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Welcome to Unravelling. This is a podcast that sees the world through the lens of mental health. I'm Mary Wilson, a journalist.
And I'm Curt White, a social worker and psychotherapist. You know, a few episodes ago, Mary, we we started to talk a bit about bipolar disorder by getting into it with Peter Mendelson and Betsy Lerner. Some of their creative works had been influenced by their personal experiences with that particular psychiatric illness. And it's a complicated one. It involves phases of mania or hypomania, well as phases of depression, which can be deep depressions or less deep.
And I think it's, you know, it's one of those words that's out there in the world, but which I I don't know how much people really understand
about that.
I think it's very misunderstood. The portrayals in media are sensationalized. And before listening to today's interview, I knew about the highs and the lows and mood swings, mania, depression, but I didn't really know, you know, what that looks like in real life.
Yeah. I think it is really misunderstood, and it's not that unusual, I would say. You know, it might be less common than something like a sort of unipolar depression. We would say where a person just gets depressed, but it's a thing that we see a lot in intensive psychiatric settings. It's a reason why people get hospitalized, need hospitalization sometimes.
And it can look kind of dramatic in some parts of the illness, in other times, might be really quite invisible to others, like when folks are withdrawn and depressed. We had the thought it would be great to get somebody who really does that kind of work, works with folks like that in a day to day way.
Yeah. And so you were able to speak to our colleague, Matt Dove, who works here at the Bredebro Retreat.
Matt Dove is a duly certified nurse practitioner in family medicine and psychiatric mental health. He's studied at multiple universities, Shenandoah University, Johns Hopkins School of Nursing, Chamberlain University, Maryland University. Has done work, as I mentioned, in lots of different intensive settings, and in general, is just one of the smartest, kindest, and most interesting people that I know. So I'm really happy to to bring this interview to us today.
Alright. Let's listen in.
So, Matt, welcome to Unravelling.
Thank you so much for having me.
Now we we've known each other for some years and have worked together on various projects, often involving folks on the the more complicated end of the mental health diagnosis spectrum. And there's a lot of room on that complicated end. One thing that comes up a lot and is sometimes talked about in popular culture and imagination is this bipolar disorder, formerly called manic depressive illness. People might have heard that. And I was hoping that today we could have a conversation about that and try to unpack some of what that really is and to sort of maybe untangle some of the myth from reality in it.
Yeah. And I just wanted to first start by saying thank you so much for, to you and Mary and the team here for how you approach thoughtful conversations about, you know, complicated psychiatric care need ideas. And so I I've been kind of listening to the the show itself, and I know there's been some conversations about bipolar before this. And I just think that, like, it's exactly right. When you when you first approached me about this, you were like, well, we've done some other things talking to folks that have been kind of in artistic endeavors and have spoken their story.
And I was like, that's exactly right. To that that we lead with the person, and then we kind of look at the clinical details maybe as a second thought to that experience. Right?
Yeah. We recently talked to Betsy Lerner and Peter Mendelson who who were very candid with us about speaking about different phases of their own bipolar illness. The depressive, really, and Peter Mendelson's discussion and writing, and Betsy Lerner, a bit of both, but really focusing more on the expansive and manic parts of that illness. And I thought, well, this is this is kinda this is sort of leading us to sort of how how can we get at what this what this is? So maybe that is a starting question.
What do we mean when we say bipolar disorder?
Yeah. I think over time, you know, diagnoses have evolved particularly for this this idea. And like you said earlier, it was initially thought as a mood swing. You know, I I was always taught, and it was it was a very crude and oversimplified idea of like a gas gauge or a fuel gauge of like empty means that you've experienced a depressive episode, and then the the full gauge is when you sort of are in a more manic state, a more heightened state. I think that there's absolutely gradient and spectrum to that, but that was kind of the the polarities that I learned about initially were that manic phase and that depressive phase.
We've realized through better understanding of the brain itself is that this this is a much more complicated kind of experience that that I almost look at as like a temporal disease or a need. You know, it affects energy levels. It affects cognition. It affects, you know, basically sleep cycles and and other things that are not just mood.
