1
00:00:00,120 --> 00:00:04,360
Speaker 1: Support for today's podcast comes from Curology. As I've gotten older,

2
00:00:04,559 --> 00:00:07,000
Speaker 1: I've become more invested in doing the best I can

3
00:00:07,120 --> 00:00:09,920
Speaker 1: to take great care of my skin, but I've often

4
00:00:09,960 --> 00:00:14,120
Speaker 1: felt overwhelmed by where to start. Thankfully, I found Curology.

5
00:00:14,640 --> 00:00:17,799
Speaker 1: Whether you're trying to take control of acne, fine lines,

6
00:00:18,200 --> 00:00:23,759
Speaker 1: dark spots, occasional breakouts, or clogged pores, Curology will customize

7
00:00:23,760 --> 00:00:27,639
Speaker 1: a prescription formula with three active ingredients pick just for

8
00:00:27,760 --> 00:00:31,760
Speaker 1: you to tackle your skincare needs. The formula that was

9
00:00:31,800 --> 00:00:34,960
Speaker 1: customized for me is to help minimize fine lines and

10
00:00:35,080 --> 00:00:39,040
Speaker 1: dark spots. To get your treatment plan, you start by

11
00:00:39,080 --> 00:00:42,440
Speaker 1: answering questions online about your skin and sending in a

12
00:00:42,479 --> 00:00:46,080
Speaker 1: couple of selfies. Next, they match you with a licensed

13
00:00:46,080 --> 00:00:49,919
Speaker 1: dermatology provider who gets to know your skin and if

14
00:00:49,920 --> 00:00:53,120
Speaker 1: it's a good fit, you'll get a customized prescription cream

15
00:00:53,240 --> 00:00:58,040
Speaker 1: to address your unique skin concerns. Then Curology sets you

16
00:00:58,160 --> 00:01:01,240
Speaker 1: up with a personalized treatment plan and ships your custom

17
00:01:01,320 --> 00:01:05,000
Speaker 1: formula right to your door. The whole process was pretty

18
00:01:05,040 --> 00:01:07,959
Speaker 1: easy to complete, and the products arrived to my home

19
00:01:08,040 --> 00:01:11,200
Speaker 1: in only a few days. I've been using the formula

20
00:01:11,240 --> 00:01:13,760
Speaker 1: for a few weeks now and have already noticed some

21
00:01:13,800 --> 00:01:16,800
Speaker 1: fading of a few dark spots. I love that the

22
00:01:16,840 --> 00:01:21,119
Speaker 1: products aren't complicated. There's a cleanser, your formula and then

23
00:01:21,120 --> 00:01:25,120
Speaker 1: a moisturizer, so it doesn't feel too complicated, and there's

24
00:01:25,120 --> 00:01:28,560
Speaker 1: no strong smell, which is my preference in skin care products.

25
00:01:29,400 --> 00:01:31,520
Speaker 1: So if you've been searching for a solution to your

26
00:01:31,560 --> 00:01:35,000
Speaker 1: skin concerns, cure Ology may be just the thing for you.

27
00:01:35,760 --> 00:01:38,720
Speaker 1: For your free thirty day trial, go to cure ology

28
00:01:38,840 --> 00:01:42,120
Speaker 1: dot com slash tv G and you only pay for

29
00:01:42,160 --> 00:01:45,880
Speaker 1: shipping and handling. That s you are O L O

30
00:01:46,319 --> 00:01:50,600
Speaker 1: G Y dot com slash tv g to unlock your

31
00:01:50,600 --> 00:01:54,920
Speaker 1: free thirty day trial. Support for today's podcast also comes

32
00:01:54,920 --> 00:01:57,680
Speaker 1: from Cricket Wireless. Are you looking for a way to

33
00:01:57,800 --> 00:02:00,440
Speaker 1: end summer on a high note? They've got the thing.

34
00:02:00,960 --> 00:02:05,240
Speaker 1: Get ready for unlimited smiles, unlimited times. For get four

35
00:02:05,320 --> 00:02:08,120
Speaker 1: lines of unlimited data for a hundred dollars a month.

36
00:02:08,919 --> 00:02:11,840
Speaker 1: Please note that Cricket Core is required on four lines.

37
00:02:12,360 --> 00:02:15,920
Speaker 1: Data spe limited to three megabits per second. Cricket may

38
00:02:15,960 --> 00:02:19,440
Speaker 1: slow data speeds when the network is busy. Additional fees,

39
00:02:19,680 --> 00:02:23,120
Speaker 1: usage and restrictions apply. Now, let's get into the show.

40
00:02:34,080 --> 00:02:37,800
Speaker 1: Welcome to the Therapy for Black Girls Podcast, a weekly

41
00:02:37,840 --> 00:02:42,600
Speaker 1: conversation about mental health, personal development, and all the small

42
00:02:42,639 --> 00:02:45,760
Speaker 1: decisions we can make to become the best possible versions

43
00:02:45,800 --> 00:02:49,920
Speaker 1: of ourselves. I'm your host, Dr joy hard and Bradford,

44
00:02:50,280 --> 00:02:55,360
Speaker 1: a licensed psychologist in Atlanta, Georgia. For more information or

45
00:02:55,480 --> 00:02:58,840
Speaker 1: to find a therapist in your area, visit our website

46
00:02:59,000 --> 00:03:02,600
Speaker 1: at Therapy for Black Girls dot com. While I hope

47
00:03:02,639 --> 00:03:06,480
Speaker 1: you love listening to and learning from the podcast, it

48
00:03:06,639 --> 00:03:09,560
Speaker 1: is not meant to be a substitute for a relationship

49
00:03:09,600 --> 00:03:20,880
Speaker 1: with a licensed mental health professional. Hey, y'all, thanks so

50
00:03:20,960 --> 00:03:23,320
Speaker 1: much for joining me for session one seventies six of

51
00:03:23,360 --> 00:03:27,440
Speaker 1: the Therapy for Black Girls Podcast. Bipolar disorders are among

52
00:03:27,480 --> 00:03:31,120
Speaker 1: the most commonly misunderstood disorders when it comes to mental illness.

53
00:03:31,480 --> 00:03:34,639
Speaker 1: There's still a lot of confusion about how this disorder presents,

54
00:03:34,800 --> 00:03:38,360
Speaker 1: and it's also often misdiagnosed. So we wanted to take

55
00:03:38,400 --> 00:03:40,520
Speaker 1: some time to clear up some of the confusion and

56
00:03:40,600 --> 00:03:44,120
Speaker 1: provide you with some accurate information about what a bipolar

57
00:03:44,160 --> 00:03:47,600
Speaker 1: disorder can look like. For this conversation, I was joined

58
00:03:47,600 --> 00:03:51,600
Speaker 1: by yet another Xavier, right, Dr Valdisia de Jon, Dr

59
00:03:51,720 --> 00:03:55,360
Speaker 1: Dejon received her medical degree from a Hairy Medical college.

60
00:03:55,920 --> 00:04:00,040
Speaker 1: She completed her psychiatry residency training at Baylor College of

61
00:04:00,120 --> 00:04:04,360
Speaker 1: Benison's Manager Department of Psychiatry, where she served as the

62
00:04:04,400 --> 00:04:09,480
Speaker 1: first black female Chief resident of the General Residency Training program.

63
00:04:09,480 --> 00:04:12,600
Speaker 1: She has also been recognized as a Distinguished Fellow of

64
00:04:12,640 --> 00:04:17,200
Speaker 1: the American Psychiatric Association. She's recently returned to her hometown

65
00:04:17,200 --> 00:04:20,600
Speaker 1: of Atlanta and is currently working in private practice at

66
00:04:20,640 --> 00:04:24,400
Speaker 1: the Georgia Psychological Treatment Center. Dr de john and I

67
00:04:24,520 --> 00:04:27,920
Speaker 1: talked about the symptoms of both bipolar one and bipolar

68
00:04:28,000 --> 00:04:32,320
Speaker 1: to disorder, some of the treatment options typically suggested, the

69
00:04:32,400 --> 00:04:36,400
Speaker 1: concerns related to creativity and medication, how to support a

70
00:04:36,440 --> 00:04:40,240
Speaker 1: family member who's been diagnosed, and she answered some community

71
00:04:40,320 --> 00:04:43,440
Speaker 1: questions from some of you. If there's something that resonates

72
00:04:43,440 --> 00:04:45,960
Speaker 1: with you while listening, please be sure to share with

73
00:04:46,040 --> 00:04:49,479
Speaker 1: us on social media using the hashtag TBG in Session.

74
00:04:49,680 --> 00:04:55,480
Speaker 1: Here's our conversation. Thank you so much for joining us today,

75
00:04:55,560 --> 00:04:58,760
Speaker 1: Dr Dejoon, Thank you so much for having me. Always

76
00:04:58,800 --> 00:05:01,440
Speaker 1: excited to connect with the another fellow Xavier right. So

77
00:05:01,520 --> 00:05:03,800
Speaker 1: you probably are the fourth or film Xavier right we've

78
00:05:03,800 --> 00:05:07,880
Speaker 1: had on the podcast. Oh that's awesome. Yeah, And of

79
00:05:07,920 --> 00:05:10,960
Speaker 1: course there has been lots in the media recently about

80
00:05:10,960 --> 00:05:15,080
Speaker 1: bipolar disorder. We talked about bipolar disorder on the podcast before,

81
00:05:15,160 --> 00:05:17,719
Speaker 1: but really wanted to have you joined us today to

82
00:05:17,800 --> 00:05:21,400
Speaker 1: really expound on that conversation. So can you start by

83
00:05:21,440 --> 00:05:24,560
Speaker 1: telling us a little bit about the different types of

84
00:05:24,560 --> 00:05:29,239
Speaker 1: bipolar disorders. Sure? So, there are two types of bipolar disorder.

