The Mood Roller Coaster. Understanding Bipolar Disorders.

                                                                    


     Variations in our moods and energy levels are normal. We all have our share of days when we feel happy and excited, days when we feel sad and down, and even days when we feel both. On our "happy days" we may feel invigorated, joyful, and have an extra dose of self-confidence. On our "down days" we might feel blue, less energetic, and may have fleeting moments of sadness. For most people variations in their mood and energy do not prevent them from taking care of their daily responsibilities or interfere with their relationships and careers. Their "swings" in mood are far and few in between. People with bipolar disorder, on the other hand, have significant and frequent variations in their moods and energy levels. They rapidly go back and forth between periods of feeling very "high" to periods of feeling very "low". The disease is called bipolar disorder because the person affected with it alternates between two completely opposite poles-euphoric happiness and extreme sadness. Bipolar disorder affects men and women equally. The average age of onset is between late teens to early 20's. The disease has also been shown to run in families, so a person that has a relative diagnosed with bipolar disorder has a higher risk of developing the disorder at some point during his/her life time.
     There are two types of bipolar disorders: bipolar type I and bipolar type II. In bipolar type I the person has had at least one manic mood along with periods of major depression. A manic mood is described as feeling "unusually high" and euphoric. Some people during a manic period will go on shopping sprees, gamble, drink more alcohol than usual, participate in recreational drug use, and have numerous and risky sexual encounters. They may also experience disturbances with their sleep, have racing thoughts, and become hyper-verbal. A manic period can also be experienced as a persistent irritable mood.

                                                              
     Bipolar type II disorder is less extreme than bipolar type I. People with bipolar type II have never had a full manic episode. Instead they experience elevated moods (hypo-mania) and high energy with periods of depression, but their "highs" are not as extreme as they are in bipolar type I disorder.  And people with bipolar disorder type II are often wrongly diagnosed with clinical depression. Furthermore, in both bipolar type I and bipolar type II manic states can occur in rapid succession to depressive moods and this is called a "mixed" state.
     The good news is that with proper treatment, often including medications, this disease can be effectively managed. A combination of mood stabilizers, psychotherapy, and cognitive-behavioral therapy (CBT) has been shown to be the most successful combination of treatment. Psychotherapy and CBT aims to alleviate core symptoms by helping the individual to recognize mood triggers, reduce negative expressed and felt emotions, and practice coping strategies that may lead to remission.
    It is important to get an evaluation by a mental health professional if you think you have either bipolar type I or bipolar type II disorder. With proper treatment this diease can be successfully treated and managed. Below are four tips to help those with bipolar type I and bipolar type II disorder:

1. Make sure you get enough sleep. Not getting proper rest can trigger a manic episode.

2. Get regular physical exercise. Exercise has been shown to reduce symptoms of depression.

3. Make sure you have a plan in place for when your symptoms return.  This will help reduce the severity of consequences that can occur in a manic or depressive state.

4. Join a support group. Getting support from other people diagnosed with bipolar disorder can help decrease feelings of isolation. A support group can also give you the chance to learn new strategies for coping with your symptoms.

 Do you have bipolar type I or bipolar type II disorder? Do you have a loved one that has been diagnosed with this disorder? Do you have useful tips to share? I would like to hear from you.

This article was written by Paula Durlofsky, Ph.D., a practicing psychologist in Bryn Mawr, PA. Please email all questions or comments to drpauladurlofsky@gmail.com. To learn more about me and my practice visit my web page at www.drpauladurlofsky.com. 

It's REALLY Okay To Be Angry.

 

                                                  

     Anger is an emotion we are all familiar with. We have all felt it at times whether as a fleeting annoyance or full-fledged rage.  When we feel anger we experience it both physically and emotionally. Our bodies react with visceral responses such as increases in heart rate, breathing, and perspiration and our ancestral instinct of "flight or fight" kicks in.  Anger is necessary for our survival-it provides us with the drive and ability to defend ourselves. But not every circumstance warrants such a severe reaction and it would be destructive to lash out at every person that caused us to feel angry or every situation that irritated us. This does not mean we should deny our feelings of anger. It's REALLY okay to be angry. Problems develop when our anger is not effectively expressed and derailed anger can cause significant harm to ourselves, others, or both. 
     We all use a variety of psychological defenses to cope with anger, some healthy and some not so healthy. The two most common approaches to dealing with anger are repression and aggression.
      When we repress our anger we use behaviors that are passive, evasive, and obsessive (needing to be inordinately clean and tidy).  Repression can also involve emotional manipulation, self-blame, and self-sacrifice.  Defenses and behaviors of this kind prevent us from directly confronting our negative emotions and/or the source of it. This can be a "slippery slope" since repressed anger can easily turn into depression, anxiety, low self-esteem, and contributes to drug and alcohol abuse. 
     Individuals who have aggressive anger are often described as being "hotheads". They have difficulty  modulating negative emotions and they have a low tolerance for frustration. Common everyday life annoyances, inconveniences, and unexpected changes in routine causes exaggerated feelings of anger.  Bullying, being physically destructive to self or others, and overly punitive reactions such as refusing to forgive people that contributed to your anger in the first place are all forms of aggressive anger. Aggressive anger is a serious concern since it has a real potential to negatively impact important personal and professional relationships.
     No one sails through life without being touched by anger. Situations will arise where we will feel we are being unjustly treated or unplanned events will happen that require us to change our expected life course. This is why it is important to work on understanding the "why and what" that causes us to be angry and the "how to" constructively resolve it. Below are four tips to help you:

1. Simplify Your Life. If you find you are quick to get irritable or angry when you feel frustrated simplifying your life should help. Evaluate what responsibilities you can "give up" so you have less self-imposed reasons to be angry.

