My Support - February 21, 2010
I do earnestly hope this e-newsletter finds you well.
This electronic newsletter has been re-formatted and I often have difficulty getting articles & pictures to upload properly, I apologize for that but will continue to work through the kinks in upcoming issues.
P.S. Please contact me at anytime: email@example.com
Community Alliance for Healthy Minds
4th Annual Forum
Saturday, February 27, 2010, 8:30 a.m.-3:00 p.m.
Presents: Wellness...Mind,Body & Soul
converging paths to recovery, health and wholeness
Who should attend? Community members, consumers, caregivers, seniors, students, social workers, psychologists, psychiatrists, faith community leaders, marriage and family therapists, and all interested in the emotional wellbeing of their community
Hosted by: Abraxas High School 12450 Glen Oak Road Poway, CA 92064
Presented by: Community Alliance for Healthy Minds (CAHM) founded by Rex & Connie Kennemer after their son Todd's death from mental illness, to honor his life and struggle 1980-2005
- Resource & Arts Fair: begins at 8:30 a.m.
- Keynote speakers at 9:00 a.m.
- Carol LeBeau, Palomar Pomerado Health's "champion for healthy living"
- Dr. Nick Yphantides, author of "My Big Fat Greek Diet" ·
- Leaders in mental health, substance abuse, crisis intervention, support and recovery
- Outstanding breakout sessions by experts in nutrition, hands-on collage art, writing
- therapy, dance and movement, suicide prevention and survivor support, the journey with
- grief, and creating caring faith communities
- Panel Q & A
- Art Show & Sale, Silent Auction & Raffle Prizes
- Music, Dance & Drama
FREE event. (A donation of $20 or any amount is appreciated) Lunch is included free of charge with pre-registration. Funds raised will assist community mental health and wellness programs, including programs for students.
CAHM Forum donations may be made online at: www.yellowribbonsd.org Yellow Ribbon Suicide Prevention Program®, San Diego Chapter Event sponsorship opportunities, please contact:
Rex Kennemer, CAHM founder
Legal Aid Society of San Diego, Inc.
Conservatorship Clinic - information about conservatorships and alternatives
Ongoing - Tuesday mornings
9:30 am - 12:00 noon
Probate Courthouse, Madge Bradley Building
1409 Fourth Avenue, San Diego 92101
Fifth Floor, next to Department PC-2
For more information: 877-534-2524
Think Beyond the Label
We are proud to share the first national TV commercial by Think Beyond the Label. Labels get in the way, but disabilities rarely do. Visit ThinkBeyondtheLabel.com to evolve your workforce!
Watch this 10 second video: http://www.youtube.com/user/thinkbeyondthelabel
From our friends "across the pond"
One out of four people in this country is mentally unbalanced.
Think of your 3 closest friends....
If they seem OK, then you're the one!
with Anu Garg
noun: A scene of wild uproar and confusion.
Alteration of the name Bethlehem, a hospital for the insane in London.
The Hospital of St. Mary of Bethlehem in London, now known as Bethlem Royal Hospital, is the oldest hospital for treating the mentally ill. The treatment was not always what's considered the norm today. At one time the "sane" used to go see the "insane" as if in a zoo -- there was an admission ticket. The William Hogarth painting of the Bedlam shows fashionable ladies visiting the hospital to amuse themselves by gawking at the patients. See the art of the hospital inmates at The Bethlem Gallery.
Mood Mapping: Plot Your Way to Emotional Health and Happiness
by Doctor Liz Miller
Dr Liz Miller is herself diagnosed with Type I Bipolar Disorder and writes for MDF The Bipolar Organisation's Pendulum magazine. She also appeared last year on Comic Relief with Ruby Wax to raise public awareness of mental health problems. Before becoming ill, she worked as a neurosurgeon and now works part-time as a GP and in Occupational Health. Despite her diagnosis and three mental health sections, she remains well and has happily lived without medication for the last eight years so she certainly has some experience to share in this area!
Liz has been a guest speaker at both the Sutton and Cambridge MDF community groups. She's been to the Cambridge group twice. Her first talk examined how recording your mood can provide cues to better self management. She returned last year to look at how your mood can be influenced by the food you eat. At that talk, we heard that her mood mapping technique was to be released as a book in October last year.
Her book offers a completely new view on mood charting and how you can help yourself find greater stability with self management. The basis of the book is Liz's concept of Mood Mapping. The MDF's Self Management course encourages recording your daily mood on a scale of one to ten but Mood Mapping proposes that mood is governed by two independent causes: your energy level and how positive or negative you feel.
The book comes in two parts. The first leads you through a 14-day programme that uses Mood Mapping as the core to assessing how you feel when considering areas of your life that can affect your mood such as your surroundings and relationships. By Day 11, you know how to work out how you feel and the factors that affect it. The final four days of the programme look at ways to change your mood.
The second part gives tips on managing the moods of groups and others before finally discussing mood disorders. I must say that I really enjoyed reading this book and found it first gave me the tools to work out how I felt before trying to change it!
PUBLISHED BY RODALE (MACMILLAN)
How to Help the One You Love
Loving someone who is living with mental illness stretches your commitment. But by working together to solve day-to-day problems, along with having realistic expectations, communicating your needs and defining your boundaries, the two of you can grow and heal together. When the one you love is living with depression or bipolar disorder, your relationship, no matter how strong, will be challenged. You can't make the illness go away, but you can offer practical support as your loved one works on recovery.
Active Minds wants to end stigma about mental health
By Andy Treese
It's a mysterious condition that's plagued mankind since the start of its existence.
Even thousands of years later, in the current age of the 21st century, one out of four people suffer from mental illness. Under the broad spectrum of mental illness are disorders of varying severity, from depression and seasonal anxiety disorder, to bipolar disorder and schizophrenia. They affect the young and the old alike, and outside of classrooms and hospitals, mental disorders are not usually discussed openly.
