Friday, August 31, 2012

Bullies and Brothers

Today was another day... with another bully.

My two older boys wanted to exercise together by running a lap around the block. It was my 9 year olds first time to go with his big brother. Less than 10 minutes later they both barge in screaming for help, one bleeding from his knee. My first thought was that he tripped, but quickly I found out they were chased down by an older kid from middle school. They explained that he threatened them at first, saying, “I’m coming for you.” Thinking it was a joke the laughed it off as they jogged by, but before they knew it they realized he was chasing them down. To protect themselves, they took cover under some bushes in a nearby house. The safety was short lived when the bully found them. As he approached them he slammed his fists together saying, “This is going to be you!”

Immediately the bully started swinging punches at my 9 year old, but big brother wasn’t going to stand by and watch his brother get hurt, as he said, “If someone is going to get hurt, it might as well be me instead of my little brother!” So he jumped in, taking a few swings at the bully. Seconds later they were back on their feet running to the safety of our home.

When they arrived, they were terrified, almost hysterical! After calming them down so they could breath between tears I took off, chasing the bully down.

To my surprise, it’s a kid who I know from my work. I think he was just as surprised to see me. It’s also a friend of the previous bully that chased down my oldest with an airsoft gun earlier this year. In the awkward moment, I got him to apologize to my boys! Then tonight I sent a message to his Dad.

I hope this is the end of this, but unfortunately, this bully attends the same middle school as my oldest and I don’t imagine things will go smoothly when their paths cross again.

As for my sons, Dad gave them a lesson on how to defend themselves, which was uplifting for them both. But more than anything, tonight I’m so proud of my boys for sticking together and trying to protect one another in this scary situation. Brothers are not meant to be messed with!

Tuesday, August 28, 2012

Little Brother Struggles in School

As my oldest adjusts to middle school better than we expected, my youngest has already run out of the classroom because the kids were cheering loudly with the teacher, as the teacher pointed out, “He was very upset.” He has also complained about the noise in the cafeteria being too loud for him.

I’m meeting with his teacher soon, she feels that he’s struggling in other areas too. I wouldn’t doubt that we’ll need a 504 plan before long, in the meantime, I’ll see what the school will allow to help him get through the day. If I’ve learned one thing about surviving school with my oldest, it’s that accommodations are critical for success.

It all comes at no surprise. Summer was pretty rough for my youngest and just this week he dropped to the ground in total panic when a employee at Old Navy gave my boys a free ballon. As the boys held their balloons at a distance, my little one was writhing on the floor, screaming to get them away and that he couldn’t handle seeing them since, “they have a spell on me!” Needless to say, the balloons didn’t stick around. Then today he exploded in a fit, screaming at me, “I’m going to kill you!” all because I wouldn’t buy him something at the store and as a result, that was causing him to “worry”.

It’s always something...

Sunday, August 26, 2012

Giving Our Therapist a Second Chance

You may be surprised by the title of this post after what happened with our therapist—to be honest, I’m surprised too!

Last week I called our therapist to cancel our routine Friday appointment because we felt that we needed a little distance after her threats to send our son to a group home. And more importantly, our son was doing so good now that he was back in school and we didn’t want to do anything to disturb that.

When I spoke with our therapist I expressed how upset we were after the last appointment. I explained that my husband and I were very angry with her bringing up a group home for the first time in front of our son and other children without first discussing the idea with us. I let her know that she scared our son with her threats and that he no longer trusted her, in fact he no longer wanted to talk to her again. I also explained that my middle son was in tears and terrified because he thought that she wanted to take his big brother away from us.