Yeah. And depression I think we probably have a better sense of culturally and socially. Partly it's maybe a more common problem, it can show up in lots of ways. Although even then, I mean, do we know that one person's depression is the same as another? Hard to know, but generally speaking something with bad feelings, trouble sleeping, lack of interest in things, lack of pleasure from things, sometimes a wish not to be here anymore.
Those are common things with depression. And if that's the low, what what is this high part of it?
Yeah. I think, you know, when we look at the the American Psychiatric Association's kind of definition and and we look at, like, rudimentary DSM criteria for the most current version, we look at ideas of, like, at least an episode of mania for bipolar one disorder, and then those are characterized by at least a week of that period, not just kind of, like, you know, day to day kind of feeling low or feeling high. It's sustained period of labality is how I describe that. And then a duration that could have functional impairment. And so within mania, you have certain characteristics or what we call symptom constellations, and and they include, like, grandiose ideas of self, they include, like, decreased need for sleep, impulsiveness or risky behavior is what they would define that as.
And then pressured speech, the way we talk, changes from what we normally would would have in typical conversations. And then the other one, ideas, a a flight of ideas, they they sometimes describe it. And then sort of in a most, severe space, mania can can go towards psychosis.
Could you give some examples of what that what that might look like?
Yeah. I think I think what happens a lot in mania is that it can be like this sort of, at first, this transcendent creative, almost chosen experience for the person that is living with it, and it can look very different for for different folks. And, you know, we understand multiple kind of what we describe as delusional elements, which are fixed false beliefs, so non consensus reality. Some of those can be somatic, believing something that's happening to your body that might not be occurring in in reality. The a common one is being infested or feeling like you've gotten something in your body that might not be there.
Sometimes they they used to call them erotic mania, ideas of, like, love or belief that maybe someone that is a celebrity is in love with you or that you have a relationship that might be overextended that it's not really the same relationship to the other person. And then there's there's there are times are are religious delusions, and they look they're culturally bound, of course, for the person that's experiencing them. And so sometimes people have a belief that they're a they're a deity or someone that's really important in a religious doctrine or dogma. And so you can really have this, like, inflated sense of self, and those moments are are difficult to, like, have self awareness or insight in. Mhmm.
Yeah. People don't when people feel good, they don't always seek treatment for that, in other words. Right?
That's right.
It's like feeling feeling good is good a lot of the time.
Yes.
Yeah. Well, and and sometimes people, when you get into a very expansive mental state, people start to do things and make different decisions than they would in a more typical state of mind for them. Now maybe you could say that it's not necessarily reflective of illness sometimes depending on, you know, a psychiatrist once told me about a person that bought 12 cars in a day. Right? That's probably not great for most people.
I mean, if you're a billionaire, maybe you can get away with it, I guess. Right? So it's a little contextual. But for most people, it's probably gonna gonna be bad. But what about the person that decides they want a new car even though they wouldn't normally be doing that right now. They're just making different decisions, but they're not necessarily, you know. And I think that's part of what makes it hard sometimes to to sort of where to draw that line.
I would agree. And and, you know, these are the moments where we, like, look at things like omania and, like, we even have, like, modifiers to the diagnosis of bipolar. There's a bipolar one where we we typify one episode of mania as the the major, like, distinction between that and bipolar two. And so bipolar two, I think of two moods with that. Obviously, people experience more than that, but I think of hypomania and I think of the depression as well.
And so the hypomania can be what's like, what you're describing is that it's it's just a different way of being in the world that they would not have typically chosen for themselves.
Mhmm. Mhmm. Yeah. But others might notice it, for example. Right? You might show up to work and and seem a bit different in that way. So it might it might come to others' attention before maybe it would ring true as a problem or a symptom or something like that for for an individual.
It's it's very accurate. I I think there was a poet Robert Lowell, he described depression as my illness, and he described mania as everyone else's illness. And so the manic phase for him really was about, you know, going in the middle of the night and waking someone up and saying, like, I just wrote my magnum opus or I just did this thing. I bought this car today. Right?