But one on-campus organization aims to make the stigma behind mental illness a thing of the past.
Active Minds, a nationwide nonprofit organization devoted to raising mental health awareness on college campuses, was founded in 2001 by Alison Malmon at the University of Pennsylvania following the suicide of her older brother a year earlier. Since then, the organization has expanded nationwide and is currently supporting chapters stationed at 242 active campuses, including the Rock.
Senior marketing and communication major, Carol Barsody, 20, is the current president of the SRU chapter. Barsody has been with the chapter since its first stages of forming.
"It all started with our adviser," she said. "She was really dedicated about it, and at the Fall Organizational Fair, she was handing out fliers to people. Eventually, a group of us found it, thinking that it was very interesting, and decided to create the campus organization."
Dr. Melissa Nard of the Student Counseling Center serves as the adviser of the student chapter on campus.
"Last semester, I held great interest in creating a local Active Minds chapter for our campus," she said. "I advertised and held a meeting. And since then, the students have just ran with it and have done a great job."
The vice president of Active Minds is junior psychology major Whitney Wideman, 21, who's contributing to the club's effort of increasing awareness.
"What we basically aim to do is to get people talking about mental health issues," she said. "By making it so more people will feel comfortable about seeking help for any mental issues, we will get people to understand the truth and to hopefully 'stomp the stigma.'"
Research from the National Institution of Mental Health shows that in 2006, suicide was the third leading cause of death amongst people ages 15-24.
As fellow treasurer of Active Minds, sophomore special education and elementary education major, Sami Hayduk, 21, also understands the level of mental illness's impact.
"Our services extend beyond that of just mental illnesses," she said. "Mental health issues altogether-ranging from stress to depression-is what we mainly address. That way, we can reach out to more people who deal with this on a daily basis."
Even with the increase in organizations that encourage open communication about mental health, the stigma behind mental illness still exists in society.
"A lot of times, students are reluctant to admit that they go to the counseling center, or that they have issues they need help with," Nard said. "By creating a more open environment, and talking about the issues openly, we hope to reach out to students."
Having grown rapidly during its first semester of existence, Active Minds has several potential events lined up to take place this semester-such as National Stress Out Day-and is continuing to plan more ideas for future events.
"As a new organization, we are very limited to what we can do for the time being," Wideman said. "Ultimately, however, we hope to eventually bring a special guest speaker to the campus in the future, for everyone to see."
Although the group focuses on aiding a specific problem, Active Minds is not an exclusive membership club limited to certain students.
"All students and faculty alike are more than welcome to join," Hayduk said. "Everybody is welcome."
Active Minds meetings are held every Thursday at 5 p.m. in the Student Counseling Center.
Police: More Calls Involve Mental Illness
By KEEGAN KYLE
As one of San Diego's newest police officers, David Ramirez said he didn't know the signs of schizophrenia, depression or bipolar disorders. He knew their names, not the symptoms. He's a police officer, not a doctor.
In the department's academy, new officers get trained for a few hours about how to address people suffering from mental health problems. After all, they can be callers, victims, suspects or witnesses like anyone else.
After graduation, Ramirez started his patrol training in southern San Diego and realized, for the first time, how often police actually come in contact with these issues.
"We see it every day," he said. "I haven't dealt with that outside of being a police officer."
At a time when San Diego's crime rate is at a historic low, police say the number of incidents involving mental health issues is increasing. The city's police chief has pointed to a decline in social services and called mental illness one of the city's most growing public safety concerns. Some officers like Ramirez end up getting in-depth training to help them understand mental illness, but it's uncommon.
The result, in some cases, is police officers being thrown into situations without the specialized training that advocates say could help them make better decisions. Some incidents, like suicide threats, develop so quickly that the average patrol officer can't wait for crisis negotiators or licensed clinicians to assist.
Last year, San Diego Police received 4,812 calls for incidents involving suicide attempts or suicide threats, a 7 percent increase from the previous year. And 768 of those calls elevated to a point where police needed to intervene and document a serious threat to life, a 13 percent increase from the previous year.
These trends have caught the attention of police at a time when the rates of San Diego's major crimes continue to sink well below normal levels. Violent crime decreased by 2 percent last year and property crime by 20 percent, police reported in January.
"The two areas that we've seen increase are aggravated assaults and mental health issues -- suicides and people in deep emotional distress," Police Chief William Lansdowne said about the city's crime trends. "As the state cuts back and the county cuts back on those (mental health) issues, it's the responsibility of local law enforcement to manage them."
Lansdowne said police are coming in contact with mental illness more often as a result of government cuts in preventive programs. Gov. Schwarzenegger, for example, has proposed slicing the state's health and human services budget by 16 percent during the next fiscal year.
San Diego County, bolstered by funding from the 2004 Mental Health Services Act, has increased funding levels over the last few years for its behavior health services, which includes drug treatment programs, mental health programs and the county's mental health hospital. At the same time though, some officials like Lansdowne say these budget increases haven't kept pace with rising demand.
Even though the county's behavior health services budget has increased by 28 percent since 2008, people are now waiting longer for mental health outpatient care. More people are receiving care, but the county is doing it with fewer staff. As these services become stressed, police argue, more people end up in their temporary care.
As part of its mental health budget, the county funds a nonprofit called Psychiatric Emergency Response Team, or PERT, to improve training and provide licensed clinicians to assist police in the field. That assistance could mean anything from calming a crisis to interviewing a witness with schizophrenia.
