What's Next, Tri-Polar?

The BBQ Pit
41

Here’s something I’ve always wondered about:

For the sake of argument, let’s apply a 0-100 scale to the severity of clinical depression or bipolarism.

Let’s say that being determined to “gut it out” and not depend on treatment and/or meds is sufficient to overcome symptoms of CD & BP of severity level 30. Would it be likewise sufficient for severity 31? 35? 40? 50? How is this line determined?

In the case of someone not getting out of bed for two weeks … let’s rewind fourteen days to the first day someone couldn’t get out of bed. Presumably, the day before, that someone could get out of bed. What changed in the intervening 24 hours? Environmental change, or something internal, or both? Could a doctor hypothetically draw blood or brain fluid from a) the day before not being able to get out of bed and b) the day after and detect differences in the two samples?

Also … can “the mind” control the brain chemicals? Does environment affect brain chemicals or do brain chemicals affect perception and response to environment?

Can any human become clinically depressed? How might this occur in previously non-depressed people? Can environment alone do it? Can it be from a random brain chemical foul-up? Can CD or BP be artifically induced (an especially cruel experiment)?

Are some people naturally immune to CD & BP … the brain-chemical equivalent of 20-20 vision?

Do CD & BP occur in simians? Other mammals? Is this determinable?

How well is all of this understood?

Ummm … sorry … I know that’s a lot of questions for the Pit. Thanks to anyone who can shed some light on this rather confusing, hard-to-grasp subject.

42

I also know someone (my ex-sister-in-law) who is severely mentally ill and is bi-polar among other things. When she’s on her meds, she is able to function normally in society but when she goes off her meds it doesn’t take her long to spin out of control. Off her meds she is highly likely to wind up in a mental hospital (7 times in the last 2 1/2 years) and engage in unbelievably self-destructive behavior.

So in response to the OP’s question, yes, medication does work when taken as prescribed.
And seeing the effects of bi-polar disorder firsthand, I can also guarantee you that bipolar disorder is very real and not as “rare” as you think it is.

43

Yep. That’s how it starts.

44

No, not in trouble, Just trying to explain my thoughts better.

45

And what led you to “understand” this? Do tell me.

46

I’m going to restrain myself from saying how I really feel about this statement. :mad:

47

IYO, is determination not ever a factor, even in mild cases?

From what I’m reading here, it seems that varying levels of severity of CD and BP truly do exist, as opposed to a “got it or you don’t” system.

Perhaps it is a matter of interpretation – do some psychiatrists hold that if you can “will” yourslef out of apparent CD or BP symptoms, that perhaps you never HAD real CD or BP? Is there variation among the opinions psychiatrists (and research scientists, etc.) on this point?

48

Opal, as I stated before, I’m not implying that anybody with clinical depression can just put on a happy face and make it go away. Far from it. My point was to ask basically what bordelond just asked (only much more articulately), based on the fact that some people I know seem determined to function without meds. That’s all, dude.

49

Fuck. You.
Let’s try something like this:
I try to get out of my chair and the arm catches on my keyboard tray. Before I even know what has happened, I’ve thrown my desk chair across the room. My husband tries to calm me down and I scream at him to fuck off. Then I go upstairs and cry for an hour and tell myself what a worthless person I am and how could anyone ever like me, and this is why I have no friends, and blah blah blah. Then I fall asleep for 16 hours.

The next day I’m better. In fact, I have a lot of energy. In fact, I stay up on the computer for 3 days without sleep. Or maybe I go somewhere with someone and I start talking so fast that they can’t even understand me.

Have you ever had the experience of feeling completely out of control? I’ve been able to control myself at times by going catatonic for hours at a time. Totally awake but not moving, barely blinking, not speaking, not acknowledging anything. This is the only way I can make sure that I won’t take a knife to my arm (lots of scars there btw) or start beating my head against the wall.

And speaking of that… ever bashed your head against the corner of the wall so hard that your scalp split open and blood ran down your face from under your hair, and yet felt no pain at all? All because someone made a joke at your expense? Or how about suddenly having the strength, as a 16 year old, 5’2", 115lb girl, to grab your father and throw him up against the wall?

Or… oh oh how about this? Running into the woods in your nightgown, in the rain, in the middle of the night, and staying there for hours until the police find you… because you had a minor argument with a friend? Or how about running off into the desert and hiding under a bit of desert scrub for hours crying and screaming for god-only-knows what reason?

What… you haven’t had these experiences? But…but… they’re just a part of life, right?

I’ve been on medication for 8-9 years and will be for the rest of my life. I have relapses when I miss taking it for a couple of days, but it has saved my life–quite literally.

You say that you weren’t being flippant and that you have more coming… well it had better be pretty fucking good because what you said was… well I think I’ve expressed my feelings about it already.

Witch: you’re on Lamictal, too? I take it with Celexa but I’m switching to Welbutrin this spring. How much is your dose? Mine is 200mg/day. People get confused when I tell them… they ask “you are epileptic??”

50

I’ve had two close friends who are bi-polar, and a third friend who I strongly suspect is bi-polar, but doesn’t want to get treatment. It’s a VERY serious illness, and no, you can’t just make it go away through sheer willpower. One of the problems is that people may not seek treatment unless they are in their depressed cycle. The “up” cycle often includes feelings of euphoria in addition to paranoia, so they often feel like they don’t need help and react against anyone suggesting that they do. One of the things I found out from knowing these people is that the illness goes way beyond just feeling “happy” and “sad”. It can also include true psychotic episodes. It’s no joke.

