A Piece of My Mind

How To Get The Most Out of Therapy

2014-07-14T16:31:00.002-04:00

Is this your first appointment with a new therapist? If this is the case, it will take a while for you to get to know the therapist and their style, as well as for them to get to know you. Therapy is useless if there’s not positive energy both ways. Evaluate your sessions, and do not accept or stay with a therapist who imposes his/her own opinions, interest/ issues into your therapy, or establishes goals for your therapy that you don't want.

Collaboration is one of the most important issues when selecting a therapist. In order to determine the most effective route, determining who is going to be on your side is one of the essential aspects. For example, communication’s an important factor and will your therapist provide open contact with your psychiatrist. And don’t forget you are a part of the team as well!

Whether you are with a new therapist, or one that you have been seeing, preparing what to discuss from session to session is important. Think about things prior to your appointment is helpful. Are there specific things that are presently bothering you or causing you stress? Nevertheless, it is the therapist’s job to guide you and help stimulate discussion. However, while a therapy session usually lasts 45-50, and seems like a fair amount of time, the time goes quickly because one topic often leads to another topic, and the list you prepared prior to the appointment, most likely will only be able to touch upon a few things before the next session.

Another point is frequency, if there are many things in your life that need to be addressed, deciding how often you need to attend sessions, is important. The need to visit your therapist weekly or biweekly is not out of the norm.

Additionally one important thing to keep in your mind is therapy is not a quick fix. It is a long process, and should never be looked at as being a “cure.”

Talking about your problems can help you to spot things which are causing difficulties in your life. A person with a different perspective of your situation can help you decide how to address the problems you are having, and how to deal with the things you cannot fix. Through discussion, you can find ways to handle your problems so that the same issues will not continually disrupt your life.

There are many different kinds of talk therapy. The two most commonly used for depression are cognitive-behavioral therapy (CBT) and interpersonal therapy. Both types of therapy can be effective in treating mood disorders, especially the depression aspect. Finding a provider that specializes in mood disorders is essential, and one of the most important aspects of treatment. It’s critical as well that the therapist is versed in the various forms of talk therapist. Mood disorders do not entail utilizing psychotropic drugs, they include coping strategies provided through talk therapy.

Therapy in Latin means "curing, healing” and is the attempted remediation of a health problem. Below are some examples of talk therapy techniques that your therapist may implicate:

Cognitive-Behavioral Therapy (CBT): helps you change harmful ways of thinking. If you tend to see things negatively, it teaches you how to look at the world more clearly; it also helps on look at how negative thought patterns may be affecting your mood. The therapist helps you learn how to make positive changes in your thoughts and behaviors.

Interpersonal Therapy (IT): helps you learn to relate better with others and to focus on how to express your feelings, and how to develop better people skills. IT focuses on how you relate to others and helps you make positive changes in your personal relationships.

Behavioral Therapy (BT): helps you change harmful ways of acting. The goal is to get control over behavior that is causing problems for you.

Group Therapy: a form of therapy in which multiple clients are treated simultaneously. Although talk therapy with a therapist is commonly performed, one on one, group talk therapy can also be effective. In traditional group therapy, the existence of the group plays a key role, and the simple act of discussing your feelings with others allows you to gain new insight and perspective.

Dialectical behavior therapy (DBT): a cognitive-behavioral approach that emphasizes the psychosocial aspects of treatment. It’s a type of therapy designed to help people change patterns of behavior that are not effective, and developed to treat interpersonal chaos, intense emotional swings, impulsiveness, confusion about the self (identity), and suicidal behavior. Helps people increase their emotional and cognitive regulation by learning about the triggers that lead to reactive states and helping to assess which coping skills to apply. It’s a cognitive-behavioral approach that emphasizes the psychosocial aspects of treatment

While these examples don’t include the gamut of methods, these may provide a basic understanding of what your therapist might employ. The most important factors are that you feel comfortable sitting with your therapist face to face and can communicate with him or her in a safe environment. Being able to be unconditionally understood is so important, and feeling like there is no judgment no matter what is said. Every therapist utilizes various approaches and finding the one that meshes with your personal view is essential.

Bipolar Disorder and Coexisting Disease

2014-04-21T12:29:00.001-04:00

Coexisting Disease

As you may have noticed I haven’t been keeping up with my blog. Unfortunately I’ve been dealing with multiple hospitalizations for my bipolar disorder as well as my eating disorder. I was at John Hopkins from June-September 2013, and was at the Princeton Eating Disorder Unit in February of this year.

I’ve decided to focus on the topic of co-occurring/co-existing diseases that may occur with bipolar disorder, or may mimic symptom as well creating a foggy or inaccurate diagnosis. I picked the most common psychiatric co-occurring disorders and provide briefly a description as well at show the discrepancies which arise when making the determination of an accurate diagnosis.

Statistically individuals with bipolar disorder are more likely to be suffering from other psychiatric issues such as substance abuse, eating disorders, attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD) and personality disorders. People with bipolar disorder are also at higher risk for thyroid disease, migraine headaches, heart disease, diabetes, obesity, and other physical illnesses. So how does one deal with the coexisting (comorbid) psychiatric issues? And if so many disorders coexist, where is the overlap for distinguishing what’s what?

Obviously the first thing to tackle is anything that threatens an individual’s immediate safety. After that is achieved, trying to navigate through the minefields becomes the next focus. I’ve chosen to focus on a few psychiatric issues that seem to blur the picture when trying to obtain an accurate diagnosis of bipolar disorder.

Difference between bipolar and ADHD?

I’ve asked medical professionals this question multiple times, and have received a wide variety of answers. How does one determine the difference between bipolar and ADHD, and is it one or the other or both? The differences between the two especially the mania aspects can be difficult. Because ADHD is usually diagnosed as a child the characteristics are easier to tease out from bipolar disorder so I’ve provided descriptions. It’s also thought that medical professional’s may misdiagnosis. Sometimes ADHD is diagnosed when bipolar disorder was a more accurate diagnosis, and vice versa.

In young children distinct periods of mania tend to be rarer. Symptoms of irritability, rage, impulsivity, aggression, hyperactivity, mood swings, learning problems, and poor frustration tolerance are commonly seen. Temper tantrums or rages in children diagnosed with bipolar are seen as storms. Mood shifts come out of the blue, and destruction can occur at the blink of an eye. Stopping them requires patience and care. According to recent research five early childhood symptoms most likely to predict later bipolar are grandiosity, suicidal and rapid thoughts, irritability, and hyperactivity. Factors such as irritability, hyperactivity, rapid speech, and distractibility co-exist with ADHD and bipolar disorder and when comparing the two don’t provide help for differentiating among them.

Considering 40% of bipolar preteens also have ADHD, which usually starts first, this makes it one of the most confusing issues for the medical community, in particularly psychiatrists, in establishing the diagnosis of childhood onset bipolar and its relationship to ADHD. What makes it confusing is the fact that symptoms of ADHD can include hyperactivity, agitation, impulsivity, distractibility, talkativeness and poor concentration, which is mentioned above, and appear commonly in bipolar disorder. Age of onset is utilized to determine a diagnosis. When making the diagnosis for adults, if ADHD symptoms were not present during childhood, then a diagnosis of bipolar disorder would be most accurate. ADHD is chronic and continuously present, bipolar moods alternate. Life events may also trigger ADHD individuals, but bipolar mood shifts have no connection to these types of events. Duration of moods are another factor, bipolar individuals have more rapid mood shift. While children with ADHD may sometimes feel sad for no reason, children with bipolar disorder may feel sad for weeks. Additionally, one thing that they do have in common is genetic components. Studies have shown that children diagnosed with ADHD will eventually receive a diagnosis of bipolar as well.

Children with untreated bipolar disorder have an increased risk of suicide, poorer school performances, relationship difficulties, increased rate for abuse of substances and risk for multiple hospitalizations.

I have received a diagnosis of both ADHD and bipolar disorder. Stimulant use for individuals with bipolar used to treat the co-existence of ADHD can exasperate the problem and cause individuals to go into a rapid-cycling mode. Psychiatrists may prescribe a stimulant once stability has been achieved over a period of time and bipolar symptoms have subsided.

Anxiety and Bipolar disorder

Anxiety commonly co-occurs with bipolar disorder as well. When someone is in the manic phase it’s not uncommon to occur. During the manic phase anxiety tends to be more extreme than regular generalized anxiety. And irritability and racing and disorganized thoughts can occur. Treatment of this anxiety is difficult because the line of drugs used for those without bipolar are SSRI’s. SSRI’s are risky to use with individuals with bipolar because they can exasperate symptoms and cause rapid cycling. In these instances a combination of medications are characteristically the best approaches.

Bipolar Disorder and Substance Abuse Issues

Mood disorders frequently co-exist with abuse of alcohol and other substances, and occur together at a higher rate. When an individual is in a manic phase, impulse control, and reckless behaviors may take place. Depression may precede substance use, with the hope of making an effort to feel better. Substances such as alcohol, PCP, heroin, cocaine, and marijuana have the possibility of causing severe mood swings which mimic bipolar disorder if not diagnosed properly.

Additionally, those dealing with addiction issues are at a higher risk of suicide, and have greater hospitalization rates. Of male and females, females have a higher rate in developing alcoholism than those without bipolar disorder, but up to 60% of individuals with bipolar disorder may have substance use or other addiction issues.

Having a professional onboard specializing in the treatment of individuals with substance abuse issues particularly co-existing bipolar, provides the most successful outcome possible. As well as development of a solid treatment plan.

