Category Archives: Research, Reviews & Resources

What if I Have Bipolar Plus Anxiety Disorder?

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Anxiety is often a symptom of bipolar disorder.  In a depressive or manic state, a person can feel excessive worry, panic, paranoia, agitation, irritability, and experience social phobia.  The level of anxiety can fluctuate along with the bipolar mood states.

It is also possible to have bipolar disorder with a separate diagnosis of an anxiety disorder, where a person’s worries and fears can go on for months or even years, even when the bipolar moods are stable.  There doesn’t have to be a reason for the anxiety.  It could just be a sense of something bad about to happen at any moment.

There are several types of anxiety disorders including:

Panic Disorder

People with panic disorders have unexpected panic attacks with intense fear, shortness of breath and fast heartbeats; some may sweat and feel like they are choking or are going to faint or die.  They feel like they are out of control when having a panic attack.  They often fear they will have another one, and avoid the places where they have had them before.

Intense fear and highly noisy, over stimulating, chaotic environments, such as a kid’s birthday party, can bring on a panic attack for me.  I used to get them at work, at sporting events, at the grocery store, and recitals.  So, improvements have been made, but I do still suffer from them.

Social Anxiety Disorder

People with social anxiety disorder fear being around others, where they are worried about being embarrassed or judged or rejected.  They have a hard time talking to others and making eye contact.  They often feel like running away in social situations.  They may sweat, shake or get nauseous when called upon to interact with others.

My social anxiety manifests itself in many of the ways described above, however, I am not always completely shy as one might imagine someone with social anxiety being.  Quite the opposite, I will often overcompensate and come off a bit brash.  I blame that on my bipolar impulsivity.

So, I actually take an fast, but short-acting, antianxiety medication prior to social events to, one, decrease my chances of having a panic attack, and two, to give my prefrontal cortex a bit more time to censor what I want to say.

Generalized Anxiety Disorder (GAD)

People with GAD tend to worry about things, both large and small, but out of proportion to the impact of the event.  They can’t let go of the worry, and worry about being worried all of the time.  They feel restless and can’t relax.  They are fatigued, irritable, have trouble sleeping, and are tense to the point of having sore muscles and headaches and/or GI problems.  They have a hard time concentrating or their mind often goes “blank,” except when carrying every option out to its possible negative conclusion.

Even when their worries don’t completely consume them they still feel anxious for no apparent reason.  I function most frequently in this state, always worried about my safety and that of my children, and feeling like something bad is going to happen at any moment.

 

Do I Have An Anxiety Disorder or Is It Part Of My Bipolar?

Of course, any disorder has to be properly diagnosed by a professional, which I am not.  To find out for sure if you have an anxiety disorder, talk to your physician.  From what I have learned and personally experienced, however, the difference between having one of these anxiety disorders in addition to bipolar disorder and having “bipolar anxiety” alone is that with anxiety as a symptom of bipolar, one may experience a mix-mash of random symptoms from each disorder.  Having a separate anxiety disorder, on the other hand, requires the person to fit the diagnostic criteria for said disorder.

For panic disorder, for example, one would have to have recurring attacks, and be fearful of having future ones to the point of avoiding situations and places where he or she have had them in the past.

For GAD the person would have to have:

“excessive and unrealistic worry over a period of at least six months…associated with at least three of the following symptoms:

  • Restlessness
  • Fatigue
  • Difficulty concentrating
  • Irritability or explosive anger
  • Muscle tension
  • Personality changes, such as becoming less social”

Source: http://www.webmd.com/anxiety-panic/guide/anxiety-attack-symptoms

If a person is only experiencing some of the symptoms of anxiety but not enough to fit the diagnostic criteria of having the disorder, then he or she merely has anxiety as a symptom of the bipolar disorder.

The reason this is important is because they are treated in different ways.

Treatment

If a person has bipolar disorder with anxiety symptoms, as his or her bipolar disorder came under control, the anxiety symptoms would most likely subside.  If he or she has bipolar disorder and an anxiety disorder, the moods may be stable but the anxiety may still be disabling.

The problem with having both bipolar disorder and an anxiety disorder is that while anxiety disorders alone are normally treated with antidepressants, it is often unwise to give someone with bipolar an antidepressant since it may trigger a manic episode.  Many physicians treat people with these comorbid conditions by addressing the bipolar symptoms first with mood stabilizers and other “bipolar medications.”

