My Support July 30, 2010
I hope you are enjoying these lazy days of summer. You will see below the announcement of our Annual Pool Party - families are invited and encouraged to bring spouses, siblings, everyone!
IBPF just keeps growing! We have another new board member; Roxanne Smith-Kovac. Read below to learn more about her.
P.S. Please contact me at anytime: firstname.lastname@example.org
July 30, 2010
If you are in a crisis,
SAVE THE DATE
Annual Family Pool Party
Sunday, August 29, 2:00 - 4:00pm
Please contact Lisa at email@example.com
to RSVP & for directions.
Please bring your towels & an appetizer to share.
Welcome to the Board!
Roxanne was born and raised in San Diego, California. She is married with 4 children ranging in ages from 9 to 29, two of whom have bipolar disorder.
Roxanne Smith-Kovac is an owner and managing partner for Precision Medical Management, Inc., a multi-specialty behavioral health billing & management company. Her focus is on education with providers in the community on the needs of mental health patients.
Smith-Kovac is an avid speaker at healthcare meetings and an advocate for the mentally ill. In her free time she enjoys bike riding with her children. Roxanne's motto: "always be flexible on any given day".
bp Kids: Finding your family's own "normal"
Parents, take note: The better you can establish a sense of normalcy around your child's bipolar disorder, the more protection that child has against the ill effects of stigma.
Those are recent findings from a Case Western University study of adolescents ages 12 to 17 who were taking medication for a diagnosed mental illness. At least 90 percent of the study's participants reported experiencing some form of stigma which led to shame, secrecy and limiting social interactions.
The researchers found that parents can buffer their children from stigma by helping them lead a normal life-or conversely, contribute to the youth's feelings of being different. Or as lead author Derrick Kranke puts it, "Parents, who embrace and love their children for whom they are and accept the illness as part of their child's being, help their children overcome these stigmas."
"Finding your own 'normal' " is exactly the topic taken up by our new Family Matters Panel, introduced in the Summer issue of bp Magazine. Panelists who have both professional and personal experience with children with bipolar give real-world advice on how to stay on course amid the mood storms of bipolar.
Emerging treatments in the management of bipolar disorder - focus on risperidone long acting injection
Bipolar disorder is a life-long psychiatric illness characterized by a high frequency of relapses and substantial societal costs. Almost half of the patients are prescribed second generation antipsychotics for treatment of manic states, or as the maintenance therapy. Risperidone long acting injection (RLAI) as a monotherapy or as adjunctive therapy to lithium or valproate for the maintenance treatment of bipolar I disorder was approved by Food and Drug Administration (FDA) in United States in May 2009. In this review the authors will consider the aspects of pharmacology, pharmacokinetics, metabolism, safety and tolerability, and clinical trials focusing on the efficacy of RLAI in bipolar disorder. The patients' perspective and attitudes to long-acting injections will also be discussed.
'One Voice' 4 Mental Heath Awareness is a global advocacy
group which wants to ensure human rights for adults and
children with mental health challenges.
As they say, each deserves support, respect, and dignity
without shame, stigma, or fear.
The originator of the petition has set herself the
monumental task of getting 100,000 signatures so it can be
presented to the United Nations.
There's a long way to go. Please take a look and see if you
can help Keith, who's determined to get things moving.
"Life with Bob:" A New Parenting Blog For Parents of Children With A Mental Illness
I think we can agree that there's a lot of good information out there today about mental health issues facing adults. Unfortunately, the same cannot be said of children with a mental illness. A good part of the problem is that there haven't been a lot of studies and clinical trials established around children. It's only been recently that the federal government asked the pharmaceutical companies to hold clinical trials, using children and adolescents as subjects, to establish efficacy and side-effect issues for today's psychiatric medications and their use in children.
Where does that leave parents? Many are out there in no-mans land trying to understand and deal with the problems associated with their child's mental illness. Angela McClanahan was one of those parents. Her 9-year old son has bipolar disorder. Angela feels parents are horribly under-represented in both the "blogosphere" and mainstream media.
