Pristiq's FDA Chances: Depression – Yea; Menopause – Nay

As more info on Pristiq continues to roll out, I'll do my best to track them quite closely.

While Wyeth scrambles to resolve issues in its Puerto Rico plant to meet FDA standards, Ms. Kathleen Kerr of Newsday recently reported on Pristiq's potential to be approved for use in depression and hot flashes resulting from menopause. I was so excited to see some decent reporting on a mental health issue in a paper other than the NYT. It was also nice to see that it didn't end with "Shares of Wyeth fell 38 cents Friday to close at $51.50 on the New York Stock Exchange."

"If Pristiq wins Food and Drug Administration approval, it will be the first antidepressant and only non-hormonal remedy marketed specifically for hot flashes. But Pristiq isn't without problems – it poses rare suicide risks in young people."

Read the rest of this entry »

Celebrity sensitivity: Britney’s mental illness

Britney SpearsI originally posed a theory that Britney Spears might be suffering from a mental illness such as postpartum depression (PPD) or bipolar disorder. Furious Seasons linked to an article on tmz.com (by way of Celebrity Baby Blog – wtf?) where “sources say doctors at her rehab facility think the underlying reason for her trouble may be post-partum depression.”

As for my theories:

“Sources tell TMZ that Britney’s doctors have two operating theories — either that she suffers from post-partum depression or bipolar disorder. The doctors strongly believe post-partum is the problem.”

At least I got the plausible diagnoses. Damn, I’m good.

(A nice pic of the former ‘sexy’ days of Ms. Spears.)

UPDATE: The Trouble With Spikol also wrote her own take on it too.

Mean behavior isn't always mental illness

OK – I continue my streak of NYTimesing (lookee! A verb!) and post a link to an essay by Dr. Richard Friedman about how chronically "mean" people may not have a mental illness. They are just… well, mean.

Friedman raises an interesting point about how psychiatry and psychology try to explain away so much of people’s behaviors via diagnosis that people aren’t left any room to be "normal." Mean people don’t need to be lumped into a category of "anger disorder" or some crazy nonsense like that. Perhaps there are people who have extreme issues with anger and need to learn behavioral techniques to get it under control. But other people at their very core like to hurt, manipulate, and demean others. This is not a mental illness. This is a human, sinful nature.

Panic disorders relieved by talk and behavioral therapies

The NYT published a story on Feb. 6 about how talk therapy aids panic disorders.

The study seems interesting. The psych world is excited because of its promising results. The results do seem hopeful but give the sample size, it's too early to tell.

"A team of New York analysts published [in The American Journal of Psychiatry] the first scientifically rigorous study of a short-term variation of the therapy for panic disorder, a very common form of anxiety. The study was small, but the therapy proved to be surprisingly effective in a group of severely disabled people… The brand of therapy tested relies on core tenets of analysis, like the search for the underlying psychological meaning of symptoms. But unlike traditional psychoanalysis, it focused on relieving symptoms quickly, and was time-limited. Previous studies of similar approaches have shown some promise for other disorders, like depression."

Perhaps Dr. David H. Barlow, a psychologist at Boston University, had the best insight:

"[He] said… that the study was too small to be conclusive but that 'the authors should be congratulated for actually  taking the first step in doing the hard work of beginning to evaluate treatments” that are widely used without good supportive evidence.

The researchers tested a pared-down version of analysis tailored specifically for panic attacks, the breathless, paralyzing dread that strikes some 1 percent to 2 percent of people, seemingly out of nowhere. Previous studies had found that other kinds of therapy — including exposure techniques, in which people learn to diffuse their anxieties by facing them one small step at a time — can relieve panic attacks in half to two-thirds of patients, depending on the severity and type of anxiety."

The article doesn't mention where the estimated "some 1 percent to 2 percent of people" comes from so I'll probably do some digging around to find out how many people are estimated to suffer from anxiety disorders and panic attacks. It's also interesting to note that studies used a form of psychological behavioral therapy to help patients manage their symptoms.

"Half of the group received a form of relaxation training, in which they learned how to moderate their arousal by tensing and relaxing specific muscle groups. The other half received psychodynamic therapy, working with their therapist in two weekly sessions to understand the underlying meaning of their symptoms — when the reactions first started and how they might be linked to loss, broken relationships or childhood experiences that unconsciously haunted their current lives."

Relaxation techniques — don't Ativan and Klonopin achieve the same result except much faster?

"After 12 weeks, 39 percent of those working with relaxation techniques improved significantly on standard measures of anxiety and reported fewer panic-related problems in their relationships and work. But almost three-quarters of those receiving psychodynamic therapy reported similar benefits. "

Thirty-nine percent of 49 patients equals about 19 patients who "improved significantly." It's not brain science, but you've left with another 30 who didn't. However, nearly 75 percent of the sample size "reported similar benefits" from psychodynamic therapy. Perhaps it wasn't revealed in the American Journal or it's a shoddy article thrown together at the last minute, but I'd like to know what "similar benefits" the study is speaking of.

