My Support - June 26, 2009

FDA Advisory Committee Votes In Favor Of Zyprexa For Two Adolescent Indications

The U.S. Food and Drug Administration (FDA) Psychopharmacologic Drugs Advisory Committee (PDAC) voted that Zyprexa(R) (olanzapine), an atypical antipsychotic, is effective and acceptably safe for the acute treatment of schizophrenia or manic or mixed episodes associated with bipolar I disorder in adolescents aged 13-17 years old.

Soccer league for people with special needs

Our VIP program provides quality soccer experiences for children and adults whose physical and mental disabilities make it difficult for them to successfully participate in mainstream activities.

These athletes are Very Important Players. We recognize the importance for the need to feel accepted. Our VIP program offers that acceptance and carries the philosophy that everyone plays to new heights-giving everyone a chance to play.

• Meet and be comfortable with new people
• Understand the fundamentals of the game
• Learn team work and fair play
• Have fun playing soccer
• Become more physically fit
• Increase positive self-esteem
• Coaching staff with more than 20 years experience working with players with special needs.
• $45 Registration fee includes jersey, shorts, socks, picture package, trophy, insurance, and a end of season party.
• Season runs from September to mid-November: Saturdays 9:30 am to 10:30 am

JOIN NOW ! Registration run from April 16 thru June 26 pre-register online at www.elcajonaysovip.com or call: Coach Mike at 619-443-2580

TEAMS FILL QUICKLY ! In 2006, we had 17 players and in 2008 we grew to 70+ players, making our VIP program the 2nd largest in the country. That can only mean one thing we have FUN !

Thank you
Coach Mike

Free Ticket to Sea World, Zoo & LegoLand

Did you know that San Diego Zoo, Sea World & Legoland offer a FREE ADULT TICKET WHEN YOU PURCHASE A TICKET FOR A PERSON WITH A DISABILITY? You just need to show a doctor's note that states the person has a disability and needs supervision while in the community.

Recreational Activities for those with special needs

Exceptional Family Resource Center receives many inquiries about recreational activities and camps for children with special needs. Below you will find a listing with phone numbers and web site links to assist you in your search.

2009 Summer Camp Information
http://www.efrconline.org/efrc.cfm?pid=Recreation

WHAT IS THE DIFFERENCE BETWEEN BIPOLAR I AND BIPOLAR II ?

It's often difficult to know the difference between the two main types of bipolar disorder. It can even be difficult for health care professionals to explain unless they have had special training on the topic. When you know the facts, you can see that the difference between the two is actually quite simple.

Bipolar I and Bipolar II (two) have the exact same symptoms in terms of depression and both have mania. The difference between the two diagnoses is the type of mania a person experiences. Bipolar I (one) has full blown mania while Bipolar I has hypomania.

What is the difference between full blown mania and hypomania you may wonder? The difference is intensity.

Full blown mania if untreated usually leads to a hospital stay- especially if it's someone's first episode. This episode usually starts around the age of 20. The mania can start off mildly with a sense of creativity and then spin out of control very quickly. When my partner Ivan had his first full blown episode it started with agitation and confusion, then moved into a complete behavioral change as he started to talk more than usual and couldn't hold a coherent thought. The night before he went into the hospital, he wasn't able to remember how to write a check or even have a normal conversation. He was seemingly very creative, but it was agitated and not fun and very scattered. He talked over people and moved around very rapidly. His face looked different and he talked with a different voice. He had what is called dysphoric mania- in other words he didn't feel very well! This mania was accompanied by severe psychosis.

Euphoric mania is the opposite of dysphoric mania. When it's full blown, it's very dangerous as it feels so good. The person almost always refuses help when they are really euphoric. When a person has euphoric mania, they feel no pain and have no reasoning ability- and most importantly, they can't see the consequences of their behaviors as they feel invincible. This is very, very dangerous mania as it can just seem like excessive enthusiasm, creativity and charisma from the outside.

All full blown manias lead to disasters and most people go into a deep depression if medications are not used successfully.

Hypomania
Hypomania is much less intense and doesn't put a person into the hospital. As with full blown mania, a person can have euphoric and dysphoric hypomania. Extreme psychosis is rare with hypomania- though it's common to have grandiose thoughts as well as negative thoughts. I get euphoric mania at the beginning of my hypomanias. Nothing feels as good as euphoric mania- absolutely nothing- but I always do something stupid and I always crash. I work very hard at preventing hypomania.

As I say in my book Take Charge of Bipolar Disorder, it's essential that you have a distinct diagnosis of either Bipolar I or Bipolar II as the treatments for the two can be quite different! You have to know if you have full blown mania or hypomania. No matter what form you have, the mania is serious- you can make horrible and life altering decisions when you're full blown manic or even hypomanic. Prevention is the only way to make sure this doesn't happen.
Julie Fast

Called Manic Depression or Bipolar Disorder Stigma Persists

Tuesday June 16, 2009
About.com
Manic depression is another term for bipolar disorder. Manic depression, a phrase that describes the extremes of mood associated with bipolar disorder. A phrase with origins rooted in Ancient Greek where the coupling of the words was used as early as the first century to describe symptoms of mental illness and an official title of the disorder coined by Emil Kraepelin in 1902. Over the last few days, I've been researching the etymology - the development and use of a word or phrase through history and across languages - of the axiom manic depression. (Yes, I know I'm a complete word nerd.) What is particularly interesting about the term manic depression is that in the last decade the medical profession, psychiatry specifically, has made a concerted effort to shift the vernacular to the now official DSM diagnostic term of bipolar disorder.

