Generalized Anxiety Disorder

If a person suffers from constant worry over the diverse issues and activities, he is supposed to be suffering from Generalized Anxiety Disorder. The things they are worried about is unlikely to happen most of the time. They remain unnecessarily involved in those things. Being worried sometimes about something is common to every man. But when it is constant and comes between our daily activities and takes away all our peace of mind, it may be the warning sign of GAD. So persistent worrying, tension and nervousness always shroud the mind of the person suffering from this disorder.
The difference between normal worry and Generalized Anxiety Disorder lies in intensity. Normal worry doesn't hinder you performing daily activities. But, GAD drastically interrupts social life and makes you overburdened with worries and anxieties all the time. Normal worry can be controlled and overcome by you but uncontrollable worry takes you to GAD. Unlike normal worry, the sufferer becomes extremely stressful and upsetting and tend to anticipate the worst. The person with GDA experiences a number of emotional,behavioral,and physical indications. Though this disorder sounds uncommon, it is a somewhat common predicament that affects almost 1 in 20 people. It is likely to take care of Generalized Anxiety Disorder, that often consists of recognizing the basic causes and shifting the thought patterns of the person. What is important is to find out an expert therapist with lots of experience to have the best opportunity of overcoming the awful affliction before it afflicts so many of your neiborhood and other associates.
Generalized Anxiety Disorder symptoms may be unique for different person who experiences comprehensive apprehension and habitually depend on the present intensity of apparent stress. Generally people with GDA have unreasonable anxiety and fears over things that other people would least worry about.
Emotional generalized anxiety disorder symptoms are the most devastating for a person who find it difficult to come out of pessimism. It leads a person to a state of being out of control, and he thinks that there is no possible way out to stop the anxiety. These thoughts can be illogical or even on the whole a fantasy, but that doesn't make any difference for them. For someone with Generalized Anxiety Disorder symptom it is extremely difficult to stop operating the pessimistic feelings and thoughts in him. The victim of the disorder can never focus on anything other than fear and anxiety. He always keeps himself away from the situations that don't help him to nourish the feelings of anxiety and fear.
The most common physical symptoms of this disorder are the tightness of muscles and the aching of the body. It also causes sleeplessness, indigestion, nausea and diarrhea. The warning signs of this disorder should never be neglected. It may possess your life by making you secluded from other members of the society. It is very important to consult an expert as soon as you are under this disorder. The right treatment at the right time can help a person to identify the cause behind it and help him to cope with the techniques to get his mind out of negative thoughts. A well experienced therapist can help you to teach the techniques of relaxation, meditation and medication to get rid of this disorder.

Generalized anxiety disorder occurs when you are worried and anxious about many everyday events and activities. Often the things you are apprehensive about are small or not important. This kind of worry interrupts your life in many ways. Worries or anxieties are common to all. But people with generalized anxiety disorder experience worries more than normal.

Bi-Polar- Wendy's Story

Wendy's Changing Behavior
Wendy was a charismatic, high-school junior with sandy blonde hair and blue eyes. She was an athletic young woman who loved sports, drama and music. Her friends described her as a person with high energy, drive and a wide circle of friends. Her friend Alicia said "Wow, she has the energy of two people." However, Wendy seemed to be changing, and her friends were beginning to find her annoying. They thought she seemed depressed, and they wondered if she had family problems. Alicia remarked, "I don't get it, one week she's so revved, and a week later she's as slow as a turtle."
Wendy had been staying up late for two weeks, whizzing through various projects and spending time on Facebook and YouTube. She had a variety of hobbies that included fashion design and baking. She loved designing new apparel and writing articles about her recipes for the school newspaper. She felt positive and abundantly energetic, and her projects kept her busy into the wee hours of the morning. She usually went to bed around 3 a.m. and would wake up at 7 a.m. feeling energized for her day at school.
Sometimes Wendy felt like chatting in the middle of the night and would call her best friend, Phillip, at 2 a.m. This behavior seemed rude and intrusive to him, but when he tried to talk to her about the problem, she was hard to interrupt, and didn't seem to be listening. Wendy was experiencing racing thoughts and some mood swings, and her friends couldn't understand what was going on.She was not particularly aware of these changes, but she loved her extra energy. There was another subtle change that annoyed her friends -- Wendy became boastful, thinking she had skills beyond her abilities.
She told Phillip that she was going to bring fame to her hometown by winning at the state tennis match being held in St. Cloud, Minnesota. Tennis had been part of Wendy's life since she was in elementary school, and now she was a top player on the Minneapolis Mavericks. Her net game had improved, but hard work was necessary to excel in her overall game.Wendy had a good serve and felt that her backhand stroke was strong, and she was in the best aerobic condition ever because she lifted weights, ran on her mother's treadmill and took Zumba classes. She was superconfident that she would win against the top-seeded player, and she came across as boastful when she said, "I'll show her tennis she hasn't seen before -- I'm going to blow her out of the water."Although Wendy had always been good at winning matches against local teams, she had never played at the state level, yet she reveled in her self-confidence.
A History of Anxiety and Depression
Wendy had not always felt self-confident. When she was about 12 years old, she started struggling with anxiety and depression. She had some sleep problems, and she occasionally felt down, restless and agitated. For some people, feeling agitated can be a way to mask an inner emptiness. Sometimes Wendy had bad dreams in which she was being chased by someone scary or searching for something she couldn't find.
After Wendy turned 13, she began to have days when she felt sluggish and didn't have her normal interest in her many activities. Although she had a lot of energy, Wendy had down days when she didn't feel like doing much. Sometimes, while she was working on a project, she would suddenly space out and vaguely sense that inner emptiness again. Her mother said it seemed like Wendy was "somewhere else."
Problems sleeping, agitation, lethargy, down days and a feeling of emptiness are a few of the behavior patterns that are common among teenagers with both bipolar II and/or depressive conditions. At this point it was unclear what condition Wendy had -- her symptoms could be red flags for an emerging bipolar II condition or a more serious depression, and either can exist simultaneously with an anxiety disorder. A complete assessment is necessary to accurately target what disorder may be emerging. The emptiness and sluggish days can be part of the depressive side of bipolar; it is common for teenagers with bipolar to start out with depressive symptoms although some teens start out by experiencing the elevated energy that is the high side of bipolar.
When she was about 14, Wendy was getting worse and finally talked to her mother about her behaviors and feelings. Her mother was worried and took her to see a relationship therapist who had a good reputation with teens. With some professional help, Wendy was able to learn positive coping skills and manage her symptoms well, as many can. She learned to regularly relax and take necessary quiet time. She continued to exercise daily, which greatly helped with her depression and helped manage her agitation. Additionally, she was in a support group where she made friends with others who had mental health challenges. Wendy made it a habit to go to bed at the same time each night and wake up at the same time each morning to help regulate her sleep. She also made sure to get eight hours of sleep. She still had sleep issues but felt generally rested during the day.
When she was a high-school freshman, Wendy started seeing a psychiatrist, Dr. Smith, for depression. He had prescribed a low dose of an antidepressant that had helped her, and she generally saw him once every three months. During the period before the state tennis finals, Wendy's behavior became erratic, and she stopped her relaxation routine, cut back on her exercise and quit the support group. What was really going on? Fortunately, Wendy's mother made an appointment for Wendy to see Dr. Smith within a few days.
When she went to see Dr. Smith, Wendy learned that she was exhibiting the symptoms of bipolar II. When teenagers have bipolar disorder, it can be difficult for them to maintain good habits because of the depression and the mood swings into "hypomania" (the highs of bipolar II). Wendy was surprised because she had been feeling at the top of her mental game, primarily because of her exercise, support group and wins on the tennis court. However, the emerging mood swings were making it difficult for Wendy to maintain her healthy habits, and she needed an updated treatment plan based on her new diagnosis. She was especially concerned that her agitated behavior would push away her friends and that depression would affect her tennis game.
The Different Types of Bipolar Disorder
Bipolar disorder is multidimensional in nature, and because of this, experts are now considering bipolar I, bipolar II, cyclothymia and bipolar NOS as the "bipolar spectrum." Here are the different types:

• Bipolar I is identified by episodes alternating between manic periods of abnormal euphoria, optimism, and energy and depressive periods of sadness, helplessness, guilt and sometimes suicidal feelings. People with bipolar I can experience hallucinations and delusions while those with bipolar II do not.


• Bipolar II is marked by major depressive episodes alternating with episodes of hypomania, a milder form of mania. People with bipolar II depression often have extremely low energy, slowed mental and physical processes, and profound fatigue. People with bipolar II struggle more with chronic depression while people with bipolar I struggle much more with mania.


• Cyclothymia is a chronic mood disturbance lasting for at least two years (one year in adolescents) involving numerous hypomanic episodes and numerous periods of depressed mood that aren't severe enough to meet the criteria for a major depressive or a manic episode.


• Bipolar NOS (Not Otherwise Specified) describes a disorder with manic or hypomanic features that does not meet the criteria for any specific bipolar disorder.

Much research has been done on bipolar I, but less attention has been focused on bipolar II and bipolar NOS. People with bipolar II don't have the psychotic features or extreme elevated moods of bipolar I, and hypomania usually doesn't cause significant distress or greatly impair one's daily life. However, some research indicates that bipolar II can be severe because of the chronic and deep depressions that these people struggle with. Nevertheless, with advances in education, more people are getting diagnosed, new medications and treatment strategies are being developed, and further research continues.
It is especially important to diagnose and treat teenagers with bipolar disorder because the condition can interfere with healthy growth and development: mood shifts can cause a decline in school performance and a loss of friends, and excessive sleep can waste valuable life opportunities. Bipolar also causes unnecessary pain and suffering, which can lead to substance abuse and sometimes suicide in untreated young people.
If your teen talks about suicide, it is crucial to take it seriously. Call your doctor, or if the doctor isn't available, contact 911 or your nearest hotline. Make every effort to get your teen in a support group for teens with mental health challenges, and, if you are a parent, try your best to get your teen to a therapist.
Diagnosing Bipolar II
Dr. Smith had been treating Wendy for several years, but this was the first time he had assessed her for bipolar II. In order to meet the criteria for this condition, a history of depression and at least one episode of hypomania are necessary. Bipolar II often goes undetected because of problems with a clear definition and a lack of understanding of hypomania. Bipolar II is often misdiagnosed because of the overlap with other conditions such as anxiety, depression, oppositional disorder and ADHD.
While most of Wendy's friends were bothered by her constant talking and boastful attitude, they admired her confidence, endless energy, and various talents. These characteristics can make bipolar II even more challenging to diagnose because the hypomania may appear to be a period of successful high productivity and happiness. Because hypomania can cause a person to feel good, it is reported less frequently than a painful depression.
Dr. Smith believed Wendy was experiencing hypomania based on her grandiosity about winning the state championships, her need for little sleep and her rapid talking. Upon questioning from the doctor, Wendy shared that she had been experiencing an increase in her sex drive but figured it was normal for her age. This cluster of symptoms confirmed a bipolar II diagnosis and the need for an adjustment in her medication. Dr. Smith explained bipolar II to Wendy, but she denied that she had it, explaining that she was just buzzed about the upcoming championships.
People with bipolar II typically don't have the severe mood swings of bipolar I patients, but they may be prone to longer depressive episodes. Teenagers with bipolar II disorder may often start out with the depressive side of bipolar, and helping professionals may believe that the patient has unipolar depression. If a person has a history of substance abuse, eating disorders, schizophrenia and/or major mood disorders, it's important to realize that these are red flags for bipolar; however, not all people with this background get this disorder.
Of course, there are a percentage of cases where hypomania causes significant distress, and it's important to detect hypomania early on. Some research indicates that teens are more prone to auto accidents and may suffer a decline in grades because of the distractibility caused by racing thoughts.There are many faces of hypomania that can help you differentiate the disorder; however, remember that any one person has a cluster of symptoms and not all of them.
Wendy didn't like the term "hypomania" for the wonderful feelings she was experiencing, and she didn't want to take any additional medication. Dr. Smith was concerned when Wendy refused to take the recommended medication because ignoring hypomania can make bipolar II worse and possibly lead to the more severe bipolar I. People with bipolar I can lose touch with reality, so it is crucial to stop the progression of low-end bipolar conditions.
Fortunately, with education, Dr. Smith was able to convince Wendy to take a mood stabilizer to regulate her mood and keep treating her depression. He also referred Wendy to me because I have a specialty with bipolar II in teenagers. I taught Wendy a variety of coping skills that will be discussed in the section on treatment interventions.
Bipolar II and Hypomania
Most people with bipolar II experience a cluster of hypomania symptoms, but not all of them.The majority of the highs of bipolar II include the following symptoms:

