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“Mania Days” – Movie about Bipolar Disorder

“Mania Days,” Debuts at South by Southwest Film Festival in Austin

Mania Days” is a movie by Paul Dalio, features Katie Holmes and Luke Kirby as two New Yorkers suffering in the various stages of Bipolar DisorderMovie About Bipolar DisorderDalio, who in actual bipolar mode, wrote, directed, produced, edited and unbelievably – “scored” his own movie which is based on his own discovery of his bipolar disorder.

In an interview with the Huffington Post, Dalio describes the Holmes character as what he was like when he had his first episode “really scared and ashamed of it”.  The other character, played by Luke Kirby is based on a period of when he “started to romanticize bipolar disorder” and “embraced lunacy”.

Dalio himself endured three years of bipolar misery but eventually adhered to treatment when he recognized the pain he was causing his family.  Now he credits much of his inner peace to meditation (in addition to medication) and adherence to a routine schedule – including sleep.

The film debuts at the 2015 South by Southwest (SXSW) Music, Film, and Interactive Festival in Austin, Texas which runs a number of independent films.  The film festival coincides with the world famous music festival and an “interactive” conference which includes “gaming” and interactive media.

Katie HolmesKatie Holmes’ presence in the film shows potential for commercial success, but whether it achieves stardom – it is a good thing for bipolar disorder.  Basically, any attention for bipolar disorder is good – even the “bad” of bipolar disorder – as awareness can only reduce bipolar stigma.

I know that in my own journey over 20 plus years, I have gone through many stages.  I don’t much remember being “scared” of the diagnosis – or even of my behavior.  I have chosen to steel myself with “it is what it is”.

I did, however, maintain a long romance with the idea of “crazy” is good.  I spent many years believing (and many hours arguing with my therapist) that being “normal” was boring.  The last thing I wanted to be was “normal”.

I would like to say I was young and stupid – which I was but maybe part of the truth was that I had been crazy for so long that it was “normal”.  Eventually, crazy is exhausting – and you can’t do it anymore.

In most cases – you are eventually stopped from being crazy – up against a wall, sometimes caught by family members but sometimes a lot worse.  You get normal – only to get bored and do it all again.

As much as I would like to say that there is a real way to stop this cycle – in many cases there is not.  Even with medication, the cycle will continue – for a while.  Eventually, hopefully, you just get too tired of doing crazy.  Lost relationships, lost jobs… lost stuff.  It is exhausting.

Today – I am stable on medication.  Like an alcoholic – I say today.  Tomorrow and likely next week I will be stable on medication.  I would like to say forever – but I remember (at least what I do remember) that someday I may not.  The best I can do is to be open and forthright about my disorder so that those around me may know the signs if I decide to do “crazy” again.

Even though, I live near the festival and have many friends who are attendees, musicians, event planners, and sponsors – I won’t be seeing the film in Austin… crowds, excitement, and all that are no longer my thing – but I will see it, and I hope it is good.  Even if it isn’t great, it is another step in the right direction for the disease.

The Movie about Bipolar Disorder, “Mania Days”, Debuts at Film Festival in Austin

Melissa Lind

Face of Borderline Personality Disorder

Pro Football Player Brandon Marshall Wants to be the “face” of Borderline Personality Disorder

Brandon Marshall - The Face of Borderline Personality DisorderIf you don’t follow professional sports in the U.S., you may not know who Brandon Marshall is. He is an NFL Wide Receiver, recently acquired by the New York Jets. His long history of violent outbursts, brushes with law enforcement and behavioral issues that have affected both his personal and professional life.

Marshall had played professional football since 2006 when the Denver Broncos drafted him. He has since played for the Miami Dolphins, the Chicago Bears and was recently acquired by the New York Jets. The Wide Receiver played in five Pro-Bowls, receiving an MVP award in 2011 and has set several receiving records during his NFL career.

Brandon Marshall - BPDThough he has played for four different teams in only nine years, most of the trades have come after a series of injuries. Not all of those injuries, however, have come from football and Marshall has a long history of legal trouble, and those issues have affected various team’s willingness to put up with his erratic behavior.

One notable injury was sustained in 2008 when he slipped on an empty bag in McDonalds. While this seems like a complete accident, the incident occurred during a physical scuffle with “family members”. Shortly after the event, he fell through a television set at his home, causing a severe arm injury.

Marshall has faced multiple fines with the NFL including two penalties for violating the team’s dress code by wearing brightly colored cleats during a game. The list of legal troubles he has had include drunk driving charges, domestic violence, assault, battery and disorderly conduct. Marshall was diagnosed with Borderline Personality Disorder in 2011.

