Wednesday, July 31, 2013

Update and Misc Ramblings

I am out of the hospital and, coincidentally, also finished splitting up with my family and have them (ex-wife and daughter) moved into a new place of their own. I am officially a ward of the province of British Columbia, staying in a transition house for people with mental health difficulties. It is not a permanent solution as this housing is only temporary while one seeks permanent housing. Which with no present income and in the most expensive city in Canada (and one of the more expensive cities in the world for housing), should be interesting. I still hope to be able to buy a cheap motor home and live out of that but so far those plans have been thwarted. Meanwhile, I wait for my persons with disabilities pension, something that would give me MUCH needed income.

All in all, it could be worse as I have worked with homeless people in the past (briefly as a volunteer) and know that scenario well enough to fully realize how rough that can be. Nonetheless, my recent life all has a very nightmarish quality to it. As someone who's worked all his life and provided for himself, this feels like a very long fall from grace. But so life goes. I was thinking this morning how in life luck can turn. I realized that much of my life had depended on lucky breaks and always meeting the right people and how that pipeline of luck and good fortune has simply just dried up. My experience, always valuable before, suddenly seems without value and without a formal post-secondary education, along with being over fifty years in age, I am stuck in quite an unemployable position (if employers are going to train someone they'd much rather train a younger person).

I don't believe in superstition like "karma" and such but I have done some shitty things to people over the years so during my lower dark moods it feels like this is responsible for my turn in luck. I also burned through my daughter's small education fund (I had no choice and was sure at the time that employment was just around the corner or that a new "job" was going to work out and I'd be able to pay it back but of course that never happened) and this was no small factor in feeling dark and suicidal again recently. This is part of the "joys" of manic depressive swings; you feel up and full of sunny optimism - which then doesn't work out - and so you return, in an inevitable downward slide, to the dark pits of depression where this hideous uncontrollable dark voice reminds you of all the optimistic idiocy of your "up" times. The dark voice of manic depression is, I'm convinced, different than the negative voice of "regular" depression. I've had much experience with both and they "feel" much different. Manic depression (by which I mean the depressed cycle of bipolar) has much more oomph behind it. Like the up cycle, with its uncontrollable optimism, lack of insight, this driving power and so on, the down cycle also lacks insight but rather than runaway optimism there's this driving force of darkness and gloom with a pipeline of negative, destructive thoughts and a suicidal drive. Unlike regular depression, where one still has some insight and can utilize techniques such as cognitive behaviour therapy (as I've done in the past) to ward off negative thoughts, manic depression's lack of insight and manic like oomph makes this much more difficult if not all but impossible (which is all very difficult to explain to people though Kay Jamison does a not bad job describing it in An Unquiet Mind and on Charlie Rose's the Mentally Ill Brain). As I've described before, manic depression is, I'm sure (and brain scans bear this out), as dark as the human brain can go.

But bad luck and down life circumstances aside, however, I AM feeling better. I do not currently feel dark or suicidally depressed (though not exactly "up" either). To what do I owe this? Is it the drugs to which I had to return? I'm not sure to be honest. Personally, I'd more credit the most excellent group therapy at the hospital than anything (I knew the practitioners from a previous stay and they deliberately tailored the sessions to my needs ... largely because I was at times the only one who attended and that I was the only one who attended every session). The drugs? Who knows. There are people who do swear that drugs work for them (among them the afore mentioned Ms Jamison, the grand champion of lithium therapy, which is what I'm on). I have my concerns about  lithium (the side effects include a Parkinson's like hand tremor, impact on reading ability, among others) but my dose is not too high (1,200 mg ... the max is 1,800). A standard "therapy" for bipolar is also to prescribe antipsychotics which is a big WTF to me. I'm not currently psychotic so why the hell would I take harmful antipsychotics when I'm not psychotic? In fact, I became even more psychotic while on them, a phenomenon well described in Robert Whitaker's Anatomy of an Epidemic. Sheer lunacy in my (quite learned) opinion. But this is one of the advantages of no longer being in the hospital; I am not forced to take them (and they do force you to take them in the hospital) so I'll simply not take them. There's no practical, logical or medical reason in the world to take them so I won't. As for the lithium, I'll likely, as a requirement of being on a PWD, have to take that but I'll ... uuhhmm, "tailor" my doses so as to minimize its impact.

Anyway, enough boo-hoo crap.

I still hold out hope for my motor home idea (which would be cheap housing and offer my beloved freedom and mobility) and - ta-da! - I'm looking into taking some college courses. Not, exactly, courses that would aid future employment but courses taken for the simple (and best, IMO) reason of nurturing my mind, that is subjects that I am truly interested in. Since I started researching for my book I've become greatly interested in psychology, philosophy and neuroscience. Neuroscience courses may be above me for now but I can take first year psychology and philosophy courses so that's what I'm looking into (at the most excellent local college). It'll engage my mind, I'll have a chance to meet like minded people and it'll give me something to do. And hey, who knows, perhaps I'll do well then I'll just keep forging forward, and maybe I could get a psychology degree and become a practicing psychologist some day. It's something I'd love doing and I've already got my "It Takes One to Know One" degree. So what if it may take ten years; a journey of a thousand miles begins with a single step. So ... we'll see. No matter where you are in life you have to look forward to something.

Saturday, July 27, 2013

Miscellaneous Musings

Lots of various thoughts that don't merit a full post on themselves.

I am a deep thinker and it's not possible to have been so tempted by death (or driven to it as I described in my series Bipolar and Suicide) and not think about what happens after death. And here is what I concluded happens after death - nothing. I am, as I've written elsewhere, purely an atheist and I look for answers to life strictly in the sciences, particularly of late cognitive neuroscience. Everything we are, you see, is in our brain. It's been said, by whom I'm not sure, that the body is nothing more than a life support for the brain and when the body ceases to function, when the heart and lungs stop supplying oxygen throughout the body, the brain will cease to exist and because the brain, and mind, are all of "who we are", when the brain stops, that it, "we" stop. There is nothing else. Any kind of "afterlife" is merely the human theory of mind at work or, if you prefer, the human over exuberant imagination at work. Or the myths that religions sell. All this is designed to make us feel better about death or, perhaps, make us feel better about life. It is "reassuring", I suppose, to think we're going to get another kick at the can in some sort of afterlife or that we're going to have some sort of "life after death" and get to see all the dead ancestors that we dearly miss (presumably the ones you don't miss will be in hell). Much of what you "believe" will depend on whether you believe in a loving God or a punitive one. I'm delightfully free of believing in either.

All of life is here on earth. Is there any need for more than that? It's beyond me why people would want anymore than that but then I've had a very good life. For those not satisfied with their time on earth, I can see wanting - hoping for - something better after they leave (yes, yes, I can see the irony in my being suicidal and in saying that I've had a good life ... it's an odd thing for sure). Anyway, when the lights go out - when your heart stops supplying blood to your brain - that's it; it dies like any other organism and because "you" die along with your brain, there is no "you" to observe what happens after death despite what you may be led to "believe" by movies such as GhostA Sixth Sense, Contact, and countless other movies and books and not to mention all the religious tripe. I know, science isn't very sexy or romantic and a rather a drab stick in the mud on the whole thing but there ya go. Personally, I prefer to think we're all just a part of nature and die like anything else in nature and that our bodies return to the soil just as any other biological organism (the latter half of ashes to ashes, dust to dust except for the former parts of each of those clauses, IE; just the dust part) but that's just me.