There are a number of reasons cited for this shift:

• Bipolar disorder is more of a clinical term; less emotionally loaded.
• Manic depression gives emphasis to the predominant emotional symptoms, but implies exclusion of the physical or cognitive symptoms. The term also excludes the cyclothymic or hypomanic (bipolar II disorder) versions of the disorder.
• Manic depression has been greatly stigmatized. Consider popular phrases such manic Monday, Animanics, homicidal maniac, etc. And depression is now generally used as an everyday replacement for the word sad or tired.

The diagnostic and clinical applications are most often referenced by medical professionals. But those with the disorder talk more about how manic depression is bandied about as if it is no more serious than the common cold. What is wonderfully ironic is that it took centuries for the expression manic depression to become politically incorrect. It's taken less than a decade for the replacement title bipolar disorder to reach the same status. I did a search on Twitter looking for other members of the online bipolar disorder communities. Tweet after tweet came up with the phrase "bipolar weather" referencing a sudden change in the temperature or precipitation. Raisinear posted in our Forums about this very thing venting about how a person referenced their bipolar landlord because he is unbalanced and unpredictable. Raisinear pointed out that bipolar disorder can also be used interchangeably with brilliant, creative, energetic or artist. She asks, "Should I just walk away from this, knowing that nothing I say will get through to them or should I try to educate them about why equating "unpredictable and unbalanced" with bipolar is hurtful and, for lack of a better word, just plain wrong?" What advice do you have for Raisinear? ~Kimberly

Ask the Doctor...

The spring issue of bp Magazine introduced a new column called Clinician's Corner. This exciting new addition to the magazine is written by Steven Weisblatt, MD, a clinical assistant professor of psychiatry at SUNY Downstate Medical Center in Brooklyn. He also has private practices in New York and Pennsylvania and has spoken and consulted widely about accurate diagnoses and effective treatments.

Do you have a question you'd like Dr. Weisblatt to answer in this column or a subject you'd like him to address?

Click here to submit your question http://www.bphope.com/community/LetterToEditor.aspx

Explaining Bipolar Disorder

What is Bipolar Disorder?

It's hard to explain this illness to people- especially if you or someone you care about was just diagnosed- here is a script you can use:

Most people know what depression looks and feels like- a lack of motivation, waking up in the morning with the thought, what is the point of my life?, asking- is this all there is?, Depression includes a lot of anxiety (fear), ADD, symptoms, irritation, and sometimes psychosis. (Psychosis is a break with reality that includes hallucinations and delusions). Depression symptoms also include crying, catatonic feelings and what I call psychic pain.

Bipolar disorder has everything described in depression- the difference between a diagnosis of depression and bipolar disorder is a mood swing called mania. This is a mood swing where the mood elevates instead of going down. This elevation is due to a chemical imbalance in the brain. There are two types of mania- full blown mania and hypomania. If you have full blown mania, your diagnosis is Bipolar One. If you have hypomania, your diagnosis is Bipolar Two. Mania in both forms can be exciting, wonderful, vibrant, awesome and great! You can feel like the most beautiful person in the world and the world feels the same!

Many artists with bipolar disorder such as Virginia Woolf and Vincent Van Gogh did their most successful work when they were manic. It really can be an exciting time with lots of energy and creativity. This exciting mania is called euphoric mania.

Then there is agitated mania- also called dysphoric mania. It's awful. It's like having gravel in your eyes and anxiety in your blood. You can't sleep- you roam around and have trouble dealing with the world because it's all so overstimulating. You can't work, maintain relationships or take care of yourself. It's very uncomfortable.

The main symptom of both euphoric and dysphoric mania is SLEEPING LESS WITHOUT BEING TIRED THE NEXT DAY. This is the difference between mania and insomnia. You desperately want to sleep when you have insomnia. You can't sleep or don't even want to sleep when you have mania.

Mania makes you do things you would never do if given the choice. It can wreck lives and often does a lot of damage.

Mania doesn't last- what goes up always goes down. Always.

You can't have a diagnosis of bipolar disorder unless you have experienced clear cut mania.
So, there you go. A nutshell explanation of the two main parts of bipolar disorder- there are a million more, but that is a good place to start.
© Julie A. Fast - All Rights Reserved www.bipolarhappens.com

Share your story - be interviewed!

An upcoming issue, bp Magazine will include a comprehensive article on the topic of DUAL DIAGNOSIS.

We are seeking individuals who wish to be interviewed by our professional journalist about the issues they face coping with both bipolar disorder and substance abuse--alcohol and/or drug use.

Click here http://www.bphope.com/community/Interview.aspx if you would like to share your story with readers. Please include a paragraph describing yourself and your situation. We are seeking persons who are willing to have their real names and photos used as part of the story. We will not be able to contact all respondents.

