Insight?

I had a very fruitful discussion with my shrink Saturday morning. I wanted to know why it is that some of the folks on the bipolar lists who are obviously far more stable than I am are on disability. It has been suggested that I have force of will, a concept that is complete and total <useless substance>, as is evidenced by my lack of control over my weight.

I’m in a weight loss program. Forget WW, they are amazingly ineffective. But at least they’re inexpensive, eh? This one was $550 for a 17-week program. My goal is to lose at least 30 lbs by the end of the program. F*cking expensive 30 lbs. But you know, you do what you have to. This one is going to work – the emphasis is on identifying triggers and modifying behaviors, and it builds in the changes on a week-by-week basis to avoid an overwhelm. The goal, then, is not weight loss, per se, but creating new habits to replace the old, dysfunctional habits.

What I walked away from the shrink’s office with on Saturday was this: “Motivation is ephemeral.” $125 and worth every penny of it.

If anyone else is interested in “playing in mind” instead of “playing in world”, here’s the concept: “Motivation” implies an external goal of some sort, and external goals can become less important or can have hidden demotivators.

*Commitment* is a better thing to have, because it is self-directed and unwavering.

Or something like that. I will be mulling this over for the next few days, particularly with regard to my weight-loss program. I’ll be continuing the antipsychotics until I get a grip on things.

Disability. No, I couldn’t do it, not permanently. I would lose my already poor social skills, I would break loose from the 24 hour day, I would get *nothing* done. I need the structure that working a 40 hour week gives me.

Besides, engineering pays a whole lot better than mental illness. I’m not clear how they tax SSDI, but my base salary is about 3.5 times what I’d get on SSDI. For the record, I make less than half of what I’d make if I were stable. It’s a tradeoff. I would have to quit my shrink – I pay out of pocket to get a shrink who is competent enough to keep me functional – so I would definitely lose ground as far as controlling the illness goes. The public health shrinks are worse than useless, they are outright damaging. If you fall into the system, it’s all over for you. And engineers aren’t expected to be paragons of normalcy anyway. Being bipolar isn’t a big issue so long as you don’t deliberately antagonize anybody. Geeks and autistics have a lot in common, but that’s another story for another day.

My big worry is this – since bipolars are notorious for lack of insight into our own illness, perhaps I am fooling myself into believing I’m doing ok when in reality I’m tottering about making a total ass of myself. And blogging it, no less.

My next worry is this – we always chide the newbies for quitting their meds and winding up having another episode. "But I’m not sick any more!" you hear them bleat. So I take a base of two meds. If I feel an episode coming on, I can add others as needed. It’s the new food pyramid, with an all-seeing chocolate eye at the apex. Being allowed to adjust the meds myself posits, of course, that I have the insight to know when it’s time to do so. Given my big worry, lack of insight, perhaps I should be rapping my own knuckles for stopping the emergency meds once I stabilize. Perhaps I should just take it all the time and stop worrying about TD and weight gain and drooling.

NO. That’s not an option.

So what I’m getting at is… if you don’t use it, you lose it. Social skills, reasoning ability, mathematics, whatever. If you reward yourself for being disabled, you will become more disabled. If you reward yourself for being healthy, you will be more healthy. The key is to find effective rewards and to apply them.

Or maybe the key is that motivation vs. commitment thing.

BUT… all of that is psychological bullshit. Stuff that I have to work out in my own head. It is *about* bipolar disorder, but it is not a commonality to all bipolars, it’s not part of the diagnosis. Does that make sense?

About the weight loss program. The manual we are working from assumes that the people in the class are unable to weigh pros and cons of menu choices. Now, on a good day I’m able to say… do I need to eat 4 oz of chicken to fill up, or will I feel satisfied on a smaller portion of higher calorie beef? To go over your menu doing that for each item is complicated, and on a bad day it’s practically impossible. To uncomplicate it, they say, “Don’t eat beef, it’s too fattening.” Like, DUH. So don’t *eat* as much!

We could go on about vegans and how holy^Whealthy their dietary beliefs are… when someone lays that mess on me I ask them whether vegans breast-feed. *BOOM!* Head explodes. My shrink and I had a good laugh over that recently. I will also add the bibliographic entry for an article from an anthropology text for the ’80s or ’90s – “Science, Witchcraft and Religion” – about how the health-food industry was taking on a moral tone that even back then had a cult-like quality. Your body is a temple, and the health food clerk is its priest. The book is back in print, maybe I should buy another copy.

