Sweet Satisfaction

I find myself smiling, browsing the shelves filled with familiar names, colours, shapes, fonts and packages. Minstrels, Terry’s chocolate orange, Hula Hoops, Ripple, Skips.

My childhood was filled with desire, longing, frustration and satisfaction all centred around these sweets. The sweets of Britain. Not so different from others around the world you might think. But for some reason nothing I’ve tried in other places quite gives me that feeling of home so much as the real originals.

I’m not sure whether it was particular to a boy destined for a bipolar life. Perhaps an early form of mania made me especially frenetic in my need for sweets. Maybe early depressive thoughts were drowned out in sugar.

Sugar has always played an important part in my life. I sometimes think it’s an addiction for me. I certainly crave it. I find it hard to abstain.

Chocolate in particular seems tied to my emotions, a self-administered medicine. I revel in its luxurious silkiness. I feel the stimulation of the theobromine. I ignore my body’s repulsion of the poison that it is. It’s a sinful pleasure.

Food and mood seem intertwined in my life. It’s one of the things that I will need to untangle along the path toward wellness. An obvious health problem that rises and falls with the stability of my moods, but should be unconnected.

A well balanced diet is an essential part of a recovery from a mood disorder. I can’t claim to have that under control yet, still being controlled by my desire for sweet satisfaction.

Missing your Medications

Check out this beautifully written article about stopping your medications for depression or bipolar disorder by Marcia Purse:
http://bipolar.about.com/od/complianceissues/a/5badreasons.htm

From personal experience missing your medication even for a short time can have significant consequences, and may trigger a relapse.

It's worth checking out Marcia's blog too, which has some great articles:
http://echosweb.com/category/bipolar/

The NCAN Gene

There's a very encouraging new discovery on the genetics of mania.

A strong link was found between the gene NCAN and manic episodes in a large set of patients.

Then they reproduced manic symptoms in mice by disabling the gene. The manic symptoms in the mice were then responsive to treatment with Lithium.

Very cool.

Here's an article describing what was done:
http://medicalxpress.com/news/2012-09-decipher-manic-gene.html

Lynn Rivers

So many stories you read about bipolar only serve to increase the stigma associated with it.

The manic star's over the top antics blamed on the disorder.

A criminal's defense resting on being  bipolar.

Here's a great story about an inspiring politician who was candid about being bipolar and managing it well:
http://bipolar.about.com/od/others/a/lynn-rivers-congresswoman-bipolar.htm

Her successful career is a testament to the more positive attitudes toward mental illness that must exist in her constituents.

A story worth sharing.

Catastrophizing

Lynn Martin gives this definition of catastrophizing:

You believe the worst-case scenario will happen.
e.g. Someone turns you down for a date. You are convinced you will lead a life of loneliness.

I can remember catastrophizing from when I was a small boy. I imagined my parents dying mostly, and would bring myself to tears on a regular basis. I don't know why I did it back then. I think maybe I wanted my life to be more dramatic than it was, and did these mental exercises to spice things up a bit.

But as an adult I've come to recognize catastrophizing as a symptom that I'm not doing well. Mostly these patterns of thought come easily to mind when I'm depressed.

I'm going to lose my job. My wife will leave me. Financial ruin is imminent. These are three classics that I've visited often.

Thankfully my wife has now left me, so one of those three won't be a problem any more.

When you're in the grip of catastrophic thoughts, you feel totally overwhelmed. Paralyzed by the fear of the inevitable doom that approaches.

For me something that helped a great deal with these thoughts was CBT.

But not general CBT, a specific variation which can be characterized with the phrase:

What's the worst that could happen?

The way to tackle these catastrophic scenarios is to let them run to their natural conclusions in your mind, and take a rational approach to what you would do if that eventuated.

So think about what could happen: I'm going to lose my job. Break it down a bit. Depending on why you think you might lose it, would your employer have to give you three warnings, and an opportunity to improve first? If not, what would you actually do then? Could you find another job straight away? If not (let it go really to the worst case!) could you stay with family for a month or two until you did find work? Would you recover eventually?

