Bay Area Bipolar Educational Group

Dr. Descartes Li (see interview in our “Conversations” section) is starting another Psycho-Educational Group for Bipolar Disorder this spring. We are happy to encourage all readers in the Bay Area to find out more information about these excellent groups. The group is an especially good option if you still suffer from mood swings, or have questions about managing your meds (and …

A Worthwhile Project

A good friend of this blog, and a wonderful woman who has energy, talent and a commitment to making a difference, recently sent me an update on a project that she is working on to develop a film and website to reduce the stigma of bipolar. She and her team have put up “beta” website announcing the project. And she …

Bipolar Treatment: The “Quick Fix”

A young woman came in to see me today. She was in a hurry. She wanted to make a change in her medication, and she wanted to make that change now. She told me that medication she was taking for bipolar was making her sedated and sluggish. She said she thought the medication was a “trap.” The medication was why …

Outcomes of Childhood Bipolar

What happens to children with bipolar disorder? Boris Birmaher, M.D., a professor of psychiatry at the University of Pittsburgh, and colleagues at UCLA and Brown University, followed 367 of children with the disorder for an average of eight years to find out. 45% of the subjects had had a stable mood for most of the follow-up period. Birmaher reported the findings at a …

Mania and Depression Aren’t Opposites

Recently I found myself thinking about the similarities between two mood states that appear to be extremely different:  mania and depression. I was talking to a young man who is now quite depressed, and who was sharing with me his incredibly negative internal though processes. One of the things that he said caught my attention.  He said he felt that his illness and …

Changing Hormone Levels and Mood

I was on the phone yesterday having an urgent consultation with a woman we have worked for 15 years. She has had a pretty straight forward history of depression and anxiety that we’ve treated primarily with antidepressants and cognitive behavioral therapy. She’s had a good response to this treatment approach. The two things about her depression that are a little …

Fall Mania

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 …

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 …

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 …

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 …