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Charlie


Member

Posted Mon Apr 2nd, 2007 9:37pm Post subject: Triggers and stability?
Do you know what triggers your moods?

I didn't know at the time, because I didn't know I was manic, but looking back I know exactly what built up to a full blown manic period of my life, which I've only been able to put into perspective after the mania turned into depression and the depression turned into a period of stability.

It was a period when I was getting little sleep due to a party lifestyle. This was twinned with a traumatic experience and into a full flown mania I went.

I am left wondering if I will ever enter another mania of such proportions, if I don't encounter any traumatic triggers. In some ways I want the creativity and energy that was the friend of mania, but I know left untreated it could lead to hospitalisation/prison/death.

Can you control manic depression if you understand it enough? If you ensure you get enough sleep, if you keep away from stressful situations, if you eat healthy and do exercise can you control manic depression?

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Nadia


Member

Posted Mon Apr 2nd, 2007 10:49pm Post subject: Triggers and stability?
Hmm... I don't know. I can't control it.
I'm kinda used to be depressed, but in mania phase I can't help
myself at all.

I had that period - parties, little sleep etc. I was manic and mania
is so hard to control. That's why I stopped drinking alcohol, smoking,
partying etc. Oh wait.. Or it was because of depression ?
What came first - alcohol+drugs+parties or mania? X-D
Actually "depression" comes without any noticeable reasons.. Or maybe I
should be more observant.

Forget it, I don't know my "triggers" . But typing helps anyway

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JVONEARTH


Member

Posted Mon Apr 2nd, 2007 10:57pm Post subject: Triggers and stability?
I think it follows a pattern i sleep less eat less lose interest and then bang i'm in the manic stage and i'm on overdrive that could last any amount of time i just can't keep up with myself.
Then i get a feeling of calm and then it sinks into depression but i don't know what triggers it.

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Anonymous


Unregistered

Posted Mon Apr 2nd, 2007 11:57pm Post subject: Triggers and stability?
Hi Making it clear that my diagnosis is not Bipolar Disorder but Complex PTSD with BPD, as a result of some discussion a few weeks ago here i went and asked two of the people who work with me in my care plan 'What was the NHS's response to Bipolar Disorder?'

This is what they said, and i think is quite tied in to your question, Charlie -

...... I had my weekly session with one of the sets of psychotherapists this morning. At the end of it i asked her a few things about Bipolar Disorder specifically (rather than my stuff - borderline personality disorder, which is what she sees me about). The key part about speaking to her in particular is that she is Head of Psychological Therapies for the (Gloucestershire Partnership) Mental Health Service Trust. She heads up the entire county team of psychological therapies provision, and i think it is fair to say she knows this stuff thoroughly, but importantly she is also involved in planning of delivery of these services as part of the national development of the response to users of mh services, ie she knows what is current thinking and how these services are being developed as a health strategy... i know her views on what a mh trust should be capable of doing, and what trusts 'national' aims and expectations are, including those in London.

In rough terms (and i'm sure you already know most if not all of this ,but crucially may not have put it together in this order or interpret it this way)...

.....4 meds and 'talking' therapies can work together

5 talking therapies can be effective, either with or not with meds

6 in particular behavioural work based on responding to the change in mood/thoughts/behaviour assessed by the sufferer herself can CHANGE the OUTCOMES of events/situations


The point about (6) is that it is the experience someone has that defines their quality of life.

In a way, because Bipolar Disorder has a strong physical neurological component, as you say, it doesn't matter so much that they have the disorder, it's the effect it has on the persons life that matters. so it follows from this two things...

it becomes a meaninfgful and real response to instigate changes in thoughts/feelings/behaviours in their own right so the person has a more acceptable experience of their conscious life, and second, perhaps quite important to you [someone i was writing to] in how you descibe your current life events, the person's behavioural responses to the broader issues they face (ie bus fares or phone calls) are more effective... this is because 1 they would be feeling more in control of their reactions to stressors and 2 they would be 'in a better place' to deal with those external stressores eg unhelpful CPNs.. and their lives would begin to increasingly become more 'smoothed out', in a virtuous upward circle. Don't mistake me, they would still have Bipolar Disorder, but the experience of being in the social environment would begin to become better.

