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In a continuation of the 3 New Things series, this week follows up on the British Psychological Society’s critique of the Diagnostic and Statistical Manual of Mental Disorders, version 5 (DSM-V), talks about irritable mood in bipolar disorder and expresses my general disdain for people who can’t report about mental health accurately.
Irritability is a symptom for both depression and mania/hypomania in bipolar disorder. This seems to suggest people with bipolar disorder run around biting the heads off of everyone we meet, but this isn’t the case. While I may feel angry and irritable, I, for one, can cover this up as I know it’s a symptom of the illness and not really me.
The interesting thing is, some patients don’t even consider themselves irritable because they have the ability to hide it. Note the following interesting quote:
Patients may not understand what elevated, or euphoric, mood means, so it may be necessary to define these terms. Similarly, the meaning of “irritable” may be unclear to patients. Many patients do not regard themselves as irritable if they can refrain from expressing their easy propensity to anger. Therefore, it is critical to emphasize that although the anger may not be expressed outwardly, the emotion of simply feeling irritable is significant.
From: Psychiatric Times, Mixed States in Their Manifold Forms: Part I
Last week I asked if the British Psychological Society (BPS) was reputable as I questioned the motives behind their critique of the DSM-V revisions. It’s not that they don’t have their points, it’s just the points they’re making are copied-and-pasted to virtually every diagnosis either new to the DSM or not. It turns out my suspicions may have been wrong. The BPS does seem to be a genuine, reputable organization.
I came across an article in Psychiatric Times that explained issues with the BPS’s DSM-V critique beautifully – by blindly applying the same “feedback” to virtually every part of the DSM, their feedback has no weight at all and smacks of an agenda.
Even if they say something people should be listening to, it gets lost in the din of all the noise caused by putting the feedback where it doesn’t belong (article).
rTMS does not use magnets to “realign” a person’s brain.I am not a reporter. I try to be a true, honest, accurate writer of credibility, but a reporter I never claimed to be. For actual reporters though, I rather think they have a higher bar.
Like, to write things that are accurate. Exhibit A:
The treatment [rTMS] hinges on the idea that every cell in the body has an electromagnetic field, and when this field is out of alignment, problems develop. RTMS then uses the highly focused magnets to realign a depressed person’s brain, and get it functioning properly again.
For the record, that is incredibly wrong and rather stupid. rTMS has nothing to do with cells having “electromagnetic fields” and there is no such thing as “realignment.” That all sounds like new age mumbo-jumbo which, in this case, takes actual science and turns it into nonsense. All I can say is that if you read something in the media, you’d better check out the facts yourself because it sure seems like the reporter isn’t going to bother.
rTMS uses a very strong, magnetic field that rapidly changes polarity to create an electrical current. This current activates neurons in a specific part of the brain just like electroconvulsive therapy, but without the cognitive side effects (or likely, effecacy rate).
Perhaps it’s too much to ask that a reporter understand those two sentences. Sheesh. (And for an extra dose of outrage, check out the comments, which can only be inflamed by the misinformation in the article.)
Natasha Tracy is an award-winning writer, speaker, advocate, and consultant from the Pacific Northwest. She has been living with bipolar disorder for 26 years and has written more than 2000 articles on the subject.
Find more of Natasha’s work in her acclaimed book: "Lost Marbles: Insights into My Life with Depression & Bipolar" on Amazon.
Connect with Natasha at the social media links below.
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Kerri, you articulated your experiences in a way that I, and I imagine many others, can relate to. The out-of-proportion irritability at tiny things, and the tools you use for dealing with it. Lately I have found that becoming conscious in the moment of my irritability or anxiety, and being a little detached about it, mildly analytical, can take the sting out of it. Thank you for sharing your experiences.
Hi Jenn,
“Lately I have found that becoming conscious in the moment of my irritability or anxiety, and being a little detached about it, mildly analytical, can take the sting out of it.”
I do this a lot. It is a double-edged sword. It means that I don’t react emotionally to stimuli but it also means I tend to repress a lot and become overly-analytical and intellectual. I prefer this to the alternative, but it’s not exactly peachy-keen either.
– Natasha Tracy
Agreed.
I’m overly analytical anyway, and often wish I would just experience my emotions. I mean genuine sadness, grief, joy etc.–not depression or hypomanic giddyness.
Jenn,
“wish I would just experience my emotions. I mean genuine sadness, grief, joy etc.–not depression or hypomanic giddyness.”
I know. “Normal” people who get to do this have no idea how lucky they are.
– Natasha Tracy
Hi Natasha, I have Bi-polar 2, and years before I understood my illness, I thought depression and racing thoughts, speeding, thrill seeking etc., were my only expressions of a problem with my moods. I didn’t realize irritability was part of an assortment of symptoms I had of Bipolar 2. I seriously thought every so often every one around me just haphazardly started doing things to excessively piss me off. That it was their fault, everyone else’s fault in fact and I was just responding appropriately. I would also feel irritability and extreme anger, but did not really listen in to the internal dialogue going on at these times, to hear the inappropriate thoughts I was having.
Once I started to learn through blogs such as yours and journal articles, that irritability can be a symptom of hypomania/or/mixed mood I started to really listen to my thoughts and not just be driven blindly by the emotion. An example of this would be, one day I was hypomanic and I went to the grocery store to get some sliced meat. I was on a tight schedule as I had school pick up, and was a bit rushed. Then I requested some freshly sliced meat from the deli. Unfortunately the girl behind the counter said that they were cleaning the slicer and I would have to come back in 10-15 minutes. Normally I would be annoyed anyway, because the middle of the afternoon doesn’t seem like a smart time to be cleaning equipment. But I’d acquiesce and grumble quietly whilst occupying myself for the required time. But this day I held my breath and stood very still. I had to control myself because I suddenly had this incredible urge to run to an isle, pick up very heavy cans of groceries and return to throw them at the back wall of the deli. I listened and realized I was having the thought, I want to throw cans at this person til they are backed up in a corner cowering in fear on the floor. Now thankfully I didn’t do any thing like that, but I really had to dig deep to focus, be aware of my thoughts and walk away without commenting. My nails were digging into my hands as I did so. In the past I would still have walked away, but I would leave thinking that the person was evil and horrible and deserved to be pummeled for their bad actions, but they were really lucky I had values and would restrain myself today. It didn’t enter my head that my thoughts were disproportionate, nor did I click that having to reach really deep to restrain myself was a problem. I thought, the only people with anger problems, were the people who acted out that rage. I didn’t understand that being totally enraged and feeling like I needed to explode over delayed meat buying was a problem. I also didn’t click that apart from 10 days in every three months, I wouldn’t responded in this. I might feel mildly annoyed but that’s about it. So in my case I had very very poor insight into the cyclic nature of my moods and the nature of these weeks when I would become internally enraged over almost anything, jay walkers, drivers going too slowly, red lights taking too long, people breathing too loudly anyone talking to me at all, and so many more I can’t count. It amazes me now, that in the past I could be so dominated by moods and behaviors, yet so unaware of the things that were driving me.
Hi Kerri,
Thank-you do much for leaving this comment. I think so many people feel exactly like you did. So many people don’t have the insight you’re sharing.
It’s really a revelation when we realize what is _us_ and what are just symptoms. It’s also a big jump forward when we stop blaming other people for “making us feel” angry, irritable or other things that are related to our illness.
Thanks for being brave enough enough share.
– Natasha Tracy