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September 30, 2005
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Claims That Many Bipolar Adults Have ADHD
Orange County teacher pleads guilty to molesting three ...
SUED OVER BIPOLAR WORKER'S OUSTER
Shattered Lives. (psychological fallout of experiences endured during Hurricane Katrina)
U.S. News & World Report; 10/3/2005; Szegedy-Maszak, Marianne
Long after some semblance of order is restored to the devastated neighborhoods and communities in the Gulf Coast, those who survived Katrina will still have to contend with the emotional effects of their shattered lives. It is not as if the nation hasn't heard it all before. The psychological lessons learned from other disasters--Oklahoma City, 9/11, plane crashes, and tsunamis--are clear.
After a disaster, about 25 percent of the affected population may experience clinically significant mental health needs, while an additional 10 to 20 percent suffer from more transient needs, says Charles Curie, administrator of the Substance Abuse and Mental Health Services Administration of the Department of Health and Human Services. With 1.2 million people affected by the disaster, a conservative estimate is that a quarter of a million people will have some serious mental health needs, such as depression, severe anxiety, or post-traumatic stress disorder.
But Katrina may provide new lessons in the grim textbook of disaster psychiatry. The almost complete eradication of neighborhoods and communities, the separation of families, the tragic destruction of an entire city, the continued danger for many victims for days after the winds died down, the loss of livelihoods, and the stuttering response of the government are hallmarks of this disaster. "The more of these factors that come into play, the greater the emotional impact of the disaster," says Robert Okin, chief of psychiatry at San Francisco General Hospital.
Mastery. The key for preventing, or at least mitigating, some of the long-term mental health consequences of the cataclysm is to limit these elements. "One of the really important factors in traumatic situations is the amount of control that one has during the event," says Steven Southwick, a psychiatrist with the National Center for Post-Traumatic Stress Disorder. "When people talk about stress-induced depression, they are talking about an uncontrollable situation, and one very important.phpect for any kind of resilience and recovery for people in a stressful situation is to find some way to master some part of it."
But how can one find mastery in a force of nature so powerful? Henry Necaise of St. Martin, Miss., took refuge with his wife, two sons, a nephew and his son, and two Chihuahuas in the local school where he works as the maintenance man. Even though he figured the school was 60 feet above sea level, he had a plan if the water surged: Head for higher ground. When the water reached the floor of the school, he tied his sons to his body, picked up the dogs in a crate, and he and his family waded in waist-high water to a nearby hill.
Unlike countless others, Necaise was able to do something to improve his fate. But for those in the New Orleans Superdome and the convention center, mastery was impossible. There was no place else to go. In the city, rescue workers dodged bullets fired by the very victims they were trying to save. "People were enraged by their fate, they were enraged by the government's response, and they lashed out," says Jon Allen, a psychologist with the Menninger Clinic in Houston.
And images of the chaos were seen by millions of others, some of whom were grappling with their own reactions and agonies. Elizabeth Robison, a 37-year-old mother of two girls, grew up in New Orleans. Her house in Baton Rouge became a shelter for nine family members and friends. One evening, as they sat outside eating the red beans and rice her husband had prepared on a camp stove--there was no power--they all began to relax. Then came the news over the radio that a policeman had been shot in New Orleans and that there were looters and dead bodies in the Superdome. "No one wanted to go to sleep that night," she recalls. "Our world as we knew it was just melting away, and every day it seemed to get worse."
The dual horrors--one from nature and the other man made--conspired to deprive rescue workers and evacuees alike of that crucial component of resilience, what psychologists call "active coping." A number of studies have demonstrated that psychological outcomes are vastly improved when victims are able to do something involving their treatment, rather than being passive recipients of services.
Dwelling on circumstances while being treated like a commodity triggers another psychological mechanism known as "learned helplessness," in which negative, uncontrollable external events create a profound and debilitating sense of fatalism. Victims of child abuse and other traumas often suffer learned helplessness, which can in turn cause serious mental disorders, including anxiety and depression. "The problem is that what people most need is what they don't have," says Allen. "And that is a sense of security."
The sense of security so elusive in the chaos of New Orleans was offered in Houston. "We saw people with acute stress reactions, with anxiety and depression, even people who were psychotic," says Stuart Yudofsky, chair of the department of psychiatry at Baylor College of Medicine in Houston. "People had lost everything and had very little confidence that things could be well organized because of all their frustrations in New Orleans. They were under enormous stress and pressure."
