Archive for January, 2011

January 30, 2011

Resource on Deep Brain Stimulation

BBC’s morning program, “BBC Breakfast,” had a 5-minute segment about deep brain stimulation, or DBS. DBS involves the use of electrodes which are implanted into the brain through holes drilled in the skull. The electrodes are attached to a battery pack which delivers small amounts of electricity to stimulate or inhibit specific areas in the brain. Around the world, more than 40,000 people have gone through this procedure. Deep brain stimulation has produced promising results in the treatment of diseases such as Parkinson’s disease, depression, obsessive-compulsive disorder, and dystonia. 

Laura, on my comment wall, also told me about a book on Deep Brain Stimulation by Jamie Talan, which she says is a great read for both physicians and laypeople. (There’s an extensive excerpt on the DANA Foundation site). Thanks, Laura!

Below is a PBS segment on deep brain stimulation.


Other links:



January 29, 2011

a therapeutic alliance

It is four weeks into 2011, and I have yet to settle into some sort of a routine. It’s not that I’m so busy as much as the fact that I’m just unorganized about activities, cleanliness—well, life in general. So, it’s probably no surprise that it took me until this week to actually call my psychotherapist, Dr. L, to make an appointment. (Why did it take me less of a time to schedule ECT? That, I do not know…)

It was my first time to see Dr. L for the year. I had not met with her in well over a month, so there was much that needed catching up. It was near the end of our session when she brought up that it’s almost been a year since I first started seeing Dr. L. Originally a referral from my psychiatrist Dr. A, I only expected to meet with Dr. L for just a few sessions of EMDR. But since that initial meeting, I felt like I ‘clicked’ with her, unlike with other therapists that I’ve seen while I was in college. And somehow, what was really supposed to be a short-term deal has turned into a relationship. And it’s a good thing, because according to a new study,  a good relationship between a patient and therapist is likely to improve the patient’s recovery from depression. Researchers from the University of Ghent in Belgium looked at the outcomes of 567 people with major depression who received six months of combined treatment with therapy and antidepressants. Sure, there were other factors that affected the rate of patient improvement, which included the initial severity of depression, a history of psychiatric disorders, job status and early improvement of depressive symptoms. But overall, a strong patient-therapist alliance meant a better progress in one’s condition. And I think I have an ally in Dr. L.

I scheduled a session for next week, of what will probably become one of many that I will schedule throughout this year. As I drive away from her office, I realize how lucky I am to her as part of my treatment team.

January 28, 2011

FDA Panel: More testing needed for ECT Machines

FDA panel advises more testing of ‘shock-therapy’ devices
by David Brown/Washington Post/1.28.2011

An expert panel advising the Food and Drug Administration decided Friday that electroconvulsive therapy (ECT) machines should undergo the same rigorous testing as new medical devices coming onto the market – a decision that could drastically affect the future of psychiatry’s most controversial treatment.

The majority of the 18-member committee said not enough is known about ECT, also known as “electroshock” or simply “shock” therapy, to allow the devices to be used without more research into its usefulness and hazards.

If the agency follows the panel’s advice, which it usually does, the two companies whose machines are used in the United States will have to provide evidence of the therapy’s safety and effectiveness either from existing research or new studies. If the FDA isn’t convinced, the devices could be removed from use.

The panel’s opinion is the latest chapter in ECT’s seven-decade history, during which the treatment has been lauded as a lifesaver, villified as a form of legally sanctioned torture, and has seen its popularity rise in recent years after a long decline.

ECT machines deliver an electrical current to the brain, inducing a generalized seizure in which the patient briefly loses consciousness. How that may be therapeutic or cause permanent memory loss – the side effect most frequently mentioned by patients – isn’t known. Read More

January 28, 2011

I can’t quit you

There’s a topic that’s come up from time to time in my posts. And it’s time once again to bring the topic up. Yes, the one about my relationship with zolpidem tartrate, commonly known as Ambien.  I’ve pledged previously to stop taking these little sleepy pills because it’s just not good to take them all the time. Even the Ambien company points out that side effects include next day drowsiness, headaches, sleepiness and dizziness. And when the company itself tells you about those issues, there’s clearly reason to stop. Despite all of these very clear reasons why I need to stop taking them, I have made my way back to the arms of this night-time companion (as pictured above).

