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Bipolar Disorder

Do you experience extreme mood swings & have difficulty managing these high & low emotions?
Couples Counselor NYC
Do you have racing thoughts, poor attention & focusing? Do you want to manage your moods effectively?
Couples Counselor NYC
Does your expansive mood turn to impatience and irritable anger? Do you act impulsively?
Couples Counselor NYC

Bipolar disorder (manic depression) involves extreme swings in mood, ranging from the low depression to the high mania. The periods of severe high or low moods may negatively impact day-to-day functioning. Learning to live with your own bipolar disorder is not easy. However, a combination of psychotherapy and medicines can be effective treatment. spiral2grow of New York City can help people better manage their illness and reduce repeated experiences of mood episodes.

Effective psychotherapy, like Cognitive Behavioral Therapy (CBT) teaches patients to reduce the negative impact of extreme emotions and cope better in their reality. It helps them to decrease the extremeness of their mood swings (where possible), reduce the impact of their illness on their social and occupational relationships, improve their motivation to remain on medication, and generally function to help reduce their chance of catastrophic relapse.

More about Bipolar Disorder
Bipolar Disorder Overview
  • Bipolar disorder involves extreme swings in mood, ranging from the low depression to the high mania. When depressed, a person may feel sad, have problems with sleeping, eating, and loosing weight, have many negative thoughts about oneself (including thoughts about death and hurting oneself), and experience difficulties with attention and concentration. During periods of mania, the individual may experience euphoric or irritable mood, inflated self-esteem and over-confidence, increased talkativeness, distractibility, and boundless energy, including a decreased need for sleep.
  • In more severe forms, mania can be accompanied by psychotic symptoms such as hallucinations or delusions, and often requires hospitalisation. Hypomania, a milder form of mania, causes less impairment but can often go unnoticed for several years before receiving appropriate diagnosis and treatment.
  • Many people are not aware that there are two major types of bipolar disorder, - bipolar I and bipolar II (also known as bipolar 1 and 2), which are separate diagnoses.
  • There are major differences between these two types of bipolar disorder. Some of the information below is taken mostly from the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders). It might be that DSM V might revise this information. Here are the main points that describes the differences between bipolar I and II.
  • Individuals with bipolar I suffers from manic episodes, while individuals with bipolar II suffers from hypomanic episodes. The key difference between mania and hypomania is a level of degree. Hypomania (in bipolar II) is more elevated (more extreme) than mania and also is more sustainable (stay over longer of period). Mania is manifested over shorter period of time, yet it is much noticeable and considered abnormal. In Mania the level of energy and activity increased dramatically.
  • Other differences includes: Mania may include psychotic symptoms (delusions or hallucinations) while hypomania does not have it. In addition, mania dramatically impairs daily life and significantly affect the day-to-day functioning as compare to hypomania.
  • Untreated, bipolar disorder can result in damaged relationships, poor job or school performance, and even suicide. However, there are effective treatments: medicines and psychotherapy. A combination usually works best.
Bipolar Symptoms and Causes
  • Because the symptoms of bipolar disorder are expressed as moods, feelings, and actions, deciding what is the illness and what is part of your "personality" can be confusing. That can sometimes make it hard to accept a diagnosis of bipolar disorder.
  • There are specific criteria for diagnosing bipolar disorder, including the presence of at least one manic or hypomanic episode, but diagnosis can be challenging. Since the symptoms of bipolar depression are similar to those of other types of depression, it can take years for some people with bipolar disorder to get an accurate diagnosis.
  • An early sign of manic-depressive illness may be hypomania- a state in which the person shows a high level of energy, excessive moodiness or irritability, and impulsive or reckless behavior. Hypomania may feel good to the person who experiences it. Thus, even when family and friends learn to recognize the mood swings, the individual often will deny that anything is wrong.
  • And as with nearly all mental disorder diagnoses, the symptoms of manic depression must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  • Although we don’t know exactly what causes bipolar disorder, we do know that genes and chemicals in the brain play a strong role in making people vulnerable to developing the disorder. Stress alone does not cause bipolar disorder, but episodes of mania or depression are often triggered by stressful life events. Risk factors for relapse in bipolar disorder include abusing alcohol or drugs, not taking psychiatric medication as prescribed, and changes in routine leading to lack of sleep or irregular sleeping habits.
