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.

Stories Link Copied 05.16.23

7 People on What Psychosis Actually Feels Like

“Most of the time it feels like a glitch in the matrix.” BySam Brodsky

When psychosis comes up in conversation, it usually starts with something like, “Did you hear about that terrible thing in the news?” and is followed by, “Man, mental health is such a problem in this country.” While, yeah, the latter is sort of true, research shows that people with a psychosis-related disorder are actually more likely to be a victim of a crime than a perpetrator. The reality is that most people who experience psychosis symptoms won’t  be featured in dramatic headlines or national tragedies. 

That said, psychosis can be a very intense and sometimes scary experience. But it’s one that plenty of people recover from with the help of mental health pros and the right meds. Actually, Selena Gomez (Wondermind’s co-founder and Chief Impact Officer) talked about previously having a psychotic episode in the documentary My Mind & Me. 

But even though it’s more common than you’d think—as many as 100 people out of every 100,000 develop psychosis each year, according to the National Institute of Mental Health (NIMH)—the general public’s lack of knowledge about psychosis adds to the stigma, says licensed psychologist Eve Lewandowski, PhD, who works with patients who have psychotic disorders at McLean Hospital and Harvard Medical School. 

So, ICYMI, psychosis can be a symptom of mental health disorders like schizophrenia, schizoaffective disorder, bipolar disorder (in manic or depressive episodes), and even PTSD, explains Dr. Lewandowski. Also, psychosis can sometimes happen shortly after people give birth in what’s known as “postpartum psychosis,” according to the American Psychological Association. It can be a condition in itself or occur due to an underlying mental health condition that started before, during, or after pregnancy.

Psychosis may also happen to people without mental health conditions who are sleep deprived, according to the NIMH. Same goes for some who take medications like stimulants or antidepressants and for those who misuse or withdraw from alcohol or certain substances, notes Dr. Lewandowski.

When psychosis happens, it’s common to see or hear stuff that isn’t there (hallucinations) and/or believe things that aren’t based in reality (delusions), Dr. Lewandowski says. For example, you might think people on TV are trying to warn you that everyone is out to get you. It’s important to take culture, religion, and personal experience into account too, says licensed clinical psychologist Jenny Wang, PhD. So, if you don’t normally hear God speak to you, and you suddenly do, something could be off. 

You could also talk in a way that’s hard to understand or jump from one topic to another, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). Plus, those who develop psychosis might isolate themselves, lose interest in things they’re usually game for, or act unusually, Dr. Lewandowski adds. 

Psychosis symptoms can last for days, weeks, or even up to a year, especially if they go untreated, says Dr. Lewandowski. But whether or not psychosis is a one-time thing or comes and goes, people can recover from it. With treatment like meds (antipsychotics, for instance), therapy, and outside support, they can “live rich, full lives,” says Dr. Lewandowski. 

“Though people like me have experienced really intense mental states, we’re just people too,” says Esmé Weijun Wang, author of The Collected Schizophrenias, who’s dealt with psychosis. “It’s not something to be afraid of. It’s not something to feel like is so alien that we’re beyond human or beyond saving,” she adds.

Here, we asked people who’ve been there to share their experiences with psychosis so you can feel less alone or just get a better idea of how they’ve learned to deal. 

1. I felt disconnected from the earth.

“Being in psychosis is very overwhelming for me. [As someone with schizoaffective disorder, bipolar type,] I think I’ve experienced it maybe three to four times within the last several years. And usually when I have an episode, it starts with bizarre thoughts and behaviors. I feel this intense state of fear and feelings of paranoia, like an existential threat or some kind of crisis. Sometimes I lose grip on reality and, most of the time, it feels like a glitch in the matrix, like a disturbance in my mind. So these thoughts make me feel disconnected with reality, ungrounded, and untethered from the earth.

It usually lasts a few days, and, in a worst-case scenario, I end up going to the hospital. But I’ve been grounded for a few years now.” —Sarah A., 34

2. I felt weird in my body.

“Over time, my psychosis [which is related to schizophrenia] has most definitely changed. It started with being extremely, extremely difficult. It literally felt like I was falling into a pit of despair all the time. I had a lot of fear, anxiety, all that kind of stuff. A lot of sleepless nights, paranoia, the feeling of wanting to jump out of my skin. I couldn’t stand being in my tangible body because of how bad it all felt and how much was going through my mind.

[When my psychosis was most extreme,] some of the feelings and thoughts were very, very religious. I believed that I was Jesus Christ and that we were trying to narrow down who the ‘true Jesus’ was. When I was really ill years ago, I had auditory hallucinations, visual hallucinations, and delusions. I couldn’t even focus on anything. There was no ability for me to be living a typical life. I’d just walk down the street, yelling at people, thinking that cars were alive and they were trying to kill me.

