Archive for July, 2010

July 31, 2010

‘Helen’: depression on film

Stephen Whitty from the Star-Ledger summed up this movie as “Really-it’s depressing”…and “isn’t very good,” but the New York Times gave it a good review…

from Jeannette Catsoulis, The New York Times:
Opening with a sobering quotation from Andrew Solomon’s 1998 confession of suicidal depression in The New Yorker, “Helen” dives into this painful mental illness with sensitivity and grace. As Helen, a successful music professor and contented wife and mother, Ashley Judd is, initially, gleamingly serene. But as the first ripples of sadness swell to a paralyzing crescendo of distress, she never loses her grip on a character that is unrelentingly embattled. Unable to communicate with her appalled husband (Goran Visnjic, tone perfect) and teenage daughter (Alexia Fast), Helen finds comfort only in the company of a self-destructive student (an excellent Lauren Lee Smith) who is struggling with her own psychological demons. Drawing inspiration from the suicide of a childhood friend, the writer and director, Sandra Nettelbeck, orchestrates a story that somehow avoids punishing the audience as much as its heroine.

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July 30, 2010

Predicting suicide attempts via a computer test

From Medical News Today:

Two powerful new tests developed by psychologists at Harvard University show great promise in predicting patients’ risk of attempting suicide. Both new tests are easily administered within minutes on a computer, giving quick insight into how patients are thinking about suicide, as well as their propensity to attempt suicide in the near future.

In one study, 124 patients in a psychiatric emergency department were administered a modified Stroop test measuring speed in articulating the color of words on a computer screen. Suicidal individuals were found to pay more attention to suicide-related words than to neutral words.

“Suicide Stroop scores predicted six-month follow-up suicide attempts above and beyond well-known risk factors such as a history of suicide attempts, patients’ reported likelihood of attempt, and clinicians’ predictions regarding patients’ likelihood of attempt,” says co-author Christine B. Cha, a doctoral student in psychology at Harvard.

A second study adapted the Implicit Association Test developed by Harvard psychologist Mahzarin R. Banaji, using reaction times to semantic stimuli to measure 157 subjects’ automatic mental associations — in this case, the strength of associations between words related to “self” and words related to either “life” or “death/suicide.” Participants were shown pairs of words on a screen, with response speed revealing unconscious associations between the terms. For instance, a rapid response to stimuli associating self with death/suicide suggests a strong unconscious association between the two.

The researchers found that those participants with strong associations between self and death/suicide were six times more likely to attempt suicide within the next six months than those holding stronger associations between self and life.

July 30, 2010

that’s peanuts

As you all may know, Hallmark card store sells much more than just cards. They have all sorts of little trinkets for the house. Their newest collection of stuff is a line of ‘Peanuts’ merchandise. They have an assortment of cute little Snoopy stuff available, including a memo pad that has the illustration from Lucy behind her ‘Psychiatric help’ booth. I was tempted to snatch that up for one of my doctors. But among all the merchandise, this little stand with the quote, “Keep looking up! That’s the secret of life!,” with both Snoopy and Woodstock looking up, caught my eye.

Maybe it’s too cutesy to be a legitimate advice. But sometimes we could use those life reminders, and what better than getting one from Snoopy?

July 29, 2010

Study: More social ties = longer life

According to a study published in PLoS Medicine, more than 100 years’ worth of research (148 studies) shows that social support increases survival by about 50 percent. The study shows that the benefit of friends, family and even colleagues turns out to be just as good for long-term survival as giving up a 15-cigarette-a-day smoking habit. And by the study’s numbers, interpersonal social networks are more crucial to physical health than exercising or beating obesity.

Here’s a snippet from Scientific American:

The more, the healthier
Despite the hyperconnected era of Facebook friends and Blackberry messaging, social isolation is on the rise. More people than not report not having a single person they feel that they can confide in—up threefold from 20 years ago, the report authors noted.”People have assumed a threshold effect” when it comes to social relationships, Holt-Lunstad says. Many researchers thought “you’re at risk if you’re socially isolated, but as long as you have one person, you’re okay,” she says.

