Mindfulness for Self-Harm: A DBT Skills Video

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Using mindfulness for self-harm is a dialectical behavior therapy (DBT) skill. Dialectical behavior therapy is an effective type of treatment used for issues of self-harm. Originally developed to treat borderline personality disorder (BPD), it is currently used to treat a variety of mental illnesses such as eating disorders and chronic depression. Dialectical behavior therapy targets emotion dysregulation to help patients cope with the severity of their distress.

Self-Harm and Mindfulness

In this video, I teach you how to use mindfulness skills, one of the core components of DBT, to cope with your self-harm urges. Mindfulness in DBT is all about staying aware of the present moment and of how you are feeling in the present moment, and learning to accept these feelings as they are. 

Become an Advocate for Eating Disorder Awareness

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The mainstream culture needs more advocates for eating disorder awareness—and as someone in pursuit of healing for your own life, you could become an advocate. 

It has been estimated that every 62 minutes, at least one person dies from an eating disorder which means this disease has the highest mortality rate out of any mental illness,1 but it also remains one of the most painfully misunderstood ("Eating Disorder Statistics"). If there is a passion inside of you to raise the public consciousness for eating disorder recovery and to draw attention to the millions of people whose lives are affected by this illness, then here are some guideposts to help you become an advocate for eating disorder awareness. 

5 Tips to Become an Advocate for Eating Disorder Awareness

Please never diminish the influence that your voice has the potential to carry out in the world. You know firsthand the torment, anxiety, isolation, self-hatred, and desperation that an eating disorder can cause. But if you have entered the recovery process, then you also know that hope is both real and accessible. The capacity to hold this tension between healing and affliction can be what makes you the right person to become an advocate for eating disorder awareness, and these are five ways to get started.  

  1. Lobby for equitable funding to provide treatment resources and advance clinical research to better approach this disease. In the U.S. alone, eating disorders are some of the most inadequately funded mental illnesses by the federal government. The cost of treatment for just one patient can total as much as $119,200, whereas the amount of money allocated to the psychiatric research of this disease is $.73 for each patient.These statistics are grim, but you can help effect change in this area when you contact lawmakers to urge for policy reform in medical or therapeutic care, insurance, and research studies.  
  2. Partner with local or even national organizations that already further the mission and impact of eating disorder advocacy. If you do not feel equipped to spearhead your own initiative to raise awareness, there are a number of different coalitions and non-profits that are making positive strides in this arena. You can join their efforts through a financial donation, assistance with an outreach event, or directing someone in need of support to their online resources and materials. The eating disorder recovery website Mirror Mirror has compiled a list of trustworthy organizations you should connect with.
  3. Start meaningful discussions on social media to push back against cultural beauty standards and normalize body acceptance. You might not realize it, but a powerful and influential tool to become an advocate exists at your fingertips, and you do not need to leave the couch or computer to access it. This platform is social media, and when you harness it to spark a conversation about the realities of eating disorders, your potential to reach a diverse audience with the message of recovery is monumental. Just a raw, authentic post on your social networks could bring education and awareness around this issue in unprecedented ways.   
  4. Volunteer at an eating disorder crisis hotline to offer support to those who are suffering and point them to treatment access. If you are not familiar with a hotline, this is a free phone service that anyone across the nation can either text or call to receive confidential assistance from someone who is knowledgeable about the illness. There are hotlines for eating disorders, addictions, suicide and self-harm prevention, and other mental health concerns—many of which offer 24/7 information and support. These resources are available for the friends or family members of an affected person too, but they need volunteers to manage the phones which is where you come in.  
  5. Participate in a National Eating Disorder Association (NEDA) walk to help fundraise and boost awareness in the community. Each year, NEDA hosts a series of walks around the country, so people of all backgrounds have the opportunity to band together in their hometowns and march for a cause that has impacted millions of lives. This annual initiative raises money for the organization to continue its work, but it also promotes the visibility of eating disorders all over the United States. You can register to participate in a NEDA walk, or you could sponsor a walk for the members of your own community. 

Have you already become an advocate for eating disorder awareness? If so, please leave your tips in the comments.

Sources

  1. Crow, S., and Swanson, S., "Facts About Eating Disorders: What the Research Shows." The Eating Disorders Coalition for Research, Policy, and Action. September 2014.
  2. Griffiths, S., Le Grange, D., et al, "When Illness Severity and Research Dollars Do Not Align: Why Are We Overlooking Eating Disorders?" World Psychiatry. October 2017.

Taking Risks Is a Part of Mental Health Recovery

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You'll never know what you're truly capable of until you take risks and push yourself. This applies to everyone -- with or without a mental illness.

There have been times in my recovery where I was presented with new opportunities that I could have very easily turned down. I wanted to play it safe in fear of becoming symptomatic. Sometimes it's easy to hide behind my diagnosis to say "no". Other times I was told to play it safe.

Living with a mental illness is challenging to say the least. It took me quite a while after receiving my diagnosis to get to a place where I was not only stable but also thriving. Even though I am in mental health recovery, I have taken risks to get to where I am today.

I Learned to Take Risks as a College Student

I struggled between playing it safe and taking risks during my time as a college student -- which lasted 13 years. A college degree had always been important to me, and I would have been crushed if my mental illness had prevented me from getting it.

I dropped out a few times, and it would have been so easy to quit right then. I felt defeated and would often blame my mental illness. I was scared to go back, and at one point I was told, "College isn't for everyone." I would generalize, too. College must be impossible for everyone with schizoaffective disorder.

The truth is, college is difficult for almost every student and everyone has his or her own story and struggles. Schizoaffective disorder just happens to be mine.

I bolstered up my courage and went back, and it was worth it to take the risk. I finally graduated in 2014.

A Mental Illness Diagnosis Does Not Mean You Must Stop Taking Risks

From that point on I decided that I would never hide behind my diagnosis. I might become symptomatic if I take a risk, but I might also accomplish something great. You never know until you try.

I'm not trying to downplay the seriousness of mental health issues, but I don't think receiving a diagnosis means you have to give up on achieving your goals. Mental illness does not make you a hopeless case. It just means you might have to take a different path. 

