Bipolar Disorder and Decision Making
When in a manic mood, people with bipolar disorder can act recklessly. Here's how to take responsibility and manage your emotions.
By Malinda Gibbons-Gwyn
Medically reviewed by Niya Jones, MD, MPH
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The dramatic mood swings of bipolar disorder can interfere with your ability to make good choices, particularly during a manic episode. Symptoms of depression include intense sadness, emotional indifference, fatigue, and feelings of despair, whereas mania often causes restlessness, anxiety, irritability, and impulsive behavior.
One recent study explored decision-making skills among manic patients. Study participants were given the Iowa Gambling Task, a psychological test that involves picking cards from different decks with the goal of winning money. Manic participants chose more cards from the decks of cards deemed "risky" than other people and did not learn from their mistakes as easily. The researchers found that manic people made poor decisions because of an inability to understand the consequences.
During a manic period, people with bipolar disorder often have impaired judgment and act recklessly. People with bipolar disorder often do not recognize just how ill they are (a condition known as anosognosia) and may blame their problems on outside factors.
One patient, a teacher in Pittsburgh named Susan, says she had trouble learning to take responsibility for her actions. Her "past faults and mistakes are too numerous to name," she says.
"Admitting that I am wrong is so painfully difficult," she notes. "Yet I have had occasions to [apologize], and there have been those who have received it warmly."
Bipolar Disorder: Partners and a Plan Experts recommend that a person with bipolar disorder have a care team in place. Care partners — friends, family and trusted health-care providers — can help steer you away from the triggers that lead to manic episodes; if an episode does occur, they can help you take responsibility for your actions.
When you are not depressed or manic, make a pact with someone you trust. If you have a manic episode, tell that person to intervene by:
Helping you avoid situations that intensify mood swings
Providing feedback on your mood and behavior
Giving you constant reassurance
Contacting your doctor to make an appointment or to talk about treatment
Having such a plan will not only help you avoid mistakes, it will also help you cope with mistakes even if you do make them. You and the care partners can agree on additional parameters that are relevant to your personal circumstances.
According to Gary Sachs, MD, an associate professor in psychiatry at Harvard Medical School and director of the Bipolar Clinic and Research Program at Massachusetts General Hospital in Boston: "You cannot rely exclusively on yourself and have much hope; you must have a plan in writing and care partners in place. This process is like physical exercise — if you keep working on it, you will be able to do it sooner or later. You have to work at the process."
If you have bipolar disorder, he says, realize that your perception of a given situation may be biased and that you must have someone to help you "see accurately."
Bipolar Disorder: Communication Jair Soares, MD, professor of psychiatry at the University of North Carolina School of Medicine and director of the UNC Center of Excellence for Research and Treatment of Bipolar Disorders, says it is important to communicate honestly with your care partners after an episode. "When you are doing well, have a good conversation about the things that were done or said," he says. This is also a good time to review your bipolar treatment with your doctor or therapist and admit past mistakes.
Bipolar Disorder: Support Groups It may be helpful for you and your care partners to join a support group. Organizations such as the National Alliance on Mental Illness (NAMI) provide helpful information for people with bipolar disorder.
Of course, the best way to avoid making the same mistakes during future episodes is by recognizing the mistakes you have made in the past. When you realize you are experiencing familiar symptoms of mania (talking too quickly, not sleeping or eating well, needing instant gratification), be sure to contact your doctor or therapist as soon as possible.
Last Updated: 03/06/2009
This section created and produced exclusively by the editorial staff of EverydayHealth.com. © 2009 EverydayHealth.com; all rights reserved.
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Tuesday, March 31, 2009
Tuesday, March 10, 2009
Ways to Rev up Your Metabolism--J. Michaels
Your body may not be burning calories quickly because of poor eating habits and a sedentary lifestyle. Fortunately, you can boost your metabolism. Use these tips to rev up your inner engine. Plus: What’s your calorie IQ?
If your body’s engine is already running at full-speed, there’s little you can do to boost your fat-burning potential – you’re already performing at peak. But if your tank is continually running on half-empty, you have room for improvement. Use these seven tips to rev up your metabolism.
