mental illness issues

Mental Health Information – 3 New Things

→ August 4, 2011 - 1 Comment

Sometimes writing for a living drives me bonkers. Basically, I have to be brilliant on-command. And seriously. That’s hard.

You. Write. Be brilliant. Now!

It’s a lot of work for me. My brilliance gets tired and bogged down in the bits of my job I don’t like doing.

However, then I’m reminded there are many wonderful things about my job. Specifically, I get to learn new things, every day, all the time. While others work at real jobs I spend all day looking up facts and studies and learning things I didn’t know when I woke up.

I love that stuff.

3 Things I’ve Learned About Mental Health

Three New Mental Health Articles

So, I’m creating a weekly feature by sincerely flattering Jane Friedman and stealing her idea. (Jane writes Three Happy Things about writing once a week. Go check her out.) I’m not sure they will be three happy things, exactly, but I will be sharing three new things about mental health I’ve learned each week.

This will give me a chance to share smaller details that don’t make it into a full blog post, pimp the resources I like and otherwise share my knowledge.

On board? Great!

Three New Things About Mental Health

Not surprisingly, I’m inundated with information about mental illness/psychiatry/psychology. I’m constantly researching, reading articles, checking sources and other such things. I come across things I like and things I don’t.

  1. What I don’t like – the British Psychological Society’s comments on the revisions proposed for the fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). The British Psychological Society appears to be a non-profit group dedicated to psychology/psychologists. Which is fine. I’m a fan of psychology/psychologists. But their remarks on the DSM-V revision sound like propaganda nonsense. Not only can they not get through a paragraph without cutting-and-pasting, they seem to have only one thing to say – we don’t like the idea of diagnosing mental illness; oh, and we’re better than you.
  2. What I do like – a Psychiatric Times article: The FDA Advisory Panel on the Reclassification of ECT Devices. I wrote about this issue for Breaking Bipolar to put it into smaller, more easily-digested chunks. (Why There Isn’t More Modern Data on ECT and Should the FDA Consider ECT Devices Less Dangerous.) But read the original article. It’s good and shines a light on yet another ECT issue that get’s people’s knickers all twisted.
  3. What I think is interesting – a journal article on methods of schizophrenia treatment. This article is interesting because it outlines non-North American treatment options as well as standard antipsychotic/medication options. The article’s goal is to define schizophrenia recovery and use evidenced-based methods to determine the best path to schizophrenia recovery. Do yourself a favor and educate yourself about schizophrenia.

I do admit, those may not be easy reading, but they are worthwhile reading (or skimming, anyway).

I’ll see you next week when will I learn more and try to do better.

PS: If anyone has any direct knowledge of the British Psychological Society I’d love to hear it. They seem quite legitimate but I have to question the motives of such an odd report.

Mental Health and Suicide – Information Round-Up

→ August 3, 2011 - 6 Comments

As loyal readers know over the last couple of weeks I have written quite a few pieces both on the Burble and on Breaking Bipolar on suicide after a person I consider a friend attempted suicide. Luckily he is still with us, and I think the writings on the topic will help others who have been through a suicide attempt and the loved ones of those who have attempted suicide.

Something Good From a Suicide Attempt?

I don’t want to say something “good” came out of my friend’s suicide attempt because I think that diminishes his personal experience. But maybe others have been helped. And that is thanks to him. Thanks to his honesty and bravery in speaking about his suicide attempt. I’m honored to know him.

So here are articles for:

  • Those who have attempted suicide
  • Those who love someone who has attempted suicide
  • How to prevent a suicide attempt

What to do After a Suicide Attempt

To Those Who Have Attempted Suicide

I know many people have attempted suicide and they feel ashamed and alone. Often those who have attempted suicide are treated like lepers by those who love them.

Well, not by me.

Please read my words to you:

To the Loved Ones of Those Who Have Attempted Suicide

You’re not in an easy position, and I know it. Please read:

Preventing a Suicide Attempt

And, of course, the best of all results would be to avoid a suicide attempt in the first place. If I could give that gift to everyone, I would. Please read these articles:

Get Help for Suicidal Thoughts Now

If you feel you may hurt yourself (or anyone else) please get help now. You are not alone. We are with you. We have survived. You will find a way through.

Mood Tracking for Bipolar Disorder – Why Track Your Mood? (1/2)

→ July 25, 2011 - 17 Comments

Ask a Bipolar: What about mood charting?

Most doctors (mostly psychiatrists) will ask you to track your mood if you have a mood disorder like bipolar disorder or depression. And while most people (psychiatrists and patients) would agree mood tracking is good, most people would also admit to not doing it.