This kind of breakdown is really helpful. Once you know what you would do in the absolute worst case scenario, you'll generally find it's not so bad. You could deal with it and get back on your feet.

Having this knowledge is really powerful. It takes some of the emotional power out of the thoughts, and lets you deal with the reality of the situation away from the intensity of feeling that catastrophizing brings.

Fortunately I've been free of depression for over 2 years now, and touch wood will manage to stay free of depression and catastrophizing thoughts for years to come. If it does rear it's head again this is one tool I've found invaluable to help cope with it.

The Power of Perception

How we perceive the world is fascinating.

None of what we see, feel, hear or touch is real. It's our brain's translation of sensory information. The brain has incredibly complex processes to interpret the huge volume of constantly changing signals from our senses.

Thankfully, all of this sense processing is completely unconscious. The brain just presents you with a simple, stable perception of the world.

This allows you to say "I saw a dog", instead of being overwhelmed by the vastness of information that a dog is. Colours, shadows, lines and shapes, all constantly changing through the dog's movement, the changing environment, the wind, the light.

Well, "so what?" you might say. The brain filtering out most of the information we have about the world allows us to get on with our day instead of standing there looking at a dog for an hour just trying to take it all in.

But what about our perception of something slightly more abstract. What is it that allows us to say "I saw an angry dog"? How do you know how the dog was feeling? That a dog can feel anger? This is where the world of perception starts to be coloured by our beliefs. Animals having human feelings is something we believe, because we have anthropomorphised them. It's probably not true, but we believe it. And because we believe it, our brain delivers up a perception about what's happening that matches our belief.

Now think about what happens when a group of people get together and start believing in something supernatural. The idea that people can be touched by God. Or that they can heal, see auras, read thoughts. Proofs might be offered, peer pressure exerted, exciting possibilities raised, and what you perceive can change according to your new expectations.

Having supernatural beliefs can enable you to perceive things that don't exist.

The same is true of emotions. Alan Saks and Gary Jons list in their components of perception:

In different motivational or emotional states, the perceiver will react to or perceive something in different ways. Also in different situations he or she might employ a "perceptual defence" where they tend to "see what they want to see". 

(emphasis added - from Wikipedia: Perception)

This tendency we have to 'see what we want to see' leads to a compounding effect. Because you see things more bleakly than they are when your mood is depressed. You alienate your friends, and generally become further depressed by negative experiences brought about by your own negativity and apathy.

The reverse is true as well. People with smiles and positive attitudes are attractive to positive reactions from others. This feedback leads to a more positive perception of the world.

I can visualise this feedback loop as a spiral. A negative mood leading to negative feedback leading to more negative moods. A tightening, closing off leading inward to the dark center of the spiral. A positive mood opening out to positive feedback, leading to more positivity, more expansion and light.

Regardless of the causes, each of us see the world differently to one another, to other creatures and to reality (whatever that might be).

I think that understanding perception is a powerful thing. It can help you disassociate yourself from unhelpful perceptions that cause you pain or lead you into depression. It can help you perceive the possibility of better things happening, and help to bring them about.

Photography:
Rose Coloured Deceptions - Derek Gavey,
Spiraling - papalars

The Joy of Sauna

Breathe deeply. The heat is almost too much to bear. Your lungs expand, oxygen runs through every part of you. You feel great.
The wooden boards are hot but not scolding, and you sit on them as long as you can stand it. Then out into the bracing air to hop in the cool water and chill out. Repeat.

I've been fighting off a bout of influenza the likes of which I haven't had to cope with in years. Fever, chills, gastro, sinus infection, chesty cough. The whole box and dice.

I was reading about cures one day, when I came across a reference to using a sauna. Apparently the virus can't live in the temperatures they keep a sauna at. So all the time you're breathing in that hot air, you're helping your body kill off the invaders. It's a bit like a manually induced fever, which the body uses for the same reason - heating you up to try to kill off the virus.

