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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 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 and mood are very much related. Often a trip is associated with a significant change in mood. This can be…
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 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 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 …
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 …
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 …
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 …
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 …
For people who have been exposed to violence or trauma, and who naturally experience some symptoms of anxiety, what approaches are most useful for PTSD prediction? The majority of people exposed to violence or trauma do not go on to develop posttraumatic stress disorder or PTSD, but, depending on the nature of the trauma (sexual trauma has the highest risk) …
Depression is often untreated, according to the results from the federal government’s National Health and Nutrition Examination study. The vast majority of Americans with depression didn’t seek help from a mental health professional Only 35% of people with severe depression and 20% of those with moderate depression said they had sought help from a mental health professional, according to the report …
Addressing Shame and Guilt After a Manic Episode I have witnessed the immense pain caused by the shame and guilt experienced by people with bipolar disorder following a manic episode. After a manic episode, most have engaged in behaviors that they regret. The resulting shame and guilt can contribute greatly to symptoms of depression that follow an episode. Understanding techniques …
We are putting our Bipolar 101 course online. The first portion of that 9 part course is going to be available free on our sister site, Gateway Psychiatric Services, but here is a preview of one section entitled “What is Bipolar?” Future sections will address self care, medications, other therapies, and a host of other issues and concerns.
Scientists are uncovering a fascinating relationship between circadian rhythms and food consumption. It looks as though when you eat can have a big impact on how your body metabolizes the food and on whether or not you gain weight. It has long been clear that light exposure plays an important role in setting a number of circadian rhythms in the …
“How can I get my creativity back?” One of my patients, who has been wrestling with depression for quite a while, asked me if I could think of anything that might help give her creativity a boost. My quick, off the cuff, reply was “go running again” (she was an avid runner before she got depressed), in part because of …
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 …
Mood trends are useful to track in order to prevent a full blown episode of depression, hypomania or mania. I think of them as equivalent to the idea of a falling or rising barometer. Before satellites and modern weather forecasting, whether the barometer was rising or falling was the best predictor of the weather. If the barometer was rising it …
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 …
In an era of ever-present video and constant texting and snapchatting, many parents are trying to figure out how to deal with childhood insomnia. Here is a quick guide for busy parents of things to think about and things to do if your child is having trouble getting to sleep or getting enough sleep. Consider possible causes – Stress. Kids, …