Some victims received immediate counseling, as just having the opportunity to talk about what they had gone through was valuable. A number of the evacuees suffered from serious mental illnesses like schizophrenia or bipolar disorder and had run out of their medicines, so physicians could prescribe them and get them stabilized. Others were former addicts, deprived of methadone. Responding to the physical needs of those who were there "all served to help reduce the stress," says Yudofsky. "When they first came in, they were dazed and overwhelmed, then in four or five days of relative stability, they began to look a bit happier, more confident."
Among the most vulnerable victims, of course, are the children. Some were separated from their families, while others witnessed the ordeals and despair of their parents. John Krystal, professor of psychiatry at Yale University School of Medicine, says that studies of children who had been emotionally abused or who had faced traumatic situations revealed that the major differences in outcomes were dependent on how much support they received later on. "Even if faced with horrible maltreatment, those who were more resilient experienced at some point a supportive environment," says Krystal.
What the long-term effects of this catastrophe will be, no one can tell. And yet, as desperate as the images were, and as psychologically damaging as the disaster may prove to be, the capacity for resilience among those who have lost everything is one of the greatest psychological gifts and mysteries. Research has shown that one form of active coping that is deeply connected to resilience is altruism. Anthony Ng, chair of the American Psychiatric Association's Committee on Psychiatric Dimensions of Disasters, visited Pearlington, Miss., last week, one of the hardest-hit locations in the storm's wake. Only 600 of the town's 1,700 residents remain. "A lot of folks here are really dependent on each other to begin with," Ng says. "Are we tapping into helping people help each other? That is our job right now. "
Coping. The maximized community involvement may result, experts hope, in long-term psychological well-being for Katrina's victims. Another.phpect of active coping entails turning victims into partners as recovery efforts are being shaped. "If instead of active participation, people are treated as supplicants for whom the government is doing a favor, if their futures are simply handed down to them from the top, their sense of powerlessness will be intensified," says Okin. "And so will their long-term painful responses to the hurricane."
While there have been abundant images of loss, there have been similarly abundant images of generosity. When families are reunited, when perfect strangers become intimates, when communities mobilize to help, psychological damage is minimized. As Rita bears down, the still-fresh lessons of Katrina serve as a reminder both of what not to do and what must be done. "You have to do what you always do during times like this," says Robison. "People will get through this by helping each other." Within that neighborly statement resides a profound psychological truth.
COPYRIGHT 2005 All rights reserved.
BIPOLAR DISORDER IS FOCUS OF CCC EVENT NEXT WEEK.
The Post-Standard (Syracuse, NY); 9/26/2005
Bipolar Disorder Awareness Day will be observed from noon to 3 p.m. Oct. 6 at Cayuga Community College's student lounge.
Free materials on depression and bipolar disorder will be provided. For information, call 834-8633.
COPYRIGHT 2005 All rights reserved. Reproduced with the permission of The Herald Co. by the Gale Group, Inc.
What every woman should know about mental health ailments. (WOMEN'S HEALTH)
Ebony; 10/1/2005; Holloway, Lynette R.
FINDING lately that you are too blue to get out of bed, let alone get dressed and go to work?
How about food? Eating more or less? What about sleep--too much or too little? Does the slightest provocation trigger tsunami-like mood swings? And do the unflinching demands of daily life, such as showering, cooking and cleaning, seem like insurmountable tasks? Have any of these symptoms persisted for weeks on end?
If you've answered yes to any combination of the above questions, you may be experiencing some form of depression and should seek professional help, mental health experts say.
You are not alone, especially if you are an African-American woman. Clinical depression is a serious medical illness that has a 15 percent chance of affecting a person during his or her lifetime. That figure is perhaps as high as 25 percent for women, according to the Diagnostic Statistical Manual of Mental Disorders, the reference guide for mental health professionals.
Higher rates of clinical depression among women may be linked to stress from work, family responsibilities, the roles and expectations of women and increased rates of sexual abuse and poverty, researchers say. Other factors such as diet, hormones, genetics and other biological differences (premenstrual syndrome, childbirth, infertility and menopause) also are thought to play a role in depressive illnesses.
But despite the huge toll mental disorders exact on the lives of its sufferers, only a small percentage of Black women who suffer from depression and other ailments receive any treatment.
Shame, embarrassment, fear of being labeled "crazy," the disparity in health care, and lack of insurance coverage are just a few of the reasons many African-American women do not seek professional help for mental health issues. But failure to seek treatment for any form of mental illness can result in a recurrence of the disease--yes, it is a disease--and a litany of other troubles, including hospitalization, substance abuse, economic woes, isolation, and ultimately suicide.
