How Stigma Works

Some of the folks on Pendulum and The Bipolar Planet may remember back in 1999/2000 when my employer gaslighted me. Things like writing me up for being unable to get to work during a flood. Refusing to provide reasonable accommodations under the Americans with Disabilities Act (ADA) that would have improved my productivity.

No, really, what I asked for was a little cubicle at one end of the very noisy computer lab to cut down some of the fan noise and block the visual stimulation of people wandering in and out of the room all day. And that instructions be sent via email instead of verbally, and that stated task priority be filtered through my supervisor to assist my then-lithium-impaired memory. And that I be allowed some leeway in the time I start my day because of a co-morbid, or perhaps drug-induced, sleep disorder. All told it may have cost about $1000 for a couple of cubicle walls. Not a hardship for them. Perhaps it would occasionally inconvenience an engineer who wanted some soldering done first thing in the morning, but in the main I worked alone in the lab – nothing but me and ten or so distractingly noisy desktops and servers.

One engineer gaslighted me a number of times – telling another department that I would do a task for them, but not bothering to actually ask me to do the task. Or giving me incorrect instructions that led to two or three days worth of worthless measurements. He would assign the task last thing before he took a couple of days off, so I couldn’t even ask for clarifications. You can guess how bad this made me look. The negative effect on my self-esteem was incalculable.

There were two other handicapped women working there – they got us really cheap, I suppose. This fellow engaged in the same sort of behavior with them. I thought it was rather odd that he often talked about his kid, but never about his wife. At some point I caught on – the gentleman was a truly wretched misogynist.

It got to me. I began to think that maybe it was me, not discrimination and stigma. Maybe I really was incompetent. Maybe the bipolar disorder was really progressing toward total disability. My self-esteem plummeted. I was about to quit my job when one of the other victims suggested that I go on disability for a bit to get my head back together. So I did.

When I came back, the company refused to give me internet access. That meant no searching for component datasheets, no on-line parts orders, no package tracking. I literally could not do my job without it.

It was the worst kind of nightmare, the kind that follows you home at the end of the day, the kind that intrudes into your dreams, the kind that wakes up with you in the morning, the kind that makes your entire world lose its color and taste.

Eventually, the Director of Human Resources called me into her office and forced me to accept a “mutually agreed-to separation.” The woman even told me that I’m not suited to work in the electronics industry.

I want to know one reason why it is good for society to prevent the mentally ill from working.

The victimized co-worker that I mentioned later helped me put together letters to HR, took me along when she went down to the U.S. Equal Employment Opportunity Commission (EEOC) to file a complaint, and took me to her lawyer. I wouldn’t have done these things on my own.

For the record, the EEOC gave me a “right to sue” document, but I had another episode and so was unable to follow through.

Since my self-esteem was so shot, I was unable to find another job. Instead I went back to school and finished up my BS in Engineering Science – with a minor in Mathematics.

It’s been on my mind because I have been cleaning out old files including all my records about my complaint with the EEOC. Folks, if someone discriminates, report them – after you are terminated, of course. Even if you don’t profit from it – and you probably won’t – it lays a groundwork for future employees who experience the same thing you did. Three different women called and asked for my EEOC case number within the next six months after I left.

Yesterday, just out of curiousity, I looked up the Director of HR on the ‘net. She now heads up a local National Alliance on Mental Illness (NAMI) chapter. If that’s what NAMI is all about, teaching HR people how to use our illnesses against us at work, I will never give them another cent.

NAMI.

I went to a local meeting one time. It was frightening.

This fellow brought his college-age daughter and talked about her in the third person throughout the meeting. He kept his arm around her as if she might jump up and run away. As if she might open her mouth and express her own opinion. As if she were his property. No wonder she was sick.

Another couple complained why can’t the doctors medicate their son against his wishes. The son is crazy, he can’t make a rational decision! Well, their son’s wishes are not irrational just because they differ from the parents’. When there are drugs that really work and don’t have debilitating side effects, the seriously mentally ill may feel better about taking them.

The NAMI facilitator glanced at me and then carefully said, “Forced medication is against the law. It violates the patient’s rights.” I know damned well that if I weren’t there the conversation would have gone differently.

