Archive for June, 2010

June 30, 2010

a little unwell

My cat just spilled my water all over the table. I know I should clean it up, but I have no motivation to do so. There’s a family matter that’s going on that should upset me to some point, but I started bawling in front of my mother about five random times today. I need to finish an essay exam for class. Instead, I popped a sleeping pill and waited for everything to just shut down for the day. I feel anxious and sad at the same time. I feel disengaged. Not even ‘The Daily Show with Jon Stewart’ could bring me laugh a little bit. In fact, I had to turn the television off because it just became noise (and I really do love tv, so this is not usual for me).

I think this is going in the wrong direction.

It’s now the next morning, and my mood hasn’t changed. I made myself go workout, so now I do have to take a shower, which is good, since I neglected to take one yesterday.

Good thing there’s an appointment with Dr. L scheduled in a few hours.

June 28, 2010

‘Best Buy’ antidepressants

Can’t decide which antidepressant to take? Well, Consumer Reports may be able to help you just as they help people decide which car or laundry detergent might be best.

Apparently, in the ‘Best Buy Drugs‘ issue in 2009, Consumer Reports ranked several antidepressants on market. Here’s the entire report in PDF. The list even tells you which drug they rate as ‘Best Buy.’

So, next time you need a new drug to try, look through an issue of Consumer Reports for some ideas  as you also look for tips about which vacuum cleaner works best.

June 27, 2010

me minus abilify equals…

a possible slow digression back to depression? Maybe, maybe not. But I’ve kind of ‘forgotten’ to take Abilify for the last week or so, and in that week, I’ve become increasingly tired. Am I just tired or is something wrong with me? The problem with having a diagnosed mental illness is that sometimes, you can’t really tell what’s just a normal emotional state. When I cry over something, I’m having to wonder whether it’s just a normal reaction or if I’m getting depressed.

This is one of those moments. I feel a sense of uneasiness, perhaps because I shouldn’t have stopped taking one of the meds in the first place, but also because I don’t know what to make of how I’m feeling. This becomes a bit of a problem this week because when I have ECT in a few days, my doctor is sure to ask me how I’ve been feeling –and if I tell the truth, there’s always that chance that I’m going to get told that I’ll have to have ECT more often. Maybe this tiring feeling is coming on because the ECT is wearing out since the last time I had it.

Maybe I’m just tired and I’m just worried over no reason.

This experience still makes me ask myself: What emotions are controlled by meds, and what are controlled solely by me? Can I separate those two things anymore?

June 26, 2010

suicide on my mind (but I’m fine, really)

“Overcome writer’s block with Plinky prompts,” said the blog alert I got from WordPress just yesterday. I was intrigued, because honestly, I’ve been having a hard time posting my own words lately. It’s not that there’s been nothing going on in my life. For example, I had a very emotional session last week during therapy with Dr. L. Somehow, I feel the hesitation to write my real thoughts out in my fingertips. The hands just seem to come to a halt or find itself pressing the backspace button to erase whatever I had written out. But my head hasn’t stopped thinking about what I wanted to write about all last week. So, here it goes…

I’m familiar with suicide. I’ve talked about it on several posts in the past. So, when the topic of suicide among the elderly came up in class the other day, I thought I’d be fine about it. The facts on suicide and the elderly were really interesting, and I was just intellectually intrigued, but not emotionally stirred. However, we also talked about when suicide sometimes becomes a ‘rational choice’ for older people, rather than something caused by some mental illness. I began asking myself, ‘can’t young people commit ‘rational choice’ suicide, too, if the elderly can do it?’

I immediately grew frightened by my thoughts.  After all this time, do I still find suicide to be a feasible option for me? While I can usually write openly about these thoughts in this journal, I hesitated to write anything about it because I think the topic of suicide isn’t something that’s discussed honestly…and when it is, I didn’t want people to mistake my thoughts as a sign that I’m suicidal or something. I think I really just want to talk about the topic of suicide with someone, and not just with my therapist.

