Loose Screws Mental Health News

As reported by The New York Times, people with bipolar disorder have a higher risk of suffering from fatal illness according to a study (that reviewed 17 other studies involving more than 331,000 people) reported in the February issue of Psychiatric Services.

In the larger studies, almost every cause of death was higher among bipolar patients: cardiovascular, respiratory, cerebrovascular (including strokes), and endocrine (like diabetes). In the smaller studies, mortality from cerebrovascular disease was higher among those with bipolar illness, but they showed inconsistent results, probably because they used smaller samples or less representative populations.

Gianna at Beyond Meds provides here take here.

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Some crazy nurse in Minnesota convinced a Canadian college student to kill herself and walked her through the process of appropriately hanging herself. Ed Morrissey of Hot Air calls the nurse "the first serial suicide-inciter of the modern age." Couldn't have said it better myself.

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Philip Dawdy at Furious Seasons is on a roll, holding AstraZeneca accountable for its actions regarding hidden information about Seroquel and now he hosts the Seroquel documents — alongside Lilly's Zyprexa documents — that indicate buried studies. Dawdy's also running a spring fundraiser and I suggest you get your butt in gear and donate to him if it's important to you that someone holds pharmaceutical companies accountable for their actions. I've already done my part.

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Sorry this post isn't filled with my normal snark and cynicism. I'm behind on a lot personally — still trying to get the hang of this self-employment thing — and this is what I can throw out for now.

…and on to AstraZeneca's problems with Seroquel

Eli Lilly seems to be passing along its misfortune off to AstraZeneca, which now appears to be having issues with masking evidence of Seroquel side effects. From Furious Seasons:

A great article appeared in the St. Petersburg Times over the weekend, revealing that lawyers for AstraZeneca will argue in court later this month that the company wants documents introduced into a federal court hearing in a case over various allegations around Seroquel sealed and hidden from public view. They want an upcoming hearing in the federal class action lawsuit against AZ closed to the public as well. Lawyers argue that they are protecting patients and, oddly, the public at-large.

Read the rest of Philip's post.

Loose Screws Mental Health News (the ODD version)

I came across an article in my Google Alerts titled, “Harvard study: Under-treatment of mental illness contributes to crime.” Intrigued, I clicked on the link to read more of the article. Turns out the lede is:

Two thirds of prisoners nationwide with a mental illness were off treatment at the time of their arrest, according to a new study by Harvard researchers that suggests under-treatment of mental illness
contributes to crime and incarceration.

The article is poorly titled. The headline was designed to be alarming: “Watch out for those crazy people! They’re violent!” It’s not “under-treatment of mental illness” that “contributes to crime” so much as it is “two-thirds of inmates with mental illness are off medication.” There’s nothing in the article that asserts people with mental illness contribute to the crime rate in America. An interesting read but an inaccurate head.

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The New York Times had an article a few weeks ago on compulsive shopping eventually becoming a legitimate disorder. I’d been wanting to write about this for a while but Gianna at Beyond Meds beat me to it. She aptly titles her post, “It’s called poor impulse control, people .” She writes:

It’s a psychological problem. But let’s relegate out of control shopping to a brain disorder too, so people can have one less thing to take responsibility for. This is really getting ridiculous. Pretty soon we won’t be responsible for any of our bad behavior as it all becomes pathologized and out of our hands. And you can be sure they’ll be a drug for it, too. Since their calling it OCD related it’s a good bet they’ll try out SSRIs.

The DSM-V is currently being crafted in secret but everyone in the medical field fully expects new disorders (such as subthreshold bipolar disorder and Internet addiction) to pop up. Don’t be surprised if CSD (compulsive shopping disorder) pops up in it too. (pic via pro.corbis.com)

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In related let’s-give-everything-a-diagnosis news, some mental health experts are assigning a new label to women obsessed with having children: baby addiction.

…Sometimes the desire to keep having children can be rooted in complex psychological issues dating as far back as one’s childhood. In certain cases, experts say, it can become a compulsion, an obsession or even a “baby addiction.”

While the current book of psychiatric diagnoses, the “Diagnostic and Statistical Manual of Mental Disorders,” has no entry on baby addiction, mental-health professionals say they see patients, mostly women, who desperately want to keep having newborns, even when they already have several children and aren’t managing their family situation well. That, they say, is a big red flag, no matter what term is used to describe it.

