Into the Void

Like many folks on psych meds, I’m obese. I make no excuses. I hate being fat and I’m doing what I can.

The other weekend I decided to break my diet and have breakfast at a Perkins Pancake House on a Sunday morning with two family members who are also on psych meds for bipolar disorder.

As the three of us were being led back to the table one of the wait staff looked me over then turned and called out to another staff member, “We got three pork chops!”

There is simply no call for Perkins employees to verbally abuse their customers, not even the lard-asses. It was the low spot of the day, and it has totally dimmed my enthusiasm for Perkins restaurants. I most certainly won’t set foot in the Moorestown, NJ restaurant again. Too bad for them, because when I’m there I eat a lot.

Perkins Pancake House obesity bipolar disorder rude waiters bipolar

I worked late Thursday night because I’ve been having trouble getting there on time. Typically I leave at around 8, and it’s a 45 minute drive home.

I’ve been in that place where… well, it’s as if I need to stop and let my mind catch its breath, if that makes sense. Instead, I just keep putting one foot in front of the other and trudging onward in this death march we call life.

Of course, my mind is taking this opportunity to slap me around. Self-defeating thoughts like:
I’m a fraud, I’m only pretending to be an engineer.
Everything I’ve ever done was stupid
or hurtful
or self-destructive.
My husband only stays with me because he made a promise to my mother to take care of me when she was on her deathbed. (Nice dramatic touch.)
Creationists don’t want their children to be more successful than they are, because that would support the theory of evolution.
Pro-lifers love rapists almost as much as they hate women.
Millenialists are working on bringing about a utopian, agrarian 1000-year peace through war in the Middle East, and are too unsophisticated to understand that a 1000-year global interregnum doesn’t equal peace, it equals The Dark Ages.
Evangelicals want to kill non-believers just as desperately as the Wahabbist Islamics want to.

I mean, rationally I know it’s all BS, but that’s how I FEEL. As long as I don’t let it suck me in intellectually too I’ll be fine.

But let me clarify, That’s what my neurotransmitters are trying to do to me. *I’m* ok. It’s the bipolar talking, it’s pessimism.

Just keep putting one foot in front of the other.

Well, that’s the point of going to support groups, right? To learn how to move forward even when we don’t care about any of it. We don’t have to get sucked in. It’s about having a rational, objective observer. Yes, so I have a shitload of training in how to be logical and objective.

I wish everybody took four years of science and five years of math in high school. It’s a good start. It teaches you how to think and how to form conclusions. If you let it, it also teaches you how to be objective.

Eh, well, I can still feel it and the thoughts are there when I’m not thinking about anything else.

On Thursday I told the boss I’d be taking a mental health day Friday. Cranked out the first version of Friday’s work and tested it on the hardware. Updated a test document. RARed the whole mess, dropped it into my shared docs for review. Sent the boss an email with a 9:30PM timestamp so he knows when I left. Heaved a sigh of relief and headed home.

I was in an accident on the way home. I was on the turnpike about a mile from my exit. There’s construction near the exit and some fellow came flying down and rear-ended me.

I’m ok, got the wind knocked out of me by the impact and breathed in some Hybrid nastiness. Contusions on my chest and abdomen from the seat belt, nausea, vertigo, and a neck sprain, but nothing life-threatening.

I suspect that my car is a total loss. It’s a classic Prius. The rear was crushed in so deep it cut through the tire and jammed the wheels. The auxiliary battery was crushed and exuding a visible a cloud of acid. Fortunately most of that got sucked into his car, not mine. The Prius avenges its own death. I don’t know how the hybrid battery fared. It may have taken out a cell or so on the left side.

Standing in a construction zone on the turnpike at 10:15PM with all the sirens and flashing lights and cars flying by just a few feet away was the most frightening thing I’ve ever experienced in my life. I had to hang onto the concrete barrier to keep myself from running away.

I was looking for an excuse to buy a new car. Maybe a Toyota Matrix. I playing around online this morning comparing prices.

Mishaps are like knives. They can cut you or they can serve you depending upon whether you grab them by the blade or by the handle.

Early manifestations and first-contact incidence of schizophrenia in different cultures. A preliminary report on the initial evaluation phase of the WHO Collaborative Study on determinants of outcome of severe mental disorders.

Psychol Med. 1986 Nov;16(4):909-28.
Sartorius N, Jablensky A, Korten A, Ernberg G, Anker M, Cooper JE, Day R.

The results provide strong support for the notion that schizophrenic illnesses occur with comparable frequency in different populations and support earlier findings that the prognosis is better in less industrialized societies.

