The biology of emotion

As someone who has experienced several manic episodes and one very long depressive episode, I have taken a keen interest in understanding what I believe is the root cause of the episodes. That is, the breakdown of the body's emotional regulatory system.

First you have to understand what emotions are and what their purpose is. The simple explanation is that they are the brain's "muscle memory". They serve as a short cut to determining how you should react to immediate circumstances. You don't have to ponder every change in your environment. Certain changes trigger chemical releases that make you feel a certain way physically. This physical reaction affects your judgment and behavior, especially if it's a circumstance that you've experienced before.

The amygdala is the part of the brain that, among other things, helps regulate emotions, their duration and their intensity. It does so by signaling other parts of the brain to signal certain organs to release specific chemicals. It's not necessary to understand the details of how all this occurs, only to understand that it is a semi-automatic system and basing your judgment and behavior solely on it is not always in your best interest.

I believe, in the case of bipolar episodes, that for some reason this system goes awry. For example, in a manic episode, I was constantly immersed in a feeling of euphoria laced with adrenaline. Every idea I had was brilliant and I wanted to act upon it immediately. If the system were working properly, a great idea or epiphany might trigger this response for a few moments. Instead, it was constant. Whatever is responsible for turning it off was not working. The interesting thing is that it only seemed to malfunction for a particular emotional state. This was glaringly evident in the depressive episode, which lasted an entire year. My brain seemed only to be able to focus and dwell on the negative. Everything was hopeless and pointless. When it finally stopped, there had been no significant change in my circumstances, only my emotional state. It just stopped.

The realization that overwhelming emotion is a sign of a physical malfunction has helped me to be much more aware of my emotional state and to always question its validity. It's been about 7 years since my last episode and I think part of the credit goes to the fact that I keep my emotions on a short leash these days. For example, I recently was feeling very agitated and short-tempered. This, by itself, is not necessarily a red flag. However, after a couple of hours I began to do some self-analysis. There really was no reason for it and it wasn't going away. In addition, I realized that even if there were a reason for it, it's not a very productive state of mind anyway. While I couldn't immediately shut down the physical feeling by shear power of will, I could adjust my thought process and reaction to the feeling. I essentially regarded it as a temporary ailment, like having a cold. I was careful not to take it out on the people I came in contact with and to disassociate the physical feeling from my reasoning process. Eventually, it subsided.

This is important because the brain can be trained. Your reaction to an emotion this time, influences the chemical releases that will occur next time. Your brain stores information on how you reacted and whether the result was good or bad. You may not have to work so hard to control it in the future. On the other hand, if you allow yourself to wallow in an emotion without question, you are reinforcing the chemical reaction which may make it more difficult to counteract in the future.

Like most tools, emotions can be very useful. However, if you don't take the time to learn how to control them and recognize when they're not working properly, they can be dangerous and even deadly. Drugs can mask the problem, and if you need them, take them, but don't be afraid to confront, challenge, get to know and understand the various physical states we call emotion. Make them work for you rather than govern you.

Charlie Sheen syndrome

It's obvious to me, and probably to any of you who have dealt with bipolar disorder, that Mr. Sheen's drug and alcohol use are a side issue to what's currently on display in the media. He's a bipolar in the midst of a full blown manic episode.

It may be that drug and alcohol over-indulgence provide the bipolar individual with an easily recognizable, familiar scapegoat for how they're feeling and behaving. It provides an illusion of control, even when you're out of control. After all, you can take another drink or not; have another hit or not. It's something you do to yourself, as opposed to a chemical imbalance that you have no control over. Control is better.

Here are some insights into my own condition. Maybe you can recognize some of it.

I drank and used drugs to great excess for many years, but I was not addicted. I do have addictive tendencies in that I'm always over-indulging in something (currently, it's coffee). That's not to say that one can't be bipolar and an addict. I guess I just don't have the addict gene.

It took several episodes and many years before I acknowledged that in terms of awareness and intelligence, I was not on a higher plane, that mere mortals just didn't understand. I had a biological problem that was a real detriment to myself and those around me. It wasn't until the depressive episode that I finally decided I'd had enough (the mania seemed pretty cool from my vantage point, the depression very nearly killed me). I tried to hide the mania because I wanted to continue to explore it. It can seem quite productive and I thought I could learn to control it and put it to good use.

Sleep is huge. Bipolars should ensure that they get sleep every night. If that means taking sleep aids, take sleep aids. In addition to any treatment and/or drugs, it helps to engage in constant, logical, self-analysis, especially of one's emotional state. You can still have undue emotions like anxiety, fear, anger, depression, euphoria, but you can train yourself to question them and disregard them if appropriate. Easily said. Not easily done.

