Psychology Articles

Video / Updated 08-14-2023

Body language reveals a lot about how you are feeling. Before you’ve spoken at a job interview, interviewers will already have formed judgements based on your posture, gestures and facial expressions. There are a number of techniques you can use to make a positive impression and project confidence, commitment and credibility. What you should do before the job interview Send out a clear message that you belong in the organization by projecting assured and confident behavior. Relieve yourself of clutter and carry only what you need. Remain standing while you are waiting in reception. Chairs make you look small and can be awkward to get out of. Make a positive entrance: move confidently, smoothly and purposefully to be perceived as someone with an upbeat and positive attitude. Hesitations and shuffles make you appear unsure of yourself Instead of shaking hands across a desk, move around it so that there are no barriers between you and the other person. Return the same amount of pressure as the interviewer and let them decide when the handshake should end. What to do during the interview for a job Positioning: when invited to sit, try to ensure that your body is at a 45 degree angle from the other person. Facing the interviewer directly, especially if your chair is lower than his, can make you look like a child about to be reprimanded. Sit upright and don’t slouch. Answering questions: portray a positive and serious attitude through your body language, Close your mouth and breathe through your nose. Remember to hold your head vertically as though your chin is supported. Place your knees directly over your ankles with your feet planted firmly on the ground. This will make you appear grounded and secure, giving your answers added authority. Telltale signs of nervousness include fidgeting; picking at fingernails; scratching your face, head, neck or chest. They give the impression that you’re uncomfortable in this new environment and make it difficult for interviewers to have faith in your abilities. Watch yourself on video to check whether you demonstrate any of these behaviors: Replace a nervous gesture with another action. Let your hands rest on the desk or table in front of you. If there isn’t a surface, rest them in your lap. Keep your fingers closed to demonstrate confidence and control Use accessories to enhance your image: Decide what image you want to project and choose good quality accessories to project this.

Article / Updated 07-10-2023

Any number of different disciplines are involved in mental illness treatment and working with people with mental disorders. Psychological testing, however, is considered the sole domain of psychologists. Although some professionals, including school counselors and learning disability specialists, conduct psychological testing, their testing is limited in scope and to a specific problem. Psychologists are thoroughly trained in all aspects of psychological testing and are the primary professionals in this area. Testing formats include surveys, pencil-and-paper tests, exercises and activities (like putting a puzzle together), interviews, and observation. Psychological testing focuses on the subject matter of psychology, behavior, and mental processes. Intelligence tests Intelligence tests may be the most frequently administered type of psychological test. They measure a broad range of intellectual and cognitive abilities and often provide a general measure of intelligence, which is sometimes called an IQ — intelligence quotient. Intelligence tests are used in a wide variety of settings and applications. They can be used for diagnostic purposes to identify disabilities and cognitive disorders. They’re commonly used in academic and school settings. Intelligence tests have been around since the beginning of psychology as an established science, dating back to the work of Wilhelm Wundt — one of the founders of psychology — in the early 20th century. The most commonly used tests of intelligence are the Wechsler Adult Intelligence Scale, 4th Edition, for adults, and the Wechsler Intelligence Scale for Children, 4th Edition, for children. Each of these tests contains several subtests designed to measure specific aspects of intelligence, such as attention, general knowledge, visual organization, and comprehension. Both tests provide individual scores for each subtest and an overall score representing overall intelligence. Neuropsychological and cognitive tests Although not a new field, tests of neuropsychological functioning and cognitive ability, related specifically to brain functioning, are rapidly becoming a standard part of a psychologist’s testing toolset. Neuropsychological tests have traditionally been used to augment neurological exams and brain imaging techniques (such as MRIs, CT scans, and PET scans) but they’re being used more widely now in psychoeducational testing and other clinical testing situations. The technology of scanning techniques picks up on the presence of brain damage, but neuropsychological tests serve as a more precise measure of the actual functional impairments an individual may suffer from. Scans say, “Yep, there’s damage!” Neuropsychological tests say, “. . . and here’s the cognitive problem related to it.” Neuropsychological testing is used in hospitals, clinics, private practices, and other places where psychologists work with patients who are suspected of neuropsychological impairment. People suffering head trauma, developmental disorder, or other insults to the brain may need a thorough neuropsychological examination. A popular neuropsychological test is a collection of tests called a test battery. The Halstead-Reitan Neuropsychological Test Battery includes tests that measure neuropsychological constructs, such as memory, attention and concentration, language ability, motor skills, auditory skill, and planning. Completing the battery requires several hours, and it’s never done in one sitting. However, when conducted by a competent professional, the testing can yield a tremendous amount of helpful information. Many neuropsychological instruments are available; some are comprehensive, like the Halstead-Reitan, and some are designed to measure a specific function such as language or attention. A neuropsychological evaluation is conducted using a comprehensive instrument or a collection of individual instruments to create a profile of neuropsychological strengths and weaknesses. The following areas of neuropsychological functioning are typically assessed: Executive Functions: Focusing, planning, organizing, monitoring, inhibiting, and self-regulating Communication and Language: Perceiving, receiving, and expressing self with language and nonverbal communication Memory: Auditory memory, visual memory, working memory, and long-term memory Sensorimotor Functions: Sensory and motor functions, including hearing, touch, smell, and fine and gross muscle movements Visual-Spatial Functions: Visual perception, visual motor coordination, visual scanning, and perceptual reasoning Speed and Efficiency: How fast and how efficient thinking is