Technorati: schizophrenia WHO+Collaborative+Study

UPenn’s Center for Resuscitation Science

Interesting web site. It’s about how we define the moment of death. They are turning Emergency Medicine on its head.

If you have advance directives, a living will or a DNR order, it’s because you don’t want to wind up a vegetable after a medical emergency or because you have an incurable, fatal condition. Advanced directives are NOT intended to force the ER doctors to let you die when medical treatment can easily fix you right up. With the exception, of course, of folks whose religion forbids medical treatment.

When I was a whitewater rafting guide I had to be certified in Advanced First Aid and Life Support. This program took four weekends to complete. It was hard for me to put in that kind of sustained effort, now that I think about it, but it really helped my confidence on the job. The point of the course was to enable the guides to stabilize someone injured on the river until we could get real medical help. And it wasn’t a far stretch to consider CPR in case a guest had a heart attack on the river.

Read the UPenn web site. Look at the powerpoint presentations. Read the doctors’ curriculum vitae.

Again: it’s about how we define the moment of death.

So.

Google “cellular reperfusion injury” and read a few of the articles that come up.

Your cells don’t die right away when you die. When oxygen-deprived they go into a kind of stasis and even after several hours a doctor can still extract undamaged, living cells. They haven’t stopped, they’ve just slowed down. You don’t fade out in that first magic 5 minutes. You fall into a deep coma, then actual cell death takes hours - or longer.

This is completely different than what the public and most of the medical profession believes at this time. The current belief is that no pulse equals death. Which really sucks for a few folks who have temporary a artificial heart that whirrrrrs instead of beating. But I digress.

So if you want to define death in terms of brain activity as monitored on an Electroencephalogram (EEG), well, the EEG can only measure down to about 0.5 Hz. This is a limitation of our technology. As you fall asleep brainwaves slow from 30Hz maximum down to around 4Hz. If you go into a deep coma, they slow down even more. No brainwave equals death, then. Except that our technology has serious limitations. Well, it turns out that brain cells go into stasis too.

Now here’s where it gets weird.

Think about what they do in the ER. It’s all about reperfusion, getting oxygen back into the brain as quickly as possible. Jump-start the heart, pump oxygen into the lungs, get a cold patient warm. Well, it turns out that if you pump too much oxygen into a cell that’s in stasis, it self-destructs. That magic 5 minutes isn’t the time that it takes the cells to die. The magic 5 minutes is the time it takes for some of the cells to go into stasis, that is, enough that the self-destruction, or apoptosis, causes wide-spread damage to the body on reperfusion. The heart seems to be the most susceptable organ.

The gist of the web page I linked to is that if someone is brought into the ER suffering from cardiac arrest, they have a better chance at survival if the ER doctors immediately cool them down and add some chemicals to prevent apoptosis before beginning slow reperfusion. The Resuscitation Medicine department at the U of P is working on establishing a new set of protocols.

Where it gets scary is here:

If they bring you in after the magic 5 minutes, present ER protocols can’t save you. Not without massive, permanent damage to the heart and to the brain. They declare you, and that’s it. The body is sent to a funeral home and cremated or injected with preservatives, sometimes long before the several-hour deadline (so to speak) is up.

No wonder the Irish hold wakes. The British, after discovering that an unsettling number of people had been buried alive - used to attach bell cords to the wrists of folks they buried. Saved by the bell.

IRL your family can decide to keep your brain-dead corpse alive despite anything you said in life. Witness what poor Terri Schaivo’s parents did to keep her mindless body alive long after her spirit was gone.

I’ll be watching the Rescusitation Medicine story with great interest.

Rescusitation Medicine apoptosis Emergency Medicine cellular reperfusion injury EEG cardiac arrest moment of death

<rant>
Email to someone I don’t even know who has been spamming me with chain letters.

Date: Sun, 13 May 2007 09:57:50 -0400
To: ————-
From: Leslie
Subject: I’m blogging this. Thanks. Re: Gas War

Did you write this in crayon? Or worse, did someone else write it in crayon and you merely forwarded it because you liked the big purple letters? You obviously didn’t think this through.

If you do this you’ll drive the price up at the other gas stations…

1. because most Exxon-Mobil gas stations are privately owned by local merchants, not by Exxon-Mobil
2. because unbranded gas stations usually buy from the big oil companies, including Exxon-Mobil
3. because when BP and Citgo and Hess and Lukoil stations run low on gas they’ll buy some at an exorbitant price from Exxon-Mobil
4. because the small stations also increase their prices according to supply and demand - they have to make a living.

