What follows is my personal story, my experience, of bipolar disorder(BPD) as well as several other manifestations of mental health disorders. It is my life-narrative with a special focus on the idiosyncratic manifestations, the symptomologies, of BPD. The second leading cause of death globally by 2020 will, arguably, be due to the multitude of mental health disorders of which BPD is but one. For this reason, among others, I have posted part or all of what I call my 'chaos-narrative' at a number of internet sites.
Severe mental tests have been afflicting people across most cultures in the last century, arguably, since the onset of the Great War: 1914-1918—to say nothing of their presence in the long history of humankind. These tests will continue to do so in the decades ahead as the tempest afflicting society continues apparently unabated. Severe mental tests are everywhere apparent, not only in the field of psychiatry and clinical psychology whose role is to deal with these afflications, but also across the wider culture in which we all live in the print and electronic media and often in our own personal lives.
There has come to be a burgeoning range of resources, though, that are now available in that print and electronic media to help people understand this complex field. This story, my life-narrative with respect to this disorder, is but one small resource for readers and I hope it will be of help. I post sections of this account at internet sites which have a dialogue between people interested in particular mental health issues about which I have some experience in life.
There are now many internet sites, some organized for and by mental health experts and others for the general public and especially for mental-illness sufferers to provide information, opportunities to discuss issues and obtain help for what has become a very large range of specific disorders. If one googles the following words: mental health, depression, bipolar disorder, affective disorders, OCD, PTSD, anger management, inter alia one gets a host of sites of interest and of relevance to one’s special concerns.
One-third of all people in western cultures will suffer from a disorder or emotional problem during their lifetime and they would benefit from therapy, according to one source. In the last half century there has been a revolution in treatment programs and regimes which have found better and permanent cures for many, if not most, of the mentally afflicted. In this world mental illness is truly a heavy burden to bear. I leave it to readers to do more googling for there is much to read for those who are interested in this subject.
I have joined over 100 of these sites and participate, as circumstances permit, in the discussions on mental health, bipolar disorder, depression and personality disorders among other topics in the field of psychiatry. What I have posted below is, as I say, also posted in whole or inpart at many of these sites. I have posted this account because this is part of my own effort to destigmatize the field of mental illness.
This lengthy account will hopefully provide mental health sufferers, clients or consumers, as they are now variously called these days, with: (i) a more adequate information base to make some comparisons and contrasts with their own situation, their own predicament, whatever it may be, (ii) some helpful general knowledge and understanding, (iii) some useful techniques in assisting them to cope with and sort out problems associated with their particular form of mental health problem or some othertraumatized disorder that affects their body, their spirit, their soul and their everyday life and (iv) some detailed instructions on how to manage their lives more successfully despite the negativeconsequences of their BPD or whatever trauma or illness affects their lives.
For many readers the following post will simply be too long for their reading tastes and interests. In that case just file this document for future use, skim and scan it as suits your taste, go to the sections relevant to your interest or delete it now.
A Longitudinal Context: October 1943 To October 2010
10th Edition, Draft #5
By Ron Price of George Town Tasmania Australia (150 Pages: Font 14—60,000 words)
1. Preamble and Introduction:
1.1 This medium-sized book was once very small, indeed, not much more than a long essay. It started out as a very short essay in 2000 a decade ago as an appendix to my memoirs, a five volume 2600 page opus found in whole and in part at various places on the internet. Both this book and my memoirs could benefit from the assistance of one, Rob Cowley, affectionately known in publishing circles back in the seventies and early eighties as “the Boston slasher.” His editing was regarded by some as constructive and deeply sensitive. If he could amputate several dozen pages, several thousand words, of this exploration of my life experience of bipolar disorder(BPD) with minimal agony to my emotional equipment I’m sure readers would be the beneficiaries. But, alas, I think Bob is dead.
I did find an editor, a proofreader and friend who did not slash and burn but left my soul quite intact as he waded through my labyrinthine passages, smoothed them all out and excised undesirable elements. But this editor is in the late evening of his life and, after editing several hundred pages of my writing, he has tired of any continued exercise in my literary fields and so I am left on my own. I have begun to assume the role that both Cowley and my friend exercised, but it is a difficult and relentless role and I, therefore, only take it up sporadically given the quantity of my writing which requires editing. Without my editor friend, now nearly 80 and leading a quiet non-editing life, I advise readers not to hold their breath waiting for me to do what is a necessary edit in this now lengthy work.
