tag:blogger.com,1999:blog-6370037552262220822024-03-16T11:53:08.572-07:00Bipolar 101Focused on distilling the latest scientific findings on bipolar disorder into everyday language with some other bipolar disorder 'stuff' to keep it light.crazygirlhttp://www.blogger.com/profile/14814752703102263063noreply@blogger.comBlogger38125tag:blogger.com,1999:blog-637003755226222082.post-28405276478678492222016-10-25T14:29:00.002-07:002016-10-26T10:59:04.303-07:00Mental Health Prescription: NatureI love to travel. It satiates my curiousity about the world and it disrupts the monotony that can accompany daily life. And when I travel, exploring the natural world is always on my agenda; whether it is an urban garden or outlying areas of unspoiled nature.<br />
<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-0MyhOCYiNRvciZcttUfx_y-KRCjbcYWfLefv0FAgXxo8-I44h5BtRfh4zFQCCg1P36zsYn9NNqo-LlmNwNJOzvMR473-xLDLlWgYkeDE8wGvPGjU0H0Zmi_ppYNBTk4krXInj-BdP-Y_/s1600/woodlandcreek.JPG" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-0MyhOCYiNRvciZcttUfx_y-KRCjbcYWfLefv0FAgXxo8-I44h5BtRfh4zFQCCg1P36zsYn9NNqo-LlmNwNJOzvMR473-xLDLlWgYkeDE8wGvPGjU0H0Zmi_ppYNBTk4krXInj-BdP-Y_/s320/woodlandcreek.JPG" width="240" /></a></div>
Travel also serves as a way to de-stress because I disconnect from the usual demands of my home base. One of my favorite ways to stay healthy on the road and at home - both physically and mentally - is to go for a hike. Walking in nature is a powerful mood stabilizer with great side effects. Instead of the long litany of negative side effects that often come with taking medications for mental health, walking outside comes with a great list of benefits: reduced risk of heart disease, hypertension, diabetes and some forms of cancer and is a great way to reach and maintain a healthy weight.<br />
<br />
A recent study* by Stanford researchers published in the Proceedings of the National Academy of Science (July 2015) found that walking in nature served as an anti-depressant. The study wanted to explore why it is that people who live in urban areas have a much higher risk of mental illness. This has been a consistent finding but the cause/effect relationship is unclear. For example, city dwellers have a 20% increased risk of anxiety and a 40% increased risk of mood disorders as compared to people who live in rural areas**.<br />
<br />
<a href="http://www.pnas.org/content/112/28/8567.abstract" target="_blank">The study</a> assigned one group of people to walk in a grassland area with trees and another group to walk along a busy 4-lane urban road. They found little to no impact on physiological conditions but marked differences in the brain. Those who walked in nature had a lot less activity in the area of the brain that is active when people focus on negative emotions.<br />
<br />
So the takeaway for people with bipolar disorder: Take a hike! Get your mind and body healthy by going outside and enjoying the positive benefits for your mind and your body.<br />
<br />
*Bratman, GN, Hamilton, JP, Hahn, KS, Daily GC, & Gross, JJ. (2015). Nature experiences reduces rumination and subgenual prefrontal cortex activation. Proceedings of the National Academy of Science, 112 (28), 8567-8572.<br />
**<a href="http://news.stanford.edu/2015/06/30/hiking-mental-health-063015/" target="_blank">Jordan, R. (2015). Stanford researchers find mental health prescription: Nature. Stanford News, June 30</a>.<br />
Photo credit: I took this picture on a recent trip to Glacier National Park with my daughter.<br />
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<br />
<a href="http://www.womenshealthmag.com/health/ruth-white-bipolar-disorder" target="_blank">My Bipolar Disorder was misdiagnosed as ADHD</a>, Women's Health, May 2016<br />
<br />
<a href="http://www.vh1.com/news/261723/bipolar-disorder-hollywood-misconceptions/" target="_blank">Here's what Hollywood gets wrong about bipolar disorder</a>, Vh1, May 5, 2016<br />
<br />
<a href="http://www.womenshealthmag.com/health/mental-health-awareness" target="_blank">Women's Health magazine feature on mental health awareness</a>, May 2016<br />
<a href="http://www.matermea.com/blog/mental-illness-is-not-a-white-person-disorder" target="_blank"><br /></a><a href="http://www.matermea.com/blog/mental-illness-is-not-a-white-person-disorder" target="_blank">Mental illness is not a "white person disorder"</a>, Mater Mea, May 2016<br />
<br />
<a href="https://www.nami.org/" target="_blank">National Alliance on Mental Illness</a><div class="blogger-post-footer"><form Method="POST"
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Hirschfeld, R. M. (2014). Differential diagnosis of bipolar disorder and major depressive disorder. <i>Journal of Affective Disorders, 169</i>(S1), S12-S16.<br />
<br />
<b>Summary & Overview</b><br />
In this article the author - a leading scholar of bipolar disorder - discusses the challenges of differentiating between bipolar disorder and major depressive disorder. Prevalence of unipolar depression is almost four times that of the range of bipolar disorders (including bipolar disorder I, bipolar disorder II and sub-threshold bipolar disorder).<br />
<br />
The major challenge is that people with bipolar disorder tend to experience more depressive symptoms than symptoms of mania or hypomania and are much more likely to seek help when experiencing the lows of depression than when they are experiencing the highs of mania or hypomania. Several studies referenced in this article found that many people suffering from depression have undiagnosed bipolar disorder.<br />
<br />
Therefore, if someone is seeking help for the first time it is important to differentiate between bipolar disorder and depression because anti-depressants alone are not helpful for people with bipolar disorder and are best used in combination with mood stabilizers; even then anti-depressants are not very effective. Furthermore, there is considerable debate about whether or not anti-depressants can cause destabilization or manic symptoms in people with bipolar disorder.<br />
<br />
<b>Symptomatic and Experiential Differences</b><br />
The possible indicators of bipolar disorder in depressed patients include: earlier onset of symptoms, a family history of bipolar disorder, seasonality (with depression more likely in the winter months), mixed states, history of hospitalization, history of treatment-resistant depression, numerous past episodes, mood reactivity, switching on anti-depressants, more likely to experience psychosis and cognitive impairment, and are more likely to have a history of suicide attempts.<br />
<br />
<b>Screening and Diagnosis</b><br />
The most popular screening tool for bipolar disorder is the 15-question <b>Mood Disorder Questionnaire</b> (MDQ) that takes approximately 5 minutes <i>for the patient to complete</i>. However, it is a <i>screening</i> tool and not a <i>diagnostic</i> instrument. The MDQ measures <i>lifetime</i> symptoms of hypomania and mania. It has been translated into 19 languages and has been cited in more than 600 publications. It correctly identifies 75% of people with bipolar disorder and screens out 90% of people without the illness.<br />
<br />
The <b>Hypomania/Mania Checklist</b> (HCL-32) has 34 <i>self-report</i> questions that are completed in less than 10 minutes and assesses <i>lifetime symptoms</i> of mania and hypomania and will correctly identify 80% of patients with bipolar disorder and screen out 51% of people without the illness.<br />
<br />
Another self-report instrument is the <b>Patient Health Questionnaire</b> (PHQ-9) which has 9 questions - that can be <i>completed by the patient </i>in less than 5 minutes - that assess <i>current</i> depressive symptoms. It correctly identifies 88% of cases of major depression and screens out 88% of people without symptoms. The author suggests that this is the best tool to measure depression among general patient populations because it is so short and so widely used.<br />
<br />
The <b>Beck Depression Inventory</b> (BDI) is a widely-used 21-question (in the main version) instrument that screens for symptoms of depression and takes less than 10 minutes to complete.<br />
<br />
The <b>Inventory of Depressive Symptomology</b> (IDS-SR) is a 30-item <i>self-report</i> questionnaire and the <b>Quick Inventory of Depressive Symptomology</b> (QIDS) is a 16-item version. Both instruments measure symptoms of depression and can be completed by a clinician or by the patient.<br />
<br />
Included in this article is a table (Table 3) that compares all of the above instruments and 2 other <i>clinician-rated</i> scales. The <b>Hamilton Depression Rating Scale</b> (HAM-D) has 21 questions that are <i>completed by a clinician</i> and takes less than 20 minutes to administer. It assesses <i>current</i> depressive symptoms and has several different versions. The <b>Montgomery-Asberg Depression Rating Scale</b> (MADRS) is a 10-question scale that takes less than 10 minutes for a <i>clinician</i> to assess <i>current</i> depressive symptoms.<br />
<br />
The PHQ-9, BDI, HAM-D and MADRS <b>do not</b> distinguish between bipolar and unipolar depressive symptoms.<br />
<br />
<b>Conclusion</b><br />
Understanding the difference between instruments can help inform your discussion with clinicians about assessing symptoms and making the correct diagnosis.<!--20--><div class="blogger-post-footer"><form Method="POST"
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<br />
<a href="http://www.theguardian.com/society/2014/aug/15/suicide-silence-depressed-men" target="_blank">Suicide and Silence: Why depressed men are dying for someone to talk to</a><br />
by Owen Jones, The Guardian, Friday 15 August, 2014<div class="blogger-post-footer"><form Method="POST"
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<br />
<a href="http://www.psychologytoday.com/blog/mental-wealth/201407/dose-matters-exercise-antidepressant" target="_blank">Dose Matters: Exercise as Anti-depressant</a> by Dr. Victoria L. Dunckley - a board-certified psychiatrist.<br />
<br />
Quotes:<br />
<span style="background-color: white; font-family: Arial, helvetica, sans-serif; font-size: 13.63636302947998px; line-height: 20px;">"Interestingly, in a recent </span><a class="ext" href="http://www.recurrentdepression.com/site/more/1295/" style="background-color: white; color: #333333; font-family: Arial, helvetica, sans-serif; font-size: 13.63636302947998px; line-height: 20px;" target="_blank">study</a><span class="ext" style="background: url(http://assets.sussexpublishers.netdna-cdn.com/sites/all/modules/contrib/extlink/extlink.png) 100% 50% no-repeat rgb(255, 255, 255); font-family: Arial, helvetica, sans-serif; font-size: 13.63636302947998px; line-height: 20px; padding-right: 12px;"></span><span style="background-color: white; font-family: Arial, helvetica, sans-serif; font-size: 13.63636302947998px; line-height: 20px;"> in which patients were assigned to </span><a class="pt-basics-link" href="http://www.psychologytoday.com/basics/ssris" style="background-color: white; border-bottom-color: rgb(153, 153, 153); border-bottom-style: dashed; border-bottom-width: 1px; color: #333333; font-family: Arial, helvetica, sans-serif; font-size: 13.63636302947998px; line-height: 20px; text-decoration: none;" title="Psychology Today looks at SSRIs">antidepressant</a><span style="background-color: white; font-family: Arial, helvetica, sans-serif; font-size: 13.63636302947998px; line-height: 20px;"> </span><a class="pt-basics-link" href="http://www.psychologytoday.com/basics/psychopharmacology" style="background-color: white; border-bottom-color: rgb(153, 153, 153); border-bottom-style: dashed; border-bottom-width: 1px; color: #333333; font-family: Arial, helvetica, sans-serif; font-size: 13.63636302947998px; line-height: 20px; text-decoration: none;" title="Psychology Today looks at Psychopharmacology">medication</a><span style="background-color: white; font-family: Arial, helvetica, sans-serif; font-size: 13.63636302947998px; line-height: 20px;">, exercise, or combined medication plus exercise, the combination treatment did not appear to provide any additional benefit than exercise alone—which was equivalent to the medication effect (sertraline, brand-name Zoloft was used). In fact, when researchers looked at 6-month relapse rates, the exercise-only group did better than the combination group. (only 9% had relapsed compared to 30% in the other two groups.)"</span><br />
<span style="background-color: white; font-family: Arial, helvetica, sans-serif; font-size: 13.63636302947998px; line-height: 20px;"><br /></span>
