Louise Hay affirmations for illness

A

ABDOMINAL CRAMPS:  Fear. Stopping the process.
Affirmation:  I trust the process of life. I am safe.

ABSCESS: Fermenting thoughts over hurts, slights and revenge.
Affirmation: I allow my thoughts to be free. The past is over. I am at peace.

ACCIDENTS: Inability to speak up for the self. Rebellion against authority. Belief in violence. 
Affirmation: I release in me that created this. I am at Peace. I am worthwhile.

ACHES: Longing for love. Longing to be held.
Affirmation: I love and approve of myself. I am loving and lovable.

ACNE: Not accepting or disliking self.
Affirmation: I am a Divine expression of life. I love & accept myself where I am right now.

ADENOIDS: Family friction, arguments. Child feeling unwelcome, in a way.
Affirmation: This child is wanted and welcomed and deeply loved.

ADDICTIONS: Running away from self. Not facing the fear. Not knowing how to love the self.
Affirmation: I now discover how wonderful I am. I choose to love and enjoy myself.

ADDISON’S DISEASE: Severe emotional malnutrition. Anger at the self.
Affirmation: I lovingly take care of my body, my mind, and my emotions.

ADRENAL PROBLEMS: Defeatism. No longer caring for the self. Anxiety.
Affirmation: I love & approve of myself. It is safe for me to care for myself.

AGEING PROBLEMS: Social beliefs. Old thinking. Fear of being one’s self. Rejection of the now.
Affirmation: I love and accept myself at every age. Each moment in life is perfect.

AIDS: Feeling defenceless and hopeless. A strong belief in not being good enough. Denial of the true inner being, or sexual guilt.
Affirmation: I am Divine, Magnificent expression of Life. I rejoice in my sexuality. I rejoice in all that I am. I love myself.

ALCOHOLISM / ABUSE: Futility, guilt, inadequacy, self-rejection
Affirmation: I live in the now. Each moment is new. I choose to see my self-worth. I love and approve of myself.

ALLERGY & HAY-FEVER: You are allergic to someone who or yourself denies your power. Irritated to Life.
Affirmation: The world is safe and friendly. I am safe. I am at peace with life.

ALZHEIMER’S DISEASE: Desire to leave the planet. The inability to face life as it is.
Affirmation: Everything happens in the right time, space, sequence. Divine right action is taking place at all times.

AMNESIA: Fear. Running from life. Inability to stand up for the self.
Affirmation: Intelligence, courage and self worth are always present. It is safe to be alive.

ANAEMIA: Yes but, Attitude. Lack of Joy. Fear of Life. Feeling not good enough.
Affirmation: It is safe for me to experience joy in every area of my life. I love life.

ANKLE PROBLEMS: Inflexibility and guilt Inability to receive pleasure/ Represent mobility & direction.
Affirmation: I deserve to rejoice in life. I accept all the pleasure life has to offer. I move forward easily in life.

ANORECTAL BLEEDING: Anger & Frustration.
Affirmation: I trust the process of life. Only right & good action is taking place in my life.

ANOREXIA: Denying the self and life. Extreme fear of rejection.
Affirmation: It is safe for me. I am wonderful just as I am. I choose joy and self-acceptance.

Affirmation: I easily and comfortably release that which is no longer need in life.

-ANUS/ ABSCESS: Anger in relation to what you don’t want to release.
Affirmation:
It is safe to let go. Only that which i no longer need leaves my life.

-ANUS BLEEDING: (See ANORECTAL Bleeding)

-ANUS, FISTULA:
Incomplete releasing of trash. Holding onto garbage of the past.
Affirmation:
It is with love that i totally release the past. I am free. I am love.

-ANUS, ITCHING: Guilt over the past. Remorse.
Affirmation:
I lovingly forgive myself. I am free.

-ANUS PAIN: Guilt. Desire for punishment. Not good enough.
Affirmation:
The past is over. I choose to love & approve of myself in the now.

ANXIETY / NERVOUSNESS: Distrust the natural flow & process of life.
Affirmation: I love and approve of myself and I trust in the process of life. I am safe.

APATHY: Resistance to feeling. Deadening of the self. Fear.
Affirmation:
It is safe to feel. I am open myself to life. I am willing to experience life.

