Tag Archives: Bipolar

My plans for the end of the world

Posted on by
Reply
Planet Earth

Earth.

As we transition from the year 2011 to the year 2012 many of you are recalling the news that this year is slated for the end of the world. Now those of you familiar with the old prophecies should be relieved to know that they did not predict an end to the earth! What was predicted was an end to some entrenched social and political systems. For my way of thinking that will come none too soon. The last few years we have had way too much bad news and it is time for us to start planning to do some things differently.

Back in the sixties, we wanted to change the world. That didn’t go so well and what we found was the only thing we could really change was ourselves. So for 2012, I will work on being the change I hope for, changing myself. On difficult days I will be content to just change my socks. I am not expecting much in the way of political change, we shall see, we shall see – about that. What happens in my house, my office and my town are, after all, more important most of the time than anything done in a capital somewhere.

As you saw by my last post I am not big on resolutions. In the past that just set me up for disappointment. So here are some of the things I plan to do during the next year while waiting and hoping for some improvement in the human condition. Mostly I plan to start small.

Through the year I will make an effort to try to be of service to as many people as I can. Mostly I will do that by doing the work I have been doing for a while now and hoping that sometimes I will be rewarded for my efforts with that green energy we call money and other times maybe the reward will be the good feeling that comes from helping others. Occasionally we are blessed to get both. Anyone interested in joining me in this effort? If we all do our best then should the world come to an end we can feel good about our efforts. If the end of the world fails to materialize, as it always does, then well – there is always next year and in the meantime, we can feel good about ourselves.

Over the next year, my plan is to write posts for this blog at least twice a week. Some weeks there will be more. Last year there were about 40 posts, part of my learning curve. Next year we will aim for a hundred or more. Since it is not polite to fill anyone’s inbox with blog posts I will endeavor to restrain myself and post no more than once a day. That sound fair? The key word here is “try”, as I find that restraining my urge to share is almost as difficult as getting the ideas to write about.

My posts are mostly things that counselors and therapists might talk about, current trends and topics. I do plan to write the posts in ways that will be of interest to consumers or clients so there is a minimum of references and citations. Just enough sources will be included to show whose ideas I am exploring here. If I leave out a source you are interested in please let me know and I will dig it up for you when possible.

In case any of those infectious journalists stumble in here, this blog is not meant to be journalism, not sure any of it is really news. It is meant to be opinionated, mine especially but reader’s opinions are valued also. Think of this page more like letters to the editor and the opinion page than page one. I hope you will all enjoy the next year of this blog and feel free to participate.

Most of the topics cover mental health, substance abuse, parenting, and the journey toward having a happy life. Sometimes I feel the need to get political, sometimes there will be things I just find humorous. Most of the time, humorous and political turn out to be the same thing.

The topics currently on the agenda for blog posts, which I will try to mix up to be of interest to as many people as possible are:

1. Change and how we do it

2. Recovery and resiliency

3. Bipolar disorder and some of the newer research in that area

4. Behavior modification and ways to help kids grow up happy

5. The process of writing this blog and the other writing I am doing

Anything else you think needs to be added to this list? Thanks for reading this blog and here is wishing you a happy life and a joyful year.

David Miller. LMFT, LPCC

An extra post

Posted on by
Reply

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Found a really good post over at another blog and needed to pass it on.

The post was about the relationship between smoking, nicotine and mental health.

An interesting post and some good comments from consumers. Thought I would share this with you.

I left my comments over at James Claims blog so I will not repeat them here.

And just for the record, don’t get spoiled by all these extra posts, it may not happen again for a while, but then it just might.

The link is

http://jamesclaims.wordpress.com/2011/11/08/nicotine-may-help-bipolar-disorder-and-schizophrenia/

Is your child taking too many meds? Are you?

Posted on by
1

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Drugs

Medications.
Photo courtesy of Pixabay.com

Is your child taking too many meds? Are you?

Ever wonder about the amount of medication, especially heavy psychiatric medication, which is being prescribed to very young children, especially foster children? I know I do. How did we get so many children who need that level of medication? What should you think if your child or the child you care for was prescribed that kind of medication?

There was an article on the internet this morning about the large number of prescriptions for antipsychotics to foster children.  These kids were being given not one medication but multiple medications and many of those medications have serious long-term side effects. Some of these side effects do not go away even after the medication is discontinued. So is all that medication really necessary?

The usual warning applies here. No matter what you and I think, it is unwise to stop, start or alter the dose of a medication without talking with your doctor first. If you are not confident with that doctor’s opinion get a second opinion. It is not safe to play doctor and change the meds yourself. But you should question things if the medications are not working or if it appears to be creating serious side effects.

