Episode #84
Bipolar Disorder & CBT - Part 2
ft. Michael Mikulski, MFT
Bipolar Disorder is an often misunderstood mental illness.
What is Bipolar Disorder? And what isn’t it?
How is it diagnosed?
And how can you use CBT to manage Bipolar Disorder?
Join me, Dr Julie Osborn, and my special guest, Dr Michael Mikulski, as we share with you practical ways you can use the power of CBT to help with Bipolar Disorder.
Click to listen now!
Reference Guides:
Full Episode Transcript
Dr Julie
Hi, my name is Dr. Julie Osborn. I'm a Doctor of Psychology and a licensed clinical social worker specializing in Cognitive Behavioral Therapy. I'm here to help you bring the power of CBT into your own life. So in this podcast I'm going to answer your questions and share with you some practical ways to apply CBT principles so you can achieve a greater level of happiness and satisfaction in your life and your relationships.
I appreciate you being here with me. And this is our part two of discussing bipolar Disorder with Mike Mikulski. He's a licensed marriage family therapist, a colleague and a friend. And I welcome you back. And I thank you for being with us again.
Dr Michael
Great to be here, Julie.
Dr Julie
I'm sure most of our listeners or all of them are very excited that we're continuing this conversation because we're going to talk more today about specifically what bipolar is, the diagnosis. Right. And the treatments regarding medication we recommend people to go for, as well as the therapy. And that's where the CBT can come in and give them some tools and some resources.
Dr Michael
Yeah.
Dr Julie
So we talked about your sister in law, Vicki, and we do know today she's doing really well, which is good news. Yes. Which can be the story for many people.
Dr Michael
That's right.
Dr Julie
If they go and get treatment and if they're open to it. So would you like to start with sharing more about bipolar disorder and how people can get diagnosed and what it maybe looks like?
Dr Michael
Yeah. There are no brain scans or blood work to test for bipolar disorder. It's really on the symptoms and what they're reporting. And that's why family is so important, too. For example, Vicki doesn't remember her manic episodes.
Dr Julie
Oh, interesting.
Dr Michael
Yeah. She doesn't remember them, but she knows she can't remember two weeks of her life at different times.
Dr Julie
That can be scary.
Dr Michael
That's very scary. So that made her realize she does have a problem. She's been Med compliant and worked with her psychiatrist to make sure the dose is right for her. So it's not too much or too little. And she's her normal self and able to live her life. When I'm meeting with somebody or the family or the client and I never assume that they have bipolar disorder, I kind of look at the diagnosis as a collaborative process. And I use visual. So here on the podcast, we can't do that, but I can sort of describe it.
I use a whiteboard usually, and I draw a line in the middle across the middle of the board, and I say, imagine that's our neutral mood over time. Right. We don't have a neutral mood. We're not happy or not happy. And I just sort of a squiggly line a little bit above a little bit below this neutral line. And I say that's our normal mood over time, we're sometimes kind of happy. Usually we're a little bit above neutral. Let's say everything is kind of fine in our life, right?
Dr Julie
Yes.
Dr Michael
It's easy to get up in the morning or maybe not so easy to get up. You have your coffee, you might hear the birds singing. You talk to people yes. You go about your day that's kind of above neutral, right?
Dr Julie
Yes.
Dr Michael
There's a certain energy that propels you throughout the day, but life is not always sun and roses, right. So we have bad moments and we feel sad and we have lost in our life and struggles and difficulties. So feeling kind of depressed and sad, it's a normal part of life. So all this is sort of in a normal range, right. A bunch of positive and negative feelings, the full gamut of human emotions. It's healthy to feel the full gamut of human emotions just within a healthy kind of arrange. Right. So then I draw a line going down, way down the board, a depressed mood. And the visual speaks a lot to people. And then I asked them, have you ever felt very depressed in your life? And what does that look like for you? And then I write their words on the board. I can't get out of bed for six months. Everything looked dreary to me. I had no interest in life, had suicidal thoughts or thoughts of death, no interest in doing things, and just had no energy anymore. That would be consistent with a major depressive episode.
