Bipolar

Social Media & Bipolar Disorder | Can Social Media Activity Predict Depressive Or Manic Episodes?

images (71)In the past few days I have been able to come out from under the covers. Visiting family, taking walks, eating, bathing regularly, you know, the things that I take for granted when I am not sick. It feels good to see some light. Literally though, it has brightened up in terms of weather in the past two days which doesn’t hurt the progress.

During the last month or so I have really struggled with the lower end of this illness as evidenced by my intermittent to non-existent Blog posts, Tweets and Facebook activity. This got me thinking. Could social media play some role in predicting or somehow catching an episode whether it be an early stage depression or early hypo-mania? Of course, when I start to wonder things like this I go straight to Google and interestingly enough, I am not the only one that has noticed this.

I know that when I get depressed I have incredible anxiety. I get physically sick to my stomach when the phone rings, if I need to take care of some paperwork, pay rent, interact with people….Opening my computer to write, communicate on Twitter or Facebook becomes unbearable to think about. Emails feel like little attacks of more things that I am going to have to take care of. Then I start to get even more depressed and anxious because I am not keeping up with all of these things and I worry that I am missing some appointment or some important email. I worry about not keeping up on social media, hell, I am worried about who has been calling and what I am missing or what problems I might be causing myself because of the missed calls. It is irrational, I know. I can’t explain it. I know it sounds like a simple fix. Just suck it up and do it. One email at a time, just pick up the phone, it is probably just a friend, just look to see who it is that is calling before you answer. I can’t explain it, I can only share it. If you haven’t felt it, that knife in the gut feeling and then the guilt from not doing whatever that knife in the gut feeling images (69)stopped you from doing, you cannot understand. If you haven’t curled up into the fetal position and audibly moaned with agony from the butterflies on speed in your stomach, you can’t get it. It is not your fault, it just cannot be gotten. But I have gotten off track.

Back to my observation about my social media activity during this time of depression. I can actually track my activity on all platforms and watch it decline. My posts, tweets and Facebook messages become fewer and farther between as the depression continued. That made me wonder if the opposite might be true. I thought back to my last manic episode. It started early last summer and continued through most of the summer months. It was before this blog however, but during this time I had 5 Twitter accounts, I was dabbling in a couple of blogs, one is still active, 3 Facebook accounts for different causes that I had become involved in. I was even contacted by a radio host who wanted to do an interview because of my other blog and its cause. My posts were 2,3,4,5 am then 9am again. I was constantly monitoring my computer and my social accounts. I was obsessed. I couldn’t be stopped! A member of my family mentioned something to me about the strange hours that I was posting on Facebook, but that is all I heard about it. So I know that in my case, my activity on social media could quite likely be used to predict an episode, either depression or mania.

With a little searching, I found that this is being studied right now. Facebook in particular has been popular for researchers in terms of what is normal and what is out of the ordinary for the individual it is monitoring.

Here is an article about one such study: Facebook posts of Bipolar patients to be studied to monitor signs of relapse in world first study:

A world-first study will use Facebook as an early intervention tool to help prevent people with Bipolar from lapsing into manic episodes.

The Facebook use in Affective Disorders study will analyse the changes in social media use by an individual before and during a bipolar relapse.

If the first part of the trial proves that the Facebook monitoring helps to avert people from experiencing relapses then an application will be designed for users to download. ~ By Leesa Smith | Mail Online

Roisin Kiberd in, How Facebook Can Be Used to Predict a Manic Episode gives an example of some out-of-character Facebook use that he has noticed.

Recently a friend of mine began to post excessively on Facebook every day, usually between 5 AM and 8 AM. One day I used wordcounter.net to add up 9734 words in total; another day, 6288. His page became an archive of racing thoughts, manifested in aggressive, disturbing updates that friends found difficult to read.

Readers will remember a similar, very public series of tweets made by actor Amanda Bynes in the run-up to her eventual hospitalization, along with countless other examples both in public and private. ~ Raisin Kiberd

…it goes on the explain the method behind how researchers are planning to study what is normal Facebook use for an individual, and how that can be used as an indicator of a shift activity and perhaps mood.