It's also okay to admit defeat if you fail. At least you tried. You can move on to a different goal.

Mental health recovery takes some getting used to. You have to get into a routine, practice some healthy living skills, and learn what works best for you. Yes, mental illness makes life difficult and recovery takes work, but that doesn't mean you have to give up on your dreams. It means you have to adapt and be flexible and patient. You may have to find another way to achieve your goals, and that could include taking risks. In my experience, it has been worth it. I would rather try and fail than live with regret. Don't let your mental illness steal your ambition. You deserve a full and meaningful life.

How Learned Helplessness Causes Anxiety

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Learned helplessness is a psychological concept I’ve been familiar with for a while, but had never, until recently, thought to apply it to anxiety. It is most commonly framed in terms of depression, but as I’ve given it more thought, the concept can very easily be carried over to anxiety and may provide insight as to why it can be so difficult to pick yourself up when things get really bad.

What Is Learned Helplessness?

That begs the question: what is learned helplessness? To put it simply, it is the idea that, after being faced with repeated negative, uncontrollable stimuli, a person will eventually give up trying to avoid anything unpleasant, even that which can be avoided, because they believe they have no control whatsoever.

The concept is one that has the weight of many scientific studies behind it, albeit ones that may be horrifying to modern sensibilities. In the late 1960s, Martin Seligman, while studying classical conditioning on dogs, discovered that certain dogs that received unavoidable electric shocks would fail to take action when faced with any subsequent, avoidable danger. Seligman later replicated the experiment on humans and found similar results.1

Applying Learned Helplessness to Anxiety

The application of learned helplessness to anxiety seems so obvious I feel embarrassed it took me this long to make the connection. At its core, learned helplessness is caused by feeling powerless in the face of an uncomfortable situation. We’re dealing with a lack of control – I can’t do anything to change the situation, so why try?

But the lack of control extends beyond just that. There’s no way to know when the uncomfortable situation is going to happen, even if you expect it. This uncertainty can make a world already painted in hostile colors look even more frightening.

I hope you can start to see how negative thought patterns can develop here. Say you’re in your house, which is your one safe place. If you expect bad things to happen when you leave that safe place, but don’t know when to expect them, you start to feel crippled. Maybe you avoid making plans in order to artificially maintain that sense of security. At worst, maybe you refuse to leave your safe place at all.

How to Combat Learned Helplessness

Fear not – though difficult, learned helplessness can be combatted. A major factor in its development is having a pessimistic explanatory style – basically, a negative way of viewing and interpreting what happens around you.2 If you have a way to change your pessimistic explanatory style, you will go a long way to combat learned helplessness.

The easiest way to do this is by finding someone to talk to. This can be a therapist, but it doesn’t even need to be something so formal – it could be a trusted friend or family member. Get someone who can challenge your negative thoughts, and help guide you to a clearer, more realistic, and healthier place.

Sources

  1. Nolen, J., "Learned Helplessness." Encyclopaedia Britannica. August 17, 2009.
  2. Legg, T., "What is learned helplessness?" MedicalNewsToday. May 31, 2019

Bipolar Depression Symptoms in Men Hard to Deal With

Bipolar depression symptoms in men can be hard to deal with. The symptoms themselves can make functioning seem like an insurmountable challenge. In severe cases, even getting out of bed or off the couch is nearly impossible. But for many men, bipolar depression symptoms aren’t the only challenge. The stigma of facing depression, of admitting that something is wrong mentally and emotionally, keeps a lot of men suffering in silence.

Partly because of the silence surrounding bipolar depression in guys, it can seem as though no one else is dealing with the problem. That’s an illusion created by a lack of conversations about bipolar depression symptoms in males. The reality is that if you’re male and living with bipolar depression, you’re not alone. Depression is a mental health struggle that over six million men in the United States face every year (Depression and Bipolar Support Alliance (DBSA), n.d.).

Because bipolar depression is so difficult to live with and all too common, let’s explore men’s bipolar depression symptoms.

Bipolar Depression Symptoms in Males

Bipolar depression, according to the American Psychiatric Association’s authoritative Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, is one of the mood episodes people with bipolar I or bipolar II disorder experience. The other is mania or hypomania. To be diagnosed with bipolar depression, someone must have at least five of the following symptoms and experience them together for at least two consecutive weeks.

One or both of these:

  • Depressed mood nearly all the time
  • Loss of interest and drastically diminished feelings of pleasure in almost all activities once enjoyed

Three or four (or more) of these symptoms:

  • Exhaustion that doesn’t lift
  • Weight changes (loss or gain) without trying
  • Sleeping too much or too little
  • Feeling agitated or slowed down
  • Difficulty thinking, concentrating, paying attention, and/or making decisions
  • Sense of worthlessness and strong (and misplaced) feelings of guilt

Many bipolar depression symptoms are similar for males and females. Men and women sometimes experience them differently, though.  For example, it’s slightly more common for men than women to experience these bipolar depression symptoms while also in a state of mania.  This blend of mania and depression can be overwhelming, exhausting, and frustrating.

Also overwhelming, exhausting, and frustrating for a lot of men is how to deal with the presence of bipolar depression in their lives.

Ways That Many Men Deal with Symptoms of Bipolar Depression

Cultural norms dictate that men be strong, independent, self-reliant, stable, and possess emotional control. By extension, males tend to associate bipolar depression with character flaws and weakness. Men, therefore, aren’t always willing to admit to struggling—especially emotionally. Many go so far as to actively work to hide their bipolar depression symptoms.

Often, insight into what men are experiencing comes from what they will and will not talk about. While many men are reluctant to talk about their emotions and feelings such as sadness, crying, or generally feeling down, some will talk about feeling bored or unmotivated as well as their loss of interest in certain activities.

Depression symptoms in males often reveal themselves in actions. Extreme irritability, withdrawal from friends, family, and work, and changes in eating and sleeping habits can communicate suffering. Guys often believe that mentioning certain behavioral symptoms and choices rather than feelings is often seen as a more acceptable way to talk about bipolar depression.

