What exactly is "Severe manic depression?"

[gina164]

Few people here know that I hold a Master of Science Degree in Psychology, although most everyone knows that I also have a family member who suffers from "severe manic depression."

After reading some of the movie reviews, especially some of which say that Dan suffers mainly from Schizoprenia, I wanted to copy and paste some info about "severe manic depression," in case any fans need/want to know more about the illness. Severe manic depression includes delusions and sometimes hallucnations.

You have read about some of Dan's past delusions...my sis had some, too, along the way, when off meds. Once she thought she was Jesus...another time we ate lunch in a restaurant in Santa Monica, CA and she seemed quite 'normal,' but later told me she had been thinking at the time that we were two famous actresses...anyway, I and my family are intimately aware of what it means to have a close relative with severe manic depression. For the fans who are not aware of what this illness means, here is some info:
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What is manic depression?
An insight into manic depression...
By Robert Kokoska, 2/21/2006     


Also called bipolar mood disorder, manic depression is a very serious disease of brain associated with extreme shifts in moods, body functioning and behavior. Just a few years back, manic depression was glorified as a trait so common with many well known artists, composers and brilliant writers; but in reality, thousands of lives have been lost or their career ruined due to this strange disease. An extreme case of manic depression has even lead to many people committing suicide. This debilitating disease affects almost 3 million Americans and 1.5 millions Europeans, and both men and women are equally troubled by this disease.

Manic depression usually starts occurring during early teenage or even during childhood; the symptoms are manifested by irregular cycles or episodes of maniac tendencies, depression and mood swing, often disrupting normal daily life. Three different types of episodes are associated with manic depression and each one of them is quite different from the other. Episodes of depression signify a persistent sad or withdrawn mood, while an episode of mania may show frequent or abnormal mood swings from one extreme to another. However, a mixed or combined state that consists of both mania and depression is probably the most difficult stage to manage and treat.

Signs and symptoms which occur during an episode of mania are:

1. Enhanced energy, high state of excitability and increased activity.
2. Feelings of euphoria, greatness and generally excited mood.
3. Gets irritable even at the smallest of incidences.
4. Lightening speed talk, thoughts and changing ideas.
5. Lack of concentration accompanied by less sleep.
6. Feelings of grandeur and false belief in their own capacity.
7. Lack of a good judgment.
8. Unusual behavior that is easily recognizable.
9. Easily provoked, excessive intrusion in other’s affairs, state of aggression and angry.
10. Provocative, intrusive, or aggressive behavior.

Signs and symptoms which occur during an episode of depression are:

1. Frequent sad, melancholic or empty mood.
2. Feelings of dejection, guilt, or helplessness.
3. Progressive loss of interest in day to day activities.
4. Depleted energy levels and feeling of tiredness.
5. Difficulty concentrating, remembering, making decision.
6. Suicidal talk and tendencies.

During early part of the illness these episodes are usually separated by a period of no symptoms and the patient usually feels very good and behaves normal. However, when five or more episodes of illness occur within a year, rapid manic depression sets in and becomes too frequent, leading to extreme consequences. This is also sometimes called a state of rapid recycling, when the degeneration of body and mind sets in at a rapid rate.

A chronic and severe manic depression may lead the patient to a stage of psychosis, when typical symptoms like hallucinations and delusions occur, and such a stage is probably an offshoot of highly dangerous, Schizophrenia. Many people with manic depression will get immense help from a sustained level of treatment and good results are usually achieved by stabilizing their mood swings and other associated symptoms. Highly improvised drugs and medicines like Lithium, atypical antipsychotic medications and high-potency benzodiazepine medications are usually prescribed to patients, depending on the history and intensity of the symptoms. Apart from drugs and medicines, patients are also recommended session of psychotherapy and behavioral therapy.

[Henry Long]

Gina-

A welcomed explanation. So many terms get tossed around, it's sometimes difficult to know what, exactly, one means. Mental illness, to be sure, but to what degree?

I was once in a relationship with someone who's brother was diagnosed as Daniel is. He and I hung out, made poetry and music together, and had great discussions. We were friends. I was told later he was "Manic Depressive." Up til then, I had no idea. Then, one night following a poetry reading where he accompanied me on guitar, I caught a glimpse. He began to talk VERY intensely about U-2 and Nirvana, that they were speaking directly to him through their songs, that "The End" was coming and only he and a few bands were gonna be saved...he wasn't kidding around.

He was eventually institutionalized for a number of months (for pulling a kitchen knife on some cops and claiming he was Jesus) and put on so many drugs he slept for 16-18 hours a day and gained 60 pounds. Heartbreaking. He never played the guitar again, as far as I know.

