Celebrity Sensitivity: Michelle Williams

Michelle Williams, singer most popularly known as part of the trio Destiny’s Child, has revealed that she struggles with depression and has struggled with depression since she was a teenager.

I had to choose to get out of bed and do whatever I needed to do to be happy.

A simplistic approach, but we’ll merely assume that Williams’s depression has been mild.

Sometimes you are going to wake up on the wrong side of the bed or some situation than might have you down in the dumps, but you have to choose to be happy.

According to The Miami Herald, Williams has not taken any medication but has used exercise, therapy, and positive thinking. But Williams isn’t anti-medication either.

Go see a professional so that they can assess you. It’s OK if you’re going through something. Depression is not OK, but it is OK to go get help.

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Loose Screws Mental Health News

Ebselen, an experimental bipolar disorder drug, has been found by British researchers to work like lithium but without lithium’s side effects. In mice. In testing, mice that were somehow made manic with “small doses of amphetamine” were placated with ebselen. Researchers are now moving on to testing on healthy human volunteers before studying those suffering with bipolar disorder.


A study, published in JAMA Neurology, discovered that retired NFL players were more likely to suffer from depression and brain impairment. The study comes on the heels of the suicides of Dave Duerson, Ray Easterling, and Junior Seau. Researchers suspect a link between “hard hits to the head and depression.” These problems have also been noted in NHL players and combat soldiers who have suffered a brain injury. Many of the retired NFL players developed a type of brain damage called chronic traumatic encephalopathy (CTE). Duerson and Easterling were found to have CTE during autopsy. In related sports news, the UK’s Telegraph reports that depression is a problem for soccer players in England and Scotland.


According to Time magazine, ketamine—a drug that induces hallucinations and other trippy effects—may hold potential as an antidepressant.

And now scientists report on two formulations of drugs with ketamine’s benefits, but without its consciousness-altering risks, that could advance the drug even further toward a possible treatment for depression.

Ketamine is seen as a fast-acting antidepressant for those at high risk for suicide. GLYX-13, mentioned here previously, is a ketamine-like antidepressant currently in clinical trials. AstraZeneca has AZD6765, a “ketamine mimic” that does not appear to be as effective as actual ketamine.

New research has discovered that people with mental illness are more likely to be victims of domestic violence. Even though the study evaluated men and women, the results for women were overwhelmingly striking.

It finds that women with symptoms of depression were 2.5 times more likely to have experienced domestic violence over their lifetimes than those in the general population, while those with anxiety disorders were more than 3.5 times more likely to have suffered domestic abuse. The extra risk grew to seven times more likely among those with post-traumatic stress disorder.


An analysis of more than 1 million Scandinavian women has shown that taking SSRIs during pregnancy may not increase the risk of stillbirth. This study could help revolutionize treating depression in pregnant women.

“From our study, we don’t find any reason to stop taking your medication, because untreated depression may be harmful for the pregnancy and the baby,” [Dr. Olof Stephansson, the lead author of the new report] told Reuters Health.


Finally, “gender identity disorder” has been removed from the DSM-V and has been replaced by “gender dysphoria,” a condition in which people are concerned about their gender identity. “Gender identity disorder” seemed to stigmatize gays, lesbians, and transgender individuals. The continuing inclusion of “gender dysphoria,” however, ensures that people suffering with gender identity disorder still have access to health care treatment. (In my opinion, the renaming of “gender identity disorder” to “gender dysphoria” is really a politically correct change. Homosexuality was removed from the DSM back in 1973.)

Loose Screws Mental Health News

An antipsychotic inhalation powder has been approved by the FDA for the treatment of agitation in adults with schizophrenia or bipolar I disorder. While loxapine (brand name: Adasuve) by Alexza Pharmaceuticals acts rapidly, the side effects include “bronchospasm and increased mortality in elderly patients with dementia-related psychosis,” according to Medscape. In case you don’t know, bronchospasm can lead to acute respiratory problems in people with lung disease, asthma, or COPD (chronic obstructive pulmonary disease).

Plans are for the drug to only be accessible through a medical facility with the ability to treat bronchospasms.

In related and somewhat interesting news, the Medscape article also notes that 3.2 million people in the U.S. are being treated for schizophrenia or bipolar I. “Of these, approximately 90% will develop agitation during the course of their illness.”

That’s an incredibly high number of people who develop agitation. Just sayin’.


According to an article in U.S. News & World Report, patients in a study dealing with depression seemed to have high levels of C-reactive protein (CRP), a marker for increased risk of heart and inflammatory disease. The lead researcher notes that “people with increased CRP have a two- to threefold risk of depression.” It is not clear whether CRP causes depression or is simply a sign of it. Increased levels of CRP tend to be seen in obese patients and those with chronic diseases.

“More than 21 million Americans suffer from depression, a leading cause of disability, according to Mental Health America.”

Note: the 2011 estimate of those residing in the U.S. stands at more than 311 million.


Depression is increasing among Japan’s public school teachers.

“A report by the Ministry of Education, Sports, Culture, Science and Technology shows that in 2011, around 5,200 public school teachers had to go on sick leave due to various mental illnesses, including severe depression.”

The Japan Daily Press article also notes:

“The study also highlights the fact that the main reason for the increasing depression is a school environment that puts too much workload and pressure on the teachers that they cannot have a healthy work-life balance anymore, much less deal with students, their guardians and the paper work that comes with all of these. (emphasis mine)

I recently finished a book by actor Tony Danza called I’d Like to Apologize to Every Teacher I Ever Had in which he chronicles his yearlong stint in Philadelphia’s inner city public school system. He echoes some of these sentiments as well. After trying to teach his students, he notes that it is difficult not to get involved in their personal lives as well. In the Epilogue, Danza writes:

“…I can only do so much. Where does teaching stop, and start? Where should it? I don’t really know. To engage my students, I found that I had to become engaged in their lives, their problems, and their futures. That connection was what made the job the most rewarding. Yet it was also the intensity of that involvement that, by the end of the year, had made the job of teaching so much tougher than I’d ever expected.”

It seems that Japan’s public school teachers are no different from American public school teachers.


Although 38 states require mental health background checks, only a quarter of states actually report their statistics to the federal NICS (National Instant Criminal Background Check System).


And surprise, according to a recent study, pot could lead to psychosis in teens or teens who smoke pot can later develop psychosis. I find it interesting that teens were actually evaluated after smoking pot.

Loose Screws Mental Health News

According to an article in USA Today, researchers have found that siblings who argue could have negative effects on their mental health.

Researchers report that conflicts about personal space and property, such as borrowing items without asking and hanging around when older siblings have friends over, are associated with increased anxiety and lower self-esteem in teens a year later. And fights over issues of fairness and equality, such as whose turn it is to do chores, are associated with later depression in teens.

I’d like to tell these siblings to get over it, but I don’t have any siblings of my own to relate my experience to.


PBS’s Frontline reports that most soldiers who commit suicide have never seen combat or even been deployed. According to the Defense Department, the Army has the sharpest rate of suicides of all the military branches. About 53 percent of military personnel who took their lives in 2011 had no history of deployment to active combat zones such as Iraq or Afghanistan. Even more troubling is that 85 percent of those who committed suicide may have been deployed but not involved in direct combat. Even though the military has invested $50 million to study mental health and suicide, a stigma of getting help still remains. It seems as though military personnel would rather take their own lives than seek help.


An antidepressant called GLYX-13, currently under study, appears to work within hours and last for up to a week. The lead researcher reports little to no side effects on the drug, which is injected intravenously. The drug is in phase 2, which means that its effectiveness and safety are still being tested. I have my doubts about an intravenous drug. If doctors are not currently testing patients’ serotonin levels, how would they be able to prescribe an intravenous antidepressant?


Depression has passed asthma as the top disability among North American (U.S. and Canadian) teens.

Asthma had been the largest contributor to YLDs (years lived with disabilities) for youths in that age range in the US and Canada in 1990, but the study published in The Lancet on Thursday led by researchers at the Institute of Health Metrics and Evaluation (IHME) at the University of Washington, Seattle showed that in this group depression surpassed asthma to claim the number one spot in 2010.

Back in the 1990s, depression was not widely regarded or evaluated among teens. It was still “suck it up” and “pull yourself up by your bootstraps.” My depression was viewed as laziness or “senioritis” among my teachers. I had no sympathy and very little leeway. Now, mental health is being taken more seriously for teens, and I think that’s a good thing.


See you if you can keep an elder person in mind during this holiday season. Senior depression is always on the rise during the holiday season due to problems with health, loneliness, or finances.

Anxiety. Depression. Suicidal Thoughts.

Anxiety. Depression. Suicidal thoughts. They are all rolled up in one.

I am anxious about a lot of things these days. From something as mundane as sitting here typing on the computer to driving to cold calling a prospective client (which may never pan out because I’m too anxious to call right now). My anxiety has been debilitating in the past where I didn’t want to leave my home, and I fear it’s getting to the point of debilitation again on some days.

My anxiety depresses me. It keeps me from doing things that no one would think twice about. But here I sit, a prisoner in my own body, freaking out about nearly everything. To escape this, combined with my severe lethargy, I crawl into bed and sleep, hoping that when I wake up, things will be better. But they usually are not.

Please don’t get me wrong. I have a life many people would envy: a loving husband, a supportive family, and a steady job. I am thankful for the good things in my life. But this attitude of thankfulness and gratefulness doesn’t take away the depression inside of me.

I do not want to go back to the hospital. If I fear anything worse than death, it may be going back to a psych hospital. I have passing suicidal thoughts about hanging myself, but I haven’t been able to act upon it. I can’t determine whether I am a harm to myself in which case I would need to go to the hospital. The point of the hospital (for me) is to get me away from things that would cause immediate harm to myself. But I can’t be locked up in a hospital forever. (I guess I could in a state institution but that would be a nightmare.)

Somehow, existing in this jumbled mix is me. Somewhere inside, I am bubbly, wonderfully wacky, and beautifully strange. The depression and anxiety fuzz all of that. I am only some of what I used to be. I go to sleep, hoping for some kind of reprieve from this dark cloud that hangs over me.

What is depression like?

For me, it’s like losing pieces of myself . . . one by one. The things that used to interest me aren’t so interesting anymore.

What’s depression like for you?

Lamictal and Abilify: Back on Medication

Images from rxlist.com & drugs.com

After 2 years of not being on medication, I am back to a daily regimen of lamotrigine (Lamictal) and aripiprazole (Abilify) with lorazepam (Ativan) as needed.

