Sunday, June 19, 2011

managing bipolar disorder

How to manage your mood disorder?
Managing bipolar disorder requires making certain adjustments to lifestyle and self awareness. Like recovering alcoholics who avoid drinking or diabetics who take insulin, if you have bipolar disorder, it’s important to make healthy choices for yourself. Making healthy choices helps us to keep mood episodes under control and feel more satisfied with our lives. Managing bipolar disorder involves taking responsibility for our level of self awareness about our sensitive disposition, and finding our way to the most helpful information for our particular beliefs.

Our belief system has a powerful influence on our sense of wellness as proven time and again by the placebo effect in psychotropic drug trails. Many people with a long experience of managing bipolar disorder find their beliefs changing over time as their journey unfolds. Some people have a good experience with medical and family support and find no great conflict in the official model of bipolar as a brain disorder. Other people have trouble finding a medication fit for their beliefs and support systems and up to 40% of people finding no significant long term relief from the generally accepted medical model. Many people around the world still see mania and psychosis as a spiritual breakthrough in line with mystical beliefs dating back to humanities origins.

Official managing bipolar disorder model:

Bipolar Disorder: Key Recovery Concepts From DBSA.

Hope. With good symptom management, it is possible to experience long periods of wellness. Believing that you can cope with your mood disorder is both accurate and essential to recovery.

Perspective. Depression and manic-depression often follow cyclical patterns. Although you may go through some painful times and it may be difficult to believe things will get better, it is important not to give up hope.

Personal Responsibility. It’s up to you to take action to keep your moods stabilized. This includes asking for help from others when you need it, taking your medication as prescribed and keeping appointments with your health care providers.

Self Advocacy. Become an effective advocate for yourself so you can get the services and treatment you need, and make the life you want for yourself.

Education. Learn all you can about your illness. This allows you to make informed decisions about all aspects of your life and treatment.

Support. Working toward wellness is up to you. However, support from others is essential to maintaining your stability and enhancing the quality of your life.

And from the queen of bipolar disorder Dr Kay Redfield Jamison, writer of "An Unquiet Mind: A Memoir of Moods and Madness" and "Touched with Fire: Manic-Depressive Illness and the Artistic Temperament" a video interview about her personal experience of managing bipolar disorder.

My personal managing bipolar disorder model:

Hope. After losing hope in using medications to manage my sensitive condition, I discovered hope, faith and a full recovery through education.

Perspective. I found a more accurate perspective through human development science, beyond the mainstream focus on managing illness. Self education took me into areas of science that is breaking new ground on the nature of being human. A new perspective of natural cause is emerging beyond a narrow focus on crisis management.

Personal Responsibility. After 27 years of personal responsibility which helped me to manage my condition largely through self medication (sleeping pills), I moved into taking personal responsibility for a full recovery, beyond acceptance of a lifelong condition.

Education. From September 2007 on I have perused a self education into the internal reality of my sensitive bipolar nature, beyond the description of external behaviors. Going beyond the descriptions of symptoms to learn how my brain and nervous system create my experience of bipolar disorder, has brought a deep self awareness. Critical and accurate insights into my biology have allowed me to make a full recovery given me a new model for managing bipolar disorder.

1. Take personal responsibility for improved self awareness using the best science as an insightful guide. My own responsibility for improved self awareness took me to writers like Stephen Porges, Peter Levine and the many others mentioned throughout this blog.

2. Allow time for reading and re-reading new concepts of health and wellness, while seeking a mindful awareness of internal sensations. Accept that full knowledge integration is an organic process involving both the 100 million neurons in our head, as well as the 100 million neurons in our stomach.

3. Accept an evolutionary perspective on brain/body order and disorder, with a common heritage in our autonomic nervous system shared with all other mammals. Accept that feedback signals from our auto nervous system are intimately involved in a sensitive bipolar nature.

4. Practice a mindful awareness of thoughts and feelings stimulated by unconscious auto nervous system activity. This means accepting an evolution view of human development that views movement as the prime motivation, before the mind evolved to our current level of conscious awareness.

