Mental Health: The Big Elephant in the Room

Over the past 50 years, mental health has been an area of medicine often stigmatized and surrounded with controversy. Mental health disorders are a leading cause for disability worldwide.

Many associate the term mental health with mental hospitals, involuntary medical treatment, and drugs. It is no surprise that such a term has a negative connotation, given some of the infamous “innovations” that have been recorded in its history, such as lobotomies, electro-convulsive therapy, and others. However, it is safe to say that the days of “institutionalization” and definition of mental health issues as pure biological anomalies are, for the most part, behind us now.

Two important distinctions must be made with respect to mental health: First, there are two primary types of cases — those that are severe and persistently ill, and those that are of common mental health “disorders” (e.g., depression, anxiety). Second is that there are professionals whose philosophy is disease-focused vs. personal development-focused — in other words, treating symptoms vs. treating the person as a whole.

One of the more modern interpretations of mental health issues is that they are no different than other medical conditions like HIV or cancer, which are prevalent yet not fully understood. Some of these disorders, simply put, are situations that we do not understand but need to explore and cope with.

Recent statistics from the Centers for Disease Control reveal some interesting facts about mental health:

    • Every year, approximately 67.4 million people have ambulatory care visits (to physician offices, hospital outpatient and emergency departments) with mental disorders as primary diagnosis.
  • “Less than one-third of Americans taking one antidepressant medication and less than one-half of those taking multiple antidepressants have seen a mental health professional in the past year.”

Given these numbers, we should ask ourselves: Why is the use of antidepressant medication skyrocketing? Why are mental health expenditures on the rise? What could be the impact of health care policy changes? Is the legalization of controlled substances going to help?

Read Full Article by Eduardo Garcia, Huffington Post

More Evidence Cannabis Use Linked to Schizophrenia

Cannabis use causes a temporary cognitive breakdown in nonpsychotic individuals, leading to long-term psychosis, new research shows.

In an imaging study, investigators at the University of Bergin, in Norway, report that they found a different brain activity pattern in schizophrenia patients who had a history of cannabis use compared with schizophrenia patients who had never used cannabis.

“While brain activity for both groups was similar, there are subtle differences between schizophrenia sufferers with a history of cannabis use and those who have never used cannabis. These differences lead us to believe that the cognitive weakness leading to schizophrenia is imitated by the effects of cannabis in otherwise non psychotic people,” lead author Else-Marie Loberg, PhD, University of Bergen, said in a statement.

by Pam Harrison

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Charlie Beljan — The Ultimate Example of Mental Toughness

Friday night, PGA Tour rookie Charlie Beljan was wondering if he’d live another day. On Sunday afternoon, he was standing in the winner’s circle of the Children’s Miracle Network Hospitals Classic just outside Orlando, Fla.

In Friday’s second round, Beljan, who was previously 139th on the money list, shot a 64 including two eagles and six birdies — all while suffering difficulty breathing, a rapid heartbeat and feeling like he was going to faint. Immediately following his second round, Beljan was rushed to a nearby hospital, with all tests coming back inconclusive and it being called anxiety and panic attacks. What’s more is he wasn’t released from the hospital until early Saturday morning, getting about one hour of sleep before his third round tee time.

Those who suffer panic attacks will tell you it’s one of the most terrifying experiences — the ultimate fight or flight response causing an array of both mental and physical symptoms including: a rapid heartbeat, numbness, sweating or chills, uncontrollable shaking, lightheadedness, confusion, shortness of breath and a barrage of negative and horrifying images that make you feel as if you’re about to die, lose control or need to escape the situation you’re in.

It’s remarkable enough that Charlie Beljan was able to confront his anxiety and step back on the golf course, and it’s truly incredible he went on to win the championship. This is the ultimate example of mental toughness — and there are lessons to be learned for all of us.

Champions Handle Fear like a Snake Charmer

The relationship performers have with fear is a significant distinction between amateurs and professionals. Amateurs are controlled by their fears, while professionals learn to embrace fear. The great ones use the energy and intensity of fear to drive them to great heights. They learn how to become comfortable while performing in an uncomfortable state of mind.

Repeated exposure to their fears systematically desensitizes them, eventually depleting the fear. An interesting phenomenon often occurs after this desensitization process: performers fall in love with the activity they used to fear. Whatever your fears, be it public speaking, flying, spiders or anything else, the freedom you will gain from overcoming these fears will leave you wondering what took you so long to confront the fear in the first place.

Beljan will undoubtedly have to learn to control the fear and work through it better, and if he can, the sky is truly the limit.

by Steve Siebold, Huffington Post

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Olanzapine Effective for Acute Bipolar Depression

Olanzapine monotherapy is effective in the acute treatment of bipolar depression, with a safety profile similar to that already known for the antipsychotic, new research shows.