1.1.1 John Kenneth Galbraith, the famous economist and a fine writer, had some helpful comments for writers like myself. So, too, did Galbraith’s first editor Henry Luce, the founder of Time Magazine. Both Luce and Galbraith were aces at helping a writer like me to avoid excess. Galbraith saw this capacity to be succinct as a basic part of all good writing. Galbraith also emphasized the music and the rhythm of the words as well as the need to go through many drafts. I've always admired Galbraith, a man who helped me understand some of the mystery that is economics. He passed away while I was writing this book. I’ve followed his advice on the need to go through endless drafts. I’ve lost count of the number of changes, of additions and of deletions to this text. I know I have not avoided excess or repetition among other writing weaknesses that readers will find in the following pages. In some ways I have found that the more drafts I do, the more I have had to say. Excess is one of the qualities of my life, it seems to me, as I muse over seven decades of living, if I may begin the confessional aspect of this work in a minor key.
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In Canada and the USA BPD (Borderline Personality Disorder ) is not the same as Manic Depresion , now known as Bipolar Affective Disorder .
The BPD , started in childhood according to a friend . The Bipolar usually starts according to me doctor when a person is around twenty some years old .
The thing is regardless of how it starts a person needs medication . That being said I know some who have the Bipolar Affective Disorder and now that they live in peace they have no need of medication . One has been off medication for thirty years . In my mind its not all about medication . I tried going off my meds and that didn't work for me . I've had no episode of acute manis in twenty some years . I too try to live in peace . i pray daily and I believe in the resurrection . I too will resurrect ....Marie
Thanks, belleo...my story like so many is complex...here is a little more.-Ron(I won't post any more unless people ask for it here)
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And so it is that I have Galbraith watching over my shoulder and his mentor, Henry Luce, as well. Galbraith spent his last years in a nursing home before he passed away in 2006 at the age of 98. Perhaps his spirit will live on in my writing as an expression of my appreciation for his work and for a man who lived and worked not far from where I grew up and studied in Ontario, in Canada. His spirit is needed here for there is much editing that is required in this far too-lengthy work; but I do not have the energy or enthusiasm or, perhaps, even the skill, to take on the task.
Spontaneity did not begin to come into this piece of exposition until, perhaps, one of the drafts of its fifth edition back in 2005. Galbraith says that artificiality enters a text along with spontaneity because of the process of writing many drafts. I think he is right; part of this artificiality is the same as that artificiality which one senses in life itself: at least that I sense. Galbraith also observed with considerable accuracy, in discussing the role of a columnist, that a literary man or woman is obliged by the nature of their trade to find significance three times a week in events, often, of absolutely no consequence. I trust that the nature of my work here, as I say a part of my memoir, what I have come to call my chaos narrative, will not result in my being obliged to find significance where there is none. I’m not optimistic though. Perhaps I should simply say “no comment” and accept the reality of the presence of the inevitable gassy emissions that are part of the world of memoirs.
1.2 This is a longitudinal, retrospective account going back to my conception in the last half of October 1943. The story continues up to October 2010, a work inprogress, as they say these days, some 67 years. Neurobiological, neuropsychiatric and affective disorders like BPD are found in diverse forms as well as in a broad range of age of onset and in a specificity of symptoms. Little is still known about its pathogenesis, that is, the origin and development of the disease. What follows is one person’s story, one person’s life experience of BPD. It is my personal life-narrative with the many manifestations, the symptomology of BPD as I experienced it.
1.3 I make reference to a strong genetic contribution to the aetiology of BPD, a genetic predisposition, a genetic susceptibility as a factor in the pathogenesis of BPD. A family history, what is sometimes referred to as a family pedigree, of affective disorder in a first-degree relative, in my case my mother(1904-1978) is relevant to this narrative. My mother had a mild case of what may very well have been BPD, at least I have come to think of her mood swings as falling into a significantly high place in what is sometimes called the BPD or affective spectrum during her 75 year life. Her mood-swing disability or affective disorder, though, was never given the formal medical diagnosis manic-depressive(MD), a term which developed from several concepts as early as the 1850s if not centuries before. The term MD was replaced in 1980 after my mother died in 1978 by the term BPD. In retrospect my mother exhibited symptoms which may be more accurately labelled: (a) explosive disorder disability, (b) neurotic disorder: anxiety state or (d) depressive disorder.