Men and Coping with Bipolar Depression Symptoms

Possibly because they are sometimes reluctant to talk about depression, men find ways to cope with their symptoms. Unfortunately, bipolar disorder—both mania and depression—leads to some dangerous coping behaviors. These can include:

  • Alcohol and other substance use and abuse
  • Engagement in dangerous activities (in mania for the thrill; in depression because people don’t always care about their own safety and survival)
  • Over-involvement in work despite fatigue in order to avoid friends and family

Even though it might feel impossible, bipolar depression is treatable. Doctors and therapists will listen without judging as well as keep your information confidential (unless you are expressing suicidal ideation).  Just as with bipolar depression symptoms in women, bipolar depression symptoms in men can gradually diminish to be replaced with a return of happiness and interest in life.

article references

APA Reference
Peterson, T. (2019, June 11). Bipolar Depression Symptoms in Men Hard to Deal With, HealthyPlace. Retrieved on 2019, June 26 from https://www.healthyplace.com/bipolar-disorder/bipolar-depression/bipolar-depression-symptoms-in-men-hard-to-deal-with

Last Updated: June 15, 2019

Bipolar Depression Symptoms in Women

Bipolar depression symptoms in women can be different than bipolar depression symptoms in men. Both women and men with bipolar disorder I or II can develop bipolar depression, of course, but the way they experience it can vary. Keeping in mind that there are individual differences within genders and that each person’s experience with bipolar depression is unique, let’s explore, in general, what bipolar depression symptoms in women are like.

According to the authority on all mental disorders, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), women are more likely than men to experience bipolar depression. In bipolar I disorder, which occurs at equal rates in females and males, more females than males sink into depression. Further, more women than men are diagnosed with bipolar II, a mood disorder involving hypomania and more depressive episodes than bipolar I.

Females with bipolar disorder spend more time in bipolar depression than their male counterparts. What do these women experience?

Bipolar Depression Symptoms in Females

Bipolar depression symptoms in women are often debilitating. They can occur as a mixed episode right alongside or back-to-back with mania, or they can strike suddenly after a period of mood stability. Either way, they quickly lead to a downward spiral of thoughts, emotions, and behaviors. Women suffering from symptoms of bipolar depression often face:

  • Feelings of utter worthlessness
  • Strong guilt over things she thinks she’s done wrong
  • Isolation and loneliness
  • Feeling hollow, empty, and/or very sad and generally down
  • Apathy—no interest in activities or participation in life
  • Lack of energy so all-encompassing it is often referred to as leaden paralysis
  • Difficulty concentrating and making even simple decisions
  • Unhealthy sleeping and/or eating patterns (too much or too little of either)
  • Recurrent thoughts of death or suicide

While men do develop bipolar depression, and it can be devastating, women tend to experience more depressive symptoms, and they often experience them before they begin having manic episodes. There’s a fundamental difference between the genders that underlies a significant part of the reason: hormones.

Hormones and Bipolar Depression Symptoms in Women

Females’ unique hormonal activity increases the risk of developing bipolar depression, and it also increases the chance of relapse once that depression has entered remission. It’s important to note, however, that while hormones impact the severity of bipolar depression and its frequent recurrence, hormones don’t cause bipolar disorder.

Female hormones that underlie depression are those involved in:

  • Premenstrual syndrome (PMS)
  • Menstruation
  • Menopause
  • Pregnancy

Symptoms of these biological activities are often more intense when a woman has bipolar depression. Additionally, women with bipolar disorder are more likely to have episodes of bipolar depression during menopause.

The hormones and experience of pregnancy and childbirth often intensify bipolar depression. Postpartum depression can be much stronger and more difficult to manage when it’s accompanied by bipolar depression.

Pregnancy hormones have such an impact that women who are pregnant or who have recently given birth are seven times more likely than women without bipolar disorder to be admitted to the hospital because of symptoms of their disorder.  (WebMD Medical Reference, 2016).

Because the hormones of the menstrual cycle, menopause, pregnancy, and childbirth carry risks of worsening bipolar depression symptoms or leading to a new depressive episode, it’s important for women to be aware of how hormonal and mood activities affect them. Knowing how you experience bipolar depression and how your hormones impact your mood can help you take measures to manage both depression and hormones. Experiment to see what makes things better, create a treatment plan, and promise yourself to stick to it even when you don’t feel up to it.

Medication is almost always used to treat bipolar depression (in pregnancy, though, it’s used much less due to risks to the developing baby). It’s often used to treat female hormonal fluctuations as well. Include your medication in your treatment plan to help your brain find stability.

Bipolar depression symptoms in women can be intense and disruptive to life. Fortunately, symptoms can be treated and managed, and women with bipolar depression can live well.

article references

APA Reference
Peterson, T. (2019, June 11). Bipolar Depression Symptoms in Women, HealthyPlace. Retrieved on 2019, June 26 from https://www.healthyplace.com/bipolar-disorder/bipolar-depression/bipolar-depression-symptoms-in-women

Last Updated: June 15, 2019

Bipolar Depression Article References

Bipolar Depression Early Warning Signs

Bipolar disorder. (n.d.). Office on Women’s Health. Retrieved January 2019 from https://www.womenshealth.gov/mental-health/mental-health-conditions/bipolar-disorder-manic-depressive-illness

MacGill, M. (2018). Symptoms of bipolar disorder in women. MedicalNewsToday. Retrieved January 2019 from https://www.medicalnewstoday.com/articles/314837.php

Montero, H.A. (2018). Bipolar symptoms in men: 10 signs to look for. Psycom. Retrieved January 2019 from https://www.psycom.net/bipolar-symptoms-in-men

Purse, M. (2019). Symptoms and diagnosis of bipolar disorder. Verywell mind. Retrieved January 2019 from https://www.verywellmind.com/bipolar-disorder-symptoms-and-diagnosis-379962

Watson, K. & The Healthline Editorial Team. (2017). Could it be bipolar? 14 signs to watch for. Healthline. Retrieved January 2019 from https://www.healthline.com/health/could-it-be-bipolar-signs-to-look-for

WebMD Medical Reference. (2018). Depression in bipolar disorder: What you can do. WebMd. Retrieved January 2019 from https://www.webmd.com/bipolar-disorder/bipolar-life-17/depression

WebMD Medical Reference. (2016). Warning signs and symptoms of bipolar disorder. WebMD. Retrieved January 2019 from https://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-warning-signs#1

Worth, T. (n.d.). 10 subtle signs of bipolar disorder. Health. Retrieved January 2019 from https://www.health.com/health/gallery/0,,20436786,00.html?

