Bipolar Hope

I rarely post on the weekend. But I wanted to make an exception because the Ellen Frank quote I shared in my last post so distressed me that I've been feeling bad about it for 24 hours. The way I retain wellness is to determine what's making me feel bad, and to take action.

In this case, my action is to share my final thoughts about what Dr.Frank wrote, to discuss what bipolar wellness means to me, and to provide a few inspirational quotes.

To me, bipolar wellness (as a frame of mind) means thinking positively about bipolarity rather than negatively. When psychiatrists, psychologists, or other mental health professionals say, "Bipolar disorder is 'like a death,' or it's a lifelong illness, or we need to grieve for our 'lost healthy self,'" I sometimes need to acknowledge what has been said, refute it, and move on.

Unlike earlier periods in my life, I don't allow other people's negative perceptions of bipolarity to depress me. One of the greatest values of writing this blog has been to meet other bipolar wellness seekers. Before my blog, I'd never talked with one person who had been labeled "bipolar." Now, I have more than 44,000 hits on this blog, and I have read comments from hundreds of people, and responded in kind.

What I've learned is that we all approach our bipolarity differently. We have different symptoms. Some of us come to this illness from unipolar depression, others from mania, and still others from psychotic episodes. But I believe the reason we have come together as a "virtual support group" is because we all seek wellness.

When I started Bipolar Wellness Writer in February of 2007, it was because I wanted to share the information I had learned, and the wellness activities I had developed, and learn new ones. I wanted to discover people who were "more than their illness."

I felt that if we could tell each other what was working for us, it would help us in our quest. If we could share disappointments, it would make them less difficult to deal with. And if we could provide hope for each other--when it's so lacking within the mental health professional community--we would strengthen our collective resolve in seeking wellness.

And I believe that has happened in a significant way. So, rather than ending the week on a negative note, I wish to end with some life-affirming quotes about hope.

"I believe that imagination is stronger than knowledge,
That myth is more potent than history.
I believe that dreams are more powerful than facts
That hope always triumphs over experience
That laughter is the only cure for grief
And I believe that love is stronger than death."
~Robert Fulghum, Storyteller's Creed

"Become the change you seek in the world."
~Mahatma Gandhi

"Your hopes, dreams and aspirations are legitimate. They are trying to take you airborne, above the clouds, above the storms, if you only let them."
~William James

Before We Were Bipolar (Part 2)

As I mentioned yesterday in response to a comment by Meredith, I believe there's a big difference between those of us who weren't diagnosed for many years, and who still aren't sure the diagnosis is correct, and those who are much younger, and feel it's an accurate diagnosis.

I also think there's a big difference between people who try a few medications, stabilize, and feel good within a reasonable time frame--and those of us who don't. And maybe sometime in the future, I'll be able to say there's a difference between those who are diagnosed, begin an exercise program, participate in neural path therapy, change their diet, receive insightful counseling, and stabilize--and those of us for whom it took a much longer period to reach the same outcome.

For me personally, unipolar depression turned into bipolar disorder after many years of undiagnosed episodes combined with antidepressants. When an illness is medication-induced (and perhaps even when it's not), I don't think it's unusual to mourn our "lost healthy self," which was the topic of yesterday's post.

While Ellen Frank, Ph.D., author of Treating Bipolar Disorder: A Clinician's Guide to Interpersonal and Social Rhythm Therapy, and her colleagues may have found that mourning our "lost healthy self," is unique among bipolar patients, her reasoning why this is so, astounds and infuriates me!

She writes, "Some of our colleagues who are experts in IPT for unipolar disorder have argued that this problem area is more appropriately thought of as a subset of the role transition problem area, but we have found that presenting it to patients as a form of grief has a very profound impact and tends to motivate them to work on this issue in a way that presenting it as a role transition does not. Perhaps this is because 'becoming bipolar' has a kind of unalterability that is more like a death than the loss of a job or even a divorce."

