UNDERSTANDING MENTAL ILLNESS

This may be of assistance as you journey through my blog…

DEPRESSION

Problems and misfortunes are a part of life. Everyone experiences unhappiness, and many people may become depressed temporarily when things don’t go as they would like. Experiences of failure commonly result in temporary feelings of worthlessness and self-blame, while personal losses cause feelings of sadness, disappointment and emptiness. Such feelings are normal, and they usually pass after a short time. This is not the case with depressive illness.What are the signs of depressive illness? 

STIGMA: Definition

Source:  YourDictionary.com

stigma (stig′mə)

noun pl. stigmas -·mas, stigmata stig·ma′ta (stig′mə tə; stig mät′ə, -mat′ə)

1. something that detracts from the character or reputation of a person, group, etc.; mark of disgrace or reproach
2. a mark, sign, etc. indicating that something is not considered normal or standard

Living with a mental illness is trying enough, yet we must also contend with mental illness stigma

Stroke Puts Stress on Spousal Relationship

Patient/caregiver roles often take the place of a partnership, researchers say

TUESDAY, Nov. 10 (HealthDay News) — Although many wedding vows include the phrase “in sickness and in health,” a stroke can put that promise to the test by causing major relationship problems for married couples, according to British researchers.

The University of Ulster study included 16 married stroke survivors (nine males, seven females), aged 33 to 78. The time since their stroke ranged from two months to four years, with an average of 18 months.

The researchers found that the stroke significantly affected sexual activity, led to blurred relationship roles, and feelings such as anger and frustration were confounded by persistent fatigue and lack of independence.

Among the findings:

• All but one of the stroke survivors experienced a reduction or total loss of sexual desire. Some believed this was due to the effects of medication or fear of another stroke.
• Most of the females lost interest in their appearance, regardless of age.
• All the survivors said they’d changed since their stroke. Many said they experienced irritability, anger, agitation and intolerance due to their frustration at not being able to perform daily activities. In some cases, over-protective spouses increased feelings of anger and frustration.
• Many survivors were reluctant to resume social activities with their spouses because of fatigue, anxiety and swallowing problems.
• Fatigue was often associated with reduced independence and guilt because survivors didn’t know how they’d feel from day to day and couldn’t plan ahead.

“All the participants perceived a stroke as a life-changing event. They faced a continuous daily struggle to achieve some sense of normality and that required huge amounts of physical and mental effort,” study co-author Assumpta Ryan, of the University of Ulster’s Nursing Research Institute, said in a university news release.

The study was published online in the Journal of Clinical Nursing.

http://www.nlm.nih.gov/medlineplus/news/fullstory_91677.html

Smoking tied to suicide risk in bipolar disorder

NEW YORK (Reuters Health) – November 11, 2009 – 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.

Bipolar disorder, also known as manic depression, is marked by dramatic swings in mood — ranging from episodes of debilitating depression to periods of euphoric recklessness. Previous studies have found that bipolar patients who smoke have a higher suicide risk than their non-smoking counterparts, but the reasons have not been clear.

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.

Dr. Michael J. Ostacher and colleagues at Massachusetts General Hospital in Boston found that among 116 bipolar patients they followed, current smokers generally scored higher on a standard measure of suicidal thoughts and behaviors.

Moreover, smokers were more likely to make a suicide attempt over the next nine months, the researchers report in the journal Bipolar Disorders.

Five of the 31 smokers in the study (16 percent) attempted suicide during the study period. By comparison, only 3 of 85 non-smokers (3.5 percent) attempted suicide during the study.

The researchers also used a standard questionnaire to gauge patients’ impulsiveness — such as how often they speak or act without thinking and how well they plan for the future.

When those scores were factored in, the link between smoking and suicidal behavior diminished. The implication, according to Ostacher’s team, is that high levels of impulsivity partly explain why smokers were at greater risk.

From a practical standpoint, the researchers write, the findings add more evidence that smoking can be considered a “clinical marker” of higher suicide risk in bipolar patients.

Smoking, in and of itself, may not be a strong predictor of patients’ suicide odds, but doctors can still consider it as part of a comprehensive patient assessment, the researchers suggest.

It is unknown, they note, whether helping bipolar patients quit smoking would have any effect on their risk of suicidal behavior.

http://www.nlm.nih.gov/medlineplus/news/fullstory_91755.html

Is This As Good As Life Gets?

I used to ask myself, practically every day during my illness; is this it?  What if I never get better?  Does it get any better?

Sounds pessimistic, but my history of recurring hospital admissions and medications that were ineffective, coupled with suicide attempts and unrelenting depression, didn’t illustrate a positive picture.  At separate hospital admissions, I was frequently greeted by the same bed, same patients and same nurses who knew precisely my medications.  Nothing changing; asking “is this as good as it gets?”

It’s frightening, and no one should ever have to endure this type of life.  Depression, for me, proved a nasty existence.  After spending months in hospital, then at last discharged, I would forever feel that I was one footstep away from hospital waters every waking day.  Always just a step away from hell; existing only on the surface.

And now I feel somewhat selfish.  I do have a new life now; but a life filled with stress and I feel overwhelmed at times.  Yes indeed, I have broken free from the jaws of depression to a degree, but now have taken on the next chapter after the illness.  Although I am not consumed with depression and suicidal pain currently, I now must mesh with people and mental illness stigma.  For me, hospitalization was a sort of incarcerated life; that of daily rituals of set meal times and social activities, lights out at 11:30 pm, and scheduled visits from family (friends were long gone).   Then finally discharge, after serving my “time”, which meant adjusting to home life all over again.

