• 27 Jan
    Prerna Sharma

    Not all mood swings are bipolar disorder.

    mood swing

    We often hear people saying “he got mood swings, he must be bipolar”, “her mood fluctuations are too much to handle, she is suffering from bipolar perhaps” lot of celebrities have come out openly to talk about their diagnosis of bipolar disorder.

    Have we ever wondered if bipolar disorder is over diagnosed or misdiagnosed being merely mood swings! Well, mood swings and bipolar disorder are not mutually exclusive, but there is a fairly dramatic difference in mood swings in regular people and those with bipolar disorder.

     

    Lets understand bipolar disorder first.

    Bipolar disorder is also known as manic-depressive illness and it is a brain disorder caused due to imbalances in neurotransmitters or to say simply, chemicals in the brain that cause unusual shifts in mood, energy levels, and the ability to carry out day-to-day tasks.

    Bipolar disorder is an illness that impacts a person’s thoughts, feelings, perceptions (both mental and physical), as well as behavior. Research findings suggest that people are genetically vulnerable to inheriting the disease if any of their family members have a history of psychiatric illness.

    Typically, a person with manic-depression experiences moods that shift from high to low and back again, with varying degrees of severity.

    The symptoms are severe enough to lead to impairment in work, social, or academic functioning, and may lead to involuntary hospitalization to prevent harm to self or others.

     

    There are various types of bipolar disorder depending upon varied symptomology nevertheless; all of them involve clear changes in mood, energy, and activity levels.

    These moods range from periods of extremely “up,” elated, and energized behavior (known as manic episodes) to very sad, “down,” or hopeless periods (known as depressive episodes). Less severe manic periods are known as hypomanic episodes.

     

    A manic episode is generally characterized by:

    Feeling like you can do anything, even something unsafe or illegal, Extreme displays of emotion, agitation, decreased need for sleep,  inflated self esteem or grandiosity, highly talkative, distractability, dressing flamboyantly, spending money extravagantly, living recklessly having increased sexual desires.

     

    A depressive episode is generally characterized by:

    Mood Changes: A long period of feeling sad, hopeless, worthless, worried, guilty or tearful, loss of interest in previously pleasurable activities.

    Behavioral Changes: Fatigability, problem concentrating, remembering, and making decisions irritability changes in eating, sleeping, or other habits, thinking of death or idea of suicide, or attempting suicide.

     

    The symptoms of bipolar disorder are severe, and the criteria for receiving a diagnosis are quite specific. They are different from the normal ups and downs that everyone goes through from time to time, as well as more extreme mood shifts.

     

    Now let’s understand what defines a mood.

    A more general definition of a mood is the current state of the mind, disposition as of the moment. As such, your mood may range from being too happy, to or deep sadness.

    An observer may only see the non-verbal signs of your mood through facial expressions or behavior, but it is the individual himself/herself who can basically indicate what his mood truly is.

    In regular people, the mood swings usually do not interfere with their lives. If a person is a little bit down or a little bit up, he can still go to work, meet his friends, can still make dinner, or can still take care of your children or house.

    On the contrary, when a person has bipolar disorder, the mood swings are such that they disrupt his life.

    He can be so depressed that he cannot get out of bed. He can be so depressed that he doesn’t want to live.

    On the other side of the continuum, he can be so manic that he spends his family's fortune in a moment.

     

    Mood is usually influenced by a lot of factors, both internally and externally.

    For example, a person unable to sleep during the night may be irritable and gloomy in the morning. Individuals may also suffer from mood swings brought about by an external influence, or among females, hormonal changes.

    Our mood can change without warning, usually influenced by such internal or external factors. Mood swings are less intense, can go away in days, and cannot disrupt the life of an individual. Though mood swings can be part of bipolar disorder but the difference in mood swings in regular people and mood swings in bipolar disorder, is the severity and duration.

     

    Coping with bipolar disorder:

    Bipolar disorder needs immediate attention and help by mental health professionals such as psychiatrist for prescribing medications and a clinical psychologist or therapist to engage the person in psychotherapy.

