Effects Of Bullying

I am an effect of bullying. I experienced during school and after school bullying from the time I was about 7 to the age of 16. This bullying occurred in one form or another at every school I attended from grammar school through high school. The consequences of said bullying have lasted well into my adult years. I have trouble trusting another’s intentions, I feel that people are out to hurt me for no logical reason, I suffer panic attacks and fear when in a group of people I do not know, and, consequently, I have very few friends among other effects. Following is some information I found at www.stopbullying.gov . I find it disturbing that the trend has grown to such a proportion that there is actually a governmental website devoted to the subject. When I was experiencing bullying growing up it was literally thought of as something to be endured and wasn’t very important in terms of mental and physical health. While reading some of the material I located, I was mildly surprised to find myself thinking back to those days, and identifying with much of what had been written.

Bullying Definition

Bullying is “unwanted, aggressive behavior among school aged children that involves a real or a perceived power imbalance. The behavior is repeated, or has the potential to be repeated, over time. Both kids who are bullied and who bully others may have serious, lasting problems.”

In order to be considered bullying, the behavior must be aggressive and include:

• An imbalance of power: Kids who bully use their power ~ such as physical strength, access to embarrassing information, or popularity ~ to control or harm others. Power imbalances can change over time and in different situations, even if they involve the same people.
• Repetition: Bullying behaviors happen more than once or have the potential to happen more than once.

Bullying includes actions such as making threats, spreading rumors, attacking someone verbally or physically, and excluding someone from a group on purpose. (I have experienced all of these at some point in time).

Types Of Bullying

• Verbal bullying is saying or writing mean things. Verbal bullying includes:
  • Teasing
  • Name-calling
  • Inappropriate sexual comments
  • Taunting
  • Threatening to cause harm
• Social bullying, sometimes called relational bullying, involves:
  • Leaving someone out on purpose
  • Telling other children not to be friends with someone
  • Spreading rumors about someone
  • Embarrassing someone in public
• Physical bullying involves hurting a person or possessions including:
  • Hitting/kicking/pinching
  • Spitting
  • Tripping/pushing
  • Taking or breaking a person’s things
  • Making mean or rude hand gestures

Where And When Bullying Happens

It can occur either during or after school hours. While most reported bullying occurs within the school building, a significant portion occurs in places like the playground or on the bus. It happens on the way to or from school, in the neighborhood, or (now) on the Internet.

Frequency Of Bullying

There are two sources of federally collected data on youth bullying:

• The 2011 Youth Risk Behavior Surveillance System (the CDC) indicates that, nationwide, about 20% of students grades 9-12 experienced bullying.
• The 2008-2009 School Crime Supplement (National Center for Education Statistics and Bureau of Justice Statistics) found that, nationwide, about 28% of students grades 6-12 experienced bullying.

On average, that is approximately %25 of kids aged 11-17 that have reported bullying. I would like to emphasize the word “reported”. These statistics are a) out of date, and b) the students who have reported bullying, and does not include those who do not tell anyone. That means that, in reality, the number of students being bullied may be higher, and I suspect it is. A number of students may not report bullying for fear of retaliation or simply out of shame. These students are not captured by these studies.

Effects Of Bullying

The effects of bullying both by those being bullied and those who bully others have been linked to many negative outcomes including but not limited to impacts on mental and physical health, substance use and abuse, and suicide. An interesting study conducted by the National Institute for Mental Health highlights some of the long lasting effects of bullying. http://www.nimh.nih.gov/news/science-news/2013/bullying-exerts-psychiatric-effects-into-adulthood.shtml

Kids Who Are Bullied

Students who experience bullying at school, after school, in their neighborhoods, or by technological means such as the Internet or texts on their phones are more likely to experience:

• Depression and anxiety, increased feelings of sadness and loneliness, changes in sleep and eating patterns loss of interest in activities they used to enjoy or anhedonia, and I would add low self-esteem and self-worth.
• Health complaints such as frequent headaches and stomachaches, or being too sick to go to school
• Decreased academic achievement and school participation. They are more likely to miss, skip or drop out of school.

A very small proportion of students who are bullied may react in extremely violent ways. In 12 of 15 school shootings in the 1990’s, the shooters had a history of being bullied.

Kids Who Bully Others

Students who are bullies can also continue to engage in violent and other risky behaviors into adulthood. They are more likely to:

• Abuse alcohol and other drugs in adolescence and into adulthood
• Get into fights, vandalize property, and drop out of school
• Engage in early sexual activity (the same could be said for the kids being bullied as a way of “belonging”)
• Have criminal records and traffic citations as adults
• Be abusive in romantic or intimate relationships as adults

Bystanders

Children who witness bullying tend to be more likely to:

• Have increased use of tobacco, alcohol and other drugs
• Have increased mental health problems, including depression and anxiety
• Miss or skip school

The Relationship Between Bullying And Suicide

The media often link suicide and bullying. However, most kids that are experiencing bullying do not have thoughts of suicide or engage in suicidal behavior.

Although they are at risk of suicide, other factors must be considered. Depression, problems at home and a history of trauma tend to be better indicators than bullying alone or when combined with bullying. Additionally, specific groups are more at risk for suicide, including American Indian and Alaskan Native, Asian American, and LCBT youth. The risk is highest when these groups of students are not supported by family, peer groups and schools. Bullying simply makes the problem worse.

Warning Signs And Risk Factors

There are many warning signs that a child is being affected by bullying ~ either being bullied or bullying others. Recognizing these warning signs is often the first step in stopping the behavior. Since not all children will report problems with bullying, it is important to talk to kids who are displaying symptoms. Talking to kids can help identify the root of the problem.

