Medication is Not the Whole Answer

Dear Reader,

Bipolar depression is historically known to be especially difficult to treat. The patients experience terrible fatigue, hopelessness, helplessness, and many times the medications that are used to treat only provide minimum relief.

While we realize that we just may not know enough about the biochemical interactions, there is extensive research to not only help find better medications but also to help treat the social ramifications of the illness.

Understanding the family dynamics and the impact this may have on illness treatment, remission, and relapse are just as important as pharmacological intervention.

Mania: The "Up-side" of Bipolar Disorder

Dear Reader,

It has been my experience that a patient while going through a manic episode feels the best they have ever felt.

The experience of "being on top of the world" and "energized" are just a few phrases that have been mentioned when I have spoken to my own patients. 

It can be considered almost a savior if you've struggled with severe depression during the course of your Bipolar illness and mania is a welcomed relief.

Hearing patients tell me that they've blown their whole life savings in a weekend, and hurt family and friends through promiscuous and inconsiderate acts is what many times is the thing that really affects most patients while struggling to bounce back from a manic episode.  

Trying to teach families that the illness should be blamed and not the person rarely works when finances, health, and family are concerned. 

It is important to hear out these concerns, and try to create an atmosphere of understanding while also educating the family about the illnesses. My experience has so far shown me that education is the best way to help families cope with this illness. Explaining how medications work and what signs to look out for when a patient is decompensating can also help prevent full blown mania.

 As is often the case, education is key in understanding and coping with mania.

Love to Label

Dear Reader,

I’ve noticed that as doctors we love to label everything!  

We even have a whole book dedicated to labels; it is called the Diagnostic and Statistical Manual of Mental Disorders and is currently in its fourth revision—you might sometimes hear it referred to as the “DSM-4” or “DSM-4-TR.” That’s where the most current diagnostic criteria are listed for all psychiatric illnesses, and where the symptoms for things like mania or depressive episodes are listed and defined. 

  

Something I’ve experienced as a treatment provider for people with Bipolar Disorder is that it is sometimes hard to know when a certain behavior deserves a label, and when it’s just normal.

When you tell your doctor that you just bought a new computer, does she scramble to increase your mood stabilizer?  

Sometimes it’s hard for us doctors to know when those behaviors which might otherwise characterize a manic episode for you, are really just a symptom of your old computer breaking down! The same goes for depression—sometimes it can be challenging to decide when a person is having a normal reaction to a regular disappointment in life, and when they are dipping into a dangerous depression that requires medical attention.

What’s the solution? 

All we can really do is make sure to keep up excellent communication.  

• Always keep your doctor tuned in to where you’re at, mood-wise.  


• Be honest and open, and if you feel like you can’t do that, you might need to find a new doctor.   


• Be honest and open with your family and friends, too—they will often know you best and be the first to notice a change that could end up being dangerous.

Be well and keep talking!

We are here to answer your questions!

Dear Reader,

Welcome to our blog. We -- the staff of the Family Center for Bipolar -- have stared this blog to help you understand and live with your bipolar illness or a related disorder, whether you have it or you think you may have it. This blog should also be helpful to those whose relatives or friends have a Bipolar Spectrum Disorder.  

We would like this blog to be a dialogue between you and us. We want you to ask questions and we'll do our best to answer them!

Our first entry discussed the meaning of the term "Bipolar World." We decided to use the term because it encompasses the three main domains of bipolarity:

1) Your inner world of unpredictable moods that you may be living in.
2) Our outside world, increasingly stressful, polarized, and condusive to developing a bipolar illness in those     genetically vulnerable to it.
3) The interaction of the inner and outer worlds, which is so often the key to healthy living.

We, the physicians, and other clinical staff members are here to help you negotiate the bipolar qualities of both your inner and outer world, as well as their interactions and manifestations in the healthiest possible way.

We would love to hear your questions, concerns, and comments.

Remember, out family is here to help you and your family. 

 Dr. G

The "inner" bipolar world.

Dear Reader,

Welcome to the Living in a Bipolar World blog!

All of us at one point or another have felt "bipolar". You are up, then you are down. You are in a great mood one day, and the next day you don't want to see or talk to anyone. Are we all bipolar? The answer is no. Changes in mood are a normal part of life. Our mood can change in reaction to work, family life, diet, weather, and so on. However, when these mood changes become debilitating and destructive, causing turmoil both in your personal and professional life, it's time to consider that perhaps you are not just "being moody". Perhaps you may be experiencing life in a bipolar world. 

First we'd like to take a moment to clarify just what we mean by "bipolar world". The phrase can be interpreted in two ways. The first interpretation is that of the "outer" bipolar world. By outer bipolar world we are referring to the world at large, the one we all live in. What makes our world bipolar? The list is quite long and will be covered in depth in a later entry. Suffice to say for now that the fast paced/sleep deprived/high stress life style many of us have come to accept as normal is far from the kind of routine that nurtures healthy mental functioning. We will return to this subject at a later time. Right now, we would like to focus on the "inner" bipolar world. By inner bipolar world  we are referring to the world as it is experienced by an individual living with a bipolar spectrum disorder.

Life in the inner bipolar world is characterized by alternating episodes of Mania and Depression.

Some common signs of Depressive episodes are:
-Sleeping much more than usual
-Being tired all the time, but unable to sleep.
-Having bouts of uncontrollable crying.
-Becoming entirely uninterested in things you once really enjoyed.
-Paying no attention to daily responsibilities.
-Feeling hopeless or worthless for a sustained period of time.

And for Mania, the signs may include:
-Feeling like you can do anything, even if it is unsafe or illegal.
-Needing very little sleep, yet never feeling down.
-Living Recklessly - this can include frivolous spending, sexual promiscuity, etc.
-Experiencing hallucinations and delusions.

You can also experience something called a Mixed State which can include aspects of both Depression and Mania in a single episode.

As you can see, mood changes in the inner bipolar world are not the same as your average "mood swings". Mood changes from high to low and back again can be dramatic and rapid. Symptoms of both depressive and manic episodes may be severe and often lead to impaired functioning. If left untreated, these symptoms will continue to worsen over time. For this reason, life in the inner bipolar world can often feel lonely and stigmatizing. It is important to remember, however, that though it may feel lonely you are not actually alone. There is help, support, and a future for anyone living with bipolar disorder.

Don't believe us? Just look at this list!
-Charles Dickens
-Abrahan Lincoln
-Ludwig van Beethoven
-Vincent van Gogh
-Winston Churchull

These are just a few of the distinguished authors, artists, and politicians that are known to have lived with a bipolar spectrum disorder. What these names signify is that if you are living with a bipolar illness, you can still achieve your goals, be a well-respected member of society, and live a happy and productive life. Through determination, self-confidence, and proper treatment bipolar disorder can be very manageable.

Of course we recognize that living and thriving in the inner bipolar world is no small feat. The road to success is wrought with obstacles.

For this reason, we believe very strongly in utilizing family support as part of treatment for Bipolar spectrum disorders. Whether it be parents, siblings, partners, or good friends, having a social network of support can help you take leaps and bounds on the road to better mental health. Having the support of people who are closest to you helps to reduce the stigma that you may feel, and alleviate the loneliness that may accompany your diagnosis. This is of course not the only factor that contributes to successful treatment, but it is a very important one.

And so, as we wrap up this first blog entry of Living in a Bipolar World, we would like to leave you with:

Survival Tip #1: Utilize the support of your family, friends, and loved ones. They can make a big difference in the improvement of your symptoms and success of your treatment.