My Support - January, 30 2010

Greetings!

I do earnestly hope this e-newsletter finds you well.

This newsletter is chock full of very interesting articles. I do hope you will take the time to read them.

Our annual fundraiser Click! is just a few weeks away. If you haven't purchased tickets yet and are planning on attending, I encourage you to do so soon, there are only a few seats remaining. If you do attend, please introduce yourself to me.

Sincerely,
Muffy Walker

P.S. Please contact me at anytime: muffwalk@aol.com
 

CLICK!

Only 2 tables left for our annual fund raiser. Join us for a fun, energetic evening with open bar, sumptuous food stations and an interactive game show starring you!
Tickets are only $125 per person.
Friday, February 26
6:00pm
Del Mar Fairgrounds
Casual-Chic Attire
Click the Donate now button on our web site or call Muffy: 858.342.0327
Hurry, you won't want to miss this one!

2010 California Youth Leadership Forum for Students with Disabilities

This is a special invitation for California high school juniors and seniors who have disabilities to apply to come to Sacramento and attend the California Youth Leadership Forum July 24-29, 2010. Students will have the opportunity to live on a college campus and join more than 900 alumni from across the state that have been a part of this unique program created specifically for young leaders with disabilities.

At no cost for the student!

Students who attend YLF make new, life-long friendships and resource connections to help them reach their personal, academic, and career goals.

Alumni of the California Youth Leadership Forum for Students with Disabilities (YLF) say it has forever changed their lives for the better. Go to www.calylf.org for more information and a copy of the application and instructions.

If you experience any difficulty in filling out this application, we can help you if you please contact the Department of Rehabilitation, Dani Anderson at Voice (916) 558-5407, TTY (916) 558-5403, email DAnderso@dor.ca.gov. Dani will be able to help you with your application questions.

Deadline to submit applications, February 3, 2010

Annual Conference on Improving Services for Children and Families: "Stigma and Disparities in Children's Mental Health: Practice and Research"

February 26th and 27th, 2010
Let us put our minds together and see what we can do for our children
CALL 619-546-5852 to register today! A barrier to communities having healthy, safe, and thriving children and families is Stigma
Register today, become a champion in your community to reduce stigma

A look at the bipolar life

Triwik Kurniasari , THE JAKARTA POST , JAKARTA | Sun, 01/10/2010 3:51 PM | Screen

Mainstream films have accustomed us to expect movies to tell romantic tales about the love between a man and a woman, or heroic tales of superheroes and warriors, or horror stories, all following certain set formulas and conventions.

Running alongside these are the products of filmmakers who are seeking to make movies that take a new approach or perspective, and explore alternative cultural values, often using experimental techniques.

One such filmmaker is Paul Agusta. After his first feature film The Anniversary Gift or (Kado Hari Jadi), recently showcased in the Jakarta Film Festival (Jiffest), he is presenting his sophomore effort titled At the Very Bottom of Everything or (Di Dasar Segalanya).

The young director is continuing his exploration of how to bend, twist and rip apart the traditional paradigms of Indonesian filmmaking. He introduces a kind of cinematic storytelling method that is quite new and unconventional in the context of Indonesian cinema in particular.

At the Very Bottom of Everything tells the tale of a young woman's struggle with bipolar disorder, also known as manic depression, a mental illness that causes extreme and uncontrollable shifts in a person's mood.

The bipolar patient's mood can swing wildly from overly "high" or irritable to sad and hopeless, and then back again.

The movie provides viewers with a blunt and moving description of the experience of a bipolar patient through the narration of a young woman (played by Kartika Jahja) who has just recently survived a suicide attempt.

The movie begins with a stop motion animation, portraying a human falling from a high place, followed by the woman's narration.

There are 10 chapters in the film, each of which describes the illness verbally, visually and musically from its onset through its various stages, including the attempted suicide, until treatment is sought, initiated and a balance is reached, Agusta says.

In Chapter 3, titled "Broken Branches", for instance, the woman expresses how she suffers from the illness, which forces her to take medication three times a day to keep her mood in balance, and how it has been haunting generations in her family tree.

Agusta combines his storytelling methods with visual metaphors to describe the main character's various stages of illness.

He uses some of the cast in theatrical-like performances along with stop motion animation using fabric puppets and latex-covered urethane puppets with steel armature.

"I tried to be emotionally accurate in describing the stages in the life of people with bipolar disorder," he says of his choice of the methods.

Consider Chapter 6, for example, which depicts a puppet lying on the floor, trying to move forward slowly and escape from four odd-hooded creatures that suddenly surround it.

Agusta also used rats to portray the pain (of the illness), shooting the scene from every angle as the rats set about eating parts of a bleeding human body, trying hard to escape the rats' attack.

Chapter 8, "the Fight", shows a woman chained to a cross, before she successfully frees herself and sees a bright light.

This scene, Agusta says, "shows how the leading character is finally free from the burden".

The following chapter (nine), "Leveling Out", shows a naked man lying on a floating bamboo raft, before he finally manages to stand up straight on it.

This symbolizes the stage where bipolar disorder patients begin to feel balance in their lives.

The last chapter is a portrayal of the stage where the patient no longer feels afraid. The main character says that she finally knows what she has to do to be OK, avoiding stress and filling her days with positive things.

At the Very Bottom of Everything offers a look at the dark side of bipolar disorder patients with their depression problems. Paul admits that the film is based on his personal experiences.

The aim of the film, he says, is to educate people about the illness.

"The public tends to dismiss them *bipolar disorder patients* as *crazy' without having any understanding of the fact that this can be treated and managed so that they can live normally," he says.

"I want to show that it *bipolar disorder* can happen to anybody, at whatever age and gender."

At the Very Bottom of Everything is produced by Kinekuma Pictures (formerly HouseofWaves Productions) in cooperation with PT Visi Integra Media (vi.em) and funded in part with a grant from the Digital Production Fund from the Hubert Bals Fund of the International Film Festival Rotterdam in the Netherlands.

The world premiere of the film will be at the 2010 International Film Festival Rotterdam, which runs from Jan. 27 to Feb. 7.

Call to lift ban on jury service for people with mental illness

Barristers join forces with mental health charity to urge rethink

Denis Campbell, health correspondent

Ministers are facing demands to scrap an "unfair and discriminatory" law that bans thousands from being jurors because they have suffered from mental ill-health.

Campaigners claim that many law-abiding citizens are wrongly excluded from jury service after being treated for conditions such as depression, schizophrenia and bipolar disorder.

One in four Britons suffers mental illness at some point in their lives, and one in 10 is prescribed antidepressants, which would be enough to debar them.

Rethink, a mental health charity supported by barristers in England and Wales, will this week launch a campaign to have the rule rescinded. It agrees that some people's mental state makes them unfit to be jurors, but argues that many others are victims of an "archaic" ban.

More than 9,000 people a year in England are refused permission to serve on juries. The government promised in 2004 - and again in early 2008 - to review the situation, but has not done so.

The ban arises from the Juries Act 1974. A section on "mentally disordered persons" bars from jury service anyone "who suffers or has suffered from mental illness, psychopathic disorder, mental handicap or severe mental handicap, and on account of that condition either is resident in a hospital or other similar institution, or regularly attends for treatment by a medical practitioner". Rethink wants that replaced with a new definition of "capacity", based on the 2005 Mental Capacity Act, which would allow many of those currently banned to serve, while excluding those who are genuinely unfit.

Stephen Fry, the actor and comedian, who has suffered from bipolar disorder since childhood, is backing the campaign. "There are thousands of people with mental health problems who are willing and perfectly capable of serving on a jury, but who find themselves rejected solely because they see a doctor from time to time for support or medication," he said. "Exclusion purely on the grounds of treatment for a mental health problem is unfair and discriminatory."

Rethink cites Winston Churchill as someone who, owing to his depression, would be banned. Paul Corry, Rethink's director of public affairs, said that about 50,000 people with mental health problems had been excluded since the government's first pledge in 2004 to consult on the issue.

"People should be judged on their capacity, rather than being arbitrarily written off. It is high time the government carried out a consultation and considered outlawing this archaic and discriminatory practice, which prevents capable citizens from carrying out a basic civic duty."

The Criminal Bar Association, which represents barristers in England and Wales, also argues that the ban is wrong. "Trial by jury is a vital component of our criminal justice system and, in order to work at its best, juries should represent a cross-section of society," said Paul Mendelle, its chairman. "Figures suggest that one in four people will be affected by mental health problems, so it is inappropriate to impose a blanket ban that prevents anyone with a history of mental illness from sitting on a jury without assessment of their capacity."

But the Ministry of Justice ruled out any revision of the rule, and refused to say why the government had reneged on its pledges to consult. While ministers were committed to tackling the stigma and discrimination around mental ill-health, "any change would need to strengthen our jury system. There can be no question of changing the law to allow people to serve as jurors where their ability to do so is in doubt", said a spokesman.

Through a glass darkly: How Catholics struggle with mental illness

Mental illness is still murky territory for those who experience it, their families, and their church.

Not long after Rich Salazar moved to DeKalb, Illinois from California, he found himself knocking at the door of St. Mary's Church. The then-college student had recently been diagnosed with bipolar disorder and was in crisis mode. Unable to reach his mother at work and not knowing where else to go, Salazar told himself, "I have to go to church."