51

The thing is auntie em, no amount of determination can change the chemical balance in your brain.

Opalcat, I’m taking 100mg Lamactil and 200mg Wellbutrin in the AM, and 200 mg Topamax and another200 mg of Wellbutrin in the PM. I tried Depokate, Seroquel, many others I can’t recall until we hit upon this combination. It’s worked well for me. It’s even taken care of most of my anxiety.
I really like the Topamax. Not only has it been a godsend for my illness, it takes weight off like you wouldn’t believe :wink:
Do you like the Lamactil? Is it the only mood stabilizer you take?

52

Is this a fact? Do you mean that determination is expressed in no way by brain chemicals? Or that what change in brain chemistry someone can affect will not be be enough of a change to counter severe depression/bi-polarism?

53

bordelond…your second statement conveys what I wanted to get across much more accurately. Thank you.
Actually, change that to “not nearly enough” and I’ll be completely satisfied.

54

Well I was composing some long winded statement that word just ate so to hell with doing that again.

To be honest I don’t know how I feel about medication being used to treat some of these mental conditions. Obviously it has been of enormous benefit to some, but it seems like a stopgap measure, and has the potential to be seriously abused. It seems the criteria for BP (milder like Cyclothymia or even BP2) these days is extremely ambiguous, and with such a loose definition it’s no wonder the medicine is being doled out like candy. I don’t know if being dependent on these meds is any better then being dependant on other substances. Another question I ask is what’s the point in taking these meds then quitting them and attempting to live a normal life. You might as well skip them and go straight to the “gutting it out” and living a normal life. Do they buy a person time to gather their head for the task ahead of quitting them?

I think it would be better to focus on the task of figuring out the causes of mental disorders and trying to deal with them in their infancy, but with millions of possible reasons, unique to each individual, this is simply impossible.

I still think many conditions are over-diagnosed, but I don’t have a better solution to offer, then the one currently in place.

55

OpalCat, I think there may be a huge gulf between what is popularly understood to be bipolarism and the symptomatic episodes you’ve described. That might be what’s getting World Eater and others off track.

What you described in your last post on page 1 seemed far above and beyond what lay people believe to be depression or bi-polarism. When most think of depression or BP, as you are aware, they are thinking of “moodiness”, or “the blues” – and this “understanding” has a lot to do with perceptions about and ractions to the illnesses.

Thank you for your candid post.

56

Yes, Lamictal is the only mood stabilizer. I have gone from Paxil to Celexa for anti-depressants, but both have rendered me completely sexless. I’m hoping that Welbutrin will do better for me. Fortunately I don’t have anxiety problems.

57

Depression can be caused by external events as well as internal, so to some extent, “force of will” (or more likely, getting over a sad thing like a death, or going through therapy) may be successful in some cases. The problem is that severe depression causes emotional and even cognitive problems that may prevent the person from being able to even try to “pull themselves up”. There’s such an emphasis on “cheer up, it’s not that bad” that when this reasoning doesn’t work, it just adds to the negative feedback loop-type of thinking that many depressive people experience.

Offhand, I know of no research saying that bipolar disorder is caused by external events. (IANAP, but I majored in psych in college and went to grad school for psych for a couple of years.)

My husband has an extremely mild version of bipolar disorder (I forget the name offhand, but it’s not classified directly under the name of “bipolar disorder”), which is aggravated by stress in his case. If he does his best to avoid or work through stress, he can minimize or avoid big “spikes” of mood swings. However, I don’t know if this is really an external event, or if the stressful occurances cause neurochemical changes.

58

World Eater - I should have previewed, cyclothymia was the word I was looking for. My husband is not on medication for this, but did go through therapy and some “training” to help him deal with stress and recognize when he isn’t feeling normal.

His father has true, full-blown bipolar disorder. He knows it, he’s unmedicated, and he prefers it that way because the high points are a rush. (As part of his personality and not necessarily the disorder, I suspect, he expects everyone around him to simply live with it, and never expresses any remorse for his actions regardless of where he is in a cycle.) From him, I have seen some simply astounding mood swings and other behavior over the most inconsequential events.

59

Depression that has legitimate cause is a completely different situation. Your brain is creating and shifting around the chemicals to create an emotion that corresponds to what is going on. Other things that happen will send the instructions to your brain and your emotions will shift accordingly. This is why breaking up with your boyfriend might make you depressed, and going out to a movie with your friend might cheer you up again.

When you have a chemical imbalance, the chemicals that create emotion in the brain (you realize that all thought and emotion is just chemical and electrical reactions in the brain, right?) have little or no connection with what is happening. Thus, it is almost impossible to “turn it around” by will alone, as the brain isn’t creating the proper soup for that emotional shift, either. At best, most people could control their behavior, but they’d still be suffering inside.

60

Space Dog:

During low-traffic times, do an SDMB search for my name and words like “psychiatric” or “mentally ill”. The short version is that a lot of my attitude arises from issues of forced treatment.

There are also issues of inadequately informed consent (including a pattern of statements being made to psychiatric patients about medications, mental illness, chemical imbalances, efficacy, and so forth which are not true).

You are also invited to check out my web site.

[/hijack]