Posted 3/9/2009 11:35 PM (GMT -7)
I Posted Here Two Years Ago....some of my BPD story....but I can't find the post....so I will post instalment #1 again and if readers want more they can let me know.-Ron in Tasmania
AN ACCOUNT OF MY BIPOLAR DISORDER
A 66 YEAR CONTEXT: October 1943 To March 2009
RON PRICE: George Town Tasmania Australia
(83 Pages: Font 14—32,000 words)
1. Preamble and Introduction:
1.1 This is a longitudinal, retrospective account going back to my conception in October 1943. I make reference to a genetic predisposition to bipolar disorder(BPD) due to a family history of affective disorder in a first-degree relative, my mother(1904-1978). She had BPD, although her disability was never given that medical diagnosis. about half of all patients with BPD have one parent who also has a mood disorder. There is, therefore, a clinical significance in my mother’s mood disorder in the diagnosis of my own BPD. The high heritability of BPD has been well documented through familial incidence, twin, and adoption studies. There is an unquestionable justification for the inclusion of my family in my understanding of BPD. No specific gene has yet been identified as the one "bipolar gene." It appears likely that BPD is caused by the presence of multiple genes conferring susceptibility to BPD when combined with psychosocial stressors. I make this point as an opening remark and pass on to my story.
1.2 My account also provides a statement of my most recent experiences in the last two years, 2007-2009, with manic-depression(MD) or BPD as it has come to be called in recent years. Some prospective analysis of my illness is also included with the view to assessing potential long-term strategies, appropriate lifestyle choices and activities in which to engage in the years ahead. For the most part, though, this account, this statement I have written here in some 32,000 words is an outline, a description, of this partially genetic-family-based illness and my experience with it throughout my life.
1.3 Some of the personal context for this illness over the lifespan in my private and public life, in the relationships to my family of birth and my two families of marriage, in my employment life and now in my retirement are discussed in this document. I include some of what seems to me my major and relevant: (a) personal circumstances as they relate to my values, beliefs and attitudes on the one hand--what some might call my religion as defined in a broad sense; (b) family circumstances; for example, my parents’ life and my wife’s illness; (c) employment circumstances involving as they did: (i) stress, (ii) movement from place to place and (iii) my sense of identity and meaning; (d) a range of other aspects of my day-to-day life and their wider socio-historical setting and (e) some details on other aspects of my medical condition to help provide a wider context for this BPD in the last two years.
1.4 This lengthy account will hopefully provide mental health sufferers, clients or consumers, as they are now variously called these days, with: (i) a more adequate information base to make some comparisons and contrasts with their own situation, their own predicament whatever it may be, (ii) some helpful general knowledge and understanding and (iii) some useful techniques in assisting them to cope with and sort out problems associated with their particular form of mental illness or some other traumatized disorder that affects their body, their spirit and their soul.
1.5 This document was originally written in 2001 to assist others in assessing my suitability for: (a) employment, (b) for a disability pension of some kind and/or (c) a volunteer public or private office. This is no longer the case. Although this document no longer serves the purpose of helping others to make such an evaluation and make such a decision a more informed one; although there is no need for others to assess my capacity or incapacity to take on some task or responsibility, I have kept this original general statement, what was a first edition in 2001 and have extended it to what is now a 7th edition eight years later.
1.6 Many do not feel comfortable going to doctors, to psychologists and, more especially, to psychiatrists. Perhaps this is part of a general distrust of certain professional fields in our world today. Perhaps it is part of a general public being more critical. Others do seek help; still others try to work things out themselves and there are, of course, various combinations of those who try, those who have given up and those who go back and forth between the two poles of trying and not trying to sort out their disorder. Many often find the journey through the corridors of mental health problems so complex, such a labyrinth, that they give up in despair. Suicide is common among the group I refer to here—the sufferers from BPD and I could include depression(D) as well as a range of other illnesses and life battles of a traumatic nature. This account may help such people obtain appropriate treatment and, as a result, dramatically improve their quality of life. I think, too, that this essay of more than 32,000 words and sixty-four A-4 pages(font 14) is part of: (a) my own small part in reducing the damaging stigma associated with BPD and (b) what might be termed “my coming out.”
1.7 The wider framework of my experience which I outline here is intended to place my BPD in context and should provide others with what I hope is a helpful perspective, as I say above, in relation to their own condition, their own problems and situations. Perhaps my statement may help some BPD sufferers describing and understand their personal histories. My BPD exists on an affective spectrum which is a grouping of related psychiatric and medical symptoms which accompany bipolar, unipolar and schizoaffective disorders at statistically higher rates than normally exist in the general population. These disorders are identified by a common positive response to the same types of pharmacologic treatments. They also aggregate strongly in families and may therefore share common heritable underlying physiologic anomalies.
1.8 This essay, as I say, of eighty-two A-4 pages(font-14) is written: (a) for doctors and various medical professionals who have dealt with or will come to deal with my disorder and especially for those who are now, at this present time, involved with my treatment should they find such a statement useful; (b) for internet sites and those registered/inquirers on the www at a range of health and mental health sites, especially the sections of sites dealing with D and MD/BPD; (c) for some of my relatives, friends and associations over the years with whom I still have contact in these early years(60-65) of my late adulthood(60-80) and to whom it seemed relevant to give such a statement; (d) for government departments, voluntary organizations, interest groups and Baha’i institutions who require such statements for reasons associated with our relationships and interactions; and (e) for myself as a reflection, for my own satisfaction, to put into words the story, the results, of an illness, a sickness, a disorder that has influenced my life for over more than six decades.
