Relapsing [Without Being a Moron About It]

 A Bumpy Road: Dealing with Relapse

There may not ever be a last episode, but there are ways to fend off and mitigate the next one.

By Jodi Helmer

Doctors never talked to Elly L. about RELAPSE.

Although she was hospitalized during a manic episode and diagnosed with bipolar disorder, doctors never mentioned that it could happen again. Instead, Elly was stabilized, handed a prescription for mood stabilizers and discharged. She had no idea that she’d be battling mania and depression for the rest of her life.

“I was told that as long as I took my medications, I’d be okay,” recalls Elly, a mental health coach in Toronto, Ontario.

Elly experienced at least eight relapses between her diagnosis in 1978 and 1991. Each time, she was hospitalized, often placed in restraints and taken to the psychiatric ward in a police car or ambulance. Upon discharge, Elly always promised herself it would be her last hospital admission-but she had no idea how to stave off future relapses.

In bipolar disorder, relapse is defined as the return of depression or a manic or hypomanic episode after a period of wellness. According to a 1999 study published in the American Journal of Psychiatry, 73 percent of those diagnosed with bipolar disorder experienced at least one relapse over a five-year period; of those who relapsed, two-thirds had multiple relapses.

“You can never say that someone with bipolar disorder has had their last episode; relapse is part of the illness,” explains Alan C. Swann, MD, professor and vice chair for research in the Department of Psychiatry and Behavioral Sciences at The University of Texas Medical School at Houston and director of research for the University of Texas Harris County Psychiatric Center. “Relapse is self-perpetuating; once it happens, the more likely it is to happen again.”

Searching for Answers

It’s possible to do all of the right things- follow a proper medication regimen, eat well, exercise, minimize stress and get enough sleep-and still experience relapse. Unfortunately, there is no clear understanding of why this happens.
“There may be changes in the cellular level that cause cycling but their cause is unknown,” says Joseph R. Calabrese, MD, director of the Mood Disorders Program at the Case Western Reserve University School of Medicine in Cleveland, Ohio.

While the neurological causes of relapse are unknown, a few things are certain: Those who are diagnosed with bipolar II are more likely to relapse than those with bipolar I. Their episodes of depression, mania or hypomania are often shorter than the episodes experienced by those with bipolar I but tend to return more often, according to Calabrese. It’s also far more common to relapse into depression than into mania or hypomania. Calabrese estimates that in bipolar II, there is a 40-to-1 ratio of depression to mania; the ratio of depression to mania drops to 3-to-1 in bipolar I.

“The key to recovery is a low tolerance for relapse,” says Calabrese.

In fact, Dr. Roger S. McIntyre, MD, associate professor of psychiatry and pharmacology at the University of Toronto and head of the Mood Disorders Psychopharmacology Unit at the University Health Network, believes that even the mildest symptoms of depression and mania should be treated as potentially hazardous.

“The takeaway message is that we need to seek complete elimination of symptoms as our treatment objective,” he says…

Click here to read the full article, “A Bumpy Road: Dealing with Relapse”

“bp Magazine” is a wonderful “shot in the arm.”  I would suggest that you get a subscription, and for a friend as well.

 cropped-cropped-cropped-christiangraffiti1-11.jpg

Join NAMI today!

When you become a member of NAMI, you become part of America’s largest grassroots organization dedicated to improving the lives of persons living with serious mental illness. And now you can join online.

http://www.nami.org/template.cfm?section=About_NAMI

Shedding Self-Importance

Bryan & Lynn, Still learning to be servants

“I have had more trouble with myself than with any other man.”  D.L. Moody


April, 2000

Shortly after Lynn and I were accepted by Kachemak Bay Christian Center to be their pastor, we traveled to California to be with family for a few weeks.  On our return to Alaska we drove from Anchorage to our home in Homer on the Kenai Peninsula.  I could hardly wait to jump in and be a real pastor. It was my dream, and God had “groomed” me for this moment!

As we drove into Homer I noticed the marquee on the movie theater.  It read, “Congrats to Bryan and Abi”.  I immediately stopped the car to gawk in amazement.  I was flabbergasted.  I suddenly felt a warm flush of self importance.  Homer was recognizing me as a pastor, as well as ABI, the Bible school in town that I had been teaching at, also in Homer.

I was delighted and duly impressed with how enlightened my town had become in recognizing me since my trip ‘outside.’.  I actually drove around the block to take in this wonder and took another look.  I was completely taken in by this marquee.  My pride took over and I felt invincible.  Words would pour off my lips and my little town would be guided by my spiritual brilliance.  I felt a warm surge of “heavenly” authority.