Sheen has a handicap in that he's got so much money to spend on his entourage. Those around him are likely to reinforce his notion that he's some kind of super-human that the rest of us "can't process". He'll come out of this episode at some point. Then I expect he'll start looking for ways to recreate that awesome euphoria. I don't know where it goes from there. I just hope nobody gets hurt.

update; What a difference a day makes.

I don't want to do a series of Sheen posts, but it's worth updating. His "Winning Recipes" sketch that he aired today was well done and funny. He looked like he'd gotten a good nights sleep and a shower and some people actually went to the time and effort of putting together a good piece of sketch comedy. It was like Charlie Sheen doing a sketch about Charlie Sheen. In addition, his lawsuit against the producers of 2 1/2 men states that he was fired "while he was sick". That and his apology to co-star John Crier indicate that he's aware that he was not well. It's possible he actually has a good crew around him. I have no way of knowing. But if he can get himself together and make yet another fortune being his own reality show, more power to him.

Addicted to mania

I was watching an episode of celebrity rehab when Dr. Drew said that addiction was the only disease you had to convince people that they have. My first thought was "not true". It took several manic episodes before I was convinced that I was bipolar. I decided it was all just due to insomnia. Then, after a bit of reflection, I realized it really was kind of an addiction. An addiction to the mania.

I liked the mania. It was fun. It was exciting. I wanted to learn to feel like that all the time. If only I could figure out how to behave in a manner that didn't freak people out while I was experiencing it. Two things changed my outlook. One, was my first bout with depression. It lasted a full year. If that's the other half of this thing, I don't want anything to do with it. The other was the realization that my wife was not going to tolerate my little brain experiment indefinitely. If I didn't get my head out of my butt, I was going to be a very lonely manic.

That's when I really started taking the whole thing seriously. I still wanted to learn to handle it as drug free as possible, but I was going to handle it. And if the thoughts started racing, I wasn't going to try to hide it. I was going to get help.

I came to realize eventually, that it wasn't really the mania I was enjoying. It was the thoughts, ideas and awareness that came with it. Unfortunately it also came with a total loss of control of moment to moment judgment and behavior. I didn't go berserk or anything, but I obsessed about things and had to express every idea as it came up and they never stopped coming up. I didn't want to sleep because I didn't want to stop thinking and since I felt an urgency to express everything I was thinking, I never stopped talking or acting out my ideas, no matter how bizarre.

There's nothing wrong with bizarre ideas or lofty thoughts. I just didn't need to be sharing them all or acting on them. That's what I focused on. Now I make sure I get sleep, every night and if I'm having trouble, I don't hesitate to reach for the over the counter sleep aid, although I do mix them up so I'm not taking too much of any one. I probably average one or two doses a month over the course of a year.

It's been several years since I've had an episode, manic or depressive. But I have no delusions that it can't happen again. However, I am no longer a willing host. If/when it comes on again, I'll be wary and I'll combat it, with all the help I can muster. I still enjoy thinking, observing, discovering, pondering and the occasional epiphany, with the euphoria it can bring. But I can do all that without forcing everyone around me to participate. Everyone's got their own thing going on in their head and I'm not going in there uninvited. That's not sharing, it's just rude.

If you can't laugh at yourself....

The Maulder Method

Back in the day, I was a big fan of the X Files. Although I'm a very logical person, I admired Agent Maulder's problem solving technique. I couldn't quite put my finger on it, but somehow, starting with an outrageous working theory, adding new input and following where it leads seemed to me to be an efficient way to solve complex problems or mysteries.

I think I've worked out why. Most of the time, when faced with a problem or mystery we have a set of possible solutions or working theories in mind. If something doesn't fit in with it; a pattern, a clue, a statement; the brain has a tendency to ignore it because it is deemed insignificant. It doesn't fit in to any of the possible solutions, therefore it must simply be a random event or object. By keeping even the most outrageous possibilities open (aliens, monsters, mega-conspiracies), you are tricking your brain into allowing you to acknowledge and store data and patterns it otherwise would have disposed of. This can be crucial when a potential solution that you hadn't previously thought of comes to mind and suddenly, everything fits.

Harnessing emotion; Go from slave to master

I've pointed out before that I think the problems associated with bipolar disorder or any chemical imbalance disorder arise from emotion.

The imbalanced chemicals cause the experience of emotion at inappropriate times. This affects your thought process and your behavior if you're not very aware of it.

