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Writer's pictureJustin Sunseri, LMFT

Bipolar Disorder and the Polyvagal Theory / ep46 show notes

Updated: Nov 17


**Disclaimer: This information is NOT meant to diagnose. If you feel like you may be experiencing symptoms of bipolar disorder, consult with a mental health or medical professional. We are speaking in generalities. Your specific situation, diagnosis, treatment and medication are entirely between you and your provider.


MANIA & MAJOR DEPRESSIVE EPISODES

Fluctuation between extreme highs and lows


TOPIC - TYPES OF BIPOLAR DISORDER

  • Bipolar I disorder is a manic-depressive disorder that can exist both with and without psychotic episodes

  • Bipolar II disorder consists of depressive and manic episodes which alternate and are typically less severe and do not inhibit function

  • Cyclothymic disorder is a cyclic disorder that causes brief episodes of hypomania and depression

A manic episode is a period of at least one week when a person is very high spirited or irritable in an extreme way most of the day for most days, has more energy than usual and experiences at least three of the following, showing a change in behavior:


Exaggerated self-esteem or grandiosity

  • Sympathetic charge

  • Story follows state

  • Flight or fight energy? Dunno.

Less need for sleep

  • Sympathetically active

  • Can’t fall asleep when in flight/fight

Talking more than usual, talking loudly and quickly

  • Loss of vocal prosody when in sympathetic

  • Shorter breathing leads to faster rate of speaking

Easily distracted

  • Sympathetically active due to neuroception of danger

  • Always scanning the environment

Doing many activities at once, scheduling more events in a day than can be accomplished

  • Sympathetic energy with no place to direct it

  • Lack of mindfulness of the energy, not being in the moment

  • Not feeling the root of the energy, just acting

  • Probably a low tolerance to being in the moment

Increased risky behavior (e.g., reckless driving, spending sprees)

  • No direction for the energy

Uncontrollable racing thoughts or quickly changing ideas or topics

  • Anxious or aggressive thinking of the sympathetic state


A hypomanic episode is similar to a manic episode (above) but the symptoms are less severe and need only last four days in a row. Hypomanic symptoms do not lead to the major problems that mania often causes and the person is still able to function.


A major depressive episode is a period of two weeks in which a person has at least five of the following (including one of the first two):


Intense sadness or despair; feeling helpless, hopeless or worthless

  • Shutdown

  • Empty, foggy, detached

Loss of interest in activities once enjoyed

  • Anhedonia, the life force energy is gone

  • The sympathetic connection or motivation

Feeling worthless or guilty

  • Very much the feelings of being in a shutdown as well

Sleep problems — sleeping too little or too much

  • Too much is a shutdown thing

  • Too little might be due to some sympathetic energy returning

  • Or shutdown danger cues being too overwhelming?

Feeling restless or agitated (e.g., pacing or hand-wringing), or slowed speech or movements

  • Sympathetic or shutdown

  • Undirected energy of sympathetic emerging

Changes in appetite (increase or decrease)

  • Coping skill of the emerging sympathetic energy?

  • Appetite returning from shutdown?

  • Decrease due to shutdown since feeling hunger less?

  • Prepping for death

Loss of energy, fatigue

  • Prepping for death

Difficulty concentrating, remembering making decisions

  • Cognitive functions of shutdown are… shut. down.

Frequent thoughts of death or suicide

  • Preparing for death brings thoughts of death

  • Emerging from freeze is also scary and might be related to suicide imo

  • For another time


BIGGER PICTURE OF THE PVT

  • Uncontrolled return of sympathetic energy or maybe uncontrolled release of frozen energy


ANNOUNCEMENTS -


SUPER FAN SUBMISSION -

“Thank you for your page. It’s like home.” -keeping anonymous




Intro/Outro music & Transition Sounds by Benjo Beats - https://soundcloud.com/benjobeats

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