I nibbled a bit of Microsoft, and a byte of Apple.
Interview with Steve Jobs and Bill Gates at D7 (2007)
Q: “…personally come in every day to save it…?
A: “…that’s my life’s work…”
While it is true that patients who experience hypomania as a side effect of Clonazepam may prove to have a form of bipolar disorder that has previously gone unrecognized, drug-induced hypomania is not invariably indicative of bipolar affective disorders.
It’s frustrating because suddenly I’m facing the woes I wrote about in college regarding labeling mental illness, and the impact of the use of labels, such as “creative” or “over-achiever”.
- I am hyperthymic, literally, “over spirited”.
- It’s not a diagnosis, because being “consistently happy” is not recognized as a mood disorder.
- I became hypomanic, but that wasn’t exhibiting hidden underlying bipolar or schizophrenic disorder.
- It’s not bipolar… it’s drug induced paradoxical side effects.
Label it or Leave it?
Some people would include in the Bipolar Disorder category a consistently elevated mood called hyperthymia. Being constantly upbeat and always enthusiastic is not unheard of, but it is not the norm in the general population. It is more common to experience a fairly steady, neither-too-high-nor-too-low mood characterized by some contentment, some discontentment, some happiness, and some sadness — usually associated with external events such as receiving good news, problems with personal relationships, etc.
Does a long-lasting, exuberant mood that causes no problem need to be placed on the spectrum of mood disorders? In a clinical sense, no. If it poses no threat to anyone’s health, it is not a concern for psychiatrists. Cataloging and understanding a mental state like this, however, may help us better understand the full spectrum of emotional states related to mood disorders and provide clues about what can go wrong when moods become extreme.
Some people always seem to be upbeat and energetic, trying new things and initiating new projects. This trait, which is sometimes called hyperthymia, is not unlike being on a “permanent high.” Some people argue that hyperthymia is a type of mood disorder that results in high activity and inflated sense of self-esteem — something like living with constant hypomania but with the crucial difference that it is not as clearly episodic. Instead, it seems to last and is without any associated depression.
While observations of many people indicate some of them have this mood trait, hyperthymic disorder is not recognized as a mood disorder by either of the two mainstream authorities, the American Psychiatric Association and the World Health Organization. It appears in neither of their diagnostic manuals, the DSM IV and the ICD-10.
On the surface, people with hyperthymia seem optimistic and full of energy. They radiate self-confidence and self-reliance; they seem to believe they can do whatever needs to be done. They thrive on new experiences that promise variety, intrigue, and novelty. Usually, they have a great many personal interests, as well as plans for the future. They also can be articulate and witty.
It might be most accurate to think of hyperthymia as a temperament or personality trait rather than as a marker of a mental disorder. Of course, if this trait causes problems, then it becomes a legitimate subject for psychological or psychiatric care.
In fact, criticism of mainstream psychiatry is often directed at its alleged predisposition to label people with problems that don’t exist. The inclusion of homosexuality in earlier editions of the DSM IV — an error since corrected — is a frequently cited example. The reality is if someone is not unhappy, suffering, or a threat to themselves or others, psychiatrists have no reason to intervene. They are busy enough treating people with serious mental problems. It is only when complaints or serious problems appear that the labels of the DSM IV are applied as part of the process for providing effective treatment. A hyperthymic personality can be satisfying, productive, and creative. But if for some individuals it is a manifestation of a part of a spectrum of mood disorders, it could be problematic. For example, some people later diagnosed with bipolar disorder first seek help with depression after they have experienced a set-back in their lives. A close look back over their lives may reveal that they have been hyperthymic. Rather than having easily recognizable mood swings, these people may have been experiencing years of constant emotional elevation and enthusiasm along with a long history of uncompleted endeavors.
Also, the lack of a healthy response to the full range of life experience might cause problems for some people who always seem to have elevated spirits. A full, healthy life for most people includes periods of elation and introspection, action and reflection. If only one pole of our emotional lives is present, we may miss the benefits of the counterbalancing half of our responses to events. Consequently, we may lack understanding and empathy in the way we interact with people and respond to events in our lives.
“I know, you’re bi-polar.”
“Old man, look at my life, I’m a lot like you were.”
Born to Be Happy, Through a Twist of Human Hard Wire
By RICHARD A. FRIEDMAN, M.D.
In the course of the last year, the woman lost her husband to cancer and then her job. But she did not come to my office as a patient; she sought advice about her teenage son who was having trouble dealing with his father’s death.
