Anger – Uses and Abuses

What do we mean by anger uses and abuses? Righteous anger is a powerful force for change in the world. But some folks seem to live in anger all the time, and for them, and those around them, anger can become a trap. As others pull away from them they feel more helpless, and more angry. How to break this …

Cynical Hostility

Cynical Hostility

Cynical hostility is a personality style of cynicism and anger mismanagement in social relationships. Sometimes called chronic anger, it is associated with mistrust and weakened social support networks. In a recent study, researchers from France and University College London looked at data from a long-term study of 3,399 British civil servants. Those in the top 25% of cynical hostility levels were over four-and- a-half …

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 …

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 …

Avoiding Heartbreak in a Relationship

An attractive, intelligent young woman asked me, “Why can’t he show me any love, what is wrong with me?” The two of them have been having a difficult time recently and she was feeling sad about how their relationship had changed in the last several months. She told me that she was in the shower crying about this when her partner …

It Takes Two to Fight

“I just can’t believe what my mother told me on the phone, she said I was a bad mother, can you believe it? I wasn’t going to put up with that, believe me…” A delightful and pretty feisty mother came in the other day brimming with frustration. We spent the entire session talking about how she got derailed from a …

Controlling Crazy Behavior

A young man came in and wanted to talk about his friend with bipolar, who, when he gets manic, can become uncontrollable. I said that the idea of controlling dangerous behavior can be problematic. The need to control someone else’s recklessness can lead towards confrontation and anger, which often does not work out well. I thought of the often repeated story …

Through the looking glass 2 – Meeting the Therapist

The last blog posted some three hours ago jumped over this one, much as thoughts are given to do in my head. This, in fact is a description of me meeting the therapist for the first time. My earnest apologies. Maestro, the music if you please. …My wife, caught up in a Maelstrom of hypomania, seeks and finds a Therapist. I am …

Law of Attraction – Creating a Hostile World

The law of attraction is the belief that “like attracts like.” Focusing on positive or negative thoughts can bring about positive or negative results. If you are angry or hostile your world responds with anger or hostility. Wikipedia has this to say about the philosophy that is called the Law of Attraction – “This belief is based upon the idea that people …

Men Get Mad Not Sad

There are hundreds of papers written about why it is that women have a much higher rate of depression than men. A new article published in the journal JAMA Psychiatry (August 28, 2013) suggests that some if not all of that difference may have to do with the fact that men express and experience depression differently.   The authors of the …

Pay Attention

We need to be noticed and attended to. It is one of the most important psychological needs we have. For several years, I have been lecturing residents in psychiatry at UCSF on the management of people in crisis. One of the topics, is how to work with people who are potentially violent. On an inpatient psychiatric unit there are, from …

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 …

Leaving War Behind

I spent many sessions working with a successful entrepreneur to try to help him cope better with stress and depression. His problems seem to be neatly encapsulated in Joseph Campbell’s notion of the Hero. Like all of the heroes in the past, he set out as a young man to make fame and fortune and to change the world for …

The Big Fight

How is it that so many couples end up having knock down, drag out fights?  How can seemingly rational people end up saying things that just don’t make any sense? Several people that I’ve seen recently have told me a similar story.  As in every relationship, they have had certain long-standing issues in their relationships, areas where one or the …

Creative Tension

I was inspired to write today’s post after watching a video sent out by a colleague as her “Valentine’s Day gift” to a group of mental health professionals interested  in women’s issues. The video was from the TED series (strongly recommended) and had to do with the challenge of having a long-term passionate relationship. The author was a delightful, French …

A Protest

So many of us have to deal with things that are not fair – depression, unsupporting spouses, financial reversals, weight gain, etcetera, it can be tempting to launch a protest of some kind against the unfairness. These protest actions don’t have to be obvious at all, but they can have powerful effects, nonetheless. A few women recently told me, “I …

Tripolar Disorder

For a long time I have been trying to figure out how to convey to the people I work with the view of mental health professionals that a certain type of depression is really a kind of mania, called “mixed mania.” From an “objective” standpoint, this makes a lot of sense. A mixed state generates lots of energy and agitation. …

The Cycle of Disappointment

Today’s post revolves around the universal desire to find one or more other people who is perfectly attuned to our needs, and the resulting cycle of disappointment. A woman we have seen for years continually experiences a strong sense of disappointment and loss because her highly anxious mother was never really able to be attuned to her needs. She told …