My BPD Story: Instalment #1

In the last ten months this account has been extended to 115 pages and 43,000 words and can be found at several internet sites.-Ron Price, Tasmania

This is terrific! You've got a great command of the language. Are you submitting for publication, or has this been published already?

I just post instalments, JennyDots, of my story on the internet at mental health sites. Publication is served in this way if one goes to over 100 depression, BPD, schizophrenia, inter alia, sites as I do. Thanks for your positive words about my language. Really appreciated.-Ron in Australia

1.4 The new diagnostic term, BPD, is now found in the Diagnostic and Statistical Manual of Mental Disorders-IV published by the American Psychiatric Association.  DSM-III had 300 disorders twice as many as in the DSM-II.  DSM-V is due for publication in 2013.  The DSM is considered the bible by specialists and by the various professions and other interest groups.  It is considered by many as a core/basic information source, a major scientific instrument in the field of mental health.  In the DSM-IV the term maniac was deleted and the one-size-fits-all classification system for MD and BPD was more finely tuned by the 4th edition published in 1994.  The exact discourse that has come to have jurisdiction in this labelling process, the circumstances that have come to result in a person given some mental illness label are due to: (a) norms and expectations as well as (b) medical, psychological, physiological and (c)  most recently, neurochemical and electrical brain activity as seen in brain imaging.

1.5 About half of all patients with BPD have one parent who also has some form of mood disorder.  There is then, or so it seems to me, a clinical significance in my mother’s mood disorder in the explanation of the origins and diagnosis of my own BPD.   The high heritability of BPD has been well-documented through familial incidence, twin and adoption studies.  There is an unquestionable justification for the inclusion of my family in the understanding of my BPD.   No specific gene has yet been identified as the one bipolar gene.  It appears likely that BPD is caused by the presence of multiple genes conferring susceptibility to BPD when combined with psychosocial stressors. I make this point as an opening remark and pass on to my story.  

1.6  This account also provides a statement of my most recent experiences with BPD in the last three years, 2007-2010.   Some prospective analysis of my illness is also included with the view to assessing: potential short term, medium term and long-term strategies,  appropriate lifestyle choices and activities in which to engage in the years ahead in these middle years(65-75) of late adulthood(60-80) and old age(80++), if I last that long.  For the most part, though, this account, this statement I have written here in some 55,000 words, is an outline, a description, of this partially genetically predisposing family-based illness and of my experience with it throughout my life.  I would, though, discourage others from blaming their parents for their genetic contribution to the disorders.  I would also discourage them from blaming other family members for their contributions in the form of stress and conflict and failure to understand.  Rather than wasting time and energy in finger-pointing or bemoaning the fact that one has BPD, I would encourage sufferers to learn how to best use available treatment programs, or modalities as they are sometimes called in the literature, to minimize their symptoms and to find success and satisfaction in their lives despite their disorder.
----------------INSTALMENT # 3 TO COME IF DESIRED---------------------------------

JOHNNY O’KEEFE

When someone who is or was a celebrity has or had bipolar disorder I take a special interest in their life-narrative.  Having had to deal with this mental health issue for seven decades now, I find the many manifestations of it in people’s lives make a heuristic comparison and contrast with my own experience. So it was when Johnny O’Keefe: The Wild One was televised on ABC11 I took note.-Ron Price with thanks to ABC1, 12:20-1:30 a.m. on 25/7/’11 and also televised at other times in the last several years here in Tasmania Australia.

You went to the USA in October ‘59
the same month and year I became
a Baha’i. I knew nothing of you back
then, nor very little even after your
24 hits and all your work leading to
the establishment of the Australian
recording industry. All those nervous
breakdowns as they called your BPD1
episodes awakened my interest. You
were in a psych-ward in August 1962
in Sydney as I started pioneering for
the Canadian Baha’i community. What
a long story, Johnny: thank God I found
lithium and did not get into drugs & OH
or I might have also had an early demise.

