
How I Overcame Bipolar II (and Saved My Own Life) - zatara
http://www.forbes.com/sites/michaelellsberg/2011/07/18/how-i-overcame-bipolar-ii/
======
willidiots
This is a dangerous article. A dangerous, slightly manic article.

Someone close to me is affected with bipolar, which drags me into that
universe. People who self-medicate - such as the author - are very common with
this disease. There are a million people who claim they've "overcome" it, some
through alcohol or street drugs, some through nutrition and lifestyle changes.
The danger is that when you're manic, you are your own blind spot - you're in
no position to self-assess, you think things are great when they clearly
aren't.

It's been three years since the end of his "challenge", and from the sound of
it, three lovely years. Meeting a new love, getting married, positive things.
How will the unmedicated author react when, say, a parent dies? Or the
marriage ends?

There's nothing wrong with trying to understand the disease, its effects on
your body, and the effects of alternative therapies - I commend the author for
that. However, the claim that he's "overcome" bipolar this way is reckless and
frankly dangerous. There are countless bipolar patients out there who struggle
every day with their medications; the costs, the terrible side effects, and
who fight a battle of willpower to stay on them despite feeling "cured". One
article like this, one claim to the opposite, is all it takes to break them.

I'd love for this article to be true. I'd love it if my friend didn't have to
spend thousands on medications that are slowly killing her, but somehow I
doubt this is the answer.

 __Edit __: What great feedback! It's interesting hearing people's different
experiences with various forms of treatment. I think the lifestyle changes the
author recommends are sane and sensible, helpful changes. They just aren't a
"cure". You _manage_ these diseases and you must be very careful when tweaking
that management.

I highly recommend that anyone who's involved with - or interested in - a mood
disorder read An Unquiet Mind, by Kay Redfield Jamison. It gives you an
excellent understanding of the subtleties and trickery this cunning disease
exhibits.

~~~
larve
I can relate to this article, having being diagnosed with bipolar I, and
having had an extended manic phase (with psychosis) in which I was actually
trying to save myself:

\- eating well \- todo lists \- self discipline \- sports \- stopping drugs /
coffee / alcohol

I'm kind of "scared" of these things now, but also realize that they are,
while not the complete solution, necessary ingredients to living a "normal"
life. It took me 28 years to realize that you could have a regular sleep
schedule and daily routine for example. It's these kind of "symptoms" that I
find very hard to share with "normal" people, who just can't see how that is
that big of a problem.

The funny thing is that all of this further fueled my mania, but on the other
hand, it also made me check in with a psychiatrist. I'm now on lamotrigine,
which makes living seem so easy now.

Yet I can skip a day of pills, and drink maybe a bit too much coffee and sleep
badly, and it's all there again. Only now I have a baseline I can come back
to. I don't think the article sounds too manic. I'm a bit wary of the new agey
"that's what all people should do with our method" thing, while it really is a
"common sense" that is shared by pretty much all cultures on the planet (eat
healthy, sleep, exercise, don't worry too much), but it's cool.

while I didn't have much one-on-one therapy, I went to a "psychoeducation"
group about bipolar with about 10 other afflicted individuals, and basically,
the most important thing really is to have these checklists: eat healthy,
sleep healthy, don't drink alcohol, don't drink coffee, try to sleep more than
4 hours a night, try to sleep less than 12 hours a night, and write yourself
reminders so you won't forget them.

~~~
Aron
I'm curious about the coffee part. What happens with coffee?

~~~
TheCowboy
It's the caffeine and its side effects. It can cause sleep disorders, anxiety,
and so on. Of course, not everyone encounters these problems with their
coffee-drinking. See the Wikipedia entry for caffeine if you want more details
though.

~~~
larve
yes, mostly sleep disorder, the intense crash and burn of coffee compared to a
more mellow effect of for example green tea, and the tummy problems.

especially the crash/burn + sleep problems though, which lead to anxiety,
which leads to either depression, or in my case a kind of jittery angst-fueled
hyperactivity.

------
3am
The literary editor on page 2 had the author completely pegged:

"Mr. Ellsberg’s writing is not strong enough to overcome the simple fact that
he is not a very likable person. Sorry, but there it is."

