Abilify, Not I : Adventures in Antipsychotics

Lately, I have written a series of posts over the last two months describing certain troublesome symptoms I associated with the worsening of Bipolar Disorder, or the potential for comorbid disorders.

In my last post, When Medications Go Wrong, I briefly wrote about my recent discontiuation of the pharmocological treatment using Abilify as part of my medication regimen:

Recently, I stopped my Abilify.  Admittedly, it was because I noticed an interaction between the Abilify and my weekend consumption of alcohol.  I started to find that I would fall asleep soon after taking it on Friday’s while we drank.  I decided that I would just stop over the weekend, and continue during the weekdays as normal.  But, eventually, I just forgot to take it at all.  And soon, I started to notice an improvement in my worsening condition.

I went on to describe some of the awful side effects I was experiencing as a result.  However, the list was truncated for the sake of keeping word count down.  The description is rather limited in terms of accurately depicting exactly what I was subject to.

• Cognition Disturbances and Memory Fragmenting.  Originally, I wrongfully blamed Lamictal in Vitamin L : Medication Adventures for my aphasia-like symptoms.  The disturbances felt like aphasia.  At first, it was almost indescernable.  I started word dropping again, meaning I would be reaching for a word, but was unable to grasp it.  Instead, I would be able to get to every synonym around it, however, those words did not fit the exact context.  Eventually, it became a more severe form of word dropping, and I found myself dropping sentences entirely at the loss of any word or synonyms around it.  It progressed into entirely dropping conversations at the loss of a sentence.  Then, I found myself

  I started forgetting things again.  These were simple things, like losing my purse or shoes in the house.  It seemed like just a simple case of forgetfulness, maybe stress related.

• Emotional Blunting and Partial Flattening.  I had never had too much trouble with emotional blunting in the past.  While I’ve found myself in times where it was difficult to express my emotions, this didn’t indicate a lack of emotional response.  I describe it as a partial emotional flattening, because it wasn’t an entire lack of reactivity.  It felt like my spectrum of emotions had been significantly reduced, although not completely removed.  There was a certain inaccessibility to certain strong emotions.  Rather than completely removing extreme emotions, it threw a wet blanket on top of them, leaving them to bubble under the surface.  So, the emotions still existed, but were muted and unable to be adequately expressed.

  At it’s worst, I began to lose most feeling entirely, with the exception of irritation and the sensation of boredom and fatigue.  I began to lose love and my attachments to meaningful people and my relationships with them.

• Dissociation.  I touched on a summary of the dissociative symptoms that Abilify had brought on.  I have been writing articles on the experience throughout the last few months on the subject, describing the feeling in great detail, but remained unable to exactly identify is appropriately.  The dissociation probably occurred as a response to the prior bullet points.

  The dissociation cited was experienced as a removal of self and removal from my own life.  I had felt as if I had been separated from myself and my world.  It was a feeling of something being stolen from me, or something fundamentally inaccessible.  Like, I was being locked out of my own life, or becoming transparent and just fading away.

• Worsening of Depressive States.   This is probably a direct result of the first three bullet points.  I started to disengage from my life.  I lost interest in just about everything.  Most things were considered to be either boring or tedious.  Important things started to lose meaning.  This was experienced as a part of the emotional flattening, but it caused a concerning and distressful reaction.
• Exacerbation of Social Anxiety.  Since I had lost the ability to carry on a conversation and found myself completely disinterested in socialization, my social anxiety went through the roof.  I simply didn’t care about anything anymore, especially trivial things I used to find interest in.  Therefore, I found it difficult to carry on a conversation.  This caused extreme distress in social situations, and encouraged further isolation.
• Disturbed Sugar Levels.  While I have no concrete proof in terms of tests, certain symptoms have come to my attention.  They are notated below in the next two bullet points as thirst and weight gain.
• Loss of Sensation of Bodily Hunger, Thirst, and Fullness.  Within the last few years, I started to become more in tune with my body.  I was able to feel the sensations of hunger through my sugar level, which probably caused the loss of bodily hunger.  The disturbed sugar levels probably also caused an extreme thirst that could not be quenched.  At first, I craved water.  Eventually, I started to put the soda back down, which probably caused part of the weight gain mentioned below.  And I felt an extreme pressure in my stomach, which was also exacerbated by the influx of so much fluid.
• Extreme Weight Gain.  Truthfully, I don’t dare get on a scale at the moment, so I am unable to notate at this time exactly how much weight I’ve gained.  By the fit of my clothing, I will estimate that I have gained somewhere between ten and fifteen pounds in the last three months.  That is a substantial gain for me, especially since I was losing weight prior to the start of this medication.
• Exacerbation of Eating Related Problems.  By all definitions, it’s completely possible that I am living with an undiagnosed eating disorder.  However, I am not entirely convinced, since it isn’t an ongoing and prevalent problem.  Therefore, I define it as eating related problems and difficulties.