Also, isn't 12 weeks longer than most clinical trials funded by drug companies? Perhaps I'm thinking that's just the first phase of a clinical trial…?

"One former patient treated with this therapy began to have panic attacks after witnessing a young woman die of an illness, said her doctor, Fredric N. Busch, a Cornell psychiatrist and a co-author of the new study.

The patient, who was not a part of the study, described the death as deeply unfair, and in sessions explored perceptions of unfairness in her work and her life, including her childhood. “Once she was able to understand this pattern, the panic became less frightening, she felt safer and was eventually able to get rid of the symptoms,” Dr. Busch said."

I'm no doctor, but this sounds more like Post-Traumatic Stress Disorder. This example makes PTSD sound less like a mental illness and more like a behavior to be unlearned. Perhaps it's true? How do events "trigger" a mental illness? Is it inherited or can it be acquired? What a debatable topic. Oy.

"The researchers said that even if this approach was not for everyone, it appeared to be especially beneficial for a particular group. In an analysis of individual patient’s responses, the researchers found that those who also had a personality disorder, like avoidant personality, showed significantly greater improvement than those whose symptoms were related solely to anxiety. Patients with multiple diagnoses are usually more difficult to treat. "

It's nice to think that these techniques could replace anti-anxiety meds. But alas, they won't; Big Pharma wouldn't allow it. But a girl can dream, can't she?

(The boss won't let me skip lunch and leave early so… here are your updates…)

Be more active

Taking a break from pharma for a bit, one of my suggestions for "Staving off the blues" is being "more active." I never fail to include my disclaimer that being more active does not make mental illness disappear. It helps to temporarily relieve symptoms associated with those who suffer from chronic mental illness.

I’ve been attempting to exercise for 25-45 minutes twice a week. (Doesn’t always happen.) But for the days when I do, I get a "high" that elevates my mood for about an hour or so. Nevermind that my mood may drop off two to three hours later or that I wake up depressed in the morning. Those precious few minutes of exercise helped me to feel good for a little while. And every little bit helps.

Puppy of the Week

Blogs: Possibly induced by antipsychotics

I’ve been following soulful sepulcher and am captivated by her story of her daughter, Lindsay, struggling with multiple health issues: childhood bipolar disorder with psychosis possibly induced by antipsychotics, not to mention chiari malformation and syringomyelia. (I feel like I’m forgetting something.) She’s also struggled through the state mental health system. I’ve never been in a state hospital, but these stories don’t particularly encourage me to end up there anytime soon. My heart goes out to her and her daughter, Lindsay. Having been in private psychiatric hospitals, I can confidently say that they are no cakewalk. My mind can’t fathom the depths of the environment at a state hospital. Can’t. Fathom.

In a related matter, psychiatric patients owe their love and gratitude to Eli Lilly for creating Zyprexa, one of the biggest medical shams in the psych market. Go to soulful sepulcher’s blog to read more.

Mind Over Matter, Pt. 2

Perhaps I've written about this previously. Perhaps I haven't. Regardless, I'll tackle it anyway.

Some people with a mental illness who hear what I'm about to say will tell me I'm crazy. Perhaps I'd get "partially correct."

Read the rest of this entry »

Babies and toddlers are mentally ill

The new fad? Diagnosing young children with mental illness.

Oh and I mean young.

Originally, I’d written about how psychiatrists are diagnosing mental illness in infants. Mental health blogs now are all over the Rebecca Riley case and rightly so.  She was a 2½-­year-old toddler diagnosed with ADHD and bipolar disorder. How a psychiatrist can diagnose a child that young is beyond me.

intueri has written a brilliant post about the case and diagnosing children that young:

“We need to stop labeling behavior as pathological just because it causes us inconvenience. We also need to stop using diagnoses as means of absolving us of our responsibilities (”it was the bipolar that made me say those mean things to you; it wasn’t me”). We, as providers, need to stop colluding in these goals: We need to stop the belief that a pill will always cure everything.”

(linkage attribution: Furious Seasons)

Catching up: Furious Seasons

I’ve been out of it. Really out of it.

In my backlog of reading, Furious Seasons has posted the results of what he’s entitled, "The Zyprexa Chronicles."

The judge ruled in favor of Lilly.

Holy crap. I knew this would happen, but hoped it wouldn’t.

This all occurred on Feb. 13, so I’m really behind the times here. (Did Punxsawtawney Phil see his shadow yet?) But it’s a reminder to, not just the blogosphere, but also to the media that, well, pharma companies are more powerful and have more sway in court.

