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RonPrice · 12-21-2008, 05:44 AM

2. My Experience of Manic-Depression:
Phase One--The First 37 Years 1943 To 1980

2.1 In the first 37 years of my life I had many episodes of various kinds of emotional imbalance or disorientation, themselves of varying lengths and intensities, ranging from a euphoric, impetuous, expansive or high mood to a depressed, grey, low energy or despondent mood. Indeed the range of mood in these 37 years was much more extreme, but the complete/extreme range was rarely experienced. In these years I learned various self-monitoring skills as well as some self-reinforcing tactics. Sometimes these symptoms affected my day-to-day life severely and negatively, sometimes positively and sometimes the affect was non-existent, insignificant and hardly noticeable.

2.2 After many experiences on the fringe of a normality that was my usual modus operandi or modus vivendi, as it is said in Latin , on the fringe of what I saw as my general everyday experience of life, an experience that is sometimes called the quotidian by writers, poets and novelists, I was diagnosed as a MD in May 1980. I was treated by a psychiatrist in Launceston Tasmania while in hospital. I had often been on the fringe of this disorder, as I say above, a borderline zone, a limen as some historians call it, a border territory, a zone between normality and various behavioural extremes and eccentricities from my birth in 1944 to 1980. But in 1980 the symptoms were extreme and required hospitalization. The treatment regime in 1980 was lithium carbonate, an antimanic medication for the treatment and prophylaxis of BPD. Lithium was the first really successful mood stabilizer used by doctors to treat MD, an illness that in the 1990s began to be called BPD. This medication cushioned the effects of extreme depression and hypomania and prevented their effects from striking at my life. The perils of BPD lie in what I did in the midst of hypomanic episodes to deal with: decreased need for sleep, decreased self-control, increased sexual desires, irritability, rage, risk-taking behaviours and, in my 1968 and 1979-80 episodes, schizo-affective or psychotic states; and in the midst of depression periods with moroseness, extreme melancholia and suicidal wishes.

2.3 My history to that point, to 1980, had been far from smooth and linear as my remarks above indicate. Those thirty-six years had often been bisected, polarised and traumatised. As I indicated above I have written a more detailed account of these years elsewhere but this outline, this brief sketch here, of particular episodes and the periods between episodes will suffice. My experience of these highly diverse emotional and psychological swings of mood in everyday experience away form the norm, from my norm, is only part of my story. But it is a crucial part. Everyone has their story for everyone experiences all sorts of abnormal eccentricities and health problems in life, some people of course more than others and some more traumatic and intense than others.

2.4 My account of the years from 1943 to 1980 follows. I try, in writing about and in summarizing these first 37 years of my life, not to overstate my case, nor to understate it, but give an account of those first 37 years which I refer to here in this general statement as phase one of my bi-polar life. In some ways the inclusion of the names of those doctors who treated me over the years in this first phase and in later phases would personalise this account, but names are not that important and to include them here in this narrative causes confidentiality problems and raises privacy issues for some readers and for people in my own past who might not want to be mentioned. This question of confidentiality and privacy is especially true at some internet sites where posts are rejected if names are included in any posting at the site concerned---and so I leave names out. Those whose names I could mention would not be troubled by their inclusion here, not now, not in 2008 after an extensive destigmatization of the disorder in recent years and after so much of my experience and so many of the people concerned are now, what you might call, ancient history.

2.5 1 I certainly appreciate the medical and clinical work of: (a) several of the doctors I went to in my childhood, adolescence and adulthood, (b) the psychiatrists who have treated me since June of 1968, nearly four decades ago and (c) many family members, friends, colleagues and associations, some known well and others hardly at all, who have helped me ride the waves when the disorder raised its head yet again along the way, the road of life.