    In severe case the person requires admission in hospital for improving compliance to the treatment. With regard to mood swings in regular people the help can range from simple relaxation exercises, breathing techniques to take better control of the body and then working on cognitions, thinking, feeling aspect of mind.

    With prolonged stress and poor handling our minds become susceptible to perceive everything overwhelming and before we realize we get into a pattern of cyclic emotions which come flooding and we find ourselves hard to take charge.

    Making smaller goals, appreciating positives in us and environment, taking a break from usual routine, and evaluating our emotions for what they actually are can help in controlling swings.

    A good time management, cherishing our relationships and doing mindfulness meditation can help us deal with mood swings a great deal.

    Dr.Prerna Sharma

    M.Phil, Ph.D Clinical Psychology

    Image source

  • 24 Jan
    Neelima Krishnakumar

    Difference between therapy and advice

    therapy or advice

    Very often clients meet with a therapist in a confused state of mind. They meet the therapist with an inherent feeling of instability of their own minds.

    But this feeling has to be experienced and sorted out by the same mind which makes up the confused state.

    They feel that their experience of pain and confusion are genuine. They look up to the therapist for comfort and help for which they have visited him/her.

    But giving advice is not part of therapy. Advice is mostly superficial and therapist is to explore it more deeply.

    Therapy is actually a place to explore the feelings of the client about themselves. It is a place of self discovery.

    The therapist can at best help the client to find out how he has become tangled up so that an attempt at untangling can be carried out together.

    The therapy is successful only if the client gets a better understanding of his inner world and his relationship.

    Many a time it takes time and reflection to see the inner pattern because of the client’s reluctance to open up in full.

    Very often the therapist has to acknowledge the pain and confusion of the client and wait patiently till the inner problem is sorted out by the client themselves.

     

    This doesn’t mean that information has to be withheld from the client. Many a time, speaking up directly with the client is the best possible way.

    Sometimes CBT has to be integrated into the therapy when patients need symptomatic relief or when they are trying to break habits.

    The most extreme that can happen is when the person is having suicidal tendencies or aggressive habits. In such cases, a list of people from their family circle or friends circle has to be made, to fetch immediate medical help.

    Mindfulness meditation, relaxation techniques like JPMR, guided imagery, etc can be employed in simple cases.

    Communication techniques and relation building exercises can be employed in cases regarding close family relationships.

     

    But a therapist has to be careful not to advice patients with major life decisions.

    The therapist can give hints to help him reach the decisions. A therapist can always point to what is the right decision in a given environment rather than telling what to do.

    Some patients insist to specifically advise them what to do. But this may be because he can distance himself from responsibility if things don’t work as planned.

    Friends and family members can be dependent on giving advice and counselling.

    For e.g. – If a person asks his best friend for an advice regarding his failing relationship with his spouse because of spouses infidelity, the friend might ask him to get a divorce and move on. But a therapist will respond using a solution focused response saying something like “What can you do about your spouse’s infidelity?”  The difference here is that a friend or family member gives advice by answering your question whereas a therapist always helps you to find the answer for your own questions.

    A psycho therapist should always avoid giving advice because then it no longer is part of psycho therapy.

    If the client finds the therapist fill the time with advice, suggestions or anecdotes about their life, it could indicate that he has some difficulty for the therapeutic process to unfold.

    Better search for someone else who creates the space for the process of becoming conscious oneself.

     

    This doesn’t mean that opinions should not be shared. The therapist has to be cautious about giving advice because the client is usually visiting him only to get advice.

    But such advice is not going to help in the long run. Encourage the client to share his experiences; but don’t indulge in giving council.

    If you have a compulsive habit to give advices, the following questionnaire is going to help.

    1. What are my motivations for giving advice? Is it to boost the ego and hence make myself feel important?
    2. How often am I giving advices?
    3. How to ensure that my advice is going to help the client?
    4. Am I crossing the limits? Am I blocking the client from taking decisions by filling him with details?
    5. Would I take my own advice if I were a client?