The Facebook use in Affective Disord​ers (FAD) Study is currently underway in Melbourne, Australia; it’s a collaboration between researchers from the Monash Alfred Psychiatry Centre and computer scientists from the School of Intelligent Systems at RMIT University. It tracks the Facebook activity and mood of participants with bipolar disorder to work out what “normal” is for them, with the hope of alerting subjects when they begin to stray from their usual patterns towards a potential relapse. ~ Raisin Kiberd

In my research I even found a researcher from Michigan who is testing a phone app that would predict Manic episodes in Bipolar patients by monitoring the user’s voice. The app would record the user’s voice picking up changes in speech patterns, intonations and speed to predict a manic episode. The data would be sent to the user’s doctor for monitoring so that the doctor could be aware of the patient’s possible oncoming episode. You can read more about it hereApp May Help Predict Manic Episodes in Bipolar Disorder

I suppose then, that I am not the only person to have noticed that there might just be a link here. I’m not sure how soon we will have access to any of these apps or on-line tools to monitor our social media activity, or that anybody would want them to, but I do think that it is a good tool that we can use ourselves. I find it particularly helpful in a hypo-manic stage. If I am depressed, it doesn’t take the guilt of not keeping up my on-line presence to let me know that I am depressed, but when I feel good, that is when I might need to pay more attention.

There is a fine line between happiness and illness with this disorder. It is actually one of the things I find most frustrating. I am never quite sure if I am doing well and am happy or if I am becoming manic and need to monitor myself after I finally feel great. Is it happy or is it hypo mania? It is extremely disappointing to discover that it is the latter, and that it is now time to medicate away the enthusiasm. I think with experience we get closer to understanding on what side of that fine line we are on, and if it is travelling in one direction or the other. I believe that happiness is feeling good without needing to do, or be or go, or have anything. It is quiet, contentment, without the busy, racing sun storm. There you go, I think I am getting closer to recognising that line after all.

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Awareness, Bipolar, Information and Resources, Shared, Social Media, Stigma, Video

The Stigma Fighters | Fighting The Stigma Of Mental Illness One Story At A Time

cropped-cropped-cropped-Stigma-Fighters-V1Stigma Fighters is a blog series about real people living with mental illness.

The site aims to raise awareness about mental illness. It addresses stigma by creating a platform for people to share their personal stories and experiences battling mental illness. Sharing personal stories from everyday people, doctors, students, teachers, those who haven’t dared share this part of their lives because of the misconceptions, creates a more realistic representation of the face of mental illness. For those of us battling our illness, reading the struggles of others and sharing our own can be healing, and a way to feel less isolated and alone.

Plus, they have T-Shirts!

[…]I wanted to show the world that there are people living with mental illness who are not just homeless or institutionalized. There are those of us who are living within the confines of society.

There are teachers, doctors, lawyers, psychologists, actors, writers all living with mental illness. These are the stories that need to be told; the people who seem to be “regular” or “normal” people but are actually hiding a big secret. They are living with an invisible illness. They are struggling to function like the rest of society.

I’m using my forum to raise awareness for people (like me) who are seemingly “normal” but actually fighting hard to survive.

~ Sarah Fader

Websites                                                Twitter

The Stigma Fighters                          @stigmafighters

The Stigma Fighters Canada          @stigmafightersc

There are two chapters, US and Canada, created by Sarah Fader (of Old School New School Mom)

The Canadian page is managed by the bipolar dynamic duo, Marisa Lancione (Mad Girl’s Lament) and Nicole Lyons (The Lithium Chronicles).


Awareness, Bipolar, Information and Resources, Shared, Social Media, Stigma, Video

Feisty Stigma Fighter Video

This sassy, to-the-point video exposes the reality of not just stigma surrounding mental health, but blatant neglect and unsympathetic treatment of those suffering from mental illness. It’s almost as though when someone is open enough to share their illness, there is still that lack of certainty about the validity of the claim. Like, does she really have depression, or does she just want attention, or is she just dwelling on something for too long. Is she having a pity party? Is she even trying to not be depressed? I still feel as though I will be perceived this way if I share. I am choosing to be open though. I will not allow anyone to make me feel as though I am allowing this to happen, that it is completely in my control. It 100% is not.

Here is the video. Enjoy!

Awareness, Bipolar, Information and Resources, Social Media, Special Days or Events

Mental Health Twitter Group ~ Come And Connect!

https://twitter.com/MentalHealthTL/status/559708156155396096

Bipolar, Shared, Stories

Why I Sometimes, Rarely, Never Tell People I Have Bipolar Disorder

This is a great post by Dori Owen from “The Lithium Chronicles” about how stigma silences and isolates those with mental illness. It has some great descriptions of what people know, or think they know about the illness; and thinking they know means dialogue shuts down. It’s worth a read!

Why I Sometimes, Rarely, Never Tell People I Have Bipolar Disorder.