85
00:05:29,279 --> 00:05:31,200
Speaker 1: There the main types, and then there are some that

86
00:05:31,240 --> 00:05:34,200
Speaker 1: are related to medical conditions. But when we talk about

87
00:05:34,240 --> 00:05:36,760
Speaker 1: in the community, most people are referring to either bipolar

88
00:05:36,839 --> 00:05:40,400
Speaker 1: one disorder or bipolar to disorder, and in general, what

89
00:05:40,520 --> 00:05:44,080
Speaker 1: bipolar disorder is this is a type of mood disorder

90
00:05:44,360 --> 00:05:48,680
Speaker 1: that is characterized by two different types of smooth states

91
00:05:48,720 --> 00:05:51,880
Speaker 1: that you can be in at a single point in time,

92
00:05:52,680 --> 00:05:57,080
Speaker 1: one being severely depressed mood, the other being a manic episode.

93
00:05:57,800 --> 00:06:02,160
Speaker 1: And with both moods states they can last four days

94
00:06:02,839 --> 00:06:07,640
Speaker 1: or more for mania and with the depression two weeks

95
00:06:07,640 --> 00:06:10,719
Speaker 1: and more so. Starting with depression, when you're in that

96
00:06:10,760 --> 00:06:17,160
Speaker 1: mood state that usually involves problems with sleep, extreme fatigue,

97
00:06:17,400 --> 00:06:22,520
Speaker 1: not feeling motivated, not feeling like you want to engage socially,

98
00:06:23,560 --> 00:06:27,000
Speaker 1: you may not find pleasure and activities as much. Your

99
00:06:27,000 --> 00:06:31,000
Speaker 1: thoughts may be more morbid. You may even have suicidal thinking,

100
00:06:31,839 --> 00:06:36,359
Speaker 1: and sometimes you have concentration difficulties or memory problems. And

101
00:06:36,400 --> 00:06:39,800
Speaker 1: then when you're in a manic phase or episode, that

102
00:06:40,000 --> 00:06:43,600
Speaker 1: usually involves if you can imagine the opposite of depression,

103
00:06:44,279 --> 00:06:48,640
Speaker 1: so you would have an extreme elation in your mood,

104
00:06:48,720 --> 00:06:52,160
Speaker 1: extream elevation of mood to the point of euphoria, and

105
00:06:52,200 --> 00:06:57,440
Speaker 1: so it seems excessively happy associated with increased energy. And

106
00:06:57,480 --> 00:07:01,480
Speaker 1: when people are in this episode, they tend to feel

107
00:07:02,320 --> 00:07:07,800
Speaker 1: extremely excited and confident there and self esteem gets really inflated.

108
00:07:08,000 --> 00:07:10,800
Speaker 1: And when it's in the severe range, they can even

109
00:07:10,840 --> 00:07:13,560
Speaker 1: get to the point where they're grandiose and they're thinking

110
00:07:14,240 --> 00:07:16,200
Speaker 1: and it could even get to the point of boarding

111
00:07:16,280 --> 00:07:20,800
Speaker 1: un delusional. So, for an example, one patient I had

112
00:07:20,920 --> 00:07:25,360
Speaker 1: once had thoughts that he or she was famous, or

113
00:07:25,520 --> 00:07:29,480
Speaker 1: may have thoughts that they might be married to someone famous,

114
00:07:29,560 --> 00:07:32,280
Speaker 1: or if they may think they have special gifts or powers.

115
00:07:33,400 --> 00:07:37,160
Speaker 1: During these periods, they can go days without sleep, or

116
00:07:37,200 --> 00:07:39,440
Speaker 1: sometimes they may just sleep for two to three hours

117
00:07:39,480 --> 00:07:43,840
Speaker 1: and wake up the next day extremely energized. Their mind

118
00:07:43,960 --> 00:07:46,600
Speaker 1: is racing full of thoughts that we call it flight

119
00:07:46,640 --> 00:07:49,840
Speaker 1: of ideas technically as the term for that. But the

120
00:07:49,960 --> 00:07:53,760
Speaker 1: mind becomes extremely creative to the point that their speech

121
00:07:53,880 --> 00:07:58,520
Speaker 1: becomes very rapid, and they're very talkative, sometimes to the

122
00:07:58,520 --> 00:08:00,840
Speaker 1: point where you can't even comprehend and what they're saying.

123
00:08:00,880 --> 00:08:05,680
Speaker 1: At times. They're also very distractable in these episodes, and

124
00:08:05,760 --> 00:08:09,240
Speaker 1: they began to engage in a lot of projects. They

125
00:08:09,240 --> 00:08:12,480
Speaker 1: can stay up all night painting, for an example, and

126
00:08:12,520 --> 00:08:14,960
Speaker 1: they can become impulsive to the point where it can

127
00:08:15,000 --> 00:08:19,520
Speaker 1: be impairing to their relationships. Some people will spend excessive

128
00:08:19,520 --> 00:08:22,040
Speaker 1: amounts of money to the point that they've compromised their

129
00:08:22,080 --> 00:08:27,800
Speaker 1: financial integrity. And other people may even have hyper sexuality

130
00:08:27,800 --> 00:08:31,120
Speaker 1: where they become more flirtatious or they involved in sexual

131
00:08:31,160 --> 00:08:34,080
Speaker 1: activity that's outside of their character to be involved in.

132
00:08:34,679 --> 00:08:38,920
Speaker 1: So sometimes you may even see people have extramarital affairs

133
00:08:39,080 --> 00:08:42,560
Speaker 1: during a manic episode when that's not necessarily something that

134
00:08:42,640 --> 00:08:45,600
Speaker 1: they would do. And so that's bipolar one. This already

135
00:08:45,600 --> 00:08:49,600
Speaker 1: you're describing there, So that's usually bipolar one. The difference

136
00:08:49,640 --> 00:08:53,000
Speaker 1: between bipolar one and bipolar to disorder is usually the

137
00:08:53,080 --> 00:08:56,920
Speaker 1: duration of the symptoms. Whereas been bipolar one, those symptoms

138
00:08:56,960 --> 00:09:00,200
Speaker 1: can last for one week. In bipolar to the sort

139
00:09:00,240 --> 00:09:03,160
Speaker 1: of they tend to last about four days or more.

140
00:09:03,640 --> 00:09:07,640
Speaker 1: But that's the average. And the difference between bipolar one

141
00:09:07,640 --> 00:09:11,080
Speaker 1: and two specifically is the severity and intensity of those

142
00:09:11,120 --> 00:09:14,839
Speaker 1: symptoms in terms of the manic symptoms. So with bipolar

143
00:09:14,880 --> 00:09:19,400
Speaker 1: one disorder, we have manic episodes. With bipolar two disorder,

144
00:09:19,440 --> 00:09:22,679
Speaker 1: we have hypo manic episodes. So they're less intense. They

145
00:09:22,679 --> 00:09:25,880
Speaker 1: don't tend to cause as much problems in their social

146
00:09:26,320 --> 00:09:31,240
Speaker 1: relationships or cause as much impairment there, or cause as

147
00:09:31,280 --> 00:09:35,200
Speaker 1: much impairment in the occupational setting in their workplace, and

148
00:09:35,240 --> 00:09:39,440
Speaker 1: that doesn't require hospitalization and bipolar two as it would

149
00:09:39,440 --> 00:09:42,040
Speaker 1: in bipolar one disorder. So and bipolar one disorder could

150
00:09:42,040 --> 00:09:45,040
Speaker 1: be so severe that someone may be so delusional, they

151
00:09:45,040 --> 00:09:48,560
Speaker 1: may even become psychotic, that they will require stabilization in

152
00:09:48,600 --> 00:09:51,960
Speaker 1: the hospital setting. Sometimes bipolar two disorder, others may not

153
00:09:52,040 --> 00:09:56,560
Speaker 1: even notice this change because it can seem so So

154
00:09:56,960 --> 00:10:00,120
Speaker 1: the severity intensity is the major difference between the two.

155
00:10:00,679 --> 00:10:03,480
Speaker 1: Got it okay? And Dr de John, can you talk

156
00:10:03,520 --> 00:10:07,360
Speaker 1: to us also about like how someone might know that

157
00:10:07,400 --> 00:10:09,880
Speaker 1: they're struggling, Like when somebody is maybe on the brink

158
00:10:09,880 --> 00:10:11,960
Speaker 1: of maybe being diagnosed, like what might be some of

159
00:10:12,000 --> 00:10:15,200
Speaker 1: the first symptoms that they might experience, great question. The

160
00:10:15,280 --> 00:10:18,840
Speaker 1: first early warning sign that most people tend to experience

161
00:10:19,240 --> 00:10:21,720
Speaker 1: is a decreased need for sleep. And I want to

162
00:10:21,760 --> 00:10:24,679
Speaker 1: make sure that I make a distinction. It's not insomnia.