It’s kind of like, well, I don’t want to make people examine the liver and muscles of every pig they slaughter to be sure it doesn’t contain the particular diseases and parasites that will also harm humans – issues that don’t pertain to cattle – so I’ll just set up a rule of thumb… “Don’t eat pork!” And so you have kosher laws. Orthodox Jews may try to separate the dietary laws from any pragmatic, temporal reasons for their existence, but trust me, there are very good reasons for not letting pre-literate nomads risk their lives on “unclean” foods.

Do we trust the guys who butcher pigs to put our health above their money when it comes to rejecting infested pork? Hmmmm…

Did you know that fat carries toxins right up the food chain, where it gets more concentrated the higher up you go? So maybe we should eat less fat? NO, wrong answer. The brain is 60% fat. No wonder the kids are hammering down french fries, their brains are starving. We think that low-fat is healthy, so we starve their brains from before birth. I think we’re going to discover that autism is due to insufficient fat in the dient. There is considerable evidence that adding fish oil to the diet improves AHDH and bipolar disorder. The answer, then, is to provide foods with a healthy Omega-6 to Omega-3 ratio. The MH docs are saying a max of 4:1 with a minimum of 1 gram of Omega-3. I’ll edit this later to include links. Grocery stores are carrying a cooking oil that meets the criterion. It browns a little bit at normal temps when you saute with it, but that’s not an insurmountable obstacle.

Or maybe I’m inventing all this.

Something I wrote last year: Mitochondria Food. I will be updating this.

[Hey, this new version of WordPress makes it easier to insert links. And here I’ve been doing it manually.]

But back to the stability issue. Ah, hell, I’ll break this into separate posts later. Why do I care what other bipolars do? I care because there’s a good chance that bipolars are an important genetic variation, one that brings inventiveness and creativity at the price of instability. By medicating us into submission, the status quo is preventing the evolution of the human species. Evolution is a very real threat to folks whose power lies in making the little people follow their small-minded rules of thumb. Uh, yes, this was part of the discussion I had with the shrink. He recommended a book on neuroplasticity, which I will post separately.

Alien Registration

When I was around 3 or 4 years old I saw a commercial on TV about alien registration. It blew my mind. I watched scifi even then and I knew what an alien was. And that spacemen and martians didn’t really exist.
So I went to my mother, kind of freaked out, and asked her about these aliens that seemed to exist outside of the TV. She told me “I’m an alien.”
Boom! Head explodes. I asked her, “Where are you from, Mars or Venus?”
This must have been before my first trip to England – when I was 3-1/2 or so.
We spent the summers at the shore and I used to stare out over the ocean for hours trying to see England where my grandmother lived.

TFTD – "meaning"

To insist that the world has one meaning rather than another is politics.

TFTD – Gimmicks and gadgets

Gimmicks, gadgets and techniques are the genius of America.

TFTD – On "being"

Being can be likened to a projective test.

Thought for the Day (TFTD)

Man can experience himself and the world in myriad ways.

Jessica Wants an MRI

This is an expansion on a comment I left on The Zucchini Patch.

I think they use PET scans for what you want to do. An MRI isn’t capable of telling the difference between a live brain and a dead brain. It can, however, spot a shrunken hippocampus or amygdala or anomalies in the blood vessels.

An fMRI can see more. They can use tagged glucose or neurotransmitters, whatever they want to study. The fMRI shows where the substance concentrates in the brain, where it is used the most. The NIMH has information about this.

It’s all still under investigation, though. The fMRI is not ready to be used to diagnose.

Did you know that in ADHD, the harder the person tries to concentrate, the more the prefrontal cortex shuts down? Oddly enough, motor areas of the brain work harder at the same time. Can’t we just find a way to teach these kids that will fit with that kind of brain response? Running around in circles shouting out calculus problems, perhaps?

Apologies to my friends of the hyperactive persuasion.

Somewhere in this computer I have a letter I wrote to one of the scientists in the movie “What the Bleep Do We Know!?” who works down at Penn. I met him at the preview and asked him a few questions to correct some of my assumptions in writing the “Putting the Genie Back Into the Bottle” article. The study I was interested in was over, unfortunately. (Yes, dogs and cats *do* have Broca’s and Wernickes areas – it’s not just defined by function, it’s a physical location.)

