Stability you can eat?! E-Book

Annett Oehlschläger

• Herausgeber: Books on Demand
• Kategorie: Ratgeber
• Sprache: Englisch

Seitenzahl: 570

Veröffentlichungsjahr: 2023

Beschreibung

What does mood have to do with food? Are you really what you eat? Are there certain foods that trigger mood swings or prevent them? This book provides answers, explains connections, and shows from the perspective of someone with bipolar what you can do yourself to become or remain mood stable. Do you know what the molecules of emotion are made of; why the nature of the cell membrane is important to bipolars; how the interaction of omega-3 and vitamin D affects behavior? If not, you should read this book. Stability also includes knowledge about the effect of exercise, biological rhythms, and sleep on mood and drive. This creates a picture for the reader of many building blocks that can help people with a disposition for mood swings to regain psychological balance and equilibrium. The book is written for people who want to do more for themselves than just passively follow the doctor's instructions and prescription pad; for people who want to take the reins of their treatment and their lives into their own hands again and for people who are willing to engage in something new and unfamiliar in order to do so. Therefore, the book is above all a compilation of how and what one can do oneself as a person affected. It is a book that encourages people to take a closer look at their eating habits and to focus much more on them.

Leseprobe

Take care of your body and it will take care of your psyche.

Note: All information and notes contained in this book have been compiled by the author to the best of her knowledge and checked with the greatest possible care. In consideration of product liability law, the author points out that errors and omissions in content cannot be completely ruled out. The author, publisher or publishing staff cannot accept any obligation or liability for any incorrect information. Corrections are welcome at any time and will be taken into account.

Furthermore, this book is for informational and educational purposes only. Recommendations are based on personal experience and are neither medical nor therapeutic advice.

The author accepts no liability or responsibility for any damage caused by methods used and consequently is not liable. It is strongly recommended that all readers who wish to use these methods consult a trusted doctor or alternative practitioner.

This book is first and foremost an account of experience. Imitation is the responsibility of the reader. The author cannot accept any liability for this.

The author declares that she does not receive any advertising commissions or similar for products mentioned by name and that the suggestions are merely examples. Likewise, the author cannot guarantee the quality of the products.

Table of contents

CAN YOU „EAT“ STABILITY?!

Foreword by Prof. Stephanie Krüger

A few words from the author in advance

I. MY JOURNEY THROUGH PSYCHIATRY

In the labyrinth of psychiatry

Psychotropic drugs – can‘t do without them?

Psychiatry treats symptoms but not causes

My expectations of psychiatric treatment

Psychiatric fairy tales

Possible alternative: day-care treatment

Become an expert on your disease

Mania and depression are the poles of bipolar disorder

Mania is boundless energy

Depression is the absence of energy

Phases of the dispute

Why didn‘t anyone tell me this?

Cooperation at eye level

This is how it should be treated

II. (MY) BUILDING BLOCKS OF STABILITY

Can you eat stability?

It won‘t work without the „47”

Does eating the wrong food put you in a bad mood?

From macro- and micronutrients

From cells with black dots

Measuring instead of guessing - It doesn‘t work without blood measurement

My medical odyssey

Laboratory values and costs

Mineral profile

Interpreting laboratory values

How reference values are created

Molecules of emotion or protein and its meaning for mood and drive?

Protein is more than just the white of an egg

Amino acids are the building blocks of life

Protein levels and amino acids can be measured

Amino acids presented

Proteins influence mood and drive

The molecules of emotions influence behaviour

Neurotransmitters as gene switches lift the mood

Protein-rich foods

Facts about protein

Protein – myths, what‘s the truth?

For the drive: Tyrosine

For the mood: serotonin, the happiness hormone

Brain oil omega 3 or have the fats for the mood and the drive Meaning?

Depression due to omega-3 deficiency

„Omega-3 in bipolar disorder“. It even says so on Wikipedia

The Omega-3 and Vitamin-D Sensation

Without fat we could not exist

What is fat?

What is so special about omega-3 fatty acids?

What the cell membrane has to do with mood

Which foods contain omega-3?

Carbohydrates as a mood killer

Sugar triggers the mood rollercoaster

Carbohydrates have different effects

Why we love sweets

The dilemma of abundance

The excess of carbohydrates is the problem

Does the brain need sugar?

Energy production also goes into ketosis

Empty carbohydrates in ready-made products

What hurdles do you have to overcome when changing your diet? overcome?

Never again carbohydrates?

Special topic: Bread

What are we doing wrong?

Vitamin alphabet against depression

Psychotropic drugs as micronutrient predators

Vitamin means life

Free radicals – curse and blessing

Vitamins are radical scavengers

Varied and balanced – what does that mean?

The myth of sufficient vitamin supply

Vitamins are safe and cheap

How much would you like?

The family of nerve vitamins – the B vitamins

The importance of the individual B vitamins from the point of view of of the mood and the drive

Homocysteine – a marker for vitamin B supply

Examples of foods containing B vitamins

The sun hormone helps against depression

Vitamin D can do much more

Vitamin with hormone effect

The sun vitamin needs enough sun

Vitamin D deficiency and depression

Medicines are vitamin D predators

Have vitamin D levels measured

Foods containing vitamin D

Substitution

Magnesium - the salt of inner peace

Magnesium – three hundred times necessary

Magnesium and vitamin D

Magnesium blood levels – replenish your depots

Special case of migraine

Small substances with a big effect

Enzymes enable orderly metabolism

No energy without coenzyme Q

10

No good mood without zinc

Selenium – The mood lifter

The second brain talks to

Inflammation and depression

What GABA and glutamine have to do with mood

Stomach acid and mood

What can you do for your intestinal flora?

Dispute over food supplements

Johann Peter Hebel (1811): The Dentist

Some suggestions for NEM

Have the posture and movement Influence on mood and drive?

Embodiment – Body states influence the psyche

Every upward movement makes happy

Almost every bipolar has other illnesses

Reduce risk through exercise

How biological rhythms, light and sleep influence our mood

Our biological rhythms

Good and bad times for work and leisure

Does it really matter when you do something?

