While some disagree, it’s important that people understand that antipsychotics need to be used for non-psychotic depression treatment, when appropriate.
At any one time, 14 million people suffer from depression but only 60-70% of these people respond to antidepressant treatment. Of those who do not respond, 10-30% exhibit treatment-resistant symptoms including “difficulties in social and occupational function, decline of physical health, suicidal thoughts, and increased health care utilization.” Treating these people presents a huge issue for healthcare practitioners and one of the options they consider is the use of a medication class known as antipsychotics.
Recently, a group called the Therapeutics Initiative wrote a letter entitled Antipsychotics should not be used for non-psychotic depression. Their conclusions are as the title suggests: this body found little evidence to support the use of antipsychotics in the treatment of non-psychotic major depressive disorder.
And while I respect the work of this body and while they have considered some evidence (in the case of quetiapine [Seroquel], an antipsychotic), there is more to consider on the issue.
Today, on the Bipolar Burble Facebook page, someone posted a link to an article on The Health Magazine (a website) that had the headline: A Urine Test Can Distinguish Between Bipolar Disorder And Depression. The poster bought into this headline and felt that “people should know about this.”
Well, I can tell you that when someone claims to have found a urine test to distinguish between bipolar and depression, you should be very skeptical. Believe me, if this were a real thing, it wouldn’t just show up in some clickbait website, written by someone named “admin.” (Normally, these types of sites even steal the content they do have.)
Let’s look at the facts of the matter. Does a urine test to differentiate between depression and bipolar disorder really exist?
Akathisia is a psychiatric medication side effect that revolves around psychological and psychical restlessness which causes distress. People with bipolar disorder report more akathisia with psych med treatment than do those with schizophrenia. And I am now reporting the horrible restlessness, agitation and distress of akathisia is happening to me.
I wrote that Mindfulness Doesn’t Help My Bipolar Disorder. And I think mindfulness, at least how I was taught it, just doesn’t significantly, positive affect a serious, neurological illness. I find it works best in people who experience stress and anxiety. And many do agree with me on this.
That said, John McManamy does not. Here are his thoughts on mindfulness in bipolar disorder.
Mindfulness is essentially the mind watching the mind. The practice has been around forever. It is a staple of Buddhist practice, and is also the basis of modern talking therapies such as cognitive behavioral therapy (CBT), even if its proponents fail to give it credit.
In all likelihood, if you have had success in managing your bipolar, you are employing mindfulness techniques, though you may be unaware of it.
I have experienced so many bipolar medication side effects that I can’t remember them all. They have ranged from the common that many people experience like weight gain and dry mouth to the more unusual such as falling out hair and me falling over. When I started taking bipolar medication and started experiencing side effects, I tended to just grit my teeth, bear it and suffer. And I see this all the time in people. People constantly contact me and ask what to do about bipolar medication side effects because they are currently suffering.
I don’t believe in needless suffering. I believe there are things you can do about many, if not most, of the bipolar medication side effects.
People ask me about the research on bipolar disorder and pregnancy quite a bit. Now, I am not a doctor and nor do I claim to be one; moreover, this is a subject that I haven’t studied exhaustively so I tell these women to talk to their doctors. Unfortunately, that’s the best advice I have been able to give about bipolar disorder and pregnancy.
That said, I read a new paper on bipolar disorder in pregnancy and I thought I would take the time to summarize some of its recommendations regarding pregnancy and bipolar disorder. I’ll add my two cents here and there (clearly noted as just my opinion), but for the most part, this advice comes from the references following the article and not from me. If any of the below concerns or interests you, please check the references and discuss it with your doctor.
It’s difficult to find real patient experiences with, and perspectives on, electroconvulsive therapy (ECT) online. Well, it’s easy to find patient experiences and people’s perspectives on ECT but what tends to happen is that those that scream about ECT the loudest are the only ones people hear. I suspect this is thanks to the extreme animosity held on at least one side of the debate.
I aim to change this with real data from real people who have experienced ECT. What I want is data that will prove or disprove the assumptions that people make about ECT. I really hope you’ll support me in this effort.
I used to be a person who was very mad about psychiatry and psychiatric medication (psych meds). I had that vehement anger we often hear from antipsychiatrists although I was not antipsychatiry, per se. My biggest fantasy, at the time, was to take the horrible medications I was prescribed and shove them down the throat of the prescribing doctor. If only they had to take the medications, they would be more empathetic, more compassionate, more human. But I learned that being mad about psychiatric medication and psychiatry is a losing game and it really got me nowhere.
Transcranial magnetic stimulation is an option for depression treatment and may be an alternative, for some, to electroconvulsive therapy. Transcranial magnetic stimulation (when used as a treatment for depression known as repetitive transcranial magnetic stimulation or rTMS) is actually similar to electroconvulsive therapy (ECT) in that it’s also a neuromodulation technique. It does differ, though, as rTMS is much less invasive and has a very favorable side effect profile, particularly when compared to ECT. There are reasons that people aren’t flocking to rTMS as a depression treatment, though.
[Note: I am running a survey on real patients’ experiences with, and perspectives on, electroconvulsive therapy (ECT). If you’ve had ECT and want your voice heard, please take the survey here. More detailed information on the ECT survey can be found here.]
As some of you may know, I write pieces that sometimes get a lot of hate mail in response to them. This is normal for a writer with an opinion. It happens here, it happens with newspaper pieces, it happens in response to books, it happens absolutely anywhere a writer stands out and says something others consider controversial. (Sometimes, people even threaten to sue me.)
I totally get that and pay it no mind, as a general rule. In fact, I mostly don’t talk to critics as I have very limited time and feel they are not worth it. I write for the people who respond positively to my work, not those who don’t. If you want to know my thoughts, I suggest you reread the article, as that’s where they are.
Peer-Support-Based Initiatives Funding Clarifications
However, I am making an exception today. People have so misrepresented my views and so spewed such ridiculous notions that I feel compelled to at least clarify a few things.
Here is my additional clarification on We Shouldn’t Fund Peer Support-Based Initiatives for Mental Illness.
There is this growing movement of people who think that peer support is critical in the treatment of people with mental illness – but I would contend that, in spite of this movement, peer support does not treat mental illness. And, in fact, by funding these peer support-based initiatives and peer-delivered services we take away dollars that should actually be spent on the evidence-based treatment of serious mental illness.
A baby of Truehope believers died of meningitis likely because they chose to use alternative remedies instead of actual medicine to treat their son. No one can say, of course, whether the baby would have lived with proper care, but what we can say is that without it, he died.
The parents of the baby are David and Collet Stephan – David being the son of Tony Stephan, one of the founders of Truehope.