The Power of Music

Music has the power to evoke emotions and feelings, transport you to a moment in time, soothe, express and can fleetingly remind you of  various people for various reasons. Music for me well it can do a multitude of things…it can encourage me to write both academically or for pleasure; whilst at university I often listened to music to get me through deadlines and even know I tend to listen to Spotify whilst writing this blog. It can have the power to impede my mood and emotions both positively and negatively.

Whilst on the bus home from shopping a few days ago I put my headphones in; a reaction which comes natural to me nowadays. I tend to listen to my music on shuffle…every song with the ability to invoke emotions, transport me to a particular time or place in my life or remind me of certain people. Now there were songs which I was quick to skip over those which could negatively affect my mood but others I ruminated on…songs which reminded me of Summer, nights out and memories with friends both those which made me smile to recall and those which made me smile to remember those whom were a big part of my life whom sadly are no longer. This got to me thinking why is Music so  influential in a person’s mood, behaviour and emotions…it seems relatively obvious to most people and I am sure that I am not the only person to ponder on this notion.

Whilst reading a book recently music was brought to the forefront of my mind; the book is an autobiographical account of a daughter whom is learning to cope and understand dementia and it’s affects on her mother. She noted that when her mother was feeling uneasy and anxious she could quite quickly change her mood by singing a song which her mother used to sing her when she was a young child. Then when the progression of dementia took over her loving mother, the life and soul of the party where seemingly she had lost her sense of self music had the power to not only bring her back but was found to be a great therapeutic technique for many degenerative diseases such as Dementia. The book didn’t really look into scientific studies but the basic premise was that due to the different areas of the brain which music can affect it would be more likely to cause a reaction and spark the memory which otherwise was compromised. I’ve since lent the book to another person so can’t directly quote what was said but the daughter spoke to a specialist whom stated that due to the differing areas which music can affect; tone, beat, rhythm, lyrics and the memories associated are most likely to affect some area of the brain and can be compelling in seeing a spark of a person pre-symptoms of diseases.

Despite the focus of Dementia surely as I know myself this happens to all of us. I know that; ‘I’ve had the time of my life’ from Dirty Dancing can take me back to my college prom as it was the last song, similarly ‘Sing’ by Gary Barlow and The Military Wives can take me back to my last few days at college- our form tutor played it us on our last day, ‘Come on Eileen‘ invokes memories of irritating my Mum- it’s not her favourite song in the world, ‘Bohemian Rhapsody‘ reminds me of English Literature classes at college- we were studying Paradise Lost by John Milton refers to Beelzebub similarly as Queen does it was sang frequently during our studies of Paradise Lost likewise Colplay’s ‘Paradise‘ in the same vain, any song by Westlife reminds me of my Grandma and conjures memories of her, The Housemartins ‘Caravan of Love‘ takes me back to year 7 we all had to sing a song when we first started at secondary school-that was ours, Queen ‘Crazy Little Thing Called Love‘ and ‘Brown Eyed Girl’ by Van Morrison reminds me of my Aunt and Uncle, ‘Rotterdam‘ by The Beautiful South reminds me of being in Amsterdam with my best-friend, Alicia Keys ‘Empire State of Mind‘ takes me back to Year 9 when we went on a school trip to New York, ‘Build me up Buttercup‘ by The Foundations reminds me of my friends from university, again songs with names in also evoke memories of people which I shall not name as it would be obvious whom they are related to, any Eminem or 50 Cent Song can take me back to going camping with my brother and my Dad, ‘Peanut Butter Jelly‘ by Galantis and David Zowie’s ‘House Every Weekend‘ takes me to my 21st birthday in a sunny field with my two best-friends at Creamfields, ‘Nessun Dorma‘ by Pavorotti, ‘Fast Car‘ by Tracey Chapman and ‘I love it‘ by Icona Pop also conjures images of my best-friend driving when he first got his car, ‘Poker Face‘ by Lady Gaga and ‘My Girl‘ by the Temptations remind me of my Dad and memories associated with him and those songs, ‘Bangerang‘ by Skrillex, ‘Ni**as in Paris‘ by JayZ and Kanye West and ‘212‘ by Azelia Banks takes me to my first year at university, similarly individual songs I have unconsciously paired with people in my life and when those come on they are the person which first comes into my mind for example, a very old song called ‘Waiting at the Church‘ makes me think of my Gran as she has sung it to me numerous times, ‘Let it Go‘ by James Bay and any song my Catfish and the Bottlemen reminds me of someone who also liked those artists and songs and finally, ‘Valerie‘ by Amy Winehouse reminds me of my best-friend’s Grandma who meant a lot to me.