Borderline Personality Disorder is not a well-known disorder and is highly stigmatized, with many people unwilling to disclose the condition. It is characterized by severe abandonment issues, risky behavior, personal identity issues, rapid changes in an Borderline Personality Disorder - Brandon Marshallemotional level, and high potential for self-harm. Treatment is largely comprised of behavioral therapy. However, some patients receive medication for other psychiatric disorders that may improve BPD symptoms. There is also some thought that medication treatment may be useful in Borderline Personality Disorder. However, no drugs are approved to treat the condition.

Marshall’s diagnosis of BPD likely comes as no surprise to those who understand the disorder. His willingness to come forward and publicly announce his condition may help others to understand BPD. He has been and is currently undergoing treatment and is in the process of filming a documentary about his battle with BPD. Marshall has stated that his goal is to be the “face” of Borderline Personality Disorder to bring public awareness for those who struggle with the condition.

Though he has been forthright, many in the sports world had stated that the New York Jets will have their hands full when he joins the team as his troubles have decreased only slightly since he began treatment.

Melissa Lind

Intermittent Explosive Disorder

Intermittent Explosive Disorder – More Than Just Anger

Intermittent Explosive Disorder (also called IED, that is appropriate as it can go off unexpectedly and cause significant damage)

Intermittent Hulk Explosive DisorderProbably everyone knows that teenage boy (or girl) who punched a hole through the wall.  Perhaps for some, this became a regular pattern of behavior during adolescence but most of those teenagers outgrew it.  In fact, at least one-quarter of teenage boys has done something dumb like punching a wall.

One boy I knew in high school even broke his hand by punching the roof of his car, and some boys were routinely doing stupid stuff.  Despite that, all of it was teenage angst and changes that can be attributed to the massive amounts of testosterone flowing through the male adolescent body – none of them had intermittent explosive disorder.

Intermittent Explosive Disorder is worse than punching a hole through a wall.

It typically is first identified in the early teens – but can be seen much earlier in some cases.    In order to be actually characterized as intermittent explosive disorder, an individual must have had three episodes of explosive behavior that is severely out of proportion to the stressor.

Intermittent Explosive Disorder HulkinsectThey must have broken or smashed something that is monetarily valuable (more than a few dollars), physically attacked or made explicit threats to attack someone with the intent of causing harm.  If these three episodes occur within the space of 12 months, the disorder is considered to be more severe.

Here is the catch.

How do you distinguish between IED, average – though extreme teenage behavior and other psychiatric conditions?  It turns out that IED is probably a diagnosis of “if nothing else fits” as other psychiatric disorders certainly overlap with similar symptoms – and you have to rule out the adolescent hormone issue.

Bipolar disorder may cause outbursts of extreme anger and agitation, Borderline personality disorder may cause outbreaks, ADHD patients can exhibit a severe lack of self-control, and drug abuse is always a potential cause.  Even though those diseases may cause IED-like events, a sustained behavior pattern is something to address.

Intermittent Explosive Disorder WarningA recent study reported by the National Institutes of Health shows that IED can actually affect up to 4 percent of adults and lead to an estimated 43 attacks over a lifespan.  The disorder may also increase that chance of depression, anxiety and substance abuse disorders.  People with IED have an obvious increased risk of legal trouble, financial difficulties, and divorce – that’s a no-brainer.

So the biggest problem for mental health professionals, like many other disorders, is to untangle all of the information leading in and out with a mix of behaviors and a mix of causes.  What came first – the chicken or the egg?  What came first – the drug abuse or the anger?  Which illness is more important – bipolar disorder or the IED?

One of the biggest clues may be in examining (or better, paying attention to) behavior that occurs before puberty.  In other words: What came first – the behavior or puberty?  Clearly if the behavior started before puberty, there was and is an issue.  If the behavior begins during adolescence – you have to wait (and hope) to see if the behavior goes away once the hormones are settled.

IED is not a simple diagnosis.

It requires a careful examination of an entire psychiatric and behavioral history – and the “ruling out” of a lot of other disorders that may be to blame.  Unfortunately, in the end – unless an underlying cause can be found, there is no medicationAnger management and cognitive behavioral therapy are likely the only answer – minimization of harm, not very satisfactory if it was your car window that got smashed in a fit of rage.

Melissa Lind

Borderline Personality Disorder or Traumatic Stress Disorder

Borderline Personality Disorder – What if it is a traumatic stress disorder?

