The Mood Disorders Support Group of New York City

	M O O D S
Newsletter of the Mood Disorders Support Group of New York City
November 2003	Table of Contents (all articles are on this page) Winter Lecture Line-up: Cold Weather, Hot Topics  Letter from the Chair by Betsy Naylor  Knowledge Is Power When It Comes To Your Mental Health by J. McEwen Ask the Doctors with Ivan Goldberg and Joe Nieder The Reader's Corner  Book Review by Betsy Naylor  Life Inside: A Memoir By Mindy Lewis We Get By with a Little Help from Our Friends . . . About MDSG	When printed, this page will automatically re-format itself. Formatted for Printing

A new season of lectures begins in September with renowned speakers and compelling topics. 

December 1, 2003
Working the Workforce

These three lawyers bring decades of experience in employment law to their presentation. They can answer all of those tricky questions that constantly come up in our support groups. Does the Americans With Disabilities Act really protect the disabled from arbitrary firings? Should you ask for “reasonable accommodations” from your boss as the law allows, or will that type of request be used as a pretext to let you go? What about getting the job in the first place? What should you do about all the holes in your resume? If you’ve been hospitalized and you don’t reveal this, what are the possible legal repercussions if that omission is uncovered later? Is it smart to pay for expensive medications out of pocket instead of using the much cheaper employees insurance so that your boss doesn’t find out? Who gets to see your health insurance records anyway? And then there’s all the mysteries surrounding disability and getting back to work. What are your rights?
Bring all your employment questions to their lecture and put these lawyers to the test. And don’t worry, we promise you won’t get a bill after!

The Distinguished Panel:
Philip Taubman, partner at Taubman & Kimelman-Employment discrimination, disciplinary issues, civil litigation
John Beranbaum, founding member of Beranbaum Menken & Ben-Asher LLP-Labor Law, civil rights, criminal law
Arnold Pedowitz, Vice-President of the National Employment Lawyers Association and Adjunct Professor at Bejamin Cardozo School of Law/ Yeshiva University.

January 5, 2004
What’s Typical About Atypical Depression?

with Donald F. Klein MD
Professor of Psychiatry, Columbia University College of Physicians and Surgeons and Director of Psychiatric Research and the Dept. of Therapeutics at the New York State Psychiatric Institute  

Don’t let the name fool you. Atypical features are quite common. Even if you don’t have an atypical mood disorder, your illness could have some atypical aspects. This could mean a different kind of treatment approach, other medications and even changes in lifestyle. Learn about this often misunderstood aspect of mood disorders from the man who is considered the Dean of American Psychopharmacology. He is back by popular demand and you won’t want to miss this! 

February 2, 2004
Love, Sex, Relationships and Mood Disorders

with Anne Sheffield  Award-winning Author

Do mood disorders affect our ability to love? And what about sex? Does it seem like these illnesses suck the passion out of life? Or do they add passion? Can we have fulfilling relationships? Anne Sheffield is author of How You Can Survive When They’re Depressed , Depression Fallout, and Sorrow’s Web—Overcoming the Legacy of Maternal Depression. She is Formerly Director of Development for the Planned Parenthood Federation of America and the International Planned Parenthood Federation. Her first book won a “Books for a Better Life Award” for Psychology, as well as the “Ken Award” of the National Alliance for the Mentally Ill. She worked as a scientist at the Population and Development Program of the Battelle Memorial Institute and has run her own consulting firm. Further information can be found at www.depressionfallout.com where she also runs a highly active on-line chat room. Ms Sheffield is an old friend of MDSG and her books sell faster than all others at our events. Come hear what everyone should know about having rewarding and successful relationships when mood disorders are involved.

More information about our lectures is available on the lectures page. 

Did you miss a lecture? Tapes of our lectures are available - $13 for one, $25 for two, $35 for three. For more, see our lectures page.

 By Betsy Naylor,  MDSG Chair

Imagine that your mental health is balanced on a three-legged stool. One leg is your psychiatrist, the second leg, your talk therapist, and the third leg is MDSG.  Why does MDSG earn such a position of balance and importance?

A person new to MDSG will find that they get validation for their experiences which before, no one else had understood.  Newcomers and “regulars” help the even newer newcomers.  We may have one of the few places in New York where people say "How are you?" and they actually want to hear your answer.  

The pithy motto of our national organization (Depression and Bipolar Support Alliance) tells us, "We've been there.  We can help."

We track each other, following how things have been going over time.  We share our resources and our innermost selves.  What we give each other cannot be measured in milligrams.  It is a softer, more subtle kind of help. But no less necessary.

