Bipolar Brains Are Different

In the largest MRI study on people with bipolar disorder, researchers determined that the areas in the brain that control inhibition and emotion – the frontal and temporal regions – are significantly different than those of people without the disorder.

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Bipolar patients tend to have gray matter reductions in frontal brain regions involved in self-control (orange colors), while sensory and visual regions are normal (gray colors). Credit: Image courtesy of the ENIGMA Bipolar Consortium/Derrek Hibar et al

 

The study was led by the University of Southern California Stevens Neuroimaging and Informatics Institute at the Keck School of Medicine of USC: ENIGMA (Enhancing Neuro Imaging Genetics Through Meta Analysis). It involved 76 centers and included 26 different research groups around the world.

The researchers measured the MRI scans of 2,447 adults with bipolar disorder and 4,056 healthy controls. They also looked at the effects of commonly used prescription medications, age of illness onset, history of psychosis, mood state, age and sex differences on cortical regions.

Some findings suggest those with a history of psychosis have greater deficits in the affected regions and there are “different brain signatures in patients who took lithium, anti-psychotics and anti-epileptic treatments.”

Further studies will look at how these medications affect brain measures and subsequently, modify symptoms and outcomes for patients. “This new map of the bipolar brain gives us a roadmap of where to look for treatment effects,” said Thompson, an associate director of the USC Stevens Neuroimaging and Informatics Institute at the Keck School of Medicine.

I think it is awesome that they are finding physical proof of the nature of bipolar disorder; that it is not some myth or personality flaw or weakness or moral shortcoming. These findings can give people like me the validation they need to know that they are not “crazy,” but ill.

Having a brain that doesn’t function normally is no different than having a pancreas that doesn’t function normally (diabetes.) Granted the symptoms of bipolar disorder may affect those around the individual more severely than the symptoms of diabetes, but the general analogy is still the same.

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Suicide in the Media: Getting it Done Right

I have been reading thoughts online and hearing opinions in real life regarding a Netflix series about a teenage girl who dies by suicide, and what questions this show raises about the media’s responsibility for portraying triggering, and even instructional, scenes on how to take one’s own life. In response to this, I would like to refer to an article published this month by Lisa Firestone, PhD in Psychology Today, who states:

“Guidelines on the media’s portrayal of suicide include never glamorizing or sensationalizing it in any way, period. Specific means for suicide should not be shown or related. Any depiction of suicide should include a story of a survivor who is living proof that the suicidal state can be temporary…In addition, any discussion of suicide should include resources for people who may be in crisis or are worried about someone they know. Media should also include a list of warning signs for suicide, which can help people identify when someone’s at risk.”

I feel distressed because so many preteen and young teenagers are watching this show, which has a ‘MA’ rating. I feel worried because kids with mental illness are watching this and possibly being triggered into self-harming behaviors and emotional anguish. And, God forbid, if any one of them is moved to end their life because this show’s message gives them the final reason to do it or the final way to go about doing it.

Don’t get me wrong…It is important to talk about suicide to raise awareness and get people who need help to open up and reach out for it, but like Firestone says, without following proven recommendations on how to report on suicide, “we risk contributing to individuals’ suicide risk and even creating contagion, especially among teens.”

Please remember, the suicide state is often passing and temporary. It can be a trance-like state that can leave people with diminished awareness of the fact that if they wait things out they may regret even considering suicide at all. Many people who have made serious attempts often have these types of regrets, because like everyone says, things do get better. Nothing ever stays the same. Don’t give up just before things change!

Warning Signs of Suicide

(from the American Association of Suicidology)

  • Talking about wanting to die.
  • Looking for a way to kill oneself.
  • Talking about feeling hopeless or having no purpose.
  • Talking about feeling trapped or being in unbearable pain.
  • Talking about being a burden to others.
  • Increasing the use of alcohol or drugs.
  • Acting anxious, agitated or recklessly.
  • Sleeping too little or too much.
  • Withdrawing or feeling isolated.
  • Showing rage or talking about seeking revenge.
  • Displaying extreme mood swings.

Resources:

Is a Daily Routine or An Unstructured Lifestyle Better for Our Mental Health?

When I was first diagnosed with Bipolar Disorder my life was in complete chaos. I had a job that didn’t have set hours, with responsibilities and a caseload that changed on a daily basis. Plus, I had three small children with a husband who worked varying hours, including nights and weekends. My days were anything but routine.

Fast forward five years later, and I am a stay-at-home mom with a set routine of getting up at the same time every morning to get the kids off to school, work on house chores during the day as my illness allows me, rest in the afternoon, be there for the kids when they get home from school and in the evening for school and sport events. I also take my medications on a routine schedule and go to bed around the same time every night.

Researchers have demonstrated that routines can help those with bipolar disorder by balancing their sleep/wake cycles. Routines can also help those with anxiety by making daily activities more manageable and predictable. Routines help us get more stuff done by keeping us on task, thus providing more time for rest and relaxation, which is also good for mental health. And routines give us a sense of control over our lives since we get to choose what we include in them.

I do find that as my illness symptoms creep back into my life, there is sometimes the need for flexibility in my routine. For example, when I am fatigued from depression, I may spend more time in bed and less time on chores.

However, after a few days or a week, my routine usually kicks back in and I am at least doing a little bit each day. While I might not feel motivated to engage in my routine, my routine motivates me to get things done, because it is what I am used to doing. It doesn’t feel right to not do it.