"True, there was a time--happily, a time past--when mental illness was used as an excuse to shackle those of us who listened to a different drummer," writes Marilyn Martin, M.D., M.P.H., in Saving Our Last Nerves: The Black Woman's Path to Mental Health. "The result was that many Black women are afraid of the mental health care industry, and buckling under pressures we could have handled if we'd had a little help ..."
In some cases, women do not realize that they are experiencing symptoms of mental illness. Some visit the doctor, complaining of headaches, back pain and other ailments. Others go to church, thinking that their spirituality needs rebuilding. Indeed, church can help, but mental health experts say that church and spirituality are not a cure-all. Mental health experts such as James E. Savage Jr., Ph.D., president of the Association of Black Psychologists, are working hard to educate African-Americans about the importance of seeking help.
"We are trying to debunk the myths and remove the stigma surrounding mental health that prevents us from receiving good mental health services," says Dr. Savage, president of the Institute for Life Enrichment, an outpatient mental health clinic with several offices in the Washington, D.C.-area. "We need to inform the community that they have rights to certain [mental health] treatments."
Besides depression, other forms of mental illness include psychotic disorders such as schizophrenia, which is diagnosed when a person has two or more of these symptoms for more than a month: delusions, hallucinations, extreme paranoia and disorganized speech. Further, a person suffering from the disease may experience disorganized or catatonic behavior, lack feeling and lose ability to function at work.
"The voices and delusions are frightening," writes Dr. Martin, the author. "The rate of suicide for people with schizophrenia approaches that of those with depression."
If you, or someone you know, are suffering from symptoms of mental illness, it is important to seek help. If you don't know where to begin, start with your primary care physician or your pastor; both can refer you to a mental health professional.
Crying spells, alone or in public spaces--especially when you are trying to have fun--may be a sign of depression, or the result of a panic disorder. Consult a mental health professional if you experience such emotional swings.
HERE ARE BRIEF DESCRIPTIONS OF SOME COMMON FORMS OF MENTAL AILMENTS THAT OFTEN AFFECT BLACK WOMEN:
* BIPOLAR DISORDER, OR MANIC-DEPRESSIVE ILLNESS, is marked by periods of major depression and periods of mania, according to the National Institute of Mental Health (NIMH). Symptoms of mania include abnormal highs accompanied by at least three of the following symptoms: overly inflated self-esteem, racing thoughts, distractibility, increased talkativeness, decreased need for sleep, physical agitation, and excessive involvement in pleasurable activities that have high potential for painful consequences.
* POSTPARTUM DEPRESSION was thrust into the media spotlight recently when Tom Cruise criticized Brooke Shields for taking medication to treat the condition. And few can forget the story of Andrea Yates, who had a previous history of postpartum depression and admitted to the drowning deaths of her five children in 2001. The disorder is characterized by depressive symptoms that begin within four weeks and up to a year after birth. The condition causes a mother to experience sadness, bouts of crying, moodiness, loss of interest in activities she once enjoyed, and she displays little interest in the baby. The mother may be overwhelmed by feelings of shame and guilt, suffer from sleep and appetite disturbances, as well as marital discord, says Helen Davis Gardner, M.D., a board certified psychiatrist in the Chicago area who specializes in women's mood disorders.
"Many mothers remain silent about what they're going through out of fear that they may be perceived as a 'bad mother,'" says Dr. Gardner. "In fact, they are suffering on the inside, hanging on by a thread and yet are told: 'Snap out of it! Those feelings will pass.' But failing to seek treatment increases the risk of future episodes of depression."
Postpartum depression, Dr. Gardner says, is different from what is commonly called "the baby blues," a bout of sadness that affects up to 90 percent of all new mothers after childbirth.
* PANIC DISORDER is diagnosed when a person experiences recurrent panic attacks, at least one of which leads to at least a month of increased anxiety or avoidant behavior, according to NAMI. Diagnosis comes after a person experiences at least four of the following symptoms during a panic attack: sweating, choking or smothering sensations, racing heart, labored breathing, trembling, chest pains, faintness, numbness, nausea, disorientation, and feelings of losing one's mind, dying or losing control. Panic attacks typically last about 10 minutes, but may be a few minutes shorter or longer.
"These are all things that can be treated," Dr. James E. Savage Jr. says of the range of mental illnesses. "We want people to know that they do not have to live with these symptoms."
COPYRIGHT 2005 Johnson Publishing Co.