Consumers don’t call the tune in a capitalist society. Deal with it. The producers do and they employ sophisticated marketing strategies based upon well-established behaviorial psychology techniques to do so. Psychology in the US has been focused on predicting the actions of large numbers of people, and of MANIPULATING them. You don’t get to decide what you want - you buy without thinking why you prefer one brand over another. And you forward junk mail with the same lack of thought.

The real answers to the problem are too hard for Americans. Bicycle. Take the bus. Get a hybrid vehicle. Don’t use electricity from oil-burning power plants. Instead, set up solar panels and wind turbines to generate your own electricity, using commercial nuclear power as a backup only.

Let’s see… an food industry executive is an expert on the oil industry? What’s his name again?  And the Halliburton engineer - knowing how to crack petroleum doesn’t make you an expert in Microeconomics.

According to Snopes.com, the Gas Wars email you sent me has been circulating since 2001. You missed the May 15th boycott by 6 years.

Who are you and where did you get my email address?

Leslie

</rant>

At 08:13 PM 5/8/2007 -0700, you wrote:
Date: Tue, 8 May 2007 20:13:09 -0700 (PDT)
From: ————————-
Subject: Gas War
To: ———————

In addition to the Gas War set for 15th May 2007, here is something else we all can do ..

jdowney01@GAS GAS WAR - an idea that WILL work. This was originally sent by a retired Coca Cola executive. It came from one of his engineer buddies who retired from Halliburton.
It’s worthy of your consideration.
Join the resistance!  I hear we are going to hit close to $4.00 a gallon by summer and it might possibly go higher! Want gasoline prices to come down? We need to take some intelligent, united action. Phillip Hollsworth offered this good idea,
This makes MUCH MORE SENSE than the “don’t buy gas on a certain day” campaign that was going around earlier!

… and lots more of the same. Click the snopes.com link above.

Mental Health Care Failing At-Risk Troops, Related Study Finds Battlefield Ethics Also Suffering - CBS News

This story on CBS shows an ongoing problem in Iraq. Overworked, stressed-out soldiers start to fall apart due to long deployments and irrational (if any) strategy. I question labeling someone as mentally ill when it’s due to long-term stress.

Think about it. You get sent to the Middle East on a six-month deployment. 18 months later they still won’t let you go home. Your kids think you lied when you said you’d be home in six months - and again when you said you’d be home in a year - and are showing behavioral problems in school; your mortgage is in arrears because you took a pay cut for what you thought would be only six months; if you owned a business it has long since failed; you’ve missed 18 months worth of family get-togethers; you have to climb over a half-dozen Jersey Barriers to get to your ratty, noisy little home-away-from-home. And every day you drive highly-paid civilian contractors up and down the road to the airport like a duck in a shooting gallery. You start to envy the ones who get to go home in a body bag.

You see no progress being made, and you no longer believe that your efforts can make a difference. It creates a lot of confusion.

And in frustration you start lashing out at people. This is not good. We are literally driving thousands of our best citizens insane with our irrational policy and complete lack of strategy for rebuilding the country we tore apart. For someone with a degree in History, Bush seems incapable of learning from the mistakes of the past. Perhaps he was AWOL for history class, too.

I would like to remind everyone that we are not at war over there. Bush declared that the war was over years ago. Let’s get the other Islamic countries involved at the political level - their citizens are already in there helping the “insurgency,” as we like to call their freedom fighters. Whether you like Iran or not, they have what passes in the Middle East as a Democracy. So does Turkey. You’d have to get all kinds of agreements to stop the sectarian violence, but we knew that before we started this whole thing.

Technorati: Bush civilian+contractors Democracy freedom+fighters insurgency Iran Iraq Islamic stress mentally+ill Middle+East politics sectarian+violence

Woodwarbler’s JazzGrass stream. The music starts about a minute into the stream after the tail end of the previous show.

My friend Brian Aust has a new radio show called Woodwarbler’s JazzGrass at WGDR Goddard College in Plainfield, Vermont. I took a quick listen before writing this post and wound up listening for a half hour! What is JazzGrass? you might wonder. It is an eclectic mix of Old Timey Bluegrass that evolves into Jazz later in the show. Brian is a great guy and Bluegrass music is just plain fun. Kind of like speed metal for country boys.

In case the link above doesn’t work, go to the WGDR music archive page and select April 30,2007 at 1935 (7:35PM) Eastern Time. The show is 2 hours long. The show is available for download, too, for download to your mp3 player.