Between July and November, the nonprofit's staff assisted police on more than 5,200 incidents throughout the county. If that rate continues through 2010, it will be the nonprofit's busiest year in existence, said Jim Fix, the executive director. When Fix adjusted the rate for staff increases, he found the number of calls increased by 20 percent in 2009.
"In a perfect world, we'd have more clinicians out there assisting law enforcement whenever possible," Fix said. "(Police) go on far more calls than us that deal with this stuff."
The department three years ago held crisis response training, which included some coursework on mental health issues, for every officer. The department also schedules four-hour refresher classes on mental health, which 157 officers attended last year. For more advanced training, officers can volunteer for a three-day course from PERT.
Last week, Ramirez, the rookie officer, graduated from PERT's training course with about 50 other officers and dispatchers. He learned the symptoms of different mental illnesses and some tactics to approach them differently. He was taught to use less aggressive body language and more casual language, ask short questions and give people more time to respond when dealing with someone with mental illness.
"I'm just looking for something to make me a better police officer," Ramirez said.
Ramirez and some of his colleagues at San Diego police attended training after petitioning their supervisors. With fewer officers working at the department than previous years, letting them take three days off for training puts more pressure on staffing levels. Around 400 officers have attended the PERT academy in recent years.
San Diego police leaders said they recognize mental illness may be a growing problem, but they haven't committed to making major changes in department policy. When asked whether more mental health training would be made available or even made mandatory, Assistant Chief David Ramirez, who is not related to the rookie Ramirez, said officers are being encouraged to attend the PERT classes.
"I don't know if we're in a position to make it mandatory yet," Ramirez said. "If we were going to do more mandatory training, we got to look at the impacts to scheduling."
Although sometimes a critic of the department, Kevin Keenan, executive director of the American Civil Liberties Union in San Diego, said San Diego police are doing a better job with mental health issues than other cities around the country through crisis response training. He still wants police to get more mental health training, but acknowledges that some incidents might be unavoidable.
"There absolutely needs to be more mental health training ... but that may not solve these difficult problems," Keenan said. "It's not a problem that law enforcement can pass off on anyone else unfortunately. They have to deal with it."
In Schizophrenia And Bipolar Disorder, Life Is Not Black And White
Schizophrenia and bipolar disorder affect tens of millions of individuals around the world. These disorders have a typical onset in the early twenties and in most cases have a chronic or recurring course. Neither disorder has an objective biological marker than can be used to make diagnoses or to guide treatment.
Findings in Biological Psychiatry, published by Elsevier suggest that electroretinography (ERG), a specialized measure of retinal function might be a useful biomarker of risk for these disorders, and retinal deficits may contribute to the perceptual problems associated with schizophrenia and bipolar disorder.
Over the past several years, research has suggested that cognitive impairments in schizophrenia might be linked to early stages of visual perception. This work is now drawing attention to the function of the retina, the component of the eye that detects light. Within the retina, rods are light sensors that respond to black and white, but not to color. Rods are particularly important for maintaining vision under conditions of low light and for detecting stimuli at the periphery of vision. Cones are light sensors that detect color and perceive stimuli at the center of vision.
Using ERG, Canadian researchers Marc Hébert, Michel Maziade and their colleagues observed that the ability of light to activate rods was significantly reduced in currently healthy individuals who descended from multigenerational families that had members diagnosed with either schizophrenia or bipolar disorder. In contrast, the response of their cones to light was normal.
"We take for granted that other people experience the world in the same way that we do. It is important to appreciate that for schizophrenia and bipolar disorder, as for colorblindness or selective hearing loss, people who appear to perceive the world normally may actually have subtle but important problems with perception, which may contribute to other adaptive impairments," comments Dr. John Krystal, Editor of Biological Psychiatry.
Scientists are still searching for a valid biomarker for the heritable risk for schizophrenia and bipolar disorder. Although the current data are interesting, extensive testing is still needed before the utility of this measure as a risk biomarker can be evaluated.
High achievers more likely to be bipolar
February 5, 2010 by Lin Edwards
Some historians believe Vincent van Gogh suffered from bipolar disorder.
The Greek philosopher Aristotle once said "there is no great genius without a mixture of madness," and now there is some scientific evidence that there is a link between mania and high IQ and creativity, since a study of over 700,000 subjects showed those who scored the highest grades were almost four times more likely to develop bipolar disorder in their adult lives than those scoring average grades.
Have Bipolar Depression? - Learn about a bipolar depression research study in your area today - www.BDstudy.com
People with bipolar disorder, or manic depression, suffer severe and uncontrollable mood swings from elation to depression. During their elation (manic) periods they may have insomnia, restlessness, racing thoughts, and may have an over-inflated self-esteem. In the depressed stages they may be suicidal. Around 1% of the population suffers from bipolar disorder.
The national cohort study was carried out by scientists from King's College London's Institute of Psychiatry and the Karolinska Institute in Stockholm, Sweden. The team, led by King's College senior lecturer in psychiatric epidemiology, Dr James MacCabe, studied the final exam results of all 15-16-year-old pupils attending High Schools in Sweden from 1988 to 1997, and compared them to hospital records of bipolar disorder admissions of patients between the ages of 17 and 31.
They found those with A-grade results were almost four times more likely to be admitted for the condition than average students, even after the findings were controlled for income and education level of the parents. The link was stronger in males than females. They also found students with low exam grades had a greater risk of developing bipolar disorder than average pupils.
The researchers found the highest rate of bipolar disorder developed in those who excelled in the humanities, such as literature or music, which are the two subjects traditionally most associated with "madness". For example, the artist Van Gogh, poet Sylvia Plath, and writer Virginia Woolf, are widely believed to have had bipolar disorder.
The findings of a link between the disorder and academic and intellectual performance may explain the association between genius and mania that has long been thought to exist. People with bipolar disorder who are in a manic phase can have exaggerated emotional responses and can be witty, inventive and have high cognitive capabilities. They are also capable of sustained concentration and have high stamina, and so can achieve much more than people without the disorder.
