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Bipolar

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The Maniac

After schizophrenia related psychosis, it seems fair to characterize mania as being the next most insane example of a state of insanity. There is something deeply troubling about someone who seemingly has no insight into their erratic and overly energetic behavior. Somebody who makes irrational and impulsive decisions and is unable to regulate or control their excitement. We are quick to judge people whose behavior seems to be driven by emotion rather than rational deduction, controlling our behavior seems easy and appears to be the rational thing to do, so a person experiencing a manic episode must not care about doing the rational thing which makes them a risk to themselves and the group. Their values and emotions are not the same as normal human values and emotions and thus they it makes little sense to extend to them normal human empathy. 

[The tortured artist, creative genius and madness/mania, the romanticization of mental illness and artistic creativity]

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Bipolar: Text

“Though I am often in the depths of misery, there is still calmness, pure harmony and music inside me.”

Vincent VanGogh

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Bipolar: Quote
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Kanye West

"The most beautiful thoughts are always beside the darkest"

Bipolar: Quote

The archetype of the tortured artistic genius

Writing by the Water
Bipolar: About
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Bipolar: Image
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Bipolar Disorders

The Current Understanding of Bipolar as a Psychiatric Disease

Anyone who experiences unusual fluctuations of their mood in such a way that meets certain criteria, may be diagnosed with a mood disorder such as depression (which involves periods of intense sadness) or a bipolar disorder (which involves periods of depression and mania/hypomania). Bipolar I is the only diagnoses that can be given to somebody who experiences a full blown manic episode. A manic episode can be distinguished from a hypomanic episode because full blow mania is much more severe and likely to have harmful consequences.

Bipolar: Text

The Neurobiology of Bipolar Disorder: Major Findings

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Bipolar and Genetics

In summary, genetic studies of bipolar disorder have encountered numerous obstacles, in large part resulting from the need to bridge phenotypic and etiological heterogeneities. Evidence points to a complex polygenetic pattern of inheritance, involving a large number of genes with small to moderate individual effects, modified by epistasis, epigenetic modifications, and interactions with the environment.

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Neurobiology

More consistent findings have emerged at a cellular level, providing evidence that bipolar disorder is reliably associated with dysregulation of glial–neuronal interactions and with abnormalities more apparent in glial elements than in neurons. Among these glial elements are microglia – the brain’s primary immune elements, which appear to be overactive in the context of bipolarity.

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The Manic Brain

These studies suggest that, in bipolar disorder, there may be diminished prefrontal modulation of subcortical and medial temporal structures within the anterior limbic network (eg, amygdala, anterior striatum and thalamus) that results in dysregulation of mood. Future prospective and longitudinal studies focusing on these specific relationships are necessary to clarify the functional neuroanatomy of bipolar disorder.

Bipolar: Work
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Overactive Patterns of Arousal and Emotionally Significant Indicators

The Current Understanding of Bipolar as a Psychiatric Disease

Anyone who experiences unusual fluctuations of their mood in such a way that meets certain criteria, may be diagnosed with a mood disorder such as depression (which involves periods of intense sadness) or a bipolar disorder (which involves periods of depression and mania/hypomania). Bipolar I is the only diagnoses that can be given to somebody who experiences a full blown manic episode. A manic episode can be distinguished from a hypomanic episode because full blow mania is much more severe and likely to have harmful consequences.

Bipolar: Text
A Woman Writing by the Window

Interview

Official Writing Portfolio

Bipolar: Welcome

Can you begin by telling me about your early life and what your childhood was like?


I think I had a pretty normal childhood one thing that relates to the bipolar though and with the psychosis part is my mom instilled a lot of superstition in us because she's from Bolivia so there's a lot of like ghosts and spirits and religion. Religion is kind of normal but in the house and we all believe in ghost in the house and everything like that so it was kind of like we grew up thinking like that. Other than that, as far as my childhood goes, I think it was a pretty normal childhood. I had friends, I had a lot of friends and you know I was popular, pretty popular. I was born in 71 I got along with everyone at school, I didn’t misbehave or anything like that. I graduated in 89.


