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Passive-aggressive behavior is a pattern of indirectly expressing negative feelings instead of openly addressing them. There’s a disconnect between what a passive-aggressive person says and what he or she does.

For example, a passive-aggressive person might appear to agree — perhaps even enthusiastically — with another person’s request. Rather than complying with the request, however, he or she might express anger or resentment by failing to follow through or missing deadlines.

Specific signs of passive-aggressive behavior include:
•Resentment and opposition to the demands of others
•Procrastination and intentional mistakes in response to others’ demands
•Cynical, sullen or hostile attitude
•Frequent complaints about feeling underappreciated or cheated

Although passive-aggressive behavior can be a feature of various mental health conditions, it isn’t considered a distinct mental illness. However, passive-aggressive behavior can interfere with relationships and cause difficulties on the job. If you’re struggling with passive-aggressive behavior — or you think a loved one is — consider consulting a therapist.

What’s the difference between mental health and mental illness? Sometimes the answer is clear, but often the distinction between mental health and mental illness isn’t so obvious. For example, if you’re afraid of giving a speech in public, does it mean you have a mental health condition or a run-of-the-mill case of nerves? Or, when does shyness become a case of social phobia?

Here’s help understanding how mental health conditions are identified.

Why is it so tough to tell what’s normal?

It’s often difficult to distinguish normal mental health from mental illness because there’s no easy test to show if something’s wrong. Also, primary mental health conditions can be mimicked by physical disorders. Mental health conditions are judged not to be due to a physical disorder and are diagnosed and treated based on signs and symptoms, as well as on how much the condition affects your daily life. Signs and symptoms can affect your:
•Behavior. Obsessive hand-washing or drinking too much alcohol might be signs of a mental health condition.
•Feelings. Sometimes a mental health condition is characterized by a deep or ongoing sadness, euphoria or anger.
•Thinking. Delusions — fixed beliefs that are not changeable in light of conflicting evidence — or thoughts of suicide might be symptoms of a mental health condition.

What is the Diagnostic and Statistical Manual of Mental Disorders (DSM)?

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a guide published by the American Psychiatric Association that explains the signs and symptoms of several hundred mental health conditions.

Mental health providers use the DSM to diagnose everything from anorexia to voyeurism and, if necessary, determine appropriate treatment. Health insurance companies also use the DSM to determine coverage and benefits and to reimburse mental health providers.

It can be challenging to help a loved one struggling with alcoholism, drug problems, an eating disorder or other destructive behavior. Sometimes a direct, heart-to-heart conversation can start the road to recovery. But when it comes to addiction, a more focused approach is often needed. You may need to join forces with others and take action through a formal intervention.

People who struggle with addictive behaviors are often in denial about their situation or are unwilling to seek treatment. Often they don’t recognize the negative effects their behavior has on themselves and others. An intervention presents your loved one a structured opportunity to make changes before things get even worse.

What is an intervention?

An intervention is a carefully planned process involving family and friends and sometimes colleagues, clergy members or others who care about a person struggling with addiction. During the intervention, these people gather together to confront the person about the consequences of addiction and ask him or her to accept treatment. The intervention:
•Provides specific examples of destructive behaviors and their impact on the addicted person and loved ones
•Offers a prearranged treatment plan with clear steps, goals and guidelines
•Spells out what each person will do if a loved one refuses to accept treatment

Who might benefit from an intervention?

An intervention can help people who struggle with addictive behaviors but who are in denial about their situation or who have been unwilling to accept treatment. Some examples of behaviors that may warrant an intervention include:
•Alcoholism
•Prescription drug abuse
•Abuse of street drugs
•Eating disorders
•Compulsive gambling

People with addiction often don’t see the negative effects their behavior has on them and others. It’s important not to wait until they “want help.” Instead, think of an intervention as giving your loved one a clear opportunity to make changes before things get really bad.

How does a typical intervention work?

