Gratitude

A Blessing for a Day to Spend in Gratitude

BY PIERRE PRADERVAND

Such a great deal has been written about the power of gratitude it appears unnecessary to belabor this point: it is impossible – repeat, impossible – to hold at the same time the slightest negativity of any sort and authentic gratitude. Their coexistence is simply impossible and the choice is ours. We invite you to take a few slow, deep breaths when you arise in the morning and begin your day with this blessing…

 

May this day be a constant canticle of gratitude from now on till I retire tonight.

May I welcome any negative event with gratitude for the growth
it will produce in my life.

May I face every single encounter with gratitude for the manifestation
of divine love it represents.

May I react to any disgruntled, depressed, angry or sad face with gratitude
that my blessings can uplift and help dissolve them.

May I eat my meals with gratitude for all those who have participated
in bringing them on to my table.

However tedious, unimportant or boring my work may appear, may I perform it with the understanding that the very act of giving thanks can profoundly transform it.

And above all, may I understand that the choice between complaint, indifference, and gratitude is mine at every…moment of my life.

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What is Mental Health

What is mental health? We often talk about mental health and mental illness. But what do we mean by mental health and what can you do to look after yours? What do we mean by mental health? There is often a lot of confusion about what we mean when we talk about mental health. Many people immediately start thinking about mental health problems or mental illness – but this is only one part of the picture. Everyone has ‘mental health’ and this can be thought of in terms of: • How we feel about ourselves and the people around us. • Our ability to make and keep friends and relationships. • Our ability to learn from others and to develop emotionally. Being mentally healthy is also about having the strength to overcome the difficulties and challenges we can all face at times in our lives – to have confidence and selfesteem, to be able to take decisions and to believe in ourselves. Dealing with life’s ups and downs Having said that we all have mental health, it’s also important to understand when you might need to get some help or support with how you are feeling – or to know when perhaps you may be experiencing a more serious problem. It is quite normal to sometimes feel worried, anxious or upset when things don’t go as you hope – everyone faces pressure in their lives at certain times and these can include: • Exams. • Work and getting a job. • Growing up and becoming more independent from your family. • Making up (and breaking up) with friends. You can find more information to help if you are feeling stressed or under pressure from any of these on our website at http://www.rethink.org/youngpeople For further information on Rethink Mental Illness Phone 0300 5000 927 Email info@rethink.org http://www.rethink.org To find out about how you can look after your mental health, help someone who is experiencing mental health issues and read about some of the common mental health problems young people can experience visit our website at http://www.rethink.org/youngpeople Rethink Mental Illness is a partner in: Registered in England Number 1227970. Registered Charity Number 271028. Registered Office 89 Albert Embankment, London, SE1 7TP. Rethink Mental Illness is the operating name of National Schizophrenia Fellowship, a company limited by guarantee. © Rethink Mental Illness 2012. Knowing when to get help and advice Mental health problems affect many more young people than you probably realise: • National studies suggest that in the UK, about 1 in 10 (10%) of all young people may experience a mental health problem or disorder where they may need help from a mental health specialist. • These studies also emphasise that it’s important to get help early, that these conditions are treatable and that getting help early can help prevent difficulties getting more serious. • There are many different types of mental health problems and disorders and they affect young people differently and last for different lengths of time. What to look out for? If someone is experiencing worries, anxieties and difficult feelings to the extent that they are seriously interfering with their everyday life, for instance: • Being able to study and go to school. • Being able to eat or sleep as they normally do. • To go out with their friends or take part in their favourite hobby. and these feelings are becoming persistent, that is lasting for a few weeks or more, then it might be that they have a mental health problem or disorder and need to get some advice and help.

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Depression Information Sheet

What is depression? It is when the low feelings or down mood, along with other symptoms, lasts for more than a couple of weeks that a person may have depression (sometimes referred to as clinical depression). Depression is a lot more common than most people think. It can affect people of all ages and in many different ways. Some of the signs and symptoms include: • Feeling hopeless or worthless. • A loss of appetite. • Feeling very tired or on the other hand, agitated and unable to concentrate on anything. • Finding it hard to sleep, to study or to find pleasure in hobbies. • Avoiding friends or feeling like they want to harm themselves. Everyone has times when they feel stressed, upset or down – and it’s normal to feel disappointed when things don’t go as you hoped. These feelings will come and go from time to time and generally, don’t last very long. Depression can happen suddenly as a result of some difficult life experience, or can emerge more slowly, with no clear reason for it. Either way, it’s important to understand that depression is not a weakness, it is a recognised mental health issue and it is important that a person with depression gets help. For further information on Rethink Mental Illness Phone 0300 5000 927 Email info@rethink.org http://www.rethink.org For more info Visit our website at http://www.rethink.org/youngpeople If you want to talk to someone about anything that is worrying you childline offer a free helpline for young people which you can call on – 0800 1111 visit at http://www.childline.org.uk or

