Bipolar4LifeSupport Blog

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Twenty percent of Americans take three or more prescriptions each month; you might be among them if you’re managing a mental illness such as depression or schizophrenia. Between these drugs and ones you may be taking for other conditions (such as allergies) — as well as vitamins or supplements that your doctor has recommended — it’s a lot to keep track of. Here are some strategies for managing it all.

Make Sure You Have a Consolidated View of Your Medications

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Create a list of all the medications you currently take, both prescription and nonprescription. Include antidepressants, vitamins, herbal supplements, patches, inhalers, and prescription creams — everything! For each medication, record why you’re taking it along with how much and when to take it. Also record any important food or drug interactions, and any special instructions (such as if the medication should be taken with food). If you’re working closely with a pharmacist, she can help you put together this list. Post a printout where you keep your prescriptions and email a copy to a friend or family member, as well as to your primary care physician. Then set a reminder in your calendar to check the list every few months to ensure it’s up to date.

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• Choose a Pharmacy That Looks Out for You

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  Filling all of your prescriptions in one place is not only more convenient for you, it can also give your pharmacist a single view of your current and past medications. Having this information makes her a healthcare ally by enabling her to alert you to any potential side effects or drug interactions between medications prescribed by different doctors. She can also help you set up automatic refills so you never run out of a medication.

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  Create Reminders

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  Sometimes you can get so busy or fatigued that you forget to refill or take a medication. That’s where technology can help. Use a computer or smartphone calendar to set up recurring alerts to help you remember when it’s time for a refill or dose. The best option? Download PillPack’s medication reminder app.

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  Let Your Pharmacy Do the Work

  Sponsored by PillPack

  PillPack is a full-service online pharmacy that delivers — in all senses of the word. PillPack will mail your prescriptions (as well as vitamins, supplements, and over-the-counter medications) right to your door, automatically and on time. Your medications arrive pre-sorted and grouped by the date and time you’re to take them, in clearly labeled packets that include images of your medications, so you’re sure about which drugs you’re taking. Now you can stop manually sorting your medications into plastic pill organizers. Just tear off the next pack and you’ll know you’re taking the right doses at the right time.

  PillPack ships your medications for free — with guaranteed on-time delivery — and manages all your refills, offering you all the advantages of using a pharmacy while ensuring that you never again have to stand in line for a prescription. And like your local pharmacy, PillPack is always open. Should you ever have a question, you can contact a PillPack pharmacist — any time of the day or night — for help.

  Best of all, PillPack is free. You’ll pay the same amount as your health plan’s 30-day co-pays for prescriptions, and PillPack is compatible with most insurance plans.

   

Reaching middle age can be satisfying to some and more worrying for others. Find out the signs of a midlife crisis.

Midlife crises are the subject of many jokes — middle-aged men buying sports cars, hanging out at bars, and generally acting half their age. The unfortunate reality is that most midlife crises are anything but funny, and midlife crisis symptoms can be felt by women as well as men.

A midlife crisis can tear a family, a marriage, or an individual apart and leave a lot of victims in its wake. “A person often makes an impulsive decision uncharacteristically or changes their lifestyle dramatically,” says Sheila K. Collins, PhD, a psychotherapist and author of Stillpoint: The Dance of Self-Caring and Self-Healing. “I’ve seen men come to their wives and say without any warning, ‘I’ve decided I don’t want to be married anymore.’”

What You Might Experience During a Midlife Crisis

To the outside observer, the actions taken during a midlife crisis may seem rash or even foolish. But under the surface, a lot of emotions and experiences have been going on for a long time to lead to this moment. A midlife crisis “doesn’t just ‘occur,’” says Penny B. Donnenfeld, PhD, a psychologist in private practice in New York City. “We are talking about the development over time of negative self-assessments — feelings of being limited and burdened by life responsibilities, having limited choices, or of having missed opportunities for choices that are no longer available.”

When it comes to men and midlife crisis, their professional life is often thought to play an important role. “For men, it often happens when they begin to plateau in their careers,” says Dr. Collins. “There begins to be a realization of the limitations of time, talent, and resources on people’s lives. Some questions they ask are, ‘Is this where I was going?’ or, ‘Is this all there is?’”