Father William Schwartz answered his knocks and, although the parish was closed for the evening, invited him in. "He talked to me, calmed me down," Salazar says. The priest called his mother and told him he could stay at the church as long as he needed. "He was very kind. I told him the church has never let me down."

That's when Schwartz responded, "Someday it might."

Read more... . http://www.uscatholic.org/node/5811

Crazy Like Us

Jon Stewart spoke with author Ethan Watters last night about his new book, "Crazy Like Us." Watters believes that when the United States exports its ideas about mental illness to the rest of the world, it might be doing more harm than good. "Do we really want the rest of the world to think like us in this way?" he asked. He explained that while we may be bringing helpful treatments to other countries, we also "often bring cultural ideas that may be replacing ideas that are actually helpful."

Watch the interview - VERY interesting: http://www.huffingtonpost.com/2010/01/28/jon-stewart-author-interv_n_440...

Actress Debi Mazar speaks out about her family's ordeal with bipolar depression

Published: Tuesday, January 5, 2010 12:00 AM CST
(ARA) - An estimated 8 million American adults may be affected by bipolar disorder, a complex mental illness in which people experience extreme mood swings from highs (bipolar mania) to lows (bipolar depression). Episodes of bipolar depression can include symptoms of prolonged periods of sadness, loss of interest in activities once enjoyed, and feelings of worthlessness. These symptoms can interfere with a person's ability to handle everyday tasks, such as those related to work or family life. Most people with bipolar disorder when ill or when symptomatic experience more depressive moods (lows) than elevated moods (highs).

Actress Debi Mazar, of HBO's "Entourage" who was seen recently on ABC's "Dancing With the Stars," is opening up for the first time about a close family member's battle with bipolar depression. About 10 years ago, Mazar's family began to notice alarming changes in her relative's behavior. He saw a doctor and was incorrectly diagnosed twice with anxiety disorder and later with depression. Mazar's family quickly learned that mental illnesses can also be very hard not only on the patient but also on family members, who may find themselves in the role of caretaker.

"It was very frustrating for my family because we didn't know what to do to help," recalled Mazar. "The symptoms took a huge toll on him and it was very difficult for us."

Eventually, Mazar's relative was accurately diagnosed with bipolar disorder. His doctor helped him find the best combination of medication and talk therapy to manage his bipolar depression, and today he has a successful job, works out regularly, and has re-engaged with family and friends.

"I'm speaking out about what my family went through because I want to help change public perception of bipolar depression, reduce stigma, and show other families that bipolar depression can be managed successfully," said Mazar.

Dr. Janet Taylor, a psychiatrist who works with people who have bipolar depression, says it's common for chronic diseases like this one to take a toll on family members. She recommends these general tips from the National Family Caregivers Association:

* Educate yourself about your loved one's condition and how to communicate effectively with doctors.

* Seek support from other caregivers who are facing the same issues.

* Accept friends' and neighbors' offers to help and suggest specific things that they can do.

"Family and friends can play a very important role in helping a person with bipolar depression manage his or her disease," said Dr. Taylor. "I hope that Debi's courage in sharing her story will inspire other families to talk to a doctor and get the help and support they need."

Both Mazar and Dr. Taylor have participated in the "SPEAK and Be Heard . . . Living With Bipolar Depression" campaign, which was developed to encourage people with bipolar depression and their caregivers who are successfully managing their condition to become role models and inspire others by sharing their own stories. This campaign, sponsored by AstraZeneca as part of its ongoing efforts to raise awareness of mental illness, is also designed to show the importance of seeking an accurate diagnosis and developing an appropriate treatment plan with a health care provider in an effort to successfully manage bipolar depression.

To learn more about Debi's story-and the stories of other caregivers and people living with bipolar disorder - visit www.FacingBipolar.com.

Out of Sight, Out of Mind: Monologues on Mental Health Issues

Stanford students, part of a student theater group called Stanford Theatre Activist Mobilization Project (STAMP), will dramatize living with depression, bipolar disorder, panic attacks, obsessive-compulsive disorder and other mental health problems. The goal
is to lessen the stigma of mental illness and increase awareness of the resources available to students with mental health struggles. read more

Mental Health Kills the Mentally Ill

D.J. Jaffee Huffington Post

Doris Jones (pseudonym) of Scarsdale, NY (where I grew up) felt sad. Her husband left her, the kids were at college and she was feeling alone in her big house on three quarters of an acre. At the same time, Alejandro Morales, a 25-year-old man with schizophrenia, started becoming paranoid.
Free hotline services, support groups and counseling were instantly made available to Ms. Jones, but nothing was available for Alehandro Morales. As a result,he stabbed to death 9-year-old Anthony Maldonado.

Ms. Jones mental "health" needs trumped Alehandro Morales's mental "illness".

This is the result of an intentional, disastrous and massive migration in America away from treating the seriously mentally "ill" in favor of improving mental "health".

Mental "health" is defined "as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community." Mental health services focus on making the worried-well less worried. There's plenty 'o funding for that.

On the other hand, mental illness is a biologically based no-fault medical problem that resides in the brain's chemistry or neuroanatomy. Untreated, it can lead to irrational thinking, and therefore irrational behavior. There are virtually no programs left for this group. According to a Treatment Advocacy Center study, in 1955 there were 340 public psychiatric beds available per 100,000 U.S. citizens. By 2005, the number plummeted to a staggering 17 beds per 100,000 persons.

The amount spent on mental health has exploded exponentially as every life experience is medicalized. On the side of increasing 'mental health' services at the expense of mental illness services are providers of mental health services, state mental health departments, the Center for Mental Health Services, the National Institute of Mental Health, the Mental Health Association, 501c3s galore, misguided advocates, a government funded consumertocracy, stewards of political correctness, and the medico-psycho-industrial complex.

Try this test. Google mental illness and Google mental health. Look how many results are returned.

Hardly anyone is still fighting for the mentally ill. In fact, it is no longer even considered politically correct to use the term "mental illness". One must say "mental health". You are not allowed to say "patients", you are supposed to say "consumers" as in "consumers of mental health services."

The people we see under 12 layers of smelly lice-infected clothing talking to themselves, fearing their hallucinations as they forage through garbage cans looking for food are not "consumers". They should be patients, but no one wants them. Oops. Was that politically incorrect? I don't care.

One organization that tries to bring attention to their plight, the Treatment Advocacy Center in Arlington, Va. is considered a pariah by some mental "health" organizations. They think the fact TAC addresses issues like hospital bed shortages, violence and incarceration by the untreated is stigmatizing to the treated.

That's like saying focusing on women who need mastectomies is stigmatizing to those opting for enlargement. Oops. I did it again.

Ethan Walters wrote about this mission creep in a thought-provoking article (even though I don't agree with it all) in the New York Times Magazine:

"Westerners share...evolving beliefs about what type of life event is likely to make one psychologically traumatized, and we agree that venting emotions by talking is more healthy than stoic silence. We've come to agree that the human mind is rather fragile and that it is best to consider many emotional experiences and mental states as illnesses that require professional intervention. (The National Institute of Mental Health reports that a quarter of Americans have diagnosable mental illnesses each year.) The ideas we export often have at their heart a particularly American brand of hyperintrospection -- a penchant for "psychologizing" daily existence.

...(W)e are investing our great wealth in researching and treating mental illness -- medicalizing ever larger swaths of human experience -- because we have rather suddenly lost older belief systems that once gave meaning and context to mental suffering."

NIMH: The National Institute of Mental "Health" has run so far away from focusing on "illness" that, they claim there is not enough money left over to find a cure for illness. According to a report by Dr. E. Fuller Torrey of the Treatment Advocacy Center and Dr. Sidney Wolfe of Public Citizen, between 1997 and 2002:

"NIMH rejected funding for many reasonable research proposals on serious mental illnesses and funded much research that had no relationship to any mental illness. For example, NIMH rejected funding for a treatment trial for schizophrenia but funded research on how people think in Papua New Guinea; rejected funding for research on bipolar disorder in children but funded research on self-esteem in college students; and rejected funding for research on the causes of postpartum depression but funded research on the hearing mechanism of crickets."

While NIMH claims there is not enough money to fund the search for a cure for schizophrenia, they conducted 18 studies of pigeons.

State Offices of Mental Health: It's not just NIMH that is avoiding the mentally ill, so are state departments of mental health. The NYS Office of Mental Health is led by Michael Hogan, PhD. (NYS used to have a requirement that the Commissioner of Mental Health be a medical doctor, but they have waived that so sociologists and other PhDs, can apply)

The important question for OMH to answer according to his statewide plan for mental 'health' services is

How do we create hope filled, humanized environments and relationships in which people can grow?

So much for helping people with serious mental illnesses and for the medical model. NYS OMH is now going to help people "grow". It's not just rhetoric. NYS is racing to kick people out of hospitals and Assisted Outpatient Treatment, two of the programs that actually helps the seriously ill. They have made electroconvulsive therapy, an important treatment, harder to get.

