M O O D S

New Year’s Eve—Your Last Chance to Celebrate a Quarter Century of MDSG!

Face it, watching the ball drop really isn’t that fun. As 2006 comes to a close, what better way is there to celebrate than to support MDSG ? Your money will help fund our invaluable support groups, top-notch lecture series, informative website and this very newsletter. Don’t put it off any longer. Until the end of the year, anything you give will go even further thanks to the board’s special matching gift. For every three dollars you give (up to $25,000 total), the board will give another dollar. Finally, a New Year’s tradition that will leave you feeling better in the morning!! 

Please make check payable to MDSG, Inc. and send to:

MDSG, Inc., 
PO Box 30377, 
New York, NY 10011

Thanks for your support!
From all of us at MDSG

Did you miss a lecture of great interest to you? Recordings of past lectures are available through the mail. Recent lectures are on CD; older one are on cassette tape.

Lecture recordings are $13 each (including postage and handling) or $25 for two, $35 for three. Allow up to two weeks for delivery. To order, write a letter requesting any lecture by number, make check out to MDSG Inc. and send it to: 
     Lecture Recordings c/o MDSG, PO Box 30377, New York, NY 10011

Dr. Ivan Goldberg, Psychopharmacologist

Q:  Do patients with borderline personality disorder who are free of any diagnosable mood disorders respond to mood stabilizers?

A: In a recent study, patients with borderline personality disorder but no diagnosable mood disorder were treated with Lamictal (lamotragine), up to 300 milligrams per day, after they had not responded to antidepressants and other mood stabilizers. These patients had a history of suicidal behavior, hostile depression and/or labile (rapidly shifting) moods, stimulant and alcohol abuse, and multiple unprotected sexual encounters. Over fifty percent of the patients responded. Impulsive sexuality, drug taking and suicidal behaviors disappeared and those who responded no longer met the criteria for borderline personality disorder.

Q: In people with bipolar disorder, does treatment with a mood stabilizer reduce any substance abuse problems they may have?

A: Substance abusing individuals with bipolar disorder who are treated with a mood stabilizer show not only an improvement in mood, but also in the substance abuse. However, specific treatments of substance abuse may be required in addition to mood stabilizers.

Q: Is there any evidence that a deficiency of vitamin B-12 causes depression?

A: Vitamin B-12 deficiency has been linked to depression. In one study, individuals with this deficiency were seventy percent more likely to be diagnosed with major depression than those without it..

Dr. Joe Nieder, Pediatric Psychiatrist

Q. My 16-year-old son takes Ritalin for ADHD. I suspect he is drinking and smoking marijuana with his friends. How might alcohol and marijuana interfere with his treatment?

A. Adolescents treated with Ritalin for ADHD should avoid alcohol and marijuana. Because all three act on the brain, there can be additive or interfering effects. If the teenager does drink at night, hopefully a morning or daytime dose of Ritalin will be out of his system before he consumes alcohol. The situation is somewhat more complicated if the teen is being treated with a time release methylphenidate such as Concerta, which has an effect for 12 hours, but is still in the system after the therapeutic effect wears off. 

There is also an issue in a teen who takes a dose of short acting Ritalin to study in the evening, and then might go out drinking with friends while the Ritalin is still having an effect. This would be like driving a car with the brake on since the two different substances effect the brain in different and opposing ways. I am concerned about the short term effects of alcohol, as well, such as on the possibility of a seizure with severe binge drinking, The situation is more complex in regard to marijuana because there are hundreds of active compounds in marijuana. The major active agent is called THC. Because this substance is used so widely by teens and college students, one would hope that the interaction had been widely studied for harmful effects. I have spoken to a number of pharmaceutical companies about this, but they all say they cannot study an illegal substance. Unfortunately there is little scientific data about the interaction of marijuana with Ritalin or methylphenidate. 

I encourage my teen patients not to experiment with either alcohol or marijuana. Marijuana presents a special concern because of the fact that marijuana stays in the body for up to a month, and the sedation and cognitive effects can counteract the effects of Ritalin on alertness and attention and concentration. 

