Archive for October, 2008

Learn, Vote, Matter

Tuesday, October 14th, 2008

As we in the U.S. near our national election, I encourage every eligible citizen to vote, and vote responsibly.

Research the issues and candidates, and then elect officials who will represent you appropriately and who will make a positive difference in the lives of those living with mental illness.

And how do you know which candidates will work to achieve the legislation you favor?

One way is to turn to the Web.

For starters, check out the official sites for Barack Obama and John McCain by clicking on their names here. Read their official statements and policies rather than the pundits’ and pols’ opinions thereof.

Learn the facts.

Make up your own mind.

Next, go to www.FactCheck.org, a nonpartisan, nonprofit project of the Annenberg Public Policy Center of the University of Pennsylvania, for an unbiased look at the facts behind most political ads and comments made by U.S. politicians.

For detailed analyses of election news, health policy, and the candidates’ views on medical issues, go to Health08, sponsored by the Kaiser Family Foundation, were you’ll also find videos, podcasts, schedules and current events.

Lastly, if you want to know what your peers are thinking, go to www.PollingReport.com, an independent, nonpartisan resource where you can research public opinion polls and their responses.

Become Informed.

Know what’s important and make up your own mind.

Be heard.

VOTE!

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The Link Between Creativity & Mood Disorders

Monday, October 13th, 2008

Last week, CNN’s Elizabeth Landau wrote an insightful article regarding creativity and mood disorders. It is excerpted below.

The works of David Foster Wallace, who committed suicide September 12, are famous for their obsessively observed detail and emotional nuance.

David Foster Wallace reportedly battled depression for 20 years. Certain characteristics of his prose — hypersensitivity and constant rumination, or persistent contemplation — reflect a pattern of temperament that some psychology researchers say connects mental illness, especially bipolar disorder and depression, with creativity.

There have been more than 20 studies that suggest an increased rate of bipolar and depressive illnesses in highly creative people, says Kay Redfield Jamison, professor of psychiatry at Johns Hopkins University and author of the “An Unquiet Mind,” a memoir of living with bipolar disorder.

Experts say mental illness does not necessarily cause creativity, nor does creativity necessarily contribute to mental illness, but a certain ruminating personality type may contribute to both mental health issues and art.

“Unquestionably, I think a major link is to the underlying temperaments of both bipolar illness and depression, of reflectiveness and so forth,” Jamison said.


This theory could help explain why eminent artists throughout history, from composer Robert Schumann to poet Sylvia Plath to Wallace — suffered mood disorders.

“It’s pretty clear if you read [Wallace's] books that he was a very obsessive, kind of ruminating guy,” said Paul Verhaeghen, associate professor of psychology at Georgia Institute of Technology.

“You can see it in his sentences. … They’re breathless and they need to be annotated, and the annotations need to be annotated again.”

The research of Verhaeghen and colleagues shows when people are in a reflective mode, they may become more creative, depressed, or both. Previous research shows that when people are in a ruminating mode, they are more likely to be depressed, he said.

“If you think about stuff in your life and you start thinking about it again, and again, and again, and you kind of spiral away in this continuous rumination about what’s happening to you and to the world — people who do that are at risk for depression,” he said.

Verhaeghen, who is also a novelist and describes himself as a “somewhat mood disordered person,” had a particular interest in the connection between creativity and this ruminating state of mind.

“One of the things I do is think about something over and over and over again, and that’s when I start writing,” he said.

Sensitivity to one’s surroundings is also associated with both creativity and depression, according to some experts.

Creative people in the arts must develop a deep sensitivity to their surroundings — colors, sounds, and emotions, says Mihaly Csikszentmihalyi, professor of psychology and management at Claremont Graduate University in Claremont, California. Such hypersensitivity can lead people to worry about things that other people don’t worry about as much, he said, and can lead to depression.

“The arts are more dangerous [than other professions] because they require sensitivity to a large extent,” he said. “If you go too far you can pay a price — you can be too sensitive to live in this world.”