I’ve been taking my antipsychotic for six years and an antidepressant for a while too. I don’t feel that anxiety. I don’t feel the extreme paranoia that I used to, where I thought people were trying to kill me. I just have moderate thoughts that are kind of paranoid.

If I’m really stressed out, it’ll come back a little bit like that, but it won’t reach the point where I lose the ability to recognize: OK, this isn’t real. Nothing’s perfect, right? But you can get to a spot where you do feel like you’re living a life that’s fulfilling.” —Celia F., 35

3. It was like a bad dream.

“My first hallucinogenic episode happened after I relapsed from alcohol addiction in March 2017.  Up until that point, I’d been drinking for about seven years. In that time, I’d gone from drinking one to three glasses of wine per night to two to three bottles a night or sometimes more.

When I stopped drinking abruptly or cut back from what I was drinking too quickly, I would begin to get severe alcohol withdrawal symptoms known as delirium tremens (DTs). This began with the shakes, fever, and nausea usually between 24 and 36 hours after the last drink. After 48 hours, my withdrawals would progress, and I began to hallucinate. It was like I was dreaming while I was awake.

During these episodes, my senses were heightened and everything I saw, heard, and felt was distorted. Typically, I’d see wasps, bats, spiders, and crab-like creatures. They would be terrifying experiences, and I couldn’t control my body or easily snap out of these episodes.

I was eventually able to embrace my recovery in November 2019. It inspired me to write Smashed Not Wasted  about my experiences.” —Sam T., 37

4. It’s not always scary. 

“I feel like psychosis is almost just not believing anything or believing false things, like I can’t really trust what’s around me because I think everyone’s lying to me. I don’t believe anybody is telling the truth.

Getting diagnosed with schizophrenia was not a bad thing because then I could finally be treated for the correct illness. I’m on medication, which helps 95% of the time. I’m cool with that. Otherwise, this would happen all the time and I wouldn’t be able to leave my house.

I now know how to ignore the really bad voices. I know that they’re fake now, but they’ll still come in like, ‘Why did you just say that? What did you do? Why would you do that? That was stupid. That’s why those people don’t like you.’ It’s just like a big ball of self-hate smacking you in the face.

[People who haven’t experienced psychosis might] think, Oh, it’s a psychosis episode. It’s scary. It’s so frightening. No, it’s not frightening. It’s not scary. It’s not really dangerous for me. It can happen just while sitting on your futon, and you’re not going to hurt anybody.” —Michelle H., 35

5. I believed some bizarre things about my family.

“During the pandemic, in December of 2020 to April 2021, was my first major manic episode that turned into psychosis. That’s the first time, and only time, I went to a hospital, and that’s where I was first diagnosed [with bipolar I]. I didn’t have any visual hallucinations or audio hallucinations, but I was convinced my family had always been part of this international criminal organization, and all the evidence I was finding about that explained every detail of my life up to that point.

Nothing has ever felt more true than how that felt to me during that time. I thought I was finding all this evidence online of their criminal activities. I actually took screenshots of Reddit posts of people talking about situations they had been in, where people they knew were part of bad stuff, and, later, after my psychosis, I realized what they said was not what I was reading or seeing at all. 

I was building and building this narrative for close to three weeks. I was convinced that people wanted to hurt me because I was figuring this out. And when my family actually came to help me, they asked me to come out to my apartment building’s garage. It’s probably 100 feet from the apartment door. I was too scared to do it, so I asked my brother to come get me. 

[Once I got to the hospital,] the antipsychotic kicked in, so I was starting to [come back to reality] within three days, but I was still very wary of certain people in my family for maybe another month. Although I didn’t believe the full story I had created.” —Brandon C., 30

6. I wasn’t myself.

“I had undiagnosed postpartum depression and anxiety. The week leading up to my actual postpartum psychosis event—which lasted for at least three weeks—I was very much on cloud nine, thinking I was untouchable. The day that I went completely outside of reality, I woke up feeling like the weight of the world was on my shoulders, thinking that God was telling me I needed the prayers of many to tell my story. At that time, I didn’t know what story that was. I also did things that morning that were not like myself, including quitting my job. 

I spent two or three nights in the psychiatric ER, and I ended up being transferred to an inpatient unit, where I stayed for two weeks. I remember being very scared. I would call my family at least 20 times a day. I do  try to find some humor in it [because] I thought that I was on the set of Grey’s Anatomy  and that other patients were LeBron James and Bradley Cooper.

