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Bipolar News

August 16, 2005

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Workplace challenge: mental illness stigma
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Students cope with bipolar disorder

University Wire; 8/11/2005; Lesley Longstreth

(The Lantern) (U-WIRE) COLUMBUS, Ohio -- While filling out her Ohio State forms for housing preferences, incoming freshman Beth Fosselman thought some of the questions were pointless.

She said for her, there is no such thing as being a slob or neat freak. Asking if she is more of a morning or night person is pointless as well, she said. To other 18-year-olds, these might be important things to help find a compatible roommate, but Fosselman is not like most other Ohio State University students. She has bipolar disorder.

"I see students like this every day," said John Paulus, a psychiatrist and mood disorder specialist at OSU's Harding Hospital.

He sees many patients, ranging from young undergraduates to people finishing up their master's, he said.

Bipolar disorder is a biological brain disorder that causes severe fluctuations in thinking, energy, mood and behavior. Sufferers can feel happy and energetic one minute, depressed the next, and then blow up in a rage. Symptoms can begin at any stage in life and can range from mild to extreme.

The mental disorder may begin as an episode of depression. In addition, the hyperactive mania stages in children might be misdiagnosed as Attention Deficit Hyperactivity Disorder.

Paulus uses three distinguishing factors to decide if someone is bipolar and not ADD-ADHD.

The first factor is anxiety, but headaches and backaches are also symptoms, he said.

"If you have a lot of social, test or performance anxiety, that may be a tip off," Paulus said.

Secondly, sleep problems, such as insomnia, can be a clue to being bipolar, he said. Lastly, bipolar sufferers often have disorganized thinking. Their minds wander and can be easily distracted and unable to read for more than a few minutes.

"(This causes) learning difficulties in reading, math and possibly writing," Paulus said.

Fosselman was diagnosed when she was a freshman at Westerville North High School. Since then, she has been on eight medications to try to stabilize her moods and actions. She and her doctor settled on Concerta, an ADHD medication that helps her concentrate when she is in her high manic stage. It also helps keep her stay alert and motivated when in her depressed stage. Diagnosis and on-going treatment are necessary to help sufferers adjust to the most normal and productive life possible. Students without medical and therapeutic help are at higher risk of failing school, substance abuse and suicide.

Paulus said high school is usually easier than college for bipolar students because the disorder causes problems in relationships and stress, and affects test taking and impairs the ability to focus on course work.

"That's where medication and counseling make a difference," he said.

Help is available at OSU for bipolar students, said Lois Burke, a counselor at OSU's Disability Services office.

"We offer priority registration for them," Burke said.

Some students with bipolar disorder have trouble waking up in the morning because of drowsiness caused by certain medications, and by letting them have priority scheduling, students can opt for non-morning classes, Burke said. However, she said not all students with mental illnesses take advantage of this.

"Not everybody here with that diagnosis will register at the counseling center (either)," Burke said.

Some additional help is offered, including having extended time for test taking or having a note taker for the student. Another helpful resource is the OSU Counseling and Consultation Service in the Younkin Success Center. CCS offers free services to students and some dependents. Services include counseling, support groups and physician referrals. Not all bipolar students at OSU are aware of all the different kinds of help available on campus.

"I hadn't the slightest clue," Fosselman said. "I know there is free counseling available in the wellness center, but I didn't really pay attention. I guess I didn't want to make it a big deal."

Students such as Fosselman do not often address their disorder because they are scared how people will react to it. Some of society still has a stigma against people with mental disorders, Paulus said.

"People need to realize that the majority of these problems are more common in college and professional settings than they realize, and people can function well with treatment and support," he said.

Fosselman said she acknowledges being stereotyped and judged by other people because of her condition. She has even experienced cruelty from her extended family.

"They didn't want any more 'crazy people' in the family," she said.

While there is no cure for bipolar disorder, it can be managed. Medication and lifestyle changes can help to achieve a normal, happy life.

"The sooner you get help, the better," Paulus said. "Get help as soon as you can to help prevent problems."

(C) 2005 The Lantern via U-WIRE

Mental illness rampant inside women's prison.

The Boston Herald; 8/14/2005; News), Peter Reuell (Metrowest Daily

The women's prison in Framingham houses by far the largest percentage of mentally ill inmates in the state, a review of state Department of Correction records shows.

Of the 645 inmates serving time in Framingham, 391 are classified as "open mental health cases," meaning more than 60 percent of the prison population suffer from some form of mental illness.

By comparison, nearly 1 in 4 male inmates in Massachusetts prisons has been diagnosed with some form of mental illness, ranging from mild depression to debilitating diseases such as schizophrenia and bipolar disorder.

Experts attribute the high percentage of mentally ill female inmates to the confluence of trauma, abuse or domestic violence, as well as family problems experienced by the prison's all-female population, particularly if they have children.

"It's a very big problem," said Steve Kenneway, president of the Massachusetts Correction Officers Federated Union. "There is a great deal of mental illness involved with every shift."

For many female inmates, though, prison is simply one more trip through a revolving door that punishes the mentally ill for their symptoms while doing little to treat the underlying disease.

It's a carousel ride Leslie Walker knows all too well: She worked in the public defenders office for 16 years.

"A huge number of cases I had there were people that had already cycled through, and you knew they were going to come back," said Walker, executive director of Massachusetts Correctional Legal Services, a Boston-based prison advocacy group.

Although prisons do have mental health professionals on staff, their numbers remain relatively low. Kenneway said correction officers do receive some mental-health training, but that it's largely focused on suicide prevention, not on spotting the symptoms of mental illness.

COPYRIGHT 2005 Boston Herald

Tennessee to slash state health benefits for the needy.