• grandiosity
• a decreased need for sleep
• distractibility
• racing thoughts
• rapid speech, interrupting while others are speaking
• excess energy
• hypersexuality
• a tendency to engage in reckless behavior
• irritability
• silly behavior

*See below for detailed information about these symptoms.
Grandiosity: Grandiosity is an exaggerated sense of one's importance, knowledge, power, or identity. A person with grandiosity may seem outrageously boastful, pompous, or pretentious.
Hypersexuality: Hypersexual behavior is an excessive interest in, or preoccupation with, sex and a markedly increased need for sexual gratification. A person experiencing hypersexuality may appear to be obsessed with sex. In bipolar disorder, hypersexuality is often seen along with a distinct change in a person's behavior and personality.
Many people with bipolar II do not experience hypersexuality, but it was becoming a problem for Wendy. When she was hypersexual, she would masturbate three times a day and spend time buying sexy clothes, which she didn't wear when she was in a stabilized mood. Usually, she was somewhat shy around guys, but during a period of hypomania, she would become provocative and seductive. When she recovered from a hypersexual episode, she said she felt guilty because sleeping with a boy she hardly knew was completely out of character for her. Fortunately, the right medication (a mood stabilizer) helped her gain control of her urges before she could be hurt or become pregnant at an early age. Hypersexuality is an aspect of bipolar that is reportedly seldom investigated, and education is greatly needed about this symptom.
Silly behavior: Another symptom of hypomania is silly and goofy behavior. Sometimes Wendy became silly around her friends and roared at her own jokes and goofy behavior. For example, she would make a steady stream of puns throughout the day, and although her friends thought she was funny, they turned away when she wouldn't stop.
The Depression of Bipolar
Bipolar I is considered the more severe disorder because of the accompanying psychotic behavior, but people with bipolar II generally have more chronic depression than those with bipolar I. Wendy had been diagnosed with depression when she was a freshman in high school. She would get periodic episodes where she just wanted to sleep, felt pessimistic and dwelled on negative thoughts. Wendy told me that she tried to think of something positive when she was depressed, but she couldn't even get a picture in her mind.
Life seemed to have no meaning for Wendy, and she lost interest in her usual activities. I worked with her to develop a road map to help her get moving because "action, action, action" is essential to treating depression. Accomplishing tasks slowly and successively along with therapy and a support group can help a teen gradually pull out of a depression.
Based on my extensive experience with teenagers and young adults with depression, I wrote a poem that describes the lethargy of depression, and reading it has helped many teens in my practice to open up. Encourage your child, teen or patient to find ways to express their pain because expressing pain can help release it. Here is a verse from that poem:
Toes cold, same socks mold for days in a row.
Energy compressed, can't do my best
Feeling stuck behind a barbed wire fence.
©2006 Patrice Wolters
In therapy, I helped Wendy find words to express her feelings. Here is a verse from her poem:
I don't want to walk and I don't want to talk
I'm feeling so low; leave a message on the phone
No, I don't feel like eating, my energy is depleting
They call it depression, down days in succession
Focus on helping your teen or patient create some sort of mental health poetry to help them overcome their unique issues. Remember that people think in distorted ways when they are depressed, which only makes them more depressed. Educate teens in the cultivation of empowering thoughts and help them to make it a daily habit. Teach them to use negative thoughts as a trigger for repeating their empowering mantras.
Bipolar and Drug Abuse
A percentage of people with undetected bipolar II conditions may abuse drugs such as methamphetamine, which helps people escape the chronic lows of bipolar II. Methamphetamine can energize depressed people and get them up and out, getting things done. However, they subsequently crash, become more depressed, and end up in a dangerous cycle. They gradually need more of the drug, and it kills off important brain cells. The possibility of drug abuse is another argument for early identification of bipolar conditions. Alcohol abuse is also common because it self-medicates the pain and chronic irritability of bipolar II depression.
Research indicates that college students abuse prescription drugs, and I expect that the rate is particularly high among students with depression and an undetected bipolar condition. The demand for counselors in colleges has greatly increased, but many colleges don't have the necessary services to meet students' needs. Bipolar appears most frequently after kids have left home and are in their early twenties.
If you have a patient or teenager who you believe is using drugs, make every effort to get him or her to a drug specialist who has knowledge of mood disorders. Involvement in a Narcotics Anonymous or Alcoholics Anonymous program has also been successful and often provides a good support group for people trying to quit addictive behavior.
Drugs are a dead-end street, and most people with bipolar conditions need to get on the right medication. A fairly small percentage of people with bipolar disorder are able to manage without medication and lead successful lives. A healthy lifestyle and a variety of cultivated mood management skills can enable these people to live fulfilling lives. If your patient or teen doesn't want to take medication, make sure they eat well, sleep well and stay involved in activities they enjoy. Of course, help them use the positive coping skills discussed in this article.
The Bright Side of Bipolar
Important research has been done regarding the special gifts of people with bipolar conditions. Research by Dr. Kay Jamison indicates that many of our talented poets, actors, politicians, and painters had bipolar conditions. Abraham Lincoln, Winston Churchill, Catherine Zeta Jones and Robin Williams are a few of those with bipolar who have had remarkable success. There are many people, in a range of professions, who are making significant contributions when they are effectively treated for bipolar. In my practice, I have found that many teenagers with bipolar are highly talented and want to make significant contributions with their talents. It's important to realize that the high energy, creativity and goal-oriented behavior patterns of bipolar II can enable people to make major contributions to society and/or be highly successful.
One area that needs research is the creative management of hypomanic symptoms for success in life. For example, racing thoughts can be used for brainstorming, journaling and creative writing. For a person who commits to the practice, meditation or a martial art can calm thoughts down and help to open new vistas. Writing about symptoms can enable a teen to work through issues, solve problems and move toward positive goals. The chronic irritability and hypersexuality of bipolar II can motivate people to begin a daily fitness program and stay fit for life. People with bipolar II can also learn to channel their irritability into assertiveness and get a lot accomplished.
Working through a depression requires teens to develop resiliency (the ability to master the biological and psychological challenges of life) and take responsibility for their moods and behaviors. Additionally, cultivating discipline and a support network helps bipolar teens cope with their symptoms and develop success skills. Teens can become compassionate and sensitive to the pain of others when they deal with the depressive side of bipolar, and this can motivate them to become involved in important social causes.
Overcoming a depression is a struggle that allows young people to develop a variety of strengths and capacities such as willpower, ego strength, flexibility, patience, persistence and, most importantly, responsibility. Bipolar conditions provide an ongoing challenge for teens to find their outer limits in life and become multidimensional people. I like to call this "the bipolar challenge."
Positive Coping Skills
We have come a long way in terms of treatment for bipolar conditions, and many people benefit from a combination of therapy and medication. Nevertheless, more research is needed in determining how people can manage this challenging illness. There are several important skills that can help teenagers, and adults, with bipolar disorder.
Determination: One of the most important things to develop is a determination to make positive coping skills lifelong friends and to turn symptoms into assets. Here is a verse to give your teens if they struggle with lethargy and lack of persistence. Positive thinking in a rhyme format will help teens remember important mental maps that can help them get up and get going. Adults can also help teens write their own rhymes based on inspiring words that motivate them. Do whatever works!
Persistence
I can pull myself up against my own resistance
To get a job done that I don't want to do
And I can do it over and over for as long as it takes
To alter my existence, based on my insistence
That I can create the world that I want.
©2006 by Patrice Wolters
Focus on health and strength: Teenagers with bipolar disorder generally need a variety of outlets for their energy and good strategies to pull out of a depression. They often require some form of medication, the benefit of a healthy diet, and good sleep hygiene. Since bipolar teens may feel bad about themselves, it's essential to help guide them to think realistically and optimistically about their condition and to help cultivate their strengths.
Teach your teens and patients to write their strengths on an index card and have them post it where they can see it regularly to remind them of their strengths. People with bipolar disorder, and depression, need to find positive thoughts to replace the chronic negative ones. Remind your teens that they are brilliant, talented and resourceful (or whatever words might inspire them).
Postponement: Hypersexual behavior had a compulsive quality for Wendy, but the medication decreased the intensity of her urges and helped her settle down. Still, she needed some strategies to control her urges, so I taught Wendy to use postponement to manage her sexual urges. When she felt hypersexual, Wendy learned to take charge of her thinking by saying to herself "I can postpone this urge and get something physical done instead." She would often lift weights, run or work on an unfinished project. With practice, Wendy learned to develop the habit of postponing her desires to masturbate, go to parties, and buy sexy clothes. Wendy gradually learned to be more in charge of her hypomania and developed some self-esteem as a result. She sometimes reflected, "I can do anything I set my mind to."
Wendy also made use of a thinking tool I developed called "Take charge, channel and change." When she felt a sexual urge, she would talk to herself in a proactive and realistic manner by saying something like "Okay, I'm starting to feel hypersexual, and this is a signal that I need to get moving with my projects. I am 'in charge' of my moods. Right now, I'm going to postpone acting on these urges and 'channel' my energy to get a project done. It's dangerous to act on these urges, and I will not. I am in charge of me, and I can 'change' some each day." These realistic thinking patterns helped Wendy take charge of her sexual urges. Learning to postpone any behavior that feels excessive or intense can be challenging at first, but it can do wonders for self-esteem and a sense of empowerment.
Wendy made up a list of the following projects to get involved in when she felt either hypomanic or depressed. The projects required a push with the persistence rhyme, but they were easy physical tasks that gave her a sense of accomplishment and got her moving through the challenging symptoms.

