My Support - May 1, 2010
CBF is proud to continue our tradition of celebrating "May is Mental Health Month". May was officially proclaimed Mental Health Month by Congress in 1949.
We all know someone with a diagnosis of a mental illness, and we encourage you to educate a friend about your loved one's diagnosis. Learn more about mental well-being and celebrate the accomplishments and strengths of those diagnosed with bipolar disorder.
In the next issue of My Support, CBF will be celebrating this special month with some exciting announcements.
P.S. Please contact me at anytime: firstname.lastname@example.org
Omega-3 fatty acids are key to a healthier life
Research shows they promote heart health and reduce pain in people with rheumatoid arthritis. They also may help treat autism, bipolar disorder, depression, Alzheimer's disease, ADHD and prostate cancer.
Pregnant women need them for their babies' brains. Kids need them to learn. Adults get healthier hearts from them. The do-it-all nutrients known as omega-3 fatty acids appear to reduce pain in people with rheumatoid arthritis - and may help treat autism, bipolar disorder, depression, Alzheimer's disease, ADHD and prostate cancer. more... http://www.latimes.com/features/health/la-he-omega-3s-20100426,0,4578236...
Mental Health America's 2010 Annual Conference
Mental Health America's 2010 Annual Conference
Get Connected: Social Inclusion in Wellness and Recovery
June 9-12, 2010 | Washington, D.C.
From all across the country, advocates, consumers, educators, researchers, business and community leaders, health professionals and our nationwide network of 300 affiliates will gather this June 9-12th at Mental Health America's 2010 Annual Conference in Washington, D.C. This year's theme, Get Connected: Social Inclusion in Wellness and Recovery, will explore the importance of meaningful social roles and connections in maintaining health and achieving recovery. Learn from leaders who have forged the way for building inclusive communities through their research, innovative community programs and personal commitment.
San Diego Survivors of Suicide Loss Day
Featuring a panel discussion:
After Loss: Finding a New Normal
Panel of survivors and professionals followed by questions and answers
Saturday, May 22nd 10 a.m. to 2 p.m.
Vista Grande Community Church
10881 Tierrasanta Blvd. San Diego 92124 (On Tierrasanta Blvd. off I-15)
- Registration and coffee at 10 AM
- Panel of survivors and professionals 10:30-11:30 AM
- Lunch: 11:30 a.m.-12:15 p.m.
- Small, facilitated groups according to your loss (child, parent, spouse, sibling, friend, etc.) · 12:30-2:00 p.m.
This is a unique opportunity for survivors of suicide loss to meet with other survivors having a similar loss. We will break into small, facilitated groups according to your loss.
Teens are welcome to attend & will have their own professionally led support group after lunch.
* Due to the nature of the topic, attendance is limited to those who are 13 years old or older.
For more information: Call 619-482-0297 or E mail email@example.com
Bipolar Social Anxiety - How to Cure Bipolar Social Anxiety
Bipolar social anxiety is a more severe type of social anxiety (SA). The main difference is that sufferers of bipolar SA have much more physical symptoms, sometimes it is very hard for them to concentrate, they may have have an urge to stand up and start walking around and many others symptoms. With this article I want to tell you about bipolar SA generally and about treatment options.
Symptoms of Bipolar Social Anxiety
Sufferers feel like they have some kind of energy inside, for example while having a talk or doing an interview with someone sufferers foot may start to bounce on the floor or they can't sit down, they feel like they must stand up and start walking.
Another common symptom is having hard time thinking about something, because thoughts are so rapid that they change so fast and these thoughts are often irrelevant, this makes thinking about an specific subject extremely hard, which can cause many problems at shool or work.
In short words sufferers of bipolar social anxiety can't relax at all in social situations. It's hard for them to stay calm. Having these kind of problems can cause many problems, and it can even develop and lead to next problems, like stress and depression. This is why it's very important to cure bipolar SA as soon as possible.
Bipolar Social Anxiety Treatment
One method to cure it, is to consulate with your doctor, who can give you some medicines, which can be effective, but bad side of medicines is that they usually don't do anything more than just hide your symptoms and they often have different side effects. This is why wouldn't recommend you to cure bipolar SA with medicines.
Much more effective method is going to therapy, where you can a get real cure to your symptoms. First you have to find a therapist, just make sure that your therapist has worked with people with bipolar social anxiety before and that this person is specialized in that area.
Another way to cure bipolar SA is to find a self-help guide, for that I recommend you to find a book, there are many available just make sure that the author is someone who is specialized on that area.
Author is a former social anxiety disorder sufferer, he recovered it by using self help methods. So if you're looking for a social anxiety cure, then author highly recommends you to try self-help guides.
Psychiatric Advance Directive Helps You Control Options For Treatment
If you have a psychiatric condition that could lead to hospitalization - such as bipolar disorder, schizophrenia or severe depression, you may have strong feelings about various treatment options. This is when a psychiatric advance directive, or PAD, can be helpful, according to a Johns Hopkins Health Alert.
A psychiatric advance directive is a legal document that clearly states your wishes for treatment of a mental health disorder. People with mild anxiety or depression or seasonal affective disorder probably do not need to worry about being hospitalized for such conditions.
