My “Manic Episodes” and the Diagnosis of Bipolar Disorder in General

This is a very old post. See date of March 25, 2007. Google just indexed it for the first time apparently so some of you are getting it in feeds and subscriptions etc. I don’t think quite the same about some of what I’m talking about in this post anymore. Mostly I just don’t think about things like this anymore as far as my situation goes. Read it with the knowledge that time has passed. I will say that I do not, by any means, believe the states I’m talking about below were manic as they were not in the least bit dysfunctional nor did they cause any real problems. 

I want to say a bit more about my last few “manic episodes.” Those being the ones in approximately 1992, two in 2002 and the last in 2006 immediately following treatment with an antidepressant. Oh, I almost forgot I also had one in 1999 triggered by smoking pot, a mild hallucinogen, even though many don’t experience it that way. I hadn’t smoked in many years and that was the last time I ever will. Those are the only manic episodes I’ve had since being diagnosed with psychotic manias in the period between 1985-1988 or so. Some of the early ones are a bit unclear in my mind since they were all induced by hallucinogens. And my recollections during some of that period of my life is a bit fuzzy. (I should add, that in general, what I write here is based on my best recollection–I do my best to keep all details accurate–but my memory is poor and my cognition is impaired, so occasionally there my be some inconsistencies. If you should ever catch one, let me know and I’ll try to work it out in my mind and make a clarification)

The later ones, except the one induced by pot, were most probably caused by antidepressant use. The one in 1992 was triggered by following the suggestions of a holistic health practitioner for treatment of depression. She prescribed numerous herbs and amino acids which can frequently have psychoactive properties.

In any case all of the above “manic episodes” after the ones in the 80’s were remarkable in that they were not classic bipolar manic episodes as defined below:

An abnormally elevated mood state characterized by such symptoms as inappropriate elation, increased irritability, severe insomnia, grandiose notions, increased speed and/or volume of speech, disconnected and racing thoughts, increased sexual desire, markedly increased energy and activity level, poor judgment, and inappropriate social behavior. A mild form in mania that does not require hospitalization is termed hypomania.

These later episodes were characterized only by increased energy and insomnia. None of the rest applies. What also characterized them was an increased clarity of thinking and lucidity, not associated with rapid thoughts, and an increased ability to articulate myself clearly, but again not associated with increased talkativeness, which is also considered a symptom of mania. I did not exhibit poor judgment or inappropriate behavior. I did experience fear based on my earlier history.

You might argue that I could not possibly ascertain all of this in my condition, a fair enough assumption to make given what is assumed about bipolar mania. But I had many people in my life at the time, including my husband, family, employers and friends who corroborated my perception of the experiences.

So then we might assume I was simply experiencing hypomania. But in my experience with hundreds of clients in my work as a social worker, I’ve seen that most hypomanias include talkativeness and poor judgment.

So was I experiencing mania at all? Well, I really don’t know. I treated them like manias out of fear and took copious amounts of drugs which were then never removed. The exception to this was the last episode in 2006. My doctor recommended that I increase my Seroquel dose from 25 mg to 100 mg. I had called him out of fear. I was, however, at the time at the beginning of my 180 degree turn around in how I perceived my “mental illness.” I chose not to treat the symptoms. They abated in about a week after discontinuing my antidepressant and then, most remarkably, I immediately began my withdrawal from all the drugs to no ill effect. This was accompanied by radical changes in my diet and nutrition and the return to neurofeedback training. I have not, since that time, had another manic episode in spite of drastically reducing my meds.

I want to make clear here, that I don’t think I was simply misdiagnosed, because basically I question the diagnosis of bipolar disorder in general. I question the legitimacy in diagnosing anyone with bipolar disorder. I do not deny that there are symptom clusters that can be associated with the label, but I do question the validity of it being a disease. As I have discovered in my journey, diet and nutrition seems to heal. I posted a recovery story of someone diagnosed with bipolar disorder here. Anecdotal as it may be, I find it a compelling story that must prompt one to question the rampant diagnosing of bipolar disorder that goes on today. I’ve also witnessed the recovery of many other people who were diagnosed with bipolar disorder both in my personal life and on the internet. Most of these recoveries were associated with dietary and lifestyle changes. The most simple being the addition of fish oil and magnesium.