Since low achievers, especially those poor at handicrafts and sport, also had an increased risk, the scientists suggest there are two distinct groups of people with bipolar disorder: the high achievers who are aided by their manic stages, and low achievers who have poor motor skills, which may be caused by "subtle neurodevelopmental abnormalities".
The paper is published in the British Journal of Psychiatry 196: 109-115.
More information: Excellent school performance at age 16 and risk of adult bipolar disorder: national cohort study, The British Journal of Psychiatry 196: 109-115. doi:10.1192/bjp.bp.108.060368
© 2010 PhysOrg.com
Preschool Children of Bipolar Parents Have Eight-fold Increase in Risk for ADHD
By University of Pittsburgh School of Medicine
(HealthNewsDigest.com) - PITTSBURGH, - Preschool children of parents with bipolar disorder have an eight-fold increase in the risk for attention deficit hyperactivity disorder (ADHD) and significantly higher rates of multiple psychiatric disorders, compared with children of parents who don't have the mental illness, according to a study by University of Pittsburgh School of Medicine researchers to be published in the March issue of the American Journal of Psychiatry and currently available online.
"Studies already have shown that the children of bipolar parents are far more likely to develop the disease, although typically not in the preschool years. By identifying ADHD and other developmental issues in this group, we can treat them early and potentially prevent full-blown development of bipolar disorder," said Boris Birmaher, M.D., lead author of the study and co-director of the Child and Adolescent Bipolar Services at Western Psychiatric Institute and Clinic of UPMC.
According to previously published results from the Pittsburgh Bipolar Offspring Study (BIOS), having parents with bipolar disorder is the best predictor of whether their children will go on to develop the condition. However, until now, little has been known about the effects of having bipolar parents on preschool-aged children.
For the current study, researchers compared 121 children, ages 2 to 5, of 83 parents with bipolar disorder to 102 offspring of 65 parents without bipolar disorder in a demographically matched control group. Parents were assessed for psychiatric disorders, family mental health history, family environment and exposure to negative life events. They also were interviewed about their children. Children were assessed directly for bipolar disorder and other psychiatric disorders by researchers who did not know their parents' diagnoses.
Compared with the offspring of parents in the control groups, children with bipolar parents had an eight-fold increase in the risk of having ADHD, as well as a six-fold increase in the risk of having two or more other psychiatric disorders. Although only three children had clinically certified full-blown mood disorders, children of bipolar parents, particularly those with ADHD or oppositional defiant disorder, had more subclinical manic and depressive symptoms when comparing with children in the control group.
"Because BIOS is prospectively following all of these children, we will be able to address their developmental issues and delineate the types and severity of symptoms that may predict a possible conversion to bipolar disorder," said Dr. Birmaher, who also is the endowed chair in Early Onset Bipolar Disease and professor of psychiatry at the University of Pittsburgh School of Medicine. "Also, because almost 70 percent of the children of parents with bipolar disorder in our study did not have any diagnosable psychiatric illnesses and very few appeared to be on the cusp of developing mood disorders, we believe there is a window of opportunity for prevention in the high-risk group of kids."
The researchers note that these findings have important implications. "Clinicians who treat adults with bipolar disorder should question them about their children's psychopathology to offer prompt identification and early interventions for any psychiatric problems that may be affecting the children's functioning," noted Dr. Birmaher. "Further studies are needed to help determine the clinical, biological and genetic risk factors that may be modified to prevent the development of psychiatric disorders in the children of those with bipolar disorder."
Co-authors of the Pittsburgh Bipolar Offspring Study include David Axelson, M.D., Kelly Monk, R.N., Catherine Kalas, R.N., Benjamin Goldstein, M.D., Mary Beth Hickey, B.A., Mihaela Obreja, M.S., Mary Ehmann, M.A., Satish Iyengar, Ph.D., Warl Shamseddeen, M.D., David Kupfer, M.D., and David Brent, M.D., all from WPIC and the University of Pittsburgh Department of Psychiatry.
The Pittsburgh Bipolar Offspring Study was supported in part by funding provided by the National Institute of Mental Health.
Western Psychiatric Institute and Clinic (WPIC) is considered to be one of the nation's foremost university-based psychiatric care facilities and one of the world's leading centers for research and treatment of mental health disorders. WPIC houses the Department of Psychiatry of the University of Pittsburgh School of Medicine and is the flagship of UPMC Behavioral Health, the psychiatric specialty division of the University of Pittsburgh Medical Center.
Schizophrenia and Bipolar Disorder: No Dichotomy, A Continuum, or One Disease?
By C. Ray Lake, MD, PhD
This issue, and an upcoming issue, of Psychiatric Annals address the idea that the "Kraepelinian dichotomy" may be obsolete. This is truly of field-altering effect because the concept that schizophrenia and bipolar disorders are separate and distinct illnesses has been a cornerstone of psychiatric diagnosis for almost a century. This concept has been accepted by academic psychiatry, the mental health professions, physicians in general, the public, and the media and is presented in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition-text revision (DSM-IV-TR), the International Classification of Diseases (ICD), and major textbooks in psychiatry. The validity of schizophrenia as separate from psychotic bipolar disorder was established before chronicity and psychosis were recognized as consistent with severe disorders of mood. That schizophrenia and bipolar disorder are more alike than different is no longer a question among some researchers, as represented by several of the authors in these issues of Psychiatric Annals However, the idea of "no dichotomy" remains a minority opinion.
