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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by holymama on June 21, 2004, at 17:18:51
Over the past year I have been seeing my first therapist and trying out medications for the first time in my life. After going manic on an antidepressant, my depression has been rediagnosed as bipolar II. It's been a rough year, trying many meds, in the hospital once, very unfunctionally depressed much of the time. When I get depressed I lose interest in everything, have very negative thoughts, think about suicide, need a lot of help caring for my kids.
My question is this. How much of bipolar depression (and the swing the other way) is a habit -- a learned behavior -- that might be able to be changed with therapy? My husband, therapist and I have diffeering theories about my depressions. Personally, when I am depressed, the right medication change feels like a 'light switch' has turned on in my head, and I feel better. My negative thoughts turn around and start spinning the other way -- positive and hopeful. I feel like this must be chemical, and I feel like I have very little control over it -- I'm relying on medication now to get better. My therapist reinforces this belief (or maybe helped me form it). She tells me when I am depressed that she can't really do therapy with me, so I just go in and kind of complain and figure out how to 'get though it' until medication works. She says to treat it as if I have the flu. My husband has a problem with that. He thinks my therapist should be helping me change my attitudes and my negative thinking so that I can help pull myself out of a depression. He doesn't like how she treats me as if I have no control over it and should rely on medication.
While I feel insulted by my husband's comments that 'I can control my depression', I feel there may be a grain of truth, as if I've learned over time that once I start getting depressed, I'll be there for a while, so I'll just settle into it. But also, fighting it all of the time is damn hard work, feels like it doesn't work, and it really does feel like my moods take me for a ride. Any thoughts of the role of therapy in treating bipolar? ~~Autumn~~
Posted by fires on June 21, 2004, at 19:56:19
In reply to Can bipolar 'behaviors' be changed with therapy?, posted by holymama on June 21, 2004, at 17:18:51
My 2 cents worth: I think therapy would only be useful to help you cope until your meds kick in. I think your husband is wrong.
bye
Posted by tabitha on June 22, 2004, at 1:28:09
In reply to Can bipolar 'behaviors' be changed with therapy?, posted by holymama on June 21, 2004, at 17:18:51
Hi, I don't think anyone really knows how much is just brain chemistry going haywire, and how much is psychological. I had bipolar II diagnosis, and after a *lot* of therapy I evened out and was able to reduce meds. The thing that helped most was learning to interpret events differently, so I was less emotionally reactive to interpersonal events. You could call that an attitude change. I also worked a lot on reducing thought distortions-- the typical cognitive therapy stuff.
That all made a huge difference, but it took a really long time. I needed the meds to even be able to do the therapy work. I still have moods, and still have some depression, but nowhere near what it was, and on less meds. So I credit the therapy for that.I think you and your husband are both right-- you know you need the meds to get out of the pit, but he sees that you also need help with the thinking styles that feed the moodswings. Why not combine the two?
Oh, and for me there's a third essential-- keeping basic self-care, a reasonable diet, and a regular sleep schedule. Exercise would no doubt help a lot too, but for now I'm not doing too well with that.
Posted by holymama on June 22, 2004, at 6:40:18
In reply to Re: Can bipolar 'behaviors' be changed with therapy?, posted by fires on June 21, 2004, at 19:56:19
thanks fires, your 2 cents is worth more than most peoples', considering you're on this site and must have some experience with what I'm talking about. Most people give me their 50 cents worth, and know nothing about depression. :)
Posted by holymama on June 22, 2004, at 6:41:07
In reply to Re: Can bipolar 'behaviors' be changed with therapy?, posted by holymama on June 22, 2004, at 6:40:18
Posted by holymama on June 22, 2004, at 6:46:52
In reply to Re: Can bipolar 'behaviors' be changed with therapy?, posted by tabitha on June 22, 2004, at 1:28:09
thank you Tabitha, I think that you must be right, that both behaviors and brain chemistry must be involved. It's helpful to hear that you did improve your mood swings with therapy. How much is a 'lot' of therapy? I'm seeing a psychotherapist who I really like and trust. She's helped me through many a crisis. But I do feel like someone who could help me with cognitive behavioral changes would be more useful. I wonder if I'll need to switch therapists at some point.
Thank you for your post. It was helpful to me.
Posted by tabitha on June 22, 2004, at 13:11:06
In reply to Re: Can bipolar 'behaviors' be changed with therapy? » tabitha, posted by holymama on June 22, 2004, at 6:46:52
How much is a 'lot' of therapy? I'm seeing a psychotherapist who I really like and trust. She's helped me through many a crisis. But I do feel like someone who could help me with cognitive behavioral changes would be more useful. I wonder if I'll need to switch therapists at some point.
> Thank you for your post. It was helpful to me.I don't mean to discourage you, but I've been going for over 10 years. A lot of that I'd say was just support through my day to day struggles. It wasn't until I was a bit more stable that I could absorb the cognitive reframing stuff. The way I look at it, since my depression started so young, I had been using depressive thinking styles my whole life. So.. it was quite an effort to undo some of that, since it felt so very true for me. A book that spells out the main distortions is "Mind Over Mood". I didn't get much help just from reading the book though. I really needed the one-on-one coaching over a long period. There are probably short-term therapies that focus on similar stuff though, maybe you'd get some relief from those? But if you like your current T, how about asking him/her about some cognitive stuff, or offering a referral? I think the interpersonal connection with the T is important too. It takes a lot of trust in someone to let them change your thinking.
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