A contributor to our Bipolar Blog recently shared her story of living with Bipolar II and how a vegan diet along with 5-HTP and exercise helps her maintain mood stability. That got me thinking that it might be interesting and helpful to hear from others about what works (and what hasn’t) for them.

We’re all on a bipolar journey, and everyone travels a different path. Hearing what works and what doesn’t can often keep others off dead-end roads and provide shortcuts to more effective treatments so they feel better sooner.

Please share. What’s your diagnosis? What works for you – medication and non-medication? What hasn’t worked in the past?

Note: This is just for people with bipolar disorder. On Thursday, family and friends of those with bipolar will have their chance to share.

Photo by Martin Cathrae, available under a Creative Commons attribution license.

When’s the last time you saw your doctor for a med check? A month ago? Six months ago? A year or more? Getting regular med checks, which can vary from weekly to quarterly depending on the level of acuteness of your symptoms, is important for a number of reasons:

• If you were placed on medications to treat acute mania or depression and you’re feeling better now, your doctor may want to remove certain medications and/or decrease dosages to maintenance levels. You don’t want to be taking more medication than necessary. During a major manic episode, for example, doctors often prescribe a mood stabilizer, such as lithium, along with an atypical antipsychotic, such as Zyprexa, and then gradually withdraw the atypical antipsychotic as the patient improves.
Continue reading… »

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.

If brain chemistry can affect thoughts and behaviors, can thoughts and behaviors affect brain chemistry and perhaps even rewire the brain?

Yes.

An accumulating body of evidence supports the notion that non-medical interventions – especially mindfulness – can create changes in the body and brain that help reduce distress and improve brain function in a variety of ways.

MindfulnessA mental state of heightened awareness, free of distraction, and more conducive to deliberate thought and action.

Kelly Asks…

About a month ago, I was taken off my Lamictal, lithium, Seroquel, and Zoloft. I have a new Dr. who has prescribed me 150mg of Wellbutrin SR and 600mg of Neurontin. I became very depressed, had sleeping problems, and then as the third week hit, I became suicidal.

She increased my Wellbutrin SR to 150 mg twice a day and Neurontin up to 900mg (300mg morning and 600mg in the evening). I feel she is not treating me for my rapid-cycling Bipolar. I am either up or real real down, more down moments than my manic high, which often occurs.

Is she helping me or going to hurt me? I do not want to visit any more hospitals as a result of a doctor not giving me the right doses or too little or, as it is now, I have no antipsychotic meds, which is worrying me. Is this why I feel so depressed and suicidal thinking?

Please help. I am 43. I am not a child with Bipolar. Is this weak for my case? I have been hospitalized twice with Bipolar and I really wish to stay out of them. HELP PLEASE!!!!

Dr. Fink Answers…

Hi, Kelly. I am so sorry to hear that you are struggling like this right now. Most importantly, you should continue to express to your new doctor how badly you are feeling and insist that she explain to you what she is doing and why.

I recently read an interesting article by Kristy Foster on the Farm and Dairy website entitled “A healing place: Farming has a hand in recovery for those suffering from mental illness.” The article shines a spotlight on Hopewell Farm in Mesopotamia, Ohio – a unique 300-acre treatment center for adults with “schizophrenia, schizoaffective disorder, bipolar disorder, major depression, and other forms of serious mental illness.”

Hopewell has the capacity to serve 40 adults, each of whom is expected to work on a crew, when well enough to do so. Each work crew serves a specific need in the community: housekeeping, kitchen, maintenance and grounds, farm and garden. In addition to requiring residents to serve on a work crew, Hopewell’s program includes:

Just read an article out of Glasgow, Scotland entitled “Laughter’s the Best Medicine,” about an interesting supplemental treatment for bipolar disorder and other illnesses – comedy courses.

According to the article, a Glasgow-based charity organization won a three-year £62,500 (approximately $100,000) grant from the Esmee Fairbairn Foundation to “provide free comedy courses aimed at improving confidence and self-esteem, as well as reducing the social isolation and depression, that ill health – mental and physical – can cause.”

I’m not sure how effective this would be in treating acute bipolar symptoms, but it certainly sounds like a great way recover from the fallout and remove a major stressor – the social isolation that often rides the tail of a major mood episode.

What I wonder is, would insurance cover this? Maybe I’ll call just to hear them laugh.

Photo by Cristiano Betta, available under a Creative Commons attribution license.

Recently, 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.

Dialectical Behavioral Therapy (DBT for short) is a specific subtype of Cognitive Behavioral Therapy (CBT for short) originally developed by Dr. Marsha Linehan to treat individuals with borderline personality disorder. The program focuses on learning and practicing emotional and interpersonal skills that are usually not well developed in people suffering with this condition.

DBT’s Five Core Modules/Skills

DBT contains a number of modules for building specific skills both in an individual and group setting. Training targets the development of five core skills:

• Mindfulness
• Distress Tolerance
• Emotion Regulation
• Interpersonal Effectiveness
• Self Management

The Case for Using DBT to Treat Bipolar Disorder

Beyond its role in DBT, mindfulness has gained a great deal of attention recently as a tool for helping in the treatment of a number of psychiatric conditions including depression and ADHD. The strategies of mindfulness are actually ancient techniques, but we are increasingly able to study and prove the brain benefits of these practices.

We have three cats. Since our dog passed away several years ago, I’ve been the one holdout in the family in our decision to get another dog. I like the freedom of being able to take off for a couple days without having to figure out “what to do about the dog.” Besides, bringing a clueless dog into a house with three crafty, conceited cats seems to me to be borderline animal cruelty.