I have learned, over many years, to react very differently to my own emotional state. I don't dismiss all emotion. After all, some are pleasant and even very useful. If I'm experiencing an adrenaline rush during one of my favorite songs, I'll go ahead and immerse myself in it for a few minutes. If I'm angry and it's helping me focus in a productive manner, I'll go ahead and be angry for a few minutes.

However, if I'm experiencing an unusual level of anxiety, fear, depression, irritability or even glee, my first response now is "imbalance". I don't look for circumstantial conditions to attach the emotion to. I know there aren't any. I regard it much like having a cold or flu (depending on the level of severity), take medicine if necessary, just ignore it if it's not.

There is a big difference between being aware of your condition and allowing it to define who you are. I don't mind sharing my insights and opinions for what they're worth, but I'm not joining any support groups, becoming an activist or asking anyone for funding. I will not make "bipolar" that big a part of my life. It's an interesting footnote, and that's all it's going to be. The lessons I've learned from dealing with chemical imbalance are just as useful for those who don't experience chemical imbalance. Understanding your emotional system and making it work for you, instead of being its puppet, will make anyone happier and more productive.

Get to know your brain

It's a common misconception that the self and the brain are one and the same. Not so. The brain is a very complex and capable computer. The self is the user. There are aspects of the way the computer functions that make it very efficient, but can also lead to poor judgments and decision making if one is not aware of them. One to be very aware of is rationalization.

The brain doesn't like uncertainty or not knowing. It wants an answer and it wants one now. It will make one up if it has to. If you suddenly experience fear, the brain wants to know why. The emotion is supposed to give the brain a heads up to something that has changed in the environment or situation. If you look around and take stock of the situation and there is no obvious answer, the brain will move from facts to possibilities and it will keep piecing bits of data together until it has something plausible.

The problem is the brain will find an answer whether the alarm bell was legitimate or not. If you're experiencing fear or anxiety due to a chemical imbalance and not due to any real danger, your brain will find something for you to be afraid of. It works the same with depression. If you're in depressive mode your brain will make mountains out of molehills for you and give you something, many things, to be depressed about.

Awareness is your counter-measure. Objective, logical analysis is your best tool. Your brain and your emotions are your advisers. You are the boss, or at least you're supposed to be. If you've been derelict in your duties, take back the reigns and get back to driving.

Don't let success lead to burning bridges

I have had four episodes in the past 25 years that required some hospitalization due to my irrational behavior. Three of those times, I saw it coming and couldn't stop it. I am under no illusions that because I haven't had such an episode in a long while, I'm no longer prone to one.

Both my doctor and therapist wondered if I needed to continue to see them. I said absolutely, if only because it keeps me in their system. I now see the therapist for a few minutes each month and the doctor for about 5 minutes every six months. This ensures that if things go south in a hurry, there will be no mountains of paperwork for my wife to sit and fill out on top of all the turmoil she'd have to deal with.

I may go the rest of my life without another episode, but keeping the supply lines open in terms of treatment (or plan B) is still a great investment. If it only brings my family some extra peace of mind, it's paid off in spades.

Don't let your ailment define you

My son is low-functioning autistic. He's now 19 years-old. By the time he was 6, I realized that there was no cure for the condition and the medical community really didn't understand where it came from. I put the notion of a "cure" out of my head and accepted Max as Max. The most frustrating thing I had to deal with from that point forward was the school system insisting on more and more tests. For some reason, they needed a more refined label for him. I just wanted them to teach him as much as he was able to learn. They wanted to find a just the right pigeon-hole to put him in.

Giving your problem a name isn't a solution. Learning to survive and thrive in spite of it is. I've had a handful of diagnosis to explain my occasional vacations from reality. I've settled on bipolar because I no longer care what anyone calls it. I'm becoming more aware of it and learning to work-around it, regardless of what you call it. While I don't really care if others know about it, I don't need them to know, or understand or make accommodations. My condition may be described as "bipolar" but "I" am not "bipolar". My son is autistic. He is not autism.

No doubt, there are times when making others aware of your condition and the nature of it is helpful and advantageous. But, don't live there. You will never excel if you convince others (and yourself) that it's not possible. Trying to force people to accept you as their burden, rather than an asset is not progress. You can't be a champion and a victim. Pick one.

Sleep is a powerful medicine

In my first manic episodes, things didn't really get out of hand until I had gone without sleep for a few days. I had convinced myself that as long as I got rest, sleep was not necessary. I have since learned that sleep is the brain's reset mechanism. It's not just for the body, it's essential for the mind.

