Bipolar Disorder Research

This was something I posted in a discussion for my Pathophysiology class.

Bipolar affective disorder, formerly known as manic-depressive disorder, is a mood disorder with a cyclic pattern between a depressive state, a normal state, and a manic or hypomanic state. Type I bipolar disorder presents with full mania, Type II presents with hypomania. Bipolar disorder used to be classified as a psychosis, however not everyone with bipolar disorder presents with psychotic manifestations and thus it was re-classified as a mood disorder.

Scientists believe that the mutation for bipolar disorder occurs on the 13th chromosome. Recent studies conducted by J.A. Badner and E.S. Gershon have shown that the chromosomal regions 13q32-33 and 22q11 are believed to confer susceptibility to this disorder.

Bipolar disorder usually onsets at puberty, but there are childhood onset cases and sometimes it can be triggered later in life. It affects people of all races equally. There is no way to tell that a person has bipolar disorder by looking at them. Bipolar II can be misdiagnosed as unipolar depression as the hypomanic state does not present with the extreme behaviors of the manic state. In my own case, I was misdiagnosed as having unipolar depression with anxiety until I was 38 years old, when in fact I have Bipolar II.

A person having one parent with bipolar disorder has a 25% chance of manifesting the disease at some point in their life. If both parents have bipolar disorder, the chances rise to 50%.

Bipolar disorder can be treated by a variety of medications. One of the medications is usually a mood stabilizer such as Lithium. Each person is different and will respond differently to medications. I am personally unable to tolerate either antidepressants or sedatives and thus only take Lithium. Other people may not be able to tolerate Lithium but might respond well to other mood stabilizers or to antidepressants. Some mood stabilizers, such as Depakote, are also anti-seizure medications. Pharmacologically speaking, Lithium is a unique medication and is not classified as anything but a mood stabilizer.

References: The American Society of Human Genetics

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1180266/

Polymorphisms at the G72/G30 Gene Locus, on 13q33, Are Associated with Bipolar Disorder in Two Independent Pedigree Series

Eiji Hattori, Chunyu Liu, Judith A. Badner, Tom I. Bonner, Susan L. Christian, Manjula Maheshwari, Sevilla D. Detera-Wadleigh, Richard A. Gibbs, and Elliot S. Gershon

Asperger-ish?

I took this test to determine the possibility that my discomfort in social situations and inability to interact with people in a socially adept way may indicate Asperger's syndrome.

I scored a 29. According to their scale:

Average woman scores 15. Average female scientist scores 17. Average man scores 18. Average male scientist scores 19. Average computer scientist of either sex scores 21. Average mathematician scores 24.

Scores over 32 indicate possible Asperger's or high functioning autism.

I am not saying that I am a genius by any means, but I actually did a test to see if I could get into Mensa, and I can (in spite of my incredibly shitty understanding of math.) I did not join, but it was interesting to know that I could, because I took the test as a lark. I was actually judged as being borderline retarded because of my poor scoring on the Ravens test (a type of IQ test that determines pattern recognition abilities) when I was twelve years old. What I learned was that I am not in fact retarded (except socially, evidently) but I am somewhat dyslexic. This surprised me because I am better than average at spelling, but I do have to triple check any number to make sure that I have it correct. 

I may not have Asperger's syndrome, but the test that I took does reflect that I have a terrible ability to mesh with normal society, because I don't think like "normal" people do. I'm not antisocial but I am somewhat asocial. I don't care a thing for being fashionable or looking or acting like everyone else. I notice what people look like and am in fact fascinated by facial features, different hair and skin colors, and figuring out what a person's heritage may be based on these factors. I also started noticing people who might have disorders in their genotype based on its expression their phenotype. For instance, you may enjoy this essay on Marfan Syndrome, a genetic mutation on the 15th chromosome which interferes with the production of fibrillin.

There's an old song by Rod Stewart, the main line of which is "she's just a little misunderstood, that's all."

