This is a bit late...
National Mental Health Week (in Canada) - May 1-7, 2006
This week is National Mental Health Week in Canada. Many Canadians are affected personally by mental illness - including many who support family members, friends and co-workers - which is why the Government of Canada continues to work with the provinces and territories to improve prevention and treatment of mental illness.
One in five Canadians will directly experience a mental illness at some point in their lifetime. For far too long, the stigma of mental illness has made the victim hide their suffering while society failed to adequately address and meet their needs. The perception of mental illness is improving but more work needs to be done to educate people about the illness. It can happen to absolutely anyone and, like other illnesses, many people can successfully recover with proper treatment.
For those who suffer with mental illness it's important they know what avenue they can take to receive treatment. Whether it is speaking with your doctor, counsellor, psychologist, psychiatrist or attending a support group, help is available.
Today there are effective medications that doctors can prescribe along with other treatments to deal with mental illness. Reaching out to family, friends or colleagues for support and assistance can be quite helpful.
The Canadian Mental Health Association (CMHA) is building on last year's Mental Health Week theme, practicing mind and body fitness, to promote nation-wide awareness and education. Improving individual mental health is a step in the right direction toward reducing the number of mental illnesses that affect Canadians each year.
Mental health is a vital part of overall wellness. As Minister of Health, I encourage you to join the CMHA in marking this important week.
Tony Clement
Minister of Health
For more information about mental health, please visit It's Your Health - Mental Illness.
Wednesday, May 31, 2006
Tuesday, February 28, 2006
Facts about Mental Illness
astonishing facts about mental illness
From Royal Ottawa Health Care Group
According to the World Health Organization, Mental Illness is the leading cause of disability in Canada, the US and Western Europe 8 of the 10 leading causes of disability are mental illnesses According to the Canadian Institute for Health Information - Hospital Mental Health Database, 2003 the average length of stay for a patient in an Ontario Mental Health Hospital is 99 days The annual direct and indirect cost to the Canadian economy of mental illness is $14 Billion
From Royal Ottawa Health Care Group
Sunday, February 19, 2006
Pretending you have jet lag to help overcome insomnia
Pretending you have jet lag to help overcome insomnia
Originally posted on Friday, August 26, 2005
CHANGE YOUR SLEEP PATTERN TIPS: I read a number of articles and chose to include the suggestions I kept coming across.
1 - Drink lots of water.
2 - Forget your old sleep pattern - those days are over (well, at least while you're on your trip) and work with local times only.
3 - Take sleeping pills before bed to help you a) get to sleep and b) stay asleep throughout the night. Lots of articles mentioned taking melatonin - interesting hormone. You can get it from health food stores, but not in Canada because it's banned here. Also, if the thought of taking sleeping pills doesn't jive with you, you might want to consider making an exception just for jet lag (real or imagined) because it really will help you get to sleep and stay asleep if you've had trouble doing so in the past.
4 - Wake up and stay up. Some articles said short naps were ok, but that would never work for me. Keep yourself busy, surf the net, play video games, go for a walk - whatever it takes. This day might seem really loooong. That's OK, it'll be over soon and tomorrow won't be as bad.
5 - Use caffeine if you wish, but don't over do it, drink lots of water and don't use it near bedtime. If you have too much you may find that you feel exhausted, but no matter how hard you try, you can't sleep - extremely frustrating.
6 - And this one is just from me - eat breads and pastas to help settle your stomach if you're not feeling good.
And Further Suggestions for Fake Jet Lag:
I asked myself what I would do if I were catching a plane to England (which I used to do once a year when my dad was working out there). The flights would always leave in the evening and arrive in their morning. I could never sleep on the plane, so I would end up staying awake for a day, night and day. Then, I would make sure I go to bed at a reasonable local time (that means 10 or 11pm for me) and get up at 8 or 9am (again, reasonable for me) and stay awake the entire day, doing the same thing all over again.
Originally posted on Friday, August 26, 2005
CHANGE YOUR SLEEP PATTERN TIPS: I read a number of articles and chose to include the suggestions I kept coming across.
1 - Drink lots of water.
2 - Forget your old sleep pattern - those days are over (well, at least while you're on your trip) and work with local times only.
3 - Take sleeping pills before bed to help you a) get to sleep and b) stay asleep throughout the night. Lots of articles mentioned taking melatonin - interesting hormone. You can get it from health food stores, but not in Canada because it's banned here. Also, if the thought of taking sleeping pills doesn't jive with you, you might want to consider making an exception just for jet lag (real or imagined) because it really will help you get to sleep and stay asleep if you've had trouble doing so in the past.