Well, that's the theory.

But I'm also just enjoying them too. Every day since then I've been down to the gym to use the sauna and spa, and I'm feeling much better for it.

Not sure if it's speeding up my recovery or not, but hey, I'm enjoying it, and it can't do any harm.

A big part of your wellness planning is regularly doing things that lift your mood. I've just found one more activity to add to my list.

photograph by comedy_nose

Madness Redefined

This is a fascinating discussion: (start at 12 minutes 55 seconds)
http://worldsciencefestival.com/webcasts/madness_redefined


Video streaming by Ustream

An interesting topic:

"The notion of a “tortured genius” or “mad scientist” may be more than a romantic aberration. Mounting studies have established that bipolar disorder and schizophrenia correlate with high creativity and intelligence. Join leading researchers as they examine the shifting spectrum between brilliance and madness."

And a fascinating group of people:

Elyn Saks
What a wonderful, positive person. Incredibly insightful, gifted and clear. You can see her struggle, and her brilliance in spite of it.

James Fallon
Absolutely high the whole time. A case study in mania. As someone who has experienced being manic it's almost painful to watch him speak. The contrast with his colleagues on the panel that are actually managing their bipolar or schizophrenia is staggering. He is a bipolar sufferer who doesn't really realise he's suffering and thinks everything's great because he's manic. The credibility of the other panellists slams his to the ground. Watching him really reinforces my decision to manage my condition with medication, despite the loss of the perceived fun of mania.

Kay Jamison
Very down to earth, and clearly driving an agenda. Albeit a great agenda with a well reasoned argument. That is to treat bipolar and schizophrenia as illnesses, and not to romanticize them with the possible links to creativity.

I absolutely loved this statement from Elyn:

"for me always though I've always had social judgement, so I've known what people would think was crazy and I didn't want to appear crazy so I didn't say it out-loud except to my therapist. So that way I was able to kind of make my way through a professional world having crazy beliefs but not antagonising or alienating the rest of my environment because I always knew what would be seen as crazy, even though I didn't think it was."
Elyn Saks - 1 hr, 32 mins in

And this is a nicely put illustration of the deleterious nature of manic episodes:

"If you don't get treated, these illnesses are really bad for your brain. If you look at brain scan on 1 mania and your brain scan on 8 manias, you want your brain on 1 mania. You want to be able to prevent those manias. So these are very damaging, potentially lethal illnesses."
Kay Jamison - 38 mins in

If you have the time to watch it, I highly recommend it. Some brilliant people with interesting minds and lives.

The Causes of Bipolar

Bipolar disorder has no known cause, and no known cure. It's a scary thing to have.
Here's what we do know:

• Bipolar disorder is genetically inherited.
• Identical twins have an 80% chance of concordance.
• Kids with one parent having bipolar have a 10% chance of developing it. Where both parents have it, the chances are 40%.
• Half of all bipolar sufferers have a family member with a mood disorder.
  
  To me that's pretty conclusive.
  
  What the genes are, how they work and what they trigger is still being researched.
• The genes alone don't manifest the disorder.
• Bipolar episodes are triggered by 'stressors'. These can include the death of a loved one, losing a job, moving house, post-natal depression, or things that appear more trivial too. No-one can define what exactly they will be, because everyone's level of stress in handling these kinds of events is different.
• Physical well-being is critical to maintaining a stable mood. Having enough sleep, good diet and exercise give a person a much better chance of fending off stresses that could otherwise trigger an episode.
• It seems that once the first bipolar episode has been triggered the disease can take on a life of it's own, not necessarily relying on another similar event to trigger further episodes.
• Seasons seem to influence the onset of episodes for some people, for example it could be more likely to have a hypomanic episode in spring.
• Neurochemistry plays a major part, although how it works is not yet known.

So if you've got the genes, you've got them. There's no test that can tell you conclusively. You find out when your doctor leans across to you and says: 

      "I believe that you have bipolar disorder, and you're having a manic episode right now."