But if you've been admitted to a hospital for a psychiatric illness in the past, or if your doctor believes you may at some point lose the ability to make rational decisions, even temporarily, a psychiatric advance directive may be worthwhile.
A PAD must be filled out while you are competent and healthy. Usually you must have it signed by two witnesses and notarized. For more information, and a PAD form, visit the National Resource Center on Psychiatric Advance Directives ( www.nrc-pad.org), and click on "State by State Info."
To find a form to appoint a health care representative, Connecticut residents should visit the attorney general's site at bit.ly/cKSVtj.
Source: Johns Hopkins Depression and Anxiety Health Alert
UNDERSTANDING SOCIAL SECURITY & SSI BENEFITS
Saturday, October 9, 2010
9:00 a.m. - 12:00 Noon
SNTF (619) 201-2672
SPECIAL NEEDS TRUST SEMINARS
Saturday, October 16, 2010
9:30 a.m. - 11:30 a.m.
SNTF (619) 201-2672
Dear Friend & Advocate
Do any of these questions and concerns sound familiar?
What happens when your child does not make any progress?
What about related services in the IEP?
Can my child's IEP be changed or revised?
Can I get any training so that I can help my child more?
In this issue of the Special Ed Advocate, we answer your frequently asked questions about developing your child's IEP, including parent/teacher training, documenting concerns and disagreements, and how to get your child's IEP revised.
Dear Friend & Advocate
When Congress reauthorized IDEA 2004, requirements for IEPs changed.
IEP season is here and you need to learn, or review, what the law really says. This may be different from what you have been told!
This issue of the Special Ed Advocate provides you with an overview of the significant changes to Individualized Education Programs in IDEA 2004. You will learn about the legal requirements of IEPs.
Public Policy and the CEC
One of the functions of the Council on Exceptional Children is to advocate for policy at the state and federal level that impacts children with disabilities and those who teach them. Read about the current priorities at
Lamictal - generic lamotrigine - is an anticonvulsant epilepsy medication approved for use as a mood stabilizer in the treatment of bipolar disorder. Two 18-month studies demonstrated that Lamictal was effective in treating bipolar disorder, one when the most recent episode was manic or hypomanic and the other when the most recent episode was depressive.
Lamictal Carries Major Warnings
The first Black Box Warning on the Lamictal label contains the information that Lamictal can cause dangerous, even fatal rashes. The warning (shown below) says that Lamictal treatment should be discontinued at the first sign of any rash.
The first Lamictal boxed warning is as follows:
Serious rashes requiring hospitalization and discontinuation of treatment have been reported in association with the use of Lamictal. The incidence of these rashes, which have included Stevens-Johnson Syndrome, is approximately 0.8% (8 per 1,000) in pediatric patients (age <16 years) receiving Lamictal as adjunctive therapy for epilepsy and 0.3% (3 per 1,000) in adults on adjunctive therapy for epilepsy. In clinical trials of bipolar and other mood disorders, the rate of serious rash was 0.08% (0.8 per 1,000) in adult patients receiving Lamictal as initial monotherapy and 0.13% (1.3 per 1,000) in adult patients receiving Lamictal as adjunctive therapy. In a prospectively followed cohort of 1,983 pediatric patients with epilepsy taking adjunctive Lamictal, there was 1 rash-related death. In worldwide postmarketing experience, rare cases of toxic epidermal necrolysis and/or rash-related death have been reported in adult and pediatric patients, but their numbers are too few to permit a precise estimate of the rate.
Because the rate of serious rash is greater in pediatric patients than in adults, it bears emphasis that Lamictal is approved only for use in pediatric patients below the age of 16 years who have seizures associated with the Lennox-Gastaut Syndrome or in patients with partial seizures (see Indications). Other than age, there are as yet no factors identified that are known to predict the risk of occurrence or the severity of rash associated with Lamictal. There are suggestions, yet to be proven, that the risk of rash may also be increased by (1) coadministration of Lamictal with valproate (includes valproic acid and divalproex sodium [e.g., Depakote]; (2) exceeding the recommended initial dose of Lamictal, or (3) exceeding the recommended dose escalation for Lamictal. However, cases have been reported in the absence of these factors.
Nearly all cases of life-threatening rashes associated with Lamictal have occurred within 2 to 8 weeks of treatment initiation. However, isolated cases have been reported after prolonged treatment (e.g., 6 months). Accordingly, duration of therapy cannot be relied upon as a means to predict the potential risk heralded by the first appearance of a rash.
Although benign rashes also occur with Lamictal, it is not possible to predict reliably which rashes will prove to be serious or life threatening. Accordingly, Lamictal should ordinarily be discontinued at the first sign of rash, unless the rash is clearly not drug related. Discontinuation of treatment may not prevent a rash from becoming life threatening or permanently disabling or disfiguring.