4 - Wake up and stay up. Some articles said short naps were ok, but that would never work for me. Keep yourself busy, surf the net, play video games, go for a walk - whatever it takes. This day might seem really loooong. That's OK, it'll be over soon and tomorrow won't be as bad.
5 - Use caffeine if you wish, but don't over do it, drink lots of water and don't use it near bedtime. If you have too much you may find that you feel exhausted, but no matter how hard you try, you can't sleep - extremely frustrating.
6 - And this one is just from me - eat breads and pastas to help settle your stomach if you're not feeling good.
And Further Suggestions for Fake Jet Lag:
I asked myself what I would do if I were catching a plane to England (which I used to do once a year when my dad was working out there). The flights would always leave in the evening and arrive in their morning. I could never sleep on the plane, so I would end up staying awake for a day, night and day. Then, I would make sure I go to bed at a reasonable local time (that means 10 or 11pm for me) and get up at 8 or 9am (again, reasonable for me) and stay awake the entire day, doing the same thing all over again.
Friday, February 03, 2006
What's it like to be Schizophrenic?
I do not have schizophrenia, but I have lived with someone who has had psychosis. Regardless, I thought this article was great for general awareness.
Coping With Schizophrenia Requires Effort...
The following is an adaptation by the Menninger Letter of “Twelve Aspects of Coping for Persons with Schizophrenia” by Frederick J. Frese, Ph.D. (Innovations and Research, Vol 2., No. 3, 1993, pp. 39-46.)
I am a person with schizophrenia. I am not currently psychotic, but I have been in the state of psychosis often enough to be somewhat familiar with the trips there and back.
A few years ago I decided to talk openly about my experiences with schizophrenia. My initial talks on the theory and politics of caring for the mentally ill were well received.
But I soon learned that most nonprofessional audiences prefer to learn how families can cope with the condition. I now focus on 12 aspects of coping with schizophrenia: denial, knowledge , medication, delusional thinking, social deficits, replaying, expressed emotion, stress, music and hobbies, stigma, revealing, and networking.
Denial and acceptance
I can’t tell you how difficult it is to accept a diagnosis of schizophrenia. Humans are governed by logic and reason: the unreasonable is unacceptable. But this disorder disrupts brain chemistry and fools you into believing that your thoughts are rational when other people can usually tell that they’re not.
Psychosis is a “catch-22.” If you understand that you are insane, then you’re thinking properly and are therefore not insane. You can be psychotic only if you believe you are not. It is generally best not to confront denial outright, but rather to chip away at it. Acceptance of the diagnosis can help motivate us to learn more about the disorder.
With people who deny that they have the disorder, it is helpful to point out to them that they are being treated by others as though they have a mental illness. Once they concede this point, they may be more willing to seek medical treatment.
Knowledge of the disorder
Schizophrenia is now widely accepted as a brain-based imbalance in the biochemistry of the neurotransmitting systems. On a practical level, it disturbs thought and belief systems and affects confidence in what is truthful. It can even evoke mystical experiences that seem very real, but which mus be viewed as a symptom of an illness that requires treatment.
Medication
People who are physically disabled can be helped by artificial supports such as seeing eye dogs, hearing aids, or crutches. Schizophrenia requires the chemical “crutch” of neuroleptic medication. Without it, I would not be able to function as I do today. True, some medications have serious side effects, but new drugs are constantly being developed, and many of them are more effective with fewer side effects.
Delusional Thinking
Our psychological systems were designed to protect us from reasonable amounts of stress. Stress affects everyone, but different individuals react in different ways, and sustained stress affects various physiological functions and thought patterns.
When normal brain functioning is disrupted, our brains revert to responding from our emotional center rather than from our center for rational thought processing. It is important for us to recognize that stress can overload our rational capacities and make us react in an overly defensive, vigilant, or delusional way.
Social deficits
People with schizophrenia tend not to look at the person they’re conversing with. There is a good reason for this avoidance of eye contact. We’re more easily distracted, and the other person’s facial expressions can make it difficult to focus on what we are trying to say. Because we’re slower to process information our recognition of what the other person says is often delayed.
These tendencies throw off the rhythm of conversation because they disconcert other people. We also have trouble knowing when and how to end a conversation. But, if we can get other people to understand these social deficits, then we can work together to overcome them.
Replaying/rehearsing
In psychiatric hospitals patients often appear to be talking to people who aren’t really there. Sometimes these patients are responding to voices, but not always.
Those of us with schizophrenia are quite sensitive to having our feelings hurt. We may seek to protect ourselves by replaying past painful experiences and then rehearsing responses (often out loud) that might be useful in the future.
