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Living well with bipolar disorder
This is a reblog from the blog the bipolar writer. The post if written by Allie, and I found it very informative and inspiring.
Reading it felt even more useful after the first day on a conference I’m on, where Allen Frances, a main contribution to the DSM-IV spoke. He told us more about the American mental health care system, and how hard it can be to get adequate help. Posts like these can help those who suffer from a mental health problem.
1 in 4 Americans suffer from a mental disorder, and out of those millions of Americans, 5.7 million Americans suffer from bipolar disorder, characterized by erratic moods consisting of mania (an elated state of being) and the more familiar depressive episodes. I am one of those 5.7 million Americans.
Bipolar disorder is often considered the “artist’s disease,” from Sylvia Plath to Vincent van Gogh exemplifying the creative bursts of energy, severe depressions, and unstable highs and lows that come with the disorder. There is a range of creative treatments that safeguard mood stability, including traditional medications and therapies that are universally recommended to treat bipolar disorder. Often, mood stabilizers, antipsychotics, and psychotherapy are the first lines of defense, alongside a good support system, to prevent mania and depression. However, three simple life changes can safeguard against serious bipolar episodes and help those who suffer from bipolar disorder maintain a stable, healthy lifestyle.
Early to Bed, Early to Rise – Healthy and Wise
Sleep is perhaps the most important preventer of manic relapses and a strong source of mood stability. Bipolar disorder is directly related to insomnia. The fewer people with bipolar disorder sleep, the more likely they are to become manic. The Center for Disease Control recommends seven hours of sleep daily for adults. Having a healthy sleep routine, such as an established bed time and avoidance of caffeine after 2:00 PM can help people with bipolar disorder achieve a good night’s rest. As someone who is diagnosed with bipolar disorder and has worked for years to combat insomnia, I have found that turning off screens (from televisions, phones, computers, tablets, etc.) an hour before bedtime and having a strong sleep routine where I turn in around the same time each night works wonders. If insomnia persists, one can talk to a doctor about sleep aids available by prescription and consider using Melatonin or a Circadian rhythm stabilizer (available over-the-counter).
Healthy Body, Healthy Mind
Exercise is another great mood booster, especially during depressive episodes and to combat the side effects of bipolar medications that often cause weight gain. The NIH recommends 150 minutes of moderate exercise a week. When you are active, dopamine floods your brain and gives you feelings of happiness similar to a runner’s high. This is especially important for bipolar disorder sufferers, whose serotonin levels are often imbalanced. However, staying active can be a challenge during depressive lows. I like to hike or cycle, which leaves me feeling satisfied and helps keep the pounds off from medicine. Find an activity you enjoy, whether it is biking or running, and watch as your mood improves.
Nourishing Your Brain, Nourishing Your Soul
Finally, good nutrition is directly linked to mental health, especially for those with bipolar disorder. Nourishing one’s body with healthy foods like whole grains, veggies, and lean meats, while reducing intake of fatty and sugary foods, and using probiotic supplements can improve mental health, buffering mood swings. I rediscovered my love of cooking healthy meals and have seen vast mood improvements since choosing a diet that works for me, specifically the low carb diet. Perhaps the Mediterranean or vegetarian diets will suit you? Experiment with food groups you like and remember to take probiotic supplements for a happy gut and brain.
Your brain, body, and emotions are all linked, bipolar or not, and with these healthy lifestyle changes, supplemented by the proper medication and therapy, bipolar disorder patients can not only survive but thrive.
Why do police in this Canadian town hand out tickets for good driving?
This is Jim (white beard) from Pointe-Claire, Montreal. He’s just been handed a ticket for good behaviour by Mayor Morris Trudeau (white shirt, former cop, no relation to Justin) in a pioneering project we’re studying as part of our Smart Cities research at Fluxx.
Since May 2015, over 1,000 citizens have been given tickets for good behaviour like “using roads in a safe and respectful manner, stopping at red lights and stop signs, obeying signals, waiting for the crossing lights at busy intersections and neither texting nor talking on a cellphone while driving.”
Citizens are a little confused: “I saw the flashing lights of the police car but I had no idea what was going on,” Scott told the Montreal Gazette. “I wondered why they were approaching me.” The ticket he received has a thumbs up logo, and no monetary or prize value.
This kind of positive reinforcement can seem strange in the context of police enforcement, but is rooted in the most basic behavioural psychology, and is increasingly being used by cities around the world to deal with a range of issues.
Milan: The insurer paying drivers to leave their cars at home
Milan has the worst traffic in Europe and North America. Drivers there spend 57 hours a year in jams. (INRIX data, reported here in the Daily Mail).
To counter this and following a similar approach to Montreal campaign the second largest insurance company in Italy Unipol came up with an interesting solution to the city’s problems. By giving the residents of Milan free public transit vouchers in return for leaving their cars at home.
“The city is using connected car devices made by Octo Telematics, a Rome-based telematics provider, installed behind the dashboards of Unipol customers’ vehicles, to transmit location data and ensure that cars remain parked on the driveway.” (FT).
This is the little box of traffic magic from Octo, called Unibox
Unipol policyholders receive a credit of €1,50 — the cost of one public transportation ticket — for every day their vehicles remain parked during peak hours.
In a lovely connected cities detail, participants can collect their tickets at any ATM ticket machine, in Milan.
Breda, Netherlands: The city rewarding drivers for staying at home
Dealing with traffic issues of their own, the Dutch city of Breda in 2012 launched the initiative ‘Positive Drive’. Instead of an expensive telematics box that needs to be installed in the car, they used a simple smartphone ap.
The Positive Drive app uses nudges (coaching, prizes, social status, achievements, etc) to strengthen the positive behaviours.
“Positive Drive rewards car drivers who respect speed limits with (s)miles. If they cycle instead of driving, they earn more (s)miles. Bonus (s)miles are rewarded when road users choose certain trajectories over others. In this way, the municipality can promote particular cycle routes and locations, and with their ‘smiles’ the participants can win prizes donated by enterprises based Breda” (Eltis).
Dubai: White Points to reduce deaths in traffic
Back in 2013 the city of Dubai together with its police department launched a project called the ‘White Point’ system. Where participants can earn points by following traffic laws and avoid getting fines and tickets.
It was launched by Maj Gen Mohammed Al Zafeen, head of the Federal Traffic Council and assistant to the Dubai Police chief in operational affairs as an experiment that hopefully could help reducing the amount of deaths in traffic, but also encourage positive driving.
“We started in 2013 by honouring 700 motorists, and now in 2016 we’ll be honouring more than double that amount. The system is still being developed, and we believe the more we reward people for good behaviour, the more positive the effect will be.” Maj Gen Al Zafeen (The National)
The participants can then earn a maximum of 24 points in one year. In case of a traffic violation, motorists can lose a month’s points and if involved in a huge violation, may lose their accumulated white points. These violations also include traffic fines such as ‘Salik’ (tolls) and parking fines. The system also allows drivers to recover points lost on their licences by driving without any infringement over a period of time.
What is tryphophobia
I have two phobias: Trypohobia and blood phobia. What follows is a description of my first and most severe phobia.
Trypophobia is relatively unknown peculiar phenomenon that affects thousands of people. The term ‘trypophobia’ itself was only coined in 2005. It is not recognised as a phobia technically, but it does seem to be a uncontrolled reaction or response (typically fear, anxiety, revulsion and/or self-defense) of a kind of pattern of holes or bumps. It seems to affect all kinds of people young and old and across different cultural barriers which suggests it is not a culturally learned response. Often, a trypophobe will not know that anyone else suffers from the same experiences that they do.
For a long time I wondered why do certain patterns give me goosebumps? As long as I can remember since I was a kid I had this reaction, and there was very little information about it on the Internet that I could find. I wanted to add my knowledge on it.
What triggers it and what doesn’t?
The effect of a triggering image on any individual trypophobe can vary from no response to a severe reaction, but many trypophobes will agree that certain images are triggering. Generally speaking, any kind of cluster (of say at least 7) of holes or bumps (and in some cases, lesions) may cause discomfort. For me, asymmetric/non-uniform patterns are worse. Others have said that the texture of the holes (in the sense of touch) matters. Some repetitive patterns like honeycomb, clusters of bubbles on the surface of water, the texture of crumpets and the bumps in your skin on your knees when you kneel in carpet for too long can also be triggering.
You can do a Google search for “trypophobia” and many of the images that turn up will illustrate the concept.
To know more about triggers, we must explore why trypophobes have this reaction.
Why do trypophobes have this reaction?
There is not much research data on trypophobia to conclusively explain this reaction. From what I’ve read, and what I’ve experienced, my best guess is that certain kinds of clusters are similar in nature (visually) to some degenerative diseases, pox, infections/infestations, swarms, etc., which one would do well to avoid. You could bring some kind of evolutionary hypothesis into this, the revulsion and therefore aversion of anything that looks like this would be beneficial for survival.
For most, when the clusters/pattern is on something natural/biological such as skin, the reaction is worse. Perfectly symmetrical patterns like the holes in a cheese grater may not be triggering at all (like in my case) due to its visual uniformity (man-made appearance.) But again, different people are sensitive to different things.
As it is, trypophobes are not generally aware of any particular reason they have a reaction. It is like getting goosebumps when it gets cold; it is a reaction one cannot typically prevent.
I have done some small experimentation with this since I am affected by trypophobia, and it is very interesting to me (I’m sort of a scientist at heart.) In my case, the visual scale of holes makes a big difference. For example, looking at something from a certain distance may have no affect on me, but viewing it from further back may trigger a response. It doesn’t seem to depend so much on the “understood” scale (compared relative to other objects around it) as the visual scale – how many of the holes can be seen, how much detail, how big they are, the spaces in between them, etc.
What are the reactions to triggering images?
Reactions vary from person to person. Speaking only from my own experience, the first and most noticeable reaction I get is goosebumps. I always get goosebumps when I am triggered, and my hairs stand on end. It will continue until I am no longer triggered. I believe this is part of some kind of overall self-defense/self-preservation mechanism. At the same time, I feel anxious. I feel as though there is possibly some kind of danger. My mind starts analysing the image and for long exposure, it is all I can think about. Heart rate increases. It can have such a strong presence in the mind that it affects your ability to focus on a task. To that extreme level, it is a little bit debilitating.
The worst, though, is having the triggering images flash into your head. Continuously, more and more, until you start to feel panicky and feverish. In my opinion it is a very unpleasant experience to have a war with your mind, in trying “not” to think about something, which is slowly driving you crazy. After extended exposure, I got more sensitive to trypo triggers. I started to get reactions from simple everyday things like the shower head, bubbles of oil in the frying pan, and even the texture of toilet paper.
Others have said their reactions include things like anger (possibly aggression which can be linked to self-preservation), a desire to destroy the clusters, as well as wanting to cry (a natural reaction after being scared.) One thing that trypophobes all have in common is a very strong revulsion. Most will physically move further away (subconsciously) or look away from the image with disgust. Other common reactions include itching, skin crawling, and being sick to the stomach.
How can I get rid of it?
It takes a lot of mental solidarity to reduce your sensitivity to trypophobic triggers. I don’t believe you will be able to get rid of any reaction altogether, especially to the more severe triggers, but being able to control your reaction and curb the effect it has on you is a good start.
Firstly, I don’t recommend take the exposure/desensitizing route if you already experience any of the reactions above. Being exposed to a lot of triggers in a short amount of time can make you panicky. A lot of the images aren’t real and just created for shock value. Some people have said desensitizing works, and it can, depending on how you do it. Don’t go on a binge looking at triggers until you’re sick. If you’re out and about and see a trigger you can take the time to share your phobia with someone close to you. Being able to explain it and share it can turn it into a good experience and help condition you to associate less negativity with triggers.
Accept that you are not in control of the physical reaction your body has, and know that it is natural. Just like goosebumps, or getting hungry, these are natural feelings and it isn’t something to worry about. What you are in control of is how you deal with it.
If you need to, remind yourself that you are not in any danger.
Do not reinforce yourself into a corner of fear. The more you label trypophobia as something scary, the more it is scary, to you. It is uncomfortable and unpleasant, but do not encourage it by saying things like “This is going to give me nightmares,” and “I’m so afraid to click on this link.” Just forget those thoughts. Own it, don’t be a prisoner to it.
Finally, do not expose yourself more than you have to. I know there is a deathly curiosity that comes along with trypophobia. It takes a lot of willpower to pass up an opportunity to freak yourself out. But once you are able to say, “No, I don’t want to see that,” and go on to do other things, you will be one step closer to feeling more at ease.
By doing these, over time, your reactions to trypo images should decrease.
What are some of the worst triggers?
Here is a list of well-known trypophobia triggers. You will know immediately if you have trypophobia if you experience anxiety in response to these stimuli.
- Lotus seed pod, lotus breast, lotus seeds photoshopped onto skin (there are many of these), etc.,
- Surinam toad giving birth
- Botfly removal
- Tafoni (rock formation)
- The “frozen peas” image, most likely also photoshopped
- Googly eyes on face
Sleep therapy for depression
Sleep Therapy Seen as an Aid for Depression
Published: November 18, 2013 355 Comments
Curing insomnia in people with depression could double their chance of a full recovery, scientists are reporting. The findings, based on an insomnia treatment that uses talk therapy rather than drugs, are the first to emerge from a series of closely watched studies of sleep and depression to be released in the coming year.
Ryerson University
A student demonstrating equipment at Colleen Carney’s sleep lab at Ryerson University. Dr. Carney is the lead author of a new report about the effects of insomnia treatment on depression.
The new report affirms the results of a smaller pilot study, giving scientists confidence that the effects of the insomnia treatment are real. If the figures continue to hold up, the advance will be the most significant in the treatment of depression since the introduction of Prozac in 1987.
Depression is the most common mental disorder, affecting some 18 million Americans in any given year, according to government figures, and more than half of them also have insomnia.
Experts familiar with the new report said that the results were plausible and that if supported by other studies, they should lead to major changes in treatment.
“It would be an absolute boon to the field,” said Dr. Nada L. Stotland, professor of psychiatry at Rush Medical College in Chicago, who was not connected with the latest research.
“It makes good common sense clinically,” she continued. “If you have a depression, you’re often awake all night, it’s extremely lonely, it’s dark, you’re aware every moment that the world around you is sleeping, every concern you have is magnified.”
The study is the first of four on sleep and depression nearing completion, all financed by the National Institute of Mental Health. They are evaluating a type of talk therapy for insomnia that is cheap, relatively brief and usually effective, but not currently a part of standard treatment.
The new report, from a team at Ryerson University in Toronto, found that 87 percent of patients who resolved their insomnia in four biweekly talk therapy sessions also saw their depression symptoms dissolve after eight weeks of treatment, either with an antidepressant drug or a placebo pill — almost twice the rate of those who could not shake their insomnia. Those numbers are in line with a previous pilot study of insomnia treatment at Stanford.
In an interview, the report’s lead author, Colleen E. Carney, said, “The way this story is unfolding, I think we need to start augmenting standard depression treatment with therapy focused on insomnia.”
Dr. Carney acknowledged that the study was small — just 66 patients — and said a clearer picture should emerge as the other teams of scientists released their results. Those studies are being done at Stanford, Duke and the University of Pittsburgh and include about 70 subjects each. Dr. Carney will present her data on Saturday at a convention of the Association for Behavioral and Cognitive Therapies, in Nashville.
Doctors have known for years that sleep problems are intertwined with mood disorders. But only recently have they begun to investigate the effects of treating both at the same time. Antidepressant drugs like Prozac help many people, as does talk therapy, but in rigorous studies the treatments, administered individually, only slightly outperform placebo pills. Used together the treatments produce a cure rate — full recovery — for about 40 percent of patients.
Adding insomnia therapy, however, to an antidepressant would sharply lift the cure rate, Dr. Carney’s data suggests, as do the findings from the Stanford pilot study, which included 30 people.