Signs A Child Is Being Bullied

First of all, look for changes in the child’s behavior, but also be aware that not all kids will display warning signs. The warning signs include:

• Unexplainable injuries
• Lost or destroyed clothing, books, electronics, or jewelry
• Frequent headaches, stomach aches, feeling ill, or faking illness
• Changes in eating habits ~ not eating, or binge eating
• Difficulty sleeping, sleeping too much, or frequent nightmares
• Declining grades, loss of interest in schoolwork, or not wanting to go to school
• A sudden loss of friends or avoidance of social situations
• Feeling helpless or decreased self-esteem/self-worth
• Self-destructive behaviors ~ running away, harming themselves, or suicidal ideation or talking about suicide

If you notice these any of these warning signs, do not ignore them. Get help right away.

Signs A Child Is Bullying Others

• Getting into physical and/or verbal fights
• Having friends who bully others
• Are increasingly aggressive
• Are frequently in trouble at school ~ detention and/or being called to principal’s office
• Having unexplained extra money or new belongings
• Blaming others for their problems
• Will not accept responsibility for their actions
• Are competitive and worry about their reputation or popularity

Why Children Don’t Ask For Help

Statistics from the 2008-2009 School Crime Supplement (see above for reporting agencies) show that only about 1 out of 3 bullying cases is reported to an adult. There are many reasons why kids don’t talk:

• Kids want to handle it on their own in order to regain a sense of control or they may fear being seen as weak or a “tattle-tale”
• They may fear backlash from their bullies (this is a very real concern)
• Bullying is a humiliating experience, and kids may not want adults to know what is happening. They also may fear being punished and/or judged for being “weak”
• They already feel socially isolated and like nobody can or will understand
• Kids may fear being rejected by their peers; friends can help protect kids from being bullied and they do not want to lose this protection

Risk Factors

There is no single variable that puts one child at risk for bullying over another. It is a complex mixture of environment, group identification, and others. In general, kids who are at risk of being bullied have one or more of the following:

• Are perceived as different than their peers such as being over or underweight, not having the latest cool toy or clothes, being new to school among others
• Are perceived as weak and unable to defend themselves
• Are depressed, nervous or anxious, and/or have low self-esteem
• Are less popular than others and have few friends, are socially isolated
• Do not get along well with other kids, are perceived as annoying or provoking

These are only indicators that a child may be bullied. They may or may not experience bullying as a result of these risk factors.

Children More Likely To Bully Others

In general, there are two types of kids who bully others ~ some are well connected to their peers, have social power, or like to dominate others, and some are isolated from their peer group and may be depressed (in children, depression can be expressed as aggression) or anxious, be less involved in school, or not identify with the feelings of others. They also have other existing factors such as:

• Aggressive or easily frustrated
• Have less parental involvement or problems at home
• Have difficulty following rules
• View violence in a positive light
• Have friends who are bullies

Remember that bullies do not need to be bigger or stronger than those they bully. The ability to bully others comes from a real or perceived power imbalance which can come from a number of sources: popularity, strength, cognitive ability, etc. Children who bully also may have a combination of these factors.

Who Is At Risk?

Bullying can happen anywhere, but depending on the environment, some groups of kids may be more at risk. No single factor puts a student or child at risk for bullying or for being bullied by others. The behavior can happen anywhere ~ cities, suburbs, and rural towns. What does seem to increase risk is the environment and/or belonging to certain groups such as ~ LGBT youth, disabled (mentally or developmentally) youth, and socially isolated youth. Recognizing the many warning signs that a child is bullying others or is being bullied is often the first step in taking action against bullying. Not all children will report being bullied or that they themselves are bullying others. Bullying affects everyone involved. There are many negative outcomes of being bullied, being the one doing the bullying, or simply observing bullying behavior. These outcomes may include depression, anxiety issues, substance abuse and suicide. This is why it is important to monitor kids, and ask them if bullying or something else is wrong.

 

I Seem To Be More Agitated Than I Thought (Damn Mixed Episode) ~ Warning: Profanity

So, I have been experiencing the dreaded “mixed” episode for about a month now. This one has been particularly bad. The last one I had that even comes close was 8 years ago. The main problem with the mixed episode is that you cannot medicate yourself out of it the same way that you can a psychotic or manic episode. Depressive episodes are a category all their own. I would gladly give a body part for this to go away. The main problem with the mixed episode is that you are stuck between mania and depression. Your sleep habits change, your eating habits change, your whole structured life is ruined; this helps the mania, but does little for the depression.

I am freaking annoyed and pissed off at people for no other reason than that they cannot seem to understand that I am trying as hard as I can just to survive this. Another one of my little tells that let me know where I am on the Richter scale: Am I listening to Alice in Chains? And…….wait for it……wait for it…….the answer is yes. My absolute all-time favorite I am pissed off at the world so I am going to listen to songs that are as angry as I am. Yes, I realize this is childish. But, so is contemplating the amount of medication I have at my disposal. No, I am not suicidal, so do not get your panties in a bunch. I am just exceedingly tired of feeling like this. I am tired of presenting the happy face to the world. I am tired of pretending that I am not really that sick so people will leave me alone, I am just tired. What a cliche ~ I am sick and tired. Except it is true. I am sick. I am tired. It takes a lot energy to appear as if you are in remission (because it never really goes away, now, does it?) or at least to appear to be functioning, and that you do not mind that everything about your life is fucked.