Has negative thinking got you down? Do your emotions sometimes take over? Are you unable to do anything about these out-of-control moments of fear or anger or hopelessness? Even if you already take medication, the same triggers can hurt every time. Dr. Rian McMullin has created a variety of cognitive therapy called cognitive restructuring therapy which emphasizes basic values and beliefs and has much in common with cognitive behavioral therapy. 

He has been developing the concepts he outlines in this book during thirty years of therapy practice. Having tested out many ways to help, he now writes of the methods that really work. This guide may help chip away at our pain. (Of course this can be a lifelong process.) First we have to identify our basic beliefs, values, attitudes, assumptions and conclusions about life. The most obvious and accessible ones are about ourselves, for instance, “Strong people don’t ask for help,” or “I need to be sure to decide,” or “The world ought to be fair,” or, “If someone criticizes me, I must have done something wrong.” During the early exercises in the book, you begin a list of core beliefs—those judgments and conclusions you have drawn about yourself and the world.

 Later, McMullin directs us to refine our statements and throw some of them away. It may take a while to make the connection between beliefs and extreme upset, because the trouble lies in the brain, where everything can get sliced and diced and twisted into a distortion of what has actually happened. This self-help book contains steps and exercises for gaining some understanding of why we react as we do. Most often we find fault with someone or something outside of ourselves. (“The dog ate my homework.”) 

To obtain any level of learning about oneself, it takes a willingness to look inside to change habits of thinking, and to acknowledge that you might have distorted perceptions of what just happened. Blaming will close off the chance to learn. We cannot control what other people do. This is yet another advisory to take responsibility for oneself. Mullin returns again and again to the importance of articulating one’s values because they are basic to how we interpret our experience. 

Virtually every person, consciously or unconsciously, is troubled by thoughts which are not true. Although Taking Out Your Mental Trash does not dwell on childhood and concerns about one’s mother and father, early life does enter the picture because our ideas about ourselves and everything else were shaped when we were young. 

Those ideas become obsolete as we grow up, and yet we hang on to them. The book’s approach reminds me of a recurring theme in MDSG groups. My group often talks about how members can take a negative view of everything, resulting in feelings of anger and depression. The subject of cognitive behavioral therapy frequently comes up as an excellent approach to combating this negative thinking. McMcMullin’s method should come as a welcome addition to the tools and methods available. This book, and others that help teach versions of cognitive therapy, contribute to helping people to grow and change and let go of destructive thinking. This creative program aims for what I like to call the Goldilocks outcome: Not too high, not too low, but just right.

How many times have you watched television and thought, I could have written something better than that? Well now’s your chance to prove it. Writing new titles for television shows is the object of our latest contest. The twist? Your title should be a spoof of an existing show, but with mood disorders as the theme. Here are some examples of what we mean:

• America’s Most Medicated
• I Dream of Generics
• Twilight Serazone
• 60 Milligrams Under
• The Jim Leher Blues Hour
• Wheel of Misfortune
• Meet the Depressed
• Mad TV
• Medicationpiece Theatre
• Who Wants to me a Millionaire? (My Psychiatrist)
• Psychoanalysis in the City
• Happy Daze
• All in the Family and Friends Group
• Survivor: Payne Whitney
• The Amazing Race to Duane Reade for My Valium Before They Close. . .

First prize: Dinner for two at Mumbles (3rd Avenue at 17th Street in Manhattan).
Second prize: A copy of Joshua Wolf Shenk’s bestselling book, Lincoln’s Melancholy
Third Prize: A tin of Nate’s famous brownies.

Send as many entries as you like to TV Parody Contest, c/o MDSG-NY, PO Bosx 30377, New York, NY 10011 or email your submission to newsletter@mdsg.org. You must include your name and phone number for confirmation. Entries must be received no later than December 31. The decision of the newsletter editors is final and winning entries, along with the winners’ names will be published in the next issue. Good luck!

Letters to the editor and other submissions are welcome and will be printed at the discretion of the newsletter editor. Send submissions by postal mail to our Post Office Box, addressed to "Newsletter Submissions", or email them to newsletter@mdsg.org