People are Different: Medication and Mental Disorder

People function and react differently given the same chemical cocktail. One medication can be a wonder drug for consumers of Mental disorder, restoring their ability to function adequately for a long duration of time. Another patient may not respond at all to the same prescribed psychiatric medication. And the next consumer could have serious negative or dangerous effects from the same medical therapy.
People are different.

A funny story about me….

Lithium is a commonly prescribed drug for Bipolar Disorder. It is a relatively cheap, successful and safe mood stabilizer. It’s a naturally found substance – Lithium compounds are  salts. Most consumers who take the drug therapy successfully usually only deal with the side effects of weight gain, mild tremors and dry mouth. Lithium can take up to three months to build up in a consumers system to show full effect.
Unfortunately, for me: I am highly sensitive to the stuff. After a period of build, actually a smaller dosage than normally prescribed for someone of my weight, I began to REALLY feel the effects… the side effects. my eyes came close to swelling shut, throat constantly dry and thick to the wear I had trouble swallowing.
Scream.jpgI remember sitting at a fast food restaurant trying to ingest a meal of soda and fries… the tremors!  my hands and arms shook so violently that I had trouble getting fries in my mouth until I gave up, eyes squinted, and a lethargy that made me look like a  shaky zombie. (definitely not like those cool superfast zombies I see on TV. Now that would have been cool!)
This was still better than being “Manic” (An elevated level of mood and energy that made impossible for me to sit still, or do things like read,watch tv, drive, or even walk for a long period of time.) However, I was not one of the fortunate  who use this drug successfully…. I would not be able to work or enjoy leisure with lithium
The funny part was the drug to almost as long to get out of my system as it took to build up. Those were the early days of my mental wellness management. I joke about how bad I looked out in public at times, and how I was cursed to wait to I pissed the salt out of my system.   Well,I guess you had to be there..

A serious story that is important to know…

I know of a person who says she suffered from major depression for over twenty years.  She was prescribed many medications and therapies over the years, including electroconvulsive therapy  — the latter is often reserved when no other therapies seem to work.   Nothing worked. (She had a physical handicap as well, which further complicated her health woes leading to many stays in the hospital). After twenty years, Someone finally prescribed her a different class of medication than she we would normally be prescribed for severe depression…  Her “Wonder Drug”.. in her words.
It was a mood stabilizer called lithium. She would be diagnosed with Bipolar Disorder II  soon after.  She told me repeatedly that “Lithium saved her life”. After a few months Her depression cleared, she got back part of her life again. I have not heard from her for along time, but she said was generally  happy when we  last spoke.
Her success , of course, is important, but…

here is another important observation in mental health:

Many people seek treatment for severe depression and are prescribed anti-depressants… only to experience their depression get significantly worse, including suicidal thoughts.
As it seems,  something is  physically different in the manifestation that would correctly be diagnosed as Depression and in the manifestation that would be correctly diagnosed as Bipolar Disorder II. Unipolar (major) depression and bipolar disorder in depression  be appear outwardly  as the same.
But in fact, a therapy of prescribed antidepressants, WITHOUT a mood stabilizer or a like drug can make Bipolar Depression far more severe.
A commonly observed side effect of someone who should receive treatment for Bipolar Disorder, but is only taking Antidepressants is increased mood cycling with with deeper peaks and/or valleys.

A  little more about this subject: “Bipolar Disorder: A Mistaken Diagnosis“.

As it turns out: even Clinical Depression and Bipolar Depression can be physically different, just like results  of  treatment with that commonly prescribed salt.
A treatment that works for one person , may not for the next.  

Perhaps we  just can’t treat all people to the same, after all.

Forgive my pun-word game… its just a segue for my next post on how  my experience with Mental Disorder   matured my philosophical approaches and attitude.

Post-Post

mood-charting-example

mood-charting-example

If one is suffering from depression, inhibiting levels of  anxiousness, or extreme shifts in mood or emotion, enough to seek out professional medical treatment…
Mood Charting can be very advantageous. There is no way to predict completely the outcome of treatment and diagnosis.  But one can improve his chances of avoiding misdiagnosis by tracking his/her own  shifts and patterns in mood, energy level, focus and behaviours.    Getting the correct diagnosis early could certainly improve a consumer’s  chance of getting to a functional, productive  and happier day-to-day life.

Here is one suggested  reason  for   common misdiagnosis of  Bipolar Disorder Depression  for Major Depression:
a patient simply doesn’t recognize the brief  period of  hypomania that they experience. Up moods, with extra energy and alertness  can feel good.  A person doesn’t  normally think or know something is wrong when he/she  feels good.   He/she   fails  to describe or report these hypomanic periods to his doctor.
Tracking moods, focus, anxiety, sleep patterns over a long period of time can help doctors detect the right diagnosis.