I understand why mood tracking doesn’t get done. It’s like a homework assignment when you’re already working full-time. You just happen to be working full-time at being crazy. Homework tends to get left in the book bag.

However, there are easy, painless, simple ways to track your mood that can offer real benefits. Sixty seconds a day. Promise.

What is Mood Tracking?

Mood tracking is pretty simple. Mood tracking is just a way of writing down various aspects of your mood and mental illness symptoms on a daily basis to look for trends.

Mood tracking attempts to look for variables that affect a mental illness like bipolar disorder or depression. You generally want the results in a graph so it’s easier to see mood trending.

Why Track Your Mood in Depression or Bipolar?

It’s easy to tell your doctor your mood right? Depressed or manic? Severity: one-through-ten. Simple.

Except it isn’t. At least not in the most helpful sense. Telling your psychiatrist what your mood is when you’re sitting in front of him might be useful, but that’s only one tiny data point and these was probably a month between that answer and your last appointment. You can’t see trends when you track moods by months unless they absolutely smack you in the face.

Ups and Downs and Mood TrackingPeople Can’t Remember Their Mood (Even When Paying Attention)

People are terrible at remembering mood. This is pretty much what happens:

“What was your mood last week?”

“Um, mostly OK, I guess.” Or you might say, “Depressed.”

This is not accurate mood reporting. In reality, everyone’s mood fluctuates to some degree. You were more depressed on Thursday because they didn’t air a new episode of Burn Notice. You had a visitor that lifted your mood a little for two days. That sort of thing.

Benefits of Mood Tracking

By tracking your moods for depression or bipolar disorder (or any mental illness, really), you can find:

And about a million other things. Not to mention the fact you will have a record of your mood (and hopefully side effects) and when some future doctor asks how you reacted to med X from two years ago, you’ll have the answer. (Yes, an endless frustrating reality.)

How to Track Your Mood in 60 Seconds

So, have I sold you on mood-tracking? Good. In part two I’ll talk about how to track your mood, what to track, how to remember to track your mood and I how I track my mood in 60 seconds a day.

Warning Signs You Need to Know – How to Predict a Suicide Attempt (2/2)

→ July 20, 2011 - 36 Comments

Warning Signs You Need to Know – How to Predict a Suicide Attempt (2/2)

In part one I discussed the details of a study about 100 people who attempted suicide in Florida. Part two outlines the predictive factors for suicide attempts identified in this study and how we can use this information to predict who will attempt suicide.

And perhaps more importantly, how you can prevent a suicide attempt in a loved one.

Read more

Suicide Warning Signs You Need to Know – Who Attempts Suicide? (1/2)

→ July 18, 2011 - 14 Comments

Suicide Warning Signs You Need to Know – Who Attempts Suicide? (1/2)

Some of us in the mental health field have heard the suicide warning signs so often it’s practically tattooed on the back of our skull: suicide note, suicide plan persistent thoughts of suicide, previous suicide attempt and so on.

But if you think you know the warning signs for a suicide attempt you’re probably wrong, at least according to a study out of Florida. For example, fewer than 1-in-10 people leave suicide notes and fewer than one-third of people have persistent thoughts of suicide before their suicide attempt.

Read more

No Hospitalization after a Suicide Attempt?

→ July 13, 2011 - 167 Comments

No Hospitalization after a Suicide Attempt?

As I mentioned, a friend of mine attempted suicide last Friday. His life was saved by his friends, the police and hospital staff. I’m grateful his suicide attempt was not successful.

But one of the oddest things about this scenario is after the suicide attempt he was not hospitalized. The hospital stabilized and released him. Just like that. No psychiatric hold. No psychiatric treatment. Nothing.

What the hell is up with that?

Read more

To The Mentally Ill Who Attempt Suicide

→ July 10, 2011 - 50 Comments

It is a depressing reality most people with a serious mental illness will attempt suicide at some time. Yes, more than half will attempt suicide. That’s a very large number. More women will attempt suicide but more men will commit suicide. Women will overdose while men will use firearms. More than half of these people will not leave suicide notes.

We are lucky most suicide attempts fail. Most people who attempt suicide will be rescued by others.

A Suicide Attempt

Last Friday night a man I met online tried to kill himself. He posted his suicide note online. Thankfully, some friends of his called 9-1-1, the police entered his apartment and took him to the hospital.

I am very grateful he is still alive.