An intervention usually includes the following steps:
1.Planning. A family member or friend proposes an intervention and forms a planning group. It’s best if you consult with an intervention professional (interventionist), a qualified professional counselor or a social worker when planning an intervention. An intervention is a highly charged situation and has the potential to cause anger, resentment or a sense of betrayal. If you have any concerns that the intervention may trigger anger or violent behavior, consult an intervention professional before taking any action.
2.Gathering information. The group members find out about the extent of the loved one’s problem and research the condition and treatment programs. The group may make arrangements to enroll the loved one in a specific treatment program.
3.Forming the intervention team. The planning group forms a team that will personally participate in the intervention. Team members set a date and location and work together to present a consistent, rehearsed message and a structured treatment plan. Do not let your loved one know what you are doing until the day of the intervention.
4.Deciding on specific consequences. If your loved one doesn’t accept treatment, each person on the team needs to decide what action he or she will take. Examples include asking your loved one to move out or taking away contact with children.
5.Writing down what to say. Each member of the intervention team should detail specific incidents where the addiction has resulted in problems, such as emotional or financial issues. Discuss the toll of your loved one’s behavior while still expressing care and the expectation that your loved one can change.
6.The intervention meeting. Without revealing the reason, the loved one is asked to the intervention site. Members of the core team then take turns expressing their concerns and feelings. The loved one is presented with a treatment option and asked to accept that option on the spot. Each team member will say what specific changes they will make if the addicted person doesn’t accept the plan.
7.Follow-up. Involving a spouse, family members or others is critical in helping someone with an addiction stay in treatment and avoid relapsing. This can include changing patterns of everyday living to make it easier to avoid destructive behavior, offering to participate in counseling with your loved one, seeking your own therapist and recovery support, and knowing what to do if relapse occurs.

A successful intervention must be planned carefully to work as intended. A poorly planned intervention can worsen the situation — your loved one may feel attacked and become isolated or more resistant to treatment.

Should you consult a professional for an intervention?

Consulting an intervention professional (interventionist), an addiction specialist, psychologist or mental health counselor can help you organize an effective intervention. It may be a good idea to have the intervention professional attend the actual intervention to help keep things on track.

It’s a good idea to get professional help if your loved one:
•Has a history of serious mental illness
•Has a history of violence
•Has had suicidal behavior or recently talked about suicide
•May be taking several mood-altering substances
•Is in denial, likely to become angry or tends to minimize his or her situation

It’s especially important to consult an intervention professional if you suspect your loved one may react violently or self-destructively.

If you’ve never seen a mental health provider before, you may not know how to find one who suits your specific needs. Here are some points to keep in mind as you search for a mental health provider.

What type of mental health provider do you need?

Mental health providers are professionals who diagnose mental health conditions and provide treatment. Most have either a master’s degree or more advanced education and training. Be sure that the mental health provider you choose is licensed to provide mental health services. Services offered depend on the provider’s training and specialty area.

Below you’ll find some of the most common types of mental health providers. Some may specialize in certain areas, such as depression, substance misuse or family therapy. They may work in different settings, such as private practice, hospitals, community agencies or other facilities.

Psychiatrist

A psychiatrist is a physician — doctor of medicine (M.D.) or doctor of osteopathic medicine (D.O.) — who specializes in mental health. This type of doctor may further specialize in areas such as child and adolescent, geriatric, or addiction psychiatry. A psychiatrist can:
•Diagnose and treat mental health disorders
•Provide psychological counseling, also called psychotherapy
•Prescribe medication

Psychologist

A psychologist is trained in psychology — a science that deals with thoughts, emotions and behaviors. Typically, a psychologist holds a doctoral degree (Ph.D., Psy.D., Ed.D.). A psychologist:
•Can diagnose and treat a number of mental health disorders, providing psychological counseling, in one-on-one or group settings
•Cannot prescribe medication unless he or she is licensed to do so
•May work with another provider who can prescribe medication if needed

Psychiatric-mental health nurse

A psychiatric-mental health nurse (P.M.H.N.) is a registered nurse with training in mental health issues. A psychiatric-mental health advanced practice registered nurse (P.M.H.-A.P.R.N.) has at least a master’s degree in psychiatric-mental health nursing. Other types of advanced practice nurses able to provide mental health services include a clinical nurse specialist (C.N.S.), a certified nurse practitioner (C.N.P) or a doctorate of nursing practice (D.N.P.). Mental health nurses:
•Vary in the services they can offer, depending on their education, level of training, experience and state law
•Can assess, diagnose and treat mental illnesses, depending on their education, training and experience
•Can — if state law allows — prescribe medication if they’re an advanced practice nurse