Examples of mood charts can be downloaded on the CHARTS  tab above.

 

Advertisements

Cognitive Distortions and Thinking Errors of CBT (revisited)

Cognitive Distortions  is just another term  for “Thought Errors” or “Thinking Errors”.   A common strategy  for a client of Cognitive Behavioral Therapy, for mood disorder (including depression), anxiety disorder and emotional management,  is  to:   “Catch”, and then “Correct”   Cognitive Distortions, aka  “Thinking Errors” or  ” Thought errors”,  before they trigger more intrusive thoughts, moods or actions.

Thought Errors are usually described as   thought in  symbols and verbal language, that are  irrational and self-defeating, and that lead to intrusions in ones life.  Because clients seeking Cognitive Behavioral Therapy (C.B.T.)  are often hypersensitive to judgment and self-judgement , cognitive distortion maybe the preferred wordage to Errors.  The jargon  is   descriptive rather than definitive of processes,  with the purpose of overall treatment.

An common Example of   Cognitive  Distortion is:

“I’m going to the a meeting today.  I’m sure that its going to be a disaster.  What If I lose my job?  How will I pay the bills?”

This is catastrophizing.  Thinking  of the worst possible outcome of an event, (while all the time denying, ignoring or minimizing other potential  outcomes.)  Very common.. everybody catastrophizes sometimes.  However if this  thought becomes chronic , repetitive , intrusive, or if it triggers other intrusive cognitions and actions, or complicates illnesses then considering therapies is not a bad idea.

“Catching”  Cognitive Errors can be tricky:   One learns to be mindful of them  when they happen. this takes time.
From   the phenomenological perspective of Gestalt Therapy,  these strands  of  symbols and verbal language, spoken or subvocalized (thought)  are experienced with intense emotions (excitement) as they form as figures out of the   consciousness  ground  of the present moment.  A client can learn to further explore and understand hidden tenants and semantics, such as thoughts, attitudes or physiological  reactions  in the “field” when  cognitive distortions  form.  — this is generally more of a Gestalt Therapy approach, but could be applied in other Therapies.

Good Strategies for preparing for “Catch and Correct” use repetition.
working through CBT Workbooks,  Journaling , and writing / memorizing plans can be  useful.
Good plans are short, privately practiced often, and can include “walking away”, self-talk, and Breathing-Exercise.  Therapists and clients, or even other family members can create plans together,

…  previously posted:

Common Thought or Thinking Errors:

Emotional reasoning – rationalizing a fact out of feeling.

. “I feel bad, therefore I am a bad person.

  • I feel bad right now, but everyone feels bad, sad , ugly, or angry sometimes. “Feeling bad Is not a reason to judge myself as a bad person.”

Catastrophizing – concluding the worst possible outcome of a potential situation, no matter how likey the possibility.

My son is out with the car and is late. He’s been in an accident!

  • There are many possibilities why my son is late. He could be held up in traffic, which is more likely”.

Personalizing. self – judgment : Blaming one self for something that isn’t their fault.

My Son failed his exam at school. This is my fault.

  • I am responsible for myself, and can only control so many things.

Black / White Rigid Thinking – One divides everything into good and bad, right or wrong, all or nothing.

I wish I could work at that place, its the perfect dream job

  • Everyone and Every situation(including jobs) has qualities and difficulties. Thinking A place or person job or situation, will be entirely perfect or entirely dismal will lead to disappointment.

Should statements: self -judgment and top dogging oneself.

I should be doing more with my life, right now.”

  • Although its important to wish, and to hope: Saying what I should be doing is self judging, and takes me away from who I am and can lead to resentments.

Over-Labeling: Applying an adjective or a descriptive trait of someone or something and assuming it is the whole of it.

he is a conservative…. he is a Liberal…. she is an academic

  • Someone may be conservative or liberal, etc, or have some values as such. But believing that some traits make the whole of something may lead me to the wrong overall conclusions or prejudgments.

Magnifying– 1.blowing out of proportion your error, or another persons success       2 overstating a the  importance of a situation.

” I just had a fender-bender,  I’m a horrible driver and I’ll never drive again…
” i didn’t get hired job after my bad interview.  this is a sign I will NEVER get a job.

  •   Accidents happen,  bad performances happen in Interviews.  That doesn’t reflect on  All my driving or actions.


Some other Thought or “Thinking Errors”
:
Leaping (to conclusions) – assuming the outcomes of events without evidence or information.

Mind reading – assuming what another person is thinking or feeling, without asking.