Bipolar Disorder and Borderline Personality Disorder

Scientist for years has been trying to figure out a distinction between bipolar disorder and borderline personality disorder (BPD). Many of the symptoms concerning these two disorders overlap one another. BPD indicators include but are not limited to: abandonment issues, idealization and devaluation of individuals, impulsivity (spending, sex, substance abuse, binge eating), self-mutilation, recurrent suicidal behavior, affect instability, feeling of emptiness, severe anger issues, and loss of temper.

As you can see these symptoms are similar to hypomanic and manic phases. Personality traits are thought to be different than actual bipolar traits. One of the main differences is that bipolar patients characteristically have a stronger sense of self, when medicated properly. Mood liability and affect in BPD tends to lean more toward anger, anxiousness, and depression. Bipolar affect tends to lean more towards depression, elation and irritability. Many times, medicated BPD individuals won’t improve with psychiatric medications, whereas bipolar sufferers will. This is not to say that a patient can’t have both disorders, thus creating a co-occurring diagnosis.

There’s many other coexisting disease that may mimic bipolar disorder, these just summarize a few. As science and research advances, scientists are able to obtain a clearer picture and accurately diagnosis. With the continuous changes to the DSM, definitions are becoming more concrete, making the medical communities job more successful.

Suicide

2013-09-14T21:13:00.000-04:00

DISLOSURE

STOP and read the following clearly. This article may be troubling to somebody thinking about suicide. This article is about personal and factual experiences regarding suicide. Please do not read if you are in a dark place and feeling suicidal. Suicide is never the answer, finding help and support IS. At the end of this article, I listed numerous resources, to obtain more information on this topic, as well as crisis hotline numbers for immediate support. Please utilize these fully.

Suicide:

I’m writing this from a room on one ofthe floors of John Hopkins Hospital’s Affective Mood Disorder clinic. I’mgetting help, for my severe bipolar disorder and these suicidal ideations andthoughts. I am still here in the hospital, it has been 11 weeks. Personally,for me, I get triggers when folks are talking about suicide. Whether it is adiscussion or action of somebody cutting and feeling triggered that way, orbeing triggered because someone is discussing how he or she want to killthemselves. I have chosen to write thisarticle, so others may be helped and they know they are not alone.

Sowhat is exactly the definition of suicide: Suicide is defined at the “act oftaking one’s own life?” In addition, suicidal ideation is “thinking of endingone’s life.” Some view suicide as a cry for help. I view suicide as a way out,getting to the point where life is just too painful to live. Yes, part of mewants to live, but the other part has given up and cannot handle the highs andlows. I know my friends and family would miss me, but in the end, suicide is aselfish choice. However, most individuals who commit suicide really do not wantto die. Forfolks without a mental illness it is very hard for outsiders to understand whyone would choose to take their own lives. I have heard this comment many atime. “Somebody has cancer and is dying, don’t you think they would be angryknowing they could have lived and you killed yourself on purpose”? What folksdo not get is that it is an illness, and I am hurting. Yes, you are not seeingit, but it does not make it not there. People in the depths of feeling suicidalare in SO much pain, it actually hurts to live, and can see no other way out.

Therapyand medication can also help individuals that are feeling suicidal. While themedication can sometimes take a few weeks to get to therapeutic level, therapycan take place starting right away, and help reduce the thoughts of suicide.

Statistics

Becausestatistics vary, the stats below are accurate according to various sources:

TheWorld Health Organization estimates that about 1 million deaths by suicideoccur each year, making it the 10^th leading cause of deathworldwide. Of these the highest risk of suicide are white men. However, womenand teens have more suicide attempts. Of these about 30,000 or 2/3s arepatients with major depression or bipolar illness. In addition, even scarier,10-20 million non-fatal attempts are made each year.

Triggers and Risks

Sowhat factors contribute to the sad completion of a suicide or increase therisk?

Whatare the risk factors and triggers (I have chosen to name the predominant ones)?

Mental Illness (Depression, Bipolar disorder (especially mixed states, schizophrenia, substance abuse)
Means of suicide (i.e. pills, weapons, etc.)
Social situation (i.e. living alone, single, recent loss)
Severity of mood disorder (hallucinations, mixed states, moods and reasoning),
Employment (i.e. new job, job loss, new position)
Incarceration/Trouble with the Law (i.e. in jail or prison)
Previous attempt within 30 days or exposure to others suicidal behavior, peers, media, etc.
Family history of suicide attempts, and/or family history of mental disorder, or substance abuse
Physical illness (chronic pain, early on-set diabetes, stroke, epilepsy, multiple sclerosis, AIDS, and terminal illness)
Relationship Change (new marriage, divorce, break up)
History of trauma, abuse, or violence.

Mixedstate bipolar mental illness is the most dangerous of all. This is because depressionand mania are occurring simultaneously. Somebody in a mixed state has the energy tocommit suicide, and the depression to want to. Being that they are depressedand manic at the same time.

Warning Signs

Whilethis may not entail all warning signs below captures a large amount of the mostcommon signs.

Discussing death, such as talking about wanting to die or that life is not worth living. Feeling like you have no purpose to live or no sense of purpose in life.
Threatening to hurt or kill oneself.
Feeling agitated and anxious.
Feeling hopeless about future and feeling there is nothing worth living for, wishing you‘d never been born.
Hating oneself, and feeling like you are a burden. Feelings of worthless or having low self-esteem.
Writing a suicide letter, saying goodbye to friends or family, writing about death or dying.
Start withdrawing from family and friends, also isolating and not wanting to leave the house, and deal with society.
Looking for lethal means to hurt oneself, such as guns, stock piling pills
Preoccupation with death, such as discussing death on a frequent basis.
Increase in alcohol and/or drug use.
Driving recklessly and obsession with killing oneself will attempt theses self-destructive behaviors.
Feeling rage or uncontrolled rage, or dramatic mood changes
Unable to sleep, or on the other end of the spectrum sleeping all the time.
A spurt of energy, allowing the person who is depressed to be able to enact the plan they have developed.1 (i.e. mixed states)
Depressed, psychosis, impulsive
Crying out for help in various ways
Philosophical reason to die (feelings it’s their destiny)

Prevention of Suicide

Howcan we prevent those considering suicide to turn their thoughts around andthink about the positive factors in their life that would, that would make lifeworth living?

Iunderstand how hard this is. While I am still a work in progress regardingreversing my thought and training my brain to see the positive and not thenegative. I am not saying it is easy, but as I am learning, it is possible.

Ipersonally find that when the seasons change, and the light outside get shortermy mood changes. In addition, as silly as this may sound, the full moon throwsoff my mood.

Ifsomebody brings up suicide, ALWAYS take it seriously, talking to the person whois suicidal cannot cause somebody to be worse off. For example, if anindividual seems to be suffering from depression, creating a casualconversation about suicide is not inappropriate. If the individuals reveal thatthey are indeed suicidal, they need all the support they can get. For starters,ask how long that they have felt suicidal, and ask if there was a particulartrigger or cause. Being attentive, as well as listening in a calm manner canhelp the suicidal individual.

Anotherhelpful tip is to share with the individual any similar situations in which youhave felt depressed, manic, or suicidal as well. The individual will be able torelate which in turn will create an understandable dialog.

Evaluating Suicide Risk:

Sowhat do you do if the people you are discussing suicide with tell you they havea plan and they are going to kill themselves?

Ifthe individual has a plan and the means, the quickest suggestion is to call 911or take the person to an emergency room, or psychiatric facility. If the personwill not budge staying with the individual and calling, a suicide hotline isthe next best thing. Perhaps the hotline can convince them to hand over their“means” of suicide, or convince them to go to a hospital to be evaluated. NEVER leave them by themselves!

Being Supportive and Empathic:

Sohow do you help somebody whom of which is suicidal? If somebody is suicidal but not in such a badplace that they need quick hospitalization, helping them to find supportwhether through a support group, or professional support and help. Set a safetyplan, for example, that the individual will call you every few hours to checkin. Another suggestion is to remove any means for committing suicide.

Additionallyhelp the person to create a suicide plan during which time they promise todelay suicide by 24hrs…then 48 hrs...etc. Help the individual call theirimmediately doctor, therapist, and/or psychiatrist. If needed go with theperson to the appointment.

Resources:

Suicide Hotline Information

NationalSuicide Prevention Hotline (available 24/7)

1-800-SUICIDE

(1-800-784-2433)

NationalSuicide Prevention Lifeline (available 24/7)

www.suicidepreventionlifeline.org

1-800-273-TALK

(1-800-273-8255)

NationalSuicide Hotline

888-999-9999

Additional Resources:

NationalInstitute of Mental Health

301-443-4513

www.nimh.nih.gov

AmericanFoundation for Suicide Prevention (AFSP)

www.afsp.org

888-333-2377

AmericanPsychiatric Association (APA)

www.psych.org

202-682-6000

AmericanPsychological Association

www.apa.org

800-374-3120

NationalAlliance for the Mentally Ill (NAMI)

800-950-NAMI

www.nami.org

NationalDepressive and Manic Depressive Association (NDMDA)

800-826-3632

www.ndmda.org

NationalMental Health Association (NMHA)

703-684-7722

www.nmha.org

SubstanceAbuse and Mental Health Services Administration (SAMHSA)

301-443-8956

www.samhsa.gov

***Ihave obtained much of this information from various sources available on theinternet. Much of the research I have done for this article is a compilation ofthesesources.

Upcoming Suicide Awareness Day Article

2013-09-04T14:54:00.002-04:00

I'm currently working on an article about suicide for the International Bipolar Foundation. I will post the article link on here! It can be such a triggering topic on one hand and on the other hand a much needed discussion. Suicide Awareness Day is September 10th! There will be a disclaimer on the article for individuals feeling suicidal to take caution while reading as the article may evoke unsafe feelings. Writing this article has really helped with overcoming many feelings. Please LOOK out in a few days for the article and link.