About two weeks later I picked up the local newspaper.  As I paged through I came across an announcement for a wedding for someone named Bryan and Abby.  I suddenly pieced it together.  Abby had been an employee at that movie theater before she got married!  The management had put this message on their behalf.

Immediately the Lord jolted me back into reality.  My arrogance and pride drained from me.  I felt like a pompous ass.  I had so inflated myself, thinking I was so impressive and important that the crash devastated me.  I was not as awesome as I thought I was.  I was embarrassed by how easily I was led into this spiritual trap of self-importance.

The Bible has a great deal to say about pride and arrogance.  “One’s pride will bring him low, but he who is lowly in spirit will obtain honor.”   I would like to say that I have overcome this arrogance, but I catch it growing in the corners.  I can say that even though I was so self-absorbed and self-important that I am now immune from this sin.  But that would be a lie.

Jesus loves the humble.  He favors those who are poor in spirit.  But he resists people who are proud and self-sufficient.  He stands against the arrogant.  The Father hates my pride and my arrogance.

I want to encourage you to come to Jesus now.  Come as you are and He shall meet you.  Dispense with your pride and “humble yourself before the Lord”We do all right if we see ourself as ordinary and average.  Satan will look for any handle you give him.  Pride is one of his favorite ways to control you.  When the disciples tried to figure this out they ended up fighting (Mark 9:33-34).

 “But it should not be that way among you. Whoever wants to become great among you must serve the rest of you like a servant. Whoever wants to become first among you must serve the rest of you like a slave.  In the same way, the Son of Man did not come to be served. He came to serve others and to give his life as a ransom for many people.”

Matthew 20:26-28, NCV

The ”marquee incident” was 15 years ago, but I am determined to remember how the Lord revealed to me my pride.  It has become humorous to me now, but at the time it was brutal.  I have had to learn through weakness.  When I am weak, He is strong.

“True humility is not thinking less of yourself; it is thinking of yourself less.”  Tim Keller

bry-signat (1)

cropped-christiangraffiti1.jpg

*

A Doubting Faith

faith-and-doubt“”Then the disciples came to Jesus in private and asked, “Why couldn’t we drive it out?”

20 He replied, “Because you have so little faith. Truly I tell you, if you have faith as small as a mustard seed, you can say to this mountain, ‘Move from here to there,’ and it will move. Nothing will be impossible for you.””

Matthew 17:19-20, NLT

The text is intriguing; it seems to direct us to consider the unbelief of the disciples. They had tried so hard to do what Jesus wanted; they get an “A” for effort, but they can’t heal this boy. They correctly discern a demons presence, but they are stymied after trying to exorcise it.

The disciples “crash and burn” is uppermost in their hearts. They have a private meeting with Jesus to determine what went wrong. Their expectations were running high; they expected success in this encounter with darkness. After all, weren’t they Jesus main followers?

Even after Jesus had performed so many signs in their presence, they still would not believe in him.” John 12:37, NIV

 Jesus is on his way to be crucified. It would be fair to say that his mind was occupied with this. He is still performing healings for the needy, and although awesome things are happening, the crowds remained doubting. They would remain uncertain about him, and many would go on to mock and revile him in just a few days.

Doubt is an insidious thing. It allows one to see, but not respond. It seems to be a cowardly attitude that masks itself as safety and security. There is a willingness not to make a response when that is precisely what is being called for. It is content to live uncommitted and remain unaffiliated. Truth is neutered and we want it to be so.

I certainly don’t mean to be overly harsh to those with doubts. But there are some who put their faith in their doubts and that is slightly disturbing. They see, but do not perceive. They hear, but do not really listen.

“So faith comes from hearing, and hearing through the word of Christ.” Romans 10:17

 Believers who doubt are in a strange place. But saving faith is always growing, in spite of one’s own skepticism. Questions are to be welcomed; honest inquiry is not a threat, but an issue of a seeking heart. Faith without evidence is no better than superstition. I think believers who never ever doubt are “a freak of nature.” Our faith may struggle, and hard questions be asked, but my faith still holds.

“Now faith is confidence in what we hope for and assurance about what we do not see.” Hebrews 11:1

We are to grow in our faith. The Bible describes it as “life.” To be a believer in Jesus is a journey of confidence and hope (these words have been carefully chosen). When we find ourselves without these two working in our hearts we become unbelieving believers. Maybe we should doubt our doubts before we doubt our faith.

“Faith never knows where it is being led, but it loves and knows the One who is leading.”   Oswald Chambers

bry-signat (1)

cropped-christiangraffiti1.jpg