Top ten bipolar disorder blogs ...

... as determined by John M. Grohol, Psy.D. and posted on September 12th. To view the list, click here.

Serenity precious to bipolar sufferer

This is one of the best descriptions of bipolar disorder that I have ever read. It was published in the Halifax Chronicle Herald on September 12, 2007.

By CHRISTINE STAPLETON

I HAVE BEEN DIAGNOSED with a type of bipolar called hypomania. I am going to try to explain what it feels like to be bipolar — a form of depression characterized by severe mood swings.

When I am manic, I feel like a race horse in the gate, waiting for the bell. Sitting still for a hair appointment is almost impossible — one of the reasons I have let my hair go gray, or "silver," as I like to say. My thoughts race.

If I do become fixated on one thought, it consumes me. I become obsessed with thinking through every detail, possibility and outcome. This has made me a successful journalist.

Let me give you an example. I was once assigned to cover the case of a young man who walked into his parents’ bedroom and shot them as they slept. The father died. The mother lived.

Within moments of hearing the news, I had analyzed the entire case. Would the kid’s attorney ask a judge for a furlough so he could attend his father’s funeral?

Would the Department of Corrections allow the mother (the victim) on the visitor list of her son (the killer)? And would prosecutors subpoena the mother and force her testify against her only child — testimony that could put him in the electric chair?

Today, I analyze data for investigative projects. I can sit in front of my computer for hours, unaware of the time — amped on trying to find an answer.

Then there are the physical symptoms.

My muscles ache to be used. I exercise until my heart rate reaches 180 beats per minute. My off switch doesn’t work.

I once ran the last five miles of a marathon without shoes because they hurt my feet.

But when I am down, I want to be alone. Caller ID is my best friend. I don’t talk much. I do my work and try to look so busy that no one will bother me. I am not tired. I am weary. Life is bleak. Numb days roll by. I have no hope that life will get better.

In between, there can be long periods of feeling stable and content. Life is fine, except I’m waiting?

Today, the anxious ache that once welled up every time I inhaled is
gone. With the help of my therapist, my nurse practitioner and my medications, I now have an emotional floor beneath me.

Sadness and anxiety have expiration dates. I can pause when agitated. I understand that everyone is not entitled to my opinion.

I have serenity.

If you are not bipolar, I cannot describe how wonderful and amazing this feels — believing that you can trust your ability to handle your feelings and that you won’t lose these skills.

Life can be good.

Christine Stapleton writes for The Palm Beach Post, West Palm Beach, Florida.

Photo of Christine Stapleton courtesy of The Palm Beach Post.

Lithium, Circadian Clocks, and Bipolar Disorder

A nice summary on the above has been posted by A Blog Around the Clock.

Related to the above, work on synthesizing glycogen synthase kinase-3beta (GSK-3beta) inhibitors was recently published by Kozikowski et al. in the Journal of the American Chemical Society. This paper provides many literature references implicating GSK-3beta in bipolar disorder.

Resolutions for Mental Health Care

Below is an article by Christine Stapleton (second from left in the above photograph) of the Palm Beach Post as published in the Halifax Chronicle Herald on January 3, 2007:

I AM NOT big on New Year’s resolutions. If I need to change something, I change it. Doesn’t matter what time of year it is.

But to mental health advocates, I offer you these New Year’s resolutions:

1. Do something for people who suffer dual-diagnosis. It is estimated that as many as half of the alcoholics and addicts out there suffer from another mental illness, the most common being depression and bipolar disorders. In order for these people to have a shot of recovery, both illnesses must be treated. A sober alcoholic is ripe for relapse if a major depression sets in. An alcoholic still out there is fuelling his depression with booze, a depressant.

2. Organize support groups. There are hundreds of meetings every week in the area for alcoholics and addicts. Let’s have as many for people with depression or other mental illnesses. Arrange for meeting space in a church or a community centre. Advertise at pharmacies, on buses, on the radio and in newspapers.

3. Educate the medical community. How many general practitioners are prescribing antidepressants without requiring a checkup within a month to find out whether the drug is even working? Here’s what the FDA says about it: "Adults being treated with antidepressant medications, particularly those being treated for depression, should be watched closely for worsening of depression and for increased suicidal thinking or behaviour. Close watching may be especially important early in treatment, or when the dose is changed."

4. Support one-stop shopping. A person in the throes of a major depression is not capable of making all kinds of phone calls to get help, find a doctor, find a therapist, or figure out bus routes or how to pay for meds. Partner with local hospitals, clinics, the health department and crisis lines so that sick people need only make one phone call.

