Category: mood swings

Medication: An Interview with Andrew Solomon

What domedications you say to people who ask if you’ll eventually stop taking medication?

“I say to people that they don’t expect a diabetic to stop taking insulin, or someone with a heart condition to stop taking blood thinners. I have a chronic, lifetime disease and the only responsible thing for me to do is stick with my medications.

People wonder about medications’ long-term effects on the brain. I explain that while the medications’ effects appear to be reversible as soon as you stop taking them, the long-term effects of having repeated depressive episodes appear to be absolutely dire. There is lesioning of the hippocampus, and brain cells die. And this is in addition to the havoc that such repeated episodes cause in your daily life.

Imagine you have heart disease. You’re prescribed medication, you do better for a while, so you stop the meds. Then you have another heart attack, so you go back on the medication to get better. Twelve heart attacks later, what kind of shape are you in? It’s obviously crazy. If you have recurrent depression, you are not being “courageous” or “genuine” to go off your medication. You’re being foolish.

Can you explain the importance of balancing therapy and medication?

Different treatments work for different people, and I am open to the endless possibilities out there. But for most people, a combination of medication and therapy is the surest-fire way to handle depression.

The medication alleviates the worst symptoms and lets you function again. It makes life and the world bearable. But once you have emerged from the horror, you need to learn skills for managing the illness. You need to understand where it comes from. You need to make your peace with the idea that you cannot be fully yourself without the use of medications or other support structures.

And you need someone capable who can keep an eye on you. Ideally, you also need to understand the structure of your own personality and who you are; this gives you a feeling of peace and allows you to get through a difficult time with dignity.

…………………………………….

AndrewsolomonBy his mid-twenties, Solomon established himself as a multi-disciplinary wunderkind, earning international accolades for his work as a novelist, journalist and historian. After the death of his mother, the then 31 year old Solomon descended into a major depression, rendering him unable to work or even care for himself. He was helped by a combination of medications and talk therapy. This experience formed the bedrock for his National Book Award-winning “Noonday Demon: An Atlas of Depression”, a tour de force examining the disorder in personal, cultural, and scientific terms.

 

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A couple of decent websites:

http://www.pbs.org/wgbh/takeonestep/depression/faces-andrew.html

http://www.noondaydemon.com/biography.html

 

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Mental Illness in Children & Teens

Does your child go through intense mood changes?

Does your child have extreme behavior changes too? Does your child get too excited or silly sometimes? Do you notice he or she is very sad at other times? Do these changes affect how your child acts at school or at home?

Some children and teens with these symptoms may have bipolar disorder, a serious mental illness. Read on to understand more.

What is bipolar disorder?

Bipolar disorder is a serious brain illness. It is also called manic-depressive illness. Children with bipolar disorder go through unusual mood changes. Sometimes they feel very happy or “up,” and are much more active than usual. This is called mania. And sometimes children with bipolar disorder feel very sad and “down,” and are much less active than usual. This is called depression.

Bipolar disorder is not the same as the normal ups and downs every kid goes through. Bipolar symptoms are more powerful than that. The illness can make it hard for a child to do well in school or get along with friends and family members. The illness can also be dangerous. Some young people with bipolar disorder try to hurt themselves or attempt suicide.

Children and teens with bipolar disorder should get treatment. With help, they can manage their symptoms and lead successful lives.

Who develops bipolar disorder?

Anyone can develop bipolar disorder, including children and teens. However, most people with bipolar disorder develop it in their late teen or early adult years. The illness usually lasts a lifetime.

How is bipolar disorder different in children and teens than it is in adults?

When children develop the illness, it is called early-onset bipolar disorder. This type can be more severe than bipolar disorder in older teens and adults. Also, young people with bipolar disorder may have symptoms more often and switch moods more frequently than adults with the illness.

What causes bipolar disorder?

Several factors may contribute to bipolar disorder, including:

  • Genes, because the illness runs in families. Children with a parent or sibling with bipolar disorder are more likely to get the illness than other children.
  • Abnormal brain structure and brain function.
  • Anxiety disorders. Children with anxiety disorders are more likely to develop bipolar disorder.

The causes of bipolar disorder aren’t always clear. Scientists are studying it to find out more about possible causes and risk factors. This research may help doctors predict whether a person will get bipolar disorder. One day, it may also help doctors prevent the illness in some people.

What are the symptoms of bipolar disorder?

Bipolar mood changes are called “mood episodes.” Your child may have manic episodes, depressive episodes, or “mixed” episodes. A mixed episode has both manic and depressive symptoms. Children and teens with bipolar disorder may have more mixed episodes than adults with the illness.

Mood episodes last a week or two—sometimes longer. During an episode, the symptoms last every day for most of the day.

Mood episodes are intense. The feelings are strong and happen along with extreme changes in behavior and energy levels.

Children and teens having a manic episode may:

  • Feel very happy or act silly in a way that’s unusual
  • Have a very short temper
  • Talk really fast about a lot of different things
  • Have trouble sleeping but not feel tired
  • Have trouble staying focused
  • Talk and think about sex more often
  • Do risky things.

