Dr Bradt's Mailbag

  1. Can the govt help with living conditions?
  2. Question about Dieting
  3. About Dr Bradt
  4. Should I seek counseling?
  5. Psychiatrist, Psychologist and Meds
  6. Question for the Doctor
  7. How do I stop being upset when boyfriend is with friends
  8. Validation and Expectations
  9. Does TMJ have anything to do with Bipolar Disorder?
  10. Abuse - Nowhere to Go
  11. Refused for Military because of Bipolar Disorder
  12. Gaining Weight on Meds
  13. Madness and Creativity
  14. Typical Bipolar Behavior?
  15. How to slow down rapid speech
  16. How to lose flab on waist and tummy
  17. Is it normal to have poor memory as one ages?
  18. Is it possible for 2 bipolars to form a good relationship?
  19. What exactly does mood disorder with psychotic features mean?
  20. Can you gain weight by smelling food etc?
  21. Is it normal to hear my voice inside my head?
  22. Looking for Success Stories about Bipolar
  23. Does Bipolar Disorder cause memory loss?
  24. Boyfriends mania cause affairs?
  25. Should I tell a prospective employer i have Bipolar?  When and how?
  26. Fear of Colonoscopy makes me a Coward?
  27. First name basis with therapist?
  28. Boyfriend wants marriage after a break
  29. Starting menopause-gynecologist or pdoc?
  30. Diagnosis at 56 years old?
  31. Uncontrollable diabetes factor in manic episode?
  32. Need counseling in addition to lithium?

 

Chad,

You wrote, "I was wondering if you knew if I could get some kind of
government help with living conditions."

You probably could. Call any social worker and he or she will know how you
can apply for government housing programs.

Take care,
Jean M. Bradt, Ph.D.

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Andrea

 Q. I have a question about dieting. I am at university now so have three
meals prepared for me. I don't find it difficult to make healthy choices.
I'm
just wondering if I am eating too many calories to lose weight. I am 5'3 and
130 pounds but I would like to weigh 115. Here is a sample of what I have
eaten today:

1 and a half power bars
1 bottle (540 ml.) of cranberry juice

1/2 bowl of cream of carrot soup
1/2 pita with veggies, mustard and 1 tbsp. cheddar
1/2 plate of veggies with 1 tbsp. dressing
small glass of apple juice

Dinner is usually bowl of soup, plate of veggies and about 1 cup of pasta
with tomato sauce
and maybe an apple or banana.

Is this too many calories or should I stick with this plan? If I eat all my
calories by 3 pm., let's say by having a big lunch, should I not eat for the
rest of the day?

I really want to lose the weight.

Sincerely, andrea

A. Andrea, I'll try to answer your questions one by one!

Q. 'I'm just wondering if I'm eating too many calories to lose weight. I'm
5'3"
and 130 pounds. I would like to be 115.

A. There are 2 steps to finding out how many calories a day you should eat
to weigh 115 pounds:
1. Go to your doctor for a check-up.
2. Ask your doctor how many calories a day you should eat.

Q. Is this too many calories or should I stick with this plan?

A. Only your doctor can tell you how many calories you should eat per
day. To find out how many calories you're actually eating, you want to buy
a calorie chart or go to: www.FreeWeightloss.com.

It looks as if you're eating enough fruits and veggies, which is great. But
you may not be getting enough protein. Power bars contain some protein,
but it's incomplete protein. You need meat and/or dairy products. Also,
power bars (and some dairy products, actually) are a
calorie-laden way to get your protein. Fish and well-cooked beef and
chicken give you protein without giving you so many calories. I'm just
giving
you the facts. Eat what you like the most. But don't you like meat? It's
hard
to lose weight on a vegetarian diet.

Q. If I eat all my calories by 3 pm., let's say by having a big lunch,
should I
not eat for the rest of the day?

A. Not eating after 3 pm. is hard; I couldn't do it. I'd eat, but only
celery
(with no dip), carrots, etc.

Good luck!

Take care,
Jean

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Adrienne,

I'll answer your questions one by one:

> So i was wondering what school(s) you went to get your degrees?

Catholic University in Washington, D.C.
Loyola University in Chicago, IL

> How long it actually took you

4 years as an undergraduate, and 7 more years to get the Ph.D.

> What made you want to become a Psychologist?

I love people. Also, I wanted a job where I can use my intelligence.

> What do you work with more(children psychology or mental illness problems
more adults)?

Mental illness in adults because I, myself, have a mental illness. For lots
more information about me, click on: http://www.willigocrazy.org, scroll down
to where it says Any Dream Will Do, Inc. (on the left side of the page), and
click on it.

