The Flatland Dilemma in Interpreting Bipolar Mania.

People in mania are known for flights of fancy and the rapid association of ideas. Of all the forms of intelligence that we may possess, it is only the ability to recognize analogies and build associations that suffers when we go on mood stabilizers. I think it can be a mistake for outsiders to believe that this ability leads to wild, random, and unusable linkages in our mind. I find that my ability to write poetry — meaningful poetry — suffered after I started taking lithium; I lost insights. Of course, many other more negative traits like my irritability, grandiosity, and racing thoughts disappeared so I consider it a net gain.

The things we bring back from our adventures in mania land aren’t all rubbish. Poets such as Shelley and Byron depended on their manic states to generate compelling material. Some scientists have conceived startling new concepts. Isaac Newton is a classic example of a maniac whose insights transformed the science of his day and enabled him to revolutionize mathematics with his invention of calculus. The trouble comes when we try to bring our insights back from the fine and private place of our sickness.

William Knowland’s Flatland — which was written to explain the difficulties inherent in Faith — presents a useful allegory for our struggle to explain what we have found. Imagine a two dimensional figure, say a square. Imagine that it is you. Your perceptions are limited to two dimensions, so while you can make out one dimensional figures such as lines and points, you cannot appreciate three dimensional ones. If you were one dimensional, squares would appear as lines to you. Angles and other aspects of the square would invisible.

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What could go wrong?

FDA asked to consider adherence sensor on Abilify

http://www.modernhealthcare.com/article/20150910/NEWS/150919997

http://www.proteus.com/press-releases/u-s-fda-accepts-first-digital-medicine-new-drug-application-for-otsuka-and-proteus-digital-health/

Proteus Health, located in Redwood City CA, along with Tokyo based Otsuka Pharmaceutical Co. have a new drug application that is ready for review by regulators determined by the FDA.

The new drug is embedded with an ingestible sensor. When the medication, and sensor, reach the stomach, it sends a signal to a patch the patient wears externally. The information can be sent to physicians or caregivers with consent.

The sensor has previously been approved in a placebo taken along with a medication.

The goal is to help with medication compliance. All well and good up to this point. But, what is the first drug they choose? Abilify, an atypical anti-psychotic. It isn’t always taken for psychosis. It can be used as an add-on for depression and other ways. But, it is also used to treat psychosis.

Some, not uncommon, delusions are that:

you have sensors embedded, that your medicine has been poisoned or tampered with or that people are tracking you. This is to be taken by consent, but personally, I think they chose a bad medication.

I don’t know what is wrong with injectable abilify? That would be my choice.

 

How to Talk Listen to a Mentally Ill Person

The mentally ill person is not a child. I have had the experience of would-be helpers who treated me so. When I attempted to describe what I needed, they argued and belittled me for needing help. I felt very alone and one result was that I stayed away from the church where this person was not only a member, but an officer of sorts. It was hard for me to treat him with charity. I turned my back when he greeted me afterwards because I could not stand his hypocrisy.

We are sensitive about being patronized because of our condition for the same reasons that African Americans are sensitive about race. No one wants to be excluded on the basis of a condition that he cannot help. No one wants his condition denied. No one wants to feel cut away from the body politic. What we want is for people to take us seriously whether or not we are in episode.

Many of the problems that people have with the mentally ill have to do with communication. Those who wish to help (and those who do not want to help) believe that the objective of interaction is to get the mentally ill person to follow a treatment plan or pull herself up by her bootstraps or realize that it is “all in your mind”. (“Have you tried not being depressed?”).

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Reality Testing in Virtual Reality

Social media has become a large part of my daily activities. My friends live in my computer. I am married and have a family and do interact in the real world, too.

One thing about the Internet is things go so fast. And then you can’t take back that email or tweet. I can go off on tangents in 140 characters or less.

It is easy to feel like you are being cyberstalked. People do hack computers or follow people ‘s online activity, but paranoia can make you feel like it is happening, also.

Stress exacerbates my symptoms so it really is not a good idea for me to stay up getting tense in debates. I like to discuss ideas and facts just not argue.

I used to get messages through media. They would be hidden in written words, spoken, sometimes visual. They stopped years ago. But, I would search for clues. Everyone thought the computer was making me crazy, but the messages were everywhere.

My delusions are a lot like the Truman Show where I think everyone else is acting, filming, with product placement even. That I just can’t break through that 4th wall. Delusions are different depending on culture. I have heard voices. They weren’t mean. They would guide me and humor me. I actually missed them, I felt lost when they stopped.