Physician assistant

A certified physician assistant (P.A.-C.) practices medicine under the supervision of a physician. Physician assistants can specialize in psychiatry. These physician assistants can:
•Diagnose and treat mental health disorders
•Provide psychological counseling, also called psychotherapy
•Prescribe medication

Licensed clinical social worker

If you prefer a social worker, look for a licensed clinical social worker (L.C.S.W.) with training and experience specifically in mental health. A licensed clinical social worker must have a master’s degree in social work (M.S.W.), a Master of Science in social work (M.S.S.W.) or a doctorate in social work (D.S.W. or Ph.D.). These social workers:
•Provide assessment, psychological counseling and a range of other services, depending on their licensing and training
•Are not licensed to prescribe medication
•May work with another provider who can prescribe medication if needed

Licensed professional counselor

Training required for a licensed professional counselor (L.P.C.) may vary by state, but most have at least a master’s degree with clinical experience. These counselors:
•Provide diagnosis and psychological counseling (psychotherapy) for a range of concerns
•Are not licensed to prescribe medication
•May work with another provider who can prescribe medication if needed

What factors should you consider?

Consider these factors when choosing among the various types of mental health providers:
•Your concern or condition. Most mental health providers treat a range of conditions, but one with a specialized focus may be more suited to your needs. For example, if you have an eating disorder, you may need to see a psychologist who specializes in that area. If you’re having marital problems, you may want to consult a licensed marriage and family therapist. In general, the more severe your symptoms or complex your diagnosis, the more expertise and training you need to look for in a mental health provider.
•Whether you need medications, counseling or both. Some mental health providers are not licensed to prescribe medications. So your choice may depend, in part, on your concern and the severity of your symptoms. You may need to see more than one mental health provider. For example, you may need to see a psychiatrist to manage your medications and a psychologist or another mental health provider for counseling.
•Your health insurance coverage. Your insurance policy may have a list of specific mental health providers that are covered or only cover certain types of mental health providers. Check ahead of time with your insurance company, Medicare or Medicaid to find out what types of mental health services are covered and what your benefit limits are.

Stigma is when someone judges you based on a personal trait. Unfortunately, this is a common experience for people who have a mental health condition. Stigma may be obvious and direct, such as someone making a negative remark about your mental illness or your treatment. Or it may be subtle, such as someone assuming you could be unstable, violent or dangerous because you have a mental health condition. You may even judge yourself. Some of the harmful effects of stigma can include:
•Lack of understanding by family, friends, colleagues or others you know
•Discrimination at work or school
•Difficulty finding housing
•Bullying, physical violence or harassment
•Health insurance that doesn’t adequately cover your mental illness
•The belief that you will never be able to succeed at certain challenges or that you can’t improve your situation

Steps to cope with stigma

Here are some ways you can deal with stigma:
•Get treatment. You may be reluctant to admit you have a condition that needs treatment. Don’t let the fear of being “labeled” with a mental illness prevent you from seeking help. Treatment can provide relief by identifying what’s wrong in concrete terms and reducing symptoms that interfere with your work and personal life.
•Don’t let stigma create self-doubt and shame. Stigma doesn’t just come from others. You may have the mistaken belief that your condition is a sign of personal weakness, or that you should be able to control it without help. Seeking psychological counseling, educating yourself about your condition and connecting with others with mental illness can help you gain self-esteem and overcome destructive self-judgment.
•Don’t isolate yourself. If you have a mental illness, you may be reluctant to tell anyone about it. Have the courage to confide in your spouse, family members, friends, clergy or other members of your community. Reach out to people you trust for the compassion, support and understanding you need.
•Don’t equate yourself with your illness. You are not an illness. So instead of saying “I’m bipolar,” say “I have bipolar disorder.” Instead of calling yourself “a schizophrenic,” call yourself “a person with schizophrenia.” Don’t say you “are depressed.” Say you “have clinical depression.”
•Join a support group. Some local and national groups, such as the National Alliance on Mental Illness (NAMI) offer local programs and Internet resources that help reduce stigma by educating people with mental illness, their family members and the general public. A number of state and federal agencies and programs also offer support for people who have mental health conditions. Examples include agencies such as Vocational Rehabilitation and Veterans Affairs (VA).
•Get help at school. If you or your child has a mental illness that affects learning, find out what plans and programs might help. Discrimination against students because of a mental health condition is against the law, and educators at primary, secondary and college levels are required to accommodate students as best they can. Talk to teachers, professors or administrators about the best approach and available resources. If a teacher doesn’t know about a student’s disability, it can lead to discrimination, barriers to learning and poor grades.
•Speak out against stigma. Express your opinions at events, in letters to the editor or on the Internet. It can help instill courage in others facing similar challenges and educate the public about mental illness.

