Hi! I believe I can be of help with this issue.
First, let me say I can imagine how overwhelming and distressing it can get if you're worried about having Bipolar Disorder (BD) or being manic depressive. The two terms refer to the same disorder. BD is the current diagnostic terminology we've been using for the last 15 years or more. Manic depressive disorder was the old term for BD. People often feel it is more descriptive than Bipolar Disorder, so I don't know why BD is the diagnostic term today. But the truth behind the disorder is a "swing" in moods from one extreme to another in a way that disrupts the person's ability to function normally in their life. And that is very difficult.
I also want to say that I will paste for you a technique for getting some quick relief when you are feeling anxiety or overwhelm. The technique is not a cure, but it will help you in moments of difficulties, depression and anxiety, and you can use it over and over again. Because your moods when they swing from one pole to the other will produce a lot of anxiety.
And this is actually the key to my answer to you that you need to consider and think about. You need to get a proper psychiatric evaluation for BD. The best way to prepare for this is to track your moods throughout the day for a few weeks so the doctor can use that information to evaluate if indeed BD is the correct diagnosis and how best to treat it. Let's look at the Here are three resources: the first are computer programs for tracking moods:
They are both popular; Moodtracker is perhaps more well known, at least here in the US. Here, though, is a simple printout with charts that you can copy and fill in by hand and that may be enough:
Diagnostic Criteria for BD. Then I'll continue.
Symptoms of mania or a manic episode include:
Symptoms of depression or a depressive episode include:
- A long period of feeling "high," or an overly happy or outgoing mood
- Extremely irritable mood, agitation, feeling "jumpy" or "wired."
- Talking very fast, jumping from one idea to another, having racing thoughts
- Being easily distracted
- Increasing goal-directed activities, such as taking on new projects
- Being restless
- Sleeping little
- Having an unrealistic belief in one's abilities
- Behaving impulsively and taking part in a lot of pleasurable,
high-risk behaviors, such as spending sprees, impulsive sex, and impulsive business investments.
- A long period of feeling worried or empty
- Loss of interest in activities once enjoyed, including sex.
- Feeling tired or "slowed down"
- Having problems concentrating, remembering, and making decisions
- Being restless or irritable
- Changing eating, sleeping, or other habits
- Thinking of death or suicide, or attempting suicide.
What do you think? Does this sound like it describes your situation? The idea is that the mood swings back and forth unpredictably, with some quicker than others. Here's a quote from the DSM-IV: "Sometimes individuals experience severe mood swings from periods of extreme depression to periods of exaggerated happiness. This is known as bipolar disorder or manic-depressive illness, an illness that involves episodes of serious mania and depression. The individual's mood usually swings from overly "high" and irritable (mania) to sad and hopeless (depression) and then back again, with periods of normal moods interspersed."
Let me end off with this because it may be of use to you:\
In my practice, I use the resources with people with BD from Mary Ellen Copeland. I have found her work easy for people to use and easy to keep up with. The biggest problem is forgetting to keep to the plan when times are good and then something happens! Copeland also had BD and was hospitalized. She's a therapist and developed a BD treatment protocol called Wellness Recovery Action Plan (WRAP). First let me cite one of her books for you.
The Depression Workbook: A Guide for Living with Depression and Manic Depression by Mary Ellen Copeland. Amazon: http://www.amazon.com/Depression-Workbook-Guide-Living-Second/dp/157224268X/ref=sr_1_1?ie=UTF8&s=books&qid=1284317815&sr=8-1-catcorr
I believe from my experience that it is SO important with BD to not just take the meds and expect them to do everything. YOU have to take charge of managing your BD. And having a strategy like the WRAP program is a coherent way to do this. So that you can regulate your moods as they cycle. Here's what I mean:
Most people are like cars with automatic transmission. They tool around the day going from a little sad and then they feel a little glad and if they get to too high a gear, the emotional transmission just automatically sends them back to a lower gear and if the low gets too low, the transmission clicks into a higher gear. Rarely are they thinking about it. They are usually within their normal range.
