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Bipolar News
December 15, 2004
Note: One or more of the following
articles may require a subscription to view the entire article.
We cannot post articles that require a subscription. We are
sorry for the inconvenience.
Equetro
OK'd for Bipolar Disorder
Forbes - New York,NY,USA
... has approved the Shire Pharmaceuticals drug Equetro (extended
release carbamazepine) for acute manic episodes associated with bipolar
disorder, the company ...
Bipolar
Disorder - New Evidence of Brain Chemistry Abnormali
About Mental Health - USA
ANN ARBOR, MI (October, 2000) People with bipolar disorder have
an average of thirty percent more of an important class of
signal-sending brain cells ...
MR
spectroscopy may be best bipolar-disorder gauge
Charlotte Observer (subscription)
- Charlotte,NC,USA
WEST PALM BEACH, Fla. - Magnetic resonance (MR) spectroscopy may prove
to be the definitive diagnostic test for bipolar disorder, a
serious brain illness ...
SHIRE'S
BIPOLAR DRUG GETS FDA APPROVAL
PharmExec.com - Iselin,NJ,USA
Shire Pharmaceuticals Group Plc announced it has been granted Food and
Drug Administration approval for its bipolar drug Equetro
(extended-release ...
Study
Demonstrated Long-Term Treatment with Zyprexa(R) Reduced ...
mysan.de - Germany
... is indicated in the United States for the short-term and
long-term treatment of schizophrenia, for maintenance in the treatment
of bipolar disorder, and either ...
Feeling blue?
St. Louis Post-Dispatch; 12/13/2004; HARRY
JACKSON JR.; Of the Post-Dispatch
You're not alone. Lots of people feel down during the holidays. The
good news: You can do something about it.
When the holidays aren't as happy as they're supposed to be, counselors
call the mental state -- unofficially -- the holiday blues. The generic
moniker doesn't describe a clinical condition, but one that's all too
common.
Holiday blues occur when people stress out as times get too chaotic or
don't live up to their expectations. Counselors say having the blues is
about control: The holidays control the person and the person has lost
control of the holidays.
"We're separated from our families, we overindulge -- eat a lot of
rich foods, drink to excess -- and the overindulging can contribute to
our feelings of not being ourselves and not feeling quite right,"
says Dr. Karen Broquet, associate professor of clinical psychiatry and
internal medicine at Southern Illinois University School of Medicine in
Springfield. "It compounds things if you're feeling blah and
unsettled, anyway, and you've got invitations to four parties in a week,
and you're eating a lot of fatty foods or drinking more than you're
accustomed to. It just contributes to a cycle."
Randy Larsen, head of the Department of Psychology at Washington
University, prefers to frame the malady as holiday stress rather than
blues.
"The people who get in trouble around the holidays are people who
do too much, expecting too much of themselves and others," he said.
The birth of the blues
The blah feeling that's opposite of what folks are supposed to feel
during the holidays has many sources:
Biology: Larsen says stress combines with a biochemical component to
bring on the holiday blues. "People drink more alcohol. People
change their eating patterns. They eat more unusual kinds of foods that
throw them off."
Disruption: "There's just a lot of disruption around the holidays,
socially, biochemically," Larsen said. "People are thrown
off-track, and they're more emotional and reactive."
Too much time: Add that to the extra time on some people's hands, and
the mix can be sorrowful. "Some people have trouble when they have
a lot of time on their hands," Larsen said. He compared it to the
Sunday effect: Psychotherapists generally get most of their emergency
calls on Sunday. Their patients are alone, not at work, not socializing.
Loneliness: Loneliness is a feeling of being out of control, a feeling
of being separated from family and friends because of forces that you
can't control.
Unrealistic expectations: "If your expectations are too
unrealistic, then you're setting yourself up for disappointment, and
disappointment is a big part of the blues," said Dr. Joan Lang,
head of the Department of Psychiatry at St. Louis University School of
Medicine. "Take a realistic look at your expectations and how
likely it is that this holiday will meet them at all."
Flooded with false images: Television constantly presents the public
with images of family and holidays that relatively few people are
living.
"Resist the constant bombardment of things that don't exist but are
presented throughout the atmosphere as the norm, such as the perfect
family, the perfect body, the perfect incomes that few, if any, people
ever achieve," Lang said. "It's the 'Santa only brings toys to
good little kids -- not naughty kids or kids living in poverty.'
