A Therapist’s Thoughts on Bipolar Disorder Inside and Outside the Therapy Room
As a therapist I have had many clients who were diagnosed with or in the process of being identified as having Bipolar I Disorder. Similarly, I recognize experiences with acquaintances whose personalities seemed to dramatically change over time. Before learning more about bipolar disorder, I wondered what had caused these changes, was it me, them, or had our relationships simply changed.
Bipolar I Disorder was once called manic depression because a person with this diagnosis often swings from extreme highs and lows as part of mania and depression phases. Typically, mania involves extreme increases in energy levels and reduced sleep needs, risky and impulsive behaviors, poor decision making, restlessness, and irritability among other symptoms. During a manic episode, a person may feel invincible, on top of the world, and as though nothing can stand in the way of success.
And after, depression occurs as part of a cycle—what goes up, must come down. As good as the mania feels, the depression feels equally bad, including extreme symptoms of sadness, emptiness, and hopelessness/helplessness. Both mania and depression symptoms may occur for several days as part of a repeated cycle. A person can become psychotic during each phase, seeing, hearing, or smelling things that are not there. Likewise, a person may experience suicidal ideation during each phase of bipolar disorder, wanting to end their cycle of pain, poor decision making, and confusion about what happened.
Without treatment a person with Bipolar I Disorder can cycle more regularly between mania and depression, also experiencing more extreme symptoms of each. Examples could be a person quitting their job, filing for divorce, or trying to end their life. Bipolar I Disorder can be difficult to diagnose. This is because mood swings may look different for different people. Additionally, symptoms of mania, including jumpiness, anxiety, and restlessness, may be confused with a generalized anxiety disorder. Distractibility can be confused with ADHD. Depression can look like a simple depressive disorder.
Diagnosis and treatment for a bipolar disorder may not occur until a trained mental health professional observes the significant and long-lasting symptoms of mania and depression as part of a recurrent cycle. Likewise, obtaining a history of similar symptoms among family members can be critical for making a bipolar diagnosis. Additionally, knowing a history of recent trauma as potentially triggering the beginning of the mania/depression cycle might be helpful.
The good news is that there is help to better regulate mood swings and return to a more stable lifestyle. As with any other medical condition, taking medications has proven beneficial for feeling more in control of mania/depression symptoms. Mental health therapy, including individual therapy, couples/marital therapy, and family therapy, has been proven helpful for understanding the impact of having bipolar symptoms, including how we perceive ourselves and are perceived by others.
Supportive therapy can help people with a bipolar diagnosis learn how to create balances between working excessively, staying up late, doing drugs, drinking too much alcohol, and building financial safeguards for preventing overspending. Establishing a supportive circle of friends, professionals, and community resources is usually part of feeling better about self and the world. Keeping mood diaries through various apps can help people monitor potential mood swings.
I look at the world today as being more humane and supportive of people with a mental illness like Bipolar I or II. However, it remains essential that a person with manic/depression symptoms recognize the advancements in treatment of this disorder and reach out for help.
The Counseling and Wellness Center of Pittsburgh is here to help if you are experiencing symptoms of bipolar disorder. Please contact us at 412-322-2129 if you need support.
Written by: Stephanie Davis, MEd, LPC at the Counseling and Wellness Center of Pittsburgh.
Learn MoreAnti-Inflammatory Diet – Including Meal Plan by Licensed Nutrition Counselor, Liz Mckinney, CNS, LDN.
Anti-Inflammatory Diet for wellness, food as therapy.
Anti-Inflammatory Diet, What it is, What it Does and Including a Meal Plan by Licensed Nutrition Counselor, Liz Mckinney, CNS, LDN.
Every standard anatomy course covers a section on inflammation, health circles and modern medicine studies how this physiological process effects our bodies. Modern science has uncovered much evidence related to how our dietary consumption fuels our internal inflammation. To understand inflammation, let’s talk what about what inflammation really is. Inflammation is a normal part of our body’s healing process. Think of the redness, pain and swelling that comes along with an acute injury. These are bio-markers that our white blood cells are migrating to the origin of a wound, when the white blood cells arrive they will unfold to facilitate the healing process. This mechanism is a normal and necessary indication that our immune response is hard at work. But what happens when our immune systems are working over time in a way we can’t see? This is a part of what is termed ‘chronic inflammation’, and our diet definitely plays a large role in both calming it down or conversely, throwing fuel on the flames.