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Take the Mental Health Quizz

http://www.time-to-change.org.uk/mental-health-quiz

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About Stigma and Discrimination

About stigma and discrimination

It’s quite likely that one day you, one of your friends, colleagues or family members will experience a mental health problem. Yet mental illness is still surrounded by prejudice, ignorance and fear. The attitudes people have towards those of us with mental health problems mean it is harder for them to work, make friends and in short, live a normal life.

What effect does stigma have?

Making friends, holding down a job, keeping fit, staying healthy… these are all normal parts of life. But the stigma that surrounds mental illness makes all these things harder for people who have mental health problems.

Stigma isolates people. People often find it hard to tell others about a mental health problem they have, because they fear a negative reaction. And when they do speak up, the overwhelming majority say they are misunderstood by family members, shunned and ignored by friends, work colleagues and neighbours.

Stigma excludes people from day-to-day activities. Everyday activities like going shopping, going to the pub, going on holiday or joining a club are far harder for people with mental health problems. What’s more, about a quarter of people with a mental illness have been refused by insurance or finance companies, making it hard to travel, own property or run a business.

Stigma stops people getting and keeping jobs. People with mental health problems have the highest ‘want to work’ rate of any disability group – but have the lowest in-work rate. One third report having been dismissed or forced to resign from their job and 70% have been put off applying for jobs, fearing unfair treatment.

Stigma prevents people seeking help. We know that when people first experience a mental health problem they tend not to seek help early and tend to come into contact with mental health services only when a crisis has developed.

Stigma has a negative impact on physical health. We know that people with mental health problems tend to have poorer than average physical health and their physical health problems are often misdiagnosed. As a result, people with the most severe mental health problems die on average ten years younger.

How widespread is stigma?

Despite attitudes about sexuality, ethnicity and other similar issues improving, and despite someimprovements since the launch of Time to Change, discrimination against people with mental health problems is still widespread.

The Stigma Shout survey that we carried out at the beginning of Time to Change showed that almost nine out of ten people with mental health problems (87%) reported the negative impact of stigma and discrimination on their lives.

The research also showed that the way family, friends, neighbours and colleagues behave can have a big impact on the lives of people with mental health problems.

Man running

“I try and openly talk about my experiences, though that does bring laughter and ridicule sometimes.” Read Alan’s blog >>

How can I help?

You can help us create a society where mental health problems are not hidden in shame and secrecy. You can ensure your friend or relative is not afraid to speak out about their problems, or is left wondering where they can turn for help.

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What is Bipolar Disorder

What is Bipolar Disorder?

Bipolar Disorder is a mood disorder that is characterised by alternating periods of mania and depression. It was formerly known as manic depression. People with Bipolar Disorder can swing from extreme highs to extreme lows, sometimes very quickly. This can often feel confusing or even frightening for the sufferer and their loved ones.

The good news is that effective treatments are available for people with Bipolar Disorder.

At the London Psychiatry Centre, we have a wealth of knowledge and experience with the condition and can help you take the right steps to move forward in improving your quality of life. The first is recognising there is a problem, and seeking an accurate diagnosis.

Types of Bipolar Disorders

Bipolar Disorder

The various types of Bipolar Disorders and their symptoms are described below:

Bipolar I
This applies to patients who have one or more manic or mixed episodes, often combined with depression. Patients with Bipolar I Disorder typically have severe manic (high) episodes along with shorter depressive episodes. In other words, they are ‘high’ more often than they are low – which can make this condition hard to recognise.

Bipolar II
Patients with Bipolar II Disorder tend to have longer periods of depression that alternate with shorter manic episodes. In other words, depression is the dominant factor.