  The concern for weight gain and the sensation of fullness caused a very terrible reaction of binging and purging.  I was unable to control my eating, as notated above, therefore the sensation of extreme fullness would cause me to perceive the overeating as worse than it actually was.  Unfortunately, this led to a very vicious cycle and encouraged further weight gain.

• Disturbed REM Sleep.  I was waking up tired, and noticed that it felt like I had stopped dreaming.  This caused my mental state to take a considerable dive.  It caused extreme fatigue and excessive, unproductive sleeping.

While I am cleared of most dissociative symptoms, emotional flattening, and my depressive state is lifting a little, some side effects have remained.

• Cognitive Disturbances.   The aphasia-like symptoms remain, but to a lesser degree.  I am back to just being a little forgetful, and have some minor word dropping.
• Memory Fragmenting.   Some of my memories remain dull, but seem to be returning.  However, most of the last three months remains inaccessible.  It may never become accessible, due to the disruption in the formation of short-term memory.
• Disturbed Sugar Levels.   I am still thirsty, but I am no longer engaging in carbohydrate seeking consumption behavior.  I figure it will take awhile before my sugar is regulated properly again.
• Weight.   Thankfully, my weight does seem to be coming down.  I have only been completely off of the medication for less than a week, and my clothes are already fitting better.  I’m going to assume that in addition to the weight gain, I was retaining water and constipation.  My regularity has come back, and I don’t feel as puffy as I did

Unfortunately, I am experiencing a return of some of my milder psychotic symptoms.  In Imaginary Enemies, I described a cognitive disturbance I described as “The Voice”.  “The Voice” can be characterized as a singular persona, as I wrote about in Conscious, Subconscious, and Extraconscious, where I described a theory of a third consciousness that exists between the subconscious and the conscious mind.

The Extraconscious is postulated as where the persona(s) reside, laying in semi-dormant waiting, perfectly aware of the current reality that is being experienced.  “The Voice”, in more severe psychotic states, can be experienced as a separate entity entirely, detached from the consciousness.  That is the defining line between a cognitive distortion and an auditory hallucination, when a persona detaches itself from the extraconscious as an external sensation.

As an extraconscious persona, “The Voice” can best be defined as a quasipersona, lying somewhere between Dissociative Identity Disorder and psychosis.  It is experienced as a semi-active part of the conscious mind, as the dominant persona is well aware of it’s existence and there is a certain interaction that occurs between the dominant persona and “The Voice”.

That is the best theory I can offer as to the existence and function of the quasipersona, known to me as “The Voice”.

The mild auditory hallucinations and visual hallucinations have returned, probably defined better as a sensory disturbance, rather than a symptom of psychosis.  When experiencing a sensory disturbance, it’s not full on hallucinations as described in the definition of psychosis.  There are not entities separate from the body.  They are recognized as a disturbance in the current reality, distorting shapes, colors, and contrast in the vision.  In the hearing, it is experienced as a distortion in sound, causing sounds to be sharper, duller, muffled, or louder than they actually are.  It can only be sensed by a sudden shift in perception.

So, instead of hearing things at a normal sound level, the sound volume may increase to deafening levels or may become muted and difficult to discern from nonexistent static that occurs in the mind.  My visual disturbances may be perceived as viewing the world in high contrast, extremely bright colors, and / or extra high definition resolution.  Or, they may be seen as duller than usual, muting colors, distorting shapes, and / or clouding the vision with that appearance of a veil or foggy goggles.

Intrusive thoughts have returned, but not with the same extreme nature as experienced several months ago.  In truth, they were never completely removed by the Abilify, and at some points were made worse by the drug.  Instead of experiencing them as a truth in reality, I am now able to separate them using logic.  I can talk myself off of the ledge and separate them from the reality of a situation using DBT techniques of mindfulness and distress tolerance.  Prior to the cessation of Abilify, I was unable to utilize those techniques.

