Hola Halloween Fans, welcome to ‘How to Understand and Manage Bipolar Disorder: Brain Injury.’ This post departs slightly from the previous posts which focused on the symptoms of bipolar and examines brain injury.
If you thought, Halloween Fans, that a bipolar blog would be straight forward and read like a textbook, then I am happy to disappoint you. I may start the blog with the best of intentions and propose a structure, but bipolar creativity does not work in such a linear fashion and I am very pleased about this. Text books, I would be bored silly writing a text book. Although I do compose non-fiction pieces but find the structure stifling. Anyway, today I am going to talk about another syndrome that results in mood disorders; Post-Traumatic Brain Syndrome, also known as Post-Traumatic Brain Injury. I know a lot about this subject as my husband Declan has the condition (and he has given me permission to speak freely).
The History of the Brain Injury
Declan was a road accident victim in his teens. I don’t want to go into the details suffice it to say that he was in a coma and had surgery on both sides of his brain. Subsequently the injuries were checked up on, but not the effects on his psychological state. Following heart surgery, the functionality of the heart would be carefully monitored. The same is true with kidneys, liver and eyes. But this does not happen with brain functionality. Any form of thought process interference is deemed as mental illness. This is still largely stigmatized and poorly understood. But mental illness stems from physiological conditions and is no different from any other condition.
Brain Injury and Cognitive Function
The brain’s primary function, alongside controlling movements and homeostasis, is to think and respond to stimulus. By analogy, any trauma to the brain would result in trauma to the cognitive processes.
There seems to be a huge chasm of medical ignorance in this area. This is worrying as common sense should indicate the psychological outcomes of neuro-physiological procedures. However, Declan’s cognitive functions were not analysed until four years later after he got into a bit of trouble with the law. Had the correct investigations been implemented this may have never happened. Following his interaction with the law a psychiatrist was called upon to provide a report. The report identified issues with Declan’s memory, perceptions and other processes. He received legal leniency but once again there was no follow up whatsoever. This is an example of total legal and medical failure and I am sure Declan is not the only victim of such negligence.
Brain Injury and Mood Disorder
Over the years Declan has had problems, although they have lessened. He did see a counselor for a year after I pushed for it. Declan asked me to go with him as he was unable to talk alone. He also saw a psychiatrist, but this was not followed up! Declan’s problem has triggered a mood disorder known as Post-Traumatic Brain Injury (or Syndrome). There is now a charity which provides support for this condition in Ireland. He has what he calls, ‘my moods.’ Declan requires more sleep than most people and reacts instinctively and impulsively to stressful situations. Over time we have developed a few strategies to overcome these moods, which are usually successful. The primary strategy is de-escalation, that is removing the stressor and offering security. Declan’s memory will always be bad. This has led to some funny situations.
A Humorous Result of Brain Injury
If we separate when shopping we have an arranged meeting point. Declan will choose a location that he will remember. On one occasion Declan could not remember the meeting point, but he knew which financial institution I bank with. Now, another characteristic of brain disorder is nerve palsy. Declan unintentionally shakes all of the time. Imagine, if you will, the reaction of a security guard when a man of Declan’s great height walks into the bank, shaking and vibrating, and just stands there for a long period of time doing nothing. Try it yourself, walk into a bank and do nothing! Needless to say, Declan was removed from the institution. We do look back on this incident and laugh, the same is true of many other similar instances.
Couples Sharing Mood Disorders
Another blogger asked the question, ‘should two people with mood disorders be together?’ In our case I would say yes as we have a good understanding of each other. There is no judgement for the symptoms of the illnesses and a deeper than usual attraction. Of the two of us Declan has a more reactive and protective temper, where as I tend towards irritable energy, which I have learned to manage. Due to the continuing stigma attached to mental illness in Ireland Declan has not been privy to the support network that I have had. I have actually seen people deliberately aggravating Declan with the intention of triggering his illness. I have removed him from the situation. This is totally unacceptable, it is like kicking someone repeatedly when their leg is broken. I don’t understand it, but it is very worrying.
How to Understand and Manage Bipolar Disorder: Brain Injury and Stigma
I would say it took the better part of three years to overcome the primary symptoms. I guess my problem is with a failing medical service. Ireland has one of the highest suicide rates in the EU averaging 480 confirmed suicides per year. Perhaps, just perhaps, if the stigma lifted and people were not ashamed of their conditions and perhaps if more support structures both in public health and within society were in place this statistic could be substantially lowered. I am not saying that this arises just in Ireland, I believe that mental health stigma occurs internationally on a huge scale. This is why survivors have taken it upon themselves to form the wealth of social networks to offer each other support and advice.
How to Understand and Manage Bipolar Disorder: Brain Injury and Social Support
Within these groups I have found the most common problems to be; lack of family support and poor media portrayal. Think of the films about mental health; Split, Psycho and Identity. I actually love these three films, even though there has been an outcry over at least one of them, but each portrays survivors as serial killers. Not the best reflection and certainly not an honest one. Violent crimes tend to be carried out by people without a diagnosed disorder, not people with a diagnosed mental illness. I would suspect the reason for this would be the great empathy people with mental illness feel for others. It is almost karmic, any pain given out is endured by the survivor. I would also like to add that most people do not fit the medical definition of what is normal.
I remember a House MD episode in which House identifies a character who he considers far too happy and states immediately that this is a symptom of an unknown illness (after clarifying that he is not Canadian). The medical definition of normality stems from a complete lack of stress and ability to adapt to change with an underlying positivity. Such a person would be constantly grinning like a Cheshire cat. This would make anyone feel uncomfortable. So, anyone sitting in judgement of another’s condition should get themselves tested first, the results might not be as expected.
As For Declan
As for Declan, he is doing very well. I remember one day he took me to Kilcummin head (a cliff) and explained that he used to go there to contemplate suicide, he no longer does this. Not because I offered attention for every down moment, but because I responded with humor and support. Humor is a fantastic tool for overcoming depression, if two people are depressed then the situation is exacerbated. Early on in our relationship Declan said he was going to jump, I said ‘you will have to jump tomorrow, I don’t have enough petrol in the car to rescue you today.’
That was the last time he felt that way. As I said before, I am not a doctor, I am someone with years of experience with a mood disorder who has tried to look objectively at a very subjective condition.
How to Understand and Manage Bipolar Disorder: Brain Injury and Occupational Therapy
I would love to say that I got Declan into writing, but that’s not the case. Declan does help with the production processes, but he is not interested in writing itself. We found something that does occupy him and that is local history. So, we visit local sites and purchase books on local history which Declan reads for hours, and he has joined online local history groups.
Managing mood disorders is all about converting that irritable energy into something positive and productive. It is about finding a useful distraction and engaging with it. The bad days will still come, but they will also pass. I promise they will pass. The charity that offers support to those with and those caring for Post-Traumatic Brain Injury can be contacted at ABI Ireland.
I hope something in this article is helpful to readers.
Valkyrie Kerry Kelly