Others’ judgments almost always stem from a lack of understanding rather than information based on the facts. Learning to accept your condition and recognize what you need to do to treat it, seeking support, and helping educate others can make a big difference.

http://www.bipolar4lifesupport.co

Bipolar disorder and alcoholism often occur together. Up to half the people who have bipolar disorder also struggle with alcoholism.

Although the association between bipolar disorder and alcoholism isn’t clearly understood, these factors likely play a role:
•Inherited traits. Genetic differences appear to affect brain chemistry linked to bipolar disorder. These same traits may also affect the way the brain responds to alcohol and other drugs, increasing the risk of alcoholism and addiction to other drugs.
•Depression and anxiety. Some people drink to ease depression, anxiety and other symptoms of bipolar disorder. Drinking may seem to help, but in the long run it makes symptoms worse. This can lead to more drinking — a vicious cycle that’s difficult to overcome.
•Mania. This upswing from depression is usually characterized by an intensely elated (euphoric) mood and hyperactivity. It commonly causes bad judgment and lowered inhibitions, which can lead to increased alcohol use or drug abuse.

Bipolar disorder and alcoholism or other types of substance abuse can be a dangerous combination. Each can worsen the symptoms and severity of the other. Having both conditions increases the risk of mood swings, depression, violence and suicide.

Someone who has both bipolar disorder and alcoholism or another addiction is said to have a dual diagnosis. Treatment may require the expertise of mental health care providers who specialize in the treatment of dual disorders.

If you’ve lost control over your drinking or you abuse drugs, get help before your problems become worse and harder to treat. Seeing a mental health expert right away is especially important if you also have signs and symptoms of bipolar disorder or another mental health condition.

http://www.bipolar4lifesupport.co

RESULTS

Light therapy probably won’t cure seasonal affective disorder, depression or other conditions. But it may ease symptoms, increase your energy levels, and help you feel better about yourself and life.

Light therapy can start to improve symptoms within just a few days. In some cases, though, it can take two or more weeks.

Getting the most out of light therapy
Light therapy isn’t effective for everyone. But you can take steps to get the most out of your light therapy and help make it a success.
•Get the right light box. Do some research and talk to your doctor before buying a light therapy box. That way you can be sure your light box is safe, the right brightness, and that its style and features make it convenient to use.
•Be consistent. Stick to a daily routine of light therapy sessions to help ensure that you maintain improvements over time. If you simply can’t do light therapy every day, take a day or two off, but monitor your mood and other symptoms — you may have to find a way to fit in light therapy every day.
•Time it right. If you interrupt light therapy during the winter months or stop too soon in the spring when you think you’re improving, your symptoms could return.
•Include other treatment. If your symptoms don’t improve enough with light therapy, you may need additional treatment. Talk to your doctor about other treatment options, such as psychotherapy or antidepressants.

http://www.bipolar4lifesupport.co

Starting light therapy

Generally, most people with seasonal affective disorder begin treatment with light therapy in the early fall, when it typically becomes cloudy in many regions of the country. Treatment usually continues until spring, when outdoor light alone is sufficient to sustain a good mood and higher levels of energy.