Respite Care

EFMP at MCRD San Diego

If you are enrolled in the Exceptional Family Member Program and stationed at MCRD San Diego then you are eligible for our respite care program.

Respite Care is a service that provides short-term or temporary care of a family member with special needs so that the regular caregiver may have some time off. The EFMP Respite Program will pay for care provided to each EFMP enrolled family member, for the siblings of the EFM and for an EFM spouse to use the services of a childcare provider for up to 40 hours a month.

Childcare can be given by a person or program the parent selects such as a family member or friend, camps, summer camps, childcare centers, visiting nurses or skilled nursing facilities.

There is a short application to complete. Once we receive this, a reimbursement rate will be determined based on the level of care needed and the number of siblings in the family. Please note that each EFMP enrolled family member is entitled to 40 hours.

Please let me know if you have any questions. Please have families call me or Erin McConnell-Vanko, Family Case Worker if they would like to sign up for the respite program or have questions. Erin's contact information is (619) 524-8086.

Thank you, Erin M Vanko
EFMP Family Case Worker
MCRD San Diego
3602 Hochmuth Ave
San Diego CA 92140
(619) 524-8086

New Legislation Introduced to Restore Parent Right to Expert Witness Fees

Congressman Chris Van Hollen of Maryland and Congressman Pete Sessions of Texas introduced the IDEA Fairness Restoration Act. This bipartisan bill would allow prevailing parents to recover their expert witness costs in due process and litigation under the Individuals with Disabilities Education Act. The bill is important to protect parents, most of whom cannot afford to pay thousands of dollars for expert witnesses. The right to due process must be affordable to be meaningful.

In 1986, Congress adopted legislation that was intended to allow prevailing parents to recover their expert witness fees. But in 2006, the Supreme Court ignoredCongress' intent and held that parents cannot recover these costs in Arlington Central School District v.. Murphy. The IDEA Fairness Restoration Act will override the Supreme Court's decision.

Few parents can afford the thousands of dollars needed to pay qualified medical, educational, and technical experts needed in IDEA due process. Almost 2/3 of children with disabilities live in families earning under $50,000 a year. By contrast, school districts can pay their experts with taxpayer dollars or use staff already on their payroll. With their greater resources, school districts are no match for parents. Congress should allow parents in IDEA cases to recover expert fees just like prevailing plaintiffs in ADA , Title VII, and other civil rights cases.

The Murphy decision has the potential to affect many many families. Here are some examples:

~A Pennsylvania 8th grader with dyslexia and a written expression disorder had struggled intensely with reading and writing all of his life. His single mothe r sought due process to implement the Independent Educational Evaluation recommendations. She had to borrow $1,400 to pay the evaluator to testify. She also had to pay for the expert's time during two days of school district cross-examination. Before the Supreme Court's Murphy decision, she was able to recover these fees after prevailing and getting the scientifically-based reading instruction to which her son was entitled. After Murphy, she would not.

~Many attorneys, in small/solo practices, report being unable to take pro bono cases because neither they nor their clients can pay the expert fees. Others report that where they had previously been able to lay out funds for expert witnesses because parents could recover them, they no longer could afford to do so.

~From a Special Education Advocate in the Midwest, "Since Arlington, I have had no fewer than three clients who had to withdraw the ir request for a hearing, and no fewer than five clients who wanted to request a hearing but did not, due to the fact that they could not afford witness fees and costs." She explained how one of her clients had become deeply depressed because he was powerless to to stop the school district from denying his children the educational services they needed.

Last year, over 100 organizations joined COPAA in supporting the IDEA Fairness Restoration Act and overriding Murphy.

The right to a hearing before an impartial, independent hearing officer is meaningful only if parents can afford it. Approximately 7 million children with disabilities are covered by the IDEA. None the less, parents proceed to litigation only as a last resort. In 2003, the GAO reported that there were only 5 hearings per 10,000 special education students. Parents prevail in IDEA cases only when the y show that the school district provided an education so inferior that it failed its legal obligations. But when this happens, due process must be affordable for parents.

COPAA is grateful for the hard work and leadership of Congressman Van Hollen and Congressman Sessions on this bill. We will have copies of the IDEA Fairness Restoration Act on our webpage, www.copaa.org in the next few days. (We do not yet have a bill number but will post that when we get it.)

Please stay tuned for additional activities to support this important legislation to restore Congress' original intent and protect children with disabilities.

For more information on the IDEA Fairness Restoration Act and the impact of Arlington C.S.D. v. Murphy on parents, see http://www.copaa.org/pdf/MurphyBrochure.pdf

Please feel free to share and forward this legislative alert.
Thank you,
Robert Berlow and Jessica Butler
Co-Chairs, Government Relations
Council of Parent Attorneys and Advocates (COPAA)
a national voice for special education rights and advoacy www.copaa.org email: protectidea@copaa.org

FREE Sibling Support Groups

New groups are forming now for the summer. CBF is pleased to offer two groups; one for children in grades 3-5 and a second for those in grades 6-10. Groups meet once a month on a Sunday afternoon and run in cycles of 4 sessions. They are led by a trained, licensed psychotherapist.

Meet other kids who have siblings with bipolar disorder, share your feelings in a safe, confidential place and get the support you need and deserve.

