My Daily Creed

My Daily Creed

Let me be a little kinder,

Let me be a little blinder

To the faults of those about me;

Let me praise a little more;

Let me be, when I am weary,

Just a little bit more cheery;

Let me serve a little better

Those that I am striving for.

Let me be a little braver

When temptation bids me waver;

Let me strive a little harder

To be all that I should be;

Let me be a little meeker

With the brother that is weaker;

Let me think more of my neighbor

And a little less of me.

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Lonely Fire

So many questions are drifting
in life, answers slipping
before it even starts,

Days got the mind thinking,
whilst grains of doubt sifting
happiness apart

Still nights love fishing
through pain, quietly printing
the canvas with blue art,

A world without you sinking…
lonely fire, spreading
in my heart.

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2012′ Codes for Mood Disorders

http://www.bipolar4lifesupport.co

“CODES FOR MOOD DISORDERS”

Most of the time, there are people who are caught off-guard by written notes from a physician since they can barely understand the writings. On some occasions, unless you ask, your physician will not explain in detail what you or your caregiver should know. There are even instances when physicians only inscribe codes.

This is true when you are a patient with bipolar disorder. Commonly, mental health experts use codes to interpret their findings.
Psychiatrists habitually scribble codes in your records. Knowing the codes by heart will help you or your
caregiver to understand and gauge the pertinent actions to undertake.

Codes are arranged by the Diagnostic and Statistical Manual of Mental Disorders (DSM). DSM is the typical categorization of mental disorders utilized by psychiatrists or other mental health experts.
For bipolar disorder, there are chiefly three important codes such as codes for mood disorders, codes for substance induced mood disorders and code extensions for psychotic features.

Codes for Mood Disorders
There are several code categories under “codes for mood disorders.” If a patient has a sole “manic episode” and there is no history of major depressive episodes then mental health experts usually interpret in under code 296.0x (F30.x).

A patient with bipolar disorder who experiences a “hypomanic episode” in progress and had at least one incident of manic or mixed episode then it is categorized as code 296.40 (F31.0).

The code 296.4x (F31.x) is characterized in patients who suffers from a current manic episode who have undergone major depressive, manic or mixed episodes.

A patient with Bipolar I Disorder and have occurrences of mixed episodes and experienced any of major depressive, manic or mixed episodes falls into code 296.6x (F31.6).

If a patient has major depressive episode and has a history of having manic or mixed episodes then mental health experts categorize this under code 296.5x (F31.x).

The code 296.7 (F31.9) is being written down for patients who experience any of the following: mixed, manic, hypomanic or major depressive episodes. Along with the criteria, the patient suffered from at least one mixed or manic episode.

Bipolar II Disorder can either be hypomania or depressed, has a code of 296.89 (F31.8) wherein the patient has more than one attack of major depressive episodes or at least one episode of hypomanic. Under this category, you must take note that there was never an attack of manic or mixed episode.

Codes for Substance Induced Mood Disorder
Mental health experts came up with codes to gauge measurable substances which heighten mood disorder.
If a patient has alcohol intake which can stimulate mood disorder, then mental health experts interpret this as code 291.8 (F10.8). Ingestion of cocaine, on the other hand have code 292.84 (F14.8).
Inhalants can also incite mood disorder, when this happens it is being regarded as code 292.84 (F18.8). Aside from inhalants, some sedatives can also stir up mood disorder. Mental health experts code sedatives as 292.84 (F13.8).

For further information on codes for substance-induced mood disorder, you can check with your physician. It is important for patients as well as caregivers to know what substance triggers their temper so that preventive ways can be sought.

Code Extensions for Psychotic Features
On this type of code, it will be regarded into two categories (1) severe without psychotic episodes; and (2) severe with psychotic episodes.
A patient with Bipolar I Disorder having the most current manic episode has codes 296.43 (F31.1) and 296.44 (F31.2) for severe without and severe with psychotic episodes respectively.

The code 296.63 is for regarded for patients with severe disorder without psychotic episodes for patients with Bipolar I Disorder who have current experience of mixed episodes. On the other hand, 296.64 is the code for patients with severe disorder having psychotic episodes.

A patient who have depressed episodes with Bipolar I Disorder has a code 296.53 (F31.4) if he has severe disorder with no psychotic episodes while 296.54 (F31.5) is the code for patients have severe disorder but with psychotic episodes.