People do tend to misunderstand my intentions. They get angry at the way I put things under a microscope, yet get angry at the way I find it impossible to categorize things in the same way that they do. Other women want to talk about how "hot" guys are. I may know if a guy is attractive to me, though my perceptions of attractive tend to be radically different from other people's. But I wouldn't know "hot" from the proper measurements to make nitroglycerin. I will not feel "hot" for somebody unless I have gotten to know something about him and there is reason to. To me, "hot" is a feeling, not an arbitrary attribute. I could go on all day about why certain facial features may or may not make a person attractive given another person's perspective. But is he hot? I don't know. That's subjective. Is he "hot" to you? Fine, that's how you feel. Does it really matter whether or not I do? I don't know the guy. I don't really feel it is right of me to pass such a value judgment on him.

It's this sort of thing that tends to alienate me from the crowd. I am not willing to pass a value judgment on another person based on his or her physical appearance. Some of the ugliest people are packaged in technically pretty wrappings, and some of the most beautiful people have external packages that may be a little the worse for wear. I tend to prefer the ones who are a little rough around the edges externally but beautiful inside to the ones who are considered beautiful outside but either have nothing on the inside, or worse, have nothing but ugliness there. Getting to know some people is like unwrapping a pretty box filled with cockroaches and centipedes. It is very traumatic and destructive.

One of my problems is that whenever a connection is severed, I tend to think about it obsessively to the point that my productivity is compromised. I am not sure if this is a feature of my OCD, a feature of my borderline personality disorder, if I actually have a degree of Asperger's, or a combination of the three. A lot of these disorders express co-morbidly. There may be overlapping features. 

I may be hard to figure--hell, I've really never figured myself out. But I do want to have friends. I'm very lonely. I may be incapable of being a social butterfly, but I'd love it if someone understood me a little. I hate looking in my email and finding nothing but fucking penny stock picks and advertisements. I wish that sometimes I'd get an email from a person.

I hope that maybe someone reading this will understand me just a little.

How the American Medical System Fails Seriously Ill Psych Patients

This was my response to a post at the Dreamin' Demon regarding a seriously psychologically ill and dangerous man who tried to circumcise his eleven month old son.

Commenter "Lizard" says: It seems to be common among those with serious psychiatric problems that they stop taking their meds. Why? My impression is that (a) the meds make them feel like they're "just fine," so they think they don't need the meds any more and (b) the meds have serious side effects that would dissuade about anyone from voluntarily taking them on a regular basis. 

The Cheese says: Another problem is that he was released. Our medical system fails people with serious psychiatric problems (and less serious psychiatric problems, and non-psychiatric medical issues...) There was a case here in Denver some 15-20 years ago where a man checked himself into the state hospital, telling them "keep me here, or I'm going to do something bad." But he had no insurance. So they released him. Lo and behold, he raped a woman and set her on fire.

This man should not have been released in the first place.

The majority of people with mental illness are not dangerous to others. Statistically, approximately one-third of mentally ill individuals total present a danger. Most people with mental illness are not, in fact, "insane." They are cognizant of reality and possess impulse control. Individuals such as this, however, fall well outside that category.

My grandmother worked in the state hospital in New York for her entire working life. She knew the patients better than the doctors who saw them once a week. Yet they wouldn't listen to her because she was "just an orderly." Sure enough, one patient she pleaded with them not to release went back out into society and knifed a couple of people to death.

Dumb Question of the Year: Is Anybody Bipolar?

Huffington post user "Lamirabelle" made this brilliant statement:

Everybody is bipolar these days. The American association of psychiatry did a swell job when they discovered or made up (depending on the point of view) this disease. All I know, it makes gooood money.
Anybody bipolar? Come on! 

