Explainer Link Copied 05.31.24

Dysthymia May Be the Reason You’ve Felt Depressed for So Long

It’s more mild than major depression, but it can still really suck. BySam Brodsky

When you think of depression, your brain might immediately jump to those debilitating depressive episodes which feel like big, dark clouds that hang around for a while and then clear up—sometimes coming back later or not at all. That’s major depressive disorder for ya, otherwise known as major depression or MDD. But what happens when someone feels low-key depressed for what seems like years? Well, they may literally be  depressed for years—and they might have what’s called dysthymia, otherwise known as dysthymic disorder or persistent depressive disorder. 

People with dysthymia have long-term depression that’s usually considered more mild than an episode of major depression, explains David Hellerstein, MD, professor of clinical psychiatry at the Columbia University Irving Medical Center and director of the university’s Depression Evaluation Service. 

If you can’t really remember a time when you weren’t  bummed out, it’s worth learning more about this mood disorder, how it compares to major depression, and how it’s treated. Because even though this long-lasting depression can be super draining and frustrating to go through, there are ways you can manage it and get better.

One quick thing before we dive into the details: Mental health is complex and everyone has a unique experience, so don’t go diagnosing yourself just because you read a few articles on the internet (though, we do appreciate you stopping by to learn a few things). If this resonates with you, consider it a jumping-off point in your journey to getting care. OK, let’s get into it…

What is dysthymia?

People with dysthymia have low mood and energy pretty much every day for at least two years, says psychiatrist Beth Salcedo, MD, medical director of The Ross Center and a former board president of the Anxiety and Depression Association of America. 

Dysthymia, or dysthymic disorder, used to be a diagnosis in previous versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), but, in 2013, it was thrown under the umbrella of a new disorder: persistent depressive disorder (PDD). This new diagnosis covers everyone who previously would have been diagnosed with this low-grade, long-term depression and also folks who’ve had full-blown symptoms of major depressive disorder for more than two years (oof). So some mental health pros use PDD and dysthymia interchangeably, JFYI.

As with major depression, the root causes aren’t 100% known, but they’re probably a mix of environmental factors, like trauma or loss, and genetic factors, like a family history of this brand of depression, says Dr. Salcedo. 

Dysthymia symptoms, explained

Living with dysthymia means living with a low level of depressed mood for a long time, says Dr. Salcedo. In her experience, people with dysthymia also say their energy is consistently off-kilter, and it’s difficult to enjoy things.

The symptoms of dysthymia are pretty much the same as what you’d see with major depressive disorder. More specifically, that looks like at least two years of feeling consistently depressed, as well as experiencing at least two other depression-related symptoms, according to the latest edition of the DSM (the DSM-5-TR). These can include feeling fatigued, experiencing low self-esteem, having concentration or decision-making issues, feeling hopeless, sleeping too much or not enough, and having a poor appetite or overeating. (FYI, for kids, these symptoms only have to last at least a year.) 

All of this needs to impact some area of your life, like your relationships or work, per the DSM-5-TR. Even if the symptoms are relatively mild on any given day, not getting a break from dysthymia can still significantly mess with you and lead to a super pessimistic outlook on life, notes Dr. Hellerstein. It’s like you can’t get your head above water, he adds.

But it’s not always obvious to someone that they’re experiencing this mood disorder because it’s often hard for people with dysthymia to recognize when they didn’t  feel bad, Dr. Salcedo says. “They become used to it, or they might think they just have a negative personality type, and so they don’t really realize that there’s treatment that could help,” Dr. Salcedo says. That’s also probably a reason why it’s hard to pinpoint how common dysthymia actually is, she notes. 

Dysthymia vs major depression

The big difference between these two disorders is timing. Major depression comes in distinct episodes that last for at least two weeks at a time but usually resolve within several months to a year, notes Dr. Salcedo, whereas people with dysthymia deal with depression symptoms for two years minimum. And, if there are  stretches of time where the depression seems to subside for people with dysthymia, these periods don’t last longer than two months, per the DSM-5-TR.

It’s relatively rare for a major depressive episode to span two years, notes Dr. Salcedo. Though when it does, you’d technically meet criteria for a subset of persistent depressive disorder, aptly named persistent depressive disorder with persistent major depressive episode, according to the DSM-5-TR.

Another difference: You’ll need to check off more symptoms to be diagnosed with major depression (at least four in addition to either depressed mood or loss of interest or pleasure) than you would for dysthymia or PDD (at least two in addition to depressed mood). The list of possible major depression symptoms is also a little more robust, including things like suicidal ideation and anhedonia, though that doesn’t mean people with dysthymia can’t experience these too, notes Dr. Hellerstein. 

Criteria aside, you can’t really tell whether someone is experiencing a major depressive episode versus dysthymia just by looking at them (especially if you aren’t a mental health professional). It’s also entirely possible that they could be experiencing both at the same time—like when someone with a baseline level of dysthymia experiences a period of more severe symptoms that meet the criteria for a full major depressive episode, notes Dr. Hellerstein. This is referred to as “double depression,” by the way. (Fun?) “It’s like being in California in the dry season. All it takes is one spark or match, and that can start a forest fire. The [dysthymia] conditions are already ripe for a full [major depressive] episode,” he explains. 

As for how they feel for the person experiencing it, MDD might feel like a more drastic shift than dysthymia, Dr. Salcedo says. With dysthymia, you might think, Well, maybe this is just me, even if it’s really hard and messing with your functioning, she explains. “Usually it’s this low-grade thing that they live with for a long time until something happens—they get worse or maybe somebody says something—and then they realize: Maybe this isn’t how most people live.” Which brings us to…

How is dysthymia treated?

Both experts told us that the research behind dysthymia treatment is sort of lacking. That said, therapy and medication can help—just like they can with major depressive disorder. But you wouldn’t necessarily turn to more extreme depression treatments, like ketamine and electroconvulsive therapy, for dysthymia, notes Dr. Hellerstein. 

Good ol’ cognitive behavioral therapy can help people with dysthymia recognize the thoughts and behaviors that may be making their mood worse, says Dr. Salcedo. Interpersonal psychotherapy can help them work on their relationships if their depression has interfered with those, she notes. And behavioral activation can help motivate people to get out and participate in life, which could make them feel better too, Dr. Salcedo adds. 

There’s also a therapy specifically designed to treat chronic forms of depression, called Cognitive Behavioral Analysis System of Psychotherapy, or CBASP for short (it’s a mouthful, we know). CBASP uses a combo of different techniques (like the ones above) to help you cope with depression symptoms and how they impact other people in your life. Heads up though: Dr. Hellerstein says it can be hard to find a therapist who’s well-versed in it.

As for meds, antidepressants like SSRIs and SNRIs can boost your mood, which can give you the energy you need to do stuff on your own that may also benefit your depression, says Dr. Salcedo. Think: lifestyle changes like getting better sleep, moving your body, and seeing friends and family. “It’s not just that the medication makes people feel better; it’s that any alleviation of symptoms can allow people to do more for themselves,” she says. “It’s a ripple effect.”