<span style="background-color: white; font-family: Arial, helvetica, sans-serif; font-size: 13.63636302947998px; line-height: 20px;">"...</span><span style="background-color: white; font-family: Arial, helvetica, sans-serif; font-size: 13.63636302947998px; line-height: 20px;">based on other </span><a class="ext" href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3131723/" style="background-color: white; color: #333333; font-family: Arial, helvetica, sans-serif; font-size: 13.63636302947998px; line-height: 20px;" target="_blank">research</a><span class="ext" style="background: url(http://assets.sussexpublishers.netdna-cdn.com/sites/all/modules/contrib/extlink/extlink.png) 100% 50% no-repeat rgb(255, 255, 255); font-family: Arial, helvetica, sans-serif; font-size: 13.63636302947998px; line-height: 20px; padding-right: 12px;"></span><span style="background-color: white; font-family: Arial, helvetica, sans-serif; font-size: 13.63636302947998px; line-height: 20px;"> regarding the beneficial of morning bright-light exposure on mood and </span><a class="pt-basics-link" href="http://www.psychologytoday.com/basics/sleep" style="background-color: white; border-bottom-color: rgb(153, 153, 153); border-bottom-style: dashed; border-bottom-width: 1px; color: #333333; font-family: Arial, helvetica, sans-serif; font-size: 13.63636302947998px; line-height: 20px; text-decoration: none;" title="Psychology Today looks at Sleep">sleep</a><span style="background-color: white; font-family: Arial, helvetica, sans-serif; font-size: 13.63636302947998px; line-height: 20px;"> quality, that an outdoor workout in the morning will augment exercise’s effect even further."</span><div class="blogger-post-footer"><form Method="POST"
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<br />
<div class="MsoBodyTextIndent">
<span style="font-family: "Times New Roman";">Several
studies have shown that social support from friends and family is important to
preventing bipolar disorder. Studies seem to be biased towards the impact of
social support on depression, probably because people with mania are less
likely to seek help. The onset of symptoms can be accompanied by social
behaviors such as irritability, anxiety and anger that impact social
relationships and negative social relationships can exacerbate or trigger mood
changes creating a downward spiral. Some studies of the link between social
support and bipolar disorder is discussed below to demonstrate the evidence for
making a case for seeking and maintaining a social support network that will
improve your overall mental health and prevent and reduce the impact of
symptoms of both mania and depression.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent">
<span style="font-family: "Times New Roman";"><br /></span></div>
<div class="MsoBodyTextIndent">
<span style="font-family: "Times New Roman";">A study
of social support and social strain (Eidelman et al, 2012) compared people
living with bipolar disorder and people without a mental illness (control
group) for 28 days using journals. The bipolar disorder group had lower
measures of social support and more social strain that the control group. Manic
and depressive symptoms in the bipolar disorder group were increased the more
social strain they experienced. Social support was also associated with more
stable sleep in people living with bipolar disorder.<o:p></o:p></span></div>
<div class="MsoBodyTextIndent">
<span style="font-family: "Times New Roman";"><br /></span></div>
<div class="MsoBodyTextIndent">
<span style="font-family: "Times New Roman";">Another
study of social support and mood symptoms (Pratchett, 2010) among
high-functioning people living with bipolar disorder showed that lower levels
of perceived social social support was related to more severe symptoms of lower
mood and higher mood, and to persistence of these symptoms 6 months later,
regardless of age, marital status, income or gender. <o:p></o:p></span></div>
<div class="MsoBodyTextIndent">
<span style="font-family: "Times New Roman";"><br /></span></div>
<div class="MsoBodyTextIndent">
<span style="font-family: "Times New Roman";">Unsupportive
social networks have also been found to increase the likelihood of medication
non-adherence (Sajatovic et al., 2011). A study of unipolar and bipolar
disorders found differences in the functioning of social networks between the two
groups but found that stabilizing supportive relationships should be a goal of
psychotherapy because both groups had minimal social networks and relied on one
primary person for all their social support (Poradowska-Trosz, Dudek, Rogoz and
Zieba, 2009).<o:p></o:p></span></div>
<div class="MsoBodyTextIndent">
<span style="font-family: "Times New Roman";"><br /></span></div>
<div class="MsoBodyTextIndent">
<span style="font-family: "Times New Roman";">Self-esteem
has also been shown to be a mediating factor through which social support is
expressed<b>. </b><span style="mso-bidi-font-weight: bold;">This means that
people with higher self-esteem are more likely to seek out social support and
to have more friends. It also means that people with higher self-esteem are
more open to the social support that a strong network of friends provide</span>.
<o:p></o:p></span></div>
<div class="MsoBodyTextIndent">
<span style="font-family: "Times New Roman";"><br /></span></div>
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<span style="font-family: "Times New Roman";">For
adolescents with bipolar disorder it appears that family relationships are
important to onset and continuation of symptoms (Sullivan et al, 2012). Family
conflict, adaptability and lack of cohesion are predictors of adolescent mood
symptoms<b>. </b>The authors suggest that family conflict be a focus of
psychosocial intervention in early onset bipolar disorder.<o:p></o:p></span></div>
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<span style="font-family: Times New Roman;"><b>REFERENCES</b></span></div>
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<span style="font-size: 12.0pt; line-height: 200%;">Poradowska-Trzos,
Magdalena, Dominika Dudek, Monika Rogoż, and Andrzej Zięba, "The
comparison of social networks of patients with unipolar and bipolar affective
disorder." <i>Archives Of Psychiatry & Psychotherapy</i> 11
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<span style="font-size: 12.0pt; line-height: 200%;">Sajatovic, M., M.
Valenstein and F. Blow, “Treatment adherence with antipsychotic medications in
bipolar disorder”, <i>Bipolar Disorders</i><span style="mso-bidi-font-style: italic;"> 8 </span>(2006): 232 – 241.</span></div>
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adolescent bipolar disorder”, </span><i style="font-size: 12pt; line-height: 200%; text-indent: -0.5in;">Behavior
Therapy, </i><span style="font-size: 12pt; line-height: 200%; text-indent: -0.5in;">43 (2012): 837-847.</span></div>
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On Wednesday, June 4 from 9-10am Pacific I lead a webinar on strategies that prevent bipolar relapse that are taken from my book, Preventing Bipolar Disorder (New Harbinger, 2014) and distilled into a 1-hour presentation. The webinar is sponsored by the <a href="http://ibpf.org/" target="_blank">International Bipolar Foundation</a> and is titled: SNAP: A simple 4-step plan for preventing bipolar relapse. The science-based presentation focused on: good sleep hygiene, a healthy diet that includes good mood foods, a routine of physical activity, and the development and maintenance of a healthy support network.<br />
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To view/listen <a href="http://live-ibpf.gotpantheon.com/snap-simple-4-step-plan-preventing-bipolar-relapse-dr-ruth-white-6-4-14-900-am" target="_blank">click here.</a><br />
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Take the time to make room in your life to do the things that promote mental well being. The four key paths are better sleep, good nutrition, regular exercise and healthy interpersonal relationships. If you have bipolar disorder, you may want to check out my books and learn more about the disorder and how to prevent and manage symptoms and promote a stable emotional and psychological state.<br />
<br />
Also take time to participate in this month's events in your local area that promote increased access to services, the elimination of stigma and the increased knowledge and awareness of mental health.<div class="blogger-post-footer"><form Method="POST"
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All the writing about sleep, nutrition, exercise and interpersonal relationships has evolved into a program called SNAP (Sleep, Nutrition, Activity, People) and into a new book to be published in May by New Harbinger Press: Preventing Bipolar Relapse, that seeks to reduce the likelihood, frequency and intensity of bipolar episodes.<br />
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Click on the links below to order yours now:<br />
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<a href="https://www.newharbinger.com/preventing-bipolar-relapse" target="_blank">Preventing Bipolar Relapse</a> (New Harbinger Press)<br />
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<a href="http://www.amazon.com/Preventing-Bipolar-Relapse-Lifestyle-Maintain/dp/1608828816/ref=sr_1_1?s=books&ie=UTF8&qid=1393799138&sr=1-1&keywords=preventing+bipolar+relapse" target="_blank">Preventing Bipolar Relapse</a> (Amazon)<br />
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From the publisher's website:<br />
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<div style="border: 0px; color: #252525; font-family: ProximaNova-Regular, Arial; font-size: 14px; line-height: 21px; margin-bottom: 20px; outline: 0px; padding: 0px; vertical-align: baseline;">
"If you buy just one book on bipolar disorder, let this be it.</div>
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There's an old saying: “Prevention is better than cure.” If you have bipolar disorder, this is especially true. For you, it's incredibly important to read the warning signs of a possible episode. For instance, you may find you are not sleeping as well as usual, or you might be sleeping too much. You may stop doing things that you normally enjoy, or you may start acting out your impulses in ways that alienate those around you or get you into trouble.</div>
<div style="border: 0px; color: #252525; font-family: ProximaNova-Regular, Arial; font-size: 14px; line-height: 21px; margin-bottom: 20px; outline: 0px; padding: 0px; vertical-align: baseline;">
While the path to wellness for those with bipolar may involve psychiatric visits and medication adjustments, preventing manic and depressive episodes is the true key to staying healthy and happy. So how do you do it? And most importantly, how can you keep yourself motivated?</div>
<div style="border: 0px; color: #252525; font-family: ProximaNova-Regular, Arial; font-size: 14px; line-height: 21px; margin-bottom: 20px; outline: 0px; padding: 0px; vertical-align: baseline;">
In this powerful, breakthrough book, bipolar expert Ruth C. White shares her own personal approach to relapse prevention using the innovative program SNAP (Sleep, Nutrition, Activity, and People). White also offers practical tips and tracking tools you can use anytime, anywhere. By making necessary lifestyle adjustments, you can maintain balanced moods, recognize the warning signs of an oncoming episode, and make the necessary changes to reduce or prevent it.</div>
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This is the first and only book on bipolar disorder that focuses exclusively on prevention. To help you stay well, White includes links to helpful online tracking tools so that you can manage your symptoms, anytime, anywhere. If you are ready to stop living in fear of your next episode, this life-changing book can help you take charge of your diagnosis-and your life."</div>
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<span style="font-size: 14px;">“</span><span style="border: 0px; font-family: ProximaNova-RegularIt; font-size: 14px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Preventing Bipolar Relapse</span><span style="font-size: 14px;"> is an essential guide for the consumer and caregiver alike. White's SNAP approach gives the reader an easy method to successfully navigate the complexities of bipolar disorder. Her personal experience offers hope, encouragement, and the tools to prevent relapse.”</span><br />
<span style="font-size: 14px;">-</span><strong style="border: 0px; font-size: 14px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">Muffy Walker, MSN, MBA</strong><span style="font-size: 14px;">, founder and chairman of the board at the International Bipolar Foundation</span></div>