Role of extended release quetiapine in the management of bipolar disorders
Authors: Rayan K Al Jurdi, Lena A Dixit, Martha Sajatovic
Published Date February 2010 , Volume 2010:6
Rayan K Al Jurdi1,2, Lena A Dixit1, Martha Sajatovic3
1Baylor College of Medicine, Department of Psychiatry, Houston, Texas, USA; 2South Central Mental Illness Research and Clinical Core, Department of Veterans Affairs, Houston, Texas; 3Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
Abstract: Atypical antipsychotics have become a widely utilized component of the bipolar disorder treatment armamentarium, with approximately 45% of bipolar patients prescribed atypicals. Over the last decade all atypical drugs except for clozapine have received a Food and Drug Administration (FDA) bipolar indication. In October 2008, the FDA approved quetiapine XR monotherapy for the treatment of acute depressive episodes of bipolar disorder and acute manic or mixed episodes in bipolar I disorder based on two placebo-control trials. Quetiapine was also approved as adjunct therapy with lithium and divalproex for the treatment of acute manic or mixed episodes as well as maintenance of bipolar I disorder. In contrast to immediate release quetiapine which may require a twice-daily regimen, the XR formulation is intended for once-daily administration. This drug profile of quetiapine XR will address chemistry, pharmacodynamics, pharmacokinetics, metabolism, safety and tolerability and clinical trials in bipolar disorder.
What would lead a child to suicide? Signs to watch for
03:25 PM CST on Monday, February 8, 2010
By MICHAEL E. YOUNG / The Dallas Morning News
The story hit like a punch to the gut.
Montana Lance, a 9-year-old with a toothy grin and a love of anything mechanical, had apparently committed suicide in a restroom at his elementary school in The Colony.
And in homes across North Texas, people wondered how that could even be possible. Why would a 9-year-old take his own life? How would a child that age even know about suicide?
The numbers of suicides involving children 5 to 9 years old are extremely low - a total of 33 nationally in the eight-year period of 1999 through 2006, with just two in Texas, according to the Centers for Disease Control and Prevention.
The numbers are so small as to be statistically insignificant, the CDC says - a rate of .02 deaths per 100,000 children, compared with much higher rates of 10- to 14-year-olds (1.25 per 100,000), 15- to 19-year-olds (7.74 per 100,000) and 20- to 24-year-olds (12.35 per 100,000).
For children up to age 9, suicide isn't even in the top 10 causes of death. It ranks third for 10- to 14-year-olds and second for those 15 to 24.
But those 33 deaths of young children are "completed suicides," said Dr. Gregory Fritz, academic director at Bradley Children's Hospital, a psychiatric hospital for children in East Providence, R.I., and a professor at Alpert Medical School at Brown University.
"It's hard to know what the number of attempted suicides are compared with completed suicides," Dr. Fritz said, "but there are probably several hundred times more attempted suicides.
"We have an in-patient ward for children under 12, and every day there are children there who have attempted to kill themselves. And we're not an unusual psychiatric ward."
Fortunately, young children typically aren't left alone. Parents or other caregivers are nearby, able to intervene.
"Attempts are not as rare as people might think, but deaths are rare, thank goodness," Dr. Fritz said.
Thirty years ago, even professionals rejected the idea of child suicides. Cases that seem clear in retrospect were often described as "accidental."
"It used to be thought that children 5 to 9 years old couldn't be depressed, and that because they didn't have the capacity to think of time in the same way as adults they couldn't be hopeless," Dr. Fritz said.
"But kids that age can have profound sadness and want to kill themselves."
Those who knew Montana Lance didn't see him that way.
Robby Wright, a friend who served as spokesman for the Lance family, told The Dallas Morning News that Montana's death on Jan. 21 seemed to stem from "a sudden idea he had."
"If the building had fallen in on us, we couldn't be any more shocked," he said.
Brian Bradford, pastor of Horizons Church in The Colony, said the Lances are "a very giving family. Naturally, they're just numb."
"What makes this such a tough tragedy is there's nothing I know of that contributes to the 'why' of this," Bradford said. Montana's dad, Jason, works part-time as sound and media director at the church.
Over the past few decades, a growing base of knowledge about the way kids think, and what they think about, has changed the way psychiatrists and psychologists consider child suicide.
"It wasn't until the early '80s that this became much more of a topic," said Dr. Cynthia Pfeffer, a child and adolescent psychiatrist and a professor at Weill Cornell Medical College, part of Cornell University, in New York City.
"Kids always have pressures - peer issues, academic issues - and if a child has a tendency to be anxious, that's difficult also," she said. "This group has lower rates [of suicide], but that doesn't mean that a particular child might not be more at risk."
Anxiety, trauma, peer interaction and various conditions like bipolar disorder can be factors, Dr. Pfeffer said.
"Bullying is often a big issue," she said. "Hopelessness can be a risk factor."
And the motivation that leads to suicide can be very different from child to child.
"For some kids, it can be because they feel bad. They have a strong conscience and feel guilty and worthless and [as if they] don't deserve to live," Dr. Fritz said. "Sometimes kids do it because they're in an environment where their pain isn't recognized, or no one sees how unhappy they are. It can be a product of desperation."
But unlike teenagers, younger children are more "contextually dependent" - reacting impulsively to things that happen.
Even then, though, there probably are warning signs.
Both Dr. Pfeffer and Dr. Fritz say parents need to be watchful for indications their child is troubled or unhappy.
"It isn't out of the blue that they decide to kill themselves," Dr. Fritz said. "If a parent sees their child withdrawing or being unhappy a lot of the time, being depressed, changing the way they act with friends, they should be concerned about that.
"Now, every kid will be moody, sad, mad at the world," he said. "But usually those feelings are more transient. If it lasts for several weeks, that's much worse than being mad for the day."
None of those signs necessarily point to suicide. But parents should consult a professional if the moods persist, the doctors said.