     

    Remember that when the therapist imposes specific suggestions, he is blocking the client in taking decision. This is counterproductive. But when the therapist teaches their client to solve their problem themselves, they are actually helping the client to develop an insight into the problem all by himself.

    Image source

    Responses 2

    • Radhika Goel
      Radhika Goel   Jul 22, 2017 04:46 PM

      When faced with a difficult decision or any other problem that can have profound consequences on a person's life they look to others for help and advice to avoid being responsible for the consequences. People often approach therapists when the burden gets too much and their existing resources are not enough to cope with the stressful situation before them. In such a situation, they are looking for someone to tell them what to do and find a quick fix to the situation. However, contrary to popular belief, therapists should not and do not offer their clients advice, they help them to find their own solutions. The therapist's job is to lend an ear, have positive regard and explain to the client what bothers them so that they are able to navigate through their own problems. 

      Thank you for bringing this forward and I think these five questions that one should address before giving advice can prevent us from making bad decisions.

    • Stephanie Shapiro
      Stephanie Shapiro   Jan 29, 2017 08:40 AM

      The points in this article were wonderful! I will certainly use this in my private practice- thanks for sharing.

       

      Stephanie Shapiro,LCSW, PhD Candidate

  • 02 Jan
    Neelima Krishnakumar

    The ultimate aim of cognitive behavioural therapy

    cognitive behavioural therapy

     

    CBT can breakdown the sense of overwhelming problems by fragmenting them into parts. In CBT, problems are disintegrated to mainly 5 functional areas like

    • Situations
    • Thoughts
    • Emotions
    • Physical feelings
    • Actions

     cognitive therapy

    According to CBT, these 5 functional areas are interconnected and affect each other. Situations lead to thoughts and feelings which further percolates into emotions and actions.

    CBT differs from other psychotherapy concepts by solving the problem amicably and by stopping negative thought cycles. Suppose you lose the job because of recession or some other unforeseen reason, you can be pensive, brood over it and remain inactive.

    But you can be actually socially more active by interacting among your friends circle, which can fetch sometimes a better job. This will further boost up your social standing.

    CBT teaches you to avoid negative life cycles and to remain always positively charged. CBT controls the negative life cycles by breaking them to components so that identification of a rational solution is easier.

    By making your problems more manageable, CBT thus can help you change your negative thought patterns and improve the way you feel.

    More important is that since CBT is a self helping process, you can achieve this on your own over a period of time and tackle your problems without even the help of a therapist. This is the ultimate aim of cognitive behavioural therapy.

     

    CBT sessions

    CBT can be carried out with a therapist in one to one sessions or in groups with other people facing similar problems as you.

    These sessions can be carried out

    • In the clinic of the therapist
    • Outside in a congenial environment
    • It can be conducted even at your home especially if you have agoraphobia
    • Virtual sessions (Skype sessions / telephonic sessions) with the therapist without leaving the convenience of your home

     

    A CBT session can last for 30 minutes to 1 hour and if you are taking CBT on an individual basis, you will have to meet the therapist for 5 to 20 weekly or fortnightly sessions, as the situation is assessed by the therapist.

    CBT is usually conducted by a specialist trained in CBT such as a psychiatrist, psychologist, mental health nurse or even a general practitioner.

     

    First sessions

    These are aimed at assessing whether CBT is the right therapy for you and whether you are comfortable with the process. The therapist will estimate the percentage of interferences your condition has contributed to your family, work and social life.

     

    Further sessions

    Then the therapist will help you segregate your problem into the essential components as already suggested. The therapist may ask you to keep a diary and write down your thoughts and behaviour patterns.

    The next process is to analyse these thoughts, feelings and behaviours to segregate unrealistic, fanciful and unhelpful ones from positive ones. After working out what you can change, your therapist will suggest to practice these changes in your daily life.

     

    Example for an unhelpful thought process and how it affects you is given below

    Situation: You saw one of your friends walking by the road and he ignored you.

    Unhelpful Thoughts: He ignored me which means that he hates me.

    Emotions: Sad, anger

    Physical feelings: Very low energy, feeling sick

    Action: Ignore/avoid that friend going forward

     

    Now let’s look at the same situation by switching to helpful thought process and see how the outcome varies as a result

    Situation: You saw one of your friends walking by the road and he ignored you.

