I’ve been dealing with intrusive self-hatred for some time, and it isn’t tied to anything as clear as your pattern, though it’s frequently set off by working on useful things.
Lately, I’ve made some progress—I found out that there seems to be a background fear that a particular bad thing would happen if I made my life better, and reassuring myself that things aren’t entangled that way helps tremendously. Reassuring myself is more will-oriented than just saying it’s a fact that things aren’t entangled the way I feared.
Sorry to not be more specific, but the details are both sufficiently personal that I don’t want to post about them (a sufficient reason for not posting) and sufficiently idiosyncratic that it might not do much good for other people in any case. I’m down to relatively ordinary procrastination rather than utter paralysis.
Have you tried addressing the hatred from the second personality as a separate issue? It’s not as though it has a useful motivating effect, and my experience is that self-hatred is distracting and debilitating to a much greater extent than other sorts of intrusive thought.
One thing that’s helped gradually is to find out something about a habitual pattern of muscle tension which is associated with self-hatred—in my case, it’s in my upper back and may be connected to reaching. Learning this wasn’t a quick fix, but it made a difference to get a little distance on the emotion rather than having it just come from nowhere.
Something which made a big difference was realizing that there’s a difference between an intrusive thought and the habit(?) of amplifying it. I can’t directly control whether a thought appears, but amplification seems to have a larger voluntary component. Some of the time, I can refrain from amplifying.
My hypothesis about amplifying is that a large part of it is a desire for a feeling of energy. This isn’t pathological in itself.
Have you tried anything body-oriented to defuse anxiety? I’m thinking about yoga or Alexander Technique or such. I think one of the things which has helped me is realizing that there’s more to me than the feelings of anxiety.
Have you tried addressing the hatred from the second personality as a separate issue? It’s not as though it has a useful motivating effect, and my experience is that self-hatred is distracting and debilitating to a much greater extent than other sorts of intrusive thought.
Yes. I’ve been able to (temporarily) reduce it, mostly through anti-depressants and acceptance-based techniques. At my most successful, I was happily apathetic and really enjoyed staring at a wall. Alternatively, exercise channels the aggression outward, but as I’m not trying to eventually punch someone in the face, it’s not helpful.
I’ve also tried paying attention to the amplification, which is how I originally noticed that this is happening in the first place. I saw from looking at my chat logs and similar data that I was going through fairly regular cycles of one side being dominant or the other, with a period of about 3 months. (I suspected being bipolar based on that, but I’m not particularly manic or get much of an emotional change, nor did any typical bipolar treatment do anything.)
Unfortunately, I can now totally see one side starting to take over, but not do anything about it. I can exert willpower to postpone it, but not for long.
Bipolar is something to think about even if you don’t see strong manic components. There is a spectrum for bipolar just as for autism. Those on the “lower” end of the spectrum mainly just have depression (and I notice you mentioned anti-depressants)… and low-grade manic symptoms can easily be mistaken for “just having a good day”—especially if you aren’t in many social situations and therefore don’t get a chance for other people to notice/tell you that you happen to be acting strangely (eg as though you’d had ten cups of coffee).
The very fact that you have an active personality and a passive personality… and regularly swing between them… is a big hint it may be what you’re looking for—just perhaps in a form you wouldn’t normally recognise.
You say that “typical bipolar treatment” did nothing… but of course—you may need an atypical treatment—and you won’t know unless you try.
I’d suggest going to see somebody that specialises in bipolar disorder, and have a long chat.
Might be nothing, but perhaps worth investigating a bit more.
OTOH, the surge of bipolar diagnoses, esp. self-diagnoses, suggests it’s overdiagnosed. How would you test? (This is a matter of some interest to me as well.)
Firstly by understanding that psychology is not physics—and there are no definitive tests. This is an area where probabilities are the way to go.
If a person complains of regular mood swings of a long period of time—where for three months they are in an intense depression, then for three months they are literally manic—crazy busy and euphoric, working like mad on crazy new projects and speaking at a million miles an hour.
That would be a high probability of being classic type 2 bipolar.
note that I picked the period of “three months” at random, mood-period is highly individual and can range from a year to a few weeks.