Take care,
Jean M. Bradt, Ph.D.

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Q. This might sound stupid but do you think I have issues? Lately I have
been feeling extremely down. I have a lot going on in my life that's good
and bad. I am extremely busy with school but I feel like I'm not enjoying it
as much as I should. I seem to be enjoying myself. I laugh and stuff but
afterwards I feel down. I constantly need people telling me you're pretty,
you're beautiful. The one person that I would love to hear it from is my
sister. Not once does she say Oh you looked nice there. It bothers me deep
inside. I am losing touch with her and it's scary. Also I feel like I need
to be superskinny but I'm not at the point where I don't eat. I do 1000
situps a night just to look skinny. But I eat...sometimes I even eat a lot.
I went through a huge pregnancy scare this year and for 5 months I thought I
was pregnant even though I had negative tests and pelvic exams. Do you think
I need to seek counselling?
Thanks,
Sonia
A. Sonia, are you saying that you won't seek counselling unless you "need"
it? Counseling is fun! With a good counselor or therapist you get:
--companionship and intelligent conversation
--somebody else's undivided attention
--empathy and kind treatment
--insights into what's going on in your own mind
--insights about other people and life in general
--and much much more
You don't have to have issues to see a counselor. Everybody can get
something out of therapy. Go to a counselor and have fun!
Dr. Bradt

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Q. A friend of mine has many problems, including bipolar disorder,
anxiety/panic attacks, and asthma. She has numerous medicines prescribed for
her conditions. She often has breathing spells and has to go to the
hospital, and she is on Medicare. The problem is with her psychologist. This
doctor only comes in once a month and fills out prescriptions, and he is
never around at any other time. There is not a lot of counseling or
discussion, and she needs to talk about her problems. Also, she does not
know if any med she has to take interacts badly with the others. The doctors
just throw medicine at her, send her home, and let her sit. -- Joy

A. Joy, it's hard when you're a Medicare patient going to a clinic. You and
your friend are smart because you keep trying to get good information about
her health despite the red tape involved. Here are my suggestions:

1. The doctor who fills out your friend's prescriptions is a psychiatrist,
not a psychologist. Psychiatrists covered by Medicare can't be relied on to
talk to you. But if your friend can find a psychologist or nurse/caseworker
or social worker, etc., (in that same hospital) she will have much better
luck getting the counseling and support she needs.

2. Since her doctors can't be trusted to prescribe meds that don't interact
badly with each other, you might want to check the meds out with a
pharmacist. The pharmacists at the big drug store chains tend to be very
reliable and informative, even over the phone.

Keep on trying, and be assertive!

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Q:  hi my name is sophia. i am only 32 yrs old. i
am bipolar disorder. i am
 taking the medication of lithum and rispodroal. i was think about to
taking the baby butiam worry
that will affect harm to the baby how can i handle without the medicaiton
for about 9 months pls help me and explain to me. if idont handle with that can i take other
mediciation during the
 prggnacy but can the other medixationa ffect harm to the baby, which
medications is the best
 medcation to less risk for the baby health thk you for understanding me
and please email me bkc

A: 

You asked the wrong person. I'm a psychologist and I can't answer
medical questions like yours. You need to ask the doctor at:
http://www.bipolarworld.net/Phelps/phelps.html.

Jean M. Bradt, Ph.D.

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My fiance has several friends that I do not like.  They do not treat me
well, and I refuse to be around them if at all possible.  However, I feel
guilty keeping my fiance from doing things with them, and so I tell him I
want him to go.
The whole time he is gone, I am upset that he is out with people I do not
like and then am mad at him when he gets home for going out with them and
leaving me home, even though I know it is an unreasonable reason to be
upset.
What can I do to get myself to stop being upset that he is out?
Kristen

A. First change your actions. Eventually your feelings will change as a result. Are you upset because he's out or because he's out with people who treat you badly? If it's because he's out, the solution is simple: when he's out, you go out too. Go somewhere you enjoy going, with friends of your own. Your actions will change your feelings. If you're upset because your fiance is out with people who treat you badly the solution is more complicated. Your first step is to tell your fiance that you only let him go out with his friends because you would feel guilty if you said no. In other words, start a dialog. What you do next depends on how he responds, of course. Probably he will be concerned that you are upset at the way his friends treat you, if he isn't already. If he decides to defend you (insist that his friends treat you better) your problem is solved. If he doesn't, you need to ask yourself, "How important is this problem? Is it likely to start our marriage out on the wrong foot and cause me a lot of grief in the future? Or is it something I can let go?" If the problem is so important that it could threaten your marriage, you need to talk to your fiance again and tell him firmly how you feel about his unwillingness to defend you. If the problem isn't that important, just keep going out with your own friends, and also try to get along with his, and pretty soon those actions will change your feelings. Dr. Bradt

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Q: 

Good Day Dr. Bradt,

I recently had a discussion with a friend whom we will call Barry, on the subject of validation and expectations.