1.4 My father also suffered from what seems to me now, in retrospect, a mild case of what today is sometimes called intermittent explosive disorder(I.E.D.) or impulse control disorder(I.C.D.), as opposed to planned acts of violence or a simple temper. Given the rarity of I.C.D., it seems to me that my father had only a mild I.C.D. Other names for I.E.D. include: rage attacks, anger attacks and episodic dyscontrol. People with I.E.D. experience anger which is grossly disproportionate to the provocation or the precipitating psychosocial stressor. My father may have been exposed to this type of behaviour as a child and so his I.E.D. may have been learned rather than organic and brain-centred. There are also complications associated with the diagnosis of I.E.D. and they include job or financial loss. My father lost much money on the stock market in his late middle age, his late 50s and early 60s. My father was also genuinely upset, regretful, remorseful, bewildered or embarrassed by his impulsive and aggressive behavior. In my father’s late 60s, and perhaps at earlier stages in his life, his disorder also exhibited, or so it seems to me now in retrospect, comorbidity perhaps due to his genuine sense of remorse. I don’t know for sure. I know nothing, either, of the mental health of his parents or grandparents all born in the 19th century. My conclusions regarding my father’s emotional disability are largely tentative. Perhaps he just had a bad temper.
1.4.1 About half of all patients with BPD have one parent who also has some form of mood disorder. There is then, or so it seems to me, a clinical significance in my mother’s and father’s mood disorders in the explanation of the origins and diagnosis of my own BPD. The high heritability of BPD has been well-documented through familial incidence, twin and adoption studies. There is an unquestionable justification for the inclusion of my family in the understanding of my BPD. No specific gene has yet been identified as the one bipolar gene. It appears likely that BPD is caused by the presence of multiple genes conferring susceptibility to BPD when combined with psychosocial stressors. I make this point as an opening remark and pass on to my story.
1.5 For an elaboration of the subject of the genetic connection of BPD and in utero BPD see: David Healy’s Mania: A Short History of BPD (Johns Hopkins, 2008) and a short history of the disorder is also available on the internet. Genes may also contribute to the age of onset of BPD and this is analysed now in the context of a phenomenon called genetic anticipation. Anticipation refers to the phenomenon of an illness occurring in successive generations at earlier ages of onset and/or increasing severity. In a recent study using registry data of BPD subjects, age at onset of the first illness episode was examined over two successive generations. Subjects born from 1900 through 1939(my mother) and from 1940 through 1959(myself) were studied. The median age at onset of the first episode of BPD was lower by 4.5 years in subjects born during or after 1940. It was not until my mother was in at least her twenties that her first episode of BPD occurred, although this is somewhat of a guesstimation.
1.6 The goal of what is sometimes called ‘personalized medicine’ is to utilize a person's genetic makeup for appropriate disease diagnosis and treatment, an idea conceptualized initially in the recent years of the Human Genome Project. The current conceptualisation of MD/BPD can be traced back, as I indicated briefly above, to the 1850s, although its history can be traced as far back as ancient history in Turkey. Both terms, MD and psychosis, were coined in 1875 by Jules Falret, a French psychiatrist and he recognized its genetic link. German psychiatrist Emil Kraepelin (1856–1926), the founder of modern psychopharmacology, also made a major contribution to the early understanding of MD/BPD, only one of the many disorders in the general mood disorder category, but a cyclical mood disorder associated with a circularity between D and euphoria.
1.7 About 37,000 years ago Neanderthals arguably intermingled with modern humans and thus a new gene entered the human genome, the DRD4 7R gene. This gene arguably originated from Neanderthals. This gene is associated with risk-taking, sensation-seeking and novelty-seeking, and correlated with openness to new experiences, intolerance to monotony, and exploratory behavior, features of Neanderthal behaviour. About 10% of the population have the activated DRD4 7R gene. So goes yet another theory on the genetic predisposition to BPD.
1.8 All manifestations of BPD share uncertain etiologies, with often opaque, obscure, relationships between genes and environment. Some medical experts and theorists in the field of such studies posit latent changes in the expression of specific genes initially primed at the developmental stage of life. Some studies and some experts emphasize that certain environmental agents disturb gene regulation in a long-term manner, beginning at early developmental stages in the lifespan perhaps even inutero. But these disturbances, these perturbations as they are sometimes called, might not have pathological results until significantly later in life. In retrospect, as I look back from these middle years(65-75) of late adulthood, the years 60 to 80 as some developmental psychologists call these years of the lifespan, these perturbations and pathological results were clearly manifested at the age of 18. I could easily theorize an earlier onset on the basis of behavioural perturbations manifested in early childhood and into adolescence and I do such theorizing later in this account(see sections 2.7.1 and 2.7.2 below).
1.9 I received two or three diagnoses between 1963 and 1980 from psychiatrists, friends, family, GPs and concerned others. The diagnosis that was made in 1980, namely, BPD, is a diagnosis that is standardized according The Diagnostic and Statistical Manual of Mental Disorders (DSMMD-IV) which provides diagnostic criteria for mental disorders. I use the term BPD not MD throughout this document and I use that acronym. In the DSM-IV MD is a 5 axis/level system of diagnosis that is used.