The decades of research that Holt-Lunstad and her colleagues examined showed that in fact social support and survival operate on a continuum: “The greater the extent of the relationships, the lower the risk,” she says.The analysis also assessed what kind of studies worked best to predict a person’s survival. Questionnaires that had asked participants at least a few in-depth questions about various social connections (such as, “To what extent are you participating or involved in your social network?” or “To what extent can you count on other people?”) were more effective at pinpointing a person’s overall risk of mortality from all causes than those that simply determined if a person was single or married or lived with at least one other person. The more nuanced questions “tap into the perception of the availability” of other people, Holt-Lunstad explains, rather than just determining if a person is co-habitating. Holt-Lunstad and her colleagues found that divvied up this way, complex social networks increased survival rates by 91 percent. (read rest of the article)

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I think one of the tough aspects of depression is that you lose touch with people. I’m not very good at making good friends, and I don’t really know how to make connections with people. It’s very hard for me to ever feel at ease around others.  To be honest, I am often envious of others who can so openly talk/post to buddies or their ‘friends’ on Facebook, because I feel absolutely uncomfortable telling almost anyone anything. Sometimes, I’ve gotten so afraid of having a close friendship that I totally cut off communicating with them for a while. I do have to say that through all my treatments, I’ve come to appreciate social connections more. I hope I keep getting better at it.

July 29, 2010

ECT #32: (my 17th maintenance treatment)

How many is too many, I ask myself.

While I’ve visited the hospital 32 times, I’ve technically had 33 treatments.Once they gave me two little sparks during one appointment, because the duration of the first one was too short. Anyway. ..

I can’t really tell if I’m that depressed right now or not. My home is horrifically messy, and that usually means that I’ve fallen into depression. But I kind of think this is just my being lazy. Also, my psychotherapist, who sees me every week, thinks that I’ve been doing much better in the last five months that she’s known me.  I’ve been having ECT every four weeks, but I persuaded Dr. F today that I don’t need to have one for another six weeks. Was this a good decision on my (and his) part? I will know if I start to slip back into the darkness after the next four weeks pass.

I tend to forget why this treatment is called “maintenance ECT.” It’s all about maintaining. Really, I shouldn’t be falling into a depressed state since the procedure is supposed to maintain me from doing so. As for the number of treatments, according to books like Dr. Max Fink’s ‘Electroconvulsive Therapy‘ or from the info gathered by journalist Larry Tye, who co-wrote “Shock” with Kitty Dukakis, there seems to be no negative effects from long-term maintenance ECT. And it doesn’t specify any limit. So, I guess it’s okay that there seems to be no end-date for my having ECT.

As my horoscope tells me today, “Work with the flow instead of pushing against it.”

July 28, 2010

will ‘normal’ exist after DSM-V?

Til Wykes andFelicity Callard, of Kings’ Institute of Psychiatry, and Nick Craddock of Cardiff University’s department of psychological medicine and neurology, put out a statement today that says that many in the psychiatric community are worried that the further the guidelines are expanded for the upcoming DSM-V, the more likely it will become that nobody will be classed as normal any more.

Examples they pointed included new additions like “mild anxiety depression,” “psychosis risk syndrome,” and “temper dysregulation disorder.” They believe many people previously seen as perfectly healthy could in future be told they are ill.

Read the whole article:
Mental Health Experts ask: Will anyone be normal?

July 28, 2010

in place of antidepressants

A new article by Dr. Christiane Northup in Huffingtonpost.com looks at “The Limits of Antidepressants: (and) Exploring the Alternatives.” She starts out by reciting recent research that showed that the benefits of antidepressants have been greatly overstated. For instance, in January 2010, a study published in the Journal of the American Medical Association (JAMA)  evaluated another class of antidepressants, tricyclic antidepressants. Again, researchers determined that the typical patient, one with mild to moderate depression, gets the same amount of relief from a placebo as from an antidepressant. The New York Times reported that the co-author of the study, Robert J. DeRubeis, shared this important insight: “The message for patients with mild to moderate depression is ‘Look, medications are always an option, but there’s little evidence that they add to other efforts to shake depression–whether it’s exercise, seeing the doctor, reading about the disorder or going for psychotherapy.'”

The article goes on to talk about the benefits of fish oil, 5-HTP, exercise, and being honest with your feelings.

