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 …
MoodRhythm: Beta Users Needed
One of our readers forwarded to us a story about a new application called MoodRhythm that was developed at Cornell University and won the prestigious $100,000 Heritage Open mHealth Challenge. The full story is available here. The application, which is available as a beta, is available for both iPhones and Android smartphones (although how to download it may be a bit …
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 …
DSM5
In the next few days the American Psychiatric Association is meeting in San Francisco and will announce the latest version of its diagnostic and statistical manual: DSM5. Tom Insel, the Chief of the National Institute for Mental Health, created quite a stir last week by seeming to announce that the new diagnostic manual was an emperor with no clothes. The …
Parallel Universes: The Duality of Hopelessness and Optimism
It’s hard to explain how it is possible to go from a state of complete hopelessness and a sense that the universe is profoundly hostile, to a state of optimism and and the experience of receiving support from the world and others within a single day. The fact of the matter is that it often seems as though there are …
The Search for Meaning
When three people independently send you an article and urge you to read it, there is something very important contained in that article. A New York Times article by a woman with bipolar elicited that kind of response from people who know me. The article talks about the struggle of a woman who discovers that she has bipolar, struggles to …
Phew… That’s Done: Sustaining Attention
It is such a relief, after worrying about some health problem for a long time, to suddenly realize that that problem no longer needs acute and urgent attention. This is as true for an ankle or knee injury in sports as it is of anxiety or depression, or any other mood state that impairs our ability to function. There is …
Lowering Your Profile
This is the season (spring) when there is suddenly lots of energy around. I used to regularly run around a local lake. The run was peaceful and pleasant at all times of year except in the spring. In the spring the male geese suddenly felt that that had to make their presence known. They would flap their wings and attack …
Trojan Horse Medications
From time to time we are asked to review the care that people with cycling moods have received, trying to figure out, from a complicated story of medication changes and mood cycles, what to do to get someone out of a period of deep pain and dysfunction. A few years ago I did such a review on a young man …
Kindling
What do small sticks used to start a fire have to do with bipolar moods? Not much… Kindling in the context of this post refers to a phenomenon that is well documented in some people with seizure disorders and which may have relevance to some people with bipolar moods. Bob Post, who was for many years Chief of the Biological …
On the Borderline
I am writing a presentation for the UCSF Bipolar Program on the topic of the relationship between Borderline Personality Disorder and Bipolar Disorder and I thought I would jot down some of my thoughts in a quick post. Borderline personality disorder involves a “pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity” which begins by early adulthood …
Fish Oil Update
Since so many people with bipolar and depression take fish oil we thought we would pass on some information in a summary form from Consumer Labs. The full information is available if you subscribe. Consumer Labs is the only source of reliable information about supplements (the only place that does any testing) and if you take supplements we strongly encourage …
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 …
Season Specific Interventions
One of the challenging things about bipolar moods is the constant process of shifting priorities and directions that is involved in “moodsurfing”. A young man we’ve been working with for a couple of years has a very seasonal pattern to his moods. Most of the time, the focus of our work is trying to help him emerge from a constant …
Drug Companies
This blog has mostly not dealt with questions related to medications for treating mood disorders. When we looked around to see what was out there on the Internet, it seemed to us that there was no dearth of information about medications. The problem was finding reliable information about non-medication approaches to living with moods. This morning I met with an …
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. …
Crisis – When to Consider Hospitalization
A delightful, funny, smart young man we know called us on Friday to say that he had stopped his medications a few weeks ago, and now he felt he was entering a mania. We did our best over the weekend to patch things up, got him more medications, talked to him every day, worked with him to make sure that …
Running a Marathon
Many of us are strongly motivated by the desire to achieve results, complete tasks and succeed. Often we want to get where we are going quickly. Life is too short. Seize the day. Dealing with moods can be very frustrating. Change may take place slowly. Sometimes you have to put in a fair amount of energy just to hold on …