Doctors have long considered poor sleep to be a symptom of depression that would clear up with treatments, said Rachel Manber, a professor in the psychiatry and behavioral sciences department at Stanford, whose 2008 pilot trial of insomnia therapy provided the rationale for larger studies. “But we now know that’s not the case,” she said. “The relationship is bidirectional — that insomnia can precede the depression.”
Full-blown insomnia is more serious than the sleep problems most people occasionally have. To qualify for a diagnosis, people must have endured at least a month of chronic sleep loss that has caused problems at work, at home or in important relationships. Several studies now suggest that developing insomnia doubles a person’s risk of later becoming depressed — the sleep problem preceding the mood disorder, rather than the other way around.
The therapy that Dr. Manber, Dr. Carney and the other researchers are using is called cognitive behavior therapy for insomnia, or CBT-I for short. The therapist teaches people to establish a regular wake-up time and stick to it; get out of bed during waking periods; avoid eating, reading, watching TV or similar activities in bed; and eliminate daytime napping.
The aim is to reserve time in bed for only sleeping and — at least as important — to “curb this idea that sleeping requires effort, that it’s something you have to fix,” Dr. Carney said. “That’s when people get in trouble, when they begin to think they have to do something to get to sleep.”
This kind of therapy is distinct from what is commonly known as sleep hygiene: exercising regularly, but not too close to bedtime, and avoiding coffee and too much alcohol in the evening. These healthful habits do not amount to an effective treatment for insomnia.
In her 2008 pilot study testing CBT-I in people with depression, Dr. Manber of Stanford used sleep hygiene as part of her control treatment. She found that 60 percent of patients who received seven sessions of the talk therapy and an antidepressant fully recovered from their depression, compared with 33 percent who got the same drug and the sleep hygiene therapy.
In the four larger trials expected to be published in 2014, researchers had participants keep sleep journals to track the effect of the CBT-I therapy, writing down what time they went to bed every night, what time they tried to fall asleep, how long it took, how many awakenings they had and what time they woke up.
When the diaries show consistent, seldom-interrupted, good-quality slumber, the therapist conducts an interview to determine if there are any lingering issues. If there are none, the person has recovered. The therapy results in sharp reductions in nighttime wakefulness for most people who follow through.
In interviews, several researchers noted that the National Institute of Mental Health had sharply curtailed funding for work in sleep treatment. Aleksandra Vicentic, the acting chief of the agency’s behavioral and integrative neuroscience research branch, said that in 2009 the funding strategy changed for sleep projects.
In an effort to illuminate the biology of sleep’s impact on behavior, the agency is now focusing on how sleep affects the functioning of neural circuits. But Dr. Vicentic added that the agency continued to fund clinical work like the depression trials.
Dr. Andrew Krystal, who is running the CBT-I study at Duke, called sleep “this huge, still unexplored frontier of psychiatry.”
“The body has complex circadian cycles, and mostly in psychiatry we’ve ignored them,” he said. “Our treatments are driven by convenience. We treat during the day and make little effort to find out what’s happening at night.”
Related articles
- Treating Insomnia to Heal Depression (nytimes.com)
- Sleep Therapy Seen as an Aid for Depression (truthfrequencyradio.com)
- Mental Health And Sleep Therapy: How Overcoming Insomnia May Help Treat Depression (medicaldaily.com)
- Have Researchers Discovered a Quick Fix for Depression? (psychologytoday.com)
- Treating insomnia helping heal those suffering from depression (sandiego6.com)
- Sleep (isteve.blogspot.com)
- Insomnia Cure Boosts Success of Depression Treatment, Study Finds (oddonion.com)
- Dr. Max Gomez: Helping Depressed Patients Get Some Sleep (newyork.cbslocal.com)
The Helpers
The events in USA lately has gotten to many of us. We start to think about evil and unjustice. If you think to much about that, it`s easy to feel helpless and scared. Completely natural and reasonable, but just remember how many good people there are. I have personally talked with one of them this week, and she actually lives in Boston. If you read this, thank you so much for everything, and I wish you the very best tomorrow!
I know you also know a lot of good people out there. Put you`r imagination on fire, and let them mentally hug you. For people who still need more inspiration, read about more good people (relevant for the latest events) in the reblogged post!
Mirrorgirl 
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