Music has the power to improve, challenge and affect a person’s mood I know one song which I can no longer listen to due to me listening to it when I wasn’t too well- I imagine that it would be difficult to listen to due to the memories and emotions associated with it.I know for me personal upbeat music can empower and energise me to get things done, soothing and calming music does just that, music can also get me in the mood to go on a night out and finally music can also shut you out from the world and forget what’s on the other side of your headphones.

Music and lyrics especially has the power in conveniently puts into words what you cannot express and sometimes seems to explain your life or a part of your life more than you can say.  I by no means am a musical person I can at best press the ‘DJ’ button on a keyboard- a staple of growing up in the UK when having loosely referred to music lessons. I at a time also had singing lessons again ‘Downtown‘ by Petula Clark takes me back to that time in  my life. As you have already figured out I am by no means a singer other than in the shower and when no one is around but music itself if you can play, write or sing (well or otherwise) has the ability to express and free yourself from societal ties which we are all affected by nowadays. Even throughout writing this blog I have lent towards lyrical quotes from songs to explain or portray what I am trying to express.

Now for Music and Mental Health, Mind released information that when listening to music the neurotransmitter Dopamine (the feel-good hormone) is released and volunteers whom listened to music they liked their Dopamine levels were 9% higher in those individuals. Therefore Mind and the researchers carrying out that study are linking music and mental well-being. So music has the power to affect our mood, emotions and behaviours and seemingly is being introduced in the treatment of mental health and has been used in degenerative disease therapies for a while now. So bare in mind that the song your listening to at the moment in 10 years to come you may hear it and it will take you back to this time in your life, a song you sing as a joke like me with ‘Candy Shop‘ by 50 Cent (in a posh voice may I add) or ‘Three Little Birds‘ by Bob Marley will remind others of you and songs you specifically listen to when your down may always have that negative affect on your life so bare it in mind when your next listening to music.

To put it bluntly music has the power to; empathise, express, energise, motivate, soothe, calm, uplift, capture moments and feelings, take you back to a particular time in your life, affect your mood both positively and negatively, and lets face it it makes the world a little more bearable…I do wonder how we would all cope without music…it does really affect a person’s soul doesn’t it? If you really think about it. Now put on a song which makes you think of me – if you need to and know I am with you wherever you are perhaps not in body but in spirit and through the lovely voices of those singing- hopefully you’ve not put some god awful scream music on right now! Let me know what it is! Or just put on Louis Armstrong ‘What a wonderful World’ or Bill Withers ‘Lean on Me‘ I find they are quite uplifting songs- listen to the lyrics.

Good bye for now! 

*Note; I have a very eclectic mix of music tastes and this is just a snapshot of songs which immediately make me think of of time, place or people in my life. Like a walk back through memories getting all the links for the songs.

Further Information;

Mind; http://www.mind.org.uk/information-support/your-stories/why-music-is-great-for-your-mental-health/

News Article; http://www.bbc.co.uk/news/health-12135590

Images; the presentation of mental health

What I’m discussing tonight?

Similar to my other posts on Depression, Anxiety and OCD. I thought I would look at the presentation of Bipolar Disorder through images shared through social media platforms.

If you are unsure as to what Bipolar is have a look at a more in-depth BLOG post I put together a good few weeks ago.

1. 
   The constant ‘see saw’ that people with Bipolar Disorder may experience. The instability in emotional and mood regulation and of a cyclical disorder.
2. 
   I find this image to be good in displaying the varying often lack of controlled emotions and mood and lets face it the lady seems as if she is moving. Someone with Bipolar Disorder may struggle daily to seem stable and not moving through the ups and downs of emotions and mood.
3. 

This image does it’s best to visually explain many mood disorders and the use of the height of the horse and person riding around the merry go round also is a symbolic of the varying mood disorders; highs, lows and cyclical nature of rapid cycling…moving from moods up and down.