    Helpful Thoughts: He didn’t notice me! He looks very worried too. May be he is a little preoccupied with something.

    Emotions: Positive

    Physical feelings: Usual

    Action: Call up your friend and check if he is ok

    The situation in both the examples remained the same but it led to two different outcomes based on the thought process which was used. This clearly shows that your thought process affects your feelings and actions.

    One of the biggest benefits of CBT is that once the therapy is finished, you can apply these principles in your daily life as well. A number of interactive software programmes are now available that allow you to benefit from CBT with

    How can you get CBT?

    • You can go to a trained CBT therapist for a face to face session
    • You can use online counselling sites like eWellness expert for a virtual session (i.e. via Skype/phone)
    • You can try self help CBT books / apps

    Image source 1 2

  • 14 Dec
    eWellness Expert

    12 keys to an extraordinary life of fulfillment

    man running

     

    Unlock your true potential through the power of parallel. While exclusive focus on outward achievement or fulfillment will bring results- combine these forces through the six primary categories of your life to create the truly extraordinary.

     

     Your Keys to an Extraordinary Life of Fulfillment from Tony Robbins

     

    Health

    Key 1 Balance Your Body

    Power up the right way of eating more leafy green vegetables and cutting down on sugar to alkalize your body-

    75% of your diet should be composed of alkaline foods

     

    Key 2 Help Others

    Giving activates regions of the brain associated with pleasure, social connection and trust – and also releases endorphins resulting in a positive feeling known as the helper’s high.

     

    Time

    Key 3 Master your time

    Feed your mind and put you N.E.T. time (No extra time) to use.

    While you commute, run errands, exercise or clean the house, listen to podcasts or other short burst resources that will help you achieve your dreams.

     

    Key 4 Always know your purpose

    Challenges will always arise, even with the best time management system in place. Since 20% of what you do in life usually makes 80% of the difference, the ”why” is the most important thing to know. If you have a great enough “why”, you will ignite the emotional fuel achieve the “how”

     

    Wealth

    Key 5 Build a money machine

    The power of compounding can build your nest egg – but associated fees can rob you of what you’ve earned! A simple 1% in fees can cost you over 10 years of comfortable retirement funds.

     

    Key 6 Discover true wealth

    Money doesn’t buy happiness

    Become financially free by saving more and building you money machine, but allow  yourself to spend wisely. Create “magic moments” and incredible memories you can share for a lifetime with loved ones.

     

    Business

    Key 7 Optimize and maximize

    Sometimes, the greatest growth opportunities don’t come from new initiatives, but executing existing processes more effectively. Small, incremental improvements in a few key areas, multiplied over time= geometric growth to the whole business

     

    Key 8 Align with your true nature

    Discover and cultivate your core leadership gifts to learn how to live to the fullest with what you do best. By not only cultivating your own abilities, but having compassion and appreciation of others’ gifts, you can create a synergy that allows you to work effectively toward a common vision.

     

    Mind & spirit

    Key 9 Adopt empowering beliefs

    Free yourself from the beliefs that limit positive action and prevent you from reaching your potential.

    Our beliefs come from 5 places: our environment or circumstances, powerful life events, our knowledge, past results and future vision.

    Do your beliefs limit you or empower you?

     

    Key 10 Live in the present and create a beautiful state

    By exploring and identifying which emotions uniquely infuse your mind and spirit with the most joy, you can learn to cultivate their power to create a more fulfilling state of being.

     

    Relationships

    Key 11 Keep the passion alive

    Create, experience and – most vitally – maintain the lasting passion you desire.

    By identifying and understanding what worked best in the beginning of your relationship, you can continue to meet the needs of your lover and enrich your mutual experience.

     

    Key 12 Put your partner first

    The ultimate key to creating and experiencing an extraordinary, fulfilling relationship is to first work on yourself.

    When you raise your standards for your own behavior and actions, you will naturally empower and engage with the best in your partner.

     

    Source 

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