Article / Updated 07-10-2023

Psychological tests are part of the entire psychological assessment process. Assessment is a set of scientific procedures used to measure and evaluate an individual’s behavior and mental processes. Psychologist Anne Anastasi (1908–2001), a past president of the American Psychological Association, defines a psychological test as an objective, standardized sample of behavior or mental processes. Nearly all topics in psychology can be measured with a test. Clinical tests Clinical psychologists (psychologists who work with mental disorders and abnormal behavior) typically use clinical testing as a way to clarify diagnoses and assess the scope and nature of a person’s or family’s disturbance and dysfunction. Specific tests are designed to assess the extent to which a patient may or may not be experiencing the symptoms of a particular disorder. These are diagnostic tests. Behavioral and adaptive functioning tests are two types of clinical tests that determine how well a person is doing in her everyday life and whether she exhibits specific problem behaviors. A common instrument used with children is the Child Behavior Checklist, which assesses the extent of a child’s behavior problems. Another commonly used clinical test is the Conner’s Parent Rating Scale, which detects attention deficit/hyperactivity disorder (ADHD) symptoms. In addition to disorder-specific inventories and tests, a wide variety of tests designed for other purposes lend themselves to the diagnostic process. Intelligence tests are designed to measure intelligence, but they can also show signs of cognitive dysfunction and learning disabilities. Personality tests are designed to measure personality, but they can also provide helpful insight to the types of psychological problems an individual is experiencing. Educational and achievement tests Educational and achievement tests measure an individual’s current level of academic competence. Glen Aylward, chair of the Division of Developmental and Behavioral Pediatrics at the Southern Illinois University School of Medicine, identifies three major purposes of this type of testing: Identify students who need special instruction. Identify the nature of a student’s difficulties in order to rule out learning disabilities. Assist in educational planning and approach to instruction. A typical educational/achievement test assesses the most common areas of school activity: reading, mathematics, spelling, and writing skills. Some tests include other areas such as science and social studies. A popular achievement test in use today is the Woodcock-Johnson Psychoeducational Battery, Revised. The test consists of nine subtests, measuring the standard areas of instruction but in more detail (mathematics is broken down into calculation and applied problems, for example). When a student has a hard time in school, it’s not unusual to administer an achievement test. Sometimes, students have a difficult time because they have a learning disability. Part of identifying a learning disability is assessing the student’s achievement level. Other times, a student struggles because of non-academic difficulties including emotional problems, substance abuse, or family issues. An achievement test sometimes helps to tease out these non-academic problems. Personality tests Personality tests measure many different things, not just personality. Numerous tests are designed to measure emotion, motivation, and interpersonal skills as well as specific aspects of personality, according to the given theory on which a test is based. Most personality tests are known as self-reports. With self-reports, the person answering questions about herself, typically in a pencil-and-paper format, provides the information. Personality tests are usually developed with a particular theory of personality in mind. A test may measure id, ego, or superego issues, for example, if it originates from a Freudian view of personality development. MMPI-2 Perhaps the most widely used personality test in the United States is the MMPI-2, The Minnesota Multiphasic Personality Inventory, 2nd Edition. Almost all American psychologists are trained to use the MMPI-2, which is considered to be a very reliable and valid instrument. A patient’s results from a MMPI-2 test provide rich information about the presence of psychopathology and level of severity, if present. The test’s results also reveal information about the emotional, behavioral, and social functioning of the test taker. A lot of psychologists use the MMPI-2 as a way to check the accuracy of their observations and diagnoses. The MMPI-2 test consists of 567 individual items and produces a score on nine clinical categories or scales. If a score is over a specific cutoff, it usually gets the attention of the psychologist administering the test. Psychologists consider such scores to be of clinical significance. The MMPI-2 covers a wide variety of areas, including depression, physical complaints, anger, social contact, anxiety, and energy level. Projective personality tests Projective personality tests are a unique breed of test. When most people think of psychological testing, these kinds of tests come readily to mind. The stereotype involves sitting across from a psychologist, looking at a card with smeared ink or a picture of somebody doing something on it, and answering questions like “What do you see here?” (You can take a free, mock personality test at here.) Projective personality tests are based on the projective hypothesis, which states that when presented with ambiguous stimuli, people project parts of themselves and their psychological functioning that they may not reveal if asked directly The idea is that many people can’t exactly describe what’s going on mentally and emotionally because of psychological defense mechanisms. Projective tests get past the defenses and penetrate the deep recesses of the psyche. Perhaps the most popular projective personality test and maybe even the most popular psychological test of all time is the Rorschach Inkblot Test (RIT). The RIT consists of ten cards, each with its own standard inkblot figure. None of these inkblots are a picture or representation of anything. They were created by simply pouring ink onto a sheet of paper and folding it in half. The only meaning and structure the cards have are provided by the projections of the test taker himself.

