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.

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Drug-induced suicidal ideation

This is a great post from Ana on how she struggled with suicidal thoughts while tapering off of Effexor. She was a lot better about identifying this stuff than I’ve ever been. I’m linking to this because I want people to know that suicidal thoughts CAN be drug-induced. I’m well aware of that now coming off of Lamictal. No problems so far but I have struggled with it in the past when I tried to jump down from 200 mg to 150 mg.

Loose Screws Mental Health News: Suicide slide

congregationA new study from the University of Manitoba shows people who regularly attend some kind of religious service are less likely to attempt suicide. The study, published in the Journal of Affective Disorders, surveyed 37,000 Canadians and their connection with spirituality, religious worship, and suicidal behavior. Those who simply said they were spiritual but didn’t attend religious services did not show a reduced risk of suicide attempts. However, I was dismayed to read that researchers didn’t investigate why regular church attendance decreases the risk of suicide attempts. (Note to self: Go to church each Sunday!) (pic via www.assumpta.fr)

Alison Go of U.S. News & World Report cites a study from Academic Medicine (originally reported by Inside Higher Ed) which suggests depression affects 21.2 percent of medical students. The rates is 11.2 percent higher than that of the general population. And unfortunately, 13 percent of black medical student reported suicidal ideation in the survey, suggesting that the demographic is more likely to suffer from suicidal thoughts.

And yet another study about suicide… The University of Gothenberg in Sweden performed a study on people who had nightmares following a suicide attempt and found out that they were five times more likely to try committing suicide again. The conclusion is based on a meager sample size of 165 patients but I suppose it’s a start.

While it appears that other sleeping obstacles do not raise the risk of multiple suicide attempts, patients who have attempted suicide seem to battle sleeping problems on a regular basis.

It is normal for patients that have attempted suicide to suffer from sleeping difficulties. Some 89 percent of the patients examined reported some kind of sleep disturbance. The most common problems were difficulty initiating sleep, followed by difficulty maintaining sleep, nightmares and early morning awakening.

Interesting observation considering that I have pretty much all of the common problems with the exception of early morning awakening.

Finally in a semi-cool story, a 22-year-old New Jersey guy who was friends with an 18-year-old Californian over the Internet called California police when he found out the 18-year-old said he would attempt suicide. Although it sounds like the teen (his name was not disclosed) is pretty upset about being saved (I know the feeling), it’s a (somewhat) happy ending compared to what happened in November when a Florida teenager streamed a webcast of him committing suicide by dying of a drug overdose. The Florida teen died before police arrived.

FDA: No link between Singulair and suicidal behavior

On Tuesday, the FDA announced that an investigation into Merck’s clinical trial data did not discover a link between Singulair (montelukast) and suicidal behavior. The investigation, which began 9 months ago, was prompted by a number of reported suicides, especially that of 15-year-old Cody Miller who took the drug and appeared to have no history of mood or behavioral problems. (It is worth noting here that Singulair “is the top-selling drug for people under 17 years old” and Merck’s biggest seller with annual sales of close to $4.5 billion.)

In attempt to assess Merck’s data better, the FDA also investigated AstraZeneca’s Accolate (zafirlukast) and Cornerstone Therapeutics’s Zyflo (zileuton). Although the FDA did imply that “the data were inadequate to draw a firm conclusion” and said that the clinical trials were not set up to observe any psychiatric behavior. Here are the data the FDA discovered during their review of these trials:

SingulairSingulair: 41 placebo-controlled trials that included 9,929 patients

  • Reports of suicidal thoughts: 1 (treated with Singulair)
  • Attempted suicides: None reported
  • Completed suicides: None reported

AccolateAccolate: 45 placebo-controlled trials that included 7,540 patients

  • Reports of suicidal thoughts: 1 (placebo group)
  • Attempted suicides: 1 (placebo group)
  • Completed suicides: None reported

ZyfloZyflo: 11 placebo-controlled trials (number of patients unknown)

  • Reports of suicidal thoughts: None reported
  • Attempted suicides: None reported
  • Completed suicides: None reported

Forgive me for being cynical but the data sounds fishy. I can’t pinpoint why but it does. The suicide numbers and patient involvement data seem to deviate some from the numbers listed in Merck’s PR issued last March. (I’m seeing 11,000+ patients vs. 9,929 patients.) Regardless of the clinical trial data, it appears that the FDA as of yet have not reviewed post-marketing data.