If the depressions are suicidal (ie has to go on suicide watch) and the manias are accompanied by delusions of grandeur, then the probability of type 1 is raised. This often results in being “sectioned” (ie, been taken to a mental health facility to recover)
I’ve never heard of a Type 1 bipolar that has not been sectioned at least once… and usually repeatedly.
Both of the above “types” are fairly easy to diagnose. You can’t miss those symptoms—though the patient themself may not recognise them for what they are. Mania (especially hypomania) “feels like” being happy and busy and efficient and on top of the world. Depression “feels like” the world really is shit and everything you do just isn’t worthwhile. It often takes an outside perspective to point out that actually—the world is no different from what it was last month.
However—neither of the above “types” sounds like what muflax has. I raised the possibility, because a) bipolar starts small and gets bigger as you get older (and muflax is not old enough yet to know for sure). and b) there is a third, less-severe type that may well be over-diagnosed because it’s more difficult to pick out from the background noise.
but if you’ve seen and spent time with a type 1 or 2 bipolar person—you recognise the symptoms. Mood swings that are like a rising/falling tide with a regular rhythm, what muflux reports sounds like what mild bipolar feels like from the inside: periods of depression-like symptoms (including apathy) followed by a period of crazy-busy, happy-to-do-lots of projects.
Obviously this is not a convincing diagnosis… it just raises the probability of it being so. and thus my recommendation to go see a professional who will have an outside perspective and is experienced enough to be able to tell whether it really is, or not.
I agree that the problem with self-diagnosis is extremely bad atm. That’s why a professional, outside opinion is a Good Idea.
Possibly you’d take a good selection of people whom health professionals have proposed may be suffering from bipolar disorder, and randomly select for patients to either be treated for bipolar disorder, or for doctors to pursue an alternate explanation for the victim’s symptoms (such as regular depression or attention deficit disorder—the latter of which has been proposed to be responsible for the vast majority of “bipolar disorder cases” in children). Although this is a pretty sketchy concept. The alternative is for the other group to not be treated at all, but the ethics thereof are even more questionable.
Moreover, by “not treated at all” you merely mean “not treated with specialized medication for bipolar disorder”. Throwing lots of stuff (talk therapy, catch-all medication, support groups, random tricks and environment changes) at the problem until one sticks can work. I’m also rather skeptical of professionals—they have experience, sometimes permission to prescribe stuff, but they don’t seem to be all that awesomer than, say, a specialized IRC channel.
I had considered this. Further evidence: I have an atypical reaction to coffee. I get sleepy, then really calm. I react to very small doses and don’t seem to build resistance (except to the anti-tiredness property). This is not unusual for manics and ADD folk. Both my parents drink coffee right before going to bed, to sleep better. (I don’t, normally. Sleep quality goes way up, but caffeine also disrupts it, so memory suffers.)
But going with “alright, I’m bipolar” is just a label. I’ve gone through enough of those already.
As far as I know, there’s no good bipolar treatment. Lithium might be useful for more major cases, but my general mood is fairly stable as is. Inspired by Seth Roberts, I experimented with morning faces, movement and sunlight. Light therapy seems to stabilize my depression (though it’s too early to tell; winter is coming). The other two do nothing.
Besides the stuff I already listened, I’m not aware of any other promising treatment. I have a fairly low opinion of therapists, so I haven’t made a great effort to check them out. I studied all plausible methods though, often with neat successes, but unfortunately only for different problems.
(Don’t take this as negative dismissal. It’s just that so far I haven’t been successful down this road. Right now, I suspect that working on the level of thought or mood is useless as that’s not were the issue is. I’m trying to escalate the problem now to get a better picture of what exactly isn’t working, so I’m actively seeking out boredom, pain, guilt and so on. That’s certainly an atypical approach. I don’t know if it is successful or sane, but when you can’t find a bug, it always helps to have more data about what input causes it break...)
But going with “alright, I’m bipolar” is just a label. I’ve gone through enough of those already.
As far as I know, there’s no good bipolar treatment. Lithium might be useful for more major cases, but my general mood is fairly stable as is.
