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This heart-felt video is of a mother who shares her family’s struggle with depression. Please share your thoughts and experiences in the comments below.Continue reading
What does it mean to have success in treating bipolar disorder? What should we measure to define success? What gets measured gets done.
Tom Peters, the author of management books “In Search of Excellence” and “A Passion for Excellence” talks a lot about measurements and how they affect success. In an article about business success he said, “I think the soundest management advice I’ve heard is the old saw; ‘What gets measured gets done.'” The concept applies especially well when we look at the outcomes from the treatment approaches to bipolar disorder.
The current standard of care for bipolar disorder is to measure how long one can stay in remission. Many tools exist to help achieve such a result, and most people talk about remission as the ultimate goal of treatment. Most academic studies measure outcomes based on the same standard. That is why they are unable to create anything better.
What movies do you watch when depressed?
I facilitate a support group for people with mental conditions along with those who loveand support them. Several of us have years of experience of functioning while depressed. The other day we were exploring what it feels like to be deeply depressed yet not needing to make it go away. We were talking about the things we do while depressed and the topic of watching movies came up. It brought up interesting ideas that I hope you will share your insights about.
We started calling out favorite movies to watch while depressed, like The Hours or What Dreams May Come, and started joking about why would we want to watch comedies during depression. Somebody said that if others heard us they would be shocked. When asked why, the conversation turned to what we thought most people would think.
The holy grail for most people with bipolar disorder is to be hypomanic without losing control.
I have discussed bipolar with thousands of people over the last 10 years. I dare guesstimate that being hypomanic without losing control is the Holy Grail for 75% to 80% of them. Most say their goal is “permanent hypomania and to never be depressed again.” If you ask their parents, though, their response would be “I don’t mind him being a little depressed. But could you make the mania and deep depression go away forever?”
There is good reason for the discrepancy between parents and bipolars. Bipolar people may like being manic. Yet their behaviors are often so out-of-control that they become a problem for those around them. Bipolars and non-bipolars alike are justifiably afraid of mania because of past history with manic episodes.
It is commonly believed that it is impossible to even be hypomanic without rapidly escalating to an out-of-control state. The belief is so prevalent that the standard of care for mania according to the National Institute of Mental Health is to make it go away entirely.
Let’s not let mindfulness advocates confuse happiness with equanimity.
The part of our minds that most people identify with is the part that silently talks to us with a running commentary. We listen to it all day long. Let’s call it “The Talker.”
“The Talker” prefers pleasure over pain, happiness over sadness, winning over losing, health over sickness, and any of the other judgments that help us navigate our lives. Although it plays a critical role that we cannot live without, “The Talker” is stuck in the duality that makes us judge one thing better than another. It does not allow us to experience the world without judgment.
The central principle of mindfulness is to look at experiences without judgment.
Adherents of mindfulness often speak of the part that practices mindfulness as “The Watcher.” It lives outside of the duality and sees everything as equally valuable. Mindfulness is a wonderful practice that increases awareness of what is really happening because “The Watcher” does not ignore or accentuate details based on preferences.
Unfortunately, many claim that mindfulness leads to happiness. As happiness and sadness are judgments based on preferences, this breaks with the whole concept of looking at our experiences without judgment. Mindfulness practiced properly does not lead to happiness; it leads to a greater awareness of whatever you are experiencing whether you like it or not.
People in remission are still considered to have bipolar disorder.
My recent article called “Why I Am Against Bipolar Meds” turned out to be less controversial than I expected. Some people refused to read past the title and that is unfortunate because the vast majority of those who commented said that it was a very fair assessment of both sides of the debate. There were several misconceptions, though, that need to be cleared up.
I mentioned the three stages of Bipolar Dis-Order and the three stages of Bipolar IN Order assuming most of the readers are familiar with the terms and my work. Unfortunately, that was not the case for many readers. In trying to keep the article to under 1000 words, I did not go into detail regarding the stages and what I mean by Bipolar IN Order.
This caused confusion for several psychiatrists who assumed that Self-Mastery means remission. At the other end of the scale were several people with Bipolar Dis-Order who declared that they were in Self-Mastery when their statements seemed to contradict their self-assessment. It seems greater detail of the Bipolar IN Order concept is warranted.Continue reading
Challenging the premise of remission as the end goal of treatment.
I wrote an article some time ago that I deviously titled “Why I Am Against Bipolar Meds” because I wanted to attract and call out both extremes in the debate. I argued for a moderate stance and we had a good discussion with all points of view respectfully considered.
My friend Dr. Nassir Ghaemi wrote an article recently in response and clarified some important points. Dr Ghaemi is the Director of the Mood Disorders Program at Tufts Medical Center in Boston and is familiar with my work; he quoted some of it in his recent book, “A First-Rate Madness: Uncovering the Links Between Leadership and Mental Illness.” The discussion from his article went further into the med controversy, but also veered into new territory that I would like to address: My opposition to remission as the end goal of treatment.
How a simple eye exam can lead to better bipolar treatment.
One of the many traits of being bipolar is the ability to see the world in a different way. Many might say it is a curse, but it can also be a gift when looked at from a positive perspective. This change in perspective can literally help you to see with greater clarity.
From early childhood, we have been taking tests to assess our understanding of the world. They have created a world view that places too much importance on passing the test and not enough on learning more about ourselves. In some ways, the tests themselves have gotten in the way of what the goal was in the first place.
I have been wearing glasses for almost 30 years. Every year or so I take a new exam to make sure my prescription is still the same. The test seems simple enough: the clinician shows me letters at different sizes and asks me to identify what letters I see. Anyone who has a driver’s license has taken a similar test as has anyone who wears glasses or contact lenses.
A few years ago I discovered a major breakthrough that has completely changed my life. It has brought my life into focus in many ways. I share it with you in hope that it will help you to see better too.Continue reading
Learning to act with wisdom no matter how we feel.
One of the first steps toward getting “Bipolar In Order” is to learn the difference between what we feel or experience and how we react. In our first workshop and in our support group meetings we have an exercise that helps. I want to share it with you here and see how it works without as much guidance or background.
One of the main stumbling blocks to getting Bipolar In Order is the belief that we have no choice in how we react. When presented with the fact that we do, I always hear “what about the times when it is too intense?” or “what about when I go to bed happy and wake up depressed?” “Surely we have no control then?” While it is currently true for most people, with training and practice we can learn to have the choice in an ever increasing range. Eventually we can get to the point where nothing is too intense.
The extremes both for and against bipolar meds give new meaning to the word bipolar.
Many people say you should not discuss politics or religion with your friends because you might not be friends much longer. If your friends are Bipolar or associated with it in any way you might want to add meds to the list. The extremes both for and against meds give new meaning to the word Bipolar. The poles often seem further apart than the most intense debates in politics or religion.
I have been speaking with groups about Bipolar for almost fifteen years now and have tried my best to stay out of the debate. But many in the audience won’t let me. At the end of my talks I am frequently accosted by members of one camp or both. It is pretty clear that neither side even heard what I said and the only thing they listened for is whether I took their side in the only thing that matters to them. I didn’t validate their extreme point of view and they are furious with me.