01_584510 ffirs.qxd 8/1/05 9:00 PM Page i Bipolar Disorder FOR DUMmIES ‰ by Candida Fink,MD and Joseph Kraynak 01_584510 ffirs.qxd 8/1/05 9:00 PM Page iv 01_584510 ffirs.qxd 8/1/05 9:00 PM Page i Bipolar Disorder FOR DUMmIES ‰ by Candida Fink,MD and Joseph Kraynak 01_584510 ffirs.qxd 8/1/05 9:00 PM Page ii Bipolar Disorder For Dummies® Published by Wiley Publishing, Inc. 111 River St. Hoboken, NJ 07030-5774 www.wiley.com Copyright © 2005 by Wiley Publishing, Inc., Indianapolis, Indiana Published simultaneously in Canada No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permit- ted under Sections 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400, fax 978-646-8600. 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NO WARRANTY MAY BE CREATED OR EXTENDED BY ANY PROMOTIONAL STATEMENTS FOR THIS WORK. NEITHER THE PUBLISHER NOR THE AUTHOR SHALL BE LIABLE FOR ANY DAMAGES ARISING HEREFROM. For general information on our other products and services, please contact our Customer Care Department within the U.S. at 800-762-2974, outside the U.S. at 317-572-3993, or fax 317-572-4002. For technical support, please visit www.wiley.com/techsupport. Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. Library of Congress Control Number: 2005924620 ISBN-013: 978-0-7645-8451-0 ISBN-10: 0-7645-8451-0 Manufactured in the United States of America 10 9 8 7 6 5 4 3 2 1 1O/RY/QY/QV/IN 01_584510 ffirs.qxd 8/1/05 9:00 PM Page iii About the Authors Candida Fink, MD (New Rochelle, New York) is a Board Certified Adult, Child, and Adolescent Psychiatrist in private practice in the New York area. Dr. Fink graduated from Boston University Medical School and did her postgraduate training through Harvard Medical School. She’s currently an Assistant Clinical Professor of Psychiatry at Westchester Medical College. She has worked extensively with children and adults with complicated psychi- atric illnesses. Mood disorders, especially the diagnostic and treatment ques- tions surrounding bipolar disorder, comprise much of her practice. She also works extensively with schools and other institutions regarding developmen- tal and psychiatric issues. Dr. Fink grew up with mood disorders in her family, so she has seen them from every angle and knows the importance of mobiliz- ing the family as a part of any successful treatment. She has previously co- authored, with Judith Lederman, The Ups and Downs of Raising a Bipolar Child: A Survival Guide for Parents (Fireside). She frequently consults and speaks on bipolar disorder in children. Joe Kraynak, MA(Speedway, Indiana) is a freelance author who has written and co-authored dozens of books on topics ranging from slam poetry to per- sonal computers. Joe received his degree in bipolar disorder from the College of Hard Knocks. On December 10, 1999, Joe’s wife, Cecie, a Spanish teacher at the time, was diagnosed with bipolar disorder. Since that day, they have bounced around to a half dozen doctors and even more therapists, broke in a few young marriage counselors, survived several changes in health insurance coverage, attended dozens of support group meetings, and endured the career changes and financial hardships that commonly accompany bipolar disorder. In this book, Joe offers his experience and insight from life in the trenches. Dedications From Candida: To my Mom, who loved and taught with compassion and self- lessness that profoundly changed all who knew her. She was my rock, and she’s deeply missed. From Joe: To my wife, Cecie, whose zest for life and genuine interest in the lives of others engage and inspire everyone she touches. 01_584510 ffirs.qxd 8/1/05 9:00 PM Page iv 01_584510 ffirs.qxd 8/1/05 9:00 PM Page v Authors’ Acknowledgments Although we wrote the book, dozens of other talented individuals con- tributed to its conception, development, and perfection. Special thanks goes to Mikal Belicove, who chose us to author this book; Mikal has an uncanny knack for connecting authors who work well together and enjoy the experi- ence. Chrissy Guthrie, project editor, deserves a round of applause for acting as the choreographer — developing chapters, shepherding the text and illus- trations through production, making sure any technical issues were properly addressed, and serving as unofficial quality control manager. Thanks also to Josh Dials, our copy editor, who read through everything — forward and backward — to identify and obliterate our many grammatical goofs and typos. We also tip our hats to the folks in Composition Services at Wiley for doing such an outstanding job of transforming a loose collection of text and illustrations into such an attractive volume. We owe special thanks to our technical editors for ferreting out technical errors in the manuscript and helping guide its content: Ellen Frank, PhD, professor of psychiatry and psychology at the University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, and Depression and Bipolar Support Alliance scientific advisory board chair. Paul E. Keck, Jr., MD, professor and vice chairman for Research, Department of Psychiatry, University of Cincinnati College of Medicine, and a Depression and