Pharmaceutical companies: Pharmaceutical companies run massive advertising campaigns designed to convince people they have a mental health issue that only their medicines can solve. So millions of people who have had their life experiences redefined as a medical issue are now taking the medications.

Perhaps the most absurd result of this is that it is making it more difficult for those who truly need the medications to get them. Insurers resist paying for them, since so many who don't need them take them. And now research is being done that shows some of these treatments are no more effective than placebos. Why? Because the people taking them in the first place didn't need them so naturally they didn't help. If these studies were done among the genuinely ill, the results would be much different.

Mental Health Services Providers: Because up to 50 percent of Americans have now been defined as having a diagnosable mental disorder, providers have more customers than they can handle. So what do they do? They pick and choose the easiest to treat. The ability to get care is now inversely related to need. Seriously ill need not apply.

Advocates: Advocates are running TV campaigns that say the "mentally ill are just like you and me". But they refuse to show the seriously mentally ill in their commercials. You won't see anyone standing on a street corner screaming, "I am the antichrist. Follow me". Ask anyone who has experience with schizophrenia. Are people with schizophrenia human and have the same needs as us? Yes. But would you define yourself as being like them? Not likely. They have a serious illness and need our help. But advocates have addressed their needs by ignoring and shunning them. Even advocates for the homeless, who know up to one-third of the homeless have serious mental illness, do PSAs showing most homelessness is the result of joblessness.

Consumers: Under the guise of empowerment, validation, recovery and opportunity, high-functioning ex-patients have been given massive funding by the Substance Abuse and Mental Health Services Agency, put in charge of peer programs, and given virtual black ball power over which state programs get funding. And the only ones they want funded are their own. A former deputy director of NAMI/NYS described the opposition to Kendra's Law, a law that allowed courts to commit the NYS Office of Mental Health to provide services to the seriously ill they preferred ignoring. According to NAMI/NYS:

(T)here is a movement to stop the law led by...a consortium of mental health rehab organizations that I cannot respect on this issue. These organizations do skills acquisition, not symptom management. To benefit from their programs, one must be stable and have insight into one's illness. Yet their leaders are foolish enough to plug their own programs as an alternative to AOT.

Their leaders tend to dismiss "the medical model" and adhere to a philosophy of self-determination. Unfortunately, for those who need AOT, this approach is something of a cruel joke. As Edgar Rivera (who lost his legs when he was pushed onto an oncoming subway by someone with schizophrenia) so eloquently put it in his testimony, those who need (what this law offers) don't need philosophy, they need help.

Andrea Peyser of the New York Daily News wrote a recent article exposing a board member of NYAPRS, the trade association for consumer cum providers in NYS. She documented how Steve Muccio intentionally caused someone with serious mental illness to become homeless. "I'm an advocate," he said.

Police and Criminal Justice: Tah Dah. They are the only ones advocating for the seriously mentally ill. Police and Sheriffs are the ones who are called in to provide the services mental health departments have decided not to provide the ill. The largest psychiatric hospital in New York is Riker's Island Prison. In California, it's the L.A. County Jail. The few advocates left who still care about the seriously mentally ill have been blessed that progressive criminal justice types are working to fill the void left by mental health advocates. Using the parens patraie powers of the state to help those who can't help themselves, the police will help the seriously mentally ill who are homeless and psychotic in ways the mental health system would never consider. They will pick these people up, bring them to the hospital, and sit with them -- often for hours -- until a doctor sees them. Unfortunately, at that point the mentally ill patients become part of the mental health system and are usually refused admission. Today, it's harder to get into Bellevue than Harvard.

We have to dismantle the mental health system and return the dollars to where the public wants them: helping the mentally ill.

From Goodspeed to Broadway: How a hit show was created

By Kristina Dorsey

Festival includes readings of new musicals, talks by theater professionals

Composer Tom Kitt was at Goodspeed again on Saturday, a return to the place where, in 2008, he was the musical director for the show "13."

Back then, Kitt recalled, he had a visitor while at Goodspeed. It was Brian Yorkey, his collaborator on a then-in-the-works musical called "Next to Normal." They talked about possible changes and tweaks they might make in the show.

Flash forward to 2009. "Next to Normal" is on Broadway. It is a hit - a rather unlikely one, considering its story focuses on a woman who is bipolar. It is nominated for Tony Awards in pretty much every category it can be - 11 nominations in all. And Kitt wins two Tonys, for best original score and best orchestrations.

That success was actually 11 years in the making, and Kitt talked about it all as part of this weekend's Goodspeed Festival of New Artists in East Haddam.

The bedrock of the festival is the staged reading of three musicals by new artists.

This fifth annual event also, though, featured talks by experienced theater professionals. Among the highlights was the symposium on "Creating 'Next to Normal,'" with part of the musical's team: Kitt; director Michael Greif, who also directed "Rent" and "Grey Gardens," and producer David Stone, who produced "Wicked."

Kitt recalled how the unusual idea for "Next to Normal" came about. Yorkey had seen a report on people with mental illnesses, and he suggested they work together on a musical about the subject. They did, creating a 10-minute piece for a BMI workshop in 1998.

They got good feedback and enough encouragement that they expanded on the original short piece. Over time, it wound its way through various readings and workshops.

Eventually, Stone and Greif came onboard, things moved into high gear, and the musical underwent some alterations. Stone said that the show was originally more about ideas than about people and family; that shifted with rewrites. Even the title changed, from the original "Feeling Electric" to "Next to Normal," moving away from the notion of electric shock therapy and moving toward the idea of mental illness and loss and what it means to the family involved.

"Next to Normal" opened on Broadway in April 2009, although Stone said that, at one point before that, he was questioning whether, in the recession, it made sense to bring a show with this difficult subject matter to Broadway.

"It took me about six weeks to get my courage up and say, 'Yes, let's do this,'" he said.

Besides the quality of its production, "Next to Normal" became known for its ingenious use of Twitter. A few weeks after the Broadway opening, the team began use Twitter to help stir even more interest in the show.

They Tweeted sort of an adapted version of "Next to Normal," with one line posted each day in which a character described how he or she felt at a particular point in the show. These new lines were written by Yorkey, and the Tweeting ran over the course of 30 days.

Then, the "Next to Normal" folks asked their Twitter followers - they have 1.1 million followers now - what they thought happens after the end of the show.

They even did a collaboration of sorts, with Kitt and Yorkey writing a song inspired by the show, with input from the Twitter followers.

"It became this dialogue, this community," Stone said.

The show itself has had quite an impact on audiences. Kitt said that, after one performance, a teenager told Yorkey and him that he was bipolar. People had often asked him what it was like, but he had never been able to truly describe it.

He told them, "Now I can say to people, 'Go see this show, and you'll understand what I go through.'"

Someone in Saturday's symposium audience asked the "Next to Normal" trio what advice they would give to new artists. Kitt said you have to be open to advice and to collaboration. And, he said simply, whatever you do should be something you really believe in.

The pieces performed as part of the Festival of New Artists were, on Friday, "Hello Out There," by Eric Price and Frank Terry, and, on Saturday, "Rewrite," by Joe Iconis.

Pharmaceutical Direct to Consumer Advertising on The American Law Journal

PHILADELPHIA, Jan. 17 /PRNewswire/ -- In the last decade, the number of consumers taking antidepressants has more than doubled, with a staggering 4000% increase in the diagnosis of bipolar disorder in children in that time. Doctors wrote 164 million prescriptions for antidepressants in 2008. Pharmaceutical companies spend billions of dollars on direct to consumer pharmaceutical advertising psychiatric drugs. Is there a connection? And when a patient experiences harm from a drug, does direct to consumer advertising play a role in litigation?

Monday January 18 live from 7:00-8:00 p.m. EST on the Philadelphia CNN-News affiliate WFMZ-TV and streaming online at WFMZ.com, The American Law Journal presents "Ask Your Doctor If 'x' is Right for You- Does Drug Advertising Help or Hurt the Consumer?" Philadelphia-based lawyers and a prominent pain physician address the legal, medical and social implications of direct to consumer drug advertising. Former New Jersey prosecutor Christopher Naughton, a legal commentator and 20-year legal broadcasting veteran, hosts the program.

On the panel representing consumers and pharmaceutical whistleblowers in nationwide, complex pharmaceutical litigation and recent landmark pharmaceutical settlements is Stephen Sheller, Esq. of the law firm of Sheller, P.C.. Raymond Williams, Esq. of DLA Piper brings his expertise defending top-tier pharmaceutical companies in high-profile cases to the conversation. Joining Sheller and Williams is physician Frank J.E. Falco, M.D., CEO of the Mid-Atlantic Spine & Pain Physicians and Vice President of the American Society of Interventional Pain Physicians.The program will address both informational and product drug advertising with an emphasis on the rapid growth of marketing and prescribing antidepressant and antipsychotic drugs.

Despite health concerns and the increase in lawsuits involving antipsychotic drugs, "we're seeing more drug advertising with 'if you're antidepressant isn't doing enough for you' ads," says Sheller, "and with the FDA approving the use of antipsychotics in children, it's becoming a huge moral question."

