Nutrition and mental health

wordcloud_Nutrition(2)

“Most behaviour change requires a certain amount of skill and desire by itself is simply not enough” Brian Colbert

Patrick Holford

“My first recommendation to someone with Manic Depression would be a full consultation with a nutritionalist” … who will “give you a personally tailored nutritional strategy to help relieve your symptoms” Patrick Holford [1].

“If mood changes are not owing to any drug intake (caffeine, alcohol or cocaine), the possibility of food allergy or hypoglycaemia (low blood sugar) should be carefully investigated. If your blood sugar levels are in serious imbalance, severe mood swings can result”. He also discusses the condition pyroluria which is linked to depleted B6 and zinc.

“A hyperactive thyroid can induce mania, while an underactive thyroid can trigger depression, so thyroid function is well worth investigating”. Lack of light and SAD (Seasonal Affective Disorder) can lead to Depression. A light box might be a good investment. Under the guidance of a nutrition therapist he mentions the use of of amino acid tryptophan. If a person is on medication they would need to watch out for any contraindications when it comes to taking supplements at the same time.

Eating oily fish or taking fish oils can have benefits for the brain, heart, skin and immune system. There are 2 types of Omega-3 fats. DHA and EPA. EPA can help with Depression. Flaxseed oil is a vegetarian alternative [1].

James Greenblatt MD

High homocysteine levels in the blood can increase the likelihood of suffering from Depression.
“Several important, mood associated vitamins and minerals (folate, vitamins B12 and B6, and zinc) are responsible for the conversion of homocysteine to the non-harmful cysteine”… “
By embracing the concept of biochemical individuality, that every patient is different. That their genetic, biochemical and nutritional status impacts how a person feels, and how, in turn, they are treated, we are able to make well informed decisions about how to help” James Greenblatt MD [2].

Is depression a kind of allergic reaction? [3]

“Both cytokines and inflammation have been shown to rocket during depressive episodes, and in people with Bipolar, to drop off in periods of remission”….”A diet rich in trans fats and sugar has been shown to promote inflammation, while a healthy one full of fruit, veg and oily fish helps keep it at bay. Obesity is another risk factor, probably because body fat, particularly around the belly, stores large quantities of cytokines” … “stress, particularly the kind that follows social rejection or loneliness, also causes inflammation, and it starts to look as if depression is a kind of allergy to modern life – which might explain its spiraling prevalence all over the world as we increasingly eat, sloth and isolate ourselves into a state of chronic inflammation” [3]. Curcumin which is a component of turmeric has anti-inflammatory properties and also Omega-3.

Allergies can cause mental and physical health symptoms. An allergic reaction can lead to inflammation in the body.

Antibiotics

“Several studies have also found an association between the receipt of antibiotics and an increased incidence of psychiatric disorders, perhaps due to alterations in the microbiome” [4]. “While animal models focus on the bacterial composition of the intestinal tract, studies to date in individuals with psychiatric disorders also point to the possible role of viruses and fungi”.

Alcohol

Sometimes people with mental health difficulties may have resorted to unhelpful coping mechanisms in dealing with their problems eg drinking too much. Dual Diagnosis is a term used to refer to cases where a person has both a mental health issue and addiction issues. This usually leads to a worsening of symptoms. Alcohol can fuel Manic Depressive symptoms. It can make the highs higher or the lows lower.

The person may need assistance in dealing with such a problem and needs to want to stop or want to change their habit. There is help out there for people who want to make such changes so that they can have a better quality, more productive life e.g. Alcoholics Anonymous meetings [5]. You don’t need to be an alcoholic to attend such services. There is also a good Allen Carr book on how to control alcohol [6].

My own journey

I am currently taking a magnesium supplement as I suffer with insomnia [7]. I know that I have a problem with inflammation in my body and I’m working on it. I noticed after my last antibiotic that my mood went a bit ‘high’. I took a course of probiotics, which doctors should recommend.

Sleep is a big part of healing and recovery and I need to make it a priority. I need to stay self-aware of anything that can impact the quality of my sleep. I found this interview between sleep expert Dr Guy Meadows and Dr Rangan Chatterjee helpful [8].

I’m also taking Krill oil and have changed to a more vegetarian based diet, while reducing dairy. Mental / physical health requires daily work, planning and dedication. But the idea of becoming healthier, more balanced, with more energy to get through the day is a good motivator.

References

[1] 500 Health and Nutrition Questions Answered by Patrick Holford, 2004 ~
https://www.amazon.co.uk/500-Health-Nutrition-Questions-Answered/dp/0749924934

[2] Can a Simple Blood Test Solve Depression? Testing for Homocysteine Can Help in Depression Treatment by James Greenblatt MD
https://www.psychologytoday.com/us/blog/the-breakthrough-depression-solution/201110/can-simple-blood-test-solve-depression

[3] Is depression a kind of allergic reaction? by Caroline Williams, 2015 ~

https://www.theguardian.com/lifeandstyle/2015/jan/04/depression-allergic-reaction-inflammation-immune-system

[4] The microbiome, immunity, and Schizophrenia and Bipolar ~

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5503102/

[5] Alcoholics Anonymous ~
http://www.alcoholicsanonymous.ie/

[6] Allen Carr’s Easyway to Control Alcohol, 2009 ~
https://www.amazon.com/Allen-Carrs-Easyway-Control-Alcohol/dp/1848374658

[7] Magnesium – How it affects your sleep ~
https://www.thesleepdoctor.com/2017/11/20/magnesium-effects-sleep/

[8] Episode 11: Good Sleep Habits and Sleep Misconceptions with Dr Guy Meadows ~
https://drchatterjee.com/guymeadows/

Other useful information

* The Breakthrough Depression Solution: A Personalized 9-Step Method for Beating the Physical Causes of Your Depression, James Greenblatt MD, 2011
https://www.amazon.com/Breakthrough-Depression-Solution-Personalized-Physical/dp/1934716553

* New research suggests gut microbiome plays a role in Bipolar ~

http://www.psypost.org/2017/05/new-research-suggests-gut-microbiome-plays-role-bipolar-disorder-48953

* Action plan for Bipolar ~ http://www.foodforthebrain.org/nutrition-solutions/bipolar-disorder/action-plan-for-bipolar-disorder.aspx (magnesium is discussed)

* Think Twice: How the Gut’s “Second Brain” Influences Mood and Well-Being ~

www.scientificamerican.com/article/gut-second-brain/

* Omega-3 fatty acid supplementation in patients with recurrent self-harm. Hallahan et al 2007 ~
http://bjp.rcpsych.org/content/190/2/118

* Mood disorders and complementary and alternative medicine: a literature review ~ “Low levels of vitamin D have been identified in patients with major depressive and other mood disorders”, Quereshi et al, 2013 ~ www.ncbi.nlm.nih.gov/pmc/articles/PMC3660126/

* Vitamin D: a potential role in reducing suicide risk? Tariq et al, 2011 ~

https://www.ncbi.nlm.nih.gov/pubmed/22191178

* The Feel Good Factor: 10 Proven Ways to Feel Happy and Motivated by Patrick Holford, 2010

www.amazon.com/Feel-Good-Factor-Proven-Motivated/dp/0749953160

* Antibiotic exposure and the risk for depression, anxiety, or psychosis: a nested case-control study

https://www.ncbi.nlm.nih.gov/pubmed/26580313
(Recurrent antibiotic exposure shown to increase risk of anxiety & Depression)

 

 

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Social stigma and Discrimination

Discrimination_wordcloud2

Monitoring and tackling discrimination is an important issue for Irish society” Frances McGinnity

“Discrimination takes place when one person or a group of persons are treated less favourably than others because of their gender, marital status, family status, age, disability, ‘race’ – skin colour or ethnic group, sexual orientation, religious belief, and/or membership of the Traveller community” [1]

Disability is “an impairment that may be cognitive, developmental, intellectual, mental, physical, sensory, or some combination of these. It substantially affects a person’s life activities” Wikipedia.

About 4 years ago I was sitting in a pub with a friend and the barman sat down close to us and said “You are Bipolar, you are on medication and the whole town knows about it!”. While I was aware of social stigma and discrimination and had experienced it, this was the first blatant “in your face” experience of it that I remember. By the way the barman had a lot of inaccuracies in what he said but it still affected me deeply. The “Bipolar” he mentioned (or Manic Depression to give the condition its correct name) is in fact an adverse reaction to antidepressants I took for anxiety, I am not on prescribed psychoactive drugs (since 2011) and I don’t know the “whole town”.

When researching this area I came across a lot of interesting books and resources. Erving Goffman’s book Stigma “is an illuminating excursion into the situation of persons who are unable to conform to standards that society calls normal. Disqualified from full social acceptance, they are stigmatised individuals. Physically deformed people, ex-mental patients, drug addicts, prostitutes, or those ostracised for other reasons must constantly strive to adjust to their precarious social identities. Their image of themselves must daily confront and be affronted by the image which others reflect back to them” [2]. This often happens in subtle ways.

“New research entitled Who experiences discrimination in Ireland? Evidence from the QNHS Equality Modules published jointly by the ESRI and the Irish Human Rights and Equality Commission (IHREC) examines people’s experiences of discrimination at work, in recruitment and in accessing public services (education, transport, health, other public services) and private services (housing, banks/insurance companies, shops/pubs/restaurants)” [3].

“Discrimination can be damaging to the individuals who experience it, in terms of their self-esteem, well-being and for their material outcomes, such as their income and access to valued positions and services. There are also costs at a societal level. Discrimination in the labour market may be economically inefficient, as the skills of individuals are not effectively used. Discrimination can also undermine social cohesion. Monitoring and tackling discrimination is therefore an important issue for Irish society.” lead author Frances McGinnity in study for the Economic and Social Research Institute (ESRI) [3].

Approaches to overcoming Social Stigma and Discrimination

One of the key ways of overcoming social stigma and discrimination is Education. But people also need to be more supportive of each other in families, our social circle and communities. I sometimes find empathy is lacking and people can be very judgemental about others. Listening non-judgementally, while keeping certain boundaries, is an important part of supporting people going through emotional distress.

The following quotes are taken from a report ~ Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change (2016). Chapter 4 ~ Approaches to reducing Stigma [4].

Educational anti-stigma interventions present factual information about the stigmatized condition with the goal of correcting misinformation or contradicting negative attitudes and beliefs. They counter inaccurate stereotypes or myths by replacing them with factual information”.

“In contact-based behavioral health anti-stigma interventions, people with lived experience of mental illness or substance use disorders interact with the public describing their challenges and stories of success”.

Peer support is where “people with lived experience who work as health care team members and foster the provision of nonjudgmental, nondiscriminatory services while openly identifying their own experiences. When integrated into service-provision teams, peers can help others to identify problems and suggest effective coping strategies”.

Protest and Advocacy is another method. “Protest strategies are rooted in advancing civil rights agendas. In the context of this report, protest is formal objection to negative representations of people with mental illness or the nature of these illnesses. Protests are often carried out at the grassroots level by those who have experienced discrimination and by advocates on their behalf”.

A review by Dr. Eleanor Longden and Dr. John Read evaluates the effects of mental health anti-stigma campaigns. They “found that although biomedical explanations of mental illness predominate in current anti-stigma discourse, not only are they ineffective but they also tend to increase stigma. Conversely, evidence indicates that psycho-social explanations of psychosis are effective in reducing stigma and humanizing those who live with the condition” [5].

Referring to the same study “There is a reasonably substantial evidence base supporting the hypothesis that anti-stigma campaigns which frame psychosis as a meaningful response to adversity are effective. They are a more promising approach to ‘humanizing’ people with complex mental health problems than strategies based on models of disease and disability” [6].

Relating this to my own personal experiences of adversity I’ve have a number of traumas over the past year. It’s taken a lot of resilience to get through. I sometimes underestimate my own coping ability, even if I have some coping strategies that aren’t perfect.

Employment

Discrimination when it comes to employment is another area of importance. “People seen as ‘mentally ill’ are often avoided, treated harshly and subject to discrimination. For example, although having a job can be very important in people’s recovery, employers are less likely to offer work to someone if they know that they have a psychiatric diagnosis and unemployment rates for people with a ‘psychotic’ diagnosis are very high” [7]. This report by the British Psychological Society has a lot of information on stigma and discrimination, including the effect of racial discrimination on mental health.