Yeah, I can pretty cheerfully say, “Oh, I really do not mind having no car in a city where public transportation is a joke” or “No, I don’t mind hauling 50 pounds of food on foot one mile to my apartment” and “No, I really don’t mind living on $6.00 an hour”. I can easily and believably say all this bullshit, because that is what it is. Bullshit comes easy to me. If I can make the head of Children’s Psychiatric services at the University Hospital here believe that I am okay and that I don’t need to see him anymore, and then turn around two weeks later and try to kill myself (I was 16, and it was my first serious attempt), then I can make anybody believe anything. This guy was supposed to be a professional. I also had convinced that I didn’t do drugs as I sat stoned in his office. Am I that good, or was he just that stupid?I think, personally, he was just that stupid, because I sure as hell am not that good. 

And, I am tired and absolutely sick of people telling me I need to get a car, and a job. Well, people, if I had a normal fucking brain like the rest of the sheep on this planet who want nothing more than a 9 to 5 job, a house, 2.5 kids, and a dog, then maybe I wouldn’t get fired from every job I have ever held. I have been fired from a Temp agency. How the fuck do you accomplish that? How many people do you know that have been fired not just from the temp assignment, but from the agency itself? I mean, that takes skill. Serious skill.

How many people can honestly believe that I do not want to work? I have taken to talking to myself just to keep myself from going absolutely insane as opposed to the semi-sane state that I am currently in. Why can’t people see that? What is it that makes the people in my life so fucking blind that they can’t see that I am pretending to be well? I am not well. I am manic, I am depressed. Come on people, I don’t sense things the same way you do. My perception of emotion is fucked up. I don’t just have a bad day, I have bad years. I don’t have good days. I rise to heights that would scare tightrope walkers and I spend weeks there. And, somebody wants to employ that combination? What the fuck planet are you from? I do not even want to live that combination, but here I am, living it as successfully as I know how. Fuck you all…….get back to me when I am well…..or maybe when you are not operating under some delusion that I am just like everyone else. Everyone else does not see the world through a chemical cocktail designed to keep you as level as possible. Everyone else does not have wild, unpredictable mood swings. Everyone else is not addicted to anti-anxiety drugs that you take just to get through the day without having some form of panic attack. Everyone else is not on anti-psychotics that are supposed to keep you grounded to this planet, and wreak havoc on your body.

Come on, you fucking normal people, try to get a clue about the different people in this world and your life. I am sick of fucking “normal” people telling me what to do. Just because I look “normal” with my painted nails, made-up face, straightened hair, and well thought out clothing choices does not mean that I am anywhere near freaking “normal”. I am just a well-groomed freak. I am a well-groomed waste of space. But, at least I am well-groomed. That’s not even funny. Talk to me about being “normal” when the voices in my head have stopped talking, and my moods are not on a see-saw. I do not even know where I am going to be on the scale from moment to moment, let alone for my whole life. Yeah, I am fucking employable. At least, I don’t have any more monkeys on my back. That may be the only healthy thing about me right now. Please get a clue, step outside for a minute and realize that I am pretending to be okay. I am most definitely not okay. Far from it.  But, I will be. I always am. Because I have to be. I apparently have no choice.

 

7 Annoying Things People Tell Bipolars (And why they hurt)

Reblogged from The Bipolarized: I found this on my bloggie friend Brad’s blog, and when I read it, I could relate to every single thing the author pointed out. My personal favorites: “Can’t you just control your moods?” (No, I can’t. I have never been able too. Don’t you think I would if I could), and I am assuming this one to be apropos to a depressive episode: “Just suck it up and be a man.” or my version “Pull yourself up by your bootstraps. There are worse things in life!” (Ummmm, no, there really aren’t. My depression trumps all other world problems, and I cannot just get up and pretend everything is hunky-dory because my brain chemistry says it is time to be depressed. What about faulty wiring do you not get? I am not like you). Oh, and my other favorite: “Are you taking your meds?” (NO, No, I am not……duh, I must be taking them if I am functioning. It is pretty obvious when a mentally interesting person goes off their meds. It is really obvious in some cases, and more subtle in others, but you can tell that the individual is not acting “right.” Of course I am taking my meds, I am gaining weight and my teeth are falling out. What more evidence do you want?). So, for all you Bipolars out there who have heard any one of these things, this is a great post!

7 Annoying Things People Tell Bipolars (And why they hurt).

 

Was Just Watching The Movie, Jobs…..

Image via CrunchBase

 

and I realized that someone that driven, that innovative, that much of a perfectionist had to be mentally interesting as most geniuses are. I found this article that sums Jobs up pretty well I especially like the last line; you have to be crazy enough – not too crazy, not too little – to think differently.

 

Mood Swings 

A psychiatrist surveys the mind and the wider world

by Dr. Nassir Ghaemi

Steven Jobs: The Power of Being Crazy Enough

Steven Jobs was crazy enough to be a genius.

Published on October 13, 2011 by Dr. Nassir Ghaemi in Mood Swings

Of the many encomia Steven Jobs has received after his recent death, few have focused on not just how special he was, but why he was so special.

Here is a hint from a famous motto that Apple made its own, and used in posters and in its “Think differently” advertising campaigns:

“Here’s to the crazy ones. The misfits. The rebels. The troublemakers. The round pegs in the square holes. The ones who see things differently. They’re not fond of rules. And they have no respect for the status quo. You can quote them, disagree with them, glorify or vilify them. About the only thing you can’t do is ignore them. Because they change things. They push the human race forward. While some may see them as the crazy ones, we see genius. Because the people who are crazy enough to think they can change the world, are the ones who do. – Apple Inc.”