Scott Korn, a senior safety surveillance executive for Merck said in an article for Reuters:

“‘At the time we did not believe, and we still don’t think a link has been established’ between Singulair and the suicides.”

In the same article, Sanford Berstein analyst Tim Anderson had this to say about the possibility of the FDA finding a link:

“If the… safety review leads to a stern warning about behavioral changes in the Singulair label, this could frighten users of the drug or their parents and give Merck’s competitors ammunition to attack the brand.”

The Washington Post has Dr. David Weldon, director of the Allergy and Pulmonary Lab Services at Scott & White in College Station, Texas, on record saying that he had not “seen any increase in psychiatric problems with the drug but that some patients had complained of nightmares after starting on Singulair.” (Note: It appears that the closest conflict of interest Weldon would have here is that he served as a consultant and is honoraria for AstraZeneca.)

Dr. Rauno Joks, head of the SUNY Downstate division of allergy and immunology, made an interesting point in the Washington Post article:

“The physician really needs to review whether there are symptoms that have developed since patients started taking the medication, if there’s an underlying depression that was there before medication started.

Also, seasonal allergies in and of themselves can cause fatigue and lethargy, which makes it harder to assess, because those are some of the symptoms you have with depression.”

The FDA says they’ve completed analyses of submitted clinical trial data but their “safety review will continue” for several more months before they come to a concrete conclusion. For customer testimonials, check out medications.com that has over 2,300 people reporting side effects and askapatient.com that has an average 2.3 rating from 524 reviewers. The most commonly reported mood-related side effect on both of the sites is irritability.

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

Beware XYZAL — allergy drug

I’m having a terrible allergy reaction that’s last 2 days. I visited my physician who gave me a few 5-mg samples of an allergy medicine, Xyzal (levocetirizine). This is supposed to be an alternative to Allegra, Zyrtec, and OTC Benadryl. I took time in the middle of the workday for this impromptu appointment so when I got back to work, I immediately took the drug. Then, I began feeling incredibly drowsy. I decided to look up the side effects on the xyzal site and found:

Patients taking XYZAL should avoid operating machinery or driving a motor vehicle. … Take XYZAL at bedtime. Do not increase the dose due to increased risk of sleepiness.

Great. I wish my doctor had warned me of this before I popped one at 3:45 in the afternoon at work, 13 miles away from my home. Not only that, but after doing some more reading in the Prescribing Information, I found:

Besides these events reported under treatment with XYZAL, other potentially severe adverse events have been reported from the post-marketing experience with cetirizine. Since levocetirizine is the principal pharmacologically active component of cetirizine, one should take into account the fact that the following adverse events could also potentially occur under treatment with XYZAL: hallucinations, suicidal ideation, orofacial dyskinesia, severe hypotension, cholestasis, glomerulonephritis, and still birth.

A one-time dose probably won’t affect me negatively in the ways reported above but still — it’s an allergy drug. ALLERGY drug. All this crap comes from something that’s supposed to make you feel better? Sheesh. Glad I read it. I’ll be sure to avoid regular consumption Xyzal in the future.

So now it’s 4:50 pm and I can barely keep my head up but I figured I’d make this quick post to warn anyone with mental illness who:

a) takes Xyzal or
b) thinks that allergy drugs are free from side effects triggering mental illness.

Granted, the risk is low but it exists. It also sounds like it can impair renal and hepatic functions somehow. Watch out if you’ve got kidney problems.

When work is over, I’m going straight home and making a beeline for my bed.


Mood Rating: 4

Generic Lamictal (lamotrigine)

I'm on "Day I-don't-know" of lamotrigine (generic Lamictal). It's been at least 2 weeks. I haven't had any significant side effects except for extreme fatigue. I am often tired. Some days, I can give myself a boost of energy by playing the Wii Fit (which I snagged Saturday afternoon) and other days, exercising just wears me to out to the point where I head to the shower and then to bed. I can have 3 cups of coffee, never become fully awake, and still go to sleep at a decent time.

I'm still not sleeping well. Haven't slept well since before I went into the hospital in October 2006. I can't remember the last time I had truly restful sleep.

My symptoms remain at bay. I haven't had many suicidal thoughts or impulses. In fact, some days, I can go without thinking about suicide at all. I can't say it's all the medicine — my counseling and faith play a much bigger role — but I'm sure the medicine helps.