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Click on the link below to hear the interview and read the highlights:<br />
<span style="-webkit-composition-fill-color: rgba(175, 192, 227, 0.230469); -webkit-composition-frame-color: rgba(77, 128, 180, 0.230469); -webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); font-family: '.HelveticaNeueUI'; font-size: 15px; line-height: 19px; white-space: nowrap;">http://m.npr.org/programs/all/13/212276021</span><br />
<blockquote class="tr_bq">
<span style="-webkit-composition-fill-color: rgba(175, 192, 227, 0.230469); -webkit-composition-frame-color: rgba(77, 128, 180, 0.230469); -webkit-tap-highlight-color: rgba(26, 26, 26, 0.296875); font-family: '.HelveticaNeueUI'; font-size: 15px; line-height: 19px; white-space: nowrap;"><br /></span></blockquote>
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Written by someone with bipolar disorder who had several hospitalizations she writes about what happens to the self in the treatment of bipolar disorder.<br />
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For the article click the link below:<br />
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<a href="http://www.nytimes.com/2013/04/28/magazine/the-problem-with-how-we-treat-bipolar-disorder.html?pagewanted=all&_r=0" target="_blank">The Problem with how we Treat Bipolar Disorder</a><br />
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Though I haven't seen it, the stories in one film would seem to be the first time one film covers a wide range of mental illness from a wide range of perspectives. So I thought it was worth the publicity and tentative endorsement.<br />
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ABOUT CALL ME CRAZY: A FIVE FILM<br />
Lifetime 4/20 8pm<br />
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Written by Deirdre O'Connor (Five) and directed by Howard, Lucy follows the film's title character (Snow), a law student who finds herself amidst the horror of schizophrenia, landing her in an institution where, through the support of a new friend (Ritter), meds and her psychotherapist (Spencer), she begins her path to not only healing, but a promising future. Lucy also features Clint Howard (Fringe).<br />
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Grace, directed by Maguire and written by Howard J. Morris (Five), explores bipolar disorder through the experience of a teenage daughter (Hyland) whose mother (Leo) grapples with the condition. Also starring in Grace are Melissa Farman (Temple Grandin) and Aimee Teegarden (Friday Night Lights).<br />
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Allison weaves together comedy and family drama in a story about healing when its eldest daughter "Lucy" (Snow) returns home from inpatient treatment and spoils her sister "Allison's" (Vassilieva) unveiling of her new boyfriend to their parents (real-life wife and husband Smart and Richard Gilliland, Desperate Housewives). Allison, also featuring Ken Baumann (The Secret Life of an American Teenager), was written by Jan Oxenberg (Parenthood) and is directed by Dern.<br />
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Eddie, directed by Hunt and written by Stephan Godchaux (Five), delves into the world of depression as seen through the eyes of a comedian's wife (Thompson) as she grapples with understanding how her husband Eddie (Mitch Rouse, According to Jim), whom is so loved, can be so withdrawn and overcome with sadness. The short also stars Handler and features appearances by Dave Foley (The Kids in the Hall), Jay Chandrasekhar (Super Troopers), James Avery (The Closer) and Ross Mathews (Chelsea Lately).<br />
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In Maggie, penned by Erin Cressida Wilson (Secretary) and directed by Judd, a female veteran (Hudson) returns home from war to her son and father (Ernie Hudson), only to have her life shattered by the onset of posttraumatic stress disorder, through which her lawyer, "Lucy," helps her. Griffith also stars in Maggie.<div class="blogger-post-footer"><form Method="POST"
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<span style="font-family: "Times New Roman";">Exercise is well-known to influence both physical and mental health. The articles reviewed in this post are specific to the impact of exercise on mental health and the symptoms of bipolar disorder. These articles show that people living with bipolar disorder are more likely to be overweight and to have poor eating habits. The implications of these studies is that people living with bipolar disorder must develop good eating habits and a routing habit of physical activity.</span></div>
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<span style="font-family: "Times New Roman";">Kilbourne, Amy M., Dana L. Rofey, John F. McCarthy, Edward P. Post, Deborah Welsh, and Frederic C. Blow. 2007. "Nutrition and exercise behavior among patients with bipolar disorder." <i>Bipolar Disorders</i> 9, no. 5: 443-452.<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman";"><i>Objectives</i>: There have been few comprehensive studies of nutrition and exercise behaviors among patients with bipolar disorder (BPD). Based on a national sample of patients receiving care in the Veterans Affairs (VA) health care system, we compared nutrition and exercise behaviors among individuals diagnosed with BPD, others diagnosed with schizophrenia, and others who did not receive diagnoses of serious mental illness (SMI). <i>Methods</i>: A cross-sectional study of patients who completed the VA's Large Health Survey of Veteran Enrollees section on health and nutrition in fiscal year (FY) 1999 and who either received a diagnosis of BPD (n = 2,032) or schizophrenia (n = 1,895), or were included in a random sample of non-SMI VA patients (n = 3,065). The groups were compared about nutrition and exercise behaviors <i>Results</i>: <b>Patients with BPD were more likely to report poor exercise habits, including infrequent walking or strength exercises than those with no SMI. They were also more likely to self-report suboptimal eating behaviors, including having fewer than two daily meals. </b><o:p></o:p></span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgG8Zui7yuzHouQq7QRDQFoIz1-Tkc2F-3oqTgrQxYRVel6k1Of9XOzqxIPF6Bkiz2_b3rVjuUm8FgoRX7P8hx5luOWYs1huot01PJnWLWjRxiCWF6q58qFq-sPySZpvOlhRPFlq8gWeJE/s1600/swimmer.gif" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="193" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgG8Zui7yuzHouQq7QRDQFoIz1-Tkc2F-3oqTgrQxYRVel6k1Of9XOzqxIPF6Bkiz2_b3rVjuUm8FgoRX7P8hx5luOWYs1huot01PJnWLWjRxiCWF6q58qFq-sPySZpvOlhRPFlq8gWeJE/s200/swimmer.gif" width="200" /></a></div>
<span style="font-family: "Times New Roman";">Piri, Mohsen, Shirin Zardoshtian, Shahrzad Khazaee, and Roghieh Piri. 2012. "The Effect of Eight Weeks of Aerobic Training on Reducing Mood Disorders, Depression And Mania in High School Students High School Boys." <i>International Journal Of Academic Research In Business & Social Sciences</i> 2, no. 1: 267-273.<o:p></o:p></span></div>
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<b>Abstract</b><span style="font-family: "Times New Roman"; mso-fareast-font-family: "Times New Roman";">: The aim of this study was to consider the effect of eight weeks of aerobic training on the reduction of mood disorders, depression and mania in boys' high school in Ilam-Iran. This was a quasi-experimental and field research taking the experimental and control groups into consideration. In this study, 60 students were randomly selected as the sample. In order to measure students' Depression and mania, multifaceted Minnesota questionnaire (MMPI-2) and depression and mania sub-scales were used. We applied both descriptive and inferential statistics using SPSS software for statistical analysis of data. <b><i>The results showed that eight weeks of aerobic exercise had a significant effect on students` depressive disorders and mania. Eight weeks of aerobic exercise reduced depression and mania in experimental group of students</i></b>. [Edited from the abstract written by the author]<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman";">Eriksson, Sebastian, and Gunvor Gard. 2011. "Physical exercise and depression." <i>Physical Therapy Reviews</i> 16, no. 4: 261-268.<o:p></o:p></span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjO5H9xfc6PY02iZkri7Wb5qaSZsMyEuGFL_aysOkJKpp6MJBudnivWAM2C7fPOtNB_HYvLiZzLAIC30upbT_tI_HlhyphenhyphenwkUnmaNh-7XSgpQWqUkJJymOPdUsKiwhdc5CKjsSPKkAfgnqQg/s1600/yoga-classes.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="144" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjO5H9xfc6PY02iZkri7Wb5qaSZsMyEuGFL_aysOkJKpp6MJBudnivWAM2C7fPOtNB_HYvLiZzLAIC30upbT_tI_HlhyphenhyphenwkUnmaNh-7XSgpQWqUkJJymOPdUsKiwhdc5CKjsSPKkAfgnqQg/s200/yoga-classes.jpg" width="200" /></a><i style="font-family: 'Times New Roman';">Objectives</i><span style="font-family: 'Times New Roman';">: The objective was to review studies which used physical exercise as an intervention to treat major depression, focusing on methodology, mechanisms of action, types of physical exercise and treatment outcomes. </span><i style="font-family: 'Times New Roman';">Methods</i><span style="font-family: 'Times New Roman';">: A literature review from PsycInfo and PubMed databases from 2000-2010 using the key words 'major depression', 'exercise', 'outcome', 'physical activity' and 'aerobic training' as search terms. </span><i style="font-family: 'Times New Roman';">Results</i><span style="font-family: 'Times New Roman';">: Eight studies met the inclusion criteria. Seven of the eight studies showed significantly improved mood and reduced depression. Three studies measured an increase in aerobic capacity, two with correlated mood improvements. One showed a correlation between increased muscle strength and reduced feelings of depression. </span><i style="font-family: 'Times New Roman';">Conclusion</i><span style="font-family: 'Times New Roman';">: </span><b style="font-family: 'Times New Roman';"><i>Physical exercise can be an effective treatment against depression. A mood enhancing effect of exercise was identified in the interventions regardless of the mechanism of action. </i></b><span style="font-family: 'Times New Roman';"> [Edited from the abstract from the author]</span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 200%;">Although
citrus juices including grapefruit juice are very good for you with their high
levels of vitamin C and other nutrients, they have been known to have negative
interactions with certain medications and some medications taken for bipolar
disorder are included on that list. </span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-T7kF4TB3ordmDUMMqLfexK6lVaddx25APlvn0JZPlUq_s04RMYQG8RdkI8OWcboJkwKhKFGJuQ8Zjm4AUuL3NEbSDOI-jhTx4qA9xEDwlf5osbrsYvCJ2v0HsaqG6Y7u3R4DGczGqf8/s1600/citrus+splash.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="162" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-T7kF4TB3ordmDUMMqLfexK6lVaddx25APlvn0JZPlUq_s04RMYQG8RdkI8OWcboJkwKhKFGJuQ8Zjm4AUuL3NEbSDOI-jhTx4qA9xEDwlf5osbrsYvCJ2v0HsaqG6Y7u3R4DGczGqf8/s320/citrus+splash.jpg" width="320" /></a><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 200%;">Certain nutrients within this family of
fruits interact with medications that treat bipolar disorder (such as
olanzapine) and this must be taken into consideration when deciding what fruit juice to drink. Olanzapine comes with a warning associated with the ingestion of grapefruits or grapefruit juice while on the medication
because it impacts the way the body processes the active ingredient in the
medication. Grapefruit juice has been known to impact the uptake (the rate of absorption) of certain substances and/or the bioavailability (how much is available to the body) of others.<o:p></o:p></span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 200%;">Some
researchers suggest that the pharmacokinetics (or intereactions) with medications
is very complex and in one literature review almost 200 studies were found that
studied grapefruit juice interaction and interactions were published for 40
drugs (Saito, Hirata-Koizumi, & Matsumoto et al, 2005). </span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%; text-indent: 0.5in;">Another study found
that due to the complexity involved in measuring intake and magnitude of
interactions it was challenging to predict the extent of grapefruit
product-drug interactions (Seden, Dickinson, Khoo, & Back, 2010). </span></div>
