Journal Entry: 2

Well, the good news is, is that my psychologist was wrong the other day, where she said that I should check myself into hospital. I spoke to my psychiatrist, who believes that what is wrong with me right now could be a neurological problem. I have a neurologist appointment in a few days to find out, fingers crossed.


However, I have been doing more Bipolar research, and found this interesting passage describing five different possible states of mania. I am definitely in this category today I think: 


Group 4 (21.4 percent) had the highest ratings of dysphoria and the lowest of hedonic activation. Corresponding with Kraepelin’s depressive or anxious mania, these patients were marked by prominent depressed mood, anxiety, suicidal ideation, and feelings of guilt, along with high levels of irritability, aggression, psychosis, and paranoid thinking.


I have been very irritable with my boyfriend, and obviously was having psychosis a few days ago (has it fully gone?...not sure). Ok, the suicidal ideation is a little much (although I'm thinking a lot about suicide because of the anniversary of my attempt), but I am anxious and depressed. Thanks Kraepelin for allowing me to label myself again! lol.

How to kill someone with Bipolar in six easy steps

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Journal Entry: 1

Today I am feeling like I might be losing control of the hypomanic state I have been in for the previous two or so weeks. I have been enjoying this period of energy and intense creativity, having been playing piano and writing avidly. But right now I am feeling frenzied. At this moment, I have racing thoughts, I feel nauseous and dizzy, and when I close my eyes I see the flickering strobe-like light. I'm getting worried.

I know for instance that I am having psychotic symptoms. In the night I was hallucinating about there being something in the corner of the room. I was absolutely terrified of this creature/being/obvious figment of my imagination (which during my migraine had became the Baphomet). My boyfriend told me to get out of bed and confront it, but I absolutely couldn't. And I am smelling that familiar scent of nutty mustiness, that seems to come with this mood state.

I want to talk to someone about how I'm feeling, but for some reason don't feel like I can. Also, my usual therapy appointment is on Mondays, but next week due to Thanksgiving, my appointment is on Wednesday. I really wish I had that appointment tomorrow.

Should I be taking Abilify right now? I don't know what to do.

Artists with Bipolar: Emily Dickinson

Hope is the thing with feathers

That perches in the soul,

And sings the tune without the words,

And never stops at all... 

(XIX, p. 19)

I have decided to start a series of postings about famous artists which had Bipolar, discussing the clear connection between artistic creativity and the disorder. As a writer of poetry, piano player and occasional visual art maker myself, this is of utmost interest to me. Also, having started looking into this topic, I am startled by the amount of Bipolar artists/writers/musicians whose style and subject I have enjoyed for a long time, without knowing the connection. My first entry of the Artists with Bipolar is the poet Emily Dickinson.

Emily Dickinson was a Victorian writer, who lived in Amherst, MA in the United States in the mid 19th Century. Her life was a hard one: full of loneliness and misfortune. Known as a eccentric and a recluse, she mainly kept within intense family circles, never marrying and dying at a relatively early age, of kidney dysfunction. Her mother was a very depressed individual, showing hereditary roots behind the Bipolar disorder, alongside clear environmental factors that she faced during her lifetime.

Dickinson is seen as a founding figure in American Poetry history, heralding the start of various pre-modernist forms such as slant rhyme, short lines and unconventional punctuation and capitalization. She was startlingly original and unconventional in comparison to other Victorian poets. For example:

I'm Nobody! Who are you?
Are you -- Nobody -- Too?
Then there's a pair of us!
Don't tell! they'd advertise -- you know!

(XVII, p. 18)

Within her poetry, she deals with subjects such as issues of death and mortality, which clearly points to depressive tendencies. However, what clearly links her work to Bipolar in particular, is the pattern of different phases in her life and writings. She is known to have had two four-year phases (from 1858-1865) of intense emotion and therefore productivity, followed by many years of moderate to low creative turn-out. During her most active phase, she developed her characteristic topics, probably most famously known in poems such as 'XV':

There's a certain slant of light,

On winter afternoons,

That oppresses, like the weight

Of cathedral tunes.

(XV, p. 87)

and 'XXXVII':

Much madness is divinest sense
To a discerning eye;
Much sense the starkest madness.
'Tis the majority
In this, as all, prevails.
Assent, and you are sane; 
Demur,-- you're straightaway dangerous,
And handled with a chain.
(XXXVII, p. 30)

Quotation source: Dickinson, Emily, Selected Poems (New York: Random House, 1993)

Website Find: MentalHealth.com

Eureka! I made a wonderful discovery recently, of a website that really spoke to me as a Bipolar individual. On MentalHealth.com, there is a huge page dedicated to Bipolar disorder, including a gigantic section of weblinks to resource and other sources. This is definitely the best webpage I've found so far on the subject.

