Likable Ideas

These items came from a different bipolar post. It is written, as you can see, from the view point of the bipolar disorder person. Like I state in my book, the family does probably share some of these ideas; but my opinion, as a person who is not bipolar, is the hardest thing about living with bipolar is the extreme patience required to live with someone who cannot think rationally most of the time. Then throw in the severe mood swings and high anger issues, and you will see that it takes a mixture of un-conditional love and super-natural patience to be able to daily keep a positive, loving attitude toward this "bipolar disorder". To be honest, since my bipolar loved one was my mother, I did not feel that I was ever given a choice of whether to love her, hate her, or continue to stay and help her. I, of course, stayed with her in my formative years, but after I left home and had the "choice" of really staying to help my blind dad with her care, did realize that I could never turn my back on her. I did love her deeply, not necessarily un-conditionally. But what I am saying is I know some people who have been married to a person who was bipolar and they chose to leave and get a divorce. I know a lot of bipolar married persons get divorces because the non-bipolar one chooses to not stay. If I were being honest, and knowing what I know about the disorder, I would have a hard time staying married to someone who has a severe illness. I hope you don't judge me too hard on that, I did say I was being totally honest. I know the bipolar disorder people are great, I work with students who are and I love them all and have total sympathy for and with them, but at the end of the day, I go to my home and they go to theirs. I do think these listed items will useful to someone who needs them though.

The Top 10 Ways to Support Your Mate. Keep in mind this is written from the point of view of the bipolar disorder “sufferer”. In the near future, we’ll revisit this topic from my wife’s point of view.
1. Give us confidence. If you can make your partner or loved one feel good about him or herself, life will be SO much easier for both of you.
2. Take an active role in our treatment. Help with med administration. Don’t count on us to be faithful to our medication, we all slip from time to time. If we are under the care of a psychiatrist or counselor, maybe a yearly session where you join us would be helpful. At a minimum, if you have questions or concerns write them down so we can take them with us to our appointments.
3. Recognize there are things we just can’t bring ourselves to do, and try to work with us on this. For example, my wife pays the bills, as my stress level goes through the roof, and I blow up at the family if I try to do it. Of course, it’s worse when I then give her a hard time for not “doing it right”. When this happens, try to be understanding.
4. Remember that we have certain strengths and super-hero abilities at times. Take advantage of this. For example, if we go hypomanic and suddenly desire intimacy for hours on end, or multiple times per day, help us out. Keep in mind our meds sometimes take this desire away for months on end, so when it does come around use this to your advantage. You might even go so far as to say “Paint the house and I’ll fulfill that little fantasy you’ve been hinting at for years…” The house will be painted in a matter of hours.
5. When we get in a really bad frame of mind, and we all do, be there for us. Don’t be afraid, don’t put up a defense against us, don’t brace yourself for something bad. Be there to talk and support. It may not be pleasant, personally I can be downright mean when in a bad frame of mind. But you’ll both be glad you were there.
6. We know when we’ve made fools of ourselves, or done something bold, brash, or stupid. We’ll be embarrassed to face you, or others affected. Don’t hang us out to dry. Step up and support us, not in a condescending way, but as you would with any loved one. Don’t say “that’s the bipolar disorder talking” or something like that. We may say that, but please let that be our decision. Accept us, don’t dwell on it, give us a hug to show you understand, and move on. We’ll be eternally grateful.
7. Embrace our diagnosis, it’s not going to change, and may not improve. Meds can control it, but we won’t be “cured”. Realize that it’s not always a bad thing, we’re still the same people we’ve always been. To look at the bright side, we now even have an official title.
8. Remember that even though we’re diagnosed, and likely medicated, things aren’t necessarily going to be easy. In fact, when the bad times come around, we now know what’s happening, and we understand why. Rather than use our old (and maybe dangerous) coping techniques, we may try harder to rein in our feelings and behaviors. This can make these episodes even more dangerous and volatile than before.
9. Help us to recognize those coping mechanisms that may not be good for us. We may not realize we are doing something, and the gentle input from a loved one may be extremely valuable.
10. Watch for triggers, and watch our behavior for clues of an upcoming change of mood or frame of mind. You are in the best position to recognize this, and to help us see and understand this.

No medical test?