Members of my most recent group talked about their loneliness, reasons for it, the sadness of it, the fact that isolation is so often a part of a mood disorder. 

Discussion moved very quickly as everyone had something to contribute on this subject. The isolation dissipated through the process. One person stood up and declared, "Happiness is a group." The MDSG community provides a thread of human connection. 

The Mood Disorders Information Explosion
By J. McEwen

Let's go back in time ten years. You or someone close to you has just been diagnosed with a mood disorder. You want to learn as much as you can, so you hit the library and bookstores looking for reading material. You are disappointed and frustrated to find that books addressing Depression and Manic-depression are few and far between.

Now let's fast forward. It's the year 2003 and you or someone close to you has just been diagnosed with a mood disorder. Times have changed in the publishing world. Books about mood disorders are now plentiful and varied. There are books addressing symptoms, treatment options, medications and side effects. There are personal accounts of living with depression and manic depression. There are even books especially for parents, spouses and families.

And what about other conditions that many people with mood disorders also have to deal with? Do you need to know more about Obsessive-Compulsive Disorder? Anxiety? Social phobias? Attention Deficit Disorder? Books addressing all of these topics (and more) are now readily available. 

Depression and Manic-depression have become topics addressed at an ever-increasing rate in the media. Celebrities have come forward to discuss their struggles with these illnesses. Astounding progress in medical research has made more information and treatment options available. New books are published at a dizzying rate. There has been a profound shift in the public’s perception of mood disorders.

Knowledge is power. It is a cliché, but it is true. The more we as patients know about our illness and ways in which to treat it, the more likely it is that the outcome of that treatment will be positive. The professionals with whom we deal respect a knowledgeable, informed, and proactive patient. The more information you have, the more you will be able to ask intelligent questions and make informed choices about your treatment.

It is an article of faith at MDSG that the more informed of your illness you are, the more successful your treatment and the better your quality of your life. To that end, we maintain a literature table at which you can purchase books to help you learn about and manage your illness. Some of the best books talked about by MDSG members are:

• Undoing Depression: What Therapy Doesn’t Teach You and Medication Can’t Give You by Richard O’Connor
    
• The Bipolar Child by Demitri Papolos, M.D. and Janice Papolos
   
• Bipolar Disorder: A Guide For Patients and Families by Francis Mark Mondemore, M.D.
   
• How You Can Survive when They’re Depressed: Living and Coping with Depression Fallout by Anne Sheffield
   
• An Unquiet Mind by Kay Redfield Jamieson
   
• Touched With Fire Manic Depressive Illness and the Artistic Temperament by Kay Redfield Jamison 
   
• The Bipolar Disorder Survival Guide: What you and your Family Need to Know by David J. Miklowitz, Ph.D.
   
• The Noonday Demon: An Atlas of Depression by Andrew Solomon
   
• Unholy Ghost: Writers on Depression by Nell Casey
   
• Essential Guide to Psychiatric Drugs by Jack M. Gorman, M.D.

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You can purchase and read more about any of these books at Amazon.com. Doing so will result in a referral fee being paid by Amazon to MDSG, at no cost to you.

Ask the Doctors    with Dr. Ivan Goldberg  and  Dr. Joe Nieder

Top Of Page

Dr. Ivan Goldberg, Psychopharmacologist

Q: When I took an abnormal psychology course in college there was a sharp distinction made between reactive and endogenous depressions. Do antidepressants work on both of these types of Major Depression?

A: At one time it was thought important whether or not a depression had a clear-cut environmental trigger. Many years’ experience with antidepressants has shown that so long as a depression meets the criteria for a diagnosis of Major Depression, it is likely to respond to antidepressants, whether or not there was a precipitating event.

Q: Is there any evidence that eating a diet high in fish may offer some protection against becoming depressed?

A: There are two studies that suggest that those who eat much fish may be less likely to become depressed than people who seldom eat fish. In countries where women consume a good deal of seafood, post-partum depression is less common than in countries where less seafood is eaten .

Q: Is the combination of an antianxiety agent and an antidepressant a rational choice for some patients?

A: The combination of an antianxiety agent and an antidepressant is an effective treatment for people with both anxiety and depression. Such combined treatment may produce a quicker antidepressant effect than the prescription of an antidepressant alone. 

Dr. Joe Nieder, Pediatric Psychiatrist

Q: Which antidepressants have been found safe and effective for children below the age of 18? 

A: Zoloft and Prozac, for different indications. Pharmaceutical companies tend not to test new medications in children because of the difficulties involved in testing children. The companies know that once a medication is approved by the FDA, it can be prescribed by a physician for "off-label indications".