4. 

This MRI scan displays the activity within the brain of a person whom has Bipolar Disorder…I would suggest that this is someone whom endures manic episodes…the over-activity displayed within the red areas of the MRI.

5. 

This artistic image displays the extremity of emotions someone with Bipolar Disorder may experience…the darkness portraying the Depression and the brightly coloured side portraying mania. A visual depiction of Bipolar Disorder.

Only a short post tonight, I am afraid. However, these images I feel portray Bipolar Disorder in some way. Do take a look at the in-depth post if you want to know more about the disorder.

Medication Therapy for Bipolar Disorder

Medication is often the first type of therapy offered to people with Bipolar disorder. As it is very hard to undertake any other therapies whilst their mood is still swinging from one extreme to another.

The medication offered will depend on various factors which the doctor will take into account when prescribing medication for Bipolar disorder. For instance; the current symptoms, previous symptoms, how a person has responded to treatments in the past, physical health and the person’s sex and age.

Lithium for Bipolar Disorder

Lithium is probably one of the most well-known treatments for people with Bipolar disorder. This form of medication can be very effective treatment for mania, but is less effective in treating symptoms of Depression (Smith,2012). It helps to reduce the severity and frequency of mania, and is often the long-term method of treating Bipolar disorder (Geddes et al., 2004).Evidence suggests that Lithium is most effective for;

• repeated episodes of mania without depression
• episodes of mania and depression with stable periods in between
• people who have a family history of bipolar disorder
• forms of the problem where there is no rapid cycling (moving in between moods rapidly; going up and down)

(Mind, Online).

Lithium acts on a person’s central nervous system. Doctors don’t exactly know how lithium works in stabilising a person’s mood but it is thought to help strengthen nerve cell connections in brain regions that are involved in regulating mood, thinking and behaviour (Stahl, 2008).

It usually takes several weeks for lithium to begin working (similar to anti-depressants). However, regular blood tests will be required to ensure that normal kidney and thyroid function, as lithium can affect both of these functions (Mind, Online). For lithium to work effectively the medication must have the correct dosage.

Lithium is often paired with side effects, although they may be minor. It can often lead to the person suffering with Bipolar Disorder to stop taking the medication. People with Bipolar disorder also enjoy the feeling of ‘mania’ therefore, medication that dulls the euphoria may not be enjoyed by the person and may be discontinued. Common side effects include; weight gain, drowsiness, hair loss, acne and poor concentration (information taken from NHS, Online).

Anti-convulsants for Bipolar Disorder 

There are a few anti-convulsant drugs that are used as mood stabilisers in the treatment of Bipolar disorder. Carbamazepine and valproate are comparatively effective in treating; mixed episodes, rapid cycling and very severe mania. Lamotrigine  has anti-depressant effects therefore can be used to treat Depression. It is also used to prevent future episodes. Whereas carbamazepine and valproate are used to treat acute episodes of mania rather than a ‘preventative’ treatment (Mind, Online).

Anti-convulsants work by calming the hyperactivity within the brain
(Goldberg, 2014). These medications were initially used to treat epilepsy, a neurological condition. As with all medication these come with some side effects; dizziness, drowsiness, weight gain and tremors. Again, regular blood tests should be carried out as anti-convulsant drugs carry a risk of liver and kidney damage (Ascconape, 2002).

Anti-psychotics for Bipolar Disorder

People who experience psychotic symptoms during mania or depression may be more likely to be prescribed an anti-psychotic. However, more recently these medications are being prescribed to people whom are suffering from severe side effects and/or pregnant as this drug is typically safer for pregnant women. The most likely anti-psychotics to be prescribed are; olanzapine, quetiapine, aripiprazole and risperidone (Mind, Online).

These medications are often prescribed on a short-term basis to control psychotic symptoms such as; hallucinations, delusions and manic symptoms. Often these medications are taken with a mood-stabilising drug and can decrease symptoms of mania until the mood stabilisers take effect.

These drugs help regulate the functioning of brain circuits that control thinking, mood and perception (Goldberg, 2014). It is not clear exactly how these drugs work but evidence suggests that they usually improve manic episodes quickly. Again, side effects can occur with these medications similar to ones previously outlined above.

