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http://www.medicaldaily.com/pulse/what-depression-difference-between-feeling-depressed-and-actually-having-mental-365338

The following signs may mean someone is at risk for suicide. The risk of suicide is greater if a behavior is new or has increased and if it seems related to a painful event, loss, or change. If you or someone you know exhibits any of these signs, seek help as soon as possible by calling the Lifeline at 1-800-273-TALK (8255).

• Talking about wanting to die or to kill themselves.
• Looking for a way to kill themselves, such as searching online or buying a gun
• Talking about feeling hopeless or having no reason to live.
• Talking about feeling trapped or in unbearable pain.
• Talking about being a burden to others.
• Increasing the use of alcohol or drugs.
• Acting anxious or agitated; behaving recklessly.
• Sleeping too little or too much.
• Withdrawing or isolating themselves.
• Showing rage or talking about seeking revenge.
• Displaying extreme mood swings.

Dr. Jerry Kennard, psychologist and Associate Fellow and Chartered member of the British Psychological Society, provides some expertise and insight into the diagnosis and treatment of Bipolar Disorder.

What causes bipolar disorder?

We don’t really know but current wisdom suggests interplay between physical and environmental factors. For example, although no single gene is responsible for bipolar there is evidence that it runs in families. Chemical imbalances in the brain are also influential. Too much or too little of certain brain chemicals (neurotransmitters) can result in either depression or mania.

What is the difference between Bipolar I and Bipolar II?

Symptoms are the key, although the distinction isn’t always that clear cut. The central feature of bipolar I is mania and this is usually severe enough to require hospitalization. People with bipolar I disorder have experienced at least one episode of mania and usually depression. Bipolar II may be diagnosed if the person experiences a less severe form of mania called hypomania. Again, hypomania and depression are the main characteristics and the intensity of the highs is not severe enough to lead to hospitalization. Sometimes the dividing line between care at home and hospitalization may be quite thin and may depend upon the level of support available.

Bipolar II is sometimes wrongly considered a milder form of bipolar disorder. An episode of bipolar is equally severe whether you are diagnosed as bipolar I or II. There is some evidence that suggests episodes of depression are more severe and more frequent in people with bipolar II.

What medications help treat bipolar disorder?

A variety of medications are available but it may take a little time before you settle on what’s best for you. Mood stabilizing medications are the cornerstone treatment but other medications can be used to help control psychotic symptoms and sometimes these are combined within a single tablet. Many people with bipolar disorder experience symptoms of anxiety so it is not unusual for the symptoms to be treated with medication. Antidepressant medication is usually avoided where possible as it may trigger manic episodes. Depending on your symptoms antidepressants may be recommended and carefully monitored.

What should I do if I have a manic episode?

This is often one of the most difficult areas for the patient and those around them. For the patient the question is why, when you’re feeling so good, so full of energy and great ideas would you need treatment? The answer is the effect this behavior has. Hypomania and mania are characterized by a lack of impulse control that can lead to destructive, disinhibited and high-risk behaviors.

Manic episodes can take months to develop or they can appear within just a couple of days. Your first ever episode may be extremely difficult to predict. You may be buzzing with optimism, sleep less and feel more impatient with the apparent slowness of things around you, but it’s really only with the benefit of hindsight that your emotional and behavioral changes start to mean something.

In order to head off potential problems at a future date it can help if you devise a plan with the support of loved ones and your doctor. Reflect on what happened during your first episode and take practical measures. For example, if you blew your savings and racked up credit, try to ensure this can’t happen again. If your thoughts were leading in a certain direction (big plans, radical lifestyle change etc.) try to monitor these. Perhaps you were expressing grandiose ideas that involved special abilities? Your plan might include such things being monitored and could also involve a loved-one contacting your dortor. Consider keeping a mood diary so you can predict change.

How can psychotherapy help with bipolar disorder?

Psychotherapy can be very useful. It can help to put your symptoms into context and help to define the parameters of the disorder. A therapist can work with you to devise methods for self-observation and will show you important self-help techniques for stress management and stress reduction. Accepting a diagnosis of bipolar disorder can be difficult. Some people resist, some become too accepting and feel disabled as a result. Psychotherapy can help you and sometimes a loved-one and other family members feel a sense of mastery over the situation rather than become victims of it.

How often should I see a therapist?

This is something to negotiate with your therapist(s). In the early stages following a diagnosis you may feel most benefit from regular weekly meetings, for example. These days it isn’t always necessary to meet face-to-face and a telephone or video communication may be acceptable. Different therapists offer different support so your family doctor may ask to see you less often than your counselor or psychologist.

Are there any programs or alternative options to help me manage bipolar disorder?

People who manage their bipolar disorder best will often point out that it’s a lifetime and lifestyle issue. Medication and therapy helps a lot but your own choices and behaviors can help lessen or possibly even prevent bipolar episodes from developing.

Our Western diet of red meats, fats, sugars and simple carbohydrates are not known to influence bipolar disorder directly but a more nutritious diet may help to reduce stress and improve overall health, thus reducing the risk of possible triggers. Fatty fish (mackerel, trout, salmon) a couple of times a week combined with complex carbohydrates (whole-grain breads, beans, vegetables) is far more beneficial for overall health. Avoiding alcohol, smoking, drugs, and even stimulants like coffee are important considerations.