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<span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 200%;">Some people with bipolar disorder take hormone substitutes </span><span style="font-family: 'Times New Roman', serif; font-size: 16px; line-height: 200%; text-indent: 0.5in;">such as levothyroxine </span><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 200%; text-indent: 0.5in;">due to thyroid dysfunction, which can be a side-effect of lithium. It appears that although there is some effect of grapefruit juice on absorption of the hormone it does not impact the availability of the hormone to the endocrine system (Lilja, Laintinen & Neuvonen, 2005).</span></div>
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<span style="font-family: 'Times New Roman', serif; font-size: 16px;">These articles and the warning labels on some medications would suggest that people taking medications for mental illness should avoid grapefruits until science can give firm recommendations. </span><span style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 200%;">To be safe it is best to read the documentation that comes with your medication, especially the sections that describe possible interactions and side-effects. Discuss with your medical provider any risk
of citrus/grapefruit interactions with any medications you are taking.</span></div>
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<span style="font-family: 'Times New Roman', serif; line-height: 200%;"><span style="font-size: x-small;">Lilja, J. L., Laintine, K., & Neuvonen, P. J. (2005). Effects of grapefruit juice on the absorption of levothyroxine. <i>British Journal of Pharmacology, 60</i>(3), 337-341</span></span></div>
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<span style="font-family: 'Times New Roman', serif; line-height: 200%;"><span style="font-size: x-small;">Saito, M., Hirata_Koizumi, M., Matsumoto, M, Urano, T., & Hasegawa, R. (2005). Undesirable effects of citrus juice on the pharmacokinetics of drugs: focus on recent studies. <i>Drug safety: an international journal of medical toxicology and drug experience 28</i>(8): 677-694.</span></span></div>
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<span style="font-family: 'Times New Roman', serif; line-height: 200%;"><span style="font-size: x-small;">Seden, K., Dickinson, L., Khoo, S., & Back, D. (2010). Grapefruit-drug interactions. <i>Drugs, 70</i>(18): 2373-2407.</span></span></div>
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<span style="font-family: Verdana, sans-serif;">In selecting articles to review for this blogpost, I first find articles I understand as many neuroscience articles can be highly technical. Second, I find articles that have some practical utility to people living with bipolar disorder. So I tend to avoid articles that are related to mice or other animals. </span><br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhqBtAeeC_fX2jzp6G8BUP9OEP0PEiWDkjl4LapDVL5B-_g6nfsWe_Hzf1mRC6LOsBqmtaLKS9Gx5tA4Cpgy2Q1og_RKXjwxzqFuxODDrckaH7gFIAplsuMAb51b_gN-lUq-zzaJB0PVtU/s1600/circadian+rhythms.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhqBtAeeC_fX2jzp6G8BUP9OEP0PEiWDkjl4LapDVL5B-_g6nfsWe_Hzf1mRC6LOsBqmtaLKS9Gx5tA4Cpgy2Q1og_RKXjwxzqFuxODDrckaH7gFIAplsuMAb51b_gN-lUq-zzaJB0PVtU/s1600/circadian+rhythms.jpg" /></a><span style="font-family: Verdana, sans-serif;"><br /></span>
<span style="font-family: Verdana, sans-serif;">The first article is about the circadian rhythms. According to the <a href="http://www.nigms.nih.gov/Education/Factsheet_CircadianRhythms.htm" target="_blank">National Institute of General Medical Sciences (NIGMS)</a>, which is a part of the National Institutes of Health (NIH), circadian rhythms are the physical, mental and behavioural patterns that closely follow a 24 hour cycle. These patterns are found in most living things including animals, plants and even microbes. Chronobiology is the study of circadian rhythms. Produced by natural factors in the body, circadian rhythms are also affected by factors in the environment with light being the most important as it controls the genetic switches that influence these patterns. Circadian rhythms influence many bodily functions such as body temperature, hormone releases and sleep/wake patterns. </span><br />
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<span style="background-color: transparent; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><i><span style="font-family: Verdana, sans-serif;"><br /></span></i></span>
<span style="border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><i><span style="font-family: Verdana, sans-serif;"><b>Circadian rhythm characteristics in mood <span style="border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">disorders</span>: Comparison among <span style="border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">bipolar</span> I <span style="border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">disorder</span>, <span style="border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">bipolar</span> II <span style="border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">disorder</span> and recurrent major depressive <span style="border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;">disorder</span></b>. </span></i></span><a href="http://www.blogger.com/blogger.g?blogID=637003755226222082" name="citation" style="background-color: white; border: 0px; line-height: 23.6875px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="background-color: transparent; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="font-family: Verdana, sans-serif; font-size: x-small;"><span style="line-height: normal;">Chung, JK, Lee, KY, Kim, SH et al. (012) </span></span></span></a><span style="font-family: Verdana, sans-serif; font-size: x-small;"><a href="http://www.blogger.com/blogger.g?blogID=637003755226222082" id="linkClinicalPsychopharmacologyandNeuroscience" style="border: 0px; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; text-decoration: initial; vertical-align: baseline;" title="Search for Clinical Psychopharmacology and Neuroscience"><span style="color: black;">Clinical Psychopharmacology and Neuroscience</span></a><span style="line-height: 18px;">, Vol 10(2), Aug, 2012. pp. 110-116.</span></span><br />
<span style="font-family: Verdana, sans-serif; font-size: x-small;"><span style="line-height: 18px;"><br /></span></span>
<span style="font-family: Verdana, sans-serif;"><b>Summary of Findings</b></span><br />
<span style="background-color: transparent; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="font-family: Verdana, sans-serif;">This Korea-based study used factor analysis to study data on how people experience the rhythms of day and night and found that people with mood disorders were more likely to be evening types than people with no mood disorders. Those with bipolar disorder I were more likely to have evening tiredness than those with bipolar disorder II. Those with bipolar I scored higher for morning alertness than people with recurrent major depressive disorder (RMDD).</span></span><br />
<span style="background-color: transparent; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="font-family: Verdana, sans-serif;"><br /></span></span>
<br />
<br />
<span style="font-family: Verdana, sans-serif;">The second article is highly technical and the practical implications are not as explicit but the findings are worth a mention because they reinforce the link between abnormal circadian rhythm patterns and bipolar disorder.</span><br />
<span style="font-family: Verdana, sans-serif;"><br /></span>
<span style="font-family: Verdana, sans-serif;"><i><b>A survey of genetic studies supports association of circadian clock genes with bipolar disorder spectrum illnesses and lithium response</b>.</i> <span style="font-size: x-small;">McCarthy, MJ, Nievergelt, CM, Kelsoe, JR, & Welsh, DK. (2012), PLoS ONE, 7(2) </span></span><br />
<span style="font-family: Verdana, sans-serif;"><b><br /></b></span>
<span style="font-family: Verdana, sans-serif;"><b>Summary of Findings</b></span><br />
<span style="font-family: Verdana, sans-serif;">This study acknowledges the relationship between abnormal circadian rhythms and bipolar spectrum disorders and that this has inspired the search for genetic sources for this abnormality. However, to date there have been no significant findings from this research that would link genes to these abnormalities. The researchers list 3 factors that could be a reason for this lack of significant findings: 1. complex traits usually involve more than one gene; 2. circadian rhythms may be more complicated than they first appeared; and, 3. genetic risk for bipolar disorder could be spread among many illnesses. Without going into technical detail, the major finding was that their analysis revealed previously unrecognized links between bipolar disorder and circadian rhythms.</span><br />
<span style="font-family: Verdana, sans-serif;"><br /></span>
<span style="font-family: Verdana, sans-serif;"><b><i>Circadian rhythms and bipolar disorder</i></b>. <span style="font-size: x-small;">Murray, G. (2010). Bipolar Disorders, 12(5), 459-472</span></span><br />
<span style="font-family: Verdana, sans-serif;"><br /><b>Summary of Findings</b></span><br />
<span style="font-family: Verdana, sans-serif;">This accessible article is a review of existing literature on the relationship between abnormal circadian rhythms and bipolar disorder. It does not present anything particularly new but does reinforce what is already known.</span><br />
<span style="background-color: white; color: #333333; font-size: 12px; line-height: 18px;"><span style="font-family: Verdana, sans-serif;"><br /></span></span>
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The list of symptoms for bipolar disorder as it appears in
the DSM IV states that people with bipolar disorder are more likely to have
problems sleeping and lack of sleep is both a cause and a symptom of bipolar
disorder symptoms. Sleeplessness is a symptom of mania and although feeling
tired is a symptom of depression, so are changes in sleep, which might result
in sleeplessness or in sleeping too much. Not being able to sleep is also
symptomatic of a mixed bipolar state. <o:p></o:p></div>
<div style="background: white; line-height: 200%; text-indent: .5in;">
Before or early in a bipolar episode you may experience a
change in your sleep patterns, whether in quantity of hours, or the quality of
your sleep – not feeling rested or frequent waking – that allow you to make the
changes necessary to prevent an episode or mediate its length and severity
through changes in behaviors that influence sleep. Being aware of these changes
and recording them and the behaviors that accompany them will help you and your
healthcare provider take the necessary steps to bypass an episode.<o:p></o:p></div>
<div style="background: white; line-height: 200%; text-indent: .5in;">
Once bipolar disorder has been treated people are less
likely to have sleep problems. Having insufficient sleep can cause hypomania, depression and mania. Sleep
loss is also a symptom of depression, mania and hypomania and thus is a
significant issue for mental well-being that should be monitored by people
living with bipolar disorder. Even if you need medications to sleep you can have a better quality sleep by taking the following steps which may even help you reduce your reliance on sleep medications.</div>
<div style="background: white; line-height: 200%; text-indent: .5in;">
</div>
<ol>
<li><span style="line-height: 200%; text-indent: 0.5in;"><b>Develop a sleep routine </b>to keep your circadian rhythms in order. This means going to bed and waking, and taking any medications at the same time every day, including weekends. This gets your body in a pattern of knowing when to feel sleepy and when to wake and allows you to get the amount of sleep your body needs for you to feel rested in the morning with the energy you need for your day.</span></li>
<li><span style="line-height: 200%; text-indent: 0.5in;"><b>Sleep in a cool, dark, quiet room on a comfortable bed</b>. If there are lights or noises that annoy you then sleep with an eyeshade and/or earplugs. Or perhaps you want the soothing noise of a particular sound or music collection. Make sure your bed, pillow and linens are comfortable.</span></li>
<li><span style="line-height: 200%; text-indent: 0.5in;"><b>Exercise regularly</b> to give your body a reason to be tired. Complete your exercise at least 2 hours before bedtime so that your body is not overheated or have an elevated heartrate near bedtime</span></li>