After reading a bit more on the situation (ok – I’m getting all my info from ONE blog), it seems that the judge hasn’t really ruled against blogs using or disseminating these documents (MindFreedom.org being the exception apparently) but these leaked documents could cause Lilly "irreparable harm." What? Documents that need to be made public would harm Lilly? It’s David against Goliath. Mainstream media — CBS, ABC, NBC, AP — haven’t picked up on this story. The majority of Americans – I’d venture to say the majority of Zyprexa consumers – don’t know about the proven side effects of this drug. I highly doubt it would cause "irreparable harm."

Classic quote:

"The way reporters work is a good deal for the public. We get paid like school teachers, think like lawyers and detectives, fight like Marines when necessary and write like… oh, nevermind."

Man, ain’t it the truth. Especially the schoolteacher pay. Except in Brooklyn, NY where they’ll pay a starting teacher at $40K because they need teachers in the inner city. But I digress.

"So, Ms. [Marni] Lemons (Eli Lilly spokeswoman), what I reported on yesterday — that your company was talking about potentially downplaying glucose increases noted in studies used to approve Zyprexa for long-term use in bipolar disorder — was based on these documents and it sure looks to me like your employees were strategizing all over the Lilly email system. I contacted your press office on Monday and asked them to respond to several questions about that document. Your people never responded….

The same goes for you people at the FDA. Stop telling me to file FOIAs in order to get basic public information that affects millions of people that should already be freely available on your website."

For those who don’t know, FOIA stands for Freedom of Information Act, in which anyone can write to a governmental agency and appeal for documents that have been made public. The nice part about this? The agency can black out information that don’t want you to know. They can deny your request, block out some data, or block out so much that the document ends up being useless. Oh, and FOIAs take forever and freaking day to arrive because the gov’t sends them when it’s convenient for them.

Furious Seasons has also been following the NYT’s coverage about a child diagnosed with ADHD and bipolar, who was killed and supposedly overdosed on medication. Riiight. Unfortunately, from what I can see – perhaps I’ll find a bit more – the NYT is extensively covering mental health issues. Perhaps they’re getting a ton of hits on the Zyprexa series and have figured out that people actually care about mental health topics. Whatever the reasoning, I’m glad they’re doing it.

Astute observation from Furious Seasons:

"This whole diagnose-medicate-blame-the-"illness"-for-bad-outcomes nonsense has got to stop. It’s bad enough in adults and teens, but in kids it is a complete outrage. It is interesting to me, though, that when a child dies, the skeptical questions are asked. When an adult has awful results from taking Zyprexa, say, or Paxil, the media is largely silent."

More to come on other blogs…

Quote of the Week

“Light thinks it travels faster than anything but it is wrong. No matter how fast light travels, it finds the darkness has always got there first, and is waiting for it.” — Terry Prachett

A final update on my Effexor withdrawal

I failed to update on my Effexor withdrawal because, well, you know why.

After three to four weeks, my Effexor symptoms – well, most of them anyway – have dissipated. The brain shocks were gone by early February. The vertigo as of now has completely resolved. (Although I’ll probably still have occasional instances where it may linger.) The dizziness also has lightened up. I can confidently say that I’m pretty much back-to-normal. All cases will differ, but for me, it took about five weeks total to have a complete recovery.

But don’t do headstands after Effexor – whoo, boy, can that throw you for a loop.

Also – it took about four weeks to get the drowsy effect of fluoxetine (Prozac) out of my system. January was an extremely rough month for meds, let me tell you.

Saturday Stats

"In 2001, 55% of suicides were committed with a firearm," – National Center for Injury Prevention and Control

Britney Spears has a mental illness

I haven’t kept up on other news except for Britney Spears. (By way of my husband.) Prime Minister Tony Blair has announced his plan for pulling British troops out of Iraq and I’m more interested in Britney Spears’ life. Where are my priorities?

Anyway, I’m convinced that Britney Spears has a mental illness. She’s suffering from postpartum depression and struggling with her addiction to drugs (recreational mixed with prescription, from what I understand) and alcohol.

Britney Spears (crazy)The image to the left are a recent photo collage (courtesy of x17online.com) of her angry and trying supposedly trying to smash her soon-to-be ex-husband Kevin Federline’s car. They also show more detailed images of her newly shaved head.

She has two kids at home and barely spends any time with them. Could it be that she’s just irresponsible or that she’s suffering from a severe depression, not only after having kids but also going through a stressful divorce at the same time?

Maybe she suffers from bipolar disorder — her actions certainly seem to fit the bill. The happy housewife, then the big party girl. Her erratic stint of checking in and out of rehab. Twice. As of this post, she’s checked into rehab a third time. It must be nice to be a celebrity. Once most people have checked into rehab or a psych hospital , there’s at least a 48-hour wait before they can leave.  She’s checked in and out in one day. At least Keith Urban stayed and finished his treatment — with a brief reprieve during Christmas.