Anti-depressants for Bipolar Disorder

Some people suffering from Bipolar disorder may be prescribed anti-depressants. A commonly prescribed anti-depressant is SSRI’s (selective serotonin re-uptake inhibitors- see ‘The strive for the right medication’ for an explanation of SSRI’s). 
Often a combination of medications (where possible) will be prescribed to alleviate the symptoms of mania and depression for people with Bipolar disorder.

Further Information;

Mind; http://www.mind.org.uk/information-support/types-of-mental-health-problems/bipolar-disorder/medication.aspx#.Vksn5vnhDIU

Stahl, S. M. (2008) Stahl’s Essential Psychopharmacology: Neuroscientific basis and practical applications. Cambridge University Press.

Goldberg, J. (2014) Anti Convulsant Medication for Bipolar Disorder. [Online] http://www.webmd.com/bipolar-disorder/anticonvulsant-medication

Goldberg, J. (2014) Antipsychotic Medication for Bipolar Disorder. [Online] http://www.webmd.com/bipolar-disorder/antipsychotic-medication

Ascapone, J.J.(2002) ‘Some common issues in the use of antileptic drugs’ Seminars in Neurology. 22 (1) pp.27-39

Geddes, J.R., Burgess, S., Hawton, K., Jamison, K. & Goodwin, G.M. (2004) ‘Long-term tithium therapy for bipolar disorder: systematic review and meta-analysis of randomized controlled trials’ The American Journal of Psychiatry. 161 (2) pp.217-222

Smith, D.J. (2002) Medications for bipolar disorder [Online] http://www.rcpsych.ac.uk/healthadvice/treatmentswellbeing/medicationsbipolardisorder.aspx

NHS; http://www.nhs.uk/Conditions/Bipolar-disorder/Pages/Introduction.aspx

 

How to help someone manage a Manic Episode?

Naturally when someone is experiencing a depressive or manic episode their loved ones surrounding them may feel helpless and hopeless. Throughout researching Bipolar disorder for my previous post I came across a few things that can help a loved one help manage a ‘manic episode’.

Recognise triggers and warning signs

Each person is unique and so is mental illness, not one trigger will trigger every person and cause a manic episode. Equally a person may exhibit warning signs when they are going into a ‘manic episode’. Essentially these signs are muted symptoms of mania. For example, a person may begin sleeping less; staying up later and waking earlier and not feeling tired he next day.

Researchers also suggest looking for a sudden improvement in mood. They may be upbeat and optimistic which doesn’t seem realistic; this may be seen as a ‘giddy’ sort of mood.

The person with Bipolar disorder may also start to feel inpatient and irritable. They may also start to talk rapidly and express expansive and unrealistic ideas; often a sign of their thoughts beginning to race.

Researchers suggest that families are the best people to pick up on warning signs and triggers.

Create a proactive plan

When the person is well make a plan on how their treatment should be played out when they are in a manic episode. The key is to be proactive rather than reactive having a plan put in place can be really beneficial for a person experiencing an overwhelming manic episode. Mania can be a scary experience so knowing a person whom knows what the person wants in terms of treatment when they are experiencing mania and whom you trust may put their mind at ease.

Set limits around self-destruction

Again, being proactive rather than reactive. Often when a person is experiencing an manic episode people often lack impulse control. For instance a person with Bipolar Disorder may have previously had issues with spending vast amounts of money. Therefore, setting limits on their bank account (which they’ve agreed to) or limiting their access to finances may be beneficial in reducing the likelihood of impulsive spending. This may also be beneficial after the manic episode as vast spending may create guilt afterwards so it may also ease this post-mania.

Delay impulsive behaviours

When a person is in a manic episode they may have extravagant ideas, delaying these behaviours may be more beneficial then saying NO from the get-go. For example if they are discussing ideas of buying a new business advising them to see how they are doing on the stock market later in the week may be a good idea. Delaying this extravagant idea may hopefully benefit them in the long-term as they may come out of the manic episode or forget the idea in a few days. The person may still rebel but at least you are trying to steer them away from impulsive, extravagant behaviours.