Dr Julie
Yes.
Dr Michael
And it's very common for people with bipolar disorder. Bipolar means two extremes, right? Top and the very bottom. And so I first look at the depression. What is their depression look like? How does it feel for them? And then I draw a line from the very bottom and I start to go up towards the middle line, and then I go past the middle line, way up above that. And I ask them first I ask everybody that I work with, whether it's family or the client. Have you ever felt kind of really good and it had nothing to do with the monster drink or lots of caffeine or any drugs or anything like the stars have suddenly aligned over your head and you feel this energy. Have you ever felt that, Julie?
Dr Julie
Yes, I've had a moment.
Dr Michael
Yeah. And how long does that last?
Dr Julie
Not too long.
Dr Michael
How long does it last for you? Would you say.
Dr Julie
Maybe a good part of the day? Maybe if it's something that exciting? If it's that exciting. Yeah.
Dr Michael
I've experienced it, too. And it lasts for me about three or four minutes.
Dr Julie
Okay. That's.
Dr Michael
But we can have this sort of magnetizing feeling when I have that whenever it happens. Not very often, but I just wish I could always stay there.
Dr Julie
Yes.
Dr Michael
Because my mind feels so clear and I can think so well, I just feel so energized and awake. Mania is kind of like that on steroids. Right. You're going to go up and up and that's the seduction of mania because the person's been depressed and now they suddenly have energy and they don't want to let that go. What?
Right.
Dr Michael
I have that kind of energy every day. In a way, yes. So I draw the line all the way up. And I write mania. And I asked them, have they ever had a manic episode? Have they ever been super energized? And then I write down what they say. And if they do a bipolar disorder, they're going to say yes.
It varies, but usually they're up without sleeping at all, and the next day they're totally energized as well. Or for hypomania, which is kind of halfway up the line for bipolar two diagnosis. They have this elevated energy that has to persist at least four days for a hypomanic and a week for a manic episode for the diagnosis.
Dr Julie
Okay.
Dr Michael
But we go through what are they doing? So it's going to be unusual behaviors that they're not normally doing. And spending is one of those behaviors or intense sexual promiscuity that they wouldn't ordinarily do. So when you're super manic, often people believe that there's somebody else, a famous singer, famous whatever. People not always, but can often become delusional. Where I actually think there's somebody else, like my sister in law.
Or they don't think there's somebody else, but they believe they have special abilities. It's not like wanting to be a writer or aspire to be a painter or something. They actually believe that suddenly they can do all these things and they get to work on doing it. Another symptom is what's called golddirected activity, but that's too vague to be helpful.
Dr Julie
Okay.
Dr Michael
Because, Julie, you have goal-directed activity every day.
Dr Julie
Right.
Dr Michael
And so do I. But that doesn't mean you're a magic episode.
Dr Julie
Exactly.
Dr Michael
This goal directed activity is beyond what you would ordinarily do.
Dr Julie
Okay.
Dr Michael
So suddenly I'm going to write that best seller and I write for four days and nights. That's a little unusual.
Dr Julie
Yes.
Dr Michael
Right.
Dr Julie
For sure.
Dr Michael
Or I know somebody actually a family member of somebody I know who bought cars and guitars like a bunch we can laugh, but kind of horrifying.
Dr Julie
Oh, at the time, yeah.
Dr Michael
For the people, it's devastating financially.
Dr Julie
Yeah.
Dr Michael
So that's why you want to catch this, because it's not good. But that's where the confusion can set in. Because just because somebody suddenly buys something that's expensive doesn't mean they have a manic episode, but they're really driven individual doesn't mean that they have bipolar disorder. So there is a lot of confusion about how to diagnose it. But the main thing is sleep. If they're not sleeping and they're very energized throughout the week, that's one of the main symptoms of bipolar disorder.
Dr Julie
Okay. Even I would think like some racing thoughts. Right.
Dr Michael
Oh, thank you for saying that.