Ladies, start your engines!
Secret #1: Early to bed makes you a slim girl.Believe it or not, the number of zzz’s you catch can have a big effect on your waistline. Research shows that sleep deprivation can send your hunger and appetite hormones out of whack.
Leptin, an appetite-suppressing hormone, decreases in adults who are sleep-deprived while ghrelin, a hunger-increasing hormone, spikes.
This means double trouble for your fat cells: You end up eating more than you need, leaving you with extra pounds to show for it.
How much sleep do you need to avoid this? Some people swear they can get by on just a few hours, but experts recommend that you get seven to eight hours of uninterrupted sleep each night.
In case you’re one of those people who think they thrive on less snooze time, take heed: A four-year joint study by the University of Wisconsin and Stanford University found that adults who regularly slept for only five hours a night increased their levels of hunger-inducing ghrelin by 14.9% and lowered their levels of appetite-suppressing leptin by 15.5%.
Getting into a good sleep routine may take a little work, but it’s worth the effort.
Click here for 7 Tips for a Good Night’s Sleep.
Secret #2: Early to rise starts your metabolism off right.Does your morning ritual consist only of showering, brushing your teeth and getting dressed? Then you’re skipping two important things that could boost your metabolism.
The first: Eat breakfast – and coffee doesn’t count. Skipping that bowl of oatmeal might sound harmless, but you’re missing the first opportunity of the day to jumpstart your metabolism.
Think of it in literal terms: Breakfast is “breaking” the overnight “fast” your body was in to conserve calories. Eating – especially a balanced breakfast every day – stimulates your metabolism.
The second key to starting your morning off right? Exercise. Sure, you might struggle to throw off those cozy sheets – who doesn’t? – but it’s a battle worth winning. Why? It boosts your metabolism.
As a result, you’ll burn more calories throughout the day simply doing the same stuff you always do. Who wouldn’t want that? Even a 20-minute walk or jog will make a difference. So skip that second cup o’ joe and strap on your walking shoes instead.
Secret #3: The more you move, the more you’ll lose.Speaking of exercise, you should do it every day. Cardiovascular exercise (running, swimming, aerobics, walking) stimulates your metabolism, helps you burn tons of calories and can even temporarily suppress your appetite post-workout.
But don’t let cardio get all the metabolic-boosting glory. Weight training is important, too, because it tones your muscles and boosts lean tissue mass, which burns more calories per pound than fat. The more lean muscle tissue you have, the more calories you burn each day.
Also, don’t be afraid to exercise more than once a day. Breaking up a 60-minute workout into two 30-minute (or three 20-minute) sessions is not only convenient, but also it may help you burn more fat, according to recent research.
Secret #4: Eat all day to keep weight gain at bay.Don’t take this literally. “Eat all day” means you should be eating more snacks or smaller meals instead of gorging on large meals. Eating five or six small meals throughout the day keeps a steady stream of energy available to your body. This boosts your metabolism and your brain power.
Keep healthy snacks (fruits, veggies, nuts, yogurt) with you and graze throughout the day as needed. Just be sure your main meals are smaller to accommodate all this snacking, or you’ll load up on extra calories you don’t need.
A big weight-loss no-no is skipping meals. Dieters often try to get that extra weight-loss edge by cutting entire meals instead of just cutting calories throughout the day. But this is counterproductive. Skipping meals forces your metabolism to slow down and conserve calories to compensate for the lack of food.
So when you finally do eat, your body remembers that it went for a long time without food and will store more calories to get ready for the next time you’re going to starve it. Stay off this roller-coaster by eating at regular intervals throughout the entire day.
Secret #5: Raise a glass to drinking yourself skinny.Dehydration is a funny thing. The number on the scale may look good when you haven’t had enough water, but you’re risking major weight gain by not drinking enough. Dehydration can trick your brain into thinking you’re hungry, so instead of reaching for a cold one – water, that is – you reach for whatever snack is nearby.
A simple exercise in math may illustrate the importance of hydration:8 ounces of water = 0 calories1 candy bar from the office vending machine = 270 caloriesSwapping that candy bar for a glass of water, then waiting 20 minutes to see if you were really hungry in the first place = priceless.
