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Monday, October 31, 2011

ADHD or Childhood Bipolar Disorder?

Question: Why do little kids get diagnosed with ADHD or ADD before the possibility of bi-polar?                                                                        -Kaitlyn F., Woodhaven, NY

Answer: Diagnosis of mental illnesses is almost entirely based on a person exhibiting a particular set of thoughts and behaviors or in clinical jargon “symptoms” that indicate the diagnosis.  ADHD and bipolar disorder share several symptoms including hyper-activity, short attention span, and lack of impulse control.  Since ADHD is much more common than bipolar disorder in children (about 4 cases of ADHD for every 1 of bipolar disorder), sometimes a clinician can mistakenly diagnose ADHD when in fact it is bipolar disorder.  Interestingly, recent research has shown that it is very common for children with bipolar disorder to also have ADHD.

You raise an important but difficult question.  ADHD and bipolar disorder have commonalities that sometimes confuse professionals.  However, the treatment courses for each are very different.  This makes the need for accurate diagnosis that much more important.

Friday, September 30, 2011

Mood Swings = Bipolar Disorder?!

Question: I’m getting a lot of mood swings and day by day it's getting worse.  Are these signs of bipolar disorder? 
                                                                                             Juan S., Astoria, NY
Answer: One of the defining characteristics of bipolar disorder is periods of sadness and hopelessness (depression) followed by periods of hyper-activity and euphoria (manic) or vice versa; periods of manic thoughts followed by periods of depression.  That’s why some people call it “manic-depressive disorder”.  Very often these “mood” symptoms are combined with “behavior” symptoms.  For example, during a manic phase, a person might be restless, have racing thoughts, act impulsively (eg. Shopping spree).

What is important to recognize though, is that everyone has mood swings on occasion.  We all go through periods where we are happy and periods when we are sad, and generally we are somewhere in the middle of that continuum.  You should start being concerned when these periods are extreme happiness or sadness, last a significant amount of time, and are affecting your daily functioning.  

If you think that you may have bipolar disorder, it’s a good idea to get a professional opinion by visiting a mental health professional.  There are millions of people that have bipolar disorder who live successful and fulfilling lives.  The key is speaking with a professional and finding the proper help for you.

Tuesday, August 9, 2011

Always Worrying


Question: I have a big anxiety problem.  I worry about everything; my dog, school, parents, brothers, school work, everything.  I take sleeping pills at night, but what can I do during the day to stop it?
                                                               -Christine B., Ridgewood, NY

Answer: Christine, perhaps the most important thing to realize about anxiety, is that often once you recognize (or believe) that you have an anxiety problem it can feed on itself.  Sometimes people become anxious about becoming anxious and that definitely doesn’t help any.  For that reason, I strongly recommend that if you think you have an anxiety problem, you consult with a professional.  That way, in addition to having a clearer picture of the problem, it will also be easier to avoid being anxious about anxiety because you will know that you have someone that can help you with it. 
 
There are many methods that can be helpful with anxiety including behavioral techniques such as muscle relaxation and square breathing, cognitive techniques that help focus on “living in the moment” or on the source of the anxiety, and anti-anxiety medications that can be helpful as well.  A mental health professional can help you with your anxiety using the above tools and much more.  Thousands of people have overcome anxiety problems with proper help, you can do it too!  Best of luck.

Sunday, August 7, 2011

Is Depression Hereditary

Question: My mother and sister both have had serious problems with depression and anxiety.  Is this hereditary?  Should I be worried?
                                                                            -Joe R., Jackson Heights, NY

Answer: There is a lot of research being done on this topic.  It is definitely more common to have a mental illness if someone else in your immediate family does.  Understanding why that is where it gets complicated.  Research has shown a hereditary biological factor to many mental illnesses.  However, in addition to biological factors, there are also important social factors that play a role in mental illnesses.  For example, if someone was laid-off of their job then they would be more likely to be depressed.  Similarly, growing up and/or living with others that have a negative outlook on life can influence your own view of the world and methods for coping with challenges.
The bottom line is that while there are some hereditary and social factors, every person and situation is unique.  If you think you might have a mental illness, as usual, I recommend getting an evaluation from a professional.  Also, there are many support groups and programs for family members of those with mental illnesses.  A great resource for this in New York is the National Alliance on Mental Illness (NAMI).