I can’t imagine being wrestled to the ground and forcibly injected with intoxicants. I can tell you this – if you tried to do that to me right now I’d fight you until I ran out of strength. Of course, you would then be able to say, “See, see, she’s irrational, she’s being violent.” This is so much more than an issue of the patient’s rights – it is a violation of their person on the order of rape.

My opinions and my wishes are not irrational just because they differ from my family’s – or from NAMI’s.

Jagged Peak Adventure

YouTube – Line Rider – Jagged Peak Adventure

A new game. If I did drugs I might waste a year or two playing this game.

Remission in Bipolar Disorder

If someone figures out how to “cure” genetics, let me know. You can’t exactly pick up a bottle of Grecian Formula for Brain at the local pharmacy.

Remission is another thing altogether. That simply means that you are having an extended symptom-free period. Given that the DSM-IV bipolar criteria only require that the patient have ONE episode of mania or hypomania, some folks may remain in remission for the rest of their lives even without meds.

Science *is* empiricism. I would like to suggest that a large percentage doctors are not particularly careful in their application of the science of medicine. If they were scientific, they’d test and retest the bipolar patient’s continued need for meds instead of following the bizarre rule of thumb that once you’re on meds you need them forever. The killer is that as long as the illness is masked by drugs, it is impossible to practice “evidence-based medicine” as they disparagingly call it.

None of us on meds is being treated in an scientific manner. It isn’t scientifically valid to say that bipolar disorder causes cognitive deficits if a large percentage of the patients in the study were on meds. Antipsychotics have been *proven* to reduce the IQ by affecting the short-term memory. They aren’t the only drug to cause cognitive deficits. Lithium makes you feel as if your brain is wrapped in cotton wool.

I don’t believe that it is scientifically valid to say that bipolars must be on meds for life. If the patient stops the meds and experiences a return of symptoms… well, you’ve rewired the brain. The drugs themselves create a continued need for themselves by reconfiguring the brain’s neurons to need higher levels of serotonin in the synapses. The symptoms are bound to return, and much worse than before the drug did its damage.

Another thing about remission is that so many things besides bipolar disorder cause mood swings. Bipolar disorder has periods of remission. Things like the personality disorders, schizophrenia, schizoaffective disorder, PTSD and any of a hundred organic illness all cause mood swings. But they don’t necessarily have periods of remission, and in many cases remission just doesn’t occur.

Here – this is my particular manifestation of bipolar disorder. Three-year cycles. They come no matter what, but fortunately the meds attentuate the episodes. On the other hand, until I was on meds the cycles didn’t seriously impact my salary.

I think that it’s important, if a bipolar isn’t having remissions, to figure out why. Ultra-rapid cycling could be caused by an antidepressant, particularly in women. Newly-diagnosed bipolars often experience a great deal of fear or anxiety that might be better treated with therapy than with additional meds. Antipsychotics may ruin the patient’s ability to effectively manage the illness by dumbing them down. Sometimes it isn’t the illness, it is the meds that make bipolars disabled.

Are your drugs masking periods of remission?

Sometimes I get tired of the reverse stigma that I get for taking fewer meds so that I can continue to have a life. Isn’t that the purpose of treatment? If not, what is?

Most bipolars have the so-called milder varieties of the illness, and many of them are unfairly overmedicated and isolated from society for no good reason. It is unbearably sad to see that happening. So if I can tolerate psychosis instead of trying to medicate away every little nuance of mood or emotion, does that make me somehow inferior? I don’t f*cking think so. It isn’t pathological until it has a negative effect on my life.

Talking to Dog Again

Follow up to https://intothevoid.us/2005/07/09/talking-to-dog/

There is this thing called the religious experience. This is where you feel the presence of something larger than yourself, and know your place in the grand scheme. Sometimes you only get a glimpse of it, but it’s enough to change your opinions completely. Uh, epiphany, that’s what it’s called. Epiphanies are associated with the amygdala and certain brain chemicals which I don’t care to look up right this instant.

Organized religions cannot allow their laypeople to have religious epiphanies. Why? Because they are exploiting that divine revelations to exert power over us. What if Dog told one of us to stop following the kosher laws or to take down the graven images in the church, or whatever your particular religion requires?

I can hear the Elders now: “What’s that? Dog told you that the church must allow rape victims to obtain abortions if they want so that they aren’t troubled by the life-long trigger of a child with the face of their rapist? Hmmm, he didn’t tell us about it! Heresy! BURN THE WITCH!!!

