Treatment

Bipolar disorder (BD) is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out daily responsibilities. If you have been diagnosed with BD, you may experience mania and/or depression, depending on the type of BD you have. Mania is often characterized as having heightened energy, feelings of elatedness, a sense of grandeur and more. Depressive episodes involve extreme fatigue, a sense of hopeless, sadness, and even suicidal ideation. While many people may address the challenges that are associated with BD, there are aspects of this disorder to celebrate: creativity! BD has long been linked to creativity, but it’s been relatively unknown how this sense of creativity positively impacts those with the disorder. Some past research has taught us that those with BD to a lesser extent have been shown to be more creative than those with severe cases of BD, but many people with the disorder tend to take on creative careers such as those in filmmaking, visual artistry, performing, writing, designing and more. A 2015 study published in Qualitative Health Research conducted focus groups with creative participants who were diagnosed with BD. During the focus groups, the researchers asked several questions, including:

Recovery can be challenging because it involves building a new lifestyle for a better future. If you’ve recently begun a treatment program, you may feel apprehensive about your capabilities; many people who begin recovery have identified with a label – “addict”, for example – that holds them back from their true potential. Motivational enhancement therapy (MET), may help you discover the self-confidence that you need to push through the barriers that addiction tries to enforce on you. MET is designed to help people find new labels of their lives – ones that incorporate happiness, health, recovery, and much more. In the first session, your therapist will conduct an initial assessment to learn more about your history with substance abuse and your thoughts on recovery. Your therapist may work with you to come up with an action plan, as well as discuss with you some useful coping strategies that could help you in times of need. MET therapists are trained to listen to you rather than tell you what to do – this places the decision-making process in your hands. Your therapist won’t argue with you regarding any thoughts or decisions you plan to make about recovery; rather, they will explore with you all of the possibilities that you could take and help you make an informed decision. Ambivalence is completely normal when considering a major change. Often a key method for deciding if treatment would be best is to conduct a cost/benefit analysis; talk to your therapist about the benefits of attending treatment and what it could do for your life, as well as some potential challenges you may run into and some hesitancies you are having. On some occasions, addressing these issues may allow you to reconsider if the risks are all that bad – or more, what you may do in situations where these risks arise. If you’re unsure of whether treatment is the best option with you, schedule an appointment with a professional at a reputable treatment center. Get more information and speak with a therapist regarding your thoughts. Sometimes all it takes is talking to another person out loud so that you can process everything in front of someone who truly cares about your happiness and health.

If you have anxiety, you’ve probably noticed at one point or another your heartbeat escalating, your thoughts racing, and feelings of nausea, fatigue, dizziness, etc. Anxiety is caused by worry, nervousness, or unease typically surrounding an event or something with an unpredictable outcome. Thankfully, cognitive behavioral therapy (CBT) has been shown to help many people with anxiety; in fact, it’s one of the most effective, widely-used therapies for this issue. If you’re ready to incorporate CBT into your daily life, begin taking control over your anxiety by following these steps: Step 1: Begin taking note of your thoughts, feelings, and sensations in a log. Get a journal and write down every instance that you feel anxiety. What are your thoughts at the time? What situation is this regarding? Did someone say or do something to make you feel this way? How would you describe your feelings? What physical sensations are you feeling (ex. sweaty palms, heart racing, etc.)? Lastly, how did your anxiety influence the situation/interaction? For example – did it cause you to leave an event early? Not go at all? Taking inventory of these can help you become an investigator of your own reactions. Step 2: Recognize patterns that are coming from these notes. Is there a certain time of day you experience anxiety the most? What about a specific person or place that tends to lead you to a lot of anxiety? Highlight commonalities between your experiences – with assorted colors if that makes it easier for you. Step 3: Do a cost-benefit analysis. As you review the notes you’ve taken so far, write another list that weights out the benefits and the consequences to having this anxiety. For example, how has having anxiety helped you? In what situations has it caused more pain or discomfort, when it didn’t really need to? This is your change to get an understanding for how anxiety is affecting your life. Step 4: Create alternative ways to react. What can you think to yourself that will make you more at ease, more confident, and less worried? For example, if you’re nervous about going to a work gathering, write the following thought: “The gathering will go well, and I’m excited to get to know other people.” Even if you don’t necessarily feel that way, stick with these positive thoughts. Step 5: Practice daily, no matter how you’re feeling. This is a great start to CBT – towards changing your thought processes towards something more positive and productive. Practice this every day, no matter how you’re feeling.

