Tag: Bipolar Disorder

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Mental Health

Telemental Health: Bridging the Gap Between Care, Coronavirus

We are living in unprecedented times. A deadly pandemic has surfaced, the likes of which have not been experienced since the early 1900’s. The impact of this current pandemic has the potential to be even more devastating than the last, as the world is much more interconnected and interdependent than before.

On the other hand, the potential for people to receive applicable treatment for both the physical and psychological impact of this pandemic is in a much better place than in decades past. Thanks to the technological progress which has been made over the past several years, people are often no further from a phone call or video conference away from being able to consult with professionals regarding their concerns.

What Is Telemental Health?

Telehealth refers to any type of health service which is delivered via a medium other than face-to-face contact. It can include telephone calls, texts, video conference, and online interaction. Telemental health refers specifically to the ability to deliver and receive mental health support from a distance. It encompasses other, more familiar, terms such as telepsychiatry, telepsychology, and teletherapy.

Proponents for the widespread availability of telemental health services have long pointed to statistics which indicate that certain portions of the population are lacking in mental health support due to lack of access to physical mental health locations. Individuals who live in rural areas, those who suffer from mobility difficulties, and those who lack transportation and time are often unable to make the journey from their locations to a facility which provides quality mental health care.

The progress toward providing telemental health services has met with some resistance from regulating agencies. These types of agencies were constructed along with the growing popularity of mental health treatment from the mid 1900’s, and were charged with overseeing the requirements of mental health care providers to include best care practices for their patrons. Changes in these regulations have not quite kept pace with the growth of technology, leaving access to quality telehealth services in a gray area.

How Mental Health Care Rules Are Evolving for Coronavirus

With the coronavirus pandemic and associated social distancing guidelines arriving suddenly on the scene, regulators were compelled to take a closer look at the convenience of receiving therapy from a remote location. Data indicating that telemental health is similarly effective in treating a multitude of disorders was placed in the forefront, and privacy rights of patients and clients receiving remote care were scrutinized.

Similarly, insurance companies began to be pressured toward accepting claims for mental health services provided through such avenues. The result is a temporary lifting of former restrictions so that providers can deliver much needed therapy to those who are suffering from mental health symptoms while simultaneously heeding the call to avoid excessive social contact. There are many providers who hold out the hope that these current progressions in acceptance of telehealth as a viable treatment option will remain far into the future.

Telemental Health Services and Support

Telemental health services rely on the effectiveness of talk therapy toward treating mental health concerns and disorders. Talk therapy has been the go-to treatment since its early application by psychotherapy pioneers such as Sigmund Freud and Carl Jung. It has been demonstrated as being effective with disorders ranging from anxiety, depression, bipolar disorder, addiction, and personality disorders.

When it comes to deciding upon the right type of telemental health treatment for you, some insight into how you best learn and communicate can be helpful. If you are a visual person, support provided through video conference may be what provides you with the best outcome. An auditory person will tend to benefit most from sessions provided over phone. Someone who gains more from reading and writing is likely to find therapy bulletin boards and interactive journals useful.

Anxiety Treatment

Anxiety is already the most common disorder experienced in the country. With the stress of COVID-19 in play, there are even more reasons to feel anxious. Our health, finances, and future  plans are all at risk. Receiving telemental health support during this time can help you to examine your core values, reframe your fearful thoughts, and develop coping mechanisms to use when the anxiety levels are high.

Depression Treatment

Experiences of depression run a close second when it comes to prevalence of mental health disorder in America. While anxiety tends to focus on fear of the future, depression tends to focus on current and past situations. Many people are feeling the weight of our current crisis, yet are unable to engage in activities which might otherwise work to alleviate and distract from depressive thoughts and feelings.

Bipolar Disorder Treatment

A hallmark of bipolar disorder is that a person’s mood shifts from highs to lows. While largely thought to be due to a chemical fluctuation in the brain, moods can definitely be negatively and positively affected by situations and mindset. Talk therapy can assist in helping a person with bipolar disorder to learn to recognize the impending mood shifts, and mitigate the drastic responses and behaviors which often result.