Terence Ketter is professor of psychiatry and behavioral science at Stanford University.

Ketter and his colleagues compared a healthy control group with bipolar patients, depression patients, and a control group of graduate students in writing and the arts.

They found that people with bipolar disorder scored better — up to about 50 percent higher — on creativity tests than the healthy control group. The creative control group had about the same increase in score relative to the healthy control group.

But more research is needed, says Ketter. The study does not explain the connection or show a causal relationship, he said.

Some have pointed out that being engaged in creative pursuits makes a person more open to experience, while others say the pressure of being engaged in the arts causes negative emotion, according to Ketter.

Still, the temperamental characteristics in question are thought to be somewhat inherent.

“It’s a little hard to argue that engaging in creative activity could create the temperament, and it may be a little bit more possible that this temperament gives you a creative advantage,” he said.

Verhaeghen’s theory that rumination contributes to negative emotions generally sounds plausible and in some ways consistent with his own views, said Ketter.

Many hope that this type of research will be helpful in developing better strategies to manage and detect mental illness. These strategies can sometimes mean the difference between life and death.
“Tragically, mood disorders can still present a sudden death in people who have been undiagnosed and untreated, and die from the illness,” says Ketter.

More specifically, Ketter says, just as heart disease sometimes presents itself for the first time as a fatal heart attack, mental illness sometimes presents itself for the first time as a suicide.

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National Depression Screening Day

Friday, October 10th, 2008

DEPRESSION…

…is the leading cause of disability in the U.S. for ages 15-44.

…affects approximately 14.8 million American adults, or about 6.7 percent of U.S. adults.

…is more prevalent in women than in men.

…is a state of mind in which the things that used to make you happy no longer do.

…is sometimes called “the blues” or being “down in the dumps.”

…is very common after some of life’s most cruel events, like death, divorce, or disappointment.

… takes the joy out of life.

…steals your energy and makes you feel like there is no hope, no reason to go on.

…makes getting dressed and out of the house feel like climbing a mountain.

…diminishes overall health and exacerbates other problems.

…is not just a rare day of sadness.

HERE ARE SOME COMMON SYMPTOMS OF DEPRESSION:

  • persistently sad or irritable mood
  • pronounced changes in sleep, appetite, and energy
  • difficulty thinking, concentrating, and remembering
  • physical slowing or agitation
  • lack of interest in or pleasure from activities that were once enjoyed
  • feelings of guilt, worthlessness, hopelessness, and emptiness
  • recurrent thoughts of death or suicide
  • persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic pain

DEPRESSION…

can sometimes be prevented, and can always be treated.

If you are depressed, it can be hard to believe that life can get better again - but it can. Getting help for depression can give you your life back. Start with the links below to learn more; and make an appointment with your doctor if you or someone you love is depressed.

Especially for college students:

ULifeline

The Jed Foundation

National Alliance on Mental Illness Depression Fact Sheets

Depression and Bipolar Alliance Fact Sheets

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College Kids–Get Help NOW!

Thursday, October 9th, 2008

ESPECIALLY FOR COLLEGE STUDENTS AND THEIR FAMILIES

You should know that, as a college student, it’s easier to get professional help now than it may be after you leave school. This doesn’t mean you won’t run into any problems, but now is the time to get help. You’ll find confidential on-campus resources at your school’s counseling center, health center and places like a Women’s Center on your campus.

Students sometimes feel embarrassed or scared to seek help. Talking about your problems actually takes an immense amount of strength, and it’s important to move past the stigma surrounding mental health issues and get the help you need.

Often, the best place to start is your school’s counseling center. Visit its website or call its main number to find out what they can offer you.

Most on-campus centers provide two to eight free visits, so you can use their confidential services free of charge.

Counseling centers can offer a range of services, from individual sessions with psychologists or social workers, to group sessions for people who share a common issue (such as body-image issues, grief and loss, or academic anxiety), to sessions with psychiatrists. Since services vary campus to campus, your best bet is to find out exactly what your school offers.

