Anybody Experiencing Memory Loss?

This is a question for folks who have a mood disorder including bipolar illness. For the last several years I have been experiencing mild to moderate memory issues. I have chalked it up to strong psyche meds and basically have not worried about it much. What is the most difficult is that sometimes I forget where I put things. It seems worse for short-term items than long-term items and so far is manageable. It seems worse in the age of covid-19 than before March 2020.

I am wondering if memory issues typically accompany mood disorders including bipolar illness? Not big things like forgetting family names and places but where I put the phone or the keys. So far, I have chalked this up to too much brain function due to the bipolar and too much time at home due to covid-19.

Has anyone with mood issues noticed short-term memory impacts? Thanks in advance for sharing.

Giving Thanks…

I am not yet in the habit of giving thanks every day for my blessings. So here goes a try…..

I have a beautiful (inside and out) daughter. She is healthy, funny, smart, caring and resilient. I have a loving husband and understanding in-laws. He is non-judgmental and generally puts up with my anxiety that surfaces almost every day on some level. My in-laws also are not judgmental. I have a very good relationship with my Mom who is 83 though this has not always been the case. Now, she and I can talk pretty openly about events of the day including things that are hard emotionally or difficult because of my diagnosis. I have a solid rapport with my older sister who lives up North but continues to be a support for me every time I ask which is fairly often. I have a therapist I can trust and a doctor/ psycho-pharmacologist who I can talk to about raising or lowering meds depending on what’s going on with me. I have seen my therapist and my meds doctor since 2008 — there is little they don’t know about me and that is a blessing. I take meds that are largely therapeutic for me. I recently had a scare (this summer) with breast cancer but thankfully the mammogram, ultrasound and MRI were all benign / negative. I have strong bonds with my best friend from 1985 forward. She and I can talk to each other about everything and anything pretty much.

In writing this, I am noting that most of the things I am thankful for are relationships and health. Does any one else see a pattern in what you are thankful for?

My Sojourn through Bipolar Illness – Cohort Model Proposed

Adequate resources for mental health in my book would include funding allocated to the development of a Cohort Model to assist those experiencing a debilitating health event to gradually reenter society.  In my opinion, it would be less expensive for the State (at the State and Federal levels) to offer a Graduated Reentry Program than it is to provide disability insurance payments for all those who are unable to work a full-time job due to some sort of behavioral health or developmental disability.  This might include a mood disorder and/or an addiction issue.  In my opinion, people with behavioral health diagnoses ought to be able to work a 10 to 20 to 25 to 30 hour week and bring home enough pay so as to be a valid contributor to a family’s income.    Today this is generally not the case.  There are few part-time jobs available in the market today and the ones that are available do not provide a living wage or health insurance or occur during times of the day that are generally associated with sleep or family time. Also, disability payments in the US are few and far between and very difficult to qualify for.

The idea of a “Graduated Reentry Program” is that behavioral health consumers would progress from a 10-hour work week to a 20-hour work week to a 30-hour work week to a 40-hour work week depending on their health.  Participants would still be eligible for health insurance during this time provided they were engaged in all prescribed wellness activities.  When the hourly work week is at a reduced level, participants are expected to attend any given number of behavioral support meetings with their doctors or their therapists or in their community in order to prevent a repeat occurrence.  The reduced work week would be coupled with a regime of self-stewardship that might include mood support and recovery meetings, meetings with a therapist and/or meetings with a psycho-pharmacologist.  This time might also be time spent developing an exercise regime to reduce stress and limit unwanted thoughts.

The idea of a “Graduated Reentry Program” assumes:  1) behavioral health patients have serious work to do that is not part of a paying job typically and 2) it should be cheaper in the long-run for the State to sponsor a partial work week for behavioral health patients until such a time that they are ready to work a 20, or 30 or 40 hour week.  3) This type of program would allow people who manage a serious behavioral health disability or addiction to still earn a “living wage” even if they were working 25 or 30 hours of work per week.  4) This ability to work at a reduced level in order to dedicate time to managing aspects of the prescribed illness through support groups and support group programs, exercise and diet regimes, talk therapy programs and med management programs is hugely different than how that juggling act occurs today. 