I don’t mean to put anybody off of treatment with psychiatric medications, but I felt this was important to document and have as a resource on the internet for anyone who is thinking about taking the drug.  Some of these side effects aren’t listed in the pamphlet, as they are probably isolated to a condition.  But, I feel they are still a distinct possibility for anyone who is being treated for similar conditions.  It is vital that this information be notated and readily available for medication education purposes.  This information probably should not be generalized to all psychiatric medications, especially in the class of antipsychotics.

 

Jungian Theory in Personality Assessments

JUNGIAN THEORY IN PERSONALITY ASSESSMENTS

Jungian Theory in Personality Assessments

Tiffany M.

Personality Development

 

Take the MBTI now, if you’re interested.

On the Myers-Briggs Type Indicators (MBTI), I scored ENFJ.  (Note:  Since, I score an INFJ, because of medication changes.)  ENFJ personality breaks down into traits that are extroverted, intuition, feeling, and judging.  Mostly, I would agree with this assessment of my personality.  However, I feel it is a limited, as many others have criticized.  Jung asserts that extraverts project their energies outward to others and their environment and characterizes these people as sociable.  I feel I embody this description to a point.  I would be more inclined to believe that it is a better measure of sociability.  I disagree that personality type is affected by heredity, seeing as how neither one of my parents is ENFJ, and only my father scored as an extravert.  In addition, I don’t agree that personality is static throughout an entire lifetime.  Jung’s personality theory neglects attention to childhood development and major events affecting adult development.  I feel that I am very intuitive, however, I once again don’t feel as if I completely fit the description.  While I am apt to “tune in” to others and have a certain innate understanding of situations as well as their outcomes, I don’t feel as if I’m focused on the “big picture”.  Family, friends, and co-workers can attest to my attention to detail and highly cultivated level of organization.  The assessment of feeling is given when people are thought to place value on things that create a positive emotional response.  This is opposed to utilizing logic for decision making.  I feel that is a very hedonistic evaluation.  We all, as humans, are subject to hedonism according to Freud’s Hedonic Hypothesis.  By this logic, that would place all humans into the feeling category.  Instead, Planap and Fitness proposed that said traits function together.  Therefore, I am able to embody both empathy and logic.  Another problem with this assessment is the obvious gender bias.  Jung personally though that women typically score “feeling” and men score “thinking”.  This can even be seen in my marriage.  My husband and I are fundamentally the same, hence the original attraction.  However, on the MBTI, he scored ENTJ.  The only difference between my husband and myself is the way that we process emotions.  Perhaps this scale measures empathy and expression of emotions better than it’s original intention.  (Judging)

The MBTI is the most recognized and frequently employed assessment when “measuring Jungian functions”. (pg 88 review citation)  Essentially, the MBTI is based on Jungian personality theory and hardly differs.  It incorporates the eight basic personality types in Jungian theory.  These psychetypes combine extroversion and introversion with thinking or feeling and intuition or sensation in pairs of two.  The MBTI expands upon Jungian personality theory by identifying a fourth trait which functions as a person’s conscious interaction with the external world.  This trait works differently for extraverts and introverts.  In extraverts, the fourth trait is the dominant function and contrastingly introverts utilize it as an auxiliary function.  For example, one assessing a MBTI result can combine extroverted with either judging or thinking as how they interact with their environment.  The other functions are introverted and therefore how they deal with themselves.  For introverts, it is the reverse.  By allowing a fourth trait, the MBTI provides a more comprehensive analysis with sixteen types instead of the eight in Jungian typology.

MBTI has a high degree of reliability and validity; it is objective and free of interpretation by the administrator.  The Inkblot exam is purely subjective, and also, subject to the subjective interpretation of the administrator.  MBTI measures the types of individuals, while the Inkblot exam measures individual traits of individuals.  It seems that each time an individual takes the MBTI they score the same or close to the same as the time before; however, an individual may not picture the same things he once saw in an inkblot revealing that the inkblot has a low test-retest reliability.  In the case of the Inkblot exam, it would mean that individual personalities are constantly subject to change.  While personality is subject to revision, it is not subject to total change.  The inherent, learned traits that an individual has will remain with them, despite certain revisions.  Each exam, however, provides valuable information about the individual’s personality and therefore a tool in evaluating a client.

