Archive for January, 2011

Have You Decompensated Lately?

Friday, January 28th, 2011

distressed young womanRecently, I heard the term decompensate for the first time. The therapist seemed surprised that I had never heard it.

Given the definition of compensate – to reimburse – I thought decompensate might mean something along the lines of having your disability payments taken away. You might say something like “Social security just decompensated me, now what am I going to do?” or “Bipolar disorder decompensated me, and now I have no money to pay the bills.”

The therapist explained that decompensation is what occurs when everything you’re doing to prevent a mood episode (to compensate for the illness) just isn’t enough.

When I mentioned to Dr. Fink that I had never heard the word, she said I must be a big dummy. Well, she didn’t actually use those words. Here’s what she really said.


Do You Have Seasonal Bipolar Disorder?

Tuesday, January 25th, 2011

seasonal bipolar disorderAccording to an article by Debra-Lynn B. Hook entitled “How SAD Affects Bipolar Disorder,” as many as 20 percent of people with bipolar disorder can expect to experience seasonal depression and/or mania or hypomania. The article distinguishes between those who experience seasonal affective disorder (SAD) and seasonal bipolar disorder.

Hook describes several treatment options for dealing with this seasonal component, including using light therapy in the winter and melatonin to help regulate circadian rhythms.

I was somewhat surprised that only 20 percent of people with bipolar report a connection between mood and seasonal changes.

Have you noticed a connection? What do you do, if anything, to maintain mood stability as the seasons change?

Photo by Michael Spoula, available under a Creative Commons attribution license.


Just a Poor Choice of Words?

Tuesday, January 18th, 2011

mental illness and stigmaPaul Heroux recently penned an op-ed piece entitled “Can we help them before they hurt us.” To be fair, Heroux admits the poor choice of words in the title in his response to a reader’s comment:

“I write op-eds all the time. I don’t choose the titles of my op-eds, the editors do. That said, I don’t think the editor meant anything malicious by it but you do raise a good point.”

Unfortunately, malice is rarely the motive that drives stigma. Ignorance and insensitivity are the primary culprits. Also, I don’t believe Heroux’s admission gets him completely off the hook. Although he attempts to write a balanced piece, his approach tends to lean toward fueling fear and reinforcing an us-vs-them mentality.

I encourage you to read Heroux’s op-ed in its entirety before reading my comments on it, so you can see the quotes I reference in their context. It’s only fair.

While I understand that writers need to be a little dramatic or controversial to hook readers, I think the hook in this article goes a little too far in inciting fear:


How Long Before I Can Taper My Bipolar Meds After a Manic Episode?

Tuesday, January 11th, 2011

tapering bipolar meds

Cecie Asks…

I’ve been told that it has become increasingly the norm to only take the anti-psychotic medications and the heavier hitting mood-stabilizers for a limited period of time to get the moods and scary thoughts under control (when you feel an episode “coming on” or to recover from an episode you were unable to avoid) and then to stop them when you are stabilized.

I guess the idea is…

  1. You don’t have to be under the effects of these medications any longer that is absolutely necessary.
  2. These medications are actually more effective when used for only a short period of time, during the “acute” phase of the illness.

My questions are:

  1. Is this something you recommend to some/all of your patients?
  2. How long can I expect to be on an anti-psychotic medication and stronger mood-stabilizer after a manic episode with psychotic features?

College Campuses Experiencing More Mental Health Needs

Friday, January 7th, 2011

mental health on campusIn an article in The New York Times entitled “Mental Health Needs Seen Growing at Colleges,” Trip Gabriel explores the increasing demand for mental health services on college campuses across the country.

The college years have always been vulnerable to mental health issues – partially due to the stresses of academic demands and the transition to living more independently and partially because late adolescence/early adulthood is the most common time to see full blown first breaks of major mental illnesses, including depression, bipolar disorder, and schizophrenia.

But in recent years it has become clear that more and more students are coming to campus with previously diagnosed psychiatric conditions and taking medications. While this may be a sign of over-diagnosed and over-medicated youth, I see it in a more positive light for three possible reasons:


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Candida Fink, M.D. and Joe Kraynak are authors of
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