Back to her possible bipolarity (I’ve broken my own grammatical rule), her drinking and late-night partying while she’s got children at home makes no sense to pretty much everybody. The actions of those who suffer from bipolar disorder never make any sense to anyone except the person with the disorder.

Perhaps, Ms. Spears doesn’t realize what she’s doing. This is common with those who have bpd. And for those with mental illness, it doesn’t help that she’s under a media microscope being judged, not only by her peers, but by the entire world. All of us with mental illness — once we’re in our right mind — prefer to keep our suffering quiet. We wouldn’t want anyone to know lest we suffer because of it. My anonymity for this blog is an example of this. I don’t want any potential employers to know who I am lest it prevents me from obtaining a job.

The world thinks Britney Spears is crazy and needs help. Perhaps, they’re right.

The Worst Things To Say To Someone Who Is Depressed: 51-60

This list is divided to have 10 of "The Worst Things To Say To Someone Who Is Depressed" published each week. To see the entire list: go here. The ones that apply to me are bolded.

51. "This is a place of BUSINESS, not a HOSPITAL."

52. "Depression is a symptom of your sin against God."

53. "You can make the choice for depression and its effects, or against depression, it’s all in YOUR hands."

54. "Get off your rear and do something." -or- "Just do it!"

55. "Why should I care?"

56. "Snap out of it, will you?"

57. "You *want* to feel this way."

58. "You have no reason to feel this way."

59. "It’s your own fault."

60. "That which does not kill us makes us stronger."

Diagnosing Myself

I've been away from this journal for a while for a number of reasons. I'll be candid:

1. Work has become busy. The yearly schedule at work is in line with tax season (even though I don't work in anything related to accounting) so I'm usually busy from January through May. Expect tons of blogging in June and July — there is NOTHING to do.

2. My personal life has become quite busy too. I don't really have a free night except for Sundays and I'm left exhausted from doing something every single night of the week. Free Friday nights tend to be a rare commodity.

3. I feel awful that I can't keep up on anyone's blog at the moment. There are so many wonderful blogs that I'm addicted to reading and it's much too time-consuming at the moment. (I have this tendency to read the first post and then read back entries all the way to January. Before I know it, I've spent 2 hours at work wasting time.)

4. I'm a perfectionist who meticulously reads over most of my previously written posts and corrects grammar, spelling, etc.

There's probably more that I can't remember at the moment, but you get the picture. Now, on to diagnosing myself…

Read the rest of this entry »

Puppy of the Week

Living My Lamictal Life

Things have slowed down a bit at work – temporarily. So I might provide some updates in the world and catch up on a few blogs. But don't hold me to it.

In the meantime, the Abilify ad is still up.

Quote of the Week

“I start to feel like I can’t maintain the facade any longer, that I may just start to show through. And I wish I knew what was wrong. Maybe something about how stupid my whole life is. I don’t know. Why does the rest of the world put up with the hypocrisy, the need to put a happy face on sorrow, the need to keep on keeping on?… I don’t know the answer, I know only that I can’t. I don’t want any more vicissitudes, I don’t want any more of this try, try again stuff. I just want out. I’ve had it. I am so tired. I am twenty and I am already exhausted.”— Elizabeth Wurtzel

Saturday Stats

"Males are four times more likely to die from suicide than females." – National Center for Injury Prevention and Control

The Worst Things To Say To Someone Who Is Depressed: 41-50

This list is divided to have 10 of "The Worst Things To Say To Someone Who Is Depressed" published each week. To see the entire list: go here. The ones that apply to me are bolded.

41. "You never think of anyone but yourself!"

42. "Have you got PMS?"

43. "You’ll be a better person because of it!"

44. "You’re just looking for attention." (I don’t know how many times I’ve heard that one. This one probably tops the list in my life.)

45. "Everybody has a bad day now and then."

46. "You should buy nicer clothes to wear."

47. "You catch more flies with honey than with vinegar."

48. "A person your age should be having the time of your life."

49. "The only one you’re hurting is yourself."

50. "You can do anything you want if you just set your mind to it."

Puppy of the Week

Quote of the Week

"So often we dwell on the things that seem impossible rather than on the things that are possible. So often we are depressed by what remains to be done and forget to be thankful for all that has been done." — Marian Wright Edelman

Saturday Stats

"Of the nearly 35 million Americans age 65 and older, an estimated 2
million have a depressive illness (major depressive disorder, dysthymic
disorder, or bipolar disorder) and another 5 million may have
"subsyndromal depression," or depressive symptoms that fall short of
meeting full diagnostic criteria for a disorder." – National Institute of Mental Health

The Worst Things To Say To Someone Who Is Depressed: 31-40

This list is divided to have 10 of "The Worst Things To Say To Someone Who Is Depressed" published each week. To see the entire list: go here. The ones that apply to me are bolded.

31. "You need to get out more."