163
00:10:25,120 --> 00:10:27,599
Speaker 1: Sometimes people think, oh, I have bipolar disorder because I

164
00:10:27,640 --> 00:10:30,920
Speaker 1: can't sleep. It's not insomnia because within sounder you want

165
00:10:30,960 --> 00:10:34,040
Speaker 1: to get to sleep. But with bi polar disorder, you

166
00:10:34,080 --> 00:10:38,520
Speaker 1: have a decreased need for sleep. So that's usually an

167
00:10:38,520 --> 00:10:43,160
Speaker 1: early warning signal. Associate with extreme changes in food, so

168
00:10:43,240 --> 00:10:47,360
Speaker 1: you can become extremely euphoric and extremely energized if you know,

169
00:10:47,480 --> 00:10:53,280
Speaker 1: that's not your typical way of experiencing emotion and feeling states.

170
00:10:53,360 --> 00:10:57,000
Speaker 1: So that is a sign that something has changed for you.

171
00:10:57,440 --> 00:10:59,920
Speaker 1: And I must also add that sometimes with by quoltage,

172
00:11:00,000 --> 00:11:02,400
Speaker 1: are you not extremely you for it? You may also

173
00:11:02,480 --> 00:11:06,920
Speaker 1: be extremely irritable, So that is also a sign if

174
00:11:06,960 --> 00:11:10,600
Speaker 1: there's an extreme change in mood that's outside of character.

175
00:11:10,880 --> 00:11:12,679
Speaker 1: Those are the warning signs you want to look for

176
00:11:12,800 --> 00:11:15,479
Speaker 1: early on. And I know, at least in my experience,

177
00:11:15,520 --> 00:11:18,600
Speaker 1: sometimes what will happened is that other people are the

178
00:11:18,600 --> 00:11:21,120
Speaker 1: ones who start to notice this change in you before

179
00:11:21,160 --> 00:11:24,320
Speaker 1: you even recognize it in yourself. That is so true

180
00:11:24,360 --> 00:11:26,959
Speaker 1: and a very good point to make, because a lot

181
00:11:27,000 --> 00:11:31,800
Speaker 1: of times patients may not have insight into their illness,

182
00:11:31,840 --> 00:11:35,400
Speaker 1: and some people don't even remember the illness or the

183
00:11:35,440 --> 00:11:37,839
Speaker 1: episodes when they're in it in that moment. So a

184
00:11:37,920 --> 00:11:40,760
Speaker 1: lot of times we do rely on people who love

185
00:11:40,880 --> 00:11:43,880
Speaker 1: us to share the information and to get patients aware

186
00:11:44,000 --> 00:11:47,479
Speaker 1: that something has shifted. So at least in my experience,

187
00:11:47,840 --> 00:11:51,360
Speaker 1: is often other people who are aware that somebody might

188
00:11:51,360 --> 00:11:54,520
Speaker 1: be struggling with these symptoms before they even become aware.

189
00:11:54,920 --> 00:11:57,439
Speaker 1: That is so true. A lot of times patients were

190
00:11:57,440 --> 00:12:00,400
Speaker 1: bipolar disorder may not have insight when they're actually going

191
00:12:00,480 --> 00:12:04,920
Speaker 1: through the episode, so we oftentimes do rely on family

192
00:12:04,960 --> 00:12:09,000
Speaker 1: to give input to the patient about the symptoms, and

193
00:12:09,040 --> 00:12:12,480
Speaker 1: sometimes they don't even remember the episodes after the episodes

194
00:12:12,520 --> 00:12:16,000
Speaker 1: have occurred, So that's a struggle at times, especially if

195
00:12:16,040 --> 00:12:18,560
Speaker 1: they don't have insight. But we do rely on family

196
00:12:18,640 --> 00:12:22,640
Speaker 1: to help identify those early warning signs and what are

197
00:12:22,679 --> 00:12:26,079
Speaker 1: some of the common treatments for a bipolar disorder, especially

198
00:12:26,200 --> 00:12:29,360
Speaker 1: given the fact that the collection of symptoms it seems

199
00:12:29,360 --> 00:12:32,520
Speaker 1: like could look so different from person to person. Yes.

200
00:12:32,760 --> 00:12:36,920
Speaker 1: So typically with bipolar disorder, the first line of treatment

201
00:12:37,040 --> 00:12:40,840
Speaker 1: is to start a mood stabilizer and the examples of

202
00:12:40,880 --> 00:12:43,680
Speaker 1: this that people may have heard of maybe like lamental

203
00:12:44,360 --> 00:12:48,600
Speaker 1: or liptium or depicode, those are common ones that are

204
00:12:48,600 --> 00:12:53,080
Speaker 1: prescribed in the community. Sometimes you will need to add

205
00:12:53,440 --> 00:12:58,840
Speaker 1: an antipsychotic medicine to the regimen to help stabilize the mood.

206
00:12:59,080 --> 00:13:01,040
Speaker 1: And some people may say, and why are they giving

207
00:13:01,040 --> 00:13:04,160
Speaker 1: me this medicine for psychotic symtims when I'm not psychota,

208
00:13:04,240 --> 00:13:07,680
Speaker 1: I don't have schizophrenic But we are learning now that

209
00:13:07,679 --> 00:13:12,440
Speaker 1: that medication can help also because it has mood stabilizing effects.

210
00:13:12,600 --> 00:13:15,559
Speaker 1: And it's really important for diagnosis to be accurate because

211
00:13:15,960 --> 00:13:20,160
Speaker 1: there's a different protocol of treatment for bipolar disorder as

212
00:13:20,160 --> 00:13:24,280
Speaker 1: opposed to major depressive disorder. And with bipolar disorder, if

213
00:13:24,320 --> 00:13:28,920
Speaker 1: you are in the depressed phase of the treatment, you

214
00:13:29,000 --> 00:13:31,960
Speaker 1: can sometimes get antidepressants, but it's important not to be

215
00:13:32,000 --> 00:13:34,880
Speaker 1: on an antidepression without a mood stabilizers are part of

216
00:13:34,920 --> 00:13:40,280
Speaker 1: the regiment because antidepressants by itself can actually put the

217
00:13:40,320 --> 00:13:44,080
Speaker 1: patient at risk for another mannate episode. It can actually

218
00:13:44,160 --> 00:13:47,760
Speaker 1: precipitate it. So That's why it's important for diagnosis to

219
00:13:47,800 --> 00:13:51,560
Speaker 1: make that distinction, because we don't want people on an

220
00:13:51,600 --> 00:13:54,800
Speaker 1: antidepressant if they actually have a diagnosis bipolar disorder and

221
00:13:54,840 --> 00:13:57,839
Speaker 1: put them at risk of another manic episode. R. Can

222
00:13:57,880 --> 00:14:02,360
Speaker 1: you say more about that antidepressed and precipitating another manic episode, Like,

223
00:14:02,400 --> 00:14:06,959
Speaker 1: what's the mechanics there? So, yes, we don't know fully

224
00:14:07,200 --> 00:14:10,559
Speaker 1: the whole cause a biolos sort of. There are a

225
00:14:10,559 --> 00:14:12,440
Speaker 1: lot of theories out there, but we know that there

226
00:14:12,440 --> 00:14:17,240
Speaker 1: are some changes in the neurotransmitters that can cause bipolar disorder.

227
00:14:17,480 --> 00:14:19,680
Speaker 1: And what we do know is that if there is

228
00:14:19,760 --> 00:14:24,680
Speaker 1: too much serotonin in the body, and that's what antidepressants increase,

229
00:14:24,840 --> 00:14:27,800
Speaker 1: many of them, right, So they increased serotonin, so that

230
00:14:27,960 --> 00:14:33,400
Speaker 1: surge of serotonin is likely to increase the risk of

231
00:14:33,400 --> 00:14:36,480
Speaker 1: a manic episode. It makes sense a little bit when

232
00:14:36,480 --> 00:14:38,600
Speaker 1: you think about it, because serotonis to make us happy,

233
00:14:38,720 --> 00:14:42,480
Speaker 1: so too much of that happiness can put on or

234
00:14:42,760 --> 00:14:47,320
Speaker 1: precipitate the maniam gout. It Okay, that makes sense. That

235
00:14:47,360 --> 00:14:49,880
Speaker 1: does make sense. And so you said that you would

236
00:14:49,880 --> 00:14:54,480
Speaker 1: likely start with the mood stabilizer and sometimes add an antipsychotic.

237
00:14:55,120 --> 00:14:57,040
Speaker 1: Is this like a long term kind of thing where

238
00:14:57,040 --> 00:14:59,640
Speaker 1: you would likely be on both of them for like

239
00:14:59,680 --> 00:15:02,600
Speaker 1: a on time or what is the typical course of treatment,

240
00:15:03,640 --> 00:15:07,400
Speaker 1: So that is really dependent on the severity. It is

241
00:15:07,440 --> 00:15:11,760
Speaker 1: a biological illness, So just as diabetes and high blood pressure,

242
00:15:12,000 --> 00:15:14,280
Speaker 1: you want to make sure you keep the illness in

243
00:15:14,320 --> 00:15:20,960
Speaker 1: remission because it has relapsing and remitting phases. So particularly

244
00:15:20,960 --> 00:15:23,680
Speaker 1: for patients who have a lot of cycling in and

245
00:15:23,720 --> 00:15:26,520
Speaker 1: out of the depression and the mania, we want to

246
00:15:26,520 --> 00:15:29,040
Speaker 1: make sure those patients stay on medication long term because

247
00:15:29,080 --> 00:15:31,680
Speaker 1: we don't want them to have impairment in their lives.

248
00:15:31,720 --> 00:15:34,880
Speaker 1: We want them to be able to work and function socially.