Article / Updated 07-10-2023

Bipolar disorder and borderline personality disorder often share many of the same symptoms — mood shifts, emotion dysregulation, impulsivity. Prior to settling on a diagnosis of bipolar disorder, your doctor should consider borderline personality disorder, among other conditions with symptoms that overlap with those of bipolar disorder. Treatment for bipolar disorder and borderline personality disorder differ significantly, so determining which condition a person has plays a major role in selecting the most effective treatments. The following sections present guidelines for distinguishing between bipolar disorder and borderline personality disorder. Considering whether symptoms represent a deviation from a person's baseline A core diagnostic feature that's helpful in distinguishing between bipolar disorder and borderline personality disorder is whether the symptoms represent a deviation from a person's usual moods and behavior: Borderline personality disorder describes patterns of ineffective interpersonal skills and poorly modulated emotional and behavioral responses to the ups and downs of day-to-day life. These patterns have developed since adolescence or even earlier, and the symptoms have always been present — they are part of the person's typical or baseline self. Bipolar disorder is a condition in which emotional and behavioral patterns emerge that differ from the person's typical or baseline self. For example, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) requires that a hypomanic (elevated mood and energy) episode be an "unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic." Distinguishing between situational and episodic symptoms Mood dysregulation in borderline personal disorder and bipolar disorder also differs according to whether the moods changes are situational and short-lived or episodic (lasting for an extended period of time): Borderline personality disorder is characterized by affective dysregulation — big, painful, emotional reactions to stimuli that wouldn't typically cause so much internal and external upheaval. People living with borderline personality disorder struggle chronically with feelings of anger, sadness, and anxiety that often trigger painful and damaging behaviors, such as explosive rages, impulsive actions, or self-harm. These frequent mood changes and behavioral responses are the baseline for a person with this disorder — they occur often and may occur minute-to-minute or hour-to-hour. Something, often frustration, perceived frustration, or fear of abandonment typically triggers the mood disruption in borderline personality disorder. Bipolar disorder is characterized by episodes of mania, hypomania, or depression that last for longer periods of time (days or weeks), are a change from a person's baseline, may occur without any clear trigger, and typically diminish significantly when the mood episode ends. Comparing the types of mood symptoms Although borderline personality disorder and bipolar disorder share some symptoms (for example, irritability that may result from and lead to interpersonal conflict), their symptoms differ: Borderline personality disorder mood symptoms tend toward chronic feelings of irritability/anger, sadness/emptiness, and anxiety. Euphoric feelings aren't part of the diagnostic criteria for borderline personality disorder. Bipolar disorder requires at least one episode of mania or hypomania (elevated mood or euphoria). Mood symptoms in bipolar disorder — specifically mania or hypomania — almost always include some periods of euphoria and grandiose thinking — not just anger. (It can be just irritability/anger, but this isn't typical.) Comparing the nature of the impulsivity Borderline personality disorder and bipolar disorder share the symptom of impulsivity, but the nature of the impulsivity differs: In borderline personality disorder, the impulsivity is a chronic symptom; difficulty controlling or regulating behavior is a challenge that is part of everyday life. In bipolar disorder, impulsivity and disinhibited behaviors occur in the context of a manic or hypomanic period; they aren't chronic or baseline. And if someone is impulsive at baseline, the impulsivity must look significantly worse during a sustained period of time to qualify as a symptom of mania or hypomania. Differentiating bipolar depression from borderline personality disorder The depressive phase of bipolar disorder is also often confused with borderline personality disorder, because both conditions are characterized by periods of sadness that may be accompanied by irritability or anger. However, the two differ in the following ways: Borderline personality disorder is characterized by chronic sadness and anger, which again are part of the person's baseline self. Bipolar depression is episodic, not momentary, and is not limited to mood symptoms such as sadness, anger, or irritability. Bipolar depression is characterized by broader changes in function, which can include low energy and fatigue, diminished interest in activities normally considered pleasurable, changes in appetite or weight, sleeping too much or too little, moving slowly or having physical agitation, feelings of worthlessness or excessive guilt, diminished ability to think clearly or concentrate on a given task or make decisions, and recurrent thoughts of death or suicide. Determining whether they can occur together People with borderline personality disorder are at high risk of developing major depressive episodes and anxiety disorders. They can also develop bipolar disorder, but for both diagnoses to be present the bipolar symptoms have to be different from the person's typical way of behaving (the baseline self). The sadness or impulsivity or anger must differ significantly from the person's usual patterns and must be sustained for longer than just a few moments. Also, sustained euphoric/grandiose periods are almost always going to be present in bipolar disorder, and these must differ from the person's baseline thoughts, feelings, and behaviors. The differentiation between borderline personality disorder and bipolar disorder is often challenging, but important. If you're getting different diagnoses from different doctors, try to have a conversation with your doctor about why the doctor has made a particular diagnosis. Expressing your confusion and asking about your doctor's thought process is okay. If your current doctor is unwilling to have this conversation, consider exploring it with another doctor or therapist. You have a right to understand your diagnosis and have your questions answered.