And if a child mentions suicide, take it seriously.
"I don't think most kids talk about suicide," Dr. Fritz said. "They don't say, 'I wish I was dead,' or 'I want to die' at any age. But if parents hear something like that, they should be worried.
"No parent wants to admit that a child is so unhappy that they mention suicide," he said. "They'll say, 'Oh, you don't mean that.'
"Well, they might."
Medical marijuana users celebrate a victory as another condition is added to the list of diseases that qualify for the state's medical marijuana program.
So far, there are 1,188 active patients in the Department of Health's medical marijuana program. Over the last year, a total of ten new diseases have been added to the list.
Under the new addition, people with inflammatory auto immune-mediated arthritis can now apply for a medical marijuana card in New Mexico.
Essie de Bonet is one of the many New Mexicans who believes in the benefits of medical marijuana and she worked closely with Governor Richardson to push the reform.
"I have AIDS. Twenty-one years, and been nauseous for the last ten -- and it's getting worse."
It's stories like hers that have state politicians thinking twice about what kind of diseases to now include on their medical marijuana list.
Two other conditions up for consideration, bipolar disorder and migraine headaches, were not added to the list. Critics still argue medical marijuana is a step closer to its legalization, with some considering the plant as a gateway drug.
But de Bonet, who spoke at a Roundhouse rally for the legislation Sunday, disagrees.
"I'll be alive to see my second grandson (turn) six-weeks-old, next month," she said.
Will you lose your health insurance if you have an eating problem diagnosed as a mental disorder?
February 12, 8:59 PM Sacramento Nutrition ExaminerAnne Hart
Eating disorders, autism, and substance abuse are among the conditions for which the American Psychiatric Association is proposing changes in the fifth edition of its diagnostic bible, posted online. If you are labeled with "risk disorder," you diagnosis becomes treatable with a drug, and you might eventually lose health insurance or the chance to find a job. The public has a voice. See, the American Psychiatric Associationsite. Check out, "DSM-5 Draft Criteria Available Online."
Since Feb. 10, 2010, the resulting recommendations for revisions to the current DSM have been posted on the APA's Web site for the manual, , for public review and written comment. These comments will be reviewed and considered by the relevant DSM-5 Work Groups.
According to a Feb. 10, 2010 Washington Post article by Rob Stein, "Revamping manual of mental disorders spurs fierce debate," the updating in 2013 of the manual called the Diagnostic and Statistical Manual of Mental Disorders (DSM), possibly could have far-reaching implications such as preventing you from getting long-term care insurance if you were deemed to be genetically at risk for dementia, for example.
The Diagnostic and Statistical Manual of Mental Disorders, or DSM, determines how mental disorders are diagnosed. It also influences research and what is going to be researched. But it also opens the door to new drugs to treat the new diagnostic labels of what formerly might have been normal behavior along a spectrum.
For kids, a child with too many tantrums would no longer be called frustrated or trying out his/her willpower on parents but instead would be labeled as having "temper dysregulation disorder." You no longer have the terrible twos. Your kid has a temper disorder.
An introverted teenager would no longer just be focused on specializing rather than generalizing, but instead might be labeled with a diagnosis of having "psychosis risk syndrome." This opens doors for drug treatment to make the teen less eccentric, for example.
New recognition of binge eating disorder and improved criteria for anorexia nervosa and bulimia nervosa, as well as recommended changes in the definitions of some eating disorders now described as beginning in infancy and childhood to emphasize that they may also develop in older individuals. See the Feb. 10, 2010 press release, "APA Announces Draft Diagnostic Criteria for DSM-5."
A person too interested in sex with a partner might be diagnosed with having "hypersexual disorder." All these disorders that didn't exist before as labels to prime people for psychiatric drug treatments open doors to the large pharmaceutical corporations to find new labels of diagnoses to "drug down" with new drugs. For those with less interest, there's the label hyposexual disorder. Is it really a disorder or simply a preference or choice?
If your brain reacts with anxiety when you eat wheat, because you might have a brain allergy, you won't have a brain allergy to wheat anymore, but a mental disorder, if the new manual decides to include such a diagnosis.
These definitions of mental disordrs are among many being aired as proposals by the American Psychiatric Association. The APA is revising its' DMA, the first revision since 1994. This book that defines a whole slew of mental disorders is the 'bible' for modern psychiatry.
Will the new revision in three years be set up so psychiatrists will be able to sell more drugs to fit the labels? The manual is the product of ten years of research by many experts.
The revisions are supposed to bring the best scientific evidence to be applied to psychiatric diagnoses. The result is to decide who should get the powerful psychotropic new drugs. But more importantly, the new manual will tell insurance companies whether or not and how much to pay for your healthcare.
The new diagnoses will impact how you see yourself. Are you normal, eccentric, quirky, or mentally disordered and in need to be drugged into complacency?
The manual also influences what areas of medicine are researched. The new manual will affect you legally. It will influence industry, whether you get hired or not, and whether you get insurance. It also will affect how much money government programs will give for research or other programs related to mental health and mental disorders.
The new manual could lead to you being stigmatized by health insurance firms, by your employer or potential employers, and how the pharmaceutical industry will impact your needs.
Patient advocacy groups, pharmaceutical corporations, doctors, the government, and insurance companies all will be influenced by changes in what label is put on you personality quirkiness, eccentricity, or mental disorder.
The idea is to find which personality traits 'society' considers as mentally disordered on the spectrum of emotions and behavior. The manual will define what's pathological, requireming drugs or simply talk therapy or expressive therapies. The manual might also influence what society considers as criminal behavior in need of punishment and rehabilitation versus training and a change of diet.
The proposed changes are the subject of debate. So far no one really knows whether the changes are the result of realistic scientific evidence. Maybe the pharmaceutical industry influenced the definitions so more drugs might be sold?