Many of you may know, or may not know, what I decided to taper off of medication so that I could get pregnant. Well, that hasn’t happened. And my thoughts got to a point where it became life and death again. I didn’t want to go back to the psych hospital so I asked my psychiatrist for help.

My psychiatrist (God bless him) is a very conservative psychiatrist. He was the one who helped me off of medication 2 years ago, and he’s the one titrating my dosages up now. Lamotrigine is for long-term maintenance of the bipolar disorder, aripiprazole is for short-term maintenance of bipolar disorder and SAD (seasonal affective disorder), and lorazepam assists with severe anxiety as needed. I started taking the medication four weeks ago, and I’m only on 50 mg of lamotrigine and 5 mg of Abilify. There will be no increase on Abilify and I titrate up on lamotrigine every 2 weeks. My next big jump is 100 mg.

My psychiatrist expects me to come off of aripiprazole within the next few months (hopefully by December). If not, I will have to get regular blood sugar and cholesterol tests performed. He will adjust all medications as necessary in the event that I am pregnant. He’s a great psychiatrist; he’s willing to work with me based on my situation rather than him throwing drugs at me. He allows me to have complete control over my treatment regimen, which is something I like and respect.

In the past, I may have come off as anti-medication, but really, I’m not. I advocate for use of medication in a necessary, responsible manner. In 2010, 253 million prescriptions were written for antidepressants.¹ (Keep in mind that the U.S. is estimated to have 307 million people in the country.² That’s about 82.4% of the population taking antidepressants.) This is not responsible; this is too much. In the comments, people have rightly corrected me in the assumption that 1 person can get multiple prescriptions in a year; I failed to remember that.

Let’s assume a person is on 1 antidepressant (the majority of people take 1). Beginning in January, that person gets 5 refills for 30 days. By May, the person will need another 5 refills. Then another prescription is dispensed in October. That’s 3 prescriptions per person. Of course, this can vary depending on how often the doctor will see a patient so let’s generalize and say 5 prescriptions per person per year. My calculations for prescriptions per American mean that nearly 20 percent (about 17%) of the population is on antidepressants. Sure, it’s not my original ridiculous number of 82.4%, but I still think this is pretty high. (By the way, feel free to correct my stats in the comments if necessary; I don’t claim to be a math wizard.)

While I am not on an antidepressant, I am one of the millions of Americans who is on medication for mental illness. For 2 years, honestly, I’d forgotten I had anything relating to mental illness. It was nice to wake up and be myself without thinking about me plus bipolar disorder. Every morning and every evening, it’s now me plus bipolar disorder plus SAD plus anxiety. These are all real symptoms that need to be managed. I don’t want to be dependent on this medication forever, but I may have to. If it helps me manage my suicidal thoughts and function with people in life, then it’s worth it.

Your turn: What do you think about taking psychotropic medication? Do the symptoms outweigh the risks for you? What’s been your experience in taking (or not taking) psych meds?

Notes:

1. Shirley S. Wang, “Antidepressants Given More Widely,” The Wall Street Journal. Published on August 4, 2011. Available at: http://online.wsj.com/article/SB10001424053111903885604576486294087849246.html. Accessed October 20, 2011.
2. Google Public Data Explorer. Population in the U.S. Last updated: July 28, 2011. Available at: http://www.google.com/publicdata/explore?ds=kf7tgg1uo9ude_&met_y=population&tdim=true&dl=en&hl=en&q=us+population. Accessed October 20, 2011.

Celebrity Sensitivity: Catherine Zeta-Jones

Image from people.com

Of all the celebrities I would have pegged with some kind of mental health disorder, Ms. Zeta-Jones would have never made the list. After supporting her husband Michael Douglas through his cancer treatment, she remained quiet about herself only outspoken on issues pertaining to how upbeat and positive the couple was on Douglas’s treatment.

But clearly, being a bedrock for her husband has taken its toll on her. Last week, she checked into a mental health facility seeking treatment for her bipolar II disorder. Bipolar II is characterized by frequent depressive episodes rather than a constant swing of manic-depressive ones. While only Ms. Zeta-Jones knows what’s been going on inside her mind and her heart, I can only imagine that she’s been suffering with some depression for a while but quietly put it aside as her husband struggled to become healthy again.

In the past, I’ve used the Celebrity Sensitivity feature of this blog to mock celebrities who seem to be diagnosed with nearly any mental illness fad that goes around (normally, depression), but this time my heart goes out to Ms. Zeta-Jones who decided to seek treatment for herself instead of putting on a face like everything’s okay and toughing it out.

My Dark Passenger: The Suicide Side

Image from zazzle.com

Although I’m not a fan of the Dexter books or TV series, I’ve been introduced to both by way of my husband who enjoys both forms of Dexter media.

The other day I flipped through Jeff Lindsay’s latest, Dexter Is Delicious, and read a little bit about the part of Dexter that he calls his “Dark Passenger,” the voice inside of him that compels him to kill. (But he justifies this by killing murderers. An interesting twist on the anti-hero.)

I ruminated on this as I’ve been dealing with a lot of suicidal thoughts lately. And really, there’s nothing wrong in my life that would cause these suicidal thoughts to arise. It’s just something in me gone haywire. It’s like a part of me that’s not really a part of me that I can kind of talk back to. It sounds otherworldly and crazy.

It is.

So I’ve taken to calling the suicidal voice (unlike Dexter’s homicidal one) in my head the “Dark Passenger.” My husband kind of likes this too as it identifies something that’s not really me although it’s a part of me.

The Dark Passenger is pretty random these days. Even if I have a slight mood crash, he’ll—because my sinister voice is clearly not a seductive she, maybe androgynous—tell me that life is not worth living and to go kill myself.

Me: What?
Dark Passenger: Go kill yourself. Life isn’t worth living anyway. You’re a total failure and you know you can’t do anything right.
Me: Um, why are you bugging me? I’m not even depressed right now.
Dark Passenger: [silence]

Yeah, that’s pretty much how our conversations go. It probably sounds a bit schizophrenic or something but that’s basically my stupid battle to stay alive. You can probably imagine how terrible our conversations are when I am depressed.

My Dark Passenger’s a bit starved, you see, because I haven’t tried to kill myself in a while and he’s getting antsy. I was last hospitalized for a suicide attempt in 2006 and even though I’ve had a few half-hearted attempts since or serious thoughts about an attempt, I haven’t had a serious attempt that has required me to be locked away for a good bit of time. I still get freaked out about my near-sexual assault encounter and that’s done a good job of keeping me in check for now.

So the Dark Passenger tries to get me whenever he thinks he’s got an opening:

No one signed up for your class. You’re a loser. Go kill yourself.

She never called you back. See? No one likes you. Go kill yourself.

You can’t get pregnant or do anything right. You’re not cut out to be a mother. In fact, you weren’t meant to be one because you need to go kill yourself.

And on and on and on. It’s easy to tell him to shut up when I’m not deeply depressed. Not so much otherwise.

Maybe there’s something to that “Get behind me, Satan” stuff after all. D. Martyn Lloyd-Jones, a famous British preacher, once suggested in his book Spiritual Depression to “talk back” to one’s negative voices. While it doesn’t work in the most severe of cases for me, it works. . . for the most part.

Quote of the Week

“It seemed like this was one big Prozac nation, one big mess of
malaise. Perhaps the next time half a million people gather for a
protest march on the White House green it will not be for abortion
rights or gay liberation, but because we’re all so bummed out.” —
Elizabeth Wurtzel

Quote of the Week

“For me being depressed means you can spend all day in bed, and still not get a good night’s rest.” — Unknown

Should psych drugs be avoided at ALL costs?

My brain isn’t functioning today quite honestly so my apologies if the following makes no sense whatsoever. It’s long and I ended up rambling.


Lately, I’ve been thinking about whether there are any benefits to using pharmaceutical drugs. I have blogger friends who are very much anti-pharmaceuticals anything, try to avoid drugs as much as possible but take them if necessary, or think pharmaceutical drugs are a Godsend.

I’m still trying to figure out where I stand.

Pharmaceutical companies are in the business of making money. It is not to their advantage to put out completely shoddy products that do not work. I’m sure many of them bury negative data and findings that do not shed a positive light on their drugs but if something works overall, they’ll put it out there. I don’t believe the doctors who are involved in these trials are all dirty, rotten sell-outs. Some of them are very well-meaning and honest who work to make these drugs as effective as possible. Call me naïve if you like but I just can’t bring myself to believe there are more greedy docs who skew results than there are those who are concerned with advancement.

I don’t think twice about popping Excedrin Migraine when I’ve got a painful, debilitating migraine; I have no problem taking naproxen (aka Aleve) when I’ve got menstrual cramps, and taking ibuprofen isn’t an issue if I have severe muscle pain. I don’t question the safety of these drugs. I’ve used them for so long, they’ve proven to be relatively safe for me (not everyone can tolerate those drugs) and efficacious. The safety risk of taking Excedrin Migraine sometimes outweighs the benefits of not taking it. (Note: I only speak of adults in terms of ingesting this kind of medication.I don’t believe developing bodies, such as youngsters, are able to handle medication that can significantly affect mood.)

When it comes to psych meds, I am not anti-medication. Psych meds should be taken on a case-by-case basis. There are some people who consider these meds to be a life-saver while others complain that it has made them miserable and worsened their lives. This is the gamble people take when choosing to ingest a psych med—most people don’t know that. Trouble is, most people don’t know when the stakes are high enough to take that risk.

I shouldn’t be in a position to judge anyone but when I hear people taking antidepressants based on circumstances—a job loss, failed relationship, loss of a life—I worry that it’s unnecessary. We are becoming a nation that is more reliant on “quick fixes” rather than developing coping mechanisms. It’s easier to pop a pill and dull your emotions than it is to face problems, tackle issues head on, and learn to work your way through it. Case in point: rising unemployment hasn’t slowed sales of antidepressants or sleeping pills.

  • I have an aunt who was a violent paranoid-schizophrenic. She was placed in a mental institution and drugged up the wazoo. Now, she’s basically existing; the lights are on but no one’s home. The drugs have killed her. She’s alive but not really.
  • My father was a non-violent paranoid-schizophrenic. It got to the point where we needed to medicate him to get him on track. The medication helped him to function “normally” but his thought processes and physical ability was significantly slowed. He once told me that he felt useless because my mother was busting her butt at work to pay for my college and he was basically an invalid because his mental illness had prevented him from being able to work. He died 4 months later. A few days after the funeral, my mom began to find his psych meds hidden all around the house. I often wonder if the drugs killed him.
  • Another aunt (this is all on the paternal side of the family) also became a paranoid-schizophrenic. She was a brilliant woman who was basically reduced to moving from place to place to the point where she eventually became homeless and could not hold down a job. She disappeared for a while but during one cold winter, was found and brought into a homeless shelter. She was placed on meds and her cognitive functions returned despite the fact that her speech was sometimes garbled. She traveled the world, went on cruises and various excursions. The change was remarkable. Psych meds improved her life and saved her—the benefits of the drugs outweighed the side effects.

