How I Manage My Bipolar Disorder

by

 

I went six years between my first (2007) and second (2013) hospitalizations. I pride myself on that. I was hospitalized for a third time in 2014. Through my three hospitalizations and three IOPs (Intensive Outpatient Therapy) I’ve met people on their 10th or 15th hospitalization. Some people are chronically unemployed or on disability. Their illness dictates the course for their life.

It doesn’t necessarily have to be this way.

To make sure I stay stable and highly functioning, I do a number of things:

  1. For the past seven years, I’ve seen my therapist every three weeks and my psychiatrist every three months.
  2. I’m a compliant patient; I take my medicine faithfully and go to all follow-up appointments.
  3. I make time for leisure (reading, hanging out with friends, going out to eat, getting massages, shopping, watching TV, etc.).
  4. For the past year I’ve been getting acupuncture regularly. I’m trying to balance out my reliance on Western medicine with more holistic practices.
  5. I’m protective of my sleep. Not getting enough sleep can trigger depression or mania.
  6. I exercise two to four days per week. There are numerous health benefits gained from exercise.
  7. I try to eat healthy. I can definitely do a better job at this. I saw a nutritionist this summer and have made the dietary changes she suggested.
  8. I try to minimize my stress triggers. Keeping up with all of the paperwork for my job usually takes a toll on me. So I try to manage my procrastination. I don’t always succeed at this. But I’m trying.

A stable life is highly doable. You have to take stock of your life and shape one you’d be proud and happy to live. It is a lot of work. But what in life isn’t?

 

Click here for original article: http://www.huffingtonpost.com/krystal-reddick/how-i-manage-my-bipolar-d_b_5559720.html?utm_hp_ref=healthy-living

PTSD: It’s Not Just for Veterans

When Post-Traumatic Stress Disorder is in the news, it is mostly because of the number of veterans suffering as a result of combat-related trauma. Victims of other kinds of trauma can also suffer from PTSD, though, and often do without realizing it. PTSD mirrors other mental illnesses such as depression and anxiety, and can also present as, “I feel fine,” when really the “feeling fine” rooted in numbness and avoidance.

Click to read more:http://www.huffingtonpost.com/dani-bostick/ptsd-its-not-just-for-veterans_b_8309184.html?ir=Australia

Anxiety and Depression Together

By Hara Estroff Marano
The disorders are two sides of the same coin. Over the past couple of years, clinicians and researchers alike have been moving toward a new conclusion: Depression and anxiety are not two disorders that coexist. They are two faces of one disorder.

Are you anxious or are you depressed? In the world of mental health care, where exact diagnosis dictates treatment, anxiety and depression are regarded as two distinct disorders. But in the world of real people, many suffer from both conditions. In fact, most mood disorders present as a combination of anxiety and depression. Surveys show that 60-70% of those with depression also have anxiety. And half of those with chronic anxiety also have clinically significant symptoms of depression.

The coexistence of anxiety and depression-called comorbidity in the psych biz-carries some serious repercussions. It makes the course of disorder more chronic, it impairs functioning at work and in relationships more, and it substantially raises suicide risk.

Over the past couple of years, clinicians and researchers alike have been moving towards a new conclusion: Depression and anxiety are not two disorders that coexist. They are two faces of one disorder.

“They’re probably two sides of the same coin,” says David Barlow, Ph.D., director of the Center for Anxiety and Related Disorders at Boston University. “The genetics seem to be the same. The neurobiology seems to overlap. The psychological and biological nature of the vulnerability are the same. It just seems that some people with the vulnerability react with anxiety to life stressors. And some people, in addition, go beyond that to become depressed.”

They close down. “Depression seems to be a shutdown,” explains Barlow. “Anxiety is a kind of looking to the future, seeing dangerous things that might happen in the next hour, day or weeks. Depression is all that with the addition of ‘I really don’t think I’m going to be able to cope with this, maybe I’ll just give up.’ It’s shutdown marked by mental, cognitive or behavioral slowing.”

At the core of the double disorder is some shared mechanism gone awry. Research points to overreactivity of the stress response system, which sends into overdrive emotional centers of the brain, including the “fear center” in the amygdala. Negative stimuli make a disproportionate impact and hijack response systems.

Mental health professionals often have difficulty distinguishing anxiety from depression, and to some degree they’re off the hook. The treatments that work best for depression also combat anxiety. Cognitive-behavioral therapy (CBT) gets at response patterns central to both conditions. And the drugs most commonly used against depression, the SSRIs, or selective serotonin reuptake inhibitors, have also been proved effective against an array of anxiety disorders, from social phobia to panic and post-traumatic stress disorder (PTSD). Which drug a patient should get is based more on what he or she can tolerate rather than on symptoms.

