Mood Spectrum

Author and psychiatrist James Phelps presented a thought provoking presentation about the notion of a mood spectrum (from very unipolar to very bipolar) and how that idea is changing the way that clinicians work with people with depression. The title of the presentation was “A More Nuanced View of Hypomania” but the talk itself is broader than that. The spectrum …

How High is High?

We met a few days ago with one of our favorite people. She’s a writer and an artist and she has been gradually reducing some of her medications to see whether the combination of more diligent self-care and a lower dose of medications can lead to better quality of life and a return of some of her creative capacities. This …

Impatience Warning

Sometimes I wish that my depressed patients had more impatience. Eagerness for change when you have been depressed for a long time can be a good thing. But if you have bipolar depression, impatience is not always a useful emotion. This past week, several people began expressing impatience with their progress. A couple of them expressed the view that I …

Mindfulness: No Gain without Pain?

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 …

Impulsivity – Gina

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 …

Bipolar Type 4

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 …

Mania Warning Signs in the Eyes – Gina

Recognizing Mania Warning Signs, Even in the Eyes Knowing and understanding warning signs of depression, hypomania and mania can be crucial in accessing the resources and supports needed at different times in your life. Warning signs can vary across individuals but there are also many warning signs that are thought to be more universal such as changes in sleep. The …

Pace Yourself for More Manageable Moods

I have been doing a lot of thinking about how to pace yourself so that you can capture some of the energy and creativity associated with being mildly energized while not getting so involved that you burn out or edge into full-fledged mania. There’s nothing quite so exciting as entering a time of increased energy and ideas after a long …

Hamster Brain

A young woman who has been making good progress tackling the problem of severe depressive episodes suddenly is having trouble managing the opposite end of the mood spectrum.  She gets energized and is consumed with getting stuff done. She is unable to stop until she is exhausted and she crashes. I call this state of mind “hamster mind” because it is like the …

Hypomania and Success

During the 1990s clinical psychologist John Gartner was planning on writing a book about religious movements started by manic profits, but he began to be distracted by the energy and excitement swirling around him as people became immersed in the Internet “bubble”. He decided instead to write a book about the relationship between hypomania and success in the business world (The Hypomanic …

Through the Looking Glass 4 – a result

…The Becks Questionnaire II business continues. What brings it alive are the questions that Dr. Black continues to ask me throughout the test until we arrive at, what for me, is an astonishing discovery… At some point Dr. Black tells me there is a store on Martha s Vineyard, a ritzy, gentrified island off of Cape Cod, Massachusetts, that has …

THROUGH THE LOOKING GLASS: 2 – Depression Assessment

  …I’m returning to do the test suggested by my therapist in our previous meeting – the Beck Depression Inventory II. Tremendous. Doing a test sounds like something you see in those silly magazines that tell you how good a lover you are are some such other rubbish, but apparently this test is rather serious. So I return that afternoon and Dr Black …

Memory and Cognitive Problems

Memory and/or cognitive problems are the rule rather than the exception in people with mood disorders1. There are a number of reasons for this and figuring out the best approach to these problems is tricky. Mood episodes (episodes of mania, hypomania or depression) appear to be harmful to the brain. Studies find that those with the largest number of episodes …

Hypomania and Sensory Experience

More than a decade ago, Dr. Suzanne Black, who occasionally writes posts on this blog, got me interested in the sensory experiences associated with hypomania.In our Diagnostic and Statistical Manual, the only reference to these is under the heading of “distractibility.” And, indeed, sometimes people who are experiencing intense and profound sensory experiences everywhere they look and listen, may have trouble …

Mood Swings – What Causes Them?

What causes mood swings? What do we think about when someone says their mood has been “up and down?”Among the most common causes of mood shifts are the following: A mood disorder such as bipolar, or an atypical depression. Bipolar as a cause is obvious, but an atypical depression can also be associated with mood swings. In the case of bipolar …

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 …