So, I have no answer to the question, “were these manic episodes?” But I do think it’s all a question of semantics. Symptom clusters can either be labeled or not. I choose not to label them. You might ask, why then is my blog entitled “Bipolar Blast?” Well, I’m reaching out to an audience that believes bipolar disorder is a tangible disease–a brain disorder or chemical imbalance. Even though there has been no evidence of this to be the case. Bipolar brains are no different than anybody else’s brain. The inbalance in them that can be seen on EEG’s are not brain disease they are simply brain wave patterns that are established by a life-time of behaviors that reinforce the patterns. The fact that the mind can be trained by neurofeedback is evidence that it is not a chemical imbalance per se. The brain can learn to respond differently without any chemical intervention.

About Monica Cassani

Author/Editor Beyond Meds: Everything Matters

21 Responses

  1. Terra:

    I saw that book “the Mood Cure” at the bookstore and didn’t pick it up. I wish I had. I had *never* experienced mania until I took Zoloft because of some anxiety issues. Then I became what they call “rapid cycling Bipolar II”. I experienced another “mania” after being introduced to Geodon, so the doctors pulled me off of it and put me on a low dose of Seroquel. On my own, with my own research, I added Omega 3s and a bunch of vitamins and minerals. After about a month, the doctor decreased my Seroquel and called me stable. Stable? Woohoo!! Anyway, I’m going to check out the book and keep up with your blog. I’m interested in seeing what happens with you, and hope you can be an inspiration to me to get off the drugs eventually.
    Good luck!

  2. Gianna

    Terra,
    A lot of people are first diagnosed “bipolar” due to an adverse reaction to an antidepressant. And many of these people, like you, never had any kind of mania in the past. But then they get labeled and thrown into the system and the next thing you know you’re on 7 drugs.

    I’m glad you’re relatively stable now. I would think seriously about healing your body so that you can be strong enough to be without the meds. That does involve diet and nutrition in most cases. The Mood Cure has a good diet in it and basic nutritional advice. I would be careful about adding amino acids, since you had a bad reaction to an antidepressant…it means you have some sort of predisposition to mania…that of course does not mean you are bipolar. It just means you shouldn’t take antidepressants and may be sensitive to other stimulant like substances.

    good luck. nice to see you here.

  3. Gianna

    Terra,
    Do you have a blog? I followed the link with your name, got a profile, but couldn’t find a blog?

    Is my head on crooked? Can you send me a link to your blog?
    thanks,
    G

  4. Anonymous

    I must disagree with your opinion at this point. I do believe that a person who has accurately been diagnosed with Bipolar Disorder has a very different brain then those who are not bipolar. Take this into consideration please, when an EEG shows altered wave patterns, no matter the direct correlation, it is strong evidence of DIFFERENCE. When scientifically comparing EEGs of bipolar and non they are NOT the same. No matter the cause of the patterns. I pose this, an EEG is just a useful measuring tool for a form of Brain activity. Brain activity is directly caused by particular nerves being stimulated by chemicals, natural or unnatural. Hence, the nerves of a bipolar diagnosed individual then could be said to have different chemical stimulation on the brain waves. In other words, an actual physiological difference.

  5. Gianna

    One last comment Anonymous,
    This blog is an exploration. I don’t have fully developed thought on all I talk about. I make assertions perhaps, but I am open to considering an evolving philosophy. I hope you stick around. I don’t claim to know some ultimate truth about the causes of mental anguish. I just think that much of what is labeled disease can be healed, psychiatry tends not to believe in cure or complete recovery. The word recovery is usually just used to mean that someone can function to some degree, usually much less than optimally.

    If you come back would you name yourself…with a pseudonym of course. I just want to know it’s you talking and not some other “anonymous.”
    respectfully,
    Gianna

  6. Terra:

    Gianna,
    I just came back to your blog. I couldn’t remember what post I commented to LOL.
    I have a blog, but I do not mention anywhere that I have bipolar disorder. It is a way of protecting my family (namely my kids) from the stigma that may be attached to the “label”. I keep my identity hidden as well.
    You can find my blog at
    thetrailweblaze.blogspot.com.
    I am also “alittleimpaired” at the mood garden forums. I recently saw some exchange you had there, and that’s where I originally came upon your site.
    By the way, I bought the book “The Mood Cure”. I am going to talk to my (competent) pdoc about trying the amino acids. I know you are right, that I am predisposed to mania, in the mild form. But according to the book, taurine, GABA and Melatonin can all be used as “inhibitory”, which is basically all the Seroquel is doing anyway.
    I will let you know what the pdoc says. Most likely it will go down like a ton of bricks, but you never know. My pdoc actually said that she is of the mind that “western and eastern treatments can be combined” when it comes to this illness.
    It sucks that many of the amino acids can be bad news for Bipolar sufferers. But in my humble opinion, when I read on a pharmaceutical website that “the exact mechanisms of this drug are unknown”, it seems to me like medicating people with psychotropics is a shot in the dark anyway.
    Sorry for babbling on. PM me through Mood Garden if you can.

