Saturday, December 22, 2012

Mental Illness - Its Metabolic Energy Shifts?

We see a world "out there," while unaware of a "metabolic" world within?
We make image symbols like this, yet don't understand, holistic functioning?

"Socio-affective experience-dependant elicitation of internal chemical regulators of mitochondrial differentiation directly influences the observed postnatal changes in organelle morphology and function that underlie the transformation of energy production responsible for critical period phenomena, the effects of these events are long lasting.


Mitochondria play an essential role not only in structural circuit formation but also in neuronal functional activity in the mature brain." _Allan N Schore. 'What the?'

"Socio-affective?" "experience-dependant?" "internal chemical regulators?"

This is the kind of language that began to change my understanding and sense-of-myself, back in 2007. That was when my journey of medication free, mental illness recovery, began in earnest, through self-education? Stumbling on Allan Schore's amazing work, set me off on a personal quest to understand just exactly what the word "affective" actually means, in relation to my socially challenging, bipolar, affective disoder? 'It just means emotional disorder, affect is just another word for emotion,' several psychiatrist's told me, when I asked for an interpretation of this mysterious word "affective." Mysterious, becuase it does explain a more holistic sense of our reactive energy states and moods, and is becoming increasingly understood as the very foundation of our sense-of self? Hence the title of Allan N Schore's penultimate work "Affect Regulation & The Orgin of The Self."

Google It? And other modes of self-education, for better self-understanding and self-regulation? Please consider;

"Mitochondrial dysfunction and psychiatric disorders.
Bipolar disorder is a prevalent psychiatric disorder characterized by alternating episodes of mania and depression. Recent studies have demonstrated that important enzymes involved in brain energy are altered in bipolar disorder patients and after amphetamine administration, an animal model of mania. Depressive disorders, including major depression, are serious and disabling. However, the exact pathophysiology of depression is not clearly understood. Several works have demonstrated that metabolism is impaired in some animal models of depression, induced by chronic stress, especially the activities of the complexes of mitochondrial respiratory chain.

Schizophrenia is a devastating mental disorder characterized by disturbed thoughts and perception, alongside cognitive and emotional decline associated with a severe reduction in occupational and social functioning, and in coping abilities. Alterations of mitochondrial oxidative phosphorylation in schizophrenia have been reported in several brain regions and also in platelets. Abnormal mitochondrial morphology, size and density have all been reported in the brains of schizophrenic individuals."

Books are better?  At least, after the fourth and fifth reading, I began to understand the meaning? Please consider;

"The development of brain mitochondria and the regulation of organism bioenergetics:

Reparative mechanisms and stress proteins:

A deeper understanding of another self-regulatory phenomenon, the reparative response of the self during and following various schizoaffective stresses, may also be elucidated by a multilevel perspective. The capacity of the dual innervated orbitofrontal cortex to shift between high and low arousal psychobiological states and sympathetic and parasympathetic modes in response to stressful environmental conditions may define a fundamental adaptive regulatory function. The transition into a quiescent, low energy-utilisation state of conservation-withdrawal in response to certain hyper arousal, hyper energetic stresses is adaptive in terms of replenishing energy stores and restoring physiological equilibrium. The shift into this level is from tensional, alert, engaged, powered up, to withdrawn, atonic, inhibited, unseen, and disengaged; the organism strategy is to conserve energy, to allow healing of wounds and restitution of depleted resources. The same psychobiological mechanisms which optimises ‘healing of wounds’ is utilised not only in repairing stressful physical trauma that produces ’tissue injury’ but also in stressful psychological assaults against the self that produce ’psychic’ or ’narcissistic’ injury.

The parasympathetic mechanisms of conservation-withdrawal is biochemically expressed in elevated corticosteriod activity which increases glycogen synthesis, thereby replenishing energy stores and putting the tissues in better condition to withstand stress in general. Adrenal glucocorticoids play an essential role in behavioural adaptation, and the failure to increase their concentrations in the circulation in response to stress is associated with potentially deleterious sequelae such as tissue damage. In the cortex this stress system is physiologically manifest in a decrease in cerebral blood flow and an inhibition of cerebral energy metabolism. This could reflect the known modulation of the blood-brain barrier by pituitary adrenal glucocorticiods.

At a cellular level, a stressor is defined as a condition that exerts an effect upon the cell that disturbs homeostatic balance beyond the cells ability to compensate for that disturbance. (An "affective" disturbance?)