Dr Julie
Yeah, right. Racing thoughts is a huge symptom, too. Just going, going.
Dr Michael
So they report having racing thoughts. And when you're talking with somebody. Exactly. Julie talking with somebody who is in a manic episode, they're just talking through you. They're just talking nonstop like you and I have pauses. We listen to each other. It's more of a dialogue. Of course, I'm kind of narrating something, but we stop person with racing thoughts. They're just going to go from one topic to another and you can't really get in there.
Dr Julie
Yeah.
Dr Michael
And the other issue is if the mania is the good feeling kind of maniacs. I mentioned the other podcast. Sometimes it can be very negative. It's hard to get people to get help. Right. Because they feel good. Right. And a lot of times this is something to mention, too, which is important, is a lot of times people come into therapy because they're depressed and they go see their psychiatrist, and then they get put on an antidepressant, which induces a manic episode. And that's how a lot of people get diagnosed. Right. Because when people are feeling good, they're not going to go see a therapist or a doctor or psychiatrist. Right. So I've met a lot of people, a lot of clients that end up getting diagnosed, that they have more of the bipolar, too. So they have mostly depression. And so, okay, let's put you on some antidepressant. All of a sudden this manic episode. Oh, you're bipolar now. We got to change the medicine and the treatment plan. So there's lots of different ways. You may never really see the mania, especially if it's more of that hypo where it's only a few days, that the depression is where people will go for help because that's so more uncomfortable and difficult in their eyes to deal with.
Right. And then that can happen as well. And that's how a lot of people I've met have ended up getting diagnosed with a bipolar diagnosis. We're not going to be able to cover everything, you guys, just to let you know, because there's so much to this. There's like six different quotes. Bipolar one, bipolar two. There's a lot. So that's why getting educated on your own, if you feel it's important, I'm hoping this will be a jump start for you to start thinking maybe differently about it and understand what's going on with whether yourself or a loved one you care about. But it's very complicated. And going back again, if your mania is a feel good mania, it's very hard to get the person in treatment because a lot of times when they do go on medicine, they'll say, I kind of feel flat or that creativity is gone. So then they go off the medication and then you're back into a manic episode. So you want to work with the clients, with your family member, with the family member and the doctors and the therapist to get them to accept this diagnosis and see the hope in getting better.
Dr Julie
Like my one client I mentioned in other podcasts who would get suicidal right away. She was very Proactive. Like, she would call me and her psychiatrist, like, immediately, and what do I need to do? She come back to the hospital, she'd go on her meds. She was very active in her treatment, which is how she eventually got stable and did a lot better. So there's lots of black and white, lots of shades of Gray here regarding getting diagnosed correctly. Right. And then getting on the right medicine for you and learning tools on how to manage what's going on. So we know you mentioned before, Mike, that the medicine is definitely for the mania. Correct.
Dr Michael
Okay. Yeah. So I'm not an MD.
Dr Julie
No. But just working with our clients, public knowledge for sure.
Dr Michael
And I did talk to a psychiatrist last week. We were talking about one of your points you were just making is so important. People coming off an SSRI, which is a Med generally for depression. If they have a vulnerability to bipolar disorder, it can lead to a hypomanic or a manic episode. Now everybody coming off a depressive medication. They won't go into a manic episode unless they have bipolar dysphoria, as you know.
So it's true that lots of people treated for depression and they start a medication and they come off of the medication depression. It can lead to a manic episode. Then you realize this is bipolar disorder. I like to speak about your other point, which I thought was important, too, and that's denial and bipolar disorder.
Dr Julie
Okay.
Dr Michael
And I actually think of this as two spectrum, also of overprotection on one hand and denial on the other part of the family first.
Dr Julie
Okay.
Dr Michael
So I draw a line and I write over protection on one end and deny on the other. And I ask family members to come up and put an X where they're at.
Dr Julie
Oh, I love that.
Dr Michael
And people in the same family can be in very different places.
Dr Julie
Yes.