Cyclothymia
This is Bipolar Disorder with less obvious highs and lows. Although a comparatively milder condition, it can still have a serious impact on quality of life.

Bipolar Disorder Not Otherwise Specified (BD-NOS)
When a person doesn’t follow all the patterns of other known forms of the condition, they are said to have BD-NOS, and/or sometimes when bipolar occurs as part of other coexisting mental health conditions.

Causes of Bipolar Disorder

Bipolar Disorder is thought to be caused by a combination of biochemical, genetic and environmental factors. It may be due to a lack of serotonin (the ‘happy’ hormone) or an irregular release of dopamine (which helps control a person’s relationship to pleasure and reward) in the brain.

Bipolar Disorder tends to run in families and may lie dormant for years, only to be triggered by a traumatic event such as a relationship break-up, divorce, job loss, change of home, bereavement, etc.

Symptoms of Manic Phase (Mania)

The so-called ‘manic’ stage of the condition means a person is likely to be bursting with energy and ideas, intense and prone to seemingly bizarre behaviour such as excessive spending, heavy drinking or wild sexual behaviour.

Symptoms include:

  • Exaggerated euphoria
  • Insomnia
  • Grandiosity
  • Racing ideas
  • Rapid speech
  • Reckless behaviour
Symptoms of Depressed Phase (Depression)

While a person battling depression may not realise they have the condition, fortunately it tends to be fairly straightforward for us to identify here at the London Psychiatry Centre.

The patient may feel disproportionately angry or sad, seemingly about nothing. They may have frequent crying bouts and fantasise about dying. Patients often say their lives have become unmanageable, they feel overwhelmed and their confidence is at rock bottom.

Symptoms include:

  • Frequent crying or sad mood
  • Lethargy (e.g. not wanting to get up in the morning)
  • Insomnia or excessive sleeping
  • Obsessive thought patterns
  • Feelings of guilt, pessimism and low self-esteem
  • Thoughts about/attempts at suicide
Bipolar Disorder Test

Many factors are involved in diagnosing Bipolar Disorder. Factors that we will consider before making a bipolar diagnosis include:

  • A patient’s family medical history, such as whether anyone has or have had bipolar disorder/depression
  • Any pronounced mood swings – and for how long they have been occurring

We may also suggest a thorough examination to look for illnesses that may be causing the symptoms, such as thyroid problems or possible drug use.

Note: Drug use may cause some bipolar symptoms. But this doesn’t mean the patient doesn’t have bipolar disorder. In fact, they may be ‘self medicating’ their symptoms.

Bipolar Disorder Treatment

Bipolar Disorder can be effectively treated, but there is always a chance it will re-occur. That is why at the London Psychiatry Centre we encourage our patients to practice ongoing awareness, and we are always available should they need any further help. The major goals of treatment are to:

  • Treat and reduce the severity of acute episodes of mania or depression when they occur
  • Reduce the frequency of episodes
  • Avoid the cycling from one phase to another
  • Improve the patient’s overall quality of life

An important aspect of treatment is to determine what might have triggered a bipolar episode and work at minimising its negative impact. At the Centre, we work with the patient to identify key emotional triggers and anything that might interfere with the treatments prescribed.

Drugs Used in Bipolar Disorder
  • Lithium – Lithium has been used for years for Bipolar Disorder. It remains the most common drug for people with pure mania characterised by euphoria and pure depression
  • Anti-seizure Drugs – such as Valproate (valproic acid) carbamazepine (Tegretol, Carbatrol, Equetro), oxcarbazepine (Trileptal), and lamotrigine (Lamictal). These drugs might be an alternative for people who do not respond well to lithium, particularly those with substance abuse problems
  • Atypical Anti-psychotics – Drugs known as atypical anti-psychotics are used to treat schizophrenia and also have mood stabilising properties that help treat Bipolar Disorder. They may be used either alone or in combination with lithium or valproate
  • Anti-depressants – Anti-depressant drugs (SSRIs) like fluoxetine (Prozac) and Effexor are not typically used in treating bipolar disorder as they can trigger manic or mixed episodes. Recent studies have shown that exposure to anti-depressants in bipolar patients produces worse long-term outcomes than no treatment. This is known as mood destabilisation.
Non-Medical Treatments

In addition to medical treatments, psychotherapy and sleep management are also parts of Bipolar Disorder treatment. They can help reduce symptoms and prevent relapse.
If you think you or a loved one may be suffering from Bipolar Disorder, please contact us. The London Psychiatry Centre is home to the UK’s leading affective disorder experts who can correctly diagnose bipolar disorders and offer suitable treatment programmes.

