Mental Health in America – Bipolar Disorder


Bipolar Disorder pic
Bipolar Disorder

Psychiatrist Dr. Lester Sandman has helped people challenged by bipolar disorder and other mental health issues through his private clinic near Seattle for over 20 years. He now evaluates veterans in Palm Springs. Before entering private practice, Dr. Lester Sandman served as the chief of inpatient services with the Fitzsimons Army Medical Center Department of Psychiatry.

In the United States, practitioners like Lester Sandman, MD, work with millions of people in their efforts to control the mood swings associated with bipolar disorder. Patients with the condition experience “mania,” or periods of high activity, with intervening depressive episodes.

Nearly 6 million adults in America live with bipolar disorder. This number represents just over 2.5 percent of entire adult population. On average, the condition begins manifesting itself in patients at 25 years old. According to a study published in the Archives of General Psychiatry, the U.S. has the highest rate of bipolar disorder in the world measured by lifetime prevalence.

Unfortunately, many patients with bipolar disorder are not getting the help they need. Research demonstrates that somewhere between roughly 19 and 22 percent of the bipolar population is receiving the minimally adequate treatment required for their condition.


Major Depression and Bipolar Disorder – Similarities and Differences

Major Depression and Bipolar Disorder  pic
Major Depression and Bipolar Disorder

Dr. Lester Sandman earned his MD at the Medical College of Wisconsin and now practices psychiatry in Bellevue and Kirkland, Washington. In his work with patients, Dr. Lester Sandman focuses on mood and anxiety disorders.

Major depression and bipolar disorder are both types of mood disorders. These common conditions annually affect 16 million and 3 million American adults, respectively. They also tend to be misunderstood and confused with each other. The similarities and differences between major depression and bipolar disorder include the following:

Bipolar disorder is characterized by cycles of manic and depressed states, with moods typically swinging back and forth between the two extremes. Manic states often involve intense feelings of excitement, irritability, or self-importance. Sometimes people become increasingly reckless during manic states. However these states can be more subtle with primarily irritability or anxiety along with insomnia & feeling “wired”.

During depressive states, many people experience a lack of pleasure or interest in daily life. Symptoms also include fatigue, pervasive sadness, and issues with sleep. There are also mixed states that combine elements of both mania and depression.

Major depression, unlike bipolar disorder, is a unipolar condition. People living with depression do not generally experience the symptoms of manic states, only depressive ones. These symptoms are sometimes accompanied by persistent physical symptoms that do not disappear with treatment.

The more severe conditions are thought to be “biologically driven” with a strong genetic component. But they can be easily confused with psychological mood states which are experienced as more in- proportion to events that are driving them (such as grief).

People of all ages experience both of these common mood disorders. Both are also treatable. Many patients with bipolar disorder or depression experience positive outcomes with medication, talk therapy, or a combination of the two. If the mood problem is primarily psychologically driven, then talk therapy is the main treatment. If the mood problem is biologically driven, talk therapy can help manage symptoms but medications will be necessary to fully control the condition.

Medication Management for Generalized Anxiety Disorder

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Generalized Anxiety Disorder

Dr. Lester Sandman, who runs a referral-based private psychiatry practice in Washington state, develops medication-based treatment plans for patients with mental illnesses. Lester Sandman, MD, has developed such plans for individuals with varying forms of anxiety disorders.

An individual with generalized anxiety disorder, or GAD, experiences chronic worry that is out of proportion to the topic of concern. They may feel extremely nervous about such everyday issues as money, work, or parenting, and they report being unable to control these feelings. For such patients, anti-anxiety medications or antidepressants may be effective in achieving that control.

Many antidepressants used for anxiety are selective serotonin uptake inhibitors (SSRI’s), which improve mood by increasing the amount of serotonin available in the brain. Serotonin-norepinephrine reuptake inhibitors (SNRI’s) also stand out as common primary prescriptions for GAD. These drugs have an effect similar to that of an SSRI but also act on a second brain chemical.

Some patients, however, require one or more of a variety of medications, some off- label for anxiety disorders. Benzodiazepines are used for the short term, but in long term use have problems with dependence & sometimes addiction. Often there is also psychological learning & a “fear of fear cycle”. Fear of fear requires “unlearning” either through time after medication treatment or through cognitive behavioral psychotherapy. No one drug will work for all patients, and it is important to seek the advice of a qualified psychiatrist before beginning any treatment regimen.

Essential Tools for Preventing Brain Freeze

Brain Freeze pic
Brain Freeze

Dr. Lester Sandman is a psychiatrist based in Bellevue, Washington. A referral private medical practitioner with extensive experience in treating mood disorders, Lester Sandman, MD, is also knowledgeable of the phenomenon of brain freeze.