While there’s no exact cure for depression in general, or dysthymia specifically, there are definitely ways to manage it, says Dr. Salcedo. “If people feel like their mood is in any way impacting the quality of their relationships and their ability to do the work that they want or live the life they want, I would strongly encourage them to get treatment,” she says. “You deserve to feel good.”

The post Dysthymia May Be the Reason You’ve Felt Depressed for So Long appeared first on Wondermind.

Explainer Link Copied 02.21.24

A Nice Lil Intro to Antipsychotics

These meds might sound scary, but they’re really helpful. BySam Brodsky

For years, Esmé Weijun Wang, author of The Collected Schizophrenias, heard things that weren’t there and believed things that weren’t based in reality. Eventually she was diagnosed with schizoaffective disorder. While these hallucinations and delusions—symptoms of psychosis—aren’t totally gone now, she doesn’t have them as much anymore thanks to antipsychotic medications, she tells Wondermind. “For the most part, medication has helped me a lot,” she says. “I’m really grateful.”  

For people like Wang who’ve had hallucinations or delusions, it may be hard to sort out what’s real from what’s not. But antipsychotic meds can help them do life without those things getting in the way. If you’re hearing voices or truly believing that someone’s trying to hurt you when they aren’t, it’s going to be super difficult to go about your day, says psychiatrist Kamleh Shaban, MD. Antipsychotics “turn down this ‘noise,’” she explains. (It’s in the name after all: antipsychotics.) 

But these meds don’t only make psychosis better. For example, antipsychotics can also help people who don’t have psychosis deal with mood symptoms that are really messing with them, according to experts. (More on that in a bit.) 

So, if you’re just curious about antipsychotic medications, think you might need them, or have an important person in your life who’s about to start them, we’re here to talk about the basics. Here’s how they work, side effects to look out for, and how long you can expect to be on them. Your doctor will ultimately help you suss out what makes the most sense for the symptoms you’re having, but this is a good place to start.  

What are antipsychotics?

Like we said, these meds treat outside-of-reality symptoms like hallucinations and delusions. This means they help people with conditions that can come with psychosis, like schizophrenia, bipolar disorder, and even severe depression, according to the National Institute of Mental Health (NIMH).

But you don’t actually need to experience psychosis to be on antipsychotics. These meds can also help stabilize the high highs and low lows of people with mood disorders, says Dr. Shaban. They’re prescribed to treat dementia and Tourette syndrome too, says psychiatrist Efraim Keisari, MD. And some are even FDA-approved to help with irritability in autism spectrum disorder. So don’t be shocked if you aren’t seeing or hearing weird things and your doctor brings up antipsychotics.

And, just so you know, there are two main classes of antipsychotics: older ones (called first-generation or typical antipsychotics), like haloperidol and chlorpromazine, and newer ones (called second-generation or atypical antipsychotics), like aripiprazole and risperidone. These newer ones can treat more kinds of symptoms compared to the older drugs, according to the NIMH.

So how do antipsychotics work? 

The specifics are still sort of murky, to be honest. That said, experts think that these meds prevent an overproduction of dopamine in certain parts of the brain that causes psychotic symptoms, Dr. Shaban explains. They do this by blocking some of the brain’s dopamine receptors, sorta like putting in earplugs, says Dr. Keisari.

The same dopamine-blocking powers can potentially help stabilize your mood if you’re manic—or at least that’s the theory, says Dr. Shaban. At the same time, atypical antipsychotics can be a green light for dopamine in certain parts of the brain, letting it be released instead of blocked, which might contribute to improved mood, she explains. Sometimes taking one of those atypical antipsychotics can also help your depression in a way your antidepressant can’t by affecting a few different types of receptors in your brain, Dr. Keisari says.

What are the side effects of antipsychotics?

It’s possible you won’t have too many side effects when starting antipsychotics, depending on what dose and medication you’re on, says Dr. Keisari. But there are  ones to know about.

Muscle jerks or cramps you can’t control are more likely to happen with first-gen antipsychotics, says Dr. Shaban. (FYI, this is one reason why a lot of psychiatrists prefer to prescribe second-gens now, Dr. Keisari notes.) But you’re more likely to experience higher cholesterol and weight gain (aka metabolic side effects) from certain second-gen antipsychotics rather than the older meds, says Dr. Shaban. Plus, you can have a dry mouth, constipation, blurry vision, and trouble peeing because of some first- and  second-gen antipsychotics, says Dr. Keisari. 

Because of potential side effects, psychiatrists may send you for bloodwork. For example, they’ll usually have you get blood sugar and cholesterol labs done every three to six months if you’re on antipsychotics that can mess with that, Dr. Shaban says. And doctors will need to monitor your white blood cell count super closely if you’re taking the atypical antipsychotic clozapine, since it can lower a specific type of infection-fighting white blood cell, says Dr. Keisari.  

You’ll also want to talk to your doctor about the risks versus benefits of being on antipsychotics if you’re planning on getting pregnant, says Dr. Shaban. Using antipsychotic meds while pregnant may increase the baby’s risk for birth defects, research suggests. That said, “untreated mental health in a mother can have really lasting effects,” Dr. Shaban says, so only you and your doctor can decide what’s best for you. (Just so you know, she’s personally had pregnant patients who stayed on antipsychotics, so it’s not unheard of.)

How long can you take antipsychotics?

It really depends on what you’re being treated for. Someone with schizophrenia or schizoaffective disorder, for example, will probably need to stay on antipsychotic meds to manage their psychosis, says Dr. Shaban. But someone who’s using an antipsychotic in addition to other medication for depression or manic episodes might wean off that antipsychotic when they’re feeling stable, she adds. 

Remember that everyone’s different, so it might take some trial and error to find an antipsychotic that manages your symptoms and doesn’t give you bad side effects, Dr. Shaban says. Once you do, your symptoms may start to get better in a few days, though it could take a number of weeks to get the full effects, Dr. Keisari says.

Bottom line: Antipsychotic medications are usually prescribed for treating psychosis in disorders like schizophrenia, but they’re also used for other mental health conditions. Regardless of what you’re taking antipsychotics for, be open with your doctor about side effects and any questions you have, says Dr. Shaban. They can help you find what works for you.

The post A Nice Lil Intro to Antipsychotics appeared first on Wondermind.

Explainer Link Copied 12.01.23

Everything You Ever Wanted to Know About Mood Stabilizers

No emotionless zombies here. BySam Brodsky

You know that mental health medications can help you manage the symptoms that make it hard to live your life. And if you’re dealing with a condition that impacts your mood in a big way (or know someone who does), you might’ve heard about meds called mood stabilizers.

For some, these can be game-changing. Take Brandon, 30, who has bipolar I. He previously told Wondermind that mood stabilizers help with the “impending sense of doom” he often experienced in the morning. Therapist Amanda Eldabh, LCSW, who has bipolar II, told Wondermind in that same story that her mood stabilizer (along with an antidepressant) is totally life-saving. 

But how does someone get prescribed mood stabilizers, and how do they know which one works for them? Truth is, your primary care provider or psychiatrist will ultimately be the one to help you figure out what prescription makes the most sense for your situation. In the meantime, here are the need-to-know basics about these mental health meds.