Eye test could help diagnose depression

By Anna Salleh for ABC Science
Posted Tue Jan 19, 2010 4:46pm AEDT
Updated Tue Jan 19, 2010 5:02pm AEDT

Dr Miller says it is possible that the flip rate may be a marker for susceptibility to both schizophrenia and bipolar disorder. (Flickr: Sean Dreilinger)

Australian researchers hope a curious visual phenomenon will improve our understanding of manic depression and may one day lead to a diagnostic test.

Neuroscientist, Dr Steven Miller of Monash University in Melbourne and colleagues report their findings today in the journal Proceedings of the National Academy of Sciences.

"We know that manic depression, or bipolar disorder, is a highly heritable disorder," says Dr Miller.

"But the world is having a lot of trouble trying to find genes [involved in] bipolar disorder."
He says one of the key problems is that the diagnosis of people with manic depression can be unreliable.

Dr Miller and colleagues have been trying to establish a biological marker for manic depression, which could be used to complement clinical diagnosis.
To do this, they have been studying an artificially-induced visual phenomenon known as 'binocular rivalry'.

"In everyday life, the left and right eyes are looking at more or less the same thing and your brain combines both inputs, allowing you to perceive distances," says Dr Miller.

But if each eye is given a completely different image to look at, it induces an abnormal state.
Rather than combine the images, the brain first focuses on one image and then flips to the other.
"It's a perceptual flip phenomenon," says Dr Miller.
He says the flip usually occurs on average every 1 to 2 seconds but this rate is known to vary widely between individuals.

Studying flip rates
In two previous studies Dr Miller, working with Professor Jack Pettigrew at the University of Queensland, tested the flip rate in more than 200 subjects given special goggles that showed horizontal stripes to one eye and vertical stripes to the other.

They found that people with manic depression had a statistically significantly slower average flip rate of around 3 to 4 seconds, and some were as slow as 7 to 10 seconds.

But to establish whether this difference in flip rate was a true biological marker for manic depression and not, for example, a side-effect of medication, further research was needed.

In the most recent study, Dr Miller, and colleagues at the Queensland Institute of Medical Research, compared the flip rate in nearly 350 pairs of twins with no psychiatric disorders.
Identical twins had a more similar flip rate than non-identical twins, which was evidence that flip rate is inherited, says Dr Miller.

"If the difference in flip rate was due to a side-effect of medication, you would not expect this result," he says.

Dr Miller says genetics is responsible for 52 per cent of the variability in flip rate and suggests it is a biological marker of the inherited bipolar disorder.

"That finding has clinical relevance," he says.

Diagnostic test?
But Dr Miller says it is too early to say whether measuring the flip rate could be used as a diagnostic test for bipolar disorder.

He says the flip rate needs to be verified, for example, in large numbers of people with established clinical diagnoses of manic depression.

Studies in asymptomatic relatives of people with manic depression may also show that the flip rate is a useful biological marker for predisposition to the condition, says Dr Miller.
And he says using the flip rate, instead of clinical diagnosis, to categorise people in genetic studies on mental illness could help net more of the genes involved.

He emphasises such studies would not lead to definitive genetic tests for manic depression and other mental illnesses, but could identify genes that help make people susceptible to such conditions.

Dr Miller says it is possible that the flip rate may prove to be a biological marker for susceptibility to both schizophrenia and bipolar disorder, which can be hard to distinguish using clinical diagnoses.

Psychiatrist Professor Gordon Parker of Sydney's Black Dog Institute says there is much more work required to establish the flip rate as a marker but agrees the development of biological markers are important.

"The field [for both depressive and bipolar disorders] would be distinctly advanced by such markers as there have been no definitive ones up to now," says Professor Parker.

Examining The Impact Of FDA Safety Warnings
A study published in the Archives of Internal Medicine examines the impact of a safety warning issued by the Food and Drug Administration for commonly prescribed antipsychotic medications. The results show the warnings resulted in a decline in usage among the elderly with dementia, yet raise the question as to whether the FDA's system of communicating these warnings is sufficiently targeted and effective. http://mnt.to/a/3wbF

£770,000 education programme for Welsh bipolar patients

The programme is aimed at encouraging a better understanding of treatment
A new project aimed at helping patients with bipolar disorders, and their families, is being rolled out across Wales.

The bipolar education programme hopes to offer 200 people a year the chance to take part in the 10-week sessions.

The courses, which are the brainchild of Cardiff University's mood disorders team, aim to help people understand and cope with manic depression.

The five year scheme has been funded by £770,000 from the Big Lottery Fund.

Bipolar disorder, often referred to as manic depression, is a complex condition sometimes described as a person's 'mood thermostat' malfunctioning.

It can lead to bouts of severe depression and other periods of intense 'highs', where judgement can be severely impaired.

However, the Wales education programme hopes it can help those with the condition better understand how it affects them, their families and the wider community.

Dr Ian Jones, from Cardiff University's School of Medicine, said it would help people with the disorder improve awareness of their condition.

He said it would also help them "have a better understanding of their treatment, provide the skills necessary to detect early signs of relapse and, most importantly, enable them to make informed decisions about their treatment".

Dr Jones, the programme's coordinator, added: "The National Institute for Clinical Excellence (NICE) has highlighted the need for treatment for bipolar disorder to be combined with other interventions such as psycho-education in order to gain maximum effect.

"The launch of the bipolar education programme Cymru helps us meet this recommendation."

An initial pilot programme has already been held in Cardiff, and further sessions are due to get under way in the Welsh capital in the near future.

Barriers

The whole project will then be rolled out across Wales, with the support of local community mental health teams.

The former chief constable of South Wales Police, Barbara Wilding has welcomed the launch, in her role as the chair of the Big Lottery Fund Wales mental health matters committee.

"One in four of us will experience mental health problems at some point during our lives so it is important to recognise the issue," she said.

"People with mental health problems are some of the most disadvantaged people in society. Many are isolated and have low self-esteem and low aspirations.

"Their condition is made worse by the stigma, lack of understanding and discrimination they face daily."

She said the project would have a "significant impact" on the lives of people with mental health problems in Wales.

In addition to the main programme, single sessions will be run for families and carers of individuals attending the programme.

Over the lifetime of the programme, it is hoped that some 1,000 will benefit directly from the sessions.

Exemption for Eligible Students with Disabilities

Exemption of the Requirement to Pass the California High School Exit Examination (CAHSEE) as a Condition of Graduation from High School for Eligible Students with Disabilities: California Education Code (EC) Section 60852.3 (ABX4 2)
http://www.cde.ca.gov/ta/tg/hs/cahseefaqexempt.asp

EmFinders EmSeeQ Offers Option for Wanderers

GPS system integrated with 9-1-1
EmFinders EmSeeQ is a new wide-area location device and service. This device is an emergency response solution designed to work in conjunction with law enforcement officials and the 9-1-1 community to help immediately locate adults with cognitive and developmental disabilities and children who wander, including those diagnosed with Alzheimer's disease and autism. The solution utilizes a watch-like wearable device and cellular network- based technology to provide tracking information in emergency situations. Read on...

Special Needs Karate class in La Jolla

Hi, My name is Stephanie Armijo and I am emailing from La Jolla Yoga Center. We have just added a Special Needs Karate class and we were hoping you could help us get the word out. We are offering one free month of classes so that parents can see if it is a good fit for their children. Below is some information, please let me know if you need any additional information.

La Jolla Yoga Center is pleased to offer Special Needs Karate classes with Frank McCarroll on Tuesdays and Fridays from 3:30-4:30pm. Special Needs Karate is a traditional martial arts class for people with a wide range of physical and cognitive disabilities.

La Jolla Yoga Center will be offering one month of free Special Needs classes.

Frank McCarroll is the only martial arts teacher in the San Diego area that is also a full time special education teacher. He is trained in Applied Behavioral Analysis (ABA), Positive Behavior Intervention in Schools (PBIS), Behavior Intervention Planning (BIP), and firmly believes in using positive reinforcement to shape behaviors.

Please visit our website:
http://www.lajollayogacenter.com
Frank McCarroll's website:
http://www.practicalkarate.com
Best,
Stephanie Armijo
La Jolla Yoga Center

Sandoz launches generic mental disorder treatment

By Alaric DeArment

PRINCETON, N.J. (Jan. 21) Sandoz has launched a generic version of a drug for schizophrenia and bipolar disorder, the generic drug maker announced.
Sandoz, the generics arm of Swiss pharmaceutical giant Novartis, introduced risperidone orally disintegrating tablets in the 2-mg, 3-mg and 4-mg strengths.
The drug is a generic version of Johnson & Johnson's Risperdal M-TAB, which had sales of $108 million in 2008, according to IMS Health.

Take steps to prevent bipolar card splurges

By Sally Herigstad

CreditCards.com

Dear To Her Credit,
I am a 32-year-old woman with bipolar disorder. I receive disability payments and work part-time as a waitress. This past year I had a relapse and ended up back in the hospital, but not before I created a large amount of debt for myself through credit cards and spent all my savings.
My job welcomed me back but with reduced hours, and business has been slow. I'm having trouble keeping up with my bills. I was just wondering if there was some type of help for those with bipolar disorder who have the characteristics of untamed spending.

Thank you for your time. -- Keisha

Dear Keisha,
Untamed spending is one of the most common signs of bipolar disorder and yes, there is help for it.