Mauricio Tohen, MD, DrPH, University of Texas Health Science Center at San Antonio, and colleagues found that a largely East Asian cohort of patients with bipolar I depression randomly assigned to olanzapine therapy had improvements in depression as measured by multiple assessment tools at the end of 6 weeks of treatment.

The most commonly reported adverse events in the active therapy arm were somnolence, increased appetite and weight, and sedation.

Unfavorable changes in fasting cholesterol, triglycerides, and glucose levels were observed as well.

“It is important to consider that bipolar disorder is a particularly difficult to treat condition and that there are very few regulatory approved treatments for bipolar depression,” investigators write.

“Therefore, even a modest effect size may be of clinical relevance to patients, although treatment-emergent adverse events need to be taken into consideration as well.”

by Pam Harrison

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Holidays Bring Family Fights. Forgiveness: Letting Go of Grudges and Bitterness

When someone you care about hurts you, you can hold on to anger, resentment and thoughts of revenge — or embrace forgiveness and move forward.

By Mayo Clinic staff

Nearly everyone has been hurt by the actions or words of another. Perhaps your mother criticized your parenting skills, your colleague sabotaged a project or your partner had an affair. These wounds can leave you with lasting feelings of anger, bitterness or even vengeance — but if you don’t practice forgiveness, you might be the one who pays most dearly. By embracing forgiveness, you can also embrace peace, hope, gratitude and joy. Consider how forgiveness can lead you down the path of physical, emotional and spiritual well-being.
What is forgiveness?
Generally, forgiveness is a decision to let go of resentment and thoughts of revenge. The act that hurt or offended you might always remain a part of your life, but forgiveness can lessen its grip on you and help you focus on other, positive parts of your life. Forgiveness can even lead to feelings of understanding, empathy and compassion for the one who hurt you.

Forgiveness doesn’t mean that you deny the other person’s responsibility for hurting you, and it doesn’t minimize or justify the wrong. You can forgive the person without excusing the act. Forgiveness brings a kind of peace that helps you go on with life.

What are the benefits of forgiving someone?

Letting go of grudges and bitterness can make way for compassion, kindness and peace. Forgiveness can lead to:

  • Healthier relationships
  • Greater spiritual and psychological well-being
  • Less anxiety, stress and hostility
  • Lower blood pressure
  • Fewer symptoms of depression
  • Lower risk of alcohol and substance abuse

Why is it so easy to hold a grudge?

When you’re hurt by someone you love and trust, you might become angry, sad or confused. If you dwell on hurtful events or situations, grudges filled with resentment, vengeance and hostility can take root. If you allow negative feelings to crowd out positive feelings, you might find yourself swallowed up by your own bitterness or sense of injustice.

What are the effects of holding a grudge?

If you’re unforgiving, you might pay the price repeatedly by bringing anger and bitterness into every relationship and new experience. Your life might become so wrapped up in the wrong that you can’t enjoy the present. You might become depressed or anxious. You might feel that your life lacks meaning or purpose, or that you’re at odds with your spiritual beliefs. You might lose valuable and enriching connectedness with others.

How do I reach a state of forgiveness?

Forgiveness is a commitment to a process of change. To begin, you might:

  • Consider the value of forgiveness and its importance in your life at a given time
  • Reflect on the facts of the situation, how you’ve reacted, and how this combination has affected your life, health and well-being
  • When you’re ready, actively choose to forgive the person who’s offended you
  • Move away from your role as victim and release the control and power the offending person and situation have had in your life

As you let go of grudges, you’ll no longer define your life by how you’ve been hurt. You might even find compassion and understanding.

What happens if I can’t forgive someone?

Forgiveness can be challenging, especially if the person who’s hurt you doesn’t admit wrong or doesn’t speak of his or her sorrow. If you find yourself stuck, consider the situation from the other person’s point of view. Ask yourself why he or she would behave in such a way. Perhaps you would have reacted similarly if you faced the same situation. In addition, consider broadening your view of the world. Expect occasional imperfections from the people in your life. You might want to reflect on times you’ve hurt others and on those who’ve forgiven you. It can also be helpful to write in a journal, pray or use guided meditation — or talk with a person you’ve found to be wise and compassionate, such as a spiritual leader, a mental health provider, or an impartial loved one or friend.

Does forgiveness guarantee reconciliation?

If the hurtful event involved someone whose relationship you otherwise value, forgiveness can lead to reconciliation. This isn’t always the case, however. Reconciliation might be impossible if the offender has died or is unwilling to communicate with you. In other cases, reconciliation might not be appropriate. Still, forgiveness is possible — even if reconciliation isn’t.

What if I have to interact with the person who hurt me but I don’t want to?