What are mood stabilizers, and how do they work?

Mood stabilizers basically do what the name implies: stabilize your mood. For people with bipolar disorders and schizoaffective disorder, or mental health conditions that cause dramatic mood swings, these meds keep those high highs (mania and hypomania) and low lows (depression) in check, says psychiatrist Samantha Saltz, MD. Mood stabilizers can treat other conditions that impact your mood too, like depression and generalized anxiety disorder, if other meds aren’t doing the job on their own, according to psychiatrist and psychotherapist Patrice Mann, MD, MPH. 

And there isn’t just one kind of mood stabilizer out there. Docs can prescribe one of the three main types depending on your age, symptoms, how your brain has responded to other meds, and whether you’re pregnant (or want to be soon), explains Dr. Saltz. For some, that means taking lithium, antipsychotics (like aripiprazole and quetiapine), or antiseizure or anticonvulsant medications (like valproic acid and lamotrigine), explains Dr. Mann. 

Each of these work in a different way. Lithium is an OG mood stabilizer first used to treat mania in the 1940s, according to the American Psychological Association (APA). Though it’s not totally clear how it works, it might have to do with something called cellular signaling, per the APA. 

Antipsychotics can double as mood stabilizers too (even if you don’t have psychosis) by stifling extra dopamine in the brain, Dr. Mann explains. Antiseizure meds are another type of mood stabilizer that “decrease hyperactivity in certain brain areas,” she adds.

Sometimes, doctors prescribe more than one type of mood stabilizer, Dr. Mann says. It really just depends on how you respond to the first prescription you try and if you’re still having symptoms, she explains.

Science aside, a lot of people (maybe you!) often think mood stabilizers work by turning people into emotionless zombies—which isn’t the case, says psychiatrist Aarti Jerath, MD. 

Cat, 31, thought that starting mood stabilizers would make her a “boring potato”…literally. “I thought creativity, bubbliness, and friendliness came hand in hand with what I now know can  be hypomania,” she previously told Wondermind. But she’s still able to tap into all of those parts of her personality. The meds just turn down the volume on her hypomania and depression symptoms. 

Obviously, if you’re used to having certain highs and lows, it’ll feel different and maybe even uncomfortable to live without those extremes, says Dr. Mann. That said, if you feel like something is really off, like you’re more apathetic than ever, you can talk to your doc about changing up your medication, she notes.

What are the side effects of mood stabilizers?

Like any medication, this type of pharmaceutical can, unfortunately, have drawbacks. For example, some antipsychotics can come with metabolic side effects like increases in blood sugar, weight, and cholesterol, says Dr. Mann. Antiseizure meds can make you tired and upset your stomach, while lithium is associated with shakiness and thyroid issues, notes Dr. Saltz. Certain antiseizure meds aren’t suggested during pregnancy since they can lead to birth defects, she says. Lithium has also been linked to risks during pregnancy, but recent research suggests that risk may be low and is something each person should discuss with their doctor.  That sounds like a lot, but it really varies from person to person and your doctor can keep a close eye on your blood work, weight, and blood pressure to make sure everything’s OK, says Dr. Mann. 

You might also be able to manage mood stabilizer side effects by being strategic about when you take it. “I have felt incredibly stable on this medication over the years, especially if I can time it right with food and taking them before bed,” says one 35-year-old woman who wanted to stay anonymous.

It’s also possible that you might not have any side effects, notes Dr. Jerath, who says she’s had patients on mood stabilizers like lithium, lamotrigine, and aripiprazole without any reactions. 

How long can you take mood stabilizers?

Some people stay on mood stabilizers for the long haul, says Dr. Saltz. And while others come off of them after several months or years, ultimately it depends on their diagnosis. For example, people with bipolar disorder are often on mood stabilizers for their whole lives, and someone with depression who’s using a mood stabilizer in addition to an antidepressant might get off of the mood stabilizer once their symptoms improve, says Dr. Jerath. 

Regardless of how long you take them, you might not be on the same exact mood stabilizer forever. For instance, if you need to be hospitalized for a manic episode, your doctors might put you on a higher dose or a different type for a couple of months to see how it impacts your mood, says Dr. Mann.  

Depending on the medication and your symptoms, you may need to take them for weeks or months to see the full effects, so try to level set your expectations before you get discouraged, says Dr. Mann.

The bottom line: Mood stabilizers are a solid way to manage any mental health condition that causes extreme highs and lows. With the help of a doctor, you can find the one that makes the most sense for you and start feeling better soon.

The post Everything You Ever Wanted to Know About Mood Stabilizers appeared first on Wondermind.

Stories Link Copied 05.26.23

11 Things People With Bipolar Disorder Want You to Know

No, meds won’t make you a “boring potato.” BySam Brodsky

Heads up: This article mentions the topic of suicide and self-harm if you want to skip it. 

Amber, 27, notices that some people shy away from getting to know her when they find out she has bipolar disorder. Some have even called her “crazy” when she’s reached out for help, she says. And she’s not the only one noticing the stigma. Three in five people with a mood disorder like bipolar said they get treated differently once others hear about their diagnosis, according to a National Alliance on Mental Illness (NAMI) survey from 2021.

Despite the progress society has made in raising awareness of mental health issues, there’s still a lot of shame attached to bipolar disorder. Amber sees this stigma when the media mainly paints people like her as being erratic 24/7 and only really features them in “crisis mode,” she says. Brandon, 30, sees it when he posts videos about his bipolar disorder and people leave massive generalizations in the comment sections. And Tara, 41, saw it when a former boss told her never to disclose her diagnosis in the office. Ever. This just shows that the less you understand the condition, the easier it is for you to make assumptions about how a person with bipolar thinks, feels, or acts. 

What it all comes down to is that bipolar disorder is often an “invisible disability, and people don’t understand what they can’t see,” says Brandon. This is why Christina, 34, who spent years advocating for herself before she got a diagnosis, says more awareness is crucial. Setting the record straight about what bipolar disorder is (and isn’t) and calling out harmful stereotypes can get people to be a bit more empathetic and understanding when they find out somebody has the disorder, Christina notes. 

So, some bipolar 101 to start: Bipolar disorder means someone has significant shifts in energy and mood that can interfere with their everyday life. To break it down even further, there are three main types. In bipolar I, someone experiences episodes of uber elevated, energetic, and/or irritable mood (aka mania), plus the lows of depression and sometimes milder elevated mood episodes (aka hypomania). In bipolar II, they have depressive episodes and hypomania. With cyclothymia, a person deals with less intense and shorter hypomania and depression symptoms that don’t quite fit a bipolar II diagnosis, and it lasts for at least two years, per the American Psychological Association.

People with bipolar disorder can also have mixed episodes where they have a combo of both manic and depressive symptoms, like feeling hopeless and sad but also very energized, according to the National Institute of Mental Health (NIMH).

Even if you do  know all this info, you might still consciously or subconsciously have some preconceived notions about people with bipolar disorder. To help chip away at the stigma, we spoke to people with a range of experiences living with the condition. Here’s what they want those not  living with it—or those who were just diagnosed and have a million and one questions—to remember.

