Posts tagged bipolar
Posts tagged bipolar
For seven years, mental illness has been a major part of Elizabeth’s life – but she bravely battles on. She shares her story.
Manic moods controlled Elizabeth’s life until she picked up the phone and asked for help.
She had suicidal thoughts and tried to kill herself. She went to see her doctor.
“I knew I was ill,” said the 50-year-old from Derby. “How I was feeling was not right.
“There’s nothing normal about staying awake all night chatting on the phone to a friend and at the same time, manically cleaning your house from top to bottom.
“There is nothing normal about feeling so low and depressed that you can’t even find the energy to change out of your nightwear and keep it on all day.”
For years, Elizabeth coped the best way she could. She endured several stays in hospital and took a concoction of drugs to try to stabilise her moods.
Then she was diagnosed as being bipolar – a serious medical condition that causes shifts in moods, energy and ability to function. Since then, life has been a whole lot better.
“I suppose once I was told that I had bipolar, I began to realise why I had been feeling the way I had. In 2011, I was in hospital for 11 weeks and that was a long time but, in that period, the doctors worked hard to work out what was wrong and now I know what I’ve got, I can deal with it.
‘‘I am learning to live with it. I am finding room in my life for this condition.”
Elizabeth does not want to be identified. She says the stigma attached to mental health is too big and she is afraid to be labelled.
While she battles to lead a normal life, she says she does not want to be discriminated against. And in her community, like many others, it is simply never discussed.
But at the same time, she wants to speak out about mental illness and highlight how hard it.
“People don’t talk about mental illness,” she said.
“It is something people hide away and keep close to them. I don’t feel ready to tell everyone that I am bipolar.
“Life is hard enough for me. But day by day, I get more strength and I know, with the right medication, I can survive this.”
Elizabeth was only diagnosed with bipolar two years ago. Her mental illness first started to show itself in 2007.
But, before then, life was normal for the mum-of-one.
“I had a job, a house and a husband,” said Elizabeth.
“I worked in the caring industry and everything was fine. My daughter was all grown up and had her own place and I thought I had been a good mum.
“Looking back, I think things started to spiral out of control when my marriage failed. It was 2005. I literally lost the house and was made bankrupt.
“I started feeling paranoid and my mood dropped. I struggled to sleep because of the paranoia. I was worried about my future and what was going to happen. I think this was the start of it.
“I stopped sleeping and eating. I was worried about my life and that’s when the depression kicked in.”
Elizabeth went to see her GP and was put in touch with the team at Derbyshire Healthcare NHS Foundation Trust. She was assigned a lead nurse. It was life-saving, says Elizabeth.
“To be honest, my nurse has been fantastic,” said Elizabeth.
“When I’ve felt like I’m losing it, I have picked up the phone and called her.
“I have always been able to recognise the signs of my illness and I think that has actually saved my life.
“Instead of suffering in silence, I have asked for help.
“Instead of getting more and more unwell, I have moved quickly to get the right kind of support.”
Elizabeth is not proud to have spent time in Derby’s Radbourne Unit – a service dealing with mental health, learning disability or substance misuse.
She has been detained under the Mental Health Act. “People don’t know what it is like to have a mental health problem,” said Elizabeth.
“It can be tough.
“Most of the time, my moods are low. But I have experienced severe highs and that can be dangerous too.
“Once I went out shopping and spent far too much money. I severely overspent and got into debt.”
Despite feeling stable at the moment, Elizabeth still describes herself as ‘vulnerable’.
She takes medication and the tablets are keeping her well, but she does worry about her future. “People do take advantage of me,” she said.
“I was in a relationship and we got engaged. Then he started asking me for money and I gave it to him. Before I knew it, I had given him quite a lot. He said the money was for our future. In the end, that wasn’t the case at all. The relationship ended.
“I am vulnerable. I know I am. And when things like this happen, my moods can dip.”
Elizabeth lives on her own. She admits she struggles to get motivated but says she would like to get back into employment.
She says she needs a purpose in life. Getting up and getting out, she says, could help her. Volunteering is something Elizabeth is interested in.
“My daughter is a good support to me,” said Elizabeth. “And my mum, who is elderly now, talks to me on the phone. We ring each other every day.
“But I suppose it’s my daughter who keeps her eye on me. She comes over for a meal and that makes me get up and cook something nice.
“She’s the one who says ‘tidy up the house, mum’. I don’t like to think that she worries about me, but I guess she does. I worry about myself sometimes.”
THE DISORDER CAN BE A SEVERELY DISABLING CONDITION’
BIPOLAR disorder is a condition in which a person has periods of depression and periods of being extremely happy, cross or irritable.
It is also known as manic depressive illness. It is a serious medical condition and can leave sufferers unable to function.
Bipolar disorder is relatively common. It affects about one person in every 100.