I do believe there is a substantial difference between this portrayal and the idea of 'thinking your way out of the shit', as it were, or somehow magically 'changing how you perceive things' and 'just getting it together'.


And the second inquisition for my long-suffering health care team brought this ...

Since I spoke to Alex S, the psychologist, on Thursday, I’ve also had my 2-weekly meeting with my named worker, Louise. She is a CPN, but more-so these days the manager of the community mental health day centre here, which is where she fits into my life.

I spent about ten minutes of the half hour talking with her about working with Bipolar Disorder (BD). I asked her ‘What is the aim of therapeutic intervention with a client/patient with BD?’

This was her response, in pretty uncompiled form, from my journal I wrote later in the day, at home:

‘What is the aim of therapeutic intervention with a client/patient with BD?’

The aim would ultimately be to reduce symptoms that interfered with functional day-to-day living

To reduce negative impact of mood shift on person’s life i.e. dysfunctional circumstances/difficulties of situation e.g. job retention etc.

To cause no harm, and to remain on client’s agenda whilst still developing choices for client

To bring more choice/control to client’s life

To do this by the client responding to her mood shifts with behavioural actions based on the cognitive understandings (of the client)


Her comments:

Medication is not a pre-requisite. Newer drugs are available in place of Lithium and/or anti-psychotic drugs [I know you know this]. ‘Frequent cycling’ has its own sets of issues. However, even so, there is a small window when the precursor to mood shift is cogniscent to self/others around (partner, friends, health workers etc.), and THIS is the opportunity to work for reduction of mood change. A person may choose to go into either mood shift (up or down) because doing so is attractive to them. It is IMPORTANT the person recognises this is a choice, and also the reasons why they might ‘permit’ mood change to occur. (This is the part that cognitive therapies can act on. Adjusting outcomes of mood shift is the behavioural component).

This is Louise’s view of it, based on many, many years of training, and community and ward experience.


I would be interested to know how much sense or resonance this has with people with Bipolar Disorder. Is it an attractive proposition to contemplate?

Best wishes

Chris

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Flossy


Member

Posted Wed Apr 4th, 2007 1:03am Post subject: Triggers and stability?
Another facinating discussion!

Having suffered two bouts of deppression which kept me off work for months I can speak with a smidgeon of authority on the state of my own noggin at least.

I took LSD on several occassions over fifteen years ago which gives me a pretty strange handle on some things at times but I feel confident enough to make a few coments on this trigger question.

The kind of mood swings I get, which will be nowhere near the kind of up's and down's you BPD people get, tend to be kind of socio environmerntal factors, like being around certain people or being in certain social situations.

What terrifys the shit out of me is other peoples hatred. I couldn't stand being at work when the biggots started, the racist comments, "the asylum seekers" this, or "the asylum seekers" that, paki's darkies etc! I feel a sense of complete panic and isolation as all those who normaly keep quiet start nodding their heads in agreement with these big mouth noisy bastards!

This is a big trigger for a bout of deppression for me. It doen't feel like a big clinical undeniable welling of uncontroled emotion but I feel very ill at a mental level none the less and the feelings can last for a couple of days as I recall the encounter to myself over and over.

This kind of leads me to think that these moods may be tied to memory function? As time passes and the sharpness of particular memories become blured so their impact upon us reduces and the effects disipate? ChrisB?

This example of despair happened quite a lot before I left that job and did not count for my two major bouts of deppression which were separte incidents. But needless to say it's those feelins of fear and isolation which had me on a regular downer.

Sounds contradictory but.................I hate hate!

It makes me ill to see it in others. It feels like I am soaking it up even when it's not directed at me.

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Anonymous


Unregistered

Posted Wed Apr 4th, 2007 2:37am Post subject: Triggers and stability?
Hi

Good to read your interesting post.

