Bipolar disorder Buying sprees and gambling

Bipolar Disorder And Money IssuesBipolar disorder affects more than two million Americans, and countless more worldwide. In his book Bipolar II, Dr Ronald Fieve examines the causes, symptoms and treatments of this treatable illness. The following excerpt talks about two highly damaging symptoms: excessive spending and gambling.

Bipolar disorder: Reckless behavior

Along with sexual indiscretions and comorbid alcohol and substance abuse, many with Bipolar II seek help only after they have recklessly spent their life savings or made wild bets on the stock market -- and lost. It is not unusual for hypomanics to go on wild shopping sprees, spending money they do not have (by running up debt on credit cards) and buying items they never intend to use but want more than anything at the time of the purchase. For instance, I will never forget the patient who came to our first appointment carrying a duffel bag filled with more than 100 pairs of white tennis socks!

Bipolar disorder: Impulsive behavior leads to debt

I asked Veronica, a 31-year-old retail fashion buyer with Bipolar II, to write down her thoughts and feelings when she was unable to restrain herself from overspending. She wrote the following:

"When I start feeling that hypomanic 'buzz,' I never worry about earning money. Instead, I become intent on spending as much as I want. It is not unusual for me to run up my credit card debt in excess of 15 to 20 thousand dollars over a period of 2 or 3 weeks during this mental state. I buy anything and everything I see without regard to whether I need it or will use it. For example, last spring when I was experiencing a mild high, I booked a 2-week Mediterranean cruise for myself and two girlfriends. I didn't even ask my friends if they could get off work at that time. I then realized that I had nothing to wear on the cruise and charged about $6,000 in resort wear, including two evening gowns for the late-night formal dinners. Looking back, I see how extravagant and emotionally based the spending was, especially when I found out my friends could not go and my credit cards were over their limits. But at the time, it seemed the right thing to do -- get what I wanted to soothe my hypomanic state, and try to impress my friends at the same time."

Bipolar disorder: Out of touch with reality

Compulsive spending is regarded as a problem with impulse control. At times, the hypomanic individual may be right on the brink of being out of touch with reality. An extreme example of this is a patient of mine who threw $50,000 out of his office window in midtown Manhattan and then called his bank to send over more money. Of course, the bank did not comply with his request, and my patient was later treated with a mood stabilizer to modulate his hypomanic mood state. Sure, this is a rare example, but it really did happen. And is there really any difference between tossing thousands of dollars "to the wind" and the compulsive gambler who loses all of his money in risky investments? Sadly, either might in consequence try to commit suicide -- and succeed.

Bipolar disorder: Thrill seekers

We believe that many hypomanics have the same components as what some psychologists label a "Type-T," or thrill-seeking personality. This personality dimension refers to individual differences in stimulation seeking, excitement seeking, thrill seeking, arousal seeking, and risk taking. Whether he or she chooses the stock market, the racetrack, a poker game, or an all-nighter doing slots in Las Vegas, the hypomanic seeks excitement, craves the adrenaline rush, and thrives on the tension. When he loses, he starts again with a bigger and better plan to win. He finds that this form of instant gratification suits his hyperalert, fast-moving, impulsive temperament. And why not? I mean, with a real job, you have to clock in daily and wait 2 weeks for a bona fide paycheck. With high stakes at the racetrack, your winnings are instantaneous -- or far too often simply nonexistent.

Bipolar disorder: Looking for the ultimate high

As I explained in Moodswing, when hypomanics are making a fast deal, they feel in control. They love the sensation of power and the thrill of winning. Usually, the money is secondary -- something to have in case you need to eat. The real high comes from the thrill of the gambling itself -- and most try to beat the system until their last day. But while gambling is a high for the hypomanic, it can lead to far-reaching consequences at work and in the family. The problem of gambling with Bipolar II has escalated greatly with unlimited access to gambling facilities and day-trading accounts on the Internet. When the hypomania goes too high, the compulsive gambler may look for new ways to win money.

Bipolar disorder: Suicide risk

But why should someone get so depressed over money, one might ask; many people have repeatedly made and lost fortunes. But the psychiatrist wonders which came first in a financial disaster: Was it the chemical mood swing to a deep depression, or was it the actual loss of the fortune that prompted such a severe reaction? I maintain that the hypomanic high often prompts a reckless loss of money, and suicide is a consequence of what is now called double depression: the combination of the depression, which would have occurred once the mania subsided, and the depressive reaction to loss.