The Shame of Attempting Suicide

After a suicide attempt, many people are thankful they didn’t succeed. Most people who attempt suicide later realize the moment they attempted suicide was a particularly brutal part of the fight against their mental illness and death is not truly what they want. They end up feeling ashamed of their suicide attempt.

Suicide Attempt isn't ShamefulPlease Don’t Feel Ashamed of a Symptom of Your Illness

I understand the shame that goes with doing something you later regret. I understand the shame of realizing you did something because of your mental illness. I understand the shame of acknowledging you admitted defeat at the hands of pain and depression.

But a suicide attempt is not shameful.

A suicide attempt is a symptom of an illness. It is no more shameful than sneezing from a cold. Attempting suicide is brutal and hard and painful on you and those around you. No one wants to see you die, see you gone. But the fact for one moment you gave in to the pain isn’t shameful, it’s human.

Those who do not know the pain may not understand. But sometimes you hit a wall. A wall of pain. And sometimes that wall tries to kill you.

You Are Not Who People Say You Are

Some people try to hurt you because you have attempted suicide. Some people try to use this symptom as evidence you are, in some way, “bad.”

But you are not bad. You are sick. Anyone that would use an illness to hurt another person is an abuser. Anyone that would try to use a suicide attempt as a weapon does not deserve a second thought. Or a first one for that matter. You are better than that. They are not worthy of you.

Humans Make Mistakes

Every one of us has done things we later regret. Some of us (most of us) have been complete assholes at one time or another. Humans are selfish, crass, hurtful, awful people sometimes. We’re like that. We’re wildly imperfect beings.

But these mistakes make us human. Recognition of frailties is a strength. It’s only after realizing what we don’t like in ourselves that we can change it.

A Suicide Attempt Isn’t the End of the World

Yes, a suicide attempt is horrible; a suicide attempt may run roughshod over your life; a suicide attempt may hurt those around you. A suicide attempt is painful but it isn’t the end of your world.

Attempting suicide puts you in the company of many of your fellow crazies. If you look to the left and to the right of you, you will see thousands of people just like you. Who made the same choice. Who now live to tell the tale.

A suicide attempt is horrible, but it is part of mental illness and not the end of the world.

Save Yourself Now

If you feel unsafe, don’t wait, contact someone right now. Here is information on how to get help. Let these people help you. You need to fight your mental illness.

I am extremely grateful my friend is still here. The people in your life want you to be here too.

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Know that there is zero latitude when commenting on this post. I will not tolerate negative, hurtful or sarcastic comments.
 

Share Your Tips on Talking to Doctors / Psychiatrists

→ July 8, 2011 - 22 Comments

Communication with Psychiatrists

I’m working on my first ebook. It’s going to be about building a relationship with your doctor. Essentially, it’s about getting what you, the patient, need from the person behind the prescription pad.

Why Write About Doctor-Patient Communication?

I’m writing this book because of the plethora of mental health questions I get on the subject. I believe people with bipolar disorder, depression and other mental illnesses don’t get optimal care due to dysfunctional medical relationships. This is not necessarily the fault of the doctor / psychiatrist or the patient. It just means the relationship isn’t as good as it could be. Think of it like couples counseling between doctor and patient.

So, I have some questions for you; please weigh in. (Oh, you don’t have to answer all the questions. Any that interest you would be great though.)

What Do You Wish You Had Asked Your Doctor When You Were Diagnosed?

Pre-diagnosis, before you understood your mental illness, what do you wish you had known? What do you wish you had asked your doctor about your diagnosis? What do you wish you had said to your family doctor or psychiatrist specifically?

Communication with Psychiatrists

What Do You Wish You Had Asked About Your First Treatment?

What do you wish you had known about treatment? What do you wish your doctor had told you? What do you think new patients should know? Who do you think should handle treatment?

What Do You Think Patients Should Ask About Treatments / Side Effects?

When you get a new treatment or change your treatment, what do you ask your doctor? What should people ask? What do you want to ask but always forget? What do you want to ask but are too afraid too? What do you wish your doctor would tell you?

What Should You Tell Your Doctor / Psychiatrist?

What is most important for a doctor / psychiatrist to know? What do you always tell your doctor? What are you too scared to tell your doctor? Is there something you think you shouldn’t tell a doctor/psychiatrist?

What Makes a Relationship with a Doctor / Psychiatrist Work?

After dealing with doctors for over a decade, I have my own ways of making the psychiatrist-patient relationship work. What are your tips for patients? What works with a doctor and what doesn’t?

What Other Questions Would You Like to See Addressed?

What else do you think I should put in the book?