2.6 Comments on My Ante-Natal, Neo-Natal,
Childhood and Adolescence Life: 1943-1963

2.6.1 As I refer to above, I had some experience of what may well have been BPD in childhood as far back as infancy and at the toddler stage, all of the pre-school years, 0-5, of early childhood development. My mother nearly died in the first month after my birth, the implications of which it is not my intention to go into here. If there are any significant implications of this birth process and/or events in my ante-natal and neo- natal phases of my life, I do not examine here, however important they may be in the aetiology of this illness. Before the age of five there is evidence that my behaviour had some of the features of what is now called Attention-Deficit/Hyperactivity Disorder (ADHD), but it is difficult to disentangle those features from those of BPD. For the most part, though, I did not manifest BPD symptoms like: elated mood, grandiose behaviours, decreased need for sleep, racing thoughts or hyper-sexuality. Children are developmentally incapable of many manifestations of BPD described in adults; for example, children do not "max" out credit cards or have four marriages, pre-puberal and early adolescent age equivalents of adult mania behaviours. Still, as David Healy emphasizes in his book Mania: A Short History of BPD, some doctors are now associating BPD as beginning in utero.

Perhaps in a later edition of this essay I will attempt a more detailed outline of what I recall from these years of early childhood, but my recollections are minimal and it is difficult, if not impossible, to excavate my memories from those years at this late stage of my life. It is not my intention to comment further on these early years except for the occasional passing reference when it seems appropriate.

2.6.2 Through middle and late childhood, say, the age of 6 to 12(1950-1956) into the puberty cusp of 12/13 in 1956/7, I did exhibit personality features, behaviours or symptoms that had features of BPD, at least to a limited degree, or so it could be argued if not proved: (a) a lack of control of my emotions, impetuosity, lack of emotional restraint, hyper-sexuality and (b) a far too intense activity threshold what is now called hyperactivity, mild mania or hypomania. It should be emphasized in this context, though, that mania is now considered by many in popular culture as a pleasantly grandiose, somewhat overactive feeling and behaviour orientation, but is not considered as evidence of a disorder, of insanity or of a maniacal posture. I recall at the age of 12/13, at the onset of puberty, exhibiting inappropriate or precocious sexual behaviour, although the particular manifestations only involved one episode which constituted groping and an attempt to kiss a girl who did not want to be kissed.

Adolescent BPD or adolescence presented me with an accentuation of puberty and teen-turbulence caused by hormonal shifts. Society value shifts in the 1960s accentuated my tensions and behavioural problems more, or so it seems to me, as I look back from the perspective of half a century. My mother’s understanding, commitment, perseverance and patience even though she did not know that I even had BPD is now in my memory bank and in my greater appreciation for my mother than ever before.

2.6.3 Although symptoms of BPD that I exhibited in childhood and adolescence are largely not described here, I could go back to my birth and, indeed, to conception itself and my in utero life as I intimated above, for possible origins and manifestations of BPD. The relationship with my mother, my sexual proclivities, my OCD tendencies could all be described, could be gone into, in more detail. I have also written about this subject briefly in my memoirs. I do not attempt in this now quite lengthy account to describe this period of my life in more detail, nor do I discuss my death wish or my suicidal tendencies during the many years of BPD beginning in the last months of my adolescent years, in October of 1963, during which I experienced the death wish for the first time. Before the official diagnosis of manic- depression in 1980 the death wish was only associated with a few periods of intense D. I do not allude to this death wish except en passant and, then, only in the most cursory fashion.

2.6.4 I don’t think I will ever know enough about the early years in my life before the age of 18 anyway, to assess whether my short periods of behavioural disorientation were examples of: (a) a mild-mania, hypomania, (b) BPD, (c) an affective disorder of some kind like schizo-affective disorder or (d) even OCD. The very validity of the diagnosis of BPD in paediatrics and in adolescent studies is now in question becoming, some say, a simple catchall applied to explosive and aggressive children and other kinds of idiosyncratic behaviour. Others say that many behavioural abnormalities are finally being recognized as part of a single disorder.