1.9.1 In my case, axis/level 1 is for clinical disorders that are mood disorders. Axis 3 in this system is for what they refer to as acute medical concerns that relate to BPD; axis-4 is for psycho-social and environmental problems that contribute to BPD and axis-5 is an overall caregiver’s assessment of my functioning on a scale 1 to 100. Most of the successful diagnoses and treatment of my BPD have come from psychopharmacology and its roots in physiological assumptions. In the last decade, say, 2000 to 2010, talking cures and behaviour modification techniques like cognitive behaviour therapy with their roots, their emphasis on assumptions in the domain of intrapsychic experience have also been successful as adjuncts to medications or separate from them.
1.9.2 In my case, my caregiver, namely my wife, evaluated me at 61-70 on the numeric scale. This place on the scale reads as follows: “this adult has some mild symptoms as well as some difficulty in social and occupational functioning. Generally, though, he functions pretty well. He also has some meaningful interpersonal relationships." The bar is set quite high by government departments in order for my wife to get a Caregiver’s Allowance and so it is that she and I have not seriously considered applying for such an allowance. My symptoms are not sufficiently extreme for her to qualify as my Caregiver. Readers wanting access to this diagnostic tool can easily find it on the internet. I have appended it to this statement in appendix 2.
1.10 The literature now available to those wanting to explore the subject, the field of BPD, is massive both on the internet and off and much of it should be considered by readers wanting to become more familiar with BPD. My story is only one of thousands, if not 100s of thousands, now available. Readers wanting what to me is the best resource to help them deal with BPD should go to The Bipolar Toolkit(Sarah Freeman, 2009). It is far better than this personal, idiosyncraticand non-systematic account.
1.11 BPD is not medically curable but it is possible through psychiatry, medicine, some types of talk therapy and nutritional supplements or adjuncts, as I say above, to achieve varying degrees/periods of long-term stability. I feel I have achieved this stability by degrees since the 1960s. This is not to say that I have never had any more episodes since those 1960s, that I have not become hypomanic again nor exhibited other symptoms of BPD. I have had five, and arguably as many as seven, decades of experience of BPD symptoms and some of these symptoms are still in my day-to-day life. This lengthy 60,000 word statement is an account of my experience in achieving varying degrees of stability at various periods of my life.
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How have you found the availability and quality of mental health services where you are? Have you needed to travel far to seek treatment? Last month I drove to Sydney for MRI scans. And how conducive to mental health do you find your locale?
I'll post a little more of my story, Karma_Yeshe. It may not answer your question, but it will get this story off-the-ground, so to speak.-Ron
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1.11.1 I should emphasize at the outset of this statement that any research showing that some form of psychotherapy or talk therapy is an effective substitute for medication is not something I entertain seriously after 30 years of dependence(1980-2010) on mood stabilizers and anti-depressant medications. I may seriously consider engaging in talk therapy in the years ahead. Time will tell. I have taken medication in some form as far back as June 1968. Although I acknowledge the research showing that health food and nutritional supplements like fish oil, for example and/or vitamins and minerals and/or amino acid(s) are effective for BPD, and although I in fact take these supplements, I am still not prepared now after all these years to ‘go-it-alone’ without the medication. Both my GP and my psychiatrist concur with this decision.
1.11.2 There is a world of language associated with an attempt like this to describe a lifetime of BPD. I only try to define some of the terms. For me the words short term apply to: today, this week and this month; medium term applies to a period of two months to a year and the two words long term applies to all the time after one year in my personal medical history, retrospectively or prospectively. I try, as far as it is logically possible to use the term mental health or mental distress and not mental illness. This has been a recent emphasis in mental health discussions and in the literature. Apologies at the outset of this statement for the occasional use of complex language. The field of mental health is replete with complex terminology. It is helpful for those with different types of mental health problems to become as familiar as they can with this language. I try for the most part to use simple language—but I do not always achieve this aim. treatment, as well as perhaps preventing psychosis in those at high risk.
1.11.2.1 A good example of the language difficulties is the following part of this paragraph discussing the neurobiological bases of behavioural differences. The language used by specialists is often way over one’s head. See Erik Kandel, “A Biology of Mental Disorder,” Newsweek, June 27, 2009; and C. Langan & C McDonald, “Neurobiological trait abnormalities in bipolar disorder,” Molecular Psychiatry, Vol. 14, pp. 833–846, published online on 19 May 2009. The abstract of this article is as follows: “Dissecting trait neurobiological abnormalities in bipolar disorder (BD) from those characterizing episodes of mood disturbance will help elucidate the aetiopathogenesis of the illness. This selective review highlights the immunological, neuroendocrinological, molecular biological and neuroimaging abnormalities characteristic of BD, with a focus on those likely to reflect trait abnormalities by virtue of their presence in euthymic patients or in unaffected relatives of patients at high genetic liability for illness. Trait neurobiological abnormalities of BPD include heightened pro-inflammatory function and hypothalamic–pituitary–adrenal axis dysfunction.
