Monday, May 25, 2009


Sometimes I read information about mental illness and it seems like the field is still in it's infancy. This stigma that has prevailed forever may have kept a lid on a lot of research and just real facts. We shall see.

Psychiatrists rewriting the mental health bible
The Diagnostic and Statistical Manual of Mental Disorders, commonly called DSM, is getting an update. Now experts must decide what is a disorder and what falls in the range of normal human behavior.
By Shari Roan
6:12 PM PDT, May 25, 2009
Reporting from San Francisco -- Is the compulsion to hoard things a mental disorder? How about the practice of eating excessively at night?

And what of Internet addiction: Should it be diagnosed and treated?

As the clock ticks toward the release of the most influential of mental health textbooks, psychiatrists are asking themselves thousands of complex and sometimes questions.

The answers will determine how Americans' mental health is assessed, diagnosed and treated.

Over the next 18 months, psychiatrists will hammer out a draft of the fifth edition of the American Psychiatric Assn.'s Diagnostic and Statistical Manual of Mental Disorders, more commonly called DSM-V. Nowhere have the discussions been more heated, the ramifications most vividly foretold, than here at the organization's annual meeting.

Some psychiatrists warn that the tome runs the risk of medicalizing the normal range of human behaviors; others vehemently argue that it must be broad enough to guide treatment of those who need it.

But all agree that the so-called bible of psychiatry is expected to be considerably more nuanced and science-based than the last edition, DSM-IV, published in 1994.

Brain imaging and other technologies, plus new knowledge on biological and genetic causes of many disorders, have almost guaranteed significant alterations in how many mental afflictions are described.

"There are no constraints on the degree of change," said Dr. David J. Kupfer, chairman of the DSM-V task force and a psychiatrist at the University of Pittsburgh's Western Psychiatric Institute and Clinic.

The book will describe disorders in more detail, acknowledge variations that haven't been viewed as part of "classic" illness and explain how conditions differ based on age, race, gender, culture and physical health, Kupfer said.

Planning on the text began almost a decade ago, and leaders delivered a progress report to their colleagues last week. They emphasized that the book, slated for publication in 2012, should better reflect the lives and complexities of real people, not simply the most severe cases or most cut-and-dried diagnoses.

Critics of the current edition -- and there are many -- say that it allows for diagnosis only after a dramatic threshold has been reached.

"We are really hoping we'll be able to improve things," Kupfer said. "And that will help us do a better job of taking care of our patients."

Used around the world and available in 13 languages, the book has evolved from its humble origins in 1952 as a dry collection of statistics on psychiatric hospitalization. It is now used by not just psychiatrists, but internists, family practitioners, psychologists, social workers, courts and education professionals to guide the diagnosis and therapy for a host of mental and behavioral conditions. More than one million copies of DSM-IV have been sold.

Having a DSM diagnosis can mean an autistic child will get services from the public school system or that an adult is covered by workplace anti-discrimination laws.

For health insurance companies, it has become a basis for decisions on paying for care.

Some have questioned whether those writing the new book may be influenced by the pharmaceutical industry. Over the past two decades more medications have become available to treat mental disorders, and some doctors worry that the text may be written in a way that expands the market for drug therapies.

Wednesday, May 13, 2009

What's this? Bipolar and/or Autism? Interesting.

One of my SPED students is diagnosed as being high functioning autistic and bipolar. What a great discovery if they are related and sometimes are often twin diagnosis.

Optimism For Bipolar Disorder And Schizophrenia If Psychiatrists Abandon 19th Century Dogma, Uk

Nineteenth century thinking about schizophrenia and bipolar disorder must be abandoned if psychiatry is to progress, said a leading UK psychiatrist. At a meeting of the Biochemical Society, Professor Nick Craddock from Cardiff University urged his profession to embrace the opportunities offered by new research methodologies.

