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Dr Yanni's Soapbox

Yanni talks and rants about developments with BipolarLab.com

Blogger: Dr Yanni Malliaris
Dr Yanni Malliaris
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Professor Goodwin's recent blog post on the mental health elf blog is very helpful in terms of summarising some of the problems we have with structured psychological therapies across most psychological disorders not just bipolar disorder. He is also a much respected figure and scientist in the field of Bipolar disorders in UK and internationally. It is also very encouraging that despite his significant involvement and contribution to pharmacological treatments of bipolar disorder, more recently he has been involved in the therapeutic role of psycho-education.

However, it is very disconcerting to read that psychoeducation as a psychosocial treatment modality in bipolar disorder is based on some coherent model of Bipolar disorder, whereas the other structured psychosocial treatments (CBT, IPSRT, FFT) are lacking in this respect.

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A recent interview and book publication by the former Olympic champion Suzy Hamilton reveals how her bipolar disorder led to her to become a high class prostitute. The only certainty is that her "bipolar disorder", and the bipolar disorder of most of our patients, do not lead them to a career in prostitution.

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picture courtesy of Christina Tsevis (Crosti) – see https://www.facebook.com/christina.tsevis

picture courtesy of Christina Tsevis (Crosti) – see https://www.facebook.com/christina.tsevis

In our clinical work at BipolarLab, we often come across bipolar patients who seek help when they are depressed. Depression may be the most common symptom, and the most frequent episode of bipolar disorder, but it is not always the most urgent phase to treat. Manic episodes may be more urgent, and more dangerous. Nevertheless, it takes an experienced, and a well trained bipolar patient to seek help once manic. Depressive episodes with increased suicidal ideation or psychotic symptoms can be equally urgent, but for the most common depressive episodes urgency is a matter of choice.

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Reading so many articles about holidays and depression but at the same time working almost exclusively with bipolar patients, I wondered too. Is Christmas good for your Bipolar disorder? What can I really tell you or to our patients about this?

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picture copyright & courtesy of Christina Tsevis (crosti)

Dear BipolarLab Friends,

We are pleased to announce a pilot trial based on BipolarLab's specialist services.

Since our launch, in 2011, we have been working hard to deliver the best evidence-based programs for patients with Bipolar disorder and recurrent depression remotely all over the world. We have learned a lot since that time, and we are now in a position to take up a few patients at a minimal cost (25 euros per session instead of the normal rate of 70-100 euros).

Setting up and running an evidence based clinical e-practice in the field of mental health is an exhilarating challenge!

In other fields of medicine, this may not be the case, but in the mental health world, evidence based practice is a relatively new development.

"Evidence-based practice" means we conduct our clinical practice based on evidence that we've acquired from clinical research. Similar to drug research, your doctor will usually prescribe medications that've been tested thoroughly through many trials, and have been proven to benefit your health condition. Once upon a time, your therapy could've been based on Dr. Ego’s clinical expertise, big name or great insights, but thankfully these days such practices are slowly becoming a nightmare of the past (although, drug companies still invest on armies of Dr. Egos “aka opinion leaders” to influence your local doctor’s prescription practices).

However, evidence-based practice is a fairly recent development in the field of mental health, and especially in the field of psychotherapy. The rise of behavioral therapy in the 60s, partly as a reaction to the psychoanalytic status quo, and later its marriage with cognitive therapy, have given us a remarkable new tradition of true evidence-based psychotherapeutic practice.

 

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I recently attended one of the lovely webinars hosted by the International Bipolar Foundation. The speaker Dr Nassir Ghaemi (Professor at Tufts university) presented his book, a First Rate Madness: Mood disorders and Crisis Leadership and discussed the issue of leadership and mood disorders.

According to his talk people with mood disorders and in general mentally abnormal people make better leaders especially at times of crisis. He gave examples of many American and European political leaders who achieved "greatness" and their psychohistory suggests also had a mental disorder - in most cases a bipolar disorder.

I have trouble digesting this argument, not for personal reasons, I also love my bipolar patients and wish to think and speak well of them, but for scientific reasons.

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Being critical of yourself or being on the receiving end of other people’s criticism is a challenge. Add a mood disorder in the recipe and the impact of criticism becomes even more explosive.

Early research by Julian Leff at the Institute of Psychiatry and David Goldberg at UCLA on schizophrenia focused on the role of “expressed emotion” in families. They coined this term to essentially describe a negative and critical communication style that appeared to characterize many of the families who had members suffering from schizophrenia.

 

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It’s that time of the year again – spring. Our interest in life literally springs up, our moods and love life improve and many patients with bipolar disorder begin to experience their first signs of hypomania.

Call it a seasonal effect, blame it on light or the forthcoming changes in our social routines, spring appears to be a period that every bipolar and their family should keep an eye on.

So what better time than now to write about our bipolar fleas – the early warning signs of manic and depressive relapses?

 

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Dear Bipolar friends,

It is with great pleasure that I welcome you to our new bipolar blog hosted by Psychcentral.comBipolar Trek: The Voyages of BipolarLab.

I met Dr John Grohol quite early in my online psychology days back in 1996 when he was starting Psychcentral.com, and I was beginning my psychology degree in rainy Scotland. Since that time a lot has changed and I was always happy to see Psychcentral’s tremendous growth driven by John’s passion and energy for mental health education.

 

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Dear Colleagues,

It is with great pleasure that we announce our forthcoming workshop with Professor Carl Lejuez that will take place on the 17th of March 2012 in Athens, Greece.

Professor Carl Lejuez is one of the leading clinical psychologists in the field of Behavior therapy for Mood disorders and has agreed to visit Greece to deliver an intensive workshop on the application of Behavior Activation Therapy for the treatment of Mood disorders. I will also present my work on the application of this therapeutic model for the treatment of Bipolar depression.

Behavior Activation Therapy is the most effective treatment for unipolar depression and holds great promise for the treatment of bipolar depression. It is now more than ever that we need evidence based and effective psychotherapeutic treatments for the treatment of mood disorders.

Please note that thanks to Professor Lejuez we have a very low attendance fee that we hope will enable the participation of all interested colleagues and students. Please read below for further information about the workshop. http://edoba.bipolar.gr

We welcome participants from all over the world. Visiting Greece at this time of the year would be a delightful experience despite all the negative press about the impending Greek doom.

I am looking forward to seeing you all there.

With best wishes,

Dr Yanni Malliaris

 

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