The TL;DR version:
Mania and Depression are NOT opposite sides of normality. Instead, in mania is the brain signals (chemical / electrical) speed up slightly more than normal. So far so typical. The new bit is that in depression the brain signals speed up even more than in mania. The mind can't cope with the even higher signal speed and starts shutting down, giving rise to depression symptoms.
If you are one of the persons who can't get their depression under control, talk with your psych about using an anti-epileptic / anti-manic to see if that can help. I'm currently using carbamazepine (Tegretol, Equetro, Epitol, Carbagen, Carbatrol, Teril) and it seems to work to work for me. But I'm sure there are other anti-epileptics that can work.
The Long Version (still being expanded / edited)
For most of us the modern antidepressants don't work so well. I've long thought that the medical model for what mood swings are, is inaccurate. Not wrong, mind you, just not the full picture. That's why the meds don't work so well - we are not quite shooting at the right target, as it were. Compare this to diabetes, where the medical model is pretty well understood, and treatment works very well.
Ok, what's a medical model. It's the model of what happens inside of you - the complicated chemical and electrical interactions that happen inside of you. Think about your car engine. How it works is a physics model or an energy model which describes how we get the energy out of the gasoline and put it to work in moving your car.
The depression and mania medical model describes what the brain does to get from you thinking about doing something to you actually doing it. And it's a lot more complicated than your car engine. Lots. When you think about doing something, you don't just go "I shall do....". Feelings about doing it, considering the effects of the action, wondering what other people will think, etc., all get mixed into the decision of "I shall do...". We assume things are simple because we do them effortlessly, but it's not. The brain and how we think and how we do things is very very complicated.
I think that bipolar disorder, or mood swings, or depression, or mania, is really a fouling up of the "I shall do..." mechanism. It's not really about sadness, or feelings. But because these things are entangled in the "I shall do..." mechanism, they also get affected. And because our feelings are visible to others or because that how we, er, feel, that's how we describe what is going wrong.
Here's what I think is going wrong.
Before I go further, I'd like to distinguish between your brain, which is the squishy thing in your head - and your mind, which is the part of you that makes decisions, thinks, feels; the part of you that is your consciousness, your you. I'll need the distinction in the explanation that follow.
I think that bipolar disorder, all of it, is our brain signals increasing beyond typical. Let's assume that for a normal person, the brain signals have a certain signal speed, which we shall call the standard speed. When the brain's signals are working at standard speed, then your mind works just fine (well, not yours if you are here reading this blog, but normal people). There can be a bit of variation on the standard speed, but the normal person's brain has safety mechanisms that keep the signal speed at something close to standard.
In bipolar people, the safety mechanisms for regulating the brain signals don't work well.
In mania, the brain signals speed up a bit. Not a whole lot, just amped up a bit. Here's where the mind / brain distinction becomes important. So, the brain is not working quite properly, but the mind, the part of you that is you that makes decisions etc., is able to compensate. The mind still works. You still function. Of course the mind is making some slightly weird interpretations of what is going on because the increase in brain signals speed is providing wrong information to the mind, skewing what it thinks is going on around it. Slightly, because we still see the world around us as normal people do.
The increase in brain signals is also skewing other things, like feelings, and judgments, and decisions that the mind is making / feeling. Which the mind can't exactly realise because, you know, wrong signals and feedback. Ask a manic person - if they stop to reflect, they may understand intellectually what they are doing may be not quite right, - but it feels right / normal to them.
In depression, and here's where I depart from accepted medical models, the brain signals speed up even more. At higher speeds, the mind can't cope - it can't compensate enough. The mind starts shutting down, piece by piece, until you're in bed under the covers not wanting to talk to anyone. The body still works, but the mind, well, that's barely there. You're barely there.
What is the difference in the model mean? Well, for the first part, we aren't bipolar. We don't have two sides of the same coin. We have a disorder that increases through a tolerable variation (mania) to an intolerable variation (depression). And it's based on brain signals. In many ways we are similar to epileptics - their manifestation is in the body and ours is in the brain.
The second thing is that anything that slows down the brain signals should help. I'm betting that's why MDMA and other drugs that tend to make us laid back appear to work for depression. Because they slow or brain signal propogation. But it also means that anti-epileptic drugs may work as well for depression. As they say in the ads on TV, ask your doctor.
