Postcards from the Funny Farm

When we go to the doctor or hire a lawyer or take a college course, we expect the people we encounter to be professionals.  As such, we assume they don’t have any mental illnesses … that is, many people assume that.  The truth is that many people in the professional world are doing their jobs while living with mental illnesses.  Bipolar is one of them.  In Kay Redfield Jamison’s book “An Unquiet Mind” she gives an anecdote where she reveals her bipolar illness to her boss at Johns Hopkins University.  He sort of blows it off and then tells her that if they got rid of every person with bipolar in the department it would leave them high and dry.  In other words, he assured her it was okay. He let her know he trusted her.

Ultimately, that should be the goal of any person at work, with family, wherever with people: to earn trust.

Many people do not know that famous song and screenwriters are bipolar.  They never hear about it because they live responsibly with their disorder.  Beyond that, we might assume they create such amazing art because of their disorder, not in spite of it.  I guess it’s a circular question.  People in society need more awareness of mentall illness in the professionals among us and less fear of what’s going on “over there.”

For bipolars, Lithium is a lifetime medication to be used daily just like toothpaste or acne cream. The difference is, you can’t miss this one. If you ask a psychiatrist how it works to quell mania, she/he will not be able to tell you exactly. They will, however, tell you that it works. We have gotten far enough along in science to know it isn’t the fault of a full moon.

There are assumptions about kindling in the brain and somehow the salt called Lithium in blood concentrations of .8 to .12 equalize that, but nothing truly measurable exists to explain what Lithium does. The bummer is that if a patient gets more than the .12 concentration it becomes toxic to the liver and kidneys. For this reason, bipolars have to get their blood taken regularly to measure the level. At the same time, if the lithium level is below .8, it is not even therapeutic.

There is a very interesting account on the history of Lithium here.

Some bipolars have to take as many as 16 capsules a day to achieve the right level. Others have to take less depending on their metabolism. Bipolars must be responsible. How many people in their 30’s to 50’s go regularly to a psychiatrist on a monthly basis? Bipolars do and I think that shows a lot of responsibility. Of course, some are in denial and try to avoid therapy. Bipolar has been called “the disease that sleeps.” Those people will have a manic episode eventually and it can destroy jobs, marriages, relationships, everhything. Bipolars that are silent about it and professionals know this risk and work hard to see that they make it to 80 years with luck managing this ferocious sleeping giant.

Bipolar is a serious illness as I have laid out in this series.  But just because it is serious doesn’t mean it can’t be managed.  Let me make something very clear though: it cannot and will not manage itself.  It is an aggressive disorder thate gets worse through a lifetime.  With medication and psychotherapy though, it can be managed.  Bipolars have made enormous contributions to art and science.  It is correct to fear the disorder but incorrect to judge those who have it.  In many cases they are more equipped to handle the world than non-bipolars because they have to watch and learn about their brains every day.  That might be a good endeavor for us all.

I was discussing this series with my wife and she suggested I do a post on what spouses/loved ones should look for as symptoms of bipolar disorder.  After all, this is a mental illness so the person suffering it usually will not notice the symptoms on their own.  Here are some symptoms of a bipolar manic episode:

• Racing thoughts
• Decreased need for sleep
• Grandiosity
• Irritability
• Excessive spending, usually to the point of being overdrawn or maxing credit cards for silly items. Rule of thumb: If authorize.net starts calling your house repeatedly … something bad is going on.
• Highly verbal, almost annoyingly so to others.
• Not eating enough
• overly elevated mood and/or deep depression

Based on what I have read and put together, those are key signs.  You can get a broader and more formal perspective in the DSM section on bipolar/manic depressive illness.

Okay, so now you suspect your spouse or loved one has bipolar: Now what?

Bipolar is “special” among mental illnesses in that it has something called “The Manic Episode.”  People ranging from Carrie Fisher (Princess Leia) to Robert Downey Jr. (Iron Man) have spoken publicly about their manic episode.  Carrie Fisher talked about how she stared at the full moon all night with no need for sleep.  By the way, a little trivia: Carrie Fisher’s novel “Postcards from the Edge” inspired the title of this blog.  That, and Chevy Chase’s 1988 Mental Health humorous film “Funny Farm.”Okay, trivia over.  Robert Downey talked about how the mania brought on drug use.  The fact of the matter is that anyone who suffers a manic episode is lucky to be alive.  Extreme care should be taken with a spouse or loved one who is suffering through one.  They can last for weeks and even sometimes months and they are brutal to the person and anyone who is close to them.  The good news is, there are things you can do:

1. Stay calm and in control.
2. Call the local hospital and ask if they have a psych admitting ward.  Explain the situation.
3. Take them there for admittance or get a referral.
4. If you can’t get them admitted … try to keep them fed, get them to sleep if possible, keep them calm.
5. Unfortunately, some insurances will not pay for the hospitalization unless the patient is “a danger to themself or to others.”  This is a bummer but it is the reality.  Use your best judgment.