32. "We have to get together some time."

33. "Get a grip!"

34. "Most folks are about as happy as they make up their minds to be."

35. "Take a hot bath. That’s what I always do when I’m upset."

36. "Well, everyone gets depressed sometimes!"

37. "Get a job!"

38. "Smile and the world smiles with you; cry and you cry alone." (I’ve never heard that one, but that’s harsh.)

39. "You don’t *look* depressed!"

40. "You’re so selfish!"

Birthday Weekend: Part IV

Monday was the end of the birthday weekend. The Colts won the Super Bowl (I missed it because of a wicked migraine) and my mother was back home in NY.

I didn’t sleep. I woke up on Sunday at 1 p.m. and didn’t sleep at all. I decided to go to work at 8 a.m. as a result and faked a cold (stuffy nose and occasional coughing) to corroborate my story from Friday. Guilty plagued me so I e-mailed all of my co-workers, pouring my heart and soul into apologizing. I didn’t get a response to my e-mail. My best – or worst – guess is that no one bought it. I figured that everyone was mad at me, hated me, and wanted nothing to do with me. The fact that no one talked to me but my boss and the lady who sits across from me spiraled my mood even further. I talked to my boss, told her that I’d get my immediate work done, then head home early.

See that depression scale to the right? I plunged to 0. If I’m lucky, I was a 0.5. I wanted to die, I wanted to commit suicide and just couldn’t formulate a plan. I wrote a suicide e-mail on delayed delivery to my husband. I even had a suicide post planned for my blog. Just before I left work, I came to my senses and realized that if I hadn’t died from my attempts in the past 10 years, I wouldn’t be dying today. I deleted the e-mail and post.

My thoughts indulged me in suicide. I couldn’t wait to die and make my co-workers regret not talking to me. Post-mortem thoughts of their words swirled in my head: “I had no clue she was suicidal, I couldn’t tell!”

No one can. I was sulky but I didn’t appear suicidal… I don’t think anyway.

On my way to the train station, I thought about all the ways I could die. Perhaps getting hit by a car? No, too much risk of becoming a vegetable. How about throwing myself on the train tracks? Nah, too messy.

I walked and sat in 9 degree Farenheit weather, hoping I’d develop hyperthermia. No such luck. Just an extremely cold face and fingers.

I called my mother, purposely sounding cheerful to throw her off. I just called her to tell her much I loved her. (Nothing unusual; I do that occasionally.) I kept hoping she’d let me off the phone eventually, but the conversation dragged on and on with long dead spots. I became frustrated. I just wanted to tell her I loved her one last time. And then – ooh, I know! – drown myself in the Schuylkill River!

The conversation lingered. She told me that I had a good husband who loved me and took great care of me and that I should take great care of him. She said we were lucky to have each other. Then, I made a mistake. A BIG mistake.

Read the rest of this entry »

Birthday Weekend: Part III

Saturday was a bit better than Friday. The hubby and I went to the gym and exercised for 45 minutes (30 cardio, 15 weight training). I was pretty pumped because I’d never been able to do 30 straight minutes of cardio in my life. (You’re talking to the girl who always got picked last for teams in elementary school.)

After the gym, I ate a snack and jumped from 150 mg to 200 mg on Lamictal. The jumped knocked me for a loop. I immediately fell asleep for the rest of the afternoon into the evening. I woke up in time for us to get to TGIFriday’s for dinner. At 10 o’clock. We hopped in the car and drove to Applebee’s for dessert at 11:30. We didn’t get home until well after midnight. By this point, my husband was really depressed. From his POV, nothing went right for my birthday: he didn’t me give a cake, a card, or a present. *shrugs* A cake would have been nice, but my husband being around is much nicer.

Saturday’s mood weaved its way into Sunday. We were to be inducted as church members at the morning service, but the hubby developed a migraine at 8 a.m. I called the church secretary at home and notified her that we wouldn’t be able to make it and she cheerfully wished him well and said that we could join in two weeks with other new members. He woke up around 1 in the afternoon and moped around all day, dwelling on Friday and the absence of the cake, card, and present. I kept an upbeat spirit, trying to cheer him up, but he insisted on beating himself up.

Although I struggle with depression, sometimes it’s even hard for me to truly sympathize with my husband in his depression. It’s hypocritical, I know. He’s so sweet, loving, and supportive when I’m depressed, but when he is, I try to employ the “pull yourself up by your bootstraps” tactic. I never liked that done to me so what gives me the right to do it to my husband when he’s legitimately depressed?

I try not to. I try to catch myself and empathize with him where he is. I try to be patient, I try to love him and encourage him, but sometimes I feel like he’s stuck in this narrow hole and he doesn’t want to budge.

Talk about the pot calling the kettle black.