Bipolar Support Alliance scientific advisory board member. And thanks to Laura Hoofnagle, publications manager, and Susan R. Bergeson, vice president of the Depression and Bipolar Support Alliance, Chicago, Illinois, for their assistance in ensuring the technical accuracy of the material. And we thank our agent, Faith Hamlin, of Sanford J. Greenburger Associates, Inc., for managing the contract negotiations so we could focus on writing rather than the legal stuff. We would also like to thank all the people with bipolar disorder and their family members and friends whom we’ve met along the way. Without these brave souls, along with their stories, their struggles, and their achievements, this book wouldn’t be possible. And we acknowledge nonprofit organizations, including the Depression and Bipolar Support Alliance (DBSA), the Child and Adolescent Bipolar Foundation, and the National Alliance for the Mentally Ill (NAMI), for their valuable contributions and continued dedication to educat- ing, supporting, and advocating for all those in the bipolar community. 01_584510 ffirs.qxd 8/1/05 9:00 PM Page vi Publisher’s Acknowledgments We’re proud of this book; please send us your comments through our Dummies online registration form located at www.dummies.com/register/. Some of the people who helped bring this book to market include the following: Acquisitions, Editorial, and Composition Services Media Development Project Coordinator: Nancee Reeves Project Editor: Christina Guthrie Layout and Graphics:Carl Byers, Andrea Dahl Acquisitions Editor: Mikal Belicove Special Art: Medical illustrations by Copy Editor: Josh Dials Kathryn Born Editorial Program Assistant: Courtney Allen Proofreaders:LeeannHarney, Jessica Kramer, Robert Springer, TECHBOOKS Production Technical Editors: Ellen Frank, PhD; Services Paul E. Keck, Jr., MD; Laura Hoofnagle; Susan R. Bergeson Indexer: TECHBOOKS Production Services Editorial Manager: Christine Meloy Beck Editorial Assistants: Hanna Scott, Melissa S. Bennett, Nadine Bell Cover Photo:© David Evans/Getty Images/ National Geographic Cartoons: Rich Tennant (www.the5thwave.com) Publishing and Editorial for Consumer Dummies Diane Graves Steele, Vice President and Publisher, Consumer Dummies Joyce Pepple, Acquisitions Director, Consumer Dummies Kristin A. Cocks, Product Development Director, Consumer Dummies Michael Spring, Vice President and Publisher, Travel Kelly Regan,Editorial Director, Travel Publishing for Technology Dummies Andy Cummings,Vice President and Publisher, Dummies Technology/General User Composition Services Gerry Fahey,Vice President of Production Services Debbie Stailey,Director of Composition Services 02_584510 ftoc.qxd 8/1/05 9:05 PM Page vii Contents at a Glance Introduction ................................................................1 Part I: Boning Up on Bipolar Disorder ...........................7 Chapter 1: Living La Vida Bipolar ....................................................................................9 Chapter 2: Demystifying Bipolar Disorder ...................................................................25 Chapter 3: A Positive Prognosis with a Proactive Plan ..............................................45 Part II: Taming the Bipolar Beast ...............................57 Chapter 4: Let’s Get Physical: Ruling Out Other Health Issues .................................59 Chapter 5: Getting a Psychiatric Evaluation and Treatment Plan .............................71 Chapter 6: Building a Winning Mood-Management Team ..........................................89 Part III: Opening the Treatment Toolbox: A Comprehensive, Integrated Approach .....................107 Chapter 7: Touring the Bipolar Pharmacy .................................................................109 Chapter 8: Retooling Your Mind through Therapy ...................................................127 Chapter 9: Expanding Your Treatment Options ........................................................147 Part IV: Helping Yourself .........................................159 Chapter 10: Surviving Your Current Crisis .................................................................161 Chapter 11: Healing at Your Own Pace .......................................................................173 Chapter 12: Identifying Your Triggers and Mapping Your Moods ...........................189 Chapter 13: Restructuring Your Life ...........................................................................203 Chapter 14: Working Out and Eating Right .................................................................219 Chapter 15: Battling the Urge to Fly Solo ...................................................................231 Part V: Assisting a Friend or Relative with Bipolar Disorder ...............................................245 Chapter 16: Supporting Your Loved One ....................................................................247 Chapter 17: Planning Ahead for a Possible Crisis .....................................................265 Chapter 18: Backing Your Bipolar Child .....................................................................279