Unstable moods and bad memories seem to go together. In the clinic where many of us work we have noticed how often it is that folks who we see with bipolar have had traumatic experiences in childhood. Why that happens is speculation. But we do know that dealing with those experiences can be very, very hard, and, potentially, life transforming. …
Fallow Fields
Farmers will sometimes leave a field “fallow” – they won’t plant anything in it but rather let native plants grow in it – as a way of rejuvenating the land. Then when they do plant the field it is often very productive. We were talking with one of our clients this morning about the topic of seasonal variability in mood …
Productivity: Hiding Things You Have to Do
The key to being productive (and managing anxiety) is using tools to keep track of things that you have to do… and, most important, hiding things that you will have to do at some future time but don’t need to do now. We think that one of the reasons we have this state called “anxiety” is because in human history …
The Heart of Evil
We have had the experience of feeling that we were in the presence of evil. A sense of foreboding, a shiver that involuntarily runs down the spine. An awareness that our expectations of rational behavior in others may be misplaced. As we have experienced it evil may be clever, but it is not creative. At its heart lies fear. Fear …
Negative Emotions
We’ve all been there. Maybe we’ve noticed feeling impatient while driving in traffic, or expressing anger towards the barista who didn’t leave you room for milk in your coffee. Whenever we express our dissatisfaction towards the mundane events that don’t go our way, we are more than likely misplacing anxiety, fear, anger, or hurt that stems from one of the …
Money: Having Enough
These are hard times for many people. And the future doesn’t look all that bright. Naturally this leads to anxiety. Will we have enough? Perhaps because we live in a world that constantly sends us confusing messages about what “enough” is, and confusing messages about how to achieve happiness (the entire advertising industry is more or less based on telling …
Francine Shapiro: EMDR – A Crazy Idea that Works
As a young psychiatrist I was interested in posttraumatic stress disorder (PTSD – psychological reactions to severe traumatic events) and did a research fellowship on the subject with Charles Marmar at the San Francisco VA Hospital. One Thursday morning, during our regular clinical case conference, we had a woman come in to tell us about her recently discovered technique for …
Starbucks Therapy
We aren’t sure how we feel about the spread of Starbucks into every corner of America. But it does allow us to suggest a kind of intervention that may help you if you are depressed. It is based on Interpersonal Social Rhythm Therapy – which is one of the best validated psychotherapies for people with bipolar moods. Every morning, at …
Running a Bit Late
This has been a super busy week and for the first time since we started this website we missed a couple of days of posts. That, plus the experience of waiting for someone to show up for coaching, made me think back on when I used to always be late for events and appointments. I was an absolutely incurable late …
Breathing Techniques
One of the oldest “self help” practices is based on breathing, changing how we breathe in order to reduce stress and to achieve a sense of connection with the world around us: Pranayama Yoga. Prana is the Sanskrit word for “breath” and also means “life.” Therefore, prana can be translated as “the breath of life” or “life energy.” Yama means …
Online Resources
There is so much information on the internet. And so much misinformation. How to find good answers to your questions? This is a very selective list of resources that we have found helpful – Medications UpToDate – This is an online medical textbook that is updated continuously. It is the resource we use when we have questions. It also includes …
Mood and Reality: Mood’s Ability to Shape Perception and Interactions
We have been thinking for a while about how mood powerfully creates our reality. And how hard it is to hold on to a consistent sense of the world as moods change. Mood affects what we notice and remember and how we see it. It also affects where our thoughts naturally tend to go. We ran across an intriguing article …
Reward the Effort
Why is it so hard to make positive changes in our lives? A woman we have been working with came in yesterday and told us about all of the things that she had been doing – making a serious effort to find a satisfying job and career, beginning to get healthy by exercising and joining weight watchers, working on her …
The End of Summer
Every year we notice two weeks that seem to affect a number of folks who have had seasonal depressions. The first period is the “End of Summer” – a foreshadowing of the coming fall that happens in late August or early September (depending on the weather, we guess). The second period is the “Beginning of Winter” – which usually takes …
Stress, Distress and Eustress
We met this afternoon with a delightful young man who said he was having more anxiety and depression because of all of the stressful things that he had to deal with. He gave us a list, and, perhaps because we are natural skeptics, we started to wonder whether that list really explained what was going on. For one thing, as …
Loving Kindness or Metta
Love is something that if you give it away, give it away, you’ll end up having more… Last Sunday at church there was a children’s chorus singing, and this was one of the songs. It seemed very familiar… The cultivation of loving-kindness (mettā bhāvanā) is a popular form of meditation in Buddhism. In some Buddhist traditions, the meditator begins cultivating loving-kindness …
Dynamic Balance
We were talking to a young woman trying to figure out how to maintain more of a balance in her life. She knows that one of the challenges with energized moods is that they can lead to becoming over-committed. On the other hand, one of the great things about that energy is that it often results in getting a lot done. So how do you find …
Stress Eating
Weight gain may be not only a psychological (“I hate how I look, it makes me depressed”) but also a biological (overweight people have elevated levels of inflammation that may increase depression) factor worsening depression. Great, but what to do about this? Most of us already knew that we should lose weight, and more guilt doesn’t help. One very interesting …
NAC (n-acetyl-cysteine)
We were impressed by a recent study of n-acetyl cysteine as a treatment for marijuana dependence. It was a well designed study from a very reputable research group and the results were significant: the number of clean urines in the group getting NAC was twice as high as in the placebo group. It got us more interested in the agent …
How to Change Your Sleep Pattern
One of the best studied and fastest treatments for depression is not a medication, it is waking up earlier and get bright light exposure… We will write at a another time about the evidence for this, and maybe even why it works. But for now let’s talk about the practical question. How do I change when I get up? First I …