So, it’s now the following week and the class has moved on to talking about the elderly and dementia, but I seem to be stuck on thinking about last week’s topic.

If I write any more about this topic, I know I’ll start tearing up, which is not a good thing since I have get ready to attend a wedding in Bowling Green, Ky., today. Any thoughts?

June 25, 2010

Can an ad ‘BringChange2Mind’?

Only if you’ve seen it….

This ad from the BringChange2Mind campaign just won a Silver Telly Award, which honors the best in cable television commercials and programs, video and film productions, as well as work created for the Web.

Why have I never seen this ad until now? Apparently, this campaign is sponsored by every major mental health organization. Campaigns work only when they are visible to others. Where was this ad when Mental Health Month was going on?

June 24, 2010

Diagnosing Bipolar Disorder with a MRI

From Medical News Today:

A single MRI (magnetic resonance imaging) scan may soon help hundreds of thousands of people with bipolar disorder to get a faster, more accurate – and possibly life-saving – diagnosis, a leading researcher reported at the Royal College of Psychiatrists’ International Congress.

Professor Mary Phillips, professor of psychiatry and director of the Clinical and Translational Affective Neurosicence Program at the University of Pittsburgh, told the Congress that missed and delayed diagnosis was a major problem with bipolar disorder.

She said: “Only one in five sufferers are correctly diagnosed at first presentation to a doctor and it can take up to ten years before sufferers receive a correct diagnosis.” A major problem for clinicians is the difficulty of differentiating between unipolar (normal) depression and bipolar disorder. Professor Phillips explained: “The problem is that sufferers [of bipolar disorder] frequently fail to tell their doctors about hypomanic phases because they can be experienced as quite pleasant or judged not to be abnormal at all.”

Yet research carried out at Pittsburgh has shown that BPD may in the near future be more accurately diagnosed with a combination of a Functional MRI, which scans the brain’s ‘software’ or neural pathways, as well as a DTI (Diffusion Tension Imaging) which scans the brain’s white matter.

Professor Philips told the Congress that scans of the brains of people who are suffering depression or bipolar disorder show ‘functionally coupled’ activity in two regions of the brain, the amygdala which processes emotions, and the pre-frontal cortex, important for emotional regulation.

Professor Phillips’ study involved MRI scans comparing brain function in two groups of people, one group with bipolar disorder and the other with depression. It revealed that the two types of depression appear to be easily distinguished “by a very different and distinct pattern of brain activity”.

She said: “If there’s a plan to do just one MRI in the future to try to decide whether someone has bipolar or depression , I’d suggest focussing the right pre-frontal cortex. If there is any abnormality in functioning between the right and pre-frontal cortex and right amygdala, the chances are that the person has bipolar.”

Professor Phillips suggested that the scans may also be used at some point to predict a future onset of bipolar disorder in young people who are not yet affected by the disease.

References:

International Congress of the Royal College of Psychiatrists, Edinburgh, 21-24 June 2010.

Source:
Royal College of Psychiatrists

June 17, 2010

Suicide and its circumstances

originally appeared in The Psychiatric Times:

Circumstances Associated with Suicide

The Centers for Disease Control and Prevention (CDC) estimated the suicide rate in the United States at 11.6 per 100,000 in 2007 (18.4 and 5.0 per 100,000 in male and female populations, respectively). Mental health problems were the most common known circumstance associated with suicide deaths. Firearm was the most common method used (50.7 percent overall). The full surveillance report on violent deaths, dated May 14, is posted at <www.cdc.gov/mmwr/pdf/ss/ss5904.pdf>.

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June 14, 2010

A spoonful of cash helps the medicine go down…

One-third to one-half of all patients do not take medication as prescribed, and up to one-quarter never fill prescriptions at all, experts say. Such lapses fuel more than $100 billion dollars in health costs annually because those patients often get sicker. So, a solution? Let’s offer cash incentives to get people to take their meds!