Children and teens having a depressive episode may:

  • Feel very sad
  • Complain about pain a lot, like stomachaches and headaches
  • Sleep too little or too much
  • Feel guilty and worthless
  • Eat too little or too much
  • Have little energy and no interest in fun activities
  • Think about death or suicide.

Do children and teens with bipolar disorder have other problems?

Bipolar disorder in young people can co-exist with several problems.

  • Substance abuse. Both adults and kids with bipolar disorder are at risk of drinking or taking drugs.
  • Attention deficit/hyperactivity disorder, or ADHD. Children with bipolar disorder and ADHD may have trouble staying focused.
  • Anxiety disorders, like separation anxiety. Children with both types of disorders may need to go to the hospital more often than other people with bipolar disorder.
  • Other mental illnesses, like depression. Some mental illnesses cause symptoms that look like bipolar disorder. Tell a doctor about any manic or depressive symptoms your child has had.

Sometimes behavior problems go along with mood episodes. Young people may take a lot of risks, like drive too fast or spend too much money. Some young people with bipolar disorder think about suicide. Watch out for any sign of suicidal thinking. Take these signs seriously and call your child’s doctor.

How is bipolar disorder diagnosed?

An experienced doctor will carefully examine your child. There are no blood tests or brain scans that can diagnose bipolar disorder. Instead, the doctor will ask questions about your child’s mood and sleeping patterns. The doctor will also ask about your child’s energy and behavior. Sometimes doctors need to know about medical problems in your family, such as depression or alcoholism. The doctor may use tests to see if an illness other than bipolar disorder is causing your child’s symptoms.

How is bipolar disorder treated?

Right now, there is no cure for bipolar disorder. Doctors often treat children who have the illness in a similar way they treat adults. Treatment can help control symptoms. Treatment works best when it is ongoing, instead of on and off.

1. Medication. Different types of medication can help. Children respond to medications in different ways, so the type of medication depends on the child. Some children may need more than one type of medication because their symptoms are so complex. Sometimes they need to try different types of medicine to see which are best for them.

Children should take the fewest number and smallest amounts of medications as possible to help their symptoms. A good way to remember this is “start low, go slow”. Always tell your child’s doctor about any problems with side effects. Do not stop giving your child medication without a doctor’s help. Stopping medication suddenly can be dangerous, and it can make bipolar symptoms worse.

2. Therapy. Different kinds of psychotherapy, or “talk” therapy, can help children with bipolar disorder. Therapy can help children change their behavior and manage their routines. It can also help young people get along better with family and friends. Sometimes therapy includes family members.

What can children and teens expect from treatment?

With treatment, children and teens with bipolar disorder can get better over time. It helps when doctors, parents, and young people work together.

Sometimes a child’s bipolar disorder changes. When this happens, treatment needs to change too. For example, your child may need to try a different medication. The doctor may also recommend other treatment changes. Symptoms may come back after a while, and more adjustments may be needed. Treatment can take time, but sticking with it helps many children and teens have fewer bipolar symptoms.

You can help treatment be more effective. Try keeping a chart of your child’s moods, behaviors, and sleep patterns. This is called a “daily life chart” or “mood chart.” It can help you and your child understand and track the illness. A chart can also help the doctor see whether treatment is working.

How can I help my child or teen?

Help your child or teen get the right diagnosis and treatment. If you think he or she may have bipolar disorder, make an appointment with your family doctor to talk about the symptoms you notice.

If your child has bipolar disorder, here are some basic things you can do:

  • Be patient
  • Encourage your child to talk, and listen to him or her carefully
  • Be understanding about mood episodes
  • Help your child have fun
  • Help your child understand that treatment can help him or her get better.

How does bipolar disorder affect parents and family?

Taking care of a child or teenager with bipolar disorder can be stressful for you too. You have to cope with the mood swings and other problems, such as short tempers and risky activities. This can challenge any parent. Sometimes the stress can strain your relationships with other people, and you may miss work or lose free time.

If you are taking care of a child with bipolar disorder, take care of yourself too. If you keep your stress level down you will do a better job. It might help your child get better too.

Where do I go for help?

If you’re not sure where to get help, call your family doctor. You can also check the phone book for mental health professionals. Hospital doctors can help in an emergency.

I know a child or teen who is in crisis. What do I do?

If you’re thinking about hurting yourself, or if you know someone who might, get help quickly.

  • Do not leave the person alone
  • Call your doctor
  • Call 911 or go to the emergency room

  • Call a toll-free suicide hotline: 1-800-273-TALK (8255) for the National Suicide Prevention Lifeline.

Contact NIMH to find out more about bipolar disorder.

National Institute of Mental Health
Science Writing, Press & Dissemination Branch
6001 Executive Boulevard
Room 8184, MSC 9663
Bethesda, MD 20892-9663

Phone: 301-443-4513 or
Toll-free: 1-866-615-NIMH (6464)
TTY Toll-free: 1-866-415-8051
Fax: 301-443-4279
E-mail: nimhinfo@nih.gov
Web site: www.nimh.nih.gov

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Choosing to Walk With the Broken

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It seems the world is divided into two groups.

