|
The Mood Disorders Support Group of New York City |
| NEWSLETTERSLECTURESDEPRESSION IN THE NEWSCONTRIBUTELINKSDIRECTIONSCONTACT US |
M O O D S |
||
Newsletter of the Mood Disorders Support Group of New York City | ||
August2001 |
|
When printed, this page will automatically re-format itself.
Formatted for Printing |
by Arun Aguiar
Whether this is your first, fourth, or fifteenth mood disorder episode, you are probably in troubled emotional and psychological waters. Where do you turn for help?
Family and friends can certainly provide a shoulder to lean on. Their listening and feedback is great. A professional counselor who specializes in mood disorders can help you ride out the tumult. Unfortunately, good therapy is scarce and can be expensive. Many psychopharmacologists give their patients only 20 to 60 minutes a month, if that. And your medical insurance may limit the number of talk therapy sessions with a psychologist or social worker.
A self-help support group is another option. It is a forum where people facing similar challenges meet to discuss their feelings, solve problems, and exchange information. The group can be led by a professional, usually a paid facilitator, or it can be guided by a trained, voluntary facilitator who is a member of the group.
The important thing is this: Participating in a self-help support group can help you regain your emotional center.
But finding the right group is another challenge. A word-of-mouth recommendation is always a good starting place. Ask your doctor, minister, or hospital social worker for tips. Then ask yourself these questions to decide if a group is for you:
At MDSG, we've applied these yardsticks to ourselves, and we hope that in MDSG, you'll find a group that’s right for you.
by Rich Satkin, Chairperson of MDSG
MDSG has provided support and education for 20 years. Education is particularly important for people affected by mood disorders. Those emerging from a crisis need effective psychopharmacologic and psychological treatments; they need to learn about possible side effects, understand the importance of compliance, and watch out for stressors that may “trigger” future episodes.
Because mood disorders--while not curable--can be controlled, educating yourself is crucial. MDSG seeks to educate in four ways: the support groups in which information is shared; this newsletter, MOODS, which is produced quarterly; the lecture series; and the MDSG Web site.
The lecture series, which began about 19 years ago, was for many years run by David Chowes, former MDSG chairman. He invited top mental health professionals to lecture on research and science, and this tradition continues. While MDSG has no particular viewpoint, we seek the latest in medical science for the lecture series, because mood disorders respond best to both psychopharmacology and psychotherapy. Today the MDSG Board requires that at least seven of 10 annual lectures be science-based. You’ll read in this issue about fall lectures including a panel on different psychotherapies for mood disorders; women with bipolar disorder and hormones; and a talk on suicide and suicide prevention. Next January, there will be a panel of distinguished writers whose work focuses on depression. I want to thank Alexandra Klein, our lecture series coordinator, and the many volunteers who help with lectures.
Over the past two years, the MDSG web site, created and maintained by Michael Horowitz, has grown from a schedule of our meetings into an extensive web site full of news and links to other mental health sites. Hardly a week goes by without updates such as media accounts of mental health topics, TV shows to look for, and other articles.
I hope our support groups, this newsletter, the lecture series, and our web site serve to broaden our sense of community and lessen stigma. The more we accept that mood disorders are physiological, psychological, and treatable, the more we’ll want to keep on learning about treatments and ways to succeed in spite of them.
by Li Lippman
As the knowledge of mood disorders grows, it is becoming apparent that families of those suffering also are effected greatly by these illnesses. Books have been written about how a family can cope with and help a family member with a mood disorder. Since everyone with a mood disorder is effected by how the family responds, whether positively or negatively, it’s good families are being studied now.
At the Sixth Annual Fall Psychiatric Conference last November, one of the afternoon workshops was entitled, “The Impact of Bipolar Illness on Parents and Siblings.” This workshop was given by Ellen Lukens, MSW, Ph.D., and Helle Thorning, MS, CSW, of the New York State Psychiatric Institute. They have been researching the stress on parents and siblings. It was heart-warming to hear several family members share their experiences with bipolar illness. Dr. Lukens identifies “stages” that family members experience:
Most significant in their research is a separate study of siblings. They’ve discovered many families are frustrated the mental health system does not acknowledge siblings as primary caregivers. In addition, they have found that siblings are often angry about how much parental attention goes to the child with bipolar illness.
This workshop interested me, because MDSG friends and families are participating in a similar study in which I am acting as liaison. Deborah Perlick, Ph.D., Yale Medical School, is assessing the needs of caregivers.
As in Dr. Luken’s study, she has identified frustration with the mental health system for its lack of communication with families, lack of understanding, in general, of bipolar illness by doctors and therapists, and lack of help for families coping with emotional and financial strains. In addition, Dr. Perlick wants to find out what will enhance the quality of life for these families. Similar to the stages noted by Dr. Lukens, Dr. Perlick found that caregivers’ needs increase as they progress through a “timeline” in dealing with the illness.