I hope this post on what to watch for will help you notice a loved one beginning or going through a manic episode.  Get psychiatric help, this is the key to avoiding disaster.

My hope in this series is to produce a paradigm shift in people’s attitude toward bipolar.  Remember when you were a kid and your parents said you were going somewhere really special?  Depending on your age, it could have been grandmother’s house or a flight to a 3 day stay at Disneyland.  Remember feeling your mood rise instantly beyond what is normal?  Well … that is normal.  Unfortunately for bipolars, their brain can experience this transition for no apparent reason at any random time.  You might think that it’s a good thing, how can it be bad to shoot up to a high mood right?  Well, when there are no logical reasons to be in such an elevated mood a bipolar person can succumb to all sorts of crazy activity … some of it potentially damaging, even deadly.  The brain is a fragile and delicate instrument and for those afflicted with bipolar, life is filled with all sorts of heavy duty work.

In a highly elevated mood, bipolars can experience what is called “grandiosity.”  This is one of the most malicious of all symptoms.  It has been described as a flight of ideas, the feeling one can conquer the world.  You don’t see yourself as Napoleon as a schizophrenic might, but you see yourself as like Napoleon out to conquer the world and you never feel as if you can lose.  This is one possible symptom of a manic episode.  The manic episode can last several days and I have even read of famous bipolars who experienced these for months or more.  This has an effect on blood pressure, spending, sleep habits, etc.  The manic episode has a profoundly devastating effect on relationships, jobs, family, and finances.  I read of one man who went to 20 stores over a 2 days period without sleeping to buy every Buzz Lightyear action figure.  When the episode passed, he realized he had maxed many credit cards in this manic acting out.  Bipolars in a manic state can be very offended and angry if you confront them.  Often this can lead to a straight jacket and a paddy wagon to a hospital.

Then there is the depression.  Just like on a globe there is a South pole and a North pole that are diametrically opposed, so the moods of a bipolar are polarized.  If you remember having a dog or pet die, you remember sinking moods.  Some drops in mood are inevitable in normal brains.  In biopolars they attack viciously with no regard for reason.  For bipolars, ones mood will drop from being manic to being in the utter depths of despair.  I know many people reading this understand depression.  We call this “unipolar.”  The psyche and mood of a person stays down too long and that produces debilitating issues for the depressed person.  For the bipolar person it can be multiple times worse due to all the damage one has done while manic.  Depending on how severe the episode, the bipolar may not even remember the insane theings she/he did while manic.  In a depressed state she/he is ill-equipped to pick up the pieces and get their mood back to normal.

It is like the mood thermostat is broken.  You might set it on “calm” but it fluctuates out of control without any mercy whatsoever.  The brain of a bipolar lacks the natural ability to adjust moods.  Thank goodness for bipolars, there is a wonder drug called Lithium that we will discuss in a future post.  Lithium acts as a repairman who can make the thermostat work a heck of a lot better than without.  As I discuss how Lithium works, I think you will be shocked and amazed to hear about the stigma that keeps many individuals and families from taking this drug.  The same way a Cat5e patch cable connects a computer to a network, si Lithium enables the bipolar to function in society. I’ll explain how it was discovered as a drug for bipolars and why anyone diagnosed with bipolar should talk to their psychiatrist about getting it if they haven’t already.  Lithium is the thermostat fixer for bipolar.  There is hope, thanks to Lithium.

Before discussing the abstract art that we call bipolar, we have to look at diagnosis and what is required.  It seems like more and more news stories about rapists, murderers, garden variety psychopaths, and the like contain a tag at the end of something like:

“This story is truly a tragedy, such and such was being treated for bipolar before they went bad.”

You must have a heart for the bipolars out there who are living productive, often high-level professional albeit silent lives.  They are still dealing with the unbearable highs and lows (which we will discuss in a later post) and they also have to maintain in such a way as to never let anyone expect they have the specter.  After all, the evening news is no friend to bipolars.  They extend the stigma along with ill-informed people, the media, and Hollywood.  It puts an albatross around the neck of anyone who finds out they might have it. Many bipolars say it makes them want to search for the best flight deals out of town.

Even bloggers can spread false stigma about bipolar.  I remember reading one guy’s blog (I won’t link or mention it).  He would write everyday how the walls were breathing and making him angry and other outlandish truly psychotic things.  He would justify it by saying he was bipolar.  I wrote him a note saying his symptoms seemed more schizophrenic than and he said he had read a book and diagnosed himself as bipolar without ever seeing a psychiatrist.  Ah, the downside of the internet.

