advertisement
Anger

Explosive Outbursts Not Necessarily Childhood Bipolar

My phone buzzed with a panicked text from Lisa, the mother of Ariana, an eight-year-old girl I am treating for anxiety and school phobia. Ariana's terror at the idea of going to school has often led to explosive outbursts when parents have pushed her to go. The treatment has been stop and go, but Ariana is making some very slow progress with a lot of support.


Advocacy

Stop Trying to Stop Enabling Bipolar Behavior!

Sandra lives with bipolar disorder. I am her psychiatrist or p-doc or shrink (as in Dr. Fink, the shrink). Sandra (not her real name), and I have worked together for many years. At today's appointment, she is moving a little slowly due to some back pain, but she tells me that her mood and energy have remained steady. That is outstanding news, because until a couple of months ago she was experiencing a terrible mood episode that rocked her life—a difficult mixed episode (mania and depression), along with substance use and memory and thinking problems. Her symptoms disrupted relationships with her family and worsened existing financial troubles. But, fortunately, her mood and energy level have not wavered to any clinically significant degree. Today she smiles and tells me about her volunteer work and playing tennis with a friend. Then she stops, and she cries softly and asks me how to help her parents understand what is wrong with her.

While the good news is that many people in Sandra's life are starting to grasp that bipolar disorder is the problem (and that Sandra is not the problem), her own family of origin shuns and shames her, telling her that they have been advised to "stop enabling" her "bad behavior." They will not let her come to stay with them, and she has been excluded from family events. Sandra is heartbroken.


Bipolar Depression

Depression and Bipolar Disorder Linked Biologically to Cardiovascular Disease

The American Heart Association has released a statement (circ.ahajournals.org/content/early/2015/08/10/CIR.0000000000000229.abstract) identifying major depressive disorder and bipolar disorder in adolescents as specific risk factors for the early development of cardiovascular disease. Their review of numerous studies shows consistently higher risks of cardiovascular disease in adolescents with mood disorders compared to those without.

Increased rates of heart disease in adults with depression and bipolar disorder have been well documented, but this is the first full examination of the data in young people with mood disorders.


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.


Antidepressant

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.