Once the person’s mood is stabilized, then any remaining anxiety symptoms are addressed in any number of ways depending on the doctor and patient’s plan.  Since antidepressants could have detrimental effects on the course of one’s bipolar disorder, atypical antipsychotics are often used to treat anxiety disorders in those with bipolar.

Psychotherapy or Cognitive Behavioral Therapy and relaxation training are always safe bets.  If antidepressants are tried, careful monitoring for any hypomania or mood cycling must be done.  Benzodiazepines are effective in relieving many anxiety disorder symptoms, but they are habit-forming and must be prescribed with caution.

Do you have comorbid bipolar and anxiety disorders?  How has this mix played out in your every day life?

Sources:
Mayo Clinic
National Institute of Mental Health (NIMH)
Psychiatric Times

 

 

 

 

 

Another Brain Region Linked to Bipolar Disorder

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For several years, neuroimaging studies have noted differences in the prefrontal cortex and limbic areas (which includes the hippocampus) of the brains of individuals with bipolar disorder compared to those without bipolar disorder.  Now, a new study is suggesting that the genes and proteins found in the striatum are linked to bipolar disorder as well.  The striatum acts as a reward pathway and helps to regulate motivation among other things.

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“Our finding of a link between bipolar disorder and the striatum at the molecular level complements studies that implicate the same brain region in bipolar disorder at the anatomical level, including functional imaging studies that show altered activity in the striatum of bipolar subjects during tasks that involve balancing reward and risk,” said Research Associate Rodrigo Pacifico, who was first author of the new study.

Researchers are hoping that their findings will lead to the development of diagnostics and treatments.

The more research I find, such as this, the more I realize that bipolar is so much more than a “chemical imbalance.” It truly is a brain disorder. Our brains are anatomically and molecularly different from those without bipolar. It’s so much more than a simple lack of neurotransmitters (i.e., serotonin, dopamine, etc.)

We should all be proud of the progress we’ve made considering what we are up against. Thank goodness for continued research which will hopefully lead to improved treatments. Let’s continue to do our part by taking care of ourselves as best as we can and never giving up!

Source: The Scripps Research Institute

What to Do About Bipolar Disorder and Stress

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Bipolar and Stress

We all have stress. Can’t avoid it. Can’t get rid of it. Might as well learn how to deal with it. Right? Wrong. Let’s make a list of our stressors. Pretty long list, eh? I bet we can avoid or get rid of at least a few of them if we really wanted to. It may take some finagling, help from others and a lot of courage, but I bet we can do it.

The problem is we may be too worried about what other people think or hurting someone’s feelings or feeling too guilty to make the changes necessary to reduce our stress. We may be too proud to ask others for help or too embarrassed to let others see how we really are, so we put on our masks and act like everything is fine, thereby increasing our stress.

For those of us with bipolar disorder, this is especially dangerous because stress can trigger mood episodes. According to an article on PsychCentral, “people with bipolar disorder are more prone to stress than the average population.”

Along with the danger of triggering mood episodes, chronic stress can over-produce stress hormones resulting in “chemical imbalances and physical changes in parts of the brain already vulnerable due to bipolar disorder. The prefrontal cortex shrinks, leading to emotional instability, self-regulation problems, and mood changes.”

So, you can see how important it is to reduce the amount of stress in your life! My doctor told me just that and my response was: “Yeah, right! I’ll just get rid of my kids then.”

There are some stressors we obviously cannot eliminate. However, I have made changes to reduce my stress, even with my kids like making them do more for themselves and not saying yes to every activity they want to do.

I go to support group meetings for people in recovery from drugs and alcohol. In one meeting, there is this one lady in particular who causes me a lot of anxiety whenever I see her. So, I now avoid that meeting even though I like the other people who go there. The stress is not worth it to me. There are too many other meetings I can go to where I don’t feel stressed.

I say “no” to seventy-five percent of the parties I am invited to because of my social anxiety. I know I offend some people because I say no so much, but I don’t care. I used to force myself to go and then get panic attacks while there and sick with anxiety and migraines for days afterwards. I have to eliminate the stress that I can from my life in order to stay balanced and healthy.

