Depression: Out of the Shadows: Live Blogging

I’m on EST so I’m watching the Depression PBS show. I’ll be live blogging about it because I have nothing better to do with my life. Probably no interesting observations but, like I said, I have nothing better to do right now.

UPDATE: Jane Pauley doesn’t appear until 10.25.

9.07 pm – Andrew Solomon, author of The Noonday Demon is sharing his story about his bout of depression. It doesn’t help that his mother, who suffered from a terminal illness, chose to end her life.

9.09 – Dr. Myrna Weissman says that depression "is a biological disorder. It’s not all in your head."

9.12 – The show highlights an adolescent named Emma who’s been struggling with depression since 5th grade. She began "acting out" as a form of self-medication. She ended up going to to an out-of-state psychiatric hospital.

9.15 – Cut to an adolescent male, Hart, who has been suffering from depression since 6th grade. After going to a hospital, he was diagnosed with bipolar disorder.

9.19 – Jed, a 20-year-old college student killed himself supposedly from undiagnosed depression. Dr. Thomas Insel says that suicide is almost twice as common as homicide in the United States.

9.21 – Drs. Geed(?) and Casey at NAMI are using MRI to further research in adolescent depression. An explanation on the neurochemical brain functions in adolescent depression follows.

9.25 – A narrative on postpartum depression begins. Ellie’s husband videotaped Ellie with the baby, Graham, shortly after his birth, and you could see the unhappiness of postpartum of depression on her face. In the homemade video, she holds her child while saying that she had suicidal thoughts the day before and wanted to die because she "couldn’t do this" anymore.

9.29 – Cut to Shep Nuland, author of Lost In America, and explains the circumstances that led to his depression.

9.32 – Dashaun, a member of the Bloods gang, suffered from early life trauma that led to his bouts of depression.

This probably goes without saying but so far, the program is replete with different doctors, none of which appear in segments other than the first one they were featured in.

9.37 – "When you gang bang, it’s just a form of suicide."

9.38 – Segue to Terrie Williams who not only helped Dashaun write his story and helped him recover from his depression, but also suffers from a mild form of depression, dysthymia. Dysthymia is estimated to affect 10-15 million Americans. One of the symptoms is overeating.

9.40 – Williams mentions that stigma of mental illness in the African American community prevents African Americans from seeking treatment.

9.41 – Philip Burguieres(?), a former CEO, suffers from depression and discusses the stigma of mental illness in corporate America.

They’re really covering the whole gamut.

The hubby is getting frustrated because the segments are really just that – segments and they never fully finish anyone’s story but jump back and forth.

9.45 – Back to Andrew Solomon from the beginning of the show. He’s currently taking Remeron, Zoloft, ZYprexa, Wellbutrin, Nemenda(? an alzheimer’s drug), Ranantadine(?), two kinds of fish oil. HOLY CRAP. (I think he’s also on Prozac but don’t hold me to that.)

9.47 – We’re being walked through the neurotransmitter explanation.

9.48 – Poor Andrew thinks he wouldn’t be on as many medications today if he had been on medication a long time ago.

9.48 – Ooh, look! It’s Richard Friedman, the psychologist/psychiatrist from the NYTimes.

9.52 – Back to adolescent Hart Lipton, who is in a special
school that gives him specialized attention. He has bipolar II. He is
on an antidepressant and a mood stabilizer.

9.52 – Emma takes one antidepressant and engages in talk therapy. She tried several different ones before she found one that worked.

9.53  – The Narrator admits that meds in young people isn’t
fully researched and may be a problem. He mentions the black box
warning on antid’s.

9.55 – NIMH docs are working on faster-acting meds for depression – as in 1 to 2-hour relief. Guinea pig patients were administered intravenous ketamine for depression. (WTF???) One of the patients, Carl, says he felt instantly better.

9.58 – Back to Shep. Doctors suggested performing a lobotomy but a resident intervened and suggested ECT. They cut to a scene from One Bird Flew Over the Cuckoo’s Nest in which Jack Nicholson got ECT. Shep says it was worth it and that he began to feel better by the 11th treatment.

10.00 – ECT especially works well on the elderly. A woman, Sue, who developed late onset depression at age 65 comes back for her 9th treatment of ECT. It helps her. Her husband says, "She’s back to her old self."