Once I got to reading this article, it becomes somewhat clear that ‘people taking antidepressants’ really refers to ‘people with mild to moderate depression,’ which she refers to as ‘the typical patient.’ Really, couldn’t we follow her suggested alternatives without leaving psychotropic medication? There’s often an assumption that if only we followed a certain regimen, we wouldn’t need to be taking any meds. Well, in many cases, I’m guessing that people have tried those other options before being prescribed antidepressants. We are not a bunch of lazy people who decided to pop some ‘happy pills’ in lieu of taking care of our bodies. From my experience, the antidepressants are what helped me start taking care of my body, because without it, I sometimes didn’t even bother taking showers or just waking up.

I realize the article wasn’t meant for those ‘severe’ cases, but it still tends to lump everyone in as if we can all just “get over it,” as Northup says.

Man, if I could just ‘get over it’ by simply taking fish oil and being honest with my feelings (again, I doubt not every depressive lies to him/herself), I think I would have taken that option a long time ago.

July 27, 2010

morning call

My clock appeared to read 4 am when I awoke this morning. I watched some BBC News (instead of all those paid programming selling me stuff like snuggies), and yet I couldn’t get back to sleep. So, my cat Simon and I decided to come out to the porch with my laptop and some jasmine white tea in hand. I can’t even call this time ‘morning’ just yet. Though the darkness has begun to fade away, certain to be accompanied by the breaking of dawn any moment now, the sky is still without any brightness. The birds and insects are already up and chirping away, however. I wonder what their business is for being up so early when the sun hasn’t even shown its face yet.

My grandfather (my father’s father) passed away yesterday. He was 92.

I don’t even know if I believe in heaven, but perhaps those birds are calling to announce the arrival of a new spirit that has arrived at the gates.

The clouds have now slowly shifted and begun to make room for the morning light. I look up and wonder if he has made it to his destination.

Rest in peace.

July 26, 2010

in renovation

I work at the mall. I was on break from work today when I passed by the storefront of Restoration Hardware and saw this quote on their window. Apparently, they are doing some sort of remodeling and this is how they chose to notify the customers.

I’ve been fascinated by these words by Picasso on the glass since I encountered it this afternoon. It’s an interesting quote, but what does it mean? How does it apply to me? For some reason, this quote made me think about ECT.

I don’t really know exactly why this quote has anything to do with ECT. I don’t think I see ECT as being ‘an act of destruction,” but I guess the treatment is about redoing the connections in your brain, thus deconstructing the existing neural networks.  But if that’s the case, does this mean that ECT is constructing a new me? And is that what I want?

I think that to some extent, I do want something new. I am tired of the mind that seems trapped between the walls of utter desperation. Why wouldn’t I want that to be destroyed and allowed to start over again? As much as there is a longing to be stripped of all that is ugly and painful, I also wish to get to know the real me that must be underneath all of that. I don’t want me to become completely unrecognizable to myself.

But is a complete change what Restoration Hardware had in mind when they picked such a quote to announce their renovation? Well, though they are creating something new, neither their name nor the general concept of the store going to change as a result of this renovation. They are simply hoping to become a better store. So, perhaps that’s the way to view this quote, and my reason for having ECT. I’m simply trying to become a better me, and despite going through this procedure, my name will still be the same, and what makes me the person that I am will still stand as is.

And like Restoration Hardware, I’ll still be in my process of renovation, with the next ECT coming up on Thursday.

July 25, 2010

I don’t see your true colors shining through

…because that’s what happens when you’re depressed. According to a new research published in the journal Biological Psychiatry, the world really does look gray to depressed people.

From the MSNBC article:
Vision test
The research team had 40 patients with major depression and 40 healthy individuals view a sequence of five black-and-white checkerboards of different contrasts. Each checkerboard flickered (with a black square turning white and white turning black) 12 times per second on a computer screen.

Meanwhile, the researchers used an objective measure called the pattern electroretinogram, which is similar to an electrocardiogram (ECG) of the retina of the eye. The retina ECG shows the response of neurons inside the retinal cells. “That’s not conscious vision, it’s much earlier than you conscioulsy perceive something, within milliseconds,” said lead researcher Dr. Ludger Tebartz van Elst.