Puppy of the Week

Birthday Weekend: Part II

Once I finished my WBC research, I went to bed and covered my head to escape the guilt of not going to work and being a complete loser. Imagining the worst: my co-workers hated me or they thought I’d purposely skipped out on work just for the hell of it. (The latter I’d never do since I had so much work that needed to be accomplished.) I slept the rest of the afternoon and well into the evening. During this time, the hubby freaked and called my mother at work in Manhattan. She dropped everything and hopped on Amtrak from Penn Station to 30th Street Station in Philadelphia.

His parents came over (they live 15 minutes away) and spent time with him, trying to reassure him because he TOO was beating himself up over guilt.

I woke up around 8 p.m. and realized that I couldn’t go to work and make things all better. So I decided to make the best of the rest of my birthday and go to Applebee’s with my family to indulge myself. Unlike many married couples, I love my in-laws and get along quite well with them so it wasn’t a bear to go out and spend time with my in-laws and husband.

My mother arrived just before 10:45 p.m. and gave me the biggest hug. She had a lot of things going on in her life at work (too complicated to explain on a blog), but she dropped everything to be there for me and my husband.

Although most of Friday turned out to be a stinker, Friday night with my husband, in-laws, and mom was awesome. My mother arriving all the way from NY was a real blessing. There was a time when my mother would put work ahead of me (or so I felt), but now she’ll drop everything at a moment’s notice to be at my side when I need her. Her presence was the best birthday present anyone could have ever given me.

P.S. I’m a quarter-of-a-century old. Oh, woe is me! [sarcasm]

Birthday Weekend: Part I

Friday was not a good day.

It was my birthday and the well-wishers poured in like a Miami rainstorm. But I wasn’t in the mood for talking. In fact, I waited for someone to wish me, “Have an unhappy birthday!”

It was a mistake not just on my husband’s part, but mine as well. I was supposed to go to work for my birthday and celebrate with my co-workers but I woke up groggy and my husband immediately assumed that I was coming down with a bad cold or flu or something. I slept and all morning then woke up in the late afternoon. Waking up in the middle of the afternoon after my husband called in sick for me just didn’t make me feel right.

I had a doctor’s appointment at around 3:15 and the news was somewhat hopeful. But at the same time, it raised tiny concerns. I have a low white blood cell count (WBC) that’s been raising some eyebrows. At my last appointment a few weeks ago, my primary care doctor was kind enough to assume, “Hey, it’s probably just your normal WBC or your body’s fighting off an infection, but I’m sending you to a hematologist just to cover all our bases.”

Because of my line of work, I am familiar with reading complete blood count (CBC) data.

Off to the hematologist I went on Friday. My husband took the day off and went with me (he’d had an inlay put in earlier that day). I sat in the waiting room for a half-hour, sulking. Sulking more because I was in a foul mood of not going to work than the long wait. As restitution for my long wait, the doctor was kind enough to offer me Girl Scout de-lite cookies, which despite my aversion to chocolate, I fell in love with. (I’m purposely not buying them lest I blow my recent weight loss.)

The PCP office faxed my lab records from July 2006 and January 2007. My WBC in July was 3.7%. By January, my WBC had dipped down to 3.3%. Considering that the normal range is between 4.0-10.4, the low leukocyte count raised some eyebrows but wasn’t immediate cause for concern. My hematologist laid down the law:

“The normal range is 4.0-10, but it’s based on the average blood cell count of a Caucasian. African-Americans tend to have a lower count, on average.”

Okay, so that’s not so bad. I haven’t been freaking out really. I have severe eczema on different parts of my body (mainly my legs and back these days) so I figure my WBC will always be a little on the low side because I bleed at least once a day and my WBCs say, “Oh no! Platelets and white blood cell counts come together now to fight the evil infection!” The low leukocyte range doesn’t scare me.

What does scare me is a continued dip in my WBC. I’ve got a follow-up hematologist appointment in July. I need to get blood work done sometime in June. If my WBC count dips below 3.3, approaches 3.0, or worse – make a rapid turn for the worse at 2.2 – I’ve got to have – ack! – a bone marrow biopsy.

Read the rest of this entry »

Brain Shivers quote

"The brain shivers are even scarier. If I straighten my head to fast or look up too quickly I get this out of body experience where it feels like I’m being electrocuted. It feels like my brain bounces back and forth. And for those few seconds I am unreachable."

I can totally relate. (quote courtesy Graham’s Blog)

Suicide and baseball

I’m suicidal right now. And it sucks.

According to my mood rating, yesterday I was a 0. Then I forced myself into a 10. I really felt more like a 5. I’m a 3.2 today: moderately depressed, passing thoughts of suicide with some difficulty functioning.

I know exactly what’s triggering my suicidal thoughts: my stupid assumptions about how my co-workers and boss feel about me.

I’m a total people-pleaser. Despite my assumptions, I have a tendency to read people quite well. I can tell when they don’t like me, when they do, and when they’re pretty much ho-hum about me.