  7. Gianna

    I think inhibitory amino acids can be fine, but all should be used carefully. I do use GABA, Taurine and Tryptophan at times. They seem to help take the edge off of the benzo tolerance withdrawal. I’ll try to find you at Mood Garden.

  8. allotmentjunkies

    Hi Gianna

    Thought I’d jump in on the issue of eegs and the dialogue you are having with ‘anonymous’.

    Its got me thinking – when psychiatrists were trying their best to misdiagnose me with bipolar (as you know i experienced a severe effexor withdrawal reaction), I asked for a ‘brain scan’. I was kinda hoping my brain waves would not be ‘typical’ of someone with bi-polar and this would add weight to my argument that I was in withdrawal. My psych told me that it wouldn’t show/prove anything.

    He could well have been trying to shut me up (lol) or perhaps there wasn’t enough in his departmental budget to allow a referral. Who knows!

    But my point is – I wonder if differences in eegs in bi-polar patients is an established, undisputable fact. Or perhaps my psych was ignorant.

    If it is an established fact then it leads me to think why aren’t people offered eegs as a matter of course – perhaps its too expensive… (a big issue in UK – not sure about USA)

    I really don’t know – but I do know that I am very cynical… I also know that like you Gianna, I am keen to learn… Therefore anonymous if you check in again, I’d love to hear your view on my thoughts/ramblings…

    Keener
    PS I am sorry to hear about your sad news.. best wishes to you and your family

  9. Gianna

    Hey there Keener,
    thanks for your input.

    I want to add a piece of info about me. I now, most of the time, have a “normal” EEG. My neuropsychologist says my brain no longer appears bipolar most of the time. I continue to go to aid in stability as I withdraw from drugs. But my question to the psychiatrist…how does he explain the normal EEG. Am I no longer bipolar? Was I ever? Am I cured? The mere fact that my EEG can be completely changed by training makes it hard for me to believe there was any sort of chemical imbalance.

    Also, Keener, my guess is that at the time you were asking for an EEG you would have appeared bipolar. Your brain was out of whack due to the withdrawal. EEG just show the current wave states of the brain. It’s not static. It changes every time you have one done.

  10. Gianna

    Hi again, Anonymous,
    yes,I’ve said that I had a measurable brain difference in my EEG. But neurofeedback made it go away. And diet makes many other peoples’ go away or working through trauma can do the same. I guess I just don’t buy that something that responds naturally, with no chemical intervention is truly a chemical disorder and I find labels themselves problematic, because, as I’ve said, a vast array of symptom clusters get labeled bipolar. Yes, I agree, something is up, but disease, necessarily? That is where I’m not so sure. Frankly, I ultimately don’t know enough, but I don’t think science does either. There is no hard evidence for any chemical imbalance in psychiatric disease. EEG’s I agree are proof that something is going on, but when, my brain, for example responded so dramatically to neuorfeedback, a non chemical intervention, I think that it is different than diabetes, the disease mental illness is so often compared to. The brain can LEARN to not be bipolar. That suggests something else to me. I guess if you say physiology can be trained to be different and respond to diet and nutrition, then we don’t necessarily have an argument.

    I appreciate your critique, as I’m working things out for myself here.

    I hope you come back and look at my responses.

  11. River

    “Chemical imbalance” This is a very loaded term because people do not always agree with what it means. I do not like to use it for this very reason.

    Most people when hearing this term assume 1) it is a life-long condition that came from birth or some kind of head trauma 2) it can only be changed by “adding” a chemical(s) by ingestion or patch, or depleting the bad chemical by surgery 3) it is so “hardwired” that talking about it or changing your behaviors/habits may at best have little effect. I think these are only partial-truths.