And it's this very paragraph, which represents everything I despise about the psychiatric profession's attitude toward bipolar disorder. To present a bipolar diagnosis as a form of death is exactly what so many psychiatrists do--either knowingly or not. In one fell swoop, they destroy a patient's hope for achieving wellness, and their dreams of living a life with any possibility of normalcy.

One only has to substitute any other illness for bipolar disorder to see just how ridiculous it is. What if a diabetes researcher wrote, "Perhaps this is because 'becoming diabetic' has a kind of unalterability that is more like a death than the loss of a job or even a divorce."

I can guarantee you that researcher would be publicly condemned--within the medical and diabetic communities. What's so strangely awful is that Dr. Frank has a wonderful reputation and has done some excellent research in the bipolar field. But if she doesn't really have a clue what a huge disservice it is to tell bipolar patients that their illness is more "like a death than the loss of a job or even a divorce" than it's no wonder the suicide rate for bipolars is so high.

And, we who disagree with "the death knell analogy" need to find some way to voice our disapproval so loudly and so publicly that our voices will be heard from Washington D.C. to Ottawa to London to Canberra to Manila to Moscow to Beijing and beyond!

P.S. While I'm focusing on Ellen Frank in this article, I don't truly mean to single her out. As far as I'm concerned, her attitude typifies every bipolar researcher in the field who preaches despair rather than hope, and dwells on illness rather than wellness.

Before We Were Bipolar (Part 1)

I would like to share the following quote from Treating Bipolar Disorder: A Clinician's Guide to Interpersonal and Social Rhythm Therapy by Dr. Ellen Frank.

"After many years of working with patients who suffered exclusively from unipolar depression, we began a major program involving those with bipolar I disorder. We were immediately struck by the tendency (which we had never observed in the unipolar patients we had treated) of the people with bipolar disorder to divide their lives in two: before their diagnosis and after their diagnosis.

"We soon realized that in this new group, a patient often saw him- or herself almost as two different people: the person he or she had been before developing bipolar disorder and the person he or she was now. We began to talk about the idea of grief over the 'lost healthy self' as another form of unresolved grief that was common among people with bipolar disorder."

I'm hoping you'll share your thoughts about Ellen Frank's observation. I'll tell you how I feel about it tomorrow.

Neural Path Therapy (Part 2)

Before I write the second post on Neural Path Therapy, I'd like to share an exciting bit of news about one of our fellow bloggers. Marja's new book, A Firm Place to Stand, will be coming out soon. Although there's not yet a link to the book, it's being excerpted in canadianchristianity.com. As an author I know how important it is to have people post comments on an article. So, if you have a moment, it would be nice if you could read the excerpted article and post on it. I'm sure Marja would be thrilled!

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One of the things I like best about Neural Path Therapy by Matthew McKay, Ph.D., and David Harp, M.A., is that they explain things very simply. The central thesis of the book is that "You can focus the power of your brain where you want it, when you want it."

"Unfortunately, most of us have never been taught how to focus--or not focus--on mental objects, like thoughts, emotions, or neural pathways," they write.

So, if a particular person triggers a particular emotion, we respond the way we always have. If that means we ultimately become depressed by the exchange, then most of us believe our doctors who say, "It's an automatic response and you can't change it." But, McKay and Harp believe we can change our neural pathways.

They believe all of our emotions are based on the "fight or flight" syndrome. That just means that our brains have not really evolved since we were cavemen or cavewomen. If something frightens us, we automatically respond...like people did thousands of years ago when they saw a lion or a tiger coming at them.

In our contemporary world, we (like the cavepeople who preceded us) don't have time to think when we see a car in an alley headed toward us, or we see our child running away in a busy department store. Instead, we instinctively respond by running away from the car, and running after our child before we lose him/her in the crowd.

McKay and Harp liken our thought processes to the automatic response patterns we use if we or our kids are in danger. If someone triggers an emotion like anger, fear, or jealousy, we automatically respond. But...and this is the key to their theory...if we anticipate our response to a common stressor or we stop the "fight or flight" syndrome by relaxing rather than stressing out, we can change our response.