Wp 1 Like, 7 Comments
lukeJan 14, 2017User InfoIn reply to:I won’t respond directly to your concerns, but I do feel compelled to respond. If you believe in your concerns, and you want people to listen, if you want dialogue, then please write civilly. The tone of your contribution has no place here. Jinnah, and this blog, have been enormously helpful to myself and presumably countless others. We’re all battling with our illnesses and just trying to survive the day. Show some respect.Yes, i understand when you say “battling with illnesses,” which is why i am putting a little emphasis on some points which show the reasoning for my disagreement. Taking and telling people to take medication while having symptoms opposite of those which the medication has been made and distributed for, is something not unreasonable to get a little passionate contending against, atleast when the poster is reporting they are doing this and others are replying they are considering this. The statements being made are not even backed up at all, and some are just blantantly wrong. I respect opinions. I don’t respect statements supporting a porous hyposthesis suggesting people to detrimentally take the wrong meds, atleast when those statements are wrong. Still, well, you found my post ”uncivil”, well, ….grow some skin, and i guess some mental skin too, whatever thatd be.ApprovedSpamTrashLikeEditReplyLuke MasonJan 14, 2017User InfoIn reply to:Your hypothesis is based on the assumption that the limitations of the mind’s computational capability (NOT the mind’s consciousness, or thought matter, or the mind altogether) is something disjoint from the brain’s physical composition. There has been a significant number of actual, substantive research showing correlation between the composition of a neurochemical and the performance of a brain with that chemical composition. Think about what youre saying. The mind cant keep up with the brain. What does it mean for the mind to not be able to keep up? What would it take for the mind to be able to keep up? Something a soul or a spirit, except for the mind? In any case, something of that nature is what your hypothesis depends on. And you are suggesting people experiencing depressive modes get anti epileptics/anti manics? And mdma does NOT slow “brain signals” down. In fact, if you wouldve even bothered doing any research before thoughtlessly suggesting meds to people for whom those people are NOT intended, you wouldve easily found that mdma SIGNIFICANTLY INCREASES multiple neurotransmitter activity.I won’t respond directly to your concerns, but I do feel compelled to respond. If you believe in your concerns, and you want people to listen, if you want dialogue, then please write civilly. The tone of your contribution has no place here.Jinnah, and this blog, have been enormously helpful to myself and presumably countless others. We’re all battling with our illnesses and just trying to survive the day. Show some respect.ApprovedSpamTrashLikeEditReplylukeJan 14, 2017User InfoYour hypothesis is based on the assumption that the limitations of the mind’s computational capability (NOT the mind’s consciousness, or thought matter, or the mind altogether) is something disjoint from the brain’s physical composition. There has been a significant number of actual, substantive research showing correlation between the composition of a neurochemical and the performance of a brain with that chemical composition.Think about what youre saying. The mind cant keep up with the brain. What does it mean for the mind to not be able to keep up? What would it take for the mind to be able to keep up? Something a soul or a spirit, except for the mind? In any case, something of that nature is what your hypothesis depends on. And you are suggesting people experiencing depressive modes get anti epileptics/anti manics?And mdma does NOT slow “brain signals” down. In fact, if you wouldve even bothered doing any research before thoughtlessly suggesting meds to people for whom those people are NOT intended, you wouldve easily found that mdma SIGNIFICANTLY INCREASES multiple neurotransmitter activity.ApprovedSpamTrashLikeEditReplyjinnahMay 20, 2016User InfoIn reply to:“(…)then your mind works just fine (well, not yours if you are here reading this blog, but normal people).” OMG that was so hilarious hahahahahahaha…. nice you are back, I read your blog since 2011, I can never get enough of it I kind of agree with you about your theory on depression…. lamotrigine is also an anti-epilectic and is the one that works for me Good to hear from you too. I missed being here too. But, well, depression. You know how it is.ApprovedSpamTrashLikeEditReplyjinnahMay 20, 2016User InfoIn reply to:Welcome back. It’s become increasingly tough for me lately, so as I woke at 4am for work, seeing the email notification brightened me considerably. Hopefully there’ll more to come. Regarding your theory. It’s an interesting and provoking theory. Something worth discussing with my psychiatrist. May I ask what led you to this point, to this conclusion? What further reading you’d recommend. Wishing you lucid dreams, Luke@Luke: I’m in my late forties, when the mood swings and depression in particular seems to get worse. In the last 3 or so years, I’ve become frantic – my 5-10 year predictions of where I was heading were getting bleaker and bleaker. As a result, I have (unofficially) tried both ketamine and mdma in an effort to stave off the depression.Both work on depression by the way. The media stories aren’t wrong. Both of them are capable of getting me out of a depression within 30 minutes, something none of the conventional antidepressants could do, but something my anti-manic medication does for my mania.More surprisingly, was how they felt. This is a bit harder to describe. When I take a medication, I generally create a description on how it feels while being on the medication. Both ketamine and mdma feel far more like my how my antimanic feels rather than how conventional antidepressants feel. And yet they work on depression and they don’t make me manic.I didn’t have a eureka moment that after a two week period. It was much more that it kind of dawned upon me over a period of months while trying ketamine and then mdma.There is also a further element. Some of my cousins have related disorders. One is epileptic, I am bipolar, and one shares some of the elements of mild epilepsy and some of the elements of depression. We had long theorised that we all had the same disorder, just manifesting in different ways. For me, it’s not so much of a jump to connect them all together with my theory.Theory is one thing, but being able to make predictions from the theory is another. If depression is form of surging brain signals similar in kind to epilepsy, then possibly an anti-epileptic medication might work. So I’ve been trying it. I’m on carbamazepine 200 mg every 12 hours. And it seems to work for both depression and mania.It’s only been 5 weeks, but by my standards that is an incredible time frame – my system usually rejects antidepressants within 2-3 weeks, and only two medications have made it out to 5 weeks before (K and mdma). I’m waiting to see if it can break the three month barrier – which is the longest any medication has worked previously. Will know by the mid-July. Meanwhile, it’s nice to have a continuous life.ApprovedSpamTrashLikeEditReplyLuke MasonMay 20, 2016User InfoWelcome back. It’s become increasingly tough for me lately, so as I woke at 4am for work, seeing the email notification brightened me considerably. Hopefully there’ll more to come.Regarding your theory. It’s an interesting and provoking theory. Something worth discussing with my psychiatrist. May I ask what led you to this point, to this conclusion? What further reading you’d recommend.Wishing you lucid dreams,LukeApprovedSpamTrashLikeEditReplyDanielaMay 20, 2016User Info“(…)then your mind works just fine (well, not yours if you are here reading this blog, but normal people).” OMG that was so hilarious hahahahahahaha…. nice you are back, I read your blog since 2011, I can never get enough of it I kind of agree with you about your theory on depression…. lamotrigine is also an anti-epilectic and is the one that works for me ApprovedSpamTrashLikeEditReply