Bipolar Depression Symptoms in Women

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association.

Arnold, L.M. (2003). Gender differences in bipolar disorder. The Psychiatric Clinics of North America, 26(3), 595-620. Retrieved January 2019 from https://www.ncbi.nlm.nih.gov/pubmed/14563100/

Bipolar disorder. (n.d.). Office on Women’s Health. Retrieved January 2019 from https://www.womenshealth.gov/mental-health/mental-health-conditions/bipolar-disorder-manic-depressive-illness

Gordon, L. (2018). Bipolar disorder in women: Know the facts. Healthline. Retrieved January 2019 from https://www.healthline.com/health/bipolar-disorder/bipolar-symptoms-in-women

MacGill, M. (2018). Symptoms of bipolar disorder in women. MedicalNewsToday. Retrieved January 2019 from https://www.medicalnewstoday.com/articles/314837.php

Migala, J. (2018).  7 women on what it’s really like to live with bipolar disorder. Health. Retrieved January 2019 from https://www.health.com/bipolar/bipolar-symptoms

Sit, D. (2004). Women and bipolar disorder across the life span. Journal of the American Medical Women’s Association; 59(2): 91–100. Retrieved January 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3107596/

WebMD Medical Reference. (2016). Warning signs and symptoms of bipolar disorder. WebMD. Retrieved January 2019 from https://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-warning-signs#1

Bipolar Depression Symptoms in Men Hard to Deal With

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association.

MacGill, M. (2018). Symptoms of bipolar disorder in women. MedicalNewsToday. Retrieved January 2019 from https://www.medicalnewstoday.com/articles/314837.php

Men and depression. (n.d.). Depression and Bipolar Support Alliance. Retrieved January 2019 from https://secure2.convio.net/dabsa/site/SPageServer/?NONCE_TOKEN=5BF953C959A0F4ADF870260E0C730A1F&pagename=education_brochures_men_depression

Montero, H.A. (2018). Bipolar symptoms in men: 10 signs to look for. Psycom. Retrieved January 2019 from https://www.psycom.net/bipolar-symptoms-in-men

Bipolar Depression in Teens: How Parents Can Help

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Bipolar disorder basics. (n.d.) Child Mind Institute. Retrieved January 2019 from https://childmind.org/guide/guide-to-bipolar-disorder/

Bipolar disorder in children and teens. (2015). National Institute of Mental Health. Retrieved January 2019 from https://www.nimh.nih.gov/health/publications/bipolar-disorder-in-children-and-teens/index.shtml

Broderick, P.C., & Blewitt, P. (2006). The lifespan: Human development for helping professionals. Upper Saddle River, NJ: Pearson Merrill Prentice Hall.

Get treatment for bipolar disorder in children and teens. (n.d.). Crosswinds. Retrieved January 2019 from https://crosswinds.org/troubled-youth/risk-factors-warning-signs/bipolar-disorder/?gclid=CjwKCAiA1ZDiBRAXEiwAIWyNC4QOUHKsTa370I20qVQ3WUwrn1Z0PID7219Ak_oVY1i8Gw7SIiKgSxoCVRkQAvD_BwE

Montero, H.A. (2018). Bipolar symptoms in men: 10 signs to look for. Psycom. Retrieved January 2019 from https://www.psycom.net/bipolar-symptoms-in-men

Scaccia, A. (2018). How to recognize and treat bipolar disorder in teens. Healthline. Retrieved January 2019 from https://www.healthline.com/health/bipolar-disorder/bipolar-disorder-in-teens

Watson, K. & The Healthline Editorial Team. (2017). Could it be bipolar? 14 signs to watch for. Healthline. Retrieved January 2019 from https://www.healthline.com/health/could-it-be-bipolar-signs-to-look-for

WebMD Medical Reference. (2016). Warning signs and symptoms of bipolar disorder. WebMD. Retrieved January 2019 from https://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-warning-signs#1

Bipolar Depression with Anxiety: What Treatments Work

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association.

Cirino, E. (2017). Can you have bipolar disorder and an anxiety disorder at the same time? Healthline. Retrieved January 2019 from https://www.healthline.com/health/bipolar-and-anxiety

Lohano, K. & El-mallakh, R. (2011). The anxious bipolar patient. Psychiatric Times, 28(9). Retrieved January 2019 from http://www.psychiatrictimes.com/bipolar-disorder/anxious-bipolar-patient

Swingle, C. (2014). When bipolar dances with anxiety. Bp Hope Magazine. Retrieved January 2019 from https://www.bphope.com/the-tension-tango/

Understand the facts: Bipolar disorder. (n.d.). Anxiety and Depression Association of America. Retrieved January 2019 from https://adaa.org/understanding-anxiety/related-illnesses/bipolar-disorder

Treatment-Resistant Bipolar Depression: What Helps?