Dr Michael
And my response is always trying to be compassionate and loving. Right. So if they're overprotecting, that makes sense to me. They get it. This is a serious illness. But the problem with overprotecting is it's not giving the person the respect of they can live a full life like you were pointing out before.
Dr Julie
Yes.
Dr Michael
Just when it's managed. Well, they can do anything. Just about anything anybody else can do.
Dr Julie
Right.
Dr Michael
And then denial is the other end where people it's just in their head, or they're just lazy or they're just acting out or they just want attention. I've heard all those things. That's more of the denial. But when we graphed it out. Right. We really show the highs and the lows and sort of the normal kind of range that people are in. And that this is a very different thing. Mostly people's eyes are open and they say, yes, I see this. And I don't think I've ever experienced somebody saying no.
Dr Julie
Right.
Dr Michael
But it's a tricky diagnosis. Right. So PTSD can be confused with this. Even severe anxiety. People who have characteristics of borderline personality disorder, even people who are on the autism spectrum, can be misdiagnosed as having bipolar disorder.
Dr Julie
Excellent to know.
Dr Michael
Yeah.
Dr Julie
Okay. That's really important to know.
Dr Michael
So it's tough.
Dr Julie
Yes. And that's why I need to go find an expert. And there are people that specialize in this psychiatrist. And a lot of times if they end up in the hospital, that could be the best thing because then they're really being monitored. Twenty four seven. And can kind of get diagnosed more accurately. And then. So let's talk about it. Since this is my CBT podcast, let's talk about how we use both of us specialize in CBT.
Dr Michael
Sure.
Dr Julie
So how can we use that to help someone with this diagnosis as well?
Dr Michael
Yeah, I love that. Well, I know you've covered this in your podcast, but I'll give my word, please.
Dr Julie
Yes.
Dr Michael
Find the same thing. But CBT is going to be really important to understanding both polarities here.
Dr Julie
Okay.
Dr Michael
But let's look at depression.
Dr Julie
Okay.
Dr Michael
The meds don't make people feel happy.
Dr Julie
Right.
Dr Michael
This is what the psychiatrist told me last week. Right. And I always work with a psychiatrist if somebody has bipolar disorder, for sure, I said I would love to treat you, but you have to have a psychiatrist. Your decisions about Medicare between you and your doctor. But I want somebody there.
Dr Julie
Yes.
Dr Michael
Right. So the negative thoughts. Right. So people can really beat themselves up whether they have bipolar disorder or not. I'm a failure. This will never get better. I can never do this or that. These are the thoughts that can make us feel very depressed and really Rob us of a lot of joy and productivity in our life. So even though that this is considered a real biological disorder, the bipolar disorder, because it seems like you really need meds for mood stabilized to keep that stable. However, they're not done living. Right. They're still living.
Dr Julie
And the meds aren't a cure. They help.
Dr Michael
Yeah. It doesn't cure it, unfortunately. But it does allow people to function and not have those dangerous swings.
Dr Julie
Yes.
Dr Michael
So the CBT would be paying attention to what they're thinking. Right. So lots of us people are not trained to think about our thinking.
Dr Julie
Most of us are not. We're just reacting off our feelings.
Dr Michael
Yeah. So you want that great relationship and therapy where you can be honest about what you're thinking and you write it down together and you think about thinking. Okay, well, I'm telling myself these things, is it true? And you sort of analyze it and then you talk back to those negative thoughts.
Dr Julie
Yes.
Dr Michael
Just because I had a manic episode just kind of pretend I'm and I made a fool out of myself in front of this group of people because unfortunately it can happen. Right.
Dr Julie
Good point. Yeah.
Dr Michael
It does not mean I'm a failure. It does not mean my life isn't worth living. Not at all. In fact, I've made a fool out of myself. And for some crazy reason, people still like me. That's right. Not everybody.