Many people with mental health conditions, including myself, may not be able to work a full-time work schedule.  These people should have the sponsorship in society of working a 10 or 20 or 30 hour a week job as they are able.  Many people with mental health conditions seek financial assistance through Social Security Disability Insurance payments.  While this is often considered a critical financial development for some people with a mental health diagnosis, consider if more emphasis was additionally provided on programming to reentry society and the economy. 

Again, it is my belief that such a Graduated Reentry Program would pay for itself by increasing the productivity of workers who may move from a disability status to a 10 or 20 or 30 or 40 hour a week job status.  If it does not pay for itself, I believe the cost savings from the Paranoia Hotline / Paranormal Institute would pay for this Graduated Reentry Program. (See prior post regarding Paranoia Hotline).

Through the on-going development of this text, I am becoming more and more clear to myself and in myself as to my current emotional challenges.  While I am clear that a high paying job in project management is not a fit, I am not completely clear what type of job might be a fit for me.   While just a few years ago I was a keen advocate for a Graduated Reentry into society of working first 10 hours, then 20 hours then 30 hours a week, I currently am of the mindset that applying for Disability Insurance may be an important option for many people particularly in the absence of the Cohort Model in today’s America. If I am to continue to place a premium on our daughter’s development and on my own health, this may mean not working a job in the traditional sense.  This leaves the door wide open as to the possibility of making writing like the writing of this text to become “my work.”

My Sojourn through Bipolar Illness – Paranoia Hotline?

Is There an Impetus for Founding a Paranoia Hotline and/or Paranormal Institute?

*** Discussion includes talk of paranoia***

Another idea I have had along the lines of paranoia is in consideration of whether or not any aspects of paranoia are based on “the truth.”  What if my six-year-old child within has access to paranormal thoughts or heightened intuition like a blind person may have exceptional musical abilities?   What if other people with mood disorders or developmental disabilities have access to paranormal thoughts or heightened intuition?  What if there exist bits of truth, albeit highly fractured, that are hidden in paranoia?  Even if there is no paranormal thought pattern for behavioral health or developmental disabilities patients, what if we were able to develop a “Paranoia Hotline”?  People who have paranoid or paranormal (if they exist) thoughts would have a place to discharge and release or let go of these thoughts.

As an example, consider if 25 people call in with the same fear (this is a fictive example) that the water supply in Augusta is not safe.  The sheer number of people with the same paranoid thoughts may be enough to signal authorities that there is in fact some tangible threat to Augusta’s water that needs to be addressed. 

In this example, consider a man living in Minneapolis-Saint Paul who is telling his therapist that he envisions a strange color in the water in some US city.  Consider that three people in Boston call in with the fear that there is a strange odor coming from the Augusta water supply.  Consider two people in Newark call in reporting that Augusta is unsafe from terrorists.   Consider that one person has indicated a criminal who lives on East Woodland Road and is targeting the Augusta water supply.  Alone any one of these thoughts could be considered paranoia.  But putting these stories together possibly, possibly may mean there is an underlying element of “truth” to the paranoid perceptions.  Perhaps the threat to the Augusta water supply is clear in the aggregate of these reported thoughts in a way that would not be the case for any individual report of paranoia. If these paranoid perceptions have at their root a real concern or a real threat, perhaps that threat can be identified before harm sets in.  If this were to be the case that aggregate accounts of paranoia or paranormal thought allow crime prevention, a Paranormal Institute would more than pay for itself.    

This should be a “win-win” for everybody.  The behaviorally or developmentally ill have a place or a person specifically designed to listen to the dynamics of paranoid thoughts, review them or at a minimum unload them.  This creates a great sense of relief for the patient just in the downloading of the paranoid thought.  First Responders could create a database of all the reported paranoid thoughts and track their various data attributes.  If there were data trends in the data attributes, it may be that the information reported could prove helpful in preventing some sort of security threat or breach to society.   First Responders ideally might get more accurate and earlier aggregate data on various threats. 

Such a Paranormal Institute if found to be warranted may more than pay for itself in a matter of months or years.  The extra funding that may develop as part of this Institute could be designated to making the Cohort Model and Graduated Reentry Model discussed in an upcoming post a reality.  