After this last go around in the hospital and dealing with the doctors and nurses and pharmacists again, I'm more convinced than ever that we're a good fifty years or so away from truly understanding mental health disorders and treating them properly. Despite what I presented on what I'd found about the damaging effects of many of the drugs they were proposing for me and despite pleading that my present problems were strictly psychological in nature, they still roboticly spouted The System line: "you need the medications to get better". Though I repeatedly told them I did not get "better" on their medications but got worse, they still just recited rote System propaganda. It was beyond frustrating.


And speaking of frustration, one of the things about being "mentally ill" is that no one takes your word for anything any longer. You see, because I - we - are "mentally ill", we couldn't possibly be right in the head and thinking straight and so people tend not to trust what we say. This was especially so in the hospital even with fellow patients. Whatever I argued about my case, my words were not heard because it was the "sickness talking" or what could I possibly know, I'm a patient in the hospital (being in the hospital certainly didn't lend much credibility to my claims that meditation was my main tool for getting better). If you are reading this, and have read my previous posts, there's a good chance you'll subconsciously question the validity of what I'm saying because I'm "sick". This is pretty broadly the experience of many people with mental health issues and it's certainly my experience. People - non-mental health issue people - will deny that they do this, but they do; it's just that it happens, as 99% of our stuff does, subconsciously without our conscious knowledge.


Further along the lines of what I talked about in the posts on To Be or Not to Be about whether one is mentally ill or not. One thing I touched on was the inability to diagnose a mental illness by any physical means. This also means that the sufferer can point to no medical evidence of being "ill". Right now, for me, I am unable to work due to the long term effects of to a smaller degree my illness and to a larger degree the devastating effects of stress on the mind and body. But there's nothing to point to, no one thing to tell, to indicate my "state" to people. I "appear" to be fine so people assume I'm fine. There's no cast or anything to point to to say that "hey, this part is broken so I can't run a marathon just now". Very frustrating, I guarantee you. As well, people point out all kinds of miracle recoveries as "inspiration". That's cool, and I read those too, but here's the thing; the number one thing that you need to recover from an illness or injury is a strongly functioning brain. And here's the thing with recovering from a mental health disorder; your brain is part of the problem; it's broken (somehow, no one knows how ... further frustration). And here's further the thing; the drugs they put you on are a big part of the problem; they shut down  certain functions. So to get better, you need a healthy brain but your illness is that you have a malfunctioning brain and to "fix" your malfunctioning brain they put you on drugs that cause further malfunctions. All jolly good fun, what?! Uuhhmm, no. 

I don't believe in drugs to get better. Been there, done that, got the suicidal t-shirt to prove it, thank you ver much. I believe in meditation and other mind techniques that have their footings firmly rooted in bleeding edge neuroscience. That plus just getting my life sorted out so that I don't have so many stressors.

Friday, July 26, 2013

To Be or Not to Be (Mentally Ill); That is the Question - II

As I was saying in the previous post of the same name, it's a bit of a quandary as to how one should consider oneself. Trust me, it's not as easy as it would seem.

There can be strong psychological affects as I argue in my book, Dancing in the Dark - Why?. The reasons for this are the two sided psychological trick of placebo - nocebo effect. Placebo is well known but nocebo is the negative counterpart to placebo. I believe that the worst of my "mental illness" was a result of the nocebo effect of the very term itself, a sort of self fulfilling prophecy if you will. I read, was told and heard that bipolar I (and especially in someone like me who'd lived with it undiagnosed for so long) was a "serious, potentially deadly illness" therefor I believed I was seriously ill, so I was seriously ill. At the beginning of this year when I tossed my meds away and boldly declared (to myself first and then to others when it seemed sure that it worked) - I AM NOT MENTALLY ILL, I turned the tables on the placebo/nocebo phenomenon. Just in taking that action, I changed my belief system and shucked off the worst of the effects of what I had been going through. Then all was well most of the year until ...

... we got to where I had to be hospitalized again.


But this is how these things work; they wax and wane, much to my chagrin. And it's frustrating when I feel my mind is very strong and highly functioning over here yet it's still very malfunctioning over there (mostly as a result of five plus years of non-stop stress). But as I said back in the post on the human brain; there are one hundred billion neurons, a hundred and fifty trillion synapses and enough "wiring" to stretch around the world twice. Folks, that's a lot of room for error.

So am I mentally ill? Well, yes, no and maybe. One the one hand I feel as mentally strong as I ever have in my life. On the other hand I feel as mentally weak as I ever have in my life. And my mind might do anything. And here's the thing when it comes to living a "normal" life (IE; the one I used to live, the one that was a highly productive worker who owned his own condo, had lots of savings, etc), the part that's strong is not of much use. I can't see being paid anytime soon to do the kind of research and writing that I do. It's the part that I need for productive work that's part of what's broken. That and that little wee bit that wants to .... eerrrr, "self destruct" as I detailed in a three part series starting here. As much as people close to me would like that to just not be there, uhhmm, nope, it's not that simple. I don't know, nor does any doctor or psychologist know when that may rear its ugly head. So that's the "maybe" wild card.

So what do I think? Well, I don't like the mentally ill label because I feel I'm too "smart" for that. On the other hand it's a fact that it's kind of bureaucratically expedient for me to declare myself so just now. I truly am unfit for most work now and I think I just have to stop even looking until I can get myself back into better mental and physical condition. Plus there's the matter of  all the "land mines" out there that I could step on anytime and have blow up ("triggers" for suicidal episodes in other words). That is just not something I have any control over at this time. I work like hell at it but I really need to work with someone on that (I'm five weeks away from starting my therapy again). So for now, I'm going with the bureaucratic expediency angle which in truth, I really am disabled as far as being a productive worker goes. Or at least as much as anyone is (I've met several people who are on government disability for mental illnesses). This will help me get housing and a pension I can live on which will take an enormous load of stress off me while I better recover. So for now I have to wear the label.

This ties into medications now as well. To "wear the label" and get the benefits, I'll have to show that I've been a good boy and taking my meds. One of the reasons docs like prescribing "problem patients" like me lithium is that it requires regular blood tests to be sure it's in non-toxic levels in the bloodstream (lithium is ...uuhhmm, "yum", a toxic metal). So while this is medically necessary, it also tells the docs if you've been taking it regularly or not. I'm also on antipsychotics which I'll likely not take. Bad shit that stuff is. But to medicate or not is a larger issue that I'll address in the future. But I will have to show I'm taking the lithium because if I don't, that'll void the medical designation I need to draw long term disability benefits and that is something I really need right now. I hope not to stay on them long but you never know. I've burned through so many plans in the past several years that never worked out, I really need something I can count on and government bennies is something I could count on.

So to answer the question posed in the title? The answer, for now, is yes.

Just don't tell the "good half" of my brain that.