The second black box warning on the Lamictal label tells that there is a possibility of life-threatening or fatal hypersensitivity reactions. The warning reads:
Hypersensitivity reactions: Hypersensitivity reactions, some fatal or life-threatening, have also occurred. Some of these reactions have included clinical features of multiorgan dysfunction such as hepatic [liver] abnormalities and evidence of disseminated intravascular coagulation [formation of small blood clots throughout the body]. It is important to note that early manifestations of hypersensitivity (e.g., fever, lymphadenopathy [swelling of lymph nodes]) may be present even though a rash is not evident. If such signs or symptoms are present, the patient should be evaluated immediately. LAMICTAL® should be discontinued if an alternative etiology [cause] for the signs or symptoms cannot be established.
Prior to initiation of treatment with LAMICTAL®, the patient should be instructed that a rash or other signs or symptoms of hypersensitivity (e.g., fever, lymphadenopathy) may herald a serious medical event and that the patient should report any such occurrence to a physician immediately.
Other Major Precautions and Warnings
Unless rash or hypersensitivity reactions appear, Lamictal should not be discontinued abruptly, but should be tapered off over a period of at least two weeks to help avoid the risk of seizures.
Dosage adjustment will be necessary in most patients who start or stop taking oral contraceptives (birth control pills) containing estrogen while taking Lamictal.
The safety and effectiveness of Lamictal in patients under 18 with mood disorders have not been established.
Breast-feeding while taking Lamictal is not recommended.
Disclaimer: This is not intended to be all-inclusive or to replace information provided by your doctor or with the prescription from the manufacturer.
See also Lamictal Warning on Birth Defects, Side Effects, References
Prize for 'Next to Normal'
It's another big shout-out for Next to Normal, the Tony Award-winning Broadway hit built around a character with bipolar. The rock musical just won the 2010 Pulitzer Prize for drama. It's a fantastic strike against stigma when a realistic presentation of bipolar disorder like Next to Normal gets celebrated in the mainstream.
Only seven other musicals have won the drama category since the Pulitzers were established in 1917-and the last one, Rent, was 14 years ago.
It gets better: Next to Normal wasn't even on the original short list for the 2010 prize. According to The New York Times, the Pulitzer board made a bold decision to add it just a day or two before voting. The board called the show "a powerful rock musical that grapples with mental illness in a suburban family and expands the scope of subject matter for musicals."
"We tried to write a musical that goes to the heart of the human condition... one that is about healing, that shows a family trying to improve," composer Tom Kitt told bp in "Tackling stigma from the stage" (Fall 2009). "There is a lot of hope in this show."
Women Who Eat Foods With High Glycemic Index May Be at Greater Risk for Heart Disease
Newswise, April 9, 2010-Women with bipolar, already at higher risk for heart disease and diabetes, now have extra reason to watch what they eat. Consuming carbohydrates with high glycemic index-an indicator of how quickly a food affects blood glucose levels-appears to be associated with the risk of coronary heart disease in women, according to a report in the April 12 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. The association did not seem to hold true for men.
High-carbohydrate diets increase the levels of blood glucose and of harmful blood fats known as triglycerides while reducing levels of protective HDL or "good" cholesterol, thereby increasing heart disease risk, according to background information in the article. However, not all carbohydrates have the same effect on blood glucose levels. The glycemic index is a measure of how much a food raises blood glucose levels compared with the same amount of glucose or white bread. A related measure, the glycemic load, is calculated based on the glycemic index of a given food and also on the total amount of carbohydrates it contains.
Sabina Sieri, Ph.D., of Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, and colleagues studied 47,749 Italian adults-15,171 men and 32,578 women-who completed dietary questionnaires. Based on their responses, the researchers calculated their overall carbohydrate intakes as well as the average glycemic index of the foods they consumed and the glycemic loads of their diets. During a median (midpoint) of 7.9 years of follow-up, 463 participants (158 women and 305 men) developed coronary heart disease.
The one-fourth of women who consumed the most carbohydrates overall had approximately twice the risk of heart disease as the one-fourth who consumed the least. When these carbohydrates were separated into high- and low-glycemic index categories, increased intake from high-glycemic index foods was significantly associated with greater risk of coronary heart disease, whereas low-glycemic index carbohydrates were not. "Thus, a high consumption of carbohydrates from high-glycemic index foods, rather than the overall quantity of carbohydrates consumed, appears to influence the risk of developing coronary heart disease," the authors write.
The one-fourth of women whose diet had the highest glycemic load had 2.24 times the risk of heart disease compared with the one-fourth of women with the lowest glycemic load.
Overall carbohydrate intake, glycemic index and glycemic load were not associated with heart disease risk in men. This could be because the adverse changes associated with carbohydrate intake, including triglyceride levels, are stronger risk factors for heart disease in women than in men, the authors note.
"We tentatively suggest that the adverse effects of a high glycemic diet in women are mediated by sex-related differences in lipoprotein and glucose metabolism, but further prospective studies are required to verify a lack of association of a high dietary glycemic load with cardiovascular disease in men," they conclude.
(Arch Intern Med. 2010;170:640-647. Available pre-embargo to the media at www.jamamedia.org.)