2.6.5 Keeping sexual stimuli under control has always been a struggle for me to regulate so that thoughts of a sexual nature did not claim too great a share of my attention. With the years, the half century since 1960, the opportunities to go over the top and to let physical/sexual temptations assume too great an importance have increased. My mother took a liberal attitude to my sexual frustrations and this liberal attitude became part of my own attitude to the battles I had to face in this domain of life’s tests.

2.6.6 It was not until much later in life, though, that I began to see my aberrant childhood behaviours and my aberrations at puberty and then in adolescence as possibly having a link with my future mental illness. It was not until I was 19 in 1963 that any characteristics of BPD became quite clearly apparent, pathological and, in retrospect, could be called part of BPD and given that medical diagnosis. At the time, though, in 1963 no doctor would have given, or at least gave me, that diagnosis. Looking back to the age of 19 in October of 1963, I recall feeling a depression so deep it was like ‘a sickness unto death’ that I had never experienced. It was a sadness so pathological that it made me feel suicidal, like death not warmed over, as one could say colloquially. It does not surprise me that the third leading cause of death among people aged 15-24 is, in fact, BPD. I could very easily have been one of those dead souls especially back in the early 1960s when there was such little understanding of this illness.

2.6.7 One can read about this intensity of depression in many fields of literature and of mental health, although the work ‘depression’ does not seem to have entered the lexicon until about 1900. The desire to die at that time was overwhelming. But I did not talk about it to anyone except perhaps my mother, although I honestly can not now recall the extent of my openness with her. She knew I was depressed but neither she nor I really understood the dynamics or the intensity of the depression. I think it was assumed that I would grow out of it. And I did. By December 1963 the depression began to lift. I wrote my December exams at university and I continued with my first year studies in liberal arts.
-----------INSTALMENT #3 TO COME LATER--------