APPENDICITIS: Fear. Fear of life. Blocking the flow of good.
Affirmation: I am safe & relax. I let life flow joyously.

APPETITE, EXCESSIVE: Fear. Needing protection. Judging the emotions.
Affirmation: I am safe. It is safe to feel. My feelings are normal & acceptable.

APPETITE, LOSS OF: Fear. Protecting the self. Distrusting life.
Affirmation: I love & approve of myself. I am safe. Life is safe & joyous.

ARM PROBLEMS: Represent the capacity & ability to hold the experience of life.
Affirmation: I lovingly hold & embrace my experiences with ease & joy.

ARTERIOSCLEROSIS: Resistance, tension. Hardened narrow-mindedness. Refusing to see good.
Affirmation: I am completely open to life and to joy. I choose to see with love.

ARTERIES: Carry the joy of life.
Affirmation: I am filled with joy. It flows through me with every beat of my heart.

ARTHRITIS: Feeling unloved, criticism, resentment and bitterness. Feeling not good enough.
Affirmation: I am love. I now choose to love and approve of myself. I see others with love.

ARTHRITIC FINGERS: A desire to punish. Blame. Feeling victimized.
Affirmation: I see with love & understanding. I hold all my experiences up to the light of love.

ASPHYXIATING ATTACKS: Fear. Distrusting the life. Stuck in childhood.
Affirmation: It is safe to grow up. The world is safe. I am safe.

ASTHMA: Unresolved guilt. Smother love. Inability to breathe for one’s self. Feeling stifled. Suppressed crying.
Affirmation: It is safe now for me to take charge of my own life. I choose to be free.

ATHLETE’S FOOT: Frustration at not being accepted. Inability to move forward with ease.
Affirmations: I love and approve of myself. I give permission myself to go ahead. It’s safe to move.

Next
B

Posted in News & updates | Leave a comment

Personality type Borderline Personality Disorder (BPD)

If you have borderline personality disorder (BPD), you probably feel like you’re on a rollercoaster—and not just because of your unstable emotions or relationships, but also the wavering sense of who you are. Your self-image, goals, and even your likes and dislikes may change frequently in ways that feel confusing and unclear.

People with BPD tend to be extremely sensitive. Some describe it as like having an exposed nerve ending. Small things can trigger intense reactions. And once upset, you have trouble calming down. It’s easy to understand how this emotional volatility and inability to self-soothe leads to relationship turmoil and impulsive—even reckless—behavior.

When you’re in the throes of overwhelming emotions, you’re unable to think straight or stay grounded. You may say hurtful things or act out in dangerous or inappropriate ways that make you feel guilty or ashamed afterwards. It’s a painful cycle that can feel impossible to escape. But it’s not. There are effective BPD treatments and coping skills that can help you feel better and back in control of your thoughts, feelings, and actions.

BPD is treatable

In the past, many mental health professionals found it difficult to treat borderline personality disorder (BPD), so they came to the conclusion that there was little to be done. But we now know that BPD is treatable. In fact, the long-term prognosis for BPD is better than those for depression and bipolar disorder. However, it requires a specialized approach. The bottom line is that most people with BPD can and do get better—and they do so fairly rapidly with the right treatments and support.

[Read: Helping Someone with Borderline Personality Disorder]

Healing is a matter of breaking the dysfunctional patterns of thinking, feeling, and behaving that are causing you distress. It’s not easy to change lifelong habits. Choosing to pause, reflect, and then act in new ways will feel unnatural and uncomfortable at first. But with time you’ll form new habits that help you maintain your emotional balance and stay in control.

Recognizing borderline personality disorder

Do you identify with the following statements?

  • I often feel “empty.”
  • My emotions shift very quickly, and I often experience extreme sadness, anger, and anxiety.
  • I’m constantly afraid that the people I care about will abandon me or leave me.
  • I would describe most of my romantic relationships as intense, but unstable.
  • The way I feel about the people in my life can dramatically change from one moment to the next—and I don’t always understand why.
  • I often do things that I know are dangerous or unhealthy, such as driving recklessly, having unsafe sex, binge drinking, using drugs, or going on spending sprees.
  • I’ve attempted to hurt myself, engaged in self-harm behaviors such as cutting, or threatened suicide.
  • When I’m feeling insecure in a relationship, I tend to lash out or make impulsive gestures to keep the other person close.