If you haven’t reached a state of forgiveness, being near the person who hurt you might be tense and stressful. To handle these situations, remember that you can choose to attend or avoid specific functions and gatherings. Respect yourself and do what seems best. If you choose to attend, don’t be surprised by a certain amount of awkwardness and perhaps even more intense feelings. Do your best to keep an open heart and mind. You might find that the experience helps you to move forward with forgiveness.

What if the person I’m forgiving doesn’t change?

Getting another person to change his or her actions, behavior or words isn’t the point of forgiveness. Think of forgiveness more about how it can change your life — by bringing you peace, happiness, and emotional and spiritual healing. Forgiveness can take away the power the other person continues to wield in your life.

What if I’m the one who needs forgiveness?

The first step is to honestly assess and acknowledge the wrongs you’ve done and how those wrongs have affected others. At the same time, avoid judging yourself too harshly. You’re human, and you’ll make mistakes. If you’re truly sorry for something you’ve said or done, consider admitting it to those you’ve harmed. Speak of your sincere sorrow or regret, and specifically ask for forgiveness — without making excuses. Remember, however, you can’t force someone to forgive you. Others need to move to forgiveness in their own time. Whatever the outcome, commit to treating others with compassion, empathy and respect.

Stress, Depression and The Holidays: Tips for Coping

Mayo Clinic: Stress and Depression can ruin your holidays and hurt your health. Being realistic, planning ahead and seeking support can help ward off stress and depression.

The holiday season often brings unwelcome guests — stress and depression. And it’s no wonder. The holidays present a dizzying array of demands — parties, shopping, baking, cleaning and entertaining, to name just a few.

But with some practical tips, you can minimize the stress that accompanies the holidays. You may even end up enjoying the holidays more than you thought you would.

When stress is at its peak, it’s hard to stop and regroup. Try to prevent stress and depression in the first place, especially if the holidays have taken an emotional toll on you in the past.

  1. Acknowledge your feelings. If someone close to you has recently died or you can’t be with loved ones, realize that it’s normal to feel sadness and grief. It’s OK to take time to cry or express your feelings. You can’t force yourself to be happy just because it’s the holiday season.
  2. Reach out. If you feel lonely or isolated, seek out community, religious or other social events. They can offer support and companionship. Volunteering your time to help others also is a good way to lift your spirits and broaden your friendships.
  3. Be realistic. The holidays don’t have to be perfect or just like last year. As families change and grow, traditions and rituals often change as well. Choose a few to hold on to, and be open to creating new ones. For example, if your adult children can’t come to your house, find new ways to celebrate together, such as sharing pictures, emails or videos.
  4. Set aside differences. Try to accept family members and friends as they are, even if they don’t live up to all of your expectations. Set aside grievances until a more appropriate time for discussion. And be understanding if others get upset or distressed when something goes awry. Chances are they’re feeling the effects of holiday stress and depression, too.
  5. Stick to a budget. Before you go gift and food shopping, decide how much money you can afford to spend. Then stick to your budget. Don’t try to buy happiness with an avalanche of gifts. Try these alternatives: Donate to a charity in someone’s name, give homemade gifts or start a family gift exchange.
  6. Plan ahead. Set aside specific days for shopping, baking, visiting friends and other activities. Plan your menus and then make your shopping list. That’ll help prevent last-minute scrambling to buy forgotten ingredients. And make sure to line up help for party prep and cleanup.
  7. Learn to say no. Saying yes when you should say no can leave you feeling resentful and overwhelmed. Friends and colleagues will understand if you can’t participate in every project or activity. If it’s not possible to say no when your boss asks you to work overtime, try to remove something else from your agenda to make up for the lost time.
  8. Don’t abandon healthy habits. Don’t let the holidays become a free-for-all. Overindulgence only adds to your stress and guilt. Have a healthy snack before holiday parties so that you don’t go overboard on sweets, cheese or drinks. Continue to get plenty of sleep and physical activity.
  9. Take a breather. Make some time for yourself. Spending just 15 minutes alone, without distractions, may refresh you enough to handle everything you need to do. Take a walk at night and stargaze. Listen to soothing music. Find something that reduces stress by clearing your mind, slowing your breathing and restoring inner calm.
  10. Seek professional help if you need it. Despite your best efforts, you may find yourself feeling persistently sad or anxious, plagued by physical complaints, unable to sleep, irritable and hopeless, and unable to face routine chores. If these feelings last for a while, talk to your doctor or a mental health professional.

Take control of the holidays

Don’t let the holidays become something you dread. Instead, take steps to prevent the stress and depression that can descend during the holidays. Learn to recognize your holiday triggers, such as financial pressures or personal demands, so you can combat them before they lead to a meltdown. With a little planning and some positive thinking, you can find peace and joy during the holidays.