There are quite a few significant points in your words. If I may I'll highlight them in a general way, with two qualifications:

a) I'm hesitant to personalise the comment to your individual circumstances, being somewhat unethical in my training due to the possibility of raising issues for you which I can not then respond to adequately, as well as being sensitive to you in a public space. But I feel I can draw out the points in general terms.

b) my current level of training does not allow me to give fully qualified views about what you say so I need to be careful not to give inaccurate info or interpretation.

What I can say is that these types of discussions do give me a lot of challenging ideas which deepen my understanding of psychology and psychotherapy, and stimulate me to join up the different strands of my training. So thanks for your interest.

Crap English I know, it's quite late...There’s quite a lot in your post which strikes me as being connected:

I’m not unfamiliar with the effect of LSD, and this drug is certainly very powerful, with the capacity to influence thinking in certain conditions at times much later than when it was initially used. In some people it can be connected to trauma response, meaning that certain events can ‘reactivate’ moods associated with its initial use. In other words it leaves an echo that can contribute to some people’s later psychological ‘standpoint’.

The ‘trigger’ of being amongst racist people has a big affect on you, eh? It would for most people obviously, but the following quote is important, I feel:

“I feel a sense of complete panic and isolation [when others are complicit with racism - ?and don’t stand up for their principles??]… …this is a big trigger for a bout of depression for me…”

combined with:

“It makes me ill to see it [hatred] in others. It feels like I am soaking it up even when it's not directed at me”

leading to:

“…these moods may be tied to memory function? As time passes and the sharpness of particular memories become blurred so their impact upon us reduces and the effects dissipate?”

...which is clear I think from people’s general experience… but it’s like the racist behaviour resets something in this person’s experience, bringing to the fore strong anxiety leading on to a depressed state.

So the story here is that ‘triggers’ are very effective at ‘re-instating’ emotions that were likely to be associated with different previous experiences. It comes from this that the therapeutic response to someone who felt they wanted to address this would be to alter the meaning the individual put on to the triggering event – in this case prejudice. Anxiety is connected to fear of something and the usual response would be to check out the validity of that fear in the context in which it is being experienced. So this brief trip through your post suggests to me that the meaning to the individual of the ‘trigger’ event/situation is pretty central to how they react, and consequently what they do, their behaviour e.g. depressed so stay in bed etc. Which kinda brings me back to my training which is that what we think affects how we feel – i.e. the individual’s ‘emotional reactions are essentially a function of how [he/she] construes the world.’ (Gross, 2005, p. 827, from Beck, 1967).

Hope this is interesting, and appropriately put.

What do others think about the words of Louise (above but one post) about the NHS response to treating Bipolar Disorder? –

…there is a small window when the precursor to mood shift is cogniscent to self/others around (partner, friends, health workers etc.), and THIS is the opportunity to work for reduction of mood change. A person may choose to go into either mood shift (up or down) because doing so is attractive to them. It is IMPORTANT the person recognises this is a choice, and also the reasons why they might ‘permit’ mood change to occur. (This is the part that cognitive therapies can act on. Adjusting outcomes of mood shift is the behavioural component).

Best wishes C

Beck, A.T. (1967). Depression: Causes and Treatment. Philadelphia: University of Philadelphia Press.

Gross, R. (2005). Psychology – The Science of Mind and Behaviour. London: Hodder Arnold.

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Nadia


Member

Posted Wed Apr 4th, 2007 2:54am Post subject: Triggers and stability?
...
What terrifys the shit out of me is other peoples hatred. I couldn't stand being at work when the biggots started, the racist comments, "the asylum seekers" this, or "the asylum seekers" that, paki's darkies etc! I feel a sense of complete panic and isolation as all those who normaly keep quiet start nodding their heads in agreement with these big mouth noisy bastards!
...
Sounds contradictory but.................I hate hate!

It makes me ill to see it in others. It feels like I am soaking it up even when it's not directed at me.