"The first several years of my son's life were very, very lonely, and my husband and I often felt as if we were floundering alone in an endless ocean. I conducted so many searches looking for someone, anyone, who could relate to what we were experiencing. To be able to provide that for other parents would be an honor for me. I would hope to provide other parents a place to share humor, sadness, anger, and most of all, a feeling they are not alone on this roller coaster ride."
Angela's new blog is called "Life with Bob" and although her son has bipolar disorder, the blog focuses on "parents of children with any mental illness" because there are many universal things that parents of these children face.
Here is Angela McClanahan's "about me" post with accompanying video. I encourage you to join in the conversation on her blog and share your experiences and knowledge through comments.
And I have one favor to ask. If you belong to a support group (real world or online), have a website or blog, participate on facebook, twitter or another social network, would you please share Angela's blog with other parents. As she noted, there aren't many places for parents of children with a mental illness to go to. Thank you.
Life with Bob: A Parenting Blog for Parents of Children With A Mental Illness
IBPF will be hosting Glenn Close for a special evening, Friday, November 12, 2010 at the Grand Del Mar Resort in San Diego. Tickets will go on sale in August, watch for our announcement.
Money Approved for Design of Golden Gate Bridge Suicide Barrier
By MALIA WOLLAN (NYT)
A Bay Area agency approved $5 million in federal money for the final engineering and design of a steel mesh net hanging 20 feet below the span, to catch jumpers.
Lithium for Older Adults with Bipolar Disorder: Should it Still be Considered a First-Line Agent?
Drugs & Aging, 07/29/2010
Shulman KI - Despite having the strongest evidence base for effectiveness, lithium does pose significant concerns in the older population, including the risk of drug interactions that cause toxicity associated with decreased creatinine clearance. The evidence for lithium's impact on chronic renal disease is still controversial and is reviewed in this article. Mixed evidence exists regarding the impact of lithium on suicide risk, although there is a consensus that it does have protective properties through its mood-stabilizing effect. Because of the very limited research base regarding the use of lithium in old age, guidelines for dosing and maintenance of serum concentrations are not well established, and this may be leading to increased episodes of lithium toxicity. Lithium may have neuroprotective properties. Its action of inhibiting the enzyme glycogen synthase kinase-3 may be responsible in part for a decrease in the induction of amyloid ? peptide and hyperphosphorylated tau protein, which have been implicated in the development of Alzheimer's disease.
Cognitive Function in Bipolar Different in Men and Women
By JESSICA WARD JONES, MD, MPH Associate News Editor
Reviewed by John M. Grohol, Psy.D. on July 24, 2010
Bipolar disorder may affect the brains of men and women in different ways.
The effect of the illness on memory, according to one recent study, is more severe in men.
Dr. Sophia Frangou, of the section of Neurobiology of Psychosis, at the Institute of Psychiatry, King's College in London, and her colleagues found that compared to women, men with bipolar disorder type I had more difficulty performing on tests of immediate memory, as well as auditory and visual memory.
Bipolar disorder is a serious mood disorder that affects nearly 5 million Americans. In addition to the classic symptoms of cycling between periods of 'low' (depressed) mood and 'high' (manic or hypomanic) the illness can have severe effects on one's personal life, family, career goals, physical health, overall life functioning, and survival. More than 20 percent, according to some data, commit suicide. Many studies have shown negative effects of the illness on cognition, and although the exact cause is difficult to ascertain, clearly untreated illness can cause cognitive defects, as can certain medications or treatments.
To analyze the effect of gender on cognition in bipolar patients, Frangou and her colleagues enrolled 132 patients in the study. 86 patients had bipolar I (a subtype of bipolar disorder characterized by more extreme mania); this group included 36 bipolar men and 50 women with the disorder. 46 healthy controls were included (21 men and 25 women.) All of the patients with bipolar I disorder were similar in age of onset, duration of illness, number of episodes or hospitalizations, and global assessment of functioning (GAF) scores.
All study participants were asked to complete a variety of tests to assess cognitive function, including tasks to measure general intellectual ability, memory encoding, recognition, retrieval, response inhibition, and executive function (abstraction and perseveration). Bipolar illness's effect on patients' daily lives was assessed using the global assessment of functioning (GAF) scale.