Our inner clocks

Sleep is not wasted time

Why do we need sleep?

Too little light during the day disturbs our sleep

Too much light at night disturbs our sleep

Eating at the wrong time disturbs our sleep

The sleep hormone melatonin

Melatonin and mood

Melatonin for sleep improvement

GABA brings relaxation and fatigue

Priority list of all building blocks or How am I supposed to implement all this?

Scenario 1: They are relatively stable

Scenario 2: You are currently manic

Scenario 3: You are currently depressed

Instead of a conclusion

Johann Peter Hebel: The Cured Patient (1810)

Acknowledgement

Bibliography

List of image sources

Foreword

The old saying - you are what you eat - contains a lot of truth. We all know that sleep, exercise and stress are important factors for mental stability, but that the composition of our food also plays a major role in how we feel mentally has long been neglected. Yet we know that the right diet can prevent diseases of civilisation such as type II diabetes, high blood pressure or heart attacks. So why not mental illnesses as well? There are now many serious scientific studies that have closely examined the influence of food components on mental health. They have been able to show that food components, certain vitamins, trace elements and enzymes, have a positive effect on mental stability and that, conversely, excessive consumption of, for example, so-called simple carbohydrates, but also certain unhealthy fats can disturb the mental balance.

You don‘t have to become a nutrition expert and you don‘t have to give up everything that tastes good but is not good for your psyche according to science. What you should try to do, however, is to question your eating habits.

This means a lot of self-responsibility. In contrast to medicines prescribed by the doctor, you decide for yourself what to take in the case of nutritional intake. Can you actively work on your own stability? Or is that too strenuous?

This guidebook is intended to help integrate the important component ‚nutrition‘ into the therapy of bipolar disorder. This addresses one of the fundamental, but also most difficult to implement aspects of the holistic therapy of mental illness. However, it is worthwhile to deal with it, because: only in a healthy body can a healthy mind live.

Prof. Dr Stephanie Krüger Chief

Physician

Centre for Mental Women‘s Health

Gender Medicine (DGGM)

Psychooncology (DKG)

Stability can be „eaten“?!

Building blocks for self-management in bipolar disorder

A field report and guidebook for people with manias and depressions

A few words beforehand

If you have bipolar disorder - like I do - you often feel helplessly at the mercy of the illness. The mood swings come and go as they please, and seemingly nothing can stop them. You feel that you are being controlled by others because of your illness.

The doctor in charge, who specialises in psychiatry, often has only one treatment option: psychotropic drugs. If you are lucky, you will also be prescribed psychotherapy. And if you are very lucky, you will find a clinic that also offers psychoeducation and other treatment options. Then you can learn to live with the disorder and control it. Sometimes this works better and sometimes not so well.

However, according to current doctrine, a cure is virtually impossible, as it is a chronic disease. For many sufferers, this usually means taking medication for life, early retirement and a life dominated by the disease!

This book was written because I found my way out of bipolar disorder. I am symptom-free and no longer need medication.

I would like to tell you about it and describe my path to encourage you to also take action yourself.

I no longer relied solely on the recommendations and prescriptions of doctors and therapists, but dared to take a self-determined look at a part of my life that was not addressed in the therapies: my diet. I dared to change my diet after reading about it having an influence on mood and drive. So I gave up sugar, bread, potatoes, rice and pasta, started cooking and baking myself, eliminated convenience foods from my diet, eliminated deficiencies in my body chemistry and started exercising regularly.

That is what this book is about.

This book also came into being because my friends from the self-help group asked me to write it. They did not feel able to read the many books I have written on this topic and wanted a summary and compilation of my findings from the perspective of those affected. That is why the second part in particular contains many quotations from various books.

It is very important to me that other sufferers learn that, in addition to the established treatment guidelines, there are ways to achieve more stability through changes in lifestyle and eating behaviour. Under certain circumstances, psychotropic drugs can become superfluous, but this does not have to be the case for everyone. Everyone is individual, and each person affected has their own particular form of bipolar disorder. There is no one solution for everyone, each person has to find their own way. However, I am convinced that these measures improve the quality of life for everyone, especially if they have to take psychotropic drugs.

The search for this is worthwhile: the goal is stability and a higher quality of life.

One thing this book is not, however: the book is not a „doctor bashing“, an „anti-psychiatry“ book or an „anti-psychotropic drugs“ book, even though I critically examine the psychiatry system in some places. For the most part, I have met committed doctors and therapists who have made an honest and intensive effort to help me.

If I had not met Professor Peter Bräunig, who knows whether I would not have ended my life long ago out of despair.

If I hadn‘t met Professor Stephanie Krüger, who knows if I would have ever become so stable and not had to take medication to this day.

If I hadn‘t met Dr. Katja Salkow, who knows whether I would ever have learned to deal with the disease and would have dared to look for my own way.

In my experience, established psychiatry, as well as conventional medicine as a whole, too often gives the impression that health problems can be treated primarily with medication. That is part of the treatment, and for a while I couldn‘t do without it either, but not everything. As a rule, the doctor or therapist does not explain enough about the other options available to the person concerned, and he or she is not taught enough to (re)take responsibility for his or her own actions. But nobody tells you that. I believe that every person affected has this experience at some point.

Therefore, the book is primarily a compilation of how and what you can do yourself as a person affected, regardless of whether you are accompanied and supported by a doctor or therapist, whether you are currently undergoing medical or therapeutic treatment, or whether you are taking, should take or do not want to take tablets.

The book is written for people who want to do more for themselves than just passively follow the doctor‘s instructions and prescription pad; for people who want to take the reins of their treatment and their lives into their own hands again and for people who are prepared to engage in something new and unfamiliar in order to do so.

Please note: The book is not a „manual for miracle healing“. So far I have not found such a manual. I have taken the tips and advice in this book from many different books. I have tried to list the sources in such a way that they can be found by the reader without much effort.

I am neither a doctor nor a non-medical practitioner - I am a sufferer and in the meantime probably also an „expert by experience“, as it is now called, and I simply enjoy reading. What I describe I have tried myself and can therefore tell you what I have experienced and what you should pay attention to when implementing it.