Hopkins

2013-06-23T19:23:00.000-04:00

Arrive at Johns Hopkins on Thursday! Finally....started to take me off of my first drug Wellbutrin. Up and down. My eating disorder is being triggered so I'm on fluids for awhile. I'll keep you posted more when I have more mania,,,

A New Start In Life?

2013-06-02T15:18:00.000-04:00

In a few days I will be arriving at John Hopkins Affective Mood Disorder Unit. For those readers not familiar with this hospital it is the leading medical and teaching hospital in the United States. I'm 39 now, and my bipolar symptoms started about age 23. Currently I'm on 8 psych meds. The way I describe it is now patchwork. When one new symptom would arise they psychiatrist would add a medication. After going through a few different psychiatrist, one left private practice, one (after seeing me for 10 years told me I was to complicated of a case), and now my current one my medication regimine has become a mess. Even if my doctor decreases my anti-depressant by a quarter I get depressed. And as many of you know bipolars shouldn't be on ANY anti-depressants!

My doctor did his residency on the John Hopkins Mood Unit and thinks this will be a positive thing. He told me straight up I'm going to go through hell for 2 weeks until my brain resets itself! Wish me luck I will need it!

I've decided to post every few days on this blog what I'm feeling and how it's going in general! Hopefully I won't be psychotic, which very well could happen, and I post about elephants and rabbits flying above my head. Or a real any common theme for when I get really manic is thinking the police are out to get me, yes I know highly paranoid!

Please check in every few days and give me words of encouragement or advice. Thank you all for your reads. I'm almost up to 7000 hits, so I guess someone is reading my blog! That's for your support and keep reading. I should be there for approximately a month (ish). But the good thing is I can bring my iPad, laptop, and most importantly my cell phone!!

Shame

2013-05-22T12:31:00.000-04:00

I was introduced to a song the other day that hit home, and brings tears to my eyes every time I hear it. The song (with some lyrics below) touches on something that is not discussed in detail SHAME.

I cannot begin to tell you even 17 years after my Bipolar diagnosis the shame I still feel inside.

The definition below is just one of many that define shame;

Shame: (a) a painful emotion caused by consciousness of guilt, shortcoming, or impropriety (b) a condition of humiliating disgrace or repute.

Some adjectives includes: blame, fault, embarrassment, anguish, distress, sadness.

While others may feel differently and may not feel shame, I do. So how does it effect me currently and play a role in my life? The answer is constantly.

I’m on SSDI and on Medicare. My husband is the breadwinner. His job is stressful for him, and he too suffers from Bipolar. When he is upset about work, which is frequent, it makes me feel a sense of shame. Shame that I cannot contribute to finances by working, and shame that he feels stressed on a daily basis. While he tells me he feels nothing of the sort, I still cannot get rid of the negative thoughts and worthlessness I feel.

I think a big reason for sources of shame, is stigma. To tell or not to tell that is the question. How are folks going to react? I feel a large part is due to the stigma and judgments of the way we feel people will react. We are scared that telling people will make them think, or say things about us…“She’s crazy”; “He needs his Prozac.” These are not uncommon comments!

Shame affects all those involved in the individual’s life diagnosed with a mental illness. Including the circle around them, i.e. family, friends, etc. For me I feel like I am not living up to the norms those others without bipolar feel. I feel flawed, broken, and judged. Revealing the diagnosis to those persons who do not relate negative judgments or evaluation fuels my shame.

Many times shame leads to isolation and withdrawal socially. This just fuels the depression, one is feeling already, and possibly even creates a sense of anger. Negative emotions such as hurt and sadness are not uncommon, as well as worthlessness. The feeling of worthlessness it what drew me to this topic of shame.

So the question is how to deal with shame? The answer from my point of view is it is hard. Nevertheless, there are suggestions from various sources that suggest beneficial ways to improve one’s self confidence. Such as getting involved in a hobby that you enjoy and feel successful at. Positive affirmations may help such as, “I’m a good and kind person that people enjoy to be around.”

Emeli Sande sings the song that started me thinking about this topic. The name of the song is “Read all about it.” I have chosen only pieces of the song that I feel really reflect the topic and hit home regarding shame.

“You've got the words to change a nation but you're biting your tongue. You've spent a life time stuck in silence afraid you'll say something wrong If no one ever hears it how we gonna learn your song”

“You've got a heart as loud as lions. So why let your voice be tamed? Baby we're a little different there's no need to be ashamed. You've got the light to fight the shadows so stop hiding it away”

“At night we're waking up the neighbours while we sing away the blues making sure that we remember yeah cause we all matter too if the truth has been forbidden then we're breaking all the rules”

“Yeah we're all wonderful, wonderful people so when did we all get so fearful? Now we're finally finding our voices so take a chance, come help me sing this.”

Here is the link to the full version of this song….

https://www.youtube.com/watch?v=Q03E7oTc5qo&list=UUcemkeZKHXdDkIinIwar1pg&index=10

Please feel free to comment on this topic, I think it’s a topic that’s not frequently discussed.

Pregnancy and Bipolar or Mental Illness

2013-02-16T14:29:00.002-05:00

Pregnancy and Mental Illness

This issue is close to heart. Mental illness/Bipolar vs. pregnancy. To conceive or not conceive? The odds of having a child also with a mental illness? What are the medication risks? Because of so many facts that go into these issues, and I could write for days, I have limited this more to the mental and basic decision-making aspects, and have limited the detail of pharmaceutical aspects. Going through psychotropic uses during pregnancy (Psychiatric medications are psychoactive drugs prescribed for the management of mental and emotional disorders), would be much too daunting to write about in one article.

Pregnancy is such a wonderful experience and exciting time for parents to be. All parents want their kids healthy. While the capability of testing for some genetic markers is possible, mental illness at this time is not one of those.

In 2007, my husband and I were at the point in our lives of deciding whether to conceive, I decided to look for a book on this topic to help my decision. What I discovered amazed me, finding a book on this topic was difficult. In 2007, one book was in the process of release. The book was entitled “Bipolar and Pregnant” by Kristin K. Finn. ONE BOOK. There were plenty of articles on this topic, but I was just flabbergasted there were not published books. The books I did find only dealt with raising a child with bipolar or mental illness, or dealing with a spouse or significant other with a mental disorder.

Another factor I felt needed to be considered is both my husband and I are Bipolar so that added more complexity to our decision. The odds (according to many sources), of having one parent that is bipolar, passing on the disease is approximately 15-30%**. The statistics can jump to 55%**. when two bipolar parents have these genes. I struggled with this tremendously. What would happen to my child if they were diagnosed with bipolar? Would they be angry knowing that I conceived them knowing that the odds were against them? If I was in their position knowing that I would be bipolar, would I be angry with my parents? These questions were just many of the numerous ones that went through my head.

While struggling with the above issues, I needed to look at the physical issues as well. Pregnancy can irritate symptoms. The additional hormones and the decision to manage symptoms with or without medication is an enormous issue to tackle.

Planning a pregnancy, in itself consists of many factors, stopping smoking, caffeine use, and prescription and over the counter medication use. It also involves taking care of one’s general health and eating healthy. Dealing with pregnancy while having any mental illness, comes with many trials and tribulations. For those specifically with bipolar disorder or a mental illness additional questions may arise:

· What psychotropic medications can I take

· Will m y child inherit a mental illness?

· Will pregnancy hormones work for or against me?

· Will there be an increased risk for the severity of postpartum depression?

· Should I breastfeed or not?

· Will medications that I am presently on be transferred through the breast milk?

· Will my disability destabilize me, and influence my ability to care for my newborn?

· Sleep? Will lack of sleep be destabilizing? (Personally, for me, sleep throws me off when I do not get enough, and throws me into either a manic or a depressive episode.)

I wish I had a magic ball that helped me to answer these questions. Bipolar typically emerges during early adulthood, presiding throughout the lifespan, usually coinciding with a woman’s childbearing years. I think many women, like me, grow up thinking I want to be a mommy one day. So trying to deal with this issue and this roadblock was very hard. There are still so many: “Why’s,” Why me? What did I do to deserve this? All I wanted was to grow up and be a mommy!”

Unfortunately, there has not been a lot of sizable and comprehensive research on this topic. While some psychotropic medications have been shown not to “have a significant” impact on the fetus…what does “significant” really mean? There really is no definitive information that answers this question. The answer usually comes down to risk vs. harm, and do you manage the illness or simply consider the baby. Stopping medication is very risky and can contribute to a relapse, which jeopardizes the health and ability of care of the newborn.

What do you do when an infant is depending on you for his or hers’ needs.

So what do you do when you are not able to stop, prescription medications? The bottom line really comes down to a personal decision to make by the parents. Many folks believe that conceiving a childhood, is worth the risk for both themselves and the child.

Carefully planning before conception will help ease and aid in managing symptoms that may arise. I am still struggling with these questions, as I have been for 6 years. I am still undecided, still trying to stabilize myself. It is a difficult decision, and I think taken for granted sometimes, by those who do not have the same questions we with mental illnesses have. My husband and I still do not have an answer of yes or no…..if only I had that magic ball.

***Statistics are estimates and from various sources, they should not be considered as exactly accurate.

My Bio Posted at the International Bipolar Foundation

2013-01-18T13:43:00.000-05:00

Hello all, I feel so privileged to be sharing this blog with others through the International Bipolar Foundation, as well as being able to direct you to my personal blog.