<li><span style="line-height: 200%; text-indent: 0.5in;"><b>Avoid caffeine, nicotine and alcohol</b>. Caffeine and nicotine are stimulants and alcohol may help you fall asleep but interferes with sleep patterns to make your sleep less restful.</span></li>
<li><span style="line-height: 200%; text-indent: 0.5in;"><b>Relax before going to bed</b>. Do relaxing activities before going to bed such as meditation or reading or knitting and avoid doing anything in bed but sleep and intimacy. </span></li>
</ol>
<br />
<div style="background: white; line-height: 200%;">
Monitoring your sleep patterns may help you know what factors are helping you sleep and what factors are keeping you from a good night's rest. For a sleep log: <span style="background-color: transparent; font-family: Wingdings; font-size: 12pt; line-height: 115%; text-indent: -0.25in;">§<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;"> </span></span><span style="background-color: transparent; font-family: 'Times New Roman'; font-size: 12pt; line-height: 115%; text-indent: -0.25in;"><a href="http://www.helpguide.org/life/pdfs/sleep_diary.pdf">http://www.helpguide.org/life/pdfs/sleep_diary.pdf</a></span></div>
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<!--StartFragment-->
<!--EndFragment--><div style="background: white; line-height: 200%;">
<br /></div>
<div style="background: white; line-height: 200%;">
Other sleep resources: </div>
<div style="background: white; line-height: 200%;">
'Sleep Matters: The Impact of Sleep on Health and Well-Being'
which is downloadable from <a href="http://www.mentalhealth.org.uk/publications/sleep-report/">http://www.mentalhealth.org.uk/publications/sleep-report/</a>.</div>
<div style="background: white; line-height: 200%;">
<br /></div>
<div style="background: white; line-height: 200%;">
'Your Guide
to Healthy Sleep' and it is available free at <a href="http://www.nhlbi.nih.gov/health/public/sleep/healthysleepfs.pdf">http://www.nhlbi.nih.gov/health/public/sleep/healthysleepfs.pdf</a>. </div>
<div style="background: white; line-height: 200%;">
<br /></div>
<div style="background: white; line-height: 200%;">
National Sleep Foundation (<a href="http://www.sleepfoundation.org/">www.sleepfoundation.org</a>)</div>
<div style="background: white; line-height: 200%;">
<br /></div>
<div style="background: white; line-height: 200%;">
American
Academy of Sleep Medicine (<a href="http://www.sleepeducation.com/">http://www.sleepeducation.com/</a>)<o:p></o:p></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgU32udgRG1l-gHD5fQjDJ64G25LrCXkuzEM1fN_gcfaHGzVO2R0pZNUApWW21ypuIFTjUjz6m1Id4N7xdElDlkrz6xfXimndWuDmQWE0-hcGjKoKVDATNIaQSThZLQ0R1V7qjRXhoMkMQ/s1600/2012flyer.jpeg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="171" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgU32udgRG1l-gHD5fQjDJ64G25LrCXkuzEM1fN_gcfaHGzVO2R0pZNUApWW21ypuIFTjUjz6m1Id4N7xdElDlkrz6xfXimndWuDmQWE0-hcGjKoKVDATNIaQSThZLQ0R1V7qjRXhoMkMQ/s320/2012flyer.jpeg" width="320" /></a></div>
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July is National Minority Mental Health Awareness Month.<br />
<br />
So instead of creating original content for this entry, I will simply add links for sites where information and resources can be found about mental health issues among minority communities.<br />
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<a href="http://www.nami.org/Template.cfm?Section=Multicultural_Support&Template=/ContentManagement/ContentDisplay.cfm&ContentID=120508" target="_blank">National Alliance on Mental Illness</a><br />
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<a href="http://www.healthyminds.org/Home-Page-Feature/Minority-Mental-Health-Month.aspx" target="_blank">American Psychiatric Association</a><br />
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<a href="http://nned.net/index-nned.php/NNED_content/news_announcement/nmmham-webinar-II" target="_blank">National Network to Eliminate Disparities in Behavioral Health: Webinar</a><br />
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<a href="http://nlbha.org/index.php/the-news/158-july-is-national-minority-mental-health-awareness-month" target="_blank">National Latino Behavioral Health Association</a><br />
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<a href="http://www.blackmentalhealthnet.com/" target="_blank">Black Mental Health.net</a><br />
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<a href="http://naapimha.org/" target="_blank">National Asian American and Pacific Islander Mental Health Association</a><div class="blogger-post-footer"><form Method="POST"
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Powered by <a href="http://www.feedblitz.com">FeedBlitz</a></form></div>crazygirlhttp://www.blogger.com/profile/14814752703102263063noreply@blogger.com27tag:blogger.com,1999:blog-637003755226222082.post-40906168341165700262012-06-07T01:26:00.001-07:002012-06-07T01:59:04.139-07:00HYPERGRAPHIA - the compulsion to write in bipolar disorder<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiLzK4szgw1_P2nn5mNij7ttgOparPfixD6qiUoeYBgmomcMUCwJwWR8LmS2go40DjTpUze2OgFdV8wP0N4yXf9Co22PFySeHKKi2ikeVtRVzzLm8mrvWgyLlkdxQH2NDZgWLRUT0RtyLs/s1600/writing.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="150" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiLzK4szgw1_P2nn5mNij7ttgOparPfixD6qiUoeYBgmomcMUCwJwWR8LmS2go40DjTpUze2OgFdV8wP0N4yXf9Co22PFySeHKKi2ikeVtRVzzLm8mrvWgyLlkdxQH2NDZgWLRUT0RtyLs/s200/writing.jpg" width="200" /></a><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"></span><br />
<span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">It was not easy finding a 'reputable' definition of hypergraphia so I will accept the one from About.com as it is comprehensive and consistent with other definitions found in various more reputable sources.</span><br />
<b style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><br /></b><br />
<b style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">A Definition</b><br />
<span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">About.com definition (not the most scientific of sources):</span><br />
<span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><b style="background-color: white; color: #333333; line-height: 18px; text-align: left;">Hypergraphia</b><span style="background-color: white; color: #333333; line-height: 18px; text-align: left;"> is a condition in which a person feels an overwhelming compulsion to write. People with bipolar disorder, especially during mania or hypomania, may find themselves writing for hours at a time, not necessarily realizing that this is unusual. It may take the form of journalling, creative writing, or copying page after page of a book. </span><span style="background-color: white; color: #333333; line-height: 18px; text-align: left;">Hypergraphia may also be associated with temporal lobe epilepsy and <a href="http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml" target="_blank">schizophrenia</a>, as well as certain brain injuries. </span></span><br />
<b style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><br /></b><br />
<b style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">The Experience of Hypergraphia</b><br />
<span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">I realized that my hypergraphia was associated with both hypomanic and depressive episodes but in different ways. When I am hypomanic I get creative and write all sorts of things - poetry, magazine articles, blogs, academic articles, abstracts, and long emails to friends. I also find myself entering notes into my blackberry, when I dont have access to paper or a computer. When depressed, I write dark poetry but have no other creative productivity. When I am hypomanic I have no desire to write poetry. My brain is just not so inspired. So in my search to understand this pattern, I found some interesting information I wanted to share with you and I would love to hear your stories.</span><br />
<b style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><br /></b><br />
<b style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">What the Scientists Dont Say</b><br />
<span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">It was not easy to find information on this condition. It did not show up in a search on the Merriam Webster online dictionary. A search on the website of the </span><a href="http://www.nimh.nih.gov/index.shtml" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;" target="_blank">National Institutes of Mental Health </a><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">(NIMH) and the Mayo Clinic also resulted in no entries. No books could be found in my school library database but In the PsycInfo and Medline databases it is primarily associated with temporal lobe epilepsy.</span><br />
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<span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">However there are some well known experts in psychiatry and neurology who have been writing about the behavior from personal and scientific perspectives.</span><br />
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<b style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">What Some Scientists Say</b><br />
<a href="http://www.amazon.co.uk/The-Midnight-Disease-Writers-Creative/dp/0618230653" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;" target="_blank">The Midnight Disease</a><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"> - is a book by </span><a href="http://www.massgeneral.org/neurology/doctors/doctor.aspx?id=17016" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;" target="_blank">Alice Flaherty</a><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">, a neurologist at </span><a href="http://www.massgeneral.org/" style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;" target="_blank">Massachussetts General Hospital</a><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">. She found herself writing compulsively both after the death of premature twin boys and the birth of healthy twin girls later diagnosed herself with hypergraphia. She believes that this behavior is attached to extreme moods that are found in people with manic depression and other people with brain disorders and brain injuries. </span><br />
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<span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><a href="http://www.peterwhybrow.com/" target="_blank">Peter Whybrow</a>, MD, Director of the <a href="http://www.semel.ucla.edu/" target="_blank">Semel Institute for Neuroscience and Human Behavior </a>at the University of California in Los Angeles and a specialist in mood disorders, was reported in the <a href="http://www.guardian.co.uk/education/2004/mar/18/research.highereducation" target="_blank">The Guardian</a> (March 17 2004) as saying that m<span style="background-color: white; color: #333333; line-height: 18px;">anic depressives with a predisposition to chronicling their lives or composing poetry are likely to engage in voluminous writing in their darkest hours.</span>disord<span style="color: #1a2c59;"><span style="line-height: 24px;">ers.</span></span></span></div>
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<span style="background-color: white; color: #333333; line-height: 18px;"><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><a href="http://www.hopkinsmedicine.org/psychiatry/expert_team/faculty/J/Jamison.html" target="_blank">Dr Kay Jamison</a>, a professor of <a href="http://www.hopkinsmedicine.org/psychiatry" target="_blank">psychiatry at John Hopkins University</a>, was quoted in The Guardian (March 17, 2004) as saying that "Two aspects of thinking are pronounced in both creative and hypomanic thought: fluency, rapidity and flexibility ... and the ability to combine ideas or categories of thought in order to form new and original connections."</span></span></div>
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<span style="background-color: white; color: #333333; line-height: 18px;"><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><b>Mood Disorders and Creativity</b></span></span></div>