But we need to recognize this tendency and understand that it may upset other people. Since my own inclination to talk out loud annoys my wife, I try to confine myself to doing so only in the shower of while mowing the yard.
Expressed emotion (EE)
The EE concept focuses on the relationship between family and other environmental characteristics and the likelihood of relapse by persons recently released from hospital treatment. Researchers have found that patients who go back to live with family members who frequently express emotional over-involvement or negative emotions (resentment, hostility) are much more likely to relapse than those who live with families who are les emotionally expressive.
Those of us with schizophrenia need to avoid persons, place, and activities where we are likely to encounter high expressed emotion. We also need to learn how to let others know something about the nature of our disability and what triggers a relapse.
Stress and excitement.
Stressful and stimulating situations tend to cause relapses. My own breakdowns often occur while I am attending conferences or shortly thereafter. Even visits to s shopping mall can be too stressful. I find it helpful to limit my exposure to, or withdraw slightly from, such situations. Adjusting medication dosage might also be made in consultation with one’s doctor.
Music and hobbies
Because the ability of persons with schizophrenia to sustain rational processes is damaged, activities that do not tax logical abilities are often helpful. Music, art, and poetic forms can all be used as a way to communicate.
These aesthetic expressions can release pressures and be most and be most therapeutic. Such activity has been called “woodshedding,” from the jazz musician’s custom of experimenting in isolation until the sounds form patterns that others can appreciate. Woodshedding in any expressive art can build bridges back to the world of normality.
Stigma/discrimination
Traditionally, persons judged “insane” were summarily dismissed as unimportant by the general population. When we started returning to society, we were often unwelcome. The media have mostly portrayed mentally ill persons as monsters. Although such conditions as cancer and heart disease can be openly discussed, the topic of schizophrenia elicits emotional reactions of fear or derisive humor.
Those of us who find ourselves unwelcome in what I sometimes call “the chronically normal community” must work together to change our image. We can promote greater understanding and acceptance by being open about the nature of mental illness.
Revealing/covering
Recovered mentally ill persons often contact me about whether to reveal their condition to others, especially employers. I usually encourage them to show their boss an article about me or another recovered person as a way to gauge that person’s receptivity—and then to be guided by the reaction they elicit.
As a practical matter, however, many people should probably not be too open about their past. You can usually account for time spent in the hospital or spells of unemployment in creative ways that involve no real falsehood—such as by indicating you were doing freelance work, consulting, or writing.
Networking
When I was released from the hospital, I had trouble connecting with other former patients. But that’s changing because organizations such as the National Alliance for the Mentally Ill (NAMI) have established a national network with groups in all large cities and many smaller ones nationwide. It has been my experience that recovering persons benefit greatly from associating with others with similar disabilities. To locate a NAMI affiliate in your area, call their national office at 1-800-950-6264.
___________________________________________
Frederick Frese, Ph.D. is coordinator of Recovery Services for Summit County, Ohio. He has a website: fredfrese.com and can be reached online at fresef@admboard.org.Article source is from Dr Frese's website here:http://fredfrese.com/?q=node/view/2
Coping With Schizophrenia Requires Effort...
The following is an adaptation by the Menninger Letter of “Twelve Aspects of Coping for Persons with Schizophrenia” by Frederick J. Frese, Ph.D. (Innovations and Research, Vol 2., No. 3, 1993, pp. 39-46.)
I am a person with schizophrenia. I am not currently psychotic, but I have been in the state of psychosis often enough to be somewhat familiar with the trips there and back.
A few years ago I decided to talk openly about my experiences with schizophrenia. My initial talks on the theory and politics of caring for the mentally ill were well received.
But I soon learned that most nonprofessional audiences prefer to learn how families can cope with the condition. I now focus on 12 aspects of coping with schizophrenia: denial, knowledge , medication, delusional thinking, social deficits, replaying, expressed emotion, stress, music and hobbies, stigma, revealing, and networking.
Denial and acceptance
I can’t tell you how difficult it is to accept a diagnosis of schizophrenia. Humans are governed by logic and reason: the unreasonable is unacceptable. But this disorder disrupts brain chemistry and fools you into believing that your thoughts are rational when other people can usually tell that they’re not.
Psychosis is a “catch-22.” If you understand that you are insane, then you’re thinking properly and are therefore not insane. You can be psychotic only if you believe you are not. It is generally best not to confront denial outright, but rather to chip away at it. Acceptance of the diagnosis can help motivate us to learn more about the disorder.
With people who deny that they have the disorder, it is helpful to point out to them that they are being treated by others as though they have a mental illness. Once they concede this point, they may be more willing to seek medical treatment.