Depression tears your life into pieces of paper.  At different stages I had to piece them back together again.  It’s a very difficult life we live with mental illness, and all of us should be congratulated with what we have accomplished.  But to answer the question:  Does it get better?  Yes, it does, but (my opinion only) it’s not without sweat on the brow and a constant daily struggle.

Written by: Me

Radical Medicine, Radical Treatment

Treatment for mental illness took a turn in the mid 1940’s with ECT (electroconvulsive therapy) and insulin shock therapy and the use of frontal lobotomy. In modern times, insulin shock therapy and lobotomies are viewed as being almost as barbaric as the Bedlam “treatments”. The effect of a lobotomy on an overly excitable patient often allowed them to be discharged to their homes, which was seen by administrators (and often guardians) as a preferable solution than institutionalization.

Lobotomies were performed in great numbers from the 1930s to the 1950s.

A new Mental Disorders and Treatment Ordinance were introduced in 1935. The term ‘lunatic’ was changed to ‘person of unsound mind’. Doctors were given the power to admit patients and voluntary treatment was allowed.

Restraining devices used in hospitals in the 1800’s and early 1900’s included the padded helmet which was attached to the patient’s head to keep him from banging it against sharp or hard objects, the hand mitten which looked like a boxing glove and prevented patients from gouging and scratching, the straight jacket which restrained the patient’s arms, and cold wet packs which were used by wrapping the patient in ice cold, wet sheets. In addition, patients having seizures were given hydrotherapy, in which they were restrained in bath tubs, covered up to their necks with canvas and bathed with warm water. Electroshock, insulin shock and lobotomies were used only in rare uncontrollable cases.

Emotions Increase Or Decrease Pain, Say Researchers

ScienceDaily (Nov. 11, 2009) — Getting a flu shot this fall? Canadians scientists have found that focusing on a pretty image could alleviate the sting of that vaccine. According to a new Université de Montréal study, published in the latest edition of the Proceedings of the National Academy of Sciences (PNAS), negative and positive emotions have a direct impact on pain.

“Emotions — or mood — can alter how we react to pain since they’re interlinked,” says lead author Mathieu Roy, who completed the study as a Université de Montréal PhD student and is now a post-doctoral fellow at Columbia University. “Our tests revealed when pain is perceived by our brain and how that pain can be amplified when combined with negative emotions.”

As part of the study, 13 subjects were recruited to undergo small yet painful electric shocks, which caused knee-jerk reactions controlled by the spine that could be measured. During the fMRI process, subjects were shown a succession of images that were either pleasant (i.e. summer water-skiing), unpleasant (i.e. a vicious bear) or neutral (i.e. a book). Brain reaction was simultaneously measured in participants through functional magnetic resonance imaging (fMRI).

The fMRI readings allowed the scientists to divide emotion-related brain activity from pain-related reactions. “We found that seeing unpleasant pictures elicited stronger pain in subjects getting shocks than looking at pleasant pictures,” says Dr. Roy.

The discovery provides scientific evidence that pain is governed by mood and builds on Dr. Roy’s previous studies that showed how pleasant music could decrease aches. “Our findings show that non-pharmaceutical interventions — mood enhancers such as photography or music — could be used in the healthcare to help alleviate pain. These interventions would be inexpensive and adaptable to several fields,” he stresses.

The study was authored by Mathieu Roy, Piché, Mathieu, Chen, Jen-I, Isabelle Peretz and Pierre Rainville of the Université de Montréal.

Support was provided by the Fonds de recherche en santé du Québec, the Natural Science and Engineering Research Council of Canada and the Canadian Institutes of Health Research.

http://www.sciencedaily.com/releases/2009/11/091110105357.htm

Women, Depression & Stroke

Women More Likely Than Men To Suffer Depression After Stroke

ScienceDaily (Nov. 11, 2009) — Depression occurs in as many as one-third of patients after a stroke, and women are at somewhat higher risk, according to a large new review of studies. Post-stroke depression is associated with greater disability, reduced quality of life and an increased risk of death.

The systematic review appears in the November-December issue of the journal Psychosomatics.

Brittany Poynter, M.D., and colleagues from the University of Toronto looked at 56 studies on stroke and depression comprising more than 75,000 people, about 12,000 of them women. The time between the stroke and onset of depression ranged from less than two weeks to 15 years.

In women, rates of post-stroke depression ranged from about 6 percent to 78 percent, while in men depression rates ranged from 4.7 percent to about 65 percent.

These findings are important, Poynter said, because women who have had a stroke generally do more poorly than men. They tend to have higher rates of disability and longer hospitalization times. The authors say this might be due in part to higher rates of depression. In addition, “women may have less access to care,” Poynter said.

“People think of stroke as a ‘male’ disease — and it is slightly more common in men — but because it increases with age, more women end up having strokes because they live longer,” said Linda S. Williams, M.D., chief of neurology at the Roudebush VA Medical Center in Indianapolis. She is not associated with the review.