The debate focuses on how much financial interests of drug companies are at stake. Should health care professionals look at the old or the upcoming new diagnostic definitions of mental disorders?
Who's to say what's normal behavior on a spectrum of personality traits? Will the revision make diagnoses a lot more accurate than it is today? Will the definitions be more precise?
On the autistic spectrum, for example, Asperger's syndrome would be eliminated. Instead, there would be a single category called "autism spectrum disorders."
But spectrum disorders might be applied to a lot of other diagnosis, for example, introversion or other diagnoses such as fear of public speaking or obsessive behavior.
The problem is that new diagnoses stigmatize more people that in the past were just called eccentric, solitary, overly devout, or shy. On one hand, people with hair-trigger tempers need to have some anger management control to lighten up, but are drugs the answer?
The big fear is the overuse of psychiatric medicines to increase the income of the pharmaceutical companies. Another fear is the applying more pathologies to the masses. The verb is "pathologizing" individuals.
By creating more diagnoses of mental quirks, you send people down a path that leads to more and more drugging. Maybe the individual only needed a change of diet. For example, the person could have a brain allergy to wheat.
If you're experiencing distress that formerly was labeled as normal grief or anxiety, should you be drugged, put on a diet that better manages the stress hormones, or listen to calming music?
A public comment period lasts until April 20th. The final version of the new manual won't be published until May, 2013. So there's time for public input on the matter.
Are you ready to be overdiagnosed and micromanaged? Or are you in favor of scientists finding out how much psychopathology really exists in society? And is pathology in one society different than what would be normal in another society or culture? How will the decisions be made?
What's the risk syndrome? How would teenagers with odd ideas be diagnosed? How do you feel about a proposal to create a new condition for people at risk for dementia? What happens if you're denied long-term care insurance because of the creation of a new condition that puts you at risk?
New conditions such as temper disregulation dysphoria (TDD) puts you in the category of having a mental disorder. How will your health insurance company look at that diagnosis? And what happens when too many kids are being treated for bipolar disorder? Should the new diagnosis be specific?
It's the job of the APA to prevent controversy. What's happening is that normal behavior is now a sickness that needs to be treated with drugs. But is anyone looking at a dietary, nutrition-based cause to food-based brain allergies?
Proposals for diagnoses of new mental disorders include labels such as binge eating, gambling addiction, normal grief when a family member dies gets labeled as drug-treatable depression, and Internet addiction becomes a mental disorder. All these terms may become mental disorders treatable with specific psychotropic or anti-anxiety drugs instead of changes in foods, more exercise, or talk, behavior, and music therapies.
Other proposed changes include replacing substance abuse and dependence with "addiction and related disorders." "Dependence," the normal tolerance and withdrawal some patients have when taking prescribed painkillers, often is confused with addiction. What if you don't have an addiction? Is your problem instead related to undertreatment of pain? Or do you need pain control drugs that you are becoming addicted to?
Are you a binge eater? That will be classified as a specific disorder. But what if you think you're normal when you eat a large amount of food once in a while and feel embarrassed by your sweets, meat, cheese, or chocolate cravings? Stress eating will be a disorder now. The disorder will be especially targeted to label women that are more likely to reach for high-fat foods. The new label will be called "stress eating."
A new category of "behavioral addictions," which includes only gambling will probably be added. But Internet addiction was considered, and it was decided that more research is needed. For further information see the Feb. 8, 2010 USA Today article by Rita Rubin, "Psychiatry's bible: Autism, binge-eating updates proposed for 'DSM'."
The four most addictive foods are sugar, chocolate, cheese, meat, and dairy products. Will they be classified as food addictions? It's up to the APA for a final decision, but there's time for the public's input. Also see, "Is there an ecological unconscious?"
DBSA San Diego presents ... Rafael M. Reyes, Psy.D.
Licensed Clinical Psychologist, PsychSanDiego
Getting Ready: Using Cognitive Therapy Tools to Prepare for the Expected
Please join Dr. Reyes for a discussion on how to use basic and simple cognitive therapy techniques to prepare for life's everyday obstacles. In life there is so much we face that we cannot prepare for, we might as well prepare for what we can! We tend to prepare for the big challenges in life (most times) but fail to prepare for daily changes which often leads to feelings of being buried under insurmountable obstacles. Using simple cognitive techniques can help us be prepared for the expected, but often ignored, challenges in life thus leading to a stronger sense of stability and control.
Dr. Reyes will explain how some simple changes to our thinking can help us deal with challenges and reduce the anxiety and negative impact stress has on our lives. He will also explain how simple behavioral changes can help regain control when faced with increasingly chaotic obstacles. The ultimate goal of this presentation will be to empower the audience to Get Ready for the daily challenges they face and avoid getting buried in stress!
Dr. Reyes will be available after the presentation to answer questions.
When: Monday, 01 March 2010 6:00pm - 7:30pm
Where: Garren Auditorium Biomedical Sciences Building, Medical School Campus University of California, San Diego La Jolla, California
Rafael M. Reyes, Psy.D., is a licensed clinical psychologist and co-founder of PsychSanDiego. He works with both adults and children and specializes in treating depression and bipolar disorders, anxiety disorders, and behavioral disorders in children and adolescents. For further information about Dr. Reyes, visit http://www.psychsandiego.org/about.htm
There is free parking in the VA San Diego Medical Center parking lot. Garren Auditorium is a short walk over the footbridge. Follow the signs for about one block.
Pioneer Day School Presents: Behavior Strategies for Home and School
Learn behavior strategies from Pioneer Day Schools Director, Jim Leiner and Experimental Psychologist, Jake Henn. Both will have a presentation with time for questions at the end. Join us!
