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 …
Higher Carbohydrate Meals Increase Punishment
A study in 2017 finds that the composition of food in one meal can significantly affect behavior in the following hours, higher carbohydrate meals increase punishment behavior. How does this work and what does it mean in terms of understanding how diet affects mood? In the study, a high carbohydrate breakfast boosted tryptophan and lowered tyrosine. Tryptophan is the key …
Mindful Speech
Mindful speech seems to be in short supply these days. A pervasive sense of urgency about communication propels us into comments that we later regret. Rick Hanson reminds us of the words of Buddha, wise speech always has five characteristics. It is: Well-intended – Born of goodwill, seeks to support and strengthen rather than belittle and criticize. True – Not overstated, taken out …
Fall 2017 UCSF Bipolar Psychoeducation Group
The UCSF bipolar psychoeducational group starts on August 7, 2017. It runs for 8 weekly sessions, Mondays 12pm to 130pm. Most commercial insurance accepted. I often describe this group as “an advanced class about bipolar disorder for people who have bipolar disorder.” I have attached a flyer and a draft schedule. Please feel free to give/show either to your patients. There is also …
Ride the Tiger
Ride the Tiger is a wonderful PBS documentary that covers a lot of important information about bipolar in an entertaining and informative one hour program. One of my patients strongly recommended it. Treatment Stories about treatment, the good, the bad and the ugly. Self Care The importance of self care. A brief introduction to some useful ideas. The Genetics of …
Examine Your Fears
Why would you want to examine your fears? Remember that part in the scary movie when the hero suggests going down into the basement to take a look around and you cringe in your seat and mentally say “don’t do it”? Tim Ferriss, who has bipolar himself, says that engaging with and examining your fears is how to stay mentally …
Exercise Solutions to Roadblocks
I was inspired to write this post on exercise solutions by a wonderful article in BP Hope that not only talks about reasons for making sure that you are exercising but also tries to overcome some of the barriers to making this change. You already know why Exercise is critical for brain health Exercise and physical activity is the most …
Sitting with Emotions – Gina
Sitting with Emotions I regularly work with clients who are trying to avoid and push away feelings of sadness, anger, loneliness — so-called “negative” emotions. On the one hand, I can entirely relate with this draw and have experienced it myself. However, the more I’ve learned to sit with these emotions, and witnessed others sit with them, the more important …
Connection – Gina
Support and Connecting I think about the value of human connection a great deal in my work, especially when working with those with co-occurring substance use and mental health disorders. I am continuously reminded of the value that support plays in the lives of individuals in recovery both in relationship to addiction and mood disorders. There is a great deal …
Tools for Change
In my previous post I outlined the idea of “stages of change,” here I want to focus on some of the tools for change. In the picture below you will they the stages of change lined up with appropriate tools for change. Some of the tools are appropriate in more than one stage and, in general, the activities that support …
Ready for Change?
Getting Ready for Change The process of getting ready for change has been the focus of the research of James Prochaska for the last 40 years. James O. Prochaska and Carlo Di Clemente, developed the Transtheoretical Model for change (TTM), which is the most widely accepted framework for understanding change in the mental health and substance use treatment communities. They found …
Nature and Wellbeing – Gina
Nature and Wellbeing Many patients I work with speak of the value that nature plays in their lives and I can say that I also strongly relate to the value it plays in my own. Through personal experience and repeated accounts from others, I have seen how nature can improve moods, increase feelings of connectedness, and impact thought patterns. More …
Travel Preparation for Bipolar
Travel and mood are very much related. Often a trip is associated with a significant change in mood. This can be…
Mindfulness for Children
Mindfulness for children may be a hard concept to envisage if your family life is something other than the ideal home of tranquility and good feeling. But it is an idea worth exploring, for a couple of reasons. Habits acquired early in life can have a profound impact on future development. With all of the interest in mindfulness as a …
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 …
Treatment Controversies
Treatment controversies abound in psychiatry. An earlier post about a conversation I had with a patient’s therapist in which it seemed that both therapist and patient agreed that being encouraged to come in for an early appointment was a kind of punishment, sparked an interesting dialog with one of this blog’s many dedicated readers. The reader wrote – As one who has experienced that …
Better Sleep with SHUTi – Gina
Using Shuti to Get Better Sleep Better sleep is a priority for many of the people I see. Recently I’ve started supporting clients in using an online CBTi (Cognitive Behavioral Therapy for Insomnia) program. I decided to check out the program for myself to get a better feel for what clients are working with. Ultimately I recommend SHUTi to clients …
Radical Acceptance and Coping with Bipolar Disorder – Gina
What is radical acceptance? Radical acceptance is an approach named by Marsha Linehan, PhD who created Dialectical Behavior Therapy that is about completely and totally accepting something, stopping the fight against reality, and ultimately, suffering less. Things will regularly happen in our lives that are outside of our control, such as having a diagnosis of bipolar disorder or experiencing a …
12 Steps
There are a few people in my experience who are as impressive in maturity and integrity as those people we have worked with who have been the most involved in 12 Step Programs. I didn’t come to this observation from any pre-conceived bias in favor of 12 Step Program. If anything, my involvement with 12 Step early on was pretty negative. It …
Sadness Benefits
Are there sadness benefits? It often seems as though the work I am supposed to do is to eliminate all negative emotion on behalf of the people who come to me for psychiatric help. But is that possible, and if it were possible would it be a good thing to do? Are there sadness benefits that would be lost if …