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Last Online: 21st December 2008 Join Date: Tue Nov 2006 |  BPD: Very Complex -
7th December 2008
Sorry for taking some 40 or so days to get back to you, Zouxi....According to Hagop Akiskal, M.D., at the one end of the BPD(bipolar disorder) spectrum is bipolar type schizoaffective disorder, and at the other end is recurrent unipolar depression, with the anxiety disorders present across the spectrum. This is a useful term, Zouxi---spectrum...I will add a few more paragraphs here since: (a) I promised a series of instalments and (b) BPD is quite complex and a more lengthy statement is useful for some(though not all) readers here at the Orange Room.--Ron Price, Tasmania
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1.6 The wider framework of my experience which I outline here is intended to place my BPD in context and should provide others with what I hope is a helpful perspective, as I say above, in relation to their own condition, their own problems and situations. Perhaps my statement may help some BPD sufferers describing and understand their personal histories. This essay, as I say, of sixty-four A-4 pages(font-14) is written: (a) for doctors and various medical professionals who have dealt with or will come to deal with my disorder and especially for those who are now, at this present time, involved with my treatment should they find such a statement useful; (b) for internet sites and those registered/inquirers on the www at a range of health and mental health sites, especially the sections of sites dealing with D and MD/BPD; (c) for some of my relatives, friends and associations over the years with whom I still have contact in these early years(60-65) of my late adulthood(60-80) and to whom it seemed relevant to give such a statement; (d) for government departments, voluntary organizations, interest groups and Baha’i institutions who require such statements for reasons associated with our relationships and interactions; and (e) for myself as a reflection, for my own satisfaction, to put into words the story, the results, of an illness, a sickness, a disorder that has influenced my life for over more than six decades.
1.7 This document, this statement, originally written in 2003 for the Australian government’s now department of Human Services, its Centrelink section which with Disability Support Pensions, has been revised many times after further reflection. Now in its sixth edition after feedback from various doctors, friends and internet respondents as well as after an increase in my own knowledge of the illness as a result of further study, this document is an ongoing and changing entity as my experience of the disorder continues into the middle years(65-75) of my late adulthood(60-80). In eight months I will go on the Old Age Pension in Australia with this BPD still a part of my life.
1.8 I do not claim to possess a specialized and/or professional expertise in the field of the study and treatment of BPD. I do not work with people who have such problems, nor do I have a desire to do so, except as a participant at a number of internet sites concerned with relevant mental health topics and with people who cross my path serendipitously with various related problems. This long piece of writing, too long for some perhaps for most, not as sharply focussed on my actual day to day experience as some respondents on the internet have already indicated and not particularly relevant to the experience of others in an illness that has a very wide range of behavioural typicalities---this long piece of writing is but one of the many pieces of my writing these days. The vast majority of my writing and my interests both in and off the internet has nothing to do with this disorder.
1.9 After more than 60 years of dealing with this medical problem in my private and public life, I would be only too happy to put it to bed, to put it into some final corner and forget it. Sadly, or perhaps fortuitously, I can not do so because I still suffer, even after more than 60 years, with problems that are part of this disorder’s long history and current manifestation in my life. I have also become more conscious as I have come out, or so it is said colloquially, of how this statement has come to be of great help to many, especially at the 90 mental health sites on the Internet where I place all or parts of this document. Major affective disorders continue to be the leading causes of psychiatric disability and the need to develop safe, effective, and efficient long-term treatments for these disorders is of extreme importance not only to professional but to the millions of sufferers. People like myself with life experience of BPD have stories that can be of use to other sufferers. That is the core of my motivation for all the internet posting I do at mental health sites related to BPD.
1.10 Readers who are busy and not inclined to read a long statement like this are advised to skip to section 10.3.7 and following to avoid reading much of the history and much of this statement that is not relevant to their needs. They can then: (a) make some practical assessment of this account, an assessment relevant to their present and personal needs; (b) obtain a shorthand account of whatever information in this document is relevant to their particular situation; (c) assess my suitability to: (1) undertake some form of employment: FT, PT, casual or volunteer; (2) some task that they think I could take on or some social or leisure activity in which I could engage with profit to others; (c) go onto a pension of some kind and, finally, (d) understand my background of BPD more fully and so contextualize my life in order that they might understand me better.
1.11 Data from the United States on the lifetime prevalence of this disorder--and mine has been a lifetime of BPD--indicate a rate of 1 percent for Bipolar I, 0.5 to 1 percent for Bipolar II or cyclothymia and between 2 and 5 percent for subthreshold cases meeting some but not all criteria
1.12 I would like to close this introductory section with a general comment about the increasingly close relationship between the pharmaceutical industry and the American Psychiatric Association (APA) and about a sub-field of philosophy and sociology known as hermeneutic phenomenology.