It’s a possibility to keep an eye on in any case. How old are you? Anecdotally there’s a tendency for the cycling in untreated bipolar people increase in amplitude and frequency with time. If symptoms worsen, consider the following:
If I remember correctly, historically Lithium cuts suicide rates in diagnosed bipolar people by a factor of ten or so (can dig up a reference if you’d like).
There are of course other mood stabilizers that one can experiment with.
CBT, self-monitoring & being monitored by others can be used to recognize the onset of (hypo)manic episodes. This can be useful because one can then take tranquilizers and/or atypical anti-psychotics to reduce the severity of (hypo)manic episodes. This in turn tends to reduce the severity of subsequent depressive crashes.
Maintaining a regular sleep schedule with enough hours a night is thought to be important to maintaining (relative) emotional stability. Also, sleep deprivation can trigger (hypo)mania.
I’m 25. I noticed the cycling at about 17, though it started at 14, I guess. The worst period was at 20-21.
If symptoms worsen, consider the following: [...]
I will. Should I enter full-blown mania or depression, I’ll give lithium a try. I’ll see if I can get access to some other mood stabilizers until then.
Maintaining a regular sleep schedule with enough hours a night is thought to be important to maintaining (relative) emotional stability. Also, sleep deprivation can trigger (hypo)mania.
I have rather the opposite problem (even when manic). I sleep 8-9 hours on good days and often 11 or more. This seems unrelated to how depressed I am, nor does my sleep seem disrupted. I’ve slept lots and really deep for all my life. Sleep deprivation (and polyphasic sleep in general) absolutely triggers hypomania. I rarely use this intentionally to get stuff done before a deadline, but it’s really destabilizing for at least 1-2 weeks afterwards.
Interesting study since one of the hallmark symptoms of bipolar is a lack of sleep, and BDNF is lacking in bipolar individuals who are depressed. I think more research should be done to see if this therapy can throw someone into bipolar disorder.
A bothering trend in the psychiatric community, which is now being recognized by mental health professionals, is the overuse of labels without looking at the patient’s individual symptoms and tackling them accordingly. The lack of objective tests also gives rise to misdiagnosis, even for severe disorders such as bipolar, and is dangerously more common than people realize:
“According to Zimmerman’s study, the underdiagnosis of bipolar disorder is not the case. Rather, only 43 percent of those surveyed who were diagnosed with bipolar disorder actually match the criteria for the disorder.”
In addition, some important institutions in mental health realize the current mental health institution is broken and want to incorporate genetics, cognitive science, neuroimaging etc. to develop a new one. While far from perfect, this is a step towards the right direction and will bring us closer to an objective test of mental health.
At the moment, people are being diagnosed on an illness built on shaky grounds, and there is a good chance that professionals won’t even bother to consult those shaky grounds when diagnosing.
Nice! I picked up the same idea some years ago from a therapist who used short-term sleep deprivation to get someone too depressed to do anything at all enough into a manic state to begin real therapy. (Sorry, no citation.) I wonder how sustainable this is, though.
I’m 25. I noticed the cycling at about 17, though it started at 14, I guess. The worst period was at 20-21.
From the info that I’ve seen on bipolar… it really “gets into the swing” when you get to your late 20s and early 30s. Earlier than this and it can easily be mistaken for normal moods affected by outside forces.
Lithium is a treatment that does not work on everybody. It is, in fact, the oldest of the known treatments, and the newer treatments are different and work with different people.
I have a bipolar (type 2) family member—who went through lithium and two other treatments before settling on seroquel. The best use of a “therapist” in this case is somebody that has great experience with what drugs are appropriate and what level you should be taking them at. After all, it’s always possible that lithium is your drug, but you were using the wrong dosage...
As to the other forms of treatment you’ve mentioned. These are emphatically not treatments for bipolar disorder. They are treatments for seasonal affective disorder (ie lack of sufficient light during the darker months causing emotional imbalance). Bipolar mood-swings occur regardless of light-levels.
Very tentative suggestion: Your post made me wonder about the underlying assumption that personalities just heal if damaging effects are eliminated. I may be on a path like that, but that doesn’t mean it’s true in general. It’s possible that sometimes improvements need to built rather than allowed to happen.
I’m not sure you and I mean the same thing by “amplification”. I meant something like “you’re such a piece of shit” (addressed to me), and then I start repeating it to myself, mixing it with thoughts about how defective I am for having something like that in my mind. What did you mean?