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Depressive Disorders

Trying to cope amidst a chronic feeling of low mood, physical tiredness or extreme anxiety. Persistent bad feelings about oneself and life in general are draining, unhelpful and most importantly, not your fault.

If you have been struggling with Depression, know that there is something that can be done about it. At the London Psychiatry Centre, we are experts in tackling this condition. With the right help, you can feel better.

What is Depression?

Major Depressive Disorder, often referred to as ‘Clinical Depression’ is a type of mood disorder. It can vary in its severity and precise patterns from person to person but there are common symptoms that psychiatrists have identified.

Depression is sometimes an overused term. People may say they ‘feel depressed’ when referring to a passing low mood; at the end of a holiday or after Christmas for instance. However, actually being depressed in the clinical sense is something quite different.

Clinical Depression (Major Depressive Disorder) can be incredibly disorientating and debilitating. It can affect a person physically, mentally and emotionally. It can drain your energy, making it literally difficult to get out of bed. It can get in the way of your ability to work, sleep, and enjoy close relationships. It is real, and quite complex. It is not something you ‘choose’ to have, nor something you can simply ‘snap out of’.

Depression Symptoms: Am I Depressed?

It can be difficult to identify when you are suffering with Depression because the condition lowers self-esteem and feelings of confidence in your own judgment. Ironically, you may be more likely to think you’re ‘making a fuss about nothing’ at a time when you most need help.

To assist you, we’ve listed some of the common symptoms of Depression here. Though remember, Depression affects different people in different ways. You most probably won’t have experienced all of these symptoms. On the other hand, you may have suffered other symptoms not included on the list.

If you are suffering from Depression, you may be likely to:

  • Experience a low mood for extended periods of time
  • Lose your ability to enjoy life – even activities you used to love, such as hobbies
  • Feel difficulty in connecting and enjoying spending time with people, even those closest to you. Sometimes Depression sufferers can even lose their ability to feel love for family and friends.
  • Suffer with anxiety. This can be extremely troubling, sometimes even more so than the low mood. It can at times make everyday activities almost impossible.
  • Have problems with your appetite. Many people struggle to eat enough when they are depressed. Or others may comfort eat to try to counteract negative emotions.
  • Experience disturbed sleep patterns. Some people sleep more when they are depressed. Others suffer with problems getting to sleep at night, followed by a tendency to wake very early.
  • Be preoccupied with the past, often with a sense of regret or guilt
  • Find it difficult or even impossible to concentrate
  • Be irritable
  • Suffer with poor short-term memory or a sense of absent-mindedness
  • Avoid socialising
  • Experience a sense of dread or hopelessness about the future

Depression is also bad for physical health. We know, for example, that the risk of suffering a heart attack, or some other serious medical problem, is significantly increased by the presence of Depression.

To make matters even more challenging, Depression is a condition which is often misunderstood. Sometimes even the people who love you the most don’t understand why you’re feeling so bad. They may wonder why you don’t seem to want to socialise, or you may be slow to get in touch. They may even become frustrated. Sadly, this can leave a sufferer feeling even more alone, and with a heightened sense of guilt.

What causes Depression?

The roots of depression are complex. It is often a combination of problems and stresses in life, along with particular traits in an individual’s personality (for example a tendency to be overly self-critical). Traumas and life changes can be contributing factors – a marital breakdown or a difficult boss for example. At times loss can trigger Depression; loss of a child, spouse, or a role in life perhaps. Sometimes a genetic predisposition is also responsible for Depression.

How common is Depression?

Depression is the third most common reason for a visit to the GP in Britain. It is the most common psychiatric disorder by far. At any given point, it is estimated that 1 in every 10 people is living with depression or anxiety. Almost 1 in every 5 people will suffer an episode of Depression in the course of their lifetime, and around two thirds of adults will experience a depressed mood significant enough to interfere with their normal life. Women are around twice as likely as men to be depressed.

What are the treatments for Depression?

There are a number of different treatments available for Clinical Depression. Since Depression can be such a complex condition, different interventions may work for different people, and often, a combination is appropriate.