"If you're aware that you're being manipulated, the chances of (TV
images) working are reduced a little bit. You know the shows on TV are
made up, and the beautiful people who surround you at every turn, that's
their full-time job, being beautiful."
Counselors suggest doing something about it.
Larsen has co-written a textbook that includes a chapter on being happy.
He says those elements can apply to holiday blues. The bottom line is
take control, he says, and decide not to feel bad and not to do the
things that generate bad feelings.
"Manage the stress or the expectations or activities," he
said. That sometimes means to learn to say no. "Keep a lid on
things and don't let them get out of control."
Don't let demands on yourself and the demands of others wreck your
disposition. For example, if you're supposed to bring pumpkin pies to a
gathering, buy them at a store, he said. The hours it takes to prepare
them sometimes can take more of a toll than just the time.
Broquet, of Southern Illinois University School of Medicine, says
another way to take control is to embrace the original meaning of the
holidays.
"People who have a strong faith or spiritual background tend to be
less prone to the expectation mismatch of holiday blues than people who
have a purely secular approach," she said. "And it doesn't
matter what your faith background is, whether it's Christian or some
other faith.
"One of the theories is that a strong faith goes hand in hand with
a sense of meaning or a sense of purpose. When things are going well,
having a core sense of meaning is nice, but when things are not going
well, having a core sense of meaning or purpose for the suffering has a
very strong protection against depression and other emotional fallout
from the suffering."
Lang suggested setting priorities and limits. "Don't expect more
than your world might deliver," she said, "and don't take on
more than is realistic.
"Concentrate on the part of the holiday that has to do with being
with loved ones, faith traditions. Look at the reality you have and see
what you can do about it so it won't sandbag you."
As for loneliness, "Realize you don't have to be alone," Lang
said. "There are people in the same boat, people in the
neighborhood, or at work or more distant family.
"A lot of it has to do with how you frame it. If you're thinking,
'Poor me, I'm alone,' that's not likely to turn into a nice day."
Larsen suggested continuing your routine and taking time for yourself.
"Don't quit exercising because you're busy," he said. "To
keep down the disruption, continue doing the things you like to
do."
= = = =
How to feel better
Mental health experts emphasize that you shouldn't get holiday blues
mixed up with depression. Depression brings your life to a standstill
and should be treated with counseling and possibly medication. Holiday
blues can be relieved with some affirmative action. If you can laugh,
and an invitation or getting out of the house cheers you up, you've got
the blues, not depression.
Counselors suggest avoiding excessive alcohol as a way to buffer
sadness. Alcohol is a depressive drug and will make matters worse.
Here are some other suggestions:
Don't automatically attribute sadness to the holidays. You may have a
reason to feel sad that has nothing to do with the holidays.
Don't try to do and be everything. "Negotiate with yourself,"
said Dr. Joan Lang, head of the Department of Psychiatry at St. Louis
University School of Medicine. Decide what you can and can't do and what
you will and won't do, and then enforce your decisions.
Don't dwell on past bad holidays. Look to the future and dwell on the
good things that are happening to you now. Both the good ol' days and
the bad ol' days are gone.
Focus on what you have, not what you don't have. This attitude protects
people around the holidays: "In another generation we would have
called that counting your blessings," said Lang. "We tend to
focus on what we don't have. But when we focus on what we do have,
regardless of how meager it might be, it really has an impact on the
emotional component."
Surround yourself with people who care. Make new friends. Renew old
friendships.
Don't sit around the house feeling sorry for yourself. Hit the road,
take in a movie. A lot of people are out after the day's festivities are
done.
Do something new. If you haven't tried it, try it. If you have and you
liked it, do it again.
Do free things. Drive around looking at holiday decorations. Go
window-shopping. Check local calendars for free or inexpensive outings.
Accept people's invitations. Just because you're too cool for a
tree-decorating party doesn't mean there won't be nice people there.
Have your own party. Invite friends over and enjoy the company.
Volunteer to help others. This can range from building houses to reading
books to children. For ideas, check out the United Way Web site (www.stl.unitedway.org/
volunteer). Or call Rick Skinner at 314- 539-4284, or e-mail him at
skinnerr@ stl.unitedway.org. "It's fine to support charities that
support your goals and values," said Lang. "The more personal
and meaningful the gift, the better."
