Types of Anxiety and Mood One of the most complicated questions we face working with people who have experienced depression or mood swings has to do with the relationship between mood and anxiety. One way of trying to bring a little bit of clarity to this discussion is by considering the different types of anxiety. In this post we will …
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 …
Avoid Intimidation
Rick Hanson has written an elegant and timely newsletter article about how to avoid intimidation and fear from paper tigers and media demagogues. I love his weekly email newsletters and it is again time to encourage readers of this blog to sign up. Here is the link. One of Rick’s themes, elegantly outlined in this most recent article, is how …
The Science of Slow Breathing
In an April 5, 2017 article in the New York Times, Gretchen Reynolds reviews new research on the science of slow breathing and how this ancient technique may work to promote relaxation, reduce anxiety, and prevent panic attacks. The technique of controlled breathing or pranayama (प्राणायाम) is referred to in the Bhagavad Gita, and thus dates back at least to …
Acceptance and Commitment Therapy Part 3: Present Moment Awareness
I hope you have a few minutes to engage in a few exercises with me…. First, I’d like you to take 1 or 2 minutes to imagine that you are sitting on a white sand beach looking at the ocean, watching the waves roll onto the shore. Set your phone timer if that would be helpful. And….go. What did you …
Mixed Depression and Anxiety or Bipolar ?
A young man who recently graduated from chiropractic school came in for a second opinion. He has had a many year history of depressive episodes with prominent anxiety symptoms. Is this mixed depression and anxiety? This past summer, he went to see a new psychiatrist to get help with another episode of depression. The psychiatrist started him on Lexapro (a serotonin …
Coping with Political Uncertainty
Many of the people that I work with on a regular basis have been experiencing symptoms of depression and anxiety related to the recent election results. Unfortunately, mental health professionals are no better as news analysts than the so-called professionals. I have been struggling a little bit trying to figure out what to say to these people. Coping with Political …
Anxiety and Bipolar
For many people with bipolar anxiety is a bigger problem than mood swings. It is not that unusual for someone with bipolar to report that their first “symptom” of a psychiatric nature was the onset of anxiety early in childhood. Let’s take a look at this information again… 90% of people with bipolar have an anxiety disorder diagnosis. 2/3rds have had …
Acceptance and Commitment Therapy Part 2: Defusion
Defusion is one of the six core processes that make up Acceptance and Commitment Therapy (ACT). These core processes, which also include acceptance (click here to review this process as described in Part 1), present-moment awareness, self-as-context, values, and committed action, are aimed at cultivating psychological flexibility, or the ability to have all of our thoughts and feelings while continuing …
Accepting the Loss
One of my patients wrote to me this morning asking if she could get a medication to help with her anxiety. She has been trying to find a good therapist for quite a while and I think she might have found someone who could really help her. But this is making her feel anxious and irritable. Now she has to wrestle …
Acceptance and Commitment Therapy Part 1: Acceptance and Willingness
I recently attended the Anxiety and Depression Association of America conference in Philadelphia, where I offered a two-hour workshop on Acceptance and Commitment Therapy (ACT) and deepening experiential practices in ACT sessions (largely based on the book The Big Book of ACT Metaphors: A Practitioner’s Guide to Experiential Exercises and Metaphors in Acceptance and Commitment Therapy*). This post is Part …
Herd Instinct in Humans: The Source of Anxiety and Depression?
Jeffrey Kahn has written a fascinating book (Angst: Origins of Anxiety and Depression in Oxford Press) suggesting an evolutionary source for much of human psychopathology. He gave a Grand Rounds presentation at UCLA in February of 2015 that outlined some of his theories and that presentation has been the subject of a vigorous discussion online. In essence, Jeffrey argues that …
Performance Anxiety is Good
Although I have given thousands of presentations to professional audiences over the course of my career, when I was beginning that career I had severe dread of presenting. I would hardly sleep the night before a presentation and was visibly trembling as I went on to the stage (at least that’s how I saw it). Thinking back on that time …
Digital noise – don’t you just love it?
Digital noise: phone chatter, loud music cross-talk, the incessant tip-tapping of keyboards, the beeps, bongs and rings of text messages and horrible mobiles ring tones that expose you to things like Wagner played on what sounds like a xylophone – I’m stuck on a bus in the middle of nowhere. It’s hell. Coping with noisy, busy places for many bipolars is often stressful. …
Treating Anxiety – An Update by Kelsey
Treating anxiety is an important part of working with people with depression or bipolar. This update focuses on changes that have taken place in the field in the last five years that might be relevant to many people dealing with depression and anxiety. Imagine that you are taking a nice, peaceful walk in the woods. It is a lovely, warm, clear …
Blowing Things Up: Self-Destructive Responses to Frustration
Why do we sometimes come up with self-destructive responses to the unpleasant feeling of being trapped or the anxiety of an unhappy life situation? I talked about this a little bit in an earlier post that was based on an article in the New York Times. In that article, it was noted that many people may find it so hard to deal with the stress …
Accepting Uncertainty
We are often trapped more by what we think about how things should be, or “have to be,” than by the reality of the challenges we face. This week I have been noticing how often the phrase “I can’t stand.XX” precedes a statement that is quite obviously not true. Someone who has been living with the uncertainty of multiple sclerosis for …
Bipolar Disorders and Exercise: Working Out Can Tone Up Your Neurotransmitters – Arnrow
Neurotransmitters are the chemicals that your brain cells (neurons) use to transmit information, without them we cannot think or act. It is no wonder that too much or too little of any one particular neurotransmitter can have substantial effects on how our body and brain functions. For example, people with mood disorders tend to have low levels of the four major …
Medications for Anxiety
A writer we have been seeing for about a year for depression and bipolar sent me an email yesterday – “I need something for my anxiety…” Often anxiety is the symptom that is of greatest concern to people who have bipolar or depression. Working through my thought process as I tried to come up with an answer for the woman …
Passing on PTSD to Children
At a recent scientific meeting, Rachael Yehada showed that traits that are related to posttraumatic stress disorder PTSD can be passed on to children during pregnancy. Mothers in New York City who were pregnant on September 11, 2001 and developed post-traumatic stress disorder (PTSD) had children with low cortisol in their blood (a sign of PTSD). But if the fathers …