Where to start? I thought writing a bio would be easier, but my manic mind right now is thinking…what do I share, what not, what relevant information do folks want to know, and lastly I don’t want to bore folks!

My name is Ashley, 39 years old, and I live right outside of Washington DC in Northern Virginia. I have never been one for change so I plan to be here the rest of my good ole life. I am married to a wonderful man, who also has Bipolar and ADD. No kids but 4 wonderful kitties.

Right from the start, the ADHD was apparent…my mom jokes I jumped out of her womb and took off running down the hall. From the start, I was not the “typical” girl. My hyperrness was out of control. This was during the 1970’s so ADD/ADHD was just beginning to surface. In 1^st grade, my parents took me to a psychologist, and the psychologist diagnosed me with Oppositional Defiant Disorder. Which means, I’m purposely trying to ignore authority and I’m on the path to perhaps become an arsonist in the future? I have many childhood scars from this. I think I spent at least ½ my elementary school life with my desk in the hall.

Skip ahead 26 years until now. Unfortunately, 15 years ago I received the diagnosis of bipolar disorder, which happened to be the type of bipolar which is the most difficult to treat. In 1998, three years after initial symptoms developed, the complete diagnosis of bipolar I, mixed state, ultra rapid cycling, with psychotic features was made. Also at this time, I developed an eating disorder, anorexia, and bulimia. I also have OCD, thankfully it not severe and just on the “it’s driving me crazy,” level!

My bipolar is not a euphoric mania but a dysphoric mania; I become highly paranoid, agitated, and aggressive. In the past, I have experienced psychotic episodes, and when my mania is severe I have a heightening of senses, I see colors brightly, almost in 3-D, noises are very loud, and there is increased creativity. I had 4 suicide attempts.

I have been hospitalized in psychiatric units at least 18 times, two of which were in eating disorder clinics. I once tried to estimate how much of my life was spent in hospitals, and it added up to approximately 3 years!

I’m currently on 9 psych meds. My new psychiatrist would like me to go to the John Hopkins’s Mood Disorder Ward and be “detoxed” from meds. Especially since, I’m on 2 anti-depressants which is a no-no for those with bipolar. I’m so scared, knowing that for the first 2 weeks he stated I would be in an extreme amount of discomfort. I’ll keep you posted as to my decisions.

Again, I look forward to bonding with individuals with mental illnesses, and exchanging information that will help me grow and understand that bipolar is not a life sentence just some speed bumps and potholes in the road!

Check out my new blog!!!

http://www.internationalbipolarfoundation.org/please-welcome-our-new-blogger-ashley-and-her-first-post

Health and the New Year - Blog for International Bipolar Foundation

2013-01-18T13:40:00.006-05:00

A person may set goals and resolutions for the New Year. It may be regarding a habit that they are trying to break. Sometimes it may be to make an improvement in physical well-being, such as healthier eating, weight loss, exercise. Additionally is may include mental related goals, such as positive thinking, relaxing and enjoying life, or trying to decrease self-criticism.

Helping with mood swings, depression, decrease in OCD behaviors, etc. are great goals, and are achievable in different ways. Thinking positively will help achieve stability, as well as taking medication religiously and correctly. Severe symptoms of our mental illness are really out of our control. Nevertheless, here are some suggestions that can help achieve more stability, and aid with this. These suggestions are in our control and attainable.

Suggestion 1- Start by setting realistic and achievable goals. It is possible, other than medications, to aid in mood stability. In conjunction with taking your medication(s), psychotherapy, self-management techniques, and avoiding outside triggers, help with alleviating symptoms. Fortunately coping in society is 100% possible.

Suggestions 2- Consistently monitor mood and physical changes. The quicker these issues are addressed the quicker you can tackle the issue (s). For example, monitoring my sleep is important; I need to make sure every night I go to bed on time. When I notice that I am having difficulty sleeping, it could indicate I am becoming Hypomanic. This also includes sleeping to much; this could be a sign of depression. When these situations do occur, it is our control to call our psychiatrist as well as your therapist right away. Do not ever be scared of seeking any type of help, the quicker these “red” flags are identified that quicker your will alleviate symptoms.

Suggestion 3- Another factor for contributing to relapse is stress, this can be a huge trigger. Reducing stress as much as possible really helps. This could include exercising, relaxation techniques such as meditation or yoga, and eating healthy. There, are ups and there are downs in life, and the road has many potholes, however, I do not feel doomed, and shackled for the rest of my life!

Suggestion 4- Check in daily with how you are feeling. Some questions I constantly ask to myself: Is my mood stable right now, have I noticed any hypomanic, manic or depression symptoms? Have there been triggers lately that may be destabilizing and need to stay away from? How can I make sure I can diminish my chances for destabilization? For me personally I self manage by tracking my moods daily, by using a mood chart. My husband also does a mood chart with his observations; it is nice to get an outside perspective. This also proves beneficial when meeting with my psychiatrist so that he can see how stable or unstable I have been. Which in turn also helps with adjusts, if needed, with medication.

One point listed above I would like to stress as one of the most important aspects of being to obtain mood related resolutions. TRACK YOUR MOODS. For example, do you remember how you were feeling yesterday, last week? Personally, this is so important since I have mixed mania, rapid cycling bipolar assessing my behavior and moods has become second nature to me.

Suggestion 5- Developing a positive support network is so important in many different ways. It is great to get out and chat with friends, family, etc. It is a way to relax and escape in a positive way. On the other side of the support network, those diagnosed with a mental illness as well provides many beneficial aspects. Personally, the first couple of years after diagnosis were very difficult, feeling lost at sea, with no lifeboat. Folks were there but they did not “get it.” I too was just learning about bipolar.

Someone times it is harder for me to observe my mood and my actions, thus, making it important for those close to you to monitor your mood and actions as well. Now I do not have to ask my friends about my behavior they will tell me if I am acting manic, or seem depressed! I attend a weekly support group for those with Bipolar and Depression as well. This helps me vent and listen to suggestions from folks who understand fully what I am going through.

These are just a few suggestions for aiding with your mental health and the New Year. This list by no means is inclusive, but provides suggestions to assist you with obtaining and succeeding in resolutions you have already set in place. The ultimate goal for those with mental illnesses will always be the same, finding ways to cope, be stabile, and live our lives to the fullest!

International Bipolar Foundation Blogger!!!

2013-01-16T18:55:00.002-05:00

For those who follow this blog, I would like to take this opportunity to share a link. The International Bipolar Foundation has picked me up to blog monthly for their organization. Please check out my bio, blog, and all the additional information this organization has to offer! As well as any feedback.

http://www.internationalbipolarfoundation.org/please-welcome-our-new-blogger-ashley-and-her-first-post

Does Having a Mental Illness Equate to Violence?

2012-12-26T17:09:00.000-05:00

In light of the events that have taken place over the past few weeks, as well as in the past, I’ve decided to blog regarding the discussion as to “the supposed correlation” as to guns and mental illness. Just because you have a mental illness, does this mean you are going to go on a shooting rampage, and denied a gun permit? Although not a gun owner, nor do I ever plan to be, nevertheless, why is the connection to having a “mental illness” and “going on a killing rampage” have to be used in the same sentence?

I agree there is a big gap between treatment needs for those with a mental illness, and the lack of available resources.

Pete Earley, in USA Today, says he worries that those with mental illness will be lumped together with the small group of people who have committed heinous acts of violence, who have also had their share of mental health issues.

Read it on Global News: Global News | The debate between guns and mental illness

Another assumption the news jumps to when a shooting occurs is the individual who just committed this horrible act of violence has a mental illness and I feel jumping to this conclusion is not fair.

Is treatment of an individual with a mental illness with medication, going to eliminate all these shootings? I really do not think so. I realize in certain circumstances this may be true, but I guarantee shootings still will occur from those individuals considered “mental illness free.”

Another thing I don’t understand, in many states that require people with a history of violently mental illness (from 72 hour or 96 hour holds) to be placed in the National Instant Criminal Background Check system.

I understand in some certain circumstances this may prevent violence….but it has been my understanding that those individuals on this (72/96 hour hold list) were not individuals involved in these recent and passed shootings!

In general though…is sending individuals who commit crimes, to jail appropriate. Many times those individuals sent to prison or jail has an increase in symptoms because the environment exacerbates symptoms. It is my opinion; the United States jumps right away to locking up individuals with mental illnesses not provide medication management, therapy, or an understanding of the diagnosed or specially undiagnosed mental disorder. The law should consider putting those mental ill into the state facilities specially designed for this.

According to Human Rights Watch, the number of mentally ill inmates in U.S. prisons quadrupled from 2000 to 2006, and it continues to rise -- in fact, the rate of inmate mental illness is five times greater (56 percent) than in the non-incarcerated population.

I would love to hear feedback on this topic, please provide comments, so that we can all figure out the best solution for preventing and understanding these folks.

Thanks everyone for reading!

Help Me Help You

2012-11-25T13:32:00.003-05:00

I've been in a depressive slump. I'm in the process (slowly) of writing a new blog. In order to get a general idea of the interests out there, please comment and respond to this as to suggestions of blog topics to come, and the blog itself!!!

Navigating the Medicare Nightmare

2012-10-09T20:39:00.001-04:00

What is Medicare?

This is one of the hardest blog topics thus far. This topic of Medicare is so complicated and this topic could go on forever. I have summarized the information that I feel will help others understand the in’s and out’s of Medicare, which is very difficult for those in need of health care.