It can occur at any age, although it typically develops between the ages of 18 and 24. Men and women from all backgrounds are equally likely to develop bipolar disorder.
The pattern of mood swings in bipolar disorder varies widely between people. Some people will only have a couple of bipolar episodes in their lifetime and will be stable in between, while others may experience many episodes.
The exact causes of bipolar disorder are not known. However, it is thought that several things can trigger an episode.
Extreme stress, overwhelming problems and life-changing events are often thought to contribute, as well as genetic and chemical factors.
The high and low phases of bipolar disorder are often so extreme that they interfere with everyday life.
Elizabeth’s lead nurse at Derbyshire Healthcare Foundation Trust, said: “Bipolar disorder can be a severely disabling medical condition. However, many individuals can live full and satisfying lives within their own homes with the use of regular doses of medication to stabilise their mood. Although bipolar disorder is usually a long-term condition, effective treatment combined with self-help techniques can limit its impact on everyday life. Staying active and maintaining a healthy diet are important. Exercise and taking up a new hobby can also help to reduce the symptoms, particularly depressive symptoms.
“To date there is no cure, but proper treatment helps most people with bipolar disorder gain better control of their mood swings and symptoms, because this is a lifelong and recurrent illness.
“People with the disorder need long-term treatment to maintain and control symptoms. An effective maintenance treatment plan includes medication and psychotherapy for preventing relapse and reducing symptoms.
“Not everyone responds to medication in the same way, therefore several different medications may need to be trialed before the preferred course of treatment is identified.
“Understanding the illness is key for the person with bipolar disorder, allowing them to gain insight into their condition and recognise relapse symptoms unique to them.
‘‘Should anyone feel they suffer with the above symptoms then your first port of contact should be your GP who will assess you and make a referral to mental health services if they feel this is necessary.”
For more information, visit www.nhs.uk/Conditions/Bipolar-disorder/Pages/Introduction.aspx
Professor John Read, back in the UK after a long period away, is struck by some important changes in the way we view mental health problems
It’s good to be back in the UK after twenty years in New Zealand – well, apart from the weather, the political, economic and spiritual state of England, and the endless phone calls to India to get someone from up the road to install a phone. Amid it all I’m writing my first ever blog! What an antiquated old prof.
Two papers I’ve published since returning will both, I hope, contribute to this on-going development. The first was published with colleagues from Scandinavia and the USA in the journal Neuropsychiatry With the snappy title ‘The Traumagenic Neurodevelopmental Model of Psychosis Revisited’it reports on 125 papers that support a model we first put forward in 2001 outlining how psychosis can be related to trauma. This model is a challenge to those I call ‘contextless brain researchers’: people who when they find a difference in the brains of two groups of people, assume that they have found the cause of the difference. It rarely seems to occur to them to ask a vital (and some might say obvious) question: ‘what might have happened to make the groups different?’ I would not for a moment dispute that such researchers are well-intentioned folk. They may have a deep knowledge of neurology and access to some very fancy technology. However, they often don’t seem to grasp the simple fact that a primary function of the brain is to respond to the environment.
One of the findings underpinning our model is that there are some striking similarities between the brains of traumatised young children and those of people diagnosed with schizophrenia. Perhaps the most important is in the way that the nervous systems (the ‘HPA axis’, to be precise) of the two groups respond to stress. We’ve been told for decades that the reason that people who experience ‘psychosis’ are sensitive to stress is genetic. It now seems that for many people the cause of such heightened sensitivity may lie elsewhere: in early trauma.
This goes to the heart of whether the much touted ‘bio-psycho-social model’ and its alter ego the ‘stress-vulnerability model’ really do what it says on the tin, and offer a genuine integration of nature and nurture. I argue in my book Models of Madness that these terms can sometimes disguise what is still fundamentally a biological explanation of our experiences. We’re told that stress can play a role, but only in people who already have a supposed genetic predisposition. Life events, even serious and traumatic ones, are relegated to the role of ‘triggers’ of an underlying genetic time bomb. Bio-genetics enthusiasts claim that the ‘vulnerability’ part of the equation must be genetic. This conveniently ignores the fact that the inventors of the model, Joseph Zubin and Bonnie Spring, stated in their seminal 1977 paper that the vulnerability can be acquired from early life events. As Michael Caine used to say, ‘Not a lot of people know that’.
This all reminds me that a few years back Robin Murray, Professor of Research at London’s Institute of Psychiatry, announced from a Canadian conference stage that ‘The schizophrenia wars ended in the 1970s’. I couldn’t help raising my hand and pointing out that the occupying force in a colonial war is usually quick to announce the end of hostilities, and that the war would not be over until the occupying forces withdrew to the appropriate boundary.