Editor's Note: The EPICOR study is supported by the Compagnia di San Paolo. The Italian EPIC collaboration is supported by the Associazione Italiana per la Ricerca sul Cancro. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Source: American Medical Association (AMA)
Olanzapine: In Adolescents with Schizophrenia or Bipolar I Disorder
CNS Drugs, 04/12/10
McCormack PL - Oral olanzapine was generally well tolerated in adolescents with schizophrenia or bipolar mania. Sedation and weight gain were the most common adverse events in placebo-controlled trials. Extrapyramidal symptoms were reported by 10% of olanzapine recipients compared with 6% of placebo recipients. Olanzapine-treated adolescents were likely to experience greater increases in bodyweight, sedation, blood lipids, serum prolactin and liver transaminase levels than olanzapine-treated adults. Therefore, careful consideration of risk-benefit is recommended before using olanzapine in adolescents.
NADD Teleconference Series
Welcome to NADD - An association for persons with developmental disabilities and mental health needs.
NADD is the leading North American expert in providing professionals, educators, policy makers, and families with education, training, and information on mental health issues relating to persons with intellectual or developmental disabilities.
The mission of NADD is to advance mental wellness for persons with developmental disabilities through the promotion of excellence in mental health care.
Teleconferences scheduled throughout May and June
The National Association for the Dually Diagnosed (NADD) will offer its teleconference series featuring experts in the field of dual diagnosis this spring. Teleconferences allow participants to take an educational program without having to make travel plans or even leave their offices.
The sessions will take place on the telephone, with handouts available three days prior to each teleconference for participants to access online. The session will include the presentation and a facilitated Q&A session with the presenters. Click here for more information http://www.thenadd.org/pages/conferences/teleconference.shtml.
Special Education Resources on the Internet (SERI)
Special Education Resources on the Internet (SERI) is a collection of Internet accessible information resources of interest to those involved in the fields related to Special Education. This collection exists in order to make on-line Special Education resources more easily and readily available in one location. This site will continually modify, update, and add additional informative links. http://seriweb.com/
Special Needs Trust Foundation
A non-profit service developed to assist families establish special needs trusts for their loved ones with disabilities. Formed in 1989, the San Diego Special Needs Trust Foundation created a master trust to provide private support to persons with disabilities without jeopardizing their public support. Special needs are those things for which you or your family members are not entitled to receive government assistance. Through a Special Needs Trust, individuals or family members may leave assets to benefit themselves or their loved ones in a manner that is compatible with the continuation of public assistance. http://www.sntf-sd.org/index.html
Not too young to need a trail guide
"Welcome to the Jungle" (Conari Press, $14.95)
Canadian writer Hilary Smith has come through big time with a book about bipolar disorder targeted to teens or 20-somethings experiencing mental illness for the first time. Smith, 24, wrote "Welcome to the Jungle" because it's the sort of book she said she needed after receiving a diagnosis of bipolar disorder in her junior year of college. The chapter titles reflect her darkly humorous tone: "Hell Is Finding Good Insurance," "Voices Not in Your Head: Dealing With Friends and Family" and "Here Be Downers: Drugs, Booze and Suicide." While the book doesn't have much in the way of scientific content or statistics -- in fact, she leaves them out on purpose "because the whole point of this book is to make you feel less like a human scorecard and more like a human" -- it does have a section on what it's like to call a crisis telephone line and how to deal with the temptation to go off medication. It even has tongue-in-cheek instructions for putting on your shoes and leaving the house.
Pfizer's warning letter for pediatric Geodon trials could impact patent extension
By Kirsty Barnes
Published: April 26 2010 20:12 | Last updated: April 26 2010 20:12
This article is provided to FT.com readers by Pharmawire-a news service focused on providing insight into the most price sensitive issues in the global pharmaceutical market. www.pharmawire.com
Pfizer's (NYSE:PFE) recent FDA warning letter could jeopardize the marketing exclusivity extension - worth up to USD 500m - on its blockbuster antipsychotic Geodon (ziprasidone HCl), as well as potentially impact the timeliness of future drug applications, industry experts told Pharmawire.
As this news service first reported, an FDA warning letter issued to Pfizer on 9 April cited violations in adherence to good clinical practice (GCP) in the conduct and monitoring of two Geodon trials in 2006 and 2007 in children with bipolar disorder and schizophrenia. Pfizer has said it will outline its response to the agency's concerns within the next two weeks.
Geodon is currently approved in the US for the treatment of adults with schizophrenia and acute bipolar disorder. Four pharmaceutical industry regulatory consultants pointed out that Pfizer's purpose in running the Geodon pediatric trials was to take advantage of The Best Pharmaceuticals for Children Act. The act allows a company to receive six months of extra marketing exclusivity if it conducts the particular studies in pediatrics that the FDA requires to establish dose, safety, and efficacy.
Unraveling the family tree
For some families, bipolar disorder runs through the generations as invariably as freckles or cleft chins appear in other family trees. Even so, looking for your family's source of bipolar disorder can be a little like searching for the headwaters of the Nile. You start backtracking through the generations and suddenly realize that the quirky behavior you once brushed aside as your grandmother's eccentricity was really a signpost.
If only you had recognized her outlandishness or rage for what it was-the genetic source of your own bipolar disorder. You might have been more tolerant of her. Perhaps you wouldn't have distanced yourself so much. At the very least, you might have asked some questions.