The conversation started when Barry explained to me that he was disappointed in his brother because after having helped him find a good job he never got a "thank you" from him.

Barry's brother has now been employed for a few months and is doing very well (as per a conversation with another of his family members). Barry believes that because he is the one who helped his brother "get back on his feet" -- he went to great lengths to arrange contact with potential employers, and one of those employers then hired his brother -- his brother "owes him" a "thank you" at the very least.

I am troubled by this because I feel that if one chooses to do something for another, it should be done unconditionally and to have a "hidden agenda" for the action or expect a re-payment such as a "thank you" means you may be doing it for the wrong reasons.

I looked all over the place for information on "the need for validation" and how to understand it, but I suspect I am not looking up the proper term.

Can you please offer some light on this subject or point me to a place I may find some?

Thank you Mark

 

Mark,

You've brought up several interesting psychological/philosophical issues:

1. Altruistic (Unconditionally Loving) Actions

Is it morally wrong to expect a re-payment such as a "thank you" for one's charitable acts? Are purely altruistic acts the only truly morally right acts?

I'm not sure that I can answer those questions, as I have never known of anyone doing anything for purely altruistic reasons. One always seems to get something in return, if only a sense of satisfaction. Perhaps Barry expects a "thank you" because he didn't mean to or want to act purely altruistically, but would that be so bad? Is it morally wrong to work toward one's own good, toward success, to make "deals" with others rather than always acting altruistically? Are there right and wrong reasons for one's charitable behaviors, or are the reasons we have for our behavior unjudgeable?

2. Hidden Agendas and Communication

I think that "hidden agenda" might be too strong a term for Barry's unexpressed expectation for a "thank you". It's very common for people to do favors and then become disappointed when the favor doesn't seem to be appreciated. In fact, I've done it myself; I even wrote a story about it. (Click on http://www.willigocrazy.org/Ch08x03.htm to read the story.) It's not about morality or lack of altruism. It's just a question of communication. And communication itself isn't "good" or "bad". We simply choose whether to undergo the embarrassing process of communicating our expectations or else to forego what we expect. By that I mean that Barry can either (a) say, "I'll be happy to do you this favor, but I want an expression of gratitude in return," or (b) not say it, and forego the gratitude. It's a question of personal choice, not right or wrong.

3. Need For Validation

Maybe the reason you haven't been successful finding information on the need for validation is that it's virtually universal. Never have I met anyone who didn't need validation. That also goes for appreciation, support and, most of all, respect. But these things come in many different guises. Barry's brother didn't show appreciation with a "thank you", but I wonder if he showed it with a smile or a nod of his head. And he is certainly showing appreciation by doing his job "very well". Imagine Barry's chagrin if his brother had screwed around and lost the job Barry had spent so much time helping him get!

By listening to and doing so much research on Barry's complaint about his brother, you yourself showed him a great deal of respect.

Dr. Bradt

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I get bad headaches from TMJ. Does the problem of TMJ have anything to do
with bipolar disorder? Any advice or website info?
Margie
Dear Margie,
Temporal mandibular joint disfunction (TMJ) is a condition that co-exists
with bipolar disorder; that is, bipolars are more likely than others to have
TMJ problems. We humans tend to clench our teeth when we get tense. If we
clench them long enough and hard enough our jaws start to hurt. If we keep
clenching our sore jaws our whole head may even start to hurt.
For more information, click onhttp://www.willigocrazy.org/Ch06.htm, then on the
"Co-exist" link after "C. Psychogenic Symptoms". At the bottom of the
symptoms page, you will find a link to some TMJ treatments that worked for
me. I hope you feel better soon!
Dr. Bradt

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Q. I am 24 and I have two kids. I believe that there is something seriously
wrong with my husband. Today he threw a rock through my bedroom window. He
has punched holes in the wall. He breaks stuff of mine. He gets jealous of
my friends, even my mom. His behavior keeps intensifying, and he will not
get help. I think that if he doesn't get help he will kill me one day. I am
also worried about my 4-year-old. Today she said, "Daddy is scary." I have
nowhere to go.

