Rango's Dog House

it’s widely known that bipolar patients experience major swings in mood, from manic to depressed, and the entire spectrum in between.

people tend to associate this disorder with sudden, dramatic changes in moods, but this is a culturally-induced fallacy.  with the rare exception of a specific type of symptom expression called rapid-cycling, suddenly shifting moods on a moment’s notice is not bipolar, it’s something else.

it typically takes three weeks or more to rebuild the neural network the defines a mood swing.  i refer to this time as the inception period.  it’s a similar time frame as with an antidepressant, three weeks or so to kick in, but the changes can persist for months or years after inception since they are self-propagating.  i’ve had my own personal fight club moment, where i had a moment of awareness in the midst of madness and acknowledged the fact that i’m bipolar.  i could recall the worst mood swings in my life and inevitably trace each of them back to a single, deeply impacting emotional event, either good or bad, roughly three weeks before i demonstrated the first symptoms of extreme wakefulness or dreadful fatigue.

once the trigger event starts the neural synaptic cascade things can only get worse, until they get better.

your job: make them get better, sooner, even if it’s only a little bit, because it will pay off in the long haul.

Dichotomous Me

the pitfalls of depression are obvious. extreme fatigue, overwhelming sadness, abject grief, lack of confidence, a sense of hopelessness, attempts to self-medicate that lead to substance abuse and an incidence of suicide that is an order of magnitude higher than the population at large.

the pitfalls of mania are not as obvious until they’re in full bloom. manic wakefulness starts as an unlikely level of energy and confidence that builds over days and weeks, eventually depriving the mind of sleep and cognitive function.  it slowly introduces randomness in thinking and symptoms that are hard to predict.  they can mimic sleep-deprivation, but also OCD, including repetitive and otherwise maladaptive behaviors.  they can mimic social disorders, including overwhelming anxiety and panic attacks. they can lead to impatience and anger, or unspecified angst.  they can lead to delusions, and ultimately auditory and visual hallucinations that mimic schizophrenia.  they can even include synesthesia, from songs that taste like chocolate cake (uncanny) to mind-rending chromesthesia where your visual and auditory lobes become cross linked, causing you to see sound and hear colors with perfect coherence, including seeing photisms in response to music`.

when two emotional triggers happen within less than the inception period for the mood change, this can lead to rapid-cycling, which is comparatively rare.  i’ve had bipolar symptoms for ~30 years and only had rapid-cycling a few times, most notably this year in a three month episode called #romeovoid after losing my only physical companion, my rabbit franklin, a week before my girlfriend in another state broke up with me.  three weeks later i got very sick and by the fourth week i was rapid-cycling.  this is the edge case i mentioned in my opening comments.  in this case what happens is you can experience extremes of mood on the same day.  these episodes tend to be capped at hypomanic, which is to say you’ll experience, say, extreme grief and overwhelming social anxiety on the same day, but you’re unlikely to have full-on hallucinations or commit suicide because the mixed state ensures you’ll get some sleep, even it’s from crying yourself out.

as bipolars are to the red pill / blue pill conundrum, the mixed state of bipolar is to purple.  herein lies a solution of sorts.  since mixed-states tends to mitigate the most extreme symptoms, it can offer some insight to our long-term prognosis.

Go For Purple

rango always says “go for purple”, which is to say when given the red pill / blue pill conundrum, take both.  this is more than just a convenient captain-kirk solution. the intended suggestion is try to mitigate the extremes of both symptom sets by acknowledging it’s natural to oscillate and simply try to curb the amplitude of the oscillation by addressing symptoms directly, both tactically and strategically.  this usually involves medical therapies but can also include changes to diet, exercise and sleep routines. indeed, dark therapy (where the patient is isolated in long, natural uninterrupted sleep cycles) is one of the most effective treatments of bipolar but simply impractical given the social realities of keeping a job in a modern world that requires time-zone attentiveness with peers.  the thinking here is that just as the impact of the symptoms accelerates on a brutal asymptote, so does the impact of the applied therapies.

bipolar tends to be progressive, which is to say the long-term outlook degrades with age.  however, the same logic applies to this curve as the red pill / blue pill conundrum.  i can attest based on my personal experience that you can improve your long-term outlook and the quality of life by applying both strategic and tactical solutions to address specific symptoms and behaviors, and reap the long-term benefits of honing towards the middle.  it requires discipline and counsel, honest friends and a willingness to acknowledge blind spots, but it can be done.  for how long is anybody’s guess, but every good month offsets the impact of a bad one and shaves the ultimate resolution in your favor.

Dichotomous Me

“go for purple” – #rangothedog

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