Postcards from the Funny Farm

Mental health has not been an exact science for long.  Some argue it still isn’t and that psychiatry is barbaric.  Here is a simple list of ten types of psychiatry that qualify to me as barbaric, past and present:

1. ECT - Electric Shock
2. Lobotomy
3. Trephining (drilling a hole into the skull revealing the brain.)
4. Bleeding
5. Witch Trials
6. Water dunking
7. Unkempt Asylums
8. Striking (sometimes to the head with bats)
9. Opium and ether
10. Over generalized diagnosis and prescription of psychotropic drugs for many mental disorders.

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.

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.

“We are all time travelers moving at the speed of exactly 60 minutes per hour.”
-Spider Robinson

Some of us are traveling in limousines, others are at the freeway on-ramp with cardboard signs. Regardless of the means, we are going from a point a to a point b every day of our lives. It is easy to look at other peoples work and art in life as nonsensical and bad. Have you ever seen a car with a million poorly placed stickers on it and gone: “Why? It is such a nice car.” That is their art and you should respect it. Once we were down at the beach years ago and I was making sand castles with my niece. I saw the remnants of a sand castle with sticks like towers and assumed the creator was long gone. It was in a good spot so I swept it away as if it never existed. I think the creator must have been mentally ill because she came screaming at me and my young niece as if we were the devil for destroying her sand castle. We got through the scene some how and relocated. Luckily it didn’t seem to affect my niece much but I thought about it for weeks after. I really felt bad about it.

The sand castle wasn’t the real lesson here. For me, it was a lesson about other people and respecting the art they create along the journey. My recommendation is to be very slow to criticize the art that people make whether it is their bumper stickers, their sand castles, or … the way they do simple things in life. It never hurts to give compliments, you can find one for anything. Another way to grow in this area: do a listening experiment.  I hope the sand castle incident will have the same effect on you as it had on me and make you less reckless with other people’s art and hence other people’s emotions. Just like an effective acne treatment, so your words can help and heal someone struggling.

Did you know that science has looked into anger and rage as they relate to the brain? The findings have been quite interesting. A Harvard study found that when subjects revisited tapes they recorded about events that made them angry or enraged they had measurable chemical reactions in the brain. The beginning of what I refer to here as possibility thinking is having an open mind. Many people in the media and in the everyday world struggle with anger and rage and so I’m tackling this issue in hopes it might offer understanding and direction to open minded people who are concerned with their anger and rage.

Here is a somewhat long quote (for me anyway) that explains what happened in the Harvard study better than I could. It is fascinating:

A look into the brains of normal subjects revealed that anger increases blood flow to a reasoning part of their brains, an area over the left eye just behind the forehead, technically called the orbitofrontal cortex. This flow inhibits thoughts of rage. At the same time, blood flow increased activity in the amygdala, an almond-shaped knot of tissue deep in the brain that deals with emotion and vigilance.

Angry feelings arising in the amygdala are normally cooled by activity in the frontal cortex, part of the thinking region of the brain. However, in some severely depressed people a lack of both recognition and control of anger, can lead to violent rage.

“All of us get angry from time to time,” comments Darin Dougherty, an assistant professor who led the research. “At such times, feelings of wrath in the primitive parts of our brains seem to be balanced by inhibitions of our will to act on those feelings.” Source

This process is like a miracle. Of course, the brain itself is a composite of so many apparent miracles it boggles any brain that seeks to understand it. Still we try. While one part of the brain is fed blood and reacts in anger, in unison other blood is fed to an area that controls inhibition that sort of keeps the angry thought under a lid. Of course, brain damage and mental illness can upset the balance of this process. This is why we see movies of people in mental hospitals screaming in rage without stopping. Somehow the delicate balance their brain was meant to have has been disturbed.

So what does this mean to me and you? Once again, it points us to the truths of Phineas Gage: our mind is a delicate instrument that needs care to stay in balance. When we are getting angry often we should ask ourselves: “Is this chemical?” Is there something disrupting the balance between those two parts of the brain? If so, there are likely drugs that can help … see a psychiatrist or a psychologist that has a practice in concert with a psychiatrist. There are so many triggers that make us angry and even despondent. It could be as big as someone ripping you off or maybe just suffering the empty results of top diet pills.

If you feel the issue has more to do with behavioral issues such as a recurring annoyance in the form of a memory or if you are suffering from some of the cognitive distortions, get thee to a therapist and discuss those issues. Or, you can go to a book store or library and do your own study on these issues. Personally, I would recommend going to a professional instead but just make sure you tend to the problem in some way.

Your brain is your lens to the rich pageant called life. Don’t let anger steal anything from you, there is no reason for that.

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.