• Clean room
• Organize closet
• Wash clothes
• Iron clothes
• Clean bathroom
• Run, practice tennis or weight train
• Vacuum room

These were all things that she could do at home, and they provided a focus for her excessive energy. When broken down into mini-steps, the projects also provided a focus for when she was depressed, and they facilitated "change." Wendy was artistic, so she created a picture with the tasks drawn in cartoons that helped her get going when she felt down.
Of course, Wendy would still get some urges while involved in her projects, but she practiced bringing her mind back to the task at hand. The statement"I am in charge, I can channel and I can change" became her mantra to get started, follow through and complete daily living tasks. The completion of tasks reinforces positive thinking, which eventually became a mind-set for Wendy.
Get up and going -- 1-2-3-4: When Wendy was depressed, her biggest challenge was to get out of bed. Together, Wendy and I laid out an initial 1-2-3-4 routine that would get her up and going on the weekends. This routine has helped many teenagers with bipolar depression beat the bipolar blues. It has also helped those with unipolar depression.

1. Lie in bed and set a priority for the day. When Wendy was depressed, her priority was often to get out and practice some tennis because she knew it helped her mood. Most any athletic activity is an effective treatment for depression.


2. Shout, "Two, I can bust my mood!" and jump out of bed. Just getting up is a big achievement when a person is depressed, and shouting gets the energy going.
3. Make the bed. This gives a beginning sense of accomplishment and makes it harder to get back in bed.


4. Get a cup of coffee or tea, and eat some breakfast to provide nutrients for the day and get some energy flowing.

At this point, it was time to perform the next four steps and to continue this process throughout the day. Built into this behavioral pattern was breaking Wendy's day into small tasks that helped her build some momentum. While people vary on their steps, the next four for Wendy consisted of the following:

1. Put on makeup.
2. Brush teeth and floss.
3. Get dressed.
4. Get out the door.

Once she was out in the fresh air and on her way to the tennis court, the probability of her going back to bed was low. Encourage your teen or patient to create a routine and make it a habit. Using numbers or some type of sequence can facilitate breaking steps down to help teens get moving and begin to beat the blues. Talking or singing to themselves can be helpful because action is the name of the game. Teens who are not in treatment for bipolar disorder can get help from healthy friends, community groups, or trusted ministers.
Learn to master procrastination: Many depressed people procrastinate because their motivation and energy are low, but they can move toward creating positive energy by getting things done that they don't want to do. The trick is to set aside some time for the completion of unpleasant tasks. Wendy didn't like her history teacher, and she often arrived late to class. It was her first class of the day, so it was easy to sleep in longer. She would imagine how boring the class would be and think, "Well, I'll be on time tomorrow," but her tomorrows became a string of yesterdays, and she had a D average by the middle of the semester.
So, Wendy was to start her day by imagining how good she would feel with a B in the class. She was to schedule "History at 9 a.m." on her iPod and get to class regardless of her mood. If she was depressed, tired, anxious or unmotivated, she was to get up and go anyway. Taking charge of this problem and other aversive tasks gave Wendy positive energy and a sense of empowerment because she was taking care of business. Learning to push through lethargy is a habit that can gradually transform your world.
Bipolar II is a challenging condition, but it is treatable. Knowing the early symptoms of this condition can increase the probability of an accurate diagnosis in your teen, your patient or yourself. You can do something about bipolar, and you can get well. Remember, you are not your illness, you have an illness, and I encourage you to form mood management habits for a fulfilling life. Although social stigma may still cause considerable shame about coming forward with bipolar symptoms, you can be one of the people who seek help, and help can make all the difference in the world. Remember there is hope, there is help and it can be just a phone call away.

Patrice Wolters, Ph.D., has been studying ways to improve relationship therapy, child and adolescent therapy, and the treatment and diagnosis of bipolar II disorder for over 22 years as a licensed psychologist. She has helped many couples revitalize their marriages, improve family functioning and create healthy environments for children and teens. She is particularly interested in the early diagnosis and treatment of challenges in young people so they can go on to have amazing relationships, resiliency and a joyous life. Her trademark "Go from a Maze to Amazing" represents her model of therapy, which is based in the emerging area of positive psychology. For more information on positive change, visit http://www.patricewolters.com.

What Is The Difference Between Psychotic Depression and Schizophrenia?