“It can be an addiction,” says Gayle Peterson, a family therapist in the San Francisco area and author of “Making Healthy Families.”

Peterson has seen several women in her practice who’ve been overwhelmed with four or five children, including those with special needs. Some of the women were suffering with depression or panic attacks and yet when their youngest child became a toddler, they wanted another baby. These women can be driven to have more children in an effort to make up for some sort of void or loss, usually from their own unhappy childhood, explains Peterson.

“If you’re just having babies to complete something in yourself that never got completed, you really are talking about an addiction,” she says.

While it might be an addiction, it’s not DSM-V diagnosis-worthy and it definitely doesn’t need medicinal treatment. Get some psychotherapy and call it a day. An addiction like this is behavioral more than anything else. (pic via sodahead.com)

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And last but not least, we’ve also got a new case of “climate change delusion.” (Ha!)

Last year, an anxious, depressed 17-year-old boy was admitted to the psychiatric unit at the Royal Children’s Hospital in Melbourne. He was refusing to drink water. Worried about drought related to climate change, the young man was convinced that if he drank, millions of people would die. The Australian doctors wrote the case up as the first known instance of “climate change delusion.”Robert Salo, the psychiatrist who runs the inpatient unit where the boy was treated, has now seen several more patients with psychosis or anxiety disorders focused on climate change, as well as children who are having nightmares about global-warming-related natural disasters.

–snip–

Of course, no one can predict what effect warming will have on our psyches. The links between mental illness and the weather can be tenuous or even downright contradictory. Depending on which studies you read, suicide is more common, less common, or equally common in hot weather. Ditto dry weather.

It looks like my post just turned into an ODD (OverDiagnosis Disorder) case. I’ll get back to you once I’m free of my concern for the environment, my desire for multiple children, and my penchant for window shopping.

Coming off of Lamictal (lamotrigine)

I am officially joining the ranks of those who are facing the challenge of Lamictal withdrawal.

On Wednesday, I went to see my psychiatrist with a plan to come off of Lamictal:

• 150 mg for 3 months
• 100 mg for 3 months
• 75 mg for 3 months
• 50 mg for 3 months
• 25 mg for 3 months
• 12.5 mg (depending on whether my side effects on the 25 mg are bad)

I told him that my husband and I were looking to have a child sometime next year and that I’d like to taper off of Lamictal but was open to the possibility of getting back on it should I encounter severe suicidal ideation and mixed episodes. He warned me against it and thought it was a bad idea.

He proceeded to say that it’s a maintenance medication, I have a lifelong disorder, it won’t just go away, my symptoms would probably return, I have a higher risk of attempting suicide, blah blah blah — am I aware of all these risks?

He explained people with bipolar depression after coming off of meds can actually be worse, undergo severe depressive episodes, have more suicide attempts, and yadda yadda yadda. To sum it all up, I was risking my life just to get off of Lamictal.

My pdoc was trying to scare me into staying medicated.

He then added if I really wanted to come off of my meds, I could “just stop.”

WHAT?! My eyes flew open.

He stated he’d had patients who had stopped cold turkey without a problem. According to him, anticonvulsants don’t have severe withdrawal effects.

WHAT?! His advice just flies in the face of what most doctors recommend. In fact, quitting Lamictal immediately increases the risk of seizures, which is exactly what I’m afraid of.

Philip’s experience and Gianna’s experience along with the comments on each blog are proof that many people have experienced tremendous withdrawal effects from decreasing Lamictal’s dosage. In the past, I’ve quit Paxil and Lexapro cold turkey — both with not-so-good results to put it mildly.

I insisted that I wanted to come off of it slowly so he said I could just cut my 200 mg pills in half and jump down to 100 mg and stop after 2 weeks.

For real? Two weeks, doc? I had a plan that would take me over a year and you’re reducing it to a mere two weeks? On 100 mg dosage?

Again, I insisted that I wanted to take more time. He reluctantly wrote me a 30-day prescription for 100 mg and said since I was off the medication, I had no need to see him anymore. “Good luck,” he flatly told me.