The team found that there was a difference in the test results of the men compared both to the women with bipolar illness and to the healthy individuals. The cognitive defects were noted particularly in the areas of immediate memory (similar to short-term memory), encoding, and retrieval processes. (Memory encoding is the ability to store new memories.)
Furthermore, in the men, there was a statistically significant association between a decreased immediate memory function and an overall decreased global assessment of functioning score, which indicates that the more severely affected men with bipolar I would have a harder time in their daily function.
There were no apparent differences in general intellectual function, the ability to form concepts, perseverence, or the ability to appropriately inhibit a response.
"Our results support the notion that gender may modulate the degree of immediate memory dysfunction in bipolar disorder and its impact on overall level of function," says Frangou.
Previous studies have shown that gender plays a role in the clinical course and severity of bipolar disorder, and these results shed some light on one pathway by which such a decline in function may occur. In addition to deciphering why men are more severely affected in this area, with the ultimate goal of a novel therapy, future research may be able to help further define precisely where memory deficits occur, and allow for development of targeted treatments. Perhaps occupational or other therapy designed to improve memory function might result in improved global functional outcome in severely affected men.
Dr. Frangou's results can be found in the journal Psychological Medicine.
Source: Psychological Medicine
Only Some Epilepsy Drugs Increase Risk of Suicide
By RICK NAUERT PHD Senior News Editor
A new study has determined that only some epilepsy drugs increase the risk for suicide. Currently, the Food and Drug Administration (FDA) requires a warning of an increased risk of suicide for all epilepsy drugs.
Newer drugs with a higher risk of causing depression than other epilepsy drugs, such as levetiracetam (Keppra), topiramate (Topamax) and vigabatrin (Sabril) were found to increase the risk of self-harm or suicidal behavior among people with epilepsy.
In contrast, newer drugs that have a low risk of causing depression and conventional epilepsy drugs did not have any increased risk of self-harm or suicidal behavior. These groups include drugs such as lamotrigine (Lamictal), gabapentin (Neurontin), carbamazepine (Tegretol), valproate (Depakote) and phenytoin (Dilantin).
"These results may be helpful for doctors and people with epilepsy as they decide which drugs to use," said study author Frank Andersohn, MD, of Charité University Medical Center in Berlin, Germany.
"An earlier analysis of data by the FDA grouped all of the epilepsy drugs together and found an increased risk of suicidal thoughts and behavior, but could not address the question of whether there were differences among the various classes of epilepsy drugs."
In an editorial accompanying the article, Josemir Sander, MD, PhD, of the University College London in the United Kingdom and the Epilepsy Institute of the Netherlands Foundation and Marco Mula, MD, PhD, of the University Hospital Maggiore della Carità in Novara, Italy, noted that some researchers have been concerned that the risks of people stopping taking their epilepsy drugs or not starting to take a drug due to worries about the risk of suicide would be greater than the risk of suicidal behavior.
The study looked at all of the people in the United Kingdom General Practice Research Database who had epilepsy and had at least one prescription for an epilepsy drug from 1989 through 2005. The participants were followed for an average of five and a half years.
Of the 44,300 people, 453 had harmed themselves or attempted suicide; 78 people died at the time or within four weeks of the initial attempt. The 453 people were compared to 8,962 in the larger group who had not harmed themselves or attempted suicide.
People who were currently using the newer drugs with a higher risk of depression, such as Keppra, Topamax and Sabril, were three times more likely to harm themselves or attempt suicide than those who were not currently taking any epilepsy drugs.
A total of six of the 453 people, or 1.3 percent, who harmed themselves or attempted suicide were taking the newer drugs with the higher risk of depression, compared to 45 of the 8,962 people, or 0.5 percent, of those who did not harm themselves.
According to the authors, the number of people taking some of the drugs was small, so the results need to be confirmed by additional studies.
People should not abruptly stop or change their epilepsy medication based on the findings of this study but should discuss this issue with their physician, Andersohn noted.
The study is published in the current issue of Neurology, the medical journal of the American Academy of Neurology.