What about you?  Are routines good for your mental health or do you prefer an unstructured lifestyle?

How to Avoid Post Holiday Winter Blues

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After all of the fun and excitement of the holidays are behind us, how can we avoid the let down that comes so quickly into the new year?

Personally, I was feeling depressed one measley day after Christmas!  After a month of adventurous shopping to find just the right gifts to thrill of getting our first ever REAL Christmas tree, the holiday season seems like it is going to be hard for me to let go of this year.  It feels as if letting go of the season itself means letting go of the joy of the season as well.

I suffer from seasonal affective disorder (SAD), which is a mental illness where one’s mood state significantly changes from season to season.  In the winter months, my mood has a tendency towards depression.  There are ways, however, I can fight the depression that comes from both post holiday blues and SAD.

One thing I can do is keep some of my seasonal decorations up well into the cold months of February.  Maybe not Santa and his reindeer, but snowmen and snowflakes make for fun winter decor.

In an effort to extend the social benefits of holiday parties, I could make it a point to host small get-togethers once a month in January and February.  I must remember that social isolation can increase my depression.

I could send out Valentine’s and give small Valentine’s Day gifts (to select individuals), like I did with Christmas cards and gifts, to stay in a holiday-type spirit throughout winter.

Many people, myself included, tend to go to church only on special occasions like Christmas.  Continuing to attend service every Sunday can keep that feeling of spirituality and connectedness to something greater than myself alive. I plan to do this; I’ve already declared it as a new year resolution.

Some people volunteer or donate money or gifts around the holidays. We all know the recipients of our time, talents and treasures need them year-round, so why not continue giving well past the holiday season?  It will be good for them and us, too!

Finally, and specifically for those with SAD, light therapy can help chase depression away. I have used this in the past and it has been very beneficial for me.  Be sure to talk with your doctor before trying this, however, especially if you have bipolar, because it can trigger mania or mixed states if used improperly.

What are some other things you do or you can come up with to do to avoid those post holiday and winter blues?

5 Tips on How to Love Yourself When You Have a Mental Illness

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This morning, my middle schooler brought to my attention a quote she heard on social media:

“Can anyone say they truly love themselves?”

I asked her if she loved herself and to my relief she said, yes, except for how tall she is. ūüôā¬† Then she asked me if I loved myself.¬† My breath caught in my throat as years of self-hatred flashed before my eyes, and I hesitated for half a second before giving her my best answer:¬† I love my¬†true self, but I don’t like everything that I do.

I prayed she didn’t notice my hesitation, because I want to lead by example and instill a good sense of self-worth within her, but apparently, and thankfully,¬†she already has that despite my poor self-esteem and overall dissatisfaction with my appearance and behaviors.

I went on to explain to her that our “true selves,” our spiritual selves, are different from our human selves, and that I really love my true self, the pure, perfect side of me.¬† It is the human side, the ill side, that is hard to like sometimes.¬† She looked at me like I was¬†crazy, because, well, she’s only twelve and I was getting way too philosophical for her.¬† ūüôā

Our conversation got me thinking though, about how much I dislike myself because of my mental illness, its symptoms and subsequent behaviors Рthe depression that leads to crying and laying in bed all day, the irritability that leads to losing my temper with the kids, the anxiety that leads to extra work for my husband to do.  All of these things surmount to loads of guilt and self-hatred, thereby perpetuating the symptoms which caused the behaviors in the first place.

How do those of us with mental illness combat this destructive thinking; disrupt this negative thought cycle?

How do we come to love ourselves despite our mental illnesses?

Here are some ideas:

  1. Change our thoughts – I know, I know – easier said than done.¬† A long time ago, I even wrote about how impossible it can be, (How Positive Thinking Can Be a Crock) but try replacing negative thoughts with positive ones.¬† For example, instead of thinking, “I’m such a loser,” say to yourself, “I am a kind, thoughtful person with friends who enjoy my company.”¬† If you can’t bring yourself to think of positive thoughts, that is ok.¬† Don’t stress over it.¬† Just being aware of the negative ones is a good start.
  2. Keep a thought journal and write down any negative thoughts you have that day in one column.¬† In a second column challenge those thoughts.¬† For example, when my daughter said she didn’t like the fact that she is taller than everyone else, I said, “Even though being tall is an advantage when playing volleyball?”¬† She said, “Oh yeah, I guess I do like being tall then.”
  3. Make a list of positive attributes in your journal.  If you have a hard time coming up with things, ask friends or family members for ideas.  Keep adding to the list and refer to it often.
  4. Practice, practice, practice.¬† Just like learning any new skill or playing a sport, you won’t get good at this over night.¬† It will take lots of repetition before it becomes more automatic.¬† I have been keeping a thought journal for almost two months now and I still have a hard time catching myself in the midst of self-criticism, but this brings me to the final tip:
  5. Don’t give up!¬† Keep trying.¬† Have faith that it will work and that your¬†joy and peace of mind are worth it.

And remember:

You are not your mental illness.

Your true self is perfect.

New Issue of Turtle Way Journal

Check out the new issue of Turtle Way, Write into the Light’s online literary art journal supporting those with mental illness. There is some great photography, poetry and prose in this issue. Turtle Way Journal.

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Call for Submissions

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I am calling for submissions to Write into the Light’s literary-art emagazine, Turtle Way. A new issue will come out in April, so send in your work (i.e., poetry, photos, art, essays, opinion pieces, meditations, quotes, jokes, prose, and stories) asap. Click here for submission guidelines.