Wednesday, July 24, 2013

Update from the Loony Bin

OK, I shouldn't joke like that but I find that looking at it humorously helps take some of the sting out of it and believe me, it does sting. Six years ago I had "it all" (at least as far as my modest goals go): condo half paid off, a nice car, a nice motorbike, an education fund for the snid, lots of savings and now here I am just a short few years later with every single penny of it gone, tens of thousands of dollars in debt, no prospect for employment, no home and in the loony bin. Take my word for it, it stings.

How much of it was "me" and how much of it was the telltale signs of manic behaviour? Or manic depression? (manic depression is much worse than unipolar depression I'd argue ... and I have much experience with both) Who knows. No on will ever know that.

Anyway, all water past the damn now, no sense boo-hooing over spilled milk and all that. The above picture is not my room by the way but it's something like that. Loony bins are a great cry away from the bad old days. In addition to a single bed like that, I have a desk where I can do my studies and write. It's really all I need right now.

My application for a persons with disabilities pension (and I very much feel very debilitated at this point) application is moving along. That's the one thing that I'm really sweating bullets about. If that doesn't go through, I'm really hooped so cross your collective fingers for me there.

I'm legally entitled to a second opinion about my mental state and medications so I had that done yesterday evening. That went really well and I think he's far more sympathetic to my concerns about medications. I'm currently at 1200mg of lithium, a mood stabilizer infamous for its affect on one's ability to read. I told my main team clearly that if I can't read, I'm f**ked; that's all I've got left, my ability to read at a high level. I got really upset about my dosage level one night and ... ahem, spent the night in the "penalty box" (solitary confinement). So I'm hoping my re-val will get the dosage knocked down some. Which might not be a big deal. When I get out, I'll ... uuhhmm, "self-prescribe" anyway. I simply will NOT allow my reading level to be impacted. I'll not take the anti-psychotic either because, well, I'm not psychotic. Anti-psychotics are just something that psychiatrists just brainlessly prescribe to all bipolar and schizophrenic peeps no matter what. Screw that. The affects of anti-psychotics are well known for impairing cognitive functions which, well, I kind of like to have as much of that as possible, please and thank you.

It sounds like I'm going to get out of the hospital soon and to a sort of "half-way house" for psyche patients. I went there last year after that hospitalization. There's more freedom there, more computer access and ... pum-puh-puh-pum, much better food. After that there's another housing deally were I can stay for several weeks. After that, I just hope something works out for a more long term lodging.

THANKS so much to everybody who's been reading along and for the encouraging words.

Sunday, July 21, 2013

A Hopeful Post

I promised myself that I'd start posting some more positive material and I'm going to start that right here and now. As well, everyone who I've talked to about my ideas for fighting back against mental health disorders tells me I should "write a book about it". Which, well, I am. Anyway, here's some of what I learned and what has helped pull me away from the precipice of suicide.

It is hard for us people struggling with mental health disorders to take what I somewhat disparagingly call "shiny-happy" advice from those who have not gone through our struggles. And I'm talking the real serious stuff here, not just bouts of the blues or what have you. I mean stuff that disrupts your life, costs you jobs and relationships and so on. If you think "they" don't get it, you are right, they don't, or most often don't.

But no such case here. You are getting this advice and encouragement from someone who's been to hell and back. I struggle through elements of all the "big five" (schizophrenia, bipolar, major depressive disorder, anxiety, ADHD AND very bad suicidal issues). I've lived through suicidal psychosis. I've lived through depression so dark and deep that getting put out of my misery with a bullet would have been very welcome relief indeed. Yet here I still am.

And I am here to tell you that there is hope, there really is. As long as your heart is beating and your lungs drawing air, there is hope.

I'll just be brief today but here are some of my foundations of hope based on what's been working for me;

  1. I shucked off the "mentally ill" label. This is a big factor. When I declared earlier this year in a huge loud voice that may well have woken the neighbours, "I AM NOT MENTALLY ILL!!!", it had a huge psychological boost effect. It was like letting go of a millstone around my neck. It doesn't mean your illness just "goes away", but it gives you a greater strength to fend it off. I'll get more into this in future posts.
  2. Drugs are not the answer. They really and truly aren't. This is a huge topic, I know, and I'll leave it for now but for me it made a huge difference. There are psychological factors and scientific factors that makes it potentially work for anyone but for now I'll just let it sit with people. 
  3. Meditation IS the answer. My mantra now is to take the "c" out of medication and replace it with a "t" for meditation. The powers of meditation are vastly too little understood. The powers of meditation can be tracked with brain scans. Meditation can be proven to enlarge parts of your brain in positive ways (while in contrast, long term studies show that many medications will shrink your brain matter or otherwise cause harm to your one and only beautiful brain).
  4. Neuroplasticity is another answer. This is the concept of being able to change your brain through meditation and brain excercises. This science is rock solid and bleeding edge. This WILL change your brain in positive ways.
  5. Changing daily habits and eating habits. You CAN do this. Better habits and better nutrition WILL change you for the better. There is a blog I follow called Thug Kitchen whose motto is ... ahem ... "eat like you give a fuck". And it's true; you start eating like you really care about yourself and you WILL start to feel better. 
  6. Self-compassion. This is essential. You may have to kind of forget about other people in your life and what they think of you. You just start with YOU and have compassion for YOU. It's hard to learn, I know, but I did it and so can you.
This is just a rough list and I want to get into more detail on all of this stuff. This is the funnest stuff I write about. Look, I can't tell you how close I've been to you-know-what. Trust me, I've been down there ("there" being the deepest, darkest, miserable pits of hell). My last psychotic episode was a true horror show. But here I am, because I just keep applying those six things (well, #2 I'm in a bit of a bind just now but I'll get back off of them as soon as I can). These, and other methods, have made amazing differences for me and I am positive they can do so for you as well.

I've made and lost enough hope the last few years of struggles to fill a container ship. Yet I know that to get through all the tomorrows you still need hope so I just get up off the mat after each knock out punch and build more hope. You can too. 

Oh, there's one more take away I want you to have. You have a brain. It's an amazing brain. Ponder this; your brain has one hundred billion neurons, a hundred and fifty trillion synapses and enough "wiring" to go around the earth twice . That, baby, is a lot of power - and you can learn to use it to defeat anything. Yes, anything. In future posts I'll tell some inspiring stories. 

That's it for today. So for now, ponder on those six things along with the power of your brain and 

To Be or Not to Be (mentally ill); That is the Question

I probable drive everyone I know crazy about how I see my condition. I call it "bipolar like mind" here, a "mental phenomenon" over there, a "mental illness" in some cases, mental health disorder in yet other cases. It really is a case of "to be or not to be, that is the question".

You see, good reader, it truly is an dilemma for us "mental illness" people. You label it one way and people don't take it seriously, you label it another way and they read "too much into it". "Mental illness" conjures up all kinds of negative images of insane asylums past or acts of violence or of being not trustworthy and on and on. This is impossible to understand unless you've seen it from our view or have been in our shoes. And the kicker is that you probably won't take my word for what I'm observing because you'll subconsciously think - "he's not quite right in the head" and you'll value my views less than you would a "normal" person! It's kind of maddening, really.

But I've been furtively been taking notes and mental notes on how people view me and that together what other mental health issue people (note how I avoid the word "illness") and I am almost completely certain that people - even some people on the psyche ward! - change their behaviour towards me when I describe the extent of my condition.