249
00:15:35,520 --> 00:15:40,000
Speaker 1: There are rare cases in which patients who maybe they

250
00:15:40,000 --> 00:15:41,840
Speaker 1: don't have a lot of manic episodes, so they don't

251
00:15:41,880 --> 00:15:43,560
Speaker 1: have a lot of depression. Maybe the last one was

252
00:15:43,880 --> 00:15:47,080
Speaker 1: the episode of depression remaining was twenty years ago. For

253
00:15:47,120 --> 00:15:50,280
Speaker 1: those patients, sometimes they really don't want to be on medicine,

254
00:15:51,160 --> 00:15:54,680
Speaker 1: and so I try to honor respect people's autonomy as

255
00:15:54,760 --> 00:15:57,320
Speaker 1: much as we can and just talk about that and

256
00:15:57,360 --> 00:15:59,480
Speaker 1: what I usually will say, well, let's do some long

257
00:15:59,600 --> 00:16:02,600
Speaker 1: terms the therapy. Make sure you have some good coping

258
00:16:02,680 --> 00:16:06,880
Speaker 1: skills and resilience there and if you do, let's come

259
00:16:06,920 --> 00:16:09,840
Speaker 1: to an agreement together. If you do have another episode

260
00:16:10,280 --> 00:16:13,480
Speaker 1: without this medicine, then net's agree that if you continue

261
00:16:13,480 --> 00:16:16,440
Speaker 1: to have more, we need to talk about long term

262
00:16:16,440 --> 00:16:20,120
Speaker 1: options that you would take indefinitely. I also want to

263
00:16:20,120 --> 00:16:23,960
Speaker 1: make a point that if someone is acutely in a

264
00:16:24,120 --> 00:16:27,760
Speaker 1: manic episode, the treatment is going to be a little

265
00:16:27,760 --> 00:16:32,240
Speaker 1: bit different than just preventative and stabilization. So if you're

266
00:16:32,240 --> 00:16:35,000
Speaker 1: acutely in a manic episode, the first thing we're gonna

267
00:16:35,000 --> 00:16:37,600
Speaker 1: go to is an anti psychotic medication because that is

268
00:16:37,640 --> 00:16:41,560
Speaker 1: the first line treatment for acute mania. Okay, so you

269
00:16:41,600 --> 00:16:44,640
Speaker 1: wouldn't even start with the mood stabilizer. Then you would

270
00:16:44,640 --> 00:16:47,120
Speaker 1: start first with the anti psychotic. You would start first

271
00:16:47,160 --> 00:16:49,320
Speaker 1: with the antischada. A lot of times the mood stabilize

272
00:16:49,360 --> 00:16:52,200
Speaker 1: maybe added on in conjunction with it at the same

273
00:16:52,240 --> 00:16:55,880
Speaker 1: time or later on. But yes, the first thing we're

274
00:16:55,920 --> 00:16:59,920
Speaker 1: gonna reach for for starting is the uh anti psycho

275
00:17:00,040 --> 00:17:02,680
Speaker 1: it because that is the treatment for acute mania. But

276
00:17:02,760 --> 00:17:05,280
Speaker 1: a lot of times we are adding the mood stabilizer

277
00:17:05,280 --> 00:17:08,119
Speaker 1: at the same time. It just depends on the psychiatrists

278
00:17:08,160 --> 00:17:11,399
Speaker 1: and the way they think about the treatment. M hmmm.

279
00:17:11,800 --> 00:17:13,800
Speaker 1: And I know you know a lot of times when

280
00:17:13,840 --> 00:17:16,080
Speaker 1: we're talking about working with clients who have been diagnosed

281
00:17:16,080 --> 00:17:18,879
Speaker 1: with a bipolar disorder, it really is like a team

282
00:17:18,880 --> 00:17:21,959
Speaker 1: approach and like a lot of wraparound services. So can

283
00:17:22,000 --> 00:17:24,360
Speaker 1: you talk about some of those other things in terms

284
00:17:24,400 --> 00:17:27,840
Speaker 1: of like lifestyle changes and other supporting factors that you

285
00:17:27,920 --> 00:17:30,159
Speaker 1: might talk with with a client who is diagnosed with

286
00:17:30,200 --> 00:17:33,320
Speaker 1: a bipolar disorder? Right? I love that. I love thinking

287
00:17:33,320 --> 00:17:37,680
Speaker 1: about it from a biopsychosocial model, so meaning we're thinking

288
00:17:37,680 --> 00:17:40,840
Speaker 1: about the biology of the medicines through medications, we're thinking

289
00:17:40,840 --> 00:17:45,280
Speaker 1: about the psychological person involved. So we're thinking about how

290
00:17:45,280 --> 00:17:47,760
Speaker 1: do we think about the way you see life, the

291
00:17:47,800 --> 00:17:50,240
Speaker 1: way you view things, the way you view your illness,

292
00:17:50,680 --> 00:17:53,720
Speaker 1: and so we address that with psychotherapy, and then thinking

293
00:17:53,760 --> 00:17:57,720
Speaker 1: about social supports. So who can we get involved to

294
00:17:57,960 --> 00:18:01,120
Speaker 1: help garner support for you at all times, Who are

295
00:18:01,160 --> 00:18:04,280
Speaker 1: your closest friends that you feel comfortable talking to, Who

296
00:18:04,320 --> 00:18:07,200
Speaker 1: are your family members who you can rely on that

297
00:18:07,240 --> 00:18:11,080
Speaker 1: you trust to help you, and making sure that those

298
00:18:11,160 --> 00:18:14,000
Speaker 1: people are involved in the treatment because they can help

299
00:18:14,240 --> 00:18:17,840
Speaker 1: find the early warning signs. Sometimes patients who have more

300
00:18:17,880 --> 00:18:22,560
Speaker 1: severe bipolar disorder, we will put them in teams called

301
00:18:22,560 --> 00:18:25,920
Speaker 1: the act team. So certain cities have that where there's

302
00:18:25,920 --> 00:18:30,800
Speaker 1: a team involving a social worker, psychiatrist, a case manager

303
00:18:31,280 --> 00:18:34,720
Speaker 1: that they sometimes even come to the homes of the

304
00:18:34,760 --> 00:18:38,560
Speaker 1: individuals to check on them periodically. So it really depends

305
00:18:38,600 --> 00:18:42,359
Speaker 1: on the severity of the illness. But those are the

306
00:18:42,400 --> 00:18:44,720
Speaker 1: type of supports we want. We want to rally the

307
00:18:44,800 --> 00:18:49,159
Speaker 1: support around them to make them as most successful as possible. So,

308
00:18:49,280 --> 00:18:51,520
Speaker 1: kind of going back to the medication piece, I know

309
00:18:51,640 --> 00:18:54,120
Speaker 1: that for a lot of times, Uman, maybe you can

310
00:18:54,160 --> 00:18:57,080
Speaker 1: speak to the prevalence of this. It seems like people

311
00:18:57,080 --> 00:19:00,560
Speaker 1: who are like excel creatively right will offer and have

312
00:19:01,040 --> 00:19:04,840
Speaker 1: a diagnosis of a bipolar disorder. And so sometimes when

313
00:19:04,840 --> 00:19:07,439
Speaker 1: they meet with a psychiatrist and talk about medication and

314
00:19:07,480 --> 00:19:11,000
Speaker 1: they start medication, they talk about their creativity being gone

315
00:19:11,080 --> 00:19:13,880
Speaker 1: or they feel dull in some ways. Can you talk

316
00:19:13,920 --> 00:19:16,280
Speaker 1: a little bit about that, and then how as a

317
00:19:16,280 --> 00:19:19,600
Speaker 1: psychiatrist you work with them too, maybe you know mediate

318
00:19:19,640 --> 00:19:22,880
Speaker 1: some of those side effects. Yes, I will say I

319
00:19:22,920 --> 00:19:27,040
Speaker 1: don't hear a lot about that, but I hear enough

320
00:19:27,200 --> 00:19:29,840
Speaker 1: to have to address it at times. A lot of

321
00:19:29,880 --> 00:19:33,320
Speaker 1: times I would say that peace about the creativity can

322
00:19:33,359 --> 00:19:37,200
Speaker 1: be dependent on the dosage of medication. So sometimes maybe

323
00:19:37,240 --> 00:19:40,000
Speaker 1: the dosages if a patients coming to me on a regiment,

324
00:19:40,040 --> 00:19:43,480
Speaker 1: maybe a little bit higher than necessary, so we will

325
00:19:43,520 --> 00:19:47,120
Speaker 1: try to lower the dosage and see if that will

326
00:19:47,200 --> 00:19:50,840
Speaker 1: help with them feeling a little bit more creative. But

327
00:19:50,960 --> 00:19:53,240
Speaker 1: for some people, I will say, there are people who

328
00:19:53,320 --> 00:19:56,400
Speaker 1: just say, this is just not working for me. Sometimes

329
00:19:56,400 --> 00:19:59,359
Speaker 1: you can change the mood stabilizer from one to another

330
00:19:59,400 --> 00:20:01,280
Speaker 1: to see if that will help, and then there are

331
00:20:01,280 --> 00:20:04,240
Speaker 1: people ultimately like it. No, I just want my creativity.

332
00:20:04,359 --> 00:20:06,280
Speaker 1: When we get into that, that's when I move into

333
00:20:06,320 --> 00:20:11,040
Speaker 1: the psychotherapy or pharmacal therapy of speaking with the individuals.

