Is it just me or … ?

Someone says something thoughtlessly offensive and

… you stop, like you just took an arrow to the knee. Dry ice races through your veins, time slows and you think …

Was that really intended to hurt, was it even offensive, or am I just being bloody oversensitive again? Should I say something? Better not.

Something aches; your ribs, your gut – things feel hollow, precarious. You wish you didn’t feel it so hard, you wish you could shrug better.

You fear hearing that you took it too personally, that it was just a joke.

You do your best to bury it and sometimes you can forget. And sometimes it returns like a mantra and sometimes it spiders ink under your skin till the whole world can see the words you made your own.

Bipolar Polypolar Roundup

(Posting frequency due to mixed state.) (It’s ok, I have chocolate.)

Geodon fatal side effect – 6 cases, 0 deaths. And may I remind you that many, many drugs have at least one scary but rare side effect. Like this one.  And Lamotrigine can (hardly ever does, but it can) cause the fatal Stevens-Johnsons rash – but so can some antibiotics. Moral of the story: don’t effing well panic. And if you get blisters or similar inside your mouth, eyes and other places pimples fear to go; go directly to ER, where they will swiftly save you.

People keep getting shocked about this stuff ZOMG NOOOOOOO WTF ANTI-DEPRESSANTS CAN MAKE U SUICIDAL ERMAHGERRRRD! Just read the fucking insert willya? Also deploy google and forums before having conniptions*.

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I keep seeing posts about ‘straightjackets.’ Wikipedia is talking rubbish, it’s spelled straitjacket. Strait means tight or narrow. Straight just means uptight. I kid, I kid! I retract the heterophobia and offer you a nice soothing cup of tea.

Bipolar & Broke?

Anyone used Needymeds? It’s for Americans who either need help affording meds, or who want to help others afford their meds.

Then there’s Just Another Lab Rat where you can volunteer for clinical trials and suchlike.
I read a very scathing article a while back, claiming that companies who run clinical trials of psych meds abuse and exploit the homeless. As with everything, caveat emptor, erm … even if you’re the one getting paid.

Bipolar American who ‘defected’ to North Korea
Dunno about you, but I refuse to even ponder whether this should make us question his sanity till we get stats on a whole bunch more ‘defectors’. Being sent to a psychiatric unit is certainly insufficient evidence. The article said he was ‘paraded in front of press,’ by which they meant there was a press conference.

In his comments to reporters, Martinez strongly criticised the US for alleged human rights violations and its attempt at forcing imperialist influence and domination on other countries, North Korea’s state news agency KCNA said in an article released with the footage.

Psycheducation is old and old school. I like it, you might too. I found the following graphic there, which illustrates just how inaccurate the term bipolar is. Hence the post title. Yup, I’m running out of titles.

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Pong!

* conniption
kəˈnɪpʃ(ə)n/Submit
nounNORTH AMERICANinformal
plural noun: conniptions
a fit of rage or hysterics.
“his client was having conniptions on the phone”
Origin
mid 19th century: probably an invented word.

Weakly Bipolar Roundup

This is why I feel privileged to be able to afford a psychiatrist every few months.

One third of all South Africans have mental illnesses – and 75% of them will not get any kind of help.
source

The earlier the onset of a major psychiatric disorder, the greater the risk of dementia. Source Long term lithium (sounds like a good name for a folk singer) reduces the risk.

Interesting – dreams as subsyndromal symptoms? Might be useful.

Bipolar patients report bizarre dreams with death and injury themes before their shift to mania (Beauchemin and Hays, 1995). Beauchemin and Hays (1996) found that dreams of bipolar depressed patients have more anxiety than those of unipolar patients. Dreams of bipolar patients, particularly those with rapid cycling, may show evidence of the subsequent shift prior to noticeable affective and behavioral changes (Frayn, 1991).
does bipolar affect dreams?

They’re researching bipolar in dogs. Thanks for that, but howzabout you research a cure for bipolar in humans first? Improved palliative treatment, even.

