Infernal Triangle?

As I was sitting in bed, waiting for my brain and my body to get used to the higher dose of medication my psychiatrist and I agreed I should go on, a thought struck me. I am pretty sure it's not brilliant nor is it original but it fills a gap for me in the way I think of my Bi-Polar Disorder (BPD II).

It seems to me we cannot truly understand our condition unless we honour all aspects of it. But it is challenging - not to say confusing - because HOW do we include all aspect of this highly complex illness in our considerations?

I find the following diagram helpful:

I like it for these reasons:

  • It shows that medication is meant to have an impact on brain function, more specifically our deep limbic system (Hypothalamus, Amygdala, Hippocampus). It is therefore essential that we move towards a proper understanding of brain function, away from what is still a trial and error method of prescribing psychiatric medications. This trial and error approach is expensive (except of course for pharmaceutical companies who are very keen to maintain the status quo) AND EXTREMELY DISTRESSING/DISCOURAGING for the patient - and for the psychiatrist.  I know this may be a novel idea but psychiatrists are human beings and they too get discouraged and despondent when they fail to improve the well-being of their patients...  If you wish to look further into the functioning of the deep limbic system and its relationship with BPD and Depression, I highly recommend Dr Daniel Amen's book Change Your Brain, Change Your Life. It is also available on
  • Brain Function is at the top of the triangle. We could argue ourselves in circles over this one but plenty of people have emotional traumas and psychological wounds and they do not develop BPD. We could of course argue that it is all due to personality type but I cannot accept that the extensive research carried out on this subject can be reduced to such a narrow simplification. I also acknowledge that brain chemistry can be affected by the way we think and what we feel but, again, I cannot see how our deep limbic functional fluctuations can be reduced to just our thought patterns. To me, BPD starts with brain function (or rather malfunction).
  • The triangle rests squarely on our Internal and External Responses to our brain functional problems. As Batty (my own BPD) is keen on saying: "I am that which I am PLUS the way you respond to me". In order to respond in the most effective way, we need sustained help and support. Six weeks' worth of so-called counselling is not enough. Recovery from a BPD manic episode or - even worse a BPD crash - takes a long time. We need to learn to give time to Time. Medication can only help restore our functionality - our Internal Responses to our experience require sustained understanding and guidance. Let's not forget that after a crisis, we have not only lost our compass but we have also lost our ability to read it. We need a lot of quality help for us to learn how to read again. All that is very well but it will not get us anywhere if we do not take responsibility for ourselves and the way we think and behave. The help we need, medical and otherwise, is meant to help us grab hold of ourselves and our life again. It is not meant for others (doctors and loved ones in particular) to take responsibility for our attitudes or our actions because this is not good for us, and it is definitely not good for them either.

It goes without saying that all three corners of the triangle interact with each other continuously, in all directions and often all at the same time.

No wonder BPD feels disorienting, confusion and frustration too.

In this regard, the title of 'Infernal Triangle' suits it very well because it is a devil of a thing to have to live with. On the other hand, life is never dull.... :D

Hi GabrielleFor me this is

Hi Gabrielle

For me this is one of your better ones 

For a lay person it is a huge help in the understanding of what BPD is all about

As always, JC

Thank you JC

Thank you for your encouragement - as always  :D xxxxxxxxxx

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