Friday, 28 March 2014

Bipolar Anger

"Anger, frustration" by
I have been intermittently angry for at least a month now. In keeping with the general pattern of anger I feel justified in my anger but that doesn't make it any easier to deal with. Actually that makes it worse. The trigger is a whole lot of stuff going on where I work and whichever way I look at things I can't see how I am going to get out of this situation in a satisfactory manner. I need some tools to deal with this, because I can't stand feeling this way and it is starting to feel ... like a relapse, after years of good health. The intensity and prolonged nature of this anger probably isn't normal. Thus I reproduce the following extracts from Berk et al, Living with Bipolar:
"... anger can be a sign that you are feeling frustrated due to stress, or because someone has done something that that doesn't fit with your expectations ... If your irritability or anger is intense, persistent and not too discriminating in whom it targets, you should consider whether it might be a symptom of illness. 

Saturday, 1 March 2014

Daily Meditation Practice

Over the last few months I have taken a break from daily meditation practice and it has left me determined to bring myself back to it (I always intended to come back to it by March, if not February)  definitely my overall sense of well-being and contentment was enhanced last year when I meditated nearly daily for over seven months. I also felt less prone to emotional outbursts and anxiety. I have recited a mantra a number of times in the last few days but I'm a bit rusty regarding the whole practice I was doing. Here follows my notes reminding me how to do a daily meditation practice.* 

Find a place to meditate
Ideally one should create a special place where one goes to meditate. This place should be laid out in a way which promotes meditation. I ended up setting up a space on a small table on my balcony. On it I have placed a framed photograph of a statue of Padmasambhava, as well as a mosquito repelling candle, a singing bowl, and a couple of larger images of Padmasambhava in the background in a larger frame. You could say it is like a shrine to Padmasambhava, but I think that would be overstating it  for I have never made offerings there. Rather it is a space created to aid my meditative practice.  

Sunday, 9 February 2014

Probiotics as Psychobiotics - Part of an Antidepressant Diet

"Yogurt with berries" by LilyBrilliant
A recent article published in the Biological Psychiatry Journal has suggested that probiotics - usually ingested via fermented milk products such as yogurt - may produce a health benefit in patients suffering from psychiatric illnesses, such as depression, when ingested in adequate amounts. The authors, Dynan, Stanton and Cryan, noted that not all probiotics produce this benefit and therefore those strains that are effective have been labelled "psychobiotics", with Bifidobacterium infants cautiously put forward as amongst the probiotic strains most likely to be effective. They conclude:
"Preclinical evaluation in rodents suggests that certain psychobiotics possess antidepressant or anxiolytic activity ... So far, psychobiotics have been most extensively studied in a liaison psychiatric setting in patients with irritable bowel syndrome, where positive benefits have been reported for a number of organisms including Bifidobacterium infantis. Evidence is emerging of benefits in alleviating symptoms of depression and in chronic fatigue syndrome. Such benefits may be related to the anti-inflammatory actions of certain psychobiotics ... 

There are sufficient preclinical data to support the view that clinical studies with probiotics in depression are worth conducting ... There is no doubt that many patients would value the emergence of nonconventional antidepressants in the form of psychobiotics."

Tuesday, 28 January 2014

Reducing Seroquel

"Font of Hygeia" by
Around this time last year I was taking 400mg of Seroquel a day. I am now on 325mg a day and am planning to get down to 300mg as this is the minimum dose my psychiatrist told me I should take (I have a bipolar 1 diagnosis - but I have been "well", for the most part, for around three years). I feel I have got the process of reduction sorted out now so I thought I'd share my technique. 

Essentially what I've been doing is reducing by 12.5mg at a time and I do so over a period of weeks. I generally have one day on the usual dose then alternate with a dose that is 12.5mg lower the next day, and so on, for a week or two. Then I plunge down to 12.5mg less every day. There has been some pain at times but generally it isn't too bad if I take more Seroquel than I normally would in the day, but less at night. This means I am more "sedated" in the day than usual, just while I am dropping the dose. It really is that simple. There are a few other things to consider though, such as being in a relatively good place when you start the reduction and not even trying to reduce during periods that are likely to be stressful (for me the festive season in December is a vulnerable time). That said, there is always stress - life is like that. If one tries to find a time when there is no stress whatsoever then one will likely find that that time never comes. A willingness to experience some discomfort is important - that discomfort which feels like being under-medicated should be short lived (by which I mean days).