= = = =
The suicide myth
The belief that suicides increase during the holidays has become so
entrenched that some news stories tend to repeat it without checking out
the facts, according to several studies on the issue.
The truth is that suicides actually drop between Thanksgiving and
Christmas, said Dr. Karen Broquet, a professor of psychiatry at Southern
Illinois University School of Medicine in Springfield. The American
Association of Suicidology confirms that December has the lowest suicide
rate of any month of the year. The National Center for Health Statistics
has found that suicides drop by about 20 percent during the holidays.
Studies show that suicides average about 36 for every 1 million people
nationwide during the year, but drop to under 30 during the holidays.
April, June and July are actually the highest months for suicides in
America.
Researchers found that very few publications attributed statements that
the risk of suicide increased during the holidays. The studies didn't
address television news.
The National Institutes of Health reports that the primary causes for
suicide in America are bipolar disorder, also known as manic depression,
and conditions that mimic mental illness during episodes of drug or
alcohol abuse. The federal agency added, however, that depression can
intensify during the holidays.
(Copyright (c) 2004 The Post-Dispatch)
NATION Ronald Williamson, exonerated death row
inmate
Newsday; 12/13/2004; THE ASSOCIATED PRESS
OKLAHOMA CITY - Ronald Williamson, a former death row
inmate exonerated by DNA evidence five days before his scheduled
execution,
died Dec. 4, his sister said.
Williamson died at 51, five years after he was freed from prison and
nearly
seven weeks after being told he had cirrhosis of the liver, Annette
Hudson
said.
Williamson, a second-round draft choice for the Oakland Athletics in
1971
and a star high school athlete from Asher, spent six years playing
baseball for
farm teams of the Oakland A's and New York Yankees, Hudson said.
When arm injuries ended his career, Williamson returned to nearby Ada,
where he had a brief marriage and held various sales jobs. He then moved
back
in with his parents and stopped working, Hudson said.
"From the disappointment of not making it in baseball, he turned to
alcohol," Hudson said. "He just started declining."
In late 1982, the body of Deborah Sue Carter, 21, was found in a garage
apartment. Williamson was arrested for the murder four years later.
Williamson,
diagnosed as suffering from bipolar disorder, told authorities he
recalled
having a dream in which he pulled a cord around the woman's neck, but he
also
dreamed he stabbed her. Carter had not been stabbed.
He and another man allegedly linked to the slaying by hairs from the
crime
scene were convicted in the case. After 12 years, they were freed in
April 1999
after DNA evidence proved their innocence; Williamson was just five days
away
from execution. Their civil lawsuit was settled in 2002 for an
undisclosed sum.
Another man whom prosecutors used to link Williamson to the crime was
ultimately sentenced to death for Carter's murder.
After his release from prison, Williamson lived with his sister, unable
to
live on his own because of his mental problems and alcoholism.
"The only time he had happiness in his life, he told me, was his
years
playing baseball," Hudson said.
Copyright 2004, Newsday Inc.
BIPOLAR DISORDER Drugs that help also are
harmful
Newsday; 12/12/2004; OFELIA CASILLAS. CHICAGO
TRIBUNE
CHICAGO - The same drug that helped Rachel Mason
graduate from eighth grade by controlling her bipolar disorder
caused her to
weigh more than most girls at the ceremony.
The drug that eased her rages also sparked insatiable hunger. When she
slipped into a white-flowered red skirt for the event, the teen who
stands only
a few inches taller than 5 feet weighed 243 pounds.
"It's in my head," said Rachel, now a high school freshman in
Mount
Pulaski, Ill. "In my stomach, I usually don't want to eat
anything."
Apprehensive about severe side effects associated with the first
generation
of drugs approved to treat psychosis - including tremors, muscle
contractions
and involuntary movements that can cause disfigurement - doctors have
embraced
a new group of drugs during the last decade, among them Risperdal and
Zyprexa.
As time passes, however, adverse effects have emerged for these new
drugs -
including a ravenous hunger that makes children badly overweight and
susceptible to future diabetes.
The dramatic weight gain can be emotionally difficult for teens at a
time
when social pressures are especially intense. Some refuse to take a drug
that
causes weight gain.