Socioaffective transactions between two individuals mediate psychobiological regulatory functions, both stress-inducing and stress-modulating. These changes occur at the molecular (stress protein) level, and effect function at the organelle, cellular, organ, and organismic levels. Limbic activity - socioemotional function - is central to the individuals recovery mechanisms. Social connectedness provides protection and recovery from physical and psychological illness.

Emotional expressions are associated with changes in blood flow and tempreture in sub-cortical areas. Thermo-sensitive cells in the hypothalamus would sense rapid temperature shifts associated with intense emotional transactions.

Psychological states are coherent packages of cognitions, behaviours, and affects, and state transitions involve coordinated changes in patterns of arousal, energy level, motor behaviour, cognitive processing, and affect. In this manner the maturing brain shifts between different states that constitute essential components of motivational systems and provide the neural substrate of the internal and communicative aspects of affects. The developmental advances in the ability to access an expanded array of internal states that supports more complex state-dependant information processing capacities, are responsible for the appearance of emergent higher states of consciousness.

Critical period dyadic experiences which subserve gene-enviroment interactions are imprinted into and influence the phenotypic maturation of the various brain systems that set the limits and ranges of the types of external and internal information the child’s emotion regulating right hemisphere can process. This socioaffective information processing capacity is equated with the efficiency of the organism to enter into matter-energy transformations during interactions with the social environment, that to enter into various basic types of dynamic low or high energy affective transactions with and without other humans. (Inter & Intra, Metabolic Energy Regulation?)

A personality’s unique range of schizoaffective experiences may define the individuals ‘affect array’, and the capacity to consciously experience a regulated affect may characterise ‘affect tolerance’. These dimensions may in turn operationally define the ’boundaries’ of the self as a psychosocial system. In contrast to the ‘dominant’ left hemisphere, the right hemisphere’s total contribution to human adaptation has until recently been consistently undervalued and under addressed.

Regulatory systems exist at the physical, chemical, biological, and social level of living systems. The self-assembly of hierarchical regulatory systems that allows for an adaptive capacity to cope with changing conditions in the surrounding physical and social environments is an essential characteristic of development.

A series of early environments influences the activation of nuclear and mitochondrial genomic programs that encode the maturation of biological structures from the organelle to the organ level. An essential common property of all biological systems, including human systems, is that they exist within an immediate environment from which they receive matter and energy and to which they return matter and energy.

Since the growth of the infant brain occurs only by virtue of being coupled to a source of energy, an appreciation of developmental bioenergetics is an absolute necessity to a deeper understanding of human development. In postnatal periods, the human social environment serves as a medium for essential energy transformations that are embedded in emotional transactions. These psychobiological interactions are essential to the individuals well-being throughout the lifespan, but during human infancy they are critical to the child’s survival and future growth.

In contemporary bioenergetic theory, information is conceived of as ’a special kind of energy required for the work of establishing biological order’. The processing of all forms of information by the brain, including that embedded in internal representations, occur through transformations of metabolic energy.

The extraordinary power of the concept of energy transformations derives from the fact that these fundamental phenomena occur on each and every level of living systems, from the molecular to the societal.

The growing postnatal brain, the physical matrix of the emerging human mind, is supplied with a continuous supply of energy from metabolic processes. A fundamental tenant of this theory states that the assembly of complex systems occurs under conditions of thermodynamic non-equilibrium (a directed flow of energy). This energy is utilised to facilitate the cooperativity of simpler sub-system components into a hierarchically-structured complex system that expresses the emergent functions of organising and maintaining stability.

Two essential conclusions of this volume are that energy shifts are the most basic and fundamental feature of emotion, and that the energetic transactions embedded in the socioemotional interchanges, between an adult and a developing brain indelibly shape the child’s emerging capacity for self-organisation. (Self-Regulation?)

Bioenergetic conceptualisations thus need to be implanted into the central core of psychoanalytic and psychological theory, a position they now occupy in physics, chemistry, and biology. Thermodynamics are not only the essence of biodynamic, they are also the essence of neurodynamics, and therefore of psychodynamics."