12-21-2008, 05:44 AM	#2 (permalink)
RonPrice Mr Ron Price Join Date: Jan 2008 Location: George Town Tasmania Posts: 11	My BPD Story: Installment #2 2. My Experience of Manic-Depression: Phase One--The First 37 Years 1943 To 1980 2.1 In the first 37 years of my life I had many episodes of various kinds of emotional imbalance or disorientation, themselves of varying lengths and intensities, ranging from a euphoric, impetuous, expansive or high mood to a depressed, grey, low energy or despondent mood. Indeed the range of mood in these 37 years was much more extreme, but the complete/extreme range was rarely experienced. In these years I learned various self-monitoring skills as well as some self-reinforcing tactics. Sometimes these symptoms affected my day-to-day life severely and negatively, sometimes positively and sometimes the affect was non-existent, insignificant and hardly noticeable. 2.2 After many experiences on the fringe of a normality that was my usual modus operandi or modus vivendi, as it is said in Latin , on the fringe of what I saw as my general everyday experience of life, an experience that is sometimes called the quotidian by writers, poets and novelists, I was diagnosed as a MD in May 1980. I was treated by a psychiatrist in Launceston Tasmania while in hospital. I had often been on the fringe of this disorder, as I say above, a borderline zone, a limen as some historians call it, a border territory, a zone between normality and various behavioural extremes and eccentricities from my birth in 1944 to 1980. But in 1980 the symptoms were extreme and required hospitalization. The treatment regime in 1980 was lithium carbonate, an antimanic medication for the treatment and prophylaxis of BPD. Lithium was the first really successful mood stabilizer used by doctors to treat MD, an illness that in the 1990s began to be called BPD. This medication cushioned the effects of extreme depression and hypomania and prevented their effects from striking at my life. The perils of BPD lie in what I did in the midst of hypomanic episodes to deal with: decreased need for sleep, decreased self-control, increased sexual desires, irritability, rage, risk-taking behaviours and, in my 1968 and 1979-80 episodes, schizo-affective or psychotic states; and in the midst of depression periods with moroseness, extreme melancholia and suicidal wishes. 2.3 My history to that point, to 1980, had been far from smooth and linear as my remarks above indicate. Those thirty-six years had often been bisected, polarised and traumatised. As I indicated above I have written a more detailed account of these years elsewhere but this outline, this brief sketch here, of particular episodes and the periods between episodes will suffice. My experience of these highly diverse emotional and psychological swings of mood in everyday experience away form the norm, from my norm, is only part of my story. But it is a crucial part. Everyone has their story for everyone experiences all sorts of abnormal eccentricities and health problems in life, some people of course more than others and some more traumatic and intense than others. 2.4 My account of the years from 1943 to 1980 follows. I try, in writing about and in summarizing these first 37 years of my life, not to overstate my case, nor to understate it, but give an account of those first 37 years which I refer to here in this general statement as phase one of my bi-polar life. In some ways the inclusion of the names of those doctors who treated me over the years in this first phase and in later phases would personalise this account, but names are not that important and to include them here in this narrative causes confidentiality problems and raises privacy issues for some readers and for people in my own past who might not want to be mentioned. This question of confidentiality and privacy is especially true at some internet sites where posts are rejected if names are included in any posting at the site concerned---and so I leave names out. Those whose names I could mention would not be troubled by their inclusion here, not now, not in 2008 after an extensive destigmatization of the disorder in recent years and after so much of my experience and so many of the people concerned are now, what you might call, ancient history. 2.5 1 I certainly appreciate the medical and clinical work of: (a) several of the doctors I went to in my childhood, adolescence and adulthood, (b) the psychiatrists who have treated me since June of 1968, nearly four decades ago and (c) many family members, friends, colleagues and associations, some known well and others hardly at all, who have helped me ride the waves when the disorder raised its head yet again along the way, the road of life. 2.6 Comments on My Ante-Natal, Neo-Natal, Childhood and Adolescence Life: 1943-1963 2.6.1 As I refer to above, I had some experience of what may well have been BPD in childhood as far back as infancy and at the toddler stage, all of the pre-school years, 0-5, of early childhood development. My mother nearly died in the first month after my birth, the implications of which it is not my intention to go into here. If there are any significant implications of this birth process and/or events in my ante-natal and neo- natal phases of my life, I do not examine here, however important they may be in the aetiology of this illness. Before the age of five there is evidence that my behaviour had some of the features of what is now called Attention-Deficit/Hyperactivity Disorder (ADHD), but it is difficult to disentangle those features from those of BPD. For the most part, though, I did not manifest BPD symptoms like: elated mood, grandiose behaviours, decreased need for sleep, racing thoughts or hyper-sexuality. Children are developmentally incapable of many manifestations of BPD described in adults; for example, children do not "max" out credit cards or have four marriages, pre-puberal and early adolescent age equivalents of adult mania behaviours. Still, as David Healy emphasizes in his book Mania: A Short History of BPD, some doctors are now associating BPD as beginning in utero. Perhaps in a later edition of this essay I will attempt a more detailed outline of what I recall from these years of early childhood, but my recollections are minimal and it is difficult, if not impossible, to excavate my memories from those years at this late stage of my life. It is not my intention to comment further on these early years except for the occasional passing reference when it seems appropriate. 