Tag therapist specializing with bipolar disorder

“Newly Diagnosed With Bipolar Disorder Club” Topic #1: Complying & Coping With Medication

This blog series is dedicated to everyone Newly Diagnosed with Bipolar Disorder. Welcome to the club! You have unwillingly joined an elite club in which some of the members are among the most brilliant, creative and talented in history.

Unfortunately there is no manual that comes with our bipolar disorder diagnoses when becoming a member of this club.

This blog will be followed by a series of blogs called “Newly Diagnosed With Bipolar Disorder Club”. Each blog will address issues that members have shared with me or issues I or clients I have worked with when newly diagnosed face.

Today’s topic is coping with medication and medication compliance.

Topics coming soon based on members’ request will include:

Building daily routine and structure
Developing sleep patterns

If you would like to make a request for this series, please contact me and I will be happy to address your concern.

Today”s Topic:

The #1 problem that people have when joining this club is coping with medication and medication compliance.

There are not many people in a club like ours where the medication completely changes your experience of yourself.

Our medications may change:

Our energy and exuberance level
Our ability to feel the rich emotion of emotion
How we think
How we express ourselves
Our creativity and innovation
Our memory
Our weight
Our ability to be super productive and goal-focused

*Note: Not all medications cause these effects, but all medications are mood stabilizers which function to reduce emotional extremes.

Nobody would want to take medication if it did changed who they are AND keeps them from feeling like themselves and maybe weird or slightly off at first.

This is why we, the members of this club, are so strong and courageous. Each one of us has a different reason for why we are willing to sacrifice the amount of some these of these things. I made this sacrifice because I was willing to do anything I possibly could to prevent myself from experiencing the peak of full-blown mania and feeling like I am dead in depression. Some of the people I’ve had the privilege of working with shared with me that they made this sacrifice because medication made their quality of life so much better. They got to experience stability for the first time. It improved their abilities to function at work and improved their quality of relationships.

Most often, the consequences of not making the sacrifice are far more painful than what there is to gain by taking medication.

It’s a hard choice to make, but something we remember by taking our medication every day at the same time.

Before continuing on to an activity, take a moment and ask yourself what has you committed to being on medication.

Now that we understand why we are committed to being on medication, let’s explore how to cope with the losses:

The loss you experience is a death because it is that significant of a loss therefore in order to cope, I invite you to mourn the loss for a specific set amount of time before taking actions to explore your new life.

Ways to take action and help mourn the loss of your manic and depressive self:

1. Write down the qualities you miss.
Examples: creativity, exuberance, productivity, passion, emotion etc

2. Write down what you miss about each quality.

3. How did it affect your life?

4. How did you feel when you experienced it?

5. What did you tell yourself about yourself when you experienced it?

6. What abilities did each quality give you?

7. What qualities or parts of qualities did you get to keep?

8. What new abilities do you have because of being on medication?

9. What action are you willing to take to further develop these abilities?

* This is an activity that could be very useful done in therapy if it feels overwhelming to do on your own.

Here’s one example put in action from my life.

1. Write down the qualities you miss.

I miss my exuberance that was expressed through passion and an energy that completely filled the room.

2. Write down what you miss about each quality.

I miss the feeling I had when I walked into the room and the affect my presence had on people. I felt special. I felt wanted. It felt so good to make people smile. (I wasn’t aware of how uncomfortable it made some people until I was in graduate school.)

3. How did it affect your life?

People relied on my presence to make them feel good. I relied on my presence as a way to not be vulnerable because I always had a smile on my face and was a burst of energy. It made it easy for me to meet people and engage groups of people.

4. How did you feel when you experienced it?

Wanted. My presence made people’s day. I felt passionate and alive. I felt seen. At times insecure because with age, I could feel that it made people uncomfortable.

5. What did you tell yourself about yourself when you experienced it?

People like me. People want me around. My presence matters and makes a difference. I make people’s days better.

6. What abilities did each quality give you?

The ability to be free and break social rules (which I didn’t inherently know what they were anyway). I could get away with so much because I did everything with a smile on my face.

7. What qualities or parts of qualities did you get to keep?

I still have my passion and exuberance, but it has changed form. Now I’m a light in the room, instead of completely filling the room. I am not overwhelming. My energy is more relaxed and channeled, yet still very passionate. My energy isn’t as anxious and manic, except when I go to the doctor.