334
00:20:11,080 --> 00:20:14,800
Speaker 1: So we then explore, okay, let's look at this. Let's

335
00:20:15,000 --> 00:20:18,320
Speaker 1: have a risk benefit analysis right now, when you are

336
00:20:18,359 --> 00:20:21,240
Speaker 1: most creative and I get that, you value that, and

337
00:20:21,280 --> 00:20:24,600
Speaker 1: I normalize that and empathize with that patient. When you're

338
00:20:24,640 --> 00:20:29,080
Speaker 1: creative and you're manic, because you're at risk of creative

339
00:20:29,119 --> 00:20:31,600
Speaker 1: and you're not functioning as well because you're in a

340
00:20:31,640 --> 00:20:35,199
Speaker 1: manic episode, what does your life look like. Is it

341
00:20:35,240 --> 00:20:38,560
Speaker 1: impaired socially? How are those relationships at that time? Are

342
00:20:38,600 --> 00:20:41,960
Speaker 1: you able to work? Because we don't want to value

343
00:20:42,000 --> 00:20:48,480
Speaker 1: creativity at the expense of impairment. So if they say, yes,

344
00:20:48,560 --> 00:20:51,359
Speaker 1: everything is good when I'm creative, well then we'll have

345
00:20:51,400 --> 00:20:53,960
Speaker 1: to kind of check and see if that's a distorted

346
00:20:54,000 --> 00:20:57,199
Speaker 1: way of thinking. So sometimes it's about let's grieve a

347
00:20:57,200 --> 00:20:59,560
Speaker 1: little bit of the loss of that creativity so that

348
00:20:59,600 --> 00:21:02,160
Speaker 1: we can have have more functionality in your life. So

349
00:21:02,280 --> 00:21:05,040
Speaker 1: we really take a look at this. And also another

350
00:21:05,080 --> 00:21:08,240
Speaker 1: point is that you know, when you in a manic episode,

351
00:21:08,280 --> 00:21:12,360
Speaker 1: you are so creative. Your mind is beyond creative. It's productive,

352
00:21:12,680 --> 00:21:15,919
Speaker 1: and it feels elating and exciting for a lot of people.

353
00:21:16,240 --> 00:21:19,320
Speaker 1: So of course when you're in a normal phase or

354
00:21:19,359 --> 00:21:22,880
Speaker 1: when you're maybe medicated, you're going to feel more muted,

355
00:21:23,160 --> 00:21:26,320
Speaker 1: but it still could be at the same level of

356
00:21:26,400 --> 00:21:30,160
Speaker 1: someone who's naturally artistic and who doesn't have the diagnosis.

357
00:21:30,280 --> 00:21:34,919
Speaker 1: We have to make sure that we're not over estimating,

358
00:21:35,440 --> 00:21:38,440
Speaker 1: you know, or underestimating the creativity when you are well

359
00:21:38,840 --> 00:21:41,560
Speaker 1: m m m m yeah, because I wonder if that

360
00:21:41,760 --> 00:21:44,880
Speaker 1: could be something that potentially happens, is that people think

361
00:21:44,920 --> 00:21:48,440
Speaker 1: that their creativity only comes when they're manic, as opposed

362
00:21:48,480 --> 00:21:50,680
Speaker 1: to like, no, you can also acts as this when

363
00:21:50,680 --> 00:21:55,840
Speaker 1: you're not having a manic episode. Absolutely. Yeah. Yeah, So

364
00:21:56,160 --> 00:21:58,680
Speaker 1: Dr de Gene, you talked a little bit about making

365
00:21:58,680 --> 00:22:02,000
Speaker 1: sure that the diagnosis is correct, especially when we're talking

366
00:22:02,000 --> 00:22:05,399
Speaker 1: about starting medications. What are some of them may be

367
00:22:05,760 --> 00:22:08,560
Speaker 1: misdiagnosis you've seen, Like, what are some of the things

368
00:22:08,640 --> 00:22:11,360
Speaker 1: that people think maybe might be bipolar and it's not

369
00:22:11,520 --> 00:22:14,359
Speaker 1: our people diagnosing with something else and it actually is

370
00:22:14,400 --> 00:22:18,320
Speaker 1: a bipolar disorder. Oh, that's such a great question because

371
00:22:18,400 --> 00:22:22,240
Speaker 1: this is a problem of misdiagnosis. It's not always easy

372
00:22:22,280 --> 00:22:27,439
Speaker 1: to diagnose because sometimes people don't see those symptoms in themselves,

373
00:22:27,440 --> 00:22:30,439
Speaker 1: as you mentioned earlier, right, maybe the family members sees it.

374
00:22:30,640 --> 00:22:34,359
Speaker 1: So there are four main common misdiagnosis. I tend to

375
00:22:34,400 --> 00:22:39,840
Speaker 1: see Sometimes patients actually have borderline personality disorder and it

376
00:22:39,960 --> 00:22:43,200
Speaker 1: is misdiagnosis a bipolar disorder. And I think the reason

377
00:22:43,240 --> 00:22:47,400
Speaker 1: why this happens is people with borderline personality disorder tend

378
00:22:47,440 --> 00:22:50,160
Speaker 1: to have a lot of mood swings, and I think

379
00:22:50,240 --> 00:22:52,520
Speaker 1: some clinicies they hear mood swings and they're ready to

380
00:22:52,520 --> 00:22:56,240
Speaker 1: diagnose bipolar disorder. But it's important to take this information

381
00:22:56,320 --> 00:23:02,280
Speaker 1: into context with borderline personnel alogy disorder, the move swings

382
00:23:02,720 --> 00:23:08,119
Speaker 1: can vary and range from one hour to a day,

383
00:23:08,520 --> 00:23:12,800
Speaker 1: and usually someone gets back into a normal move state

384
00:23:12,880 --> 00:23:18,040
Speaker 1: for themselves, what we call euthymia. So moo swings tend

385
00:23:18,119 --> 00:23:23,680
Speaker 1: to fluctuate within a day or hours with borderline personality disorder. However,

386
00:23:23,760 --> 00:23:29,119
Speaker 1: with h APOLOG disorder, the moves are sustained episodic periods

387
00:23:29,160 --> 00:23:33,280
Speaker 1: of changes. So the manic episode will last seven days

388
00:23:33,359 --> 00:23:36,600
Speaker 1: or more and it's usually followed by a crash into

389
00:23:36,680 --> 00:23:40,560
Speaker 1: the depression, which will be two weeks or more. So

390
00:23:41,480 --> 00:23:43,640
Speaker 1: that is the main distinction that needs to be made

391
00:23:43,640 --> 00:23:47,560
Speaker 1: with borderline personality disorder, and they can also be impulsive

392
00:23:47,600 --> 00:23:51,320
Speaker 1: patients with borderline personality disorder, but the impulsivity is usually

393
00:23:51,320 --> 00:23:54,879
Speaker 1: related to an intense emotional response to some type of

394
00:23:55,000 --> 00:23:58,760
Speaker 1: situational trigger in their environment that's upset them or some

395
00:23:58,880 --> 00:24:04,560
Speaker 1: type of interaction. Another common misdiagnosed is PTSD or post

396
00:24:04,600 --> 00:24:08,399
Speaker 1: traumatic stress disorder. You can also have mood swings because

397
00:24:08,440 --> 00:24:11,719
Speaker 1: of post traumatic stress disorder, and that's usually because something

398
00:24:12,320 --> 00:24:16,000
Speaker 1: has reminded you of past trauma and has triggered an

399
00:24:16,000 --> 00:24:20,640
Speaker 1: emotional response, and emotional disregulation is a part of that

400
00:24:20,800 --> 00:24:25,040
Speaker 1: illness as well. A d h D is also commonly

401
00:24:25,119 --> 00:24:28,960
Speaker 1: misdiagnosed for bipolar disorder, and that's because patients tend to

402
00:24:29,000 --> 00:24:30,919
Speaker 1: be more impulsive who have a d h D, and

403
00:24:30,920 --> 00:24:34,200
Speaker 1: they may be hyperactive. But again it's important to look

404
00:24:34,240 --> 00:24:38,359
Speaker 1: at if the changes are episodic in nature. Most of

405
00:24:38,359 --> 00:24:41,080
Speaker 1: the time, people with a d h D, they're hyperactive

406
00:24:41,119 --> 00:24:43,879
Speaker 1: most of the day until they go to sleep, and

407
00:24:43,920 --> 00:24:46,920
Speaker 1: they can be distractable, but this is not episodic in nature.

408
00:24:46,920 --> 00:24:50,600
Speaker 1: It's just a part of the construct of their everyday functioning.