Even if the data shows that there are no “paranormal” aspects to paranoia, such an institute may still be of use. The discharge and letting go of paranoid thoughts to a concerned party at a Paranoia Hotline may allow the patient relief from a life-threatening episode.  Even if my hopes of uncovering paranormal data trends from paranoia do not bear out, there still may be great value in a Paranoia Hotline. The Paranoia Hotline would ease the minds of the person reporting his or her paranoia.  Meanwhile First Responders may be provided extra time to assess and address what could be the precursor to a society-threatening event.   

All in all, I am not in a position to know if paranormal thoughts are a portion of what makes up paranoia.  I alone am not capable of making that assessment.  But, First Responders with a database of reported paranoia could readily research the data and make that determination.  Whether the data bears out for a Paranormal Institute or a Paranoia Hotline, either way the patient and society win.

Autism and Anomalous Perception

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0177804

“Adults with autism spectrum conditions experience increased levels of anomalous perception” (link cited above – authors below).

For many years I have been interested in anomalous perception which some medical dictionaries define as extrasensory perception. From what I understand there is no designation for extrasensory perception in the DSM-5.

A couple of years ago my therapist asked me if I thought I was highly functioning with some aspects of Aspergers Syndrome now considered as on-the-spectrum or ASC (autism spectrum conditions). I was not sure how to respond but I do wonder about being on the spectrum and having anomalous perceptions. I tend to call these experiences paranormal experiences. Although my therapist and I have talked about it, I have not heard from my psychiatrist about it nor have I asked. My official diagnosis is bipolar disorder with mixed states highs and lows.

The article also talks about stress as accompanying the anomalous perception which I am wondering might also help to explain in part my high anxiety.

In general, I think there is not a lot of support among providers and caregivers for the existence of extra sensory perceptions since there is difficulty in determining what is a paranoid thought versus what is anomalous perception. And perhaps rightfully so.

Does anybody else have questions about highly functioning autism and anomalous perception? Can anomalous perception surface with bipolar disorder? Or does it require an ASC diagnosis? Thanks in advance for sharing your thoughts.

*****

Question for You?

** This post deals with paranoid thoughts and experiencing them**

We have all been told that paranoid thoughts do not have any value whatsoever. They are thoughts not grounded in reality and therefore something to forget or ignore or get past as well as we are able.

I have been prone to paranoid thoughts off and on since the onset of my bipolar illness in 1984 / 1985. Most times this paranoid thought is confusing, upsetting and painful. However, I am wondering whether to write a blog post that talks about the potential that there may be a small or very small kernel of truth in paranoid thought however hidden or misshapen particularly when paranoid thoughts from several people about the same topic are considered at one time.

For example consider that someone is paranoid about the water quality in the town where he lives and reports that to police. In that same week, police get reports from 5 different people that there has been a suspicious character near the water works for that town and 2 to 3 neighboring towns. These reports each taken by themselves these might be examples of paranoid thought but taken together might hint that there is a potential risk with the water supply in a nearby town.

The key is that there would need to be some independent entity that is recording the paranoid thoughts from individuals and looking for trends in them, then verifying whether the trends are grounded in reality or not.

Does this type of suggestion of trending paranoid thoughts interest you or cause you anxiety? I would like to write more about this potential hidden kernel of truth in paranoid thought but I don’t want to make you uncomfortable in any way. I also do not wish to glorify paranoid thoughts in any way since most of what paranoid thought is is confusing and upsetting. I am looking for your feedback as to whether this type of discussion would be helpful to you or not?

My mistake

Earlier today I published a post that quoted the National Alliance on Mental Illness regarding suicide rates. I failed to put a warning about suicide content in that posting. Please consider this a warning about following that post – that it contains mention of suicide that may be a trigger for some people. I was trying to talk about limited funding for behavioral health.