And so you're exactly right. It can be very visible and loud, and that's oftentimes where we start to see the distinction and movement in a different way towards treatment. I think that there's a delay in diagnosis of bipolar disorder pretty commonly of seven to eight years. And a lot of it has to do with, like, we are very attuned to depression. Sometimes I often hear is, like, the person says, you know, I've been taking all the different antidepressants and they just make me angry or nothing really is working.
And so there's the moment where you you imagine, like, diagnostic clarification might might be useful here and that might be, you know, a a real, like, bellwether sign that we're we're talking about a different mood spectrum altogether, bipolar disorder.
So let's get into a little bit what the what this diagnosis looks like and its different permutations. I I guess I I was taught that there's a kind of a kind of a textbook version of this, the old fashioned bipolar, you might call it that or something like that. Not that it's just because it's been described like this for a long time. And that would be a person who, when they're doing well, is doing well. They're neither depressed nor manic nor hypomanic, which is like a little bit manic.
And they're bebopping along their life roughly the same way everyone else would be. But then you have episodic experiences of depression and or mania or hypomania that could be years apart. Right? Mean, that was the classic picture. You might have relatively few of those episodes over a lifetime, but they're really severe peaks and valleys. Right?
They used to describe it as bimodal in the in the literature, you'd see it in in periods of vulnerability, maybe in the teenage years or twenties, and then kind of you would see maybe a treatment episode or you would see a dormancy, and then you'd see it again maybe a decade later. But you're right. Like, these were the classical versions of that.
And that's one obstacle to diagnosis, isn't it? That, like, even if you've had an episode of of mania, sometimes if you're not presenting that way and even just describing it to a psychiatrist even. I've had people, the psychiatrist say, well, they sure don't look manic to me. And I'm like, well they're not because they're not in a manic episode right now. But boy, when they were, they were.
Right? Everyone would agree. And so things that are kind of longitudinal like that where they show up intermittently over the course of a person's life, those are almost always harder things to diagnose, aren't they?
Yeah. And I think that's that's what, you know, like, longitudinal kind of you know, this is where your history becomes so important and really understanding that that temporal course, even just like writing it on a, you know, like a calendar or something, and really understanding that differently because you're you're right. Like, this is what I think one of the challenges to diagnosis can can be is, like, unless there's someone that's in front of you that's clearly manic, it's hard to really, like, differentiate in ways, and this this can be, like, the kindling effect as they describe. Right? Like, untreated mood spectrum, particularly like mania, I kinda talk about with neuroplasticity is, like, what fires together, wires together.
And so if people are not getting the right diagnosis or the right treatment at at this time, we are forming neural connections that can be maladaptive in ways.
Yeah. What about maybe a more complicated picture where people don't necessarily maybe they have more frequent episodes or more frequent movement between manic and depressive and hypomanic episodes or where they don't get the easy full remission that I'm describing here? Is why does it sometimes look like one thing and look like another thing?
Well, you know, there's a there was this really interesting study last year from molecular psychiatry, and it talked about kind of what you're describing. And and, like, there's just such a genetic architecture that we don't fully understand. And so part of that really is that we have these, like, what you described, like, polymorphisms or or permutations on the genetic expression. And over time, they accumulate, and they just look different, like they have different phenotypes or different presentations for each person. I mean, there's a high heritability to it too, and you you know, you've talked about that in, like, generational kind of traumas and generational kind of things that are happening for folks.
And so I think there's a lot of environmental factors, a lot of genetic factors, and a lot of, you know, personal factors. Certainly, like substance use comes into mind, like, maybe I'm feeling this a certain way and substances are important for treating it on my own. Maybe I don't know what's going on, and I just know this helps.
And there are things, both sort of prescribed pharmaceuticals as well as things people use on their own for various reasons that can make things potentially worsen some folks. Right? I mean, note notably in particular, certain classes of antidepressants can sometimes Yeah.