There are times when we see changes in our loved ones – changes they may not directly be able to see. When it comes to mental illness, stigma often causes people to either fear to have one or to fear others who have one. If your loved one does not believe they have a mental illness, but you are certain there are obvious signs of this, they may be in denial. This can be particularly challenging, especially if you want your loved one to seek help. A 2015 study titled “Assessing and Improving Clinical Insight Among Patients in ‘Denial’”, emphasized the difference between denial and lack of insight – does your loved one reject the notion that they have a mental illness or have symptoms of one, or have they simply not recognized the connection between their thoughts, feelings, and experiences and how they relate to mental illness? Denial is often considered a psychological defense mechanism, while lack of insight could be due to symptoms being perceived as a sign of something else, having neurocognitive deficits that make it challenging to form connections between instances such as these, or having a unique way of thinking about symptoms, mental illness, etc. If your loved one has been open to talking about mental illness with you, you may want to consider having them speak to a therapist. Motivational interviewing is a technique that helps those with apprehension come to their own realizations about their mental health and recovery options. Rather than push the client towards choosing recovery, the therapist may gently probe them with questions and will remain supportive and neutral during the entire process. Some people with a lack of insight into their mental illness don’t seek treatment because they don’t know they need to – this could be a wonderful time to help them gain insight into their experiences. If your loved one doesn’t believe they show signs of a mental illness, but you can see it’s potential for significantly reducing their quality of life, you may want to speak with a professional about staging a family mental health intervention. Untreated mental illnesses often get worse over time and could lead to the development of either another mental illness or an addiction, as a person tries to self-medicate to cope with their symptoms. Getting several friends or family members together with clear examples could help your loved one understand the truth.

The American Society of Addiction Medicine (ASAM) has identified drug overdose as the leading cause of accidental death in the United States, with 20,101 overdose deaths related to prescription pain relievers and 12,990 overdose deaths related to heroin use in 2015. People all over the United States have been attempting to find an alternative, holistic solutions to chronic pain due to the epidemic. Acupuncture is considered a form of complementary medicine used to alleviate pain and to treat various mental, physical, and emotional conditions – as such, it is becoming a more popular tool for both those who want to avoid taking opioids and for those detoxing from them. Many people detoxing from opioids are turning to holistic treatment methods such as acupuncture to assist them in their recovery. A 2016 study published in the Eastern Asian Archives of Psychiatry found that acupuncture accelerates a person’s endorphins and encephalin productions in addition to up-regulating the dynorphin level, suppressing withdrawal at the spinal level. Overall, it was found that acupuncture could assist in depressive and anxiety-related withdrawal symptoms. In general, acupuncture has been known to treat musculoskeletal problems such as back and neck pain, as well as issues such as nausea, migraines, insomnia, and more. For those seeking a route other than opioid medication for their pain, acupuncture shows promising results; this treatment method has been shown to increase the levels of various chemicals in the body, such as epinephrine, endorphins, serotonin, and dopamine. An increase in these levels is what contributes to the pain and stress relief that many people report. Although many people are advocating for these benefits, research is still being conducted on the efficacy of this method for the prevention and treatment of opioid addiction. If you are in a reputable treatment program for addiction, however, acupuncture could be an excellent therapy method to complement your treatment regime. If you’re currently struggling with opioid addiction, make the decision to seek help today. By participating in a treatment program, you can develop tools towards living a happier, healthier life.

Individualized treatment has become more widespread than ever before, as researchers have found that each person’s unique history, experiences, and background contribute to their needs in recovery. Whether you’re attending treatment for a mental illness or addiction, your family dynamic can provide a lot of information to your healthcare team. When a therapist asks you questions regarding your family, this gives them insight into how you were raised and what problems you may have endured when you were younger. Most of us carry the weight of these issues far into adulthood, affecting our mental health and potentially factoring in as a cause of our substance abuse. Family systems theory was coined by American psychiatrist Dr. Murray Bowen and is based on the idea that a person is always connected to their relationships; they cannot be looked at individually without exploring the dynamic of their relationships and how they fit into a larger, complex system that serves as an emotional unit. According to Dr. Bowen, changes of behavior in one family member are likely to have an influence on everyone else in the family. The theory further suggests that as boundaries of a family system tend to change, roles within the family must change to maintain the family’s stability. If a family refuses to change their pattern of behavior, dysfunction may occur. Family doesn’t always mean “mother” or “father” – family is often made up of traditional families such as couples, single parents, adoptive families, foster relationships, grandparents raising children and stepfamilies, extended families such as grandparents, uncles, cousins, etc., and elected families such as godparents, friends, etc. The way in which you relate and communicate with these various systems says a lot about you and how you experience life. From this, a treatment center can explore what your needs are and what type of treatment would be best for you. Family systems are a major informant of what you need for treatment, but this is not the only factor. Your mental health and substance use history, genetics, biology, abuse history, personality, behavioral patterns and more can provide a lot of information as well.