1.9 This document, this statement, originally written in 2003 for the Australian government’s now department of Human Services, its Centrelink section which with Disability Support Pensions, has been revised many times after further reflection. Now in its sixth edition after feedback from various doctors, friends and internet respondents as well as after an increase in my own knowledge of the illness as a result of further study, this document is an ongoing and changing entity as my experience of the disorder continues into the middle years(65-75) of my late adulthood(60-80). In eight months I will go on the Old Age Pension in Australia with this BPD still a part of my life.
1.10 I do not claim to possess a specialized and/or professional expertise in the field of the study and treatment of BPD. I do not work with people who have such problems, nor do I have a desire to do so, except as a participant at a number of internet sites concerned with relevant mental health topics and with people who cross my path serendipitously with various related problems. This long piece of writing, too long for some perhaps for most, not as sharply focussed on my actual day to day experience as some respondents on the internet have already indicated and not particularly relevant to the experience of others in an illness that has a very wide range of behavioural typicalities---this long piece of writing is but one of the many pieces of my writing these days. The vast majority of my writing and my interests both in and off the internet has nothing to do with this disorder.
1.11 After more than 60 years of dealing with this medical problem in my private and public life, I would be only too happy to put it to bed, to put it into some final corner and forget it. Sadly, or perhaps fortuitously, I can not do so because I still suffer, even after more than 60 years, with problems that are part of this disorder’s long history and current manifestation in my life. I have also become more conscious as I have come out, or so it is said colloquially, of how this statement has come to be of great help to many, especially at the 90 mental health sites on the Internet where I place all or parts of this document. Major affective disorders continue to be the leading causes of psychiatric disability and the need to develop safe, effective, and efficient long-term treatments for these disorders is of extreme importance not only to professional but to the millions of sufferers. People like myself with life experience of BPD have stories that can be of use to other sufferers. That is the core of my motivation for all the internet posting I do at mental health sites related to BPD.
1.12 Readers who are busy and not inclined to read a long statement like this are advised to skip especially to section 10.3.8 below and some of the following sections after 10.3.8 to avoid reading much of the history and much of this statement that is not relevant to their needs. They can then: (a) make some practical assessment of this account, an assessment relevant to their present and personal needs; (b) obtain a shorthand account of whatever information in this document is relevant to their particular situation; (c) assess my suitability to: (1) undertake some form of employment: FT, PT, casual or volunteer; (2) some task that they think I could take on or some social or leisure activity in which I could engage with profit to others; (c) go onto a pension of some kind and, finally, (d) understand my background of BPD more fully and so contextualize my life in order that they might understand me better.
1.13 Data from the United States on the lifetime prevalence of this disorder--and mine has been a lifetime of BPD--indicate a rate of 1 percent for Bipolar I, 0.5 to 1 percent for Bipolar II or cyclothymia and between 2 and 5 percent for sub-threshold cases meeting some but not all criteria
1.14 I would like to close this introductory section with a general comment about the increasingly close relationship between the pharmaceutical industry and the American Psychiatric Association (APA) and about a sub-field of philosophy and sociology known as hermeneutic phenomenology.
1.14.1 Since at least 1980 when by illness was given the label BPD, there has been a growing tendency in the mental health professions to interpret everyday emotional suffering and behaviour as a medical condition that can be treated with a particular drug. Hermeneutic phenomenology, a field within both philosophy and sociology, is uniquely suited to challenge the core assumptions of this particular form of the medicalization of BPD, among other psychiatric disorders. Hermeneutical phenomenology can function within psychiatry: (a) to expand psychiatry's narrow conception of the self as an enclosed, biological individual and (b) to assist psychiatry to recognize the ways in which our experience of things--including mental illness--is shaped by the socio-historical situation in which we grow. Informed by hermeneutic phenomenology psychiatry's first priority, so it could be argued, is to suspend the prejudices that come with being a medical doctor in order to hear what the patient is saying. To this end, psychiatry can begin to understand the patient not as a static, material body with a clearly defined brain dysfunction but as an unfolding, situated existence already involved in an irreducibly complex social world, an involvement that allows the patient to experience, feel, and make sense of their emotional suffering.
1.14.2 This increasingly close relationship between the pharmaceutical industry and the American Psychiatric Association (APA) and this sub-field of philosophy and sociology known as hermeneutic phenomenology offers the sufferers of BPD a potentially useful line of inquiry in the future, but it is not a line of inquiry that I investigate in this statement. For my story, my account and my analysis, I see these two directions of inquiry as tangential to the central thrust of both my story and its treatment both in the last and the future.
2. My Experience of Manic-Depression:
Phase One--The First 37 Years 1943 To 1980
2.1 In the first 37 years of my life I had many episodes of various kinds of emotional imbalance or disorientation, themselves of varying lengths and intensities, ranging from a euphoric, impetuous, expansive or high mood to a depressed, grey, low energy or despondent mood. Indeed the range of mood in these 37 years was much more extreme, but the complete/extreme range was rarely experienced. In these years I learned various self-monitoring skills as well as some self-reinforcing tactics. Sometimes these symptoms affected my day-to-day life severely and negatively, sometimes positively and sometimes the affect was non-existent, insignificant and hardly noticeable.
-----------------------INSTALMENT #2 TO COME AFTER FEEDBACK--------------------------------