Do you have a problem?

Many people do not realize that they have a gambling problem until they lose everything. That's why an open discussion with a psychiatrist or other professional may help the person own up to the problem and seek intervention. When Bipolar II patients come to my office presenting with a possible gambling problem, I ask them the following questions. (If you answer "yes" to 5 or more of these 16 questions, you most likely have an addiction.)

Do you gamble for money frequently?Do you regularly bet on sports games?Have you ever used a bookie?Do you regularly use slot machines or other "devices"?Do you bet on the lottery frequently?Did anyone in your immediate family have a problem with gambling?Do you feel guilty for gambling?Have you borrowed money to gamble?Have you neglected paying your mortgage or food bills to gamble?Have you missed work because of gambling?Have you ever overextended, gambling more money than you actually had?Has gambling ever led you to consume alcohol or recreational drugs?Do you receive criticism from a spouse or friend for gambling?Have you stolen money to gamble?Have you prostituted yourself to get money for gambling?Have you had to borrow money to pay back gambling debts?

Bipolar disorder treatment

Treatment goals for Bipolar II patients who are pathologic gamblers are consistent with treatment for major affective disorders, alcoholism, or substance abuse, in that the psychiatrist works on restoring to the patient a normal way of thinking and living. Behavioral therapy is used to improve the patient's social skills, and cognitive-behavioral therapy may help the patient prevent relapse. Intervention to reduce the risk of suicide is also necessary.

Lose weight with the MyPlate food guide

Lose Weight
With The PlateAfter years of following the food pyramid, the USDA recently changed its look with the new MyPlate food guide icon. Following this new guide can help you fill your plate wisely and may even help you lose weight, too. Try these diet tips on for size.

Pick the right plate

Be sure to choose a plate that works for you, not against you. Pick a plate that is no larger than 10 inches across, since a properly sized plate can help you avoid oversize portions. Make sure to measure, since a plate that is just two more inches across can increase your portions by 44 percent. Only fill your plate inside the rim.

What about the new Dietary Guidelines for Americans? >>

Fill half your plate fruits and vegetables

Following the new MyPlate food guide by making half your plate fruits and vegetables is a sure way to slim down. Fruits and vegetables are packed with nutrients but provide relatively few calories. Try sneaking some fruit into salads by tossing pears and strawberries with spinach. If speed is what you need, frozen vegetables can be a good option and are just as nutritious as fresh vegetables.

5 Ways to get your 5-a-day veggies >>

Hold out for whole grains

About a quarter of your plate should be filled with grains, especially whole grains. Unlike refined grains such as white bread and white rice, whole grain foods have not had the healthful bran and germ removed. (And "germ" here refers to part of the seed, not bacteria!) In addition to the vitamins and minerals provided by whole grains, they are also a good source of fiber, to keep you feeling full longer. Look for 100 percent whole wheat bread for sandwiches or microwaveable brown rice pouches that are ready in 90 seconds for a speedy side with dinner. Swap out refined sugary cereals for thick-cut oats.

Get the dish on whole grains >>

Pick a lean protein

A portion of protein should fit inside a quarter of your plate. Although red meat can be higher in saturated fat than other choices, if you shop carefully, red meat can still make it to your menus on occasion. Let the label be your guide. Choose cuts with the words "round" or "loin," as in top round or sirloin, since these are among the leanest options. Buy those with the least amount of solid, visible fat.

The truth about protein in your diet >>

When it comes to dairy, fat-free or 1 percent is best

The bone-building dairy group is represented as a circle next to the MyPlate guide, which can translate to a glass of skim milk or small cup of low-fat yogurt or cottage cheese. To get all of the calcium and protein without the added saturated fat and calories, choose fat-free or low-fat (1 percent) milk and yogurt. Opt for reduced-fat cheeses, which still retain a pleasing texture and taste. Try thick and creamy 0 percent fat Greek yogurt, which serves up twice the protein of regular yogurt.