Borderline personality disorder (BPD) is a mental illness categorized as having difficulty regulating emotions, difficulty controlling behaviors, and holding an unstable sense of self. People with BPD often experience emotions intensely and for extended periods of time, making it rather difficult for them to return to a foundational baseline after a particularly upsetting event. If you have BPD, you may experience symptoms of insecurity, impulsivity, feelings of worthlessness, and more, which can greatly affect your daily life. Unfortunately, there is much stigma associated with BPD, and between these and the symptoms experienced with the disorder, individuals with BPD are prone to self-injury and suicidal behaviors. Dialectical behavior therapy (DBT) is a form of cognitive behavioral therapy (CBT) which has been used to help treat those with BPD. The primary goal of DBT is to transform negative thinking and destructive thought patterns into more positive outcomes, such as building skills to better regulate emotions, reduce stress and anxiety, build self-management skills, control destructive habits, and more. Despite all of these wonderful outcomes, how does DBT address suicidal thoughts and behaviors specifically? One study sought to explore this very question. A 2015 study published in the journal JAMA Psychiatry analyzed the results of 99 women who were diagnosed with BPD and had previously had 2 suicide attempts and/or acts of self-injury within the past 5 years, attempts within the past 8 weeks before the study was conducted, and a suicide attempt within the past year. Participants were placed in either a standard DBT treatment program, a DBT skills training program, or a DBT individual therapy program. Results from the study indicated that while DBT is an effective form of support for those with BPD who are struggling with self-injury and/or suicidal behaviors, DBT skills training may lend itself the most to outcomes related to this area of concern. What skills are taught in DBT skills training? The following are just a few:

Major depressive disorder (MDD) and generalized anxiety disorder (GAD) have been clinically shown to have four major overlapping symptoms: restlessness, loss of energy or feeling fatigued much of the day, difficulty concentrating, and sleep disturbances of insomnia. Rumination can be another experience associated with either disorder and has been defined in previous studies as “a negative, repetitive style of thinking about present and past symptoms, loss, and failure.” When we ruminate, we tend to dwell not only on events that we can’t change, but also on the “negative” aspects of our lives. While rumination is dangerous for anyone, it can be especially dangerous for those with MDD and/or GAD due to the other symptoms experienced. A 2015 study published in the Journal of Abnormal Psychology sought to the effects of rumination on those with either or both disorders. The research study involved 145 participants, 38 of whom were diagnosed with MDD but not GAD, 36 of whom were diagnosed with GAD but not MDD, a dual-diagnosis group which consists of 38 individuals whom were diagnosed with both MDD and GAD, and 33 individuals with no diagnosis to serve as a controlled group. Participants completed interviews and also wore an electronic device that would produce signals throughout the day; individuals were asked to record their thoughts and whether they were “positive” or “negative” each time the device signaled them to. Results from the study showed the greater rumination predicted more symptoms of those experienced with MDD or GAD; it also predicted greater levels of social withdrawal, inactivity, and behavioral avoidance. This makes sense, because during those times that we engage in rumination, we’re so hyper-focused on what our lives our lacking – why would we want to participate in life more? Participants with either MDD or GAD experienced difficulty in engaging in motivated activity when they were ruminating. Overall, the study’s results show that rumination can cause a lot of damage. Why? Because it can take us away from the present moment, it can exacerbate the symptoms of a mental illness, and it can cause us to hold back on what is supposed to make life more enjoyable. Speak with your therapist about ruminating if it’s something that you struggle with. Identify tools to overcome it. It is possible to change your thinking patterns – cognitive behavioral therapy (CBT) is a common therapy tool for this.

Recovery can be challenging, because it involves building a new lifestyle for a better future. If you’ve recently begun a treatment program, you may feel apprehensive about your capabilities; many people who begin recovery have identified with a label – “addict”, for example – that holds them back from their true potential. Motivational enhancement therapy (MET), may help you discover the self-confidence that you need to push through the barriers that addiction tries to enforce on you. MET is designed to help people find new labels of their lives – ones that incorporate happiness, health, recovery, and much more. In the first session, your therapist will conduct an initial assessment to learn more about your history with substance abuse and your thoughts on recovery. Your therapist may work with you to come up with an action plan, as well as discuss with you some useful coping strategies that could help you in times of need. MET therapists are trained to listen to you rather than tell you what to do – this places the decision-making process in your hands. Your therapist won’t argue with you regarding any thoughts or decisions you plan to make about recovery; rather, they will explore with you all of the possibilities that you could take and help you make an informed decision. Ambivalence is completely normal when considering a major change. Often a key method for deciding if treatment would be best is to conduct a cost/benefit analysis; talk to your therapist about the benefits of attending treatment and what it could do for your life, as well as some potential challenges you may run into and some hesitancies you are having. On some occasions, addressing these issues may allow you to reconsider if the risks are all that bad – or more, what you may do in situations where these risks arise. If you’re unsure of whether treatment is the best option with you, schedule an appointment with a professional at a reputable treatment center. Get more information and speak with a therapist regarding your thoughts. Sometimes all it takes is talking to another person out loud so that you can process everything in front of someone who truly cares about your happiness and health.