Absolutely. Right. Like, this is something that really comes to mind when I'm getting a a history is, you know, oh, I've been given Lexapro or I've I've been taking sertraline, and I noticed that, like, I have all types of energy now, and people are saying, like, you're you're really talking very fast. And so they can really activate those pathways like dopamine and serotonin that are the same intrinsic circuits that that mania works on. Stimulants can certainly put a lot of dopamine into the brain and and react differently for someone that experiences bipolar disorder than ADHD.
And it can be difficult like you're you're describing diagnostically because there there is this polypathetic kind of process where symptoms overlap, distractibility, attention. This is where I think the rigor of the diagnosis is is needing a little bit more oomph, is to really kinda differentiate the two. I think time is an important element for for bipolar disorders like you're describing.
Yeah. So there's there's an overlap of there's only so many things that we I mean, right? Depression makes concentration bad, so can mania make concentration bad. Right? We are very different things. So can ADHD. So can PTSD. Right? And so there's only so many mental functions we can observe at once, so we have to look at them kind of in combination of the total picture and what's the thing that fits the best and
Right.
Or do they have more than one thing? That can also be true. Right?
That's an important, like, distinction, the dialectic of they both could be existing in a person's profile.
Yeah. Hickam's dictum.
Yes. Yes.
Yeah. A man can have as many diseases as he damn well pleases. Yeah. But how do you tease those things out? Is there particular kinds of things you'll look for as a as a sort of clinical expert with a lot of experience?
Yeah. I mean, this is where the art comes in. I mean, I it's we're not treating strep throat here. Right? Part of our our work is not just saying, like, here's a medication, and I hope you get better.
It's really understanding the the emotional and the experience, the expression of that for them. You know, why maybe medications have something been something they don't enjoy, like the cognition factor, like, is this gonna change me? Is this gonna change how I how I become creative in the world? Like, these are questions that I get asked a lot. So it's not just about, like, the clinical symptoms, it's really about the expression of the illness itself for the person and how they've kind of worked worked in the past with with what they know to be true.
You see, I think I always at some point along the way, I developed a kind of a I don't know. It's not exactly a litmus test. But if the person isn't having at least some decreased need for sleep, I very often think it might be something other than a manic episode. That one is so particular. And there aren't nearly as many things that make you not need sleep. Right? You can have insomnia, but not need it.
Right.
That often for me has been a hallmark symptom.
It's it's a huge part of mania and it's it's a huge thing that we we target when we start to acutely treat mania is trying to get people as as much sleep as possible. Because, you know, you'll hear stories of I wasn't sleeping for seven days and sometimes people are like, is great. I was trying to get something done and it was very helpful. But like you said, it it really is a hallmark of an acute phase of mania. Yeah. Yeah.
And and it's interesting because we do talk about it as a mood disorder, But actually, we've already said that it can have significant impacts on a person's thinking and thought process. It can overlap with even thought disorders, right, and bringing you into feelings or experiences rather of psychosis where maybe it's harder to distinguish what everyone else agrees is reality from what you think is reality. I remember one person, and this is a true story, in to my office He was doing mental arithmetic in his head so quickly that he could not, I later learned, could not normally do. He could only do this in a manic episode. So he would take words and phrases and associate it with the letters like A is one, B is two, C is three and so on.
And he would add up the total of all the numbers and then mentally compare them to other words and phrases with similar or the same total and then draw meaning from the similarity or difference in the total. And afterwards, I almost didn't believe it because I could see him doing it in real time and I had to make a graph and count it out and add that they had to know. And I'll be damned. He was spot on every time, And you so, what is that? It is kind of like this feeling to me like people's everything is sort of like the throttle is wide open.