Despite crushing loss and stress, she was not at all depressed – sad, yes, but still upbeat. I found myself stunned by her resilience. What accounted for her ability to weather such sorrow with buoyant optimism? So I asked her directly.
“All my life,” she recalled recently, “I’ve been happy for no good reason. It’s just my nature, I guess.”
But it was more than that. She was a happy extrovert, full of energy and enthusiasm who was indefatigably sociable. And she could get by with five or six hours of sleep each night.
Like this woman, a journalist I know realized when she was a teenager that she was different from others. “It’s actually kind of embarrassing to be so cheerful and happy all the time,” she said. “When I was in high school I read the Robert Browning poem `My Last Duchess.’ In it, the narrator said he killed his wife, the duchess, because, `she had a heart – how shall I say, too soon made glad?’ And I thought, uh-oh, that’s me.”
These two women were lucky to be born with a joyous temperament, which in its most extreme forms is called hyperthymia. Cheerful despite life’s misfortunes, energetic and productive, they are often the envy of all who know them because they don’t even have to work at it.
In a sense, they are the psychiatric mirror image of people who suffer from a chronic, often lifelong, mild depression called dysthymia, which affects about 3 percent of American adults. Always down, dysthymics experience little pleasure and battle through life with a dreary pessimism. Despite whatever fortune comes their way, they remain glum.
But hyperthymia certainly doesn’t look like an illness; there appears to be no disadvantage to being a euphoric extrovert, except, perhaps, for inspiring an occasional homicidal impulse from jealous friends or peers. But little is actually known about people with hyperthymia for the simple reason that they don’t see psychiatrists complaining that they are happy.
I was talking with my momma this morning about orthomolecular medicine, and all the work she’s done to help people achieve better health over the years. Most often when I’m thinking about my momma in this regard, I think of how it is that she’s responsible for bringing life to families struggling to have children. What more beautiful work can there be as a humanitarian than to care for the quality of human life, and it’s propagation through it’s generations of families? Continue reading
Think You Got What It Takes?
Leadership, “Madness,” and Empathic Power : Mockingbird
What makes the great ones?
Ask almost anyone anywhere, and you’ll get the same response: some form of personal exertion, “determination” or “perseverance” or “vision”.
Ask almost anyone, and you’ll receive a response rooted in the individual’s uncompromising leadership–they’ll speak of the necessary qualities which brought him/her to helm in a time when he/she was most needed.
Others might go so far as to say that this kind of leadership sits within us all, but is only activated when one realizes it, believes in oneself, and confidently makes the strides towards achievement.
This mythology speaks for presidents as much as social activists or stadium rockers. It is the “I will” and not the “Can I?” that brings one beyond one’s constraints…
“It is no measure of health to be well adjusted to a profoundly sick society.”—J. Krishnamurti
In July 2011, I spent a total of nine days in the San Diego County Psychiatric Hospital. Being sane in an insane place is much harder than you might think, but then again maybe you don’t think I’m sane.*
I know how the caged bird sings, she sings with resonation found only on the super slick floors that only an insane asylum can afford where she sings “Crazy“.
“How do we know precisely what constitutes “normality” or mental illness? Conventional wisdom suggests that specially trained professionals have the ability to make reasonably accurate diagnoses. What is—or is not—“normal” may have much to do with the labels that are applied to people in particular settings.”
The Rosenhan Experiment
The Rosenhan experiment was a famous experiment into the validity of psychiatric diagnosis conducted by psychologist David Rosenhan in 1973. It was published in the journal Science under the title “On Being Sane in Insane Places.” Rosenhan DL (January 1973). The study is considered an important and influential criticism of psychiatric diagnosis. Lauren Slater later revisits the experiment and publishes her findings in Opening Skinner’s Box: Great Psychological Experiments of the Twentieth Century (2004).
Link: Hyperthymic Personality
Now, the better question would be, what if there is no depression? Can people just have mild mania? And the answer to that is at one level it appears that God or nature or Darwin or whoever evolved our brains or created our brains did it in such a way that it doesn’t seem that episodic, mild mania can happen by itself. It has not really been described that people can have intermittent hypomania and nothing else, no depression. It can happen, but it’s probably rare. Just having manic episodes without depressive episodes is reported in maybe 5 to 10 percent of bipolar patients, and we don’t really know if just having hypomanic episodes can happen.
Trying to capture all my thoughts is exhausting but seems necessary in my creative process. The connections I see forming, as I let my thoughts go rather than trying to focus them, are astounding. Continue reading