Same here!
Every racist comment from TV or from Lj makes me depressed - first
come tears, disappointment and despair, soon depression.
We've got a lot of racism here, sometimes veiled.. No wonder I'm depressed
most of the time. Intolerance occurring everywhere.
2 days ago my good old friend mentioned the fact he is gay-hater. Feels like hell now. I had anxiety before, but now I'm sure and.. I don't know what to do.
Scared and disillusioned.

Yes, this is huge "trigger" for sure.

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Aoibheann


Member

Posted Wed Apr 4th, 2007 3:05am Post subject: Triggers and stability?
I have to agree! did anyone see that documentry on c4, i think it was called 'the most hated family in america'? i felt sick watching it, i couldnt stop crying during it out of sheer disguist and sadness that people say things like that, think things like that...
At one point i couldnt take any more and had to turn it over... and its funny, ive been going downhill since watching it.... over thinking things a lot, you know?

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Anonymous


Unregistered

Posted Wed Apr 4th, 2007 3:55am Post subject: Triggers and stability?
I watched the C4 program in total amazement and disgust.

The last two posts people strongly affected by their exposure to specific episodes of prejudice. There's much compassion in those responses. But again without personalising it, but try ing to draw out generalisations -

going downhill since watching it.... over thinking things a lot, you know?

and

I had anxiety before, but now I'm sure and.. I don't know what to do.
Scared and disillusioned.


- that's a strong level of affect.

I don't know.... my reaction was to 'feel sad for the world we live in' but was also real anger at the american 'church' people.

Just writing it as i think it so pretty unrefined but , the anger is about injustice, right?

it seems to have affected you to (and Flossy earlier) differently, very negatively at a personal level, 'scared' 'going downhill'....

I just kind of sense its the meaning wer're each putting to the trigger/event... Not that we interpret the evil of racism differently.... like not the meaning of racism, we all know the meaning of it... but the meaning it has for us each.... whish i could pinpoint what i mean exactly.

cos that meaning is how we interpret thhe thoughts we have of what we've seen. the interpretations are attitudes - predetermined points of view we all have about lots of stuff eg you have an attitude to say strawberry ice-cream... each time you are confronted with it you know whether you like it or not, you don't have to decide each time if you like it or not (differrent from whether you feel like it or not that day) its an attitude to icecream or types of music etc. ....Attitudes..... so when someone sees injustice they have a preformed thought about what that injustice means for them in their world. the fact that we've had different levels of response to what we saw ... the tv.... indicates different preformed attitudes about the significance individually to us each. so when a person is scared or depressed by what they've seen it relates to how they're regarding that thing. If that scaredness is distrssing for the person excessively, makes them ill then to feel better its about looking at what the thing meant personally to them, giving the opportunity tio challenge that meaning - not challenge racism is bad, it is - challenge what they think it signifies for them, otherrwise your the prisoner of those thoughts.


This must be confusing to read , is their some sense in what i'm saying not verry well?

the reason i am on this line of thought elusive as it is, is that i'm interested in how people can alter the outcomes of what happens to them in illness, though they can't necessarily alter the illness or perhaps the event that caused it or bits i=of it or whatever.

Anyway i'm confused now, soi expect you lot are sorry. I just sense there is something in all that that can be part of managing the outcomes or consequences of serious mental distress and i want ot find it.


need tea....

sorry if i'm boring :-//

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shatzi


Member

Posted Thu Apr 5th, 2007 3:03am Post subject: Triggers and stability?
I cannot control mine at all. Stress, extreme stress, causes sleep paralysis at times which is terrifying even though I know what it is. But the moods? Uncontrollable. I can feel like I can fly one day and wake up wanting to lie on the carpet crying for a week. The one thing that got me through those hell-pit episodes was knowing it would pass, I knew I had something like a pendulum swinging both ways but didn't know exactly what it was. Thanks to Wellbutrin I haven't been in the pits for awhile.

