Archives for Psychotherapy


Confusing How and Why Is Prolonging The Suffering in Bipolar Disorder

Do you suffer from bipolar disorder or know someone who does? If you want to end all suffering you need to understand the difference between why and how. The reason so many people are still suffering is because this difference has not been made clear enough.

Why do people go to a psychiatrist? To end the suffering. Why do they go to a therapist? To end the suffering. Why do they engage in any treatment regimen? To end the suffering. We don't go there for medicine, for therapy, or for any of the other tools that we are given. We go there in hopes that they can help us remove the suffering.

And we didn't go there seeking remission for mania or depression. We went there to remove the suffering. We were told, though, that remission and the tools that aim to produce remission is the way to do it.

Does remission work? Perhaps temporarily. But in the end we must admit that the answer is no. And that is the conclusion of the biggest research on bipolar disorder ever conducted by the National Institute Of Mental Health. The research is called STEP-BD and this is what they say: "
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We Are Capable Of Far More Than The Limitations Most People Accept

Do you have bipolar disorder or know somebody who does? What would change if you could learn how to turn depression and mania on and off whenever you wanted to? The entire way we look at bipolar disorder would change in profound ways. Some of them are beyond most people’s imagination, but a simple illustration will help you to see why some of us say bipolar is an advantage that we do not want to give up.
Please understand that I am not talking about people who do not know how yet say “snap out of it” or any other offensive phrase, but the actual ability to do it which is an incredibly advanced skill.
I have been openly sharing my journey and exploration of the possibilities with bipolar for over 10 years now. It seems that sometimes I push the boundaries a bit too far and am met with pretty hostile pushback. This is a dilemma for me because I want to help others but I am afraid that this time it may be perceived once again as going too far. Nonetheless I have been thinking about and working on this idea for the better part of this year and I feel it is the most significant breakthrough that I have made so far in my understanding of bipolar.
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X-Men: Days of Future Past Explores Bipolar Disorder

I have long argued that the X-Men movies are a great metaphor for bipolar disorder. When X-Men: The Last Stand came out I wrote an article about how the X-Men’s struggle to control their “super powers” are analogous to our struggles with mania and depression. When the newest movie came out I was hoping to see further evidence in support of my ideas and was not disappointed.

There are so many parallels between X-Men: Days of Future Past and bipolar conditions that I could write several articles about them, but I want to just briefly mention a few and then focus in on the one that I find the most meaning in. The movie mentions meds, genetics, and mental difficulties, but the parallels to my own views on depression is uncanny.
Medication plays a central role in the movie. Hank uses a special formula to control his tendency to turn into “the beast.” Based on that formula, Hank creates a different version for the young Charles Xavier to use to control his condition. Young Charles takes too much and loses his ability to function at all. The parallel to common experience with psych meds is pretty obvious.
Later in the movie, young Charles tells Eric that the meds help him to walk. Eric mocks him for trading his power for the ability to walk and young Charles responds that he takes meds because it helps him sleep. The way he says it indicates that without the meds his life is unbearable.
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Bipolar People Get Angry Too

Bipolar in disorder combined with anger is a very dangerous mix. The disordered person tends to become very volatile and can explode into a rage with little provocation. It is best for the person to avoid anything that might trigger anger until the disorder is in remission, but even then an angering stimulus can trigger another manic or depressive episode with anger as one of the troubling elements.

Bipolar people who have their condition in order have learned important lessons that can be applied to most of our experiences. For example, since we understand bipolar so well that we can function highly during depression and mania, we can also handle more intense states of anger without losing control.

As with every experience, most people can usually function fine when anger is at a very low intensity, but when the intensity of anger increases beyond their comfort zone they begin to lose the ability to choose their response to it. They act in ways that are less than optimal. They may even become a danger to themselves and others if the anger becomes too intense.

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Mindfulness Does Not Lead To Happiness

The part of our minds that most people identify with is the part that silently talks to us with a running commentary. We listen to it all day long. Let’s call it “The Talker.”

“The Talker” prefers pleasure over pain, happiness over sadness, winning over losing, health over sickness, and any of the other judgments that help us navigate our lives. Although it plays a critical role that we cannot live without, “The Talker” is stuck in the duality that makes us judge one thing better than another. It does not allow us to experience the world without judgment.

The central principle of mindfulness is to look at experiences without judgment. Adherents of mindfulness often speak of the part that practices mindfulness as “The Watcher.” It lives outside of the duality and sees everything as equally valuable. Mindfulness is a wonderful practice that increases awareness of what is really happening because “The Watcher” does not ignore or accentuate details based on preferences.

Unfortunately, many claim that mindfulness leads to happiness. As happiness and sadness are judgments based on preferences, this breaks with the whole concept of looking at our experiences without judgment. Mindfulness practiced properly does not lead to happiness; it leads to a greater awareness of whatever you are experiencing whether you like it or not.
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Bipolar Advantages – No Longer If, But Why And How

I attended a great presentation at the APA annual conference in San Francisco about Achievement, Innovation, and Leadership in the Affective Spectrum. Four distinguished panelists gave presentations about their research into why people with bipolar disorder tend to exhibit advantages in some parts of their lives. They said it was the first time ever that the APA had such a discussion and it was a great honor to be a part of it.

First up was
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Accounting For Time In Depression and Mania

When I look at how they account for time in the DSM-V, I wonder if they know anything about depression or bipolar. They know time plays an important role, but they don't seem to understand the role that time plays whatsoever. By the way they define it, you can have a very low intensity depression for 14 days and it's called depression, yet an intense depression for 13 days doesn't count. This makes no sense at all, yet is the only accounting for time they provide.

Properly accounting for time takes an understanding of the relationship between time and intensity. You cannot learn that relationship by asking people a brief checklist of common symptoms as is done in the currently popular assessments. You need to know the right questions to ask.

I learned the right questions by doing more accurate assessments that include asking about the relationship at different intensities between awareness, understanding, functionality, comfort, and value mentioned in the previous articles in this series. This led to a deeper understanding of how to ask about time.

The most important question to ask about time is how long before each level of intensity causes one to lose functionality. When we base the answer on a thorough functionality assessment, we understand the relationship between time and intensity in ways the authors of the DSM completely miss. Although intensity is a major factor in predicting how long one can remain highly functional, there are many others equally important. If one is not aware of the lowest intensities of depression or mania until functionality has already been lost, for example, there is very little time to do something about it and avoid another crisis.
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Measuring Functionality In Depression and Bipolar Disorder

Many bipolar people say they are "high-functioning," but most of them mean they function OK when in remission and cannot function when things get too intense. How well one functions DURING depression or mania defines the difference between Bipolar Disorder and Bipolar IN Order. At every intensity, functionality influences the comfort of everyone involved and whether they see value in the experience. Functionality should be the central focus of any approach to bipolar instead of simply trying to make it go away.

Many think intensity of depressive or manic episodes is the determining factor in functionality, but evidence contradicts such belief. Far more important are awareness and right understanding as outlined in the previous articles in this series. With enough education and practice, intensity becomes far less relevant to functionality than most people believe. Functionality does not mean driving as fast as your car will go or talking so much you take over the conversation. It must include the ability to do the things necessary to function in society. Measurements for physical, mental, emotional, spiritual, social, and career/financial productivity need to be part of the analysis. Real functionality includes the ability to get along with others and for them to be comfortable with your behavior.

The functionality scale, like the other items in the graph, runs from zero to one hundred percent in increments of ten. Fifty is a normal person during normal times. Less than fifty means that depression or mania is causing one to function less well than normal, whereas above fifty means functionality is enhanced.
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