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  • mercurialmind 5:06 am on June 22, 2019 Permalink | Reply
    Tags: , , caffeine, food additives, HPA axis, hypomania, irritability, mixed depression, Pitta   

    Recently I’ve experienced symptoms that seem more in the direction of hypomania than depression. I think this could be possibly due to drinking more caffeine in the afternoon, deliberately phase advancing my sleep schedule because of job, changing my diet and increasing my stress by working more hours. Some of my symptoms included racing/crowded thoughts, a decrease in the amount of sleep, and periods of extreme irritability. Today I had a bad case of rage over something minor and I realized that I had consumed junk food(Cheetos) and more caffeine than usual and at a later time.Rage in connection to junk food( MSG?) and caffeine is something that has consistently been a problem ever since a teenager. I noticed in the news that there recently has also been a connection with sodium nitrate and mania. It occurred to me that both sodium nitrate and junk food can induce severe thirst. Thirst/water balance is in turn intimately connected with the HPA axis. Perhaps an increase in cortisol here? The increase in excitability seems fairly close to when the food is eaten and the excitabilty is reduced by consuming water. Ayurveda would concur that food items which cause thirst would be the ones who would also increase irritability. Ayurveda would also say that an increase in thirst inducing foods would change one’s perception of temperature. This seemed to be the case since I felt much warmer than usual.

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  • mercurialmind 10:26 pm on August 9, 2018 Permalink | Reply
    Tags: Bourdain, , mixed depression,   

    A case for mixed depression with Bourdain 

    Mixed depression according to some researchers is rather common but for some reason 0AMZgedO_400x400people don’t think of it when someone like Bourdain commits suicide. Perhaps the depression goes unrecognized since the person’s behavior isn’t consistent with depression and the hypomanic symptoms are not meeting some arbitrary threshold. According to Targum:

    “Mixed” depression is a clinical presentation in which a patient meets the full criteria for MDD and, at the same time, has a mixture of other features that are consistent with hypomania or mania. However, when only two or three of these manic symptoms are present, the duration fails to meet current criteria for hypomania (4 days) or mania (7 days), and therefore the diagnosis does reach the full criteria for a hypomanic or manic episode.2  

    One hypomanic symptom would be Bourdain’s restlessness and consistent traveling in search of the perfect meal in Parts Unknown. This is at odds with depression but his affect while doing so often seemed depressed to me. His commentary for the most part rather acerbic/cynical but punctuated with periods of levity.

    A second sign of hypomanic symptoms was his suicide. It is fairly well known that suicide increases with mixed states. A mixed state is often a high energy state combined with a depressed mood. What constitutes high energy though is somewhat debatable. Most see it as an increase in physical activity which is productive but I contend from personal experience that one can have an extremely restless mind and be quite fatigued at the same time. In addition to the high energy there is often insomnia which might be attributed to stress or depression and not a symptom of hypomania.

    A third sign of bipolar disorder was that Bourdain also seemed irritable which is another symptom of hypomania but most would probably see it as consistent with agitated depression. Depressed people can be irritable but it is usually not combined with excess goal orientated energy.

    A fourth indication of bipolar was he was an ex addict. Addiction is more common among people with bipolar and could be due to a need to medicate or control an agitated and unhappy mind. What is unknown is had he relapsed or was he taking any antidepressants which might have precipitated the suicide. Antidepressants are known to aggravate bipolar depression and it is not a stretch to think they might have been involved.

    A fifth sign was that he was married twice and in a relationship with a third woman. Multiple marriages are more consistent with bipolar tendencies. Irritability, grandiosity and restlessness is obviously going to cause more conflict.

    And finally, his success as author, journalist and chef supports someone with a tendency towards hypomania. On average individuals with bipolar tend to be more productive and creative people which he certainly was. He wrote numerous books and was a famous TV personality.

    Symptoms can fluctuate to quite a degree in bipolar disorder/unipolar depression and if that happens within a day this is often just attributed to what is know as diurnal variation. Personally, I experienced a very pronounced variation when younger. Somewhat of a mixed state early in morning, around 3am- 6am and then an improvement as the day went on. At night I often felt much better and was considerably more productive. This was considered as still consistent with Dysthymia according to my doctor.

    What really seems to confound a diagnosis of “mixed depression” or bipolar disorder is how one evaluates what is “high energy”. Is it always productive or can it be nonproductive as in anxiety? Dr. Phelps is one doctor who challenges how excessive energy is evaluated. How can one measure a racing mind which can occur in mania or depression with mixed features. It sounds like it often depends on self report and a rather subjective evaluation of a patient’s symptoms.

     

     

     

     

     
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