Yeah. I mean, I I've heard it referred to as superpowers and things, and I I don't know that I love romanticizing these moments for folks, you know. I think that it's important to like recognize that like there is distress to it too, but I certainly can appreciate that that's it's a complicated kind of conversation of like, you know, people are having more amplified experience. Like I I heard a story once of a person that had a thousands patents at one point in time, and they were given the charge by Mercedes that they couldn't build a particular car this long or add double wheels, and they took it as a challenge, and they did it, you know, and it really was this visual representation of, like the expansiveness that you're describing. And and certainly like there's a there's a lot of literature that talks about creativity and how people are fearful to to remove themselves from mania because they they worry they won't be as good of an artist or they won't be as creative.
And for me, it's important to kind of recognize that it's not always what you're describing. Right? It can just be pages and pages of information that the hypographia that's not really sensical. It's it's not really information at all.
It doesn't it doesn't make sense. It's Yeah. Yeah. I had been more skeptical of that creativity link in that way because I think I a lot of the creative people that I had known, you know, there was a real kind of nose to the grindstone quality to their creativity. They really had lean into repeated efforts of doing something that didn't necessarily have a magical muse quality to it.
Although I have come to feel that there probably is something to it, especially maybe in a particular narrow band of increasing hypomania or something that sort of potentiates some maybe disinhibited You're going to write that book, What's Getting in the Way? Well, if all of a sudden nothing's getting in the way, maybe you do it. Right? Yeah. And then I have experienced people have that, but then it often gets disorganized.
Right. Right. Yeah. We we can recognize there's extraordinary shifts in the human consciousness and maybe they're unlocking something that, like you said, was inhibited before and now it's it's it's open. That risk taking is really just writing that book now, and I can appreciate that.
You know, that that same person later on when they were getting more well asked me if I thought they had been manic. And I said, Yeah. And he said to me something I never forgot, was he said, It's so much harder to be depressed than to be manic. But it's much worse for someone to tell you that you were manic than for someone to tell you that you were depressed.
And you you bring up the the really important point that this is devastating. This is a really life altering like, the World Health Organization talks about, like, its its prevalence is, one percent in the worldwide population, so about I think that's about forty million people, and how much it's a leading cause of disability early in life. You know, what you're describing is really a key here that this is a very deadly disease ultimately. Right? Like, that people do kill themselves.
This is a very real stakes of this disorder. Like, I've gone from this this very significant high to this very significant low, and neither of them really at at a certain point, some people recognize that it's not working for me, and so this is where things get really insidious and dangerous.
And the depressive states are also particularly awful for folks in my I mean, I've known any number of therapists and psychiatric prescribers, psychiatrists and others have said that there's really no depressed state worse than the depressed state that follows a manic episode. And what is it about that that is so particularly devastating?
I mean, it it's kind of what we were describing is, like, you you are in a place where you you might feel incredibly special or that this is your best self, that you're in a heightened state that you you you lose. And and then on the other side, I think the the sort of sophisticated perspective that most people have taught me is that you spend a lot more time in a depressive state than you do in the mania, and I can only imagine the the, like, intoxicant of that that phase and then losing that phase and having to kind of be back to this sort of, like, reality, but at the same time recognizing that there could have been some some broken relationships, some relational ruptures. There could be financial consequences. There could be sort of, like, all sorts of dynamic things that happen to you while you're in the manic phase that now you're kind of, recognizing you have to like, legal trouble, things that you could have to kind of appreciate when you're in a depressive phase.
How do you treat this disease both in the manic and depressive phases of this? Like, what is it? Is it medicine? Is it therapy? What does it look like?
Yeah. I mean, Hippocrates talked about this. Right? And he did a pretty good job of describing mechalalia, you know, the the melancholy, and and the depression. And he talked about the prognosis was things get worse and people often kill themselves.
And so, like, the state of the science now is that we do have treatable, like, interventions. And I think that what you described is really, you know, kind of where we are in 2,026 is that we can offer both pharmacological and non pharmacological elements. In acute phases, I mean, it's it's really interesting that we, seventy five years later, go to a body salt, which is lithium. Lithium remains a standard of care for people experiencing both mania and depression. And when we talk about suicide, it it does have antisuicide effect as well.