2. Learn Better Communication Skills. Angry people tend to jump to conclusions before they have all the facts. Learn to listen to other people by slowing down yourself and not responding too quickly when angry. 

3. Own Your Anger. If you cope with anger by repressing it learn to be able to identify when you feel anger and allow yourself to be angry. Individuals that repress their anger can feel powerless but when "get in touch" with their anger and express it in an effective way they feel empowered.

4. Make Personal Time For Yourself. Schedule time during the day to relax. We all get weighed down and irritated by our daily responsibilities. Making the time to relax by doing deep breathing exercises, meditation, and/or regular exercise helps reduce stress in general and improves our ability to better cope with those unexpected stressful situations.

How do you cope with your anger? Do you repress your anger or do you become aggressive? I would like to hear from you.

This post was written by Dr. Paula Durlofsky, a practicing psychologist in Bryn Mawr, Pa.  Email all questions or comments about this post or previous posts to drpauladurlofsky@gmail.com. You can also visit my web site at www.drpauladurlofsky.com to learn more about me and my practice.  

        

Hit The Mental Gym. Why Our Minds Need Daily Exercise To Maintain Good Mental Health.

 
      Most of us are well aware of what it means to be physically healthy and what we need to do to achieve optimal health. A balanced diet of fruits and vegetables, maintaining a healthy weight, not drinking alcohol to excess, not smoking, and daily exercise all contribute to our well-being. Exercise in particular has shown to significantly improve one's health. Not only does it keep us fit, it also helps to ward off cardiac illness and cardiovascular disease and improves our brain's capacity to retain, process, and integrate new information. But what about the idea of what it means to be "emotionally healthy".  And when necessary, what we need to do in order to improve our emotional health?  There may seem to be an obvious answer to this question, but emotional health is in fact a multi-faceted concept and maintaining it takes daily effort, just like maintaining our bodies. 
     Good mental health is composed of having high self-esteem, the ability to modulate and express both positive and negative emotions in an effective way, accurately assess reality (especially when emotions run high), having compassion both for ourselves and others, and maintaining a healthy balance between work and play. Good emotional health also entails keeping our brains physically fit. Just as our bodies change with age so do our minds. We may become more forgetful and may not be "on top" of things the way we used to be. It is important to be aware of these issues so that you can keep your mind happy and healthy.
     The first step in achieving good emotional health is deciding what aspects need to be addressed and worked on. Begin by getting an overall baseline of your emotional health by keeping track of your feelings for a minimum of two weeks. Be cognizant of when you feel anger, anxiety, and/or depression and the circumstances in which these feelings tend to occur. It is also important to be aware of the times you feel happy, satisfied, and accomplished and the situations in which good emotions are felt. The next step is to discover patterns between your feelings and specific circumstances and/or specific thoughts. For example, one mental exercise to help strengthen your self-esteem is to make a list of your actual accomplishments and emotional strengths, such as being a devoted mother, an accomplished professional, and/or being a compassionate and assertive individual. Set aside time every day to read and remind yourself of your strengths and accomplishments. Just as daily exercise needs to be done regularly in order to get results the same rule holds true for our emotional health.
     Despite old habits and attitudes being difficult to change, it is not impossible when we consistently work on replacing them with healthy and new ones. Our brain develops new ways of thinking when we regularly train it just as our muscles develop and strengthen when we consistently train them. Sometimes our own efforts to improve our emotional health are not effective and when this happens seeking professional help is often indicated. It can be difficult to improve our emotional health and for some it can take years to come to realize who you are and what parts of your emotional well being need attention. But you can begin by following these four tips:

-Take care of yourself physically by eating well, getting regular exercise, and enough sleep.
-Get a baseline of your emotional health and determine what aspects need a "work out". Develop your own emotional "work out".
-Make time to enjoy yourself. Reward yourself for a job well done. Remember your achievements. 
-Get support. Sometimes improving your emotional health means seeking professional help.

Do you have aspects of your emotional health that need a work-out? What is your emotional exercise? I would like to hear from you. 


This article was written by Paula Durlofsky, Ph.D. a practicing psychologist in Bryn Mawr, PA. Please email comments or questions to drpauladurlofsky@gmail.com. To learn more about me and my practice please visit my web site at www.drpauladurlofsky.com.