So why so much medication in children? And why foster children in particular?

Now we have been hearing tales about facilities that overmedicate residents to keep them manageable for a long time. Mary Jane Ward in her book “Snakepit” describes patients in a mental hospital who were heavily medicated primarily to keep them from causing the staff problems. We also hear stories about jails and prisons using lots of meds to keep inmates from causing trouble. But is that sort of thing happening to kids? And why foster kids?

Maybe the reason is that foster kids are the ones that have the most problems? Are children in foster care more likely to have serious mental illnesses? There are two reasons to think this is not true.

The study reported that when kids in foster care were compared to other kids who were receiving Medicare the foster kids got a lot more medication that the kids who were not in foster care. Secondly, the kids in foster care should be the ones who would respond to a secure home situation. Foster care is usually looked at as a housing problem, not a mental health problem. So the seriously mentally ill children should and often do end up in group homes and institutions where they can be managed with less, not more medication. So what is going on here?

One problem is that as a society we are increasingly relying on medications, drugs if you will, to fix all our problems. Despite all our programs to get people off drugs, there are countless commercials that try to convince us to go to the local drug store and get some pills to cure all that ails us. Try counting the number of pro-drug ads on the television on any given night and then tell me that we as a society are opposed to drugs. In this country we love drugs so much, are so convinced there is a chemical that can cure whatever is wrong with us that we now want all our children to take all the drugs they can. We just want them to get their drugs from a drug store not a drug dealer in an alley.

So why are children being given so many drugs? To relieve suffering? Not a chance!

Kids are getting prescribed drugs to make them smarter and to make them behave.

Kids are being prescribed powerful stimulants for ADHD. Even kids with mental retardation and developmental delays are getting ADHD medication. This makes me question the accuracy of some ADHD diagnoses. And if the pills make one kid smarter shouldn’t all children take them?  Here is hoping you read that blog post also.

The other reason kids get so much psychiatric medication is to make them behave. I thought not always behaving properly was a symptom of childhood? Can’t we teach them to behave without sedating medications?

Children are being given lots of sedating antipsychotics mostly because their behavior is causing some adult a problem. Some of my colleagues will argue that if the child does poorly in school or gets in trouble for bad behavior they will end up suffering so by giving them medication we are preventing suffering. For me, that would make sense if there were no other alternatives. But there are other options.

Many of the problems of children for which we give them medication can be controlled, even cured by giving them attention in the proper way. Therapy and counseling are especially helpful for treating many emotional problems. ADHD can be treated by training parents as I wrote about in a previous blog. But far more kids get a prescription for a medication than are getting a session with a caring adult.

Yes, there are professional counselors and therapists; I do that for a living. But the benefits of other adults in a child’s life should not be underestimated. Teachers, grandparents, natural or foster, and friends all are helpful in a child’s learning emotional regulation. So why do we reach for meds first instead of human contact for all the emotional and behavioral problems?

Some people have suggested that counseling is just too expensive. I am not buying that argument and you won’t either if you see how much agencies are spending on medications.

Despite all the things we have learned over the last couple of centuries about the benefits of counseling in overcoming life’s problems we as a society still seem to think that if something bothers you there should be a drug to fix that.

My conclusion from all this is that a lot of kids and some adults are being given lots of medication instead of human contact. It appears that we as a society and some people individually just don’t care enough to bother with anything more than a pill to make the kid behave.

So what do you think? Could we try another approach? Are kids and adults taking too much psychiatric medication because we don’t care enough to do better?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

“Speeding up” the third grade

Posted on by
1

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Sad child

ADHD?
Photo courtesy of Pixabay.com

There must be a connection between Attention Deficit Hyperactivity Disorder (ADHD), Bipolar Disorder, and behavioral problems like Disruptive Behavior Disorder. If they are not connected why do I see so many children who progressively get all three diagnoses?

Recently a child was referred for assessment. The parents were concerned their child might have ADHD. They had been sent by the third-grade teacher with a stern warning that they needed to get this child help before it was too late. The teacher pointed out that she had been teaching for a great many years, she had seen many ADHD children, and that she knew a child with ADHD when she saw one. She was certain that this child had ADHD and needed medication. The teacher had told the parents she was sure of this because the child was in the bottom third of the class.

This troubles me. Now I know that there are people who suffer from ADHD. I have worked with adults who were unable to stay focused enough to succeed on a job without their medication. I have seen children with ADHD who have been struggling in school and then they get put on the right medication. It can work miracles. But this was different. If we are going to refer every child in the bottom third of the class for medications what does that say about us and our educational system? Really does that mean one in three children has ADHD? I find that hard to believe.