“Post-stroke depression is often unrecognized, both by the patient and the provider,” Williams said. “Patients may have symptoms, but they think that’s a natural reaction to having a stroke. Providers may think it is natural that the patient feels down after having this major life event. So there is a watch-and-see approach instead of a more of an aggressive screening-and-treatment approach.”

It is uncertain what the best treatments for post-stroke depression might be. “There may be multiple treatments beyond antidepressants and counseling, such as exercise, physical rehabilitation and support groups,” Poynter said. “A multimodal approach may be the most effective.”

Both Poynter and Williams emphasized that all stroke patients should be routinely screened for depression.

Adapted from materials provided by Center for Advancing Health.

http://www.sciencedaily.com/releases/2009/11/091110210509.htm

Depressed and Pregnant? Flu Shot May Be Needed

MONDAY, Nov. 9 (HealthDay News) — Pregnant women who are depressed may suffer severe symptoms if they catch seasonal flu, a new study suggests.

Ohio State University researchers assessed depressive symptoms and took blood samples from 22 pregnant women before they received a seasonal flu shot. Those with significant symptoms of depression had a stronger inflammatory response to the flu shot than the other women.

 This finding suggests that a depressed pregnant woman’s immune system doesn’t function normally, which means they may experience more serious symptoms if they’re infected with seasonal flu.

 ”Inflammatory responses to vaccination do no harm, are mild, and typically go away within a few days. But an extended inflammatory response to vaccination, such as the one seen in women with the most depressive symptoms, isn’t expected, and it serves as a way to estimate how somebody might respond to an actual infection or illness,” lead author Lisa Christian, an assistant professor of psychiatry, said in a university news release.

 The researchers said their study shows the need for pregnant women to get seasonal flu shots. The study was published online in advance of publication in the November print issue of the journal Brain, Behavior, and Immunity.

 Public health groups advise pregnant women to get seasonal flu shots, but only 12 percent to 13 percent of them have done so in recent years, according to the U.S. Centers for Disease Control and Prevention.

 ”It will be interesting to see how that might change this year,” in light of CDC recommendations that pregnant women receive both seasonal and H1N1 flu vaccinations, Christian said.

http://health.yahoo.com/news/healthday/depressedandpregnantflushotmaybeneeded.html

INFANT DEATH: Grief and the Path To Loving Rememberance

 

Infant death causes heart-wrenching grief. A Mayo Clinic psychologist offers parents insight and hope.

There is a wonderful article in the MayoClinic.com site written by Shawna Ehlers, Ph.d, a psychologist dealing with infant death grief.

Just click on the following:   Mayo Clinic

CAN YOU TELL?

I’m just re-posting this in case readers have come across this before.  It’s probably one of my favorite articles as it just describes my bp disorder and always brings me back down to earth again when I think I’m an oddity when I expect too much from myself.

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Mental illness is surrounded by a glut of half-truths and untruths. If you tell someone that you’ve been diagnosed with, for example, bipolar disorder, they are likely to roll their eyes and say, “I don’t believe it – you don’t look mentally ill…?”

Which brings me to my question: Do I perchance look like I have Bipolar Disorder? I don’t think I do. Am I perhaps making something out of nothing? Self-confidence and self-esteem slid into the basement and remained there for too many years. Trudging through the mud down there, and finally locating some stairs to climb up, rung by rung, I achieved the surface.

To look at me, I hope you’d never guess I’m bipolar and PTSD. There’s no sign around my neck, but if you worked with me, for example, you’d soon notice that I’m “different,” or a little “odd”.  For one thing, “I’m somewhat negative at times, having difficult moments following directions and have to write everything down. Sometimes I can’t keep focus, and where other people find new work assignments challenging; I sit in self-doubt and bewilderment. My self-confidence feels in jeopardy each moment. I am the one who takes their performance review to heart. Out of nine rights, one negative is discussed, for which I feel total devastation, berating myself repeatedly. A true perfectionist, at least I try to be, however letting myself down is somewhat of a crucifixion. But, I am your dependable employee, the gleeful one, the one who shows little anger, and the one touted as one of the paramount in customer service. I must apply a mask for the most part.

Although felt as if a hex was put upon me years ago, I feel slightly different now. I’m still bitter about the illness at times, but realizing that THIS is ME.

Written by:
Me

Bipolar Disorder in Children: How Early Can It Be Diagnosed?

www.mayoclinic.com  Question:

Can a child be diagnosed with bipolar disorder? Most of what I’ve read says bipolar disorder develops in adults.

Mayo Clinic psychiatrist Daniel Hall-Flavin, M.D., answers:

Although bipolar disorder usually affects adults, there is substantial evidence that it also can occur in children. Making a diagnosis of bipolar disorder in children may be more difficult because its symptoms may be different in children and adolescents than in adults. In addition, some symptoms of bipolar disorder may be initially mistaken as normal mood swings or other psychiatric disorders, such as attention-deficit/hyperactivity disorder (ADHD) or conduct disorder.

However, unlike the normal turbulence of late childhood and adolescence, bipolar disorder is associated with severe difficulties in daily functioning at home and school and with peers.