What gives me pause about all this is the drugs. It seems we are a society and an age so willing to be "on" something, so quick to pop a pill to get immediate relief, that mistakes are inevitable. Not long after my friend was put away, I went to see a "professional" myself. (I was feeling depressed, having alot of racing thoughts, insomnia, trouble focusing, etc.) Went to a therapist for awhile, then got put on drugs. Zoloft, Lithium (1500mg a day!), and Blood Pressure pills, among others. The result was NO painting or writing got done, very little excitement about life, and forget about sex. It made me even more depressed, but I seemed to be okay with it. Nice therapy. In fact, it was the relationship (the guy's sister) and my unhappiness in it (she was very contolling) that I was letting mess me up (ah...the wisdom of hindsight). I took these drugs for less than 10 months. That was 9 years ago. Since that time, I quit drinking, quit eating crap, lost 40 pounds and got off all forms of drugs, (other than vitamin C and such). Oh, and I also began to love myself, forgive others who had wronged me, and spent 2 years NOT in a relationship of any kind working on my ****.
 
I believe the drug industry is way too powerful in this country. Fort Knox is no longer filled with gold. It’s filled with pharmaceuticals. Believe me. I was mis-diagnosed 9 years ago, quickly put on drugs that made me numb, and never once made the connection between diet and mental health. At 43, I am healthier and more productive and more “stable” than ever before, and have actually reversed or eliminated such conditions as hypertension, I.B.S. and re-occurring migrane headaches. Its been years since I've been to a doctor other than a yearly check up. Everything that was once dangerously "up" is now "down" or "normal." (And was was once unfortunately "down" is now quite happily "up.") I guess my point is, well, drugs are bad, m’kay? Whether scored from the skinny guy over on 4th street, or pushed through fat Doctors and hugely profitable Astra Zeneca. I know many are “helped” by this insanely lucrative industry, but many are also totally ****ed up because of it.

My friend I mentioned earlier had lived on cheeseburgers and cokes. Smoked constantly. Had opressive controlling ambitious parents he lived with and sisters who had reached  high levels of their respective ambitious professional careers, while he had odd jobs for a few weeks at a time at best, and usually ended up just not going. His number one complaint to me, (prior to being told he was Manic Depressive") was that he felt like crap most of the time.

I may be really naive on this matter, but what if someone diagnosed as “Severely Manic Depressive” were to cut out the sugar and processed foods (junk food, sodas, sweets) stop smoking 3 packs a day (another drug, to be sure) loose some weight, get out for 1/2 hour brisk walks a couple times a week and seek out others who have been through similar health problems for emotional support- Would all these liver and kidney and libido killing drugs still be necessary? Would mental health improve proportionally along with physical well being? Would this person feel “better?” Would they live longer?

Seeing as you hold a "Master of Science Degree in Psychology," and have a sister who suffers from mental illness, I’d really be interested in your personal take on this.

[gina164]

Hi, Henry

Thanks for all of the sharing, and for your question about my take on some of this stuff -

First, I want to touch on some stuff about manic depression and genetics:

Unfortunately, it runs in families - 

When I took psychopathology in grad school, I learned that "identical twin studies" - studies done on adopted out people - reveal about a 70% concordance rate. That is to say that, if one identical twin 'has it in the clinically observable sense,' the other will, too. Paternal twins come in at around 15% or so, and siblings at 2%, whereas the general population has a rate of about 1% afflicted, same as schizophrenia.

So...environment (including food and drugs) DOES account for part of the 'variance' - if it did not, there would be a 100% concordance rate in adopted out identical twins.

In my own family, the gene(S?) my sis got came from my dad's side...my father's twin sister is also manic depressive, although she never became an alcoholic, nor did she 'do cocaine' like my older sis (who was a professional dancer and traveled around the world dancing before her first break with reality)...So, my aunt's illness has not been as devastating (perhaps because of the differences in environmeental influences?) but even she has also had numerous hospitalizations and delusions (especiallly post partum).

Still - your question is excellent....

What would have happened if my sis and Dan had been in a highly controlled environment  all along and had never been allowed any crap food or drugs? Well...that will never be known...because we cannot impose this on others...

PLUS, most manic depressives WILL 'use' food and drugs/alcohol as a way 'to self-medicate' before and after diagnosis...

But, I do agree with you that for 'the average person,' one who IS stable enough to be able to choose to eat healthily, not do drugs, eat healthy and exercise regularly, along with keeping a level wake time each day, getting lots of social support, etc ...goes a LONG way to avoiding 'the not wanted downs'...and the 'not wanted ups' ....

One of the reviews of TDADJ that I just read was interesting - the movie left the guy pissed about what God does to some geniuses...
guess he was referring to the genetic aspects of the illness.

Anyway - VERY glad that you found 'yourself' again, without the need for meds! Some of them are wonderful, and help  many people lead better lives...other meds are scary...and, yes, perhaps too quickly prescribed.