When did you start to experience symptoms and what symptoms were you experiencing that lead to you being diagnosed?


I was thirteen years old, I remember that I was having problems and like forgetting things in school and that was just my thinking was starting to go off and everything and I was talking about like, supernatural things with my mom and stuff like that. The first time they put me in the hospital in a mental institution when I was thirteen at the University of Michigan and they diagnosed me as a drug induced psychosis. I wasn't diagnosed as bipolar at the time, I guess it's hard to diagnose young people so...


And were you on any drugs?


I took a hit acid over the summer like two or three months before any of the problems, oh and I was smoking Marijuana and drinking too.There were nurses and doctors who said they said that they thought that the acid is what set it off. Then I was hospitalized again when I was like fourteen or fifteen and they put me in a state hospital. And back then they kept people in the hospital for like a long time, like a year or something like that so I tried to run away and then I got really depressed and then I kind of had to work the system, I was like “well if I'm a drug-induced psychosis why don’t you send me to drug rehab” So they’re like “that’s a really good idea” and they had to take me off all my psych meds because they didn't wanna have me on medication in rehab while I was in there so they took me off all my psych meds and then I went to drug rehab and then I was sober for like a year and then it happened again and I got manic and then that's when they diagnosed me. So when I was sixteen that was the third time I was in the hospital a doctor diagnosed me with being bipolar because he said, you know “you can't be in drug induced psychosis if you're not on drugs” so that's when I was diagnosed as being Bipolar. 



Did you have a concept of what your disease was before being diagnosed? What was your understanding before versus after your diagnosis?


I didn't know about it, I was just a kid so it’s not like I knew anything about mental illness or anything like that but I had always wondered until I was diagnosed why I went through what I went through and everything like that.


What are the specific symptoms you experienced?


Delusions of grandeur or powers, like being psychic like being a shaman and having supernatural powers and thinking I could control the weather and yeah. I also took a shaman class actually as an adult, and I still believe in that stuff somewhat but now I think they got me I like Seroquel or something like that so that kind of takes away from it, cause I used to be really spiritual but now that I am on the meds that I'm on now I think it takes away from my spirituality.


What is the difference between what you know and what’s a delusion? Where is the line?


Well when I’m sick, I don't know because you're delusional so you don't really know what you believe you believe all things. For instance, the last time I was in the hospital I believed my dad had killed somebody and I remember thinking that my dad killed somebody and that he had bodies buried by the creek which is delusional I guess.


When did you first start to receive treatment for your disorder? And how did that go?


So I first got treatment when I was thirteen but I was not diagnosed as bipolar so I wasn't really being treated for bipolar but I they give me medication for like the delusions and for being psychotic so I guess that helped was in the hospital but after I got out of the hospital I wasn't on medication it was just they just treated me for the psychosis and then when I was sixteen they put me on lithium after they diagnosed me as being bipolar and I was on that for a little while and then I just stop taking it because I guess I didn't really like the way it made me feel like it kind of dulled me or whatever. And then I wasn't on medication at all and everything was fine then when I was nineteen I was hospitalized again and then when I open my twenties all I did was like smoke marijuana and drink and I was fine and then when I was like thirty that's when the bipolar problems came again and I saw someone and she put me on medication that helped someone but I was doing a lot of drugs and stuff so I think of that kind of messed it up.



What aspects of treatment were the most helpful or the most difficult for you?


Both helpful and most difficult the difficult part was opening up about my feelings because like when I was like thirteen I remember having to go to therapy and what they told me was that part of my problem was that I was holding in my feelings and that's what was causing a lot of the problems, so it was really difficult for me to like learn to open up about my feelings and discuss my feelings because I grew up in a household where we like we didn't do that. Some people thought my dad was bipolar because he only demonstrated feelings or like anger and happiness and he was a really angry person growing up and everything. So it's difficult for me to express my feelings because we didn't really do that. But my mom on the other hand was a really caring and nurturing soul but we didn't really discuss our feelings so that was the difficult part. The other difficult part is just being scared. Being psychotic and stuff can be really scary. The helpful part I guess throughout my life I guess was just being able to go to the hospital and having that resource available to me. I took myself to the hospital all the time.


