(AP Photo/Bill Robles, Pool)
Shawn Maxam talks about James Holmes and the different types of mania a person with bipolar disorder can experience.
Dr. Victor Reus, a professor of psychiatry at the University of California, San Francisco, said dysphoric mania is not uncommon in patients with bipolar disorder, a vast majority of whom never turn to violence.
To be clear. I have experienced dysphoric mania several times during the course of my life. I just had an near episode of psychosis last week. Today the New York Times published a piece that profiled suspected Aurora, Colorado shooter James Holmes. The article discusses James Holmes’ mental health struggles and the possibility that he was experiencing a mixed-mood which is a layman’s term for dysphoric mania.
But what the hell is dysphoric mania anyway? It’s usually when a person has the symptoms of mania and depression at the same time. It is the very highs and extreme lows occurring in the mind simultaneously. I have had this experience and I can’t articulate how psychologically exhausting it feels.
A HealthyPlace has an apt description:
Dysphoric mania (a combination of mania and agitated depression that is also known as mixed mania) is the opposite of euphoric mania. A person with this mood swing is agitated, uncomfortable, irritated, depressed, pessimistic and filled with negative energy. They don’t sleep well, if at all, and ultimately their behaviors are destructive and sometimes life threatening. Dysphoric mania is especially dangerous due to driving, fighting and other self-destructive behavior. Dysphoric mania can be mild to moderate (hypomania) or full blown. I have heard it described as, “It feels like I’m coming out of my skin. My body and mind are in a civil war.”
Does this supposed diagnosis or assessment of James Holmes’s mental state explain why he did what he is accused of? No it doesn’t because the vast majority of people who have had this type of mania have never committed a violent crime. I have had several episodes of mixed mania and I have never attacked anyone. Have I had delusional and dangerous thoughts? Yes I have. But thoughts are not behaviors or actions. Until we stop condemning people for their thoughts then they will fail to seek treatment for their mental illness like I did. This is important especially for men who are taught to believe that masculinity, violence and emotional repression are synonymous with each other. They are not.
The tragedy that happened in Aurora is devastating and nothing can replace the lives lost that day. Yet we can learn from this. Five years ago when I was first diagnosed with a mental illness I never thought I would see mainstream media outlets discussing not only bipolar disorder but the spectrum of symptoms the disease has. Please read the Times article here.
Please share this with friends, enemies and temporary allies alike.
Thanks for reading, sharing and commenting!
R.I.P. SKH
About S. Maxam
Psychiatry, like all branches of medicine, loves to spit disorders up into individual syndromes according to their stage of advancement, with a drug for each stage. Looking at Holmes overall life it sounds to me like simply a stage of advancing paranoid schizophrenia. “Keep away from me” he says. He’s is becoming terrified that he is going to ‘lose his mind’, ie go beserk and kill someone or a lot of people. Give him an antipsychotic and he’d gain a huge amount of weight, develop diabetes 2, become a manic depressive instead and shoot himself. A much more satisfactory outcome for society but not much chop for him.
Psychiatric diagnosis is the most hit and miss pseudoscience on Earth. I look at a persons metabolism first. What looks like hyperthyroidism by his slim frame, his eyes and enlarged thyroid I’d reckon that he wouldn’t take an antipsychotic as he knew how toxic they are. He’d reckon Fenton was trying to poison him. Lots of abuse, no REAL help whatsoever, and the outcome becomes totally inevitable. So why the Hell blame him? He was manufactured by stupidity, avarice, inequality, Milton bloody Freidman, Richard Dawkins, Freud, Billy Graham and everyone else. Phew!!!
Maybe the Uni is trying to fit Fenton up as the scapegoat, after all she was his shrink so she’s an obvious target. What if Holmes was subject to ever worsening ridicule and bullying by peers AND tutors as he became more socially dysfunctional (cognitively impaired). He was in a very dog eat dog environment. Of course none would ever admit it He told a stranger he got into LSD. what if he had a really bad freak out in company and got ridiculed. ‘The great GURU having a hard time is he.” “Oh how bloody dreadful.” Sarcasm sounds so much more threatening when extremely paranoid. Tall poppy syndrome.