Selected excerpts from "Affect Regulation & The Origin of The Self," by Allan N Schore.
(In brackets, mine)
* * *

How does all this scientific research on our metabolic energies, translate to clinical practice, in the treatment of mental illness and "affective (mood) disorders" though? And how does reading this kind of science, help me to self-manage bipolar type 1 disorder, medication free, including the processing of three manic psychoses, without a rebound reaction into depression? After a 27 year experience of classic manic-depressive, energy cycles since my first episode of mania in 1980? An episode triggered by a sudden Attachment Loss. ( see: In The Beginning - Before Mental Illness? ) An online memoir of my experience.

Trauma & Its Disruption of our Vital Attachment Needs?
Please watch this video of Attachment Disorder and Trauma Resilience With Allan Schore, PhD


We interviewed Allan Schore PhD as part of our newest teleseminar series on Trauma Treatment. In this clip, Allan Schore talks about attachment disorders and how they shape adult attachment psychology. Also, he touches on why attachment disorders can affect trauma resilience. Here are some exciting clips. For more information on this free series, visit our website: http://www.nicabm.com/treating-trauma/?del=youtube

And a Pertentant Response? @nicabm, brilliant lesson. I've been a victim of serious emotional and psychological abuse as a child. I'm a survivor of Reactive Attachment disorder and have a huge capacity for emotion, and those emotions speak volumes. I've also been a victim of abusive relationships but I've since recovered and am presently in a healthy, loving, nurturing relationship. Thank you a lot.

* * *

Trauma, Reactive Attachment Disorders & The Body/Brain Nervous Systems?
"Education has taught me that bipolar involves the autonomic nervous system, not just the brain alone?"

Right at the top of my blog, this statement of my new self-understanding, a new self-awareness which has helped set me free from decades of cognitive assumptions, about my brain and bipolar disorder. Cognitive assumptions of a disease like process "affecting" (sounds like "affective"), some mysterious chemical imbalance within my brain alone? (no references in psychiatry's simple metaphor, to the body & nervous systems?) Of coarse, like all metaphors & myths (urban & otherwise), there is a kernal of truth in psychiatry's chemical imbalance theory, a theory which my brothers & sisters in the psychiatric survivior community, tend to rage and rail against?

I do agree with the kernal of truth, in this "cognitive construct" of a chemical imbalance (there is no emperical, scientific evidence), only after much self-education and self-exploration, has taught me a better (chemical/metabolic) internal energy regulation? I have come to understand, through sensation awareness, through my felt sense, that this "imbalance," is affected through the autonomic nervous system and its vital role in our self-preservation, with unconscious reflexes/responses? Particularily our innate "freeze" response, which "entrains" through habitual postural experience, a maladapted "trait" of "tonic immobility," in a defense, of an over-sensitized, sense-of-self?

Recall: "to shift between high and low arousal psychobiological states and sympathetic and parasympathetic modes in response to stressful environmental conditions may define a fundamental adaptive regulatory function." _ Allan N Schore. And; "However, the exact pathophysiology of depression is not clearly understood." (see: Mental Illness - Psychological & Physiological?) for Peter Levine's articulation of our habitual postures, and their relationship to mental illness?

From Top of the Head, Cognitive Constructs? 
To an Holistic Sense, of Metabolic Energy Shifts?

Please consider;
Regulating Self-Esteem, with Sympathetic/Parasympathetic, Metabolic Energy Shifts?
Reading, Allan N Schore & others, taught me to search beneath my own taken for granted cognitive constucts (rationalizations). Consider;

"Infant researchers now report that ‘maternal perception of oneself as a mother and the effective value (such as pride, shame) attached to the self-evaluation, appear to be critical factors in maternal self-constructs. Maternal self-esteem is a primary determinant of the developmental outcomes of the infant, and is related to the efficacy of the mothers transactional attempts to influence her child’s autonomic regulation. (autonomic nervous system)  The functional output of this homeostatic system represents the activity of two dissociable psychobiological components, and the co-activity of these components mediates the dynamics of the shame-pride axis. (see: Bipolar Anger & Toxic Shame?)

