My Bipolar Mixed State


Hi All! My plan is to give a monthly update rather than a weekly (or biweekly in this case) update, but I had some interesting developments in my life over the last couple of weeks and thought it was a good idea to share – since one of the goals of this blog is to decrease stigma of mental illness, I should share my own experiences. 

I got a bit burnt out on all the activities I’ve been participating in as described in my September updateQuick summary, I’d been working full time, volunteering 4 hours a week at a crisis hotline, taking a 3 credit Abnormal Psychology class as well as a 7 credit EMT class. When I first signed up for the EMT class, I hadn’t realized it was 7 credits (that wasn’t mentioned on the class description), so I didn’t realize how hard it would be. After a few weeks of it, I got so burnt out that I got really sick – this was last week. 

I decided to drop the EMT class, and they were kind enough to let my tuition transfer to next semester. I will NOT sign up for another class – so I’ll be able to focus on the EMT class in January.

Then on Monday, I had a 3 hour anxiety attack. I’m not sure how many of you have had anxiety attacks before, but they aren’t supposed to last that long. It’s sort of like running a marathon for 3 hours. This happened at work, and because I’m the manager, I can’t call my boss and be like: “oh, gotta go home.” I simply had to finish the work. It was an exhausting day. 

The next day, I freaked out on my boyfriend for no reason (other than our political differences), and then when I was trying to sleep I felt like a screaming monster was trying to claw its way out of my brain. That’s when I realized I was in a bipolar mixed state.

Bipolar mixed states have characteristics of both depression and mania. They’re very dangerous because they have suicidal ideation mixed with impulsivity, motivation, and energy. Mixed state people are much more likely to commit suicide than a depressed person, because depressed people often lack the energy and impulsivity, motivation, and energy to commit suicide. 

Yesterday, I called my psychiatrist but I got stuck in the labyrinthine maze of monsters that is the Park Nicollet phone reception system. One of the monsters even hung up on me, and I had to proceed to “Go” without collecting my $200. By the time I got through to the nurse (an hour later), I was rather worked up. She calmly told me that this is not a crisis line, and I should call Crisis Connection (where, by the way, I volunteer). I practically yelled at her that I didn’t want a crisis hotline, I wanted to talk to my psychiatrist. She made an appointment for me to see her later that afternoon. I also made an emergency appointment with my therapist, who I haven’t seen since March. 

In the end, my psychiatrist tweaked my mood stabilizer and gave me a prescription to Klonopin, which is a benzodiazepine – an addictive sedative. I’m a little worried since addiction runs in my family, and when I start getting symptoms of mania (or apparently mixed symptoms) I start craving alcohol, pain meds, and other such things. I’m not much of drinker, and I’m not in the habit of taking unprescribed pain meds, but I crave them all the same. So getting permission to take a benzodiazepine is a little troubling to me. However, I recognize that I need it in situations like those described earlier in my post. 

On a happier note, I was able to go to the Nobel Conference at Gustavus Adolphus College on Tuesday and Wednesday. The theme was addiction, and my Abnormal Psychology prof took a bunch of his students. There were 6 speakers and they were all really interesting. 

One of the speakers was Marc Lewis, the author of The Biology of Desire, which I just finished. It turns out Marc Lewis is a bit annoying. He kept trying to push his point (that addiction is a choice and not a disease), until Eric Kandel, the 2000 Nobel Prize Laureate in Medicine, told him “it’s either bullshit or science.” Another speaker, Carl Hart, who is big on social justice, tried to break the tension by saying “I didn’t know we could swear at this conference!” And then the next day during Hart’s speech he said “and to quote Dr Kandel, this is bullshit!” It was a pretty amusing conference. Of course, the science was really interesting too, but I plan on writing a review both of the conference and of Biology of Desire, so I’ll stop here. 

I’m currently reading or listening to:

Books completed:



Movies/Shows watched:

The Definition of Abnormal

Well, my first week of Abnormal Psychology is through. We’ve read chapters 1-2 of our textbook, Abnormal Psychology by James N Butcher.

Chapter 1 was mainly about defining “abnormal” in the sense of “abnormal psychology.” This is a lot more difficult than you might imagine. 




You could try a statistical approach, for instance. If someone’s behavior is statistically rare, then that behavior is abnormal. But lots of people have behavior that is statistically rare. For instance, I went to the Minnesota Renaissance Festival just yesterday, and enjoyed some good people-watching. The Ren Fest has a variety of people – some are just pop-culture “nerds.” Some are people who love cosplay (where you dress up as a character – either made up by you or pre-created in popular culture – and act as if you are that person). And some people honestly believe they are wizards. Should we consider any of these statistically rare behaviors due to mental illness? Well, perhaps people who really believe they are wizards, but some of those people are pagans – and should we consider people of a rare religion to be mentally ill per se

You could also try a societal norm approach. If someone behaves outside the behavioral norm, then they are abnormal. But this, in itself does not imply mental illness. Societal norms can change from culture to culture. As an example, in some tribal cultures, the men cut themselves over and over again to “beautify” themselves with scars; but in America teens who cut are generally diagnosed with depression. Norms can also change within one culture over time. For instance, a couple decades ago homosexuality was considered a mental illness, but now it is, for the most part, accepted as “normal” behavior for certain individuals. 

There is also the maladaptive approach. If someone’s behavior is injurious to himself or to society, then he is abnormal. A person with OCD who washes her hands so much that they are cracked and bleeding is maladaptive. But this approach is not full-proof either. Not everyone who commits a crime is mentally ill. Likewise, should we consider someone who donates bone marrow, blood, or a kidney mentally ill?