1 BPD=bipolar disorder was the name given to manic depression in 1980 after O’Keefe died(1978). Biographies of O’Keefe: The Wild One: The Life and Times of Johnny O’Keefe, Damian Johnstone, 2001; and The Official Johnny O’Keefe Story, John Bryden-Brown, 1982, as well as the mini-series The Johnny O’Keefe Story in 1986 all gave publicity to both O’Keefe and his BPD.

Ron Price
25 July 2011

A WAR-ZONE
16 MARCH TO 16 JUNE 1968

In the period mid-March to mid-June 1968 that I lived on Baffin Island, a great deal happened in both the wider world and in my own personal-micro world. This prose-poem is about those three months.
-------------------------------------
In the My Lai massacre which took place on 16 March, American troops killed scores of civilians in the war in Vietnam. The story first became public in November 1969. By this time I was teaching in a small rural town called Cherry Valley just outside Ontario’s Greater Golden Horseshoe. The publication of the account of the My Lai massacre helped to undermine public support for those U.S. war efforts.  

I won’t give you chapter-and-verse of the other major events in the following three month period; you can easily access all the details on Wikipedia. But I will mention below some of the events of these three months, events which now hold personal interest in these years of my late adulthood as I head for old-age.

I was teaching 16 grade three Inuit children in March 1967; I was in the first year of my marriage and living with my wife in a small flat in a small town on the shore of Frobisher Bay  In March, with the arrival of spring, winter still held the town, the island and the entire District of MacKenzie, the eastern Arctic, in its grip.  Winter would only begin to lose its icy-cold hold sometime in May, if I recall correctly after the passing of more than 40 years.

On 31 March the U.S. President Lyndon B. Johnson announced that he would not seek re-election. The film 2001: A Space Odyssey premiered in Washington, D.C. on 4 April, and on the same day Martin Luther King, Jr. was shot dead at the Lorraine Motel in Memphis, Tennessee. Riots immediately erupted in major American cities, lasting for several days.  I knew nothing of these things locked as I was in Canada’s Arctic far away from the print and electronic media and occupied with those 16 Inuit kids and a new marriage.

U.S. President Lyndon B. Johnson signed the Civil Rights Act of 1968 on 11 April among the many pieces of liberal legislation he worked for during his time in office.   The trendy Pierre Trudeau became Canada’s 15th Prime Minister on 20 April. In late April a new National Spiritual Assembly of the Baha’is of Canada was elected celebrating, in the process, 20 years of the existence of that institution: 1948-1968.  

On 13 May student riots broke-out in Paris resulting in one million marching through the streets.  On 5 June  the U.S. presidential candidate Robert F. Kennedy was shot at the Ambassador Hotel in Los Angeles California by Sirhan Sirhan. He died the next day. By 5 June I had been in the psychiatric wing of the Frobisher Bay General Hospital for several days. -Ron Price with thanks to Wikipedia, 3 May 2012.

On 29 May an eruption (or was it
an irruption?)1…took place in my
brain, my micro-world…..a force
that came to be called hypomania;
an episode which became a central
part of my life, a bipolar I disorder.

On 16/6 I left Baffin Island and flew
to Montreal and Verdun’s Psychiatric
Hospital. Thus ended the three month
episode that this prose-poem describes
as simply as it possibly can here, as I
say, after the passing of more than 40
years and my young life into old age!!

1 The fundamental difference lies in the prefix. Irruption starts with a variant of Latin 'in', and means bursting or breaking in; eruption starts with a variant of Latin 'ex', and means bursting or breaking out.

Ron Price
3 May 2012

The following paragraphs are an update on "my chaos narrative" my 69 years dealing with BPD.  These paragraphs are concerned with the last five months: 4/12-9/12. Go to this link and search for the word seroquel:  http://bahai-library.com/price_mental-health_history_autobiography-memoir&e=true ....If readers are unable to click on this link, then read the following:
-------------------------------
11. A NEW PSYCHIATRIST AND A NEW MEDS REGIME: THE FIRST 4 MONTHS--16/4/'12 TO 16/9/'12