And that was discovered quite by accident by an Australian Yeah. World War two veteran who was doing his own experimentation with literal guinea pigs and probably poisoning them. Probably. Yeah. But it turns out he was onto something.
Did you did you know that it was in soda in the 1929?
Yes. Lithinated lithinated seven Up.
Seven Up? Yeah. And and it's called seven Up because seven is the atomic weight of lithium, isn't it, on the periodic table?
Oh my goodness. I didn't I did not know that. Of course, that would make sense. I love that. Yeah.
Yeah. So and, you know, again, like, we don't really quite understand what lithium does. There's a really there's some interesting stuff from oh, goodness. I think it's like molecular psychiatry journal last year talked about mitochondria, and they're saying that, you know, this this energy reserve, the ATP might be why lithium works. It works on the the mitochondria, the cellular energy.
Wow. The powerhouse of the cell. Powerhouse of the cell. Yeah. We remember that from biology. Absolutely. Yeah.
There's some evolutionary thought of, like, you know, these are just variations of normal sleep wake cycles. Right? Like, the mammals have hibernation states, and so there's benefit to slowing down these seasonal kind of experiences with winter and then revving up during warmer times.
I've just taught that that in that in the acute phase of mania, that like in a hospital setting, the most important thing to do is to get folks to be able to sleep again.
Right.
And that the sleep is part of what actually brings people out of that state. Is that how you see it?
That's how I how I understand it and how I've seen it happen in clinical practice is that, you know, someone would come into the to the hospital and and, you know, it it can be a messy phase where we're adding even antipsychotic medications, mood stabilizers, sleep medications, really to get the person into a, you know, kind of a a state of sleep to to help, you know, limit the mania to sometimes they call that breaking. I don't love that term, but Yeah. Yeah.
And there's a couple different categories of those medicines, but they're all trying to do the same thing in those phases of things, kind of bring bring a person out of this very expansive state. And they all have some pretty significant potential side effects, at least that have to be watched. Right? I think it's Yeah.
I mean, lithium has its own monitoring. Certainly, the amount of fluids you're taking in, how much you're sweating, if you're having, you know, illness, your kidney function. These are really important things to know about. And then, you know, with the antipsychotic class, there's different generations, and those have have their own kind of profiles, metabolic side effects, sometimes movement side effects. But, you know, again, these are these are medications that have been prescribed for many years, and we we're well aware of of what they can do for people.
And the most important thing is that they can restore function, they can help, you know, reduce mania and and the distress of the illness, the illness burden.
Yeah. Yeah. What about in the depressive phase of things? How do we how do we think of that? I mean, we've already talked about some of the complications with these medicines that we usually use for depression that sometimes can make the mania problem worse.
Yeah. I think I think there's careful prescribing. It doesn't mean that just because you have bipolar one doesn't mean that we'll never treat depression ever again or that, like, we have to avoid it. There there are certainly medications that are less likely to induce mania. And and what's what's really helpful about the mood stabilizers is they do that just that.
They stabilize both both sides of of things. So lithium has been really known to have an antimanic quality, but it can also help with depressive phase as well. And just Depakote two really can help
on
that depressive quality. And then you augment with other things. There's definitely medications that can be helpful in in adding to what's there.
This gets a little controversial with medicines because I think there's different perspectives about how one would do this in maybe a more American way and a more European way. But to what extent do we see the use of these medicines outside of the active problematic symptom states, like a manic episode or depressive episode, to what extent do they keep mania or depression away? Because that's always the hope, guess, since I got to take this and it'll keep it away. But do people is that true for everybody? Or what's the evidence for that?
Yeah. I I think you're what you're describing is like a maintenance phase. Is that kinda what you described?
Yeah. Like a maintenance phase. How do you treat then?
Yeah. I think I think you work with your provider. I think you work collaboratively. You know, I don't think there's anything controversial about saying like, you know, is this is this something that I can change? Is this something that can be different for me? You know, I really think I've done pretty well at this dose. My levels look pretty good. Is it worth you know, I see it's, you know, maybe worth trying something different or I heard about this new medication.