1.12 My wife, Chris, has suffered from different disorders all of our married life and her years before our marriage in 1975 were also beset by different troubles. Her story is long, but I have not included it here except in a tangential sense when it seems relevant to my own experience of BPD. My references to my current marriage, my previous marriage, the three major families in my life and their extensions, my work experience and my values are emphasised in this account, but briefly and only en passant. My religion, the Baha’i Faith, which provides the major base for my values, beliefs and attitudes, is also important--but I do not focus on this Faith here, except in an indirect way. However important this religion has been to me in the past and in the present I do not refer to it except, as I say, en passant in my elaboration of my experience of BPD.
1.13 The new diagnostic term, BPD, is now found in the Diagnostic and Statistical Manualof Mental Disorders-IV published by the American Psychiatric Association. DSM-III had 300 disorders twice as many as in the DSM-II. DSM-V is due for publication in 2013. The DSM is considered the bible by specialists and by the various professions and other interest groups. It is considered by many as a core/basic information source, a major scientific instrument in the field of mental health. In the DSM-IV the term maniac was deleted and the one-size-fits-all classification system for MD and BPD was more finely tuned by the 4th edition published in 1994. The exact discourse that has come to have jurisdiction in this labelling process, the circumstances that have come to result in a person given some mental illness label are due to: (a) norms and expectations as well as (b) medical, psychological, physiological and (c) most recently, neurochemical and electrical brain activity as seen in brain imaging.
1.14 This account also provides a statement of my most recent experiences with BPD in the last three years, 2007-2010. Some prospective analysis of my illness is also included with the view to assessing: potential short term, medium term and long-term strategies, appropriate lifestyle choices and activities in which to engage in the years ahead in these middle years(65-75) of late adulthood(60-80) and old age(80++), if I last that long. For the most part, though, this account, this statement I have written here in some 60,000 words, is an outline, a description, of this partially genetically predisposing family-based illness and of my experience with it throughout my life. I would, though, discourage others from blaming their parents for their genetic contribution to the disorders. I would also discourage them from blaming other family members for their contributions in the form of stress and conflict and failure to understand. Rather than wasting time and energy in finger-pointing or bemoaning the fact that one has BPD, I would encourage sufferers to learn how to best use available treatment programs, or modalities as they are sometimes called in the literature, to minimize their symptoms and to find success and satisfaction in their lives despite their disorder.
1.15 Some of the personal context for this illness over the lifespan in my private and public life, in the relationships with my consanguineal family(family of birth) and in my two affinal families(families by marriage), in my employment life(1961-2005) and now in my retirement(2000-2010) are discussed in this document. I include some of what seems to me my major and relevant: (a) personal circumstances as they relate to my values, beliefs and attitudes--what some might call my religion as defined in the broad of senses; (b) family circumstances; for example, my parents’ life, my wife’s illnesses, the life-experiences of my three children as well as significant others in my lifespan like my father and mother and my first wife;[1] (c) employment circumstances involving as they did: (i) stress, (ii) movement from place to place and (iii) my sense of identity and meaning; (d) aspects of day-to-day life and their wider socio-historical setting and (e) details on other aspects of my medical condition to help provide a wider context for this BPD in the last two years.
1.16 This lengthy account will hopefully provide mental health sufferers, clients or consumers, as they are now variously called these days, with: (i) a more adequate information base to make some comparisons and contrasts with their own situation, their own predicament, whatever it may be, (ii) some helpful general knowledge and understanding, (iii) some useful techniques in assisting them to cope with and sort out problems associated with their particular form of mental health[2] problem or some other traumatized disorder that affects their body, their spirit, their soul and their everyday life and (iv) some detailed instructions on how to manage their lives more successfully despite the negative consequences of their BPD or whatever trauma or illness affects their lives.
1.17 I like to think that what has become over the last few years this book of 150 pages has advice that could be used by many people with BPD as well as others without BPD. Keeping detailed records, for example, written or mnemonic, ingrained in memory and/or with signs for immediate recall when required--of one’s feelings and relationships and, in the process, taking responsibility for maintaining and improving them, might help BPD sufferers and others deal with their problems and have more successful lives. As for the meaning of successful, I prefer Thoreau's evocative lines: "If the day and the night are such that you greet them with joy and life emits a fragrance like flowers and sweet-scented herbs; if life is more elastic, more starry and more immortal in the process--that is your success." Even ‘Abdu’l-Bahá’s ‘oft repeated phrase: “Be Happy!” is a simple enough aphorism and yardstick for measuring your daily life, your sense of well-being and the extent to which you are well-oriented and well-positioned to assume the responsibilities that are the result of your interests and commitments. Of course, in using such definitions of ‘success’ like this, one must recognize that millions of people without mental health issues don’t have success defined in these terms. Finally, success and happiness are highly idiosyncratic terms and how each person sees them, defines them and experiences them are their own--even if there are many common threads from person to person.