In A First-Rate Madness, I argue that our greatest leaders have mental illness or mental abnormality (at least to a mild to moderate degree of depression or mania).  Some prominent media sources have not so much refuted these ideas or the supportive major scientific and historical evidence, but simply ridiculed it as just unbelievable, thereby confirming Schopenhauer’s teaching that all truths are first ridiculed, then violently opposed, and finally accepted as self-evident.One such knee-jerk negative reaction was even titled “Crazy Enough”, which, ironicially, had been the working title of my book for a number of years until the final title was chosen.

Thinking of the phrase “Crazy Enough,” I realized after some time that it had probably entered my awareness through the Apple campaign, and I searched for its source so that I could quote it. In the end, I concluded that the most likely source was, as some have suggested, that Apple adapted it from a similar quotation in Jack Kerouac’s On the Road.  Here is Kerouac:

“The only people for me are the mad ones, the ones who are mad to live, mad to talk, mad to be saved, desirous of everything at the same time, the ones who never yawn or say a commonplace thing, but burn, burn, burn.”

I used Kerouac’s phrase in the frontspiece to A First Rate Madness, along with the famous original quote from Aristotle asking why genius seemed to be linked to madness. The idea was there in ancient Greece and it’s repeatedly seen again in modern America.

Despite the incredulity of some mainstream arts and letters cognoscenti who (because of stigma against mental illness, or a less-than-complete formalpsychiatric education , or both) don’t appear to understand what it means to have depression or mania, we only need educate ourselves and open our minds to see this process happening over and over again before our eyes. Steven Jobs was a great example, one who was aware, rather explicitly, of the sources of his genius. Let’s not forget some unique aspects to who he was:

As a young man, he became a hippie, traveled to India, used acid, and studiedphilosophy and Eastern traditions of thought (and certainly studied Kerouac carefully). According to some sources , he was manipulative and difficult, especially early in his career , had bad personal hygiene, and abandoned a baby daughter to live in poverty. He did not get along well with people in his own company; as is well known, many major conflicts occurred internally, leading to his resignation at age 30. He viewed most people as “bozos” and had a “volcanic temper.”

Wrote one author: 
“Jobs has embraced the personality traits that some consider flaws – narcissism ,perfectionism , total faith in his intuition – to lead Apple and Pixar to triumph against steep odds. And in the process, he has become a self-made billionaire.”

Years later, especially after his departure and eventual return and later serious medical illness, the hard edges of his personality dulled and he became the icon we just lost. Jobs was very private, actively resisted letting others know about his psychological states of mind, and rarely gave interviews. But who he was, and who he became, grew out of an unusual personality, one that, if all the facts ever become known, may well have been rather abnormal psychiatrically. One thing we can say with high probability: he was not a nice, middle-of-the-road, friendly, straight-laced, upright, respectable person; he was not the kind of person who would score in the middle of the normal range of personality traits of mental health. He was not a normal, average, mentally healthy person – unlike most of us.

Jobs was a great man, no doubt, and one reason why is this:

You have to be crazy enough – not too crazy and not too little – to think differently.

 

 

Mind Riot ~ Soundgarden (Another Rant On The Treatment Of The Mentally Ill)

The Madhouse (Photo credit: Wikipedia)

I know I have something to say, and I cannot figure out what it is. Perhaps another rant about how people with mental health issues are treated in the US. I recently became aware of some very scary legislation that Ohio is considering concerning involuntary and indefinite admission to an inpatient mental facility. I can’t find the post that it was in so I looked the Ohio civil commitment laws, and they are pretty creepy as they stand. Emergency Hospitalization is the scariest as it really does deny a person due process and the number of people that are “qualified” to assess a person’s mental health status is quite broad in scope, and I would argue that many of these people are not in a position to assess a person’s mental health.

“As its name suggests, emergency hospitalization is a narrow exception to the requirement that the individual receive at least some judicial review prior to involuntary commitment or detention and, therefore, should only be invoked in an emergency. Pursuant to the emergency hospitalization statute, any psychiatrist, licensed clinical psychologist, licensed physician, health officer, parole officer, police officer, or sheriff (hereinafter collectively “professional”) may take an individual into custody and transport the individual to a hospital or a general hospital unlicensed by the Department of Mental Health, provided the following criteria are met:

1) the professional must have reason to believe that the individual is a person with mental illness subject to hospitalization by court order, as defined by ORC 5122.01(B), and

2) the professional must have reason to believe that the individual represents a substantial risk of physical harm to self or others if allowed to remain at liberty pending examination.

The professional must provide a written statement to the hospital stating the circumstances and reasons for taking the individual into custody. The individual and the individual’s counsel has a right to the statement upon request. The professional is required to take the individual into custody in the least conspicuous manner possible and must explain that it is not a criminal arrest, that the purpose is for examination, and must provide the professional’s identity and the identity of the hospital where the individual is being transported.”

The part of this code that really bothers me is the scope of individuals who can make the determination of “mental Illness”. I do not think that anyone other than a licensed psychologist, a psychiatrist, or other M.D. with knowledge of mental illness should be able to make the call as to whether a person may be mentally ill. Notice the word “may”. Having had experience with others that are qualified by the state of Ohio include health officer, parole officer, police officer, or sheriff, I strongly disagree with their being able to determine possible mental illness. They simply have no training, and anyone who is combatant will be taken to a hospital.

I have had the pleasure of dealing with the police (who generally have no training to deal with the mentally ill), and the sheriff. These people are NOT qualified to make a diagnosis of any type of mental illness. Frequently, if a person struggles, they will be placed in handcuffs, and in my case, have their face pushed into gravel. I have not called 911 after that night due to the treatment I received at the hands of the police. i have relied on myself to get to the hospital if necessary. 