Happened to me once. Took months to get over it. Felt the whole town was laughing at me. But I never saw the bloke who put the boot in again. What if Holmes’ PhD peers were tripping with him at the time and THEY put the boot in. They were COMPETING with each other for the best jobs, labs. Dog eat dog. Intensely jealous of his academic achievement up to that point.
What I want to know was what he was eating and drinking. Combine Coca Cola with the big doses of paracetamol he was taking causing liver damage and you’ve got a lotta moodswing. Swig after swig after swig. Blood sugar high equals manic high. Come the crash, panic attacks, terror of impending death, going berserk etc.followed by suicidal depression at the inevitable prospect of going completely insane, which of course he did go, compliments of psychiatry. The worse the liver pathology the greater the Coke craving and the shorter the cycle.
I forgot to mention that Holmes last talk was on dopamine precursors which is way off topic with his previous stuff. As schizophrenia is, according to dogma, an excess of dopamine production in the brain and an excess of receptors on neurons in the limbic area of the brain, it would seem to indicate that HE thought that he was schizophrenic back then. Clozapine was supposedly designed as an antagonist or blocker of these receptors, but ended up agonising (stimulating) serotonin, antagonising noradrenalin, adrenalin, dopamine, acetylecholine and histamine. Not bad eh. Six instead of one. Still that’s close? Great range of side effects too. Just the shot for an extreme masochist. BLOKES can start to lactate on antipsychotics. Just the shot for a bloke with a sexual identity problem, milk dribbling out of his nipples in a public dressing room. Body temperature regulation affected, pH, water, electolyte affected. The list goes on and on.
My blog.
http://www.tumblr.com/blog/noduleata
One problem with psychiatric diagnosis is that it’s all descriptive of symptoms. By that I mean, it’s as if instead of a doctor saying “you have a torn meniscus” he said “you have a painful knee.” Dysphoric mania simply describes an emotional state of being depressed and agitated at the same time.
My sister has a mental illness and for a number of years, every time she was hospitalized, she saw new doctors and got a new set of diagnoses. Over the years we were told she had major depression, psychotic depression, rapid cycling bipolar disorder, obsessive-compulsive disorder, borderline personality disorder, schizoid personality disorder, psychoaffective disorder, schizophrenia. In the end the label doesn’t really matter, she’s delusional and depressed and she needs the right combination of meds to stay functional.
I’m not an expert but it sounds to me like James Holmes is probably schizophrenic although his symptoms may fit the criteria for a number of conditions in the DSM.
I’ve expanded this section of the above on Coke. For full details on schizophrenia the Tumblr link.
What I want to know was what Holmes was eating and drinking. Combine Coca Cola with the big doses of paracetamol he was taking causing liver damage and you’ve got a lotta moodswing. Swig after swig after swig. Blood sugar very high equals manic high. Come the crash, panic attacks, terror of impending death, going berserk etc.followed by suicidal depression at the inevitable prospect of going completely insane, which of course he did go, compliments of psychiatry. The worse the liver pathology the greater the Coke craving and the shorter the cycle.
Looking at my stuff on the blood sugar swing (Tumblr link), the peak is euphoric (manic?) and the trough is associated with tiredness and depression, but with very poor liver storage of glycogen there is the release of noradrenalin and panic attack accompanying the depression. Dysphoric mania? Fast cycling schizophrenia, with BIG highs (mania) and big lows (depression with panic). Coca Cola contains a lot of sugar, caffeine and threobromine, a caffeine like substance and is thus extremely addictive as well as the combination causing a very fast rise in blood sugar to a high peak followed by a rapid fall to a deep low (reactive hypoglycemia). Single sugars (monosaccharides) enter the blood stream faster than polysaccharides (sucrose) which first have to be split by enzymes in the duodenum. However with Coke this limiting factor is bypassed. To hydrolyze the double sugar sucrose to single sugars fructose:glucose which are absorbed more rapidly into the bloodstream requires acid and heat. Coke contains a lot of phosphoric acid and must be boiled in the cooking process. The PERFECT combination for huge swings in blood sugar. Coke, a deadly poison. The juice of schizophrenia.