Knowledge of the disorder
Schizophrenia is now widely accepted as a brain-based imbalance in the biochemistry of the neurotransmitting systems. On a practical level, it disturbs thought and belief systems and affects confidence in what is truthful. It can even evoke mystical experiences that seem very real, but which mus be viewed as a symptom of an illness that requires treatment.
Medication
People who are physically disabled can be helped by artificial supports such as seeing eye dogs, hearing aids, or crutches. Schizophrenia requires the chemical “crutch” of neuroleptic medication. Without it, I would not be able to function as I do today. True, some medications have serious side effects, but new drugs are constantly being developed, and many of them are more effective with fewer side effects.
Delusional Thinking
Our psychological systems were designed to protect us from reasonable amounts of stress. Stress affects everyone, but different individuals react in different ways, and sustained stress affects various physiological functions and thought patterns.
When normal brain functioning is disrupted, our brains revert to responding from our emotional center rather than from our center for rational thought processing. It is important for us to recognize that stress can overload our rational capacities and make us react in an overly defensive, vigilant, or delusional way.
Social deficits
People with schizophrenia tend not to look at the person they’re conversing with. There is a good reason for this avoidance of eye contact. We’re more easily distracted, and the other person’s facial expressions can make it difficult to focus on what we are trying to say. Because we’re slower to process information our recognition of what the other person says is often delayed.
These tendencies throw off the rhythm of conversation because they disconcert other people. We also have trouble knowing when and how to end a conversation. But, if we can get other people to understand these social deficits, then we can work together to overcome them.
Replaying/rehearsing
In psychiatric hospitals patients often appear to be talking to people who aren’t really there. Sometimes these patients are responding to voices, but not always.
Those of us with schizophrenia are quite sensitive to having our feelings hurt. We may seek to protect ourselves by replaying past painful experiences and then rehearsing responses (often out loud) that might be useful in the future.
But we need to recognize this tendency and understand that it may upset other people. Since my own inclination to talk out loud annoys my wife, I try to confine myself to doing so only in the shower of while mowing the yard.
Expressed emotion (EE)
The EE concept focuses on the relationship between family and other environmental characteristics and the likelihood of relapse by persons recently released from hospital treatment. Researchers have found that patients who go back to live with family members who frequently express emotional over-involvement or negative emotions (resentment, hostility) are much more likely to relapse than those who live with families who are les emotionally expressive.
Those of us with schizophrenia need to avoid persons, place, and activities where we are likely to encounter high expressed emotion. We also need to learn how to let others know something about the nature of our disability and what triggers a relapse.
Stress and excitement.
Stressful and stimulating situations tend to cause relapses. My own breakdowns often occur while I am attending conferences or shortly thereafter. Even visits to s shopping mall can be too stressful. I find it helpful to limit my exposure to, or withdraw slightly from, such situations. Adjusting medication dosage might also be made in consultation with one’s doctor.
Music and hobbies
Because the ability of persons with schizophrenia to sustain rational processes is damaged, activities that do not tax logical abilities are often helpful. Music, art, and poetic forms can all be used as a way to communicate.
These aesthetic expressions can release pressures and be most and be most therapeutic. Such activity has been called “woodshedding,” from the jazz musician’s custom of experimenting in isolation until the sounds form patterns that others can appreciate. Woodshedding in any expressive art can build bridges back to the world of normality.
Stigma/discrimination
Traditionally, persons judged “insane” were summarily dismissed as unimportant by the general population. When we started returning to society, we were often unwelcome. The media have mostly portrayed mentally ill persons as monsters. Although such conditions as cancer and heart disease can be openly discussed, the topic of schizophrenia elicits emotional reactions of fear or derisive humor.
Those of us who find ourselves unwelcome in what I sometimes call “the chronically normal community” must work together to change our image. We can promote greater understanding and acceptance by being open about the nature of mental illness.
Revealing/covering
Recovered mentally ill persons often contact me about whether to reveal their condition to others, especially employers. I usually encourage them to show their boss an article about me or another recovered person as a way to gauge that person’s receptivity—and then to be guided by the reaction they elicit.
As a practical matter, however, many people should probably not be too open about their past. You can usually account for time spent in the hospital or spells of unemployment in creative ways that involve no real falsehood—such as by indicating you were doing freelance work, consulting, or writing.
Networking
When I was released from the hospital, I had trouble connecting with other former patients. But that’s changing because organizations such as the National Alliance for the Mentally Ill (NAMI) have established a national network with groups in all large cities and many smaller ones nationwide. It has been my experience that recovering persons benefit greatly from associating with others with similar disabilities. To locate a NAMI affiliate in your area, call their national office at 1-800-950-6264.