1. Bipolar disorder is not the same thing as having mood swings. 

“It’s normal for everybody to feel sad, to feel anxious, to feel hyper, to feel happy, to feel elated,”  says therapist Amanda Eldabh, LCSW, who also happens to have bipolar II. It’s only when those changes in mood last for days, weeks, or more and impact how you function in daily life that they could fall into bipolar disorder territory, she clarifies. 

“I know guys whose ex-girlfriends had extreme reactions, tempers, or were unreasonable, and they labeled them as bipolar,” recalls Tara, who has bipolar I. “While we do experience extreme moods, it’s not typically a sudden change. We experience moods that can be extremely high or low … [and] may last days or weeks. It’s very different from someone getting angry or reacting in an extreme [way].”

Amber, who also has bipolar I, wants to clear up this misconception too. “These episodes are more than just a feeling. They impact behaviors and thought-processing. In manic episodes, I become rageful and convince myself that other people are conspiring against me,” she shares. “It seems like people are talking to me in a foreign language, my speech becomes illogical and rapid, and I have trouble sleeping.”

When Amber is depressed, she says she feels like she can’t breathe. “I convince myself that everyone would be better off without me, especially when dealing with the repercussions of my manic episodes,” she adds.

2. Bipolar disorder is treatable. 

Thinking that bipolar disorder can’t be treated just adds to the stigma that it’s this dreadful “life sentence,” says Eldabh. It can be treated with a combo of meds and psychotherapy, plus lifestyle changes (like a consistent routine and fam/friend support), per the NIMH. 

That said, treatment will look different for each person. For Eldabh, it’s a mood stabilizer and an antidepressant (that she says are lifesaving), along with regular meditation and mindfulness. For Brandon, who has bipolar I, mood stabilizers help him not  wake up with this “impending sense of doom.” Also, the antipsychotic he’s on helps with the paranoia that everyone was judging him, which makes doing things outside of his apartment so much easier, he says.

For Cat, 31, who was told by psychiatrists that she either has cyclothymia or bipolar II, treatment looks like therapy and a mood stabilizer. Exercise and journaling help her overall mental health, and she goes to support groups to hear from people with similar symptoms as a reminder she’s not alone. 

3. No two people will experience bipolar disorder in the exact same way. 

Maybe you’re generalizing what you think you know about bipolar disorder based on one interaction you’ve had with a cousin, friend, or co-worker. To avoid stereotyping, it’s good to know different people experience bipolar disorder differently, says Christina.

For example, Eldabh and Christina both have bipolar II. When Eldabh is hypomanic, she says she’ll get impulsive. Sometimes that means spending too much money, being hypersexual, or going on a random road trip without much thought. Christina says she’ll have a bunch of flowing ideas (she’ll write a full essay or tons of jokes for a new stand-up routine), she’ll have extra energy, and she’ll call or text people more than usual.

4. Mania isn’t necessarily a fun experience. 

Amber says people always assume that mania is euphoric, and while it can be for some who have bipolar disorder, it’s not fun or a good time, in her opinion. When she’s in manic episodes, “it feels as if I’m screaming on the inside but can’t control my actions and what I say on the outside,” she says. These episodes are exhausting for her—but she can’t sleep—and they can sometimes lead to self-harm. She also can experience delusions (a sign of psychosis) where she’ll speak super illogically and think people are targeting her.

Similarly, Brandon says that, for him, there’s really no positive aspect to mania even if the extreme confidence he felt was a nice change. In his first manic episode—which happened during the Covid pandemic—he had this elaborate delusion that people wanted to hurt him because he was figuring out his family members were criminals. So mania was really scary, and he ended up in the hospital for mental health treatment.

5. And hypomania isn’t just being in a good mood. 

Christina was first diagnosed with depression when she was 14, and it wasn’t until her mid-20s that she had periods of high energy and euphoria that she later realized were hypomania from bipolar II. But even when she told psychiatrists about her symptoms, it took years for a doctor to listen her and confirm the diagnosis she’d already suspected. One psychiatrist even said he thought she was just in a good mood because life was good (WTF!). 

Equating hypomania to a “just a good mood” (whether you’re a mental health professional or not) is simplifying a symptom that, for some people, can mess with a normal sleep schedule and cause impulsive behavior. Brandon says his bouts of hypomania—which happen a couple times a year and don’t include delusions—feel similar to mania in that he’s much more impulsive than usual (even if he does  feel more in control of those impulses when he’s hypomanic as opposed to manic).

6. Bipolar disorder doesn’t make people dangerous.

Sometimes Brandon will see comments on his videos about bipolar disorder from people who say their loved ones have verbally lashed out at them, and they’ll continue on to claim that every person with the disorder is like this. “It’s sad because they obviously went through something really traumatic with someone with bipolar disorder, but the issue, obviously, is that it’s such a blanket statement,” Brandon notes.

Saying that all people with bipolar disorder will lash out perpetuates the stereotype that those with the disorder—especially those with severe forms of mania—are violent. In reality, just because someone with bipolar disorder can be irritable during manic episodes, doesn’t mean they will become violent, says clinical social worker Kirsten Bolton, LICSW, who works with patients who have bipolar disorder or psychotic disorders in one of McLean Hospital’s residential treatment programs. Plus, someone with bipolar disorder is way more likely to be a victim of violence than a perpetrator of violence, she adds.

7. People with bipolar disorder aren’t always manic or depressed.

Christina was nervous colleagues would think she was “unstable” once they found out that she had bipolar II and that it might cloud their judgment about what she could bring to the table as an employee. “I was worried people would think, Oh my gosh, who knows what version we’re gonna get today at the office? ” she says.

But it’s not like Christina is either hypomanic or depressed all day, every day. Her mood is at a stable baseline the vast majority of the time thanks to the medication she’s on, she says. As Tara explains it: It’s not like a yo-yo. It’s more like a rollercoaster where she has extreme moods broken up by periods where she feels like herself. 

This baseline or stable mood is called euthymia, says Sarah Sperry, PhD, assistant professor of psychiatry at the University of Michigan and an associate director in the university’s Heinz C. Prechter Bipolar Research Program. Even without medication, people with bipolar disorder still experience a baseline mood and aren’t just constantly fluctuating between manic and depressive symptoms, she says. Plus, it’s important to note that not every big emotion experienced is due to someone’s bipolar disorder—everyone has big feelings and they aren’t necessarily a symptom just because you live with bipolar disorder.  

8. You can have bipolar disorder and be in healthy partnerships.

Cat felt like it would be impossible to keep up a healthy love life since she hadn’t seen any positive examples of that in the media. “I have seen our society sexualize bipolar disorder with phrases and memes, saying things like, ‘People with bipolar disorder are great for one night stands but not girlfriend/boyfriend/partner material ’cause they’re always gonna be crazy,’” Cat explains. 

As she learned about her own diagnosis and continued to live with her condition, she realized that wasn’t true. She reports that she’s been in a happy, monogamous relationship for two and a half years now, and she says it’s important to know that bipolar disorder does not disqualify you from having meaningful bonds. 

