Category: Depression

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BIPOLAR and DEMENTIA: AN UNHAPPY PAIRING

Bipolar and Dementia: An Unhappy Pairing

5 Novemberr, 2022

This post requires a preface: 

Life seems to give us as many obstacles as it does choices. If you are lucky enough, you will find a path around or through your obstacles. Never overlook obscure opportunities that may help you on your way. In a worst-case scenario, blaze your own way … kick ass and take names. 
I won’t say that we only live once because I do not believe that, but we do owe it to ourselves to make the best of the life we are living now.

With the greatest blessings, 
Noor 

(“Noor,” is a common Arabic unisex name meaning “light”, “The Divine Light.” May I help bring light to you through life’s many foibles and success!)

A couple of weeks ago, I loaned a book to my boss about dementia and how the philosophy and education methods we use are being applied to persons with dementia. It is a way to keep dementia patients mentally active and engaged, and potentially to slow the rate of the disease’s progression. I have taken many courses that are specific to working with persons with dementia, and my Master’s degree is specific to my educational philosophy and methodology. It is a union with a great deal of promise. 

After lending the book to her, I started thinking about how my Bipolar might be affected should I begin to develop dementia. I took an entirely fresh and idealistic approach to researching bipolar and dementia. I thought of it as a big “IF” or “unlikely” that I develop it. What I began to discover killed the glee and optimism I was feeling. What I was finding was terribly disturbing. For once this was not some creative writer’s errant opinion, but rather it was hard scientific investigation and facts from doctors and researchers … medical professionals. I did not like what I was finding. To quote a line from a recently watched show, â€śPeople lie. Facts do not.” Since a lot of this material was in scientific journals with terms and formulas which I would struggle to paraphrase, there will be some direct quotes with hopefully sufficient documentation should you wish to delve further. I will spare us all the torture of APA formatting in this post.

What immediately jumped out was a 2020 analysis where it was determined that people with bipolar disorder are about three times more likely to develop dementia, while another expansive analysis also found a significantly increased risk (1). These chances increased exponentially with the earlier the age that Bipolar arises in the individual. My Bipolar reared its ugly head at around the age of 12 or 14, so this was not exciting news for me. My pediatrician at the time chalked it up to prepubescent mood swings and anxieties, setting a decades-long period where I went undiagnosed and untreated despite what should have been clear Bipolar warning signs.

Another statistic that was commonly shared by most of the researchers revolved around the frequency of severe Bipolar episodes in relation to increases in the likelihood of dementia. “The number of bipolar episodes someone experiences could also play a role in dementia risk. In a 2004 study published in the Journal of Neurology, Neurosurgery & Psychiatry, the rate of dementia increased about 6% with each bipolar episode that led to a hospital admission.” (2)  For me, as well as for most people (especially for those with finance or insurance limitations, or more importantly those who are not yet aware they are dealing with something as serious as Bipolar) there are likely a myriad of instances when we should have gone to the hospital but didn’t. This qualification of hospital-admission is skewed in my opinion because the number of serious Bipolar episodes one has had may not be properly credited to Bipolar-and-hospital stay stats. 

On a bit of personal reflection regarding my last post and my family medical history, I found more statistics, heavy on the Bipolar numbers. They say that “if you were diagnosed with Bipolar at an early age, this generally predicts a shorter overall lifespan (see above paragraph). Though, it does depend on your lifestyle and individual contributing factors, which can be improved.” (2)“Experts have established that living with any mental health condition reduces your life expectancy by anywhere from 8-10 years. The life expectancy for someone with Bipolar Disorder is approximately 67 years old.” (3)  This I found particularly upsetting as I have enough planned for my future to maybe get me to 80. But it might also explain why of three of my grandparents with mental health issues, two died at 69 and a third barely made 70. As good healthcare and healthy living are important to all of us, this may be a key primarily for dementia, proper medication care can be the tool for Bipolars to outlive the statistics.

I am including the results of a couple of pharmaceutical studies that show us that no matter what the facts tell us, there is always something new and promising waiting around the corner, in this case a lithium vs. valproate comparison: Which one works?

Scientific Reports volume 12, Article number: 14142 (2022)

“Effect of valproate and lithium on dementia onset risk in bipolar disorder patients“

Compared to non-users, valproate-only users and both users showed a higher risk of dementia (59% and 62%, respectively). In sub-group analysis, valproate increased the dementia risk when prescribed for at least 59 days or 23 cumulative defined daily doses. However, the dementia risk associated with lithium is unclear. Therefore, we concluded that lithium has the potential to be the safer choice as a mood stabilizer over valproate for elderly bipolar disorder patients considering the risk of dementia. (My note to you: I have been on lithium for almost 15 years. Look for studies related to Lithium treatments).