Article / Updated 07-10-2023

Cognitive psychologists use the information processing model to explain cognition. This model assumes that human cognition is a lot like a computer and the way the human brain works is by processing information through a series of stages: Perception: Input stage. People need to encode information from the world in order to process it and then respond to it appropriately. In part, perception is guided by experience, which changes the way people see the world. If information is attended to, it’s transferred from perception to memory. Memory: Storage center. Information is stored in long-term memory and processed and used by short-term memory. All knowledge is stored in long-term memory. Thinking: A high-level cognitive function. Information from perception and memory is used to make decisions, to reason and to make deductions. Language: A high-level output stage of cognition. Often, the results of thinking need to be acted upon in terms of speaking or writing. The information processing model of cognition shows how information enters and leaves the mind.

Article / Updated 07-05-2023

To be a savvy consumer in the world of doctors and therapists, you have to assess your caregiver's credentials and qualifications, make informed treatment choices for your bipolar disorder, determine how you can tell if treatment is working, and know what to do if you begin feeling worse. This article provides a list of questions to ask a psychiatrist or therapist to obtain the information you need. (If you have other questions, write them down so you remember to ask them.) Research shows that medical outcomes improve dramatically when patients are empowered to ask questions and actively participate in their care. Don't assume that the doctor has all the answers and will tell you everything you need to know. Be proactive! You have the right to ask for clarification, simplification, or more information at any point in your care. How much experience do you have in treating bipolar disorder? Some psychiatrists and therapists are like general practitioners, whereas others specialize in particular areas, such as bipolar disorder, depression, anxiety disorders, or schizophrenia. Still others specialize in treating children and adolescents. Professionals who have more experience in treating bipolar disorder may be more attuned to the many ways people experience bipolar disorder and better equipped to sort through your history and ask pertinent questions to effectively identify patterns of your condition. They may also have a deeper range of experiences with different treatments and know how to apply their understanding of how people have responded to them over the years. Is it tough to get an appointment? If you can't get in to see your doctor or therapist when your moods begin to cycle, they can't help you much. So before you choose a psychiatrist or therapist, make sure that you won't have to wait three months before your next appointment. (Getting in for an initial appointment with the doctor may take more time because those appointments are longer.) Ask the office how far in advance you usually need to call to make a follow-up appointment so you can get an idea of how hard it is to get in to see this particular doctor or therapist. Can I contact you during a crisis? Nights, weekends, and holidays — the three times you most need your doctor or therapist, they're at home, spending time with their friends and family. The nerve of these medical people! Everybody, even doctors and therapists, needs some time off, but as a person with bipolar disorder, you need some numbers to call in a crisis. Doctors and therapists have a variety of systems for after-hours emergencies. Ask for your doctor's policy and procedures, which should include the following information: Office number: When you call the office after hours, a recorded message should provide instructions for emergency calls. After-hours number: Does the doctor use an answering service that can reach them? Do you call their cellphone or home phone for emergencies? Make sure you're clear about this. Name and number of the person who covers for the doctor or therapist when they're out: Doctors often take turns being on call. Emergency number of the hospital or mental health center where you should go in a crisis: If you're in the middle of a mental health crisis and you can't get in touch with your doctor, where should you go? Ask how long it typically takes your doctor or therapist to return calls if you need to leave a message. What's the diagnosis and how did you arrive at it? Sometimes a doctor prescribes medication without providing a final diagnosis, especially when some uncertainty exists. For example, if a patient is experiencing mania, the doctor may prescribe an antimanic medication without diagnosing bipolar disorder until they have the opportunity to rule out other possibilities. However, your doctor will have some ideas (working diagnoses, as they're often called) that drive their treatment choices. If your doctor doesn't mention a diagnosis, ask them to explain their thinking and the possible diagnoses they're considering. You have a right to understand what they think may be going on and why they're choosing particular treatment plans. How your doctor arrived at your diagnosis may be just as important as the diagnosis itself. Make sure your doctor has considered your family history, any prior mood episodes, the possibility of medication- or substance-induced symptoms, other medical conditions that may be causing symptoms, and aspects of your life that may be causing stress or sleeplessness or is otherwise contributing to symptoms. What's the treatment plan? Your doctor may hand you one or