I seem to burn a lot of witches in this blog. Apologies to my Wiccan friends. I am not condoning witch hunts, I am raling against them.

There’s another problem. In certain mental disorders the patient finds change very distressing. In the case where the patient is incapable of seeing others’ points of view, and is in a position of power, it can get very ugly. Since the patient doesn’t acknowledge other points of view, he perceives that his own dysfunctional ideas fill the entire universe – are intrinsic to it, are the Word of Dog. This has a lot of useful side-effects. One of them is that the patient, in externalizing his own faults, can deny them and even project them onto others! If another opinion ever impinged up the patient, he would believe that it threatens his very existance, that it threatens the order of his universe, that it is Blasphemy. He will label other opinions as Evil and then try to destroy them.

I believe that this is precisely why so many people in power use organized religion to control the populace.

Anyone who foists their particular flavor of religion on another person is, by definition, trying to control them. It has absolutely nothing to do with “saving” them or helping them “attain enlightenment” whatever the Big Idea in their particular religion might be. It is all about pathology and projection and POWER.

So don’t even think about proselytizing. Why should I follow instructions that were meant only for you? If I want to talk to Dog I’ll do it myself, thankyouverymuch.

TFTD – Effective communication

“Effective communication requires constant effort, but ineffective
communication requires constant apologies.”
– Adam Pacio, used with permission

Metaprogramming the Meat Computer

I’ve been trying to find out where my personal evolution stopped – using the transpersonal psychology model for lack of a better plan – so that I can decide what to work on next. Change is pretty destabilizing, I’m afraid, but stagnancy is another form of death. Yeah, probably hanging on too long is an issue. When I was a kid I’d get frustrated and walk away from difficulties, so I’m thinking this is a matter of finding the Tao, the middle way. The answer isn’t immediately obvious.

I think that a big part of healing is to reframe the issues (as the Republicans say).

The nature of an epiphany is to show you everyday things in a new light. To extend your vision far beyond your normal point of view. To show you things you never even knew existed, if only for a moment. Maybe this is the source of creativity? For the most part, however, you make changes by a slow retraining process.

When I took Chinese History I learned that when a new Dynasty began, the first thing they’d do is hire historians to rewrite the history books. I don’t advocate completely lying about your past or going into denial, but you can certainly try to find good things that you may have missed, and you can underemphasize the bad things. In school you may have repeated the times tables until you memorized them. Well, it works with anything. Tell yourself bad things about yourself over and over, and you will learn that. Tell yourself that you are competent and satisfied with you life, and you will learn that. This is the difference between a winner and a loser.

The winner always gets to write the history books. *Always*

Fortunately, many of our drugs keep us from being dangerously creative, from having epiphanies, and sometimes even from feeling our own feelings.

Oh, speaking of metaprogramming the meat computer, there’s an interesting site in Australia you might like to check out. It is a free online CBT course from the Australian National University. You aren’t going to cure bipolar disorder with it, but you may learn how to keep a bad day from getting worse. Thanks go to the Pendulum Resources forum for this gem.

Family Values

There has been a lot of verbiage in the media lately about how marriage is a Sacred Institution. Atavistic politicians go on and on about how giving same-sex domestic partnerships the same benefits as marriage would be a financial burden on employers and social services, and possibly bring about not only an end to civilization but possibly to the entire space-time continuum.

There’s a problem with all that.

More heterosexual couples are setting up housekeeping and even having kids without ever getting married. It’s so prevalent that unmarried couples actually outnumber married couples for the first time in years. Many states recognize common-law marriages and give them the same status and benefits as any other marriage.

However, social policyin the U.S. is entirely based on the premise that women and children derive their social benefits through a man. Retirement, healthcare, housing, all of it. Most policy is based on a post-WWII “Leave it to Beaver” mentality that has very little validity now. I don’t think it ever did, actually. What is all this reminiscence and longing for a past that never was?

Why do we still filter benefits through a husband? Women don’t go directly from their father’s house to their husband’s house any more. Everyone works, both husband and wife, and they don’t start having the kids until they can actually afford them. People who marry young are just as likely to divorce as to stay together. And less than half of couples living together in the U.S. have traditional marriages.