When most people think of Borderline Personality Disorder – they think of bad behavior.  It is someone that is very difficult to deal with, someone that you have to be on guard against, Borderline Disordersomeone who will try their best to manipulate you.
But, while that may be the outcome, just like most psychiatric disorders, it isn’t exactly their fault.

One of the problems with BPD is that since it is a “personality disorder“, there is often no recognized medical treatment.

We simply expect that the patient should self-monitor and control their behavior.  Therapy may help this, but how many of us (psychiatric patients, in general) really want to go to therapy.

Many of us have already spent hundreds of hours with a therapist – who may or may not help.  In addition, the best therapists are likely people who can “see through the bullshit” and refuse to be manipulated.  This obviously goes against the nature of someone with Borderline Personality Disorder.

In fact, the stigma is so bad that some therapists won’t even work with Borderline patients.

Co Morbid DisordersOne theory may help.  Some therapists have developed an automatic assumption that a Borderline patient is also a trauma victim.  While this co-morbid condition may not always be true, it can help some therapists feel more comfortable treating the patient.

Due to many soldiers returning from impossible battlefields in the Middle East, Post Traumatic Stress Disorder is fairly well recognized.  Remember; I am not saying that it is easily treatable, but to some extent, the stigma is less.

When therapists look at Borderline patients as truly a PTSD patient, they may be more willing to treat the disorder. And they will attempt to get to the underlying causes of abandonment, impulsive and destructive issues, loss of control and poor self-image.

While PTSD is well defined by the professional psychiatric community, a longer-term disorder currently known as complex traumatic disorder is not.  Most examples of CTSD still involve soldiers, or they may involve women who had difficult pregnancies or who were violently sexually abused, repeatedly.

However, what if you don’t fit any of those recognized categories?

There are more ways to treat traumatic stress disorders such as Cognitive Behavioral Therapy or a newer one, Dialectical Behavior TherapyDBT focuses on four major areas:

•    Regulation of emotionsPost-Traumatic Stress Disorder
•    Tolerance for distress
•    Interpersonal effectiveness
•    Mindfulness

Unlike CBT, there is no “processing” component – making it work well as an initial treatment, starting before the patient has developed coping skills.  It builds up the feeling of emotional safety so that coping skills may develop.

Differentiating between “plain” Borderline patients – and those whose behavior is brought on by traumatic experience may help to eliminate some of the stigma still associated with BPD.  It may also offer actual, more effective treatment than CBT or other approaches.

Melissa Lind

Bipolar Disorder and Exercise

Does Exercise Help with Bipolar Disorder?

Everyone knows that exercise is good for your health.  It is a no-brainer, and it is repeated so often that you have probably gotten tired of it.  I know I should do some physical activity. It is good for my heart, my bones… blah, blah, blah.

Bipolar DepressionOn the other hand, aside from needing to exercise because I am getting old and tired – the idea, that exercise might be good for my Bipolar Disorder, might just motivate me to do it.
Nothing else has.

A research study conducted in 2012 showed that exercise may have positive benefits for people with Bipolar Disorder.  I should have thought of that – but I didn’t (probably because I am bipolar and tend to ignore obvious things that might help me).

When asked – I have given advice to those who have depression (major depressive disorder, clinical depression, situational depression – or even bipolar depression).  What I tell those people is in addition to taking their meds, they should get up.  Get out of bed, get outside, and get some exercise – even if it is just around the kitchen.  Exercise increases the blood supply to your brain and helps to rise your energy levels – even if you don’t want to, it will do you some good.

Bipolar Disorder ShadowI give that advice to people when they are depressed, but I am not usually depressed.  My disorder tends toward mania or at least a mixed mood state.  So I don’t think about the need to increase my energy level.

Evidence has shown that exercise has some positive effects for people with Bipolar Disorder – even those that are not depressed.  In addition to the obvious health benefits, it can help to regulate your mood levels and “bring structure to chaos”.

As “bipolar“, we are often subject to disorderDisordered mind, disordered days, disordered environment.  One of the biggest tools for a bipolar patient to get and keep their body and mind regulated is the establishment of a schedule.

Go to bed at bedtime (and not at 2 am when you fall asleep in front of the TV). Get up in the morning, go to work on time, eat on a schedule – and take your meds when you should.
Establishing a routine does, in fact, help to keep from extreme ups and downs.

Exercise can be a big part of this – and physically reinforce a schedule on your body – that then affects your brain.  Just like getting up at the same time and going to sleep at the same time helps to establish a normal circadian rhythmexercise can reinforce that in a big way.