When I was discharged, I couldn’t be by myself. I couldn’t be with my kids by myself. I couldn’t work and I couldn’t drive. That went on for several weeks and I ended up going to an intensive outpatient program. I spent a year [total] recovering. I got off antipsychotics after that year, and I’m still on an antidepressant. I quickly shared my story and started a nonprofit [to advocate for postpartum psychosis awareness].” —Kristina D., 38

7. I felt like I was on a tightrope.

“The first time I experienced a hallucination, it was a voice in my ear that said, ‘I hate you,’ when I was in the shower of my dorm in college. It was so realistic, it was so real, that I could hear it directly in my ear, and I started thinking, Is this something coming from the pipes? Is there something weird going on where a sound is coming through the drain from downstairs or upstairs? 

Delusion tends to be more of what I experience these days. One that I’ve experienced, that I wrote about in my book, The Collected Schizophrenias, was believing that I was dead. Another one that I experienced a lot in my younger years was a delusion where you believe that all of your loved ones are replaced by doubles or robots.

Around 2013 or 2014, when I was diagnosed with schizoaffective disorder, I became quite hopeless, and my doctor told me I had a drug-resistant form of psychosis and schizoaffective disorder, bipolar type. But I ended up [finding meds that have worked for me, which] I’ve been taking for a number of years. Now, it’s unlikely for me to have a psychotic episode unless I’m under a lot of stress.

I feel like there was a period of time where my mind was much more fragile and I had to be aware of whether or not I was on the verge of having an episode. Now, I’ll go through maybe a few weeks where the symptoms are kind of more present—where I have the physical sensation of walking on a tightrope or just standing on a very small square foot of flooring with a very deep and dark abyss around it. For me, there’s a sense of not feeling physically stable in addition to mentally stable. But, for the most part, medication has helped me a lot.” —Esmé W., 39

Quotes have been edited and condensed for length and clarity.

The post 7 People on What Psychosis Actually Feels Like 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.

Essay Link Copied 09.16.22

Let’s Talk About Dating With Bipolar Disorder

I’ve weathered enough storms and come to understand myself and this condition so much better. ByBrielle Diskin

Dating, like any noble pursuit, is best approached with honesty and bravery. But as someone who lives with bipolar disorder, ashamed of the mechanics of my mind, sometimes I find it’s easier to avoid honesty and hide in the shadows of shame—at least for now.

ICYMI, bipolar disorder causes dramatic shifts in a person’s mood (see: mania and depression), energy, and ability to function. There are a few different types of bipolar disorders, depending on the severity of your symptoms as well as how often and how long they come up. With bipolar II, the type that I have, a person goes through patterns of hypomania (a milder form of mania) and depression. 

I was diagnosed in 2014, when I was 17, after my family and I grew concerned with how I behaved and my frequent outbursts, mood swings, racing thoughts, and recklessness. Now, at 25, after years of cycling through doctors and doses, I am finally in a comfortable place with my treatment.

On a first date, you wouldn’t know I live with bipolar disorder.

That’s because bipolar disorder is often an invisible disability even though it can also be a debilitating one. Instead, you’d just see that I have a fulfilling full-time job, financial independence, and an active social life. I work out, eat well, and I even have a morning routine that involves yoga, journaling, and ~hot lemon water.~ It’s annoyingly That Girl, I know. But you also wouldn’t know because, ever since my last breakup, I haven’t told anyone I’ve dated that I have bipolar disorder.

Before then, I proudly wore my diagnosis on my sleeve. To me, it felt like a personality trait that made me unique. In sharing, I felt like I was breaking down stereotypes and defying the stigma-riddled feeling that it was some shameful secret. But after a series of relationships where my condition was often used to dismiss my feelings and oversexualize me, it became clear just how damaging the stigma around bipolar disorder still is. 

When I fall in love, or merely develop a crush, I melt into that person.

I give them everything and save little for myself. Turns out, some aspects of falling in love could actually trigger mania for some people with bipolar disorder, says David Miklowitz, PhD, a professor of psychiatry at the University of California, Los Angeles. That can mostly be chalked up to changes in your routine that can be both delightful and disruptive.

I’m sure most people can relate to this on some level—when you’re in that fun and exciting stage of a new relationship, your routines get thrown out the window in favor of impromptu dates and late-night phone calls. But for people with bipolar disorder, routines and regularity can be pretty crucial to managing the condition, explains Dr. Miklowitz. That’s especially true for your sleep schedules since sleep disturbances can worsen symptoms of bipolar disorder for some people. For me, the start of a relationship can bring on overthinking and under-sleeping, both of which make it harder for me to balance my moods.