My Sojourn through Bipolar Illness – Intermixing with Police and First Responders

I am of the mindset that police and college campus police could do well with more training as to what constitutes a paranoid episode that is largely safe and what constitutes a paranoid episode that is largely unsafe.  I feel that the police serve in a hugely defining role as to whether someone experiencing an episode of bipolar illness should go the hospital or be incarcerated.  There is no such distinction for any other type of intervention that the police are called upon to mediate.  It takes a great amount of training about paranoia and how it operates particularly in the minds of our youth.  If psychiatrists are largely unable to determine when paranoia is linked with violence or not after days or months or years of working with that person, think what a challenge it is for a police man or woman intervening with no case history on the patient while being charged with the safety of that patient and all bystanders.  It is a huge responsibility that falls on the police and college police. 

I have worked through NAMI (the National Alliance on Mental Health) in their In Our Own Voice Program to talk with these First Responders and provide more insight into the patient’s point of view when these incidents occur.  I found the reception at that event quite welcoming as if the police or campus police had never had a conversation with someone prone to paranoia when that person was outside of that paranoia event.

In any case, I find the work of police and campus police to be a gargantuan task.  It almost requires the intervening police officer to be all-knowing and to be able to size up the situation in a matter of minutes as to whether the person before them is paranoid and a danger to others or paranoid, a danger to themselves and needing hospitalization.  I feel that additional training in differentiating these behavioral health outcomes should be mandatory both for crisis interventionists as well as medical and clinical professionals.  As a person who has experienced mania and being a danger to self and perhaps others, I readily do not see a clear line for police to follow from which to determine how best to intervene.  If I am unclear on that intervention after 30 plus years of managing (or trying to) the illness, I would imagine most police and campus police feel that they are overwhelmed and alone as First Responders in assessing the case of a behavioral health incident.

I feel for the police and the campus police and their courage in this line of work and believe that greater training like that of NAMI’s In Our Own Voice Program is extremely important.  I had one first responder come up to me at that In Our Own Voice presentation and thank me.  The officer had never talked to someone with a tendency toward paranoia when they were not in a paranoid state.  All he had ever seen was the patient at the height of a paranoid event – he must have assumed through no fault of his own that that state of paranoia was the norm for that person rather than a state that comes and goes and can be managed for the most part through medications and talk therapy.   

The First Responders should have some sort of script that allows them to assess if the danger is being directed internally toward the patient or if the danger is more generalized to people external to the person experiencing the breach of reality.  I do not claim to have the content to that script in full, but my current thoughts about how questions for this script might go is something like what follows.  This script below should be vetted by a team of first responders, therapists, doctors and other professionals and is only a “strawman” from the point of view of one patient.

 I am going to ask you a series of 20 questions.  I would like for you to respond to each question to the best of your ability. OK, are you ready?  First question: 

          1) What is your name?

2) Are you a student here?

3) Are you feeling OK?

4) What is the date today?

5) Are you feeling suicidal?                

6) Have you ever felt this way before? 

7) Do you have a mood disorder illness?   Have you ever been hospitalized for a mood disorder?

8) Are you hearing voices?

9) What are the voices saying?

10) Are the voices asking you or telling you to harm yourself?

11) Are the voices asking you or telling you to hurt anyone else?

12) Do you have a weapon?  Are you intending to use it? 

13) Where did you get it?  Have you had it on you for several days or just a few hours?

14) How long has it been since you took a shower?

15) How long has it been since you had a full meal?

16) Have you been using any mind-altering, recreational or prescription drugs?

17) If so, what are they?

18) Do you feel safer now that the paramedics are here and we are talking?

19) Is there someone in particular you would like to talk to? Your parent? Your friend? Your psychiatrist? Your therapist?

20) What do you need to feel more calm?    

If there had been such a script available for use by First Responders at the West Ferry airport back in 1985, perhaps my first episode would not have been so cataclysmic.  Perhaps I would not have been plagued by security concerns for several years after this first episode if that episode had been less threatening and less dramatic. 

My Sojourn through Bipolar Illness – Paranoid Thoughts and Depression

Just because I have been able to hold a good job (at times) and have married successfully and had a child in no way shape or form means I have been immune from paranoid thoughts, depressive thoughts, anxiety or mania.  My illness over the years includes acute paranoia that I have had to process or let go of and get past. 

