Making Healthy Decisions When You Have Bipolar Disorder

“When you have bipolar disorder, it can often feel like you’re at the mercy of your emotional states — like you’re the passenger in the car, just along for the ride,” writes Sheri Van Dijk, MSW, in The Dialectical BehaviorTherapy Skills Workbook for Bipolar Disorder. But “this doesn’t have to be the case.”

In the book, Van Dijk shares how individuals with bipolar disorder can learn to act — rather than react and make smart decisions. (I personally think these insights and advice are valuable for all readers, regardless of whether you struggle with bipolar disorder.)

 Finding the Balance Between Emotions & Logic

According to Van Dijk, in order to make healthy choices, we need to find a balance between our emotions (emotion mind) and our logic (reasoning mind). This balance is called “wise mind,” a concept from dialectical behavior therapy (DBT).

Wise mind means that you’re able to feel your emotions while still being able to think straight, she writes.  It’s possible to make smart decisions based both on your feelings and your thoughts about a situation.

Everyone has a wise mind. According to Van Dijk, you’ve used this wise mind whenever you’ve gotten out of bed even though you felt depressed, or gone to work even though you felt anxious or taken a walk even though you wanted to watch TV and be alone.

Telling the Difference Between Wise Mind & Emotion Mind

It can be tough to tell if you’re making a decision based on your wise mind or your emotion mind, because, as Van Dijk writes, both include emotions.

She suggests assessing the strength of your emotion. If your emotion is intense or overwhelming, you’re likely in emotion mind. If it’s not overpowering, you’re likely in wise mind.

Also, making a decision from your wise mind means sitting with it. If you find yourself vacillating, you’re probably letting emotion mind take over. That just means that you need to give yourself more time.

An Exercise to Be More Effective

A wise mind will help you be more effective in life, according to Van Dijk. In other words, this involves “doing what it takes in a situation to get your needs met.”

Think about it this way: How many times have you acted in a way that felt great in the short term but not so great in the long term?

Van Dijk uses the example of stopping your medication. Let’s say you’re experiencing unpleasant side effects. Instead of telling your psychiatrist that the side effects are bothering you, you just stop abruptly. The side effects do go away in the short term. But you end up in the hospital because of a manic episode.

Van Dijk says that several things can interfere with acting effectively and making good decisions: your thoughts, or how you wish a situation was; not knowing what you want out of a situation; and thinking short-term needs vs. long term.

For instance, as Van Dijk explains, “While you might get some satisfaction out of yelling at an employer whom you feel didn’t treat you with respect, in the long run, you must remember that you need that person to say good things about you to help you get to the next job.”

Also, consider the earlier example about stopping medication abruptly. There, you were letting your emotions make your decision. If you were to consult your “reasoning mind,” you’d realize that not taking your medication can lead to a relapse and other risks.

When you think with both your emotions and reasoning, you’re able to identify your goals (making sure that they’re not at the expense of others). As Van Dijk writes, you might say: “I’m frustrated with the side effects and have decided that [they’re] not acceptable. I need to book an appointment with my psychiatrist to inform her of this request that she prescribe a different mood stabilizer.”

Van Dijk suggests readers practice by thinking of a situation that requires a decision. She suggests asking yourself the following questions (and recording your responses):

  • Describe the situation
  • What are the emotions you are experiencing about this situation?
  • What is your urge in this situation? (What is emotion mind telling you to do?)
  • What is your long-term goal in this situation?
  • What would be a helpful action for you to take in this situation? (In other words, what can you do that would make it most likely for you to meet your long-term goal?)

Other Ways to Be Less Reactive

According to Van Dijk, there are other things you can do to be less reactive, so you don’t let emotions rule your decisions. These include: improving your sleep habits (key for bipolar disorder — shaky sleep can trigger manic or hypomanic episodes); avoiding drugs and alcohol; practicing good self-care; reducing your caffeine intake; not skipping meals; getting nutrients from your diet; and participating in physical activities you enjoy.

This article is originally posted at PsychCenral By 

Understanding My Son’s Learning Styles

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Vincent ( far right ) engaging with a ‘tactile’ learning style during a class activity.

For several years, Vincent’s teachers have sought our attention because apparently he is having a hard time focusing in school, sometimes not participating in class, and always needing to do something with his hands. Because of these concerns, we have sat down and had talk with him a million times regarding these issues at school. We were getting frustrated! It’s always dreadful every time we receive an email from his teacher saying the same things.