And the Cheese raved:

Yes, Cookie, I am. It is not a "made up diagnosis." It is a very real disease. Mine was not discovered until I was 38 years old, and I went through years of hating myself because I would come out of a disabling depression that had caused me to be nearly non-functional and think that I was okay, only to spiral down into the depression again. People with bipolar disorder, especially type II bipolar disorder such as I have, run the danger of committing suicide at some point because of the horrific depressions we suffer from. We are not "crazy," but our brains magnify whatever mood we have. Bipolar disorder IS A VERY REAL MOOD DISORDER. And if it made good money I'd be one rich bipolar old bat right now. Instead, I am marginalized and feeling suicidal much of the time because I don't think I'll ever get out of my financial hell hole that having to live with this disease is part and parcel of putting me into. Sooooo nice that you are perfect and have no problems, Lamirabelle. Some of us are not so lucky.

Read the Article at HuffingtonPost

Woulda Coulda Shoulda

 

Following the death of a troubled famous person (i.e. Kurt Cobain) people often say "if I had known him, I would have been there for him." My thought is, hell you would have. Think about the troubled people that you actually do know. Are you there for them or do you avoid them because they make you uncomfortable? Well, that's exactly how you would have treated Kurt Cobain, or whomever. There is a certain glamor or mystique about such people that makes them appealing, whether they thought themselves to be "glamorous" or "mysterious" in any way or not. If you knew them in real life, they'd be just another unhappy individual that you couldn't be bothered with. So, let's cut the crap, shall we? Sure, it's cool to think "I could have been the one to save Kurt Cobain if only I'd known him." Well, you can't. And what about all the potential "Kurt Cobains" that one ignores because they're too depressing to be bothered with? What do you think Kurt Cobain was? He was an unhappy guy with a talent. Only this and nothing more.

What if you were on the other side of the world and happened to know this fellow, the best description of whom is "he was a nice guy with a lot of personal and mental problems." His name was Per Yngve Ohlin, and although he is less well known than Kurt Cobain, he too had a degree of musical talent and his stage image has well outlived whatever he actually was as a person. His mental disturbances went beyond severe depression. As someone who has studied psychology I don't believe that schizophrenia was an accurate diagnosis, but it's close enough for the general public. He did suffer from some sort of psychosis. He wasn't dangerous, but do you think you would really have wanted to keep company with someone who talked about death all the time and believed himself to already be dead? Perhaps you  already know people who suffer from delusions. Do you make their acquaintance, or do you run the mile?

Woulda Coulda Shoulda is easy. "If I'd have known so and so I would have been there for them and I would have helped them if I could have." Well, you can't. It's too late for either of these guys. They both committed suicide a long time ago. Nobody was able to help them. But what are you doing for the mentally troubled people that we might be able to help now? Are you befriending them--or are you running the mile?

The Real Cheesemeister is Back

Can we all please forget that "other" Cheesemeister that took over my body during the past day?

I kind of feel like I had a nervous breakdown or something because right now I just can't understand my actions. I have been under so much stress with work, my microbiology class, my parents, helping my son go to his certification class an hour and a half away every day for 2 weeks (he doesn't drive) and trying to complete a short story for a compilation book to benefit breast cancer, plus PMS, I think I just snapped and got a bad case of the paranoids. 

 

I used to go off like this a LOT before I got on Lithium. And I think it's more the borderline personality disorder than the bipolar to blame in this case. Borderline personality disorder is (in my opinion) the result of learned behavior during a dysfunctional childhood. One feels unheard and neglected and only extreme behavior tends to get a "rise" out of one's family. Although studies indicate that the oxytocin levels in people with borderline personality disorder are abnormal. People with this disorder have trouble bonding in healthy ways. At our worse we engage in histrionics (like I did over the past day) and drive others away.

I will be forever grateful who anyone who can forgive me for this insane behavior. And yes, I feel like it is a form of temporary insanity.

I'm glad to be back to abnormal.

The (sheepish) Cheese

Let's Go Crazy

No thanks--hate it when I do.
Things seem to be settling out, though I am in a fair bit of pain. I'm not sure how much the physical problem had to do with me snapping mentally. I think stress is behind both. If I still have any friends left among you, will you please let me know and perhaps ignore everything that came before this. I am standing before you with my head hung low, hat in hand, hoping for your forgiveness.