I have two co-workers that are basically annoyed with me because of my absence on my birthday Friday (I know this because they were fine on Thursday), my boss is "ho-hum," and the rest of my co-workers don’t really care. (More later throughout the week on my birthday weekend.)

My husband continues to remind me that I need to keep my thoughts focused on God. My suicidal tendencies develop because I’m so self-absorbed that I take my focus off of God.

I want to kill myself as I way to punish my co-workers. There. I said it. I want to kill myself because two people are annoyed with me. (And I know they’ll get over it; they always tend to.) But I can’t stand the cold, stony silence. I can’t stand not knowing what people are thinking about me. I can’t stand the cold e-mails I receive when I try to be warm and friendly.

I have a lot to do at work. I’m a little overwhelmed because I’m still quite new, but I’m doing my best to keep up with things here. I should be currently working, but I’m taking the opportunity to use my 15-minute paid break as a way to relieve the pain that’s beginning to develop in my mind and heart.

It’s totally stupid to kill myself because TWO people don’t like me. I have a whole bunch of family and friends who love me to death (npi) and I’m suicidal because TWO people are currently annoyed with me.

I realize how silly that is.

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I don't have a cold; I am a cold

I’ve been wanting to comment on this for a while, and The Last Psychiatrist reminded me about it:

(NB: "the patient has bipolar," not "the patient is bipolar.")

Precisely. Who goes around linking their illness to who they are? It sounds ridiculous to say, "I am cancer" or "I am diabetes." People have depression; they struggle with bipolar disorder; they suffer from anemia.

I suppose I understand the mistake. (Grammar lesson, folks.) When people refer to themselves as bipolar, it’s being used as a predicate adjective. Americans do this commonly in the English language: "I am ill" as opposed to "I have an illness." Or perhaps, "I am anemic" instead of "I have anemia." It’d be confusing, however, for a person to declare, "I am cold" instead of "I have a cold."

So what’s today’s lesson, kids? Tell people that you have an illness as opposed to saying that you are an illness. Your personality will be less inclined to take a beating.

Credit goes to my husband for reminding me that a linking verb is followed by a predicate adjective. (I initially got the adjective part.) So much for me and my English degree.

I'm articulate. I'm also not "black enough."

Barack Obamaserotoninrain posted a link to a NYT piece about the fallout after Sen. Joe Biden called Sen. Barack Obama “the first mainstream African-American who is articulate and bright and clean and a nice-looking guy.”

Oops. Like the NYT lead-in said:

“Senator Joseph R.  Biden’s characterization of his fellow Democratic presidential contender Senator Barack Obama … was so painfully clumsy that it nearly warranted pity.”

No kidding. Sen. Biden, congratulations. You, like fellow Democrat John Kerry, have shot your presidential aspirations in the foot. Big-time.

Using the word “articulate” in reference to black people is nothing new. In fact, I see Sen. Biden’s point. With all of the ebonics and slang being slung around (how’d ya like that?), it’s difficult to find a black person who is truly articulate.

That’s right. I said it’s hard to find an articulate black person.

Black people under 40 are part of the MTV/BET generation. All that matters is getting girls, being “gangsta,” and C.R.E.A.M. (“Cash Rules Everything Around Me, C.R.E.A.M. get the money, dollar dollar bill, ya’ll!”).

I grew up speaking properly. Teachers and various adults referred to me as “articulate” and “precocious.” I was “well-spoken.” None of those adjectives offended me or my parents. However, black peers shunned me for those very same reasons. My speech and my actions weren’t “black enough.”

Now that Sen. “articulate” Obama is the first real African-American contender for a presidential nomination (Al Sharpton and Jesse Jackson were jokes), blacks are praising him as the second coming. African-Americans love him because Mr. Obama could be the FIRST BLACK PRESIDENT.

Whee. Nevermind that he probably was shunned by his peers for being articulate. Nevermind that black people “hate on” fellow black peers who seem to be “sellouts,” “Uncle Toms,” or “sound/act white.” But when a black person makes history through the very venue that blacks chide against, the black community rallies to protect the person even though he represents the epitome of who they cannot stand.

Black people need to worry about being more “articulate” so that Sen. Biden’s comment doesn’t just sound ridiculous – it would never have any validity.

Blogs vs. Mainstream Media

“Mr. [James B.] Gottstein, [a lawyer from Alaska, who was pursuing unrelated litigation for mentally ill patients in his state], sends [Dr. David Egilman, a consulting witness in ongoing litigation against Lilly] a subpoena for copies. Hell begins breaking loose.” – Tom Zeller, Jr. in The New York Times

I think Furious Seasons originally linked to this (I can’t remember the source of the post), but I read this on the NYT and had a few thoughts, regarding brick-and-mortar courts vs. “teh Internets.”

Warning: Rant ahead.