If you identify with several of the statements, you may suffer from borderline personality disorder. Of course, you need a mental health professional to make an official diagnosis, as BPD can be easily confused with other issues. But even without a diagnosis, you may find the self-help tips in this article helpful for calming your inner emotional storm and learning to control self-damaging impulses.

Signs and symptoms

Borderline personality disorder (BPD) manifests in many different ways, but for the purposes of diagnosis, mental health professionals group the symptoms into nine major categories. In order to be diagnosed with BPD, you must show signs of at least five of these symptoms. Furthermore, the symptoms must be long-standing (usually beginning in adolescence) and impact many areas of your life.

The 9 symptoms of BPD

  1. Fear of abandonment. People with BPD are often terrified of being abandoned or left alone. Even something as innocuous as a loved one arriving home late from work or going away for the weekend may trigger intense fear. This can prompt frantic efforts to keep the other person close. You may beg, cling, start fights, track your loved one’s movements, or even physically block the person from leaving. Unfortunately, this behavior tends to have the opposite effect—driving others away.
  2. Unstable relationships. People with BPD tend to have relationships that are intense and short-lived. You may fall in love quickly, believing that each new person is the one who will make you feel whole, only to be quickly disappointed. Your relationships either seem perfect or horrible, without any middle ground. Your lovers, friends, or family members may feel like they have emotional whiplash as a result of your rapid swings from idealization to devaluation, anger, and hate.
  3. Unclear or shifting self-image. When you have BPD, your sense of self is typically unstable. Sometimes you may feel good about yourself, but other times you hate yourself, or even view yourself as evil. You probably don’t have a clear idea of who you are or what you want in life. As a result, you may frequently change jobs, friends, lovers, religion, values, goals, or even sexual identity.
  4. Impulsive, self-destructive behaviors. If you have BPD, you may engage in harmful, sensation-seeking behaviors, especially when you’re upset. You may impulsively spend money you can’t afford, binge eat, drive recklessly, shoplift, engage in risky sex, or overdo it with drugs or alcohol. These risky behaviors may help you feel better in the moment, but they hurt you and those around you over the long-term.
  5. Self-harm. Suicidal behavior and deliberate self-harm is common in people with BPD. Suicidal behavior includes thinking about suicide, making suicidal gestures or threats, or actually carrying out a suicide attempt. Self-harm encompasses all other attempts to hurt yourself without suicidal intent. Common forms of self-harm include cutting and burning.
  6. Extreme emotional swings. Unstable emotions and moods are common with BPD. One moment, you may feel happy, and the next, despondent. Little things that other people brush off can send you into an emotional tailspin. These mood swings are intense, but they tend to pass fairly quickly (unlike the emotional swings of depression or bipolar disorder), usually lasting just a few minutes or hours.
  7. Chronic feelings of emptiness. People with BPD often talk about feeling empty, as if there’s a hole or a void inside them. At the extreme, you may feel as if you’re “nothing” or “nobody.” This feeling is uncomfortable, so you may try to fill the void with things like drugs, food, or sex. But nothing feels truly satisfying.
  8. Explosive anger. If you have BPD, you may struggle with intense anger and a short temper. You may also have trouble controlling yourself once the fuse is lit—yelling, throwing things, or becoming completely consumed by rage. It’s important to note that this anger isn’t always directed outwards. You may spend a lot of time feeling angry at yourself.
  9. Feeling suspicious or out of touch with reality. People with BPD often struggle with paranoia or suspicious thoughts about others’ motives. When under stress, you may even lose touch with reality—an experience known as dissociation. You may feel foggy, spaced out, or as if you’re outside your own body.

Common co-occurring disorders

Borderline personality disorder is rarely diagnosed on its own. Common co-occurring disorders include:

When BPD is successfully treated, the other disorders often get improve, too. But the reverse isn’t always true. For example, you may successfully treat symptoms of depression and still struggle with BPD.

causes—hope

Most mental health professionals believe that borderline personality disorder (BPD) is caused by a combination of inherited or internal biological factors and external environmental factors, such as traumatic experiences in childhood.

Brain differences

There are many complex things happening in the BPD brain, and researchers are still untangling what it all means. But in essence, if you have BPD, your brain is on high alert. Things feel more scary and stressful to you than they do to other people. Your fight-or-flight switch is easily tripped, and once it’s on, it hijacks your rational brain, triggering primitive survival instincts that aren’t always appropriate to the situation at hand.