Minimizing – 1. denying ones own success and qualities. 2 denying the consequences of an action.

Read More on Thinking errors here.

Happy cognitions ;)

Mood definition… a disorderly description, Reposted

Reposted
Mood definition … A Disorderly Discription by a Bipolar Disorder Manager..”
was origionally posted on 5-10-2009

 
You wake up one morning.

  • You feel happy,loving, humorous  optimistic.
  • Your confidence and self worth are high.
  • You are motivated.
  • Your body feels healthy and energetic
  • You are  thinking is clear, focused,  positive.
  • You are not concerned witht bad thoughts.
  • Your impulses are strong and up mind/body feel crisp.
  • You  look outside your window and everything appears crisp , bright and colorful.

You are  in a “good mood”or an up mood.

You don’t need all these attributes to be in a “good” or “up” mood, when you wake up. You may be happy and thinking positive, but not feeling energetic…. You might feel very energetic a little confident and optimistic  and not particularly impulsive.
However, these attributes are loosely tied together… or appear commonly together in feelings … and we describe them as “being in a good mood”.
An Up mood.

You wake up one morning,

  • You feel sad, lonely, or pessimistic.
  • Your confidence and self worth low.
  • Your body feels, detached, achy, and slow. Your  thinking is disinterested and unfocused .
  • Your  thoughts are  self defeating..
  • You feel detached.
  • You look outside you window  and everything looks hazy and dull.

You are feeling down or in a down mood.

Just the same as an up mood, not every trait is necessary to “feeling down” or “feeling low”. You may have mildly self defeating thoughts, your body may feel achy and slow, you may feel extremely detached and disinterested…. and may not feel sad at all.
but your mood  is still described as down.

When  your over- all mood is very up… its referred  manicy and when it is really down your mood is depressed.

The word “mood“, much the same as the word “mind” is an abstract description.. It is an organization (or integration) of traits that are otherwise difficult describe. There exists no exact physical or concrete  thing called “mood”.

Even more difficult to describe is a mood disorder diagnosis. a diagnosis, such as “Bipolar disorder , “is made by matching a person’s intrusive traits with criteria in the DSM- IV . A mood disorder is not something you can see with an x-ray such as a spine injury. However, “mood disorder“is description is as real as description as  “mind”… and it is a diagnosis to be taken as serious as any medical diagnosis that is easier to see wit an X-ray or MRI.

For someone  diagnosed with a mood disorder…
These mood traits and the  behaviors linked to them are pushed to further extremes, until they become extremely intrusive in their life.

  • An extreme up mood or “manic mood” for example may lead an individual to have super- high  self esteem in denial of any consequence and lead to reckless behavior.
  • An extreme down mood or “depressed mood”  may have lost all self worth , have intense self defeating thoughts leading them to suicidal behavior.

These is usually a periodic conditions.. but it requires a life time of management.

The exact cause of Bipolar disorder and other mood disorders is not entirely understood yet. Western medicine and scientific evidence strongly supports that  they are biological, in origin.

From a Holistic point of view… we may say that the body, mind, mood, behavior, interaction with people and environment, all are components that act in an integrated fashion as whole of us.
When I, consumer who  manages Bipolar disorder , has these mood traits that are very intrusive at a given time, the mood distortions can throw all  integrated parts of me  off. In periods when this happen  I am described as being “symptomatic“… the symptoms being the intrusions. Each  consumer who manages a mood disorder has a unique  set of symptoms.

Sound complicated? no real concrete definitions?
Defining “Mood, “mood disorder and Bipolar disorder… just a simple component to be integrated with the whole of “Living with Bipolar Disorder”.

There  is  wisdom to be  gained:. Our perception of reality and our perceived personality  are all determined by all the components of us in an integrated fashion.
Just as my choice words to describe “mood”.
 
 

Thanks for re-reading my post and thanks if you are reading it for the first time.
please take a look at the list of posts in “Maslows Toolbox” on the left hand column:
a collection of posts and tags that I hope are helpful for mental health – wellness tool building.

 

Planting Potatoes and Paternal Wisdom

Without the daily prescribed medication: I would lose my ability to think rationally, and my attention span would dwindle to nothing, my body would creep into overdrive. I could feel this at the end of a work day as the medicine wore off and it scared me every day. Without the medication I could become more and more manic, eventually I would have to be hospitalize or worse… risk being incarcerated in prison.

This was one of the new realities of “Bipolar Disorder“. I was in my late twenties and just diagnosed . and there is more:
The daily medication was very expensive. without them,  I was a risk to myself or (mildly)to society.  So I had to work a full time job to pay for the medication.  I had to pay for and take the medication to work the full time job and remain part of society.