5. Accept that muscular tensions fire the mind and that the heightened sensitivity of bipolar disorder is stimulated by the negative affect fear and its muscular constriction. Accept that avoidance lies at the heart of bipolar disorder, an avoidance that is internalized as a fear of our own sensations.

6. Accept that mother nature's spontaneous muscular tensions come before our thoughts in the essential experience of this moment. Positive thinking can only simulate the innate responses nature equipped us with at birth and the mind is evolving to observe and master its own nature.

Getting in touch with your auto nervous system and its hidden control of your experience?

Please try relaxing the muscles of your face, your tongue, the tensions of the jaw & around the eyes and be aware of spontaneous shifts in the depth of your breathe. As your focus turns to awareness of body sensations, the grip of mind focused attention should ease and as the muscular system relaxes, the minds activity will follow? This is how I manage the excitement phase of coming up and out of myself, away from habitual withdrawal, that judgmental doctors like to call mania or a symptom.

Contrast this muscular relaxation technique with the well known technique of "thought stopping."
An example of thought-stopping
Here's an example of how thought-stopping might work:
You're worried about a presentation you are giving at work later in the day. You're prepared. You know you're ready. But you can't stop worrying about it. You imagine making a mistake.
When you start to think of yourself stumbling over words, you say "Stop" quietly in your mind. You get up and move around, or you snap your rubber band as you say "Stop." Then you think of something pleasant to take your mind off the thought-such as a trip you are planning to take or a movie you saw recently that made you laugh.

One of the main problems with bipolar disorder is the minds need to identify, while avoiding the sensations of a very sensitive body. Accepting that all our metabolic energy is primarily about movement and the body, and that fear lies at the root of a bipolar avoidance of body sensations, we are tempted back into a felt experience. Through the practice of mindful awareness of our auto nervous system motivation within muscular tensions, we can return to a natural balance of body/brain/mind. Or we can accept the illness model and remain dependent on outside intervention for our sense of well-being.

Approach or Avoidance?

Without going into the technical vocabulary of autonomic nervous system activity below the level of our conscious awareness, the ANS emits constant approach or avoid feedback signals to the brain. Like a submarine's sonar radar, our auto pilot nervous system sends information about the state of the body back to the brain. Habitual muscular tensions send signals back to the brain about threats to the organism. Previous negative experiences are held within the sensitive body by unconscious muscular constriction, thereby internalizing a sense of threat and avoidance of body sensations.

I maintained by bipolar condition unconsciously over a period of 30 years through sheer ignorance of how my unconscious motivation works. Accurate knowledge about my body/brain has allowed my mind to identify the source of internalized threat which so constricted my life. When viewed with more insightful awareness I now accept that my initial experience of mania was a spontaneous attempt to re-balance an organism fundamentally stimulated by fear. We are hard wired for crisis activity in the very nature of life eats life survival.

It is a sad reflection on rational science that few seek to understand what is happening during the onset phase of bipolar mania when the universal experience is one of wellness. It is only the nature of trail and error history that sees the medical model of disease managing bipolar disorder as an illness. Yet like our own personal growth, medical history stumbles from one "it seemed like a good idea at the time" to the next period of deeper insight and understanding. Stephen Porges "The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation (Norton Series on Interpersonal Neurobiology)" and his concept of "neuroception" are new insights into human development and the causes of what we think of as mental illnesses.

The Auto Pilot responsible for Approach or Avoid stimulation?

The Polyvagal Theory describes three stages in the development of a mammal’s autonomic nervous system.
Each of the three major adaptive behavioral strategies is supported by a distinct neural circuit involving the autonomic nervous system:

1. Immobilization
• Feigning death, behavioral shutdown.
• The most primitive component, shared with most vertebrates.
• Dependent on the oldest branch of the vagus nerve (an unmyelinated portion originating in an area of the brain stem known as the dorsal motor nucleus of the vagus).