Many folks think Medicare is for those 65 or older. When in fact it also includes those deemed disabled, and includes individuals under 65 with certain disabilities. Additionally those people of any age with End-Stage Renal Disease (ESRD). It is based on Federal and state laws, and national coverage decisions are made by Medicare as to if something is covered or not. For me personally, I qualified, even though I am 37, for SSDI, which automatically provides me with Medicare.

When I went to sign up for Medicare two years ago I thought it would be a simple process! I was wrong. I actually spent about a month researching and figuring out what would be the best advantage plan (I will discuss this definition); including the costs of all 17 of my medications! Discussion of the basic definitions and parts of Medicare is provided below.

So let us start with the basic aspects of Medicare and the coverage’s included. Medicare consists of four parts, Medicare A, B, C, and D.

Medicare Part A: Hospital Insurance helps to cover:

Inpatient care in hospitals; Skilled nursing facility care; Hospice care; and Home health care

Medicare Part B: Medical Insurance helps to cover:

Services considered medically necessary to treat and diagnosis disease or illness. This could include lab tests, doctor’s visits, surgeries, and durable medical supplies such as a wheelchair.

Under this section of Medicare, preventative services are included. I have found that Medicare and Medicare Advantage plans encourage the use of these services, and many plans include these services at no cost as long as you find a health care provider who accepts costs. Some of the preventative services include (this list is brief): flu shots; breast cancer screening; cervical and vaginal cancer screening; colorectal screening; depression screening; and diabetes screening. Under Part B, diabetes self-management, and diabetes supplies are included.

Additionally Part B pays for inpatient hospital care; including mental health inpatient; outpatient and partial hospitalization. Limited outpatient prescription drugs are included as well.

Medicare Part C: Medicare Advantage Plans

This is the part, for me found very confusing, and what I referenced above as taking me a month to research. This is where Medicare Advantage Plans come into play. Medicare approved private insurance companies run these plans. The benefits of these companies include Part A and B, with the option to pick up Part D, which is the prescription drug coverage. With these plans, there are many different policies so this is where the dreaded decision comes as to whether one wants a supplemental plan such as a HMO, PPO, PFFS, Medigap, and others. If you are in a Medicare Advantage Plan or other Medicare plan, you may have different rules, but your plan must give you at least the same coverage as Original Medicare.

Some services may only be covered in certain settings or for patients with certain conditions, and on top of the regular cost of Part A and B Medicare premiums, there is an extra cost. Medicare Advantage Plans are from some of the same companies that group employee and private individual plans pay for. Some of these are Humana; Care First; Anthem; Blue Cross Blue Shield, these are just some examples. Additionally plan coverage is based on place of residency. Companies in each state that process claims for Medicare make local coverage decisions.

Medicare Part D: Prescription Drug Coverage

The Medicare approved private insurance companies that include Part D, the prescription drug coverage, run similar to Part C. You can pick this Medicare part up by itself or most Advantage Plans include it when you pay out of pocket. Under this part additional drug coverage is provided, and aids to help lower prescription costs. I would like to note, Original Medicare only provides standard Medicare Part A and B, with limited prescription coverage. For me I’m on a Medicare Advantage Plan, which includes Part D, the prescription plan as well, and helps enormously with out of pocket prescription costs, being that I’m on 17 medications.

I know I know your heads are probably spinning. I do not understand how this country’s biggest health plan, is so confusing to understand and difficult with all its twists and turns. Luckily, for me I am “with it” enough to go online and research the Advantage Plans for extra help with my enormous medical and prescription costs. For those who are elderly and severely disabled, I have found that there is not a lot of local help to help navigate this steep path.

Lastly, the most important thing I will mention, upon deciding on a Medicare plan make sure the Medicare plan covers what you need. Talk to your doctor or health care provider to make sure your coverage includes their services. Also, discuss with them what services or supplies they will not cover. You can also call Medicare directly to ask about specific procedures and services. Below are some resources to help you getting started on your quest to navigate through the Medicare system, or prepare you for future use.

Resources to help get some additional information and questions answered

Direct Medicare Help

1-800-633-4227

TTY 1-877-486-2048

www.medicare.gov

Social Security Administration

1-800-772-1213

TTY 1-800-325-0779

www.socialsecurity.gov

Relief Is On Its Way: Initial Diagnosis Part 1

2012-10-05T19:48:00.002-04:00

On average, there is an eight-year lag between a first episode of depression or manic symptoms and the first time the disorder is diagnosed and treated (Goodwin & Jamison; Lewis 2000).

Usually individual’s first stop is to their primary care physician. While some physicians’ have a little experience treating psychological issues, their primary role is for regular medical issues that are not emotional in nature. Psychiatrists really are the type of medical doctor that specifically and solely deal with mental and emotional issues.

It has been my experience from discussing this topic with others, that their primary care physicians more frequently prescribe Prozac whenever a patient complains of depression. Their repertoire usually does not include a supplementary understanding of additional medications like anti-depressants and especially mood stabilizers!

What happens upon making that initial appointment to see a psychiatrist? For me it was fear… a “what happens from here on?” kind of feeling. This is what I have found and still find the most important piece of the puzzle, of getting your life back on track. Something I will call “the discovery.”

Nobody jumps up and down when they are first diagnosed with a mental or psychiatric illness. Personally, for me I went through the, shock, blame, anger, and acceptance phases’ sort of equivalent to the stages of loss. I thought my life was over and I could see no light at the end of the tunnel. Even now after 15 years, that light comes and goes!

The average person diagnosed with bipolar disorder experiences four episodes per year during the first 10 years of the illness. Like any mental illness, there are no limits to who will acquire a diagnosis. Old or young, female or male, rich or poor, etc.

One fact I found very fascinating is men tend to start in the mania phase while woman tend to start initial diagnosis in the depressed phase! Note to person’s with bipolar, woman are not the only dramatic ones!

For me, I feel the bipolar diagnosis is much more stigmatizing than depression. I cannot tell you how many folks, who do not know about my bipolar, will make comments like “that person is so wacko, she is bipolar,” or “you never can predict if he is going to be unstable”! It is easier I think to understand “being depressed,” that usually equates to a low or sad mood. However, for those who don’t understand it “bipolar” means folks are all over the place, up and down.

So after you get the courage to make that initial appointment to see a psychiatrist, make sure you feel comfortable with him or her. This is where the discussion regarding treatment and medication begins. From experience with various psychiatrist’s I have found that the same steps take place. Initially, the psychiatrist sits down to discuss what brought you to him or her. I have found as if this is almost like a job interview. Your road to recovery needs to happen in an environment that will help you progress further. I can vouch. I have had really great, intelligent, warm, and non-arrogant psychiatrists’, and I have had intelligent rude psychiatrists. It is hard sometimes to decided, do you want smart with no interpersonal skills, or a more caring one not as informed. It is your call. Yes, I know this does not make the choice easier.

The psychiatrist usually wants to get an idea of what brought you into the office. What symptoms have you been experiencing that is so difficult that you feel medication might be useful? In addition, the doctor probably will discuss your life from birth to present age. This takes place to see if there has been a pattern and/or how long your symptoms have been in existence.

So have your medical history available, with current and past doctor’s information in the case the psychiatrist needs to discuss other medical issues. As well as past medication use, for any other health reason.

This topic could go on and on. I have chosen to end it here and write a second part to this later. More along the lines of “what continuous care” looks like after the initial psychiatric visit. Please provide comments for those going through this difficult time in their lives!

On The Road to Treatment: Figuring Out As Quickly As Possible If One Is Bipolar

2012-08-21T19:30:00.002-04:00

Bipolar disorder affects at least 1 in 70 people. Bipolar disorder can start as early as adolescence, or as late as the fifties.

One difficulty can be diagnosis of bipolar disorder in adolescence. What adolescent doesn’t have raging hormones? Looking back, of course I cried when the person I liked starting dating someone else, or broke up with me for no reason. On the other hand, the backstabbing friend that starts spreading rumors. I think as a girl, these can tend to be normal or common reactions. Alternatively, what about about the moodiness, as a boy, and dealing with the raging hormones, resulting in anger.

The National Institute of Mental Health conducted studies on mental illness, and concluded that 48% of all adults in the United States will at some point in their life will have a diagnosis if a mental illness. Although this is only one study, it really surprised me how high this statistics is! Like me, many individuals will be diagnosed with multiple psychiatric disorders, which usually referred to as “co-morbidity or co-occurrence.”

It is not uncommon for those who eventually are diagnosed with a mental illness, to initially try to grin and bear it, and try to “deal” with it on their own. Sadly this rarely works. However, upon receiving treatment, the sense of relief is tremendous.

While it took my psychiatrist a few years to “officially” diagnosis me with bipolar disorder, statistically the onset age was accurate. Multiple research studies out there suggest the median age of onset is between 20 and 25 years. At the time of my first hospitalization, I was 23 years.

I have always wondered why it takes so long for the initial diagnosis of bipolar disorder. I think in my case it’s because my bipolar is mixed and rapid cycling, so if the doctor sees me depressed he or she would probably diagnosis me with major depression. Sometimes when I am so depressed, it is hard to see the ups at that point in time. In my opinion, diagnosing bipolar is becoming easier to spot and the gap between initial symptoms and diagnosis of bipolar is becoming smaller.

While receiving initial treatment is great, the next step is not so simple. It is at this point I find and continue to find the most difficult. Discussing the type of medication. When somebody is diagnosed with Bipolar or any other mood disorder, other issues concurrently might be diagnosed. There includes alcohol and substance abuse, ADHD, and an increased risk of suicide. These are the most common, but it is not unusual that there are also other co-morbid diseases.