Or you don't find out. Most people take a long time to get a correct diagnosis, if they're lucky. It can take a lot of personal struggle to accept it and then get the help that is available too.

I read stories about bipolar almost every day, most of them sad, some even heartbreaking. The many unknowns surrounding the causes of bipolar are the cause of so much real pain and suffering. But I'm always on the look out for the hopeful news, especially about the increasing amount of research and understanding of the disorder.

I have every faith in the teams of scientists all over the world looking for the causes, and therefore the cure for bipolar. 

Further reading:

http://www.blackdoginstitute.org.au/public/bipolardisorder/causes.cfm

http://bipolar.about.com/cs/bpbasics/a/what_causes_bp.htm

http://psychcentral.com/lib/2007/the-causes-of-bipolar-disorder-manic-depression/

http://www.psychologytoday.com/blog/bipolar-you/201103/spring-has-sprung-and-so-might-your-hypomania-0

photograph by Sbrools

Support Groups

I think I'm going to be managing my bipolar for the rest of my life.

I've been incredibly fortunate to have the friendship and strength provided by my support group to help me do that.

Even with a correct diagnosis and having found a good psychologist, psychiatrist, medication and a support group, I face a struggle. A struggle for normalcy, or at least efficacy.

But I want more than that.

I don't want to be just well enough to rub along despite issues I learn to live with. I want to be truly well. To have a rich, healthy and rewarding life filled with good friends, love and happiness.

I was talking to a friend at work the other day about chiropractors. He'd had a bad experience going to one who kept him coming back again and again. I think you get the same with good and bad psychologists too. I've been fortunate to have found some good therapists over time whose attitude is 'my goal is to get you better and then not see you again'. I was thinking that we should take the same attitude with our support groups too. I sincerely hope within my group we'll be friends and support one another for the rest of our lives, but I think the goal of the group should be for all of us to become well and not to need the group support any more, rather than for it to become a crutch that ceases to make real movement toward that end.

I hope we can keep working hard together on our recovery and increasing well being.

Why you shouldn’t Judge Yourself

You shouldn’t judge yourself for the same reason that BP shouldn’t run an environmental impact study on oil drilling.

You’re not qualified, because you’re biased.

You also don’t have enough data.

If you were really to have a chance at judging yourself accurately, you’d need a large enough sample set of other people to compare yourself against, from a range of social groups. You’d need to use some kind of objective set of criteria to choose data points, and then have the information collected scientifically.

Are you fat?

Are you attractive?

Are you smart?

Did you perform a certain task well?

How would you know? How could you know?

Unless you have a team of scientists on hand to do the research and comparative study, you just have two choices:

1) Keep an open mind

2) Judge yourself, inaccurately

So how do you know what you’re like? You don’t, and no-one else does either.

The truth is interesting, unusual. It’s doesn’t fit into neat little boxes. How you perceive things can change. Things you perceive can change. You probably have an idea, but it’s not the truth, just one version of it.

If you’re like me, interested in self discovery, then the idea that you can’t really judge yourself objectively is a bit scary. But I believe it’s true that you can’t. I hope this idea will help me be more fluid, and less judgemental.

Cognitive Behavioural Therapy (CBT)

The narrative in my head is sometimes a friend, optimistic, encouraging and helpful. At other times it's my worst enemy, driving my anxiety up and my mood down.

Your mood is a bit like the musical score to a movie.

Have you ever watched a scary movie with the sound muted? It can weaken the effect to comical proportions. The suspense and the drama is built up by the music. You're informed by the music whether current events and events about to occur will be happy or sad, scary or bland.

What might normally have seemed a mere trifle to be laughed off might appear to be a nightmare when your mood is black.

So how to change the score, to keep it bright more of the time?

For a person with a chemical imbalance, medication could be the answer. If you're at the mercy of your genetics and neurochemistry you may need some medical help to redress that balance and bring you out of a depression that sends your inner narrative down dark paths.

But genetically affected or not, good mental health and well being isn't as simple as swallowing a pill.