As an example of what can happen in employment I came across an article on a website called Sprudge. After Sharon “revealed to her employer that she had … been successfully treated for Bipolar disorder, she says the cafe owner became very withdrawn and Sharon was later let go via a phone call” [8].

In Ireland there is an organisation called Employability that does help people with disabilities get back into the workforce. It’s an employment support service that provides the person with a job coach.

Being Supportive

This is a world full of social stigma and discrimination. But also some good, supportive people. Social stigma can be a trigger for the person and can seriously impact their recovery. Due to the subtle nature of social stigma I notice people may initially seem nice but then use information you gave them against you. Some of the things we say can be thrown back at us in dis-empowering ways. These days people are asked to talk and share their story around any mental health struggles. But the reality is we need to be careful who we share with. At the same time if someone is in deep distress or about to take their own life they should reach out to others who care or ring a helpline (e.g. The Samaritans 116 123).

I find it a bit frustrating that people seem more comfortable complaining about symptoms of mental health issues than they are at supporting the person in overcoming or managing their condition. For example a person with Manic Depression/Bipolar who seems to be developing hypomanic or manic symptoms may need help in identifying some habits that are not helping them (e.g. over spending or drinking to try to cope with the symptoms). There are certain ways to help or even to phrase feedback to the person that is more effective than others. See my blogs on:

  • Tips on dealing with symptoms of Bipolar and

  • Family, Friends and Community (in section Strategies to enable family and friends to help someone through mania and/or Psychosis).

Recovery and Healing
The following quote is from a document by Mental Health Reform ~
“From the perspective of people with lived experience of a mental health condition, recovery is an individual process of discovering one’s own strengths, values, meaning and aspiration; a self-determined journey that can take place inside or outside the mental health system, through personal development, through partnership relationships with professionals, through peer support or through community support. It is a process of reconnecting with life that can happen for some with the continuation of symptoms while for others, a reduction in symptoms is important” [9].

As someone that went through the mental health system, found it harmful overall and ran away from it in January 2012 I think there is a misconception that its the responsibility of doctors and this system to fix people. There is a danger when we hand over responsibility to others to “fix” us, instead of doing our best to take personal responsibility for our own healing journey. I learned this the hard way! I’m not recommending running away from the system, as you need supports in place and everyone’s journey is unique. There are parts of the system that I found helpful e.g. Occupational therapy and I had a very good Occupational therapist called Orla.

Seeing as none of us live in a vacuum and we are all very much interconnected families, communities and society in general can benefit from helping people on their healing journey. People who have lived through difficult symptoms and experiences may need some ongoing support in their community. This would also take some of the pressure off the already stretched mental health service. At the same time this system should be able to provide timely psychological support, especially to children. At the moment it seems to be still very biomedical based, with a focus on drugs and blaming faulty genes!

Conclusion

In the area of mental health there are various ways we can support each other on our life journeys including tolerance and listening non-judgmentally when someone is in distress. To quote from Ivor Browne, now in his 90th year, “the only real, lasting change comes when we help a person to bring about the painful work of change within themselves”. This needs to happen within a supportive environment and community. A community that strives to tackle social stigma and discrimination. As we are all interconnected this will mean a healthier, more content and more productive community for those who live in it.

References

[1] Experience of Discrimination in Ireland: Analysis of the QNHS Equality Module ~
http://eprints.maynoothuniversity.ie/2873/1/RKOR_Discrimination.pdf

[2] Stigma: Notes on the Management of Spoiled Identity by Erving Goffman, 1986 ~

https://www.amazon.com/Stigma-Notes-Management-Spoiled-Identity/dp/0671622447

[3] Who experiences discrimination in Ireland?

https://www.esri.ie/news/who-experiences-discrimination-in-ireland/

Who experiences discrimination in Ireland? Evidence from the QNHS Equality Modules ~
https://www.ihrec.ie/app/uploads/2017/11/Who-experiences-discrimination-in-Ireland-Report.pdf

[4] Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change (2016). Chapter 4 ~ Approaches to reducing Stigma ~ https://www.nap.edu/read/23442/chapter/6

Study produced by the National Academies of Sciences Engineering Medicine in Washington DC ~
http://www.national-academies.org/

Patrick Corrigan ~ https://humansciences.iit.edu/faculty/patrick-corrigan

[5] Psychosocial Explanations of Psychosis Reduce Stigma, Study Finds ~

https://www.madinamerica.com/2018/03/psychosocial-explanations-psychosis-reduce-stigma-study-finds/

[6] ‘People with Problems, Not Patients with Illnesses’: Using Psychosocial Frameworks to Reduce the Stigma of Psychosis (Eleanor Longden & John Read, 2017) ~
https://www.ncbi.nlm.nih.gov/pubmed/28857755

[7] Understanding Psychosis and Schizophrenia. A report by the British Psychological Society from 2014. Updated in 2017 ~
https://www1.bps.org.uk/system/files/user-files/Division%20of%20Clinical%20Psychology/public/CAT-1657.pdf

[8] Mental Health in the Service Industry: Confronting the Stigma ~
http://sprudge.com/health-series-part-iii-118876.html

[9] “Recovery … what you should expect from a good quality mental health service” by Mental Health Reform (2013) ~
https://www.mentalhealthreform.ie/wp-content/uploads/2013/03/MHR-Recovery-paper-final-April-2013.pdf

Other relevant links

* Bar staff should get anti-racism training, says Traveller activist ~
https://www.irishtimes.com/news/social-affairs/bar-staff-should-get-anti-racism-training-says-traveller-activist-1.3330696

* Blind nun wins discrimination case against pub ~
https://www.irishtimes.com/news/blind-nun-wins-discrimination-case-against-pub-1.1185227

* Convention on the Rights of Persons with Disabilities ~

http://www.ohchr.org/EN/Issues/Disability/Pages/DisabilityIndex.aspx

* UN convention on disability rights passed by Dáil (after 10 years) ~
https://www.rte.ie/news/ireland/2018/0307/945705-disability-rights/

* Irish Human Rights and Equality Commission ~ https://www.ihrec.ie/

* Challenging the Public Stigma of Mental Illness: A Meta-Analysis of Outcome Studies ~

https://ps.psychiatryonline.org/doi/pdf/10.1176/appi.ps.201100529

* Pull Yourself Together! A survey on the stigma and discrimination faced by people who experience mental distress ~ by the Mental Health Foundation (2000) ~

https://www.mentalhealth.org.uk/publications/pull-yourself-together-update

* Psychiatry in Context : Experience, Meaning & Communities by Dr Philip Thomas 2015 ~

https://www.pccs-books.co.uk/products/psychiatry-in-context/

My review of this book ~ www.goodreads.com/user/show/46943899-anne

“It’s necessary to engage with people in emotional distress within the social and cultural contexts of the communities they come from. The author explores the impact racism has on the mental health of people in Black and Minority Ethnic communities.”

* “The Secret Life of a Manic Depressive” presented by Stephen Fry ~

www.topdocumentaryfilms.com/stephen-fry-the-secret-life-of-the-manic-depressive/

* Mental Health and the Service Industry: How to Get Help (from US) ~ https://talesofthecocktail.com/wellness/substance-abuse-addiction-insurance

* A physical hearing problem that causes me a lot of distress.
What is hyperacusis ? http://www.hyperacusis.net/what-is-it/ 

Some of my efforts at tackling social stigma head on (2015)

* One woman’s account of suffering from ‘Psychosis’ (which was an adverse reaction to antidepressants and fuelled by other prescribed psychoactive substances!) ~

www.todayfm.com/One-womans-account-of-sufferinbg-from-psychosis

* More on my experience ~ ‘I was unaware of potential adverse effects to my prescribed antidepressants’

https://www.independent.ie/life/health-wellbeing/mental-health/aines-story-i-was-unaware-of-potential-adverse-effects-to-my-prescribed-antidepressants-31218347.html

Therapy

Therapy

“Knowing your true self is the greatest achievement you can obtain” Deepak Chopra

Psychotherapy is the treatment of emotional distress by Psychological means. Counselling is “providing guidance in resolving personal and psychological problems” (Oxford dictionary).

Having someone to listen non-judgmentally with compassion and empathy can improve emotional well-being. The world at the moment is quite judgemental and critical at times. Having a safe space to go to, where you can develop trust with a therapist, can give a person the breathing space to express their emotions, work through certain issues and come to some resolution. If an issue is unresolved that has caused deep hurt, it can continue to fester on a sub-conscious and conscious level. It may seem to be resolved, but certain things can trigger memories or make a person aware that the issue is still causing some distress.

The therapist may need to work with clients that are culturally different and to be aware of those differences. Therapy should be relatively non-directive. It can help the client develop self-awareness and a better understanding of themselves. It allows them to change specific aspects of their feelings, thoughts and behaviour that may not be serving them well. It can also help a person clarify some issues and make decisions. They may feel blocked or stuck. People have the capacity to understand their problems and the resources to resolve them. But sometimes they may need help realising that.

The therapist needs to be able to listen to verbal and non-verbal messages and their contexts. Confidentiality, genuineness and respect is also important. As well as identifying and exploring defense mechanisms.

If people can sort out some of their issues it is possible to live a more fulfilling, satisfying and productive life that has more purpose and meaning. Various areas can be worked with e.g. grief and addiction. There are different schools of therapy e.g. Gestalt, Regression, Logotherapy etc. Different types of therapy are suited to different people.

The therapist would need to be comfortable with certain experiences and have a good understanding of them e.g. Hearing voices. To be able to help a person in ‘psychosis’ would require specialized training. The person in distress can be quite perceptive, even when they seem “out of it”. Family therapy may also be needed. If there is turmoil in a family this should happen early on before relationships break down or become more dysfunctional.

The person themselves is the true expert on their own experiences. Therapy helps a person make sense of their experiences and gives them personal responsibility for their own recovery. A psychological formulation process and the idea of personal narratives can facilitate the person in making sense of their experience [1].

This is a quote from a man I know who has a diagnosis of Bipolar and is benefiting from therapy ~

“we all carry life baggage, some of which we want to unpack, discuss, possibly even move on from. I think Psychotherapy gives me that space. I engage with it for that reason. Therapy is empowering, if you feel your family or community are not listening. It’s a gradual process for me, as much on my terms as that of the therapist”.

From another perspective “It is possible for therapy to do harm as well as good. It can be difficult to talk about painful issues. Sometimes people receive incompetent or inadequate therapy” [2, 3]. There are regulatory bodies that set guidelines e.g. the IACP (Irish Association for Counselling and Psychotherapy) [4].

This quote is from a mother who lost her son tragically by suicide. He was only 17 years old and on an anti-depressant. “I think that the practice of many counsellors which involves pathologising grief is harmful and that, along with outdated notions of the need to sever attachment with the deceased, is the cause of harm. Exceptions would include counsellors or therapists who employ methods such as those of Dr. Joanne Cacciatore whose processes and understandings I have found personally helpful”. Joanne Cacciatore therapeutic interventions include narrative, dialectical and logo therapies, in addition to trauma focused therapies [5]

A Psychosocial approach to healing can help empower the person, develop emotional resilience and allow them to be a better and more content member of their family, community and society. The overuse of certain drugs e.g. major tranquilizers, can be disempowering and disabling. In the long run the Psycho-social approach can be more effective. That usually requires ongoing holistic work by the person on their physical and emotional well-being.

CBT (Cognitive Behaviour Therapy)

The biochemistry of the brain is influenced by our thoughts so we need to stay aware of our thought patterns. Negative self talk affects our mood. Techniques used in Cognitive Behaviour Therapy (CBT) can help change negative thought patterns into more positive ones. The Feeling Good Handbook has exercises that can allow the person work on CBT in their own time [6].

Life Coaching

Life coaching helps draw out from within a person what they would like to achieve in life. We have the answers to problems and difficulties within ourselves. Techniques and tools are used to bring solutions to light. Good coaching has a lot to do with knowing the right questions to ask. Obstacles, challenges, self-limiting beliefs and behaviour can be identified and overcome. It helps people set goals and time frames for achieving those goals. The coach has to park their own life experience and only occasionally gives advice.

