Bipolar Disorder
(Manic-Depression)

Bipolar disorder is a widely misunderstood condition. The stereotype focuses on major mood swings, ranging from deep depression to extremely energetic and unrealistic, "crazy" behavior. Wild mood swings that a person cannot control may happen (and could lead to hospitalization), but bipolar disorder is often much more subtle. Everyone has mood swings, so it's often difficult to distinguish between people who are simply "moody" and those who are truly bipolar. A person with bipolar disorder may have manic episodes that dazzle friends and family with admirable insights or accomplishments -- bursts of artistic or business creativity, for example. Conversely, depressive periods do not always involve major depression. Many people with mild bioplar disorder suffer the blues for a while, then seem to pull out of their down moods, only to sink back into mild depression a while later. Or they might have mild to major depression alternating with periods of unusual cheerfulness, optimism, or self-confidence. Their thinking may seem simultaneously coherent and muddled, giving insistent advice about an unfamiliar topic, for example. Mild manic episodes may mean a person is agitated or irritable; more severe episodes may involve paranoia or anger.

Note, however, that these quick descriptions hardly do justice to bipolar disorder. Its signs are as unique and varied as the individuals who develop the condition. Typically, bipolar disorder develops without any clear cause, and is marked in most cases by alternating highs and lows that a person cannot control or change. Also, instead of feeling in charge of their mood, people with bipolar disorder feel victimized by them.

Forms of Twisted Thinking
How many of these depressing emotional traps have you fallen into?

All-or-nothing thinking. You see things as black or white. If you're not perfect, you're a total failure. You make one mistake at work, and decide you're going to be fired. You get a B on a test, and it's the end of the world. Your husband reprimands you for not checking the oil when you got gas, and you decide he doesn't love you.

An extension of all-or-nothing thinking. You make a mistake, but instead of thinking I made a mistake, you label yourself: I'm a jerk. Your girlfriend breaks up with you, but instead of thinking she doesn't love me, you decide: I'm unlovable.

Over-generalization. The tip-offs are the use of the words "always" or "never." You drop something and think: I'm always so clumsy. You make a mistake and think: I'll never get it right. Mental filtering. In complicated situations that involve both positive and negative elements, you dwell on the latter. Your mother clearly enjoys the dinner party you throw in her honor, but comments that the cake was a bit dry. You filter out all her positive comments and whip yourself for being such a lousy baker.

Discounting the positive. The tip-offs here are the phrases: "That doesn't count," "That wasn't good enough," or "Anyone could have done it." You do well on a test, and think: It doesn't count. Your colleagues praise a presentation, and you think: It wasn't good enough. You win a commendation and think: Anyone could have done it.

Jumping to conclusions. You assume the worst based on no evidence. In "mind-reading," you decide that another person is reacting negatively to you. Two of your co-workers are chatting at the coffee machine at work, but as you approach, they fall silent. Chances are they'd simply finished their conversation, but you assume they've been criticizing you behind your back. In "fortune-telling," you predict the worst possible outcome. A test is difficult, so you decide you failed. The sky is cloudy before your lawn party, so you decide a thunderstorm must be imminent.

Magnification. You exaggerate the importance of problems, shortcomings, and minor annoyances. Your toilet backs up, and you believe you need your entire plumbing system replaced. You forget to close a window before it rains, and imagine that you'll return to a flooded home. A neighbor's dog tramples a few flowers and you decide your garden is ruined.

Emotional reasoning. You mistake your emotions for reality. I feel nervous about flying, therefore, it must be dangerous. I feel guilty about forgetting my brother's birthday, therefore, I'm a bad person. I feel lonely, therefore, I must not be good company. "Should" and "shouldn't" statements. You play well in the company volleyball tournament, but miss one shot and berate yourself: I should have made that shot. I shouldn't have missed. You eat a donut and think: I shouldn't have done that. I should lose 10 pounds.

Other self-demanding tip-offs include: "must," "ought to," and "have to." Personalizing the blame. You hold yourself personally responsible for things beyond your control. Your child misbehaves at school and you think: I'm a bad mother.

Seven Ways To Untwist Your Thinking
"When you feel badly,"

This is the ABC of emotion: 'A' stands for the Actual event, 'B' for your Beliefs about it, and 'C' for the Consequences you experience because of your beliefs." Suppose the actual event is a divorce. You might believe many of the charges your ex leveled against you: You're selfish, uncaring, vindictive, and lousy in bed. The consequences of these beliefs might be deep depression. Cognitive therapy tries to change the "Bs" so you don't experience the "C." How can you change your beliefs about the slings and arrows of outrageous fortune? Subjecting any negative belief to the following tests: What would you say to a friend? "People are generally much harder on themselves than they are on others."

Suppose a friend were getting divorced, and felt like a selfish, uncaring, vindictive failure. What would you say? Probably something like: You're not a failure simply because your relationship ended. Many marriages end in divorce, just like many winning teams lose games. It's rough to endure a divorce, and break-ups never bring out the best in people, but I've known you for years, and you're a warm, kind, caring person.