Psychotic depression and schizophrenia can be easily confused with each other, but they are not the same. By definition, psychotic depression is a major depressive disorder that presents with hallucinations and delusions, while schizophrenia is a mental illness whereby the individual has difficulty thinking logically, identifying between what's real and what's imagined, and to express feelings appropriately. It's possible for psychotic depression to turn into schizophrenia just as it is possible for schizophrenia to cause psychotic depression.
Psychotic Depression vs Schizophrenia: Differentiating the Symptoms
Individuals with psychotic depression are usually agitated and anxious with some degree of intellectual impairment and physical immobility. They have sleeping problems, as well, excessive preoccupation with their health (hypochondriasis), hallucinations and delusions.
Schizophrenics, on the other hand, are hostile and suspicious. When you look at them you will find their gaze devoid of any expression. Social withdrawal is very likely, and along with it the reduced need or lack of desire to take care of one's self. Personal hygiene suffers, and so do personal and social relationships. Individuals diagnosed with this mental disorder are irrational, forgetful, and defensive to criticisms. Insomnia and depression are problems often met by schizophrenics.
Later Signs and Symptoms of Schizophrenia
As schizophrenia progress, delusions, hallucinations, disorganized speech and behavior become more apparent.
Delusions
It's typical of schizophrenics to be delusional. Most of them experience one or several of the following types of delusion:
· Delusions of persecution. Schizophrenics with delusions of persecution believe that someone is out there to persecute him/her.
· Delusions of grandeur. This is a strange believe that one is a VIP or who possesses super powers.
· Delusions of control. Schizophrenics believe that how they think or what they do are influenced by an outside force.
Hallucinations
Also common to schizophrenics are hallucinations. Hallucinations are signs and sounds that are believed to be real but which actually exist nowhere else but in the mind of the patient.
Disorganized Speech and Behavior
Schizophrenics have difficulty focusing. They can shift from topic to topic, which when you put them all together, no longer makes any sense. If you ask them questions, they will answer, but inappropriately. They keep repeating words and phrases over and over again. Sometimes they create their own words that nobody else understands.
Psychotic Depression and Schizophrenia: Understanding the Causes
There are a number of factors that can lead to psychotic depression, among them:
· Genetics.
· Neurotransmitter problems
· Hormonal imbalances
· Inability to cope with stresses and tragedies.
· Personality problems.
With schizophrenia, the following factors are said to trigger its occurrence:
· Genetics. If someone in your immediate family has the disorder, there's a 10% chance that you will have it, too. If both your parents have been diagnosed with the disorder, there's a 40% chance of you developing it as well.
· Neurotransmitter problems of imbalances in the brain chemicals.
· Structural abnormalities in the brain.
· Complications experienced during pregnancy or birth.
· Substance abuse. Marijuana consumption can cause schizophrenia.
Treatment Options For Psychotic Depression and Schizophrenia
Psychotic Depression is managed with a combination of antidepressants and antipsychotic drugs (using only antidepressants is found to be not very effective in many patients), and electroconvulsive therapy for patients found to have significant retardation of the psychomotor. The use of drugs needs to be strictly monitored, though, while electroconvulsive therapy has to be done in a hospital facility by a trained specialist.
To treat schizophrenia, antipsychotic drugs will be prescribed, but with extreme caution considering the many side effects they come with. The patient will also be advised to undergo psychosocial treatments, learn disease management skills and coping skills to deal with everyday stresses. If substance abuse is what triggered the disorder, integrating treatment for substance abuse will be employed.

The Psychology of Addiction

On why addiction is largely a state of the mind so addicts are more addicted to their addiction, the temporary feeling of pleasure, rather than the drugs...
Addiction is primarily psychological although addiction is defined according to the physiological changes in the body, and addiction continues to be considered as a social, cultural, genetic and experiential process as well. Addictive behaviour could be explained as any behaviour that gives temporary or short term pleasure and also provides relief from discomfort although there may be long term adverse effects.
Addiction is generally described as dependence on any drug and results from substance abuse. Any drug or alcohol can produce addiction as can other things such as the internet, gaming, gadgets, chocolates etc. However the physical and psychological effects of drugs and alcohol are detrimental and actually result in loss of productivity, withdrawal and physical dependence and lack of attention and such other conditions. The primary feature of addiction is dependence as an individual shows increased psychological and physiological dependence on the substance he is addicted to and without the addictive substance the person is unable to return to normal life.
Dependence on anything may not be too bad and some amount of social dependence is expected of us as social beings. However when there is excessive dependence with inability to live without the substance in question, then withdrawal symptoms result and there are physiological changes in the body including pain and in some cases medical attention is required. Addiction is an extreme dependence and can cause people to lose sense of reality as people become cripple without the substance they are addicted to. Addiction leads to crime and anti-social behaviour as addicts can resort to violent behaviour, to stealing, to murder simply to attain what they want. Addiction to a substance could be separated from healthy use of the substance such as some amount of alcohol is considered acceptable and healthy in a social setting but being completely dependent on alcohol to that which amounts to addiction can have adverse social and personal implications for the individual. Some of the common addictive drugs and substances are opium, alcohol, nicotine and barbiturates. Giving up any addiction, requires strength and this is largely the strength of the mind that aids in stopping any addictive behaviour. Thus if addiction is a disease, the cure of addiction or even its prevention is largely a psychological process suggesting that the 'mind' is responsible for the addiction, the beginning of it and also the end of it.