Life can seem frightening and daunting for a person who has been through trauma and emotional distress. A person can become stuck in a rut. Life coaching can help them take more control over their lives, feel empowered and find purpose in life. Areas that people may need help with include motivation, structure and self-discipline.

Part of the process of life coaching involves listening intently to the person, with dignity and respect, in a non-judgemental way. And sometimes summarising and reflecting back to the person so that they gain a better self-understanding. People can have blind spots. Aspects of themselves that they may be unaware of but that may be obvious to others.

The individual can discover areas of their lives that are out of balance. Some balance in life can be restored, leading to a more fulfilling, satisfying and effective life. Coaching has the potential to help a person create a vision for their future and support in turning that vision into reality.

Ivor Browne and how he helped me on my healing journey

Prof Ivor Browne has worked in the field of mental health for about 60 years. He has published a number of good books [7, 8]. A lot can be learned about the history of Psychiatry in Ireland in the last 60 years from Ivor’s great work.

While Professor Ivor Browne worked as a Psychiatrist, he is also a trained therapist, unlike most mainstream Psychiatrists who are trained in a biomedical approach and mainly prescribe drugs. Only a relatively small percentage of Psychiatrists in Ireland are trained therapists and Dr Michael Corry discusses this gap in their training in an interview [9]. In my experience this puts the human beings they are working with at a serious disadvantage and delays healing. “12 years of schooling and I can’t do basic therapy techniques … how did we get to this point where we as a field have become fixated on medications ?” Dr Daniel Carlat (Psychiatrist).

I first went to see Prof Ivor Browne for therapy in February 2012 for one intensive session and then he took me back in 2015 where I received about nine more sessions, including Regression therapy. The first time we met I was on 25 mg of Seroquel / Quetiapine, which is more or less the lowest dosage (it goes all the way up to 800 mg !). Ivor believes that anti-psychotic medication (mainly tranquilizers) should be used for as short a time as possible in as low a dosage as possible.

Having met doctors that seemed closed and programmed, I found myself sitting in front of someone who was very open-minded and didn’t dismiss some of the things that I said. He was able to “listen to my human story, validate my feelings and then offer an alternative perspective”, to use a phrase from clincial Psychologist Lucy Johnstone. He worked in a very methodical way and gave me an action plan at the end, at a time when my life was lacking direction. He told me that I needed to “take back control of my life”. Whether I have or not over 6 years on is debatable. Life has been a struggle since mainstream Psychiatric intervention. At the same time I’ve learned from my Tao meditations “No one can know you as well as you can know yourself. All that you can gain from a wise person is the assurance of some initial guidance”.

My maternal grandmother that I was very close to died suddenly when I was 11 years old. No one really talked to me about her death at the time. It was a major trauma for me. In one of my Regression therapy sessions I found myself walking up a hill with her, close to the little cottage she lived in. It was like I was there and reliving the experience. Regression therapy can be quite powerful. Afterwards I sat by the sea and processed what came up in that session. I also wrote about it after as part of homework for Ivor and processed some of the emotions surrounding her death. Which was 34 years earlier.

Giving away power to others

One of the important pieces of advice Ivor gave me was not to give my power away to other people, yet I seem to continually do so on a regular basis. It took me a long time to understand how not to give my power away and I’m still a work in progress.

While we are told by various campaigns to be open about mental health and to talk, we really have to be careful about who we talk to. While it’s not good to bottle up emotions and what we are thinking, if in distress, we also have to tell people on a need to know basis e.g. a therapist or a trusted friend. And to protect ourselves by maintaining appropriate boundaries and not over sharing with people in our social circle or community. At times however sharing how I feel has been a coping strategy, in dealing with distressing emotions.

Another way we give away power is explained in the 7 Habits of Highly Effective families [10] ~

Each time you build your emotional life on the weaknesses of others, you give your power away to their weaknesses so that your emotional life is a product of how they treat you. You disempower yourself and empower the weaknesses of others.

For example, I focused a lot on what I see as the cruelty of others in my initial treatment. Societies lack of good knowledge around mental health was a weakness that directly impacted my life. I invested a lot of energy emotionally in reacting to this injury. It particularly bothered me at night where I was left ruminating on past hurts. This was affecting my sleep but also taking up valuable head space. As well as causing me distress. It was disempowering. And still is sometimes.

I’m working on learning not to dwell on the hurt and distracting myself, so that my thought processes and energy can be spent on more productive things and on moving my life forward. I have accumulated a lot of important knowledge around mental health over the years and want to share that knowledge with others. If I had this knowledge back in 2008 when I went through a crisis, my healing process would be less painful and more successful. Thanks to all those who have helped me and who have been patient and supportive.

{ Note ~ What I discuss in part of this blog is my own experience and is not medical advice. We all have our own unique journey}

References

[1] Good Practice Guidelines on the use of Psychological formulation ~

https://www1.bps.org.uk/system/files/Public%20files/DCP/cat-842.pdf

[2] Understanding Psychosis and Schizophrenia ~
https://www1.bps.org.uk/system/files/user-files/Division%20of%20Clinical%20Psychology/public/CAT-1657.pdf

[3] When therapy causes harm ~

http://thepsychologist.bps.org.uk/volume-21/edition-1/when-therapy-causes-harm

[4] Irish Association for Counselling and Psychotherapy ~ www.iacp.ie

[5] Joanne Cacciatore and the MISS Foundation that helps grieving families ~

http://missfoundation.org/about/joanne-cacciatore

[6] The Feeling Good Handbook by David D. Burns, 1999

www.amazon.com/Feeling-Good-Handbook-David-Burns/dp/0452281326

[7] Music and Madness by Ivor Browne, 2008 ~

https://www.amazon.co.uk/Ivor-Browne-Music-Madness/dp/0955226120

[8] The Writings of Ivor Browne: Steps Along the Road, the Evolution of a Slow Learner, 2013 ~

www.amazon.co.uk/Writings-Ivor-Browne-Evolution-Learner/dp/1855942194

[9] Dr Michael Corry at 19 mins discusses the lack of training of Psychiatrists in the area of therapy www.theenchantingvalley.ning.com/video/dr-michael-corry

[10] The 7 Habits of Highly Effective Families by Stephen Covey, 1998

www.amazon.com/Habits-Highly-Effective-Families/dp/0307440850

Ivor Browne

The Frozen Present ~
http://networkmagazine.ie/articles/ivor-browne-frozen-present

Trailer for Meetings with Ivor documentary (which will air on RTE1 on 14.08.2017) ~
https://www.youtube.com/watch?v=uILm5nUoyJI

Article I wrote for a holistic magazine after going to see Meetings with Ivor ~
http://networkmagazine.ie/articles/meetings-ivor

Pat Kenny interviews a young girl called Ruth O’Doherty that Ivor helped ~

www.newstalk.com/podcasts/The_Pat_Kenny_Show/The_Pat_Kenny_Show_Highlights/93403/

Musician Dylan Tighe speaking to Ivor Browne ~ www.mixcloud.com/corkmidsummer/talking-theatre-dylan-tighe-in-conversation-with-prof-ivor-browne-and-chaired-by-dylan-haskins/

Other Resources

* Eye Movement Desensitization and Reprocessing (EMDR) “is a psychotherapy treatment that was originally designed to alleviate the distress associated with traumatic memories” ~
http://www.emdr.com/what-is-emdr/

* Don’t Let Your Emotions Run Your Life: How Dialectical Behavior Therapy (DBT) Can Put You in Control by Scott Spradlin, 2003 ~

www.amazon.com/Dont-Let-Your-Emotions-Life/dp/1572243090

* What Is Dialectical Behavior Therapy?

https://www.psychologytoday.com/therapy-types/dialectical-behavior-therapy

* The Body Keeps the Score by Dr Bessel van der Kolk, 2015 ~
https://www.amazon.co.uk/Body-Keeps-Score-Transformation-Trauma/dp/0141978619/

* The lifelong cost of burying our traumatic experiences ~
https://www.newscientist.com/article/mg22429941-200-the-lifelong-cost-of-burying-our-traumatic-experiences/

* Waking the Tiger: Healing Trauma by Peter Levine, 1997 ~

https://www.amazon.com/Waking-Tiger-Healing-Peter-Levine/dp/155643233X

* In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness

By Peter Levine, 2010 ~

https://www.amazon.com/Unspoken-Voice-Releases-Restores-Goodness/dp/1556439431

* Peter Levine Demonstrates How Trauma Sticks in the Body ~
https://www.youtube.com/watch?v=fiq0sILHiJs

* Conversation with Alanis Morissette & Dr. Peter Levine (includes discussion on Panic Attacks) ~
https://www.youtube.com/watch?v=wDK09A49tRU

* 8 Tips to Help Stop Ruminating ~
www.psychcentral.com/blog/archives/2014/02/16/8-tips-to-help-stop-ruminating

* “The Power of your subconscious mind” by Joseph Murphy ~

www.amazon.com/The-Power-Your-Subconscious-Mind/dp/1614270198

* The Efficacy of Play Therapy With Children: A Meta-Analytic Review of Treatment Outcomes

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.472.68&rep=rep1&type=pdf

Definitions

Family therapy “is a type of psychological counseling (psychotherapy) that helps family members improve communication and resolve conflicts” www.mayoclinic.org

Logotherapy “was developed by neurologist and psychiatrist Viktor Frankl. … Rather than power or pleasure, logotherapy is founded upon the belief that it is the striving to find a meaning in one’s life that is the primary, most powerful motivating and driving force in humans” (Wikipedia).

Psychosocial relating to the interrelation of social factors and individual thought and behaviour.

An Open Dialogue around ‘Psychosis’

“The deepest hunger of the human heart is to be understood” Stephen Covey

Psychosis_hand

Cabiria, 1914 (from a silent movie by Giovanni Pastroni). Trying to capture how terrifying Psychosis sometimes feels like, which is difficult and the clip that goes with this photo reminded me of the experience.

In November 2014 I went to the launch of the lengthy report “Understanding Psychosis and Schizophrenia” by the British Psychological Society (BPS) in London. There I got to meet and hear from some of the top experts and clinical Psychologists in the UK. A revised version was published in 2017 [1].

‘Psychosis’ is a loss of touch with reality, which is usually temporary. Because the general population don’t understand it, they can overreact. The person themselves may feel quite confused & scared. Especially if it’s their 1st experience. It can involve unusual perceptions e.g. the person feels they are under attack from evil and the need to protect themselves. In my experience, how I protected myself was influenced by religious upbringing. I even started to go to Latin mass to try and calm my brain down. While some would have frowned upon that at the time, for me it was a coping mechanism. I only occasionally go to a church these days. Usually to light a candle and to sit in silence for a while.

As an example of one of my “psychotic breaks”, in my last experience I decided that the town I live in, which is prone to flooding as it is built on a river, was going to become immersed in water. I checked into a hotel that was a few stories high & took a bus to a ‘safer’, inland county. At the time I was frightened. It wasn’t based on reality but could have been based on news reports and worries about climate change. Stress and lack of sleep would have been a trigger, plus the fact that I was still going through drug withdrawal. It took at least two years to get the main effects of long term use of prescribed psychotropic drugs out of my system and I was left with long term sleep issues, the effects of which I still feel to this day.

Psychosis can be triggered by anti-depressant use and severe lack of sleep / stress [2]. I had been on anti-depressants for anxiety / panic attacks for 3 years when I had a ‘psychotic break’ in August 2008. Other illicit drugs can also trigger psychosis e.g. skunk cannabis [3].

Trying to make sense of the symptoms can help. In the context of the person’s life. As through making sense of experiences or learning to process them, a person is more likely to recover.

Usually the people around you will not understand and might not be supportive. I went through my last ‘psychotic break’ alone (2012). I would not recommend that but maybe getting through it alone is why I no longer fear it. There was also a Spiritual aspect to the experience and I wish I kept notes at the time to give me more insight into what I was going through. In my terrified state, particularly at night time, with no support around me, I used the online work of Sean Blackwell to help me through. “Bipolar or Waking up?” [4, 5, 6]. I do believe this was more of an awakening and a spiritual journey. A part of my own evolution as a soul on this planet.