The next hour of the show under the cut…

Celebrity Sensitivity: Christina Ricci, Mel Gibson, and Britney Spears

Liz Spikol has a new post on celebrities talking about mental disorders. This time, it’s Christina Ricci and Mel Gibson. Ricci has previously admitted to suffering from anorexia but now admits to suffering from depression. Gibson, on the other hand, said in a 2002 interview that he was bipolar (manic-depressive back in the day). Then she’s got a whole list of people who have recently admitted to depression.

Then there’s Britney Spears. If you don’t know who she is, be thankful. For the rest of us who spend our time following celebrity news, there have been rumors swirling around recently that she is pregnant because she’s got a big, protruding belly (bigger than the botched VMA’s last year) even though she’s been exercising regularly.

According to the Daily Mail, Spears isn’t pregnant but seriously bloated as a result of her medication.

A source close to the family says that Britney has been struggling with her weight ever since she had her second son Jayden James, 20 months, and the medication has not helped.

The pop star has been back in training in preparation for a comeback, spending plenty of time on the treadmill – but despite all the effort, she is failing to regain the svelte figure which made her famous.

I wonder what antipsychotics she’s on. Seroquel?

Finally, ABC News wrote about celebrities who suffer from various mental illnesses. I’d been wanting to blog on this some time ago but never had the chance. BPD in OKC beat me to it.

Thoughts on Bipolar Overawareness Week: Part II

Here are some things that have occurred in my life:

• racing thoughts
• spending sprees when I have no money
• cleaning at odd hours of the night
• thinking that I’m the most amazing job interviewer ever
• worrying that people are watching me through video cameras or the wall in public bathroom stalls
• afraid that a video camera exists in our bedroom (I know it doesn’t. I think?)
• talking to "friends" who don’t really exist
• disobeyed parents
• talked back to authority
• suicide attempts
• rage/anger/hostility/irritability
• temper tantrums
• violent outbursts
• socially awkward
• extreme mood swings (happy to sad or angry in the same day)
• doing things and barely remembering them
• memory loss/forgetfulness
• chronic fatigue
• indecisiveness
• no interest in sleep
• inability to focus on one thing for an extended period of time/lack of concentration
• anxious about being around people I don’t know/don’t like
• anxious to go out and spend time with friends and/or family
• impulsiveness
• overeating
• persistent, negative thoughts

All right. So those are some things that have occurred over the course of my life. Let’s see what I diagnoses I can pigeonhole myself into.

Bipolar I

"You’re manic, manic / There is a chemical in your brain / It’s pouring sunshine and rage / You can never know what to expect / You’re manic, manic" ~ Plumb: Manic

I spoke to someone online in November who asked me if I was bipolar I or II. I was reading the mood-tracking chart that my doctor gave me  (courtesy of GSK via Lamictal) and noticed it mentioned bipolar I.

But I am still left with many questions regarding bipolar disorder:

• How will it affect me personally?
• When I have an "episode," what is my husband supposed to do?

The bp diagnosis has explained a lot of things, but prompts so many more questions, which need answers…

Fun with ICD-9 codes

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

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

UPDATE: Okay, maybe I was wrong?

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

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

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

Loose Screws Mental Health News

Since I was born on Groundhog Day (Google it if you don’t know when it is), I found this story about a groundhog so endearing. (And I make sure to turn around on my birthday to see my shadow.)

If you’re over 50 and on antidepressants, look out – you might be doubling your risk for osteoporosis. Fracture risks seem to be unrelated to falls caused by dizziness and low blood pressure. CLPsych’s analysis is also worth a read. (Many thanks to Bob Thompson for the link.)

People has an article on Cate Blanchett talking about marriage:

“Getting married is insanity; I mean, it’s a risk – who knows if you’re going to be together forever? But you both say, ‘’We’re going to take this chance, in the same spirit.’”

The Holidays

How were your holidays?

Mine were tumultuous.

Let me explain: I had a week of mania and depression on and off. I’m more accustomed to calling it a “mixed state.” I’d be sad and suicidal one minute and then happy and elated the next. (Correlation with PMS currently unidentified. I’ll tell you my verdict in about three months.)

