Archive for November, 2009

November 30, 2009

“how would you kill yourself?”

A friend invited me to a  Thanksgiving “Orphans” dinner this past Thursday. It was really wonderful. We ate, drank and played some games. Even though it was a joyous occasion, I can never seem to escape being reminded of some random topic in my life that don’t need reminding. We played a game called “If,” where we are supposed to complete “If” statements, such as “If you were to become an animal, you’d be….” Some statements were more strange than others, with one being “If you had to kill someone, your method would be…” Upon hearing this sentence, someone shouts, “Let’s make it a little darker.  How would you kill yourself?”

People actually started pondering and responding to this question, even talking about where one would need to shoot oneself in order to die instantly (this person was a doctor). Another pointed out how men tend to complete more suicides and that more women tend to choose taking pills as the preferred method. Someone then adds, “that’s because women don’t really mean it.”

I don’t know if it was inappropriate for someone to bring this topic up, but it was hard for me to sit there while people so casually talked about suicide. The thing is, it’s not that hard for me to think about the methods without someone having to bring it up. By discussing this topic, it only gives me more ideas. I don’t know if this is always the case, but once you’ve gone through something like this, you can never act as if you’ve never thought of it; thinking about suicide and death is always going to be a part of me, or at least very close to me.

It was especially uncomfortable when one commented about how women don’t really mean it when they’re attempting suicide. How in the world would he know that? When I made my attempt, I meant every bit of it.  I think it also saddened me to realize some people’s views on those who make an attempt. Whether they picked a “successful” form is another matter. The fact that someone went through just the actions of carrying out a suicide means that the person was carrying an insurmountable amount of pain that I’m not sure can be expressed accurately to those who’ve never been in such position. It’s an ache, a sadness that overwhelms me even as I think about it now.

I really did have a great time at this Thanksgiving gathering, but the lingering thoughts from that dinner isn’t just about the lovely evening I had with friends. I’ve yet to be able to have this topic of suicide leave my mind, and I don’t know if it’ll go away anytime soon. Again, I don’t necessarily think it was a bad thing to have this subject brought up since it could use some public recognition, but it’s never easy to have to rethink what suicide means in your own life.

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November 30, 2009

Media Should Tread Carefully In Covering Suicide : NPR

(Note: My friend suggested that I look into the relationship between holidays and suicide. Though that may be a myth, suicide is always a topic that needs to be  covered anyway. And here’s a recent story by NPR. I hope this serves as my first in the series on the topic of holidays and suicide.)

Media Should Tread Carefully In Covering Suicide :NPR
“Suicides following the exposure to someone’s death by suicide, was about two to four times higher among 15- to 19-year-olds than [in] other age groups,” epidemiologist Madelyn Gould says in this NPR piece, broadcast  on November 30 in the Morning Edition. She says that other peer group members often serve as role models for adolescents “and suicide is another behavior that can be modeled, unfortunately.”

NPR listed the following resources at the bottom of this story:
National Suicide Prevention Lifeline: 800-273-TALK (8255), A Free, 24-Hour Hotline

TeenScreen National Center For Mental Health Checkups

American Foundation For Suicide Prevention

American Association Of Suicide Professionals: Upcoming Meeting

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Some related NPR stories:

November 26, 2009

Surgery for Mental Ills offers hope and risk – NYTimes.com

Brain Power – New Techniques in Brain Surgery Mix Hope With Risk – Series – NYTimes.com.

November 26, 2009

Addressing Mental Health Crisis In Developing Countries

Medical News Today: Counselors Address Mental Health Crisis In Developing Countries.

More than 450 million people around the globe live with unmet mental health care needs. Wake Forest University Counseling Professor Donna Henderson co-developed a training course called the Mental Health Facilitators (MHF) program, with easy-to-follow lessons that helps nonprofessional community volunteers in developing countries respond to mental health issues. MHF was formed by the National Board of Certified Counselors International (NBCC) in response to a request by the World Health Organization to help people in developing countries who have never had access to mental health care. The program sends a team of counselors to towns and villages in other countries to train local people how to recognize mental health issues and make references for professional care. What’s especially neat about this program is that it actually takes into account the cultural differences of the countries. The curriculum can be modified according to the culture of the targeted country.