Dr Julie
And then I talk about the double standard technique. Right. If I found out my friend or the situation I was in. Oh, that person is bipart. I mean, I would just have empathy. I wouldn't dislike the person. Right. So if I'm thinking, oh, my God, I made a fool of myself. And these are what I call hot thoughts. My listeners know, like, those are your thoughts that are not 100% true, that we want to challenge that really feed into the negative moods. And my thought is, like you said, I'm a failure. People are going to think less of me or judge me. Right. That the double standard technique would be like, if I find out that's really what happened, if anything, I would reach out to them and I would want to let them know, don't worry about it. Like this is a big deal and you're doing whatever you can to get better. And I'm still here for you. So I know it will take time to process that because it is difficult. That's a good example. If you do something in public and then you're embarrassed, but you need to work through that so you can keep going forward, right?
Dr Michael
Exactly.
Dr Julie
Yeah.
Dr Michael
I think the negative thoughts can also be your warning signs. I mean, I love everything you're saying.
Dr Julie
Exactly.
Dr Michael
Just continue it.
Dr Julie
Yes.
Dr Michael
A person may have some negative thoughts, but not really affect them too much because they're able to SWAT them away. That's what I like about CBT. They're kind of like tools.
Dr Julie
Totally tools.
Dr Michael
I use them.
Dr Julie
I use them every day.
Dr Michael
Yeah. So understanding. Okay. When I have these certain thoughts, I'm really going down, right?
Dr Julie
Yes.
Dr Michael
Like that signature you can identify, these are my dangerous negative thoughts.
Dr Julie
Yes.
Dr Michael
And what are the tools to help them? And then it can be helpful to have family members helping you through that.
Dr Julie
Right. Mike and I spoke about this before we started the podcast. I was saying is what we're talking about is what they call symptom management. Right. So managing your symptoms. So if you know, what are my negative thoughts or my behaviors that are red flags, either the mania or the depression, write them down on a piece of paper and have someone you really trust, a family member or best friend, a spouse, whoever that might get the adult child and say, hey, if you notice this, I'm okay with you saying, I've noticed, like you're not sleeping as much or you're just talking. You're not really paying attention or you're kind of all these boxes from Amazon are showing up. What's going on, right. I've had someone do that. I've had someone say, oh, my God, ten boxes a day. My spouse is ordering things. So for you to know, you don't have to say, oh, yeah, what are my symptoms? I'm going to go to my piece of paper and say, oh, yeah, I don't want part of the denials. I don't want to think I'm going back to that place. Right. But okay, I need to jump on it right now or again, having someone you really trust and to be open because it could be really irritating when someone says, oh, I think you're heavy mania.
No, I'm not. I mean, it's frustrating. But if I have someone I trust and they're going to be able to come to me and say, I'm noticing these things, let's call your doctor. That's where you can have that team and build that family connection and support, which having that village. Right. Or if you go to, like you mentioned in the other podcast, Nami, the National Association for Mentally Ill, to have that support that you can go to your family member. You don't have to be alone. There's nothing to be ashamed about. Like we said, it's a biological mental illness. There might be other family history that you can find out about. And generations back, they weren't diagnosed necessarily. So someone say, oh, yeah, aunt so and so we do this or my grandfather. So sometimes you can see there's definitely connection. Right. Which is good to understand as well. So it's important to now walk through this alone and share what your symptoms are and even what your tools are. And Sharon say, this will help me if I can come talk to you. And I can say, this is what I'm thinking. And if they know the same language of CBT and be able to say, well, those are hot thoughts.
That's not 100% true. Let's walk through that together. So then you don't have to ever feel alone.
Dr Michael
I love you highlighting this. That's why having a plan together that you've agreed on, that the person with bipolar disorder is kind of in charge of that plan.
Dr Julie
Yes.
Dr Michael
And Eliciting, here's what you can do. And please don't do this. This is how to say it. Right. Because, well, intelligent people can there could be conflict there. We don't want to have conflict. We want to have a smooth plane upon earlier. I have another story, a little story I'd like to share to highlight another aspect.
Dr Julie
Excellent.
Dr Michael
Working together as a family.
Dr Julie
Okay.
