Dr. E. Fuller Torrey, Schizophrenia, Bipolar, and Me.

Dr. E Fuller Torrey's opinion is that schizophrenia and bipolar disorder are one and the same. Although this isn't the first time I've read reports that make this claim, the degenerative quality of my disorder leads to a stronger understanding of the truth within it. The more delusions and psychotic breaks I have as a result of mania induced anxiety, the more I fear that I will lose complete control on a more regular basis. 

"The brains of individuals with these diseases are measurably different from individuals who do not have these diseases, both structurally and functionally." Source

Although I can't say I remember everything that's happened in the year and a half since I've been diagnosed, I do know that I've had several instances of what I understand to be psychosis. Far more than many sources have indicated as the norm. And the thing is that I've only really kept track of the episodes that have included hallucination, dissociation, and extreme delusions because I've been under the impression that the intensity of the symptom was a distinguishing factor. From what I've read recently, though, even less severe delusions and feelings of unreality are considered psychotic. This site even suggests that merely the most serious and intense symptoms of mania can be considered psychotic.

Here is a list of the major psychotic breaks that I recall since I entered my first inpatient rehab, which is where I was diagnosed:

- On three separate occasions (twice at White Deer Run and once at Greenbriar) I was described as restlessly walking in circles, wringing my hands and mumbling about something ridiculously insignificant. At Greenbriar I spoke of towels. I'm not quite sure about White Deer Run because I left when they couldn't get me in for another psych visit soon enough.

- At Greenbriar, I woke up and both shoulders were stiff and completely immobile. I was advised to sit in the shower to let the hot water loosen my muscles. While I did so I had a very vivid visual hallucination. My eyes were closed and it was very dark. Ephemerally emerging from the darkness, the glow of bone appeared and solidified into a ribcage, surrounding me entirely. All of a sudden a knife plunged in between the ribs and came toward me, repeatedly stopping just inches from my face.

-  While fighting with Mike, he threatened to kill me and the cats, so I gathered all of my belongings and barricaded myself into the living room. After a few days I was completely detached from any meaningful sense of reality. I paced all over the apartment and eventually left the house in inadequate pajamas, neglecting to put on shoes or take my keys. I wandered around the South Side of Pittsburgh aimlessly, unsure of where I was going, what I was doing,or even who I was at all. It was strangely dizzying and basically amounted to a long, intense panic attack with delusions that I was a ghost wandering the streets. 

- When I was moving from Pittsburgh to Florida, my aunt picked me up and took me back to Buffalo so I could be on the same flight as she and her boyfriend. When we got to Buffalo, I went out with a few of my cousins and good friends. Toward the end of the night, someone asked me how I spent my last night in Pittsburgh and I mentioned something that didn't sit well with one of my cousins. He confronted me about it and apparently I got so upset that I dissociated and ran away incoherently, hiding in backyards until my friends had no choice but to call 911 -- at which point an ambulance came, strapped me onto a gurney, tranquilized me, and took me to Erie County Medical Center. Once the tranquilizer wore off, I remember flipping and throwing trash cans because I couldn't sleep. Needless to say, they tranquilized me again. Somehow my father managed to get me out the next day and I flew to Florida by myself.

There are a few others that aren't really worth writing about, especially in comparison to these ones. 

There were also episodes when I was a child that were attributed to lucid dreams or that weren't taken seriously at all. I'm pretty certain my math teacher wouldn't be at all surprised with my diagnosis, considering how many times I yelled and cussed at her about how I would be a famous musician if only high school wasn't holding me back.

Anyhow, this post was inspired by the paper that I'm editing for use as a writing sample. It addresses Freud's concept of the uncanny, which has a relationship with psychosis that is better saved for another post.  

I don't believe in holistic treatment, but just maybe...

“Bipolar disorder, we now believe, isn’t a disease of too much or too little serotonin or dopamine. It is not about the ‘chemical soup’ of neurotransmitters in the brain, but rather it is about synaptic and neural plasticity.”

“What we’ve learned in the last 10 years is that whether we’re talking about memory or mood or movement, all advanced brain functions involve changes in the ability to convey information between synapses in different circuits.”

These quotes from Dr. Husseini Manji appear in an article written about new treatments of bipolar disorder. The primary supposition is that mood disorders are concerned with the synaptic plasticity of the brain rather than the excess or lack of certain neurochemicals. He believes that the shrinkage or atrophy of neurons makes communication across the synapses between them much more difficult, if not impossible. Considering the difficulties I've been having with verbal recall lately, this seems like a reasonable explanation.

Although I'm definitely not an expert in neuroscience, it also makes sense to me that the effects of this atrophy or shrinkage depend on the specific neurons being affected. The hope of finding ways to reverse, or at least halt the intellectual problems I've been having has led me to spend a substantial amount of time researching neuroscience and one of the many things I've learned so far is that neurons can be classified as to whether they perform sensory or motor functions. Mood disorders, then, would be a result of the degeneration of sensory neurons. The delusions, leaps of logic, irritability and psychosis all seem to me as if they'd fall under the jurisdiction of sensory neurons. 

I just wish that there was some way to harness the good parts of my mania and prevent the crash that happens when it's over. I think I will eventually see if I can decrease my dosage and try to control the negative aspects of my disorder with cognitive behavioral therapy. Before I became a Depakote zombie, the neurons of mine that are not atrophied worked exceptionally well. I would like to have that back, please!