I had a very fruitful discussion with my shrink Saturday morning. I wanted to know why it is that some of the folks on the bipolar lists who are obviously far more stable than I am are on disability. It has been suggested that I have force of will, a concept that is complete and total <useless substance>, as is evidenced by my lack of control over my weight.

I’m in a weight loss program. Forget WW, they are amazingly ineffective. But at least they’re inexpensive, eh? This one was $550 for a 17-week program. My goal is to lose at least 30 lbs by the end of the program. F*cking expensive 30 lbs. But you know, you do what you have to. This one is going to work – the emphasis is on identifying triggers and modifying behaviors, and it builds in the changes on a week-by-week basis to avoid an overwhelm. The goal, then, is not weight loss, per se, but creating new habits to replace the old, dysfunctional habits.

What I walked away from the shrink’s office with on Saturday was this: “Motivation is ephemeral.” $125 and worth every penny of it.

If anyone else is interested in “playing in mind” instead of “playing in world”, here’s the concept: “Motivation” implies an external goal of some sort, and external goals can become less important or can have hidden demotivators.

*Commitment* is a better thing to have, because it is self-directed and unwavering.

Or something like that. I will be mulling this over for the next few days, particularly with regard to my weight-loss program. I’ll be continuing the antipsychotics until I get a grip on things.

Disability. No, I couldn’t do it, not permanently. I would lose my already poor social skills, I would break loose from the 24 hour day, I would get *nothing* done. I need the structure that working a 40 hour week gives me.

Besides, engineering pays a whole lot better than mental illness. I’m not clear how they tax SSDI, but my base salary is about 3.5 times what I’d get on SSDI. For the record, I make less than half of what I’d make if I were stable. It’s a tradeoff. I would have to quit my shrink – I pay out of pocket to get a shrink who is competent enough to keep me functional – so I would definitely lose ground as far as controlling the illness goes. The public health shrinks are worse than useless, they are outright damaging. If you fall into the system, it’s all over for you. And engineers aren’t expected to be paragons of normalcy anyway. Being bipolar isn’t a big issue so long as you don’t deliberately antagonize anybody. Geeks and autistics have a lot in common, but that’s another story for another day.

My big worry is this – since bipolars are notorious for lack of insight into our own illness, perhaps I am fooling myself into believing I’m doing ok when in reality I’m tottering about making a total ass of myself. And blogging it, no less.

My next worry is this – we always chide the newbies for quitting their meds and winding up having another episode. "But I’m not sick any more!" you hear them bleat. So I take a base of two meds. If I feel an episode coming on, I can add others as needed. It’s the new food pyramid, with an all-seeing chocolate eye at the apex. Being allowed to adjust the meds myself posits, of course, that I have the insight to know when it’s time to do so. Given my big worry, lack of insight, perhaps I should be rapping my own knuckles for stopping the emergency meds once I stabilize. Perhaps I should just take it all the time and stop worrying about TD and weight gain and drooling.

NO. That’s not an option.

So what I’m getting at is… if you don’t use it, you lose it. Social skills, reasoning ability, mathematics, whatever. If you reward yourself for being disabled, you will become more disabled. If you reward yourself for being healthy, you will be more healthy. The key is to find effective rewards and to apply them.

Or maybe the key is that motivation vs. commitment thing.

BUT… all of that is psychological bullshit. Stuff that I have to work out in my own head. It is *about* bipolar disorder, but it is not a commonality to all bipolars, it’s not part of the diagnosis. Does that make sense?
About the weight loss program. The manual we are working from assumes that the people in the class are unable to weigh pros and cons of menu choices. Now, on a good day I’m able to say… do I need to eat 4 oz of chicken to fill up, or will I feel satisfied on a smaller portion of higher calorie beef? To go over your menu doing that for each item is complicated, and on a bad day it’s practically impossible. To uncomplicate it, they say, “Don’t eat beef, it’s too fattening.” Like, DUH. So don’t *eat* as much!

We could go on about vegans and how holy^Whealthy their dietary beliefs are… when someone lays that mess on me I ask them whether vegans breast-feed. *BOOM!* Head explodes. My shrink and I had a good laugh over that recently. I will also add the bibliographic entry for an article from an anthropology text for the ’80s or ’90s – “Science, Witchcraft and Religion” – about how the health-food industry was taking on a moral tone that even back then had a cult-like quality. Your body is a temple, and the health food clerk is its priest. The book is back in print, maybe I should buy another copy.

It’s kind of like, well, I don’t want to make people examine the liver and muscles of every pig they slaughter to be sure it doesn’t contain the particular diseases and parasites that will also harm humans – issues that don’t pertain to cattle – so I’ll just set up a rule of thumb… “Don’t eat pork!” And so you have kosher laws. Orthodox Jews may try to separate the dietary laws from any pragmatic, temporal reasons for their existance, but trust me, there are very good reasons for not letting pre-literate nomads risk their lives on “unclean” foods.

Do we trust the guys who butcher pigs to put our health above their money when it comes to rejecting infested pork? Hmmmm…

Did you know that fat carries toxins right up the food chain, where it gets more concentrated the higher up you go? So maybe we should eat less fat? NO, wrong answer. The brain is 60% fat. No wonder the kids are hammering down french fries, their brains are starving. We think that low-fat is healthy, so we starve their brains from before birth. I think we’re going to discover that autism is due to insufficient fat in the dient. There is considerable evidence that adding fish oil to the diet improves AHDH and bipolar disorder. The answer, then, is to provide foods with a healthy Omega-6 to Omega-3 ratio. The MH docs are saying a max of 4:1 with a minimum of 1 gram of Omega-3. I’ll edit this later to include links. Grocery stores are carrying a cooking oil that meets the criterion. It browns a little bit at normal temps when you saute with it, but that’s not an insurmountable obstacle.

Or maybe I’m inventing all this.

Something I wrote last year: Mitochondria Food. I will be updating this.

[Hey, this new version of WordPress makes it easier to insert links. And here I’ve been doing it manually.]

But back to the stability issue. Ah, hell, I’ll break this into separate posts later. Why do I care what other bipolars do? I care because there’s a good chance that bipolars are an important genetic variation, one that brings inventiveness and creativity at the price of instability. By medicating us into submission, the status quo is preventing the evolution of the human species. Evolution is a very real threat to folks whose power lies in making the little people follow their small-minded rules of thumb. Uh, yes, this was part of the discussion I had with the shrink. He recommended a book on neuroplasticity, which I will post separately.



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