Let’s not forget about positive stressors, too. A recent weekend trip to see friends, while fun, left me feeling exhausted and overwhelmed. I came home and crashed for two days straight just to mentally and physically recuperate from lack of sleep and over-stimulation. Fortunately, my husband helped around the house so I could do this.

Before I understood how bipolar works, I would have continued trying to do everything for and with the kids until I crashed into yet another severe depression. I also would have returned from that weekend trip and went on with my week like any “normal” person would have. Only unlike a “normal person,” by week’s end, I would have been in full manic irritability and dissociation. This would have lasted for a week or two followed by a depressive episode lasting for who knows how long. Now, I know good self-care is the key to managing my stress.

I don’t know about you, but I don’t want to play shrinky-dink with my brain, so

My basic plan when dealing with stress is this:

  • Identify my stressors
  • Get rid of them when possible (e.g., say, “No.”)
  • Avoid them when possible (e.g., remove self from situation)
  • Ask for help
  • Practice good self-care (eat well, sleep well, take meds, have routine)
  • This goes without saying, but I’ll say it anyway – when I am stressed I write.  (Guess you know how I am feeling right now.) 😉

What helps you deal with the stress in your life?

Light Deprivation to Decrease Mania in Bipolar Disorder

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Bright light therapy has been used for years to treat seasonal affective disorder and depressed patients in general. Patients sit in front of a special lamp which has similar effects on their circadian rhythms or wake cycle as the sun would, thus increasing their energy and lifting their moods. I had great success with my light therapy box during a particularly trying depressive episode several years ago.

Researchers are now speculating that light DEPRIVATION therapy, the opposite of bright light therapy, may be a viable treatment for bipolar mania. Light deprivation therapy can be achieved by limiting exposure to sunlight or by wearing specialized glasses.

There are only a few studies testing this theory, however, and while results of these studies are positive, sample sizes are too small to be generalized. Hopefully, they will continue to look into this further because if it works, it would be a safe, non-invasive option for treating bipolar mania.

Study Comparing Bipolar II vs. Bipolar I

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A recent study showed that Bipolar Type II, often thought of as the less severe form of Bipolar Disorder, is actually worse than Bipolar Type I is some ways.

Some of the ways Bipolar II is more severe than Bipolar I:

  • increased comorbid anxiety
  • increased first-degree relative with mood disorder
  • more prior mood episodes
  • current depression
  • current antidepressant use
  • rapid cycling in the prior year
  • childhood onset

On the other hand, Bipolar II patients had significantly less hospitalizations and current prescription psychotropic use compared to Bipolar I patients.

Both groups had a statistically similar rate of prior suicide attempts.

New Issue of Turtle Way Journal

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Check out the new issue of Turtle Way, Write into the Light’s online literary art journal supporting those with mental illness. There is some great photography, poetry and prose in this issue. Turtle Way Journal.

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Are You Addicted to Chaos?

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Today’s post is by Laura Wills. She writes about addiction, which I have stated before is a form of mental illness. After one is no longer using his drug of choice and life is not as chaotic, he may feel uncomfortable with this calmness. I felt this way after I stopped drinking a long time ago. I sometimes feel this way when my bipolar symptoms are at bay. While I am glad that my symptoms subside, life can become a bit boring without them. “Chaos Addiction” may be the reason for this, which Laura explains below.

Falling Out of Comfort and Into Chaos..?

Recovering from addiction isn’t a case of “just” weaning yourself free from substances, alcohol, smoking – or even gambling or shopping. It’s a multi-layered and complex approach that in itself can reveal more about the hidden problems and associations lying underneath.

Very often, people who are in recovery report that as their lives settle down and they begin to take stock, they don’t like the feeling that everything in their world feels as though it is going well, or too smoothly. Many say that they find it difficult to let go of the chaos and dysfunction that surrounds their addiction and therefore seek to try and find it in other areas of their life – such as possibly creating rows with their spouse or partner or keeping troublesome or worrisome situations in their working lives going instead of actively trying to resolve them. This kind of activity has a name – Chaos Addiction and it is something that psychologists are becoming increasingly interested in, in terms of addressing addiction issues.

Many people who find themselves falling into such a problem can usually find at some point in their lives they have been victims of it themselves, perhaps through dysfunctional parenting, constant arguments or even being exposed to addictive behaviors in the home. When they reach maturity they may find themselves adopting the same patterns – especially if they fall into an addiction (however, it does not necessarily mean they will fall into addiction, merely carry on the dysfunctional behaviors they have known all their lives.) For more information on this fascinating subject, you can read on here.