Here are some of the new findings that I thought most relevant or interesting to me on the site:

• Bipolar I Disorder is a life-long disease and runs in families but has a complex mode of inheritance
• About half of all patients with Bipolar I Disorder have one parent who also has a mood disorder, usually Major Depressive Disorder.
• Mania can be triggered by giving birth, sleep deprivation, and major stressful life events.
• a variety of imaging studies suggests the involvement of structural abnormalities in the amygdala, basal ganglia and prefrontal cortex. Research is now showing that this disorder is associated with abnormal brain levels of serotonin, norepinephrine, and dopamine.
• The first episode may occur at any age from childhood to old age. The average age at onset is 21.
• Bipolar I Disorder may develop psychotic symptoms. The psychotic symptoms in Bipolar I Disorder only occur during severe manic, mixed or depressive episodes. In contrast, the psychotic symptoms in Schizophrenia can occur when there is no mania or depression.
• the majority of bipolar patients are noncompliant and stop their medication after one year.
• Women with bipolar disorder lose, on average, 9 years in life expectancy, 14 years of lost productivity and 12 years of normal health.
• Monotherapy (treatment with just one medication) for Bipolar Disorder is usually inadequate, and most patients require a combination of a mood-stabilizer and antipsychotic medication.
• Untreated depressive episodes usually last 11 weeks
• Untreated pure manic episodes usually last 6 weeks
• Untreated mixed (manic+depressive) episodes usually last 17 weeks
• Within 2-4 years of first lifetime hospitalization for mania, 43% achieved functional recovery, and 57% switched or had new illness episodes.

To Antipsychotic or Not to Antipsychotic, That is the Question

One of the hardest decisions about my course of treatment has concerned the use of Antipsychotics. My psychiatrist and I (with the often not helpful input of my over-eager family and friends) have gone both ways with me using Abilify, a very modern anti-psychotic medication, alongside my mood stabilizer, Lamictal. I think one of the major problems with my using this (in my family's eyes) is that it is a medicine used by schizophrenics. "There is no way that she is that mentally ill" they say. However -- and this is a big however -- this is just to do mainly with social stigma and also not fully understanding what is happening here.

First of all, that us address what this 'psychotic' nonsense is all about. What does an anti-psychotic prevent?

Well, I have learnt that a manic episode can be with or without psychosis, and I'm pretty darn sure that mine have been with. The BBC Website on Health describes it thus:

If a mood swing becomes very severe, you may have 'psychotic’ symptoms. These include:

• When depressed, you feel guilty, worse than anybody else, or even that you don't exist.
• When manic, you may feel you’re on an important mission or you have special powers or abilities.
• You might also experience hallucinations - when you hear, smell, feel or see something that isn’t there.

An issue with all of this, is about the severity of an episode. So my family might be upset thinking that I am a severe manic (although we know very well that I am Bipolar I but nonetheless...). Let's just say that although psychosis is most commonly known regarding schizophrenics, its also prevalent amongst people with epilepsy, people with cancer, oh, and err people who are drunk(!). So please calm down everyone, it's possible that you were psychotic at some point yourselves....

Due to seeing, hearing, feeling and smelling things that aren't actually there, I am becoming increasingly convinced that I do require an Antipsychotic in my mental health regime. Unless I just get used to the feeling of creepie crawlies on my head, the musty smell that I'm certain cannot possibly be everywhere in this city, the flashy disco lights when I close my eyes, and oh yeah, the Dark Lord or whatever at the end of my bed. But, I do also heed the idea that Abilify is just one of the newest evils out of the best evil of the corporations, the Pharmaceutical companies (just reading this article is enough I think). Just the fact that it costs me $160 a month (after the insurance covers 80%) is enough to make me KNOW that I do not want to take it. But are there alternatives...?

One idea that I have recently got, is from this research paper on Cannabidiols. I may well do a little of my own self-study here...

Book Review: An Inquiet Mind: A Memoir of Moods and Madness, Kay Redfield Jamison

Jamison, Kay Redfield, An Inquiet Mind: A Memoir of Moods and Madness (New York: Vintage, 1995)

When I was diagnosed with Bipolar, many of the closest people in my life recommended I read a book called An Inquiet Mind: A Memoir of Moods and Madness. My mother herself read the book that month and then even sent me a copy. It was unanimously agreed upon within my circle of friends and family that this memoir would be helpful to me. So I read it.

What followed was very unexpected and perhaps unusual: this book actually made me worse. Jamison's memoir didn't aid me, it put me into a severely depressed state; it didn't inform me further, it made me feel less able to cope with having Bipolar Disorder. From looking at reviews into this title, it seems as though my reaction was in the minority, but I thought I'd share a few of my opinions on it.