8. What new abilities do you have because of being on medication?

I am able to feel peace and centered. I don’t feel the need to be “on” or performing all the time. Instead, I feel more genuine because I don’t always have to have a permanent smile on my face. I’m able to use the abilities I’ve always had with more ease. I could go on and on…it has been tremendous.

9. What actions are you willing to take to further develop these abilities?

Focus on my breathing during to increase my feelings of peace and centered. Continue to be transparent about what I’m thinking and feeling and continue being honest when I’m not able to be what people expect from me.

If this is helpful, feel free to contact me with interests for future blogs.

The Bipolar Brain: The Fight For Domination…when the left cerebral hemisphere is winning

in Information by Robin Mohilner May 10, 2010 15 comments

One question I often get is, “What’s happening in the brain during a manic and depressive episode?”

The truth is that scientists don’t fully know. Scientists are finding common evidence, but the brain is so complex that nothing we know about it can not be considered fact that will apply to everyone.

Therefore, I am going to share with you my ideas that are based on both my current research and my own experience of my brain in action.

A Balanced Brain – (No brain is truly balance, but let’s pretend)

A balanced brain does its best to equally disperse resources. Therefore there is no competition for resources. Both hemispheres have what they need, the layers of cortex (where our higher functioning takes place) have what they need. The limbic system (the seat of our emotions) has what its needs. Everything is basically working together and there’s harmony.

Yeah right! No brain works like this most of the time.

Bipolar brains just happen to be extreme.

A bipolar brain is a highly competitive brain, which is why many of us are so intelligent, inventive and creative. Different structures and hemispheres of our brain compete for resources to be able to do extreme things that require a lot of energy and brain power.

During Mania – Reminder this is not fact it is my theory

During Mania the left hemisphere of the brain is dominating the right hemisphere. But the right hemisphere isn’t turning it’s cheek, it is fighting back with all it’s got. This is how the peak of mania and mixed episodes may come to be.

Mood – Mood Swings

This may be do to a structure in our brain called the Orbitofrontal Cortex getting too much energy and not enough energy as it gets pushed and pulled back and forth during the battle between the hemispheres. The Orbitofrontal Cortex is responsible for things like decision making and is sensitive to reward and punishment which may be a large factor in mood.

Memory

The structure in the brain called the Hippocampus (that is responsible for forming, sorting and storing memory) appears to be significantly inhibited during mania and/or depression. My experience was that it was incredibly inhibited when the right hemisphere took over and I went into depression, but not inhibited at all during mania.

When we are able to consume analytical information faster and easier than ever before, when our thoughts are racing, when we have multiple thoughts at once and when these thoughts get jumbled up because we cannot keep up with them….

This may be our left hemisphere, particularly in a structure called our Pre-Frontal Cortex, that is consuming so much energy and power that it has taken by dominating the right hemisphere that we cannot keep up with our brain’s ability to function and we cannot express ourselves because we cannot get it out fast enough.

They say that the average human being uses 7-10% of their brain power, well that’s a joke to someone who is manic!

When we are impulsive and take tremendous risks…

This may mean that two specific structures called the Anterior Cingulate (responsible for social inhibition)and Posterior Cingulate (responsible for being sensitive to risk) have been shut down by the lack of resources in the battle between the hemispheres. Research shows that these structures are somewhat depleted in bipolar brains to begin with, so during mania they may not be functioning.

When we feel invincible…

The battle in our brain may be taking a huge toll on our Amygdalas. The amygdalas are both responsible for emotional responses as well as our response to fear. According to some studies, bipolar brains may have smaller amygdala in the left hemisphere and larger in the right. Therefore, when the left hemisphere is taking over during mania, the little amygdala is overloaded and may be depleted of its resources to appropriately respond to fear.

When we have a heightened sense of spirituality or oneness with all life…basically when we feel we are a god, prophets, higher being, aliens etc…

There is a part of the left hemisphere, whose name I do not know, that has been identified as the seat of spirituality. Some people have it, other people do not. During mania when the left hemisphere is consuming all of the brain’s resources this part of the brain soaks it up and runs with the energy until it is all burned up.

