Surviving the Daily Grind

daily-grind

“I am reckoned among those who go down to the pit;
I have become like a man without strength,

Psalm 88:4

In May 2011, this is what I wrote–

“I feel like I am going through a meat grinder. Pushed against my will (and desire) I’m finding myself in a place I’d rather not be. My therapist confirmed today that I’m in a “mixed state” where bipolar mania and depression come together.  I compare it to two massive ocean currents smashing into each other.  (please Google, “mixed state”).

I’ve been into this state for just two weeks and the urge to commit suicide is starting to become surprisingly strong. For my own safety, I’m almost thinking that it maybe time to go to the hospital again.  I must tell you that these are places that you really don’t want to go if you don’t have to.  (FYI, my particular choice is Alaska Psychiatric Institute in Anchorage. It’s actually a somewhat “nicer” degree of miserable, and they have cooler art.)

I also get paranoid that people are attacking me and are plotting to ruin me. I am quite  suspicious of Facebook and my depression chat. I believe that the people that I encounter there are trying to get at me behind my back. Social networking with these type of services can be a nightmare.

But, then there is also the grandiosity. I believe that I think clearer, better, and faster than other people. It’s like I have superpowers.  I will think of myself as extremely gifted, superior to others.  I paint and write poetry and do “noble” things.

But I also have tremendous anxiety, with racing thoughts, and even heart palpitations esp. when I am sitting trying to relax. I don’t sleep well at all, in spite of the sleeping pill, the Klonopin and the melatonin, and the Benadryl, (to make sure I do sleep).

I continue to take my psych meds like a good boy. But they don’t seem to work like they used to. I think they can’t handle this particular concoction of depression/mania.  Sometimes, I feel like I’m getting better, but I never seem to get well.

The endless cycle of feeling really good and then feeling really bad is a challenging thing.  It is difficult to have a stable walk of discipleship under these circumstances.  I think being starkly honest and broken over my own fallenness is the key for me. (Now if I can only remember this.)

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I know that I’m being very blunt here. Tact has never been an easy thing. As I read I remember the struggle, and how I couldn’t see a way out. I’m thankful for the Holy Spirit who led me when no one else could. I wrote this post some time ag0. I’ve been reasonably stable, but I’m certain that putting it up now maybe timely for some. I’m in a better frame of mind the last several months.

 “For when we were still without strength, in due time Christ died for the ungodly.”

Romans 5:6

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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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Ministry & the Mentally Ill

“Turning Your Back,” Russian Folk Art

Religious people love to hide behind religion. They love the rules of religion more than they love Jesus. With practice, the Condemners let rules become more important than the spiritual life. “

— Michael Yaconelli

Mentally ill people are rarely seen in our Churches.  We are pushed into hiding our true identity;  we can come out into the open, but only if we agree to play according to the rules–their rules.  We are expected to censor ourselves, and say proper things at the right time.  Pharisees [who are alive and well] insist on a level of purity that all must maintain. [Hey, I am not picking on anyone, it’s just a generality.]

If I say that I am depressed, paranoid, manic or desperate, I will upset the apple cart and muddle up everything.  “Truth?  You can’t handle the truth?”, [from the movie, “A Few Good Men”.] 

But– if we use our shortcomings as credentials– we have the ability to speak about grace, love and of self-acceptance, with real authority.

Christians with mental illnesses, have been given a gift that we are to share with the Church.  The Holy Spirit has sprinkled us into each fellowship of believers.  He places us who are presently afflicted and suffering into strategic places.

We are “sprinkled” throughout the Body. Our “gifts” are to speak to the Body, spiritually about a lot of things, but especially grace. We are bearers of grace. We’re the audio/visual department of the church.

If our fellowships become religious, it might be because we in our weaknesses, have allowed ourselves to be silenced into submission by the “interpreters” of scripture.  If we don’t like the rules, we are told to go elsewhere.  We are not welcome, they say with a thin smile.

But don’t you see, that is our moment to shine!  Our “unsightly” presence shouts out to the “wonderful” people, proclaiming grace in weakness.  Those who receive us, in a way, receive Him.  Those who turn from us, muffling us, are doing that to Jesus. Frightening, isn’t it?