Are you addicted to chaos? Share your thoughts and experiences below.

How a Detox Bath Can Help Ease Depression Symptoms

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Anyone who has experienced depression knows how tired it can make you feel.  Surprisingly, metabolic toxic build up can make us feel pretty lousy as well.  Sluggish.  Run down.

In fact, when metabolic waste from toxins builds up in our body, we get sick. Functional medicine expert, Dr. Mark Hyman, says, “problems with detoxification is one root of illness. If you feel lousy, it’s likely you’re toxic.”

We all are exposed to toxins on a daily basis from the medicines we take to the foods we eat to the fluoride in our water to the pollutants in the air we breathe to the chemicals in the soaps we use to clean our bodies and clothes.

The liver does a great job of getting rid of toxins by sending them out through our bowel and bladder. Our skin releases toxins when we sweat as well, which brings me to the Detox Bath…

Typically, a detox bath is made with Epsom salt also known as magnesium sulfate, which not only draws out toxins, but has physical and mental health benefits of its own:

  • Eases stress and improves sleep and concentration
  • Helps muscles and nerves function properly
  • Regulates activity of 325+ enzymes
  • Helps prevent artery hardening and blood clots
  • Makes insulin more effective
  • Reduces inflammation to relieve pain and muscle cramps
  • Improves oxygen use
  • Flushes toxins
  • Improves absorption of nutrients
  • Helps form joint proteins, brain tissue and mucin proteins
  • Helps prevent or ease migraine headaches

 

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Vanessa Romero of Healthy Living How To provides the following guide to

How to Draw a Detox Bath

1. Add 5-10 drops essential oil (I love lavender) to 2 cups Epsom salt, then add to a standard tub full of water.

2. Ideally, you want the water quite hot as we are looking to create a nice sweat.

3. If your bath water is not filtered, add 1 cup of baking soda as this helps neutralize the chemicals, primarily chlorine, as well as increase mineral absorption.

4. Immerse yourself in the water, all the way up to your neck. You want as much of your body underwater as you can. Close your eyes, do some breathing exercises and soak for at least 20 minutes.

5. Once you are done soaking, rise out of the tub very slowly and cautiously. You may feel a little dizzy and light-headed, this will go away as you shower off quickly in cool water.

6. It is important not to use harsh soaps or shampoos as your pores are open and will just absorb the chemicals found in those products.

7. Once dry you can apply a natural moisturizer like body butter, shea butter or coconut oil and some aluminum-free deodorant, but again no lotions with perfumes, dyes or chemicals.

8. Do not eat immediately before or after taking a detox bath.

9. Instead hydrate yourself with filtered water before and after.

10. Allow time after your bath to rest and rejuvenate.

I took a detox bath last night after a day overshadowed with depression and a slight migraine. Afterwards, I felt relaxed, lighter, airier, less stressed, and pain-free. I added mood lighting and music to my detox bath, so the whole experience was a great gesture of self-care which totally combats depression. So, yay! Score one for me! The detox bath wasn’t a lot of work and it had many benefits. I’ll definitely be doing another one again soon.

5 Reasons I Hate Leaving My House

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Anxiety is a bitch! It has been several years since I have had a full-blown panic attack – the one where you can’t breathe and you think you are dying – but on a regular basis I have bouts of anxiety where my heart races, I get a bit short of breath, and I fear I may go into panic mode. These smaller anxiety attacks, along with some low levels of depression, are enough to make leaving the house a big chore for me.

Top 5 Reasons I Hate Leaving My House

1) Showering takes more energy than I have on most days. And then there is the fixing of the hair, and OMG! make-up, and God-forbid getting out of my pajama pants. I mean, come on…that’s a lot to ask of a girl. By the time I do all of that I am ready for a nap!

2) Driving is stressful. I live in a busy metropolitan area and traffic is heavy. Patience, concentration, and sometimes aggressiveness are needed to safely navigate the roads around here – all of which I basically lack.

3) Social anxiety. Leaving the house often means going to some sort of social event, and I don’t feel comfortable around other people because small talk is like nails on a chalk board to me! I’m definitely an introvert and prefer to be alone or with my immediate family. Also, if it is a larger party, the noise and extra stimuli is overwhelming to my senses.