A significant percentage of people hear voices and for many this is not a problem. If the person hears voices that are distressing or ask them to harm themselves or others and the person finds this overwhelming, they would need help and support in coping with the voices. There are people who have managed to integrate their voices into their lives, without been affected negatively by them e.g. Eleanor Longden [7] , Jacqui Dillon [8] and Rai Waddingham [9]. Dutch Psychiatrist Dr Marius Romme has also done a lot of great work in the Hearing Voices Movement [10]. Some children also hear voices and may need support.

Others experience hallucinations. If the hallucinations affect a persons quality of life, including ability to work, sleep and relate with others, the person may need help in dealing with their experiences.

Open Dialogue

I’m a believer in the Open Dialogue approach, where the person should be involved as much as feasibly possible in decision making about their care or treatment plan [11, 12].

Open Dialogue includes the gathering of clinicians, family members, friends and other relevant persons for a joint discussion. It was started in Lapland by Jaakko Seikkula et al. It is also used in other countries eg the Parachute project in New York [13]. In West Cork a successful pilot project was implemented [14, 15]. It would be great to see widespread use of this approach. If a more traditional, backward approach is used it can lead to more dysfunction within a family and the fracturing of relationships, sometimes long term, in my experience. It is important to get the approach right at the start. Not everyone will want family involved in their care.

I write more about the trauma of what happened me in 2008 in the blog Anti-depressants are great, until you have an Adverse Drug Reaction, where I outline some of the things that would have helped at that crucial time. Because of the way people in ‘psychosis’ are treated, I ended up with Post Traumatic stress for the past decade, which is only starting to ease recently. It has improved via therapy and hard work on my self, but it is something that will probably always be there are a protective force in my life. A necessary hyper vigilance and a lack of trust in others!

I have learned as much as I can about what is helpful when a person is in distress. I’ve dedicated several years to learning via reading, listening to audio/visual presentations (of experts I respect), courses, conferences and various short training sessions. A summary version of what happened to me can be found under Other Relevant Resources at the end of this blog.

During my first ‘psychotic break’ (where I had not harmed myself or others) I needed:

  • truth and honesty about the anti-depressant drug I was on & its adverse effects (2)

  • An Open Dialogue approach

  • Re-assurance that my stay in the hospital was temporary ( the survival part of my brain was convinced I would be there for a very long time, possibly forever. This left me in a very distressed and agitated state and naturally so)

In places like Finland, where they employ the Open Dialogue approach and where prescribed psychoactive drugs are not the main form of treatment, they have proven that recovery is possible. They use early intervention and involve the person in decision making. In general, instead of the person ending up on disability, they go back to being productive members of society.

Below is now 89 yr old Prof Ivor Browne giving a talk in the National College of Ireland in 2015. As opposed to being “anti-drug”, Prof Ivor Browne believes in using the lowest dosage of tranquilizing drugs possible for as short a time as possible. Ivor explained that people need help in understanding the psychotic process. He also recognises the importance of therapeutic relationships, personal friendships and loving relationships, when it comes to healing from trauma and distress. What are referred to as “Anti-psychotics” e.g. Olanzapine, as mainly major tranquilizers.

Anti_psychotics

For people to have “Recovery spaces”, they need to be with supportive people who can tolerate, be patient and interact with the person in ‘Psychosis’. Soteria is a network of people in the UK promoting the development of drug-free and minimum medication therapeutic environments for people experiencing ‘psychosis’ or extreme states [16]. If a person is a carer for someone in emotional distress e.g. a family member, the long term goal should be to enable the person they are caring for.

The public have learned to associate the word ‘psychosis’ with violence and there is not necessarily a link, unless drugs or alcohol are involved [17, 18]. That can include prescribed psychotropic substances or withdrawal from these drugs [19].

People in distress need hope that they can recover and heal. Education from reliable, unbiased sources is an important part of that healing journey. As are supportive and understanding people who can hold space for the person in distress. These support networks also need education around Psychosis, what is helpful and what is not. Being judgemental, getting into arguments with the person, being critical and dismissive of their experience is usually unhelpful. Trying to stay calm and creating a calm space for the person, where they are not over stimulated, might be helpful. Everyone is an individual and has their own unique journey and experience.

Note: This blog is not medical advice and is mainly based on my own experience. But also on my extensive interest and learning in the whole area. Do not stop or change prescribed psychotropic drugs without advice, due to the dangers of withdrawal. Any changes need to be made slowly, under the supervision of an expert in this field. At the start of my journey I was never given that advice from the ‘experts’ I was dealing with and this delayed my healing journey.

Minor and major tranquilizers did help me at times e.g. with sleep, which can help restore some normality. But overall, in hindsight, I found that the large cocktail of drugs I was on (over a 3 year period) fueled symptoms, as opposed to ‘curing’ them. “The ethical use of psychotropic drugs is perhaps the single most important aspect of Psychiatric care that requires urgent attention” Dr Phil Thomas [20, 21].

References

[1] Understanding Psychosis and Schizophrenia, revised version 2017 ~

https://www.bps.org.uk/system/files/user-files/Division%20of%20Clinical%20Psychology/public/CAT-1657.pdf (Edited by Anne Cooke)

[2] Antidepressant-associated Mania and Psychosis resulting in Psychiatric admissions. Yale study (2001) www.ncbi.nlm.nih.gov/pubmed/11235925

[3] Smoking skunk cannabis triples risk of serious psychotic episode, says research, 2015 ~

https://www.theguardian.com/society/2015/feb/16/skunk-cannabis-triples-risk-psychotic-episodes-study

[4] Am I Bipolar or Waking Up? Sean Blackwell, 2011 ~

http://www.amazon.com/Am-I-Bipolar-Waking-Up/dp/1461178258

[5] Sean Blackwell’s work ~ www.youtube.com/user/bipolarorwakingup

[6] Corrina Rachel speaking to Sean Blackwell about Bipolar ~

www.youtube.com/watch?v=WLIeS6idzD4

[7] TED video by Eleanor Longden (Voice Hearing) ~

www.ted.com/talks/eleanor_longden_the_voices_in_my_head?language=en

[8] Jacqui Dillon (Voice Hearing) ~

www.rte.ie/radio1/doconone/radio-documentary-sounds-mad-hearing-voices-psychology.html

[9] Rai Waddingham ~ http://www.behindthelabel.co.uk/

[10] Hearing Voices Network ~ www.hearing-voices.org

[11] OPEN DIALOGUE: an alternative Finnish approach to healing psychosis (by Daniel Mackler) ~

https://www.youtube.com/watch?v=HDVhZHJagfQ

[12] A collection of resources on Open Dialogue and Open Dialogue practices ~

http://willhall.net/opendialogue/

[13] New York ‘Parachute’ programme for people with acute mental distress lands in the UK ~

https://www.theguardian.com/society/2015/oct/20/parachute-therapy-psychosis-new-york-uk

[14] Mental health pilot focus of Finnish film ‘Open Dialogue’ ~

http://www.irishexaminer.com/ireland/mental-health-pilot-focus-of-finnish-film-open-dialogue-393492.html

[15] A fresh approach to mental health ~
http://www.irishexaminer.com/lifestyle/features/a-fresh-approach-to-mental-health-396031.html

[16] Soteria ~ www.soterianetwork.org.uk

[17] ‘Mental disorders’ are neither necessary nor sufficient causes of violence ~ 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525086/

[18] Dispelling the Myth of Violence and Mental Illness ~

https://psychcentral.com/archives/violence.htm

[19] Prescription Drugs Associated with Reports of Violence Towards Others

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0015337

[20] Psychiatry in Context : Experience, Meaning & Communities by Dr Philip Thomas

https://www.amazon.com/Psychiatry-Context-Experience-Meaning-Communities/dp/1906254729

Dr Philip Thomas highlights the limitations of neuroscience in explaining Psychosis or distress. He also explores how Racism plays a key role in many black people’s experience of Psychosis.

[21] My review of this book ~ www.goodreads.com/user/show/46943899-anne

This review was published in the Journal of Critical Psychology, Counselling and Psychotherapy (Volume 16, Number 1, March 2016)

Other relevant Resources

* ‘I was unaware of potential adverse effects to my prescribed antidepressants’

https://www.independent.ie/life/health-wellbeing/mental-health/aines-story-i-was-unaware-of-potential-adverse-effects-to-my-prescribed-antidepressants-31218347.html

* One woman’s account of suffering from Psychosis ~

www.todayfm.com/One-womans-account-of-sufferinbg-from-psychosis

* Course ~ Caring for People with Psychosis and Schizophrenia (pharma funded which influences the advice given) ~

https://www.futurelearn.com/courses/caring-psychosis-schizophrenia

* Intervoice (International Hearing Voices Projects) ~ www.intervoiceonline.org

* Hearing Voices Network Ireland ~
http://hearingvoicesnetworkireland.ie/

* The Icarus Project ~ http://theicarusproject.net/

* CRAZYWISE – Official Extended Trailer ~ https://www.youtube.com/watch?v=iKfQd0bk214 

* Peter Lehmann “Recovery from Psychosis and Depression by Taking Psychiatric Drugs versus Recovery by Coming off Psychiatric Drugs”

www.peter-lehmann-publishing.com/articles/lehmann/pdf/recovery-from.pdf

* 8 Tips to Help Stop Ruminating ~
www.psychcentral.com/blog/archives/2014/02/16/8-tips-to-help-stop-ruminating

Lets blame genetics. Or not ?

In my experience, claiming Manic Depression / Bipolar is genetic :

a) allows mental health professionals to rush to a wrong diagnosis, without examining the facts before their eyes e.g. the person may be having a drug reaction.

b) increases social stigma and discrimination. Including from within the family itself.

c) can leave the person thinking they can do nothing about their symptoms, as opposed to helping empower the person to bring about change in their own lives. Which requires daily work on physical / mental health and a holistic approach.

d) leaves those who have children anxious that their children could be next or those who have had a parent with this diagnosis anxious. This sometimes becomes a self-fulfilling prophecy.

Thanks to the work of people like Dr Yolande Lucire, there is one aspect of genetics however that may be very relevant. Sometimes people genetically can’t metabolize certain drugs [1]. Forensic Psychiatrist Dr Yolande Lucire explains that not all people are born with a full complement of metabolizing enzymes, increasing the risk of side effects which can range from mild to life-threatening. Changing dosage up or down and starting / stopping drugs are also crucial times, sometimes affecting the person months after stopping. “There is a genetic problem in the cytochrome P450 (CYP450) family of metabolizing genes”.

It can be drugs that are causing the symptoms (prescribed or illicit). Those who have experienced trauma in life may be more likely to end up on prescribed drugs in the first place. In my own experience I was prescribed the drug Citalopram as I was suffering from severe anxiety and panic attacks, which would link back to some trauma in childhood and probably some lifestyle factors. This anti-depressant triggered mania and psychosis leading to a diagnosis of “Bipolar” in 2008, without factoring in that the drug was more than likely a major cause of my symptoms. I also have a 1st cousin that took a similar drug (Escitalopram/Lexapro) and ended up with the same diagnosis! My father was also given the label Manic Depression and experienced symptoms up until 1983 (which was for about a decade and then didn’t have obvious symptoms for the ten years up until his death in 1993). I now know that drugs can cause highs and lows. One day I will have the relevant test based on Dr Lucire’s work.

In many families there is a certain amount of dysfunction and inter-generational trauma. Not forgetting in Ireland it’s only a few generations ago that we had the trauma of the Famine. In my case about 4 or 5 generations back, as my grandparents were born in the late 1800s or very early 1900s. It may be more helpful to explore these traumas. Family therapy may also have a role to play.

Generations of families, especially in Ireland, have been indoctrinated into the flawed biomedical model. It can sometimes be more convenient to blame genetics than address issues and struggles within the family. Or within society itself.

In my opinion and there are experts that say this, research into genetics is not a priority. Money would be better spent on supporting families where a parent is going through emotional distress, in parenting courses and in helping children build resilience. Young people would benefit from learning about stress management and how to cope with anxieties early on in their lives [2]. They also need support with trauma e.g. if their parents separate or any childhood bereavement. Play therapy can also help younger children work through certain issues [3]. Play therapy is “a form of counseling or Psychotherapy in which play is used as a means of helping children express or communicate their feelings”.