The application of the advice is at the user‘s own risk.

Look for an open-minded doctor or alternative practitioner who is willing to support you. Such professionals usually call themselves molecular physicians or orthomolecular physicians; you may also find the terms „mitochondrial therapy“.

In this sense, I see myself as a pilot, a guide and perhaps also as a door opener. I can show you the way, but you can only walk it yourself.

Annett Oehlschläger wishes you many new and helpful insights.

Wustermark, autumn 2017

I. MY WAY THROUGH PSYCHIATRY

When I was diagnosed with bipolar disorder, I didn‘t know what to do with it at first. I had never heard the term before. That was supposed to be the cause of my problems? I was supposed to have a mental illness? Not me! Only gradually did the extent of this diagnosis. But by then I was already in the closed psychiatric ward of the Charité.

Ten years have passed since then, seven of which I spent almost exclusively dealing with the illness. Looking back, I would like to tell you in the first part of the book how my path through psychiatry went and in the second part how I managed to find my way out of this labyrinth again.

In the labyrinth of psychiatry

My bipolar disorder was diagnosed when I was 47. With the help of an extensive diagnosis, a so-called life chart analysis, I found out in retrospect that I had already had a first pronounced depressive phase at the age of 22 after a divorce. I had known mood swings since the end of puberty, which usually veered into the manic range, but I always assessed them as a special manifestation of my personality.

I was occasionally particularly creative and efficient, sometimes had bizarre ideas and solutions, always had to do everything perfectly, was very fast in many things and didn‘t understand why others couldn‘t follow my pace. Every now and then I was called a „workaholic“, but I didn‘t see anything wrong with that. It didn‘t seem unusual to me to do a vocational training course with an Abitur to become a business management assistant and to study dance education at the Cultural Academy at the weekend, and then to have a child at the same time. That continued in my studies. In the first year of my studies I was the best student and received a scholarship for it, in the second year I had a second child. After a year‘s interruption, I was still able to complete my studies on schedule.

Until I was diagnosed with the disease, I had several acute phases that were not recognised and remained untreated. A mania that I developed during a stay at a health resort was not recognised as such despite daily contacts with a specialist in psychiatry and psychotherapy. It is not easy for doctors to diagnose bipolar disorder.

On the other hand, I also experienced how quickly diagnoses can be changed. After a conversation of only 50 minutes, a head doctor rejected the previous diagnosis of „bipolar“ made by other clinics because he was of the opinion that I „only“ had a histrionic and anankastic personality disorder. Since such a disorder could not be treated with tablets, everything was stopped immediately, which ultimately led to rapid cycling, five hospital stays within half a year and repeated suicidal phases.

Between the age of 47 and 54, I was in six different psychiatric hospitals a total of four and twenty times. That was 571 hospital days. Anyone who has ever been in a psychiatric ward will know that a day in a psychiatric ward can sometimes be the length of three days outside.

In the first year of treatment, I tried to take my own life twice. I was so desperate that I came to the conclusion that it would be best for everyone if I were no longer there. It was mainly my daughter who took this pressure off me. She once said to me, „Mummy, we love you just the way you are.“ Being suicidal is considered a psychiatric emergency and leads to admission to closed wards. There I experienced what it means to be ruled over by others. These were drastic experiences that I would rather not have had. On one such closed ward, I was even restrained, i.e. strapped to the bed with restraining belts. These experiences left their mark on me and encouraged my striving for autonomy and selfdetermination. My desire to regain control over my life as quickly as possible was a strong motive in my search for a good clinic.

Within the first two years of my illness, I went through five clinics, always looking for an effective treatment. It was only at the sixth clinic, the Vivantes Humboldt-Klinikum Berlin-Reinickendorf, that I found a treatment programme that suited me. But even there I needed another twelve stays to stabilise myself.

Psychotropic drugs – you can‘t do without them?

In these seven years I was treated with the following psychotropic drugs: Valproate, Lithium, Carbamazepine, Oxcarbazepine, Quetiapine, Levetiracetam, Asenapine, Sertraline, Pregabalin, Venlafaxine, Bupropion, Lorazepam, Diazepam – mostly two or three different drugs at the same time.

The topic of medication is always hotly debated among sufferers. Should one or should one not, if so, how much of which? At first, I was puzzled by these discussions, some of which were controversial and some heated, because I didn‘t know what to say.

Understood why the others did not simply take their medication as prescribed. I was not familiar with psychotropic drugs and had not experienced such discussions with people with other illnesses, such as those who have to take blood pressure or diabetes medication.

That‘s why I had no reservations about taking psychotropic drugs. But it didn‘t take long before I noticed what these psychotropic drugs were doing to me: They changed my conscious being, slowed me down a lot, created fog in my head and a constant tiredness, made me sleep without dreams and took away any desire to do anything. In the long term, there was also a considerable weight gain of about 15 kg.

When asked, the nursing staff explained to me that these phenomena were not caused by the medication but were signs of the disease itself. The doctors explained differently: these unpleasant side effects were unfortunately unavoidable, because there was no other alternative to treat the illness and prevent future phases. I trusted these arguments and took the psychotropic drugs regularly for seven years.

Psychiatry treats symptoms but not causes

During my many hospital stays, the focus was on quick symptom relief. That always meant psychotropic drugs. When I asked doctors about the causes of my bipolar disorder, they usually gave me evasive answers or no answers at all. There was no time for that now, first I had to become stable again.

Certainly, symptom relief is necessary for therapy to be possible in the first place. Unfortunately, I have experienced too often that the therapy was already over with the administration of tablets, that there were no further treatment offers apart from medication and some occupational therapy. This did not help me in the long run.

An investigation into the causes only took place to the extent that other illnesses were the cause of my mental problems.

were to be ruled out. When these examinations were inconclusive, it was clear that it could only be the psyche. The fact that there could be an imbalance and even deficiencies in the field of body chemistry was never considered.

