Break the Bipolar Cycle - link to

This book doesn’t spend much time on positive reinforcement (People with bipolar are great artists! Your symptoms are OK! You are not alone!), and I am more than fine with that. Instead, it focuses on practical approaches to getting through the day, meeting goals, and overcoming hurdles — even “small” hurdles.

Until I read this book, I felt alone in:

  • Dreading phonecalls
  • Being a medication guinea pig
  • Feeling “up” and yet so negative ( “mixed state”)
  • Every small task being so utterly difficult
  • Being such a finicky sleeper

The books introduces the reader to various symptoms along the Bipolar spectrum (Bipolar type I, type II, cyclothymia, Bipolar NOS, etc) by way of brief descriptions and then several stories of real people’s experiences.  These are helpful not only by way of illustration, but also as a means of practicing empathy: it can be easier to feel kindly towards others who have a diagnosis than towards yourself, and kindliness towards oneself is a precursor towards any positive action at all!

In addition to these descriptions and stories, the book contains a whole lot of worksheets.  There’s a certain amount of inertia you must overcome to make full use of the book, but if you can, the worksheets are very useful.  Some features include:

  • A worksheet to prioritize phonecalls, one at a time
  • Various mood-tracking worksheets — down the road, when you’re miserable/jittery/angry, they’ll remind you that you haven’t always been that way
  • Symptom worksheets
  • A worksheet for identifying stressors
  • Drug efficacy & side-effect worksheets
  • …And a whole bunch of others that I certainly haven’t tackled yet

For best results, have partners/friends/family members help with these worksheets; they can be overwhelming for someone who’s coping with a new diagnosis. The worksheets make a huge difference in the ability of your psychiatrist to treat you, since they offer a broad view of symptoms over time, and they provide you with that same broad perspective — it reminds you that you’re not always ___________ (fill in the blank of your current mood).

This book alone won’t “break the bipolar cycle”, but it is one of many useful tools (along with chocolate and drugs) that can make bipolar more manageable.  It’s the best book I’ve found, of maybe 5 at my local library.


Meds 4 Life

October 11, 2009

Can I stop taking drugs if I feel better?

Here’s an abrupt answer from WebMD:

Anyone who has experienced two to three episodes of bipolar disorder is considered a long-term — if not lifetime — bipolar patient. That person should have maintenance therapy. Once your doctor has helped stabilize the moods of the acute phase of the disorder (either a manic or depressive episode), drug therapy is continued indefinitely — often at lower doses.

People with bipolar disorder may take lifelong lithium as maintenance therapy to prevent relapses. When lithium treatment stops, relapses can occur within six months in 90% of patients. Moreover, subsequent lithium treatment and other treatments are less likely to be effective.

WebMD doesn’t cite their sources, so take this with a grain of sodium.

What about if a woman with bipolar wants to get pregnant?  Or don’t I even want to know?

What is bipolar disorder?

October 11, 2009

Cheesy old ad with a young woman saying - so simple

If experts don't understand bipolar, how can patients?

“Bipolar disorder” is a spectrum of disorders whose symptoms include periods of mania and depression; it is thought to be largely genetic, but research is not yet conclusive about the causes, neurology, or treatment. There is a 15% fatality rate, due to suicide.

Here’s a more eloquent definition, exerpted from my favorite resource, “Break the Bipolar Cycle” by doctors Elizabeth Brondolo & Xavier Amador:

Bipolar spectrum disorders (BSDs) are a group of disorders all of which involve cycling moods.  But BSDs are also accompanied by a wide range of other symptoms that affect not just your mood but also your energy, your memory and thinking, and your connection with other people. Because the symptoms change or cycle, it may feel like you are always losing ground, never gaining control over your life.

Then there’s the more clinical DSM-IV diagnostic criteria for each of the 4 types of bipolar it defines:

  • Bipolar I Disorder – at least one Manic or Mixed episode, but there may be episodes of Hypomania or Major Depression (this is what people typically think of when they think of Bipolar or Manic-Depression)
  • Bipolar II Disorder (here I’m quoting Wikipedia, which is quoting the DSM)
    1. Presence (or history) of one or more Major Depressive Episodes.
    2. Presence (or history) of at least one Hypomanic Episode.
    3. There has never been a Manic Episode or a Mixed Episode.
    4. The mood symptoms in Criteria A and B are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, delusional disorder, or Psychotic Disorder Not Otherwise Specified.
    5. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  • Cyclothymic Disorder – Highs and lows that impair functioning as with Bipolar II, but without meeting the criteria for a Major Depressive episode or a Manic episode
  • Bipolar Disorder NOS – “This designation abbreviated NOS can be used when the mental disorder appears to fall within the larger category but does not meet the criteria of any specific disorder within that category.”

The DSM-IV definitions immediately lead one to ask “what’s mania?  what’s depression?” — there are plenty of links here to lead you to the answers, but I think this is all more than enough for one post.

Hello, I hate you -- that's bipolar