___________________________________________
Frederick Frese, Ph.D. is coordinator of Recovery Services for Summit County, Ohio. He has a website: fredfrese.com and can be reached online at fresef@admboard.org.Article source is from Dr Frese's website here:http://fredfrese.com/?q=node/view/2
Monday, January 09, 2006
Take Suicide Off the Table
One of my blogging friends wrote this and I thought it was excellent. I thought you might too.
Take Suicide Off the Table
byDavid Michael
When life is dark and dreary,
and pain is deep within your soul;
thoughts of death and destruction emerge
and depression takes its toll.
Solutions may be hard to find,
and optimism seems too cavalier;
find a space between your thoughts
before spiraling down in fear.
Take suicide off the table;
it's not an option for your pain.
Open your mind to possibilities
there is so much to gain.
Suicide is not painless,
those who are left behind will say,
Suicide is severely painful,
and it never goes away;
it never goes away.
Take Suicide Off the Table
byDavid Michael
When life is dark and dreary,
and pain is deep within your soul;
thoughts of death and destruction emerge
and depression takes its toll.
Solutions may be hard to find,
and optimism seems too cavalier;
find a space between your thoughts
before spiraling down in fear.
Take suicide off the table;
it's not an option for your pain.
Open your mind to possibilities
there is so much to gain.
Suicide is not painless,
those who are left behind will say,
Suicide is severely painful,
and it never goes away;
it never goes away.
Friday, January 06, 2006
Antidepressants Work and Don't Boost Suicide Risk
Antidepressants Work and Don't Boost Suicide Risk
Sun Jan 1, 2005
by Steven Reinberg, HealthDay
SUNDAY, Jan. 1 (HealthDay News) -- Contrary to what has been feared, the antidepressants known as serotonin reuptake inhibitors (SSRIs) are initially effective in as many as one-third of depressed patients and don't appear to increase the risk of suicide, two new studies claim.
The reports, both of which were funded by the National Institute of Mental Health, appear in the January issue of the American Journal of Psychiatry.
The suicide findings seem to challenge a 2004 advisory by the U.S. Food and Drug Administration that warned that suicidal behavior may increase after treatment with SSRIs. However, the study did find that suicide attempts were higher among teens than adults, a finding borne out by other research.
The first report is based on early data from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial, the largest study of its kind. This research looked at the benefits of antidepressants in "real world" settings.
About a third of the patients achieved remission," said lead researcher Dr. Madhukar Trivedi, director of the Mood Disorders Research Program and Clinic at the University of Texas Southwestern Medical Center, in Dallas. "An additional 10 to 15 percent achieved a response."
The object of the study was to provide physicians with guidelines for treating depression, Trivedi said. "The goal is to have patients provided with an adequate dose of medication for an adequate time," he explained. "Treatment would be tailored for each individual patient to get the most benefit from treatment."
For the study, researchers looked at the results of prescribing the SSRI Celexa to 2,876 patients with major depression. These patients also had other physical and psychological problems. The researchers found that about a third of the patients had their depression cured during the first 12 weeks of treatment.
In addition, another 10 percent to 15 percent of the patients showed a response to the medication, or reduction of at least half their symptoms. For patients who did not improve, later phases of the trial will use other medications or combinations of medications to see what might help those who did not benefit from the drug used in the first phase of the trial.
"These antidepressants in routine clinical care produce outcomes comparable with what is seen in research settings," Trivedi said. "These treatments do work in routine clinical care. There also has to be careful monitoring of side effects. In addition, you have to monitor dose and duration of the treatment, based on the patient's progression."
One expert thinks this study will eventually provide guideposts for treating depression that physicians can follow.
"This study, when it is all finally published, will give us a very good idea of how to treat treatment-resistant depression, and what the next step is after the SSRI fails," said Dr. David L. Dunner, director of the University of Washington's Center for Anxiety and Depression.
In the second study, researchers found the risk of suicide attempts and of successful suicides actually dropped in the weeks following the start of SSRI therapy.
"The risk of a serious suicide attempt in people who start taking antidepressant medication is, fortunately, quite low -- less than one in 1,000," said lead author Dr. Greg Simon, a researcher at the Group Health Cooperative, in Seattle. "The risk actually goes down after people start antidepressant medication."
The study also found no increase in suicide risk with the newer antidepressants, such as SSRIs, Simon added. "If anything, our data suggests that with the newer antidepressants there is less risk than with the older antidepressants," he said.
For the study, Simons's team collected data on 65,103 patients who had prescriptions for antidepressants between 1992 and 2003.
The researchers found the number of suicide attempts dropped by 60 percent in adults in the first month after starting treatment. The suicide rate continued to drop in the succeeding five months.