Quote from Psychiatrist Dr Joanna Moncrieff ~ “The idea that we are doomed by our genetic make-up to develop life-threatening or disabling conditions is surely a profoundly depressing one. We will likely never be able to fully account for why some people experience extreme mental states, but we know that poverty, unemployment, insecure attachments, familial disruption, low self-esteem, abuse etc. play a role for many. We would be better concentrating on how to eliminate these from our society if we really want to reduce the impact of mental disorder, rather that pouring more money into the bottomless pit of genetic research” [4]. While this article is about “Schizophrenia”, this can also apply to Manic Depression / Bipolar.

When it comes to Manic Depression/Bipolar, no true biomarkers have been found and no significant genetic abnormalities have been reliably identified, that I’m aware of. When I wake up in the morning, whether or not mental health issues are genetic is irrelevant. Once I let go of blaming “faulty genetics” and started to see a more holistic picture of health, there was a lot more room for healing. When it comes to mental health there is nothing wrong with my genes. I feel we are a bit more prone to anxiety than some. There are people in my family who have had a lot of success in life.

References

[1] Adverse Drug Reactions ~

http://www.drlucire.com/adverse-drug-reactions.html

[2] 7 Ways to Help Students Who Struggle with Anxiety ~

www.weareteachers.com/7-ways-to-help-students-who-struggle-with-anxiety/

[3] The Efficacy of Play Therapy With Children: A Meta-Analytic Review of Treatment Outcomes ~

https://pdfs.semanticscholar.org/c74c/5352290babfa53960f1f6e74c2591ef3e88b.pdf

[4] A critique of genetic research on schizophrenia – expensive castles in the air ~

www.joannamoncrieff.com/2014/09/01/a-critique-of-genetic-research-on-schizophrenia-expensive-castles-in-the-air/

Other Relevant Information

* The 7 Habits of Highly Effective Families by Stephen Covey, 1998 ~

www.amazon.com/Habits-Highly-Effective-Families/dp/0307440850

* R D Laing used work of Nash and Game theory to study human relationships (18 & 25 mins) ~

www.ruthenians.net/kArpatia/portfolio/the-trap-episode-1-fk-you-buddy/

* Music and Madness, Prof Ivor Browne, 2008 ~

http://www.amazon.co.uk/Ivor-Browne-Music-Madness/dp/0955226120

Ivor talks about the family in here (don’t have access to this book at the moment but will come back to this again)

* ‘Physician heal thyself’ may be impossible task for a Psychiatry profession in crisis ~

www.theconversation.com/physician-heal-thyself-may-be-impossible-task-for-a-psychiatry-profession-in-crisis-30845

“Today’s Psychiatry has strong eugenic roots in this 19th-century political philosophy. Its current obsession with genetics maintains that tradition”

* The Secret Life of a Manic Depressive presented by Stephen Fry

www.topdocumentaryfilms.com/stephen-fry-the-secret-life-of-the-manic-depressive/

(some reference to genetics in here but nothing of real significance found. Not forgetting that some people in this documentary had taken cocaine, which can cause highs / lows).

Definitions

Family therapy “is a type of psychological counseling (psychotherapy) that helps family members improve communication and resolve conflicts” www.mayoclinic.org

“Family systems therapy draws on systems thinking in its view of the family as an emotional unit. When systems thinking—which evaluates the parts of a system in relation to the whole—is applied to families, it suggests behavior is both often informed by and inseparable from the functioning of one’s family of origin”

https://www.goodtherapy.org/learn-about-therapy/types/family-systems-therapy

Pharmacogenetics “is the study of inherited genetic differences in drug metabolic pathways which can affect individual responses to drugs, both in terms of therapeutic effect as well as adverse effects” (Wikipedia)

What is Bipolar / Manic Depression ?

“Giving someone a Psychiatric diagnosis is an immensely powerful act which has profound implications for their identity, relationships place in the community, employment, health and future” Lucy Johnstone, clinical Psychologist

Bipolar / Manic Depression can involve extremes of high and low mood, including depression and periods of elation, over activity and irritability (mania). A person’s sleep can be affected, sleeping more when depressed or not feeling the need for much sleep when in mania or hypomania (the word used to describe a milder version of mania). They can lose the concept of money and spending. As well as lose the sense of time. Some people also experience psychosis (a temporary loss of touch with so called reality).

Depression and Manic Depression can be caused by a number of things including poor nutrition, unresolved trauma from childhood, poverty, unemployment, work related stress, lifestyle choices, life circumstances and thought processes.

Manic Depression can impact a person’s life in several ways, so it is important when the symptoms first develop that the person gets the empathy and understanding they need, as well as the most accurate and honest information available. How the first episode is dealt with can have a big impact on the speed of recovery and potential future episodes.

What causes Manic Depression / Bipolar ?

When it comes to Manic Depression, no true biomarkers have been found and no genetic abnormalities have been reliably identified. “A biological marker is an identifiable biological abnormality that consistently and reliably demonstrates the presence of a particular disease … The lack of any investigative tests relative to the diagnosis and management of Psychiatric disorders is striking” Dr Terry Lynch [1].

We are told that Manic Depression is a “disease” yet there is no evidence there to back this up. The drugs used to treat mania / psychosis are basically strong tranquilizers eg Olanzapine, Quetiapine etc Some people claim that Lithium helps. Others feel it doesn’t. In my experience, there is a lot more to be gained from looking from an environmental and emotional perspective. Including addressing lifestyle issues.

When it comes to the “chemical imbalance” theory, it is not possible to measure neurotransmitter levels in the brain of a live human. Information sources e.g. brochures sponsored by drug companies, make unscientific and unproven claims that anti-depressants rebalance brain neurotransmitter levels.

However, it’s been known since at least 2001 that anti-depressants, instead of bringing “balance”, can lead to mania & psychosis in some people [2]. These drugs do not “unmask” serious mental health conditions, as some Psychiatrists try to claim. They cause them.

Potential adverse effects of anti-depressants are not highlighted enough to ensure the person has informed consent. “Anti-depressants” can turn mild / moderate, temporary feelings of Depression into a more chronic condition called tardive dysphoria, according to medical journalist Robert Whitaker and his research. This has been my experience of the drug Citalopram [3].

Prior to initiating treatment with an antidepressant, patients with depressive symptoms should be adequately screened to determine if they are at risk for bipolar disorder; such screening should include a detailed psychiatric history, including a family history of suicide, bipolar disorder, and depression” [4]. Due to family history relating to my father I should never have been put on an antidepressant for anxiety as it triggered mania/psychosis and resulted in a diagnosis of Bipolar. Something similar happened to my 1st cousin.

According to Dr John Studd, in women sometimes severe Premenstral tension is misdiagnosed as Bipolar with tragic consequences. “Examples are given of patients who have had between 5 to 20 years of mood stabilising drugs, multiple admissions to hospital, ECT and in one case severe renal damage due to 20 years of Lithium. It is not known how frequently severe PMS is misdiagnosed as Bipolar disease by Psychiatrists but it does occur”. [5]

In the current system people are told that Bipolar is a life long illness that will require medication for life. Such a prognosis, while being very lucrative for the pharma industry, can be a life sentence for many and also takes away hope of true healing. With the right information and knowledge, healing is possible.

In her book clinical Psychologist Lucy Johnstone highlights that the process of recovery has to start with the most accurate description of what is going on for the person [6]. In the current system this sometimes gets hidden, overlooked or forgotten, in the rush to label and prescribe psychoactive drugs.

I found the book by Declan Henry called Why Bipolar? to be very good. A review of this book that I wrote can be found here [7].

The work of Sean Blackwell was a big part of my own recovery journey, as I was left to deal with my last episode of mania/psychosis alone (December 2012). Not something I recommend but I got through it and haven’t experienced ‘Psychosis’ since [8]. See my blog entitled An Open Dialogue around Psychosis.

Dr Terry Lynch has also a great insight into Bipolar and has set up online courses [9]. And this is what Prof Ivor Browne has to say “Every third person who comes to me now is labelled Bipolar … If you looked back, that was once considered a rare condition and what’s more, most people eventually recovered” [10].

In the field of mental health people need to be as informed as possible as some day, without much warning, we can find ourselves, a relative or a friend coming in contact with the current mental health system. While some people may feel they benefit from been told they have Bipolar, in my experience with the stroke of a pen a Psychiatrist can change a person’s life. For a decade I’ve been left picking up the shattered pieces. I am a work in progress. On one levels it has been a Spiritual journey. If only that side of the experience was recognised at the beginning and supported in a therapeutic way, as opposed to the over reliance on the dominant biomedical / drug approach which caused a lot of trauma, suffering and harm, delaying my healing.

Tips on Dealing with Symptoms of Bipolar

“Honour the physical temple that houses your body by eating healthfully, exercising, listening to your body’s needs and treating it with dignity and love” Wayne Dyer

One way to manage Mania is not to engage too much with the Ego. I learned about the Ego in Eckhart Tolle’s book A New Earth [11]. “Unless you know the basic mechanics of the Ego, it will trick you into identifying with it again and again”.

Other ways of managing the highs and lows of Manic Depression ~

  • Develop a good sleeping pattern and wind down in the evening

  • Learn about nutrition & cook nutritious meals. Watch diet and sugar intake. Take a good quality multi-vitamin (without copper). Learn about foods that help to balance mood [12]

  • Avoid too much stimulants e.g. a doctor once advised me that I should have only one coffee a day and in the morning

  • Work on developing self-awareness, as sometimes awareness is lost during an episode e.g. with money & spending. Learn to recognise the symptoms at an early stage and use techniques to get some balance back. Keeping a journal.

  • When you develop self-knowledge, work with that knowledge and try not to repeat past mistakes

  • Use a calendar or yearly diary / planner to track changes in symptoms

  • Don’t be seduced by the “high” as it can be very seductive. Try not to feed it and not to over-stimulate yourself.

  • Mind yourself and take it easy, but at the same time have goals

  • Avoid alcohol or street drugs. Alcohol is like adding fuel to the fire. It can make the highs higher and the lows lower.

  • Learn about WRAP (Wellness Recover Action Plan) and have a WRAP plan [13]. The plan needs to be very specific about the steps you need to take to alleviate low or overly elevated moods.

  • Identify and resolve triggers, including what can trigger strong emotions and learn constructive ways of dealing with this.

  • Learn how to self-sooth in positive ways. This can be written into the WRAP plan.

  • Develop self confidence and a sense of Self. Dr Terry Lynch wrote a good book called Selfhood [14].

  • Try to create a support network made up of people who are understanding of the symptoms and supportive of your healing journey. Join a support group.

  • Work on relaxation daily e.g. daily meditation, Yoga, learn to breathe properly

  • Drink enough water

  • Stay hopeful for Recovery and healing. Visualise the end result.

  • Bibliotherapy ~ reading books can help with mood but some of what’s learned from books will need to be put into action for the knowledge to be effective.

  • Develop structure in the day and week. Manage time as much as possible. Use a diary.

  • Write down important things that need to be done each week.

  • Work with your skills, strengths and creativity

  • Work towards achieving balance in the various areas of life. The Happiness Habit identifies the following areas ~ Career & Finance, Personal development, Health & Fitness, Spiritual, Contribution, Family & Social, Fun & Creativity, Mental & Emotional [15]

  • Ask yourself the question if you had only one month to live what would you do

  • Learn to replace bad habits with more useful habits and build this into a daily routine

  • Reward yourself each time you make progress and remind yourself how much better you are getting. When it comes to any setbacks be gentle and kind to yourself, like you would be with a good friend. Pick up the pieces and start again.

  • Accept where you are on your journey

  • Practice self-compassion. Try not to be too self-critical.

  • Let go of Perfectionism

  • If there is trauma from the past or issues that need to be discussed, some Psychotherapy and/or counseling can be helpful.