Many people do not understand bipolar spending. To those unfamiliar with bipolar episodes, it can look a lot like compulsive overspending, or even an excuse or a simple lack of self control. However, true bipolar spending differs from ordinary over shopping in some important ways, according to Drs. John M. Kuzma and Donald W. Black in their research paper "Compulsive shopping: When spending begins to consume the consumer."

They found that:

• Bipolar patients overspend during manic episodes of hyperactivity. Compulsive shoppers never stop.
• Bipolar patients feel good about their shopping afterward and often show off their purchases. Compulsive shoppers tend to feel guilty and try to hide the evidence.
• A defining characteristic of bipolar episodes is outrageous grandiosity, far above the fleeting feeling of power experienced by the compulsive shopper.

The first step for anyone who suspects she may have a bipolar disorder is to find help to treat the problem, not just the symptoms. Because you have been hospitalized and receive disability, I'm assuming you are getting medical help. I would encourage you to also find support groups and concentrate on improving your general health.

Next, make a plan to prevent future spending sprees. Sarah Freeman, author of Bipolar-lives.com, recommends enlisting other people's help. If you are married, your husband can drastically restrict your access to credit cards, checks and even car keys when he sees signs of an episode coming. You can also opt out of receiving credit card offers and credit card cash advance checks in the mail to further reduce accessibility.

If you're single, you have to take charge yourself. You can do this by avoiding situations that make spending more likely and by making it harder to overspend.

First, avoid spending triggers (this is good advice for everyone, bipolar or not):

• Don't go shopping. The mall is not a good place for a walk! And don't even think about browsing the new car lots.
• Limit Internet use. If Internet spending is a problem, perhaps you should not have it at your house. You can always use it at a friend or relative's house or at the library.
• Slow the volley of ads and opportunities that come your way. Unsubscribe from e-mail lists, get off catalog mailing lists.
• If TV ads make you want to shop, turn the TV off.
• Call (888) 5-OPT-OUT or visit optoutprescreen.com to stop those tempting preapproved credit cards from flooding your mailbox.
• Find something to do that makes it impossible for you to shop at the same time. I like to sculpt, for instance, and I've noticed it's impossible to shop -- or eat -- when I'm sculpting with wet clay. Maybe you like to garden or do volunteer work.

Making it harder to spend or make imprudent money decisions is also essential:

• Don't keep excessive lines of credit. A couple of credit cards are plenty. Close excess accounts. (Any slight disadvantage to your credit score from closing the accounts is far outweighed by reduced risk of overspending.)
• Call your credit card company and tell them not to send you those blank "convenience checks."
• If you don't use paper checks to pay bills, get rid of them. Or put them with any extra credit cards and at-risk valuables in a bank safe or at your parents' house.
• Enlist the help of others. For example, Freeman says, "If you are lucky enough to have any kind of portfolio, you may need to confide in your investment adviser or broker. Although they are bound to carry out the client's instructions, a heads up can encourage them to insist on written instructions and a face-to-face meeting. You may even be able to agree that they will notify a spouse, doctor or other appropriate person if any unusual transactions are requested."
• Consider giving a trusted person power of attorney if necessary.

As for not being able to keep up with your current credit card bills, you may want to contact your credit card issuers and explain your situation. They may or may not be willing to work with you in lowering your interest rates or reducing your payments. One alternative would be to go to a local nonprofit credit counselor (affiliated with either the National Foundation for Credit Counseling or the Association of Independent Consumer Credit Counseling Agencies) to work out a payment plan. Your credit counselor will then contact the card issuers for you.

Fattened by pills; One of the biggest causes of obesity is seldom discussed.

By Paula J. Caplan The Boston Globe
As Americans struggle to keep New Year's weight-loss resolutions, experts' alarms about obesity ring in our heads. We obsess about portion control, flock to the gym, and can't get enough of The Biggest Loser. As schools, congressional subcommittees, and even first lady Michelle Obama -- who's made the issue a top priority -- take on the problem, the focus turns to the usual suspects: fast food, oversize servings, and sedentary lifestyle. For some battling weight problems, those factors are indeed critical. But overlooked in all this is one of the primary causes of America's obesity epidemic: The elephant in the living room is the skyrocketing use of psychiatric drugs. Many of these, which are used to treat emotional problems including depression and anxiety, cause weight gain -- often of the rapid and massive sort -- as one of their "side effects," that brilliant marketing term for what are simply negative effects of a drug.

It is striking that the weight of many Americans has ballooned just as the prescribing of psychiatric drugs has surged. The Obesity Society categorizes nearly two-thirds of adult Americans as overweight, the average weight of an adult having increased since 1960 by 25 pounds, and between 1996 and 2006 alone, prescriptions of psychiatric drugs for US adults increased 73 percent. The courageous Alaskan attorney James Gottstein in 2006 exposed drug company Eli Lilly's concealment of its knowledge about the effects of its drug Zyprexa3 (approved to treat schizophrenia and bipolar disorder but also prescribed for other conditions) on weight gain, and subsequent reports have revealed such effects of a whole range of psychiatric drugs. But nearly all researchers and journalists who focus on obesity fail to mention the drug link.

It's hard not to wonder why this happens. Could drug companies be that much more powerful than fast-food chains, or does it take the former much longer to come up with drugs lacking unwanted effects than for McDonald's to produce healthier foods in smaller portions? Is it perhaps clinicians' fear of not knowing what to do other than prescribe these drugs? If so, then it's time to broaden their training so they know more about the wide array of other courses of action that can help many who suffer from emotional problems, such as exercise, meditation, changes in vitamin/mineral intake, participating in the arts, volunteer work, and developing or maintaining close friendships. Whatever the reasons, the result is that not enough people know that many of these emotionally troubled patients now will have added burdens.

What's worse is that the connection between psychiatric drugs and obesity involves children, too. Over the past two decades the number of obese adolescents has tripled, while the 10 years after 1996 saw prescriptions of psychiatric drugs for US children rise 50 percent. And a new federal study shows that poor children are more likely than other kids to be put on drugs marketed as antipsychotics, one of the greatest culprits for causing major weight gain as well as lifelong metabolic problems. Add the humiliation to which kids subject overweight peers, and the potential psychological damage is frightening.

Another disturbing link could be on the way. The fifth edition of the major psychiatric diagnostic manual, the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), is expected to be released in 2013. One proposal under consideration: listing obesity as a mental illness. That would be a mistake, since obesity can be caused by metabolic and other physical problems that are often undiagnosed. And because obesity can also result from psychiatric drugs, calling it a mental illness would create a vicious cycle: Someone is troubled, put them on drugs, they become obese, therefore diagnose them as mentally ill, give them more drugs.

Overall, much must be done. The first lady should talk about the obesity/drugs link. The Food and Drug Administration must ride herd -- hard -- on drug companies that conceal that connection. Every physician should alert patients to this potential effect and explore other non-drug ways to treat emotional problems. Publishers and editors should insist that this link be addressed in stories about obesity. The American Psychiatric Association should refuse to categorize it as a mental illness in its DSM-V. And every citizen should stop the knee-jerk blaming of people with weight problems for allegedly lacking self-control.

Paula J. Caplan, a clinical and research psychologist at Harvard University, is the author of They Say You're Crazy: How the World's Most Powerful Psychiatrists Decide Who's Normal.

Service dog helps woman fight mental illness

By Dalson Chen, The Windsor StarJanuary 23, 2010
Jennifer Francis, 23, and her mental health assistance dog, named Spirit, at a forum at the University of Windsor on Jan., 19, 2010 in Windsor, Ont.
Photograph by: Jason Kryk, The Windsor Star

WINDSOR, ONT. -- Jennifer Francis has a disability and requires a service dog - but there's nothing wrong with her sight, hearing or limbs.

The 23-year-old London resident and engineering student is a diagnosed sufferer of bipolar Type 2 disorder, obsessive compulsive disorder and panic disorder.

"I have a disability, and it is chronic," Francis told an audience at the University of Windsor student centre this week. "For many years to come, I will be healing."

Francis was a featured speaker at a campus presentation on taking the stigma out of mental illness.

Francis said her condition is unusual in that she's comfortable sharing intimate details of her life with a room full of strangers, but a simple family gathering or a trip to the mall is a stressful event that can lead to an episode.

As she spoke at the podium, Francis was accompanied by Spirit, her four-year-old female golden retriever.

Francis said Spirit is Southwestern Ontario's first recognized mental health assistance dog, trained by a Hamilton-based organization called Encouraging Paws Service Dogs.

According to Francis, Spirit has been taught to read her body language and recognize panic attacks. Wherever Francis goes - including classes and exams - Spirit follows, tethered to Francis's waist.

Although Francis continues to take an array of mood stabilizers and anti-psychotic drugs for her condition, she described an episode that occurred last summer where she awoke one night with hallucinations and suicidal thoughts.

Francis credits Spirit with alerting her mother of her need for immediate help.

"I do not, and will not, have to fight this battle alone," Francis said about her support system.

Asked if anyone ever questions Spirit's presence for example, at places of business - Francis said Spirit has all the necessary documents that identify her as a service dog.

If a problem persists, Francis said she invites complainants to call the police. "That usually shuts them up," she said.