Substance Abuse Treatment

Mental health disorders and tendency toward substance abuse are highly correlated. Mental health disorders can prompt a person to self-medicate with drugs and alcohol, and substance abuse can exacerbate pre-existing mental health conditions. With so many people stuck at home, and with idle time on their hands, even old habits of abusing drugs and alcohol may creep back in. Talking with a therapist can help to weigh the pros and cons of giving into the temptation to use substances, and can assist you in finding more healthy ways to cope with the stress and boredom.

Personality Disorders Treatment

Personality disorders are those which tend to influence a person’s entire approach and evaluation of life. One of the most diagnosed personality disorders is that of borderline personality disorder (BPD). Talk therapies have been shown to be extremely successful for those struggling with this disorder, as such therapy is focused on providing the client with new ideas and techniques for navigating life situations.

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Bipolar Disorder Dialectical Behavioral Therapy (DBT) Mental Health Recovery Therapy Treatment

A Brief Overview of DBT – Dialectical Behavioral Therapy

In this brief overview of Dialectical Behavioral Therapy (DBT), we are illustrating the efficacy of  DBT for the treatment of patients with suicidal behavior, bipolar disorder, and borderline personality disorder. DBT has been shown to reduce severe dysfunctional behaviors in clients. DBT uses validation has a tool to the client accept unpleasant thoughts and feelings rather than react to them in a dysfunctional way.  Simply put, dialectical means that two ideas can be true at the same time. Validation is the action of telling someone that what they see, feel, think or experience is real, logical and understandable. It’s important to remember that validation is non-judgmental and doesn’t mean you agree or even approve of the behavior you are validating.

 

Over the last year, Visions has effectively trained the staff to be DBT informed. We hold regular DBT skills groups at our residential and outpatient facilities. We have adopted and incorporated DBT skills into our day-to-day interactions with clients and are finding it to be incredibly beneficial.

 

I took some time to speak to Jesse Engdahl, MA, RRW, about his observations and experience with running the DBT skills group. He said, “We are happily surprised that it’s (DBT) become a community within a community. It’s set itself apart through the kids’ commitment to not only use the skills but in their support of each other. There is a high level of trust. We have kids coming into IOP who’ve felt marginalized and who hadn’t felt a broader amount of support, but find their place in DBT.”

 

The emphasis on validation in DBT is profound. Someone suffering from borderline personality disorder often has a movie playing in their heads and when the validity of that “movie” is denied, it can create a waterfall of dysregulation which can include anxiety, depression, anger, and fear. Taking a counter-intuitive stance and validating one’s reality is has been shown to be particularly efficacious. It deescalates the anxiety, and it teaches the client to self-regulate.

 

Joseph Rogers, MDiv-Candidate and DBT skills group facilitator and mindfulness teacher succinctly illustrates the value of our DBT groups, “Our DBT skills group gives our clients the confidence that they have the ability to meet their difficulties with skills that can be found within themselves and their capabilities.  By utilizing daily skills diary cards and reporting on their results, clients are able to see where they are being effective and can acknowledge the positive outcomes they are responsible for through their actions.  DBT has the ability to move clients out of their diagnosis toward a confidence in their personhood.”

 

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Addiction Adolescence Alumni Guest Posts Bipolar Disorder Mental Health Recovery

Alumni Voices: “I’m 17, Bipolar and In Recovery”

I’m pleased to share a guest post from one of our Alumni, bravely sharing about her experience as a bipolar teen in recovery. She is not only inspiring and courageous, her post is a testament to the clarity and hope willingness and recovery brings.

“I’m 17, Bipolar and in Recovery”

How old are you when you are in the 5th grade? Ten, maybe 11 years old? I was probably closer to 11 given that I was held back in preschool. Now, who exactly gets held back in preschool? I didn’t really pay it any mind when I was in preschool, yet I still struggle with the shame of having repeated a grade so early on in my education. I remember feeling extremely uncomfortable in the 3rd grade for having to be pulled out of class to learn to read in a private room with Mrs. A, the learning specialist teacher. Learning to read had come so easily to my older sister, C; it was not the same case for me.