  • People need to feel that their life has meaning and a purpose and to be able to make a contribution to their community [16]. This may be through paid work or voluntarily. It may not be possible to work, but having a part-time or full-time job can give the week structure. Some jobs are more stressful than others, so that needs to be factored in. People should not be pressured about their work status but instead should be gently encouraged or told about potential opportunities that are out there. Trying to intimidate a person about their work status can be very unhelpful. Some people are doing their best. Their is a lot of social stigma out there relating to unemployment.

There is an energy that comes from a mild ‘high’ (hypomania) that just needs to be channeled in the right direction. I try to be self-aware of my mood and take corrective action. Even 10 mins of Yoga and some meditation can help ground me.

Recovery and healing usually just doesn’t happen. Time has to be made for it. Changes need to be made in daily and weekly routines. Sacrifices may have to be made to make progress. The body needs balance and depends on biorhythms. Regular eating and sleeping patterns are important. And routine.


Bipolar InOrder

Tom Wootton founded Bipolar Advantage with the mission to help people with mental conditions shift their thinking and behavior … His most recent work focuses on moving beyond recovery in bipolar disorder to what he calls Bipolar In Order” … “The medical model that only sees Bipolar as a disorder or an illness is not working. The assessments, tools, and goals are all based on the idea that Bipolar is a disease that must be managed toward reduction if not completely eliminated. It is a system that has been proven not to work by their own studies and is unacceptable given that we have already produced much better outcomes” [17].

Wootton lays out his roadmap for living with bipolar disorder not as a disorder or condition that needs to eradicated and “cured,” but one that needs to be better understood and accepted – and even embraced – by oneself. Embraced in the sense of understanding the pros and cons of one’s moods and finding a balance to bring them into a state where one can live with them and leverage them to improve one’s life” [18].

Lithium

To write about the subject of Lithium I have consulted Dr David Healy’s book “Mania: A Short History of Bipolar Disorder” [19]. Some quotes and information at the start of this blog are from his book.

As an alkaline substance, Lithium was initially used to treat gout and rheumatic conditions. “While using Lithium to treat gout, Garrod reported that patients often showed a general sense of well-being”, pg. 92. Considering the more recent knowledge about inflammation that functional medicine doctors discuss, I find this interesting.

The key individual in the emergence of a prophylactic use of Lithium for mood disorders is Carl Georg Lange”, pg. 94. Another person to use Lithium with some success in treating Manic symptoms in patients was John Cade in Australia. However the toxic effect of Lithium carbonate caused the death of some of his patients. “The use of Lithium was linked to cardiac difficulties and it was banned by the FDA in 1949 … The question of toxicity highlighted the need to establish a safe dose and to be able to monitor treatment”.

But consider what makes for a placebo response. The natural history of mood disorders means that many will improve within a few weeks whether treated or not. It is also widely thought that sensible clinical advice on matters of diet, life-style, alcohol intake, and work and relationship problem solving may make a difference. It is suspected that patients’ perceptions that they are being cared for by a medical expert may make a difference, and this effect may be enhancing by being given a substance they think will restore chemical imbalance to normal – even if that imbalance is mythical and the substance is placebo. The fact that the patients present themselves for treatment may also make a difference. All of these factors are reflected in the placebo response. But it is not possible to quantify the distinct contribution of these components” pg. 129.

My experience on Lithium

I now want to talk about my own experience with Lithium and some of the things I learned when on it. It may under certain conditions lead to kidney damage and/or damage to the thyroid. If a woman becomes pregnant on Lithium it can damage the developing foetus.

In 2008, after my Adverse Drug Reaction to the anti-depressant Citalopram and when mainstream Psychiatry had hastily slapped on the label Bipolar 1 (while ignoring advice in DSM-IV-TR [20]) I was put on Lithium. According to Dr Healy’s book, Bipolar 1 only affects about 1 in 100,000 people, so it is a rare condition. I’ve also learned that from Prof Ivor Browne. From my reading, I do believe that the overuse of anti-depressants is one of the factors that have caused the current Bipolar epidemic.

When I was introduced to Lithium, it appeared to be informed consent at the time. Someone talked to me about this drug and I was given some material to read, but it wasn’t true informed consent. I wasn’t fully aware of the truly toxic nature of this drug. I was put on 1000 mg and ended up on that dosage for nearly 2 years. I had regular blood tests to see if the the Lithium levels were in the so called therapeutic range, as well as thyroid function tests.

After the anti-depressant Citalopram caused mania / psychosis or what I refer to as “SSRI induced Bipolar type symptoms” (August 2008), I have 9 foolscap pages showing the large cocktail of expensive drugs I was on from when I left hospital in October 2008 up until August 2011. While on Lithium (and Seroquel) I had a long Manic episode in 2010, for about 3 months. I don’t remember Seroquel having any benefit at all. I don’t feel that Lithium did anything for me therapeutically either, in a true sense. I was eventually switched from Seroquel to Olanzapine in June 2010 and things improved i.e. I eventually came out of that horrendous episode, which may have seemed fun at the time but I also remember feeling that I just wanted the “manic” feeling to end.

I also decided to come off Lithium towards the end of that “episode” and I let the Psychiatrist know. I withdrew from Lithium in jumps of 200 mg, which is far too fast a rate. As I write this I wonder why the Psychiatrist didn’t give me a strict warning and a better withdrawal plan. I was still going to see him on a regular basis (up until January 2012 when I left mainstream Psychiatry behind me and their drugs, other than a few 5mg Olanzapine that I kept on standby for a while. These pills eventually went out of date, which in hindsight meant this whole disaster was coming to some kind of ending).

When jumping down off Lithium at what I now realise was a fast rate, I would have gone into withdrawal, with all the symptoms that goes with that. I became very depressed after coming off it and, due to the brainwashing about Manic Depression, felt that this was just part of “my illness”. I was lethargic and lay in bed with not much interest in life. Based on what I now know about the complexity of the withdrawal process, I now see this differently and realise Lithium withdrawal was the cause of my symptoms.

I felt that Lithium blunted my emotions and also remember the day when this “fog” lifted and I started to feel again. I cried when I realised what the drug had done to me. I regret taking Lithium.

My father was on Lithium for years and his thyroid was affected by it. While he died from prostate cancer, I sometimes wonder if the kidney failure he experienced towards the very end of his life had something to do with being on this drug long term!

An Unquiet Mind by Kay Redfield Jamison

When I first read An Unquiet Mind [21] a number of years ago, while still ingrained in the biomedical model and on the drugs, I thought it was a good book. When I re-read it recently I see things differently now, not forgetting that it’s over 2 decades since it was published (1995). Jamison is a talented writer.

When she talks about the marvelous kind of cosmic relatedness, “the webbings of the universe”, and how everything seems interrelated even when sometimes others can’t see, I can relate to that. It tries to describe in words the experience of mania / psychosis (loss of touch with so called reality), which is not so easy to write about or even to describe verbally. A person’s thoughts can become out of control and tolerance can be lacking from others.

She says in her book that she briefly took antidepressants but they only made her more dangerously agitated. She also claims that it is not uncommon for depressed doctors to prescribe anti-depressants for themselves and that the results can be disastrous.

Even though she praises Lithium as a wonder drug in her life, the efficacy and safety of Lithium is not as compelling as she claims. She also admits that she had she continued to experience fluctuations in mood while on Lithium. When she eventually had her dosage of Lithium reduced “it was as though I had taken bandages off my eyes after many years of partial blindness … I wept for the poignancy of all the intensity I had lost without knowing it and I wept for the pleasure of experiencing it again … the subtle, dreadful muffling of the senses”. I can relate to this when I think back to the time I was coming off Lithium.

Dr Jamison talks about the mind healing if it is given a chance. She also mentions how important love is in the healing process and that it can act as a very strong medicine. The love and support of others helped her through.

Several times she refers to the hereditary nature of Manic Depression and she mentions ongoing genetic research, but in reality no true bio-markers have been found. Even today over two decades later. While Dr Yolande Lucire has discovered that there can be a problem metabolizing the drugs and there may be a genetic aspect to that [22], in general nothing of real significance has materialised because of genetic research into Manic Depression / Bipolar, that I’m aware of.

She talks about the brain-damaging effects of stopping medication. While people have to be very careful changing or stopping prescribed drugs, if anything the opposite is true. The drugs cause brain damage. Olanzapine, for example, which came to the market in 1996 [23]. Changes in the brain can sometimes be explained by treatment history, as opposed to “mental illness”. In 2005, a study funded by the maker of Zyprexa / Olanzapine, found that chronic / long term exposure to this major tranquilizer causes shrinkage of the brain. “significant reduction in brain volume that affects both gray and white matter”! I learned about this from honest Psychiatrists Dr Peter Breggin and Dr Joanna Moncrieff. I was put on Zyprexa, at what I now consider too high a dosage (10mg) long term in 2008! I did not have informed consent about this powerful but potentially damaging drug. Very short term use would have been enough and proper advice about withdrawal and stopping. Something I never got from a private hospital. I was let out the door with nothing but a prescription. I ran to the train and thought all was great. I stopped this expensive, powerful tranquilizer as I had not been told doing so would lead to withdrawal symptoms.

2 weeks later I went into what I now know to be withdrawal and akathisia (a severe inner restlessness). I ended up back in hospital for a month, a broken woman. The year that followed is a complete blur and the last decade has been very difficult because of what I was put through. Mainstream Psychiatrists I saw at the time withheld valuable but vital information.

Symptoms are not always beyond our control and we are not as “beholden to medication” as some would like us to believe. But that takes patience, self-discipline, persistence and daily work on physical / emotional well-being. As well as tolerance of setbacks and support from others. I do not believe Bipolar is a life long illness or disease, but if that is what you tell your sub-conscious, it can become a self-fulfilling prophecy. Hope of recovery is a cornerstone of the healing process.

I do feel that my symptoms were mainly iatrogenic i.e. caused by taking the SSRI anti-depressant Citalopram for anxiety (2005 to 2008). I haven’t experienced Mania / Psychosis since December 2012. I was prone to relapse for at least 2 years after all the drugging. Support from doctors was lacking. They seem to have no problem getting you on a drug but stopping their cocktail of drugs is frowned upon.

I still struggle with certain issues e.g. Sleep and irritability (which can be related to hormonal issues). I have problems with my circadian rhythm, which seems to have worsened since I was on all the prescribed psychoactive drugs [24]. I suffer from Tardive Dysphoria, where anti-depressant use turned a milder Depression into a more severe, chronic condition.

I’m all for personal responsibility, but the bottom line is I feel mainstream Psychiatry got it very wrong at the start and caused major, ongoing, devastating trauma in my life on many levels. I’m still coming to terms with that and learning to let go.

“A person should be enabled to reach a point of inner peace, self-empowerment and contentment” Dr Terry Lynch

Lets Blame Genetics or Not ?

In my experience, claiming Manic Depression / Bipolar is genetic :

a) allows mental health professionals to rush to a wrong diagnosis, without examining the facts before their eyes e.g. the person may be having a drug reaction.

b) increases social stigma and discrimination. Including from within the family itself.

c) can leave the person thinking they can do nothing about their symptoms, as opposed to helping empower the person to bring about change in their own lives. Which requires daily work on physical / mental health and a holistic approach.

d) leaves those who have children anxious that their children could be next or those who have had a parent with this diagnosis anxious. This sometimes becomes a self-fulfilling prophecy.

Thanks to the work of people like Dr Yolande Lucire, there is one aspect of genetics however that may be very relevant. Sometimes people genetically can’t metabolize certain drugs [22]. Forensic Psychiatrist Dr Yolande Lucire explains that not all people are born with a full complement of metabolizing enzymes, increasing the risk of side effects which can range from mild to life-threatening. Changing dosage up or down and starting / stopping drugs are also crucial times, sometimes affecting the person months after stopping. “There is a genetic problem in the cytochrome P450 (CYP450) family of metabolizing genes”.