Minds matter State should fund requests for Valley's mental-health needs. (Editorial)
The Fresno Bee (Fresno, CA); 9/28/2005
Nearly $4 million could be distributed this year to meet the needs of the mentally ill of Fresno County if a new plan for providing additional services is approved by the state.
This could mean a great deal of help to people suffering from serious cases of illnesses such as bipolar disorder, schizophrenia, obsessive-compulsive disorder and clinical depression.
The plan must be submitted to the state by Saturday and then the state has 90 days to approve all or parts of the plan. The county could collect up to $7.9 million annually for three years from the Mental Health Services Act to enhance and improve mental-health programs for children, youth, adults and seniors. Voters created the act when they approved Proposition 63 in November 2004.
Because the year is more than half over, the county is eligible for about half of the first year's allotment.
The county has been holding task force meetings and public forums over the past few months to get the required suggestions from consumers. Some of the ideas from those meetings have been included in the plan, which now includes a drop-in recovery and support center for teenagers, adults and older adults that would be staffed by mental-health consumers and family members of consumers. That arrangement was suggested by the Fresno chapter of the National Alliance for the Mentally Ill.
Increasing the number of children in two school-based mental-health programs is part of the plan. The programs educate parents on child development and nonviolent discipline techniques. And they help parents improve their collaborations with teachers and students.
The Mental Health Services Act allows for revisions in the plan each year, so updates in the plan can be expected.
One of the best parts of this planning process has been the requirement that the county listen to the families of the mentally ill and consumers of mental health services while considering how the money should be spent. That connection is vital if treatments offered are going to be effective and progressive.
The treatment of the mentally ill in Fresno County has long been underfunded and it's important that the needs identified in this document be urgently addressed. Particularly when it comes to children, the care here is shamefully lacking in resources. We don't even have an inpatient hospital to care for the most fragile of the children, leaving their families to add hours of travel to their expense and their grief.
The Mental Health Services Act funding is just one of many tools we must aggressively pursue to bring the Valley's mentally ill the care that they need and deserve.
COPYRIGHT 2005 The Fresno Bee. All rights reserved. Reproduced with the permission of the Dialog Corporation by Gale Group.
Over 550 Psychiatrists Attend Cyberonics' 49-City VNS Therapy (TM) for Treatment-Resistant Depression (TRD) Satellite Broadcast Event.
PR Newswire; 9/28/2005
HOUSTON, Sept. 28 /PRNewswire-FirstCall/ -- Cyberonics, Inc. today announced that more than 550 psychiatrists attended last evening's 49-city VNS Therapy for TRD Satellite Broadcast Event chaired by A. John Rush, M.D., Professor and Vice Chairman for Research, Department of Psychiatry, Betty Jo Hay Chair in Mental Health, Rosewood Corporation Chair in Biomedical Science, University of Texas Southwestern Medical Center, Dallas, TX. The TRD satellite broadcast event included presentations on TRD, VNS long-term clinical data, VNS mechanism of action, Cyberonics' post-approval TRD study plans, VNS labeling and patient selection, VNS coverage, coding and reimbursement and Cyberonics' VNS support services by:
A replay of the satellite broadcast event will be available on the Cyberonics website http://www.cyberonics.com/, on the VNS Therapy website http://www.vnstherapy.com/ and at http://www.vnstherapyvideo.com/ beginning Monday, October 3, 2005 at 9:00 AM EDT.
"Cyberonics continues to make excellent progress in creating awareness, acceptance and demand for VNS Therapy as the only FDA-approved treatment for TRD among those psychiatrists who treat patients with TRD," commented Robert P. Cummins, Cyberonics' Chairman of the Board and Chief Executive Officer. "In less than eight weeks following the TRD launch on August 1, 2005, more than 1,200 psychiatrists have been educated and trained at either the Satellite Broadcast Event or the eleven regional symposia sponsored by Cyberonics. We plan to educate and train more than 5,000 psychiatrists in the first twelve months after launch and in less than eight weeks we are ahead of that plan with 20% of the goal achieved."