As I downloaded our feelings, I was surprised by her reaction. She was sincerely sorry. She immediately admitted that she had made a terrible mistake, in fact she described it as a “major bomb!” She explained that just like medications, in therapy you try different things to see what will work and sometimes it works and sometimes it fails miserably. She said that she never intend to cause the disruption that occurred and never did she want to harm our family. In fact, she said that she really cared for our family and feels sick to her stomach to think about how our son was dealing with what happened. She explained that she already recognized that he was dealing with some deep issues over being rejected by a childhood friend and now she was worried that she would be perceived as another rejection in his life. She then explained that once the trust is broken, it would need to be repaired immediately because time won’t heal it, only solidify it. Instead, she was desperately asking me to allow her to see my son one more time to repair the damage she had done and apologize to him and explain that even therapists make mistakes. She wanted to tell him how much she cared for him and that she would not give up on him. Then if we decided to end the relationship, she would accept that.

I was moved by her sincere apology. After all these years and all our doctors, we’ve come across a lot of bad decisions by those in charge of his treatment, and never have we received an apology, that is until now. I think that shows a lot of character and responsibility. I also recognize that this process has no road map, what works for one kid doesn’t work for another and sometimes we can make a wrong turn. Until now, she has made a lot of good decisions. But more than anything I agreed with her prediction that if we didn’t allow her to apologize, this experience could do more damage in the long run by discouraging him to ever trust another therapist or even worse, feel rejected by another person he thought he could trust with his illness.

So I agreed we would meet with her.

In order to make this as easy as possible for our son, she suggested that we meet at a local donut shop near her office where she could treat the boys to a donut while keeping them away from her office where they may feel uncomfortable. My son agreed to go after I explained that he didn’t have to talk to her and that we could leave after only five minutes if he wanted to.

The meeting went better than I expected. As our therapist took the kids to the counter to pick out their donuts she immediately pulled my son aside and began apologizing in depth. As she spoke I saw his defensive stance melt away and before I knew it, she was hugging him and he was laughing. After that, she spent most of the time visiting with him like an old friend, I could tell that my son had forgiven her as he shared all about his day and first week of school. At one point, she even turned to my other kids and acknowledged that she had scared them too and that she was so sorry for doing that, asking for their forgiveness. Towards the end of the meeting she pulled the three boys together and told them that she learned something special about our family. She said, “I learned that no matter what happens, your family will always stick together, I really admire that!

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In case you missed my weekend post, Starting Middle School, check it out here:

Friday, August 24, 2012

Starting Middle School

Sorry for the long silence this week, I’ve been one busy mama with the boys starting school. As for my boys, well I’m happy to report that things are fantastic! All three started school on Wednesday, and with my youngest crying the day before about not wanting to go to school, you can imagine my surprise when he came home with giggles and a huge smile! 

As for my oldest, his middle school transition couldn’t have gone better! He was definitely stressed going in, but once there he fell in love with his first period teacher (who was a former kindergarten teacher). He’s also embraced the new freedoms middle school has to offer and likes changing classes throughout the day. Thanks to our 504 plan, we grouped his first 4 classes with 2 teachers & classrooms, allowing the transition from elementary to middle school to be easier. Next, the principal placed him in the Study Skills class we wanted so he could do his homework at school with the help of 2 teachers in a small group setting. This has been very encouraging to my son and even if he has a little homework left after school, he has a better attitude from the start since he’s accomplished so much at school. 

The only challenge for him has been another boy in P.E. who has targeted my son from the first day. He’s been pushing him around, threatening to throw punches at him and cussing him out. My son has been working on staying strong and holding his ground without being abusive back. We’ll be keeping a close eye on that!

The most amazing aspect has been the total shift in my kids, they’ve been so good this week! I mean REALLY good. They’ve been respectful, patient, obedient and just plain fun. At dinner one night we got to experience our kids in a way we haven’t in months—as the boys giggled and shared stories from their day, I was tearing up from joy and my husband whispered to me, “I don’t want this meal to end!” It’s obvious now that the long summer days, too much time together and the growing anxiety over school starting completely unglued them! 

Looking back on the comment section from my last post, I think Meg predicted our success this week when she said:

It is the end of the summer and all kids are wild as March Hares right now. It's like taming wild beasts to get them back into a routine. Things will settle down as school begins and you can see how it all sifts out. At least then your other sons have some place else to go all day and some structure and something else to focus on. Then you can see what is really going on with the oldest.”

