Bipolar Breakthrough: The Essential Guide to Going Beyond Moodswings to Harness Your Highs, Escape the Cycles of Recurrent Depression, and Thrive with Bipolar II - Softcover

Fieve, Ronald R.

Softcover

ISBN 10: 1605296457 ISBN 13: 9781605296456

Verlag: Harmony/Rodale/Convergent, 2009

Inhaltsangabe

More than 30 years ago, Ronald R. Fieve, MD, gained national recognition for his pioneering treatment of what was then known as "manic-depression." Since then, he has focused on patients with mild bipolarity, also known as Bipolar II. With the right treatment, these patients can turn their illness into an asset.
In this groundbreaking book, Dr. Fieve presents a highly successful program that allows Bipolar II patients to harness the creativity and energy of their hypomanic "highs" while minimizing the potentially devastating "lows" of depression.
Now with a new foreword explaining the most up-to-date research on the bipolar spectrum, Bipolar Breakthrough includes:
-six stay-well strategies for anyone suffering from Bipolar II
-the latest information on cutting-edge medications with fewer side effects
-a special section on the complications of a bipolar diagnosis for pregnant women, children, and the elderly
With results supported by thousands of patient histories, Dr. Fieve's Bipolar Breakthrough is a landmark work that will help the millions of Bipolar II sufferers live better lives.

Über diesen Titel

Über die Autorin bzw. den Autor

RONALD R. FIEVE, MD, is a pioneer in the use of lithium for bipolar illness in America. An internationally renowned psychiatrist and psychopharmacologist, he is professor of Clinical Psychiatry at Columbia Presbyterian Medical Center and executive director of the Foundation for Mood Disorders. Author of the best-selling Moodswing, Dr. Fieve is also president of Fieve Clinical Services, which offers no-cost evaluation and treatment for patients willing to participate in clinical drug trials. He lives and practices in New York City.

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chapter 1

THE DECADE OF BIPOLAR II

Until recently, much of the scientific information, research, and treatments concerning manic depression were focused on Bipolar I, a major affective (that is, mood) disorder in which a person alternates between the extreme states of deep depression and intense euphoria.1 This serious illness is characterized by elated mania with sleeplessness (often for days), hallucinations, psychosis, grandiose delusions, and/or paranoid rage. Starting in adolescence or early adulthood, Bipolar I typically persists throughout a person's life. Because of the psychotic features, those with Bipolar I almost always require hospitalization for periods of time. Well aware of Bipolar I, the general population and media have received too little information on Bipolar II, a subtype of manic depression.

I first began to notice this less-extreme version of manic depression (officially called manic-depressive psychosis at the time) in 1971 while I was in charge of the acute psychiatric service at the New York State Psychiatric Institute. Many of these milder manic-depressive patients were dynamic and industrious men and women with exuberant moods and high energy. Initially, they had come to the clinic for treatment of major depression. Yet, unlike others I had treated with manic depression, these men and women had had episodes of mildly elevated moods with high energy and tremendous productivity. In fact, these people were the proverbial "movers and shakers" of New York City. They were extremely motivated, talented, and strong-minded producers, artists, writers, musicians, doctors, lawyers, investment bankers, CEOs, sales professionals--in other words, women and men who had achieved lofty goals and the highest levels of distinction in their professional lives. Now they were sitting in front of me in my office, asking me to help stop their relentless depression.

During the years that followed, I treated literally hundreds of these mildly elated individuals for recurrent or episodic depressions--sometimes mild, but usually quite serious. Unlike their manic-depressive counterparts who alternated between extreme highs and lows, these men and women seemed to get over their depression after effective doses of antidepressants for several months, often combined with psychotherapy. During their so-called well phases, I rarely saw them.

One of these mildly elated patients whom I treated in the mid-1970s was James, who at the time was in his early twenties. The youngest of four children, he was referred to me by his sister, Susan, also a patient.

"James's personality has changed dramatically, almost overnight, and we are extremely concerned," Susan said. "Depression runs strong in our family, and James has suffered with depressed mood for almost a year.

"Recently, he became a totally different person that none of us could recognize. He hardly sleeps, and he's overly confident, flirtatious, and flamboyant, which is not like my brother at all. Also, James went with a 'hunch' last month at his securities firm and made a dreadful investment, losing more than a million dollars of his clients' money."