Lorna

Dear Lorna,

Yes, there is somewhere you can go. Call your nearest "crisis hotline", tell
them your problem, and ask them where you can get advice and maybe some
help. If you can't find a crisis hotline, just call the local operator and
ask how you can get help.

Dr. Bradt

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Q. I was diagnosed bipolar when I was about 13 years old. I've been on
lithium carbonate ever since. Right about the time I was a senior in high
school I decided that what I really wanted to do was to become a soldier. I
never really thought that I could be disqualified from joining because of my
illness. I never had problems with studying, and I graduated early. I never
got in trouble in school or with any authorities.

If I went to another doctor for a second opinion do you think it would be
possible for me to get a medical waiver and change the military's minds? Do
you think if I was taken off the medication and seemed to do fine I could
get into the military? Maybe its a stupid question, but I just want to serve
my country very badly. Thanks in advance.

Mike

Dear Mike,

It's not a stupid question at all. If anyone is "stupid", it's the military
person who wrote the rule keeping persons diagnosed with mental illness out.
Like most organizations, the military discriminates against bipolars. Did
they give you any tests to see if you've recovered from bipolar disorder --
to see how well you function right now? I'll bet they didn't; I'll bet
they're keeping you out just because you were diagnosed bipolar years ago.

If the rule is that anyone who has ever been diagnosed bipolar, no matter
how long ago, can't enter the military, getting a second opinion from
another doctor or going off the medication probably won't change their minds
about admitting you. And that
makes me angry!

Dr. Bradt

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Q. I was diagnosed bipolar in Oct 2001. I'm on Lithium and Effexor. Do you
automatically gain weight from lithium or from being bipolar ?

I feel like I am a different person on these meds. I think differently. Have
you heard this from others?

If I stay on my meds, will I stay this well-balanced ? It's amazing! They
diagnose you and give you the meds but do little to educate you about what
it means to be bipolar.

Thanks,
Wendy

Dear Wendy,

I think your first question is a very good one because you sense the truth:
you don't automatically gain weight from anything. To gain weight, you have
to eat more food than your body can use. Doctors suspect that, on lithium,
your body uses less food, which makes things tough because then you have to
cut down. But if you do cut down, you won't gain weight.

No, I haven't heard anyone say that they think differently on psychotropic
meds. But I have heard them say that they feel different -- calmer, more in
control.

As to your third question, I'm so glad that the medicine has you well
balanced. You could stay that way all your life if you stay on the meds. But
I'll be honest with you. Sometimes the meds you're on stop working after
several years and you need to
"graduate" to new meds.

I myself am also amazed that so few people educate people about their
bipolar disorder. I try to fill that need on my website,
http://www.willigocrazy.org.

Dr. Bradt

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Q. Hello, I have recently been reading into psychopharmacological treatments
for the so-called 'mad' and concerns regarding the present day treatments of
the 'mentally ill' which put people into a state of lethargy and
incapability. If the link between 'madness' and creativity, as well as
genius, is so strong, what effect does this type of medicinal therapy have
on the mentally ill, though creative or genius, mind? How, by numbing the
senses and quietening the voices, can these medicines be positive remedies?

Colin

Dear Colin,

Although a few years ago, in the days of Halperidol and Thorazine, it was
necessary to numb the senses in order to quiet the hallucinated voices in a
patient's mind, I'm happy to report that it's no longer necessary. New
psychotropic drugs have come out that don't turn people into "zombies".

Whether these new drugs reduce creativity is still being debated. For my own
opinions on how the psychotropic drugs I have taken have affected my
creativity, capabilities and, dare I say it, genius, click on my own website,
http://www.willigocrazy.org, then on Chapter 6 Coping With Bipolar Disorder, which
will lead you to an article on Lithium and Creativity.

Dr. Bradt

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Q. My concern is for my daughter-in-law, who was diagnosed eight or so
years ago with bipolar disorder, although she no longer takes lithium. She
has
embraced a very fundamentalist community church with a vengeance, and she
spends a lot of time in Bible study. She is VERY controlling and demands
that her husband and three children participate and accept her strong beliefs as
well.

Is this typical behavior, or would you expect it has no connection with her
bipolar disorder? Is it common for persons to turn to religious groups such
as this and become "born again?"

Annette

Dear Annette,

Bipolars in the manic stage are often very confident, assertive, decisive,
enthusiastic, and dedicated. (Since I'm a bipolar myself, I'm not going to
use the word "controlling"!) When bipolars are in the depressive stage, it's a
whole different story.

As for turning to fundamentalist religious groups, I've seen no connection
between bipolar disorder and choice of religion.