So, from what I've observed from my own experience and what I've read in individual case studies, others will, a) outright reject or shun "mental cases", b) not outright shun but actively avoid them (make excuses to not get together or talk on the phone, etc.) or c) maintain some relationship but reduce the intimacy of the relationship, or a subset of c, d) tolerate but not get too close.

The labeling thing is a tough one and there are several things at work here. First is understanding just what a mental health disorder is. This is truly the toughest as even trained psychiatrists have trouble with what a certain person may or may not have. From the blog The Neuroskeptic;

"... now the talk has moved into a new phase, because the results of theDSM-5 ‘field trials’ are finally out. In these studies, the reliability of the new diagnostic criteria for different psychiatric disorders was measured. The new editorial is a summary and discussion of the field trial data.
Two different psychiatrists assessed each patient, and the agreement between their diagnoses was calculated, as the kappa statistic, where 0 indicates no correlation at all and 1 is perfect.
It turns out that the reliabilities of most DSM-5 disorders were not very good. The majority were around 0.5, which is at best mediocre. These included such pillars of psychiatric diagnosis like schizophrenia, bipolar disorder, and alcoholism.
Others were worse. Depression, had a frankly crap kappa of 0.28, and the new ‘Mixed Anxiety-Depressive Disorder’ came in at -0.004 (sic). It was completely meaningless."

I have many such quotes about the DSM-V and its predessor the DSM-IV but this one will do. What it does is tell us that not even the highest trained psychiatrists can reliably get diagnoses right. And this is the thing with mental health disorders. There are NO tests for them; not a piss test, not an x-ray or brain scan (though I put much faith in the future of brain scan technology), nothing. It's all based on observable "behaviours". So if the docs have trouble getting it right, and there are no tests, how is the general public supposed to know what we "have"?

This is the thing, you can't. And this is where it gets really tough for us mental health disorder peeps; no one understands us. This frustration is so great that it becomes, I firmly believe, part of our problem; we're suffering like the Dickens inside but nobody (save for a very few very empathetic and perceptive people) can "see" that suffering. We end up getting lashed by most of the public or friends or family even because they think we're just being "lazy" when we can't do something because of our condition. There's a part of our minds that is "disabled" and not working right. But those on the outside tend to see a perfectly "healthy" person. It's like having someone who was disabled with polio lashed because they can't run a marathon.

The term "mental illness" was meant to alleviate this in that it'd tell people that us "ill" peeps were suffering from a real illness - which we are. But the term is useless if the general public remains ignorant - and they, you, ARE very ignorant - of what mental health disorders are and how difficult they make life for those who suffer from them. Furthermore, the story (and it is a story) that mental illnesses are biological in nature due to "chemical imbalances" only makes the situation worse; people in polls, as explained here, have even more negative attitudes towards those with mental health disorders.

So this is the rock and the hard place we're in. Call it a serious illness and people have negative attitudes towards us, give it another term and people can't understand why we can't work for example or have days we can't work or why we have to go to the hospital sometimes.

So, should I be "mentally ill" or not be "mentally ill"? It's really lose/lose to be honest.

I see I am already running to the end of my blog post word limit. I'll post more on this in a future post. I want to get more into the psychological impact of illness labels both good and bad.

In the meantime, mental conditions can be very hard to live with and societal blame and shaming is a big part of the problem. I trust that I am helping you, dear reader, overcome your ignorance (which I only use in the lack of knowledge sense of the word) and that you can learn to be more empathetic and encouraging to anyone you know who may be struggling with a mental health disorder even if it may not seem to be a "big deal" to you.

Saturday, July 20, 2013

Do Your Part to Reduce the Stigma of Mental Illnesses

I find it interesting how little response there is to my posts on mental illness, interesting but not surprising. 

One of the toughest things sufferers of mental illness face is the discomfort - and resulting stigma - that wider society, or even from our own families, feel. It is, as far as my research and thoughts can see, a kind of mass denial; ignore it enough and it'll go away. Further, my thoughts are that this is how people are designed by evolution to deal with illnesses of this kind; as if a kind of shunning will remove these "broken people" from the gene pool. 

I see how my posts on mental illness seldom get plusses (or likes on FB) or any comments (I do get many page hits sometimes but this doesn't say if people actually read them or not). Post a cat picture or a political cartoon and watch the plusses and comments roll in. Post something on mental illness and everyone goes silent.

I've been aware since I started blogging and sharing the blog posts that I could be shooting holes in my own boat, that is that I could be damaging my own reputation. But I refuse to hide this from society. Too many people die because they could not open up about their suffering and kept it hidden where it eats at them as surely as acid. So I write about my own situation and day to day experience to not only declare openly what I am, but to educate.

Hey, folks, I'm not a "wacko" or "loon" or whatever it is you people think about my people, I'm really OK. I'm that person who more or less intelligently posts about all kinds of things just with an added "bug". Most of my brain is really strong and OK! <points to majority of brain> It's just that there's this part <points to small portion of brain> that's really kind of broken. 

But no need to be afraid of reading about mental health issues! Jump in, the water's fine!! You'll learn stuff! Honest!! 

And please, share! Share like crazy! Do YOUR part to diminish the stigma that we mental health issues people suffer from. I can guarantee you that the worst part we suffer from is from societal stigmatization. 

[PS - I have no idea how the format got that way]

Weird Scenes Inside the Goldmine - Cops and Cuffs

Life inside a psychiatric institute isn't as bad as during the One Flew Over the Cuckoo's Nest days of course (still Jack Nicholson's best film, IMO). I have a comfortable bed (well, sort of; it's just a step up on the softness scale from concrete), a private room with a desk at which I can do my studying and writing. I have a lovely view and get the morning sun. I get three meals a day plus an evening snack. All in all, it's a huge step up from the psychiatric institution days like that depicted in that movie and the horror shows of earlier institutions as depicted below:

So I certainly have nothing to complain about as far as comfort and more compassionate treatment goes.

Regular readers will know I am opposed to the chemical treatment of mental heath disorders and feel that other approaches are not explored or promoted well enough. I feel this way from my own experience and from the deep research I've done on psychiatric medications and the negative effects they have on tens of thousands of people in the Western world. For thousands of those people, and almost me on many occasions, that "negative effect" means fatal. I need far more space and time than I have available today to fully flesh out my anti-psychiatric drug stance but for anyone interested, Pulitzer Prize nominated science writer (be careful to note that does not mean sci-fi writer), Robert Whitaker deeply researches mental health and psychiatric drugs. His columns and books make an excellent starting point to begin to understand the potentially harmful effects of psychiatric drugs.

So it was with this stance that I entered the psychiatric system once again. This is my fourth go-around in psychiatric hospitals and by far the least dignified way of "entry". The previous three times I went there on my own volition. Not so this time.

I had a very bad breakdown a week ago Wednesday (the 10th of July). It was ... hard to describe ... just a very bad and dangerous breakdown (see previous posts on suicide) but this is the good thing of having had a suicide safety plan for these last several years AND having had it rehearsed and memorized. While one part of my mind was in full blown catastrophic meltdown mode, another part reacted to the training. That part of me knew I was in very grave danger and blew past the first five steps of the safety plan and straight to where it says dial 911. Based on my state, the operator did not send an ambulance, however, she sent cops. Lots of 'em. I was talked out of my suite to the street. There I was surrounded by a half dozen members of the RCMP and a single SWAT unit.