1.18 There are two kinds of lists that BPD sufferers need to keep in mind in going about their daily lives in dealing with this disorder. So wrote one writer and, liking what he wrote, I include his ideas here. The first list is what you could call risk-factors that increase the chances of BPD sufferers becoming ill and/or having their symptoms dominate their daily life and produce ill-effects for themselves and others in their environment. Such socio-environmental factors as: family distress, drinking alcohol or using drugs, sleep deprivation or missing medication are in this category. A second list of what could be called protective factors help to protect people with BPD from becoming ill. They include: keeping charts of one’s moods, going to bed and getting up at the same time every day, staying on one’s programs/regimes of medication and psychotherapy and avoiding social stressors that one knows will precipitate negative symptoms of BPD.
1.19 I would like to expand on this notion of records, lists, charts and plans to help BPD sufferers.
1. The Mood Chart can be used every day in order to gain insight into how you are doing, the things that act as triggers and stressors for you, the things that help you stay well, and the results you are getting from your medication and diet and exercise program, or other strategies you may be using.
2. The Wellness Plan can be used when you detect the first signs of symptoms in order to help you stay well and protect you from a full-blown episode of mania or depression.
3. The Treatment Contract can be used as a safety net you put in place before an episode develops so that your loved ones, medical team and other supporters have a clear and shared understanding of what should happen to get you well again as soon as possible, and limit any damage that may result from serious mania or depression.
1.20 I like to think that this account is crammed full of useful information for patients with BPD and other illnesses, for their family members, for therapists, for friends, lovers, employers and anyone else interested in this disorder. The insights I share were not acquired by reading the voluminous literature on BPD, although I have taken a serious intellectual interest in the subject in the last decade since I retired from FT employment in 1999. My insights come, in the main, from reflecting on 67 years of life since my conception in October 1943. I have benefited, though, from what you might call a collective wisdom about what it means to live with BPD and other conditions, a wisdom that comes from the reflections of other writers.
1.20.1 Finding solutions to my BPD problems and telling about what works for me taps into my creative resources and it also requires investigating my own trial and error efforts to create a personally satisfying life in order to separate what works from what doesn’t work. Finding solutions and what works in one’s own life is a form of artistry that can result in highly individual and unique solutions and outcomes. I like to think that this book taps into both my own wisdom and experience and the collective wisdom of others looking for a better quality of life by writing about what has been helpful for them as sufferers with BPD or some other condition or, indeed, as a loved one or family member.
1.21 There are other psychiatric disorders often confused or associated with BPD and sufferers with BPD need to be aware of these other disorders in their diagnostic dialogue with their doctor and as they go about negotiating their lives. Differential diagnoses, as they are sometimes called, include: ADHD, schizophrenia, obsessive-compulsive personality disorder; recurrent major depressive disorder, schizo-affective disorder, post-traumatic stress disorder, narcissistic personality disorder, borderline personality disorder, antisocial personality disorder, avoidance disorder. I have had all of these disorders except schizophrenia at one time or another in the last seven decades. Some of these disorders were officially diagnosed by a psychiatrist and some were not.
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.5.2 The illness I had suffered from, starting perhaps at my conception in 1943, had become, in some ways, a source of claim to fame. But it was not all a story of a new age of understanding. On television, that most popular story-teller in modern society, people negotiated their attitudes to and their understandings of different social and political issues of which mental illness/distress was but one. The most common disability portrayed on television during the years that this autobiography was being written, 1984-2010, has been mental illness/distress. We find the following mental problems portrayed: agoraphobia, BPD, autism, OCD, personality disorders, amnesia, various anxiety disorders and schizophrenia among others. People’s information and knowledge of the subject comes, for the most part, from TV which often perpetuates the stigma and the negative sterotypes by inaccurate depictions, misinformation and uninformed dramatic sketches. This has been part of the world of the mentally ill for centuries and it has been part of the backdrop of my own experience in these several epochs. In some ways it is difficult to appreciate how far society has come in its knowledge and understanding; in other ways the problems are massive and complex
I was born in 1944 . Not quite the middle child in a family of fourteen . My parents didn't want another girl . Our small one acre farm needed boys . I was told over and over that I wasn't wanted by my mother .She had her own past full of pain and shadows . I know that today but I didn't know it back then .