11.1 On 16 and 23 April, as well as on 9 May and 10 August 2012, I had consultations with a new psychiatrist, a Dr. George Hyde, in Launceston. I began a new program of pharmacology, pharmacotherapy, or drug therapy. I had a one hour, a 20 minute, a 40 minute, and finally a 30 minute consultation, respectively, on these four occasions. At the end of the 4th consultation we decided that: (i) I would not call to make another apppointment unless some problem occurred or I was in need of more advice, and (ii) I was happy with my progress. I would now be in the hands of my GP in George Town to discuss any problems that arose. I wrote a four page report to put my GP in the picture and Dr. Hyde sent an email to my GP informing her of my current status. 11.2 I discussed my OCD and decided that it was my responsibility not to annoy my wife with my OCD habits and the key was to exercise more restraint when it was clear that I was bothering her. My wife and I had decided over the first months of 2012 that it would be a better life-style and pattern if I did not sleep during the day, and if I had more energy to exercise and do physical work around the house. In the process it would be hoped that I might reduce my cholesterol levels and weight, as well as be more gregarious. I had gained 75 lbs since 1980 on meds for BPD. My wife wanted to have my old social self back, the self I was like back in the years I was on lithium(1980-2001), and in my early middle age(1984-1994) as well as my young adult stage(1964-1984) in the lifespan.

11.3 On the last meds package from 4/'07 to 4/'12, I did not have the enthusiasm to exercise sufficiently to get my weight off. It was my wife's hope that I would also, as I say above, be more gregarious and be capable of enjoying more than 2 hours of social activity at a time without losing my edge, my self-control, without speeding, as I had done in the last five years on my NAVAL and effexor meds package. Dr Hyde was a psychiatrist whom my wife regarded as more modern and inclined to use the latest medications and approaches to my BPD. He might even help me initiate some CBT therapy if I wanted to go down that route---such was the view of my wife. I decided by the end of my third visit with Dr Hyde that, for the present time, I would not engage in any form of talk therapy:CBT or otherwise. I had been with my previous psychiatrist of a dozen years, 2001-2012. This new chap was 40ish and not 70ish. He was a colleague of my old psychiatrist, and both my wife and I were more than satisfied with his service after these visits. I told Dr Hyde that I was coming to him due to my wife's insistence that I try a new psychiatrist, and I asked him to convey my best wishes to my old psychiatrist. I might even write to him to thank him for his service over more than a decade.

11.4 As a result of these 4 consultations I became stabilized on a Seroquel-Effexor package. Seroquel is an atypical antipsychotic. These came into use in the 1990s and were approved for the treatment of BPD by the FDA in the USA. It is one of the neuroleptics which is just another word for an anti-psychotic, a tranquilizing psychiatric medication primarily used to manage psychosis for BPD sufferers. Typical antipsychotics, sometimes referred to as first generation antipsychotics, conventional antipsychotics, classical neuroleptics, traditional antipsychotics, or major tranquilizers, are a class of antipsychotic drugs first developed in the 1950s and used to treat psychosis. Typical antipsychotics may also be used for the treatment of acute mania, agitation, and other conditions. The first typical antipsychotics to enter clinical use were the phenothiazines. Second-generation antipsychotics are known as atypical antipsychotics. Most of the drugs in the second generation, known as atypical antipsychotics, have been developed more recently, although the first atypical antipsychotic, clozapine, was discovered in the 1950s and introduced clinically in the 1970s. 11.4.1 Both generations of medication tend to block receptors in the brain's dopamine pathways. Antipsychotic drugs encompass a wide range of receptor targets. The atypicals are less likely to cause abnormal body movements, or motor control disabilities. in patients. They are now deployed as: antidepressants, anti-anxiety drugs, mood stabilizers, cognitive enhancers, anti-aggressive, anti-impulsive, anti-suicidal and hypnotic or sleep medications. Seroquel began to be used to treat BPD in 2004 as a tranquilizing psychiatric medication primarily to manage psychosis but, as I say, it is now used for the other purposes I've listed. 11.4.2 Seroquel has come to be increasingly used in the management of non-psychotic disorders and as an add-on with medications like effexor to treat: depression, episodes associated with bipolar I disorder(my disorder), and schizophrenia. It is also used as an adjunct therapy to and maintenance treatment with NAVAL. I went off NAVAL after only 7 days on this new medication--Seroquel---in April 2012. Seroquel is also used to treat conditions such as: OCD, PTSD, borderline personality disorder, and Tourette/'s syndrome. It is my view that I have some symptoms of all of these disorders, as I point out elsewhere in this lengthy account of my experience of BPD.

