The Bipolar II Disorder Workbook Quotes

“For most people, disruptions in routine are simply annoying, but for someone with BPII, these types of disruptions may actually lead to depressive or hypomanic symptoms. In addition, research has found that individuals with bipolar disorder have more difficulty than the average person in maintaining a regular schedule (Shen et al. 2008).”
― Stephanie McMurrich Roberts, The Bipolar II Disorder Workbook: Managing Recurring Depression, Hypomania, and Anxiety

“For example, an individual with BPII is more likely to have negative thoughts when stuck in traffic, such as My friend is going to be so mad at me because I will be late, and act in potentially unhealthy ways, such as driving recklessly or canceling the meeting, and thus feel more negatively (e.g., sad, angry, disappointed). In short, the biological tendencies of the individual with BPII are interacting with the situation to create a more negative outcome.”
― Stephanie McMurrich Roberts, The Bipolar II Disorder Workbook: Managing Recurring Depression, Hypomania, and Anxiety

“BPII is considered a biological illness because it is associated with structural and functional abnormalities in the brain. In recent years, psychologists have learned much about how the brain of someone with BPII differs from that of someone without the disorder; however, because the brain is very complex, there is still a lot that we do not understand. We know that BPII is caused, at least in part, by problems with the brain’s chemical messengers, or neurotransmitters. But it seems that each person with BPII may have slightly different problems with his or her neurotransmitters and we don’t yet understand exactly what these differences are.”
― Stephanie McMurrich Roberts, The Bipolar II Disorder Workbook: Managing Recurring Depression, Hypomania, and Anxiety

“BPII differs from the other main type of bipolar disorder, bipolar I (BPI), in two key ways. First, everyone with BPII experiences one or more periods of depression; however, depression may or may not be present in BPI. Second, people with BPII experience hypomania, a less severe version of mania, the episodic high or elevated mood that is the defining feature of BPI.”
― Stephanie McMurrich Roberts, The Bipolar II Disorder Workbook: Managing Recurring Depression, Hypomania, and Anxiety

“Bipolar II disorder is a highly misunderstood form of bipolar illness. By its very designation as type II, clinicians, patients, and the public often assume it is less impairing than bipolar I, “the real thing.” When we examine the diagnostic criteria for bipolar II, they sound very mild. Who doesn’t get sad and happy? Who doesn’t have mood swings? Why would a four-day period of excess energy, which does not affect the ability to function, be of any clinical importance? Several longitudinal studies have found that bipolar II is far more impairing than we once thought. It is characterized by lengthy and recurrent periods of depression, comorbid anxiety disorders, and high rates of substance and alcohol misuse. The occasional hypomanias of bipolar II—in which people experience elation and irritability, exuberance, increased energy, and reduced need to sleep—are not as impairing as the full manic episodes of bipolar I, but they can certainly have a negative impact on family members and friends. Moreover, for the person with the disorder, these high periods are often short-lived, and they do little to alleviate the suffering caused by depressive phases. The hypomanic periods may even overlap with the low phases, resulting in an agitated, anxiety-ridden, and highly distressing period of depression. People with bipolar II often have difficulty maintaining jobs and relationships, and, like people with bipolar I, they are at high risk for suicide.”
― Stephanie McMurrich Roberts, The Bipolar II Disorder Workbook: Managing Recurring Depression, Hypomania, and Anxiety

“Unfortunately, you may be less likely to keep a daily routine because you have BPII.”
― Stephanie McMurrich Roberts, The Bipolar II Disorder Workbook: Managing Recurring Depression, Hypomania, and Anxiety

“For most people, disruptions in routine are simply annoying, but for someone with BPII, these types of disruptions may actually lead to depressive or hypomanic symptoms. In addition, research has found that individuals with bipolar disorder have more difficulty than the average person in maintaining a regular schedule (Shen et al. 2008). Does this ring true for you? During times of stress, is it harder for you to maintain a daily schedule? How do you feel when you have no daily structure or routine? Perhaps you oversleep, skip meals, watch TV late at night, or overeat. How do these feelings and behaviors affect your mood?”
― Stephanie McMurrich Roberts, The Bipolar II Disorder Workbook: Managing Recurring Depression, Hypomania, and Anxiety

“Unfortunately, you may be less likely to keep a daily routine because you have BPII. IPSRT is a skills-based psychotherapy that addresses this issue. IPSRT focuses on recognizing the association of stress and mood, stabilizing daily routines (i.e., social rhythms), and identifying and managing affective symptoms. In addition, it teaches skills that help resolve interpersonal problems (Frank 2005; Frank, Swartz, and Kupfer 2000).”
― Stephanie McMurrich Roberts, The Bipolar II Disorder Workbook: Managing Recurring Depression, Hypomania, and Anxiety