The meanings of codes are not simply for the medical practitioners to know. The patient should be knowledgeable of such codes for him to understand the course of his illness. Equally important is for caregivers to also acquire information with regards to different Bipolar Disorder codes so that they will properly take good care of their patients. ============== It doesn’t matter if you or a loved one have been recently diagnosed or been struggling with bipolar disorder for years – This guide will tell you everything you need to know, without spending too much brainpower! Many people are unaware of THIS: your failing relationship and marriage could be DUE TO one of you suffering from Bipolar!! Discover how to cope with bipolar disorder and lead a normal fulfilling life again! ==============

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Words are Powerful

“Words are Powerful” & “Action is Magical”
Every time you make a casual promise to yourself — without checking in first to see if you actually want to and are able to keep this promise — you erode your trust in yourself ~
ACTION EXERCISE = Make an analysis of your current energy levels and your daily health habits. Resolve today to improve your levels of health and energy by asking the following questions:

[1] What are you doing physically that you should do more of?
[2] What are you doing that you should do less of?
[3] What are you doing that you should START DOING —- if you want to perform at your best?

What are you doing today that affects your health that you should STOP DOING altogether?
Whatever your answers are to these questions, TAKE ACTIONS TODAY!

Here’s a process and some tools to help you formulate inspired resolutions, and achieve significant results and long term success.

Take a moment to reflect.

Reflection is an action, a very powerful action. With paper and pen in hand, go to a comfortable and inspiring place and reflect.

Reflect on Your Past

When we take a moment to reflect, without blame or judgment, and in a state of wonder, on significant events, triumphs, and challenges we experienced during the year or during our lives, we often discover we’ve accomplished so much more than we give ourselves credit for. We discover how much strength we have and we see the values we embody. We realize the valuable lessons we have learned. As you reflect, take note of the ideas you receive on how to build upon and expand these strengths, accomplishments and learning.

When we reflect on how we spent our time and money, on what and who influenced us (the economy, a friend, family, a book, an advisor, fear, worry, creativity, inspiration…), and what happened with our relationships, we discover we have been in alignment with what truly matters – or not. Take note of the ideas you receive how to move forward in a meaningful way that serves your purpose.

Reflect on Your Reflections
When we step back, reflect upon the reflections, and notice what we are thankful for, we become truly inspired—in touch with our highest awareness and creativity. Our vision and purpose becomes clear and we begin to formulate resolutions.

Focus on what you want, not what you don’t want.

Most of us frame our resolutions in terms of what we don’t want or can’t have. Resolutions to quit smoking lose weight, be more balanced, reduce stress, and getting rid of debt, are actually focused on what we don’t want, or can’t have—not inspiring!
Let’s look at the resolutions to quit smoking or to lose weight for example. The resolutions themselves are focused on what I don’t want – smoking and excess weight. And, as I face each day, I am focused on not smoking or not eating bad foods which instructs my brain to look for and point out to me all cigarettes I can’t have and the food I am not supposed to eat. We are torturing ourselves. Then at the end of the day, I berate myself for the cigarettes and bad food I did have and for my lack of will power. Again, I am instructing my brain to notice what I did wrong. It will not notice anything I did right.

Because that wasn’t the instruction! Now I’m a failure. I am not in a state of joy or gratitude or vision and possibility (which brings about transformation) and the downward spiral continues.

Resolutions of being healthy, enjoying life, choosing peace, and increasing wealth or cash flow, instruct our brains to focus us on what we want and work with us, not against us.
In the process of refining our resolutions, we begin to feel inspired.

Let’s say, in this process, for example, you discover that you don’t really want to quit smoking and that smoking brings you peace and inspires you. In this instance, ask yourself what smoking brings you to get to the essence of what you want. You may discover that it gives you the opportunity to re-center yourself or to reflect, to have some quiet time, to get outside, to connect with friends, etc. You may then discover that it is not smoking that brings you these valuable opportunities – it is taking a break that does. What you really want is to take breaks.

By discovering the essence of what we really want, we re-discover ourselves and what is true to us. It is when we are true to ourselves that we become inspired. Often times our resolutions are based on what we think we are supposed to do or have to do or should do, which is not what we truly want.

So take a look at your resolutions and see how you can re-frame them to reflect what you want. Then say them out loud several times and notice how you feel. You either feel right or you don’t. Keep saying them out loud and making adjustments to the resolutions until they are truly yours, until you feel, “This is me, this is possible, this is my new story.”

We are all about contributing and making a difference. Keep asking yourself, “What does this bring me?” and “What does this bring others?” until you see and feel the difference you make in your life and the lives of others by fulfilling your resolution. For example, if I ask, “What does health bring me?” I may say, “I am able to play and enjoy activities with my kids.” When I ask what that brings me, I may say, “I have fun and bond with my kids. They feel safe to talk with me. Then I can fulfill my vision of being a guide and mentor to them which helps them in their lives.” When I re-frame my resolution to include the ripple effect, then my resolution is meaningful to me, and I become inspired.

Tell the story.
When we can tell the story of how we are fulfilling the resolution, and we’re inspired, that’s when we become energized and receive all kinds of ideas on how to fulfill our resolution.