A healthy amount of sleep is around 7.5 hours/day. If you're falling substantially short of that, see your doctor or go to the store and get some diphenhydramine. Ideally, you want to learn to sleep on your own whenever possible, but don't dwell on that. Get your sleep however you can.

When you're in depressive mode, you may have the opposite problem. You want to sleep all the time. This is a reaction to your emotions and the best way to combat that is to simply ignore the urge. If you know you've had enough sleep, get up and find something to do. Take a walk, clean the house, read something.

In manic mode, your thoughts can often keep you awake. You have an idea or train of thought that's stuck in a loop and you can't let it go. One thing that helps is to make use of external memory, that is, write it down. You can go to your computer or pick up a pen and paper and just write yourself an article, essay or letter. The idea will be there in its entirety should you decide to pick it up again tomorrow or later. If you're re-thinking all the things you need to do tomorrow, make your to-do list and set it on the kitchen table. Get all the things rolling over in your head onto hard copy. You'll find it quite relieving.

Alcohol is not a good solution. Trust me on that one. Turkey soup, however, does help. Another trick is to count backwards in your head, slowly, from 1000. If you lose count, start over. If you get to zero, start over. It's tedious and boring and keeps your brain occupied. Eventually your thoughts drift and you'll find yourself nodding off. Also, if you're consistently not getting enough sleep, layoff the caffeine for a while. You don't have to give it up forever. You can live without it for a week or two.

The need for sleep is a biological fact. It's important to acknowledge that because your brain will sometimes try to convince you otherwise. The world will still be there when you wake up. It's okay to ignore it for a few hours. In fact, you'll deal with it much more efficiently if you do.

Obsession - Are You Doing Other People's Homework?

When I was in high school, things came pretty easy to me. I had empathy for those who did not pick up on things so quickly. So much so that I would often take it upon myself to help them catch up in class. This actually put me in a position where I had to stay late to finish some final projects because I hadn't spent enough time on my own work.

I was not experiencing bipolarism at the time. It was just a bad habit. But, when you are chemically imbalanced, this same type of behavior can exhibit itself in the extreme.

In my own experience, during one fairly lengthy episode I took to joining scientific forums and going on for hours about the cosmos, it's origins and the nature of physics. I'm not a scientist, just curious. All this would have been fine except that I had two businesses barely hanging on and I was spending five hours a day or more on something that was not benefiting myself, my businesses or my family in any way, shape or form. Fortunately I caught on after a while. Now when I notice myself falling into some kind of obsessive behavior, I try to direct it toward something more productive. I'll still find an hour or two a week to ponder the universe, but if I'm going to spend 1/3 of a day on something, it better be making me money or improving my lot in life in some way. No more doing other people's homework.

Be on guard for such behavior. You may not be able to control the chemicals that run through your bloodstream, but again, you can control your reaction to them with practice. If you find yourself spending a lot of time pondering one thing, or engaged in a specific type of activity, stop and look at the situation objectively. Does it make sense? Are there better ways to spend your time? What are your goals for the next 6 months, 3 years, 5 years? What can you be doing now to get you closer to them? Why aren't you doing that instead of trying to become the Sudoko champion of the world?

A good way to start is to simply make a list each morning of the things you'd like to accomplish today. If you get them all done you can spend a little time in trivial pursuits. Eventually you want to mesh the things you have to do with things you like to do. You can do this by trying to find entertainment value in the things you have to do, as well as constantly reevaluating what it is you think you want to do.

If you can find a way to pursue your interests in a way that benefits someone else, you've stumbled onto a potential productive enterprise. We call it capitalism. Don't be in too big a hurry. You don't have to figure it all out this week. Just keep your eyes and ears open for opportunities and take them when they arise. In the meantime, don't lose sight of your present reality. Do your own homework.

Get comfortable being uncomfortable

The big problem with being bipolar or subject to chemical imbalance is not so much the way it makes you feel, it's how you react to the way it makes you feel and how those reactions affect those around you.

Drugs can mask the problem, but they wont repair the system. You can actively manage the system, however. Work with what you have. Don't wait for your body chemistry to change. Get familiar with it and make the necessary adjustments.

I was a severe party-er in high school and college, which may have been some subconscious self-medication, or it could just have been that I enjoyed it. No matter. I got to a point that I could be completely wasted and you'd never know it if I didn't tell you. I became so familiar with being inebriated that I was able to function normally when I had to, whether I was inebriated or not. Of course, the damage to the internal organs was the same. Only my behavior was different.