more prescriptions for antidepressants, antimanics, antipsychotics, or sedatives, but your medication doesn't make up your complete treatment plan. In most cases, you should have a doctor and a therapist; ideally, they work together to develop a treatment plan specifically for you. The doctor typically handles the medications, and the therapist deals with everything else, although some doctors are more actively involved in the bigger treatment picture. Your treatment plan should include the following: Medications Individual therapy, self-help, and lifestyle changes Family education and, possibly, family therapy Instructions on what to do if your moods begin to cycle Whenever your doctor recommends a change in medication, be sure to ask what the goal of the change is and how you and your doctor will evaluate whether the change met its objective. In the real world, having ready access to a psychiatrist and therapist isn't always possible. In such cases, you may find yourself relying on your primary-care physician, self-help, lifestyle changes, family and friends, and community resources. When can I expect to feel better? Your doctor and therapist are likely to tell you to remain patient, but you should know upfront what patient means. A week? A month? Two months? In most cases, you can expect to see some improvement in one to two weeks, but some medications may take four to six weeks or even longer to become fully effective. Ask your doctor and therapist to be sure. Typically, your doctor will follow up with you two to four weeks after your initial appointment or after you start a new medication to assess the effectiveness of the treatment and monitor for side effects. If you're feeling very unstable, they may want to see you even sooner. If the doctor tells you to come back in more than one month after you start a new medicine, find out why they don't want to follow your situation more closely. How will I know I'm getting better? With bipolar disorder, feeling better may convince you that you are better even when you're not, particularly if you're cycling into mania. Ask your doctor for more objective signs that your mental health is improving. When an episode of depression is lifting, you may experience these signs: Sleeping more regularly and getting better-quality sleep Doing more with less effort — in other words, better energy Socializing more Crying less Diminished thoughts of death or suicide When recovering from an episode of mania, these signs may appear: More sleep in general and less restless sleep overall Sustained stability in thought patterns — not racing or flying from topic to topic Reduction in pressured speech (rapid, nonstop talking) More typical energy and activity levels Fewer and less intense confrontations with others Improved ability to control impulses Less irritability What should I do if I feel worse? Getting just the right combination of medications requires communication between you and your doctor. Being able to get in touch with your doctor between visits is especially important when you're first starting medicine. Some medications may not work for you or may have an adverse effect on you. If your condition fails to improve or worsens or if you have a bad reaction to the medication (such as a rash or shortness of breath), contact your doctor, who may suggest one or more of the following steps: Stop taking the medication. Keep taking the medication to see whether the side effect settles down or the desired effects kick in and then call or come in to the office in a few days. Take a lower dose of the medication. Take a higher dose of the medication. Add something else to the medication. Be sure to follow up all these actions with additional phone calls or office visits to further optimize your treatment plan. How did you pick this medicine and what can happen when I take it? Most doctors hand you a prescription for the medications they think are going to be most effective and have the least chance of causing serious side effects. The doctor should always review with you how they chose this medicine over other ones (alternatives) and carefully review the potential effects and side effects of the medicine they have chosen to prescribe. Make sure that your doctor has answered the following questions for you before they reach for the prescription pad: How effective is the medication at treating the symptoms I have? Are there more effective medications? What are the potential risks and side effects of this medication, and what are the chances that I'll experience them? Are there any medications that may have fewer, less serious side effects? How will this medicine interact with other prescribed medications and over-the-counter products and with other substances including alcohol and caffeine? Make sure you always know the possible side effects and interactions of a medication before you begin taking it so you know what to watch for. Armed with a list of the most common and most serious potential side effects, ask what you should do if you notice any signs that you may be experiencing one of them. Will you work with my other providers? Coordinated treatment, especially between your doctor and therapist, is an essential component of success. Ask your doctor and therapist if they're willing to exchange notes. Make sure they have each other's contact information and signed consent forms that enable them to share information. If you want family members, friends, and other nonprofessionals to enter the treatment discussion, ask the doctors if they're willing to talk with the people in your support network. Your doctor and therapist can't legally discuss your condition or treatment with anyone unless you've signed consent forms for them.

