Saturday, June 29, 2013

What the F**k is Bipolar Disorder - Part II

To understand bipolar - or manic depression disorder - we first have to understand mania and this is where the fun starts.

Mania can be so many things that any one attempt to define it is meaningless. It can be great for you. It can be connected to artists, artistic expression and great artistic expression. Mozart is said to have been bipolar (something I've been meaning to investigate further but haven't gotten to yet). This is what the most excellent book, The Human Brain (by Rita Carter and others) has to say about this connection between mania and creative output:

Biographical studies suggest that bipolar disorder may be more common among accomplished artists than the general population, and some artists seem to be able to utilize periods of mania as a spur to creativity. For example, the musical output of German composer Robert Schumann (1810-56) - illustrated on the graph below - shows a link between his bouts of mania and the number of compositions he produced. He was most productive during manic phases and least productive when depressed. However, the quality of his work was not affected by his moods.

First of all, I'm not sure how Schumann was diagnosed as manic depressive nor how it was known he was manic - or "hypomanic" as the graph says - during those phases but I'll track that down another time and we'll just give his diagnosis the benefit of the doubt for now. You'll also note that Schumann's life didn't end well but that - how bipolar often ends - is a topic for another day.

Ted Turner is also said to be bipolar (another claim that I'm trying to track down but this is according to the author of Psychology Today's Taming Bipolar). Ted Turner is bipolar? Last time I checked, TT seems to be doing pretty well. If that's mania at work, I'll take two scoops, please.

So it seems that mania can be a Good Thing (at least for a while, not in the end for ol' Schumie).

But there are many known cases of mania leading to ... well, acting simply as a maniac and maybe ending up strapped down to a gurney in a psychiatric ER getting a needle full of drugs pumped into your ass. This is what's known as manic psychosis. This would appear undoubtedly to be a Bad Thing. I have some case studies to present on this when we look into this deeper. I have my own stories about this. It's all very instructive.

Those are the extremes and of course there are all shades and hues in between. Which may or may not exist in the same person at any one time. Then you have concepts such as "rapid cycling", hypomania, cyclothymia, mixed episodes, Bipolar I and Bipolar II and on and on it goes. If you have "mood swings" (a euphemism if I ever saw one), good luck in getting all that sorted out. Maybe you're luckier than me but thirteen people with "Dr." in front of their names (and I could expand that number if I threw in the various GPs I've seen over the years and even more if I included psychologists but "lucky" thirteen - a baker's dozen - seems like such an appropriate number here) couldn't figure mine out to any kind of consensus. I apologize for the word "luckier". "Lucky" is probably not an adjective that can apply to mania (except when you're in the throws of Good Mania and on top of the world ... just mind the step down).

All we can really take from this is that mania is a many splendored thing. Or cursed thing. Or ... well fuck, you get the point. Or at least I hope you do. Confused yet? Good, welcome to the club.

Reading people's personal accounts won't do you much good either. There's a reason for this. It's called embellishment. You see, here's the thing about personal accounts of mental health disorders - they're mostly written by famous people and often from people in the entertainment industry (Kay Jamison is an exception to this but I'll get to her and her books another time). And what do people in the entertainment industry do? They entertain. It's in their blood, they can't help it. Embellishment, therefore, is just part of what they naturally are. Celebrities, to anyone who pays attention, screw up a lot. It's part of the lifestyle (sex and drugs and rock'n'roll and all that). Then, when they grow up, they feel guilty about it. Then they write a tell all book to explain themselves. And this leads to another thing people have a tendency to do - they scapegoat. People have the hardest time owning their own shit. They can't just come out and say, "sorry, I fucked up. It's all on me." So here's one of the dirty little secrets about mental health "disorders" - they're used an excuse for deplorable behaviour. "It wasn't me, it was the mania". And they'll have doctors that go along with all this. It all looks very boo-hoo and impressive. Except some, or a lot, or who knows, is bullshit. It's just all too convenient to live like a complete shit most of your life, do a lot of stupid regrettable shit and then, one day when you grow up and maybe have kids to explain yourself to, to blame it all on some illness.

How much and to what degree an illness like bipolar may or may not have played a role is virtually impossible to say. It's not like there's a blood test or an x-ray or a test of any kind to show how "bipolar" they were or were not. We have to take their word for it and maybe the word of a doctor. And doctors' words, as I'll demonstrate as we go along, can't be taken at full face value either. So I take these accounts with a grain of salt. Or a salt shakers' worth. I'm not saying - nor can I - that a disorder didn't cause some celebrity's behaviour, I just have trouble taking their accounts completely at face value. There's just too much fuzziness around it all (which I'll explore in more detail in future posts).

And part of my insight here is good old fashioned "it takes one to know one". This is what I wrestle with all the time with all the stupid shit I've done in my life - was it me or was it the mania? (or manic depression or mixed episode or whatever). There are no sharp lines between the two. I think I can look at my normal default behaviour and see a difference between illness affected behaviour and not but I can never be sure. And no doctor can help you figure that out either. That is for your own heart of hearts to examine. It is, I can tell you though, far too easy to just escape culpability and responsibility for your actions and blame them on something else.

Bloggers (and believe me, the irony here doesn't escape me) aren't much better. A lot of the understanding of what bipolar and mania are is urban legend I believe. What you see a lot of in some blogs, chat rooms and forums is what I like to call "magnetic symptom syndrome". This is when all kinds of perfectly normal (if imperfect) human behaviours and foibles get drawn in like metal shavings to a magnet as part of the "symptoms" for any one person's "disorder" (if you really want to see examples of this try following an ADD (or ADHD) forum for a while. Everything under the sun seems to become a "symptom".) So trying to learn what bipolar and mania are in the Internet world can be extremely confusing and frustrating as well.

And then there's drugs. Drug and alcohol use may or may not be part of the problem, triggers for the problem or exacerbate the problem. Where this all begins and ends is another nightmare to figure out.Oh, by drugs I don't mean illicit drugs (though that may be part of the mix too), I mean psychiatric drugs. I bet you didn't know that psychiatric drugs could cause mania or that "anti-psychotics" could cause psychosis, did you. Some of the the very drugs they give you to "control" bipolar symptoms could cause them and/or make them worse.

Hey, didn't I tell you this would be fun!

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