This is normal, however, for super distraught cases like mine. The reason, or part of it, is the growing phenomenon of suicide by cop. So unlike times past, this time I was handcuffed and put in the back of a squad car. I will say though that they treated me exceedingly well and respectfully. The show of force and handcuff protocal was put in place for good reason and once they saw I was not violent, they treated me well. The officer who drove me in - "Kat" was her nickname - handled me very well and stayed with me all through triad and admission. I plan to go to the station and thank her personally and the other male officer who who gave me a very heart warming "you did the right thing today buddy. All the best to you" and a little "fist bump" thing through the squad car bars. Through the whole process from my initial call to 911 and the two female officers that talked me through it, I felt they were truly being compassion of my situation.

So that is what led to giving psychiatry another kick at the can in helping me.

So far their "diagnostic" process (one of these days I'll write a post on this sham of a "process") and "drug therapy" hasn't been very effective for me. The reason, in a nut shell, is that my most pressing problems are largely environmental in nature; that is, it's "life issues" that have caused my latest breakdown or in my case it's not so much a manic or manic depression phase though I do seem to have certain "wired in" issues that I discussed earlier in a three part series starting here

But I argue that my current state is largely due to life stressors such as long term chronic unemployment, debt issues, loss of esteem that comes from those issues, loneliness and isolation issues, plus possible homelessness and separation from my family. Pills aren't going to fix those things. A pill is not going to get me a job, it's not going to find me a romantic partner, it's not going fix any of my life problems. In other words, my problems are more psychological in nature rather than in "brain chemistry" stuff. If we were to properly arrange the horse before the cart, my psychological issues would be the horse and counselling help would be the cart. Psychiatry would be an onlooker at best. As far as suicide and my situation goes, I'm smack dab in the middle of the largest suicide demographic there is today. I hit all of those markers.

My personal experience, which I dab at here and there throughout this blog, is that anti-psychotics and lithium will have a very negative impact on my cognitive abilities and impact my reading ability and my abilities to form thoughts and create ideas. This is how the drugs "prevent" mania (which is not the boogeyman they make it out to be, or not in me anyway), they "knock down" your thinking process and dull your senses. Well, ALL I have left after this five and half year slide toward's financial ruin and homelessness is my mind. That's it. Take that away and then I truly have nothing left. That will make me MORE suicidal, not less.

So it's with all of this in mind that I am strongly anti-medication at the best of times but when my suicidal thoughts are being driven by environmental issues and not "psychiatric issues", I am doubly anti-medications.

But let me tell you, a psychiatric hospital is the last place  you want to take a stubborn anti-psychiatric medications stand. They hold all the cards, you hold none.

They will force/impel you to take their drugs two ways.

When you enter the psyche ward you have zero privileges. You are stripped of all your clothing and that gets locked up so you can't access it. You'll have no off-ward privileges at all. So one way is to promise more privileges. If you're a good boy or girl, you'll get raised to "level 2". Wheee <sarcastic tone of voice>. Continue to be a good boy or girl and you'll get up to the highly coveted "level 3"! You get your own clothes back and more off ward privileges, like the ability to go over to Starbucks and get a real cup of coffee or to get some food  with actual substance and flavour. Those are the carrots. The sticks are getting tossed in the "isolation room" or losing privileges.

The isolation room is exactly what it sounds like - solitary confinement and it IS used as punishment. I've had three stints in there. Haha, but I fooled them. I used the isolation room to my advantage. It is, you see, a GREAT place to meditate. It's just four bare walls, a bare floor and a mattress and pillow and pitch black when the lights are out. So I just used my time in there to meditate, come up with ideas and lots of fun stuff. My first night in, they broke before I did. So if you refuse your meds (which I did on two occasions), you WILL be forcibly - with big, burly security guards - tossed in solitary confinement and possibly forcibly injected with the drugs. Even if you can demonstrate that they cause more harm than good.

Another time I got tossed in there was for blowing up at my "team" (three of which look like they're barely old enough to date my daughter). This team - the kids along with their "leader" - was extremely frustrating to deal with. I felt - with very good reason - that a) my situation was not a "psychiatric" one but a psychological one based on difficult life issues and b) that the drugs had a history of doing me more harm than good. And no matter how many times I explained this or how many ways, they just kept coming back to "you need drugs to make you better". There is no scientific proof of this and I could demonstrate my mental decline on them and how that worked down to the synaptic level of brain operations but they just kept coming back to the same line as if they were dolls that spoke when you pulled the cord in their back. Honestly, they're just like that. Seemingly no thoughts at all, just rote citations of the standard psychiatric dogma. So I kind of blew my top once. And was sent to "the penalty box" (the isolation room).

It was my ... third time, I believe, that I meditated and ruminated and mulled and thought over that this was a battle I had no chance of winning. I thought they could see reason but they could not. So I concluded that I'd just "play ball" with them. I'm not happy with either the meds or the doses but I can tough them out for a while then get them adjusted elsewhere. Which reminds me, there's a third carrot/stick they use. I desperately need an income of some sort and the best one for me would be the provincial government's Persons With Disabilities program. But here's the rub; you can't qualify without a mental health diagnosis and by taking a prescribed medication. So in order to get money to live on, I have to take their drugs.

Oh, one final note. This now makes seventeen different psychiatrists I've seen over the last decade or so.

Tres curieux, n'est pas?!

Wednesday, July 10, 2013

Bipolar and Suicide - III

Bipolar and Death Becomes Your Hope:

Bipolar does some very strange things to the concept of hope. Hope is vital to the human spirit and is one of the things - I think, I believe - that is part of what makes our uniquely human brains unique. The ability to form hope and hold on to it in times of darkness (and I don't mean mental illness darkness but the darkness of life's struggles in the "outer world") is a key survival tool. When things look logically impossible, it is hope that will drive us to continue. 

I've been blessed with a lot of capacity for hope. I've been in some of the goofiest hopeless looking situations and just stumbled through them because of pure blind faith hope. But bipolar may, paradoxically, be turning that against me.

There's a strong connection between mania and hope, I believe. This is more my personal theory. The other things I've talked about I'm pretty sure about and there's more science and studies to back them up but I can't recall reading any specific references to hope. But to support my case I turn to the amount of great leaders that were supposedly bipolar. We're talking from Alexander the Great to Winston Churchill. And I think it's evolution that created this feature (and what else would it be?). 

I'll connect the rest of mania's "features" to evolutionary design another day but I just want to focus on hope here. When times are tough and difficult and the tribe is in mortal danger, you'd better have a leader that can create, envision, maintain and inspire hope. Enter the manic mind. The manic mind can create hope out of nothing. The manic mind can create and envision crazy, crazy amounts of hope. And maybe even throw in delusions of grandeur for good measure (which, if it's a good leader, will make him a visionary). Anyway, all handy stuff when your tribe is outnumbered ten to one and about to be annihilated by the neighbouring tribe. 

But - and this connects back to my previous post - you'd better have the chops to back it up. I'm sure evolution culled out a lot of manic "visionary leaders" over the millenia who didn't have the chops - or balls - to back up their visions of hope.  