–Source: Medical News Today

November 25, 2009

a step back

I hate to admit it, but I guess I’m going to have to. I haven’t been feeling as well as I’d like to be feeling.

That sounds so ambiguous, and my attempt to explain the above statement will only make things sound more confusing and whiny. But this state is not where I want to be only a week after the ECT. Hell, this damn treatment should last me a whole month! But perhaps it’s beyond the little spark’s control. Am I just scared about the fact that I have a huge paper due in two weeks that I’ve really yet to do much work on? I think I’ve gained back some weight, and I can’t be fat when I see my parents in a few weeks. Or have I caused all of this because I, well, haven’t been quite meticulous about taking all the drugs each and every day? I’ve used up my prescription drug coverage for the year, so for a single drug (out of five or six that I take), it costs around $500….per month. I’m trying to stretch my stash out by breaking them into half or not take them at all on some days. Such a stupid move, I know, but I’m just not looking forward to paying nearly $1,000 for a one-month supply of my medication.

It’s not that I’ve crawled back into my depression cave or something. I’ve just found myself slower to get up in the morning and eager to have the day end (with Ambien, of course). I kind of feel like I’m in some emotional lockdown, except that I seem to be tearing up and I am making a futile attempt for the tears to not ruin the mascara I decided to wear today.

Sometimes you may be able to forget that you have this mental illness that has crippled you in the past. Other times, like now, something just jerks you right back into making sure that you remember you have bipolar disorder. It’s such a humbling feeling, to be pushed back down to recognizing that you’re really not all better, not just yet, and that I have to work at it constantly to gain and maintain a sense of normalcy. And even if I achieve that, I can’t forget that an illness exists at my core.

Hello. I have bipolar disorder, and frankly, right now I’m pissed about it.

…to be continued.

November 24, 2009

Another ‘mommy’s little helper’ ad

This is a continuation of my previous post, ‘desperate housewives.’


Meprospan is chemically similar to Miltown.


I love that this ad suggests we give Ritalin to “the apathetic.”

 

image credit: http://www.decodog.com

November 24, 2009

NYTimes: Why Exercise Makes You Less Anxious

Phys Ed: Why Exercise Makes You Less Anxious – Well Blog – NYTimes.com.

November 24, 2009

Tennessee’s First Proclamation Supporting Mental Health Initiative

Tennessee’s First Proclamation Supporting Mental Health Initiative.

New Safe ’til Stable Program, is a preventative care measure for bipolar disorder

MEMPHIS, Tenn., Nov. 18 /PRNewswire-USNewswire/ — On November 9, 2009, Honorable Speaker of the Senate Ron Ramsey, and Honorable Senator Mark Norris issued the first proclamation in support of a Mental Health initiative in the state of Tennessee. This is a major breakthrough to benefit people living with bipolar disorder in the State of Tennessee, and support The Brilliance in Bipolar Initiative.

The National Bipolar Foundation (NBPF) was founded, in 2007 by Marc Kullman, in order to reduce stigma, educate, and seek affordable healthcare for those people living with bipolar disorder. A National Awareness Initiative has been launched to spread awareness through press releases, press conferences, proclamations, influential people, and its online campaign through social media networking. The MedicAlert Foundation, founded in 1956, is the leader in providing identification and emergency medical information. Together both foundations have developed a program that will prevent the misdirection, misdiagnosis, and mistreatments of people living with bipolar disorder.

Bipolar disorder is said to affect at least 1 in 100 people, including their family and friends, and some say as many as 1 in 25, including undiagnosed cases. This cooperative effort between NBPF and the MedicAlert Foundation will have widespread impact on our society. Children, adolescents and adults living with bipolar disorder who are involved in accidents and unable to speak for themselves, will have the MedicAlert Emergency Services speaking for them; informing hospital staff and medical providers of their diagnoses and current medications in order to avoid potential dangerous withdrawal and the acute onset of instability in regards to any symptoms of bipolar disorder. Another major benefit of the program is that when a person living with bipolar disorder finds themselves in an unforeseen incident, responders will react in an appropriate manner, thus given the opportunity to defuse the situation or transport the person to an appropriate facility. The implementation of this program immediately creates jail diversion benefiting all of society. The “Safe ’til” Stable program will benefit individuals wearing the identification jewelry, reduce stress on their families and friends, and ultimately reduce the cost of their care for all taxpayers.