Most people have experienced brain freeze at some point in their lives. According to psychologists, brain freeze is characterized by a malfunction of the prefrontal cortex, the area of the brain responsible for blocking out distractions and allowing individuals to focus on a single task.

Brain freeze is triggered by exposure to a lot of pressure at school, work, or home or by overthinking a situation such as a debate or a test.

Psychologists recommend a variety of tools to train your brain against freezing when you need it the most. The first tool is practice. By practicing, you expose yourself to the situation you will face and practice different methods of handling it. If it’s a presentation before a large audience, rehearse in front of your colleagues to prepare you for the big day.

Relaxation techniques such as meditation have also been shown to help increase the performance of the prefrontal cortex and to improve an individual’s ability to stay focused.

Types of Bipolar Disorder

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Types of Bipolar Disorder

As a privately practicing psychiatrist, Dr. Lester Sandman focuses on anxiety and mood disorders that have resisted prior treatment. Lester Sandman, MD, has treated numerous patients with bipolar disorders.

The term “bipolar disorder” refers to a particular form of mental illness that is characterized by extreme highs and lows of mood. The severity of these moods and the frequency with which they alternate determines a patient’s specific diagnosis.

Bipolar I disorder involves at least one major depressive episode as well as one or more manic or mixed episode. Diagnostic standards define a mixed episode as the presence of both manic and depressive symptoms almost daily for a minimum of one week. Because of the severity of mania present in bipolar I, it stands out as the most severe of the bipolar disorders.

Bipolar II, by contrast, presents as at least one major depressive episode and one or more episodes of hypomania, a less severe form of elevated mood. The hypomania of bipolar II disorder interferes with functioning to a lesser degree than full mania and often evades the patient’s recognition. Upon further consideration, however, the patient may be able to remember periods of abnormally high energy, irritability, or changes in concentration ability.

Patients with less frequent episodes of hypomania and less severe periods of depression may be suffering from cyclothymia, which causes such fluctuations over the course of at least two years. This is a less severe form of bipolar disorder, while rapid-cycling bipolar disorder causes a minimum of four episodes of mania, hypomania, depression, or mixed episodes within a single year. Individuals who experience similar symptoms but whose presentation does not fit within a standard bipolar diagnosis may fall into the category of bipolar disorder not otherwise specified (NOS).

Professional Mental Health Care Is Important for Bipolar Disorder

A psychiatrist in Bellevue, Washington, Dr. Lester Sandman holds licenses to practice psychiatry in four states. Often, Dr. Lester Sandman works with patients who have explored prior treatments, such as medication and counseling, but have not achieved the desired results. Lester Sandman, MD, treats a broad array of conditions, including bipolar disorder.

According to the National Institutes of Mental Health (NIMH), bipolar disorder often appears in the teen years or early adulthood, with approximately half of all cases manifesting in individuals before the age of 25. While no cure exists for bipolar disorder, proper treatment can help individuals manage symptoms over the long term. Effective bipolar medications, including mood stabilizers, antidepressants, and atypical anti-psychotics, are available, but not all individuals respond to these medications in the same way. In addition, since other mental health or addictive disorders can coexist with bipolar disorder, individuals may need to try different combinations of medications to find out what works best for them.

NIMH recommends that individuals with bipolar disorder seek out a mental health professional to get the care they need. Once in treatment, individuals should develop awareness of the warning signs of a shift into mania or depression, take medications regularly, and anticipate gradual relief of symptoms.

Training Your Brain to Deal With Stress

Lester Sandman, MD, receives referrals for patients with psychiatric conditions who have attempted to find help elsewhere through counseling, medications, and other treatments without success. On his website, Dr. Lester Sandman offers links to a variety of articles about mental and psychological health, such as Excel Under Pressure.

In her article titled Excel Under Pressure: Prepping for Stress Can Enhance Your Response, Megan Johnson describes a common problem when people face too much stress. In colloquial terms, they have a brain freeze. Johnson attributes the problem not to the working of the brain, although the prefrontal cortex is involved, but rather to people’s tendencies to ignore the capabilities of their automatic response and instead focus on the importance of the moment.

For instance, if a politician stands up in front of the camera, he or she may suddenly blank out on how to continue. Or, in another case, a student may do poorly on an exam after doing well on a practice test for that exam. They may have prepared well, but when it comes to the important moment, they focus on the consequences of that moment rather than the current task. In order to avoid this, Johnson suggests preparing for that important event with a situation that simulates stress, but at a lower level. That, she says, is enough.