A family history of bipolar disorder is associated with a greater risk of bipolar disorder in children. According to the National Institute of Mental Health, symptoms of bipolar disorder in children and adolescents include:

·         Destructive outbursts

·         Physical complaints, such as headaches

·         Changes in school performance and relationships with peers

·         School absences

·         Substance abuse

 If your child exhibits such symptoms, it is important that he or she be evaluated by a mental health professional that specializes in child psychiatry to establish an appropriate diagnosis and prescribe effective treatment. Earlier intervention may prevent serious consequences and improve the course of bipolar disorder in children.

http://www.mayoclinic.com/health/bipolar-disorder-in-children/AN01470

Hunting For The Prozac Gene

ScienceDaily (Nov. 7, 2009) — Prozac works wonders for some depressed people, but not for others. In some cases, patients derive little benefit and at worst, it can lead to bizarre hallucinations and fits of rage. Researchers and doctors remain puzzled as to what causes the wide range of reaction to Prozac and similar antidepressants.

The answer, Tel Aviv University researchers believe, can be found in a patient’s genes. And if their research is successful, these scientists may be able to provide psychiatrists with a simple genetic test to revolutionize the treatment of depression.

Hunting for “the Prozac gene” — its response biomarker, in science-speak — is the foundation of a new Tel Aviv University project established by a unique biobank in TAU’s Sackler School of Medicine. Initiated by the biobank’s director Dr. David Gurwitz, and his student Ayelet Morag, the researchers are attempting to discover reliable pharmacogenic markers for antidepressants such as Prozac.

“Many drugs for treating depression are on the market,” says Dr. Gurwitz. “The most popular ones — including Prozac — are the selective serotonin reuptake inhibitors (SSRIs). But they only work for about 60% of people with depression. A drug from other families of antidepressants could be effective for the other 40%,” he says. “We are working to move the treatment of depression from a trial-and-error approach to a best-fit, personalized regimen.”

A genetic basis for psychiatric treatment

Dr. Gurwitz says the key is in our genes, and the first step to unlocking the puzzle lies in discovering relevant biomarkers, the biological elements in blood or DNA that provide clues for disease or conditions such as blood glucose in diabetes, blood pressure in heart disease, and hormones released in pregnancy. Clinicians already base treatments for cancer patients on genetic tests. This has proven especially useful for breast-cancer, where drugs such as Tamoxifen or Herceptin are prescribed only after genetic tests show that they would benefit the patient.

“Why not embrace the same approach for treating depression?” he asks. “We’ve designed an experiment to search for elements that can determine who will — and who won’t — benefit from drugs such as Prozac,” says Dr. Gurwitz.

An effective response to “extreme responders”

Can a Bad Boss Make You Sick?

FRIDAY, Nov. 6 (HealthDay News) — If an inept or abrasive boss is ruining your workday, you may be taking that stress to heart, literally.

New research links having a poor supervisor to a higher risk of heart attack, and that’s not all: people who don’t like their managers also take more sick leave.

 The findings, which come from surveys of thousands of employees in Europe, don’t prove that bad bosses cause illness and heart problems, the report’s author said. And the findings regarding heart attacks only look at men.

 Still, the research does suggest that what happens at work doesn’t stay at work, said Anna Nyberg, a postgraduate student at the Karolinska Institute in Sweden and author of a thesis based on the results of the surveys.

 ”Our findings provide clear support for an association between managers’ leadership and employee stress and health,” she said.

 Nyberg examined the results of several studies that she took part in. Among other things, she examined polls taken of almost 20,000 employees in Sweden, Finland, Germany, Poland and Italy.

 Nyberg found that male workers in Stockholm, Sweden, had a 25 percent higher risk of heart attack over the 10 years following the survey if they’d said their bosses were less than satisfactory. The heart attack rates went up the longer that the employees had to suffer with bosses they disliked.

 Also, workers who complained about their bosses took more sick time. “The amount of sick days taken by employees in our study was associated with how the managers acted, regardless of the employees’ general health status,” Nyberg noted. This “indicates that employees may take sick leave as a means to cope with stress due to destructive leadership at work and perhaps to prevent their health from becoming affected.”

 The researchers behind the various studies included in Nyberg’s report adjusted their statistics to take into account other possible factors, but the link between bosses and health remained intact.

 What about women? There weren’t enough heart-attack cases over the 10-year follow-up period for the researchers to consider how bosses affected female workers’ heart health, Nyberg said. But the trends around sick leave applied to both genders, she said.

 One expert thought the findings had merit.

 Dr. Redford Williams, director of the Behavioral Medicine Research Center at Duke University in Durham, N.C., said stress at work — such as that caused by a boss with poor leadership skills — “arouses the body’s fight/flight response, causing changes in stress hormones that increase blood pressure, inflammatory cytokines, blood glucose levels, even makes platelets stickier and more likely to clot.”

 Over time, this can increase blockages in the arteries and lead to heart attacks and strokes, he said.

 In general, Williams said, “it’s still safe to conclude that poor leadership has the potential to adversely affect the health of the led. It’s likely that there are differences in how sensitive different persons are to these effects, but still clear that poor leadership is bad for health.”

http://health.yahoo.com/news/healthday/canabadbossmakeyousick.html

Flu Shots for Wall Street before us – Not fair, How come?

Flu shots for Wall Street stirs ire in New York

NEW YORK (Reuters) – Nov 5, 2009 – New York City health officials scrambled to explain themselves on Thursday following outraged media reports about bankers who got scarce H1N1 flu vaccines through their employers.