Mostert, M., & Dubovsky, S.L. (2008). When bipolar treatment fails: What’s your next step? Current Psychiatry, 7(1), 39-46. Retrieved January 2019 from https://www.mdedge.com/psychiatry/article/62970/when-bipolar-treatment-fails-whats-your-next-step

Poon, S.H., Sim, K., & Baldessarini, R.J. (2015). Pharmacological approaches for treatment-resistant bipolar disorder. Current Neuropharmacology, 13(5), 592-604. Retrieved January 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4761631/

Schaffer, C.B., Schaffer, L.C., & Howe, J. (2017). Treatment-Resistant bipolar disorder. Psychiatric Times, 34(11). Retrieved January 2019 from http://www.psychiatrictimes.com/special-reports/treatment-resistant-bipolar-disorder-2017

Sit, D. (2004). Women and bipolar disorder across the life span. Journal of the American Medical Women’s Association; 59(2): 91–100. Retrieved January 2019 from     https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3107596/

Help for Bipolar Depression: Where to Find It

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Behavioral Health Treatment Services Locator. (n.d.). Substance Abuse and Mental Health Services
Administration (SAMSHA). Retrieved January 2019 from https://findtreatment.samhsa.gov/

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How support groups help. (n.d.). Depression and Bipolar Support Alliance (DBSA). Retrieved January 2019 from https://secure2.convio.net/dabsa/site/SPageServer/?pagename=wellness_support_groups Let’s talk about it. (n.d.). Mental Health [dot] Gov. Retrieved January 2019 from https://www.mentalhealth.gov/get-help

Mental Health America Affiliate Resource Center. (n.d.). Find an affiliate. Mental Health America. Retrieved January 2019 from https://arc.mentalhealthamerica.net/find-an-affiliate

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Welcome to the DBSA balanced mind parent network. (n.d.) The Balanced Mind Parent Network: A Program of DBSA. Retrieved January 2019 from https://secure2.convio.net/dabsa/site/SPageServe /;jsessionid=00000000.app268b?NONCE_TOKEN=4CD5C368F676FF0940FFE63BB5355537&pagename=bmpn_landing

Bipolar Depression and Light Therapy: Does It Really Work?

Nasr, S.J., Elmaadawi, A.Z., & Patel, R. (2018). Bright light therapy for bipolar depression. Current Psychiatry, 17(11), 28-32. Retrieved January 2019 from https://www.mdedge.com/psychiatry/article/178250/bipolar-disorder/bright-light-therapy-bipolar-depression

Neighmond, P. (2017). Light therapy might help people with bipolar depression. NPR. Retrieved January 2019 from https://www.npr.org/sections/health-shots/2017/11/27/561574259/light-therapy-might-help-people-with-bipolar-depression

Purse, M. (2019). Light therapy for bipolar disorder. Verywell mind. Retrieved January 2019 from https://www.verywellmind.com/light-therapy-for-bipolar-disorder-380665

Watson, J. (2018). Brighter days ahead: Light therapy effective for bipolar depression. Medscape. Retrieved January 2019 from https://www.medscape.com/viewarticle/894358#vp_2

Are Antidepressants Safe and Effective in Bipolar Depression Treatment?

Bipolar disorder basics. (n.d.) Child Mind Institute. Retrieved January 2019 from https://childmind.org/guide/guide-to-bipolar-disorder/

Cascade, E.F., Reites, J., Kalali, A.H., & Ghaemi, N. (2007). Antidepressants in bipolar disorder. Psychiatry Edgmont), 4(3), 56-58. Retrieved January 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2922360/   

Malhi, G.S. (2015). Antidepressants in bipolar depression: yes, no, maybe? Evidence-Based Mental Health, 18, 100-102. Retrieved January 2019 from https://ebmh.bmj.com/content/18/4/100  

Sit, D. (2004). Women and bipolar disorder across the life span. Journal of the American Medical Women’s Association; 59(2): 91–100. Retrieved January 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3107596/

Smith, M., Robinson, L., & Segal, J. (2018). Bipolar medication guide: The role of medication in bipolar disorder treatment. Help Guide. Retrieved January 2019 from https://www.helpguide.org/articles/bipolar-disorder/bipolar-medication-guide.htm/

Worth, T. (n.d.). 10 subtle signs of bipolar disorder. Health. Retrieved January 2019 from https://www.health.com/health/gallery/0,,20436786,00.html?

Ketamine Treatment for Bipolar Depression: Does it Help

Collins, S. (2018). What you need to know about ketamine’s effects. WebMD. Retrieved January 2019 from https://www.webmd.com/depression/features/what-does-ketamine-do-your-brain#1

Ketamine. (n.d.). Partnership for Drug-Free Kids. Retrieved January 2019 from https://drugfree.org/drug/ketamine/

Ketamine for depression: Does it work? (n.d.). Depression Alliance. Retrieved January 2019 from https://www.depressionalliance.org/ketamine-for-depression/      

McMillan, M. (2018). Ketamine a “Lifesaving” aid for depression? WebMD. Retrieved January 2019 from https://www.webmd.com/mental-health/addiction/news/20180821/ketamine-a-lifesaving-aid-for-depression  

Serafini, G., Howland, R.H., Rovedi, F., Giardi, P., & Amore, M. (2014). The role of ketamine in treatment-resistant depression: A systematic review. Current Neuropharmacology, 12(5), 444-461. Retrieved January 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4243034/

What Natural Treatments Help Bipolar Depression?

Calabro, S. with Vann, M. (2016). 9 natural therapies for bipolar depression. Everyday Health. Retrieved January 2019 from https://www.everydayhealth.com/bipolar-disorder/alternative-treatments-for-bipolar-disorder.aspx

Consumer Lab. https://www.consumerlab.com/

Dietary supplement fact sheets. (n.d.). National Institutes of Health Office of Dietary Supplements. Retrieved January 2019 from https://ods.od.nih.gov/factsheets/list-all/

Higuera, V. & Healthline Editorial Team. (2018). 10 alternative treatments for bipolar disorder. Healthline. Retrieved January 2019 from https://www.healthline.com/health/bipolar-disorder/alternative-treatments

Men and depression. (n.d.). Depression and Bipolar Support Alliance. Retrieved January 2019 from https://secure2.convio.net/dabsa/site/SPageServer/?NONCE_TOKEN=5BF953C959A0F4ADF870260E0C730A1F&pagename=education_brochures_men_depression

Purse, M. (2018). Treating bipolar disorder. Verywell mind. Retrieved January 2019 from https://www.verywellmind.com/treating-bipolar-disorder-3576129#complementary-treatments

Railton, D. (2018). Natural remedies for treating bipolar disorder. Medical News Today. Retrieved January 2019 from https://www.medicalnewstoday.com/articles/314435.php

3 Bipolar Depression Coping Skills You Need to Have

Swingle, C. (2014). When bipolar dances with anxiety. Bp Hope Magazine. Retrieved January 2019 from https://www.bphope.com/the-tension-tango/

WebMD Medical Reference. (2018). Depression in bipolar disorder: What you can do. WebMD. Retrieved January 2019 from https://www.webmd.com/bipolar-disorder/bipolar-life-17/depression

Can Therapy for Bipolar Depression Help Me?