Here's what two moms had to say about the group:

"I think the most beneficial thing for ME from the group is a decrease in the guilt I feel for how awful this bp has been to them (the siblings) over the years. It gave them a much better understanding of the disorder, and a recognition that other families struggle with this as well. They no longer feel alone or that there is something wrong with THEM for the way their sister is. The group also opened up the lines of communication between us. They started talking more with me about it and asking more questions and that has been so good for us all. They have more understanding and patience (sometimes) for their affected sister. They feel that her bp is not as bad as it could be, but also now do have some fear for what it could possibly look like in the future. The group normalized their feelings. The group also gave them a place to release some long pent up emotions and I'm grateful for that."

" I just wanted to take a minute to tell you how much my son enjoyed the group the other night. He came out feeling so much better and thanking me for taking him. He really felt comfortable with you and finally felt like he was being heard with people who understand. It's been so hard on him! We can't thank you enough for doing this for all of us and of course, especially our children.He did not tell me what went on at the group (Nor did I ask) except for he finally had people he could relate to regarding his brother who is BP. He can't wait for the next group! Thank you again."

Contact Tom Kelly for more information or to set up a private, confidential intake appointment.

Exploring Ethnic Diversity in the Older Adult Mental Health Community

4th Semi-Annual Senior Mental Health Partnership Conference

Topic: Exploring Ethnic Diversity in the Older Adult Mental Health Community
Date: October 9, 2009
Location: UCSD Medical Center - Auditorium
200. W Arbor Drive
San Diego, CA92116
Time: 8AM-4PM
6 CEU's provided

1. Is 'diversity' just a buzz word?
2. Population Diversity in San Diego, CA
3. Culture/diversity of healthcare organizations
4. What can you/your organization do to provide ethnogeriatric care?
5. Essential for nurses, social workers, community agency staff, therapists, psychologists, primary care providers, and community members
6. Panel discussions with providers who serve different ethnic groups

*More information about the conference and registration will be posted later on our website.

Cost: $70
Older Adults (65+) - $20
Students - $30
For groups of 2 from the same organization will receive a 10% discount
For groups of 3 or more from the same organization will receive a 15% discount
NEW: If you become a member of NAMI San Diego today then you will receive a 15% discount at all Senior Mental Health Partnership Conferences.

19 STATES HAVE ZERO REGULATIONS PROTECTING OUR DISABLED CHILDREN IN SCHOOLS!!!

STATES THAT DO HAVE REGULATIONS OR GUIDELINES ARE NOT BEING FOLLOWED BY MANY SCHOOL DISTRICTS.

Our federal lawmakers say they have not heard from us on harmful restraint and seclusion!!

According to a May 2009 government report on restraint and seclusion practices, an overwhelming amount of abuse, neglect, and emotional abuse is happening in schools throughout the country.

Respite worker available

I have experience working with students ages 4-13, many of whom have developmental difficulties. I have helped to implement IEP goals and worked with students on both academic and behavioral goals. I have worked for three years in the Solana Beach School District. I received my undergraduate degree and teaching credential through USD and am pursuing my master's degree in educational psychology at Chapman University. I am centrally located in San Diego, and can provide my own transportation. Any family that needs additional childcare, help with goal implementation, behavioral therapy, etc. would be the perfect match for me. I am asking for $20/hr, but I am willing to negotiate as per needs.
Thanks so much!
Jessica Rose
jessica3303@sbcglobal.net

Dance Classes for Students with Special Needs

Teens and young adults of all abilities are invited to experience the joy of movement and dance in an inclusive, positive, and encouraging environment. Students will be challenged to find creative ways to experience level change, locomotion, body part isolation, increased spatial awareness, and authentic reactions to music through their movement.

Instructor Molly Puryear is a dance teaching artist with over 10 year of experience who strives to facilitate fun, diverse, and meaningful participation in her classes. Malashock Dance works with KIT (Kids Included Together) to provide programs designed to support and encourage arts education for anyone who feels inspired to move.

Who:
Students with special needs Ages 15 & Up (Co-Ed)
Where:
The Malashock Dance School
Dance Place San Diego located in NTC
2650 Truxtun Rd, Studio 200 (Upstairs)
San Diego, CA 92106
When: Saturdays, 12-1:15pm
BEGINS JUNE 13th
Cost: $48/month or $14/class

Questions or Registration, please call Malashock Dance 619-260-1622 or visit www.MalashockDance.org

Irritability should be considered when diagnosing bipolar disorder in children

EAST PROVIDENCE, RI - A new study from Bradley Hospital and The Warren Alpert Medical School of Brown University, as well as two other institutions, adds to mounting evidence that clinicians consider irritability as a symptom when diagnosing pediatric bipolar disorder.

Reporting in the July issue of the Journal of the American Academy of Child and Adolescent Psychiatry, researchers say a small percentage of children with bipolar disorder experience manic episodes without extreme elation - one of the hallmarks of the disorder - and are diagnosed based on irritable mood alone.

