Peggy-Sax 2Peggy Sax: March 9, 2012

I am currently working with a university student who experienced a major manic episode in September, which rocked her world. “Katharina” was in the hospital for 9 days, diagnosed with manic-depressive illness. She then took the semester off, and is now back at school. She is learning to live with medication, and still shifting through what happened, and the real effects on her current life/future dreams. K has many gifts – a very accomplished hard-working student,  an exceptional athlete, a gifted artist, an articulate and sensitive conversationalist, a loving and supportive family and network of friends. Best of all, she has what her mom calls ‘a built-in bullshit detector.” This week, I met with K’s parents for the first time. It was a very good meeting. K’s mom told me her journey of attempting to learn about manic-depressive illness while staying in touch with the daughter she knows (and loves). I asked her if she would send me a list of the books she read, and to briefly describe her reactions. I would now like to share this list with you. Imagining the mother’s perspective sure gives food for thought. Here is what she wrote:

I wanted to follow up with you regarding the books I have been reading. I am going to list them in the exact progression of what  I was first encouraged to read after K’s discharge from the hospital (by her outpatient therapist),  to what I am presently reading… seeing this progression one might better see how I have gone from a perspective of “No Hope” to “HOPE” over the last several months since K’s episode.

1. Touched with Fire
-Kay Redfield Jamison
(Historical perspective of the “disorder”  going through all the “famous” people that have lived with this disorder over the last hundred or so years. Leaves one feeling, “Gee, at least our daughter is in good company? )
2. An UnQuiet Mind
-Kay Redfield Jamison
(Her personal journey. OK, she’s a clinical psychologist that apparently is BiPolar1…. so she must know then right? Very depressing. Nothing about her story we could connect with except the “shared diagnosis” .)
3. Manic
-Terri Cheny
(Hummm, an intelligent woman that I heard on NPR radio. Successful lawyer at one point in time. Story is more about her life as an adult. No mention of her childhood though….)
4. The Dark Side of Innocence
-Terri Cheny
(This is the part of her story that deals with her symptoms through childhood. So upsetting that I can’t ever finish the book. Nothing of about it connects me to our daughter’s story
At this point I am becoming a bit depressed and feeling total hopelessness.)
5. Am I BiPolar or just Waking Up?
-Sean Blackwell
(Canadian man’s story that drops out of the advertising world after a manic episode. Gives me another way to look at this… hope begins to return due to his  story and puts me on another way to look at all this from a medical perspective)
6. The Wisdom of the Ennegram
-Don Riso, Russ Hudson
(Hummm, could she be a #7 in the Ennegram. I’m left thinking maybe there is a different way to explain this knowing her personality?)
7. Anatomy of an Epidemic
-Robert Whitaker
(Still in the early stages of this book…. he talks about the over use of medications….)
8. Dianetics: The Modern Science of Mental Health
-Hubbard
(Hope is returning to me now… I am enjoying this book and it makes a lot of sense to me regarding our daughter’s case in many ways)

—

It is very sobering to imagine how this mom is drawn to scientology after their foray into psychiatry..

Does anyone have some other readings to recommend?

Peggy

Mohammad-Arefnia-150x150 2Mohammad Afrenia: March 11, 2012

Hi Peggy,
I don’t have a book to recomend but want to point out a fundamental error!
Ms. Jaimison is here at Hopkins and has very much accepted the medical logic as the only way to explain her experiences!
The error is in calling herself Bipolar. I disagree with this on the ground that not only she is not Bipolar, no one IS Bipolar! People are diagnosed with Bipolar disorder I or II,
and one thing we know is that diagnosis can change not only over time but also from one diagnostician to another. I have colleagues who diagnose almost every one with Bipolar D/O!
Thirty years ago it was schizophrenia and manic depressive disorder and now Bopolar!

One thing I want to emphasize is that, when someone is diagnosed with cancer no one would say “she is cancer” but we readily consider people to be one and the same with so called “mental illness” and inseparable from it. Much of this goes back to the stigmatization and the attitude we have toward those who display the difficulties of life in ways that we are terrified of and hence believe that there must be something inherently wrong with them that such malady has befallen on them, and that they are a broken vessel that needs fixing but since it is them who are broken then there is no hope either except to manage it with education about the illness and life time medication!
In short: Bipolar is the problem, K is not the problem!

And there is hope!