The number one enemy of people with bipolar is people who self-diagnose themselves as bipolar.

To be clinically diagnosed bipolar, according to the DSM, several quite explicit and profound symptoms must be present over time.  I read one doctor that said true diagnosis can take about 10 years.

The reason this is important is because we all have moods.  Just because someone has mood swings does NOT make her/him bipolar.  Often irresponsible people tell everyone they are bipolar before getting a medical diagnosis.  They do this for mixed reasons.  Bipolar unfortunately has become a “catch all” for people with issues.

Even if a responsible person feels moments of extreme highs and lows and goes to the doctor to get diagnosed, the doctor may be wrong.  Bipolars have to sort through feelings, facts, and the data day to day.  They have to become experts on their disorder because even the doctors can’t know for sure until time has passed and behavior observed.

Do you know someone who claims to be bipolar?  Have you seen a movie or news show that equated moodiness with bipolar?  Remember diagnosis is the key. If they aren’t seeing a psychiatrist regularly (either in real life or on the show) it is likely they are not truly the texbook bipolar.  Rather, they are part of a stereotype.  There is a lot more than mood to bipolar as you will learn in this series. Take this list linked below for example. It is famous people who have been clinically diagnosed as having bipolar.  Recognize any of them?

Remember seeing any of them frothing at the mouth or filmed in a straight-jacket?  Hardly.  Most of them are/were world changers and that’s one thing science can associate with bipolars.  I’ll bet you never heard that in the media!  Consider the silent bipolars when you hear and see the loud ones on your television screen.  Based on what I have researched and experienced regarding bipolar, I think society needs a real paradigm shift toward the truth about it.

Wiki partial list of Famous people with Bipolar

I once read that the Chinese dragon we see in parades and such is an emblem of an enemy to defeat. By making ones enemy beautiful, it is thought that one can better defeat him. Depression is well known to have risen in diagnosis in past decades.  Other mental illnesses remain in the shadows.  For an estimated 3-5% of the world’s population, a mental illness called bipolar is the enemy that must be defeated.  Unfortunately for them, their families, and friends, there isn’t a whole lot of help easily available. It is neurological and not a purely psychological disorder (though cognitive therapy must be present in concert with drugs).  The worst thing about it is the largely unfounded social stigmas that often keep bipolars from sharing their disorder.

Many true diagnosed bipolars live silent lives of quiet desperation.

As with most things, learning the facts produces a paradigm shift but society doesn’t seem too interested.  Folks with bipolar who find understanding are like unlocked cell phones.  Unfortunately friends of people with bipolar can’t get a clear understanding, neither can family.  Even bipolars themselves are many times confused and in denial of what they suffer from. It has been compared to life on a roller coaster.  That’s why I created a series on bipolar.  I hope you are entertained by it and that you learn more about your brain through it.

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This is the introduction to a series at Postcards from the Funny Farm.  If you are interested in the topic of this series, you may want to subscribe via -or- to not miss a post.

The first time I ever listened to BlogTalkRadio was when I heard an interview with Matt Mullenwegg, co-creator of WordPress. Since then, when I hear an interesting voice of our times is being featured on there, I click back over and put my headphones on to enjoy a great show.

I’m writing here about a new show being featured on BlogTalkRadio, it’s called Your Mental Health Radio Talk Show. Some readers will assume immediately that mental health is neither interesting nor does it have anything to do with them: bare with me, I beg to differ, it does. Other readers’ ears perk up because they know mental illness. Whether schizophrenia has touched an aunt or bipolar has ravaged a brother, mental illness (and/or health) is too close to home for many many people in the world. The next time you are walking through a swarmed crowd, remember that one in three people are affected by mental illness. It could be a million dollar movie star you adore or an unseen immigrant in the back of a restaurant quietly cleaning dishes in sinks.

An upcoming show will feature Dr. Raymond Moody, MD author of the world-reknown book Life After Life and his new book Life After Loss takes up where Life After Life left off. The esteemed host and more information about this talk radio channel can be cound here: www.authorsden.com/jacquelinesforeman

That’s what is so great about this new Blog Talk Radio service. I’ll be tuning in regularly because psychology has played a huge role in my personal development. Not only have I read Peck’s treatise but many many others. Incidentally, another amazing one is the classic, Don’t Sweat the Small Stuff by Richard Carlson. Books and other media like these can transform your life from simple survival to truly enjoying life. It can be like the sun shining through the clouds of your life. A regular internet radio show like this can be a great tool for your mental health and that of your friends and loved ones.

Don’t you agree the time for such an internet medium has come?

To raise your awareness of mental health issues or just to be entertained, I wholeheartedly endorse listening to Your Mental Health Talk Radio at blogtalkradio.com/yourmentalhealth Tuesday’s and Thursday’s at 6 PM EST.