On the video portion of this blog you will find several medical professionals stating that there are no current chemical or medical tests that prove what specific mental illnesses are. That is, no x-ray or blood test is going to tell us whether someone is bipolar or manic-depressive. We are all diagnosed by our symptoms that fit into a mold or category, then the trained medical staff makes an educated guess based on experience. That is pretty crazy by itself when you really think about it. All other illnesses are diagnosed by x-ray or blood tests, for example, if you have strep throat, they take a culture of your throat, send it to the lab and you get a positive or negative result. Mental illness is not a tangible diagnosis. This article talks about a study that has proven that the "grey"matter, your brain, could have early atophy if you have a mental illness. Atrophy means you have less brain in your cranium than the average person. I will say that when my mother was near death, her MRI scans were read as having severe atrophy and she was only 70-73 years old. She never had an MRI when she was early diagnosed at the age of 26. Who knows, maybe she always had early atrophy, not as much brain tissue, and maybe they might have something tangible to make an accurate diagnosis of mental illness now.

Lack Of Grey Matter In Brain Is Linked To Schizophrenia And Bipolar Disorder
Main Category: Bipolar
Also Included In: Schizophrenia; Neurology / Neuroscience
Article Date: 16 Jan 2009 - 1:00 PST

A research study led by scientists from the Gregorio Marañón University Hospital in Madrid and the Network of Centres for Biomedical Research in Mental Health Networks (CIBERSAM) shows that adolescents experiencing a first outbreak of psychosis have lower levels of grey matter in their brains than healthy teenagers. Strangely, this change was seen in patients suffering from various psychoses, including bipolar disorder and schizophrenia.

The aim of the study was to examine and locate differences in the volume of grey matter in the brains of healthy people (controls) and individuals diagnosed with psychotic outbreaks in infancy or adolescence. The researchers broke such psychosis down into three sub-groups schizophrenia, bipolar disorder and other psychoses that did not fit into either of the other two classifications.

The study, published recently in the Journal of the American Academy of Child and Adolescent Psychiatry, analysed a sample of 121 people aged between 7 and 18, inclusive. All the patients and controls were examined using magnetic resonance imaging in order to detect any possible changes in the structure of their brains.

"The interesting thing was that we found common alterations among those with two types of clinically-differentiated psychoses, schizophrenia and bipolar disorder, and this could help to improve diagnosis of these illnesses," Santiago Reig, one of the study's authors and a researcher in the Medical Imaging Laboratory of the Gregorio Marañón Hospital, tells SINC.

The study confirmed these lower levels of grey matter, the brain substance in which neurone cells are concentrated. This lack, which was shared between the schizophrenia and type 1 bipolar diaorder sufferers, means the functions of this part of the brain are "somehow atrophied".

In addition, the technique used by the experts can pinpoint the location of these alterations. For example, "patients with early psychotic outbreaks (before the age of 18) showed alterations in the medial prefrontal gyrus region of the brain, which controls processes such as cognition and the regulation of sensations", says Reig.

Improving diagnosis

"Anything that helps to detect alterations shared between distinct pathologies can help in the development of drugs and in finding common characteristics between these different diseases," the researcher tells SINC. "Results like these are fundamental for the diagnosis and treatment of illnesses," he adds.

However, it is important not to draw any causal link between alterations in this area of the brain and the appearance of these pathologies. Psychiatric disorders need more complex diagnosis. What the research does show, however, is that the majority of people with schizophrenia and type 1 bipolar disorder do suffer from this lack of grey matter and the majority of healthy people have normal levels of this substance.

"We still do not know whether this loss of grey matter is caused by the disorder or not," says Reig. This is just one more piece of the puzzle to help in understanding common features of psychiatric disorders. "Maybe relating these developments with other new findings will one day help us to solve the riddle of psychiatric disorders," he concludes.

Heard this before but good to revisit

My mother's doctor shared this information with me a lot of years ago. It is good to revisit these informative data again though.

Schizophrenia And Bipolar Disorder Share A Genetic Cause

Article Date: 16 Jan 2009 - 0:00 PST

A new study from Sweden found evidence that schizophrenia and bipolar disorder partly share a common genetic cause; if one disorder runs in the family there is a good chance that the other will too. The researchers said their finding challenges the view that these disorders are separate entities, and call for a change in the way they are currently diagnosed.

The study was the work of lead author Paul Lichtenstein, a genetic epidemiologist at the Karolinska Institutet in Stockholm, Sweden, and other colleagues from Sweden and the US, and is published in the 17 January issue of The Lancet.

For the study, Lichtenstein and colleagues examined records of all patients discharged from psychiatric hospitals in Sweden from 1973 to 2004 and found 35,985 cases of schizophrenia (0.40 percent of the population) and 40,487 cases of bipolar disorder (0.45 percent of the population). They then looked in the Swedish multi-generation register, which contains information about all children and their parents in the country, and identified over 9 million individuals living in more than 2 million nuclear families between 1973 and 2004.