1.12.1 Since at least 1980 when by illness was given the label BPD, there has been a growing tendency in the mental health professions to interpret everyday emotional suffering and behaviour as a medical condition that can be treated with a particular drug. Hermeneutic phenomenology, a field within both philosophy and sociology, is uniquely suited to challenge the core assumptions of this particular form of the medicalization of BPD, among other psychiatric disorders. Hermeneutical phenomenology can function within psychiatry: (a) to expand psychiatry's narrow conception of the self as an enclosed, biological individual and (b) to assist psychiatry to recognize the ways in which our experience of things--including mental illness--is shaped by the socio-historical situation in which we grow. Informed by hermeneutic phenomenology psychiatry's first priority, so it could be argued, is to suspend the prejudices that come with being a medical doctor in order to hear what the patient is saying. To this end, psychiatry can begin to understand the patient not as a static, material body with a clearly defined brain dysfunction but as an unfolding, situated existence already involved in an irreducibly complex social world, an involvement that allows the patient to experience, feel, and make sense of their emotional suffering.
1.12.2 This increasingly close relationship between the pharmaceutical industry and the American Psychiatric Association (APA) and this sub-field of philosophy and sociology known as hermeneutic phenomenology offers the sufferers of BPD a potentially useful line of inquiry in the future, but it is not a line of inquiry that I investigate in this statement. For my story, my account and my analysis, I see these two directions of inquiry as tangential to the central thrust of both my story and its treatment both in the last and the future.
2. My Experience of Manic-Depression:
Phase One--The First 37 Years 1943 To 1980
2.1 In the first 37 years of my life I had many episodes of various kinds of emotional imbalance or disorientation, themselves of varying lengths and intensities, ranging from a euphoric, impetuous, expansive or high mood to a depressed, grey, low energy or despondent mood. Indeed the range of mood in these 37 years was much more extreme, but the complete/extreme range was rarely experienced. In these years I learned various self-monitoring skills as well as some self-reinforcing tactics. Sometimes these symptoms affected my day-to-day life severely and negatively, sometimes positively and sometimes the affect was non-existent, insignificant and hardly noticeable.
2.2 After many experiences on the fringe of a normality that was my usual modus operandi or modus vivendi, as it is said in Latin , on the fringe of what I saw as my general everyday experience of life, an experience that is sometimes called the quotidian by writers, poets and novelists, I was diagnosed as a MD in May 1980. I was treated by a psychiatrist in Launceston Tasmania while in hospital. I had often been on the fringe of this disorder, as I say above, a borderline zone, a limen as some historians call it, a border territory, a zone between normality and various behavioural extremes and eccentricities from my birth in 1944 to 1980. But in 1980 the symptoms were extreme and required hospitalization. The treatment regime in 1980 was lithium carbonate, an antimanic medication. Lithium was the first really successful mood stabilizer used by doctors to treat MD, an illness that in the 1990s began to be called BPD. This medication cushioned the effects of extreme depression and hypomania and prevented their effects from striking at my life. The perils of BPD lie in what I did in the midst of hypomanic episodes to deal with: decreased need for sleep, decreased self-control, increased sexual desires, irritability, rage, risk-taking behaviours and, in my 1968 and 1979-80 episodes, schizo-affective or psychotic states; and in the midst of depression periods with moroseness, extreme melancholia and suicidal wishes.
2.3 My history to that point, to 1980, had been far from smooth and linear as my remarks above indicate. Those thirty-six years had often been bisected, polarised and traumatised. As I indicated above I have written a more detailed account of these years elsewhere but this outline, this brief sketch here, of particular episodes and the periods between episodes will suffice. My experience of these highly diverse emotional and psychological swings of mood in everyday experience away form the norm, from my norm, is only part of my story. But it is a crucial part. Everyone has their story for everyone experiences all sorts of abnormal eccentricities and health problems in life, some people of course more than others and some more traumatic and intense than others.
2.4 My account of the years from 1943 to 1980 follows. I try, in writing about and in summarizing these first 37 years of my life, not to overstate my case, nor to understate it, but give an account of those first 37 years which I refer to here in this general statement as phase one of my bi-polar life. In some ways the inclusion of the names of those doctors who treated me over the years in this first phase and in later phases would personalise this account, but names are not that important and to include them here in this narrative causes confidentiality problems and raises privacy issues for some readers and for people in my own past who might not want to be mentioned. This question of confidentiality and privacy is especially true at some internet sites where posts are rejected if names are included in any posting at the site concerned---and so I leave names out. Those whose names I could mention would not be troubled by their inclusion here, not now, not in 2008 after an extensive destigmatization of the disorder in recent years and after so much of my experience and so many of the people concerned are now, what you might call, ancient history.
2.5 1 I certainly appreciate the medical and clinical work of: (a) several of the doctors I went to in my childhood, adolescence and adulthood, (b) the psychiatrists who have treated me since June of 1968, nearly four decades ago and (c) many family members, friends, colleagues and associations, some known well and others hardly at all, who have helped me ride the waves when the disorder raised its head yet again along the way, the road of life.
2.6 Comments on My Ante-Natal, Neo-Natal,
Childhood and Adolescence Life: 1943-1963
....more later after more responses.-Ron in Australia
Last edited by RonPrice; 7th December 2008 at 08:24 AM..
Reason: to add some words
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But since you guys are Mentioning the Bipolars then is there a homoPolar person? I know several ppl who like it in both pipes I will inform them maybe they would like to contribute to the Discussion on "Bi"s.
