How I Overcame Bipolar II (and Saved My Own Life) | Hacker News Reader

How I Overcame Bipolar II (and Saved My Own Life)

forbes.com

128 pointszatara44 comments

This is a dangerous article. A dangerous, slightly manic article.

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

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

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

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

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

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

On the contrary, as someone with my own firsthand experience, I think positive, empowering, live-affirming articles are needed alongside the concerned frowns and furrowed brows of often-helpless friends, family, and psychiatrists.

A brilliant, introspective mind given hope that they have some power within themselves to help their condition will discover that diet, regulation of sleep and social contact, healthy life structure and goals, sources of self-esteem, etc. are a big part of dealing with a mood disorder long-term. It is certainly possible to achieve change that lasts, with or without medication, though medication is a powerful and useful tool.

My intent was never to discount the importance of hope and positivity, nor the value of lifestyle changes such as the author's. I am intimately close with the affected person in my life; the disease (and its treatment) has a way of consuming her life, it's supporting to hear a positive tale.

It's semantics to me - the term "overcame", the tone of the article. I get the feeling that the author believes he's permanently rid himself of the disease, and that he's suggesting others can do the same (through whatever method). The disease is with you for life, you manage it. The author never makes that clear, and I hope (for his sake) he realizes that.

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

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

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

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

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

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

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

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

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

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

Some people can manage it without constant meds - some only need meds some of the time - BUT with managing the things that throws that person in a tail spin. (i.e. not sleeping, chaotic relationships, travel in some cases). When it's mostly mania the person experiences - life is probably pretty good, but for those who mainly experience the depressive side (like a friend of mine) - it cripples his life and he can barely function. Each case is different. I really think the key is having someone close to the person who can make sure they're doing all the things they need to - like sleeping, eating regularly etc.

I disagree. Each of those things he compounded by adding one to the other. He's successful and that support structure he's built around himself along with his nutritional discipline allows him to essentially "overcome" the disorder.

The guy is giving speeches on networking to the first group of Thiel Fellows and he blogs on Forbes. Nothing he's saying seems irrational or ridiculous. Being a so-called "beast" in your field doesn't mean you are mentally ill.

Cures exist for mental illness; mostly by nutrition, therapy, hard work and strong social ties.

> Cures exist for mental illness; mostly by nutrition, therapy, hard work and strong social ties.

[Citations to peer-reviewed, double-blind, placebo-controlled studies needed]

This is one of medicine's major problems: such a study is considered to be required, yet no one with enough funds (read: big pharma) will execute a study of the enormous size required to control for all these variables (because there is nothing to be gained for them). For all we know, every mental illness is cured in 80% of the cases by changing to -- and adhering to -- a healthy lifestyle. As the situation is, there will never be a study that proves it.

So how do you know it's 80% - sounds pretty confident.

I really agree with your original comment. We're in serious trouble when Forbes starts letting the patients run the asylum and promote herbal remedies to serious psychological problems on their website (with links -- hopefully not paid affiliate links, but links nonetheless). Self treating patients are bad news all around; if the guy's crazy and treating himself with herbs then giving him a microphone is basically "spreading craziness". If he's not crazy, then this is just bunk, self-aggrandizing BS that wouldn't get past the editors at the huff.

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

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

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

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

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

Funny, that part resonated with me as well.

Totally confirmed after I followed the link to his book on amazon and saw that it had been blatantly astroturfed with fake 5 star reviews.

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

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

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

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

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

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

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

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

So kudos to Michael for sharing.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Michael Ellsburg (the author) also just posted this article (http://www.fourhourworkweek.com/blog/2011/09/29/8-steps-to-g...) which is somewhat related, and an excellent read.

my favorite part:

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

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

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

There is so much sugar added to our food that it's not surprising that aside from epidemic diabetes there might be other health impacts.

Nearly all processed food has sugar (or corn syrup) added. The only really easy way to avoid it is to buy unprocessed or minimally processed ingredients and make meals from scratch.

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

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

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

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

The article itself is interesting, though.

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

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

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

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

IF u have

- focus problems

- sleeping issues at home or at work

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

- fluctuating work / sex performance

- alcoholic or drug abusing parents / grand parents

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Switch to using honey as a sweetener

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

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

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

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

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

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

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

Thank you!

TL;DR;

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

It was a good read.

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

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

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