My first episode at the West Ferry airport is a case in point.  In addition to that mania and paranoia I have believed that I could see some terrorists in the Himalayas who had two “broken arrows” pointed at the US specifically at Washington, DC.  I have felt that I could see the boot camp of these terrorists as well as know the path that got them to their hide-out and the code associated with both of the bombs at their disposal.  I have envisioned the recovery of these weapons from such a terrorist camp via a team of highly trained military personnel and their dogs. 

The day the Challenger exploded, I was in a complete state of paranoia.  I was on the train from Chicago back to my college campus and believed the conductor was signaling me to exit the train.  I got off in an unknown location and started hitch-hiking down icy back roads in the pitch black of night with snow and frozen ice all around.  At some point I ended up on Interstate 400 going North.  I believed I was conducting the cars in various colors in a symphony along the highway.  I must have been in the middle of the interstate when a trucker named Bill picked me up on the highway and took me to a nearby exit from the highway where by some turn of fate I ended up at the police station.  I remember that the Challenger had exploded and that I felt somehow responsible for this.  I kept repeating that “I have a dream….” like Martin Luther King but instead of stating it I was screaming it over and over as if it were more a nightmare that I had instead of a dream…  Thanks to the police, I ended up back at the hospital on campus.

In addition, I later came to believe that I was a master code-breaker for bombs and machines that had been constructed by the military.  I believed that I was able to isolate code line by line that had been altered by terrorists and to communicate those lines of code to the military so that the code could be disengaged.

In addition, I came to believe that HIV was becoming a food-borne illness in need of early intervention and that a nuclear meltdown had been grossly underestimated by the military establishment — that the whole electric grid was liable to go up in smoke within minutes considering the griddle like effect that the grid provides its ability to relay power between destinations within seconds. 

In the early months of the postpartum period, I believed that three men from Eastern Europe had immigrated to Canada in order to migrate from Canada to the US as Canadian citizens.  I believed that these three men were planning a “nuclear accident” somewhere in New Hampshire such that the entire watershed East of the Mississippi would be unpotable and contaminated with nuclear waste.

Almost all of my paranoid thoughts have involved feelings of unsafety.  Whether around the corner at a neighbor’s house or on the international nuclear war stage, I can get easily paranoid about human safety.    Could these issues of safety be tied to the fact that I was not safe as a six-year-old child?  Probably so – more work is needed.

This tendency toward thoughts of safety more than likely dates back to my first episode in the snow at the West Ferry airport.  When I allowed my fears about safety to be expressed, I was treated as a criminal and as someone who was unsafe.  If my fears had somehow been allowed to be conveyed to friends, family, an airport personnel or even a passer-by, perhaps the reaction to my fears might not have been so dramatic.  Even more compelling, if my fears of flying had been addressed in the airport with airport personnel in a way that they could understand, I may have been able to avoid what became years of preoccupation with fear and safety.  Instead of them seeing me as a threat to self and others, perhaps they would have been able to request I be moved directly to a hospital setting rather than being arrested and handcuffed and locked to the door of a police vehicle with flashing blue lights. 

My Sojourn through Bipolar Illness – Stigma

I have often felt that the stigma associated with bipolar illness is as big if not bigger (twice as big) as dealing with the illness itself.  Every time there is a school shooting or a gun incident or a drug cartel development that involves an unstable person with mood issues, all parties with a behavioral health diagnosis suffer.  The emphasis in society rarely is on developing preventive care for people with behavioral care diagnoses.  Admitting such people to jails appears to be more of the status quo in the years following the closing of many State-run facilities.  Undoubtedly, there has been a cost savings with the closing of hospitals across the United States but the flip side of this is that many people with behavioral health diagnoses end up in jail or homeless on the streets.  Too often people may encounter the fact that there are no beds available when they go to be evaluated for admission to a behavioral health facility.

While I am not an expert in addiction issues at all, I feel that the opiod epidemic of the last several years is evidence of the fact that our behavioral health and addiction facilities are lacking in funding and in expertise while the world is lacking in understanding and compassion.  The stigma associated with having an addiction or an addiction-based personality is a huge factor I believe in addressing this crisis.  What is evident now more than ever is that addiction issues (and behavioral health issues) do not discriminate based on race or socioeconomic stature or religion or any other factors.

