“Which of my feelings are real? Which of the me’s is me? The wild, compulsive, chaotic, energetic, and crazy one? Or the shy, withdrawn, desperate, suicidal, doomed, and tired one? Probably a bit of both, hopefully much that is neither.”
– Kay Redfield Jamison ?
January 2022, Volume 11
The G.T.Health Letter
~Adding a dose of mental health awareness to our community~
Mental Health Spotlight – Bipolar Disorder (BPD)
Xtra Scoop of the Week – The Stigma Surrounding BPD
Weekly Testimonial – Mood Swings Don’t Come Close
G.T.Health will be putting on another CHECK-IN EVENT in February!!! We will collect our thoughts in the new year and set ourselves up for success in 2022 by using a self-help book to guide us through some mental decluttering! The book we will be using is pictured below; it’s all about mental clarity and positivity, which are awesome goals to have for the next year! If you are interested in attending, please feel free to reach out to us at firstname.lastname@example.org, and check out our website at https://www.gtlink.us/!
Mental Health Spotlight – Bipolar Disorder (BPD)
What is BPD? What are the types of BPD?
Bipolar Disorder (BPD) is a type of mood disorder characterized by extreme fluctuations in mood, ability to function, and energy that make it very difficult for a person to live an uneventful life without help. People with BPD are not experiencing fluctuations 24/7, but they cannot easily control the extremes of their mood. BPD affects about 2-3% of the population. There are two main kinds of bipolar disorders: Bipolar I is a manic-depressive disorder that can exist with or without psychotic/manic episodes, and Bipolar II consists of both manic and depressive episodes that are less severe in character. There is also a third type of BPD, called cyclothymic disorder, which causes brief episodes of depression and hypomania. It can be compared to dysthymia, which is a less severe form of major depression. So what does manic-depressive mean? Manic-depressive refers to the types of mood swings BPD sufferers experience: on one end of the spectrum there is mania, and on the other there is depression. Mania is a high, an elevation of feeling and a dampening of inhibitions, or the logical thoughts that prevent most of us from doing impulsive things like skydiving or drunk driving. Mania therefore involves taking things to extremes: using up a month’s salary on new lamps, eating uncontrollably, crying inconsolably, refusing sleep. Depression, on the other hand, is a beast we’ve tackled before: it involves the lowest lows, like sleeping for a week or refusing to eat or move or convincing oneself that life is not worth living. To be clear, though: BPD is NOT a cyclic disorder. People with BPD do not fluctuate between mania and depression on a regular schedule, and in fact don’t have to fluctuate at all. They are also familiar with periods of clarity, which can even last years, wherein they experience no huge extremes and are able to reflect lucidly on their past actions. Mania is diagnosed if the irritable, overinflated, or elevated mood is present for over a week and for most of each day; hypomania (less severe mania) needs to be present for four days. Specific symptoms of mania include agitation, grandiosity, talkativeness, racing thoughts, lack of sleep, and engaging in activities with painful consequences for the self or others. Depressive symptoms include loss of appetite and energy, feelings of worthlessness or guilt, weight loss, and loss of pleasure.
How can you help someone with BPD?
This segment stays fairly consistent throughout: the best ways to react to disorder are to educate yourself, be compassionate, and take symptoms seriously without encouraging them. You also should not take them at face value. A person with OCD likely does not want to be checking the fridge for bugs every 15 minutes, but they are compelled to do so by a mental itch that won’t go away. What I mean is: what you see isn’t always what the person is feeling, thinking, or wanting, so don’t simply project that person’s actions onto their motivations or inner monologue. Another big way you can help people with BPD, or any disorder, is to be an advocate: you can spread awareness of the disorder to others (especially if they are uneducated on it), give your friend the courage to speak out for themselves, attend awareness events or rallies with your friend, and even attend therapy with them as a support system if they ask you to (and if you feel comfortable!). Try your best to be patient and optimistic when around your friend; don’t push them too hard or shame them for what they can’t fully control, and make plans to keep yourself mentally well as you work with and around their disorder. It is essential that you take care of yourself and maintain comfortable boundaries, as you don’t want to ruin your own mental health by trying to be a hero.
How is BPD treated?
Like most disorders, BPD is not curable but is treatable with, ideally, a mix of medication and therapy: medication to contain the most intense symptoms, and therapy to work through the psychological trauma in this newfound state of consistent lucidity. Failing to take mood stabilizing medication with BPD can lead to intense emotional relapse, or mood swings more extreme than before. However, incorrect medication can also have dire consequences. Historically, doctors and psychiatrists did not fully understand the nature of most disorders, and often overlooked the pervasive threat of depression. They would, therefore, prescribe antipsychotic medication to BPD patients, attacking the mania whilst ignoring the depression. The problem? Depression is not only the more common extreme to experience in BPD, but antipsychotics also remove any emotional barriers that have been erected against depression; if the mania is gone, depression will fill the void, thus intensifying the lows. It is more than likely, therefore, that the overprescription of antipsychotics actually led to widespread suicide and hospitalization amongst people with BPD. The symptoms that affected others, the mania and impulsivity, were gone, but the individual was left with an overabundance of the symptoms that affected them internally. These days, antidepressants are common in the treatment of BPD (alongside antipsychotics), and cognitive behavioral therapy (CBT) can help an individual think through their emotional triggers and manage stress in upsetting situations to potentially stop an episode before it starts.
Does BPD affect different types of people differently?