What is life like for you now trying to manage your disease?


So now been out of the hospital all I do is take my medication and try not to use drugs or whatever I think the drugs had a big impact on the medication’s working properly or whatever I hope I will do well on the medication's and like that they're going to hell but I I donut I do expect to like because I've had this disease always be haunting me or whatever and I think that I always come back OK so I don't expect like it so what I'm saying is it I don't expect to like just just cause I'm on a good regimen of medication now I don't expect to be you know the rest of my life to be completely manic free.



What do you think your life would look like if you were magically cured of your disease over night?


Probably not much different than it is now, I think my life would've been different in the past but like if you’re  talking about from like today if it was magically cured today, I don’t think it would be much different than it is now. I'd probably be doing the same things but I wouldn't be tied into having to take my medications which would be a good thing I guess.


What if you were cured at say, eighteen?


If it was cured when I was 18 I think my life would been a lot different because like I went to school and stuff and I got a degree and I never did anything with it and a lot of my time growing up I was more hypomanic, so being like hypomanic is like being like the life of the party you know.  I was a bartender and I had a lot of fun and I listened to music and it was a big party scene and I lived in Chicago and it was a lot of fun and everything and I was always like the life of the party. And so I don't know… it would have been different because I would have been just a whole different person you know what I mean? 


What fictional portrayals of your disease have you seen? Do you feel that they accurately represent your disease or do they totally get it wrong?


I would say “Six Feet Under” there was one character, I can’t remember her name, and she had a brother who was a photographer and he was bipolar. I thought that was a pretty good portrayal of being bipolar. The only thing that I don't like about the portrayal of people with mental illnesses in movies is they always vilify them so they make them like a killer or something like that. I can't think of any other movies or anything with bipolar so yeah. I was a photographer too I did photography too so I can relate with the photography artistic part. That's another thing that goes along with being bipolar is the hypomania makes you really creative. It is like a big imagination and just being artistic and also smarter.



Did anything change concerning your relationships with friends and family because of your disease? Do you feel supported by them?


I think the people fear me because when they see me and what I go through they're afraid of me. So I think that that definitely has a factor in it. I can only think of one person who made fun of me and this was somebody I worked with. He said “when people start working here I try to have them on my side” and he was just somebody who was a troublemaker. I I guess he always tried to make big problems at work between people and stuff like that but he made fun of me a little bit or whatever. Not so much to my face but then there's other people like who were afraid of me. I never got violent or anything like that it was just like being psychotic could be scary.


How do you think going into psychosis affected your relationship with like your parents and your siblings?


I don't know if it affected so much my relationship...  it made them like scared as well as concerned about me so it definitely wasn't just my problem or whatever. It didn’t just affect me, it affected my family too.


Do you feel supported by them?


Yeah.


How should people treat a family member or close friend who has your disease?


I think they should be supportive of them and I think that it can be difficult to have a relationship with somebody who is bipolar because when you're sick it can be a lot of work and it can really strain them. I mean I'm sure it's broken up a lot of marriages too because people who are bipolar can cheat on their spouse because of their hyper sexuality caused by being manic. 


How should people treat a stranger or unfamiliar person who has your disease? How would you suggest people interact if they know someone has Bipolar?


Depends on if they’re sick or not because I’m as normal as you are right now but when I’m sick I’m not and my thinking is off and I don’t really know I’m getting sick it's a point but then it gets to a point where I’m like “I'm sick”. I think I’ve heard the question “do crazy people know they’re crazy” and the answer is it depends. It depends on the state they’re in, if they’re sick people should stay away from them I guess. I remember this guy in Chicago and I think he was schizophrenic. I'd give him money sometimes and sometimes he’d mess with me.  it was it was winter and there was no one on the street that was the middle middle of the night and he was just standing in a huddle in the corner and when I walked by he [throws arms forward and yells] and I remember that I didn’t react at all and I just looked at him sternly and he was like “oh” because he didn’t get the reaction he wanted and I remember thinking “oh yeah I have a mental illness too” [laughs]

In what situations do you hide your disease from people? Do you hide it because of shame, stigma, or some other reason?