The more you know about bipolar illness and the health care system, the more needs you have! Very often, exhaustion from working outside and inside the home, from dealing with hospitals, doctors, and chronic sadness can dramatically change the relationship families have with the ill member. Also, caregivers often neglect their own health, because they don’t have time to take care of themselves. Dr. Perlick’s study has helped identify how some of the strains can be reduced so family relationships work better.
Another aspect of studying families involves treatment of bipolar illness through “Family-Focused Therapy.” Dr. David Miklowitz explained this at the Fourth International Conference on Bipolar Disorder in Pittsburgh in June. If the entire family is involved in therapy, treatment for the person suffering from bipolar disorder improves. This is cutting-edge methodology.
Denial, faith, loss, and stigma can affect the care the ill person gets. How these are dealt with can change the course of the illness. Researchers hope heightened awareness of families’ needs will garner more funds for supportive services for caregivers. This can make everyone in the family feel better.
The
Readers Corner (Book Review)by Betsy Naylor
The Noonday Demon: An Atlas of Depression
By Andrew Solomon
571 pages
Scribner $28
Why read another book on depression? Because The Noonday Demon explains depression with creative language and ideas. Familiar notions are expressed in the unique style of its wonderful author, Andrew Solomon. The Noonday Demon could be one’s only reference on depression. It is what it says it is—an atlas of depression.
You may remember Solomon from his 1998 New Yorker article, a vivid account of his first depressive episode. It struck a cord with many of us at MDSG.
As I understand it, The Noonday Demon refers to a primitive concept of melancholia. Solomon tells us the demon normally needs the cover of night, but The Noonday Demon that is depression is out there in the brightest light of day bringing terrible suffering.
Perhaps most compelling in this book is the voice of Solomon himself. Amid many facts about the illness is the continuing thread of his own experience -- sometimes horrific, always memorable. His advice is gentle, his writing beautiful, and his sense of humor evident. For example, he writes, “Living with depression is like trying to keep your balance while you dance with a goat.” And Solomon is a scholar, able to digest a huge amount of information and present it in a clear, coherent way.
Chapters are titled by one-word subjects like evolution, suicide, and breakdowns (his). I particularly recommend the chapter on addictions in which he discusses the meshing of mood disorders with addictions. He suggests that each problem must be dealt with on its own.
Solomon presents a balanced view of medications; he takes note of both benefits and side effects. He writes, “It is humiliating to be reliant on them . . . the constant presence of them is a reminder of my frailty and imperfection.” On the positive side, he writes “drugs allow you to have your pain in more important places, in better places, for richer reasons.”
Here are some of his thoughts on therapy:
“Psychoanalysis is good for explaining things, but it is not an efficient way to change them.
“ . . . Your therapist matters more than your choice of therapeutic systems.
“ . . . Therapy has a protective effect against recurrence.”
In the final chapter titled “Hope,” Solomon offers cautionary advice. “ . . . Whatever time is eaten by depression is gone forever.” He encourages us to use time as fully as we can whether depressed or well. If you make the effort to get better, he writes, you can use time the way you want. This is the difference between wishing your life away and doing what you can when you can.
I learned so much from Solomon’s careful research, his special way of making things clear, through the poignant example of his own story. He writes that depression has allowed him to discover new parts of himself. I observe the qualities he names in many MDSG members: compassion, wisdom, and the absolute joyfulness of being well.
You can purchase (and read more about) The Noonday Demon: An Atlas of Depression from Amazon.com by clicking here. Doing so will result in a referral fee being paid by Amazon to MDSG, at no cost to you. The book is available in hardcover and as of January 2002 Amazon was selling it for $19.60 (the price can change at any time). There are 29 reader comments, readers rated it 4.5 stars (out of 5) and there are also sample pages. The book is also discussed at length in Depression mania! Why has a cultural cottage industry sprung up around the most isolating of illnesses? by Maria Russo in Salon.com (June 27, 2001).
Ask the Doctorwith Dr. Ivan Goldberg |
 |
Q. Does menopause exacerbate anger and irritability associated with bipolar II? I am taking Tamoxifen for breast cancer, and it’s hastened the symptoms of menopause. Unfortunately, I can’t take estrogen to ease menopausal symptoms. I am also taking Zoloft (150 mg), Effexor (75 mg), Depakote (1,250 mg), and trazodone (100 mg). My psychiatrist has prescribed clonazepam (Klonopin) (0.5 mg) to take when I’m very angry,
but it just makes me tired and angry. The anger is so severe that it’s very difficult to control. What do you recommend?
A. The symptoms of bipolar disorder may be exacerbated by menopause. I have had good fortune treating irritability and/or anger with the anticonvulsant Trileptal. For unknown reasons, it often seems to work better than Depakote. In my opinion, clonazepam (Klonopin) can make the problem worse.
Q. I have taken the antidepressant Zoloft for months and have gained 10 pounds. I am already overweight and can’t afford to gain. Can Zoloft cause this? Is there something else that wouldn’t cause weight gain? Would 100 mg of Zoloft make me gain more weight? A friend told me I’m not taking enough, and this is why I’m still depressed and gaining weight.