ABOUT VNS THERAPY AND CYBERONICS
Cyberonics, Inc. was founded in 1987 to design, develop and market medical devices for the long-term treatment of epilepsy, depression and other chronic treatment-resistant disorders using a unique therapy, vagus nerve stimulation (VNS). Stimulation is delivered by the VNS Therapy System(TM), an implantable generator similar to a cardiac pacemaker. The VNS Therapy System delivers preprogrammed intermittent mild electrical pulses to the vagus nerve in the patient's neck 24 hours a day. The Company's initial market was epilepsy, a disorder characterized by recurrent seizures. Epilepsy is the second most prevalent neurological disorder. The Cyberonics VNS Therapy System was approved by the FDA on July 16, 1997 for use as an adjunctive therapy in reducing the frequency of seizures in adults and adolescents over 12 years of age with partial onset seizures that are refractory to antiepileptic medications. The VNS Therapy System is also approved for sale as a treatment for epilepsy in all the European Economic Area, Canada, Australia and other markets. To date, more than 32,000 epilepsy patients in 24 countries have accumulated over 100,000 patient years of experience using VNS Therapy.
The VNS Therapy System was approved by the FDA on July 15, 2005 "as an adjunctive long-term treatment for chronic or recurrent depression for patients 18 years of age and older who are experiencing a major depressive episode and have not had an adequate response to four or more adequate antidepressant treatments." As part of FDA's approval order, Cyberonics is required to conduct a 450-patient post-market dosing study and a 1,000- patient, five-year patient outcome registry. For more information on VNS Therapy for treatment-resistant depression, including the contraindications, warnings and precautions, see the Physician's and Patient's Manuals and other information at http://www.cyberonics.com/ or http://www.vnstherapy.com/ or call 1-877-NOW 4 VNS.
The VNS Therapy System has been approved for sale in the European Economic Area and in Canada as a treatment for depression in patients with treatment- resistant or treatment-intolerant major depressive episodes, including unipolar depression and bipolar disorder (manic depression) since 2001.
VNS Therapy is at various levels of investigational clinical study as a potential treatment for anxiety disorders, Alzheimer's disease, chronic headache/migraine and bulimia. The Company is headquartered in Houston, Texas and has an office in Brussels, Belgium. For additional information please visit us at http://www.cyberonics.com/ .
SAFE HARBOR STATEMENT
This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended and Section 21E of the Securities Exchange Act of 1934, as amended. These statements can be identified by the use of forward-looking terminology, including "may," "believe," "will," "expect," "anticipate," "estimate," "plan," "intend," and "forecast," or other similar words. Statements contained in this press release are based upon information presently available to us and assumptions that we believe to be reasonable. We are not assuming any duty to update this information should those facts change or should we no longer believe the assumptions to be reasonable. Investors are cautioned that all such statements involve risks and uncertainties, including without limitation, whether or not Cyberonics will actually educate over 5,000 psychiatrists in the first twelve months after launch. Our actual results may differ materially. Important factors that may cause actual results to differ include, but are not limited to: continued market acceptance of VNS Therapy and sales of our product; the development and satisfactory completion of clinical trials and/or market test and/or regulatory approval of VNS Therapy for the treatment of Alzheimer's disease, anxiety, or other indications; adverse changes in coverage or reimbursement amounts by third-parties; intellectual property protection and potential infringement claims; maintaining compliance with government regulations and obtaining necessary government approvals for new applications; product liability claims and potential litigation; reliance on single suppliers and manufacturers for certain components; the accuracy of management's estimates of future expenses and sales; and other risks detailed from time to time in the Company's filings with the SEC. For a detailed discussion of these and other cautionary statements, please refer to Cyberonics most recent filings with the Securities and Exchange Commission, including its Form 10-K for the fiscal year ended April 29, 2005.
CONTACT: Pamela B. Westbrook, Vice President of Finance and CFO of Cyberonics, Inc., +1-281-228-7200, or fax, +1-281-218-9332, or email@example.com ; or Helen Shik, Vice President of Schwartz Communications, +1-781-684-0770, or fax, +1-781-684-6500, or firstname.lastname@example.org , for Cyberonics, Inc.
Web site: http://www.cyberonics.com/ http://www.vnstherapy.com/ http://www.vnstherapyvideo.com/
COPYRIGHT 2005 PR Newswire Association LLC
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The Warning Signs Of An Impending Bipolar Disorder Manic Episode
Bipolar disorder - as the name implies - involves two distinct set of symptoms. One set throws the individual down into the depths of a massive depression. The other places the individual who suffers with bipolar disorder at the top of a peak manic episode.
Most everyone can eventually recognize the warning signs of an impending depressive episode related to bipolar disorder. More likely than not, individuals with bipolar disorder try very hard to avoid it.
However, for many individuals with bipolar disorder, it's more difficult to recognize the signs of an impending manic episode. After all, a manic episode of bipolar disorder can be mistaken in some cases - especially in the very early formation -- for the lifting of the corresponding mood swing of the depression.
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