The health benefits of drinking milk >>

Power to the plants

Overall, the MyPlate boils down to eating a larger portion of plant foods, and a smaller portion of high fat animal-based foods. For more information on the USDA's MyPlate food guide, check out www.choosemyplate.gov.

More weight loss and healthy eating tips

How to make healthy eating a way of life
How to curb unhealthy food cravings
Spring clean your kitchen for healthy eating

Super Bowl trivia game

Print & Play!Looking for a fun way to kickoff your Super Bowl party? Print this Super Bowl trivia game, split into teams, nominate your captains and start playing! See which team can answer the most questions correctly and give the losing team clean up duty. This Super Bowl party game is just right to help you get your Super Bowl party started!

Answers: 1a, 2c, 3c, 4a, 5b

  Answers: 1c, 2c, 3a, 4b, 5a

  Answers: 1c, 2b, 3b, 4a, 5a

Answers:1c, 2c, 3a, 4b, 5a

The 12-day fitness challenge

Work Out With 12 Days Of Fitness TipsThe holiday season isn't just about fun, food and parties. It can be a time of stress, slack dieting and exercise, and weight gain. However, we've got a 12-day fitness challenge for you to jump-start your holiday season and have you in shape even before the new year.

Day 1: Let it go, let it go, let it go

On the first day of this challenge, grab a notebook and write down all of your fears, negative thoughts, past fitness failures and any excuses you have for not committing to fitness. Then write down why it is important to get into shape. Decide to focus on your positives and toss your negative thoughts and excuses list into a trash can.

Day 2: Brisk walking in a winter wonderland

Walking is one of the easiest and most convenient exercises that can be done throughout your day, whether you’re at work or at home. Don’t let the colder months keep you indoors — bundle up in your trendy winter gear and head outside. Jenny Miller, personal trainer from Glenview, Illinois, suggests brisk walking around the neighborhood for 30 minutes while enjoying the sights and scenery of the holidays.

Quick Tip

Do you live in a snowy climate? Use that to your advantage. Miller points out that walking in the snow could add more resistance than walking on a flat surface.

Day 3: Rockin’ around the Christmas tree

The holiday season is a great time to celebrate, so why not have some fun and let your hair down while you break a sweat? Miller says that dancing is a great way to raise your heart rate and burn calories (Did you know that a Zumba dance workout can burn 500 to 900 calories an hour?). So put on your favorite songs and Christmas carols and challenge yourself to dance for 30 minutes. Chances are you’ll have so much fun that you won’t even realize that you’re workin’ as you’re rockin’.

Day 4: Jingle bell rock

Tank tops may not be in season, but it’s still important to strength train your shoulders, arms and upper body. Rick Applewhite, a personal trainer in Chicago, says that it's important to develop coordination and strength, so grab your dumbbells (between two and five pounds) and complete his recommended balancing exercise:

Stand on one leg with the opposite leg lifted slightly off of the ground and do 10 arm curls with your dumbbells. Alternate the legs and repeat for two more sets. "This exercise will teach you how to balance while improving your strength," says Applewhite.

Day 5: Girlie, it’s cold outside

Maybe the weather outside is frightful, but that doesn’t mean you can’t bring your workout indoors. Whether you pop in a 30-minute fitness DVD or run up and down the stairs, exercising in your home can be just as effective as going to the gym.

"I think a big thing people can realize is that there is a lot you can do in your home. There are so many options that you don't need equipment for, and you can find 10 to 15 minutes a day," says Miller. "While watching your favorite TV shows or holiday movies, you can do sit-ups, lunges, push-ups, biceps curls holding a can of soup, triceps dips on the edge of your couch and leg lifts during the commercial breaks."

Day 6: Family/friends are coming to town

If you feel your time is limited as you prepare for holiday gatherings and parties with family and friends, you can still get in a workout while cleaning and decorating. Whether you're mopping, sweeping, dusting, or taking out the trash, holiday cleaning can help you burn calories, so throw on some holiday music as you scrub and clean. You can also add a few lunges, squats and stretches to your cleaning routine as you multitask.

Day 7: You’re a lean one, on the move

Cardio is essential to making sure your body is lean and fit for the challenge. Set this day aside to knock out any holiday stress by engaging in punching exercises. Applewhite recommends doing 15 quick jabs followed by 15 side kicks and then run in place for 30 seconds. Take a 30-second break and switch to the other side. Repeat the circuit three times.