A. Weight gain is a common side effect of the SSRI antidepressants, including Zoloft. To some extent, weight gain is dose-related, so a larger dose of Zoloft probably would cause more gain. When one of my patients gains unacceptable weight, I usually do one of two things:
Q. I have been diagnosed with bipolar disorder (mixed states) by my psychiatrist. In the past, I’ve been diagnosed with generalized anxiety disorder, identity crisis disorder, and borderline personality disorder/bipolar disorder. Lithium as well as another mood stabilizer didn’t help, so my psychiatrist put me on Seroquel, an antipsychotic. I have taken it for five days—the first and third nights were the roughest; it really messed me up. I am confused as to why I am on an antipsychotic. Will Seroquel will help me?
A. Seroquel and Zyprexa are marketed as antipsychotic drugs, but both of them have mood-regulating actions. When prescribing a medication for someone with a mood disorder and possibly a borderline personality disorder, I generally go with Lamictal (lamotrigine). (To read about the psychiatric uses of Lamictal, please see:
http://www.psycom.net/depression.central.lamotrigine.html). (To read about the use of Lamictal for borderline personality disorder, please see:
http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10333987&dopt=Abstract).
You don’t know me yet. I haven’t attended a support group. Nor have I come to a lecture. I’ve tried a few times, though.
One night I arrived early for the West Side meeting on 57th Street. It was pretty cold outside, and I didn’t want to appear as though I were waiting for something, so I walked into the shoe store next door. I pretended to shop for shoes. I did see a pair that I liked, but then I remembered what I was there for. I was waiting, waiting for a push, a pull, an invitation, a nudge. I’d been wanting to try out a meeting ever since I discovered MDSG online. In fact, I circled the dates on my calendar several times.
That cold night was the first time I actually made it to the front door. But, the doorway looked a little narrow. (I’m a bit claustrophobic as well as depressed.) I had trouble imagining what it would be like inside.
Some weeks or maybe months later--I can’t remember which--I read the MOODS newsletter that arrived in the mail. There was an article written by a woman about my age (30 ). She wrote about her experience leading a group on the East Side, one especially for young people. I made another date in my appointment book to go, this time on a Friday evening, to that group. Again, sidetracked, I went home and curled up in bed.
Several more weeks passed, more dates circled, appointments never kept. Another newsletter arrived. This time, this invitation:
"Personal stories sought."
I can do that, I thought; I can at least show up in print. Until I can get there in person, however, I find comfort in knowing MDSG is out there.
Hope to see you soon.
Submitted by K.P.
MDSG has received generous contributions in memory of Trevor Dagg, 39, director of human resources at MTV Network, New York City, who died in June after suffering many years with bipolar disorder and anxiety. His mother said she and other family members chose MDSG because it offers group support to those who would otherwise suffer alone with affective disorders.
We, at MDSG, thank the family and contributors, and we extend our heartfelt sympathy.
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..
| Postal Mail | Telephone | Fax | Web | |
|---|---|---|---|---|
| The Mood Disorders Support Group P.O. Box 30377 New York, N.Y. 10011 |
(212) 533-MDSG 533-6374 |
info@mdsg.org | (212) 675-0218 | www.mdsg.org |
MDSG/NY sponsors a series of lectures on various aspects of mood disorders. Anyone can attend our lectures. More information is available on our lectures page at www.mdsg.org/lectures.html. Our next lectures are:
What Kind of Therapy is Best For
You? A Panel Discussion
Monday, September 10, 2001 Moderator: Dr. Ngaere Baxter
Panel: Dr. Paul Geltner, Dr. Ingrid Kemperman, Dr.Myrna
Weissman, Dr. Ivan Goldberg
Research has shown that people with mood disorders recover best when treated with medication and psychotherapy together. Neither alone works as well. So, what kinds of therapy are available? From psychoanalytic to psychodynamic to cognitive therapy to interpersonal therapy---how are they similar, different? Which is best for
you? This panel will give you the opportunity to hear from five top practitioners, each of different orientations, yet all of whom treat people with mood disorders.
Bipolar Disorder in Women: Hormonal
Influences and Treatment Issues
Monday, October 1, 2001 David Printz, M.D., Columbia
University
Although equal numbers of men and women suffer from bipolar illness, women
frequently experience a more difficult course. They are much more prone to rapid
cycling (a subtype of bipolar disorder) marked by more frequent episodes, a
poorer response to standard treatments and a worse clinical outcome. The
treatment of bipolar illness is more complicated in women than in men. This
presentation will focus on these important issues in the treatment of women with
bipolar disorder, reviewing the course of illness across the lifecycle as well
as specific issues involved in the use of psychotropic medications.
| NEWSLETTERSLECTURESDEPRESSION IN THE NEWSCONTRIBUTELINKSDIRECTIONSCONTACT UStop |
Subscribe to the MDSG
 feed |
For questions or problems contact webmaster@mdsg.org |