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

The Art of Begging

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Jesus looked at his followers and said,
    “You people who are poor are blessed,
      because the kingdom of God belongs to you”.

Luke 6:20, NCV

It is an astonishing thing, to have Jesus look at you.

His steady, focused gaze is transformational, He sees me, and in this huge mass of people Jesus has picked me!  It’s like He takes His ‘spiritual highlighter’ and sets me apart from everyone else.  Amazing grace!

But this really isn’t arrogance, or even wishful thinking.  We’ve been selected to be the special ones, not so much in an elite way, but in a way that glorifies only Him.  Scripture emphasizes this by stating ‘the weak are chosen’.  As I stood in this teeming crowd, I was surrounded by some very attractive and muscular people.  They preened and postured, but that wasn’t what He was looking for.  When He saw me, He stopped, and then He picked me out of the crowd.

Those who have been ‘chosen’ are definitely not superhero material.  We are the weak, and blind, and very foolish.  There is ‘zero attractiveness’.  In the classroom, we are the nerdiest of nerds.  (We are nerdisimos.)  In the spirit, we have a ‘less than zero’ rating.  In a sense, we’re not even remotely ‘the right stuff’, we are so pathetic.

Every once in a while, we find someone that seems to have figured out how to put it together.  Then often we go ahead and put our ‘mark’ on that person and then become loyal followers.  But if we extend ourselves to hear the Spirit (who by the way, is very easily heard) we find that our choice is a Saul, and not a David.  In other words, he is very close but is disqualified.

We are Christians because Jesus chose us.  We come into His presence because He left the doors open for us to squeeze in.  We enter in because Jesus has been ‘bled out’ for us.  Everything was drained when He died.  He stepped into our ‘nightmare’ to allow us to escape into the light.  Without His presence, we would decay into a dark and perpetual night.

And now He stands directly in front of us.  He looks (it seems He is always looking) and says something to us that is strange. ‘Those who are poor will become those who are very, very ‘blessed’.  Quite strange and bizarre.  Like the guy sitting on mass transit right next to you, who is talking to himself!  He simply doesn’t mesh with what is real.  He has lost touch with reality.

The kingdom is up for grabs!  Anyone can snatch it and bring home something substantial.  Poor people, those who are at the level ‘of very little account’ have been moved ahead in the line, right up to the front.  Suddenly, those in the back become envious.  This envy becomes jealousy and then rebellion.  But it changes nothing.

The ‘poor in spirit’ have just inherited the Kingdom of God.  It has become theirs and it won’t be something that can be overturned.  The ‘ultimate’ has become fully available to the ‘least’.  Those out there who are starving, will be those who get the most.

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A Towel, Not a Title

There are no shortcuts in discipleship
“Jesus knew that the Father had given him authority over everything and that he had come from God and would return to God. 4 So he got up from the table, took off his robe, wrapped a towel around his waist.”  

John 13:3-4, NLT

Jesus was always constant.  Nothing could erode His place or position.  The authority had been His Fathers, and it had been given to Him.  He carried it as a special burden, treasured and separating Him.  Jesus had the freedom to act like the servant.  It didn’t bother or confuse Him, He understood perfectly who He was.

With the supreme authority given to him, he got down on His knees, and began to wash dirty feet.  I can offer no magic or flair to adjust this scene.  He washed off dirt, cleaned between toes, making filthy feet clean.  And all of this ‘as God in human flesh’.  This staggered the disciples, perhaps a baseball bat on the side of the head, would’ve been more compassionate.

This was revolutionary, it completely devastated the disciples.  They just couldn’t grasp what was happening.  Jesus, who was ‘God in flesh’, had decided, in a moment of time, to clean their feet.  Outrageous!  Not really happening!  No way! Never!

The reality.

This spun them around.  They tried as fast as possible to process what had just happened, and ‘who’ it had happened from.

Essentially, it buried them.  Jesus Christ, as Servant pounded them into the ground.  Servanthood was to take the supremacy from this point forward.  Becoming an indentured slave was now the way of Christlikeness.  This servanthood was to now guide us to a point of slavery.

Gone are the days of Zebedee, when one can ask for a position, on the right or the left.  We can ask, most certainly, but we haven’t been the first.  We can ask but the sheer weight is against us.  So very many have gone before us.  We must become a people who accept, and then presses into His grace, His specialness, His presence.

Today, more towels are what we need.

We have got to turn over our ‘need’ for recognition and pick up from the pile the rag of servanthood, we must ‘ask’ our brother/sister if we can scrub their feet.  We must get on our knees and do the unspeakable.  We must find a way to clean off their feet. This dear one, is what you’ve been told to do.

“There are many of us that are willing to do great things for the Lord, but few of us are willing to do little things.”   D.L. Moody

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We Have Nothing, Unless He Gives It

 

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 “To the praise of the glory of His grace, by which He made us accepted in the Beloved.”

Ephesians 1:6

“We’re all stumbling towards the light with varying degrees of grace at any given moment.”

-Bo Lozoff

We really must come to this point in our discipleship.  Simply we must realize that we can generate nothing at all, unless He gives it to us.  This pretty much strips us of any kind of self-righteousness. His intention is to bring us (screaming if need be) into this place where we are devoid of any self-goodness. It’s taken me almost 40 years of discipleship to realize this.

He alone can transmit goodness. He intends that we come to Him without any extraneous issues.  In the spiritual realm we are always naked, and needing His covering.  But relax, He will never shame or belittle us.  He meets us with an outrageous love that encases us in a holy goodness that we reflect. But make no mistake– it is entirely His!

We have nothing, unless He gives it.

He alone is the deep source of goodness and grace.  If He isn’t there, we will find nothing but a sad desperation.  Without Him, there would be nothing, and a deep darkness that would engulf our souls

His presence makes a deep and solid difference.  He has chosen to enter into our blackness, in order to escort us safely into His light.  He alone, decides everything we need.  And His presence with our souls is all we really need.  He simply surrounds us with a holy kindness. This really isn’t what we expected, but we will take it.

Dear saint, we must make much of His grace.

Dear one, I encourage you to make much of His grace.  No matter your weakness or illness. Your sin is no longer a substantive issue.  He has forgiven you of so much.  You are now His, by the right of sacrifice and a deep love. You should be aware He wants to give you His righteousness, and exchange it for your sin.

Instead of moving away from you, and your sin, He now is moving directly toward you.  His love is waiting for you, and nothing else matters.

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