, but time and available space seem such an obstacle. On the plus side, I’m going to the art expo in Pasadena in a couple of weeks and taking some classes there. Yay!
As I get nearer my birthday, Ive been starting to beat up on myself a bit for not even getting close to one of the goals I set for the year of dropping all the weight I had wanted to. I initially lost about 15 pounds, but have gained about five of those back again.
But perhaps that was the wrong goal anyway. I have eaten far better this year, worked out a lot more, and am far stronger and have more lean muscle mass than I did last year. While I’m still “Rubenesque” (and yes, I could have posed for the picture above), and always will be with these hips, I think I can be happy about the “gains” I have made in my overall health. I’ve even gone off one of my mainstay bipolar drugs, Effexor, since it was pushing up my blood pressure and intraocular (eye) pressure. While I haven’t found quite the right combination of nutritional replacements and supplements yet, I’m certainly paying way more attention to what I eat and gaining a lot of knowledge about what the nutritional needs are for people with bipolar disorder.
As I do my research, I occasionally run across gems like this one that remind me that I need to keep my eyes on the real prize, better health, and not on my scale.
How easy is it to take off weight and keep it off? Unfortunately, we run into a wall when we lose 10 percent of our body weight, Dr Korner reported. Adipose tissue shrinks, which results in less leptin, which puts the hypothalamus on red alert. The body goes into survival mode, increasing hunger pangs and lowering metabolism. Within three to five years, she said, almost all dieters are back up to original body weight.
All this comes as cold comfort to those of us caught in the pincers of our illness and our meds. Depression sends many of us into the warm embrace of ice cream and chocolate while our meds can amount to hot fudge sundaes in pill form with none of the pleasures. Weight management obviously needs to be regarded as a lifetime task – eating the right foods and getting plenty of exercise, while setting realistic goals.
Setting realistic goals may mean that aiming for a Rubenesque ideal is okay for now. Trying to accomplish too much too soon is counterproductive and will only lead to disappointment.
Keep in mind that BMI (body mass index) – which purports to define ideal weight according to one’s height, gender, and age – fails to account for body fat. Muscle is heavier than fat, which may mean that working out after a certain point could put on weight (which is good, in this context). A 5′ 9′ light heavyweight boxer who tips the scales at 175 pounds is only overweight in BMI Land..
The BMI is also blind to body type. Ectomorphs – with light bones, slight muscles, and long limbs (such as marathon runners) are not going to turn into mesomorphic Tarzans – with large bones, broad chest, and well-defined muscles – simply by gulping down protein drinks and going to the gym. Likewise, medical science has yet to find a way for endomorphic Santas to stretch their soft round, short-limbed bodies into a mesomorphic or ecto-meso ideal.
Basically, we have to work with what we’ve got, but this should not discourage you. Athletically chunky is beautiful, as is pleasingly plump. Ignore the computer-enhanced cover girls that bombard our environment and pay attention, instead, to the paintings of the old masters.
I don’t usually reprint entire articles here, but this one is really good – very good overview of bipolar disorder and potential treatments on the horizon.
My own wonder drug is lamictal. I’ve also switched to Lexapro recently from Effexor, and was not adjusting too well until I added L-tryosine to complement it since Lexapro doesn’t affect norapenephrine. L-tyrosine is the prescursor protein to norepinephrine.
It’s really tough to have to become your own chemist to treat your problems, but I find I spend a lot of time researching treatments and then talking my shrink into them. Last week he told me I ought to write drug reviews!
Scientists are testing seasickness patches and other surprising options in a challenging search for new ways to treat the crushing depression and uncontrolled mania of bipolar disorder.
Also called manic-depression, it’s an illness that can rip careers and marriages apart and drive people to suicide. And it’s so complex and mysterious that researchers haven’t developed a medication specifically for it since lithium, more than half a century ago.
Yet bipolar appears in various forms and severity in about 1 in every 25 American adults at some point in their lives, according to a major study published in May.
Current medicines help, but often fall short.
They “certainly reduce symptoms but don’t do a good enough job,” said Dr. Husseini Manji of the National Institute of Mental Health. “Many patients are helped, but they’re not well.”
Nobody knows yet whether the latest crop of possible treatments will pan out. Besides the motion sickness patch, unusual choices include a drug that treats Lou Gehrig’s disease and a device that produces an electric field around the brain. Even the breast cancer drug tamoxifen has been tested.
Some of these approaches were identified by logic, and others by pure chance. Scientists already have early evidence that someday they may prove useful against bipolar.
The disorder’s classic feature is episodes of mania, which are periods of boosted energy and restlessness that can run for a week or more.
“You have so much energy, you have so many great ideas” said Tamara, 26, a Pittsburgh resident who was diagnosed several years ago. She asked that her last name not be used.
“You feel like you’re thinking so clear, you’ve got the answer for everybody. You need to tell them, you need to phone all your friends… It’s so hard to sleep. You keep thinking of all sorts of things.”
But mania can also bring extreme irritability. Tamara’s energetic charisma made her the life of the party, but “if somebody spilled a drink on me, I would just explode,” she recalled. “It’s like all your emotions are just completely intensified.”
She got into fights and experienced road rage. She made bad decisions, plagiarizing a college paper and behaving promiscuously.
“A lot of things sound like a good idea when you’re manic,” she said, “and they’re really not.”
During manic episodes many people even get hallucinations or delusions, and Tamara experienced those too. “I was convinced I could hear other people’s thoughts, or at least know what they were,” she recalled. “I thought everybody was saying bad things about me.”
The other side of the bipolar coin is episodes of depression that last a week or more. For Tamara, depression was life turning gray.