[Henry Long]

Thanks for taking the time to respond. I guess I'm less curious about what "could have" been, had there been, as you put it, a "controlled environment," and what can be done, as of now, to create a higher quality of life or, at least,  to not add more destruction and atrophy to already existing health problems. In my (limited) experience, our bodies are completely entwined with our environment and our empathies, our families and our daily lives. I think alot of people make themselves quite ill BELIEVING they are ill. Just as many make themselves well believing they, in fact, are.

Having personally gone through the Martyrdom machine (and come out the other end only to unplug the damned contraption) I am under the impression that at least for some of us, we are our own worse enemies.

Thanks again Gina for the information.

[gina164]

Hi, again -

Sorry - I see that I really didn't address your questions - actually, thinking back...I must have tried to side-step them...but, answering them would be right, so -

You asked:
"I may be really naive on this matter, but what if someone diagnosed as “Severely Manic Depressive” were to cut out the sugar and processed foods (junk food, sodas, sweets) stop smoking 3 packs a day (another drug, to be sure) loose some weight, get out for 1/2 hour brisk walks a couple times a week and seek out others who have been through similar health problems for emotional support- Would all these liver and kidney and libido killing drugs still be necessary? Would mental health improve proportionally along with physical well being? Would this person feel “better?” Would they live longer?"

Knowing Dan, I know that all of this applies to him -
I also know that his family has tried to control him, and is sometimes successful...but, he is VERY 'willful' ...

When I recently visited, I made dinner on two nights for him and his folks, and I eat VERY healthily. BUT the one night I had to boil the potatoes and broccoli mix I made to the point where he could simple swallow without chewing because he hates to wear his false teeth! (AND, I had to 'convince him' at the dinner table to eat those few veggies)...So, obviously, he never ate the raw veggie salads, that the rest of us ate and which were full of great nutrients...He did enjoy the shrimp and rice dish (a risotto), and some gourmet (bunless) burgers (which I made with lean meat), and also mixed strawberries/pineapple salad I made, (with sugar free chocolate syrup topping).

His dad usually cooks, and he makes the usual fare - Dan goes over to eat at his folks house each evening. Dan said he had had chili the night before I arrived, so that's kinda healthy...but, Dan's father is now 85 and is looking after his wife, who needs constant attention when she is not asleep....so it is not possible for him to completely control Dan's diet.

When Dan goes out, he orders whatever he wants... I always 'made' him use Sweet & Lo(w?) for his second iced tea...but, he always made sure he got the leaded version to start with!

What I came to learn about Dan:

Dan REALLY 'needs' a full-time assistant - someone to cook for him and help to keep him away from too many 'slushies' and cokes...and chocolate bars...these are his favorite endulgences.. This is one reason why I keep hoping that the movie/art sales will help him financially...I keep hoping that perhaps his family could afford to hire someone to 'live in' with him? But, THAT would not be cheap, to get the right person!

He had diet Dr. Pepper in the frig, so the family is trying.
Yet, I know that his Type II Diabetes is such now that he needs injectable insulin every morning - his father wakes him at 7:30 every morning to do this.

Unfortunately, I believe that the cigarettes are never going away...he truly depends on them, psychologically...he doesn't really inhale much...I saw it, and he even told me he smokes them like cigars.

About taking a walk each day - I encouraged him to get out and walk - he lives on a lovely rural road...but, he's really not the type to want to do that, alone or with a friend...He'd rather walk to the car to go comic book shopping, or to go to buy a DVD, or to go to Sonic for a slushie ...I think, honestly, the only way Dan is ever going to do some regular exercise is if he meets someone to marry and she 'makes him' do some with her Or, if he gets a full-time assistant that he enjoys enough to do that kind of stuff with.

About whether or not he, or anyone like him, would be able to go off meds entirely...not possible,  due to his brain chemistry being off - but, the injectible insulin could go IF his diet was controllable, and IF he exercised/lost weight...

But, Dan is not likely to lose weight - he eats quickly, so 'waiting the 20 mins' for his brain to signal his stomach that he is satiated probably won't ever happen

About our thoughts and their efffects on our bodies...sure, we can and do influence our health, but not enough to wipe away the effects of 'true' diseases...Dan's severe manic depression is with him for life...no matter how heathily he lives.

IF he could receive an optimum diet, and get regular exercise, some meds could be reduced or eliminated, but not all.
And, yes...he would live longer, in all probability.

I often think about him and wish that he will meet someone to look after him full-time... my husband met me when he was 58...and he certainly has 'cleaned up his act' in order to keep me...

Anyway...

A TRUE happy ending for Dan would be if he met someone to marry, and live 'happily ever after with' -

If that time ever comes for him, I will believe he is blessed beyond message.