Unfortunately, many people never think to connect the dots in their family's history of wellness until the day a family member is diagnosed with bipolar. Suddenly, it hits like a ton of bricks-everything falls into place. As one mother describes it, it wasn't until her son was diagnosed that she recognized her own illness. "Oh my gosh, that's what's the matter with me!"
This experience was related in one way or another by several individuals interviewed for this story. Jolted by the diagnosis of a child or a grandchild, an older family member may reluctantly acknowledge the symptoms as his or her own. Sometimes, it comes as a bolt of self-recognition; other times, it's a case of reluctant consent, a muttered admission, "Yes, that's me."
Scientists don't know how many or which genes are involved in bipolar. But there is no way at pre- sent to determine whether someone will inherit the disorder. Nevertheless, according to a study published in the March 2009 issue ofArchives of General Psychiatry, having family members with bipolar disorder is the best predictor of whether an individual will go on to develop the illness. (See sidebar below.)
Here, we relate the stories of three families: one in Ohio, one in California, the third in Quebec and Alberta. Though each is unique, the similarities among them are often striking. In each case, the individuals interviewed, whose real names have not been used in this story, have begun to unravel their bipolar family tree. They are looking for the genetic source and observing patterns from one generation to the next.
In the Canadian family, a young man shares an unhealthy obsession with military history with a grandfather he's never met. In California, the son doesn't have much insight into his own illness, but he's great at giving advice. "Just like his grandfather," his mother wearily observes. "And he likes to talk, talk, talk-just like my dad."
Several of the people who spoke with bp Magazine lamented that their brothers and sisters were unwilling to acknowledge the illness that seems to run between the generations. Buck up! they say. Meanwhile, some members of the next generation-now in their 20s and 30s-are self-medicating with alcohol and drugs.
At the same time, the parents whose children have not been diagnosed watch guardedly, looking for any behavior that may signify bipolar.
When Emma of San Diego scrutinizes her family tree for bipolar disorder, she traces it back to her paternal grandfather-a charismatic fellow who could never hold down a job. Even during the Depression, when jobs were scarce, he repeatedly quit his in a huff, only to let his wife, Emma's grandmother, beg the boss to take him back.
But it was Emma's father, Larry, whom she considers the real link. A brilliant man with a long line of academic degrees following his name, Larry insisted on giving his wife an IQ test before he would take her out on a date.
Just like his own father, Larry had trouble holding on to a job. He did, however, keep his kids in check through a combination of fear and play: "The way he played with us was very manic, tickling and chasing, or locking us out of the house 'til someone got hurt," Emma recalls.
Once, when she was 5 years old, he donned a bug-eyed gas mask from World War I and hid himself in the hallway. When she walked by unsuspecting, he leaped out and roared at her. Her terror made him laugh-that was his idea of fun.
Larry was a man of passions. He grew dozens of epiphyllums (cacti that put out an annual flower) in each room of the house and took thousands of photographs of them. He had 10 fish tanks and stayed up until the wee hours of the morning, feeding them.
Whenever he was home, Emma went on high-alert. He could lose his temper without warning, screaming, throwing objects, tossing his kids across the room. Like the time her brother, who was about 8 years old, received a letter from a foreign country and ripped the stamp in opening it. Her father was enraged and showed it. Why? "Because he was a stamp collector." She pauses. "And a gun collector. And a camera collector. And a coin collector."
Many years later, when Emma's son, Patrick, was diagnosed with bipolar disorder at age 13, her father-who had consistently refused to see a psychologist or psychiatrist -read over the list of symptoms and nodded. "Yeah, that's me," he said.
Patrick had been an unhappy child from the start. "When he was two weeks old, he started screaming and turning purple 'til he vomited," Emma says. His parents got a brief reprieve the year he signed up for Little League, when all his obsessive energies went into making sure his baseball uniform looked just right.
A couple years later, the stresses start-ed piling up again, and when Patrick was 11, Emma's psychiatrist diagnosed him, sight unseen, with depression. "He knew the history," she says in the doctor's defense. "I saw him for 10 years and he was a wonderful man, but not the best psychiatrist."
For a while, a common antidepressant seemed to help. But then the boy couldn't sleep, prompting the psychiatrist to prescribe a sedative.
"And that sent him over the edge," says Emma. "So here I had a child who was just unable to function. He just lay on the floor of his room, asking 'What's the matter with me, mom?'"
After the difficult high school years-during which he was diagnosed-Patrick quit school at 18, discovered cocaine, and began stealing. "He just went completely over the edge with cocaine and meth and alcohol," says Emma. "We finally got him into a treatment program in 2007 after he had two drug possession charges."
Although Patrick was the first in the family diagnosed with bipolar disorder, Emma was the first to be diagnosed with a mental illness. Twenty years ago, she learned she had anxiety disorder.
In the past year, her younger sister, like Patrick, has been diagnosed with bipolar. "My sister really struggles," Emma says. "She has four grown children and two of them are diagnosed with bipolar and are on and off their meds."