For example, it may not be enough to resolve health. Just resolving health can be overwhelming. Without a definition of health, I can feel that health is unattainable. Or it can be underwhelming – if I don’t know what health means or looks like, it’s hard to feel motivated to do anything. So
first I define to myself what health looks like and means to me. I may decide that health means making good eating choices, exercising (or moving) regularly, and having peace of mind.

Then I can expand and describe what making good eating choices, moving regularly and having peace of mind looks like and means to me. I may then be inspired to list the foods I want to eat (vegetables, green tea, whole grains), movement I want to do (walking, dancing, yoga, hula hooping, P90X!), and what I can do that brings me peace (breathe, a thankfulness journal, practicing managing thought). I keep adding detail until I get to the point where I feel a click – it feels real and it feels possible..

Focus on.

The future is an illusion. What we do have is a NOW followed by a NOW followed by a whole lot of NOWs. We do not suddenly become bankrupt. We have a series of bankrupt NOW moments. We do not suddenly become a great leader or a great parent or healthy. We have a series of great leader or great parent or healthy NOW moments. And it’s the same with accomplishing a goal or fulfilling a resolution. It doesn’t suddenly happen. It’s a series of NOW moments and the resolution is fulfilled when we have achieved a critical mass of these NOW moments!
To focus on the NOW, prepare powerful questions (focused on what you want) to ask yourself: What can I eat right now that’s healthy? How can I move today? What can I do that brings me peace in this moment? What one day each week can I eat healthy? (Then I’m 1/7 of the way there!) What one meal can I eat each day that’s healthy? (Then I’m 1/3 of the way there!) Or I can make Monday movement day and Tuesday is healthy eating day and Wednesday is peace of mind day. (And then I’m half way there!)

Acknowledge your progress and do do-overs.

When you catch yourself thinking, saying, or doing something contrary to your resolution, don’t blame or judge or criticize yourself. That accomplishes nothing and actually works against you. Instead, simply do it over, and re-think, re-say, or re-do it the way you intend. You are giving your brain and body a new script. And the more often your brain rehearses these new thoughts and actions, the sooner your brain starts focusing on presenting you with your new thoughts and actions–automatically.

At the end of the day, when we take stock of how we did, it doesn’t matter that we didn’t exercise five times. It does matter that we exercised once. That is a NOW moment to be recognized and celebrated toward our goal. It does not matter that we smoked or ate bad things today. It does matter that we are aware of the choices and that we made one or more healthy choices. It’s the slow gradual changes that are lasting.

Include in your resolution a daily process or ritual to reflect on the day and celebrate or acknowledge the NOW moments you were successful or that you were aware of your choices. When we are thankful and acknowledge the progress we have made, no matter how small, we become inspired and we receive ideas on how to expand and rise to the next level.

As Lao-Tzu said, “The journey of a thousand miles begins in a single step.” I invite you to make just one small change each week. These very small NOW changes add up to big changes over a year and significant change for a lifetime..
May your thoughts bring you peace and inspire you.

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Peace with yourself and Others “Mind Recipes”

When you find peace within yourself, you become the kind of person who can live at peace with others.” Peace Pilgrim

Are you always “at war” with others? Reacting to everything they say because you KNOW they are wrong. I do not mean the occasional disagreement – I am talking about a continuing and familiar pattern of disagreements with everyone – same arguments – different faces? You need to argue and prove your point, no matter what!

Ok – yes I am being a bit confronting – not an easy thing to look at, I agree. But, look at your history – is there a pattern of confrontation? What is the one consistent with these confrontations? ………..YOU!
This is not about blame – it is about finding peace within yourself. Once you have that, it really won’t matter to you what someone else says or does – you do not need to prove yourself or show the world that they have done wrong. When you have that peace, something miraculous will occur……you will be at peace with others as well. It doesn’t mean that you are best buddies, but the change is well worth the effort.

This may not apply to any or so of you for that matter but unfortunately it does with my husband basically and my ex best friend………

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Recovery is a Journey

Recovering from mental illness includes not only getting better, but achieving a full and satisfying life. Many people affirm that their journey to recovery has not been a straight, steady road. Rather there are ups and downs, new discoveries and setbacks. Over time, it is possible to look back and see, despite the halting progress and discouragements, how far we have really come. Each time we reach such a milestone, we see that we have recovered a piece of our lives and we draw new strength from it. The journey to full recovery takes time, but positive changes can happen all along the way.

Stages of Recovery

The first step in the journey to recovery begins with a decision that life must improve. Having a mental illness can affect our lives in many ways:
•Our normal activities suffer;
•Intimate relationships can be profoundly affected;
•Friendships may be lost;
•We may lose employment and financial security.

The pain of mental illness, coupled with such losses, can be overwhelming. Yet at some point we find the determination to stop just surviving, and start gaining back life, piece by piece. That is when recovery begins.
Early on in the recovery process, treatment may focus on finding the right diagnosis and relieving the most severe symptoms. It’s important to realize at this early stage that it is vital to find support from people who understand what you’re going through. Family, friends, your faith community, self-help groups, and community organizations can all be of help.