So you've lived with these visions of hope all your life and none of them have worked out and then you've been plunged down into the worst depths of your life after you've lost everything you've ever owned, ever worked for and you've lost all concepts of who you are, or who you were, and robbed you of all ability you thought you had and the years of stress have broken down your brain and body - in other words, everything you've ever had, every tool you've ever had, every weapon you've ever had has been taken from you, they're no longer available to you. 

Yet your manic mind still keeps putting up these visions of "hope". Except they're not hope anymore, not in a positive sense. Because when you've reached for something so many times and fallen on your face each time, the brain creates something else. It creates a pain response. Hope creates pain. Hope IS pain. Cruel, sadistic pain. But you can't make it go away so it taunts you and pains you  every day. And maybe this is part of the psychic pain some people talk about. It's a pain very, very few people can understand because you'd have had to have walked down a very particular path to have gotten to this point to understand it.

So rather than hope being a "positive" thing, as most people would think quite naturally think of it, after awhile hope becomes something cruel and negative. And then the mind - whether this is an "exclusive" of the bipolar mind or not - twists this around and offers a new take on hope. Death becomes your hope. Hope, at its core, is designed to deliver the human mind from suffering, to offer a way forward in times of darkness. In the suicidal mind (bipolar or otherwise), this is what becomes broken. Death becomes a vision of hope. As I wrote earlier, this is something that would be incomprehensible to 99.9% of people, including "professionals". This death as hope twist in the mind takes place in many people who have attempted suicide successfully or not but I believe that the bipolar mind has a particular "talent" for creating this mental state.  

Bipolar, Suicide and the Dark Side of Neuroplasticity: 

Neuroplasticity is how the brain responds to environmental conditions. Create a certain environment (outside stimuli of all imaginable variety) or a repeated thought process and the brain will "re-wire" itself, or reconfigure itself, to adapt to that. This can be a good thing - such as how the brains of blind people develop other highly attuned skills that sighted people do not possess - or it can be a bad thing, like addictions, Obsessive Compulsive Disorder, pedophilia and so on. I hate to toot my own horn as a smarty pants again, but as soon as I understood the concept of neuroplasticity (earlier this year, after I'd started my general research into the brain and mental health disorders), I knew that the answers to suicidal ideation lay here - the brain's wiring gets out of wack. 

This can be both horrifying - to think that a brain can be "wired for self-death" (which it is in the case of suicide bombers for example) - or full of promise for those with a suicidal drive; for what has become "wired" in the brain can become "unwired" or rewired. It takes an enormous amount of work, but it can be done. At any rate, this is what's going on - in a strictly scientific view - with the suicidal brain. What can make a brain "hope" to die, to view death as "hope"? The answer, my friend, is not blowing in the wind, it's in the science of neuroplasticity.

It would appear that my ideas on this are born out and being looked into by others

Bipolar, Suicide and Psychiatric Medications:

My book, Dancing in the Dark - Why?, is based entirely on that question - why? And that "why?" was this; why did I become more suicidal after I entered the "care" of the mental health care system and systematically took their prescribed potions? Further, why did this not just happen to me, but happen to thousands of people? My book, people, has already grown past 150,000 words so I could not possibly even briefly summarize that here. If you are interested in this question, all I can do is give you some paths to follow. I was on at various times, during my two and a half year pharmacological reign of terror on my mind, lithium, dovalproax, anti-psychotics, SSRI anti-depressants, a benzodiazopine, sleep aids and ... I think that's it. How would the drugs that are ostensibly supposed to "help" a suicidal man drive him to worse suicidal "ideation" (a euphemism of utterly no practical meaning that I despise, by the way)? Let me count the ways:

There is copious evidence linking SSRI use to suicide and increased suicidal ideation. I fill a large portion of one chapter of my book with case histories and evidence on this.

Lithium is not exactly "good" for the human brain or central nervous system. I despised how I felt on lithium. It is well known to reduce joy in life (and hence "knock down mania"). Again, much more detail to go into on lithium. 

Anti-psychotics can not only increase or worsen psychosis but also change your brain structure.

Divalproex is an anti-seizure drug developed to treat epilepsy which my one psychiatrist described to me as "the zombie drug". Which is exactly how many people who saw me during this period described me. Google "divalproex zombie" and you'll get many references to "feeling like a zombie"

So take your pick. Aside from actual changes in brain structure and function, there are the devastating psychological side effects of being changed from a life loving, gregarious, smart, lively person into being what people characterize as a zombie. Or that it feels like your soul is being sucked out of you. And all your joy for life. Or the psychological impact of a life long skinny guy ballooning up by close to fifty pounds because of weight gain side effects. 

Why doesn't suicide or suicidal risk happen to everyone? That's a good and fair question. As I described about the human brain and mind, it is an extremely complex organ and the most mysterious device in the known universe. But for starters, one would have to look at the blood-brain barrier and each individual body's drug metabolism. We're all the same yet we're all different. How each of us responds to alcohol is different. How each of us respond to something as simple and every day life as a conversation with the opposite sex is different. We're a complicated species. So I guess it's just the "luck of the draw" whether some people are driven to suicide by psychiatric drugs or not. 


So, take your pick among all these factors. One way or the other, the bipolar brain becomes physically different. The bipolar brain can greatly mess with your psychology. The bipolar brain can really mess with your wiring and cause it to do wrong things, including suicide. I've written before about how life just wears one down. If life blows and life losses are straw, there just comes a day when a last straw breaks the camel's back. Dealing with all these factors for thirty plus years just wears you down. That bipolar disorder worsens over time and with each cycle is well established. 

But if nothing else, I am a tough SOB. I was born to a tough family and my life in logging made me pretty tough. Am I tough enough? Tough enough for that day? That's a question I answer one day at a time, my friend. 

Monday, July 8, 2013

Bipolar and Suicide - II

Bipolar and "Reality":

There is a good chance that bipolar will completely destroy your concept of reality. Mania will create one reality. Manic depression will create another. Mixed episodes will create yet other realities. 

Mania and delusions are well documented. Not well understood, but well documented. The delusions can be all kinds of things. Seeing God for example. Being God for another. That's at the high end of the scale of course. It will make you believe all kinds of things about yourself. If it's on the positive side, it can make you believe that you're capable of anything on earth. It can also create some pretty goofy shit. Some of my goofy shit I'm too embarrassed to say (though I do describe some of it in one chapter of my book).

Whatever it is - and I have to emphasize that it could be almost anything - at the time it's happening, that's your reality. You have no concept whatsoever that it's anything but real and no one - and I do mean no one - can tell you any different. No matter how crazy or out there it is, it's absolutely real in your mind. That's the delusion part, you see? But it might be totally wacko delusional, or it might be plausible. Or maybe it IS real. If you're Mozart and it's presenting unbelievable music to you, then you have the chops to take the "delusion" and make it real. Or not. Who knows. And this is the thing - who knows. I mean, who fucking knows. Not you, that's for sure. 

And manic depression does the same thing except in reverse. Instead of cool, positive way out there things, they will be the most horrid, negative things. And these too will be your reality. It doesn't matter how "wrong" they are or appear to be to others, they are your reality. You can't fight them off because you don't have the "awareness" to recognize them as not reality. You don't have the awareness because this is what true mania or manic depression do - they take over your brain's functions. You don't get a "choice". Things like Cognitive Behaviour Therapy won't work because for that to work you have to have some control over your cognitive functions and true mania and true manic depression take that right out of your hands. After it's over you can do your little mental tricks and techniques, but not during.

