In large measure the sense that there is much missing in the practice of psychiatry in working with people with moods and helping them to find a creative path to adapt to and live with those moods is the reason for this blog. In particular, it was my vision of an active dialogue among intelligent people with bipolar and depression that is at the heart of the idea of the forum that I have been trying to nurture and nourish.
Stay Engaged and Feel Alive
There is a strong relationship between life energy, pleasure and vitality, not only psychological vitality, but physical health as well. One of the observations that I have often made about people who are getting older is that the decline in their physical health is often preceded by a decline in their life energy, their interest in creative and pleasurable activity, traveling, sex, romance, etcetera. I think this may not be a coincidence.
Recently I came across an intriguing study that suggested that levels of gonadotropin releasing hormone (the brain hormone that regulates the levels of the sex hormones estrogen and testosterone in the body) correlated with memory and brain function. Of course, this intriguing finding is no more than a tantalizing hint about how libido and aging may interrelate.
Talking with the widower attorney, I noticed that his reduced sexual ability correlated with a shift in his mood towards a mild depression. Along with that shift, had come a noticeable reduction in physical exercise and how much he was involved in pleasurable activities such as going to concerts and listening to music.
I suggested that he might focus on reversing some of these changes (getting more physically active, going outdoors more, doing more pleasurable things) before he turned to focus on the more purely physical aspects of sexuality.
Freud’s notion of a limited amount of libidinal energy seems clearly contradicted by the evidence that the more we do, the more active we are (in many spheres and dimensions) the more we seek and use life energy, the healthier and stronger we are. In other words, husbanding our energy, leading more and more constricted and constrained lives, is exactly the opposite of what science suggests leads to long life and health.
Share Ideas with support Groups
There are also a myriad of other activities that can lead to greater mood stability. Having a support group is a great way to cope with symptoms. This reinforces the fact that you are not alone and others are sharing in your journey. Support groups are a great way to exchange ideas about strategies that have and have not worked in managing symptoms. Getting more sleep, cutting back on sugar and caffeine, relaxing, writing in a journal, and engaging in creative activities are also everyday strategies for preventing mood episodes
The role of Creativity in Relationships
First, two strong and conflicting wishes exist in any committed romantic relationship:
1. The wish to have stability, to know what you can expect support from a partner, the desire for a home that is secure.
2. The wish for change, novelty, excitement and the unexpected.
Both of these wishes are a part of healthy long-term relationships and getting stuck in one or the other of these is a recipe for unhappiness in a relationship. The solution is to work with the two contradictory wishes, and use the power of human imagination to create various creative solutions that respond to both of these needs at different times and in different ways.
The overall recipe for happiness she proposed sounded very familiar: recognizing conflicting wishes, or states, seeing them clearly, and using creative imagination to find solutions.
In the case of Moodsurfing, the two states are –
1. Seeking security, fear of threat, avoiding conflict, increased sensitivity to others (depression).
2. Looking for novelty, excitement, change, being less concerned about others (mania).
You can see that there is considerable overlap with Esther Perel’s two wishes in long term relationships.
This mixing process has seemed to me to have relevance to finding solutions to other problems.
A woman trying to work out a conflict with her husband inspired me to think about how human relationships are like good food (a leap I will admit) – just as we don’t like food that has only one taste (a food that is only sweet, for example) and prefer foods that combine tastes (sweet and salt), similarly we sometimes we need to combine emotions to find solutions to human relationships – for example combining anger (a spicy flavor) with humor (sweetness). I encouraged this woman to neither ignore her anger, nor to just sit in that state and hope for a solution, but rather to try to mix in her good sense of humor.