It's true of this article, too. I don't want to play armchair psychologist,
but this individual has an enormous ego and shows shockingly little empathy. I
think there is more wrong than he is letting on.

~~~
watmough
My thoughts after plowing through this, were that it's a shame the conclusion
was at the end of such a hard-to-read article.

If ever there was an article that could benefit from a solid abstract, this is
it.

------
tokenadult
From the submitted article: "In later Internet research, I found several
articles suggesting that—for unknown reasons—bipolar II is one of the most
lethal of mental conditions, possibly more lethal than major unipolar
depression and even bipolar I, with a suicide rate estimated up to 20%. (One
Medscape article, for example: 'bipolar II depression. . . carries the highest
suicide risk among all subtypes of major mood disorders.')"

This is some of the most important information in the article. Just before the
quoted paragraph, the author notes that it is unusual for people in the
hypomanic phase or manic phase of a mood disorder to seek treatment, because
most people in that mode state feel great. Treatments vary for mood disorders
between those with manic and hypomanic phases and those without, because of
course many treatments that elevate mood can cause vulnerable persons to
switch into hypomania or even mania from depression.

It's a bit early (over the course of the author's lifetime, and in terms of
the number of patients who have tried to apply his advice) to conclude that
what he thinks helped him function better would work for a lot of other
patients. He sometimes concedes that, in his own words in his article, but
seems to end with a flourish and announcement that he has found a general
answer. Anyone dealing with this issue would be well advised to do what the
author advised in one part of his article and check with an experienced M.D.
before figuring that self-treatment will do the whole job.

~~~
codeslush
What about the countless people that likely suffer from __some __form of
problem like that described, that will never go see a psychiatrist,
psychologist, or any other doctor about the problem because of __whatever
__reason? Or, how about the people that have tried, and found the experience
to be less than satisfying? How about the people that simply suffer, maybe
cognizant of the fact that they aren't completely normal, but have lost hope?
Maybe, for these people, the article will provide some hope. Maybe not, but
certainly worth considering.

------
eggdude
I just started reading the book he swears by (The UltraMind Solution: Fix Your
Broken Brain by Healing Your Body First by Dr. Mark Hyman) and I am appalled
at how sensationalist and unscientific it is. It mixes well-proven facts (e.g.
exercise, diet, sleep, and relaxation promote mental health) with absurd
claims like "Just as brain problems all stem from the same root causes, they
all have the same solution - The Ultramind Solution". Has anyone else read the
book?

~~~
dirtyaura
I'm all for this recent trend in understanding how nutrition affects us in
many ways, but both Mark Hyman and his book looked dubious to me. Googling
revealed this Salon article, which is worth of read after reading the Forbes
article. <http://www.salon.com/2009/03/12/mark_hyman/>

~~~
larve
I agree he's pretty much a self-healing new-age self-promotion marketeer. the
books he suggests are just populistic ramblings. also, reading up about
psychological disorders on the internet is even worse than reading up on
"normal" diseases. just don't do it, either you will persuaded that you have a
disorder while you don't, or be supported in whatever delusion you can come up
with, as there probably is a whole community built around it. HN is no
exception in this regard, as a lot of the "self-help" articles on here are
just a ripe breeding ground for mania :)

------
onetimer
I am impressed by Michael's willingness to talk about his personal experience
with bipolar disorder. People don't realize how prevalent it is, as those
affected are often too embarrassed by past behaviors from when manic, too
unsure when depressed, or rightfully concerned about the stigma from outing
themselves to want to share their experiences with others. That's why you
don't know how many of your acquaintances have it and that's why the stigma
persists.

So kudos to Michael for sharing.

Michael's piece reads like many others I've read on reddit's bipolarreddit
subreddit. A 20 something self-diagnoses themselves with bipolar II and lets
the world in on their ability to self-control the disorder without medicine
(in many posters' cases, without a medical support team).

In most cases I'm glad for them, and the provided advice is usually what any
book on bipolar will tell you to change about your lifestyle. Sleep 8 hours,
cut out stimulants, cut out inebriates, exercise and meditate.

My concern is that the subtler message of "just overcome your brain disorders
with pure will power" might mislead readers to dismiss medication as one-size-
fits-all tranquilizers/stimulants and provide their fragile egos one more
reason not to seek help from a health care professional.

When I encounter clearly manic or psychotic individuals online I reach out,
gently. I've made friends on TF2, Reddit and via YouTube. I've watched
helplessly as many who categorically eschewed all medical assistance
eventually slipped into psychotic states, evidenced by incoherent, often angry
messages about their delusions in my inbox. It's not always fun reaching out
but in a number of cases you can get the message across early enough and they
successfully get help.

I was diagnosed with bipolar disorder a couple of years ago and worked with a
doctor to find a combination of low-dose medications that has squashed any
sort of noticeable irrational moods without any noticeable side effects. It
took nearly a year of experimentation to find the right combination. It's
frustrating, especially on the downswings, but worth it in hindsight.