When I came home after the appointment (and a bitching session to my husband), I remembered that I’d stashed a few 150 mg pills away sometime ago after I jumped back up to 200. So as of Wednesday, my arsenal included:

• A bottle of six 150 mg pills
• A bottle twenty-five 200 mg pills
• A prescription for thirty 100 mg pills

I dropped down to the 150 mg on Wednesday and have been doing all right so far. I intend to keep myself at 150 mg (cutting the 200 mg and the 100 mg in half) for at least 2 weeks, then drop down to 75 mg for 2 weeks and then 50 mg for 2 weeks. I’m most worried about coming off of the 25 mg. This is a way more accelerated plan that I hoped for but I’ve got to work with the cards that I’m dealt.

We’ll see what happens.

Bipolar Awareness Month

Apparently February is Bipolar Awareness Month. (Who decided this?) I’m well aware that I suffer from bipolar disorder, thankyouverymuch. Looking forward to Bipolar Overawareness Week in May.

Do I have bipolar disorder because my father had schizophrenia?

According to researchers at Stockholm's Karolinska Institute, schizophrenia and bipolar disorder may have common genetic causes. Researchers studied 9 million Swedish people during a 30-year period and discovered that "relatives of people with schizophrenia or bipolar disorder had an increased risk of both disorders." The study may also suggest that "the two conditions may simply be different manifestations of the same disease."

The article from Reuters also points out that Seroquel and Zyprexa are used to treat both disorders, which may lead people in the psychiatric industry to further investigate the link between the two illnesses. Here are some interesting discoveries from the study:

 *  First-degree relatives (parents, siblings, or offspring) of people with either schizophrenia or bipolar disorder were at increased risk for both of these conditions.

 * If a sibling had schizophrenia, full siblings were nine times more likely than the general population to have schizophrenia and four times more likely to have bipolar disorder.

 * If a sibling had bipolar disorder, they were eight times more likely to have bipolar disorder and four times more likely to have schizophrenia.

 * Half siblings who shared the same mother were 3.6 times more likely to have schizophrenia if their half sibling had schizophrenia and 4.5 times more likely to have bipolar disorder if their half sibling had bipolar disorder. Half siblings who shared the same father had a 2.7-fold increase in schizophrenia risk and a 2.4-fold increase in bipolar disorder.

 * Adopted children with a biological parent with one of the disorders had a significant increase in risk for the other.

Creepy. My father's schizophrenia didn't begin to manifest itself until he was in his 40s. The same is true for my two other aunts as well. It may be silly but I live in fear that I may have the same problem. I'll eventually get a psychiatric advance directive in place just in case that day ever comes. After seeing three family members with debilitating schizophrenia/paranoia, sometimes it gets to the point where the benefits of being drugged up outweigh the risks.

Mood rating: 6

Eli Lilly settles with U.S. Gov't for $1.42 billion over illegal Zyprexa off-label marketing

Yes, you read that right. Eli Lilly has reached a settlement for $1.42 billion with the U.S. government over the illegal off-label marketing of Zyprexa. The company also pleaded guilty to criminal misdemeanor charges. Basically this is how I see it:

U.S. Gov’t: Eli Lilly, you did a bad, bad thing by doing illegal things. Pay a fine, please, and then you can go.

Eli Lilly: Okayyyy. [reluctantly hands over $1.42 billion to the government]

U.S. Gov’t: [slaps Eli Lilly on the hand] Now, don’t you ever, ever do this again!

It’s a record settlement for a whistleblowing case. According to Philip Dawdy at Furious Seasons, Eli Lilly has paid over $2.7 billion in settlement payouts so far. (With certainly more to come.)

Christian counseling: Nouthetic vs. Biblical

Last night, I spent some time on the phone with my husband’s friend’s sister (aka my former pastor’s sister). We’ll call her Natalie.

Natalie was very sweet and kind, really encouraging and strengthening me by sharing her testimony of faith in God. She suffers from anxiety and panic attacks, which has led her to take Paxil (on and off) for the past 7 years. She says the drug has helped her tremendously and who am I to knock the drug (knowing what I know about Paxil/Seroxat) when she has seen the wonders that it has worked in her life?

I briefly explained my story of depression, history of suicide, and diagnosis of bipolar disorder. Although she couldn’t fully relate, she was very sympathetic and understanding. In fact, our conversation was so fruitful, I ended up taking notes!

