Category: treatments

Exercise and Bipolar — Evidence and My Experience

Many suggest that exercise can help with bipolar disorder. For those of us with severe bipolar disorder, this is a bit frustrating. After all, if you can’t get out of bed, taking a brisk jog is right out of the question. And I’m a stellar example of someone who has always hated exercise — before bipolar and now with bipolar disorder. I’m also someone who has tried to exercise over and over again with great failure as a result. So today I want to talk about the evidence of exercise in bipolar disorder and my past year-and-a-half attempt to exercise.

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Bipolar, Depression and Diet — The Evidence

Can your diet actually impact your depression or bipolar disorder? This is the question. While people claim that certain diets do help with mental illnesses like depression and bipolar disorder, the evidence just hasn’t been there. About the only thing the research can say is that eating an unhealthy, processed diet can lead to nutrient deficiencies and this can make mental illness outcomes worse. That’s it. And that makes perfect sense. But can your diet actually improve your bipolar disorder, depression or other mental health issue? Here’s what we know today.

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Antipsychotics Should Be Used for Non-Psychotic Depression Treatment

While some disagree, it’s important that people understand that antipsychotics need to be used for non-psychotic depression treatment, when appropriate.

At any one time, 14 million people suffer from depression but only 60-70% of these people respond to antidepressant treatment. Of those who do not respond, 10-30% exhibit treatment-resistant symptoms including “difficulties in social and occupational function, decline of physical health, suicidal thoughts, and increased health care utilization.” Treating these people presents a huge issue for healthcare practitioners and one of the options they consider is the use of a medication class known as antipsychotics.

Recently, a group called the Therapeutics Initiative wrote a letter entitled Antipsychotics should not be used for non-psychotic depression. Their conclusions are as the title suggests: this body found little evidence to support the use of antipsychotics in the treatment of non-psychotic major depressive disorder.

And while I respect the work of this body and while they have considered some evidence (in the case of quetiapine [Seroquel], an antipsychotic), there is more to consider on the issue.

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Mindfulness — Essential Bipolar Survival Skill?

I wrote that Mindfulness Doesn’t Help My Bipolar Disorder. And I think mindfulness, at least how I was taught it, just doesn’t significantly, positive affect a serious, neurological illness. I find it works best in people who experience stress and anxiety. And many do agree with me on this.

That said, John McManamy does not. Here are his thoughts on mindfulness in bipolar disorder.

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Mindfulness is essentially the mind watching the mind. The practice has been around forever. It is a staple of Buddhist practice, and is also the basis of modern talking therapies such as cognitive behavioral therapy (CBT), even if its proponents fail to give it credit.

In all likelihood, if you have had success in managing your bipolar, you are employing mindfulness techniques, though you may be unaware of it.

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Transcranial Magnetic Stimulation vs. ECT for Depression

Transcranial magnetic stimulation is an option for depression treatment and may be an alternative, for some, to electroconvulsive therapy. Transcranial magnetic stimulation (when used as a treatment for depression known as repetitive transcranial magnetic stimulation or rTMS) is actually similar to electroconvulsive therapy (ECT) in that it’s also a neuromodulation technique. It does differ, though, as rTMS is much less invasive and has a very favorable side effect profile, particularly when compared to ECT. There are reasons that people aren’t flocking to rTMS as a depression treatment, though.

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Why Therapy Can’t Treat Uncontrolled, Serious Mental Illnesses

I have been through lots of therapy and lots of therapists in my life and my contention is that therapy can’t be used to actually treat uncontrolled, serious mental illnesses. Now, don’t get me wrong, therapy can be supportive to a person with an uncontrolled, serious mental illness and therapy can be useful to a person with an uncontrolled, serious mental illness (such as in the case where the therapist tracks your bipolar symptoms and report changes to your doctor) but therapy cannot be used to actually treat a serious and uncontrolled mental illness.

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I write a three-time Web Health Award winning column for HealthyPlace called Breaking Bipolar.

Also, find my writings on The Huffington Post and my work for BPHope (BP Magazine).

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