Some experts claim that your body burns extra calories as it works to raise the temperature of that icy water to your internal body temperature. It’s a controversial claim, but I say why not? It’s refreshing, it’s hydrating and you’ll burn calories on your walk over to the water cooler.
Secret #6: Set your metabolism on fire with spicy foods.Spicing up your meals may do more than just add great flavor. “Hot” foods, such as jalapeños, chili peppers and spices (like curry and cayenne), may increase body temperature.
Body temperature and metabolism are related: As you burn energy, heat is released. By increasing your internal body temperature, spicy foods may temporarily raise your metabolism and stimulate the use of stored fat as energy. Experts go back and forth on this theory, stating that it’s not enough of a boost to make a difference.
But they do agree that eating spicy foods can increase feelings of satiety. And the sooner you’re satisfied at a meal, the faster you’ll stop eating. You can easily save yourself 100 calories at a meal by taking fewer bites, so pile on the hot sauce.
Secret #7: You can count on calcium for an extra boost.Lots of research shows that calcium, an essential mineral, can boost your basal metabolic rate, which can help with your weight-loss efforts. In a National Dairy Council-funded study, researchers found that a high-calcium, low-calorie diet boosted fat loss by 42%, compared to only 8% for a solely low-calorie diet.
Studies also show that dairy lovers are less likely to suffer from metabolic syndrome, whose symptoms include high blood pressure, cholesterol and triglycerides, as well as poor blood sugar control and increased abdominal obesity – all factors that increase risk of diabetes and heart disease.
If you don’t eat enough calcium-rich dairy foods – such as yogurt, skim milk and low-fat cheeses – start adding them to your diet or take a daily calcium supplement.
How Calorie-Conscious are You?Although calorie-counting seems like a tedious task, having a basic knowledge of which foods will send you into a diet trap isn't. How calorie-conscious are you? Find out with this quiz.
Sponsored and provided by:
If your body’s engine is already running at full-speed, there’s little you can do to boost your fat-burning potential – you’re already performing at peak. But if your tank is continually running on half-empty, you have room for improvement. Use these seven tips to rev up your metabolism.
Ladies, start your engines!
Secret #1: Early to bed makes you a slim girl.Believe it or not, the number of zzz’s you catch can have a big effect on your waistline. Research shows that sleep deprivation can send your hunger and appetite hormones out of whack.
Leptin, an appetite-suppressing hormone, decreases in adults who are sleep-deprived while ghrelin, a hunger-increasing hormone, spikes.
This means double trouble for your fat cells: You end up eating more than you need, leaving you with extra pounds to show for it.
How much sleep do you need to avoid this? Some people swear they can get by on just a few hours, but experts recommend that you get seven to eight hours of uninterrupted sleep each night.
In case you’re one of those people who think they thrive on less snooze time, take heed: A four-year joint study by the University of Wisconsin and Stanford University found that adults who regularly slept for only five hours a night increased their levels of hunger-inducing ghrelin by 14.9% and lowered their levels of appetite-suppressing leptin by 15.5%.
Getting into a good sleep routine may take a little work, but it’s worth the effort.
Click here for 7 Tips for a Good Night’s Sleep.
Secret #2: Early to rise starts your metabolism off right.Does your morning ritual consist only of showering, brushing your teeth and getting dressed? Then you’re skipping two important things that could boost your metabolism.
The first: Eat breakfast – and coffee doesn’t count. Skipping that bowl of oatmeal might sound harmless, but you’re missing the first opportunity of the day to jumpstart your metabolism.
Think of it in literal terms: Breakfast is “breaking” the overnight “fast” your body was in to conserve calories. Eating – especially a balanced breakfast every day – stimulates your metabolism.
The second key to starting your morning off right? Exercise. Sure, you might struggle to throw off those cozy sheets – who doesn’t? – but it’s a battle worth winning. Why? It boosts your metabolism.
As a result, you’ll burn more calories throughout the day simply doing the same stuff you always do. Who wouldn’t want that? Even a 20-minute walk or jog will make a difference. So skip that second cup o’ joe and strap on your walking shoes instead.