Thanks Michael for the interesting piece and if Michael's story resonates with
you, consider investing in a visit to an experienced provider. Be patient.

And if you have experiences with bipolar disorder I urge you to suppress your
ego and share them. Only with widespread sharing can the stigma be quashed,
and people will be more comfortable seeking treatment early.

------
natasham25
Wow! Thanks so much for sharing this. It is unbelievable how much medicine and
nutrition is separated in this country. Nutrition ABSOLUTELY affects you in so
many ways. Eating healthy is soooo important, but unfortunately most people
prefer to take a drug for any problems they have instead of making the effort
to eat healthy.

------
MarkPNeyer
i have bipolar 2 myself, and although i wouldn't say i've 'overcome' it, i've
made a lot of progress.

keeping regular routines, eating healthy, and avoiding drugs have all be great
for me. i tried these many times in the past, and kept failing to stick with
them. it wasn't until i underwent intensive psychotherapy five times a week
before i was able to start helping myself better. because i feel my emotions
so strongly, for the longest time i was terrified of any form of
introspection; all i knew was that if i thought too much about how i was
feeling, i was likely to end up in tears.

after a bunch of failed relationships, several suicide attempts, and months of
a worsening drug addiction, i finally found a therapist who was able to work
with me.

i'm no longer so afraid of being a terrible person that i let people walk over
me. i'm no longer so resistant to think about other people's feelings because
i've learned how to do that without getting swept away by them. i can even
look people in the eyes without feeling like i'm intruding on their privacy.

most importantly, though, i've learned how to understand my own feelings, by
talking to them and asking how i can help them, rather than trying to suppress
them or running from them in terror, when they do things like convince me that
i'm starting the singularity and have become a telepathic warrior monk. even
though that can be pretty fun, it usually doesn't end well.

------
gbaygon
I could never have expected this article was about quitting sugar and coffee.
On the other hand i'm not sure if the big change in his life has to do with
sugar levels affecting mood or the fact that he took a decision and follow it
to the end, strengthening his will in the process.

------
mashmac2
Michael Ellsburg (the author) also just posted this article
([http://www.fourhourworkweek.com/blog/2011/09/29/8-steps-
to-g...](http://www.fourhourworkweek.com/blog/2011/09/29/8-steps-to-getting-
what-you-want-without-formal-credentials/)) which is somewhat related, and an
excellent read.

------
pella
my favorite part:

 _'Based on what I told him, Dr. Hoffman ran a number of alternative
diagnostic tests on me: glucose tolerance (which tests fluctuation of blood
sugar levels in response to sugar intake), food and chemical sensitivities,
vitamin and fatty-acid levels, and heavy metals toxicity.

The most relevant test appeared to be the glucose tolerance test. If I recall
correctly, I appeared to be highly sensitive to sugar: after eating sugar, my
blood sugar spiked higher, and then crashed lower, than most people’s.

Dr. Hoffman told me there is mounting clinical evidence linking moodswings to
blood sugar issues, and that in his experience bipolar patients respond well
to cutting out refined sugar, and coffee and alcohol (which affect blood
sugar) from their diets. “You should stop eating refined sugar altogether, and
stop drinking alcohol and coffee,” he told me.'_

~~~
watmough
The sugar thing certainly tallies with my experience. I've never done a
glucose tolerance test, but something about sugar highs, followed by deep
crashes, sounds very familiar.

I ended up largely eliminating refined sugar from my diet. I still eat some,
very hard to avoid entirely, but I try to eat mainly scratch cooked food,
wholewheat bread, lots of bulky starches and proteins.

------
jrubinovitz
I've been wondering about the connection between mental illness (specifically
bipolar) and start up life now that I work at one, and find the experience
very bipolar. The way I see this article (as someone who knows bipolar people
and what they go through): if changing you diet helps (I've only seen it help
friends of mine a tiny bit if at all), great, if not, please seek some other
kind of assistance if you end it. I also give props to him for sharing, I wish
there were more positive role models that suffer from mental illness.

------
ad80
Because Michael Ellsburg's (the author) new book has just been launched we get
this pretty old article on the first page of HN... sort of crap.

The article itself is interesting, though.

------
runjake
I couldn't get through the whole article. I tried, but it was too long-winded
and the author still seems like he has an inflated sense of self-grandiosity.

However, the resultant comments here on HN have been superb, and my hope is
that many people share their own stories.

------
onetom
so, drinking nescafe gold decaffeinated is a safe choice of coffee, right?
because im drinking it for the taste only, without sugar but with milk...

coffee was definitely not helping with my ADD / ADHD... im on ritalin /
concerta 54mg for 2 weeks now, stopping for the weekend and it works great so
far with a slight sleeplessness and a little loss of apetite which i perceive
as normal apetite actually, since im over weight. i have more inclination for
riding the bike too.

IF u have

\- focus problems

\- sleeping issues at home or at work

\- lots of great projects which u haven't finished for months or years

\- fluctuating work / sex performance

\- alcoholic or drug abusing parents / grand parents

i would highly recommend to learn a bit about ADHD via Dr. Edward Hallowell's
"Delivered from Distraction" book (
[http://www.drhallowell.com/books/delivered-from-
distraction-...](http://www.drhallowell.com/books/delivered-from-distraction-
getting-the-most-out-of-life-with-attention-deficit-disorder/) ), because you
have a high chance to seriously suppress these problems with some medications
OR simply life style changes.

in my case i have pretty high sensitivity to sugar and certain carbs. i feel
so sleepy after eating rice or drinking a liter of even no-added-sugar fruit
juices, as if my head wants to fall off. my mother is diabetic, btw.