Members of Congress fired off letters demanding immediate explanations and the U.S. Centers for Disease Control and Prevention reminded state and city health officers of the need to make sure the most vulnerable people get shots first.

“I am concerned that the distribution of the vaccine is resulting in favored treatment for the privileged,” New Jersey Democratic Representative Frank Pallone said.

The shortage of H1N1 vaccines has frayed nerves, and public health departments across the country say they will not be able to meet the bulk of the demand until December or January.

The CDC estimates swine flu has infected more than 5 million people and it is documented as having killed 1,000.

The federal government, which is buying the vaccines and distributing them for free to 62 state and city health departments, says 35.6 million doses have been made and packaged since production began.

Connecticut Sen. Chris Dodd released a letter to Health and Human Services Secretary Kathleen Sebelius saying he was “stunned”.

“I implore you to use whatever authorities you have to ensure that H1N1 vaccines already distributed but not yet used are promptly redirected to hospitals, schools, community health clinics, school-based health clinics, and pediatricians so that they can be made immediately available to at-risk members of the public as identified by the Department,” Dodd wrote.

CDC Director Dr. Thomas Frieden sent out a reminder to state and city health departments, which distribute vaccine.

“I ask each of you to review your plans immediately and work to ensure that the maximum number of doses is delivered to those at greatest risk as rapidly as possible,” he wrote.

“I especially appreciate the many innovative ways you’ve found to reach them, including school-located vaccine clinics, special clinics for pregnant women, outreach to children with special needs, and making vaccine available to community- and faith-based organizations serving these high-risk populations.”

Close to 160 million people are in the priority groups to get vaccine first — healthcare workers, pregnant women, children and adults under 65 with medical conditions, caregivers for infants too young to be vaccinated and people 24 and younger.

“When H1N1 vaccine first became available in the fall, we directed all available doses to pediatricians, OB-GYNs, community health centers, public and private hospitals,” New York City health department spokeswoman Jessica Scaperotti said in a telephone interview.

“As more vaccine became available we started to place small orders to providers that serve adults, including employee health centers.”

She said the city had given 800,000 doses to about 1,100 providers, with Lenox Hill Hospital, for example, getting 1,200 doses and banker Goldman Sachs getting 200 of the 5,300 doses it asked for, Scaperotti said.

She said 16 of the city’s 25 biggest employers had vaccine, including Columbia University, Citi Group and others, as well as the Federal Reserve Bank, which is not among the top 25 employers.

(Reporting by Bill Berkrot, Dan Wilchins and Maggie Fox, editing by Alan Elsner and Eric Walsh)

http://health.yahoo.com/news/reuters/us_flu_newyork.html;_ylt=Ah7Gh7Y5NtsZTWakoBpQL9umxbAB

Depression May Blur Memory of Aches and Pains

Expert suggests having people write down symptoms as they occur

TUESDAY, Nov. 3 (HealthDay News) — Depressed people tend to report more physical symptoms than they actually experience, a new study finds.

The study involved 109 women who completed questionnaires designed to assess their levels of neuroticism and depression. For the next three weeks, they kept daily records of whether they felt any of 15 common physical symptoms, including aches and pains, gastrointestinal problems and upper-respiratory issues.

At the end of the three-week period, the women were asked to recall how often they’d experienced each symptom. Those who had a higher depression score at the start of the study were more likely to overstate the frequency of their symptoms.

“People who felt depressed made the most errors when asked to remember their physical symptoms,” psychologist Jerry Suls, a professor and collegiate fellow at the University of Iowa said in a university news release. “They tended to exaggerate their experience.”

It’s long been believed that a high level of neuroticism — a general disposition that includes irritability, sadness, anxiety and fear — is associated with exaggerated reporting of physical symptoms. But the study suggests that a more likely reason is depression.

“For 30 years, the hypothesis has been that neuroticism is behind inflated reports of symptoms,” Suls said. “We’re saying no — depression appears to be the big player. We discovered that people high in neuroticism but low in depression are not likely to mis-remember symptoms.”

The findings, published online Oct. 15 in Psychosomatic Medicine, are important, Suls said, because symptoms reported by patients play a major role in doctors’ diagnosis and treatment decisions.

“Depressed individuals and their physicians shouldn’t discount common symptoms because they can indicate serious problems,” he said. “However, since we now know that depressed individuals tend to over-remember the frequency of symptoms, it wouldn’t hurt to encourage patients to write down their symptoms as they’re happening. That way the patient and doctor have an accurate record of what has been going on, rather than relying on memory.”

http://www.nlm.nih.gov/medlineplus/news/fullstory_91394.html

SITTING IN JUDGMENT

 

 

 

Who am I to judge someone?   Who are they to judge me?

Dictionary:  Judgment: the ability to judge, makes a decision, or form an opinion objectively, authoritatively, and wisely, esp. in matters affecting action; good sense; discretion: a man of sound judgment.

Stigma: a mark of disgrace or infamy; a stain or reproach, as on one’s reputation; a mental or physical mark that is characteristic of a defect or disease: the stigmata of leprosy.

In my opinion, judgment intertwines with stigma.

Why do we judge?

I have voiced previously about my personal experience with both judgment and stigma, in the instance of a family member.  Not long after my hospitalization with major depression, my brother-in-law severed ties with my spouse and me, fearing for his children (or so he claimed).  Each Christmastime thereafter my name was omitted from the Christmas card; only my spouse’s name appearing.  I did nothing immoral or sinful, yet I was judged due to my illness of depression.  That was a case of both judging and stigma of mental illness.