I've recently noticed that I'm not suffering from as much social anxiety. Again, I don't know if this is due so much to the medication as it is to the resurgence of my spiritual life. I ventured out on Sunday to a meetup writers workshop group that I'd never been to before. It was extremely weird. Not the situation, but the fact that I walked into a room full of strangers, made myself comfortable on the couch at the coffeehouse and offered input quite freely without worrying about what the others thought of me. I even had the audacity to network with a woman who works at a trade magazine in the area. How strange. I don't have balls. This is not me.

What the heck has happened to me?

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.

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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 »

Gone but I don't know where

You have been drifting for so long / I know you don’t want to come down / Somewhere below you, there’s people who love you / And they’re ready for you to come home / Please come home
~ Sarah McLachlan, “Drifting”

I have an appointment with my psychiatrist on Tuesday morning. I’m not quite sure what to do.

My “symptoms” are back. Now that I know what to look for as someone with bipolar disorder, I am aware of them. I’m having mania moments. I don’t want to sleep. I have no desire to. My husband sometimes MAKES me go to sleep. I’d rather be up doing the laundry, washing the dishes, blogging, reading other blogs, making to-do lists, and organizing the apartment–all at the same time–at 2 or 3 am. (This doesn’t mean all of this stuff gets finished.)

My husband and I have had physical fights in the past where he has had to restrain me because I wouldn’t go to bed and I wouldn’t sleep. It would be 4 in the morning and I refused to sleep and I’d fight him tooth and nail. I don’t know why. I have no problem wanting to sleep at 2 pm. Make it 2 am and there’s too much to do suddenly. I have the superhuman ability to get things accomplished between midnight and 5 am more than I can during the hours of 9 am to 11 pm. Right.

So now it’s almost 1 in the morning and I have nursery duty at church later in the morning. Then I have a hair appointment in the afternoon. Then I’m paranoid about what my hair stylist thinks of me.

She says she’s my friend but I wonder if she’s just pretending to like me because she feels sorry for me. I’m really lame you know. People at work acted nice to my face and then dissed me behind my back. She does the same thing to others, why wouldn’t she do the same to me? She just keeps me around and kisses up to me because I tip well.

Thinking like that scares me. It reminds me of the way my father used to think. Paranoid. (You can stop reading here. At this point on, it’s just a manic ramble that’s basically full of nothing but stream-of-consciousness just because i can.)

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Celebrity Sensitivity: Juanita Bynum

Juanita BynumAs reported by BET News, Juanita Bynum, a televangelist who is in the middle of divorcing her husband Thomas Weeks III, admitted that she wanted to kill herself when she saw her marriage falling apart.

“Suicide crossed my mind … You know, I felt hopeless,” Bynum says in a two-part episode of the TV show “Divorce Court. “I didn’t because the name Bynum represents a legacy of people that have gone before me and had I done that I would have given too much power to an individual to not just wipe me out but to wipe out the integrity of the legacy I was born in.”

There’s a debate in the comments section of this post in which people are arguing that Bynum, who calls herself a prophetess, is human and is allowed to have a weak moment like Jesus did in the garden but there are others who aren’t taking her claim seriously citing her “self-absorbed” reasoning about the “Bynum legacy.”

Suicide? If you believe that I have a bridge I want to sell you. She is too infatuated with herself to do that. We need to stop listening to this person of continuous drama. She does not practice what she preaches.

Many people reach a point in their lives where they either have suicidal thoughts or consider committing suicide but move past it. I’m sure Bynum falls into this category, and it’s understandable. J.K. Rowling recently admitted to something similar while she was in the middle of divorce proceedings.

Calls for VA's top official to resign

I’d been meaning to talk about this story but it’s progressed faster than my typing hands can keep up.

An e-mail sent around at the Veterans Health Administration among Dr. Ira Katz, the VA mental health director, and other officials, discussed the issue of hiding the number of suicides committed by veterans from the public—an estimated five out 18 of them being under VA care. Now, a number of senators (and bloggers) are calling for Katz’s resignation.

Read the rest of this entry »

Current Mood Rating

I haven’t used the mood rating system (left sidebar) on this blog since 2006. Since I’ve been struggling with suicidal thoughts recently, I’ll be posting mood rating updates. I’ve created a "Mood Rating" category for myself so I can keep track of the progression or (non-progression) of my depression. They’ll likely include no more information than the following:

Current Mood Rating:
3

"You can do this"

From October 10, 2006:

carI’m tempted to go crash my car.

Again, the boy cried wolf.

Except I’m a girl.