In my experience with involuntary commitment (in our state they can hold you for 72 hours to observe you, and then decide if further hospitalization is necessary), you get dumped in a public facility with so many other people that one to one conversation with a health professional is next to impossible. The next step is transfer to the State Hospital for more intensive and longer lasting confinement. People lose their jobs, their state and Federal benefits, their homes and apartments due to “incarceration” against their will. That is just not right. Like I said earlier, the only people who should be able to initiate the involuntary hold process are licensed psychologists and psychiatrists who presumably know their patient well enough to determine if hospitalization is necessary, and even then, they should suggest to the patient first that it might be in their best interest to go to the hospital rather than using the involuntary commitment laws of any state. Most patients, if lucid enough, will usually agree that they need to cool their heels for a bit in a safe environment. 

OCR 5122.01 (B)

defined by Ohio Revised Code (ORC) 5122.01(B). The term “mentally ill person subject to hospitalization by court order” means a person who because of their mental illness:

● represents a substantial risk of physical harm to self as manifested by evidence of          threats of, or attempts at, suicide or serious self-inflicted bodily harm;

● represents a substantial risk of physical harm to others as manifested by evidence of      recent homicidal or other violent behavior, evidence of recent threats that place            another in reasonable fear of violent behavior and serious physical harm, or other          evidence of present dangerousness;

● represents a substantial and immediate risk of serious physical impairment or injury      to self as manifested by evidence that the person is unable to provide for and is not      providing for the person’s basic physical needs because of the person’s mental illness    and that appropriate provision for those needs cannot be made immediately available    in the community; or

● would benefit from treatment in a hospital for the person’s mental illness and is in        need of such treatment as manifested by evidence of behavior that creates grave          and imminent risk to substantial rights of others or the person.

On the surface, it all looks pretty benign. There is a court order issued, examinations performed, and the person really is not denied due process. However, these are the same criteria by which a person can be judged mentally ill by health workers, parole officers, police, and the Sheriff”s office. Most of these people are simply not trained in the nuances of mental illness.

Take someone who is Bipolar, for example, and they have been either manic for a week, haven’t slept, and are the verge of a psychotic break, or they have been so severely depressed that they don’t eat, they don’t bathe, they don’t get out of bed, and generally think that life would be better if they were dead. Both types of episodes can be suicidal or can be homicidal, but more than likely suicidal. The suffering person calls 911 because they cannot take it any more.

The police are called, and they have no training in how to deal with a mentally ill person in crisis. The paramedics arrive, but they have training in how to deal with a mental health crisis; they know how to talk to the person to bring them a bit. The police only aggrevate an already highly “strung” situation. They may treat the Bipolar as if it is their fault they are suicidal, they may restrain the person thinking them to be harmful, they simply escalate an already bad situation. The only way I would ever agree to police, parole officers, sheriffs having the say so in determining a person’s mental status or degree of mental illness is if they received extensive training in how to deal with a mentally ill person in a highly agitated state. And, I do mean extensive; like going back to school extensive. We used to have a team here that was trained to deal with mentally ill people, but the budget got cut, and so did the team. Now you’re as likely to get shot if you seem agitated (the police will say you advanced on them or you had a weapon; in other words, they lie), or arrested, or involuntarily committed for the 72 hour hold that usually lasts a week or more while they “observe”you.

Either way the whole issue is treated as if ALL mentally ill people are a danger (mostly to themselves) to society at large, that they are always violent, that they are unpredictable (this is sort of true), that they need to be restrained for their own good and the good of the responding officers (if 911 is called; like I said, after my last experience with the police, I have not called 911 again), and that they need to be medicated into submission and locked up n hospitals for “observation” which is ridiculous because once the medication starts to work, guess what? The person is back to their version of “normal.” 

The fact remains that for the most part, people who struggle with mental illness (and I use the word “struggle” intentionally because I tend to view mental illness much like physical illness; it is something that you live with everyday, and it is something that you treat everyday just like you would if you had diabetes or heart problems. It is NOT the one thing that defines who and what you are, it is merely a part of who you are), are just trying to live as normally as possible within the parameters set up by society. They are generally quiet, tend to keep to themselves, and try not to rock the boat. This is for the more extreme, chronic illnesses like Schizoaffective Disorder, Schizophrenia, Bipolar Disorders, PTSD, Borderline Personality disorder to name a few. Okay I am finished ranting for the day.

 

It Is A Beautiful Fall Day Here…..

Bipolar Affective Disorder (Photo credit: tamahaji)

 

so why do I not feel excited about it? I could have gone bicycling, taken a walk, something to be able to experience this beautiful fall day. But, I chose to stay inside, doing nothing of any importance, and trying to wrap my head around the fact that I am going to have to start the whole relationship/dating thing all over in my 40’s. I thought it was bad enough in my 20’s. Now, I have been diagnosed as Bipolar, with PTSD, and associated anxiety issues, and ADD. So, I will have to find a man that is not an alcoholic/drug addict, or trying to relive the 80’s, lives at home (although there are exceptions), does not want to have to do any research on Bipolar disorder, and will love me just the way I am. I am approaching 43; I am pretty set in the way I do some things, and you won’t get me to change (a mistake my ex made), So, I figure I have already ruled out about 98% of the eligible male population in my age range where I live. I think I’ll just be that weird cat lady that everyone talks about but never talks to. 

 

I really want a different diagnosis. Because it does come up. I do not think it fair to not tell a person that I am serious about who is serious about me that I have Bipolar disorder. See them run screaming for the door, next please…. I think i am just depressed a little bit. Yuck, I hate feeling icky. 