Finally, use the information above as a tool to improve your lives – and stats. I am not married to the statistics above, but rather I will try to rewrite them. Eat well, mind my foods choices (or in moderation) that promote good health. See a doctor often. Change my meds if/when they are no longer effective. Create a happy and full existence and watch as I pass that 67 year old landmine! I intend to look back at it from my 70’s or 80’s.

Hang in there!!!

Blessings,

Noor

  • Bipolar Disorder and Dementia: What’s the Connection? Written by Angel Ridout, Jul 19, 2022
  • National Library of Medicine, National Center for Biotechnology Information. History of Bipolar disorder and the risk of dementia: a systematic review and meta-analysis. Journal List, HHS Author Manuscripts, PMC5365367

Trusted Source, 2021

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CHANGE CAN BE A BLESSING

1 October 2022

CHANGE CAN BE A BLESSING

Constant and often difficult change defines my youth and early adulthood. My family was always moving … New York, Pennsylvania, Chicago, and Europe (I was packed off to university in England to get as far away from the smothering and dictatorial control of my parents … it brought about significant changes in my development as a person), Phoenix and Dallas. The next few moves were of my choice, so they were better, but it was still change, starting all over with a new city, new job, new home, and new friends. When you are young and experience significant change, it can offer the opportunity to reinvent yourself. New friends did not know the painfully shy boy that I left behind in the last city. Sometimes change provides opportunities for personal growth. Moving to NYC with my then-boyfriend, now-husband, was a period of great change and social upheaval. After many wild years, we settled into our quiet comfort zone, pleased with the metamorphosis that has become us, and we settle into a calm peace.

Being enveloped in the status quo feels safe and comfortable, like the blanket carried around by Linus (the Peanuts cartoon character). I’ll admit, I am keen on consistency and calm, things being the same, stable, and safe. I do not even like changing planes at the airport even when I know it will get me to the destination I seek. Moving in the near future (anywhere) for retirement scares me even though I know the outcome will likely be incredible. Any degree of change, now or in the foreseeable future, ramps up my anxiety, and I have to labor to bring it down to a palatable level. Well, that, and I have medication.

One thing that has affected me very strongly in the last year is a severe deepening and dark descent into the depression side of my bipolar. These dark days last longer than my normal lulls, often passing a week or more. I have been dealing with bipolar/depression almost my entire life. I know how to read it, how to pacify it, and how to act and react in order to try to minimize its impact on my daily life. But these trips to the depths of the Bipolar Sea have been different. I had lost interest in simple things, things I needed or wanted to do, and was overall indifferent to everything. I was not suicidal, but bipolar and depression run wild in my family tree, and the suicides I am aware of in my family happened in older age. I am not going to be part of a family statistic.

My first step was to have a serious and revealing chat with my psychiatrist (NOT with Lucy from the Peanuts). It is the longest discussion we have had in a long time. My frequency and severity of bipolar episodes have worsened with age, and medications may need to be changed, or medication amounts of what I already take might need to be adjusted or increased. When I spoke with my doctor, I let her know that my medications and their amounts had changed minimally since I was diagnosed and prescribed in Switzerland 15 years ago, although symptoms presented themselves while I was in my teens and I lived untreated the bulk of my life.

I had previously been reluctant to request changes since I had remained relatively stable all of these years, but I knew that something in my body and brain was changing and becoming less stable. I mean, who wants to walk around all day every day ready to burst into tears for absolutely no reason? Plus, I realized I was manifesting more afflictions attributed to maturing persons with Bipolar, including constant sadness and fatigue, concentration issues, sleep changes, and hopelessness. My doctor, alarmed by what I was sharing, changed (actually doubled) one of my daytime medications. I am happy to say, it has made a profound impact on me and my outlook. I only wish I had addressed this sooner. But better late than never.

But that was weeks ago now. The euphoria I experienced during the first week on the increased medication was great. I felt as if I was walking on sunshine. I was happy and invincible on a level I had not experienced in quite a long time. Now, I have somewhat reverted backward. I am not beaming rays of light, but likewise, I have not fallen back into the dark caverns that haunted me so often. I am in a middle ground, neither elated nor depressed. If that is the best I can get for now, I can be content that it is not worse. This is a status quo I can live with until the next adjustments in my medications.

What do your medications and mood swings tell you? Are you in a good enough place to just keep plugging along? Are you as happy as a kid at the carnival? Or do you feel like you fell through a hole in the ice and are frantically clutching at the ice around you just to hang on?

Think about where you are and where you want to be. Only you can make a difference, and be the catalyst for the life you want and deserve.