  • Although bipolar disorder is a serious condition, if it is diagnosed and treated appropriately, the symptoms can be effectively controlled, relapses can be prevented, and the person can live a happy and rewarding life.
Bipolar Treatment
  • Pharmacotherapy, or drug therapy, is essential for the treatment of bipolar disorder. It usually involves the use of one or more mood stabilizers, such as Lithium, combined with other medications. There is now strong evidence that Psychological Interventions can be added to drug therapy in order to help people better manage their illness and reduce repeated experiences of mood episodes.
  • Psychoeducation consists of giving patients and their relatives’ adequate knowledge about bipolar disorder and teaching illness self-management skills, so that people have a better understanding of their illness and its treatment. Psychoeducation is usually given in short-term (i.e., 5 to 10 sessions) group format.
  • Cognitive-Behavioral Therapy (CBT) and Interpersonal Therapy (IPT) are short-term forms of psychotherapy that have been shown effective in the treatment of depression. In bipolar disorder, Cognitive-Behavioral Therapy (CBT) uses psychoeducation and mood monitoring to help people identify triggers of mood episodes and develop a written relapse prevention plan. Increasing activities in depression, reducing activities in mania, and correcting over-negative or over-positive thoughts are also strategies used in CBT. An adapted version of IPT, Interpersonal and Social Rhythm Therapy (IPSRT), has also been shown effective for bipolar disorder. The main goals of IPSRT are to help people better deal with relational difficulties, and learn how to maintain a stable and healthy daily routine, in order to regulate important biological rhythms, such as sleep, that can trigger mood episodes like mania.
  • Family Therapy interventions have been found to be helpful in bipolar disorder. In Family Focused Therapy (FFT), patients and their families learn how to better understand bipolar disorder by getting information on the disorder and its treatment (psychoeducation), and learning communication and problem-solving skills, in order to deal more effectively with the consequences of bipolar disorder. Finally, social support is also very important for people with bipolar disorder, and therefore joining local support groups for mood disorders may be helpful.
  • Benefits of Counseling for Bipolar:
  • Improved relationships
  • Fewer employment problems
  • Avoid the extreme lows
  • Set and achieve more realistic goal
Bipolar Depression
  • The distinguishing characteristic of Bipolar Disorder, as compared to other mood disorders, is the presence of at least one manic episode. Additionally, it is presumed to be a chronic condition because the vast majority of individuals who have one manic episode have additional episodes in the future.
  • Every individual with bipolar disorder has a unique pattern of mood cycles, combining depression and manic episodes, that is specific to that individual, but predictable once the pattern is identified.
  • Effective treatment is available for bipolar disorder. Without treatment, marital breakups, job loss, alcohol and drug abuse, and suicide may result from the chronic, episodic mood swings. The most significant treatment issue is noncompliance with treatment. Most individuals with bipolar disorder do not perceive their manic episodes as needing treatment, and they resist entering treatment. In fact, most people report feeling very good during the beginning of a manic episode, and don't want it to stop. This is a serious judgment problem. As the manic episode progresses, concentration becomes difficult, thinking becomes more grandiose, and problems develop. Unfortunately, the risk taking behavior usually results in significant painful consequences such as loss of a job or a relationship, running up excessive debts, or getting into legal difficulties. Many individuals with bipolar disorder abuse drugs or alcohol during manic episodes, and some of these develop secondary substance abuse problems.
Early Signs of Bipolar Disorder
  • The following are early warning signs for bipolar depression, which can be difficult to detect:
  • Reduced activity or/and low interest in activities you generally find enjoyable
  • Loss of motivation, while being indifference and apathetic
  • This that were easy to do feels to be difficult
  • Sadness that won’t go away
  • Decreased energy and overall weakness
  • Isolation and social withdrawal
  • Increased sleeping or not being able to sleep
  • Lowered self-esteem and reduced confidence
  • Heightened self-criticism, guilt and shame
  • Irritability, anxiousness, and outburst of anger
  • Physical pains aches without apparent explanation
  • Dramatic change in appetite and weight