It's a Sin

I'm fairly sure that the lyrics have to do with the shame society inflicts on homosexuals. But they can apply to anybody. I was always shamed for what I thought, what I dreamed of, what I wanted, who I was. And now, I am still dependent on my family because for so many years my damn mental illness controlled my life before I had learned what the enemy was so I could fight it. I am trying to break free of this but it is difficult. And I end up feeling sick and angry as hell at myself that at my age I am still in this position, and thinking what a fucking LOSER I am.

Here are the lyrics.

I am really fucking suffering today. Not that it matters.

"It's A Sin"

(Twenty seconds and counting...
T minus fifteen seconds, guidance is okay)
??
When I look back upon my life
It's always with a sense of shame
I've always been the one to blame
For everything I long to do
No matter when or where or who
Has one thing in common, too

It's a, it's a, it's a, it's a sin
It's a sin
Everything I've ever done
Everything I ever do
Every place I've ever been
Everywhere I'm going to
It's a sin

At school they taught me how to be
So pure in thought and word and deed
They didn't quite succeed
For everything I long to do
No matter when or where or who
Has one thing in common, too

It's a, it's a, it's a, it's a sin
It's a sin
Everything I've ever done
Everything I ever do
Every place I've ever been
Everywhere I'm going to
It's a sin

Father, forgive me, I tried not to do it
Turned over a new leaf, then tore right through it
Whatever you taught me, I didn't believe it
Father, you fought me, 'cause I didn't care
And I still don't understand

So I look back upon my life
Forever with a sense of shame
I've always been the one to blame
For everything I long to do
No matter when or where or who
Has one thing in common, too

It's a, it's a, it's a, it's a sin
It's a sin
Everything I've ever done
Everything I ever do
Every place I've ever been
Everywhere I'm going to - it's a sin
It's a, it's a, it's a, it's a sin
It's a, it's a, it's a, it's a sin

(Confiteor Deo omnipotenti vobis fratres, quia peccavi nimis cogitatione,
verbo, opere et omissione, mea culpa, mea culpa, mea maxima culpa)
[trans. "I confess to almighty god,
and to you my brothers,
that I have sinned exceedingly
in thought, word, act and omission,
through my fault, through my fault,
through my most grievous fault"]

(Zero!)

So lonely

I try to avoid whining like this these days because I know it's so pathetic. But I'm really lonely. Nobody reads or comments on my posts here or my blurbs on Facebook. I haven't gotten a personal email in a long time. I know I'm a real odd character and nobody gets me. It's probably got a logical, annoying explanation like people with borderline personality disorder don't do well with being alone. If that's the case what the shit fuck am I going to do when my annoying parents who never gave me jack shit for emotional support but whom I'm completely enmeshed with die, my brother is living 1000 miles away, and my son has his own life and no longer needs his old maw? The first person who tells me to get a boyfriend gets a hammer to the privates. The first one who tells me to get a girlfriend gets bitch slapped. I'm straight, but I'll take it easy on you if you didn't know that. With the guy thing you get worse because it actually pains me a bit to know that this is something that is impossible for me. With all my mental and physical problems, such a relationship is quite out of the question. I either end up with abusive guys or I fuck things up either way, or they die on me, or some other happy horseshit like that. Anyway, don't want that, and it is not a good idea, so don't suggest it.
I don't do a lot of wallowing any more about what should have been but sometimes with all the shit that didn't go right and when I'm alone I can't help it. Seems like I've lost my spiritual connection too and really this world just plain scares me. I wish I could be productive right now, I really do. Maybe I'll take a bath and get me a snack and try to work on something. It's better than wallowing.

Shit fuck, I'm lonely right now.

If you don't like the Alan Parsons Project ask yourself: "what the fuck is wrong with me?"