Although the Food and Drug Administration has approved these
second-generation anti-psychotic drugs to treat mentally ill adults, the
agency
has not agreed to their use in youths. Doctors prescribe the drugs based
on
clinical trials, experience and limited data.
Some of these newer drugs have other side effects as well - one drug
causes
a decrease in white blood cells, for example; others cause tremors,
sedation
and low blood pressure.
An FDA red flag
This year, the FDA added a warning label about increased diabetes risk
to
the anti-psychotic drugs, which doctors find are tied to increased
cholesterol
and triglyceride levels.
"It's a huge problem. All of these medications right now are
double-edged
swords," said Dr. Michael Naylor, University of Illinois at Chicago
director of
child psychiatry. "You're kind of left with a dilemma: Do I choose
a
medication that can harm me or an illness that can harm me? It's a
terrible
choice."
Rachel's parents, Stephen and Michelle Mason, knew early that something
was
wrong. In second grade, Rachel would crawl under her desk. She'd scream,
chew
on erasers, eat paper. Other children were afraid. After her rages,
Rachel
never remembered what happened.
Rachel saw four psychiatrists in six months and was diagnosed with bipolar
disorder at age 8. No medication worked as well as the Zyprexa she
started in
sixth grade.
Her body soon ballooned. She never felt full. In June, she weighed 253
pounds.
Dr. Christoph Correll, a research psychiatrist at The Zucker Hillside
Hospital in Glenn Oaks, N.Y., has followed 360 children ages 4 to 19 on
second-generation anti-psychotic drugs. Interim results found children
gained
mostly fat, some of it deposited on their abdomens. With many putting on
more
than 7 percent of their baseline body weight, they were at risk for
future
heart attack, stroke and diabetes.
Results of a study
"The gateway to these serious complications in the future is the
weight
gain," Correll said. "The numbers we found were very
surprising and sobering."
A 12-week study of 50 youths published in the 2002 Journal of the
American
Academy of Child and Adolescent Psychiatry found Zyprexa and Risperdal
were
associated with "extreme weight gain in adolescents, much higher
than that
reported in adults." Experts say the increased weight can not only
affect
health but also perpetuate depression. "Oh gosh, it puts their
self-esteem to
the floor," said Dr. Louis Kraus, Rush University Medical Center
chief of child
and adolescent psychiatry.
Pharmaceutical companies say they are working to eliminate the
weight-gain
problem.
Eli Lilly and Co., which makes Zyprexa, is looking into which patients
gain
the most weight, said spokeswoman Marni Lemons. "It's possible that
a receptor
that improves your functioning [also] improves your appetite,"
Lemons said.
"Is it possible to create a drug that doesn't have weight gain as a
side
effect? We don't know. We have researchers looking into that."
Doctors also say they worry over how the drugs work in growing bodies
since
long-term effects have not been extensively studied in children.
"We are learning about the safety issues as we are using the drugs
in
children," said Dr. Julie Zito, a University of Maryland pharmacy
and
psychiatry associate professor. "In my mind, there is not
sufficient data that
establishes them as effective and safe in children for long-term
use."
The FDA has requested that five of these drugs be evaluated in children,
a
spokesman said.
A delicate balance
In the meantime, parents like Michelle Mason struggle to balance the
drugs'
risk with their control over paranoia, delusions, aggression, and, in
Rachel's
case, violent rages.
"If a child is psychotic, they can't be in school, OK?" said
Suzanne
Andriukaitis, executive director of the National Alliance for the
Mentally Ill
in Chicago. "Overweight kids can be in school and will have plenty
of company."
In June, Rachel stopped taking Zyprexa and began Risperdal. She had
gained
50 pounds since the previous August.
On the new drug, Rachel has been in a good mood, but sometimes, she
still
can't stop eating. Her weight peaked in August at 266 pounds. That same
month,
she started high school - the "new world" she had been hoping
for. She became
an officer in her first club - the Family, Career and Community Leaders
of
America. She gets good grades and has served as greeter for visiting
volleyball
teams.
On Risperdal, Rachel's mood is better than her mother had anticipated.
And
since August, she has lost 2 pounds.
Best of all, Rachel has found new friends who accept her.
Copyright 2004, Newsday Inc.
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