According to this article in the New York Times, one example was in Philadelphia, where people were prescribed warfarin, an anti-blood-clot medication, can win $10 or $100 each day they take the drug — a kind of lottery using a computerized pillbox to record if they took the medicine and whether they won that day. CVS Caremark began by discounting copayments for employees of some corporations in its drug plans, to encourage prescription filling, and is studying “the ‘I’ll pay you $10 a month to be adherent’ approach, the lottery approach,” and other incentives, said Dr. Troy Brennan, the chief medical officer.

Initial reports from various programs seem to look promising.  I do wonder how it is that our health care system has enough money to give out bribes but can’t lower the price of health care itself. As much as it would be very nice to get cash incentives to take my meds on a regular basis, I hate to think that we need to lure people with money in order to remember/be adherent to take their drugs. But if such a program indeed lowers overall health care costs and improves people’s health, maybe it’s a good thing.

Just a thought: in countries with universal health care coverage, what’s the rate of prescription drug compliance? Does that make a difference?

June 13, 2010

Research: Belly fat and depression

Is there a link between depression and belly fat? New research from University of Alabama at Birmingham thinks so.

Among other things, the researchers wanted to figure out if depressed people were more likely to have larger waist circumferences and a higher BMI, and how that changed over time. They found that over a 15-year period, all the subjects put on some pounds, but those who were depressed gained weight faster.

The study raises the possibility that depression causes people to put on extra pounds around the belly. But the opposite doesn’t appear to be the case: researchers found that overweight people aren’t more likely to become depressed than their normal-weight peers.

June 12, 2010

Stronger

Last night, I got to have dinner with my good friend Katy. We hadn’t seen each other in a while since she gave birth to a beautiful baby girl just this spring. We talked about bunch of stuff, and somehow we got to talking about my weight. It’s an awkward subject for me since since I have parents who still comment about my weight and have since I was little. I don’t think I’ve ever even brought up this issue in this journal. I have gained about 15 lbs. this year, and I know that I don’t need that extra weight on my 5 ft 2 in. frame (I weigh around 140 lbs). It’s just not easy to feel good about yourself anyway when someone is always telling you that you’d be so much prettier if you were thinner.

When I told Katy how I needed to work out to lose weight, she said to me, “maybe you should think about working out because you want to be stronger.” Though I’ve learned to look at my parents’ comments differently, I’ve never thought about working out, not to lose weight, but really to improve who I am right now. With the other times I’ve tried to lose weight, I have tried to tell myself that I’m doing it for myself, but it never really felt like it. But with this single comment from my friend, I realized that I want to take steps to get stronger. It just so happens that I might lose weight while taking those steps.

So, I’m going to make a commitment on this journal that I want to be stronger. And in order to do so, I commit to start working out regularly. Sure, I want to get to a healthy weight, but now I can tell myself that my main goal is to be a better me.

Thank you, Katy.

June 11, 2010

Share Your Story, Share Your Strength

Before I get to the rest of the post:

Go to http://www.lifeline-gallery.org and share how you may have been affected by your own suicide attempt or someone else’s. Or just express your support for suicide prevention. It’s a “place to share, and listen to, stories of hope and recovery.” You even get to even make your own avatar to go along with your story.

June 11, 2010

Work it!

(I think I’ve watched too much ‘America’s Next Top Model’ to have come up with that title for the post…..)

As I’ve become more involved in my therapy, I’ve really come to realize that therapy is indeed hard work. And I think my (new) therapist, Dr. L, has brought out something in me that I haven’t always found in myself: my own true self. I find myself crying pretty much every session, and it’s not necessarily because I’m sad. I find that I am being able to be more honest to myself than I ever knew how to be. Part of this might have to do with Dr. L and how I get along with her, but all the treatments I’ve had up to now have finally begun to pay off for me to get to this point in my treatment plan.

After every session, Dr. L gives me a hug and tells me how proud she is of me. For a long time, I found it kind of odd that she was proud of me, but lately, I’m kind of thinking that I should be proud of myself for making it at least this far.