Dysphoric mania. indeed. We are ALL bipolar. For the complete picture. Might have to copy it into a word processor so that it turn blue and is thus active.
http://www.tumblr.com/blog/noduleata
PROBLEMS OF DIAGNOSES.
It must be apparent to anyone reading my stuff that I use a person’s metabolism and bodyweight relative to their height to determine a diagnose of their psychiatric profile. Not too many psychiatrist would agree with this making, a diagnosis depending on how a patient presents on their first contact i.e. very agitated or depressed. Yet looking at psychiatrist’s patient’s profiles metabolism doesn’t even get a mention. Many years ago, I read a book called ‘Uppers and Downers’ which defined psychotropic drugs as such. Essentially what it said that uppers such as speed made a person with a low metabolic rate feel and function better, doing say an exam, than someone with a high metabolic rate who would simply become confused. Alternatively, someone with a high metabolic rate, especially if he or she was very reactive and agitated, taking a metabolic depressant, such as an antipsychotic would calm down and feel much better initially.
Many years ago I read the book written by the discoverer of Lithium in which he claimed that a female patient brought into a New York psychiatric hospital had been completely misdiagnosed. She had been diagnosed on entry as a paranoid schizophrenic. In an extremely agitated aggressive state on arrival she had threatened to kill everyone in the hospital as well as half of New York if she wasn’t IMMEDIATELY released. Yet when the author saw he she was in a conciliatory depressed state, therefore he reckoned she has been misdiagnosed and was, in fact, a bipolar which suited the author as Lithium was used to treat bipolar.
What he failed to see was that when it became patently obvious to this woman that her threats did not gain her an immediate release but guaranteed her a prolonged stay instead, as she was considered a threat to the public, i.e. that the depression was in relation to the aggression. In objectifying the patient as possessing a ‘psychosis’ there is a failure to connect one state with its opposite. Or take the ‘bipolar’ individual who has a flash of inspiration that going out on a shopping spree and buying everyone he knows an expensive present will be greeted with such affection for him it will open up all manner of employment or business opportunities, well heeled sexual partners and so on. Thus the cost of the spree will be repaid many times over.
But when all of the presents have been rejected as it is obvious that they come with huge string attached, and the bill comes in as impossible to pay, this individual sinks into a deep depression. Not only is he way into debt, he has alienated himself even further, especially if he has become abusive toward those who more vehemently rejected his ‘bribes’.
On the flip side a ‘schizophrenic’ woman wanting out with a relationship with a man who adores her, and is trying to provoke him into ending the relationship by being extremely abusive and cruel. She doesn’t believe that a man is capable of love and that she is just his possession, like a cow. She wants him to end it so if he DOES commit suicide it’ll be no fault of hers. Instead he is so dreadfully hurt that he breaks down and weeps, possibly talks of suicide if she leaves him. (Crocodile tears and emotional blackmail) Suddenly, frightened of her own aggression and callousness, and fearful that if he does suicide he might take her with him, she becomes very conciliatory and precocious. Seizing on this sudden openness he then rattles off a litany of her sins, she doesn’t do any thing around the house et, thinking she will take all of this criticism on board, mend her ways and they’ll live happily ever after. Suddenly her face contorts with rage and she yells at him, ‘You patronising bastard’, He breaks down again ad infinitum.