Day 8: Bike ride (giddy up, let’s go)

Bike riding is an effective cardio exercise that can help you lose weight and build muscle mass and endurance, and it's a great way to get your lower body into shape. If you're not up for bike riding in the cold, take a spinning class (a high-level intensity class can burn 600 calories per hour) or go at your own speed on a stationary bike and push yourself by changing the resistance to increase the intensity.

Day 9: A few of your favorite thingsTip: If you only have one favorite, then engage in that activity for 30 minutes and give it all you got.

Do you dread push-ups? You can skip them today. Instead, focus on your favorite exercises. Maybe you enjoy jumping jacks or mountain climbers or just walking. Miller suggests picking five activities that you can do in your home (e.g., incline push-ups on your kitchen counter) or outside (e.g., shoveling snow or jogging around the block) and go through the circuit three times. Whatever exercises you choose, pick the ones that you enjoy.

Day 10: Silent workout

Focus on your technique, breathing and your fitness goals today by exercising in silence (yes, that means no iPod). Relax and get rid of any stress by engaging in yoga exercises and practicing deep-breathing meditation. Let this be a day of reflection as you focus on what you've already accomplished as well as your ultimate health goals for today and beyond.

Day 11: Deck the abs

Do you have rock-hard abs on your fitness wish list this year? Dedicate this day to working on your abdominal muscles. Though these exercises won't melt away belly fat and tone your abdomen overnight, they are effective and can help you develop a strong core to help you tone your midsection (along with cardio activity and a healthy diet). Do these ab exercises with a 30-second cardio interval between each set.

Bicycle (12 reps) followed by 30 seconds of cardio (such as running or jumping jacks)Reverse crunch (12 reps) followed by 30 seconds of cardioPlank of elbows and toes (hold for 30 seconds) followed by 30 seconds of cardioRepeat circuit three times.Day 12: Dreaming of a light workout

Congrats — you made it through the 12 days! Today you can engage in light exercise, such as swimming, jogging, walking or slow biking, because you deserve it.

"There are great health benefits to working out and staying in shape," says Miller. "You are giving yourself a healthier lifestyle. You can make it a habit, as well as end this year and start off the new year in shape and healthy."

Remember, the 12 days of fitness doesn't end here. Continue to spoil yourself with healthy living from this day forward. The long-term effects of living a healthy lifestyle are priceless.

More holiday health tips

Best mind-body workouts to start now
Eat well to be well: Avoid colds and flu
Easy ways to unload holiday stress

Cheers to 5 festive cocktail recipes

Raise A Glass To
Toast The Season!It’s the time of year to put on your party dress and enjoy the season with friends! If you’re hosting a party, be sure to try these festive holiday cocktail recipes and raise your glass to toast the season!

These recipes make delightful holiday drinks. They're just the type that you want to break out for this special time of year. Whether you like to clink glasses with a drink that's bubbly or colorful, you'll be sure to enjoy these! Be sure to check out the non-alcoholic version for the designated driver.

Pomegranate Champagne punch

You can't have a holiday party without Champagne -- or something bubbly! This cocktail recipe from Eating Well is lively and colorful, can be easily modified as a non-alcoholic version by combining 2-1/2 cups seltzer and 2 cups pomegranate juice along with the garnish. Cheers!

Serves 6

Ingredients:2 cups Champagne1 cup pomegranate juice1 cup seltzer1/2 cup citrus vodkaLemon twists, for garnishDirections:

Combine Champagne, pomegranate juice, seltzer and vodka in a large bowl or pitcher.Serve over ice with a twist of lemon.

Gin, Chambord and peppermint sparkler

Peppermint adds the taste of the season to this gin-based cocktail recipe. The pretty rose color and fizz of this drink might have you toasting all evening!

Serves 2

Ingredients:4 ounces gin2 ounces Chambord2 splashes peppermint schnappsLemon-lime sodaDirections:

Place the gin, Chambord and schnapps into a tall cocktail glass filled with ice.Stir the mixture briefly and then top with the soda. Serve immediately.

Cappuccino up

Created by Nikki Cascone, this martini has "holidays" written all over it! Not only is the drink delicious with its vanilla and coffee flavors, but it's garnished with a graham cracker and cinnamon for added holiday spirit.