I have an MRI of my head hanging on the wall next the the desk This is your brain on bipolar to remind me that I have a brain – you can see it, the small pea-sized thing in the center of the glob of mush. ;-) Several years ago I made an animation out of the scan through the layers. Where the hell did I put that?

Oh, here. I see that this one is from after I had my sinuses repaired in uhhhhh 1996 or thereabouts. Refresh the page to see the animation. My favorite part is the eye stalks. We must have had crustacean ancestors.

When did they decide that the Rorschacht test and the MMPI diagnose bipolar disorder? Bipolar isn’t a personality disorder, it’s a mood disorder. My last psychologist told me that when they modified the inkblot test, it was not longer useful in diagnosing borderline personality disorder, either. I question the whole thing at this point.

I took one years ago. The psychologist took my money out of pocket twice a week for over a year and wasn’t able to catch the bipolar disorder. When we did the inkblot test, I thought about what I’d been reading in the psychology books and created a mindset before we started. He had seascapes all over the walls so I picked an undersea theme – so that undersea pictures would be the first thing to pop off the paper at me. Dancing crabs, an octopus in a Jester’s cap. That sort of thing. The MMPI and the Thematic Apperception test were similarly transparent. And drawing pictures of my house and my family and myself. It might have been easier if I didn’t read so damn much. I read a lot more then than I do now.

Anyway, that’s what you want, a functional MRI rather than a plain old MRI.

Tom Cruise and Oprah

The bipolars were up in arms about Tom Cruise’s comments on psychiatry, UFOs and medications while on Oprah’s show. Since I work full time, I don’t get to watch Oprah and I missed the famous “TC goes apeshit on Oprah” episode.
In case you missed it too, here’s the film clip.

Is he still dating that little girl? There’s a clip on Oprah’s site called “Tom Cruise Engaged.” In it, Oprah asks Katie, “What does this feel like, when you grew up wanting marry Tom Cruise?”

Eeeeeeeeew.

Thought for the Day (TFTD)

Who listens to my thoughts?

Plato on Virtual Reality

Next, said I, here is a parable to illustrate the degrees in which our nature may be enlightened or unenlightened. Imagine the condition of men living in a sort of cavernous chamber underground, with an entrance open to the light and a long passage all down to the cave. Here they have been since childhood, chained by the leg and also by the neck, so that they cannot move and can only see what is in front of them, because the chains will not let them turn their heads. At some distance higher up is the light of a fire burning behind them; and between the prisoners and the fire is a track with a parapet built along it, like the screen at a puppet-show, which hides the performers while they show their puppets over the top.
I see, said he.
Now behind this parapet imagine persons carrying along various artificial objects, including figures of men and animals in wood or stone or other materials, which project above the parapet. Naturally, some of these persons will be talking, others silent.
It is a strange picture, he said, and a strange sort of prisoners.
Like ourselves, I replied; for in the first place prisoners so confined would have seen nothing of themselves or of one another, except the shadows thrown by the fire-light on the wall of the cave facing them, would they?
Not if all their lives they had been prevented from moving their heads.
And they would have seen as little of the objects carried past.
Of course.
Now, if they could talk to one another, would they not suppose that their words referred only to those passing shadows which they saw?
Necessarily.
And suppose their prison had an echo from the wall facing them? When one of the people crossing behind them spoke, they could only suppose that the sound came from the shadow passing before their eyes.
No doubt.
In every way, then, such prisoners would recognize as reality nothing but the shadows of those artificial objects.
Inevitably.
Now consider what would happen if their release from the chains and the healing of their unwisdom should come about in this way. Suppose one of them set free and forced suddenly to stand up, turn his head, and walk with eyes lifted to the light; all these movements would be painful, and he would be too dazzled to make out the objects whose shadows he had been used to see. What do you think he would say, if someone told him that what he had formerly seen was meaningless illusion, but now, being somewhat nearer to reality and turned towards more real objects, he was getting a truer view. Suppose further that he were shown the various objects being carried by and were made to say, in reply to questions, what each of them was. Would he not be perplexed and believe the objects now shown him to be not so real as what he formerly saw?
Yes, not nearly so real.
from THE ALLEGORY OF THE CAVE,
The Republic of Plato,
Francis Cornford, trans.

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