"I get a big smile out of it, after a while, because I know they're in the wrong and I'm in the right."

Francis described her family life as "wonderful," and said there were no indications of mental illness in her childhood and adolescence. Her symptoms began in her first year of university.

Asked if there is any history of mental illness in her family, Francis said: "There is a genetic component . . . But no one talked about it. It wasn't dealt with."

Six years after her struggles began, Francis will graduate this year with an engineering degree. She has close friends and a boyfriend, and is active in raising awareness about mental health issues, on campus and beyond.

"I have been given a gift," Francis told the audience. "I am better because of my disability."

Barbara Hall, head of the Ontario Human Rights Commission, also spoke at Tuesday's event.

"We need to have more conversations like this," Hall told the audience.

According to Hall, one in five Canadians will experience mental illness in their lifetime. She said education efforts must continue to dispel the fear and stigma associated with such problems.

"The more we believe this is not unusual, the more we will talk about it openly," Hall said.

Budget Funds New Mental Health Gene Research

Friday, June 16, 2000

BUDGET INCREASES FUND NEW MENTAL HEALTH GENE RESEARCH

Additional budget funding of $3 million per year* (including GST) for the Health Research Council has enabled 12 new projects to be funded, two of which will search for the genes involved in depression and bipolar disorder.

The extra projects total $4.97 million and last for up to three years. Some of the budget boost will also be used for areas such as nutrition, environmental health, determinants of health, biotechnology and occupational safety, which will be jointly funded with other purchase agencies. The Budget increase brings the total HRC allocation for new contracts to $47.33 million (excluding GST).

The mental health gene studies are together worth almost $1 million. The University of Otago group, led by Professor Robin Olds, will also find genes influenced by the drug lithium, used to treat bipolar disorder (manic depression), and examine them for variations affecting those with the condition. These researchers have already recruited more than 250 South Island families with a history of bipolar disorder.
The depression study, led by Dr Martin Kennedy at the Christchurch School of Medicine, will enrol more than 200 people who have had treatment for major depression as well as their family members.

Other studies will investigate the genetics of thyroid disease, cell death in cancer, indicators of deprivation and iron deficiency in teenagers.

Says HRC Chair Jane Holden: "The HRC is pleased that health research has been recognised in the budget as a high-performing area of the research sector. The Council also welcomes $11.8 million in grants to enable the private sector to do more research. This will benefit local biotechnology companies arising from health research into genetics, computer modelling and the development of new drugs."

The budget also included extra funding for the New Economy Research Fund and the Marsden Fund, both of which also support biomedical research.

The HRC is also releasing details of new or extended programme contracts, worth more than $11 million, whose totals have just been approved. These contracts were funded before the Budget.

Washington's mental-health-care system needs resources, family input

The Washington Legislature should change the law so families are better able to help their loved ones with mental illness, writes guest columnist Martha Monfried. And lawmakers must not cut further a system that tries to help the mentally ill.

By Martha Monfried Seattle Times, January 27,2010

My sister recently tried to kill herself by abandoning her car and jumping from the 520 bridge. I am grateful to those boaters and others who rescued her that day and everyone else who has repeatedly tried to help her. She was definitely not in her right mind and has suffered from mental illness for most of her life. As her physician said, "It's a terrible disease; I wouldn't wish it on anyone."

Not only is mental illness a terrible disease, the way we treat those who have it is insane. Our mental-health system is inadequate and current law makes it almost impossible for families to help their loved ones.

Only when they are an imminent danger to themselves or others can they be admitted to a hospital on a voluntary or involuntary basis. Even then, they generally receive care for a very short period of time: an involuntary 72-hour hold.

Courts then decide if they can receive more help as advocated by prosecutors and designated medical professionals or refuse treatment, which is their right as they are represented by appointed public defenders.

The hospitals become revolving doors without enough beds locally or at Western and Eastern State hospitals to help those who need longer-term care. It takes months, if not years, for the seriously mentally ill to get into the few community group homes in each county.

It also takes months, if not years, with determined help from someone like me, for them to qualify for state or federal assistance. All too often they end up homeless, dead or in jail.

Nationwide in the 1970s, there were 500,000 hospital beds for the mentally ill. Today, there are 50,000. A quarter of the 700,000 homeless on any given night in America suffer from serious mental illness. More than 2,300 inmates in Washington state prisons and about 300,000 nationwide are mentally ill.

Because my sister is currently mentally unable to make good decisions about treatment, it's unlikely she'll ever make any progress - and we fear she will eventually succeed in killing herself or will hurt someone and be incarcerated.

The current system has failed her. Since May 2009, she has been in most of King County's health facilities at least once. After racking up more than $100,000 in medical bills, we have still found no affordable live-in care facilities for her in the area.

There are some options to help my sister and others like her. One is to support Browning Communities in Seattle whose mission is to "provide structured, comprehensive and therapeutic living facilities in order to end the crisis of neglect, victimization, violence, abuse and homelessness for all chronically mentally ill." A year's treatment there is estimated to be $70,000. We can also donate to Sound Mental Health, the Overlake Hospital Foundation and Seattle's Union Gospel Mission.

At a minimum, the Legislature should act this session to allow families in Washington to petition the court to commit their loved ones who suffer from mental illness. Sadly, in view of Washington's budget crisis, advocacy groups like the state chapters of the National Alliance on Mental Illness are hoping only to preserve the inadequate system that exists.

We cannot afford to eliminate or restructure the general-assistance program, reduce the Medicaid rates paid to mental-health providers or cut the unrestricted state dollars supporting those with mental illness as proposed in this round of budget cuts. If we do, more people like my sister will end up dead, in prison or on the street.

Simply put, it is inhumane and uneconomic only to preserve or further block the revolving door of short hospital stays and inadequate follow-up support. We can and must do better.

Martha Monfried is director of corporate communications at Puget Sound Energy and lives in Bellevue.

bp Magazine Celebrates 5 Years
Where are they now?

Ross Szabo (CBF Consumer Advisory Committee member) - Fall 2004

A new book. A new wife. And a milestone any professional speaker could be proud of: reaching nearly a million people with his message. Such is life for Ross Szabo, who was diagnosed with bipolar disorder at age 16. At 17 he began speaking about his experiences in high schools and on college campuses to raise awareness about mental health issues.

Now 31, he's ready to take a break while he and his bride spend time abroad.

"I have had a great time doing this work," says Szabo. "And now it's time to focus on other things for a while."

Szabo, who continues to serve as director of Youth Outreach for the National Mental Health Awareness Campaign, is looking to spread his message in other ways. He co-wrote Behind Happy Faces: Taking Charge of Your Mental Health (Volt Press, 2007), a guide to symptoms and treatment of mental illness written for adolescents.

Ross says his continuing treatment for bipolar disorder now reaches far beyond medication. "The biggest work I've done recently is to focus on my coping mechanisms. I've been trying to analyze which ones came from my bipolar disorder, and which ones were enhanced by it.

"For me, I've wanted to find out what is bipolar disorder and what is me," he says. "I try never to use the disorder to get out of anything or as an excuse, but to use it as a challenge to understand who I really am, how my brain works."

To read more, click here: http://www.bphope.com/Item.aspx?id=633

New Caregiver Support Group Forming

A new Caregiver Support Group will start in February in Rancho Santa Fe. Join Wendy W. the 2nd Tuesday of the month from 10:00 - 12:00. The first group will be Tuesday, February 8th.
As always, please RSVP to Tom Kelly; tkelly@californiabipolarfoundation.org and he will send you the address and directions.

California Bipolar Foundation Joins the Give-a-Day, Get-a-Day

Watch for volunteer opportunities (coming soon for Click!) for our organization & if you volunteer, Disney will give you a free 1-day pass!!!

'Cause as part of the "Give a Day. Get a Disney Day." program*, it's time to choose a volunteer activity at a participating organization in your community! And the sooner you complete your volunteer service...the sooner you'll be able to get your FREE ticket to a Walt Disney World® or Disneyland® Resort Theme Park.

You still have to do the following to get your FREE admission to a Disneyland Resort or Walt Disney World theme park:

• Search for and commit to a volunteer activity. Start now!
• Complete your volunteer service.
• Print the voucher we'll email to you once your service is verified. Follow the instructions on the voucher to redeem it by December 15, 2010. Then enjoy! (Or you can donate your ticket to a designated organization.)

 Thanks again for choosing to be part of our "Give a Day. Get a Disney Day." program. There's no better time to make a dream come true for others...or to let us make a few come true for you.

*Must preregister and sign up for eligible volunteer opportunity at disneyparks.com. Ticket quantities for this program are limited. Must be at least age 6 to participate. One ticket per person. Other terms and conditions apply. See disneyparks.com for details.

LEGAL AID SOCIETY OF SAN DIEGO, INC.
HOMELESS ADVOCACY PROGRAM NORTH COUNTY

WHAT: Come talk to our attorneys and legal volunteers regarding a wide-range of legal problems, including, for example:

· Child Support and Custody
· Immigration
· Divorce and Family Law
· California Identification
· Landlord/Tenant
· Small Claims Court
· Consumer Issues
· Medi-Cal, Medicare and CMS
· General Relief and CalWorks
· Referrals on Criminal Law Issues and Warrants
· SSI, SS-DI and Social Security
· Identity Theft
· State Disability Income

WHY: We try to assist you with your legal problems or refer you to appropriate community resources.