2.6.2 Through middle and late childhood, say, the age of 6 to 12(1950-1956) into the puberty cusp of 12/13 in 1956/7, I did exhibit personality features, behaviours or symptoms that had features of BPD, at least to a limited degree, or so it could be argued if not proved: (a) a lack of control of my emotions, impetuosity, lack of emotional restraint, hyper-sexuality and (b) a far too intense activity threshold what is now called hyperactivity, mild mania or hypomania. It should be emphasized in this context, though, that mania is now considered by many in popular culture as a pleasantly grandiose, somewhat overactive feeling and behaviour orientation, but is not considered as evidence of a disorder, of insanity or of a maniacal posture. I recall at the age of 12/13, at the onset of puberty, exhibiting inappropriate or precocious sexual behaviour, although the particular manifestations only involved one episode which constituted groping and an attempt to kiss a girl who did not want to be kissed. Adolescent BPD or adolescence presented me with an accentuation of puberty and teen-turbulence caused by hormonal shifts. Society value shifts in the 1960s accentuated my tensions and behavioural problems more, or so it seems to me, as I look back from the perspective of half a century. My mother’s understanding, commitment, perseverance and patience even though she did not know that I even had BPD is now in my memory bank and in my greater appreciation for my mother than ever before. 2.6.3 Although symptoms of BPD that I exhibited in childhood and adolescence are largely not described here, I could go back to my birth and, indeed, to conception itself and my in utero life as I intimated above, for possible origins and manifestations of BPD. The relationship with my mother, my sexual proclivities, my OCD tendencies could all be described, could be gone into, in more detail. I have also written about this subject briefly in my memoirs. I do not attempt in this now quite lengthy account to describe this period of my life in more detail, nor do I discuss my death wish or my suicidal tendencies during the many years of BPD beginning in the last months of my adolescent years, in October of 1963, during which I experienced the death wish for the first time. Before the official diagnosis of manic- depression in 1980 the death wish was only associated with a few periods of intense D. I do not allude to this death wish except en passant and, then, only in the most cursory fashion. 2.6.4 I don’t think I will ever know enough about the early years in my life before the age of 18 anyway, to assess whether my short periods of behavioural disorientation were examples of: (a) a mild-mania, hypomania, (b) BPD, (c) an affective disorder of some kind like schizo-affective disorder or (d) even OCD. The very validity of the diagnosis of BPD in paediatrics and in adolescent studies is now in question becoming, some say, a simple catchall applied to explosive and aggressive children and other kinds of idiosyncratic behaviour. Others say that many behavioural abnormalities are finally being recognized as part of a single disorder. 2.6.5 Keeping sexual stimuli under control has always been a struggle for me to regulate so that thoughts of a sexual nature did not claim too great a share of my attention. With the years, the half century since 1960, the opportunities to go over the top and to let physical/sexual temptations assume too great an importance have increased. My mother took a liberal attitude to my sexual frustrations and this liberal attitude became part of my own attitude to the battles I had to face in this domain of life’s tests. 2.6.6 It was not until much later in life, though, that I began to see my aberrant childhood behaviours and my aberrations at puberty and then in adolescence as possibly having a link with my future mental illness. It was not until I was 19 in 1963 that any characteristics of BPD became quite clearly apparent, pathological and, in retrospect, could be called part of BPD and given that medical diagnosis. At the time, though, in 1963 no doctor would have given, or at least gave me, that diagnosis. Looking back to the age of 19 in October of 1963, I recall feeling a depression so deep it was like ‘a sickness unto death’ that I had never experienced. It was a sadness so pathological that it made me feel suicidal, like death not warmed over, as one could say colloquially. It does not surprise me that the third leading cause of death among people aged 15-24 is, in fact, BPD. I could very easily have been one of those dead souls especially back in the early 1960s when there was such little understanding of this illness. 2.6.7 One can read about this intensity of depression in many fields of literature and of mental health, although the work ‘depression’ does not seem to have entered the lexicon until about 1900. The desire to die at that time was overwhelming. But I did not talk about it to anyone except perhaps my mother, although I honestly can not now recall the extent of my openness with her. She knew I was depressed but neither she nor I really understood the dynamics or the intensity of the depression. I think it was assumed that I would grow out of it. And I did. By December 1963 the depression began to lift. I wrote my December exams at university and I continued with my first year studies in liberal arts. -----------INSTALMENT #3 TO COME LATER-------- __________________ married for 42 years, a teacher for 35 and a Baha'i for 50.