From personal experience, I can confirm that relationships of all kinds can affect—and be affected by—a mental health condition like bipolar disorder. So, maybe it’s not surprising that my last serious relationship was a disaster. I ended up disclosing my diagnosis the first time we spoke. Taken over by the whole I’m-not-like-other-girls thing and thinking he’d decide I was some sexy enigma, it just slipped out. As soon as I heard myself say it, I felt like I probably should have given that disclosure more thought. I figured it was something people don’t casually come out with, but I was still following that defiant feeling that makes me feel powerful. Immediately, he revealed his own mental health struggles, and it gave me a sense of relief. I thought, Wow, here’s someone who could understand.

Dating someone with bipolar disorder means being there for both manic and depressive episodes.

Shortly after we made our relationship official, things started getting serious. Falling in love triggered a new hypomanic state for me, which, at first, he seemed to love. (My exes all have.) It’s exciting and euphoric to be with someone who is so elated about life, ready for spontaneous day trips, to party every weekend, to cook restaurant-level five-course dinners, and spend hours sharing my thoughts on everything from French new wave films to Beyoncé lyrics. He called me the most positive, bright person he’d ever met and expressed his gratitude for the burst of light I’d been for him. 

Then there were the physical aspects of our relationship. While it was never explicitly said, I felt like sharing my bipolar diagnosis enabled a narrative he created about me. One of an energetic, manic, “mysterious” type of girl. (It’s a stereotype I’ve heard before. I even once had a therapist  tell me that bipolar women were the sexiest.) 

This recurring narrative made me feel like an object. Then the relationship got dark, and I got quiet. When I tried to share what I was going through or when my sex drive left during those unavoidable depression periods, he seemed angry, disappointed, and made me feel like I was betraying that initial “down for whatever” persona he first fell in love with. No matter what, it always felt like my diagnosis was being used against me and was to blame for everything that went wrong. Now I realize that whether or not you live with a mental health condition, a partner should accept all of you, even the “less fun” parts, and listen when you confide in them.

The manic and depressive states can make it hard for people like me to feel grounded and trust their own emotions in an intimate relationship, says therapist Melanie Shapiro, LCSW. And this tracks. There was a time, particularly in that   relationship, where I thought being attached to someone would solve all my problems. I thought relationships made you whole and meant you were happy. But this thinking diluted my gut feeling that things weren’t going well, and I wasn’t comfortable with speaking up when I did have an urge to. Part of that came from being scared to be alone, afraid of how being single would force me to be alone with myself and deal with a mental illness that I still didn’t understand.

And then there’s the worst fear people have disclosing a diagnosis: that we’ll be labeled “crazy.” Yeah, that happened too. I trembled with shame and embarrassment, and it reinforced the feeling that I’d always be judged because of this condition. From then on, I decided to stop telling casual dates and acquaintances about my diagnosis until I felt absolutely sure I could trust them.

Today, I’m trying to feel OK with telling new potential partners.

But I know that I need some security before I do. “For people who struggle with mental illness, it’s always better to share when you feel comfortable and ready,” says Shapiro. Still, I know that if I wait too long, a partner could find out about my diagnosis before I’m ready if they spot my medication or inevitably witness me having an episode, lying on the bathroom floor with the lights off for hours, ghosting them for days at a time, or talking obsessively and overthinking.

Of course, there’s no one-size-fits-all answer to how disclosure conversations should go, Dr. Miklowtiz says. That would be too easy, right? But I’ve recently found power in starting to disclose my diagnosis to new friends again. At first, it was terrifying. I worried that no one would look at me the same ever again. Sometimes I get the “Oh, that makes sense” response. That used to tick me off, but now I find a certain satisfaction and freedom in people knowing where my head is at. I do exhibit bipolar symptoms, and it feels better when loved ones know why. It also opens the door for sharing what I’m going through and building a larger support system. 

The idea of opening up again is scary. And I won’t lie: It has held me back and made me reluctant to date. But I’m a romantic who doesn’t want to live my life in the shadows, afraid. I’m ready to step out and be brave with the knowledge that some people might not be worthy. Not everyone will be open-minded, but I feel more prepared now to deal with whatever reaction I get. I’ve weathered enough storms and come to understand myself and this condition so much better. In fact, I’m starting to feel like disclosing doesn’t scare me as much as giving into the stigma does. 

The post Let’s Talk About Dating With Bipolar Disorder appeared first on Wondermind.

Explainer Link Copied 09.16.22

What’s the Difference Between Mania and Hypomania?