It can be drugs that are causing the symptoms (prescribed or illicit). Those who have experienced trauma in life may be more likely to end up on prescribed drugs in the first place. In my own experience I was prescribed the drug Citalopram as I was suffering from severe anxiety and panic attacks, which would link back to some trauma in childhood and probably some lifestyle factors. This anti-depressant triggered mania and psychosis leading to a diagnosis of “Bipolar” in 2008, without factoring in that the drug was more than likely a major cause of my symptoms. I also have a 1st cousin that took a similar drug (Escitalopram/Lexapro) and ended up with the same diagnosis! My father was also given the label Manic Depression and experienced symptoms up until 1983 (which was for about a decade and then didn’t have obvious symptoms for the ten years up until his death in 1993). I now know that drugs can cause highs and lows. One day I will have the relevant test based on Dr Lucire’s work.

In many families there is a certain amount of dysfunction and inter-generational trauma. Not forgetting in Ireland it’s only a few generations ago that we had the trauma of the Famine. In my case about 4 or 5 generations back, as my grandparents were born in the late 1800s or very early 1900s. It may be more helpful to explore these traumas. Family therapy may also have a role to play.

Generations of families, especially in Ireland, have been indoctrinated into the flawed biomedical model. It can sometimes be more convenient to blame genetics than address issues and struggles within the family. Or within society itself.

In my opinion and there are experts that say this, research into genetics is not a priority. Money would be better spent on supporting families where a parent is going through emotional distress, in parenting courses and in helping children build resilience. Young people would benefit from learning about stress management and how to cope with anxieties early on in their lives [25]. They also need support with trauma e.g. if their parents separate or any childhood bereavement. Play therapy can also help younger children work through certain issues [26]. Play therapy is “a form of counseling or Psychotherapy in which play is used as a means of helping children express or communicate their feelings”.

Quote from Psychiatrist Dr Joanna Moncrieff ~ “The idea that we are doomed by our genetic make-up to develop life-threatening or disabling conditions is surely a profoundly depressing one. We will likely never be able to fully account for why some people experience extreme mental states, but we know that poverty, unemployment, insecure attachments, familial disruption, low self-esteem, abuse etc. play a role for many. We would be better concentrating on how to eliminate these from our society if we really want to reduce the impact of mental disorder, rather that pouring more money into the bottomless pit of genetic research” [27]. While this article is about “Schizophrenia”, this can also apply to Manic Depression / Bipolar.

“Today’s Psychiatry has strong eugenic roots in this 19th-century political philosophy. Its current obsession with genetics maintains that tradition” [28]. When it comes to Manic Depression/Bipolar, no true biomarkers have been found and no significant genetic abnormalities have been reliably identified, that I’m aware of. When I wake up in the morning, whether or not mental health issues are genetic is irrelevant. Once I let go of blaming “faulty genetics” and started to see a more holistic picture of health, there was a lot more room for healing. When it comes to mental health there is nothing wrong with my genes. I feel we are a bit more prone to anxiety than some. There are people in my family who have had a lot of success in life.

{ Important Do not stop or change prescribed psychoactive drugs without consulting your prescriber, due to the dangers of withdrawal. Any changes need to take place under the supervision of an expert. Some people may feel they benefit from Lithium or other drugs I mention here. What I discuss in part of this blog is my own experience and is not medical advice. We all have our own unique journey.}

Note ~ ‘Psychosis’ does not necessarily mean the person will become violent, even though that is how it is portrayed in the media and by some Psychiatrists in the courts. We are not always given the full picture e.g. what drugs or alcohol the person was taking and the effect withdrawal from or stopping drugs, both prescribed and illicit, can have on the person’s mental state.

References

[1] Depression Delusion: The Myth of the Brain Chemical Imbalance ~

www.amazon.com/DEPRESSION-DELUSION-Volume-One-Imbalance/dp/1908561017

My review of this book ~ www.goodreads.com/user/show/46943899-anne

[2] Antidepressant-associated Mania and Psychosis resulting in Psychiatric admissions, 2001

www.ncbi.nlm.nih.gov/pubmed/11235925 (Yale study)

[3] Now Antidepressant-Induced Chronic Depression Has a Name: Tardive Dysphoria, 2011

by medical journalist Robert Whitaker ~

http://www.psychologytoday.com/blog/mad-in-america/201106/now-antidepressant-induced-chronic-depression-has-name-tardive-dysphoria

[4] FDA document Revision of Product Labelling ~ https://www.fda.gov/downloads/Drugs/DrugSafety/InformationbyDrugClass/UCM173233.pdf

[5] Severe PMS and Bipolar Disease – a tragic confusion, Dr. John Studd ~

http://www.studd.co.uk/bipolar.php

[6] A Straight Talking Introduction to Psychiatric Diagnosis by Lucy Johnstone
www.amazon.co.uk/Straight-Introduction-Psychiatric-Diagnosis-Introductions/dp/1906254664

My review of this book ~
https://www.amazon.co.uk/gp/aw/cr/rRZTSBCCI1MGDN/ref=aw_cr_i_1

[7] My review of Why Bipolar? by Declan Henry ~

https://www.facebook.com/DeclanHenryIrishAuthor/posts/1573462929337695:0

[8] Sean Blackwell’s work ~ www.youtube.com/user/bipolarorwakingup

[9] Dr. Terry Lynch has information and courses on the topic of Manic Depression / Bipolar ~

http://doctorterrylynch.com/tag/bipolar-disorder/

[10] Most people labelled as having Depression have suffered grief that hasn’t been resolved ~
www.herald.ie/lifestyle/health-beauty/most-people-labelled-as-having-depression-have-suffered-grief-that-hasnt-been-resolved-31216116.html (Prof Ivor Browne, 2015)

[11] A New Earth Eckhart Tolle, 2009
www.amazon.co.uk/New-Earth-Create-Better-Life/dp/0141039418

[12] Action plan for Bipolar ~
www.foodforthebrain.org/nutrition-solutions/bipolar-disorder/action-plan-for-bipolar-disorder.aspx

[13] Wellness Recovery Action Plan (WRAP) by Mary Ellen Copeland et al ~

www.mentalhealthrecovery.com/

WRAP Crisis Plan & Working Through Hard Times (includes link to pdf)
www.mentalhealthrecovery.com/info-center/crisis-plan/

[14] Selfhood by Dr Terry Lynch, 2011 (includes practical exercises to work through) ~

www.amazon.com/SELFHOOD-Emotional-Wellbeing-Prevention-Psychology/dp/1908561009

[15] The Happiness Habit by Brian Colbert, 2010

www.amazon.com/Happiness-Habit-Choose-Path-Better/dp/0717147762
See exercise on pg. 79 (Cutting the cord) and The Magpie Technique (involves recognising achievements in life)

[16] Man’s Search for Meaning by Viktor Frankl (first published in 1946) ~

www.amazon.com/Mans-Search-Meaning-VThe Happiness Habitiktor-Frankl/dp/080701429X

Viktor Frankl was a Psychiatrist that survived the concentration camps in WWII

[17] The Six Stages of Bipolar and Depression by Tom Wootton ~

www.bipolaradvantage.com/six-stages-bipolar-depression/

[18] Bipolar InOrder ~ Book reviewed by John Grohol
www.psychcentral.com/lib/bipolar-in-order/

[19] Mania: A Short History of Bipolar Disorder by Dr David Healy (2008)

https://www.amazon.com/Mania-History-Bipolar-Disorder-Biographies/dp/1421403978

[20] Suicidality, violence and mania caused by selective serotonin reuptake inhibitors (SSRIs): A review and analysis ~
http://breggin.com/wp-content/uploads/2005/01/31-49.pdf

DSM-IV-TR “emphasizes that a diagnosis of Mania or Bipolar Disorder should not be made when the hypomania or mania first appears while the individual is taking a medication that can cause these symptoms”. DSM-IV-TR (2000) ~ Diagnostic and Statistics Manual. Fourth edition, text revision.

[21] An Unquiet Mind by Kay Redfield Jamison (1995) ~

www.amazon.com/Unquiet-Mind-Memoir-Moods-Madness/dp/0679763309

[22] Adverse Drug Reactions (Dr Yolande Lucire, Forensic Psychiatrist) ~
http://www.drlucire.com/adverse-drug-reactions.html

[23] “The Influence of Chronic Exposure to Antipsychotic Medications on Brain Size before and after Tissue Fixation…” ~ http://www.nature.com/npp/journal/v30/n9/full/1300710a.html

[24] What is Circadian Rhythm ?

https://sleepfoundation.org/sleep-topics/what-circadian-rhythm

[25] 7 Ways to Help Students Who Struggle with Anxiety ~

www.weareteachers.com/7-ways-to-help-students-who-struggle-with-anxiety/

[26] The Efficacy of Play Therapy With Children: A Meta-Analytic Review of Treatment Outcomes ~

https://pdfs.semanticscholar.org/c74c/5352290babfa53960f1f6e74c2591ef3e88b.pdf

[27] A critique of genetic research on schizophrenia – expensive castles in the air ~

www.joannamoncrieff.com/2014/09/01/a-critique-of-genetic-research-on-schizophrenia-expensive-castles-in-the-air/

[28] Physician heal thyself’ may be impossible task for a Psychiatry profession in crisis ~

www.theconversation.com/physician-heal-thyself-may-be-impossible-task-for-a-psychiatry-profession-in-crisis-30845


Other useful Resources

* PMS (Pre-menstral Syndrome) ~
https://www.marilynglenville.com/womens-health-issues/pre-menstrual-syndrome/

* Menopause ~ https://www.marilynglenville.com/womens-health-issues/menopause/

* The Secret Life of a Manic Depressive presented by Stephen Fry ~

www.topdocumentaryfilms.com/stephen-fry-the-secret-life-of-the-manic-depressive/

* Why Bipolar by Declan Henry, 2013 ( I highly recommend this good book) ~

www.amazon.com/Why-Bipolar-Demystification-Affective-Disorder/dp/0957689306

* How to Avoid a Manic Episode ~ www.bpso.org/nomania.htm

{I agree with some but not all of what’s in this link but it has useful tips e.g. Reduce stimulation and decrease activity}

* Moving From Bipolar Disorder To Bipolar IN Order ~ www.youtube.com/watch?v=e4mTW-3mpMM

* Think Twice: How the Gut’s “Second Brain” Influences Mood and Well-Being

www.scientificamerican.com/article/gut-second-brain/

* Psychiatric Drug Withdrawal A Guide for Prescribers, Therapists, Patients and their Families

www.breggin.com/index.php?option=com_content&task=view&id=296

* An independent drug safety website to help you weigh the benefits of any medication against its potential dangers. www.rxisk.org

* Council for Evidence Based Psychiatry ~ www.cepuk.org

* Corrina Rachel speaking to Sean Blackwell about Bipolar ~

www.youtube.com/watch?v=WLIeS6idzD4

* GROWing towards recovery: a re-enchantment with life – Mike Watts ~

www.youtube.com/watch?v=g08yo4Phwic

* The Feel Good Factor: 10 Proven Ways to Feel Happy and Motivated by Patrick Holford, 2011

www.amazon.com/Feel-Good-Factor-Proven-Motivated/dp/0749953160

* The Feeling Good Handbook by David D. Burns, 1999 (CBT ~ Cognitive Behaviour Therapy)

www.amazon.com/Feeling-Good-Handbook-David-Burns/dp/0452281326

* 8 Tips to Help Stop Ruminating ~
www.psychcentral.com/blog/archives/2014/02/16/8-tips-to-help-stop-ruminating

* Fish oil Bipolar treatment benefits ~ www.bipolar-lives.com/fish-oil-bipolar.html

* Medication-free Alternatives for Long-term Maintenance of Bipolar Disorder: A Case Series ~

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4424923/

* Treatment of bipolar, seizure, and sleep disorders and migraine headaches utilizing a chiropractic technique, Elster, 2004 ~

https://www.ncbi.nlm.nih.gov/pubmed/15129207

* ‘The Myth of the chemical cure’ Dr Joanna Moncrieff ~

www.psychologytoday.com/blog/rethinking-mental-health/201602/joanna-moncrieff-the-myth-the-chemical-cure

* Joanna Moncrieff – The Myth of the Chemical Cure: The Politics of Psychiatric Drug Treatment ~

www.youtube.com/watch?v=IV1S5zw096U

* Play Therapy Ireland ~ www.playtherapy.ie

* The 7 Habits of Highly Effective Families by Stephen Covey, 1998 ~

www.amazon.com/Habits-Highly-Effective-Families/dp/0307440850

* R D Laing used work of Nash and Game theory to study human relationships (18 & 25 mins) ~

www.ruthenians.net/kArpatia/portfolio/the-trap-episode-1-fk-you-buddy/

* Music and Madness, Prof Ivor Browne, 2008 ~

www.amazon.co.uk/Ivor-Browne-Music-Madness/dp/0955226120

* Your Best Year Yet by Jinny Ditzer (2006) ~

www.amazon.co.uk/Your-Best-Year-Yet-months/dp/0007223226

* Men’s Sheds ~ www.menssheds.ie/

* Soteria ~ a network of people in the UK promoting the development of drug-free and minimum medication therapeutic environments for people experiencing ‘psychosis’ or extreme states www.soterianetwork.org.uk

Definitions

Family therapy “is a type of psychological counseling (psychotherapy) that helps family members improve communication and resolve conflicts” www.mayoclinic.org

“Family systems therapy draws on systems thinking in its view of the family as an emotional unit. When systems thinking—which evaluates the parts of a system in relation to the whole—is applied to families, it suggests behavior is both often informed by and inseparable from the functioning of one’s family of origin”

https://www.goodtherapy.org/learn-about-therapy/types/family-systems-therapy

Pharmacogenetics “is the study of inherited genetic differences in drug metabolic pathways which can affect individual responses to drugs, both in terms of therapeutic effect as well as adverse effects” (Wikipedia)

 

Lithium

To write about the subject of Lithium I have consulted Dr David Healy’s book “Mania: A Short History of Bipolar Disorder” [1]. Some quotes and information at the start of this blog are from his book. I am in awe at the level of detail and research that must have gone into it.