I’ll update this link when I hear that the show has become a permanent institution at WGDR. Drop a dollar or two in the hat while you’re there.

Public radio needs your help. But that is a topic for a huge rant about large corporations owning all the media outlets in town and taking wonderful but less popular music genres off the airwaves in the name of profit. Not to mention pooling all the news outlets into one incestual mass of mediocrity.

Before you think I’m defending the borderline, let me state uncategorically that I avoid them like the plague in real life.

Here’s a good article that explains why borderline personality disorder is often misdiagnosed as bipolar disorder.
http://www.nimh.nih.gov/publicat/bpd.cfm

While a person with depression or bipolar disorder typically endures the same mood for weeks, a person with BPD may experience intense bouts of anger, depression, and anxiety that may last only hours, or at most a day. These may be associated with episodes of impulsive aggression, self-injury, and drug or alcohol abuse. Distortions in cognition and sense of self can lead to frequent changes in long-term goals, career plans, jobs, friendships, gender identity, and values. Sometimes people with BPD view themselves as fundamentally bad, or unworthy. They may feel unfairly misunderstood or mistreated, bored, empty, and have little idea who they are. Such symptoms are most acute when people with BPD feel isolated and lacking in social support, and may result in frantic efforts to avoid being alone.

I’d like to put forth the observation that psychology in the US is mainly concerned with predicting and manipulating the behavior of large numbers of people. There is little or no acknowledgement of an internal landscape, because you can’t measure emotions - you can only measure how they are expressed. The psychologists aren’t healers, they are agents of social control.

So. “Personality Disorder” means that a certain type of personality has been pathologized because their behaviors are uncomfortable to others. The behaviors relate to the coping style - but the real problem is that the person has a damaged ego. They have to rely on others to give them clues as to who they are!

The borderlines experience an overwhelming fear of abandonment. All of the crazy behavior is to prevent you from leaving. Unfortunately, the set point is so low that most of what you do looks like abandonment. Abandonment in this context doesn’t mean left alone to rebuild their life - which majorly sucks but isn’t the End of the World. Abandonment means that who they are has been taken away from them. They have little “I” so they have to be part of a “we.”

You can teach a borderline to withhold their emotions with Dialectic Behavioral Therapy (among others), but I’m not entirely convinced that any therapy changes the real problem. It has very little to do with wanting to change, and everything to do with the fact that the fear of abandonment is so deep that - well, damn, you practically have to tear down the whole house to fix the foundation. You see?

Here is the website for Dr. Marsha Linehan, Ph.D., ABPP, who developed DBT.
http://www.behavioraltech.com/index.cfm

Marsha Linehanborderline personality disorderDialectic Behavioral Therapypsychologybipolar disorder
egoNIMH

people who experience
  mood swings
    fear
      voices
        visions

each other on the internet
    for advocacy and support

I don’t know where to start to talk about Sylvia Caras. Award-winning mental health consumer advocate, speaker and author, founder of the Madness group and of People Who, Grandma, and a really together lady. I really look up to her - and if you know me, I don’t look up to anyone!

Sylvia recently accepted two of my blog articles for inclusion on the People Who site. Do stop over and look at what she is doing for us.

Sylvia Caras People Who mood swings

Great news! Two new bipolar t-shirts in the [tag]Manic Mall[/tag]. The first one, called “Crazily is…” is the [tag]Chinese[/tag] characters for [tag]bipolar disorder[/tag] cut-and-pasted from a [tag]medical[/tag] site in China. A back-translation on babelfish tells me that the Chinese have an interesting perception of us. Interesting as in the ancient Chinese curse, “May you live in interesting times.” Click the picture to see the shirt, “Crazily is [tag]hot-tempered[/tag] the depression!”

The second t-shirt should have been the first shirt, since I was researching it when I came across the translation above. It inspired me to create the Official Bipolar Planet® World Tour 2007 [tag]t-shirt[/tag].

Well, I was looking at an Israeli search engine that links to [tag]Pendulum[/tag] Resources and got curious. Is [tag]manic depression[/tag] a world-wide problem? Do some cultures accept “eccentric” behavior more than others do? How did they treat manic-depressives before lithium? I am very curious about it. A very quick trip to world-wide googles helped me find dozens of ways to say “[tag]bipolar disorder[/tag]” and “manic depression.” It really is a Bipolar Planet®.

Update 5/1:
Someone pointed out to me that I didn’t include the English words for bipolar disorder or manic-depression. Oops! I thought it went without saying that English-speaking countries are nuts.