And therein lies a problem. According to physicians Edward Shorter of Canada and Peter Tyrer of England, the prevailing view of anxiety and depression as two distinct disorders, with multiple flavors of anxiety, is a “wrong classification” that has led the pharmaceutical industry down a “blind alley.” It’s bad enough that the separation of anxiety and depression lacks clinical relevance. But it’s also “one reason for the big slowdown in drug discovery in psychiatric drugs,” the two contend in a recent article published in the British Medical Journal. It’s difficult to create effective drugs for marketing-driven disease “niches.”

Who is at risk for combined anxiety and depression? There’s definitely a family component. “Looking at [what disorders populate] the family history of a person who presents with either primary anxiety or depression provides a clue to whether he or she will end up with both,” says Joseph Himle, Ph.D., associate director of the anxiety disorders unit at University of Michigan.

The nature of the anxiety disorder also has an influence. Obsessive-compulsive disorder, panic disorder and social phobia are particularly associated with depression. Specific phobias are less so.

Age plays a role, too. A person who develops an anxiety disorder for the first time after age 40 is likely also to have depression, observes Himle. “Someone who develops panic attacks for the first time at age 50 often has a history of depression or is experiencing depression at the same time.”

Usually, anxiety precedes depression, typically by several years. Currently, the average age of onset of any anxiety disorder is late childhood/early adolescence. Psychologist Michael Yapko, Ph.D., contends that presents a huge opportunity for the prevention of depression, as the average age of first onset is now mid-20s. “A young person is not likely to outgrow anxiety unless treated and taught cognitive skills,” he says. “But aggressive treatment of the anxiety when it appears can prevent the subsequent development of depression.”

“The shared cornerstone of anxiety and depression is the perceptual process of overestimating the risk in a situation and underestimating personal resources for coping.” Those vulnerable see lots of risk in everyday things-applying for a job, asking for a favor, asking for a date.

Further, anxiety and depression share an avoidant coping style. Sufferers avoid what they fear instead of developing the skills to handle the kinds of situations that make them uncomfortable. Often enough a lack of social skills is at the root.

In fact, says Jerilyn Ross, LICSW, president of the Anxiety Disorders Association of America, the link between social phobia and depression is “dramatic. It often affects young people who can’t go out, can’t date, don’t have friends. They’re very isolated, all alone, and feel cut off.”

Sometimes anxiety is dispositional, and sometimes it’s transmitted to children by parental overconcern. “The largest group of depression/anxiety sufferers is Baby Boomers,” says Yapko. “The fastest growing group is their children. They can’t teach kids what they don’t know. Plus their desire to raise perfect children puts tremendous pressures on the kids. They’re creating a bumper crop of anxious/depressed children.”

Treatment seldom hinges on which disorder came first. “In many cases,” says Ross, “the depression exists because the anxiety is so draining. Once you treat the anxiety, the depression lifts.”

In practice, treatment is targeted at depression and anxiety simultaneously. “There’s increasing interest in treating both disorders at the same time,” reports Himle. “Cognitive behavioral therapy is particularly attractive because it has applications to both.”

Studies show that it is effective against both. But sometimes the depression is so incapacitating that it has to be tackled first. Depression, for example, typically interferes with exposure therapy for anxiety, in which people confront in a graduated way situations they avoid because they give rise to overwhelming fear.

“Exposure therapy requires substantial effort,” explains Himle. “That’s effort that depressed people often do not have available to them.” Antidepressants can make a difference. Most SSRIs are approved for use in anxiety disorders and are the first line of drug therapy. But which drug works best for whom can not be predicted in advance. It takes some trial and error.

Ross finds CBT 80-90% successful in getting people functioning well, “provided it’s done correctly.” Not all psychotherapy is CBT, which has a very specific set of procedures, nor is every mental health professional trained in CBT. “Patients have to make sure that is what they are really getting.”

Medication and CBT are equally effective in reducing anxiety/depression. But CBT is better at preventing relapse, and it creates greater patient satisfaction. “It’s more empowering,” says Yapko. “Patients like feeling responsible for their own success.” Further, new data suggests that the active coping CBT encourages creates new brain circuits that circumvent the dysfunctional response pathways.

Treatment averages 12 to 15 weeks, and patients can expect to see significant improvement by six weeks. “CBT doesn’t involve years and years of talk therapy,” says Ross. “There’s homework, practice and development of lifestyle changes. Once patients learn how to identify the trigger thoughts or feelings, or events or people, they need to keep doing that. CBT gives people the tools they need.”