11.4.3 Since Seroquel has also been used by physicians as a sedative for those with sleep and/or anxiety disorders to calm people down, it turned out to be the perfect medication to accompany NAVAL and effexor, or just effexor as was my case by 23 April 2012. After the 2nd appointment with Dr Hyde I went off the NAVAL. I kept 500 mgs of NAVAL for the first week and on 23/4/'12 I went right-off the NAVAL. By my 3rd appointment in early May 2012 I was on 100 mgs of seroquel. As I write these latest words on 15 September 2012, I have been on the seroquel for exactly 5 months. I took 50 mgs of Seroquel for the first week, 100 mgs starting on 23/4/'12. I take a 100 mg tablet between 6 and 8 pm and its peak effectiveness is at midnight. By 10 a.m. seroquel is at its lowest level of effect thus ensuring that I have energy for the day ahead. By 10 a.m. I have been out of bed for 1 to 2 hours.

11.5 The general effects of this new medication package have included: (a) a slower movement, and a very relaxed, slightly euphoric, state, (b)less anxiety and sleepiness during the day, as well as more calmness. I go to bed between 8 and 10 p.m. and get up earlier, usually between 7 a.m. and 9 a.m. at the latest. In the first two days when I was also taking NAVAL I felt, what you might say, "out-of-it" in my daily activity. I only had enough energy to walk about slowly and go about my domestic activity slowly: eat, wash dishes, read and send emails, watch TV and chat with my wife, inter alia. By day 3, though,I had more energy. I still had that slightly euphoric and relaxed state. The most common side-effect of seroquel or quetiapine, as it is also called, is somnolence. This does not surprise me now after 5 months on this new anti-psychotic drug. I am still in bed for 11 to 12 hours a day and I sleep for at least 8 to 9 hours.

11.5.1 Other common side-effects listed in the description of this medication and which I can see occurring due to my being on it now for 5 months include: sluggishness, fatigue, weakness, dry mouth, and less libido. I am pleased with this decrease in libido because I tend to be more relaxed and less turned-on sexually. This pleases my wife. Dr Hyde suggested I stay on seroquel in the range of 100 to 125 mgs. I'll report on any changes and on these side-effects in the days ahead as this new meds package continues.

11.5.2 I am much less frenetic and do far less speeding on this new meds pkg. After varying amounts of social interaction, though, I have a strong tendency to speed, experience the related anxiety with its tendency to "go over the top" and lose my self-control. If I monitor this tendency, that is, if I simply eliminate social interaction after a certain length of time---as I did on my previous meds package---I have no problems. Anger still occurs and this frightens my wife. In the first 5 months I got angry once. My wife's ill-health, her auto-immune disorder, makes her less patient and this exacerbates the problems that arise from my anger. 11.5.3 It concerns my wife when my interaction is not appropriate: (i) anger, (ii) saying things that are not appropriate and (iii)doing things that are not appropriate. This was one reason for this meds shift back in April 2012. A second major concern of my wife is, as I say, my OCD which has been high since going on NAVAL more than 5 years ago, and has remained high on this new meds package. When left alone or just dealing with everyday activity with my wife around the house, I don't speed or experience any anxiety. My wife tells me that I thrash in bed far less. She also says that my facial expressions are more relaxed as is the sound of my voice and general demeanor even in social situations with others.

11.5.2.1 Dr Hyde says I am a classic BPDI since I have had at least 1 full manic episode in my lfe. BPDII people never have a full manic episode, just hypomania as well as highs and lows. I am also defecating 2 to 3 times a day on average and not 4 or 5 as was the case on my previous meds. My feces are not as loose as they were on NAVAL. I take the seroquel and effexor generally at 7 pm with my evening meal. By 10 a.m., as I say above, the affect of seroquel is back to its lowest state. I will visit Dr Hyde again at a date when I feel it useful to continue our consultations.