A patient represented by an attorney obtained AETNA health insurance coverage for rTMS treatment of bipolar depression. The patient satisfied the insurer’s policy guidelines for rTMS treatment of major depression by demonstrating failed trials of 4 different medications. Reimbursement was based on the plan’s allowed percentage of the “covered amount”. The AETNA Appeals Decision stated: “TMS treatment is being authorized for …
Mindfulness and Irritable Mania or Hypomania
Ginger showed up in my office today feeling “incredibly irritated” by “people who don’t do their jobs.” She is a small business owner who relies on the work of many contractors for her business and she has been running into the usual excuses for work done late, or not at all, and finding the excuses to be almost intolerable. She …
“Are You Living a Life You Value?”
Sometimes our lives can become so full of the myriad items to manage and tend to that we lose track of what is most meaningful. Rarely do we afford ourselves the time to stop and ask, “How do I really want to be spending my time? What is it that I value?” The end-result of this way of functioning tends …
Spring Forward?
Those of us in the United States tried to remember what happens to the clock with daylight savings time using the phrase “spring forward and fall back.” In California daylight savings time has been accompanied by a week of the sunniest weather in a couple of months. For whatever reason, in our practice at Gateway Psychiatric there has been a sudden uptick …
A Magic Solution for Children’s Behavior Problems
For readers who have children a common concern is what to do with children’s behavior problems. Of course, there’s no one size fits all solution to the problem but over the years we’ve been repeatedly impressed with the effectiveness of the solutions to be found in a series of books by psychologist Kevin Leman entitled Have a New Kid by …
Time is Health – Nancy
I want to try and start a new proverb this year: Time is not money, time is health. Time is health. If you get a couple minutes’ break, use them for stress management, a few simple breathing exercises, then get back to work. If you get 15 minutes, close your eyes for a real rest. Every work day should have an hour …
Survival Strategies for the Holidays Reviewed
Why should you need survival strategies for the holidays? Aren’t they supposed to be fun? That’s part of the problem of course, there are so many expectations and hopes wrapped up in holiday season that it’s easy to end up feeling disappointed. If things haven’t worked out for you in a relationship or someone close to you is passed away this …
Bipolar Workbook
Gateway Psychiatric Services is excited to announce the release of our latest book: The Bipolar Disorder Workbook from Callisto Media. Designed to educate and motivate people who have questions, particularly about Bipolar II and cyclothymia, the workbook walks users through a series of structured exercises, beginning with a basic checklist intended to identify symptoms that may warrant further investigation. The …
Diagnosis – Nancy
What does it mean to have a diagnosis of Bipolar I or II? For some, finally getting a diagnosis can be a relief, as it was for Demi Lovato, whose story was shared in Moodsurfing a few weeks ago. For others, not so much. Mariah Carey was diagnosed with bipolar back in 2011, but she says “I didn’t want to …
Building Healthy Habits – Gina
Building healthy habits can be very important in managing mood. Regular sleep, exercise and diet can play a key role in reinforcing a stable mood. As a result, I regularly work with clients to identify healthy habits they would like to form and steps they can take in doing so. Most of the the time they are core habits such …
Making A Daily Plan
Consider the value of “boring”. Steve Jobs reportedly once said “I’m a big believer in boredom” –meaning maybe that if life is quiet and predictable enough you may have time to think, time to daydream, and time to make new decisions and choices. For people living with bipolar, boring can be a tough goal. But structure is everything when it …
Breastfeeding and Mood – Nancy
A young mother noticed a relationship between breastfeeding and mood. as she begins to wean her son from breast-feeding she is experiencing a return of occasional irritability which disappeared towards the end of her pregnancy. We know that there is a strong effect of breast-feeding on many hormone levels and thought we would check into the literature. What does the …
Checking Up Versus Building Intimacy
Moodsurfing has often focused on improving the quality of intimate relationships, in a therapy session today I explored with a young woman the difference between checking up on her partner and building a more intimate and connected relationship. Early in a relationship it is pretty common to have anxiety about the other person. Are they really committed to the relationship, …
Too Busy to Enjoy Life? – Nancy
Are you busy? Why? Are you rushing? Why? Being busy and accomplishing a lot of things is supposed to get us somewhere we want to be, or something we want to have. But is it working? We usually believe that we have to rush to get everything done and we have to get everything done in order to get what …
Pregnancy and Depression
Bipolar Network News just published a set of articles on pregnancy and depression which are a useful update of the research in this important area. Other recent articles on moodsurfing about pregnancy include one by Nancy on apps for depression in pregnancy, an article summarizing a controversial study suggesting a link between antidepressants in pregnancy and autism, an article on the subject …
Undiagnosed Hypomania – Nancy
How big a problem is undiagnosed hypomania? By some estimates as many as 50% of people being treated for depression may have hypomania (similar to mania, but milder) episodes as well. A recent article in Psychiatric Times encourages doctors to maintain an increased level of suspicion about the possibility of hypomania in patients who are receiving treatment for a range …
You Are Never Too Old to Keep on Living!- DeborahMichelle
Sometimes people feel that it is time to end it all because they have become too old without having achieved a dream, or because they are no longer attractive. It seems to me that these feelings may have been behind Ms Kate Spade’s recent death. Everyone faces disappointments. And as we age we have to deal with more of them. …
Depression Increasing – Nancy
Is depression increasing? Major depression diagnoses have risen by as much as 33% according to a report by insurer Blue Cross Blue Shield. These numbers may be under-reports since they do not include the uninsured, and even among insured people there is significant under-diagnosis. Particularly concerning is the rise in depression among adolescents and young adults. Rates have increased as much …
Resistance Training for Depression – Nancy
Exercise is good for depression, but what kind of exercise is better and how well does it work, is resistance training better than aerobic exercise? The prestigious journal JAMA Psychiatry has published a lengthy meta-analysis of 33 studies looking into the effectiveness of resistance training (RET) in reducing depressive symptoms. RET includes exercises such as weight training, push ups, etc., …
Absence of Posts
Several long time followers of moodsurfing have noticed the absence of posts written by me on this site. This is not due to a lack of concern or interest. In fact, for the last three months I have been writing a workbook with Gina focused on helping people with bipolar two, cyclothymia and other bipolar disorders (not bipolar one). Some …