I's say a little kid needs love and affirmation . To this day what caused the mental illness in my mind had deep roots in ancestry. My church believes in healing the family tree and so do I. A young man I know has schizo-affective disorder . He is a kind , compassionate man .
Years ago in my church I was in the healing ministry . We were usally a group of three praying one person at a time .The young man with the disorder came to ask me for prayer . He was extremely shy . I laid hands on him as he requested and prayed in Jesus name . By your stripes we are healed . I prayed for him several times after this and he told me his thoughts had gotten much better He is still on medication and in no way will I tell him to get off it . IMO , we are body , mind , heart and soul .
In retrospect, I now see the autumn of 1968 as the first formal diagnosis of my BPD, although I was not to personally receive/read that diagnosis until 1970 when I visited a psychiatrist in Kingston Ontario some two years after I was released from the large psychiatric hospital outside Toronto in the town of Whitby. At the age of 19, though, I was given lots of advice from religious to common-sensical: diet, exercise, prayer, vitamins, interesting leisure distractions/interests like horse-riding, watching TV, music, et cetera. After several months to several years, 1963 to 1968, the emotional aberrations disappeared or could be said to be sub-threshold at least for a time. My episodes over those years and in the years December 1977 to June 1980 seemed to exhibit quite separate and distinct tendencies and patterns from those I had experiences in the 1960s.
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The first major episode of BPD began in 1963 and continued in a complex series of forms up to and including 1968 when I was institutionalized, as I have outlined above. This episode was not diagnosed as either MD or BPD in those years. This episode, part of my first phase of BPD as I see it in retrospect more than 40 years later, did not receive any professional psychiatric diagnosis until June of 1968. From June 1968 to November of that year I received institutional care in: the Frobisher Bay, now Iqaluit, General Hospital; the Verdun Psychiatric Hospital in Montreal; the Scarborough General Hospital in a Toronto suburb and the Whitby Psychiatric Hospital about a 30 minute drive from Toronto. The story of those years from 1963 to 1968 and those four psychiatric units and hospitals were my years of university study and the first year of full employment. The story of these years is long, stony and tortuous and I will not write the account of these five years in any more detail since no medical diagnosis was given to me in writing or verbally. I did receive a great deal of advice and types of treatment: (a) more exercise and prayer, (b) a better diet and sex, (c) drug therapy, 8 ECTs and other types of therapy from talk to art and manual activities. I do write of these six months in these several facilities in my memoirs in much more detail than I do here. To write of it here would result in prolixity.
2.8.2 In June or July of 1968, though, one member of a battery of doctors, psychologists, psychiatrists and other care givers who were then providing my treatment program in Montreal Canada at the Verdun Psychiatric Hospital took a personal interest in my case. He was the first attending psychiatrist in my life about whom I remember anything at all. He was a Baha’i, a religion that had its origins in Iran in 1844; he was one of perhaps 4000 Baha’is in Canada at the time and perhaps its only psychiatrist. He was himself at the outset of his own career in psychiatry. I had been serendipitously institutionalized here after the onset in late May of 1968 of an episode of BPD which was given no name at the time, although colloquially I recall it being said I had become “bushed” or, as they say in Australia, “gone tropo.”
2.8.3 I had been working with the Inuit at the time in Canada’s high Arctic as a grade three classroom teacher. Looking back it seems highly fortuitous that this first institutionalized care that I received was, in part, from a psychiatrist who shared the same belief system as I did, the Baha’i Faith. I remember him taking me out into the community to meet some of the Montreal Baha’is and their friends. Such an exercise, I assume, he felt was a normalizing experience.
2.8.4 I appreciate, as I say above, the interest, care and assistance shown by a long series of individuals, particularly the relatives and friends in my life over the years and as far back as 1963. In that year, as I say above, was what I now see as the first clear episode of MD or BPD began to manifest itself. The professional work of those doctors and the personal assistance of those family members and friends has been invaluable and I want readers to appreciate the primacy I give to the work of these special people for their help and support, their saving me from what in any previous age and time period would have been a horrific, virtually end-of-normal-life experience. I want, too, to particularly emphasise the personal care-givers in my consanguineal and affinal families, that is my family of birth and marriage, especially my mother, my first wife and my second wife. These three people were there to help inspite of the difficulties they experienced as a result of their care-giving attitudes and supporting activities. They were absolutely critical and significant others in that wider social context of family, friends and doctors over the years.