Now if this was an isolated incident I could explain it away. But this sort of thing is happening more and more.  Another parent shared with me that they were pressured to have their child evaluated for ADHD. The school had said that the child did not stay in their desk or do their work. Further, the parents were told that if the child continued to ignore the teacher and not do their work they might have to be placed on homeschooling. This parent took the bold step of talking to other parents in the class. Turns out that in this class of about thirty students more than half were on ADHD medication, most of them referred by the teacher and principal.

Have we reached the point where test scores are so important that we need to put a third of a class on stimulant medication to get their test scores up?

And if taking pills to get smarter really works, if drugs make kids smarter, than why only the bottom third? Aren’t we then cheating the top third by not giving them the drugs so they can do better also?

What also bothers me is the number of children who are diagnosed with ADHD who are subsequently suspended, sometimes expelled for fighting and violent behavior. I know from my work with substance abusers that when they abuse stimulants they are more likely to become violent or otherwise act impulsively. So could a stimulant ADHD med increase the child’s level of violence and result in him being expelled for behavioral problems? I asked a couple of psychiatrists about this issue. I was told that yes a side effect of some ADHD medications is an increase in violence.

On interesting new development in the field has been the availability of several newer drugs that are non-stimulant ADHD medications. While every medication has its side effects, and these meds are no exception, if the medication we are giving a child is making the problem worse not better shouldn’t we consider other options? I would if it was my child.

Now, remember here I am a therapist and not a doctor so if this gets you thinking how about talking with your doctor? And please don’t just suddenly stop giving or taking meds without consulting your doctor.

Here is another example of this problem. A child was referred for assessment. Please hold your CPS dialing finger till you read to the end. The caregiver, an older sibling, was trying to help her younger brother. He was constantly in trouble at school. Did not do his homework, daydreams in class, and would not stay in his seat. The teacher (different teacher this time) was sure this was another classic case of ADHD. The sister told me she tried to do what she could but she and her baby’s father were living with friends in a motel room and there was no place for this young man. Still, she was his school contact and she came to help him when she could. His primary care doctor had prescribed ADHD meds, but the minor still was not doing his homework and was not paying attention. His meds had been increased and still no improvement. What to think?

So I interviewed the young man. He reported his father was not around. Bio Father was in prison and would not be released for a few more years. He was staying with his mother but she was in jail right now and would not be released until Monday. So in the meantime, he had been staying with relatives. He had slept on the couch, several different couches for that matter, different relatives on different nights, and most of these homes were small and overcrowded. He had not slept well or eaten well since mom had been arrested. He was sad all the time and nothing made him feel better anymore. So was my diagnosis ADHD? Not on your life. Clearly, this young man was suffering, and I do mean suffering, from depression. The end of the story is, mom was released, the minor, and mom found a safe place to stay and the child is in counseling. I hope mom gets some counseling also.

Did I mention the referral for ADHD whose father was just deported and dad will not be allowed back in the U. S.again? He refuses to do his homework, will not listen to the teacher, and – Well you get the idea.

In each of these cases and so many, more, the first diagnosis was ADHD because of poor schoolwork, inattention, and not following rules, like being out of their seat. Later when the medication did not fix them they get diagnosed with some kind of disruptive behavior diagnosis. But in most cases when we look really carefully there was also a lot of depression and sometimes eventually a manic episode occurs and the diagnosis changes to Bipolar Disorder. Not every child who does not do homework has ADHD.

If you have had an experience with this issue or thoughts you would like to share please contact me. So much for my thoughts on Attention Deficit Hyperactivity Disorder (ADHD), Bipolar Disorder, behavioral problems like Disruptive Behavior Disorder, and Depression.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Am I Bipolar?

Posted on by
4

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Person with masks

Bipolar.
Photo courtesy of Pixabay.com

Am I Bipolar?

Occasionally I get asked this question. More often the person asking the question is asking if their child, spouse, or friend is Bipolar. Almost no one ever asks me if they are depressed. Why the difference?

Most of us know when we are depressed. We know that we can be a little depressed and get over it naturally or we can get a lot depressed and need help. It is also easy to see that there is a difference between being a “little depressed” and suffering from Major Depressive Disorder which is the technical term we professionals use when we diagnose clinical depression that needs treatment.  We also have some other lesser degrees of depression we can diagnose like Dysthymic Disorder. Not so much with bipolar disorder.

Even my more liberal colleagues are uncomfortable with the idea that people could be “a little bit bipolar” even though all people have some of the characteristics of bipolar from time to time. It would be more comfortable to think that there are “those people” meaning the mentally ill – over there and then “us people” the normal ones over here. Forget for a moment that our friends and family may think we belong with the over-there folks. Why is it so hard to accept that most of the symptoms of mental illness are on a continuum from a few to a lot?