Unfortunately, for me I have a SEVERE case of Bipolar I. My full diagnosis is Bipolar I, mixed state, ultra rapid cycling, with psychotic features. Yes, I know that is a mouthful. When psychiatrists look at mood disorders there are a number of “specific clusters” the doctor assess. This is just a brief description, but for me this was used to help aid in the diagnoses of my bipolar. I was not diagnosed with bipolar right away, which is not that uncommon. I presented initially with depression, than mania, and after 4 years of observation during hospitalization, my psychiatrist finally gave me the mood disorder diagnoses.

In a future blog, I will discuss in detail the more common symptoms that can lead to a diagnosis of bipolar disorder.

Staying Healthy and Avoiding Triggers

2012-07-23T16:46:00.002-04:00

It is possible, other than medications, to aid in mood stability. In conjunction with taking your medication(s), psychotherapy, self-management techniques, which I will address later, and avoiding outside triggers, stabilizing your mood is possible. Fortunately coping in society is 100% possible. I personally have discovered and am still discovering healthy ways and self-management techniques to assist with my stability. Additionally, monitoring my sleep is SO important. I need to make sure every night I go to bed on time, and take my initial does of medication at 6:00pm; otherwise, I will sleep until 1:00pm. Clozaril makes me sleep 12-14 hours a night. It SUCKS!!!

One factor for contributing to relapse is stress. This can be a huge trigger and destabilize. Reducing stress as much as possible really helps. Way in which I do this includes exercising, relaxing, and eating healthy. Some folks find meditation and yoga helps, but I have not tried this before. As I have experienced, there are ups and downs in my life, and I cannot say that it is also easy and that the road had no potholes. However, I do not feel doomed, and shackled for the rest of my life!

As I have experienced now and in the past that there are “red” flags. For example, my psychiatrist put me on a stimulant for my ADHD. For those that do not know, if a person is Bipolar, prescribed a stimulant, such as Adderall, can cause manic and rapid cycling episodes to occur. Particularly if a person is not stabilized with a mood disorder. I am not a medical doctor, so everything I am saying is based on my experience and personal opinion.

Some questions I constantly ask to myself: Is my mood stable right now, have I noticed any severe manic or depression symptoms? What trigger my moods, and have I been staying away from these triggers? Can I make sure I can diminish my chances for destabilization? For me personally I self manage by tracking my moods daily, by using a mood chart. This also proves beneficial when I meet with my psychiatrist so that she can see how stable or unstable I have been. Which in turn also helps with adjusts, if needed, with my medication. Another point I would like to make, is if you have a mood disorder, and do not track your mood, think make….do you clearly remember your mood yesterday, the day before, last week. Assessing my behavior and moods has become second nature to me. Sometimes I do get paranoid a little around folks who know I have bipolar disorder. I tend to ask myself when around them, how is my behavior and how am I being perceived. What if I am manic and don’t notice, what if I am depressed and not sociable? These questions are constantly in my head!

For me, as well, there are questions I am constantly asking myself, to ensure that I am remaining stable. I also ask my friends and family to have these questions in the back of their mind when interacting with me. Some of this includes: Am I talking a lot? Jumping from topic to topic? Not sleeping as much? Sleeping too much? Keep to myself for more? This is only a summary of the questions that arise. Someone times it is harder for me to look in rather than look out at yourself. Thus, making it important those close to you are also monitoring your mood and actions as well.

Another suggestion that I have found usual, and others too, is building a support network. This includes friends, family, and others diagnosed with a mental illness. For me personally for the first couple of years I found it difficult to rely on my friends and family for support. Not because they were not there for me but because they did not “get it.” However, I too was just learning about it.

**Additionally another suggestion is to contact your local Depressive Manic Depressive Association (DMDA) to identify local support groups. www.dbsalliance.org

If there is not one in your area, there is a link on this website that provides suggestions and help for starting your own support group. While at first the membership may be low, eventually folks will come out of the woodwork and reach out! Research has shown that individuals diagnosed with a mental illness who have some sort of support network stay healthy and do better. So if it's finding a support group, checking out resources online, as well as online blog or mental illness "talk" forums, there's help out there.

**Bipolar Support Group: http://bipolar.supportgroups.com/

How do you avoid triggers, still healthy, or utilize outside resources?

Bipolar Betty

**These resources I have utilized....I don't have any connection to these websites, I've just suggested them because they have helped me.

Check In 2

2012-06-10T12:15:00.002-04:00

Have not forgotten about my readers!!! Been a little depressed and unmotivated, as many of you can relate to!!! Trying to post this week a new topic(s)......Hoping for a little wave of mania to help with motivate me!!!!

Expression of Creativity, Such As Poetry, In Those With Mood Disorders

2012-05-25T12:18:00.004-04:00

Hello Followers,

I created this next blog to provide an outlet for those with mood disorders, or other psychiatric illnesses to post their poetry or reveal how you express your creativity. It is a known and studied fact that bipolar individuals tend to be the most creative. I eventually would like to publish a book on poetry and expression's of creativity among folks like us!!!!

The History of Your Treatment

2012-04-27T15:38:00.000-04:00

For this blog, I decided to do something a little differently. Because I am a research analyst by trade, I really enjoyed looking up this information and learned SO MUCH from this blog post!

For anybody whom has not toured Williamsburg, Virginia’s Asylum for the mentally ill, it is very enlightening and I highly recommend the visit.

In 1773, known as the Eastern State Hospital, the first public building in colonial Williamsburg Virginia, devoted to treatment of mentally ill, opened. On October 12, 1773, the first patient was admitted. The "Public Hospital for Persons of Insane and Disordered Minds" was the first building in North America devoted solely to the treatment of the mentally ill. The Hospital was situated on 500 acres and consisted of two patient care buildings, and had a staff of over 900 to care for the 300 patients.

By then the popular theory of the colonists, entailed mental illnesses being diseases of the brain and nervous system, in which the mentally ill “chose” to be irrational. Another theory was these “lunatics” were possessed by the devil, and removal of these types of individuals from society into an asylum was essential and off the street society would be safer.

Prolonged and often permanent confinement in an asylum was not uncommon. In the beginning, patients were subjected to immoral procedures and often subjected to horrific treatments. Some patients were continuously restrained in straitjackets and were treated like criminals rather than individuals with a “sickness.” Additional treatments consisted of the use of strong drugs, plunge baths, and cold "shock" water treatment until the patient passed out, which caused bleeding, and blistering salves. Colonists felt that if these “insane” individuals bled, the draining of the “bad” blood would lead to a cure.

In Europe around the turn of the 19^th century, Europeans created a new treatment approach for individuals diagnosed as mentally ill. This approach was known as “Moral Management,” which embraced the belief that environment played an essential role in treating mental illness. For example, creating a more relaxing atmosphere for confined patients would help to “calm” them. By placing pictures, decorations, and providing comfortable beds, it was more likely recovery could occur and patients would feel more at ease because these surroundings would mimic the comfort of their home. This was not really an effective tool!

Between 1773 and 1790, about 20 percent of the inmates were discharged as cured. However, there still was severe overcrowding of these asylums, and how and what to do with these patients was an important issue. The overcrowding led to a decline in the patient care and use of the harshest treatment methods were once again utilized to keep patients sedated and quiet. Around this time, the lobotomy was introduced. Surgeons would open up the patient’s brain and separate neural passages. The desired outcome was for patients to forget their depression or tendencies. The result was horrible. Many patients became comatose, had no memory, or died.

Thankfully, through the years an increased understanding of emotional and mental illnesses has lead to further ethical and civilized procedures.

It was not until 1808, the German physician Johann Christian Reil formulated the term “psychiatry.” This term literally means the “medical treatment of the mind.” Translated from ancient Greek, psych=soul or mind; iatros=healer.

By 1840, in the United States, there still were only eight mental health asylums for the “insane.” Around this time a woman by the name of Dorothea Dix started crusading for the establishment and enlargement of many more mental health facilities and removing from jail patients that had a mental illness and where not just thought of as “crazy”.

In the 1930s, a treatment method, known as Electroconvulsive Therapy (ECT), was developed for treatment of schizophrenia. This included the use of electrodes place on the head, and use of an electrical current that would create a seizure. Today this procedure is more refined, while back in the 1930s patients were not put to sleep for the treatments.

In 1949, Lithium was discovered to treat and reduce symptoms for folks diagnosed with bipolar disorder. In the mid-1950s the development of additional psychiatric medications for treating mental illness was developed. For example, in 1952 Thorazine, one of the first psychotropic drugs, known as an antipsychotic, was produced. This medication assisted those with severe psychosis, such as delusions and hallucinations. Unfortunately, the initial medications came with unfavorable side effects, which were often unpleasant, and included patients looking like over sedated “walking zombies.”

Unfortunately, because this field was slowly emerging, there was a severe lack of medical professionals and funding to further understanding of the treatment of those with mental illnesses.

By 1946 politicians, such as President Truman got on the bandwagon to aid in funding mental health research, and created the National Mental Health Act. For the first time in the U.S., this was the most significant funding to date. Truman created a course that continues to present day. He put mental health on the radar and now funding, research programs continue to grow, and advancement in psychotropic medication is constantly evolving.

Over the years, fortunately, the development of psychotropic medications has advanced, and research on medical treatments continues to transpire. Inpatient treatment as well has changed over the past several decades. In the beginning, patients were kept sometimes in the asylums for a lifetime. Over the past 30 years, psychiatric patients were often hospitalized for six months or more. At present, the average length of stay in a psychiatric facility is one to two weeks, and psychiatric hospitalization is used as a last resort if outpatient therapy is not working.

