We’re coming up on a time of year that for many (maybe even most) people offers significant challenges. Now is the time to plan ahead for the difficulties you typically face during the holiday season, and call to mind coping strategies that have worked for you in the past, or new ones that you want to try. Depression is a …
Bipolar or Unipolar Depression?
If you have an episode of depression, how can you tell if it is bipolar or unipolar depression? The simple answer is, you have bipolar depression if you have ever experienced an energized (not necessarily pleasant) state that qualified as a hypomanic or manic episode. And if you only have had depressed episodes, you are considered to have unipolar depression. …
Controlling Mania – Even When it Feels Good
Learning to stop a manic episode in its tracks is an important skill for living creatively with moods. Mania is a dangerous state, and failing to control it leads to worse and deeper depressive moods afterwards. In order to gain more stability in the midst of mood swings, it is important not to give in to the call of the …
Spring Mania
Seasonal Mood Changes Spring is coming, a season that some call “mania season”. Even those without mood disorders often feel a rush of energy and hopefulness as the days finally start to get longer, and the temperatures go up. Many of our bipolar patients find that their mood swings follow a predictable pattern: for the majority, “up” in the spring …
Hypomania Management
Hypomania also needs management Of all the different mood states that people working through bipolar I or II have to deal with, hypomania may be the most difficult to understand. Often misdiagnosed, or left untreated for a variety of reasons, hypomania can also have its own stigma attached, as a post in BPHope reminds us. Friends, family members and other …
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 …
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 …
Famous Bipolar People – Nancy
Why are there so many famous bipolar people? Will a diagnosis of bipolar make you famous? Probably not, at least not immediately. Nonetheless, it is a reality that a surprising number of famous people, contemporary and historical have a confirmed or suspected diagnosis of bipolar. Winston Churchill, Isaac Newton, Ernest Hemingway, and other household names are included in this inventory. …
What is a manic episode? – Nancy
What is a manic episode? Recognizing a true manic episode is critical to the diagnosis of bipolar 1 disorder. It is not merely feeling energetic, or high-spirited. During a manic episode, one may not be able to work, may avoid or seem fearful of family members and other close associates, and may require hospitalization. Similar, but at a milder level, …
Mood Spectrum
Author and psychiatrist James Phelps presented a thought provoking presentation about the notion of a mood spectrum (from very unipolar to very bipolar) and how that idea is changing the way that clinicians work with people with depression. The title of the presentation was “A More Nuanced View of Hypomania” but the talk itself is broader than that. The spectrum …
How High is High?
We met a few days ago with one of our favorite people. She’s a writer and an artist and she has been gradually reducing some of her medications to see whether the combination of more diligent self-care and a lower dose of medications can lead to better quality of life and a return of some of her creative capacities. This …
Impatience Warning
Sometimes I wish that my depressed patients had more impatience. Eagerness for change when you have been depressed for a long time can be a good thing. But if you have bipolar depression, impatience is not always a useful emotion. This past week, several people began expressing impatience with their progress. A couple of them expressed the view that I …
Mindfulness: No Gain without Pain?
Mindfulness is one of those practices that seems to, quite perversely, be most important to practice at times when it is most difficult to do. A successful interior designer with bipolar disorder who has been on a mild run of hypomania for a month or so told me, in a roundabout way, about how people around her were getting a bit exhausted …
Impulsivity – Gina
Impulsivity is something everyone has experienced. We have all had moments when we have said something impulsively that we regret or have gotten carried away with an idea. Sometimes the consequences of an impulsive action are minimal. But that is not always the case. Impulsive decision-making is more common in people with bipolar. And this increase is not just something seen …
Bipolar Type 4
We’ve recently been re-reading some of the works of Hagop Akiskal, one of the most important writers about Bipolar of the last 50 years. He is particularly focused on identifying sub-types of bipolar as well as exploring the relationship between bipolar and creativity. We were particularly struck with his description of type 4 bipolar. This is someone (he says usually …
Early Intervention Can Prevent Episodes
Early intervention can prevent episodes of depression or hypomania or mania. This is not always the case but most of the people that we work with find that it is helpful to go through a process of systematically identifying possible early warning signs of an episode and working with a friend or partner to come up with a plan for …
Pace Yourself for More Manageable Moods
I have been doing a lot of thinking about how to pace yourself so that you can capture some of the energy and creativity associated with being mildly energized while not getting so involved that you burn out or edge into full-fledged mania. There’s nothing quite so exciting as entering a time of increased energy and ideas after a long …
Hamster Brain
A young woman who has been making good progress tackling the problem of severe depressive episodes suddenly is having trouble managing the opposite end of the mood spectrum. She gets energized and is consumed with getting stuff done. She is unable to stop until she is exhausted and she crashes. I call this state of mind “hamster mind” because it is like the …
Hypomania and Success
During the 1990s clinical psychologist John Gartner was planning on writing a book about religious movements started by manic profits, but he began to be distracted by the energy and excitement swirling around him as people became immersed in the Internet “bubble”. He decided instead to write a book about the relationship between hypomania and success in the business world (The Hypomanic …
Through the Looking Glass 4 – a result
…The Becks Questionnaire II business continues. What brings it alive are the questions that Dr. Black continues to ask me throughout the test until we arrive at, what for me, is an astonishing discovery… At some point Dr. Black tells me there is a store on Martha s Vineyard, a ritzy, gentrified island off of Cape Cod, Massachusetts, that has …
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