409
00:24:51,600 --> 00:24:54,919
Speaker 1: And then substance induced mood disorders can also look like

410
00:24:55,040 --> 00:24:59,280
Speaker 1: bipolar disorders. So if someone's using cocaine or amphetamines are

411
00:24:59,520 --> 00:25:04,280
Speaker 1: upper drugs that really elevate the mood, they could very

412
00:25:04,359 --> 00:25:07,119
Speaker 1: much look like they're in a manic episodes. That's another

413
00:25:07,160 --> 00:25:11,880
Speaker 1: common misdiagnosis. Yeah, so it really is incumbent upon the

414
00:25:11,880 --> 00:25:14,280
Speaker 1: therapist of the psychiatrist whoever is kind of getting this

415
00:25:14,359 --> 00:25:17,199
Speaker 1: intake information to make sure that they are grounding the

416
00:25:17,400 --> 00:25:22,000
Speaker 1: symptoms in context of everything else happening in the person's life. Absolutely,

417
00:25:22,040 --> 00:25:25,080
Speaker 1: and sometimes you do have to rely on family members

418
00:25:25,119 --> 00:25:30,400
Speaker 1: to give some interview details so that you know exactly

419
00:25:30,400 --> 00:25:32,800
Speaker 1: what you're dealing with. If the patient doesn't remember it

420
00:25:32,840 --> 00:25:35,280
Speaker 1: as well. When you were talking about like some of

421
00:25:35,320 --> 00:25:39,200
Speaker 1: the common misdiagnosis you talked about, borderline personality disorder. You've

422
00:25:39,200 --> 00:25:44,359
Speaker 1: talked about schizophrenia earlier, and those, in addition to bipolar disorders,

423
00:25:44,400 --> 00:25:48,040
Speaker 1: seems to be the mental health diagnoses that people really

424
00:25:48,080 --> 00:25:52,400
Speaker 1: struggle with, just in terms of like the general population. Right, So,

425
00:25:52,760 --> 00:25:55,520
Speaker 1: I think most people kind of understand what happens with

426
00:25:55,560 --> 00:25:58,320
Speaker 1: the president of anxiety. It feels like there tends to

427
00:25:58,359 --> 00:26:01,000
Speaker 1: be at least some empathy towards people who may be

428
00:26:01,040 --> 00:26:04,080
Speaker 1: a struggle with depression and anxiety. And for some reason,

429
00:26:04,200 --> 00:26:06,840
Speaker 1: it seems as though people who may be struggled with

430
00:26:06,840 --> 00:26:10,920
Speaker 1: a bipolar disorder or borderline personality disorder, like those diagnoses

431
00:26:10,920 --> 00:26:14,080
Speaker 1: don't corner the same sympathy from people, and so we

432
00:26:14,160 --> 00:26:18,040
Speaker 1: tend to get a lot of really harsh language, a

433
00:26:18,040 --> 00:26:20,640
Speaker 1: lot of you know, like look at the damage they've

434
00:26:20,640 --> 00:26:23,120
Speaker 1: done in people's lives, like that kind of thing. I'm

435
00:26:23,160 --> 00:26:26,040
Speaker 1: curious to hear your thoughts about how we can maybe

436
00:26:26,080 --> 00:26:30,000
Speaker 1: take some steps to better educate or to really you know,

437
00:26:30,040 --> 00:26:32,280
Speaker 1: get rid of some of that stigma related to these

438
00:26:32,359 --> 00:26:37,760
Speaker 1: kinds of diagnoses. Right, Oh, that's so important to think about.

439
00:26:38,320 --> 00:26:40,920
Speaker 1: You know, one of the things about stigma that I've

440
00:26:41,000 --> 00:26:44,280
Speaker 1: learned over these years is that it's not just about

441
00:26:44,480 --> 00:26:48,639
Speaker 1: fear for some people, because the fear generates helplessness. Right,

442
00:26:48,680 --> 00:26:51,679
Speaker 1: So I don't know what to do with this, I'm afraid.

443
00:26:51,720 --> 00:26:53,280
Speaker 1: I don't know how to help this person who it's

444
00:26:53,320 --> 00:26:56,680
Speaker 1: easier to dismiss it or to just push that person aside.

445
00:26:57,080 --> 00:27:00,440
Speaker 1: You know, stigmas based on fears, also based on lack

446
00:27:00,480 --> 00:27:03,840
Speaker 1: of knowledge. But there's a huge piece to this that

447
00:27:03,920 --> 00:27:08,960
Speaker 1: stigmas based on denial of vulnerability, of your own vulnerability.

448
00:27:09,160 --> 00:27:13,200
Speaker 1: And really, I've seen the most well adjusted people develop

449
00:27:13,280 --> 00:27:16,840
Speaker 1: schizophrenia or bipolar disorder. You would never imagine that this

450
00:27:16,880 --> 00:27:19,680
Speaker 1: person will end up in this situation. And the truth

451
00:27:19,720 --> 00:27:21,800
Speaker 1: of the matter is there's a risk percentage even in

452
00:27:21,840 --> 00:27:25,240
Speaker 1: the population. So if we could really acknowledge our own vulnerability,

453
00:27:25,560 --> 00:27:29,960
Speaker 1: then that could translate to more empathy for other people.

454
00:27:30,200 --> 00:27:33,040
Speaker 1: Look at this pandemic how it's changing us. Now of

455
00:27:33,080 --> 00:27:36,719
Speaker 1: Americans after this pandemic is going to end up with

456
00:27:36,760 --> 00:27:39,760
Speaker 1: a mental health diagnosis. So if you could say, you know,

457
00:27:40,000 --> 00:27:42,000
Speaker 1: if I have been in that set of circumstances in

458
00:27:42,040 --> 00:27:44,160
Speaker 1: person's life, or I had that family history and really

459
00:27:44,160 --> 00:27:47,480
Speaker 1: putting yourself in their position, you have more compassion for

460
00:27:47,560 --> 00:27:50,800
Speaker 1: that person. But there are other things that also generate stigma.

461
00:27:51,040 --> 00:27:53,359
Speaker 1: I think we have to look about the language we use,

462
00:27:53,440 --> 00:27:57,040
Speaker 1: as you mentioned, in our culture and our family and

463
00:27:57,080 --> 00:28:00,080
Speaker 1: our churches, how we think about these things. How do

464
00:28:00,200 --> 00:28:04,080
Speaker 1: we be inclusive because a lot of times the diagnosis

465
00:28:04,119 --> 00:28:08,199
Speaker 1: is demonized is something that spiritual rather than understanding it

466
00:28:08,720 --> 00:28:12,880
Speaker 1: in truth to be a biological illness. Sometimes people are said,

467
00:28:12,920 --> 00:28:15,560
Speaker 1: don't take medicine, so then you're more at risk of

468
00:28:16,000 --> 00:28:19,000
Speaker 1: the expression of the illness. We're told that we should

469
00:28:19,000 --> 00:28:23,280
Speaker 1: be good Christians or that you should be strong enough

470
00:28:23,320 --> 00:28:27,320
Speaker 1: to pray away. So we have to think about the

471
00:28:27,480 --> 00:28:31,480
Speaker 1: narrative and change that paradigm and the core belief systems

472
00:28:31,800 --> 00:28:35,640
Speaker 1: to make sure they're accurate and they reflect compassion and empathy.

473
00:28:35,920 --> 00:28:40,240
Speaker 1: Another thing is we need to speak up more when

474
00:28:40,400 --> 00:28:44,360
Speaker 1: we are suffering, even if it's just depression and it's

475
00:28:44,400 --> 00:28:47,200
Speaker 1: not my poem disorder. We need to normalize that for

476
00:28:47,280 --> 00:28:50,080
Speaker 1: patients so that they can feel more comfortable opening up.

477
00:28:50,640 --> 00:28:53,520
Speaker 1: We need to stop coding with stigma and the silence

478
00:28:53,640 --> 00:28:57,400
Speaker 1: that we have so many times and it's interesting and

479
00:28:57,440 --> 00:29:01,200
Speaker 1: a lot of my patients I find out that there

480
00:29:01,200 --> 00:29:03,640
Speaker 1: are other people that have by polar disorder in their

481
00:29:03,680 --> 00:29:06,480
Speaker 1: family until they get sick, and then they find out

482
00:29:06,520 --> 00:29:10,760
Speaker 1: Aunt Susie, Uncle Joe, headed and all these other people,

483
00:29:11,480 --> 00:29:15,080
Speaker 1: and it was just everyone hit it. But when it

484
00:29:15,200 --> 00:29:18,280
Speaker 1: came out, it, you know, make the patients feel better.

485
00:29:18,800 --> 00:29:22,120
Speaker 1: So we need to be transparent, We need to be

486
00:29:22,200 --> 00:29:25,960
Speaker 1: authentic so that we can help normalize this and not

487
00:29:26,080 --> 00:29:28,800
Speaker 1: see it as something bad. It's just a part of

488
00:29:28,840 --> 00:29:31,920
Speaker 1: your experience. It doesn't define who you are, and changing

489
00:29:31,960 --> 00:29:35,880
Speaker 1: that narrative. And I'm thankful to the public figures and

490
00:29:35,920 --> 00:29:38,040
Speaker 1: the famous people who have come out to speak out

491
00:29:38,080 --> 00:29:41,840
Speaker 1: about mental illness. We saw that even Michelle Obama spoke

492
00:29:41,920 --> 00:29:47,520
Speaker 1: out recently about being depressed. Those actions of people who

493
00:29:47,520 --> 00:29:50,680
Speaker 1: are leaders in our community help us get closer to

494
00:29:50,800 --> 00:29:56,280
Speaker 1: destigmatizing not just by polar disorder, but any mental health diagnosis. Yeah,

495
00:29:56,360 --> 00:29:58,280
Speaker 1: that's great for me, so thank you so much for that.

496
00:29:59,000 --> 00:30:01,880
Speaker 1: We already talked about the family involved in reporting some

497
00:30:01,960 --> 00:30:05,280
Speaker 1: of those symptoms, but once there is a diagnosis, what

498
00:30:05,440 --> 00:30:08,840
Speaker 1: kinds of things can family members and friends due to

499
00:30:08,920 --> 00:30:12,680
Speaker 1: support somebody who has been diagnosed with a bipolar disorder.

