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.

This morning on my way to teach summer school for day one, I heard news on the radio that Tim Russert had suffered a thrombosis and succumbed to a massive heart attack. The news shocked me, he was only 58. The radio host explained he had an enlarged heart which usually means high blood pressure was present and could have been prevented through medication. In the past I have been open about my own struggle with hypertension and you may recall that I take hypertensive medications to keep my numbers below the normal 120/80. So far, so good. My blog is here 100% for the inspiration of my reader but …

It doesn’t matter how inspired your work is if you are not healthy.

That goes for my teaching and any other work I do. So, in this post today I’m killing the buzz a bit, for a good cause.

I’m 39 as of the 9th this month and I recognize that the treadmill and medication have to be part of my routine if I want to have longevity. Your thing might be diabetic lancets or who knows what. Are you working your program? As you get caught up on your computer and the CAT6 cables around your workspace, how do you feel?

It’s easy to think we can live to be 100 but it’s another thing to do what we can to ensure that. It takes inspiration to live and creativity to incorporating health into our dream. In my life as a dad, I owe it to my wife and kids to be around as long as I can. Tim Russert’s premature passing should be a wake up call, broadcast as far as “Meet the Press” ever did. Are you thinking about your health? Maybe you should be. What does the topic of health make you feel like? Sorry if it bugs ya. not.

My friend Shelly wrote in a recent comment:

we don’t prepare for old age, because when we are young we think we are immortal.

This is so true. We see this in young men under 25 and the psychologists call it “young man’s syndrome.” It is near impossible for men in this age bracket to imagine their own death. So why does it come into clear focus later in life? What changes? Is there a certain quota of aches and pains that have to occur before we realize we are mortal? Maybe this syndrome is a survival mechanism. Maybe it once kept us at the top of the food chain before we became domesticated creatures. Whatever the reason for it, it shows a very important point:

Our brain has a lot to do with our notion of reality.

Phineas Gage, whose skull and brain injury is a pillar of brain study, emerged from his injury virtually unaffected. The thick metal rod shot directly through his cheek and up through his brain leaving fragments of of brain and bone on it yards away. Though everyone thought he would die, he lived another 15 years. His reason and inhibitions drastically changed in those 15 years, but he did indeed live.

I think we take for granted that our brain is like a knee or an elbow or any other external body part: It can get bruised, it can get scratched and upset. Birth defects are a given, but during our life, parts of our brain can be neglected, causing neuroses. It doesn’t have to be a metal rod through the skull to affect our brain chemistry. We tend to think that our brains are immortal. Just because they are there hidden and snug inside our skulls, we can trust they are feeding us a perception that is 100% “reality.” I challenge that common belief. I posit that for as many brains there are walking the Earth there are different notions of reality. We may share some of the basics, but after that brain chemistry differs and therefore so does perception.

So what does this mean to you? Do all you can to take care of your brain. The instrument is fine. The treasures you will find will be in your mind. If you are chronically upset, see a doctor. It could be a chemical problem. There are many out there untreated. Why suffer when drugs exist to bring you into balance? Short of drugs, make sure you eat right and get the vitamins you need. Sleep is also crucial to mental balance. The next time you think you are upset because of “real” things, remember that your imperfect and delicate brain interprets real. Until you’ve had the decent sleep, mediation, and diet, you should never assume that your brain is qualified to judge reality. Even then, it still can be wrong.

This blog is dedicated to addressing issues of inspiration and psychology in 2008. I hope you’ll be back as we explore more questions and issues in this niche.

Is your brain getting all it needs?