The attachment deactivator, a shame stimulator component, mediated by activation of the lateral tegmental limbic circuit, acutely brakes hyper-arousal and hyper stimulated states, diminishes positive narcissistic affective-coloring of self-representation, contracts the self, lowers expectations, decreases self-esteem, active coping, interest and curiosity, interferes with cognition and increases overt consciously experienced shame, para-sympathetic supported passive coping, blushing, gaze aversion, and depressive affect toned mood. (toned by the ANS's regulation of the heart?) The second component, the attachment re-activator, a shame modulator, mediated by activation of the mesocortical ventral tegmental limbic circuit, reduces consciously experienced shame, negative affect (that word "affect" again?) self-representations, low-keyed depressive states and passive coping, and initiates self-comforting functions which enable recovery of sympathetic supported positive hedonic-toned mood and narcissistic affect, expansion of the self, and active stress coping capacities. (the nervous system's, "affect" on the heart?)

The functional operation of these two components, (sympathetic & parasympathetic)  reflected in specific patterns of physiological activity regulated by the two neuromodulator circuits, is responsible for the generation of distinct psychobiological states. These circuits may act in a coupled reciprocal mode, a coupled nonreciprocal mode, or an uncoupled mode. Such potential relational patterns account for three modes of interaction - increased activity in one and decreased in the other, concurrent increases or decreases in both components, and responses in one subsystem in the absence of activation in the other. The confluence of their dissociable outputs is phenomenologically experienced as discrete emotions and enduring "affect states" - moods - that infuse and color distinctive internal states of consciousness, and that are externally expressed as discrete behavioural states.

These states are ubiquitous background phenomena, and in daily life most switches between states produce minor bodily changes that occur just below the threshold of awareness and are marked by the conscious experience of mild, low intensity emotions. This state transition is usually seamless and contextually appropriate, but in conditions of socio-emotional stress, the experience of intense emotion associated with major autonomic alterations punctuates and inaugurates a discontinuity in consciousness.

In the light of the related principles of state-dependant learning of affectively charged information, - that retrieval of information is minimal when the subject’s current state differs from that in which the information was acquired, and state-dependant recall - that achieving a particular bodily state is necessary in order to access certain cognitions, switching between states allows for a full range of access to qualitatively different affectively laden autobiographical memories and various psychobiological motivations For example, the operation of the attachment deactivator component suspends the behavioural state which drives attachment dynamics, while activity of the attachment activator re-initiates attachment motivation and drives the self into merger states which potentially generate positive affect.

In an attachment deactivation predominant state, the self is motivated to withdraw inwardly, away from the view of social objects, and seeks to avoid direct gaze and face to face object relations.

In attachment reactivation motivational state, the self actively seeks reunion transactions in which it reveals and exhibits itself to an appraised emotionally meaningful social object in anticipation of a mirrored amplification of positive affect. Izard notes that in the experience of joy the object is seen as enhancing the self of the perceiver."
Selected excerpts from "Affect Regulation & The Origin of The Self," by Allan N Schore.

Is Mental Illness, about Reactive Attachment Disorder? As Reactive Energy Shifts?
Beneath our "taken for granted," everyday thoughts and speach, lies a hidden world of metabolic energy states and the hidden reality of our sense-of-self? Please consider;

"Critical period dyadic experiences which subserve gene-enviroment interactions are imprinted into and influence the phenotypic maturation of the various brain systems that set the limits and ranges of the types of external and internal information the child’s emotion regulating right hemisphere can process. This socioaffective information processing capacity is equated with the efficiency of the organism to enter into matter-energy transformations during interactions with the social environment, that to enter into various basic types of dynamic low or high energy affective transactions with and without other humans.

A personality’s unique range of schizoaffective experiences may define the individuals ‘affect array’, and the capacity to consciously experience a regulated affect may characterise ‘affect tolerance’. These dimensions may in turn operationally define the ’boundaries’ of the self as a psychosocial system. In contrast to the ‘dominant’ left hemisphere, the right hemisphere’s total contribution to human adaptation has until recently been consistently undervalued and under addressed.

Regulatory systems exist at the physical, chemical, biological, and social level of living systems. The self-assembly of hierarchical regulatory systems that allows for an adaptive capacity to cope with changing conditions in the surrounding physical and social environments is an essential characteristic of development.

A series of early environments influences the activation of nuclear and mitochondrial genomic programs that encode the maturation of biological structures from the organelle to the organ level. An essential common property of all biological systems, including human systems, is that they exist within an immediate environment from which they receive matter and energy and to which they return matter and energy. Since the growth of the infant brain occurs only by virtue of being coupled to a source of energy, an appreciation of developmental bioenergetics is an absolute necessity to a deeper understanding of human development. In postnatal periods, the human social environment serves as a medium for essential energy transformations that are embedded in emotional transactions. These psychobiological interactions are essential to the individuals well-being throughout the lifespan, but during human infancy they are critical to the child’s survival and future growth.