The National Bipolar Foundation is encouraging people to support their National Awareness Initiative to help start the conversation on bipolar disorder. For more information please call or visit the website at www.nationalbipolarfoundation.org.

SOURCE National Bipolar Foundation

November 24, 2009

Giving thanks

In a blog post on mayoclinic.com–Being grateful: Giving thanks helps with depression, Dr. Melin suggests “that you write down three things each day that you’re thankful for. This can be three sentences or three words, the simpler the better. Keep paper or a journal by your bedside and jot in it daily. This can be at bedtime or in the morning, whichever works best for you.”

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Since I’m posting this tip, I should actually write down three things I’m thankful for right now.
Today, I’m thankful for….
1) My friend/professor Robin. She brought over some lunch today, and we got to chat for a while. I feel a lot more rejuvenated after our conversation, and I now feel like I can get through the rest of this month.

2) My cat Simon. I am so glad he is my buddy. It’s been about a month since his surgery, and he seems to be doing well.

3) NFL. Without it, I wouldn’t have a paper topic. And I also love watching the game (when I should be researching for that paper).

 

 

November 22, 2009

Smoking Tied to Suicide Risk in Bipolar Disorder

Smoking Tied to Suicide Risk in Bipolar Disorder – ABC News.

People with bipolar disorder who smoke appear to have a heightened risk of suicidal behavior — possibly because they are generally prone to impulsive acts, a new study suggests. The new findings suggest that high levels of impulsivity — one of the symptoms of bipolar disorder — may draw some patients to both smoking and suicidal behavior.

November 21, 2009

How to Find Mental Health Care When Money Is Tight: NYTimes.com

Patient Money – How to Find Mental Health Care When Money Is Tight – NYTimes.com.

November 20, 2009

Sound Waves

I totally forgot about the following account til today, but I thought it was still interesting enough to write it down. When you think of places that play soothing sounds in the background, people usually think of salons and spas. Well, add ECT treatment room to that list. As I was getting situated for ECT, I noticed the sound of the ocean that seem to fill the room. Since the last time I had my treatment, they had decided to install a bunch of sound machines in the room. Someone asked me if I wanted to hear something else, but I stuck with the rolling waves. I could hear from the other beds the sounds of chirping birds, though. I can’t quite remember what all was said about this machine since it was right before my ECT.

As strange as it may seem to install something like a sound machine to the ECT room, I think it’s a pretty good idea. I often have to lie there having to listen to my own thoughts, and it was nice to be distracted by these tides crashing to the shore. This is yet another reason why I appreciate Parthenon Pavilion.

November 19, 2009

NIMH: Teens and Long-term Depression treatment

From NIMH:

Long-term treatment of adolescents with major depression is associated with continuous and persistent improvement of depression symptoms in most cases, according to the most recent analysis of follow-up data from the NIMH-funded Treatment of Adolescents with Depression Study (TADS). The report, along with a commentary compiling the take-home messages of the study, was published in the October 2009 issue of the American Journal of Psychiatry.

Background

The TADS team randomly assigned 439 adolescents aged 12 to 17 to one of four treatment strategies for 36 weeks—the antidepressant fluoxetine (Prozac) only, cognitive behavioral therapy (CBT) only, the combination of the two, or placebo (inactive or “sugar” pill). After the first 12 weeks, the placebo group was discontinued, while the participants assigned to the active interventions continued treatment for another six months. Overall, the combination therapy was found to be the most effective in speeding up remission. Visit the NIMH website for more information about TADS results.

After the trial ended, the teens who had been assigned to the active treatments were assessed up to four times during the following year to determine if improvements were sustained over time. TADS treatments were no longer offered, but participants were encouraged to continue to seek treatment within their communities.

Participants who had been assigned to the placebo group received open treatment during the one-year follow-up period and were not included in this follow-up assessment. About 66 percent of TADS subjects (not including those who had been in the placebo group) participated in at least one assessment during the follow-up year.