  • No medication or no work meant catastrophe.
  • Anytime with the medication, meant dealing with side effects, or the meds could stop working.
  • Miss time at work and I could lose my job.
  • Life was a daily cycle of fending off catastrophe.

I found this cycle frustrating, and I complain to my Father ( I had just moved home with my parents):

All I do is work ,so I can pay for bipolar disorder management, so I can work, so I can pay  for bipolar disorder...”

Dad’s replied with  a sympathetic grin:congratulations!.. you now have a child.

A truth blunted with humor.  The message was clear. The message , clearly and poetically stated  from a war veteran (Dad) ,who came home to raise a family while he worked (some times two jobs ) and finished college.
I had a new life-long responsibility. I was responsible for managing my health (the best I could). I was learning to be responsible to my self, family and community by doing what it to takes to manage my circumstances… Just like any other responsibility. I would do my best to repay those who helped me in those difficult days… especially my parents.

My father passed away recently and I am reminded of his wisdom on being responsible.
He also encouraged me to plant a potato just for fun (the photo above). It just bloomed recently.

S.A.D. Seasons change and so doth mood.(revised)

grasping-the-sun (This  post is a revised repost about S.A.D.)
‘Twas a dark and stormy Autumn   night”… as I  write from Pennsylvania.
the daylight lessens each day as we head towards Winter. I like Autumn, but many others I know, Diagnosed with Mood disorder or Bipolar disorder often slide towards depression, fatigue or low energy at this time of year.

In fact many people with no mental health diagnosis will start to feel depressed, extremely fatigued, or sleep excessively in the Fall and Winter.

For those with extreme intrusive symptoms  a diagnosis of  S.A.D…
or Seasonal Affective Disorder may be made by a health care professional.
Read more of this post

Hourly Mood and Symptom Chart

Mood charts and symptom charts are simple tools for tracking symptoms over along period of time. But many mood disorder managers may experience intrusive mood fluctuations or other symptoms (anxiety for example) in  shorter periods of time.
Mental Health  Consumers  diagnosed with  Rapid Cycling Bipolar Disorder, Personality Disorders, Post-Traumatic Disorder, for example, can experience fast changing moods, energy levels or anxiety. Mood can shift to extremes, multiple times a day,
In any case, rapid cycling of moods can be debilitating, making it difficult to function through ones daily life.

I thought it might be helpful to create a downloadable  chart for tracking  moods and symptoms  hourly, or over  intervals over a day. This mood chart is for those who are trying get a handle highly fluctuating moods.

Hourly mood and Symptom Chart

                    

So I made a simple chart for tracking mood and symptoms hour by hour if necessary.
the left thumbnail is a view of this chart.
the right is an example of what one might look like filled out.
(sorry if it looks a little clumsy.)

The chart has enough columns to chart 48 hours. Since charting hour by hour may be a bit tedious for ones needs , the top row is left blank so one could label the time slots  that suits them best.

you may download this PDF mood chart freely r if you wish,
I made and its free. click the link below for PDF
(readable with Adobe Acrobat, Foxit reader, Open office etc.)

Hourly mood and symptom tracking chart PDF

Also the chart  available  in MS doc format and Open Office odt (writer format).

As always these charts are to encourage your own creativity in making tools  in wellness management.

Daily Mood Chart and Emotions chart

Mood and Emotions chart in  now in Doc and Odt  format .
A Mood Chart is a simple tool that people diagnosed with Mood Disorders  such as Bipolar Disorder, Major Depression, Borderline Personality Disorder, and Schizo affective disorder use from time to time, for tracking their symptoms and Affect mood level.

With the K.I.S.S (keep – it- simple-stupid) attitude in mind, a mood chart that can be made to meet any personal symptoms and then taken to to a doctor and therapist.

Why keep a mood chart?
Mood charts can give a consumer and his/her professionals a better idea of the cycling, symptoms and possible triggers of symptoms over a long period of time. Thus a mood chart is a tool for personal awareness and an aid for a doctor who is prescribing treatment.

From my post my post: Charting my Moods Bipolar
That post includes an example of how to fill out a mood chart and a free down loadable simple mood chart in PDF format.

I now have an update of that Mood tracking chart available in ‘.Doc’ format ( readable in in MS Word) and in Open Office Writer format.
Also Available in those formats  is the Daily Emotions Chart for Special Needs Children, previously posted in PDF form with explanation.

   …            

Left: Daily mood tracking chart download:

Right: Daily Feelings/Emotion Charts for kids

These downloads are free, to be used as are and are to encourage you to create your own tools as well. Just click on the links above
There are more Downloads on the Charts page.