As I withdraw from Lamictal, I am curious to see who I am without this drug. Will my creative juices flow freely once again or are they now somewhat hindered? Will my cognitive functioning correct itself or will I forever suffer from problems? Will my short-term memory loss issues smooth out or will I still suffer from intermittent forgetfulness? I have some side effects that may remain with me for a while or perhaps forever (though I hope not) but seeing others fully recover after taking drugs for 10 times longer than I have gives me hope.

I feel the majority of my progress has come from intensive counseling and being infused with the truths as laid out in the Bible. I’d say 90% of my progress has been due to counseling. I give the meds 10%. You can tell I don’t place much stock in them. But they’ve helped to cut down on the mixed episodes.

So far, I haven’t had any suicidal thoughts are behaviors that are out of the ordinary. (Thank GOD.) I’ve been dealing with a mild depression but that stems from basing my worth based off of my career rather than any biological imbalances. The last time I suffered a severe depression, I was on Lexapro (if that tells you anything).

I’ve gotten a lot of resistance and concern from family members who question my decision to come off of the medication. They’ve seen a miraculous change in me and attribute it to being on meds. Meds aren’t a cure-all. They don’t see the counseling and shifting of thought processes going on that has helped me to develop coping mechanisms. Meds may help people “cope” but they don’t develop the tools needed to cope.

I’ve decided that I’ll probably give that Christian psychiatrist a call. My counselor recommended him and she said that he’s very neutral on meds and doesn’t shove them on anyone. I mentioned that I wasn’t sure if anyone would accept me as a patient only to lose me in the end—she insisted he wouldn’t mind. The intake cost is hefty but since I was able to temp a few days for my job this week—I’m not permanently returning, I can swing it.

Which brings me back to my position on psych meds: I said it earlier but I think it’s a case-by-case basis. In my personal life, I’ve seen the benefits outweigh the side effects and I’ve seen the side effects outweigh the benefits. And I’ve seen benefits (not necessarily beneficial) as a result of side effects. Psychiatry is the biggest medical guessing game of all medical specialties. There are no certainties, and there’s no one medication that works best for everyone. Pharmaceutical companies make it a point to put the disclaimer on the patient information sheet that they’re not exactly sure HOW these drugs work. All that stuff about serotonin, dopamine, and neurotransmitters is pure speculation when it comes to depression. You’ll have me convinced about chemical imbalances once I can get a MRI and blood test done. Until then, it’s all trial-and-error.

So if I do suffer from relapses while withdrawing from this medication and it gets to the point where I may need to be hospitalized, I’m not averse to remaining on the drug. Better to be alive and on a psych drug than dead because I was determined not to use it at risk to my safety. If I end up having to stay on the drug, the future of giving birth to children will seem a bit more uncertain.

Joy vs. Happiness

joyJoy has always been an issue that I’ve wrestled with. Nehemiah 8:10 says, “Do not sorrow, for the joy of the LORD is your strength.”

I’ve been a born again Christian for more than 10 years and the one thing I can’t seem to get a handle on is joy. I’ve had many people advise me that one of the hallmarks of being a Christian is being joyful. Galatians 5:22 lists the fruit of the Spirit; joy being secondary in the list next to love.

Thelma Wells The November/December 2008 issue of Today’s Christian Woman (TCW) published a special section that focused specifically on the topic of joy. TCW editor Ginger Kolbaba interviewed Thelma Wells, a popular Christian speaker and author who struggled with cancer. If anyone would know about the highs and lows of joy, it’d be a woman who was placed on life support with the grim prognosis of impending death.

The entire interview is worth reading but Ginger asks Thelma key questions that elicit winning answers—one of them being that people don’t lose joy but rather, it goes “underground.” I’ve highlighted a few of Thelma’s answers that I really identified with.

TCW: What gets in the way of us truly experiencing joy?

THELMA: Trying to be somebody we’re not. God made us wonderfully in his image. But we look at life from the eyes of our culture: where I should live, what I should drive, where my kids should go to school, what I should have in my house. We compete for status, for recognition, for all these things that mean little or nothing in the end. And when we do that, we become confused about who we serve and why we serve.

If we aren’t careful, we can become so depressed and confused and overwhelmed that our joy goes underground. [emphasis mine]

Here I can identify the source of my lack of joy: discontentment. I’m not discontent with my family or my friends or most of my circumstances, however, I am continuously discontent with myself. I am always trying to be—or wishing to be—someone I’m not. I am never satisfied with the person God made me. I try to be a social chameleon but never quite succeed (in my own mind anyway). Discontentment with myself breeds depression in my life.

Read the rest of this entry »

Loose Screws Mental Health News

Portland, Oregon has been recently declared the most depressed city in the country. BusinessWeek determined this based on “antidepressant sales, suicide rates, unemployment, divorce, and crappy weather.” Philly didn’t make the top 20 list. That’s because we’re too busy enjoying the highest suicide rate in the country.


smokingA great way to avoid depression, however, is to simply stop breathing. Yes, that’s right. Just stop breathing. A new study presented at an American Psychological Society meeting shows people who are consistently exposed to secondhand smoke are twice as likely to suffer from depression. So that’s my recommendation to you: STOP BREATHING. I guarantee you won’t be depressed after a while. (By the way, that’s a joke so you can go ahead and take a deep breath now.)


Apparently all this talk of an economic depression is causing people to be depressed enough to buy more antidepressants. I don’t get how it works but it seems as though antidepressant prescriptions (along with sleeping aid prescriptions) are rising alongside the unemployment rate in this country. Big Pharma isn’t filing for bankruptcy anytime soon. And if they do, it’s their own freakin’ fault.


In what appears to be a landmark ruling (correct me if I’m wrong), the U.S. Supreme Court ruled that pharmaceutical companies are still liable for injuries cause by FDA-approved drugs and devices and juries can legitimately award damages. The buzzword I’ve learned for this case is preemption.

A woman who was injected with an antinausea drug (Phenergan, if you’re wondering) brought a damage suit against Wyeth after her arm had to be amputated. After a jury awarded her with $6.7 million, Wyeth took the case to the U.S. Supreme Court, expecting a cool victory after the court sided with Medtronic in last year’s Riegel v. Medtronic case. Wyeth, the defendant in the case, hoped the Supreme Court would rule in their favor since the FDA had already evaluated their product for safety—a preemptive act. However, this time the court ruled 6-3 in favor of allowing the woman to keep her award money. The decision also sets a precedent for pharmaceutical consumers to sue pharmaceutical companies for injuries despite FDA approval—striking down preemption. For further information, check out Doug Bremner’s and Philip Dawdy’s blogs that have already covered this. In the meantime, I leave you with this:

Ronald Rogers, a spokesman for Merck, said, “We believe state courts should not be second-guessing the doctors and scientists at the F.D.A.”Merck was hit with several huge damage awards over its painkiller Vioxx before agreeing to a $4.85 billion settlement in 2007. Allowing juries to make determinations about drug risks, Mr. Rogers said, would cause “mass confusion.”

Hm. Make of that what you will.

…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.

Antidepressant rankings: Zoloft and Lexapro considered best overall

A number of antidepressants were recently ranked in different surveys:

Zoloft and Lexapro came in first for a combination of effectiveness and fewer side effects, followed by Prozac (fluoxetine), Paxil (paroxetine), Cymbalta, and Luvox among others.

The first was efficacy — or how likely patients were to experience the desired effects of the drug.

Efficacy:

1. Remeron (Mirtazapine)
2. Lexapro (Escitalopram)
3. Effexor (Venlafaxine)
4. Zoloft (Sertraline)
5. Celexa (Citalopram)
6. Wellbutrin (Buproprion)
7. Paxil (Paroxetine)
8. Savella (Milnacipran)
9. Prozac (Fluoxetine)
10. Cymbalta (Duloxetine)
11. Luvox (Fluvoxamine)
12. Vestra (Reboxetine)

The second was acceptability — the likelihood that a patient would continue using a drug for the duration of the study (it is generally assumed that a high ratio of patients dropping out indicates the presence of undesirable side effects for a drug).

Acceptability:

1. Zoloft (Sertraline)
2. Lexapro (Escitalopram)
3. Wellbutrin (Buproprion)
4. Celexa (Citalopram)
5. Prozac (Fluoxetine)
6. Savella (Milnacipran)
7.
Remeron (Mirtazapine)
8. Effexor (Venlafaxine)
9. Paxil (Paroxetine)
10. Cymbalta (Duloxetine)
11. Luvox (Fluvoxamine)
12. Vestra (Reboxetine)

antidepressantsMy experience with Lexapro was a disaster and I’ve written about Zoloft’s connection with irritability and rage. Paxil’s side effects are especially rough (see Bob Fiddaman’s Seroxat page) while Effexor’s withdrawal effects proved to be significantly challgenging. Although Prozac offset Effexor’s withdrawal symptoms, it causes severe somnolence that can impair cognitive functioning. And last but not least, Cymbalta contributed to the unfortunate death of Traci Johnson who had no history of depression.

These drugs may be effective for many people but it’s still a guessing game. Dr. Mark I. Levy, quoted in ABC News’s article on the rankings, mentioned that while psychiatrists may not have much use for the rankings, he sees them as beneficial for primary care physicians. And Dr. Harold G. Koenig, a professor at Duke University Medical Center, adds:

“I would be likely to start patients on either Zoloft [because it’s cheaper] or Lexapro … Unfortunately, that is almost none of my patients. By the time they get to me [a psychiatrist], the primary-care doctors have tried Zoloft and other antidepressants, so my patient are not the “new to medication” kind of patients,” he said.

I won’t rehash my thoughts on PCPs prescribing antidepressants and other psych meds. You can read about them here.

