I’M A MANIAC

 I’m a maniac. No really, right up until 1980 before they revised the “American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders” 3rd Edition. I would have been called a maniac for most of my life. I am a maniac, along with 2.4% of other “maniacs” around the world. Today, I am included with the largest population of 4.4% of the “maniacs” living in the United States. (1)

Am I a maniac? Possibly on any given day I could be described that way by some. We would not want to ask my ex. I remember the day I left him. He was talking, and I asked him to stop. He continued, and I believe he even got louder. I simply picked up my purse and car keys, walked out the door, got in my car, and drove away. It had taken him two weeks to find me, but by then I had already started a new life. To this day, I have no emotional connection to the man I once spent eight years of my life. However, since that March day back in 1980, I am no longer a “maniac” now I am referred to as a Bipolar.

Bipolar is defined as;

(of psychiatric illness) characterized by both manic and depressive episodes, or manic ones only. (2)

Bipolar is not a new disorder.  In as early as the 1st Century of Greece, Arteaus of Cappadocia began writing and detailing symptoms in the medical field. Terms we use today, such as, manic and depression were once defined as mania and melancholia by the ancient Greeks and Romans. Romans were known for the “lithium salt” baths to raise the spirits of the melancholy and relax the mania. Today, lithium is still used in treatments for balancing bipolar patients. Even Aristotle was noted for crediting melancholy for contributing greatly to artist of his time with inspiration. “For as men differ in appearance not because they possess a face but because they possess such and such a face, some handsome, others ugly, others with nothing extraordinary about it, so those who have little of this temperament are ordinary, but those who have much are unlike them, majority of people. For if their melancholy habitus is quite undiluted they are too melancholy but if it somewhat tempered they are outstanding. (Aristotle 954b21-27) (3)   It was not until 1851 when French Psychiatrist Jean- Pierre Falret published the article “la folie circulaire “  (translated “Circular Insanity”) he describe one’s switching from severe depression to manic excitement. Falret, was also the first in the medical field to bring to light the genetic connection. This is believed to be the earliest document diagnosis of what is called bipolar today. (4)

Have we advanced much in our research on mental illness from the Greece 1st Century? Has the advancement of technology and understanding of the human body given us answers to reduce this illness to similarities of the common cold? What are the goals of today’s psychiatrist and what do they see for us “the maniacs” and our offspring in the future?

“It is all in your head.” I have been told that since I was a small child. In fact, looking back on my childhood, what memories are mine and what memories did “my head” create?  However the amazing fact, it is all in my head. Bipolar affects several areas of the brain. The main areas of the brain involved with Bipolar are the frontal and temporal lobes of the forebrain.  Bipolar affects the hippocampus, which helps us regulate the creation of memories and stress management, the thalamus, which helps us control emotions (especially, fight or flight), and the anterior cingulated, which helps us to respond to our environment. The cerebral cortex is accredited with being responsible for the negative thoughts associated with the depressive episodes of bipolar disorder. (5)

Over my lifetime, I had been described as someone who switches on and off.  Most of the people would say they are describing a character trait. However, with the advancement of technology I have learned that is exactly what I do. Now, we know neurotransmitters are involved in the causes of mood disorders. The two main neuroanatomical circuits in mood regulation are the limbic-thalamic-cortical circuit and the limbic-striatal-pallial-cortical circuit. A mood disorder may develop with any dysfunction of these mood-regulating circuits. Include that with the lack of control of a cell with the imbalance of chemicals, such as, the monoamines (noradrenaline, serotonin, and dopamine) and acetylcholine we have enough spark to set-off the roller coaster ride. A roller coaster ride, a common expression I find in group sessions after group sessions. (6)

What do the medical pioneers see for us “maniacs” in the future? One such pioneer is Dr. Yurgelun- Todd. To monitor brain activity she uses an imaging technique called functional magnetic resonance imaging (fMRI). “When we perform a task, like lifting a finger or memorizing a list of words, the regions of the brain that enable us to carry out that job is turned on. “The neurons are firing more and require more energy that changes the blood flow in the brain,” explains Dr. Yurgelun-Todd. (7) She one day hopes to advance preventive care so that we may have a medical exam that not only include a blood profile to help evaluate our physical health, but also a brain profile, as well.

I am Bipolar. I am a medicated coupled with therapy Bipolar patient. I do not carry it around like a privilege granting me exceptions or excuses for my daily actions. I am not a product nor a prisoner of my environment. I have hopes for future medical advancements but none so grand that it keeps me from confronting today. I have been reconditioned over the years to take the “excess” my mind allows in and create outwardly. I work and befriend other bipolar patients. We are not a club. We do not all have the same tendencies, likes, dislikes, and boundaries. But we are known to short circuit. No. I am not a “maniac”.

(1)A study was conducted by researchers around the world and funded by grants from the National Institute of Mental Health, the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, and a variety of other pharmaceutical companies and public health organizations.

(2) Merriam-Webster Dictionary

(3) This is the translation by Klibansky et al. (1964, p. 26)

(4) Wikipedia

(5, ) (6)(Manji & Lenox, 2000).

(7) Dr. Yurgelun-Todd was hired by the Brain Institute under the USTAR initiative and joined the Department of Psychiatry at the University of Utah July 1, 2008. She comes to Utah from the Department of Psychiatry at Harvard University Medical School. She was also the Director of the internationally recognized Cognitive Neuroimaging laboratory at the Brain Imaging Center of McLean Hospital.