• Juan-Fernando Duque-Osorio

How to Get Rid of the Changes in Thoughts and Plans Caused by Bipolar Disorder?

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Summary: A couple of romantic fantasies that I published recently are cited. I don’t like to feel the desire of bringing them to reality when my mood is low. Other examples are the temporary romances in which we bipolars can embark when our mood gets risen. Private therapeutic writing serves to help stabilize our mood, preventively and curatively, thus avoiding making inappropriate decisions with lasting consequences, among other therapeutic benefits.

Key Words: #PrivateTherapeuticWriting #Fantasies #DestructiveRomances #InappropriateDecisions #PreventingChangesInPlansAndThoughtPatterns #GetStabilizedToMakeGoodDecisions #GettingRelieved.



Last Monday I had my mood a little low and the flu, from which I have already recovered and hopefully wanted it be COVID-19 to gain at least some immunity; although I don't think it was said disease because it was a very mild flu. In fact, the low mood affected me more and I had changes in plans such as not continuing to specialize my blog in bipolar disorder. What do you think of this idea? And that is what I want to talk about in this post: in the changes of plans and even of personality when the mood alterations typical of bipolar disorder occur and find how to solve this type of situations.


Before this, on Saturday I was chatting with another bipolar patient and we agree that it is as if one does not know what his true self is with so many mood swings. Even so now that my changes are minimal. So since yesterday I was looking for scientific articles on personality or plans changes with the variable course of bipolar disorder, and in addition to the patients getting involved in fleeting love affairs during manias and hypomanias, I didn't find anything else.


But in cases of strong manias this can be a big problem because the patient runs the risk of losing his family, destroying his family and/or losing the love of his life, due to one or more temporary loves during an altered state of mind. During my life I only had two long relationships of five years each, and in both I was unfaithful several times. I don't know if this was because of the polygyny (polys = several and gyne = female) typical of a young man or because of my bipolarity. Most likely, it was a mixture of both. But as for women, now in my 46 years, I almost feel beyond good and evil because I think I have fulfilled my sales quota (men function as salespeople and women as clients and sales are the consummations of each relationship) and I decided to stay single and without children, among other things to be able to study calmly and live the things typical of a bipolar disorder without greater demands from the environment in which I live.


So, the above seems like an already firm plan. But when my mood decreases, I hesitate and wonder what would have become of me if I had done this or that in past relationships. Each time I hesitate less. But in 2015 when I got what I call my crisis of "marriagitis" I got to feel very bad for not having married and I began to have many romantic fantasies whose plots I managed to write down in my Microsoft OneNote and in recent months I have been posting as stories (“For Writing About Bipolarity I was Adopted by a Beautiful Patron in the Suburbs of Bogotá” [1, 2] y “Succumbing to the Marital Slavery Because of Slavic Girls (Ukrainians)” [3, 4]). Even during last Monday and because of mildly low mood I felt nostalgic for not having reached something definitive with a girlfriend I had in my 20s in the early 1990s. I thought I was completely over all this, but it seems like this kind of things never gets completely overcome. I am talking about to the minimal and fleeting desire of having started a family. But when I think about things like the costs, discomfort, effort, loss of freedom and possible disappointments of having a family, I feel like a legend for having arrived to my 40s without marital or reproductive messes [5-7].


But I do not like these changes on my wishes because, although now they are very slight and temporary, they deviate me from my objectives. I tried to find how to minimize them in some scientific article and I did not find any, no matter how much I searched. I repeat, the most that is talked about in these bibliographic sources is the danger of taking temporary loves seriously when we bipolars get our moods raised (manias or hypomanias).