As time passes, you may find yourself in another stage of recovery. Your condition is becoming more manageable. Many things can contribute to this improvement: an accurate diagnosis, effective medication, supportive talking therapy, and your own growing knowledge of your condition and how to live with it.
Once it was thought that this plateau of stability was as far as people with mental illness could go. Maintaining stability was the goal of treatment. But today we understand that much more is possible. You can expect to return to an active life based on your desires, preferences and abilities.

Finding Hope

Being told that you have a mental illness is not the end of the world. With help and support, you can recover and achieve your life’s ambitions. Of course, you will face many challenges as you begin your treatment, but there is hope. Mental illnesses are manageable. And there are a number of things you can do for yourself after a diagnosis to cope with the news, keep up with your treatment, and support your own recovery.
Understanding of mental illness is much better today than it was in the past. There are different illnesses that require different approaches to treatment. New medications and new types of therapy improve the chance of successful treatment. And , also a lot has been learned, a lot about how people recover and lead full lives.
It’s important to realize that you are not alone. Mental illnesses are common, affecting one in five Americans.

Many people with mental illness, including well-known celebrities, are leading very successful lives. You can gain hope by connecting with other people who share your condition. From them, you will gain insight, experience acceptance, and get invaluable support.
Hope can come from our own inner desire to regain health and live. It also can come from the assurances of people who care about us or from the examples of those who have lived through similar experiences. The more active we are in understanding our condition, taking responsibility for our own care, and reaching out for help, the more chances we have of making gains that give us greater reason to hope.

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Discount Card Pharmacy

http://www.bipolar4lifesupport.co

Hi all,

I received this card in the mail a little bit ago,
it states that over 50,000 meds and 50,00 pharmacies let u use this card for a discount up to 75% off, here is the information

Rx Relief
Pharmacy help Line= 1-800-776-0760

http://www.rxreliefcard.com

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Meaningful Work and Recovery

http://www.bipolar4lifesupport.co

Meaningful Work and Recovery:

Although you will encounter roadblocks and setbacks on the road to recovery, working at something that is meaningful to you can bring you a sense of purpose that will anchor you. Meaningful activity expands your sense of self-worth by adding to your skills and helping you accomplish your personal goals and feel good about yourself. Meaningful activity, which includes school, volunteer work, part-time work and full-time employment, also enables you to meet new people and make friends.

We all need some form of meaningful activity in our lives and a means of supporting ourselves, but having a mental health condition can be an obstacle. Mental health conditions impact different people in various ways. Some people with mental health conditions may never stop working; others find that their condition interrupts their career, and still others may be able to do only limited work. As people recover from a mental health condition, they also face varied challenges in relation to work.

Some people with mental health conditions find that they are able, with minor accommodations, to work in the same way they did before. Others may have to re-enter work gradually. And people on disability benefits will need to observe back-to-work rules when employed. No matter your situation and no matter the hurdles you face, hold on to your goals for yourself and keep striving to incorporate meaningful activity into your life. In the past, people with mental illness were often discouraged from working, but today we understand that work is not only a possibility, but it can also play a vital role in recovery. It’s true, however, that having a mental health condition can pose some practical barriers to working, such as having breaks in your career, feeling unsure of yourself, or needing to ask for an accommodation such as time for doctors’ appointments. You can figure out strategies to work around these barriers, often with the help of friends, mentors or an employment specialist. Don’t give up! Supported Employment Your Work Choices Work-Related Issues

Supported Employment

Supported employment services assist you in preparing to work, finding and keeping a job and thriving in a work environment. Depending on where you live, you might be offered supported employment help through the local office of your state’s vocational rehabilitation service, through the mental health agency where you get mental health services, or through a nonprofit disability employment agency. Because of local differences, be sure to check with all of these sources. Your state’s Office of Vocational Rehabilitation should be able to help you find supported employment services. In supported employment, a vocational counselor will help you assess your career interests, job skills, and work challenges. The counselor may suggest job categories that fit your interests, help you write a resume, coach you for interviews, and prepare you for what to expect if you haven’t worked recently. While you will get a lot of help, you will also be expected to work hard on solving problems, planning your career, and looking for jobs. Don’t expect to be handed a job or simply placed in work. The main responsibility will be yours.

The prospect of job hunting can seem daunting, and looking for work is like a job in itself. You need to put in regular hours and keep at it. Perhaps the biggest challenge is getting discouraged. In the competitive marketplace for work, expect to be turned down by many prospective employers before landing a job. An important source of help that many job hunters in your community use is the local public employment office. These days, such offices are typically called “career one-stop centers”.