Loose Screws Mental Health News

ReadWriteWeb reports Stony Brook University researchers discovered too much exposure to “texting, instant messaging, and social networking” can make teenage girls more likely to suffer from anxiety and depression. This landmark discovery sampled a whopping 83 teenage girls.

computer useThe results of their tests, recently published in The Journal of Adolescence, showed that the girls who excessively talked with their friends about their issues had significantly higher levels of depression. Today’s online tools provide even more ways for this to occur. Says Dr. Davila, “Texting, instant messaging and social networking make it very easy for adolescents to become even more anxious, which can lead to depression.”

The problem with these electronic tools du jour is that they allowed the girls to discuss the same problems over and over again. This caused them to get stuck obsessing over a particular emotional setback, unable to move forward.

–snip–

It’s not necessarily the medium through which the chatter tasks place that’s the issue – it’s the amount of discussion that leads to the feelings of depression. Said Dr. Davila, “[The girls] often don’t realize that excessive talking is actually making them feel worse.”

So we can conclude then that keeping your teenage daughter from MySpace, Facebook, Twitter, AIM, and texting will help improve her mental health so she’s less likely to be depressed. Back in the day, I just wrote morbid poetry in a sad, lonely marble notebook. Alas, those days are gone. (pic via reviews-for-you.com)

On a related note, another study has discovered that teens who watch TV for long periods of time are more likely to be depressed. (Does nearly everything cause an increased risk of depression these days?) The study tracked over 4,000 teenagers and their TV-watching habits. The conclusion? Seven years later, participants were more likely to be depressed and the risk increase with each hour of television exposure. Perhaps it’s because TV creates an unrealistic perception of how a person should look and act and how life should be. Although researchers of the study did note that exposure to electronic media yielded the same result.

PregnantOn the Christian tip, I need to once again dispel this nasty rumor that the MOTHERS Act is intent on drugging pregnant women (and thereby the baby) to oblivion. (I addressed this issue around this time last year once again from Christians who think some left-wing liberal nuts are out to “indoctrinate hundreds of thousands of mothers into taking dangerous psych drugs.”) Once again, I need to repost the goal of the MOTHERS Act as stated in the original bill:

To ensure that new mothers and their families are educated about postpartum depression, screened for symptoms, and provided with essential services, and to increase research at the National Institutes of Health on postpartum depression.

The legislation is only intended to increase the resources for screening of mental issues in women. Women will NOT be forced to take medication if they do not want it.

In the Congressional findings, medication is mentioned only as a form of treating PPD. That’s not directly encouraging new moms to take drugs; it’s encouraging them to seek treatment, whether it be therapy or some other course. Not every new mom will need therapy, hospitalization, or medication, and this bill is far from attempting to “indoctrinate” moms with psych drugs. Also, the bill only mentions “medication” once. It does not even use the word “drug.”

It’s unfortunate to hear stories of women who suffered miscarriages or acted erratically as a result of medication. However, postpartum depression has become such a prevalent issue that proper screening — not necessarily medication — is needed. And the mother in conjunction with her doctor must make an informed and appropriate decision on how to proceed with treating her mental health. A great resource on the MOTHERS Act can be found at Postpartum Progress where blogger Katherine Stone vigilantly monitors the progress of this bill and clearly lays out what the bill entails:

  • Encouraging Health and Human Services (HHS) to coordinate and continue research to expand the understanding of the causes of, and find treatments for, postpartum conditions.
  • Encouraging a National Public Awareness Campaign, to be administered by HHS, to increase awareness and knowledge of postpartum depression and psychosis.
  • Requiring the Secretary of HHS to conduct a study on the benefits of screening for postpartum depression and postpartum psychosis.
  • Creating a grant program to public or nonprofit private entities to deliver or enhance outpatient, inpatient and home-based health and support services, including case management and comprehensive treatment services for individuals with or at risk for postpartum conditions.  Activities may also include providing education about postpartum conditions to new mothers and their families, including symptoms, methods of coping with the illness, and treatment resources, in order to promote earlier diagnosis and treatment.

Although a vote on the act was blocked in the Senate in September, Sen. Robert Menendez of NJ has reintroduced the bill, championing the cause for PPD awareness at the federal level.

And on a humorous note, if you are single and mentally ill, you can go to TrueAcceptance.com and find someone who suffers from mental illness just like you. That’s right, TrueAcceptance matches the mentally ill with… the mentally ill. The premise is based on the idea that matching people who both suffer from mental illness are more likely to understand and support each other. The idea amuses me but I’d be too afraid that being with someone else who suffers from mental illness would end up being an enabler. (via Fox News)

Celebrity Sensitivity: Lily Allen

Lily AllenFor those of us not hip-to-the-jive, Lily Allen is a British pop singer who allegedly attempted suicide when she was a teen. Celebrity blog Pop Crunch reports:

The 24-year-old singer was committed after she was left so distraught by the breakdown of her first romance that she tried to “slit her wrists,” the 24-year-old singing star’s half-sister has revealed to a British tabloid.

“Aged 18, she tried to slit her wrists when her first relationship ended and she ended up in The Priory rehab clinic for four weeks,” Sarah Owen, 29, who shares the same mother with Lily said in an interview with Grazia Magazine this week.

“I had a big gang of friends but Lily was more of a loner. She had no-one to talk to about getting her first period or breaking up with her first boyfriend.

“Would it have been different if we’d been closer? Probably,” Sarah says.

As you can tell, Sarah was a caring big sister, really looking out for her little Lily. However, it seems like the incident was only a shadow of mental health struggles to come as she became famous. Lily has publicly said that she sees a therapist for depression ranging from constant attacks in the media to a miscarriage. An excerpt from Billboard magazine notes:

And does she ever worry the attention might push her down the self-destructive path that’s been trod by Spears and Winehouse?

“No,” she says. “I know myself well enough. As soon as I feel remotely depressed I’m checked into a clinic and having intensive therapy. I’ve seen enough people fall apart to know that’s not going to happen to me.”

It’s about time we had some smart celebrities who know when to check themselves before they wreck themselves.

Blog to check out: Postpartum Dads Project

A blog that I'd recommend, especially for both moms and dads of new children, is Postpartum Dads Project. I think the idea is very cool and long overdue. The goal is to be a resource and place of encouragement and education for fathers who have wives going through postpartum depression or are experiencing depression themselves. As the tagline says, "Because PPD is a WHOLE family thing." Katherine Stone over at Postpartum Progress has a small write-up about it.

Emotional depression along with economic recession?

suicide rates compared to employment ratesCNN has a story looking into whether suicides increase as the economy falls into a recession and investors begin to lose thousands of dollars in the stock market. According to a chart by the NIH & Bureau of Labor Statistics, there seems to be a correlation. Here are the latest high-profile suicides that seem to have been prompted by the economic downturn:

  • Steven Good, a chairman and CEO of Sheldon Good & Co., a major U.S. real estate auction company, may have shot himself, according to police.
  • Adolf Merckle, a 74-year-old German billionaire who was ranked the 94th richest person in the world by Forbes magazine, killed himself by walking in front of a train. According to the CNN article, “in recent months his empire had been near collapse.”
  • Rene-Thierry Magon de la Villehuchet, a 65-year-old French investor, killed himself after losing $1.4 billion in the Ponzi scheme that Bernard Madoff ran.
  • Kirk Stephenson, 47-year-old English financier  and COO of Olivant Ltd., jumped in front of a train in September (the real climax in the economic collapse).

The Centers for Disease Control and Prevention (CDC) estimates more than 32,000 people commit suicide each year but public health experts expect an increase upwards to an additional 1200 suicides because of the economic climate. Here are a few more stats that are worth reading:

  • Calls to the National Suicide Prevention Hotline went from 412,768 in 2007 up to 540,041 in 2008.
  • Unemployed people are two to four times more likely to kill themselves than those who are employed.

I have to admit, I found that following paragraph interesting:

So what about these wealthy and powerful men who have recently killed themselves? Mental health experts say it’s impossible to say why they did it, but they say that people who kill themselves have an underlying psychological issue, such as depression or bipolar disorder, so it’s not only about the money.

So I pose a question: Do all those who commit suicide have a mental illness? Or is it possible to kill oneself without being mentally ill?

The Art of Distraction

I babysat the 21-month-old son of a friend on Thursday. He's an adorable, sweet little kid. Very affable and social. With the addition of a new brother, he's been craving the attention that he used to have as an only child so he's always happy when someone takes the time to sit and play with him.

His mother had to go to court to contest a traffic ticket and she took the baby with her so I offered my (free) babysitting services. I'm not a babysitter and I normally don't offer to babysit kids alone because I'm not very good with them and most young children don't like me much. However, I've really grown to love my friend's son—we'll call him Danny—and felt like I could take care of him without too many problems.

We were upstairs on the second floor in his bedroom and I talked to his mother about a few logistics before she left. Finally, she kissed Danny goodbye and headed down the stairs. Since Danny's only 21 months, he needs to be carried down the stairs. When he saw his mother disappear, he began crying (much to my surprise and much to my dismay). My first thought was, Oh great. Now, he's crying for his mommy. This isn't going to be as easy as I thought.

I tried to sit down with him on my lap in the bedroom but he was extremely fidgety and got up and began running to the edge of the steps. Fearful of a fall (remember I don't have much babysitting experience!), I grabbed him, picked him up, and shut the door to the bedroom. Realizing this meant mommy wasn't coming back right away, he cried even harder. Now I was really at a loss of what to do.

I saw a little toy helicopter that he had been playing with earlier. The helicopter made noises and I tried to hand it to him and pressed all sorts of buttons to amuse him. He wasn't fazed. Danny kept right on crying.

Suddenly feeling desperate, my next thought was, I can't have this kid crying until his mother comes back. She's going to think I hurt the poor child. I searched around the room and found a teddy bear and handed it to him. He wasn't interested in that either. Finally, my eyes fell upon a toy set up like a two-level parking lot with a car ramp that twisted around to the ground. Several small cars sat on top of the lot. Remembering Danny loved to pick up cars and hand them to people one by one, I tried the tactic as a last-ditch effort.

I picked up the first car and held it open in the palm of my hand. He kept crying but looked down at it. I grabbed a second car. His crying began to die down and he began to look at the two cars with curiosity. I snatched another car. He stopped crying and simply looked at me with a blank stare, wondering what I'd do next. I picked up another car and held them flat out on my hands for a few moments, letting him take in the number of growing vehicles. Finally, he gave me a little smile. I started rolling a car up and down his belly and he began giggling.

Problem solved. We stayed busy until his mother came home. I expected him to run and cling to his mother after she got home but he gave her a quick glance and wanted me to keep playing with him because he was having so much fun. That was pretty satisfying and felt like my first solo babysitting gig had been a success.