Source: American Academy of Neurology
Advocate for mentally ill to meet Obama
Charlotte's Mike Weaver, diagnosed with bipolar disorder, will attend event at White House.
By Ames Alexander
Mike Weaver, a Charlotte man who lives with bipolar disorder and works to help others cope with mental illness, has been invited to attend an event at the White House with President Barack Obama.
Weaver is among four people with mental illness scheduled to attend the July 26 event, which has been organized to mark the 20th anniversary of the Americans with Disabilities Act.
"The president wants to mingle and meet and talk to people with disabilities where the law has made a difference in their lives," said Andrew Sperling, director of legislative advocacy for the National Alliance on Mental Illness (NAMI), a leading group for those with psychiatric ailments.
Signed into law by former President George H.W. Bush on July 26, 1990, the Americans with Disabilities Act prohibits discrimination on the basis of disability.
Weaver was recently elected NAMI's Consumer Council director. In his new position, he'll also serve a three-year term on NAMI's national board of directors.
Weaver says he hopes to use his roles to help demonstrate that those with mental illness can learn to shape their own futures.
"I'd like people with mental health diagnoses not to be viewed as problems to be fixed - but as fellow humans who have hopes and aspirations and dreams ... and can achieve them," he said.
A former schoolteacher, Weaver switched to a career in the mental health profession after battling the effects of his own illness.
Today, he's a program developer with Mecklenburg's Promise, a nonprofit that promotes mental health recovery.
Mental Health Ministries e-Spotlight - Special Edition
This is a special e-Spotlight to highlight our new resource/study guide that is now available in English and Spanish as a free, downloadable resource on the Mental Health Ministries website.
MENTAL ILLNESS AND FAMILIES OF FAITH: HOW CONGREGATIONS CAN RESPOND
I have written a four session resource/study guide for clergy and communities of faith in response to the many questions and requests for information that I receive from persons who want to include spirituality as an important part of the treatment and recovery process.
Surveys show that over forty percent of Americans seeking help with mental health issues turn first to ministers, priests and rabbis. This is twice as many as those who went first to a psychiatrist, psychologist or family physician. Unfortunately, the response of clergy and congregations falls significantly short of what parishioners expect of their faith leaders. Individuals struggling with mental illness are significantly less likely to receive the same level of pastoral care as persons in the hospital with physical illnesses, persons who are dying or those who have long-term illnesses. Mental illness has been called the "no casserole disease."
This resource is designed to be used with clergy, members of congregations, family members and anyone desiring to learn more about mental illness and how to respond with compassion and care. It can be used as a small group study or leaders can adapt it to use in an extended class or seminar. Faith leaders can use this guide to quickly find information on a specific topic when the need arrives.
The four sections included in this resource/study guide include:
Understanding Mental Illness
The Unique Role of Faith Communities
Creating Caring Congregations
Help for Faith Leaders.
What is INGENIUM
INGENIUM is a non-profit organization that provides support to families through educational programs on mental health. Located in Monterrey, Mexico, they have a program called "An Alliance for Mental Health." Their mission is to provide information to all areas of society that might be in contact with persons with a mental illness. They work on prevention, early detection and appropriate referral of patients and their families. Their target market is currently high school teachers and parents. Their objective in 2010 is to broaden the program to reach the spiritual leaders of the Monterrey community.
As one of NAMI's multicultural and international partner organizations, INGENIUM has collaborated to translate the NAMI Family to Family and Peer to Peer programs into Spanish. Mental Health Ministries is most grateful that this group has volunteered to translate many of our resources into Spanish. Most recently, four members worked to translate our resource/study guide, Mental Illness and Families of Faith: How Congregations Can Respond. Persons who worked on this translation include Fortino Garza, Ramon Rios, Ana Mary Solbes de Cruz and, my contact person, Tutuy Escamez de Guerra. Dr. Isabel Gonzalez supervised the translation of the technical terminology.
Mental Health Ministries is most grateful to INGENIUM for making these resources available to the international Spanish speaking community. Click here to download this resource in Spanish.