If your school doesn’t have a counseling center, check with the school’s health center; mental health professionals may be able to see you there.

Some counseling centers may disclose information to the school administration if a student is suicidal or has thoughts of hurting him- or herself. You have a right to know if your school’s counseling center has such a policy and if the center plans to do this in regard to your situation.

Some schools have policies that require students who disclose self-injurious thoughts or acts to take an involuntary leave of absence; they may require students who have been hospitalized to be cleared by the counseling center before they can return to classes or live on campus. Check your school’s leave policies, code of conduct and residence hall contracts, or ask the counseling center or dean of students about the school’s policies and practices

You also want to look into what health insurance you have (if you have it) and what it covers. Some plans don’t cover mental health care at all while others have limits on the number of visits. If you don’t want to see a clinician on campus, or if the number of visits your counseling center will allow you isn’t enough, your insurance policy may dictate what outside options are available for you. Be aware that if you are on your parents’ health insurance, they may learn that you are receiving treatment from the insurer. Ask your insurance company about its billing practices.

Even if you have no insurance, there are agencies in most communities that offer services on a sliding scale. You can find them listed under “counseling,” “social service agencies” and similar categories. Many religious groups operate family service agencies that provide a range of counseling services.

If you choose not to seek services on campus, your school’s counseling center can be a resource for referral to practitioners and programs off-campus. You may end up seeing a psychologist, psychiatrist or social worker in a private practice near your campus or in your hometown. You can also go to a family doctor to discuss your symptoms, though it is a good idea that you follow up with a mental health professional since a general practitioner is not the most knowledgeable about mental health issues.

Check out ULifeline, an online resource that provides information about mental health issues and professional resources on and around many campuses, you can get additional information at your school’s counseling and psychological services center.

°Thank you, Bazelon Center for Mental Health Law

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Mental Health Awareness Week

Wednesday, October 8th, 2008

I spent two days on college campuses this week, talking to parents and students about mental health and mental illness. So many questions arose, so many kids suffer unnecessarily.

Here are some of the facts, as published by the Bazelon Center for Mental Health Law:

  • Many college students suffer from anxiety, depression and other mental health concerns.
  • Anxiety is the issue most often mentioned by college students who visited campus mental health services.
  • Students also named depression as one of the top ten impediments to academic performance as well as stress, sleep difficulties, relationship and family difficulties
  • In the 2006 National College Health Assessment, 43.8% of the 94,806 students surveyed reported they “felt so depressed it was difficult to function” during the past year, and 9.3% said that they had “seriously considered suicide” during the year.
  • More than 30% of all college freshmen report feeling overwhelmed a great deal of the time-college women, even more (about 38%).
  • In 2006, more than 13% of college students reported experiencing an anxiety disorder within the previous year.
  • While anxiety disorders are common for both genders, women are five times as likely to have them.
  • Eating disorders affect 5-10 million women and one million men, with the highest rates occurring in college-age women.
  • Thirteen percent of students reported experiencing an emotionally abusive relationship in the last school year.

If you are experiencing depression, anxiety, mood swings, sleep disturbances, delusions or hallucinations, or if you feel overwhelmed, immobilized, hopeless or irritable, there is treatment that can help.

You may also benefit from therapy to address common issues such as body image or low self-esteem, to help with a crisis involving your relationship or family, or if you are in the middle of a transition, such as beginning a new school.

Students who seek treatment are not “weak” or “crazy.”

Therapy is a hopeful and affirming act of caring for yourself.

If you are affected by any of these mental health issues, contact your primary care physician or your campus’ college and psychological services.

You can feel better.

Treatment works.

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Tonight’s The Night!

Tuesday, October 7th, 2008

Turn the page…

Understand mental illness…

Have your questions answered…

Join the real-time, online discussion of MOMMY I’M STILL IN HERE with author Kate McLaughlin.