BPD can affect people of all identities and backgrounds. It can even be diagnosed in children and adolescents, although symptoms of childhood BPD do not really align with adult diagnostic criteria. Some mood disorders common in childhood, like oppositional defiant disorder (ODD) can be precursors to BPD. Bipolar disorder is more common in people with a close relative that has been diagnosed, meaning that there is a genetic component; it can also be triggered by intensely traumatic events, like the death of a loved one or a major life change, like a move. Childhood trauma can lead to an earlier age of disorder onset, higher risk of suicide, and more intense emotional symptoms; if the trauma is long-term (consistent) or left unaddressed, it can lead to more problems down the road. Essentially, mood disorders are the result of adverse life experiences and genetic vulnerability to symptoms, which is the case with most disorders. BPD is, unlike disorders like schizophrenia, culturally dependent, although differing levels of diagnosis could be due to quantitative factors like misdiagnosis, under-diagnosis, or misunderstanding. For example, people of Asian and Latinx descent are more likely to be diagnosed with BPD, but this does not necessarily imply an inherent ethnocultural difference. Culture does, however, definitely influence the symptoms different people experience: because social norms fluctuate by culture, what is considered impulsive or problematic also fluctuates. For example, in a strict, traditionalist culture, a woman wearing her hair down and uncovered might be considered a manic, impulsive symptom, an act of rebellion; in a more laissez-faire situation, this would not even be considered relevant to the disorder.https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/diagnosis-treatment/drc-20355961
Untitled – Rupi Kaur
i don’t know what living a balanced life feels like
when i am sad
i don’t cry i pour
when i am happy
i don’t smile i glow
when i am angry
i don’t yell i burn
the good thing about feeling in extremes is
when i love i give them wings
but perhaps that isn’t
such a good thing cause they always tend to leave
and you should see me
when my heart is broken
i don’t grieve i shatter
Let’s talk about this poem. I think the most important takeaway here is how the writer describes BPD: it is like feeling in extremes. People who suffer from BPD experience emotions in a way that is difficult to deal with, meaning that the emotions are often expressed in an impulsive or uncontrolled fashion. BPD can be compared to depression in many ways: both are mood disorders, and depressive episodes are essential to the diagnosis of BPD. Therefore, the component of agency is also comparable: people sometimes describe their depression as a person or bug that has taken over the driver’s seat and is steering their brain towards destruction; they are often conscious of what they are saying, doing, and thinking, but can do nothing to stop themselves, especially because they have learned how helpless they are in the face of a mood swing. People with mood disorders are not weak or broken: they are tired. Depression and mania are exhausting, as is the medication used to treat them; some people will even stop taking their medication because they miss the mania, the feeling of flying high, so much while they are mired in depression. Remember all of this when you think about BPD and other mood disorders: you might be confronted with a person who is abrasive, deaf to your advice, impulsive, or catatonic, but they are still a person like any other, who crumbles when abandoned and reaches for help behind a mask of psychological trauma.
Xtra Scoop of the Week – The Stigma Surrounding BPD
A lot of attempts are made in mass media to portray BPD. Most have good intentions: they want to be accurate, they want to give people with BPD a voice, they want to spread awareness. But even the films, books, and TV shows bearing no ill will towards mental health often still, even subconsciously, fall into the trap of stigmatizing disorder and feeding a public opinion that is less than flattering. A few weeks ago I talked about Split, a movie that was actually pretty accurate in its portrayal of dissociative identity disorder (DID) until the end, when it superhumanized the main character and distancedthem from ‘normal’ people in a way that was very unhelpful. The same can be said for movies about BPD. For example, Silver Linings Playbook is a film from 2012 about a relationship with a BPD sufferer. Although the film is fairly accurate, it is criticized by the BPD community for over-relying on violent outbursts to show the character’s manic episodes. This not only feeds the perception of disorder as criminal and violent, but also neglects the fact that mania can come in any form: spending huge sums of money on useless things, rearranging the entire house and not sleeping for a week, stripping naked and taking a run in the middle of the night. Other films, like Mad Love from 1995, are accused of romanticizing disorder and making it much more glamorous than the reality, as well as failing to acknowledge that people with disorders are not symptomatic 24/7. The bottom line? Despite there being many great actors, great intentions, and great researchers, the progress made towards accurate portrayals of disorder in film is still often hindered by the stigma that clings like a leech to most disorders.
They really don’t. I, and many of us I’m sure, went through that phase in adolescence when puberty intensified my emotions tenfold; hormone fluctuations, menses, and other factors contributed to a personality I didn’t altogether recognize. Of course, years later I realize how many cognitive distortions I created, how many events I blew out of proportion and how many actions I projected significance onto. Now that my hormones are more regulated, I am able to look back and think about how silly I must have appeared, being jealous of my friends, eager to spend all my money on succulent plants, and offended when adults put limits on my activities. Imagine being a teen all over again. Then imagine you don’t get to stop. You don’t get to ‘grow out of it;’ you don’t get to experience the smoothing of your hormones. You are perpetually imbalanced, whether you frequently experience both highs and lows or are just stuck at one end of the spectrum. There are small periods when you are lucid and able to reflect on your past actions and see error in your judgments, but you know this clarity won’t last. This is bipolar disorder.
Or, at least, this is bipolar disorder through the eyes of someone who does not have it. I have no personal experience with any of the disorders I write about; I rely on psychological research, the testimonials of others, and my empathetic intellect to give you as accurate a picture as possible, but I should be doing this alongside the voice of someone with the disorder, not alone. I should not be speaking for you. It is not fair to you.
For this reason, I implore all you readers to have courage and share your testimonials with me, to be posted anonymously on this blog. You don’t need to write about a specific disorder, or have any major experience with any of our topics so far, but it would be my honor to hear your stories, as I can get pretty sick of hearing myself talk.
That’s all for this week, folks!
Next week’s topic:
Personality Disorders (PDs)
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