With depression, we all accept that if someone in your family dies – say, grandma, for instance, you should be sad. That is assuming, of course, you like grandma. If someone close to you dies we expect you to be sad, depressed even, we have a special name for that – Bereavement. But if five years later you are still stuck at home, too depressed to go to work because of this loss, then we think there is something excessive going on here and you will be diagnosed as depressed, probably diagnosed with Major Depressive disorder. So why don’t we do that with Bipolar disorder?

One caution is in order.  DO NOT ATTEMPT THIS AT HOME! Diagnosis is not a do-it-yourself project. This blog is meant to be informative and as you will see below most of this is not a matter of yes or no answers on a questionnaire. Some “clinical judgment” needs to be used, which is why even professionals sometimes need to consult with other professionals on close calls.

Let’s look at the criteria for Bipolar and see how someone might have all the signs or symptoms and still not qualify for the diagnosis. Some of you who read my earlier blog about Bipolar Disorder will remember that the main difference between depression and bipolar disorder is the occurrence, at least one time, of an episode of large mania or small mania (Hypomania.) I have simplified these descriptions so if you want the long-form, check the DSM.  After the 7 criteria will come the big stuff.

Here are the 7 criteria:

1. Inflated self-esteem or grandiosity.

So this sounds like an occupational disease. Wouldn’t all politicians, entertainers, and sports personalities fit this description? So thinking a lot of yourself could be good self-confidence or it could be grandiosity depending on whether you win or not. Certainly, people with bipolar disorder may be attracted to these kinds of occupations but not everyone in those fields should be diagnosed with bipolar disorder. As with all the other symptoms, this is not a yes or no answer, it is a matter of degree.

2. Decreased need for sleep.

Many people experience a night or two when they are doing something exciting and they get by on less than normal sleep for a day or two. As a society, we like people who get a lot done. But eventually, the novelty wears off and the need for sleep returns. Bipolar people have extended periods of high activities with a reduced need for sleep.  Parents with bipolar children report the child never slept that much. Though most parents don’t think their child sleeps enough when the kid keeps waking you up at night. So again the sleep issue is a matter of degree.

3. More talkative than usual or a pressure to keep talking.

Now we have all met people who talk a lot. And when you are with someone who has not seen you for a while you both may feel the need to say a lot. Some kids are so needy for attention that once the mouth opens they will talk nonstop. None of these things meet the criterion of it only happens occasionally. To really be bipolar disorder the person needs to have an out of control need to do these things.

4. Racing thoughts.

This is from the client’s point of view. They feel that even they are having difficulty keeping up with their own thoughts. Writers have this happen sometimes; the muse strikes and we have trouble getting it down on paper. That is not the same thing. Being a writer does not make you Bipolar. (We are not all bipolar are we?) These fast thoughts are also called flights of ideas, hard to stay on track when your ideas jump from subject to subject.

5. Distractibility.

This involves being pulled away easily or getting stuck on irrelevant things. Now, this is perilously close to ADHD. Kids with bipolar disorder are sometimes given an ADHD diagnosis the first time until the symptoms of bipolar disorder become clearer. More on ADHD at another time.

6. An increase in goal-directed behavior.

This is also a tricky one. If it means studying a lot and getting all “A’s” or making lots of money we may let this go. But if you are really good at having sex with lots of people or working so many hours you forget where you live – then you get diagnosed.

7. Excessive involvement in pleasurable activities that may cause you pain.

The official guide lists too much sex, buying sprees, sexual indiscretions, and foolish business investments. This leaves out gambling, substance abuse and some other impulse control problems.  What is a foolish business investment is also open to question. Should we dump the internet stock and invest in a sound carriage manufacturer’s stock? So see how some interpretation is needed?

Now all the above notwithstanding, for anything to be diagnosed – yes you heard me right – for anything to be diagnosed as a mental illness it must cause one of three things.

A. The problem keeps you from having or keeping a job. For kids, this includes going to school. In fancy-speak, we call this interfering with occupation functioning.

B. It keeps you from having good relationships with your friends or family this is called social functioning.

C. It causes you pain. So if the problem is causing you pain we are much more likely to think it is a mental or emotional disorder than if you and your friends are OK with your difference and you can keep a job.

More next time on some of these problematic diagnoses and on some other relationship issues that you have emailed me about.

Bye for now

David Miller, LMFT, LPCC

Bipolar doesn’t mean moody

Posted on by
7

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Person with masks

Bipolar.
Photo courtesy of Pixabay.com

Bipolar doesn’t mean moody.