I realize that if I’m serious about quitting, I need to devise a plan. And  How to Stop Taking Sleeping Pills and Stay Sane pretty much hashed out what I should watch for when choosing to get off sleeping pills.

  • Taper off gradually
  • Expect that you may have trouble sleeping for about 1 to 3 weeks
  • Be patient and know that it is temporary
  • Don’t be surprised if you dream more.
  • Might experience physical symptoms like anxiety, shaky hands, muscle tension and dizziness
  • Keep a sleep diary

There’s also the usual stuff that people should/shouldn’t do anyways if they want to get good sleep .

  • No caffeine after lunch
  • Wind down gradually before bed
  • No TV in the bedroom
  • Read in bed if it helps you
  • Practice relaxation exercises

Okay. Now that I’ve laid out some guidelines, I should be ready to leave behind this terrible habit, right? They say, old habits die hard.  Well, we’ll see just how hard…..

 

 

January 26, 2011

after-shock

photo taken while stopped at a red light

The sky is an eerie pale gray. Snowfall must be imminent, but right now it is raining.  I am driving through this rain that’s making everything around a blur. Such weather would understandably make anyone’s mood sink a bit, including mine, but today I feel fine.

People ask me what it feels like after ECT, and I always have a hard time putting it in some easy-to-understand example, but I feel like I just found it. Last week, everything seemed gray and a blur even when there wasn’t rain. My body moved a little slower amidst the rest of the world. Then, I had my ECT. It’s been almost a week since the treatment, and in general, my list of stuff-to-do and stressors hasn’t really been altered since before the little spark. But today, while I’m not seeing songbirds and butterflies, I don’t feel dragged down by a simple change in surroundings. I recognize the state around me, but I still feel awake, aware, and real.

Before having ECT, I think I kind of expected the post-ECT to be existing in a world that’s all shiny, bright and wonderful. Well, what I’ve found out is that I instead get to experience reality, not any better or worse, but for what it is. In short, I get life. And that’s ok with me.

January 24, 2011

Measuring the risk of ECT machines

UPDATE ON STORY–link here
This week, the FDA is re-evaluating the risk classification for electroshock devices/ECT machines, which is currently classified as high-risk. American Psychiatric Association and other specialists wants to see the devices downgraded to a medium-risk category, which would mean that the equipment could be promoted and sold without new testing. Such a downgrade would place the devices in the same risk category as syringes and surgical drills. If the F.D.A. leaves the devices in the high-risk category, however, manufacturers may, depending on the agency, have to withdraw them from the market. The F.D.A. could require safety and effectiveness tests that have not previously been done. By regulating the devices, the F.D.A. is indirectly regulating the procedure. The agency could make a formal decision later this year.

The F.D.A. usually, but not always, follows recommendations of its advisory panels. While that may often be the case, the road to actually getting there is filled with mixed comments from both sides.

Dr. James H. Scully Jr., medical director and chief executive of the American Psychiatric Association, wrote the F.D.A. recently to say the treatment was “extremely effective and safe.” It provides relief some 80 percent of the time, he wrote. Dr. Scully and the psychiatry association also say there is no evidence it causes brain damage.

A task force is updating the association’s 2001 recommendations on the treatment. Its report is at least a year away.

“People use it because it works,” said Dr. Laura J. Fochtmann, a member of the task force, professor and director of the Electroconvulsive Therapy Service at Stony Brook University Medical Center, Long Island.

“These disorders can be extremely life-threatening, and when it works, it can be dramatically effective,” she said.

Opponents of electroshock include some patient advocacy groups, but the opponents, clearly, are outnumbered among physicians.

Dr. Peter R. Breggin, author of more than a dozen books including one about electroshock and a consultant in personal injury cases involving drugs and the therapy, says he is the only American psychiatrist he knows who opposes the treatment.

“It’s a big money-maker,” he said. “I would say if anything it’s been on the increase because there’s a market that’s been exploited, that is the elderly depressed women on Medicare. The reason for that is they’re covered, and there’s no one to protect them. What commonly stops shock treatment is a family member saying ‘over my dead body.’ ”

Depressed older people, Dr. Breggin said, can be helped more by a pet or conversation.