So back to my original question: I was 11, and I had already been diagnosed with ADHD. By the time I was in the 8th grade, I was prescribed 100 mg of Adderall per day. Well, it turns out that I did have a mild case of ADHD, yet it also turns out that ADHD is commonly misdiagnosed and mistaken for bipolar Disorder. No one found out that I had a mood disorder until I came to Visions.

 

It is not uncommon for a person who is bipolar to not want to take their medication. The first time I went through Visions treatment I was diagnosed as having mood instability and not full-blown bipolar Disorder. This mood disorder accounts for a lot of the feelings I was having before and even after I came through Visions. Before I reached the point of needing inpatient care for the first time, which far preceded the time in which it took for me to ask for it, I had experienced quite a bit of depression. I have also dealt with my fair share of manic episodes.

 

For someone with a mood instability disorder, drugs of any kind will make for a much more painful and deep depression, a much more insane manic high, and will far from help the situation. This is not to say that abusing any kind of drugs or medication, illicit or otherwise, will help anyone. Yet, when your brain chemistry is already messed up and you continue to pile any kind of chemically enhanced drugs on top of that, it makes for a manic-depressive individual.

 

It is not uncommon for a person who is bipolar to not want to take their medication. The first time I left treatment, I wasn’t taking my medication as prescribed. I missed many days in a row, I took it at different times throughout the day, and I even flushed a whole handful of my pills down the toilet. This definitely didn’t help my condition. The combination of illicit drug use, consistently missing my meds, and a variety of other unpleasant behaviors can only lead to a few options. Those of us in recovery know what those options are.

 

Given that I had already been locked up in a psych ward at the age of 14, had not yet been to Juvi, and was still breathing, the last option would be recovery.

 

I haven’t discussed my recovery much because it is not only something I deal with on a daily basis, but it is also something that I am quite insecure about. As I have already shared, I have been through Visions Adolescent Treatment twice. I once had almost a year and a half of sobriety. I had gotten sober at 15, yet I prided myself on the time I had sober, and not the work I was doing. How could I? I wasn’t actually working a program.

 

I had struggled with the idea of sobriety the moment I found out what the other residents were using in my inpatient program. I had only been smoking weed, while the other residents were in treatment for much harder drugs. I knew that I deserved to be there; my story was pretty intense, yet I still felt insecure about my drug use.

 

That statement alone is what reminds me on a daily basis that I need to be sober. Only an addict-alcoholic would feel the need to go further and to use harder. I guess that wasn’t enough for me, because after about a year and four months of sobriety, I relapsed. This time, it did not take long for me to realize how utterly unmanageable my life was.

 

I did not need to prove to anyone else that it was a good idea for me to be sober, especially not my mother. That’s another good point: Only someone who is extremely sick and in their illness would put someone they love in that much pain. I guess I still had to prove it to myself.

 

Today, when I have a moment where I think of using, I think of my family. I say to myself, “Even if I’m not an addict, I couldn’t put them through what I used to.” I believe that the “issues” I deal with are not only related to one another, but they are also a gift: Not only is my recovery a gift, but I see my bipolar disorder as a gift as well. I feel lucky to have the ability to feel things as intensely as I do. I hope that this will be that last time I am getting sober. I will take one day at a time in keeping it that way.

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Uncategorized

Behavioral Health Educational Seminar: Complex Approaches for Complex Disorders

On Friday, September 28, we had the honor of co-hosting a Behavioral Health Educational Seminar, addressing Treatment Resistant Mood Disorders, and BiPolar Disorders. We co-hosted the seminar with Austen Riggs and PCH Treatment at the beautiful Victorian in Santa Monica, California.

Eric Plakun, MD, DFAPA, FACPsych and Director of Admissions and Public Relations at Austen Riggs Center spoke about A Psychodynamic Approach to Treatment Resistant Mood Disorders.