Advanced technology and the large sample sizes in research have led to unprecedented advances in the identification of specific genetic risk factors for psychiatric disorders as recently as the last two years. "For more than 100 years there has been a widespread assumption that bipolar disorder (manic depression) and schizophrenia are completely separate diseases. Recent evidence, particularly from molecular genetics, shows the situation is not so simple. Some of the susceptibility genes are shared," he said.

Strong genetic associations have been reported in bipolar disorder and schizophrenia. Emerging data provide a powerful resource for exploring the relationship between psychiatric characteristics. "This new knowledge will help to explain why some people receive a diagnosis of schizophrenia at one time and bipolar disorder at another time and why some receive a mixed diagnosis - so called 'schizoaffective' disorder," he said.

It is already clear that, in general, genetic associations are not specific to one of the traditional diagnostic categories. For example, one gene variation (ZNF804A) is associated with risk of both bipolar disorder and schizophrenia, and some rare 'copy number' variations are associated with the risk of autism and epilepsy as well as schizophrenia. "There is an urgent need to think beyond diagnostic "boxes" and consider how variations in brain biology and function lead to the huge range of clinical variations seen in people with psychiatric diseases," said Professor Craddock.

Whilst many family and twin studies have demonstrated the importance of genetic factors influencing susceptibility to bipolar disorder, only recently have research technologies started to identify these risk factors. It is, according to Professor Craddock, a successful start to a long journey.

"We know that there are many genes involved in bipolar disorder. Two such genes have been strongly implicated in recent studies of over 10,000 individuals," he said. The action of both genes is thought to be through effects on the basic control of the excitability of nerve cells. Although not of immediate clinical use, this new understanding will open up new avenues for research and should ultimately lead to improved treatments.

Professor Craddock concluded, "This is a time of rapid progress in bipolar disorder research. Those with illness can be optimistic for the next generation."

Monday, May 11, 2009

"Was At One Time taking Lithium"

These are key words, at one time was taking. Just because you feel " normal" does not mean you can stop taking your meds, the meds are the "reason" why you are feeling so well. Please take your prescribed meds so these things don't happen to innocent people.

Uncle says mental illness at root of Manchester pacemaker attack
By Matthew Wilde
Waterloo Courier

(Waterloo Courier)
This is the rural Manchester home of Charles Fierstine, a cabin that is similar to a barn in appearance. It is where authorities say Fierstine's son, Jesse, 32, attacked his father on April 25 and cut a pacemaker out of his father's chest. Jesse Fierstine then fled across the bridge in front of his father's home and hid in the garage at his nearby home until he was arrested.

Mental illness may explain why a rural Manchester man cut the pacemaker out of his father's chest, a family relative says.

Jesse Lewis Fierstine, 32, is charged with attacking his father, Charles Fierstine, on April 25 and cutting his father's pacemaker out of his chest. Delaware County authorities have said it is one of the more unusual and gruesome crimes they've ever handled.

Jesse Fierstine is charged with attempted murder and is being held on $750,000 cash bond in the Delaware County Jail.

Jim Fierstine, Jesse's uncle, and law enforcement officers say Jesse Fierstine suffers from bipolar disorder but was not on medication at the time of the attack. Officials said he struggles with reality.

"He (Jesse) asked me to take him for a walk (outside) today," Deb Lynch, Delaware County Jail administrator, said recently. "He doesn't comprehend anything."

Jim Fierstine of rural Garber, while waiting to visit his nephew in jail, said he and other family members are convinced Jesse's mental state caused the attack. Sheriff's deputies said Jesse told them he'd drunk a bottle of wine before the attack.

Jesse and his father are close, Jim Fierstine said. Charles Fierstine, a 63-year-old retired dairy farmer, had heart problems, and those health problems bothered Jesse, he said.

By going after his father's pacemaker, Jim Fierstine believes, his nephew thought he was in some way helping his dad.

"I think that was on his mind, but who knows what was going on in there," he said. "If he intended to (just) murder him, one good blow to the heart would have done that."

