My previous article covered the controversy about why people think it is not possible to be hypomanic without losing control. It’s a good backdrop for this article.

There are four steps that lead to hypomanic success:

1. Determine the starting point.
2. Assemble the tools necessary for the task and become proficient at using them.
3. Create a realistic plan.
4. Do the work.

Assessments

Most assessment tools for bipolar disorder are only for making a diagnosis. Rarely does one assess where someone is in terms of their ability to actually handle elevated states. If we are going to succeed at being hypomanic without losing control, we need to assess a number of factors, including intensity, awareness, understanding, functionality, comfort, and what value the person sees in the experience. These criteria need to be gauged at different levels of intensity until you find the one where they are all optimized.

I have discussed bipolar with thousands of people over the last 10 years and would guesstimate that being hypomanic without losing control is the Holy Grail for 75% or 80% of them. Most say their goal is “permanent hypomania and to never be depressed again.” If you ask their parents, though, they will say “I don’t mind him being a little depressed, but could you make the mania and deep depression go away forever?”

There is good reason for the discrepancy between parents and bipolars. Bipolar people may like being manic, but their behaviors are so often out-of-control that they become a problem for those around them. Bipolars and non-bipolars alike are justifiably afraid of mania because of past history with manic episodes.

It is commonly believed that it is impossible to even be hypomanic without rapidly escalating to an out-of-control state. The belief is so prevalent that the standard of care for mania according to the National Institute of Mental Health is to make it go away entirely.

On the other hand, there are many people who advocate that bipolar is a dangerous gift. Some take it too far and say we should allow all states no matter the consequences. While I fully agree with the dangerous gift idea, we must learn to take responsibility for our states and keep them from getting to places that we cannot control.

A recent question on our Depression and Bipolar Advantage LinkedIN Group brings up a point that needs to be addressed if we are to fully understand depression: What are some of the positives about having experienced bouts of depression? Since most people assume there are none it is important to put it in perspective.

The answer to the question depends completely on where one is on the six stage of growth from bipolar disorder to bipolar in order. The inability to see value in the experience is a major contributor to the suffering that those in disorder experience. Finding value in the experience is one of the keys to removing the suffering and starting on the path to self-mastery.

For someone in the Crisis Stage the only positive may be that the person knows that he/she has survived before. This can literally mean the difference between life and death. It would be counterproductive to ask if there are any positives while one is in crisis.

You cannot fully understand bipolar until you see the whole picture. This video shows the pieces that are missing in most descriptions. For those of you who have seen the video along with the article “The Shocking Truth About Recovery From Bipolar Disorder” you can skip forward in this video to about 3:15.

The first few minutes repeat the study by the National Institute of Mental Health so those who have not seen the previous video can understand the context. The video is part of a much longer video available at http://www.bipolaradvantage.com as a part of the free online concepts course.

© http://jonathanwallacestudio.com/

My ankle was broken during a hockey game when I was sixteen. The pain was so intense that by the time I got to the hospital an hour later I couldn’t bear it any longer.

If the doctor had given me a choice between suffering from the pain or cutting my leg off at the knee I would have chosen the amputation. I would still be paying for the mistake if he told me the best evidence calls for amputation and gave me no other option other than suffering for the rest of my life.

This sounds absurd. But, what if the pain was in my head? According to a recent article in the BBC News Magazine (http://www.bbc.co.uk/news/magazine-15629160), they did something even worse in the 1950s – they amputated part of people’s brains.

They lobotomized people with depression and bipolar (and other issues) because it was the best evidence-based treatment at the time. From the article, “But from the mid-1950s, it rapidly fell out of favour, partly because of poor results and partly because of the introduction of the first wave of effective psychiatric drugs.” Chemical lobotomies became the evidence-based treatment of the day.

Today’s evidence-based treatments are so much more humane. Or are they? The tools are more refined, but the goal of treatment is the same: cut off the part that is broken. We are no longer poking ice picks into people’s eye sockets, but are still trying to accomplish similar outcomes.