Emma says she feels neither guilty nor responsible for bequeathing the "bipolar gene" to her son.
"I'm sure there was a point I felt guilty but that's long past," she says. "When he was diagnosed we did a lot to educate ourselves. We got on the Internet, we read a lot of books, and we took a Family-to-Family course through NAMI."
It has been a unique education, Emma says-one that has brought her tremendous rewards. Most recently, she and her husband underwent training to become teachers in the 12-week course for family caregivers. Today, they work with families in the San Diego area, teaching them about the disorder, offering strategies on how to cope, and providing techniques for problem solving and communication.
"If I can't help my son, at least I can help someone else," she says.
For years, Karen of Ohio, regarded her grandmother as just plain mean. The old woman was shunned within her family for making unreasonable demands and refusing to talk to one or more of her children for weeks at a time. Once, she even declined to break a self-imposed speech ban long enough to wish her teenage daughter a happy birthday. She refused to seek medical help, insisting that a doctor would make her "go crazy."
Karen's mother was also abusive. "I was petrified of her," says Karen, recalling a childhood being chased around the house with rubber spatulas, belts, and wooden spoons. "You could just watch the mood swings." Up and down. When she was up, her mother went on "super duper spending sprees." When she was down, everyone steered clear.
In 1988, her mother was diagnosed with bipolar. Thirteen years later, Karen's son, then 8 years old, received the same diagnosis. A few years later, it was Karen's turn.
Then, in 1995, Karen's sister was diagnosed with depression, as was Karen's then-9-year-old daughter in 2006 and a niece in 2009. "It's obviously a family affair," she says.
These days, Karen works four days a week at her job as a customer support specialist. She reserves the fifth day for doctors' appointments-for herself, her son, and her daughter. She also attends counseling sessions with her mother and is working on anger management.
"Unfortunately, I see a lot of my mother in me," she says. "I think her anger comes from the way she was raised.... A lot of what I'm angry about is having to pass it on to my son."
Karen has wrestled with depression ever since she was a teenager. When she gets manic, she can be just like her mother. She goes on frenzied shopping sprees, sometimes plunking down $10,000 in a single afternoon. She has already pushed her family into bankruptcy and they're close to it again.
"All the credit cards are maxed out," she says tautly. "My daughter and I just went on a three-day cruise to Mexico. Everything was paid for, and I ended up spending another $1,000 in Ensenada. The worst thing is, I can't even remember what I bought."
The biggest challenge, however, has been her son, Nate. He was a difficult child from birth, crying almost nonstop, sleeping little, and demanding such constant attention that for the first two years Karen and her husband traded off nights sitting up with him.
At age 4, he told his parents that he was unhappy to be alive, an announcement that sent them in a tailspin searching for counseling. One psychiatrist told them that Nate wasn't getting adequate stimulation; another informed them that they were failing his basic needs. Eventually, the family doctor observed the boy's tics and referred the family to a psychiatrist at Ohio State University, where Nate was soon diagnosed with bipolar.
It was there, while attending an educational program for families of bipolar patients, that Karen suddenly recognized the criteria of symptoms as her own: "Like, oh my gosh! That's what's the matter with me."
Now 16 and a high school sophomore, Nate regularly sees four separate therapists and doctors and is on nine different medications. He has been hospitalized nine times-the first time for throwing a chair at his schoolteacher. He has been placed in foster care following a violent outbreak against his sister and mother. He has been committed to an inpatient treatment center for five months, and placed in a behavioral program on a ranch in Idaho for seven weeks that cost his parents $25,000-an expense that Karen says, "We'll be paying for the rest of our lives." For now, he's living at home.
"Even though I know it's not my fault, I still blame myself for giving it to him," says Karen. "The one good thing is it's something that the two of us can joke about. Because we know what's going on in our heads. And no one else can understand it."
Rebecca grew up just outside Moncton in New Brunswick, on a large property surrounded by orchards and maple trees for tapping, berry-picking, and a river over- flowing with trout. The way Rebecca remembers it, it was an idyllic childhood-that is, until the time she turned 14 and her father lost his job. Then began his fast descent into alcoholism, during which time the family farm was transformed into a "kind of World War II barracks," complete with guns, dogs, and a copy of Mein Kampf.
"His depressions hung over the house and the house lost all its joy and light," she says.
Rebecca, who was diagnosed with bipolar disorder at 24 (she is now 59), lives in Montreal on a limited budget. She has never worked, although she holds two university degrees, one in education, the other in translation.
Teaching is out of the question, since school buildings are far too stressful and stimulating environments: "Too many lights, too much noise," she says, ruling them out. And though she is a talented French-English translator, she can't endure the pressure of deadlines.
Instead, she manages to live within the limitations of a modest disability pension and considers herself an excellent money manager.
Although her family is prominent and successful, many of its members-from the Maritimes to the prairies-have variously struggled with mental illness. During one hospitalization in Nova Scotia, Rebecca recalls, she ran into a second cousin who also happened to be a patient. She counts off cousins, nieces, and nephews across Canada-all of whom have been diagnosed with bipolar, depression, or anxiety.