Chronic inflammation is a contributing factor to many common diseases in the U.S today. Obesity, heart disease, and Type 2 Diabetes are some common diseases to which inflammation contributes to the onset and progression (Lopez-Condelez 2017). Additionally, according to a 2018 study Dr. Billmore et, al, which was published in Nature, there is also evidence that inflammation may contribute to certain forms of depression as well as aiding in the development and progression of this mental health disease, inflammation is also being study as a contributing factor in the development of other mood disorders. Of course diet alone can not provide total therapy for depression or disease but it is an important pathway to providing our best course to become well.
The fact is when our immune system becomes chronically activated, low-grade, systemic inflammation occurs. Even if you aren’t suffering from an overt disease, things like stress, leaky gut, food sensitivities and even an imbalance in our gut micro-biome all are capable of pushing our bodies into an inflammatory state. The consequences of chronic inflammation are serious. Increased risk of neuro-degenerative and cardiovascular disease, trouble losing weight, digestive problems, hormonal imbalances, and cellular damage may all occur as a result.
Our food choices can either promote or calm inflammation. Many of the diseases and problems listed above may be prevented or mitigated with an anti-inflammatory diet. The top foods that commonly contribute to chronic inflammation in the standard American diet are:
- Refined grains (bread, crackers, cookies, cakes, snack foods)
- Dairy (all cow dairy products including milk, ice cream, and yogurt
- Sugar (table sugar, high fructose corn syrup, sugar alcohols or artificial sweeteners)
- Vegetable oils (Canola, Corn, Safflower, Sunflower and Rapeseed oils)
- Trans fat (Margarine, peanut butter, mayonnaise, packaged snacks)
- Conventional/commercially raised meat
- Alcohol (More than 1 drink per day for women and 2 for men)
- Food additives (MSG, artificial flavors and food dyes)
On the flip side, nourishing foods can also accelerate healing in the body and prevent the inflammatory cascade from becoming chronic. For whole body health and wellness, add these anti-inflammatory foods into your daily diet:
- Fatty fish (Halibut, salmon, sardines, trout)
- Coconut oil
- Olive oil
- Vegetables (Any and all kinds!)
- Berries
- Pineapple
- Ginger
- Chia seeds
- Flax seeds
- Turmeric
- Grass-fed animal meats
We know that one of the barriers to incorporating dietary changes is that we simply don’t know where to begin. As an added bonus, we will share an example one-day meal plan, made by a certified and licensed Nutrition Counselor, Liz Mckinney, by using this plan, you can jump start your anti-inflammatory diet today!
- Breakfast
- 2 scrambled eggs with sautéed spinach, mushrooms and garlic
- ½ avocado
- Lunch
- 2 cups mixed greens with 4 oz. salmon or chicken and walnuts with a turmeric ginger dressing (Juice from 2 large organic lemons, approximately 1/4 cup of fresh juice, 1″ fresh ginger, skin removed, 1 garlic clove, 2 teaspoon ground turmeric, 3 tablespoons extra virgin olive oil, 1 tablespoon apple cider vinegar, 1/4 teaspoon black pepper, Salt to taste – Blend in food processor)
- Dinner
- Sautéed lemon pepper shrimp over zucchini “noodles” sautéed in olive oil with salt and pepper
- Snacks
- 70% or greater dark chocolate, almonds/walnuts, rice cake with mashed avocado, hard boiled egg with spicy mustard, cut up veggies with hummus or another home made veggie dip
Additionally, by working with a licensed nutritionist or dietitian to identify food sensitivities, heal leaky gut, balance your gut micro-biome, eradicating bacterial overgrowth, and implementing a stress reduction plan into your daily life, your wellness, emotional, and physical health can be optimized. As always, wellness routines that include yoga, meditation, mindfulness, progressive muscle relaxation, spending time in nature, or deep breathing are all proven techniques to increase resilience to stress.
Certified Licensed Nutritionist, Nutrition and Wellness Counseling
Blog article is written by Liz Mckinney, CNS, Liz is the licensed and certified nutritionist for the Counseling and Wellness Center of Pittsburgh, Liz can provide nutrition counseling near you, now accepting new patients in Western Pennsylvania.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5542678/
https://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5488800/
https://www.nature.com/articles/d41586-018-05261-3
edited, by Stephanie Wijkstrom, MS, LPC, NCC
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