"Diagnosing children with bipolar disorder is challenging. One of the chief controversies is whether irritability should be included among the criteria for this diagnosis because it can also overlap with a number of other psychiatric disorders, such as attention deficit hyperactivity disorder," says lead author Jeffrey Hunt, MD, a child psychiatrist and training director at Bradley Hospital. "Our findings confirm that while irritable-only mania is uncommon, it does exist - particularly in younger children - and should be considered in a bipolar diagnosis."

Bipolar disorder is characterized by dramatic mood swings from euphoria, elation and irritability - the manic phase of the disorder - to severe depression. Bipolar disorder often begins in late adolescence or early adulthood, although it can develop as early as the preschool years. Recent studies have shown that the number of children and teens being treated for bipolar disorder has grown dramatically in the last decade. Although it is unclear what has caused this increase, experts believe it may be due in part to more aggressive diagnoses by physicians and a greater awareness of pediatric bipolar disorder in the medical community.

Hunt and colleagues studied 361 children between the ages of 7 and 17 with bipolar disorder participating in the multi-site Course and Outcome of Bipolar Illness in Youth (COBY) study at Bradley Hospital and Alpert Medical School, the University of Pittsburgh and the University of California-Los Angeles. COBY is the largest and most comprehensive study of children and adolescents with bipolar disorder to date.

Researchers quantified the frequency and severity of manic symptoms of each participant, including whether irritability and elation were present. Based on this data, the group was then reclassified into three subgroups: elation-only, irritable-only and both elated and irritable.

Approximately 10 percent of children fell into the irritable-only category, while elated-only constituted about 15 percent. Nearly three-quarters experienced both elation and irritability. The irritable-only participants were significantly younger in age than the other two groups; however, there were no other sociodemographic differences between the groups. There were also no significant differences in terms of bipolar subtype, rate of psychiatric comorbidities, severity and duration of illness, and family history of mania and other psychiatric disorders. However, depression and alcohol abuse in second-degree relatives occurred more frequently in the irritable-only subgroup.

"The fact that the irritable-only and elation-only subgroup had similar clinical characteristics and family histories of bipolar disorder provides support for continuing to consider episodic irritability in the diagnosis of pediatric bipolar disorder," says Hunt, who is an assistant professor of psychiatry and human behavior at Alpert Medical School. Hunt is also training director of the child and adolescent fellowship and triple board residency programs.

The authors say continual, long-term follow-up of this study sample will help clarify whether the presence or predominance of elation or irritability at baseline will predict future clinical outcomes.

i3 Explores Link Between Bipolar Disorder and Lipid Disorder at NCDEU

BASKING RIDGE, NJ, June 18, 2009-Pharmaceutical services company i3 announced today that i3 Research will present seven posters at the 49th Annual New Clinical Drug Evaluation Unit meeting (NCDEU), a critical venue for psychopharmacology, to be held June 29-July 2 in Hollywood, FL. Highlights include:
1. Is the Presence of Bipolar Disorder a Risk Factor for Lipid Disorder? People who suffer from bipolar disorder have a higher incidence of lipid disorder. Moss et al. conducted a database study using de-identified health claims from a large US insurer to quantify the association. The authors determined the rates of lipid disorder, thyroid disorder, and diabetes in bipolar patients as compared to a sample of patients who had no diagnosis of a mood or psychotic disorder. They found that patients diagnosed with thyroid disorder or diabetes had similar incidence of lipid disorder whether or not they had a mood disorder. However, those bipolar patients without thyroid disorder or diabetes had a significantly higher likelihood of having lipid disorder than the control group, and that risk increased in males in their 20s and 30s.

Famous bipolar artists

Having a mental illness like bipolar disorder can present some challenges to patients. Life is tough enough, but trying to stabilize your moods while facing ordinary and extraordinary obstacles is a challenge in itself.

Yet what some people may not know is that the accomplished, rich or famous also face similar challenges. Some of them have also been diagnosed with bipolar disorder. For many, they are able to cope and are outspoken about their condition, proving that under the right circumstances, bipolar disorder is manageable and you can lead an above- normal life. Artists with bipolar disorder tend to stand out. Here's a list of famous creative people with bipolar disorder and their descriptions of dealing with it.

Patricia Cornwell, award-winning crime novel writer of the Kay Scarpetta series, thinks that her bipolar disorder contributes to her creativity because she explores a wider range of emotions.

Pete Wentz, guitarist for popular emo rock band Fall Out Boy, is quoted as saying "I have manic depression. I obsess over everything. When I am depressed, I can't get out of bed."

Axl Rose, Guns N' Roses front man, discussed how he went to a clinic and was diagnosed after filling out a 500-question test. He felt the medication didn't help with his disorder, but people left him alone because he was on medication.

Linda Hamilton, star of, Beauty and the Beast, Terminator and Terminator 2.Hamilton recalls wrecking both marriages with rage and anger associated with undiagnosed bipolar disorder.

In Brief: Schizophrenia and bipolar disorder may share genetic origins

A long-running debate in psychiatry is whether schizophrenia and bipolar disorder are really two distinct illnesses, or instead represent different manifestations of a single mental illness. A large study provides evidence that, however they are classified, schizophrenia and bipolar disorder are more alike genetically than they are different.