When James arrived at my office, he was immaculately dressed. After exchanging greetings, I asked James about his past, including his childhood and adolescent years.

"There's nothing impressive about my childhood," he said nonchalantly. "I was overweight, shy, and had few friends. In high school, I was more outgoing and was elected student body president at a private school in New England. I graduated when I was 16, and then I went to Yale on an academic scholarship to study business.

"About a year ago, I went through a horrible low period in my life," James told me. "When I sought medical care, our family doctor said it was depression and prescribed medication. I tried the drug but could not stand the way I felt. Finally, after a few weeks, I stopped the medication."

To mask his depressed feelings, James admitted that he had started drinking alcohol heavily from "breakfast until bedtime" and was using marijuana, but usually only after work or on weekends. He then told of a mystery mood transformation that had occurred over the previous month.

"Over the past couple of weeks, the depression resolved, and my mood has switched into this amazing high. I feel like I've had several cups of strong coffee, and this buzz lasts all day until late at night. I have never felt so incredible in my entire life, or had such creative ideas and high motivation," James said.

I wanted to know more about his risky investment and how he was handling the loss of a large sum of money. James brushed it off as no big deal. In fact, he was quite arrogant, remarking that no problem--even losing a million dollars--was unsolvable to him. In fact, he hinted that some insider knowledge he had on a little-known stock would more than cover the loss. And because of his "insightful brilliance," he would triple his earnings by playing the futures market over the next few months.

As I listened to James go on about his financial "genius," I could tell that he had an inflated sense of confidence with no fear of repercussions. He talked incessantly about extravagant spending on a red Jaguar, a mountain chalet in upstate New York, and wild sexual escapades that he agreed were out of character but highly enjoyable.

I recognized that James was living with a softer type of manic depression, one that we now call Bipolar II disorder. As I had observed in patients for almost a decade, this milder cyclical illness produces the enthusiasm, fervor, and incredible capacity for hard work that can be seen in many of the superachievers in our society. During the hypomanic (mildly manic) times, I saw that many of the often-brilliant high achievers were able to push themselves. It was during these times when they made the most of their ingenious ideas and productivity. But I had also witnessed a downside to this disorder, as it is accompanied by periods of bad judgment as well as episodes of deep depression, as James had experienced, that leave these men and women feeling helpless, hopeless, and worthless. When the major depression hit--and it always did--these patients usually came to see me for medication. Or if they extended too high, like James did with his investments and excessive spending, a family member or colleague would persuade them to seek medical treatment.

After talking with James for more than an hour and doing a full medical evaluation, I explained the diagnosis of this soft bipolar subtype--not yet naming it Bipolar II--and his specific treatment plan, which included stopping drinking and starting Alcoholics Anonymous (AA). All forms of bipolar disorder go hand in hand with alcoholism, and the conditions are probably related genetically. I talked with James about the ill effects of using cocaine, heroin, alcohol, marijuana, amphetamines, potentially addictive tranquilizers, and sleeping pills in an attempt to self-medicate a mood disorder.

I recommended psychotherapy to James so he could openly talk about problems that were fueling this need to drink alcohol and smoke marijuana, as well as begin to face the emotional and financial damage he had done to his personal relationships while in his hypomanic state. I then started James on a very low dose of lithium carbonate, a mood-stabilizing com£d that had been approved by the FDA in 1970 for the treatment of mania in bipolar disorder. Lithium, as I'll explain further in chapter 8, is highly effective in leveling the moodswings of bipolar disorder, as well as helping to prevent future episodes.

Within a few weeks, James's mood was completely stable. He had to spend a lot of time mending fences at work and in his social life, but he was able to save his job and his reputation. Today, James is in his fifties and is still...

Details zur Ausgabe

• Verlag: Harmony/Rodale/Convergent
• Erscheinungsdatum: 2009
• Sprache: Englisch
• ISBN 10: 1605296457
• ISBN 13: 9781605296456
• Einband: Taschenbuch
• Anzahl der Seiten: 288
• Kontakt zum Hersteller: Nicht verfügbar
• Verantwortliche Person: Nicht verfügbar