If you have anxiety, you’ve probably noticed at one point or another your heartbeat escalating, your thoughts racing, and feelings of nausea, fatigue, dizziness, etc. Anxiety is caused by worry, nervousness, or unease typically surrounding an event or something with an unpredictable outcome. Thankfully, cognitive behavioral therapy (CBT) has been shown to help many people with anxiety; in fact, it’s one of the most effective, widely-used therapies for this issue. If you’re ready to incorporate CBT into your daily life, begin taking control over your anxiety by following these steps: Step 1: Begin taking note of your thoughts, feelings, and sensations in a log. Get a journal and write down every instance that you feel anxiety. What are your thoughts at the time? What situation is this regarding? Did someone say or do something to make you feel this way? How would you describe your feelings? What physical sensations are you feeling (ex. sweaty palms, heart racing, etc.)? Lastly, how did your anxiety influence the situation/interaction? For example – did it cause you to leave an event early? Not go at all? Taking inventory of these can help you become an investigator of your own reactions. Step 2: Recognize patterns that are coming from these notes. Is there a certain time of day you experience anxiety the most? What about a specific person or place that tends to lead you to a lot of anxiety? Highlight commonalities between your experiences – with assorted colors if that makes it easier for you. Step 3: Do a cost-benefit analysis. As you review the notes you’ve taken so far, write another list that weights out the benefits and the consequences to having this anxiety. For example, how has having anxiety helped you? In what situations has it caused more pain or discomfort, when it didn’t really need to? This is your change to get an understanding for how anxiety is affecting your life. Step 4: Create alternative ways to react. What can you think to yourself that will make you more at ease, more confident, and less worried? For example, if you’re nervous about going to a work gathering, write the following thought: “The gathering will go well, and I’m excited to get to know other people.” Even if you don’t necessarily feel that way, stick with these positive thoughts. Step 5: Practice daily, no matter how you’re feeling. This is a great start to CBT – towards changing your thought processes towards something more positive and productive. Practice this every day, no matter how you’re feeling.

There are times when we see changes in our loved ones – changes they may not directly be able to see. When it comes to mental illness, stigma often causes people to either fear having one or to fear others who have one. If your loved one does not believe they have a mental illness, but you are certain there are obvious signs of this, they may be in denial. This can be particularly challenging, especially if you want your loved one to seek help. A 2015 study titled “Assessing and Improving Clinical Insight Among Patients in ‘Denial’”, emphasized the difference between denial and lack of insight – does your loved one reject the notion that they have a mental illness or have symptoms of one, or have they simply not recognized the connection between their thoughts, feelings, and experiences and how they relate to mental illness? Denial is often considered a psychological defense mechanism, while lack of insight could be due to symptoms being perceived as a sign of something else, having neurocognitive deficits that make it challenging to form connections between instances such as these, or having a unique way of thinking about symptoms, mental illness, etc. If your loved one has been open to talking about mental illness with you, you may want to consider having them speak to a therapist. Motivational interviewing is a technique that helps those with apprehension come to their own realizations about their mental health and recovery options. Rather than push the client towards choosing recovery, the therapist may gently probe them with questions and will remain supportive and neutral during the entire process. Some people with a lack of insight to their mental illness don’t seek treatment because they don’t know they need to – this could be a wonderful time to help them gain insight into their experiences. If your loved one doesn’t believe they show signs of a mental illness, but you can see it’s potential for significantly reducing their quality of life, you may want to speak with a professional about staging a family mental health intervention. Untreated mental illnesses often get worse over time and could lead to the development of either another mental illness or an addiction, as a person tries to self-medicate to cope with their symptoms. Getting several friends or family members together with clear examples could help your loved one understanding the truth.

They both sound similar – codependency and dependent personality disorder (DPD) – but are they the same? What level of dependency constitutes as having a mental disorder versus an unhealthy view of relationships? Whether you’ve recently been diagnosed or are concerned about a loved one, there are some distinct differences between the two. Both can be very distressing and there are ways to treat each – but DPD is classified as a mental disorder whereas codependency is not. The following is a brief breakdown of what each means: