Bipolar Disorder

Bipolar disorder, which is classified as a mood disorder. Bipolar disorder used to be called manic depression – it is most known for its mood swings, which can be of varying degrees – mild, moderate, all the way to severe. Moods can be up – like the highs of mania, or they can be down, like the lows of depression. The periods of these mood swings can be brief, as in hours, or as long as months in duration. I have read that the average time between episodes can be about 3 years.

So what is “mania”? Mania is the up side of the mood swing – it can mean the person feels high energy, very creative, very happy. It can also involve irritability, impulsive behaviors like acting out sexually, or going on spending or gambling sprees. It usually means the person feels little need for sleep. They may be hyperactive and notice that their thoughts and even their speech seems to be racing. Again, symptoms of mania can be mild, or they can be severe – anywhere along the spectrum.

Most of us are familiar with the depression side of the disorder. Depression can mean deep sadness, possibly out of proportion to life events. There may be a lack of energy, too much sleep, and no sense of joy in things that used to be pleasurable. The person may feel hopeless and worthless.

During episodes of mania or depression, the person may self medicate with drugs or alcohol to try to manage the symptoms. This doesn’t help, and usually makes it worse.

Bipolar disorder tends to be recurrent. What I mean is, it’s not just one episode then it’s over, or cured. In 90% of people who are diagnosed with bipolar disorder, there will be recurring mood swings of depression and/or mania.

The symptoms of both mania and depression can overwhelm the ability to deal with everyday life. The person’s ability to use reason and logic to manage their behaviors, relationships, personal safety, work, etc may be greatly impaired. One of the most challenging aspects of bipolar disorder is that the person may not recognize that they are in the midst of a manic or a depressive episode. They can go from euphoria to aggression to deep sadness and not be able to identify or verbalize what they are feeling.

All of this can make it difficult for loved ones to stay connected and offer support. It may take them a great deal of time to notice patterns of behavior that may indicate bipolar disorder in a friend or family member. And if they do notice, how do they express their concern in a way that the person can hear, in a non-threatening way? “Hey, I was just noticing that maybe you are bipolar – let’s go to the doctor and see,” probably will not get a favorable response. Bipolar disorder has such a stigma in our society, as does any mental health diagnosis. People misunderstand, they judge, they even make jokes about it. How many times have you heard someone say “Yeah, I changed my mind so many times I must be bipolar!” Ugh. The concept of having someone you care about dealing with bipolar disorder is complex enough for its own video, and that will be coming soon.

For now, let’s focus on the person who may possibly have bipolar disorder and how to get help. I’m going to cover three areas for your attention, to maximize the odds of the best results possible:

See a licensed mental health professional. You might start with a psychiatrist, or a therapist who has experience with bipolar disorder. Chances are, medications may be recommended to help manage your symptoms and help bring about more balance to your life. If you have concerns about this, by all means talk to your doctor and be an active participant in your treatment, but DO see a professional. Bipolar disorder is not something you just have to get tougher to recover from. There is plenty of self-help advice and I am going to mention some tips, but first – see a qualified professional to join your team. Be honest with them about your symptoms, about your family history (particularly if anyone else in your family has bipolar disorder), and about your lifestyle and behaviors. Help them give you the best care available.

Next, lifestyle changes. Here is the self-help stuff, and it’s pretty much common sense. Get enough sleep. Eat right. Exercise. Minimize stress. Take care of your physical health. If you are self-medicating with drugs or alcohol, stop – there is real help available, and drinking too much or other substance abuse is not real help.

Third, get support. Bipolar disorder affects your friends, family, and even co-workers. Talk to the people close to you and let them know what you need and how they can help you. Join a support group, or go to see a counselor for talk therapy. Read the many books available about bipolar disorder. You are not alone.

 Bipolar disorder can disrupt virtually every area of your life if left untreated. Reach out for support, develop a treatment plan with a qualified professional, and take good care of yourself. The majority of patients with bipolar disorder do find relief by following these steps. The very nature of bipolar disorder can convince you that either you don’t need treatment, or that it wouldn’t work anyway. Talk to those around you, and see what a doctor or therapist says. Look at it this way. If you were diabetic, you could suffer with the roller coaster of your blood sugar going way up then way down, but you would probably see a doctor, get medications, and adjust your lifestyle to maximize your overall health. Bipolar disorder is no different. There are resources available to help you live your life the way you want to.


Video of this blog article can be found here: http://youtu.be/UTb4QSWAEas


Inner Critic Doll

Building Ebenezers

Inner Critic Doll Sometimes you get a nudge from the universe. And sometimes that message comes in the form of a cute, squishy doll.

The past few weeks, I have been wrestling with my Inner Critic. I used to think of the Inner Critic in terms of something that got in the way of my writing by stifling my creativity. But creativity is more than just producing a story or a painting or a song. I’ve always believed that – or at least said I believed that – but I lately I have been developing a deeper appreciation of how living life and moving through the world is a creative act. And how my Inner Critic effects the way I do that every day.

I think of my Inner Critic as the part of me that is working overtime to keep me “safe.” And not in a good way. It’s almost like the…

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Your Life – Who’s in the Driver’s Seat?

People often come to see me to get help with some type of habit or feeling that is disrupting their lives. It can be anything from depression to smoking to hair pulling to procrastination to alcohol. The common thread is the sense that they are no longer in control of their own lives, and they want the ability to make healthy choices again without the influence of unwanted habits or feelings.

 A conversation I have quite often with them focuses on what the issue is and the amount of control or power it has over them and their daily lives. I ask “Who’s in the driver’s seat here? What has taken over your sense of personal power?” This never fails to start them thinking about ways in which they take a backseat and feel like something other than their own good sense is making their decisions for them.

In some cases, we liken the unwelcome part to a little devil perched on their shoulder, whispering in their ear, convincing them to go off course and give in to things that knock their lives off track. Some examples of things that whispering voice can say include:

“Go ahead…have one more drink. You can handle it.”

“This will be the last time you pick at your skin. You can quit tomorrow.”

“Yeah, there is a lot piling up on your to-do list. So just surf the internet a little bit…you’ll get to it later.”

“You don’t really want to exercise. Go back to bed…you’ll feel nice and rested later.”

“You’re never going to lose that weight anyway. Have another piece of cake.”


That little voice can have a big effect on what we choose to do, especially if it’s something we are struggling to resist in the first place. It’s easy to let those distorted messages prevent you from moving forward successfully into the life you want to have for yourself. I often ask clients if they can identify the voice. “Who does it sound like?” Sometimes it’s a critical parent, or teacher. Sometimes it’s the client’s own inner critical voice. Another common thread here is that those messages are typically not in your best interest, and fairly easy to dismantle once you begin to examine and challenge them.

So what does it mean to challenge a negative inner voice that steers you in ways you don’t want to go?

-First, as I say a lot, thoughts are just thoughts. They are not facts, and they may be completely untrue.

-Second, make a plan for your life. Set goals, make a Vision Board, anything you need to do to create the track you want to be on and stick to it. It’s easy to be steered off track if you don’t have one.

-Third, value yourself. Believe that you can chart the course you want to be on, and that you are not that little nagging, negative voice.

-Finally, face your fears. Fears are famous for sneaking up on us and chipping away at our best efforts. Don’t be scared to step up and take control of your life. If it feels scary, maybe it is. That doesn’t mean you can’t do it. J

If that little voice starts to lead you and your one, precious life onto paths you don’t want to follow, you are the one in charge. Don’t allow anything or anyone to manipulate your strings like a puppet. When you are the one in the driver’s seat of your life, you have the freedom to choose a healthy and happy destination. Give it a try!

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This post is available on YouTube here: http://youtu.be/RaIz1Pmildo



Skin Picking: The Freedom to Finally Stop by Annette Pasternak

The Pluviophile Writer

5/5 stars.
ebook, 148 pages.
Read from January 17 to March 07, 2014.

This book is by far the most comprehensive, supportive and positive guide out there right now for Dermatillomania. I can’t say enough good things about this book!

For those that don’t know, Dermatillomania, orExcoriation disorder, can be defined as:

…an impulse control disorder characterized by the repeated urge to pick at one’s own skin, often to the extent that damage is caused. Research has suggested that the urge to pick is similar to an obsessive compulsive disorder but others have argued that for some the condition is more akin to substance abuse disorder. The two main strategies for treating this condition are pharmacological and behavioral intervention.” – Wikipedia

This is a condition that I have personally struggled with deeply. I can safely say that through my own methods I was able to battle this condition…

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Therapy Made Me Worse!

Clearly, as a therapist, I believe that therapy can work.  Whether for individuals working through life’s issues or for couples trying to improve their relationships, good therapy can provide the tools to get there.