Riding the bus home last Friday, was a true example of judging/stigma. 

A very large woman boarded the already crowded bus, and of course, no one offered her a seat.  I was seated almost to the rear of the bus, aside this young woman.  Immediately, this woman turns to me and says “wow, she is huge, disgusting, you would think she would take better care of herself”.  I retorted back “who are we to judge?”  She gave me a very dirty look.  I also overheard insulting comments behind me about this woman, “imagine her poor husband”, and “she must eat at McDonalds four times per day”; unfair remarks.  Stigma and unfair judgment.

Who made these people judges?  It is unknown what is happening in other people’s lives.  Perhaps they lost a family member, maybe surviving a divorce, surviving mental illness or another illness.  Even if it wasn’t any of those, what affect is it having on anyone else’s life anyways?  Why would it be up to someone else to pass a comment?  What about them; are they so perfect?  I think not. 

The way I try and live my life is, and live by these words; if it doesn’t directly affect me, then why should I judge another person?

Many years ago, a friend of mine was going through marital problems, was married a few times, and her family all but deserted her.   I believe they felt disgrace due to this.  It was her words that forever stuck in my head, “who are they to judge me – this is not affecting them”.  There were no children in the picture.  I think it’s nosy, opinionated people most times, who have to have their say.  They judge, and criticize and hurt.  And they repeat this practice over and over, causing riffs in families or friends.  Do they have self-esteem problems?

I’m not an angel, for I have done it myself; but I try to be aware of it as much as possible.  I think it’s almost required to have an opinion, who would want to go through life and not be opinionated.  But when it travels outside that realm and leaves a trail of judgment and hurt; then it’s gone too far.

Try to be aware of it too.

 

Risks for Post-Traumatic Stress Disorder

Genes And Environment May Interact To Influence Risk For Post-traumatic Stress Disorder

ScienceDaily (Nov. 3, 2009) — Individuals who experience both childhood adversity and traumatic events in adulthood appear more likely to develop post-traumatic stress disorder than those exposed to only one of these types of incidents, according to a report in the November issue of Archives of General Psychiatry, one of the JAMA/Archives journals. In addition, the risk was further increased in individuals with a certain genetic mutation.

Although 40 percent to 70 percent of Americans have experienced traumatic events, only about 8 percent develop PTSD during their lifetimes, according to background information in the article. PTSD is a complex anxiety disorder that involves re-experiencing, avoidance and increased arousal following exposure to a life-threatening event. “In addition to the obvious effect of environmental factors, PTSD has a heritable component,” the authors write. Recent studies estimate that genetic factors account for approximately 30 percent of the difference in PTSD symptoms.

Pingxing Xie, B.S., of Yale University School of Medicine, New Haven, Conn., and VA Connecticut Healthcare Center, West Haven, and colleagues studied 1,252 individuals who had experienced childhood adversity (including abuse or neglect), adult trauma (such as combat, sexual assault or a natural disaster) or both. Participants age 17 to 79 (average age 38.9) were interviewed and assessed for a variety of psychiatric and substance use disorders. DNA was extracted and used to differentiate between versions of a particular polymorphism or gene mutation — known as the 5-HTTLPR genotype — previously found to be associated with emotional response after stressful life events.

About one-fifth of the participants (229, or 18.3 percent) met criteria for PTSD. A total of 552 of the 1,252 participants (44.1 percent) experienced both childhood adversity and traumatic events in adulthood. These individuals were more likely to have a lifetime diagnosis of PTSD than were those who experienced trauma in only one life stage (29 percent vs. 9.9 percent).

“Although the 5-HTTLPR genotype alone did not predict the onset of PTSD, it interacted with adult traumatic events and childhood adversity to increase the risk for PTSD, especially for those with high rates of both types of trauma exposure,” the authors write. The genotype may influence the way the brain processes the neurotransmitter serotonin, affecting an individual’s anxiety levels and changing the way neurons react to fearful stimuli, they note.

“It was only in the group of subjects who could be characterized as having had the highest rates of trauma exposure (i.e., in both childhood and adulthood) that an impact of 5-HTTLPR could be detected,” the authors conclude. “This suggests that there may be many neurobiological (including genetically determined) ‘buffers’ to PTSD; only in instances of extreme and/or repeated trauma exposure (which, it should be pointed out, characterizes those trauma ‘types’ with the highest conditional risk for PTSD, e.g., domestic violence and military combat), in which these buffers are overwhelmed, can the impact of specific genes such as 5-HTTLPR be detected.”

This work was supported by National Institutes of Health grants.

http://www.sciencedaily.com/releases/2009/11/091102171409.htm

Deep Brain Stimulation Gives Hope For Very Severe Depression

ScienceDaily (Nov. 3, 2009) — Thanks to a new method, there is a reason for hope for patients with very severe depression. Physicians at the University Clinics of Bonn and Cologne have treated ten patients with deep brain stimulation. This involved implanting electrodes in the patients’ nucleus accumbens. This centre has a key role in as the brains reward system, whose function may be impaired in depressive people. Subsequent to this treatment, the patients’ depression improved significantly in half of the patients. All patients had suffered from very severe depression for many years and did not respond to any other therapies.