I found the stuff below on helpguide.org:

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From: http://helpguide.org/mental/psychotherapy_therapist_counseling.htm

Making psychotherapy work for you

Therapy is hard work, but the rewards are worth it. Here are some tips for getting the most out of your therapy:

-Don’t expect the therapist to tell you what to do. You and your therapists are partners in your recovery. Your therapist can help guide you and make suggestions for treatment, but only you can make the changes you need to move forward.

-Share what you are feeling. You will get the most out of therapy if you are open and honest with your therapist about your feelings. If you feel embarrassed or ashamed, or something is too painful to talk about, don’t be afraid to tell your therapist. Slowly, you can work together to get at the issues.
-Make a commitment to your treatment. Don’t skip sessions unless you absolutely have to. If your therapist gives you homework in between sessions, be sure to do it. If you find yourself skipping sessions or are reluctant to go, ask yourself why. Are you avoiding painful discussion? Did last session touch a nerve? Talk about your reluctance with your therapist.
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June 10, 2010

sign of the times

June 9, 2010

7 Depression Busters for Men

Therese Borchard had posted an article: 7 Depression  Busters for Men in the Huffington Post.

1. Get a male perspective.

When I hit bottom after the birth of my second baby, I was lucky enough to see Brook Sheild’s beautiful face on “Oprah” describing how I felt. In her book, and in Kay Redfield Jamison’s “An Unquiet Mind” and Tracy Thompson’s “The Ghost in the House,” I found female companionship, as they articulated what was happening to me. That alone made me less scared.

There are some wonderful books tackling the male perspective of depression. Among them: “I Don’t Want to Talk About It: Overcoming the Secret Legacy of Male Depression” by Terrence Real, “Unmasking Male Depression” by Archibald Halt, and, of course, the classic, “Darkness Visible” by William Styron. There are also an array of blogs by men on the topic of depression and mental health. For example, check out “Storied Mind,” “Chipur.com,” “Knowledge Is Necessity,” “Lawyers with Depression,” “Midlife-Men.com,” “Finding Optimism,” and “A Splintered Mind.”

2. Identify the symptoms.

Part of what makes male depression so misunderstood is that a depressed guy doesn’t act the way a depressed lady does, and the feminine symptoms are the ones most often presented in pharmaceutical ads and in glossy brochures you pick up at your doctor’s office . For example, it is not uncommon for a man to complain to his primary care physician about sleep problems, headaches, fatigue and other unspecified pain, some or all of which may be related to untreated depression. In her Newsweek article, “Men & Depression,” Julie Scelfo writes, “Depressed women often weep and talk about feeling bad; depressed men are more likely to get into bar fights, scream at their wives, have affairs or become enraged by small inconveniences like lousy service at a restaurant.”
3. Limit the alcohol.

An interesting study by Yale University discovered that men and women respond to stress differently. According to lead scientist Tara Chaplin, women are much more likely to feel sad or anxious as a result of stress, whereas men turn to alcohol. “Men’s tendency to crave alcohol when upset may be a learned behavior or may be related to known gender differences in reward pathways in the brain,” she said. The tendency, however, puts men at more risk for alcohol-use disorders. And since alcohol is, itself, a depressive, you really don’t want a lot of it in your system. Trust me on this one.

4. Watch the stress.

You can’t drink away your worries, so what DO you do? I offer 10 stress busters. But I imagine the most important way to manage stress for men is to work in a job and environment that isn’t … well … toxic. Unfortunately, the more impressive your title, the more stress brewing underneath your skin. Dr. Charles Nemeroff, a psychiatrist who treated both Tom Johnson (president of CNN during the 90s) and philanthropist J.B. Fuqua says stress is a major factor in male depression and a CEO’s (or any executive’s) higher stress level makes them more vulnerable to the illness. The pressure can become unbearable. Unfortunately, some men will have to choose between good mental health and the corner office.

5. Help another dude.

At age 46 Philip Burguieres was running a Fortune 500 company. Now he lends a hand to CEOs who are living lives of quiet desperation and have nowhere to turn. In an interview with PBS, Burguieres said, “I am open about my own experience, and I share my story with other CEOs in lecture settings several times a year [because] I have found that helping other people helps me, and keeps me healthier.” Art Buchwald, another very successful depressive, said in a “Psychology Today” interview some years back that talking about his depression helped him as much as the people he was talking to. It seems to me that the more misunderstood the illness, the greater the need to reach out and help each other.