Blessings,

Noor

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I’M ONLY A MAN IN A SILLY RED SHEET

4 July, 2022

I’M ONLY A MAN IN A SILLY RED SHEET

I can’t stand to fly
I’m not that naive
I’m just out to find
The better part of me

I’m more than a bird, I’m more than a plane
I’m more than just some pretty face beside a train
And it’s not easy to be me

I wish that I could cry
Fall upon my knees
Find a way to lie
‘Bout a home I’ll never see

It may sound absurd, but don’t be naive
Even heroes have the right to bleed
I may be disturbed, but won’t you concede
Even heroes have the right to dream?
And it’s not easy to be me

(“Superman,” Songwriter: John Ondrasik)

Kitchen storage cabinet made by my Great-Grandfather Otto Geschke, or his father Heinrich

I am back a week now from the annual pilgrimage to somehow rescue the farmhouse, ironically exactly a year after my last trip and posting about how that went. This was my fourth trip to the farmhouse to sort and sell some of the massive amounts of stuff inside and around it. It is incomprehensible how my father accumulated so much shit, and I mean that in a not very nice way, and managed to stuff the house floor to ceiling and wall to wall on four floors, in addition to a 30’ trailer beside it. With everything we have been able to sell already deeply discounted, $2.00 here, $5.00 there, $20.00 probably being the most expensive items, we have to deal with cheap ”garage-salers” who want to fight you over a dollar, plus the ones that get past you without paying, and the friends of my father who as if they haven’t stolen enough from him already, try pitting me and my sister against each other over prices and then do fuzzy math to get away with more for less. These people disgust me and makes trying to do the right thing by my parents even harder. I might as well have a sign at the curb that says, “Come rob me.”

Artifacts from the kitchen dig

This being the fourth year of sorting and selling, we chose to skip the dumpster and focus on what we could sell, leaving the “crap” to huge piles in corners, mostly in the basement where the endless supply of old farm tools were the biggest sellers. Opening the basement to be as safe as possible to shoppers was itself a Herculean task. It takes Superheroes, (my sister included) to accomplish what we did, often touching (gloved) the masses of now-garbage items covered in white mold, but it was still not enough. We even dug a huge pit off the back side of the kitchen to bury shovels full of rotted things we wouldn’t even touch gloved. In the end, little got buried because we became consumed with more urgent projects, but interestingly we discovered china and pottery fragments about two feet down. It must have been a kitchen garbage pit at one point because I cannot imagine an outhouse placed that close to the main house. Ironically, almost everywhere we have ever dug turned out artifacts. Right now I have a few metal/iron items soaking in a big bowl of Coca Cola. If it will eat away very heavy rust deposits and crusting off iron, imagine what it does to your insides if you drink it regularly. 

Probably the second-most Superhero task was acting as historian and tour guide of the house and grounds and extended property for the people who came, mostly out of curiosity about the house and it’s insides. I even had a couple of people ask to see the attic which for safety reasons we had as off-limits. I had reached out to several local historians and historical societies with little result. Shameful on their parts, actually, as that is the job they are paid to do. I had to act as the homestead’s most dedicated advocate in a move to find a sympathetic buyer. 

In terms of dealing with emptying the contents of the house, it’s been pretty much a shit-show. I am very angry with both of my parents for letting everything about the house and their finances get to where they are today. Most of his retirement income went into the acquisition of things we can’t seem to sell or have had to throw away. My father apparently never passed up a yard or garage sale. A lot of items still had old price tags on them. There are so many small items that rather than add price tags, my sister and I made the prices up as we were asked. We will never get the house empty, just the two of us, and we will never recover the millions of dollars that were squandered on fair weather “friends” (the vultures who kept showing up for money and freebies), crooked contractor friends, charitable gifts (but not to their own children), and junk. 

Me on a good day

Like, what was my father thinking? He let the 1838 porches on the front of the house rot until they half fell off and had to be removed. We have over a dozen refrigerators, nearly 30 ancient TVs, 20+ dinosaur microwaves, and about a dozen antique washing machines – one is so old that I think Jesus used it to wash his robes. My trips upstate cost triple what we recoup having these farmhouse garage sales. It would be cheaper to send money to my mother directly, but that then negates the fact that the house still needs to be emptied before it is sold. I saw a really great quote from Power of Positivity yesterday. Shortened: “ … this is the oldest you’ve ever been and the youngest you’ll ever be again.” It is true, and I have said it many times, I am not getting any younger and every run up there gets harder. I guess we do until we can’t.

Bottom line: There is no answer or end in sight. I have always tried to be all and do all for all. I have tried this for the last several years, including the trip to Dallas with my sisters to empty two massive storage units of my parents’ personal possessions. We have become the guardians, the babysitters. It’s a lot of weight to tow. While I am in the role, I am best served operating on autopilot. Once I leave, the walls come down. I am no longer pretending to be Superman. I have left my silly red cape in Jesus’ washing machine until the next trip. 

I returned home and my Bipolar clearly took over. I met with my therapist the next day and put my depression and anxiety at a 12 on a 1-10 scale. I returned home feeling completed defeated and powerfully depressed. I felt so bad that all I wanted to was cry for the next few days back. I was too emotional to even write. Do Superheroes cry, bleed, or give up? They should, at least occasionally. It is still a long road ahead of me.

Blessings,

Noor