The Swinging Pendulum of Bipolar Disorder

Bipolar Disorder | Cluff CounselingWhat do Sinead O’Conner, Demi Lovato, Catherine Zeta-Jones, and the late Carrie Fisher all have in common?  They are some of the 5.7 million American adults who suffer from bipolar disorder.  This is not a rare condition; 2.6% of our population experiences the markedly different mood swings that characterize this disorder–the prolonged state of depression coupled with feelings of intense euphoria.

A few months ago I wrote about decreasing the stigma of mental illness. While we are growing increasingly aware of the implications of bipolar disorder, there is still a stigma attached to this mental illness that I hope to alleviate. Bipolar disorder is identified by intense mood swings–and not the type we experience on a day-to-day basis. You and I can go from feeling absolutely defeated after failing a test to completely elated after winning the lottery all in the same evening. Or, on a less intense scale, we can feel discouragement after an argument with a loved one, and shortly thereafter feel calm and content once we reconcile. Such mood swings come with life and should not alarm us. The mood swings I am referring to are high levels of positivity followed by striking levels of negativity and depression that last for a time.

I recently got lunch with a dear friend that I had not seen for awhile. During our hour together, she explained why she had fallen off the map–she had been diagnosed with bipolar disorder. At first I was surprised…I never would have expected her to be bipolar! However, as I listened to her talk about the past several months of her life, I realized she was a textbook example of bipolar disorder and I had been completely blind to it. My post in May hit close to home for many of you; nearly all of us know someone who is affected by the intense sadness and defeating thoughts of self-deprecation that come with depression. But how many of us overlook the possibility of our loved ones having bipolar because we simply peg them (or let them peg themselves) as “having depression”? My intent of this post is to increase awareness so we can recognize when we ourselves–or our loved ones–suffer from more than depression and need the assistance of a mental health professional.

My friend told me about how she had started a massive social media campaign to help the youth of her church, signed up to sell beauty products, and became a decent boxer all in the month of February. Then came March and she completely erased all of the material she poured thousands of hours into for her social media campaign, literally threw all of her beauty products in a dumpster, quit boxing altogether, and promptly gained 25 pounds. My friend’s experience reflects the common symptoms of bipolar disorder–alternating periods of elation and depression. The highs for those with bipolar disorder are HIGH, and the lows are extremely low.  Individuals who have bipolar will experience heightened euphoria and happiness, followed by drastic depression and guilt. According to the National Institute of Mental Health, these distinct periods are called “mood episodes.” Mood episodes come with extreme changes in energy, activity, and sleep that are drastically different from the typical moods and behaviors of the affected individual. The low period is called the depressive mood; the high period is called the manic mood; and the in-between or buffer stage is called “hypomania” (mild manic episodes which do not significantly interfere with the patient’s everyday responsibilities and behavior). The following are symptoms associated each mood-type:

Depressive mood:

  • Feeling sad, tearful, hopeless, or empty for the majority of the day on a daily basis
  • Loss of interest in all aspects of life
  • No pleasure or interest in day to day activities
  • Loss of appetite
  • Fatigue/mental sluggishness
  • Chronic pain with no known cause (and curiously anti-depressants seem to help  the most)
  • Weight fluctuations – including significant weight loss or weight gain
  • Sleep disturbances – sleeping too much or other sleep problems, such as insomnia
  • Restlessness or slowed behaviors
  • Feelings of guilt and worthlessness
  • Inability to concentrate
  • Indecisiveness
  • Fatigue/loss of energy
  • Psychosis – being detached from reality; delusions or hallucinations
  • Loss of interest in activities you once enjoyed
  • Anxiety
  • Uncontrollable crying
  • Suicidal thoughts, planning, or attempts

Manic mood:

  • Long period of feeling “high” – an overly elated, happy, and outgoing mood
  • Euphoria
  • Rapid speech (as well as jumping from one thought to another when talking)
  • Racing thoughts
  • Inability to focus
  • Increased physical activity
  • Careless use of drugs/alcohol
  • Decreased need for sleep (often mischaracterized as insomnia)
  • Being easily distracted
  • Taking on a lot of new projects
  • Restlessness
  • Boundless energy
  • Sleeping very little
  • Unrealistically believing you can do something
  • Engaging in impulsive, pleasurable, and high-risk behaviors (e.g., poor financial investments, sexual indiscretions, shopping sprees)
  • Sexual promiscuity
  • Inflated self-esteem (overestimation of one’s own abilities)
  • feelings of grandiosity
  • Increased goal-directed activity
  • Detachment from reality (psychosis that may include delusions or hallucinations)

Both depressive and manic moods:

  • Mood swings
  • Feeling extremely irritable
  • Inability to keep a schedule (missing work/school)

Manic periods can last anywhere from a few days to a few months, as can their depressive counterparts. This can be extremely dangerous since bipolar disorder also commonly includes compulsiveness. A person feeling despondent to the point of suicide may suddenly attempt to take his or her own life. It is important to note that there is also Bipolar II disorder; the main difference between the two types of bipolar disorder is that a person with bipolar I has manic episodes, while someone with bipolar II has hypomanic episodes… it’s the severity of the mania that distinguishes these two types. If these symptoms present themselves in yourself or someone you care about, seek medical or professional attention immediately. Patients suffering from suicidal ideations or suicidal behavior need prompt and aggressive interventions to defuse the risk of tragic consequences.

Just like I did, you may be failing to see the pendulum of bipolar disorder swinging from the depressive stage to the manic stage in those closest to you. It is often easier to recognize when our friends or loved ones seem depressed than when they are seemingly “on fire”, or having a manic episode. If you believe you or your loved one has more than seasonal depression, please seek the needed medical attention in order to live a healthy, balanced, and safe life.

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The Cure for Loneliness

Cluff Counseling - Anxiety & Depression CounselingAmericans are lonelier than ever. According to Public Radio International, about 50.2 percent or 124.6 million American adults are single today. In the 1950s, that number was around 22 percent! What has caused this great rise in isolation?

In a recent article, featured both in Forbes and Psychology Today, author Caroline Beaton shares a compelling argument that millennials are among the loneliest in American History. She deduces that loneliness is literally contagious, and that we exacerbate the issue by our addiction to social media. It is easier for us to stay at home, glued to our phones alone in our warm beds than to be out socializing with friends, neighbors or acquaintances. These days, social connection does not require a car, a phone call, or a plan… just a click. When we feel isolated, depressed or anxious, it is convenient for us to go online in search of connection. Basically, we use the Internet to alleviate our loneliness…

But that satisfaction is temporary…fleeting, even!

So you may think that the answer is to simply use less internet in order to overcome societal loneliness. While there is definitely some truth to that, there is more to the equation. If we click out of Instagram and put our phones down, we may instead be inclined to reach for the remote and begin another mindless, solitary activity. My advice is simple but timeless, and it goes along perfectly with Caroline Beaton’s follow-up article, “The Solution to Millennial Loneliness.” The cure to loneliness is simply alter your priorities. Place relationships and connection at the top of your list.

I fully recognize that technology and social media are addictive. This is why I recommend we change our priorities and focus on those around us–to be present in the moment. Imagine what would happen if you put down your phone while your parent or partner was talking to you. Or if you actually conversed with all your friends over pizza instead of sharing a meal together while just staring at your phones. I am absolutely guilty of this myself! We need to be assertive with our time. If we are not being intentional about where our focus goes, we will ultimately end up sucked into the distractions all around us.

The solution is to prioritize relationships into your day. Do not let the Internet and social media gobble up your prime and extra time. Make the decision today to forego the next episode of Downton Abbey until a time that your significant other is not looking to connect with you. Set aside time to chat with your father before beginning your homework. Schedule a time (even weeks in advance!) to grab lunch with a friend. A valiant and consistent effort is required to make and preserve relationships…but it can be done.  Prioritize. Schedule time for the ones you love and be present when you are with them. This is the cure for loneliness. Watch out– its effects will be more far-reaching than loneliness itself!

Resources:
Cluff Counseling: “Are You Addicted to Your Phone?”
Forbes:  “The Solution to Millennial Loneliness”
PRI: “Singles now outnumber married people in America — and that’s a good thing”
Psychology Today: “The Loneliness Epidemic and What We Can Do About It”
Psychology Today: “Why Millennials are Lonely”

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The Power Behind Vulnerability

The Power Behind Vulnerability | Marriage & Family Therapy Dallas, TX

“To let ourselves be seen, deeply seen, vulnerably seen… to love with our whole hearts, even though there’s no guarantee… to practice gratitude and joy in those moments of terror, when we’re wondering, ‘Can I love you this much? Can I believe in this this passionately? Can I be this fierce about this?’ just to be able to stop and, instead of catastrophizing what might happen, to say, ‘I’m just so grateful, because to feel this vulnerable means I’m alive.’”

-Brené Brown

Vulnerability is a powerful, yet misunderstood concept. In our society, vulnerability is viewed as a weakness–something we should avoid and not learn about. When I think of vulnerable individuals, however, I do not think of downtrodden, susceptible, needy, or neglected beings. Instead, I think of my amazing clients: a husband leaning on his wife for support while he battles debilitating depression; sex-addicts relearning how to have an emotionally intimate relationship with their partners; battered women re-adjusting their paradigms to see themselves as valuable; or teens challenging peer pressure to realize their worth. I see those who are “vulnerable” as brave, open, and authentic; willing to be comfortable in their own imperfect skin and take life on as they are. It is this vulnerability that allows these individuals to have meaningful, honest relationships–both with themselves and with others. I refer to vulnerability as the “underlying, ever-present, under-current of our natural state,” as David Whyte puts it; the ability to show our raw, true selves–flaws and all. My purpose of this post is to explain how welcoming, instead of numbing, vulnerability can cure most relationship ailments.

Brené Brown did a quick poll on Twitter asking people what made them feel vulnerable; within 90 minutes, she received 150 answers of common situations we can all relate to–having to ask my husband for help because I’m sick, and we’re newly married; initiating sex with my husband; initiating sex with my wife; being turned down; asking someone out; waiting for the doctor to call back; getting laid off; laying off people. You will notice that each of those are interpersonal examples–meaning each is an instance where at least two people are interacting. This is because vulnerability is at the very core of relationships! Unfortunately, too often we become consumed by how others perceive us or how we measure up compared to those around us…so we let our automatic defense mechanism kick in: we numb our emotions. We block out painful feelings like embarrassment, grief, shame, fear, and disappointment to combat being vulnerable. The issue with doing this, however, is that there is no such thing as “selective numbing”–it is physically impossible to block out only negative emotions without blocking all emotions. Brené says, “When we numb those [hard emotions], we [also] numb joy, we numb gratitude,…we numb happiness.”

As a Marriage and Family Therapist, one of my areas of expertise is relationships; I find fulfillment in helping my clients strengthen and improve their relationships with others and with themselves. I have seen countless clients who have resorted to numbing their emotions because they do not know how to care for themselves when they experience pain. Consequently, they miss out on the full spectrum of feelings that meaningful relationships offer, including and especially positive emotions. Yes, being vulnerable opens us up to feelings of hurt, rejection and sadness, but it also means we can have more happiness and satisfaction in our relationships. Our relationships can be so much more fulfilling as we welcome our imperfections and allow ourselves to truly be seen!

How does one begin to welcome vulnerability? First, adopt the unquestionable notion that you are worthy of love. There is nothing you had to do to earn it, and thus there is nothing you can do to take that worthiness away. Second, know that you (and your friend/sister/partner/spouse) are imperfect beings, prone to mistakes, misdeeds, and miscommunication; expecting perfection is the quickest way to extinguish vulnerability. I will expand on these ideas further in upcoming blog posts.

Brené says, “Those who have a strong sense of love and belonging believe they’re worthy of love and belonging.” Believing this will give us the courage we need to be authentic (read: vulnerable) in our relationships–to be honest about who and how we are. I have seen firsthand how numbing emotion to curb vulnerability stifles relationships, whereas welcoming vulnerability makes relationships thrive and progress. If you would like to learn how to be more vulnerable in your relationships, contact me today to set up your first session.

Additional Resources:
David Whyte, “Vulnerability”
Ted Talk: Brené Brown: The power of vulnerability