I would strongly suggest that we take our illnesses into the open. 

That we become transparent before others.  As we do this, we can ‘oh-so-gently’ guide our fellowships into true grace and love.  They look at me and they see Jesus.  And that is our ministry as mentally ill people to the Church.  Our weaknesses are really our strengths.

9″ But He said to me, “My grace is sufficient for you, for power  is perfected in weakness.”  Therefore, I will most gladly boast all the more about my weaknesses, so that Christ’s power may reside in me.” 

10 “So because of Christ,  I am pleased in weaknesses, in insults, in catastrophes, in persecutions, and in pressures. For when I am weak, then I am strong.” 

                               2 Corinthians 12:9-10, NLT

 

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[This is a re-blog of one of our core teachings, originally posted 11/20/2009. I felt it was time to bring out of our musty old closet and set it before you again. I hope that it resounds deep within, and that it encourages those who must mix their discipleship with disability.]

 

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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.

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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

Should I Take Medication? by John Piper

What’s Your Take on Christians Using Antidepressants?

by John Piper

Pastor John Piper

In the end I’m going to say that there are times when I think it is appropriate, but I want to go there cautiously and slowly, with warnings.

Depression is a very complex thing. It’s got many layers. I think we all would agree that there are conditions in which nobody would deny that certain people are depressed in a pathological way, because they’re immobile. They’re not even able to function.

And then there’s a continuum of discouragements and wrestlings with having an ‘Eeyore-type’ personality, which may or many not be depressed.

So that means that I want to be so careful not to have a knee-jerk reaction. When you come into my office and describe to me your discouragements, I don’t want my first response to be, “See a doctor and get a prescription.”

I fear that is way too quick today. The number of people on antidepressants as a first course rather than a last course is large.

And the assumption is that you can’t make any progress in counseling unless you get yourself stabilized or something.

So I just want to be very cautious.

As a Christian who believes that Christ is given by the Holy Spirit to deliver us from discouragements and from unbelief and from sorrow and to help us live a life of usefulness, what makes me able to allow for antidepressants is the fact that medicine corresponds to physical realities.

And the physical realities are that we get headaches that make us almost unable to think. Migraine headaches can put a man out. And we are pretty much OK if the doctor can help us find some medicine that would not let us get these immobilizing headaches.

And the headaches clearly have a spiritual impact, because they’re making me unable to read my Bible and function in relation to people that I want to love and serve. And so medicine becomes spiritually effective in that way.

So we apply this principle that we all use to depression, and then the fact that the body is included in depression. Whether we should use the terms “chemical imbalances”—I’ve read both sides on that. Some people say that there is no scientific evidence for such a thing and others say that it is a given. Whatever. Everybody knows that there are physical dimensions to depression.

If that physical dimension could be helped by medicine—in the short run especially, sometimes long term—then I think, in God’s grace and mercy, we should take it as a gift from his hand.


© Desiring God, desiringGod.org

John Piper is the Pastor for Preaching at Bethlehem Baptist Church in Minneapolis, Minnesota. He grew up in Greenville, South Carolina, and studied at Wheaton College, where he first sensed God’s call to enter the ministry. He went on to earn degrees from Fuller Theological Seminary (B.D.) and the University of Munich (D.theol.). For six years he taught Biblical Studies at Bethel College in St. Paul, Minnesota, and in 1980 accepted the call to serve as pastor at Bethlehem. John is the author of more than 30 books and more than 25 years of his preaching and teaching is available free at desiringGod.org. John and his wife, Noel, have four sons, one daughter, and an increasing number of grandchildren.
http://www.desiringgod.org/ResourceLibrary/AskPastorJohn
/ByTopic/81/4233_Whats_your_take_on_Christians_
using_antidepressants/

Paranoia for Beginners

No Escape
No Escape

A person who is paranoid has fears, such as being watched, harmed or poisoned. He or she does not trust others and is suspicious that others are “out to get” him or her.

It is normal to wonder if people are talking about you when you hear them whispering as you walk into a room. These thoughts are usually passed off and not dwelled upon for most people.

