Table Of ContentB r e a k t h e
B i p o l a r C y c l e
A D AY- B Y- D AY G U I D E T O
L I V I N G W I T H
B I P O L A R D I S O R D E R
E l i z a b e t h B r o n d o l o , P h . D . , a n d X av i e r A m a d o r, P h . D .
New York Chicago San Francisco Lisbon London Madrid Mexico City
Milan New Delhi San Juan Seoul Singapore Sydney Toronto
Copyright © 2008 by Elizabeth Brondolo and Xavier Amador. All rights reserved. Manufactured in the
United States of America. Except as permitted under the United States Copyright Act of 1976, no part of
this publication may be reproduced or distributed in any form or by any means, or stored in a database or
retrieval system, without the prior written permission of the publisher.
0-07-159406-X
The material in this eBook also appears in the print version of this title: 0-07-148153-2.
All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every
occurrence of a trademarked name, we use names in an editorial fashion only, and to the benefit of the
trademark owner, with no intention of infringement of the trademark. Where such designations appear in
this book, they have been printed with initial caps.
McGraw-Hill eBooks are available at special quantity discounts to use as premiums and sales promotions,
or for use in corporate training programs. For more information, please contact George Hoare, Special
Sales, at
Professional
Want to learn more?
We hope you enjoy this
McGraw-Hill eBook! If
you’d like more information about this book,
its author, or related books and websites,
please click here.
To my family, Tom, Emma, and Elena Brondolo, with love
—E.B.
To my patients and friends with bipolar disorders
—X.A.
This page intentionally left blank
For more information about this title, click here
Contents
Preface vii
Acknowledgments xv
PART 1 The Big Questions
1 How Do I Know T at I Have a Bipolar Spectrum Disorder?
Understanding the Diagnosis 3
2 Is It Really BSD?
Common Diagnostic Dilemmas 27
3 If I’m Taking My Medication, Why Do I Feel Bad Again?
The Importance of Ongoing Assessment of Symptoms 39
4 What Exactly Is Going On?
Some Background on the Neurobiology of Bipolar Disorder 59
5 Do I Have to Take My Meds?
The Role of Medications in Managing BSD 77
PART 2 Problems and Solutions
6 I Just Don’t Feel Like It
The Effects of BSD on Motivation 115
7 I Just Want T ings to Go Back to the Way T ey Were
The Effects of BSD on Your Motivation to Recover 129
8 I Don’t Know Where to Begin
Setting Goals with BSD 137
9 My Mood Aff ects Everything I Do
How Mood Regulation Affects Your Functioning 153
10 I T ought I Was Smart, but I Just Can’t Perform
The Role of Information-Processing Problems 171
11 Just When I Felt OK, I Got Sick Again
The Dangers of Relapse 193
v
vi Contents
Conclusion
What’s Next? 209
Exercises 219
Resources 247
Selected References 249
Index 271
Preface
ipolar spectrum disorders (BSDs) are a group of disorders all
of which involve cycling moods. But BSDs are also accom-
Bpanied by a wide range of other symptoms that aff ect not
just your mood but also your energy, your memory and thinking,
and your connection with other people. Because the symptoms
change or cycle, it may feel like you are always losing ground, never
gaining control over your life.
But it doesn’t have to be that way. A systematic approach to
understanding and managing BSD can make the cycles more pre-
dictable and more controllable. We wrote this book to help you
break the bipolar cycle—to get some momentum on recovery.
The Big Picture
Bipolar spectrum disorders are fi nally getting the attention they
deserve. T e media is covering the story, so the public is more aware
of BSDs. Researchers have a clearer understanding of how many peo-
ple are aff ected (about to percent of the U.S. population). T ey
have been able to document the personal and fi nancial costs to those
with the condition and to their families, friends, and employers.
vii
Copyright © 2008 by Elizabeth Brondolo and Xavier Amador. Click here for terms of use.
viii Preface
T is new understanding about BSDs changes public policy.
Many more research dollars are being spent than ever before, and
the science is improving. New medicines and psychotherapies have
been—and continue to be—developed. Many people are treated
eff ectively with medicines and psychotherapy. And with more and
more celebrities sharing stories of their own struggles with BSD, the
stigma has been greatly reduced. So things will get even better.
Here’s the part that’s a little more diffi cult. BSD is a harder,
more painful, and more disabling disorder than doctors previously
recognized. Of course, if you have BSD, you may already know this.
But your family, friends, or employers might not. It is not unusual
for our BSD patients to tell us that people get angry at them for
not “getting better.” At diff erent points, you may have wondered if
you’re not getting better because you are just lazy or diffi cult. But in
fact, it’s the BSD that is diffi cult.
Why Is It So Diffi cult?
BSD is diffi cult because it involves problems in two key areas: mood
regulation and information processing. You know you experience
problems with the quality, stability, and intensity of your mood and
your energy level. But the mood symptoms are not the only prob-
lem. BSD can also be accompanied by impairments in informa-
tion processing—in your ability to pay attention, to remember, and
to organize information. Combined, these mood-regulation and
i nformation-processing problems aff ect your motivation and func-
tioning—your ability to start the process of recovery, to accomplish
your personal and professional goals, and to develop meaningful
relationships with other people.
BSD is diffi cult because it is a stress-related disorder. Stress
increases your symptoms, and your symptoms make it harder to tol-
erate stress. Even little events that might not have caused a moment’s