The depressed patientshad dramatically lower retinal responses to the varying black-and-white contrasts than healthy individuals. The results held regardless of whether patients were taking antidepressants.

Since conscious vision wasn’t measured, the researchers can’t say for certain whether the patients would be aware of the visual “impairment” in the real world, though they suspect that would be the case.

How the depressed eye works
While the researchers aren’t sure exactly why depressed people might sort of “see the world as gray,” they have a strong hypothesis. Here’s how they figure it works: Contrast vision relies on so-called amacrine cells within the retina, which horizontally connect the retina’s neurons called ganglion cells with each other. These cells rely on dopamine, a substance known to be important for drive and attention – when lacking, two main symptoms of depression.

“We think the retina is some sort of outpost marker of the integrity of the dopaminergic system in the whole brain,” van Elst said. So the dopamine is linked with both the vision and the depression.

The study scientists noted that although these findings are strong, they still need to be replicated in further studies.

The finding has plenty of practical implications, van Elst said, including acting as an indicator of whether anti-depression drugs are working. In addition, the test could provide an objective measure of depression, as clinical tests are not always reliable.

“It’s really amazing that we are able to distinguish healthy controls from depressed patients. That means we have an objective marker for essentially the subjective state of being depressed,” van Elst told LiveScience.

July 25, 2010

a bad cocktail


I messed up. I already take Zolpidem Tartrate (generic Ambien) to go to sleep, but for some reason, I just wanted to feel that sleepiness right away on Friday. So, what do I do? I decide to take a random mix of pills in my house, e.g. Seroquel, Seroquel XL, Trazodone, etc. (Yes, it’s a bad idea to keep old pills I’m no longer prescribed to around, but I do it anyway).

Seroquel and Trazodone have never really been my friends, so I should have known that rather than making me fall asleep fast, they will simply make me sleep for the entire following day…..which is exactly what happened. I couldn’t get out of bed  ’til about 5pm, making me miss my shift at work on Saturday. That zombie-like state I stumbled into from the cocktail of pills lasted pretty much until about mid-day today. I made it to work, albeit an hour late. They’re understanding because they’ve dealt with me on occasion with me and the meds, but I know they can’t keep being kind to me for too long.

Why do I do this to myself?

July 22, 2010

Let me count the ways

It is hot. It’s past 8pm, and I am still sweating as I knock back a Miller Lite on the porch. Even my cat, who usually joins me in sitting outside, has chosen to stay inside. There’s a heat advisory out for tomorrow, with the prediction that the heat index will be around 105 degrees. Oh, how I miss the Santa Barbara weather.

I must admit I’ve spent a considerable amount of time today just thinking of what I wanted to write in this journal….well, and watching episodes of ‘Mad Men’ (trying to catch up before the new season starts this Sunday). Though I did gather some usable ideas, I really wasn’t in the mood to write about ECT or mental health. Just as I was ready to give up on writing something for the day, I came across a page that I thought was an useful reminder for me to look over. It’s copyblogger.com’s “73 Ways to become a better writer.

Here’s the first several ways:

  1. Become a blogger.
  2. Use self-imposed word limits.
  3. Accept all forms of criticism and learn to grow from it.
  4. Read what you’ve written over and over, until you can’t find any more problems.
  5. Show what you write to a trusted friend for feedback.
  6. Outline. And then write to that outline.
  7. Edit, and edit again.
  8. Live with passion.
  9. Be open, curious, present, and engaged.
  10. Take a break between writing and editing.
  11. Learn a new word a day.
    And more……..

Maybe some of the rules don’t necessarily apply to casual blogging (and if they did, it would take a very long time to write a single post), but I thought it’s a good list of advice to think about. One of the thoughts that came to me was about the self-censoring that I’ve found myself doing lately. I realized that it’s not that I don’t have anything to write about; it’s that I don’t know if I want to write it out.

The sun’s gone down, the moon’s out, and there’s finally a slight breeze in the air. I should be working on my take-home exam tonight, but instead, I think I will read this list again and try to regain some confidence in my writing. Maybe a little boost of assurance in my writing abilities will come to help in writing my exam later :) (Okay. Really, I’m just procrastinating….)