Investigators at the Karolinska Institute examined two national registry databases in Sweden, which included information about family psychiatric histories of 9 million people from 1973 to 2004. They identified 35,985 individuals with hospital discharge diagnoses of schizophrenia and 40,487 with bipolar disorder. The researchers excluded patients with schizoaffective disorder, a separate condition that shares symptoms of both illnesses.

The researchers then determined the risk for schizophrenia and bipolar disorder, depending on the degree that genes and environmental factors were shared, by looking at relationships between parents, siblings, half-siblings, and adoptees from families with either diagnosis.

The investigators concluded that schizophrenia and bipolar disorder shared many of the same risk genes - in part because adopted children whose biological parents had one of these disorders had an increased risk of developing the other. However, unique genetic factors also contributed significantly to both disorders - explaining about 48% of the genetic variance in individuals with schizophrenia and 31% of the genetic variance in bipolar disorder.

Some cautions to keep in mind: One study, no matter how large, is not enough to settle the question of how best to classify schizophrenia and bipolar disorder. (And previous studies have reported mixed results.) For now, the information is probably most valuable to researchers.

Lichtenstein P, et al. "Common Genetic Determinants of Schizophrenia and Bipolar Disorder in Swedish Families: A Population-Based Study," Lancet (Jan. 17, 2009): Vol. 373, No. 9659, pp. 234-39

Bipolar Often Misdiagnosed

By Rick Nauert PhD Senior News Editor
Reviewed by John M. Grohol, Psy.D. on June 8, 2009
Bipolar disorder is misdiagnosed as depression in over a quarter of cases, a new study suggests.

Psychiatrists Dr Krishna Gangineni and Dr Richard Annear, who work in Wales, reviewed the medical notes of people referred to psychiatric services for assessment. Their research was presented at the Royal College of Psychiatrists' 2009 Annual Meeting in Liverpool.
They found that over 25 percent of the patients with bipolar disorder had initially had their condition misdiagnosed as unipolar depression.

Misdiagnosis often occurs because the symptoms of bipolar disorder overlap with depression and other psychiatric disorders. However, misdiagnosis can cause serious problems. For example, if people are wrongly prescribed antidepressants this can make their bipolar illness worse.

Dr Gangineni and Dr Annear said: "Our study found that bipolar disorder was misdiagnosed as unipolar disorder in more than 25 percent of the patients who first see a mental health professional.

"Recognition of bipolar disorder and its adequate treatment is paramount because bipolar disorder exacts such a high personal and societal toll, with high rates of suicide and interpersonal problems and a substantial economic burden."
Source: Royal College of Psychiatrists

Could My Child Have Bipolar Disorder?

by Kimberly Read

A mother in our forums, who has bipolar disorder herself, shared, "My four year-old is extremely angry these days. He flies off the handle for no apparent reason. He becomes enraged and it's hard to calm him down. Is it possible he has bipolar disorder at four or is this normal behavior?" Great question, mom. The answer is yes. Yes, it is possible he has bipolar disorder. And yes, it is possible this is normal behavior.

As I noted in Childhood Onset Bipolar Disorder - Beyond Obscurity, the number of children tagged with a diagnosis of bipolar disorder has increased exponentially over the last 10 years. The medical community now generally accepts that kids develop this disorder. So should you consider scheduling an appointment for your child to be evaluated by a psychiatrist? Consider three basic rules of thumb: functioning, feeling and family.

Functioning - Are the problem behaviors of your child interfering with his daily functioning? Is your son able to play with other children his age? Is your child able to attend school regularly? What about family functionality? Do the demands of your son's difficulties outweigh the needs of other members of the family or even you? In her book "Mommy I'm Still in Here," author Kate McLaughlin shares the toll her daughter's illness took on her family. "Taking care of her took most of my time, leaving little one-on-one with Michael and Monica (her other two kids). They felt ignored, lost in the shuffle ... We lived our lives around an illness."

Feeling - Does your child feel like there is something wrong with her? Does he feel overwhelmed handling normal activities other kids his age engage in? Does your child worry about things other kids don't even think about?

Family - Is there a history of mental illness in your child's family? Research indicates that as many as 10% of those with a parent or sibling who has bipolar disorder will also develop bipolar disorder. Studies have also demonstrated that family members with both schizophrenia and unipolar depression are commonly found in the same family tree as those with bipolar disorder (Maier et al, 2005).

If your child is having difficulty with daily functioning or if your child is struggling with feeling normal -- most especially over an extended period of time -- then an evaluation by a psychiatrist may be warranted. If you answer yes to either of the first two rules of thumb and you have a family history of mental illness, an unbiased, professional opinion could bring you some peace of mind and perhaps a few new parenting skills. Now, with all of this said, please be aware that even with all three rules of thumb checked off, your child might not actually have bipolar disorder. In Childhood Onset Bipolar Disorder - The Book, the Controversy and the Reality, I shared my personal experience about having to make the decision to take my son to a psychiatrist and his subsequent diagnosis -- not bipolar disorder.

What is Childhood onset bipolar disorder?