One of them is her brother's son, a bright, 28-year-old history student named Matthew, who lives with his mother, Meg -Rebecca's former sister-in-law-about a hundred miles outside Calgary, on the other side of the country. Meg, long divorced, reached out to her former husband's family-and specifically Rebecca -after Matthew's first psychotic episode five years ago.
Matthew had borrowed her car and when it broke down on a country road he jogged for a few miles, arriving at a stranger's property during a bonfire party in the middle of the night. The partygoers grew queasy after Matthew started bragging that he had a brother in Al Qaeda. Someone called the Royal Canadian Mounted Police (RCMP); a couple hours later a helicopter was circling overhead.
"I got a phone call around midnight that he was at a party somewhere," recalls Meg. "I picked him up right before the RCMP arrived."
After two days of his waking her every half hour, jabbering nonstop, and refusing to eat, Meg knew that she had to get him to a hospital. So she called Matthew's aunt by marriage, Rebecca, a woman she hadn't seen or talked to in more than 20 years. Meg could not forget the first time they met, when Rebecca came to visit the family at their cabin in the woods. She remembered Rebecca's bizarre behavior during the visit, writing over Meg's sketches with her poetry, feeding her psychiatric medication to the houseplants in order to kill them, and generally impressing her new sister-in-law as someone who was larger than life-beautiful, talented, and "off the wall," as Meg puts it.
Still, it never occurred to Meg at that time that her sister-in-law's illness held any special significance down the road.
After Matthew was diagnosed with bipolar, however, she began thinking about the family's genetic history. She and Rebecca renewed their acquaintance and began steeping themselves in the language and literature of bipolar disorder.
Today, Meg sees her son as someone who will probably struggle all his life to balance mania and depression. Like his paternal grandfather, he has an obsession with military thoughts. Also like his grandfather, he has a predilection for alcohol and drugs.
Moreover, Meg has known her son to fantasize about being Attila the Hun. After a motorcycle tour of France's war-time bunkers, he visited the University of Calgary's library and told people that he had a bomb. The police were called and he was hospitalized.
Mostly, his mother is concerned for his safety. She hopes that he will be able to complete his university studies, but she also hopes that he will find some peace of mind-like his Aunt Rebecca who, after 25 years of struggle, knows enough to appreciate the good days when they come.
"I'm so grateful each morning when I get up and my mind is in order," says Rebecca. "Whether I feel a mania coming on or a psychosis, I don't care anymore -as long as I can put my two feet on the ground."
Meg isn't quite as sanguine. The newly acquired knowledge has left her with worries that she never would have considered previously. Mostly, they have to do with her daughter, a healthy, happy 33-year-old, who last year married a wonderful young man. It was a happy wedding and Meg thinks the world of her new son-in-law.
There's just one problem-his mother has bipolar disorder.
"I'm not going to be the one to say, 'Oh my God, have you looked at the gene pool?' Hopefully, they're thinking about it. But life's a crapshoot. I look at it and I think, hmm, that ups the odds."
Canadian-born Sara Solovitch is a freelance writer based in Santa Cruz, California.
Couple launches Web site to help disabled find discounts
The beautiful wings of a butterfly suggest freedom.
Freedom to go wherever you want. Freedom to see whatever you desire.
That's why Mara Squar and her husband, David, chose the butterfly as a symbol for their new Web site, DisabledDiscounts.com, which is intended to give people with disabilities that sense of freedom. https://www.disableddiscounts.com/index.asp
Upcoming Event for Siblings
My Department within the San Diego Unified School District's Special Education Division will be offering a training for facilitators for "Sibshops" an internationally known program for the siblings of children with special needs.
As I'm getting things prepared for the district's upcoming Sibshop training, I'm working on finding a group (up to 20) of children ages 7-14 who are the siblings of students with special needs to participate in a Sibshop event on Sunday, May 16th. Sibshop events are recreation based (FUN!), activity filled times for siblings of children with special needs to get together. This is open, free of charge, to any sibling within the San Diego Unified School District boundaries. Please contact me if you'd like more information.
Thank you very much for sharing this information with your families!
Program Manager, Special Education
Parent Services and Charter Schools
San Diego Unified School District
CLUB Xcite is offering scholarships
Stefan and Matt, founders of XciteSteps, have put together a scholarship fund for families who need financial assistance involving their child experiencing special needs in after school and summer programs. The scholarship funds is available for the following XciteSteps services: Summer Camps, Social and Sports Clubs, Special Needs Nanny Service and our one on one social skills coaching program. We have scholarships available for kids, teens and adults ranging from $50 to $100 per child per program. The scholarships will be given out on a first come first serve basis. To view the services and apply for the scholarship visit www.excitesteps.com and contact Pamela Machala at 858 703 7305.
858 703 7305
Simple Test Identifies Suicide Risk from Antidepressants
By RICK NAUERT PHD Senior News Editor
UCLA researchers have developed a noninvasive brain scan to determine if an individual may be susceptible to suicidal thoughts while taking an antidepressant medication.
While antidepressant medications have proven to be beneficial in helping people overcome major depression, it has long been known that a small subset of individuals taking these drugs can actually experience a worsening of mood, and even thoughts of suicide.