“Why is it that every organ in your body can get sick and you get sympathy except the brain?”―Ruby Wax

Subtitle: It would be so much easier to disclose I have a blood disorder. Which I actually do. But unlike a bipolar disorder it’s not so much of a conversation stopper. Most people have never heard of it so a lengthy explanation on the blood disorder follows. They then become well-educated on what the it is and how it affects me.

Bipolar, Information and Resources, Shared, Social Media, Video

UP/DOWN: a documentary about bipolar disorder

This is a full length video about bipolar disorder called “UP/DOWN”. It is a good tool to help educate about the illness. I believe education is key to ending stigma associated with mental illness.
There are approximately 5.7 million people in the United States with bipolar disorder. In an attempt to eliminate the mystery and misinformation surrounding the illness, many throughout the country diagnosed with this condition were interviewed extensively. They diligently explain the struggle to balance themselves between floating to a state of euphoria and sinking to a devastating depression.[…] In short, “Up/Down” is a personal analysis of bipolar disorder from those living with it.
Awareness, Bipolar, Information and Resources, Musings, Stigma

Ending The Stigma Of Mental Illness ~ Not Calling It Mental Illness Might Be A Good Start

download (4)It is wonderful to see that there is an increased awareness of and drive to end the stigma associated with mental illness. Bell did a great job with their “Let’s Talk” Campaign, raising $6, 107, 538, 60 toward mental health initiatives! There is more dialogue happening than in the past, and I think that more than ever people are speaking out about their illness, and that even those without a mental illness are speaking out for those suffering. I think that it will continue to grow and through education and dialogue the stigma will become less of a threat to so many suffering.

images (42)If I am totally honest though, I still feel as though I live under the shadow of stigmatization and fear the consequences of sharing my illness with others. I recently wrote a post about a couple of incidents that made it very clear to me that there is a misconception about what mental illness looks like. You can check out the story here.

I have been living with Bipolar 1 for as long as I can remember, although I have only been living with medically treated Bipolar 1 since my diagnosis about 10 years ago. I have come to terms with my illness. Although I have to admit that despite knowing now that my manic and depressive episodes had a medical explanation, and that my condition is stable with proper medical care and medication, I still am not willing to be completely open about my illness. I am very careful about sharing that part of myself.

images (39)The illness has caused me an incredible number of challenges, missed opportunities, loss, has lead to self-destructive behaviour and I have hurt many people that I love. Fortunately, I have had the privilege of working with medical professionals to monitor my medications, I have psychiatric treatment/counselling and I’m learning to recognize symptoms and to make positive lifestyle changes. Thanks to this I live a fairly normal and functional life. Proper treatment allows me to maintain balance and some stability, reducing the number and the intensity of episodes I experience.

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I have to ask myself though, why are we still differentiating between physical and mental illness? Mental illnesses are a result of brain functioning, and I’m pretty sure the brain is a part of the body. Is it not? Not to mention the fact that symptoms respond to medication, which can in turn allow a person to lead a relatively stable and balanced life.

Maybe we need to rethink the divide. If what is considered to be physical illness is usually diagnosed by definitive tests, is often visible, and is viewed as a legitimate affliction, then mental illness must be something else.

images (49)Unfortunately, differentiating between physical and mental illness gives the impression that mental illness is something different, that it is not an illness of the body and therefore must be a problem of the “mind”. The mind is associated with behaviour, personality, and amongst other things, the ability of one to change or choose their disposition. Maybe the very distinction is perpetuating the stigma. Perhaps the decision to no longer label one type of illness physical and one mental is a necessary beginning step in ending the stigma.

Why do we differentiate between mental and physical illness? Where does this come from? Why does it matter?

There is much debate over the definition of Mental Illness. It is generally accepted that it exists and that it can have serious and an often detrimental impact of the lives of those suffering.

While there is debate over how to define mental illness, it is generally accepted that mental illnesses are real and involve disturbances of thought, experience, and emotion serious enough to cause functional impairment in people, making it more difficult for them to sustain interpersonal relationships and carry on their jobs, and sometimes leading to self-destructive behaviour and even suicide. The most serious mental illnesses, such as schizophrenia, bipolar disorder, major depression, and schizo-affective disorder are often chronic and can cause serious disability.~ SEP

download (2)The mainstream Western view of mental illness has changed with increased knowledge and conceptual sophistication. We have moved past the  less sophisticated, ignorance based view that what we now call mental illness was demon possession, or the result of some other supernatural phenomenon. Could the archaic diagnosis of a spiritual or supernatural cause of mental illness  still be lingering in today’s perception?  What do we mean when we differentiate mental and physical illness? To me that would imply that a mental illness is somehow an illness or disruption in some part of a person that is external to the physical body wouldn’t it? Which in turn would have to mean that we are more than our physical body, and that our mind is something outside of our physical selves.