9. Bipolar II isn’t necessarily less severe than bipolar I. 

Eldabh says a lot of people think because she has bipolar II (and not bipolar I) and she’s successful as a mental health professional that she doesn’t struggle—and that’s not fair to assume. For her, bipolar II can be debilitating. For example, she attempted suicide during a hypomanic episode in the past.

Not to mention, depressive episodes in bipolar II can actually be longer and come on more often than depression in bipolar I, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). For Eldabh, her depressive episodes can be intense and sometimes manifest as intense guilt and regret for things she did during a hypomanic episode, which can lead to suicidal thoughts.

10. Bipolar disorder meds don’t turn you into a zombie.

At first, Cat fell into the trap of thinking she would be emotionless once she started mood stabilizers to level out her extreme highs and lows. “I thought medication would make me a boring potato because I thought creativity, bubbliness, and friendliness came hand in hand with what I now know can  be hypomania,” she says. But Cat found out that she can be joyful, bubbly, and excited even when she’s not hypomanic.

We’re happy to report that Cat is NOT a boring potato. Her periods of hypomania and depression aren’t as long or intense because of her meds, and she still taps into her creative side as an artist, she says. Facts: Cat painted a giant canvas of a whale while jamming out to Rihanna after the last Super Bowl, and she continues to do makeup gigs for film and photoshoots.  

Bottom line: It’s a major misconception that all mental health meds will flatten your emotions. Sure, that might be the case for some people depending on what they’re taking—Nick, 36, who has bipolar II, says he thinks his combo of meds was partially to blame for his “stifled” emotions—but that’s not something that’ll 100% happen.

11. And getting off medication isn’t really the goal for most people with bipolar disorder. 

Since there’s such a stigma around mental health meds in general, Brandon says people always assume he wants to stop taking them as soon as possible. But, turns out, he’s finally found stability after 20 years, so he’s for sure staying on them, he says. “I’m under the impression that I will be on medicine the rest of my life, and I’ve accepted that,” he adds.

It’s true that a lot of people with bipolar disorder take medication to help prevent future mood episodes and reduce symptoms in between episodes—so the majority of those living with the disorder will stay on meds, explains Dr. Sperry. But some people can decrease their meds or go off of them depending on their circumstances, she says.

Thanks to medication, help from mental health professionals, and social support, Amber says she’s living a fulfilling life. “Bipolar disorder may be an obstacle you have to live with, but it does not need to define where you will go and who you want to be,” she assures.

The post 11 Things People With Bipolar Disorder Want You to Know appeared first on Wondermind.

Q&A Link Copied 04.26.23

Camilla Luddington Gets Real About PMDD and Postpartum Anxiety

Plus, the aha moment that changed her mind about antidepressants. BySam Brodsky

When Camilla Luddington puts on scrubs, she turns into kickass Grey’s Anatomy  doctor Jo Wilson. But, in typical Grey’s  style, Dr. Wilson has been through some stuff, including childhood trauma, an abusive marriage, depression, and inpatient psychiatric treatment. Getting mental health support is actually one thing that Luddington could relate to on a personal level. The actor shared with Wondermind that she went to therapy for postpartum anxiety and she started antidepressants this past year for premenstrual dysphoric disorder (PMDD), a mood disorder considered to be a severe form of PMS.

Looking back, Luddington knows there’s no shame in finding help, but she was definitely skeptical about antidepressants up until she had an aha moment at the vet (of all places). “My dog Gus went to the doctor, and [the vet said], ‘It sounds like he has anxiety, and he can get medication for it.’ And I was like, ‘OK, great! Of course!’” Luddington explains. “And I was like, Wait a second. I’m not telling my dog to just hold off on the medication and see if he can just get through it himself. There’s something that can help him, and [I’m saying] he should take that. But I can’t do that for myself? ” Hello, reality check.

Here, the actor talks more about PMDD and postpartum anxiety, getting on mental health meds, and learning to ground herself amid worst-case-scenario spirals.

[Sign up here to never miss these candid conversations delivered straight to your inbox.]

WM: How are you doing lately?

Camilla Luddington: That’s such a great question. How am I doing lately? You know what? I just started hiatus, which means that we’re not filming this week. We won’t be filming again until maybe August, so I think I’ve gotten to breathe a little bit for the first time. But I am tired this week, and sleep is huge for my mental health. I have kiddos that are getting sick back to back, and so I feel not all there, to be honest, because of lack of sleep. I’m hoping that’s something that I’ll be able to catch up on because it’s just important for me and for everybody while we stop working.

WM: What helps you when you’re having lulls in your mental health or a bad mental health day?

CL: If I’m having a really tough mental health day, honestly, knowing that I have a therapist appointment that week is super beneficial for me because I feel like, in my mind, I can unload. At that point, I know there’s an hour just for myself to [get] all these things out, so that feels really good for me. And sometimes just stepping away from a situation even if it’s going to take the dogs for a walk. Even getting that 20 minutes just to be by myself is also really, really helpful.

WM: You’ve said previously that you started therapy after your daughter was born. How was that experience for you?

CL: The funny thing is, I don’t sound it right now, but I’m British, and it’s a very British thing to not really seek therapy. So I remember one day being on set and realizing: Wait, I think Americans go to therapy. I think everyone’s going to therapy—I was the odd man out. Maybe I should do that.

But I never felt like I needed to, and then my daughter was born. I now look back and realize I had postpartum anxiety, which I didn’t know was a thing. I knew about postpartum depression, and I knew I didn’t have that, but I had so much anxiety.

And that’s when I was like, I can’t parent from this place of anxiety all the time. It’s not going to be healthy for my kids either. I don’t want them to feel that constant anxiety from me. So I sought therapy. … My mom passed when I was younger, and when you have a kid, it can be super triggering. It can bring up constant worst-case-scenario [thinking] for you, where you feel like, Oh, I will die young because that’s what happened to me. That’s what I knew. That was my reality. It was super intense, and I had never felt that way before. And so I was like, OK, I need to do this for myself. I need to gift this to myself, gift this to my family, and go seek therapy.

WM: What did your therapist teach you about combatting that worst-case-scenario thinking?

CL: She talked about separating my legacy from my mom’s. My mom passed from a medical procedure that went wrong. She had surgery, and she ended up getting necrotizing fasciitis, a flesh-eating bacteria, and she passed very quickly. So it was a complete anomaly. Very, very strange.

Something I felt was [that I’d] inherit passing young. My mom was 43, and so one thing [my therapist] made me do is she made me go back through my lineage, and [she’d] be like, “Well, how long did your grandma live till? How long did this grandma live till?” She made me look at my whole family tree. Is everyone passing early? No, that’s not true. That’s not actually my lineage. And so it was just helpful to separate myself from that, and, also, she tells me all the time, “That’s a story you’re telling yourself.”

I mean, I’m a storyteller, I’m an actor, so it’s been really hard to be like, OK, that’s a story. That’s not really real. That’s not what’s happening right now. That’s a story I’m telling myself.  So that’s two things: What am I really inheriting, and what is my story?