Last year, two psychology professors, John Read of the University of Auckland, New Zealand, and Richard Bentall of Bangor University, Wales, criticized electroshock after reviewing studies comparing it with simulated treatment. Their findings were published in Epidemiologia e Psichiatria Sociale, a peer-reviewed European psychiatric journal. “The cost-benefit analysis is so poor that its use cannot be scientifically justified,” Dr. Read wrote in an e-mail.

John Breeding, a psychologist and member of the Coalition for Abolition of Electroshock in Texas, said that state had banned electroshock for youths under 16 and required second opinions for treating the elderly, giving it the strictest rules in the nation.

“It’s a very strong treatment for despair and hopelessness,” he said. “It’s a temporary blunting of your feelings, so you feel better for a while, then you feel worse, and now you’ve got the memory loss and brain damage.” (from NYTimes, FDA is Studying the Risk of Electroshock Devices)

While I don’t know if a syringe and a ECT machine have comparable risk factors, I can think of things like scalpels that could potentially cause huge physical harm. All I’m hoping for is that the FDA gives a ruling that would keep the option of electroconvulsive therapy open to all patients that are considering this treatment.

UPDATE (1.28.2011): FDA panel wants more testing

January 23, 2011

ECT Lessons-I’ve-Learned #10: When in doubt, talk.

I know I already have a “Lesson” titled “Communication is Key” but I thought I needed another lesson for myself to emphasize the importance of talking to your doctor. It’s been about two years since I first started ECT (about 1.5years since I started maintenance ECT), and I’m coming to a point where I am starting to question if I should keep on going with the process. After all, I am on medication and see a therapist…do I still need to have ECT?

As much as it is ultimately my decision to keep on going or stop the ECT, this really is something that should be discussed with your psychiatrist. S/he can evaluate your current condition to determine what treatment(s) would be best for you.  Quitting the process without talking to anyone may actually seriously affect your mental health….one that might cause you to have to go back to having ECT again.

In closing, I do think it’s a good thing to question your ECT treatments, because I don’t think this is something you should keep doing without putting any thought into it. But it’s really important that you open up to someone who has something to do with your treatments.

See the other “ECT Lessons-I’ve-Learned”

January 20, 2011

ECT #36: (my 21th maintenance treatment)

I had my 36th electroconvulsive therapy treatment today. I usually have the procedure every six weeks or so, but with being of town and other scheduling issues, it’s been at least two months since I had my last one.  I was the first ECT patient to arrive when I got to the hospital, so the staff set me up in the treatment room without realizing that my doctor, Dr. F, couldn’t actually come over for a while. So, with the cannula already in my arm, I laid in the bed for a good hour before he came.

Before giving me that ‘little spark,’ Dr. F checked in with me to see if I’m doing okay. I didn’t necessarily feel depressed, but I felt tired (perhaps still from my trip), so all I could tell him was I was doing okay. He made me rate my mood on a scale from 1-10 and asked me couple other things. Then, he asked me, “Do you think this is helping?”

I said yes at the time, but to be really honest, I can’t really tell anymore. It’s been a long time since I’ve had a life without having ECT, so I don’t really know what would happen if I decided to stop having them. I used to slip back into depression as it got around to the next ECT–maybe this little spark is sustaining my mood a little longer.

Usually I feel good immediately after the treatment, but today, even Nurse J told me that I looked really tired. And she was right. I ended up taking a long nap when I got home. Did it have more to do with the fact that I didn’t sleep well last night? I just don’t know.

My next ECT is in six weeks. Will I keep my appointment? Stay tuned…

January 19, 2011

judging a book by its cover

The UPS man just dropped off a box that we’ve probably all seen at our doorsteps—the one with that swishing arrow on the side of the package…yes, the Amazon.com box. My Amazon box usually contains a required textbook, but there’s still some sense of excitement in getting that Amazon package and getting to open it.

I admit I don’t read all the books that I buy, but I do love books, not always for reading them but for the physical existence of them. I love looking at the color and design of the cover, feeling those pages in my hands, and looking at the printed pages.

While I have bought books this past year, I haven’t been that excited to read any book in a while. Perhaps it has to do with the fact that most of them had to do with some academic topic, but in general, the reading portion of the reason why most people buy books haven’t been of that much interest to me. The person I know who actually reads the books she buys is my mother. Currently, she’s dug into the writings of  Haruki Murakami, a Japanese writer and translator.  A writer who writes both fiction and non-fiction, he’s has garnered worldwide acclaim and numerous awards. In the US, he’s known more for his short stories, but his bestsellers in the United States have included his novels like Norweigian Wood and After Dark. Considered an important figure in postmodern literature, The Guardian praised him as “among the world’s greatest living novelists” for his works and achievements.