When I think about your situation, it does seem that you have a rather different tangle than I do.
I’ve been dealing with intrusive self-hatred for some time, and it isn’t tied to anything as clear as your pattern, though it’s frequently set off by working on useful things.
Lately, I’ve made some progress—I found out that there seems to be a background fear that a particular bad thing would happen if I made my life better, and reassuring myself that things aren’t entangled that way helps tremendously. Reassuring myself is more will-oriented than just saying it’s a fact that things aren’t entangled the way I feared.
Sorry to not be more specific, but the details are both sufficiently personal that I don’t want to post about them (a sufficient reason for not posting) and sufficiently idiosyncratic that it might not do much good for other people in any case. I’m down to relatively ordinary procrastination rather than utter paralysis.
Have you tried addressing the hatred from the second personality as a separate issue? It’s not as though it has a useful motivating effect, and my experience is that self-hatred is distracting and debilitating to a much greater extent than other sorts of intrusive thought.
One thing that’s helped gradually is to find out something about a habitual pattern of muscle tension which is associated with self-hatred—in my case, it’s in my upper back and may be connected to reaching. Learning this wasn’t a quick fix, but it made a difference to get a little distance on the emotion rather than having it just come from nowhere.
Something which made a big difference was realizing that there’s a difference between an intrusive thought and the habit(?) of amplifying it. I can’t directly control whether a thought appears, but amplification seems to have a larger voluntary component. Some of the time, I can refrain from amplifying.
My hypothesis about amplifying is that a large part of it is a desire for a feeling of energy. This isn’t pathological in itself.
Have you tried anything body-oriented to defuse anxiety? I’m thinking about yoga or Alexander Technique or such. I think one of the things which has helped me is realizing that there’s more to me than the feelings of anxiety.
Yes. I’ve been able to (temporarily) reduce it, mostly through anti-depressants and acceptance-based techniques. At my most successful, I was happily apathetic and really enjoyed staring at a wall. Alternatively, exercise channels the aggression outward, but as I’m not trying to eventually punch someone in the face, it’s not helpful.
I’ve also tried paying attention to the amplification, which is how I originally noticed that this is happening in the first place. I saw from looking at my chat logs and similar data that I was going through fairly regular cycles of one side being dominant or the other, with a period of about 3 months. (I suspected being bipolar based on that, but I’m not particularly manic or get much of an emotional change, nor did any typical bipolar treatment do anything.)
Unfortunately, I can now totally see one side starting to take over, but not do anything about it. I can exert willpower to postpone it, but not for long.
Bipolar is something to think about even if you don’t see strong manic components. There is a spectrum for bipolar just as for autism. Those on the “lower” end of the spectrum mainly just have depression (and I notice you mentioned anti-depressants)… and low-grade manic symptoms can easily be mistaken for “just having a good day”—especially if you aren’t in many social situations and therefore don’t get a chance for other people to notice/tell you that you happen to be acting strangely (eg as though you’d had ten cups of coffee).
The very fact that you have an active personality and a passive personality… and regularly swing between them… is a big hint it may be what you’re looking for—just perhaps in a form you wouldn’t normally recognise.
You say that “typical bipolar treatment” did nothing… but of course—you may need an atypical treatment—and you won’t know unless you try.
I’d suggest going to see somebody that specialises in bipolar disorder, and have a long chat. Might be nothing, but perhaps worth investigating a bit more.
OTOH, the surge of bipolar diagnoses, esp. self-diagnoses, suggests it’s overdiagnosed. How would you test? (This is a matter of some interest to me as well.)
Firstly by understanding that psychology is not physics—and there are no definitive tests. This is an area where probabilities are the way to go.
If a person complains of regular mood swings of a long period of time—where for three months they are in an intense depression, then for three months they are literally manic—crazy busy and euphoric, working like mad on crazy new projects and speaking at a million miles an hour.
That would be a high probability of being classic type 2 bipolar. note that I picked the period of “three months” at random, mood-period is highly individual and can range from a year to a few weeks.