This may make it sound as if there’s nothing you can do. After all, what can you do if your brain is different? But the truth is that you can change your brain. Every time you practice a new coping response or self-soothing technique you are creating new neural pathways. Some treatments, such as mindfulness meditation, can even grow your brain matter. And the more you practice, the stronger and more automatic these pathways will become. So don’t give up! With time and dedication, you can change the way you think, feel, and act.

Personality disorders and stigma

When psychologists talk about “personality,” they’re referring to the patterns of thinking, feeling, and behaving that make each of us unique. No one acts exactly the same all the time, but we do tend to interact and engage with the world in fairly consistent ways. This is why people are often described as “shy,” “outgoing,” “meticulous,” “fun-loving,” and so on. These are elements of personality.

Because personality is so intrinsically connected to identity, the term “personality disorder” might leave you feeling like there’s something fundamentally wrong with who you are. But a personality disorder is not a character judgment. In clinical terms, “personality disorder” means that your pattern of relating to the world is significantly different from the norm. (In other words, you don’t act in ways that most people expect). This causes consistent problems for you in many areas of your life, such as your relationships, career, and your feelings about yourself and others. But most importantly, these patterns can be changed!

Self-help tips: 3 keys to coping with BPD

  1. Calm the emotional storm
  2. Learn to control impulsivity and tolerate distress
  3. Improve your interpersonal skills

Self-help tip 1: Calm the emotional storm

As someone with BPD, you’ve probably spent a lot of time fighting your impulses and emotions, so acceptance can be a tough thing to wrap your mind around. But accepting your emotions doesn’t mean approving of them or resigning yourself to suffering. All it means is that you stop trying to fight, avoid, suppress, or deny what you’re feeling. Giving yourself permission to have these feelings can take away a lot of their power.

Try to simply experience your feelings without judgment or criticism. Let go of the past and the future and focus exclusively on the present moment. Mindfulness techniques can be very effective in this regard.

  • Start by observing your emotions, as if from the outside.
  • Watch as they come and go (it may help to think of them as waves).
  • Focus on the physical sensations that accompany your emotions.
  • Tell yourself that you accept what you’re feeling right now.
  • Remind yourself that just because you’re feeling something doesn’t mean it’s reality.

[Listen: Eye of the Storm Meditation]

Do something that stimulates one or more of your senses

Engaging your sense is one of the quickest and easiest ways to quickly self-soothe. You will need to experiment to find out which sensory-based stimulation works best for you. You’ll also need different strategies for different moods. What may help when you’re angry or agitated is very different from what may help when you’re numb or depressed. Here are some ideas to get started:

Touch. If you’re not feeling enough, try running cold or hot (but not scalding hot) water over your hands; hold a piece of ice; or grip an object or the edge of a piece of furniture as tightly as you can. If you’re feeling too much, and need to calm down, try taking a hot bath or shower; snuggling under the bed covers, or cuddling with a pet.

Taste. If you’re feeling empty and numb, try sucking on strong-flavored mints or candies, or slowly eat something with an intense flavor, such as salt-and-vinegar chips. If you want to calm down, try something soothing such as hot tea or soup.

Smell. Light a candle, smell the flowers, try aromatherapy, spritz your favorite perfume, or whip up something in the kitchen that smells good. You may find that you respond best to strong smells, such as citrus, spices, and incense.

Sight. Focus on an image that captures your attention. This can be something in your immediate environment (a great view, a beautiful flower arrangement, a favorite painting or photo) or something in your imagination that you visualize.

Sound. Try listening to loud music, ringing a buzzer, or blowing a whistle when you need a jolt. To calm down, turn on soothing music or listen to the soothing sounds of nature, such as wind, birds, or the ocean. A sound machine works well if you can’t hear the real thing.

Reduce your emotional vulnerability

You’re more likely to experience negative emotions when you’re run down and under stress. That’s why it’s very important to take care of your physical and mental well-being.