By comparing the patient discharge data for schizophrenia and bipolar disorder with the register, the researchers were able to identify parents, children, brothers and sisters who shared the disorders. Using a sophisticated statistical tool they then assessed risks for the two disorders, separately and together, for biological and adoptive parents, their children, full and half siblings, of patients with either of the two disorders. The tool they used was a multivariate generalised linear mixed model, and they assessed both genetic and environmental contributions to risks.

The results showed that:

* First degree relatives of patients whose discharge record showed they had either schizophrenia or bipolar disorder were at higher risk of having these disorders.

* Having a mother or father with schizophrenia raised the risk of a person having the disorder by 9.9 times, compared with someone who did not.

* Having a mother or father with schizophrenia raised the risk of a person having bipolar disorder by 5.2 times, compared with someone whose mother or father did not have schizophrenia.

* Having a mother or father with bipolar disorder raised the risk of a person having it 6.4 times, and the risk of having schizophrenia, 2.4 times, compared with a person whose mother or father did not have bipolar disorder.

* Having a brother or sister with one of the disorders significantly increased their risk of having them too, with half siblings having a lower risk than full siblings.

* Overall, relatives of patients with bipolar disorder showed increased risk for schizophrenia, including adopted children whose biological parents had the disorder.

* Heritability for schizophrenia and bipolar disorder was 64 and 59 per cent respectively.

* For both together, the figure was 63 per cent, mostly due to additive genetic effects common to both disorders, wrote the authors.

* Shared environmental effects were small but subtantial, they added.

Lichtenstein and colleagues concluded that:

"Similar to molecular genetic studies, we showed evidence that schizophrenia and bipolar disorder partly share a common genetic cause."

"These results challenge the current nosological dichotomy between schizophrenia and bipolar disorder, and are consistent with a reappraisal of these disorders as distinct diagnostic entities," they added.

In a separate press statement reported by Scientific American, Lichtenstein said he and his colleages suggest there are hundreds if not thousands of genes involved in the development of these two disorders, and many of them overlap. However, many of them have not yet been discovered.

Lichtenstein said there were many large scale studies happening around the world searching for the genes behind these disorders, and he is also researching in this area. He said scientists should look not only for overlap between these two disorders but with other psychiatric conditions too, like depression for instance.

Not In cooperation (compliance) with medical advice

It really comes as no surprise that people who are living on the street or some in-mates are there because they are not taking their prescribed meds. This is the same story over and over, not new news to the family and friends of the mentally ill.

Two thirds of prisoners nationwide with a mental illness were off treatment at the time of their arrest, according to a new study by Harvard researchers that suggests under-treatment of mental illness contributes to crime and incarceration.

The study, published today online in the American Journal of Public Health, found that about a quarter of inmates nationwide had a history of chronic mental illnesses like schizophrenia, bipolar illness and depression. Researchers analyzed data collected in 2002 and 2004 from local, state and federal correctional facilities.

While only one in three were taking medications for their illness at the time of their arrest, that number jumped to nearly two-thirds during incarceration, the researchers found

"For many of them, treatment of their mental illness before their arrest might have prevented criminality and the staggering human and financial costs of incarceration," said study author Dr. Steffie Woolhandler, an associate professor of medicine at Harvard and a primary care physician at the Cambridge Health Alliance's Cambridge Hospital campus.

Woolhandler said the findings portend significant problems for Massachusetts, where the Department of Mental Health last week laid off about 100 case managers -- nearly one quarter of the staffers who supervise people with severe mental illness and make sure they get the services they need.

State officials said about 3,000 clients would lose their current case managers. The layoffs were in response to the state's economic crisis.

"You are going to pay a much higher cost in the future prosecuting these people and putting them in jail, where they have a right to treatment," Woolhandler said. "I don�t know how good a treatment it is, but the taxpayers end up paying."

