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.

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As Joe pointed out in his post “Bipolar Disorder and Family Dynamics,” bipolar disorder typically affects and is affected by everyone in a family. While no family member is to blame for having or causing the disorder, all family members can and should work together to try to avoid conflict and keep the tone of unavoidable disagreements to a dull roar. Strong emotions tend to fuel conflicts, which isn’t good for anyone involved.

While every family is different, here are some basic strategies that are often helpful in reducing the level of conflict at home:

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Researchers at Lewisham Counselling and Counsellor Associates in Britain performed a very small study to determine what impact, if any, diet and nutrition have on a person with bipolar disorder and the implications of this on psychotherapeutic practice. They presented their findings at the BACP (British Association for Counseling & Psychotherapy) Research Conference 2011. Here’s what they found:

• A link does exist between diet and bipolar disorder. Omega 3, Magnesium, Vitamin B, and low sugar intake seemed helpful in minimizing the intensity and frequency of the mood swings.
• A sudden increase or decrease in appetite or erratic eating pattern is common at the onset of bipolar disorder.
• Bipolar treatments seldom consider diet, perhaps because of its perceived association with alternative medicine.

The authors of the study suggest that including a dietitian or nutritionist on the treatment team might be a good idea.

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Recently, Bob posted a story on our original Bipolar Blog called “Heartbroken and devastated from ending a marriage with my bipolar wife.” In his story, Bob talks about all he would do for his wife only to feel unappreciated and heartbroken. I don’t know Bob or his wife or their situation. Nobody really knows what goes on behind closed doors in anyone’s home. However, I could sort of relate to Bob’s description of how he responded and how he felt.

When you’re in a loving relationship with someone who has bipolar disorder, it’s common to feel frustrated and unappreciated at times. No matter how much you do to show your love, your loved one may not be in a condition to return that love or respond to it in any positive way. The more you do without receiving anything positive in return, the greater the frustration and resentment.

You might start to wonder, “What about me? How long should I have to put up with this?”

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In a recent study entitled “Postural Control in Bipolar Disorder: Increased Sway Area and Decreased Dynamical Complexity,” Indiana University researchers measured and compared the magnitude of postural sway between study participants with and without bipolar disorder. The study involved 32 participants, 16 of whom carried the bipolar diagnosis. The control group was made up of 16 age-matched non-psychiatric healthy participants. Participants were asked to stand as still as possible on a force platform for 2 minutes under 4 conditions: (1) eyes open-open base (feet apart); (2) eyes closed-open base; (3) eyes open-closed base (feet together); and (4) eyes closed-closed base.

The researchers postulated that because many of the structural, neurochemical, and functional abnormalities identified in the brains of those with bipolar disorder are also implicated in postural control, people with bipolar disorder would have less postural control and hence a greater magnitude of sway than those without a brain disorder. In other words, there’s a connection between motor and mood disorders. The results supported their hypothesis:

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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.

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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.

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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.

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