Take care of yourself by:

  • Avoid mood-altering drugs
  • Eating a balanced, nutritious diet
  • Getting plenty of quality sleep
  • Exercising regularly
  • Minimizing stress
  • Practicing relaxation techniques

Tip 2: Learn to control impulsivity and tolerate distress

The calming techniques discussed above can help you relax when you’re starting to become derailed by stress. But what do you do when you’re feeling overwhelmed by difficult feelings? This is where the impulsivity of borderline personality disorder (BPD) comes in. In the heat of the moment, you’re so desperate for relief that you’ll do anything, including things you know you shouldn’t—such as cutting, reckless sex, dangerous driving, and binge drinking. It may even feel like you don’t have a choice.

Moving from being out of control of your behavior to being in control

It’s important to recognize that these impulsive behaviors serve a purpose. They’re coping mechanisms for dealing with distress. They make you feel better, even if just for a brief moment. But the long-term costs are extremely high.

Regaining control of your behavior starts with learning to tolerate distress. It’s the key to changing the destructive patterns of BPD. The ability to tolerate distress will help you press pause when you have the urge to act out. Instead of reacting to difficult emotions with self-destructive behaviors, you will learn to ride them out while remaining in control of the experience.

For a step-by-step, self-guided program that will teach you how to ride the “wild horse” of overwhelming feelings, check out our free Emotional Intelligence Toolkit. The toolkit teaches you how to:

  • get in touch with your emotions
  • live with emotional intensity
  • manage unpleasant or threatening feelings
  • stay calm and focused even in upsetting situations

The toolkit will teach you how to tolerate distress, but it doesn’t stop there. It will also teach you how to move from being emotionally shut down to experiencing your emotions fully. This allows you to experience the full range of positive emotions such as joy, peace, and fulfillment that are also cut off when you attempt to avoid negative feelings.

A grounding exercise to help you pause and regain control

Once the fight-or-flight response is triggered, there is no way to “think yourself” calm. Instead of focusing on your thoughts, focus on what you’re feeling in your body. The following grounding exercise is a simple, quick way to put the brakes on impulsivity, calm down, and regain control. It can make a big difference in just a few short minutes.

Find a quiet spot and sit in a comfortable position.

Focus on what you’re experiencing in your body. Feel the surface you’re sitting on. Feel your feet on the floor. Feel your hands in your lap.

Concentrate on your breathing, taking slow, deep breaths. Breathe in slowly. Pause for a count of three. Then slowly breathe out, once more pausing for a count of three. Continue to do this for several minutes.

In case of emergency, distract yourself

If your attempts to calm down aren’t working and you’re starting to feel overwhelmed by destructive urges, distracting yourself may help. All you need is something to capture your focus long enough for the negative impulse to go away. Anything that draws your attention can work, but distraction is most effective when the activity is also soothing. In addition to the sensory-based strategies mentioned previously, here are some things you might try:

Watch TV. Choose something that’s the opposite of what you’re feeling: a comedy, if you’re feeling sad, or something relaxing if you’re angry or agitated.

Do something you enjoy that keeps you busy. This could be anything: gardening, painting, playing an instrument, knitting, reading a book, playing a computer game, or doing a Sudoku or word puzzle.

Throw yourself into work. You can also distract yourself with chores and errands: cleaning your house, doing yard work, going grocery shopping, grooming your pet, or doing the laundry.

Get active. Vigorous exercise is a healthy way to get your adrenaline pumping and let off steam. If you’re feeling stressed, you may want to try more relaxing activities such as yoga or a walk around your neighborhood.

Call a friend. Talking to someone you trust can be a quick and highly effective way to distract yourself, feel better, and gain some perspective.

Tip 3: Improve your interpersonal skills

If you have borderline personality disorder, you’ve probably struggled with maintaining stable, satisfying relationships with lovers, co-workers, and friends. This is because you have trouble stepping back and seeing things from other people’s perspective. You tend to misread the thoughts and feelings of others, misunderstand how others see you, and overlook how they’re affected by your behavior. It’s not that you don’t care, but when it comes to other people, you have a big blind spot. Recognizing your interpersonal blind spot is the first step. When you stop blaming others, you can start taking steps to improve your relationships and your social skills.

Check your assumptions

When you’re derailed by stress and negativity, as people with BPD often are, it’s easy to misread the intentions of others. If you’re aware of this tendency, check your assumptions. Remember, you’re not a mind reader! Instead of jumping to (usually negative) conclusions, consider alternative motivations. As an example, let’s say that your partner was abrupt with you on the phone and now you’re feeling insecure and afraid they’ve lost interest in you. Before you act on those feelings:

Stop to consider the different possibilities. Maybe your partner is under pressure at work. Maybe he’s having a stressful day. Maybe he hasn’t had his coffee yet. There are many alternative explanations for his behavior.