At one point, we considered home schooling him so we don’t get this kind of pressure from the school. We have to admit, and to our shame, there were times Moses and I yelled at him and took away some of his privileges at home. I compared him to other kids and to my own study habits when I was in grade school.   We were aware that it isn’t fair to him to be treated that way. It was very challenging and frustrating that we lose our patience.

We also enrolled him to Kumon hoping it’ll help him develop concentration and better study habits. Although we help and support him doing his homework at home, we make sure that he takes responsibility as well. We know that Vincent is a very smart, clever and witty boy. But some teachers have suggested have him checked, maybe he has ADHD. Though we were in denial for long time, we are now considering seeing a specialist.

What’s interesting is, every time we get his report card, he excels basing on California Standard Test although his learning behavior is below average. We also get different opinions from our friends and family as well so it can be very confusing sometimes.

Our minister in our church also helped us understand that we, his parents should be his number one fan when it comes to learning. If he feels unloved and ‘not accepted’ because of his inability to concentrate, he will develop low self-esteem and more insecurity in life. I’ve been reading a lot about this topic and it’s overwhelming.

I bumped into an article written by Denise Mann of WebMD site. It is very enlightening and for the first time I felt there are ways how to help my son succeed in learning.

According to Denise Mann, you shouldn’t panic if your son has trouble spelling or your daughter can’t sit still during history class. It may be that he or she simply has a different learning style. She emphasized that every child learns in a slightly different way, experts say, and figuring out your child’s own learning style can help assure academic success.

In some cases, it may even help do away with labels, like “attention deficit disorder (ADD)” and “learning disabled (LD).” So she recommends a step-by-step guide to identifying, understanding, and making the most of your child’s learning style.

Identifying Your Child’s Strengths  

Parents need to keep their eyes and ears open to figure out what works best for their children when it comes to learning, says Mel Levine, MD, co-founder of All Kinds of Minds, a nonprofit institute for the study of learning differences. “Some children are hands-on, while others work best through language and do well with reading,” says Levine, a pediatrics professor at the University of North Carolina Medical School. “Some children understand things better than they remember them.

”There are many different patterns of learning, and the best thing that a parent can do is step back and observe what seems to be happening and what seems to be working with their child.”

Levine suggests that parents begin evaluating their child’s learning style at age 6 or 7. Learning styles really start to crystallize during the middle school years.

Understanding your child’s disposition can also help you determine his or her learning style, says Mariaemma Pelullo-Willis, MS, a learning coach based in Ventura, Calif., and author of Discover Your Child’s Learning Style. For example, is your child adventurous? Inventing? Or thinking/creating like a poet or a philosopher? “An adventurous personality really has to move to learn, so sitting at desk all day doesn’t do it for them,” she says.

By contrast, “a child with an inventing disposition asks a million questions, such as ‘How does this work?’ ‘What about this?’” Another factor to observe is your child’s “learning modality”, she says. This refers to which senses your child best learns through. Are they auditory (listening and verbal), visual (picture or print), or tactile-kinesthetics (hands-on, whole-body, sketching or writing)? “Some people are more visual and need pictures to learn, while print learners need print,” she explains.

Another aspect of learning style involves the environment, she says. For example, noise, temperature or lighting may affect some children’s ability to learn. “For one child, temperature might not make a difference, but some children can’t concentrate if it’s too hot, and/or lighting can be a crucial factor for some people if fluorescent lighting causes eyestrain,” she says.

Playing to Your Child’s Strengths

Once you have identified your child’s learning style, you can begin to build on his or her strengths to compensate for learning weaknesses — without labels. “If a little girl has a lot of spatial problems (difficulty picturing things), but is terrific in English, she can learn math by putting everything into her own words,” Levine explains. “If you show her an equilateral triangle and ask her to talk about it, boy, will she understand it. “She can only understand things in words, which is why she is such a terrific English student.”

Another way to enhance learning is to focus on your child’s affinities and areas of interest. “A lot of strength could ride on the coattails of their passions, and you can build academic skills in that area,” Levine says. “Have him became an expert in the area that he feels passionate about.” Pelullo-Willis agrees.

“Parents really should encourage children’s interests, talents and what they love to do,” she says. “Parents tend to say ‘If you are not doing well in school, you can’t take horseback riding lessons,’ but those are things that can build self-esteem.

