Month: January 2012

Dialectical Behavior Therapy for Borderline Personality Disorder

Posted by Natasha Tracy | Jan 29, 2012

In spite of what some people intimate, I do endorse non-drug solutions and one of the best adjunct treatments to medications is psychotherapy. Many types of therapy can work for different people, but one current and research-backed therapy is Dialectical Behavior Therapy (DBT).

Now, don’t let the big words scare you – this is not a scary therapy. This is simply a therapy that works to use reason to integrate and synthesize to opposite points of view. Meaning, the techniques taught are designed to find a balance in emotion, behavior and acceptance.

Dialectical Behavior Therapy and Borderline Personality Disorder

Dialectical behavior therapy was designed specifically to treat borderline personality disorder; however, it has shown usefulness in mood disorders and research is currently underway to see if DBT techniques are also useful in other disorders. This therapy represents a huge breakthrough as the first indicated treatment of borderline personality disorder.

Nominate a Superior Mental Health Advocate for $10,000

Posted by Natasha Tracy | Jan 27, 2012

The National Council is an organization I recently become involved with as they have asked me to speak at their conference in Chicago this April.

The National Council

In their words, this organization,

… is the unifying voice of America’s behavioral health organizations. Together with our 1,950 member organizations, we serve our nation’s most vulnerable citizens — more than 6 million adults and children with mental illnesses and addiction disorders. We are committed to providing comprehensive, quality care that affords every opportunity for recovery and inclusion in all aspects of community life.

The National Council advocates for public policies in mental and behavioral health that ensure that people who are ill can access comprehensive healthcare services. And we offer state-of-the-science education and practice improvement resources so that services are efficient and effective.

From what I can tell, this organization believes in community care over hospitalization, advocates for people with a mental illness and are just one quality organization.

And they’re giving away $10,000.

Amazing right? Well, I sure think so.

The Reintegration Awards

The awards are known as the Reintegration Awards and there are nine categories. The Reintegration awards have, for 15 years,

… celebrated the achievements of those in the community who dedicate themselves to improving the lives of individuals with serious mental illnesses, and the achievements of those living with schizophrenia or bipolar disorder who battle tremendous odds to improve their own lives and the lives of their peers.

And, as fun as it would be, the $10,000 is actually granted to an organization of the individual’s choice, and not the individual themselves. Most of us, though, would be thrilled to give a $10,000 cheque to a deserving organization.

So, please nominate a spectacular mental health advocate or worker here. People who work hard for us deserve our support. And act fast because nominations close on the 31st of January.

Learn more about The National Council’s initiative here.

Dr. Oz Show – The Shock That Could Save Your Life – Electroshock Therapy for Depression

Posted by Natasha Tracy | Jan 25, 2012

As many people know the Dr. Oz show, did 30 minutes today on electroshock therapy. I’m going to talk a little about the Dr. Oz show’s representation of electroshock therapy and add a few additional facts.

First off, the Dr. Oz show is a source of entertainment, like anything else on TV, so he added drama that wasn’t particularly necessary. That is the way of the show, and TV, however. Specifically, the show started off with scenes of electroshock therapy being given pre-1950 which is when you see people having convulsions in the bad old days before people were anesthetized during treatments. This is not the best way to start a show that is supposed to educate about current treatment, but he does balance this later on.

The Good About the Dr. Oz Show

I was impressed really. They did do a lot of things right and they did share a lot of facts about electroshock therapy, now known as electroconvulsive therapy (ECT). What the Dr. Oz show did right:

Represented the modern procedure accurately and even showed the procedure being performed
Mentioned repetitive transcranial magnetic stimulation (rTMS) as an alternative therapy (rTMS uses magnetic waves rather than electricity)
Stated that almost all insurance companies cover ECT (to the best of my knowledge this is true)
Spoke that it should be used judiciously
Placed it in a reasonable historical context
Tried to reduce stigma and fear and increase awareness around the procedure
Mentioned memory loss (twice) as a side effect

The Bad about the Dr. Oz Show on Electroconvulsive Therapy (ECT)

As with all things in life, nothing is perfect. Some things you should know that weren’t altogether accurate about the show:

Only talked about right unilateral brief-pulse ECT – while this is considered the most modern form of ECT it is not the only type. Before getting ECT you need to know what type you are getting in order to accurately judge the risks.
Stated that ECT “reset the chemical messengers / receptors” in the brain – the truth is we don’t know exactly how ECT works, we only know that it does. It’s likely it works in multiple ways but “resetting chemical messengers / receptors” is mostly just a simplified concept and not medically accurate or at the very least, not medically complete.
Didn’t mention the other side effects of ECT – while memory loss is generally considered the most concerning, other side effects are also possible.