 

What Exactly Is Bipolar Disorder? Part Three

This is my summation of my research, and some personal opinions gleaned from a lifetime of mental illness:

Part Three:

Due to the length of this treatise, I am skipping the different types of psychotherapy and just saying that your therapist and your psychiatrist should communicate and be on the same page. As for the patient. Complying with treatment including psychotherapy is key to recovery or management, whichever you prefer. Also, if you are going through a tough life event, it is a good time to talk to your doctors about your medication needs and you therapy needs. You may need to add a medication or increase you already take, and you may need to see your therapist more frequently until you feel that you are safe, and can handle the situation.

In closing, Bipolar Disorder in all its various forms, manifestations and severity of symptoms is a rollercoaster ride. I tend to compare calm times to being on a long frequency sine wave where you rock gently through the ups and downs, and episodes both depressed and manic as being on the Richter scale. Then you are like an earthquake, and you never know what devastation you will leave in your wake. Hopefully, you never go higher than a 2.0 earthquake because then real damage can be done. Having Bipolar Disorder, in my opinion, requires a level of inner strength that is difficult to achieve because you will lose friends, you will lose husbands and wives, lovers and partners, jobs, and a sense of who you once were. You will question your self-worth, and your worth to other people. It is a devastating disease. It takes and takes, but will never give back. That you have to learn how to do on your own. It is a very needy disease that wears out everyone including the afflicted person. Even if you have the best doctors, and you have the disorder mostly managed, it is usually at a great cost to a lot of people including you. It can be a very lonely illness. But, this is not to say that it is a hopeless situation. You can manage it, you can find friends who will understand or will be willing to learn about it, you can find partners that are understanding that it’s not you that is acting out of sorts, it is the disorder. It is possible to rebuild your life with sympathetic people who will be there when you really need them, and they will understand that you are going through a rough patch, and need help. So, all is not lost as I once thought, and I would imagine other people have felt upon being diagnosed. If you choose to educate yourself about the whole thing, medication, therapy, mood swings, etc. you will know what you are fighting, and you can get the better of it.

 

What Exactly Is Bipolar Disorder? Part Two

This section covers diagnosis and treatments:

Part Two:

Diagnosis

Bipolar disorder operates on a spectrum that includes four types. To be diagnosed with any form of Bipolar disorder, one must meet the criteria set out in the Diagnostic and Statistical Manual of Mental Disorder (the DSM).

1. Bipolar I Disorder ~ defined by manic or mixed episodes that last for more than a week, or by manic symptoms so severe hospitalization is required. There is usually a depressive episode lasting longer than 2 weeks. This is the “classic” form of the illness
2. Bipolar II Disorder ~ characterized by a pattern of depressive episodes and hypomanic episodes, but no full-blown manic or mixed episodes.
3. Bipolar Disorder Not Otherwise Specified (BP-NOS) ~ used when symptoms of  Type I or Type II are not present, but the behavior is clearly not within the normal range for that person.
4. Cyclothymic Disorder, or Cyclothymia ~ a mild form of Bipolar Disorder (there has been some talk as to whether to include this in the Bipolar Spectrum). It is used when the person has episodes of hypomania as well as mild depression for at least 2 years. The symptoms do not meet the criteria for Bipolar Disorder as laid out in the DSM.

Since people are more likely to seek out treatment when depressed, the diagnosing clinician should take a very specific medical history to avoid a misdiagnosis of Major Depressive Disorder. People who what they refer to as Unipolar Depression do not have manic or hypomanic episodes.

Bipolar Disorder can get worse with time if left untreated. Episodes may be more frequent or more intense. In addition, delays in getting the correct diagnosis can lead to significant personal, social and work-related problems (oh, how well I know that having been fired from 2 jobs before being correctly diagnosed with Type I Bipolar). Proper treatment of the illness can help reduce the frequency and intensity of the episodes making it possible for a person with manic-depresseive illness able to lead a full and productive life.

Substance abuse is high among Bipolars although the reasons for the connection are not clear. The working hypothesis is that people are self-medicating. Taking CNS inhibitors like alcohol or certain groups of pills to bring themselves down, and using stimulants when feeling depressed.

Anxiety Disorders such as PTSD, social phobia and generalized anxiety often co-occur in people with Bipolar Disorder. Bipolar Disorder is also co-morbid with ADHD/ADD which both mimic some of the symptoms of Bipolar like restlessness or an inability to focus. I am one such lucky individual to have the PTSD, Social Phobias, and ADD. Makes for an interesting ride sometimes.

Treatments

Now we get into the fun stuff: medication, or the “med-go-round” as I have named it. Bipolar Disorder cannot be cured but it can be effectively managed. Proper treatment can help many people ~even those with the most severe forms ~ manage their mood swings and the resulting behavior. As it is a lifelong illness, treatment is an ongoing long-term process and even those who have most successfully recovered may have continued albeit not as intense mood swing and changes in behavior. The NIMH funded “Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD)” is the largest study ever conducted on Bipolar Disorder. It found that almost half of those who had recovered still had lingering symptoms, and having additional mental disorders increased the chance of relapse (no wonder I cannot hold down a job).

Treatment is most effective when the patient works closely with his or her doctor and there is open and honest communication about medication and how the patient feels they are doing on it. The most effective treatment plan usually includes medication and psychotherapy.

Medication

This is where the patient gets turned into a guinea pig. I am really not kidding. Finding the right medications to stabilize a person’s mood and therefore their behavior is a really un-fun (yes, I know that’s not a word) proposition. There are many different types of medication used for the treatment of Bipolar Disorder. One suggestion for the early phases of medicating a person is to have the patient log their moods, sleep patterns, and “life events”/stress/anxiety and tell the psychiatrist about side effects, especially if they become intolerable, or if your moods change for the worst. That will give the clinician an idea of what’s working and what’s not working. Although, my experience with the first go at medication had me on 6 different medications. How could they tell what worked and what didn’t? I eventually found a psychiatrist who thinks the way I do about medication. The fewer to accomplish the goal, the better.