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Anonymous


Unregistered

Posted Thu Apr 5th, 2007 9:46am Post subject: Triggers and stability?
Hi

"The one thing that got me through those hell-pit episodes was knowing it would pass, I knew I had something like a pendulum swinging both ways but didn't know exactly what it was. "

I wonder if it's fair to say that your thought 'the mood will pass' alters your feelings and behaviour during these hard-to-bear periods? What would you have felt and what would your actions have been without that belief ie thought ? (That's a rhetorical question).

Can you say your experience of the mood was ameliorated by what your thoughts about it were?

I am still very very interested in people's reaction to my health worker's view(an experienced CPN and community mh manager):

…there is a small window when the precursor to mood shift is cogniscent to self/others around (partner, friends, health workers etc.), and THIS is the opportunity to work for reduction of mood change. A person may choose to go into either mood shift (up or down) because doing so is attractive to them. It is IMPORTANT the person recognises this is a choice, and also the reasons why they might ‘permit’ mood change to occur. (This is the part that cognitive therapies can act on. Adjusting outcomes of mood shift is the behavioural component).

So where do conscious thoughts fit into altering the experience of depresion and mania?

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shatzi


Member

Posted Thu Apr 5th, 2007 7:01pm Post subject: Triggers and stability?
To answer that I thought back to when I was in terrible depressions and had no reson why. There were times I thought I would never get out of it, and that did perhaps make it worse. It's hard to explain, but knowing I will go back "up" eventually helps in a way, but does not make the need to lie in bed or cry or stare or anything any less intense. I just feel like dying sometimes, but somewhere something tells me it will go away again. Hope this makes sense!

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Anonymous


Unregistered

Posted Thu Apr 5th, 2007 7:25pm Post subject: Triggers and stability?
Hi Thanks very much for your reply.

I'm just very interested in this but dont have Bipolar, but have complex PTSD and Borderline Personality Disorder, where my proposition about how you see things definately does work - I'm going to be discharged in the New Year after two years (now) of very heavy psychotherapy (5 hours a week).

What i think it is fair to say from your info is that -

When you (in this case) felt no reason to think the depression would go away it was (probably) worse to endure than when you did know iet hink it would go away eventually.

It's clear it didn't make the intensity of the depression less but it did appear to make your ability to tolerate the distress higher. I think that is what comes out of your words in your case - correct me if i'm wrong.


So what this tells me is that how someone regards their experience of mood alters their relationship to it ie moods are amenable to thought patterns in Bipolar...perhaps, sometimes, in this person's case ....

Thankyou very very much.

Has anyone else out there in Wonderland got any views on this or experiences especially about this:


I am still very very interested in people's reaction to my health worker's view(an experienced CPN and community mh manager):

…there is a small window when the precursor to mood shift is cogniscent to self/others around (partner, friends, health workers etc.), and THIS is the opportunity to work for reduction of mood change. A person may choose to go into either mood shift (up or down) because doing so is attractive to them. It is IMPORTANT the person recognises this is a choice, and also the reasons why they might ‘permit’ mood change to occur. (This is the part that cognitive therapies can act on. Adjusting outcomes of mood shift is the behavioural component).

So where do conscious thoughts fit into altering the experience of depresion and mania?



Chris

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shatzi


Member

Posted Fri Apr 6th, 2007 2:20am Post subject: Triggers and stability?
Actually that is completely on the mark. The downs are as bad, but my ability to tolerate them is better. Perfect!

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Crazy_in_a_box


Member

Posted Fri Apr 6th, 2007 2:51am Post subject: Triggers and stability?
Well if its anything to ya, When I get a low I can feel it coming for up to a few days before it really hits. I can get it all of a sudden but I generally have a small inkling its coming... Because of this, I can nearly tell if its passable or not. I wont know how bad it will get.... but I know if I'll get through it or not.

Its like, Ive been through really bad ones - ones where Ive never thought Id live to see the end, so when I get a not so bad one, I can see its not how I felt before therefore I'll be ok.....

I dont know If Im getting it across correctly lol, do you understand what Im explaining terribly LOL?!

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