Using addictive substances stimulate and release the pleasure inducing neurotransmitters in the brain and the dependence on this feeling of pleasure leads to more such pleasure seeking behaviour and this can spiral out of control and doesn't remain within the control of the individual who then is completely controlled by his addiction rather than the other way round. Withdrawal or abstinence symptoms of an addictive substance could include anxiety, depression, craving, irritability, restlessness or even thoughts of suicide with fatal consequences. Craving, irritability, depression, anxiety are all psychological withdrawal symptoms of addiction although closely related to the physical withdrawal symptoms. So addiction is largely in the mind and if a person wants, he or she can overcome this extreme dependence on an activity or a substance through self control and with better insight into his condition.
Why do people develop addiction?
People who develop addiction are more prone to mental illnesses as addiction has been related to mood or affective disorders, to neurotic illnesses and obsessive disorders, to anxiety disorders and many other psychological problems. Addiction is largely akin to compulsion or the need to repeat any particular behaviour in an abnormal dependent manner and addiction like compulsion is an abnormal dependence. Addicts are obsessed with the substance or objects or activity that they are addicted to and show an abnormal dependence on the substance or activity. Individuals with mood disorders or people prone to frequent depression are prone to addiction as any addictive substance or drug or even activity such as sex that gives short term pleasure can cause the addict to return to this activity or substance again and again so that the depression is forgotten for a while. This need for short term pleasure leads to repeated pleasure seeking behaviour and thus creates addiction.
All human beings are necessarily pleasure seekers, we all like to experience that is good or beautiful or provides a moment of happiness but addicts are in turn addicted to this pleasure as well. In fact addicts are addicted to the pleasure and not to the drugs, which are simply catalysts to provide them this pleasure. The drugs and the objects as also the activities that they repeatedly engage in provide them a solace that they feel they would not find in other options. There are of course chemical changes in the body so there are substantive proofs that addicts do get short term pleasure. Thus a drug addict repeated uses drug because it provides a particular form of pleasure that he will not get by say watching films and a sex addict repeatedly seeks sex because the pleasure from sex according to her may not be found in other activities such as travelling or reading. However this is only a belief that the addict has and is not necessarily true. In fact there is a sort of fixation of want, and an obsession with the object of want so an addict repeatedly thinks about this want and convinces himself that without the addictive substance he will not be able to survive. When love becomes an addiction, it can lead to suicide or fatal consequences when the object of desire is not attained.
Addicts are thus obsessed and largely depressed individuals who sometimes use the obsession against the depression or to overcome the depression. They are socially withdrawn although they may apparently have a huge circle of friends with whom they may not be able to relate at all levels. Addicts are also susceptible to suggestion and they are vulnerable to opinions of other people. Strange that it may sound, it is easy to mold or change addicts and also easy to hypnotize them as they are very impressionable and easily affected by what people and society have to say about them. This weakness of addicts is also their strength as both negative and positive influences can act equally well on addicts and the right guidance would be necessary to show them what is good for them and what is bad.
How is addiction controlled and stopped?
Stopping or overcoming any addiction could be a challenge but as addicts are changeable and affected easily, it may be relatively easy to bring them back to normal life provided they have the right type of guidance and counseling.
One of the strategies that could be used to cure addictive behaviour would be 'diversion', providing alternative substances/activities or shifting their attention or interest into something other than the addictive substance or object. As a TV addict could be encouraged to develop more constructive habits of reading for instance.
'Substitution' would be another method and a person addicted to alcohol could be encouraged to take a drink that tastes like wine but does not contain alcohol.
'Eradication' or complete unavailability of the addictive substance or object can gradually lead to forgetting the pleasure giving substance and interests in other activities. The complete unavailability of a drug, even a sleeping pill can lead to lessening of addiction for that drug and help the addict to develop other interests, although this should not be done abruptly as physiological and psychological symptoms of withdrawal may result. So if someone is addicted to a specific medicine or pill, the doses could be slowly reduced before completely stopping intake of the drug.
Finally 'suggestion' or counseling to change behavior highlighting the bad effects of a drug or an obsessive activity could be effective at a later stage after withdrawal from the drug or activity has been attempted as when in need of any substance, addicts lose all sense of reality and may not even want to listen to advice. So, only when their dependence reduces to an extent with the help of the other methods of substitution, eradication or diversion, counseling could help them to show more reasonable and socially responsible behavior and prevent further conditions of relapse