500
00:30:13,240 --> 00:30:15,360
Speaker 1: I think the first thing they can do is to

501
00:30:16,080 --> 00:30:20,200
Speaker 1: gently call it out that they see something different in

502
00:30:20,240 --> 00:30:22,600
Speaker 1: them and that they want to be there for them

503
00:30:22,640 --> 00:30:25,200
Speaker 1: because they want the best for them, and to do

504
00:30:25,240 --> 00:30:29,680
Speaker 1: it in a way that is least likely to make

505
00:30:29,720 --> 00:30:32,280
Speaker 1: the person feel judged. A lot of times people are

506
00:30:32,320 --> 00:30:34,640
Speaker 1: just afraid to go through the psychiatrists, and I get it.

507
00:30:34,640 --> 00:30:37,120
Speaker 1: It's like, well, what is this person going to do

508
00:30:37,160 --> 00:30:40,480
Speaker 1: with that vulnerability? They handle me with care and compassion.

509
00:30:40,760 --> 00:30:43,640
Speaker 1: So a lot of times just being willing and offering

510
00:30:43,760 --> 00:30:46,680
Speaker 1: to accompany them to the visit can help reduce the

511
00:30:46,720 --> 00:30:51,440
Speaker 1: anxiety about seeking mental health treatment. Also being involved in

512
00:30:51,480 --> 00:30:55,040
Speaker 1: the treatment team and the treatment planning, helping them research,

513
00:30:55,160 --> 00:30:58,640
Speaker 1: going to support groups with them. I think those are

514
00:30:58,640 --> 00:31:01,400
Speaker 1: all good steps that can be It can to make

515
00:31:01,440 --> 00:31:05,040
Speaker 1: the patient feel heard and seen. Yeah, And I think

516
00:31:05,080 --> 00:31:07,920
Speaker 1: it is also important, you know, because we know that sometimes,

517
00:31:08,000 --> 00:31:11,680
Speaker 1: especially with the mood swings, it is also important as

518
00:31:11,680 --> 00:31:13,840
Speaker 1: a caregiver, as a friend and family member to make

519
00:31:13,880 --> 00:31:16,440
Speaker 1: sure that you're checking in with yourself to make sure

520
00:31:16,520 --> 00:31:18,760
Speaker 1: that you're you know, taking care of yourself as you're

521
00:31:18,800 --> 00:31:20,720
Speaker 1: helping to try to take care of this other person.

522
00:31:20,760 --> 00:31:24,680
Speaker 1: As well. Absolutely so, DNA di gen are there. You know,

523
00:31:24,800 --> 00:31:27,120
Speaker 1: I know school it is starting soon. People are kind

524
00:31:27,120 --> 00:31:30,000
Speaker 1: of you know, getting back into the workplaces. Are there

525
00:31:30,120 --> 00:31:34,320
Speaker 1: some common accommodations that you may be typically suggests or

526
00:31:34,400 --> 00:31:37,560
Speaker 1: that you've seen work for clients who have a bipolar

527
00:31:37,600 --> 00:31:40,080
Speaker 1: disorder that they may want to talk with their employer

528
00:31:40,600 --> 00:31:44,080
Speaker 1: or their schools about. Yes. Because of the episodic nature

529
00:31:44,160 --> 00:31:47,239
Speaker 1: of bipolar disorder, there are often times where we can

530
00:31:47,520 --> 00:31:49,840
Speaker 1: fill out f M mel A forms for and that

531
00:31:49,880 --> 00:31:53,360
Speaker 1: stands for the Family Medical Levat Form for patients, so

532
00:31:53,520 --> 00:31:56,040
Speaker 1: if they are in an episode, we can protect them,

533
00:31:56,240 --> 00:31:57,920
Speaker 1: like if they're in the middle of a medic episode,

534
00:31:58,320 --> 00:32:02,280
Speaker 1: we can have them already available two we filled out

535
00:32:02,280 --> 00:32:04,280
Speaker 1: a form saying this is episode, they may needed to

536
00:32:04,360 --> 00:32:07,040
Speaker 1: leave work so that they're protected and they'll have that

537
00:32:07,160 --> 00:32:10,840
Speaker 1: time off intermittently. We can also make sure we say, hey,

538
00:32:10,880 --> 00:32:14,440
Speaker 1: you know school starting school is stressful this week, so

539
00:32:14,600 --> 00:32:17,400
Speaker 1: maybe you take a couple of days off to protect

540
00:32:17,440 --> 00:32:20,520
Speaker 1: your stress level from not having to manage work and

541
00:32:21,000 --> 00:32:23,800
Speaker 1: dealing with the kids right now, so that you can

542
00:32:23,840 --> 00:32:26,680
Speaker 1: focus on one thing at a time. So those are

543
00:32:26,720 --> 00:32:30,200
Speaker 1: types of measures and making sure they're having time for

544
00:32:30,320 --> 00:32:34,640
Speaker 1: psychotherapy for any support groups will also be important to

545
00:32:34,720 --> 00:32:37,720
Speaker 1: make sure that they are able to still function well

546
00:32:38,080 --> 00:32:45,160
Speaker 1: with the illness. Before we jump into the community questions,

547
00:32:45,560 --> 00:32:49,120
Speaker 1: let's show some love to our sponsors. Today's podcast is

548
00:32:49,160 --> 00:32:52,640
Speaker 1: also sponsored by the number one new scripted series on cable,

549
00:32:53,120 --> 00:32:57,719
Speaker 1: Tyler Perry's Sisters on BAT. The Juicy two Hours Season

550
00:32:57,760 --> 00:33:01,280
Speaker 1: two premiere happens on Wednesday. I told of fourteen at

551
00:33:01,400 --> 00:33:04,760
Speaker 1: nine eight Central on b ET, So be sure to

552
00:33:04,800 --> 00:33:08,520
Speaker 1: grab your popcorn and use the hashtag Sisters on BT

553
00:33:09,120 --> 00:33:12,920
Speaker 1: as you watch live. We also have a quick message

554
00:33:12,920 --> 00:33:17,040
Speaker 1: paid for by the Leadership Conference Education Fund. Remember that

555
00:33:17,120 --> 00:33:19,560
Speaker 1: you don't have to wait until November three to cast

556
00:33:19,600 --> 00:33:23,920
Speaker 1: your ballot. You can be an October voter. In most cases,

557
00:33:23,960 --> 00:33:27,760
Speaker 1: you can vote early, request your mail ballot, return your

558
00:33:27,800 --> 00:33:31,120
Speaker 1: completed ballot in the mail or in person. Our vote

559
00:33:31,160 --> 00:33:34,760
Speaker 1: early at an early voting location. Let's do our part

560
00:33:34,840 --> 00:33:37,920
Speaker 1: to try to make sure all voices are heard. Make

561
00:33:37,960 --> 00:33:41,520
Speaker 1: a plan to vote, visit and still I vote dot

562
00:33:41,600 --> 00:33:44,640
Speaker 1: org to join the fight for voting rights today. Now

563
00:33:44,720 --> 00:33:46,880
Speaker 1: let's get back to the questions with Dr de Jon.

564
00:33:49,920 --> 00:33:52,200
Speaker 1: We also have a couple of questions from some of

565
00:33:52,200 --> 00:33:54,440
Speaker 1: our community members. So they wanted you to weigh in

566
00:33:54,480 --> 00:33:57,720
Speaker 1: on some of these questions. So the first question is

567
00:33:57,720 --> 00:34:01,320
Speaker 1: is this disorder genetic? How does it present in teens

568
00:34:01,360 --> 00:34:03,720
Speaker 1: and young adults? This person is saying that they weren't

569
00:34:03,720 --> 00:34:08,160
Speaker 1: diagnosed until they were forty, So yes, bipolar disorder is

570
00:34:08,400 --> 00:34:12,640
Speaker 1: very commonly run in families. For family histories will increase

571
00:34:12,680 --> 00:34:16,640
Speaker 1: the risk about tenfold for bipolar disorders. So a lot

572
00:34:16,640 --> 00:34:18,840
Speaker 1: of times there are people in the family that probably

573
00:34:18,880 --> 00:34:22,359
Speaker 1: haven't even if you don't know those family members, there

574
00:34:22,400 --> 00:34:25,960
Speaker 1: are family factors that are genetic. We don't know the

575
00:34:26,000 --> 00:34:30,480
Speaker 1: exact physiology or pathology of how exactly works. We just

576
00:34:30,560 --> 00:34:33,799
Speaker 1: know that there's changes in neurotransmitters in the brain and

577
00:34:33,880 --> 00:34:37,759
Speaker 1: how they are operating that puts you at risk for

578
00:34:37,800 --> 00:34:39,920
Speaker 1: the illness. But we do know that it is genetic.

579
00:34:40,440 --> 00:34:42,480
Speaker 1: And Dr de Gene, would you say that it is

580
00:34:42,520 --> 00:34:45,239
Speaker 1: important for us to go ahead and start having some

581
00:34:45,280 --> 00:34:50,000
Speaker 1: conversations with our families regardless of symptoms. Right, Like you mentioned,

582
00:34:50,080 --> 00:34:53,160
Speaker 1: sometimes we don't know that uncle's and aunts and everybody

583
00:34:53,440 --> 00:34:56,640
Speaker 1: had these diagnosis before like a crisis happened. So would

584
00:34:56,680 --> 00:34:59,560
Speaker 1: you suggest people you know starting some of these conversations

585
00:34:59,560 --> 00:35:01,640
Speaker 1: with their fami Emilia's now. I think it would be

586
00:35:01,680 --> 00:35:04,640
Speaker 1: great if families can open up. Some people may not

587
00:35:04,800 --> 00:35:08,360
Speaker 1: be as open, but I think that's important for anything.