~~~
onetimer
I am interested to follow how your progress with your ADHD medication goes --
are you keeping a log anywhere?

Have you been able to get a full 8 hours of sleep every night?

------
23david
I think that the prevalence of manic-depressive (bipolar) illness among
software entrepreneurs is many times greater than that of the general
population. Many of the symptoms characterizing manic or hypomanic behavior
are possibly extremely helpful for software entrepreneurs and I would argue
that founders exhibiting manic-depressive characteristics have a higher rate
of success than those without such traits.

However, success is really dependent on founders being careful to manage their
symptoms to avoid the 'burn-out/depression' cycles that generally follow the
manic and hypomanic cycles. It IS possible to have some measure of control or
regulation of these cycles by some combination of medication, careful diet,
proper sleep, CBT (Cognitive-Behavior Therapy) or Psychoanalysis. And there
are lots of books on Amazon discussing these topics (but very very few
reliable online websites). But this is more of an ART than a science and it
can take a very very long time to figure out the proper balance.

The main main issue for all software entrepreneurs with manic-depressive
illness is that they need to avoid having their entrepreneur lifestyle trigger
their mania/hypomania episodes and run out of control.

And I would wonder if the caffeine-fueled programmer paradigm actually leads
to stress-related brain damage that makes software entrepreneurs more
susceptible to full-blown manic-depression. A kind of entrepreneur PTSD.

The article is good if it spurs people to do more research on their own and to
seek out professional evaluations (from people very experienced with
bipolar/manic-depression. not just anyone please...) if they have a sense that
something about their moods just might be a bit _off_.

The average time from onset to diagnosis of manic-depression/bipolar is
approximately 10 years. An entire decade lost. Greater awareness of manic-
depressive illness and its causes might help entrepreneurs create companies
that are more conducive towards promoting mental health. How many companies
have utterly failed after a co-founder or key programmer hits a depressive
cycle and is suddenly completely able to perform their jobs?

I'm speaking from my own experience here: I only sought out help after
starting and having only marginal success with 3 startups. After a decade of
these failures I had the sinking feeling that something was wrong with me and
I couldn't justify placing the blame on my co-founders and _poor market
conditions_. And then after eliminating sugar and white flour from my diet and
take small doses of lithium I finally realized how _off_ I had really been all
this time.

I think it'll take a few more years at least before I have a full
understanding of the illness and how to best manage it. It'll be expensive to
see all these specialists, etc. but the alternatives are severe depressive,
likely financial ruin and a high chance of eventual suicide.

A few books that helped me learn more about manic-depressive illness (and made
me feel like there was actually hope...):

\- Touched with Fire: Manic-Depressive Illness and the Artistic Temperament by
Dr. Kay Jameson \-- Documents how creativity and manic-depressive illness are
linked, and discusses the prevalence of mood disorders among the most famous
artists and writers in Western culture.

\- An Unquiet Mind: A Memoir of Moods and Madness by Dr. Kay Jameson \-- The
author is a clinical psychologist and wrote this breakthrough memoir revealing
her own battles against manic-depressive illness.

\- Loving Someone with Bipolar Disorder by Julie Fast \-- This is extremely
useful for founders who may have a member or their team or company that does
have or seems to have manic-depressive illness. It helps explain how to
communicate with manic-depressive friends/loved-ones in a way that they can
hear you, particularly when they are in the midst of a manic/hypomanic cycle.
And it will help you learn how to avoid triggering manic/depressive episodes.