This is why, at The London Psychiatry Centre, we take an integrated approach to your recovery, assessing every patient as a complex individual in their own right. Our approach can encompass Cognitive Behavioural Therapy, Counselling and Psychotherapy, Personal Training, Medication and Nutrition. Furthermore, we are now the first clinic in the UK able to offer patients the new world-leading, evidence-based treatment for Depression; Repetitive Transcranial Magnetic Stimulation (rTMS).

With the right help, you can feel better.

Here we’ll discuss each intervention briefly in turn, in order to give you more of an idea of how they work.

Antidepressant medications

There are different ‘families’ of antidepressants. In recent years, ‘selective serotonin reuptake inhibitors’ (SSRIs) have become widely used. These drugs work to help keep serotonin in your system for longer, regulating the ‘feel good’ chemicals in the brain. Many patients report favourable results with these medications, but a significant proportion show no significant response. Still others are unable to tolerate the side effects that often accompany
them, such as sexual dysfunction, stomach problems, disturbed sleep and so on. In any case, antidepressant medications are shown to work better long-term in conjunction with psychotherapy than as a sole solution.

Psychotherapy (including Cognitive Behavioural Therapy)

There are a number of different approaches to ‘talking therapies’ and here at The London Psychiatry we cover a variety of approaches to address the individual needs of our patients. As one of the leading centres in the UK, we particularly favour approaches with strong evidences bases, such as Cognitive Behavioural Therapy; but we do also work with a number of other disciplines as appropriate. Our specialists are experts in their fields, and when you come to us for assessment we will talk with you in depth, to help determine which approach is best for you.

In any case, all talking therapies are concerned with uncovering and identifying unhelpful thought and behaviour patterns, releasing negative feelings, and developing new, positive strategies for dealing with life’s challenges. Other approaches to tackling Depression, such as treatment with medication, tend to fare better when combined with some element of talking therapy. Conversely, talking therapies often tend to have higher rates of recovery when combined with medication.

However, there are still a significant proportion of sufferers who do not respond to either medication or psychotherapy. For those persons, and people who choose not to take those routes, The London Psychiatry Centre is now able to offer rTMS. A highly effective, leading-edge treatment for Depression, rTMS offers a solution without the side effects associated with medications.

Repetitive Transcranial Magnetic Stimulation (rTMS)

rTMS is a pioneering treatment, proven in extensive research and many thousands of patient cases to be a safe and highly effective intervention to beat Depression. It works with your body’s own natural resources through the use of magnetic energy to stimulate the brain, improving brain chemistry and helping you to feel more balanced and positive.

Depression treatment with rTMS is non-invasive, highly-effective and provides long-lasting results. It comes without the many side effects often linked to medication, such as stomach problems, disturbed sleep, exhaustion or even heart problems. For many patients who have found antidepressants to offer insufficient relief, rTMS has made the difference.

On par with the world-famous Mayo Clinic, John Hopkins and Harvard’s McLean Hospital in the US, The London Psychiatry Centre is the only centre in Britain able to offer the treatment. To find out more about this leading-edge solution for Depression, visit our rTMS page.

Important complementary components: Exercise and Nutrition

Studies on both sides of the Atlantic have shown the value of regular exercise and smart nutrition in helping to tackle Depression.

When we exercise, our bodies release endorphins, helping to stabilise energy levels, relieve anxiety and improve mood. In a similar vein, science has shown certain foods to be good for the brain; sometimes informally referred to as ‘brain foods’. Other foods contain a lot of synthetic chemicals or sugars, causing spikes in glucose levels, which can have a negative effect on energy levels and our brain’s ability to regulate mood. Combining the right foods, at the right times of the day, can help to create balance.

Here at The London Psychiatry Centre, our wide variety of in-house experts enables us as a clinic to take an integrated approach to your treatment. Along with medication, psychotherapy or rTMS, we can also provide personal training and nutritional planning wherever appropriate. No two people are the same, so here at The London Psychiatry Centre, no two treatment plans are exactly the same. Tailored care that fits you – that is our philosophy.

Milder and less frequent forms of Depression

Dysthymia

Dysthymia is a mood disorder consisting of chronic depression but with less severity than Major Depressive Disorder. Chronic depression is diagnosed when a person has a prolonged period of repeated mild depression.