I don't really hide it because, what is it they say? To overcome stigma you have to like no hide, or…? It’s probably by personality or whatever because I've never been one to be like… like being gay, I've never been the one to not tell people I’m gay unless I’m in like a situation that would be putting myself at harm, do you know what I mean? But mostly I’m like, “yeah I’m, gay… is that a problem?”. I mean I don’t always tell everyone but I’ve told like managers before that I’m bipolar. I don't hide it or anything like that at work I remembered working at a job, I went back to a job that I worked at for like 20 years at Red Lobster and I grew up having a lot of fun there and then went back. And I remember there we had a lot of people talking about being bipolar and I was like and I was new there so I didn't really talk to them about it, I just listened to what they had to say. I read articles on Facebook where they say “oh you're so bipolar” or “you're being bipolar”. And it doesn't bother me so much really it just kind of shows ignorance.

Is there anything you want people to know about your disease that you feel like a lot of people don’t understand?


I don’t know, I think that mental illness is becoming more.. I don’t know if it’s being accepted but I think people are becoming knowledgeable about it. Kind of like the way society is moving like becoming more accepting of people who are gay. I don’t think it’s something that’s becoming necessarily accepted but I mean I also remember when I was going to the hospital, I asked my friend to take me to the hospital because I wasn’t doing well. And I remember commenting to each other like “look how they hide the mental hospital” in the back. So it’s kind of like a shame in society.


What has your disease taught you about life in general?


Okay so my disease I think has taught me so much more than anyone else or anything in the world because being bipolar and thinking you’re god or you’re connected to nature is more eye-opening there’s definitely a connection there. I don’t know if it’s all in your head but if you could be spiritual and have a connection with god or think you do… you think you’re an enlightened being. And it’s something that I think is eye-opening and there’s a perspective I have that other people don’t have. So being bipolar is a curse and a blessing at the same time. But there’s also a scary part because like with god comes the devil in the religion I was brought up in being Catholic. So there’s two sides to that song. Also with that too, I read tarot cards, and I would say that I do have a psychic side to me or whatever. And I know it’s not just me because friends who are close to me have seen it too so I know it’s not just me. But I think the medications they put me on suppresses that or whatever. I think that yeah definitely you get to see more than what most people think, your perspective of reality is different… not always, but it can be. Being bipolar is up and down you know what I mean?

You talked about being psychotic and manic, did you ever have the depression?


Oh yeah, the depression. Then there’s the depression, so yeah. The hypomania is the best part, I always ask my doctors to balance my meds so that I could be hypomanic all the time because being hypomanic is like being on cocaine and feeling good. So being hypomanic is the best feeling. But what sucks is being hypomanic, then you become manic and everything starts to get out of control and you start to crash and you spend money that you don’t have and then you get- I guess not everyone gets psychotic but I get psychotic and the psychosis gets out of and and I go into the hospital. Then after that you crash and become depressed and the depression gets out of hand and just lasts a long time. You’re really paying for what you got out of the good stuff. You lay on the couch and don’t feel like doing anything and you sleep a lot. Oh and being bipolar too affects your sleep, you can go days without sleeping when you’re manic and days without eating and then you get depressed and you gain all that weight and don’t feel like doing anything you feel miserable you get suicidal. I tried to kill myself a few times. I got a scar right here I remember I was at work and fixated on suicide for no reason. I went home and I was like “I’m gonna try it” and I took a serrated knife and just started sawing away at it and eventually was like “I don’t want to do this anymore” so I called 911 and they came and took me to the hospital. That was I think six years ago and I haven’t even gotten my tattoo to cover it up yet but I think I should before I become a nurse.

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