That said, I have heard stories from friends and even my own clients of therapy where they not only felt it didn’t help, but perhaps even felt worse. So let’s talk about some of the most common reasons that can happen.

The first has to do with the fit between therapist and client. Some say this is the most important predictor of a successful outcome. If you have a therapist who is present for you, shows acceptance and empathy, listens well, and you are making progress toward the goals of the treatment plan you created together, you probably know you have a good fit. It doesn’t have to feel comfortable all the time – in fact, personal growth can be anything but comfortable. But they are there with you to offer the assistance you need to work through it. 

Sometimes it’s not a fit. This can be for any number of reasons, or no obvious reason at all.  Let me share with you some of the reasons that I’ve been told:

* The therapist had no experience in my problem, and didn’t seem interested in learning about it.

* She was always running late and seemed distracted. She took phone calls during my session.

* He took notes the whole time. Never looked at me, never said much.

* I live in a small community, and my therapist violated my confidentiality in a social setting we both share.

* She constantly told me what to do. I needed to find my own answers.

* He insisted we talk about my childhood, and I wasn’t ready. I started having panic attacks after our sessions – it was too much, too fast.

* She talked about herself the entire hour. I just sat there and listened.

Those are a few of the statements I have heard. Now, I have to take all of them with a grain of salt. The therapists in question were not present to explain their side, and I am certain there have been a few clients just as unhappy with me for one reason or another. It’s hard to judge what happened, but the fact that these are the clients’ perceptions make them matter.

There are some challenges that we, as therapists, experience with clients that can hamper the outcome of therapy, as well.  Maybe that will be another video someday. 

I am a fan of, for lack of a better word, shopping around a little for a therapist. There may be hundreds where you live, so starting with an online search in your area is a typical way to begin. Check out the practitioner’s profile, visit their webpage, and see if they offer a brief, free consultation. Before you call, make a few notes on your primary issue and the type of person you’d like to help you. Some people feel more comfortable with a male therapist, or someone who is older. A consultation isn’t a session, but it can give you a chance to get a sense of the therapist and to express your needs and goals. Many people give more research to the choice of a car mechanic than they do when they choose a psychotherapist, so prepare a little and have an idea of what you need.

I have to add again that even the very best therapy is going to feel uncomfortable sometimes. You may be discussing deep-seated, painful issues. But you should feel that your therapist is present and engaged in what the process is like for you.

If you are experiencing dissatisfaction with your therapist, it is absolutely okay to bring it up. “I notice our sessions are only 30 minutes, because we routinely start late every week. Can we talk about that?” or “What I would like most to focus on is my marriage. Can we discuss that today?” or “I feel this is moving too fast for me. I want to explore my past, but I am struggling with how worked up I am when I leave each session.”  Good therapists welcome questions and ways to collaborate on the process. That’s our job. When there are questions or roadblocks, often working through them together can be a great benefit.

If there is truly no fit between client and therapist and you can’t work it out, it’s okay to switch providers. This is your journey. Your therapist can provide you with a few names of other practitioners, and there should be no hard feelings.  You have every right to the best therapy you can find. So identify what that looks like for you, ask for what you need, and keep making progress. 🙂

What do the letters after my counselor’s name mean??

LMFT (or MFT) Licensed Marriage and Family Therapist

LPCC: Licensed Professional Clinical Counselor

LCSW: Licensed Clinical Social Worker

Ph.D: The person holds a doctoral degree. Check to see if they are a Licensed Psychologist or hold one of the licenses above

Psy.D.: The person holds Doctor of Psychology degree

M.D.: Medical doctor. Psychiatrists are medical doctors.



Dandelion fights


dandelions 3

They fight on my sofa.

The themes are familiar.  He never listens to me.  She won’t stop trying to control me.

Thirty minutes, this goes on.

Finally she breaks down and sobs, and he stares angrily off into space.

 “Do you guys have a lawn?” I ask.

Betty wipes her eyes, looks at me.  Bob, suspecting  I’m crazy, frowns.

“With dandelions on it?” I continue.  “What happens when you mow dandelions?  Right.  They come up again tomorrow.  Because to remove a dandelion you have to dig up the root.

“This is a dandelion fight,” I say.  “You keep having it for the same reason you can’t mow dandelions away.  You’re not getting to the root.”

“What root?” Bob asks.

“Two roots, actually.  One’s emotional: how you feel right now.  You guys never talk about that.  Betty, what are you feeling right now?”

She sniffles.  “Like he doesn’t love me at all.”

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