How best to avoid heart attack – Interview with Dr. Aseem Malhotra on mercola.com

This British cardiologist, Dr. Aseem Malhotra, really knows his stuff.

If you are short of time just listen to the second half of this 19m 20s minute interview – from 9m 30s onward.

http://articles.mercola.com/sites/articles/archive/2016/06/05/saturated-fat-heart-disease-risk.aspx

Clearly this is not just for those diagnosed as bipolar. There again, if you are on any kind of prescribed drug listen near the end as the doctor talks about how he defines unacceptable side-effects.

Bipolar Driving Analogy #Wootton

Yesterday, in ‘Psychology Today’, my good friend, Tom Wootton posted a useful short article called, “Bipolar Treatment Is More Than Just Tools To Lower Intensity

Here are a few words from it; “I see too many people who have never learned yet convince themselves that they know how to drive. When their mania gets stronger than they can handle they don’t even have the good sense to put on the brakes. And then, when someone else puts on the brakes for them, they go back to imagining that they know how to drive. Their repeated failure to actually learn the necessary steps is just reinforcing the false notion among everyone around them that it cannot be done.

In the work I have been doing I have found car and driving analogies to be really useful. It fits with the picture millions of people have of recovery, or even everything about life being a journey.

Most people reading this will have passed a driving test after many hours of instruction from a tutor with a great deal of experience. How many of us have done such intensive training for managing our moods and our long-term well-being?

What is bipolar? / Types of Bipolar #mentalhealth #bipolar

What is bipolar? / Types of Bipolar

Bipolar recovery requires finding out about causes, but first we may need some understanding of the psychiatric bipolar categorisation in use today.

Receiving medications for bipolar disorder is a serious thing, with patients on average dying 20 years earlier than the general population. However, with no medical tests for bipolar, it has only ever been a way of saying, “Something is wrong with your moods but we do not know what is causing it.”

With such a wide meaning then:

  • Are we all, from time to time, a bit bipolar?
  • Are there as many forms of bipolar as there are people in the world?

Bipolar is about categorization rather than diagnosis. Diagnosis means identifying causes, so technically speaking no one can ever be diagnosed as bipolar because bipolar categorization is reserved for people where the cause is not being identified. Bipolar categorization is about labeling.

There are four main categories of bipolar:

1)      Bipolar 1: This is the label given to people who admit to having low energy moods and have been seen to have some extremely high energy moods, whether associated with positive or negative feelings. This is equivalent to the old Manic Depression, other than; the highs in bipolar often being unpleasant with negative feelings or a confusing mix of positive and negative feelings, rather than the traditional manic depressive’s high which was considered to be a kind of ‘happy’ time for the person experiencing it. When the bipolar label first became available to psychiatry in 1980 this was the only type of bipolar.  Although the numbers with this label continue to grow it still accounts for less than 2%* of the adult population.

2)      Bipolar 2: This relatively new label is probably the fastest growing in the UK and may already have been applied to nearly 10%* of the adult population. It is used for people who admit to having low energy yet have never been seen to have extremely high energy moods. It tends to be given to people who previously would have been described as depressed as well as to people who suffer from fatigue syndromes where mood changes seem to be their main problem.

3)      The next less severe bipolar option is called cyclothymia, rather than bipolar 3. It again informs us, “Something is wrong with your moods but we do not know what is causing it.”

4)      Bipolar 4: This can be used when there is no dispute about a prescribed drug or ‘street’ drug triggering the damaging high energy moods. (It is unlikely to be used if the trigger is thought to be ‘a legal high’, nicotine or caffeine.)

At first a label can help us find support, however, bipolar labels stay on our (UK) health records for life, often preventing professionals from looking for or tackling the causes of our troubles.

In many ways the exact label is not so important. The part that needs to be tackled is the cause or causes. Only by getting to grips with what causes us to be seeing a psychiatrist can we start to make a lasting recovery, otherwise we will continue to have to manage/cope with moods we do not want to be having.

I am hoping I can help readers to find and tackle the causes of their disordered moods.

Roger A. Smith

31st January 2014

*In the UK it is difficult to know exactly how many people are affected as many people are not told what is in their medical notes. I would like to hear from anyone who can provide up to date estimates of numbers affected.

Bipolar Recovery Bite-size – Mood Mapping #moodmapping

Two years ago I was writing ‘Bipolar Recovery Bite-size’.  This was to explain how I and others had come to understand what had happened to us and so recovered from the diagnosis. The reason for ‘bite-size’ was that emotional disturbances can make it difficult to read long articles – The challenge became one of sharing this important information in small chunks/bites.

I have started updating all the bipolar recovery bites and over the next few weeks hope to share the new versions here at Rethinking Bipolar

1.What are emotions made of?

Fourteen years ago as a patient on an acute psychiatric ward I was told I had an emotional disorder that would need to be treated with medication for the rest of my life. I was given a label, “Manic depressive”. There was no explanation of emotions, what was causing the disorder or what I could do other than take tablets.

I wonder how different the next few years of my life would have been if the psychiatrist had been able to explain to me something about emotions.

Perhaps he thought I was too ill to understand or perhaps he did not know how to explain?