If you are battling this condition, it is possible you may have become used to feeling significantly low, and be reticent about seeking medical help. But the truth is, you do deserve to be enjoying life and reaching your potential. We can help you to achieve recovery with therapy and medication.

Depressive Disorder Not Otherwise Specified

This is a common phrase for other types of mild depression with some similar symptoms to the above mentioned categories, but that don’t fall into them fully.

Depressive disorders can affect people of all ages and from all walks of life and circumstances. If you or someone you know is suffering from a depressive disorder, book an appointment with one of our experts. Our skilled practitioners treat all kinds of depressive illnesses. We will do everything possible to help you recover and enjoy the best life has to offer.

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Panic Attacks get the Facts

Get the facts:

Your options:

Take medicines for panic disorder.
Don’t take medicines. Try home treatment and counselling to deal with your symptoms.
Key points to remember
Two types of medicines work well for treating panic attacks. Benzodiazepines can help you feel better right away. You can take antidepressants for long-term treatment.

Counselling may work just as well as medicines.
If you take medicines, follow your doctor’s directions with care. You may have side effects such as headaches or trouble sleeping. Some medicines can treat both depression and panic attacks.

For some people, taking medicines along with getting counselling works best.
Don’t feel bad about taking medicines. Panic disorder is a medical problem, not a weakness. The medicines won’t change your personality.

Compare your options:
Compare
Take medicines for panic disorder Don’t take medicines
What is usually involved?
For antidepressants, you take pills or liquids every day or on certain days of the month, for months or years.
For benzodiazepines, you take pills or liquids as needed.
You may also try counselling along with taking medicine.
You try counselling, such as cognitive-behaviour therapy, to control your symptoms.

What are the benefits?
Medicines for panic disorder work well.
Counselling works as well as medicine for many people who have panic disorder.
You don’t have side effects from taking medicine.

What are the risks and side effects?
Medicine may cause side effects such as:
Nausea.
Headaches.
Nervousness.
Tiredness.
Trouble sleeping.

Benzodiazepines can lead to addiction. (Antidepressants do NOT lead to addiction.)
Your panic disorder may get worse if you have no treatment.
Personal stories about people deciding whether to take medicine to treat panic disorder

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

As an executive, I have to travel a lot for my job. A few months ago, I was boarding a plane for a business trip, and I began to feel very apprehensive. I felt trapped and got off the plane because I was shaking and sweating and my heart was pounding. I wasn’t sure exactly what was wrong, but I felt like I was dying. I had a drink at the bar and was still shaky but took a later flight. After that I began to feel nervous if I even thought about flying, and I had several more similar attacks. Then I had an attack on the subway. I felt like everyone was watching me and there was no escape. I didn’t even want to go to the office after that because I was afraid I could have an attack at any moment. My doctor says I have panic disorder and agoraphobia. I can hardly function, so I am going to take antidepressants and try exposure therapy. My doctor says a benzodiazepine would make the symptoms go away sooner. But I am worried they will make me too drowsy and they may be too hard for me to quit.
Manuel, age 43

I was having lunch with some friends and suddenly began to feel strange—like I couldn’t breathe and my heart was pounding. I didn’t know what was happening; I thought I was having a heart attack. Although the symptoms began to go away after about 10 minutes, I went to the emergency room, where they did some tests and didn’t find anything wrong. A week later, the same thing happened in the middle of the night. I went to see my doctor, and she suggested I may have had a panic attack. Since then, the attacks have been occurring at least once a week, and I have been diagnosed with panic disorder. Although each attack is still a horrible experience, I now know what is happening and that I will get through it. I have been going to therapy for several weeks and am learning how to deal with the symptoms of panic attacks. They are less frequent now and less intense. I think I can get through this without taking any medicine.
Annie, age 32

When I divorced my wife, Celia, I began to feel down and very anxious. As a contractor, I have to deal with people every day, and it seemed very hard to do my job when I felt so stressed out and depressed. I had my first panic attack when my dog got lost at a job. I knew he was probably fine and would soon come back, but with the stress of everything else it just seemed like more than I could handle. I felt awful; I was choking and had bad stomach cramps. Since then, I have had attacks like this nearly every day and a lot of the time I feel down in the dumps. I have been diagnosed with panic disorder and depression. I am going to therapy, and it seems to help a little, but I still have panic attacks and often feel like life is not worth living, and I feel anxious about interacting with people at all. At first I didn’t want to take any medicine. But after reading about it and talking it over with my doctor, I decided to start taking an antidepressant.
Louis, age 28

WHAT MATTERS MOST TO YOU:
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take medicines for panic disorderReasons not to take medicines for panic disorder
I am willing to take medicine for at least several months, or longer if I need to.I don’t want to take medicines if at all possible.