Just like I'd distracted Danny from the sadness of his mother's disappearance, I'm finding that a lot of people in my life have been trying to distract me from the sadness and emotional pain that have been plaguing me lately.

Read the rest of this entry »

This Girl’s Biblical View: Introduction

During my conversation with Natalie two nights ago, she emphasized infusing her brain with Bible verses and Scriptural passages and encouraged me to do the same. Finally, a thought came to me that a good way of constantly keeping myself in step with the Bible would be to meditate on God’s word. I know all about creating 3 x 5 index cards to help memorize Bible verses but I think a great way for me to really absorb some of the principles that I read would be to post a Bible verse and reflect on:

    1. What I think it means
    2. What it means to me
    3. How it has impacted or can impact my life

      Open BibleWhile the Bible is no cure-all (nothing currently in this world is!), I believe God’s word “is living and active, sharper than any two-edged sword, piercing to the division of soul and of spirit, of joints and of marrow, and discerning the thoughts and intentions of the heart.” (Hebrews 4:12)

      I plan on trying to make this a weekly thing, hopefully for publication each Wednesday. I don’t promise to be perfect but I think doing this over the coming weeks (maybe even months!) will deepen and strengthen my relationship with God and others and will help me to overcome some associated behavioral issues (ie, fear, anxiety, etc.).

      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!

      Jay AdamsWe 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.

      Read the rest of this entry »

      Celebrity Sensitivity: Rolex watches helped Owen Wilson overcome suicide

      Wow. If this isn’t a blatant advertisement for Rolex watches, I don’t know what is:

      Owen WilsonAfter a frightening suicide attempt in 2007, Rolex watches and benefits appeared to play an essential role in actor Owen Wilson’s recovery. On August 29, 2007, Time magazine reported: “speculation about his drug use, depression over his May break-up from Hudson and a recent fight with a friend have peppered the coverage of Wilson’s hospitalization. A People magazine cover story out Friday quotes a friend as saying: “Owen was very despondent. He slit his wrists. He almost did not make it.” It was a dark period in Wilson life, and Rolex played a key role in helping Owen regain his bearings and his success.

      RolexAlthough Owen Wilson has worn a Rolex GMT Master in the popular films Wedding Crashers and The Life Aquatic with Steve Zissou, he chooses to wear a Rolex Submariner in his everyday life. It is not surprising that he would make such a choice. The Rolex Oyster Perpetual Submariner originally was designed for diving and known for their resistance to water. The first Submariner was introduced to the public in 1954 at the Swiss Watch Fair. Copied by other watchmakers, the Rolex Submariner is recognized as a classic, and one of the most widely recognized luxury products in the world. The Rolex Submariner is part of Rolex’s Oyster Perpetual Professional line. After returning home from the hospital, Owen was captured by a photographer walking on the beach, wearing his Rolex Submariner. Later, he was seen riding his mountain bike in Santa Monica with the Rolex Submariner on his wrist. Obviously, the quality of a Rolex watch helped Owen realize and appreciate the quality of his own life.

      If I had known that the answer to overcoming suicide was this easy, I could have avoided myself years of trouble.

      Goal for 2009: Staying Alive

      I’m being hit by suicidal thoughts again. Hard.

      I’m not going to the hospital but if these thoughts keep pummeling me, it’ll become a consideration again. I’m walking a fine line here because my husband’s family has had a suicide hit close to home earlier this year and they don’t need to experience another loss. I try to keep in mind how important I am to many people that I know: my husband, my in-laws, my mom (I’m her only child). I try to visualize the grief my mother would experience losing her only kid. It’s worked so far. I can only pray that it lasts.

      In the meantime, I’ve had my husband hide my belts. I ended up in the hospital in October 2006 after my husband woke up just in time to find me kicking a chair away in an attempt to hang myself from an air vent.

      After what now seems like a short reprieve, I constantly glance up at the ceiling air vent in our bedroom thinking about trying the hanging thing again. I’m sure I could find something else to use if I really wanted to but I’m trying not to dwell on the idea too much.

      The lies that used to convince me to try killing myself, oh say, three years ago, don’t work as well anymore. I can fight off most of them:

      Lie #1: Nobody cares about you.
      Answer: I have a husband, a big family, and wonderful friends who love and care for me. I’d be missed.

      Lie #2: You don’t make a difference in this world.
      Answer: I have a 98-year-old grandmother who loves me to pieces, I have a mother who I bring so much joy to, I have a husband who tells me I’m the best thing that’s happened to him, and I have a mother-in-law who thinks that I’m so cool, she wants to spend time with me. I do make a difference.

      Lie #3: You’re worthless.
      Answer: My husband tells me all the time that I’m worth something to him and that he’d be lost without me. If only for him, I’m worthwhile.

      So the “lies,” or challenges if you will, have changed. Here’s the new one:

      “You’re such a liar. You’re just looking for attention. You want people to pity and feel bad for you while you sit there and cry wolf. So, if you’re so serious about committing suicide, why don’t you show them that you’re not kidding and prove ’em all wrong?”

      Hmm. Good question.

      Mood rating: 3

      The Boxer: Fighting Depression

      John over at Storied Mind wrote a post on fighting depression that really hit home. It had a profound thought that I know but often overlook.

      Fight it.

      If I can step aside for just an instant from the full assault of the symptom, long enough to glance sideways at it, I can spot what’s happening and immediately see myself experiencing that particular bend of mind or feeling. Here it comes, here it is, I’m feeling miserable because I’m depressed. Or I’m tearing myself down with every other thought – I don’t have to do that so you in there, you shut up, I’m not listening anymore – you’re just a disease, and you will not get me to believe what you’re saying. Of I see obsessive thinking taking hold, sizzling my mind and gut with something, invariably, that I did wrong. I see that I’m replaying it over and over, and I have to step back and just say to myself, you’re obsessing, that’s another symptom, so stop!

      boxingWhich reminds of a song (“The Boxer”) from one of my favorite Christian artists, Sara Groves:

      When you said this was a fight, you weren’t kidding
      When you said this was a fight, you weren’t kidding, kidding
      Cause my ribs are bruised and it’s just round two

      When you said this was a fight, you weren’t kidding
      When you said this was a fight, you weren’t kidding
      Cause there’s a cut on my eye and it’s just round five

      And I used to be quick I used to see it coming
      I used to know how to move my feet
      Now I can’t duck and I can’t land nothing
      And I forgot how to bob and weave
      Bob and weave

      When you said this was a fight, you weren’t kidding
      When you said this was a fight, you weren’t kidding, kidding, kidding
      Cause this room’s in a spin and it’s just round ten

      If you care at all take that towel from your neck
      Cause I’ve reached down deep and there is nothing left
      I’ve got nothing
      I’ve got nothing
      I’ve got nothing

      Greater is he who is in me
      Greater is he who is in me
      Greater, greater
      Greater, greater

      Okay, okay

      Bob and weave
      Bob and weave
      Bob and weave

      And I can’t just know it I’ve got to feel it
      And I can’t just feel it, I’ve got to believe it
      And I can’t just believe it, I’ve got to live it

      I need to put up a fight and I won’t be successful without God’s help. I can’t just *think* I have to fight and leave it as head knowledge, I have to put it into action. I have to — as John put it — “glance sideways at it” and watch those punches, see it coming, then — as Sara put it — “bob and weave” to dodge it before it knocks me down completely.

      Emotional eating, Part 3

      Now getting back to my current issue…

      I am currently bouncing between 152 and 157 these days — a range I’m not particularly satisfied with. While my long-shot goal is 130-140 lbs, my current (and realistic) goal is 140-145 lbs. All I need is to fit in my pants. I don’t have money to buy new ones and the current ones I have in rotation are either uncomfortable or too dressy (read: formerly a corporate America drone).

      Why am I having such a hard time? Well, other than the fact that I don’t get much cardio in, I’m also terrible about controlling my diet. (I’ve been playing the Wii religiously for about 30-60+ mins each day but it doesn’t seem to be doing much for the scale.)

      dessertI indulge myself in anything I want: cupcakes; cake batter ice cream; pound cake topped with vanilla ice cream, strawberries laden in syrup, drizzled with caramel and decorated with whipped cream on the sides. I’m trying to teach myself discipline, but an undisciplined person trying to teach herself discipline is a recipe for failure.

      But I’m trying.

      I’ve been successful at times. For a while I was addicted to cinnamon buns sold at UPenn bookstore’s cafe. They were (and probably still are) absolutely delicious. Somehow — and I don’t know how I talked myself into this — I looked at them one day and said, “You know, those are disgusting. They’re topped with all that icing. That huge bun underneath the icing is nothing but carbs and does you no good. You don’t like it anymore. Don’t eat it.”

      I haven’t touched a cinnamon bun since.

      It’s strange how I’ve been able to use that psychology on some food items but not on others. Let me tell you, how I’d love to give up my addiction to cakes and cupcakes. I can’t eat chocolate but I find  plenty of other things to take its place: strawberry shortcakes, strawberry sundaes, the Strawberry-Banana Rendezvous with cake batter ice cream from Cold Stone Creamery, carrot cakes, and Krispy Kreme donuts drenched in its original glaze icing. You can probably tell now why I can’t seem to dip below 150 lbs.

      I want to stop. But each night, the ice cream place down the street beckons my name. Every morning, the bakery’s aroma wafts across the street and into the windows of my apartment, taunting me to defy the scale one more time for a temporary delight. There’s a diner that has dessert that is so good, I need to avoid eating there or else it becomes a requirement to indulge in after my entreé.

      I’ve tried eating strawberries and grapes — natural sweets that should satisfy my sweet tooth. Grapes seem to make me hungrier and strawberries alone just don’t seem to cut it. I have tiny dessert cups used for individual shortcake servings but I’ve decided recently to cut them out to save calories.

      I guess that it doesn’t help that I’m addicted to calorie-counting.

      Goya riceI’m also trying to rid myself of my carb addiction. People from the Caribbean are notorious for their staples of rice and beans. As a product of Caribbean parents, I simply cannot live without rice. I can easily forgo meat if I can get my hands on some good rice and beans.

      I don’t mind most veggies but trying to incorporate them into every single meal is incredibly difficult for me. And a house salad for lunch satisfies my hunger like a sip of water… that is to say, not at all.

      So I’m currently faced with a dilemma. I need to stop eating so much and eat the right kind of food so I can lose weight. Because I lack discipline and feel hopeless and discouraged, I continue to overeat (American portions are larger than necessary) and indulge in dessert each night, continuing my slow trend toward weight gain.