Cheat Sheet / Updated 07-03-2023

Everyone feels special from time to time. Maybe you finally get that promotion you’ve had your eye on at work, or your closest friends surprise you with a birthday bash. But narcissists feel uniquely special all the time and expect to be treated accordingly. This unfounded belief in their own superiority often creates distressing conflict in personal and/or professional relationships. Narcissism is a set of personality traits that lie on a continuum. In other words, some people are a little bit narcissistic while others are very much so and may be diagnosed with narcissistic personality disorder (NPD). When you’re dealing with a narcissist, it can be helpful to recognize the common tactics narcissists use and distance yourself from them to preserve your own emotional well-being.

Cheat Sheet / Updated 05-12-2023

Want to find out more about how to be the person you’ve always wanted to be? This Cheat Sheet tells you how to act "as if." Explore how to behave without giving the game away. Try a few easy exercises that will strengthen your body.

Article / Updated 05-03-2023

When you have bipolar disorder, you're encouraged to chart your moods, sleep, and energy levels daily to record patterns that may help you spot the early warning signs of a developing mood episode (mania or depression). In addition, this log provides valuable information to guide your doctor and therapist in their treatment decisions. Print this version of the mood chart and make as many copies as you need — or feel free to make your own, if you're spreadsheet-savvy. In the column for each day, record the following: Mood level: Place a check mark in the box that represents your overall mood for that day, which ranges from –5 (Depressed) to +5 (Manic). Hours sleep: Record the total number of hours you slept. Assigning sleep hours for a day can get tricky, because you're likely to fall asleep late one day and wake up early the next day. Consider assigning sleep hours to the night before. For example, if you slept from 10 p.m. Sunday to 6 a.m. Monday, assign those hours to Sunday (add in any nap time from during the day on Sunday). Energy level: Write a number from 0 (no energy) to 5 (supercharged) in the Energy level box. Notes: Jot down notes, such as a change in medication, exercise routine, or diet. Bring your mood charts to your doctor and therapy visits. Having this type of document to point back to and reflect on can be a powerful tool.

