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! 

Am I capable of graduate study?

My mom has been pushing the issue of applying for disability for a while and since the Obamacare insurance deadline is coming up, she decided that it's the perfect time to put in the application, even though it takes five months to start paying out anyhow.

While we were at the lawyer's office, my mom asks about what would happen if we were to move once it was instated and tells him that I am applying to graduate school. Of course, this results in a question on his side: is she really capable of keeping up with school? If so, then why not work?

He asked further questions about where I went to school and what I studied, and commented on the fact that English was a useless degree, and I explained very hastily and passionately that literature was the one thing that I can actually do and if I were to be able to work at the same job for a reasonable amount of time, it would be in this field.

But of course his questions have made me doubt myself. Am I capable? I've been struggling with reading comprehension, memory, and attention issues. I had a bit of a crisis, but I guess we'll see.

Black-and-White Thinking

This post has been inspired by a book that I'm currently reading: Change Your Thinking: Overcome Stress, Anxiety & Depression, and Improve Your Life with CBT by Dr. Sarah Edelman.

The second chapter of her book, Recognizing Faulty Thinking lists a multitude of common logical mistakes that people make when thinking about their present situations and circumstances. I may write more posts as I go if more of them strike me as closely as this one did, but I don't want to lose my focus right now.

Rather recently, both my mom and stepfather pointed out that I always had problems socially. While I agree that I wasn't an overly social child or teenager, at the time I never really noticed how reclusive I really was. I have a notoriously unreliable memory, but when I think back on my life, I know I preferred being alone most of the time. I did have friends here and there, but never anything long-term and I never really got close to people. I never really wondered why, it just never really happened. I was never interested in people.  

At some point my mom brought up that as far as people were concerned, I always either really loved someone or really hated them. She said if a friend or a boyfriend did something wrong, I immediately cut them off and proceeded to completely forget they ever existed. This is something I notice a little bit in my life as an adult, but hearing her describe my childhood like this shocked and saddened me to a degree, even knowing I preferred to be alone. It just seems so brash and cold, and I never thought I came off that way. I never understood social relationships.

I never really did see any middle ground, not just in my social life but at all whatsoever. It either is or it isn't, what's the problem?

Sarah Edelman writes an example of this type of thinking in her book: "Sasha's black-and-white thinking causes her to feel unnecessary resentment, and limits her ability to make friends and enjoy social relationships."

Recognizing this as faulty thinking is going to be a bit tough but hopefully with the help of Cognitive Behavioral Therapy I can turn it around. As I've been able to recognize my behavior more in adulthood and have considered what I want for my life, I've realized that I shut people out, alienate them, and generally make them feel terrible and that's not what I mean to do. Then I wonder why my relationships don't work out or why I only really have one friend. Why people don't include me in their social circles and look at me like I'm crazy when I try to socialize. Some have said to me "that's just the way she is" and that they know me and it's okay when I'm out of line, but those kinds of flippant dismissals just make me feel worse about myself.

I know that my mood disorder has caused a lot of the issues -- cancelling plans, causing an argument over nothing, refusing to compromise, not responding to someone's messages, thinking and acting selfishly, etc -- but now that I'm on my medication and my moods are relatively stable, I can take steps to change these behaviors and I no longer have any excuse for making everyone around me miserable. I no longer have to see things in black and white, I can choose to see the gray. That doesn't necessarily mean I'm lowering my standards or that anyone is any "worse" than I am, but that not everyone agrees on everything and not everyone has to comply with my moods.

The older I get, the more I wish I had more social skills and was able to be a better friend, the more I wish I had someone to turn to when I wanted to talk. I hope cognitive behavioral therapy helps me to fix my faulty thinking and develop friendships so I can provide support for others and give something in return.

This first and foremost includes my parents who have forever loved me and provided for me even though I've always had these problems and never done anything for them. I guess we'll see. 

Some time ago, the writer of some magazine article that I've since forgotten quoted Slash and discussed a principle that I immediately loved and have tried to keep in mind ever since. That principle was that if you wanted to make your dream job a reality, you should treat your passion as if it was already your job, no matter what it is. 

