I had been gearing up to write my usual set of posts about seasonal affective disorder, and then this afternoon I met with a young woman who has had a clear and consistent pattern of getting hypomanic in the fall. We talk a lot about winter and fall depression. And, for many people, as the days get shorter and darker …
Therapy for Anxiety in Bipolar
Anxiety is very common in people with bipolar moods. In fact, anxiety is typically the first sign of mental health problems (often it is present in childhood) for people who later develop bipolar. As a psychiatrist, I am aware that we have fewer useful long term treatments for anxiety in bipolar than we do for the mood swings of the …
Lithium, Bipolar and Creativity
A very talented writer who we’ve been seeing for about six months has noticed that her creativity seems to be way down. Creativity is a fundamental part of her view of herself. She is very upset. Her concern is that the lithium she has been taking might be the cause. However, she has been quite depressed for the last month. What …
But Hypomania is Great!
Sometimes I feel like the Grinch. This past week I found myself in the uncomfortable position of suggesting that it might be good to moderate the hypomania one of my patients was experiencing. I also got a somewhat frantic call from the therapist of another mutual patient, the therapist was asking, “how does this end… he really doesn’t want to …
Crossing Boundaries
An hour after I dictated a post about the complexity of working with patients with extreme moods. People whose moods may affect them so powerfully that a model of treatment that is purely based on the ethical principle of autonomy (I provide you with the information and you make the decisions about whether or not to seek treatment) doesn’t make …
My Brain Isn’t Working
Difficulties with cognition and focus are almost universal in folks with moods. In the scientific literature there have been attempts to distinguish between mood related problems and problems that tend to persist regardless of mood state. There is probably nothing that can more profoundly affect our brain’s ability to focus than an episode of depression or mania. These functional brain …
Mood and Gender
A very recently published study in the Journal of Affective Disorders confirmed earlier research showing significant gender differences in symptoms of bipolar type I disorder. Variables examined for gender differences were demographics , illness course , clinical comorbidity, and temperament among a population of 1090 bipolar type I manic inpatients diagnosed according to DSM-IV criteria. Women with bipolar I disorder …
I Need New Friends
“I thought I needed to replace my friends.” This is how one of our patients described her experience of a several week period of mania last summer. Her friends insisted that she needed to get help and that something had to be done about her energized state. But she had just emerged from a many year depression and felt that …
Brain Scan Diagnosis?
A newly developed brain scanning method that measures blood flow to different parts of the brain may help to distinguish between bipolar and unipolar depression, according to a study that got a fair amount of media attention. The study of 54 adult women used a novel way of measuring brain function called arterial spin labeling (ASL). This approach allowed much …
Blood Flow Measures Predict Bipolar Disorder
To the delight of the medical community, there has been a surge of new methods and techniques for more effectively diagnosing bipolar disorder. One of these new methods is a blood-flow measure, where clinicians use different levels in blood flow activity to determine whether an individual is suffering from bipolar disorder or unipolar depression. In the British Journal of Psychiatry, …
Emotion Regulation and Bipolar
Researchers from the University of Mannheim investigated brain activity in people at increased risk of bipolar disorder to see if there was something about how these people handled negative emotions that might them be at increased risk of mood cycles. They used a powerful brain imaging technique called functional magnetic resonance imaging that allows researchers to see which parts of the …
The Hunt for New Medications for Depression and Bipolar Disorder
Dr. Gerald Sanacora, Professor of Psychiatry and Director of Yale Depression Research at Yale School of Medicine, explains that when it comes to depression and bipolar medications, there are some serious limitations. Although in the short term, it seems like many people are doing better with current medications, as time goes on, these same people start showing signs of relapse. …
Mood and the Brain’s Clock
As we slowly move from summer to fall, it may be timely that the issue of Biological Psychiatry that arrived in the mail today is devoted to how the brain’s clock affects mood. It points to growing evidence that part of what drives mood cycles are disruptions in the brain’s daily (circadian) rhythms. It appears that people who are vulnerable …
Recovery from Disability
Sometimes we are privileged to help someone who is disabled due to bipolar or depression to recover and resume a full and happy life. In the beginning we face many questions about the process. Family members may have become very skeptical about the value of treatment. Or they may wonder if the disabled person is exaggerating his or her symptoms …
The Switch: Manic to Normal Mood
I have been thinking about what it is that we do in Psychiatry that is potentially helpful for people with bipolar and why that works. In many ways, the fulcrum of our work involves addressing the “switch process”. This refers to the way that moods can shift from manic to normal behavior, often quite suddenly. A recent discovery has been …
Suzanne Alexandra Black
I am excited to be working with Suzanne Alexandra Black again. Suzanne is a psychologist who is an expert in bipolar moods. She is a brilliant woman who has an active Skype practice with patients on several continents and she divides her time between Paris and New York. Over the course of the next couple of months I hope to have …
Hypothyroidism Diagnosis Confusion
Hypothyroidism elicits many similar symptoms to other mental health disorders. Dr. Kristi Estabrook, MD, explains where the symptoms overlap and how unfortunately those experiencing Hypothyroidism are misdiagnosed. First, what exactly is hypothyroidism? Hypothyroidism is a thyroid hormone deficiency and there are two types: Primary and Secondary. In Primary, the thyroid gland does not respond to thyroid stimulating hormone correctly. Causes …
Treatment for Insomnia when Bipolar
Many people with bipolar disorder also experience symptoms of insomnia and sleep disturbance. Researchers have been investigating treatments for this condition that do not involve medications. After numerous clinical trials, there has been significant success with CBT-I treatment. CBT-I is cognitive behavioral therapy for insomnia and it involves sleep restriction and stimulus control. The purpose of the first treatment is …
Odd Couple’s Therapy
I met today with two interesting people: they’re both attorneys. They have a remarkably different style and presentation. One of them is usually animated, energetic, and optimistic. However, he also has bipolar mood cycles. Sometimes his energized vibe may get a bit intense, while at other times he will be in a depressed state that makes it hard for him …
Strategies for Bipolar Disorder
Living with Bipolar Disorder is not an easy feat. On the bright side, there are different strategies for coping with and managing the various symptoms. By making healthy choices and pairing medication and therapy, individuals with Bipolar Disorder can gain more control of their lives. Some factors that are necessary for maintaining a healthy lifestyle with bipolar disorder include hope, …