My last post was about the correlation among mental health, loneliness, and friendship. This morning on my walk I was thinking about the subject again. I was trying to connect the dots from my own life of how and when those interactions took place. As a side note, a brain like mine doesn’t do well connecting dots inside of it. I have always been a visual learner. This is why writing things out helps me see problems and solutions much better than hearing or simply thinking about them. The only exception is audio books. For some reason I can listen to an audio book and follow the story or even glean something from a non-fiction piece. Of course, my natural instinct kicks in when I pause the book to write down information I desire to remember, or when I buy the book after listening to it because I want to go through and mark the important nuggets I desire to remember. Okay, that all aside, my thoughts that once again turned to the idea of friendship among what in the mental health community is known as neurodivergent. Simply put, that is the way those with varying mental health issues think differently than those without such issues. Science has actually proven that bipolar disorder changes your brain–physically alters it. Every manic episode as well as the bipolar depressive episodes change the structure of the brain in that it shrinks certain regions of it.
The most prominent region of the brain affected by the disorder is the gray matter. (I bet you didn’t think you’d get a science lesson reading this. Stick with me. I circle back around to the main topic) According to Medical News Today, gray matter is essential in enabling humans to function every day. It is present in both the central nervous system of the brain as well as the spinal cord. Gray matter is reduced by bipolar episodes, at least that is what imaging showed in the study of brains of neurodivergent people. I have done a ton of research on the effects of bipolar disorder and was fascinated to learn this little-known fact. The reduction of gray matter happened in areas of the brain associated with mood regulation, information processing, and awareness of bodily states. The gray matter reduction was seen most in the prefrontal cortex, the part of the brain responsible for mood control, cognitive control, impulsivity, and attention. Many people diagnosed with bipolar disorder also have additional mental health diagnoses related to the prefrontal cortex. ADHD and major depressive disorder are two of the several comorbidities. The third area scientists found affected by the disorder is the hippocampus. This region of the brain is responsible for emotion, stress response and memory formation and retrieval. This is why people like me often struggle to remember things without writing them down. Writing is a reinforcement that aids in memory for many people. If you looked in the backpack I carry everywhere I go, you would find several pens (okay, I have an addiction to pens anyway), a few pencils, and a spiral notebook. Mine is a full size, one subject notebook, but I have also carried similar notebooks in smaller sizes. It also explains why a person diagnosed with the disorder handles stress levels less well than many other people. There is no cure for bipolar disorder, and changes to the brain can be permanent. There is a plethora of medications used to treat the disorder, but they all come with side effects, and what one body tolerates another is unable to. This all makes treating the disorder extremely difficult. Plus, someone on medications who has memory issues are often affected in the medication department in the form of forgetting to take their medications. Things like alarms set and pill sorters can sometimes help but too often even these aids fail.
Okay, now that the science lesson is over, hopefully you have a better understanding of why a person who has mental health issues often struggles in ways those without such issues do not. One area greatly impacted, as I wrote last time, is friendships. As I walked this morning, I thought about the friendships I have had over the years. I reflected on how some of them ended. Usually, they just fizzled out, like fireworks that for a few seconds lit up the sky then begin to fade until all that is left is the smoke trail. Some ended because of a move. I could only remember a couple that ended because of a specific incident, and those were not completely caused by mental health issues although I have no doubt there was some influence of a damaged brain involved in these. I reflected on my dismal current status in the friend department. I remembered something my dad used to say to me because mental health issues have not been confined to only my adulthood. I went undiagnosed because, well, back in those days mental health was not discussed let alone acknowledged. If I was particularly lonely, and my dad saw me moping around because of it, he would say, “In order to have friends you have to show yourself friendly.” The irony is not lost on me now: my dad had no real friends, although he had many acquaintances, and he was as unsocial as they come outside of his business. I’ve written before about the difference between my mom and dad when it came to relating to other people, so I won’t go into it again. I have to say my personality is just like my dad’s. I am the most introverts of introverts. That really isn’t completely changeable. God created each of us with different personalities and temperaments. I could not be an extrovert if I tried to give it my all. This bleeds into my dad’s words about showing oneself friendly. Along with many mental health issues comnes social anxiety.
Social Anxiety Disorder is an actual, diagnoseable condition found in the DSM 5: Diagnostic and Statistical Manual of Mental Health. For conditions found in this manual, criteria have to be met in order for a diagnosis to be made. The problem with mental health as opposed to the majority of physical health issues is there is no blood test or X-ray that definitively shows a condition. It is based solely on symptoms and behaviors. It is why more often than anyone would want, patients are misdiagnosed. For example, one of the hallmarks of bipolar mania is extra energy high enough to be noticeable as well as being more talkative than others; in other words, one can’t stop talking or stop the racing thoughts. These same symptoms are also part of ADHD. Believe it or not, these two conditions are often mixed up and even missed since one can have both disorders. (Raising my hand here). Anyway, back to social anxiety. For someone who deals with it, (also raising my hand) walking into a room full of people, even people one knows, is often a terrifying experience. One look around the room to see people standing/sitting in smaller groups talking and/or laughing sends a sense of panic through the body of the socially anxious person. Who should you go up to? Will you have anything to contribute to a conversation whose subject isn’t even known to you yet? What if more people join the group? That’s getting overwhelming. Everyone talking at the same time is sending you into sensory overload, similar to what you experience at a grocery store or a restaurant. It’s way better for the psyche to just stay home. See why keeping friends is so difficult? It also explains why showing yourself friendly seems impossible to do. The safety of home is comforting even if the loneliness sometimes is crushing. It isn’t that the person wants people to ignore her or be mad; it’s a matter of the intense emotions that come from such invitations or, worse, required get togethers like workplaces often have.
Mental health disorders change a person. The same person who ten years ago volunteered at their child’s school or went faithfully every week to a Bible study has morphed into someone who would usually prefer staying home, often in order to avoid a possible panic attack that could happen. Being the person to make the first move is even harder than keeping friendships once they are formed. It only takes a couple rejections (or perceived rejections) to add a brick to the wall a person is constructing to protect his mind and heart. It doesn’t mean it will always be that way. Sometimes doctors hit the jackpot on a medication regimen that works. That has not happened for me nor most people in my Facebook mental health groups. I have learned to live with the loneliness that comes with multiple mental health diagnoses. I have found hobbies and projects to do that keep me busy, and even though sometimes it sends my anxiety through the roof, I am there when my family needs me. It isn’t that I don’t want to be friendly (admittedly, sometimes it is just that); it’s more a problem with my brain and how it thinks.