Ask the person to clarify their intentions.One of the simplest ways to check your assumptions is to ask the other person what they’re thinking or feeling. Double check what they meant by their words or actions. Instead of asking in an accusatory manner, try a softer approach: “I could be wrong, but it feels like…”or “Maybe I’m being overly sensitive, but I get the sense that…“

Put a stop to projection

Do you have a tendency to take your negative feelings and project them on to other people? Do you lash out at others when you’re feeling bad about yourself? Does feedback or constructive criticism feel like a personal attack? If so, you may have a problem with projection.

To fight projection, you’ll need to learn to apply the brakes—just like you did to curb your impulsive behaviors. Tune in to your emotions and the physical sensations in your body. Take note of signs of stress, such as rapid heart rate, muscle tension, sweating, nausea, or light-headedness. When you’re feeling this way, you’re likely to go on the attack and say something you’ll regret later. Pause and take a few slow deep breaths. Then ask yourself the following three questions:

  1. Am I upset with myself?
  2. Am I feeling ashamed or afraid?
  3. Am I worried about being abandoned?

If the answer is yes, take a conversation break. Tell the other person that you’re feeling emotional and would like some time to think before discussing things further.

Take responsibility for your role

Finally, it’s important to take responsibility for the role you play in your relationships. Ask yourself how your actions might contribute to problems. How do your words and behaviors make your loved ones feel? Are you falling into the trap of seeing the other person as either all good or all bad? As you make an effort to put yourself in other people’s shoes, give them the benefit of the doubt, and reduce your defensiveness, you’ll start to notice a difference in the quality of your relationships.

Diagnosis and treatment

It’s important to remember that you can’t diagnose borderline personality disorder on your own. So if you think that you or a loved one may be suffering from BPD, it’s best to seek professional help. BPD is often confused or overlaps with other conditions, so you need a mental health professional to evaluate you and make an accurate diagnosis. Try to find someone with experience diagnosing and treating BPD.

Posted in News & updates | Leave a comment

How to Treat Anxiety in Bipolar Disorder

RESEARCH UPDATE

The way to treat anxiety in bipolar disorder is to treat the bipolar disorder. Anxiety is a synonym for distress, and nearly all mental disorders cause distress, except perhaps the classic, euphoric manias that lift the patient into a carefree state of bliss.

Some mood episodes are more anxiety-provoking than others, and at the top of the list are mixed states. Although anxiety does not appear in the criteria for mixed states, it is often created when depression and mania mix together.1 The International Society for Bipolar Disorders has even calculated the exact proportions for this troubling recipe. It takes only 1 manic symptom during a depression, or 2 depressive symptoms during a mania, to spark anxiety.1

Mixed states tend to respond better to anticonvulsants and atypical antipsychotics than to lithium, which may be why anxiety predicts resistance to lithium in bipolar disorder.2 There are, however, 2 exceptions to this rule: suicide and panic disorder. Both mixed states and anxiety raise the risk of suicide in bipolar disorder, and lithium lowers that risk 6-fold.3 This preventative effect is independent of lithium’s mood benefits, so it is worth considering lithium in patients who are suicidal, even when it has a lower chance of reducing the core symptoms.

Although the classic lithium-responsive patient tends to have pure manias and hypomanias and no anxiety disorder comorbidities, a recent study identified panic disorder as a predictor of lithium response.4 Although anxiety is low in pure mania and hypomania, these patients are on high alert for threat, which is the essence of panic disorder. One study found that they had more phobias of panic sensations than patients in bipolar depression or mixed states.5

The next step in treating mixed states is to reduce antidepressants and anything else that contributes to manic symptoms (eg, drugs of abuse, steroids, and irregular circadian rhythms). Most patients who are in a mixed state have been on an antidepressant for a long time, and it can be difficult to tell if the drug is exacerbating the mixed presentation. Given these uncertainties, it is best to taper slowly, over weeks or months.6 Rapid discontinuation can trigger mania and other mood symptoms. The work is much like tapering a benzodiazepine. If the symptoms worsen, raise back the dose and slow down the taper.