Among all the patients, there were 31 suicides in the six months after starting antidepressant therapy. That rate did not change from one month after starting treatment or in subsequent months.
However, teens had more suicide attempts than adults. Simon's group found that in the first six months of antidepressant treatment, the suicide rate was 314 attempts per 100,000 in teens, vs. 78 attempts per 100,000 in adults. For teens and adults, the rate was highest in the month before treatment and dropped by about 60 percent after treatment began, the researchers found.
In its 2004 warning, the FDA said people taking antidepressants should be closely monitored because of the risk of suicide.
"People should be closely monitored, but not because these drugs are especially risky," Simon said. "The real problem in the treatment of depression is that people start medicine and the medicine has side effects or the medicine doesn't work right away, and they get discouraged and they drop out."
Dunner agreed that close monitoring is essential when prescribing patients antidepressants. "Monitoring depression is very important," he said. "Often people come in for treatment when they are starting to get worse."
Monitoring is needed more for side effects from the drugs than to watch for suicidal behavior, Dunner said. "Suicide is a pretty rare event," he said. "It is more important to monitor for side effects and adherence to the medication."
Sun Jan 1, 2005
by Steven Reinberg, HealthDay
SUNDAY, Jan. 1 (HealthDay News) -- Contrary to what has been feared, the antidepressants known as serotonin reuptake inhibitors (SSRIs) are initially effective in as many as one-third of depressed patients and don't appear to increase the risk of suicide, two new studies claim.
The reports, both of which were funded by the National Institute of Mental Health, appear in the January issue of the American Journal of Psychiatry.
The suicide findings seem to challenge a 2004 advisory by the U.S. Food and Drug Administration that warned that suicidal behavior may increase after treatment with SSRIs. However, the study did find that suicide attempts were higher among teens than adults, a finding borne out by other research.
The first report is based on early data from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial, the largest study of its kind. This research looked at the benefits of antidepressants in "real world" settings.
About a third of the patients achieved remission," said lead researcher Dr. Madhukar Trivedi, director of the Mood Disorders Research Program and Clinic at the University of Texas Southwestern Medical Center, in Dallas. "An additional 10 to 15 percent achieved a response."
The object of the study was to provide physicians with guidelines for treating depression, Trivedi said. "The goal is to have patients provided with an adequate dose of medication for an adequate time," he explained. "Treatment would be tailored for each individual patient to get the most benefit from treatment."
For the study, researchers looked at the results of prescribing the SSRI Celexa to 2,876 patients with major depression. These patients also had other physical and psychological problems. The researchers found that about a third of the patients had their depression cured during the first 12 weeks of treatment.
In addition, another 10 percent to 15 percent of the patients showed a response to the medication, or reduction of at least half their symptoms. For patients who did not improve, later phases of the trial will use other medications or combinations of medications to see what might help those who did not benefit from the drug used in the first phase of the trial.
"These antidepressants in routine clinical care produce outcomes comparable with what is seen in research settings," Trivedi said. "These treatments do work in routine clinical care. There also has to be careful monitoring of side effects. In addition, you have to monitor dose and duration of the treatment, based on the patient's progression."
One expert thinks this study will eventually provide guideposts for treating depression that physicians can follow.
"This study, when it is all finally published, will give us a very good idea of how to treat treatment-resistant depression, and what the next step is after the SSRI fails," said Dr. David L. Dunner, director of the University of Washington's Center for Anxiety and Depression.
In the second study, researchers found the risk of suicide attempts and of successful suicides actually dropped in the weeks following the start of SSRI therapy.
"The risk of a serious suicide attempt in people who start taking antidepressant medication is, fortunately, quite low -- less than one in 1,000," said lead author Dr. Greg Simon, a researcher at the Group Health Cooperative, in Seattle. "The risk actually goes down after people start antidepressant medication."
The study also found no increase in suicide risk with the newer antidepressants, such as SSRIs, Simon added. "If anything, our data suggests that with the newer antidepressants there is less risk than with the older antidepressants," he said.
For the study, Simons's team collected data on 65,103 patients who had prescriptions for antidepressants between 1992 and 2003.
The researchers found the number of suicide attempts dropped by 60 percent in adults in the first month after starting treatment. The suicide rate continued to drop in the succeeding five months.
Among all the patients, there were 31 suicides in the six months after starting antidepressant therapy. That rate did not change from one month after starting treatment or in subsequent months.
However, teens had more suicide attempts than adults. Simon's group found that in the first six months of antidepressant treatment, the suicide rate was 314 attempts per 100,000 in teens, vs. 78 attempts per 100,000 in adults. For teens and adults, the rate was highest in the month before treatment and dropped by about 60 percent after treatment began, the researchers found.