More importantEqually important More important
My panic disorder is not improving enough with counselling alone.I want to continue counselling, without medicine, at least for a while.

More importantEqually important More important
I think my symptoms may be worse than the possible side effects of the medicine.I think the side effects of the medicine would be worse than my symptoms.

More importantEqually important More important
My other important reasons:My other important reasons:

YOUR DECISION:
Where are you leaning now?
Now that you’ve thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Taking medicines NOT taking medicines
Leaning toward Undecided Leaning toward.

WHAT ELSE DO YOU NEED TO MAKE YOUR DECISION:
Check the facts
1. Taking medicine is the only way I can treat my panic disorder.
True
False
I’m not sure
2. There are two different kinds of medicines that I can take to help my panic disorder.
True
False
I’m not sure

Decide what’s next
1.
Do you understand the options available to you?
Yes No
2.
Are you clear about which benefits and side effects matter most to you?
Yes No
3.
Do you have enough support and advice from others to make a choice?
Yes No

Certainty
1. How sure do you feel right now about your decision?
Not sure at allSomewhat sure Very sure
2. Check what you need to do before you make this decision.
I’m ready to take action.
I want to discuss the options with others.
I want to learn more about my options.
3. Use the following space to list questions, concerns, and next steps.
Your Summary:

Here’s a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Your decision
Next steps
Finishing all the steps will help you make the best decision. You can skip steps if you want, but your summary page won’t be complete. Answer question >
Which way you’re leaning
Finishing all the steps will help you make the best decision. You can skip steps if you want, but your summary page won’t be complete. Answer question >
How sure you are
Finishing all the steps will help you make the best decision. You can skip steps if you want, but your summary page won’t be complete. Answer question >
Your knowledge of the facts
Getting ready to act
What matters to you…

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BIPOLAR: How it can impact the ability to maintain a job and how we help

There are several typical concerns that many job seekers have, such as conflict with co-workers or a supervisor and being overworked and underpaid. But for those dealing with a bipolar diagnosis, being able to cope effectively with these concerns, among others, can make the difference as to whether the young adult is able to maintain a job.
While on the job search, we ask our participants to consider a few things before deciding on where to apply. We specifically ask them to consider the work environment, schedule, and potential stress level of the position and how shifts in mood, energy, behaviors, and thinking will affect his or her ability to cope with these.

Aside from the job being a good fit with interest areas and desired career path, we want each participant to get an idea as to whether the job’s environment will likely be a fit for them as an individual. We often utilize online reviews, word of mouth, and Google searches to find out about work conditions at the companies they are considering.

We use this information to help determine whether the environment will be potentially supportive or harmful. It is important for each participant to know how they work best. Is it a busy, fast-paced environment or something more quiet and relaxed? To determine a participant’s best environment fit, we offer in-office career assessments and recommend volunteering as the step prior to obtaining a job. One-time commitments, recurring commitments, and community service all serve to test different environments and structures. The participant then has information to work with in order to make a Wise

Mind decision about pursuing a particular job.
For scheduling, we want participants to secure positions that will have set, structured schedules as opposed to those that have call-in shifts. Schedules that do not change weekly and that do not require staff to stay after hours without advance notice are recommended. This will help with decreasing stress that can trigger a manic episode and negatively impact job performance.

Ideal jobs often include tutoring, office work, after school programs, and certain retail stores and restaurants that hire for specific days and times. We also encourage participants to find work that won’t interfere with sleep routines. Regular sleep routines increase the likelihood of mood stability. For example, working at a movie theater that has late showings and overnight jobs would not be conducive to balanced sleep.

We generally want our participants to lead balanced lives, and stress on the job can negatively impact this balance. We research jobs that have stressors like last minute deadlines, unclear job descriptions, and no consistency. Commission-based jobs in retail or telemarketing or fast paced jobs like busy coffee shops are not typically the best match.