The Beginning

Another opinion I just formulated is this. My mother was bi-polar as was her grand-mother and I am sure this form of mental illness in my family was and is a chemical imbalance and a genetic defect. This mental illness was passed down, not created. My son in medical school just completed his clinical rotations in psy. and he said that with a mother being bi-polar, my brothers and I had a 40% chance of also being bi-polar, although we are not. But the real story is about one of my special 3rd grade students, a very sad story. Physically and sexually abused by his parents, he, his 7th grade brother and 3 years old sister became wards of the state. The sister was adopted, but the two brothers have been in and out of foster and group homes. This one 3rd grade student, 10 years old, in my opinion is manifesting mental illness. Who knows whether it is a inherited thing or the trauma of his young life. He has been on various drugs, in a foster home with a single foster mom. His meds. were changed, he hit his brothers new bicycle with a baseball bat, the brother in return hit him on the head with a rock causing a huge gash that needed staples to be fixed. The foster mom says she can't care for the brothers, so they were separated, one went to juvie for striking his brother; the 3rd grader is on his way to a psy. ward, then back into a different group or foster home, separated from his brother.So after these young men probably go through this scenario over and over again, they will be dumped out on the street at age 18 and told "Good luck". I can't imagine not having any family at all to care for me or who is concerned about my welfare at the tender age of 10 years old. No one in the whole world who "really " loves you. So let your imagination go 8 or 9 nine years into the future and see what kind of young men these guys will be when they are having to make their own way in the world. I am convinced that the 10 year old one was probably delusional today when he told me he had gotten a puppy for Christmas, that he was being adopted and all was well with him. When actually he spent Christmas in a respite home with people he never met before because he got into a fight with his brother, so all the things he told me, I am sure were things he "Wished" were happening and not the reality of his very sad life. So this is probably the birth of his very mentally ill road, starting with the adults who were supposed to love and care for him, his very parents who took a young blank slate of a child and sexually and physically abused their gift from God. No telling how his story will end. 'Nuff said. Liz.

Probably a good book

I have not read this book, but I bet I could write the story, just like I wrote the book and story about my mother. The stories of the mentally are all the same, in-patient, out-patient, going from one doctor to a different one, in and out of either prison or mental institutes, family helps or does not help, tremendous ups and downs, etc. They all hear voices and are usually directly chosen by God to do something that only they can accomplish. I don't mean to sound bitter, but after you hear those stories for 48 years, you really don't want to hear them all over again, just being honest.

Understanding Mental Illness -- Author and Nurse Recalls Twenty Years of Her Life in a Psych Ward

FENTON, Mo., Jan. 7, 2009 (GLOBE NEWSWIRE) -- Do you know someone who's mentally ill -- or has been in a mental institution? These patients seem very difficult to take care of; that's why their families sent them to mental hospitals. But have you realized the burden hospital attendants are carrying, just to provide for the medical needs of these people? Get a glimpse of Donna Snyder's life as she battles the insanity-causing pressures and complexities during her twenty-year stay in a mental institution with Define Crazy.

Every day came with a new surprise for Donna Snyder when she started working as a member of the nursing staff in VA Medical Center. Through her book, Snyder recounts her experiences from day one until the end of her stay in a psych ward, recalling her patients' idiosyncrasies. She shares her encounters with the psychiatrically ill, and narrates how she was able to adjust to a peculiarly new environment. She revisits the years when she uncomplainingly dealt with those who screamed endlessly in the middle of the night, those who created trouble in the ward, and felt empathy for those who met heartbreaking tragedies at a very young age. Being in a mental institution for twenty long years taught Snyder to understand the reality of mental illness -- a reality we must all accept. As she transferred to another psychiatric institution, Snyder carried with her the lessons she got from her experiences and from the people she worked for.

Define Crazy is an enlightening book which exposes the actual setting of psychiatric institutions, and how the government deals with citizens who need help. It asserts that mental illness is not a condition one must be ashamed of; rather, it is a situation that needs proper attention to avoid unwanted incidents. For more information, log on to www.Xlibris.com.

About the Author

Donna Snyder received her nursing license in 1976 and has practiced nursing since. She completed her BSN degree from Webster University in 1998. She has worked in psychiatric hospitals since 1978. She has worked as Supervisor RNIV at the St. Louis Psychiatric Rehabilitation Center, and is currently working in an Acute Psychiatric Unit as a Health Care Professional and Registered Nurse. Additionally, she is President of the Missouri State Nurses Investment Club. Donna lives in St. Louis with her husband, son, and two dogs.


Define Crazy * by Donna Snyder, RN, BSN
A Nurse's 20 Years On A Locked Psych Ward
Publication Date: January 2, 2009
Trade Paperback; $19.99; 138 pages; 978-1-4363-5642-8
Cloth Hardback; $29.99; 138 pages; 978-1-4363-5643-5

To purchase copies of the book for resale, please fax Xlibris at (610) 915-0294 or call (888) 795-4274 x. 7876 or on the web at www.Xlibris.com.

Good book

Vincent

Book Cover of 'Voluntary Madness'



Am I mentally ill? Or have I been diagnosed as such because it means that the insurance companies will pony up for my meds and my stays in the hospital only if I am placed in a category in the Diagnostic and Statistical Manual of Mental Disorders (DSM), whether I truly belong there or not?