In its 2004 warning, the FDA said people taking antidepressants should be closely monitored because of the risk of suicide.
"People should be closely monitored, but not because these drugs are especially risky," Simon said. "The real problem in the treatment of depression is that people start medicine and the medicine has side effects or the medicine doesn't work right away, and they get discouraged and they drop out."
Dunner agreed that close monitoring is essential when prescribing patients antidepressants. "Monitoring depression is very important," he said. "Often people come in for treatment when they are starting to get worse."
Monitoring is needed more for side effects from the drugs than to watch for suicidal behavior, Dunner said. "Suicide is a pretty rare event," he said. "It is more important to monitor for side effects and adherence to the medication."
Wednesday, January 04, 2006
What to Do if Someone You Know is Suicidal
What To Do if Someone You Know is Suicidal
MayoClinic, April 16, 2004
Talking to someone about suicide won't plant the idea in their mind. Instead, your support and guidance may help someone find treatment — and renewed hope.
Hearing someone talk about suicide may make you uncomfortable. You may not be sure how to step in and help or even if you should take them seriously.
Not everyone who thinks or talks about suicide actually attempts it. But it's not true that people who talk about suicide won't really try it. That's why it is important to take them seriously, especially if they have depression or another mental disorder or are intoxicated or behaving impulsively.
Potential warning signs
You may notice possible indications that a friend or loved one is thinking about suicide. Here are some typical warning signals:
MayoClinic, April 16, 2004
Talking to someone about suicide won't plant the idea in their mind. Instead, your support and guidance may help someone find treatment — and renewed hope.
Hearing someone talk about suicide may make you uncomfortable. You may not be sure how to step in and help or even if you should take them seriously.
Not everyone who thinks or talks about suicide actually attempts it. But it's not true that people who talk about suicide won't really try it. That's why it is important to take them seriously, especially if they have depression or another mental disorder or are intoxicated or behaving impulsively.
Potential warning signs
You may notice possible indications that a friend or loved one is thinking about suicide. Here are some typical warning signals:
Talking about suicide, including such statements as "I'm going to kill myself," "I wish I was dead" or "I wish I hadn't been born."
Withdrawing from social contact and increased desire to be left alone
Wide mood swings, such as being emotionally high one day but deeply discouraged the next
Preoccupation with death and dying or violence
Changes in routine, including eating or sleeping patterns
Personality changes, such as becoming very outgoing after being shy
Risky or self-destructive behavior, such as drug use or unsafe driving
Giving away belongings or getting affairs in order
Saying goodbye to people as if they won't be seen again
Some people don't reveal any suicidal feelings or actions. And many who consider or attempt suicide do so when you think they should be feeling better — during what may seem like a recovery from depression, for instance. That's because they may finally be able to muster emotional energy to take action on their feelings.
Questions to ask
The best way to find out if someone is considering suicide is to directly ask. Asking them won't give them the idea or push them into doing something self-destructive. To the contrary, your willingness to ask can decrease the risk of suicide by giving them an opportunity to talk about their feelings.
You may have to overcome your own discomfort to discuss the issue. Here are some questions you can ask someone you're concerned about:
Are you thinking about dying?
Are you thinking about hurting yourself?
Are you thinking about suicide?
Have you thought about how you would do it?
Do you know when you would do it?
Do you have the means to do it?
Remember, you're not trying to take on the role of doctor or mental health professional or to conduct psychotherapy sessions. But these questions can help you assess what sort of danger your friend or loved one might pose to themselves.
Don't swear your discussions to secrecy. Not only is that an unwanted burden for you, but if you do make such a promise, you risk having to betray that trust if you need to enlist professional help. Don't worry about losing a friendship to mistrust when it's a life that could be lost.
Do be supportive and empathetic, not judgmental. Listen to their concerns. Reassure them that help is available and that with appropriate treatment they can feel better. Don't patronize them by simply telling them that "everything will be OK," that "things could be worse" or that they have "everything to live for."
If possible, assess their home for potentially dangerous items. You may have to remove items that could become weapons of self-destruction, such as guns or knives. But don't put yourself in harm's way, either.
Getting help
If the person is at imminent risk of suicide, call the police or emergency personnel, or take them to a hospital emergency room if possible. Some people who are a danger to themselves may need to get help against their will, such as involuntary hospitalization. If possible, find out if they are under the influence of alcohol or drugs or may have taken an overdose.
If the danger isn't imminent, offer to work together to find appropriate help, and then follow through. Someone who is suicidal or has severe depression may not have the energy or motivation to find help. You may be able to make phone calls to set up medical appointments or go along with them, or help sort through health insurance policies for benefits information.