Dr Michael
In 2010, Vicki Stable on her meds and everything. My wife takes our four and two year old to Taiwan for several months because that's her family from there.
Dr Julie
Yes.
Dr Michael
And I get a call on a Friday night from a doctor in Saiwan who's speaking broken English, but I'm grateful he's speaking English and he says, hello, is this Michael? I said yes. He said, your family is okay. Your wife is in the hospital and she can't come to the phone and your kids are here with me. Would you like to talk to them?
Dr Julie
Oh, my goodness.
Dr Michael
Now they're two and four, right? So I hear their happy voices. I say, okay, they're okay. And he said there was this fire and you should probably come.
Dr Julie
Oh, my gosh.
Dr Michael
Yeah. So that's all I know. The next day I go get a ticket and I make arrangements for FEMA. You cannot leave for a family emergency. And I flew to Taiwan. Now, on the plane to Taiwan, I was thinking, this is going to trigger a manic episode. Yes, that's one of the first thoughts I have is for Vicky. So I get there. My wife is still an ICU. Seven days in ICU with tubes down her throat from smoke inhalation damage. What happened was, this is what we think happens. They have this restaurant above. They're living in the apartments above 3rd, fourth and fifth floor. They're hanging out in kind of a lounge area on the third floor. And then my wife and took the kids up to bed. And Vicki took her medicine and fell asleep. Right. The meds are pretty powerful. And she was smoking and she must have dropped a cigarette in the massage chair where she was sitting. And she went up to sleep. And in the middle of the night, her brother, who was on the fifth floor, was pounding the floor with his shoe and saying, fire. And she got up.
And sure enough, fire was kind of streaming through the back and the front of the apartment, kind of like a rectangular shape. Right. My wife grabbed both kids under each arm and ran to the balcony. And people across the way shouted, don't jump because it's several stories.
Dr Julie
Oh, my goodness.
Dr Michael
And the brother was able to jump onto a landing next to where they are, which is several feet up. And my wife would lift their kids up and the brother in law would reach down and pull them up. Oh, my gosh, to this landing. So there's a dog, his nephew, and him up there to pull my kids up. She slipped with my daughter, but she did not fall. I mean, this is scary, scary. My sister in law Vicki got up and then last was my wife, who's just inhaling all this smoke and people die from smoking.
Dr Julie
Yes.
Dr Michael
And I find all this out when I get there. And when I get there, my wife is released from ICU. And there's two parts to this I want to get to.
Dr Julie
Okay.
Dr Michael
I'm kind of looking out if Vicky is going to have a manic episode. So I have my radar fully open. I'm talking with my wife. I'm soberly. She's fine. The kids are fine. Nobody's hurt. But there's major fire, right? I have the newspaper clippings at home. It shows them that the amendments on the street, they're big spread. So Mickey comes in, and I could tell by her body language it's very rigid. So this is the eyes and ears of the family. And she talks to my wife. She doesn't really greet me, which is unusual for her. And she leaves. And I asked, what do you guys talk about? She's like, oh, this is the goal directed behavior. She's going to go do this, like seven or ten chores throughout the city, right in the next hour.
Dr Julie
Oh, my gosh.
Dr Michael
And I could just tell by the rigidity of her body and her face that she's not quite right. So I said to my wife, you know what? You need to take her down to the ground floor where her psychiatrist is, because he happened to be in that same hospital. And you need to take her to the doctor right now. And she's like, no, I think I'm like, please kind of begging her again. And I'm not 100% sure, but this is what my guts tell me.
Dr Julie
Yes.
Dr Michael
So I persuaded my wife, a nurse came with a wheelchair and took them down. And sure enough, the psychiatrist confirmed that she's going to have a manic episode. She's beginning to have the warning signs. He adjusted the meds, and she did not have a man. But that stress is warning. So part of it is stress management. And what I do is I use a visual books and like a cardboard, and I put things in the middle of that cardboard and it begins to bend down. Right. So the things I'm putting in the middle of cardboard, all the things in our life. Right. It's stresses we need a little bit of stress to function fully, but when we have too much, we're too stressed out. So when you're stressed, you have to take some things out of your agenda. The other thing that's helpful as you move the books closer together and it forms more support. So the books represent family. When we're stressed out, we need support from family and we need to take some stuff off of our plate.
