More than half of people with bipolar will qualify for a substance use disorder diagnosis at some point. In many places, the most popular drug (other than alcohol) in people with bipolar is cannabis. People with bipolar are almost 7 times as likely to use cannabis than the general population. In the United States, many states have legalized cannabis for medical indications, and two states have legalized its recreational use. …
Mind Maps and Post Its
Stuck with a problem that you can’t figure out? Having trouble generating ideas? One of the things that the mind is very good at is coming up with potential pitfalls. And all of us have found ourselves trapped with recurring negative thoughts that make it hard to do any creative thinking. Sometimes changing the process or framework for thinking about …
Parity is What We Want
An overwhelming majority of Americans want parity. A large study found that almost 90% of Americans reported that mental health and non-mental health care were equally important to them in terms of their overall well-being. At the same time nearly a third of those Americans surveyed felt that mental health care was inaccessible and 40% felt that it was something that …
Self Injury is the 8th Leading Cause of Death
An article just published online in the prestigious journal JAMA Psychiatry makes us drawn case that our fascination with trying to come up with clear answers to questions that may ultimately be impossible to answer (what a person’s intent was when they injured themselves) is obscuring the fact that self-injury is now the eighth leading cause of death in this …
Omega 3 Prevents Psychosis
The Omega – 3 supplementation story seems to take many twists and turns. At one point, based on double blinded controlled study published by Andy Stoll, et al, from Harvard, in JAMA Psychiatry in 1999, it looked as though omega 3 fatty acids would turn out to be a very effective treatment for bipolar, with almost no side effects. Subsequent …
Is It Bipolar? The “Rule of Three”
Confession time: When I was younger I used to take the women’s magazine quizzes – How to know if you have met your ideal partner? When to worry about your sex life. It turned out that all kinds of interesting and complicated life questions could be boiled down to the answers to about 6 multiple choice questions. Of course it was …
Fall Warning
Northern Hemisphere Fall Warning If you live in the northern hemisphere, and particularly if you live in the United States, this seems like an appropriate time to point out that fall is coming. The yellow school buses are once again trundling through the streets taking kids to school, the commute has once again jumped up by a factor of two …
MIND Diet Prevents Memory Loss
Researchers at Rush University have developed a diet (the MIND diet) that appears to be associated with significantly reduced cognitive decline in aging. The diet was developed from three sources of information: the Mediterranean diet (as elsewhere on this blog), the DASH diet for the prevention of hypertension, and a review of the literature on the effects of specific dietary components …
Distress Tolerance
A wonderful young woman we have been seeing for a few months asked for some recommendations for skills to help her deal with her experience of moments of overwhelming negative emotions that often seem to come out of nowhere. This post is a relatively quickly pulled together document derived from Marsha Linehan’s Dialectical Behavior Therapy. Think of it as a “draft” …
St. John’s Wort for Depression
A recently published study raises questions about whether the natural supplement St. John’s wort is actually associated with fewer adverse effects than commonly prescribed SSRIs. Living in the Bay Area it is common for me to run into a strong conviction that any natural supplement is bound to be safer than any manufactured medication. Perhaps the most problematic of these …
DBT for Bipolar Group
We are very happy to pass this information on about a great group for people with bipolar being offered in the bay area by an expert in the psychosocial treatments for bipolar: Dr. Jenifer Culver. Dialectical Behavior Therapy (DBT) Skills Group for Individuals with Bipolar Disorder in Los Altos, CA. The Next group begins September 2015. This group focuses on teaching …
UCSF Bipolar Group
The UCSF bipolar psychoeducational group starts on September 14, 2015. This group is lead by bay area bipolar expert Descartes Li, MD. It runs for 8 sessions, Mondays 12pm to 115pm. Most commercial insurance is accepted. Dr. Li describes this group as “an advanced class about bipolar disorder for people who have bipolar disorder.” For regular readers of this blog it …
Bipolar Types
One of my new patients introduced herself this way, “Hello Dr. Forster, I have Bipolar 2 and a half.” Had she just finished watching Harry Potter and was thinking about the invisible platform that takes young wizards to Hogwarts? No, she was referring to a type system developed by Hajop Akiskal, probably one of the most influential thinkers in the …
Mindfulness for Bipolar – Eric
Could mindfulness meditation be a viable treatment for bipolar disorder? What are the aims of modern-day meditation? Transcendence? Inner peace? Maybe a sort of vague, on-and-off tingling around your body where you think your chakras should be? With mindfulness meditation, there really aren’t any guarantees. In fact, just having any expectations, or the experience of “anticipation,” runs counter to the …
Bipolar Depression Articles – WSJ
The mother of a young man with bipolar depression sent us the link to this article in the Wall Street Journal which gives a pretty balanced update on what we know about diagnosing bipolar depression (as opposed to unipolar depression). http://www.wsj.com/articles/seeking-better-ways-to-treat-the-lows-of-bipolar-disorder-1436221964 Perhaps in keeping with the overall mission of the newspaper, the discussion is heavily focused on technology, as opposed …
Parity Website
We ran across information about a new website that is drawing attention to the issue of mental health parity and that is dedicated to helping people get the behavioral health treatment they need – Paritytrack.org. The essence of the federal law that requires mental health parity in insurance coverage is not that mental health needs to have a certain level of …
Bipolar Story in New York Times
I ran across a fascinating article in The New York Times magazine this past week entitled “I Don’t Believe in God but I Believe in Lithium” by Jaime Lowe dated June 25th 2015. It is a remarkable story, most particularly remarkable because it deals with some of the most charged issues connected with bipolar – inpatient and involuntary treatment, medications …
Prefrontal Cortex and Limbic System
A very bright young man who has a great potential as the therapist but who is wrestled with chronic depression for years and has developed a pattern of avoiding doing things that he knows he has to do in order to move ahead with his life led me to talk again about the relationship between depression, the limbic system (or emotional …
Medical Marijuana
20 states have laws authorizing the use of medical marijuana, but what is the evidence for the medical effectiveness of marijuana? An exhaustive review of the topic just published in the Journal of the American Medical Association finds that, overall, the evidence for marijuana’s effectiveness is quite poor. And while many of my younger patients tell me that the problem …
Sleep and Learning
What is the point of sleep? We have a page on this blog devoted to the question but in the last couple of years there’s been an outpouring of research pointing to the critical importance of sleep in sorting out memories (getting rid of unuseful ones) and generally “tuning up” the brain. A fascinating article last year pointed to evidence …