Today’s article is another in the series on inpatient treatment facilities. These questions have been answered by the staff at Timberline Knolls – the Bipolar Burble blog’s new sponsor. These questions were submitted by readers and cover bipolar treatments, length of stay, mental illness life skills, and use of discipline.
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Today marks the start of a few articles I’ll be writing about private inpatient psychiatric treatment facilities. This is thanks to our new sponsor, Timberline Knolls. The highly-trained staff at their facility have agreed to answer my, and your, questions about inpatient treatment facilities. Today we’ll be talking about the basics of inpatient treatment facilities including services offered, intake, what professionals are there and what it’s like to stay in a residential treatment facility.
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I’m always going on and on about how there are only two medications approved to treat bipolar depression (quetiapine and a fluoxetine/olanzapine combination) and about how we need new, novel ways of treating depression in bipolar disorder.
Well, this might not be novel, but it is new.
Lurasidone (Latuda) has now been approved both as monotherapy and as adjunct therapy (with lithium or valproate) in the treatment of bipolar depression by the Food and Drug Administration (FDA). Lurasidone was tested and approved for people with bipolar I.
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Recently, I wrote a piece for PsychCentral that outlined some recommendations for treatment-resistant bipolar disorder. This piece talked about first-line and second-line agents for the treatment of bipolar disorder but I wanted to delve a little further into the novel agents that are now being studied for the treatment of bipolar depression. These are medications that are not typically used to treat bipolar disorder, work in new ways and show promise in recent studies. This is cutting edge and if you’re treatment-resistant this is an area that can offer you hope.
The reason why this piece is about unusual bipolar depression medication and not medication for mania is because the medications we have for mania are quite effective for most people. It is the bipolar depression that, typically, is very hard to treat. Additionally the two Food and Drug Administration (FDA)-approved bipolar depression treatments (quetiapine and an olanzapine/fluoxetine combination) tend to carry very serious side effects like weight gain, risk of diabetes including diabetic ketoacidosis and others. We also know that most people with bipolar disorder spend vastly more time in a depressed state than in a manic state.
According to Dr. Prakash Masand, CEO and founder of Global Medical Education, “Less than 30% of bipolar patients achieve remission that is maintained long term. There are great unmet needs in the treatment of bipolar depression. Innovative approaches are needed rather than ‘me-too’ agents that offer little incremental benefit.”
Dr. Masand notes the following are new, novel agents that look promising in the treatment of bipolar depression.
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People ask me if they can treat their bipolar disorder without medication all the time. They think that I have some secret answer to give them. Like I secretly know something that doctors don’t. Like there is a giant conspiracy to keep non-medication treatments away from people with bipolar disorder.
So let me answer the question: Can you treat bipolar disorder without medication?
The quick answer is: no, not really. The long answer is: sort of, a bit.
So here I outline the treatments I’m aware of that treat bipolar disorder without prescription medication (or neuromodulation, like electroconvulsive therapy or repetitive transcranaial magnetic stimulation).
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As I said before, I’m taking a mindfulness meditation class and I can’t say as I particularly believe in mindfulness meditation. But, as I mentioned, I need to give treatments a chance if I want to get better, so, believe in it or not, I’m giving mindfulness meditation the ol’ college try.
In the first class we learned about deep breathing and the body scan (article to follow). These are really simple skills that anyone could do. But thinking about sitting still while “breathing” and “scanning my body” seemed kind of silly to me. I didn’t see how anything useful could result.
But I tried it anyway.
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In my effort to document the mindfulness meditation class I’m taking, I introduce skill #1, something easy: Deep breathing.
I know, you think you know how to breathe. In fact, my guess is you’re probably doing it right now (at least I hope you are). Nevertheless, many people don’t know how to deep breathe and this is a problem during mindfulness meditation. Many people, especially women, shallow breathe and this isn’t the best way to nourish your body. Some people even go so far as to occasionally hold their breath, especially when anxious.
Shallow breathing comes from the chest while deep breathing comes from the belly. (I know all about this because I was a trained signer when I was younger and you have to deep breathe in order to project and hold notes properly.) Women, often, don’t like to deep breathe because they’re scared that breathing from their belly will make them look fat. (Really.)
(They call meditation “practice.” I suppose it’s to indicate that we’re all students and that we’re never done learning. It’s kind of a warm, fuzzy concept but I think it’s worth remembering.)
Tips on Creating a Mindfulness Meditation PracticeThese are simple, easy-to-remember tips on creating a mindfulness meditation practice according to the course (and a little bit from me.)
Here are the tips provided when beginning a mindfulness meditation practice:
I admit to not using all of these tips but I do think they are a good idea.
I’ll talk about how I put these mindfulness medication tips to work with some mindfulness meditation exercised next.
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I’m going to be talking about an eight-week course I’m taking on mindfulness meditation, but before I start with my experience, I have to define a few terms so we’re all on the same page. I’m going to define mindfulness and mindfulness meditation so we all know what we’re talking about.
Well, that depends on who you ask. A very simple definition for mindfulness might be, “being right here, right now, and nowhere else.” Mindfulness has also been defined as “purposefully paying attention, in the present moment and without judgement.”
According to Sheri Van Dijk, MSW, author of The Dialectical and Behavior Therapy Skills Workbook, mindfulness skills, “. . . help people to live more in the present moment, rather than getting stuck in the thoughts about the past or future, which can trigger painful emotions. These . . . help you get to know yourself better, because you’re focusing on the present moment, you’re more aware of your emotions, thoughts, and feelings.”
Multi-tasking is the antithesis of mindfulness. (Personally, I still don’t think multitasking is always bad and I don’t think mindfulness is right for all occasions. But that’s my personality and a function of my job.)
While mindfulness is a form of meditation practice, you don’t have to sit cross-legged on a yoga mat chanting in order to do it. Both formal practice and informal practice can take place.
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