Dialectical Behavior Therapy. (n.d.) Psychology Today. Retrieved January 2019 from https://www.psychologytoday.com/us/therapy-types/dialectical-behavior-therapy

Gordon, L. (2018). Bipolar disorder in women: Know the facts. Healthline. Retrieved January 2019 from https://www.healthline.com/health/bipolar-disorder/bipolar-symptoms-in-women

Purse, M. (2018). Treating bipolar disorder. Verywell mind. Retrieved January 2019 from https://www.verywellmind.com/treating-bipolar-disorder-3576129#complementary-treatments

Railton, D. (2018). Natural remedies for treating bipolar disorder. Medical News Today. Retrieved January 2019 from https://www.medicalnewstoday.com/articles/314435.php

Seligman, L. (2006). Theories of Counseling and Psychotherapy. Upper Saddle River, NJ: Pearson Merrill Prentice Hall.

How Drinking Alcohol Affects Bipolar Depression Medications

Anderson, L. (2017). Bipolar medications and alcohol interactions. Drugs.com. Retrieved January 2019
from https://www.drugs.com/article/bipolar-medications-alcohol.html

Hall-Flavin, D.K. (2016). Bipolar disorder and alcoholism: Are they related? Mayo Clinic. Retrieved January 2019 from https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/expert-answers/bipolar-disorder/faq-20057890

Legg, T.J. (2018). How does alcohol affect bipolar disorder? Medical News Today. Retrieved January 2019 from https://www.medicalnewstoday.com/articles/313571.php

MacGill, M. (2018). Symptoms of bipolar disorder in women. MedicalNewsToday. Retrieved January 2019 from https://www.medicalnewstoday.com/articles/314837.php

Purse, M. (2019). Bipolar disorder and alcohol use. Verywell mind. Retrieved January 2019 from https://www.verywellmind.com/bipolar-medication-alcohol-interactions-379638

Relationship between alcohol and bipolar disorder, the. (2018). Alcohol Rehab Guide. Retrieved January 2019 from https://www.medicalnewstoday.com/articles/313571.php

Sonne, S.C., & Brady, K.T. (2002). Bipolar disorders and alcoholism. Alcohol Research & Health, 26(2), 103-108. Retrieved January 2019 from https://pubs.niaaa.nih.gov/publications/arh26-2/103-108.htm

WebMD Medical Reference. (2018). Depression in bipolar disorder: What you can do. WebMD. Retrieved January 2019 from https://www.webmd.com/bipolar-disorder/bipolar-life-17/depression

WebMD Medical Reference. (2016). Warning signs and symptoms of bipolar disorder. WebMD. Retrieved January 2019 from https://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-warning-signs#1

Worth, T. (n.d.). 10 subtle signs of bipolar disorder. Health. Retrieved January 2019 from https://www.health.com/health/gallery/0,,20436786,00.html?

Is There a Cure for Bipolar Depression?

Gordon, L. (2018). Bipolar disorder in women: Know the facts. Healthline. Retrieved January 2019 from https://www.healthline.com/health/bipolar-disorder/bipolar-symptoms-in-women  

Higuera, V. & Healthline Editorial Team. (2018). 10 alternative treatments for bipolar disorder. Healthline. Retrieved January 2019 from https://www.healthline.com/health/bipolar-disorder/alternative-treatments

Men and depression. (n.d.). Depression and Bipolar Support Alliance. Retrieved January 2019 from https://secure2.convio.net/dabsa/site/SPageServer/?NONCE_TOKEN=5BF953C959A0F4ADF870260E0C730A1F&pagename=education_brochures_men_depression

Montero, H.A. (2018). Bipolar symptoms in men: 10 signs to look for. Psycom. Retrieved January 2019 from https://www.psycom.net/bipolar-symptoms-in-men

Peterson, T.J. (2016). Break Free: Acceptance and Commitment Therapy in 3 Steps. Berkeley: Althea Press.

Peterson, T.J. (2018). The Mindfulness Workbook for Anxiety. Berkeley: Althea Press.

Railton, D. (2018). Natural remedies for treating bipolar disorder. Medical News Today. Retrieved January 2019 from https://www.medicalnewstoday.com/articles/314435.php

Wellness toolbox. (n.d.). Depression and Bipolar Support Alliance (DBSA). Retrieved January 2019 from https://secure2.convio.net/dabsa/site/SPageServer/?pagename=wellness_wellness_toolbox

List of Bipolar Depression Medications and Their Side-Effects

Gordon, L. (2018). Bipolar disorder in women: Know the facts. Healthline. Retrieved January 2019 from https://www.healthline.com/health/bipolar-disorder/bipolar-symptoms-in-women

Purse, M. (2018). Treating bipolar disorder. Verywell mind. Retrieved January 2019 from https://www.verywellmind.com/treating-bipolar-disorder-3576129#complementary-treatments  

Sit, D. (2004). Women and bipolar disorder across the life span. Journal of the American Medical Women’s Association; 59(2): 91–100. Retrieved January 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3107596/

Smith, M., Robinson, L., & Segal, J. (2018). Bipolar medication guide: The role of medication in bipolar disorder treatment. Help Guide. Retrieved January 2019 from https://www.helpguide.org/articles/bipolar-disorder/bipolar-medication-guide.htm/    

WebMD Medical Reference. (2018). Lithium for bipolar disorder. WebMD. Retrieved January 2019 from https://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-lithium#1

WebMD Medical Reference. (2017). Maintenance treatment for bipolar disorder. WebMD. Retrieved January 2019 from https://www.webmd.com/bipolar-disorder/bipolar-disorder-maintenance-treatment#1

WebMD Medical Reference. (2017). What are the side-effects of antidepressants? Retrieved January 2019 from https://www.webmd.com/depression/side-effects-antidepressants#2

WebMD Medical Reference. (2016). Women with Bipolar Disorder. WebMD. Retrieved January 2019 from https://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-women#1

What Are the Best Medications, Treatments for Bipolar Depression?