4) Fear of public places. Leaving the house also often means going to the store or some other public venue where crowds gather and strangers abound. Yikes! What if I see someone I know? What if I get mugged? Kidnapped? How claustrophobic I feel standing in lines and squeezing down isles. How it makes me lose my breath to bump into others or feel them in my physical space! And again, the noises, lights, and movement are all overwhelming to my senses.

5) Agoraphobia. Agoraphobia is an intense fear and anxiety of being in places where it is hard to escape, or where help might not be available. This would explain why if my husband is with me, I feel much less anxious when out of the house. He drives, I stick by him during parties, and follow him through the stores. Now if only he could shower for me. 🙂

Although I hate leaving the house, I do force myself to on a regular basis. Sometimes I have to take an anti-anxiety pill before I leave and sometimes I don’t. I think it is important for me to desensitize myself to these stressful situations as much as I can, because if I don’t my anxiety will only get worse.

I also grade the tasks in a way that will make them more successful for me. For example, when I go to the grocery store I only get a few items at a time, and leave the big list for my husband (he’s the best!) When my daughter has a 3-day sports tournament in a loud crowded gym, I will only attend one or two of the days. When going to a social event, we will only stay a short while or not go at all if I am not feeling up to it. We go out to eat early in the evening (with all the old people) so we don’t have to wait for a table. These are just a few examples of how I compensate for my increased anxiety.

As you can see, there are ways around anxiety. It doesn’t have to make you a prisoner of your own home. Although, sometimes it will. But it doesn’t have to all of the time.

How does your anxiety limit you, and what are some ways you have found helpful to decrease these limits?

How to Use Media to Improve Your Mental Health

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If you are like me, watching too much news can wreak havoc on your mood. I begin to think our world is nothing but an evil, horrible, negative, cesspool of a place to live. I lose hope in humanity quickly as I hear story after story of war, murder, robbery, rape, kidnapping, and abuse. I become cynical, despondent, and downright depressed. Therefore, I limit my exposure to the news.

I noticed that my local news stations post the more horrific stories on their Facebook news feed than they broadcast on television, so I stopped following their pages. This has helped my mental health tremendously since I check in on Facebook multiple times throughout the day versus watching a televised newscast only once per day.

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5 Types of Media That Have a Positive Affect on My Mental Health

1.  Blogs that offer hope

I enjoy reading mental health blogs written by those who have struggled or are struggling, and are trying to get better. It is uplifting to read stories of perseverance, effort, compassion, and faith.

There are many bloggers out there who write only of their destructive ways; who are stuck in their illnesses and show no signs or interest in wanting to get better. They do not seem to have the insight or awareness into the things that they can change, and that is ok. They aren’t there yet, and I am not judging them for that. However, their negativity and anger is something I have to steer clear of for my own mental well-being, just as I have to with people in real life as well.

2.  Google Images

Sometimes when I am feeling down or just bored I will search positive keywords on Google and browse through the images that come up. I often add the word “quotes” to my keyword and then many photos of positive affirmations and sayings appear. For example, this one is from searching the words “friendship quotes”:

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And of course, you can find just regular photos of anything you can think of that makes you happy, including all the puppy and kitten pictures you could want!

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3.  Pinterest

I use Pinterest because it is a great way to save all of those images you find. That way you can come back to them again and again to boost your spirits whenever you need to. Plus, on Pinterest you have the advantage of having a million other people’s search results at your finger tips on the same topic you are interested in.

4.  YouTube Music and Photo Videos

Listening to your favorite music on any media device can help improve your mood.  You can find many songs on YouTube as well.  What I like to use YouTube for is to find non-mainstream type music that helps my mood, such as relaxation or meditative music.  Music that I wouldn’t necessarily buy, but that I might want to listen to every once in a while to help calm my nerves on a particularly stressful day.

I also like searching for photo-music slide shows.  They can be very soothing.  If you would enjoy photos of wooded areas, this one is nice.

5.  Twitter

If you search the hashtag “#affirmation” on Twitter, you can read all kinds of positive messages that will help lift your mood.  I know it helps me stay in a good frame of mind.

Do you know of any other ways to use media to improve your mental health?  Please share them in the comments below.