In contemporary bioenergetic theory, information is conceived of as ’a special kind of energy required for the work of establishing biological order’. The processing of all forms of information by the brain, including that embedded in internal representations, occur through transformations of metabolic energy.

The extraordinary power of the concept of energy transformations derives from the fact that these fundamental phenomena occur on each and every level of living systems, from the molecular to the societal. The growing postnatal brain, the physical matrix of the emerging human mind, is supplied with a continuous supply of energy from metabolic processes. A fundamental tenant of this theory states that the assembly of complex systems occurs under conditions of thermodynamic non-equilibrium (a directed flow of energy). This energy is utilised to facilitate the cooperativity of simpler sub-system components into a hierarchically-structured complex system that expresses the emergent functions of organising and maintaining stability.

Two essential conclusions of this volume are that energy shifts are the most basic and fundamental feature of emotion, and that the energetic transactions embedded in the socio-emotional interchanges, between an adult and a developing brain indelibly shape the child’s emerging capacity for self-organisation. 

Bioenergetic conceptualisations thus need to be implanted into the central core of psychoanalytic and psychological theory, a position they now occupy in physics, chemistry, and biology. Thermodynamics are not only the essence of biodynamic, they are also the essence of neurodynamics, and therefore of psychodynamics."

Selected excerpts from "Affect Regulation & The Origin of The Self," by Allan N Schore.

* * *

This post is a further attempt to convey more of the nature of my shift in self-awareness and therefore self-interpretation, since I first began reading people like Allan N Schore, in 2007. There has been an ongoing process of re-framing my sense-of-myself, in terms of a more balanced, "felt/thought" sensing as I experience each passing moment? An ongoing process of freeing myself from the tyranny of self-doubt inherent in the label bipolar disorder, which gives no information about its cause, other than the "metaphor of a chemical imbalance?" When I first picked up Allan N Schore's book, I was expecting to read about my brain and its role in my symptoms of bipolar disorder, only to be constantly intrigued by references to the autonomic nervous system (ANS). Intrigued, because I had not heard any mention of the nervous system, in a 27 year experience of mental illness. I was confronted with my own ignorance, my own lack of self-awareness. I was clueless about what really makes me tick inside, simply assuming and needing to think and to feel, that Doctors know best about what goes on inside me.

Its taken time to assimilate this new knowledge and gain a new experience of myself, particularly as the language of neuroscience, is so unfamiliar to our "everyday, habitual," thought and speech patterns? And even though I'd gained an "intellectual" awareness of the meaning of those two vital words "affect" and "affective," it was not until reading Peter Levine's "In an Unspoken Voice" in early 2011, that I was able to transform an intellectual knowing, into a more solid and holistic "felt/thought" knowing. In simplistic metaphor, I guess it’s a knowing, at the gut level of my being? In this gut level of self-awareness, I found the solid ground of my own being and continue to transform decades of self-doubt, into a calmer acceptance, tolerance and forgiveness of myself and others. Learning to "feel" how I function at an unconscious level of nervous system reactions is increasingly dissolving my previous sense of "I" & "otherness," which had matured into a taken for granted, and therefore habitual sense of "us & them?"

IMO, its a diminished sense of our felt awareness of being in the moment, which underpins our Western, "I think therefore I am," and actively thwarts an unconscious, natural resolution to a trauma conditioning of so much distress, which we 'intellectualy" assume are symptoms of "mental illness," because we have forgotten how to sense the language of the body, at a felt level of our own being? We "recoil" from the sight of madness, simultaneously failing to sense our internal impulse/reaction, while mindfully assuming this reaction is about the other? As the late Teresa Brennan points out in her book "The Transmission of Affect," we assume a relationship to "otherness" as "object," diagnosing each other in a wary subjective manner, devoid of so much of our living breathing sensory nature? An egoic sense-of-self, built on the "unconscious" judgment of what we are NOT, rather than a more holistic, sensory awareness of what we are?

"Thermodynamics are not only the essence of biodynamic, they are also
 the essence of neurodynamics, and therefore of psychodynamics."