Original post:

https://www.psychologytoday.com/articles/200310/anxiety-and-depression-together

What is Obsessive-compulsive disorder (OCD)?

Original article: http://www.mind.org.uk/information-support/types-of-mental-health-problems/obsessive-compulsive-disorder-ocd/about-obsessive-compulsive-disorder/#.Vd9PBX0jnm4

 

Obsessive-compulsive disorder (OCD) is described as an anxiety disorder. The condition has two main parts: obsessions and compulsions.

Obsessions

Obsessions are unwelcome thoughts, images, urges or doubts that repeatedly appear in your mind; for example, thinking that you have been contaminated by dirt and germs, or experiencing a sudden urge to hurt someone.

These obsessions are often frightening or seem so horrible that you can’t share them with others. The obsession interrupts your other thoughts and makes you feel very anxious.

I get unwanted thoughts all through the day, which is very distressing and affects my ability to interact with others and concentrate on my studies and work.

Compulsions

Compulsions are repetitive activities that you feel you have to do. This could be something like repeatedly checking a door to make sure it is locked or repeating a specific phrase in your head to prevent harm coming to a loved one.

The aim of a compulsion is to try and deal with the distress caused by the obsessive thoughts and relieve the anxiety you are feeling. However, the process of repeating these compulsions is often distressing and any relief you feel is often short-lived.

Getting ready for each day involves so much hand washing, mental rituals, and doing things in the same order everyday… Sometimes, I feel like staying in bed and avoiding the day.

The OCD cycle

The diagram below shows how obsessions and compulsions are connected
in an OCD cycle.

OCD Pg5

Living with OCD

Although many people experience minor obsessions (e.g. worrying about leaving the gas on, or if the door is locked) and compulsions (e.g. rituals, like avoiding the cracks in the pavement), these don’t significantly interfere with their daily lives, or are short-lived.

If you experience OCD, your obsessions and compulsions will cause you considerable fear and distress. They will also take up a significant amount of time, and disrupt your ability to carry on with your day-to-day to life, including doing daily chores, going to work, or maintaining relationships with friends and family.

Many people with OCD experience feelings of shame and loneliness which often stop them from seeking help, particularly if they experience distressing thoughts about subjects such as religion, sex or violence.

This means that many people try to cope with OCD alone, until the symptoms are so severe they can’t hide them anymore.

OCD is also known to have a close association with depression, and some people find obsessions appear or get worse when they are depressed.

What’s it like living with OCD?

Watch James, Pat and Nicola talk about what living with OCD is like, and ways they have learned to cope.

What are the common signs of OCD?

Although everyone will have their own experiences, there are several
common obsessions and compulsions that occur as part of OCD.

Common obsessions

The three most common themes are:

  • unwanted thoughts about harm or aggression
  • unwanted sexual thoughts
  • unwanted blasphemous thoughts

Obsessions often appear closely linked to your individual situation. For example, if you are a loving parent, you may fear doing harm to a child and if you are religious, you may have blasphemous thoughts.

I have OCD harming thoughts and the compulsion to carry them out, which is absolutely terrifying to say the least.

Some examples of obsessions include:

• a fear of failing to prevent harm – e.g. worrying that you have left
the cooker on and might cause a fire
• imagining doing harm – e.g. thinking that you are going to push
someone in front of a train
• intrusive sexual thoughts – e.g. worrying about abusing a child
• religious or blasphemous thoughts – e.g. having thoughts that are
against your religious beliefs
• fear of contamination – e.g. from dirt and germs in a toilet
• an excessive concern with order or symmetry – e.g. worrying if objects
are not in order
• illness or physical symptoms – e.g. thinking that you have cancer
when you have no symptoms.

Common compulsions

Common compulsions include physical compulsions, e.g. washing or checking, or mental compulsions, e.g. repeating a specific word or phrase.

I have to keep checking things three times and have to have certain items on me to help me feel safe.

Some examples might be:

  • repeating actions – e.g. touching every light switch in the house every time you leave or enter the house
  • touching – e.g. only buying things in the supermarket that you have touched with both hands
  • focusing on a number – e.g. having to buy three of everything
  • washing or cleaning – e.g. having to wash your hands very frequently in  order to feel clean
  • checking – e.g. reading through an email ten times before sending it
  • ordering or arranging – e.g. keeping food organised by colour in the fridge
  • repeating a specific word or phrase – e.g. repeating someone’s name in order to prevent something bad happening to them
  • praying – e.g. repeating a prayer again and again whenever you hear about an accident
  • counteracting or neutralising a negative thought with a positive one – e.g. replacing a bad word with a good one.