Most of the time I don’t really read much fiction writing, so when my mother started to nudge me about reading a book of his I hesitated to say yes.  But last week I agreed that I would read some of Murakami’s writing. So among the shipment of some textbooks, two of Murakami’s books arrived: a set of short stories The Elephant Vanishes (I thought that might be a good way to get into his works) and a memoir What I talk about When I Talk about Running. I don’t run, but something about the title kind of attracted me to the book.  And as I read the foreward to “What I Talk about When I Talk about Running,” I knew my initial attraction was not unfounded.

From reading that foreward and the back cover, it’s becoming clear that the book’s much more than just about running. The act of running is brought alive through his style of writing, something Murakami emphasizes in the foreward. (“I decided that I should just write honestly about what I think and feel about running, and stick to my own style. I figure that was the only way to get going….”) For me that’s what’s probably what’s intriguing me to this book the most, because though my journal is based on the process of going through ECT, the expression of that experience is done through printed words. Murakami says that “one thing I noticed was that writing honestly about running and writing honestly about myself are nearly the same thing.” Likewise, those combinations of words and letters become more than about my mental health stuff; it is a representation of myself.  And I want to learn to, well, represent myself better, in that I want to be a better writer to be better at most accurately capturing my experiences.

Something in me has been stirred in having picked up Murakami’s “What I Talk About…” The Christian Science Monitor writes that “You need be neither runner or writer to find resonance in this slender but lucid meditation. The insights Murakami shares….transcent either track or page.” I truly am excited about getting to read this book, and I hope that this sense of excitement will still be within me when I am finished with it.

January 16, 2011

like father, like daughter

(This is not really the best picture of either of us, but I must have snapped it on my phone recently and thought I’d post it anyway.)

Contrary to a likely assumption given by all the posts I write about parental units, I do have a father in addition to my mother. It must have been sometime this past year when I found out that my father writes a blog for his place of work. Complete with an illustrated icon which resembles him, his blog is meant to be read by those who require services offered by the company. I decided to take a peek at what type of stuff he writes about, even though I know it’s not a personal blog of any kind. While his blog is clearly addressing issues/concerns/etc. that would be of interest to the target audience, it seems that he sometimes mixes in posts that don’t have that much to do with his work. For instance, one was mostly about our 15-year-old siberian husky. But in general, the posts are meant to support the workplace’s desired public image.

Since he works in Japan, the blog is obviously in Japanese. As I’ve grown older, it’s become more evident that all the Japanese language I acquired until fourth grade (that’s when I left Japan) has mostly slipped away. This language is still my mode of communication with my parents, but it’s become increasingly hard in trying to express my exact emotions through Japanese because I simply don’t know the appropriate words. Often I find myself  being able to convey only a portion of what I really mean.  It was in reading my father’s blog entries that I realized that while I lack some language skills,  I am still able to grasp not only the meaning of the written words, but those words’ soul. In between deciphering all the Japanese words that I don’t really know, I was still able to gather my father’s sense of being through the rhythm of his choice of words—–that kind, caring dad who’s always striving to do and become better.

Reading my father’s posts also served as a reminder that I need to renew my sense of commitment to relearn the Japanese language. Not only is it socially desirable to know a second language, it would definitely be fulfilling to me personally. Knowing a different language gives one a even broader way of expressing oneself. On the same line, if I fail to keep learning Japanese, it really is like choosing to lose a part of myself. But all those things aside, my desire to start studying Japanese again is fueled by that desire to be able to have better conversations with my family. Sure, there are many modes of communication to convey one’s thoughts, but there’s sometimes nothing like the power of words, either written or spoken. If a few sentences in a blog can capture some sense of Dad’s heart, then in order to understand even more about the essence of my father, I need to study Japanese.

I sent Dad a text message this morning telling him that I enjoy reading his blog posts and look forward to reading more. While I am not ready to tell my family about this journal, I am happy to know that I have this (secret) bond with my father.

January 15, 2011

a rather obvious connection between optimism and depression….or something else?