Bipolar disorder. (2017). Young Men’s Health. Retrieved January 2019 from https://youngmenshealthsite.org/guides/bipolar-disorder/

Gordon, L. (2018). Bipolar disorder in women: Know the facts. Healthline. Retrieved January 2019 from https://www.healthline.com/health/bipolar-disorder/bipolar-symptoms-in-women

Men and depression. (n.d.). Depression and Bipolar Support Alliance. Retrieved January 2019 from https://secure2.convio.net/dabsa/site/SPageServer/?NONCE_TOKEN=5BF953C959A0F4ADF870260E0C730A1F&pagename=education_brochures_men_depression

Purse, M. (2018). Treating bipolar disorder. Verywell mind. Retrieved January 2019 from https://www.verywellmind.com/treating-bipolar-disorder-3576129#complementary-treatments

Sit, D. (2004). Women and bipolar disorder across the life span. Journal of the American Medical Women’s Association; 59(2): 91–100. Retrieved January 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3107596/

WebMD Medical Reference. (2018). Depression in bipolar disorder: What you can do. WebMD. Retrieved January 2019 from https://www.webmd.com/bipolar-disorder/bipolar-life-17/depression

WebMD Medical Reference. (2018). Lithium for bipolar disorder. WebMD. Retrieved January 2019 from https://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-lithium#1

WebMD Medical Reference. (2016). Warning signs and symptoms of bipolar disorder. WebMD. Retrieved January 2019 from https://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-warning-signs#1

WebMD Medical Reference. (2017). What are the side-effects of antidepressants? Retrieved January
 2019 from https://www.webmd.com/depression/side-effects-antidepressants#2

WebMD Medical Reference. (2016). Women with Bipolar Disorder. WebMD. Retrieved January 2019 from https://www.webmd.com/bipolar-disorder/guide/bipolar-disorder-women#1

APA Reference
Peterson, T. (2019, June 11). Bipolar Depression Article References, HealthyPlace. Retrieved on 2019, June 26 from https://www.healthyplace.com/bipolar-disorder/bipolar-depression/bipolar-depression-article-references

Last Updated: June 17, 2019

Bipolar Depression Early Warning Signs

Knowing the early warning signs of bipolar depression can help you stay on top of your mental health. When you are aware of what to watch for, you can take measures to treat it before it becomes overpowering. Bipolar depression early warning signs indicate that you may be swinging down into the depressive side of bipolar disorder, a side of the illness that is very common.

Bipolar I disorder involves mood swings between mania and depression. While there are individual differences, time spent in depression surpasses time spent in mania by approximately three to one (WebMD Medical Reference, 2016). In bipolar II disorder, an illness marked by depression and hypomania (a milder but still disruptive form of mania), depressive states outnumber hypomanic episodes by a whopping 35 to one (WebMD Medical Reference, 2016). Knowing the warning signs of bipolar depression can be helpful in keeping this life-limiting condition at bay.

Types of Bipolar Depression Signs

Depression associated with bipolar disorder has numerous signs and symptoms, and trying to memorize the heap of them can feel impossible—especially if depression has already begun to descend upon you. Breaking them up and grouping them into categories can help you assess the different aspects of yourself and your life that might be negatively impacted by bipolar depression.

Warning signs of bipolar depression fall into four general categories:

  • Emotional
  • Cognitive (your thoughts)
  • Physical
  • Behavioral

Depression affects the whole person, both what they think and feel inside and what others see on the outside. This means that you and the people in your life whom you trust can pay attention to the following inner and outer signs to catch bipolar depression early.

Emotional Signs of Bipolar Depression

These relate to how you feel, your subjective response to your inner self and the world around you. Early warning signs that you may be developing bipolar depression include:

  • Feeling down, beyond having a bad day, for at least two weeks
  • Irritability, impatience
  • Apathy, lack of interest in people, things, and life in general
  • Strong feelings of guilt
  • Sense of hopelessness
  • Inability to feel pleasure or joy

Cognitive Signs of Bipolar Depression

Depression affects the way you think and what you think about. Watch for signs like:

  • Problems with concentration and focus
  • Difficulty paying attention, even to things you like (books, movies, people)
  • Thoughts of death, suicide
  • Short-term memory problems
  • Difficulty making decisions
  • Slowing of thoughts, often noticeable as slow speech, difficulty finding words

Early Warning Signs of Bipolar Depression: Physical Signs

People with bipolar depression feel it in their bodies. Signs of this include:

  • Low energy, overwhelming fatigue
  • Appetite changes, either wanting to eat too much or too little
  • Noticeable weight gain or weight loss
  • Sleep problems, either sleeping way too much or difficulty staying asleep despite fatigue
  • Aches and pains without a medical cause
  • Slowed movements
  • Agitation, restlessness

Bipolar Depression Signs: Behaviors

Bipolar depression can seem to take over how people act and behave. It can seem as though you’re just a puppet controlled by some unknown entity (but your strings are tangled and jumbled so you can’t do much at all). Watch for these warning signs:

  • Withdrawing from activities you like (or used to like)
  • Isolation from friends and family, wanting to be left alone
  • Sullen demeanor and behavior
  • Frequent crying for no apparent reason
  • Self-harm
  • Remaining in bed or on the couch for much of the day

These signs, whether you experience a few or many, represent changes in the way you live your life. If you notice a closing in, a downward spiral, you may be entering bipolar depression. You can use the early warning signs of bipolar depression to have a conversation with your doctor or therapist and treat it early before it engulfs you.

article references

APA Reference
Peterson, T. (2019, June 11). Bipolar Depression Early Warning Signs, HealthyPlace. Retrieved on 2019, June 26 from https://www.healthyplace.com/bipolar-disorder/bipolar-depression/bipolar-depression-early-warning-signs

Last Updated: June 15, 2019

Can Medication Noncompliance in Bipolar Ever Be a Good Thing?