The results of the study will be published in the journal Biological Psychiatry (doi: 10.1016/j.biopsych.2009.09.013).

In deep brain stimulation, doctors specifically target the impaired function of certain areas of the brain with an electric brain pacemaker. For the purpose of this study, they implanted electrodes in what is known as the nucleus accumbens. That is an important part of the ‘reward system’ which ensures that we remember good experiences and puts us in a state of pleasant anticipation. Without a reward system we would not forge any plans for the future as we would not be able to enjoy the fruits of these plans. Inactivity and the inability to experience pleasure are two important signs of depression.

A total of ten patients with very severe depression participated in the study. In all patients, symptoms did not improve despite many therapies using psychotherapy or pharmacotherapy. Overall, all participants showed signy of improvement, in half of them symptoms of depression improved significantly. Initial effects could sometimes be seen just after a few days. ‘Thus, inter alia we observed increasing activity of the patients,’ Professor Thomas E. Schlaepfer from the Bonn Clinic of Psychiatry and Psychotherapy explains. ‘This was so successful that some of them were even able to work again, after having been incapacitated for many years. None of our patients had ever responded to any other therapy to a comparable extent before.’

 Hardly any side effects

Five patients’ well-being improved considerably and in a sustained fashion. Even after a year, the stimulation of the nucleus accumbens still had the same efficacy as at the beginning of the study. During the study, the scientists also observed distinct anxiety-relieving effects which had not been observed in studies on deep brain stimulation to date. ‘Severe anxiety is often an accompanying effect of depression,’ the primary author of the study Dr. Bettina Bevernick explains. The overall brain function of the participants was not impaired by the treatment, some neurophysiological functions even improved. Overall, the scientists only noticed minor side effects, e.g. as a consequence of the operation or after changing the electrical parameters of stimulation. However, these effects always wore off after short periods of time.

 Stimulation changes the brain metabolism

But what is the exact effect of the stimulation of the nucleus accumbens? ‘We were able to show using functional brain imaging methods that the stimulation changes metabolic rates of different areas of the brain,’ Thomas Schlaepfer says. ‘What is very important is that the metabolic changes do not just affect the nucleus accumbens itself but also other regions of the limbic system, where the brain processes emotions and that are known to be dysfunctional in depression.

Due to the small number of patients in this and similar studies, the scientists warn against exaggerated hopes. Moreover, with brain surgery in psychiatric patients specific ethical issues have to be considered very carefully, not least because such an operation is always associated with risk. ‘However, our study definitely shows that deep brain stimulation can help some patients with extremely severe forms of depression,’ Thomas Schlaepfer stresses. ‘That even goes for cases which were thought to be absolutely therapy-resistant up to now.’

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Adapted from materials provided by University of Bonn, viaEurekAlert!, a service of AAAS.

 

http://www.sciencedaily.com/releases/2009/11/091102121624.htm

Can Physical or Sexual Abuse in Childhood Cause BPD?

     Can physical or sexual abuse in childhood cause             borderline personality disorder?

Mayo Clinic psychiatrist Daniel Hall-Flavin, M.D., answers:

Traumatic events in childhood — such as physical or sexual abuse — increase the risk of borderline personality disorder and other personality disorders. But the exact cause of borderline personality disorder isn’t known. Most likely, it’s caused by a combination of heredity and environmental factors.

Borderline personality disorder is a serious emotional disturbance that’s characterized by unsatisfactory and unstable personal relationships, intense anger, impulsive actions, feelings of emptiness, and real or imagined fears of abandonment. It may be that emotional trauma at a time when the brain isn’t fully developed alters something in the brain that decreases the ability to effectively deal with subsequent stressful situations.

Childhood abuse can also be associated with other mental illnesses including depression, post-traumatic stress disorder, anxiety disorders and substance abuse disorders.

http://www.mayoclinic.com/health/borderline-personality-disorder/AN01093

For People on Dialysis, Too Thin Can Be Risky

 SUNDAY, Nov. 1 (HealthDay News) — Dialysis patients with very low body fat are much more likely to die than other people on dialysis, even those with the highest levels of body fat, a new study has found.

Researchers measured body fat percentage in 671 dialysis patients in California. In the next five years, the death rate for people with less than 10 percent body fat was 2½ to three times higher than it was for those with body fat of 20 percent to 30 percent.

 Further analysis confirmed a direct link between body fat and risk of death, the researchers reported.

 ”The higher the body fat, the greater the survival,” Dr. Kamyar Kalantar-Zadeh, of the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, said in a news release from the American Society of Nephrology.

 ”Our study indicates that body fat may be protective in dialysis patients,” he said. “The results add to the increasing number of reports about the ‘obesity paradox’ or ‘reverse epidemiology’ in patients with chronic kidney disease and other chronic diseases.”

 The obesity paradox refers to the fact that a higher body-mass index is associated with greater survival in dialysis patients.

 The study was to be presented at the American Society of Nephrology’s annual meeting in San Diego.

http://health.yahoo.com/news/healthday/forpeopleondialysistoothincanberisky.html

Processed food link to depression: research

LONDON (AFP) – November 2, 2009 – A diet heavy in processed and fatty foods increases the risk of depression, according to British research published on Monday.

Researchers at University College London also found that a diet including plenty of fresh vegetables, fruit and fish could help prevent the onset of depression.