Dr. Bradt

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Q. I have been diagnosed with bipolar about 7 years. One symptom I suffer
from is rapid speech. I didn't even realize I was doing it until I heard
coworkers discussing it. Is there something I can try besides just being
conscious of what I say? Sometimes I'm not paying attention.

Vanessa

A. Vanessa, how could anyone pay attention to how they're talking all the
time? It's really hard to change a habit as subtle as how you talk. I've had
some success with:

1. Meditation and relaxation. You probably talk faster when you're on break
than while you're doing your job. You might try meditating or doing
relaxation exercises just before break.

2. Letting it go. The more worried you are about a symptom, the worse the
symptom seems to get. So I say things to myself like, "Who cares how fast I
talk? My friends won't mind, and I don't care what my enemies think." That
relaxes me and makes it easier for me to tone the symptom down.

If you're really serious about talking more slowly, try taking the coworker
you trust the most aside and asking him or her to give you some tiny sign
when you start talking fast (pulling an ear? winking at you?). The sign will
draw your attention back to how you're speaking without embarrassing you
and, after a while, I'm sure you'll break your rapid-speech habit.

Dr. Bradt

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Q. I am 5''7'' and I weigh 127 pounds. I am not interested in losing weight
totally, because I am skinny and I know that. All I want is to have less fat
around my waist and tummy. But if I cut back on calories, my arms and legs
start to look like sticks and all my friends worry. How can I just lose the
flab on my waist and tummy?

Kathleen

Kathleen, I agree. 127 pounds is not "fat" for a woman as tall as you.

To lose the fat on your waist and tummy and keep your arms and legs
muscular, exercise at the same time you're cutting back on calories. Every
day, do exercises that use both your arms and your legs (but not necessarily
both in the same exercise). Your best bet is probably to go to a gym and ask
a professional which exercise machines would be best to keep your arms and
legs from looking like
sticks. If you can't do that, find a good book that has exercises in it.

When you cut back on calories, your body tends to start burning up muscles
to produce energy. Using your muscles signals your body not to burn them up.
For more about this, click on http://www.willigograzy.org/Ch03.htm, then on
Reprogram Your Hypothalamus".

Dr. Bradt

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Q. What is the difference between impaired memory in an organic brain
disorder and memory changes over the lifespan? Is it normal to have poorer
memory as one ages?

Bob

A. Bob, Memory does change over the lifespan, but it's not accurate to say
that it gets poorer. Two things happen:

1. It takes longer to access your memory. If you ask a 20-year-old and a
70-year-old the same memory question, it will probably take the 80-year-old
a split-second longer to answer.

2. The "tip of the tongue phenomenon". This is when you don't remember
something (usually the name of a person or thing) at all for a while. So you
relax and think about something else, and usually the name comes back to
you. You know that the name is still in your memory -- it's right on the tip
of your tongue -- but it takes a while to access it. "Tip of the tongue"
experiences are more common for older
people.

There are also small changes in forming new memories (also known as
"learning") as you get older.

Whenever researchers find poorer memory in older people, there always seems
to be some other explanation for it, not age. Usually, memory loss is caused
by organic brain disorders such as Alzheimer's disease (which do happen more
often in old people than in young people). Also, older people are more
likely to have had accidents that have damaged their brains, simply because
they have lived longer. And so on.

Many psychologists believe that memory loss caused by age -- pure age and no
other factor -- is a myth.

Dr. Bradt

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Q. Is it possible for two bipolars to form a good relationship?

Sandy

Dear Sandy,

A. Yes. It's not about what psychiatric disorder you have. It's about love

and never giving up. Check out my article "Can Two Bipolars Form A Good

Relationship?" listed at the top of http://willigocrazy.org

Dr. Bradt

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Dear Dr. Bradt,

What exactly does mood disorder with psychotic features mean?

Cheryl

Dear Cheryl,

Normally I stay away from technical psychiatric phrases like this one.

They're

so cold! But I'd like to tell you this:

Depression and bipolar disorder are the major mood disorders. If you have

these disorders, you may or may not suffer from psychosis, that is, your

disorder

may or may not have "psychotic features". Possible psychotic features are:

-- Hearing or seeing things that others do not hear or see (hallucinations)

-- Having seriously illogical thoughts (delusions), e.g., believing that

others want

to harm you, despite evidence to the contrary

-- Speaking in a way that's hard to understand

-- Losing the ability to take care of daily life functions

Many people believe that all bipolars experience the above symptoms. This is

not true. Most of the time, most bipolars do not experience any psychotic

symptoms.