Unfortunately, for me I have been hospitalized at least 18 times, and usually spend a month at a time in the hospital. Due to strict guidelines set now by health insurance companies, the length of stay for individuals needing longer hospitalization is less likely to be approved because the insurance companies always find “the need” for continued inpatient treatment as unnecessary. Even times when I have been severely suicidal, with back up documentation from my psychiatrist, my insurance has booted me.

As mentioned above many folks receive psychiatric care on an outpatient basis. This usually includes the use of a psychiatrist, for prescribing the medications, and a psychotherapist “for talk” therapy. I have chosen not to go into the history of psychotherapy in this blog. Please look for further blogs on the history of the involvement of this type of treatment as well as the various types of treatment options.

In terms of diagnosing mental illnesses, in 1952 the creation of the Diagnostic and Statistical Manual of Mental Disorders (DSM) was developed. Since then this manual is used as the basis for establishing the diagnosis of all mental disorders. Every few years the manual is updated and new diagnosis are added or revised. The fifth addition is schedule to be published in 2013.

Fortunately, at present, individuals who have a severe and permanent disability can receive Social Security Disability Income (SSDI) and Medicare. While I am on both of these, I feel the federal government can do more. Last year I spent over $18,000 on out of pocket medical expenses, and only a portion I was able to write off on my taxes!!

Additionally private health insurance companies are slowly being required to provide additional coverage for individuals with mental illness, such as being required to set the same prices on psychiatric care as they do on general Medicare care. In my opinion, this process has been slow going, and even though legislation upon legislation is passed, we have such a long way to go! I am sure many of you can relate and have come across these issues and barriers as well!!!

There is so much more history I did not include, I included the points, and information I found interesting. There is so much additional information on current funding, various research, as well as the production and trials of new psychotropic medications. As mentioned above I chose not to discuss types of additional treatments, unrelated to medications, such as psychotherapy, etc. look for this topic in a future blog, as well as an in-depth discussion of the various categories and types of psychotropic medications.

Love,

Bipolar Betty

All About Me!

2012-04-26T11:27:00.000-04:00

Unfortunately, 15 years ago I received a diagnosis of bipolar, which happened to be the type of bipolar which is the most difficult to treat. In 1998, three years after initial symptoms developed, the diagnosis of bipolar I, mixed state, ultra rapid cycling, with psychotic features was made.

Having mixed state bipolar is different from being diagnosed with “bipolar” or “major depression.” The reason is a mixed state involves being in a polar opposite symptomatic state. With bipolar and depression, a person is either happy or sad. Being in a mixed state, equates to being happy and depressed at the same time.

So what symptoms for me emerge during a mixed state? When destabilized life becomes a living hell and I would not wish the symptoms on a worst enemy. There obviously are different characteristics of mania and depression. Depression for me is straightforward, I want to sleep all the time, unmotivated, can get very suicidal, and want to be left alone. During a mixed state, I become depressed and manic at the same time! Literally, I can be crying, depressed, and bouncing off the wall manic. My bipolar is not a euphoric mania but a dysphoric mania; I become highly paranoid, agitated, and aggressive. In the past, I have experienced psychotic episodes, and when my mania is severe I have a heightening of senses, I see colors brightly, almost in 3-D, noises are very loud, and there is increased creativity.

Personally, mania emerges in different ways with different types of symptom combinations for each individual. For example while one of the characteristics of bipolar can be going on shopping sprees, this behavior has never happened with me. My bipolar needs to be monitored closely or severe destabilization can occur when symptoms are not monitored. For me, when I am hypomanic, I get hyperfocused on project-oriented tasks that I see as very important to others or myself. This blog is an example of this, it has become an important mission for me to research topics and to help and bond others with mental illnesses together. This blog has also been therapeutic because I am getting everything out in the open in a positive honest venue.

While on one side of the line I am manic, I usually stay closer to the hypomania side and closer to stable (cross your fingers and knock on wood). When I am in the hypomania stage, it is usually not as severe and can be controlled with medication adjustments. Unless in full-blown mania, hospitalization can be avoided. In the past, I have been hospitalized in a psychiatric unit at least 18 times, two of which were in an eating disorder clinic called Renfrew. I once tried to estimate how much of my life was spent in a hospital, and it added up to approximately 3 years!

Because I have tried to commit suicide 4 times in the past, it is important to monitor my suicidal thoughts. To continue my path of stability it is also important that my psychiatrist, therapist, family, and friends keep a close eye on my symptoms because I do walk a fine line between mania, hypomania, and depression. Sometimes I need an outsider’s perspective since it is easier for folks to observe and notice symptoms that I do not notice.

During hypomania, I get very talkative, whether with my friends, family, or even random folks in public! Along with racing thoughts and jumping from topic to topic, pressured speech and an increase in activity and energy levels. That is why I have been able to write successfully with this blog….I cross my fingers everyday that I do not crash and become depressed and withdrawn and continue on this positive path that I have started.

Even though I received my bipolar diagnosis over 12 years ago, I still ask myself sometimes why me? This disease is highly genetic yet all other members of my family are completely healthy. My husband is bipolar as well, and we have gone back and forth about starting a family. Statistically if one parent has bipolar disorder the odds of a child, being diagnosed with it is 10%. When two parents have bipolar the odds jump to 55-65%!

One of the many questions I have struggled with for years “who am I apart from my bipolar?”Originally, for years I felt treated like Bipolar Betty by friends, family, and not Betty with bipolar. It was frustrating because I did not want to be defined as my mental illness.

Another initial question I asked my psychiatrist was “will I have to take medications the rest of my life?” The answer was ‘yes”. While he did state in the future he might be able to wean me off some of the medications, the fact I have treatment resistant bipolar makes it highly unlikely, and if anything, more medications continue to be added to the medications that I am already taking.

I know I have come a long way with acceptance but sometimes when I am taking my eight psychotropic medications in the morning and evening it gets to me. How can it not? Right?

So let me tell you about my medication regimen. This ironically makes me depressed!

Due to treatment resistance, I have consulted with three of the best psychiatrists in the country who specialize in bipolar disorder, specifically pharmacology. Different doctors have different theories and approaches. It has been so frustrating and many tears shed because I have felt so helpless. I feel sometimes I am knocked down time after time. Luckily, I am a fighter, but after 15 years, it gets harder and harder to bounce back, which doesn’t help with depression.

Currently for my bipolar and other psychiatric issues I take eight medications. These medications include Clozaril, Pristiq, Wellbutrin, Lamictal, Liothyronine, Zaleplon, Clonazapam, and Adderall. These medications facilitate in keeping various symptoms of my bipolar, ADHD, and OCD in check.

The Clozaril and Lamictal are mood stabilizers, which help keep my moods from going up and down, and rapid cycling.

The Pristiq and Wellbutrin are both anti-depressants and assist with preventing depression. It is important to note that unless an individual with bipolar disorder is stable, use of an anti-depressant is risky. Especially the class of anti-depressants known as Selective Serotonin Reuptake Inhibitors (SSRIs).

The Zaleplon is a sleep medication that aids helping me stay asleep, as well as the Clonazapam, which is an anti-anxiety medication, but it helps me sleep as well.

For my ADHD I use Adderall, which can be risky to use for a person with bipolar. This medication if not watched closely, could cause rapid cycling and severe mania. My psychiatrist is constantly monitoring my moods because multiple times in the past after only a week of use I ended up in the hospital destabilized. This medication really helps me focus, and wake up especially since some of the medications cause drowsiness throughout the day.

Lastly, I take Liothyronine which is a thyroid medication I do not have a thyroid problem, so I need to make sure my thyroid stays just below hyperthyroid, but the goal of the thyroid medication is to aid the other medications to work more effectively, with the thinking those with hypothyroid tend to be more depressed.

Of all the medications, the Clozaril is the harshest. If I do not take this medication around 6pm, I will sleep in late. Over the past two years, my dose has been decreased from 400mg to 150mg and I still sleep 12-14 hours a day. It also requires monthly blood work to make sure that my white blood cell count is normal. This is due to the fact Clozaril can cause deadly reactions.

I once made a list of all psychotropic medications I have been tried on. Of about 50+ medications, I had been tried on all but approximately eight! Some medications I have tried were rough. When I was given Zoloft, I was ready to attack, I was so angry and aggressive it was horrible. Abilify made me feel like I was about to have a seizure. Since Lithium is a salt it made me feel like a marshmallow, I gained 60 pounds, and it was horrible.

I would be lying if I do not get depressed when I am putting my medications into my weekly pill container and when I swallow these medications daily. In addition to my eight psychotropic’s I take seven others for other health issues including asthma, allergies, acid reflux, seizure disorder, and chronic pain, which includes morphine and a muscle relaxer. Because of my chronic pain, my depression is intensified.

So there you have it a brief synopsis of my psychiatric issues! While this blog is about my diagnosis of bipolar disorder, please check back for specific blogs on my other issues, such as my eating disorder, ADHD, and OCD.

Thanks for Reading,

Love Bipolar Betty

Check In 1

2012-04-11T16:32:00.003-04:00

Have not forgotten about ALL OF MY FOLLOWERS....I'm working on more topics as we speak.....keep checking back I plan on finishing some of them over the next few days!!!

To Tell or Not To Tell?

2012-04-01T14:18:00.002-04:00

The reason a pseudonym was created, is due to the fact there are folks I have told about my mental illness, and some I have kept my mental Illness secret from. Unfortunately, the latter I have found is the easiest route. It is risky, extremely risky, to tell folks who will judge you from that day on. If you cannot see it, it is not there. Obviously, the choice is personal and the decision to tell has to be an individual one. However, the question is whom should we tell and whom not? In what situations should we tell? Why should we tell and what will happen if we tell? Is there a right or wrong way to tell them?