And these "realities", the manic ones and the depressive ones, will be as polar opposite of each other as you could possibly imagine. They'll be galaxies apart. Like from people from two different planets. Both inside you. And they randomly flip around. 

Mixed episodes can produce a whole grab bag. Maybe paranoid delusions (believing people are out to harm you). So, as mentioned, you keep cycling through these like you're on a roller coaster and after a while you have no fucking idea whatsoever what "reality" is. Psychologically it's absolutely devastating. Then you get other people's input and "ideas" of who you are and what you can do. So, because you begin to trust others more than yourself, you try to live up to those. But guess what, you can't. Or not for long. Not if you're cycling. Somewhere in there might be "normal" but after a while you have no idea what that is or any connection to it. So you lose your grip on that and can't live up to others' "reality" of you either. Then you have to deal with others' anger and disappointment with you. Just being bombarded with constantly changing inner realities is enough to make you want to take a gun to your head to make it all stop. 

And what happens - and this is the psychological damage part - you just lose any kind of trust or confidence in yourself and what your "reality" might be. And worse. See, this is the suicide part. The "reality" presented to you - with great force - may just be that you're the worst scum bucket on earth. You see, because you've had so many distorted versions of "reality" and worse, you've acted on many of them and because many of them were way out there wacko this means you've done some really stupid shit. And bad shit. To other people. And hurt them. So you have a whole track record of "reality" that IS reality because you really did those things and they DO exist in your memory. Then all this gets presented to you in a sort of "trial" as the "reality" you have to be "punished" for. By "punished", I mean die. And because you're used to the "realities" created in your mind and because many of them are real memories of real actions and because you've had the cognitive control taken away from you (remember what we read earlier about damage to the frontal cortex), there's nothing you can do about it. It's just your "reality" for that day. And maybe that "reality" is that it's your day to die that day and you can't do anything about it because you're simply acting on what's real in your mind. 

You go through enough of this for enough years and it makes any grip on reality - whatever that is - extremely tenuous. Even on your best healthiest days you can't really have the confidence anymore that what you're thinking that day or how you're feeling that day is "real". And when you sink into an episode of manic depression and if the "reality" that exists in your mind that day happens to be that you're the worst scum bag on earth and that you deserve to die for that, well, good luck in sorting that out and surviving. 

Mixed Episodes:

So what about mixed episodes? Well, imagine this. A mixed episode is a really horrible negative hateful state of mind. Kind of like the worst of depression. But - BUT - instead of feeling lethargic and catatonic you also get the "pleasure" of having volcanic manic energy present too. Again, I may as well try to describe to describe the Internet to Borneo tribesmen who's idea of long distance communication is banging two coconuts together; there's just no basis for any concept of it. It's virtually impossible for people to imagine. But try. Imagine taking your worst negative energy, add in jet fuel and then lighting a match. Almost anything could happen. Virtually all of which you'll regret. But, and I hate to beat a dead horse here, you'll have no conscious awareness of what's going on. It's just your reality for that day. Or moment. Or week. Great fun, I'm telling you. And if you happen to be hating yourself, or, lord help you, do something really stupidly wrong, and have manic energy behind that, your brain WILL melt down. As in psychotically. And that psychosis might be putting you "on trial" for being the worst scum bag on earth and "sentencing" you to die for that. Again, good luck surviving. 

Bipolar and Stress: 

I'd begun to make this connection myself but I must give most credit to my online buddy, neuroscientist Mani Saint Victor. I can't recall the exact sequence of events but he became aware of my research, understood what I was looking for and started feeding me research papers on stress and the brain. I couldn't even begin to summarize everything here. But it amounts to this; constant stress - and the constant release of the stress hormone cortisol - WILL melt down your brain. 

Every bad psychotic episode I had I can look back (at my journals) and link it to mega-stress. And the damage is not just short term, there is long term damage. And not just damage to your brain, but damage throughout your body (like in blood vessels leading to cardiovascular disease). And here's the fun part - mania, manic depression, all the life shit that it causes, all create stress. The stress makes the episodes worse. The worse episodes creates more stress. The more stress creates more and worse episodes which creates more stress and around and around it goes. The science on this is super well established. Stress and bipolar and stress and schizophrenia go hand in hand like peas in a pod. 

And then it gets even more fun. All the stupid shit you do and then the label of "mental illness" starts cutting you off from society, friends, family, work, income and the next thing you know, you're all alone and scared shitless to go outside. And this causes the worse stress of all. The science on separation, loneliness, rejection and isolation and the connection to stress is very, very well established. 

The Manic Vision of Oneself:

Of everything I've described, this might be the worst. When you live with bipolar all your life you just lose any kind of connection to or concept of "normal". One thing mania does is drive you to a higher concept of yourself. This can be a Good Thing as maybe this drive matches your talent and "takes you up where you belong". Or maybe it just drives you to want to be those things but you don't have the talent for it. Again, you have no choice. It just relentlessly drives you. And then you can't, or barely can, handle anything remotely resembling "normal". 

Mania is ALL about dreams and visions. All your concepts of who you want to be are driven by these dreams and visions for yourself. You are driven to greatness. OK, cool, nothing wrong with that, is there? Well, here's the catch - maybe you have this constant drive to be something you don't have the chops, talent or energy to be. You will be constantly driven to be something you have no realistic, plausible hope of being. And it's relentless. It never lets you forget. Or if you do manage to forget or to push it out of your mind, it'll just create more. Because this is what mania and manic drive do. It might leave you alone for awhile. If you're lucky. But many aren't. It'll just drive you and drive you and drive you and drive you like the worst asshole slave driver boss you could ever imagine. And if you don't have the  chops to live up to that, it WILL drive you stark raving fucking insane. Or even if you DO have the chops it'll drive you insane. Because it'll never be satisfied. You could create the greatest music on earth and then it'll just demand more. It doesn't end. Ever. And then, if that's not enough, you'll get plunged into those dark episodes of manic depression when you are incapable of anything yet you'll STILL have the memories of the visions and drives for greatness. Or you get mixed episodes. No mental capacity to do anything BUT you are driven by manic power anyway. This here, I"m convinced, is what drives many artists to suicide. This manic vision and drive for greatness and not being able to keep up or shut it off, WILL cause insanity. I can guarantee it. 

Shit, still not finished. To Be Continued

Bipolar and Suicide

Some of my embryonic thoughts on the connection between bipolar disorder and suicide which, while embryonic, are, quite frankly, probably better than you'll find in most sources. Again, you'll have to trust me on this as I build my credibility and case. Part of my case is based on the fact that I get to study my own mind. I have vast amounts of personal experience with manic depressive cycles and episodes as well as probably being as deeply researched and widely read on both bipolar and suicide as anyone you're likely to meet. At any rate, here we go:

The numbers are stark. From the book Taming Bipolar,

The statistics on bipolar disorder and suicide are unrelentingly grim: the risk that you will attempt or commit suicide if you're bipolar are between 8 and 20 percent with the "smart money" going for the high end of that range. Put another way, if you're bipolar, then you're between ten and twenty times more likely to commit suicide than your non-bipolar friends and neighbors. You're also more likely to do it "successfully". 
To be frank, I'm not sure I really wanted to know that but there it is. The list of famous people with bipolar disorder that have committed suicide is a long one. I waver back and forth on whether bipolar is an "illness" or not (and there are strong arguments for "not") but the connection between bipolar and suicide may, I think, heavily tilt in favour of it being an illness.