[Poonhead]

That is very interesting.  I also didn't know anything about the false teeth.

[gina164]

That is very interesting.  I also didn't know anything about the false teeth.

Yes...I hestiated sharing all of that, especially the false teeth part - his Dad explained to me that Dan hasn't had the patience to get used to them.

It's why you rarely see him smile broadly in current pics - he rarely 'wears them' -

He talks and sings fine without them though.

[ondafritz]

Oh my... I'll have to talk with him about that!
How's he gonna get a girlfriend without teeth?
He left West Virginia long ago.

[Henry Long]

Ha!

[gina164]

Oh my... I'll have to talk with him about that!
How's he gonna get a girlfriend without teeth?
He left West Virginia long ago.

Hey, Fritzie!
I guess now I need to call him and fess up to blabbing that he has false teeth?!

OK,OK...so, your reply is funny...

But, a guy that can kiss with or without teeth...not necessarily a bad thing...

[birds_cant_smile]

i'd marry dan.

[gina164]

 

[wickedwill]

Yeah you seem to forget he has no teeth. I took him to the Dollar Store once and while he bought all this stuff,action figures,figurines,seeds,dogbones,etc. All I could find that I needed was that orange cream licorice. Well I forgot about the diabetes and if you ever hung around Daniel its easy to forget it. You dont think someone who guzzles Cokes that way he does as being diabetic.

SOOOOOOOO I just handed him a piece of licorice. Then I was "Oh no....um...uh can you have sweets Dan"
"Sure" and he shoved the whole piece in his mouth and just chewed and chewed and chewed...or gummed. He gave that piece of candy hell.
I noticed when we got back to his studio he spit it in the garbage.

But yeah it dont affect his speech or anything!

If you look on the Danny and the Nightmares cd "The end is near" you can see he has his teeth jutting out.

He can eat chinese food without teeth fine also!

[Poonhead]

I like these stories.  You are lucky to hang out with the guy.

[wickedwill]

What is depression?
Well I may be opening myself up here more then I should. I have talked to Henry Long about it so he has a little insight.
I suffer from severe depression with bouts of Paranoia. I take up two 6 pills a day for it. When I am having a good day its great, when I am having a bad day it is absolutely terrible. It started when I was about 15 and manifested itself in me until I snapped at the age of 21. Everything in my life fell apart.....I made wrong decisions. I was put in a institution whose only goal was to suck my insurance dry. They gave me so many of the wrong meds I did not even recognize my mother when she came to see me. It was not one of those hi-tech loony bins but the two big black guys at the door made sure nobody left.
After being in there 2 weeks I was told I could not leave even though I had willingly went in with the coaxing of my mom.
Well one day I guess the two black guys were busy and a nurse opened the front door and I just out of instinct pushed her out of the way and ran as fast as my bare feet would take me......I ran across the freeway in shorts and a Black Flag t shirt and called a friend to come get me. I realized that place cared only about one thing and that was my money. If I did not particpate in group efforts they didnt give a **** or even make me try. When we got out to exercise/swim I could not even go out because all the meds would make my eyes so sensitive to the sun I could not even open them! Its a good thing I broke free as the sun was setting because I would have ran straight into the freeway blind and prolly got creamed!
Granted my depression is nowhere as severe as Daniels and for the last five years I have had a really good grasp on it.......its still there and I still have my moments. Sometimes getting out of bed is a chore all within itself....sometimes the tears flow without reason.
Depression to the one who suffers it is a freaking nightmare,its like a never ending rollercoaster whose fun has wore off on the first three trips around the tracks. You want off but you cant get off. It took me a long time to come to terms with the fact I will have to take meds just to maintain my sanity but I have to. I have a family to support,I have kids who look up to me to be there. I realize these meds have saved me to a degree........yeah there is a chance when I am 41 like Daniel I will look 61....but I will still be here with those who need and love me.
I feel a kinship with Daniel because I know a tad bit of what he goes through to a degree and through his music I have learned that "there is a heaven and a star for you (me)"
I have the utmost respect for Dick,Bill,Mabel, because alot of folks would just wash thier hands of a sick loved one who does not do what he is supposed to do...its frustrating and can make one angry and feel helpless....but they have stuck by our hero........thats love of the deepest kind.
What Daniel has done with his life considering how bad his depression is is amazing! He is one of a kind. Like I said its tough even on a mild scale on the scale in which Daniel deals with it and all he has achieved in his life is a miracle. I guess I will have a better grasp on my situation when I am able or want to go outside and mingle with folks....I try but I sometimes just cant and give up and go home. I am almost hermit like thats where I been told the paranoia comes in......who knows?!?!
Depression sucks!
Dan Rules!