And what is 'mentally ill,' anyway? What can it mean to say that someone is mentally ill when the DSM, the psycho-bible, is, in my and many other far more qualified people's estimation, not a scientific document, but rather an entirely subjective and seemingly infinitely amendable and expandable laundry list of catchall terms for collections of symptoms.

There is, at least in the quantifiable sense, no such thing as schizophrenia, bipolar disorder, major depressive disorder, social anxiety disorder, and a whole host of other accepted diseases listed in the DSM. There is no real test for any of them (only questionnaires and symptomatic observation). They are unduly subject to political and professional fashion, and even lobbying by special- interest groups. Hence the successive redefining of homosexuality in 1973 and 1980, and, finally, its excision from the DSM in 1987.

We are nowhere near understanding the causes and mechanisms of mental illness well enough to develop reliable diagnostic criteria for any of them. We infer backward from the symptoms to the disease, which is why, when it came to doing the research for this book, it was so easy for me to gain admission to various hospitals on the pretext of undergoing a major depressive episode, even though in at least one case I was feeling quite well.

People have often asked me how I was able to do this so easily, and I always shock them when I say, 'Anyone could do it.' Getting yourself committed is very easy. Easier than it should be.

This has been true for a long time. In 1972, psychologist David Rosenhan and a group of his colleagues and graduate students conducted an experiment in which eight participants, or 'pseudopatients,' none of whom had histories of mental illness or institutionalization, set out to see how difficult it would be to get themselves committed.

They presented themselves at various hospitals across the United States, saying that they were hearing voices. They said that the voices were repeating the words 'empty,' 'hollow,' and 'thud.' They claimed to be suffering from no other symptoms and otherwise behaved normally. All eight were admitted, seven with diagnoses of schizophrenia, and one with a diagnosis of bipolar disorder. None of the staff was able to identify the pseudopatients as impostors during their stays, though a number of patients were reported to have done so.

The pseudopatients were all discharged after an average stay of nineteen days, at which time their schizophrenia was diagnosed as being 'in remission.'

The results of the experiment were published in the journal Science, and the authors concluded ominously, 'It is clear that we cannot distinguish the sane from the insane in psychiatric hospitals.'

I am sure that another Rosenhan experiment, if conducted today, would yield equally worrying results.

But this book is not another Rosenhan experiment. Though it does cast an unabashedly critical eye on the system, the practice of psychiatry, and the prevailing view of mental illness, it does so solely through the lens of my experience.

If you are looking for evidence, you will not find it here, except in the notoriously unreliable form of eyewitness testimony. My own.

The formal case against the leviathan has been made already, and is still being made in the courts and the newspapers. A number of people, several of them professionals in the field, have written extremely well-documented exposes of psychiatry, psychiatric medications, the pharmaceutical companies, and the DSM. These books are far too seldom read, in my opinion.

I admire and support what these writers, dissenting doctors, and journalists have accomplished. Initially, I sought to follow their lead. I saw probing the phenomenon of mental illness today as an effective and provocative way to take the measure of my culture. But as I plunged myself deeper in the project, I, and it, took a sharp turn inward, becoming somewhat less about what I saw around me and more about my private struggle to find a way out of chronic mental distress, a distress that the system not only seemed unable to heal but, more often than not, had only made worse.

As you read, you will see that what begins as the mostly detached report of the proverbial journalist at large, first in a big-city public hospital, then in a private rural hospital, and finally, in an alternative treatment program, soon dovetails and then merges indistinguishably with the very personal account of a bona fide patient's search for rescue and, if possible, a touch of lasting self-awareness along the way. The journalist and the patient are both me: one doing a job, or trying to; the other slouching, in her own time, toward bedlam; and each, by turns, pushing the other up and along or dragging her down.

What follows is the record of that dual journey, shot through with observational inexactitude. This is what I saw and what I thought. It is what happened to me, inside and out. That's all. It is not, nor was it intended to be, an argument, a polemic, or an investigative report, though it is, at times argumentative, conjectural, and raw. It draws no hard-and-fast conclusions. It asks. It surmises. It prods. It also wanders, meanders, spirals, and circles back. But in the end, it does no more and no less than take you with me. And that, after all, is really what you're here for, isn't it? To come along for the ride.

That much I know I can promise you. A bumpy, loopy, sideways, up-and- down ride.

A journalist I once knew had a saying about our profession: The most you can hope to do is inform and entertain.

As an invitation to these pages, that sounds about right.