Dr. Bradt

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Q. Can you gain weight by smelling food?

A. No. You can do all the smelling you want.

Q. Are there calories in toothpaste?

A. Yes, a few, in some toothpastes.

Q. Does breakfast really increase calorie-burning?

A. Not exactly. I think the way it works is that people tend to be the most

energetic in the morning. So calories eaten in the morning may be burned up

faster and more thoroughly than calories eaten at 6:00 in the evening, when

you're likely to be doing quiet things like watching TV. (Also, eating a

good, nutritious breakfast helps keep you from wanting a fatty snack later

in the morning.)

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Q. Is it 'normal' for me to hear my own voice in my head, like I'm planning
what to say? (Sometimes I go ahead and say it out loud, sometimes not.) It
drives me crazy when I'm trying to sleep. I was diagnosed BP 4 months ago.

Linda

A. Linda, yes, it is normal, that is, it's not a symptom of bipolar
disorder. But having trouble getting to sleep is a symptom of BP disorder.
Here's a trick for getting to sleep: as soon as you get into bed, take
charge of what your inner voice says. Recite some sort of list in your mind,
e.g., the birthdays of everybody you know or the shows that are in the TV
guide every week. (Don't change lists; recite the same one night after
night.) Really concentrate on remembering the items on the list. Whenever
your mind wanders off the list and starts "saying" other things, gently pull
it back. This way, you can use your inner voice to help you get to sleep.

Dr. Bradt

Q. I'm not majorly depressed but I'm BPII and, after going through so many
cycles, can you help me out? I could really use a successful example. I'm
hoping that maybe you've had exposure or experiences with people with this
illness that you might be able to share with me.

Aline

A. Aline, my site, http://www.willigocrazy.org, doesn't have other people's
experiences, but if you click on "Stories" in the box near the top of the
site you'll see a lot of successful bipolar experiences. These stories are
fictionalized versions of events in my own life, which has finally become
successful after years of bad times.

I hope the stories help you.

Dr. Bradt

Q. My husband has been recently diagnosed with bipolar disorder. Just one
question: he will do something and then say he didn't. Does this disease
involve memory loss?

Beth

A. Beth, it's extremely rare for bipolar disorder to cause memory loss.

Dr. Bradt

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Q. 24 My boyfriend is bipolar. He has had the diagnosis for eight years. I
read a lot about bipolars who have affairs when they experience manic
episodes. This really scares me; I can't think of anything worse that could
happen to our relationship. My boyfriend is a very very kind person and
would never even think of such thing when he is "normal". How common is it
that bipolars do this?

Yours sincerely, Kristine

A. Kristine, it's not that common.

By "normal" I think you mean "euthymic". You're euthymic at times when you'
re not manic and you're not depressed either. It sounds as if you're afraid
that when your boyfriend is in a manic or depressed episode he's completely
out of control over what he does. That's not true. When you're in an
episode, you're the same person with the same morals as you are when you're
euthymic. If your boyfriend is the type who wouldn't be unfaithful to you
when he's euthymic, he probably won't be unfaithful to you when he's manic
or depressed.

How much control you have during an episode is a very controversial issue.
For an essay on it, click on http://www.willigocrazy.org/Ch05e.htm

 

Dr. Bradt

Q. Should I tell a prospective employer that I am bipolar? At what stage of
the hire process and how?

So far, I am firmly convinced revealing my condition will shut the door, but
for once I would like not having "the hanging sword" over my head when going
into a new job.

JWB

A. And that sword hangs over your head all the time you're working at the
job too! I've been there. You watch everything you say for fear that your
boss will find about your disorder and fire you.

In answer to your question, it depends. Why will revealing your condition
shut the door? Very rarely, there's a certain bipolar who shouldn't be hired
for a certain job.

But usually we bipolars aren't hired even though we have all the skills we
need for the job, just because of the prejudice against us. If that's the
case for you, you have a hard decision to make between the "hanging sword"
and going to the Equal Opportunity Employment Commission (EEOC) in order to
get the job. You have the right not to reveal your disorder. But if you
choose the EEOC, here's what you do:

1. State that you have bipolar disorder in writing, right on your job
application.

2. If the interviewer asks about the statement, calmly affirm it and state
that you're taking effective medication and the disorder won't interfere in
any way with your job performance.

3. Keep detailed records on what both you and the interviewer said and did,
when, and where.

4. Go to the EEOC as soon as possible after you are denied the job and show
them what you've written down.

If you follow these steps, you will have a very good legal case. Of course,
I can't guarantee that you will win the case. Litigation is risky. If you're
unlucky, you could win the case but be blacklisted. Worse, you could lose
the case and be blacklisted. But if you win the case, you could get a nice
lump of money.