(Waterloo Courier)
This is the mobile home where Jesse Fierstine lived in rural Manchester. He was hiding in the adjacent garage when authorities arrested him April 25 on suspicion of assaulting his father. His uncle said Jesse Fierstine suffers from bipolar disorder and was not taking medication at the time of the attack.

Charles Fierstine is recovering at University of Iowa Hospitals and Clinics in Iowa City, his brother said, and has undergone medical procedures to repair the damage.

"He's coming along fine. We think he will pull through," Jim Fierstine said.

Emotionally, the family is doing "as well as possible," he added. Rather than being angry, "they (the family) want help for Jesse, especially his dad."

That means treating Jesse once again for bipolar disorder. At one time, Jesse Fierstine was seeing mental health professionals and taking lithium, a commonly prescribed medication to manage the problem, law enforcement and family said.

Jim Fierstine said Jesse was at his parents' home three miles southeast of Manchester the night of the attack. Jesse lives nearby in a mobile home. The properties are separated by a creek and connected with a foot bridge.

At about 10:30 p.m., Jim Fierstine said, Donna Fierstine found her husband and son fighting. She ran to the nearby house of another son, Jayson, to call 911. Court documents said Jesse Fierstine struck his father in the head with a flashlight and piece of firewood and then cut out his father's pacemaker with a pocket knife, leaving a gash 6 1/2 inches long and 3/4-inch wide. Deputies found wires protruding from Charles Fierstine's chest.

Jim Fierstine said Jesse has struggled to hold full-time jobs and that his parents support him in return for his help with their acreage. On his application for a public defender, Jesse said he was self-employed making less than $200 per month.

Jim Fierstine said his nephew eagerly helps with chores like mowing and shoveling snow. He also saved an abandoned baby squirrel by having a cat that recently had kittens nurse it, he said.

"That," he said, "is the Jesse I know."

Sgt. Larry Gronwold said the sheriff's department has participated in at least two mental health committals for Jesse in the past.

Jail staffers said they've requested mental help for Jesse through his attorney and have asked he be put back on lithium but that he must be seen by a psychiatrist first. He has been segregated from other inmates for their safety and his own, jail administrator Lynch said.

"I don't think he has the mental capacity to be with other inmates," Lynch said. "He's very polite to me."

Saturday, May 9, 2009

One Size does not Fit All

Sometimes I read ideas that I think are just common sense anyway. We already know that women sometimes are not taken as seriously as men when it comes to mental illness. We have a lot of body things that have to be in balance for us to be healthy women; thyroid, hormones being the largest ones. Then if you have a mental illness in the family, it has been known to travel across generations. We know this, please listen up.

New report underscores women's mental illness concerns

* Story Highlights
* HHS's Office on Women's Health releases new report on women's mental health
* Women suffer from major depression, anxiety disorders at higher rate than men
* Half of all mental illnesses occur before age 14 in both men and women
* Need for early detection and destigmatization of mental illnesses, researcher says

updated 7:08 p.m. EDT, Fri May 8, 2009

* Next Article in Health »

* Read

By Shahreen Abedin
CNN Senior Medical Producer
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(CNN) -- For the first 45 of her 50 years of living, Bonnie Neighbour used to wake up feeling sorry to be alive.
Bonnie Neighbour has struggled with mental health issues for almost all of her 50 years.

Bonnie Neighbour has struggled with mental health issues for almost all of her 50 years.
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"Even when I wasn't actually depressed, I would open my eyes in the morning and wonder if there wasn't something else; I would have preferred an alternative to being alive," she says.

She recalls being depressed as a young child. In her late teens, she started having mood problems that eventually escalated into clinical depression.

"At some point, I was suicidal. I would suffer cycles of depression and mania," Neighbour said. "I wouldn't sleep for days, and the less sleep I would get, the more revved up I'd become, and then I would make irrational decisions and act out. Then I'd alternate with serious depressive episodes.