Dr Julie
Yes.
Dr Michael
The other thing is, I was never angry at Vicky for this fire, even though it could have cost the lives of my kids and my wife and her.
Dr Julie
Yes.
Dr Michael
Because she's not intentional on this. But bad things can happen, whether it's because of the meds knock them out or they can't perform as well as they can at certain times. There's got to be a lot of love and Grace and understanding. And if you build that at the beginning, when difficulties happen, it's much easier to repair relationships, to come together as a family. And because of that, I shared with the whole family that drawing. And where are they? Are they in denial? Are they overprotective? This is what bipolar really is. They all got it. And so they're all on board with just allowing Vicky to live for a full life, not overprotecting and yet being there when they need her.
Dr Julie
Right. And just to add to that, what a great point. First, I know this about you already, that you're very loving and compassionate because that takes a while. You were talking about your family's life. What a scary story I'm remembering with the bipolar is that just thinking of that story, part of her coming in and she's rigid, and we know, we believe she's going to have a manic episode. The guilt right. And maybe not even greeting you was just like, oh, my gosh, I can't even deal with I put his family's wife in jeopardy. Right. So when something happens and someone has bipolar disorder as the support group to be a little hyper aware that this could be like, say they have a car accident or a break up of a relationship that isn't because of their bipolar. It's just life situation. Like you said, you happen to fall asleep. That could trigger the mania. Right. Or depression or whatever is going to happen. So just if you're in the support community of the person, it's just be a little hyper aware. Like this could trigger that. It's not that they're already manic and they did this.
This could happen. And then that could bring down the mania or with the depression. Right. So that's what I'm saying. Not to overwhelm you guys, but there's a lot of things to consider. And then once you get to know this person in your life, you can be like, oh, these are the things that I need to look for this. Be aware not everyone's going to have everything all the time.
Dr Michael
That's right.
Dr Julie
Right.
Dr Michael
Sensitive to how they're feeling. Like, she may have been felt guilty. I love that. Oh, for sure. Yeah. It didn't even cross my mind that she would feel guilty for that. Because I didn't attribute any guilt to her.
Dr Julie
Yes.
Dr Michael
But she may have.
Dr Julie
Yeah, right. Which is to reframe that. Right. Is because she loves her sister and her niece and nephew and you, she's so loving. Yes. So loving and would just be devastated if something horrible happened because of something she did. Right. So the guilt was if she did have that would be coming from a good place. But because of the bipolar, it could trigger the mania. Right. So that's why you guys need us. You need professionals because it's a lot of training behind this. Again, it's a big diagnosis. Don't just give someone this diagnosis because you're irritated or frustrated with them or you don't understand. Because I have people say these, oh, she's bipolar. And I'm like, Whoa, don't go putting labels on anyone. Let's really see. And the big thing with diagnosing other than if you need to bill your insurance basically is for us to come up with a good treatment plan. That's really the most important thing I've talked about in other podcasts. Don't get attached to your, quote, diagnosis that I'm bipolar. Right. That no, I'm Julie, I have bipolar.
Dr Michael
That's right.
Dr Julie
Or I'm Julie and I have depression. I'm not a depressed person. Right. Because then that feeds into the negative moods and your hot thoughts when you just see, like you were saying, with diabetes. Right. I'm Julie, I have diabetes. I'm not a diabetic person. This is something I manage.
Dr Michael
I think that's really important.
