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