Right now, I’m going through what my old pastor used to say is a “spiritual winter.” I just fall into moments when I just cease praying and reading my Bible for whatever reason. I’m not mad at God or anything; I still struggle with believing in a God that I’ve never seen with my own two eyes. But then I think about the specific events that have taken place in my life and I know He exists.

With that being said, I sat in my car this morning with the ignition turned on, ready to drive my car over the bridge into the Schuylkill River. I was ready to run home, make the stupid “goodbye world” post on this blog, text my husband “I love you. Goodbye” and then ram my car into a divider on I-76. It’s the worst suicidal thought I’ve had since I ended up in the hospital in October 2006.

Read the rest of this entry »

Celebrity Sensitivity: Pete Wentz

Pete WentzOk. I recently posted on Pete Wentz, bassist for Fall Out Boy, who has openly admitted to struggling with depression and suicidal ideation. He recently said that his relationship with Ashlee Simpson and and regular therapy sessions have helped him to overcome depression. There is no mention whether he took psych drugs as part of his recovery.

But Wentz is convinced that although he still battles with mental health issues, his relationship with Simpson has made him more emotionally balanced.

He says, “The hardest thing about depression is that it is addictive.
It begins to feel uncomfortable not to be depressed. You feel guilty
for feeling happy.

Spoken like someone who really struggles with depression. Wentz’s story underscores some points from my “about me” post that emphasizes the need for encouraging and healthy relationships.

Suicide: Understanding and Intervening – Introduction

“Won’t you share a common disaster? Share with me a common disaster. Oh, a common disaster.” – Cowboy Junkies, “A Common Disaster”

SuicideI receive weekly counseling at CCEF (Christian Counseling and Education Foundation) in Glenside, Pennsylvania, The foundation has an outreach program called Resources for Changing Lives that publishes educational material on different topics. One of the small booklets I purchased was “Suicide: Understanding and Intervening (SUI)” by Jeffrey S. Black. The booklet is a tad bigger than a 3 x 5 index card and consists of 31 pages. Of all the things I read in the book, the last paragraph stood out in my mind:

“In the years I have been involved in biblical counseling, I have not completely fathomed the hopelessness and despair in a believer that makes death more attractive than life. I pray that my inability is not merely a lack of empathy for someone who struggles. I hope that it is a vision for Christ and his kingdom that keeps the true ‘meaning’ of suicide out of my reach.”

While I understand Mr. Black has years of counseling those who struggle with suicidal ideations, I can’t help but wonder: What made him qualified to write this book?

In reading SUI, I felt as though the author took an objective stance in writing this. It came across as matter-of-factual rather than empathetic or sympathetic. I read the book – in all honesty – looking for answers and some kind of sympathy. I only received a slew of answers. The book should aptly be renamed “Suicide: A Factual Guide to Intervention.” No understanding required.

The book wasn’t bad; it just felt like the author wanted to keep his distance. “Don’t get too close to the reader lest you understand what a suicidal person is experiencing!” But the lack of emotion to relate to the reader detracted from many of the positive aspects of the book.

Out of five stars, I give the book three stars. Despite the absence of emotion, the book gives great bits of information I hope to share. As a person who struggles with suicidal thoughts on a recurring basis, the book was a bit of a disappointment. I know of other counselors at the foundation who could have written a more sympathetic book than Mr. Black. But he wrote it, so it’s time to delve into it.

Suicide debates rage

Wow. I never realized all the responses that my post on “Suicide” would garner me. Again, I am not proud of my tendencies toward suicidal actions. I have some opinions on the following comments that I’ll reserve until afterward.

First, a comment from Amy:

“My brother committed suicide via hanging in our garage. My parents will never be the same some 17 years later.

Suicide is selfish and to be brutally honest, if you are going to do it do it somewhere where your dearest family and friends will not find you first. The aftermath and lingering nightmares are just too much.”

A follow-up comment from Anna:

“Amy,

I have attempted suicide, unsuccessfully; my sister killed herself, my grandfather killed himself with arsenic, my sister-in-law's mother gassed herself, my step-father's mother took an overdose. We do suicide in my family. All of us have been severely affected by it; I still cry at the thought of walking into my sister's flat and finding the dried pool of blood – an image I will never get out of my head, some 15 years later.