The mood of the story you tell yourself is affected by real events. By misperceptions about real events. By the coping mechanisms you use to escape real events.

Cognitive behavioural therapy, or CBT, can be a great tool to instigate change.

The essence of it is to break down the negative thought patterns that we all have, analyse them and ultimately change them for the better.

The main feature of analysis is to try to be unbiased, logical and reasoned. Similar to muting the sound on the scary movie, you need to look at the thoughts you're having outside of the situation they occurred in and consider:
1) What happened
2) What you thought in response
3) Whether those thoughts were helpful or unhelpful to you
4) If they were unhelpful to you, how you could have thought about the event more usefully
5) The outcome of thinking the way you did
6) The outcome of thinking the more useful way

As an example:
Suppose you were at the gym. An attractive girl walked passed you, glanced your way and for a moment her eyes flicked down to your belly. She walks on.

What did you think, how did it make you feel, what did you do as a result?

Let's walk through the six points for this example:

1) What happened

- a girl got your attention

- she noticed you

- she looked at your belly

2) What you thought in response

- I'm fat. 

3) Whether those thoughts were helpful or unhelpful to you

- probably not :(

4) If they were unhelpful to you, what a more useful way of thinking could be

- she's hot, and she noticed me :)

- maybe could stand to lose a bit of weight there :(

- still she did look my way :)

5) What the outcome was of thinking the way you did

- made me feel unhappy

- made me go home and eat comfort food

- didn't help my waste line :)

6) What the outcome would have been thinking the more useful way

- stayed a bit more positive (or perhaps ambivalent) about the experience

- motivated me to do a few more crunches

The real trick with it is catching yourself thinking the negative thoughts. As you get better at it, you can see yourself about to have the negative thought and override it with the positive thought you worked out earlier.


Further reading:
http://au.reachout.com/find/articles/cognitive-behavioural-therapy-cbt
http://www.rcpsych.ac.uk/mentalhealthinfo/treatments/cbt.aspx
http://www.coldcreekwellness.com/addiction-treatment/cognitive-behavioral-therapy-cbt/
http://www.slbmi.com/anxiety_center/cognitive_behavior_therapy.htm

Marilyn Monroe's Vulnerability

I watched a movie recently 'My Week with Marilyn'.

I fell in love with Marilyn Monroe the first time I saw her in 'Bus Stop' years ago. I realized this week what it is that makes her so attractive.

It's her vulnerability.





I think it takes a lot of character to put your vulnerability out there for others to see. But what it does is it allows others to see that you're like them, to empathize.

I also think it takes a lot of character to put your strengths out there for others to see. Because it allows others to test them.

I think the ideal outward face of a person would portray some vulnerability, and some strengths. It would engage other people's respect at seeing your strengths, and their fellow feeling with their own (perhaps hidden) vulnerabilities.

Thoughts about letting go.

I have a problem with the way I think.

Everything good I ever had I still keep.

All the friends, the lovers, the journeys live on, like hundreds of threads clung onto and gathered and clutched at.

Why hold onto all these things?

Like a complex lie, that spirals out of control until you're juggling too many conversations and caught up in your own webs. Holding onto the past is a trap.

My head is too full of things unresolved. Not let go of.

It's only really now I'm starting to realise the value of letting go. To think about what it would be like to have fresh thoughts. To go out without comparing, or trying to join the future to these threads of mine.

To let the future be what it is, and have a space in my mind for it to abide.

But how to let it go?

I realise there is part of me that thinks holding onto everyone and everything is a loudable attribute. Being a fierce friend. Someone who will be there to the end. Keeping promises.

But what if the other people involved don't want to be held onto?

Is it noble to cling onto unrequited love forever? Is it poetic? Romantic?

Or is it just a stupid waste of time, energy and life?

I think the way to let go is to take each thing that is held onto one by one.

- decide consciously whether to keep it.
- if not why not?
- every time it comes to mind from then on, remind myself why not, and therefore why it's not worth thinking about.