WM: Is there anything else you tell yourself to help you in the moment through that anxiety?

CL: My anxiety manifests, like a lot of people’s, physically too. And so I can feel myself physically getting anxious, which is a vicious circle [because] it gives me more anxiety to feel the anxiety. I feel anxiety, for example, in my feet. My feet start to tingle—that’s how I know I’m starting to get anxious. There are different parts of my body that I then start honing in on, like my heart racing.

[My therapist] tells me to find a place in my body that feels neutral, and, the funny thing is, I always think of my butt [laughs]. My butt is never racing like my heart or tingling like my feet or hands. And actually honing in on that part of my body, or any part of [my] body that is not feeling the anxiety, is something that, in the moment, can kind of cool me down. … I know it [might] sound funny to some people, but figuring out an area of my body that is not manifesting that physical anxiety really helps me.

WM: Grey’s Jo Wilson checks in to a psychiatric facility at the end of season 15 when she goes through a period of pretty bad depression. How did you mentally prepare yourself to play that out on screen?

CL: It’s really hard because, first off, we film nine months of the year, right? So when your character’s going through something like that, it’s almost like you’re going through it with them. We’re in it with them. We’re kind of in the trenches with them.

I don’t necessarily know if there was a way to prepare myself for that, but, as an actor, it really helps me to pull from my own life and trauma. Her depression started with things to do with her mom, and so that was pretty easy to pull from my own traumatic experiences and mix it with hers and sit with it.

But I love that journey because—and I hope that people feel this way—I feel like we did a pretty good job of showing how depression can definitely sit with you and what it looks like to do the work to come out of that. Because it takes work. It does.

WM: That makes me think back to the episode where they show Jo throwing things at the wall with her therapist to get her anger out.

CL: Yes, that reminds me of something that we talk about in [my own] therapy. There are times, if I have anxiety, my therapist tells me to push against the wall. I think it’s about getting that energy out, like pulling it up and out. And I feel like every time Jo threw, she was able to take some of that pain and bring it up and out of her own body. It wasn’t just like, I’m mad so I’m going to throw something. It was a way of directing some of that energy against the wall. I really loved that scene.

WM: Given that you’ve been through your own mental health journey and you’re on a show that brings up a lot of different mental health topics, what do you want your two kids to know about it all?

CL: I don’t think it’s because my parents were trying to keep it a secret, but mental health just wasn’t really talked about. I think it’s really important for [my kids] to know to not be ashamed of seeking help or taking medication…any of those things that can reset your mental health.

That’s why I like talking about this because I feel like there’s still a stigma, and I just want to be able to be open and [want them to] understand: Hey, mom has anxiety. I had PMDD after my son was born, which I had never experienced before and didn’t know could happen. I want them to know that it doesn’t [show] weakness to seek help.

WM: Can you walk me through your experience with PMDD?

CL: I never really had PMS growing up. … I hadn’t suffered from depression before [either], so I didn’t really understand what was going on. I just felt like there were times when, for a few days, I was just sad. Just depressed. My son was born during Covid in August 2020, so I kind of chalked it up to: This is hard; this year’s hard. There are a lot of sad things happening in the world, and I’m just having one of those days.

But then it became pretty consistent. … I realized after a while, Oh, it’s coinciding with my period starting—the days before. So when I went to go see my [doctor], I said, “I’m kind of noticing this happening every month.” I described my symptoms, and she said, “Well, that’s PMDD.” And I had never even heard of that before. 

Eventually I was like, You know what? I don’t want to experience this every month. And so I went on Zoloft for the first time this year [after meeting with a psychiatrist my new therapist recommended], which I think is important to talk about because I feel like there’s still a stigma about medication. I was nervous about going on it because I was like, I’m an actress. Can I still be in touch with my feelings? Will I be able to cry on camera? Will I feel different? Will I seem out of it?  [But] honestly, it has been super amazing for me, and this is the first time I’m talking about it. It definitely took away my PMDD, so I don’t have that dip every month. But then, also, it just helped any general anxiety I have. I feel like I’m a lot less anxious.

I did not want to go on medication. [It was] a last resort for me to ever do that. [But] I was just tired. I was tired of having that dip every month, and I thought, Why am I depriving myself of something that could really help me? … [Now,] I can still do my job, but I don’t have that depression I was experiencing every month, and that’s incredible to me.

WM: What do you want younger Camilla to know about where you’re at now with your mental health?

CL: I wish I had known that postpartum anxiety existed. I did not know that. I also just wish I had known what PMDD was because I think I would’ve been a lot less confused as to what was going on. … And talking about it and seeking help is super important. … I would tell her that it gets better. “You don’t have to live with that.” That’s what I would tell her.

This interview has been edited and condensed for length and clarity.

The post Camilla Luddington Gets Real About PMDD and Postpartum Anxiety appeared first on Wondermind.

Stories Link Copied 01.31.23

8 People Share What Really Helped Them With Peripartum Depression

"Just because you feel bad doesn't mean you are bad." BySam Brodsky

If you’re going through it, peripartum depression can seem like a thing no one really warned you about, but it’s actually pretty common. About 9% of women experience depression in pregnancy—and around 7% go through a depressive episode within the first 12 months after giving birth, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). (It’s worth noting here that people of different gender identities can give birth, but these stats from the DSM-5-TR  were gathered in a way that doesn’t seem to have taken that into consideration.)

For those unfamiliar with the term, peripartum depression refers to depression that happens during or after pregnancy. You may have also heard it called postpartum depression or perinatal depression, or, more generally, referred to as part of perinatal mood and anxiety disorders (PMADs). In the DSM-5-TR, it’s listed as “major depressive disorder with peripartum onset.” The phrasing may change a bit depending on who you’re talking to, but the overall gist is the same. 

Peripartum depression can feel like you’re “paddling as hard as you can to keep your head above water. You’re just waiting and waiting and waiting for someone to throw you a life preserver and pull you out on the shore and save you,” says licensed social worker Paige Bellenbaum, LMSW, founding director and chief external relations officer at The Motherhood Center of New York. 

The exact symptoms can vary from person to person, though you may feel sad, worthless, or fatigued, and your sleeping schedule and appetite might also be off. That might sound like it’s just par for the course of being a sleep-deprived new parent, but, in the case of peripartum depression, these symptoms are debilitating and long-lasting, going far beyond what most consider to be the “baby blues.” 

In a lot of cases, there’s also an added layer of guilt since you’re in charge of this brand new human at a time that’s “supposed” to be THE best (whatever that means), says perinatal psychologist Katayune Kaeni, PsyD, PMH-C. Remember this though: “What you’re going through [does not mean anything] about who you are. It’s about being under high stress during this major life transition. Just because you feel bad doesn’t mean you are bad,” Dr. Kaeni assures. 

Many people’s peripartum depression symptoms begin during pregnancy or within the first four weeks following delivery, according to the DSM-5-TR,  but they can start up anytime within the first year of giving birth, and, if left untreated, may last for years, says Dr. Kaeni. Other types of PMADs can happen alongside depression, whether that’s OCD, an anxiety disorder, or postpartum psychosis, Dr. Kaeni explains. (And just so you know, partners of people who’ve given birth can experience postpartum depression too, says Dr. Kaeni.)