Further, she says, “acknowledging and honoring their interests and talents tells you a lot about their learning style. If your child is really interested in plants and gardening, you can see if they are more hands-on and they need to go out there and garden. Or do they learn better from pictures about gardening, or reading about gardening?”

Increasing Awareness in Schools  

As it stands, schools mainly teach to print, auditory and language learners, according to Pelullo-Willis. “They teach by saying ‘Read, answer the questions and listen to me talk’ and that only covers a small percentage of children,” she says. If your child is a hands-on learner, “You can say: ‘Of course school is so hard for you; you need to move a lot and they don’t do that in school,’” she says. “Then learn everything you can about how to use their learning style to make school easier.” Adds Levine: “We are learning more and more that there are differences in learning, and to treat everyone the same is to treat them unequally.”

The good news is that growing numbers of teachers are focusing on learning styles and reaching out to all types of learners. For example, Levine helped launch the Schools Attuned program. This professional development program helps teachers acquire the knowledge and skills they need to accommodate learning differences.

To date, the program has offered training to 30,000 teachers. But if your child’s teacher has not been trained in learning styles, don’t despair, Pelullo-Willis says. Instead, talk to him or her about what you have observed about your child’s learning style. “Say, ‘Wow, I have just discovered this and I tried it, and he got it. Do you think we could work together using this kind of information?’ And the teacher may even get interested in reading a book or article on learning style,” she says.

Now I have more in depth understanding of my son’s learning style. Vincent responds very well with visuals (picture or print), or tactile-kinesthetics (hands-on or whole-body participation. He has an adventurous personality and he really has to move to learn, so Levine is right, sitting at desk all day doesn’t do it for him.

Because I’m now empowered to support him in his study habits, I feel more relaxed and calm. I now have full acceptance that my son is different from the rest of his class. I am my son’s advocate and I will focus helping him with his strengths. Vincent’s success in learning is not defined by the school but through his parents who believes in him.

9 ways to care for yourself when you have depression

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Depression is an illness that requires a good deal of self-care,” writes psychologist Deborah Serani, PsyD, in her excellent book Living with Depression: Why Biology and Biography Matter along the Path to Hope and Healing.

But this might seem easier said than done, because when you have depression, the idea of taking care of anything feels like adding another boulder to your already heavy load. Serani understands firsthand the pain and exhaustion of depression. In addition to helping clients manage their depression, Serani works to manage her own, and shares her experiences in Living with Depression.

If you’re feeling better, you might ditch certain self-care habits, too. Maybe you skip a few therapy sessions, miss your medication or shirk other treatment tools. According to Serani, as some people improve, they get relaxed about their treatment plan, and before they know it are blinded to the warning signs and suffer a relapse.

Because skimping on self-care is a slippery slope to relapse, Serani provides readers with effective tips in her book. As a whole, the best things you can do to stave off relapse are to stick to your treatment plan and create a healthy environment. I’ve summarized her valuable suggestions below.

1. Attend your therapy sessions. As you’re feeling better, you might be tempted to skip a session or two or five. Instead, attend all sessions, and discuss your reluctance with your therapist. If changes are warranted, Serani says, you and your therapist can make the necessary adjustments.

Either way, discussing your reluctance can bring about important insights. As Serani writes:

Personally, the times I skipped sessions with my therapist showed me that I was avoiding profound subjects — or that I was reacting defensively to something in my life. Talkinginstead of walking showed me how self-defeating patterns were operating and that I needed to address these tendencies.

2. Take your meds as prescribed. Missing a dose can interfere with your medication’s effectiveness, and your symptoms might return. Alcohol and drugs also can mess with your meds. Stopping medication altogether might trigger discontinuation syndrome. If you’d like to stop taking your medication, don’t do it on your own. Talk with your prescribing physician so you can get off your medication slowly and properly.

Serani is diligent about taking her antidepressant medication and talks with her pharmacist frequently to make sure that over-the-counter medicines don’t interfere. With the help of her doctor, Serani was able to stop taking her medication. But her depression eventually returned. She writes:

…At first, it was upsetting to think that my neurobiology required ongoing repair and that I’d be one of the 20 percent of individuals who need medication for the rest of their lives. Over time, I came to view my depression as a chronic condition — one that required me to take medication much like a child with diabetes takes insulin, an adult with epilepsy takes antiseizure medication, or someone with poor eyesight wears glasses…

3. Get enough sleep Sleep has a big impact on mood disorders. As Serani explains, too little sleep exacerbates mania and too much sleep worsens depression. So it’s important to keep a consistent sleep and wake cycle along with maintaining healthy sleeping habits.