It is remarkable then that the relationship between trauma and psychosis – heresy just 15 years ago - is now one of the strongest and most consistent findings in our field. How times have changed – and how quickly. I now hear people saying ‘What’s all the fuss about? We always knew that - nothing controversial there’. Some of the most scathing critics of our first few papers are now happily putting their names on papers confirming the relationship. I was moaning about the ‘hypocrisy’ of all this to my colleague Richard Bentall recently and he replied ‘John, John, - you’ve won and you’re still bitching!’
The ‘victory’ had never felt so real as when I heard some wonderful news from New Zealand towards the end of last year. An abuse survivor had twice been denied financial aid in relation to subsequent mental health problems because two ‘experts’ - employed by the agency responsible for making such payments - had stated that there is no evidence that child abuse can cause psychosis. However, in the final appeal a psychiatrist summarised the substantial literature which attests otherwise. The judge upheld the appeal and I’ll admit I took some naughty pleasure in the NZ’s national Sunday newspaper quoting me as saying that the first two psychiatrists, ‘either knew nothing about the many studies documenting the relationship between child abuse and psychosis or were trying to mislead the judge’.
Another area where research is challenging the simplistic medical model type thinking in mental health is that of interventions. More and more studies are giving the lie to the pharmaceutical company propaganda which would have us believe that their products are targeted, specific ‘treatments’ for identified brain problems. My second recent paper reported an online survey of 1,829 people taking antidepressants. It revealed some astonishing levels of psychological and interpersonal adverse effects. For example, 60% of people reported feeling emotionally numb, 42% said that the drugs reduced positive as well as negative emotions, and 39% felt that they cared less about others whilst on the drug. Other effects are already well documented but we were surprised at their sheer frequency: 62% reported sexual difficulties (rising to 72% for men), and 39% reported feeling suicidal, rising to 55% in 18-25 year olds. Withdrawal effects, often dismissed as rare or imagined – were reported by 55%. Those who had been more depressed when the drugs were first prescribed were no more likely than others to experience these effects, suggesting that they were drug-related rather than symptoms of the depression itself.
Although biologically-rooted explanations of distress and pharmaceutical treatments are still prevalent, it seems that both professionals and the public are increasingly exploring alternatives. All over the world – with the sole exception of the USA – surveys reveal that the public, including service users and carers, tends to take the common-sense view that mental health problems are related much more closely to the events and circumstances of our lives than to biological factors such as genetics or brain chemicals. When it comes to help the public also strongly prefer psychological and social approaches over drugs, electroshock therapy or hospitals. Only a minority of professionals seem intent on continuing to ignore experience and push the idea that mental health problems are essentially problems with our brains. And those people are getting older by the minute. Things have changed unbelievably in 20 years. Hopefully, if we all keep pushing, in whatever way our circumstances allow, our mental health services will finally become evidence-based, effective and humane.
John Read is Professor of Clinical Psychology and Director of the Clinical Psychology Programme at Liverpool University. You can follow him on Twitter @ReadReadj
Once we have been diagnosed as having Bipolar Disorder, our first reaction is not to jump out and tell the entire world that we are suffering from a chronic, life long, debilitating, mental illness. For many of us, we hide our diagnosis and suffer in secret due to judgement and ridicule from many of our friends and family members. I wish the case wasn’t so, but society has left it’s mark and it is hard for us to come clean to the world around us about what is happening inside our bodies.
Telling family members we have Bipolar Disorder is often difficult and embarrassing. We never know if we are going to receive their on-going support or if they are going to put us down and judge us as parents because of an illness we have no control over.
This was one of the main reasons I wrote the book Moorestorms A Guide For The Bipolar Parent I wanted parents to feel less alone in their struggles and I wanted to give them a source of comfort and encouragement to reach out to other people for support. When I wrote that book, it really was me be coming out for the first time and I did it in a very big way. I also needed my own family and friends to understand the struggles I faced on a daily basis and so the book was written and published. I put my daily struggles and life out there for the world to see in hopes of helping family and friends understand what it is like to be a Bipolar Parent.
Now I’m not suggesting you go out and write a book about having Bipolar Disorder. Just mentioning that you have the illness can be scary enough. But finding books like Moorestorms A Guide For The Bipolar Parent, and other self-help books can help your family members understand what you are going through if you are having a hard time explaining it yourself.
You may also consider taking your loved one to a doctors appointment or therapy appointment with you. The therapist or doctor may be able to explain your illness in a way that your loved one can understand.
I have always lived by the motto that those that scream the loudest get the most attention and if we are going to break down the wall of stigma that has surrounded us, the one that has been built by society to shame us, we have to make a lot of noise and get a lot of people’s attention when it comes to being a Bipolar Parent.
Until next time….