There are other benefits to exercise as well.  Physical activity naturally increases blood flow to the brain, which gives it the best chance of functioning at optimum level. It also helps to “clear out the cobwebs” that can be especially important if you are teetering on the edge.
Bipolar ExerciseExercise can increase your self-esteem that may have taken many blows in the past.  It can also increase social activity – that is apparently good for you, even if you don’t like people.  I don’t.

In my opinion, the biggest benefit may be “getting in touch” with your body.  When you exercise, you are more likely to stay within yourself.  One of the greatest problems in people with any mental disorder, and one of the reasons why people abuse drugs or perform any other risky behavior is the inability to be comfortable within your skin.  If you are exercising, you don’t really have a choice; you have to stay there.  Over time, you feel better about yourself, you feel more comfortable there, and you learn what is and isn’t “normal” within your body.

Perhaps this can lead you to better response when something is going amiss – when you may be slipping into disorder.

I tend to disregard the advice given by those who are not bipolar experts… either those with Bipolar Disorder or those who know the disease intimately, but this advice looks pretty solid to me.

Exercise and take your medicines!

Melissa Lind

Bipolar Disorder and Exercise as text to speech article

(Mental health video for blind and partially sighted people)

Bipolar Disorder and Suicide Risk

Physical Proof and a Big Shocker – Bipolar Disorder and Suicide Risk

Bipolar HeadI read a lot of news about bipolar disorder and other psychiatric disorders (OCD, ADHD, chronic depression, borderline personality disorder, etc.).  In my reading, I came across an article that describes brain scan abnormalities in teens and young adults who have attempted suicide but I found a lot more.

A study conducted at Yale School of Medicine examined brain scans of 26 young adults and teenagers with bipolar disorder who had attempted suicide.  These were compared with scans of 42 bipolar patients who had not attempted suicide and with 45 non-bipolar subjects.  The results were not really surprising – as many research studies are not.

The bipolar patients, who had attempted suicide, showed abnormalities when compared to the other two groups, specifically in the  which showed “less integrity”.

Frontal lobe animationThis means that the frontal lobe (which controls impulses) is not as “connected” to areas that control emotion, motivation and memory.  Researchers indicate that the brain abnormalities may disrupt the ability of the impulse control mechanism to filter emotion and motivational messages appropriately.

In short this means that those patients can’t stop negative emotions and impulses to do something drastic… like attempt suicide and not surprisingly, less integrity or more abnormality – likely means more suicide attempts.

While it is good that they are discovering some physical proof of actual defect, eventually to move bipolar disorder into a category that can be scientifically documented, it doesn’t offer a lot of real-life solutions.  Most of us who are bipolar or know someone who is bipolar, know that there is something wrong or at least different about our brain…and it only makes sense that a person, who is trying to kill himself, is probably a little worse off.

As usual, I found myself thinking “…and… the point is…” which I often do when I read a synopsis of a largely inconsequential research study but then something caught my eye.  It was something that was a lot worse than I thought – statistics.

About 4 percent of Americans are afflicted with bipolar disorder, though sometimes we feel like it is others who are afflicted.  That is not surprising either.  Some groups show a slightly lower percentage at about 2.6 percent of the population.

Bipolar SuicideWhat surprised me was the statistic regarding suicide.  The article – that is from a reputable source – indicates that 25 to 50 percent of people with bipolar disorder are likely to attempt suicide and that 15 to 20 percent are likely to succeed.  Wow.  I didn’t know that.  Funny thing that I didn’t know since of the 20 or so bipolar people I have been close friends with at one time or another – at least four of them are dead.

When searching for confirmation (which I found from the NIH that about 1 in 5 bipolar patients complete suicide), I also found a number of additional shocking statistics:

  • Bipolar disorder results in a 9.2 year reduction in lifespan
  • Bipolar disorder is the 6th leading cause of disability, worldwide
  • Bipolar disorder is found in all races, ethnicities, ages, genders and socioeconomic groups
  • A child with one bipolar parent has a 15-30% chance of having the disorder
  • A child with two bipolar parents has a 50-75% chance of having the disorder
  • There are 3.4 million CHILDREN with depression in the US but up to one-third of those kids may actually have bipolar disorder
  • Bipolar disorder criteria have likely been met for at least 1 percent of all adolescents

Maybe these aren’t shocking for you.  Maybe you already knew all this – but maybe you didn’t.

I have known I had bipolar disorder for a long time – and have known a lot more people with bipolar disorder and I didn’t know all this stuff or maybe like everything else, I chose not to remember.

Food for thought; Take your medicines!

Melissa Lind