  • Confusion and difficulty in making decisions
  • Strong sense of hopelessness or despair
  • Reduced cognitive capacity, slow thinking process and impaired memory
  • Inability to focus with feeling of Chaos
  • Suicidal thoughts or ideation – thinking about or planning to commit suicidal act or hurting oneself.
Mood Disorders
  • Mood disorder is a category of mental health problems that include all types of depression and bipolar disorder. Mood disorders are sometimes called affective disorders.
  • The following are the most common types of mood disorders:
  • Major Depression - a two-week period of a depressed or irritable mood or a noticeable decrease in interest or pleasure in usual activities, along with other signs of a mood disorder.
  • Dysthymia (dysthymic disorder) - a chronic, low-grade, depressed or irritable mood for at least one year.
  • Manic Depression (bipolar disorder) - at least one episode of a depressed or irritable mood and at least one period of a manic (persistently elevated) mood.
  • Mood Disorder due to a general Medical Condition - many medical illnesses (including cancer, injuries, infections, and chronic medical illnesses) can trigger symptoms of depression.
  • Substance Induced Mood Disorder - symptoms of depression that are due to the effects of medication, drug abuse, exposure to toxins, or other forms of treatment.
Management of Bipolar Disorder
  • Bipolar disorder can be frightening to both people with the illness and their family members. In addition, because bipolar disorder often develops early in life and has disruptive effects on functioning, the illness can interrupt normal development and interfere with people's desires to achieve their aspirations. However, there are very good reasons to be hopeful that through collaborative work among individuals, their families, and practitioners, bipolar disorder can be successfully managed and people can achieve their personal life goals. Many people with bipolar disorder are extremely bright, talented, and creative. For example, the writer Virginia Woolf, the artist Vincent van Gogh, and the actress Patty Duke all had bipolar disorder. With proper treatment and family help, individuals with bipolar disorder can pursue and fulfill their life goals and dreams.
  • Because the symptoms of bipolar disorder can be quite severe and can have a major effect on people whom the person is close to, family therapy can be very helpful in the management of the condition. The primary goal of family therapy for bipolar disorder is to teach the family, including the client, information and skills necessary to effectively manage this condition. Family therapy is provided in a collaborative, positive, educational fashion in order to inform all family members about bipolar disorder and to get everyone working together. Families can play a critical role in helping to monitor the symptoms of bipolar disorder, collaborating with the treatment team to prevent relapses, and working together to achieve personal and shared goals. To accomplish this, family therapy usually involves educating the family about bipolar disorder, improving communication skills, and teaching problem solving techniques so that families are able to solve problems on their own.
  • Books
  • Berger, D., & Berger, L. (1991). We Heard the Angels of Madness: A Family Guide to Coping with Manic Depression. Written by the mother and sister of a person who developed bipolar disorder, this guide intersperses the telling of their family story with practical advice to families on how to cope with the disorder.
  • Burns, D. D. (1980). Feeling Good: The New Mood Therapy..
  • A classic self-help book that describes how to identify and challenge self-defeating, negativistic thoughts that underlie depression.
  • Duke, P., & Hochman, G. (1992). A Brilliant Madness: Living with Manic-Depressive Illness.
  • An autobiography by the actress about her experience of living with bipolar disorder, including excellent first-person accounts of many of the symptoms.
  • amison, K. R. (1996). An Unquiet Mind: A Memoir of Moods and Madness.
  • A moving autobiography by a noted psychologist and professor of her struggle with bipolar disorder, which is also the focus of her research.
  • Miklowitz, D. J. (2002). The Bipolar Disorder Survival Guide: What You and Your Family Need to Know.
  • This is a user-friendly guide for consumers and family members about how to manage bipolar disorder, written by a leading authority on family treatment for this disorder-very readable and helpful.
  • Wurtzel, E. (1994). Prozac Nation: Young and Depressed in America.
  • An excellently written memoir by a young woman who developed symptoms of bipolar disorder soon after graduating college.

Benefits of Bipolar Treatment
Reduce psychic energy and return to normal activity levels, good judgment and stable mood
Achieved controlled behavior and increase level of functioning
Improve self-esteem, develop and maintain healthy relationships
Develop more realistic expectations
Manage psychological stressors that may trigger manic depression


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