Article / Updated 05-03-2023

When choosing whether to take the name-brand or generic version of a medication for bipolar disorder, you and your doctor may want to consider the possible differences. Many people wonder whether name-brand medications are any better or even any different from their generic equivalents. Although the Food and Drug Administration (FDA) regulates both name-brand and generic medications, how those regulations apply to generic medications can lead to differences in how effective the medication is and in the side effects it causes, even when the generic has the same amount of the same active ingredient(s) as the name-brand version. The following sections provide the guidance you need to make well-informed choices between generics and name-brand medications. Consider the cost Most of the time for most people and with most medicines, generics are equivalent products and work just fine. The choice is usually straightforward: With the generic costing less, working just as well, and having the same or similar side effect profile, the more affordable generic is the better choice. However, in a minority of situations, the name-brand product is the better choice. In some cases, cost can be the determining factor in whether the person is able to obtain and take the medication. Being able to afford medications is critical for people to take the right amount of medication and to keep taking it. If the medicine is too expensive, people sometimes try to ration their medicines by lowering or skipping doses or even stopping a medicine entirely. Oddly, in certain situations, insurers cover the cost of a certain name-brand medication but not its generic. This is usually related to a financial arrangement between the insurance company and the pharmaceutical company that makes the name-brand product. Similarities between name-brand and generic medications According to the FDA, generic medications contain the same active ingredients as their name-brand counterparts, so theoretically, they should be equally effective, and in most cases they are. Here's how the two are similar: Same active ingredient(s): The vast majority of generic medications contain the same active chemical as in the name-brand version. Very similar bioequivalence: The generic version of the medication must be bioequivalent to the name brand. To be bioequivalent, the bioavailability of the generic must be very similar to that of the original medication. Bioavailability represents the amount of active chemical that gets into the system and the rate at which it does so. The bioavailability of the generic doesn't have to be identical to that of the original medication; it can be between 80 and 125 percent of the name brand. This may sound like a wide variation, but for most medications, in most people's bodies, the difference doesn't seriously affect how the generic works or the side effects it causes when compared to the name brand. Differences between name-brand and generic medications Although the generic is required by the FDA to deliver nearly the same amount of the same active ingredient(s) at about the same rate as the name-brand version, response to differences in the two can become more pronounced in the following areas: Individual response: How a person's body absorbs and then breaks down the medication can affect their response to a medication that's more or less bioavailable. If you change from a name brand to a generic, or vice versa, and you feel differently on it, let your doctor know. Medication class: Certain classes of medications have had some difficulties with these differences in bioavailability. For example, anticonvulsants (medicines for seizures, that are also often used to treat bipolar disorder) have a narrow therapeutic window, which means that getting control of seizures can require extremely tight management of doses and blood levels (within very narrow ranges). Studies have suggested that although patients who are started on a generic brand of an anticonvulsant may do well, changing from a previously well-managed dose of name brand to a similar dose of generic may cause reduced control of seizures. No specific studies show the same challenges with preventing mood cycles, but you and your doctor should consider and discuss the possibility. Extended-release versions: Long-acting versions of medications can be more difficult for generic companies to duplicate. In 2012, the FDA withdrew approval for a particular type and dose of a generic form of the long-acting antidepressant Wellbutrin XL. After patient and doctor complaints, the FDA tested and found that the generic version was only about 40 percent as bioavailable as the name brand. Other generic versions (by other manufacturers) were bioequivalent, but this one was withdrawn from the market. A similar incident happened recently with a generic version of the long-acting ADHD medication Concerta. Fillers: Medications include a variety of fillers and dyes that create the actual pill. Individuals may have more or less tolerance for these inactive ingredients (whether they're in the generic or name-brand version); they may even experience allergic reactions to them. Dealing with differences between generics of the same medication One downside to using a generic product is that a number of different manufacturers typically make the same product, and pharmacies may change suppliers to manage cost or supply levels. So, even though you may be stable on a generic version of your medicine, when you switch to a different generic, your response could change. With anti-seizure medications, this can be especially risky, but it could affect benefits or side effects in less dangerous but very important ways with other kinds of medicine, as well. Another concern is that the generic may look different depending on the manufacturer, which isn't usually a big problem, but it can cause challenges for certain populations, such as the elderly, who may experience confusion with that kind of change, or children, who may have difficulty swallowing a pill if it is much larger, for example.