In short, I suggest, based purely on my own experience, the following technique for lowering one's Seroquel dose:
  • Do it gradually - dropping down 12.5mg at a time (so, half a 25mg tablet at a time) over a period of weeks is recommended (by me). If you do it in a matter of days you may slide into feeling a bit more pain than you need to, if you do it over a matter of months then you are probably dragging out the discomfort for too long.
  • Recognise that there is no perfect time to reduce your dose and that there may be some discomfort - let your loved ones know what you are doing so they have the full picture.
  • Avoid trying to reduce during periods that you know you are very likely to find stressful - holidays are not necessarily the best times because holidays can be unpredictable and therefore stressful.
  • Try taking more Seroquel in the day (and thus, less before going to bed) than you normally would so you don't feel under-medicated.
  • Eat well - for me this means avoiding sugary food (anything that is more than 15% sugar should be avoided - this generally means no chocolate, ice cream, cake, etc, but yogurt with a moderate amount of fruit is ok) and avoiding carbs unless they are high in fibre (at least 5% fibre).

Tuesday, 3 December 2013

Interconnected and Interdependent

"The mess you made of me" by spacedementchen
Loneliness is hell. Not belonging is hell. Feeling unloved is hell. Feeling misunderstood is hell. Feeling despised, disliked or disapproved of is hell. Today that all became a little clearer for me after spending my day volunteering at a youth refuge. The centre deals with teens who have been removed from their abusive parents by court order and for whom foster care has not worked out. These are people who have felt lonely, unloved, misunderstood, despised, disliked and/or disapproved of by their parents, by their foster carers, by their teachers and sometimes by their fellow students, who might otherwise have been their friends. They understand what hell is and somehow that made me feel better about my own wobbly mental health over the past couple of days, because being able to have a glimpse of their suffering helps me to understand that I am not alone as a suffering being. There is no middle class gloating in this — this is just about not feeling alone. It is not about realising how good I actually have it. That would be a very materialistic way to look at things. Realising one is wealthier than someone else can never provoke happiness, except in a superficial and rather meaningless way. But to feel connected to others, to lose that sense of shame one has about one's own suffering, to understand how much one has in common with others, and that the posturing smiles of Facebook are only a slice of the truth of human experience — that is really therapeutic.

Saturday, 23 November 2013

A Buddhist Approach to Well-Being

Path of Meditation. Source:
Here follows some extracts from a chapter written by Sogyal Rinpoche in Andy Fraser’s The Healing Power of Meditation: Leading Experts on Buddhism, Psychology, and Medicine Explore the Health Benefits of Contemplative Practice (2013):
“Regardless of who we are, the main purpose of our life is to be happy. You could call it the heart of being human, because we all share the same wish, and the same right, to seek happiness and be free from suffering. But then if you take a closer look, you can see that there are two kinds of happiness. One is based more on physical comfort of pleasure and is the happiness of the senses, whereas the other is founded on a deeper kind of mental contentment. The former can be very expensive and also turn out to be quite unsatisfying, whereas the latter will not only bring you complete satisfaction but also doesn’t cost a thing.

Friday, 1 November 2013

The Essence of Buddhism

"Lotus" by
As I have been attending a Buddhist centre for over six months I thought I would update an earlier post where I attempted to summarise the core teachings of the Buddha (Cultivating Contentment). In that post I emphasised the five precepts, which are particularly important to Theravada teachings (Theravada = the school of Buddhism commonly associated with Sri Lanka, Myanmar and Thailand and thought to be a continuation of the most ancient form of Buddhism), and are foundational teachings in all other schools of Buddhism. The school of Buddhism which I have been learning about recently is known as Vajrayana (typically associated with Tibet but originating in NW India/Pakistan) and within this school the core focus is not so much on the five precepts - the focus within the Vajrayana school has been described thus:

Commit not a single unwholesome action.
[refrain from doing things which cause suffering for ourselves and others]
Cultivate a wealth of virtue.
[as we are interdependent, making others happy will make ourselves happy]
To tame this mind of ours.
[disentangle our minds from mental projections by meditating regularly]
This is the teaching of all the Buddhas.*
[based on verse 183 of the Dharmapada]