6. Find an outlet.

One of my male friends who is a tad depressed right now says all he needs to feel better is 18 holes of golf. I’m not sure that chasing the little white ball has the same therapeutic faculties as a high-impact hour of counseling, but I trust that he knows himself better than I know him. What I do know without a doubt is that men are much happier when they can retreat into a “man cave” or a safe corner of the world and do their thing. Some might need a little assistance finding that happy place. So keep trying on those pastimes until one fits and lets you take a deep breath.

7. Tend to the marriage.

Depression leads women into affairs and divorce. But I suspect there are even more casualties with men’s depression. In a poignant blog post, John A. discusses his longing to leave a good marriage as the “active” face of the illness. He writes, “We often focus on the passive symptoms, the inactivity, the isolation, sense of worthlessness, disruption of focused thought, lack of will to do anything. But paradoxically the inner loss and need can drive depressed people to frenzied action to fill the great emptiness in the center of their lives. They may long to replace that inadequate self with an imagined new one that makes up for every loss.” Yet, by loving the partner beside you, even though it can feel counter-intuitive and unnatural, you can protect yourself (to a certain extent) from the blows of depression and make yourself more resilient to future episodes.

Click here for even more depression busters for men.

***

Around the Web:

Depression in Men – Symptoms and Physical Effects

Men With Depression – HealthyPlace

Male depression: Understanding the issues – MayoClinic.com

Depression in Men

Men Are More Emotional Than the Women They Date, Study Says

Depression Linked to Urinary Incontinence in Men

12 Depression Busters for Men: Help for Men Struggling with Depression

Study: Postpartum depression affects fathers too

June 8, 2010

a book against ECT

Not sure how I missed catching info about this book when it was first released, but there is a book by Linda Andre called Doctors of Deception: What They Don’t Want You to Know About Shock Treatment.

Here’s the product description from Amazon:

Mechanisms and standards exist to safeguard the health and welfare of the patient, but for electroconvulsive therapy (ECT) used to treat depression and other mental illnesses approval methods have failed. Prescribed to thousands over the years, public relations as opposed to medical trials have paved the way for this popular yet dangerous and controversial treatment option.

Doctors of Deception is a revealing history of ECT (or shock therapy) in the United States, told here for the first time. Through the examination of court records, medical data, FDA reports, industry claims, her own experience as a patient of shock therapy, and the stories of others, Andre exposes tactics used by the industry to promote ECT as a responsible treatment when all the scientific evidence suggested otherwise.
As early as the 1940s, scientific literature began reporting incidences of human and animal brain damage resulting from ECT. Despite practitioner modifications, deleterious effects on memory and cognition persisted. Rather than discontinue use of ECT, the $5-billion-per-year shock industry crafted a public relations campaign to improve ECT s image. During the 1970s and 1980s, psychiatry’s PR efforts misled the government, the public, and the media into believing that ECT had made a comeback and was safe.
Andre carefully intertwines stories of ECT survivors and activists with legal, ethical, and scientific arguments to address issues of patient rights and psychiatric treatment. Echoing current debates about the use of psychopharmaceutical interventions shown to have debilitating side effects, she candidly presents ECT as a problematic therapy demanding greater scrutiny, tighter control, and full disclosure about its long-term cognitive effects.

Is ECT really a “popular” procedure? And doesn’t every medical procedure have some sort of risks involved every time it is committed? We don’t seem to argue for the end to heart surgeries because there’s evidence that some people have died from them. There’s some sense that people who choose to have ECT are somehow naive about the procedure. I obviously need to read the book if I want to make a legitimate argument, but in general, I’m annoyed that books that mention ECT often tend to have to pick sides about whether they approve or disapprove of this treatment. Can’t people talk about ECT without arguing about it?

I hate that we can’t just have a conversation about ECT—both cons and pros.

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