Secret #3: The more you move, the more you’ll lose.Speaking of exercise, you should do it every day. Cardiovascular exercise (running, swimming, aerobics, walking) stimulates your metabolism, helps you burn tons of calories and can even temporarily suppress your appetite post-workout.
But don’t let cardio get all the metabolic-boosting glory. Weight training is important, too, because it tones your muscles and boosts lean tissue mass, which burns more calories per pound than fat. The more lean muscle tissue you have, the more calories you burn each day.
Also, don’t be afraid to exercise more than once a day. Breaking up a 60-minute workout into two 30-minute (or three 20-minute) sessions is not only convenient, but also it may help you burn more fat, according to recent research.
Secret #4: Eat all day to keep weight gain at bay.Don’t take this literally. “Eat all day” means you should be eating more snacks or smaller meals instead of gorging on large meals. Eating five or six small meals throughout the day keeps a steady stream of energy available to your body. This boosts your metabolism and your brain power.
Keep healthy snacks (fruits, veggies, nuts, yogurt) with you and graze throughout the day as needed. Just be sure your main meals are smaller to accommodate all this snacking, or you’ll load up on extra calories you don’t need.
A big weight-loss no-no is skipping meals. Dieters often try to get that extra weight-loss edge by cutting entire meals instead of just cutting calories throughout the day. But this is counterproductive. Skipping meals forces your metabolism to slow down and conserve calories to compensate for the lack of food.
So when you finally do eat, your body remembers that it went for a long time without food and will store more calories to get ready for the next time you’re going to starve it. Stay off this roller-coaster by eating at regular intervals throughout the entire day.
Secret #5: Raise a glass to drinking yourself skinny.Dehydration is a funny thing. The number on the scale may look good when you haven’t had enough water, but you’re risking major weight gain by not drinking enough. Dehydration can trick your brain into thinking you’re hungry, so instead of reaching for a cold one – water, that is – you reach for whatever snack is nearby.
A simple exercise in math may illustrate the importance of hydration:8 ounces of water = 0 calories1 candy bar from the office vending machine = 270 caloriesSwapping that candy bar for a glass of water, then waiting 20 minutes to see if you were really hungry in the first place = priceless.
Some experts claim that your body burns extra calories as it works to raise the temperature of that icy water to your internal body temperature. It’s a controversial claim, but I say why not? It’s refreshing, it’s hydrating and you’ll burn calories on your walk over to the water cooler.
Secret #6: Set your metabolism on fire with spicy foods.Spicing up your meals may do more than just add great flavor. “Hot” foods, such as jalapeños, chili peppers and spices (like curry and cayenne), may increase body temperature.
Body temperature and metabolism are related: As you burn energy, heat is released. By increasing your internal body temperature, spicy foods may temporarily raise your metabolism and stimulate the use of stored fat as energy. Experts go back and forth on this theory, stating that it’s not enough of a boost to make a difference.
But they do agree that eating spicy foods can increase feelings of satiety. And the sooner you’re satisfied at a meal, the faster you’ll stop eating. You can easily save yourself 100 calories at a meal by taking fewer bites, so pile on the hot sauce.
Secret #7: You can count on calcium for an extra boost.Lots of research shows that calcium, an essential mineral, can boost your basal metabolic rate, which can help with your weight-loss efforts. In a National Dairy Council-funded study, researchers found that a high-calcium, low-calorie diet boosted fat loss by 42%, compared to only 8% for a solely low-calorie diet.
Studies also show that dairy lovers are less likely to suffer from metabolic syndrome, whose symptoms include high blood pressure, cholesterol and triglycerides, as well as poor blood sugar control and increased abdominal obesity – all factors that increase risk of diabetes and heart disease.
If you don’t eat enough calcium-rich dairy foods – such as yogurt, skim milk and low-fat cheeses – start adding them to your diet or take a daily calcium supplement.
How Calorie-Conscious are You?Although calorie-counting seems like a tedious task, having a basic knowledge of which foods will send you into a diet trap isn't. How calorie-conscious are you? Find out with this quiz.
Sponsored and provided by:
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