"At one time, for nine months, I wasn't even able to leave the house [because of depression]." At age 30, she was diagnosed with bipolar disorder.

Neighbour's story isn't uncommon.

"Action Steps for Improving Women's Mental Health," a new report by the U.S. Department of Health and Human Services' Office on Women's Health (OWH), explores the role gender plays in the diagnosis, course and treatment of mental illness. It calls for specific actions to counteract the inadequacies in this field.

According to the report, women are nearly twice as likely as men to suffer from major depression. They are three times as likely to attempt suicide, and they experience anxiety disorders two to three times more often than men. Chart: Gender and mental health »

While these statistics are not new, their importance is generally underplayed, says Wanda Jones, Dr.P.H., health scientist and director of the OWH. She notes that whereas past reports have focused on bringing mental health to the forefront of concern -- such as the 1999 publication "Mental Health: A Report of the Surgeon General" -- few have focused primarily on the specific mental illness issues specific to women, hence the need for such a publication.
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Among the actions recommended by the new report are the needs to underscore the essential importance of women's mental health to overall well-being, improve how primary care doctors and mental health professionals interface with each other, develop a greater understanding in the role of gender in mental illness, recognize the role of trauma and violence against women and its subsequent impact on mental illness and address cultural biases that serve as barriers to treatment for many women.

Reasons for the gender disparities in mental health are still unclear, according to Jones. Part of the difference is based on biology. Female hormones, thyroid disease and brain biochemistry have all been cited as possible reasons. Genetics also play a part, as family history has proven that mental illness repeats itself across multiple generations. Socio-cultural reasons also contribute to the difference.

Jones stresses that the "one-size-fits-all" approach to diagnosing and treating mental illness is not an effective approach and that acknowledging the gender differential is key to adequately and appropriately treating women.

The new report also underscores the relative young age at which mental illness often sets in for both males and females. Half of all mental illnesses occur before age 14, and three-fourths occur by the age of 24, according to the publication. Among the more common mental illnesses seen among young women: eating disorders, which can start in advance of puberty and yet last a lifetime.

Jones emphasizes the dire need for early detection and treatment of mental illnesses in young women. "When these young people grow into adults, they're more likely to end up in the criminal justice system, homeless on the streets, poor performers in school and ultimately bounced into a system that's incapable of helping them with their needs," she explains.

Another point Jones stresses is about the negative stigma around women's mental health issues. "We have to accept that mental illness is not a sign of weakness; it's not a choice. But it is treatable, and our own innate resilience protects us and plays a critical role in combating mental illness, especially depression and anxiety," she says.

Despite the relief Neighbour initially felt after finally being diagnosed with bipolar disorder, she recalls that instead of getting better, she started to get worse. The mood-stabilizing medications she was prescribed were so sedating that she slept 16 hours a day, which led her deeper into her depression. "The doctor said, 'This is how things are, and it will only get worse,' and that's what I started to believe. It became a self-fulfilling prophecy," she says.

There is a common thread to Neighbour's experience and that of other women suffering from mental illness: societal beliefs often pressure women into accepting their mental illness as "just how things are," citing hormones and traditional views of women as the emotional, weaker sex as reasons to simply accept their current situation. According to Jones, it's a barrier that keeps women from seeking treatment for an otherwise largely treatable disease.
Health Library

* Depression
* Mental health
* Adjustment disorders

Despite numerous barriers to access and adequate mental health treatment for women, recent developments in female-specific care provide a new area of hope. Over the last decade, researchers have begun to develop trauma-informed care services, which focus on the high prevalence of trauma -- such as childhood sexual abuse, relationship violence and coerced sex -- that women are more likely to have experienced compared to men. The HHS reports that 40 percent of women report a history of sexual violence, compared to only 10 percent of men. In some mental health treatment programs, recognizing these underlying factors and treating women accordingly has led to dramatically improved outcomes.