Why Am I Asking?

I’m asking because I would like to represent the real voice of the real patient as much as possible. I know what I want to write and why, but I’d like to hear varying opinions. Every one of you is different and every one of you has a different insight to share. Whether you love or hate doctors, this book is designed to make your relationship with them work better for you, and maybe for them as well.

I look forward to hearing your thoughts.

Note

By responding here you agree to be quoted in the book should I choose to do so. I’ll only use aliases to identify people so you don’t have to worry about people identifying you. If you don’t want to be quoted, that’s no problem, just say so.

If you have something to add but wish to do so privately, contact me here.

Are Psych Meds Addictive? – Antipsychotics (Part 2)

→ June 28, 2011 - 14 Comments

Are Psych Meds Addictive? – Antipsychotics (Part 2)

In the first of this series I discussed antidepressants and addiction. Some people contend antidepressants are addictive; however, not only is the term “addiction” not defined medically, the use of antidepressants does not generally match the symptoms of any defined substance use disorder either. (More information on substance abuse and substance dependence.)

This time antipsychotics are up to bat. Are antipsychotics addictive? Are people dependent on antipsychotics? Do antipsychotics cause withdrawal?

Read more

Antidepressants and Addiction, Dependence – Talkback

→ June 12, 2011 - 43 Comments

The Bipolar Burble recently received a couple of comments on the antidepressants and dependence / addiction post from Tabby. My response to her second comment ended up being so long I decided to put it in it’s own post.

Here is an excerpt from Tabby’s comments (edited for length). If you would like to read them in their entirety, please see here and here. (Symbol […] indicates removed text. Other ellipses are from the original text.)

Antidepressants and Addiction and DependenceComment on Are Antidepressants Addictive?

I know of people who cannot go not 1 day without their medication and the medication not be a life saving med like a blood thinner but be a Anti-depressant. They become all anxiety ridden and panic filled because they just know that if they miss that 1 dose or those 2 doses for that 1 day […]

They can’t sleep and they get agitated and they get quite vile until they get that dose or doses. They resort to sobbing, they resort to melodrama of threatening suicide…

[…] I’m talking a cymbalta, or a lexapro. I work in a MH agency and we have patients call cause they’ve gone 1 day without their prescription. […]

I am also one with Bipolar and when your entire day, or entire life, is solely dependent on whether you took your pill or pills that 1 day… I dare to say, you have a dependence.

Now… you have blood clots and you miss 1 day of your blood thinner.. then we may have a major issue. You miss 1 day of your Seroquel, or your Cymbalta, or your Depakote… seriously, it will be okay… if not, use your psychotherapy techniques. Oh, that’s right… not too many actually do psychotherapy… it’s all the meds baby.

[…] I am well aware of the benefits of medication compared to no medication for those with Mental Illness. My point was – too many people seek out the comfort of the medication to handle their daily life’s issues […] than to try and work on figuring why they are having the problem in the first place.

Folks do not wake up, naturally, anxious. Something has to have occurred to trigger that emotion and anxiety is an emotion that triggers a physical response. Yet, too many run to the cabinet and down pills to “calm” the anxiety rather than try to do something else non-medicated that […] The first reaction is to kill the emotion/feeling… not to try and figure why it’s happening.

No therapy doesn’t work in all settings or all situations but if you never try, then it will certainly never work. In that your blogs are predominately med supporting… I could say that you mock those who try to use more psychotherapy than meds.

Seroquel and Depakote are not equivalent to Warfarin or some of the other medications needed for literal body functioning. Yet, if you have been on a med for a long period of time, for example Seroquel to put you to sleep every night.. and then suddenly you miss a dose or 2… YOU WILL HAVE SYMPTOMS. That’s med dependence and you’ll have a psychological dependence because you’ll become frantic wanting your med.

[…] Many folks suffer with their Bipolar symptoms, or any MI symptom, long before they ever take the 1st pill. So, the life-saving aspect is only a “feeling”.

I  know the meds help but have they literally saved me? No. They take away the uncomfortable and the frightening… but they don’t keep me from dying. If they were the sole and only reason, then I’m a walking med cabinet.

Even folks that take a plethora of meds, every single day and swear on a stack of their most revered book… still kill themselves […]

Thanks Tabby for your response. I think your thoughts on the issue represent a perspective of many.

Psych Meds for Bipolar and DepressionAntidepressants (and Mood Stabilizers) Are Not Life-Saving

Naturally, I would beg to differ. While yes, people  live with a mental illness before  treatment, and obviously, they don’t successfully kill themselves, that is not proof psych meds do not save lives.