One of the many traits of being bipolar is the ability to see the world in a different way. Many might say it is a curse, but it can also be a gift when looked at from a positive perspective. This change in perspective can literally help you to see with greater clarity.

From early childhood, we have been taking tests to assess our understanding of the world. These tests have had a profound impact on us in ways that we are often unaware. They have created a world view that places too much importance on passing the test and not enough on learning more about ourselves. In some ways, the tests themselves have gotten in the way of what the goal was in the first place.

I have been wearing glasses for almost thirty years. Every year or so I take a new exam to make sure my prescription is still the same. The test seems simple enough: the clinician shows me letters at different sizes and asks me to identify what letters I see. Anyone who has a driver’s license has taken a similar test as has anyone who wears glasses or contact lenses.

A few years ago I discovered a major breakthrough that has completely changed my life. It has brought my life into focus in many ways. I share it with you in hope that it will help you to see better too.

“You don’t know the half of it” is a once-common phrase that is generally applied to negative things. It usually means that you don’t really know how bad it is. It is easy to see how bipolar people can use the phrase to describe how horrible bipolar disorder is to someone who does not experience it.

image by John Forward

I imagine many people would expect this article to be a rant on how people without bipolar disorder have no idea how bad we have it. I am sorry. It is not. It is for those who already know how bad it can be. They may not know the half of it, either.

I often joke that depression is so terrible that we sometimes wish we were dead and we act so badly during mania that everyone else wishes we were. It is good for a laugh, because we all know it has some truth in it. The horrible symptoms of depression and mania that can occur when an individual is in a disordered state are well known. They include physical, mental, emotional, spiritual, social and career/financial dysfunction.

Funded massively by the pharmaceutical industry, partly because it is one of their biggest profit centers, there have been countless studies about bipolar disorder and how to move people from crisis through managed stage to recovery. There are many who argue over the choice of tools to address depression and bipolar, but nearly everyone agrees on one thing: depression and bipolar are horrible mental illnesses that need to be removed from our lives. They don’t know the half of it.

There was a demo of a video car racing game at the mall the other day and I became fascinated by the reactions of the people who were trying it out. I stayed around for a couple of hours and did an informal study of the phenomenon.

I watched almost 100 people drive into walls and other cars and asked 25 of them what they thought was the reason for so many crashes. Almost to a person, it was the fault of the car. Although they sat in seats that were identical to those in a race car, they said it was too twitchy, loose in the corners, and was nothing like driving a real car.

I was ready to conclude that the game was not very good when a man came along who drove incredibly fast without crashing at all. I asked him his secret and he said that he had taken driving lessons at a race track and practiced often in a real race car. He concluded that the game was very realistic and those who thought otherwise were trying to compare it to a normal car. He said the problem is they don’t know how to drive and the game is not at fault.

I gave a talk the other day for NAMI Santa Rosa about my next book and a woman remarked how different it is from my previous ones. I said that my first three were about me being the black swan.

She asked if I was referencing the movie called Black Swan and I have not seen it yet, so I do not know if it is related at all to Karl Popper’s concept from the 1930s that I was referencing. Have you seen it? Does it mention Popper? Should I see it either way?

Popper suggested that if you observe only white swans, you are using inductive reasoning to extrapolate that all swans are white. This was falsified when black swans were discovered by the English naturalist John Latham in 1790. Science was forced to change the hypothesis that all swans are white by the new evidence.

I am no expert on mental health crisis intervention. I have only seven personal experiences to base my opinions on. Nonetheless, it is not a stretch to say that there are some major flaws in the system that should be addressed. I know I am not alone in such an assessment and hope that we can share our ideas for how to make it better.

In trying to better understand all of the points of view, I have spent a lot of time discussing it with all sides of the debate. I gained some great insight from those who identify themselves as part of the anti-psychiatry movement. I could be wrong, but it seems that much of the hostility that they have comes from bad experiences when in crisis. I have a unique perspective on such experiences because I was once hired to stay with someone during his lockdown in a psych facility. I saw first hand how bad it can be while I had the clarity to know what was going on.