We all have an idea what emotions are and yet we all seem to explain emotions in different ways. Emotions mean different things to different people.

 Before reading bite 2 , “Emotions Are Made Of…”, how would you describe emotion? 

“Mentally ill” – How does one clear one’s name?

In January 2012, I asked psychiatrist,  Dr Hugh Middleton for his views on ‘undiagnosis‘. This led to this question:

Once identified as one with a mental health difficulty (or even worse in some ways, a specific diagnosis) how does one clear one’s name?

Starting with Hugh Middleton’s thoughts on this subject I hope you will agree the following is realistic, useful and worth passing on as it points a way forward in reducing stigma and suffering: 

It involves being able to walk away from all the fuss others make about it.

A truly “recovered” position is when the causes of the distress do not matter any more. Unfortunate or traumatic things happen to us all. These can cause a change of direction or other lasting consequences, such a failed relationship being painful and necessitating changes to allow new possibilities.

The idea that an episode of disturbed behaviour somehow marks the person as inevitably and eternally flawed is a primitive one based upon archaic notions of mental stability. Long after a diagnosis, if one is no longer distressed, anxious or a source of concern to others, then it is only a problem if people relevant to you still believe there to be one.

Bereavement is a form of emotional distress but few would say it is a ‘mental illness’. Most people eventually move on in some way, even after a period of great emotional distress through bereavement. Having got ourselves together again, there is no question of ongoing abnormality for having been through this experience. Occasionally someone may not fully recover from a particular bereavement: I know a woman whose daughter was killed and naturally she suffered extreme emotional distress. Then her physical health rapidly deteriorated and 30 years later she is still very unwell. Even such a sad outcome did not result in a mental health diagnosis and she able to get by with support from understanding family and friends without any the stigma commonly felt for life by those who have been given a diagnosis.

When emotional distress is labelled as ‘severe mental illness’, the public (to some extent that is all of us) can associate the label with manifestations of extremely disturbing behaviour. It is difficult to shrug off terms such as ‘psychotic illness’ and move on from it.

Rituals that help people to move on after bereavement are well-known, such as the funeral, disposing of effects and making new friends/relationships. People who have suffered all forms of emotional distress have always had ways of coping and moving on if they are allowed to do so. Since the 1980’s it has become increasingly popular for those who make good recoveries to document and share these through books and training courses. How recovery happens is certainly not a mystery, as simple concepts and methods lie at the heart of these accounts of recovery. Unfortunately alongside this increased focus on recovery is a modern belief that ‘in-recovery’ is the only state worth aiming for and healthcare staff now often shy away from talk of ‘full recovery’.

Involvement with anti-stigma work has led me to doubt that this can have much effect until healthcare staff can get over the ‘in-recovery-forever’ idea. The public can be influenced by celebrities who appear to be in-recovery, but the people most of us look to for guidance about what is possible are the health professionals. It is they who need to return to the roles of the pre-drug era where belief in full recovery was widespread.

Ultimately, recovery from emotional distress will return to normal when we can all stop calling it ‘mental illness’. Hardly any of the people being diagnosed either have a definable mental problem or a diagnosable illness. Emotional distress is to do with emotions and when people can be helped to understand their emotions and what has caused their distress then full recovery becomes the norm. It is time those who have recovered start to work more closely with the medical professionals who are ready to abolish psychiatric diagnosis.

Roger Smith – based on my conversation with Dr Hugh Middleton in January 2012

 

 

Greg Montgomery – Nice film made by football star with bipolar diagnosis

I communicated with Greg Montgomery quite a few times while writing the bipolar for nurses handbook.

He was famous as a football player.

I like his film especially the way he shares about life after diagnosis.

Is there a risk that we could be glamorizing a diagnosis rather than working towards annihilating it? Take a look at the video and let us know if you think.

Greg Montgomery

 

And our target is…

To avoid, overcome or eliminate a disorder we have to be a bit cleverer than just looking at what we are trying to avoid.

Mood Map Miller

Calm moods instead of diagnosis?

On workshops I have given students cards with symptoms of bipolar disorder written on the cards.

I have asked the students to place the symptoms on a mood map according to which of the four main moods the symptoms seem to show.

At the end of the exercise the symptoms are spread out across the depressive, anxious and active sectors. It seems that the bipolar diagnosis picks up people who are exceptional at being in either two or three of these states. The people who get the diagnosis will have been seen being both depressed and anxious, or depressed and active or anxious and active. The third of these may come as a surprise, as surely you have to be seen to be depressed to be diagnosed as manic-depressive? We can come back to that another time.

With a set of say 40 typical bipolar symptoms it is rare that the students will place any of the symptoms in the fourth quadrant of the mood map. The calm quadrant remains pretty well empty. It is this quirk that only seems to be revealed by mood mapping that gives us our target and our big break in combating bipolar disorder diagnosis.

Rather than looking at one symptom after another and thinking, “I must avoid that”, “I must stop doing that”, now we can start with a mood to aim for rather than moods to avoid.

I am interested to hear from readers who have achieved a better life by being calmer.

I am interested to hear from readers who know why calmer is a great target, yet not the ‘be all and end all’/’ultimate aim’ if you want to avoid a bipolar diagnosis.