Aimee Hunter, an assistant research psychologist in the UCLA Department of Psychiatry, and colleagues report that by using quantitative electroencephalographic (QEEG), a noninvasive measurement of electrical activity in the brain, they were able to observe a sharp reduction of activity in a specific brain region in individuals who proved susceptible to thoughts of suicide. The reduction was noticeable within 48 hours of the start of treatment.
The innovation is reported in the April edition of the peer-reviewed journal Acta Psychiatrica Scandinavica.
Prior research, Hunter said, has shown that between 8 and 14 percent of depressed patients develop thoughts of suicide while taking the most common antidepressants, known as selective serotonin reuptake inhibitors (SSRIs).
Although reports have suggested that SSRIs are to blame, no firm link between these drugs and thoughts of suicide has been established.
This study suggests, for the first time, a link between worsening suicidality and specific changes in brain function while on these medications.
The researchers treated 72 people suffering from major depressive disorder (MDD) with one of two SSRIs, fluoxetine (Prozac) or venlafaxine (Effexor), or with a placebo.
All were evaluated by a clinician using the Hamilton Depression Rating Scale, a standard instrument that assesses the severity of a wide range of depression symptoms. Of the 37 participants on medication, five (13.5 percent) had worsening thoughts of suicide.
All of the participants were also examined using QEEG, which evaluates brain function based on the brain's electrical activity.
Among the 13.5 percent of participants who got worse, the researchers found a sharp drop in brain activity within 48 hours of the start of medication. The drop occurred in the midline and right-frontal sections of the brain, areas known to control emotions.
Of note, eight of the 35 participants taking a placebo (22.9 percent) also had increased thoughts of suicide. However, the placebo participants did not show the precipitous drop in brain activity within the first 48 hours.
"This is the first study to show a change in brain function after the start of medication that appears to be linked to the subsequent development of worsening thoughts of suicide during antidepressant treatment," Hunter said.
"Importantly, changes in this biomarker did not predict worsening suicidal thoughts in the placebo-treated subjects, so the results suggest that the biomarker specifically detected medication-related worsening only."
QEEG is a relatively inexpensive, noninvasive instrument; measurements are obtained by placing electrodes on the scalp.
As a result, Hunter said, further development of this biomarker could potentially lead to a tool to help clinicians predict early in the treatment process whether an individual suffering from depression will develop thoughts of suicide.
Source: University of California - Los Angeles
How Long is a Typical Bipolar Episode?
By JOHN M GROHOL PSYD
Bipolar disorder is characterized by a cycling from depression to mania, and back again over time (hence the reason it used to be called manic depression, because it includes both mania and depression). One of the commonly asked questions we get here is, "How long does a typical bipolar episode last?"
The answer has traditionally been, "Well, it varies considerably from person to person. Some may have rapid cycling bipolar disorder where that person can cycle back and forth between depression and mania in the course of a day or multiple times a week. Others may be stuck in one mood or the other for weeks or months at a time."
New research (Solomon et al., 2010) published in The Archives of General Psychiatry sheds a little more empirical light onto this question.
In a study of 219 patients with bipolar I disorder (the more serious kind of bipolar disorder), researchers asked patients to fill out an evaluation every 6 months for five years. The evaluation survey asked a number of questions to determine the length, type and severity of the person's mood episodes.
They discovered that for patients with Bipolar I disorder, the median duration for any type of mood episode - either mania or depression - was 13 weeks.
They also found that "more than 75% of the subjects recovered from their mood episodes within 1 year of onset. The probability of recovery was significantly less for an episode with severe onset" and for those who had a greater number of years spent ill with a mood episode.
The researchers also discovered that manic episodes or mild depressive episodes were easier to recover from than severe depressive episodes for people with Bipolar I disorder in this study. They also found that those who have a cycling episode - switching from depression to mania or vice-a-versa without an intervening period of recovery - fared worse.
So there you have it. The average length of time someone with Bipolar I disorder spends either depressed or manic is about 13 weeks. Of course, as always, your mileage may vary and individual differences will mean that very few people will actually have this exact average. But it's a good, rough yardstick in which to measure your own mood episode lengths.
Solomon, DA, Andrew C. Leon; William H. Coryell; Jean Endicott; Chunshan Li; Jess G. Fiedorowicz; Lara Boyken; Martin B. Keller. (2010). Arch Gen Psychiatry - Abstract: Longitudinal Course of Bipolar I Disorder: Duration of Mood Episodes. Arch Gen Psychiatry, 67, 339-347.
Seaworld "Escort" pass for children with disabilities
Hi, we just visited Sea World this past weekend, purchased a yearly pass(now cost of one day ticket), but the person checking us in at the gate, noticed our son and said he could of gotten a "escort" pass. When I asked what this was, is you go into the information center, tell them of your child's disability, ex: Autism etc, and they will add the word "escort" to his or her ticket, so whomever comes along with them, gets in free! This can be a parent or any other friend or family member. They do not advertise this, and there is also a pass for the rides etc, to go to the front of the line for special needs' children. SeaWorld is so great for our son we thought we'd pass this along. Have a great summer