While people often think of men having a midlife crisis, women can be affected in the same way, adds Collins. “Often, because women more frequently have taken their child-rearing roles into account in their lives, this may have put them 8 to 10 years behind their male peers on the career track,” she says. “Their midlife crisis, if they have one, occurs later.”

Of course, a career is not the only factor when it comes to a midlife crisis. “A midlife crisis could happen when the last child leaves home, or when someone experiences grief over a significant loss — a parent’s death, a career reversal or job loss, or a challenge to their health,” says Collins.

Navigating a Midlife Crisis

If any symptoms of a midlife crisis affect you or your partner, there are options for getting through these challenging circumstances. Here is advice that can help:

• Look on the bright side. “A midlife re-evaluation can be a positive thing,” says Collins. “In fact, it’s probably a good idea for married couples, business partners, and individuals to take time to re-evaluate their lives from time to time throughout their life cycles.”
• Be proactive. Once you have this discussion, it’s time to act on these possibilities and see what new and exciting directions they lead you in. A few options include taking a class, going on a trip, reconnecting with people from the past, or training for a new career, says Donnenfeld.
• Avoid rash decisions. By evaluating things from time to time, people can make gradual, measured changes, as opposed to rash ones that can damage a career, a family, or a life unnecessarily, adds Collins. “Remember, this may be the time to just stand there and do nothing. Let the dust settle until your direction becomes clear,” she advises.
• Be a good listener. If your partner is the one experiencing the crisis, try to really hear and to understand what your loved one is going through. Says Donnenfeld, “Don’t deny their feelings or try to ‘fix’ it immediately.” In the process of talking about the problem, many possible solutions to the midlife crisis may begin to surface. “You may figure out some things that he or she would like to do to help life feel more meaningful,” she says.
• Seek outside help. Finally, remember that there is absolutely no shame in seeing a therapist to talk out issues. Midlife can be a time of great, overpowering emotions, and many a strong man or woman has needed help working their way through these feelings.

It is possible to navigate safely through a midlife crisis. Recognizing the signs and exploring your options are key to moving forward into the next phase of your life.

We have long known that there are strong connections between heart health and mental health. And the connection goes both ways.

Depression commonly develops in patients after they have had a heart attack. In fact, major depression affects as many as 15-20% of patients in the hospital with a heart attack, and milder forms of depression likely occur in many more individuals. Women are most likely to be affected, especially younger women. Having depression after a heart attack makes recovery harder. People with depression may find it harder to take medications regularly, follow up with their care providers, and take care of themselves. Depression clearly increases the risk of being re-hospitalized.

We also know that people with depression develop heart disease at higher rates than people without depression.  A study released this week in the Journal of the American College of Cardiology gives us new information about the links between another important mental health issue, PTSD (post-traumatic stress disorder) and heart disease. A group of researchers at Emory University in Atlanta followed 562 twins from the Vietnam Era Twin Registry. Of the 177 individuals who had PTSD, nearly 1 in 4 developed heart disease. Of the other 425 without PTSD, less than 1 in 10 developed heart disease. The study also compared ‘twin sets,’ particularly those where one twin developed PTSD and the other did not. In such cases, the risk of having heart disease was nearly double the twin with PTSD.

Post-traumatic stress disorder affects as many as 7 million adults in the US alone. It can develop after someone has experienced a traumatic event. In fact, PTSD can even develop after having a major health issue, like a stroke.  People with PTSD continue to feel stressed and afraid even when they are no longer in danger or in the stressful situation. You can read more information about the symptoms and treatment of PTSD here.

As a medical community, we need to be more aware of the risks that mental health conditions pose for our patients. Depression and other mental health concerns affect recovery and treatment of heart disease. But this research also adds to the information that mental health issues may have a direct effect on the heart.

Much work is yet to be done on improving our care of patients with mental health issues. We need better ways to help identify patients who are at risk and we need better methods to treat them. Doing so will no doubt be good for both the mind and the heart.