      My mental health suffered much less when I was 140 lbs. I looked good and felt good. There’s something to the saying that the physical contributes to the spiritual, mental, and emotional well-being. Mind, body, and soul — they truly are all connected.

      Emotional eating, Part 2

      Seeing the scale at 180 scared me into action somehow. I thought of my father who died of a heart attack and remembered that I had a history of high cholesterol running through my family. I decided I had to do something so I didn’t drop dead of a myocardial infarction at 23.

      • gymBob and I joined a gym. We went 1-2 times a week for about 30 minutes, which — for a variety of reasons — was a disaster so this consistency didn’t last long. But it helped short-term. We mostly did circuit training and about 20 minutes of cardio. We also had a
        personal trainer for a while. It’s expensive and we haven’t been able to afford one since, but it was definitely worth the money. I dropped 5 lbs.
      • I stopped drinking soda. Everyone in my family will tell you that I was ADDICTED to soda. However, I knew the carbonation made me bloated.
        • I slowly weaned myself off of regular soda, forcing myself to like the significantly inferior diet products.
        • Crystal Light On-the-GoIn due time, I tired of diet drinks and became hooked on Crystal Light On-the-Go packets and forced myself to drink water regularly. This change resulted in an additional loss of 5 lbs. For whatever reason, the CL packets soon became too sweet for my sweet tooth and I stopped using them.
        • While I drink mostly water, I somehow picked up a daily habit of drinking coffee and lattés along the way. I usually make my own coffee but often order my lattés at coffee shops or cafés. I initially didn’t care about drinking whole milk but I soon learned that the calories can quickly add up between the vanilla shots and 16 oz. of milk.
        • Now, I ask for sugar-free vanilla lattés with skim milk. (These are called “skinny lattés” at Starbucks.) I always hated skim milk but forced myself to get used to it if I really wanted the pounds
          to continue to peel off. I still get my caffeine fix but for significantly less calories. Depending on the size I get, my latté can vary from 90-175 calories. Not bad when a regular vanilla latté is easily 300.
      • I began eating Lean Cuisine or Healthy Choice for lunch. This is something that’s since dropped out of my diet but I need to reincorporate because it’s offered me the most results. I limited myself to LC or HC only and fought off any other hunger urges if I could. These pre-made frozen meals led to another 5-lb weight loss. (NOTE: The sodium counts on some of these meals are ridiculous, negating the healthy benefits of the low-calorie count, and causing increased hunger. Check the Nutritional Information for products that contain — on average — 600 mg or less of sodium. I’ve found that more than that can be counterproductive. Healthy Choice is pretty good about keeping the sodium milligrams around 500 or less.)
      • walkingI began commuting to the city and walked from the train station to work for a total of 20-30 minutes round-trip. I skipped walking during severe heatwaves and rain. The bus to the train station from my job wasn’t very reliable so I often ended up walking for at least 10 minutes during the day. Or more if I walked somewhere (usually by myself at a faster pace) for lunch. I lost 5 more pounds.
      • I ended up in the psych hospital. This is NOT recommended. I didn’t like much of the food so I hardly ate anything. I was also started on Effexor XR, of which weight loss was a side effect. I dropped a good 10 lbs in 7 days as a result of this. By this point, I was down to 150 — my “Freshman 15” weight.
      • Since my body was getting used to the 20-30 minute work walks, I began working out at the gym at least 2-3 days a week for at least 30 minutes. I attempted to do a minimum of 20 minutes of cardio and 10 minutes of strength training or vice versa. I maintained a weight between 140-145 lbs for more than a year.

      I haven’t been able to crack 139 on the scale for whatever reason and my goal is for a weight maintenance of 130-135 lbs. The BMI scale recommends that I weigh 110-125 lbs for my height.  Considering that my 26-year-old body is significantly different than my 16-year-old body, I’m not going to shoot for anything less than 130. I think to do so at this point in my life would be unrealistic. Besides, I wouldn’t want to be that skinny again anyway. 110 lbs on a 16-year-old looks vastly different on a 26-year-old  or a 36-year-old or a… you get the point. I’ve made 130 my minimum — a goal I’m sure I’ll be happy with if I’m able to attain it. Even if I bounced between 130 and 140 lbs, I wouldn’t mind as long as I didn’t regain my Freshman 15 weight. But I’m a work in progress.

      Emotional eating: Part 1

      I waver on whether I should attend the CCEF conference on Addiction in November. I have my own addiction that I’m dealing with and it’s ruining my mental health like nothing else right now.

      Food.

      Especially sweets.

      donutsI’ve been keeping a record of everything I eat and while most of it is not terribly bad, it’s either the portion sizes that kill me or the delicious 5-scoop caramel strawberry brownie sundae from Friendly’s or a few helpings of those 200-calorie Krispy Kreme donuts. It also doesn’t help that I live across the street from a bakery that’s been named one of the best in the Philly area.

      I grew up skinny and petite for the majority of my life and gained the usual “Freshman 15″ (or in my case 25) when I attended college at New York University. I did an incredible amount of walking each day — an average total of at least 75 minutes — and still somehow managed to gain weight. I didn’t occur to me at the time that 2 full plates of food from the cafeteria with several scoops of ice cream needed to be phased out of my diet.

      By the time I attended a small Christian college in Florida, I was sitting at 150 lbs. (For a 5’4” female, this is considered slightly overweight.) During the nearly 2 years that I attended that college, I rarely ever rode in a car, which resulted in a drop of 20 lbs. Mind you, I still hadn’t changed my eating ways.

      Fast-forward to August 2005, the month of my wedding. After a year of Paxil (3 months) and Lexapro (9 months), I hovered around 169-170 lbs. This was the largest I had ever been in my life. I never really realized that I’d gained all that weight. I was always pretty comfortable in my own skin. Sure, my jeans didn’t fit me as well as they used to but that was OK; it just gave me an excuse to buy new clothes!

      Then, my family — pretty harsh critics, according to my husband — labeled me F-A-T. I never saw fat until they said it. The next time I looked in the mirror, I saw they were right. When I grinned, a double chin suddenly appeared. Saggy breasts hung in place of my once perky chest. Triple-fat rolls had now replaced the tummy that if I’d sucked it in just right, they’d look washboard. My lowest love handle drooped over my string bikini underwear like a fading flower.

      Stretch marks also began to appear. They showed up looking like extremely red rashes. It was like watching my capillaries slowly attempting to burst out of the seams of my skin. The marks finally made permanent rest stops on my inner biceps and inner thighs.

      A few months later, my max hit 180 lbs. To a lot of women, especially those who have been obese or overweight for a long time might pooh-pooh my weight problems. For a girl who — when her growth spurt had ended — fluctuated between 110 and 125 lbs, this was devastating. Unfortunately, it probably wouldn’t have been as bad if her family members hadn’t taken the liberty of pointing that out. Especially since she needed to be “skinny” for her wedding.

      Loose Screws Mental Health News: Suicide slide

      A National Institute for Mental Health in England report reveals particular progress in cutting suicides among young men.

      The three-year average was 8.3 suicides per 100,000 population in 2004-06, down from 8.5 in the previous three years.

      The article was brief and unclear which leaves me wondering what England is doing right.

      “Sure, Grandpa gets a little cranky and blue sometimes, but he’d never
      do anything stupid”, you might think. Wrong.  Elderly people account
      for 13% of the US population, but make up nearly 24% of completed
      suicides. Older men are the most at risk with a rate of 29 per 100,000
      people.

      Does this sound like anyone you know?

      More than you know, Dr. Chiaramonte. More than you know.

      According to the 2007 Small Arms Survey, the United States had about 90 firearms per 100 people – the highest ratio in the world – followed by Yemen, Finland, Switzerland and Iraq.

      Over half of all suicides in the United States – 52% – were committed with firearms in 2005, according to the most recent CDC data available.

      Gun control: good or bad? Discuss amongst yourselves.

      Celebrity Sensitivity: Joe Pantoliano & Blake Fielder-Civil

      Actor Joe Pantoliano, best known for his roles in The Goonies and The Sopranos, has recently admitted to struggling with depression. He didn’t tell anyone up until 3 years ago. When a close friend committed suicide, the event prompted him to seek help. He has begun the site No Kidding, Me Too to help fight the stigma of mental illness and encourage others to get help.

      Blake Fielder-CivilAlso in depression news, Amy Winehouse’s troubled husband, Blake Fielder-Civil, has been receiving counseling in prison due to worry that Winehouse is still abusing drugs.

      “Blake is on the verge of a nervous breakdown,” a prison insider told The Sun. “He has stopped his mopping job, which may sound funny, but it gave him something to do. Instead he mopes around his cell.

      Something tells me that Fielder-Civil is not taking drugs — antidepressants, of course — in prison.

      Golden Gate Bridge Barrier Update

      The San Francisco Chronicle’s site has an update on the GGB barrier debate. Unfortunately, most people don’t want any kind of barrier at all. However, of the design options, the net is proving to be the most popular. Likely because it doesn’t affect the aesthetics of the bridge by much and it is still considered a suicide prevention mechanism.

      Golden Gate Bridge net barrierI’d initially cited concerns about how jumpers would be pulled out of the net. Rachael Gordon, the Chronicle’s staff writer, got chief engineer Denis Mulligan to provide an answer:

      For starters, he said, once someone jumps over the Art Deco span’s 4-foot railing, it could take rescuers several hours to get to the scene to retrieve the person from the net, which essentially would envelop the person and make it difficult but still possible to clamber out.

      “It wouldn’t be like a trampoline, that once you jump onto, it would be easy to jump off,” Mulligan said. But, he added, “If you’re very agile, very strong and focused, you may be able to climb out.”

      I hope it’s as hard to climb out of as Mulligan cites. Just the wait to be rescued alone might get jumpers to think twice about trying again. But here’s the process in more detail:

      During a rescue operation from the net, authorities would shut down a lane of traffic. A specialized vehicle, called a “snooper” truck, would be brought in. Outfitted with a mechanical arm similar to a cherry picker used by utility crews, two specially trained rescue workers would be lowered down to the net in a bucket to pull the person out.

      Authorities said they would have to convince pranksters and daredevils that jumping into the net would not be a pleasant experience.

      “It would hurt,” Mulligan said of the 20-foot drop into a net made out of marine-grade stainless steel coated in plastic.

      This article also uses another bridge — a former suicide hotspot — as an example to show that suicides can be prevented.