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<span style="background-color: white; color: #333333; line-height: 18px;"><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">In a conference at the <a href="http://www.loc.gov/index.html" target="_blank">Library of Congress</a> (<a href="http://www.loc.gov/today/cyberlc/feature_wdesc.php?rec=4516" target="_blank">Depression and Creativity, Feb 3, 2009</a> - click link for video), both Dr Jamison, Dr. Whybrow discussed the controversial and long-standing (pre-Grecian) conversation about creativity and mood disorders. The symposium also included <a href="http://bipolar.stanford.edu/team/people.html" target="_blank">Dr. Terence Ketter</a> who is chief of the <a href="http://bipolar.stanford.edu/" target="_blank">Bipolar Disorders Clinic</a> at Stanford University, whose research focuses on the relationship between creativity and madness. Though most artists and creatives do not suffer from mental illnesses but many creatives, especially poets, suffer a disproportionately high rate of mental illnesses, particularly depression and bipolar disorder. Dr Jamison refers to Mendelssohn, Virginia Woolf, Van Gogh as creatives with mood disorders. She argues that during periods of depression people are less productive and are more productive when they are manic or hypomanic.</span></span><br />
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<span style="background-color: white; color: #333333; line-height: 18px;"><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><b>The Advantages and Disadvantages of Hypergraphia</b></span></span></div>
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<span style="background-color: white; color: #333333; line-height: 18px;"><span style="font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;">The great thing about hypergraphia for an academic is the productivity. However it is frustrating that there are often so many ideas that cannot all come to fruition. It inspires insomnia. But the indulgence to these intense desire to write is that it compensates for depressive episodes where dark moods interfere with the discipline to complete ideas.</span></span></div>
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<span style="color: #333333; font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><span style="line-height: 18px;">Manic depression has its advantages and disadvantages and though hypergraphia is both blessing and curse (depending on its expression), in a world where productivity is valued, I have no cause to resist its lure or try to medicate it away. There is beauty in seeing words that come from my brain. And one can only hope that others share the same view.</span></span></div>
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<span style="color: #333333; font-family: 'Helvetica Neue', Arial, Helvetica, sans-serif;"><span style="line-height: 18px;">Note: This was written in a hypographic period during a hypomanic phase.</span></span></div><div class="blogger-post-footer"><form Method="POST"
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<span style="font-size: small;"><a href="http://seattletimes.nwsource.com/html/localnews/2018328041_stawicki01m.html" target="_blank">Gunman: a life full of rage, a shocking final act</a></span></h1>
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<span style="color: #222222;"><span style="font-family: 'Trebuchet MS', sans-serif;">This was the headline in the Seattle Times on Wednesday May 30, Ian Lee Stawicki shot and killed 5 people in 2 locations in Seattle and then turned the gun on himself. As the news reports became one never ending roll of updates, and spread around the world, it was soon discovered that Mr. Stawicki had been showing signs of mental illness and his father suspected he had untreated manic depression (aka bipolar disorder). Once again violence and death became linked with bipolar disorder even though these events are relatively rare. </span></span></div>
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<span style="color: #222222;"><span style="font-family: 'Trebuchet MS', sans-serif;">The Other Face of Bipolar Disorder and Mental Illness</span></span><br />
<span style="color: #222222;"><span style="font-family: 'Trebuchet MS', sans-serif;">Most people who have bipolar disorder are like me and so many people I know: they are employed, have successful careers and families. We are the face of bipolar disorder and mental illness but this is not the face we see in the public sphere. National organizations like the the <a href="http://nami.org/" target="_blank">National Alliance on Mental Illness</a> (NAMI) - which has more than 1100 local chapters in all 52 states, and the newly founded Seattle-based Professionals Affected by Mental Illness (PAMI) include members that represent a wide variety of jobs and careers and levels of education.</span></span></div>
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<span style="color: #222222;"><span style="font-family: 'Trebuchet MS', sans-serif;">For some reason, we who have a mental illness have not joined the 'anonymous' movement (perhaps Mental Illness Anonymous - MIA). Perhaps if we went to meetings where we would stand up and own our issues we would get praised and supported for staying symptom free. And when we went out in public we could talk about getting our 1 year medal and be supported for our efforts.</span></span></div>
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<span style="color: #222222;"><span style="font-family: 'Trebuchet MS', sans-serif;">The Stigma of Mental Illness</span></span><br />
<span style="color: #222222;"><span style="font-family: 'Trebuchet MS', sans-serif;">Instead we hide in closets of society's making with our own support. So that when people talk about the mentally ill they think of people who are homeless shouting at the moon or just another mass killing; but most people do not think about their boss, friend, neighbor or cousin. The TV shows such as Law and Order, Criminal Minds or CSI do not help our image any. But if our image is to change we have to change it.</span></span></div>
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<span style="font-family: 'Trebuchet MS', sans-serif;"><span style="color: #222222;">Because the public links 'danger' to those of us with mental illness, many who are affected with mental illness often refuse to seek help because of the stigma that is attached to being ‘one of them’. </span><span style="color: #222222;">We have to step out and show the world that with available, accessible and high quality care we can manage our symptoms and function well, just like those with diabetes do. </span></span></div>
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<span style="color: #222222;"><span style="font-family: 'Trebuchet MS', sans-serif;">It is also a
sign of stigma that we say ‘mentally ill’ to describe someone with mental
illness as we do not say ‘cancerous’ to describe people with cancer. We are
much more than the parts of our brain that do not function as they should. The
reality is that mental illness is physical – unless my brain is not part of my
body.</span></span><br />
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<span style="color: #222222;"><span style="font-family: 'Trebuchet MS', sans-serif;">Mental illness is also stigmatized within the health professions because if someone with a mental illness is receiving health on the public dime (Medicare or Medicaid) then it is most likely that they will access care only when they are "a danger to self or others" and the kind of care that could prevent or ameliorate symptoms before a crisis is simply not available or if available, it is only for the lucky few. Feeling mentally unwell is not enough to get care because healthcare is such a precious commodity in this country - whether public or not.</span></span></div>
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<span style="color: #222222;"><span style="font-family: 'Trebuchet MS', sans-serif;">Why We Should Step Out of the Stigma Closet</span></span><br />
<span style="color: #222222;"><span style="font-family: 'Trebuchet MS', sans-serif;">If women had not stepped out of the secrecy and shame of losing a breast we would not have the movement for research, support and for public education. They had to let everyone know that breast cancer affected women of all colors, classes, creeds, nationalities etc. </span></span></div>
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<span style="font-family: 'Trebuchet MS', sans-serif;">If our only view of the mentally ill is one of limited achievement or of rare violent episodes that end up on the front pages, then the newly diagnosed are at risk of not achieving their full potential because they have no idea of what that may be. Nor do their families or their employers.</span></div>
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<span style="font-family: 'Trebuchet MS', sans-serif;"><span style="color: #222222;">Who Are the Mentally Ill</span></span><br />
<span style="font-family: 'Trebuchet MS', sans-serif;"><span style="color: #222222;">We are a
diverse group of people whose biochemistry has gone awry, just as it has for
people who suffer from other biochemical disorders. Why stigmatize me because of my brain when my brain works
well in so many other ways (such as compassion, humour, and complex problem-solving?</span><span style="color: #222222;"><o:p></o:p></span></span></div>
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<span style="font-family: 'Trebuchet MS', sans-serif;"><span style="color: #222222;">We are friends, family, colleagues and
even your healthcare providers. Just like any other illness, it does not
discriminate and everyone has a unique experience that is not summarized by
scary headlines.</span><span style="color: #222222;"><o:p></o:p></span></span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiPzTaY_hybHtSlLjQbBwfFuAU5qqJJkHHc5gVK-PapniX6myUJjnzMMkI84UGbzZdQZ0N0aCX6mTyOtiSfK10znhJSh0iPHTUtSS7B54D0P0y2S9EA-IxliK9qaazvtlnHBv0Ot_RigfM/s1600/happy-people.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="294" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiPzTaY_hybHtSlLjQbBwfFuAU5qqJJkHHc5gVK-PapniX6myUJjnzMMkI84UGbzZdQZ0N0aCX6mTyOtiSfK10znhJSh0iPHTUtSS7B54D0P0y2S9EA-IxliK9qaazvtlnHBv0Ot_RigfM/s320/happy-people.jpg" width="320" /></a><span style="font-family: 'Trebuchet MS', sans-serif;"><span style="color: #222222;">As more people
‘come out’ as mentally ill we can reduce the fear, change stereotypes and give
hope to people who are affected by a mental illness. Employers can also see
that we can be productive employees who have illnesses that can be treated
effectively with the right support.</span><span style="color: #222222;"><o:p></o:p></span></span></div>
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<span style="font-family: 'Trebuchet MS', sans-serif;">Coming Out</span><br />
<span style="font-family: 'Trebuchet MS', sans-serif;">To those of you out there who are dealing with mental illness, take a brave step and tell someone. The more diverse the faces and lives of the mentally ill, the less shame and stigma we will experience and the more resources will be put into helping to understand and treat one of the most debilitating health conditions.</span></div>
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<span style="font-family: 'Trebuchet MS', sans-serif;">For more information on bipolar disorder and other mental illnesses and ways to advocate for mental health services contact: </span><a href="http://www.dbsalliance.org/site/PageServer?pagename=home" style="font-family: 'Trebuchet MS', sans-serif;" target="_blank">Depression and Bipolar Support Alliance</a><span style="font-family: 'Trebuchet MS', sans-serif;">, </span><a href="http://nami.org/" style="font-family: 'Trebuchet MS', sans-serif;" target="_blank">National Alliance on Mental Illness</a><span style="font-family: 'Trebuchet MS', sans-serif;">, the </span><a href="http://www.apa.org/" style="font-family: 'Trebuchet MS', sans-serif;" target="_blank">American Psychological Association</a><span style="font-family: 'Trebuchet MS', sans-serif;"> and the </span><a href="http://www.nimh.nih.gov/index.shtml" style="font-family: 'Trebuchet MS', sans-serif;" target="_blank">National Institute of Mental Health</a></div>
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First, without thinking on what type of food we should eat, we should generally eat a healthy meal several times a day. That is a meal with lots of color: fruits and vegetables. But what foods and vegetables make our brains healthy while making our bodies happy.<br />
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In keeping with one of the principles of this blog, I will not make a long list (I can add more later) nor use technical scientific language nor give you a long page to read. If you know of other nutrients, other research or I have misrepresented something, please let me know by sending me a note in the comments section. And follow me on my<a href="http://www.psychologytoday.com/blog/culture-in-mind" target="_blank"> Psychology Today</a> blog as well where I write more generally about mental health.<br />