As an alkaline substance, Lithium was initially used to treat gout and rheumatic conditions. “While using Lithium to treat gout, Garrod reported that patients often showed a general sense of well-being”, pg. 92. Considering the more recent knowledge about inflammation that functional medicine doctors discuss, I find this fact interesting.

“The key individual in the emergence of a prophylactic use of Lithium for mood disorders is Carl Georg Lange”, pg. 94. Another person to use Lithium with some success in treating Manic symptoms in patients was John Cade in Australia. However the toxic effect of Lithium carbonate caused the death of some of his patients. “The use of Lithium was linked to cardiac difficulties and it was banned by the FDA in 1949 … The question of toxicity highlighted the need to establish a safe dose and to be able to monitor treatment”.

“But consider what makes for a placebo response. The natural history of mood disorders means that many will improve within a few weeks whether treated or not. It is also widely thought that sensible clinical advice on matters of diet, life-style, alcohol intake, and work and relationship problem solving may make a difference. It is suspected that patients’ perceptions that they are being cared for by a medical expert may make a difference, and this effect may be enhancing by being given a substance they think will restore chemical imbalance to normal – even if that imbalance is mythical and the substance is placebo. The fact that the patients present themselves for treatment may also make a difference. All of these factors are reflected in the placebo response. But it is not possible to quantify the distinct contribution of these components” pg. 129.

I now want to talk about my own experience with Lithium and some of the things I learned when on it. It may under certain conditions lead to kidney damage and/or damage to the thyroid. If a woman becomes pregnant on Lithium it can damage the developing foetus.

In 2008, after my Adverse Drug Reaction to the anti-depressant Citalopram and when mainstream Psychiatry had hastily labelled me “Bipolar 1” (while ignoring advice in DSM-IV-TR) I was put on Lithium [3]. According to this book, “Bipolar 1” only affects about 1 in 100,000 people, so it is a rare condition. I’ve also learned that from Prof Ivor Browne. From my reading, I do believe that the overuse of anti-depressants is one of the factors in the current Bipolar “epidemic”.

When I was introduced to Lithium, it appeared to be informed consent at the time. Someone talked to me about this drug and I was given some material to read, but it wasn’t true informed consent. I wasn’t fully aware of the truly toxic nature of this drug. I was put on 1000 mg and ended up on that dosage for nearly 2 years. I had regular blood tests to see if the the Lithium levels were in the so called therapeutic range, as well as thyroid function tests.

After the anti-depressant Citalopram caused mania / psychosis or what I refer to as “SSRI induced Bipolar type symptoms” in August 2008, I have 9 foolscap pages showing the large cocktail of expensive drugs I was on from when I left hospital in October 2008 up until August 2011. While on Lithium (and Seroquel) I had a long Manic episode in 2010, for about 3 months. I don’t remember Seroquel having any benefit at all. I don’t feel that Lithium did anything for me therapeutically either, in a true sense. I was eventually switched from Seroquel to Olanzapine in June 2010 and things improved i.e. I eventually came out of that horrendous episode, which may have seemed fun at the time but I also remember feeling that I just wanted the “manic” feeling to end.

I also decided to come off Lithium towards the end of that “episode” and I let the Psychiatrist know. I withdrew from Lithium in jumps of 200 mg, which is far too fast a rate. As I write this I wonder why the Psychiatrist didn’t give me a strict warning and a better withdrawal plan. I was still going to see him on a regular basis (up until January 2012 when I left mainstream Psychiatry behind me and their drugs, other than a few 5mg Olanzapine that I kept on standby for a while but then they eventually went out of date, which in hindsight meant this whole disaster was coming to some kind of ending).

When jumping down off Lithium at what I now realise was a fast rate, I would have gone into withdrawal, with all the symptoms that goes with that. I became very depressed after coming off it and, due to the brainwashing about Manic Depression, felt that this was just part of “my illness”. I was lethargic and lay in bed with not much interest in life. Based on what I now know about the complexity of the withdrawal process, I see this differently [4].

I felt that Lithium blunted my emotions and also remember the day when this “fog” lifted and I started to feel again. I cried when I realised what the drug had done to me. I regret taking Lithium.

My father was on Lithium for years and his thyroid was affected by it. While he died from prostate cancer, I sometimes wonder if the kidney failure he experienced towards the very end of his life had something to do with being on this drug long term.

An Unquiet Mind by Kay Redfield Jamison

When I first read An Unquiet Mind [2] a number of years ago, while still ingrained in the biomedical model and on the drugs, I thought it was a good book. When I re-read it recently I see things differently now, not forgetting that it’s over 2 decades since it was published (1995). Jamison is a talented writer.

When she talks about the marvelous kind of cosmic relatedness, “the webbings of the universe”, and how everything seems interrelated even when sometimes others can’t see, I can relate to that. It tries to describe in words the experience of mania / psychosis (loss of touch with so called reality), which is not so easy to write about or even to describe verbally. A person’s thoughts can become out of control and tolerance can be lacking from others.

She says in her book that she briefly took antidepressants but they only made her more dangerously agitated. She also claims that it is not uncommon for depressed doctors to prescribe anti-depressants for themselves and that the results can be disastrous.

Even though she praises Lithium as a wonder drug in her life, the efficacy and safety of Lithium is not as compelling as she claims. She also admits that she had she continued to experience fluctuations in mood while on Lithium. When she eventually had her dosage of Lithium reduced “it was as though I had taken bandages off my eyes after many years of partial blindness … I wept for the poignancy of all the intensity I had lost without knowing it and I wept for the pleasure of experiencing it again … the subtle, dreadful muffling of the senses”. I can relate to this when I think back to the time I was coming off Lithium.

Dr Jamison talks about the mind healing if it is given a chance. She also mentions how important love is in the healing process and that it can act as a very strong medicine.  The love and support of others helped her through.

Several times she refers to the hereditary nature of Manic Depression and she mentions ongoing genetic research, but in reality no true bio-markers have been found. Even today over two decades later. While Dr Yolande Lucire has discovered that there can be a problem metabolizing the drugs and there may be a genetic aspect to that [5], in general nothing of real significance has materialised because of genetic research into Manic Depression / Bipolar, that I’m aware of.

She talks about the brain-damaging effects of stopping medication. While people have to be very careful changing or stopping prescribed drugs, if anything the opposite is true. The drugs cause brain damage. Olanzapine, for example, which came to the market in 1996 [6].

Changes in the brain can sometimes be explained by treatment history, as opposed to “mental illness”. Symptoms are not always beyond our control and we are not as “beholden to medication” as some would like us to believe. But that takes patience, self-discipline, persistence and daily work on physical / emotional well-being. As well as tolerance of setbacks and support from others. I do not believe it is a life long illness or disease, but if you tell your sub-conscious that it can become a self-fulfilling prophecy.

Hope is another cornerstone of the healing process. I do feel that my symptoms were mainly iatrogenic i.e. caused by taking the SSRI anti-depressant Citalopram for anxiety (between 2005 and 2008). I haven’t experienced Mania / Psychosis in nearly 5 years (December 2012). I was prone to relapse for at least 2 years after all the drugging. I am now free of of prescribed psychoactive substances, but if I had to write how I got there I would find it difficult. Support from doctors was lacking. They seem to have no problem getting you on a drug but stopping their cocktail of drugs is frowned upon.

I still struggle with other issues e.g. sleep. I do not believe that I have Manic Depression / Bipolar. If I did I would not be ashamed to say it. But I no longer feel conditioned into believing this. I do however suffer from Tardive Dysphoria (long term, sometimes severe Depression after being through drugging and the whole ordeal). In some ways I miss the highs. I occasionally experience a mild high, but I’m not complaining. Or a bit of a mixed episode which I feel is connected to being on the drugs. Female hormones are also a factor. I’m all for personal responsibility, but the bottom line is I feel mainstream Psychiatry got it very wrong at the start and caused major, ongoing, devastating trauma in my life on many levels. I’m still coming to terms with that and learning to let go.

{ Important Do not stop or change prescribed psychoactive drugs without consulting your prescriber, due to the dangers of withdrawal. Any changes need to take place under the supervision of an expert. Some people may feel they benefit from Lithium or other drugs I mention here. What I discuss in part of this blog is my own experience and is not medical advice. We all have our own unique journey }


References

[1] Mania: A Short History of Bipolar Disorder by Dr David Healy (2008)

https://www.amazon.com/Mania-History-Bipolar-Disorder-Biographies/dp/1421403978

[2] An Unquiet Mind by Kay Redfield Jamison (1995)

www.amazon.com/Unquiet-Mind-Memoir-Moods-Madness/dp/0679763309

[3] Article by Dr Peter Breggin ~
http://breggin.com/wp-content/uploads/2005/01/31-49.pdf

DSM-IV-TR “emphasizes that a diagnosis of Mania or Bipolar Disorder should not be made when the hypomania or mania first appears while the individual is taking a medication that can cause these symptoms”. DSM-IV-TR (2000) ~ Diagnostic and Statistics Manual. Fourth edition, text revision

[4] Coming off Psychiatric Medication ~ Advice for Prescribers ~
http://www.comingoff.com/lith.php

[5] http://www.drlucire.com/adverse-drug-reactions.html (Dr Yolande Lucire, Forensic Psychiatrist)

Dr Lucire explains that not all people are born with a full complement of metabolizing enzymes, increasing the risk of side effects which can range from mild to life-threatening. Changing dosage up or down and starting / stopping drugs are also crucial times, sometimes affecting the person months after stopping.

[6] “The Influence of Chronic Exposure to Antipsychotic Medications on Brain Size before and after Tissue Fixation…” ~ http://www.nature.com/npp/journal/v30/n9/full/1300710a.html

In 2005, a study funded by the maker of Zyprexa / Olanzapine, found that chronic / long term exposure to this major tranquilizer causes shrinkage of the brain. “significant reduction in brain volume that affects both gray and white matter”! I learned about this from honest Psychiatrists Dr Peter Breggin and Dr Joanna Moncrieff. I was put on Zyprexa, at what I now consider too high a dosage (10mg) long term in 2008! I did not have informed consent about this powerful but potentially damaging drug. Very short term use would have been enough and proper advice about withdrawal and stopping. Something I never got from a private hospital. I was let out the door with nothing but a prescription. I ran to the train and thought all was great.

2 weeks later I went into what I now know to be withdrawal and akathisia (a severe inner restlessness). I ended up back in hospital for a month, a broken woman. The year that followed is a complete blur and the last 9 years have been difficult because of what I was put through. Mainstream Psychiatrists I saw at the time withheld valuable but vital information.