If the depressions are suicidal (ie has to go on suicide watch) and the manias are accompanied by delusions of grandeur, then the probability of type 1 is raised. This often results in being “sectioned” (ie, been taken to a mental health facility to recover)
I’ve never heard of a Type 1 bipolar that has not been sectioned at least once… and usually repeatedly.
Both of the above “types” are fairly easy to diagnose. You can’t miss those symptoms—though the patient themself may not recognise them for what they are. Mania (especially hypomania) “feels like” being happy and busy and efficient and on top of the world. Depression “feels like” the world really is shit and everything you do just isn’t worthwhile. It often takes an outside perspective to point out that actually—the world is no different from what it was last month.
However—neither of the above “types” sounds like what muflax has. I raised the possibility, because a) bipolar starts small and gets bigger as you get older (and muflax is not old enough yet to know for sure). and b) there is a third, less-severe type that may well be over-diagnosed because it’s more difficult to pick out from the background noise.
but if you’ve seen and spent time with a type 1 or 2 bipolar person—you recognise the symptoms. Mood swings that are like a rising/falling tide with a regular rhythm, what muflux reports sounds like what mild bipolar feels like from the inside: periods of depression-like symptoms (including apathy) followed by a period of crazy-busy, happy-to-do-lots of projects.
Obviously this is not a convincing diagnosis… it just raises the probability of it being so. and thus my recommendation to go see a professional who will have an outside perspective and is experienced enough to be able to tell whether it really is, or not.
I agree that the problem with self-diagnosis is extremely bad atm. That’s why a professional, outside opinion is a Good Idea.
Possibly you’d take a good selection of people whom health professionals have proposed may be suffering from bipolar disorder, and randomly select for patients to either be treated for bipolar disorder, or for doctors to pursue an alternate explanation for the victim’s symptoms (such as regular depression or attention deficit disorder—the latter of which has been proposed to be responsible for the vast majority of “bipolar disorder cases” in children). Although this is a pretty sketchy concept. The alternative is for the other group to not be treated at all, but the ethics thereof are even more questionable.
I take offense to “having control groups is unethical”.
Moreover, by “not treated at all” you merely mean “not treated with specialized medication for bipolar disorder”. Throwing lots of stuff (talk therapy, catch-all medication, support groups, random tricks and environment changes) at the problem until one sticks can work. I’m also rather skeptical of professionals—they have experience, sometimes permission to prescribe stuff, but they don’t seem to be all that awesomer than, say, a specialized IRC channel.
I had considered this. Further evidence: I have an atypical reaction to coffee. I get sleepy, then really calm. I react to very small doses and don’t seem to build resistance (except to the anti-tiredness property). This is not unusual for manics and ADD folk. Both my parents drink coffee right before going to bed, to sleep better. (I don’t, normally. Sleep quality goes way up, but caffeine also disrupts it, so memory suffers.)
But going with “alright, I’m bipolar” is just a label. I’ve gone through enough of those already.
As far as I know, there’s no good bipolar treatment. Lithium might be useful for more major cases, but my general mood is fairly stable as is. Inspired by Seth Roberts, I experimented with morning faces, movement and sunlight. Light therapy seems to stabilize my depression (though it’s too early to tell; winter is coming). The other two do nothing.
Besides the stuff I already listened, I’m not aware of any other promising treatment. I have a fairly low opinion of therapists, so I haven’t made a great effort to check them out. I studied all plausible methods though, often with neat successes, but unfortunately only for different problems.
(Don’t take this as negative dismissal. It’s just that so far I haven’t been successful down this road. Right now, I suspect that working on the level of thought or mood is useless as that’s not were the issue is. I’m trying to escalate the problem now to get a better picture of what exactly isn’t working, so I’m actively seeking out boredom, pain, guilt and so on. That’s certainly an atypical approach. I don’t know if it is successful or sane, but when you can’t find a bug, it always helps to have more data about what input causes it break...)
It’s a possibility to keep an eye on in any case. How old are you? Anecdotally there’s a tendency for the cycling in untreated bipolar people increase in amplitude and frequency with time. If symptoms worsen, consider the following:
If I remember correctly, historically Lithium cuts suicide rates in diagnosed bipolar people by a factor of ten or so (can dig up a reference if you’d like).
There are of course other mood stabilizers that one can experiment with.