Many types of help and support are available. If your loved one doesn't want to consult a doctor or mental health professional, suggest finding help from a support group, faith community or other trusted contact.
Offering new options
There's no way to predict for sure who will attempt suicide. And although you're not responsible for preventing someone from taking their own life, your intervention may help them see that other options are available.
Direct questioning, supportive listening and gentle but persistent guidance can help you bring hope and appropriate treatment to someone who believes suicide will offer the only relief.
Saturday, October 08, 2005
Mental Illness Awareness Week Oct 3 - 10
http://www.miaw-ssmm.ca/home.php
About Mental Illness Awareness Week
Mental Illness Awareness Week (MIAW) is an annual national public education campaign designed to help open the eyes of Canadians to the reality of mental illness. The week was established in 1992 by the Canadian Psychiatric Association, and is now coordinated by the Canadian Alliance on Mental Illness and Mental Health (CAMIMH) in cooperation with all its member organizations and many other supporters across Canada.
Campaign elements include: a grassroots public education initiative; a nationally-distributed poster and bookmark series; the 3rd Annual Champions of Mental Health Awards luncheon in Ottawa and an education initiative with federal Members of Parliament, both in their home ridings and on Parliament Hill.
Why Mental Illness Awareness Week?
For too long, Canadians with mental illnesses have been in the shadows. Too few Canadians know about the burden of mental illness on our society, and too few sufferers seek help when they need it. Mental Illness Awareness Week seeks to raise awareness of the level of mental illness in Canada; to reduce negative stigma about mental illness amongst the general population and health care professionals; and to promote the positive effects of best practice in prevention, diagnosis and medical treatment.
About Mental Illness in Canada
Mental illness affects more than six million—or one in five—Canadians. Of the 10 leading causes of disability worldwide, five are mental disorders. Close to 4,000 Canadians commit suicide each year and it is the most common cause of death for people aged 15 - 24. By 2020 it is estimated that depressive illnesses will become the leading cause of disease burden in developed countries like Canada.
Many Canadians do not recognize that they are ill while others don’t seek help because of misconceptions about these diseases. Taking the time to learn about mental illness could make all the difference to you or to someone you care about. It’s important to watch for warning signs of mental illness—and to seek medical advice as soon as possible if any become apparent.
Symptoms include:
Marked personality change
Inability to cope with problems and daily activities
Strange ideas or delusions
Excessive anxiety
Prolonged feelings of sadness
Marked changes in eating or sleeping patterns
Thinking or talking about suicide
Extreme highs and lows
Abuse of alcohol or drugs
Excessive anger, hostility
Violent behaviour
Irrational fears
About Mental Illness Awareness Week
Mental Illness Awareness Week (MIAW) is an annual national public education campaign designed to help open the eyes of Canadians to the reality of mental illness. The week was established in 1992 by the Canadian Psychiatric Association, and is now coordinated by the Canadian Alliance on Mental Illness and Mental Health (CAMIMH) in cooperation with all its member organizations and many other supporters across Canada.
Campaign elements include: a grassroots public education initiative; a nationally-distributed poster and bookmark series; the 3rd Annual Champions of Mental Health Awards luncheon in Ottawa and an education initiative with federal Members of Parliament, both in their home ridings and on Parliament Hill.
Why Mental Illness Awareness Week?
For too long, Canadians with mental illnesses have been in the shadows. Too few Canadians know about the burden of mental illness on our society, and too few sufferers seek help when they need it. Mental Illness Awareness Week seeks to raise awareness of the level of mental illness in Canada; to reduce negative stigma about mental illness amongst the general population and health care professionals; and to promote the positive effects of best practice in prevention, diagnosis and medical treatment.
About Mental Illness in Canada
Mental illness affects more than six million—or one in five—Canadians. Of the 10 leading causes of disability worldwide, five are mental disorders. Close to 4,000 Canadians commit suicide each year and it is the most common cause of death for people aged 15 - 24. By 2020 it is estimated that depressive illnesses will become the leading cause of disease burden in developed countries like Canada.
Many Canadians do not recognize that they are ill while others don’t seek help because of misconceptions about these diseases. Taking the time to learn about mental illness could make all the difference to you or to someone you care about. It’s important to watch for warning signs of mental illness—and to seek medical advice as soon as possible if any become apparent.
Symptoms include:
Marked personality change
Inability to cope with problems and daily activities
Strange ideas or delusions
Excessive anxiety
Prolonged feelings of sadness
Marked changes in eating or sleeping patterns
Thinking or talking about suicide
Extreme highs and lows
Abuse of alcohol or drugs
Excessive anger, hostility
Violent behaviour
Irrational fears
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