So, I'm going to write here how I solve this little problem, which is another of the "hazards of the job of being bipolar." A habit that all people should have and especially those who have a mental condition is to keep a log or diary, whatever you want to call it, where the patient can write freely and without the fear of someone else reading it. I do it in Microsoft OneNote, which is free and every week I reread my notes and pass them to a database that I made in Microsoft Access protected by a password, which allows me to have an active file (OneNote) and a passive file (Access). This, in addition to functioning as therapeutic writing [8-15] which is perhaps the most important, serves to describe the different points of view that one has, depending on the state of mind when writing, on such important things as the meaning of life, relationships, stressors and possible triggers of a crisis and how to react to them. But it also allows us to identify who our true self is like: When are certain goals in life lasting and workable? When is a relationship is deep and lifelong? It even allows you to keep a record our neuropharmacological formula to determine what the right doses are for each of medications that one takes. I repeat, it allows one to identify who one’s true self is in the periods when one is free of symptoms. That is why it is important to continue writing in a private log even when you are well, to be able to identify those sensible, lasting and healthy thought patterns. It even helps to make important decisions because we bipolars are impulsive and we can, excuse me for the expression, "screw it up" when making a quick decision that can have negative and lasting consequences. By keeping a diary, you can see, from different points of view, corresponding to the different states of mind or mood, a question to make the right decision. Once you feel or think the same about an issue, during several writing sessions, and I repeat, from various points of view (moods), then you may be reaching an appropriate, sensible and correct decision.


Maybe, if the patient is in a very serious condition from the psychiatric point of view, the most urgent thing to do is stabilize him with the help of medicines, since it is an emergency situation and at those times it is not possible to keep a diary. But if you can read these lines, and even if you are depressed or hypomanic, you can write too. In other words, I think that the more severe the state, be it depressive or manic, the more important the medicines will be, because I repeat, it is a matter of emergency. But as the patient progresses, psychological aids such as writing a journal begin to be more useful to complement pharmacological therapy. Even if one is in a depressed state of some severity, writing therapeutically can be a great help to get relieved and after a while it serves as a reference so that the patient can see his own progress and believe me, this is rewarding.


Keeping a journal can even help the person so much that after practicing it for several years it can contribute to reducing the doses of the medication taken. It is not about starting to write and immediately lowering your doses. We must be clear that, faced with a mental condition, I am a pro-medication patient. But psychotherapeutic things like keeping a private log or diary can lead to the need for fewer doses, I say this because that has happened to me. Therapeutic writing, I repeat, helps to find out the right pharmacotherapy for each patient.


I generally write in my private log listening to music on my tablet and comfortably lying down. It is super-relaxing. Just for pleasure should it be done. It is a pleasure that causes many benefits. I have it incorporated as the core of my sleep hygiene (another super-important practice that deserves a separate post) to lie down to listen to music and write in my private log for an hour and a half. I do it every day and it helps me release the "steam excess" of the day.


I get along very well with my mom. But a few weeks ago, we had a little argument and when my therapeutic writing time arrived, I was able to vent, be more empathetic and we were able to resolve our difference in a much healthier and faster way. You probably have a boss to whom you cannot say things to his face for fear of losing your job. Well, express all these things in your private diary and just by writing them you will "live the fantasy" of having told them and when you meet him you will be relieved and you will be able to speak to him in a relaxed and respectful way. In general, writing about our interpersonal relationships privately helps them to be healthier without meaning not to express openly the things that bother. Therapeutic writing helps to express them better and in a more delicate way.


I started practicing therapeutic writing in 2007 when my dad died. In cases of grief, it is especially helpful because, in addition, to exhaust the sadness, one can live the fantasy of talking to the loved one who left, saying him nice and ugly things (why did you leave!), that perhaps you never said when your loved one was alive. And all this is particularly important in people with a mental condition such as bipolar, in the face of which traumatic things such as mourning the loss of a loved one can get complicated.