About.com
Definition: Childhood onset bipolar disorder (also known as early onset bipolar disorder, pediatric bipolar disorder or juvenile onset bipolar disorder) is a term used to describe a type of bipolar disorder that starts in childhood. While this may sound simple, it's actually a somewhat complicated and controversial diagnosis, for several reasons: At present, there is no formal diagnostic definition or standardized criteria for diagnosing bipolar disorder in children. There also is considerable controversy surrounding what constitutes a diagnosis of childhood onset bipolar disorder. Required age ranges (i.e. under age 18, must be older than 2, etc.) and specific symptoms such as irritability or racing thoughts vary from one doctor or research study to another. Therefore, this term - as with the other terms for the diagnosis of bipolar disorder in kids - has a rather broad application and in some cases may not even be recognized by some practitioners.
Also Known As: COBPD
Early Onset Bipolar Disorder
Pediatric Bipolar Disorder
Juvenile Bipolar Disorder

Mental Health Ministries e-Spotlight - Summer 2009

Summer is upon us...a time to recharge and renew our spirits. Mental Health America has recently launched the Live Your Life Well campaign to help all of us deal with these stressful times. One of the suggestions is to take care of your spirit. "People who have strong spiritual lives may be healthier and live longer. Spirituality seems to cut the stress that can contribute to disease." A new downloadable bulletin insert/flyer, Mental Health in Challenging Times, includes these steps and is available on the Mental Health Ministries Home page.

UPCOMING CONFERENCES
The NAMI National Convention will be held in San Francisco, July 6-9. The theme for this year's conference is "Creating a Healthy Future or Us All." NAMI FaithNet will be sponsoring a Special Interest Workshop. I am honored to be part of the FaithNet Advisory Committee, and we will be sharing the exciting ways that FaithNet has emerged as a popular website link for persons interesting in including the faith dimension when dealing with a mental illness. A number of persons will share about their outreach ministries. This workshop will be on Tuesday, July 7, 9:00 a.m. to noon and local faith leaders may attend this workshop without registering for the conference.

There will also be a workshop, "Hard Questions on Faith and Mental Illness: A Multi-faith Panel Responds." A mental illness often results in persons of faith asking the difficult questions like where God is when we are suffering. I will be part of a panel of leaders from different faith traditions, and we will respond to the "hard questions" about faith and mental illness. This workshop will be presented from 4:00 p.m. to 5:15 p.m. on Wednesday, July 8. You can subscribe to the NAMI FaithNet e-newsletter at http://www.nami.org/faithnet.
Companions on the Road to Recovery from Mental Illness - Pathways for the 21st Century is a national summit sponsored by the interfaith group, Pathways to Promise, to be held on September 29, 30 and October 1, 2009 in Belleville, IL. It is designed to equip congregations and clergy for effective ministry with individuals and families facing serious mental health issues in their lives. The focus of the workshops and breakout sessions is to present a vision on ongoing training and collaboration. There will be national speakers including Mike Fitzpatrick, Executive Director, National Alliance on Mental Illness (NAMI), Rev. Doug Ronsheim, Executive Director of the American Association of Pastoral Counselors (AAPC), and faith leaders nationally who working in this area. I look forward to meeting and dialoguing with many of these people in person.

There is a brochure listing the many speakers along with registration information available on the Mental Health Ministries website under Upcoming Conferences. You can also go to Pathways website, http://www.pathways2promise.org/, for further information.

MENTAL HEALTH MEDIA RESOURCES
Our new DVD set, Mental Illness and Families of Faith: How Congregations Can Respond, has been very popular. Eight of our media programs are featured. Each segment has a discussion guide with background information, questions for discussion and where to find additional resources. Each segment presents an issue related to the experience of mental illness, puts a face to the issue and offers a message of hope.

The shows included in this set include Coming Out of the Dark, Mental Illness in Different Age Groups, Mental Illness and Families of Faith, Understanding Depression, Overcoming Stigma: Finding Hope, Addiction and Depression, Anxiety: Overcoming the Fear, Teenage Depression and Suicide, Eating Disorders: Wasting Away and Creating Caring Congregations.

The price is $49.95 with $6.00 shipping. It can be ordered on our website or you can write a check to Mental Health Ministries and send it to the address below. Since we are phasing out our resources, the have been marked down to $10 while supplies last. Ordering on line will reflect the sale price. The price on our three DVDs, Creating Caring Congregations, Mental Health Mission Moments and Breaking the Silence: Postpartum Depression and Families of Faith, has been reduced to $19.95. For quantity orders of any of our DVD or VHS resources, contact Susan for a reduced rate.

RADIO SPOTS ON MENTAL ILLNESS WIN GRACIE AWARD
The American Women in Radio and Television have announced they're awarding the Unsung: Family Voices on Mental Illness radio spots a Gracie Award for Outstanding Public Service Announcement/Campaign. The award will be presented at a ceremony June 3, 2009 in New York City with other invited honorees including Jane Pauley, Maya Angelou, Barbara Walters, Dr. Phil and many others. The radio spots from Mennonite Media include a number of interviewees featured in the Shadow Voices: Finding Hope in Mental Illness TV documentary including Rosalynn Carter, Dr. Joyce Burland of National Alliance on Mental Illness (NAMI), Susan Gregg-Schroeder, Stan Schroeder, Kari Broadway and Claudia Slate. You can hear the spots or read scripts here: www.thirdway.com/rad and look for "Unsung: Family Voices on Mental Illness"

You can subscribe to their e-newsletter at http://www.nami.org/faithnet. I encourage you to register to receive FaithNet e-mail updates and to visit the site for information and resources on ways to educate about mental illness in our faith communities. Registration information for the July conference is available at http://www.nami.org/. New NAMI FaithNet brochures are available in the NAMI store. 50 brochures cost $6.

