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BIPOLAR REALITYSHIFTING THE CLINICAL
FOCUS OF THE DISORDERANDREW JAMES ARCHER, LCSW
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Energy
Mania
Depression
Anxiety
CONTAINMENT
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Paternal Family
Hx:Suicide,
D+A
*21 *20 *30
*31
Red = Bipolar Disorder - *Age of onset=~21
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WHAT ARE THE SIGNS?
56%
44%
Individuals with Bipolar Disorder
Anxiety Dx
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BIPOLAR I DISORDER
MDD
PTSD
Borderline
Pers.Dis.
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Containment
Acceptance
Recovery
VEHICLE FOR TREATMENT
(CAR)
1980 ‘87 199
0
Zyprexa, Abilify,
Seroquel, etc.
DSM-III
unipolar
bipolar
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“MEDICATION NONADHERENCE”
• 60% stop medication in their lifetime
• Between 40 and 60% within first year after hospitalization
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PLACEBO EFFECT
“It now seems beyond question that the traditional account of depression as a chemical imbalance in the brain is simply wrong.” (Kirsch, 2011)
“…there is little evidence to suggest that they [antidepressants] produce specific pharmacological benefit for the majority of patients with less severe acute depressions.” (Fournier et al., 2010)
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CALABRESE ET. AL (2003)
• “The proportions of patients who were intervention-free for mania at 1 year were lamotrigine 77%, lithium 86%, and placebo 72%.”
• “…intervention-free for depression at 1 year were lamotrigine 57%, lithium 46%, and placebo 45%.”
U.S. MH DISABILITY RATES(WHITAKER, 2010)
0.2
1.86 3.38
13.75
19.69
1850
1903
1955
1987
2003
RE-INSTITUTIONALIZATION
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1959 20120
200,000
400,000
600,000
800,000
1,000,000
1,200,000
1,400,000
1,600,000
1,800,000
State HospitalsPrison & JailPrison & Jail: MH
(Torrey et al., 2014)
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ACCEPTANCE
Eye Movement Desensitization & Reprocessing (EMDR)
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Thought
Belief/Schema/ Attributions
ATTACHMENT
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DANIEL J. SIEGEL
• The embodied and relational process that regulates the flow of energy and information.
• The mechanism of energy and information flow throughout the extended nervous system distributed throughout the entire body.
• The sharing of this flow.
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RECOVERY
Mindfulness