  1. Those all together, happy, healthy, and reasonably sane.
  2. Those with incredibly significant hang-ups.

We gravitate toward success. Even in a spiritual sense, we do so. No one wants to be associated with a ‘washed-up’ loser.  We expect success (at least in its fundamental form) to ooze out of every preacher, teacher, or ‘wanna-be’ that intends to lead us to ‘the promised land.’ We expect (or demand) it to be so.

But there are those broken ‘on the wheels of life’ who offer nothing at all.

They are busted and broke. They may once have been noble and keen; they might have stared at life as if it were their own already. They were gifted, but breakable. Alas, and they broke. And they have nothing to give. So many things have disintegrated around them, they are left without a clue, and certainly without hope from a ‘fickle’ Church.

What makes a man or woman ‘spiritual’ or holy?

Is it living up to a special standard or calling? Or maybe they look and sound good at what they do? Perhaps it is none of these. Maybe it really comes down to brokenness and humility? Perhaps we’ve looked at it all wrong.

Perhaps the real yardstick is spiritual poverty?

“They are blessed who realize their spiritual poverty, for the kingdom of heaven belongs to them.”

Matthew 5:4, NCV

Make no mistake, the ‘good’ seems very good. It is easy to ‘receive’ from some preachers. They do it so seamlessly, and so correctly. We often wonder why we haven’t been so receptive before. But ‘polish’ can never replace ‘broken’ prayer.

I will trust my soul to those ‘busted’ by the meanness of life, rather than those who pretend that things are ‘rosy’ all over. Brokenness is not a given. But it really is ‘the coin of the realm’. It is how the Kingdom does ‘business.’

 “But he said to me, “My grace is enough for you. When you are weak, my power is made perfect in you.” So I am very happy to brag about my weaknesses. Then Christ’s power can live in me.”

2 Corinthians 12:4, NCV

I hate to say this, but if being broken is the desperate need of the moment, then hammer me over and over again. I can’t imagine or even explain a better calling. “Bring it Father God”, (but help me if I stumble.) Oh, and one more thing: typically ‘mercy’ is absent for those who seem to live so ‘perfectly.’ (You just don’t see them with any.)

Look for mercy, and you will probably find someone truly authentic.

Take your candle, run to the darkness, and light your world, and love the unlovely while on your way.

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Tightrope Theology

As a person with a mental illness, it seems my issues are a matter of extremes.  Life seems uncontrollable; the wheels seem to always ready to come off of the wagon.  It strikes me as a semi-crazed place to be.  I look at the “norms” with envy, as their lives are crisp, healthy, and strong.

I once met a man that had a prophetic ministry who was speaking at a local church here in Alaska.  When I met with him, he looked at me intently.  He said many things, but the most significant was this. “You are an unstable man; you are like water.”  This was almost 30 years ago.  It has been an accurate prophecy and assessment since I heard it.  At first it stung, I hated it; but now, all these years later, I find a certain comfort in it.  God knows me; He understands.  I haven’t found any reason to be condemned for being Bipolar.

Those of us who walk the tightrope of sanity and insanity have One in heaven who not only knows us, but is on our side.  Hebrews 7:25 declares:

“Consequently, he is able to save to the uttermost those who draw near to God through him, since he always lives to make intercession for them.”

I must realize that I am not the “bad apple in the barrel,” nor am I cursed.  Rather the opposite is true.  I am the richest of all men, because of His radical grace that gets extended to the weakest. Those who “touch” my life are blessed by their contact with me, and since I have been so unnaturally “graced,” they become blessed by His presence through me. WOW! I simply need to be me, and they are drawn to you.

The issues that a mentally ill person (and those who are often a struggler and a rascal) faces are formidable.  But without His promises they are impossible.  The secular view is just to create a “zero sum” game.  It is to bring a person to some stupefied place of stasis.  Not exactly up–but not down either.  Stable, sort of.

It is very good to be stable.  But my goal can not be stability, but an obedience to a supernatural God who loves me supernaturally.  I simply can’t live without knowing that.  However, when I know it, I can handle the tightrope.  I will start to walk a “supernatural” walk.

You could say that God has a hobby, or a specialty.  It is weak and handicapped people.

He loves working with us and in us.  And I have become very much convinced that He pours out special favor on those of us who struggle so difficulty, those of us who will never fit in or be ‘normal.’

We need to come to that real and authentically holy place where we see God. But also in that place, and at the same time, we need to see ourselves as well.  And actually, both are most critical.  They are done imperfectly— but both must happen, nevertheless.

I exhort you to take on your tightrope.  You will only stay upright and cross it if you are aware of His grand love and presence.  It is an amazing thing to balance and walk, and if we fall?  Well, we drop into His net.  Get back up, and get in line again.  Secure your heart into the love of God for your soul.

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