It is true that a mental illness has multi-causal causes and is closely linked to the patient‘s biography. However, the soul does not live in a vacuum, but in a body that needs to be nourished and this in a very specific environment. I had the impression that nobody was interested in this, that nobody from psychiatry felt responsible for it.

My expectations of psychiatric treatment

The longer I struggled with my phases and tried to learn methods and strategies to prevent these phases as much as possible, the more I realised that the help offered by the psychiatric system could only be an impulse for me to work on myself.

In one of the first clinics I was strongly advised to finally accept the help and get involved. I couldn‘t understand that at all. I was ready to be helped. But I couldn‘t see what this announced help consisted of. I felt physically healthy and had almost nothing to do during the day. There were no psychologists on the ward and the daily doctor‘s consultation only lasted a few hours. few minutes. I was bored. I was supposed to „calm down“, but no one told me how to do it. I was seething inside, my inner volcano was about to erupt and so some plates and a vase of flowers had to be destroyed. Just lying on the bed was not an option. At the time, I understood this request more as an attempt at discipline,

i was supposed to adapt to the daily routine in the clinic, fit in and behave „on all the time“ and not be a nuisance. I had the feeling that no one could understand my tantrums and eccentric behaviour, let alone treat them, and I felt like an exotic among the other patients. I felt as if no one – neither the doctors nor the nurses nor my fellow patients - understood what was going on inside me.

I expected a doctor to tell me what was wrong with me, why I was behaving like this, what exactly needed to be done to make it stop. This expectation was not met. It was frustrating, very frustrating. It took me a very long time to understand that the psychiatric system doesn‘t have the power to do that.

Until this realisation, I had understood the term „medical help“ rather as someone taking something off my hands. With a somatic illness, doctors usually know quite well how to treat it.

I had experienced that from childhood. Something hurts or you feel bad. Then you go to the doctor and he prescribes a medicine and tells you what to do, and a short time later you feel fine again. I, as a patient, trustingly put myself in the doctor‘s hands and he will do it.

In my experience, this does not seem to be so easy with a mental illness. The success of treatment is not predictable. The help offered consists primarily of symptom reduction (almost exclusively through medication), and then, if you are lucky enough to be offered such help – in the context of psychotherapy – in identifying and learning ways and strategies to live with the illness.

My expectations of a complete cure, i.e. a recovery as before the illness, were very quickly dashed. I was told by doctors and also read in books that bipolar disorder is a chronic illness and therefore not curable. In the best case, one could become symptom-free, but probably only in phases. You always have to expect a new phase.

Psychiatric fairy tales

Probably intended as a consolation, I was offered explanations that, from today‘s perspective, I can only describe as „fairy tales“. My illness, bipolar disorder, was compared to diabetes, for example. It is also a chronic disease and cannot be cured either. Diabetics have to take their medication all their life to keep their blood sugar level stable, and it is the same with bipolar disorder.

The fact is, if a diabetic does not take his insulin, he can quickly get into a lifethreatening condition. He has to take insulin when his body no longer produces it or no longer produces enough. The direct comparison of diabetes with bipolar disorder gave me the impression that the medication was absolutely necessary here too, that it would not work without medication because something was also missing or was no longer being produced sufficiently.

So I should also be reasonable and not complain about it. Unfortunately, the comparison is not correct at a crucial point: bipolars can live without medication, but a diabetic usually cannot. (Recently, however, I read that diabetes II can be reversed by cutting out carbohydrates).

Nevertheless, I believed this fairy tale for a long time, it seemed plausible to me. I also had the impression that the nurse who introduced the story in such a way.

I was convinced that the explanation was correct. From today‘s perspective, it seems to me that this explanation mainly served to make me „compliant“, i.e. to make me understand the illness, so that I would willingly take the prescribed psychiatric drugs.

Isn‘t it strange that such „stories“ are necessary to convince psychiatric patients to take their medication regularly? Perhaps it is because their effect is not measurable, as is the case with blood pressure medication, for example.

The next fairy tale that is told again and again is that of the serotonin-„deficiency“ in the brain. I read about this in a small patient brochure from a pharmaceutical manufacturer, which a nurse on the ward gave me when I asked for information about bipolar disorder. It explained that the depression was caused by a lack of serotonin and that the medication compensated for this deficiency. Aha, I thought, if that is so, then such a deficiency can surely be detected and remedied somehow.

At the next opportunity, I asked a senior doctor to measure the serotonin in my brain so that I could find out how much I had to compensate. He refused on the grounds that it was not possible to measure serotonin. I was dumbfounded and didn‘t dare ask any more questions, although I didn‘t understand how else the doctor could determine how much of this serotonin reuptake inhibitor I needed.

Today I am sure that this was an excuse, because serotonin can indeed be measured. But the question is whether such a measurement makes sense, because the specific amount of serotonin says nothing about the cause of the disease or its treatment. In the brain, countless messenger substances interact, much like in a large orchestra. Each substance is important and has its own specific task, but only in interaction with the other messenger substances. So the doctor‘s statement was quite justified, but his brusque answer came across quite differently to me. This message from the patient brochure of the pharmaceutical manufacturer was simply a very simplistic advertising message.

Peter and Sabine Ansari, the authors of the book „Unhappiness on prescription“ deal with the serotonin lie in detail. From my point of view it is conclusively proven that until today no one has been able to prove that serotonin or a serotonin deficiency is the cause of depression. Measurements have shown that there is no connection between the amount of this messenger substance and the effect on mood.

Prof. Müller-Oerlinghausen, psychiatrist and for many years chairman of the Drug Commission, pointed out in his lecture at the DGBS conference 2016 in Chemnitz that (quote) „with the marketing of antidepressants ... the fairy tale of the serotonin-mangel hypothesis was washed into the brain of doctors and the public“.

This claim was used to advertise the newer antidepressants, which were weak in their effect compared to placebo. The myth of serotonin deficiency was an invention of the pharmaceutical industry to better market their serotonin reuptake inhibitors. According to Prof. Müller-Oerlinghausen in his lecture, 50.97% of the effect of these drugs is due to the placebo effect, 23.87% to spontaneous remission and only 25.16% to the active substance itself.