There are a few basic types of medication used to treat Bipolar Disorder. They include mood stabilizers like Lithium, atypical antipsychotics like Abilify, and anti-depressants although one has to be careful with that class of medication as it can provoke a manic episode and/or increase mood cycling.

Lithium is the mood stabilizer of choice when a person first steps on the med-go-round. Lithium is a trace element that everyone needs to live, but in much higher doses, it is an effective mood stabilizer. Unless you are allergic to it as I am. Then, it does nothing for your mood because you are feeling like you have the flu all the time. Essentially, you are being poisoned. But, it does work for a lot of people. It was the first of the mood stabilizers to be approved for use by the FDA in the 1970’s for treating both mania and depression.

Anti-convulsants are also used as mood stabilizers although their primary purpose is to treat seizures associated with Epilepsy or other seizure disorders. The ones most commonly used are Depakote, which was approved in 1995 although there are special risk factors for younger women, Lamictal which can be effective in treating depression but comes with a “black box” warning that it may have serious side effects such as Steven-Johnson Disease which can be fatal. The anti-convulsant category comes with the FDA warning that use may increase suicidal ideation and behavior. Tried both of the above and side effects were intolerable, and didn’t need to be more suicidal than I already was. Doctors and patients need to closely monitor the effects of the anti-convulsants for any mood changes for the worse, and suicidal thoughts and/or behavior.

All of the medications in the category “mood stabilizer” have lengthy lists of side effects including dry mouth, bloating, restlessness, joint or muscle pain, and others. Other common side effects include drowsiness, dizziness, headaches, mood swings and cold-like symptoms. Medication is fun!

Atypical anti-psychotics (the new breed of Thorazine without the drooling) are sometimes used to stabilize mood and behavior. The most prominent are Zyprexa usually used with an antidepressant to control mania and psychosis, Abilify used for manic or mixed episodes, and Seroquel, Resperidal, and Geodon also used to treat mania.

I currently take 30 mg of Abilify each morning, with Welbutrin and Klonopin (for anxiety), and 500 mg of Seroquel at night as it knocks me out cold for a good 9 hours (see post on Waking up On Seroquel). Geodon is worse. Won’t take it, don’t even try.

The side effects of atypical antipsychotics are not nearly as bad as their predecessors. First of all, don’t drive until you know how they affect you (I once had the world tilt 90 degrees while at the grocery store, and I had driven my car there. That was not cool). The list of side effects for the atypicals is fairly short: drowsiness, dizziness upon standing, blurred vision, rapid heartbeat, sun sensitivity, and a couple of others.

I am going to skip the anti-depressant category because most people have either taken one of  them personally or know someone who does. The only problem with using them for Bipolar depression is mood switching and rapid cycling of moods.

 

One Thing I have Never Blogged About: What Exactly Is Bipolar Disorder?

I have never actually blogged on the subject of Bipolar Disorder in and of itself. I have written numerous posts about how I feel about it, or how it is affecting me and others on any given day. So, here goes. Most of this information comes from the National Institute for Mental Health. I am going to break this into pieces as it became something of a dissertation on Bipolar Disorder in all of its lovely forms.

Part One:

What exactly is Bipolar Disorder?

Also known as manic-depressive illness, Bipolar disorder is mental disorder belonging to the DSM category Mood Disorders. It is characterized by unusual shifts in mood, energy levels, activity levels, and the ability to carry out day to day tasks. The symptoms of Bipolar can range from mild to severe. The symptoms of Bipolar Disorder vary greatly from the experience of “normal” moods. They are far different than the usual ups and downs that most people experience from time to time. The symptoms of Bipolar Disorder can interfere with relationships causing sometimes irreparable damage; they can cause poor school or work performance, and even, at its most extreme, suicide. People with Bipolar have a high rate of death by suicide. I do not know the exact statistics, but they are higher than those of Major Depressive Disorder and other mood disorders, and even Schizophrenia. The good news is that Bipolar disorder can be successfully treated so that people who have the disorder can lead full and productive lives. This is not to say that a “treated” bipolar is not going to experience the world the same way as a person without the disorder, they will still experience “bipolar moments” from time to time. However, the episodes tend not to last as long, and seem to be less detrimental. Many people with manic-depressive illness may go for months without an episode if properly treated with a combination of medication and therapy. It is important to remember this is a lifelong illness. It may go into a “remission” of sorts, but it is still there, and people will still experience episodes from time to time.

Causes

While there is no general consensus on what causes Bipolar disorder, scientists do believe there are a number of factors that work together to produce the illness or increase the chances that a person will develop the disorder. First, we will look at role that genetics plays in the onset of the illness.

Genetics

It has been determined through self-report and the organizing of family mental health “pedigrees” (a chart of all relatives who either have problems with depression or have the illness itself), that Bipolar disorder has a strong genetic tie. Some research has determined that people with a certain gene are more at risk for developing the disorder than others. The NMIH literature states that children with a parent or sibling with the illness are more likely to develop manic-depression than those who do not have a close relative with the disorder. However, most children with a close relative with the disorder will not develop it.

An aside on the genetics model, I believe that Bipolar disorder can skip generations as long as one or both parents carry the gene predisposing one to manic-depression. The reason for my hypothesis is that my Father’s mother (my paternal grandmother) had untreated Bipolar disorder (Lithium didn’t come into play until the 1970’s). As far as I know there are no other close or immediate family members on his side of the family that have Bipolar disorder although I know very little about that side of my family.