Examine the evidence. Your ex says you're lousy in bed, but are you, really? Until you learned of your ex's unfaithfulness, you had a good sexual relationship. Of course, after your heart was broken, you didn't have any energy for sex, especially with the person who'd rejected and betrayed you. That's not being lousy in bed. That's a normal reaction to your situation. Experiment. Your ex called you selfish for wanting to keep the house, but are you really? If you were truly selfish, you wouldn't give to charity, wouldn't help friends in need, and wouldn't share credit for your group's accomplishments at work. Test your reactions the next time a charitable solicitation arrives, or a friend calls with a problem, or your group's efforts are recognized. If you write a check, offer to lend a hand, or praise a coworker, you're not entirely selfish. You may not be as magnanimous as you'd like to be, but you're not the ogre your ex says you are. Look for partial successes. Instead of thinking your marriage was a "complete failure," consider how it was successful. You took turns putting each other through school, and now both have much more fulfilling careers than you had when you met. You have two great kids, and the problems that led to your breakup have given you valuable new insights into the kind of person you'll look for in your next relationship.

Take a survey. Your ex insists that your refusal to take the kids for an extra day after a holiday weekend proves you're vindictive. You maintain that you're open to rescheduling time with the children, but not when it means allowing your ex to jet off to a luxurious resort with the new lover. You feel justified, but after a screaming argument on the phone, your confidence is shaken. Perhaps you are a vindictive SOB. That's the time to call a few friends and solicit their views. Chances are they'll say you're justified.

Define your terms. You had no idea your ex was having affairs. You were blind. Define "blind." The dictionary says "completely without sight." That wasn't you. You saw that your ex had withdrawn from you, and was spending an enormous amount of time "working late." You weren't blind, just too trusting of someone you had every reason to believe was trustworthy. Solve the problem. You blew up when you came home early and found your ex, who'd moved out months ago, unexpectedly in your house. Since that ugly scene, you've been thinking that your "terrible temper" has turned you into a "monster." Possibly, but the problem here is that you ex still has keys to your house. Maybe it's time to change the locks. Seven Steps to Feeling Better may not sound like many, but "simplicity is one of cognitive therapy's major strengths," It's quick and easy, and once people understand the basic concepts, almost anyone can practice it." Sometimes, though, cognitive therapy's very simplicity puts people off. "It's so simple, it can't possibly work." When that happens, they're jumping to a conclusion, try the steps and see if the process has value:

Step 1. Get pen and paper. Write everything down. "The act of writing automatically puts some distance between you and your negative thought, "Jotting things down provides perspective and helps people detect distorted thinking more easily." If you can't put pen to paper, saying things out loud.

Step 2. Identify the upsetting event. What's really bothering you? Is it simply the fact that you got a flat tire? Or is it that you soiled your outfit changing it? Or that you knew you needed a new tire, but didn't replace it? Or that the flat made you late for your daughter's soccer game?

Step 3. Identify your negative emotions. You might feel annoyed about the flat, frustrated that replacing it soiled your outfit, angry at yourself for not replacing it in time, and guilty for being late to the soccer game.

Step 4. Identify the negative thoughts that accompany your negative emotions. About failing to replace the tire: I always procrastinate. I never take care of things in time. About soiling the outfit: I'm a slob. I can't go anywhere and look okay. About being late for the game: My daughter will make a scene. She'll think I don't love her. And the other adults there will think I'm a bad parent.

Step 5. Identify distortions and substitute rational responses. About the tire: I don't always procrastinate. I juggle my job and family, and accomplish just about everything that has to get done. I would have replaced that tire in time, but I had to deal with an emergency at work, and the tire just got by me. About the stained outfit: I'm not a slob. I'm usually very careful about my appearance, more so than most people, which is why things like this upset me. About the tardiness: My daughter knows I love her. She knows that if I'm late, whatever detained me was beyond my control. She's unlikely to make a scene, but if she does, the other adults there will comfort her. I've done the same for their kids, and never thought them to be bad parents. No one will think the worse of me.

Step 6. Reconsider your upset. Are you still heading for an emotional tailspin? Probably not. But you still feel annoyed about getting the flat.

Step 7. Plan corrective action. As soon as the game is over, we're getting that tire fixed. That will take the time I'd planned to spend cooking dinner, so I'll pick up some take-out instead. Count Your Blessings "A major task of adulthood is to balance striving to do your best while accepting your limits. Cognitive therapy is simply a more organized way to implement traditional psychological self-care advice, "It boils down to counting your blessings. Most depressing or anxiety-producing events are not inherently awful. What makes them feel distressing is the way we react to them. Counting your blessings forces you to step back, get some perspective, and see challenges in a larger context. The problem with 'count your blessings' is that it's vague.

Cognitive therapy is a step-by-step program, and when you feel depressed or stressed by negativity, an organized program helps."