“Nothing is interesting. You’re bored with everything… Nothing sounds fun anymore. All you want to do is sleep. I slept days and days away.”
In her senior year of college, thoughts of suicide frightened her into seeking help.
Doctors currently treat bipolar with a variety of drugs including lithium, anticonvulsant medications that can stabilize mood, and antipsychotics. Psychological therapy and patient education greatly boost the effectiveness of the drugs.
Tamara takes lithium and another drug, and says, “I’m doing fine right now.”
She’s lucky. Bipolar disorder is hard to treat chiefly because the depressive episodes are more severe and more resistant to therapy than ordinary “unipolar” depression, notes Dr. Andrea Fagiolini, an associate professor of psychiatry at the University of Pittsburgh.
What’s more, many patients can’t tolerate current bipolar medications because of side effects like weight gain, sleepiness, tremor, and the sense of feeling “drugged,” Fagiolini said. (Some patients also stop taking their medicine because they miss the “highs” of the disease, he noted).
A study of treated patients published last year found that about 60 percent got well for at least eight weeks, but only half of that group remained well when followed for up to two years. And this was with very good therapy, noted Dr. Andrew Nierenberg, professor of psychiatry at Harvard Medical School.
“That means there’s a lot of room for improvement,” Nierenberg said. “That’s why we need new treatments.”
But there’s a basic problem. Just as heart attacks come from chronic heart disease, the manic and depressive episodes come from an underlying chronic brain disease. And “we just don’t really understand what’s behind the illness,” said Dr. Gary Sachs, who directs bipolar research at Harvard’s Massachusetts General Hospital.
That mystery and the complexity of the disorder have discouraged scientists from trying to develop drugs for bipolar, Manji said. Not since lithium, developed more than 50 years ago, have they developed a drug specifically for bipolar, Manji said.
Like lithium, some of the latest crop of early candidate drugs revealed their potential simply by chance.
Take the experience of NIMH researchers Maura Furey and Dr. Wayne Drevets with the drug scopolamine, which is normally used to keep people from getting seasick or carsick. Several years ago, they were studying whether scopolamine could improve memory and attention in depressed people. So they gave the drug intravenously to depressed patients, trying to find the right dose for a brain-imaging study.
But then they noticed an odd thing. These patients started feeling less depressed the night after the injections, a remarkable thing since most antidepressants take weeks to kick in.
“Some patients would say it was the best night of sleep they’d had in many years, and the next morning they woke up feeling a substantial lifting of their depression,” Drevets said. “In many cases that improvement persisted for weeks or even months.”
Drevets and Furey quickly changed their research focus to test the drug’s effect on depression itself. And in October 2006 they published an encouraging, though preliminary, result with a small group of depressed patients, some of whom had bipolar.
Now Furey is leading a study using scopolamine skin patches — like those travelers wear to prevent motion sickness — to treat depression in bipolar disorder as well as ordinary depression. For now, people shouldn’t try patch treatment for depression on their own, she said.
A similar bit of serendipity showed up at McLean Hospital in Belmont, Mass., in 2001. Depressed bipolar patients who were getting their brains scanned for a study of brain chemistry suddenly felt a lot better. Alerted by a research assistant, scientists started taking a closer look. And in 2004, they published their conclusion that the electric fields produced by the brain scans might lift depression. It’s still not clear how.
Follow-up studies have had inconsistent results. But researchers have now built a device that resembles a hair-salon dryer to produce electric fields. They plan to start testing it this fall.
Apart from luck, researchers have taken advantage of the few insights they have into bipolar disease to develop potential treatments.
That’s the story with riluzole, now used to treat the paralyzing disorder Lou Gehrig’s disease, also known as ALS or amyotrophic lateral sclerosis. Scientists found that a drug that’s effective against depression in bipolar disorder boosts the abundance of a certain protein in rat brain cells, and that riluzole does too. So the researchers tried riluzole in a small number of depressed bipolar patients, and in some patients the symptoms virtually disappeared, Manji said.
So riluzole, which is distributed by Sanofi-Aventis, might become a treatment for bipolar disorder, he said.
Similar research used an off-the-shelf drug to get a lead for developing a new medication. Studies in rats showed that lithium and another anti-mania drug hamper the effect of a particular enzyme in the brain. That suggested that other drugs that hamper that enzyme might work against mania too, Manji said.
The best available candidate: tamoxifen, used to fight breast cancer. And sure enough, Manji’s recent study in a small group of bipolar patients found that tamoxifen quickly quelled mania. Other studies have found similar results, he said.
That shows the value of blocking the enzyme, and now Manji is trying to develop other drugs that will do that, perhaps for use in emergency rooms. He wants to avoid tamoxifen itself because of concern about long-term side effects, since his work requires a higher dose than women use to stave off breast cancer for years.
Scientists say the real key to unlocking the mysteries of bipolar disorder — and thereby exposing targets for drugs — lies in a new generation of research into DNA.
In recent months, scientific journals have begun to publish the early results of a revolution in DNA analysis: the ability to scan entire genomes in detail to find genetic variants that predispose people to particular diseases. Some of the new work is implicating dozens of variants in bipolar disorder.
Such work can expose the hidden biological underpinnings of disease, and so tip off researchers to unsuspected targets for intervening.
“We’ve been stumbling in the dark for most of our history” of bipolar research, said gene expert Dr. Francis McMahon of NIMH. But “these kinds of studies … will really give us the chance to reason from biological insights back to the patient.”
Sachs, of Harvard, agreed: “I think these whole-genome scans will in fact be the important bridge to better treatments.”
And not just in some far-distant future. The new gene studies, Sachs said, help give “a great potential to advance the field in our lifetimes and treat people who are living now.”