    I believe that understanding the origin of a “chemical imbalance” is very crucial in dealing with one. There can be a genetic component to it as mental illness do tend to run in families. But it is never a 1:1 correlation so it can not all be genetic. There are confounding factors. Parents who are depressed do not pay as much attention to their kids, may be more irritable towards them, may have more negative things to say about everything they do in general–so of course these kids may grow up to be very negative people because that was the main viewpoint to life in general. This can cascade as their very nature leads to a self-fulfilling prophecy, they now being “different” from “normal” people. Watch the movie “What the ?$@#%(Bleep) Do We Know?” It expresses the idea that by observing something, you actually change it just by looking, that you are never neutral in life–you can make yourself more depressed just by being depressed in the first place!

    So if the parents can “shape” a child’s thinking, then shouldn’t it also be reversible if the person tries to think differently? I think yes. Though I have to qualify that because it may not be completely reversible via therapy considering that the circumstances and physical changes are different (we are all adults now and are brains are not changing as quickly as when we were ages 1 to 20yo, plus the therapist/counselor is not living with you and taking care of you 24 hours a day).

    What else besides therapy can change a “chemical imbalance?” 1) medications, though I would prefer to save this discussion for later as it is extensive 2) diet, I don’t remember the exact study, but they changed the cafeteria food in a school so that it was healthy (fresh vegetables, etc.) rather than the unhealthy standards (hot dogs, pizza, cakes, etc.). After a while, there were far fewer behavior problems, fighting, etc. at the school which statistically significant. 3) exercise, one study demonstrated that moderate aerobic exercise 3-4x per week gave the same benefits as Zoloft. I don’t doubt it as everyone I know say they feel better after exercising regularly. 4) meditation, the brains of monks have been scanned, the “happy areas” lighting up. I would also think that other spirituality/faith and prayer would help.

    PET scans for what they are worth, which have far better resolution than SPECT scans and EEG, have been able to capture the change in people who are depressed and after they get better. What is important to note is that whether it is through therapy, medications, diet, exercise, or meditation–the improvement all looks the same!

    So in summary, when a person comes to be asking about whether they have a “chemical imbalance” or not, my answer varies depending on their past experiences and what their expectations are. My answers could vary from “Yes, intensive therapy will help fix it,” to “Yes, we have to get you a personal trainer right away,” to “No, but take this medication because it may help you.” It really depends on the person and their viewpoint–just remember that chemical imbalances don’t mean you have to ingest chemicals to fix it.

    P. S. I’ll talk about the scam of EEG’s, SPECT, and PET in a later post.

  12. Gianna

    River,
    I want to continue this conversation, but don’t have the time right now. I would love it if you piped in about what you called the “scam” of EEG’s SPECT and PET as you said you might.

    I do want to respond to what you’ve said above…I agree with some of it and would like to comment both on how I agree and disagree…it may take a couple to a few weeks.
    thanks

  13. Gianna

    Anonymous/River (for those of you who don’t know the two are one and the same)

    Well, I’m up at an ungodly hour and so I have time to respond before I leave on my trip.

    I suppose I don’t have a real issue with how you define chemical imbalance. Especially since you note it can be altered in a multitude of ways, but I do think that medications only make chemical imbalances worse and often change brain structure as well. For example, antipsychotics shrink the brain. I view this as brain damage.

    I also don’t believe in the gene theory. Genes have been found and proved to be the cause of a multiple of diseases. Psychiatry’s total inability to find a gene suggests there is no real disease process. And I, like you, think that family dynamics play an important role. I would say the most important role along with other environmental factors. This does not place blame on families. Dysfunction in families is the norm. No one is at fault we’ve inherited it through the generations….socially, not genetically.

    Virtually everyone I’ve known with a mental disorder has had some form of trauma associated with it. The vast majority coming from dysfunctional families. This does not mean people are bad parents. It means that parents cannot always attend to all the needs of their children. We are so unique and it would take mind-readers for parents to know how to respond to every sort of pain a child may experience.

    In some cases, of course, outright abuse is to blame. Most of my most chronically ill clients had really messed up families. Trauma can also be caused by outside factors in the environment of any given individual.

    Diet is absolutely key and it is a great disservice to those suffering from mental anguish that not every psychiatrist address this issue. Since most psychiatrist probably don’t eat well, it is not surprising that they do not know how to nutritionally support their patients. I’ve now come across hundreds of people who use diet and nutrition to treat all forms of mental anguish.