They offer a wealth of self-help resources on preparing for and finding jobs, computers you can use, and trained staff. Many have a staff person trained as a disability navigator who will understand the challenges you face and guide you to sources of help. Find your state’s network of employment centers here. Once you find a job, your next challenge is to keep it. Work is rewarding, but it also can be tiring, so be sure to get enough rest and care for yourself. Give yourself time to get used to the demands of working. Above all, it’s critical to use your support system – friends and family, your therapist or case manager and peer support group – so you can talk over your experiences at work and get help if your mental health condition is affected. Be sure to let your doctor know that you are going to work and get help in making any needed adjustments to medications as your situation changes.

Your Work Choices

What comes to mind when you think of a job? Is it working full-time, five days a week? If that prospect feels daunting to you, remember that there are other work choices to choose from. One of them might be more suited to your current abilities and stamina, and might be easier to find than full-time work.

Volunteer Work

While many people want to have a paying job, volunteer work is another form of meaningful activity for many people with mental health conditions. Some people use volunteer work as a stepping stone to paid employment; volunteering can help them re-learn skills and grow comfortable working with other people. Others decide to volunteer instead of work. Volunteering not only gives you a sense of pride, but it can make you feel good about yourself to help out in the community.

If you have a cause that you feel passionately about, you may already know where you want to volunteer. Most organizations that have a lot of volunteers will have a coordinator who can help bring you on board. To find volunteer opportunities, you can contact your city or county information line for the contact information for a coordinator. You can also look for “Volunteer Clearinghouse” or “Volunteer Center” in a phone book. The Internet can be a great tool to search for volunteer opportunities; try visiting http://www.volunteermatch.org/ or http://www.1-800-volunteer.org/. Remember that just because you don’t receive a wage as a volunteer doesn’t mean you aren’t entitled to fair treatment and respect. You should feel safe and comfortable in your work environment, and people should treat you like a human being.

Internships

When most people think of internships, they think of college students working for free for credit. Internships aren’t actually student specific; they are a blend of education and work. An internship usually involves a close relationship with other staff at a business working on specific projects and tasks. Where a volunteer might answer phones or bring food to homeless people, an intern might help a program staff member develop strategies to bring the food to the homeless. Sometimes the line between intern and volunteer can be blurred. Some internships will offer an hourly wage or a paid stipend, although such internships can be highly competitive. If you are a full-time college student, ask your career office whether they participate in the U.S. Department of Labor’s Workforce Recruitment Program. Recruiters interview college students with disabilities early in the year for summer intern positions. If you are interested in an internship, make sure you ask your employer at the interview about the specific tasks and projects you will work on. You should expect to spend some of your time doing administrative work like filing, but you should also get a sense of a real opportunity to learn on the job.

Temporary Employment

Temporary employment can be a good bridge to permanent work. You register with a temp agency that can then place you in short-term assignments in companies that need extra help. These assignments could last from a few days to several months and can sometimes lead to an offer of permanent work. By temping, you establish a current resume, sharpen your skills and test your own ability to return to work.

Part-Time Employment

Some people use part-time employment (working less than 35-40 hours a week) to transition to full-time employment; other people find that they prefer working part-time to working full-time permanently. Part-time employment can give you more free time to take care of yourself and your responsibilities. It may be more accommodating if you find that you need more time away from the office to handle your mental health condition. However, part-time employment usually pays less than full-time employment, and part-time work often comes without benefits.

Full-time Employment

Many people with mental health conditions are able to work full-time. Full-time employment usually includes sick leave and may include health insurance, making it easier to handle health problems. Company retirement plans for full-time employees enable you to grow your savings. You may want to look for government work, as local, state and federal employers have a good record of hiring diversity and respecting disability regulations. Finding employment, whether full-time or part-time, usually involves preparing your own resume and job-hunting in your local employment market. Job hunting can be discouraging for anyone, especially if job openings are scarce and there is a lot of competition. If you are having a hard time finding a job, you can look for help from an employment agency, supported employment services or close family members or friends. It is important to have support while job hunting; seek it from friends, from a job-hunting club, a support group, or a peer-run drop-in center.

Self-Employment

Some people are not interested in traditional employment-working for someone else-but are able to work for themselves. You might want to start and grow your own business. Do you have a product or service that you can sell? Do you have a hobby or skill like jewelry making, baking, or playing and instrument? Can you provide a service such as lawn mowing, pet-sitting, or writing and editing? Working for yourself enables you to set your own schedule, and avoids the problem of disclosing your condition that sometimes arises in the workplace. On the other hand, it demands self-discipline and for tax purposes, you need to track your expenses and income. To prepare yourself, develop a simple business plan that outlines what you plan to sell, your customers, your competition, and your expenses. You can get help with starting your own business from local offices of the Small Business Administration, your county or state economic development office or craft guilds and associations. Also, be sure to contact your state’s vocational rehabilitation office for help with self-employment. The Abilities Fund (http://www.abilitiesfund.org/index.php) is an organization that provides assistance to people with disabilities interested in self-employment and entrepreneurship.