I have a patient diagnosed with Bipolar D/O who has been on every medication imginable who has been managing just fine without the for the past few months. We took her off of meds due to pregnancy. She explained that every time right after she gave birth to her other children she was immidiately put back on meds without even asking her opinion, and she was not offered psychotherapy either, just med management. This time we have decided to wait it out and I urged her psychiatrist not to panic as others have in the past and allow for her to put to use what she has learned in getting around the Bipolar. I maintain hope that she has loosened the hold of the Bipolar on her life enough to continue without the meds and their harmful side effects and in time dissolve it’s impact on her life.
I hope the same for K. She is a human being and no she is not one and the same as the bipolar or the manic depressive disorder or whatever else we tend to name it!
Mohammad

Cate-Ryan 2Cate Ryan: March 12, 2012

Mohammad, thank you for sharing this passion with us about the really really important yet simple step of externalising mental health problems. this has really hit the spot for me as I’ve been grappling with the the insidious influence depression is having for a young woman who i work alongside. i feel like I’ve been sidelined as the depression’s grip seem to tighten on the young woman’s motivation and ambitions and i will now take you post and reflect on it a few more times to see which ways i can maintain hope with her about life free of depression.

cheers, Cate

Mohammad-Arefnia-150x150 2Mohammad: March 12, 2012

Hi Cate,
Hi Peggy,
Hi All,

Sorry about the typos in my last post. I was using my cell phone to write as my home computer crashed.
I am at work and have a few minutes before my supervisee comes in for our weekly time together talking about psychotherapy.
My last Pt. today has been in and out of this clinic for a long time and complains of the hold of the depression getting even stronger on his life. He accuses himself of being “lazy” and is very angry that he is not doing the things that he would like to. I wondered with him if the expectations that he has, what he is hoping for are realistic and reasonable? Is he expecting himself to be able to do things that he could years ago disregarding the fact that time has changed and he is no longer the same age and the fact that strong pain killers sap energy from him. The oppression of the depression may act even in the form of unrealistic expectations and accusation that he is lazy.

The depression in a way is behaving like the crew masters who would have whipped the slaves to make them work harder, faster and longer until their death and burial as mortar in the Pyramids- my patient’s place of birth is Egypt. This is important because the position he is in is of an object, one who is acted upon in relation to the depression.
I stress on language and grammar a great deal. It is important how we form our sentences and how we speak about ourselves. Are we the active agent, the subject in the sentence or are we the object in the sentence.

  • What is our relationship with the problem? Is it something that we have any hope of changing?
  • If it is one and the same as us, do we really have the opportunity to change ourselves fundamentally? Or should we even?
  • If it is something that colonizes us then it can be expelled! A small act, such a pinch of Salt, as Gandhi took, would even topple it from the throne it has unjustly taken over.
  • What is that small act that can be taken?

 sarahhughes2_profile 2Sarah Hughes: March 13, 2012

hello all,
I have started responding to this thread 4 times now over the past few days and I keep getting interrupted and then losing my post.  I really should learn to write my response in a word document.  I will never learn! But I am persistent.

I wanted to say that I love Mohammad’s passion that comes shining through in his TYPOS!  I think it is really important us for to remember that people are not BIPOLAR and use that understanding to help give us hope.  I know it is very useful thinking for me. After reading Mohammad’s post my first interruption was a teleconference about with the pscyh unit about a woman I work with. The hospital team was calling her “a borderline”  I chose not to argue this point but just made sure I kept remembering in my head that she was “Kim” and the lovely woman I know who has great stories, imagination, creativity and great pain. I liked holding my memory of Mohammad’s passion in my mind and using it to open up the conversation about Kim in different ways – not just limiting to the stigma of a “personality disorder” as there is not much hope in that definition.  SO thanks for that.

I also wanted to respond to Peggy’s sharing of the mother’s list. I loved that you shared this as her responses also gave me hope.  I liked how she could see her journey as going from No Hope to Hope.  I am going to share this story and this way of approaching reading.

I know a lot of people who follow blogs on various mental illnesses and they find that the insider knowledge and sharing of stories approach is very connecting and informative.  It would be a good exercise to look at them through the lens of HOPE. I wanted to share a link to this discussion on one of the mental health blogs I sometimes check in with on as my friend Jody Aman has a blog on “Anxiety Schmanxiety”  This link is on the “Breaking Bipolar” blog in the same site and a discussion of the use of language.  I found it interesting and like the term “Fight the therapist power”  https://www.healthyplace.com/blogs/breakingbipolar/2011/02/in-reality-my-brain-has-been-attacked-by-bipolar-disorder/
What do others think?
Sarah