Tuesday, August 2, 2011

Veteran PTSD Indicators

Question: My son is returning from serving in the army next month and I was wondering how I could tell if he has any mental health problems.  I keep hearing about veterans having problems, so I want to know what to watch out for.
                                                                        -Jennifer M., Glendale, NY
Answer: A large number of returning service members are dealing with mental health issues including post traumatic stress disorder (PTSD), depression, and anxiety disorders.  Therefore, it is important to watch for signs of any of these problems so that they can be addressed properly without waiting for a crisis.

Here are a few of the more common symptoms that turn up for returning veterans: Increased irritability or  getting angry over small things, hyper-vigilance- being overly nervous about noises or other things that are happening as well as difficulty sleeping  due to anxiety, flashbacks and disassociation- reliving in the mind a particularly scary moment from the battlefield, relationship problems- this can be caused by the long separation during deployment but can also be a related to increased irritability due to depression or PTSD.

As always, if you are concerned that there may be a problem, it never hurts to get an evaluation.  In the case of a veteran, I would recommend contacting the Veteran Affairs (VA) or finding a mental health professional that specializes in veterans or trauma treatment as they would be best suited to evaluate and treat any issues.

Monday, May 16, 2011

Mental Health Insurance Parity

Question: My son has been having anxiety attacks about once a week for a few months already.  However, my insurance has very bad coverage for mental health and I can’t really afford it.  I heard something about health care reform changing mental health insurance.  Is it true?  And if so, how can I take advantage of it?
                                                                                     -Susan M., Flushing, NY

Answer: A challenging situation, but I strongly encourage you to take your son in for treatment.  Most clinics have a sliding scale based on income etc. and although it may still be very difficult, the other option could have long-term effects especially on a child.

As part of health care reform, “mental health parity” laws were passed.  They require that any PRIVATE insurance provider give the same level of coverage to mental healthcare that they do for physical healthcare, however this law has just begun to be implemented and does not apply to any public insurance provider such as Medicare or Medicaid. 

In New York State, a similar law was passed in 2006 called “Timothy’s Law”.  It mandates employers to provide specific minimum levels of coverage for mental healthcare.  The details of the law are beyond the scope of this column, however you can learn more about it at www.timothyslaw.org.

Friday, May 13, 2011

Psychiatrist/Psychologist/Social Worker: Where to Begin

Question: A few months ago, I was laid off from my job and haven’t been able to find work yet.  It’s been a really hard time for me and my family and I’m feeling really depressed because of the whole situation.  I want to get some help, but when I started looking around I heard a lot of different terms like psychiatrist, social worker, psychologist and I don’t know which one could help me best.
                                                                                   -Bill H., Glendale, NY

Answer: I’m sorry to hear about your difficult situation and I hope you are able to find work soon; however I am glad that you recognized the need for help and that you are actively seeking it.  That is a courageous and admirable step.

Psychiatrists, psychologists, and social workers each have a unique skill set and therefore are best suited for particular kinds of mental health care services.  Psychiatrists are medical doctors with a specialty in “psychiatry” or the treatment of mental illness.  Most psychiatrists mainly prescribe psychoactive medication like antidepressants or anti-anxiety medication.  They usually do not do psychotherapy.  Psychologists provide psychotherapy and are also experts in psychological testing.  In the vast majority of the U.S. they cannot prescribe medication because they do not have any medical training.  Social workers provide psychotherapy and do not do psychological testing or medication prescription.

So, depending on what you need (medication, therapy etc.), you would see the appropriate professional.  I recommend starting with a social worker or psychologist and asking them to evaluate you and help you determine which kind(s) of help would be best for you.

Best of luck.