It’s Sunday and here is something of a secular sermon (I’m all about alliteration). Believable positivity from veteran bipolar blogger Natasha Tracy.

I don’t know how I kept trying over the years when nothing (even ECT) worked. It’s just persistence. It’s just a tiny candle flame inside your soul that says that life is not supposed to be like this. Life is not just pain. Life can and will be better. But you have to try. And try and try and try.

… and some decent strategies for picking up the pieces when it’s all gone horribly wrong (yeah I see you nodding there).

Bitching @ Bipolar

The good parts of mania are so, so good. Sometimes it’s like MDMA, sometimes coke. Love swells and fills your heart and then stretches its fingers to strum songs on your ribcage. Colours are more saturated, everything is … well, as Kurt Vonnegut said …

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Yes, the dark side of mania is scary, dangerous, ridiculous and so no, it’s not worth hanging on to.

Still.

When/if it goes away for a long time, I will miss it. I always thought it was the universe paying a karmic debt, giving me all that love and shiny constellations and laughter. I’m damn glad I relished those good bits while they were good. I wouldn’t miss the bad bits at all, obviously. And the rest of it (depression and mixed episodes) can leave any time they like. The absolute pain … I don’t actually know how to describe it to anyone who hasn’t felt it.

Too often, we’ve been guilty of conceptualizing bipolar disorder only from the neck up. This is clearly a brain and body disorder.

This thing, this neurobiological, neurotoxic fuckup that some people blithely say shouldn’t be medicated, presents in so many sizes and shapes that it’s not possible to just wave a wand and cure it. I don’t know what works for less severe bipolar, because mine is apparently very severe, but nobody can convince me that a dab of essential oils on my neck will fix it all. The only natural treatment for bipolar that works (for some) is lithium.

I’d rather be realistic than float about with blinkers on. Bipolar shrinks your hippocampus, causes increased cortisol … the consequences can be quite hectic. And beyond brain damage, heart disease etc, there is always the bipolar depression that occurs in more cycles than MDD and the suicidality that grabs you by the jugular and doesn’t let go, no matter how long it has to wait. And if you don’t kill yourself, you have a shorter life span, heart disease and earlier onset of general geriatric decay to look forward to anyway. And more. I have to take the mofo seriously, it has already fucked up a lot of my life. But that’s what you get with a late diagnosis.

My own clinical experience has been very clear that the more episodes they have, the more cognitive impairment they have and the more difficult it is for them to get back to work and fulfill their roles and responsibilities.

(Source link further down)

Yes, I know that today is the first day of my life and so on … but sometimes I need a break from looking on the bright side (lol) and acting stoic. Sometimes I want to howl and bellow at … who? What? There isn’t even something to yell at.

Don’t comfort me, mkay? I promise I still know how fortunate I am. If you made it this far, tyvm for doing so. I feel better for it. Scroll for more from the transcript I’ve been quoting.

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More excerpts from: The Evolving Understanding of Bipolar Depression Neurobiology and the Relation to Diagnosis (Roger S. McIntyre, MD, FRCPC)

… people with bipolar depression more often present with so-called atypical depression. That is, they have hyperphagia, hypersomnia, and so-called leaden paralysis — a significant terrible fatigue particularly accentuated in the winter, but not always. These individuals who have bipolar disorder very often report an early age of onset, often before 25 years of age; in fact, very often before 20 years of age.

The lion’s share, however, of individuals who have bipolar disorder do not in fact present with severe mania. They often present with an admixture of subsyndromal depressive symptoms as well as hypomanic symptoms. In fact, longitudinally the most common presentation is this composite of depressive and hypomanic symptoms, which often is mislabeled as anxious depression or agitated depression;

Now, in the brain there is white matter and gray matter, and there is reduction in cell counts seen in both, with more replicated evidence, frankly, in loss of white matter.[16] So in other words, bipolar could be conceptualized as a white matter disease. And we also see a loss of what’s called neuropil, which is what I refer to as the connective tissue within the brain. Taken together, this loss of brain tissue may be more likely observed in those with more progressive illness. Speaking to the neurotoxicity of bipolar disorder, this is not only a disquieting observation, but it’s also really alerted us that at the brain level something’s changing. This may subserve the phenomenology we see, — the more recalcitrant bipolar over time, as well as observations of patients who may not be responding as well to the treatment after 10 or 15 episodes compared to those who’ve had 1 or 2 episodes.