Serves 1

Ingredients:2 ounces Stoli Vanil ?1-1/2 ounces espresso?1-1/2 ounces simple syrupFor garnish: ground cinnamon, raw sugar and graham crackers?Directions:?

Shake the ingredients together with a small amount of ice.Pour and spoon out the foam on top.Sprinkle cinnamon and raw sugar on top and garnish with a graham cracker piece.

Eggnog martini

You just can't let the holidays pass without sipping on some eggnog. This lovely martini recipe from Martha Stewart combines brandy with the seasonings and spices that make the festivities sparkle!

Serves 8

Ingredients:1 cup sugar1/4 cup cornstarch1 teaspoon ground nutmeg1 teaspoon pumpkin pie spice, plus more for garnish8 cups whole milk6 large egg yolks3 cups brandyDirections:

Set a large fine-mesh sieve over a large bowl. Place bottom of bowl in an ice bath; set aside. Off heat, in a medium saucepan, whisk together sugar, cornstarch, nutmeg and pumpkin pie spice. Gradually whisk in four cups milk, taking care to incorporate the cornstarch. Whisk in egg yolks.Whisking constantly, cook over medium heat until the first large bubble sputters, 10 to 12 minutes. Reduce heat to low; cook, whisking constantly, for one minute more. Remove from heat; immediately pour through sieve into bowl. Stir in remaining four cups milk. Let cool completely in bowl still set in ice bath.Just before serving, stir in brandy, and ladle into glasses; garnish with pumpkin pie spice.

Lemony gin punch

The gin, honey and citrus in this drink from Real Simple add a little bit of sunshine to the cold winter temperature outside!

Serves 4

Ingredients:1/2 cup sugar1/4 cup honey1 cup club soda3/4 cup fresh lemon juice3/4 cup ginLemon wedges for garnishDirections:

In a small saucepan, bring the sugar and one cup water to a simmer. Remove from heat, stir in the honey, and let cool.In a large pitcher, combine the sugar syrup with the club soda, lemon juice and gin. Serve over ice; garnish each glass with a lemon wedge.

It's the season for celebrating with friends and loved ones! Raise a glass of something festive and delicious and toast the season!

Try these festive holiday drinks

Low-fat spiked eggnog
10 Italian wines under $15 you should know
Warm things up with Mexican hot chocolate
Creamy hot buttered rum

5 Easy and healthy substitutions for packaged foods

Nothing like the real thing

Processed foods have an appeal. They come in attention-grabbing branded packages, are (supposedly) more convenient and have extraordinarily long shelf-lives. But many of the products are filled with unrecognizable ingredients and are loaded with additives and preservatives. Here are some ideas of how to swap out packaged food for the "real thing" -- minimal effort required.

Out: Snack bars
In: (Real) Peanut butter snacks

It happens to all of us. When you reach that midday slump, those bags of chips and granola bars are mighty tempting. Instead of succumbing to the beckoning call of the vending machine or your coworker's candy bowl, opt for a fresh apple or celery topped with organic peanut butter. Real peanut butter should contain only two ingredients: peanuts and salt. If it has extra ingredients, especially hydrogenated fats, stay far away. For a fun switch-up, or if you or your little ones are allergic to peanuts, try almond or cashew butter instead.

Out: Bottled salad dressings
In: Simple DIY dressing

Making a salad dressing from scratch is a quick and simple process. All you really need to make a simple dressing is a good oil (like extra virgin olive oil), an acid (like vinegar) and seasoning (like salt and pepper). The rule of thumb is one part acid to three parts oil. Start with one tablespoon of red wine vinegar in a large bowl and whisk in three tablespoons of good olive oil. Season generously with salt and pepper and there you have it -- a simple and delicious salad dressing, no preservatives, additives or mystery ingredients. Once you have the basis technique down, you can start experimenting with adding in extra ingredients. I often mince a shallot and let that marinate in the vinegar for a few minutes before whisking in the oil, or I'll add in some minced herbs or mustard to jazz it up a bit.