Seeing my son now, you’d never guess what happened a week ago—he’s thriving and most definitely not in need of a group home. I think one of my favorite things I came across this week was a notebook that he’s been working on. It’s a book of instructions for his younger brothers to read someday when they prepare to go to middle school. He proudly allowed me to share a few tips he wrote:

Last Day of Summer:The last day of summer is important, it tops off how your summer went. Sadly for me, I had doctors appointments, hopefully yours will be better. Everyone is nervous or stressed today, here’s a tip to help! (Tip #6): Stop thinking about it and think of all the fun you’ll have! 
First Day of School:You’ll feel nervous when you get there, but once you get to class and you’re there for a minute then you’ll love it! (If you get Mrs. Hill) If you feel nervous after your first period here are some tips to help (Tip #7): Find a friend. (Tip# 8): Go to the bathroom or get a drink. (Tip # 9): Find your next class. At lunch period just follow everyone else, sit by a friend and eat lunch. 
Second Day and Dealing with Bullies:The second day is the same as the first, but you’ll start getting use to the schedule. (Tip #10): 7th graders are handy friends, they can give you other tips on how to survive 6th grade. 
If there’s a bully at your school, stand your ground and don’t let him get to you.
Example (this really happened to me):
Bully: “Your face is so fake it makes Barbie’s look real.”
You: “Oh! You play with Barbies?” (then look away)
Reading this, I feel confident that my son is doing just fine right now. It’s such a good feeling.

* * *

Thanks again to everyone who reached out after my last post, it really helped me through a tough time!

Friday, August 17, 2012

Crushed and Broken Hearted—I’m Not Giving Up on My Son!

What can I say about today.

I still feel an ache that’s tearing apart my heart, the pounding in my chest as I hold in tears all day.

Today our therapist said the words that I’ve dreaded to hear.

“I recommend a group home.”

Like a punch in the stomach those words fell at my feet, I refused to hold them, to even consider their meaning.

So you may be wondering what happened. It’s not as bad as you think, or is it?

We’ve had a rough week as my son has been trying to cope with the stress of middle school starting next week. Small things like not having a place for his lunchbox in middle school and considering a switch to paper bags for lunch leave him unsettled, tipping a balance in his world since things will be different than last school year.

His response is the same, he takes it out on us. The usual stuff, taunting, causing his brothers to scream, “LEAVE ME ALONE!”

Combine that with a long summer of less structure (modification plan not enforced enough), too much time with his brothers and boredom and we’re left with a stew of yuck.

We go through our usual steps. We try to calm the situation, but when he doesn’t want to comply the situation escalates, usually with a smile on his face. I have to lock him out of the house where he can calm himself down away from us. Usually he fights us and pounds on the door, then minutes later he goes for a walk, plays with the hose or builds stuff outside in the backyard. Once I see that he appears settled, I let him back inside with the family.

Theses aren’t wild rages like the past, it seems to be intentional acts. He feels bad inside so he wants us to feel bad too. When he doesn’t feel in control of his feelings, he likes to take control of his surroundings by creating conflict with us. It’s a pattern of behavior that’s hard for him to break and hard for us to endure.

Today our therapist got a first hand look of this pattern. As we discussed his recent behavior at home, I could tell that he didn’t like the direction the conversation was headed, so he started picking on his little brother right in front of her (all 3 boys were present). As he initiated the conflict, his little brother responded with screams and fits. He continued. The therapist tried to encourage my son to stop the behavior, to make better choices for his own happiness, but my oldest continued to escalate, all with a smirk on his face. I think he was pleased to see that his actions were successful at stopping the therapy session, now he was in control.