Looking back on this experience, I wonder why this happened. Much of my reaction I feel comes from the message behind the book. The two biggest lessons I learnt from Redfield, were that it is an incurable and to a certain extent uncontrollable disease, the only real answer being a life of medication. The book is almost painfully negative. Like the term "manic depressive", I take exception to her reclaiming of being "mad" and "madness" in general, which I find derogative and insulting in this day and age.

However, it wasn't all bad, and there were times where she made absolute sense and I could relate well to her experiences. This is a passage that I did relate to, describing the feeling of mania which ends in deep depression:

"There is a particular kind of pain, elation, loneliness and terror involved in this kind of madness. When you're high it's tremendous. The ideas and feelings are fast and frequent like shooting stars, and you follow them until you find better and brighter ones. Shyness goes, the right words and gestures are suddenly there, the power to captivate others a felt certainty. There are interests found in uninteresting people. Sensuality is pervasive and the desire to seduce and be seduced irresistable. Feelings of ease, intensity, power, well-being, financial omnipotence, and euphoria pervade one's marrow. But, somewhere, this changes. The fast ideas are far too fast, and there are far too many; overwhelming confusion replaces clarity. Memory goes. Humor and absorption on friends' faces are replaced by fear and concern. Everything previously moving with the grain is now against -- you are irritable, angry, frightened, uncontrollable, and enmeshed totally in the blackest caves of the mind. You never knew those caves were there. It will never end, for madness carves its own reality." (p. 67)

In conclusion, I feel that this book is best read by people who are not themselves Bipolar, as a reference point to understand the condition. It's depiction of someone with Bipolar is accurate and interestingly written, and much of the research and information within the book is good.

Diagnosis: Bipolar I

On December 19, 2008, I was officially diagnosed with Bipolar Disorder. Here is my story (please note that this is a very honest and thorough account of my experiences and thoughts and may be uncomfortable/unsuitable to some readers):

Throughout my life, I have encountered periods of depression. As a child, I was often considered 'moody' and 'intense'. By the start of my teenage years, my mind had turned darker. I often considered death a desirable option, a release, and even half-heartedly had a suicide pact with a friend.

I acutely remember my first major episode of depression, which happened during the Summer vacation when I was 16, just after taking school examinations. I was constantly teary, not wanting to do anything or even get out of bed, and very unsure as to why. However, like the other periods of depression I had, I recovered exceptionally well. I often went into a jubilant and productive mood period, where it was strange to even consider me as previously being depressed. But because of my darker times, I reached out for medical help during university with limited success, and then more permanently when I got my first career job. However, I never committed myself thoroughly to any talk therapy that I received, and dismissed ideas of me being possibly 'manic depressive' as absurd and ridiculous.

In November 2008, due to a variety of life events and traumas, I was deeply depressed and having intense and deeply concerning suicidal thoughts. I was in many ways having a full breakdown. In panic, I called my previous psychologist who I was seeing earlier in the year and asked him to put me on medication. After some discussion, we decided to try Lexapro, a anti-depressant that I knew my father -- who has Major Depression -- successfully took.

Immediately after beginning taking Lexapro, I felt a dramatic difference. I felt very 'high', with pulse racing and body tingling, whilst feeling rather sedated, drowsy and socially unresponsive all of the time. My memories of this time, such as Thanksgiving Dinner, are most peculiar. At the same time, the suicidal thoughts were still very much present, only I was once more able to get out of bed and function again. Not knowing what to expect from my medication -- and with my therapist unavailable on a long holiday vacation -- I had little understanding that I was having an adverse reaction to the anti-depressant.

About four weeks after being with Lexapro, on a rainy Monday morning, I flipped and decided to kill myself that day. The previous night I was at a social function, where I had felt totally paranoid, thinking that everyone was thinking and talking about me, and unable to communicate at all. I was acutely uncomfortable in my own mind and in my skin, and as I was on medication already, the only answer seemed to be death. Having been thinking and researching about suicide on the internet for several weeks, I knew that a combination of drug overdose and suffocation was the quickest and most pain-free way to go. So, after saying goodbye to my best friend and my husband, I got into the car with all the over-the-counter and prescription medications available to me and with a pack of plastic trash bags. I then drove to the remotest place I could easily get to, thinking that I could kill myself undisturbed and at peace.

I was found two days later by an unknown local to the area, who after dragging me semi-conscious and puking blood out of the car, called for an ambulance. I was taken to hospital where after a heavy time in the ER, I was admitted for a three day stay in the Psychiatric department. I was diagnosed as Bipolar I and having a Mixed episode with psychotic behavior. I was prescribed 200mg Lamictal and 20mg Abilify, and released under family intervention, and under the understanding that I would immediately seek out-patient psychiatric treatment.

In this blog, I intend to catalog my personal journey of treatment, understanding and acknowledgement, as well as looking into Bipolar research and the history of people with Bipolar disorder.