WHEN and WHERE:
Mondays 1pm - 4:30pm Wednesdays 1pm - 4:30pm 707 Oceanside Blvd 550 W. Washington St, Ste. B Oceanside, CA Escondido, CA Please write your name on the Legal Aid Sign-up list at the reception and we will call you in order from that list. Please bring all relevant documents with you.

Question: What is Bipolar 2 Disorder?

Answer: According to the definition in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), bipolar II disorder (also known as bipolar 2 disorder or bipolar type 2) is "characterized by one or more major depressive episodes accompanied by at least one hypomanic episode." The key difference between bipolar 1 and bipolar 2 is that bipolar 2 has hypomanic but not manic episodes, meaning the symptoms of mania are generally less severe in type 2. Also, while those with bipolar I disorder may experience additional psychotic symptoms such as delusions and hallucinations, bipolar II by definition cannot have psychotic features.

The signs which would lead to a diagnosis of bipolar 2 disorder are:

• One or more major depressive episodes
• At least one hypomanic episode
• There has never been a manic or mixed episode
• Another disorder is not responsible for symptoms
• Symptoms cause distress or impair functioning

Symptoms and characteristics of depression include:

• Decreased energy
• Weight loss or gain
• Despair
• Irritability
• Uncontrollable crying

Symptoms and characteristics of hypomania include:

• Grandiosity
• Decreased need for sleep
• Pressured speech
• Racing thoughts
• Distractibility
• Tendency to engage in behavior that could have serious consequences, such as spending recklessly or inappropriate sexual encounters
• Excess energy

It should be noted that the symptoms of hypomania are the same as for mania, but they are less severe. Therefore, the official diagnostic criteria separating a diagnosis of bipolar II from that of bipolar I disorder is that hypomania does not cause marked impairment of functioning or require hospitalization.

by Kimberly Read About.com

Postpartum Depression and Psychosis

Postpartum depression is a not uncommon condition that affects women after giving birth - and sometimes men as well. About Depression Guide Nancy Schimelpfenig has put together a wonderful resource guide to this troubling condition. People with bipolar disorder are at higher than average risk of developing postpartum depression, so if you have experienced serious "baby blues," or are about to give birth, this is something you should definitely take a look at.
Postpartum psychosis is a very serious condition that has been linked to bipolar disorder. It's estimated that around four to eight thousand women experience postpartum psychosis annually in the United States alone. Pregnant women with bipolar disorder should know the symptoms of this dangerous illness and also make sure that their friends and loved ones know what to look for.
~Marcia About.com

Mail-Order Improves Medication Compliance

By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on January 19, 2010
A new study suggests purchasing medicine by mail may encourage patients to stick to their doctor-prescribed medication regimen.

In a first-of-its-kind study, researchers from UCLA and Kaiser Permanente's Division of Research in Oakland, Calif., found that patients with chronic disorders were more likely to take the medications as prescribed by their physicians than patients who obtained medications from a local pharmacy.

Researchers studied individuals with diagnoses including diabetes, high blood pressure and high cholesterol and believe the ease by which the medications were acquired is a primary reason for those patients' compliance level.

The study findings appear in the online edition of the American Journal of Managed Care.

"The field of medication adherence research typically focuses on patient factors for poor adherence, leading to a 'blame the patient' approach for non-adherence," said Dr. O. Kenrik Duru, the study's lead researcher and an assistant professor in the division of general internal medicine and health services research at UCLA.

"Our work helps to place this issue in a larger perspective," Duru said. "Our findings indicate that mail-order pharmacies streamline the medication-acquisition process, which is associated with better medication adherence."

For the 12-month study, researchers analyzed medication refill data from 2006 and 2007 for 13,922 Kaiser Permanente members in Northern California. They defined "good adherence" as having medication available and on-hand at least 80 percent of the time.

The researchers found that 84.7 percent of patients who received their medications by mail at least two-thirds of the time stuck to their physician-prescribed regimen, compared with 76.9 percent of those who picked up their medications at traditional "brick-and-mortar" Kaiser Permanente pharmacies.

"The results were consistent for all three classes of medication, including medications to control diabetes, high blood pressure and high cholesterol," said co-investigator Julie A. Schmittdiel, Ph.D., a research scientist with the Kaiser Permanente research division.

Other findings include:

• Before adjusting for other variables, white patients were more likely than Hispanics to obtain medications by mail (61.0 percent vs. 37.1 percent) and to be in the highest socioeconomic status quartile (27.5 percent vs. 17.8 percent).
• Mail-order pharmacy users were more likely than local pharmacy users to have a financial incentive to fill their prescriptions (49.6 percent vs. 23.0 percent) and to live a greater distance from a local pharmacy (8.0 miles vs. 6.7 miles). An example of a financial incentive is receiving a three-month supply of medication for the cost of a two-month supply.
• After adjusting for other variables, whites were more likely to use mail-order pharmacies (24.1 percent) than were Asian/Pacific Islanders (8.4 percent), Hispanics (5.2 percent), African Americans (4.0 percent) and individuals of mixed race (8.0 percent).

While other research has examined the association between medication costs and mail-order and local pharmacies, this is the first study to look at the relationship between pharmacy type and medication adherence.

Furthermore, it controls for differences in out-of-pocket costs and medication supply (by number of days) between mail-order and local pharmacy users, something other datasets have not included.

"In other words, our study is able to isolate the use of mail-order pharmacies specifically, without the results being affected by differences in cost or in the number of pills provided with each dispensing," Duru said.

The study does have some limitations. For example, the findings need to be confirmed by a randomized controlled trial.

Still, the research suggests that increased mail-order use to obtain medications could improve patients' adherence.

Source: UCLA

Does age at onset have clinical significance in older adults with bipolar disorder?

International Journal of Geriatric Psychiatry, 01/20/10
Gildengers AG et al. - Except for family history of major psychiatric illnesses, there were no differences between the groups on demographic or clinical variables. Patients with early and late onset experienced similar percentages of days well; however, those with early onset had slightly more percentage of days depressed than those with late onset. Distinguishing older adults with BD by early or late age at onset has limited clinical usefulness. Read the article

Couch Behavior May Shorten Life

By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on January 12, 2010
A new study finds that every hour spent in front of the television per day brings with it an 11 percent greater risk of premature death and an even higher risk of death from cardiovascular disease.

Austrian researchers followed the lifestyle habits of 8,800 adults and found that each hour spent in front of the television daily was associated with:

• an 11 percent increased risk of death from all causes,
• a 9 percent increased risk of cancer death; and
• an 18 percent increased risk of cardiovascular disease (CVD)-related death.

Compared with people who watched less than two hours of television daily, those who watched more than four hours a day had a 46 percent higher risk of death from all causes and an 80 percent increased risk for cardiovascular disease-related death.

This association held regardless of other independent and common cardiovascular disease risk factors, including smoking, high blood pressure, high blood cholesterol, unhealthy diet, excessive waist circumference, and leisure-time exercises.

While the study focused specifically on television watching, the findings suggest that any prolonged sedentary behavior, such as sitting at a desk or in front of a computer, may pose a risk to one's health.

The human body was designed to move, not sit for extended periods of time, said David Dunstan, Ph.D., the study's lead author and professor and head of the physical activity laboratory in the Division of Metabolism and Obesity at the Baker IDI Heart and Diabetes Institute in Victoria, Australia.

"What has happened is that a lot of the normal activities of daily living that involved standing up and moving the muscles in the body have been converted to sitting," Dunstan said.

"Technological, social, and economic changes mean that people don't move their muscles as much as they used to - consequently the levels of energy expenditure as people go about their lives continue to shrink. For many people, on a daily basis they simply shift from one chair to another - from the chair in the car to the chair in the office to the chair in front of the television."

Dunstan said the findings apply not only to individuals who are overweight and obese, but also those who have a healthy weight. "Even if someone has a healthy body weight, sitting for long periods of time still has an unhealthy influence on their blood sugar and blood fats," he said.

Although the study was conducted in Australia, Dunstan said the findings are certainly applicable to Americans. Average daily television watching is approximately three hours in Australia and the United Kingdom, and up to eight hours in the United States, where two-thirds of all adults are either overweight or obese.

The benefits of exercise have been long established, but researchers wanted to know what happens when people sit too much. Television-watching is the most common sedentary activity carried out in the home.

Researchers interviewed 3,846 men and 4,954 women age 25 and older who underwent oral glucose-tolerance tests and provided blood samples so researchers could measure biomarkers such as cholesterol and blood sugar levels. Participants were enrolled from 1999-2000 and followed through 2006.

They reported their television viewing habits for the previous seven days and were grouped into one of three categories: those who watched less than two hours per day; those who watched between two and four hours daily; and those who watched more than four hours.

People with a history of cardiovascular disease were excluded from the study. During the more than six-year followup, there were 284 deaths - 87 due to cardiovascular disease and 125 due to cancer.