      In Switzerland, researchers found that just the presence of the net stopped people from even trying to jump off the Munster Terrace, a medieval cathedral located in the old section of Bern, from which two or three people had been leaping to their deaths every year. They also found that the net did not shift suicides to other locations.

      And that the implementation of barriers in other places have also proven successful:

      Other well-known jump spots, among them the Eiffel Tower in Paris and the Empire State Building in New York City, were long ago outfitted with suicide barriers. Like the net attached to the Gothic cathedral in Bern, studies have shown them effective in thwarting impulsive suicide attempts.

      I’m not so idealistic to think barriers will keep suicidal people from committing suicide. Rather, I think they’re worth erecting for “thwarting impulsive suicide attempts.” Who knows how many people are still alive as a result?


      The general public is welcome to vote for a barrier on the Golden Gate Bridge and provide additional comments (ie, you don’t need to be from California or San Francisco). Visit the Golden Gate Bridge Suicide Deterrent Barrier site to make your opinion known on this issue.

      Loose Screws Mental Health News

      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.

      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.

      “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?

      Chemical imbalances do not exist; dying brain cells do

      Researchers have never been fully confident in the chemical imbalance theory, yet the media continue to purport it as fact. Dr. John Grohol over at PsychCentral recently wrote:

      We’ve all heard the theory — a chemical imbalance in your brain causes depression.

      Although researchers have known for years this not to be the case, some drug companies continue to repeat this simplistic and misleading claim in their marketing and advertising materials. Why the FTC or some other federal agency doesn’t crack down on this intentional misleading information is beyond me. Most researchers now believe depression is not caused by a chemical imbalance in the brain.

      How did we come to this conclusion? Through years of additional research. But now some are jumping on the next brain bandwagon of belief — that depression is caused by a problem in the brain neuronal network.

      Grohol cites Jonah Lehrer's article in the Boston Globe in which he posits that researchers now think depression comes from "brain cells shrinking and dying." Lehrer writes:

      Read the rest of this entry »

      Celebrity Sensitivity: Juliana Hatfield & George Michael

      Juliana HatfieldJuliana Hatfield, a singer who enjoyed great success in the 1990s, expressed frustration with the PR machine that covered up her bout with severe depression. So severe that she canceled a European tour. Her publicist spread word that she was suffering from “nervous exhaustion.” However, Hatfield reveals:

      [My depression was] so unbearable that I was going to jump out of a window to get away from it . . . I needed to check myself into some kind of psychiatric-treatment facility.

      I wondered why my publicist hadn’t simply told everyone the plain truth . . . instead of issuing such a vague, all-purpose ‘nervous exhaustion’ line, which . . . as far as I know isn’t even a real diagnosis.

      Hatfield, who has an album due out in mid-August, appears to have sacrificed long-term mainstream success in exchange for her mental well-being. Given the choice she had to make, I’m sure she couldn’t be happier.

      (Hat tip: Powerline A.D.)

      On another note, George Michael (who is currently on tour) recently divulged his 20-year battle with depression on Good Morning America. He attributed his music to helping him cope with such events as the deaths of his boyfriend and his mother.

      Pristiq's side effects: Too close to Premarin and Prempro for comfort?

      Back in January 2007, I’d mentioned that Wyeth was not only seeking to market Pristiq (desvenlafaxine) for depression but also for the use of vasomotor symptoms in menopausal women.

      I just learned that Wyeth produces two major menopause drugs, Premarin and Prempro, that allegedly has produced hormones causing cancer in more than 5,000 women. This added up to a loss of 40 million users and $1 billion annually.

      With Effexor going generic in 2 years and the introduction of Pristiq to the market, Wyeth hopes to lure some of those customers back and net an annual $2 billion. However, serious questions linger about Pristiq’s side effects in menopausal women.

      Why did two women in the study group taking Pristiq have heart attacks
      and three need procedures to repair clogged arteries compared with none
      taking placebo? How can Wyeth assure long term safety when 604 of the
      2,158 test subjects took Pristiq for only six months and 318 for a year
      or more? And what about serious liver complications seen in the studies?

      Martha Rosenberg, reporting on Pristiq’s use as a menopausal drug, culled comments from CafePharma’s message boards and found one thread rife with mixed comments on the new drug. From an Anonymous commenter:

      Read the rest of this entry »

      More Famous People With Mental Illness

      The local NAMI chapter has literature all over a counter at my local library. One of the pieces of literature actually was a 5×7 index card with a list of famous people who struggled with mental illness. It was kind of interesting so I figured I’d share it. Some I’d already known about; others were a bit of a surprise. How did they figure out who had bipolar disorder back in the 1800s?

      Read the rest of this entry »

      Pick a number: 20 or 9,000,000

      20 people annually or 9,000,000 people annually.

      Golden Gate BridgeThose are the numbers that the Golden Gate Bridge (GGB) Board of Directors will need to choose between in October.

      GGB officials are considering a proposal to erect suicide barriers on the bridge. Public forums were held on Tuesday and Wednesday to gauge public reaction to the five options designed to deter suicides. The cost of erecting one of the barriers is estimated between $40–50 million.

      Bridge officials have been culling comments about the barriers at the forums and through the site Golden Gate Bridge Suicide Deterrent Barrier. As of Wednesday, July 23, the San Francisco Chronicle reports:

      [O]f the more than 900 tallied so far, an overwhelming 75 percent of the respondents said they prefer that no barrier be built at all. But a small, passionate group of proponents – many of them family
      members of people who jumped to their deaths from the bridge – insist a barrier is needed. Any barrier.

      “Overwhelming 75 percent” prefer no barrier? That’s not good.

      Opponents of the barriers say it will ruin the aesthetic view of the bridge for the yearly estimated 9 million visitors.

      I stumbled upon a blog, Bookworm Room, yesterday that brought the issue to my attention. This blogger likely represents the sentiment of the “overwhelming 75 percent.”

      Read the rest of this entry »

      The Era of Quick Fixes

      Pink Magazine: Out of DarknessPink magazine has an article called “Out of Darkness” on high-powered, successful women (likely in corporate America) who suffer from depression and try to hide it. There’s an online exclusive but the actual article can only be read in the print version of the magazine.

      Apart from the three resourceful sidebars accompanying the article, the one thing that I felt was missing from the article more of an emphasis on psychotherapy. The article seemed to focus heavily on women whose condition improved as a result of medication. There appears to be only one mention of a women whose condition improved with psychotherapy and medication.

      While I understand that medication can be an important factor in assisting those with mental illness to recovery, it should not be the sole form of treatment. Mental illness does not only involve the chemical/biological activity of the brain, but it also involves the psyche — the part of us that comprises of our personalities and behaviors. This is why cognitive behavioral therapy (CBT) and dialetical behavioral therapy (DBT), among other forms of treatment, can be so beneficial. I’m not a fan of being on medication but I feel that 80 percent of my recovery comes from my weekly Christian counseling sessions. Therapy, medication, or other forms of treatment are not cure-alls, and I’m concerned when I read that people rely solely on medication for treatment. These are the people who are most likely to suffer relapses because after a while, their medication just “stops working.”

      Most people today are looking for a “quick fix.” We do this with weight loss (alli), food (McDonald’s), exercise (Fast Abs), and so much more. Then, it should be no surprise that people desire a quick fix to control their emotions. Some people use illegal drugs to dull the emotional pain in their life. Is it possible that psychotropics are the “legal” drugs that accomplish the same purpose?

      The Act and Follow-through of Suicide: Wrap-Up

      I’ve always found it annoying when people say a suicide attempt is
      "a cry for help." And the best one — "She’s just looking for
      attention." I ran into that quite a bit in high school.

      While a suicidal person may not realize it (I certainly didn’t), a suicide attempt is a cry for help. It’s  an action that says "I’ve come to my breaking point. I’ve run out of options
      and I don’t know what else to do. My problems are too much for me to
      handle and the only way out of them is to die." Suicide is the action
      which stem from thoughts that likely were never verbalized.

      The majority of people who commit or attempt suicide aren’t just
      seeking to die "just because."

      …[T]wo doctors who are among the most often-cited experts on suicide…readily acknowledged the high degree of impulsivity associated with [jumping], but also considered that impulsivity as simply another symptom of mental illness. “Of all the hundreds of jumping suicides I’ve looked at,” one told me, “I’ve yet to come across a case where a mentally healthy person was walking across a bridge one day and just went over the side. It just doesn’t happen. There’s almost always the presence of mental illness somewhere.”

      They feel as though they truly have "run
      out of options" and ending their life is the least favorite backup
      plan. The common thread that runs through all suicides is hopelessness.

      So to wrap this series up, is it possible to prevent someone  from committing or attempting suicide?

      Read the rest of this entry »

      The Act and Follow-through of Suicide: Part IV

      Compilation of Statistics Regarding Suicide

      Scott Anderson in his NYT article weaves the grim statistics of suicide in and out of his story. Here’s the morbid list:

      General

      • mental illnessThe nation’s suicide rate (11 victims per 100,000 inhabitants) is almost precisely what it was in 1965.
      • In 2005, approximately 32,000 Americans committed suicide, or nearly twice the number of those killed by homicide.
      • The National Institute of Mental Health says that 90 percent of all suicide “completers” display some form of diagnosable mental disorder.

      Demographics

      • Both elderly men living in Western states and white male adolescents from divorced families are at elevated risk.

      Premeditation vs. Passion

      • [T]he person who best fits the classic definition of “being suicidal” might actually be safer than one acting in the heat of the moment — at least 40 times safer in the case of someone opting for an overdose of pills over shooting himself.
      • In a 2001 University of Houston study of 153 survivors of nearly lethal attempts between the ages of 13 and 34, only 13 percent reported having contemplated their act for eight hours or longer. To the contrary, 70 percent set the interval between deciding to kill themselves and acting at less than an hour, including an astonishing 24 percent who pegged the interval at less than five minutes.
      • “Sticking one’s head in the oven” became so common in Britain that by the late 1950s it accounted for some 2,500 suicides a year, almost half the nation’s total. By the early 1970s, the amount of carbon monoxide
        running through domestic gas lines had been reduced to nearly zero. During those same years, Britain’s national suicide rate dropped by nearly a third, and it has remained close to that reduced level ever since.

      Read the rest of this entry »

      The Act and Follow-through of Suicide: Part III

      Premeditation vs. Passion

      Author Scott Anderson in his NYT magazine article, "The Urge to End It All," notes:

      Just as with homicide, researchers have long recognized a premeditation-versus-passion dichotomy in suicide.

