The DSM-V will be dropping the diagnosis of pediatric bipolar disorder. It took YEARS for the shrinks to admit that some children were experiencing psychotic manias from the stimulants given to children with ADHD because they didn’t have ADHD! The seminal book on the topic is The Bipolar Child: The Definitive and Reassuring Guide to Childhood’s Most Misunderstood Disorder, Third Edition
Another thing that is STILL missing is an anosognosia specifier. It is my nightmare to be trying to convince some evil bastard that I am not insane.
Anosognosia means you are unaware that you are exhibiting the symptoms of your illness. Self-awareness, i.e. the ability to be objective about yourself, isn’t a guaranteed just because you’re human, but when a mentally ill person doesn’t have it, they can get in extra trouble.
The DSM-IV has specifiers for “last episode depressive” or “with psychosis” but there isn’t one for “painfully aware that she is batshit insane.”
It’s not enough to stay calm and not talk about space aliens. The powers-that-be ASSUME you’ll be on your best behavior. Once on a psych ward even a sane person would be hard-pressed to get back out. There was an experiment a few years ago in which psych grad students feigned hearing voices to be admitted to a psychiatric hospital. Once in, they behaved normally and tried to be released. In all cases the students had to submit to the will of their captors and admit they were mentally ill before being allowed to leave.
“The uniform failure to recognize sanity cannot be attributed to the quality of the hospitals, for, although there were considerable variations among them, several are considered excellent. Nor can it be alleged that there was simply not enough time to observe the pseudopatients. Length of hospitalization ranged from 7 to 52 days, with an average of 19 days. The pseudopatients were not, in fact, carefully observed, but this failure speaks more to traditions within psychiatric hospitals than to lack of opportunity.”
The vagus nerve is a cranial nerve, a honking big nerve that runs from your skull, down your chest and into your abdomen. The punch-in-the-gut feeling of a jolt of adrenalin/the start of an anxiety attack is carried on the vagus nerve.
The usual paradigm for emotions is they start in the brain. Most of the body’s hormones have a dual purpose as a neurotransmitter. The vagus nerve helps coordinate the physical feeling with the emotional feeling – they are one and the same. The mind-body connection.
Most of the body’s serotonin is in the gut. A squirt of serotonin doesn’t just happen in the brain, it happens in the whole body. Ditto adrenaline. The vagus nerve conducts information in both directions. I don’t think it’s entirely accurate to blame anxiety on a brain malfunction.
An interesting treatment for anxiety is “Vagus Nerve Stimulation.” In VNS, a device is implanted that applies current to the vagus nerve is to overwhelm it. It’s kind of like a TENS unit for pain. VNS is a last resort for intractible anxiety.
One implication of this is that if you can control the physical aspects of anxiety – relax your muscles, slow down your breathing & heart rate – then the emotional component will follow. Once the emotions are managed you can work out whatever brought on the anxiety.
Candace Pert, Ph.D. discovered opium (endorphin) receptors in the brain. She wrote an enlightening book Molecules Of Emotion: The Science Behind Mind-Body Medicine.
Also check out Timothy Leary. One of his more interesting ideas is that we have receptor sites for chemicals that haven’t been invented yet. Alexander Shulgin was a chemist who formulated a lot of them, but I don’t recommend you try it. 🙂
More than half of the task force members who will oversee the next edition of the American Psychiatric Association’s most important diagnostic handbook have ties to the drug industry, reports a consumer watchdog group.
If you haven’t read Kay Redfield Jamison’s “<a href="Touched with Fire: Manic-Depressive Illness and the Artistic Temperament“>Touched With Fire; Manic-Depressive Ilness and the Artistic Temperament” run out and get a copy. She is a psychiatrist at Johns Hopkins and is bipolar herself.
“I believe that curiosity, wonder and passion are defining qualities of imaginative minds and great teachers; that restlessness and discontent are vital things; and that intense experience and suffering instruct us in ways that less intense emotions can never do. I believe, in short, that we are equally beholden to heart and mind, and that those who have particularly passionate temperaments and questioning minds leave the world a different place for their having been there. It is important to value intellect and discipline, of course, but it is also important to recognize the power of irrationality, enthusiasm and vast energy. Intensity has its costs, of course — in pain, in hastily and poorly reckoned plans, in impetuousness — but it has its advantages as well.”
Dr. Kay Redfield Jamison, Author and Professor of Psychiatry and Behavioral Sciences at Johns Hopkins University
in “The Benefits of Restlessness and Jagged Edges”
NPR Morning Edition, June 6, 2005
In order to recognize our self-image, we can no longer identify with it. In other words, we have to learn how to objectify our own mental processes.
-Matthew Flickstein, Journey to the Center
Reprinted in Daily Wisdom: 365 Buddhist Inspirations, edited by Josh Bartok.
Photo Source – Flickr
Author *Gabisa Motonia
I’m not doing so well. I had a steroid-induced hypomania for about two weeks, and a subsequent crash. I was able to continue working through it, but I’m going to need a few days off to completely level out. Unfortunately I work for a company with only 5 people, and I do the testing so that we can ship product and bill the customers for all our hard work. It’s hard to get even one day off. I took off on Friday and had to take calls all day long. I might as well have gone in.
I really enjoy my work. Engineering is just as creative as any of the humanities. The main difference is that it attracts linear-sequential people and reductionists. That trait and that philosophy can be real creativity-killers.
Hypomania, or mild mania, can be socially and financially devastating. It’s the reason I sought treatment for the bipolar disorder. “Why do I get so stupid and unreasonably optimistic over and over again?” “Why do I keep making the same mistakes?” Hypomania by definition doesn’t include psychosis, so the impairment is completely due to over-optimism. As an engineer I have Mad Skilz at reality testing.
I usually avoid steroids for that reason, but my back is a mess from the accident last year and I got an epidural to have some relief from the pain. I also avoid painkillers because opioids are a guaranteed depression. There is a DSM-IV code for opioid-induced mood disorder.
Hypomania is exhilarating. Without an occasional hypomania, life is in shades of grey. Dorothy in Kansas. All bipolars have to accept that the price of avoiding hell is to give up heaven.
No meds stop mood swings completely but they make them tolerable and easier to manage. It takes a bit of effort to avoid triggers like lack of sleep, stress, etc. I do ok. A lot of folks on the list and the forum will never do ok. There but for the grace of God go I, eh?
I saw a book online while maintaining the forums this morning. I think you know the researcher EF Torrey? He has a new book called “The Invisible Plague: The Rise of Mental Illness from 1750 to the Present.”
I don’t feel like a deadly bacillus. Mental illness isn’t contagious! You can read everything I write, you can shake my hand and even drink from my glass, but you won’t catch get bipolar disorder from me. So why call it a plague? Why not focus on the triggers that cause a simple genetic propensity to become full-blown mental illness? Is that the point, to avoid implicating societal forces like the switch to strict industrial time constraints in the time frame Torrey’s book covers? Which, incidentally, was fueled by the shortage of workers in post-Plague Europe, but that’s another story. I’m a history buff and I really get into anthropology.
Refer to Edward T. Hall’s “The Dance of Life: The Other Side of Time” for a fascinating exploration of the perception of time as defined by our cultures.
And if you like rock, listen to Dire Straits “Industrial Disease.”
How does Torrey plan to eliminate mental illness? Does he want to go back to forced sterilization? Take biopsies of unborn children to identify and abort diseased DNA, thereby destroying even the unaffected siblings? Or is he content to make a good living calling us names? “Plague” indeed!