I can’t help but think back to the 2004 showdown between Dan Rather and CBS (endearingly named Rathergate) vs. political blogs regarding a memo about George W. Bush’s service in the Texas Air National Guard. From NewsMax:

“Added [Matthew] Sheffield [of RatherBiased.com]: A virtual think-tank was born… Forty-seven posts later, a person who called himself ‘Buckhead’ offered the proposition that he thought the documents were forgeries.’

Sheffield and his Web site jumped on the bandwagon, searching the Web for experts on 1970’s typewriters. Another blogger site, PowerlineBlog.com, raised the question of forgery. ‘Matt Drudge and his DrudgeReport.com then linked to the Powerline piece, and the story took off,’ recounted Sheffield.”

Someone please tell Drudge about Zyprexa, Risperdal, Cymbalta, Seroquel, Abilify, and blah blah blah, psych med, blah blah blah.

“Some media observers now contend the “Blogosphere” is rapidly replacing CBS and the rest of the mainstream media.

“You’ll note that several blogs rank higher than mid-size daily newspapers and some are pushing the sites of papers in the top 50 (by daily circulation). The data suggest that the question isn’t “When will blogs arrive?” but rather “Blogs HAVE arrived, what now?” [said Kevin Aylward of Wizbangblog.]”

I’ll probably have a string of quotes from the newsmax article, but I will eventually get to my point.

I quoted this previously, but it’s worth requoting:

“It’s great that [Philip] Dawdy [of Furious Seasons] has stepped up for a huge, mainly voiceless population, but on the other hand, it’s weird to see citizen journalists so responsible for watchdogging our mental health industry. When we hear newspapers complain about declining readership, we can’t help but think it’s mainly because — gosh, this is awkward — the shit they’re reporting on isn’t newsworthy. And this shit is.” – Seattlest

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Fun with ICD-9 codes

I came across a situation recently in which a woman was described having mania in bipolar disorder, but was “diagnosed” with 296.2. And the recommended treatment? Venlafaxine (Effexor).

I swear, sometimes doctors themselves don’t even know what to prescribe.

UPDATE:
Okay, maybe I was wrong?

2007 ICD-9-CM Diagnosis 296.2
    Major depressive disorder single episode
        * 296.2 is a non-specific code that cannot be used to specify a diagnosis
        * 296.2 contains 72 index entries
        * View the ICD-9-CM Volume 1 296.* hierarchy

    Alternate Terminology
        * Depressive psychosis, single episode or unspecified
        * Endogenous depression, single episode or unspecified
        * Involutional melancholia, single episode or unspecified
        * Manic-depressive psychosis or reaction, depressed type, single episode or unspecified
        * Monopolar depression, single episode or unspecified
        * Psychotic depression, single episode or unspecified

So it’s totally possible to have a bipolar episode and be depressed? WTF? Am I depressed with bipolar symptoms or am I bipolar with depressive episodes? Ugh, none of this diagnosis stuff makes sense. Glad I’m not a doctor now.

Abilify phone booth

Sorry I’ve been away so long again. Work slaughtered me; I had a birthday; and I was depressed for pretty much the entire weekend until today. I’ll probably backlog some posts for the week to catch up. I’ll probably still be slow in responding to comments and e-mails. I haven’t kept up on any blogs. I’ll try to catch up as best as I can. Keep in my mind my depression has side-swiped me (sp?) and I’ve jumped up on my Lamictal from 150 mg to 200 mg. The jump knocked me for a loop yesterday afternoon. *sigh*

In attempt to make up for the absence, I have pictures of the Abilify phone booth that I see on my way to work. They’re not of the greatest quality, but you’ll get the idea. Click on the jump for the pictures.

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Quote of the Week

"Here is the test to find whether your mission on Earth is finished; if you are alive…it isn’t." —Richard Bach

Saturday Stats

"Fewer than half of those suffering from depression seek treatment." – National Mental Health Association

The Worst Things To Say To Someone Who Is Depressed: 21-30

This list is divided to have 10 of "The Worst Things To Say To Someone Who Is Depressed" published each week. To see the entire list: go here. The ones that apply to me are bolded.

21. "There is always somebody worse off than you are."

22. "Lighten up!"

23. "You should get off all those pills."

24. "You are what you think."

25. "Cheer up!"

26. "You’re always feeling sorry for yourself."

27. "Why can’t you just be normal?"

28. "Things aren’t *that* bad, are they?"

29. "Have you been praying/reading the Bible?"

30. "You brought it on yourself."

Furious Seasons: Fun With Families

Please go read this post. It’s one of the most insensitive cases of ignorance that I’ve ever read.

I consider myself a suicide survivor, but by many standards, I’ve been told I’m not. Apparently, only families who have been affected by someone who committed – and succeeded at – suicide are  survivors of suicide. *rolls eyes* Pure BS.