I have kept myself alive through all the pain because I have 3 children who I could not bear the thought of damaging in that way; I have been living for them, not for me.
However, I have tremendous sympathy for all those who attempt or succeed at committing suicide – I say succeed with emphasis. Any person who has ever felt the depths of despair of not being able to face another hour of the intolerable pain of deep depression, would understand the longing to end that pain. Living through it takes an unselfishness which is arguably admirable, arguably the biggest form of self-harm and denial possible. For someone to continue to live with that pain so as to avoid giving someone else the pain of grieving is not necessarily the kindest act; watching your loved one living (or rather "existing") with the pain of depression is arguably as bad, if not worse, than grieving for their death. They are existing in hell for that period of time it takes for them to crawl out of that hell. Nobody wants the person they love to live in hell – why keep them there???

Who is being selfish: the person who takes their life to end their suffering, or the person who watches that person suffering day in day out and doesn't want them to die because they themselves cannot stand the idea of their own grief and suffering when their loved one commits suicide? I personally cannot "judge" which person is being the more selfish.
I wouldn't want my worst enemy to have to endure that pain, day in day out, and to know that the only reason they are keeping themselves alive is for my benefit. Ultimately each of us has the choice to live or die and that choice deserves respect and compassion, not condemnation.

I understand that families left behind are often distraught as my own family has been; I have been, but I also understand why someone does it. If you can develop that understanding, it eases the pain, lessens the blame and enables all who are affected to feel compassion – a vital element in loving and being loved.”

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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.”

CPAPMy 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.

Loose Screws Mental Health News

Women who are binge drinkers are more likely to be clinically depressed, according to a joint U.S. and Canadian study. I find it funny that they’ve got a photo of a middle-aged (or senior) woman with the captions, “Binge drinking adversely affected women’s mental health, the study suggested.” It’s possible, but HIGHLY UNLIKELY that the woman in the picture is representative of a binge drinker. A picture of a female binge drinker would look more like this:

girl drinking

That’s better. (source: The Trouble With Spikol)

On a Spikol trip, she writes that she questions a bipolar diagnosis in children and young adolescents (as in 14 or 15). I wholeheartedly disagree. Once I received a bipolar diagnosis, I realized that it wasn’t something that I’d developed out of nowhere. I often thought that I began suffering from manic depressive episodes when I was 14. Looking into my childhood, I realized that there was so much more to it: the temper tantrums, the sudden happiness and instant withdrawal. Constant paranoia that no one liked me (which no one did because I was super smart as a child). My parents described me as a “happy” kid, but I remember my tumultous childhood from 6 years old and on. I was raised in Brooklyn until I was 5 and then moved to Long Island. Even though I attended kindergarten in Brooklyn, the LI school district insisted that I was too young for first grade and made me repeat kindergarten. This apparently angered me because my parents claim that the second time around, I didn’t do any of the work because I’d done it before. After an encounter with my teacher (and seeing my father cry for the first time in my life), I shaped up my act in time to move on to first grade.

So I disagree that a bipolar diagnosis in children would erroneous or inaccurate. However, it’s possible they may be misdiagnosed and find out later on in life that they really had ADHD or some other kind of mental illness. But that doesn’t mean they weren’t mentally ill at all; it simply means they weren’t diagnosed properly.

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PCPs Don't Know Jack From Zyprexa

Eli Lilly’s actions continue to be appalling.

LillyApart from trying to hide the fact that Zyprexa induces weight gain, diabetes, and hyperglycemia, they also had sales reps encourage primary care physicians to prescribe Zyprexa for patients who did not have schizophrenia or bipolar disorder (basically off-label usage).

It seems that Lilly told marketing reps to suggest Zyprexa for dementia in the elderly. Lilly denies this, of course, since olanzapine (Zyprexa’s generic name) is not approved for that kind of use since it increases the risk of death in seniors with psychosis associated with dementia. Lilly also attempted to market olanzapine to patients with mild bipolar disorder who suffer mainly from depression. (In actuality, Zyprexa is approved to treat those who suffer from mania.)

This issue with Eli Lilly delves into precisely why I am against PCPs prescribing psychiatric medicines. Primary care physicians don’t know enough about the various psychiatric conditions to prescribe the appropriate kind of medication. This type of prescription should be left to specialists like psychiatrists. PCPs should focus on the things they deal with on a daily basis that no one else can take care of: the common cold, the flu, annual physical, etc. It should be the job of the PCP to refer a patient to a psychiatrist should they present symptoms of mental illness (depression, schizophrenia, etc.). I have been burned by having a PCP prescribe antidepressants for me and as a result, attributed my horrible experience with drugs to that.

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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.