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So here are some nutrients to consider. I will acknowledge that I use Vitamin D and Omega 3 supplements in addition to other pharmaceuticals, as recommended by my doctor. I think they make a difference in reducing the amount of medication I need but who knows. My body utilizes these micronutrients for other good things so it can't harm.<br />
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1. <b>VITAMIN D</b>. Free from the sun but in the winter its harder to get and the 'stay-out-of-the-sun' recommendations from the dermatologists may be interfering with our manufacture of this very essential micronutrient. One of the side effects of taking anti-epileptic drugs is to reduce Vitamin D in the blood (Ovsiew, 2004) which can lead to osteoporosis in people living with mental illnesses who take atypical anti-psychotics like<a href="http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601213.html" target="_blank"> olanzapine</a> for the treatment of <a href="http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001924/" target="_blank">bipolar disorder</a>. At the very least, being in the sun will make you feel better whether science understands exactly how it works or not. Vitamin D3 is found in fatty fish and because it is so important to our bodies it is added to many foods such as milk and some juices.<br />
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2. <b>OMEGA 3 </b>Found in cold water fish and seeds such as flaxseed, omega 3 fatty acids are not only great for glowing skin but lubricates our brain's machinery and keeps it running smoothly. Omefa 3s can be found in cold water fish, like salmon and vegetable sources such as flax and chia seed. Jerome Sarris (2011) and a team of researchers did an analysis of studies that looked at 'nutraceuticals' and how their effect on bipolar disorder symptoms and found that though there were mixed effects of omega 3's on symptoms, there was a mostly positive effect on depression but not on mania.<br />
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3. <b>COFFEE AND ALCOHOL</b>: Avoid these substances because they have been overwhelmingly proven to alter mood in ways that are unclear and as our moods are already problematic, it is best to avoid these so that we can also get good sleep at night. If you really need a cup of brewed beans to get you started in the morning it is best to drink before noon so that the effects wear off before night.<br />
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4. <b>L-TRYPTOPHAN</b>: Sarris et al. (2011) and his team found that this nutrient had a positive impact on moods. This amino acid is used by the brain to make serotonin that is mainly linked to depression. Some foods that contain L-Tryptophan include nuts, seeds, eggs, meat, fish, tomatoes and cheese among other foods.<br />
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<b>References</b><br />
<a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1738874/" target="_blank">Ovsiew, F. (2004). Anti-epileptic drugs in psychiatry. <i>Journal of Neurology, Neurosurgery and Psychiatry, (75) </i>12, 1655-1658</a><br />
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<a href="http://www.ncbi.nlm.nih.gov/pubmed/22017215" target="_blank">Sarris, J., Mischoulon, D., Schweitzer, I. (2011). Adjunctive nutraceuticals with standard pharmacotherapies in bipolar disorder: A systematic review of clinical trials. <i>Bipolar Disorders, 13 (5-6), 454 - 465.</i></a><br />
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And here's the problem with <i>cutting edge science</i> and bipolar disorder: we get the <i>treatments </i>that could kill us or make us feel awful in a different way.<br />
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Of all the things I hate about being <i>mentally ill</i> (and there are many), it is the trading off my brain function for liver function, or one kind of brain function for another. Tweak one med and it means more frequent blood tests to make sure that my sanity doesn't kill the rest of me.<br />
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If you're like most people with a mental illness, this is the major reason people do not take their medications: <i>side effects</i>. Sometimes it doesn't even make sense to read the list of likely <i>side effects</i>, never mind the unlikely ones, because not taking psych meds can result in other ugly things happening. So you trade one bad thing for one good thing and hope it all works out in the end.<br />
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Lucky for me, I have a combination that works. Very well. But there are times they need an upgrade because the brain is not static. And the pill count gets higher or more complicated and if you have something else wrong with you it eliminates most of the drugs that could help with that problem.<br />
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For example, taking <a href="http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000531/">lithium </a>means that lots of <a href="http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001502/">hypertensive </a>drugs are off the table. If you take <a href="http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000161/">olanzapine</a>, you may end up with diabetes (hmmmmm...... sanity or diabetes??). Benzodiazepenes which are used for sleep could make you an addict.<br />
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The reason people with <i>mental illness</i> are so bad with their <a href="http://www.nejm.org/doi/full/10.1056/NEJMra050100">medication compliance</a> is not just that we feel better from taking them (which in any illness this is true) but because the side effects can be so irritating and health threatening. Anyone who takes lithium knows how annoying dry mouth is and the volumes of liquid consumed means that there are many trips to the toilet. And every 3 months you hope the blood tests don't show signs of liver damage or kidney trouble or perhaps one day you wake up and your thyroid no longer works.<br />
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Well, there dont seem to be very good answers right now. Perhaps one day science will find a way to target the parts of our brain causing us trouble and zap.... we're done. Until then, science has brought us some compromises that require us to make tough choices about our lives. So we take them as instructed and keep track of our side effects and if they get too bad, we try something else until if we're lucky we find something that works.<br />
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What choice do we have???<br />
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It's that time of year again for the high school or college student.... midterms. And soon it will be finals. If you are a student with bipolar disorder, you must take extra care to make sure the stress does not cause you to have symptoms or a full-blown manic or depressive episode. So how do you stay healthy amid all the demands on your time? The short list of strategies (I don't want to add to your to-do list:). </div>
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<span class="Apple-style-span" mce_name="strong" mce_style="font-weight: bold;" style="font-weight: bold;">1. Make a monthly assignment calendar</span> on which you put all due dates. Place it on your refrigerator, your door or your mirror: some place where you will see it everyday. This prevents surprises.</div>
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<span class="Apple-style-span" mce_name="strong" mce_style="font-weight: bold;" style="font-weight: bold;">2. Go see your professors</span> for a check-in about how you are doing and what you can do better and on what areas you should focus. If you have not registered as a student with a disability then you may want to reconsider so that you can have extra time if you need it.</div>
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<span class="Apple-style-span" mce_name="strong" mce_style="font-weight: bold;" style="font-weight: bold;">3. Go to student support workshops</span> re:stress, exams, studying strategies etc offered by your university campus.Your tuition pays for all these great resources on campus; don't waste those dollars.</div>
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<span class="Apple-style-span" mce_name="strong" mce_style="font-weight: bold;" style="font-weight: bold;">4. Go to a library orientation</span>. This will probably be one of the best spent 30-60 minutes of your entire college career. Understanding databases, references & citations, where to find what, and how to access library help, is essential to getting an A on that paper.</div>
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<span class="Apple-style-span" mce_name="strong" mce_style="font-weight: bold;" style="font-weight: bold;">5. Form a study group.</span> Accountability to others is a great motivator for us to do what we often do not like to do. You will learn from each other and you will put some structure into your study life while adding a little bit of social to the solitary study routine.</div>
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<span class="Apple-style-span" mce_name="strong" mce_style="font-weight: bold;" style="font-weight: bold;">6. Set a study schedule.</span> Now that you know when things are due, when your study group(s) will meet, and what the professor wants you to do, and how you are going to maximize the library, it's time to set a specific time and place to do your studying. Sometimes you may want to be in the library and other times at home or in a coffee shop. Change up the routine to keep you focused but do what works for you. Tip: If you get your weekend studying out of the way on Saturday and Sunday morning then you are guilt-free to enjoy your weekend night.</div>
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<span class="Apple-style-span" mce_name="strong" mce_style="font-weight: bold;" style="font-weight: bold;">7. Take care of yourself. </span>All-nighters are a college staple; minimize them by taking the steps above. Below are some ways to make sure your body is ready for the studying and testing ahead.</div>
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<ul style="background-color: white; font-family: Arial, Helvetica, sans-serif; font-size: 13px;"><a href="http://us.cdn4.123rf.com/168nwm/leaf/leaf0910/leaf091000373/5802494-three-people-walking-in-a-park-getting-some-exercise.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="http://us.cdn4.123rf.com/168nwm/leaf/leaf0910/leaf091000373/5802494-three-people-walking-in-a-park-getting-some-exercise.jpg" /></a>
<li><b><i>Take your medications as prescribed.</i> </b>This is not the time to be playing around with your medications without the supervision of your doctor.</li>
<li><span class="Apple-style-span" mce_name="strong" mce_style="font-weight: bold;" style="font-weight: bold;"><span class="Apple-style-span" mce_name="em" mce_style="font-style: italic;" style="font-style: italic;">Exercise regularly</span> </span>- daily if possible; even if its a walk to run all your errands. Get your heart rate up and stress slowly melts away and sleep comes much easier at night.</li>
<li><span class="Apple-style-span" mce_name="strong" mce_style="font-weight: bold;" style="font-weight: bold;"><i>Eat.</i></span> Fresh fruits, vegetables and protein. Many people snack when they study so pop grapes or munch on carrots to stop that freshman 15 turning into a senior 30. Add in some Vitamin D and Omega 3 supplements and get at least half hour of sun everyday if you can. Best if you get it while going for a walk. Clears the head and calms the mood.</li>
<li><span class="Apple-style-span" mce_name="em" mce_style="font-style: italic;" style="font-style: italic;"><span class="Apple-style-span" mce_name="strong" mce_style="font-weight: bold;" style="font-weight: bold;">Sleep. </span></span>Six to 8 hours of sleep maximizes memory function and brain function overall and keeps you alert in class. It may be best to skip that last hour of studying and go to bed so you can remember what you have already studied instead of forgetting everything. Maintain a sleep routine where you go to bed and wake up at the same time each night. See my post on sleep for more on how to keep your sleep and mood regular.</li>
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<li><span class="Apple-style-span" mce_name="strong" mce_style="font-weight: bold;" style="font-weight: bold;"><i>No drugs</i></span>. Avoid all non-prescribed mood-altering drugs such as alcohol and caffeine. They impair your sleep and have a negative impact on the regulation of your moods. DO NOT TAKE ANY UNPRESCRIBED MEDICATIONS especially medications that are prescribed to your friends. These could have dangerous interactions with the medications you may be taking for bipolar disorder.</li>