Dr Julie
Yeah. Really important. So you don't want to go diagnose somebody with something when you don't really know all the facts. Right. And the media throws it out there. And I watch movies with bipolar, and I'm just like they didn't even get close to what it really is. But other people think this is what it is because I'm watching it. So we all need to kind of slow down and take a breath and say, okay, let me go talk to someone that knows about this. And if the person isn't open yet, I'm going to go get educated and then bring it to them. Right. I know somebody I trust. If you trust me when you come with me, like, you got to know how to work with the person if they're not willing to go for the help right away. Right. But to let them know to get the help and to use the tools and how CBT can help with that, they can live a full life like your sister in law. She's the owner, she's successful, she's happy, and she manages it now. And she has her community to help her as well. Right.
So let's talk about just some resources for people to go from this point forward. All right. So I had a client one time who later in treatment got diagnosed with bipolar two. And he brought in the book to me, The Bipolar Disorder Survival Guide by David MC Lewitz. So we'll have he's good. Okay. And it says what you and your family need to know. So my client did tons of research. He found this book the most helpful for him. So this will be on my podcast transcription. So if you guys want to order this or look at this, we will have that on there. Of course, the Mind Over, moved by Dr. Greenberger and Pedestrian that I use with all my clients. And the way that I didn't mention this Michael and I actually met was we were at a training with Dr. David Burns, who wrote Feeling Good and Feeling Great, plus many other books. That's how we first met each other. And then we created a support group and training group together that we meet once a month that we all practice our CBT together. Did you have any other books to recommend?
Dr Michael
Well, Case Edson's book is an Unquiet mind in this memoir. So that's really helpful to learn from the inside what it's like for a person to experience bipolar disorder. And I use his books, the one you just mentioned, mainly for clinicians, right?
Dr Julie
Yes.
Dr Michael
Bipolar disorder. Mary Ellen Copeland. This goes back to the wrote the Wellness Recovery Action Plan because her mother suffered from bipolar disorder and there was nothing other than meds that were being done.
Yes.
Dr Michael
And then she developed it later in life and she realized there's a lot more to be done for people with bipolar disorder than just having medication. So Mary Ellen Copeland, you can Google her.
Dr Julie
Okay.
Dr Michael
In her Wellness Recovery Action Plan. I've learned a lot from her.
Dr Julie
Excellent.
Dr Michael
The first resource I have is published kind of privately from Dr. Christopher Amenson. And that was an invaluable introduction for me on how to work with people with bipolar disorder and their family.
Dr Julie
Okay.
Dr Michael
But I don't think that's distributed widely. But there's you can Google that as well. You can Google that.
Dr Julie
I wonder if you can Google anything. Right. So that might be out there.
Dr Michael
Yeah.
Dr Julie
Okay. All right. So I want to thank Mike again for his time and expertise. Can you share how people can find you? Because Mike is in private practice like I am and again specialize in CBT and so I want you to be able to reach out to Mike as well if you'd like to work with him or have questions. How can people find you?
Dr Michael
Yeah, I'm on a website called The Feeling Good Institute. I work with thefeelinggoodinstitute.com.
Dr Julie
Yeah, we're both on that one.
Dr Michael
Yeah.
Dr Julie
And that's through Dr. David Burnsworth and we're training.
Dr Michael
That's right.
Dr Julie
Cool.
Dr Michael
Team CDT and people find it very helpful. So they could just type in my name, I guess, and find you there.
Dr Julie
Okay. Do you have a direct email that we can give to them?
Dr Michael
Yeah, mikem@feelinggoodinstitute.com.
Dr Julie
Excellent. Okay.
Dr Michael
I'm licensed just in California or I live in also Ohio.
Dr Julie
Oh, good to know. Okay, somebody, Ohio wants to reach out.
Okay, so again, thanks you again for being with us and I hope that this was helpful. Yeah, I'm grateful that you're here with me and not all of us. Even in our careers, we need a family and a team. That's why we get together once a month and me with other colleagues because we can't all do it on our own and we need support so we can be there for you, our clients, as best as possible.
So I'm always humbled that you listen to my podcast and the feedback and remember that if you have any questions, reach out to me. You can reach me at mycbtpodcast@gmail.com.
You can find me on Instagram under mycbtpodcast.
Facebook - Dr Julie Osborn.
And my website is mycognitivebehavioraltherapy.com.
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