Results of the Study

By the end of the 36-week trial, 82 percent of participants had improved and 59 percent had reached full remission. During the follow-up year, most participants maintained their improvements, and the remission rate climbed to 68 percent. However, about 30 percent of the participants who were in remission at week 36 became depressed again during the following year.

In addition, while 91 percent of participants showed no evidence of suicidal thinking or behavior at the end of the trial, 6 percent developed suicidal thinking during the follow-up year, with no statistically significant differences among the treatment groups.

Significance

The longer-term treatment of TADS, regardless of treatment strategy, was associated with lasting benefits for the majority of participants. However, a significant number of those who had recovered worsened during the follow-up period, indicating a need for continuous clinical monitoring and further improvement in long-term treatment of youth with major depression.

What’s Next?

The final results of TADS suggest that for most teens with depression, long-term, evidence-based treatments are effective and sustainable. But future research should concentrate on improving treatment strategies to reduce the rate of depression relapse or deterioration. The authors suggest that a randomized maintenance therapy trial would help determine how long active treatment should last to ensure the effects of treatment will endure over time.

References

TADS Team. The Treatment for Adolescents with Depression Study (TADS): Outcomes over one year of naturalistic follow-up. American Journal of Psychiatry. 2009 Oct. 166(10): 1141-1149.

March JS and Vitiello B. Take home messages from the Treatment for Adolescents with Depression Study (TADS). American Journal of Psychiatry. 2009 Oct.166(10):1118-1123.

November 19, 2009

Chronically Depressed? What to Do When Antidepressants Don’t Work – US News and World Report

Click here for video on depression

The article,“Chronically Depressed? What to Do When Antidepressants Don’t Work on US News and World Report, talks about CBT, DBS and exercise as ways of getting rid of treatment-resistant/medication-resistant depression, but the author mainly talks about electroconvulsive therapy. Of course, the article is still full of the usual side effects and caveats that are pointed out about ECT, but I’m just glad someone’s talking about ECT as credible treatment in a recent article (this one came out this month).

US News had another article in April, Depressed and Coping: Treating Depression when Medication Fails, that covers more of the lifestyle changes one can make in helping relieve one’s depression. It basically tells me to: sleep well, exercise, take fish oil supplements, be social, get some light, among other things. In between the ECT, I should try these suggestions, not because it’ll alleviate the depression but because I need to be doing things like exercising anyway. And it’s a beautiful day today. Perhaps I should go enjoy the light instead of being in front of my laptop (Well, I have class today, but it’s not for another few hours).

November 19, 2009

ECT #23 (my eighth maintenance treatment)

I cried last night, not necessarily because I felt scared about today’s ECT but because I feel like I’m an emotional burden to my family. I can tell that my family is scared and worried for me. I know firsthand how the ECT is done, what it feels like, etc., but for those around me, all they know is what they’ve imagined and heard about ‘shock therapy.’ Those emotions add to the stress that they don’t need to have, especially since my parents do not live in the United States. And for my sister, she has to miss class every time she has to drive me to the hospital. I do understand that it’s better for me and everyone else that I am rid of depression, but I can’t help but feel so bad that I am putting everyone around me through this.

Those emotions carried over to my ECT this morning. I felt strangely scared about the procedure even though it’s my 23rd one. But the nurse in charge of the prep room helped calm me down a bit. Yet another set of students were in the room, and Nurse J explained to them how this room sets the feel and tone for those of us about to have ECT. Upon hearing her speak to those students, I think I understood for the first time just how important this preparation part of the ECT is to me, and what a great nurse they had picked to get us ready.

Those students who I saw at the prep room came in for observation just when I was about to get ‘a little spark.’  I seem to be the lucky study subject nearly every time I’m there. After the ECT today, though, I felt happy and almost giddy. When I was asked by a nurse if I had a headache right after I woke up, I told him that I was fine. But my headache has been quite painful all day today. On top of it, the medication Lortab has made me  nauseous. Oh well. I just have to deal with that for a day, and I’m sure they will soon go away, and I’ll get to enjoy this lightness.

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