The implications of the attack on domestic partnerships are very ugly. Why is a common-law marriage is somehow morally inferior to a marriage that started with a ceremony in a church? And what does the necessity for a license say about all the lip-service they give to family values? Marriage doesn’t have a monopoly on love or commitment or having children. I’m having a bit of trouble figuring out exactly what it *is* about at this point.

So what I’ve been thinking is that as long as we are discriminating against domestic partnerships, let’s extend it to heterosexual couples. Think about it. Big corporations would save billions if they weren’t forced to insure unmarried partners and their children. The cost of insuring same sex partners is negligible compared to that.

We should redefine marriage. The current definition is too broad. I think we should narrow it further to exclude spouses who don’t have children yet. When they do their duty to produce future taxpayers, *then* they qualify for insurance, widow’s benefits, and an income tax deduction. Think of the money we’d save!

Bipolar Disorder and Sleep

Excerpt.
The following is an excerpt from the book Bipolar II
by Ronald R. Fieve, M.D.

Published by Rodale; October 2006; $22.95US/$29.95CAN; ISBN 1-59486-224-9
Copyright © 2006 Ronald R. Fieve, M.D.

Bipolar Disorder and Sleep

“How many hours do you sleep on average at night, and what is the quality of your sleep?” are two of the first questions I ask every patient on the initial interview and all subsequent follow-up visits. While the hypomanic usually gloats over how little sleep he needs, getting by on 3 to 4 hours a night, the lack of quality sleep can wreak havoc on his mood and decision-making abilities. Sleep deprivation results in feelings of malaise, poor concentration, and moodiness, and even accidental deaths.

In a revealing sleep study published in the September 2005 issue of the Journal of the American Medical Association, Judith Owens, MD, and her team of researchers from Hasbro Children’s Hospital in Providence, Rhode Island, followed 34 pediatric residents from Brown University over the course of 2 years to compare post-call performance to performance after drinking alcohol. During this time, the residents were tested under light call (1 month of daytime duty with no overnight shift, or about 44 hours of work per week) and heavy call (overnight duty every fourth night with an average of 90 hours of work a week). The residents performed computer tasks to gauge their attention and judgment after their light call (after consuming alcohol) and heavy call shifts (with placebo). The residents who were on heavy call and had not ingested alcohol performed worse on the computer tests than those doctors who had taken alcohol and were on light call. Dr. Owens concluded that the residents were so sleep-deprived that they didn’t recognize that their own judgment was impaired.

Drugs, stressful situations, and even excessive noise can affect daily body rhythms and moods. Once a Bipolar II mood disorder with disturbed rhythms has begun, it tends to be self-perpetuating, since depression and anxiety are likely to disrupt 24-hour rhythms further. An irregular living schedule can aggravate mood disorders. The old-fashioned sanitarium rest cure was effective with the “nervous” because it put the patient on a regular schedule of sleep, activity, and meals.

Insomnia

How is your sleep? Do you have difficulty falling asleep? Or do you toss and turn most of the night until you fall into a deep sleep just hours before the alarm goes off? A person suffering from insomnia has difficulty initiating or maintaining normal sleep, which can result in non-restorative sleep and impairment of daytime functioning. Insomnia includes sleeping too little, difficulty falling asleep, awakening frequently during the night, or waking up early and being unable to get back to sleep. It is characteristic of many mental and physical disorders. Those with depression, for example, may experience overwhelming feelings of sadness, hopelessness, worthlessness, or guilt, all of which can interrupt sleep. Hypomanics, on the other hand, can be so aroused that getting quality sleep is virtually impossible without medication. In a study at the University of Oxford in the United Kingdom, Allison G. Harvey, PhD, and colleagues in the department of experimental psychology determined that even between acute episodes of bipolar disorder, sleep problems were still documented in 70 percent of those who were experiencing a normal (euthymic) mood at the time. These normal-mood patients with bipolar disorder expressed dysfunctional beliefs and behaviors regarding sleep that were similar to those suffering from insomnia, such as high levels of anxiety, fear about poor sleep, low daytime activity level, and a tendency to misperceive sleep. Dr. Harvey concluded that even when the bipolar patients were not in a depressive, hypomanic, or manic mood state, they still had difficulty maintaining good sleep.