Occasional Cocaine Use Can Do Acute and Chronic Damage

Regular cocaine use by otherwise-healthy people can increase systolic blood pressure, aortic vascular stiffness, and left ventricular mass, a new Australian study shows.

Dr. Rebecca Kozor (Royal North Shore Hospital, Sydney, Australia) and colleagues used cardiac MRI to investigate whether cocaine caused cardiovascular abnormalities in regular “social” cocaine users who are otherwise healthy. Dr. Gemma Figtree (Royal North Shore Hospital) presented results of the group’s 40-patient controlled study at the American Heart Association (AHA) 2012 Sessions.

Cocaine is known to cause MI by increasing thrombotic risk, blood pressure, and sympathetic drive, while often causing vasospasm. “We’ve had a spate of young males with large heart attacks related t cocaine use [at our center],” Figtree told heartwire. “People seem to be very ill-informed about this risk, [so] we were interested to know the background incidence of cardiovascular abnormalities in people who consider themselves social or recreational cocaine users. These guys were using cocaine usually once or twice a week, usually related to work, but considered it to be just a social thing. They were quite shocked to learn that it could cause a potentially fatal heart attack.”

by Reed Miller

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Former U.S. First Lady Rosalynn Carter, Actress Glenn Close and Activist Jessie Close Speak Out About Mental Illness

It takes guts to stand in the middle of New York City’s Grand Central Station wearing a t-shirt that says “bipolar,” especially when you’re being filmed for a national public service announcement directed by Ron Howard. Yet, that’s just what Jessie Close did in 2009, when she helped her famous sister Glenn launch Bring Change 2 Mind, an anti-stigma campaign aimed at removing misconceptions about mental illness.

“It was scary,” Jessie says of the very public “outing” of her disease. “But it was glorious and freeing afterward.”

As guests at the 28th annual Rosalynn Carter Symposium on Mental Health Policy at The Carter Center in Atlanta on Nov.1, both Jessie and Glenn Close, along with former U.S. First Lady Rosalynn Carter, sat down for an exclusive interview about how they’re creating change and advancing social inclusion for the mentally ill.

For Mrs. Carter, who’s worked for justice and proper treatment of people with mental illnesses since her pre-White House days (in the early 1970s when her husband, former President Jimmy Carter, was then Governor of Georgia) and now with The Carter Center, the Close sisters’ story is important because it illustrates the positive impact of family support on outcomes for success.

“[They’re] helping everyone understand how mental illnesses can impact someone’s life and relationships,” Mrs. Carter says of Jessie and Glenn Close. “Mental illness isn’t what we see on sensationalized news stories or in movies. People with mental illnesses are sisters or friends, who have many gifts and can make important contributions to their families and communities with our support.”

Jessie Close, 56, wasn’t fully diagnosed with bipolar disorder and mixed-state tendencies until 2004, after decades of ups and downs, battles with alcoholism and a suicide attempt. “It was all family,” she says of her support system on the road to recovery. Now “doing well” on a medication regimen and with regular check-ins from her sister and friends, she chronicles her days on a heartfelt and revealing blog at the Bring Change 2 Mind website, which along with its Facebook page, has become a safe space for people living with mental illness to share their struggles and paths to wellness.

–Kristi  York Wooten, Huffington Post

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My Son Is Schizophrenic. The ‘Reforms’ that I Worked for Have Worsened His Life

If you were to encounter my son, Tim, a tall, gaunt man in ragged clothes, on a San Francisco street, you might step away from him. His clothes, his dark unshaven face and his wild curly hair stamp him as the stereotype of the chronically mentally ill street person.

People are afraid of what they see when they glance at Tim. Policymakers pass ordinances to keep people who look like him at arm’s length. But when you look just a little more closely, what you find is a young man with a sly smile, quick wit and an inquisitive mind who — when he’s healthy — bears a striking resemblance to the youthful Muhammad Ali.

Tim is homeless. But when he was a toddler, my colleagues in the Connecticut state legislature couldn’t get enough of cuddling him. Yet it’s the policies of my generation of policymakers that put that formerly adorable toddler — now a troubled 6-foot-5 adult — on the street. And unless something changes, the policies of today’s generation of policymakers will keep him there.

From The Washington Post by Paul Gionfriddo, October 15, 2012

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Thalamocortical Dysconnectivity in Schizophrenia

The thalamus and cerebral cortex are connected via topographically organized, reciprocal connections. Previous studies have revealed thalamic abnormalities in schizophrenia; however, it is not known whether thalamocortical networks are differentially affected by the disorder. To explore this possibility, the authors examined functional connectivity in intrinsic low-frequency blood-oxygen-level-dependent (BOLD) signal fluctuations between major divisions of the cortex and thalamus using resting-state functional MRI (fMRI).

by Woodward ND; Karbasforoushan H; Heckers S

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