2.8.5 I sojourned in these first five years, in that first episode from 1963 to 1968, in a public and private world that was new to me. From time to time and beginning arguably on 29 May 1968 I sojourned in a place no less strange to me than if I had been among an exotic jungle tribe in Africa. It is the duty of some cultural anthropologists to report on their exotic travels and field trips, whether among the indigenous peoples of this earth’s Antipodes or to equally remote recesses of human experience among other culturally diverse groups. The account I write here, though, is not so much anthropological; it does not give an emphasis to the eccentricities, the absurd and the bizarre which SAD, P, D, MD and BPD accounts often do; it does not attempt to make a comprehensive statement of my experience. I leave this for my autobiography/memoirs and readers can find the story buried there in occasional references among the 2600 pages much of which is now on the internet in different forms, short and long, paragraphs here and pages there.
2.8.6 I came as I say above, insensibly over several decades--and then only at some distant and abstract level--to associate the extremes of my BPD somewhat with the role of shamans among tribal, third world and animistic communities, people who relate their myths and their meanings by means of emotionally laden quasi-ecstatic visions. On the personal level, I discovered in myself unexpected patience, humility and hope. I learned to treat life as the most precious of gifts, infinitely vulnerable and precarious, to be infinitely prized and cherished. I had not become a shaman or a saint, though; I still suffered; I was still impatient; I did not always appreciate life; I still got depressed. I had journeyed with my body, although I don’t think with my soul, into an underworld and come back, more times than I care to tell and certainly more times than I tell of here. But I have survived and lived to tell the story. This is not always the case for people with SAD, D, MD or BPD.
2.8.7 Mine was a spiritual drama of sorts—on a psycho-neurological, a psycho-pharmacological, a schizo-affective level and in 1968 the first psychiatric diagnosis, some five years after the beginning of my first episode, resulted in my suffering, my illness, having at last a label, a medical diagnosis, a name attached to it: a mild-schizo-affective disorder, for which I use the acronym SAD in what has become a somewhat long account. This mild SAD I could, as I say, narrate as a drama in religious terms and describe it as a purgatorial dark night. But, briefly, it was both a pain in the neck and a gift of the gods, I can now say in retrospect. Whatever it was and however I interpret its meaning in my life, it has unquestionably been a key part of my life. But it was not all my life. I do not define all my life in terms of this disorder. This account is of that part, that small but important part. It is the centre of my chaos narrative as some students of autobiography call such accounts.
2.8.8 It is unfortunately very trendy to attribute mood disorders like BPD to personality and spiritual illnesses. I leave those people to themselves but, after dealing with this disorder for nearly half a century, I do not take their arguments seriously--at least not for me--if others want to try their prescriptions, I leave that to them. From my point of view such attribution is done by people who don't research into what is the real cause of BPD and their understanding of the disorder is limited. Sometimes the negative stigma and the inaccurate attribution hurts more than the actual disorder. It can be very disheartening to see a negative stigma continuing in a community and in individuals. Given the complexity of BPD such an attribution is not surprising. Like so many things in life BPD is just one of the many very complex phenomena and people can’t be expected to understand all of life’s complex medical disorders and social problems.
2.8.9 Stories in life, all peoples’ stories, are chaotic and confusing at a certain level of analysis, a problematique as some social scientists call the story of one’s life, especially in the absence of some kind of narrative order, an order imposed or simply narrated in a simple fashion. Even with some order, imposed or not imposed on one’s experience, one’s life is still a problematique. I tell my own story here as briefly as possible to help establish, for me, some of that sense of order. I tell of these events, as a storyteller might, of my experience of life, but it is a story not packaged for the media. It has been packaged, though, in several written forms for the internet at some 100 sites from 2004 to 2010. I try as I get older to use soft words and hard arguments both in my writing and in my speech. This is a good goal for people with BPD. Softness, tact, kindness and gentleness are often absent from the behaviour and speech of sufferers from BPD. This has certainly been true of me in the half century trajectory of my experience of BPD. These qualities are still absent at crucial times, but so is this true of billions of others who do not have BPD.
At some of the postings of my story, my experience, on the internet there is only a brief statement and at other sites the statement is as long as this one. As in life, so on the internet: not everything a man knows can be disclosed; not everything that can be disclosed is timely and not every timely utterance is suited to the ears of the hearer. This definition of tact from the writings of Baha’u’llah is most apt here. I have used this 50,000 word statement or parts of it for other purposes. Without sequence, without narrative form, without analysis of some kind and some attempt to frame a discernible causality, one’s story remains a bit of a jumble to say the least.
2.8.10 Of course, not everyone looks at their life experience this way. We are a highly diverse species and not everyone is inclined to write an account like mine, if they write their account at all. In my experience over all these decades with this illness, I am inclined to the view that very few ever write their story in even an abbreviated form.
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