Wednesday, March 24, 2010
4764 Santa Monica Ave.
San Diego, CA 92107
RSVP with Amber at 619-758-9424.
Only 40 seats are available and they fill up fast!
To Visit Pioneer Day School's website go to www.pioneerdayschool.org.
Please leave your children at home as there will be no child care available.
Street parking only
DVD of the Week
Stephen Fry's two part documentary The Secret Life of the Manic-Depressive' appeared on the BBC in 2006 is launched this week on DVD. It was an unusually open account of his own problems with Bipolar Disorder and in addition, a journey of discovery to understand as much as he could about the problem and its causes.
You can buy the new DVD version here with an exclusive 45% discount being offered by Equilibrium, The UK BioPolar Organisation. The documentary traces Fry's own journey of discovery from the point of his 'disappearance ' in suicidal despondency, to Belgium in the midst of a theatre production, to meeting others with the disorder from celebrities to the more 'ordinary'. It features interviews with Carrie Fisher, Richard Dreyfuss, Jo Brand, Griff Rhys Jones Rick Stein and Tony Slattery. Fry also engages with razor sharp grasp those who are seeking to understand the causes in terms science, medicine and psychology such as Professor Nicholas Craddock a psychiatrist and geneticist at the University of Cardiff and brain imagers at the Institute of Psychiatry who try to examine Fry's genes and brain respectively.
The documentary can be fairly described as excellent, engaging, informative, human and uniformly intelligent. It's screening however caught attention every time Fry asked those he interviewed if they could completely switch off their bipolar disorder, would they do so - and most said no. Fry's reasons for interviewing a celebrity group were understandable given one of his key aims of destigmatising bipolar disorder and educating the public in general.
For this reason the interviews with the successful and famous who have experienced bipolar disorder are completely legitimate. Nevertheless, it left Equilibrium questioning the truth among a more representative sample of people affected by bipolar disorder in respect of the 'would you switch it off' question so they asked the same question as one of many items in the International Bipolar Disorder Survey which is now being analyzed. Of around 3317 people with bipolar disorder who answered this question the vast majority said that they would switch their bipolar disorder off completely if they could.
Unlike in the Fry programme, only 28 percent expressed the sentiment that they would definitely choose to keep the whole package of the disorder with 55% clear they would switch all of the disorder off and 17% stating they would like to keep aspects of the disorder or traits associated with it.
The Secret Life of the Manic Depressive, despite its flaws- is probably the most important factual piece on bipolar disorder there has been and as such ranks with the impact of Kay Redfield Jamison's An Unquiet Mind as being ahead of its time and worthy of its International Emmy.
Help for ADD, ADHD & Bipolar
(February 06, 2010) Are you wondering about adhd or do you want to know the real symptoms of add? Do you want to know how add or adhd manifests in children and adults? Are you looking for a place where you can go about taking a test for add in adults or are you seeking information about the disorder online and its symptoms? Do you want to know more about bipolardisease, its symptoms, treatment methods or where to find help? Visit the ADHD Center online today; whether you live in Utah or California, New York or any other state in the nation, the ADHD Center online can help you begin to understand conditions like adhd, add, and bipolar disorder.
The ADHD Center has articles that explain and identify the signs of adhd and the site provides you with an adhd checklist. Visit the ADHD Center to access adhd behavior charts, information on an adhd self test, information on the causes of adhd, and tips on identifying the signs and symptoms associated with adult woman add or adhd. The ADHD Center online also points you in the right direction if you are looking for an online test for add, information on add in adults, info on the symptoms of add, or where to get a test for add in adults too. What's more, the ADHD Center online has free articles on bipolar disease, bipolar disorder in children, the signs of bipolar in children, how a bipolar test is conducted, obsessive compulsive disorder symptoms, and more.
When you visit the ADHD Center online you can learn about spotting the many signs of adhd in a toddler, in children, and in adults too. Find out what you need to know when making use of an adhd checklist, find out more about adult adhd issues, and learn all about the Vanderbilt ADHD diagnostic teacher rating scale which is used to determine if a child has adhd. When you use the free resources offered to you on the ADHD Center online, you can begin helping your child with printable adhd behavior charts for free, and you will get plenty of useful information for helping kids of all ages that may be having difficulty living with adhd.
You are invited to use the free articles on the ADHD Center online if you are thinking about doing an adhd self test, or if you want free information on how pediatric and toddler adhd diagnosis are made. If you want to begin understanding the causes of adhd, if you wonder if television plays a role in adhd or what food might trigger severe adhd symptoms or if sugar affects a child with adhd, visit the ADHD Center online today. Of course, the information on the ADHD Center online is not only focused on children and you can find out more about adult woman add or adhd in addition to where you can go about finding a great online test for add for free. The ADHD Center online makes it easy to understand the issues one faces when dealing with add, especially in terms of add in adults, and the symptoms, treatment methods and useful strategies are supplied on the ADHD Center online.
"When my teen was diagnosed with bipolar disorder I felt like the world was crumbling around me. I did not know what to think or where to turn. The ADHD Center online not only offered a lot of information, the site had great tips for where to get professional help."
The ADHD Center online points out the symptoms that characterizes a condition like bipolar disorder so that you can begin understanding that bipolar disorder in children does exist. Find out about residential treatment for the condition, find out about its causes, and use the free articles on the ADHD Center online to go about learning about bipolar in children, the methods used while a child is taking a bipolar test, or find out where to get self tests online. What's more, the ADHD Center online even has material that will help people to begin dealing with obsessive compulsive disorder symptoms; find out more about where to take a quiz or how certain disorders can affect a personality all on one website: the ADHD Center online.
The ADHD Center online is available for free and it will inform you about a number of disorders and their treatments; visit the site now at: http://adhdcenter.net.