Avoidance

You might find that some objects or experiences make your obsessions or
compulsions worse, and you try to avoid them as a result. For example,
if you fear contamination, you might avoid eating and drinking anywhere
except in your own home. Avoiding things can have a major impact on
your life.

OCD means that I miss out on things because I [stay in] to try to protect myself from the stress. It’s sunny outside and I want to go out, but I know I probably won’t.

Obsessive Compulsive Disorder quote 4

Loving you sometimes means I cannot walk next to the things that can make you sick,

and at the same time walk next to you,

I have to protect you from germs.

I know it don’ t make sense to you,

but to me, it does.

Hope you understand.

OCD: Symptoms, Signs & Risk Factors

Written by Ann Pietrangelo

OCD: Symptoms, Signs & Risk Factors

We all double or triple check something on occasion. We forget if we’ve locked the door or wonder if we’ve left the water running, and we want to be certain. Some of us are perfectionists, so we go over our work several times to make sure it’s right. That’s not abnormal behavior. But if you have obsessive-compulsive disorder (OCD), you feel compelled to act out certain rituals repeatedly, even if you don’t want to — and even if it complicates your life unnecessarily.

Obsessions are the worrisome thoughts that cause anxiety. Compulsions are the behaviors you use to relieve that anxiety.

Signs and Symptoms of OCD

Signs of OCD usually become apparent in childhood or early adulthood. It tends to begin slowly and become more intense as you mature. For many people, symptoms come and go, but it’s usually a lifelong problem. In severe cases, it has a profound impact on quality of life. Without treatment, it can become quite disabling.

Some common obsessions associated with OCD include:

  • anxiety about germs and dirt, or fear of contamination
  • need for symmetry and order
  • concern that your thoughts or compulsions will harm others, feeling you can keep other people safe by performing certain rituals
  • worry about discarding things of little or no value
  • disturbing thoughts or images about yourself or others

Some of the behaviors that stem from these obsessive thoughts include:

  • excessive hand washing, repetitive showering, unnecessary household cleaning
  • continually arranging and reordering things to get them just right
  • checking the same things over and over even though you know you’ve already checked them
  • hoarding unnecessary material possessions like old newspapers and used wrapping paper rather than throwing them away
  • counting or repeating a particular word or phrase. Performing a ritual like having to touch something a certain number of times or take a particular number of steps
  • focusing on positive thoughts to combat the bad thoughts

Social Signs: What to Look For

Some people with OCD manage to mask their behaviors so they’re less obvious. For others, social situations trigger compulsions. Some things you might notice in a person with OCD:

  • raw hands from too much hand washing
  • fear of shaking hands or touching things in public
  • avoidance of certain situations that trigger obsessive thoughts
  • intense anxiety when things are not orderly or symmetrical
  • need to check the same things over and over
  • constant need for reassurance
  • inability to break routine
  • counting for no reason or repeating the same word, phrase, or action
  • at least an hour each day is spent on unwanted thoughts or rituals
  • having trouble getting to work on time or keeping to a schedule due to rituals

Since OCD often begins in childhood, teachers may be the first to notice signs in school. A child who is compelled to count, for instance, may not be able to complete the ritual. The stress can cause angry outbursts and other misbehaviors. One who is afraid of germs may be fearful of playing with other children. A child with OCD may fear they are crazy. Obsessions and compulsions can interfere with schoolwork and lead to poor academic performance.

Children with OCD may have trouble expressing themselves. They may be inflexible and upset when plans change. Their discomfort in social situations can make it difficult to make friends and maintain friendships. In an attempt to mask their compulsions, children with OCD may withdraw socially. Isolation increases the risk for depression.

Risk Factors and Complications

The cause of OCD is not known. It seems to run in families, but there may be environmental factors involved. Most of the time, symptoms of OCD occur before age 25.

If you have OCD, you’re also at increased risk of other anxiety disorders, including major depression and social phobias.

Just because you like things a certain way or arrange your spice rack in alphabetical order, it doesn’t mean you have OCD. However, if obsessive thoughts or ritualistic behavior feels out of your control or are interfering with your life, it’s time to seek treatment.

Treatment usually involves psychotherapy, behavioral modification therapy, or psychiatric medications, alone or in combination. According to Harvard Medical School, with treatment, approximately 10 percent of patients fully recover and about half of patients show some improvement.

Original post: http://www.healthline.com/health/ocd/social-signs