10 Tips To Staying Mentally Healthy

If it's not broke don't fix it...right? No! One of the best methods of mental health recovery is to maintain an environment prone to mental health and mental illness recovery. Staying mentally healthy is a way of life, not something you do when things start to go wrong. Keep reading for your top 10 tips to staying mentally healthy! Remember sometimes, the best treatment is prevention.
For access to some great cutting-edge research aside from the tips below, check out the Mental Health Center of Denver's Research and Evaluation Team's publications.
1) Stay Physically Active: the human mind developed in an environment requiring one travels the equivalent of 12 miles per day for sheer survival (and no that doesn't mean jumping in the car and flooring it!). Recent research has proven that increased physical activity can actually create new brain cells (once thought of as a static number), this explains why nearly every mental healthcare consumer at facilities such as MHCD are strongly encouraged to begin an exercise regiment immediately.
2) Stay Socially Active: we are social creatures, thus one's support network, be it family or friends, is of immense importance to one's general well being. It is of course OK to take a few nights to yourself, but don't stay shut in. Go out, keep your social relations strong.
3) Get a Hobby: find something creative outlet that you want to do just for yourself. Depending on what you chose, a hobby can be a great avenue into sports clubs, night classes at a local college, or staying physically active; plus if its something you enjoy it will be much easier to stick with!
4) Be Self-Reflective: you know those few nights a week I said it was OK to just take a night to yourself? Do it! Read a good book, walk your dog, just think things over. Examine where you are in life, where you want to be, and where you've come from. Be honest and complimentary to yourself. You are a brave, amazing person, so act like it :)
5) Play: play is actually tremendously important for staying mentally healthy. Devoting time to just having fun can recharge your battery, revitalize your social networks, and reduce stress/anxiety.
6) Maintain a healthy diet: this goes along with staying active. Stay healthy, both in terms of exercise and in terms of eating. Now don't go crazy here, you don't want to make yourself miserable by being the food-police, just be conscious of what is going into your body. And allow yourself some leg-room to cheat once a week or so!
7) Set goals: when people are feeling depressed, aimless, or like they are just going through the motions, often times its because they are lacking general direction. Set realistic goals for yourself so you are continuously aiming at something, this is a practice known as positive dissonance (you are constantly reaching for a new goal you set, thus you are always striving further and further even if you accomplish a goal along the way). Importantly though, one must not take this too far and find no joy in overcoming a given sub-goal; this will prove to demoralize the individual. You should celebrate your successes! Each and every one of them, and then push yourself to be even better. Once you reach your goal, set another one to get even further! This will constantly drive you, give you reasons to celebrate as you attain goals, and will increase your general level of content and mental health.
8) Balance free time: this is very important! Don't let yourself just lay in front of the TV. That is actually conducive to depressive environments. Relax, watch some TV, read a book, go for a walk, spend time on your hobby. Do it all, not just one of them.
9) Examine your locus of control: in the midst of your self reflections, it is important to examine just where your locus of control is. Are you blaming everyone else for things? Or are you taking on all the fault? Nothing is one sided, remember that. Especially if your depression is focused around relationship woes. Think of what you really did, what others really did, accept that its in the past and that the best thing to do now is learn from it and live on to never make that mistake again!
10) Don't be afraid to seek help: It is a great shame that seeking out mental health professionals in America has become a taboo or secretive endeavor! If you are worried about your mental health, you should be proud of yourself for putting forth an effort to improve yourself. If you are in the general area, I would recommend a recovery-based treatment center such as the Mental Health Center of Denver, or MHCD. The only shame in finding help is not getting help when you can benefit from it!

