Sleep Fatigue and Depression

Yesterday I gave a presentation at UCSF to the Mood Disorder Clinic psychiatrists and residents: An Update on Bipolar Depression.  Much of that material is focused on psychopharmacology and so I will be writing about that on the gatewaypsychiatric.com blog. However, one important pearly derives from a series of studies that identify a strong link between sleep and depression. There is frequent …

Medical Model

The medical model is something that many people with depression or mood swings feel frustrated about. The whole doctor-patient relationship with its power dynamics can seem exasperating, and at the same time, having an “illness” can seem as though it must be a source of stigma and shame. I’m not going to talk about the topic of the doctor-patient relationship, …

Sad Christmas

This will be a sad Christmas or some of those reading this post. You should not feel alone. I think that all of us can recall past Christmases there were disappointing or sad. We pass over these memories quickly sometimes. It’s not okay to be sad at Christmas time. Exactly how that should work, how it is that we should …

The Purple Thread – by Lyndsey

Greek philosopher Epictetus compared the masses to the white threads of a toga.  He declared himself to be a purple thread among the common white threads, saying “I desire to be the purple thread–that small and shining part which makes the rest seem fair and beautiful.” He went on to ask, when contemplating changing his personhood, “why should I attempt …

Positive Change or Mania?

Charlie is concerned that by being too positive he will trigger mania. He has been hospitalized once a year and the pattern always seems to be the same. He will have settled into a seemingly fixed state of depression, and then will begin to feel frustrated with that state and tried to make changes to escape from the swampy morass. He …

Depression Described

It can be extremely difficult trying to describe depression and therefore make the experience meaningful to loved ones, colleagues, etc. As it happens there is a TED talk by Andrew Solomon entitled, “Depression, The Secret We Share,” that is an excellent discussion and description of depression. In addition to the video itself, there’s a fascinating website that has quotes from …

Stigma Busters

One of the main purposes of this website is helping to remove stigma and shame and allowing people who wrestle with depression and mood swings to deal with their problems in a direct way. Shame and stigma make it hard to cope with depression because they make every thought about the topic painful and this makes positive coping and planning …

Psychiatrists Don’t Care About “Why”

Psychiatrists tend to be surprisingly uninterested in discussions about why people are experiencing mood symptoms or anxiety symptoms or terrible stress. Let me try and explain this stance, which often seems bizarre to my patients. A young man who was recently married and had been living at home, and hadn’t been working for the last six months because of anxiety …

Meditation Tricks

Most of us in the Gateway Clinic have been encouraging our patients to take up meditation for years.  We will explain how it works, and what the benefits are, we’ll suggest books on the topic, recommend guided meditation sources, follow up on those recommendations, and follow up, and follow up… And yet, this has been an exercise in frustration.  Very rarely …

Welcome to the Jungle

Since Welcome to the Jungle is a book about bipolar written for young adults. And since most people are diagnosed with bipolar as young adults, often thrown into a world of confusingly contradictory information, needing to suddenly understand a complicated condition, and make important self care decisions, when they have only recently started living independently, we thought this book could …

Brain Training

Brain training seems like an appealing solution to a common problem that people have with depression: a loss of cognitive function which can make you wonder if your becoming demented. Does brain training work? A number of our patients say that they have had some positive results from it. But a new study raises questions about how effectively it works …

Circadian Rhythm Self Assessment

I ran across a wonderful tool for circadian rhythm self assessment on the website of the Center for Environmental Therapeutics. The Center is devoted to providing the public and clinicians with high-quality information about natural interventions for people with stress, anxiety, and depression. I took the online test and it said I was definitely a morning person. Which is true now, …

New Staff

I am pleased to welcome a young woman, Hershe Gesmundo to this site. She is going to be working with me on a number of administrative projects related to the site, and to the companion site for the Mood Disorders clinic that I run – Gateway Psychiatric Services. Hershe had this to say about herself – Hershe Gesmundo is a …

Thank You

Thank you all of my thoughtful readers, contributors, and people posting comments. I am truly grateful for your willingness to spend your time making this site a little bit better, a little bit more useful. I was reminded of how much I have to give thanks for by a wonderful post (in the member forum) by Kelsey Schraufnagel. Kelsey shared …

Bipolar Depression – Energized States are Rare

I ran across this slide in the Psychiatric Times Bipolar Disorder Information Center. I think it neatly illustrates why so many of the people I talk with, particularly people with bipolar 2, find it hard to understand the diagnosis. On average, patients with bipolar disorder spent  roughly 70% of their time in a depression when they were having mood symptoms. Patients …

Stress and the Holidays

Stress and the Holidays– A successful businesswoman, who is herself a mother, is returning to her family’s home to have Christmas with her grandparents and her brother and wonders how she might improve the quality of that holiday experience. Her mother is someone who obsesses about all of the details involved in the holidays, she takes hours wrapping presents, and …

Suicide – But Not Death By Your Own Hand – Dr. Suzanne Black

Suicide: from the Latin “sui” – “of one s self,” “-cidium” – “a killing” – “suicidium.” “I cannot stand feeling this way anymore. Please let IT end.”  Let the pain end.  We embody the pain, therefore as the source of pain, we feel compelled to end ourselves in the desperate moments. But is it not the pain we want to …

Welcome to the Jungle

Welcome to the Jungle is a nice addition to the large list of bipolar self help books. Hillary Smith has written a book for the young person dealing with a new diagnosis. The information is up to date, but the tone is informal, and respectful of the mix of feelings that many people have facing a new diagnosis of bipolar …