In 2005, Neighbour discovered the concept of mental health recovery, which is focused on identifying triggers and symptoms that would cause her behavior to get worse, and responding with actions that she recognized helped her calm herself. She learned that there were other tools beyond medications that could help treat her mania and depression. "I went from focusing everything on 'being' my illness, to focusing on finding fulfillment."

After holding 30 jobs in 15 years, Neighbour now holds a steady full-time job and serves as a volunteer to help others in their own recovery from mental illness. She describes her healing as an ongoing process and critical to it is a network of peers who have had similar life experiences.

"Now I wake up, and I ask how can I go out and change things? I just get excited when I wake up every morning," she says.

Wednesday, May 6, 2009


This is great. I wish I had this and I wish and hope for all family members to take advantage of this.

Classes available to help cope with mental illness
Comet staff report

Do you have a loved one who suffers with serious mental illness?

The National Alliance on Mental Illness (NAMI) provides free help to families with loved ones who are suffering with mental illness.

A Family-to-Family educational class taught by trained NAMI family members who have a mentally ill loved one will possibly begin May 7 in Delphi.

The eleven-week, nationally recognized education and support classes have been taught to thousands of family members. The classes include information about the causes of mental illness, what the various diagnoses mean, upto date information on medications and side effects, where help is available, the signs of relapse and coping with stress and emotional overload.

A University of Maryland study of 95 families demonstrated significant benefits to participating in the Family-to- Family classes. Compared to a control group, six month following their classes, graduates had a greater knowledge of the causes and treatment of mental illness. Family members felt less burdened by a loved one's illness and had an improved understanding of the mental health system. Family members also showed a reduction in depression.

Monday, May 4, 2009


Mental Illness’ Secondary Symptom

May 4, 2009 by admin

Jamie Carter
Class of 2009
Guest Commentary

It is incredible that in today’s society that prides itself on being accepting, diverse, and politically correct, a widespread stigma of a large group of people can still exist. Unfortunately, though, such stigmas do exist, and one of the most prominent and dangerous ones is the stigma of mental illness.

Those who suffer from mental illness are often thought of as being weak, or merely unable to “suck it up and deal with life.” Illnesses such as depression, however, are real illnesses, much like any other sickness. The brain is a part of your body, and much like the rest of your body, it too is susceptible to disease.

In college, such a stigma can be dangerous. Friendships are often the most important part of a student’s life. You live, eat, take classes, and go out with your friends. The risk of losing or alienating these friends, then can seem like the biggest danger in the world, and will often cause a person who needs help to refrain from seeking the help they need if it is thought that they will lose their friends in the process.

Simple comments made during a conversation can lead someone who so desperately needs this help to not seek it. It is a sad fact that many of the same people who would never condone a racial joke, or stereotyping based on religion, sex, or physical disability, would, without a thought, make a joke or a simple remark that demonstrates not only ignorance, but a fear, of people suffering from mental illness. If you heard your friends making fun of or expressing doubts about depression and suicide as real illnesses, would you want them to see you sitting in the lobby of the Counseling Center in O’Boyle? Most likely not.

The fact that this stigma still exists, and is prevalent on college campuses, creates a vicious cycle that discourages those who need help from getting it before their illness spirals out of control, and when it does spiral out of control, it can become an even scarier issue that can continue to perpetuate stereotypes. Continued ignorance and fear about mental illness is dangerous, and if people, many of whom may be your friends, who need help, feel as though they can’t seek it, their illness may lead to additional and associated problems such as alcohol and drug abuse, cutting or other means of self-harm, and in the most drastic of cases, attempted suicide.

So, be there for your friends. You may not know that one of your closest friends is dealing with a mental illness. Think before the next time you make a lighthearted remark about suicide, bipolar, or ‘crazy people’ – it may not be lighthearted to everyone. It could be a matter of life and death.