Dr. Bradt

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Q. I was diagnosed with bipolar disorder many years ago. I was just in to
see a C/R surgeon for my crippling levator ani spasms. He says I need to
have a colonoscopy. Just can't do it; I have a totally unreasonable fear of
having a colonoscopy. I've even been to therapy about it. I have scars from
abuse in my rectum.

His "staff" have watched me make reservations before and cancel. They hate
me for it. I can see it in their body language. Hear it in their voices.
After all, I'm supposed to be a brave man. Instead, I'm this coward that
walks out of the hospital before they can start the colonoscopy, partly
because I'm not allowed to take my meds the day before the colonoscopy was
scheduled.

Not a person in this world can understand what it's like. Just want the
bleeding to stop so I can go places without blood on my pants and clothes.
Very embarrassing, but not as bad as having a levator spasm in a place that
has no way to get privacy.

A Coward

A. Don't be so sure that you're a coward and, guess what! I have been there,
and I do understand.

When I passed the age of 50, the doctors started telling me to get a routine
colonoscopy screen. I was scared, as almost everyone is, and I postponed the
procedure for a few years. Finally I did it. I lay on the table, too sedated
to move or speak, while the doctor inserted the proctoscope. God, did it
hurt! And I couldn't scream, "Stop it," so the doctor just kept pushing the
scope into me over and over while the nurse administered more and more of
the ineffective sedatives. Finally, the sedatives ended the pain by putting
me to sleep.

When I woke up, the C/R doctor came to see me. He said that, because of a
hysterectomy I'd had years ago, my lower intestines and colon were so full
of scars that he hadn't been able to get the scope very far in "no matter
how hard I pushed". What, didn't it occur to him that he might be hurting
me?! He just told me that the colonoscopy had "failed" and sent me to get a
barium enema.

I learned two lessons from that event:

1. Never let a doctor sedate you. You still feel pain; you just can't do
anything about it. Make them give you either a local or a general
anesthetic.

2. Your fear of colonoscopies is not unreasonable. If you have scars in the
rectal area, don't get a colonoscopy except under total anesthesia. There
are other alternatives too: virtual colonoscopy and barium enema. (Despite
my scars, I felt no pain during the barium enema.)

You're smart, my fellow bipolar, not a coward. And, by the way, I was taking
several meds similar to the ones you take and, before the colonoscopy, the
doctors never made me miss a single pill. Maybe your C/R doctor is as
insensitive as mine was.

Dr. Bradt

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Dear Dr. Bradt,

I have been seeing a psychiatrist for three years. I have been diagnosed
with bipolar II. During the first two and half years I saw a C.S.W. for my
therapy and the doctor for my meds. About six months ago I started therapy
with my psychiatrist.

The problem is, he strongly discourages my calling me him by his first name.
He also calls me by my married name (e.g., Mrs. Jones) although I have
requested he call me by my first name. I believe that therapy is like a
journey made together by two people, one guiding the other, and that I need
to feel comfortable in order to disclose information that will help
facilitate growth. My doctor says there are many ways to feel safe without
going on a first-name basis. He even says that I'm making "such a big issue"
about the name thing.

I'd like to know how you feel about your patients calling you by your first
name? I'd also like to know if I should consider finding a new doctor if we
don't find common ground on this matter.

Erin

Dear Erin,

I don't really have "patients"; I prefer to call them clients, group
members, or students. But we are all on a first-name basis.

I strongly agree that you need to feel comfortable with your psychiatrist if
you are going to continue to make positive changes. I also feel that he is
out of line accusing you of making "such a big issue" about what names you
use. You are the boss here. You are the paying customer. You can make an
"issue" out of anything you want. If you tried to self-medicate, your
psychiatrist would have the right to tell you to stop, but when he makes you
stick with last names he's just putting his comfort over and above yours.

You certainly have the right to change psychiatrists even if you have no
real reason at all. But before you consider it, you may want to find out if
there's another good psychiatrist near you that you can afford. It's no
crime to see two psychiatrists alternately (without telling either one about
the other) until you're sure which one suits you better.

Dr. Bradt

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Q. Hello. My question is regarding relationships. My boyfriend wants to marry
me some day but wants to have experiences with other women before he settles
down so he doesn't feel like he missed out on anything. This does make sense
to me, but I don't necessarily feel that way. I appreciate his honesty,
though. I told him that if he chooses to sleep with other people on our
"break" from each other, then there's a good chance I'll find someone else
or I won't want him back. I wish I could fast forward time and be with him
when he's had more experiences in relationships and matured a little more.
What am I supposed to do to stay on good terms so that one day we CAN get
married if I let him run wild and get it all out of his system?