Researchers are also pursuing illnesses with similar symptoms such as depression and schizophrenia to identify possible genetic differences that may increase the risk of a person developing Bipolar disorder. However, genetics may not be the only cause. A combination of predisposition and environment has been posited as creating a risk factor. Scientists do not fully understand the duality of genetics and environment in the risk for developing the disorder.

Brain Structure and Functioning

Some imaging studies using MRI’s and PET images have shown possible differences in the actual structure of the bipolar brain. One MRI study found that the pre-frontal cortex in people with Bipolar disorder may be smaller than that of people without the disorder. This is the “decision” making and problem-solving part of the brain. It is linked to other parts of the brain which come to full development in adolescence which may be why most people will present with manic-depression in their teens or early 20’s. Scientists are still working on how these brain structures combined with genetics may predispose a person to develop Bipolar. With more research, scientists may be able to better “predict” what types of treatment will be most successful.

Signs and Symptoms

People with manic-depression experience intense emotional states that are called “episodes.” An episode has to be a drastic change in the person’s normal mood and/or behavior. A “depressive” episode is pretty self-explanatory if you have ever experienced any form of depression. It is just a more intense form of depression and can last a very long time with detrimental effect. A “manic” episode is a different animal altogether. Manic episodes are characterized by abnormally high energy levels, lack of a need to sleep or no sleep at all, “flight of ideas” (a state where your mind is so active, even the Bipolar can’t keep up, it’s like ADD on steroids), pressured speech (an extreme need to speak), and eventually irritability and even psychosis due to the lack of sleep. There is also the “mixed state” which is what I usually present with. It isn’t exactly depression in the classical sense nor is it mania in the classic sense. It is both at the same time. I describe it as being the most unmotivated manic person, and the most motivated depressed person. It sucks. People with manic-depression can be very irritable and explosive while experiencing an episode be it depressive, manic, or mixed (which I have heard is the most dangerous of the mood episodes). Psychosis can appear in all mood episodes which frequently leads to a misdiagnosis of schizophrenia. I, myself have Bipolar disorder Type I with Psychotic Features which means I periodically (usually while depressed experience a break from reality). I do not think I will go into all of the symptoms and resulting behaviors because I have pretty much covered them.

 

So I Am All Tranced Out On House Music And Thinking…..

This is a “thought bubble”. It is an illustration depicting thought. (Photo credit: Wikipedia)

 

I am thinking about the impossible to know with a reasonable level of certainty. What do two people have to do or not do to make a marriage work or die a flaming death much like mine? AC/DC’s song “Shot Down in Flames” comes to mind. While I admit that the world is probably a safer place for all involved if I live alone, I wonder what it was that I obviously did or did not do. I know what my problem with the whole grown-ups behaving badly thing is/was. No need to cover old ground, or extremely tainted water under a falling bridge.

 

I realize that having a diagnosis such as Bipolar tends to knock you a little sideways, and your perceptions of yourself in relation to the world changes a bit (maybe more than a bit). However, once you have recovered your senses, and you happen to be a highly functional mentally interesting person, shouldn’t things get easier not more tedious? Yes, I flew off the handle one too many times, but once again, I wasn’t the one who could not leave my computer sometimes for days on end. I tried to communicate, but how do you communicate with someone who does not know how to communicate with you? It’s like clapping with one hand (thanks to Anthrax for that analogy).

 

What are you supposed to do with someone who has no desire to really get to know who you are apart from your interestingness, and does not seem to have any desire to learn anything substantial about Bipolar? I, upon receiving said diagnosis, went out and read everything that seemed legitimate. How can you battle that which you do not understand fully? Answer: you cannot effectively deal with any illness unless you know what you are dealing with. 

 

This was supposed to be forever, but I guess that’s a big fairy tale society tells little girls: your knight in shining armor will come and all will be sparkly and shiny and smiley and happily ever after. They lied. I think I met my knight in shining armor, and ditched him to get married to a man who turned out to be a far cry from the “face” he put on during the courtship. I am sure he feels the same about me, but I really do not know how to be anything but myself. He knew my moods weren’t completely handled, but he said, no problem, he could handle it. Apparently not. 

 

So, now I am in my early 40’s looking at starting all over again. Dating in my 30’s was not a problem because of said knight in shining armor. I never had to worry about someone to go drink beer and listen to blues bands with. He was always there for me, in all ways. What the hell was I thinking? Now, I am left to pick up the wreckage that used to be a perfectly satisfying life. I did not have self-worth problems, I did not have problems with how I looked, I did not have a problem with how feminine I was or was not. I didn’t have a problem with a lot of things. As I imagine he didn’t either. But, I wasn’t shattering his masculinity every single day. 

 

i think that I took him very much by surprise when I actually did file for divorce. I had mentioned it several times over the past couple of years, but he never thought I would actually take any action. He said everything I said was just talk and more talk, no action. Well, I guess you shouldn’t threaten me physically. I don’t cotton to that very well. I just wish I could pinpoint where it all went wrong. When I became unhappy with him and he with me. I play it over in my mind, and nothing seems to just pop out at me. I think I became upset with myself when I stopped getting mad about his Internet activities. There was no point. i was just wasting breath. I do not know, but I do not think I will try it again anytime soon. Talk about a learning experience. Never again will I allow myself to be treated like that. I am surprised I didn’t see it until the very end. After all, I grew up in an emotionally abusive family. I should have seen it for what it was and left much sooner. Maybe then I wouldn’t feel so scarred. Again.