When we experience hallucinations or delusions…

Hallucinations and Delusions may be where the true battle between the left and right brain taking place. This may be where the right brain starts to win at times. This is all my theory from experience.

I believe that as the left and right hemispheres of the brain are battling the messages that get passed from neuron to neuron get disrupted or convoluted causing the message to change so extremely because the message gets changed by each neuron in the neural pathway.

It is basically like playing the telephone game, gone out of control.

When this happens our brain no longer sees what our eyes see and no longer hears what our ears hear. We are no longer able to be in touch with the world outside our our brain. Our brain is battling and doesn’t have the resources that moment to focus on getting accurate messages through.

During the Peak of Mania or a Mixed Episode- when all emotions explode out

This is the last fight. Mania gives the battle everything it’s got by exploding out positive feelings and emotion. But the left hemisphere has been exhausted by the right and doesn’t have many energy left.

The right hemisphere dominates with the power it has and explodes negative, ugly, nasty, horrible feelings and emotions. It does this until it exhausts itself.

During Depression – The Exhaustion

Both left and right hemispheres are depleted. They are done. Finished. And gave up the battle. Neither has any energy left to give.

Hence this is why we feel our brain is dead.

To learn about my theory about how the right brain dominates during depression, I welcome you to come back for more.

How depression knocks on your door…And how not to let it in.

in Actions / Ideas About Depression / Ideas: Ways to Thrive by Robin Mohilner May 9, 2010 3 comments

Do you ever hear the doorbell, and feel the rush of anticipation feeling that it’s a friend surprising you. Then when you open the door…it’s a salesman, trying to sell you something you don’t need. That salesman is just like depression. But when it knocks, it is carrying all of your “baggage” and it will do anything it can to sell it to you and get you into bed.

Our goal today is to explore how it does this and ways to not answer the door. But if we do because depression is very sneaky, our goal is to not let it stay in bed with you long.

In order for depression to come into your life, there are things it needs to take from you.

Like mania, depression needs to either prevent you from sleeping OR cause you to sleep too much. Hence, why the first place it wants to get you is into bed…it MUST do this before it can even sell you its crap.

It does this because it knows sleep is very vulnerable. You cannot force yourself to sleep, so depression goes after sleep first. Sleep is best target because it regulates your brain and body. Without sleep you cannot function. Not being able to function is exactly what depression needs in order to come into your life and for it to survive.

To prevent depression or mania from having easy access to your sleep here are some actions to take:

Be consistent in your sleep pattern – go to bed and wake up daily at the same time.
Do not work on anything past a specific hour you set that is a few hours before bed time. (This is the hardest one especially if you are manic or having mixed episodes.)
Have a relaxation routine that you start an hour before bed. Ex. Turn the lights low, listen to relaxing music, take a warm bath, burn a candle. If you are tempted to try a natural approach to getting to sleep, you might even find that using a cannabis strain such as blue dream weed can help you to relax and unwind. Never smoked cannabis before? If so, you might want to consider using a mini bong. You can learn more about mini bongs here: https://fatbuddhaglass.com/collections/mini-bongs.
Keep a notepad by your bed so that when ideas wake you up in the middle of the night you can write them down and go back to sleep.
Don’t use alcohol to sleep. It will only let depression in more.
Talk with your doctor and request a non-addictive sleep aid.

Depression’s next easiest tool for plowing down your door is FEAR.

Fear is depression’s most highly developed and effective tool. This tool affects your life on many levels including: how you think, what you feel, what you do and how you do it – your body’s heightened stress response.

How You Think:

In order for depression to be in your life, it needs to manipulate and control your thoughts. In order to do so it will persistently tell you things like, “You will ALWAYS be (insert negative statement here)….You will NEVER (insert positive statement here)….You CAN’T…” And it plays these ugly messages to you like a tape recorder in an authoritative voice (sometimes your own, or maybe your mother and father’s etc).

This is how depression gains your trust….

IT MAKES YOU THINK ITS YOU.

When depression comes into your life after mania or hits you like a ton of bricks, it controls your thoughts differently. Because it didn’t knock on your door at all, it keeps you depressed by making you incapable of thinking and feeling PERIOD. (But this will be discussed another time.)