Emotions that are freely experienced and expressed without judgment or attachment tend to flow fluidly. On the other hand, repressed emotions (especially fearful or negative ones) can zap mental energy and hope and lead to health problems, such as high blood pressure or digestive disorders.

Therefore, it’s important for us to recognize and identify our thoughts and emotions, and to be aware of the impact they have—not only on each other, but also on our bodies, behavior, and relationships. As our awareness increases, we find it easier to recognize what we are thinking, how we are feeling, and our attitude towards the experience. We can then choose to adjust our thoughts and emotional responses.

Negativity and physical health

Chronic stress from negative attitudes and feelings of helplessness and hopelessness can upset the body’s hormone balance and deplete the brain chemicals required for feelings of happiness, as well as have a damaging impact on the immune system. New scientific understandings have also identified the process by which chronic stress can actually decrease our lifespan by shortening our telomeres (the “end caps” of our DNA strands, which play a big role in aging).

Poorly managed or repressed anger (hostility) is also related to a slew of health conditions, such as hypertension, cardiovascular disease, digestive disorders, and infection.

The importance of positivity

Scientist Barbara Fredrickson has shown that positive emotions have two important effects: theybroaden our perspective of the world (thus inspiring more creativity, wonder, and options), and they build up over time, creating lasting emotional resilience and flourishing.

Dr. Fredrickson has spent years researching and publishing the physical and emotional benefits of positivity, including faster recovery from cardiovascular stress, better sleep, fewer colds, and a greater sense of overall happiness. The good news is not only that positive attitudes—such as playfulness, gratitude, awe, love, interest, serenity, and feeling connected to others—have a direct impact on health and wellbeing, but that we can develop them ourselves with practice.

However, in our wish to defend against threat and loss in life, we tend to prioritize bad overgood. While this is a tidy survival mechanism for someone who needs to stay hyper vigilant in a dangerous environment, the truth is that for most of us, this “negativity bias” means that we spend time ruminating over the minor frustrations we experience—bad traffic, a disagreement with a loved one—and ignoring the many chances we have to experience wonder, awe, and gratitude throughout the day.

Fredrickson has calculated that in order to offset the negativity bias and experience a harmonious emotional state, we need to experience three positive emotions for every negative one. This, she claims, can be done intentionally for those of us less “wired” to positivity.  These positive emotions literally reverse the physical effects of negativity and build up psychological resources that contribute to a flourishing life.

Forgiveness

The attitude of forgiveness—fully accepting that a negative circumstance has occurred and relinquishing negative feelings surrounding the event—can be learned and can lead us to experience better mental, emotional and physical health. The Stanford Forgiveness Project trained 260 adults in forgiveness in a 6-week course.

• 70% reported a decrease in their feelings of hurt
• 13% experienced reduced anger
• 27% experienced fewer physical complaints (for example, pain, gastrointestinal upset, dizziness, etc.)

The practice of forgiveness has also been linked to better immune function and a longer lifespan. Other studies have shown that forgiveness has more than just a metaphorical effect on the heart: it can actually lower our blood pressure and improve cardiovascular health as well.

Gratitude

Acknowledging the good aspects of life and giving thanks have a powerful impact on emotional wellbeing. In a landmark study, people who were asked to count their blessings felt happier, exercised more, had fewer physical complaints, and slept better than those who created lists of hassles.

Brené Brown has found that there is a relationship between joy and gratitude, but with a surprising twist: it’s not joy that makes us grateful, but gratitude that makes us joyful.

Emotional resilience

Dr. Andrew Weil describes resilience as being like a rubber band—no matter how far a resilient person is stretched or pulled by negative emotions, he or she has the ability to bounce back to his or her original state. Resilient people are able to experience tough emotions like pain, sorrow, frustration, and grief without falling apart—in fact, some people are able to look at challenging times with optimism and hope, knowing that their hardships will lead to personal growth and an expanded outlook on life.

Resilient people do not deny the pain or suffering they are experiencing; rather, they retain a sense of positivity that helps them overcome the negative effects of their situation. Positive emotions have a scientific purpose—to help the body recover from the ill effects of negative emotions. Thus cultivating positivity over time can help us become more resilient in the face of crisis or stress.