Posted on:

Medication noncompliance in bipolar disorder is generally considered a bad thing -- and it generally is -- but can medication noncompliance ever be a good thing? I would say so, in very limited situations. Read on to see why medication noncompliance in bipolar disorder can occasionally be a good thing.

What Is Medication Noncompliance in Bipolar Disorder?

Medication noncompliance, also more politically correctly called medication nonadherence, is simply when a patient doesn't follow his or her medication treatment plan. This might mean not taking the medication as prescribed or not taking the medication at all.

Isn't Medication Noncompliance in Bipolar Disorder Bad?

And most of the time, when people with bipolar disorder don't take their medication as prescribed, it leads to very bad things. It's most common for people to miss the positive effects (and forget the negative effects) of bipolar mania and so they stop taking their medication to try to retrieve those effects. In other words, some people want the "high." People also commonly become medication noncompliant due to medication side effects.

And as a person with bipolar disorder, I can say that I understand both of these reasons but that still doesn't make them good ideas. Nope, if you're just being medication noncompliant as a knee-jerk reaction to something or because you want parts of the illness back, then I see a hospital stay in your near future.

When Medication Noncompliance Is a Good Thing in Bipolar Disorder

That said, there are times when not taking your medication as prescribed -- for very short periods of time -- can make sense. This medication noncompliance should always lead to an immediate doctor's visit to discuss the reasons for noncompliance.

Here are some reasons why medication noncompliance can be a good thing:

  • When you experience severe, possibly dangerous side effects or signs of being allergic to the medication -- Examples of this are getting a rash when you're taking an anticonvulsant (there is one rash that can become life-threatening so it's better to be safe than sorry) or if you experience changes in your heart rate.
  • When you're tapering off a medication and the latest medication decrease causes too many withdrawal effects -- In this case, it may be reasonable to stay on the previous dose even if that wasn't the plan. (Although what to do in this case should be part of a good plan.)
  • When you're getting on a medication and the latest increase in medication is causing too many side effects -- In this case, it may be reasonable to stay on the previous dose.

I will mention here that withdrawal effects and side effects do tend to lessen over time so the above is the exception and not the rule. In general, I try to give the doctor's plan a chance, even if it causes some pain along the way. That said, I've probably been medication noncompliant in all three of the above cases at one time or another in my bipolar career.

However, I can't stress enough, in all the above cases, you should see your doctor as soon as possible to make a new plan. 

Medication Noncompliance in Bipolar Just Because You Disagree with Your Doctor

I would say that simply disagreeing with your treatment plan isn't a good reason to be medication noncompliant. Sometimes we all have to do things we don't want to do. Sometimes that leads to wellness. Sometimes your doctor really does know better. 

That said, I believe in working with your doctor as much as possible to create a plan that you do agree with. You may be the patient and he or she may be the knowledgable and learned doctor, but that doesn't mean your voice doesn't mean anything. After all, you're the one who has to actually take the pills. Your doctor should listen to you.

And if you can't reach a place where you agree with your doctor's treatment plan, the best idea isn't to be medication noncompliant; the best idea is to find a new doctor. I know that's easier said than done, but it's worth it to work with someone who will work with you. Because while medication noncompliance does make sense occasionally, it certainly doesn't make sense generally so you need to facilitate a situation where that won't be an issue for you.

How Brain Dehydration Affects Your Mental Health

Here's what's happening on the HealthyPlace site this week:


Summer is here, and with it, heat and the possibility of brain dehydration. Discover how brain dehydration affects your mental health on HealthyPlace.

How Brain Dehydration Affects Your Mental Health

Summer is here, and with it, heat and the possibility of brain dehydration.

Hot temperatures cause us to sweat. When fluids seep out of our pores rather than circulating through our brain, we risk brain dehydration. Even mild brain dehydration has a negative impact on the brain and our mental health (Three Ways Hydration Can Affect Your Mental Health).

Water comprises a whopping 75% of the human brain (leaving only 25% for everything else, which is pretty mind-boggling). Clearly, the brain requires water to operate well. When our brain is dehydrated, we risk mental health difficulties like these:

  • Mood changes, including intensification of mood disorders
  • Anxiety
  • Increased effects of stress
  • Muddled and/or negative thoughts
  • Difficulty focusing, concentrating, and paying attention
  • Brain fog; short-term and working memory problems
  • Delirium (in cases of severe dehydration)

Hydrate Your Brain for a Mental Health Boost

It’s true: you can reduce these life-limiting issues and boost your overall mental health simply by drinking water. The recommended amount varies based on age, weight, climate, and activity level.

General guidelines apply to everyone. Drink at least 8 oz of water when you wake up in the morning, and drink it regularly throughout the day. Also, stick to water. Soda, caffeinated, and sugary beverages contribute to mental health problems.

To stay well and enjoy the summer months and every season of the year, it’s crucial to drink plenty of water to keep your brain healthy and happy.

Related Articles Dealing with Hydration and Mental Health

Your Thoughts

Today's Question: Summer’s here! If you’ve experienced dehydration, specifically brain dehydration, how has that affected your mental health? We invite you to participate by sharing your thoughts, experiences, and knowledge on the HealthyPlace Facebook page.

From the HealthyPlace Mental Health Blogs

On all our blogs, your comments and observations are welcomed.

Feel free to share your thoughts and comments at the bottom of any blog post. And visit the mental health blogs homepage for the latest posts.

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  1. How to Help ADHD Coworkers Succeed
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APA Reference
Peterson, T. (2019, June 10). How Brain Dehydration Affects Your Mental Health, HealthyPlace. Retrieved on 2019, June 26 from https://www.healthyplace.com/other-info/mental-health-newsletter/how-brain-dehydration-affects-your-mental-health

Last Updated: June 11, 2019