This information is essential in a therapeutic setting.  Each assessment has a purpose.  MBTI is excellent for getting a feel for the patient and understanding their basic personality.  It is also been proven as an excellent tool for career placement.  It has advantages for the patient as well.  As the patient gains a better understanding of themselves, they will also be able to understand their emotions, thoughts, and motives.  This way, they can learn how to cope and self-regulate.  Inkblot and other projective tests provide a look into the subconscious.  This may reveal repressed emotions and impulses.  Once these are brought to light, the patient can then begin mitigating them and expressing them in healthy ways.  Personality disruption and abnormal behavior and development can then be resolved, resulting in a balancing affect and creating a more whole personality.  Therefore, these assessments, combined with psychotherapy can resolve conflict, establish healthy coping mechanisms, and reunify a person to promote functionality.

References

Kaplan. (2008). Past and Present Views on Personality. Boston: Pearson Custom Publishing.

Myers-Briggs Type Indicator. (n.d.). Retrieved September 15, 2009, from http://en.wikipedia.org/wiki/Myers-Briggs_Type_Indicator

Phanalp, S., & Fitness, J. (n.d.). Thinking/Feeling about Social and Personal Relationships — Planalp and Fitness 16 (6): 731 — Journal of Social and Personal Relationships. Retrieved September 15, 2009, from http://spr.sagepub.com/cgi/content/abstract/16/6/731

Related articles

• The Relationship Between Personality Type and Software Usability Using the Myers-Briggs Type Indicator (MBTI) and the Software Usability Measurement Inventory (SUMI) (udini.proquest.com)
• An Introvert’s Thoughts on Being A Professional Speaker and Consultant (insidehighered.com)
• OPPOSITES ATTRACT by Renee Baron Applies the Myers-Briggs Type Indicator to Improving Intimate Relationships (prweb.com)
• Truth in Humor: The MBTI Grid…Askew (lindaloolookingahead.wordpress.com)
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Disorder and the Internet : The Good, the Bad, and the Ugly

My newest Canvas post explores the positives and pitfalls of the internet when it is in the context of disorder.

Sensory Integration Dysfunction and Psychiatric Disorders

Most of my research in the past has been centered around affective disorders, theories surrounding the causation of dysfunction, and the cognition / behaviors that sustain it. I am broadening my horizons to include many mental health disorders and developmental disorder, particularly autism.

I have had a theory for awhile that hinged almost completely on curious connections I’ve made between bipolar disorder and autism spectrum disorder. Doctors ruminated on the potential for my father and bipolar disorder. By the way my parents describe his mother, it didn’t seem surprising.

We’ve always assumed that my “affective disorder” (assumed Major Depressive Disorder in my teens) was a result of my father. Assumptions are changing around parents house in light of serious mental health symptoms popping up on my mother’s side of the family. My grandmother has “dementia”, politely termed to describe her psychosis. And my aunt who cares for her has developed paranoid delusions. She has isolated herself, because she is sure that the family is “against” her and consorting with one another behind her back.

These things don’t come out of nowhere. They become present after certain events happen, whether they are biochemical or a result of external stressors.

So, why is it that two parents with suspected “affective” disorders bear one child with moderately severe classical autism and another with bipolar disorder? Another generation passes. Two parents, one with an affective disorder and another with a mental health disorder, both with psychotic features, bear a child with mild Autism Spectrum Disorder : Pervasive Development Disorder – Not Otherwise Specified?

I’m not at liberty to speak in detail about my husband’s disorder. I have determined that it is up to him; it is his own business, and it is best for his mental health to know that I am only vaguely referring to it as a “disorder”. I will leave it at that.

We have actually been speaking now, sometimes at great length concerning symptoms, dysfunction, and identifying with one another. Many of these symptoms seem to revolve around sensory disturbances. For me, I’ve gone to great length to describe times of sensory overload caused by a removal of a “sensory filter”. It’s a chicken and the egg conundrum. Does the emotional disturbance make me more susceptible to the sensory integration and processing dysfunction or vice versa?

Unfortunately, there isn’t a great deal of literature on sensory integration dysfunction and mental health disorders. However, there is a wealth of it, as it is considered a component of Autism Spectrum Disorders.

It is thought that the main feature, besides pervasive behaviors, is sensory integration dysfunction / disorder. It is observed that children with ASD fall into categories of sensory “seekers” or “avoiders”. Seekers are thought to have dampeners on sensory imput. Avoiders are opposite and have a sensory overload. But, in most cases, there is usually a combination of the two. Some seeking and some avoidance. Unfortunately, avoidance is considered the most recognized behavior, as it is considered the most dysfunctional.