I have used the expression "live the fantasy" about twice in this writing and also used a bad word. Well I'm going to use another. Fantasies are "mental masturbations". But they work very well as therapeutic tools. Why? Well, I think it is for the same reason that one enjoys watching TV, going to the cinema or the theater. And Desmond Morris explains it very well in his book "The Nature of Happiness" [16], that was already reviewed in this blog [17, 18]. It turns out that the symbolic capacity of us humans allows us to enjoy works of art like scenic ones. The typical example is the words. The sequence of graphs t, r, e, e actually has nothing to do with a large wooden object that provides shade, but we still understand the meaning of those graphemes placed in a certain sequence. This is why the human brain is easily fooled. That symbolic capacity then allows us to enjoy a movie or any piece of scenic art as if they were real. We consciously know that the actors are professional liars [19] and that the whole work is that, a lie; and even so we get excited and live it. Well, the same applies to what we can write in a private log. We can live, inside our brain, fantasies that allow us to vent and improve ourselves psychologically. I am already taking this to the public level, as in the last two romantic stories that I published (“For Writing About Bipolarity I was Adopted by a Beautiful Patron in the Suburbs of Bogotá” [1, 2] y “Succumbing to the Marital Slavery Because of Slavic Girls (Ukrainians)” [3, 4]) for which I need to be a little crazy to air those fantasies publicly. Maybe that's why my blog posts are so personal, because that's the way I've been writing for 13 years on my private log.


I'm divagating a bit already, but I keep going. And after several years of thinking with the help of my private log, I have come to the conclusion that it is better that those romantic stories remain as fantasies, for two main reasons:


Costs: Having a well-kept family costs a lot of money and to have a lot of money you have to work a lot. And I like to take it easy reading and writing. Sometimes I go too far writing like in that endless story that I published (“For Writing About Bipolarity I was Adopted by a Beautiful Patron in the Suburbs of Bogotá” [1, 2]). And although in 1988 (14 years of age) my bipolarity began to manifest itself in a severe way (manic-depressive degree), now I have mild bipolarity (cyclothymia) in part because I do not have the stressors (and crisis triggers) of dealing with children that luckily, I never had.


Beauty scale: Maybe, for being more sensitive as the bipolar than I am, I was more impressed by the beauty I see in women on TV and in movies. So, when it comes to females, I only have one scale of measurement (the movie and TV scale) while most common men have two: the movie and TV scale and the real-life women who are within one’s reach. The result of this is that almost none of the women I had access to, were seriously taken by me because they did not classify on my scale of feminine beauty.


And I am already divagating to much a lot because we had started this writing on how to have stable thought patterns in the face of the mood variations that we bipolars have. But it is that the romantic examples that I have given are the typical example of decisions, such as dying as a bachelor, that I do not like to change. What's more, these changes, like feeling nostalgic for a girlfriend (who was probably the only one that did fit my demanding beauty scale) in my 20s in the 1990s can be indicative of being in a dysthymic state (small depression) as was the idea of not going ahead with my blog. So, writing in a private log not only becomes a curative activity but also a preventive one because by writing what one can realize patterns of thought that are repeated when one is deviating of his euthymic state (true mood, normal mood). So therapeutic writing is not only a healing tool for changes that can be inconvenient but also works as a therapeutic aid to detect early symptoms (prodromes) of mood and affect alterations. And the faster you can act on these mood deviations, the better because a hypomania or depression will be avoided. This with the leading help of adjusted pharmacotherapy (which can be reached by keeping a log) and complemented with other therapeutic tools such as sleep hygiene. If it weren't for my hour and a half of free writing, my sleep hygiene would not work well and I would not be able to reach stability in terms of the time I currently all asleep (10:00 pm).


More can be written about therapeutic writing, based on more specialized bibliographic sources, but since this article is to be shared with other patients or their caregivers, it depends on the questions from you, my readers, if I continue to delve into this topic. So, if sections this writing seemed like being very personal and pointless, I apologize and explain again that it is the result of my decade+ of practicing my egocentric, private and therapeutic writing.


Thank you very much for reading this public post (it is derived from, but does not belong to my private log. These types of writing should very well differentiated).


References:

1. Duque-Osorio JF. Por Escribir Sobre Bipolaridad me Adoptó una Hermosa Mecenas en los Suburbios de Bogotá. El Blog de Juan Duke; 2020. Available in: https://bit.ly/HermosaMecenas. Accessed on 26-Ago-2020.