David J. Miklowitz, PhD, Professor of Psychiatry in the Divisions of Child and Adolescent Psychiatry at the UCLA Semel Institute and the Bipolar Treatment Consultant at PCH Treatment Center spoke about Bipolar Disorder: Current Thinking About Diagnosis and Treatment. Dr. Miklowitz is also a Senior Clinical Research Fellow in the Department of Psychiatry at Oxford University.

These informational seminars are a wonderful way to build upon one’s education, building upon the ever-changing information surrounding mental health care. Things will change with the new DSM-V slated to come out in the next year. We are incredibly fortunate to have so many knowledgable professionals in our midst.

Check out a few photos from the event. I must say, aside from incredible information from the speakers, the food was out of this world.

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Bipolar Disorder

Bipolar Children and Teens

Bipolar disorder isn’t soley an issue for the adult population—it affects children and teens as well.
Bipolar disorder is a mental illness categorized by its behavioral and mental extremes. Often called “manic depression,” this illness is clearly defined by its moods. Typically recognized as the manic stage, the sufferer may be elated or intensely “up,” even hyper. The flip side of this is the depressive stage, identified by its extreme lows, deep sadness, physical ailments, and for some, suicidal ideation.
According to NIMH, several factors may contribute to this mental illness:
  • Genes, because the illness runs in families. Children with a parent or sibling with bipolar disorder are more likely to get the illness than other children.
  • Abnormal brain structure and brain function.
  • Anxiety disorders. Children with anxiety disorders are more likely to develop bipolar disorder.
Since the causes aren’t concretely defined, scientists continue to do research, seeking more definitive answers in hopes of finding viable solutions, including a possible means of prevention.

These mood episodes can last a week or even two and are heavy in their intensity.  NIMHhas provided a listof symptoms from the two phases of bipolar disorder. Keep in mind, these symptoms are determined by their intensity and are not to be confused with the natural ups and downs of childhood emotional development.

Children and teens having a manic episode may:
  • Feel very happy or act silly in a way that’s unusual
  • Have a very short temper
  • Talk really fast about a lot of different things
  • Have trouble sleeping but not feel tired
  • Have trouble staying focused
  • Talk and think about sex more often
  • Do risky things.
Children and teens having a depressive episode may:
  • Feel very sad
  • Complain about pain a lot, like stomachaches and headaches
  • Sleep too little or too much
  • Feel guilty and worthless
  • Eat too little or too much
  • Have little energy and no interest in fun activities
  • Think about death or suicide.
Bipolar disorder is difficult to diagnose in children because symptoms often mirror other issues, for example: ADHD, conduct disorder, or alcohol and drug abuse issues. Bipolar disorder can, however, occur alongside these other issues, so it’s important to see a professional skilled in recognizing the affectations of various mental health disorders. Treatment for bipolar disorder requires the use of medication, but because the effectiveness in children isn’t as well researched, it’s wise to take note that children may respond differently to medications than adults. NIMH recommends children and adolescents take the “fewest number and smallest amounts of medication possible to help their symptoms,” additionally noting the danger in stopping any medication without the advice of a physician.
Pay attention to any side effects, and immediately tell the treating physician if you recognize new behaviors. Remember: the treatment for bipolar disorder is based upon the effective treatment of adults, which typically applies the use of mood stabilizers like lithium and/or valproate to control symptoms of mania and act as a preventative to the recurrence of depressive episodes.  Still, treatment of children and adults is still being researched. At this time, “NIMH is attempting to fill the current gaps intreatment knowledge with carefully designed studies involving children andadolescents with bipolar disorder.”  Further, scientists continue to perform studies looking at different types of psychotherapy, which would support the pharmaceutical treatment used in children and teens.  
Please see below for links to additional information (note, I also used some of these as reference for this article.)
1: https://www.nimh.nih.gov/health/publications/bipolar-disorder-in-children-and-teens-easy-to-read/index.shtml
2:  https://psychcentral.com/disorders/bipolarchild.htm
3: https://kidshealth.org/teen/your_mind/mental_health/bipolar.html#
4: https://www.webmd.com/bipolar-disorder/tc/bipolar-disorder-in-childhood-and-adolescence-topic-overview
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