For him this meant playing guitar for at least 8 hours a day.

For me it means: if you want to be a writer, write for 8 hours a day. If you want to be a professor, read literature and literary theory for at least 8 hours a day.

Reading Benjamin Franklin's Autobiography only added to that advice. Seeing the way he divides his day into 8-hour increments and admiring the way he breaks down his day, I was only further convinced that committing 8 hours a day was the way to go.

While filling out my applications, though, I've realized that I have lost that principle once again. I find myself thinking about books as if I've already read them and writing Statements of Purpose as though I'm compiling a list of all the things I want to do while simultaneously failing to begin doing them. How can I expect to survive as a graduate student if I barely read anymore? I will undoubtedly get overwhelmed with the sheer amount of reading required and freeze with anxiety if I don't start getting back into it sooner rather than later.

This is exactly the type of behavior that gets me into trouble. I get ahead of myself. I need to take it one step at a time and start treating this as if it's my job, which means at least 8 hours of reading books and writing about them without constant television, video game, and text message interruptions.

A lot of literature I've read about my disorder, and a lot of my sessions with my therapist have led back to the fact that structure and routine is something that I will always struggle with. No matter how many to-do lists I make, whether digital or written, no matter how many calendars I keep, no matter how much I tell myself I need to do something, I always end up forgetting about it and doing whatever I feel like doing. However, in order to take control of my moods and my days overall, I need to implement some sort of routine. Letting my mood dictate my entire life is not going to lead to any kind of accomplishment at all. 

Self-discipline is a part of the balancing act that I don't think I will ever perfect, but it's crucial that it's something that I become more aware of and work harder toward maintaining.

Week 4 Journal Writing

In your writing journal, you will begin to practice building sentences with adjective and adverbial clauses. For this journal entry, discuss some of the advantages of the place where you live. Using the lists associated with each of these types of clauses, write at least three (3) sentences including adjective clauses and three (3) sentences including adverbial clauses. Underline the adjective and adverbial clauses. Consider their function in both as a modifier and an aspect of your writing style.

Adverbial

Although I prefer to live in Pittsburgh, Florida isn't as bad as I thought it would be.

The best time to come to Cape Coral is in the fall because it is less humid. 

I haven't made many new friends since I've moved here.

Adjectival

I moved back in with my parents, who work from home in Cape Coral.

My cats, who love laying in the sun, are very happy in Florida.

I'd much rather be in a city that offers more activities for young adults.

If these sentences are less descriptive of where I live than of my experience with the town, it's  because I really dislike it here.

Week Three Journal Writings, Crafting an Efficient Writer

"Observe a scene where people are interacting. You might choose a restaurant or a shopping mall. Sporting events and parks are also good places to observe people. Write 5-6 sentences describing this scene and underline the subjects of your sentences. Write a few sentences experimenting with using different types of pronouns from the tables in Unit 3. You will want to keep all of these sentences at hand as you do the writing activities for this unit."

The hostess stares nervously at the clock. The diners at the corner table show no signs of moving, even though they had finished their coffee and dessert. They didn't seem to notice or care about the long line of guests waiting at the door. Their table was nearly clear of dishes. Dining out was clearly not a strong point of theirs. Why won't they just leave? Most people can tell they when they're overstaying their welcome, but not these two. Please just leave. 

-----

"In your journal, continue your observations of the scene observed in journal 1. Note several vivid action verbs that you have already used. Revise some of your sentences using action verbs and/or write 2-3 new sentences with action verbs. Try not to use any of the forms of “to be” (is, are, was, etc.). Underline the action verbs in your sentences. Again, you will want to keep all of these sentences at hand as you do the peer reviewed writing at the end of the unit."

"Their table was nearly clear of dishes." ---> Their waiter had cleared ever dish from the table.

"Dining out was clearly not a strong point of theirs." ---> Dining out displays the best and worst qualities of people.

"They flirt shamelessly."