Nutrition-related resources are a bit more complicated and if you have the
resources I would suggest consulting with a professional with training in
Orthomolecular Psychiatry. These types of people are MD's so they can
prescribe medications and know a lot about medications, and they also know
about nutrition and its interaction with medications and mental health. The
combination of these skills is extremely important when you are dealing with
serious medications like lithium and also changing your diet, since medication
and diet interact with each other in complicated ways. But the people who
possess both types of knowledge are very rare, and there aren't too many of
them around. If you are in the Berkeley area I would recommend seeing Dr.
Michael Lesser. If he doesn't have open appointment times he can probably
refer you to reliable colleagues of his.

But in the meantime the basic advice that he gave me is:

\- try and completely eliminate white sugar and white flour from your diet.
\-- Switch to using honey as a sweetener and 100% whole wheat bread.

\- reduce caffeine intake to around 1 cup of coffee in the morning or switch
to tea instead if that works for you.

\- Make sure to get as much high-quality sleep as your body really needs. \--
this is the hardest one for me... still working on it.

~~~
ScottBurson
_Switch to using honey as a sweetener_

Not such a great idea. Honey is full of fructose -- this indeed gives it a
lower glycemic index than sucrose, but causes other problems. Watch this (long
but very interesting) video: <http://www.youtube.com/watch?v=dBnniua6-oM>

My takeaway from this talk is that it's best to avoid all sugars, but if you
must eat something sweet, eat it with plenty of fiber to slow the absorption
of the sugar. Of course, the easy way to do this is just to eat fruit.

~~~
23david
I'm definitely not the expert here and the suggestion to use honey as a
sweetener was given to me by an Orthomolecular Psychiatrist. The context was
that if I want to use a sweetener in my tea or coffee, I should use something
like honey over white sugar or cane sugar.

Honey may have other issues, which definitely reinforces my feeling that it's
really best to consult an expert when attempting to regulate mental disorders
by using a special diet or vitamins. However as a common sense solution it
seems that using honey to sweeten tea or coffee is a reasonable alternative to
white sugar, and it is a situation where fruit simply won't substitute. For a
quick snack, fruit is a great idea and I would definitely prefer it over some
kind of honey snack or a candy bar.

googling: "honey bipolar refined sugar" leads to a bunch of links comparing
white sugar with honey, but again my experience with internet research for
vitamins and mental disorders is that the information is extremely unreliable
and all over the place. This is an area (similar to searching for information
about cancer online) where I think that the most reliable information comes
out of books written by qualified professionals and directly from qualified
specialists.

------
codeslush
re: Cutting out refined sugar: Anyone have any good links for a balanced and
nutritional daily food intake that is reasonably cost effective and doesn't
take long to prepare?

~~~
wallawe
You may have heard of Ray Kurzweil, who's very involved with the singularity
theory of technology. I read a book of his that is co-authored with Dr. Terry
Grossman called "Fantastic Voyage." If you take the time to read this book, it
gives many eating choices along with supplement suggestions for excellent
mental and physical health. It's definitely worth the read.

~~~
codeslush
Thank you!

------
noduerme
You know, I was gonna write this on Forbes but I didn't want to sign up for
it, so here goes, Mike:

According to your Forbes bio, line one, you "shatter limited thinking." Dude,
you just shattered my limited thinking about bipolar disorder. You've turned
"hypochondriac needs a girlfriend" into a heroic journey of self-
discovery...like Woody Allen without the humor. Just the heart. You've
delivered a tour de force through the causes of this widely misunderstood and
under-diagnosed syndrome; you've given a whole new generation of
overstimulated hackers a whole new disease to research on the internet; and
you've left humanity with an earth-shattering, blow-by-blow account of what it
really _feels_ like to experience spoiled-manchild melancholy, all the way
from a loft in Williamsburg back to your parents' basement, by way of Buenos
Aires. I don't know which you deserve more -- a medal, or a decent lay -- but
at least now that you've honestly expressed to half the western world which
one actually matters to you, you'll surely get the credit you deserve.

------
powertower
TL;DR;

"I gave up sugar, coffee, and alcohol".

It was a good read.

~~~
arctangent
I suspect that you'll not get many upvotes for that comment but you can have
one from me. I'm well aware that my abuse of sugar, coffee and alcohol are bad
for my health but it really does seem that these things are tied into my
lifestyle quite strongly...

------
jQueryIsAwesome
Paste this in the address bar if you want to read a forbes article in a single
page:

javascript:(function(){if(window._wait)return;window._wait = true; var i = 2;
var max = $(".page_links a").length + 1; function
all(){$("<div>").appendTo(".body:first").load(i+"/
.body",function(){i++;if(i>max)return;all()})};all();})()

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