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<li><span class="Apple-style-span" mce_name="strong" mce_style="font-weight: bold;" style="font-weight: bold;"><i>Relax.</i></span> However it is you do that: yoga, meditation etc. If your mind is clear you will find that there is more room for all the knowledge you're paying for.</li>
<li><b><i>See your doctor</i> </b>if you are not feeling well or think you may need some support to get through this stressful time. Prevention is much better than cure. </li>
</ul>
<span class="Apple-style-span" style="background-color: white; font-family: Arial, Helvetica, sans-serif; font-size: 13px;">No more points for you to learn here. You may do all this and not be able to prevent having symptoms or a full-blown episode but you will reduce the risk and improve your ability to cope.</span><br />
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<span class="Apple-style-span" style="background-color: white; font-family: Arial, Helvetica, sans-serif; font-size: 13px;">This professor is wishing you happy studying and great grades. Now for me to come up with tips on how professors can get through the grading without pulling their hair out.</span><span class="Apple-style-span" style="background-color: white; font-family: Arial, Helvetica, sans-serif; font-size: 13px;"> </span><div class="blogger-post-footer"><form Method="POST"
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This study tested people diagnosed with bipolar disorder and their first-degree (immediate family) relatives and found that variations in mood and behavior tended to run in families and influenced performance on a neuropsychological tests that tested working memory, verbal fluency, executive functioning, auditory attention among others.<br />
Rajajarvi et al (2010). The effects of seasons and seasonal variation on neuropsychological test performance in patients with bipolar 1 disorder and their first-degree relatives. <i>Journal of Affective Disorders, 127</i>(1-3), 58-65.<br />
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<b>The original post is below.</b><br />
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As fall approaches many people living with bipolar disorder find that the changes in light/dark influence their mood. So I reviewed the literature for a sample of studies on the topic. Not much has been written lately on the topic but there seems to be inconclusive evidence about the influence of seasons and climate on the moods of people living with bipolar disorder. For a small sample of the research in this area, see below:<br />
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Using observations were provided by patients from different geographic locations in North and South America, Europe and Australia a recent study conducted by numerous researchers around the world found no relationship between moods in people living with bipolar disorder and seasons, latitude or climate.<br />
<a href="" name="citation">Bauer et al (2009). Relationship among latitude, climate, <strong><em>season</em></strong> and self-reported mood in <strong><em>bipolar</em></strong> disorder. </a><a href="http://www.blogger.com/blogger.g?blogID=637003755226222082" id="linkJournalofAffectiveDisorders" style="color: black;" title="Search for Journal of Affective Disorders">Journal of Affective Disorders</a>, Vol 116(1-2), pp. 152-157.<br />
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In a large study of lithium serum levels measured between January 1995 and July 2004 in 3 large teaching hospitals in the Netherlands, there was a significant difference found in average lithium serum levels across seasons, with summer being the highest and winter being the lowest. However, these differences were too small to impact the therapeutic impact of lithium. Temperature variations followed the same pattern.<br />
Wilting et al. (2007). <a href="" name="citation">The impact of environmental temperature on lithium serum levels. </a><a href="http://www.blogger.com/blogger.g?blogID=637003755226222082" id="linkBipolarDisorders" style="color: black;" title="Search for Bipolar Disorders">Bipolar Disorders</a>, Vol 9(6), pp. 603-608.<br />
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As part of the ongoing STEP-BD (Systematic Treatment Enhancement Program for Bipolar Disorder), there was a study of seasonal and regional effects on people living with Bipolar Disorder I and II. Results showed that study participants who lived in northern areas were more likely to be depressed. Bipolar II patients were more ill year-round than were patients with Bipolar I and had greater monthly fluctuations in illness rates that patients with Bipolar I.<br />
Friedman et al. (2006). <a href="" name="citation">Seasonal changes in clinical status in <strong><em>bipolar</em></strong> disorder: A prospective study in 1000 STEP-BD patients.</a> <a href="http://www.blogger.com/blogger.g?blogID=637003755226222082" id="linkActaPsychiatricaScandinavica" style="color: black;" title="Search for Acta Psychiatrica Scandinavica">Acta Psychiatrica Scandinavica</a>, Vol 113(6), pp. 510-517.<br /><div class="blogger-post-footer"><form Method="POST"
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According to the <a href="http://www.nimh.nih.gov/">National Institutes of Health</a>, chronic sleep loss or sleep disorders may impact up to 70 million Americans and cost up to $16billion in healthcare costs and $60billion in lost productivity. So sleep is a big deal, not only to people living with bipolar disorder, who often have sleep disorders related to the illness</div>
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but also to people in general.</div>
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<b>GOOD SLEEP</b> is as essential for health as is good nutrition and physical activity. Getting good sleep means going to bed when you are tired, falling asleep within 15-30 minutes, staying asleep for 6-8 hours, and waking up feeling rested.</div>
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Sleep has been the bane of my existence ever since I was a child and I have spent a lot of my life trying to sleep when my body has other ideas so I have spent a lot of time researching sleep and trying strategies that work and spent a chapter in my book, Bipolar 101, discussing sleep. Sleep behaviors are on the list of symptoms for both depressive and manic episodes. Lack of sleep triggers bipolar symptoms and makes existing symptoms worse so getting enough sleep is very important to the mental health of someone living with bipolar disorder. <br />
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For <b>manic episodes</b> sleep goes bye bye and the rush of being able to just go-go-go eventually puts us in the hospital if we don't get back on track. During a bout of <b>depression</b> many people would prefer not to get out of bed. Treatment for bipolar disord</div>
<img alt="" border="0" id="BLOGGER_PHOTO_ID_5674213285024735858" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEheFnu5p2jkViprlnjK89TWDNjmtsdhP9TGF59r1wgNiDG4jVGDyast2LA2wSIA8-MNutZq05Rbzvy47GE6p6rwjAJiBKU2d-5cLby3qPf1KCv4IbpquwyXW4WtFea5CFu4UTYxD5sSfl0/s320/alarmclock-alarm-clock-sleep-smiley-emoticon-000760-large.gif" style="cursor: pointer; float: right; height: 108px; margin-bottom: 10px; margin-left: 10px; margin-right: 0px; margin-top: 0px; width: 151px;" /><br />
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er usually gets people back on track with their sleep but if sleeplessness continues then they are often treated with medications that induce sleep.<br />
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<b>Sleep deprivation</b> (sleep deficit) is also the leading cause of accidents (of all kinds) in the USA because the brain does not function well on lack of sleep. Too little sleep also weakens our immune system so that we are more susceptible to illness. So what I am saying in this post can apply to anyone, not just people living with mental illness.</div>
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The latest research suggests that a sleep routine that keeps our <b>circadian rhythms</b> (internal clock) on a regular schedule, also keeps the mind on an even keel. </div>
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How do we do this? By developing a sleep routine; and at a minimum your sleep routine should include the following:</div>
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<ol>
<li><b>Going to bed at the same time each night and getting up at the same time each morning.</b> Everyday. No changes on weekends. This sets your internal time clock and helps keep your moods on an even keel.</li>
<li><b>Give yourself 30 - 60 minutes to prepare for bed</b> and find a way of developing a habit in terms of the sequencing of your preparation. The point is to slow down the body so it is ready to go to bed. For example, you could start by taking your medications (in particular, medications that make you drowsy) so they have some time to take effect before getting into bed? Or if they are quick acting you may want to take them last. Make sure you have set your alarm or put a glass of water by the bed (this is especially for people suffering from the dry mouth side effects of many bipolar medications). Some people find a bath calming. Others find a shower either calming or stimulating so find the activities that work best for you.</li>
<li><b>A calming down activity</b> such as meditation or yoga or reading (a calm book:). Drinking a cup of warm milk (which has naturally occurring ingredients that make people sleepy) or chamomile tea is also helpful. </li>
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Research has also shown that we sleep better in cool temperatures so make sure to turn off/down the heating in your room. A dark room also encourages sleep and if you cannot create a really dark room then sleep with a blindfold on. TVs should be banned from the bedroom. So should laptop computers and your cellphone, if you are having a hard time with distractions.</div>
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One of the best ways to get better sleep is to be physically active on a regular basis. For those who have trouble sleeping it is better if you exercise in the morning, because the body takes some time to calm down when you exercise so if you do it too close to your bedtime, your body may be to revved up to fall asleep.</div>
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<b>If you want to know more</b> about sleep and mental well-being and find evidence-based strategies for improving sleep, then check out a new publication by the <a href="http://www.mentalhealth.org.uk/">Mental Health Foundation</a> in the UK, which has published a free downloadable book on sleep called, 'Sleep Matters: The Impact of Sleep on Health and Well-Being', click <a href="http://www.mentalhealth.org.uk/publications/sleep-report/">here</a>.</div>
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The National Institutes of Health also publishes a sleep guide called, '<i>Your Guide to Healthy Sleep</i>' is available free if you click <a href="http://www.nhlbi.nih.gov/health/public/sleep/healthy_sleep.pdf">here</a>.</div>
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Powered by <a href="http://www.feedblitz.com">FeedBlitz</a></form></div>crazygirlhttp://www.blogger.com/profile/14814752703102263063noreply@blogger.com6tag:blogger.com,1999:blog-637003755226222082.post-10506615251233110522011-11-11T21:23:00.000-08:002011-11-12T14:04:51.844-08:00War and the mindToday is Veteran's Day. And in honor of all those who have served I explore the impact of war on mental health on my <a href="http://www.psychologytoday.com/">Psychology Today</a> blog with a post titled: <a href="http://www.psychologytoday.com/blog/culture-in-mind/201111/mental-health-and-the-culture-war">Mental Health and the Culture of War</a>.<br />
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Imagine what it would be like to have bipolar disorder and deal with the challenges of war and there seems to be no clear evidence that war can trigger bipolar disorder but who knows. If you know someone who is a veteran who may have mental health problems, please refer them to the <a href="http://www.va.gov/">Department of Veteran's Affairs (VA)</a><br />
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