In his mind she has to be psychotic as he wants excuse her behaviour and to believe that she actually does love him as evidenced by her behaviour whilst she is being conciliatory, and because she become suddenly abusive WITHOUT ANY PROVOCATION WHATSOEVER. He can’t see that he is being very self righteous and that she takes this as calling her immoral and very selfish. He does everything around the house to show her how much he loves her. She sees this as just emotional blackmail as it makes it more difficult for her to walk out on him and that’s why he does it. That makes him ten times more immoral and selfish.
This situation might escalate to the point where she becomes so threatening that he has her admitted to a psychiatric hospital, believing that she will eventually see that this is for her own good and as a way of holding on to her (trapping her). Little does he realise just what they are in store for. There is almost no understanding of each other in a relationship like this and no understanding of themselves. Both sides totally misinterpret the motivation of the other. Philosophically they might be on opposite ends of the spectrum. He says spare the rod and spoil the child and she says use the rod and spoil the child. If she openly criticises him for hitting their child who’s behaviour is becoming increasingly disturbed, he blames her for this behaviour because she undermines his authority. She blames him for being repressive. He blames union power for undermining the economy she blames greedy capitalists, this argument intensifying as their own financial circumstances deteriorate. Different religions perhaps as well.
The psychiatrist is oblivious to all of these social dynamics as he doesn’t leave his ‘surgery’ to get any understanding of her family life by actually going to visit the family home. Dangerous place out there, disgruntled patients of his lurking behind every power pole with shotguns. He just talks to the patient on entry into the hospital long enough to make a diagnosis determined on how she or he presents at the time, doesn’t take into account the events just prior to her admission, prescribes the appropriate poison and the dose and that’s it. He’s got his own problems at home after all.
Gp’s seem to be prescribing mood poisons willy nilly with almost no understanding of the patient or the pill. Try this and see how it goes. If not we’ll try something else. Lab rats get more objective treatment than this, but then I suppose they deserve it!! ‘No greater love hath a rat than it lay down it’s entrails for it’s friends’. A woman friend of mine told me that her sister, who was suffering pretty severe depression had been put onto Largactil by a local GP. I was blown away by this as I know her sister and knew that she was overweight before going on the drug, showed all of the characteristics (not SYMPTOMS) of manic depression (bipolar), not much manic but lots of depression, and a low metabolic rate. Largactil, as an antipsychotic, is a metabolic depressant, i.e. the very OPPOSITE to what she should have been prescribed of there was an argument for medication which of course there is not. So she just put on more weight and got more depressed . I told her sister about Laractil and she passed on what I said, she went off the drug and perced up considerably but still depressed.
As I understand Largactil, coming out in 1950, the very first antipsychotic, has run out of copyright protection and is now cheap, hence it increasingly hit and miss prescribing by gp’s with about as much understanding of biochemistry as a giraffe. Her problem is totally unjustified GUILT which, like all guilt, has a religious or quasi religious content to it. A person who is overweight has a low level of self esteem, seen as glutinous, lethargic seen as lazy, constipated seen as full of sh— all of which reinforce the feelings of guilt over feeling responsible for past negative events. So how the bloody hell does a drug which causes more weight gain, more lethargy and, because it is anticholinergic, worsens the constipation, help her in any way. She has to be totally and utterly convinced that any concept of SIN is utterly and totally absurd.
My mother has been diagnosed as bipolar. She experiences dysphoric mania quite often. She beat the crap out of me and my siblings throughout our childhood and nearly killed at least two of my siblings. We’ve been hospitalized and stitched up for the injuries she inflicted during her bouts of violent rage. She would attack us unpredictably for no apparent reason. One minute she’s fine, the next minute she’s slamming your head into the wall over and over again or carrying her infant out to the pool to drown him (she announced these intentions herself while carrying my infant brother out to the pool). She has had her children taken away and placed in foster care 4 times (she has 10 kids, so this happened over 2 decades).
As a victim of the violence inflicted by an unmedicated bipolar parent I am sick to death of people in the media telling me how the mentally ill aren’t violent.