    Other times it just involves coming through the problem with strong psycho-social supports. Medication should be last resort if used at all. I realize that only because virtually nothing is known about how to support psycho-socially and nutritionally that meds must be used in acute situations, but only because alternatives are not understood or researched. This is a tragedy as people get stuck on meds and it’s often a downhill process after that.

    I’ve seen What the Blip Do We Know. I don’t remember it all that well, except that it resonated with me for the most part.

  14. Michael

    Gianna,

    I really just wanted to thank you for your thoughts and sharing your experiences. I’ve gone through some of the most self-destructive patterns of any person I know, and I have dissected every aspect of this condition from every possible perspective I was capable of. I’ve always felt I was more sensitive to the idiosyncrasies of life than the average person, but only with the retrospect of some major storms have I chosen to view that as a gift rather than a disease.

    In studying anthropology (I decided to go back to grad school after my most severe episode), I have always wondered why cultures that focus on a holistic rather than westernized, ego-based, reductionist lifestyles seem to always have a lower frequency of individuals with sociopathic mental behaviors. It seems to me that contemporary nueropsychology compensates for a lack of understanding of consciousness by applying a label to behaviors that are a direct result of social conditions that conflict with a cultural evolution process that has taken 150,000 years.

    I don’t want to bore you with my philosophical diatribe regarding medical science and how the label itself can be constricting to a deeper understanding of the soul, I just wanted to sincerely thank you for the original and personal information you put out there.

    By the way…..as far as your theory surrounding trauma and the diagnosis process, I was simultaneously diagnosed with manic bipolar disorder and PTSD. I’ll be picking up my fish oil and magnesium this week.

  15. Michael

    Hi Gianna,

    I just wanted to explain exactly what I meant by “sociopathic mental behaviors”. It was more of a political statement than anything. I’ve seen enough to know that our foreign policy is at best sociopathic. I believe the term probably applies to infinitely more of our population (especially those that represent us) than most would ever imagine.

    I apologize for that; I was tired and unclear, and certainly way off the subject of mania I initially started writing about. I’m all over the place sometimes. Imagine that.

    I’ve always suspected that my problem was misdiagnosed, and I’ve found a great deal of healing through methods that certainly aren’t condoned by any doctor. I’ve actively resisted being dependent upon any medication from the very start, and the uneasiness I’ve felt with that has never really subsided. Thank you for offering a clear solution for people like me.

    Again, thank you for your work. It seems to be a passion for you, and that’s definitely something to be commended.

  16. Martin

    Hi, I’m here trying to find some information to help a friend. I work with clients with intellectual impairment and sometimes psychiatric issues as well. I have attempted to support a client who had taken himself off behaviour-modifying medication, and unfortunately found I could not continue to work with him because of his increasingly violent mood-swings. My agency brought a behavioural psychologist onboard who is a great believer in non-chemical intervention. His approach was to provide training in strategies designed to help avoid ‘elevated’ episodes. Well, they didn’t really work for my client, as I doubt he had the cognitive processing ability required to bring to bear. However, I like the idea. I have a friend who has a friend who has been diagnosed as schizophrenic, and she is high-functioning (above average) and I think she could benefit. Like my client, she has a deep mistrust of medicos and medication (based on bad experience). Unlike my client, she has the cognitive processing ability required to bring to bear. Can you perhaps point me in a direction literature-wise? I know it’s a little out of your personal field of expertise, but any ideas?

  17. Rockybengals

    Wow…. I have been searching for the side effects of Zoloft and found this. My husband was “diagnosed” as Bipolar 2 and it was HORRIBLE. He had been on Zoloft for 2 1/2 years for mild depression (and I do mean MILD) and his doctor never took him off of it. Our lives spun out of control. when we sought help for the problems we suspected were from the Zoloft he was diagnosed as bipolar 2 and put on Lamictil. OMG, life got so much worse. It nearly ended a very, very good marriage.

    LONG story short, he got off both meds a year ago and is now back to the wonderful, loving man I married. No more aggitation, no more headaches, no more stomach trouble, no more insomnia, nothing.

    I think people need to think long and hard before accepting that kind of a diagnosis. We made some dietary changes, eat healthy, we are active, etc.

    In fact, a recent medical study shows that 15 minutes of increased activity is more effective at treating depression than medication. Amazing….

Comments are closed.