In our everyday, normal, and taken for granted sense-of-self, who thinks of self-awareness as thermodynamic? Who knew that mind, body and soul are made of such thermodynamic, "metabolic energy shifts?" And that so many of our thoughts/words, are really metaphors for a "hidden" metabolic processes within?

* * *

Please consider a previous post on our metabolic needs;
Objects are My Wants - My Needs are Metabolic

I want, I want - Yet What Do I Need?
An Object of My Desire? Yet is there a deeper Need it Satisfy's within me?  Is the external world of Objects a true reflection of Internal stimulation and the true nature of my Desire's? The great observations of the past century like Maslow's hierarchy of needs are being explored in their deeper reality nowadays by neuroscientist's like Stephen Porges and "The Polyvagal Theory" So how does a triune brain and nervous system stimulate our needs & desires within the hidden reality of our internal world?


These new ideas of a triune nervous system are revealing an inner reality beneath our object oriented and projected observations. The Polyvagal Theory has revealed the neural innervation of a 'social engagement system' based on the muscles & nerves of the head and face, suggesting a third branch of the autonomic nervous system. It seems we are hard wired for social engagement, and indeed our very sense of humanness is dependent on unconscious 'feedback' from other brains & nervous systems, creating what neuroscience now calls 'affective states.'

Other research suggests that the thinking mind is secondary to movement, and that the motor cortex within the brain is the real seat of psychoanalytic notions of a pre-conscious. Discovery of 'mirror neurons' suggest that despite our capacity for intelligent inquiry and design, we may still be bound by an instinctive nature, which is driven by the metabolic needs of energy & movement. Please consider;

 The brains activity began about 500 milliseconds before the person was aware of deciding to act. The conscious decision came far too late to be the cause of the action. It was as though consciousness was a mere afterthought - a way of 'explaining to ourselves' an action not evoked by consciousness. Peter Levine "In an Unspoken Voice"

So what are these unseen needs that stimulate the mind, our daydreams and our fantasies, and can we objectively define the hidden and even unfelt neural activity within our brain and nervous systems? As I write this article I'm listening to my favorite music and enjoying the stimulated sensations, although I can't tell you I'm consciously aware of the increase in temperature and blood flowing through my brain, or the particular neural networks that are firing a sensation of elation.

Emotional expressions are associated with changes in blood flow and temperature in sub-cortical areas.

Perhaps the music has triggered a firing of innate affects, deep within older layers of my triune brain, perhaps this is where animal instinct meets expanding neural networks and human emotion begins? And what metabolic needs will be served later on, when I find myself repeating this musical track, over and over in my head, with a sometimes compulsive desire? Will that be the hidden need of an energizing metabolic process? As I spontaneously repeat this song in my head while walking along, will I be stirring the kind of emotive energy that will maintain a positive level of "interest - excitement," to help me engage with life and the world "out there?"

Does the human mind, maintain or amplify innate affect/emotion, in "affective states," and is our instinctual-intelligence, overwhelmingly, a rationalization of primary, physiological, processes? Please consider these selected quotes:

"Schore proposes that the right-brain correlates with Freud’s “unconscious,’ the right brain
 is centrally involved in unconscious activities, and just as the left brain communicates to other
 brains via linguistic behaviors so the right non-verbally communicates its unconscious 
states to other right brains that are tuned to receive."  _ Roz Carroll.

"The left-brain style is to verbalize, to fall back on what is already known in order
to preserve the sense of self mastery." _ Roz Carroll.

"It may be that the “mind-body split,” is in effect a right-left split, with left-brain activation overriding the right-brain assimilation and regulation of sub-cortically generated emotional states."  _ Roz Carroll.

"The motor act is the cradle of the mind - The capacity to anticipate and predict movement,
is the basis of what consciousness is all about" _Sir Charles Sherington.

"We are exquisitely social creatures. Our survival depends on understanding the actions, intentions and emotions of others. Mirror neurons allow us to grasp the minds of others not through conceptual reasoning but through direct simulation. By feeling - not by thinking" _Giacomo Rizzolatti.



RELATED ARTICLES:
My Bipolar Recovery Method?
Madness & the Chaotic Energies of The Trauma Trap?
Mental Illness & The Face - - Heart Connection?
Mental Illness - Psychological & Physiological?
Discovering a Paradigm Shift in Mental Health?
Bipolar Anger & Toxic Shame
bipolar depression