Ask your questions, make your comments, discuss mental health issues live.

Tonight! October 7 at 6 p.m. PST. In order to do so, you must first join Mom Blogger’s Club.

A few minutes before 6, sign in to MBC, go to the “Forum” tab in the Mom Bloggers CLUB header and click on “chat”.

Discussion will begin at 6 p.m. PST, so enter the chat room a few minutes early and be ready with questions, comments and a lively exchange of information and ideas.

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Tomorrow Night–Online Book Group

Monday, October 6th, 2008

As a regular blogger and contributor at Mom Bloggers Club, I recently sponsored a giveaway, providing free copies of MOMMY I’M STILL IN HERE to the first 10 respondents.

The books were spoken for within the hour and many others ordered copies in order to join the online book group meeting I promised.

If you read the book and would like to talk about it, ask questions, or share your perceptions, you are invited to join the meeting tomorrow night.

Here’s How:

Join the real-time, online discussion of MOMMY I’M STILL IN HERE with author Kate McLaughlin tomorrow, Tuesday October 7 at 6 p.m. PST. In order to do so, you must first join Mom Blogger’s Club.

A few minutes before 6, sign in to MBC, go to the “Forum” tab in the Mom Bloggers CLUB header and click on “chat”.

Discussion will begin at 6 p.m. PST, so enter the chat room a few minutes early and be ready with questions, comments and a lively exchange of information and ideas.

Contact me here if you have any questions…This is gonna be fun!

Economic Crisis = Mental Health Parity

Friday, October 3rd, 2008

The View from Virginia

Despite scientific proof that mental illness is genetic, not unlike diabetes, cystic fibrosis and muscular dystrophy, insurance companies have always limited benefits for the treatment of mental illness.

Even as researchers and social scientists demonstrated actual cost savings if treatment and prevention were equitably funded, insurance company power brokers refused to budge. Consumers had to find a way to force movement away from their archaic, discriminatory views.

So for years mental health organizations like Mental Health America, National Alliance on Mental Illness, and Depression Bipolar Support Alliance have worked from the grass roots level to the floor of Congress to win enactment of legislation ending discrimination in mental health coverage.

Today we won!

With House passage of Emergency Economic Stabilization Act - 263-171, Congress has at last adopted mental health/addiction parity legislation. It took a national financial crisis and an unprecedented federal bailout to create fairness for 20% of America’s citizens. Unbelievable!

With speedy presidential approval assured, more than 100 million Americans will gain equitable coverage and improved access to needed mental health care.

So many will benefit. So many will live.

It’s about time.

More Gain, Less Weight

Thursday, October 2nd, 2008

This afternoon I spoke with a woman whose daughter was finding relief from symptoms of bipolar disorder after several years of mood swings, cycling, and dreams lost along the way. One caveat to her wellness…”She’s only gained 6 pounds, but she works out like mad to keep the weight off. Her doctor warned us it could be 20 pounds or more, so she’s doing well.” Keep in mind this young woman has been in treatment for only about 6 months. A pound a month, and she “works out like mad?” Most of us would not consider this successful treatment.

Therein lies one of the elemental flaws in the modern medical treatment of mental illness. Quality of life is vastly improved in some areas, but other long-term health complications are created. It is these issues that result in the seriously mentally ill having an average life-span 10-20 years shorter than otherwise healthy individuals. It is these issues that prevent patients from being medically compliant. The cost is often too high.

But things are changing. The  National Institute of Mental Health has funded research to find alternative treatment plans that will reduce or eliminate some of the most pervasive negative side effects. Below is an article from this weeks NIMH Science Update:

A new NIMH-funded grant will examine ways to control the metabolic side effects associated with the use of the newer atypical antipsychotic medications in children with schizophrenia or bipolar disorder.

