At a recent meeting of the American Psychiatric Association, researchers presented a study suggesting that ziprasidone (Geodon) was less effective in treating acute mania in people with obesity or hyperglycemia (very high blood sugar level). The study was funded by Pfizer, which makes Geodon, and was done by looking at pooled data from previous studies performed by Pfizer looking at this medication’s effectiveness.

The lead author of the study, Roger S. McIntyre, Associate Professor of Psychiatry and Pharmacology at the University of Toronto, indicated that while the findings could be related to a need for higher doses in people with higher body mass indexes, it could also be that these differences in body mass and blood sugar could reduce the effectiveness of the drug at any dose. While this type of study is apparently uncommon in psychiatric research, it is actually quite important in helping us understand patterns of effectiveness in various medications used to treat bipolar disorder.

I can usually tell when a loved one is upset with me. They sulk around the house, bang stuff, slam doors and drawers, avoid eye contact, and stop talking to me. Maybe I know the signs because I engage in the same behaviors when I’m upset.

Until relatively recently, however, I didn’t fully grasp how abusive the silent treatment can be. A major client of mine “went dark” on me. The client had failed to pay me upon completion of a project. Payment was about two months late.

After repeated phone calls and e-mail messages that never produced a payment, I stopped providing services, responding to e-mail messages, and returning phone calls.

May 25, 3pm EST, Social Security will present a 90-minute Work Incentives Seminar Event (WISE) webinar tailored to SSI and SSDI beneficiaries who live with mental illness.

The webinar, entitled “Ticket to Work for Beneficiaries with a Mental Illness – Support on Your Journey to Employment,” will provide Work Incentives and Ticket to Work program information and resources.

Register Online.

We rarely post on our original blog, Bipolar Blog, anymore; we maintain it primarily as a place where people can share their stories and insights of living with bipolar or with a bipolar loved one. I just posted a new story from Steve about his journey in rebuilding his life after receiving his diagnosis.

Check out Steve’s Story or visit our Share Your Bipolar Story page for more stories. In the middle of the page is a list of links to the stories arranged from newest to oldest. On the right is a navigation bar that list stories alphabetically.

Photo by andronicusmax, available under a Creative Commons attribution license.

As a psychiatrist, every day I encounter families struggling with mental illness, especially in their children whose lives range from disrupted to shattered as a consequence of these challenges. In these daily battles I’m most frustrated and saddened by the jaw-dropping lack of compassion surrounding me and my patients regarding their family struggles and their child’s distress.

Unfortunately, many people still view mental illness as a moral rather than a medical or developmental issue. As a result, they readily dispense judgment when someone is struggling with emotional and behavioral symptoms – shutting down open discussion and squashing attempts to problem solve rather than blame.

Even worse, stigma and misunderstanding paralyze many people who might consider seeking help but don’t because they’re afraid of being judged or feel somehow to blame. Families are told they’re being manipulated by their loved one who’s suffering or that their parenting is impaired. Just “try harder” says the teacher, the coach, the neighbor, and the in-laws.

In Bipolar Disorder For Dummies and on this blog, we have recommended numerous lifestyle and environmental changes someone can take to feel better with bipolar disorder. Readers have contributed some of their own ideas and suggestions to keep the conversation going.

While nutritional changes, mindfulness, exercise, and other such interventions don’t treat bipolar disorder, these can be important tools for making you feel better overall. Sometimes, these interventions can even reduce symptoms; for example, mindfulness can be helpful in the treatment of depression and anxiety, while exercise can boost moods.

We thought it might be interesting and fun to try something together. Making lifestyle and environmental changes is hard, so it’s usually best to make small, manageable changes – something you can do and succeed at, so you gain a sense of mastery and the encouragement to try more new things.

Last week, I attended a NAMI problem-solving workshop for people who have family members with serious mental illness, including bipolar disorder. The tone of the workshop was fairly low. Many attendees were feeling the strain of dealing with some very difficult situations.

Near the end of the workshop, the leader went around the room and asked each person what they were going to do for themselves – to take a time out and recharge their batteries. Fortunately, my family has been on a fairly even keel for several months, so I didn’t have much to say, but I think this is a good question both for those with bipolar and their loved ones:

What are you going to do for yourself? Be selfish. Think of something you really want to do that you think will help get your mind off whatever you’re currently dealing with and help recharge your batteries.

Please share. Your idea might just help someone else.

On Tuesday, Dr. Fink will be posting a Bipolar Challenge… two small changes – one lifestyle/nutritional and one having to do with activity level – to make for one week.

Photo by goXunuReviews, available under a Creative Commons license.

If you think you qualify for Social Security Disability benefits, consider taking the following steps to pursue a claim:

1. See a doctor for your condition if you have not done so already. Without documented medical evidence, you have little chance to qualify as disabled.
2. Apply for disability at your local Social Security Administration office or apply online. If you’re currently unable to do it yourself, get a close friend or relative to assist you. This should take about three to four hours.
3. If you’re denied, contact an attorney who specializes in Social Security Disability benefits.

Do you qualify as disabled?

Abilify (aripiprazole) is an atypical antipsychotic medication commonly used to treat schizophrenia and acute mania. In 2005, the Food and Drug Administration (FDA) approved its use in the maintenance treatment of bipolar disorder – to prevent the recurrence of mood episodes. Unfortunately, evidence proving the effectiveness of Abilify as a maintenance medication for bipolar disorder is scarce and questionable.

Exposing the Truth

An article published this week in the open access journal PLoS Medicine (Tsai et al) looks critically at the scientific evidence that supports such widespread use of this medicine for maintenance treatment of bipolar disorder.

The National Alliance on Mental Illness (NAMI) has a Stages of Emotional Responses chart that traces the emotional path people generally travel in coming to terms with their loved one’s mental illness. I’m pretty much at the final stage, Stage III: Moving into Advocacy, but I’m still sort of stuck at Stage II: Learning to Cope, which is characterized by Anger/Guilt/Resentment, Recognition and Grief.

Yes, we’ve been living with bipolar disorder for about 12 years now, and I’m still angry and resentful. Now, though, I’m not angry at my wife who has bipolar disorder. I blame bipolar disorder. It accosted my wife, tried to ruin our marriage, emotionally traumatized our children, ruined my wife’s career, and stole tens of thousands of dollars.