Three psychiatric diagnoses (ADHD, Bipolar, and Schizophrenia) have left the scientific literature and taken up residency in the media and in everyday conversation. The problem with these usages is it devalues the term and pretty soon it is being misused more often than it is used correctly. Bipolar is one of those terms.

Kids report that their peers call them or others “Bipolar.” We hear about it on talk shows. Sometimes parents call their children or their partner Bipolar with no clear idea what the term means. Children are being diagnosed with bipolar disorder at younger and younger ages. Early diagnosis and treatment is a good thing; it may reduce a lifetime of suffering. Referring every kid in first grade who is irritable for a bipolar evaluation is probably not warranted.

Lots of parents want their child “tested” for bipolar disorder. I wish there was a simple test, say blood or urine that would detect the disorder. There may be physical signs or markers, but so far no one seems to be able to detect bipolar disorder other than by a psychological evaluation that involves descriptions of mood and behavior. When many parents want to know if their child is bipolar, what they really mean is the child is irritable or difficult and they need help.

People refer to others who are moody as Bipolar. Bipolar disorder does not mean moody! Some people are naturally moody others get moody when something upsets them. Lack of sleep makes most anyone moody and grouchy. Not everyone with sleep disturbances has bipolar disorder by any stretch of the imagination.

When we talk about bipolar disorder we are talking about a condition, not a person. A person may have bipolar disorder that does not make them “bipolar.”

So what is Bipolar – really? It used to be called Manic Depressive disorder. I see client questionnaires where they report they have family histories of both manic-depressive disorder and Bipolar. I won’t go into the politics behind the name change but it is important to note two things. Bipolar is a mood disorder so it is in the same “family” or chapter as Depression and other mood disorders. The second characteristic is that for the problem to be bipolar it must include Mania or its cousin Hypomania.

Update – In the DSM-5 they did away with the term “mood disorders.” More and more professionals are thinking that Bipolar and Major Depressive Disorder are for-sure two separate things. You may have periods of depression for a while before the mania but we need to be careful to separate the Bipolar from the Major depression.

So what is mania? I won’t repeat the whole DSM-4-TR criteria here if you want that please go to the source. But a couple of things that separate mania and therefore bipolar disorder are important. For some clients, this looks like someone on Meth – without the drugs. This is not a little bit thing that comes and goes. When it occurs the person is debilitated.

Mania involves a period of time where the client’s behavior is elevated, expansive, or irritable. In short, they are “off the hook” and this is not deliberate but uncontrollable. During this time frame, they have a bunch of behaviors that are far too excessive. The DSM lists 7 characteristics and the person should have the majority of these symptoms. Not sleeping and not needing to sleep is a red flag. They are up all night doing things and they don’t even feel tired. They are likely to show grandiosity and excessive self-esteem. They talk faster than those around them can listen and they think faster than they can talk. But the thoughts may make sense only to the person with bipolar disorder. They are likely to get “stuck” on things, too much work, buying sprees, excessive sexual activity, and other risk-taking activities.

Since mania is seductive, who wouldn’t like to be able to have fun twenty-four hours a day and not need to sleep, during manic episodes the client with bipolar may be strongly attracted to stimulant drugs like methamphetamine and cocaine. Alcohol abuse is also common which increases the crash when the manic episode ends. And it always ends.

Most people who truly have bipolar disorder are first diagnosed with depression. One indicator that makes me suspicious is when a depressed client takes an anti-depressant and recovers suddenly and now is “better than ever.” A manic episode is about to occur.

So far talking about Bipolar disorder, with its depressive and manic symptoms makes it sound like the person runs from manic (which is not happy by the way) to depressed. That’s not the whole story. Kay Redfield Jamison writes about what we might call mixed states. It is possible, probably more common than we might think, to have both mania and depression at the same time. Think of the shifting moods like a tire on your car. When it is parked we could mark one side of the tire and call that the back, the other would be the front. But once the tire starts to move you don’t drive on the front or the back but the whole tire. So the person with bipolar may experience a mixture of depression and mania at the same time.

Another feature of Bipolar disorder that separates it from moodiness and depression is the tendency for the elevated thinking to become first delusional and then it may progress to include hallucinations. So the person with bipolar disorder is not only thinking odd thoughts but is very irritated with others that they don’t “get them.”

Hope this explanation got you thinking about Bipolar disorder. If you would like more information, check out the Depression and Bipolar Support Alliance.

As always your comments are welcome. If you like this blog spread the word. If not let me know what might improve it. Till next time.

David Miller, LMFT, LPCC