As the session went on, the pattern continued to get more intense. Nothing dangerous, just completely defiant. She explained to him that his parents may need to send him to a group home if he doesn’t learn how to manage his behavior. He then started to throw legos at his brothers, I watched the therapist intensely to see how a “pro” handles these situations. At times my son took off, leaving the office, but would return to continue his disruptive behavior. Another time she asked him to leave the office, which he seemed to receive as a moment of rejection, only escalating his behavior. When he started chasing down his screaming brothers the therapist told us to get in the car and leave our son with her, hinting that I should return in 10 minutes.

As I gathered my younger children together and moved them to the car, my middle son grabbed me and with tears in his eyes said, “You’re not going to send him to a group home are you?”

I explained that it was only a threat the therapist made and that we would be back soon and that everything was going to be alright.

But I was lying. I didn’t know if it was going to be alright. As I pulled into a parking lot down the street, out of sight from the therapist’s office I bowed my head in prayer. I started to imagine the worst. I was terrified that my son would go into a violent rage with the therapist and she would call the police. She doesn’t know him like we do, so she may not know how to handle it or what triggers to avoid. Would he get arrested? Would my son hurt her because he felt abandoned by us? As I peered down the street I felt dread and begged for God’s help.

After 10 minutes, I pulled back up to the office and I saw the blinds to the bathroom window disheveled, then a moment later, my son’s face peeking up at us. As I approached the door, the therapist greeted me and told me that she had a talk with my son and was recommending a group home. Then proceeded to escort my son out of the bathroom and into our car telling me she will call me with the contact info for the home.

Feeling overwhelmed and in shock about the whole situation I nodded my head and climbed into my car.

I didn’t want to scare my kids anymore than they were, so I refused to cry, though that’s all that I could think to do.

Once home, my son explained that the therapist locked him in the bathroom and talked to him through the door. He cried as he explained how frightened he was and how he thought that we were leaving him forever and that she was taking him to a group home.

When we got home there was a message on the machine from the therapist informing me that she had already contacted a crisis group home that could take kids from 4–6 weeks. Because he was only 11 years old, she needed to seek approval for him since they only accept kids 12-18 years.

At this point I was confused, why was this necessary? Why did his defiance indicate a need for a crisis center? He wasn’t doing any serious harm or damage? He wasn’t manic, even she agreed. The situation started to feel like a run away train that was headed down the wrong tracks.

Later that night, the therapist called me and informed me that he was too young for the home. During the call I explained that we were not ready for this step but we’re looking for tools to help our son within our own home. She respond, “Oh, I thought you needed a break and some more help with him.” She said that I didn’t have to do this alone and that there would be 5 adults at a group home that could take him for behavior modification.


I have so much more to say on this, but I want to spare you every detail. But I can say that both my husband and I feel strongly in our gut that having our son leave our home for behavior modification would be the worst thing for him. His deepest pain comes from feeling rejected (an experience caused by a sudden end to his most precious friendship 4 years ago—due to his illness), we all agree (therapist included) that this rejection has led to the predatory behavior we see today. If we as his parents send him to a group home, he would experience another rejection, only deepening the hole that we’re trying to come out of.

My son has a lot to learn—years of living with a mood disorder has destroyed his self esteem. Combine that with his challenges in processing feelings and a habit of responding in the only way he knows how, with anger, he needs time to heal, to cope and to learn new ways of responding to stress while being surrounded by the love and support of his family.

Like a dog with a torn in its side, it will bark, nip at our feet and behave in an unpleasant manner. Solving the problem with a cage will not help the dog, instead the thorn will only dig deeper. If you want to help the dog behave well, you need to start by removing the thorn from his side.

That’s what my son needs, his thorn is a deep rooted belief that he is not worthy of friends, that he has made too many mistakes to be loved and that he will never get better. I believe if we can help my son by removing his thorn, we will at the same time be able to teach him not to bark.

This is my son, a child I love dearly. I see the angry person, but I also see the boy with a broken spirit. I am not giving up on my son. I’m not looking to be rescued, I just want to help my son.