If you typically have fall and winter depression, you may notice symptoms during prolonged periods of cloudy or rainy weather during other seasons. You and your doctor can adjust your light treatment based on the timing and duration of your symptoms.

If you want to try light therapy for nonseasonal depression or another condition, talk to your doctor about how light therapy can be most effective.

During light therapy

During light therapy sessions, you sit or work near a light box. To be effective, light from the light box must enter your eyes indirectly. You can’t get the same effect merely by exposing your skin to the light. While your eyes must be open, don’t look directly at the light box, because the bright light can damage your eyes. Be sure to follow your doctor’s recommendations and the manufacturer’s directions.

Three key elements for effective light therapy

Light therapy is most effective when you have the proper combination of duration, timing and light intensity:
•Duration. When you first start light therapy, your doctor may recommend treatment for shorter blocks of time, such as 15 minutes. You gradually work up to longer periods. Eventually, light therapy typically involves daily sessions ranging from 30 minutes to two hours, depending on your light box’s intensity.
•Timing. For most people, light therapy is most effective when it’s done early in the morning, after you first wake up. Your doctor can help you find the light therapy schedule that works best.
•Intensity. The intensity of the light box is recorded in lux, which is a measure of the amount of light you receive at a specific distance from a light source. Light therapy boxes usually produce between 2,500 lux and 10,000 lux. The intensity of your light box affects how far you sit from it and the length of time you need to use it. A 10,000-lux light box usually requires 30-minute sessions, while a 2,500-lux light box may require two-hour sessions.

Finding time for light therapy

Light therapy requires time and consistency. You can set your light box on a table or desk in your home or office. That way you can read, use a computer, write, watch TV, talk on the phone or eat while having light therapy. But stick to your therapy schedule and don’t overdo it.

Some light boxes are even available as visors that you can wear, although their effectiveness isn’t proved.

How you can Prepare:

Although it’s possible to do light therapy on your own, it’s best to ask your doctor or mental health provider if it’s a good option for you. Also ask whether you need to take any special precautions. This guidance can help you get the most benefit and minimize possible side effects.

Internet retailers, drugstores and even some hardware stores offer a variety of light therapy boxes. Or your doctor may recommend a particular light therapy box. Health insurance companies rarely cover the cost.

Talk with your doctor about the best light therapy box for you, and familiarize yourself with the variety of features and options to help ensure that you buy a high-quality product that’s safe and effective.

http://www.bipolar4lifesupport.co

Risks
By Mayo Clinic Staff

Light therapy is generally safe. If side effects occur, they’re usually mild and short lasting. They may include:
•Eyestrain
•Headache
•Nausea
•Irritability or agitation
•Mania, euphoria, hyperactivity or agitation associated with bipolar disorder

When side effects do occur, they may go away on their own within a few days of starting light therapy. You also may be able to manage side effects by reducing treatment time, moving farther from your light box, taking breaks during long sessions or changing the time of day you use light therapy. Talk to your doctor for additional advice, or if side effects don’t go away or get worse.

When to use caution

It’s always a good idea to talk to a doctor before starting light therapy, but it’s especially important if:
•You have a condition that makes your skin especially sensitive to light, such as systemic lupus erythematosus
•You take medications that increase your sensitivity to sunlight, such as certain antibiotics, anti-inflammatories or the herbal supplement St. John’s Wort
•You have an eye condition that makes your eyes vulnerable to light damage
•You have a history of skin cancer

Ultraviolet light

Light therapy boxes should be designed to filter out harmful ultraviolet (UV) light, but some may not filter it all out. This type of light can cause skin and eye damage. Look for a light therapy box that emits as little UV light as possible. If you have concerns about light therapy and your skin, talk to your dermatologist.

Tanning beds: Not an alternative to light therapy

Some people claim that tanning beds help ease seasonal affective disorder symptoms. But this hasn’t been proved to work. Visible light, not the UV light released by tanning beds, is used in light therapy. The type of light released by tanning beds can damage your skin and increase your risk of skin cancer.

Caution for bipolar disorder

Light therapy may trigger mania in some people with bipolar disorder. If you have any concerns about how light therapy may be affecting your mood or thoughts, seek help right away.