CBT, self-monitoring & being monitored by others can be used to recognize the onset of (hypo)manic episodes. This can be useful because one can then take tranquilizers and/or atypical anti-psychotics to reduce the severity of (hypo)manic episodes. This in turn tends to reduce the severity of subsequent depressive crashes.
Maintaining a regular sleep schedule with enough hours a night is thought to be important to maintaining (relative) emotional stability. Also, sleep deprivation can trigger (hypo)mania.
I’m 25. I noticed the cycling at about 17, though it started at 14, I guess. The worst period was at 20-21.
I will. Should I enter full-blown mania or depression, I’ll give lithium a try. I’ll see if I can get access to some other mood stabilizers until then.
I have rather the opposite problem (even when manic). I sleep 8-9 hours on good days and often 11 or more. This seems unrelated to how depressed I am, nor does my sleep seem disrupted. I’ve slept lots and really deep for all my life. Sleep deprivation (and polyphasic sleep in general) absolutely triggers hypomania. I rarely use this intentionally to get stuff done before a deadline, but it’s really destabilizing for at least 1-2 weeks afterwards.
One of the weirder citations I’ve picked up over the years is “Rapid antidepressant effects of sleep deprivation therapy correlates with serum BDNF changes in major depression”. Apparently sleep deprivation is a known treatment for depression?
Interesting study since one of the hallmark symptoms of bipolar is a lack of sleep, and BDNF is lacking in bipolar individuals who are depressed. I think more research should be done to see if this therapy can throw someone into bipolar disorder.
A bothering trend in the psychiatric community, which is now being recognized by mental health professionals, is the overuse of labels without looking at the patient’s individual symptoms and tackling them accordingly. The lack of objective tests also gives rise to misdiagnosis, even for severe disorders such as bipolar, and is dangerously more common than people realize:
“According to Zimmerman’s study, the underdiagnosis of bipolar disorder is not the case. Rather, only 43 percent of those surveyed who were diagnosed with bipolar disorder actually match the criteria for the disorder.”
In addition, some important institutions in mental health realize the current mental health institution is broken and want to incorporate genetics, cognitive science, neuroimaging etc. to develop a new one. While far from perfect, this is a step towards the right direction and will bring us closer to an objective test of mental health.
At the moment, people are being diagnosed on an illness built on shaky grounds, and there is a good chance that professionals won’t even bother to consult those shaky grounds when diagnosing.
Sources: http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml http://hub.jhu.edu/2013/04/30/depression-diagnoses-study
Nice! I picked up the same idea some years ago from a therapist who used short-term sleep deprivation to get someone too depressed to do anything at all enough into a manic state to begin real therapy. (Sorry, no citation.) I wonder how sustainable this is, though.
From the info that I’ve seen on bipolar… it really “gets into the swing” when you get to your late 20s and early 30s. Earlier than this and it can easily be mistaken for normal moods affected by outside forces.
Thia was certainly my own experience; i’m 25 and didn’t figure it out until the past year.
Lithium is a treatment that does not work on everybody. It is, in fact, the oldest of the known treatments, and the newer treatments are different and work with different people.
I have a bipolar (type 2) family member—who went through lithium and two other treatments before settling on seroquel. The best use of a “therapist” in this case is somebody that has great experience with what drugs are appropriate and what level you should be taking them at. After all, it’s always possible that lithium is your drug, but you were using the wrong dosage...
As to the other forms of treatment you’ve mentioned. These are emphatically not treatments for bipolar disorder. They are treatments for seasonal affective disorder (ie lack of sufficient light during the darker months causing emotional imbalance). Bipolar mood-swings occur regardless of light-levels.
Very tentative suggestion: Your post made me wonder about the underlying assumption that personalities just heal if damaging effects are eliminated. I may be on a path like that, but that doesn’t mean it’s true in general. It’s possible that sometimes improvements need to built rather than allowed to happen.
I’m not sure you and I mean the same thing by “amplification”. I meant something like “you’re such a piece of shit” (addressed to me), and then I start repeating it to myself, mixing it with thoughts about how defective I am for having something like that in my mind. What did you mean?
When I think about your situation, it does seem that you have a rather different tangle than I do.