Wednesday, August 15, 2012

ADHD and Anger

I read an article recently and thought it was worth sharing with you. I know a lot of our kids have issues with anger and for some, it may be due to ADHD. Either way, I really appreciated this writer’s perspective on living with explosive anger and the patterns it sets up for future behavior and relationships.

Here is how the article starts out:
I was diagnosed with ADHD at 46. After my diagnosis, I had a long talk with my sister (who does not have ADHD). One of the most startling things she told me was when we were kids, we’d be happily playing, when – POW! –I’d have an angry outburst. It scared her.
... Being punished as a child for my anger only increased my anxiety; I couldn’t control or predict my angry outbursts, making me worry constantly. A vicious cycle began: angry outburst – punishment – anxiety and worry, leading to inability to control angry outburst… and so on. (Kessler, Z., 2012)

It’s worth reading the entire article so check it out here:

* * *

Psych Central
Undiagnosed ADHD Can Make You Angry

Sunday, August 12, 2012

Sponge Wars

This is our last week of summer before school starts. We’re starting to buy our school supplies and my son is having moments of excitement mixed with tears as he gets ready to start middle school. He’s heading into new territory and we’re all feeling a little anxious about it.

But before the school bell rings we have a little fun left and we wanted to share with you our latest activity that you can try out with your kids. It’s called sponge wars! Basically you buy a ton of cleaning sponges (only the soft ones) and you collect buckets, ice chests or anything else that can hold water and fill them up with a hose. Next, scatter the containers of water throughout a territory, for us it was the court in front of our house. Then arm every kid with a pile of sponges ready to dip and load up with water. With a blow of a whistle, let the war begin with every man for himself. The kids launch their water-soaked sponges at one another, taking cover behind bushes and trees. Once out of sponges, the kids have to dart out of their hiding places to load up again, refueling their sponges with water at the nearest water station. Within seconds there will be sponges flying everywhere and your kids will be soaked head-to-toe while they scream with joy and laughter!

Try it, you’ll have a blast with your kids, we did!

Friday, August 10, 2012

A Reason for Hope

Today is my final post about the 8th Annual Mood Disorders Education Day. I saved my most exciting experience for the end. This year I heard through Stanford staff that Kiki Chang was going to be leading the breakout session for the children’s discussion. When I heard that, I was so excited to attend because I’ve always wanted the opportunity to ask Dr. Chang questions face to face. Dr. Chang founded The Stanford Pediatric Bipolar Disorders Program in 1997 and a few years ago I saw him on an old episode of Frontline called The Medicated Child and was very interested in what he had to say.

(Please note that this is my interpretation of the information presented.)

You can imagine my disappointment when I attended the breakout session and there was no Dr. Chang. Instead, another person answered questions. Unlike previous years, this discussion felt more like a sharing time where we were asked to share our stories along with our questions. I appreciated everyone’s participation and there were some great questions from the group, but the information wasn’t as new as previous years. As the session came to an end, my friend and I hung out a little longer to ask a few more questions and to get to know one of the other parents attending, then to my complete surprise, Dr. Kiki Chang came wandering in after working where he was teased by staff for not being there sooner. Then to our good fortune, Dr. Chang volunteered to hang out with us for a bit to answer any questions that the three of us still had.

(Yes, I was giddy with excitement, I just love good surprises!)

During our discussion Dr. Chang wanted to share a new interest in mood issues caused by a strep infection that his team is getting into. It’s called PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) or as they now refer to it as PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome) because they now believe it may be more than strep bacteria causing the illness.

Dr. Chang has witness first hand kids that have bipolar-like symptoms with psychosis that required being admitted, then later be treated with a course of antibiotics for the PANS and respond to treatment. To think that some children who are experiencing the debilitating symptoms of a serious mood disorder can be cured by a course of antibiotics is amazing! Now this doesn’t mean that all kids that have mood issues are experiencing PANS, but for a group of them, this is life changing news. Dr. Chang pointed out that to consider if a child has PANS, they must have developed all their symptoms at once, it is an acute sudden onset of symptoms, which would typically have symptoms of tics and OCD. For example, your child is happy, social and performs well, then suddenly, they are obsessive with OCD qualities, experiencing tics, having mood issues, anxiety etc. all at once, the child changes overnight. Dr, Chang shared that they’re starting a new study soon so if you’re interested you may want to contact Stanford.