We as clinicians, and the literature certainly supports what we’ve observed, have noticed that many patients with bipolar disorder pursue what appears to be a progressive course. In other words, episodes become more frequent over time, and become longer in duration. The well intervals become shorter and shorter, and the symptoms become more severe. As I was saying moments ago, patients often complain of, or evince cognitive deficits. And the treatment interventions, whether pharmacotherapy, psychosocial interventions, and maybe even neuromodulator treatments such as electroconvulsive therapy (ECT), may not be as robust after 15 or 20 episodes when compared to the first 2 or 3 episodes.

Bipolar exists above and below the neck, and in fact, it is the metabolic complications of bipolar disorder, in part related to medicine and in part to biology and other factors, that leads to not only a decreased likelihood of recovery and a more unfavorable course of illness, but also accelerates premature mortality, with heart disease the most common cause of mortality in this population.

Source

Round Round, Bipolar Round

(I get around)

I’m always interested in the physical causes and consequences of bipolar. Here’s A Trip Into Bipolar Brains – don’t worry, you won’t need a seat belt or barf bag. Want the tl;dr? Bipolar 1 people have less brain volume and higher volume in the caudate nucleus and other areas associated with reward processing and decision making. Bipolar ii have less robust white matter (white matter can’t jump?). Bipolar people have more cerebrospinal fluid (comes in handy when the beer runs out) and reduced white matter integrity (more so in bipolar ii). 

A study of 68 bipolar people aged 14-25 who attempted suicide found abnormalities in the prefrontal cortex.

The brain again – although ECT affects memory, apparently it increases neurocognitive function in people with treatment resistant bipolar.

More proof that the words celebrity and bipolar are a waste of space. We will probably have to declare war or an embargo on Lil’ Kim, because she called K. Michelle a prozac popping bipolar bitch. Kim would also like Michelle to stop using her as a respirator (?) to sell stuff. Could it all get any more meaningless? Plus, I don’t think monotherapy antidepressant treatment for bipolar has caught on yet.

As usual, bipolar people have been killing people and police people have been killing bipolar people and bipolar people have been killing themselves. You don’t really want links do you?

An 18 year old talks about her experience of being bipolar at school in the UK.

I looked up Hagop Akiskal on bipolar, as recommended by my psychiatrist – who also warned me that reading him can sometimes be challenging, because the writing isn’t great. Here’s a bit about the proposed extra bipolar subtypes:

Furthermore, evidence is now compelling that hypomania in association with antidepressant treatments requires familial bipolar diathesis for bipolar disorder (bipolar III). There also exist clinical depressions superimposed on hyperthymic temperament (bipolar IV), ref erring to individuals with subthreshold hypomanic traits rather than episodes.
Source

And he suggests that many other conditions are actually soft bipolar conditions. There’s also some interesting stuff in that paper about the history of bipolar diagnosis. It isn’t new work, but I think it’s worth a read.

My bipolar is not soft. It could beat up Lil’ Kim without breaking a sweat. So there.

I was going to tell you I’d learned a new word while reading that paper (mixity), but when I googled, it didn’t exist.

Roughghost, I think you asked about the usefulness of more subtypes; here are his words on it:

… the clinical management of affective disorders will not improve significantly until there is recognition that many, if not most, depressions presenting clinically are, at some level, bipolar. As counter-intuitive as this suggestion might be, there is increasing evidence in its support summarized in this paper.

I’m quoting this just because I liked it:

The art of clinically managing these patients goes much beyond anticonvulsant concoctions. It requires the art of caring for temperamentally restless—albeit charming— individuals with troubled lives.