Altogether, I thought it was a good show, and if a tad flamboyant, represented ECT well but there are other things you should be aware of.

Why are People Antipsychiatry? Part 3/3

Posted by Natasha Tracy | Jan 24, 2012

So, I’ve talked about what antipsychiatry is and the history of antipsychiatry a little, and in this third and final part in the series I look at why people are antipsychiatry.

Now, I understand that this is a theory and will only be true for a percentage of people. And I understand that no matter what I say, I will have a deluge of people disagreeing with me.

Nevertheless, I write:

Antipsychiatrists are Scared

Bipolar Spectrum Disorders – What is Cyclothymia?

Posted by Natasha Tracy | Jan 22, 2012

Cyclothymia is neither bipolar depression nor unipolar depression but instead it is an illness that lies somewhere in the middle.

When psychiatric illnesses first started being recognized, some doctors felt that unipolar and bipolar depressions weren’t really the binary options for an illness but really just opposite ends of a spectrum. So then, one would have a spectrum where one could be a 100% bipolar depressive, or 100% unipolar depressive or they could lay somewhere in the middle. However, as illnesses need names and diagnostic criteria and not really vague percentages, bipolar and unipolar depression were defined separately.

Bipolar II – Within the Bipolar Spectrum

Bipolar 2 though, is recognition of this false dichotomy. Bipolar 2 really sits in between unipolar and bipolar depression as more depressed than bipolar 1 but more hypomanic (emotionally dysregulatory) than unipolar depression. (See the difference between bipolar 1 and bipolar 2 disorders.)

And that’s fine as far as it goes. But there is also recognition from a lot of doctors that other states lie even more in the middle, and cyclothymia is one such disorder.

Dopamine and Psychosis in Schizophrenia and News – 3 New Things

Posted by Natasha Tracy | Jan 19, 2012

Hi all. I have a couple of announcements to make and a piece of schizophrenia research to share. Today’s post is about:

Brain activity linked to delusional (psychotic) experiences in schizophrenia
An interview with ShareCare
Advertising on the Bipolar Burble

What’s the Worst Mental Illness?

Posted by Natasha Tracy | Jan 17, 2012

I, as a good little webmistress, keep an eye on my web analytics. So yes, I know some things about my audience, and one of the things I know is what people are searching for when they find me. This sometimes influences what I write about, like today: What is the worst mental illness?

What is the Worst Mental Illness?

That depends on how you judge it. You could judge it by suicide rate, in which case:

Anorexia is the worst with about a 20-25% suicide rate*
Bipolar is second worst with about a 15% suicide rate
Schizophrenia is third worst with about a 10% suicide rate

You could judge the worst mental illness based on disability rates in which case you would probably get:

Schizophrenia as the worst
Bipolar as second worst
Depression as third worst (although more people with depression are on disability overall)

Perhaps schizophrenia is the worst as it’s associated with more psychosis (delusions and hallucination). Perhaps major depression is worst because of the number of treatment-resistant cases.

Or perhaps the answer is simply this: The worst mental illness is the one you have.

Antipsychiatry History – How Did We End Up With Antipsychiatry?

Posted by Natasha Tracy | Jan 15, 2012

Last week I discussed the antipsychiatry movement in general, including some of their critiques of psychiatry – in this piece I will look at why antipsychiatry exists at all. After all, there doesn’t seem to be an anti-cardiology or anti-oncology group – what makes psychiatry so special?

Again, Henry A. Nasrallah, MD’s article: The antipsychiatry movement: Who and why nicely encapsulates this topic, but for those of you wondering about the history of antipsychiatry, here goes.

Antipsychiatry – What, Who and Why? Part 1

Posted by Natasha Tracy | Jan 9, 2012

Antipsychiatry. Yes, I’m against it. I’m what you might call anti-antipsychiatry; if that didn’t sound just so darn silly.

But in saying that, perhaps we should take a greater look at antipsychiatry and what the possible benefits are of such a group (other than giving me writing fodder, naturally).