I can only speak for me. In episodes of hypomania, I become a seeker. One would think there should be an avoidance, but in hypomania, I cannot get enough. My brain eats it at hyperspeed and processes it just as fast.

However, mania is a different story. Often, sensory stimuli overloads an overly active mind. It makes manic symptoms worse. Sometimes, the racing thoughts become fragmented and my thinking becomes disordered. My speech becomes disrupted and incoherent, because the intergation of external stimuli cannot be effectively integrated. And an overload occurs.

In psychotic states, the sensory stimuli becomes confused and distorted. Places and people may become foreign and strange. Hallucinations can occur, distorting sensory stimuli even further. And delusions are fed by misinterpreted stimuli.

Mixed states are the worst. As everyone knows, a mixed state is probably the most unstable a person with bipolar disorder can get. Sensory stimuli is integrated, but poorly. The cognitive associations are often misinterpreted and can spark even worse symptoms.

A sensory overload is common in this state. The internal struggle is enough to shy away from anything stimulating, because of the cognitive inability to process it properly.

I’m still working on interpreting mixed states, the dysfunction, and how I experience it. The problem I face is that many new symptoms I did not expect surfaced at the same time.

Moving to depressive states. I find that I am often very easily overstimulated, though my mental state is dulled. My mind suffers a certain retardation of congitive and physical function. The problem the occurs is the foggy state makes the processing of stimuli difficult. It deepens emotional distress when presented with too much. I simply do not have the processing speed.

So, there are several functions that cause the dysfunction. There are a few facts that remain. I am an auditory avoider when I am unable to process external stimuli due to aggitated or foggy states. I am a tactile seeker in these states, with the explicit exception of psychosis. In (hypo)manic states, I am a motion seeker, as it calms. In depressive states, I am a motion avoider, but a visual seeker. Contrastingly, I am a visual avoider in (hypo)manic and psychotic states.

I could go on from there, but I won’t. I am more inclined to seek input from others. Examine your behaviors of seeking and avoidance. What do you find?

Theories on the Development of Disorder

When something, an emotion, an urge, an impulse, is so severely suppressed that a person becomes oppressed, we can often observe extreme opposite reactions. This is consistent with the laws of physics and the universe, “Every action has an equal and opposite reaction.” Except, one thing. I believe when it comes to emotions and behaviors, the opposing reaction is more like equal plus. The plus being an x-value holding place for a value with the meaning “a little more.” Determining that exact value in numerical terms may be difficult, since there is no numerical value for emotions.

It basically conveys the message that the situation perpetuates itself. Any potential absence of behavior or action can still be perceived as a positive value. Inaction can still be considered an action in this case, because there isn’t really such a thing as a complete absence of behavior.

This is potentially a huge factor in mental illness. Obviously, we are aware of the psychological damage abuse and neglect in childhood can cause, even throughout adulthood. It is thought to manifest in anxiety disorders, particularly Obsessive-Compulsive Disorder and Post-traumatic Stress Disorder. However, that does not account for people who did not experience what is typically considered childhood trauma.

Even as adults, we are susceptible to psychological damage. This is a fact that is well established through research involving war veteran and victims of sexual assault. However, we only consider extreme forms of trauma as something qualifies as such. Such is also true of childhood trauma.

Other qualifying trauma often happens over a period of time, and goes consciously unrecognized. This does not mean that it is also subconsciously unrecognized as well. In fact, the subconscious is likely keenly aware, but unable to translate to the conscious mind.

Once the conscious mind becomes aware that there is something amiss, the traumatizing behavior seems commonplace. The person has likely become desensitized to what was once a subtle, but generally constant external stressor. By then, it becomes internalized and often mistaken as an internal stressor.

Those are the seeds for maladaptive behaviors in both children and adults. At this point, unhealthy coping mechanisms have already been adopted as part of a person’s behavioral repertoire. This is directly the result of an extreme reaction to the accumulation of what may be considered subtle long term stressor(s).

The maladaptive behaviors are recognized as such, and perpetuate trauma through mistreatment of oneself. It can be behaviorally observed by an unusual response to certain unpleasant stimuli. Unfortunately, the subject is often unaware that their responses are abnormal. By the time it is either pointed out or realized by oneself, the original cause is well buried under layers of self-abuse / neglect.