Example: I went to the mall with my husband and mother on New Year’s Day. I went to New York & Co., one of my favorite clothing stores, and grabbed a bunch of different clothes off the racks, knowing I didn’t have enough money to pay for anything that even fit. I didn’t have enough money for a $20 shirt. My husband said I was in every corner of the stores – which I don’t normally do – looking at nearly every single item (again, I don’t do this). I tried on all the clothes I’d picked up, promising my husband that I wouldn’t get them all and still walked to the register with about $75 worth of clothing. No, not a lot but neither he nor I had the money for them. I whipped out my debit card in an effort to deceive my husband and look like I could afford it. When the $75 total popped up, however, I quickly switched to my debt-laded Discover credit card. Alas, my mother came to the rescue and paid for the items as a Christmas gift. My husband had previously been asking me what I’d pay with and I kept insisting “a card” while not specifying which kind.

I was pretty happy, cheerful, joyful – I’d go so far as to say euphoric (I rarely use that term in relation to myself). I raced around the store, excessively happy, and chatted up a storm. My husband warned my mother that an imminent crash lurked around the bend.

He just didn’t know how soon.

Loose Screws Mental Health News

I need a new subject header for “Mental health news.” It’s so blah. I need something snazzy. Perhaps “Loose Screws News”? Okay, nevermind… That’s what I get for being a former copy editor. Renamed as of 2/16/2009.

A new study, published in the scientific journal of the American Academy of Neurology has found that women who experience chronic headaches, namely migraines, are four times as likely to report symptoms of major depressive disorder. Of the 1,000 women surveyed, “593 reported episodic headache (fewer than 15 headaches per month) and 439 had chronic headache (more than 15 headaches per month).” Migraines were diagnosed in 90 percent of the women. Author of the study Dr. Gretchen Tietjen said that more studies are being done to discover whether the a serotonin imbalance in the central nervous system is the cause of chronic headaches, severe physical problems, and major depressive disorder. (source: The Trouble With Spikol)

According to businesswire.com, the non-profit organization Stanley Medical Research Institute (SMRI) will provide up to $9 million to fund Omeros Corporation’s schizophrenia program, which will help the completion of
Phase 1 clinical trials. Business Wire basically listed SMRI’s press release so I’m curious to do some research on SMRI and how this non-profit was able to obtain $9 million. I don’t know much about this organization but a non-profit organization funding a biopharmaceutical company’s program seems out of the ordinary to me. (This may be something normal, but I’m not aware of this.) According to SMRI’s “about us” blurb at the bottom of the PR, they state:

“The Stanley Medical Research Institute (SMRI) is a nonprofit organization that supports research on the causes and treatment of schizophrenia and bipolar disorder (manic-depressive illness), both through work carried out in its own laboratories and through support of researchers worldwide who are working on these diseases. SMRI has provided over $200 million in funding since 1989.”

Whoa. $200 million since 1989 is not a whole lot. Where in the world did this $9 million come from? Do non-profit organizations actually save up money to blow on a worthy future project? (The cynical patient in me wonders if there’s a drug company like GSK or Wyeth slipping money through SMRI’s back door.)

Liz Spikol usually blogs headlines before I can even get to ‘em so I credit her with discovering the following three links:

According to the Delhi Newsline, yoga can help with cases of severe depression and schizophrenia. (Hm, interesting.) Patients who took yoga classes in addition to meds improved more rapidly than patients only on meds. The connection with yoga seems to be the relaxation component — outdoing counseling and “talk therapy,” which can aid treatment in a mentally ill individual.

Oy. UPI has reported that Swedish researchers have discovered that those who struggle with suicidal ideation have problems with nightmares and sleep problems. Of the 165 patients surveyed, 89 percent of them reported a sleep problem. Nightmares proved to be the highest indicators of those with a high suicide risk. However, lead author Nisse Sjostrom is quick to note,

“Our finding of an association between nightmares and suicidality does not imply causality.”

But —

“Our findings should inspire clinicians to include questions concerning sleep disturbance and especially nightmares in the clinical assessment of suicidal patients.”

My husband thinks I suffer from sleep apnea – he claims I stop breathing sometimes in the middle of the night. I’m going for a sleep assessment sometime in February so I’ll let you know if I come back with a CPAP (continuous positive airway pressure) machine.