588
00:35:08,400 --> 00:35:11,719
Speaker 1: To know your genetic history through family members for any

589
00:35:11,880 --> 00:35:15,360
Speaker 1: potential illness. It will help you to be prepared for

590
00:35:15,440 --> 00:35:17,319
Speaker 1: anything that could happen down a lot. I think it'd

591
00:35:17,320 --> 00:35:20,600
Speaker 1: be great to have those conversations. Thank you. And then

592
00:35:20,600 --> 00:35:24,080
Speaker 1: the second question from my community, how often is bipolar

593
00:35:24,120 --> 00:35:28,680
Speaker 1: disorder and misdiagnosed in the Black community versus in other communities?

594
00:35:29,040 --> 00:35:31,200
Speaker 1: And they also are curious to hear if you have

595
00:35:31,280 --> 00:35:34,600
Speaker 1: any credible resources to share with people who are interested

596
00:35:34,640 --> 00:35:37,719
Speaker 1: in learning more about the signs, symptoms, and treatments of

597
00:35:37,719 --> 00:35:40,279
Speaker 1: bi polar disorder. So that's a great question. A lot

598
00:35:40,320 --> 00:35:45,000
Speaker 1: of times by polar disorder is often misdiagnosed as a

599
00:35:45,040 --> 00:35:50,880
Speaker 1: schizophrenia or skis so effective disorder and Black Americans, and

600
00:35:51,360 --> 00:35:57,359
Speaker 1: we've seen linked to issues with just cultural sensitivity and

601
00:35:57,560 --> 00:36:02,879
Speaker 1: understanding different races of people. Sometimes someone we have just

602
00:36:03,440 --> 00:36:05,480
Speaker 1: you know, general moves, swims or a d D and

603
00:36:05,520 --> 00:36:07,600
Speaker 1: they made the diagnosed with by polar disorder. I don't

604
00:36:07,600 --> 00:36:10,040
Speaker 1: have is that statistics nor I And if I'm sure

605
00:36:10,040 --> 00:36:13,799
Speaker 1: that there's any particular statistics on the rate, but it's

606
00:36:13,880 --> 00:36:18,600
Speaker 1: certainly commonly misdiagnosed, and a lot of times African Americans

607
00:36:18,680 --> 00:36:24,279
Speaker 1: are commonly misdiagnosed with psychotic disorders more than our white counterparts.

608
00:36:24,520 --> 00:36:27,120
Speaker 1: And you've already talked about how that could be complicated

609
00:36:27,200 --> 00:36:30,520
Speaker 1: right because of the medication that they would start them on. Right,

610
00:36:30,560 --> 00:36:35,680
Speaker 1: So if they are misdiagnosed with schizophrenia and put on something,

611
00:36:36,000 --> 00:36:38,920
Speaker 1: there could be more of the manic episodes. Like you've

612
00:36:38,920 --> 00:36:42,800
Speaker 1: already said, Yes, if you're misdiagnosed and put medications, you're

613
00:36:42,840 --> 00:36:48,600
Speaker 1: probably side effects to those medications or things aren't getting

614
00:36:48,640 --> 00:36:53,799
Speaker 1: better because it's not being treated appropriately because of the misdiagnosis.

615
00:36:54,040 --> 00:36:57,239
Speaker 1: In terms of resources, I think it's always good to

616
00:36:57,960 --> 00:36:59,879
Speaker 1: make sure you get a second opinion if there's any

617
00:37:00,000 --> 00:37:02,279
Speaker 1: out if you don't feel comfortable, it's okay to go

618
00:37:02,840 --> 00:37:05,839
Speaker 1: and be formed consumer regarding your health care and go

619
00:37:06,000 --> 00:37:08,600
Speaker 1: to as many people as you feel that you need

620
00:37:08,640 --> 00:37:12,359
Speaker 1: to feel like you have certainty about your diagnosis. There's

621
00:37:12,400 --> 00:37:16,040
Speaker 1: also resources in the community, like the Depression by Polar

622
00:37:16,120 --> 00:37:19,880
Speaker 1: Support Alliance. That's the national organization that has local chapters

623
00:37:19,880 --> 00:37:23,960
Speaker 1: throughout the country where you can go and meet with

624
00:37:23,960 --> 00:37:26,759
Speaker 1: other people who have the same diagnosis. So d d

625
00:37:26,920 --> 00:37:30,600
Speaker 1: s A also Knowniced Depression by Polar Support Alliance. There's

626
00:37:30,640 --> 00:37:35,120
Speaker 1: also the National Alliance of Mental Illness that's called NAMI.

627
00:37:36,040 --> 00:37:38,239
Speaker 1: They also have chapters and a lot of times their

628
00:37:38,400 --> 00:37:42,480
Speaker 1: support groups even for parents or caregivers or family members

629
00:37:42,520 --> 00:37:46,000
Speaker 1: who are having loved ones with the illness that you

630
00:37:46,040 --> 00:37:48,000
Speaker 1: can reach out to. Thank you, and of course we

631
00:37:48,040 --> 00:37:50,319
Speaker 1: will include all of that in this show. Notes and

632
00:37:50,360 --> 00:37:52,880
Speaker 1: where can people find you? Dr de Gene? What is

633
00:37:52,920 --> 00:37:55,960
Speaker 1: your website address as well as any social media handles

634
00:37:56,000 --> 00:37:57,920
Speaker 1: you want to share. I could be found at the

635
00:37:57,960 --> 00:38:03,480
Speaker 1: Georgia Psychological Treatment Center. The website is www dot g

636
00:38:03,719 --> 00:38:07,160
Speaker 1: a psych treatment dot com. You're welcome to also call

637
00:38:07,239 --> 00:38:11,360
Speaker 1: the office at four zero four for two six five

638
00:38:11,640 --> 00:38:16,480
Speaker 1: three eight two. And I am not as social media savvy,

639
00:38:16,560 --> 00:38:20,200
Speaker 1: so I don't know. I'm not a problem. Not a problem.

640
00:38:20,200 --> 00:38:22,920
Speaker 1: Will include the website and the phone number. What we

641
00:38:23,000 --> 00:38:25,360
Speaker 1: really appreciate you spending some time with us today and

642
00:38:25,360 --> 00:38:29,359
Speaker 1: sharing your expertise. Thank you so much, Thank you, thanks

643
00:38:29,400 --> 00:38:35,920
Speaker 1: for having me. I really appreciate the opportunity. I'm so

644
00:38:35,960 --> 00:38:38,640
Speaker 1: glad that Dr Dejon was able to share her expertise

645
00:38:38,680 --> 00:38:41,560
Speaker 1: with us today. To learn more about her work and

646
00:38:41,600 --> 00:38:44,400
Speaker 1: to check out the resources she shared, be sure to

647
00:38:44,480 --> 00:38:46,799
Speaker 1: visit the show notes at Therapy for Black Girls dot

648
00:38:46,800 --> 00:38:50,320
Speaker 1: com slash Session one seventy six, and don't forget to

649
00:38:50,320 --> 00:38:52,720
Speaker 1: share this episode with two other sisters in your life

650
00:38:52,719 --> 00:38:56,720
Speaker 1: who just might appreciate the conversation. If there's a topic

651
00:38:56,800 --> 00:38:59,720
Speaker 1: you'd like to have covered on the podcast, please admit

652
00:38:59,800 --> 00:39:02,879
Speaker 1: it at Therapy for Black Girls dot com slash mailbox.

653
00:39:03,560 --> 00:39:05,720
Speaker 1: And if you're looking for a therapist in your area,

654
00:39:06,160 --> 00:39:09,160
Speaker 1: be sure to check out our therapist directory at Therapy

655
00:39:09,200 --> 00:39:12,960
Speaker 1: for Black Girls dot com slash directory. If you want

656
00:39:12,960 --> 00:39:15,759
Speaker 1: to continue digging into this topic and connect with some

657
00:39:15,800 --> 00:39:18,480
Speaker 1: other sisters in your area, come on over and join

658
00:39:18,600 --> 00:39:21,040
Speaker 1: us in the Yellow College Collective, where we take a

659
00:39:21,080 --> 00:39:23,719
Speaker 1: deeper dive into the topics on the podcast and just

660
00:39:23,800 --> 00:39:26,799
Speaker 1: about everything else. You can join us at Therapy for

661
00:39:26,840 --> 00:39:30,280
Speaker 1: Black Girls dot com slash y c C. Don't forget

662
00:39:30,320 --> 00:39:32,200
Speaker 1: that if you're looking for a waity in summer on

663
00:39:32,239 --> 00:39:35,000
Speaker 1: a high note, Cricket Wireless has got just the thing.

664
00:39:35,560 --> 00:39:39,719
Speaker 1: Get ready for unlimited smiles, unlimited times. For get four

665
00:39:39,800 --> 00:39:42,520
Speaker 1: lines of unlimited data for a hundred dollars a month.

666
00:39:43,760 --> 00:39:46,040
Speaker 1: Thank y'all so much for joining me again this week.

667
00:39:46,400 --> 00:39:49,120
Speaker 1: I look forward to continuing this conversation with you all

668
00:39:49,280 --> 00:40:01,160
Speaker 1: real soon. Take good care the breast pack for bread

669
00:40:01,280 --> 00:40:02,040
Speaker 1: for breast wood,