The recovery process may be slow, but treatments like therapy and antidepressants, along with support from your loved ones and those who’ve been there, can help. “When you’re on the road to recovery, it’s never a straight line to the finish line. But there comes a time where you look back and say, ‘I’m past it,’” Bellenbaum says. She knows because she’s been through it—and so has Dr. Kaeni. Ahead, you’ll hear from both of these mental health pros and other parents about what helped them navigate this type of depression. 

Heads up: There’s some discussion around suicidal ideation below.

1. Therapy and meds.

“When my daughter was about 12 months, I started feeling it. There was so much excitement and new changes with her that I relished in. Then, there was a shift—whether gradual or overnight I couldn’t say—where I would look at her do something cute and know I should smile or photograph this and be excited, but I just couldn’t. Then guilt and shame would set in because all I wanted was to be a mom and now it seemed like I didn’t like it.  

Luckily, my general practitioner listened to me when I broke down in his office. He gave me a prescription for antidepressants and encouraged me to go back to counseling. The medication gave me a boost and the counseling helped change my perspective. I was doing a lot of circular thinking by comparing myself to other moms (including celebrities) and feeling like a failure. Counseling helped me practice gratitude for what I had, celebrate what I was doing, and not do the comparison thing. I could feel myself reconnecting with some of the simple moments. I found my rhythm and balance of life. I no longer felt like an outsider to our family.” —Amanda T., 45

2. Faking it till I made it.

“After my first pregnancy, I had suicidal thoughts and was going through severe anxiety and depression, but I didn’t realize what was going on. When I expected my second child, I prepared with regular therapy sessions. I thought I avoided postpartum depression until I hit rock bottom when my baby was 5 months old.

What has helped me is dialectical behavior therapy—specifically a skill I learned from it, called opposite action, where you do the opposite of what your emotions urge you to do. For example, I was terrified of traveling because it felt like a mountain of things could go wrong and hurt my kids. I checked the facts, made a safety plan with my husband, and traveled. At first I didn’t enjoy it. I was stressed, tired, and numb. But after a few trips, I started feeling joy again. 

The exposure is the key. If I fear something, I check the facts about it. If my fear is not justified, then I do the opposite. It’s like faking it until you make it.” —Anonymous

3. Doing things I liked.

“I experienced depression both during and after my pregnancy. During my pregnancy, feelings crept up on me. I would experience heavy thoughts one day, a normal day or so would pass, and then I would feel a desire for extreme isolation away from everyone. In mentioning these thoughts and feelings to my therapist and doctor, they advised that this was clinically diagnosable as depression. 

After birth, the depression hit me like a train. My sleep was impacted; my mood was impacted; and the ability to feel like a present mother, friend, sister, and employee all became a struggle. So did attending social events and simple tasks such as getting dressed or brushing my hair.

Aside from prescribed medication, fresh air, and alone time, participating in activities that I enjoyed before pregnancy, such as watching gymnastics and coaching when physically able, helped. I returned to coaching a few months after giving birth, and it did help my mood significantly. Being active and outside of the house made a world of difference when I had the strength, because it gave me an opportunity to do something I love and be around people.” —Indira, P., 27

4. Reaching out for help.

“My symptoms started during pregnancy, but it wasn’t until about six weeks postpartum where I really crashed. I became increasingly anxious and convinced that something terrible was going to happen to my son. At the apogee of that anxiety, I also became incredibly depressed. I stopped taking care of myself. I wasn’t able to sleep at all. I stopped eating. I felt hopeless. I felt helpless. I felt like I’d made a huge mistake. I felt like I didn’t like my baby and I didn’t want him. I wanted to run away somewhere and never come back. I had nothing to look forward to. I was convinced that this is what my life was going to look like forever.

The critical point for me was when I was pushing my son in a stroller one day. I hadn’t been outside in a long, long time. As I was approaching the corner, I just felt like I was surrounded by this gray, depressing fog. I saw this bus starting to pass in front of me, and every part of my body wanted to just end my life. I remember looking at the reflection of myself in the glass and not recognizing who I saw. That’s when I made the decision to get the help I needed.

I had been in therapy, but I found a therapist who specialized in perinatal mood and anxiety disorders. I had been on an antidepressant prior, and I went back on one. As with any medication, I started to feel better slowly. At one point, I went to a support group for women experiencing postpartum depression, which I thought to be incredibly empowering and validating and normalizing—to realize I wasn’t alone.” —Paige Bellenbaum, LMSW, 49

5. Leaning into self-compassion.

“The thing that was the scariest for me about experiencing postpartum depression with my first child was that it didn’t show up like ‘normal’ depression. I didn’t notice that the intrusive thoughts had taken a permanent residence in my brain. I thought crying all day and berating myself for not being a better mom was just a normal part of being a new parent. I think this was compounded by the messages I was receiving in American culture about how this should be the best time in my life.

The biggest lesson during my first round of PMAD was that I needed to be kinder to myself. Motherhood is an ancient practice that takes time and tenderness to learn. I expected to master sleep schedules and keep my career going while raising a baby full time. When those things didn’t happen as planned, it felt like my life and my identity in the world was crashing all around me. But, in reality, I was building a new life. I was learning new priorities, new routines, and how to live with a brand new person in the world. 

The second time, I had to learn to cope with anxiety and panic attacks as well as my depressive episodes. One practice that’s helped me is to talk to my anxiety and tell her that everything is OK and ‘I got this.’ Once I allow her the space to feel safe, I feel more grounded and able to move through the panic attack quickly or avoid it altogether.” —Erin B., 35

6. Getting support.

“I experienced depression and anxiety following the birth of both of my girls, and, as I look back, there’s an incredible amount I didn’t know. The most heartbreaking thing was that I didn’t think anything was wrong and I definitely didn’t feel comfortable speaking up about it. That truly almost cost me absolutely everything when I went through postpartum psychosis and spent two weeks in a psychiatric unit. I went completely outside of reality and, at times, didn’t recognize my husband. 

Essentially, being forced to get help enabled me to understand how important self-care, being honest, and asking for (and accepting) help was. Having a support system and people to help you is absolutely imperative. 

My husband had to work during my episode and immediately became the full-time caregiver to our two kids (age 2 and 5 months at the time) and to me. Our families would alternate weeks to come help, and I wouldn’t have made it without everyone’s support.” —Kristina D., 37

7. Approaching the day in bite-sized bits.

“I developed my postpartum depression nine months after I gave birth to my daughter. I chalked my symptoms up to life stressors. But once those events passed, I was left feeling so alone and sad.

Every morning was grueling. I knew I needed to get up to take care of my baby and myself, but my body was fighting my mind. It felt like every little task and chore was so overwhelming. It was exhausting knowing everything I needed to do to provide for my little one but feeling so sad and wanting to cry. It was also incredibly hard to ask for help—from anyone. I opened up to my husband a little bit, but he had his plate full too and he was already so incredible in helping me whenever he could. I felt guilty adding anything more. Secretly, I was screaming for help in my head and wishing anyone would offer any ounce of help at all.