Common Work-Related Issues

How will working affect my government benefits?

If you have a mental health condition, you may receive Social Security or other government-funded disability benefits, or private disability benefits from a previous employer. While disability benefits typically pay below a wage you would expect to get while working, they provide regular income. Additionally, if you are on disability and/or below the poverty line, you may receive health care through Medicaid or Medicare. Remember, too, that eligibility for housing programs and the rent you pay may be affected by your income. Having a paying job or earning other types of income can affect your status in Medicaid or Medicare.

This does not mean you should be afraid to work, it means it is important to understand the rules before you work. While the interaction between Medicaid and Medicare can be complicated, under either program, you can earn a certain amount of money without losing your benefits. Because everyone’s situation is different, you should always talk to a trusted and knowledgeable person who can help you understand your work options and how your choices will affect your benefits. A good starting place is reading about Social Security Administration

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How Light Affects the Brain Part #3

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How Light Affects the Brain: Dr. Phelps a supporter and contributer to Bipolar4LifeSupport PART #1

You know about rods and cones, right? Those are the two kinds of receptors in your eyeball, on your retina, for light. But you didn’t know that there is another receptor for light in the eye (I’m guessing you don’t know, because until I came across this research, I didn’t know either).

Whereas the rods and cones send information to the visual cortex (the “occipital cortex”, at the back of your head), this other light receptor sends its information to your internal clock. The nerve cables from these receptors don’t even go to the vision center at all. They go straight to the middle of your brain, to a region of the hypothalamus called the suprachiasmatic nucleus, which is well known to be the location of the biological clock for us humans. (That’s an oversimplification but the general idea is correct. For the minute details, light researchers would prefer an overview and series of articles in Nature 2005).

You know about this clock, right? Everybody has one: it’s the gizmo that is setting your biological rhythms every day — when you feel like eating, when you feel like sleeping, when you feel like getting up in the morning. It’s the gizmo that gets confused by east-west travel, causing “jet lag”. It regulates hundreds of chemical reactions all timed to match the natural cycle of days and nights in our environment.
Or what used to be our environment. Nowadays we’ve altered that environment in many ways, of course (Nature is getting ready to get back at us, big time; but hey, that’s our kids’ worry, right?). One of the most significant changes in our environment is our ability to have LIGHT when we used to have DARKNESS.

But our brains were not built for this. There were built for a regular period of darkness within every 24 hours (by whom or what doesn’t matter right now; don’t stop, read my page on evolution later. I keep interrupting you with these big-picture ideas like God and global warming. I must be worried about something). Some people are not very strongly affected by our artificially lit environment. But some people, perhaps especially those with bipolar disorder, may suffer when they get too little, or too much. Right now most such people just have to learn this the hard way. Read on.

From the retina, to the biological clock: then what?

Your biological clock resets itself every day by the appearance of morning light. That’s why you can, over a few days, adjust your clock if you fly to some other continent, or even across one. As you may know, our biological clocks are not perfect 24-hour machines. They drift a little bit every day. Most people drift toward a longer day (their clock takes more than 24 hours to complete a cycle). This is probably why most people find it easier to stay up late than to wake up early. For some people, that drift toward later hours can be very dramatic. They may be the ones who most need to learn about what I’m presenting here. They don’t stay glued to “real time” very well. They need to avoid getting “unglued” any further. And light at night may be one of the most important ungluing factors.

So, how does the clock reset itself?

Here’s the short answer. The long answer is a beautiful example of brain science; I’ll send you there in a minute if you’re interested. Briefly then: every morning light turns off a chemical process and allows the clock process, which is a very interesting string of chemical reactions, to start all over again. Clock researchers have identified all the important molecules in this process. Lo and behold: lithium directly affects one of the key enzymes in the resetting of the clock. Here we find “ground zero” of our biological rhythms, the very center of the clock process, and there’s lithium right in the middle of it.

Very interesting. If that’s enough to get you interested, have a look at the long story about how the clock works, including how lithium affects it.

Light is central to biological rhythms — and so is DARKNESS

If light starts the clock every day, is it possible that darkness is a necessary ingredient as well? Look at the question this way: sleep deprivation can cause manic episodes. In part that’s too little sleep itself — but might part of the story be “too much light?” Generally when people are sleeping less and heading toward mania, they’re not hanging out in the dark. They’re up late at night in very well lit places, like casinos, roadways with bright car lights in their eyes, their office preparing the big talk that will secure their future millions, and so forth. They’re not sitting in some dark room. Is there any chance that being forced to stay in the dark during an emerging manic episode could actually turn them in the other direction? We’ll look at some evidence for that in just a moment.