5. Talk to each other. Create a listserv and invite physicians, clinicians, social workers, psychiatric nurse practitioners and substance abuse counsellors to subscribe. Post meetings, interesting articles, concerns, questions and problems. It’s free, it’s easy and the information comes right to e-mail.

6. Understand men. A depressed man won’t necessarily exhibit the same symptoms as a woman. Men with depression often take risks, abuse drugs or alcohol or engage in other compulsive behaviours.

7. Educate the legal community. I spent 12 years in courtrooms writing stories about all kinds of crimes. Here’s what I saw: An incredible amount of mental illness and a tremendous amount of misunderstanding by judges, prosecutors, defence attorneys and cops. The most prevalent mental illnesses I saw were alcoholism, addiction and depression. Why not send The Big Book of Alcoholics Anonymous to those in the legal system so they can better understand these diseases and the treatment programs to which they routinely sentence folks? I heard one judge sentence a defendant to a 10-step program. Last time I checked, there were 12 steps.

8. Encourage therapy. For many, drugs and lifestyle changes are not enough. The FDA and the American Psychiatric Association recommend cognitive behavioural therapy for treating depression and other mental illnesses. Partner with local psychologists, social workers and nurse practitioners to find a way to provide and encourage this invaluable treatment.

9. Fight the stigma. Speak up when you hear a wisecrack about whether someone with a mental illness has taken their meds. Show compassion but don’t condescend. Do what you can. And have a happy new year.

Including Laboratory Tests in DSM-V Diagnostic Criteria

Michael B. First, M.D. and Mark Zimmerman, M.D. write in the December issue of the American Journal of Psychiatry:

Despite widespread acceptance that most psychiatric disorders are "diseases of the brain" (1), the field of psychiatry has thus far failed to identify a single neurobiological marker that is diagnostic of a mental disorder (2). There are a number of potential advantages to including laboratory tests in diagnostic criteria. In contrast to the clinical signs and symptoms that form the basis for the current DSM criteria, laboratory tests are more objective (3), would facilitate detection of mental disorders in primary care settings (4), and would highlight the neurobiological basis of psychiatric disorders.

Are complementary and alternative therapies safe and effective?

Read what the Canadian Health Network has to say by clicking here.

Some recent publications ...

... of possible interest:


DSM and the Death of Phenomenology in America: An Example of Unintended Consequences.
Nancy C. Andreasen, Schizophrenia Bulletin, doi:10.1093/schbul/sbl054.


The Search for New Off-Label Indications for Antidepressant, Antianxiety, Antipsychotic and Anticonvulsant Drugs.
Guy Chouinard, M.D., Focus 4:528, September 2006.


Middle and Inferior Temporal Gyrus Gray Matter Volume Abnormalities in First-Episode Schizophrenia: An MRI Study.
Noriomi Kuroki, M.D., et al., American Journal of Psychiatry 163:2103-2110, December 2006.


What Is Familial About Familial Bipolar Disorder? Resemblance Among Relatives Across a Broad Spectrum of Phenotypic Characteristics.
Thomas G. Schulze, M.D., et al., Archives of General Psychiatry, 2006; 63:1368-1376.


Practice Guidelines for the Treatment of Psychiatric Disorders: Compendium 2006.
American Psychiatric Association.


Postpartum Depression: A Major Public Health Problem.
Katherine L. Wisner, MD, MS; Christina Chambers, PhD, MPH; Dorothy K. Y. Sit, MD, Journal of the American Medical Association, 2006; 296:2616-2618.


Modeling Sensitization to Stimulants in Humans: An [11C]Raclopride/Positron Emission Tomography Study in Healthy Men.
Isabelle Boileau, PhD, et al., Archives of General Psychiatry, 2006; 63:1386-1395.

Nicotine Receptor Agonist Could Aid Smoking Cessation

Joan Arehart-Treichel writes in the December 1, 2006 issue of Psychiatric News:

Counseling, CBT, and nicotine patches can help schizophrenia patients who want to quit smoking. However, other interventions — such as a nicotinic receptor agonist called DMXB-A — may work even better.

References:
Am J Psychiatry 163:1934-1942, November 2006
Am J Psychiatry 163:11, November 2006

Butterfly, by Shona

From 1st Person

Dr. Paul Greengard on Depression

A quote from Dr. Paul Greengard, 2000 Nobel Prize Winner, Physiology/Medicine:

Every year, without any treatment at all, thousands stop suffering from depression. Because it kills them.

Mental Health Bill 2006 (United Kingdom)

Recent news from Parliament in the United Kingdom:

The Mental Health Bill 2006 amends the Mental Health Act 1983. It also introduces "Bournewood" safeguards through amending the Mental Capacity Act 2005. The Bill was introduced into Parliament on 16 November 2006.