The result of this is much larger than anxiety disorders. It reaches out to grab behaviors typical of a variety of psychological disorders. Behavior repertoires are often observed in personality disorders and mood disorders. it would stand to reason this is true, due to the nature of long-term external stressors, particularly subtle abuse and neglect.

A Spectrum of Depression

Blank.

Each time I go to write, I get a blank.  Is it a blank, because I feel as if I don’t have anything important to say.  Or is it a blank, because if I make a certain statement, then it is real.  It becomes something tangible in this world, not only for me, but for others, and I will eventually have to come nose to nose with it.

I’ve grappled with this before.  Making certain admissions.  I do not lie as much as I turn a blind eye.  I rationalize.  I attempt to will it out of existence.  But, it is just not that easy.

Simply – I am in the midst of a depressive episode.

Why was that so hard?

There is a certain hesitation for me to use the word depression.  It is not a word that I use loosely; others use it as a part of their regular vernacular to describe sadness.  Depression is not sadness.  Depression has a depth beyond that of sadness, loneliness, isolation, self-loathing, or any other word.  No amount of words arranged in any way can accurately depict depression, and do it any kind of justice.

The hesitation to term it as depression stems from the idea that, if it doesn’t feel like the worst I’ve ever felt, then it’s not depression.  I have faced more gruesome depressions than this one.  With the admission comes a certain fear.  If I am to term it as a depressive episode, then it really will be such, in the worst sense of that word.  It could worsen the episode itself by acknowledging it.

Blank.  Again.

I have found it so interesting that Bipolar Disorder has this grandiose spectrum to encompass so many different types and symptoms.  However, they are exclusive to mania.  Depression is just depression, and it by itself is MDD, or unipolar depression.  Except, now psychologists are starting to recognize symptoms that are related to atypical depression.  However, by reading through these symptoms, it seems as if it may be exclusive to unipolar depression.

How much research has been done to distinguish unipolar depression from bipolar depression?  So far, the only thing that separates the two is the existence of hypomania / mania.  In theory, there wouldn’t be a difference.  I get the feeling that there is, and it is significant enough to have a separation between the two.

So far, the mood spectrum looks like this:

But, I really think that’s being too broad about it.  I fall smack dab in the middle of Bipolar II, no full on psychosis equals no full on mania, even if I have delusions.  I wouldn’t even suspect that I have full on mania, anyway.  Even with delusional thinking, I can honestly say that there has never been a time where I have been hypomanic where I lost touch with reality.

People with mood disorders are familiar with the depressive symptoms.  But, I’ll sum them up:

Sadness, anxiety, irritability,  Loss of energy,  Feelings of guilt, hopelessness, or worthlessness,  Loss of interest or enjoyment from things that were once pleasurable,  Difficulty concentrating,  Uncontrollable crying,  Difficulty making decisions,  Increased need for sleep,  Insomnia, Change in appetite causing weight loss or gain, Suicidal ideation, and / or Attempting suicide.

Symptoms of atypical depression:

Increased appetite, Unintentional weight gain. Increased desire to sleep. Heavy, leaden feeling in the arms and legs, Sensitivity to rejection or criticism that interferes with your social life or job, Relationship conflicts. Trouble maintaining long-lasting relationships, Fear of rejection that leads to avoiding relationships, Having depression that temporarily lifts with good news or positive events but returns later

These are all familiar.  I’ve bolded the ones that I’m experiencing at the moment.  It seems that I’m bordering on the more atypical part of depression.  This is the kind of depression that no one really tells you about.

I had mentioned my diagnosis of Bipolar II, resulting from non-psychotic “manias” clinically termed “hypomania”.  Fair enough.  Let me put a question out there.  Has anyone ever experienced a psychotic depressive episode?

I have.  And I have mentioned this to doctors on several occasions.  I will have breaks with reality when I am depressed.  I have severe delusions, almost completely the opposite of delusions of grandeur.  I will have severe paranoid episodes – in fact, I just had one.  I can have myself convinced that everyone hates me and is out to destroy my life.  It makes me combative.  I will sometimes invent conversations that never happened, just because my brain contorts a criticism.

Mayo Clinic appended this in fine print below their list of classical depressive symptoms:

When a person with psychosis is depressed, there may be delusions of guilt or worthlessness — perhaps there is an inaccurate belief of being ruined and penniless, or having committed a terrible crime.

Perhaps?  I’m nearly positive that exists because not enough research on bipolar depression versus unipolar depression exists to accurately differentiate between the two.