The same—but different! BySam Brodsky

Chances are you’ve heard of mania, a mood state that can make people feel next-level energized or pretty damn irritable. Whether you have bipolar disorder or randomly heard someone mention a “hypomanic episode” in passing, you might be curious about what that means exactly—and how it’s different from straight up mania.

But first, here’s what they have in common: Both mania and hypomania are episodes of elevated or irritable mood where people could have racing thoughts, be super talkative, avoid sleeping, feel restless, and have inflated self-esteem, according to the American Psychological Association (APA). They’re also both symptoms of bipolar disorder and other mental health conditions. 

People going through a manic or hypomanic episode may feel uber productive and do impulsive or overly ambitious things, like staying up all night to repaint their bedroom, says Kirsten Bolton, LICSW, a clinical social worker for McLean Hospital. Plus, they might take some serious risks, like randomly spending a ton of money they definitely can’t afford to.

All that said, there are some BIG differences between the two symptoms. Here’s what makes mania and hypomania different, who’s at risk for those symptoms, how they’re treated, and more.

How to tell the difference between hypomania and mania

TL;DR: Hypomania is usually milder than mania, according to the APA. That’s partly because untreated hypomanic episodes are typically shorter than untreated manic episodes, explains Po Wang, MD, Stanford University clinical professor of psychiatry and former director of the university’s Bipolar Disorders Clinic. A hypomanic episode lasts at least four days and a manic one lasts at least a week, per the Diagnostic And Statistical Manual Of Mental Disorders (DSM-5-TR). 

On top of that, a hypomanic episode isn’t severe enough to majorly interfere with a person’s social or work life or land them in the emergency room like a severe manic episode can, according to the DSM-5-TR.

Unlike hypomania, severe manic episodes can cause some people to experience psychosis, where they lose touch with reality in the form of hallucinations or delusions. The latter could manifest as grandiose delusions, Bolton explains, like thinking they can win the Grammys even though they can’t hold a tune (sorry). Outside of this, they might make strong connections between themself and the universe, like seeing a Vermont license plate and interpreting that as a message that they should drop everything and drive there ASAP. 

Who actually experiences hypomanic and manic episodes

There are three main types of bipolar disorder, and knowing whether you’ve experienced mania or hypomania (or both) can help experts point you to the right diagnosis. Mania is a key feature in a bipolar I disorder diagnosis (though you can still experience hypomanic episodes in bipolar I), whereas hypomania is a feature of bipolar II disorder. (FWIW, even though hypomania is a less severe form of mania, bipolar II is not a less severe form of bipolar disorder, according to the DSM-5-TR.) 

People with schizoaffective disorder can also experience a hypomanic or manic episode, explains Dr. Wang. It’s worth mentioning, too, that substances like cannabis, cocaine, steroids, and methamphetamines can sometimes trigger mania and hypomania in the general population as well as in those diagnosed with or predisposed to conditions like bipolar disorder, explains Dr. Wang.

What’s more, medical conditions that impact the part of the brain that regulates emotions and impulses may also cause hypomanic or manic symptoms, says director of Yale School of Medicine’s Mood Disorders Research Program Hilary Blumberg, MD, professor of psychiatry and psychiatric neuroscience. These can include multiple sclerosis, brain trauma, stroke, and more, according to the DSM-5-TR.

How hypomania and mania are treated

The best thing to do during a manic or hypomanic episode is to seek out support from a mental health professional. They can get to the root of the issue and prescribe the right treatment or medication, like mood stabilizers or antipsychotics. That said, if you or someone you’re looking out for has stopped eating or drinking or are getting into dangerous situations during a manic episode, it could be worth seeking help at a hospital or treatment center right away, says Bolton. 

Meds and therapy aside, Dr. Blumberg and her team at Yale are studying how regulating sleep and daily routines can help mitigate symptoms of bipolar disorder, like mania and hypomania. Dr. Blumberg says this can be an effective treatment option in addition to others like meds and psychotherapy. So, with that in mind, it could be helpful to encourage people dealing with this symptom to get more sleep and/or narrow down all the projects they want to take on, says Dr. Wang.

FYI, after mania plays out, people may have regrets about their behavior, and it’s common to have “varying degrees of lethargy and depressed mood,” says Bolton. That makes sense considering studies suggest 60% of manic episodes happen right before a major depressive one, according to the DSM-5-TR. Same goes for hypomania: Depression almost always follows a hypomanic episode, Dr. Wang says. But, by managing hypomanic or manic episodes with a solid support system and potentially some medication, it’s possible to minimize the impact of those low periods, says Dr. Wang.

The post What’s the Difference Between Mania and Hypomania? appeared first on Wondermind.