For some great links to free, cutting-edge psychological research publications, access MHCD Research and Evaluation team's mental illness research page. Or, to find out what a recovery-centered community mental health center is like, access the MHCD Home Page link above.
Stay healthy, stay happy!
Lex Douvasa
Check out the Research!

Mental Health Diagnosis In Recovery

Mental health problems are extremely frequent during the recovery process. When people suffer from substance abuse and mental health disorders, we describe them as having a dual diagnosis disorder. Many people in recovery struggle with feelings of depression and anxiety before, during and after rehab. Additionally, many people who have a dual diagnosis struggle with bipolar disorder, panic disorder, schizophrenia and other personality disorders. If you find yourself fighting behavioral health issues at any stage of your recovery process, you are not alone.
Understanding Dual Diagnosis and Mental Health Problems in Recovery
For many people with major behavioral health disorders, self-medication leads to addiction. Frequently, the symptoms of mental health disorders are uncomfortable and alarming, particularly for people who have bipolar disorder, schizophrenia or other personality disorders. Drinking or using drugs can be a way of coping and calming down symptoms such as voices, hallucinations or delusions.
In fact, it is common for people to be diagnosed with mental health problems when they are in recovery for substance abuse. Qualified behavioral health professionals are able to help patients understand their illness and learn healthy coping mechanism that can reduce symptoms.
For people with dual diagnosis, recovery can be extremely challenging. As a result, it is extremely important to remain in treatment and build a strong support group and relapse prevention plan.
Depression and Anxiety
Depression is one of the most common mental health problems for people, not only those in recovery. Feelings of depression can arise when you realize substantial parts of your life must change for you to remain healthy. You may need to change relationships, social activities and learn new ways of coping when you feel down or upset. Depression is characterized by feeling down, feeling hopeless, changes in sleeping or eating and a feeling of not wanting to participate in hobbies or previously enjoyable activities.
Anxiety is characterized by feeling anxious or agitated. Many people feel anxious so often that it impacts their behavior, decisions and choices. These people may suffer from an anxiety disorder, a common mental health problems that people face in recovery. People suffering from anxiety disorders may become easily annoyed or angry. They may also have difficulty sleeping or concentrating. Many people feel increased anxiety when they experience a craving or trigger, because they are keenly aware of the temptation to relapse. Many people find that exercise, journal writing and group meetings help them alleviate mild depression and anxiety while in recovery. Behavioral health problems are common, and for many people are a normal part of the recovery process.
Mental health problems are treatable and many people live healthy and productive lives after seeking treatment, even while they are in recovery. If you feel depressed, anxious or are struggling with substance abuse and a co-occurring mental health disorder, it is important to seek treatment. Remember that you are the most important person in your life, and your health and your recovery should always come first.

Ben Brafman, LMHC, CAP is the President and CEO of Destination Hope, a licensed dual diagnosis substance abuse treatment center in Fort Lauderdale, Florida. Ben has more than 20 years of experience in the addiction and mental health fields, which led him to develop a combination of innovative treatment protocols at Destination Hope. He has been published on various topics including dual diagnosis and chemical dependency, and gives back to the community by educating other addiction counselors at his Academy for Addiction Professionals.

Unconditional Love And Mental Illness

What can be done to offset the development of depression, anxiety, and psychosis in our families and our communities?
What does it mean to be unconditionally loving? My definition is the ability to be accepting of people with all their warts. Everyone has annoying habits.
Often it's the little things that drive us bonkers. What if your loved one opens toothpaste from the bottom instead of the right way, from the top? What if he puts the toilet paper on with the paper dropping to the back instead of the front? What if he sleeps on the right side of the bed instead of the left? These idiosyncrasies can be the straws that break the camel's back.
Unconditional love enables us to shed light on the strengths, talents, and capabilities of those close to us.
What if we endeavor to count someone's strengths and to minimize his annoying characteristics? A strength based model is so much more powerful than nit picking at small annoyances.
The power of the positive is much stronger than the power of the negative. Recognizing abilities sets the groundwork for good relationships, fun interactions, solid marriages, and good mental health. Someone who feels loved by family members instead of criticized will flourish in that environment. Constant picking and putting one down sets the stage for low self esteem and a drive to look for harmful actions to fill the empty void and heal the broken heart.
What if we set an intention to bring out the best in others instead of picking at them and criticizing?
I was responsible for the care of an elderly aunt. This was a time of serious stress for me. By nature, I tend to overprotect Unfortunately, I frequently came down on the caretakers and failed to show appreciation for them. The agency that serviced my aunt got frequent phone calls about the caregivers. One of them stopped talking to me, making my visitation times with my aunt unbearable.
Instead of coming down on the caretaker more, I made the decision to see her in the best possible light.
After about a month of intolerable behavior from her, I went in for my daily visit to my aunt. The caretaker did a sudden turn around. She apologized to me and said she regretted treating me so badly. All I did was begin to think of her in complimentary terms.
Some behaviors cannot be overlooked. Actions that interfere with someone's safety, for example, need to be challenged.
But most of us behave in ways that can be changed if we are given the gift of unconditional love.
Dear readers, feel free to share your thoughts on this matter.
From Barbara Altman, author of Recovering from Depression, anxiety, and Psychosis, available on Amazon and Kindle