The point is that one can do the same with any stimulus. You can feel the anxiety without demonstrating it. You don't have to put your mania, or your depression on display. If you need help, of course, go get help, but if you've reached the point where your emotions no longer alarm you, you don't have to put them on display. You can "play hurt". If you are not among people who understand and can help you with what you're going through, making them aware of it can actually make your immediate situation worse. You're just going to scare them. As I've said, fear is not your friend.

I'm not saying you should hide your condition or not get help in managing it. I'm just saying that if you're experiencing a panic attack while standing in line at the bank, finish your business at the bank, then go get help if you need it. If a bout of depression comes over you during a presentation, pinch yourself, focus on your task, put a smile on your face. Do your job, then call your friend, doctor, wife, or whoever you need to call. If you're not at a point where you can safely pull these things off, don't try to. Just know that it is possible. You can re-train your brain. You are in control of your behavior even if you're not in control of your emotions or body chemistry. You don't have to wait for a cure to have the happy, productive life you want to have. You are the cure.

The empathy factor

Empathy - the intellectual identification with or vicarious experiencing of the feelings, thoughts, or attitudes of another.

If you've been diagnosed bipolar, or even if you are but haven't been officially diagnosed as such, it may be tough for those around you to distinguish between irrational behavior and statements and just you being your normal, somewhat eccentric self.

Behavior or expressions that you recognize yourself as a bit goofy or off the wall, but harmless, may be perceived by others as scary. Those who care the most about you are the ones who will be dealing with you should you have a full blown episode. This can make them very, very anxious if you start showing signs that you're not completely in touch with reality. Fear is a dangerous thing, whether you're experiencing it, or causing it.

It's important to be aware, not only of your own emotional state, but of those around you. You don't have to comment on it, or call them on it, just be aware of it. If you're making people uncomfortable, check yourself. Don't explain yourself, or justify yourself, just stop doing whatever it is that's causing the anxiety. If you have some off the wall train of thought you want to follow, do it later.

This was a tough one for me. I'm an outside the box thinker whether I'm manic, depressed or on an even keel. I had to learn to stop insisting that my wife and others learn to distinguish between my potentially irrational thought and my normal random musings. When I sense anxiety, I go to humor or quickly wrap up what I was talking about or doing and move on to something much more familiar.

Remember most everyone's behavior is largely guided by emotion. Most "normal" people are at least as unconscious of the chemical stimulus that's leading them around by the nose as those with chemical imbalance issues. The emotions you help create within your environment impact your freedom, your safety, your overall quality of life. Again, don't dwell on it, just be aware of it.

Functioning with the malfunction

So you've been told you're bi-polar. Now what?

Well, if you need to take drugs to pick you up or bring you down, take them. However, at the same time you need a long term, personal solution. You don't just want to survive. You want to thrive and there's no reason you can't get back on that road.

First you need to recognize that your feelings, your emotions, your state of mind, and by extension your thought processes are all chemically generated. When the system is working perfectly, chemicals are released that make you "feel" a particular way that can subconsciously alert you to circumstances and conditions you may not yet be consciously aware of.

The "chemical imbalance" you have been experiencing is the consequence of a malfunctioning emotional system. Since each person's emotions and reactions to them have been personally developed and customized from birth, there is no drug that will enter your system and suddenly put everything back where it should be. There is however, a work-around.

The most powerful counter-measure: Objective logic and reason. You are not your emotions, or even your brain. You are the self. You are the driver of this vehicle. You are not the vehicle. If the vehicle pulls to the left, over-steer to the right. In other words, recognize the malfunctions and adjust to them. Do not respond immediately to your emotions, feelings or even thoughts. Take the time to objectively evaluate your situation and determine if what you're feeling and thinking is in sync with what's actually going on around you or in your life. When you have an idea you believe is brilliant, don't immediately act on or share it. If it's truly a great idea, it will still be great tomorrow, next week and next month. Time test it. Write it down. Let is simmer. Come back to it later and see if it still has the same appeal it did originally.

This may slow you down at first, but with constant self-training you will wind up with a new way of processing both internally and externally generated data that is just as quick and effective, if not more so, than what you had before. It will force you to think and act deliberately instead of just automatically responding to chemical stimulus. It will make you more aware, alert and prudent than the average "normal" person.

In martial arts one is taught to use the weight of one's adversary against them. Dealing with bi-polar disorder is no different. Become intimately familiar with it. Bend it to your will. Never let your body, your brain, your emotions forget who's in charge.