      Read the rest of this entry »

      The Act and Follow-through of Suicide: Part II

      The British Coal-Gas Story

      According to Scott Anderson’s NYT article, the little-known British coal-gas story — even among mental health professionals — is a good example of how suicides can be prevented if one takes away the means:

      Coal-gas ovenFor generations, the people of Britain heated their homes and fueled their stoves with coal gas. While plentiful and cheap, coal-derived gas could also be deadly; in its unburned form, it released very high levels of carbon monoxide, and an open valve or a leak in a closed space could induce asphyxiation in a matter of minutes. This extreme toxicity also made it a preferred method of suicide. “Sticking one’s head in the oven” became so common in Britain that by the late 1950s it accounted for some 2,500 suicides a year, almost half the nation’s total.

      Those numbers began dropping over the next decade as the British government embarked on a program to phase out coal gas in favor of the much cleaner natural gas. By the early 1970s, the amount of carbon monoxide running through domestic gas lines had been reduced to nearly zero. During those same years, Britain’s national suicide rate dropped by nearly a third, and it has remained close to that reduced level ever since.

      Experts seems to insist that committing suicide is proof of an underlying mental illness. Suicide that stems from impulsivity, among these experts, is also considered part of a mental illness. Anderson subtly argues against this, and I find myself agreeing with him:

      How can this be? After all, if the impulse to suicide is primarily rooted in mental illness and that illness goes untreated, how does merely closing off one means of self-destruction have any lasting effect? At least a partial answer is that many of those Britons who asphyxiated themselves did so impulsively. In a moment of deep despair or rage or sadness, they turned to what was easy and quick and deadly — “the execution chamber in everyone’s kitchen,” as one psychologist described it — and that instrument allowed little time for second thoughts. Remove it, and the process slowed down; it allowed time for the dark passion to pass.

      Would this mean that if people had less access to suicidal means that promoted “ease, speed, and certainty of death” (ESCOD), a number of suicides could be averted? It appears so. Anderson continues to make a case using the Ellington Bridge in Northwest Washington as an example:

      Read the rest of this entry »

      Celebrity Sensitivity: 135 Famous Celebrities and Their Mental Health

      The Pop-Crunch Show has a list of 135 Famous People Who Struggled with Depression. I sit on the fence and think that it should probably be retitled "135 Famous People Who Struggled with Mental Health Issues."

      But then again, we could throw nearly every celebrity in there, huh? I’m bummed that Tom Cruise isn’t on the list.

      John Grohol interviews Wyeth's VP of Medical Affairs on Pristiq

      Dr. Grohol interviewed Dr. Phil Ninan, Wyeth’s VP of Medical Affairs on Pristiq, its efficacy, and surrounding issues. It was quite an interesting interview (and long) but here are some highlights that I chose to comment on. I’ll be making some comments in between Dr. Ninan’s answers due to the extensive length. Some parts of the answers have been truncated.

      Read the rest of this entry »

      The Act and Follow-through of Suicide: Part I

      “What was immediately apparent was that none of them had truly wanted to die. They had wanted their inner pain to stop; they wanted some measure of relief; and this was the only answer they could find. They were in spiritual agony, and they sought a physical solution.”Dr. David Rosen, psychiatrist and Jungian psychoanalyst

      A recent article in New York Times magazine suggests that those who exhibit suicidal behavior or have had unsuccessful attempts are least likely to die by way of suicide.

      The author, Scott Anderson, delves into the psyche of what drives a person to commit suicide. And he attempts to answer the "what" question by evaluating the "how."

      Read the rest of this entry »

      Celebrity Sensitivity: Heather Locklear, Ruslana Korshunova, and Adam Duritz

      Heather LocklearHeather Locklear, most famous for her roles in T.J. Hooker and Dynasty, checked into an Arizona facility for treatment of anxiety and depression on June 19. As of July 2, rumors reported that she was still checked into the facility. Her publicist issued a statement on June 24:

      “Heather has been dealing with anxiety and depression. She requested an in-depth evaluation of her medication and entered into a medical facility for proper diagnosis and treatment,” says Locklear’s rep, Cece Yorke. “This is a confidential medical matter and no further statement will be released.”

      It seems that her bout of depression began after her split from rocker Richie Sambora to whom she was married for about 10 years. It appears that her current partner, actor Jack Wagner, has been a strong source of support and encouragement for her.

      However, in other upsetting news, 21-year-old model Ruslana Korshunova jumped from the window of her Manhattan apartment in what appears to be a suicide. No one is quite sure what caused it but the based on the poetry that she posted on a website, the New York Daily News has proposed the idea that it was over “a lost love.”

      Adam DuritzFinally, Counting Crows singer Adam Duritz revealed to Men’s Health magazine that he suffers from dissociative identity disorder (DID).  John Grohol of PsychCentral quoted an excerpt from the interview:

      What makes my case even worse is that every night I go out on stage and have this incredible emotional connection between me, the band, and the audience. Then, just like that, it’s over. I go backstage, back to the bus, back to my hotel room, and sit there all by myself. That deep connection is yanked away in an instant. It’s like breaking up with your girlfriend over and over again, every night.

      Lexapro maintains status as first-line antidepressant therapy

      Lexapro vs. Pristiq According to a Decision Resources (DR) press release, Lexapro (escitalopram), a SSRI, “retains leadership among first-line therapies in the treatment of major depression” despite the fact that physicians have increasingly moved toward the use of SNRIs, eg, Effexor (venlafaxine). However, the reason why SSRIs still retain their first-line status is due to

      • cost
      • efficacy
      • familiarity

      SSRIs have been out on the market for much longer than SNRIs so it’s what physicians are more comfortable with. As far as I know, there currently aren’t any generic SNRIs in the U.S.

      As a result, SNRIs are likely pricier.

      DR’s survey of psychiatrists found that the majority believe SNRIs work better in treating clinical depression than SSRIs and about 44 percent believe they have fewer sexual side effects. PCPs were also included in this survey and it seems that the majority of them believed the opposite despite DR’s spin that a lot of PCPs are on board with psychiatrists. From personal experience, four SSRIs were prescribed to me before I was shifted to a SNRI.

      In the up-and-coming SNRI department, DR forecasts a bright future for Pristiq (desvenlafaxine).

      Physicians are expected to move patients from Effexor to Pristiq-a newly approved SNRI- over the next two years. … Pristiq will begin to replace Wyeth’s Effexor XR and Lilly’s Cymbalta, especially in
      psychiatrists’ practices.

      This is an interesting analysis from DR considering that psychiatrists, health insurers, and even some investors seem less than impressed with the slight advantages the “me-too” drug has over Effexor.

      (logos from Forest Pharmaceuticals, Inc. and Wyeth)

      Pharma's "me-too" drugs face skeptical docs and health insurers

      As patents expire on a variety of drugmakers’ moneymakers, pharma companies have gone to great lengths to structurally reinvent the successful drugs then tout the benefits that differ from their predecessors.

      InvegaCase in point — Johnson & Johnson’s Invega. Invega is the successor to the popular antipsychotic drug, Risperdal, and competitor to AstraZeneca’s widely used antipsychotic Seroquel. Scott Hensley at The Wall Street Journal’s Health Blog (WSJ) reports that Risperdal is going generic in June. Gianna at Beyond Meds recently said it will not. According to the Dow Jones Newswires (DJN), these “junior” drugs face skepticism from health insurers and doctors. California-based Kaiser Permanente and Minneapolis-based UnitedHealth Group Inc. (UNH) are example of companies that have somewhat discouraged use of the drug. Kaiser doesn’t cover Invega at all, and members of UNH are required to pay higher copays for the brand name. The wire reports New York-based psychiatrist Jeffrey Lieberman wasn’t “buying it” the difference between Invega and Risperdal.

      Invega is “basically a me-too drug, and the company hasn’t done the studies that would be required to really distinguish it,” Lieberman, chairman of the psychiatry department at Columbia University’s medical school told Peter Loftus of Dow Jones Newswires.

      Ouch.

      The blog also quotes Daniel Carlat from the The Carlat Psychiatry Report.

      Dan Carlat, a psychiatrist and a tough critic of Invega, wrote that J&J’s “marketing team apparently missed the fact that the word in the English language that sounds most like “Invega” is “inveigle,” meaning “to entice, lure, or ensnare by flattery or artful talk or inducements.’ ” He asked doctors: “Will you be doing your patients a favor by taking the plunge? Or will you simply be giving them the same wine in a fancier bottle?”

      Even J&J’s Group Chairman of Pharmaceuticals, David Norton, admitted that Invega is a tough sell.

      “We need to do a better job at drawing a differentiation in a difficult-to-treat population.

      So far, Invega sales have been incredibly disappointing compared to the Risperdal blockbuster.

      Wyeth (antidepressant Effexor XR cum Pristiq) and Shire (ADHD drug Adderall XR cum Vyvanse) face the same uphill battle. Wyeth’s Effexor faces generic competition from Teva Pharmaceuticals despite efforts to halt generic sales of the drug and the patent on Shire’s Adderall is set to expire next year.

      Hensley, in his analysis, raises a question in which the answer remains to be seen:

      Cheap generics abound to treat a broad assortment of illnesses these days. What’s the point, the critics ask, of paying more for drugs that are at best only slight improvements over tried and true medicines available at bargain prices?

      It’s something that I’ve questioned myself.

      In an attempt to have the “me-too” drugs compete with its derivative, both Wyeth and Shire are slashing their prices, or as the DJN reported, “emphasizing improved dosing for the newer drugs.” Although Pristiq’s efficacy comes at higher doses, it’s being priced 20 percent lower than Effexor.

      [Deutsche Bank pharmaceutical analyst Barbara Ryan] thinks the odds of
      Pristiq’s success are slim because it appears to offer few benefits
      beyond those of Effexor.

      That remains to be seen. So far, a few patients have commented on my blog that Pristiq has already begun to help them. I haven’t seen any DTC ads for Pristiq so I can only assume that drug reps are doing a fine marketing job at selling the different benefits of the drug to doctors.

      Vyvanse, on the other hand, is looking promising for Shire, already having 7 percent of U.S. ADHD drug prescriptions. Chief Executive Matthew Emmens says the drug is chemically different from Adderall (aren’t they all?) and has better pricing. Shire expects to beat Adderall’s 26 percent peak market share. Seems like a lofty goal to me.

      As for Invega, J&J is currently seeking FDA approval to use the drug for bipolar disorder and not just treatment for schizophrenia. It is also l0oking to get approval for an injectable Invega XR.

      (Invega logo from Janssen.com)

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