Q: What is the current concern about the use of Paxil in children and adolescents, as reported recently in the press? 

A. The concerns deal with several issues, one being that a small percentage of children or adolescents may develop suicidal ideas or impulses after treatment with Paxil. It appears that antidepressants can activate a child with depression, and the result can be agitation, irritability, difficulty sleeping, and even suicidal ideas. This issue is not new, but was reported in Britain recently. Any child or adolescent given an antidepressant can flip into an agitated depression, or hypomania, just as an adult can. The other concern is since it’s not always possible to show efficacy of antidepressants in children or adolescents are they possibly having a negative effect, without a clear positive effect in these children. 

In regard to the lack of testing by pharmaceutical companies of the safety and effectiveness of some of these medications in children below the age of 18, there is a disclaimer that some medications carry. The warning says that the medicine has not been tested for safety and efficacy below the age of 18. Most importantly, they warn that children taking Paxil should not stop it suddenly, but taper off it with a doctor's close monitoring.  
  

The Reader’s Corner (Book Review)   by Betsy Naylor   Life Inside: A Memoir   By Mindy Lewis    357 pp. New York Atria Books.  $24

Top Of  Page

Mindy Lewis sent me her riveting story, Life Inside, and I could not put it down.  Now middle aged, she remembers being l5 in l967 when she was hospitalized at Psychiatric Institute for 28 months.  She has been deeply effected by that early experience.  Life Inside tells the story of life in the hospital and how she has always carried that experience with her. 

Unmanageable adolescents were handled very differently 35 years ago.  At 15, despite considerable artistic talent, Mindy dropped out of the High School of Music and Art.  She hung out at the park , sometimes drawing, sometimes doing drugs. Her parents divorced and remarried. Mindy was in constant conflict with her mother and stepfather.

Mindy must have given up on her life and future.  Her parents chose a radical remedy. They went to court to have Mindy remanded to New York State, a court process allowing the judge to commit their daughter to Psychiatric Institute until she was 18!

Was she mentally ill or a teenager acting out with intolerable behavior?  No matter. Now on the adolescent young adult ward, she was labeled schizophrenic and put on thorazine, as was almost everyone else. In this time of Sex, Drugs, and Rock & Roll, little plastic medication cups contained both thorazine and birth control pills.  Patients sometimes ran away. They took part in prohibited activity constantly and it was fun.

Maybe rebellious teenage behavior was confused with mental illness.  The patients had to wear pajamas until they were deemed "well enough" to return to street clothes, a revolving door for most.  Empathy and understanding were in short supply and punishment was abundant.

Amidst this negativity, ward residents became close friends and helped each other survive their long commitment.  Each person who died by suicide then and in future years, brought special sorrow to those still in the struggle.  The hospital had taken everything away and yet Mindy continued to express her considerable talent in drawing, painting and sketching.

Theoretically, these young patients had the best chance of getting better, if they were separated for a long time from the toxic environment they 
had come from. 

Today, hospitalizations are short, partly due to insurance, an array of medications, and a change in theory about what helps.  Parents are often involved in helping their children get well.

After her discharge, Mindy faced a world in which she felt stigmatized and labeled and was pounded by self-hating thoughts.  Despite these lurking thoughts, she carried on to be self supporting, educated, and pursued her artistic career. 

Life Inside takes us back to a troublesome time in psychiatric care.  It raises the questions of what is mental illness and what care is truly helpful.  We can certainly identify with the author's feelings and then see how she works around and through them. 

Somehow, somewhere (not mentioned in her text) Mindy Lewis learned to write beautifully. Life Inside is a captivating story and a hopeful one.

You can purchase (and read more about) Life Inside: A Memoir from Amazon.com. It is available in paperback and hardcover. Doing so will result in a referral fee being paid by Amazon to MDSG, at no cost to you. The paperback edition sells for $11.20, the hardcover for $16.80 as of November 2003 (the price can change at any time).  
  

MDSG provides award-winning services to New York’s entire mental health community---over 800 individual support groups a year, the distinguished lecture series, our telephone information service, this newsletter. And all at the lowest possible cost, through volunteers.  The $4 contribution for meetings doesn’t cover all our expenses. We need your help to pay the phone bill, print the newsletter, promote MDSG in the media, and meet other needs.

Annual membership is $35 for individuals, $50 for families. Your membership card is a free ticket to support groups and most lectures. Contributions are tax deductible. So be a friend of MDSG--support us as we support you! Memberships and contributions to MDSG are tax-deductible to the extent allowed by law. MDSG is an IRS-recognized 501(c)(3) organization.

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