I should clarify... basically my boyfriend said he's confused and doesn't
know what he wants because he doesn't want to break up with me but he
doesn't want to be with one person for the rest of his life starting NOW. He
would rather wait until he's ready to get married to be that committed. His
concerns are mainly physical -- he's a 20-year-old guy! -- so I'm not
concerned with him falling in love with another girl. How does a girl handle
a good guy who just needs time to grow?

Thanks for taking the time to read this. Any advice would be helpful.

Sincerely,
Robyn

A. Dear Robyn,

I have sooo many questions! Exactly what is this "mainly physical"
"anything" your boyfriend doesn't want to miss out on? New sexual
techniques? An opportunity to go on ElimiDate or to set a honey trap for the
boss's daughter or to control you by making you jealous of all the physical
experiences he's having?

What was his reaction when you mentioned that there's a good chance you'll
find someone else and not want him back? Does that possibility worry him
any? Is it possible for him (or you) to become significantly more mature if
you stay tied to each other? Does maturity need independence to grow? Are
you sure that he's the one you want to marry? Is he sure that you're the one
for him? If you two are not sure, would seeing others make you sure? If you'
re both sure, why are you considering other sexual partners?

If you're not sure and want to date other people, would keeping your tie to
each other make dating other people a little less scary? Would doing that be
fair to the other people you're dating?

Sorry, no answers. Just questions.

Dr. Bradt

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Q. I have bipolar affective disorder with no psychosis. I have been taking
lithium carbonate for stabilization of the illness for 16 years. I'm 42,
female, and beginning to go through menopause. I have been getting hot
flashes daily for a couple of months. I also seem to be more irritable,
although my periods are still regular.

Should I discuss this with my mental health doctor or the gynecologist?

Sincerely,  Norma

Dear Norma,

Better discuss it with both of them!
 

Q. How common is it that someone who is 56 years old with no prior problems
has a manic episode and is diagnosed as bipolar?

It seems to be getting more and more common. I wouldn't rule it out.

Q. Is uncontrollable diabetes maybe a factor in causing a manic episode
instead of my actually being bipolar?

This is really a question for the psychiatrist
(www.bipolarworld.net/Phelps/phelps.html), but I believe that bipolar
disorder is bipolar disorder, no matter what triggers your episodes. Yes,
diabetes can trigger a bipolar episode.

Dr. Bradt

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Q. My husband of 3 years is one of the most caring, loving men I have 
ever
met. He was diagnosed with bipolar disorder in 1995 after he suffered a
manic episode at work. My concern is the down times he still 
experiences. He
becomes very mean and irritable and wants to be alone. He also becomes 
very
paranoid. I can usually see it coming on, at least.

What bothers me the most is that he picks on my 13-year-old daughter 
when he
is in these moods. She can't leave a pair of shoes out without him 
going
ballistic. He has never physically touched her or me, but the tension 
at
times is unbearable. A therapist said that even though he is continuing 
his
medication things will always be tough.

My husband is convinced that because he is on his medication he is
completely all right. I don't believe that. I feel that he should get
continuous counseling along with the lithium he is taking every day. He 
is
too embarrassed to even consider getting counseling. He feels that the
lithium is all he needs.

The doctor did increase his lithium dose last year. However, every 
couple of
weeks I see a significant change in his mood, sleep habits and overall
attitude. It is hard for me to believe that the lithium makes 
everything
completely OK.

What is your opinion? I am so desperate for advice.

Shelley

A. Dear Shelley,

Your question is a hard one to answer. The only thing I know for sure 
is
that it takes months and sometimes years for lithium to stop mood 
swings.
But I'll try to tell you a little more:

Counseling helps some bipolars and doesn't help other bipolars. 
Personally,
I don't get any help from counseling. I have no idea why I don't. But I 
get
lots of emails from people who get psychiatric counseling regularly. It
really helps them when they explore their childhood and the other 
possible
causes of their symptoms. It also helps them when they explore their
personal relationships. I don't know which group your husband is in. 
Who
does know? You? Your husband?

Warning: if your husband happens to be in the group that doesn't 
respond
well to counseling, it could actually make his symptoms worse. So, if 
he is
dead set against counseling, I wouldn't push it. I would just ask him 
to try
adding other medications. For a lot of bipolars, lithium isn't enough. 
They
use other meds along with it.

Dr. Bradt

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