I am not saying that serotonin reuptake inhibitors have no effect. I know quite a number of sufferers who were helped by these drugs or who believed that the improvement in their symptoms was due to these drugs. It is also true that the tolerability has improved and the fewer side effects have led to a better „adherence to therapy“ of the patients.

What annoys me is the expectation fuelled by such claims that one only needs to pop a pill and the problem is solved. This „belief in miracle pills“ leads to patients relying on this promised effect and, on the one hand, not doing anything else or considering it necessary. On the other hand, there are also quite a number of patients for whom these antidepressants do not have the promised effect. Usually, another drug is added or a third and a fourth. Other therapy options are not in focus at all.

And relatives often believe in the omnipotence of psychotropic drugs and – in the good faith that they are supporting the patient – reinforce the doctor‘s prescription. If phases nevertheless occur, the first thing that is often assumed is that the patient did not take his tablets or did not take them regularly, i.e. that his behaviour provoked the new crisis. This is one of the reasons why the medication level in the blood is measured when the patient is admitted to hospital.

Secondly, the effectiveness of the previous medication is often doubted and a new one is tried. This is how I arrived at my long list of medications, among other things. The phasing out and phasing in usually takes days or weeks and requires a lot of patience. As a sufferer, you quickly get into the situation of having to defend and justify yourself, as if you were to blame for the crisis. I don‘t know if somatic patients are treated in the same way.

When I, as a sufferer, hear such statements from a professor and chairman of the Drug Commission, I ask myself why I should take such serotonin reuptake inhibitors at all, when a placebo, a dummy drug, i.e. an empty white pill containing flour or sugar, helps just as well.

By the way, there is an interesting book by Joe Dispenza about the placebo effect, which has actually been scientifically proven: „You are the placebo“. It is amazing how things we believe in have a retroactive effect on us. Dr. Eckart von Hirschhausen writes in detail about the placebo effect in his book „Wunder wirken Wunder“. Studies have shown, among other things, that placebos work even when you know they are placebos, and that only about 20% of conventional medicine has been proven to be more effective than placebos.

(Cf. Hirschhausen: Miracles Work Miracles, p. 54)

Moreover, besides the fact that placebos are guaranteed to be much cheaper, they would even have the advantage of not causing any side effects.

Especially for those affected who take such antidepressants, this information at the DGBS conference in Chemnitz 2016 was very sobering and led to outrage among those affected. People felt used and hoodwinked. Until then, I had never heard anyone speak so openly and clearly about the serotonin lie. You can read about it in detail in the book by Peter and Sabine Ansari.

Antidepressants are not often prescribed as monotherapy to bipolar patients because they have a switch risk. This means that the activating and stimulating effect of some antidepressants can lead to the person affected immediately going from depression to mania. I know this from my own experience. In just one day I went into full-blown mania, which ended with two policemen taking me back to the clinic and to a closed ward. People with depression often have antidepressants as a co-medication with their mood stabiliser.

The criticism of the serotonin deficiency hypothesis is not meant to imply that serotonin is unimportant. Even if the amount of serotonin is not the cause of depression, serotonin and the other neurotransmitters in the brain have a great importance for the way people think, feel and act. Therefore, the topic of „neurotransmitters“ is enormously important for people who suffer from manias and depressions. However, it is above all the interaction of all neurotransmitters and their interactions with internal and external stimuli that have an effect on mood and drive.

Psychotropic drugs can be very useful in acute cases, because they block dopamine, occupy receptors or block calcium channels, for example, and thus bring the symptoms of mania or depression to an end. In these acute phases, I urgently needed them as a helping medication and benefited from their effect. I don‘t even want to imagine what would have happened to me if these psychotropic drugs had not been available! But I now doubt that a permanent blocking of processes in the brain is necessary to prophylactically prevent moods and depressions.

This is another statement with which sufferers are confronted time and again: medication to prevent new phases is without alternative. For those affected, this often means taking medication for months, sometimes years, with all the consequences and side effects that psychotropic drugs have. The reason given is that otherwise the symptoms of the disease would reappear and new phases could occur.

It is true that symptoms can occur when weaning. I have also had some and have also heard from other sufferers that they have „noticed“ something. But aren‘t these perhaps signs that the brain is rebuilding itself after a long blockage, that receptors that helped the brain to cope with the influx of the serotonin reuptake inhibitor or the dopamine blocker are now rebuilding again? The authors of the book „Unhappiness on prescription“ explain that neither the person affected nor the psychiatrist or neurologist can distinguish exactly whether these are symptoms of discontinuation or signs of a renewed illness. The symptoms are too similar. The latter is usually assumed and seen as proof that it is not possible without psychotropic drugs.

I was very careful and accompanied by a doctor when I reduced and finally stopped taking psychotropic drugs, because I knew about the dangers. In addition, I could always reassure myself with my doctor. My experience was that the discontinuation symptoms, such as difficulty sleeping or restlessness, diminished from day to day, as if the brain was gradually getting used to the absence of the previous blockade and was now regulating itself again. In contrast, when a new phase flared up, the symptoms tended to increase. If this occurs, one can still decide whether to take something again. But if any attempt is negated from the outset, one need not be surprised about self-fulfilling prophecies.

From my point of view, this thinking, which is only focused on medication, prevents any attempt to stop. Out of fear of possibly getting a new phase, those affected sometimes take psychotropic drugs for decades. I have taken several

I have met people who had been taking lithium for over 20 years. They had to stop taking it because the kidneys were too badly damaged. Finding a new medication was very time-consuming and the changeover even required hospital stays.

The fears of new phases are unfortunately fuelled rather than alleviated by some doctors. I was told that there are even psychiatrists who put their patients under real pressure and threaten to stop treatment if you don‘t take your tablets. There are also psychotherapists who only treat bipolar patients on the condition that they are on medication.

I know patients who do not dare to even try to reduce their medication, let alone ask the doctor to do so, for fear of triggering a new crisis. For example, one sufferer told me about her compulsive sleep disorder, which keeps her in bed for 16 hours. Despite her fear of missing out on her life because she only has eight hours a day for it, she definitely does not want to change anything about her medication.