I really took some time at the start of the day to mentally prepare. That meant waking up an hour earlier than I normally would to allow myself to lay there, watch a show, and hype myself up. Another small thing I did was break down my day into 10-minute increments. I wouldn’t think about all the things I needed to do that day all at once. I would say to myself, ‘In the next 10 minutes, all you need to do is change her diaper.’ It helped in the long run.” —Joy K., 27

8. Challenging my thoughts.

“It took me about a year to realize what was going on because, as a therapist, there was this additional layer of pressure that I should have been able to figure this out. There’s also a little bit of denial. I did not want to be depressed. So, for me, the light bulb came on when I decided to just honestly sit down and fill out a depression screening myself so that I could objectively see: OK, yeah, you are actually dealing with something. Seeing that objectively on that piece of paper really made me see that I needed help.

So I went back to therapy. They were helpful, but it wasn’t a great fit, so I decided to use the skills that I know—and help people learn—to change my thought process. 

I had a colleague that used a catchphrase to describe this process: ‘Catch it, check it, change it.’ The first part is essentially building an awareness of your own thought process and trying to catch your negative self-judgmental thoughts. Checking it is: Is that really a true statement? Is it a true thought or feeling about something that’s happening? And then changing it is offering yourself an alternative. So let’s say I’m feeling like I’m a bad mom, and I catch myself saying that to myself. I check it: Am I really a bad mom? What are the things I’m doing to help my child?  Then, change it to something that’s either neutral or positive like, I’m doing my best right now. Or even a positive one would be, I am a good mom.” —Katayune Kaeni, PsyD, PMH-C, 44

These quotes have been edited and condensed for length and clarity.

The post 8 People Share What Really Helped Them With Peripartum Depression appeared first on Wondermind.

Explainer Link Copied 01.26.23

What Actually Causes Bipolar Disorder?

Get ready for a lot of gray area. BySam Brodsky

When you find out that you have bipolar disorder—or any mental health condition, for that matter—it’s not unreasonable to wonder, Why is this happening to me?  A diagnosis from a professional is cool and all, but if you don’t understand why  you are the way you are, the symptoms of a mental illness might seem even harder to deal with. So, what causes bipolar disorder anyway?

Let’s start with what we do know: Bipolar disorder is characterized by significant shifts in energy and mood that can interfere with your life. There are a few different types of bipolar disorder that you can be diagnosed with, depending on your symptoms. A bipolar I diagnosis means you’ve experienced mania (an elevated, restless, and oftentimes impulsive mood state) and usually features depressive episodes too. A bipolar II diagnosis means you’ve experienced both depressive episodes and hypomania (a milder form of mania). There’s also cyclothymia, which happens when people have ongoing hypomanic and depressive symptoms that never quite reach bipolar II level.

We know you want a clear-cut answer here, but experts say there’s no one cause of bipolar disorder. Instead, research suggests that multiple factors—like your genes and things in your upbringing—can come together to cause it. Plus, the equation for what actually causes bipolar disorder in one person isn’t going to be identical to someone else’s, says Sarah Sperry, PhD, assistant professor of psychiatry at the University of Michigan and an associate director in the university’s Heinz C. Prechter Bipolar Research Program.

Basically, researchers know bipolar disorder can be passed down in families, is correlated with certain childhood environments, and could be caused by something happening in people’s brains, but they’re still narrowing down exactly how  those things can come together to produce this mental health condition, explains Po Wang, MD, Stanford University clinical professor of psychiatry and former director of the university’s Bipolar Disorders Clinic. 

So answers aren’t 100% set in stone (because…science!), but continuing to dive into these theories will help mental health professionals fine-tune treatment for people like you or your loved ones who have bipolar disorder. Very cool and very necessary!

Ahead, you’ll find some risk factors that can up your chances of developing bipolar disorder. Though you won’t be able to say for certain why you or someone you know has bipolar disorder, it’s helpful to understand what parts might play a role. 

Family history

Though genes alone won’t determine if you have bipolar disorder, this mental health condition often runs in families, according to the National Institute of Mental Health (NIMH). It might seem like common sense, but you share more genes with your immediate fam members, so the handy dandy genetic coding that puts you more at risk for bipolar disorder is often passed down through those people (think: parents), Dr. Wang says.

For example, if your mom or dad has bipolar disorder, you have a 5-10% risk of being diagnosed with it, whereas the risk for the general population is about 1%, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). No one knows the exact genes that dictate your bipolar risk, but we do know that there are hundreds of genes that can come together to cause that risk, Dr. Sperry notes. 

Childhood trauma

Research suggests that experiencing trauma growing up can also add to your risk of developing bipolar disorder, particularly earlier on in life, according to the DSM-5-TR. FYI, that trauma can include things like violence and sexual trauma, but it can also look like extreme neglect where you don’t have enough food or a stable support system at home, says Dr. Sperry.  

Not to sound like a broken record, but it’s not clear why exactly childhood trauma can trigger bipolar disorder, Dr. Sperry says. One theory is that trauma may reduce the brain’s ability to adapt and change on the fly (aka its neuroplasticity), and without adequate ability to adapt to challenges, people could be more vulnerable to mental health issues, including bipolar disorder, she says.

Plus, facing childhood trauma can cause a supercharged fight or flight response when stressful life events happen in the future, Dr. Sperry adds. That stress response could lead you to cope by turning to substances (think: alcohol, cannabis, and stimulants) that might actually add more fuel to the fire, she explains. Just so you know, if you’re already at risk for developing bipolar disorder, it’s possible that substance use can set off manic symptoms for the first time, according to the DSM-5-TR.

On that note, some of the research that Dr. Sperry is working on right now has her diving into the idea that these substances further mess with your circadian rhythm, or your body’s internal clock that helps you know when to sleep, which may up your bipolar risk and can trigger mood episodes like mania, she says. It’s all ~connected~.

Neurological differences

Research suggests that brains of people with bipolar disorder work differently in some ways than those without bipolar disorder, according to the NIMH. Studies show some type of dysfunction in parts of the brain that deal with emotions like your amygdala and your anterior cingulate, Dr. Wang says. It’s unclear why or if it’s something that can outright cause bipolar disorder versus something that’s happening because of the bipolar disorder, but researchers are digging into it, he adds.  

There’s more: Just like putting gas in your car and running on fuel, the brain (specifically the mitochondria in the brain) burns through different molecules to give your body energy, Dr. Sperry explains. Research suggests that there’s something off with how the mitochondria produce energy in people who have bipolar disorder, she says. During a manic episode, people seem super energized and restless, so some experts believe this reflects that the brain is producing too much energy, and the opposite goes for when you’re depressed, she explains.

The bottom line: A number of things can come together to cause a person’s bipolar disorder, and research is ongoing (because, again, science!). The great news is that bipolar disorder is treatable regardless of the type, and you can read more about that here. The Depression and Bipolar Support Alliance also has info on risk factors and where to find support, if you’re interested. 

The post What Actually Causes Bipolar Disorder? appeared first on Wondermind.