The Christian Science Monitor; 8/12/2005

Byline: Amy Green Contributor to The Christian Science Monitor

COLUMBIA, TENN. -- Sitting hunched at their kitchen table strewn with papers, Loren and Shirley Ellis consider a grim choice: their home or their medicines.

The couple could sell their brick home in Columbia, Tenn., a rural town south of Nashville, and Mr. Ellis, a former restaurant owner, could return to work. That would provide enough cash for healthcare for his wife, diagnosed with ovarian cancer and bipolar disorder. Or Mrs. Ellis could give up chemotherapy and the eight medicines she takes daily. That's the prospect they face if Mrs. Ellis is dropped by TennCare, Tennessee's health plan for the poor and uninsured.

"You walk around your house and ask yourself, 'How long? How long am I going to be here?' " she says.

Many Tennessee households face a similar cutoff as the state proceeds with removing some 191,000 residents from its expanded Medicaid plan.

Across the country, states are working to rein in healthcare costs under the crush of medical inflation and anticipated federal cuts to Medicaid. Tennessee's struggles have drawn national attention, partly because TennCare was hailed as a model when it was launched a decade ago, and partly because, according to critics, the cuts are the most comprehensive ever to a state health plan.

Before the cuts, 1.3 million Tennesseans received $8.7 billion in benefits - more per capita than any other state plan. Tenn-Care achieved this by using federal matching funds and managed-care organizations, which cut state costs while covering more Tennesseans than the state Medicaid plan it replaced.

But TennCare spun out of control, most observers agree, because of myriad structural, financial, and management problems. By last year, the program consumed one-third of the state budget. Costs would have jumped $650 million - or about 7.5 percent - this fiscal year, which started July 1, says Marilyn Elam, a TennCare spokeswoman. That's why Gov. Phil Bredesen (D) ordered the cuts, arguing the program's benefits were just too generous.

"In Tennessee we cannot sustain the unlimited program that we've had," Ms. Elam says. "Our state can't afford it any longer."

Last fall, the governor threatened to scrap TennCare. Since then, enrollees like the Ellises have been at the whim of dizzying litigation and legislation as the courts and lawmakers have battled over what to do.

The couple braced for the worst after Mrs. Ellis got a letter from the state, warning that she would be dropped from Tenn-Care by the end of August. The couple filed an appeal and got a reprieve until the end of the year, but they don't know what to expect after that.

Because Tennessee was once seen as a leader in the arena, others are watching now to see what happens. "There's a lot of curiosity," says Joy Wilson, health-policy director for the National Conference of State Legislatures. "Is it that you can't do it or is it that Tennessee didn't do it right?"

Those who stand to lose TennCare benefits are the uninsured (residents who can't get insurance from employers) and the uninsurable (those whom private insurers won't take on because of pre-existing conditions). Children are spared, and so are those eligible for Medicaid and Medicare, though they will see cuts to drug and other benefits.

An additional 100,000 enrollees deemed medically needy because their health costs would plunge them into poverty unless they get assistance, were rescued from being cut this week when the governor announced they could remain, thanks to a court ruling allowing cost-saving changes to TennCare. The Ellises hope Mrs. Ellis eventually will be deemed part of this category.

For enrollees still facing a cutoff, the state has set aside $100 million to help soften the blow. Dropped enrollees can get some generic drugs free of charge through the end of the year. A discount card will help them buy other medications. The mentally ill will get additional help.

The state also has set up a dial-a-nurse service, offering health advice over the phone, and a hot line explaining all these services to dropped enrollees. And Tennessee is providing money to local health departments and community clinics.

But watching the on-again, off-again cuts wind their way through the courts and legislature has put many enrollees through an emotional wringer.

"You're a small person against some powerful forces," says Jesse Howell, a former telemarketer, now unemployed, who joined other protesters who have camped inside the state capitol for more than 40 days.

"It's terrible anxiety. It's like worrying about where your next meal is going to come from."

(c) Copyright 2005. The Christian Science Monitor

COPYRIGHT 2005 The Christian Science Publishing Society

Lloyds hits back over deluded debtor.

The Birmingham Post (England); 8/12/2005

High street bank Lloyds TSB has defended itself from claims that it loaned pounds 40,000 to a man who thought he was a millionaire and travelled the country handing out money to strangers.

The man, from Burton-upon-Trent, Staffordshire, allegedly built up pounds 70,000 debt by distributing bundles of cash to Big Issue sellers and homeless people in the mistaken belief he was a wealthy philanthropist.

He reportedly suffered from bipolar disorder - manic depression - and was later sectioned under the Mental Health Act for treatment.

Financial advisers at the town's Citizens Advice Bureau investigated his case and criticised Lloyds TSB for allegedly not making more stringent checks into his condition.

Suman Antcliffe, a CAB money adviser, said: 'Although he was on a decent wage, the bank should not be handing out these sorts of sums without doing more checks. He was not a homeowner and had already run up other debts.'

A Lloyds TSB spokesman insisted stringent checks were in place for every loan application.

But he said they were unable to comment on the allegations as the CAB had not given them full details of the case.

'We're very concerned that these types of allegations are being published and there is no corroboration about this person's circumstances.

'If we're given the customer's name, then we'll happily investigate it fully,' he added.

'If in any case there are allegations that something has gone wrong, clearly we will look at it very, very seriously.'

Bipolar disorder is the most common form of manic depression and involves a person experiencing extreme 'highs' and 'lows', according to mental health charity Mind.

Some people with the condition can experience delusions and in 'high' phases may behave extravagantly, including spending money and building up debts

COPYRIGHT 2005 Birmingham Post & Mail Ltd

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