Sometimes adjusting your medication can help with sleep. Your doctor might prescribe a different dose or have you take your medication at a different time. For instance, when Serani started taking Prozac, one of the side effects was insomnia. Her doctor suggested taking the medication in the morning, and her sleeping problems dissipated.

For Serani, catnaps help with her fatigue. But she caps her naps at 30 minutes. She also doesn’t tackle potentially stressful tasks before bed, such as paying bills or making big decisions.

(If you’re struggling with insomnia, here’s an effective solution, which doesn’t have the side effects of sleep aids.)

4. Get moving. Depression’s debilitating and depleting effects make it difficult to get up and get moving. Serani can relate to these effects. She writes:

The lethargy of depression can make exercise seem like impossibility. I know, I grew roots and collected dust when I was anchored to my depression. I can still recall how getting out of bed was a feat in and of itself. I could barely fight gravity to sit up. My body was so heavy and everything hurt.

But moving helps decrease depression. Instead of feeling overwhelmed, start small with gentle movements like stretching, deep breathing, taking a shower or doing household chores. When you can, add more active activities such as walking, yoga or playing with your kids or whatever it is you enjoy.

It might help to get support, too. For instance, Serani scheduled walking dates with her neighbors. She also prefers to run errands and do household chores every day so she’s moving regularly.

5. Eat well. We know that nourishing our bodies with vitamins and minerals is key to our health. The same is true for depression. Poor nutrition can actually exacerbate exhaustion and impact cognition and mood.

Still, you might be too exhausted to shop for groceries or make meals. Serani suggests checking out online shopping options. Some local markets and stores will offer delivery services. Or you can ask your loved ones to cook a few meals for you. Another option is Meals-on-Wheels, which some religious and community organizations offer.

6. Know your triggers. In order to prevent relapse, it’s important to know what pushes your buttons and worsens your functioning. For instance, Serani is selective with the people she lets into her life, makes sure to keep a balanced calendar, doesn’t watch violent or abuse-laden films (the movie “Sophie’s Choice” sidelined her for weeks) and has a tough time tolerating loud or excessively stimulating environments.

Once you pinpoint your triggers, express them to others so your boundaries are honored.

7. Avoid people who are toxic. Toxic individuals are like emotional vampires, who “suck the life out of you,” according to Serani. They may be envious, judgmental and competitive. If you can’t stop seeing these people in general, limit your exposure and try having healthier individuals around when you’re hanging out with the toxic ones.

8. Stay connected with others. Social isolation, Serani writes, is your worst enemy. She schedules plans with friends, tries to go places she truly enjoys and has resources on hand when she’s somewhere potentially uncomfortable, such as books and crossword puzzles.

If you’re having a difficult time connecting with others, volunteer, join a support group or find like-minded people online on blogs and social media sites, she suggests. You also can ask loved ones to encourage you to socialize when you need it.

9. Create a healthy space.According to Serani, “… research says that creating a nurturing space can help you revitalize your mind, body and soul.” She suggests opening the shades and letting sunlight in. There’s also evidence that scent can minimize stress, improve sleep and boost immunity. Lemon and lavender have been shown to improve depression.

Serani says that you can use everything from essential oils to candles to soap to incense. She prefers lavender, lilac, vanilla and mango. If you’re sensitive to fragrance, she recommends diluting essential oils, buying flowers or even using dried fruit.

You also can listen to music, meditate, use guided imagery, practice yoga and even de-clutter parts of your home a little each time.

Serani’s last point involves empowering yourself and becoming resilient. She writes:

By learning about your biology and biography, following your treatment plan, and creating a healthy environment, you don’t allow anyone to minimize you or your depression. Instead of avoiding struggles, you learn from them. You trust your own instincts and abilities because they are uniquely yours. If you experience a setback, you summon learned skills and seek help from others to get back on-point. If a person’s ignorance on mental illness presents itself in the form of a joke or stigma, you clear the air with your knowledge of neurobiology and psychology.

Check out Serani’s award-winning blog, Dr. Deb, and learn more about her work here.

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