When I first, started this blog I was terrified about asking individuals I know, to view it. Since the individuals know my name, I had to take the gamble that these folks would not judge and remain the same with their interactions. Fortunately, for those who do not know my name, I was able to call myself Bipolar Betty. I am hoping this blog reaches out to those who have been diagnosed with a mental illness and those persons whom need education. Although much of society out there is naïve, judgmental, ignorant, and stigmatizes mental illness, I took a leap of faith, with the hopes I will not lose individuals I know to the majority of society!

The problem regarding revealing is there’s not exactly a right or wrong answer, I feel for me it usually falls in between the two during which I hold my breath waiting either for an understanding reaction, or a “oh” response. I have found in the past that folks, who know about my mental illness, are closer to judge when I am moody or upset. I see their wheels turning “it’s just her bipolar acting up”!

While talking about the diagnosis is an opportunity to educate others, is the education worth the cost of potential judgment? Additionally some other questions to think about are would it benefit you by telling someone? What is the circumstances for telling, the reason, and is it enough of one to tell? Lastly if you do not experience any personal or professional benefits, why tell at all? Luckily, for me, I have some friends I have known for a while, whom have supported me for 16 years upon being diagnosed with bipolar disorder, ADHD, and an eating disorder. It is the relationships in my life that are not lengthy that concern me. Some folks are not as lucky. However, because mental illness is not uncommon, depending on the diagnosis, you may be surprised to find some of your friends have the ability to relate.

I was very fortunate when my parents found out; they were standing right by my side. They also signed up for the NAMI Family-to-Family group, which met for 6 weeks to educate family members about mental illness. It is also beneficial that my husband has bipolar disorder and ADD so together we ride the waves.

When it comes to physicians, if it is not essential to disclose my psychiatric diagnosis, or list my psychotropic medications, I usually avoid it. Surprisingly the majority of professionals today do not get it. Even among those in the healthcare field.

The World Health Organization, which is the directing and coordinating authority for health within the United Nations system, predicts that by 2020, mental illness will be the second leading cause of disability worldwide, after heart disease. With this said, will revealing become easier, or remain static. Unfortunately, 2020 is eight years away.

So what are the pros and cons, about disclosing your mental illness? I have found that I have run into many cons. Prejudice and stigma about any mental illness is still very prominent in society. Disclosure to coworkers and employer’s can really be harmful. I have experienced this. Especially when you trust, a coworker and they decided not to keep it confidential, and prove untrustworthy and reveal to coworkers. Thus, revealing to another coworker, etc. At this point, every move I feel was analyzed. Questions such as, “is she late because her medications make her tired”? She seems withdrawn, “is she depressed?”, and the comments and questions go on and on.

For me some of the instances were unavoidable, and I really had no choice. For example, when I was employed, there were times that I had to take a leave of absence because I required hospitalization. This being said, my coworkers wanted to visit me or send me flowers to the hospital! No way in getting around that, without disclosing where I was being hospitalized. Additionally, there have been times when prescribed new medication’s, which may hinder job performance, due to sedative side effects. Alternatively, what about when you need to file paperwork through human resources, that too is a difficult situation for avoiding disclosure.

While discrimination is illegal, is hard to prove, it continues. I have also found chances for a promotion are really hindered. You cannot “untell” a secret. While each and everyone’s situation is different, it is important to sit down and write a list of pros and cons for revealing your mental illness to others, and to also assess the type of relationship you have with the person you may or may not tell. This is a personal decision, which has to be made alone.

Bipolar Betty

Creatively Mood Disordered

2012-03-25T15:56:00.001-04:00

I cannot even recollect the amount of times I have been told I am so creative. I believe having bipolar allows me to feel deeper, lover harder, run faster, and see details that those without mental illnesses do not sense or experience.

Personally, the best poetry I produce is when I am in a mixed state, with manic energy, in conjunction with a down phase, where for me it usually feels like a cold, dark, and depressing depth of despair.

There are also times in my life where I am so manic, I hear color, and I see sound. The flight of ideas, sped up thoughts, heightened senses, such as visual, auditory, or other stimuli is beyond words. There is a medical term for this called hyperacuity, which means sharpness of perception.

For me personally, communicating through poetry when I am feeling sad and alone helps me to spew out my depressive thoughts, with manic urgency. My brain is usually five steps ahead of my hand on the pen. I feel such powerful emotions; I find it hard to not let them out in some outlet or way, be it poetry or some other form of art.

Why is it that individuals with mental illnesses, such as bipolar disorder, lean towards careers in the arts? It has been suggested that mental illness and creativity often go hand in hand. So many themes in poetry are about loss, despair, sadness, and depression.

For instance, Sylvia Plath was a beautiful poet who ended her life by suicide. In 2001, a psychologist by the name of James C. Kaufman created the term the Sylvia Plath to refer to the phenomenon that poets are more susceptible to mental illness than other creative writers are.

Some folks with bipolar disorder worry that they will lose energy and creativity if they agree to take medication for their illness. Personally, I have noticed that my medication does control my mania and depression, thus only allowing spurts here and there to permit me the ability to write poetry.

Whether it is drawing pictures, making jewelry, writing poetry, or writing my autobiography, I always feel creative energy within my soul. For those with mood disorders out there, can you relate?

Bipolar Betty

Diagnosed with Bipolar Disorder - I Don't Understand?

2012-03-19T14:15:00.002-04:00

What brought you to your doctor or psychiatrist’s office? Were you feeling depressed, hyperactive, and not able to sleep or sleeping all the time? What were your symptoms that were becoming disabling?

I have received many comments and questions regarding initial diagnosis, and where to go from there. I am sure these scenarios are not the same for everyone; hopefully folks can take something from each one. I decided to include this blog, and intermittently discuss my personal experiences, and provide some basic information about mood disorders.

I use the term mood disorder interchangeably with bipolar disorder. The definition of a mood disorder is the term designating a group of diagnoses where a disturbance in the person's mood is hypothesized to be the main underlying feature. The two most common “mood disorders,” are classified as Bipolar Disorder, or Major Depressive Disorder. Under these classifications, there are sub-categories, which I will briefly discuss below.

Education is very important for those just diagnosed with a mood disorder and it is important as well for family and friends to educate themselves too. The internet has such a vast amount of information on mood disorders, as well as details on medication your doctor has prescribed to you. I highly suggest folks diagnosed with a mood disorder take the time to do research on the internet, and if internet access is not available, there are wonderful books available at the library or bookstore.

A huge help has been gaining the knowledge of all aspects of my mood disorder, and it plays a huge part in understanding what my psychiatrist is suggesting, and allows me to ask questions as well. Otherwise I would feel like I was listening to someone speak a foreign language I have no idea how to speak.

Statistically it is not uncommon for individuals to be misdiagnosed at least once. As severe as my bipolar is, it took many trips to the hospital and my psychiatrist’s office to receive the diagnosis. Because there are so many facets to the disorder, if one comes in to the doctors while depressed, the odds of being diagnosed with major depression is highly likely. With all mood disorders, cycling is not uncommon and unless psychiatrists have witnessed the cycling on a continuous basis, diagnosis of bipolar disorder most likely will take longer to identify. The bad thing about this is that medications to treat mood disorders vary depending on your diagnosis.

Sometimes, if you are an individual who has bipolar, but is just showing signs of depression, a psychiatrist who prescribes an antidepressant can result in a huge disaster. The likeliness of rapid cycling while on an antidepressant without a mood stabilizer is very common.

Before I get into the “types of bipolar disorder”; here is some terminology used below. Please note that this is just a BRIEF description, and does not entail all symptoms.

Mania: Easily distracted; little need for sleep; poor judgment or temper control; reckless behavior and/or lack of control; sexual promiscuity; spending sprees; overly elevated mood (i.e. increased energy and activity; racing thoughts; overly talkative; grandiosity such as very high self-esteem); agitation and/or irritability.

Depressed Phase of Bipolar Disorder: Daily low mood or sadness; difficulty concentrating, remembering, or making decisions; eating problems, such as weight loss or weight gain; fatigue or lack of energy; feeling worthless or hopeless; low self esteem; thoughts of suicide.

Here is a brief overview of types of bipolar disorder; most likely, the doctor or psychiatrist will use similar terminology to refer to your diagnosis. Please note this does not include every subtype of bipolar disorder.

Bipolar I: (this is my diagnosis and the most severe classification) this term is usually given to individuals who have/had experiences with severe depression and full-blown mania

Bipolar II: Diagnosed when somebody has had many major depressive episodes as well as episodes of hypomania, and not severe mania. This is the most common bipolar diagnosis.

Rapid Cycling: (this also is included in my diagnosis) this is usually more an adjunct symptom, to the two subtypes of bipolar described the above. It means, over a 12-month period, an individual has more than four manic and depressive symptoms or episodes. Rapid cycling tends to be a lot more common in women.

Mixed State or Episode: (this as well is included in my diagnosis; which is why my Bipolar Disorder is SO severe) this term is defined during which symptoms of mania and depression occurs simultaneously. Mixed states are often the most dangerous period of mood disorders, the propensity to violence, suicide attempts, and other complications increase greatly.

During this phase for me, I can be crying and laughing at the same time. Coupled with rapid cycling my need at this time for hospitalization is at its highest.

Cyclothymia: This diagnosed usually given if an individual has some common bipolar disorder symptoms, which includes cyclical fluctuations in moods of mild or moderate depression and minor hypomania.

I hope I have helped some folks out there reading my blog and on my Facebook group page, with questions that have been presented. Folks out there please feel free to add comments, so that others can be educated.

Bipolar Betty