Anxiolytic Mood Stabilizers

In bipolar disorder, anxiety is a non-specific symptom with multiple causes, including mood episodes, stress, and comorbid anxiety disorders. With so many different causes, can any mood stabilizer truly be said to be anxiolytic? Probably not, but we do have a few trials that may point the way when selecting a mood stabilizer for a patient with significant anxiety.

Among the anticonvulsants, valproate and lamotrigine improved anxiety in small controlled trials of anxious bipolar disorder.7-9 Valproate’s evidence here is more robust, and this medication also improved anxiety in patients who do not have bipolar disorder, perhaps because of its benzodiazepine-like gaba-ergic properties.10,11 Lamotrigine may also treat obsessive compulsive disorder through glutamatergic effects, based on a small placebo controlled and several uncontrolled studies.12

The atypical antipsychotics can also improve anxiety. Quetiapine and olanzapine reduced anxiety in large, randomized, placebo-controlled trials of patients with bipolar depression and non-specific anxiety (both were secondary analyses). The effect sizes were large enough to make them noticeable to the casual observer (0.35 for olanzapine and 0.56 for quetiapine).13,14Quetiapine had similar anxiolytic effects in the 300 mg and 600 mg doses, and olanzapine had similar anxiolytic effects as monotherapy or when paired with fluoxetine.

These anxiolytic properties do not seem to extend to other atypical antipsychotics. Ziprasidone and risperidone both failed in placebo-controlled trials of bipolar disorder with anxiety, and risperidone actually worsened anxiety in a study of bipolar with comorbid panic disorder.7

The unanswered question here is whether these medications were targeting anxiety directly or treating mild mixed states. Most of the patients had 1 to 2 manic symptoms along with their depression, judging from their average Young Mania Rating Scale of 5, and anxiety was higher as the manic symptoms went up.13,14 On the other hand, quetiapine has a large effect size in generalized anxiety disorder (GAD), suggesting a more direct effect.15 Quetiapine came close to FDA approval in GAD, but was held back because the FDA did not think this disorder was severe enough to warrant all the risks of an antipsychotic. That lesson applies to bipolar disorder as well. Quetiapine may be very effective for anxiety, but it should not be used in mild cases.

Anxious Distress

Anxiety may not offer a direct path to pharmacotherapy in bipolar disorder, but it does tell us something about the care of the patient. These patients are at greater risk for treatment dropout, adverse effects of medications, substance abuse, and suicide. Supportive psychotherapy, fast-acting treatment, and an extra phone call to make sure they are tolerating any new medication go a long way in these cases.

Dr Aiken is the Mood Disorders Section Editor for Psychiatric TimesTM, the editor in chief of The Carlat Psychiatry Report, and the director of the Mood Treatment Center. He has written several books on mood disorders, most recently The Depression and Bipolar Workbook. The author does not accept honoraria from pharmaceutical companies but receives royalties from PESI for The Depression and Bipolar Workbook and from W.W. Norton & Co. for Bipolar, Not So Much.

Posted in News & updates | Leave a comment

Intibipolar likes dislikes Instagram

Depression

LIKES:
Being alone
Constantly telling you are not good enough
pushing people away
Sleeping lots
Feeding us negative thoughts
Casting a shadow over any positivity

Dis-Likes:
Opening up to people
peope being nice to us
goinbg out
allowing us to ask for help
Letting us out of the gloomy darkness
being kind to us
anything positive happening to us….

The support team….

Posted in News & updates | Leave a comment

Affirmations

Present Tense Affirmations

I am courageousI am braveI am fearlessI always stand up for myselfI am developing courageI am ready for anything that comes my wayI am strong and full of courageI push through my fear and do it anywayI am courageous when others are scaredMy courage helps to inspire others

Future Tense Affirmations

I will develop courageI will smash through fear and rise to the occasionI am becoming more courageous with each passing dayI will transform into a strong and fearless personFearlessness is developing within meEach day I feel stronger and more courageousOthers will notice my fearlessness

Natural Affirmations

I am naturally courageousCourage comes easily to meI always find a way to call forth courage when I need itI am the kind of person who feels fear but does it anywayBeing brave comes naturally to meDeveloping courage is something I just know I can doBeing strong in the face of adversity is one of my best

Posted in News & updates | Leave a comment