July 21, 2010

let it flow

“He who does not weep does not see.”
-Victor Hugo

Dr. Judith Orloff wrote an article on Huffingtonpost.com today about “The Health Benefits of Tears.”

Here’s an excerpt:

Try to let go of outmoded, untrue conceptions about crying. It is good to cry. It is healthy to cry. This helps to emotionally clear sadness and stress. Crying is also essential to resolve grief, when waves of tears periodically come over us after we experience a loss. Tears help us process the loss so we can keep living with open hearts. Otherwise, we are a set up for depression if we suppress these potent feelings. When a friend apologized for curling up in the fetal position on my floor, weeping, depressed over a failing romance, I told her, “Your tears blessed my floor. There is nothing to apologize for.”

July 20, 2010

speak and be heard!

From www.speakaboutdepression.com:

The SPEAK and Be Heard… Living With Depression campaign, made possible by AstraZeneca in partnership with the Depression and Bipolar Support Alliance (DBSA), is designed to inspire hope and show the importance of seeking help for the unresolved symptoms of depression and developing an appropriate treatment plan with a health care provider in an effort to successfully manage the depressive symptoms of bipolar disorder or major depressive disorder.

Select entries will be used to educate people on bipolar disorder or depression through educational, promotional, and commercial programs that are related to the SPEAK and Be Heard… Living with Depression campaign.

If you are successfully managing the depressive symptoms of bipolar disorder or depression, they invite you to share the story of your journey as part of the SPEAK and Be Heard… Living With Depression campaign. Share the struggles you have experienced, the challenges you’ve overcome, and the steps you’ve taken to successfully manage your depressive symptoms so you could participate in life again. SPEAK out. Share your journey. In doing so, you’ll share more than your success. You’ll share hope. So SPEAK. Others will hear.

Submissions will be accepted in five forms: essay, video, art, poetry, and song. Here are the full submission guidelines for more information.

July 19, 2010

“Why Suicide?,” Eric Marcus Asks again

You may have heard of Eric Marcus. He is an expert on gay issues and the author of a dozen books, including “Making Gay History” and “Together Forever,” and is coauthor with Greg Louganis of the #1 New York Times bestselling “Breaking the Surface.” He also wrote a book in 1996 called “Why Suicide?: Answers to 200 of the Most Frequently Asked Questions about Suicide, Attempted Suicide and Assisted Suicide.”

Marcus is coming out with a revised and updated version of this book on September 1, titled “Why Suicide?: Questions & Answers about Suicide, Suicide Prevention, and Coping with the Suicide of Someone You Know.”

Here’s the product description:

In our lifetimes 85 percent of us will have some up-close experience with the suicide of someone we know.  And more than 20 percent of us will have a family member die by suicide.  Journalist Eric Marcus knows this better than most people.  In 1970, his father took his life at the age of 44.  In 2008, his 49-year-old sister-in-law took her life as well.

In a completely revised and updated edition of the landmark original WHY SUICIDE?, Eric Marcus offers thoughtful answers to scores of questions about this complex, painful issue from how to recognize the signs of someone who is suicidal to strategies for coping in the aftermath of a loved one’s death.

No matter what the circumstances, those of us who are affected by suicide are left with difficult and disturbing questions: Why did they do it? Was it my fault? What should I tell people when they ask what happened? Is someone who attempts suicide likely to try again? What should I do if I’m thinking of killing myself?

Drawing from his own experience, as well as interviews with people who have been touched by suicide, Eric Marcus cuts through the veil of silence and misunderstanding to bring clarity, reassurance, and comfort to those who so desperately need it.

Marcus recently gave an interview regarding this book to Therese Borchard on beliefnet.com/Psychcentral.

I’m really interested in reading this book, but at the same time, I’m really scared to pick it up. I don’t know if I trust myself to be confronted with this topic so closely. Also, late August was when I had one of my attempts. I just don’t need any ‘temptations’ or triggers around that time. But maybe getting through this book might be a way for me to gain information about it to help me re-evaluate my opinion about suicide.

www.whysuicidebook.com
www.ericmarcus.com

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