My point is not to demonise psychotropic drugs, but to take a differentiated view. Yes, there are people who cannot do without them. Unfortunately, however, doctors often don‘t even try to reduce the dose or provide medical support for discontinuation. Because simply stopping the medication can really backfire, you need a good safety net and strategies for crises, because the outcome of the attempt is uncertain. I know from my own experience the problems with side effects and the many experiments with psychotropic drugs. You have already read how many different drugs I have taken in the years of my treatment.

I don‘t fundamentally reject psychotropic drugs. In my crises I couldn‘t do without them and I would take them again if I felt I needed them. But I don‘t think continuous use is helpful. When you hear the testimonies of the people who come to the self-help groups, you get the impression that

The impression is that psychiatrists, especially those in private practice, do not take enough time for counselling and offering alternatives. But these do exist! If there were sufficient information and training for those affected, close supervision by trained staff and benevolent support from the attending doctor, then I believe that such an attempt to discontinue can be successful. Peter Lehmann‘s book „Absetzen Psychopharmaka“ (Stopping Psychotropic Drugs) is worth reading, as it describes this difficult topic in a very differentiated way from my point of view.

Unfortunately, no one can live their life a second time. It would be nice if there was a „back to start“ button like in some games and you could turn your life back to the time before the onset of the disease. Then you could live the same life a second time under the same circumstances. live without medication and try out which works better, life with psychotropic drugs or life without.

Today I know that you can actually influence your thoughts, feelings and actions:

through a species-appropriate diet that contains everything the body needs to be able to produce all the messenger substances in the first place;

by compensating for vitamin and mineral deficiencies previously determined by measurements;

through good self-care, which includes regular exercise;

and through good self and stress management, which can be learned.

Possible alternative: day-care treatment

I was very lucky to be admitted to the Vivantes Humboldt-Klinikum Berlin-Reinickendorf. There, there is a bipolar focus, a bipolar special consultation and a bipolar day clinic, which were set up by Prof. Bräunig and Dr. Salkow. In the meantime, more than four hundred people with bipolar disorders are cared for there as inpatients, day patients or outpatients. This is a considerable number in relation to the patient group of bipolar patients. The advantage of this is that a wealth of experience has been accumulated there, which benefits those affected.

A day clinic is part of a hospital, but the treatment only takes place during the day - hence the name. You don‘t have to stay at the clinic overnight or at the weekend, but can live your daily life at home as usual. It‘s like going to work in the morning and coming back from there in the evening.

In order to be admitted to the day clinic, you do not have to make an application and wait for a cost approval, as is the case with rehabilitation, for example. All you need is a hospital referral from a doctor, which can also be your family doctor.

I was able to participate in a multimodal therapy programme that offers the patient a variety of options. At first, I was very surprised to meet people in the therapy group who were all the same. I had never met so many bipolars at once. On the wards of the previous clinics, I always felt like an exotic. I learned a lot from the other sufferers, including how to describe the thunderstorms and volcanoes raging inside me in words. I was amazed that there are other people who have experienced similar things. That was very relieving, after all, I was beginning to doubt my sanity after two years of futile attempts at therapy.

The psychoeducation, i.e. the patient training, was particularly valuable for me. For the first time, I learned more about what bipolar disorder actually is, what causes and symptoms it has and how it can be treated comprehensively. It was also a lot about self-management, which includes keeping a mood diary, a crisis plan and identifying the individual early warning signs. I will show you some examples of this later. This was new for me because until now I saw myself more in the role of the passive patient who was dependent on the doctor‘s decision.

The music and movement therapy, whose therapeutic background I did not understand at first, became the key to finding access to my feelings again and overcoming my emotional rigidity.

Here I learned how I can either charge myself up energetically through movement, but also calm myself down, i.e. how I can influence even incipient manic or depressive states through my motor behaviour. I could test how much closeness and how much distance I needed for my well-being. That was a special experience that I will probably never forget.

In music therapy, I experienced the joy of playing again; of doing something that was not aimed at a result; of having fun for the sake of having fun; of joy, of joie de vivre. And I could try myself out in a value-free space: Testing how it feels to be detached; how nice it can be to be carried away and, above all, how I can counteract when I don‘t want one or the other. Here I learned that saying no can be legitimate and that rejection does not necessarily follow - and without words!

This day-clinic stay was the treatment breakthrough and the turning point in the course of my illness.

I consider this form of therapy to be so successful that I recommend it to anyone who asks me about the optimal treatment for bipolar disorder. In my self-help group, almost all participants have already been to the day clinic. It is always amazing to me when sufferers who come to the self-help group for the first time and are completely desperate and devastated come back from the day clinic after six weeks.

People are changed! They now have a completely different understanding of their illness, have a plan for further action and, above all, hope that they can live with the disorder. Some need a longer stay than six weeks or sometimes even another course after some time, but the stay has been helpful for everyone I know so far.

Become an expert on your disease

With these means, the person affected can move from the passive role of pill popper to active manager of their disease. This brings back control and self-confidence and that strengthens and stabilises more than any medication.

One of my first therapists, Dr. Katja Salkow, who has a doctorate in psychological psychotherapy, suggested a goal to me based on a metaphor that I could accept and embrace:

Go from being a sufferer to being an expert on your disease! To explain what she meant by this, she told me about a symbolic carriage I was sitting in and about the reins of my life that I should take back into my own hands.

I liked the picture and imagined it in my mind as shown on the following page.

The „reins“ of one‘s own life are taken „out of one‘s hands“ by the illness. Someone else is now steering: sometimes the doctor, sometimes a relative or „the illness“. The bipolar sufferer has hardly any influence on what the illness does to him or her. You are shaken back and forth in the carriage, sometimes this way and sometimes that.

But if you succeed in climbing back onto the coach box, you can take the reins in your own hands again and decide for yourself who will accompany you and for how long. This can be a doctor or a therapist, and I, as the person affected, decide who may accompany me and for how long, or when I invite someone to accompany me. Then I‘ve done it, then I‘ve become an expert on my illness.