My Personal Blog
According to authors Janelle M. Caponigro, MA, Eric H. Lee, MA, Sheri L. Johnson, Ph.D, and Ann M. Kring, Ph.D, in their book Bipolar Disorder: A Guide for the Newly Diagnosed, common warning signs of mania or hypomania include: feeling irritable, sleeping less, having more energy, driving faster, talking faster, starting new projects, feeling more self-confident, dressing differently, having increased sexual feelings and feeling impatient.
Every person has his or her own unique warning signs. For instance, you might notice that your day is filled to the brim with activities, and you stop taking breaks. You might start spending several hundred dollars on items you don’t need. And others might comment on how overly enthusiastic you are.
To figure out your warning signs, think back to your latest manic episode and what symptoms and experiences precipitated it. It’s also helpful to ask others for input and keep a daily mood chart.
When you’re noticing these warning signs (or you just don’t feel like yourself), the authors recommend contacting your treatment team.
They also elaborate on three types of strategies to employ when signs point to a hypomanic or manic episode: calming yourself; protecting against negative behaviors (such as overspending); and managing medications and therapy.
Here are suggestions from Bipolar Disorder for each type of strategy to help you manage warning signs and prevent a full-blown manic episode.
Protecting Against Negative Behaviors
Managing Medication and Therapy
When people with bipolar disorder are hypomanic or manic, they commonly think they don’t need their medication. However, instead of not taking your medication (this can be dangerous), consult your prescribing physician. They may change or increase your medication, which can help to stave off a manic episode.
If you’re working with a therapist, you might want to increase your appointments or move them to an earlier time or day.
Bipolar disorder is a serious illness, and it can be tough to pinpoint your warning signs and to manage them. But by thinking ahead, brainstorming with your treatment team and having a plan of strategies that work for you, you can get better and stay well.
Image source: Dogwalla
Teen Marijuana Use Linked to Earlier Psychosis Onset
By Pauline Anderson, Medscape
New York ― Heavy marijuana use between the ages of 15 to 17 years, a period of potentially critical brain development, could result in an earlier age of onset of psychosis in those destined to develop the disorder, new research suggests.
Preliminary data from the Allied Cohort on the Early course of Schizophrenia (ACES) II project, a secondary analysis of ACES, showed that youth who used cannabis when aged 15 to 17 years experienced first episode psychosis (FEP) an average of almost 4 years earlier than their counterparts with FEP who did not use cannabis.
Any delay in psychosis onset is important because this improves outcomes in terms of severity of symptoms and functional disability, study investigator Michael T. Compton, MD, chairman, Department of Psychiatry, Lennox Hill Hospital, New York City, and professor of psychiatry, Hofstra University North Shore–LIJ School of Medicine, Hempsead, New York, told delegates attending the American Psychiatric Association’s (APA’s) 2014 Annual Meeting.
Predictors of age of onset of psychosis are male sex and family history of psychosis, which are not modifiable, said Dr. Compton. “My question has been, does premorbid cannabis use also drive the age of onset?”
The analysis included 247 hospitalized patients who had experienced FEP and who were generally treatment naive. Most study participants were single, male, and African American. About 44% had not graduated from high school, and almost 60% had been incarcerated. More than half were living below the poverty line.
In the study cohort, the average age of prodromal symptoms was 19.4 years, age at onset of psychotic symptoms was 21.8 years, and age of hospitalization was 23.1 years.
Researchers asked each patient about marijuana use “in a very detailed way,” going back to the first initiation of any use and up to the age of prodromal, psychosis, and first hospitalization, said Dr. Compton. Just fewer than 80% reported ever using marijuana.
The mean age of psychosis onset was 21.07 years in those with cannabis use from ages 15 to 17 years, compared with 23.86 years in those with no cannabis use during that age period (P ˂ .0005). For the ages of 12 to 14 years, the age of psychosis onset was 21.10 years for cannabis users during this period, compared with 22.12 for nonusers (P = .048).
The relative risk for predicting age of onset of psychosis for cannabis users between the ages of 15 and 17 years was 1.84 compared with nonusers (P ˂ .005).
Dose-Dependent Effect?Researchers also looked at the dose or the average number of marijuana cigarettes smoked per year and found that this was also a predictor of age of onset of psychosis for those using between the ages of 15 and 17 years. This was not the case with use after age 18, noted Dr. Compton.
Dr. Compton acknowledged that it is possible that the people who are likely to have an earlier onset of psychosis are also more likely, for whatever reason, which may be related to personality, social experience, or genetics, to also be more likely to use marijuana.
"That’s something my study simply cannot determine definitively," he said. "We’ve identified what looks like a consistent association, but at the end of the day, it’s an association, and there’s no way for us to prove that one is causing the other."
Critical Period of DevelopmentTeen use of marijuana might be particularly harmful.
"Our best understanding is that those years might be particularly important and impressionable with regard to factors that trigger the onset of a psychotic disorder among people who are destined to have a psychotic disorder," said Dr. Compton.