There are two types of people (at least) for whom psychiatric medications are life-saving:

  1. Those who would have killed themselves if not been treated. (Often those who previously attempted suicide and failed.)
  2. Those for whom the medication keeps them from falling into a tremendously dangerous mood such as severe depression or mania which is unpredictable and can easily kill a person (or even those around them.)

In neither case can you “prove” whose lives were saved, but many of us on this side of the illness believe we wouldn’t be here but for the medication.

(Quick FYI on suicide. When autopsies are done of suicide victims it is almost always the case that they do not have a full concentration of psych meds in their system. They either didn’t take the drug or hadn’t taken it regularly.)

Mental Illness Isn’t a Physical Problem

You suggest a blood-thinner is a necessary medication because it fixes a physical problem. Well, so do psych meds. I’ve talked here many times about the biology of mental illnesses like depression. But on top of that, mental illnesses have many physical symptoms like:

  • Headaches
  • Join and muscle pain
  • Hypersomnia / insomnia
  • Eating far too much or far too little
  • Cognitive and memory problems
  • An inability to make reasonable decisions
  • Delusions, hallucinations, psychosis

Those effects alone can lead to death, particularly the psychotic symptoms which can be present in mania, depression schizophrenia and other illnesses. These effects lead people to do things like jump off a roof. All of that sounds pretty physical and much of it life-threatening.

Mental Illness is “Just” a Feeling

I can’t comment on how you experience mental illness, but it certainly isn’t “just a feeling” for me. On top of whatever physical symptoms I may have the feelings themselves are completely out of control. Being driven to slice your wrist with a razor blade is not simply a “feeling.” Driving with your eyes closed isn’t just about a “feeling.” Spending $10,000 that you can’t afford on clothes you don’t need isn’t just a “feeling.”

And on, and on, and on.

While spending what you earn in four months on clothes may not kill you, it sure may kill your life.

You Do Not Just Wake Up with Anxiety

Certainly, you can feel that way, but a person with an anxiety disorder would likely beg to differ. Anxiety may be the sign of a troubled marriage, a bad dream or Starbucks running out of scones, but it may also be a real, organic mental illness, like any other.

I Mock People Who Do Therapy

[push]I’ve done more therapy than anyone I know.[/push]

Um, no, I really don’t. I don’t mock people for it in the slightest. I think it’s a good idea. Some people have problems that can be solved through quality therapy. You’ll get no argument from me on that.

As for non-medication treatments, I have talked about many. Light therapy, triple-chronotherapy, the importance of strict schedule, the importance of sleep and so on and so forth. This week, in fact, on Breaking Bipolar I talked about six areas to increase mental wellness that are not pharmacological.

Dependence on Antidepressants Makes You a Walking PillI Need Psych Meds to Function so I’m a Walking Medicine Cabinet

If you say so.

As you’ve mentioned, you draw a line between psych meds and other meds which you deem “acceptable” to be necessary. That’s your call. But a mental illness is just an illness and medication for it is just as critical as it is for any other illness.

I’d say the distinction there is not fair, accurate or supported by data.

People on Antidepressants Are Dependent

In the non-disordered sense of the word, yes, people are physically dependent on antidepressants. Like all people on all long-term medications.

As for psychological dependence, well it’s a grey area. For psychological dependence the drug must produce pleasure for the user. Antidepressants do not produce pleasure; they treat an illness and reduce pain. This makes them very different from a drug like cocaine, which does produce pleasure.

 

Are Psych Meds Addictive? – Antidepressants (Part 1)

→ June 6, 2011 - 16 Comments

Are Psych Meds Addictive? – Antidepressants (Part 1)

Before I started taking psych meds, one of the major concerns I had was addiction.

I didn’t want to be an addict of any sort as I’m quite familiar with the horrors of addiction, having addicts in the family. I’ve also read my fair share of substance abuse information. Will I get addicted to antidepressants?

And I knew people often took antidepressants for long periods of time, sometimes forever.

So weren’t these people addicted to antidepressants?

Read more

What you should be Reading in Mental Health

→ June 3, 2011 - Comments off

Articles to Read on Bipolar and SchizophreniaBusy. Crazy. Crazy busy. New antipsychotic. You know how it is.

Mental Illness Articles You Should Read

As per the usual, however, I plow through my own research materials like a crazy person possessed. So I do know of many excellent articles you should be reading.

Check out these articles from Breaking Bipolar and other great sources:

Hope you enjoy, I’ll be back with fresh content next week.

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