Category: treatments

Antipsychotics Should Be Used for Non-Psychotic Depression Treatment

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.

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Mindfulness — Essential Bipolar Survival Skill?

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.

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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.

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Transcranial Magnetic Stimulation vs. ECT for Depression

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.

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Why Therapy Can’t Treat Uncontrolled, Serious Mental Illnesses

I have been through lots of therapy and lots of therapists in my life and my contention is that therapy can’t be used to actually treat uncontrolled, serious mental illnesses. Now, don’t get me wrong, therapy can be supportive to a person with an uncontrolled, serious mental illness and therapy can be useful to a person with an uncontrolled, serious mental illness (such as in the case where the therapist tracks your bipolar symptoms and report changes to your doctor) but therapy cannot be used to actually treat a serious and uncontrolled mental illness.

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Pros and Cons of Electroconvulsive Therapy (ECT)

The pros and cons of electroconvulsive therapy (ECT) are actually quite numerous but in this post I will try to, unbiasedly, lay out the basic pros and cons for anyone considering ECT as a treatment. I am likely uniquely qualified to do this as I am very educated about ECT (Yes, I still have that book in the works. Did I mention I’m really busy?) and I’ve also had ECT. This does not mean it’s right for everyone, however. Do consider the pros and cons of electroconvulsive therapy carefully before you make your own mind up with the help of a doctor.

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Preliminary Evidence for EMPowerplus/Truehope in ADHD Treatment

Those of you who follow me know that I’m not a big fan of TrueHope/EMPowerplus, in spite of having tried EMPowerplus myself. And one of the things I complained about is the lack of double-blind, controlled studies of the supplement. Well, one scientific study has now been published and I figured I should mention it to be fair. This new study indicates preliminary evidence for Truehope/EMPowerplus (a micronutrient formula) in the treatment of attention-deficit/hyperactivity disorder (ADHD).

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My Psychiatrist’s Reaction to EMPowerplus/Truehope Treatment

I was really nervous to have to tell my doctor that I had decided to take the Truehope product EMPowerplus. I was pretty sure he was going to either laugh or chastise me out of his office. My anxiety about it was so bad that I didn’t want to mention it at all. Of course, that would have been a poor decision. Allowing anxiety to override your logic is never the right call.

So I told him and surprisingly, he was nonplussed. He just sort of said, “Alright then.”

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EMPowerplus/Truehope Update Day 11

I am now on day 11 of my EMPowerplus experiment and, yes, I have talked to my doctor about it (more on that later). Here’s what I have to report about the EMPowerplus:

  • I started on half a dose – that’s two pills in the morning and two in the evening.
  • Pretty much as soon as I started taking the EMPowerplus I started feeling giddy. Not quite hypomanic but notably elevated and different, although not better.
  • On day five I experienced an official rapid cycle from hypomania one day to serious debilitating depression the next day.

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I write a three-time Web Health Award winning column for HealthyPlace called Breaking Bipolar.

Also, find my writings on The Huffington Post and my work for BPHope (BP Magazine).

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