Many people who are mentally ill suffer. But not all. The mania state of bipolar disorder is often pleasant to the patient, but he is considered mentally ill. Also, where do we draw the line of diagnosing mental illness for those who are suffering? If someone has just lost her home or a loved one, she is suffering from grief. But isn’t grief a natural and healthy response, within limits? 

Another approach is irrationality and unpredictability, but teenagers and young adults often do irrational and unpredictable things for attention or just because they’re trying to impress a girl. Mental illness? Nah. 

The last approach I will discuss is dangerous behavior. But yet again, that is not always indicative of mental illness. Many people jump out of planes, bungee jump, or fight in a war. These people are not considered “abnormal.” 

The DSM-5 defines mental disorder as: 

“a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress in social, occupational, or other important activities. An expectable or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above.”

What the heck does that mean? 

In the end, mental illness diagnoses are subjective to the clinician. For instance, I was diagnosed with bipolar disorder II. This means that I experience abnormal highs and lows (as well as other traits). I totally agree with this diagnosis. But another psychiatrist diagnosed me with borderline personality disorder. “What?!” I said. I don’t have an intense fear of abandonment, a pattern of intense interpersonal relationships characterized by alternating states of idealization and devaluation, paranoid ideation, or disassociative symptoms. Granted, I have more than 5 other traits, which makes me diagnosable with borderline. But all of those symptoms are traits that can be explained by bipolar disorder. So why the boderline personality disorder diagnosis?

What do you think? How would you define “abnormal”?

This is a series of posts summarizing what I’m learning in my Abnormal Psychology course. Much of the information provided comes from reading my James N. Butcher’s textbook Abnormal Psychology. To read the other posts, follow these links: 

The Definition of Abnormal
A History of Abnormal Psychology
Abnormal Psychology in Contemporary Society
Contemporary Viewpoints on Treating Mental Illness – Biology
Contemporary Viewpoints on Treating Mental Illness – Psychology
Frontline: New Asylums
Brave New Films: This is Crazy
Clinical Mental Health Diagnosis: Biological Assessment
Clinical Mental Health Diagnosis: Psychological Assessment
Does the DSM Encourage Overmedication?
Post Traumatic Stress Syndrome – The Basics
Panic Disorder
Obsessive Compulsive Disorder
Hoarding and Body Dysmorphic Disorders
Depression – an Overview
Personality Disorders – Clusters and Dimensions
Personality Disorders – Cluster A
Personality Disorders – Cluster B
Personality Disorders – Cluster C
Biological Effects of Stress on Your Body
Somatic Symptom and Related Disorders
Dissociative Disorders
Borderline Personality Disorder
Dialectical Behavioral Therapy
Paraphilic Disorders
Gender Dysphoria – Homosexuality and Transgender
Anxiety Disorders
Bipolar Disorder – The Basics
Suicide – An Overview

References:

Butcher, James N. Hooley, Jill M. Mineka, Susan. (2014) Chapter 1: Abnormal Psychology: An Overview. Abnormal Psychology, sixteenth edition (pp. 2-27). Pearson Education Inc.

Fighting the Healthy Battle

So that time of year has come – the one in which the days become more dark – along with my thoughts. Every year about this time, I get bipolar depression. Or perhaps I should call it seasonal affective disorder. Regardless of the name, it’s very real. I become lethargic, I cry for no reason, and suicidal thoughts traipse through my brain. 

But that can’t happen to me this year because I’ve got a full time job to hold down at the same time as taking Abnormal Psychology and an EMT training class. So what do I do? Preemptive strike!



First thing: give up caffeine. I always say: I’m not addicted to caffeine – I give it up all the time. And I will try, try again. Starting today, I will only drink one can of Diet Dew a day. At the end of August, I’ll switch to one every other day. And at the end of September, I’m done. Part of my worry is that my teeth will rot out of my head. But I’ve also heard a lot of stories about how getting caffeine and aspartame out of your body does wonders for health and decreases anxiety. Let’s try it out. 



Next: exercise. Now, I have a job where I’m scrubbing and lifting and squatting all day long. I’m exhausted when I get home. But I can exercise on Saturdays and Sundays. I plan on spending an hour or so each of these two days at the gym. Running and biking is the goal  – I can listen to my audiobooks while doing that. 😉


I’ve always promised myself I wouldn’t become a pill-popper, but over the years I’ve added more and more supplements to my list. I’m going to ween it down to just a few – and make sure they’re quality. My doctor tells me that most Minnesotans are low in Vitamin D, and that raising Vit D can help fight depression. Sure enough, when tested, I was low. I will start taking Cod Liver Oil each day – it’s high in Vit D and is apparently the magical oil that fixes everything from brainpower to complexion. I will switch from the CVS brand of calcium (which is calcium carbonate) to one that uses calcium citrate. Apparently, this increases absorption. And I’m going to take an iron supplement because often when I go to the Red Cross they find that my hemoglobin is too low. 

That’s it. Those, and my multi-vitamin tablet, is all I need. Get rid of all those extra, dubious supplements. 

Last but not least, I’m going to be like this woman – basking in a happy lamp each morning. I’ve never tried this out, but I hear it works wonders. It’ll mean I have to get up a half hour earlier, but if it will save me from depression, it’s worth it. 

The scientist in me is flinching switching so many variables at once – but I must ignore those anxieties and journey on.