Here’s another angle on light and dark: suppose that the appearance of light every morning can reset your clock only when you’ve had enough darkness. Maybe the brain needs to be able to see the contrast? What would happen if you didn’t get enough darkness? Maybe you’d lose your biological rhythm entirely; your body wouldn’t know when to make you sleep and when to wake you up. You’d be up in the middle of the night sometimes, for days in a row, backwards to real time. Then you might be so asleep during the real day you could hardly get out of bed; getting up in the morning would feel like getting up from sleep in the middle of the night does for the rest of us, ugh.

And finally, imagine that if your clock cuts loose from real time, you lose even the 24-hour connection.

Remember, the clock is not really a 24 hour machine in most people. Maybe you would lose your rhythm entirely so that you body could do the sleep thing, or the really awake thing, at any time, on any day. You’d have no idea where you were, in terms of body cycling, totally erratic. Extreme forms of “rapid cycling bipolar disorder” look just like this: no rhythm at all.

All of these lines of thought led a research team at the National Institute of Mental Health to wonder: maybe some people with rapid-cycling bipolar disorder have lost the connection between their internal clock and external light/dark reality. Maybe one way to treat that would be to simply “enforce darkness”! The results of their test of this idea will be described in a moment.

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How Light Affects the Brain Part #2

http://www.bipolar4lifesupport.co

Dr. Phelps says:

Treatment Implications: Part # 2 Part #3 next

There are two aspects of this story with major implications for
treatment of bipolar disorder: first, sleep and rhythm; and then, darkness and
light (particularly one kind of light).

Sleep and Rhythm
This one’s pretty simple. Everybody
needs sleep. But people with bipolar disorder need to protect it. Sleep
deprivation is associated with having manic symptoms. But perhaps even more
important than sleep, or at least as important, is rhythm: the sleep needs to
happen at the same time every day to keep your clock organized. Move it around
too much and you may be setting yourself up for cycling, perhaps even the harder
to treat version, “rapid cycling”.

Thus most people with bipolar disorder will not be able to do
“shift work”, where the work day is rotating around the clock. That’s probably
about the worst kind of job schedule you could arrange. A close second worst is
might be an international job like pilot or flight attendant, changing time
zones over and over again. Third worst would be graveyard shift work, unless
you were extremely attentive to keeping your light exposure limited to your
“day”, and avoiding real daylight during your “night” (heavy blinds and a sleep
mask, for example). Even then we might wonder if there’s something about “real”
daylight that’s important to synchronize with your internal clock.

So, the treatment bottom line: have regular sleep hours — even on
weekends. I know, it’s going to feel really stupid to be getting up at 6 am on a
Saturday. You’ll probably have to conduct some personal tests to find out if
this is really worth it. I’ll admit: even if it’s theoretically a good idea for
the long run, you’ll probably never be able to keep it up unless you discover
some shorter-term benefit as well. So keep some mood/energy/sleep records
(several charts are linked from my home page; bottom bullet in the Bipolar II
section) and see what you think.

Darkness and Light
The following recommendations are
not standard. You won’t hear these from your doctor, for a while yet, anyway.
They are just my opinions, some logical extensions from our existing knowledge.
But since they are easy and safe, I don’t have to worry too much about being
right! You can try one, or several, and see what you think.

In my opinion, everything you just finished reading suggests that
if you have bipolar disorder, you should very deliberately manage your exposure
to light and darkness, especially darkness. I think this may be as important for
some people with bipolar disorder as regular sleep. Obviously the easiest way to
arrange this would be to make sure you’re getting good quality darkness when
you’re asleep. That means no nightlights (in one study, as little as 1/500th of
midday sunlight, just 200 lux, was enough to disturb people’s melatonin, the
sleep chemical in our brainHallam).
That means don’t turn on the lights in the middle of the night if you get up to
go to the bathroom (no hallway nightlight either). Don’t let early morning sun,
in the summer, hit your closed eyelids (which means using, if you have to, a
$3.50 sleep mask you can buy at the pharmacy. You’ll get used to it. Older guys
who have to get up to urinate anyway can put it on before going back to sleep in
the middle of the night).

Here a stunning case example to demonstrate how powerful “Dark
Therapy” can be: a patient with severe rapid-cycling bipolar disorder who
stopped cycling entirely — with no medications — just by carefully
using very regular darkness (first 14 hrs a night, then within a few weeks, to
stay well, only 10 hrs. a night). The graphs of his mood chart, before and after
this treatment, are amazing. You can see those graphs on my page about Dark
Therapy.

No nightlights? A reader suggested this might carry risk —
bruising your shin! Or worse, a fall. So, you can use nightlights, actually, but
they have to emit no blue light, as you’ll see in the next section.

