Sunday 31 January 2016

Balance sheet brain

My friend and mental health colleague has written this insightful and heart-breakingly honest blog about her bipolar disorder: 

It is a fantastic read, and has inspired me to write down a few of my own thoughts on bipolar, and how it has shaped me.  I was only diagnosed with bipolar in 2013 (following an episode of postpartum psychosis), but I believe it has been with me throughout my adult life.  To be perfectly honest, for most of the time, I give it very little thought.  Why should I be defined by a diagnosis?  I'm a person (a very flawed and imperfect one!) and not a collection of symptoms listed in the DSM.

But, from time to time, I have to accept that bipolar becomes me.  Think of it like a child's see-saw: for much of the time the see-saw gently bounces up and down, the forces acting upon it are balanced and benign.  Gentle ups followed by gentle downs.  And quite a lot of time spent barely bouncing at all.  Bipolar becomes me when the control of the bounce has gone: the see-saw swings wildly from ground to sky and those once-happy tots are in grave danger of bouncing straight out of their seats.

Another useful analogy is the accountant's balance sheet.  Assets and liabilities.  

"Fixed assets" are those elements of my brain which are basically permanent: my genetic inheritance, the nurturing childhood I enjoyed, the relationship with my son and husband, the positive elements of my basic personality.

Conversely, "long term liabilities" are a constant balancing force on the other side of the equation: my innate selfishness, my notorious short fuse, the long-lasting after effects of psychosis and mental breakdown.

Heavy stuff.

But the more interesting aspect of the balance sheet analogy is the current assets and liabilities: those things coming in and out of my life, impacting my emotions and feelings and behaviours in an immediate (and usually temporary) way.  In a person who doesn't have bipolar disorder, these ebbs and flows tend not to have too many untoward effects.  But for a person with bipolar, they can have profound consequences.  

On the "asset" side:
- financial overconfidence
- workplace arrogance
- lowered inhibitions
- impulsiveness 
- thrill seeking.

All things which feel wonderful at the time (hence landing on the asset side) but which can quickly become "hypomania" and perhaps even mania or psychosis.  I have a long list of people to whom I really ought to make amends: old friends, ex boyfriends, work colleagues, former managers, family.  (I don't include the credit card companies which must have made a small fortune from the constant high-interest debt I serviced for over ten years).

On the liabilities side:
- Low self worth and self esteem 
- Anxiety
- Sadness
- Paranoia.

These are all the R easons why bipolar disorder is a "disorder" and not some Limitless-style magical way of being.  Feeling sad, low, unworthy, are all normal human emotions.  But in bipolar disorder it seems that the thought processes going along with it are an extreme: catastrophic, overwhelming, fearful. 

The cumulative effects of all these current "assets and liabilities" then become the long-term and fixed aspects of me.

I won't ever not have bipolar disorder.  I will always have this balance sheet brain. 

But I can certainly learn how to manage it, how to account for it, and (apologies for stretching this tenuous analogy to the very limit) be my own book-keeper.

Happy "Time To Talk" day!

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