Delayed Sleep Phase Syndrome

This is the most common circadian-rhythm sleep disorder that results in insomnia and daytime sleepiness, or somnolence. A short circuit between a person’s biological clock and the 24-hour day causes this sleep disorder. It is commonly found in those with mild or major depression. In addition, certain medications used to treat bipolar disorder may disrupt the sleep-wake cycle. I often recommend chronotherapy to patients. This therapy — an attempt to move bedtime and rising time later and later each day until both times reach the desired goal — is often used to adjust delayed sleep phase syndrome. To adjust the delayed sleep phase problem, sleep specialists might also use bright light therapy or the natural hormone melatonin, particularly in depressed patients.

REM Sleep Abnormalities

REM sleep abnormalities have been implicated by doctors in a variety of psychiatric disorders, including depression, posttraumatic stress disorder, some forms of schizophrenia, and other disorders in which psychosis occurs. Special tests, called sleep electroencephalograms, record the electrical activity of the brain and the quality of sleep. From these tests, we know that in people who are depressed, NREM sleep is reduced and REM sleep is increased. Most antidepressant medications suppress REM sleep, leading some researchers to believe that REM sleep deprivation relates to an improvement in depressive symptoms. Yet Wellbutrin XL, a common antidepressant, and some older medications used to treat depression do not suppress REM sleep. Researchers are therefore still trying to determine the connection between the REM sleep mechanism and depression.

Irregular Sleep-Wake Schedule

This sleep disorder is yet another problem that many with Bipolar II experience and in large part results from a lack of lifestyle scheduling. The reverse sleep-wake cycle is usually experienced by bipolar drug abusers and/or alcoholics who stay awake all night searching for similar addicts and engaging in drug-seeking behavior, which results in sleeping the next day. This sleep disruption and irregularity make it much more difficult for the bipolar patient’s physician to treat him or her with conventional medications and adjunctive cognitive therapy. In most cases, the patient needs to acknowledge the drug-seeking behavior and get involved in a recovery program such as Alcoholics Anonymous, Cocaine Anonymous, or other group. Talk therapy with a psychologist is beneficial to many patients as they seek to change destructive lifestyle habits and learn new behaviors that will help them adhere to a more normal sleep-wake schedule.

Reprinted from: Bipolar II: Enhance Your Highs, Boost Your Creativity, and Escape the Cycles of Recurrent Depression–The Essential Guide to Recognize and Treat the Mood Swings of This Increasingly Common Disorder by Ronald R. Fieve, M.D. © 2006 Ronald R. Fieve, M.D. Permission granted by Rodale, Inc., Emmaus, PA 18098. Available wherever books are sold or directly from the publisher by calling at (800) 848-4735.

Author
Ronald R. Fieve, MD, has published more than 300 scientific papers in the field of bipolar and depression research. His work has been published in such prestigious publications as The Lancet, Nature, The American Journal of Psychiatry, Archives of General Psychiatry, The Journal of the American Medical Association, L’Encephale, and Lithium. Dr. Fieve has also written two widely acclaimed books on mental health, Moodswing and Prozac (translated into five languages). He is professor of clinical psychiatry at Columbia Presbyterian Medical Center and Columbia College of Physicians and Surgeons, Columbia University, and principal investigator, Fieve Clinical Services, Inc. He maintains a private practice in New York City.

Biometrics

BBC NEWS | Asia-Pacific | Malaysia car thieves steal finger.
Thursday, 31 March, 2005, 10:37 GMT 11:37 UK

Here’s a good argument against biometrics.

But having stripped the car, the thieves became But having stripped the car, the thieves became frustrated when they wanted to restart it. They found they again could not bypass the immobiliser, which needs the owner’s fingerprint to disarm it.

They stripped Mr. Kumaran naked and left him by the side of the road – but not before cutting off the end of his index finger with a machete.

I seem to recall a short story or newspaper article or something from my childhood in which folks were using their deceased relatives severed thumbs to cash their SSI checks. What are the techies thinking?

Hmm, I wonder whether Mr. Kumaran is able to use his other biometric devices since he has lost his password?

TFTD – Take the Path With Heart

“Never take a path that has no heart in it. You can’t lose if your heart is in your work, but you can’t win if your heart is not in it.”
— Carlos Casteneda

Bad Behavior has blocked 1706 access attempts in the last 7 days.