Alert, Alert: watch out for one kind of light at
night.
Recent research has shown that one particular kind of light is
the key to regulating the biological clock: blue light. For an explanation of
that research, see Why Blue Light is So Important.
The bottom line: blue light is a powerful signal telling your brain “it’s
morning time, wake up!” Although not formally tested yet, it looks like the
last thing you’d want to be doing right before bed is looking at a blue light.
Uh, oh. You can see it coming, can’t you: what color is the light from your
television? How about from the computer screen you’re staring at right now?
(not after 9 pm, is it? uh oh…)

The good news is this: you might be able to significantly
regulate your bipolar cycling, and at least find it easier to go to sleep at
night (without medications like zolpidem (Ambien), lorazepam (Ativan),
trazodone, etc.), by avoiding blue light at night. So, here’s the treatment
recommendation doctors ought to be giving you (if they had the time to read the
recent research in this area, which few do): no TV or computer after 9 pm if
you’re going to bed at 10 or 11. End the TV/computer even earlier if you go to
bed earlier. I’ve had quite a few patients tell me this step alone really
helped them. If you took the link above to the story about the guy whose rapid
cycling was treated with “Dark
Therapy” and no medications, you can see how closely this recommendation
matches that treatment.

A related step, recommended by Dr. Dave Avery, the light
researcher at the University of Washington: get dimmers on all the lights you
use after 9 pm and start turning them down around that time. In particular,
avoid going in to brush your teeth at 10 pm and turning on the shaving lights!
It’s just the wrong message to be sending your brain at that hour. If you have
to use some sort of “night light” to guide your way to the bathroom in the
middle of the night, use one that emits no blue light. Here’s a source of such
nightlights.

Some people are very susceptible to light; others are not. But if
you’re one who is, these could be very important ideas to consider. One woman
wrote, after reading this section:

“My daughter was very recently diagnosed with Bi-polar II. I found
your site while trying to understand what she is dealing with. When I read the
article about darkness, I was amazed. My own sleep patterns are poor at best, so
I decided to try some of your suggestions. I got away from the computer and the
television two hours before retiring for the night. I bought an eye mask. In a
little over a week, I have gone from waking up 3 to 5 times a night (and not
falling back to sleep) and getting out of bed to awaking once to turn over and
fall right back to sleep! I am at the point where I am telling anyone who will
listen to me.”

Yellow Eyeglasses to Avoid Blue Light?
This is going to
be fashionable, trust me. In fact, it may already be fashionable (I
wouldn’t be the guy to ask…) At least I’m not making any money on this, so you
don’t have to distrust it for that reason– as otherwise you should!

This idea is not yet tested. I wouldn’t even talk about it if it
weren’t utterly safe … and kind of a neat idea! It may even be pretty cheap:
$7-$10. You’ve learned here that blue light is the strongest signal telling your
brain to wake up (e.g. that page on Why Blue Light is So
Important. If you still don’t trust me on this — good! — here’s a health
reporter describing the entire history of blue light research — fascinating,
moderately technical but still plain english: Holtzman).

So, if you just had to use your computer after 9 pm; or if
for some reason you just have to use your TV after 9 pm… go ahead, try
to convince me…. what about putting on a pair of glasses that could block out
blue light? This might make it easier to fall asleep, as the signal telling your
brain “wake up!” would be blocked.

Hey, this is not as wacko an idea as it sounds. People are
already using it. I’ll show you a research result in a moment, but you may find
these business-related stories even more convincing: a company from the
Netherlands has started making a kind of fluorescent light that can vary the
amount of blue and red light through the day — including more blue in the
afternoon to help you stay awake after lunch! An American company makes 5
different products that limit your exposure to blue light at night (no-blue
bulbs, including fluorescent and LED; blue-blocking sunglasses; and a
blue-blocking filter to put over your computer screen (their site is http://www.lowbluelights.com , and they are
really nice folks; but there is a cheaper source for their blue-blocking glasses
described below). And a small American study of people with Alzheimer’s disease
showed that by using early evening blue light exposure, they could keep these
folks awake later into the evening, so that they didn’t fall asleep at 7 pm and
then wake up in the middle of the night.JAMA Both of these
uses are described in this article on blue light and
circadian rhythms in Science News from 5/2006.

Another important study showed that blocking blue light at night
really does change brain chemistry, just as one would hope. Here’s how that was
done. Melatonin, a hormone associated with falling and staying asleep, is
decreased by light. That fact is very well established. What’s new is that you
can prevent this reduction in melatonin by blocking blue light, with a
simple pair of glasses made to block that particular color of light. They let
everything else through. Things look pretty yellow through these things, but to
your brain, it’s like darkness! What a trick. This crucial article, which
shows that a simple maneuver like wearing a pair of weird glasses really can
protect your sleep hormones, was published in 2005.Kayumov

[Update 9/2010: The next step in this research will be a
“randomized trial” in which some people with sleep problems are given either the
amber lenses or a similar “control” lens that does not block blue light. Two
small pilot-studies leading toward just such a large-scale test have been
published in both
reports, results suggest that amber lenses do indeed improve sleep.]

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