People with BD are like a car with a manual transmission. You start having a racing mood and unless you downshift manually, you're going to be out of control soon until you can't maintain that and you cycle down and then get too far down, etc. So you have to continually use the clutch and manually adjust the emotional gear.
That's what a program like the WRAP plan is about. It gives you the tools to notice what's going on and to make adjustments. So that is why I'm stressing it for you. So along with medications (psychiatrist) you need to find a therapist to work on a mood management program.
If you don’t have a good referral source, here is the web address for Psychology Today's therapist directory. You can sort by zip codes and when you see someone who seems like they might be helpful (because they seem smart and not so easily manipulatable!) look at the listing and see if they list BD as one of the disorders they work with.
Good Therapy is a non profit directory. Same idea as the one above:
I wish you the very best and be hopeful and confident for the future!
Now, I want to give you a tool to use for when the irritation is overwhelming or there is anxiety. Here are instructions on a therapeutic protocol called Progressive Muscle Relaxation (PMR). It's really quite easy to do almost anywhere. My patients suffering from depression or anxiety (the poles of BD), when I teach them PMR at first are amazed how simple it is and that it is a psychological protocol. It was first used in the 1920s! Since then, of course, it has been refined and many studies have been done showing its effectiveness. You will practice PMR at first when you don't wake up with an attack so that you will be familiar with it. I want you to practice the PMR at least 5-6 times before feeling acute anxiety. Why? Because when you're in the throes of anxiety, you will only remember to do something you are very familiar with it. So practicing 5-6 times is really a minimum. And this is good also for just general anxiety without panic attacks and for feeling as though you are in a dark hole of depression as well.
I want to stress the importance of breathing as well. Part of the physiology of what is happening to you in anxiety is that your breathing is getting shallower. This reduces the oxygen in your blood to your brain. That increases the anxiety reaction, which strengthens the attack and you are in a vicious cycle! Not good. So breathing is the primary tool. I have found in my practice that learning breathing techniques can be helpful. But some of my patients are not interested in learning more than one thing at the beginning, so I have found that just reminding you to BREATHE deeply at the same time you are doing PMR is almost as good. If you are willing to take a yoga class and learn breathing techniques, that's the best. But, breathing deeply with your PMR will help.
So, we're ready for learning PMR. I want you to print my instructions below my signature and have a copy in each of the rooms of your home where you may be when you have an attack. And again, you need to practice this easy technique at least 5-6 times as soon as you can. It needs to become as natural to you as breathing. Ah, remember breathing?
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- After finding a quiet place and several free minutes to practice progressive muscle relaxation, sit or lie down and make yourself comfortable.
- Begin by tensing all the muscles in your face. Make a tight grimace, close your eyes as tightly as possible, clench your teeth, even move your ears up if you can. Hold this for the count of eight as you inhale.
- Now exhale and relax completely. Let your face go completely lax, as though you were sleeping. Feel the tension seep from your facial muscles, and enjoy the feeling.
- Next, completely tense your neck and shoulders, again inhaling and counting to eight. Then exhale and relax.
- Continue down your body, repeating the procedure with the following muscle groups:
- entire right arm
- right forearm and hand (making a fist)
- right hand
- entire left arm
- left forearm and hand (again, making a fist)
- left hand
- entire right leg
- lower right leg and foot
- right foot
- entire left leg
- lower left leg and foot
- left foot
- for the shortened version, which includes just four main muscle groups:
- neck, shoulders and arms
- abdomen and chest
- buttocks, legs and feet
Quickly focusing on each group one after the other, with practice you can relax your body like ‘liquid relaxation’ poured on your head and it flowed down and completely covered you. You can use progressive muscle relaxation to quickly de-stress any time.
What You Need:
- A comfortable place.
- Some privacy.
- A few minutes.
My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. Bonuses are always appreciated! If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, XXXXX XXXXX