We also recommend a part-time job when participants are adjusting to medications and that the young adult has open communication with his or her therapist and psychiatrist about changes in mood. We do weekly check-ins with the option to increase or decrease hours worked to ensure that each participant is getting the needed support.

Once participants have a list of locations to apply to, we talk about the applications and the interview. We recommend that participants not disclose too much personal information about medical history on the application or in the interview to ensure they being hired based on their experiences without judgment. We also encourage participants to read employee handbooks front to back to ensure they know about time-off policies in the event they need to take some self-care days.

We have had success with participants with bipolar and the job search process, even when a young adult has experienced difficulties or failures with the process in the past. Our approach to finding the appropriate fit for the unique needs of the young adult, rather than the first job that comes up, continues to be the key to success.

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Bipolar Disorder And Medication Compliance In Young Adults

Living with Bipolar Disorder can often feel like a roller coaster ride with the highs of mania and the lows of depression. In addition, there are also the twists and turns on that ride based on a person’s environment, including stressors, coping skills, support system, and lifestyle. While some people go to amusement parks, ride roller coasters and go home, others are left to ride this intense, often emotionally dysregulating mental health roller coaster throughout their entire lives. The good news is, there interventions that allow young adults with bipolar disorder to experience relief, more balance, and the potential for a more stable and productive life. Let’s begin by looking at the two main types of Bipolar Disorder.
BIPOLAR 1 vs. BIPOLAR 2
For some, the lows feel as though the floor beneath them is falling out, like they are free-falling from 1000ft in the air. Meanwhile, the highs provide a thrill of a lifetime (manic episode) that they never want to end. This is referred to as Bipolar 1.
For others, the ride is relatively smooth with just a couple of peaks and valleys, and this experience is often referred to as Bipolar 2.

REGULATING THE ROLLER COASTER

In my experience working at OPI’s residential treatment program with young adults dealing with Bipolar Disorder, medication provides a huge benefit in helping stabilize mood and creating a smoother ride throughout life.
There are a few difficulties that we see when it comes to medication compliance and this particular disorder, meaning that young adults aren’t always gung-ho about taking a daily medication in order to feel “normal” and regulated. Further, many of them report feeling like “guinea pigs,” having tried numerous medications over the years only to find that the side-effects outweighed the benefits, if any. At OPI, we overcome this issue by offering GeneSight, a painless cotton swab to the inside of the cheek that allows us to perform genetic testing. GeneSight helps take the guesswork out of which medications will likely have the most benefits and least side effects for the young adult in a very individualized way, based on his or her unique DNA.
Another common resistance to taking medication for Bipolar Disorder is that most people are used to taking a medication to treat a symptom or illness and then stop once the condition has resolved. For many people diagnosed with Bipolar Disorder, accepting not only the fact that they have this diagnosis but also the fact that they may need to be on medication for the rest of their life is a very difficult pill to swallow (no pun intended). In addition, as I was saying before, many people with Bipolar experience the highs of mania to be a thrill. They feel carefree, invincible, and experience a sense of euphoria. Now, who would want to take a pill that takes that incredible feeling away? The unfortunate part is that along with those feelings there also tends to be reckless behavior, poor impulse control, and poor judgment which can have long-term negative effects on someone’s life including one’s job, relationships, and finances.
And what goes up must come down, which means depression is inevitable for people suffering from Bipolar Disorder. Unfortunately, without medication, those lows get lower. Depression is often associated with a decrease in mood, energy level, and interest. It can also make concentration and decision making difficult. Depression impacts not only mood, but also sleep, appetite, and self-esteem and sometimes even leads to suicidal ideations or attempts. Medication helps lessen the severity of depression and creates more stability in a person’s mood.
At OPI’s residential treatment program, we believe in the benefits of medication in treating Bipolar Disorder, but not in medication alone. Our psychiatrists work collaboratively with our participants to help them understand the benefits of medication and the importance of medication compliance. In addition to psychiatry, we provide therapy to assist young adults with learning and understanding their diagnosis so that they can begin to accept it while building healthy coping skills to manage the highs and lows associated with the disorder. We also have a variety of departments to assist them with finding a life path that will fit with their lifestyle and provide them with a sense of joy and stability. While people with Bipolar Disorder cannot completely get off the roller coaster ride of life, they can definitely find a way to slow it down and create a smoother ride.

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