The use of atypical antipsychotic medications to treat children and adolescents with schizophrenia or bipolar disorder is relatively common, but the side effects associated with them are troubling. The recent NIMH-funded Treatment of Early Onset Schizophrenia Study (TEOSS) found that two atypical medications were associated with more metabolic side effects than an older generation antipsychotic. The new grant will test ways in which the metabolic side effects, such as weight gain, insulin sensitivity and other factors that can lead to type 2 diabetes and heart disease, may be controlled or reduced.

Mark Riddle, M.D., of Johns Hopkins University, Linmarie Sikich, M.D., of the University of North Carolina Chapel Hill, and Christoph Correll, M.D., of the Feinstein Institute for Medical Research in New York, will recruit 240 overweight youths ages 8 to 17 who have been diagnosed with schizophrenia or bipolar disorder, who are currently being treated with risperidone (Risperdal), quetiapine (Seroquel) or olanzapine (Zyprexa), and who have gained at least 10 percent of their baseline body weight over the past year of treatment. The youths will be randomly assigned to one of three conditions:


  • Add metformin-a medication used to treat type 2 diabetes-to their current medication
  • Switch to aripiprazole (Abilify), another type of atypical antipsychotic;
  • Continue with their current medication (control group).


All of the participants will be closely monitored and provided with advice about healthy lifestyle, diet and exercise. The children and adolescents will be evaluated over a 24-week period to determine changes in weight, insulin sensitivity, and other metabolic factors. The researchers will also track the youths’ psychiatric symptoms, quality of life, and other side effects, and will track whether and when they discontinue treatment. The researchers anticipate that the study’s results will help determine better treatment options for children and adolescents with major psychiatric disorders who need long term treatment with antipsychotics.

This kind of forward, quality-of-life thinking is encouraging. As a society, we’re putting our money where out mouth is for appropriate consideration of needs and delivery of treatment to those whose genetics fate them to live with mental illness.

Bravo!

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Youth + Depression + Social Ills = Bad Mix

Wednesday, October 1st, 2008

Having endured numerous suicide watches with my two oldest children, I’m keenly aware of the sleepness nights, painfully tense shoulders and necks, and tears-ready-to-roll moments that parents experience when their kids are in such turmoil.

Since those same two kids have bipolar disorder with deep depressive phases, I also know the angst of watching a child slip further into the dark abyss and wondering if they will again survive.

Recently, the Agency for Healthcare Research and Quality conducted a study to determine which kids were at greatest risk of suicide.  Depression is obviously linked to suicide attempts, but the fact remains that most depressed youth do not attempt suicide. However, when depression is already a factor and key stressors like a romantic breakup, being assaulted, being involved in a fight, or an arrest take place, a suicide attempt is more likely to occur. Social trauma or drama is usually a tipping point.

Here is the data:

Joan R. Asarnow, Ph.D., and colleagues examined suicide attempts among 451 ethnically diverse depressed youth aged 12 to 21 years in the largest study of adolescent depression in primary care to date. In the past 6 months, 12 percent of these youths had attempted suicide. Those who attempted suicide were significantly more likely to be female (91.1 vs. 77 percent) and to have more severe depression.

After controlling for depression severity, only externalizing behaviors remained a significant predictor of suicide attempts, increasing the risk by 58 percent. After controlling for depression severity and externalizing behaviors, none of the other psychopathology factors (substance use, anxiety, and symptoms of post-traumatic stress disorder) contributed to the prediction of suicide attempts, although youth reporting suicide attempts had elevated substance use and anxiety symptoms, including post-traumatic stress symptoms. Suffering a romantic breakup or physical assault nearly doubled or tripled, respectively, the risk of attempting suicide.

See “Suicide attempts among depressed adolescents in primary care,” by Samantha R. Fordwood, M.A., Dr. Asarnow, Diana P. Huizar, B.A., and Steven P. Reise, Ph.D., in the Journal of Clinical Child and Adolescent Psychology 36(3), pp. 392-204, 2007.

Based on this information, parents and primary care doctors should ask depressed youth about these issues. Knowing a teen’s social situation may save his life.

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