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The Suicide Matrix

"There are three kinds of people in the suicide matrix: those who succeed, those who try it and live, and those who are hounded by suicidal thoughts—ideators, as they are known in the literature." — Philip Dawdy, "One Suicide Too Many," the Seattle Weekly

I'm both a suicide survivor and an ideator. I've tried overdosing on pills many times to no avail. I've also tried jumping out of cars. Each time, the driver has caught me before I could roll out into the street. Most of my other "attempts" have been strong ideations: drinking Windex, stabbing myself, shooting myself in the head, driving my car into a wall, jumping in front of a train, jumping off a high building — TO NAME A FEW.

I'm not proud of it; the list could go on and on. I identify with Dawdy's words in his SW article:

"In each case, there was little warning. One minute I'd be muddling through a weeks-long depression—wound up, angry, and lethargic all at once—and the next I'd be on the lethal precipice."

I can't really remember planning any suicides. I don't plan suicide attempts; the ideations hit me as an impulse. I become obsessed with the thought and I can't distract my mind. It's like a train headed full speed into a wall with no reverse gear.


This is me when I am suicidal.


My Latest Obsession
My latest obsession has been shooting myself in the head with a gun despite Dawdy's stat that "It is uncommon for women to kill themselves with a gun." I've never had access to a gun but if I did, I'd be dead by now. The act of pulling a trigger is final. So much more so than any act of suicide. A person can survive a stabbing, a jump, overdosing, or self-designed accidents. But once a person sticks a gun inside the mouth and pulls the trigger… it's difficult to miss. Survival isn’t impossible but not likely.

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Suicide

I’d like to say, “Been there, done that,” but it’s not something I’m proud to dismiss. February 14, 1997 was the first time I attempted suicide: I tried to jump off a fourth-story balcony. But I’m a drama queen and like standard drama queen fare, I called my pals and left them goodbye messages. People call it a cry for help; I just can’t leave this world without saying goodbye. (I liken it to leaving home for a long trip in another continent You’d say goodbye to those you love and would miss.) It’s become a bad (or perhaps, good) pattern that has kept me alive. I’ve tried jumping out of cars, swallowing pills, slashing, stabbing, drowning, suffocating — and barely stopped short of hanging. I got as far as a chair and a noose until I couldn’t bear to imagine my father walk in the door from work to see his only child hanging from the ceiling fan in the hallway.
I’m not happy to admit all this, but people can learn a lesson from a life as varied as mine. I’ve been to the depths of desolation and desperation and I know the feeling of not being able to “go on” or even wanting to “go on.”

Who I Am

I am a 26-year-old black female who suffers from bipolar disorder. I was diagnosed with the illness in November 2006. I’d been diagnosed as suffering from major depressive disorder (MDD) beginning at the age of 14. I still consider myself to suffer primarily from depression although I do have occasional manic episodes.

This blog has helped me to recognize many of the things that I am. That
I truly am more than my diagnosis and that my diagnosis does not define
me. I am not just a person with manic and depressive episodes. I am a person with a personality. I’m smart, witty, drop-dead gorgeous—okay, I wish, but I’m not ugly—musically inclined, and ambitious. And that’s just scratching the surface.

I can be happy, sad, angry, and joyful. I have so many emotions that could classify me as anything. I have a short attention span, for instance. The docs missed the attention-deficit hyperactivity disorder (ADHD) diagnosis (although I lack the hyperactivity).  I suffer from anxiety as well but not a single medical record lists me as suffering from generalized anxiety disorder (GAD). So I self-diagnose. It helps me to realize that all of my flaws can pigeonhole me into any diagnosis I choose. I accept my flaws – “diagnosable” or not – and my strengths. This is my journey to learn more about myself, my diagnosis, my medical treatment, and anything relating to my personal life and general mental health.

I’m skeptical of pharmaceutical companies. I don’t hate them; however, many of their practices are shady and I—along with some of my favorite medical blogs —hope to shed light on the “unfavorable” news they choose to keep hidden from the public.

I highlight celebrities who admit to mental illnesses. Many of them suffer from depression, which is the fashionable mental illness of the moment, but others truly suffer from problems that are worth talking about.

I also write about my personal life relating to mental illness. I struggle with constant thoughts of suicide. Readers of this blog will note a pronounced emphasis on suicidal thoughts and behaviors.

Feel free to read on to the next entry about my Perfectionistic Tendencies. Chronicling my journey to managing and treating my illness can hopefully aid me. And eventually, someone else.