“Adolescents and adults with bipolar disorder who received the skills taught as part of FFT had fewer mood episodes, longer periods of feeling well, and greater improvements in depressive symptoms compared to bipolar individuals who did not receive FFT (Miklowitz et al. 2000)”
― Stephanie McMurrich Roberts, The Bipolar II Disorder Workbook: Managing Recurring Depression, Hypomania, and Anxiety

“DBT was originally developed to help individuals with borderline personality disorder. However, it has been adapted to successfully treat other conditions, such as eating disorders (e.g., Safer, Telch, and Agras 2001; Telch, Agras, and Linehan 2001), suicidality (Rathus and Miller 2002), and depression (Lynch et al. 2003). We the authors of this book, along with our colleagues, have also started using DBT skills in the MGH Bipolar Clinic and Research Program, with promising early results (Eisner et al. 2011).”
― Stephanie McMurrich Roberts, The Bipolar II Disorder Workbook: Managing Recurring Depression, Hypomania, and Anxiety

“The diathesis-stress model suggests that diseased conditions, such as BPII, are affected by both people’s genes (i.e., biological causes) and their environment (Ingram and Luxton 2005). Another way to think about this phenomenon is to picture two people who are stuck in traffic and are late for a meeting; one of these individuals has BPII and the other does not. The diathesis-stress model suggests that the individual with BPII is more likely to be negatively affected by this stressful situation than the person without BPII. In other words, due to his or her biology, the person with BPII may have a lower threshold for tolerating negative events.”
― Stephanie McMurrich Roberts, The Bipolar II Disorder Workbook: Managing Recurring Depression, Hypomania, and Anxiety

“A few tips to help you further distinguish hypomania is to remember that hypomania is abnormally high or irritable mood, meaning different from what a person usually experiences when happy or upset/irritable. Hypomanic episodes also last for at least four consecutive days. Thus, this abnormally high or irritable mood persists for several days and is accompanied by at least three (or four, if the mood is irritable) of the manic/hypomanic symptoms in table 1.1 for the same four days. Finally, in order to be diagnosed with BPII, you must have also experienced a major depressive episode at some time in your life.”
― Stephanie McMurrich Roberts, The Bipolar II Disorder Workbook: Managing Recurring Depression, Hypomania, and Anxiety

“Hypomania is characterized by a persistently irritable, elevated, or expansive mood, accompanied by at least three of the other hypomanic symptoms (or four with irritable mood) listed in table 1.1, over most of the day for at least four days. You may notice that the symptoms listed for hypomania and mania in table 1.1 are the same. Hypomania differs from mania in that such an episode is typically shorter and is less severe, given that it does not impair functioning. Once the symptoms impair functioning, the episode is almost always considered a manic episode, unless it is only brief (e.g., less than seven days).”
― Stephanie McMurrich Roberts, The Bipolar II Disorder Workbook: Managing Recurring Depression, Hypomania, and Anxiety

“A major depressive episode, often called “depression” or “clinical depression,” means that you have felt down or sad, or much less interested in things than usual, for most of the day, nearly every day, for at least two weeks. In addition to feeling sad or less interested in things, you have at least four other depressive symptoms”
― Stephanie McMurrich Roberts, The Bipolar II Disorder Workbook: Managing Recurring Depression, Hypomania, and Anxiety

“You may have heard people say that they feel “manic” on days when they have high energy or are in a particularly cheerful mood, perhaps even experiencing some of the manic symptoms listed in table 1.1, but this is not necessarily mania. For example, over the holidays, people may report feeling very happy and excited, have increased energy, sleep less than usual, and talk more than usual. If these “symptoms” last more than seven days, are these people actually experiencing mania? Certainly not! So, what is the difference between periods of good mood, or high energy, and mania? The difference is that when you are experiencing mania, your symptoms make it difficult for you to fulfill your responsibilities with regard to work, to friends and family, or to yourself (self-care). In other words, the symptoms associated with a manic episode interfere with your ability to function (e.g., to work, to pay bills, to take care of children, to see your friends, to accomplish daily tasks), which causes problems for you (e.g., you show up late for work, you’re not able to pay bills, your relationships with friends and family suffer, you can’t accomplish daily tasks).”
― Stephanie McMurrich Roberts, The Bipolar II Disorder Workbook: Managing Recurring Depression, Hypomania, and Anxiety

“This book is different from similar workbooks because of its focus on BPII, which is treated and managed differently than BPI. This book also includes strategies for managing anxiety, which frequently co-occurs with BPII. Finally, as opposed to other books, in this book we present strategies from several different psychotherapeutic approaches, such as cognitive behavioral therapy (CBT), family-focused treatment (FFT), and dialectical behavior therapy (DBT). Although some of these skills were developed from research studies involving people without bipolar disorder, we will show you how they can be applied to the specific needs of people with BPII.”
― Stephanie McMurrich Roberts, The Bipolar II Disorder Workbook: Managing Recurring Depression, Hypomania, and Anxiety