This post is part of a collaborative narrative series composed of my writing and Chris Arnade's photos exploring issues of addiction, poverty, prostitution and urban anthropology in Hunts Point, Bronx. For more on the series, look here.


Background The association between stressful life events and onset of bipolar episodes is unclear. The association between bipolar episode onset and types of life events that disrupt social routines, and potentially sleep, has not yet been investigated.

Methods Thirty-nine bipolar patients with primarily manic (n=20) or depressed (n=19) index episodes were interviewed with the Bedford College Life Event and Difficulty Schedule to determine the presence of severe events during 8-week pre-onset and control periods. All life events were also rated for degree of social rhythm disruption (SRD).

Results More bipolar subjects experienced at least 1 SRD event and severe event in the pre-onset vs control periods. When subjects were divided into those with manic or depressive onsets, the only significant pre-onset vs control difference was for manic patients with SRD events. Additionally, the proportion of subjects with a pre-onset SRD event was greater for manic than for depressed patients.

Conclusions We found evidence that life events characterized by SRDs routines are associated with the onset of manic, but not depressive, episodes. Severe events seem to be related to onset of bipolar episodes, although it remains unclear whether severe events relate differentially to depressive and manic onsets.¹

Pepsi: Hunts Point, Bronx. Courtesy of Chris Arnade.

This is a continuation to Pepsi, Part I.

Hell, Boy

In flames, everything.

That's what they say

you put them through,

Ash-sister. The streets

gorge on gossip.

Carbon ate the apartment

with the Barbie pink walls

where men came to buy

smoke and companion

and women kept

everyone well, spooning

Honeycomb cereal into

shared beds.

Does a fire's voice sound

like screaming from the dirt

poor friends who say you steal

their New Balance

sneakers? Enter bi-

polar fits to rage and to live

under the half-moon

skeleton bridge.

You are the Fragglewump

seen on sewage TV

in this mixed up

underworld they speak of.


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