Out: Sugary cereals
In: Old fashioned oatmeal

Simmer old fashioned oats in water for five minutes, toss in a handful of dried fruit, nuts, a sprinkle of cinnamon and a squeeze of honey or maple syrup and there you have it -- an ultra-nutritious breakfast loaded with fiber and ingredients that you can count on one hand. My favorite winter version: dried cranberries, chopped pecans, cinnamon, a sprinkle of ground ginger and a drizzle of maple syrup. In the summer months, replace the dried fruit with fresh strawberries or blueberries from the farmers market.

Out: Packaged desserts
In: Frozen grapes

Even if they claim to be low-fat, low-carb or low-sugar, those packaged dessert snacks usually contain at least a dozen ingredients, most of which sound nothing like any known food. But if you crave something sweet after you eat, you can get the same satisfaction from these popular (and pop-able!) little fruits. Due to their high water content and naturally bite-size shape, grapes are one of the best fruits to eat frozen. Just place cleaned, dried grapes in a plastic freezer bag and pop in the freezer. Or, divide them into mini bags for easy portion control.

Out: Packaged snack mixes
In: Air-popped popcorn

Who doesn't like to dig into a bowl of something crunchy and salty while watching your evening television favorites? But most packaged snack mixes are laden with unnecessary calories, sodium and preservatives. Instead, make your family a big bowl of air-popped popcorn that's easy to make and (surprise!) high in dietary fiber. All you need is a large pot and four commonly used ingredients that you probably already have in your pantry: popcorn kernels, canola oil, butter and salt. Here is my foolproof simple popcorn recipe:

Foolproof air-popped popcorn

The secret to perfect popcorn is to make sure the kernels are added when the oil is at the correct popping temperature, which is why I suggest using a few kernels as testers. When done correctly, almost all of the kernels should pop -- without any burning.

2 servings

Ingredients:2 tablespoons canola oil1/3 cup organic popcorn kernels2 tablespoons butterSalt to tasteDirections:

Heat oil in a large pot over medium heat. Add three or four kernels and cover the pot.Once they've popped, you know the oil is at the correct popping temperature. Add in the rest of the kernels, cover and shake occasionally until the popping slows to several seconds between pops.Toss with melted butter and salt to taste.

More healthy eating tips

Grocery store tips for healthy eating
What are the advantages of organic food?
Is buying local produce healthier or just hip?

Gluten-free Friday Pumpkin chocolate chip muffins

Fall Means
Pumpkin Goodies!It's that time of year! It's fall and pumpkins are on the brain. You can't go anywhere without running into a pumpkin-flavored coffee drink, cookie or bread....and we love it!

Embrace the season and start your day off with some pumpkin-flavored gluten-free breakfast goodies! These muffins are great served at breakfast with hot tea or coffee or for a special brunch or mid-afternoon snack!

This recipe is from Glutino, a company that offers gluten-free baking mixes, breads and a wide variety of other gluten-free food products.

Gluten can be found in many different foods and products, from ketchup to soy sauce to candy and seasonings. While SheKnows.com tries to ensure these recipes are gluten-free, carefully read the ingredient labels of all food and food products you use for these recipes to ensure they are also gluten free.

Pumpkin chocolate chip muffins

Makes 24 muffins

Ingredients:2-1/2 cups Gluten Free Pantry Muffin and Scone Mix 1/2 cup softened butter or margarine2 eggs, plus 4 egg whites, lightly beaten1 teaspoon cinnamon2 cups pumpkin puree1/2 cup chocolate chips or raisinsDirections:

Preheat oven to 350 degrees F.In a medium-sized bowl, beat the butter until fluffy.Add the egg mixture to the butter and beat to combine.Toss the muffin mix with cinnamon and add it to the butter mixture.Fold in the pumpkin and mix everything to combine. Fold in the chocolate chips or raisins.Spoon the batter 3/4 of the way to the top of regular-sized, prepared muffin tins and bake for 20 minutes.Remove from the oven and allow to cool before serving.

Before you know it, fall will be over. Take advantage of the treats the season has to offer and incorporate a little pumpkin into your life!More gluten-free recipes to try

Gluten-free Ghirardelli fudgy brownies
Gluten-free Parmesan-topped cornbread
Gluten-free pancakes with berry compote
Gluten-free macaroni and cheese
Gluten-free sandwich bread
Gluten-free basic barbecue sauce