My path to stability was quite long and arduous and marked by many setbacks, and to remain in the image of the carriage: I was thrown back again and again by violent jolts when trying to climb onto the coach box, but in the end I won it back.

Mania and depression are the two poles of bipolar disorder.

Bipolar disorder manifests itself primarily in altered behaviour. Both mood and drive are abnormally altered, either extremely increased, which is called mania, or extremely decreased, which is called depression. A person with bipolar disorder is therefore struggling with two completely opposite „fronts“ and then also with two phenomena: his mood and his drive. Sometimes these phases even occur simultaneously, as the above picture from the DGBS information brochure shows. This graphic representation comes from the DGBS guidebook for sufferers and relatives,

„Mania and depression - bipolar disorder“, page 6.

Here is a diagram of the main symptoms of mania and depression

Quelle: http://www.scinexx.de/wissen-aktuell-bild-15424-2012-12-19-20900.html

Mania is boundless energy

Have you ever wondered what makes mania so seductive? How it is that some bipolars even aspire to this state? Why someone who is experiencing mania wants to keep this state as long as possible and therefore ignores all well-intentioned advice, even rejects it indignantly - with all the consequences that entails?

I have already experienced several manias and tried to find out afterwards why it happened. There had to be a reason. My explanation from today‘s point of view is: I lived out needs in these phases that I could not live out in normal everyday life. From this I drew the conclusion that I „only“ needed to integrate these unfulfilled needs into my everyday life and that I would be able to live them out.

and thus deprive mania of its foundations. Mania would then have lost its function and my psyche would no longer have to resort to this means to fulfil these needs.

It may sound very simple. This chain of reasoning helped me to accept that it is not the euphoric moods that are desirable, but the balance, the equilibrium. It was only when my focus was more on balance than on the „great“ mood that I was able to consciously counteract manic excitements, which unfortunately quickly developed into mania in my case. Before, I didn‘t „want“ to prevent the mania at all, who doesn‘t think it‘s nice when you‘re – supposedly – „fine“? The fact that this was a longer process of practice and did not always succeed is shown by the frequency of my hospital stays, which I have already reported on.

So what makes mania so seductive? Mania feels really good. The state is reminiscent of the experience as a child, when there were no limits, worries and hardships, everything seemed possible, everything was easy and infinite. You live into the day, don‘t worry about anything and find everything exciting, thrilling and fun. Everything seems perfect and optimal. In the morning, you jump out of bed as bright as a button and fall into it like a stone late in the evening, or you go straight through the night because sleeping is a useless waste of time.

The euphoria is joined by omnipotence on all levels. One has the feeling of being omnipotent and all-powerful, of being able and allowed to do everything, and thus of being better, smarter and more successful than everyone else. Only the others have responsibility, only the others have to bear the consequences, everything will somehow work out and turn out well. I too know this extremely exaggerated self-confidence.

But what fascinated me most about the manias was the boundless energy.

This energy made every day a new challenge. I could work almost endlessly, I was always awake and creative, I quickly thought of solutions to problems, unpleasant events made little impression on me, I took on the most difficult tasks - in short, my engine was permanently running at 150% of its power.

Here you see a picture I made during painting therapy. I tried to paint how I experienced the two poles of mania and depression.

When I got the hint from those around me that I was overly cheerful and excited, that I didn‘t let others get a word in edgewise and that no one could follow my pace any more, I dismissed it as „annoying envy talk“ and insinuated to the well-meaning that they only wanted to slow me down. But I didn‘t want to be slowed down.

Sooner or later, that never worked for long. At some point, I began to get bogged down and could no longer distinguish between the important and the unimportant. When physical exhaustion set in, my euphoric mood turned into a dysphoric (irritable) mood. I became grumpy, could hardly stand myself and was annoyed by everything and everyone.

The tension hardly eased, which manifested itself, among other things, in physical pain or the feeling of burning up inside. Soon after came either the physical collapse with catatonic states or the fall into depression.

In the beginning, I did everything I could to get this energy boost back, which started a vicious circle that made it necessary to stay in hospital again and again. For me, manias and depressions did not exist without the other side. When the mood swung too much in one direction, at some point the swing came in the other direction.

This burning in mania I have depicted in this way.

Depression is the absence of energy

Depression is not sadness. Depression is the absence of feelings and energy. You no longer have strength and energy for anything – not even for your own feelings. In the depressive times I felt empty, perhaps comparable to a drained battery. Nothing worked any more.

Not work at all, but also no other pleasant activities. No desire for anything, no energy for anything - but time that dragged on endlessly.

I remember a situation in the clinic where I was sitting in front of a banana, thinking about what to do with it, and I was happy when someone took it out of my hand, peeled it in half and put it back in my hand so I could eat it. I just couldn‘t think of what to do with this thing, my thinking was so slowed down.

Unfortunately, there were also humiliating scenes during such depressive phases: I was sitting in front of my lunch, staring at the lid of the thermos and wondering if I was actually hungry. A student nurse came over, hurriedly took off the lid, saw just as I did that there were potatoes and a vegetable. She cut the potatoes into bite-sized pieces and put a big spoon in my hand instead of a knife and fork. I felt like I was being treated like a dementia patient and was furious about the degrading treatment. Whether this paralysis of thought and extreme slowing down actually came from the depression or was an effect of the benzodiazepine, I can‘t say – perhaps both.

Depression is the other extreme of mood swings. What is too much in the manever is too little in depression. Above all, the feeling of worthlessness and hopelessness can be very distressing for those affected, which is why it is not uncommon for depressives to become suicidal. In Germany, more than 9,000 people take their own lives every year, many of them suffering from depression.

Phases of the dispute

During and between the stays in the clinic, I had over one hundred hours of individual psychotherapy with several psychologists. I wanted to build on what I had learned in the day clinic and find out why and how I „tick“ and how I can take the reins of my life back into my own hands. In retrospect, I realised that there were various developmental steps that followed one another in my confrontation with my illness. Later I learned that this genesis is not atypical for people who have experienced severe mental crises.