There are a few questions that remain.  Again, not to just the bipolar population but the unipolar population as well, have you ever experienced a psychotic depressive episode?  Is this more commonly found in MDD, BP II, or BP I?

Because if this is common amongst all populations, then the mood spectrum should look more like this:

Perhaps a more accurate model

Perfectionists Anonymous

We’re all guilty of this at one point or another.

Hello, my name is Lulu. And I am a perfectionist.

I have at least six half-written posts ready to roll out. Each contains explanations of what has been going on in my life lately. Yes, I’m aware that nearly a week has elapsed since I posted anything.

Why don’t I release any of them? Because, they aren’t quite right. None of them are actually completed. And every time I read them, I deem that there are entirely too many non sequitur tangents, and start editing. Before you know it, I pulled the wrong thread and the whole thing unraveled! Well, sh*t!

At least I know that I’m getting closer to returning to my original condition. You see, I was born into this world as a perfectionist. It is one of those . . . (dropped the word. Thanks Lamictal!), neurotic tics in my very DNA, bred into one generation after another since the beginning of time.

During the big bang, a collection of cosmic dust got together and became determined on being perfect. In evolution, this was found as a specific enzyme that became a tiny molecule in long DNA sequences. From an amoeba, all the way through vertebrates, into the homo genus, it settled into my first line of ape ancestors 9 million years ago. This was the same ape you saw engaging in curious behavior of sorting leaves for no specific reason. Later, it was the caveman who etched, and then went back to attempt to re-etch cave drawings. Today, it’s a genetic line, mostly comprised of dark blonde Scottish women, that are consumed with the urge to perfect everything.

I hope you could find that as amusing as I did. That was exactly one of those sidebars I was describing. But, since I have deemed this a stream of consciousness post, I can write whatever pops out. Now, I want you to do something for me. Locate the little red X at the top right of your screen. If this gets to be a little too Woody Allen-esque or It’s Always Sunny in Philadelphia, you have your option. Otherwise, note the comment section below.

Back on track, or thereabouts. This started earlier than I have memory. When I was four, I recall the need to conquer everything I hadn’t yet mastered, but I was aware of. My handwriting was always meticulous. That was until I learned that handwriting is not meant to be uniform and is unique to each person. Of course, this happened during the “I am Unique, Hear Me Roar!” phase all teenagers eventually go through. For me, it was more like the discovery of self-loathing in depression that causes complete defeat and perpetuates the cycle of self-loathing.

Here’s where I’m going.

I do not have OCD. Okay, maybe I have some tendencies, but it doesn’t cause me significant dysfunction. I do have a threshold for this. Eventually, I’ll get too frustrated, throw my hands up in the air, and scream, “F**k it!”, as I’m seen setting the proverbial (or actual) fire to the whole thing. (Note: I am not an arsonist. I think. Define arsonist.)

Joking!

That’s pretty much what happened to me. Bipolar disorder probably put the stop to Obsessive Compulsive Disorder. Before, I was obsessed with perfecting skills and creations. I actually remember my life before Bipolar Disorder! Granted, I was only eleven and younger, but it did exist!

Then, I became distracted with myself. My feelings, my consciousness, my cognition, and my world. It was all about me. I went around with the blow torch and sledgehammer and demolished everything. Because, if it came from me, then it was flawed in design from its origins. It was as flawed as I was.

And for a very long time, I went through a cycle of self-fulfilling prophecies through self-sabotage. I carry an inherent flaw. Time to get to the incinerator!

But, as years of treatment have ticked by and the medicine has coursed through my veins, I began a process of ecdysis (look it up, I’m not linking it, I’m busy). I don’t consider this a process of reversion. But, it is not synonymous with metamorphosis, because I am not coming out of the cocoon as a different being. It is something different entirely.

I am moving in a corkscrew fashion down a time line that is supposed to be linear. It is only linear in the sense that one can draw lines down the outside of the corkscrew to find a correlation between that snap shot and the next at the point of intersection in the corkscrew.

So, here I am. A whole month of bipolar of stability. The longest point in my treatment that I have experienced this. And if I were idly questioned, I’d remark that I hardly feel stable. My life is a hectic mess right now. But hey, when is anything hectic organized? Pristine chaos – HA! But, my emotions are solid, though they rattle. Is this what non-Dx people feel like?

Now, I’m busy, so I’m going to stop writing now. Have a lovely day.