How You Feel:

When depression knocks on your door it needs you to feel bad. So bad that you hurt. It can’t exist unless you feel so much guilt, shame, blame, doubt, sadness, loss, pain etc…that you are willing to not resist the feelings and own them.

This is why it tells you, “Everything is your fault….” “You aren’t worthy of…” “No one will love you.” “No one wants you.” “No one will believe you.” etc.

Depression’s goal is hurt you until you go numb and can’t feel anything because it needs you to not be willing and able to do anything about it.

Depression does NOT want you to care. It needs you to not care in order for it to survive. This process often invites suicide.

What You Do:

Depression needs you to do absolutely NOTHING. In order for it to survive and make itself at home with you, it steals your energy, interests, your ability to focus, your ability to experience pleasure.

Depression needs your strength, resources and abilities in order to live.

How you do it – Your Bodies Heightened Stress Response:

The best way for depression to make you believe the thoughts and feelings that it feeds you is by making you feel it in your body.

It does this through agitation, anxiety and panic attacks.

Depression needs you to feel out of control in your body so that it can control you.

To not answer the door when depression tries to control how you think, feel, and respond in your body:

Acknowledge that the thoughts and feelings you are having are depression, NOT YOU.
See depression for what it is: Like all other living creatures it wants to survive. In order to survive it must manipulate and control you so you give it your resources. It is like a parasite.
Do not believe the tape recorded lies depression tells you about yourself and your life. Don’t buy what the salesman is trying to sell you. If you have to curse at him, “F*** You Depression!” It just feels good.
When you feel negative feelings in your body, PAUSE, breathe deeply and slowly, and ask yourself is this F.E.A.R. “False Evidence Appearing Real”.
When depression is stealing your interests from you, find at least one thing and keep doing it no matter what…even if its just getting out of bed.
Exercise – your body needs to release the stress hormones and exercise is how your body does it.
Focus on the “Here and Now”. You will find that when you are in the moment, depression can’t exist. Depression gets to you by focusing your attention on the past (what happened or what could have been) and the future (what might happen or “what if…”)…but never the present (what is, right now). Right now, there is no problem. The present lacks FEAR.

Doing these actions can be challenging. For help overcoming these obstacles and taking action, feel free to set up a consultation with me if you are in the Los Angeles area OR seek out a psychotherapist in your area:

http://www.therapistfinder.com

I will be writing a blog on what to look for that will make a therapist a good fit.

I’m Bipolar & Proud! 5 Ways to Be Bipolar & Proud

in Ideas: Ways to Thrive by Robin Mohilner May 7, 2010 2 comments

Facing the Waves Without Fear.

5 Ways to be Bipolar and proud:

1. You don’t take stigma personally.

You clearly see that stigma is based on fear and lack of knowledge. You know that you have nothing to be ashamed of and you know you are not a disgrace. Instead of feeling sorry for yourself, you have compassion for people because their fear and ignorance can only cause them pain.

You don’t have to suffer from other people’s pain.

2. You have a sense of humor about bipolar disorder.

Laughing at yourself is so important. It keeps you from being so attached to the mood or episode you are experiencing and helps you center yourself. You know you’re not a mood, risky behaviors, jumbled or racing thoughts, memory loss, mania or depression, but sometimes we all forget we’re not these things because we get so deep into them. Laughing at yourself allows you to be an observer of yourself, you connect to the part of you that is what you refer to as “Me”.

3. You educate yourself about bipolar disorder and have an awareness of what triggers your moods and episodes. You take responsibility to be aware of your episodes and do your best to manage them.

Notice how I didn’t say that you’re ALWAYS good about responding to moods and episodes effectively. You aren’t going to always be able to respond well or prevent episodes. Nonetheless, if you have the knowledge you can be aware of what you are experiencing and not be so afraid of it because you know what to expect.

4. You accept yourself.

You don’t feel sorry for yourself. You like who you are. You know that you are worthy of love, respect and kindness and that is how you treat people.

5. You ask for help and support from people when you need it.

This is the hardest thing to do when living with bipolar disorder. One of the most common coping mechanisms we have as people living with bipolar disorder is that we believe that we ALWAYS must be strong. We hold things in. We don’t allow ourselves to be vulnerable. By doing this we are inviting an episode to happen. We must find it within ourselves to allow someone to help us.