In case one wondered, it helps to be more optimistic in order to be less depressed. And new research coming from Australia shows that the most optimistic adolescents may be somewhat less likely to be depressed than their peers and have less heavy drug use and bad behavior. It should be noted though that this  new study (published online Jan. 10 and in the February print issue of Pediatrics, examined optimism in 5,634 children who began taking part in the research when they were 12 to 14 years old) doesn’t prove that optimism directly causes kids to be less depressed. Other factors could explain things. The study also suggests that the most optimistic kids were not able to avoid having as many bad things happen in their lives as more pessimistic kids. “Optimistic kids do better in avoiding emotional and behavioral problems during the teens, but it in no way makes them immune to setbacks,” said the study’s lead author, Dr. George C. Patton, of Australia’s Royal Children’s Hospital in Melbourne. “There are a whole lot of other skills and experiences that are also important in getting through life.”

If that’s the case,  is it really acting happy or just having acquired the skill to be able to put things in perspective that helps one to be less depressed? There’s this billboard from the The Foundation for a Better Life that features Michael J. Fox, which says, “Determined to Outfox Parkinson’s…..Optimism Pass it On.”

Sure, I get what they mean regarding this ad, that optimism certainly helps in getting on with life. But I’ve never quite thought that what Michael J. Fox has been doing with his life is really about optimism, but rather, a honest recognition about the reality of life.

Then again,  I looked up the definition of “Optimism” on dictionary.com, and this is what I got:
________________________

op·ti·mism
/ˈɒptəˌmɪzəm/ 

–noun 

1.a disposition or tendency to look on the more favorable side of events or conditions and to expect the
most favorable outcome.
2.the belief that good ultimately predominates over evil in the world.
3.the belief that goodness pervades reality.
4.the doctrine that the existing world is the best of all possible worlds.
_______________________
Maybe I’m the one that’s wrong here. Maybe I just need to be a bit more optimistic….
January 14, 2011

back to the Music City…

I am finally back home in the United States. I think my cat got either really bored or really missed me while I was gone, because he has decided to sleep next to me for the last two nights, something he’s never actually been into doing previously. On the slide show are just a few more photos from Japan.

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January 14, 2011

The sound of silence

They say that silence is golden.  Well, if silence is really made of gold, then that may be why all that silence that I keep is weighing heavily on my mind.  People use lies to disguise what’s truly going on, but I’ve often come to use silence as my method of disguise.  For example, I never told my parents that I had ‘gone public’ with my eperiences with ECT (and the rest of my life).  While I wanted to tell them, I never told them that I presented a paper on this topic at an academic conference this past October. I know that there isn’t any obligation for me to tell my parents about any of this, but I think a part of me does want them to know that I’m making something of these experiences. While silence could be golden, I also remembered that saying from a Simon and Garfunkel song that goes ‘silence like a cancer grows.’ And perhaps that’s what my silence has become.

So, in the morning after breakfast, mom and I were just doing something at the dining table, and I just brought that stuff up having talked about my ECT experiences to others (Note: I am not ready to say anything about having kept a blog). I know this isn’t much of anything, but telling even such small nugget of truth did take some weight off. Mother was actually supportive and thought that I should write about the experience some more (albeit in some fictionesque format that doesn’t completely make clear that I indeed had these things happen in my life). Little does she know I’ve been posting stuff for over two years now….Anyway…..

 

January 11, 2011

scenes from the homeland

I figured out the slideshow thing on WordPress.  Here are a few more photos from my stay in Japan. My sister and I were supposed to leave Japan yesterday, but the snow in the US caused some flight cancellations, thus causing us to stay for another night here in the `homeland. `  I know these photos aren`t related to mental health stuff, but they do represent a part of who I am, so I figured I`d share them.  More to come, because I took a lot of photos….

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January 9, 2011

Happy 2nd birthday, `little spark`!

Two years ago today, I decided to start keeping a journal `Jumpstarting a Life with a Little Spark to the Head.` I simply meant for it to be a personal diary as I went through ECT for the five weeks following that start. Well, I`m still here, and apparently, the journal (and ECT) decided to stay around a little longer, too. There`s more to say on this occasion (which will have to be done at a later time), but for now, just wanted to wish it a happy second birthday, and hopefully, and many more….

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