Archives for Mania

Bipolar Stories

We Can Do Better: Bipolar in the Hospital

Recently, a young adult child of a friend of mine was admitted to a hospital for a first manic episode. She presented in the most typical of ways with sudden changes in energy, sleep, mood, thinking, behavior, and judgment. She did not see that there was anything wrong, but was eventually hospitalized, against her will, due to dangerous behaviors.
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Reducing the Risk of Triggering Mania with the Use of Antidepressants in Bipolar Disorder

A recent article in the American Journal of Psychiatry sheds light on the vexing challenge of treating depression in individuals who have an underlying bipolar disorder: For many people with bipolar disorder, depression occurs more frequently and damages function more severely than mania, but treating bipolar depression with antidepressants carries the risk of triggering manic symptoms.
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Do You Hesitate to Call the Police?

Yesterday, I served on a panel of family members who have loved ones with mental illness, where we talked to a room full of police officers (approximately 30 of them) as part of their crisis intervention team (CIT) training. NAMI-WCI (West Central Indiana) provided the training.

As I prepared my story for the presentation, I realized that I am never the one who calls 911 when my wife is experiencing a manic episode. My wife has always been the one to call, usually because she is experiencing paranoia and psychosis and feels the need to call the police for protection.

This made me wonder... why?
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Bipolar Medication

Ebselen May Work Like Lithium with Fewer Serious Side Effects

According to a recent study published in the journal Nature Communications entitled "A safe lithium mimetic for bipolar disorder," British researchers are exploring a medication called ebselen as a possible treatment for bipolar disorder in humans. Originally developed to treat stroke, ebselen may be as effective as lithium in treating bipolar mania but carry fewer and less serious side effects than lithium.

As the article points out,
Lithium is the most effective mood stabilizer for the treatment of bipolar disorder, but it is toxic at only twice the therapeutic dosage and has many undesirable side effects.
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Helping Loved One

Separating What’s Bipolar From What’s Not

One of the things I hate most about bipolar disorder is how subtly sinister it can be when a loved one is trending toward mania — not manic yet or even hypomanic, just talking faster and louder, blurting out statements that are a little too open and honest and perhaps hurtful, and being more self-centered than usual.

A lot of bad stuff can happen during these times to drive a wedge between loved ones, but nothing bad enough to convince the person or a doctor or therapist that bipolar is at work.

During periods of low-grade pre-hypomania, uncertainty fogs the mind. In our family, we argue more and "walk on eggshells." Everyone's afraid to mention the elephant in the room out of fear of being accused of blaming bipolar disorder or the person who has it for our family drama. After all, the rest of us in the family are admittedly less than perfect, and even in a normal, healthy family (whatever that is), interpersonal conflicts arise.
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Bipolar Disorder Emergency: Send Police and an Ambulance

The other day, I was looking through a very helpful publication entitled "What To Do in a Psychiatric Crisis in Indiana," published by NAMI Indiana. I read it before and mentioned it in a previous post entitled "What To Do in a Psychiatric Crisis," but what struck me this time was the discussion of calling 911. If you call 911 to report a psychiatric crisis, the dispatcher is most likely to send the police, and NAMI cautions:
It is important to note that depending on the police officer involved and other contingencies, s/he may take your loved one to jail instead of to the emergency room. Be clear about what you want to have happen.
That's excellent advice, but wouldn't it be better if you called 911 to report a psychiatric crisis, and instead of just the police an ambulance arrived, too? After all, bipolar disorder is an illness, and ambulances have medications that can calm a person down. Also, wouldn't someone who's experiencing a major mood episode be more inclined to voluntarily go away in an ambulance than in a squad car? Wouldn't it be less stigmatizing?
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What To Do If a Loved One with Bipolar Disorder Is Arrested

If a loved one with mental illness or suspected mental illness is arrested, the goal is to transition the person as quickly as possible from the legal system to the healthcare system. The Los Angeles NAMI Criminal Justice Committee has posted a very thorough seven-step guide to help families navigate the criminal justice system in Los Angeles County when a family member who suffers from a brain disorder (mental illness) is arrested. It's called "Mental Illness Arrest: What do I do?"

This post changes the process a bit, removes details related to the Los Angeles jail, includes some additional notes and tips, and presents everything in more of a checklist format.
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Antipsychotics More Effective for Treating Acute Mania

A study published last week entitled "Comparative efficacy and acceptability of antimanic drugs in acute mania: a multiple-treatments meta-analysis" (Cipriani et al The Lancet 17 Aug 2011) reviewed many previous trials of medications for mania. It looked at results for any of the following medications: Aripiprazole (Abilify) , asenapine (Saphris), carbamazepine (Tegretol) , valproate (Depakote) , gabapentin (Neurontin), haloperidol (Haldol), Lamotrigine (Lamictal), lithium, Olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal) , topiramate (Topamax), and Ziprasidone (Geodon).
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