FAQ on Mental Illness and Mental Health

The website of the Peel Branch (Ontario) of the Canadian Mental Health Association has a particularly good section on frequently asked questions (FAQ) about mental illness and mental health.

Fine Line: Mental Health/Mental Illness

From the website:

FINE LINE is a documentary of voices, stories and portraits that confronts stereotypes and reveals the courage and fragility of those living with mental illnesses.

Photographer Michael Nye spent four years photographing and recording stories. Schizophrenia, depression, obsessive-compulsive, anxiety and bi-polar disorders are among the experiences considered.

In simple and eloquent detail the 55 black-and-white portraits and voices draw you closer into each life by addressing and exploring many topics: family, confusion, pain, abuse, treatment and healing.

Consider Beth. She was one of the most talented writers in her high school – she performed her own original songs on stage. Later, she was unable to leave her home, and literally stayed in one chair in her kitchen for years.

Thelma raised six children on the banks of the San Antonio River and sings Mexican ballads when she’s alone. When she was 10, her mother tried to crash a hired plane in the desert with her on board.

At the age of 20, Kerry built a house that was featured on the cover of an architectural magazine. At the age of 49, he hung himself in his mother’s garage. He was gentle, kind, intelligent and shy.

Doris received a Master’s Degree in sociology. Her passion is collecting recipes. She was homeless for 2 years. As a child she was beaten and sexually abused.

Michael was the editor/part owner of an alternative newspaper. His gift is making people laugh. He had his first breakdown at the computer screen. He started crying for no apparent reason and could not stop.

Deeply personal stories can take us inside complicated issues where empathy and understanding begin. Each face invites you to listen.

Anxiety and Happiness

The Globe and Mail has two interesting and well-written feature articles in today's edition; one on anxiety and the other on happiness. Check them out!

Human Genome more Variable than Previously Thought

The Globe and Mail reports on a new study showing that "more DNA differences exist between people than the experts expected." Additionally, the researchers found that "while people do indeed inherit one chromosome from each parent, they do not necessarily inherit one gene from mom and another from dad."

"We have to think of genetics in an entirely different way. We're actually more like a patchwork of genetic code than bar codes that line up evenly," Dr. Scherer said. "Everything we've been taught is different now."

The study, conducted by Canadian, British, American, and Japanese researchers, was published today by the journal Nature. It also made headlines in The Times Online (where it is accompanied with a nice explanatory graphic).

Also see:
CBC News
BBC News
National Geographic News

Photo caption from National Geographic News:

A new DNA study has revealed that humans show much more genetic variation than was previously believed. Scientists studying how large chunks of DNA differ among individuals found large changes in 12 percent of the human genome.

Here, superimposed profiles of different human genomes reveal the magnitude of differences, with green segments showing DNA gains, red areas representing losses, and yellow portions indicating no difference.

Image courtesy Matthew Hurles/Nature

Atomic-level Scrutiny of Neurotransmitter Vesicles is a First

From Chemical and Engineering News:

The first depiction of an organelle right down to its molecular minutia has finally come to light. Using a combination of biophysical and proteomic techniques, European and Japanese scientists examined quantitatively the relative ratios of the lipids and 180 or so proteins that adorn synaptic vesicles, the compartments that house and traffic neurotransmitters essential for brain function (Cell 2006, 127, 671).

ANATOMICALLY CORRECT

This picture of a synaptic vesicle is the first atomic-level description of any cellular organelle. Cell © 2006

Next up, the researchers will focus on how vesicles that carry different neurotransmitters — such as glutamate or gamma-aminobutyric acid — differ from one another.

Violence and Mental Illness — How Strong Is the Link?

Following up on my posting of the "This Man has a Problem" video yesterday, Dr. Richard A. Friedman concluded the following in a recent article published by the New England Journal of Medicine:

"The challenge for medical practitioners is to remain aware that some of their psychiatric patients do in fact pose a small risk of violence, while not losing sight of the larger perspective — that most people who are violent are not mentally ill, and most people who are mentally ill are not violent."

He also noted:

"A study that compared the prevalence of violence in a group of psychiatric patients during the year after hospital discharge with the rate in the community in which the patients lived showed no difference in the risk of violence between treated patients and people without a psychiatric disorder. Thus, symptoms of psychiatric illness, rather than the diagnosis itself, appear to confer the risk of violent behavior."

An interview with Dr. Friedman can be heard by clicking here.

This Man has a Problem

Wait a second while the video loads and then double click the arrow to view it.

Thanks to Liz Spikol for bringing this video to my attention.

"Functional MRI, recent advances in genetics, and improved understanding of neurophysiology are all contributing to a better understanding of how brain function influences mind, and how mind, meaning and experience can change the brain."

A conference well worth attending?