They compared participants — all civil servants — who ate a diet largely based on “whole” foods with a second group who mainly ate fried food, processed meat, high-fat dairy products and sweetened desserts.

Taking into account other indicators of a healthy lifestyle such as not smoking and taking physical exercise, those who ate the whole foods had a 26 percent lower risk of depression than those who ate mainly processed foods.

People with a diet heavy in processed food had a 58 percent higher risk of depression.

The researchers put forward several explanations for the findings, which are published in the British Journal of Psychiatry.

Firstly, the high level of antioxidants in fruits and vegetables could have a protective effect, as previous studies have shown higher antioxidant levels to be associated with a lower risk of depression.

Secondly, eating lots of fish may protect against depression because it contains high levels of the sort of polyunsaturated fatty acids which stimulate brain activity.

And they said it was possible that a “whole food” diet protects against depression because of the combined effect of consuming nutrients from lots of different types of food, rather than the effect of one single nutrient.

The researchers concluded: “Our research suggests that healthy eating policies will generate additional benefits to health and well-being, and that improving people’s diet should be considered as a potential target for preventing depressive disorders.”

The study was carried out on 3,486 people with an average age of 55, who worked for the civil service in London.

Each participant completed a questionnaire about their eating habits, and a self-assessment for depression.

http://health.yahoo.com/news/afp/lifestylebritainhealthresearch_20091102154444.html

My 2 Cents:  I don’t tend to agree with this ‘research’.  For me, I know that my diet did not bring on or about my illness of depression.  This is a mental illness.  Perhaps in others it may have been discovered that they ate fatty food, thus becoming depressed.  I don’t buy it.  What do you think?  I can see eating these bad foods WHEN you are depressed though.

What Exactly Is A ‘NERVOUS BREAKDOWN?"

What is a nervous breakdown? What causes people to have them?

Mayo Clinic psychiatrist Daniel Hall-Flavin, M.D., answers:

The term “nervous breakdown” is used by the public to characterize a wide range of mental illnesses. Nervous breakdown is not a medical term and doesn’t indicate a specific mental illness. Generally, the term describes a person who is severely and persistently emotionally distraught and unable to function at his or her normal level.

Often, when people refer to having a nervous breakdown, they’re describing severe depression.

Signs and symptoms of severe depression include:
~~ Agitation or restlessness
~~ Difficulty or inability to stop crying
~~ Sleeping difficulties
~~ Dramatic appetite changes
~~ Indecision

The causes of mental illness usually aren’t clear. But these factors may play a role:
~~ Stress
~~ Drug and alcohol use
~~ Coexisting medical conditions, such as thyroid disorders and certain vitamin deficiencies
~~ Genetics

http://www.mayoclinic.com/health/nervous-breakdown/AN00476

High Stress Jobs And GI Disorders?

New Studies Explore Connection Between High Stress Jobs And GI Disorders

ScienceDaily (Oct. 30, 2009) — In two new studies, presented at the American College of Gastroenterology’s (ACG) 74th Annual Scientific meeting in San Diego, researchers explored the connection between high stress, high exposure occupations and long-term gastrointestinal disorders.

The studies, performed by the United States Navy and the State University of New York (SUNY), Stonybrook, examine the long term effects of infectious gastroenteritis (IGE) among active duty military and the interaction between gastroesophageal reflux (GERD) and mental health disorders among World Trade Center workers, respectively. Both studies will be the highlight of an ACG roundtable discussion being held on Tuesday, October 27, 2009 entitled: “Impact of Workplace Stress and Exposure on GI Disorders: Occupations that Take Guts.”

Infectious Gastroenteritis: Risk in Military Duty

Dr. Mark Riddle, of the United States Navy, led the study that examined functional gastrointestinal disorders (FGD) within the active military population and their connection to IGE. IGE can be caused by a variety of factors, including exposure to bacterial pathogens, protozoa and/or certain viruses, and active duty military personnel are at high risk during deployments.

KEEPING UP APPEARANCES

  I was in a dilemma a few years back.  My husband’s company was having their annual picnic and he felt obligated to go.  I, of course resisted initially, and then thought I was being self-centered since I had backed out of several of his company functions previously.  These functions were of course met with forever the same excuse; my never-ending black depression.

The gigantic hands of depression kept its hands tightly around my neck for so many years; seeing only blackness, feeling only hollowness.  Previous company Christmas parties and functions would have demanded smiles, small talk and then my principal fear “where do you work” question. The only people I socialized with were a small number I met while in the hospital. 

My first sense of upset as we drove into the park was the thought of mingling with the other women at the picnic.  I was neither interested in their lives, and I definitely didn’t desire to reveal mine.  My preference was to just sit by myself, but I knew this would appear suspicious and rude.  I mingled though, and pretty much fibbed about my entire situation with a tale about a home based business.  Thank goodness they didn’t ask what product I sold, then again; they were too busy bragging about what they did.  A relief to say the least.

We stayed for about 3 hours, but what seemed like an eternity, and one of the first ones to leave.  Hubby was proud of me that day for making the attempt, and I was proud of myself too.  But, I returned home to my cocoon, and unfortunately regressed and became even more depressed following that outing.  In retrospect, I can’t really explain why I couldn’t cope, possibly depression feels like a death sentence and that’s where you feel you will always remain.

Written by:  Me