At this point some of you reading might be thinking “who cares”? Well, being diagnosed with what is called a mental illness as opposed to a physical illness can have serious, life altering consequences. Including employment, issues with insurance and discrimination, to name a few.

There are limitations and difficulty surrounding medical insurance, being qualified to receive care and benefits that someone with a physical illness would receive even though the mental illness is causing comparable limitations. There is fear of informing employers because of concern about jeopardizing a career, even though it would be beneficial for an employer to understand the illness so that he would understand that the employee might need a to step out for a moments or whatever the case may be, rather than not understanding and chalking it up to laziness or incompetence. For example it might be important for a diabetic to inform his or her employer so that there is an understanding and accommodation for certain behaviours and needs related to the illness. It does not feel safe, however, in the case of mental illness.

The reason that the parity debate exists at all is because our institutions (governmental, legal, medical, insurance/financial, etc.) are and have been (for hundreds of years!) invested in the idea that mental disorders (such as depression, psychosis, and anorexia) are somehow fundamentally different (less real, more the fault of the victim/patient, and less deserving of support) than physical disorders. Though we know today that this view (that mental disorders are different and/or inferior to physical disorders) is false, the legacy of these older prejudiced beliefs still rules:

~Within any given health insurance plan, the coverage for mental disorders is inferior to that provided for physical health concerns.

~Many health insurance providers don’t even underwrite their own mental health coverage, but rather ‘carve it out’ (sub-contract it) to other specialized companies.

~Mental and physical disorders are actually diagnosed using separate diagnostic books. In no other field of medicine (that I’m aware of) is this done! Mental disorders are diagnosed using the “Diagnostic and Statistical Manual of Mental Disorders (the DSM)”, and physical disorders are diagnosed using the “International Statistical Classification of Diseases and Related Health Problems (the ICD)”. Last I understood, the DSM is also considered a ‘carve-out’ of the ICD in that the DSM (published separately) is considered a code-compatible sub-section of the larger ICD which covers physical disorders.

~While there is stigma involved with all illness, you get stigmatized (discriminated against) by employers and society at large more when you have a mental illness as compared to when you have a physical illness. No one thinks less of you for consulting a physician for diabetes, but they generally will if you consult a psychiatrist for depression.

~ Mark Dombeck, PhDBlurring The Boundary Between Mental and Physical.

download (3)Clearly there are serious consequences in differentiating between physical and mental illness. Sure, there are differences, but there are also differences between illnesses that are both considered physical. Could it be possible that the distinction itself between physical and mental illness is adding to the problem of stigma?

I have been wondering about this for a while, so I thought I would ask the question. I have no training in medicine or psychology but I think it would be safe to say that most medical professionals treat patients based on the assumption that they are physical beings. Where would a “mental illness” originate if not in the brain? The brain is an organ. Why then, is an illness that is the result of improper brain functioning not physical? Hypothyroidism has been associated with Bipolar like symptoms, behavioural symptoms. The malfunction is in the thyroid gland, but is causing “mental/emotional” symptoms. Why is it not a mental illness? How about damage to the brain causing behavioural changes, or any other disorder that is considered a physical illness (like epilepsy, stroke, etc.) that is a result of activity in the brain? Why are those physical illnesses and not mental illnesses?

images (4)In my opinion, I don’t see how any illness that causes symptoms that are shared by millions of people, responds to some variation of the same category of treatments, and that originates in an organ in the body can be anything other than a certain type of physical illness. Illness is illness, and illness occurs in the body. Unless we want to get into arguments about the mind being something outside of or separate from the body, something supernatural, I’m pretty sure most of us would agree that what we call our mind is our brain in action. The mind is the state when the brain is alive and at work. A living functioning brain produces the mind, so mental illness by that definition of mind would be caused by a malfunctioning of the brain, causing symptoms in the mind.

download (22)It is a big question to ask, but I do think that the stigma surrounding mental illness is perpetuated by our continuing to treat mental illness as something different from physical illness. It is all physical illness. They may represent symptomatically different, but they all originate in a part of the (physical) body.

Sources:

Bell Canada (Bell “Let’s talk” campaign)

Seven Counties Services Inc., Blurring The Boundary Between Mental and Physical. By: Mark Dombeck, Ph.D.

American Psychological Association: The roots of mental illness: How much of mental illness can the biology of the brain explain? By Kirsten Weir

Stanford Encyclopaedia of Philosophy: Mental Illness.