The association between cancer and television viewing was only modest, researchers reported. However, there was a direct association between the amount of television watched and elevated cardiovascular disease death as well as death from all causes even after accounting for typical cardiovascular disease risk factors and other lifestyle factors.

The implications are simple, Dunstan said. "In addition to doing regular exercise, avoid sitting for prolonged periods and keep in mind to 'move more, more often'. Too much sitting is bad for health."

Source: American Heart Association

Introducing a New Blog, Bipolar Advantage

By John M Grohol PsyD

Bipolar disorder can be devastating... but it doesn't have to be.

I'm pleased to announce the introduction of Bipolar Advantage, hosted by Tom Wootton and his colleagues. I'm pleased to present this alternative view of bipolar disorder and depression, focused on how it can be used to achieve rather than simply endure. Tom said it best:

The mental health field is plagued with the bigotry of low expectations. Far too many people are talking about "changing the stigma," while creating the worst stigma of all - the idea that we are not capable of achieving greatness. While their intentions are good, they are doing terrible harm to everyone with a mental condition and those who love and support them. This "can't do" attitude is rampant in professionals, consumers, friends and family, and advocates.

This blog, then, will be about resetting expectations, raising the bar, and understanding how to believe in yourself once again. A diagnostic label should no longer hold you back from achieving greatness.

The mission of Tom and his colleagues is to "help people with mental conditions shift their thinking and behavior so that they can lead extraordinary lives. We are dedicated to the concept that recovery does not have to be limited to 90% of full function; true recovery means doing the hard work that brings you to 150% We strongly believe that we can turn our 'condition' into one that becomes an advantage instead of an 'illness' or a 'disorder.'"

Check it out today: Bipolar Advantage

Facebook, Myspace Can Empower Teens

By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on January 27, 2010
Although many parents are fearful that social media websites like Facebook and Myspace are dangerous for their children, a new research study suggests the online sites can have a positive effect.

University of Virginia psychologists determined well-adapted youth with positive friendships use these sites to further enhance the positive relationships they already have.

However, they warn, teens who have behavioral problems and difficulty making friends, or who are depressed, may be more inclined to use social media in negative and sometimes aggressive ways, or not to use such sites at all.

"We were interested to find that the best-adjusted young people were far more likely to use social media as an extension of their positive friendships, while less socially adept youth either did not have Facebook or MySpace pages, or, if they did, were more likely to use these sites in less-than-positive ways," said U.Va. psychology professor Amori Yee Mikami, the study's lead author.

Mikami and her colleagues assessed the friendship quality and popularity of 172 13- to 14-year-olds, and then, eight years later, "friended" the study participants on their Facebook and MySpace pages to examine their interactions and friendship quality in those domains.

"It was like being a fly on the wall at a slumber party," Mikami said.

She found that the youths who were better adjusted in their early teens were more likely to use social media in their early 20s, regardless of age, gender, ethnicity or parental income, and that, overall, the patterns of friendship quality and behavioral adjustment as early teens continued into early adulthood.

"We're finding that the interactions young adults are having on their Facebook and MySpace pages are more similar to than different from the interactions they have in their face-to-face relationships," Mikami said.

"So parents of well-adjusted teens may have little to worry about regarding the way their children behave when using social media. It's likely to be similar positive behavior."

However, Mikami warns, teens with behavioral problems or who have difficulty maintaining positive friendships may be more likely to use social media sites in negative ways, just as they may behave negatively in their face-to-face relationships.

Negative use of the sites would include using excessive profanity, making hostile remarks or aggressive gestures, or posting nude photographs of themselves or others. They also have fewer supportive relationships with their Facebook and MySpace friends. But this group also is less inclined to use social media at all.

Overall, 86 percent of the youths in Mikami's study used the social media websites, which parallels the national average, she said.

"Use of Facebook and MySpace is really pervasive among this age group, so it's understandable that young people would want to be connected with their peers in this way; it's an extension of the relationships they already share," Mikami said.

"So parents should try to stay involved with their children and make an attempt to understand their online world in the same way they would want to understand any other aspect of their lives.

"The key as a parent is to be supportive rather than intrusive and to keep an open dialogue with your children so you can know what they are up to and who their friends are, both online and in person."

The study appears in the January issue of the journal Developmental Psychology.

Source: University of Virginia

Bipolar Diagnosis for Toddlers and Preschoolers?!

By Candida Fink MD

Many people are shocked to hear that anyone as young as Rebecca Riley could be diagnosed as having bipolar disorder and prescribed powerful psychotropic medications. Following are several questions I have been hearing about the case recently that are related to early childhood diagnosis and treatment followed by my answers:

Q: Do you think diagnosing a child as young as Rebecca Riley as having bipolar disorder could be appropriate in certain situations?

A: I find it hard to imagine diagnosing a preschooler with bipolar disorder, because their brains are too immature and incompletely developed to exhibit symptoms well formed enough to meet criteria for bipolar disorder. Typical preschool development includes immature mood regulation and impulse control. Sleep problems are incredibly common in toddlers and preschoolers, as are temper tantrums. How can you define a mood state as a "change from baseline" in a child so young that they haven't even been around long enough to establish a baseline?

This is not to say that preschoolers cannot exhibit emotional and behavioral patterns that are quite atypical and that need to be evaluated and addressed. But this evaluation must focus on a wide array of specific developmental, medical, neurologic, metabolic, and environmental factors in such a young child before determining that it is primarily a disorder of mood presenting with behavioral symptoms.

Q: How does bipolar present differently in children than adults?

A: This is the million dollar question. Those who support the diagnosis of bipolar in young children have clearly said that bipolar disorder presents very differently in children. Their definition of mania is essentially mood changes that can occur multiple times per day, with bipolar primarily presenting as extreme irritability. This is a change in the use of the term bipolar disorder. The classic diagnosis of bipolar disorder must include well formed mood episodes - specifically a manic episode is necessary that lasts at least a few days, not several hours.

In adult bipolar research, people are exploring the possibility of a spectrum of bipolar disorder that includes a much wider range of mood regulation problems. However this is still early research. Most of the studies about medical treatment of bipolar disorder have been done on people with classic bipolar disorder - distinct episodes of mania and distinct periods of depression.

So the question of a more expansive diagnosis of bipolar disorder is being looked at in adults and children. However, we have few studies of any medication treatments using this spectrum model in adults and even fewer studies in children. Since we are already taking something of a leap of faith in using the medications found helpful in classic bipolar disorder for children, we are even further away from any research base when we expand our diagnostic pool so dramatically.

There is no data so far supporting the idea that these children with very atypical symptoms of "bipolar disorder" grow up to have classic bipolar disorder as adults. So whether these atypical presentations are really precursors to well defined bipolar or signs of some type of bipolar spectrum disorder in adulthood or, in fact, something else entirely remains utterly unclear.

Q: Do you think it is ever okay to prescribe psychotropic medications to children as young as Rebecca Riley was at the time?

A: Psychotropic medication in very young children is something to be extremely cautious about. There may be appropriate times to try medication when there are symptoms that are severe and causing major impairment in life and development. I will only prescribe for very young children after comprehensive evaluation, including multiple evaluators. I consider psychotropic medications for very young children only when other interventions have not worked. If the decision is made to prescribe, I will do so in the context of extremely careful monitoring, active family and environmental support and interventions, and close communication between all of the adults involved in the care and developmental needs of this child.

Q: Do you think that non-medication interventions should always be tried prior to prescribing medications for such young children?

A: As explained above, non medication interventions should be developed and implemented (especially parent and educational interventions) before looking at psychotropic medications in such young children.

Q: If a doctor does prescribe these medications to such young children, what sorts of monitoring should parents expect the doctor to do? How often should the doctor check in with the patient and in what form; for example, is a phone call to the parents standard or should the doctor actually see the child?

A: This varies from doctor to doctor, but regular office visits will be necessary. ("Regular visits" can also vary, but as a very general guideline, which does not always apply, I'd say a couple weeks from the first visit and at least monthly when actively adjusting medications.) Phone calls or emails should be encouraged between visits if family or other caretakers have questions or concerns.

Communication with all members of the team is particularly valuable and can help keep everyone aware of how the child is doing. I think of the team as including, at minimum, the psychiatrist and the family, but I find that it should also include other adults in the system, such as teachers, social workers, other school or medical supports, such as speech and occupational therapists, pediatricians, and other medical personnel.

Conversations with these people or getting reports or emails from them greatly aids my understanding and how I work with all children, but especially very young ones. Gathering collateral information is a central part of my work. Information from family members and my own observations of a small child do not give me a complete picture most of the time.

TEEN - PARENT GROUP FORMING

Exciting news! A group for teens and their parents will be starting next month. It is a life improvement group that teaches skills to effectively deal with confusion about self, impulsivity, emotional instability, interpersonal problems, and teenager and family dilemmas. If you would like to be a part of the group, please call to schedule an appointment with Dr. Lincoln.
If you would like more information about the group, please call Kelly O'Bryan at the number listed below.
Thank you,
Kelly

To schedule assessment with Dr. Lincoln (required for group participation), please call 858-444-8823 ext. 1202. His assistant, Cindy, will set up assessment time.

For more information about the group, please contact Kelly O'Bryan at 858-337-5822, or email ko'bryan@alliant.edu