I hope you find this guide and other downloadable resources available on the Mental Health Ministries website, www.MentalHealthMinistries.net, helpful resources helpful as we all work together to create caring congregations for persons with a mental illness and their families.
Rev. Susan Gregg-Schroeder
Coordinator of Mental Health Ministries
6707 Monte Verde Dr.
San Diego, CA 92119
Identifying Youth at High Risk for Bipolar Disorder
By JESSICA WARD JONES, MD, MPH Associate News Editor
Can teens and young adults who will later develop bipolar disorder be diagnosed and treated prior to developing full-blown symptoms?
Recent research has moved closer toward being able to identify individuals at high risk for bipolar disorder while still in their teens or early adulthood.
"These findings support the notion that people who develop a first episode of mania can be identified during the prodromal phase," writes Dr. Andreas Bechdolf of ORYGEN Youth Health at the University of Melbourne, Australia, who led the study with his colleagues. (A prodrome is the period of time before an illness becomes apparent, and may have some subtle signs or symptoms).
Bipolar disorder, characterized by alternating periods of depression and mania or hypomania (a milder version of mania), affects more than 20 million Americans. Most cases typically present sometime during the 20s, although doctors are becoming more aware of children with the illness.
Bechdolf and his colleagues studied records from all 173 individuals aged 15 to 24 who had intake assessments at the public clinic ORYGEN Youth Health Program in Melbourne Australia.
The researchers developed a set of bipolar-at-risk (BAR) criteria, including items such as age, low-grade manic symptoms, family history, symptoms of depression, and symptoms of cyclothymia (a milder version of bipolar disorder with mild ups and downs).
All patients in the study were treated and followed by the clinic's regular psychiatrists, and new and altered diagnoses were documented in the charts, including development of hypomania or mania. The average followup length was 265.5 days.
Of the 173 participants in the study, 22 met the BAR criteria (12.7 percent). Of the 22 that met the BAR criteria, five (22.7 percent) later went on to develop a diagnosis of bipolar disorder, as assessed by the development of mania, hypomania, or hospital admission and treatment, compared to just one patient from the non-BAR group (0.7 percent).
Bechdorf points out that while rate of development of bipolar disorder in the BAR group (22.7 percent) is more than 100 times that in the general population, "Prospective studies in bigger samples and with longer follow-up periods, better controlled antidepressant use and psychometric measures of conversions are warranted to provide further validity of these criteria."
These data are important as recurrent bouts of depression and mania can have severe consequences for an individual's physical and psychological health, neurocognitive function, career and educational goals, social functioning, and relationships. Untreated, recurrent episodes of depression and mania may make the illness more difficult to treat and less responsive to medication.
"Intervening early in the course of bipolar affective disorder, in the prodromal phase, may reduce this personal and economic burden, as this strategy has the potential to delay, lessen the severity of, or even prevent full-blown disorder," writes Bechdolf.
Dr. Bechdolf's results can be found in the July 8 online Journal of Affective Disorders.
Source: Journal of Affective Disorders
Tricyclic antidepressants are named for the chemical structure of many of the drugs in the class -- three rings. The first of the tricyclic antidepressants, imipramine (later brand-named Tofranil), was discovered in the late 1950s. Although many other antidepressants have come along since then, the tricyclics still have a place in the treatment of bipolar disorder, and some are also used to treat other conditions.
Tricyclic antidepressants are most often sold under their generic names, so they are listed by those names here, with the most common brand names following:
Amitriptyline (Elavil, Endep and many others)
Desipramine (Norpramin, Pertofrane)
Doxepin (Adapin, Sinequan)
Nortriptyline (Pamelor, Aventyl)
About the International Bipolar Foundation
International Bipolar Foundation is a not for profit organization based in San Diego whose mission is to eliminate Bipolar Disorder through the advancement of research; to provide and enhance care and support services for all affected; and to erase associated stigma through public education.
Visit us online for more information: www.internationalbipolarfoundation.org
A Word About Funding
Please note that International Bipolar Foundation does not represent any pharmaceutical company or give any speeches for a pharmaceutical company nor does our site receive advertising dollars from any company.