Don’t take things personally

During a manic episode a person may say or do things that they would not normally do and is therefore very uncharacteristic of them. Due to their high energy levels, irritability and frustration may cause a person to lash out on the people whom they love. Just remember that they love you and that it’s their fluctuating mood which is causing them to be unpleasant it’s not truly them.

Avoid high levels of activity and stimulation

Giving a person whom is already experiencing mania high levels of stimulation and activity may increase their energy and euphoria; making their episode worse and potentially increasing the time period that they experience mania.

Encourage the person to seek professional help

Avoid arguing with the person about seeking medical help but explain how much you love them and that you think they should seek professional help. Although they may not listen at first at least they know that you love them and are looking out for them where you can.

Be supportive, be there for them

I would imagine experiencing mania is a pretty scary situation. Just let the person know that you are there for them if and when they need you can truly help a person who is feeling isolated due to their illness.

These are just a few things I’ve come across. Comment if you have any more tips on how to help someone manage a manic episode.

Bipolar Disorder

Bipolar disorder is a ‘mental health’ condition which affects a person’s mood, someone suffering from Bipolar disorder may have rapidly changing moods which may swing from one extreme to another. Typically speaking a person may go from a state of mania to a major depressive episode or my constantly cycle through different moods depending on their illness; quite literally like a roller coaster, going up and down through differing mood states. 

Bipolar disorder can occur at any age although it seems to develop and become prevalent between the ages of 18 and 24. Men and women from all backgrounds are equally likely to develop bipolar disorder. On average it takes 10.5 years to receive a correct diagnosis for bipolar in the UK and before bipolar is diagnosed there is a misdiagnosis an average of 3.5 times (Bipolar UK; Online).

What is mania, hypomania and a depressive episode?

The core difference to Bipolar disorder and Depression (as we know it) is the presence of the person being in a state of mania. Mania or manic episodes is referred to as an elevated mood, feeling high; sometimes feeling exciting and fun but can also be unpleasant and distressing.

Someone experiencing a manic episode may feel; extremely happy, euphoric, uncontrollably excited, often speaks faster, can become irritable and agitated, they may have increased sexual energy, their thoughts may be racing, may perceive to be very confident, adventurous and in some way ‘special’. The person during this state may be; more active than usual, speaking quickly, often making little sense, saying or doing things which are out of character/inappropriate, sleeping very little or not at all, being rude or aggressive, misusing alcohol/drugs, spending excessively, loss of social inhibitions and acting provocatively.

Hypomania is similar to mania but, this state is not as ‘extreme’ as full-blown mania. Hypomania quite literally means ‘less than mania’. A person experiencing hypomania may have similar symptoms and behaviour too mania as outlined above. Yet, these symptoms and behaviours will be lesser than that of a manic episode.  Compared to mania, hypomanic symptoms are likely to feel more manageable and last for a shorter period of time.

A major depressive episode is exactly the same as I have previously outlined
with my posts about Depression (click on the picture to go to that post). Briefly a person experiencing a depressive episode may feel; down, upset, tired, sluggish, may not find enjoyment in previously enjoyed things (anhedonia), experience feelings of guilt or worthlessness etc.

Types of Bipolar

The best way of trying to explain the differences of certain types of bipolar disorder is through the use of line graphs. The blue line at the top of the graph indicates ‘mania’, the red line in the middle indicates a ‘normal’ level of mood, the purple line in between ‘normal’ and ‘mania’ indicates ‘hypomania’ and the green line at the bottom indicates a ‘depressive episode’.

Bipolar I;

This form of Bipolar is dependant upon the person experiencing atleast one episode of mania which has lasted longer than one week. The person may also have experienced depressive episodes but it is not dependant upon this diagnosis. Statistics from Perala et al (2007) suggests that 1-3 people in every 100 will experience Bipolar I.

Bipolar II;

A person may have Bipolar II if they have experienced both; one episode of severe depression but also symptoms of hypomania. The difference here is that the person doesn’t have to hit a manic episode. However, the person must experience hypomania for 4 consecutive days for the majority of the day (DSM-5).

Cyclothymia;

A person who has experienced both hypomanic and depressive mood states over the course of two years of more and there symptoms aren’t severe enough to meet the criteria for diagnosis of Bipolar I or II they may be diagnosed with Cyclothymia. This is where a person cycles through hypomania and low grade depression.