2. Mobilization
• Fight–flight behaviors.
• Dependent on the functioning of the sympathetic nervous system, a system associated with increasing metabolic activity and increasing cardiac output (e.g., faster heart rate, greater ability of the heart to contract).

3. Social communication or social engagement
• Facial expression, vocalization, listening.
• Dependent on the myelinated vagus, which originates in an area of the brain stem known as the nucleus ambiguus. The myelinated vagus fosters calm behavioral states by inhibiting the influence of the sympathetic nervous system on the heart.

Immobilization without tension (fear) or control of our more primitive instincts is required for spontaneous social intercourse, and it is stimulated by feedback signals from the muscles of the head and face. In my experience of bipolar disorder I could only socialize by using the more primitive motivations of aggressive mobilization and the tension fueled immobilization of withdrawal. My first episode of mania was a dream like state which relaxed muscular tensions and allowed for the stimulation of facial feedback, in my desire for social engagement.

The REM ‘dream state’ was the proto-type of waking consciousness?

As Jaak Panksepp has pointed out in "Affective Neuroscience: The Foundations of Human and Animal Emotions," - “we are forced to contemplate the strange possibility that the basic dream generators are more ancient in brain evolution than are the generators of our waking consciousness,” and “Indeed perhaps what is now the REM state (dreaming) was the original form of waking consciousness in early brain evolution when emotionality was more important than reason.”
And as I suggested in Mania Dreams and the Roots of Psychosis perhaps we slip into a pre-conscious state in mania in order to re-balance a negative experience stimulated nervous system.

The lucid dreams we experience during sleep make sense as the precursor of consciousness when looked at from evolutions point of view. The strange experiences of altered states of mind, combined with experiences like the placebo effect and the power of self hypnosis, have a common link to mental anguish issues. Both placebo and the extraordinary powers of hypnosis are known to be activated through the autonomic nervous system and can be said to harness the raw power of our animal instincts. The raw power which springs into spontaneous action when life is threatened and rational contemplation is a waste of time.

I suggest to you that managing bipolar disorder is a process of re-introducing yourself to your God given instincts for survival, and learning not to fear the sensations of your own body. Practicing a mindful letting go of the muscular pretensions to your thoughts can bring you back into proper contact with your nervous system stimulation. Effecting more spontaneous, instinctive responses in your ongoing experience and effecting a sense of security in your ability to cope with whatever comes along.

In the 1950's, Sylvan Tompkins uncovered nine primary instinctual affects (emotions of the moment) in infants. He described nine innate primary affects which he said were truly hardwired rather than learned responses. Two are positive: Joy and Excitement. One is neutral: Startle. The negative six affects that one can observe are: Fear, Disgust (tongue out), Dissmell (lifting away of the nose), Rage, Despair, and most importantly, Shame (eyes averted, head down). Shame is supposed to be a protective response to keep us connected to the group rather than wondering off dangerously by ourselves.

Contemplating these nine innate responses, we can see the raw energy discharged in mania and psychosis (Joy and Excitement) as well as the fear fueled withdrawal into chronic depression (Fear, Disgust, Dissmell and Shame) at the opposite end of bi-polar motivation. If we can accept that these energies are primarily for the body and not the mind, we can accept that the great trap contained within the mind is a failure to identify the source of its dissociated energies.

The catch 22 is the way the mind fails to let these energies discharge through the body and insists on processing them through the mind. When these energies are used creatively, what would have once run down a buffalo now writes a song or a book, or paints a masterpiece.

Mania Dreams and the Roots of Psychosis
Signs and Symptoms of Bipolar Disorder
Mental Illness: A Compass of Shame
Bipolar Mania
Bipolar Anger
Fear Filled Mental Anguish
Catch the Gap & Feel Your Mind
Unconscious Reactivity & the Pre-Tense of Intelligence?
Calming Your Bipolar Symptoms
Neuroception? An Unconscious Perception?