We briefly touched on the issue of Nouthetic counseling (NC). She has undergone the course and simply needs to be certified. The counselor I currently see is associated with the Christian Counseling Education Foundation (CCEF), which has roots in NC and was founded by the man—Jay Adams—who developed the method. However, CCEF is now known for what is called biblical counseling. The organization has since moved away from pure Nouthetic methods and become more a bit more varied, taking bits and pieces of psychology (and perhaps psychiatry) that line up with the Bible. Adams, disagreeing with the organization’s approach, founded the Institute for Nouthetic Studies and uses the Bible as the sole counseling textbook. According to the wiki entry on Nouthetic counseling, Adams developed the word Nouthetic based on the “New Testament Greek word noutheteō (νουθετέω), which can be variously translated as ‘admonish,’ ‘warn,’ ‘correct,’ ‘exhort,’ or ‘instruct.'”

NC was developed back in the ’70s as a response to the popularity of psychology/psychiatry. Many Christians reject some of the teachings of such popular psychologists as Freud, Jung, Adler, Maslow, etc. Adams’ highly successful book, Competent to Counsel, criticizes the psychology industry and counters its teaching with a Nouthetic approach.

But NC has its Christian critics.

Lamictal in consideration of pregnancy

My husband and I are talking about expanding our family. While that sounds all well and good, I just have one issue:

Lamictal.

For most women, they think, “Well, I want a kid” and the most they have to do is probably get off birth control. Just finish off their contraceptives, maybe feel a little nauseous, and move forward with their plans.

(sigh) Not me. If I want to do this right, it might be a good 6 months or so before I can consider trying.

Loose Screws Mental Health News

• Postpartum Progress reports that the Melanie Blocker Stokes MOTHERS Act bill did not pass. Spreading lies like this did not help.

• The FDA recently approved Stavzor, a valproic acid delayed release capsule, for the treatment of bipolar disorder, seizures, and migraine headaches. Wow. That’s covering the gamut. The drug looks like it’ll be competing directly with the Depakote brand.

The mastermind behind Stavzor is Noven Pharmaceuticals (in conjunction with Banner Pharmacaps Inc.). The new “small, easy-to-swallow soft gel capsule” is available in three strengths: 125, 250, and 500 mgs. The pills are are “up to 40% smaller than han Depakote® and Depakote ER® tablets at the 500 mg dosage strength.” From Noven’s PR:

Stavzor is approved for the treatment of manic episodes associated with bipolar disorder, as monotherapy and adjunctive therapy in the treatment of patients with complex partial seizures that occur either in isolation or in association with other types of seizures, and for prophylaxis of migraine headaches.

The drug will hit the market in mid to late August.

• A recent AP article notes that more than 22,000 veterans contacted the veterans portion of The National Suicide Prevention Lifeline hotline since its inception last July. The government reports that the hotline support has helped to prevent more than 1200 people from committing suicide. The Veterans Administration (VA) estimates that 6500 veterans commit suicide annually. In light of recent news regarding the increase in Marine suicides, the effectiveness of the suicide hotline is offers significant promise.

The hotline receives an average 250 calls each day from veterans that have fought in Iraq, Vietnam, and Afghanistan.

The issue of soldiers with mental illness has recently come to light with studies showing that 1 in 5 soldiers returning from Iraq and Afghanistan have shown symptoms of post-traumatic stress disorder. The issue of the high suicides rate has been a high priority of the VA since mental health director Ira Katz tried to hide the significant number of suicides committed by veterans.

The National Suicide Prevention Lifeline is available 24 hours a day by calling 800-273-TALK (8255); veterans should press “1” after being connected.

• Psychologists are now saying that hitting and yelling at children is causing an increase in mental illness, which has manifested in ages as young as 3 years old. News.com.au reports that 1 in 7 children are affected by a mental disorder.

“We have seen a 60 per cent increase in demand for our child anxiety classes in the past six months,” said [Dr. Kimberley O’Brien, of the Quirky Kids Clinic at Woollahra in Sydney].

It sounds more like the article is speaking of children who are exposed to constant physical and emotional abuse. If that’s the case, shouldn’t there rather be an increase in parenting properly classes?

• Finally, a bit of sad news: police in Connecticut report than 10-year-old killed herself apparently by hanging. Police do not believe that foul play was involved. I can’t imagine being 10 and feeling suicidal. It was tough enough at 14.