The name of my book is Dancing in the Dark - Why? (1) and that's what I just keep asking and deeply digging into - why?. And the whys of bipolar and suicide are, for obvious reasons, a big one for me. These are, as I've said, my embryonic thoughts. I started researching bipolar and suicide three years ago, just after my first psychotic episode and attempt. I quickly came across studies that showed that bipolar brains are physically different. Again from Taming bipolar,

What differences are seen in the brain in bipolar disorder? For one thing, there may be enlargement of the ventricles, those spinal fluid filled cavities at the center of your brain. It also wreaks havoc with your amygdala, your brain's almond shaped "seat of emotion" - the place from which your feelings and impulses arise. 

There are, as I pointed out in another post, observable changes in the hippocampus (found through studying cadavers of those with bipolar who committed suicide). Also there are changes in the function of the frontal cortex - the "driver's seat" of the human brain where our cognitive functions take place. But, as I've also pointed out, psychiatric drugs have been proven to cause brain tissue damage so it all becomes a chicken or the egg question - did the brain start out that way and that's why one is bipolar? Or did the presence and long term outcome of the disorder cause the physical changes? Or, as has been demonstrated as possible, did the very drugs prescribed and taken for the disorder cause the changes?

Again, and this is very frustrating, let me tell you, no one knows for sure. And as I described in the post on the human brain, things are awfully complicated up there.

But this is what I think. And this comes from someone with a) thirty years of experience with living with bipolar, b) someone who's experienced a LOT of suicidal behaviour and, most importantly <puts on science hat> c) one who is very well studied on it and able to think on a very high level about it.

These are the areas that I think that contribute.

Cycles and swings between mania and depression:

I cannot emphasize this enough. And it is so hard for anyone - even doctors - to understand just what goes on during these swings and cycles. Trying to describe this and explain it is, as I described to one person, like trying to describe colour to one who's been blind all their life; they simply cannot imagine what colour "is" because they have no "data input" in their mind for it. I could describe and explain this at great length but I'll sum it up thusly; the swings between mania and depression are so great and so opposite of each other that just these swings - never mind the states themselves, just the swings between the two - are literally maddening. There have been times - and I am by no means exaggerating here - I'd have put a gun to my head and pulled the trigger just to make them stop. It's like being on the most sickening roller coaster in the world and you will do anything to just to get the fuck off of it. So yeah, right there would be one possible reason. 

The stark difference between the manic mind and the depressed mind:

The manic mind can be many things, many of them not good, but what I need you to understand now is the "good" and "up" side to mania. When you are manic, you are fucking brilliant. I mean flat out fucking brilliant. This is well documented. You operate at levels you never in your wildest dreams thought possible for your brain. And you are optimistic. And driven. And motivated. And full of dreams. Life has endless possibilities when you are manic. You have ridiculous amounts of energy. You have mental clarity that Einstein would kill for. Mania "lifts you up where you belong". It is, without a word of a lie, a thousand times better than the best euphoric drug on earth. People would kill to have a drug that makes you feel like you do when you're manic. It is way beyond and above cloud nine. And it's all right there, right there in your own little noggin for free. 

Then, like Icarus, the wax melts off your wings and whoooooooooooooooooooooooooooooooooosh, you crash back to earth. Let me introduce you to manic depression. Manic depression is, I'll always say, much worse than "normal" depression. You'll have to trust me on this one; I've had lots of experience with both. Basic depression doesn't even come close. As high functioning as the brain was when manic the brain is as low functioning when depressed. Brain scans bear this out. A brain when in the throws of manic depression is largely shut down. It doesn't just feel like it's not functioning, it's NOT functioning. It is the blackest black possible in the human mind. The brain can barely handle even the most basic of daily tasks. Whereas when manic you barely needed any sleep, now twelve (or more) hours a day barely feels adequate. It is, I swear, as close to brain dead as you can get and still be functioning. And it's not just this state that is bad, it's the fact that just before your brain was operating at such a high level. It's the contrast that's part of what makes it feel so bad. (2)

And here's the thing - your manic mind created all these ideas, all these plans; books, music, business plans, you name it. Things which probably had great meaning to you and which you wanted so, so badly. Then - POOF! - all gone. Again, this is literally maddening. When you go through several cycles of this and you no longer have any idea of who you are and what, it's ... well, so maddening that you want to kill yourself. And here's the other thing about manic depression; it can treat you, non-stop, to the very worst memories of who you are.

And here's the other, other thing. You have no control over these states. None. You can't turn them on or off or make them stop once they take control. Your brain, your you, your personality, your actions, your thoughts, your everything is in the complete control of whatever "it" is. 

Welcome to my nightmare. But wait! It gets MORE fun!

Manic Psychosis:

Again, all but impossible to describe. I may as well try to describe the Internet to a Borneo tribesman who's never done anything more than bang two coconuts together to communicate. One of the things that "good mania" can give you is visions. When these visions are good things - like an entire story line for a book played out in my mind like a movie (literally; I did nothing, I thought of nothing, I created nothing. I just "sat back" and "watched" it unfold in my mind just like watching a movie) - it's a great thing. 

But this can go the other way. It can create horrific nightmare visions. Another thing to understand here is the power of mania. Think atomic energy. Think enough power and energy to light up a city. Or think an atom bomb strapped into the belly of the Enola Gay. It truly is that powerful. And when it goes wrong, it goes really wrong. It will fuck with your mind in ways that will make a combination of the worst nightmare you can imagine and a phobic reaction look like a trip to Disneyland. Again, I invite you to read my description of one here. While I wrote in metaphor and in allegorical form, the events and details of that were absolutely real. It is graphic, graphic visions, voices (inner or projected) and demands of self harm or death. Like slashing the shit out of your throat with a knife. Or jumping in front of a train. Or putting a gun to your head. And all your worst nightmare memories. All played out like a movie in your head. And demands to carry out what you're "watching". And I went through a dozen such events (though that one was the worst). It is the worst terror possible that you can imagine. And it's inside your head.  There's no stopping them, no turning them off, no "waking up" and them going away (like a sleeping nightmare). Nothing. You have ZERO control over them. NONE. It's just hang on for the ride and hope you survive. Or have enough to make you want to survive. 

(1) the book I refer to here (and elsewhere throughout my posts from 2013) is a book manuscript I wrote but do not intend to publish. There is a lot of good material in it that I continue to mine, however.

(2) I would later discover the neuroscience behind what happens when the brain plunges from the high, manic energy into depressive phases and summarized what I found in a three part series. The second part of that series perhaps best describes why what I describe in that paragraph (the one after which "(2)" appears in this piece) occurs. The series I link to takes a good deal of the mystery out of why mania almost always ends in "burnout" and a depressive phase. - BGE, Oct, 2014