I have encountered stigma in the workplace, during the job interview process, in the neighborhood, in the world of health insurance, and just about in every facet of society.  I have often heard of the comparison of behavioral health issues to diabetes.  Would you think less of a person who takes insulin daily? Probably not.  But would you think less of a person taking psychotropic drugs?   Today, the typical answer to this question is probably so.  Would you think less of a person who has exited the opiod epidemic and is actively addressing addiction tendencies?  Hopefully the answer is we are learning to be proud of that person for reaching out and for getting help with a problem that is real across all sectors of American society.

The stigma issue at least in behavioral health tends to feed on itself.  Because the stigma is high with regard to behavioral health diagnoses, I find it hard to share my diagnosis and my daily troubles with others.  This need for secrecy or keeping the diagnosis story a secret in turn creates undertones of distrust or lack of trust and/or continuing questions.  If I share my story with person x, will he or she keep that story confidential or not?  What will be the fallout if my diagnosis is shared in the neighborhood or in the workplace or at my daughter’s school?  These are serious questions regarding a very serious topic.

Mostly I have found that people outside my family circle are not at all aware of or supportive of mental illness concerns.  The education that they receive typically comes through the news where the typical story involves a young teen or twenty-something who is disturbed at home, who may have sought psychiatric care or may not have, and who decides to engage in some sort of heinous premeditated shooting rampage.  Unfortunately these stories of misunderstood teens and young people on a death rampage have become more of a norm in our society in the last ten to fifteen years than anyone would care to admit.

To me there are very clear steps that society should be taking to counter-act these potentially preventable heinous acts of violence. 

These include:

1) Background checks for the purchase of guns and other weapons such that people with a history of mental illness may not purchase or own a gun or weapon under any circumstances.  This includes background checks for all types of gun sales and gun ownership.

2) Some form of alert that can be provided by a mental health worker if a particular patient is in distress and appears to be a danger to himself and others, particularly to others.  Right now, most privacy laws do not allow for that disclosure given doctor-patient confidentiality laws.

3) A clearer understanding for Crisis Intervention workers and teams including training in mental health issues.  First Responders need to be armed with a greater understanding of when a crisis event is a dangerous event for others versus when a crisis event creates danger for only the patient and the patient’s life.

4) Funding and payment to Crisis Intervention workers for this training.

5) Funding and training to mental health workers to help distinguish patients who pose a threat to society as compared to patients who are experiencing a threat to themselves.    

6) Additional early intervention work for teens in inner city environments with behavioral health concerns to get them off the streets and out of association with gangs and gang behaviors with the end game being to treat these kids for psychiatric issues before they get a criminal record and are incarcerated. 

This requires that we look at the cost-benefit of treating at-risk teens for behavioral health concerns versus the current pattern of enabling criminal activity among teens by not providing the behavioral health care that they need until after they are in jails.  In my opinion, society needs to accept the cost of working with at-risk teens on behavioral health issues so as to avoid the huge cost of incarcerating a large and growing sub-population of mentally disturbed people with a history of criminal behavior in our inner cities and towns.    

If we are going to progress past the stigma of mental illness diagnoses, it may be necessary to give up some of our freedoms.  If we are going to differentiate between a mental health event that endangers the patient versus a mental health event that endangers community or society, we people with behavioral health diagnoses need to be willing to give up some of our freedom.  To me giving up freedom is agreeing to sign off on background checks for guns and other weapons as well as amending doctor-patient confidentiality laws if there is clear evidence or behavioral propensity of a danger involving the greater community.  Clearly if we are going to expect care-givers and first-responders to bear the responsibility of determining if the event scope is patient-only versus community-reaching, we will need to provide topnotch education to both mental healthcare providers and First Responders.  Both groups need to be well-versed in signs that distinguish when the patient is a threat to self but more importantly a threat to others.   Both care-givers and first-responders need to be armed with an understanding of how these two scenarios differ and how they are the same with the end goal being the care for human life – the life of a disturbed teen but also the lives of those in community with this teen.