A regular and predictable pattern is important if you are to reduce triggers. Sleep regularly, exercise regularly, eat well and keep stress levels down.
– See more at: http://www.healthcentral.com/bipolar/c/458275/166695/doctor-bipolar-disorder/?ap=818#sthash.SxDAibbH.dpuf

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10 Tools for Panic Attack Relief

1. Have an exit plan. Sometimes knowing we have a plan to leave a situation helps us not be so afraid of trying something new. For example, know you can excuse yourself, you can have your own car to drive home, or you have a friend to support you can make all the difference. We are often scared to get anxiety and not be able to do anything about it.  We are afraid of being out of control. Making a plan will make you feel more in control and this counters the anxiety.

2. Have someone you can count on ready to call. In fact, have several, in case the one is busy. Someone who knows about the anxiety and can tell you you are okay, or even better–someone who can make you laugh.

3. Spend time with your pet. (Animal Therapy)

4. Have a tranquilizer with you. Knowing you have antianxiety medication to calm you down within 15 minutes can help you not be afraid of anxiety.  Again, we are afraid of beingout of control of our anxiety so just knowing you have the medicine is all you need. Panic needs you to be scared of it for it to stay.

5. Interact with water. There is something about water that stops the energy of panic.  Sometimes crying releases it (tears). However, consider taking a hot bath or shower for immediate relief. Also drinking hot soup or a hot drink (non-caffinated, please!) can help.

6. Give yourself a massage or have your loved one give you one. This really calms the nerves and calls our attention back out of the anxious mind and into the body.

7. Forward bend. Like a fetal position, any forward bend in yoga counters anxiety. You can get in child’s position. See photo above.

8. Stare at yourself in the mirror. This is called tratak meditation. It helps build trust in yourself. Do this when you are calm to prevent anxiety and panic.

9. Go for a walk. Get a change of scenery and use up some of that excess energy. The biology of fear indicates the release of adrenaline makes your body want to do something. Doing something and feeling a sense of control on the account of that activity is by far the best thing you can do for a panic attack.

10. Laugh. Watch some funny videos on YouTube. Laughter and anxiety cannot live in the same moment together!

What did I forget? What’s worked for you?

By Jodi Lobozzo Aman

As a nurse working in the emergency department, I frequently see people come in for suicide attempts. I’ve noticed there’s a stigma surrounding some attempts, and many colleagues agree there’s a difference in the way patients are treated depending on the type of attempt.

From what I’ve seen, a patient whose attempt is more “serious,” with visible life-threatening injuries or potentially deadly pathology results, is more likely to be treated with understanding, compassion and patience. It’s as if serious injuries validate the mental illness, making the inner turmoil visible to the outside world.

But the “less serious” the attempt is (for example, taking a non-lethal amount of medication or self-inflicted injuries that aren’t fatal), the less sympathy I’ve seen patients receive. This can also be said for patients who have repeat suicide attempts. I’ve heard these patients referred to as “time-wasters,” “attention-seekers,” “taking up beds,” and they’re described as “crying out for help.” Although it’s acknowledged as wrong, there’s still anger and frustration felt towards the patient. I’ve heard many question the reason for their behavior. But I believe anyone who intentionally puts themselves in harm’s way needs help, regardless of the intended outcome, and are still entitled to be treated with dignity, understanding and kindness. 

When I was 23, I tried to jump off a cliff after being discharged from a psychiatric hospital. I have bipolar affective disorder. I rarely call this a suicide attempt, although I would’ve jumped if it weren’t for a person walking past. If that person didn’t talk me down from the edge I wouldn’t be here today. I didn’t end up in an emergency department that night; instead the person called the local psychiatric triage team for advice and made sure I got home safely. The next morning my psychiatrist arranged for me to have electroconvulsive therapy (ECT).

I was determined to take my life. However, just because I didn’t end up in the emergency department didn’t make my determination to kill myself less serious. For weeks afterwards I remained suicidal. It’s because of my wonderful family and excellent psychiatrist I got through those weeks alive.

According to the World Health Organization, 800,000 people commit suicide every year, and for every successful suicide there are many more people who attempt it. About 20 percent of people who die by suicide have made a prior suicide attempt. But the stigma attached to suicide can be isolating and discourages help-seeking behaviors.

When I was suicidal I was too embarrassed to ask for help from emergency services because I thought I would be judged. That night I stood on the cliff, dying seemed like the only way out. Like a lot of suicidal behaviors, the decision was driven by desperation and impulsivity. The method didn’t matter — only the end result. I was only seconds from death. By complete luck I survived that depression.

In seems people are fearful if we talk about suicide we’ll trigger risky behaviors. But if we don’t talk about it, how are we going to understand it? If we don’t understand it, how can we be compassionate and empathetic? And if we don’t treat those at risk with compassion and empathy, how do we expect them to seek help?

Most importantly, we need to make it known reaching out for help is one of the bravest and best things someone can do. I’ve heard nurses say it’s “heartbreaking” when patients die from a suicide attempt. But what’s more heartbreaking is how often I hear families say the person they lost had been “been unhappy for a long time’” or that “they tried suicide before.” We need to talk about suicide to offer people hope. The courage it takes to reach out must be recognized. 

Every suicide attempt needs to be taken seriously. People don’t kill themselves, mental illness does. The sooner we start understanding this, the sooner we can combat the stigma surrounding suicide. Decreasing stigma encourages help-seeking behaviors and leads to more widespread and compassionate treatment for those who need it. And this treatment needs to be available for everyone however long they need, not just for the people who end up with serious injuries in the emergency department.

If you or someone you know needs help, please visit the National Suicide Prevention Lifeline. You can also reach the Crisis Text Line by texting “START” to 741-741. Head here for a list of crisis centers around the world.

Read more: http://themighty.com/2015/09/why-im-speaking-up-about-how-suicide-is-discussed-in-the-emergency-room/#ixzz3t1EghUzv

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