One of the questions I was most anticipating asking Dr. Chang was, “Is it possible for a child who has bipolar symptoms, who with medication, therapy and a developing brain grows up to not have bipolar disorder as an adult? Essentially, the course of the illness is changed due to early intervention?”

Dr. Chang responded with “YES!” He explained that they have seen it in their own studies with kids who were put on Lithium as a child for bipolar symptoms and as they grew up they were able to come off their medication. He did believe that the early intervention helped these kids and he pointed out that in all cases of this happening, the kids were taking Lithium, which is known for it’s neuro-protective qualities. He did mention that some kids may still have some challenges, but joked, “don’t we all!”

Now if that isn’t a reason for hope, I don’t know what is.

* * *

More from Dr. Kiki Chang:
Please note that these interviews were done in 2007-2008 and may not include the latest research.

Kiki Chang interview on Frontline in 2007 in the episode The Medicated Child:

The Medicated Child Frequently Asked Questions answered by Kiki Chang posted in 2008:

Chat with Kiki Chang and The Balanced Mind Foundation in 2008:

Tuesday, August 7, 2012

Triggers for Mania and Depression

Today I’m excited to share another post from the 8th Annual Mood Disorders Clinic at Stanford. One of the most interesting presentations was from Sheri Johnson, PHD, Professor of Clinical Psychology, University of California Berkeley. She discussed the symptom triggers in bipolar disorder for both mania and depression and explained how they’re unique and very different from one another.

(Please note that this is my interpretation of the information presented.)

In depression, some known triggers are major negative life events, lack of social support, negative thoughts about oneself, family conflict and negative moods. When bad stuff happens, depression can follow.

When it comes to mania, the list of triggers is very different. Mania can be triggered by a change in meds, having too much caffeine, using certain cold medications, exciting events, quitting bipolar meds and any behavior that disrupts normal sleep.

A disruption in sleep patterns seems to be a major trigger. Dr. Johnson stressed the importance of establishing good sleep habits, then “protecting them like a religion!” She pointed out that people with bipolar disorder should aim for a minimum of 8 hours of sleep and that they should go to bed and wake up at the same time everyday to establish a healthy circadian rhythm. She stressed that one should never disrupt this pattern, even for special events or holidays since this can trigger the onset of mania.

Another interesting trigger presented was the “exciting events”. Those with bipolar disorder are reward sensitive, she called this type of trigger “activating stimuli”. Just as negative events can bring on depression, events that are rewarding can trigger mania. Such events can be a graduation, a marriage or even winning an award. Often these events start out with the individual appearing very ambitious with lots of goals. They start to get more busy and more active, appearing overly optimistic and under estimating risks. This behavior can go into overdrive triggering mania.

During the onset of this period. it’s important for the family and doctor to be on high alert. If they can help support the individual by encouraging them to stick to good sleep patterns and not take on every new project, it may help. If anything, being aware that these types of exciting events can trigger mania, will allow those around the individual to be prepared for the onset of mania.

For me, I was fascinated with this information. I immediately thought about my son and how he goes through intense, highly focused creative periods where all he can think and talk about are his plans for building some new game, invention or creation. It made me wonder if there was any correlation to negative moods and high irritability following periods of intense, project oriented creativity. I’m definitely going to start charting this “creative mode” period to see if I can in the future predict the onset of other behaviors.

Please check back as I finish this series of posts with my review of the Q&A breakout session for children with mood disorders and what I learned from Kiki Chang.