2. Duque-Osorio JF. For Writing About Bipolarity I was Adopted by a Beautiful Patron in the Suburbs of Bogotá. Juan Duke's Blog; 2020. Available in: https://bit.ly/BeautifulPatron. Accessed on 26-Ago-2020.


3. Duque-Osorio JF. Sucumbiendo a la Esclavitud Matrimonial por unas Eslavas (Ucranianas). El Blgo de Juan Duke; 2020. Available in: https://bit.ly/NoviasUcranianas. Accessed on 26-Ago-2020.


4. Duque-Osorio JF. Succumbing to the Marital Slavery Because of Slavic Girls (Ukrainians). 2020. Available in: https://bit.ly/SlavicGirls. Accessed on 26-ago-2020.


5. Duque-Osorio JF. Mis padres planearon mi vida y quedé impoluto en cuanto a enredos matrimoniales y reproductivos. El Blog de JFDO; 2020. Available in: https://bit.ly/3eyC9SV. Accessed on 27-Mar-2020.


6. Duque-Osorio JF. My Parents Planned my Life and now I am Unpolluted Regarding Marital and Reproductive Messes. JFDO's Blog; 2020. Available in: https://bit.ly/2UqgPb3. Accessed on 27-Mar-2020.


7. Zelinski EJ. The Joy of Not Being Married: The Essential Guide for Singles and Those Who Wish They Were. Visions International Publishing; 1995.


8. Fernández E, Bacon F. Invitación a la Escritura Terapéutica: Ideas Para Generar Bienestar. International Journal of Collaborative Practice. 2013; 4(1): 27-47. Available in: https://psicopedia.org/wp-content/uploads/2016/03/Invitacion-a-la-escritura-terapeutica.pdf. Accessed on 17-Oct-2019.


9. Gual ME. Carmen Martín Gaite: la escritura terapéutica. Revista de literatura. 2014; 76(152): 575-603. Available in: http://revistadeliteratura.revistas.csic.es/index.php/revistadeliteratura/article/download/349/364. Accessed on 17-Oct-2019.


10. Kohan SA. La escritura terapéutica. Alba Editorial; 2013.


11. Reyes-Iraola A. El uso de la escritura terapéutica en un contexto institucional. Revista Médica del Instituto Mexicano del Seguro Social. 2014; 52(5): 502-509. Available in: https://www.redalyc.org/pdf/4577/457745484010.pdf. Accessed on 17-Oct-2019.


12. Baikie KA, Geerligs L, Wilhelm K. Expressive writing and positive writing for participants with mood disorders: An online randomized controlled trial. Journal of affective disorders. 2012; 136(3): 310-319.


13. King R, Neilsen P, White E. Creative writing in recovery from severe mental illness. International Journal of Mental Health Nursing. 2013; 22(5): 444-452.


14. Suhr M, Risch A, Wilz G. Maintaining mental health through positive writing: Effects of a resource diary on depression and emotion regulation. Journal of clinical psychology. 2017; 73(12): 1586-1598.


15. Wright J, Chung MC. Mastery or mystery? Therapeutic writing: a review of the literature. British Journal of Guidance & Counselling. 2001; 29(3): 277-291. Available in: https://bit.ly/TherapeuticWritingAReview. Accessed on 05-Ago-2020.


16. Morris D. The Nature of Happiness. Little Books, Limited; 2006.


17. Duque-Osorio JF. Reseña Anecdótica del libro “La Naturaleza de la Felicidad” de Desmond Morris. El Blgo de Juan Duke; 2019. Available in: https://bit.ly/ResenaNaturalezaFelicidad. Accessed on 29-Ago-2019.


18. Duque-Osorio JF. Anecdotal review of the book "The Nature of Happiness" by Desmond Morris. Juan Duke's Blog; 2020. Available in: https://bit.ly/NatureHappinessReview. Accessed on 26-Ago-2020.


19. Ganten DA, Deichman TA, Sphal TA, Coll AA, Campos JAA. Vida, naturaleza y ciencia: todo lo que hay que saber. Taurus; 2004.

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