1. Denial phase

At first I denied being ill at all. I could not accept that I, who saw myself as a woman in the middle of life, should be mentally ill. I had been able to defy all challenges so far and now that was no longer possible, I could not and would not accept that. I thought my symptoms were a short-term burnout, a little bit of a Recovery and then I‘ll be fine. Several spa stays actually brought some recovery, but I tended to lose more and more energy. At some point it was my body, or rather my head, that couldn‘t take it anymore. More and more frequent migraine attacks slowed me down more and more. First once a month, then seven times and finally fifteen times a month. I simply couldn‘t work any more. The headache outpatient clinic at the Charité hospital admitted me directly to the closed ward.

2. Phase: Guilt

In the clinic, I was overcome by intense feelings of guilt. When I realised what I had done during my mania, I felt terribly ashamed. I hardly dared to look my relatives in the eye and avoided contact with colleagues and acquaintances, perhaps that‘s why my stay there lasted several months. I also doubted my role as a mother and wife and my abilities in general. I believed I had done everything wrong in my life. My self-esteem was at rock bottom.

For quite a long time, I was preoccupied with the question: „Why me?“, why do I get such an illness that makes me frightened of myself, that changes me in such a way that I no longer trust myself and even the closest relatives doubt their trust in me. Sometimes I would have liked to lock this other me up somewhere so that it wouldn‘t do so many nonsensical things again. But you can‘t get rid of yourself.

3. Phase: Anger

Quite quickly, I began to look for the causes of my illness. At first, I blamed everything and everyone around me for my illness: First my work, the bosses, the colleagues; then my parents, my upbringing, the circumstances, my marriage.

This went on until I realised at some point that there was no one to blame for my illness. In the end, I was angry at the illness and realised that this anger did not bring me much further, but was rather counterproductive. Nevertheless, this phase was important, so I could check in all areas of life which triggers tended to trigger my bipolarity and which things did me more good.

4. Phase: Mourning

At some point I realised that I could no longer do my job. I was simply no longer able to withstand the work-related stress. This realisation strangely triggered relief and sadness in me at the same time. Thanks to a good therapist, I was able to mourn my lost profession and my lost life and analyse what was good about the bad that I could take with me into my second life. I was amazed to find that I still had a number of skills and abilities that were somewhat buried but not lost.

So I started to rediscover my many fine motor skills: writing beautifully, knitting with a needle, sewing, weaving baskets, painting – some of them skills I had not practised since childhood. This gave me new self-confidence, so all was not lost after all. I also rediscovered my other professions and checked to what extent they were suitable for my new life.

5. Phase: Reorientation

The phase of reorientation was exciting. It was a time of trying things out. I was able to test whether the new skills I had acquired in therapy were suitable for everyday life and also supported me. During this time, I discovered self-help and the bipolaris association, the self-help organisation for people with mania and depression in Berlin and Brandenburg, and threw myself into voluntary work.

On the one hand, this activity was very meaningful, but on the other hand, it also required good self-management so as not to overdo it. In my zeal, it happened several times that I took on too much.

The good thing was that I now had strategies to counteract emerging phases relatively quickly. Nevertheless, there were also hospital stays and acute phases during this time, but within the self-help organisation, my sickness absences could be more or less absorbed and did not have such dramatic consequences as at work.

This voluntary work was a good opportunity for me to learn new self-confidence in a completely different field and to do meaningful work despite my illness. I think it‘s good that the health insurance companies are obliged to support selfhelp financially, but the bureaucracy is also quite large here. A large part of my work at bipolaris was applying for, managing and accounting for such funding.

I also got to know countless people who had the same disorder and was able to learn a lot from their experiences. This was very enriching and gave me a new, different perspective on my own disorder. It was mainly through this exchange that I learned that although we have the same disorder, in the end everyone can and must find their own way. Even today, the activities in the self-help group and the exchange with other sufferers are very important to me.

This phase was also the time when I perfected my mood diary. You can see an example of this here. I wanted to find out if it was possible to recognise my own emerging crises in time. It annoys me that I very often had to be told by others that I was well on the way to becoming manic again.

Therefore, I combined the mood curve, whose scale ranged from minus 5 to plus 5, with the drive scale, which ranged from zero to one hundred. I meticulously kept the mood diary for almost two years.

What I had hoped for did not happen, because my mood and drive usually changed in parallel, so there was no warning time, but my records were valuable for my doctors and therapists. Since the doctor only saw me at intervals of several weeks and then only had a few minutes to get an impression of my mood and drive, she could see the progression since the last consultation on the basis of my records.

My doctor‘s question at the beginning of every consultation, which had almost become a ritual: „Do you have your mood diary with you? I only stopped when I could only enter a zero line. Zero line here does not mean something negative, as with the heartbeat, but something very positive for a bipolar: no fluctuations! I also learned to gradually detach myself from my old, unhelpful patterns. Especially in depressive phases, I was tormented by ruminations about the past. Here it was two inconspicuous, short sentences that almost became a mantra:

„It is what it is“ and „I live in the here and now“.

Years later, when I studied time management techniques, I was surprised to discover that accepting what is at the moment and cannot be changed by oneself; actively changing circumstances that can be changed by oneself; the planned alternation of tension and relaxation as well as the conscious design of breaks are parts of stress management.

Thanks to many therapy sessions in the context of behavioural therapy, terms such as „Balance“, „equilibrium“ or „equilibrium“ became dominant themes. It seemed more and more important to me to reach this middle ground. I promised myself a different, a better life than during the illness. to be able to lead. It was only when I learned to manage my energy, to use it wisely, to take good care of myself, to find a balance through a healthy alternation of tension and relaxation, that I was able to gradually escape this vicious circle of mania - depression - mania - depression. I had already reported that this was not a „one-way street“, but was also associated with setbacks.

During the psychotherapies, which lasted more than two years, I worked hard to implement what I had learned into everyday life. My unhelpful patterns kept me intensely busy, which were often painful therapy sessions.