The way we do this is by breathing. But, instead of making the breathing process difficult by suggesting we have to sit in a lotus position on the hard floor, or go to a mountain retreat and remain silent for eight hours, McKay and Harp believe that if we only have a few minutes a day to practice our breathing, it's enough.

Each time we anticipate an emotion, and breathe rather stress out, we're strengthening our "mental muscle," which they define as "our ability to keep the power of our brain focused on an object or move it to another object." Eventually the neural pattern we no longer use will disappear, and a new pattern will evolve.

I can't really explain their breathing exercises without quoting too much from their book. But they chart out different exercises. Basically what you're doing is just inhaling, holding the breathe, and exhaling. Or you're quickly inhaling and exhaling. Or you're taking shallow or deeper breaths.

What you're also doing is focusing on the breathing rather than focusing on the emotion. So, for example, if you notice your spouse/partner always makes you feel powerless when you're at a low energy level, by saying--"Are you sure you can't go out to dinner tonight? I was really looking forward to it"--rather than focusing on the words and feeling worse, the moment you anticipate what he/she is going to say, you start breathing, and begin releasing the tension rather than building it up.

The process they're recommending works with everything. If you get angry because someone writes a comment you don't like on your blog, rather than writing a quick and angry retort, start breathing and calm down. If you feel "angst" every time your best friend mentions that you're talking too fast or straying from one subject to another, rather than feeling hurt by her judgmental tone, start breathing.

And if you get depressed every time your doctor says, "It's not a good idea to remain off medication because you could experience another mania or depression," don't feel down about it, just start breathing.

So far, breathing is the most effective depression antidote I've ever tried. And Neural Path Therapy is one of the best wellness books I've read. I highly recommend it.

P.S. I just learned there's a Neural Path Therapy site, which provides a lot of additional information.

Neural Path Therapy (Part 1)

In terms of my own search for wellness, I'm fairly sure the brain is the key to everything. So, when I saw a book called Neural Path Therapy: How to Change Your Brain's Response to Anger, Fear, Pain & Desire, I was hooked. And the fact it was co-authored by David Harp, M.A. (He uses the harmonica to teach stress reduction training as well as creativity training and peak performance training) was the final selling point. I have bought two other books by David on music and playing the blues harmonica, and I think he's wonderful. The other co-author is Matthew McKay, Ph.D. and he's the co-author of The Relaxation and Stress Reduction Workbook.

While I've only read about half the book, it's already had a huge impact. The point they make, which is critical to me, is that you can change "automaticity." This is such an important concept that I need to explain it further in relationship to bipolar disorder.

One of the key arguments psychiatrists use when they say you can't "cure" bipolar disorder is "brain kindling," which I've discussed before. Basically it means that after a few depressive episodes, whenever you get stressed, your brain automatically will respond the same way to the same triggers.

I've always found this argument to be depressing, because what they are suggesting that even if you change significantly, your brain won't change. But Harp and McKay disagree. They write, "The crucial mental skill is to be able to focus attention onto--or away from--the thought, or neural path of your choice."

What they believe is that you can learn how to observe neural pathways and change them. They say that if you stop using the same neural pathways (i.e. your supervisor always demeans you and as a result you feel powerless, or your sister pushes your hot buttons and as a result you get angry), they will fall into disuse.

Thus, if your supervisor says, "I don't like the copy you've written or the way you edited this article," rather than feeling powerless (and becoming depressed), you can anticipate she will say this, identify that it always makes you feel powerless, and stop feeling depressed.

What this means is that you can train your brain to stop kindling! How do you do it? By breathing exercises. While it sounds simplistic, it's truly a powerful tool. I've already begun using it, and it works!

P.S. I just learned there a Neural Path Therapy site, which provides a lot of additional information. So I've listed it on both posts on this topic.
(more to come)