image45

~ Mental Health & Mental Illness ~

Healthy smiling woman

Mental Health


We'd all like to experience optimal mental health, but how do we go about it? It involves much more than just seeing a psychiatrist or other medical professional and popping the right “magic pill.” (By the way, that doesn’t exist!) Optimal mental health also involves more than therapy and support groups. First, we must address our basic needs.


Maslow’s Hierarchy of Needs


Psychologist Abraham Maslow’s famous Hierarchy of Needs, usually depicted as a pyramid, illustrates several levels of human needs. At the base of the pyramid are physiological needs: oxygen, water, food, sleep, shelter and sex (assuming we wish our species to continue!). 


Thankfully, most of us don’t have to think much about oxygen or sex (though some folks think a lot about sex!). So I'll focus on the issues most important to cope with a mental illness.


Water – Some folks with diagnoses need considerably more water because many psychotropic medications dry out the mouth. Also, people who take lithium really need to keep hydrated so they can reduce how much medication reaches the kidneys at any one time. 


Food – What we consume can also affect our mental health. No special diet prevents a mental illness, but there is evidence that a Mediterranean diet can help, which involves eating:

  • Vegetables, fruits, whole grains & healthy fats, like olive oil 
  • Fish, poultry, beans & eggs 
  • Moderate portions of dairy products 
  • Limited red meat


It's also crucial to eat regularly. Folks with mood disorders sometimes forget to eat when manic or refuse to eat when depressed. Some try to “self-medicate” with food during depression. Overeating is especially dangerous when taking psychotropic medications because a number them increase the risk of developing type 2 diabetes.  


Alcohol and illegal drugs interfere with most any medication, so it’s best to refrain from drinking when taking meds – or at the very least, to have no more than one drink a day. Follow the doctor's advice. And illegal drugs are never a good idea! Many doctors also suggest avoiding or limiting caffeine. This includes not only coffee and tea but most soft drinks and chocolate (bummer!).


Sleep – The first question my psychiatrist always asks is “How is your sleep?” The lack of restful sleep interferes with anyone’s mental health, however temporarily. But severely depressed people often sleep to escape or may be unable to get out of bed, even to use the bathroom. Medications can sometimes drain one's energy, so they should be carefully monitored and adjusted with a doctor's help. Mania, on the other hand, usually brings too little sleep, even to the point of total exhaustion or if not well treated, even death!


Shelter – Optimal mental health also requires more than a roof over one’s head and protection from the elements. We all need to feel safe, secure and free from fear. These needs appear on the second level of Maslow’s Hierarchy. Until all of these needs are met, one’s mental health will be in jeopardy.


Exercise – One important need that Maslow did not address is exercise. Studies have shown that aerobic exercises such as walking, jogging, running, bicycling and swimming can help reduce depression by releasing "feel good" endorphins. Exercising also helps burn off the excess energy that comes with mania or with anger and rage. 


Spirituality – A further need for optimal mental health is some sort of spiritual life. Although a psychiatrist who reviewed Bipolar Disorder Demystified claimed that spirituality has nothing to do with mental health, I strongly disagree. My life became much more balanced when I quit resisting and finally began paying attention to my spiritual needs. 


For some people, this might mean mindfulness and meditation alone, but that works perfectly well too. That's one reason why so many of my blogs focus on on mindfulness and meditation.

Mental Illness


What do you really know about mental illness? Not every form means losing complete touch with reality, as many people think. Those of us with a mental illness may exhibit signs or symptoms part of the time and appear perfectly "normal" at others.

Mentally illness man with hands over ears

Signs & Symptoms of a Potential Mental Illness

  • Perceiving sounds or sights that aren’t present
  • Believing things that have no basis in reality
  • Perpetual irritability, anger or rage
  • Isolating and avoiding friends, family and social activities
  • Extreme sadness lasting longer than two weeks
  • Pronounced shifts in mood
  • Inability to complete daily tasks or to handle everyday stresses
  • Sleeping or eating more or less than usual for an extended period
  • Pronounced shifts in sex drive or activities
  • Unreasonable or uncontrolled worry or fear
  • Needing to check and recheck things repeatedly
  • Uncontrolled alcohol or drug use
  • Confusion or concentration and learning difficulties
  • Extreme concerns about body image and weight gain
  • Performing acts of self-harm (cutting, hitting, head banging, and so on) 
  • Making plans to end one’s life

Some of my tools can help you keep track of the details related to your mental health (A Daily Tracking form & a Medication History form). To see them, click below.

~ Mood Disorders ~

Because my expertise lies with Depression and Bipolar Disorder rather than with a Thought Disorder such as Schizophrenia, I'll focus on Mood Disorders. 


Both bipolar disorder and depression are classified as Mood Disorders. A major difference is that bipolar disorder involves two "poles" – mania or a slightly less evident form called hypomania, as well as depression, which sometimes can involve suicidal thoughts and often attempts. 


Psychiatrists describe Depression alone as Unipolar (having just one pole).


For me, living with bipolar disorder is like walking a tightrope. For a description of how this feels to me, read the introduction to Bipolar Disorder Demystified by clicking here.

image46

Signs & Symptoms of Mania or Hypomania

  • Exaggerated self-confidence, grandiosity or optimism
  • Decreased need for sleep without loss of energy
  • More talkative than usual with urgent need to speak
  • Racing thoughts
  • Distractibility/difficulty focusing
  • Increased energy/activity levels
  • Increased goal-directed activities 
  • Pacing, squirming and so on
  • Over-involvement in pleasurable or potentially risky activities (spending sprees, reckless driving, sexual indiscretions, foolish business investments)


Although the signs and symptoms of mania and hypomania are the same, a diagnosis depends on how intense they are (or have been) and whether they require (or required) hospitalization.

image47

Signs & Symptoms of Depression

  • Sadness, emptiness and/or tearfulness
  • Irritability (especially if a child or adolescent)
  • Significantly decreased interest or pleasure in all or nearly all of one’s usual activities
  • Decreased energy or fatigue
  • Sleeping significantly more or less than usual
  • Decreased appetite and weight loss without dieting or increased appetite and weight gain
  • Difficulty thinking, concentrating or making decisions
  • Slowed body movements or increase in actions such as fidgeting, hand wringing or pulling on clothes or hair
  • Feelings of worthlessness or excessive or inappropriate guilt
  • Suicidal thoughts, plans or attempts

image48

Warning Signs of Potential Suicide

  • No longer interacting with family, friends or coworkers
  • A significant change in the person's sleep patterns
  • Drinking more alcohol or using more illegal drugs
  • Hoarding pills or buying a weapon
  • Harming one's self
  • Changing one's will or giving away cherished items
  • Making statements such as, “Nobody cares about me,” “Life isn’t worth living” or “You’re better off without me.”

Asking "The Question"

Don't Be Afraid to Ask "The Question"

Asking someone if they’re feeling suicidal or thinking of taking their life won't make them do it. They may have already been considering suicide for quite some time. Sometimes, they just need to talk.

How to Ask "The Question"

  • Move to a neutral location. 
  • Start with something like “You seem to be going through a rough time lately.” 
  • Tell the person how much you care about them.
  • Ask how you can help.
  • Don't judge the person or criticize their character.

Some of my tools can help you keep track of the details related to bipolar disorder (the Daily Tracking form & Medication History form). To download them, click below.