* * *

In case you missed it, here is my first post about what I learned at the Stanford Education Day:

Thursday, August 2, 2012

Highlights from the 8th Annual Mood Disorders Educations Day at Stanford

This past weekend, I went to Stanford’s 8th Annual Mood Disorders Education Day. I wasn’t sure if I wanted to go again this year because I didn’t think that there would be enough new information, but I was very wrong about that, this event was very different that last year or the year before. Last year the focus was mainly on the genetics of mood disorders but this year the focus switched to the therapy side as well as special features such as mood disorders in women. Unlike previous years, there wasn’t a special presentation on children, however, I wasn’t disappointed since we still had a breakout session for children and mood disorders where you could ask questions to the researchers in a small group, always my favorite part of this education day.

Here are some notes I took from the event:
(Please note that this is my interpretation of the information presented.)
In the opening presentation, Terence Ketter M.D., Chief of the Bipolar Disorders Clinic shared how there’s work underway for a National Network of Depression Centers that will be throughout the United States. The ultimate goal is to have such a center within 250 miles of every citizen in America to help treat depression and bipolar disorder. This system mimics the cardiovascular and cancer centers that are currently throughout the country. Right now it is still in progress and waiting for funding.

Next there was an update on the DSM-5 Guide for mood disorders. This next guide will reflect what psychiatrists see in the field, not just extreme cases. The goal of this update is to help decrease false diagnoses. There’s special attention on mixed episodes and energized depression (mix state with irritability, pacing, negative energy etc.) Bipolar NOS will be referred to as Bipolar NEC (Not Elsewhere Classified). They also mentioned that for a bipolar disorder diagnosis there must be a change of energy. The circadian rhythms must have a change.

In the presentation for women and mood disorders, attention was brought to the increased risks that exists for women who have the disorder. Women are twice as likely to have depression and are more likely to have atypical depression. They have increased risks with seasonal patterns than men and are more likely to suffer with physical pain. Women have an increase in bipolar 2 diagnosis and more likely to experience rapid cycles and mixed episodes. There is clear research that hormonal changes in women have an impact when it comes to mood disorders.

The next speaker focused on Cognitive Behavior Therapy (CBT). An interesting point made was that even in cases where individuals are treated with optimal meds, relapse is very common. Thus demonstrating the importance of therapy when it comes to long term care for mood disorders. They discussed how our thoughts, behavior and feelings are all connected and by helping to improve one’s thoughts, behaviors can be influenced in a positive way resulting in better feelings. For those with mood disorders, negative thinking is much worse than the typical person, they’re more likely to see things as “all or nothing”, to overgeneralize, disqualify positive, catastrophize or try to read the minds of others (in a negative way). In CBT, therapists work to identify distorted thinking patterns and correct the thoughts which as a result will lead to better behavior and a positive cycle can begin. Therapists can create strategies to problem solve or help the individual distance themselves from their thoughts so they don’t assume all thoughts are true. When it comes to behaviors, therapists can teach individuals how to overcome unwanted patterns through new skills or plan of actions. Then when it comes to feelings, therapists can teach individuals how to accept their feelings or at the least tolerate them. They can also teach relaxation exercises for coping and strategies for extreme emotions such as anger. 

Research has shown that those who participate in CBT have less episodes and hospitalizations and the effects are similar to good medication. It improves overall functioning. The downside is that it requires effort to find a good therapist and it doesn’t work for everyone. The best thing to do is to meet several therapists and interview them over the phone until you find someone you feel will work best for you. If you don’t feel like it’s a good match, try someone else. Don’t worry about hurting their feelings, it’s a natural part of their practice.

I have to admit that after hearing about CBT, I realized how lucky we are to have our son’s therapist. Through this presentation, I could see exactly how our therapist is putting these methods at work, it helped me to understand the steps we have taken, especially with regards to distorted thinking patterns and strategies for coping. It was nice to hear that we’re on the right track!

Check back for my next post when I share the latest research in triggers for bipolar disorder and the differences between depression and mania triggers that was presented at this event and my Q&A discussion with Dr. Kiki Chang, you’ll find this information very interesting!