SNIPPETS FROM SUSAN
A Seed is a Promise
A simple seed holds incredible power. All that is necessary for new life is contained in a seed. A small article, tucked away in the pages of a newspaper, caught my eye. It told of some seeds shed by an East Indian lotus plant that were found in a food storage area in an ancient lake deposit in southern Manchuria. The seeds successfully germinated some 450 years after they had been placed in storage.

Planting a seed is an act of faith. Most all ministries to and with persons living with a mental illness and their families begin as seeds. We do not know which seeds will germinate in the fertile darkness of the soil. We do not know who will come along to water and tend to this new life. We do not know what form our mental health outreach will take as it continues to grow and flower.

God also plants seeds in each of us. When I was in my deepest depression, I could only experience the darkness of despair. Yet, even though I felt alone and abandoned in my pain, God was planting seeds of hope, new life and new beginnings in my soul. I thank God for the faithful family members, friends and mental health professionals who continued to water those seeds until the first sprouts broke through the black soil into the fullness of light.
Each of us can plant and nourish the seeds of ministries to help erase the stigma of mental illness. Each of us can be with persons who have lost their way in the darkness because we know that each seed holds the promise and potential to bring forth new life.
Take Sabbath time this summer and take some time to plant seeds.

Blessings,

Rev. Susan Gregg-Schroeder
Coordinator of Mental Health Ministries
6707 Monte Verde Dr.
San Diego, CA 92119
http://www.mentalhealthministries.net/

Summertime & Bipolar Disorder Meds

About.com
Yay!!! Summer is here! Summer means sunny days, warm weather, grilling out, picnics in the park, 4th of July fireworks, camping with friends. For most, summer is a carefree time. But for those of us that take psychotropic medications, it means taking special precautions to ensure our health and safety. In Part 1, we will talk about heatstroke and how our meds can increase our chances of a heat related illness. In Part 2, we will talk about how our meds can increase our risk of sunburn. Heatstroke is a medical emergency when the body's temperature-regulating system breaks down. The victim can't sweat and is unable to cool himself. Internal body temperature often rises as high as 108 degrees, which can cause irreversible brain damage and death. High temperatures injure endothelial* cells and damage almost every organ, including liver, kidneys, lungs, heart, and muscle.

A Few Facts About Heatstroke:
It's more likely when the outside temperature is very hot. A heat wave is defined by the National Weather Service as 3 or more consecutive days of temperatures at or above 90°F (32.2°C ).

Hyperpyrexia (core temperature greater than 105°F [40.6°C ]) and central nervous system impairment causing delirium or coma are characteristic.

The death rate for heatstroke ranges from 10% to 75%, depending on other variables, but averages 25%.

Mentally ill patients are a high-risk group. Some may not have the cognitive abilities to protect themselves; others are taking psychotropic medications that affect heat regulation.

Heatstroke is more likely when taking the following drugs:
Antipsychotics - especially:

• Chlorpromazine (Thorazine)
• Thioridazine (Mellaril)
• Mesoridazine (Serentil)
• Clozapine (Clozaril)
• Risperidone (Risperdal)
• Olanzapine (Zyprexa)
• Quetiapine (Seroquel)
• Ziprasidone (Geodon)
• Antiparkinson drugs such as:
• Benztropine (Cogentin)
• Trihexyphenidyl (Artane)
• Procyclidine (Arpicolin, Kemadrin)
• Biperiden
• Antihistamines such as:
• diphenhydramine (Benadryl)
• chlorpheniramine (Chlor-Trimeton, Sinutab Sinus Allergy)
• Antidepressants, especially tricyclics such as:
• Imipramine (Tofranil)
• Amitriptyline (Elavil)
• Nortriptyline (Pamelor)
• Doxepin (Sinequan)
• Desipramine (Norpramin)
• Protriptyline (Vivactil)

Do's:

• Sleep in a cool place.
• Drink extra fluids. Water is best because the body absorbs cooler solutions fast. Other fluids are juice, Gatorade, caffeine-free soda.
• Increase salt intake if no physical problems.
• If you take lithium, use extra salt in addition to extra fluids.
• Spend time in cool places (shopping malls, movies, etc.)
• Wear loose, light-colored summer-weight clothing.
• Use fans or air conditioning.
• When feeling warm, use cool wet compresses or sit in a tub of cool water.
• Remain with another person.

Don'ts:

• Engage in strenuous exercise.
• Drink alcoholic beverages, coffee and soda with caffeine (caffeine and alcohol increase water loss).
• Spend time outside in the sun.
• Sleep or sit in hot conditions.
• Warning Signs:
• Nausea, headache, feeling poorly, weakness
• Irritability, anxiety
• Fast pulse, rapid breathing, dizziness
• Hot OR dry skin, confusion, vomiting, diarrhea

*Endothelial cells line blood vessels, body cavities, organs and the inner layer of the cornea of the eye, among other things