Dysthymia;

Similar to cyclothymia a person will cycle through differing mood states however will be on the ‘depressive’ end of the spectrum rather than manic. This is referred to as a low grade depression.

Causes of Bipolar Disorders

Currently the cause for Bipolar disorders is very much misunderstood. Research has focused on the genetics and biology of the brain but many researchers also feel the social factors may also play a part in the development of this condition.

Childhood Trauma; Evidence suggests that a person may be more likely to develop Bipolar disorder if they have experienced severe emotional distress as a child. Such as; traumatic events, sexual or physical abuse, neglect or the loss of a parent. Experiencing trauma at such a young age can cause a large amount of distress and may have an impact on the child’s ability to regulate emotions effectively.

Stressful life events; The start of Bipolar symptoms can be linked to stressful periods within a person’s life; relationship breakdown, traumatic loss and or poverty. Lower levels of stress are unlikely to ’cause’ bipolar. They can trigger an episode of mania or depression.

Self-esteem problems; Researchers believe that a manic episode can be a way of escape from feeling depressed or having low self-esteem. It is believed that when a person is extremely self-critical or feels very bad about themselves mania increases their self-confidence to help them cope.

Brain Chemistry; Evidence shows that bipolar symptoms can be treated with certain psychiatric medications which are known to act upon the neurotransmitters within the brain. This infers that people with bipolar disorder may therefore have problems with the neurotransmitters functions.

Genetic Inheritance; If you experience Bipolar disorder you are more that likely to have a family member whom is also suffering from bipolar mood or symptoms. This therefore shows that their may be a strong genetic link to bipolar disorder. However, it may be also due to environmental factors which both members of the family may be experiencing rather than a ‘bipolar gene’.

Treatments?

The National Institute for Health and Care Excellence suggest that treatment of bipolar disorder should include both talking treatments and pharmocotherapy (medication). However, treatment tends to depend upon the episode the person is currently in.

Depressive Episode? A person suffering from a depressive episode may be offered medication and structured psychological treatment such as CBT.

Manic or Hypomanic Episode? Again you are likely to be offered medication but you are unlikely to be offered a talking therapeutic treatment.
*I plan on doing an in-depth post discussing treatment for Bipolar disorder.

Conclusion

Many people often use the term bipolar as a adjective to describe their mood or situation e.g. the weather- being sunny one minute and raining the next. This often can negate the seriousness of such a condition and can lead to higher levels of stigmatising attitudes.The social impact of receiving a diagnosis of Bipolar disorder can be extremely distressing. As with any mental illness people still fear the unknown and much of the media stories which is the main way of disseminating information to the general public is often negative and can draw negative associations and inaccurate depictions of a person suffering from Bipolar disorder. Which can impact on the person suffering from this condition seeking appropriate medical help and concealing their illness.

Treatment plans can be extremely challenging for a person experiencing Bipolar disorder as the person may struggle taking medication that can affect their elevated mood. Often when a person is experiencing mania they may feel on top of the world and being euphoric they may refuse medical treatment as that mood feels so good to them. On the flip side a person whom is experiencing mania may be putting themselves in unsafe positions and therefore may need medical treatment. Again, depression can make a person struggle to get out of bed in the morning therefore seeking treatment outside of their comfort zone can be challenging.

Although Bipolar disorder can have very negative associations often people whom have this disorder have been found to be more creative than those without it. When a person is experiencing a manic episode they may have extremely high levels of creativity which can also lead to greater productivity in their working lives.

Further Information;

http://www.bipolaruk.org.uk

http://www.mind.org.uk/information-support/types-of-mental-health-problems/bipolar-disorder/about-bipolar-disorder.aspx#.Vknrc_nhDIU

http://www.nhs.uk/Conditions/Bipolar-disorder/Pages/Introduction.aspx

Perala et al (2007) ‘Lifetime prevalence of psychotic and bipolar I disorders in a general population‘ Archives of general psychiatry, 64:19-28

http://www.mind.org.uk/information-support/types-of-mental-health-problems/statistics-and-facts-about-mental-health/how-common-are-mental-health-problems.aspx