So if the goal is to sort of get mood into a kind of a manageable zone that isn't too high and isn't too low. How do we know what that is?
Oh, we ask. Right? You you talk with the person and they talk about how functional they are in their in their life and how their sleep is and how their relationships are, and you take it from there. Yeah. I don't I don't pretend to be paternal around it or coercive that this has to be your lithium dose.
I just ask people how they're doing and go from there. Because at the end of the day, they they have the autonomy to do what they want with their bodies, of course. And so they might say forget you and start doing their own process and do something different. So it's always the relationship that seems like the most important thing.
Yeah. And if there was one thing that you really wanted a psychologically minded person like our listeners to know about bipolar disorder and really remember and take with them, what would that be?
I I would end with, like, the provision of hope ultimately that bipolar disorder, if you're listening and maybe you're thinking that that might be something that you're experiencing or someone in your life is experiencing, that there is hope, there is treatment available, and that you are you are you are seen, you are heard, you're believed, and that your efforts towards wellness are really important, and that, you know, the the illness itself doesn't have to be the central story of your life. I I think what's important is to recognize that you can recover and that there is there is the possibility of repair. There's a possibility of restoring the relationships that might have been ruptured. There's there's possibility of of repairing finances, and I've seen it over and over again. Like, this is not a hopeless zero sum game that once you have a manic episode and you've done maybe some disruption to your life and and maybe you felt like you've really made a mess of things, you can you can certainly find a way forward.
I think when I think to this this idea, I'll let someone that has experienced bipolar speak for themselves, and that's that's doctor Jamieson saying that I'm not ashamed of having this illness. This is what I have and not who I am.
Well, Matt, Dove, thank you so much for joining us on Unravelling today. Thank you. So thank you again to Matt Dove for that wonderful interview and all of that really enlightening information. And joining me again is Mary who's been with us and listening along. And
it was enlightening. I learned so much. I really thought that bipolar disorder was just about the highs and the lows. But learning about the spectrum of symptoms and that sleep is involved, was a big thing I did not know. And just ways of thinking, relationships, there's so much more complexity to it than I think what most of us are exposed to.
It really challenges, I think, our assumptions about a lot of things. I mean, I I think that people can really, because of an acute symptom, behave sometimes in very, very different ways than they would normally. Sometimes really contrary to their values or usual ideas about things. It's really quite complicated. And people can end up in really rough and difficult situations because of that, as well as sometimes have, you know, powerful experiences of creativity and connected ness at times in certain phases of of the mania or hypomania.
And many people are living with it and doing just fine after maybe years and years of seeking treatment and taking quite a long time to get diagnosed.
Absolutely. Absolutely. I would say that even though it might sound really different to folks that are not familiar with this, that it would be good to think about people with bipolar disorder as being everywhere in all walks of life. And it is a thing that can be lived with and managed and and treated really quite effectively. Not not always without certain kinds of pains and challenges and difficulties, but, it definitely is a thing that that people are living with all the time. Yeah.
He had a great message of hope at the end of, you know, recovery is possible, and you can repair those relationships that maybe you were fractured because of this disorder.
Absolutely. And some of my favorite, therapists I know, colleagues, yeah, have had personal experiences in bipolar disorder. And and and so absolutely. Absolutely.
So our thanks again to Matt Dove, and thank you, Kurt, for bringing us that great interview.
Oh, and thank you, Mary, and thank you, audience. And I hope folks will join us next time for what will be the the start of a very special trio of episodes that is gonna be a lot of fun and a wild ride. We'll see you then. Unravelling is brought to you by Brattleboro Retreat. Our producers at Charts and Leisure are Andrew Adkin, Hans Beuteau, and Jason Oberholzer.
And you can find us on social media by searching Brattleboro Retreat. Bratiborle Retreat is committed to exploring diverse perspectives on mental health. While we invite hosts and guests to share their insights, the views expressed are their own and do not necessarily reflect the policies or positions of the hospital or its staff.