1. BOY, INTERRUPTED: - My Magical Misery Tour by Jeff Baker Jeff Baker (Bipolar Aid) © 2012

2. BOY, INTERRUPTED

3. Bipolar Mood Swings Diagram BIPOLAR I - MANIA BIPOLAR II - HYPOMANIA AVERAGE MOOD AVERAGE MOOD LOW (SAD) BIPOLAR II - DYSTHYMIA BIPOLAR I – CLINICAL DEPRESSION AVERAGE MOOD HIGH (HAPPY)

4. NORMAL STAGES OF GRIEF (DABDA) DENIAL: “Not happening” ANGER: “Why this?” “Why ME?” BARGAINING: I'll “give” or “trade” DEPRESSION: “I'm sad. Why bother?” ACCEPTANCE: “It's okay. Why worry?”

5. NERVE ENDINGS... Microscopic: Axons & Dendrites Provide all signals to and from the brain Synaptic Gap: Neurotransmitters: Norepinephrine, Dopamine, Serotonin

6. NERVE STIMULATION LIMBIC SYSTEM (EMOTIONS) MANIA: Excess of neurotransmitters... DEPRESSION: Near lack of neurotransmitters...

7. SEROTONIN - APPETITE - SLEEP - MEMORY - LEARNING - MOOD - BEHAVIOR - BODY TEMPERATURE - MUSCULAR CONTRACTION

8. STIGMA FEAR, DISGUST, IGNORANCE BPD – BIOLOGICAL IN ORIGIN (LIKE CANCER, DIABETES) DIFFERENCE IS OUTWARD VS. INWARD BEHAVIOR VS. PHYSICALLY VISIBLE OR INVISIBLE

9. HOW WE ARE WIRED FACT >>> BELIEF >>> THOUGHT(S) >>> FEELING(S) >>> BEHAVIOUR(S) >>> RESULT(S)

10. MOOD DISORDERS 1 of 4 Americans suffers one or more mental disorder(s) Depression #3 reason for doctor visits Psych meds prescribed 2 nd only to analgesics Untreated mood disorder folks have a 33% suicide rate 90% of suicides result from clinical depression Only 49% of bipolar folks receive treatment 70% of bipolar patients have had at least 1 misdiagnosis 83% of bipolar cases are severe 37% of bipolar folks ignore or don't recognize BPD

11. PSYCHIATRIC VISITS, ETC. BPD diagnoses 13% by primary care physicians BPD diagnoses 18% by psychologists BPD diagnoses 64% by psychiatrists 10,000 suicides annually for people age 24 and under Depression 2x higher in women than in men BPD found equally among men and women BPD folks live 9.2 yrs less than the 78 yr nat'l average 40% BPD folks abuse drugs, alcohol or both BPD folks unemployment rate is 50% higher

12. BIPOLAR DISORDER - PREDISPOSITIONS Genetics – 50 % German bloodlines High IQ Arts (1 study 85%) Trauma – PTSD, abuse Stressful environment Anyone at anytime Avg onset 25-35 years

13. OTHER STATISTICS > 90% of marriages with a bipolar partner end in divorce > 33% of bipolar persons will either attempt or complete the act of suicide > Bipolar disorder 2 nd -highest reason for disability awards > Unemployment rate 50% higher > Lifetime avg 10 episodes of 2-6 months each; recovery up to 1 year; 90% more...

14. RELEVANT QUOTATIONS “You can think your way into depression, but you cannot always think yourself out of depression.” - Lewis E. Britton, M.D. “In a real dark night of the soul it is always three o'clock in the morning, day after day.” - F. Scott Fitzgerald “Where there is no hope there can be no endeavor.” - Samuel Johnson

15. APA STATISTICS Bipolar Disorder is an affective mood disorder 5.7 million adults diagnosed with Bipolar Disorder Bipolar Disorder average onset age is 25 Alcohol, drugs used to self-medicate Diagnosed Bipolar Disorder persons 15% suicide Takes up to 1 year to fully recover from a BP episode Takes up to 3 years to have meds properly adjusted It takes up to 10 years to be properly diagnosed w/BPD

16. MORE APA STATS Children, Teens are often misdiagnosed as ADHD Bipolar patients almost always need medication Not unusual for BP patient to relapse after stable Rapid-cycler – patient with 4 or more severe episodes a year Mixed Mania – episodes occur daily for approx 1 week; mania & depression co-exist

17. BIPOLAR SYMPTOMS - MANIA Grandiosity “I am God” I possess all abilities and powers Very little sleep, yet energetic Rapid, often loud speech Excessively judgmental Easily distracted, cannot concentrate Impaired judgment Wildly impulsive Reckless, despite the consequences

18. BIPOLAR MANIA, CONT'D Delusional, sometimes with hallucinations Totally uninhibited--potentially psychotic Giving away cherished valuables Unending pursuit of pleasures: Wanton sex Abuse of Alcohol Chain smoking Abuse of illicit and/or prescribed Rx

19. BIPOLAR DEPRESSION Feeling sad, useless, hopeless Irritable Cannot experience pleasure Fatigue, energy depletion Loss of interests Appetite and weight changes Sleep – restless, excessive, insomnia Lack of concentration

20. DEPRESSION, CONT'D Sporadic or total loss of memory Feeling guilty Feeling worthless Thoughts of death or suicide Loss of motor skills Catatonia Vegetative

21. MEDICAL MANAGEMENT 3 GOALS: 1. Decreased Episode Frequency (8-10 avg) 2. Decreased Episode Duration 3. Decreased Intensity of UP and DOWN Mood Swings

22. THREE TREATMENTS Psychiatric Drug Course Psychological Counseling Positive Lifestyle Changes

23. MY APPROACH SERENITY ELIMINATE STRESS AVOID ANGER ACCEPT OR CHANGE

24. SAD BUT TRUE... Mental facilities are often full, some with waiting lists Most of us are either uninsured or underinsured Primary-care physicians are untrained in mood disorders Patients are always the last to know Both unipolar and bipolar disorders are incurable; medical & lifestyle change for stability Psych Meds are powerful, with: costly, wicked side-effects

25. PREVENTATIVE MEASURES Hide the car keys Get rid of firearms Secure all debit/credit cards and checkbook – give weekly allowance Obtain Medical Power of Attorney; specify docs & hospitals Gather & list all meds Dispense meds Create a team game plan

26. WHERE TO GET HELP! Angie's List, Web M.D., Psychiatrists Primary Care Doc or Psychologist Patient Referral Public Health officials Boy, Interrupted's “Helpful Resource” links www. BipolarAid.org

27. QUESTION & ANSWER Clinical aspects My experiences My history My prognosis My beliefs My outlook THANK YOU!

28. “I am the way, the truth, and the life; no man comes to the Father, but by Me” - Jesus (John 14:6) “for God so loved the world, that He gave his only begotten Son, that whoever believes in Him shall not perish, but have everlasting life.” - (John 3:16)

29. BOY, INTERRUPTED: - My Magical Misery Tour by Jeff Baker Jeff Baker © 2012