A person who is paranoid, however, does dwells upon suspicious thoughts. He or she goes out of their way to prove their suspicions even though no evidence exists to confirm their thoughts. It’s very hard to reason or speak what is real. Paranoia is usually found in small degrees in almost every mental illness.

Symptoms

  • Use and/or withdrawal of certain drugs, such as marijuana, crack cocaine and angel dust (PCP)
  • Alcohol withdrawal
  • Deafness or problems with hearing
  • Illnesses that affect the central nervous system, such as Alzheimer’s disease or other dementias, a stroke, a brain tumor
  • Mental illnesses, such as bipolar disorder or schizophrenia
  • Paranoid personality disorder, (PPD)

How to Recognize Paranoia

A person with paranoia may also:

  • Appear cold and aloof
  • Be withdrawn and anxious in social situations
  • Act stubborn and combative
  • Appear “on guard” at all times, out of fear of being harmed

A paranoid person also:

  • Complains about his or her health and often feels vulnerable and inferior to others
  • Holds grudges easily
  • Displays bitterness and resentment toward others
  • May be easily drawn into religious cults or other groups with strict beliefs
  • Can have delusions of being persecuted

Treatment

Treatment for paranoia depends on its cause. If it is a symptom of another condition, treatment for the condition will often take care of or lessen the paranoia. Paranoid personality disorder is treated with counseling, support therapy and often with medication. Treatment for this disorder is not easy, though, due to the nature of paranoia. Persons who are paranoid often do not trust others including doctors, therapists or family members trying to help them get treatment. It is likely that you will need to intervene, patiently and gently.  Paranoia treatment requires a huge commitment.

What You Can Do for a Friend or Relative

The most important thing you can do is to encourage your friend or relative to get professional help. Be aware that you may need to make the initial appointment with a professional. You may also need to take them to the appointment and stay with them. Be supportive. Paranoia requires patience, understanding, love and encouragement of the person’s loved ones and friends.

Be aware of the types of medication your friend or relative takes and when they should take it. You should also alert their physician or psychiatrist to any side effects that you notice when they do or do not take their medication.  If I may, I would suggest a film for you to watch, “A Beautiful Mind“.  This may give you insight into what you are dealing with.

Further Resources

Cleveland Clinic PPD Intoduction Site http://my.clevelandclinic.org/disorders/personality_disorders/hic_paranoid_personality_disorder.aspx

Suite 101 PPD Site http://personalitydisorders.suite101.com/article.cfm/paranoid_personality_disorder

Are There Benefits to Being Bipolar?

Bipolar people can be different
Originally Published on July 20, 2010 in “Psychology Today”

Let me start by acknowledging what is well known: Manic Depression or Bipolar disorder can be a devastating illness. Affecting at least 1% of the population, it can, untreated, result in suicide, ruined careers and devastated families. Bipolar disorder is often accompanied by alcohol and drug abuse and addiction, criminal and even violent behavior. I acknowledge this, because I do not want to make light of the burden this illness places on people’s lives, their families and communities.

On the other hand, the history of the world has been influenced very significantly by people with manic depression (see website www.wholepsychiatry.com for details).They include:

“It seems clear that for at least some people with Bipolar disorder, there is an increased sense of spirituality, creativity, and accomplishment. It may be that having bipolar disorder holds great potential, if one is able to master or effectively channel the energies, which are periodically available, to some higher task. This would of course presume the ability to abstain from harmful drugs and alcohol, to have good character, and at least some supportive relationships and community networks.”
Y
 It might be helpful to consider a reconceptualization. Perhaps instead of it being a disorder, we can think of people with bipolarity as having access to unusual potency. This potency will find a way to be outstanding-either in a destructive way, or in a constructive way. If such a choice is presented to the person, perhaps it can open some doors.
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Originally Published on July 20, 2010 in “Psychology Today”

“And we know that God causes everything to work together for the good of those who love God and are called according to his purpose for them”

Romans 8:28, nlt

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Sourcehttp://www.psychologytoday.com/blog/health-matters/201007/are-there-benefits-having-bipolar-disorder

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