I’ve had increased dreams (or nightmares, what have you) on these psych meds. I haven’t been excessively suicidal and I hope it’s no indication of more suicide attempts on the way. *sigh* Were any of the surveyed patients on meds like Effexor and Lamictal?

(ASIDE: Dang working in a medical industry! I’m becoming more familiar with unfamiliar medical acronyms.)

And finally, News 24 reports that children who suffered from neglect and abuse are more likely to develop severe depression as adults. The study, published in the Archives of General Psychiatry, says the data specifically shows that “depression is a consequence of… abuse.” Um, who wouldn’t be depressed after such a traumatic experience? How do physicians differentiate between major depressive disorder (DSM-IV term for clinical depression) and post-traumatic stress disorder? Ah, once we get the answer, we can use it as a Jeopardy! question.

Venlafaxine withdrawal symptoms

Work has got me busy, folks, so posts may drop significantly in the next coming days/months. Possibly through April or May. (I’ll probably have one of those work days when I end up doing more blogging than working. It happens every now and then.) But don’t be surprised if Saturday quotes, Wednesday puppies, and Sunday stats are what pops up each week. I’ve got many of those backlogged through April. I’ll try to backlog some other posts on bipolar disorder and depression for the coming weeks and quickly blog on anything that’s timely.

In the meantime, I had to take a sick day today. It’s my third day off of the Effexor and I’m having some weird side effects (see Case 1: Standard Dose under the link). Whenever I turn or move too quickly (consider your “natural” body turn), I “kind of” see stars and the whole world slightly spins beyond my field of vision for about 3 seconds before coming back into focus. After doing some light research on the side effects of venlafaxine (Effexor’s generic name), I’ve found out that side effects can incude vertigo, dizziness, light-headedness (associated with dizziness), and something called “brain shivers,” which are a form of electric shock sensations. You know that feeling when you get an electric shock from somebody? Yeah, imagine feeling that throughout your whole body. Precisely; not a good feeling. Nancy Schimelpfening, blogger for depression.about.com, found a newsgroup posting on the brain shiver effect, mainly associated with venlafaxine:

It happens to me if I turn my head quickly, or if I stop suddenly, or in general with sudden motion. They’re worse if I’m nervous.

i’ve seen them described as feeling as though your brain keeps going when you turn your head. that doesn’t seem quite adequate to me. it’s more like this:

you turn your head (or your whole body — this happens to me if i whirl around too quickly as i’m taking the stairs. what. doesn’t everyone whirl on the stairs…?), but your brain *stays put* for a micro second, then tries to catch up but only in a stuttering, stopstart motion, accompanied by a staccato ‘zzt zzt zzt’ with each stop. the ‘zzt’ you can feel in your head, an electric sort of vertigo, and it often reverberates in your hands and fingers. some folks feel it in their toes; i haven’t yet.

sometimes your brain overshoots and comes strobing back, then overshoots again.. this all unfolds in just a second or two.

these days i endeavor to go around corners all smooth slow and steadylike. helps to reduce the number of brain shivers per day

Yeah, that’s me. It’s hard to explain to someone who’s never felt it. I got this feeling after not taking Paxil for three days too. The effects eventually wore off, but it was such a weird feeling.

Identification

I identify with Dawdy’s article on a variety of grounds and many of his words have me thinking.

“Mostly, the suicidal show no clues that they are on dangerous ground.”

This is true for me only with people I don’t know. When people at work, friends, or family see me, they think that all is right in my world. I’m the type of person who keeps a pleasant expression fixed on her face and in general, has a bubbly, cheery attitude. (Co-workers, acquaintances, and casual friends would never know how negative and pessimistic I am.) If people found out that I struggled with depression to the extent of attempting suicide on 10 different occasions, they’d all be shocked because it doesn’t seem to jive with my “personality.”

People who really know me — those closest to me — know that when I’m suicidal, it’s extremely hard for me to not show. I withdraw from social contact, refuse to make eye contact, become extremely quiet or reply with a succession of short, one-word answers to questions, or corner myself in a seat or in bed with my head hanging down, eyes spacing off into somewhere. Those who know me should and can know when I’m suicidal. It becomes so obvious that I don’t need to say anything. I usually don’t tell anyone, but my body language speaks volumes.